1_Introduction Part I_6min

Welcome to X. I'm Trudy Van Houten.

歡迎來(lái)到肌肉骨骼解剖學(xué) X邀摆。我是特魯?shù)稀し丁ず离?/p>

I've been teaching anatomy now for 30 years,

我教解剖學(xué)已經(jīng) 30 年了，

and I'm really looking forward to working with you as you learn anatomy over the next couple of weeks with us.我真的很期待在接下來(lái)的幾周里和你一起學(xué)習(xí)解剖學(xué)。

I thought we'd start by talking about the teaching principles that we used to design this course for you, and there arefour.

我認(rèn)為我們可以先討論一下這門(mén)課程設(shè)計(jì)中包含的教學(xué)原則朝氓，一共有四個(gè)教學(xué)原則。

The first principle is that even very complicated subjects can be distilled down to basic principles,第一個(gè)原則是，即使是非常復(fù)雜的學(xué)科也可以歸結(jié)為基本原則，

and that will be the emphasis that we use in this course.

這會(huì)是我們?cè)谶@門(mén)課程中使用的重點(diǎn)梆造。

We'll be concentrating on basic principles.

我們會(huì)專注于基本原則。

You will learn details.

你會(huì)掌握細(xì)節(jié)的知識(shí)量葬毫。

They'll be interesting details, but the main emphasis will be on the basic principles.會(huì)有一些有趣的細(xì)節(jié)镇辉，但主要重點(diǎn)仍然放在基本原則上。

The second principle is that curiosity drives learning or should drive learning.第二個(gè)原則是讓好奇心推動(dòng)學(xué)習(xí)供常，或者說(shuō)摊聋，應(yīng)該讓好奇心來(lái)推動(dòng)學(xué)習(xí)。

You're taking this course because you want to, because you'd like to learn more about the subject, and we'll want to

harness that in helping you learn.你參加這門(mén)課程栈暇，是因?yàn)槟阆肓私飧嚓P(guān)于這個(gè)學(xué)科的知識(shí)，我們希望從這一點(diǎn)出發(fā)來(lái)幫助你學(xué)習(xí)箍镜。

The third principle is that affirmation sustains learning, and the fourth is that assessment can help refine learning.第三個(gè)原則是用肯定答復(fù)提升學(xué)習(xí)源祈，第四個(gè)是用評(píng)估幫助優(yōu)化學(xué)習(xí)煎源。

So let's talk a little bit more about what these things mean.

讓我們展開(kāi)來(lái)說(shuō)這幾句話的意思。

So even though the human body has a lot of structures, it has a lot of detail.盡管人體是由很多結(jié)構(gòu)組成的香缺，但它包含了很多細(xì)節(jié)手销。

What we'll be concentrating on in this course are the basic principles that you'll actually remember.在這門(mén)課程我們聚焦的是你實(shí)際上會(huì)記住的基本原則。

So the first of the four teaching principles is that even very complex subjects, like anatomy, can be broken down into

simpler basic principles, and that's where we're going to concentrate our teaching.所以四個(gè)教學(xué)原則中的第一條就是图张，即使是非常復(fù)雜的學(xué)科锋拖，比如解剖學(xué)，也可以被分解成一些更簡(jiǎn)單的基本原則祸轮，這就是我們教學(xué)的側(cè)重點(diǎn)兽埃。

So there's quite a lot of detail, but we won't be working with that right away.所以會(huì)有很多細(xì)節(jié)，但我們不會(huì)立即處理它适袜。

The second principle is that curiosity drives learning.

第二個(gè)原則是讓好奇心驅(qū)動(dòng)學(xué)習(xí)柄错。

So we always learn much better when we're interested in what we're learning about, when it's something we've chosen

to learn about, rather than having it assigned as a required course.當(dāng)我們對(duì)所學(xué)內(nèi)容感興趣的時(shí)候，我們總是會(huì)學(xué)得更好苦酱，在這種情況下售貌，我們是主動(dòng)選擇學(xué)習(xí)某些內(nèi)容，

MusculoskeletalAnatomy

而不是這些內(nèi)容作為必修課被指派給到我們疫萤。

And we also learn better when we have to figure something out.當(dāng)我們不得不搞明白某件事的時(shí)候颂跨，我們會(huì)學(xué)得更好。

So the old model of taking a required course and sitting in the audience listening to somebody lecture while you passively

absorbing it--or don't-- is a model that most institutions are not working for anymore.所以扯饶，以往那種學(xué)習(xí)模式類似上必修課恒削，坐在觀眾席上聽(tīng)講，你被動(dòng)地吸收著帝际，或者沒(méi)有在吸收蔓同，這種模式大多數(shù)機(jī)構(gòu)已經(jīng)棄用了。

The two things we want to do then are intrigue you, get you interested in the case.我們想要做的兩件事情是勾起你的興趣蹲诀，讓你對(duì)那些案例產(chǎn)生興趣斑粱。

These are real patients.

這些來(lái)自真實(shí)的病例。

They have real problems.

他們有真正的問(wèn)題脯爪。

Some may be life-changing.

也可能會(huì)改變生命進(jìn)程则北。

And also, recruit your curiosity, not only to intrigue you,

并且，激發(fā)你的好奇心痕慢，不僅僅是為了勾起你的興趣

but to help you figure out the case.

