Medical English 1.pdf

MEDICAL ENGLISH 1

Autores: Verónica Clavijo Bazalar. Fernando Cornejo Sánchez.

UNIT

1
Booking a Doctor's Appointment
Receptionist: Doctor's office. Jane speaking. How can I help you? Caller: I need to make an appointment with Dr. Harris. Receptionist: Do you know your chart number? Caller: No, sorry. It's at home and I'm at work right now. Receptionist: No problem. What's your name, please? Caller: George Mason. Receptionist: Okay Mr. Mason. Hold one moment while I grab your chart, please. Caller: Sure. Receptionist: Thanks for waiting. Now, what do you need to see the doctor about? Caller: Well, I am fighting a cold these days, and I think I have a chest infection or something. My cough is getting worse each day. Receptionist: Hmm. Doctor Harris is off tomorrow. Do you think it can wait until Wednesday? Caller: Oh, it is urgent. I feel bad Receptionist: No problem, I will help you. Check your understanding 1. Why does the caller phone the doctor's office? a) He's running late for his appointment. b) He's booking an appointment with Dr. Harris. c) He can't remember his chart number. d) His medication ran out.

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2. Which is true about George Mason? a) He has a bad cold. b) He's running a fever. SIMPLE PRESENT TENSE TO HAVE Affirmative statements SUBJECT I You We They He She It have have have have has has has VERB COMPLEMENT fever a cold stiff neck a sunburn fever a cold a stiff neck c) His cough is better. d) He's off on a sick day.

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1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Have a headache Have an earache Have a toothache Have a stomachache Have a backache Have a sore throat Have fever Have a cold Have a cough Have a virus Have an infection Have a rash Have an insect bite

14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26.

Have a sunburn Have a stiff neck Have a runny nose Have a bloody nose Have a cavity Have a wart Have (the) hiccups Have (the) chills Have cramps Have diarrhea Have chest pain Have shortness of breath Have laryngitis

NEGATIVE STATEMENTS SUBJECT I You We They He She It AUXILIARY do not / don’t VERB have have have have have have have COMPLEMENT fever a cold a stiff neck a sunburn fever a cold a stiff neck

does not / doesn’t

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INTERROGATIVE STATEMENTS AUXILIARY Do SUBJECT I you we they he she it AUXILIARY have have have have have have have SUBJECT VERB COMPLEMENT QUESTION MARK

Does

“WH” QUESTION WORDS How often

VERB

fever ? a cold a stiff neck a sunburn fever ? a cold a stiff neck COMPLEMENT QUESTION MARK fever a cold a stiff neck a sunburn fever a cold a stiff neck ?

do

When Why

does does

I you we they he she it

have have have have have have have

?

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TO BE

27. Be faint/weak 28. Be dizzy 29. Feel nauseous

30. Be bloated 31. Be congested 32. Be exhausted

TYPE OF SENTENCE + + ? ?

SUBJECT I You She We Is Are

AUXILIARY VERB am are is are he they

NEGATIVE FORM

COMPLEMENT a patient. a physician.

not not

insane. swollen. weak. vitamins?

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OTHER VERBS

33. 34. 35. 36. 37. 38. 39. 40. 41.

Cough Sneeze Wheeze Burp Vomit/throw up Bleed Twist Sprain Dislocate

42. 43. 44. 45. 46. 47. 48. 49. 50.

Scratch Scrape Bruise Burn Break Hurt Cut Swell Itch

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ACTIVITIES
A. CHANGE THE FOLLOWING SENTENCES INTO THE APPROPRIATE FORM.

+ ?

affirmative sentences negative sentences interrogative sentences

1)

She has a cold or allergies (?) _______________________________________________________________________

2)

They sneeze every minute (-)

__________________________________________________________________
3) My sister doesn’t cough (+) ________________________________________________________________________ 4) My husband is dizzy (?) ________________________________________________________________________ 5) Does he feel nauseous? (+)

__________________________________________________________________
6) His brother is exhausted (-)

_________________________________________________________________
7) You aren’t a good dentist (?) _______________________________________________________________________ 8) I don’t wait for anybody (+)

_________________________________________________________________
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9)

It itches badly (-) _____________________________________________________________________

10)

They aren’t here (+)

________________________________________________________________
B. 1. PUT IN ORDER THE FOLLOWING SENTENCES. in / friends / I / have / don’t / class/ this / many.

________________________________________________________________
2. hospital / to / go / to / They / the / want. _____________________________________________________________________ 3. aren’t / These / your / patients. _____________________________________________________________________ 4. need / I / a / don’t / psychologist _____________________________________________________________________ 5. burp / he / vomit /?/ Does / and/ often

_______________________________________________________________
C. 1. 2. 3. 4. 5. FIND THE MISTAKES IN THE FOLLOWING SENTENCES AND REWRITE THEM. He don’t eat fish __________________________________________________ The children is tired

_____________________________________________

My patients isn’t there ____________________________________________ We has a sunburn and you feel nauseus ________________________________ Do she work in those medical facility? ____________________________________

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Medical Specialists
Medical specialists are experts in certain fields of medicine. They treat specific parts of the body, such as the stomach or the heart, or they specialize in certain diseases, such as AIDS. Family doctors keep a list of local specialists and can help patients choose the right specialist for each medical issue. In many cases, specialists require a referral from a family doctor before they will see a patient. Here is a list of the most common types of specialists. Study the list and then check your understanding by taking the quiz.

Allergist: specializes in determining food and environmental allergies Anesthesiologist: specializes in pain prevention during surgery Cardiologist: heart specialist Chiropractor: back specialist Dentist: tooth specialist Dermatologist: skin specialist Fertility specialist: helps people who have difficulty getting pregnant Gynecologist: specializes in women's needs Massage therapist: specializes in muscle relaxation Midwife: helps women deliver babies in a natural way Naturopath: specializes in natural cures and remedies Neurologist: brain specialist Obstetrician: specialist for pregnant women Occupational therapist: specializes in workplace health Oncologist: tumor specialist, including cancer Ophthalmologist: specializes in eye diseases Pediatrician: specialist for babies and children Medical English 1 Page 9

Physical therapist: specializes in the body's movement Podiatrist: foot specialist Psychiatrist: specialist in mental health Radiologist: specializes in imaging tests ACTIVITIES A. Read the patient complaints and say which specialist each patient needs.

1. I have a terrible rash on my arms and legs. I think I'm allergic to dairy food, but it also might be grass. a) chiropractor b) ophthalmologist c) allergist d) psychiatrist

2. My husband and I just took a home pregnancy test, and it came out positive. We want to know when we are due and we want to make sure the fetus is healthy. a) podiatrist b) pediatrician c) obstetrician d) pharmacist

3. I still can't walk and it's been three months since my accident. I hate being stuck in a wheelchair. a) anesthesiologist b) physical therapist c) radiologist d) dentist

4. The test results show that I have an advanced form of blood cancer. a) oncologist b) neurologist c) midwife d) allergist

5. My left eye has an infection that won't go away and my vision has been blurry for two weeks now. a) podiatrist b) massage therapist c) ophthalmologist d) radiologist

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6. I don't want to take any drugs that will cause me to become addicted to them, but I do need some sort of pain relief. a) naturopath b) dentist c) cardiologist d) dermatologist

7. I've been having major chest pains this week. I'm also having trouble breathing. a) gynecologist b) cardiologist c) oncologist d) dermatologist

8. I get terrible acne and I have tried all of the products in the pharmacy. I don't know what to do now. a) massage therapist b) podiatrist c) occupational therapist d) dermatologist

9. My baby is not developing properly. She hasn't put on any weight in two months and she keeps getting ear infections. a) anesthesiologist b) pediatrician c) midwife d) massage therapist

10. My husband and I have been trying to get pregnant for three years. We have tried everything that the books suggest. a) fertility specialist b) oncologist c) psychiatrist d) dentist

B. Which are they specialties? Choose the right word for each number. X-ray technician; gynecologist; psychiatrist; emergency medical technician; surgeon; pediatrician; cardiologist; optometrist, obstetrician; dentist; doctor; nurse; lab technician.

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UNIT

Head
Read the text below and answer the questions

2

Inside the head is the brain, which is responsible for thinking. The top of a person's scalp is covered with hair. Beneath the hairline at the front of the face is the forehead. Underneath the forehead are the eyes for seeing, the nose for smelling, and the mouth for eating. On the outside of the mouth are the lips , and on the inside of the mouth are the teeth for biting and the tongue for tasting. Food is swallowed down the throat. At the sides of the face are the cheeks and at the sides of the head are the ears for hearing. At the bottom of a person's face is the chin. The jaw is located on the inside of the cheeks and chin. The neck is what attaches the head to the upper body.

