Mezei Zsuzsa Lívia
An Introduction to Basic Medical
English Terminology 2
Coursebook for Students of Medicine
Lektorálta: Krasznai Mónika
A segédanyagot készítették:
Szabóné Enyedi Gabriella,
Papp Eszter,
John Graham,
Farkas János,
Hajdu Zita,
Dr. Nyilas Istvánné
Dr. Laczkóné Rácz Edit,
Louis J. Mattia,
Major Judit,
George Seel
TÁMOP-4.1.2.D-12/1/KONV-2012-0008
Debrecen
2014
1
CONTENTS
UNIT 1. DIGESTIVE SYSTEM I. (DIGESTIVE PROCESS, ORAL CAVITY, STOMACH, DISEASES OF THE
STOMACH) ................................................................................................................................... 7
1.1 UNDERSTANDING HOW THE DIGESTIVE SYSTEM WORKS...................................................... 8
1.1.1 Introduction to the digestive tract (L)..................................................................................... 8
1.1.2 Overview of the digestive system (V) ..................................................................................... 8
1.1.3 The digestive process (R) ...................................................................................................... 10
1.1.4 Speaking about the digestive process (S) ............................................................................. 11
1.1.5 Digestive health (W) ............................................................................................................. 12
1.2 THE ORAL CAVITY .............................................................................................................. 13
1.2.1 Parts of the oral cavity (V) .................................................................................................... 13
1.2.2 The oral cavity: overview (R) ................................................................................................ 14
1.2.3 Permanent teeth (R) ............................................................................................................. 15
1.2.4 Tooth anatomy (V)................................................................................................................ 16
1.2.5 Oral health (V) ...................................................................................................................... 17
1.2.6 Dental care (S) ...................................................................................................................... 18
1.3 THE STOMACH .................................................................................................................. 18
1.3.1 Stomach - Quiz (R) ................................................................................................................ 18
1.3.2 Stomach Anatomy and Histology (R) .................................................................................... 19
1.3.3 Oral summary of the stomach (S) ......................................................................................... 22
1.3.4 Latin word roots (V) .............................................................................................................. 23
1.4 DISEASES OF THE STOMACH .............................................................................................. 23
1.4.1 Heartburn (R) ........................................................................................................................ 23
1.4.2 Foods to eat and avoid for heartburn (V) ............................................................................. 25
1.4.3. Student-patient communication (S) .................................................................................... 26
1.4.4 Other diseases of the stomach (R) ........................................................................................ 27
1.4.5 Answering patient’s email (W) ............................................................................................. 29
1.4.6. Endoscopy (L) ....................................................................................................................... 30
1.4.7 Explaining endoscopy to the patient (S) ............................................................................... 30
UNIT 2. DIGESTIVE SYSTEM II. (SMALL AND LARGE INTESTINES, LIVER) ......................................... 31
2.1 SMALL AND LARGE INTESTINES.......................................................................................... 32
2.1.1 Small Intestine (R) ................................................................................................................. 32
2.1.2 Large Intestine (R) ................................................................................................................ 34
2
2.1.3 Appendix and appendicitis (L)............................................................................................... 35
2.1.4 Asking questions about the large intestine (W) ................................................................... 36
2.1.5 Important vocabulary of the small and large intestines (V) ................................................. 37
2.2 DISEASES OF THE SMALL AND LARGE INTESTINES ............................................................... 38
2.2.1 Collecting ideas to food poisoning (V) .................................................................................. 38
2.2.2 FAQs about food poisoning (S) ............................................................................................. 38
2.2.3 Food poisoning facts (R) ....................................................................................................... 39
2.2.4 Doctor-patient conversation (S) ........................................................................................... 40
2.2.5 Diarrhoea (L) ......................................................................................................................... 40
2.2.6 Other common gastrointestinal diseases (R)........................................................................ 41
2.2.7 Doctor-patient conversations (S) .......................................................................................... 42
2.2.8 Most common gastrointestinal diseases: an essay (W) ....................................................... 43
2.3 THE LIVER ......................................................................................................................... 43
2.3.1 FAQs about the liver (S) ........................................................................................................ 43
2.3.2 Anatomy of the liver (V)........................................................................................................ 44
2.3.3 Functions of the liver (L) ....................................................................................................... 45
2.3.4 An interview about the diseases of the liver (W) .................................................................. 46
2.3.5 Facts about the liver (R)........................................................................................................ 47
2.3.6 Talking about the liver (S) ..................................................................................................... 48
2.5 VOCABULARY .................................................................................................................... 49
UNIT 3. NERVOUS SYSTEM .......................................................................................................... 52
3.1 THE CENTRAL NERVOUS SYSTEM ....................................................................................... 53
3.1.1 Brain Quiz (R) ........................................................................................................................ 53
3.1.2 Brain Anatomy (R) ................................................................................................................ 53
3.1.3 Important vocabulary of the CNS (V).................................................................................... 55
3.1.4 Basic structures of the brain (S) ............................................................................................ 56
3.1.5 Brain Anatomy Diagram (R) ................................................................................................. 56
3.1.6 Lobes of the brain (W) .......................................................................................................... 57
3.2 CRANIAL NERVES............................................................................................................... 58
3.2.1 Cranial Nerve Song (L) .......................................................................................................... 58
3.2.2 List of the cranial nerves (R) ................................................................................................. 59
3.2.3 Scatter (V) ............................................................................................................................. 61
3.3 SPINAL NERVES ................................................................................................................. 62
3.3.1 Revision (S) ........................................................................................................................... 62
3
3.3.2 Spinal nerves (R) ................................................................................................................... 62
3.3.3 Spinal Nerves - oral summary (S) .......................................................................................... 64
3.3.4 Coverings & spaces (V) ......................................................................................................... 64
3.4 COMMON DISEASES OF THE CENTRAL NERVOUS SYSTEM................................................... 65
3.4.1 FAQS (S) ................................................................................................................................ 65
3.4.2 Neurological diseases (R)...................................................................................................... 65
3.4.3 Talking about common neurological diseases (S) ................................................................ 69
3.4.4 Seizure first Aid (W) .............................................................................................................. 70
3.5 OLD AGE AND ALZHEIMER’S DISEASE ................................................................................. 73
3.5.1 Brainstorming – Old Age (V) ................................................................................................. 73
3.5.2 Caring for the elderly (S) ....................................................................................................... 73
3.5.3 Difficulties of the elderly (W) ................................................................................................ 74
3.5.4 Alzheimer’s disease facts (R) ................................................................................................ 75
3.5.5 Stages of Alzheimer’s (L)....................................................................................................... 76
3.5.6 Doctor-patient conversation (S) ........................................................................................... 77
3.6 THE PERIPHERAL NERVOUS SYSTEM .................................................................................. 78
3.6.1 The peripheral nervous system – Key points (V) ................................................................... 78
3.6.2 The neuron (R) ...................................................................................................................... 79
3.6.3 Parts of the PNS (S) ............................................................................................................... 81
3.7 MENTAL DISEASES............................................................................................................. 81
3.7.1 What is mental illness? (R) ................................................................................................... 81
3.7.2 Symptoms (V) ....................................................................................................................... 83
3.7.3 Common mental illnesses (R) ............................................................................................... 84
3.7.4 Tourette syndrome (R) .......................................................................................................... 86
3.7.5 List of tics (V) ........................................................................................................................ 87
3.7.6 Seasonal Affective Disorder (L) ............................................................................................. 87
3.7.7 Stigma of Mental Illnesses (S)............................................................................................... 88
3.8 VOCABULARY .................................................................................................................... 90
UNIT 4. RESPIRATORY SYSTEM .................................................................................................... 93
4.1 ANATOMY OF THE RESPIRATORY SYSTEM .......................................................................... 94
4.1.1 Introduction to the Respiratory System (L) ........................................................................... 94
4.1.2 Organs of the respiratory system (R).................................................................................... 95
4.1.3 Summary of the Respiratory System (W) ............................................................................. 98
4.1.4 Medical terms vs. common English names about the respiratory system (V)...................... 99
4
4.1.5 Identifying and speaking about the structures of the respiratory system (S) .................... 100
4.2 MUSCLES OF RESPIRATION, PHYSIOLOGY OF THE RESPIRATORY SYSTEM ...........................101
4.2.1 Respiration (R) .................................................................................................................... 101
4.2.2 Health effects of smoking (S) .............................................................................................. 104
4.2.3 Decreasing smoking rates (W)............................................................................................ 105
4.2.4 Types of cough (S) ............................................................................................................... 105
4.3 DISEASES OF THE RESPIRATORY SYSTEM ...........................................................................106
4.3.1 Lung cancer (R) ................................................................................................................... 106
4.3.2 COPD (V) ............................................................................................................................. 107
4.3.3 Chronic Obstructive Pulmonary Disease causes (L) ............................................................ 108
4.3.4 COPD Quiz (R) ..................................................................................................................... 109
4.3.5 Doctor- Patient conversation (S) ........................................................................................ 110
4.4 OTHER LUNG CONDITIONS AND ASTHMA .........................................................................110
4.4.1 Other lung conditions (R) .................................................................................................... 110
4.4.2 Asthma (L)........................................................................................................................... 113
4.4.3 Doctor-Patient conversation (S) ......................................................................................... 114
4.5 VOCABULARY ...................................................................................................................115
UNIT 5. THE IMMUNE SYSTEM ...................................................................................................117
5.1 OVERVIEW OF THE IMMUNE SYSTEM ...............................................................................118
5.1.1 Brainstorming – Immune System (V) .................................................................................. 118
5.1.2 Basic terms (V) .................................................................................................................... 118
5.1.3 Function and location of the Immune System (R)............................................................... 119
5.1.4 Immune Response to Bacteria (L) ....................................................................................... 121
5.1.5 Immune System Boosters and Busters (S) .......................................................................... 122
5.2.1 Getting to know about autoimmune diseases (R) .............................................................. 123
5.2.2 Multiple sclerosis (L) ........................................................................................................... 125
5.2.3 Living with MS (S) ............................................................................................................... 128
5.2.4 Coping with MS diagnosis (L).............................................................................................. 129
5.2.5 Giving advice (W)................................................................................................................ 130
5.2.6 Talking about MS (S)........................................................................................................... 131
5.3. ORGAN TRANSPLANTATION ............................................................................................131
5.3.1 Background Vocabulary (V) ................................................................................................ 131
5.3.2 Organ Transplantation - Frequently Asked Questions (S) .................................................. 132
5.3.3 The Immune System and Organ Transplant (R).................................................................. 132
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5.4 FOOD ALLERGY.................................................................................................................134
5.4.1 Major allergenic foods (V) .................................................................................................. 134
5.4.2 Understanding food allergy (L) ........................................................................................... 135
5.4.3. Food Allergy – Everything you need to know (R) ............................................................... 136
5.4.4 Type-1 Hypersensitivity: IgE mediated food allergy (L) ...................................................... 138
5.4.5. Communicating with the patient (S).................................................................................. 139
5.4.6 Celiac disease (R) ................................................................................................................ 141
5.4.7 Celiac disease: giving advice (S) ......................................................................................... 142
5.5. AIDS ...............................................................................................................................143
5.5.1 FAQ (S) ................................................................................................................................ 143
5.5.2 Frequent words in connection with AIDS (V) ...................................................................... 144
5.5.3 Everything you need to know about AIDS (L) ..................................................................... 144
5.5.4 Talking about AIDS (S) ........................................................................................................ 145
5.6 VOCABULARY ...................................................................................................................146
L = listening activity; R = reading activity; S = speaking activity; W = writing activity; V = vocabulary
development activity
6
UNIT 1. DIGESTIVE SYSTEM I. (DIGESTIVE PROCESS,
ORAL CAVITY, STOMACH, DISEASES OF THE STOMACH)
Aims of the Unit
In this unit you will learn about:




the digestive process,
the oral cavity,
the stomach and
diseases of the stomach.
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1.1 UNDERSTANDING HOW THE DIGESTIVE SYSTEM WORKS
LISTENING
1.1.1 Introduction to the digestive tract (L)
1. Listen to the recording about digestion of food and tick (√) the
words you hear in the text.
Source: http://www.youtube.com/watch?v=44sf_AL8pfw
digest ______
mouth______
teeth ______
mince______
gland ______
esophagus______
sphincter muscle______
nutrients______
ear ______
liver______
pancreas______
large intestine______
stomach______
chyme______
bones ______
swallow______
grind ______
mastication______
saliva______
small intestine______
valve______
2. Listen again and answer the questions below.
1) What are the life giving nutrients for the body?
2) What is the job of the teeth?
3) What is mastication?
4) What is the function of saliva?
5)
What organ does food passes through from the mouth into the stomach?
6) What can be found at the lower end of the esophagus?
7) What is the function of the sphincter muscle?
8) What is food texture like once it is ready to leave the stomach? What is it called?
VOCABULARY DEVELOPMENT
1.1.2 Overview of the digestive system (V)
1. Match the words in the box with the definitions.
mouth
rectum
anus
appendix
stomach
pancreas
esophagus
gall bladder
small intestine
liver
large intestine
8
_________________: the opening at the end of the digestive system from which feces exit the body.
_________________: a small sac located near the start of the large intestine.
_________________: the long tube between the mouth and the stomach. It uses rhythmic muscle
movements (called peristalsis) to force food from the throat into the stomach.
_________________: a small, sac-like organ located by the duodenum. It stores and releases bile (a
digestive chemical which is produced in the liver) into the small intestine.
_________________: the long, wide tube that food goes through after it goes through the small
intestine.
_________________: a large organ located above and in front of the stomach. It filters toxins from
the blood, and makes bile (which breaks down fats) and some blood proteins.
_________________: the first part of the digestive system, where food enters the body. Breaking
down the food by chewing and salivary enzymes are the beginning of the digestive process.
_________________: an enzyme-producing gland located below the stomach and above the
intestines. Enzymes produced here help in the digestion of carbohydrates, fats and proteins in the
small
intestine.
_________________: the lower part of the large intestine, where feces are stored before they are
excreted
from
the
body.
_________________: the long, thin winding tube that food goes through after it leaves the stomach.
_________________: a sack-like, muscular organ that is attached to the esophagus. When food
enters this organ, it is churned in an acid bath.
http://www.enchantedlearning.com/subjects/anatomy/digestive/labeleasy/
3. Label the diagram with the words from the box above.
http://www.enchantedlearning.com/subjects/anatomy/digestive/labeleasy/
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READING
1.1.3 The digestive process (R)
1. Read the text and answer the questions below!
The digestive process
The start of the process - the mouth: The digestive
process begins in the mouth. Food is partly broken
down by the process of chewing and by the
chemical action of salivary enzymes (these enzymes
are produced by the salivary glands and break down
starches into smaller molecules).
On the way to the stomach: the esophagus - After
being chewed and swallowed, the food enters the
esophagus. The esophagus is a long tube that runs
from the mouth to the stomach. It uses rhythmic,
wave-like muscle movements (called peristalsis) to
force food from the throat into the stomach. This
muscle movement gives us the ability to eat or drink
even when we're upside-down.
In the stomach - The stomach is a large, sack-like organ that churns the food and bathes it in a very
strong acid (gastric acid). Food in the stomach that is partly digested and mixed with stomach acids is
called chyme.
In the small intestine - After being in the stomach, food enters the duodenum, the first part of the
small intestine. It then enters the jejunum and then the ileum (the final part of the small intestine). In
the small intestine, bile (produced in the liver and stored in the gall bladder), pancreatic enzymes,
and other digestive enzymes produced by the inner wall of the small intestine help in the breakdown
of food.
In the large intestine - After passing through the small intestine, food passes into the large intestine.
In the large intestine, some of the water and electrolytes (chemicals like sodium) are removed from
the food. Many microbes (bacteria like Bacteroides, Lactobacillus acidophilus, Escherichia coli,
and Klebsiella) in the large intestine help in the digestion process. The first part of the large intestine
is called the cecum (the appendix is connected to the cecum). Food then travels upward in the
ascending colon. The food travels across the abdomen in the transverse colon, goes back down the
other side of the body in the descending colon, and then through the sigmoid colon.
The end of the process - Solid waste is then stored in the rectum until it is excreted via the anus.
1) Where does the digestive process start? __________________________________________
2) What are salivary enzymes? ____________________________________________________
3) How is food forced from the throat into the stomach? _______________________________
4) What is chyme? ______________________________________________________________
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5) What are the parts of the small intestine? _________________________________________
6) What are produced in the small intestine? _________________________________________
7) What are removed from food in the large intestine? ________________________________
8) What are the parts of the large intestine? _________________________________________
9) How does the process end? ____________________________________________________
http://www.enchantedlearning.com/subjects/anatomy/digestive/
http://www.bing.com/images/search?q=the+digestive+process&FORM=HDRSC2#view=detail&id=A1B4CAFEC5AF98DE96BB7175CD1A973CFDADE8A0&selecte
dIndex=1
SPEAKING
1.1.4 Speaking about the digestive process (S)
Write down the most important information from the text above then with the help of your notes
speak about the digestive process.
Mouth
Esophagus
Stomach
Small intestine
Large
intestine
Rectum
11
http://www.ellies-whole-grains.com/human-digestive-system.html#axzz37BNYG6YF
WRITING
1.1.5 Digestive health (W)
You read the following article in a magazine. Write an essay (180-200 words) about how to improve
your digestive health.
How to improve your digestive health
Many people suffer from digestive issues, such
as constipation, diarrhea, irritable bowel
syndrome, bloating, nausea, intolerance and
celiac disease. Some of these conditions can be
avoided by following a healthy, doctorrecommended diet. If you have digestive
issues, you may consider slowly changing
your eating habits.
http://www.wikihow.com/Improve-Your-Digestive-Health
12
In your essay write about:

foods that a healthy diet should contain (probiotics, fibers
etc.)
foods and unhealthy habits to avoid
the amount of food eaten per meals
tips to lose weight, importance of exercise
importance of proceeding gradually in changing diet




1.2 THE ORAL CAVITY
VOCABULARY DEVELOPMENT
1.2.1 Parts of the oral cavity (V)
Match the words (a-f) with the definitions (1-6).
a
a)
b)
c)
d)
e)
f)
1.
2.
3.
4.
5.
b
c
d
e
f
oral cavity
vestibule
hard palate
soft palate
uvula
cheeks
The fleshy part of either side of the face below the eye and between the nose and ear which
form the lateral walls of the oral (and buccal) cavity
The relatively hard, vaulted anterior portion of the palate forming the anterior portion of the
roof of the mouth
The small, conical, fleshy mass of mucosal tissue suspended from the center of the soft
palate; it assists in completing the closure of the nasal cavity by the soft palate during
swallowing or sucking
The first portion of the gastrointestinal tract, the opening through which food is taken in and
vocalizations emerge, it is bounded by the lips, cheeks, palate, and tongue, and ends where
it merges with the oropharynx
The movable fold, consisting of skeletal muscular fibers enclosed in a mucous membrane,
13
6.
which is suspended from the rear of the hard palate and closes off the nasal cavity from the
oral cavity during swallowing or sucking; the uvula depends from it
In general, a cavity, chamber, or channel which leads to or is an entrance to another cavity;
in the oral cavity, it is the medial continuation of the buccal cavity, located between the jaws
and teeth and the labia
http://apbrwww5.apsu.edu/thompsonj/Anatomy%20&%20Physiology/2020/2020%20Exam%20Reviews/Exam
%203/CH23%20Oral%20Cavity%20I%20-%20Walls.htmREADING
READING
1.2.2 The oral cavity: overview (R)
1. Complete the text with the missing words. The first letter is given in each word.
The oral cavity represents the first part of the digestive tube. Its primary function is to serve as the
entrance of the 1. a________________ tract and to initiate the digestive process by salivation and
propulsion of the alimentary bolus into the 2. p________________. It also serves as a secondary
respiratory 3. c________________, a site of sound modification for the production of speech and a
chemosensory organ. The mobility of the 4. l________________ is also critical to speech production,
whistling, singing, the playing of wind and brass musical instruments, and human behavioral
communication (e.g. kissing, smiling, pouting). The oral cavity is oval shaped and is separated into
the oral vestibule and the oral cavity. It is bound by the lips anteriorly, the 5. c________________
laterally, the floor of the mouth inferiorly, the oropharynx posteriorly, and the 6.
p________________ superiorly. The oropharynx begins superiorly at the 7. j_______________
between the hard palate and the soft palate, and inferiorly behind the circumvallate papillae of the
14
tongue. The oral cavity includes the lips, gingivae, retromolar trigone, teeth, hard palate, cheek
mucosa, mobile tongue, and floor of the mouth. The major salivary glands are in close relation with
oral cavity structures, although they are not part of the oral cavity. The 8. t_______________ is part
of the oral cavity. The palatine tonsils, soft palate, tongue base, and posterior pharyngeal walls are
part of the oropharynx; the oropharynx is not part of the oral cavity.
http://emedicine.medscape.com/article/1899122-overview
2. Answer the following questions.
1) What are the functions of the oral cavity?
2) Why is the mobility of the lips vital?
3) What shape is the oral cavity?
4) What are the two parts of the oral cavity?
5) What is the oral cavity bound by anteriorly, posteriorly, laterally, inferiorly and superiorly?
READING
1.2.3 Permanent teeth (R)
1. Read the definitions then label the permanent teeth on the diagram.
Humans have two sets of teeth, the baby teeth (also called the primary teeth) and the permanent
teeth. Children have 20 primary teeth; they are replaced by the permanent teeth by about age 13.
Adults have 32 permanent teeth.
canine (also called cuspid) - the pointy tooth located between the incisors and the premolars. A
canine tooth has 1 root. Adults have 4 canine teeth (2 in the top jaw and 2 in the bottom jaw). Canine
means, "of or like a dog."
incisors - the front teeth, used for cutting food. An incisor has 1 root. Adults have 8 incisors (4 in the
top jaw and 4 in the bottom jaw).
premolars (also called bicuspids) - the teeth located between the canine and the molars. A premolar
tooth has 1 root. Bicuspids have two points (cusps) at the top. Adults have 8 premolars (4 in the top
jaw and 4 in the bottom jaw).
molars - the relatively flat teeth located towards the back of the mouth, used for grinding food.
Molars in the top jaw have 3 roots; molars in the lower jaw have 2 roots. Adults have 12 molars (6 in
the top jaw and 6 in the bottom jaw).
15
http://www.enchantedlearning.com/subjects/anatomy/teeth/labelteeth/
VOCABULARY DEVELOPMENT
1.2.4 Tooth anatomy (V)
Do the following tooth quiz with the help of the picture and definitions.
Cementum - a layer of tough, yellowish, bone-like
tissue that covers the root of a tooth. It helps hold
the tooth in the socket. The cementum contains
the periodontal membrane.
Crown - the visible part of a tooth.
Dentin - the hard but porous tissue located under
both the enamel and cementum of the tooth.
Dentin is harder than bone.
Enamel - the tough, shiny, white outer surface of
the tooth.
Gums - the soft tissue that surrounds the base of
the teeth.
Nerves - nerves transmit signals (conveying
messages like hot, cold, or pain) to and from the
brain.
Periodontal membrane/ligament - the fleshy
tissue between tooth and the tooth socket; it
holds the tooth in place. The fibers of the
periodontal membrane are embedded within the
cementum.
Pulp - the soft center of the tooth. The pulp contains blood vessels and nerves; it nourishes the
dentin.
Root - the anchor of a tooth that extends into the jawbone. The number of roots ranges from one to
four.
16
1) The visible part of the tooth is called the ____________________________
2) What is the name of the hard, white, outer layer of a tooth? __________________________
3) What is the name of the tissue just below this outer layer? ____________________________
4) The bottom part of the tooth that anchors it in the gums and jawbone is called the
____________________________
5)
What is the name of the soft center of a tooth? ____________________________
6) What does this soft area contain? ____________________________
7) What is the name of the soft tissue that surrounds the base of teeth? ___________________
8) What is the name of the tough outer layer of the roots? ____________________________
http://www.enchantedlearning.com/subjects/anatomy/teeth/toothanatomy.shtml
http://www.enchantedlearning.com/subjects/anatomy/teeth/toothquiz.shtml
VOCABULARY DEVELOPMENT
1.2.5 Oral health (V)
1. Collect words and expressions that come to your mind concerning ‘oral health’.
Oral Health
2. Name the following items in English.
a._______________
e._______________
b._______________
c._______________
f._______________
d._______________
g._______________
h._______________
17
SPEAKING
1.2.6 Dental care (S)
1. With a partner, discuss the following questions.
1)
2)
3)
4)
5)
6)
How should you take good care of your teeth according to dentists?
How often is it advised to visit a dentist?
Why are regular checkups important?
What kind of problems can a dentist detect?
How does a dentist treat you if tooth decay is detected?
What ensures the treatment is not painful?
2. Speak about the following topics in your own words with the help of the given prompts.


role of the teeth
dangers of bad teeth


how to keep your teeth clean
problems treated by dentists

how is a tooth decay treated
1.3 THE STOMACH
READING
1.3.1 Stomach - Quiz (R)
1. Do the quiz below! Decide if the following statements are True (write T) or False (write F).
1)
2)
3)
4)
5)
6)
7)
8)
Absorption doesn’t get place in the abdomen. _____
You cannot contract the stomach. _____
Stomach dimension relay to body size/weight. ______
Exercise cannot modify the dimension of our stomach. _____
It doesn’t kill bacteria. ______
It is a muscular organ. _____
When you blush, the lining of your stomach also turns red! _____
Your stomach produces a new layer of mucous every two weeks. _____
18
9) Without stomach life is simply not possible. _____
10) Stomach acid is corrosive. _____
http://whatthafact.com/interesting-facts-about-stomach/
http://www.softschools.com/facts/human_body/the_stomach_facts/341/
http://science-facts.top5.com/5-fascinating,-terrifying-things-about-the-human-stomach/
READING
1.3.2 Stomach Anatomy and Histology (R)
1. Match the words (1-5) with the definitions (A-E).
1)
2)
3)
4)
5)
6)
A
B
C
D
E
F
_____ sphincter
_____ ruga(e)
_____ pyloric
_____ pepsinogen
_____ secrete
_____ gastrin
a zymogen secreted by the chief cells of the gastric glands and converted into pepsin in the
presence of gastric acid or of pepsin itself
A hormone secreted in the stomach that is involved in the production of gastric acid.
Overproduction of gastric acid contributes to peptic ulcer formation.
a ridge or fold, such as the rugae of the stomach, which are large folds in the mucous
membrane of that organ
A ringlike muscle that normally maintains constriction of a body passage or orifice and that
relaxes as required by normal physiological functioning.
pertaining to the pylorus or to the pyloric part of the stomach
to produce a liquid substance
2. What do the following words refer to? Explain them in your own words.
1. fluidisation
2. secretion
3. gland
4. to break up
3. Read the text and answer the questions below.
19
The stomach is a muscular 'j'-shaped organ located on the left side of the upper abdomen. The
stomach receives food from the esophagus. As food reaches the end of the esophagus, it enters the
stomach through a muscular valve called the lower esophageal sphincter.
The stomach secretes acid and enzymes that digest food. Ridges of muscle tissue called rugae line
the stomach. The stomach muscles contract periodically, churning food to enhance digestion. The
pyloric sphincter is a muscular valve that opens to allow food to pass from the stomach to the small
intestine.
The stomach has four regions- the cardia, fundus, body and pylorus. Each region performs different
functions; the fundus collects digestive gases, the body secretes pepsinogen and hydrochloric acid,
and the pylorus is responsible for mucus, gastrin and pepsinogen secretion.
The stomach has five major functions;





