醫(yī)學(xué)英語(yǔ)情景會(huì)話口語(yǔ)訓(xùn)練范例-ClinicalDialogues-PPT精品課件

1、Clinical DialoguesPart 1. Woman complained of tightness in abdomen associated with belching(噯氣) wind which did not relieve feeling. Symptoms usually began between 5 and 6 p.m. lasting several hours. Relieved by white mixture.(D=Doctor, P=Patient)D: Does the pain come on in the night?come on: to star

2、tIf a cold, headache, or some other medical condition is coming on, it is just starting.e.g. I felt a cold coming on. 我覺(jué)得開(kāi)始感冒了。P: Not often.D: When it comes on, do you get up?P: Yes, I get up and walk around and it relieves.PainI have a headache. I have a splitting headache. （我頭痛得像要裂開(kāi)了。）I have a sto

3、mach-ache.I feel a dull pain in the stomach.I seem to have pain all over. （我似乎渾身都痛。）Im aching all over. （我渾身都痛。）Its a dull sort of pain, and I dont know whats causing it.Its not a sharp pain; just sort of a dull ache.It all began yesterday.It started two days ago.It came on last night.It hurts terri

4、ble. （痛得很厲害。）Its been hanging about for nearly a week. （這已經(jīng)持續(xù)了將近一個(gè)星期了。）It keeps hanging on. （這老是不好。）It sort of hung on. （這似乎不見(jiàn)好。）Or: Just off and on. （就是時(shí)斷時(shí)續(xù)。）Ive got a pain in my back. （背疼）My eyes have been sore. （眼睛發(fā)痛）My left foot hurts. My tooth is aching up again. I feel shivery and Ive got a so

5、re throat. （我覺(jué)得怕冷發(fā)抖，而且喉嚨疼痛。）The pains been keeping me awake.D: Does anything but the white mixture help it?P: Ive been on a strict diet for six months. I never touch milk.on a diet: If you are on a diet, you are eating special kinds of food because you want to lose weight. （為減肥）節(jié)食touch: If you do no

6、t touch a particular kind of food or drink, you never eat it or drink it. 吃；喝e.g. Drink?No, she never touches the stuff. 喝酒？不，他從不喝這種東西。D: Does any position help you?P: No, It comes on after tea, about five. I have my main meal midday.D: Have you been sick? （你嘔吐過(guò)嗎？）(=Any vomiting?)P: Only at the begi

7、nning I was very sick then.A sick person has an illness or some other problem with their health.To be sick means to bring up food through your mouth from your stomach.e.g. I think Im going to be sick.Note that “George is being sick” means “George is bringing up food from his stomach”; “George is sic

8、k” means “George is ill”. However, “George was sick” can mean either “George brought up food from his stomach” or “George was ill”.Vomit has the same meaning as “be sick”. Vomit is a fairly formal word.e.g. She was stricken with(被.折磨) pain and began to vomit.Throw up: In conversation, some people sa

9、y throw up instead of “be sick”.e.g. I think Im going to throw up.Ive been throwing up. 我一直嘔吐。D: Do you feel sick?（惡心嗎？）(= Have you got any feeling of nausea?)(=Are you feeling nausea?)P: Yes, I feel sick but I cant be sick. （我經(jīng)常惡心，但不再嘔吐。）Feel sick: To feel sick means to feel that you want to be sic

10、k.e.g. Flying always makes me feel sick.Note:ILL and sick are both used to say that that someone has a disease or some other problem with their health.e.g. Davis is ill.Your uncle is very sick.A sick child Most British speakers do not use ill in front of a noun unless they are also using an adverb(副

11、詞). For example, they do not talk about “an ill woman”, but they might talk about “a seriously ill woman”. a terminally ill patient.American and Scottish speakers sometimes use ill in front of a noun without using an adverb.We had to get medical help for our ill sisters.D: Does the pain go through t

12、o the back?P: No, but it goes under my armpits. （腋下）D: Whats your weight been doing? （你的體重最近怎樣？）(=Have you lost weight recently?)P: Ive lost one and half stone but Ive been on a fat-free diet for six months.(or: My weight fell from 65kg. to 50 kg.)Stone: a unit of weight in Great Britain, 14 pounds

