1_Introduction Part I_6min

Welcome to X. I'm Trudy Van Houten.

欢迎来到肌肉骨骼解剖学 X。我是特鲁迪·范·豪滕。

I've been teaching anatomy now for 30 years,

我教解剖学已经 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来的几周里和你一起学习解剖学。

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

我认为我们可以先讨论一下这门课程设计中包含的教学原则，一共有四个教学原则。

The first principle is that even very complicated subjects can be distilled down to basic principles,第一个原则是，即使是非常复杂的学科也可以归结为基本原则，

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

这会是我们在这门课程中使用的重点。

We'll be concentrating on basic principles.

我们会专注于基本原则。

You will learn details.

你会掌握细节的知识量。

They'll be interesting details, but the main emphasis will be on the basic principles.会有一些有趣的细节，但主要重点仍然放在基本原则上。

The second principle is that curiosity drives learning or should drive learning.第二个原则是让好奇心推动学习，或者说，应该让好奇心来推动学习。

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.你参加这门课程，是因为你想了解更多关于这个学科的知识，我们希望从这一点出发来帮助你学习。

The third principle is that affirmation sustains learning, and the fourth is that assessment can help refine learning.第三个原则是用肯定答复提升学习，第四个是用评估帮助优化学习。

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

让我们展开来说这几句话的意思。

So even though the human body has a lot of structures, it has a lot of detail.尽管人体是由很多结构组成的，但它包含了很多细节。

What we'll be concentrating on in this course are the basic principles that you'll actually remember.在这门课程我们聚焦的是你实际上会记住的基本原则。

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.所以四个教学原则中的第一条就是，即使是非常复杂的学科，比如解剖学，也可以被分解成一些更简单的基本原则，这就是我们教学的侧重点。

So there's quite a lot of detail, but we won't be working with that right away.所以会有很多细节，但我们不会立即处理它。

The second principle is that curiosity drives learning.

第二个原则是让好奇心驱动学习。

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.当我们对所学内容感兴趣的时候，我们总是会学得更好，在这种情况下，我们是主动选择学习某些内容，

MusculoskeletalAnatomy

而不是这些内容作为必修课被指派给到我们。

And we also learn better when we have to figure something out.当我们不得不搞明白某件事的时候，我们会学得更好。

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，以往那种学习模式类似上必修课，坐在观众席上听讲，你被动地吸收着，或者没有在吸收，这种模式大多数机构已经弃用了。

The two things we want to do then are intrigue you, get you interested in the case.我们想要做的两件事情是勾起你的兴趣，让你对那些案例产生兴趣。

These are real patients.

这些来自真实的病例。

They have real problems.

他们有真正的问题。

Some may be life-changing.

也可能会改变生命进程。

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

并且，激发你的好奇心，不仅仅是为了勾起你的兴趣

but to help you figure out the case.

更是为了帮助你理解案例。

Case-based learning is actually a really old method of teaching anatomy,基于案例的学习实际上是教授解剖学的一种非常古老的方法。

so this is a page from the Edwin Smith's surgical papyrus, which is at least 3,000 years old.这是埃德温·史密斯的外科纸莎草的一页，至少有 3000 年的历史。

And it is a model of case-based learning.

这是一个基于案例的学习模型。

So each case begins with a patient, and then goes through the stages in the diagnosis and physical examination,因此，每个案例都会跟随一名病患，走过诊断和身体检查的各个阶段，

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

大致与您前往 X 诊所向骨科医生展示病例是一样的情况。

So these will be mysteries.

这些将会是谜。

These will be puzzles for you to solve.

这些将是你要解决的谜题。

And the more actively you work on solving the problems,

并且你越积极地努力解决问题，

the better you'll remember it.

你就能更好的记住这些知识量。

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

所以我们采用了一个有 3000 年历史的方法。

and we're adapting it for you.