更是為了幫助你理解案例尚揣。

Case-based learning is actually a really old method of teaching anatomy,基于案例的學(xué)習(xí)實(shí)際上是教授解剖學(xué)的一種非常古老的方法。

so this is a page from the Edwin Smith's surgical papyrus, which is at least 3,000 years old.這是埃德溫·史密斯的外科紙莎草的一頁(yè)掖举，至少有 3000 年的歷史快骗。

And it is a model of case-based learning.

這是一個(gè)基于案例的學(xué)習(xí)模型。

So each case begins with a patient, and then goes through the stages in the diagnosis and physical examination,因此，每個(gè)案例都會(huì)跟隨一名病患方篮，走過(guò)診斷和身體檢查的各個(gè)階段名秀，

which won't be all that different from what you'll be observing as you show the in the Anatomy XClinic.

大致與您前往 X 診所向骨科醫(yī)生展示病例是一樣的情況。

So these will be mysteries.

這些將會(huì)是謎藕溅。

These will be puzzles for you to solve.

這些將是你要解決的謎題匕得。

And the more actively you work on solving the problems,

并且你越積極地努力解決問(wèn)題，

the better you'll remember it.

你就能更好的記住這些知識(shí)量巾表。

So we've taken a method that's got a track record of 3,000 years,

所以我們采用了一個(gè)有 3000 年歷史的方法汁掠。

and we're adapting it for you.

并為您做了調(diào)試。

Well, in the case-based learning framework, you will meet five patients.在基于案例的學(xué)習(xí)框架中集币，你會(huì)遇到五個(gè)病患考阱。

orthopedicsurgeons

And the five patient cases are designed to build over the weeks you'll be taking this course.呈現(xiàn)這五個(gè)病例是了與你學(xué)習(xí)這門(mén)課程的進(jìn)程做配合以及搭建。

So for each of them, instead of trying to teach you all of anatomy didactically right away in a big session at the beginning

of the course, it will unfold.關(guān)于每一個(gè)案例惠猿，我們沒(méi)有選擇在課程一開(kāi)始通過(guò)灌輸式的方式呈現(xiàn)全部的解剖學(xué)知識(shí)羔砾，而是選擇讓知識(shí)量逐步展開(kāi)。

So for each of the cases, you'll learn about different aspects of anatomy, different concentrations of anatomy,因此偶妖，通過(guò)每個(gè)案例姜凄，你都會(huì)了解解剖學(xué)的不同方面，不同側(cè)重點(diǎn)趾访，

and we'll go through this in a logical fashion.

我們將按照邏輯順序進(jìn)行态秧。

So we'll be intriguing you with the five patient cases.

因此，我們將通過(guò)這五個(gè)病患的案例來(lái)勾起你的興趣扼鞋。

We'll be counting on you to figure it out,

依賴你自己去解答謎題申鱼。

and we'll be giving you a lot of help along the way knowing if you understand it and what you need to refine.我們會(huì)在整個(gè)過(guò)程中給予你很多幫助，確認(rèn)你是否理解以及你需要在什么方面改進(jìn)云头。

That would be the third principle, which is that confirmation sustains learning.這就是第三個(gè)原則捐友，用肯定答復(fù)提升學(xué)習(xí)。

So on the old teaching model, again, most of the feedback that we got was criticism or number of points we took off onthe arithmetic quiz.

在舊的教學(xué)模式下溃槐，我們收到的反饋大多是批評(píng)匣砖，或者是我們?cè)跍y(cè)驗(yàn)中扣掉的分?jǐn)?shù)。

Things that we all remember.

我們都有這樣的記憶昏滴。

And it's not a balanced kind of criticism.

而這并不是一種公正的批評(píng)猴鲫。

What you need to know as you're learning is, not only what you're doing wrong-- which is usually pretty easy to find out--

你在學(xué)習(xí)時(shí)需要知道的是，不僅是哪些你做錯(cuò)——通常這很容易被發(fā)現(xiàn)到--

but also what you're doing right.

但也需要知道哪些你做對(duì)了谣殊。

And we won't have very much time to go on in your learning sessions before we'll give you a chance to confirm that you

know what you know or to indicate a situation in which you might want to go back and review something that you've

maybe missed or got a misconception about.在給你機(jī)會(huì)確認(rèn)你所了解的知識(shí)拂共，又或者，在指出你可能想要回顧姻几、可能遺漏了或誤解了的情況之前宜狐，我們不會(huì)把學(xué)習(xí)的進(jìn)度條一直往后拉势告。

So there'll be plenty of affirmation.

所以會(huì)有很多的肯定。

There'll be plenty of confirmation.

會(huì)有很多的確認(rèn)肌厨。

We want you to enjoy this.

我們希望你喜歡這個(gè)模型培慌。

We want you to know when you got it right.

我們希望你知道你做對(duì)了豁陆。

We want you have a feeling of achievement as you work hard to learn the anatomy in this course.

