UNIT 1 MEDICINE, A GENERAL SURVEY

A. WORD STUDY SECTION

Consult your teacher or a dictionary if you don’t know the meaning or the pronunciation of the following words.

A.1 illness A.2 heal (verb) life (n) = existencedisease healing (noun) live (vb)sickness health death (n) = end of lifewound healthy (adj) die (vb)injury surgery relief (n) = alleviationbody surgeon (n) relieve (vb)become ill surgicalget well doctor

physicianmedicM.DG.P

A.3 mind = the quality which gives the ability to think or feel.

breakthrough = an important discovery or advancement.

A.4 Guess the meaning of the underlined words with the help of the context.

1. He is feeling rather weak because he has had a long illness and is not quite well yet.

2. He had a high fever when his wound festered, but the surgeon cut, cleaned, and applied antibiotics causing the wound to heal quickly.

3. The surgeon made the incision with a very sharp scalpel. Then he mopped up the blood with pads, which are generally made of cotton covered with gauze. Subsequently, he continued cutting the different layers of fat and connective tissue. The O.R. sister handed him clamps and tweezers which cut off the blood flow coming out from veins and arteries.

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Exercises Fill in the blanks in the sentences below with words from the above lists.

1 Dr. White works in a hospital, he performs operations because he is a …………., he is a specialist in heart operations or heart diseases.

2 ………….. attacks all kinds of people and new drugs and serums are constantly being used to combat ………….

3 The dictum “mens sana in corpore sano” states that a ………….. mind is often in a ……………. body.

4 After an accident …………. sometimes get infected; so doctors apply disinfectants and antibiotics to induce ………….

5 Penicillin was …………. an impressive discovery or ………….. . Many people nowadays are …………… instead of sick thanks to this wonderful drug.

B. READING PASSAGE : MEDICINE, A GENERAL SURVEY

From his earliest days man has been afflicted by injuries and disease. It may be interesting to see how thousands of years ago men began to look for relief from pain and to discover remedies for disease.

The methods that are used to treat disease seem, at first sight, numerous and dissimilar; however, they are simply variations of three basic measures, namely: faith healing, hygienic therapy and drug cures – which may or may not be accompanied with surgical methods.

In the first of these measures, faith healing, an attempt is made to remove morbid states by means of influences exerted upon the mind. Primitive peoples and mediaeval civilizations practised faith healing when they exorcised the devils that, according to them, caused disease. The same principle prevails today in some forms of religious healing and also in some psychiatric techniques.

The second means of treatment, hygienic therapy, is based on the fact that the body tends to cure itself and that people recover from disease. The measures of the treatment are thus designed to provide the conditions under which patients get well, to help the body to cure itself and to minimise the effects of disease. Such treatment includes rest, fresh air, and a balanced diet.

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The use of drugs is the third means of treatment. As medicaments, drugs are used for several purposes – e.g. they are given either as an antidote against ,or a specific for, a disease or to combat the symptoms of an illness. Moreover, they are often utilised to stimulate sluggish bodily functions.

When we follow the development of medicine down through the ages, we find that primitive civilizations believed that disease was closely associated with religion. It was Hippocrates, the greatest of all physicians, who in the 5th century B.C. separates medicine from religion giving medicine the general form it has today. He postulated the basic principles upon which modern medicine is based. These principles are summed up as follows:

(1) There is no authority except facts.(2) Facts are obtained by accurate observations(3) Deductions must be made only from facts.

It seems incredible nowadays that these clear scientific principles should not have been further developed over the several centuries subsequent to Hippocrates’s death. In fact, almost sixteen centuries elapsed until Vesalius re-established them for his careful study of human anatomy. Vesalius’s work was the starting point for the accurate study of bodily functions; later on, Harvey offered an explanation of bodily processes in physical terms thus initiating the modern science of physiology. Another important breakthrough in the development of modern medicine is the germ theory of disease put forward by both Pasteur and Koch. Their scientific demonstration that a microscopic living agent was responsible for a specific disease helped Lister to draw an analogy with the infection of wounds after amputation or surgery, and to arrive at the conclusion that such infection was due to microbes from the air. Pursuing this hypothesis Lister originated the era of antiseptic surgery.

Sanitation, immunology, preventive medicine, and modern operatory techniques are today giving the world the healthiest period it has known, but what has already been accomplished in scientific medicine is small in comparison with future possibilities of eradicating disease, alleviating suffering, and prolonging human life for useful and productive work.