Temporary food storage
Control the rate at which food enters the duodenum
Acid secretion and antibacterial action
Fluidisation of stomach contents
Preliminary digestion with pepsin, lipases etc.
The Stomach – Histology



G- mucosa containing glandular tissue; different areas of the stomach contain different types
of cells which secrete compounds to aid digestion. The main types involved are:
o parietal cells which secrete hydrochloric acid
o chief cells which secrete pepsin
o enteroendocrine cells which secrete regulatory hormones.
MM- muscularis mucosae
SM- submucosa
The stomach contains three layers of involuntary smooth muscle which aid digestion by physically
breaking up the food particles;
o
o
o
OM- inner oblique muscle
CM- circular muscle
LM- outer longitudional muscle
20
http://www.le.ac.uk/pa/teach/va/anatomy/case6/frmst6.html
1) What shape is the stomach?
2) What are the regions of the stomach?
3) What are the functions of the different regions of the stomach?
4) What are the functions of the stomach?
5) Where does food enter the stomach?
6) Where does food leave the stomach?
7) What kind of cells does the stomach contain to aid digestion?
8) What kind of muscles does the stomach contain to aid digestion?
4. Label the diagram with the words from the box.
Pyloric Region of
the stomach
Duodenum of the
small intestine
Rugae
Cardiac region of
the stomach
Pyloric Sphincter
Valve
Fundus
Cardiac Sphincter
Valve
Body of the
stomach
Esophagus
21
http://anatomycorner.com/main/anatomy-topics/digestive-system/stomach-label/
SPEAKING
1.3.3 Oral summary of the stomach (S)
In pairs, speak about the stomach. The prompts may help you. Take turns.






shape of the stomach
regions of the stomach
functions of the different regions of the stomach
functions of the stomach
cells of the stomach
muscles that aid digestion
22
VOCABULARY DEVELOPMENT
1.3.4 Latin word roots (V)
Match the words in A to the words in B and write the solutions into the table below.
A
B
1
rrhagia
a
excessive flow of gastric secretion
2
pept
b
inflammation of the stomach and
intestines
3
Gastrorrhea
c
digestion
4
gastr/o
d
inflammation of the stomach
5
enter
e
inflammation
6
gastroenteritis
f
bleeding
7
-ic
g
stomach
8
-rrhea
h
abnormal flow
9
gastritis
i
pertaining to
10
-itis
j
small intestine
1
2
3
4
5
6
7
8
9
10
1.4 DISEASES OF THE STOMACH
READING
1.4.1 Heartburn (R)
1. Do the following quiz on ‘Heartburn’, write (T) for true or (F) for false or choose the correct answer.
Then read the text below and check your answers.
1. Heartburn hurts your heart. _____
2. Chewing gum can help heartburn. _____
3. Using a lot of pillows when you sleep can make heartburn better. _____
23
4. If you are overweight, the best way to stop heartburn is to drop some pounds. _____
5. You are most likely to have heartburn when you:
a) Wear tight pants
b) Lie down after a meal
c) Both the above
6. Taking antacids too much can cause:
a) leg cramps
b) constipation
c) fatigue
7. How long should you wait between dinner and going to bed?
a) 1 to 2 hours
b) 2 to 3 hours
c) 3 to 4 hours
8. Can you have GERD (gastroesophageal reflux disease) without having heartburn? _____
http://www.webmd.com/heartburn-gerd/rm-quiz-heartburn-myths-and-facts
2. Read the text and answer the questions below.
If you’ve had heartburn, you know that burning feeling in your lower chest. But despite what it’s
called and where it hurts, the pain has nothing to do with your heart. Heartburn happens when a
muscle at the end of your esophagus doesn’t close properly. Stomach acid creeps back up that pipe,
causing irritation. It’s a common problem: About 40% of adults in the United States have heartburn
at least once a month. Along with discomfort, you may also have a bitter or sour taste in your mouth
and throat. Symptoms can last from a few minutes to a few hours.
When you chew gum, your mouth makes more spit. That acts as a buffer to acid. You also swallow
more when you chew gum, and that pushes acid down. Smoking can make things worse. You’re likely
to make less spit and more stomach acid. If your heartburn is worse when you lie down, try raising
the head of your bed so your head and chest are higher than your feet. But don’t do it with pillows.
That can put your head at an angle that can put more pressure on your stomach, making things
worse. Instead, try putting 6-inch blocks under the bed posts at the head of the bed. Sleeping on your
left side also can help. Studies show lying on your right side can make heartburn worse. The left
position seems to put less pressure on the muscle connecting your stomach and esophagus.
Numbers on the scale matter more than what you eat. Pressure on your stomach from too much
weight can allow acid up into your esophagus. A study by doctors at Stanford University who
reviewed more than 2,000 studies about heartburn found no evidence that giving up foods makes it
better. But losing a few pounds really does help. If you know something gives you heartburn, don’t
eat or drink it.
24
You set yourself up for heartburn when you overeat, and lying down after a meal makes it worse.
Tight clothing, control top panty hose, and body shapers can also put pressure on your tummy, so if
you’re worried about it, wear loose-fitting, comfortable clothes.
Antacids that you can buy at the drugstore can give you quick relief, but if you depend on them too
much, they may cause other problems: constipation or diarrhea. Look for the kinds that contain
magnesium hydroxide or aluminum hydroxide. They are less likely to cause digestion problems.
It’s never a good idea to go to bed on a full stomach. Spreading out the time between dinner and
hitting the sack will give stomach acid time to settle. Don’t rush your meals, and don’t eat so much
that you are uncomfortable. Try eating four or five smaller meals instead of three large ones.
If you have heartburn more than twice a week, you might have something called GERD
(gastroesophageal reflux disease). Heartburn is a symptom of GERD, but not always. Hoarseness, a
dry cough, trouble swallowing and asthma symptoms are also signs of GERD.
Many people take nonprescription antacids for mild or occasional heartburn. Antacids neutralize
some of the stomach acid for 30 minutes to 2 hours. Antacids work faster than acid reducers (H2
blockers), but their effect does not last more than 1 to 2 hours. Acid reducers, also called histamine
receptor (or H2) blockers can provide relief for up to 12 hours. They decrease the amount of acid that
the stomach makes, which may reduce irritation to the stomach lining and decrease heartburn.
http://www.webmd.com/heartburn-gerd/features/11-meal-planning-tips-prevent-heartburn
1)
2)
3)
4)
5)
6)
7)
8)
When does heartburn happen?
What are the symptoms of heartburn?
What can make the symptoms better or worse?
Why shouldn’t you sleep with a lot of pillows when you have heartburn?
Why can sleeping on your left help when you have heartburn?
What is the connection between heartburn and overweight?
What are the signs of GERD?
How can mild heartburn be treated?
VOCABULARY DEVELOPMENT
1.4.2 Foods to eat and avoid for heartburn (V)
What can you eat and what should you avoid if you have heartburn. Put the following foods into the
correct column.
1. banana
6. fish & chips
11. alcoholic
beverages
2. tomato sauce
7. orange juice
12. ginger
16. butter
17. fennel
3. herbal tea
8. bean
13. caffeinated
drinks (coffee,
tea)
18. couscous and
rice
4. vinegar
9. chili
14. chewing gum
5. oat
10. milk
15. chocolate
19. celery/parsley
20. ice cream
http://www.webmd.com/heartburn-gerd/ss/slideshow-heartburn-foods
25
You should eat
You should avoid
SPEAKING
1.4.3. Student-patient communication (S)
1. With a partner discuss the possible questions a doctor may ask about symptoms regarding
duration, severity, location, causes, timing of the symptoms, past medical history, medication,
allergies/adverse reactions, smoking/drug and alcohol history, screening tests. Write your
questions into the table then in groups discuss them.
POSSIBLE QUESTIONS
Duration
Severity
Location
Causes
Timing
Past medical history
Medication
26
Allergies/adverse reactions
Smoking/drug and alcohol history
Screening tests
http://www.rightdiagnosis.com/diagnosis/questions-doctor-ask.htm
2. With a partner, act out the roles below.
Student
A:
Számoljon
be
orvosának éjszaka jelentkező
gyomorégéséről. Nagyon stresszes
életmódot folytat. Nem táplálkozik
rendszeresen
és
leginkább
gyorsételeket
fogyaszt.
Ön
dohányzik és túlsúlyos is. Kérje ki
orvosa véleményét a helyes
táplálkozással kapcsolatban.
Student B: Ön orvos. Kérdezze ki
beszédpartnerét a tünetekről, étkezési
szokásairól, életmódjáról. Javasoljon
néhány
készítményt a panaszok
enyhítésére, illetve adjon tanácsot a
probléma megelőzéséhez. Sorolja fel
azokat az ételeket, melyeket szabad
fogyasztani, illetve azokat, amiket el kell
kerülni. Javasolja betegének, hogy
kezdjen el fogyókúrázni, mozogjon
rendszeresen.
READING
1.4.4 Other diseases of the stomach (R)
1. Find the description to each condition. Write the correct number into the table.
1) Inflammation of the stomach, often causing nausea and/or pain. It can be caused by alcohol,
certain medications, H. pylori infection, or other factors.
2) It refers to painful sores in the lining of the stomach or first part of the small intestine, called
the duodenum.
3) It is a disease in which stomach cells become malignant (cancerous) and grow out of control,
forming a tumor.
27
4) It occurs when stomach contents flow back up into the esophagus—the muscular tube that
carries food and liquids from the mouth to the stomach. It is also called acid reflux or acid
regurgitation, whereas GERD is a disease that includes acid reflux as a symptom.
5) People who have this disease develop tumors known as gastrinomas in the pancreas and
duodenum. The gastrinomas secrete the hormone gastrin. Because gastrin creates excessive
stomach acid, patients can also develop stomach and duodenal ulcers.
Condition
Description
Symptoms
GER(D)
Gastric ulcer (Stomach ulcer)/
Peptic ulcer
Gastritis
Stomach (Gastric) cancer
Zollinger-Ellison syndrome
(ZES)
http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/#GERD
http://www.webmd.com/digestive-disorders/digestive-diseases-peptic-ulcer-disease
http://www.webmd.com/digestive-disorders/digestive-diseases-gastritis
http://www.webmd.com/cancer/understanding-stomach-cancer-basics
http://www.webmd.com/cancer/stomach-gastric-cancer
http://digestive.niddk.nih.gov/ddiseases/a-z.aspx
2. Match the symptoms with the diseases above. Some symptoms can fit more than one disease.
a. A gnawing or
burning pain in the
middle or upper
stomach between
meals or at night
b. Hiccups
e. Black, tarry stools
f. Nausea or vomiting
i. Difficulty swallowing
(dysphagia)
j. Vomiting blood
c. Chest pain
g. Regurgitation of
food or sour liquid
k. Bloating in the
stomach after eating
d. Hoarseness or sore
throat
h. Recurrent upset
stomach
l. Weakness or/and
fatigue
28
WRITING
1.4.5 Answering patient’s email (W)
You are working for Patients’ Forum Europa. You get the following email from a patient. Reply the
email in which you




try to calm her down
tell him/her possible diseases she may have
the need for urgent medical help
tests needed to identify the problem (blood test, ultrasound, endoscopy)
Dear Dr. Patients’ Forum Europa,
I am feeling very ill. I have a pain on my right side, just under the ribs, I also have a gentle
burning sensation across my lower abdomen. There has been a slight change in my bowel
movements, either slightly constipated or else a little loose, some are mostly normal but have
darker greyish patches and some are very dark all over. My main problem is extreme
weakness, I can do very little some days without having to lie down. Some days I feel sick and
have difficulty eating. I have nause and sometimes vomiting. I am not sure, but last time it
looked like blood. I am terrified that I have cancer, but could it be a bleeding ulcer, just can't
understand this extreme weakness and it'sreally getting me down. I would really appreciate
any help or advice.
Many thanks
Julie
Dear Julie,
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Regards
Dr. Patients’ Forum Europe
http://www.patient.co.uk/forums/discuss/bleeding-ulcer-and-fatigue-103875
29
LISTENING
1.4.6. Endoscopy (L)
Listen to the recording and answer the questions below.
1)
2)
3)
4)
5)
What is an upper GI endoscopy?
What does this surgical procedure involve?
What does an endoscope consist of?
Why can this procedure be necessary?
How is the operation performed? Write down the steps.
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
Step 6:
Step 8:
Step 9:
Source: http://www.youtube.com/watch?v=pBCtwHNrGYM
SPEAKING
1.4.7 Explaining endoscopy to the patient (S)
With a partner, act out the roles below.
Student A: You are a doctor. Your
patient (Student B) has to
undergo endoscopy because
he/she
shows
signs
and
symptoms of stomach ulcer.
Explain him/her:



what is endoscopy
why there is need for
endoscopy
the procedure itself
Student B: You are a patient. You
need endoscopy. You are very
afraid of the procedure. You aks
your doctor about:



reasons
procedure
if sedation is applied (to
avoid pain, discomfort)
30
UNIT 2. DIGESTIVE SYSTEM II. (SMALL AND LARGE
INTESTINES, LIVER)
Aims of the Unit
In this unit you will learn about:



the small and the large intestines,
diseases of the small and large intestines and
the liver.
31
2.1 SMALL AND LARGE INTESTINES
READING
2.1.1 Small Intestine (R)
1. Read the text about the small intestine and complete the sentences below with the missing
information.
Chyme released from the
stomach
enters
the small
intestine, which is the primary
digestive organ in the body. Not
only is this where most
digestion occurs, it is also
where practically all absorption
occurs. The longest part of the
alimentary canal, the small
intestine is about 3.05 meters
long in a living person. Since
this makes it about five times
longer than the large intestine,
you might wonder why it is called “small.” In fact, its name derives from its relatively smaller
diameter of only about 2.54 cm, compared with 7.62 cm for the large intestine. In addition to its
length, the folds and projections of the lining of the small intestine work to give it an enormous
surface area, which is approximately 200 m2, more than 100 times the surface area of your skin.
The small intestine is subdivided into three regions. From proximal (at the stomach) to distal, these
are the duodenum, jejunum, and ileum. The shortest region is the 25.4-cm duodenum. It takes in
semi-digested food from your stomach through the pylorus, and continues the digestion process. The
duodenum also uses bile from your gallbladder, liver, and pancreas to help digest food.
The jejunum is about 0.9 meters long (in life) and runs from the duodenum to the ileum. Jejunum
means “empty” in Latin and supposedly was so named by the ancient Greeks who noticed it was
always empty at death. It carries food through rapidly, with wave-like muscle contractions, towards
the ileum.
Ileum is the last section is the longest part of your small intestine, measuring about 1.8 meters in
length. It is thicker, more vascular, and has more developed mucosal folds than the jejunum. The
ileum joins the cecum, the first portion of the large intestine, at the ileocecal sphincter (or
valve). The ileum is where most of the nutrients from your food are absorbed before emptying into
the large intestine.
The small intestine has three features which allow it to have such a huge absorptive surface area
packed into a relatively small space:
 Mucosal folds: The inner surface of the small intestine is not flat, but thrown into circular
folds. This not only increases the surface area, but helps regulate the flow of digested
food through your intestine.
32


Villi: The folds form numerous tiny projections which stick out into the open space inside
your small intestine (or lumen), and are covered with cells that help absorb nutrients
from the food that passes through.
Microvilli: The cells on the villi are packed full of tiny hairlike structures called microvilli.
This helps increase the surface of each individual cell, meaning that each cell can absorb
more
nutrients.
http://cnx.org/content/m46512/latest/
http://cnx.org/content/m46512/latest/
The small intestine is the organ in the body where 1.____________________ and
2.____________________ occur. The small intestine is about 3.____________________ long and 4.
____________________ wide. Its entire surface is approximately 5.____________________. The
small intestine is made up of three segments: 6.____________________, 7.____________________,
8.____________________.
The
shortest
region
is
the
duodenum.
It
takes
in
9.____________________ from your stomach through the 10.____________________, and
continues the digestion process. To help digest food it uses 11.____________________ from your
gallbladder, liver, and pancreas. The jejunum carries food through rapidly, with 12.
____________________, towards the ileum. The ileum is where 13.____________________ before
emptying into the large intestine. The features, which increase the absorptive surface area of the
small
intestine
include:
14.____________________,
15.____________________,
16.
____________________.
2. Talk about the small intestine with the help of the prompts below.





function
size
parts
function of the parts
the absorptive surface of the small intestine
33
READING
2.1.2 Large Intestine (R)
Read the text about the large intestine and label the diagram.
The large intestine is the terminal part of the alimentary canal. The primary function of this organ is
to finish absorption of nutrients and water, synthesize certain vitamins, form feces, and eliminate
feces from the body. The large intestine runs from the appendix to the anus. It frames the small
intestine on three sides. The large intestine is subdivided into four main regions: the cecum, the
colon, the rectum, and the anus. The ileocecal valve, located at the opening between the ileum and
the large intestine, controls the flow of chyme from the small intestine to the large intestine.
The cecum is a pouch-like dead-end passage that branches inferiorly from the end of the ileum. Fecal
matter entering the large intestine from the ileum passes into the cecum before being pushed
superiorly into the ascending colon. The appendix is attached to the inferior end of the cecum and is
believed to store beneficial bacteria that help break down undigested food.
Fecal matter passes from the cecum into the colon, the largest region of the large intestine. The
ascending colon carries feces superiorly from the cecum to the transverse colon. The transverse
colon then carries feces transversely from the right side of the abdomen to the left side, where it
enters the descending colon. Next, the descending colon carries the feces inferiorly to the S-shaped
sigmoid colon and rectum.
The rectum stores feces until they are ready to be defecated.
During defecation, the anal sphincter muscles of the anal canal relax to allow feces to exit the body.
http://cnx.org/content/m46512/latest/
34
LISTENING
2.1.3 Appendix and appendicitis (L)
1. Discuss the following questions.


What is the function of the appendix?
What kind of disease is appendicitis?
2. Some researchers say, they have found the true function of the appendix. Watch the video and find
it out.
https://www.youtube.com/watch?v=a2BtkMSijUc
3. Listen to the recording about appendicitis and answer the questions below.
1) When can appendicitis happen?
2) What are the symptoms of appendicitis?
3) What is the cause of appendicitis?
4) How many types of surgery are there for
appendicitis?
5) What can happen when the inflamed appendix is
not removed?
6) What is the infection in the lining of the
abdomen called?
https://www.youtube.com/watch?v=xmBtu7S4fgI
35
WRITING
2.1.4 Asking questions about the large intestine (W)
Write questions to the answers.
1. ______________________________________________________________________________
The primary function of the large intestine is to finish absorption of nutrients and water, synthesize
certain vitamins, form feces, and eliminate feces from the body.
2. ______________________________________________________________________________
The cecum, the colon, the rectum, and the anus.
3. ______________________________________________________________________________
The flow of chyme from the small intestine to the large intestine.
4. ______________________________________________________________________________
It stores beneficial bacteria that help break down undigested food.
5. ______________________________________________________________________________
Ascending colon, transverse colon, descending colon, sigmoid colon and rectum.
6. ______________________________________________________________________________
It stores feces.
7. ______________________________________________________________________________
The anal sphincter muscles of the anal canal relax to allow feces to exit the body.
http://cnx.org/content/m46512/latest/
36
VOCABULARY DEVELOPMENT
2.1.5 Important vocabulary of the small and large intestines (V)
1. Label the following diagram.
http://www.enchantedlearning.com/subjects/anatomy/digestive/
2. Match the words (a-l) with the explanations (1-12).
a
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)
l)
b
c
d
e
f
g
h
i
j
k
l
bacterial flora
appendix
ascending colon
cecum
colon
circular fold
duodenum
gastrocolic reflex
ileum
jejunum
microvillus
villus
37
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
small projection of the plasma membrane of the absorptive cells of the small intestinal mucosa
coiled tube attached to the cecum
end of the small intestine between the jejunum and the large intestine
middle part of the small intestine between the duodenum and the ileum
projection of the mucosa of the small intestine
pouch forming the beginning of the large intestine
deep fold in the mucosa and submucosa of the small intestine
first part of the small intestine, which starts at the pyloric sphincter and ends at the jejunum
first region of the colon
part of the large intestine between the cecum and the rectum
bacteria in the large intestine
propulsive movement in the colon activated by the presence of food in the stomach
http://www.enchantedlearning.com/subjects/anatomy/digestive/
2.2 DISEASES OF THE SMALL AND LARGE INTESTINES
VOCABULARY DEVELOPMENT
2.2.1 Collecting ideas to food poisoning (V)
Collect words and expressions to the term ‘food poisoning’ then compare your ideas in groups of 3.
Food Poisoning
SPEAKING
2.2.2 FAQs about food poisoning (S)
Work in pairs. Discuss the following questions.
1)
2)
3)
4)
5)
6)
7)
What is food poisoning?
When do the signs and symptoms appear?
What are the most common symptoms of food poisoning?
What foods are more susceptible to contamination?
How can food become contaminated?
How is mild food poisoning treated? Do you know any home remedies?
When do you need to visit your GP?
38
READING
2.2.3 Food poisoning facts (R)
Read the text about food poisoning and check your answers above.
Food poisoning is an illness caused by eating contaminated food. Most people get better without the
need for treatment.
In most cases, food that causes food poisoning is contaminated by bacteria, such as salmonella or
Escherichia coli (E. coli), or a virus, such as the norovirus. The symptoms of food poisoning usually
begin 1-3 days after eating contaminated food. They include:
 feeling sick
 vomiting
 diarrhoea
 stomach cramps
Some toxins can cause food poisoning within a much shorter time. In these cases, vomiting is the
main symptom.
Foods particularly susceptible to contamination if not handled, stored or cooked properly include:
 raw meat and poultry
 raw eggs
 raw shellfish
 unpasteurised milk
 'ready to eat' foods, such as cooked sliced meats, soft cheeses and pre-packed
sandwiches
How is food contaminated?
Food can become contaminated at any stage during production, processing or cooking. For example,
food poisoning can be caused by:
 not cooking food thoroughly not storing food that needs to be chilled at below 5°C
correctly
 leaving cooked food for too long at warm temperatures
 someone who is ill or who has dirty hands touching the food
 eating food that has passed its ‘use by’ date
 cross-contamination (the spread of bacteria, such as E. coli, from contaminated
foods)
Treating food poisoning
Most people with food poisoning get better without the need for treatment. To help relieve
your symptoms you should rest and drink plenty of fluids. It is best to avoid food until you feel much
better. When you start eating again, choose foods that are easily digested, such as toast. It's
important that you do not become dehydrated because it will make you feel worse and lengthen
your recovery. Try to drink as much water as you can, even if you can only sip it, particularly every
time you pass diarrhoea. Oral rehydration salts (ORSs) are recommended for people vulnerable to
the effects of dehydration, such as the elderly and those with another health condition. Visit your GP
or accident and emergency (A&E) department if you are severely dehydrated – for example, if you
have sunken eyes and you are unable to urinate. Antibiotics may be prescribed if test results show
39
the source of your food poisoning was bacterial, and your symptoms are severe or last longer than 3–
4 days.
http://www.nhs.uk/Conditions/Food-poisoning/Pages/Introduction.aspx
SPEAKING
2.2.4 Doctor-patient conversation (S)
With a partner, act out the roles below.
Student A: You are a patient. You
have severe food poisoning. Talk
about:



Student B: You are a doctor. After
asking about the symptoms talk to
Student B about:
the symptoms
onset of the symptoms
what you ate, suspect food





