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MEDICAL SPECIALTIES AND SPECIALISTS 15 страница






Exercise 3. Ask your friend to name all the bones of the skull (use Fig. 5-1). Exercise 4. Look at Fig. 5-2 and describe the human skeleton.

Exercise 5. In the Fig. 5-3 you can see the vertebral column. How many parts does the vertebral column have? Name all of them. How many vertebrae does each of them have?

Exercise 6. Look at the pelvic girdle in Fig. 5-4. Name all its bones and their location.

Exercise 7. Describe the dif­ferences between the male pelvis and the female pelvis (use Fig. 5-5).

 

 

II. Grammar Exercises

Exercise 1. Write out sentences with the infinitive, name its forms.

The skeleton is the framework of the human body. It serves to support the body and protect its internal organs.

Two hundred and six bones compose the skeleton, about half of which are to compose the hands and the feet.


cranium.


facial bones ■ -mandible —

 

, clavicle

- scapula


 

sternum-----


 

costal cartilage


— humerus I Y-%V ribs


 


           
     


 


/

sacrum


carpals ~~4 j.'' j metacarpals -

phalanges -


 


       
   


ankle —


fibula


 


— calcaneus


 

 

axial skeleton


 


tarsals -

metatarsals ' phalanges • appendicu skeleton


. 5-2. The skeleton



side view of male pelvis

Fig. 5-5. Pelvic girdle: male pelvis and female oelvis

 

 

The flexible joints are used to connect the bones together. They allow the bones to move.

Only one bone is not connected to another bone. It is the hyoid, it anchors the tongue and is attached to the styloid processes of the skull by ligament.

 

Notes:

hyoid ['habid] під'язикова кістка

styloid ['staibid] шилоподібний відросток

I want I'd like He agreed The woun­ded asked She likes You can

 

Exercise 2. Make up sentences, translate them. Name the forms of the infinitive.

(to) be helped.

(to) speak about the skeleton, (to) describe the structure of it.

 

(to) name all possible fractures, (to) be examined by the doctor, (to) define this word meaning.


Exercise 3. Translate the sentences into English. Name the form of the infinitive.

1. Інститут був створений, щоб покращити лікування ракових захворювань.

2. Нашою метою було створення вакцини.

3. Питання, на яке потрібно відповісти, важке.

4. Більшість пацієнтів, за якими медсестрі потрібно особливо доглядати, - це лежачі хворі.

5. Цього хлопчика слід негайно госпіталізувати.

6. На зломану ногу потрібно накласти гіпс.

Exercise 4. Translate the sentences, remember that the infinitive shows the following action.

Model: He came to find the door locked.

Він прийшов і виявив, що двері замкнені.

1. Fat cells are normally arranged to form a lobule.

2. This method was rather new to provide a practical use of it.

3. This substance interacts with many hormones to give identical or different metabolic
processes.

4. He will work to understand the importance of this problem.

5. The patient asked to be read to.

Exercise 5. Test yourself. Translate the following words into Ukrainian. Show the bones on the skeleton.

 

carpal bones metatarsal bones
cervical vertebrae nasal cavity
clavicle orbit
coccyx patella
femur pedal phalanges
fibula pubis
humerus radius
ilium rib
ischium sacrum
lumbar vertebrae scapula
manual phalanges skull
metacarpal bones mandible

 

111. Independent Work: Spinal Curves

Exercise 1. Write down the following words into your vocabulary, learn them.

curve [k3:v] вигин; кривизна; закруглення disorder [dis'o:d;>] розлад; відхилення; хвороба exaggeration [ig zasq^s'reifn] перебільшення hunchback ['h.\ntjb£ek] горбань lordosis [b:'dsusis] лордоз scoliosis [.sknli'sosis] сколіоз

curvature ['k3:v3tf3J кривизна; вигин, згин; викривлення compression [kDm'preJn] стиснення teen [ti:n] віком від 13 до 19 років

 

Exercise 2. Read the text, translate it.

 

Spinal Curves

There are three abnormalities of the spinal curves. An exaggeration of the thoracic curve is a hunchback, or kiphosis. An excessive lumbar curve is called lordosis. The most common of those disorders is scoliosis. This is a lateral curvature of the vertebral column. In extreme cases there may be compression of some of the internal organs.

Scoliosis occurs in the rapid growth period of the teens, more often in girls than in boys. Early discovery and treatment produce good results.

If the curvature is mild, the treatment may involve only exercises: sit-ups, exercises to stretch the spine, and breathing exercises may strengthen the muscles of the trunk enough to correct the situation. More severe scoliosis may require wearing a special leather brace or a plastic brace.