13、(6.4 kilograms) 英石英國(guó)重量單位，等于14磅(6.4公斤）D: Whats your appetite like?（你的胃口怎樣？）(=How about your appetite?)(=Do you have any appetite?)Whats (your)/(the) ? / What seems to be the ?Whats your appetite like?Whats your complaint? (你有什么不舒服？)=Whats your trouble?=Whats the trouble?=Whats bothering you?=What see

14、ms to be bothering you?=What do you complain of?=Whats the matter with you?=What seems to be the matter?=Whats wrong with you?=What hurts you?=What seems to be the problem?=What seems to be the trouble?P: Poor as ever.(=Ive got a bad appetite.)D: What about your bowels? （大便如何？）(=Are your bowels acti

15、ng properly?)(=Are your bowels regular?)P: I go twice a day, in the morning.D: Is this a life-long habit?P: Yes.D: What do the motions look like? Well-formed, firm? （大便什么形狀？成形，堅(jiān)實(shí)嗎？）P: Yes.D: What about the color? Has it changed?P: No.D: Are they dark?P: Yes.D: Any sign of blood?P: No.D: Do they floa

16、t on the water when you flush the lavatory? （你沖洗廁所時(shí)，它漂浮在水面上嗎？）P: No.D: Have you noticed an unpleasant smell?P: No.D: Have you noticed any difference in your water?（你排尿有無(wú)異常？）P: No.D: Do you have to get up in the night?（你夜間起來(lái)上廁所嗎？）P: Once.D: Your water hasnt been darker?P: No. D: Do you smoke?P: 10 a

17、day.D: Do you drink?P: Not much.D: Have you any other trouble?P: No, my anginas been very good. （我的心絞痛已經(jīng)好了。）Ive not had much trouble with that for two years. （這兩年沒(méi)大犯過(guò)。）- Or:I feel absolutely rotten. （我覺(jué)得身體很不舒服、非常虛弱。）If you feel or look rotten, you feel or look illI feel a bit off color. （我覺(jué)得有點(diǎn)不舒服。）H

18、ere, color means reddish-pink color in ones face that shows that ones health is good. 面色；血色I(xiàn) feel so ill.I feel rather unwell.I feel very bad.I really feel terrible.I think Im dying. （我難受極了。）Im feeling rather out of sorts these days. （這些天我覺(jué)得身體很不舒服。）If you feel out of sorts, you feel slightly unwell,

19、 discontented, or annoyed. 身體不適；心情不佳；煩惱Im under the weather. （我不舒服。）If you say that you are under the weather, you mean that you feel slightly ill.My whole body feels weak.I just feel all pooped out. （我只覺(jué)得精疲力竭。）be pooped out: to be very tired; used mainly in informal American English.D: Youve also h

20、ad trouble with your leg?P: Yes, they thought it was thrombosis (血栓).D: When did you first start with your tummy trouble?（第一次胃病是什么時(shí)候發(fā)作的？）Tummy: the human stomach or belly 肚子，胃P: About 14 years ago.D: The same, but more bothersome now? （現(xiàn)在是否更厲害?）P: Yes, its tighter. （病情更重了。）Warning: 1) You do not say

21、 that someone becomes “iller” or “more ill”. You say that they become worse.2) You do not use ill or sick to say that someone has received an injury. You say that they are injured or hurt.D: Have you ever been jaundiced? （得過(guò)黃疸嗎？）P: No.D: Is your tummy swollen when you feel like this? （犯病時(shí)肚脹嗎？）P: It

22、feels as though Im going to burst. （我覺(jué)得肚子快要爆炸了。）D: Well, Id like to have a look at you. （檢查一下）Will you get undressed and lie on the couch please? （請(qǐng)脫去衣服，躺在檢查床上。）Or:Lie down on the couch there. Let me just see.Lie down on the couch there. Let me examine your belly.Would you mind taking off all your c

23、lothes except your pants (for men)/except your pants and bra奶罩 (for women)? Lie on the couch and cover yourself with the blanket.Well, lets see.Now slip off your coat and shirt, please.Strip to your waist, please.把上身衣服脫掉Roll your sleeve up.Slip your shoes off and hop up on the bed.Slip off your shoe

24、s and socks.Let me check your lungs and heart.Let me listen to your lungs and heart.Let me examine your stomach.Let me sound your lungs. (叩診)Unbutton your shirt and let me listen to your lungs.Open your mouth and say “Ah”.Open your mouth please, and show me your tongue.Put this thermometer(體溫計(jì)) unde

