診斷學(xué)頭頸部-英語

TheHeadandNeck1BonesofthefaceandskullParietal[p?'ra??t(?)l]

頂骨Occipital[?k's?p?t?l]

枕Temporal['temp(?)r(?)l]

顳Mastoid['m?st??d]

乳突Externalauditorymeatus

外耳道[ek'st??n(?)l]['??d?t?r?][m?'e?t?s]Styloidprocess['sta?l??d]

莖突2BonesofthefaceandskullMandible['m?nd?bl]

下顎骨Vomer['v??m?]

犁骨Palatine['p?l?t?n]

腭骨Frontal額骨Glabella

[gl?'bel?]

眉間Nasal[?ne?zl]鼻骨Lacrimal

['l?kr?m?l]

淚骨Zygomaticbone[,za?ɡo'm?t?k]

顴骨Maxilla[m?k‘s?l?]

顎骨3MusclesofthefaceandskullOrbicularis

oculimuscle眼輪匝肌[?:,bikju'lε?ris]['?kjuli]Orbicularis

orismuscle口輪匝肌Sternocleidomastoidmuscle['st?:n?u,klaid?'m?st?id]胸鎖乳突肌superficialmusclesunderlyingmusclesPlatysmamuscle[pl?'tizm?]

頸闊肌Trapeziusmuscle[tr?'pi?z??s]

斜方肌Temporalismuscle[,temp?'re?l?s]

顳肌Massetermuscle[m?'si?t?]

咬肌4BoundariesofthetrianglesoftheneckPosteriortriangle['tra???g(?)l]頸后三角Anteriortriangle頸前三角Clavicularhead[kl?‘v?kj?l?]

鎖骨頭Sternalhead['st??n(?)l]

胸骨頭5ThyroidglandLarynx['l?r??ks]

喉Trachea['trek??]

氣管Clavicle['kl?v?k(?)l]

鎖骨Isthmus['?sm?s]

峽部Thyroidlaterallobes[?l?t?r?l][l??b]

甲狀腺側(cè)葉6LymphnodesoftheneckAnteriorauricular耳前[??'r?kj?l?]Posteriorauricular耳后Occipital[?k's?p?t?l]

枕Posteriorcervical頸后['s?v?kl]Supraclavicular

[sju:pr?kl?‘v?kj?l?]

鎖骨上Superficialcervical[?s?:v?kl]

頸淺Deepcervical頸深Tonsillar

['t?nsil?]

扁桃體Submaxillary

頜下Submental

頦下7EndocrineSystemWordsPineal松果體Hypothalamus[,ha?p?'θ?l?m?s]

下丘腦Pituitary[p?'tju??t(?)r?]

垂體Thyroid

甲狀腺Parathytoids

甲狀旁腺Thymus

胸腺Adrenal

腎上腺Pancreas胰腺Ovary

卵巢Testes

睪丸8EndocrineSystemWordsexocine,['?ks?kr?n]外分泌endocrine,

['end?(?)kr?n]內(nèi)分泌secrete,[s?'kri?t]分泌gonad,['ɡon?d]性腺cortex,['k?rt?ks]皮質(zhì)medullar[me'd?l?],髓質(zhì)corticosteroid,[,k??t?k??'ster??d]

皮質(zhì)類固醇glucocorticoid,[,ɡl?ko'k?rt?,k??d]

糖皮質(zhì)激素cortisol['k??t?s?l],皮質(zhì)醇mineralocorticoid

[,m?n?r?lo'k?rt?,k??d],鹽皮質(zhì)激素aldosterone

[?l'd?st?r??n],醛固酮epinephrine[,ep?'nefri?n],腎上腺素norepinephrine,[,n??rep?‘nefri?n]去甲腎上腺素9EndocrineSystemWordsIslet['a?l?t]胰島細(xì)胞insulin['?ns?l?n]胰島素glucagon['glu?k?g(?)n]胰高血糖素anabolism[?‘n?b?l?z(?)m]合成代謝