1. Where is the brain? ___________________________________________________________________ 2. Where is the forehead? ___________________________________________________________________
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3. Where are the lips? __________________________________________________________________ 4. What can you do with your teeth? __________________________________________________________________ 5. Where are the ears? __________________________________________________________________ 6. Where is the chin located? __________________________________________________________________ 7. Where is the jaw located? _________________________________________________________________ Present Progressive We use the present continuous tense to talk about:
 

action happening now action in the future AUXILIARY VERB am are is are he they not not MAIN VERB examining prescribing sleeping coughing vaccinating taking the children? vitamins? COMPLEMENT a patient. the medicine in the hospital.

SUBJECT + + ? ? I You She We Is Are

ACTIVITIES A. 1. 2. 3. 4. Complete the following sentences with the present continuous. The doctors _______________ (vaccinate) the children right now. The gynecologist ________________________ (examine) Lucia these days. The doctor __________________ (prescribe) medicines right now. Listen! Michael_____________________ (cough) a lot.

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5. 6. 7. 8. 9. 10.
B.

I ______________________ (drink) cough syrup at this moment. Jake _________________________ (suffer) a terrible disease. Doctor, ______________________ you ________________ (cure) Mr. Baker? Look! A biologist _____________________ (analyze) a microbe. My children __________________________ (catch) a cold. _______________ you _______________(arrange ) an appointment?
Decide which of the choices below would best complete the article if inserted in the blanks. Circle the appropriate letters. Too Much Fast Food?

According to a recent survey, these days Hong Kong consumers (1)_______ more money on convenience foods since the economic downturn. Because companies are trying to make more with fewer staff, employees (2) ________ harder than ever before. More women (3)__________ the workforce as well. They (4) _________less time to prepare nutritious home-cooked meals for their families. Instead, families (5)_________ out or (6) ________ convenience foods, such as frozen pizzas and instant noodles. These foods (7) …………more fat, salt and sugar than home cooked meals. Experts say that eating too much of them (8)………… the risk of serious health problems, including diabetes and heart disease. However, the current trend towards convenience foods (9) ………benefitting some business sectors. Supermarkets (10)………….. to the higher demand for quick, easy -to-serve meals by increasing their selection of convenience and pre-packaged foods. These products (11) ………. for higher prices than fresh food. Restaurants also (12)…………. from the trend: most Hong Kong people now (13)………… out at least once a day. Is convenience food just a fad or is home-cooked food (14)…………. a thing of the past? How (15) …………………….this trend affecting our health? 1. A are spending B spends C spend 2. A work B works C are working 3. A joins B are joining C join 4. A has B have C had

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5. A are eating B eats C eat 6. A bought B buys C buy 7. A containing B contains C contain 8. A increase B increasing C increases 9. A is B are C be 15. A does B is
C have C.

10. A respond B responded C are responding 11. A sells B are sold C sell 12. A profit B are profiting C profits 13. A eat B ate C were eating 14. A become B became C becoming

Supplies and Tools. Here is a list of some of the most common supplies found in doctor's offices, operating rooms, and medical kits. Study the vocabulary and try the matching exercise. Antiseptic Bandage Forceps Gauze Microscope a) b) c) d) e) thin, netted material used for dressing wounds an instrument used to check a person's body temperature liquid used to sterilize (clean) the surface of the skin a cylinder-shaped piece that attaches to a needle and can be filled with liquid a cloth covering that is placed over a wound to prevent bleeding, swelling and infection f) glass cylinder that is filled with blood or other liquids and can be capped and placed in a storage area g) equipment that fits over the nose and mouth and supplies oxygen h) instrument used during operations and medical procedures (assists the doctor in pulling, holding, and retrieving) i) a device that measures a person's weight j) equipment that makes small things appear larger than they are

1. 2. 3. 4. 5.

6. Oxigen mask 7. Scales 8. Syringe 9. Test tube 10. Thermometer

ADDITIONAL INFORMATION http://www.hospitalenglish.com/flashcards/files/procedures_flash.pdf Explain: take blood pressure, give a shot, listen to lungs, check ears, check eyes, start an IV, look at an MRI scan,
take temperature, take pulse, prep for surgery, operate, bandage, write in the chart, pay the bill, take the patient to...

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UNIT

3
Main Structures of the Digestive System
The digestive tract is a long continuous tube that starts with the mouth and ends with the anus. It includes the mouth, pharynx, esophagus, stomach, small intestine, and large intestine. The tongue and teeth located in the mouth are accessory structures. The salivary glands, gallbladder, liver, and pancreas are the other accessory organs of the digestive system that secretes digestive enzymes into the digestive tract that are involved in the process of digestion. Mouth: The mouth contains tongue and teeth. With the help of these the food is chewed (broken into tiny pieces) and mixes with saliva (secreted by salivary glands) Pharynx: Is a funnel shaped opening through which the food from mouth passes to esophagus. Esophagus: Is a long tubular structure that with the help of peristalsis movement passes food to the stomach. Stomach: A large sac-like structure that holds the food for a while where it gets mixed with the hydrochloric acid and gastric juice. Small intestine: It is a long muscular tube that is divisible into the duodenum, the jejunum, and ileum. Secretions of liver, gallbladder, and pancreas are passed into the small intestine, where the major part of the digestion occurs. Large intestine: Minor part of the digestion occurs in large intestine and is divisible into cecum, colon, and rectum. Reabsorption of water and absorption of food material takes place in large intestine. Anus: The indigested food is excreted out through anus. Liver: Liver is the largest organ of the human body and it is involved in synthesis and secretion of bile that plays a role in emulsification of fats. Liver secreted from live is stored in gallbladder, from which it flows into small intestine. Pancreas: Pancreas secretes pancreatic juice.

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PLURAL FORM OF NOUNS
CASE General rule DESCRIPTION OF THE RULE The plural form of most nouns is created simply by adding the letter “s” to the end of the word. The plural is formed by adding “es” STRUCTURE NOUN + “-S” EXAMPLE minute - minutes

When nouns end in -ch, -x, -s, -sh, -z or s-like sounds

NOUN + “-ES”

Nouns ending in “o”

When they are preceded by a consonant. Except: newly created words or words with Spanish or Italian origin. When they are preceded by a consonant, they drop the “y” and add “ies” When they are preceded by a VOWEL, add a “s” Drop the “f” or “fe” and add “ves”

NOUN + “-ES”

church - churches box -boxes index -= indexes ( also indices) gas - gases bush - bushes ass -asses quiz – quizzes potato - potatoes tomato – tomatoes volcano - volcanoes photo - photos piano - pianos portico - porticos party - parties lady - ladies

NOUN + “-S”

Noun ending in “y”

NOUN – “Y” +” IES”

NOUN + “-S”

Noun ending in “f” or “fe”

NOUN – “F” + VES

Boy - boys Toy - toys Ray – rays calf – calves half - halves wolf - wolves wife – wives crisis - crises hypothesis - hypotheses oasis - oases child - children ox - oxen man – men woman - women person - people foot - feet tooth - teeth Page 17

Nouns ending in “is”

Drop the “-is” and add “-es” Some nouns change their structure to form their plural form.

NOUN – “FE” + VES NOUN – IS + ES

Irregular plural

ODD PLURAL FORM

Medical English 1

mouse - mice louse - lice Identical singular and plural form Some nouns have identical plural and singular forms, although they are still considered to have a plural form. These nouns exist only in the plural form and take a plural verb. NO CHANGE aircraft - aircraft fish - fish sheep - sheep deer - deer species - species headquarters - headquarters cattle scissors trousers tweezers congratulations pajamas court martial - courts martial son-in-law - sons-in-law passer-by - passers-by advice information luggage headquarters - headquarters news - news

Collective words or nouns associated with two parts.

ONLY PLURAL FORM

Compound nouns

Uncountable noun

In compound nouns the plural ending is usually added to the main noun. Uncountable nouns on the other hand have no plural form and take a singular verb (is / was ...).

MAIN NOUN + -S

NO PLURAL FORM

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CASE Latin or Greek origin

DESCRIPTION OF THE RULE These nouns maintain their Latin or Greek form in the plural.

STRUCTURE NOUN – US + I

EXAMPLE nucleus = nuclei syllabus = syllabi focus = foci fungus = fungi cactus = cacti (cactuses is acceptable) phenomenon = phenomena criterion = criteria datum = data medium= media alumna = alumnae trachea=tracheae

NOUN – ON + A

NOUN - UM + A

NOUN + E

NOTES:
Third person of singular in simple present tense conjugation uses the same rules that plural forms.

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ACTIVITIES
1. PRONUNCIATION A. Say the plural nouns. Then write them in the correct columns. /S/ carrots _____________ _____________ _____________ _____________ /Z/ boys ______________ ______________ _____________ ______________ /IZ/ actresses _____________ ______________ ______________ ______________

actress box boy carrot class

dictionary girl house lemon notebook

roommate son state student watch

B.

