醫(yī)學(xué)英語15專業(yè)外語

1、專 業(yè) 外 語,吉林大學(xué)中日聯(lián)誼醫(yī)院骨科王 剛,主要內(nèi)容,Examination of Specific JointsElbow examinationWrist examinationSciatica examinationHip symptomHip examination,,Part 1 Tennis ElbowP621,肘關(guān)節(jié)檢查最后一段，網(wǎng)球肘查體,,,,,,,,,,,,,Tennis elbow(網(wǎng)球

2、肘), also known as lateral epicondylitis（外上髁炎）, is a common condition characterized by pain in the region of the lateral epicondyle（外上髁） of the humerus（肱骨）. The pain radiates down the extensor（伸?。?surface of the forearm.,

3、,Patients with tennis elbow often experience pain when attempting to open a door or when lifting a glass. To test for tennis elbow, the examiner should flex the elbow and fully pronate（手掌向下，旋前） the hand. Pain over the la

4、teral epicondyle while extending the elbow is diagnostic of tennis elbow.,,Another test involves having the patient clench（緊握） the fist, dorsiflex（背伸） the wrist, and extend the elbow. Pain is elicited（引出） by trying to fo

5、rce the dorsiflexed hand into palmar（掌側(cè)的，掌的） flexion.,Vocabulary,Tennis elbow(網(wǎng)球肘)lateral epicondylitis（外上髁炎）epicondyle（上髁）humerus（肱骨）extensor（伸?。?vocabulary,pronate（手掌向下，旋前）supinate（手掌向上，旋后）clench（緊握）dorsiflex（背伸

6、）elicit（引出）palmar（掌側(cè)的，掌的）,單詞復(fù)習(xí),Tennis elbowlateral epicondylitisepicondylehumerusextensor,單詞復(fù)習(xí),pronatesupinateclenchdorsiflexelicitpalmar,Part 1 詳解,Tennis elbow(網(wǎng)球肘), also known as lateral epicondylitis（外上髁炎）,

7、 is a common condition characterized by pain in the region of the lateral epicondyle（外上髁） of the humerus（肱骨）. The pain radiates down the extensor（伸肌） surface of the forearm.,,Patients with tennis elbow often experience p

8、ain when attempting to open a door or when lifting a glass. To test for tennis elbow, the examiner should flex the elbow and fully pronate（手掌向下，旋前） the hand. Pain over the lateral epicondyle while extending the elbow is

9、diagnostic of tennis elbow.,,Another test involves having the patient clench（緊握） the fist, dorsiflex（背伸） the wrist, and extend the elbow. Pain is elicited（引出） by trying to force the dorsiflexed hand into palmar（掌側(cè)的，掌的） f

10、lexion.,,,,Part 2 Carpal Tunnel SyndromeP622 腕關(guān)節(jié)檢查最后一段，腕管綜合征查體,,,,,,,,,,When the diagnosis of carpal tunnel syndrome(腕管綜合征) is suspected, a sharp tap or pressure directly over the median nerve（正中神經(jīng)） may reproduce(復(fù)制，重

11、現(xiàn)) the paresthesias(感覺異常) of carpal tunnel syndrome, called Tinel’s sign（Tinel 征）.,,Another useful test is for the examiner to stretch the median nerve by extending the patient’s elbow and dorsiflexing (背屈)the wrist. The

12、 development of pain or paresthesias suggests the diagnosis.,,A third test entails(需要，使必要) the patient holding both wrists in a fully palmar-fixed（固定在掌屈） position for 2 minutes. The development or exacerbation（加劇，惡化） of

13、paresthesias（感覺異常） is suggestive of carpal tunnel syndrome.,vocabulary,carpal tunnel syndrome(腕管綜合征)carpal （腕骨的）tunnel （隧道）syndrome (綜合征)median nerve（正中神經(jīng)）reproduce(復(fù)制，重現(xiàn))paresthesia (感覺異常),vocabulary,Tinel’s sign（

14、Tinel 征）dorsiflex (背屈)entails(需要，使必要)palmar-fixed（固定在掌屈）exacerbation（加劇，惡化）paresthesia（感覺異常）,單詞復(fù)習(xí),carpal tunnel syndromecarpal tunnel syndrome median nervereproduceparesthesia,單詞復(fù)習(xí),Tinel’s signdorsiflex enta

15、ilspalmar-fixedexacerbationparesthesia,Part 2 詳解,When the diagnosis of carpal tunnel syndrome(腕管綜合征) is suspected, a sharp tap or pressure directly over the median nerve（正中神經(jīng)） may reproduce the paresthesias(感覺異常) of c

16、arpal tunnel syndrome, called Tinel’s sign（Tinel 征）.,,Another useful test is for the examiner to stretch the median nerve by extending the patient’s elbow and dorsiflexing (背屈)the wrist. The development of pain or parest

17、hesias suggests the diagnosis.,,A third test entails(需要，使必要) the patient holding both wrists in a fully palmar-fixed（固定在掌屈） position for 2 minutes. The development or exacerbation（加劇，惡化） of paresthesias（感覺異常） is suggesti

