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Appendicitis

Appendicitis - раздел Философия, АНГЛИЙСКИЙ ЯЗЫК Appendicitis Is The Commonest Abdominal Emergency, Occurring Mostly In People...

Appendicitis is the commonest abdominal emergency, occurring mostly in people under 30 years old, though it can appear in people of any age. When considering appendicitis as a diagnosis, always ask the patient if he knows whether his appendix has already been removed, and look for the operation scar in the right lower abdomen area.

The illness usually begins with a combination of colicky abdominal pain, nausea, and perhaps mild vomiting. The pain is usually felt in the midline just above the navel or around the navel. Later, as the illness progresses, the pain moves from the center of the abdomen to the right lower quarter of the abdomen. The character of the pain changes: from being colicky, diffuse, and not well localized when it is around the navel, it becomes sharp, distinctly felt, and localized at the junction of the outer and middle thirds of a line between the navel and the front of the right hipbone. The patient usually loses his appetite and often feels ill.

Examine the patient. If he complains of sharp stabbing pain when you press gently over the right lower quarter of his abdomen and especially if you feel his abdominal muscles tightening involuntarily when you try to press gently, you can be fairly sure that the appendix is inflamed. The temperature and the pulse rate will rise as the inflammation increases.

Treatment

Once you suspect a patient has appendicitis get RADIO MEDICAL ADVICE and GET THE PATIENT TO HOSPITAL AS SOON AS POSSIBLE. Do not give a purgative.

 

If the patient can reach hospital within 4-6 hours, give him no food or liquid and no drugs, as he will probably require a general anaesthetic. Keep him in bed until he is taken off the ship. Keep a record of the patient’s temperature, pulse, and respiration, and send these and your case notes to the hospital with the patient.

If the patient cannot get to hospital within 4-6 hours, put him to bed and the temperature, pulse rate and respiration rate hourly. The patient should have no food, but can have drinks. Treat severe pain according to RADIO MEDICAL ADVICE.

Subsequent treatment

If the patient is still on board after 48 hours, he should be given some fluids such as milk, sweet tea, and soup until he can be put ashore.

Anyone who was thought to have appendicitis but seems to have improved should be seen by a doctor at the next port. Improvement is shown by diminution of pain and fall in temperature.

 

2. Answer the following questions

1. What signs and symptoms of minor abdominal conditions do you know?

2. What abdominal emergencies exist?

3. What are the symptoms of appendicitis?

4. What should be done if the patient on board a ship cannot get to hospital?

 

3. Remember the following expressions and make up dialogues using these expressions

Pains

  1. Sudden pain – внезапная боль
  2. Marked/pronounced pain – выраженная боль
  3. Generalized pain – генерализованная боль
  4. Нeadache – головная боль
  5. Fasting pain – голодная боль
  6. Gnawing pain – грызущая боль
  7. Pressing pain – давящая боль
  8. Burning pain – жгучая боль
  9. Retrosternal pain – загрудинная боль
  10. Tooache – зубная боль
  11. Extending pain – иррадиирующая боль
  12. Colicky pain – коликообразная боль
  13. Piercing/stabbing pain – колющая боль
  14. Aching/rheumatic pain – ломящая боль
  15. Troublesome/excruciating pain – мучительная боль
  16. Muscular/muscle pain – мышечная боль
  17. Neuralgic pain – невралгическая боль
  18. Girdle pain – опоясывающая боль
  19. (Sudden) Acute pain – (внезапная) острая боль
  20. Reflected pain – отраженная боль
  21. Constant/persistent/continuous pain – постоянная/непрерывная боль
  22. Paroxysmal/periodical pain – приступообразная/ периодически возникающая боль
  23. Long-standing pain – продолжительнпя боль
  24. Transient pain – проходящая боль
  25. Throbbing pain – пульсирующая боль
  26. Arching pain – распирающая боль
  27. Cutting pain – режущая боль
  28. Tightening/pressing pain – сжимающая боль
  29. Severe/intense/violent/bad pain – сильная боль
  30. Slight pain – слабая боль
  31. Steady/lasting pain – стойкая боль
  32. Shooting pain – стреляющая боль
  33. Cramping/cramp-like/spasmodic pain – схваткообразная боль
  34. Dull pain – тупая боль
  35. Pains of unknown origin – боли неясного происходжения
  36. Angina like pains, stenocardia like pains – боли, похожие на боли при стенокардии
  37. Pain on defecation – боли при дефекации
  38. Pains on urination – боли при мочеиспускании
  39. Сhest pain – боль в груди
  40. Stomach ache – боль в желудке
  41. Abdominal pain – боль в животе
  42. Painful breathing – боль во время дыхания
  43. Back pain – боль в пояснице
  44. Joint pain – боль в суставах
  45. Начало боли (внезапное/постепенное) – Onset of pain (sudden/gradual)
  46. Episode/attack of pain, occurrence of pain – приступ боли
  47. To induce/cause pain, to bring pain on – вызывать боль
  48. To locate in, to settle in, to be limited to (of pain) – локализоваться (о боли)
  49. To suffer fro pain – мучиться о боли
  50. To increase/to worsen/to precipitate – усиливаться (о боли)
  51. To subside / to remit – стихать, уменьшаться (о боли)