25、r your tongue.Ill have your temperature taken.Well, Id better take your blood pressure.May I take your blood pressure?Let me take your blood pressure.Clinical ExaminationDuring the examination the doctor asked the following questions:D: Do you suffer from heartburn?P: No.D: Have you had any children

26、?P: No.D: Are your hands always cold and red?P: Yes. A lovely color in the winter! （冬天簡(jiǎn)直紅得可愛(ài)！）D: Just hold your breath for a moment. Breathe through your mouth. Show me where you get this pain. Your age?P: 72.D: Your periods finished when? （你什么時(shí)候停經(jīng)的。）P: When I was about 52 or 3.D: Any tenderness her

27、e?P: Its a bit sore but not a lot. D: Does it catch you at all when you breathe?（你每次呼吸都覺(jué)得痛嗎？）P: No.D: Have you any pains in your legs?(=Do you have any pains in your legs?)P: I get cramp （抽筋）a bit when Im in bed.D: More in one leg than the other?P: I get it in my right leg; thats my varicose （靜脈曲張）l

28、eg. D: Apart from this, youve had no other serious illness in the last 14 years?P: No.D: Im going to take a drop of your blood and Id like you to have a stomach X-ray. Youll have to come specially, dont eat anything before and drink a white paste which outlines your stomach and well take some pictur

29、es.Or:I think wed better give you a few tests.A blood test is necessary.Take your blood count first, please.Youre to have a blood test.Im going to take a throat culture so well know for sure.You must have an electrocardiograph examination.Well, lets take an X-ray of your chest.Go and have your chest

30、 X-rayed. BOWELS 大便Medical words: faeces, stools, to defaecateColloquial words: motion, to have the bowels opened Useful questions How often do you have your bowels opened? Is this a life-long habit? What do the motions look like? Are they quite well formed? What about the color? Has it changed? Are

31、 they darker in color？ Have you ever seen any blood in your motions? Have you noticed an unpleasant smell? Do you ever have diarrhea(腹瀉) or constipation (便秘)? Do you have to go in a hurry? （上廁所） Can you hold your motions? （控制排便） Do you have to strain(用力) to pass your motions? (tenesmus) （里急后重,下墜） Do

32、 you take laxatives(輕瀉劑)? Do the motions float on the water after flushing the lavatory? Do you ever have any pain on passing your motions? Do you get pain before, during or after passing your motions? Do you suffer from wind? Have you noticed any special food upsets your bowels? Have you lost any w

33、eight? Descriptive wordsColor: black, brown, clay-like, colorless-like rice-water (cholera霍亂), dark brown, green, grey, pale, pea-soup-like, putty-like(油灰樣), porridge-like)(麥片粥樣)(steatorrhoea脂肪痢), jelly-like, tarry(柏油樣), white, yellow, etc.Form and consistency(稠度): bloody, bulky, dry, fatty, floatin

34、g, friable, frequent, frothy(泡沫樣的), greasy(油脂過(guò)多的), hard, hard dry balls, loose, purulent(膿性的), slimy(粘液的), soft, watery, well-formed, worms, etc.Amount: copious, scantyOdor: offensive (very bad) Useful ExpressionsGreeting “Good morning, Mrs. Rayner, come and sit down.”Asking patients to describe the

35、ir symptoms “Well now, how can I help you?” “Well, Mrs. Rayner, whats the trouble?” “Your doctor says youve been having trouble with your back. Tell me about it.”Collecting casesMentioned above.Directing patients how to undress “Would you mind taking off all your clothes except your pants (for men)/

36、except your pants and bra (for women)? Lie on the couch and cover yourself with the blanket.” “Slip off your shoes and socks.” “Roll your sleeve up.”Directing patients how to assume appropriate positions “Please lie on your tummy.” “Please turn over and lie on your back.” “Roll over onto your left s

37、ide.” “Bend your knees.” “Sit up.” “Lean forward.” “Get off the couch and stand up.” “Walk across the room.”painful: 1) You say that something is painful when it makes you feel pain.e.g. a long and painful illness2) If a part of your body is painful, it hurts.e.g. My back is so painful that I can no

38、t stand upright.3) When someone feels pain, you do not say that they are “painful”. You say that they are in pain. e.g. He was in pain and could not move into a comfortable position.Part 2.D: I see you have had several attacks of influenza(流行性感冒). Anything else?P: Ive had dizziness(頭暈?zāi)垦? and Ive bee