Simple present tense conjugation. Say the third person conjugations. Then write them in the correct columns. /S/ /Z/ /IZ/ kiss work like It knocks She studies He kisses watch touch stay _____________ ______________ _____________ study cough clear _____________ ______________ ______________ knock sneeze put _____________ _____________ ______________ clean _____________ ______________ ______________

2. GRAMMAR A. Write the s plural form of the following words. 1. thesis 2. stimulus 3. alumnus 4. loaf 5. medium 6. crisis 7. veto 8. fireman 9. diagnosis 10. ox ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ 11. watch 12. mountain 13. louse 14. family 15. shelf 16. cloud 17. area 18. photo 19. home 20. logo ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ _______________

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B. Next to each word in the list, write correctly the plural for that word. If that word cannot be pluralized because it's a non-count noun, write the letter X. 1. man ______________ 16. dancing ______________ 2. furniture ______________ 17. 1990 ______________ 3. experience ______________ 18. aluminum ______________ 4. Kennedy ______________ 19. fax ______________ 5. ski ______________ 20. roof ______________ 6. gas ______________ 21. fish ______________ 7. box ______________ 22. child ______________ 8. peace ______________ 23. difficulty ______________ 9. cactus ______________ 24. knowledge ______________ 10. criterion ______________ 25. goose ______________ 11. baby ______________ 26. video ______________ 12. memo ______________ 27. curriculum ______________ 13. work ______________ 28. biology ______________ 14. self ______________ 29. URL ______________ 15. applause ______________ 30. dish ______________

C. Write the plural form of the following medical nouns. 1. mouth ______________ 2. pharynx ______________ 3. anus ______________ 4. trachea ______________ 5. pancreas ______________ 6. enzyme ______________ 7. duodenum ______________ 8. cecum ______________ 9. rectum ______________ 10. bronchus ______________ D. What are MASS (NON-COUNT or UNCOUNTABLE) NOUNS? Here is a list of MASS NOUNS for you to consider.  Can you count any of these things?  Do we use the plural form of any of these words in common speech and writing?  What do the things in the first column have in common? The second column?

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wood cloth ice plastic wool steel aluminum metal glass leather porcelain hair dust air

oxygen water milk wine beer cake sugar rice meat cheese flour reading boating smoking

dancing soccer hockey weather heat sunshine electricity biology history mathematics economics poetry Chinese Spanish

English luggage equipment furniture experience applause photography traffic harm publicity homework advice

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READING COMPREHENSION
Read the following text and answer the questions below.

Human Digestive System
How does food get digested? Digestion involves mechanical as well as chemical changes in the food taken. Mechanical alteration is brought about by teeth, grinding organs and muscular contraction of stomach and intestinal walls. Breaking food into small pieces increases the surface area exposed to the enzymes of digestive juices.

INTRODUCTION OF FOOD DIGESTION PROCESS Chemical changes, whether in protozoans or in animals from sponges to man, involve cleaving of complex, insoluble macro molecules into simpler, soluble sub units, and are brought about by the action of enzyme.

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Food Digestion Process
Food Intake: Different organisms obtain food in different ways but carry out similar reactions. To take food, protozoans use pseudopodia, flagella or cilia; sponges and muscles use a current of water; hydra uses tentacles beset with stinging cells; planarians and earthworms use a muscular pharynx; flukes and leeches use oral succer. Digestive System and process: Parts of the body concerned with the uptake and digestion of food and elimination of indigestible remains from the digestive system, also called elementary system. The digestive system consists of two sets of organs: Alimentary canal: It is a tube comprising many specialized organs. It provides and helps in the process of: (i)An inlet, the mouth, to ingest food (ii)A cavity, the lumen, where food is digested (iii)A surface for the absorption of digested food (iv)A space where indigestible remains are changed in to faeces (v)An outlet the anus for elimination of faeces. Digestive glands and their function in the process: These are the structures associated with the different regions of the alimentary canal. They sent into the digestive track their secretions which contains enzyme and other materials to help in the digestion of food. Most of the alimentary canal and certain digestive glands are supported and held in place by mesenteries, the double sheets of peritoneum with a layer of connective tissues in between. Summary for Food Digestion Process The digestive system serves three major functions are: 1. Nutrition: The digestive track primarily serves to provide food to the tissues to the body. 2. Breathing: The interior part of the alimentary canal also plays a role in respiration in the chordates. 3. Excretion: The digestive system brings about sum excretion too. Excretion is the elimination of unwanted materials from the body.

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QUESTIONS
1. Does digestion only involve mechanical changes? __________________________________________________________________________ ___________________________________________________________________ 2. Why are enzymes important during the digestion process? __________________________________________________________________________ ___________________________________________________________________ 3. Which is the final step of the digestion process? __________________________________________________________________________ ___________________________________________________________________ 4. How is the alimentary canal supported? __________________________________________________________________________ __________________________________________________________________________ 2. Matching Match the numbers with the letters 1. Cleave 2. Intake 3. Lumen 4. Faeces 5. Canal a) excrement b) the cavity of a tubular organ or part c) tube d) the amount taken in e) divide

ON-LINE EXERCISES
The following links could provide you further information and resources on plural form. Find mistakes  http://www.englishteststore.net/index.php?option=com_content&view=article&id=707:Fi nd-Mistakes-Basic-Level-Test-001&catid=117:find-mistakes&Itemid=365 Plural forms      http://www.learnenglishfeelgood.com/english-grammar-nouns-plural3.html http://www.clafoti.com/Imagenes/PLURALNOUNS.htm http://grammar.ccc.commnet.edu/grammar/quizzes/cross/plurals_gap.htm http://www.caihometype.com/course.html http://www.learnenglish.de/grammar/pluraltext.htm#Irregula Page 25

Medical English 1

THE RESPIRATORY SYSTEM

UNIT

4
What is the respiratory system? Your respiratory system is made up of the organs in your body that help you to breathe. Remember, that respiration = breathing. The goal of breathing is to deliver oxygen to the body and to take away carbon dioxide.

Parts of the respiratory system
Lungs The lungs are the main organs of the respiratory system. In the lungs oxygen is taken into the body and carbon dioxide is breathed out. The red blood cells are responsible for picking up the oxygen in the lungs and carrying the oxygen to all the body cells that need it. The red blood cells drop off the oxygen to the body cells, then pick up the carbon dioxide which is a waste gas product produced by our cells. The red blood cells transport the carbon dioxide back to the lungs and we breathe it out when we exhale.

Trachea The trachea (TRAY-kee-uh} is sometimes called the windpipe. The trachea filters the air we breathe and branches into the bronchi.

Bronchi The bronchi (BRAHN-ky) are two air tubes that branch off of the trachea and carry air directly into the lungs.

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Diaphragm Breathing starts with a dome-shaped muscle at the bottom of the lungs called the diaphragm (DY-uh-fram). When you breathe in, the diaphragm contracts. When it contracts it flattens out and pulls downward. This movement enlarges the space that the lungs are in. This larger space pulls air into the lungs. When you breathe out, the diaphragm expands reducing the amount of space for the lungs and forcing air out. The diaphragm is the main muscle used in breathing.

FREQUENTLY ASKED QUESTIONS Why Do I Yawn? When you are sleepy or drowsy the lungs do not take enough oxygen from the air. This causes a shortage of oxygen in our bodies. The brain senses this shortage of oxygen and sends a message that causes you to take a deep long breath - a YAWN.

Why Do I Sneeze? Sneezing is like a cough in the upper breathing passages. It is the body's way of removing an irritant from the sensitive mucous membranes of the nose. Many things can irritate the mucous membranes. Dust, pollen, pepper or even a cold blast of air are just some of the many things that may cause you to sneeze. What Causes Hiccups? Hiccups are the sudden movements of the diaphragm . It is involuntary. You have no control over hiccups, as you well know. There are many causes of hiccups. The diaphragm may get irritated, you may have eaten to fast, or maybe some substance in the blood could even have brought on the hiccups.
Simple Present / Negative and Interrogative Sentences Type of sentence Subject She He Auxiliary (-) does not / doesn’t Base form of the verb operate Complement a patient

They You

do not/ don’t

take care

of me

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Type of sentence ?

Auxiliary Does Do

Subject she he they you

Base form of the verb operate take care

Complement a patient of me

Question mark ? ?

Type of sentence

“Wh” question words Why Where When How

Auxiliary

Subject

Base form of the verb visit operate take care heal

Complement

Question mark ? ? ? ?

?

does does Do Do

she he they You

a patient that boy of me them

ON-LINE EXERCISES
Go to the following links to practice.
http://www.englischhilfen.de/en/exercises/tenses/simple_present_negation_long.htm http://www.englisch-hilfen.de/en/exercises/questions/simple_present.htm

ACTIVITIES
A. Read carefully the following text.