我們希望你在努力學(xué)習(xí)本課程的解剖學(xué)知識(shí)時(shí)能夠收獲成就感柑爸。The fourth principle is that assessment can refine learning.第四個(gè)原則，評(píng)估幫助優(yōu)化盒音、完善學(xué)習(xí)表鳍。

So we want you to know, as you're going along, what you're getting right.所以我們希望你知道，在進(jìn)程中祥诽，你做對(duì)了什么譬圣。

But at times, it's also very helpful to know what you haven't quite got right.但有時(shí)，知道自己做得不太對(duì)也是非常有幫助的雄坪。

And so the frequent assessment Exercises that we'll be giving you will enable you to do both.因此厘熟，我們提供了頻繁的評(píng)估練習(xí)將使你能夠做到這兩點(diǎn)。

We expect that you should get about 80% of the quiz questions right.我們期望的是维哈，你應(yīng)該能答對(duì)大約 80%的測(cè)驗(yàn)問(wèn)題。

If you're getting around 80% of them right,

如果你大約有 80%的正答率，

then you should feel like you can continue and learn the next stage.那么你應(yīng)該覺(jué)得自己可以前往下一個(gè)學(xué)習(xí)階段床未。

If you're not getting 80% right, then you might want to go back and pick up the things you've missed.如果正答率不足 80%炕柔，那么你可能想要回過(guò)頭去，重新拾起你錯(cuò)過(guò)的東西购撼。

So let's look at your first quiz question.

所以讓我們來(lái)看看你的第一個(gè)測(cè)驗(yàn)問(wèn)題跪削。

The question is-- all of the following statements are MSK Anatomy teaching principles except—以下所有陳述都屬于肌肉骨骼解剖學(xué)教學(xué)原則，除了

A, assessment refines learning,

評(píng)估幫助優(yōu)化完善學(xué)習(xí)

B, curiosity drives learning,

好奇心驅(qū)使學(xué)習(xí),

C, assessment confirms learning,

評(píng)估確認(rèn)學(xué)習(xí)

D, might makes right, and

權(quán)威的就是正確的迂求。

E, and even very complex subjects rest on simple basic principles.即使是非常復(fù)雜的主題都建立在簡(jiǎn)單的基本原則之上碾盐。

2_Introduction Part II_16min

So hopefully you identified the wrong answer as "Might makes right," which is no part of the AnatomyX course,

希望你有識(shí)別出，錯(cuò)誤答案就是“權(quán)威的就是正確的”揩局，這不是課程的組成部分毫玖。

and should feel confirmed and sustained in your learning on this issue.你應(yīng)該在這個(gè)問(wèn)題上感到自己的學(xué)習(xí)得到了確認(rèn)和支持。

But that's an example of how we'll do these things.

但這是我們接下來(lái)如何做事情的一個(gè)例子谐腰。

So most of the time, you'll get it right, and you'll think, this is good, and I know that I'm getting it.所以大多數(shù)時(shí)候孕豹，你會(huì)做對(duì)，你會(huì)想十气，這很好励背，我知道我有收獲。

And sometimes you'll identify something that you need to go back and work on.有時(shí)你會(huì)發(fā)現(xiàn)自己需要回頭補(bǔ)課砸西。

So now that we know the basic principles of the course,

現(xiàn)在我們知道了課程的基本原則叶眉，

we can go to the AnatomyX Clinic and have an introduction to the five patients that you'll be working with in this course.我們可以前往 X 診所址儒，了解一下你將在這門(mén)課程中合作的五位患者。

We developed these cases in consultation with orthopedic surgeons at the Brigham and Women's Hospital.我們與布里格姆婦女醫(yī)院的骨科醫(yī)生合作開(kāi)發(fā)了這些案例衅疙。

The patients will not actually be real patients.

患者實(shí)際上不是真正的患者莲趣。

They are students and colleagues who volunteered their time to help you learn musculoskeletal anatomy.他們是哈佛的學(xué)生和同事，志愿參與這個(gè)項(xiàng)目幫助你去學(xué)習(xí)肌肉骨骼解剖學(xué)饱溢。

So our first patient is an 18-year-old quarterback with knee pain and instability.

所以我們的第一個(gè)患者是一名 18 歲的四分衛(wèi)喧伞，膝蓋疼痛、失去穩(wěn)定性绩郎。

And here you can see him talking to Dr. Laurence Higgins, who will be his orthopedic surgeon.在這里潘鲫，你可以看到他與勞倫斯·希金斯醫(yī)生交談，希金斯會(huì)是他的骨科醫(yī)生肋杖。

During his history, we learn that he was running toward the end zone during a football game when a defender tackledhim.

透過(guò)患者的歷史溉仑，我們得知他在一場(chǎng)橄欖球比賽，朝著終點(diǎn)區(qū)域奔跑時(shí)被一名防守隊(duì)員鏟倒状植。

At the tackle, he fell to the ground, his knee was bent,

在防守中浊竟，他摔倒在地上，膝蓋屈曲津畸。

and his foot was straight out behind him.

他的腳直接來(lái)到了他身體的后面振定。

The combined weight of both of them landed on the bent knee as it hit the ground.兩人的總重量都?jí)涸诹四莻€(gè)撞擊在地面上的屈曲的膝蓋上洼畅。

He sat out the rest of the game since he was in considerable pain.他因?yàn)楦械较喈?dāng)疼痛吩案，所以坐在場(chǎng)外休息，錯(cuò)過(guò)了其余的比賽徘郭。

And when you tried to walk or move about, his knee felt unstable.在試圖走動(dòng)或移動(dòng)時(shí)残揉，他的膝蓋是有不穩(wěn)定感的抱环。

So he was benched for the rest of the game.

