医学知识双语阅读

第1页/总页数12页医学知识双语阅读导读：我根据大家的需要整理了一份关于《医学知识双语阅读》的内容，具体内容：下面我为大家带来，欢迎大家学习!：口腔检查Examinationoftheoralcavityispartofeverygeneralphysica...下面我为大家带来，欢迎大家学习!：口腔检查Examinationoftheoralcavityispartofeverygeneralphysicalexamination.Oralfindingsinmanysystemicdiseasesareunique,aresometimespathognomonic,andmaybethefirstsignofthedisease.Earlydetectionoforalcancermaybepossible.口腔检查是全身检查的一部分.在许多系统性疾病中,口腔表现是独特的,有时是病征性的,可以是疾病的首先征兆.口腔癌的早期发现是可能的.Adentalhistoryisobtainedfirst.Itmayindicateaparticulardentalproblemorneglectofdentalcare.Acomplaintofdifficultyinchewingfoodsuggestsinsufficientteethforpropermastication,looseorpainfulteeth,poorlyfittingdentalappliances,ordisordersofthetemporomandibularjointorthemasticatorymuscles.Slightbleedingafterbrushingsuggestsmildgingivitis;frequent,spontaneous,orprofusebleedingmayindicateablooddyscrasia.Recurringoralinfectionsmayindicatediabetesmellitus(themostcommoncause),agranulocytosis,neutropenia,leukemia,第2页/总页数12页immunoglobulindefects,ordisordersofleukocytefunction.Immunosuppressedpersonsmayexperiencepainfulreactivationoforalherpessimplexorotherinfections,withpain,oralulcerations,andconsequentinterferencewithfoodintake.首先采集口腔科病史,可提示一个特别的口腔问题或被忽略的口腔保健.主诉咀嚼食物困难提示能行使咀嚼功能的牙齿缺失或疼痛,或颞颌关节及咀嚼肌群功能紊乱.刷牙后轻度出血,提示轻度牙龈炎;经常的,自发的,大量出血,表示血液病.反复出现的口腔感染,可能存在糖尿病(此为最常见原因),粒细胞缺乏症,中性粒细胞减少症,白血病,免疫球蛋白缺乏病或白细胞功能紊乱.免疫抑制者可经历口腔单纯疱疹的疼痛反应,并伴有口腔溃疡而导致妨碍摄食.Athoroughevaluationrequiresgoodillumination,atongueblade,gloves,andagauzepad.Adentalorlaryngealmirror,ifavailable,ishelpful.全面的评估需要良好的照明,压舌板,手套和纱布垫.口镜或咽喉镜有助于口腔检查.Theexaminerinitiallylooksatthefaceforappreciableasymmetry,skinlesions,andotherabnormalities,suchasrestrictedmovementduringspeech,asoccursinsclerodermaoracromegaly.Numerouscongenitalsyndromesproducecharacteristicfacies.Forexample,averythinupperlipsuggeststhefetalalcoholsyndromeorPrader-Willisyndrome.Traumainyouth,particularlyblunttraumatothepointofthechin,candamagegrowthcentersinthecondylesandleadtounilateralorbilateralimpairmentofmandibulargrowth.第3页/总页数12页Idiopathichypertrophyofoneorbothsidesofthemandibleorotherpartsofthefacemaydistorttheface,asmayacromegalyorasalivaryglandorjawtumor.Iftheposteriorteethordentalprosthesesaremissing,thecheeksmaybesunken,producingaprematurelyagedorcachecticappearance.Oneorbothcheeksmayappearswollenduetocherubism,parotitis,Sjgrenssyndrome,tumor,anexcessivelythickdentureflange,orcellulitisfromanabscessedtooth.Multiplebasalcellcarcinomasonthefacemayindicatethenevoidbasalcellcarcinomasyndrome,whichalertstheexaminertolookformultipleodontogenickeratocystsonx-rays.