I have a terrible stomachache.
Doctor: Paul Ryefield: Doctor: Paul Ryefield: Doctor: Paul Ryefield: Doctor: Paul Ryefield: Doctor:

— Good morning. Please have a seat here. What´s the problem? — I have a terrible stomachache. — Do you have diarrhea? — Yes, I do. — Do you have any other symptoms? — Yes, I feel sick. — You mean you feel nauseous? — That´s right. I feel like vomiting. And right now I feel dizzy, too. — All right. Please take off your clothes to the waist and lie down there ... Just tell me if it

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hurts when I do this.
Paul Ryefield: Doctor: Paul Ryefield: Doctor:

— It doesn´t hurt. ... Ouch. It hurts there. — Okay. Let´s hope it´s just indigestion, but we´ll need to run some diagnostic tests to be sure. We´ll run a blood test and we´ll also need a urine sample. — Can you give me something for the time being? — Yes, I´ll give you a prescription for indigestion tablets.

B.

Write a dialogue using the interrogative and negative sentences. Use the vocabulary above _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

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C.

VOCABULARY. Read the text then Work with a partner and match the term in column A with its contextual meaning in column B.

Influenza is a viral infection of the respiratory tract that produces severe discomfort and debilitation. Flu should not be confused with a cold. Influenza produces symptoms that require bed rest for several days. There are several types of influenza virus and all have certain characteristics: rapid transmission from person to person, an incubation period of few days, and symptoms that become severe in a short time. Symptoms are generally respiratory in nature but gastrointestinal involvement is common with certain types of influenza. Headache and painful respiration are usually the first symptoms. Within the first hours the body temperature increases and remains elevated for several days. Severe muscle aches, headache, weakness, and chest discomfort accompany the fever. Throat tenderness and episodes of coughing are present in most cases. Symptoms are severe for 3 to 5 days, and then subside slowly. Weakness and coughing may persist for 10 days to 2 weeks.
A 1. debilitation 2. confuse 3. cold 4. require 5. severe 6. involvement 7. increases 8. remain 9. elevated 10. accompany 11. throat 12. tenderness 13. episodes 14. subside B a. abate / diminish b. acute / grave / critical c. complement / to go together with something d. event / occurrence e. higher than normal f. need or demand g. pharynx h. rhinovirus or coronavirus infection i. sensitive / painful j. to be mistaken for something else k. to be part of / to be included in l. to go up m. to incapacitate n. to stay / to continue being

D.

READING COMPREHENSION. Instructions: Work with a partner. Discuss each question in English and decide if the statements are T (true) or F (false.) T T T T T T F F F F F F

a. Influenza is caused either by virus or bacteria. b. The flu is the same thing as a cold. c. Fever is not a typical sign of the flu. d. Some patients may develop gastrointestinal troubles during influenza. e. Influenza is a very infectious disease. f. The incubation period for the flu is usually about one month.

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UNIT

5
THE CIRCULATORY SYSTEM

The circulatory system is made up of the vessels and the muscles that help and control the flow of the blood around the body. This process is called circulation. The main parts of the system are the heart, arteries, capillaries and veins.

As blood begins to circulate, it leaves the heart from the left ventricle and goes into the aorta. The aorta is the largest artery in the body. The blood leaving the aorta is full of oxygen. This is important for the cells in the brain and the body to do their work. The oxygen rich blood travels throughout the body in its system of arteries into the smallest arterioles.

On its way back to the heart, the blood travels through a system of veins. As it reaches the lungs, the carbon dioxide (a waste product) is removed from the blood and replace with fresh oxygen that we have inhaled through the lungs.

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Arteries
Arteries are tough, elastic tubes that carry blood away from the heart. As the arteries move away from the heart, they divide into smaller vessels. The largest arteries are about as thick as a thumb. The smallest arteries are thinner than hair. These thinner arteries are called arterioles. Arteries carry bright red blood! The color comes from the oxygen that it carries.

Veins
Veins carry the blood to the heart. The smallest veins, also called venules, are very thin. They join larger veins that open into the heart. The veins carry dark red blood that doesn't have much oxygen. Veins have thin walls. They don't need to be as strong as the arteries because as blood is returned to the heart, it is under less pressure

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Heart
Did you know that your heart is the strongest muscle? Your heart is divided into two sides. The right side pumps blood to your lungs where it picks up oxygen. The left side pumps oxygen-soaked blood out to your body. They do not work on their own, but together as a team. The body's blood is circulated through the heart more than 1,000 times per day. Between five and six thousand quarts of blood are pumped each day. Your heart is about the same size as your fist. Blood is thicker than water and has a little bit salty taste. In an adult body there is 10.6 pints of blood circulating around. In their blood there is billions of living blood cells floating in a liquid called plasma. If you took a small sample of this blood and poured it into a test tube and then put it in a machine called a centrifuge, you would be able to see the layers of this blood. This machine spins the blood around so fast that it separates the red blood cells, from the white blood cells, from the platelets. The red blood cells sink to the bottom because they are the heavier, more solid parts, but the plasma remains at the top because it is lighter. The plasma is 95% water and the other 5% is made up of dissolved substances including salts.

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PRONOUNS
A pronoun is a word that can be used instead of another word. Examples: The X-ray machine is automatic, so it does not need to be programmed. Helen was diagnosed as hypertensive, so the doctor gave her some beta-blockers. If you did not pass one or more laboratories, you must take them this semester. SUBJECT PRONOUNS I You He She It We You They OBJECT PRONOUNS Me You Him Her It Us You Them

When pronouns are used as subjects of clauses they are called SUBJECT PRONOUNS (SP). Their position is before verbs. They have discovered the cure. SP We are wasting time. SP OBJECT PRONOUNS (OP) are located after verbs or prepositions. They fight cancer I gave one scalpel and three tweezers to the surgeon NOTE: They fight it. I gave them to him OP OP OP

A pronoun acts as a subject or an object in a clause, so it is an error to repeat the noun it refers to in the same clause. Example The administrators they are willing to discuss your queries. Bottle-feeding them young children is as nutritious for them as breast feeding.

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Demonstrative adjectives vs. demonstrative pronouns
DISTANCE NEAR FAR SINGULAR This That PLURAL These Those

This, that, these, those are words used to refer to nouns that are near or further away in time or space. They work as adjectives when they modify a noun (the noun is written or pronounced in the same clause). If they replace a noun these words work as pronouns. Example:  This chocolate tastes delicious. (ADJECTIVE) This tastes delicious. (PRONOUN)  I don't like this prognosis. (ADJECTIVE) I don't like this. (PRONOUN)  That athlete will run for an hour. (ADJECTIVE) That will run for an hour (PRONOUN)  Jim wrote that prescription. (ADJECTIVE) Jim wrote that. (PRONOUN)  These patients look good. (ADJECTIVE) These look good. (PRONOUN)

Possessive adjective vs. possessive pronouns
Possessive adjectives modify a noun (that is written or pronounced in the clause) and show that there is a possession relation. Possessive pronouns are used when we want to substitute a group of words that are indicating a possession relation.

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POSSESSIVE ADJECTIVE My Your His Her Its Our Your Their For example:    This is my book. (ADJECTIVE) This is mine. (PRONOUN)

POSSESSIVE PRONOUN Mine Yours His Hers Its Ours Yours Theirs

Their patients are in the intensive care unit (ADJECTIVE). Theirs are in the intensive care unit. (PRONOUN) This is your disk and that's mine. (ADJECTIVE – PRONOUN) The smallest stethoscope is hers. (PRONOUN)

  NOTE

Read the following sentence When you drive to Manitoba, will you take your car or theirs?   The possessive adjective "your" depends on the noun "car." The possessive pronoun, "theirs," stands in the place of the noun phrase, "their car."

ACTIVITIES
A. Underline the object in each sentence and replace it using an object pronoun. a) Please help doctor Takashi. _______________________________________________________________ b) Peter loves chemistry _______________________________________________________________ c) Read page 104. _______________________________________________________________

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d) Ask doctor Huapaya and doctor Carhuancho. _______________________________________________________________ e) Buy five syringes for Miss La Rosa. _______________________________________________________________ B. Unscramble the words groups to write sentences. Use the correct punctuation and capitalization. a) lend / him / money / some / always / I ________________________________________________________________ b) the / showing / the / something / women / is / man / to. ________________________________________________________________ c) them / she / help / some / gives / rarely. ________________________________________________________________ d) you / tell / the / him / do / ? / answers ________________________________________________________________ e) this / us / does / explain / kind / exercises / of / she / not / to.

C.