并为您做了调试。

Well, in the case-based learning framework, you will meet five patients.在基于案例的学习框架中，你会遇到五个病患。

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And the five patient cases are designed to build over the weeks you'll be taking this course.呈现这五个病例是了与你学习这门课程的进程做配合以及搭建。

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.关于每一个案例，我们没有选择在课程一开始通过灌输式的方式呈现全部的解剖学知识，而是选择让知识量逐步展开。

So for each of the cases, you'll learn about different aspects of anatomy, different concentrations of anatomy,因此，通过每个案例，你都会了解解剖学的不同方面，不同侧重点，

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

我们将按照逻辑顺序进行。

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

因此，我们将通过这五个病患的案例来勾起你的兴趣。

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

依赖你自己去解答谜题。

and we'll be giving you a lot of help along the way knowing if you understand it and what you need to refine.我们会在整个过程中给予你很多帮助，确认你是否理解以及你需要在什么方面改进。

That would be the third principle, which is that confirmation sustains learning.这就是第三个原则，用肯定答复提升学习。

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.

在旧的教学模式下，我们收到的反馈大多是批评，或者是我们在测验中扣掉的分数。

Things that we all remember.

我们都有这样的记忆。

And it's not a balanced kind of criticism.

而这并不是一种公正的批评。

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--

你在学习时需要知道的是，不仅是哪些你做错——通常这很容易被发现到--

but also what you're doing right.

但也需要知道哪些你做对了。

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.在给你机会确认你所了解的知识，又或者，在指出你可能想要回顾、可能遗漏了或误解了的情况之前，我们不会把学习的进度条一直往后拉。

So there'll be plenty of affirmation.

所以会有很多的肯定。

There'll be plenty of confirmation.

会有很多的确认。

We want you to enjoy this.

我们希望你喜欢这个模型。

We want you to know when you got it right.

我们希望你知道你做对了。

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

我们希望你在努力学习本课程的解剖学知识时能够收获成就感。The fourth principle is that assessment can refine learning.第四个原则，评估帮助优化、完善学习。

So we want you to know, as you're going along, what you're getting right.所以我们希望你知道，在进程中，你做对了什么。

But at times, it's also very helpful to know what you haven't quite got right.但有时，知道自己做得不太对也是非常有帮助的。

And so the frequent assessment Exercises that we'll be giving you will enable you to do both.因此，我们提供了频繁的评估练习将使你能够做到这两点。

We expect that you should get about 80% of the quiz questions right.我们期望的是，你应该能答对大约 80%的测验问题。

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

如果你大约有 80%的正答率，

then you should feel like you can continue and learn the next stage.那么你应该觉得自己可以前往下一个学习阶段。

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%，那么你可能想要回过头去，重新拾起你错过的东西。

So let's look at your first quiz question.

所以让我们来看看你的第一个测验问题。

The question is-- all of the following statements are MSK Anatomy teaching principles except—以下所有陈述都属于肌肉骨骼解剖学教学原则，除了

A, assessment refines learning,

评估帮助优化完善学习

B, curiosity drives learning,

好奇心驱使学习,

C, assessment confirms learning,

评估确认学习

D, might makes right, and

权威的就是正确的。

E, and even very complex subjects rest on simple basic principles.即使是非常复杂的主题都建立在简单的基本原则之上。

2_Introduction Part II_16min

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

希望你有识别出，错误答案就是“权威的就是正确的”，这不是课程的组成部分。

and should feel confirmed and sustained in your learning on this issue.你应该在这个问题上感到自己的学习得到了确认和支持。

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

但这是我们接下来如何做事情的一个例子。

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.所以大多数时候，你会做对，你会想，这很好，我知道我有收获。

And sometimes you'll identify something that you need to go back and work on.有时你会发现自己需要回头补课。

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

现在我们知道了课程的基本原则，

we can go to the AnatomyX Clinic and have an introduction to the five patients that you'll be working with in this course.我们可以前往 X 诊所，了解一下你将在这门课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.我们与布里格姆妇女医院的骨科医生合作开发了这些案例。

The patients will not actually be real patients.