所以他被換下場(chǎng)了。

And after the game was over, he was brought to the AnatomyX Clinic complaining of pain, knee instability,比賽結(jié)束后纸巷，他被帶到 X 診所镇草，詢問(wèn)疼痛以及膝關(guān)節(jié)不穩(wěn)的問(wèn)題。

and with a very swollen right knee.

以及右膝異常腫脹的問(wèn)題瘤旨。

Our second patient is 27-year-old bicyclist with a deep laceration and difficulty standing on tiptoe.我們的第二位患者是 27 歲的自行車騎手梯啤，有深度劃傷，以及無(wú)法通過(guò)腳尖站立的困難存哲。

So Patient B was riding his bicycle to class in the crowded, traffic-ridden Longwood Avenue medical area, when a carstruck him from behind.

所以患者 B 騎著自行車去上課因宇，穿過(guò)擁擠七婴、交通擁堵的朗伍德大道醫(yī)療區(qū)時(shí)，一輛汽車從后面撞上了他察滑。He was knocked off his bike.

他被撞倒了打厘。

The bike was all crunched and twisted around him.

自行車在他周圍被擠壓和扭曲。

And during his fall, the bent frame of the bicycle cut the back of his leg, just above the heel.他摔倒的時(shí)候贺辰，畸形的自行車的車架劃傷了他的腿后面户盯，腳后跟上方的部分。

At the scene, the cut was bleeding.

當(dāng)場(chǎng)魂爪，他就流血了先舷。

Passersby helped him to the side of the road,because he wasn't really able to walk.路人幫助他移動(dòng)到路邊，因?yàn)樗麑?shí)際上無(wú)法走路滓侍。

And then one witness called an ambulance to bring him to the AnatomyX clinic.由一名目擊者打電話叫救護(hù)車把他送到 X 診所。

When he arrives, the bleeding has stopped, but it's still painful.

到達(dá)診所時(shí)牲芋，出血已經(jīng)停止撩笆，但仍然很疼。

And on physical examination, we notice that he does in fact have trouble walking, and he cannot stand on tiptoe on bothfeet.

通過(guò)身體檢查中缸浦，我們注意到他確實(shí)有行走困難夕冲，他不能靠腳尖站立。

Our third patient is a 35-year-old professional tennis player unable to serve the ball.

我們的第三位病人是一位 35 歲的職業(yè)網(wǎng)球運(yùn)動(dòng)員裂逐，她無(wú)法發(fā)球歹鱼。

She was training hard for a national tennis tournament for several months, despite increasing pain in her right shoulder.她無(wú)視右肩疼痛加劇，為了全國(guó)網(wǎng)球比賽努力訓(xùn)練了幾個(gè)月卜高。

At her coach's advice, she tried ice and drugs, but it didn't seem to help.聽(tīng)從教練建議弥姻，她嘗試了冰敷和非處方消炎藥，但似乎沒(méi)有幫助掺涛。

Courageously, she continued training and qualified for the national tournament and reached the final match.她勇敢地繼續(xù)訓(xùn)練庭敦，并成功晉級(jí)國(guó)家比賽，并進(jìn)入了決賽薪缆。

As she was hitting her powerful serve in the second set,

當(dāng)她在第二盤(pán)比賽中發(fā)出強(qiáng)有力的發(fā)球時(shí)秧廉，

however, she heard something pop in her right shoulder.

她聽(tīng)到右肩發(fā)出砰的一聲響。

She was unable to continue and had to concede the match.

她無(wú)法繼續(xù)比賽拣帽，不得不認(rèn)輸疼电。

She still experiences pain and difficulty raising her right arm as she comes to us in the Musculoskeletal AnatomyX Clinic.她來(lái)到我們 X 診所時(shí)，仍然感到自己抬起右臂時(shí)是有疼痛和困難的减拭。

Our fourth patient is 21-year-old gymnast with arm pain, wrist drop, and curled fingers.

我們的第四位患者是 21 歲的體操運(yùn)動(dòng)員蔽豺，她出現(xiàn)了手臂疼痛、腕部下垂和手指彎曲的癥狀峡谊。

Patient D was competing in a gymnastics competition.

第四位病人正在進(jìn)行體操比賽茫虽。

During her fast approach to the vaulting table,

在她快速接近跳馬桌時(shí)

she slipped just as she was about to plant her hand,

正要用著手(用手支撐)時(shí)滑倒了刊苍。

and she fell heavily against the vaulting table.

她重重地摔倒在跳馬桌上。

At the scene, paramedics bandaged a bleeding wound, splinted her left arm,在現(xiàn)場(chǎng)濒析，醫(yī)護(hù)人員給她包扎了流血的傷口正什，給她的左臂固定了夾板。

and transported her to the AnatomyX Clinic.

并將她送往 X 診所号杏。

She reports severe left arm pain, and her left arm is .

她報(bào)告左臂劇烈疼痛婴氮，左臂異常彎曲。

So it seems to be bent.

似乎是彎曲的盾致。

over-the-counteranti-inflammatory

abnormallyangulated

She also is concerned that the back of her hand is numb and that her fingers are curled and she cannot extend them.她還擔(dān)心自己的手背麻木主经，手指卷曲，無(wú)法伸展庭惜。

Our fifth patient is a 51-year-old novelist with a weak thumb and tingling fingers.