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C COMPREHENSION SECTION

According to what you have read in this Unit, say whether the statements below are true (T) or false (F).

1. There are many methods for treatingdisease and they are all different T F

2. When an organ, or a system, is workingslowly drugs can activate it. T F

3. Hippocrates is regarded as the fatherof medicine because he perfected themethods used by religious medicine. T F

4. A valid way of obtaining evidence isby patient and accurate observation. T F

5. Pasteur said that people recover fromdisease because the body normallytends to cure itself. T F

6. Lister postulated that microbesinfecting wounds after surgery camefrom the air T F

D STRUCTURE STUDY SECTION

D.1 MODIFYING CONNECTIVES Your teacher will explain them to you and will help you to locate examples in the Reading Passage.

D.2 The action described in the two last paragraphs relates to the

(a) Present(b) Past(c) Future(d) Past and Present

Give reasons for your choice.

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UNIT 2 DIAGNOSING DISEASE

C. WORD STUDY SECTION

Consult your teacher or a dictionary if you don’t know the meaning or the pronunciation of the following words.

A.1 pain A.2 weak (adj) A.3 skill = technicalmalaise weakness (n) ability orchills weaken (vb) knowledgetests rest (n) accurate = precisecounts restless (adj) finddistress restlessness (n) undergo = experiencepallor sweat degree = extentstroke swell dyspnoea = shortness ofbout swelling breathseizure

A.4 Guess the meaning of the underlined words with the help of the context.

4. Catabolism is the process by which living tissue breaks down into simpler and more stable substances.

5. Many antibiotics inhibit protein synthesis and have now been shown to disrupt a variety of different steps in the synthetic process.

6. The X-ray examination disclosed pulmonary oedema..

PAIN , ACHE, SORE

(i) The word pain, the commonest symptom of disease, usually occurs with the following adjectives.

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DullSharpMildIll-definedPhantom-limbUnbearablePiercingShootingLancinating PAINGrippingBurningTinglingNumbingNaggingAchingOverwhelmingWandering

(ii) The word ache denotes a continuous, localised pain such as

Stomach ache Tooth .............. Ear ...............Back ............ Head ...............

(iii) The word sore means painful or tender to the touch as an inflamed or injured part of the body, e.g.

Sore throat ............... knee ............... lipSore mouth ............... tongue ............... feet

............... eyes

Exercises Find the symptoms or sign to which the following definitions correspond

6 A rise of body temperature above the normal = .........................

7 Constant, generalized, indefinite pain = .........................8 A usually dull, continuous pain = .........................9 Lack of strength to make normal effort =

.........................10 Temperature falls below normal =

.........................11 Respiratory difficulty =

.........................

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12 An abnormal bodily protuberance or localisedenlargement = .........................

8. Deficiency of colour especially of the face = .........................

D. READING PASSAGE : DIAGNOSING DISEASE

A doctor examining a patient suffering from some form of disease has to formulate a tentative hypothesis relating to the malfunctioning of an organ or system. Upon formulating his hypothesis, the doctor is helped to verify its validity by means of symptoms and signs.

Symptoms are subjective responses of a patient to either a known or an unknown agent, whereas signs relate to objective manifestations of a condition. Some symptoms that are commonly expressed are : pain – both dull and sharp – weakness, malaise, chilling, fever, vomiting and many others. Signs often detected are : pallor, sweating, swelling, restlessness, shortness of breath, etc. These two important manifestations of disease, i.e. signs and symptoms, are not, however, mutually exclusive, thus we sometimes find a symptom which is also a sign of illness such as fever, nervousness and dyspnoea.

There are also other very useful devices which help the doctor to find signs of disease, they may have the form of simple or complex laboratory tests determining the exact degree of progress of a disease. Although practically all doctors nowadays widely use such laboratory tests, we must not forget that there are always imponderable factor which make diagnosis only a hypothetical tentative procedure. Amongst the most frequently used laboratory tests we find the following: X-rays, blood counts and microbiological tests.

Doctors are often faced with patients who are in great pain or distress because they are suffering from an acute form of a disaster. This is so in the case of renal or hepatic colic, a bout of pancreatitis, a heart stroke, a nervous seizure and many others. These acute crises require great skill and experience in diagnosing as the patient may be unable to describe his symptoms or co-operate in any way. Fortunately, these severe attacks, or crises, present a much clearer clinical picture to the experienced doctor as the disease signs are so clearly manifest.