18、ve of carpal tunnel syndrome.,注意預(yù)防腕管綜合征,,,,,Part 3 SciaticaP624, 最后一段 坐骨神經(jīng)痛查體,,,,,,,,,,,,Pain from entrapment（神經(jīng)卡壓） of the sciatic nerve is called sciatica（坐骨神經(jīng)痛）. Patients with sciatica describe pain, burning, or achi

19、ng in the buttocks radiating（放射） down the posterior （后方）thigh to the posterolateral aspect of the calf（小腿）. Pain is worsened by sneezing, laughing, or straining(用力) at stool（大便）.,,One of the tests for sciatica is the str

20、aight leg raising test(直腿抬高試驗). The patient is asked to lie supine（仰臥位） while the examiner flexes the extended leg to the trunk（軀干） at the hip. The presence of pain is a positive test.,,The patient is asked to plantarfle

21、x (跖屈) and dorsiflex（背屈） the foot. This stretches the sciatic nerve even more. If sciatica is present, this test reproduces(復(fù)制重現(xiàn)) pain in the leg. The test is illustrated in Figure 20-40,vocabulary,entrapment（神經(jīng)卡壓）In cr

22、iminal law, entrapment is a practice whereby a law enforcement agent induces a person to commit a criminal offense that the person would have otherwise been unlikely to commit.,,,,sciatica（坐骨神經(jīng)痛）radiate（放射）po

23、sterior （后方）calf（小腿）,vocabulary,strain(用力)stool（大便）straight leg raising test(直腿抬高試驗)supine（仰臥位）prone (俯臥位)trunk（軀干）,vocabulary,plantarflex(跖屈) plantar 跖側(cè)的dorsiflex（背屈） dorsal 背側(cè)的reproduces(復(fù)制重現(xiàn)),單詞復(fù)習(xí),entrapm

24、entsciaticaradiateposterior calf,單詞復(fù)習(xí),strainstoolstraight leg raising testsupineprone trunk,單詞復(fù)習(xí),plantarflex plantar dorsiflex dorsalreproduces,Part 3 詳解,Pain from entrapment（神經(jīng)卡壓） of the sciatic nerve is ca

25、lled sciatica（坐骨神經(jīng)痛）. Patients with sciatica describe pain, burning, or aching in the buttocks radiating（放射） down the posterior （后方）thigh to the posterolateral aspect of the calf（小腿）. Pain is worsened by sneezing, laughi

26、ng, or straining(用力) at stool（大便）.,,One of the tests for sciatica is the straight leg raising test(直腿抬高試驗). The patient is asked to lie supine（仰臥位） while the examiner flexes the extended leg to the trunk（軀干） at the hip.

27、The presence of pain is a positive test..,,The patient is asked to plantarflex (跖屈) and dorsiflex（背屈） the foot. This stretches the sciatic nerve even more. If sciatica is present, this test reproduces(復(fù)制重現(xiàn)) pain in the l

28、eg. The test is illustrated in Figure 20-40,,,,,,,,Part 4 髖關(guān)節(jié)癥狀Hip SymptomsP625 第二段,,,Limp gait,,,,,,,,Hip Symptoms,The main symptoms of hip disease are pain, stiffness（僵硬）, deformity （畸形）, and a limp(跛行). Hip pai

29、n may be localized to the groin（腹股溝） or may radiate（放射） down the medial aspect of the thigh. Stiffness may be related to periods of immobility（固定的時間段）.,An early symptom of hip disease is difficulty putting on shoes. This

30、 requires external rotation（外旋） of the hip, which is the first motion to be lost with degenerative（退變性的） disease of the hip. This is followed by loss of abduction（外展） and adduction（內(nèi)收）; hip flexion（屈曲） is the last moveme

31、nt lost.,Vocabulary,stiffness（僵硬）deformity（畸形）limp(跛行)groin（腹股溝）radiate（放射）,vocabulary,periods of immobility（固定的時間段）external rotation（外旋）degenerative（退變性的）abduction（外展）adduction（內(nèi)收）flexion（屈曲）,單詞復(fù)習(xí),stiffnessdef

32、ormitylimpgroinradiate,單詞復(fù)習(xí),periods of immobilityexternal rotationdegenerativeabductionadductionflexion,Hip Symptoms Part 4 詳解,The main symptoms of hip disease are pain, stiffness（僵硬）, deformity （畸形）, and a limp(

33、跛行). Hip pain may be localized to the groin（腹股溝） or may radiate（放射） down the medial aspect of the thigh. Stiffness may be related to periods of immobility（固定的時間段）.,,An early symptom of hip disease is difficulty putting o

34、n shoes. This requires external rotation（外旋） of the hip, which is the first motion to be lost with degenerative（退變性的） disease of the hip. This is followed by loss of abduction（外展） and adduction（內(nèi)收）; hip flexion（屈曲） is th

35、e last movement lost.,,,,Part 5Hip Examination,,,,,,,,,,,Hip Examination,The examination of the hip is performed with the patient standing and lying on the back. Inspection（望診） of the hips and gait（步態(tài)） has already