我們的第五位病人是一位 51 歲的小說(shuō)家罩驻，拇指力量較弱，手指發(fā)麻护赊。

She's been working long hours to meet a publisher's deadline for her latest novel.她為了趕最新小說(shuō)的出版截稿時(shí)間而長(zhǎng)時(shí)間工作惠遏。

Over the last few weeks, she experienced worsening pain in her right wrist and hand and uncomfortable tingling in herfingers.

在過(guò)去的幾周里，她感到右手腕和手部的疼痛加劇骏啰，手指發(fā)麻不適节吮。

The pain and tingling will sometimes awaken her at night,

疼痛和刺痛有時(shí)會(huì)在夜間喚醒她。

and she's able to attain relief by straightening her wrist and shaking out her hand.她可以通過(guò)伸直手腕和搖動(dòng)手來(lái)獲得緩解判耕。

She's kept on working.

她一直在工作透绩。

She's trying to meet her deadline.

她正努力趕截稿期限。

Recently, she's noticed increasing right thumb weakness when she tries to depress the space bar on her keyboard.最近壁熄，她注意到當(dāng)她試圖按下鍵盤(pán)上的空格鍵時(shí)帚豪，右手拇指的力量越來(lái)越弱。

So I think you'll agree that even though these aren't real patients,所以我認(rèn)為你會(huì)同意请毛，即使這些不是真實(shí)的病人志鞍，

the cases are very compelling.

案件非常具有說(shuō)服力。

These are people who've come to a point in their life where something that's important to them may no longer be

possible to do and are in some discomfort or outright pain.這些人已經(jīng)到了人生的一個(gè)節(jié)點(diǎn)方仿，他們可能不再有能力做到自己重視的事情固棚，而且有感到一些不適或直接的痛苦。

So hopefully you're intrigued and interested in addressing the case,

希望你對(duì)這個(gè)案例感到好奇并且有興趣仙蚜。

and interested in figuring out what's going wrong.

對(duì)問(wèn)題感興趣并試圖找出出了什么問(wèn)題此洲。

So we'll need a plan in order to enable you to do that.

所以我們需要一個(gè)計(jì)劃，以便讓你能夠做到這一點(diǎn)委粉。

So what tools do you need in order to be able to figure out the cases?

你需要什么工具來(lái)能夠弄清楚這些案例?

These will be the objectives for each of the AnatomyX cases.

這些將是 AnatomyX 案例的目標(biāo)呜师。

And we hope that by the end of each case,

希望在每個(gè)案例結(jié)束時(shí)，

you'll be able to do the following.

你將能夠做到以下贾节。

First, understand and use correct terms for limb anatomy vocabulary.

首先汁汗，了解并正確使用肢體解剖詞匯衷畦。

Precise communication among members of the medical team is crucial.

醫(yī)療團(tuán)隊(duì)成員之間的精確溝通至關(guān)重要。

You, as a physician, would be asking for imaging studies.

您作為一名治療師知牌，會(huì)需要使用影像學(xué)做分析祈争。

You'd be trying to consult with other physicians.

你會(huì)試圖咨詢其他醫(yī)生。

You'd be giving directions to other members of the medical team.

您將向醫(yī)療團(tuán)隊(duì)的其他成員提供指導(dǎo)角寸。

And it really matters that they know what you're talking about.

所以其他人知道你在說(shuō)什么真的很重要菩混。

So one of the things we hope to give you with each case, a little bit at a time, is a working anatomical vocabulary.也因此，我們希望每個(gè)案例都能逐漸的一點(diǎn)點(diǎn)的給到你工作中能用的解剖詞匯扁藕。

And you'll find that there are some surprises as we go along.而且在我們持續(xù)進(jìn)行的過(guò)程中沮峡，你會(huì)收獲到一些驚喜。

For example, this structure is not the arm.

例如亿柑，這個(gè)結(jié)構(gòu)不是手臂邢疙。

This is the upper limb.

這是上肢。

So the arm will actually have a slightly different meaning.

所以“arm”實(shí)際上會(huì)有稍微不同的含義橄杨。

So instead of asking you to learn all the terms at the same time,

我們不會(huì)要求你同時(shí)掌握所有術(shù)語(yǔ)秘症，

we'll give you a few with each case, and those will be the ones that you will need to understand it.我們會(huì)通過(guò)每個(gè)案例給你一些術(shù)語(yǔ)，那些就是你需要理解的式矫。

We'll also, at the beginning, give you kind of a burst of anatomical terms, which you will need to understand any of thecases.

我們也會(huì)在開(kāi)始時(shí)，一次性扔出一些解剖術(shù)語(yǔ)役耕，它們你在所有案例中都需要理解的采转。

But there are only about 10 of those, and hopefully it won't be too painful.

但只有大約 10 個(gè)，希望你不會(huì)感覺(jué)過(guò)于痛苦瞬痘。

The second thing we'll be looking at is tissues and organization.

要了解的第二件事是組織和組織結(jié)構(gòu)故慈。

So learn about cells and tissues, which are the building blocks of the body, for this course.所以要了解細(xì)胞和組織，它們是身體的基本組成部分框全。

We'll learn about how they combine to form the structures we can actually see.我們會(huì)去了解它們?nèi)绾谓Y(jié)合形成了我們實(shí)際可以看到的結(jié)構(gòu)察绷。

We'll learn where they are within the organizational plan,

我們會(huì)去了解他們?cè)诮M織結(jié)構(gòu)中的位置。

and then we'll be able to use that organization as a map for identifying the structures that we'll see.然后我們就能夠使用這個(gè)組織結(jié)構(gòu)作為地圖津辩，去識(shí)別我們會(huì)看到的結(jié)構(gòu)拆撼。

So first, vocabulary.

