2017五年制醫(yī)學(xué)英語(yǔ)

MedicalChapterThe吉林大 聯(lián)醫(yī)院心臟外科林柏Basic 1987-1992醫(yī)學(xué)本科（畢業(yè)后留科 1995-1998醫(yī) 2000-2003醫(yī)學(xué)博 2004-2008李玉林 導(dǎo)Basic 2006.1-2007.7國(guó)家公派德國(guó)心臟中 2010.09教授 醫(yī) 2013.05心臟外科 2013.09吉林 咨Truewisdomconsistsnotonlyinseeingwhatisbeforeyoureyes,butinforeseeingwhatistocome.Terence,Aldelphi,(ActIII,Scene泰倫斯，《阿德菲》，（第三幕，第三場(chǎng)BloodPressureThePrinciplesBloodpressurecanbemeasureddirectlyanintra-arterial[,intr?ɑ:'ti?ri?l]catheter['k?θ?t?]orindirectlywithasphygmomanometer[,sf?gmom?'nɑm?t?].sphygmomanometerconsistsofinflatable[?n'flet?bl]rubberbladderwithinaclothcoverarubberbulb橡皮袋toinflatethebladder,andamanometer[m?'nɑm?t?]measurethepressureintheBloodPressure 英[?'sesm?nt]美 英['pr?ns?plz]美['pr?ns?plz] 原則；法則；信念（principle的復(fù)數(shù)）；本源v.向…灌 [,intr?ɑ:'ti?ri?l]n 英['k?θ?t?]美 n.[醫(yī)sphygmomanometer美 n.[內(nèi)科]血壓sphygmous脈搏sphygmo-BloodPressure [?n'fle?t?b(?)l][?n'flet?bl] 英['r?b?]美['r?b?]n.橡膠；橡皮；合 師adj.橡膠制成的vt.涂橡膠于；用橡膠制造vi.扭轉(zhuǎn)脖子看；好奇地引頸而望n.(Rubber)人名； [b?lb][b?lb]n.電燈泡；鱗莖；球狀物vi.生球莖；膨脹成球狀 英[?n'fle?t]美[?n'flet] vt.使充氣；使通貨膨脹vi.膨脹；充氣 [m?'n?m?t?]n壓力計(jì)；[流BloodPressureThePrinciplesBloodpressurecanbemeasureddirectlyanintra-arterial[,intr?ɑ:'ti?ri?l]catheter['k?θ?t?]orindirectlywithasphygmomanometer[,sf?gmom?'nɑm?t?].sphygmomanometerconsistsofinflatable[?n'flet?bl]rubberbladderwithinaclothcoverarubberbulb橡皮袋toinflatethebladder,andamanometer[m?'nɑm?t?]measurethepressureintheBloodPressureIndirectmeasurement['m???m?nt]ofbloodpressureinvolves[?n'vɑlv]theauscultatory[?:'sk?lt?t?ri]detection[d?'t?k??n]oftheappearanceanddisappearanceofKorotkoffsounds柯氏overcompressed[k?m'pr?st]artery.Korotkoffarelow-pitched['l?u'pit?t]originating[?'rid?ineiti?]inthevesselthatarerelatedtoturbulence['t?bj?l?ns]producedbypartially['pɑr??li]occludinganarterywithabloodpressureBloodPressure [?:'sk?lt?t?riadjauscultatorygapdetection英[d?'tek?(?)n]美[d?'t?k??n] n.偵KorotkoffSounds低沈的沖擊聲氏compressed[k?m'prest][k?m'pr?st]j 英['l?u'pit?t] adj.低調(diào)的；低沉的； ['t??bj?l(?)ns] ；[流BloodPressure BloodPressure 學(xué)者柯洛特柯夫(Korotokoff)發(fā)現(xiàn)，用臂帶綁扎1905年， BloodPressureIndirectmeasurement['m???m?nt]ofbloodpressureinvolves[?n'vɑlv]theauscultatory[?:'sk?lt?t?ri]detection[d?'t?k??n]oftheappearanceanddisappearanceofKorotkoffsounds柯氏overcompressed[k?m'pr?st]artery.Korotkoffarelow-pitched['l?u'pit?t]originating[?'rid?ineiti?]inthevesselthatarerelatedtoturbulence['t?bj?l?ns]producedbypartially['pɑr??li]occludinganarterywithabloodpressureBloodPressureSeveralphases['fe?si?z]occursequence['sikw?ns]astheoccludingdrops壓力下降.Phase1occurswhentheoccludingpressurefallstothesystolic[s?s'tɑl?k]bloodpressure.Thetap [t?p??]soundsareclearandgraduallyincreaseinintensityastheoccludingpressurefalls.Phase2occursatapressureabout10to15mmHglowerthanthatinphase1andconsistsoftap followedbymurmurs.BloodPressurephase英[fe?z]美[fez] n.相；階段；[天]位相vt.使定相；逐步執(zhí)行vi.逐步前進(jìn)復(fù)數(shù)['fe?si?z] [?'klu?d][?'klud]vt.使閉塞；封閉；擋住vi.sequence英['si?kw(?)ns]美['sikw?ns] n.[數(shù)][計(jì)]序列；順序；續(xù)發(fā)事件vt.按順序排好insequence依次，逐 英[s?'st?l?k]美 adj.心臟收縮 n冶出鋼；開(kāi)孔；出渣；輕敲聲v.輕 abbr毫米柱（millimetre（s）ofmercury 單位 ['m?kj?ri]n.[化] BloodPressureSeveralphases['fe?si?z]occursequence['sikw?ns]astheoccludingdrops壓力下降.Phase1occurswhentheoccludingpressurefallstothesystolic[s?s'tɑl?k]bloodpressure.Thetap [t?p??]soundsareclearandgraduallyincreaseinintensityastheoccludingpressurefalls.Phase2occursatapressureabout10to15mmHglowerthanthatinphase1andconsistsoftap followedbymurmurs.BloodPressurePhase3occurswhentheoccludingpressurefallsenoughtoallowalargeamountofvolumetocrossthepartiallyoccludedartery.Thesoundsaresimilartothesoundsofphase2,exceptthatonlythetap soundsareheard.Phase4istheabrupt[?'br?pt]muffling['m?fli?]anddecreasedintensityofthesoundsasthepressureapproaches[?'prot?]thediastolic[,da??s'tɑl?k]bloodpressure.Phase5isthecompletedisappearance[,d?s?'p?r?ns]ofthesounds.Thevesselisnolongercompressedbytheoccludingcuff.Turbulent['t?bj?l?nt]flowisnolongerpresent.BloodPressure 英[?'br?pt]美 adj.生硬的；突然的；突的；陡峭 v.消聲（muffle的ing形式 英['m?f(?)l]美['m?fl] vt.蒙?。还?；抑制；發(fā) n.低沉 英[?'pr??t?]美 n.方法；途徑；接vt.接近；著手處理vi靠 英[,da??'st?l?k]美 adj.心臟舒的 英[d?s?'p??r?ns]美 ；不turbulent [流湍流；[流紊turbulent英['t??bj?l(?)nt]美 的的；狂暴的；吵鬧的；激流的，湍流BloodPressurePhase3occurswhentheoccludingpressurefallsenoughtoallowalargeamountofvolumetocrossthepartiallyoccludedartery.Thesoundsaresimilartothesoundsofphase2,exceptthatonlythetap soundsareheard.Phase4istheabrupt[?'br?pt]muffling['m?fli?]anddecreasedintensityofthesoundsasthepressureapproaches[?'prot?]thediastolic[,da??s'tɑl?k]bloodpressure.Phase5isthecompletedisappearance[,d?s?'p?r?ns]ofthesounds.Thevesselisnolongercompressedbytheoccludingcuff.Turbulent['t?bj?l?nt]flowisnolongerpresent.BloodPressureThenormalbloodpressureforadults['?d?lt]isupto140mmHgsystolicandupto85mmHgdiastolic.Forthediastolicbloodpressurereading,thepointofdisappearanceoftheKorotkoffsoundsisprobablymoreaccurate['?kj?r?t]thanthepointofmuffling['m?fli?].However,ifthepointofdisappearanceismorethan10mmHglowerthanthepointofmuffling,thepointofmufflingisprobablymoreaccurate.BloodPressure 英['?d?lt;?'d?lt]美['?d?lt]adj.