Unit 1

Pre-text assignments1 Learn the key words: ligament, cartilage, joint, framework, tendon, bone, lever, limb

2 Translate the following phrases: a set of interrelated organs, specialized functions, protective shields, rigid structures, longitudinal axes, expanded ends, platelike structures

3 Choose the correct definition of the following terms:1) bone a) an aggregate of cells together with their intercellular substance2) limb b) the point of contact between elements of the skeleton3) tissue c) the hard largely calcareous tissue4) joint d) a leg or arm of a human being

Skeletal System

The human organism consists of several organ systems. Each system includes a set of interrelated organs that work together to provide specialized functions. The organs of the skeletal and muscular systems function to support and move body parts. The skeletal system consists of the bones as well as the ligaments and cartilages that bind the bones together at joints. These parts provide frameworks and protective shields for softer tissues, serve as attachments for muscles, and act together with muscles when body parts move. Tissues within bones also function to produce blood cells and store inorganic salts.

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Bones Bones are composed of several kinds of tissues, and thus they are the organs of the skeletal system. Because bones are rigid structures, they provide support and protection for softer tissues, and they act together with skeletal muscles to make body movements possible. They also house the tissue that produces blood cells, and they store inorganic salts. The shapes of individual bones are closely related to their functions. Projections provide places for the attachment of muscles, tendons, and ligaments; openings serve as passageways for blood vessels and nerves; and the ends of bones are modified to form joints with other bones. Bones can be classified according to their shapes - long, short, flat, or irregular. Long bones have long longitudinal axes and expanded ends. Examples are the arm and leg bones. Short bones are somewhat cube like, with their lengths and widths roughly equal. The bones of the wrists and ankles are examples of this type.Flat bones are platelike structures with broad surfaces, such as the ribs, scapulae, and bones of the skull. Irregular bones have a variety of shapes and are usually connected to several other bones. Irregular bones include the vertebrae that comprise the backbone and many of the facial bones. In addition to these four groups of bones, some authorities recognize a fifth group called the round or sesamoid bones. The bones of this group are usually small, and they often occur within tendons adjacent to joints, where the tendons undergo compression. The kneecap (patella) is an example of a very large sesamoid bone.Functions of Bones Skeletal parts provide shape, support, and protection for body structures. They also act as levers that aid body movements, house tissues that produce blood cells and store various inorganic salts. Bones give shape to structures such as the head, face, thorax, and limbs. They also provide support and protection. For example, the bones of the feet, legs, pelvis, and backbone support the weight of

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the body. The bones of the skull protect the eyes, ears, and brain. Those of the rib cage and shoulder girdle protect the heart and lungs, while bones of the pelvic girdle protect the lower abdominal and internal reproductive organs. Although the number of bones in a human skeleton is often reported to be 206, the actual number varies from person to person. Some people lack certain bones, while others have extra ones. For example, the flat bones of the skull usually grow together and become tightly joined along irregular lines called sutures. Occasionally extra bones called wormian or sutural bones develop in these sutures. Also, extra small, round sesamoid bones may develop in tendons, where they function to reduce friction in places where tendons pass over bony prominences.

Post-text assignments1 List four groups of bones, based upon their shapes, name an example from each group.

2 Build medical terms. Choose them from the list below:1 Abnormal condition of porous bones. 2 Inflammation of bone and bone marrow. 3 Dead bone tissue. 4 A disease in which there is enlargement of the bones of the head, hands and feet resulting from a tumor of the putuitary gland that causes overproduction of growth hormone. 5 An instrument for recording muscular contractions. (a – ...graph; b – osteomyel...; c – ...porosis; d – sequestrum; e – ...megalia)

3 Match the descriptions and functions listed in column 1 with the bones listed in column II (Drawings 1, 2):

I II1) coronoid process a) ethmoid bone2) cribriform plate b) frontal bone3) foramen magnum c) mandible4) mastoid process d) maxillary bone5) palatine process e) occipital bone6) sella turcica f) temporal bone

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7) supraorbital notch g) sphenoid bone8) temporal process h) zygomatic bone

9) acromion process i) femur 10) deltoid tuberosity j) fibula 11) greater trochanter k) humerus 12) lateral malleolus l) radius 13) medial malleolus m) scapula 14) olecranon process n) sternum 15) radial tuberosity o) tibia 16) xiphoid process p) ulna

Unit 2

Pre-text assignments1 Learn the key words and phrases: joint, junction, lever system, to bend, to straighten, rigid structure, fibrous joints, cartilaginous joints, synovial joints, immovable, slightly movable, freely movable joints

2 Build medical terms:1 Inflammation of joints. 2 Inflammation of bone and joints. 3 Abnormal condition of pus in a joint. 4 Any of various immovable articulations, or joints (as in suture joints of the skull). 5 A freely movable joint; any articulation, as of the hip, permitting free movement in any direction. 6 Neuralgic pain in a joint or joints. (a – synarthr...; b – ...itis; c – ...arthritis; d – arthro...osis; e – dia…osis; f – arthr...ia)

Joints of the Skeletal System Joints are the junctions between the bones of the skeletal system. That is, a joint occurs wherever two or more bones come together. Most joints function in lever systems that make movements possible by bending or straightening. Others, however, are relatively rigid structures that help hold bones in place or enable bones to grow.

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Wherever two or more bones meet, a joint is formed. Such joints, or articulations, represent the functional junctions between bones. They bind various parts of the skeletal system together, allow bone growth to occur, permit certain parts of the skeleton to change shape during childbirth, and enable body parts to move in response to skeletal muscle contractions.Classification of Joints Although joints vary considerably in structure and function, they can be classified according to the type of tissue that binds the bones together at eachjunction. On this basis, three general groups can be identified - fibrous joints, cartilaginous joints, and synovial joints. Joints can also be grouped according to the amount of movement possible at the bony junctions. In this scheme, joints are classified as immovable (synarthrotic), slightly movable (amphiarthrotic), and freely movable (diarthrotic).Types of Joint Movements Movements at synovial joints are produced by actions of skeletal muscles. Typically, one end of a muscle is attached to a relatively immovable or fixed part on one side of a joint, and the other end of the muscle is fastened to a movable part on the other side. When the muscle contracts, its fibers pull its movable end (insertion) toward its fixed end (origin), and a movement occurs at the joint.

Post-text assignments1 Give full answers to the following questions:1 How would you explain to an athlete why damaged joint ligaments and cartilages are so slow to heal following an injury?2 Compared to the shoulder and hip joints, in what way is the knee joint poorly protected, and thus especially vulnerable to injuries?3 Based upon your knowledge of joint structures, which do you think could be most satisfactorily replaced by a prosthetic device, a hip joint or a knee joint? Why?4 If a patient's lower arm and elbow were immobilized by a cast for sevcral weeks, what changes would you expect to occur in the bones of the arm?

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5 Why is it important to encourage an inactive patient to keep all joints mobile, even if it is necessary to have another person or a device move the joints (passive movement)?6 How would you explain to a person with a dislocated shoulder that the shoulder is likely to become dislocated more easily in the future?

2 Match the movements in column I with the descriptions in column II: I II1) rotation a) turning palm upward2) supination b) decreasing angle belween parts3) extension c) moving part forward4) eversion d) moving part around an axis5) protraction e) turning sole of foot outward6) flexion f) increasing angle between parts7) pronation g) lowering a part8) abduction h) turning palm downward9) depression i) moving part away from midline

3 Render the text Skeletal System: Bones and Joints.Use some of the following expressions:

The Plan for Rendering the TextThe main idea of the text is...The text is about...The text is devoted to...The text deals with...The purpose of the text is to give the reader some information on...The aim of the text is to provide the reader with some material (data) on...Much attention is given to...It should be stressed that...Special attention is paid to...(Your opinion on the text)I found the text interesting (important, of no value, informative, useful).

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It gives the reader some information on...We have come to know and understand a lot of things.

Unit 3

Pre-text assignments1 Learn the key words and phrases: axial skeleton, appendicular skeleton, cartilaginous part, thoracic cage, hyoid bone, larynx, vertebral column, tailbone, sternum, pectorial girdle, pelvic girdle

2 Use the following expressions in the sentences of your own to show that you understand their meaning and use:1 It includes ... 2 Scientists consider that ... 3 It performs (they perform) the function of ... 4 The investigators determined ... 5 The most complicated structure ... 6 They are transmitted from ... 7 It depends upon ...

The Skeleton

For purposes of study, it is convenient to divide the skeleton into two major portions—an axial skeleton and an appendicular skeleton. The axial skeleton consists of the bony and cartilaginous parts that support and protect the organs of the head, neck, and trunk. These parts include the following:1 Skull. The skull is composed of the cranium (brain case) and the facial bones.2 Hyoid bone. The hyoid bone is located in the neck between the lower jaw and the larynx. It does not articulate with any other bones, but is fixed in position by muscles and ligaments. The hyoid bone supports the tongue and serves as an attachment for certain muscles that help move the tongue and function in swallowing. It can be felt approximately a finger’s width above the anterior prominence of the larinx.

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3 Vertebral column. The vertebral column, or backbone, consists of many vertebrae separated by cartilaginous intervertebral disks. This column forms the central axis of the skeleton. Near its distal end, several vertebrae are fused to form the sacrum, which is part of the pelvis. A small, rudimentary tailbone called the coccyx is attached to the end of the sacrum.4 Thoracic cage. The thoracic cage protects the organs of the thorax and the upper abdomen. It is composed of twelve pairs of ribs, which articulate posteriorly with thoracic vertebrae. It also includes the sternum, or breastbone, to which most of the ribs are attached anteriorly. The appendicular skeleton consists of the bones the limbs and the bones that anchor the limbs to the axial skeleton. It includes the following:1 Pectoral girdle. The pectoral girdle is formed by a scapula, or shoulder blade, and a clavicle, or collarbone, on both sides of the body. The pectoral girdle connects the bones of the arms lo the axial skeleton and aids in arm movements.2 Upper limbs (arms). Each upper limb consists of a humerus, or upper arm bone, and two lower arm bones—a radius and an ulna. These three bones articulate with each other at the elbow joint. At the distal end of the radius and ulna, are eight carpals, or wrist bones. The bones of the palm are called metacarpals, and the finger bones are called phalanges.3 Pelvic girdle. The pelvic girdle is formed by two coxal, or innominate bones (hipbones), which are attached to each other anteriorly and to the sacrum posteriorly. They connect the bones of the legs to the axial skeleton and, with the sacrum and coccyx, form the pelvis, which protects the lower abdominal and internal reproductive organs.4 Lower limbs (legs). Each lower limb consists of a femur, or thighbone, and two lower leg bones—a large tibia, or shinbone, and a slender fibula, or calf bone. These three bones articulate with each other at the knee joint, where the patella, or kneecap covers the anterior surface. At the distal ends of the tibia and fibula, are seven

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tarsals, or anklebones. The bones of the foot are called metatarsals, and those of the toes (like the fingers) are called phalanges.

Post-text assignments1 Distinguish between the axial and appendicular skeletons.