首先，詞匯喘沿。

Second, tissues and organizations.

第二闸度，組織和組織結(jié)構(gòu)。

Your third objective will be to describe and locate the normal positions of the limb bones and bone landmarks.您的第三個(gè)目標(biāo)將是描述以及定位四肢骨骼和骨性標(biāo)記的正常位置蚜印。

This is useful because, again, going back to the physician doing the physical examination, we won't be able to see the

bones, hopefully, in very many cases.這很有用莺禁，因?yàn)榛氐街委煄熯M(jìn)行身體檢查的處境下，在很多情況下是看不到骨頭的窄赋。

But we can feel them.

但我們能感覺(jué)到骨頭哟冬。

And again, that's palpation.

這又是觸診楼熄。

If we know where they should be and what they should feel like and where the landmarks are, then if we have a patient

who's been injured,如果我們知道骨骼應(yīng)該在的位置，應(yīng)有感覺(jué)如何以及骨性標(biāo)記的位置浩峡，那么如果我們接到一個(gè)受傷的患者可岂，we'll be able to use that knowledge and our wise hands to figure out if the bones are in the position that they should be.我們就能夠利用這些知識(shí)和我們聰明的雙手來(lái)判斷骨骼是否處于它應(yīng)該處于的位置。

So knowing where the bones should be, where the landmarks should be,what the bones look like,所以理解骨骼應(yīng)該在的位置红符，骨性標(biāo)記應(yīng)該在的位置青柄，骨骼的樣子。

will be the third step in our strategy for approaching the anatomy basic to these cases.這將是我們學(xué)習(xí)案例導(dǎo)向的解剖學(xué)基礎(chǔ)的策略的第三步预侯。

The fourth step in our strategy of learning the anatomy basically to the cases will be to explain and demonstrate the

motions normally permitted at the joints of the limbs.解剖學(xué)的學(xué)習(xí)策略的第四步基本上是解釋和演示四肢之中致开，關(guān)節(jié)被允許去做的活動(dòng)。

And this is where we'll bring in the notion of kinetic learning.

在這里萎馅，我們就引入動(dòng)作學(xué)習(xí)的概念双戳。

So the ways that we learn include seeing and hearing and actually doing.因此，我們學(xué)習(xí)的方式包括看糜芳、聽(tīng)飒货，實(shí)際行動(dòng)(做)。

So this is one reason we think dissection is such a powerful tool for learning anatomy at Harvard Medical School,這就是我們認(rèn)為在哈佛醫(yī)學(xué)院峭竣，大體解剖是解剖學(xué)的強(qiáng)有力的學(xué)習(xí)工具的原因之一塘辅。

is that the students are actually doing it.

學(xué)生們實(shí)際上正在這樣做。

They're looking for things.

他們?nèi)ヌ剿鳌?/p>

They're using their hands.

使用手皆撩。

They're finding things.

去做探索扣墩。

They're using all the different ways of learning.

他們也在利用各種不同的學(xué)習(xí)方式。

And so we hope that as you learn the motions normally permitted at the joints, you'll actually do them yourself.因此扛吞，我們希望當(dāng)你學(xué)習(xí)關(guān)節(jié)被允許去做的活動(dòng)時(shí)呻惕，你實(shí)際上可以親自做做看。

So for kinetic learning, we want you not only to explain them, to say what they are, but also to be able to demonstratethem.

因此滥比，對(duì)于動(dòng)作學(xué)習(xí)亚脆，我們希望你不僅能解釋它們，說(shuō)出它們是什么盲泛，而且還能夠演示它們

The motions permitted at a joint are determined by the shape of the bones meeting at the joint.關(guān)節(jié)允許的活動(dòng)是由在關(guān)節(jié)處相接的骨骼的形狀決定濒持。

Joints are the meeting places of bones.

關(guān)節(jié)是骨頭的連接處。

So what motions are possible at that joint are determined by how the bones fit together, and that's refined by dense

connective tissue structures, by tough pieces of connective tissue that form ligaments and that form a capsule around

the joint.所以查乒，關(guān)節(jié)處可以發(fā)生什么的活動(dòng)是由骨骼如何組合在一起決定的弥喉，而骨骼如何組織在一起，也受到了密

集的結(jié)締組織結(jié)構(gòu)的影響玛迄，也就是形成韌帶和形成關(guān)節(jié)囊的堅(jiān)韌的結(jié)締組織由境。

So that's what determines what a joint can actually do.

那就是決定關(guān)節(jié)實(shí)際功能的因素。

How we look at that during a physical examination is, first of all, on passive range of motion.在身體檢查過(guò)程中，我們?nèi)绾卫斫膺@一點(diǎn)呢虏杰，首先讥蟆，要看的是消極的關(guān)節(jié)活動(dòng)范圍。

So the physician will take the limb and move it around.

治療師會(huì)手持以及移動(dòng)病患肢體纺阔。

Are the things a joint should be able to do possible?

關(guān)節(jié)被允許去做的活動(dòng)瘸彤，是可能發(fā)生呢?