The use of specially designed electrical stimulation devices has met some success. The most severe scoliosis requires spinal fusion surgery.

Exercise 3. Find sentences with the infinitive, write them out, underline the infinitive, name its forms.

 

Exercise 4. Make up a plan of the text.

 

 

UNIT SIX

 

I Speaking Bones
II Grammar Functions of Infinitive in Sentences (§96)
III Independent Work At the Traumatologist's

 

I. Speaking: Bones

After careful study of this unit you should be able to:

- name three different types of bone cells;

- differentiate between compact bone and spongy bone with respect to structure and location;

- describe the structure of a long bone;

- differentiate between yellow and red marrow with respect to function and location;

- name the functions of the bones;

- describe five bone disorders;

- list and define six t\>pes of fractures.

Exercise 1. Read and learn the following words, remember their Latin/Greek equivalents.

 

 

 

 

 

 

 

 

English Latin/Greek Ukrainian
tissue textus/histos тканина
osseous osseus кістковий
enzyme enzymum фермент
osteoblasts osteoblasti остеобласти
osteocytes osteocyti остеоцити
osteclasts osteoclasti остеокласти
compact compactus компактний
spongy [-spAnd3i] spongious губчастий
red bone marrow ['msersu] medulla ossium rubra червоний кістковий мозок
yellow bone marrow medulla ossium flava жовтий кістковий мозок
diaphysis [dai'aefisis] diaphysis діафіз (тіло кістки)
epiphysis [i'pifisis] epiphysis епіфіз (кінець кістки)
cleft palate palatum bifidum розщеплене піднебіння
osteoporosis [,Dsti9upo: 'rsusis] osteoporosis остеопороз
osteomyelitis [,Dsti3u,maii'laitis] octeomyelitis остеомієліт
rickets ['rikits] rhachitis рахіт
tumor ['tjuims] tumor/-oma пухлина
aging ['еіазіп]   старіння
compound compositus складний
simple simplex простий
greenstick fracture   перелом за типом "зеленої гілки"
impacted [im'psektid] сплющений (перелом)
spiral ['spairsl] скручений/спіральний (перелом)
comminuted ['knminju:tid] осколковий (перелом)
to put in plaster (of Paris) накласти гіпс
to bend згинати
to unbend розгинати
to be knitted зростатися (про зламані кістки)

Exercise 2. Read the texts, try to understand them using the vocabulary; make up a plan of each text.

 

Text A. Bones

Bones are organs with their own system of blood, lymphatic vessels, and nerves. They are composed of bone tissue, called osseous tissue. Bone formation begins during the second and third months of embryonic life. At this time osteoblasts, or bone-building cells, become very active. Osteoblasts manufacture the intracellular material which is located between the cells and contains a protein called collagen.

Osteocytes are mature bone cells that maintain a bone, but they do not produce new bone tissue. Other cells, called osteoclasts, are responsible for the process of resorption, or the breakdown of a bone.

In the skeleton there are more than 200 bones of many different shapes. They may be flat (rib, skull), cube-shaped (wrist, ankle), or irregular (vertebrae).

The typical bones, which make up most of the arms and legs, are described as a long bone. It has a long shaft, called the diaphysis, which has a central marrow cavity and two irregular ends, epiphysys (see Fig. 6-1).

There are two types of bone tissue: compact and spongy. Compact tissue forms the shaft of long bones; it is located outside of other bones. Spongy tissue forms the ends of long bones, it is also located in the center of other bones.

Bones contain two kinds of marrow: red and yellow. Red marrow is found at the end of the long bones and at the center of other bones, which manufactures blood cells. Yellow marrow is found in the central

cavities of the long bones. It is largely fat.

Each bone is covered on the outside by the periosteum with blood and lymph vessels and nerves, and the endosteum, a thinner membrane which covers the marrow cavity of a bone.

 

Text B. Functions of Bones

Bones have a number of functions, many of which are not obvious. Some of these are listed below:

1) to serve as a firm framework for the entire body;

2) to protect such delicate structures as the brain and spinal cord;

3) to serve as levers, which are actuated by the muscles that are attached to them;

4) to serve as a storehouse for calcium, which may be resorbed into the blood if there is
not enough calcium in diet;

5) to produce blood cells (in the red marrow).

 

Text C. Disorders of Bones

We can divide the bones' disorders into some groups: miscellaneous disorders, metabolic disorders, curves of the spine, changes in aging, and fractures.