患者实际上不是真正的患者。

They are students and colleagues who volunteered their time to help you learn musculoskeletal anatomy.他们是哈佛的学生和同事，志愿参与这个项目帮助你去学习肌肉骨骼解剖学。

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

所以我们的第一个患者是一名 18 岁的四分卫，膝盖疼痛、失去稳定性。

And here you can see him talking to Dr. Laurence Higgins, who will be his orthopedic surgeon.在这里，你可以看到他与劳伦斯·希金斯医生交谈，希金斯会是他的骨科医生。

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

透过患者的历史，我们得知他在一场橄榄球比赛，朝着终点区域奔跑时被一名防守队员铲倒。

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

在防守中，他摔倒在地上，膝盖屈曲。

and his foot was straight out behind him.

他的脚直接来到了他身体的后面。

The combined weight of both of them landed on the bent knee as it hit the ground.两人的总重量都压在了那个撞击在地面上的屈曲的膝盖上。

He sat out the rest of the game since he was in considerable pain.他因为感到相当疼痛，所以坐在场外休息，错过了其余的比赛。

And when you tried to walk or move about, his knee felt unstable.在试图走动或移动时，他的膝盖是有不稳定感的。

So he was benched for the rest of the game.

所以他被换下场了。

And after the game was over, he was brought to the AnatomyX Clinic complaining of pain, knee instability,比赛结束后，他被带到 X 诊所，询问疼痛以及膝关节不稳的问题。

and with a very swollen right knee.

以及右膝异常肿胀的问题。

Our second patient is 27-year-old bicyclist with a deep laceration and difficulty standing on tiptoe.我们的第二位患者是 27 岁的自行车骑手，有深度划伤，以及无法通过脚尖站立的困难。

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 骑着自行车去上课，穿过拥挤、交通拥堵的朗伍德大道医疗区时，一辆汽车从后面撞上了他。He was knocked off his bike.

他被撞倒了。

The bike was all crunched and twisted around him.

自行车在他周围被挤压和扭曲。

And during his fall, the bent frame of the bicycle cut the back of his leg, just above the heel.他摔倒的时候，畸形的自行车的车架划伤了他的腿后面，脚后跟上方的部分。

At the scene, the cut was bleeding.

当场，他就流血了。

Passersby helped him to the side of the road,because he wasn't really able to walk.路人帮助他移动到路边，因为他实际上无法走路。

And then one witness called an ambulance to bring him to the AnatomyX clinic.由一名目击者打电话叫救护车把他送到 X 诊所。

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

到达诊所时，出血已经停止，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.

通过身体检查中，我们注意到他确实有行走困难，他不能靠脚尖站立。

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

我们的第三位病人是一位 35 岁的职业网球运动员，她无法发球。

She was training hard for a national tennis tournament for several months, despite increasing pain in her right shoulder.她无视右肩疼痛加剧，为了全国网球比赛努力训练了几个月。

At her coach's advice, she tried ice and drugs, but it didn't seem to help.听从教练建议，她尝试了冰敷和非处方消炎药，但似乎没有帮助。

Courageously, she continued training and qualified for the national tournament and reached the final match.她勇敢地继续训练，并成功晋级国家比赛，并进入了决赛。

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

当她在第二盘比赛中发出强有力的发球时，

however, she heard something pop in her right shoulder.

她听到右肩发出砰的一声响。

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

她无法继续比赛，不得不认输。

She still experiences pain and difficulty raising her right arm as she comes to us in the Musculoskeletal AnatomyX Clinic.她来到我们 X 诊所时，仍然感到自己抬起右臂时是有疼痛和困难的。

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

我们的第四位患者是 21 岁的体操运动员，她出现了手臂疼痛、腕部下垂和手指弯曲的症状。

Patient D was competing in a gymnastics competition.

第四位病人正在进行体操比赛。

During her fast approach to the vaulting table,

在她快速接近跳马桌时

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

正要用着手(用手支撑)时滑倒了。

and she fell heavily against the vaulting table.

她重重地摔倒在跳马桌上。

At the scene, paramedics bandaged a bleeding wound, splinted her left arm,在现场，医护人员给她包扎了流血的伤口，给她的左臂固定了夹板。

and transported her to the AnatomyX Clinic.