 

  1. What usually causes the pain? – Что обычно вызывает боль?
  2. After what does the pain occur? – После чего возникает боль?
  3. What kind of pain do you have? – Какая у Вас боль?
  4. Where does the pain radiate to? To which side, flank, upwards, downwards, into the arm (leg, shoulder) - Куда отдает боль? В какую сторону, в какой бок, вверх, вниз, в руку (ногу, плечо)?
  5. Is this the first occurrence of pain? – Это первый приступ боли?
  6. Has the pain gone (Does the pain persist? Has the pain become more/less intense, worsened, decreased?) – Боль прошла (не проходит, стала меньше/больше, усилилась, уменьшилась)?
  7. What do you attribute these pains to? – C чем Вы связываете эти боли?
  8. Will you show me where it hurts now? In what body position do you feel pain the most? Покажите, где Вы чувствуете боль сейчас. В каком положении Вы чувствуете боль сильнее?
  9. Was the onset of the pain sudden (gradual)? – Боли начались внезапно, постепенно?
  10. What is the pain relieved by? By rest, drugs, particular food, fasting? - Чем облегчается боль? Покоем, лекарствами, особой пищей, голоданием?
  11. Is it painful? Does it hurt? - Больно? Болит?
  12. I believe you have ….. – Полагаю, что у Вас ….

 

  1. Translate from Russian into English

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Все темы данного раздела:

Front - Спереди
Frontal region of the head – Лобная часть головы Side of head – Височная часть головы Top of head - Макушка Face – Лицо Cheek - Щека Jaw - Челюсть

Back - Сзади
Back of head - затылок Back of neck – Шея (сзади) Back of shoulder - Плечо Scapula region - Лопатка Elbow - локоть Back upper arm – Верхняя часть

General principles of first aid aboard ship
First aid must be administered immediately to: restore breathing and heart-beat, control bleeding, remove poisons, prevent further injury to the patient (for instance, his removal from a room conta

Если пострадавший в бессознательном состоянии
· Положите пострадавшего на спину и расположите голову так, чтобы подбородок был приподнят; · Опустите челюсть пострадавшего так, чтобы рот был открыт; · Убедитесь, что дыхательны

Summary of points to be remembered when applying artificial respiration and heart compression
  Don't delay - Place victim on his back on a hard surface. Step A. Airway - If patient is unconscious, open the airway; thereafter make sure it stays open.

Remember the following expressions
Тщательно составленная история болезни – careful history Запись в истории болезни – record in a case report Заполнение истории болезни – filling in a patient’s card Жалоб

Routine particulars about the ship
1.1. Name of ship 1.2. Call sign 1.3. Date and time (GMT/UTC) 1.4. Course, speed, position 1.5.1. Port of destination is … and is … hours/days away 1.5.

Routine particulars about the ship
1.5. Name of ship 1.6. Call sign 1.7. Date and time (GMT/UTC) 1.8. Course, speed, position 1.5.1. Port of destination is … and is … hours/days away 1.5.

Other comments
Comments by the radio doctor Make the following radio message Моторист, Н., 45 лет. Приступ сжимающей боли за грудиной, иррадиация в левое плечо

Electrical burns
Make sure you do not become the next casualty when approaching any person who is in contact with electricity. If possible, switch off the current. Otherwise, insulate yourself before approaching an

Treatment
Try to remove patient to hospital within 6 hours, otherwise seek RADIO MEDICAL ADVICE in the case of: third-degree burns; babies; burns of face and genitalia, and l

Translate the following sentences from Russian into English
1. Ожоги, вызванные сухим и влажным жаром, лечат одинаково. 2. Ожоги первой степени затрагивают только наружный слой кожи, вызывая покраснение, умеренный отек, болезненность при прикоснове

ABDOMINAL PAIN
Minor Abdominal Conditions This group of conditions includes indigestion, “wind”, flatulence, mild abdominal colic (spasmodic abdominal pain without vomiting or diarrhea and fever),

Indigestion
Indigestion occurs when food fails to undergo the normal changes of digestion in the alimentary canal. It is a symptom and not a disease. Occasional indigestion may be of no consequence, but chroni

Intestinal obstruction
Intestinal obstruction may come on either slowly or suddenly; a common cause is a strangulated hernia. The bowel will always try to push intestinal contents past any obstruction, and as it does so

INFECTIOUS DISEASES
Communicable diseases are those that can be transmitted from one person (or animal) to another. There may be direct or indirect transmission to a well person from an infected person or animal – at

Dysentery
This disease is due to bacteria taken into the system through water or food and usually occurs in tropical and semitropical countries. This bacteria cause severe inflammation of the mucous membrane

Fractures
A fracture is a broken bone. The bone may be broken into two or more pieces or it may have a linear crack. Fractures are described as closed if the skin remains unbroken. If there is a wound at or