At any rate, it is important to form a quick and accurate diagnosis in acute cases because patients very often have to be operated on or have to undergo special treatment without delay, in this way patients are promptly relieved from pain. Furthermore, in acute crises there is seldom any

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possibility of calling other doctors in for consultation so a patient’s life may depend almost entirely upon the doctor’s skill and experience

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C COMPREHENSION SECTION

C.1. Read the following statements and write whether they are true (T) or false (F)

1. Malaise and weakness are subjective manifestations T Fof disease so doctors refer to them a signs

2. Laboratory tests are useful to determine the stateor development of a disease with great accuracy. T F

3. Acute crises are very difficult to diagnose becausethe patient cannot explain his symptoms. T F

4. If severe attacks are controlled quickly the patientscan promptly be relieved from pain. T F

5. Since fever can be detected objectively, e.g. by usinga thermometer and also subjectively because the T Fpatient feels hot fever is a sign of disease.

C.2. 1. Examine paragraph 2

The main idea in this paragraph is the concept of signs and symptoms.

a) How are the concepts made clear to the reader?b) What important modification does this idea undergo?

2. Examine paragraph 3a) What is the main idea of this paragraph?b) There is a restriction to this idea. Can you identify it?

3. Examine paragraph 4a) Underline the main idea.b) What contradictory modification to the main idea is found in this paragraph?

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D STRUCTURE STUDY SECTION

D.1. -ING Form(a) Notice the following sentences:

1. “A doctor examining a patient has to formulate a hypothesis”

2. “Upon formulating the hypothesis the doctor is helped to verify it”

Note: This structure has several functions. For fuller explanations See Appendix “-ING Form”

D.2. MODIFYING CONNECTIVESTranslate and say to which group the modifying connectives

appearing in this unit belong

however = .............................................. ( ................ )whereas = .............................................. ( Contrast )thus = .............................................. ( Result )as = .............................................. ( ................ )also = .............................................. ( ................ )

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UNIT 3 THE HUMAN BODY

WORD STUDY SECTION

Consult your teacher or a dictionary if you don’t know the meaning or the pronunciation of the following words.

A.1 head trunk limb(s) skeletonbrain chest shoulder spineface breast(s) arm(s) girdle(s)eye(s) heart elbow(s) joint(s)nose lung(s) wrist(s)ear(s) liver hand(s)mouth gallbladder leg(s)neck spleen

kidney(s)bowelsbladdergland(s)

Exercises

A.1. Label (Complete) these diagrams. Consult your teacher if necessary.

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A.2. Provide synonyms of equivalent words for the following

umbilicus = navelthorax = ..............................intestines = ..............................spine = ..............................mammary glands = ..............................upper limb = ..............................body frame support = ..............................hormone secreting

organs = ..............................blood oxygenating

organs = ..............................digestive organs = ..............................food duct = ..............................air duct = ..............................

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A.3. Guess the meaning of the underlined words using the clues provided by the context.

1. The instep is the upper part of the arch of the foot between the ankle and the toes. The instep is normally curved whereas the foot sole is practically flat.

2. The blow caused a small hemorrage in a nose vein. You could see a trickle of blood dripping from the boy’s nose.

3. The skin of a young person is elastic and smooth. Older people`s skin gets wrinkled and creased as the tissues gradually begin to sag.

E. READING PASSAGE : THE HUMAN BODY

The above picture represents a normal healthy adult. Clearly distinguishable are the head, trunk and limbs.

In the head, inside the skull, we find the brain. On the face, we find the main sense organs, namely the eyes, the mouth and the ears on both sides.

The neck connects the head with the trunk. Inside the front part of the neck lie the thyroid and parathyroid glands, behind them are the ducts for food and air, the oesophagus and the trachea respectively.

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The trunk is divided by the diaphragm into two cavities. Inside the upper cavity, the thorax (usually called the chest), lie the heart which pumps blood, and the lungs oxygenating the bloodstream. Females have developed mammary glands or breasts on the chest. In the lowest part of the trunk, or abdomen, are the rest of the viscera. Directly or indirectly related to digestion are the stomach, the bowels (also called intestines), the pancreas, the liver and the gallbladder. The kidneys and the bladder make up the excretory apparatus, whereas the adrenals, the ovaries and the testes secrete hormones. The spleen, on the left upper side of the abdomen has an important function in blood corpuscle destruction.