Catabolism[k?'t?b?l?z(?)m]分解代謝hyperthyroidism,[,ha?p?'θa?r??d?z(?)m]

甲狀腺功能亢進(jìn)hypothyroidism,[ha?p??'θa?r??d?z(?)m]

甲狀腺功能減退Tachycardia[t?k?‘kɑ?d??]心動(dòng)過速

exophthalmos[,eks?f’θ?lm?s]突眼10PituitaryanatomyandimagingInterthalamicadhesion丘腦粘合Corpuscallosum[kɑ:‘l??s?m]胼胝體Mammillarybody[‘m?m?l?r?]乳頭體

Mesencephalon中腦[?mesen'sef?l?n]Pontine[‘p?nta?n]橋腦Medullaoblongata延髓[m?'d?l?][?bl??'ɡɑ:t?]spinal

cord脊髓[?spa?n?lk?:d]Sellaturcica蝶鞍Spheniod

sinus蝶竇

['sfi:n??d][?sa?n?s]Optic

nerve視神經(jīng)Pituitary

stalk垂體柄PinealSagittalplane11Pituitaryanatomyandimaging12Pituitaryanatomyandimaging13PituitaryanatomyandimagingCoronalplaneSellaturcica蝶鞍Spheniod

sinus蝶竇

['sfi:n??d][?sa?n?s]Optic

nerve視神經(jīng)Pituitary

stalk垂體柄Lateral

ventricle側(cè)腦室[?l?t?r?l?ventrikl]Basalnucleus基底節(jié)Cavernous

sinus[?k?v?n?s]海綿竇Internalcarotidartery[k?'r?t?d]14Pituitaryanatomyandimaging15Pituitaryanatomyandimaging16Pituitaryanatomyandimaging17Pituitaryanatomyandimaging18Pituitaryanatomyandimaging19Adrenalanatomyandimagingspine[spa?n]脊柱Abdominalaorta[e???:t?]腹主動(dòng)脈Inferiorvenacava下腔靜脈Caudallobe尾葉20Adrenalanatomyandimaging21Adrenalanatomyandimaging22Adrenalanatomyandimaging23EndocrineGlandsThyroidGlandThethyroidglandislocatedinthelowerfrontpartoftheneck.Itproducesthyroidhormonesthatregulatethebody‘smetabolism.Italsoplaysaroleinbonegrowthanddevelopmentofthebrainandnervoussysteminchildren.Thepituitaryglandcontrolsthereleaseofthyroidhormones.Thyroidhormonesalsohelpmaintainnormalbloodpressure,heartrate,digestion,muscletone,andreproductivefunctions.24Thyroidhormone25HyperthyroidismAhypermetabolicbiochemicalstateItisamultisystemdiseasewithElevatedlevelsofFT4orFT3orbothWhatisthyrotoxicosis?Whatishyperthyroidism?Whatarethevariouscauses?Howtodifferentiatethecauses?Whatistheappropriatetreatment?26﹌﹏×﹌

Referstoavarietyofcausesofthyroidhormone(TH)hypersecretion,causingincreasedexcitabilityandmetabolichyperactivityinnervous,circulatory,digestiveandothersystemsasthemainmanifestation.ThyrotoxicosisGravesT3，T4production↑c(diǎn)hroniclymphocyticthyroiditis(CLT)SubacutethyroiditisT3，T4release↑27GravesDiseaseThemostcommoncauseofthyrotoxicosis(50-60%)Organspecificauto-immunediseaseThemostimportantautoantibodyisThyroidStimulatingImmunoglobulin(TSI)orTSATSIactsasproxytoTSHandstimulatesT4andT3Antithyro

peroxidase(anti-TPO)antibodiesAntithyroglobulin(anti-TG)AntiMicrosomalandotherAutoimmunediseases-PerniciousAnemia,T1DM.28NucleotideScintigraphySubacutethyroiditisGraves29SubAcuteThyroiditis(SAT)SATisthenextmostcommonhyperthyroidism–15%T4andT3areextremelyelevatedinthisconditionImmunedestructionofthyroidduetoviralinfectionDestructivereleaseofpreformedthyroidhormoneThyroidglandispainfulandtenderonpalpationNuclearScintigraphyscan-noRIUintheglandTreatmentisNSAIDsandCorticosteroids30NormalSubacutethyroiditisGraveschroniclymphocyticthyroiditis，CLT31CommonSymptomsNervousness