Types of fractures
Closed (simple) fracture – закрытый перелом Combined fracture – сочетанный перелом Comminuted fracture – оскольчатый перелом Сompound fracture - открытый перелом

Internal Bleeding
Internal bleeding may result from a direct blow to the body, from strains, and from diseases such as peptic ulcer. Internal bleeding can be concealed or visible. Bleeding round a broken li

Toxic hazards of chemicals
Ships carry a number of substances in addition to cargo that are potentially toxic. For instance, medicines are not generally poisonous but can become so if taken other than prescribed. Then there

Diagnosis of poisoning
General Principles The diagnosis of poisoning may be simplified if one of the following factors point to the probable cause: · the circumstances of the incident, e.g. a lea

Prevention of poisoning
Remember: Prevention is better than cure Knowledge of the basic safety precautions and strict adherence to them by people working with dangerous goods, and also knowledge

Food-borne diseases (food poisoning)
Food-borne diseases - some forms of which are sometimes also referred to as food poisoning - are illnesses of an infectious or toxic nature caused, or thought to be caused, by the consumption of fo

Less common causes
· Migraine, which usually occurs only on one side of the head and is associated with vomiting and visual disturbances such as flashing lights. · Brain disease; acute as with meningitis and

Angina pectoris (pain in the chest)
Angina usually affects those of middle age and upwards. The pain varies from patient to patient in frequency of occurrence, type, and severity. It is most often brought on by physical exertion (ang

Specific treatment
Pain can be relieved by sucking (not swallowing) a tablet of glyceryl trinitrate (0.5 mg). The tablet should be allowed to dissolve slowly under the tongue. These tablets can be used as often as ne

Heat-stroke (sunstroke)
Heat-stroke is a medical emergency that is associated with a potentially high mortality rate. It occurs when the body's main mechanism of heat loss (evaporation of sweat) is blocked. There m

Treatment
Immediate treatment must be given to reduce the body temperature, or brain damage and death may occur. The patient should be undressed and placed in a tub of cold (around 20 °C) water; or co

Hernia (rupture)
The abdominal cavity is a large enclosed space lined by a sheet of tissue. The muscles of the abdominal wall resist the varying changes of pressure within the cavity. Increased pressure may force t

Strangulated hernia
Most hernias, whatever their size, manage to pass backwards and forwards through the weakness in the abdominal wall without becoming trapped in the opening. However, the contents of the hernia pouc

High blood pressure (hypertension)
  As blood is pumped by the heart, it exerts a pressure on the walls of the arteries. This pressure -blood pressure - varies within normal limits. During activity it tends to be highe

High temperature (hyper pyrexia)
Hyper pyrexia is the word used to describe too high a body temperature, i.e., one of 40 °C or higher. Such temperatures can be dangerous to the survival of the individual and require careful manage

Sore throat
A common complaint, sore throat may be local or it may be part of a serious illness. Tonsillitis (inflammation of the tonsils) and abscesses in the tissues of the tonsillar area are examples of loc

General treatment for sore throats
Take the patient's temperature, and feel for tender enlarged glands in the neck. Patients with sore throats should not smoke. For simple tonsillitis or sore throat, gargling with

Peritonsillar abscess (quinsy)
This is an abscess that can follow tonsillitis. It forms normally round one tonsil, and the swelling pushes the tonsil downwards into the mouth. The patient may find it so difficult and painful to

Abandonment of vessel
Lifeboat drills must be conducted to prepare for possible disaster. Both crew and passengers must be instructed in the procedures to be followed. Reasons for such instruction should be given to all

Survivor pick-up by survival craft (lifeboat or raft)
Surviving in a lifeboat or life-craft (hereafter referred to as "the survival craft") is one of the most strenuous ordeals an individual can face. It involves combat against all the eleme

Immediate medical problems aboard survival craft
Trauma Injuries should be handled as outlined in Chap­ter 4. However, a prepared medical survival kit might not be available, so the rescuers will have to improvise. The following m

Other medical problems aboard survival craft
Seasickness Seasickness (motion sickness) is an acute illness characterized by loss of appetite, nausea, dizziness, and vomiting. Preventive measures are often effective.

Medical problems of the rescued castaway on board the rescue vessel
The treatment of survivors will depend on the nature of the rescue facility and the number and medical condition of the survivors. Personnel on the rescue vessel should rapidly sort all su

Generalized immersion hypothermia aboard the rescue vessel
At environmental temperatures of less than 20-21 °C, man's survival depends upon insulation (body fat, clothing), the ratio of body surface to volume, the basal metabolic rate, and the w

Contamination with oil
Do not clean oil off the skin (except round the mouth and eyes) until the person is warm and comfortable. Survivors who have recovered from hypothermia can taken to a warm shower or bathroom and sh

Dehydration and malnutrition
Survivors who have been adrift for several days may be suffering from dehydration. If they have been adrift for several weeks, malnutrition may also be a problem. Caution should be exercised in try

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