The upper limbs growing out of the scapular girdle, are the arms which are articulated at the shoulders, elbows and wrists. These limbs end at the hands probably the most useful and versatile implements. The lower limbs, or legs, starting at the hip girdle, can bend at the knees as well as at the ankle.

Supporting the human body we find the skeleton, the joints and the muscles. The most important part here is the spine, or backbone, which not only joins the different parts of the skeleton but also shelters the spinal cord.

F. COMPREHENSION SECTION

C.1. In this unit the ideas are developed througha) descriptionsb) examplesc) precise definitionsd) a and b

C.2 Decide which of the following statements are true and which are false. Make the necessary alterations to make the false statements true.1) The upper limbs extend out of the hip girdle.2) In the larynx, the function of the epiglottis is very important

because the air duct is placed directly behind the oesophagus.3) The organ responsible for cell production is the spleen.4) The spinal cord is sheltered inside the backbone while the skull

protects the brain.5) The limbs can bend at the joints, i.e., at the knees and elbows.6) All the sense organs are placed on the outside of the head.

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STRUCTURE STUDY SECTION

Prepositions. (Location)

It is essential that you study prepositions now. Your teacher will help you, yet you should consult the appendix for further explanations and exercise

Adjectives (Different Position in English and Spanish)

a) Notice the following groups of words:

“normal healthy adult”“Excretory apparatus”“scapular girdle”

b) Translate these groups

G. GENERAL ACTIVITIES SECTION

1. Use the diagram to draw the following organs or structures.

kidney – heart – lungs – liver – spleenbrain – ovaries – gallbladder – hip girdle

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2. What is the name of the organs or structures founda) Inside the front part of the neck = ...........................b) On the left upper side of the abdomen = ...........................c) At the end of the upper limbs = ...........................d) Inside the chest behind the heart = ...........................e) Inside the skull = ...........................f) Behind the thyroid and = ...........................

parathyroid glands.

3. Where are the following organs or structure located?a) The ears = .......................................................b) The liver = .......................................................c) The feet = .......................................................d) The tongue = .......................................................e) The oesophagus = .......................................................

4. Follow these structuresa) Draw an about 5 cm diameter circle.b) Draw a about 1 cm long vertical line in the centre of the circle.c) Draw a short horizontal line perpendicular to the vertical line

about 1 cm below that line.d) Draw two small circles touching the big circle but on the

outside, one on the right side and one on the left side at the same height as the vertical line at the centre of the figure.

e) Draw two very small circles about 1 cm above the vertical line so that the vertical line lies between the circles.

f) What have you drawn?g) Label your diagram with your teacher’s help

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UNIT 4 THE SKELETAL SYSTEM

A. WORD STUDY SECTION

Notice the following words. Do you know their meaning and pronunciation? If not, consult your teacher or a dictionary.Make sure that you understand the definitions given in A.3.

A.1 bone sling A.2 break (n. vb.)spine plaster cast crack (n.vb.)girdle crutches splinter (n.vb.)sinew wheelchair sprain (n.vb.)bone marrow stretcher strain (n.vb.)skeleton cripple (n. vb.)

join (vb)joint (n)junction (n)

A.3. Definitionsa) girdle = the internal skeleton to which the limbs are

attached consisting of a U-shaped bony structure.b) axial skeleton = the skeleton of the head and trunk.

ExercisesFill in the blanks with appropriate words from the word study section

1. __________ are articulations between bones.2. Red cells are manufactured by the __________3. The __________ are the point of junction of the extremities.4. Our bony structure or __________ gives shape and support to our

body.5. A __________ is a common bandage to support a broken arm,

whereas __________ are used to immobilize any structure.6. In case of fractures, the physician generally applies __________7. The skeleton is made up of __________ , ligaments,

__________ , and articulations.8. A __________ ankle causes severe pain because the ligaments

are usually injured.9. Crippled patients generally need __________ or __________ to

move about.

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10.Muscles are made of soft tissue while __________ are made of hard tissue.

A.4. Guess the meaning of the underlined words using the clues provided by the context.

1. Fingers are highly movable structures which can perform the most delicate and skilled jobs. Part of their mobility is due to the joints between the phalanxes i.e. the knuckles.

2. After the operation, the orthopaedist recommended a special shoe with a slightly higher heel to make his limp less noticeable.