成年 n.成年人 ['?kj?r?t]['?kj?r?t]adj.精確 v.消聲（muffle的ing形式BloodPressureThenormalbloodpressureforadults['?d?lt]isupto140mmHgsystolicandupto85mmHgdiastolic.Forthediastolicbloodpressurereading,thepointofdisappearanceoftheKorotkoffsoundsisprobablymoreaccurate['?kj?r?t]thanthepointofmuffling['m?fli?].However,ifthepointofdisappearanceismorethan10mmHglowerthanthepointofmuffling,thepointofmufflingisprobablymoreaccurate.BloodPressureRecordingboththepointofmufflinganddisappearancefrequently['frikw?ntli]helpsincommunication[k?,mjun?'ke??n].Abloodpressuremightberecordedas125/75-65:thesystolicbloodpressureis125;thepointofmufflingis75;thepointofdisappearanceis65(thediastolicbloodpressure).BloodPressure ['fri?kw(?)ntl?]['frikw?ntli]adv.頻繁地，經(jīng)常地；時(shí)常，屢次 [k?mju?n?'ke??(?)n]mjun?'ke??nn.通訊，[通信BloodPressureRecordingboththepointofmufflinganddisappearancefrequently['frikw?ntli]helpsincommunication[k?,mjun?'ke??n].Abloodpressuremightberecordedas125/75-65:thesystolicbloodpressureis125;thepointofmufflingis75;thepointofdisappearanceis65(thediastolicbloodpressure).BloodPressureBloodpressureshouldberecordedonlytothenearest5mmHgbecausethereisa±3mmHglimitofaccuracyforallsphygmomanometers[,sf?gmom?'nɑm?t?].Inaddition,normalbloodpressurechangesoccurfrommomenttomoment,andmeasuringtolessthan5mmHgprovidesafalse[f?ls]sense[s?ns]ofaccuracy['?kj?r?si].BloodPressurefalse英[f??ls;f?ls]美[f?ls] adj.錯(cuò)誤的；虛偽 英[sens]美[s?ns] n.感覺(jué)，官能；觀念；道理；理智vt.感覺(jué)到；檢測(cè)accuracy英['?kj?r?s?]美 n.[數(shù)BloodPressureBloodpressureshouldberecordedonlytothenearest5mmHgbecausethereisa±3mmHglimitofaccuracyforallsphygmomanometers[,sf?gmom?'nɑm?t?].Inaddition,normalbloodpressurechangesoccurfrommomenttomoment,andmeasuringtolessthan5mmHgprovidesafalse[f?ls]sense[s?ns]ofaccuracy['?kj?r?si].BloodPressureThesizeofthecuffisimportantfortheaccuratedetermination[d?,t?m?'ne??n]ofbloodpressure.Itis mended[,r?k?'m?nd]thatthecuff[k?f]besnugly['sn?gli]applied[?'pla?d]aroundthearm,withitslowestedge1inchabovetheantecubital[,?nti'kju:bit?l]fossa['f?s?].Thecuffshouldbeapproxima [?'prɑks?m?tli]20%widerthanthediametertheextremity[?k'str?m?ti].Thebladderoverlie['ov?'lai]theartery.Theuseofacuffthatistoosmallforalargearmresultsinanerroneously[i'r?uni?sli]highreadingofbloodBloodPressure 英[d?,t??m?'ne??