并将她送往 X 诊所。

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

她报告左臂剧烈疼痛，左臂异常弯曲。

So it seems to be bent.

似乎是弯曲的。

over-the-counteranti-inflammatory

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She also is concerned that the back of her hand is numb and that her fingers are curled and she cannot extend them.她还担心自己的手背麻木，手指卷曲，无法伸展。

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

我们的第五位病人是一位 51 岁的小说家，拇指力量较弱，手指发麻。

She's been working long hours to meet a publisher's deadline for her latest novel.她为了赶最新小说的出版截稿时间而长时间工作。

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

在过去的几周里，她感到右手腕和手部的疼痛加剧，手指发麻不适。

The pain and tingling will sometimes awaken her at night,

疼痛和刺痛有时会在夜间唤醒她。

and she's able to attain relief by straightening her wrist and shaking out her hand.她可以通过伸直手腕和摇动手来获得缓解。

She's kept on working.

她一直在工作。

She's trying to meet her deadline.

她正努力赶截稿期限。

Recently, she's noticed increasing right thumb weakness when she tries to depress the space bar on her keyboard.最近，她注意到当她试图按下键盘上的空格键时，右手拇指的力量越来越弱。

So I think you'll agree that even though these aren't real patients,所以我认为你会同意，即使这些不是真实的病人，

the cases are very compelling.

案件非常具有说服力。

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.这些人已经到了人生的一个节点，他们可能不再有能力做到自己重视的事情，而且有感到一些不适或直接的痛苦。

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

希望你对这个案例感到好奇并且有兴趣。

and interested in figuring out what's going wrong.

对问题感兴趣并试图找出出了什么问题。

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

所以我们需要一个计划，以便让你能够做到这一点。

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

你需要什么工具来能够弄清楚这些案例?

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

这些将是 AnatomyX 案例的目标。

And we hope that by the end of each case,

希望在每个案例结束时，

you'll be able to do the following.

你将能够做到以下。

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

首先，了解并正确使用肢体解剖词汇。

Precise communication among members of the medical team is crucial.

医疗团队成员之间的精确沟通至关重要。

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

您作为一名治疗师，会需要使用影像学做分析。

You'd be trying to consult with other physicians.

你会试图咨询其他医生。

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

您将向医疗团队的其他成员提供指导。

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

所以其他人知道你在说什么真的很重要。

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，我们希望每个案例都能逐渐的一点点的给到你工作中能用的解剖词汇。

And you'll find that there are some surprises as we go along.而且在我们持续进行的过程中，你会收获到一些惊喜。

For example, this structure is not the arm.

例如，这个结构不是手臂。

This is the upper limb.

这是上肢。

So the arm will actually have a slightly different meaning.

所以“arm”实际上会有稍微不同的含义。

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

我们不会要求你同时掌握所有术语，

we'll give you a few with each case, and those will be the ones that you will need to understand it.我们会通过每个案例给你一些术语，那些就是你需要理解的。

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

我们也会在开始时，一次性扔出一些解剖术语，它们你在所有案例中都需要理解的。

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

但只有大约 10 个，希望你不会感觉过于痛苦。

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

要了解的第二件事是组织和组织结构。

So learn about cells and tissues, which are the building blocks of the body, for this course.所以要了解细胞和组织，它们是身体的基本组成部分。

We'll learn about how they combine to form the structures we can actually see.我们会去了解它们如何结合形成了我们实际可以看到的结构。

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

我们会去了解他们在组织结构中的位置。

and then we'll be able to use that organization as a map for identifying the structures that we'll see.然后我们就能够使用这个组织结构作为地图，去识别我们会看到的结构。

So first, vocabulary.

首先，词汇。

Second, tissues and organizations.

第二，组织和组织结构。

Your third objective will be to describe and locate the normal positions of the limb bones and bone landmarks.您的第三个目标将是描述以及定位四肢骨骼和骨性标记的正常位置。

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.这很有用，因为回到治疗师进行身体检查的处境下，在很多情况下是看不到骨头的。

But we can feel them.

但我们能感觉到骨头。

And again, that's palpation.