Fill in the blanks with the appropriate possessive adjective, then use possessive pronouns to replace the group of words expressing possession relation. 1. What’s the boy’s name? _____________ name is Ben Scott. __________________________________________________________________ 2. Debbie has a dog. ____________ dog is very lively. __________________________________________________________________ 3. The dog is very lively. _____________ name is Ben. __________________________________________________________________ 4. We are at school. _______________ school is very nice. __________________________________________________________________ 5. I have a new laptop. _____________ laptop is white. __________________________________________________________________ 6. I'm from Chester. Most of ______________ friends are from Chester, too. __________________________________________________________________ 7. The Guptas have a restaurant. _____________ restaurant is great. __________________________________________________________________

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8. The rabbit is white. ______________ cage is in the garden. __________________________________________________________________ 9. You are not English. ______________ name is not an English name. __________________________________________________________________ 10. Sandra and Jenny are friends. ________________school is in Chester. __________________________________________________________________ 11. The Scotts have a new car. _________________ car is blue. __________________________________________________________________ 12. Emma Peel has a brother. ________________ name is Paul. __________________________________________________________________ 13. Nick Baker has a sister._______________ name is Debbie. __________________________________________________________________ 14. Yes, we have a dog. _____________ dog is very old. __________________________________________________________________ 15. The Snows have a tortoise. ____________ name is Trundle. __________________________________________________________________ D. GROUP EXERCISE. Create a logical secrete message using at least ten abbreviations showed next pages. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

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ABBREVIATIONS
This is partial list of abbreviations used in medical prescriptions. ABBREVIATIONS Aa Ad a.c. a.d. ad lib. admov. Agit alt. h. a.m. Amp Amt Aq a.l., a.s. A.T.C. a.u. Bis b.d./b.i.d. B.M. bol. B.S. B.S.A BUCC cap., caps. c, c. cib. Cc Cf comp. cr., crm CST D5W D5NS D.A.W. dc, D/C, disc dieb. alt. dil. disp. div. LATIN OR GREEK ORIGIN Ana Ad ante cibum auris dextra ad libitum Admove Agita alternis horis ante meridiem MEANING of each up to before meals right ear use as much as one desires; freely apply stir/shake every other hour morning, before noon Ampule Amount Water left ear around the clock both ears twice twice daily bowel movement as large as single dose(usually intravenously) blood sugar body surface areas inside cheek capsule with (usually written with a bar on top of the"c") food with food, (but also cubic centimeter) with food compound cream continue same treatment dextrose 5% solution (sometimes written as D5W) dextrose 5% in normal saline (0.9%) dispense as written (i.e., no generic substitution) discontinue every other day dilute dispersible or dispense divide

Aqua auris laeva, auris sinistra auris utraque Bis bis in die Bolus

Bucca Capsula Cum Cibus cum cibo

diebus alternis

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ABBREVIATIONS d.t.d. D.W. elix. e.m.p. emuls. Et Eod Ex aq fl., fld. ft. G Gr gtt(s) H h, hr h.s. ID IM inj. IP IV IVP IVPB L.A.S. LCD Lin Liq lot. Mane M. m, min Mcg m.d.u. mEq Mg mist. Mitte mL nebul N.M.T. noct. non rep. NS 1/2NS Medical English 1

LATIN OR GREEK ORIGIN dentur tales doses

MEANING give of such doses water distilled elixir as directed emulsion and every other day in water fluid make; let it be made gram grain drop(s) hypodermic hour bedtime intradermal Intramuscular (with respect to injections) injection intraperitoneal intravenous intravenous push intravenous piggyback label as such coal tar solution liniment solution lotion in the morning mix a minimum microgram to be used as directed milliequivalent milligram mix send milliliter a spray not more than at night no repeats normal saline(0.9%) half normal saline(0.45%) Page 40

ex modo prescripto Emulsum Et ex aqua Fiat

gutta(e) hora hora somni

injectio

linimentum liquor mane misce minimum more dicto utendus

mistura mitte nebula nocte non repetatur

ABBREVIATIONS N.T.E. o_2 o.d. D.W. elix. e.m.p. emuls. Et Eod Ex aq fl., fld. ft. G Gr gtt(s) H h, hr h.s. ID IM inj. IP IV IVP IVPB L.A.S. LCD Lin Liq lot. Mane M. m, min Mcg m.d.u. mEq Mg mist. Mitte mL nebul N.M.T. Medical English 1

LATIN OR GREEK ORIGIN

MEANING not to exceed both eyes, sometimes written as o2 right eye water distilled elixir as directed emulsion and every other day in water fluid make; let it be made gram grain drop(s) hypodermic hour bedtime intradermal Intramuscular (with respect to injections) injection intraperitoneal intravenous intravenous push intravenous piggyback label as such coal tar solution liniment solution lotion in the morning mix a minimum microgram to be used as directed milliequivalent milligram mix send milliliter a spray not more than Page 41

oculus dexter

ex modo prescripto emulsum Et ex aqua fiat

gutta(e) hora hora somni

injectio

linimentum liquor mane misce minimum more dicto utendus

mistura mitte nebula

ABBREVIATIONS noct. non rep. NS 1/2NS N.T.E. o_2 o.d. o.p.d. o.s. o.u. oz per p.c. pig./pigm. p.m. PRN, prn p.o. p.r. pulv. PV q q.a.d. q.a.m. q.d.s. q.p.m. q.h. q.h.s. q.1h, q.1° q.d. q.i.d. q.o.d. qqh q.s. QWK R rep., rept. RL, R/L s s.a. Medical English 1

LATIN OR GREEK ORIGIN nocte non repetatur

MEANING at night no repeats normal saline(0.9%) half normal saline(0.45%) not to exceed both eyes, sometimes written as o2 right eye once per day left eye both eyes ounce by or through after meals paint evening or afternoon as needed by mouth or orally by rectum powder via the vagina every every other day every day before noon four times a day every time after noon every hour every night at bedtime every 1 hour; (can replace “1” with other numbers) every day four times a day every other day every four hours a sufficient quantity every week rectal repeats without (usually written with a bar on the top of the “s”) use your judgment Page 42

oculus dexter oculus sinister oculus uterque per post cibum pigmentum post meridiem pro re nata per os pulvis per vaginam quaque quoque alternis die quaque die ante meridiem quater die sumendus quaque die post meridiem quaque hora quaque hora somni quaque1 hora quaque die quater in die quater quaque hora quantum sufficiat

repetatur Ringer's lactate sine

secundum artum

ABBREVIATIONS SC, subc, subcut, subq, SQ Sig SL Sol s.o.s., si op. sit Ss Stat Supp Susp Syr Tab tal., t Tbsp troche Tsp t.i.d. t.d.s. t.i.w. top. T.P.N. tr, tinc., tinct. u.d., ut dictum ung. U.S.P. Vag W Wf w/o X Y.O.

LATIN OR GREEK ORIGIN

MEANING subcutaneous write on label sublingually, under the tongue solution if there is a need one half immediately suppository suspension syrup tablet such tablespoon lozenge teaspoon three times a day three times a day three times a week topical total parenteral nutrition tincture dict. as directed ointment United States Pharmacopoeia vaginally with with food (with meals) without times years old

solutio si opus sit semis statim suppositorium syrupus tabella talus trochiscus ter in die ter die sumendum

ut. unguentum

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UNIT

HOSPITAL FACILITIES
Melissa Memorial Hospital

6

Melissa Memorial Hospital is designed as a critical access hospital providing for 24 hour emergency care. The design is intended to present an image of a facility that provides quality healthcare in a friendly environment. This facility focuses on healing the body, mind and spirit by personalizing, humanizing, and demystifying the healthcare experience for patients and their families.

Family Waiting Lounge – The family lounge sits immediately adjacent to the inpatient bed wing, providing a bright and spacious place for families to gather.

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Main Entry Lobby - The high ceiling main lobby space was designed with comfort in mind. Its upper windows provide a beacon when lights are on at night and its contemporary design and soft colors offer patients and their families a warm welcome and an orientation point of reference.

Nursing Station - The nursing station is centrally located to offer overlapping access and control of the inpatient bed wing, the labor and delivery suite, the emergency department, the observation beds, the family lounge as well as the outpatient waiting area. Operating Room - The new surgical suite was designed primarily for outside specialists that travel to Melissa Memorial for specialty surgeries. The new surgical area will help to increase specialty surgery volumes. Floor Plan - The Floor Plan emphasizes departmental adjacencies and clean and separate corridor flows.

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Pre-operative and Recovery Areas - The hospital provides pre-operative and recovery areas adjacent to the operating room.

The total refurbishment of Melissa Memorial Hospital will be 2011. The roof will be replaced, the wards partitioned into individual cubicles to provide privacy for patients, and new nursing stations were constructed. Ceramic floor tiles give the wards a cool and clean appearance as do the acoustic ceilings in all the General Wards corridors. The next major development will be the building of an ultra-modern maternity wing. It will have eighteen beds, five are sea-facing private rooms, four semi-private rooms and eight general ward beds. It will also have its own operating theatre, a baby nursery, isolation rooms, delivery rooms, family planning area, well-baby and well-woman clinics, pediatric cardiology. The development of the hospital never really stops, because the pace of change always increases and the hospital must keep up.

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THERE IS/ THERE ARE
Both expressions are used to state the something exists or to point out something in the distance. There is/There are can be used as the sentences subject. 1.    "There is" - is used with the following subjects: Singular nouns Uncountable nouns 3rd person singular (he, she, my physician, his outpatient, etc.). Examples: There is my specialist on the corner. There is a lot of blood on the highway. There must have been an accident. There is a fracture here. 2. "There are" - is used with the following subjects:  3rd person plural (they, my doctors, the nurses, the practitioners, etc.) Examples: There are many nurses in this nursing station. There are practitioners there. There are three sites on the internet that are really good to study Medical English.