(?)n]美[d?, n.決心；果斷 [,r?k?'m?nd]adj.被推薦v.推薦，介紹；建議 mend的過(guò)去分詞it mendedthat有人推薦 adv.緊密 [?'pla?d][?'pla?d]adj.應(yīng)用的；實(shí)用的v.應(yīng)用；實(shí)施（apply的過(guò)去分詞）；敷上 [,?nti'kju:bit?l]adj.解剖肘 n.解剖凹；小BloodPressure 英[?'pr?ks?m?tl?]美[?'prɑks? adv.大約，近似地；近于 [?k'strem?t?]美[?k'str?m?ti] 英[??v?'la?]美['ov?'lai] vt.躺在…上 adv.BloodPressureThesizeofthecuffisimportantfortheaccuratedetermination[d?,t?m?'ne??n]ofbloodpressure.Itis mended[,r?k?'m?nd]thatthecuff[k?f]besnugly['sn?gli]applied[?'pla?d]aroundthearm,withitslowestedge1inchabovetheantecubital[,?nti'kju:bit?l]fossa['f?s?].Thecuffshouldbeapproxima [?'prɑks?m?tli]20%widerthanthediametertheextremity[?k'str?m?ti].Thebladderoverlie['ov?'lai]theartery.Theuseofacuffthatistoosmallforalargearmresultsinanerroneously[i'r?uni?sli]highreadingofbloodBloodPressureAnothercauseofelevated['el?ve?t?d]bloodpressurereadingsislackofsupportofthepatient’sarm.Toobtainanaccuratemeasurement,thecuffmustbeatheartlevel.Ifthearmisnotsupported,thepatientisperformingisometricexercise,whichraisestherecordedpressure.BloodPressurefalsely['f?:lsli]adv.elevated['el?ve?t?d]['?l?vet?d]adj.提高的；高尚的；嚴(yán)肅的；歡欣的v.提高；抬起；振奮；提拔（elevate的過(guò)去分詞）n.高架鐵路isometric[a?s?(?)'metr?k]['a?s?'m?tr?k]adj.[數(shù)]等距的；等角的；等軸的；等體積的n.等isometricexercise等長(zhǎng)練習(xí)；靜力訓(xùn)BloodPressureAnothercauseofelevated['el?ve?t?d]bloodpressurereadingsislackofsupportofthepatient’sarm.Toobtainanaccuratemeasurement,thecuffmustbeatheartlevel.Ifthearmisnotsupported,thepatientisperformingisometricexercise,whichraisestherecordedpressure.BloodPressureIncontrast,excessive[?k'ses?v;]pressureonthediaphragm['da??'fr?m]ofthestethoscope['st?θ?skop]producesaspuriously['spj?r??sli]lowerreadingofthediastolicbloodpressurewithoutanysignificant[s?ɡ'n?f?k?nt]alteration[,?lt?'re??n]ofsystolicpressure.Ifthearmisheldcorrectly,noskinindentations[,?lt?'re??n]shouldoccur.BloodPressure [?k'ses?v;ek-][?k'ses?v;]excessivepressure ['da??fr?m]['da??'fr?m]隔膜；快門(mén)，[攝stethoscope英['steθ?sk??p]美['st?θ?skop]vt.用聽(tīng)診器 n.[臨床]聽(tīng)診器 significant[s?g'n?f?k(?)nt][s?ɡ'n?f?k?nt]adj.重大的；有效的；有意義的；值得注意的；意味深長(zhǎng)的n.象征；有意義的事物 [??lt?'re??(?)n]美 n.修改，改變；變BloodPressureIncontrast,excessive[?k'ses?v;]pressureonthediaphragm['da??'fr?m]ofthestethoscope['st?θ?skop]producesaspuriously['spj?r??sli]lowerreadingofthediastolicbloodpressurewithoutanysignificant[s?