3. The most distinctive clinical feature or rheumatoid arthritis is pain and stiffness of the joints.

4. Beneath the skin, in areas subject to pressure, small discrete lumps or nodules develop in rheumatic fever.

Exercise

Label this diagram as fully as you can

B. READING PASSAGE : THE SKELETAL SYSTEM

The skeleton fulfils a threefold function: (1) it protects the delicate underlying organs; (2) it gives support and shape to the body; and most

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important of all, (3) it allows man to rise off the ground and move about. The skeleton is made up of bones which are hard and durable structures

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that maintain the soft tissues, or flesh, attached against the pull of gravity and not as a firm base for the attachment of muscles. In addition, ligaments and sinews (or tendons), which are specialized types of connective tissue fibres, bind bones to bones and muscles to bone respectively, controlling movements and thereby playing an important role in locomotion. Furthermore, the marrow tissue within the bone cavities performs the special task of producing all red corpuscles as well as some kind of white ones.

The vertebrate skeleton may be divided into (a) the axial skeleton, comprising the skull (or cranium), the backbone or spine (made up of the vertebrae), the ribs, and the breastbone (or sternum), and (b) the appendicular skeleton, made up of the limb bones and the girdles attaching them to the rest of the body.

Man’s appendages are comparatively primitive terminating in five digits (fingers of the hand and toes of the foot), the thumb being the most functional.

The femur (or (thighbone) is the largest, longest, and heaviest bone in the human skeleton; whilst the ossicles in the tympanic cavity of the ear are the smallest of all bones.

Apart from the items mentioned above, joints make up a very important part of the skeletal system since they are the point of junction between two bones. Some of them are non-mobile; others possess moderate freedom of motion, e.g. the hinge joint at the knee or the pivot joint at the wrists and ankles; and, lastly, others having the form of ball-and-socket permit free movement in several directions, e.g. the hip joint or the shoulder joint. The bearing surfaces of joints are enclosed in liquid-tight capsules made of ligaments and lubricated by synovial fluid secreted by the membrane lining the cavity. In youth this fluid is replaced as needed, whereas in old age the supply often diminishes leading to a gradual stiffness of joints. That is why older people sometimes need a walking stick and even wheelchairs in extreme cases.

As man walks upright on the soles of the feet, his locomotion is comparatively slow. Speed is increased in other animals by the lengthening of limbs, the raising of wrists and ankles from the ground, and by running on one or two digits or on their tips.

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As a result of accidents or falls bones may fracture causing breaks or cracks. On the other hand, slipping or wrongly applied forces usually result in sprained joints. Sprains, strains, and fractures cause severe pain and swelling, requiring bandages, adequate supporting slings, splints, -in serious cases- plaster casts.

C COMPREHENSION SECTION

C.1. 1. In this selection ideas are presenteda) from the particular to the generalb) from the general to the particularc) from a general concept to applications

2. One might say that one of the paragraphs is a digression i.e. it is rather irrelevant and could be omitted.Identify this paragraph.

3. Several parentheses have been used in this text.What function do they fulfil in each case?

4. What is the effect produced by a text where parentheses have been used too often?

5. What devices can be used to avoid this effect?6. In line ____ what does the word “ones” stand for?7. Find the antecedent to the expression “some of them in line ____.

C.2. Decide which of the following statements are true and which are false.

Make the necessary alterations so that the false statements become true.

1. Articulations and joints are necessary for walkingand types of motion because they are all movable. T F

2. Tendons and ligaments are essential to bind musclesto bones. T F

3. Old people suffer from stiffness because synovialfluid escapes when the air-tight capsules open. T F

4. The thumb is the most primitive of man’sappendages. T F

5. Apart from the lymph system, some white cells aremanufactured by the bone marrow. T F

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D STRUCTURE STUDY SECTION

D.1. -ING Form (Nouns)Translate the underlined words:1. He sprained his ankle and now he has a painful swelling in that

area.2. There is a special warning at the entrance of the X-rays room.3. The lengthening of an illness usually leads to the chronic state.3. A burning feeling is a symptom of fever.

D.2. MODIFYING CONNECTIVES

01.“in addition” in line ....................

02.“furthermore” in line ...... ..............03.“apart from” in line ...... ..............04. “since” in line ...... ..............05. “finally” in line ...... ..............

The function 06. “whereas” in line ...... ..............

of the 07. “that is why” in line ...... ..............expression 08. “as” in line ...... ..............