PREPOSITIONS

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ACTIVITIES
A. THERE IS/THERE ARE. Choose the appropriate expression from the parentheses. 1. ___________ a fly in that doctor's soup. (There is, There are) 2. ______________many health centers in Huaycan. (There isn't, There aren't) 3. ________________ any viruses in this area. (There isn't, There aren't) 4. _____________________ lots of clinics in big cities. (There is, There are) 5. ______________ a blood bank here? (Is there, Are there) 6. _________________ survivors in the mine? (Is there, Are there) 7. _____________________ a blood donor I can call? (Is there, Are there) 8. _______________ an important surgery tomorrow. (There is, There are) 9. _____________________ 8 students in my Medical English class. (There is, There are) 10._________________________ many inpatients in this hospital. (There isn't, There aren't)

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B. GROUP PROJECT. Look at the map below. Then write a description for the plan using “there is”, “there are” and prepositions.

C.

Draw three plans considering the vocabulary below. Then describe the plans using “there is”, “there are” and prepositions. 1. Ultra-modern maternity wing: eighteen beds, five are sea-facing private rooms, four semiprivate rooms and eight general ward beds; one operating theatre; a baby nursery; isolation rooms; delivery rooms; family planning area; well-baby and well-woman clinics; pediatric cardiology. 2. Third floor: two lifts; a four-bed High Dependency Unit; Renal Dialysis Unit; Radiology department. 3. Outpatient Department: Obstetrics; Gynecology; -Ear, Nose and Throat (ENT); -Dental Surgery ; Orthopedics; Dermatology; Virology; Urology; Radiation, Oncology; Obstetrics; Perinatology Consultation; Cardiology; Pathology; Psychiatry; Pulmonary Services; Neurosurgery ; Pediatrics; Internal Medicine; Endocrinology; General Surgery; Geriatrics; Gastroenterology; Electrophysiology; Neonatology; Nephrology; Rheumatology; Ophthalmology; Plastic Surgery; Otolaryngology; Pathology.

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UNIT

7
THE EXCRETORY SYSTEM
Excretion - Excretion is the removal of the metabolic wastes of an organism. Wastes that are removed include carbon dioxide, water, salt, urea and uric acid. All excreted wastes travel at some time in the blood. Organs of the Excretory System Lungs - removal of excess carbon dioxide Liver - produces urea and uric acid as a by-product of the breakdown of proteins Skin - removal of excess water, salt, urea and uric acid Urinary System - kidneys filter the blood to form urine, which is excess water, salt, urea and uric acid THE SKIN Layers of the skin Epidermis - outer protective layer without blood vessels Dermis - inner layer containing blood vessels, sensory nerve endings, sweat and oil glands, hairs, and fat cells Functions of the skin Excretion - Wastes such as excess water, salt, urea and uric acid are removed from the body in sweat. Waterproofing - The skin with its oil glands prevents the entry of water into, and loss of water out of the body.

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Protection from disease - The intact skin prevents invasion of micro-organisms and dust into the body. Protection from ultraviolet rays - Pigments reduce the intake of UV rays. Regulation of body temperature - The thin layer of fat cells in the dermis insulates the body. Contraction of small muscles attached to hairs forms 'goosebumps' and creates an insulating blanket of warm air. Also, sweat produced by sweat glands uses excess body heat to evaporate, providing a cooling effect. Sensory Detection - The nerve endings or receptors in the dermis detect heat, cold, touch, pressure and pain.

SOME / ANY
STATEMENT Affirmative statement Negative statements Interrogative statements SOME I have some health nuisances. They will need some calories _ _ Exception: Offer: Would you like some help? Request: Can you lend me some money? ANY _

I do not need any blood transfusion. Do you need any help? Does she have any classmates?

QUANTIFIERS WITH COUNTABLE AND UNCOUNTABLE NOUNS
Some adjectives and adjectival phrases describe quantity. Some can only go with countable nouns (nurses, inpatients, outpatients), and some can only go with uncountable nouns (sugar, fat, blood, advice). However, there are quantifiers that can be used with both countable and uncountable nouns.
ONLY WITH UNCOUNTABLE NOUNS How much? a little a bit (of) a great deal of a large amount of WITH UNCOUNTABLE AND COUNTABLE NOUNS How much? or How many? no/none not any some (any) a lot of plenty of lots of ONLY WITH COUNTABLE NOUNS How many? a few a number (of) several a large number of a great number of

-

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Notes: 1. Much and many are used in negative and question forms.

Example: How much sugar do you consume? How many cigarettes do you smoke? There's not much blood in the blood bank. There weren't many physicians at the meeting. 2. They are also used with too, (not) so, and (not) as :

Examples There were too many physicians at the meeting. It's a problem when there are so many patients. There's not so much work to do this week. 3. In positive statements, we use a lot of:

Examples: I have a lot of work this week. There were a lot of physicians at the meeting. 4. A few (for countable nouns) and a little (for uncountable nouns) describe the quantity in a positive way: Examples: I have a few patients (= maybe not many, but enough) I have a little money (= I have enough to live on) 5. Few and little describe the quantity in a negative way:

Few people visited him in hospital (= he had almost no visitors) He had little money (= almost no money)

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ACTIVITIES
A. QUANTIFIERS. In the following sentences, fill in the gaps with one of the following quantifiers: much, many, a lot of, most, a little, little, a few, few

1. It seems to me that we haven't had ____________ assignments in English this term. 2. How _______________ material can we be expected to read in one week? 3. I've unfortunately had _________________ headaches already because of stress. 4. Our yard looks awful this summer. There are too _____________ weeds. 5. I didn't use _____________ fertilizer last spring, and that has made a difference. 6. Also, I've paid very_________________ attention to how rain we've had. 7. I'm afraid it's rained ________________ times this summer, and that is why the grass is turning brown and dying. Farmers are very upset. 8. How _______________ good would it do if we watered the plants ourselves? 9. ________________ advice I have ever received from so-called "experts" has been useless. 10. They said that just _________________ help could make a big difference. 11.________________________ people know as much about computers as Tomas does. 12. It does us _________________________ good when the banking system collapses.

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B.

GROUP PROJECT. You are a doctor who needs to know your patient routine. Write a 30line dialogue using quantifiers in each sentence. Use affirmative, negative and interrogative statements.

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

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UNIT

THE URINARY SYSTEM
Urine

8

The first nitrogenous waste to be formed from the breakdown of protein is ammonia, a highly toxic chemical that is quickly converted by the liver to urea and uric acid. These are less toxic than ammonia and are transported in the blood to the kidneys for excretion in urine. Urine consists of excess water, excess salt, urea and uric acid. Parts of the Urinary System

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Renal Arteries Two renal arteries constantly transport blood to the kidneys. Renal Veins Two renal veins return useful nutrients back into the bloodstream. Ureters Two ureters carry urine from the kidneys to the urinary bladder. Urinary Bladder The urinary bladder temporarily stores urine until it is released from the body. Urethra The urethra is the tube that carries urine from the urinary bladder to the outside of the body. The outer end of the urethra is controlled by a circular muscle called a sphincter. Kidneys The human kidneys are the major organs of bodily excretion (see Figure 1.) They are bean-shaped organs located on either side of the backbone at about the level of the stomach and liver. Blood always enters the kidneys through renal arteries and leaves through renal veins. Tubes called ureters carry waste products from the kidneys to the urinary bladder for storage or for release.

Figure 1. Details of the human excretory system. Position and allied structures of the kidneys (top). A cross section of the kidney showing the two major portions (left). Details of the nephron, the functional unit of the kidney (right).

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The product of the kidneys is urine, a watery solution of waste products, salts, organic compounds, and two important nitrogen compounds: uric acid and urea. Uric acid results from nucleic acid decomposition, and urea results from amino acid breakdown in the liver. Both of these nitrogen products can be poisonous to the body and must be removed in the urine. Nephron The functional and structural unit of the kidney is the nephron. The nephron produces urine and is the primary unit of homeostasis in the body. It is essentially a long tubule with a series of associated blood vessels. The upper end of the tubule is an enlarged cuplike structure called the Bowman's capsule. Below the Bowman's capsule, the tubule coils to form the proximal tubule, and then it follows a hairpin turn called the loop of Henle. After the loop of Henle, the tubule coils once more as the distal tubule. It then enters a collecting duct, which also receives urine from other distal tubules. Within the Bowman's capsule is a coiled ball of capillaries known as a glomerulus. Blood from the renal artery enters the glomerulus. The force of the blood pressure induces plasma to pass through the walls of the glomerulus, pass through the walls of the Bowman's capsule, and flow into the proximal tubule. Red blood cells and large proteins remain in the blood. After plasma enters the proximal tubule, it passes through the coils, where usable materials and water are reclaimed. Salts, glucose, amino acids, and other useful compounds flow back through tubular cells into the blood by active transport. Osmosis and the activity of hormones assist the movement. The blood fluid then flows through the loop of Henle into the distal tubule. Once more, salts, water, and other useful materials flow back into the bloodstream. Homeostasis is achieved by this process: A selected amount of hydrogen, ammonium, sodium, chloride, and other ions maintain the delicate salt balance in the body. The fluid moving from the distal tubules into the collecting duct contains materials not needed by the body. This fluid is referred to as urine. Urea, uric acid, salts, and other metabolic waste products are the main components of urine. The urine flows through the ureters toward the urinary bladder. When the bladder is full, the urine flows through the urethra to the exterior.