And equally as important, are the things a joint, that joint, should not be able to do not possible?同樣重要的是，關(guān)節(jié)不應(yīng)該能夠做到的活動(dòng)笛钝，是不是也不能發(fā)生呢?

In the next step in analyzing the patient case,

在分析病例的下一步中

we'll be looking at the muscles.

我們將會(huì)看到肌肉质况。

So one of the objectives you will have for each case is to describe the muscles acting at a joint and what they do, and

also demonstrate them.所以通過(guò)每個(gè)案例，你都能學(xué)習(xí)到如何描述哪些在關(guān)節(jié)處起作用的肌肉及其功能玻靡，以及對(duì)肌肉和功能去做演示结榄。

All a muscle can ever do is contract.

所有肌肉都有的能力就是收縮。

So the particular action of the muscle is determined by the joint and the joint surface that it crosses.而肌肉的特定行動(dòng)囤捻，是其覆蓋的關(guān)節(jié)及其交叉的關(guān)節(jié)表面決定臼朗。

So all a muscle does is contract, and by contracting,

肌肉所做的就是收縮，通過(guò)收縮蝎土，

it pulls on a bone, which produces motion at a joint.

它拉動(dòng)骨頭视哑，從而在關(guān)節(jié)處產(chǎn)生活動(dòng)。

During the physical examination, at times patients will be asked to do active range-of-motions tests.在體格檢查期間誊涯，有時(shí)會(huì)要求患者進(jìn)行主動(dòng)活動(dòng)范圍測(cè)試挡毅。

So they will be asked to flex a joint or extend a joint or do a particular thing.所以他們會(huì)被要求做關(guān)節(jié)的屈曲或伸展或是去做特定的動(dòng)作。

If we know that the joint is intact and the patient is unable to do it,如果我們知道關(guān)節(jié)完好無(wú)損暴构，患者卻無(wú)法做到慷嗜，

it suggests that either the muscle is not working or the motor nerve innervating that muscle is not working, either.這就表明肌肉要么不起作用，要么支配該肌肉的運(yùn)動(dòng)神經(jīng)不起作用丹壕。

In addition to knowing the muscles and what they normally do and how they're normally positioned,除了了解肌肉及其正常功能和正常位置外，

we'll need to know the next step in our strategy, which is learning about the innervation.我們需要知道我們策略的下一步是了解神經(jīng)支配薇溃。

Your sixth objective for every case will be to explain the motor and sensory innervation of the limb nerves.

每個(gè)案例的第六個(gè)目標(biāo)是解釋肢體神經(jīng)的運(yùn)動(dòng)和感覺(jué)神經(jīng)支配菌赖。

So the sensory innervation is signals that are conveyed from particular regions of the body back to the central nervoussystem.

因此，感覺(jué)神經(jīng)支配是從身體特定區(qū)域傳達(dá)給到中樞神經(jīng)系統(tǒng)的信號(hào)沐序。

And the motor innervation will be signals that will come out from the central nervous system to direct muscles or glandsto do a particular thing.

而運(yùn)動(dòng)神經(jīng)支配是由中樞神經(jīng)系統(tǒng)發(fā)出琉用，指示肌肉或腺體執(zhí)行特定的動(dòng)作的信號(hào)。

During the physical examination, we'll be looking for clues that something is wrong with the wiring system.在身體檢查過(guò)程中策幼，我們將尋找哪些可能表明神經(jīng)系統(tǒng)出現(xiàn)問(wèn)題的線索邑时。

So a loss of sensation or numbness; tingling, which is an abnormal sensation;所以失去感覺(jué)或麻木;刺痛，這是一種異常的感覺(jué);

the inability to perform a particular motion when you're trying to do that-- these all indicate an injury to a particularnerve.

在想要去執(zhí)行但是失去了執(zhí)行特定動(dòng)作的能力時(shí)特姐，這些都表明了特定神經(jīng)的損傷晶丘。

And by that pattern of where sensation is lost, where there are particular motor deficits, we can often infer exactly where

the injury has occurred.通過(guò)觀察感覺(jué)喪失的地方，以及特定的運(yùn)動(dòng)能力缺陷沫浆，我們通彻鲋龋可以判斷出損傷的確切位置。本股。

In one of our patients, it will be obvious from her arrival at the clinic where were concerned about the injury.那么對(duì)于我們的某一個(gè)患者來(lái)說(shuō)桐腌，她到診所時(shí)，她的損傷在哪里是顯而易見(jiàn)的哩掺。

In another case, we won't be able to see exactly where the nerve injuries occurred.可以在另一種情況下嚼吞，我們將無(wú)法準(zhǔn)確看到神經(jīng)損傷發(fā)生的位置。

But we'll have a pretty good idea from exactly this pattern of motor and sensory deficits.但我們能夠從運(yùn)動(dòng)和感覺(jué)缺陷的模式中炒刁，得到很多線索誊稚。

So you'll learn at least the basic wiring circuits of the limbs,

這樣你至少會(huì)學(xué)習(xí)到四肢的基本神經(jīng)通路里伯。

and you'll be able to actually figure out,

你將能夠真正搞清楚，

in our cases, from this pattern which nerve you think is injured.在我們的病例中脖镀，在這種模式下，哪條神經(jīng)受損蜒灰。

The seventh step in your strategy for understanding the anatomy basic to the cases will be learning the vessels that supplythe limbs.