这又是触诊。

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,如果我们知道骨骼应该在的位置，应有感觉如何以及骨性标记的位置，那么如果我们接到一个受伤的患者，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.我们就能够利用这些知识和我们聪明的双手来判断骨骼是否处于它应该处于的位置。

So knowing where the bones should be, where the landmarks should be,what the bones look like,所以理解骨骼应该在的位置，骨性标记应该在的位置，骨骼的样子。

will be the third step in our strategy for approaching the anatomy basic to these cases.这将是我们学习案例导向的解剖学基础的策略的第三步。

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.解剖学的学习策略的第四步基本上是解释和演示四肢之中，关节被允许去做的活动。

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

在这里，我们就引入动作学习的概念。

So the ways that we learn include seeing and hearing and actually doing.因此，我们学习的方式包括看、听，实际行动(做)。

So this is one reason we think dissection is such a powerful tool for learning anatomy at Harvard Medical School,这就是我们认为在哈佛医学院，大体解剖是解剖学的强有力的学习工具的原因之一。

is that the students are actually doing it.

学生们实际上正在这样做。

They're looking for things.

他们去探索。

They're using their hands.

使用手。

They're finding things.

去做探索。

They're using all the different ways of learning.

他们也在利用各种不同的学习方式。

And so we hope that as you learn the motions normally permitted at the joints, you'll actually do them yourself.因此，我们希望当你学习关节被允许去做的活动时，你实际上可以亲自做做看。

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，对于动作学习，我们希望你不仅能解释它们，说出它们是什么，而且还能够演示它们

The motions permitted at a joint are determined by the shape of the bones meeting at the joint.关节允许的活动是由在关节处相接的骨骼的形状决定。

Joints are the meeting places of bones.

关节是骨头的连接处。

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，关节处可以发生什么的活动是由骨骼如何组合在一起决定的，而骨骼如何组织在一起，也受到了密

集的结缔组织结构的影响，也就是形成韧带和形成关节囊的坚韧的结缔组织。

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

那就是决定关节实际功能的因素。

How we look at that during a physical examination is, first of all, on passive range of motion.在身体检查过程中，我们如何理解这一点呢，首先，要看的是消极的关节活动范围。

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

治疗师会手持以及移动病患肢体。

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

关节被允许去做的活动，是可能发生呢?

And equally as important, are the things a joint, that joint, should not be able to do not possible?同样重要的是，关节不应该能够做到的活动，是不是也不能发生呢?

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.

我们将会看到肌肉。

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.所以通过每个案例，你都能学习到如何描述哪些在关节处起作用的肌肉及其功能，以及对肌肉和功能去做演示。

All a muscle can ever do is contract.

所有肌肉都有的能力就是收缩。

So the particular action of the muscle is determined by the joint and the joint surface that it crosses.而肌肉的特定行动，是其覆盖的关节及其交叉的关节表面决定。

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

肌肉所做的就是收缩，通过收缩，

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

它拉动骨头，从而在关节处产生活动。

During the physical examination, at times patients will be asked to do active range-of-motions tests.在体格检查期间，有时会要求患者进行主动活动范围测试。

So they will be asked to flex a joint or extend a joint or do a particular thing.所以他们会被要求做关节的屈曲或伸展或是去做特定的动作。

If we know that the joint is intact and the patient is unable to do it,如果我们知道关节完好无损，患者却无法做到，

it suggests that either the muscle is not working or the motor nerve innervating that muscle is not working, either.这就表明肌肉要么不起作用，要么支配该肌肉的运动神经不起作用。

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.我们需要知道我们策略的下一步是了解神经支配。

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

每个案例的第六个目标是解释肢体神经的运动和感觉神经支配。

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

因此，感觉神经支配是从身体特定区域传达给到中枢神经系统的信号。

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.