2 List the bones of the axial skeleton; of the appendicular skeleton (Drawings 1,2).

Unit 4

Pre-text assignments1 Learn the key words and phrases: broken, bone, blood clot, dilate, osteoblasts, multiply, fibroblasts, fibrocartilage, affected, osteoclasts, callus, hyaline, cartilage, endochondral bone, casts, metal pins

2 Match the terms to following definitions:1) a tumour or swelling containing blood a) debris2) one of the minute red granules of new b) granulationcapillaries formed on the surface of a c) castwound in healing d) hematoma3) a large amount of fibrocartilage fills e) cartilaginous callusthe gap between the ends of the brokenbone 4) the remains of something brokendown or destroyed 5) a rigid dressing of gauze impregnatedwith plaster of Paris for immobilizing adiseased or broken part

Fractures

Although a fracture may involve injury to cartilaginous structures, it is usually defined as a break in a bone. A fracture can be classified

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according to its cause and the nature of the break sustained. For example, a break due to injury is a traumatic fracture, while one resulting from disease is a spontaneous or pathologic fracture. If a broken bone is exposed to the outside by an opening in the skin, the injury is termed a compound fracture. Such a fracture is accompanied by the added danger of infection, since microorganisms almost surely enter through the broken skin. On the other hand, if the break is protected by uninjured skin, it is called a simple fracture.Repair of a Fracture Whenever a bone is broken, blood vessels within the bone and its periosteum are ruptured, and the periosteum is likely to be torn. Blood escaping from the broken vessels spreads through the damaged area and soon forms a blood clot, or hematoma. As vessels in surrounding tissues dilate, those tissues become swollen and inflamed. Within days or weeks, the hematoma is invaded by developing blood vessels and large numbers of osteoblasts, originating from the periosteum. The osteoblasts multiply rapidly in the regions close to the new blood vessels, building spongy bone nearby. Granulation tissue develops, and in regions further from a blood supply, fibroblasts produce masses of fibrocartilage. Meanwhile, phagocytic cells begin to remove the blood clot as well as any dead or damaged cells in the affected area. Osteoclasts also appear and resorb bone fragments, thus aiding in "cleaning up" debris. In time, a large amount of fibrocartilage fills the gap between the ends of the broken bone, and this mass is termed a cartilaginous callus. The callus is later replaced by bone tissue in much the same way that the hyaline cartilage of a developing endochondral bone is replaced. That is, the cartilaginous callus is broken down, the area is invaded by blood vessels and osteoblasts, and the space is filled with a bony callus. Usually more bone is produced at the site of a healing fracture than is needed to replace the damaged tissues. However, osteoclasts are able to remove the excess, and

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the final result of the repair process is a bone shaped very much like the original one. The rate at which a fracture is repaired depends on several factors. For instance, if the ends of the broken bone are close together, healing is more rapid than if they are far apart. This is the reason for setting fractured bones and for using casts or metal pins to keep the broken ends together. Also, some bones naturally heal more rapidly than others. The long bones of the arms, for example, may heal in half the time required by the long bones of the legs. Furthermore, as age increases, so does the time required for healing.

Post-text assignments1 Answer the following: 1 Define between traumatic and spontaneous fracture. 2 Define between simple and compound fracture. 3 What is hematoma? 4 What is cartilaginous callus?

2 Pick out the nouns that can combine with the given verbs: to control, to move, to send: findings, head, disease, pain, hands, movements, patient, respiration, letter, heartbeat, order, vision, legs

3 Pick out the verbs to be used together with the given nouns: the pain can (be discharged, be estimated, be controlled); the area can (be extended, be published, be pumped); the smell can (be covered, be entered, be felt); the vision can (be breathed in, be investigated, be complicated)

4 Respond to the questions:1 What steps do you think should be taken to reduce the chances of persons accumulating abnormal metallic elements such as lead, radium, and strontium in their bones?2 Why do you think incomplete, longitudinal fractures of bone shafts (greenstick fractures) are more common in children than in adults?3 When a child's bone is fractured, growth may be stimulated at the epiphyseal disk of that bone. What problems might this extra growth

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create in an arm or leg before the growth of the other limb compensates for the difference in length?4 How would you explain the observation that elderly persons often develop bowed backs and appear shorter than they were in earlier years?5 How might the condition of an infant's fontanels be used to evaluate its development? How might the fontanels be used to estimate intracranial pressure?6 Why are women more likely to develop osteoporosis than men? What steps might be taken to reduce the risks of developing this condition?

Unit 5

Pre-text assignments1 Learn the key words and phrases: muscles, contract, contraction, attach, resist, fascia, connective tissue, tendon, fibrous, fascicle, network, subcutaneous fascia, subserous fascia, cavity

2 Memorize the explanation to the terms:fascia (pl. fasciae) a sheet of connective tissue covering or binding together body structuresfascicle a small bundlesubcutaneous being under the skinfibrous containing or consisting of fibers

Muscular System

Muscles, the organs of the muscular system, consist largely of cells that are specialized to undergo contractions. During these contractions, chemical energy from nutrients is converted into mechanical energy, or movement. When muscle cells contract, they pull on the body parts to which they are attached. This action usually causes movement, as when

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joints of the legs are flex and extended during walking. But at other times, muscular contractions resist motion, as when they help hold body parts in postural positions. Muscles are also responsible for the movement of body fluids such as blood and urine. In addition, they function in heat production, which helps maintain body temperature.

Structure of a Skeletal Muscle A skeletal muscle is an organ of the muscular system composed of several kinds of tissue, including skeletal muscle tissue, nerve tissue, blood, and various connective tissues. An individual skeletal muscle is separated from adjacent muscles and held in position by layers of fibrous connective tissue called fascia. This connective tissue surrounds each muscle and may project beyond the end of its muscle fibers to form a cordlike tendon. Fibers in a tendon intertwine with those in the periosteum of a bone, thus attaching the muscle to the bone. In other cases, the connective tissues associated with a muscle form broad fibrous sheets called aponeuroses, which may be attached to the coverings of adjacent muscles. The layer of connective tissue that closely surrounds a skeletal muscle is called the epimysium. Other layers of connective tissue, called the perimysium, extend inward from the epimysium and separate the muscle tissue into small sections. These sections contain bundles of skeletal muscle fibers called fascicles (fasciculi). Each muscle fiber within a fascicle is surrounded by a layer of connective tissue in the form of a thin, delicate covering called endomysium. Thus, all parts of a skeletal muscle are enclosed in layers of connective tissue. This arrangement allows the parts to move independently. Also, numerous blood vessels and nerves pass through these layers. The fascia associated with the individual organs of the muscular system is part of a complex network of fasciae that extends throughout the body. The portion of the network that surrounds and penetrates the muscles is called deep fascia. It is continuous with the subcutaneous fascia that lies just beneath the skin, forming the subcutaneous layer. The network is also continuous with the

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subserous fascia that forms the connective tissue layer of the serous membranes covering organs in various body cavities and lining those cavities.Post-text assignments1 Respond to the following tasks: 1 List the three types of muscle tissue. 2 Describe the connective tissue coverings of a skeletal muscle. 3 Describe how connective tissue is associated with a skelelal muscle. 4 Distinguish between deep fascia, subcutaneous fascia, and subserous fascia. 5 Describe the major events that occur when a muscle fiber contracts.

2 Fill in the blanks with the words given below:1 There are many ..in the spine. 2 We use the ... and the tongue when we speak 3 There are a great number of ... ... ... in the muscles. 4 The cells are connected by connective ... . 5 ... ... ... move our internal organs such as the digestive tract, blood vessels and secretory ducts. 6 The teeth and a tongue are located in ... ... . 7 The skull encloses ... ... . 8 We chew our food with the ... . 9 The joints allow the bones ... ... . 10 The bones are of various sizes and .... . (a – the smooth muscles; b – shapes; c – vertebrae; d – lips; e – teeth; f – nerves and blood vessels; g – to move; h – the brain; i – tissue; j – the mouth)

3 Read and retell the article: Experience floating muscles. Stand in a doorway with your hands pressing on the door frame as hard as you possibly can. Hold it for a full minute. Walk away from the door. Your muscles memory will keep pushing your arms out, and they will float up without any effort on your part.

4 Translate in writing: There are two main varieties of muscle: voluntary and involuntary. Voluntary muscle is striated in appearance and may be contracted at

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will. It is usually attached at each end to different bones, which it brings closer together (e. g. in bending the arm) when it contrasts. Involuntary muscle is smooth in appearance and may not be contracted at will. It is found chiefly in internal organs, such as the intestine wall and the heart, whose function is automatic.

Unit 6

Pre-text assignments1 Learn the key words and phrases:disuse, enlarge, hypertrophy, atrophy, mitochondria, resist fatigue, fatigable fibers, filaments of actin and myosin, discontinued, reduction, capillary networks, motor neurons, reinnervate

2 Memorize the explanation to the terms:increase becoming greater in size, amount, etc.decrease becoming gradually less, smaller, etc.

Atrophy and Hypertrophy of Skeletal Muscles

Skeletal muscles are very responsive to use and disuse. For example, those that are forcefully exercised tend to enlarge. This phenomenon is called muscular hypertrophy. Conversely, a muscle that is not used undergoes atrophy – that is, it decreases in size and strength. The way a muscle responds to use also depends on the type of exercise involved. For instance, when a muscle contracts relatively weakly, as during swimming and running, its slow, fatigue-resistant red fibers are most likely to be activated. As a result, these fibers develop more mitochondria, and more extensive capillary networks develop around the fibers. Such changes increase the fibers' abilities to resist fatigue during prolonged periods of exercise, although their sizes and strengths may remain unchanged. Forceful exercise, such as weight lifting, in which a muscle exerts more than 75% of its maximum tension, involves the muscle's fast,

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fatigable white fibers. In response, existing muscle fibers develop new filaments of actin and myosin, and as their diameters increase, the whole muscle enlarges. However, no new muscle fibers are produced during hypertrophy. Since the strength of a contraction is directly related to the diameter of the muscle fibers, an enlarged muscle is capable of producing stronger contractions than before. However, such a change does not increase the muscle's ability to resist fatigue during activities such as running or swimming. If exercise is discontinued, there is a reduction in the capillary networks and in the number of mitochondria within the muscle fibers. Also, the size of the actin and myosin filaments decreases, and the entire muscle atrophies. Such atrophy commonly occurs when limbs are immobilized by casts or when accidents or diseases interfere with motor nerve impulses. A muscle that cannot be exercised may decrease to less than one-half its usual size within a few months. The fibers of muscles whose motor neurons are severed not only decrease in size, but also may become fragmented and, in time, be replaced by fat or fibrous connective tissue. However, if such a muscle is reinnervated within the first few months following an injury, its function may be restored. Meanwhile, atrophy may be delayed by treatments in which electrical stimulation is used to cause muscular contractions against loads.