检查者首先观察面部有无明显的不对称,皮肤病损和其他的不正常,如当说话时运动受限常出现于硬皮病或肢端肥大症.许多先天性综合征均产生特殊的面貌.例如,很薄的上唇提示胎儿酒精综合征或Prader-Willi综合征,青少年时期的创伤,特别是颊部的钝伤,能伤及髁状突的生长中心和导致下颌骨单侧或双侧生长发育受损.下颌一侧或双侧自发性肥大,或面部其他部分自发性肥大,如肢端肥大症或涎腺肿瘤或颌骨肿瘤均可破坏面部外貌.如果后牙或义齿缺失,颊部会凹陷而形成早老的或恶病质样的面貌.由于颌骨增大症,腮腺炎,Sjgren综合征,肿瘤,过厚的义齿突缘,或牙槽脓肿引致的蜂窝织炎,均可使一侧或双侧颊部肿起.面部多发性基底细胞肉瘤可表现痣样基底细胞肉瘤综合征,这可使检查者留心地在X线片上寻找多发性牙源性角化囊肿.Thelipsarepalpated.Withthepatientsmouthopen,thebuccal第4页/总页数12页mucosaandvestibulesareexaminedusingatongueblade;thenthehardandsoftpalates,uvula,andoropharynxareviewed.Thepatientisaskedtoextendthetongueasfaraspossible,exposingthedorsum,andtomovetheextendedtongueasfaraspossibletoeachside,sothatitsposterolateralsurfacescanbeseen.Ifapatientdoesnotextendthetonguefarenoughforthecircumvallatepapillaetobeseen,theexaminerusesagauzepadtograspthetipofthetongueandextendittothedesiredposition.Thetongueisthenraisedtoviewtheventralsurfaceandthefloorofthemouth.Theteethandgingivaeshouldbeviewed.对唇部作扪诊,同时令患者张口,用舌板检查颊粘膜和口腔前庭;然后巡检硬软腭,悬雍垂和口咽部.请患者尽快地伸出舌,暴露舌背,并且尽快地向每侧移动舌,这样就可看到舌的后侧表面.如果患者不能将舌伸出足够以使轮状乳头能被看见时,检查者可用纱布垫拉住舌尖,使其伸出到所需的体位.然后巡检舌腹部表面和口底,再检视牙齿和牙龈.Withglovedhand,theexaminerpalpatesthevestibulesandtheareaovertherootsoftheteethwithonefingerandthecheekwithtwofingers.Theindexfingerofthedominanthandisinsertedinsidethemouth,andthecontentsofthefloorofthemoutharecompressedgentlybetweenitandthefingersoftheotherhand.Tomakepalpitationmorecomfortable,theexaminerasksthepatienttorelaxthemouth,keepingitopenjustwideenoughtoallowaccess.The第5页/总页数12页cervicallymphnodesshouldalsobepalpated.检查者用戴手套的手指对口腔前庭进行扪诊并用一个指头扪所有牙齿的根部,用两个指头核对.主检手的示指放入口内,另个手的几个手指置于口外相当部位,轻柔地触扪口底.为了使扪诊更舒适些,可请患者将口腔放松,维持一定的开口度以使手指能进入口腔.对颈部淋巴结也应作扪诊.Thetemporomandibularjoint(TMJ)isassessedbylookingforjawdeviationduringopeningandbypalpatingtheheadofthecondyle,anteriortotheear.Theexaminerthenplaceshislittlefingersintrameatallywhilethepatientopenswidelyandclosesthreetimes.Thepatientshouldbeabletocomfortablyopenwideenoughtofitthreefingersbetweentheincisors.Trismus,theinabilitytoopenthemouth,mayindicatescleroderma,arthritis,ankylosisoftheTMJ,dislocationofthetemporomandibulardisk,tetanus,ortonsillarabscess.UnusuallywideopeningsuggestssubluxationortypeIIIEhlers-Danlossyndrome.颞下颌关节(TMJ)的检查为当开口时在耳前方扪诊髁状突的头,检视颌骨的偏向.然后检查者将小指深入置于外耳道内,请患者张大口和闭口3次.患者能舒适地张大口,足以使上下切牙之间能放进三个手指.不能张口的牙关紧闭提示可能为硬皮病,关节炎,颞下颌关节强直,颞下颌关节盘脱位,破伤风或扁桃体脓肿.异常的大开口提示关节盘半脱位或Ehlers-Danlos综合征的Ⅲ型(先天性遗传性综合征,特征为关节过度伸长,皮肤弹性脆弱等---译者注).Malodorofexhaledbreathmayhavemanycauses.Fetororis第6页/总页数12页originatesinthemouth.Mostcommon