第五節：表皮系統
有同學剛開始接觸醫學英語可能會奇怪，為什麼同一個東西有那麼多不同的叫法。其實這個很容易理解，因為語言是有生命的，是非常靈活的。比如我們叫新手叫「菜鳥」，外國人肯定會疑惑，「菜」和「鳥」一個是食物一個是動物，為什麼是新手的意思。再比如日本叫笨蛋叫「馬鹿」，馬和鹿都是動物，為什麼連在一起是笨蛋？除了各種各樣的名詞，再加上各種比喻，讓語言變得非常鮮活，最有意思的就是東北人，吵架善用比喻，比如：
「你瞅你啊，插個尾巴就是個猴！」
所以同學們遇到了相同意思的不同的單詞，不要牴觸，都了解一下，接觸次數多了就熟悉了；平時還要刻意訓練自己，對同一個事物儘量用不同的詞語去描述它，對學習語言真的非常有幫助。
這周我們開始按系統解剖的順序學習術語，今天要學習的是皮膚及附屬結構（integumentary system）。先來看看解剖吧：
大家知道，皮膚是人體最大的器官，大體上由表皮（epidermis）、真皮（dermis）和皮下（subcutaneous）組織構成，附屬器官包括汗腺（sudoriferous glands），皮脂腺（sebaceous glands），指甲和趾甲（nail），以及血管、淋巴、神經和肌肉等。一個成年人的皮膚展開面積在2平方米左右，重量約為人體重量的16%。藥物劑量換算中常用一個參數叫體表面積，簡稱BSA（body surface area）。
皮膚組織也是有不同類型的細胞構成，比如角質細胞（keratinocytes），黑色素細胞（melanocytes），朗格漢斯細胞（Langerhans cells ），成纖維細胞（Fibroblast cells），以及默克爾細胞（Merkel cells），也叫神經纖維末梢觸覺細胞。
接著我們學習一下相關的詞根複合結構和一些後綴。
上節課我們提到了英語病歷，今天我們簡單來學習一個：
The patient is a 52-year-old white female with a diagnosis of stage IIB (T2, N1, M0) large cell carcinoma of the right upper lobe status post right upper lobectomy. She received a course of postoperative radiation therapy directed to the mediastinum, receiving a total dose of 5,040 rads with completion of treatment on April 23, 2016. She was last seen in followup on July 29, 2016 and returns today for a routine 4-month follow-up. She was recently seen by Dr. White. Chest x-ray was obtained on October 10, 2016. This was compared with previous one of June 29, 2016. The left lung remains completely clear. There is a slight increase in interstitial markings around the left hilar area. This is within the prior radiation therapy field. This most likely represents radiation-induced scarring. She is feeling well overall. Her appetite has been good. She has occasional chest discomfort with occasional cough. She denies any pain referable to the thoracotomy site. She has no hemoptysis. She denies any bone pain. She has no bowel or bladder complaints. She remains active and is feeling well overall.
PHYSICAL EXAMINATION:
Blood pressure is 110/74 mmHg, pulse 72/min, and respirations 20/min. Weight is 153 pounds, up 4-1/2 pounds since last being seen. Today on HEENT examination, extraocular movements are intact. Pupils are equal, round, and reactive to light and accommodation. Normocephalic. She has no palpable cervical, supraclavicular, axillary, or inguinal lymphadenopathy. The heart beats with a regular rate and rhythm. Lungs are clear to auscultation and percussion. The right thoracotomy incisional site is well healed. There are no palpable abnormalities. The abdomen is soft and non-tender, with no mass or organomegaly. Extremities reveal no edema, cyanosis, or clubbing.
ASSESSMENT:
We are pleased with the patient’s condition with no evidence of recurrent, residual, or metastatic disease.
PLAN:
She is scheduled to see Dr. White in January. We have asked her to return for routine follow-up in 6 months. We have requested a chest x-ray at that time. We will keep you informed of her progress.
上面這個範例建議大家多多誦讀，最好能背誦下來。
本節課的小問題是：人體最厚的皮膚在什麼部位？最薄的皮膚在什麼部位？要用醫學術語回答哦。本節課依然有筆頭練習，練習題獲取方法：將本文轉發至朋友圈中，然後截圖發送至公眾號後臺獲取。不可分組屏蔽哦~~小編一一審核後將習題發給大家。本期習題答案在《跟毛老師學醫學英語-4》。←←（點擊此連結直達文章）
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