Post-text assignments1 Respond to the following tasks: 1 Explain how muscles may become fatigued and how a person's physical condition may affect tolerance to fatigue. 2 Explain the differerence between atrophy and hyperthrophy of skeletal muscles

2 Choose the proper term to the identification:1 The way (route) of administration of drugs. 2 The science dealing with the effect of drugs on living organisms. 3 Conditions which ban (forbid) the use of a drug. 4 The science that deals with medicinal

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products of plant, animal, or mineral origin in their crude or unprepared state. 5 The branch of pharmacology that deals with the effect and the reactions of drugs within the body. 6 Pertaining to against pain. (a – contraindications; b – analgesic, analgetic; c – intramuscular; d – pharmacology; e – pharmacognosy; f – pharmacodynamics) Key: 1 – c (intramuscular); 2 – d (pharmacology); 3 – a (contraindications); 4 – e (pharmacognosy); 5 – f (pharmacodynamics)

Unit 7

1 Match the muscles in column I with the descriptions and functions in column II (Drawings 3,4): I II1) buccinator a) inserted on the coronoid process of the mandible2) epicranius b) draws the corner of the mouth upward3) medial pterygoid c) can raise and adduct the scapula4) platysma d) can pull the head into an upright position5) rhomboideus major e) consists of two parts – the frontalis and the occipitalis.6) splenius capitis f) compresses the cheeks7) temporalis g) extends over the neck from the chest to the face8) zygomaticus h) pulls the jaw to the side in grinding movements

I II9) biceps brachii i) primary extensor of the elbow 10) brachialis j) pulls the shoulder back and downward

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11) deltoid k) abducts the arm12) latissimus dorsi l) rotates the arm laterally13) pectoralis major m) pulls the arm forward and across the chest14) pronator teres n) rotates the arm medially15) teres minor o) strongest flexor of the elbow16) triceps brachii p) strongest supinator of the forearm

I II

17) biceps femoris q) inverts the foot18) external oblique r) a member of the quadriceps femoris group19) gastrocnemius s) a plantar flexor of the foot20) gluteus maximus t) compresses the contents of the abdominal cavity21) gluteus medius u) largest muscle in the body22) gracilis v) a hamstring muscle23) rectus femoris w) adducts the thigh24) tibialis anterior x) abducts the thigh

2 Read the text and render its main idea: ln the United States, approximately 3 million people present to emergency departments for treatment of traumatic facial injuries each year. Most of these injuries are relatively minor soft tissue injuries that simply require first aid care or primary closures. A small percentage of facial traumas (0.04-0.09%) require major repair with possible bony reconstruction. Motor vehicle accidents (MVAs) were the most frequent cause of facial injuries before 1970. In recent years, with the institution of state seat belt laws, the number of deaths from MVAs has declined along with the incidence of facial injuries, although the prevalence of facial trauma has remained fairly constant. This is due to the growing population and other human factors, such as on-the-job accidents, sports-related injuries, domestic interpersonal violence, self-inflicted wounds, and animal bites.

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The mechanism of injury for facial trauma varies widely from one locality to the next, depending significantly upon the degree of urbanization, socioeconomic status of the population, and cultural background of each region. MVAs continue to be a primary contributor to significant facial injuries in rural areas. In contrast, in inner metropolitan areas, domestic violence is the leading cause of facial trauma despite a denser population, a difference that may be due to stricter enforcement of traffic laws.

Unit 8

Anatomical Terminology

Terms of relative position are used to describe the location of one body part with respect to another. They include the following:1 Superior means a part is above another part, or closer to the head. (The thoracic cavity is superior to the abdominopelvic cavity).2 Inferior means situated below another part, or toward the feet. (The neck is inferior to the head).3 Anterior (or ventral) means toward the front. (The eyes are anterior to the brain).4 Posterior (or dorsal) is the opposite of anterior; it means toward the back. (The pharynx is posterior to the oral cavity).5 Medial relates to an imaginary midline dividing the body into equal right and left halves. A part is medial if it is closer to this line than another part. (The nose is medial to the eyes).6 Lateral means toward the side with respect to the imaginary midline. (The ears are lateral to the eyes). Ipsilateral pertains to the same side (the spleen and the descending colon are ipsilateral), while contralateral refers to the opposite side (the spleen and the gallbladder are contralateral).7 Proximal is used to describe a part that is closer to a point of attachment or closer to the trunk of the body than another part. (The elbow is proximal to the wrist).

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8 Distal is the opposite of proximal. It means a particular body part is farther from the point of attachment or farther from the trunk than another part. (The fingers are distal to the wrist).9 Superficial means situated near the surface. (The epidermis is the superficial layer of the skin). Peripheral also means outward or near the surface. It is used to describe the location of certain blood vessels and nerves. (The nerves that branch from the brain and spinal cord are peripheral nerves).10 Deep is used to describe parts that are more internal. (The dermis is the deep layer of the skin).

Unit 9

Pre-text assignments1 Learn the key words:

tongue, papilla, pharynx, throat, esophagus, gullet, enzyme, saliva, antrum, ruga, bile, gallbladder, sodium, potassium, villus, cecum

2 Memorize the expressions to the text: to be moistered with smth, taste receptors, mucous membrane, oral cavity, gastric juice, further digestion, hydrochloric acid, peristaltic waves, small intestine, the fluid by-products, large intestine, sigmoid colon, vermiform appendix

3 Find substitutes for the following definitions: 1) pertaining to pepsin or to digestion a) digestion 2) excessive formation of gases in stomach or in testine b) deficiency 3) failure of digestive function c) peptic 4) a lack or shortage d) flatulence 5) the conversion of food into material assimilable by the body e) indigestion

4 Translate the sentences:1 The soft palate is a continuation of the soft tissues covering the hard palate. 2 The small intestine composed of three main portions is

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a thin-walled muscular tube. 3 The weight of the largest of the salivary glands is 28 gr. 4 The liver consists of small lobules connected together by connective tissue, different vessels and nerves. 5 The duodenum is called so because its length measures about twelve fingers. 6 The liver consisting of five lobes is covered with a fibrous coat.

Digestive System and Digestion

The human body needs energy for its functioning. Our body assimilates proteins, fats, carbohydrates and other nutrients. The digestion of the starchy parts of food begins in the mouth where it is moistered with saliva. In the tongue papillae (lingual papillae) there are the taste receptors. Over the mucous membrane of the oral cavity there are many tactile, temperature and pain receptors. The teeth, the gums, the soft and hard palates and the salivary glands are important structures located in the oral cavity. In the oral cavity the food must be well chewed between the teeth. Then the food passes through the pharynx (throat) and down through the esophagus (gullet) into the stomach which is a dilated portion of the alimentary truct pyriform in shape. The stomach is composed of a fundus (upper part), a body (middle part) and an antrum (lower, distal part). The upper opening of the stomach is called the cardiac sphincter and the lower one – pyloric. The folds in the mucous membrane lining the stomach are called rugae. In the stomach the components of food are dissolved and hydrolysed by enzymes of saliva and gastric juice. Different gastric glands are found in the stomach. They produce hydrochloric acid and pepsin to digest food. The gastric juice secreted by the stomach possesses antibacterial activity. Pepsin converts proteins to smaller substances called peptones. But food does not enter the bloodstream through the stomach. Further digestion and absorbtion of food into the blood takes place in the small intestine. After portions of the stomach contents enter into the duodenum they turn acid, but then the reaction rapidly changes because the hydrochloric acid of the gastric juice is neutralized by the bile, the juice of the pancreas, the juice of the

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duodenal glands and intestinal crypts. The bile comes from the liver and gallbladder by means of special ducts. The pancreatic juice, a colourless clear fluid contains sodium, potassium chlorides and is rich in enzymes which digest proteins, fats and carbohydrates. Food passes in peristaltic waves from the duodenum to the jejunum and the ileum, which is attached to the large intestine. The entire small intestine has many projections called villi. It is in the small intestine where the so-called cavital.and membrane hydrolyses of nutrients takes place. The products of digestion are absorbed into the blood and lymph. The remaining part of food (the fluid by-products of digestion) from the small intestine pass into the large intestine which consists of cecum, colon (ascending, transverse, descending), sigmoid colon and rectum. The vermiform appendix hags from the cecum. The rectum ends in the anus. The process of digestion is completed in the large intestine by the absorption of water. The unabsorbed and undigested components of food, the remains of the digesting fluids are evacuated from the body.

Post-text assignments1 Choose the anatomic terms for the following:1 The organ of chewing and tasting. 2 The movable muscular structure attached to the floor of the mouth; an important organ in the articulation of speech sounds. 3 The muscular membranous cavity leading from the mouth and nasal passages to the larynx and esophagus. 4 The roof of the mouth. 5 The tube through which food passes from the pharynx to the stomach. 6 Any of numerous hairlike or fingerlike vascular processes in the small intestine. 7 The first section of the small intestine between the stomach and the jejunum. 8 A large, elongated gland: some cells (beta cells) islets of Langerhans in the gland produuce the hormone insulin. 9 The largest glandular organ which secretes bile. 10 The organ for containing food and digestion of it. (a – palate; b – duodenum; c – stomach; d – pharynx; e – esophagus; f – mouth; g – tongue; h – liver; i – pancreas; j – villus (pl villi)

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2 Say what organ is spoken about: a) This organ is the largest gland in the human body. It is in the upper part of the abdominal cavity under the diaphragm in the right side of the abdomen. Its upper surface is convex. This organ consists of small lobules connected together by connective tissue, different vessels and nerves. b) This organ is pyriform in shape. It is a dilated portion of the alimentary canal. It is in the upper part of the abdomen under the diaphragm. The liver is above this organ, and the colon is below it. The pancreas is behind this organ.

3 Translate the following without consulting the dictionary: 1 Digestive juices are secreted into the alimentary canal by various glands and accessory organs. 2 The digestive system includes the organs that promote digestion and absorb the products of this process. 3 The alimentary canal includes the mouth, pharynx, esophagus, stomach, small intestine and large intestine. 4 The accessory organs include the salivary glands, liver, gallbladder and pancreas.

Unit 10

Pre-text assignments1 Learn the key words and phrases: innervation, distinct layers, innermost tissues, mucous membrane, folds, lumen, tubular invaginations, visceral peritoneum

2 Memorize the explanation to the terms:break to separate into partsabsorb to take in and use as nourishmentmoist to wet moderately

lubricate to make smooth or slippery

The Alimentary Canal

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The alimentary canal is a muscular tube about 9 meters long that passes through the body's ventral cavity. Although it is specialized in various regions to carry on particular functions, the structure of its wall, the method by which it moves food, and its type of innervation are similar throughout its length. The wall of the alimentary canal consists of four distinct layers, although the degree to which they are developed varies from region to region. Beginning with the innermost tissues, these layers, include the following:1 Mucous membrane (mucosa). This layer is formed of surface epithelium, underlying connective tissue (lamina propria), and a small amount of smooth muscle. In some regions, it develops folds and tiny projections that extend into the lumen of the digestive tube and increase its absorptive surface area. It may also contain glands that are tubular invaginations into which the lining cells secrete mucus and digestive enzymes. The mucosa protects the tissues beneath it and carries on absorption and secretion.2 Submucosa. The submucosa contains considerable loose connective tissue as well as blood vessels, lymphatic vessels, and nerves. Its vessels nourish the surrounding tissues and carry away absorbed materials.3 Muscular layer. This layer, which is responsible for the movements of the tube, consists of two coats of smooth muscle tissue. The fibers of the inner coat are arranged so that they encircle the tube, and when these circular fibers contract, the diameter of the tube is decreased. The fibers of the outer muscular coat run lengthwise, and when these longitudinal fibers contract, the tube is shortened.4 Serous layer (serosa). The serous, or outer covering of the tube is composed of the visceral peritoneum, which is formed of epithelium on the outside and connective tissue beneath. 6 The cells of the serosa secrete serous fluid, which keeps the tube's outer surface moist. This lubricates the surface so that the organs within the abdominal cavity slide freely against one another.