ɡ'n?f?k?nt]alteration[,?lt?'re??n]ofsystolicpressure.Ifthearmisheldcorrectly,noskinindentations[,?lt?'re??n]shouldoccur.BloodPressureTheauscultatory[?:'sk?lt?t?ri]gapisthesilencethatoccursbetweenthedisappearanceoftheKorotkoffsoundsaftertheinitialappearanceandtheirreappearanceatalowerpressure.Theauscultatorygapispresentwhenthereisadecreasedbloodflowtotheextremities[?k'str?m?ti],asisfoundinhypertensionandinaortic[e'?rt?k]stenosis[st?'nos?s].Itsclinicalimportanceliesinthefactthatthesystolicbloodpressuremaybemistakenforthelowerbloodpressure,thepointofreappearance.BloodPressure [?:'sk?lt?t?ri]adjauscultatorygapaortic英[e?'??t?k]美 adj.大動(dòng)脈 [st?'n??s?s][st?'nos?s]n（官）[病理聽(tīng)診間隙（柯氏第1音出現(xiàn)后又很快繼而會(huì)重新出現(xiàn)并最終為柯氏第5音，即在收縮壓與舒張壓之間較少所致，老年人及伴終末靶損害的高血壓患者較出現(xiàn)柯氏第一音時(shí)，而不是聲音再次出現(xiàn)時(shí)。BloodPressureTheauscultatory[?:'sk?lt?t?ri]gapisthesilencethatoccursbetweenthedisappearanceoftheKorotkoffsoundsaftertheinitialappearanceandtheirreappearanceatalowerpressure.Theauscultatorygapispresentwhenthereisadecreasedbloodflowtotheextremities[?k'str?m?ti],asisfoundinhypertensionandinaortic[e'?rt?k]stenosis[st?'nos?s].Itsclinicalimportanceliesinthefactthatthesystolicbloodpressuremaybemistakenforthelowerbloodpressure,thepointofreappearance.BloodPressureDetermineBloodPressurebyPalpationBloodpressureassessmentisperformedwiththepatientlyingcomfortablyinthesupine['supa?n]position.Thecuffbladderiscentered['s?nt?d]overtherightbrachial['brek??l]artery.Ifthearmisobese[?(?)'bi?s],alargeadultorthigh[θa?]cuffshouldbeused.Thearmshouldbeslightly['sla?tli]flexed[fl?ksd],anditshouldbesupportedatapproximay[?'prɑks?m?tli]theleveloftheheart.BloodPressure [p?l'pet]n觸診；捫 英['s(j)u?pa?n]美 adj.仰臥的；懶散的掌心向上的；向后靠 ['s?nt?d]adj居中的；有圓心的v.集中居中（center的過(guò)去式和過(guò)去分詞形式 ['bre?k??l]['brek??l]adj臂的，臂狀 [?(?)'bi?s][o'bis]adj肥胖的，過(guò)胖 [θa?][θa?n大腿， 英['sla?tl?]美['sla?tli] adv.些微地，輕微地；纖 [fleks][fl?ks]vt.折曲；使收縮vi彎曲；收縮n.屈曲；電線；松緊帶adj.彈性工作制的 英[?'pr?ks?m?tl?]美[?'prɑks?m?tli] dv.大約，近似地；近于BloodPressureDetermineBloodPressurebyPalpationBloodpressureassessmentisperformedwiththepatientlyingcomfortablyinthesupine['supa?n]position.Thecuffbladderiscentered['s?nt?d]overtherightbrachial['brek??l]artery.Ifthearmisobese[?(?)'bi?s],alargeadultorthigh[θa?]cuffshouldbeused.Thearmshouldbeslightly['sla?tli]flexed[fl?ksd],anditshouldbesupportedatapproximay[?'prɑks?m?tli]theleveloftheheart.BloodPressureTodeterminethesystolicbloodpressure y['?dikwitli]andtoexcludeanerrorasaresultofanauscultatorygap,bloodpressureisfirstassessed[?'sest]byIn