09. “as a result of” in line ...... ..............10. “on the other in line ...... .............. hand”11. “or” in line ...... ..............12. “and” in line ...... ..............

D.3. Adjectives (Comparison)

a) Notice the following word groups:“The thumb being the most functional” (l ......)“The longest bone” (l ......)“Older people” (l ......)

b) Consult appendix “Comparison of Adjectives” for further explanations and exercises.

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UNIT 5 THE MUSCULAR SYSTEM

C. WORD STUDY SECTION

Consult your teacher or a dictionary if you want to know the meaning or the pronunciation of the following words

A.1 muscle smooth A.2 pull (n. vb.)fibre hollow push (n. vb.)

thread strong shiver (n.vb.)cramps weak link (n.vb.)bend loss (n.)sever lose (vb.)lie lose = perder (*)lay loose = suelto (adj) (*)

(*) Notice the difference between these two words, which are often confused.

A.3. Read these definitions carefully

Clonus = A series of muscular contractions in which the individual contractions are visible.Tone = The condition of elasticity or tension proper to the living tissues of the animal body, specially muscles.

A.4. Guess the meaning of the underlined words-Use all contextual clues.

1. Sunburnt is an inflammation marked by wide-spread skin tenderness which causes pain and discomfort.

2. In Parkinson’s disease patients have speech difficulties, constant involuntary tremor and sometimes they cannot even use their hands. Furthermore, when an extremity is moved passively, it responds with a series of jerks as the patient has no control over the small muscles.

3. After the stroke he dragged his left leg, making it impossible for him to walk normally. This stroke sequel, called hemiplegic gait is not an irreversible condition.

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4. Epileptic convulsions are characterized by loss of consciousness and falling and also by tonic and clonic twitching of the muscles of the extremities, trunk, and head. They are followed by deep sleep, headache, and muscle soreness due to violent contraction.

5. As he has lost his glasses he has to strain his eye muscles to read the instructions, because he is short-sighted.

ExercisesFill in the blanks with appropriate words from the word study section

13. M......... f......... have the ability of exerting a pull.14. The combined contractions of antagonist muscles b......... the

joints to produce movement.15. The function of the sh......... is to restore heat at skin level.16. In cases of shock, the patient should l......... flat; in fact such

patients are immediately l......... down to facilitate venous return to the heart.17. It is very difficult to repair or sew s......... tendons and nerves.18. The sharp, sudden pains in the muscles occurring after

overworking or overstraining are called c.........19. Only a filament, i.e. a th......... of actomyosin is used to

demonstrate muscle contraction in vitro.

ExerciseTranslate the following word family.Ask your teacher to help you if necessary.

able = .............................................unable = .............................................ability = .............................................disability = .............................................disabled = .............................................disabling = .............................................disable (vb.) = .............................................enable = .............................................

Affixes

(a) Some abstract nouns are formed by adding the suffix –ness to adjectives.e.g. consciousness = the state of being conscious.weakness = the state of being weak

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(b) A number of verbs can be formed by adding the suffix –en to adjectives.e.g. weaken = to make or become weakshorten = to make or become shortstraighten = to make or become straight

Exercise1. Complete the table below with the corresponding nouns and verbs.

ADJECTIVES VERBS NOUN(1) NOUN(2)ADJ + NESS VERB + ING

sick sicken sickness - - - - - - -less lessen - - - - - - - lesseningloose ? ? ?tight ? ? ?soft ? ? ?stiff ? ? ?thick ? ? ?sweet ? ? ?sad ? ? - - - - - - -mad ? ? ?black ? ? ?red ? ? ?

2. Translate the nouns in (1) and (2).Notice that their meanings are different.The nouns in (1) name a state while these in (2) name a process.

3. Fill in the blanks with words from the table

a) Contraction sh............ the muscles; in this way, for example the triceps st.......... the forearm.

b) If one t.......... a bandage too much circulation may be impaired in the injured area, hence you should l.......... the bandage when it is too t...........

c) An infected area, may show a diffuse circular r..........; when pus has formed the area s.......... , later it opens up – or must be opened surgically – letting out the pus. As the wound starts to heal the cells of the epidermis th.......... to form a scab.

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D. READING PASSAGE : THE MUSCULAR SYSTEM

Our ability to move depends upon a group of specialized contractile cells, the muscle fibres, which make up almost half of our mass.