Post-text assignments

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1 Answer the following: 1 What is the alimentary canal? 2 Distingwish between mucosa and submucosa. 3 Distingwish between muscular layer and serous layer.

2 Ask questions using the parenthesized words: 1 The alimentary canal is a muscular tube about 9 maters long. (What size) 2 The wall of the alimentary canal consists of four disfinct layers. (How many) 3 Mucous membrane is formed of surface epithelium and a small amount of smooth muscle. (What ... of) 4 The mucosa protects the tissues beneath. (What) 5 The fibers of the outer muscular coat run lengthwise. (How) 6 The cells of the serosa secrete serous fluid. (What)

3 Summarize the characteristics of these layers:

Layer Composition Function

Mucous membrane

Epithelium, connective tissue,

smooth muscle

Protection, absorption, secretion

Submucosa

Loose connective tissue, blood vessels,

lymphaticvessels, nerves

Nourishes surrounding

tissues, transports absorbed materials

Muscular layer

Smooth muscle fibers arranged in circular

andlongitudinal groups

Movements of the tube and its contents

Serous layer Epithetium, connective tissue Protection

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Unit 11

Pre-text assignments1 Learn the key words and phrases: pouchlike organ, capacity, oblique fibers, cardiac, fundic, body, pyloric regions, balloon, temporal storage area, swallowed, regurgitation of food, stretch, chyme

2 Form new words by adding the prefixes. Define the part of speech and translate them: a) dis-: colouration, continue, like, appear b) un-: natural, cured, cooled, conscious, treated c) over-: use, strain, work, eating, dosage d) intra-: venous, muscular, cellular, vascular

3 Read and translate the following terms. Memorize the meaning of the term-element «gastro» – шлунок: gastroenterologist, gastroenterology, gastrology, gastrotherapy, gastrotomy, gastro-intestinal, gastromalacia, gastronephritis, gastropancreatitis, gastropathy

Stomach The stomach receives food, mixes it with gastric juice, carries on a limited amount of absorption, and moves food into the small intestine. The stomach is a J-shaped, pouchlike organ, about 25-30 centimeters long, which hangs under the diaphragm in the upper left portion of the abdominal cavity. It has a capacity of about one liter or more, and its inner lining is marked by thick folds (rugae) that tend to disappear when its wall is distended. The stomach receives food from the esophagus, mixes it with gastricjuice, initiates the digestion

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of proteins, carries on a limited amount of absorption, and moves food into the small intestine. In addition to the two layers of smooth muscle – an inner circular layer and an outer longitudinal layer – found in other regions of the alimentary canal, some parts of the stomach have another inner layer of oblique fibers. This third muscular layer is most highly developed near the opening of the esophagus and in the body of the stomach. The stomach can be divided into the cardiac, fundic, body, and pyloric regions. The cardiac region is a small area near the esophageal opening (cardia), the fundic region, which balloons above the cardiac portion, acts as a temporal storage area and sometimes becomes filled with swallowed air. This produces a gastric air bubble, which may be used as a landmark on an X-ray film of the abdomen. The dilated body region, which is the main part of the stomach, is located between the fundic and pyloric portions. The pyloric region (antrum) narrows and becomes the pyloric canal as it approaches the small intestine. At the end of the pyloric canal, the circular layer of fibers in its muscular wall is thickened, forming a powerful muscle, called the pyloric sphincter (pylorus). This muscle serves as a valve that prevents regurgitation of food from the intestine back into the stomach. Gastric glands secrete gastric juice. Gastric juice contains pepsin, hydrochloric acid, lipase, and intrinsic factor. Gastric secretions are enhanced by parasympathetic impulses and by gastrin, a hormone. The three stages of gastric secretion are the cephalic, gastric, and intestinal phases. The presence of food in the small intestine reflexly inhibits gastric secretions. The stomach is not well adapted for absorption. A few substances such as water and other small molecules may be absorbed through the stomach wall. As the stomach fills, its wall stretches, but its internal pressure remains unchanged. Mixing movements aid in producing chyme; peristaltic waves move the chyme into the pyloric region. The muscular wall of the pyloric region pumps chyme into the small intestine. The rate of emptying depends on the fluidity of the chyme and the type of food present.

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Post-text assignments1 Add the necessary part of the clinical terms pertaining to the pathology of stomach:1 Gastro... (an instrument inserted through the mouth for visually inspecting the inside of the stomach). 2 Gastr... (the surgical removal of all, or especially part of the stomach). 3 Gastro... itis (an inflammation of the stomach and the intestines). 4 Gastro... (a stony concretion formed in the stomach). 5 Gastro... (a bleeding from the blood vessels and the stomach lining). 6 Gastro... (a process of softening of stomach lining because of poor blood supply or an inflammation). 7 Gastro... (a prolapse, falling of the stomach down-wards because of weakening of some muscles). 8 Gastroentero-.. (the branch of medicine that is concerned with disorders of the digestive system). 9 Gastr... (inflammation of the stomach lining). 10 Gastro ... (surgical incisior into the stomach). (a — ...tomy; b — ...logy; c — ...lith; d — ...ectomy; e — ...rrhagia; f — ...ptosis; g — ...scope; h — ...itis; i —...malacia;j — ...enter...)

2 Choose the words that correctly complete each of the following sentences:1 Alimentary canal begins at the (mouse, mouth) and ends at the anus. 2 The (rough, roof, ruff) of the mouth is called palate. 3 By the movements of the (tan, tang, tongue, ton, tone) and cheek the food is turned about and chewed. 4 The (leaps, lips) form the opening to the oral, cavity. 5 The pancreatic juice is (reach, rich) in enzymes which digest proteins, fats and carbohydrates. 6 A soft tissue which hangs from the soft palate is (cold, called) uvula. 7 The tongue has papilae which contain (sells, seals, cells, seels) sensitive to the chemical nature of food. 8 Pharynx is a passegeway for (ear, air, are) from the nasal cavity to the larynx and for food going from the mouth to esophagus.

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3 Translate in writing the following abstract : The rate at which the stomach empties is also related to age. An infant's stomach which has a small capacity, empties very rapidly. As a person grows, the stomach enlarges, and the emptying time increases.

Unit 12

Pre-text assignments1 Learn the key words and phrases: deaminating amino acids, blood clotting, bile, fibrous capsule, hepatic cells, gallstones

2 Use the following words and expressions in sentences of your own to show that you understand their meaning and use: use by expiration date; if pain persists; the advice of a health professional; to depend on; reduced doses are recommended; rectal route of administration; oral route of administration; intravenous route of administration; subcutaneous route of administration; drug introduction into

Liver

The liver is located in the upper right and central portions of the abdominal cavity, just below the diaphragm. It is partially surrounded by the ribs, and extends from the level of the fifth intercostal space to the lower margin of the ribs. It is reddish brown in color and well supplied with blood vessels. The liver is the largest gland in the body, and it carries on many important metabolic activities. For example, it plays a key role in carbohydrate metabolism by helping maintain the normal concentration of blood glucose. The most vital liver functions are probably those related to protein metabolism. They include deaminating amino acids; forming urea; synthesizing various blood proteins, including several that are

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necessary for blood clotting ; and converting various amino acids to other amino acids. The liver also stores a variety of substances, including glycogen, iron, and vitamins A, D, and B12. Iron storage occurs when the concentration of blood iron is excessive. The extra iron is combined with a protein (apoferritin) in liver cells, and as a result, a substance called ferritin is formed. The iron remains stored in this form until the blood iron concentration reaches a certain low level. Then some of the iron is released. Thus, the liver plays an important role in the homeostasis of iron. In addition to the above functions, various liver cells help destroy damaged red blood cells and foreign substances by phagocytosis, alter the composition of toxic substances such as alcohol (detoxification), and secrete bile. The liver can also store from 200 to 400 milliliters of blood, thus it serves as a blood reservoir. The liver is enclosed in a fibrous capsule and is divided by connective tissue into lobes—a large, right lobe and, a smaller, left lobe. Within the liver lobules, are many fine bile canals, wich receive secretions from the hepatic cells. Bile is a yellowish green liquid that is secreted continuously by the hepatic cells. It is the only liver secretion that directly affects digestion. Bile contains bile salts, bile pigments, cholesterol, and various electrolytes. Only the bile salts have digestive functions. The gallbladder stores bile between meals. Release of bile from the common bile duct is controlled by a sphincter muscle. Gallstones may sometimes form within the gallbladder.

Post-text assignments1 Choose the proper terms for the definitions:1 Yellow coloration of skin and tissues. 2 Lack of hydrochloric acid. 3 Lesion of the mucous membrane when it is injured and necrosed. 4 Collection of bile (calculi) which forms in the gallbladder and bile ducts. 5 Protrusion of an organ or part of it through the wall of the cavity which contains it. 6 Binding or twisting of the intestine upon itself. 7 Removal of the gallbladder. 8 Inflammation of the pancreas. 9 Incision of the esophagus. 10 Visual examination of the stomach.

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(a – gallstones; b – hernia; c – volvulus; d – gastroscopy; e – ulcer; f – achlorhydria; g – pancreatitis; h – cholecystectomy; i – esophagotomy; j – jaundice)

2 Translate in writing: Gallstones may form if the bile is concentrated excessively, if the hepatic cells secrete too much cholesterol, or if the qallbladder is inflamed (cholecystitis). If such stones get into the bile duct, they may block the flow of bile, causing obstructive jaundice and considerable pain. Generally gallstones that cause obstructions are surgically removed. At the same time, the gallbladder is removed by a surgical procedure called cholecystectomy. Following such surgery, the person is unable to produce gallstones or store bile. However, bile continues to reach the intestine by means of the hepatic and common bile ducts.

Unit 13

Pre-text assignments1 Read the text. Write a plan of it in the form of questions:

Hepatitis

Hepatitis is an inflamation of the liver. Most commonly it is caused by a viral infection, the presence of toxins, or the effects of various drugs, including alcohol. One form of viral hepatitis, called type A hepatitis (infectious hepatitis), usualy occurs in children or young adults. It is sptead by contract with food or objects, such as eating utensils or toys, that have been contaminated with virus-containing faces. This form of hepatitis is often mild, although itmay be accompanied by weakness, abdominal discomfort, nausea, and jaundice. Usually the person recovers completely, with no lasting damage to the liver. Type B hepatitis (serum hepatitis) produces symptoms similar to those of type A, but the effects may last for a much longer time. This

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form of the disease is spread by contact with virus-containing body fluids, such as blood, saliva, or seminal fluid. Thus, it may be transmitted by means of blood transfusions, hypodermic needles, or sexual activiti. Most victims recover completely from type B hepatitis; however, some perons continue to harbor live viruses and become “carriers” who may seem healthy, but can transmit the condition to others. People who exhibit the symptoms of hepatitis for six months or more are said to have chronic hepatitis. In such cases, there is danger that the liver will be permanently damaged and its functions impaired. In addition to being caused by viral infections, chronic hepatitis maybe caused by the effects of certain drugs or by autoimmune reactions.