['n?:v?sn?s]

焦急Anxiety[???za??ti]焦慮Increasedperspiration

[?p?:sp??re??n]多汗4.Heatintolerance怕熱5.Tremor[?trem?(r)]震顫

6.Hyperactivity多動(dòng)7.Palpitations

[?p?lp??te??nz]

心悸8.Weightlossdespiteincreasedappetite消瘦食欲增加9.Reductioninmenstrualfloworoligo-menorrhea

月經(jīng)不穩(wěn)

32CommonSignsHyperactivity,Hyperkinesis[k??ni:s?s]多動(dòng)/興奮Sinustachycardiaoratrial

arrhythmia[?eitri?l

??riemi?],atrial

fibrillation[?f?br?‘le???n],congestiveheartfailure[k?n’d?est?v]竇性心動(dòng)過速/房性心律失常/房顫/心衰Systolichypertension,widepulsepressure收縮期高血壓/脈壓差大Warm,moist,softandsmoothskin-warmhandshake

熱潮濕5.Excessiveperspiration[?p?:sp??re??n]多汗6.Finetremorofoutstretchedhands[st‘ret?t]伸展細(xì)顫Largemuscleweakness,Diarrhea,Gynecomastia

肌肉無力/腹瀉/男性乳房發(fā)育33DiagnosisTypicalclinicalpresentationMarkedlysuppressedTSH(<0.05μIU/mL)ElevatedFT4andFT3

(MarkedlyinGraves)Thyroidantibodies–byElisa–anti-TPO,TSIECGtodemonstratecardiacmanifestationsNuclearScintigraphytodifferentiatethecauses34AlgorithmforHyperthyroidismMeasureTSHandFT4

TSH,FT4MeasureFT3Primary(T4)ThyrotoxicosisHighPituitaryAdenomaFNAC,NScanNormal

TSH,FT4N

TSH,FT4NTSH,FT4NT3ToxicosisSub-clinicalHyperFeaturesofGrave’sYesRx.Grave’sNoSingleAdenoma,MNGLowRAIU

RAIUSubAcuteThyroiditis,I2,↑ThyroxineF/uin6-12wks35TreatmentOptionsSymptomreliefmedicationsAntiThyroidDrugs–ATDMethimazole

（MTA）Propylthiouracil(PTU)RadioActiveIodinetreatment–RAIRx.Thyroidectomy–SubtotalorTotalNSAIDsandCorticosteroids–forSAT36SummaryofHyperthyroidismHyperthyroidismAge%EnlargedPainRAIUTreatmentGraves(TSIAbeye,dermo,bruit)20-4060%DiffuseNone↑↑ATD–18mToxicMNG>5020%LumpyPressure↑RAI,SurgerySingleAdenoma35-505%SingleNone±RAI,ATDSAcuteThyroiditisAnyage15%NoneYes↓↓NSAID,Ster.TSHismarkedlylow,FT4iselevated37EndocrineSystemReviewTheendocrinesystemconsistsofdiscreteindividualglandsandtissuesthatproduceandsecretechemicalmessengerscalledhormones.Hormonesenterthebloodstreamfordispersalthroughoutthebody.