去理解與病例相關(guān)的解剖學(xué)基礎(chǔ)的策略的第七步肩碟，是學(xué)習(xí)為四肢供氧的血管。

In , getting oxygen and nutrients is very simple.在單細(xì)胞生物中削祈，獲得氧氣和營(yíng)養(yǎng)非常簡(jiǎn)單。

They can just diffuse them in and out across their cell membranes.

氧氣和營(yíng)養(yǎng)可以通過(guò)細(xì)胞膜向內(nèi)向外擴(kuò)散未巫。

In complex animals like us, we need a basic fluid delivery system,而像我們這樣的復(fù)雜的動(dòng)物，就需要一個(gè)基本的液體輸送系統(tǒng)叙凡。

and that is the circulatory system.

那就是循環(huán)系統(tǒng)。

We won't go into too many details about the pump,

我們不會(huì)對(duì)泵的細(xì)節(jié)進(jìn)行過(guò)多討論跛璧。

which propels fluids outward and draws them inward.

泵指的就是新啼，推動(dòng)流體向外運(yùn)動(dòng)并將其吸引向內(nèi)燥撞。

unicellularorganisms

But we will at least talk about the basic vessels of the limbs.但我們會(huì)說(shuō)一下四肢的基本血管。

If the analogy to the neural system was wiring and electricity,如果用神經(jīng)系統(tǒng)來(lái)打比方的話色洞，那么它指的是電線和電力冠胯。

the analogy for things that go wrong in the vascular system is plumbing.而如果如果血管系統(tǒng)出問(wèn)題的話荠察，打比方來(lái)說(shuō)，就很像是管道系統(tǒng)出問(wèn)題了盯荤。In terms of the basic principles, it really is that simple.從基本原則來(lái)說(shuō)焕盟，事實(shí)是非常簡(jiǎn)單的。

The circulatory system is a bunch of pipes.循環(huán)系統(tǒng)是一堆管道京髓。

And if we have bleeding in a particular place,如果我們?cè)谔囟ǖ牡胤匠鲅?/p>

if we have a loss of circulation in a particular place,

如果我們?cè)谀硞€(gè)特定地方失去了循環(huán)堰怨。

you just logically work it back and figure out which pipe it is.你只需要從邏輯上計(jì)算出來(lái)，然后找出問(wèn)題出在哪根管子上蛇摸。

The final step is one that we hope you will find really interesting,最后一個(gè)步驟备图，我們希望你會(huì)覺(jué)得它非常有趣的。

which is learning at least the basics of how to read images of the limbs.那就是揽涮，學(xué)習(xí)基本的四肢影像的讀取方式。

So you've probably all had an x-ray, a radiograph.

你們可能都做過(guò) X 光檢查蒋困，放射盾似。

Some of you will have had a CT or more complicated imaging, like magnetic resonance.

一些人可能還做過(guò) CT 或更復(fù)雜的影像雪标，比如磁共振零院。

But we'll teach you at least the basics of how to see the structures that you've learned about on a plain film or a CT image.但是最起碼的，我們會(huì)教你的是如何通過(guò)普通 X 光片或 CT 圖像村刨，去理解所學(xué)過(guò)的結(jié)構(gòu)的基礎(chǔ)告抄。

This course is about ways of seeing anatomy.

這門(mén)課的重點(diǎn)在于如何去看、去看待嵌牺，解剖學(xué)的方法。

Seeing anatomy in the ways that you've always

以你一直以來(lái)的方式看解剖學(xué)

seen it-- looking at other people, looking at your own anatomy,

通過(guò)去看別人逆粹，去理解自己的解剖結(jié)構(gòu)枯饿。

maybe wondering what made it all work.

也許你會(huì)因此想要知道一切的工作機(jī)理酝锅。

And seeing that anatomy in new ways.

而使用新的方式看待解剖。

So you'll be seeing radiographs.

你會(huì)看到放射影像稿蹲。

You'll be seeing x-rays.

你將會(huì)看到 X 射線。

You'll even be learning how to read them.

你甚至?xí)W(xué)習(xí)如何讀取它們鹊奖。

We'll be looking through a microscope to see tissues at the microscopic level.

我們將通過(guò)顯微鏡來(lái)觀察微觀組織设哗。

So we'll be seeing cells and tissues that make up the body.

所以我們將看到構(gòu)成身體的細(xì)胞和組織。

In the gross anatomy lab, you'll be able to see tissues and structures in a way that very few people ever do get to see.在解剖實(shí)驗(yàn)室两蟀，你將能夠以一種很少有人真的看到方式看到組織和結(jié)構(gòu)网梢。

You'll be looking below the skin.

你將會(huì)看到皮膚下層。

We'll be removing various tissues so that you can get a better view of how things actually work.我們將移除各種組織赂毯，這樣你就可以更好地了解事物的實(shí)際運(yùn)作方式战虏。

So at the end of the AnatomyX course, what we hope is that you'll take all these different ways of seeing and put themtogether with an enhanced appreciation of your anatomy and a better understanding of how well it normally works, andwhat happens when it doesn't.

等解剖學(xué) X 課程結(jié)束時(shí)拣宰，我們希望你能掌握所有這些不同的觀察方式并將它們結(jié)合在一起，可以更好地了

解自己的解剖結(jié)構(gòu)烦感，更好地了解它正常工作的情況巡社，以及工作停擺時(shí)會(huì)發(fā)生什么。