2 Now that you have read the text and written the plan write an essay on the topic Hepatits.

Unit 14

Pre-text assignments1 Learn the key words and phrases: ulcer, open sore, localized breakdown, buffer, unbuffered acid

2 Match the following phrases with Ukrainian ones: 1) life-threatening disease a) м’язовий клапан 2) muscular valve b) кислий сік 3) harmful effect c) слизова оболонка кишечника 4) peptic ulcer d) смертельне; небезпечне 5) immunosuppressive захворювання 6) lining of the intestine e) виразка дванадцятипалої кишки 7) acidic juice f) пошкоджувальний ефект 8) duodenal e g) пептична виразка h) імуносупресорне лікування

3 Find descriptions of the following terms: 1) ulcer a) splashing of the acidic juices from the

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2) heartburn stomach into the esophagus 3) digestion b) the conversion of food into material 4) distress assimilated by the body 5) stomach c) open sore in the lining of the stomach or 6) esophagus duodenum 7) valve d) the passage for food from the pharynx to 8) bile the stomach 9) acid e) the state of suffering, pain, misery 10) relapse f) the large, saclike organ into which food 11) liver passes from esophagus or gullet for storage while undergoing the early processes of digestion g) sour, sharp and biting to the taste h) the bitter, greenish fluid secreted by the liver and found in the gallbladder; it helps digestion I) (in anatomy) a membranous structure which permits body fluids to follow in one direction only j) the largest glandular organ; it secrets bile and has an important function in metabolism k) to slip back into a former condition, especially after improvement or seeming improvement

Ulcers

An ulcer is an open sore on the surface of an organ that results from a localized breakdown of the tissues. Although ulcers may occur in various parts of the alimentary canal, they often develop in the stomach and are called gastric ulcers. Ulcers are also common in the first portion of the small intestine, the duodenum. Duodenal ulcers occur in regions that are exposed to pepsin as the contents of the stomach enter the intestine. Because gastric ulcers and duodenal ulcers are usually caused by pepsin, both

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are commonly called peptic ulcers. Ulcers often develop in people who are emotionally stressed and whose stomachs secrete increased amounts of acidic gastric juice between meals, when the stomach is essentially empty. For example, some research suggest that smoking might increase a person's risk of infection with the bacterium Helicobacter pylori (H.pylori). Most peptic ulcers are caused by this bacterium. Stomach acid is also important in producing ulcers. Normally, most of this acid is buffered by the food we eat. Most of the unbuffered acid that enters the duodenum is quickly neutralized by sodium bicarbonate, a naturally occurring alkali produced by the pancreas. Some studies show that smoking reduces the bicarbonate produced by the pancreas, interfering with the neutralization of acid in the duodenum. Other studies suggest that chronic cigarette smoking may increase the amount of acid secreted by the stomach. Whatever causes the link between smoking and ulcers two points have been repeatedly demonstrated. People who smoke are more likely to develop an ulcer, especially a duodenal ulcer, and ulcers are less likely to heal quickly among smokers in response to otherwise effective treatment. This research tracing the relationship between smoking and ulcers strongly suggests that a person with an ulcer should stop smoking.

Post-text assignments1 What disease is this? 1 The disease, which causes pain and diarrhea, usually affects the small intestine, but it can occur anywhere in the digestive tract. 2 It happens when acidic juices from the stomach splash into the esophagus. 3 It is an open sore in the lining of the stomach or duodenum, the first part of the small intestine. 4 Most cases of this disease are caused by the bacterium Helicobacter pylori.

2 Say it in one word:

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1) a small, solid mass sometimes formed in the gallbladder or bile duct 2) the passage for food from the pharynx to the stomach 3) causing hurt, injury or damage 4) the large, sacljke organ into which food passes from esophagus for storage while undergoing the early processes of digestion 5) the lower part of the alimentary canal, extending from the stomach to the anus and consisting of a convoluted upper part and a lower part of greater diameter

3 Give full answers: If a patient has 95% of the stomach removed (subtotal gastrectomy) as treatment for severe ulcers or cancer, how would the digestion and absorption of foods be affected? How would the patient's eating habits have to be altered? Why?

Unit 15

Pre-text assignments1 Learn the key words and phrases: cardiovascular system, circulatory system, nutrients, excretory organs, target tissues, favourable cellular environment, viscous, platelets, blood sample, cellular wastes

2 Match the following English word combinations with the Ukrainian ones: 1) red blood cells a) згортання крові 2) to combat infection b) підтримувати 3) to destroy bacteria потрібну кількість крові 4) the clotting of blood с) червоні кров’яні тільця 5) to maintain an adequate d) боротися з інфекцією blood volume e) знищувати бактерії

3 Translate the following:

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1 The cellular fraction consists of red blood cells, white blood cells and blood platelets. 2 The normal coagulation time is from three to five minutes. 3 Plasma is the fluid portion of the blood.

Blood

The blood, heart, and blood vessels constitute the circulatory system and provide a link between the body's internal parts and its external environment. More specifically, the blood transports nutrients from the digestive tract, oxygen from respiratory organs to the body cells, and carries wastes from these cells to the respiratory and excretory organs. It transports hormones from the endocrine glands to target tissues and bathes the body cells in a liquid of relatively stable composition. It also aids in temperature control by distributing heat from the skeletal muscles and other active organs to all the body parts. Thus, the blood provides vital support for cellular activities and aids in maintaining a favorable cellular environment. The heart and the closed system of blood vessels comprise the apparatus that moves blood throughout the body. These organs constitute the cardiovascular system. Blood is a type of connective tissue whose cells are suspended in a liquid intercellular material. It plays vital roles in transporting substances between the body cells and the external environment, and it aids in maintaining a stable cellular environment. Whole blood is slightly heavier and three to four times more viscous than water. Its cells, which are formed mostly in red bone marrow, include red blood cells and white blood cells. The blood also contains cellular fragments called platelets. The volume of blood varies with body size. It also varies with changes in the fluid and electrolyte concentrations and the amount of fat tissue present. However, an average-sized male (70 kilograms) will have a blood volume of about 5 liters.

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If a blood sample is allowed to stand in a tube for a while, the cells will become separated from the liquid portion of the blood and settle to the bottom. This separation can be speeded by centrifuging the sample so that the cells quickly become packed into the lower part of the centrifuge tube. When the amounts of cells and liquid are measured, the percentage of each in the blood sample can be calculated. A blood sample is usually about 45% cells. This percentage is called the hematocrit (HCT), or packed cell volume (PCV). The remaining 55% of a blood sample consists of clear, straw-colored plasma. In addition to red cells, which comprise over 99% of the blood cells, the solids of the blood include white blood cells and blood platelets. The plasma is composed of a complex mixture that includes water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes. Red blood cell production is significantly influenced by the availability of two of the B-complex vitamins – vitamin B12 and folic acid. These substances are required for the synthesis of DNA molecules, so they are needed by all cells for growth and reproduction. Since cellular reproduction occurs at a particularly high rate in red blood-cell-forming tissue, this tissue is especially affected by a lack of either of these vitamins. Iron is also needed for the synthesis of hemoglobin. Although much of the iron that is released during the decomposition of hemoglobin is available for reuse, some iron is lost each day and must be replaced. White blood cells, or leukocytes, function primarily to control various disease conditions. Although these cells do most of their work outside the circulatory system, they use the blood for transportation to sites of infection. Normally, five types of white cells can be found in the circulating blood. They are distinguished by their size, the nature of their

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cytoplasm, the shape of their nucleus, and their staining characteristics.

Post-text assignments1 Complete the sentances:1 The most numerous of the cellular elements of the blood are... a) white blood corpuscles; b) red blood corpuscles; c) blood platelets2 The blood is... a) connective tissue; b) muscular tissue; c) fluid tissue; d) nervous tissue

2 Read the passages and answer the questions:1 This substance is composed of plasma, red corpuscles, white corpuscles and platelets. What substance is it?2 These cellular elements are the most numerous in the blood. They range from 4 to 5 million per cu mm in healthy adults. Their colour(ing) is red. What cellular elements are they?

3 Answer the questions using the thematic words: 1 What is the main function of the blood? 2 How are the products of metabolism removed from the tissues? 3 What components does the blood consist of? 4 What is the chief constituent of the red blood cells? 5 What are the major components of blood? 6 What factors affect blood volume? 7 How is hematocrit determined? 8 What vitamins are necessary for red blood cell production? 9 Why is iron needed for the normal development of red blood cells? 10 What are the primary functions of white blood cells?

4 Read and render the article:Try this. Fill two caps half full with corn syrup. Stir two drops of red food coloring in each cup, so it looks like blood. Sprinkle one

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teaspoon of sugar in one cup and one teaspoon of flour in the other. Record how long it takes for the "blood" to absorb the sugar and flour. Which one was absorbed more quickly – the sugar or the flour?

5 Read and translate the text: One of the scientific research Institutes carried out an interesting experiment. Six young persons – four men and two girls did not sleep for 124 hours. They were under the constant observation of the doctors who took their cardiograms, determined the pulse and blood pressure and carried out many other investigations. Not to fall asleep they were allowed to do physical exercises, dance and play, but they were not allowed to take any stimulants. Vision, hearing and muscular reflexes were often examined during the experiment. The experiment was successful. Its findings showed that prolonged sleeplessness increases the amount of sugar in the blood, decreases the level (amount) of vitamins B1 and B6, produces considerable increase of white boood cells and decreases the amount of iron in the blood.

Unit 16

Pre-text assignments1 Learn the key words and phrases: transmit, clump together, obstruct, agglutinogens, agglutinins, dilute, adverse reaction, inherited trait

2 Translate and memorize the explanation to the terms:transfusion the act of transfusing fluid into a vein or arteryprecaution a measure taken beforehand to prevent harm or secure goodinheritance the reception of genetic qualities by

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transmission from parent to offspring

3 Find substitutes for the given phrases: 1) pertaining to injury a) transfusion 2) introduction of blood into the veins b) hypertension 3) inflammation of the bladder c) traumatic 4) high blood pressure in the arteries d) transplant 5) to remove and plant in another place e) cystitis

Blood Groups and Transfusions

Early attempts to transfer blood from one person to another produced varied results. Sometimes the person receiving the transfusion was aided by the procedure. At other times, the recipient suffered a blood reaction in which the red blood cells clumped together, obstructing vessels and producing other serious consequences. Eventually, it was discovered that each individual has a particular combination of substances in his or her blood. Some of these substances react with those in another person's blood. These discoveries led to the development of procedures for typing blood. It is now known that safe transfusions of whole blood depend upon properly matching the blood types of the donors and recipients.Agglutinogens and Agglutinins The clumping of red cells following a transfusion reaction is called agglutination. This phenomenon is due to the presence of substances called agglutinogens (antigens) in the red cell membranes and substances called agglutinins (antibodies) dissolved in the plasma. Blood typing involves identifying the agglutinogens that are present in a person's red cells. Although many different agglutinogens are associated with human erythrocytes, only a few of them are likely to produce serious transfusion reactions. These include the agglutinogens of the ABO group and those of the Rh group. Avoiding the mixture of certain kinds of agglutinogens and agglutinins prevents adverse transfusion reactions.