explain briefly what food
poisoning is
possible causes
treatment
recommendations to avoid
further poisoning
treatment suggestions
LISTENING
2.2.5 Diarrhoea (L)
Listen and complete the text with the missing words.
Source: https://www.youtube.com/watch?v=4XS0SbCGJCk
Hello, I'm Dr Rupal Shah. I'm a GP at the Bridge Lane Group Practice in Battersea in London. A
practical way to define diarrhoea is 1. ________________ ________________ which are looser or
more frequent than is usual for you. If the diarrhoea's caused by an infection, you might find that you
also have a fever or nasty stomach 2. ________________. Diarrhoea can cause a problem if it's very
frequent and it results in you becoming dehydrated, so it's always important to make sure you are
maintaining an adequate 3. _______________ _______________ whilst you're suffering from the
symptoms. There's many causes of diarrhoea and it's difficult to list all of them. There's different
causes according to how old you are, for example. A lot of diarrhoea is caused by an infection which
you can pick up from food or from contact with somebody else who's 4.________________ If you're
quite unwell with the diarrhoea, for example if there's blood in the diarrhoea or if you have a high
40
fever or are generally unwell, then it's worth 5. _______________ a second opinion. Although there
are many different causes of diarrhoea in children, the most common cause is certainly infections.
It's important to remember that treatments which can be used safely in adults, like Imodium,
shouldn't be given to children. For adults and children, if the diarrhoea's 6. _______________ for
more than a few days or seems particularly severe, then it's worth going to see your GP. Your GP
might want to do further tests, they might want to send a sample of stool off to the lab, they might
want to 7. ______________ for you to have some blood tests. It depends on your particular
circumstances. Most cases of diarrhoea are 8. _______________. They last for a few days and then
get better. It's embarrassing and unpleasant whilst it lasts, but rarely serious.
http://www.nhs.uk/Conditions/Diarrhoea/Pages/Introduction.aspx
READING
2.2.6 Other common gastrointestinal diseases (R)
Match the common gastrointestinal diseases (1-4) with the descriptions (A-D).
1)
2)
3)
4)
Crohn’s disease
Ulcerative Colitis
Celiac disease
IBD
A. ________________________________________
It is a functional gastrointestinal disorder, meaning symptoms are caused by changes in how
the GI tract works. People with a functional GI disorder have frequent symptoms; however,
the GI tract does not become damaged. It is a group of symptoms that occur together, not a
disease. The most common symptoms are abdominal pain or discomfort, often reported as
cramping, along with changes in bowel habits.
B. ________________________________________
It is a disease that causes inflammation, or swelling, and irritation of any part of the
digestive tract. The part most commonly affected is the end part of the small intestine,
called the ileum. In this disease, inflammation extends deep into the lining of the affected
part of the GI tract. Swelling can cause pain and can make the intestine empty frequently,
resulting in diarrhea. Chronic - or long-lasting inflammation may produce scar tissue that
builds up inside the intestine to create a stricture. The cause of Crohn’s disease is unknown,
but researchers believe it is the result of an abnormal reaction by the body’s immune
system. Researchers believe that in this disease the immune system attacks bacteria, foods,
and other substances that are actually harmless or beneficial.
C. ________________________________________
It is a chronic, or long-lasting, disease that causes inflammation and sores, called ulcers, in
the inner lining of the large intestine, which includes the colon and the rectum—the end part
of the colon. Normally, the large intestine absorbs water from stool and changes it from a
liquid to a solid, but the inflammation causes loss of the lining of the colon, leading to
41
bleeding, production of pus, diarrhea, and abdominal discomfort. The cause of it is unknown
though theories exist. According to these people have abnormalities of the immune system,
but whether these problems are a cause or a result of the disease is still unclear.
D. ________________________________________
It is a digestive disease that damages the small intestine and interferes with absorption of
nutrients from food. People cannot tolerate gluten, a protein in wheat, rye, and barley. When
foods or products are eaten that contain gluten, the immune system responds by damaging
or destroying villi. Without healthy villi, a person becomes malnourished, no matter how
much food one eats. Symptoms may occur in the digestive system or in other parts of the
body. Common digestive symptoms include: abdominal bloating and pain, chronic diarrhea,
vomiting, constipation, weight loss.
http://digestive.niddk.nih.gov/
SPEAKING
2.2.7 Doctor-patient conversations (S)
With a partner, act out the roles below.
Student A: You are a doctor. Ask
Student B about:



onset of the symptoms
the symptoms
food eaten
Talk to Student B about:


possible causes
refer him/her to blood
test, colonoscopy
Student B: You are a patient. You
turn to your GP for advice. You
have suffered from abdominal
discomfort and gastric symptoms
for several weeks. You get
diarrhoea, constipation, mucousy
stools. Your stomach makes
constant noises and gurgling, and
you have occasional vomiting.
Answer the doctor’s questions.
42
WRITING
2.2.8 Most common gastrointestinal diseases: an essay (W)
Write an essay (250-300 words) about the most common gastrointestinal diseases, possible causes,
symptoms, treatments, prevention.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2.3 THE LIVER
SPEAKING
2.3.1 FAQs about the liver (S)
With a partner discuss the questions below.
1)
2)
3)
4)
What are the major functions of the liver?
What causes liver damage?
Do you know any diseases of the liver?
Do you know any food that cleans the liver?
43
VOCABULARY DEVELOPMENT
2.3.2 Anatomy of the liver (V)
1. Label the diagram with the help of the words in the box.
right and left hepatic gall bladder
duct
liver right lobe
pancreatic duct
stomach
esophagus
duodenum
common hepatic duct
falciform ligament
liver lobe
liver left lobe
cystic duct
pancreas
http://en.wikipedia.org/wiki/Liver
2. Find out the functions of the liver. Complete the expressions with the verbs from the box.
produce (2x)
store
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
maintain
fight
make
metabolize
excrete
aid
break down
_______________ digestion
_______________ vital nutrients
_______________ waste materials
_______________ the breakdown products of digestion
_______________ iron
_______________ the hormonal balance
_______________ infections
_______________ cholesterol and other fats
_______________ the stored glycogen into glucose
_______________ bile
44
LISTENING
2.3.3 Functions of the liver (L)
Read the text about the liver and complete it with the missing words. The first letter is given in each
word. Then listen and check your answers.
Source: http://www.youtube.com/watch?v=O71niTozP-o
Liver is the most used internal part of the human body. One can understand how the liver functions
and aids the digestion of food in humans, apart from it producing vital nutrients and helping any
1. e _______________ (9letters) of waste material from the body. The liver is the largest organ in the
human body. The liver alone weighs about one and a half to three kilograms in the body. The liver
occupies much of the upper right quadrant of the 2. a_______________(6letters) to the right of the
stomach and immediately below the 3. d_______________(9letters). The liver is divided into two
unequal lobes: a large right lobe and a smaller left lobe. Liver plays a number of vital roles such as
metabolizing the breakdown products of digestion and detoxifying substances that are 4.
h_______________(7letters) to the body. The liver also provides essential energy-producing
substances and supplies vital 5. v_______________(8letters) including iron, vitamin B12 and copper.
Liver controls the production and excretion of cholesterol and metabolizes alcohol into mild toxin. It
also performs many important functions including storing iron, maintaining the hormonal balance,
producing immune factors to fight infections, regulating 6. b_______________(5letters) clotting and
producing bile. The hepatic portal veins, triplet vessels that carry blood from the gastro-intestinal
tract and spleen to the liver pick-up nutrients, send toxins from the stomach and intestines for
processing. The hepatic ducts in gallbladders send the processed bile to the 7.
d_______________(8letters), which is about 25 cm long and meaty. The stomach opens up to the
deudenum through the pyloric sphincter, a muscle the acts as a valve that controls the passage of
food from the stomach into the small intestine. The abdominal aorta and hepatic veins supply and
return blood in the liver. One of the most important functions of the liver is to produce 8.
b_______________(4letters). This digestive juice dissolves fat into watery contents much like
detergents dissolves grease. This juice is stored in the gall bladder until it is needed, then it is
sweezed out of the gall bladder through the bile ducts and into the intestines to mix with the fat in
the blood through the bile ducts. When food, medicines, etc. are 9. c_______________(8letters) are
digested, the cells within the liver that contain a number of powerful enzymes break them down into
many toxins. Ammonia, a toxin product arising from the digestion of the proteins, is converted into
the less toxic urea by liver. During exercise, the liver quickly breaks down the stored glycogen into
glucose, which is released into the blood stream to be used by muscles as a source of 10.
e_______________(6letters). Another function of the liver is to make cholesterol and other fats that
are needed by the body. Maintaining a healthy digestive system is essential for the health of the liver
and other organs so that they can continue to perform their daily tasks.
45
WRITING
2.3.4 An interview about the diseases of the liver (W)
Read the following interview with one of the leading experts of liver diseases. Play the role of the
reporter and find out the questions for the answers.
Rep.: Good Morning. Our guest is today Dr. George Smith, leading U.S. expert of liver diseases. Thank
you very much for accepting our invitation.
Dr. G.S.: Good Morning. I am glad to be here today to talk about this very serious topic which affets
millions of U.S. citizens.
Rep.: My first question is a general one. 1. _____________________________________________
Dr. G.S.: Liver disease is any abnormal process that affects the liver. The more severe the liver
disease, the greater the effect on liver function. It is true that with the loss of 75% of the liver's
function the liver cannot keep up with its required functions and it begins to fail.
Rep: 2. _____________________________________________
Dr. G.S.: Alcohol abuse is the most common cause of liver disease in North America. Alcohol is
directly toxic to liver cells and can cause inflammation, referred to as alcoholic hepatitis and cirrhosis
due to extreme scarring of the liver.
Rep: 3. _____________________________________________
Dr. G.S.: Jaundice is a sign of liver, gallbladder, or certain blood disorders. Bilirubin, which is normally
removed from the blood by the liver and excreted in bile and stool, increases in the blood. The skin
and the eyes become yellow due to the buildup of bilirubin. The urine becomes dark from the
excretion of bilirubin, and the stool becomes clay-colored due to the absence of bilirubin.
Rep: 4. _____________________________________________
Dr. G.S.: Acetaminophen in excess can cause liver failure that often is permanent and results in
death. Numerous antibiotics and statins may cause liver inflammation and failure. Excessive amounts
of vitamin A can cause hepatitis, cirrhosis, and liver failure. Additionally, many mushrooms are
poisonous to the liver, and eating unidentified mushrooms gathered in the woods can be lethal due
to liver failure.
Rep: 5. _____________________________________________
Dr. G.S.: Yes, hepatitis is a form of liver disease. The term hepatitis means "inflammation of the
liver," and liver cells can become inflamed for many reasons, including alcohol, drugs, toxins, and
infections.
Rep: 6. _____________________________________________
Dr. G.S.: Cirrhosis is a late-stage of liver disease. Diseases that lead to cirrhosis injure and kill liver
cells. Inflammation and repair associated with the dying liver cells causes scar tissue to form.
Progressive scarring leads to cirrhosis. Liver failure and liver cancer are complications of cirrhosis.
Rep: 7. _____________________________________________
Dr. G.S.: Liver biopsy, in which a sample of liver tissue is removed and analyzed under the
microscope, is the only test that can confirm a diagnosis of cirrhosis.
Rep: 8. _____________________________________________
Dr. G.S.: Hepatitis C is the most common cause of chronic viral hepatitis in the U.S. It is passed from
person to person sexually, particularly through male homosexual activities and by use of illicit,
injectable drugs. It also may be passed from mother to infant at the time of birth. Hepatitis B is the
46
second most common cause of chronic hepatitis in the U.S. Hepatitis D is a chronic viral infection of
the liver but occurs only in a small proportion of individuals with chronic hepatitis B. Hepatitis A and
E cause primarily acute hepatitis and not chronic hepatitis.
Rep: 9. _____________________________________________
Dr. G.S.: The liver is a critical organ for many bodily functions. Interference with liver function results
in excessive bleeding, jaundice, sensitivity to the effects of drugs, and toxic effects on the brain.
Interference with the production of blood proteins and the elimination of water and salt result in the
accumulation of fluid in the tissues of the body, referred to as edema.
Rep: 10. _____________________________________________
Dr. G.S.: The liver itself does not sense pain. Because of this, the liver can be cut, burned, or
compressed without causing the sensation of pain. Inside the tissue that encapsulates the liver, there
are pain fibers which are stimulated when the liver is stretched. This means that anything the causes
the liver to stretch can cause liver pain.
Rep: Dr Smith, thank you very much for your detailed explanations.
Dr. G.S.: You are welcome. Thank you for the invitation.
http://www.medicinenet.com/liver_disease_quiz/quiz.htm
READING
2.3.5 Facts about the liver (R)
Decide if the statements are true or false.
1. The liver is the second largest organ in the human body.
True__ False__
2. Bile is a liquid made in the liver that helps break down
fats and other nutrients. True__ False__
3. Just like the heart and kidneys, under no circumstances
can the liver ever regenerate itself. True__ False__
4. The liver makes protein and it also stores glucose,
vitamin B12 and iron. True__ False__
5. The liver is located under the ribs on the left side.
True__ False__
6. Even though it does its best, the liver is unable to save
up energy. True__ False __
7. Shaped like a football that is flat on one side, the adult liver weighs about three pounds. True__
False__
8. Although it is capable of doing a lot of things, the liver plays no role in stopping someone from
bleeding. True__ False__
9. Alcohol can damage or destroy liver cells, but a person who has liver disease can still practice
moderation by drinking a glass or two of alcohol every day. True__ False__
10. If someone is overweight or obese, it doesn’t affect the health of that person’s liver. True__
False__
11. The health of a person’s liver is determined by conducting various blood tests. True__ False__
12. It may be difficult to believe, but the liver helps to build muscle. True__ False__
47
13. In a polluted environment, the liver isn’t able to protect a person’s body. True__ False __
14. Primary liver cancer (cancer that starts in the liver) is one of the few cancers on the rise in the
United States. True__ False __
15. Basic over-the-counter medicines can’t affect the liver. True__ False _
http://www.liverfoundation.org/education/liverlowdown/ll0913/tfliverinfo/
http://ubcclf.com/liveright-blog-series-challenge-your-misconceptions
SPEAKING
2.3.6 Talking about the liver (S)
In pairs talk about the liver with the help of the prompts. Take turns.