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FREQUENCY ADVERBS
Adverbs of frequency are used to say how often you do something. Adverbs of frequency are often used with the present simple because they indicate repeated or routine activities. For example: They often go out for dinner The most common frequency adverbs in English are: Always Frequently Usually Often Sometimes Occasionally Seldom Rarely Never Note: The percentages here are rough estimates only. Frequency adverbs can be placed at various points in the sentence, but are most commonly used before the main verbs and after the verb to be. That surgeon always comes to work on time. Those doctors are seldom home when we call. He's usually taking her pills at this time. She's never been to Cayetano Heredia Hospital. A: Do you come here often? B: Yes. I'm here occasionally. A: What do you usually do here? B: Sometimes I just sit and wait for a blood transfusion. Medical English 1 Page 58 100% 90% 80% 70% 50% 40% 20% 10% 0%

Notes: 1. The adverbs seldom, rarely, never and hardly ever are considered negative. A: Do you always carry your medicines? B: (Yes,) I usually do. No, I usually don't. No, I rarely do. No, I hardly ever do. 2. The following expressions are used at the beginning and end of sentences, not before main verbs. Every day/week /month Every other day /week Once a week /month/year Twice a year / day, etc. (Every) once in a while Every so often Examples: Every once in a while I visit my outpatients. I visit my outpatients every once in a while. I every once in a while visit my outpatients. (Incorrect) 3. The adverbs regularly (according to schedule), normally (commonly nowadays), traditionally (commonly in the past) can come at various points in the sentence: Examples: I regularly floss my teeth. I floss my teeth regularly. Traditionally, that was considered child's play. I normally get up around 6 o'clock. Normally, I get up around 6 o'clock. Medical English 1 Page 59

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ACTIVITIES
A. Rewrite the complete sentence using the adverb in brackets in its correct position. Example: I play tennis on Sundays. (often) Answer: I often play tennis on Sundays.

1. He pays attention to the doctor's suggestions. (often) _____________________________________________________________________________ 2. They read a book on Anatomy. (sometimes) ______________________________________________________________________________ 3. Pete gets angry. (never) ________________________________________________________________________________ 4. Doctor Espinoza is very friendly. (usually) _______________________________________________________________________________ 5. I take sugar in my coffee. (sometimes) _______________________________________________________________________________ 6. Ramon and Frank are hungry. (often) _______________________________________________________________________________ 7. My dermatologist goes for a walk in the evening. (always) _______________________________________________________________________________ 8. Nurses help surgeons in the operating rooms. (usually) ________________________________________________________________________________ 9. Patients watch TV after 9 pm. (never) _______________________________________________________________________________ 10. Christine smokes. (never) _______________________________________________________________________________

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11. Nurse Hellen is upset (frequently) ________________________________________________________________________________ 12. My workmates are in a hurry (usually) _______________________________________________________________________________ B. FREQUENCY ADVERBS. Read the text below and insert the frequency adverbs from the box. usually, normally (2), regularly, always (2), never, sometimes

Control of kidney function. The activity of the nephron in the kidney is ____________ controlled by a person's choices and environment as well as hormones. For example, if a person __________ consumes large amounts of protein, much urea will be in the blood from the digestion of the protein. Also, on a hot day, a body will retain water for sweating and cooling, so the amount of urine is reduced. Humans ______________ produce a hormone called antidiuretic hormone (ADH), also known as vasopressin, which is secreted by the posterior lobe of the pituitary gland. It ___________ regulates the amount of urine by controlling the rate of water absorption in the nephron tubules. _____________ some individuals suffer from a condition in which they secrete very low levels of ADH. The result is excessive urination and a disease called diabetes insipidus. Another unrelated form of diabetes, diabetes mellitus, is more widespread. Persons with this disease ___________ produce sufficient levels of insulin. Insulin _________ transports glucose molecules into the cells. But when insulin is not available, the glucose remains in the bloodstream. The glucose is _____________removed from the bloodstream in the nephron; to dilute the glucose, the nephron removes large amounts of water from the blood. Thus, the urine tends to be plentiful. Hormones from the cortex of the adrenal glands also control the content of urine. These hormones promote reabsorption of sodium and chloride ions in the tubules. Thus, they affect the water balance in the body, because water flows in the direction of high sodium and chloride content. C. TRANSLATION. Translate the text above. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Medical English 1 Page 62

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

D. Read more: http://www.cliffsnotes.com/study_guide/Human-ExcretorySystem.topicArticleId-8741,articleId-8714.html#ixzz0zWFI53ca

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UNIT

9
THE REPRODUCTIVE SYSTEM
Introduction Sexual reproduction is the process of producing offspring for the survival of the species, and passing on hereditary traits from one generation to the next. The male and female reproductive systems contribute to the events leading to fertilization. Then, the female organs assume responsibility for the developing human, birth, and nursing. The male and female gonads (testes and ovaries) produce sex cells (ova and sperm) and the hormones necessary for the proper development, maintenance, and functioning of the organs of reproduction and other organs and tissues. 1. MALE REPRODUCTIVE SYSTEM These external structures include the penis, scrotum, and testicles.
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Penis: This is the male organ used in sexual intercourse. It has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans, which is the cone-shaped part at the end of the penis. The glans, also called the head of the penis, is covered with a loose layer of skin called foreskin. This skin is sometimes removed in a procedure called circumcision. The opening of the urethra, the tube that transports semen and urine, is at the tip of the penis. The penis also contains a number of sensitive nerve endings.

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Scrotum: This is the loose pouch-like sac of skin that hangs behind and below the penis. It contains the testicles (also called testes), as well as many nerves and blood vessels. The scrotum acts as a "climate control system" for the testes. For normal sperm development, the testes must be at a temperature slightly cooler than body temperature. Special muscles in the wall of the scrotum allow it to contract and relax, moving the testicles closer to the body for warmth or farther away from the body to cool the temperature. Testicles (testes): These are oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for generating sperm. Within the testes are coiled masses of tubes called seminiferous tubules. These tubes are responsible for producing sperm cells.

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The internal organs of the male reproductive system, also called accessory organs, include the following:
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Epididymis: The epididymis is a long, coiled tube that rests on the backside of each testicle. It transports and stores sperm cells that are produced in the testes. It also is the job of the epididymis to bring the sperm to maturity, since the sperm that emerge from the testes are immature and incapable of fertilization. During sexual arousal, contractions force the sperm into the vas deferens. Vas deferens: The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens transports mature sperm to the urethra, the tube that carries urine or sperm to outside of the body, in preparation for ejaculation.
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Ejaculatory ducts: These are formed by the fusion of the vas deferens and the seminal vesicles. The ejaculatory ducts empty into the urethra. Urethra: The urethra is the tube that carries urine from the bladder to outside of the body. In males, it has the additional function of ejaculating semen when the man reaches orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm. Seminal vesicles: The seminal vesicles are sac-like pouches that attach to the vas deferens near the base of the bladder. The seminal vesicles produce a sugar-rich fluid (fructose) that provides sperm with a source of energy to help them move. The fluid of the seminal vesicles makes up most of the volume of a man's ejaculatory fluid, or ejaculate. Prostate gland: The prostate gland is a walnut-sized structure that is located below the urinary bladder in front of the rectum. The prostate gland contributes additional fluid to the ejaculate. Prostate fluids also help to nourish the sperm. The urethra, which carries the ejaculate to be expelled during orgasm, runs through the center of the prostate gland. Bulbourethral glands: Also called Cowper's glands, these are pea-sized structures located on the sides of the urethra just below the prostate gland. These glands produce a clear, slippery fluid that empties directly into the urethra. This fluid serves to lubricate the urethra and to neutralize any acidity that may be present due to residual drops of urine in the urethra.