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ABO Blood Group The ABO blood group is based on the presence (or absence) of two major agglutinogens in red cell membranes – agglutinogen A and agglutinogen B – which are present at birth as a result of inheritance. The erythrocytes of each person contain one of the four following combinations of agglutinogens: only A, only B, both A and B, or neither A nor B. A person with only agglutinogen A is said to have type A blood; a person with only agglutinogen B has type B blood; one with both agglutinogen A and B has type AB blood; and one with neither agglutinogen A nor B has type 0 blood (also called type H). Thus, all humans have one of four possible blood types – A, B, AB, or 0. Because an agglutinin of one kind will react with an agglutinogen of the same kind and cause red blood cells to clump together, such combinations must be avoided. The major concern in blood transfusion procedures is that the cells in the transfused blood not be agglutinated by the agglutinins in the recipient's plasma. For this reason, a person with type A (anti-B) blood must not be given blood of type B or AB, because the red cells of both types would be agglutinated by the anti-B in the recipient's type A blood. Likewise, a person with type B (anti-A) blood must not be given type A or AB blood, and a person with type 0 (anti-A and anti-B) blood must not be given type A, B, or AB blood. Because type AB blood lacks both anti-A and anti-B agglutinins, it would appear that an AB person could receive a transfusion of blood of any other type. For this reason, type AB persons are sometimes called universal recipients. It should be noted, however, that type A (anti-B) blood, type B (anti-A) blood, and type0 (anti-A and anti-B) blood still contain agglutinins (either anti-A or anti-B) that could cause agglutination of type AB cells. Consequently, even for AB individuals, it is always best to use donor blood of the same type as the recipient blood. If the matching type is not available and type A, B, or 0 is used, it should be transfused slowly so that the donor blood is well diluted by the recipient's larger blood volume. This precaution usually avoids serious reactions between the donor's agglutinins and the recipients agglutinogens.

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Similarly, because type 0 blood lacks agglutinogens A and B, it would seem that this type could be transfused into persons with blood of any other type. Therefore, persons with type 0 blood are sometimes called universal donors. Type 0 blood, however, does contain both anti-A and anti-B agglutinins, and if it is given to a person with blood type A, B, or AB, it too should be transfused slowly to minimize the chance of an adverse reaction.Rh Blood Group The Rh blood group was named after the rhesus monkey in which it was first studied. In humans, this group includes several Rh agglutinogens (factors). The most important of these is agglutinogen D; however, if any of the Rh factors are present in the red cell mernbranes, the blood is said to be Rh positive. Conversely, if the red cells lack Rh agglutinogens, the blood is called Rh negative. As in the case of agglutinogens A and B, the presence (or absence) of an Rh agglutinogen is an inherited trait. Unlike anti-A and anti-B, agglutinins for Rh (anti-Rh) do not appear spontaneously. Instead, they form only in Rh-negative persons in response to special stimulation. If an Rh-negative person receives a transfusion of Rh-positive blood, the recipients antibody – producing cells are stimulated by the presence of the Rh agglutinogen and will begin producing anti-Rh agglutinin. Generally no serious consequences result from this initial transfusion, but if the Rh-negative person – who is now sensitized to Rh-positive blood – receives another transfusion of Rh-positive blood some months later, the donor's red cells are likely to agglutinate.

Post-text assignments1 Respond to the given assigments: 1 Distinguish between agglutinogens and agglutinins. 2 What is meant by blood type? 3 What is the main concern when blood is transfusedfrom one individual to another? 4 Why is a type AB person called a universal recipient?

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2 Form sentences of your own using the following words and phrases: immunity to infection, on exertion, mistaken for plasma, life-span, combatting infection, reversible function, responsible for, ulcerative lesions, engulf, deficient in vitamin K, due to hemorrhage, to test for the presence of, capillary fragility

3 Translate into English: 1 Кров - це рідка тканина, яка виконує багато різноманітних функцій. 2 Рідка частина крові називається плазмою. 3 Кров насичується киснем у легенях. 4 У дорослих кров становить від 1/12 до 1/14 маси тіла. 5 Білірубін - продукт гемоглобіну. 6 Запальні стани характеризуються підвищенням ШОЕ, тобто швидкості осідання еритроцитів. 7 Білі кров'яні тільця, або лейкоцити, відіграють важливу роль у боротьбі з інфекціями. 8 Грунтовні знання про сумісність груп крові є необхідними для переливання крові.

Unit 17

Pre-text assignments1 Learn the key words and phrases: leukocytes, myloid leukemia, red bone marrow, lymphoid leukemia, lymph nodes, mature, neutrophils, crowd out, invade, weaken, counteract

2 Find substitutes for the given phrases:1) fatal disease with marked increase in number of blood leukocytes a) myeloma2) inflammation of the skin b) cytopenia3) a tumour composed of cells of the c) lupus erythematousus type normally found in the bone d) occult marrow e) merrow

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4) deficiency in the cells of the blood f) leukemia 5) obscure or hidden from sight 6) soft material filling most ofthe cavities and cancel of the bones

Leukemia

Leukemia is a form of cancer characterized by an uncontrolled production of specific types of leukocytes. There are two major types of leukemia. Myeloid leukemia results from an abnormal production of granulocytes by the red bone marrow, while lymphoid leukemia is accompanied by increased formation of lymphocytes from lymph nodes. In both types, the cells produced usually fail to mature into functional cells. Thus, even though large numbers of neutrophils may be formed in myeloid leukemia, these immature cells have little ability to phagocytize bacteria, and the patient has a lowered resistance to infections. Eventually, the cells responsible for the overproduction of leukocytes tend to spread (metastasize) from the bone marrow or lymph nodes to other parts, and as a result white blood cells are produced abnormally in tissues throughout the body. As with other forms of cancer, the leukemic cells finally appear in such great numbers that they crowd out the normal, functioning cells. For example, leukemic cells originating in red bone marrow may invade other regions of the bone, weakening its structure and stimulating pain receptors. AIso, as the normal red marrow is crowded out, the patient is likely to become anemic and develop a deficiency of blood platelets (thrombocytopenia). The lack of platelets is usually reflected in an increasing tendency to bleed. Leukemias are also classified as either acute or chronic. An acute condition appears suddenly, the symptoms progress rapidly, and death occurs in a few months if the condition is untreated. Chronic forms begin more slowly and may remain undetected for many months. Without treatment, life expectancy is about three years.

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The greatest success in treatment has been achieved with acute lymphoid leukemia, which is the most common cancerous condition in children. This treatment usually involves counteracting the side effects of the condition, such as anemia, hemorrhaging, and an increased susceptibility to infections, as well as administering chemotherapeutic drugs. Although acute lymphoid leukemia may occur at any age, the chronic form usually occurs after fifty years of age. Acute myeloid leukemia also may occur at any age, but it is more frequent in adults; chronic myeloid leukemia is primarily a disease of adults between twenty and fïfty years of age.

Post-text assignments1 Answer the qustions using the topical unit: 1 What is leukemia? 2 Distinguish between myeloid and lymphoid leukemia.

3 Is acute leukemia easily found?4 Where can the symptoms of the disease appear?5 How is acute leukemia developed?6 What factors are involved in the course of acute leukemia?

2 Translate the following terms and use them in making sentences of your own: chemotherapy, granulocytic, dysfunction, hematologist, marrow, immunoglobulin, lymphatic, disorder

3 Discuss the problems of leukemia speculating about the chances of finding an effective treatment in the foreseeable future.

Unit 18

Pre-text assignments:1 Learn the key words and phrases: ducts, pump, mediastinum, bluntly pointed apex, apical heartbeat, atria, ventricles, septum, atrioventricular orifice, cardiac cycle

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2 Choose the correct description of the following terms: 1) disease a) the pressure exerted by the blood against the inner walls of the blood vessels

2) stroke b) any departure from health, a particular destructive process in an organism 3) blood pressure c) a sudden attack, especially of apoplexy or paralysis 4) drug d) physical or mental exhaustion, weariness 5) fatigue e) any substance used as a medicine; narcotic

3 Translate the following expressions: to be composed of smth; to be protected by smth; to be supplied with smth; to distribute smth; by means of smth; to cause smth; any interruption of smth; to be (not) equal in size;to be of vital importance

Cardiovascular System

The cardiovascular system is the portion of the circulatory system that includes the heart and blood vessels. It moves the blood between the body cells and the organs of the integumentary, digestive, respiratory, and urinary systems that communicate with the external environment. In performing this function, the heart acts as a pump that forces blood through the blood vessels. The blood vessels, in turn, form a closed system of ducts, which transports the blood and allows exchanges of gases, nutrients, and wastes between the blood and the body cells. A functional cardiovascular system is vital for survival, because without circulation, the tissues lack a supply of oxygen and nutrients, and waste substances accumulate. Under such conditions, the cells

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soon begin to undergo irreversible changes, which quickly lead to death of the organism.Heart The heart is a hollow, cone – shaped, muscular pump located within the mediastinum of the thorax and resting upon the diaphragm. Although heart size varies with body size, the heart of an average adult is generally about 14 centimeters long and 9 centimeters wide. The heart is located within the mediastinum, and is bordered laterally by the lungs, posteriorly by the backbone, and anteriorly by the sternum. Its base, which is attached to several large blood vessels, lies beneath the second rib. Its distal end extends downward and to the left, terminating as a bluntly pointed apex at the level of the fifth intercostal space. For this reason, it is possible to sense the apical heartbeat by feeling or listening to the chest wall between the fifth and sixth ribs, about 7.5 centimeters to the left of the midline. Internally, the heart is divided into four hollow chambers, two on the left and two on the right. The upper chambers, called atria (sing. atrium), have relatively thin walls and receive the blood from veins. The lower chambers, the ventricles, force the blood out of the heart into arteries. (Note: Veins are blood vessels that carry the blood toward the heart; arteries carry the blood away from the heart.) The atrium and ventricle on the right side are separated from those on the left by a septum. The atrium on each side communicates with its corresponding ventricle through an opening called the atrioventricular orifice, which is guarded by an atrioventricular valve (A-V valve). The wall of the heart is composed of three distinct layers: an outer epicardium, a middle myocardium, and an inner endocardium. The epicardium, which corresponds to the visceral pericardium, functions as an outer protective layer. It is a serous membrane that consists of connective tissue covered by epithelium, and it includes blood capillaries, lymph capillaries, and nerve fibers. The middle layer, or myocardium, is relatively thick and consists largely of the cardiac muscle tissue responsible for forcing the blood

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out of the heart chambers. The muscle fibers are arranged in planes, separated by connective tissues that are richly supplied with blood capillaries, lymph capillaries, and nerve fibers. The inner layer, or endocardium, consists of epithelium and connective tissue that contains many elastic and collagenous fibers. The connective tissue also contains blood vessels and some specialized cardiac muscle fibers called Purkinje fibers. The endocardium lines all of the heart chambers and covers the structures, such as the heart valves, that project into them. This inner lining is also continuous with the inner lining of the blood vessels (endothelium) attached to the heart.