Skeletal, cardiac, and smooth muscles have the ability to shorten when stimulation reaches the muscle fibres. However, the latter continue contracting even when nervous stimulation is severed or blocked, thus enabling the heart to beat and move material through the internal hollow viscera.

Muscles never contract singly but in groups. Furthermore, they can only exert a pull, not a push. Hence, muscles are usually paired as antagonists, i.e. one pulling a bone one way and the other pulling it in the opposite way. Thus, the biceps bends the arm at the elbow, whilst the triceps straightens the forearm. When muscles are not contracting to produce movement, they are not completely relaxed since as long as a person is conscious and even when he is lying, all the muscles are slightly contracted – a phenomenon called tone.

Posture is maintained by the partial shortening of the muscles of the back and neck and the flexors and extensors of the legs. When movement is added to posture, as in walking, a complex coordination of contraction and relaxation is required. Thus it should no be surprising that the process of learning to walk should be long and difficult.

Some of the larger muscles of our body are extremely strong. Moreover, they can be strengthened by means of physical exercises, e.g. when they have been damaged or weakened by disabling diseases.

If muscles have been contracting for too long, fatigue supervenes – primarily induced by an accumulation of lactic acid. The point of fatigue lies in the junction between the nerve and the muscle, where nerve impulses instigate muscle contraction. None the less, muscles do not lose their ability to contract suddenly; rather, their relaxation become slower and more laboured, and when fully fatigued they can no longer relax but remain contracted – this condition being commonly known as cramps. After death muscles lose their power to relax as well and go into a state of contraction called rigor mortis.

Although several hypotheses have been put forward to explain muscle contraction, the actual physical and chemical phenomena are still a matter of conjecture. Through chemical analyses it has been discovered that the actual

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contractile part of a muscle fibre is a protein chain which shortens by the folding of the links or by an expulsion of water from within the interstices of the protein molecule. Two proteins have been found to be involved in this process, namely myosin and actin, neither of which is capable of contracting alone. A thread of actomyosin with the addition of potassium and adenosine triphosphate undergoes contraction in vitro. This fact is one of the most exciting discoveries that has been carried out in biochemistry. It was made by Albert Szent-Gyorgyi using a test tube.

C COMPREHENSION SECTION

C.1. Contextual references

1. Find the words to which the expression “the latter” in line ........ refers.2. In line ......... , what does the expression “the other” refer to?3. In line ......... , what does the word “which” refer to?

4. An important biochemist is mentioned in the reading passage, find and quote the text, line and page where information about Hippocrates is given.

5. Paragraphs are usually written around one principal idea or concept. Some of the ideas in this reading passage are how muscles make movements possible and how muscles contract. Identify the principal ideas in the passage and make a simple outline.

C.2. True – False ExercisesDecide which of the following statements are true and which are false.Underline the part of the sentence or the particular word(s) that make the statement false.

1. About 50% of the body tissues are made up T Fof muscle fibres.2. Even if we pull the triceps slightly the T Fforearm bends

3 When a person is not making any kind T Fof movement his muscles are totallyrelaxed.

4. Experimentally, it has been shown that the part T FThat contracts in muscle fibre is a protein chain

5. If we add potassium salt to myosin in a test T FTube it undergoes contraction.

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D STRUCTURE STUDY SECTION

D.1. The Present Perfect Passive

Notice these structures:

“When they have been damaged or weakened by disabling diseases”“Although several hypotheses have been put forward”

These structures correspond to the Present Perfect Passive tense which is used to provide information in an impersonal way about what has happened in the past and which is relevant now, i.e. , in the present.

Exercises

a) Find and underline two more examples in the reading passage.b) Translate the underlined examples into Spanish.c) For more exercises and explanations consult appendix.

D.1. Modifying Connectives

a) Underline the modifying connectives appearing between lines ...... and .......b) Provide acceptable equivalent forms for the underlined connectives.

Consult appendix if necessary.

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UNIT 6 THE HOSPITAL

E. WORD STUDY SECTION

If you don’t know the meaning or the pronunciation of the following words get your teacher to help you or consult a dictionary.