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How does the male reproductive system function? The entire male reproductive system is dependent on hormones, which are chemicals that stimulate or regulate the activity of cells or organs. The primary hormones involved in the functioning of the male reproductive system are follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone. FSH and LH are produced by the pituitary gland located at the base of the brain. FSH is necessary for sperm production (spermatogenesis), and LH stimulates the production of testosterone, which is necessary to continue the process of spermatogenesis. Testosterone also is important in the development of male characteristics, including muscle mass and strength, fat distribution, bone mass and sex drive. 2.
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FEMALE REPRODUCTIVE SYSTEM Labia majora: The labia majora enclose and protect the other external reproductive organs. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males. The labia majora contain sweat and oil-secreting glands. After puberty, the labia majora are covered with hair. Labia minora: Literally translated as "small lips," the labia minora can be very small or up to 2 inches wide. They lie just inside the labia majora, and surround the openings to the vagina (the canal that joins the lower part of the uterus to the outside of the body) and urethra (the tube that carries urine from the bladder to the outside of the body). Bartholin's glands: These glands are located beside the vaginal opening and produce a fluid (mucus) secretion. Clitoris: The two labia minora meet at the clitoris, a small, sensitive protrusion that is comparable to the penis in males. The clitoris is covered by a fold of skin, called the prepuce, which is similar to the foreskin at the end of the penis. Like the penis, the clitoris is very sensitive to stimulation and can become erect.

The main external structures of the female reproductive system include:

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The internal reproductive organs in the female include:
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Vagina: The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal. Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus. The uterus is divided into two parts: the cervix, which is the lower
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part that opens into the vagina, and the main body of the uterus, called the corpus. The corpus can easily expand to hold a developing baby. A channel through the cervix allows sperm to enter and menstrual blood to exit.
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Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the uterus. The ovaries produce eggs and hormones. Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.

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How does the female reproductive system function? The female reproductive system is designed to carry out several functions. It produces the female egg cells necessary for reproduction, called the ova or oocytes. The system is designed to transport the ova to the site of fertilization. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The next step for the fertilized egg is to implant into the walls of the uterus, beginning the initial stages of pregnancy. If fertilization and/or implantation does not take place, the system is designed to menstruate (the monthly shedding of the uterine lining). In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.
AFFIRMATIVE STATEMENTS SUBJECT I You We They He She It analyzed removed caught drank had had had VERB COMPLEMENT a microbe a tumor a cold a cough syrup genital herpes chlamydia syphilis

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NEGATIVE STATEMENTS SUBJECT AUXILIARY VERB analyze remove catch drink have have have COMPLEMENT a microbe a tumor a cold a cough syrup genital herpes chlamydia syphilis

I You We They did not / didn´t He She It INTERROGATIVE STATEMENTS AUXILIARY Did SUBJECT I you we they he she it AUXILIARY

VERB analyze cure have have have have have SUBJECT

COMPLEMENT

QUESTION MARK

Did

“WH” QUESTION WORDS How often

VERB

the results ? the patient a stiff neck a sunburn genital herpes ? chlamydia syphilis COMPLEMENT QUESTION MARK the results the patient a stiff neck a sunburn genital herpes chlamydia syphilis ?

did

When Why

did did

I you we they he she it

analyze cure have have have have have

?

ADDITIONAL INFORMATION For further information go to http://www.saberingles.com.ar/curso/lesson14/04.html

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ACTIVITIES
A. 1. 2. 3. 4. 5. 6. 7. PUT IN ORDER TO MAKE SENTENCES its 46-Mb / we/ nuclear genome/ sequenced _____________________________________________________________________ reviewed / in/ journals/ the/ articles/ authors/ relevant ______________________________________________________________________ dysfunction/ patients/ a sexual/ female/ reported ______________________________________________________________________ dysfunction/ in/ all/ explored/ men/ studies/ sexual ______________________________________________________________________ problem/ dysfunction /an under-recognized/was / sexual/ men/ in ______________________________________________________________________ our/ showed/ Georgian population/ degrees of ED/ lesser ______________________________________________________________________ mastered/ on / student physicians/ function / information / healthy sexual/ fundamental ______________________________________________________________________ 8. an overall improvement/ described/ with long standing UC/ after surgery/function/ patients/ sexual/ their/in . ______________________________________________________________________ B. COMPLETE THE FOLLOWING TEXT WITH THE WORDS IN THE BOX
fetus- genital-ovum- pelvic-reproductive-sperm-testes-zygote

The human male ____________system (or male _________system) consists of a number of sex organs that are a part of the human reproductive process. In the case of men, these sex organs are located outside a man's body, around the _________region. The main male sex organs are the penis and the ____________which produce semen and _________, which as part of sexual intercourse fertilize an _________ in a woman's body and the fertilized ovum (_________) gradually develops into a _________, which is later born as a child.

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LIST OF VERBS Los verbos regulares forman el Simple Past y el Past Participle agregando -ed al infinitivo. Los verbos irregulares no siguen esta regla y deben de ser aprendidos de memoria, estos se encuentran marcados con (i).
Infinitive add answer apologise arrest arrive ask attack be (i) become (i) begin (i) believe boil book borrow break (i) bring (i) build (i) buy (i) catch (i) Simple Past added answered apologised arrested arrived asked attacked was / were became began believed boiled booked borrowed broke brought built bought caught Past Participle added answered apologised arrested arrived asked attacked been become begun believed boiled booked borrowed broken brought built bought caught Spanish agregar responder disculparse arrestar llegar preguntar atacar ser convertirse comenzar creer hervir reservar tomar prestado romper traer construir comprar atrapar

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carry change chop clean climb collect come (i) compose cook copy cut (i) dance describe destroy die discover discuss do (i) draw (i) dream (i) drink (i) drive (i) dye

carried changed chopped cleaned climbed collected came composed cooked copied cut danced described destroyed died discovered discussed did drew dreamt/dreamed drank drove dyed

carried changed chopped cleaned climbed collected come composed cooked copied cut danced described destroyed died discovered discussed done drawn dreamt/dreamed drunk driven dyed

llevar cambiar picar limpiar escalar colleccionar venir componer cocinar copiar cortar bailar describir destruir morir descubrir discutir hacer dibujar soñar beber conducir teñir

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eat (i) enjoy explode extinguish fall (i) feed (i) feel (i) fight (i) find (i) fly (i) forget (i) freeze (i) fry give (i) go (i) grow (i) happen hate have (i) hear (i) help hire hope

ate enjoyed exploded extinguished fell fed felt fought found flew forgot froze fried gave went grew happened hated had heard helped hired hoped

eaten enjoyed exploded extinguished fallen fed felt fought found flown forgotten frozen fried given gone grown happened hated had heard helped hired hoped

comer disfrutar explotar extinguirse caer alimentar sentir pelear encontrar volar olvidar congelar freír dar ir crecer suceder odiar tener oír ayudar alquilar esperar

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hunt hurt (i) imagine invent invite jump keep (i) kill know (i) leave(i) lend (i) lie (i) lie lift like listen live look lose (i) love make (i) meet (i) miss

hunted hurt imagined invented invited jumped kept killed knew left lent lay lied lifted liked listened lived looked lost loved made met missed

hunted hurt imagined invented invited jumped kept killed known left lent lain lied lifted liked listened lived looked lost loved made met missed

cazar herir, doler imaginar inventar invitar saltar guardar matar saber dejar prestar yacer mentir levantar gustar escuchar vivir mirar perder amar hacer conocer, encontrar perder, extrañar

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offer open pack pass pay (i) peel phone plan play pour prefer prepare push put (i) rain read (i) reduce remember rent rescue return ring (i) run (i)

offered opened packed passed paid peeled phoned planned played poured preferred prepared pushed put rained read reduced remembered rented rescued returned rang ran

offered opened packed passed paid peeled phoned planned played poured preferred prepared pushed put rained read reduced remembered rented rescued returned rung run

ofrecer abrir empacar pasar, aprobar pagar pelar llamar por teléfono planificar jugar verter preferir preparar empujar poner llover leer reducir recordar alquilar rescatar volver, devolver llamar por teléfono correr

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save say (i) search send (i) scream see (i) sell (i) shine (i) shoot (i) shut (i) sing (i) sit (i) skate ski sleep (i) smell snore speak (i) spend (i) start stay steal (i) stop

saved said searched sent screamed saw sold shone shot shut sang sat skated skied slept smelled snored spoke spent started stayed stole stopped

saved said searched sent screamed seen sold shone shot shut sung sat skated skied slept smelled snored spoken spent started stayed stolen stopped

ahorrar decir buscar enviar gritar ver vender brillar disparar cerrar cantar sentarse patinar esquiar dormir oler roncar hablar gastar comenzar quedarse robar detener

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study survive swim (i) take (i) talk teach (i) tell (i) thank think (i) throw (i) touch try use understand (i) visit wait walk want warn wash watch wear (i) win (i)

studied survived swam took talked taught told thanked thought threw touched tried used understood visited waited walked wanted warned washed watched wore won

studied survived swum taken talked taught told thanked thought thrown touched tried used understood visited waited walked wanted warned washed watched worn won

estudiar sobrevivir nadar tomar hablar enseñar decir agradecer pensar lanzar tocar intentar usar entender visitar esperar caminar querer advertir lavar mirar llevar puesto ganar

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work write (i)

worked wrote

worked written

trabajar escribir

Source: http://www.saberingles.com.ar/lists/verbs2.html

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