Post-text assignments:1 Say what heart valve is described in each sentence:1 This valve connects the atrium and the ventricle of the left heart chamber. 2 This valve connects the atrium and ventricle of the right heart chamber. 3 This valve is located at the point of origin of the aorta in the left ventricle. 4 This valve is located at the point of origin of the pulmonary artery in the right ventricle.2 Combine the nouns with appropriate verbs: the heart, the blood, the artery; contract, pass, dilate, bring, regulate, pump, vary, beat, compose, work, consist of, discharge out, receive, enter, act, serve, send, oxyginate, carry

3 Say what is meant in the following sentences: 1 This part of the heart discharges out the blood received from the pulmonary circulation through the aorta to the systemic circulation. 2 This part of the heart discharges out the blood received from the systemic circulation to the lungs through the pulmonary arteries. 3 These corpuscles have great elasticity and flexibility. These features give them the possibility to pass through very small capillaries. 4 The count of these corpuscles in the blood of a healthy person is 5,000 to 7,000 per cu mm. The number of these corpuscles increases when a person becomes ill.

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4 Choose the anatomic terms for the following:1 The valve between the left atrium and left ventricle of the heart, preventing a flow of blood into the atrium during systole. 2 The flaps on the valves. 3 A muscular wall which is between the two lower chambers of the heart. 4 A septum which separates the two upper chambers (atria) of the heart. 5 The middle, the thickest layer of the heart wall. 6 A delicate membrane (double-folded) which surrounds the heart like a sac. 7 A thin outer layer of the heart wall. 8 The vein that carries (drains) blood from the upper part (portion) of the body. 9 The vein that carries blood from the lower part of the body. 10 A blood vessel that carries blood from some part of the body toward the heart. 11 A blood vessel that carries blood from the heart to the principal parts of the body. 12 The usual contraction of the heart. 13 The usual dilatation of the heart. 14 The main artery of the body which carries blood from the left ventricle of the heart to arteries in all organs and parts. (a – superior vena cava; b – systole; c – aorta; d – mitral valve; e – vein; f – inferior vena cava; g – pericar-dium; h – interatrial septum; i – cusps; j – epicardium; k – diastole; l – myocardium; m – artery; n – interven-tricular septum)

5 Find the necessary word with a definition that best completes each sentence: 1 The aorta is the main ... of the systemic arteries. 2 Most of the arteries are composed of three ... .3 The blood vessels on the anterior ... of the arm were dilated. 4 The walls of the left ... are three times as thick as the walls of the right one. 5 Blood pressure is measured by a device called a .... 6 Diastole is the ... phase of the heartbeat. 7 Systole is the active ... phase of the heartbeat. a) coats: the layers of a tissue; b) ventricle: either of the two lower chambers of the heart which receive blood from the atria and pump it into the arteries; c) surface: the outer face or exterior of an object; d) relaxation: loosening, lessening of force, etc.; e) vessel: a tube or duct containing or circulating a body fluid; f) sphygmomanometer: an instrument consisting of a band wrapped around the upper arm to

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compress the artery, and an attached manometer; g) contraction: the drawing up and thickening of a muscle fiber or a muscle in action

6 What is it? The innermost layer of the heart, consists of an endothelial lining and its supporting connective tissue. The endothelium is a single layer of flattened epithelial cells, which is continuous with the endothelium of the vessels entering and leaving the heart. The endothelium is supported by a delicate layer of fibreelastic connective tissue which accomodates gross movements of the myocardium without damage to the endothelium. The endocardium contains blood vessels, nerves and branches of the conducting system of the heart.

7 What it is? Free surface of it is covered by a single layer of flattened epithelial cells, the mesothelium; a similar mesothelial layer lines the opposing parietal pericardial surface. The mesothelial cells secrete a small amount of serous fluid which lubricates the movement of the epicardium on the parietal pericardium. A thin layer of fibro-elastic connective tissure supports the mesothelium; this layer is connected to the myocardium by a broad layer of adipose connective tissue.

Unit 19

Pre-text assignments:1 Learn the key phrases: cardiac cycle, isolated pumps, the only route of communication, well-oxygenated, continuous circulation

2 Remember the meaning of the term-element "cardio." Form new words using it: acceleration, active, dilator, thrombosis, inhibitory, kinetic, muscular, necrosis, pneumatic, spasm, stimulator, valvulitis, vascular, myopathy, circulation

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3 Analyse the structure of the following terms: bradycardia, tachycardia, cardiomegaly, angionecrosis, angiospasm, angiography, angiostenosis, hemangioma, arteriosclerosis, arterial, arteritis, ventriculotomy, ventricular, atrioentricular, vasodilation, vasoconstriction

4 Give the meaning of the following:l) vasoconstriction a) inserting a catheter into the heart.2) cardiac murmur b) chest pain3) cardiac catheterization c) tightening of a vessel4) ischemia d) abnormal sound in the heart5) nitroglycerin e) twisted, dilated veins6) varicose veins f) abnormal heart rhythm7) infarction g) drug given for the relief of angina 8) arrhythmia pectoris9) emboli h) area of dead tissue10) angina pectoris i) closure of a blood vessel11) occlusion j) insufficient blood flow to a tissue k) floating clots or other material carried in the bloodstream

5 Tanslate the following:1 The blood will have less oxygen combined with hemoglobin because the need of the active muscles has withdrawn more oxygen than in a restful state. 2 Cardiac failure may be present when the heart is functioning at 90 per cent efficiency or any fraction of the norma1 100 per cent effectiveness. 3 A drug extracted from a plant of the digitalis group is indicated in almost all cases of heart failure.

Actions of the Heart

Although the previous discussion described the actions of the heart chambers separately, they do not function independently. Instead, their actions are regulated so that the atrial walls contract while the ventricular walls are relaxed, and ventricular walls contract while the

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atrial walls are relaxed. Such a series of events constitutes a complete heartbeat or cardiac cycle. At the end of each cycle, the atria and the ventricles remain relaxed for a moment, and then a new cycle begins. During a cardiac cycle, the pressure within the chambers of the heart rises and falls. For example, when the atria are relaxed, the blood flows into them from the large, attached veins. As these chambers fill, the pressure inside gradually increases. About 70% of the entering blood flows directly into the ventricles through the atrioventricular orifices before the atrial walls contract. Then, during atrial contraction (atrial systole), the atrial pressure rises suddenly, forcing the remaining 30% of the atrial contents into the ventricles. Although the heart is a unit, anatomically and functionally, it can be thought of as two isolated pumps – the "right heart" and the "left heart". Normally the only route of communication between these two parts of the heart is the lung. The right heart receives blood from the veins and pumps it into the lung by way of the lesser circulatory system. In the lung the blood is supplied with oxygen. Then it moves into the left heart. From the left heart the well-oxygenated blood is pumped into a large artery called the aorta, which distributes it to the entire body by means of the greater circulatory system. The blood is returned to the heart by means of the veins. A continuous circulation is thus kept up.

Post-text assignments:1 Respond to the following assignments:1 Where is the heart located?2 Name and locate the four chambers of the heart.3 Name the structure that separates the right and left sides of the heart.4 Describe the pressure changes that occur in the atria and ventricles during a cardiac cycle.5 What causes heart sounds?6 How do changes in body temperature affect the heart rate?

2 Add the proper combining form, suffix or prefix, to the parts of medical terms so as to fit their definitions:

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1 A thickening and loss of elasticity in the inner walls of arteries, accompanied by the formation of the deposition of fatty compounds (athero...). 2 A thickening and loss of elasticity of the walls of the arteries, as in old age (...sclerosis). 3 Abnormal heart rhythms (...rrhythmia). 4 Inflammation of the endocardium (endocard...). 5 A narrowing or constriction of a passage, duct, opening (as in a mitral valve of a heart (mitral .. osis). 6 High blood pressure affecting the heart and blood vessels (...tension). 7 Inflammation of a vein (...itis). 8 Lack of oxygen in blood (de...genation). 9 The branch of medicine dealing with the heart, its functions, and its diseases (cardio...). (a – a...; b - ...sclerosis; c – arterio...; d – sten...; e – ...itis; f – phleb...;g – hyper...; h – ...logia; i – oxy...)

3 Translate in writing: The valves of the heart consist of leaflets of connective tissue, the surfaces being invested with a thin endothelial layer continuous with that of the heart chambers and great vessels. The connective tissue of each leaflet forms a tough fibrous sheet, the lamina fibrosa. The valve connective tissue also contains a significant amount of elastin. At the attached margins of each valve, the collagenous tissue becomes condensed to form a fibrous ring and the rings of 'the four valves together form a central fibrous "skeleton" which is continuouswith the connective tissue of the myocardium, endocardium and epicardium.

4 Do you know that:normocardia – a heart rate 60-100 beats/mintachycardia – a heart rate that exceeds 100 beats/minbradycardia – a heart rate of less than 60 beats/min

5 Give extended answers:1 What do the contractions of the heart produce? 2 What is the cardiac cycle composed of? 3 What is the role of the ventricles and atria? 4 Describe the pulmonary circulation. 5 Describe the systemic circulations. 6 What are the corpuscular elements of blood? 7 What

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are the heart sounds? 8 Where is the first (second, third) heart sound heard? 9 What do heart sounds help the doctors to determine?

Unit 20

Pre-text assignments:1 Learn the key words and phrases: blood vessels, arteries, arterioles, capillaries, venules, veins, extensions, squamous epithelial cells, semipermeable membranes

2 Match the blood vessel or heart condition with its description:1) rheumatic heart disease a) damage of the normal heart rhythm2) atrial fibrillation b) a vessel which supplies blood to the heart3) coronary artery disease c) irregular contractions of the upper chambers of the heart4) arrhythmia d) inflammation of the inner lining of the heart5) vein e) bradycardia or tachycardia

Blood Vessels

The blood vessels are organs of the cardiovascular system, and they form a closed circuit of tubes that carries blood from the heart to the body cells and back again. These vessels include arteries, arterioles, capillaries, venules, and veins. The arteries and arterioles conduct blood away from the ventricles of the heart and lead to the capillaries. The capillaries function to exchange substances between the blood and the body cells, and the venules and veins return blood from the capillaries to the atria. Arteries are strong, elastic vessels that are adapted for

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carrying the blood away from the heart under relatively high pressure. These vessels subdivide into progressively thinner tubes and eventually give rise to fine branches called arterioles.Capillaries are the smallest blood vessels. They form the connections between the smallest arterioles and the smallest venules. Capillaries are essentially extensions of the inner linings of these larger vessels, in that their walls consist of endothelium – a single layer of squamous epithelial cells. These thin walls form the semipermeable membranes through which substances in the blood are exchanged for substances in the tissue fluid surrounding body cells. The distribution of blood in the various capillary pathways is regulated mainly by the smooth muscles that encircle the capillary entrances.Venules are the microscopic vessels that continue from the capillaries and merge to form veins. The veins, which carry blood back to the atria, follow pathways that roughly parallel those of the arteries. The walls of veins are similar to those of arteries in that way they are composed of three distinct layers. However, the middle layer of the venous wall is poorly developed. Consequently, veins have thinner walls that contain less smooth muscle and less elastic tissue than those of comparable arteries. Blood pressure is the force exerted by the blood against the inner walls of the blood vessels. Although such a force occurs throughout the vascular system, the term blood pressure most commonly refers to systemic arterial pressure. The arterial blood pressure rises and falls in a pattern corresponding to the phases of the cardiac cycle. That is, when the ventricles contract (ventricular systole), their walls squeeze the blood inside their chambers and force it into the pulmonary trunk and aorta. As a result, the pressures in these arteries rise sharply. The maximum pressure achieved during ventricular contraction is called the systolic pressure. When the ventricles relax (ventricular diastole), the arterial pressure drops, and the lowest pressure that remains in the arteries

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before the next ventricular contraction is termed the diastolic pressure. The surge of blood entering the arterial system during a ventricular contraction causes the elastic walls of the arteries to swell, but the pressure drops almost immediately as the contraction is completed, and the arterial walls recoil. This alternate expanding and recoiling of an arterial wall can be felt as a pulse in an artery that runs close to the surface.