A.1 matron A.2 nurse (vb.) succeed (vb.)midwife nurse (n) success (n)clinics do research successful (adj.)records research (n) unsuccessful (adj.)history researcher (n) available (adj.)case report search (vb.) unavailable (adj.)outpatient intern (n) availability (n)in-patient internshipmaintenancetrain

N.B. Nursing (n) occupation of a nurse

(a) Exercise

1. Every year, hospitals offer on-the-job courses to ............ new nursing staff.

2. A ............ is the head of the nursing staff, whilst a .......... assists women at labour

3. Ambulatory and chronic patients consult doctors at the ............ departments. Some outlying sectors of cities also have peripheral ............ for these people. However, since delicate equipment is not ............ elsewhere a few of these outpatients have to go to the hospital for radiographs or laboratory tests.

4. Statisticians keep and interpret ............ about admissions, discharges, births and deaths.

5. Architects, engineers and health workers cooperate in designing the most functional layout for ............

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(b) The following activities and actions are normally associated with the professions and occupations below.

advises pregnant womenassists women in labourdelivers babies

A midwife extracts the placentacleans and weighs the babiesprovides post-puerperal advice

washes patientsdresses wounds

A nurse changes dressingsAdministers medicines (pills, drops,

lozenges, etc.)

makes the roundssupervises his wardsexamines patients

A house physician (U.K.) prescribes medicationAn intern (U.S.A.) keeps

makes entries in case historiesgoes over

(c) Affixes

Notice the names of these specialists or instruments:

Researcher – resuscitator – psychiatrist – obstetrician

F. READING PASSAGE : THE HOSPITAL

The hospital is both the building and the institution where sick people are cared for; therefore its work is mainly curative. In addition, hospital work is extended preventively beyond its walls as medical supervision of people living in the district served by the hospital.

A general hospital is divided into four basic sections, namely; Internal Medicine, Surgery, Paediatrics, and Maternity.

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Internal Medicine assists patients with respiratory, cardiovascular, renal, gastrointestinal, and endocrine disorders-Those who cannot be relieved or healed through drug treatments, owing to the advanced or dangerous states of their conditions, are then sent to Surgery. In fact, several operating rooms are found in large hospitals, equipped with the most up-to-date devices and installations requiring highly-trained personnel both to perform and to assist with operations. Children are, of course, referred to Paediatrics and women about to give birth, or in labour, to the Maternity Ward.

District hospitals have emergency or First Aid wards as well, where urgent cases are assisted as efficiently and quickly as possible. Apart from the above-mentioned sections we also find a blood bank, a pharmacy and a central laboratory.

The most complex and highly-sophisticated unit, however, is the Coronary Care Unit (C.C.U.), supplied with elaborately-designed pieces of apparatus to monitor patients second after second. The Intensive Care Unit (I.C.U.), on the other hand, is in charge of the surveillance of recently-operated patients to avoid post-operatory complications or relapses.

The staff of a hospital is headed by a Director, then come the Heads of Section or Department, and the Matron-in-charge of the nursing personnel. Apart from dozens of specialists in each field, there are laboratory technicians, nutritionists, and social assistants. In addition, a teaching hospital has interns and medical students practising or studying there.

Furthermore, teaching hospitals are ideal places for research, thanks to their laboratory facilities, trained personnel, large numbers of patients, and the accumulation of records; so hospitals in general offer excellent opportunities for investigation that are not available elsewhere. Thus, research carried out in hospitals has indeed been a decisive factor in the successful and rapid development of medicine in the last twenty years.

Apart from the sections and units mentioned above, hospitals are also supplied with large kitchens, laundry, and a maintenance workshop in charge of keeping up the central heating system, water and gas piping and electrical wiring and appliances.

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Finally, a parent hospital is a health advising and coordinating centre linking outpatient departments, peripheral clinics, smaller hospitals and community health organizations. In this manner fruitful, coordinated work results in the benefit of the population as a whole.

C COMPREHENSION SECTION

1. What very general ideas about the hospital have been presented in this unit?

2. Asepsia is most important in hospital.Find and quote the reading passage, paragraph and line where information about Lister is given.

3. Find and quote the reading passage, paragraph and line where patients who should be referred to the Emergency Ward are mentioned.

D STRUCTURE STUDY SECTION

D.1. Adjective SubstitutesNotice the following word groups: equipped room

trained personneloperated patient

Exercise: Find suitable adjectives in column A for the nouns in column B

A B

1. Sophisticated .......... personnel2. Controlled .......... device3. Highly-trained .......... dosage4. Fully-endowed .......... treatment5. Strictly-checked .......... program6. Recently-devised .......... organism7. Elaborately-planned .......... techniques

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