而运动神经支配是由中枢神经系统发出，指示肌肉或腺体执行特定的动作的信号。

During the physical examination, we'll be looking for clues that something is wrong with the wiring system.在身体检查过程中，我们将寻找哪些可能表明神经系统出现问题的线索。

So a loss of sensation or numbness; tingling, which is an abnormal sensation;所以失去感觉或麻木;刺痛，这是一种异常的感觉;

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

在想要去执行但是失去了执行特定动作的能力时，这些都表明了特定神经的损伤。

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.通过观察感觉丧失的地方，以及特定的运动能力缺陷，我们通常可以判断出损伤的确切位置。。

In one of our patients, it will be obvious from her arrival at the clinic where were concerned about the injury.那么对于我们的某一个患者来说，她到诊所时，她的损伤在哪里是显而易见的。

In another case, we won't be able to see exactly where the nerve injuries occurred.可以在另一种情况下，我们将无法准确看到神经损伤发生的位置。

But we'll have a pretty good idea from exactly this pattern of motor and sensory deficits.但我们能够从运动和感觉缺陷的模式中，得到很多线索。

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

这样你至少会学习到四肢的基本神经通路。

and you'll be able to actually figure out,

你将能够真正搞清楚，

in our cases, from this pattern which nerve you think is injured.在我们的病例中，在这种模式下，哪条神经受损。

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

去理解与病例相关的解剖学基础的策略的第七步，是学习为四肢供氧的血管。

In , getting oxygen and nutrients is very simple.在单细胞生物中，获得氧气和营养非常简单。

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

氧气和营养可以通过细胞膜向内向外扩散。

In complex animals like us, we need a basic fluid delivery system,而像我们这样的复杂的动物，就需要一个基本的液体输送系统。

and that is the circulatory system.

那就是循环系统。

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

我们不会对泵的细节进行过多讨论。

which propels fluids outward and draws them inward.

泵指的就是，推动流体向外运动并将其吸引向内。

unicellularorganisms

But we will at least talk about the basic vessels of the limbs.但我们会说一下四肢的基本血管。

If the analogy to the neural system was wiring and electricity,如果用神经系统来打比方的话，那么它指的是电线和电力。

the analogy for things that go wrong in the vascular system is plumbing.而如果如果血管系统出问题的话，打比方来说，就很像是管道系统出问题了。In terms of the basic principles, it really is that simple.从基本原则来说，事实是非常简单的。

The circulatory system is a bunch of pipes.循环系统是一堆管道。

And if we have bleeding in a particular place,如果我们在特定的地方出血

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

如果我们在某个特定地方失去了循环。

you just logically work it back and figure out which pipe it is.你只需要从逻辑上计算出来，然后找出问题出在哪根管子上。

The final step is one that we hope you will find really interesting,最后一个步骤，我们希望你会觉得它非常有趣的。

which is learning at least the basics of how to read images of the limbs.那就是，学习基本的四肢影像的读取方式。

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

你们可能都做过 X 光检查，放射。

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

一些人可能还做过 CT 或更复杂的影像，比如磁共振。

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.但是最起码的，我们会教你的是如何通过普通 X 光片或 CT 图像，去理解所学过的结构的基础。

This course is about ways of seeing anatomy.

这门课的重点在于如何去看、去看待，解剖学的方法。

Seeing anatomy in the ways that you've always

以你一直以来的方式看解剖学

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

通过去看别人，去理解自己的解剖结构。

maybe wondering what made it all work.

也许你会因此想要知道一切的工作机理。

And seeing that anatomy in new ways.

而使用新的方式看待解剖。

So you'll be seeing radiographs.

你会看到放射影像。

You'll be seeing x-rays.

你将会看到 X 射线。

You'll even be learning how to read them.

你甚至会学习如何读取它们。

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

我们将通过显微镜来观察微观组织。

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

所以我们将看到构成身体的细胞和组织。

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.在解剖实验室，你将能够以一种很少有人真的看到方式看到组织和结构。

You'll be looking below the skin.

你将会看到皮肤下层。

We'll be removing various tissues so that you can get a better view of how things actually work.我们将移除各种组织，这样你就可以更好地了解事物的实际运作方式。

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.

等解剖学 X 课程结束时，我们希望你能掌握所有这些不同的观察方式并将它们结合在一起，可以更好地了

解自己的解剖结构，更好地了解它正常工作的情况，以及工作停摆时会发生什么。