Cleft palate is deformation of the maxilla. Infants born with this defect have difficultly nursing, because their mouths communicate with the nasal cavities. Surgery is usually performed to correct this defect.

Osteoporosis is a disorder of bone formation, the lack of normal calcium deposits and a decrease in bone protein. The bones become fragile and break easily. Treatment has included administration of calcium daily throughout adult life.

Osteomyelitis is the inflammation of bones caused by pus-producing bacteria.

Tumors may be benign or malignant (osteosarcomas).

Rickets is a rare childhood disease, characterized by numerous bone deformities. The bones become soft and distorted. Deficiency of the active form of vitamin D prevents the absorption of calcium and phosphorus through the intestine.

The age also puts such changes as thinning of the intervertebral disks, the vertebral bodies may lose height, the costal cartilages become calcified and flexible.

The word fracture means "a break or a rupture of a bone". Fractures can be:

- compound, when the broken bone ruptured the skin;

- simple, when the break of a bone doesn't rupture the skin;

- greenstick fracture, when the bone splits in much the same way as a piece of green wood might (it is common for children);

- impacted, when the broken ends of the bone are jammed into each other;

- comminuted, in which there is more than one fracture line with several fragments resulting;

- spiral fracture, in which the bone has been twisted apart. These are relatively common in skiing accidents (Fig. 6-2).

 

Exercise 3. Look at Fig. 6-1 and describe a long bone.

Exercise 4. Explain the difference between the terms in each of the following pairs:

a) osteoblasts and osteoclasts;

b) red marrow and yellow marrow;

c) periosteum and endosteum;

d) compact bone and spongy bone;

e) epiphysis and diaphysis.

 

Exercise 5. Tell your group about five bone disorders.

 

Exercise 6. Name six types of fractures (use Fig. 6-2).

Exercise 7. Read the dialog and act it out. Traumatologist: What's happened? Patient: I fell down and hurt my leg. T: What troubles you now?

P: I feel a severe pain in my right leg and can't walk.

T: Show me your injured leg. Place it on the chair and take off the bandage. Move the joints of your leg.

P: 1 can't. It is painful.

T: Lie down on a coach, please. I'll examine your leg. Does it hurt you when 1 touch here?

P: No, it doesn't.

T: Is it painful at pressing?

P: Yes, it is.

T: Where is the pain more acute, here or there? P: Here.

T: Try to bend and to unbend your leg. Don't move it. Sit down, please. I believe you have a fracture. You need treatment. Do you agree to be hospitalized? P: No, I do not.

T: Then you'll be treated in your polyclinic. First it's necessary to X-ray your leg and give an injection with antitetanic serum. Then your leg will be put in plaster. Stay in your bed for one-two weeks. Then we'll take off the plaster. You'll do easy exercises and massage your leg.

P: Well, doctor, I'll follow your instructions.

T: Besides, I'll prescribe you some medicine and vitamins for the improvement of your general condition. Now the nurse will accompany you to the X-ray room. Then she will call in an ambulance to transport you home without delay.

P: Well, thank you.

Exercise 8. Answer the following questions.

1) What types of bone cells do you know?

2) What kinds of tissue are there in the bones?

3) What covers the bones outside?

4) What is the difference between red and yellow marrow?

5) What is the structure of a long bone?

6) What are the functions of the bones?

7) What bone disorders do you know?

8) What is the fracture and what kind of fractures can you name?

 

II. Grammar Exercises

Exercise 1. Read the words and translate them. Name their parts of speech, pay attention to the suffixes.

a) Fibrous, numerous, continuous, venous, nervous;

b) ordinary, alimentary, primary, secondary, respiratory;

c) subdivision, subacute, subtropical, subcostal, subcutaneous, subclass, subserous.

Exercise 2. Match synonyms from A and B, translate them.

a) To intend (мати намір), force (сила), to come back, faithful (вірний), when, nervous, to occur, to receive, to appoint, grown-up (дорослий);

b) to fix, to happen, strength, to be going to, to return, adult, to get, while, true, excited.

 

Exercise 3. Translate the following sentences.

1. He decided to achieve better results in the second term. 2. In addition to the lecture we must read some articles on this subject. 3. Yesterday he finished his experiment earlier than usual. 4. The doctor fixed the date of the operation for this patient. 5. Their son graduated from the Institute and got an appointment to a village hospital. 6. Last summer we rested longer than usual. 7. The book by Prof. V.V. Kovanov contains much interesting information for medical students.