place
weight
lobes
functions
dieseases
of
the
symptoms/treatment)
prevention of liver diseases
liver
(causes,
48
2.5 VOCABULARY
absorption
appendix
alimentary bolus
alimentary tract
antrum
ascending colon
bicuspid
bilirubin
bloating
body
bolus
bounded by
buccal
canine
cardia
cecum
cementum
chief cell
circular fold
circular muscle
cirrhosis
cleft lip
coiled
colon
conduit
conical
cuspid
cystic duct
defecate
dentin
descending colon
detoxicate
duct
duodenum
dysphagia
edema
enamel
enteroendocrine cell
esophagus
excrete
expectoration
falciform ligament
fatigue
flatus
fold
frenulum
felszívódás
féregnyúlvány
táplálkozási bolus
tápcsatorna
antrum, tágulat, kamra
felszálló vastagbél
kétcsücskű
bilirubin
puffadás
gyomortest
megrágott étel
hátáros valamivel
szájüreg, száji
szemfog
gyomorszáj
vakbél
fogcement
fősejt (pepszintermelő sejt)
cirkuláris redők
cirkuláris simaizom
májzsugorodás
nyúlszáj
összecsavart, összetekercselt
vastagbél
csatorna, cső
kúp alakú, kónikus
szemfog
epehólyag kivezető csöve
ürít
dentin
leszálló vastagbél
méregtelenít
vezeték, kivezető cső
nyombél/patkóbél
nyelési zavar
ödéma
zománc
enteroendokrin sejt
nyelőcső
kiválaszt
köpet, köpés
sarló alakú szalag
fáradtság
orv. szél
gyűrődés, ránc
szalagocska
49
fundus
gastrin
gastrinoma
gingiva
glandular
gums
hard palate
hepatichiatal hernia
hoarseness
ileocecal valve
ileum
illicit
incisor
inner oblique muscle
interference
jaundice
jawbone
jejunum
junction
lesion
lining
lipase
lobe
longitudional muscle
mastication
mesentery
molar
mucosa
mucus
noma
oral vestibule
oropharynx
palate
pancreatic duct
papilla
parietal cell
periodontal
periodontal (gum) disease
portal vein
pouch
pout
premolar
propulsion
pulp
pus
pylorus
rear
fundus
gasztrin
gasztrinóma
fogíny
mirigyes, mirigyszerű
íny
kemény szájpadlás
máj
rekeszizomsérv
rekedtség
ileocoecalis billentyű
csípőbél
tiltott
metszőfog
belső ferde hasizom
beavatkozás, zavaró hatás
sárgaság
állkapocs-csont
éhbél
érintkezés, elágazás
sérülés, károsodás
barázda
lipáz
lebeny
hosszanti izom
rágás
bélfodor
örlőfog, zápfog, záp-, örlőnyálkahártya
nyálka
noma
szájüreg előcsarnoka
száj-garat
szájpadlás
hasnyálmirigy kivezető csöve
papilla
parietális sejt
periodontális
fogágybetegség
májkapu-véna, kapuvéna
erszény, zacskó
ajkat biggyeszt
előzápfog, kisőrlőfog
előre mozgatás, hajtás
pulpa, lágy szövet
genny
gyomorzár
hátsó rész
50
regurgitation
respiratory conduit
rugae
salivation
sigmoid colon
soft palate
sore
specimen
sphincter
statin
stricture
submandibular gland
tonsil
transverse colon
trigone
urea
uvula
vascular membrane
vaulted
verstibule
zymogen
felöklendezés
légúti csatorna
nyálkahártyaredők
nyálképződés
szigmabél
lágy íny
fekélyes seb
minta
záróizom
sztatin
szűkület
submandibularis mirigy
mandula
haránt vastagbél
trigonum
karbamid
uvula, nyelvcsap
érrendszeri membrán
íves, boltíves
vestibulum, bejárat
zimogén
51
UNIT 3. NERVOUS SYSTEM
Aims of the Unit
In this unit you will learn about:





the central nervous system,
cranial and spinal nerves,
common diseases of the central nervous system such as Alzheimer’s disease,
peripheral nervous system and
mental illnesses.
52
3.1 THE CENTRAL NERVOUS SYSTEM
READING
3.1.1 Brain Quiz (R)
How much do you know about the human brain? Do the quiz. Write T (True) or F (False).
1) The average human brain is made up of water up to 80%. __________
2) After age 30, the brain shrinks exactly 25% in mass each year. __________
3) The brain feels pain compared to the rest of the body. __________
4) The energy used by the brain is enough to light a 25 watt light bulb. __________
5) Your skull is made up of 28 bones. __________
6) When you laugh eight differenct areas in our brain are in action. __________
7) The differences in brain weight and size change mental abiltiy. __________
8) The human brain is so soft that a table knife would be more than enough to slice
through it. __________
9) Every time you recall a memory or have a new thought a new connection is made.
__________
10) The brain is the fattiest part of the body with a fat content of around 60%.
__________
+1. The brain can stay alive 1-3 minutes without any oxygen. __________
http://www.proprofs.com/quiz-school/story.php?title=true-false-brain-quiz#READING
VOCABULARY DEVELOPMENT
3.1.2 Brain Anatomy (R)
Complete the text with the missing words from the box.
sulcus
secretion
internal clock
spinal cord
bundle
cranial nerves
skull
nuclei
white matter
hemispheres
53
The nervous system is divided into central and peripheral
systems. The central nervous system (CNS) is composed of
the brain and 1. _______________. These structures are
protected by bone and cushioned from injury by the
cerebrospinal fluid (CSF). The peripheral nervous system
connects the central nervous system to the rest of the body.
The brain is a mass of soft nerve tissue, which is encapsulated
within the 2. _______________. It is composed of the cerebrum, cerebellum, and brainstem.
The cerebrum is the largest part of the brain and is composed of right and left 3. _______________.
It performs higher functions like interpreting touch, vision and hearing, as well as speech, reasoning,
emotions, learning, and fine control of movement. The peripheral or outer part of the cerebrum is
separated into lobes. Frontal, Parietal, Temporal, Occipital. The cerebellum is located under the
cerebrum. Its function is to coordinate muscle movements, maintain posture, and balance.
The brainstem includes the midbrain, pons, and medulla. It acts as a relay center connecting the
cerebrum and cerebellum to the spinal cord. It performs many automatic functions such as
breathing, heart rate, body temperature, wake and sleep cycles, digestion, sneezing, coughing,
vomiting, and swallowing. Ten of the twelve 4. _______________ originate in the brainstem. The
surface of the cerebrum has a folded appearance called the cortex. The cortex contains about 70% of
the 100 billion nerve cells. The nerve cell bodies color the cortex grey-brown giving it its name – gray
matter. Beneath the cortex are long connecting fibers between neurons, called axons, which make
up the 5. _______________.
Each fold is called a gyrus, and each groove between folds is called a 6. _______________. The right
and left hemispheres of the brain are joined by a 7. ______________ of fibers called the corpus
callosum that delivers messages from one side to the other. Each hemisphere controls the opposite
side of the body. Not all functions of the hemispheres are shared. In general, the left hemisphere
controls speech, comprehension, arithmetic, and writing. The right hemisphere controls creativity,
spatial ability, artistic, and musical skills.
The deep structures of the brain are the following:
Hypothalamus - is located in the floor of the third ventricle
and is the master control of the autonomic system. It plays a
role in controlling behaviors such as hunger, thirst, sleep,
and sexual response. It also regulates body temperature,
blood pressure, emotions, and 8. _______________ of
hormones. Pituitary gland - known as the “master gland,” it
controls other endocrine glands in the body. It secretes
hormones that control sexual development, promote bone
and muscle growth, respond to stress, and fight disease.
Pineal gland - is located behind the third ventricle. It helps
regulate the body’s 9. ________________ and circadian rhythms by secreting melatonin. It has some
role in sexual development. Thalamus - serves as a relay station for almost all information that
comes and goes to the cortex. It plays a role in pain sensation, attention, alertness and memory.
Basal ganglia - includes the caudate, putamen and globus pallidus. These 10. ________________
work with the cerebellum to coordinate fine motions, such as fingertip movements. Limbic system is the center of our emotions, learning, and memory. Included in this system are the cingulate gyri,
hypothalamus, amygdala (emotional reactions) and hippocampus (memory).
54
http://www.mayfieldclinic.com/PE-AnatBrain.htm#.U8o7fPl_sgV
http://sehati.org/index/patientresources/normalanatomy.html
VOCABULARY DEVELOPMENT
3.1.3 Important vocabulary of the CNS (V)
1. Translate the highlighted words into Hungarian.
central nervous system
peripheral nervous system
cerebrum
cerebellum
brain stem
cortex
gray matter
neuron
axons
gyrus
corpus callosum
hypothalamus
ventricle
pituitary gland
pineal gland
thalamus
basal ganglia
caudate
putamen
globus pallidus
limbic system
cingulate gyri
hypothalamus
amygdala
hippocampus
55
SPEAKING
3.1.4 Basic structures of the brain (S)
Label the basic structures of the brain then talk about them.
cerebellum, brainstem, cerebrum
http://lrrpublic.cli.det.nsw.edu.au/lrrSecure/Sites/LRRView/7700/documents/5657/5657/applets/001_04_1sa
_ap01.htm
READING
3.1.5 Brain Anatomy Diagram (R)
Read the definitions below then label the brain anatomy diagram.
56
Cerebellum - the part of the brain below the
back of the cerebrum. It regulates balance,
posture, movement, and muscle coordination.
Corpus Callosum - a large bundle of nerve
fibers that connect the left and right cerebral
hemispheres. In the lateral section, it looks a
bit like a "C" on its side.
Frontal Lobe of the Cerebrum - the top, front
regions of each of the cerebral hemispheres.
They are used for reasoning, emotions,
judgment, and voluntary movement.
Medulla Oblongata - the lowest section of the
brainstem (at the top end of the spinal cord); it
controls automatic functions including
heartbeat, breathing, etc.
Occipital Lobe of the Cerebrum - the region at
the back of each cerebral hemisphere that
contains the centers of vision and reading
ability (located at the back of the head).
Parietal Lobe of the Cerebrum - the middle lobe of
each cerebral hemisphere between the frontal and
occipital lobes; it contains important sensory
centers (located at the upper rear of the head).
Pituitary Gland - a gland attached to the base of the
brain (located between the Pons and the Corpus
Callosum) that secretes hormones.
Pons - the part of the brainstem that joins the
hemispheres of the cerebellum and connects the
cerebrum with the cerebellum. It is located just
above the Medulla Oblongata.
Spinal Cord - a thick bundle of nerve fibers that runs
from the base of the brain to the hip area, running
through the spine (vertebrae).
Temporal Lobe of the Cerebrum - the region at the
lower side of each cerebral hemisphere; contains
centers of hearing and memory (located at the sides
of the head).
http://www.enchantedlearning.com/subjects/anatomy/brain/label/lateralbrain/label.shtml
WRITING
3.1.6 Lobes of the brain (W)
1. Which lobe of the brain does the man in the pictures point at? Write the names below the pictures.
1. __________________
2. __________________
3. __________________
4. __________________
https://faculty.washington.edu/chudler/lobe.html
57
2. The functions of the lobes are listed here. Write the name of the correct lobe after each function.
1) Understanding language (Wernicke’s area)
__________
2) Speech: speaking and writing (Broca’s area)
__________
3) Interprets vision (color, light, movement)
__________
4) Personality, behavior, emotions __________
5) Spatial and visual perception __________
6) Sequencing and organization __________
7) Intelligence, concentration, self-awareness __________
8) Interprets language, words __________
9) Body movement (motor strip) __________
10) Sense of touch, pain, temperature (sensory strip) __________
11) Interprets signals from vision, hearing, motor, sensory and memory __________
12) Judgment, planning, problem solving __________
http://lrrpublic.cli.det.nsw.edu.au/lrrSecure/Sites/LRRView/7700/documents/5657/5657/applets/001_04_01_1tl_ap01_text.htm
http://www.chakras.org.uk/chakra_yoga_health_mind_brain_lobes.htm
3.2 CRANIAL NERVES
LISTENING
3.2.1 Cranial Nerve Song (L)
Listen to the recording. Try to remember the correct
pronounciation of the cranial nerves then in pairs
practise saying them.
https://www.youtube.com/watch?v=0lbwshg_Kj4
58
READING
3.2.2 List of the cranial nerves (R)
Study the list of the cranial nerves then cover the table and do the test below.
The brain communicates with the body through the spinal cord and twelve pairs of cranial nerves.
Ten of the twelve pairs of cranial nerves that control hearing, eye movement, facial sensations, taste,
swallowing and movement of the face, neck, shoulder and tongue muscles originate in the
brainstem. The cranial nerves for smell and vision originate in the cerebrum.
Name
I Olfactory
II. Optic
III - Oculomotor
IV - Trochlear
V - Trigeminal
VI - Abducens
VII - Facial
VIII - Vestibulocochlear
(Auditory)
IX - Glossopharyngeal
X - Vagus
XI - Accessory
XII - Hypoglossal
Distribution
Smell
Vision
Eyelid & eyeball movement
Innervates superior oblique
turns eye downward &
laterally.
Chewing, face & mouth touch
& pain
Turns eye laterally
Controls most facial expression,
Secretion of tears & saliva
Taste
Hearing, Equilibrium sensation
Taste, Pharynx contraction
Heart, lung and Viscera
Contracts the neck and
shoulder muscles
Controls tongue movements
http://www.mayfieldclinic.com/PE-AnatBrain.htm#.U8o7fPl_sgV
59
1. Which cranial nerve controls the following?
1)
2)
3)
4)
Turns eye laterally _________________________
Vision _________________________
Heart, lung and viscera _________________________
Controls most facial expressions, secretion of tears, saliva, taste _________________________
2. Find the pairs.
1) I - Olfactory
2) XI - Accessory
3) VIII - Vestibulocochlear
4) IX – Glossopharyngeal
a)
b)
c)
d)
Contracts the neck and shoulder muscles
Smell
Taste, pharynx contraction
Hearing, Equilibrium sensation
3. Choose the correct answer.
1. Innervates superior oblique turns eye downward & laterally.
a)
b)
c)
d)
II – Optic
VII – Facial
IV – Trochlear
V – Trigeminal
2. Controls tongue movements
a)
b)
c)
d)
XII – Hypoglossal
II – Optic
X – Vagus
VII – Facial
3. Eyelid & eyeball movement
a)
b)
c)
d)
III – Oculomotor
II – Optic
XI – Accessory
I – Olfactory
4. Chewing, face & mouth touch & pain
a)
b)
c)
d)
VI – Abducens
V – Trigeminal
IV – Trochlear
VII - Facial
60
4. True or False?
1. VII - Facial → Vision
True
False
2. IX - Glossopharyngeal → Taste, Pharynx contraction
True
False
3. V - Trigeminal → Chewing, Face & mouth touch & pain
True
False
4. I Olfactory → Contracts the neck and shoulder muscles
True
False
www.quizlet.com
VOCABULARY DEVELOPMENT
3.2.3 Scatter (V)
Match the corresponding items.
www.quizlet.com
61
3.3 SPINAL NERVES
SPEAKING
3.3.1 Revision (S)
With a partner discuss the following questions.
1)
2)
3)
4)
5)
Name the five sections of the spine!
How many vertebrae are in each of the sections?
What are the functions of each section of the spine?
What are the two functions of the intervertebral discs?
Name the two types of bony process which protrude from each vertebra!
READING
3.3.2 Spinal nerves (R)
Complete the text with the missing prepositions from the box.
on
through
Thirty-one
pairs
according to
off
of
spinal
nerves
alongside
down
branch
back
across
near
from
1.
__________the spinal cord. The spinal nerves act as
“telephone lines,” carrying messages 2. __________
and forth between your body and spinal cord to
control sensation and movement. Each spinal nerve
has two roots. The ventral (front) root carries motor
impulses 3. __________ the brain and the dorsal
(back) root carries sensory impulses to the brain. The
ventral and dorsal roots fuse together to form a spinal
nerve, which travels 4. __________ the spinal canal, 5. __________ the cord, until it reaches its exit
hole - the intervertebral foramen. Once the nerve passes 6. __________ the intervertebral foramen,
it branches; each branch has both motor and sensory fibers. The smaller branch (called the posterior
primary ramus) turns posteriorly to supply the skin and muscles of the back of the body. The larger
branch (called the anterior primary ramus) turns anteriorly to supply the skin and muscles of the
front of the body and forms most of the major nerves.
62
The spinal nerves are numbered 7. ___________ the vertebrae above which it exits the spinal canal.
The 8 cervical spinal nerves are C1 through C8, the 12 thoracic
spinal nerves are T1 through T12, the 5 lumbar spinal nerves are
L1 through L5, and the 5 sacral spinal nerves are S1 through S5.
There is 1 coccygeal nerve. The spinal nerves innervate specific
areas and form a striped pattern 8. ___________ the body
called dermatomes. Doctors use this pattern to diagnose the
location of a spinal problem based 9. _________ the area of
pain or muscle weakness. For example leg pain (sciatica) usually
indicates a problem 10. __________ the L4-S3 nerves.
A dermatome pattern shows which spinal nerves are responsible
for sensory and motor control of specific areas of the body.
http://www.mayfieldclinic.com/PE-AnatSpine.htm#.U-ytyvl_sgU
63
SPEAKING
3.3.3 Spinal Nerves - oral summary (S)
In pairs answer the questions on the basis of the text above.
1) Name the roots of the spinal nerve.
2) What kind of impulses do they carry?
3) What is the spinal cord covered by?
4) How does the spinal nerve travel?
5) Where does it exit? What happens after this?
6) How are the spinal nerves numbered?
7) What does the word dermatome refer to?
8) What does the dermatome pattern show?
VOCABULARY DEVELOPMENT
3.3.4 Coverings & spaces (V)
1. Match the words 1-5 with the definitions a-e.
1)
2)
3)
4)
5)
_____ arachnoid mater
_____ lumbar puncture
_____ meninges
_____ subarachnoid space
_____ pia mater
a) the three membranes that cover the brain and spinal cord (singular: meninx)
b) one of the meninges, it is the delicate innermost membrane enveloping the brain and spinal
cord.
c) a delicate fibrous membrane forming the middle of the three coverings of the central
nervous system
d) the space between the arachnoidea and pia mater filled with cerebrospinal fluid
e) it is a procedure whereby spinal fluid is removed from the spinal canal for the purpose of
diagnostic
2. Complete the text with the words above.
The spinal cord is covered with the same three membranes as the brain, called 1. ___________. The
inner membrane is the 2. ___________, which is intimately attached to the cord. The next
membrane is the 3. ___________. The outer membrane is the tough dura mater. Between these
64
membranes are spaces used in diagnostic and treatment procedures. The space between the pia and
arachnoid mater is the wide 4. ____________, which surrounds the spinal cord and contains
cerebrospinal fluid (CSF). This space is most often accessed when performing a 5. ___________ to
sample and test CSF or during a myelogram to inject contrast dye. The space between the dura mater
and the bone is the epidural space. This space is most often accessed to deliver anesthetic numbing
agents, commonly called an epidural, and to inject steroid medication.
3.4 COMMON DISEASES OF THE CENTRAL NERVOUS SYSTEM
SPEAKING
3.4.1 FAQS (S)
With a partner, discuss the following questions.