39、n sick. If you feel dizzy, you feel that you are losing your balance and are about to fall.To be sick means to bring up food through your mouth from your stomach.D: When did this start?P: Two months ago.D: How often are the attacks?P: Nearly every day.D: How long do they last?P: Some last all day, s

40、ome a couple of hours.“A couple of things or quantities” means approximately two things or quantities. You use this informal expression when you are not sure of the exact number of things or quantities you are referring to and the number is not important.D: Does anything bring on these attacks?bring

41、 on: to cause to occur 引起（疾病、痛苦、發(fā)作等）You can use the structure “Something brings on an illness, pain, or attack”.P: No.D: Will you describe one of these attacks?P: It starts with a headache a throbbing(跳動(dòng)) headache. My eyes start running. I cant touch them, they are so sore(疼痛的). And then the whole h

42、ouse goes round. Then it goes dark. D: Do you see flashing lights(閃光)?P: No.D: When you say you go dizzy, what do you mean?P: I feel Ill fall over and the room spins(旋轉(zhuǎn)) round. If I go to bed, the bed goes round.fall over: If you fall over from an upright or standing position, you become unbalanced

43、and fall to the ground, lying lengthways(縱向地) or in a heap. 跌倒；摔倒D: When you move, do you stagger?stagger: to move or stand unsteadily, as if you about to fall 蹣跚；搖晃P: Im too scared to move. （嚇得一點(diǎn)都不敢動(dòng)）If you are scared, you are very frightened of someone or something, and therefore unable to behave

44、calmly. 吃驚的；嚇壞了的D: Have you noticed anything else?P: I cough a lot.D: Do you bring anything up? （有沒(méi)有嘔吐vomit/痰sputum？）When you bring up food, you vomit; an informal use.P: No.D: Is your hearing affected? Do you have buzzing(嗡嗡聲) or ringing noises?P: Yes.D: In both ears?P: Yes.D: When you go to bed, d

45、o you sleep?P: I just lie and it goes off within a few hours.If you go off, you fall asleep; an informal use. 入睡e.g. He went off as soon as his head touched the pillow.D: Have you ever woken up like this?wake up: When you wake up or something wakes you up, you become conscious again after being asle

46、ep. 醒來(lái)；喚醒You can use “l(fā)ike this” or “l(fā)ike that” when you are drawing attention to something that you are doing or that someone else is doing. 像這樣（引起對(duì)正做之事的注意）e.g. Sorry to break in on you like this(原諒我這樣打擾您), Dr. Mark.P: No. It is always in the day.D: Does movement of the head cause it?P: No.D: If yo

47、u suddenly get up out of a chair does it start?P: No.D: How long have you been diabetic(糖尿病)?P: Four years.D: Any other serious illness?P: I had my gall bladder(膽囊) removed.“have sth. done” patternGo and have your chest X-rayed.You must have your tooth extracted.You must have your appendix (闌尾) remo

48、ved.Youll have to have your decayed tooth pulled out.D: Anything else?P: I had VD 性病 (venereal disease) nine years ago. I was in hospital for three weeks and had a course of injections(注射).Clinical ExaminationD: Take a deep breath in and hold your breath. Close your eyes gently. Not too tight. Look

49、up to the ceiling(天花板). Hold your arms out. Are your bowels (大便) all right?P: Yes.D: No trouble with your water(排尿)?P: No.D: Your periods(絕經(jīng)) finished some years ago?P: Yes. Four years ago.D: Well, there doesnt seem anything seriously wrong with you. Id like you to have some X-rays through and a blo

50、od test.Diagnosing and treatingBy the look of it, it should be a rash. 從表面看，這應(yīng)該是皮疹。By the sound of it, its bronchitis(支氣管炎).It looks like measles. 看上去像麻疹。It looks as if its SLE. 看起來(lái)這似乎是紅斑狼瘡。It sounds like bronchitis. 聽(tīng)起來(lái)像支氣管炎。It sounds as if youve caught cold. 聽(tīng)上去你似乎得了感冒。I should say youve caught cold. 感冒I should think youve got the flu. 流行性感冒You probably have contracted the flu. 你大概得了流行性感冒。You seem to have picked up some kind of infection. 你似乎已受了某種感染。It could be a case