Post-text assignments:1 Answer the questions using the topical unit:1 Distinguish between systolic and diastolic blood pressure.2 What cardiac event is responsible for the systolic pressure? For the diastolic pressure?3 What causes a pulse in an artery?

2 Respond to the given questions:1 Based on your understanding of the way capillary blood flow is regulated, do you think it is wiser to rest or to exercise following a heavy meal? Give a reason for your answer.2 If a patient develops a blood clot in the femoral vein of the left leg, and a portion of the clot breaks loose, where is the blood flow likely to carry the embolus? What symptoms is this condition likely to produce?3 When a person strains to lift a heavy object, intrathoracic pressure is increased. What do you think will happen to the rate of venous blood returning to the heart during such lifting? Why?4 Why is a ventricular fibrillation more likely to be life threatening than an atrial fibrillation?

3 Choose the proper continuation:1 the tunica intima the epicardium, surrounded by a space, the pericardial cavity, enclosed by a fibrous sac;2 the tunica demia endocardium, smooth layer of cells which lines the interior of the heart;3 the tunica adventitia myocardium, the thickest muscular layer.

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4 What is characterized by the following features?1The tunica consists of little more than the endothelial lining.2 The tunica media is thin compared with that of arteries.3 The tunica adventitia is the thickest layer-of the vessel wail and is composed of longitudinally arranged thick collagen fibres which merge with the surrounding connective tissue. (vein or aorta).

Unit 21

Pre-text assignments:1 Learn the key words and phrases: pulmonary circuit, systemic circuit, pulmonary trunk, lobar branches, pulmonary capillaries, pulmonary veins, vascular loop, companion system of veins

2 Match the following English phrases with Ukainian ones:1) red blood cells a) згортання крові2) to combat infection b) забезпечувати необхідну кількість крові3) to destroy bacteria c) червоні кров’яні тілця4) clotting of blood d) боротися з інфекцією5) to maintain an adequate blood volume e) руйнувати бактерії

3 Match the words with the opposite meaning and use them in the sentences of your own:1) benign, to exclude, frequently, insufficiency, permanent, to diminish, to improve, to appear, gradual2) to increase, seldom, malignant, sufficiency, to aggravate, to include, to be constant, sudden, to disappear

Paths of Circulation

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The blood vessels of the cardiovascular system can be divided into two major pathways – a pulmonary circuit and a systemic circuit. The pulmonary circuit consists of those vessels that carry the blood from the heart to the lungs and back to the heart. The systemic circuit is responsible for carrying the blood from the heart to all other parts of the body and back again.Pulmonary Circuit The blood enters the pulmonary circuit as it leaves the right ventricle through the pulmonary trunk. The pulmonary trunk extends upward and posteriorly from the heart, and about 5 centimeters above its origin, it divides into the right and left pulmonary arteries. These branches penetrate the right and left lungs, respectively. Within the lungs, they divide into lobar branches (three on the right side and two on the left) that accompany the main divisions of the bronchi into the lobes of the lungs. After repeated divisions, the lobar branches give rise to arterioles that continue into the capillary networks associated with the walls of the alveoly. The blood in the arteries and arterioles of the pulmonary circuit has a relatively low concentration of oxygen and a relatively high concentration of carbon dioxide.Gas exchanges occur between the blood and the air as the blood moves through the pulmonary capillaries. As a result of the gas exchanges occurring between the blood and the alveolar air, the blood entering the venules of the pulmonary circuit is rich in oxygen and low in carbon dioxide. Four pulmonary veins, two from each lung, return blood to the left atrium, and this completes the vascular loop of the pulmonary circuit.Systemic Circuit The freshly oxygenated blood received by the left atrium is forced into the systemic circuit by the contraction of the left ventricle. This circuit includes the aorta and its branches that lead to all of the body tissues, as well as the companion system of veins that returns the blood to the right atrium.

Post-text assignments:1 Respond to the following tasks:

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1 Distinguish between the pulmonary and systemic circuits.2 Trace a drop of blood through the pulmonary circuit from the right ventricle.3 Explain why the alveoli normally remain dry.

2 What system is this? A characteristic feature of the system is the numerous delicate valves in small and medium sized vessels. The structure of these valves is similar to that nerves in the venous system, but the connective tissue core consists merely of reticulum fibres and a little ground substance. (venous or lymphatic)

3 Choose the proper answer:1 What is called pulmonary circulation? a) the circulation of blood from the body organs to the heart and back again; b) the circulation of blood from the heart to ttie lungs and back to the heart.2 Where does the left ventricle discharge out the blood? a) to the lungs through the pulmonary arteries; b) to the systemic circulation through the aorta.3 What are the arteries characterized by? a) carry blood away from the heart; b) carry deoxygenated blood.

Unit 22

Pre-text assignments:1 Learn the key words: atherosclerosis, atheromatous, thrombosis, saturated, utilization

2 Translate the following phrases: to cause death, utilization ofsmth, to elevate cholesterol level, to

reduce cholesterol in blood, to affect smth.

3 Match the terms to the following definitions:61

1) hardening and degeneration of arterial walls a) atheroma2) the formation or presence of a thrombus in b) thrombosis a blood vessel c) cholesterol3) the principal animal sterol d) atherosclerosis4) degeneration of coats of blood vessels e) affection5) morbid condition or diseased state

Atherosclerosis

The diseases associated with the condition commonly known as "hardening of the arteries" cause more deaths than any other group of diseases. Atherosclerosis is the process and result of the accumulation of fats and fatlike substances (lipoids or lipidis) within the walls of arteries. Among these substances are cholesterol and phospholipids, present also in the blood plasma of all persons. High cholesterol levels are associated with increased amounts of the atheromatous materials in the arterial walls and with the complications of this pathological condition. The disease affects me coronary arteries notably, giving rise to the angina pectoris, coronary thrombosis, abnormal heart rhythms, as well as weakness and failure of the heart. The causes and methods of prevention ofafherogenesis have been under increasingly intensive study for many decades. In recent years it has been shown that cholesterol level in the blood rises with increases in the amount of ordinary fats in the diet. Fats that contain unsaturated fatty acids cause smaller increases in cholesterol blood levels than do the fats composed of saturated fatty acids. Corn oil, certain other vegetable or plant oils, and certain fish oils are example of unsaturated fats containing unsaturated fatty acids and producing smaller rises in blood cholesterol. Indeed, corn oil has been shown to lower cholesterol levels and is now used by some individuals in the belief that they may be spared much, if not all, of the atherosclerosis they may ordinarily expect. The fats of animals (even in the "lean meat"), milk and eggyolk products (including butter), and, to a

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slightly lesser extent, shortenings such as oleomargarine are mainly saturated or hard fats and definitely elevate cholesterol levels. Several products containing plant oils with unsaturated fatty acids, principally linoleic, have recently been made available. This and cortam other acids have been shown in animals to be necessary dietary factors, comparable to essential amino acids. Since pyridoxine (vitamin B^) is required for the proper utilization of these essential vegetable fatty acids, it is incorporated in many products containing these acids. Among these are Linodoxine and Arcofac. Lenic capsules contain the fatty acids without piridoxine. These products are of little value unless the saturated fat in the diet is markedly reduced. This alone is usually somewhat effective. Measures for Lowering Blood Cholesterol. An effective but not a very extensively used agent for lowering blood cholesterol is nicotinic acid or niacin (a vitamin of the B complex). It causes flushing at first but doses of 3 to 6 mg daily in divided amounts orally may be given for long periods of time with apparent safety and continued effect. Another agent for attempting to reduce blood cholesterol is a 20 per cent suspension ofbeta-sitosterols (Cytellin), the sterols of certain plants. It is used in a dose of 15 to 30 ml before meals. It is thought to suppress absorption of cholesterol from the intestines, but reports have been conflicting and it is not widely used. A new drug, triparanol, is now one of the leading agent for reducing the cholesterol level in the blood.

Post-text assignments:1 Answer the questions:1 What is atherosclerosis caused by? 2 What are highcholesterol levels associated with? 3 What does the disease affect? 4 When does the cholesterol level rise? 5 What do fats cause? 6 What produces smaller rises in blood cholesterol?

2 Name the agents lowering the blood cholesterol.

3 Translate the following:

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1 Атеросклероз супроводжується відкладанням холестерину в стінках артерій, що негативно позначається на їх еластичності. 2 Порушення жирового обміну є однією з причин розвігпсу атеросклерозу. З Гіпертонічна хвороба може спричинятися атеросклерозом. 4 Підвищення тиску крові створює сприятливі умови для відкладання холестерину на внутрішніх стінках артерій. 5 Розлад центральної нервової системи, яка регулює обмін речовин, сприяє розвиткові атеросклерозу. 6 Підвищення артеріального тиску і судинні спазми також можуть спричинити склеротичні зміни в судинах. 7 Наслідками атеросклерозу можуть бути коронарний тромбоз, порушення ритму серця і стенокардія.

4 Choose the word that correctly completes each of the following sentences:1 The atherosclerosis patient should ... at least 7 – 8 hours. 2 Those who drink alcohol do a great damage (harm) to die .... 3 Vitamins are most... in treating atherosclerosis. 4 Vitamins prevent tile ... from getting fatty and improve the metabolic processes. 5 The patient has a healthy heart, a healthy ... of lungs, and an adequate blood volume. 6 A doctor can ... heart.... 7 Do you know Ac expressions "... heart", "to... heart"?

(a – deer, dear; louse, lose, loose; b – slip, sleep; c – lever, liver; d – hair, hear, hare, here; noise, rales, clamour, murmur; e – hut, hat,

hurt, heart; f – important, impotent;g – peer, pear, pair, pyre)

5 Read the quotation. Interpret its meaning in 10-12 sentences: "When you talk with the patient you should listen, firstly, for what he wants to tell, secondly, for what he does not want to tell, thirdly, for what he cannot tell.” (Z. Henderson)

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Додаток А

Drawing 1. Major bones of the skeleton

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Anterior view

Додаток Б(обов’язковий)

Drawing 2. Major bones of the skeleton66

Posterior view

Додаток В(обов’язковий)

Drawing 3. Anterior view of superficial skeletal muscles67

Додаток Д(обов’язковий)

Drawing 4. Posterior view of superficial skeletal muscles68

Список літератури1 John W. Hole. Human Anatomy and Physiology. – USA: Wm. C. Brown Publishers, – 1990. – Cт. 179-343, 513-559.

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