What does the term neurological disease refer to?
What kind of common diseases of the central nervous system do you know? What are the
symptoms of these diseases?
How can you prevent nervous system diseases?
Do you know any age related, stress related nervous system diseases?
Are there any treatments for nervous system diseases?
How are nervous system diseases diagnosed?
Do you know any degenerative diseases?
READING
3.4.2 Neurological diseases (R)
Read the description of the following major types of neurological diseases (1-4) then decide which
disease the people below are talking about (A-D).
1. Huntington's disease
(HD) is an inherited disease that causes certain nerve cells in the brain to waste away. People are
born with the defective gene, but symptoms usually don't appear until middle age. Early symptoms
of HD may include uncontrolled movements, clumsiness, and balance problems. Later, HD can take
away the ability to walk, talk, and swallow. Some people stop recognizing family members. Others
are aware of their environment and are able to express emotions. If one of your parents has
Huntington's disease, you have a 50 percent chance of getting it. A blood test can tell you if have the
HD gene and will develop the disease. There is no cure. Medicines can help manage some of the
symptoms, but cannot slow down or stop the disease.
http://www.nlm.nih.gov/medlineplus/huntingtonsdisease.html
65
2. Stroke
It is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes,
brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic
stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind,
called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Ministrokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly
interrupted.
Symptoms of stroke are:
 sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
 sudden confusion, trouble speaking or understanding speech
 sudden trouble seeing in one or both eyes
 sudden trouble walking, dizziness, loss of balance or coordination
 sudden severe headache with no known cause
Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot
or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that
result from stroke damage. Drug therapy with blood thinners is the most common treatment for
stroke.
http://www.ninds.nih.gov/disorders/stroke/stroke_backgrounder.htm
3. Epilepsy
It is a brain disorder that causes people to have recurring seizures. The seizures happen when
clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange
sensations and emotions or behave strangely. They may have violent muscle spasms or lose
consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain
development. In many cases, the cause is unknown. Doctors use brain scans and other tests to
diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but
medicines can control seizures for most people. When medicines are not working well, surgery or
implanted devices such as vagus nerve stimulators may help. Special diets can help some children
with epilepsy.
http://nanda-nurse-diary.blogspot.hu/2012/11/nursing-diagnosis-for-epilepsy.html
http://www.nlm.nih.gov/medlineplus/epilepsy.html
66
4. Meningitis
It is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges.
There are several types of meningitis. The most common is viral meningitis, which you get when a
virus enters the body through the nose or mouth and travels to the brain. Bacterial meningitis is
rare, but can be deadly. It usually starts with bacteria that cause a cold-like infection. It can block
blood vessels in the brain and lead to stroke and brain damage. It can also harm other organs.
Pneumococcal infections and meningococcal infections can cause bacterial meningitis.
Anyone can get meningitis, but it is more common in people whose bodies have trouble fighting
infections. Meningitis can progress rapidly. You should seek medical care quickly if you have
 a sudden fever
 a severe headache
 a stiff neck.
Early treatment can help prevent serious problems, including death. Vaccines can prevent some of
the bacterial infections that cause meningitis. Parents of adolescents and students living in college
dorms should talk to a doctor about the vaccination.
http://sehati.org/index/patientresources/normalanatomy.html
http://www.nlm.nih.gov/medlineplus/meningitis.html
A) ___________________________________
My father, 66, a wonderful man, on holiday with my mom woke up in the morning,
complained of not being able to move his left side, my mom helped him out of bed, &
he collapsed. The hotel immediately called 911, he was conscious on his way to the ER,
but once there, they put him into a medically induced coma. They say that it was good
that he remained conscious & was yelling my mom's name. But, the bleeding&swelling
in his brain was so severe that the Dr. said if he was 10 years older they wouldn't have
operated. They had to wait a day or two to perform surgery, I assume to allow some of
the swelling to go down. They removed a large clot & felt they stopped most of the
bleeding.
Sarah
http://www.stroke-survivors.co.uk/stroke-forum/messages.aspx?TopicID=305
67
B) ___________________________________
I guess when it really was noticeable was 2 1/2 years ago he was fired from
working in the log woods cause his boss said he had become very clumsy and
didn't have the reaction time he needed and he would just do stuff that was
really dangerous that he knew better. He seemed to get worse but it was so
slow that it became normal everyday until this year. He began in the summer
to have just extreme sudden outburst of anger and would scream and yell
and throw the biggest fits. It was very out of character for him. He became
very aggressive and argumentive on a daily basis. He began accusing me of
cheating on him to an extreme everyday. We would fight for days about it.
Finally in July I couldn't take anymore. He was constantly yelling at me and
putting me down and I told him if he didn't get some help I was leaving him. I
made him an appt. and after talking to the neurologist we were sure he had
this disease.
Mary
http://www.hdlf.org/phorum/read.php?5,83917
C) ___________________________________
Started with extreme hedache that was in the back of the head and
neck. Headache was almost manageable with pinkillers but
persisted. Pain then moved to excruciating pain in a wide band
across lower back, up spine and neck and back of head,
accompanied by nausea. No fever. Came to ER both times. Both
times treated with intravenous Acyclovir. Pain managed by
morphine and also given something for nausea. Worst syptoms over
in 24 hours, feeling woozy for a week and less than perfect for a
while- maybe a month or so.
George
http://www.patient.co.uk/forums/discuss/second-bout-of-viral-meningitis13218
68
D) ___________________________________
HI! I’m new to this forum but I’m desperate for help. I’ve been suffering
with seizures or black outs since I was 5 years old. This has been
happening on and off throughout my child hood. My first big and most
violent seizure happened six months ago. I had numbness in the right
side off my face, I couldn't stop shaking. I lost my ability to read and right
for a short while too. However, my blood test and MRI came back all
normal.
However, for the last two months I’ve suffered with shaking (left hand)
and painful headaches, and I’m tiered all the times. I can sleep for 20
hours or more. and I have trouble remembering things.
Last week however I had like a twitch in my neck, and all off a sudden
this passed through all my body (like tremors) and I passed out. I woke
up in hospital. I had the same tests done again and they all come back
normal. I still shake uncontrollably from my head to uper back non stop
since, my head aches are getting worse.
PLEASE IF ANYONE HAS HEARD OF OR SUFFER WITH SIMILAR SYMPTOMS
PLEASE WRITE BACK, IM LOOSING CONTROL.
Jessica
http://www.patient.co.uk/forums/discuss/please-advise-134492
SPEAKING
3.4.3 Talking about common neurological diseases (S)
With the help of the prompts speak about the following diseases.
Huntington’s disease: cause, onset, symptoms,
way of diagnosis, treatment
Stroke: cause, types, „mini-stroke”, symptoms,
therapy
Epilepsy: cause, symptoms, diagnosis,
treatment
Meningitis: types of meningitis, symptoms, complications,
treatment, prevention
69
WRITING
3.4.4 Seizure first Aid (W)
What do you have to do for a person who has a seizure? Look at the pictures! What do they
demonstrate?
http://www.epilepsyheartland.org/Current/about%20epilepsy/aid.php
WRITING
3.4.5 Questions about Epilepsy (W)
1. Can you think of any questions a patient with epilepsy can ask his/her doctor? Work in pairs.
Collect your ideas.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
70
2. You found the following article about epilepsy on the Internet. Read it and do the exercise below.
What is the best first aid for a seizure?
Here are some tips if you or someone you love has epilepsy.