Exercise 4. Write out sentences with the infinitive from Exercise 3. Name its form and function in the sentence.

Exercise 5. Underline the infinitive, name its form and function in the following sentences.

1. Live not to eat, but eat to live.

2. Treat others as you would like to be treated.

3. What can't be cured must be endured.

4. It is easy to be wise after the event.

5. To know everything is to know nothing.

6. Would you try to bend your hand (leg)?

7. There are many drugs which are used to relieve pain in bones.

8. It is too late to continue studying at the Medical University.

9. These medicines are used to stop severe pain in bones.

Exercise 6. Translate into English:

1. Вам потрібно проконсультуватись у травматолога. 2. Лікар призначив йому полоскати горло щогодини. 3. Лікувати хворих - це завдання кожного лікаря. 4. Основне завдання медсестри - доглядати за своїми пацієнтами. 5. Лікар прийшов у палату, щоб обстежити нового пацієнта. 6. Медсестра не має права помилятися. 7. Вже пізно починати цю роботу сьогодні. 8. Він завжди хотів стати хірургом.

 

III. Independent Work: Traumatological Case Report

Exercise 1. Read the text and translate it.

Traumatological Case Report

A seven-year-old boy was admitted to the emergency department one hour after being struck by a car. There was no history of loss of consciousness. He complained of pain in the left side of the abdomen, in the left flank, and in the left leg. The patient had a pulse rate of 100 beats per minute, a respiratory rate of 25 times per minute and his blood pressure was 120 over 80.

A bruise on the head 2 by 2 centimeters, swellings in the left parietal region were present. Large bruises were found in the left upper and lower abdominal quadrants during observation. Microscopic hematuria was present.

Roentgenography revealed a linear fracture of the left parietal bone. A routine roentgenogram of the abdomen showed a normal condition.

It was something wrong with the spleen, but the operation was not done nor was the test for the hematocrit value repeated. The patient was taken to the operating room and 200 cubic centimeters of blood were found in the abdominal cavity.

A rupture of the spleen was seen in the region predicted by scanning. Splenectomy was performed. No postoperative reactions. The patient was discharged ten days after admission.

Exercise 2. Find terms of Latin or Greek origin, explain their meaning. Write them down in your copy-book.

 

Exercise 3. Ask questions based on the text.

 

UNIT SEVEN

 

I Speaking Joints
II Grammar Objective Infinitive Complex (§97)
III Independent Work Anti-Inflammatory Drugs

 

I. Speaking: Joints

After careful study of this unit you should be able to:

- describe three types of joints;

- describe the structure of a synovial joint and list the types of synovial joints;

- define six types of synovial joints movements;

- describe disorders of joints (four types of arthritis).

Exercise 1. Learn the following words.

amphiarthrosis [,asmfia:'9rausis] напіврухомий суглоб; амфіартроз arthritis [a:'9raitis] артрит

diarthrosis [,daia:'9reusis] (справжній) суглоб; діартроз

synarthrosis [,sina:'9r9usis] синартроз

synovial [sai'nsuvisl] синовіальний

articulation [a:,tikju'leijn] суглоб

cartilaginous [kaiti'bdjinss] хрящовий

bursa ['b3:sa] сумка

bursitis [b3:'saitis] бурсит (запалення синовіальної сумки) ellipsoid [i'lipsoid] еліпсоїд hinge [Ьіпаз] завіса; шарнір trochoid ['trsukoid] трохоїдний

condyloid ['knndi.bid] виростковий (bicondylar) saddle ['sa;dl] сідловидний, сідлоподібний spheroidal [sfiaraidsl] кулястий (суглоб) flexion ['flekfn] згинання extension [iks'tenfn] розгинання abduction [Eeb'dAkJh] відведення, абдукція adduction [е'сІлкГп] приведення, аддукція sprains [sprein] розтягнення зв'язок dislocation [rdislo'keiJh] вивих gout [gaot] подагра angle ['aerjgl] кут

Exercise 2. Read the text and try to understand it without a dictionary (your vocabulary will help you).

 

Joints

 

An articulation, or a joint unites two or more bones together. Joints are divided into three main groups according to the material between the bones. Also they are classified according to the degree of movement permitted:

- fibrous joints are found in the skull, they connect the bones of the skull, they are immovable and called synarthrosis,

- cartilaginous joints are found between the pubic bones of the pelvis, between the vertebrae; they connect the bones by cartilages, they are slightly movable and are called amphiarthrosis;

- synovial joints are placed between the bones, where there is a space betv/een them, called the joint cavity; the cavity is filled with a synovial fluid and the joints can freely move. These joints are called diarthrosis (Table 7-1).