36、been described. The Trendelenburg test indicates（提示，預(yù)示） a disorder（混亂，失調(diào)） between the pelvis（骨盆） and the femur（股骨）. The patient is asked to stand on the “good” leg, as illustrated in Figure 20-42A.,,The examiner should n

37、ote that the pelvis on the opposite side elevates（提高，提升）, demonstrating （展示，演示，說明）that the gluteus medius(臀中肌) is working efficiently（有效地）. When the patient is asked to stand on the “bad” leg, as shown in Figure 20-42B,

38、the pelvis on the opposite side falls. This is termed a positive Trendelenburg test.,,Ask the patient to lie on his or her back. The hip is acutely（強烈地，劇烈地，極度地） flexed on the abdomen（腹部） to flatten the lumbar（腰椎的） spine（

39、脊柱）. Flexion（屈曲） of the opposite thigh suggests a flexion deformity（屈曲畸形） of that hip. Figure 20-43 illustrates the technique.,,Leg length measurements are useful in evaluating hip disorders（混亂，失調(diào)，疾患）. The distance betwe

40、en the anterosuperior iliac spine（髂前上棘） and the tip of the medial（內(nèi)側(cè)的） malleolus(踝) is measured on each side and compared. A difference in leg length may be caused by hip joint disorders.,As indicated, loss of rotation（旋

41、轉(zhuǎn)） of the hip is an early finding in hip disease. To test this movement, ask the patient to lie on his or her back. Flex the hip and knee to 90° and rotate the ankle inward（向內(nèi)） for external rotation（外旋）, as illustra

42、ted in Figure 20-44A, and outward（向外） for internal rotation（內(nèi)旋）, as shown in Figure 20-44B. Restriction（限制） of this motion is a sensitive sign of degenerative（退變的） hip disease.,vocabulary,inspection（望診）gait（步態(tài)）indicate

43、s（提示，預(yù)示）disorder（混亂，失調(diào)）pelvis（骨盆）femur（股骨）,,elevates（提高，提升）demonstrate （展示，演示，說明）gluteus medius(臀中肌)gluteus （臀?。?medius（中間的）efficiently（有效地）,,acutely（強烈地，劇烈地，極度地）abdomen（腹部）lumbar（腰椎的） spine（脊柱）flexion（屈曲）fl

44、exion deformity（屈曲畸形）,,disorders（混亂，失調(diào)，疾患）anterosuperior iliac spine（髂前上棘）anterosuperior(前上的)iliac（髂骨的）spine（棘，脊柱）medial（內(nèi)側(cè)的） malleolus(踝),,rotation（旋轉(zhuǎn)）inward（向內(nèi)）external rotation（外旋）outward（向外）internal rotatio

45、n（內(nèi)旋）restriction（限制）degenerative（退變的）,單詞復(fù)習(xí),inspectiongaitindicatesdisorderpelvisfemur,單詞復(fù)習(xí),elevatesdemonstrategluteus mediusgluteusmediusefficiently,單詞復(fù)習(xí),acutelyabdomenlumbarspineflexionflexion deformity

46、,單詞復(fù)習(xí),disordersanterosuperior iliac spineanterosuperioriliacspinemedial malleolus,單詞復(fù)習(xí),rotationinwardexternal rotationoutwardinternal rotationrestrictiondegenerative,Hip Examination Part 5 詳解,The examination

47、 of the hip is performed with the patient standing and lying on the back. Inspection（望診） of the hips and gait（步態(tài)） has already been described. The Trendelenburg test indicates（提示，預(yù)示） a disorder（混亂，失調(diào)） between the pelvi

48、s（骨盆） and the femur（股骨）. The patient is asked to stand on the “good” leg, as illustrated in Figure 20-42A.,,,,The examiner should note that the pelvis on the opposite side elevates（提高，提升）, demonstrating （展示，演示，說明）that th

49、e gluteus medius(臀中肌) is working efficiently（有效地）. When the patient is asked to stand on the “bad” leg, as shown in Figure 20-42B, the pelvis on the opposite side falls. This is termed a positive Trendelenburg test.,,,,A

50、sk the patient to lie on his or her back. The hip is acutely（強烈地，劇烈地，極度地） flexed on the abdomen（腹部） to flatten the lumbar（腰椎的） spine（脊柱）. Flexion（屈曲） of the opposite thigh suggests a flexion deformity（屈曲畸形） of that hip.

51、Figure 20-43 illustrates the technique.,,,,Leg length measurements are useful in evaluating hip disorders（混亂，失調(diào)，疾患）. The distance between the anterosuperior iliac spine（髂前上棘） and the tip of the medial（內(nèi)側(cè)的） malleolus(踝) i

52、s measured on each side and compared. A difference in leg length may be caused by hip joint disorders.,,As indicated, loss of rotation（旋轉(zhuǎn)） of the hip is an early finding in hip disease. To test this movement, ask the pat

53、ient to lie on his or her back. Flex the hip and knee to 90° and rotate the ankle inward（向內(nèi)） for external rotation（外旋）, as illustrated in Figure 20-44A, and outward（向外） for internal rotation（內(nèi)旋）, as shown in Figure