Theyexerteffectsonlyonspecificcells,calledtargetcells,thatpossessreceptorsforthem.38HormonesReceptorsHormonesinfluencetargetcellsbybindingtoSpecificreceptors.ThehormonereceptorinteractionInitiatestheprocessoftransformingthechemicalmessageintotheresponseofthecell.39EndocrineSystemGlandsandHormonesInthistopicwewillreviewsomeofthewellestablishedendocrineglandsandtissues,someofthehormonestheyproduced,andasimplefunctionforeach.40GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDPinealGlandMelatoninPituitaryGlandGrowthhormone（GH）Thyroid-stimulatinghormone（TSH）Adrenocorticotropinhormone（ACTH）follicle-stimulatinghormone（FSH）Luteinizinghormone（LH）ProlactinVasopressin/Oxytocin41GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDhypothalamusThyrotropin-releasinghormone(TRH)DopamineGHRHSomatostatinCorticotropinreleasinghormone(CRH)OxytocinVasopressinThyroidGlandTriiodothyronine(T3)Thyroxine(T4)42GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDAdrenalGlands(cortexandmedulla)GlucocorticoidMineralocorticoidAndrogenAdrenalineNoradrenalineTestes(male)Androgen(testosterone)Ovaries(female)EstrogenProgesteronePancreasInsulinGlucagon43EndocrineTissuesHormonesarealsoproducedbyendocrinecellslocatedinorgansthathavenon-endocrinefuction.Werefertotheseasendocrinetissues.Theyincludethebrain,heart,kidneyandgastrointestinalTract.44EndocrineFeedbackForregulatethepituitarygland,asignalissentfromthehypothalamustothepituitaryglandintheformofa“releasinghormone,”whichstimulatesthepituitarytosecretea“stimulatinghormone”intothecirculation.Thestimulatinghormonethensignalsthetargetglandtosecreteitshormone.Whenthetargetedhormonewererisetomuch,overthenormalconcentrationatbloodstream,thehypothalamusandthepituitaryglandshutdownsecretionofthereleasinghormoneandthestimulatinghormone,sopossibletostopthetargethormones.Thissystemresultsinstablebloodconcentrationsofthehormones.45EndocrineFeedbackHypothalamussecretesTRH,whichcausesthepituitarytoreleaseTSH,whichcausesthethyroidglandtosecreteT4.Whenthebodyhasenoughthyroidhormoneintheblood,T4"feedsback"tothehypothalamusandpituitaryandcausesadecreaseinsecretionofTRHandTSH.46EndocrineGlandsPituitaryGlandPosteriorPituitaryAnteriorPituitaryThepituitaryglandisbeneaththehypothalamusandisnolargerthanapea.Itisoftenconsideredthemostimportantendocrinesystembecauseitproduceshormonesthatcontrolmanyfunctionsofotherendocrineglands.Whenthepituitaryglanddoesnotproduceoneormoreofitshormonesornotenoughofthem,itiscalledhypopituitarism.Thepituitaryglandisbeneaththehypothalamusandisnolargerthanapea.Itisoftenconsideredthemostimportantendocrinesystembecauseitproduceshormonesthatcontrolmanyfunctionsofotherendocrineglands.Whenthepituitaryglanddoesnotproduceoneormoreofitshormonesornotenoughofthem,itiscalledhypopituitarism.47EndocrineGlandsPituitaryGlandThehormonessecretedbytheposteriorpituitaryareactuallyproducedinthebrainandCarriedtothepituitaryglandthroughnerves.Theyarestoredinthepituitarygland.

Hormonesreleased:

Oxytocin

Vasopressin48EndocrineGlandsThyroidGlandThethyroidglandislocatedinthelowerfrontpartoftheneck.Itproducesthyroidhormonesthatregulatethebody'smetabolism.Italsoplaysaroleinbonegrowthanddevelopmentofthebrainandnervoussystem

inchildren.Thepituitaryglandcontrolsthereleaseofthyroidhormones.Thyroidhormonesalsohelpmaintainnormalbloodpressure,heartrate,digestion,muscletone,andreproductivefunctions.

49EndocrineGlandsParathyroidGlandFoursmallmassesofepithelialtissueareembeddedintheconnectivetissuecapsuleontheposteriorsurfaceofthethyroidglands.Parathyroidhormone(PTH)secretedbytheparathyroidglandsaffectscalciummetabolism.50EndocrineGlandsAdrenalGlandThetwoadrenalglandsarelocatedontopofeachkidney.Theadrenalglandsaremadeupoftwoparts.Theouterpartis