 

Table 7-І. Types of Joints

 

Name Movement Material Between the Bones Examples
Fibrous Immovable (Synarthrosis) No joint cavity; usually fibrous connective tissue between bones Sutures between bones of skull
Cartilaginous Slightly movable (Amphiarthrosis) No joint cavity; usually cartilaginous connective tissue between bones Pubic symphysis; joints between bodies of vertebrae
Synovial Freely movable (Diarthrosis) Joint cavity filled with synovial fluid Gliding, hinge, pivot, condyloid, saddle, ball-and-socket joints

Most joints are synovial. The bones connected by these joints are held together by ligaments. Near some joints there are small sacks called bursae, which are also filled with synovial fluid. Inflammation of a bursa is called bursitis.

Synovial joints may be classified according to the types of movement: spheroidal, trochoid, ellipsoid, bicondylar, hinge and sellar.

The chief function of the freely movable joints is to allow for changes of position and so provide for motion. Here are some examples of movement that changes the angles between bones; for example, flexion is bending the fingers to close the hand, extension is straightening the fingers to open the hand, abduction is moving the arms straight out to the sides, adduction is bringing the arms back to their original position beside the body. There are some other movements of bones: to turn the head, to turn the palm down or backward, to turn the sole inward or outward, etc.

Joints are subject to certain disorders of mechanical nature: dislocations and sprains. But the most common joint disease is arthritis or inflammation of the joints. There are different kinds of arthritis:

-osteoarthritis, which occurs mostly in joints of the hips, knees, and spinal column; degenerative changes include the formation of spurs, thickening of the synovial membrane, atrophy of the cartilage, and calcification of the ligaments;

-rheumatoid arthritis is characterized by swelling of joints of the hands, feet and other parts of the body;

-infectious arthritis can be brought on by such infection as rheumatic fever and gonorrhea;

-gout is a kind of arthritis caused by a disturbance of metabolism. Any joint can be involved, but the one most commonly affected is the big toe.

Exercise 3. a) Give definitions of the terms:

- synarthrosis;

- diarthrosis;

- amphiarthrosis.

b) List three types of joints.

 

Exercise 4. Give English equivalents of the Latin words.

Articulatio, ligamentum, cartilago, dislocatio, arthritis, articulationes synoviales. articulatio ellipsoidea. articulatio sellaris. bursa, bursitis. (Find them in the text.)

Exercise 5. Look at Table 7-1. Make up a dialog with your fellow student about types of joints, their movement, material between the bones and examples where such joints are found.

Exercise 6. Differentiate between the terms in each of the following pairs:

- flexion and extension;

- abduction and adduction.

Exercise 7. Speak about joint disorders according to the plan.

1. Disclocations and sprains.

2. Arthritis:

 

- osteoarthritis;

- rheumatoid arthritis;

- infectious arthritis;

- gout.

Exercise 8. Answer the following questions.

1. How are joints classified?

2. What is the main function of joints?

3. What types of synovial joints do you know? Can you give examples of each?

4. What kinds of movement can you name?

5. Will you describe such joint disorders as osteoarthritis? rheumatoid arthritis? infectious arthritis? gout?

 

II. Grammar Exercises

Exercise 1. Form and translate new words using the given suffixes. -ion/-ation, -sion, -tion: fix, prepare, decide, add, inform, infect, protect -ment: require, achieve, treat, appoint, excite -(i)ty: responsible, human, special, possible -(i)ly: day, successful, necessary, clear, deep, main -y: word, sleep, health, air, ease

Exercise 2. Turn the following sentences into negative.

1. My friend left the town for his summer holidays.

2. They are resting now.

3.1 returned to the hostel at 2 p.m. 4. He feels tired after his classes.

Exercise 3. Complete the sentences using the Objective Infinitive Complex.

як ви розмовляєте англійською. 1.1 have як він робить ін'єкції, never як цей хворий кашляє, heard щоб цей хворий скаржився.

щоб хворий переніс операцію добре.

2. I'd like щоб вони підтвердили наш діагноз.

щоб медсестра зміряла температуру, щоб хірург допоміг зробити перев'язку.

Exercise 4. Put special questions to the following sentences using the given interrogative words.

1. My fellow student got a good mark in English. (What)

2. Modern methods of treatment help doctors to treat people successfully. (How)

3. The surgeon was working at the clinic from 9 a.m. till 2 p.m. (Where)







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