Always carry medical identification. If an emergency happens, knowledge of your seizure disorder
can help the people around you keep you safe and provide the appropriate treatment.
Make sure your family, friends, and co-workers know what to do if you have a seizure.
Avoid potential dangers of high places or moving machinery at home, school, or work if you have
active seizures. Though there is less risk if your seizures are under control, you should focus on the
specific risks of certain activities (such as mowing, working around farm machinery, hot appliances,
etc.).
It is important for you to stay active, but you should choose your sports and other activities wisely.
You may want to avoid contact sports, but if your seizures are well controlled, you can lead a normal
life. The buddy system works well, so have another person with you who knows you have seizures
and what to do if you have one. Activities such as baseball, bike riding, canoeing, horseback riding, or
hockey can be made safer by wearing helmets and life jackets and by having another person with you
-- but this is true for all people.
If you take anticonvulsant medication, do not suddenly stop taking it or change the dosage without
consulting your doctor. The type of anticonvulsant medication you are prescribed depends on the
type of epilepsy you have, and the dose is determined by your weight, age, gender, and other
factors.
Be alert to the risks of possible drug interactions between your anticonvulsant drugs and other
medications you may take, including over-the-counter drugs.
Avoid alcohol, as it can interfere with the effectiveness of your medication and may lower the brain's
seizure threshold.
Doctors advise patients with seizures that they should not drive until their seizures are under control.
This may be after six months or a year depending on the state. If a well-controlled person has a
seizure after the doctor changes the medication, the patient may or may not be able to continue
driving.
What Should I Do for a Person Who Is Having a Seizure?
If someone is having a seizure:









Loosen clothing around the person's neck.
Do not try to hold the person down or restrain them. This can result in injury.
Do not insert any objects in the person's mouth. This can also cause injury.
Reassure concerned bystanders who may be upset and ask them to give the person room.
Remove sharp objects (glasses, furniture, and other objects) from around the person to prevent
injury.
After the seizure, it is helpful to lay the person on their side to maintain an open airway and prevent
the person from inhaling any secretions.
After a seizure, the person may be confused and should not be left alone.
In many cases, especially if the person is known to have epilepsy, it is not necessary to call 911.
Call 911 if the seizure lasts longer than 5 minutes, or if another seizure begins soon after the first, or
if the person cannot be awakened after the movements have stopped. If you are concerned that
71
something else may be wrong, or the person has another medical condition such as heart disease or
diabetes, you should contact a doctor immediately.
http://www.webmd.com/epilepsy/guide/seizures-driving
http://www.webmd.com/epilepsy/guide/first-aid-seizures
3. You got the following email from a patient with epilepsy on Epilepsy Forum UK. Answer it with the
help of the text above.
Dear Dr. Smith,
I have epilepsy. It was diagnosed a month ago. I need urgent advice. I have so
many questions. Could you please help me. I am so desparate.  My questions
are the following:

What safety measures do I need to take at home or at work to prevent
injuries when I have a seizure?


Who else should know about my epilepsy?
Is it okay for me to drive?

Are there any sports activities that I should not do? Do I need to wear
a helmet for any type of activities?

Can I drink any alcohol with my medications?

What should others do with me when I am having a seizure? After the
seizure is over, what should they do? When should they call the
doctor? When should we call 911?
Thank you very much for your help in advance.
Tom T.
Dear Tom,
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
72
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Regards
Dr. Smith
3.5 OLD AGE AND ALZHEIMER’S DISEASE
VOCABULARY DEVELOPMENT
3.5.1 Brainstorming – Old Age (V)
What do you associate with old age? Collect and write down your ideas.
Old Age
SPEAKING
3.5.2 Caring for the elderly (S)
1. Think of an old person you know well or who stands close to you and answer the questions below.




How healthy is he/she?
Where does he/she live?
Does he/she need help with daily tasks? If yes, with what?
How does he/she keep mentally fit?
73



How does he/she keep physically fit?
What worries him/her?
How happy is he/she?
2. With a partner discuss the questions about care home.


Would you like to live in a care home when you are old? Why/Why not?
Make a list of advantages and disadvantages of a care home.
+
-
3. In small groups discuss how to have a happy, healthy and spiritually fulfilled old age? Present your
ideas to the other groups.
WRITING
3.5.3 Difficulties of the elderly (W)
What difficulties do elderly people face? Use the words in the box, and write sentences.
daily tasks
food
getting around
shopping
health
recovery
medication
personal hygiene
home
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
74
READING
3.5.4 Alzheimer’s disease facts (R)
Read the text and decide if the following statements are
true (T) or false (F).
http://www.medindia.net/patients/patientinfo/infographic
s-on-Alzheimers.htm
1) Memory loss is a symptom of Alzheimer’s disease. _____
2) Alzheimer’s disease can appear before the age of 65. _____
3) As Alzheimer’s disease is a progressive disease, symptoms get better over time. _____
4) In its late stage, patients are not able to communicate any more. _____
5) After the symptoms are noticed, Alzheimer’s patients survive 4-8 years. _____
6) There is no medicine available which can cure Alzheimer’s. ____
Alzheimer's is the most common form of dementia, a general term for memory loss
and other intellectual abilities serious enough to interfere with daily life. The majority
of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old
age. Up to 5 percent of people with the disease have early onset Alzheimer's (also
known as younger-onset), which often appears when someone is in their 40s or 50s.
Alzheimer's worsens over time. Alzheimer's is a progressive disease, where dementia
symptoms gradually worsen over a number of years. In its early stages, memory loss is
mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a
conversation and respond to their environment. Alzheimer's is the sixth leading cause
of death in the United States. Those with Alzheimer's live an average of eight years
after their symptoms become noticeable to others, but survival can range from four to
20 years. Alzheimer's has no current cure, but treatments for symptoms are available
and research continues. Although current Alzheimer's treatments cannot stop
Alzheimer's from progressing, they can temporarily slow the worsening of dementia
symptoms and improve quality of life for those with Alzheimer's and their caregivers.
http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
75
2. Find the words from the text with these meanings.
1) a serious mental disorder caused by brain disease or injury, that affects the ability to think,
remember and behave normally _______________
2) the beginning of something, especially something unpleasant _______________
3) happening or developing steadily _______________
4) to become or make something worse than it was before _______________
5) slowly, over a long period of time _______________
6) to give a spoken or written answer to somebody/something _______________
7) a person who takes care of a sick or old person at home _______________
LISTENING
3.5.5 Stages of Alzheimer’s (L)
How many stages does Alzheimer’s have? Listen to the recording and write down the part of the brain
that Alzheimer’s affects and the damage it does to it.
Source: https://www.youtube.com/watch?v=7_kO6c2NfmE
STAGES
PART OF THE BRAIN AFFECTED/DAMAGE
1.
2.
3.
4.
5.
6.
7.
76
SPEAKING
3.5.6 Doctor-patient conversation (S)
With a partner, act out the roles below.
Student A: Your grandfather has
been diagnosed with Alzheimer’s.
You do not know much about the
disease. Consult your doctor about:




the disease itself
the stage your grandfather is
at
medication
treatment suggestions (As
you are mother of 3 you
cannot supervise your
grandfather in 24 hours)
Student B: You are a doctor. One of
your Alzheimer’s patient’s relative
ask you about:




the diseases itself
the stage your grandfather
is at (stage 2.)
medication (no cure, but
slows down down the
progression)
treatment suggestions
(need for long-term care,
assisted living, nursing
home)
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3.6 THE PERIPHERAL NERVOUS SYSTEM
VOCABULARY DEVELOPMENT
3.6.1 The peripheral nervous system – Key points (V)
Read the text about the peripheral nervous system then do the exercise below.
https://www.boundless.com/image/the-nervous-system/
78
The peripheral system connects the central nervous system to the rest of the body. The main
divisions of the PNS are:
The autonomic nervous system — which controls the automatic functions of the body: the heart,
smooth muscle (organs) and glands. It is divided into the “fight-or-flight” system (sympathetic
nervous system) and the “resting and digesting" system (parasympathetic nervous system).
The somatic nervous system — which allows us to consciously or voluntarily control our skeletal
muscles. The somatic system contains 12 cranial nerves and 31 spinal nerves.
https://www.boundless.com/psychology/the-brain-and-behavior/the-nervous-system/the-peripheral-nervoussystem-pns/
Match the terms with the definitions.
1)
2)
3)
4)
5)
6)
Neurons
Nerve impulses
Neurotransmitters
Dendrites
Axons
Synapse
Chemicals released by one neuron to excite a neighbouring one
Messenger cells in your nervous system
Fibres that carry information away from it, called axons
Fibres that carry information towards the cell body
Electrical signals carrying messages
The point at which a nervous impulse passes from one neuron to
another
READING
3.6.2 The neuron (R)
Read the text then locate and identify the structures of a neuron.
dendrite
cell body
axon
dendrite, cell body, axon
79
http://lrrpublic.cli.det.nsw.edu.au/lrrSecure/Sites/LRRView/7700/documents/5657/5657/applets/neuronesdn
d.html
Nerves which are made up of special cells called neurons. Neurons are comprised of a
dendrite, a cell body and an axon. Impulses travel to the dendrite into the cell body and
then onto the axon. A special sheath called myelin, which increases the conductivity of the
neuron, covers some nerves.
As messages travel from one neuron to the next they move across a synapse. At each
synapse there is a chemical releases called a neurotransmitter. At various parts of the body
specific neurotransmitters facilitate communication, for example dopamine (motor
function), serotonin (mood) and endorphins (painkillers). Sensory neurons carry messages
from a receptor to the brain. The brain then interprets the message. Motor neurons then
send the message to an affector in muscles and glands. Receptor (sensory organ) sends a
signal to the sensory neuron which sends a signal to the brain/spinal chord which sends a
signal to the motor neuron which sends a signal to the affector (muscle/gland).
http://www.bbc.co.uk/science/humanbody/body/factfiles/nervecellsandnerves/nerve_cells_and_nerves.shtml
https://www.boundless.com/psychology/the-brain-and-behavior/the-nervous-system/the-peripheral-nervous-system-pns/
2. What are the differences between the axons and the dendrites? Put the number of each feature to
the correct place in the table.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
Take information away from the cell body
Have a rough surface
Many dendrites per cell
No myelin
Branch far from the cell body
No ribosome
Only one axon per cell
Bring information to the cell body
Have ribosome
Branch near the cell body
Have myelin
Have a smooth surface
Axons
Dendrites
http://www.gwinnett.k12.ga.us/LilburnES/PromoteGA/biochemistry/Neuron_a_and_d.html
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SPEAKING
3.6.3 Parts of the PNS (S)
In your own words speak about the following parts of the PNS.




sympathetic nervous system
parasymphatetic nervous system
somatic nervous system
autonomic nervous system
3.7 MENTAL DISEASES
READING
3.7.1 What is mental illness? (R)
1. With a partner discuss, who is mentally ill. A person is mentally ill, if ……
2. Read the text about mental illnesses then do the task below.
A mental illness is a medical condition that disrupts a person's thinking, feeling, mood, ability to
relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses
are medical conditions that often result in a diminished capacity for coping with the ordinary
demands of life.
Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive
compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline
personality disorder. The good news about mental illness is that recovery is possible.
Mental illnesses can affect persons of any age, race, religion or income. Mental illnesses are not the
result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable.
Most people diagnosed with a serious mental illness can experience relief from their symptoms by
actively participating in an individual treatment plan.
http://www.nami.org/Template.cfm?Section=By_Illness
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2. Which of these people do you think may have a mental illness? Discuss each one with your partner.
a. Stephen Gough (born c. 1959), also known as Steve Gough and the Naked
Rambler, is an activist, and a British former Royal Marine. In 2003-2004, he
walked the length of Great Britain naked. He did it again in 2005-2006, but
was arrested in England and in Scotland. He subsequently spent six years in
prison, having been repeatedly rearrested for public nudity within a short
period, each time he was released.
http://en.wikipedia.org/wiki/Stephen_Gough
b. By the time Susan Smith goes to bed, she will have cleaned the
house over 10 times a day. She doesn’t feel good when she cleans the
house once but instead she finds herself continuously repeating the
same task over and over.
http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm
c. John Davis has difficulty sustaining attention in academic or work
tasks and activities. He is often bored and indifferent. He does not
pick up on other people’s mood, feelings (e.g., may say the wrong
thing at the wrong time). He has extreme mood swings, irritability or
a persistently depressed mood.
http://www.nesca-news.com/2013/09/your-teenagers-behavior-what-to-expect.html
d. Jeniffer Parkson thinks she is in danger and that is why she does not
leave her home. She believes that other people are trying to harm her. She
doubts the commitment, loyalty, or trustworthiness of others, believing
others are using or deceiving her.
http://www.webmd.com/mental-health/paranoid-personality-disorder
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e. Andy Park, 43, known as Mr Christmas, has celebrated Christmas
every day for 15 years. Every day since 1993 the divorced electrician
has breakfasted on mince pies and sherry, before opening the
presents he has bought for himself. Then he eats a full roast turkey
lunch and watches the Queen's Speech on video.
http://www.dailymail.co.uk/news/article-506249/Mr-Christmas-The-man-celebrated-festive-season-365days-year--15-years.html
f. When John Taylor gets into his car, he becomes a real monster.
He makes rude gestures, verbal insults, he drives in an unsafe or
threatening manner.
http://en.wikipedia.org/wiki/Road_rage
VOCABULARY DEVELOPMENT
3.7.2 Symptoms (V)
Match the words (1-10) with the definitions (a-j). Write your answers in the chart below.
1. hallucination
2. paranoia
3. mania
4. delusion
5. disoriented
6. anxiety
7. euphoria
8. mood
9. malingering
10. echolalia
a. the state of feeling nervous or worried that
something bad is going to happen
b. an extremely strong feeling of happiness and
excitement that usually lasts only a short time
c. to pretend to be ill/sick, especially in order to
avoid work
d. the way you are feeling at a particular time
e. feeling confused
f. something that is seen or heard when it is not
really there
g. a false belief or opinion about yourself or your
situation
h. the act of repeating everything somebody
says, as a result of a mental disorder
i. a person may wrongly believe that other
people are trying to harm them, that they are
somebody very important, etc.
j. somebody has an obsession about something
that makes them extremely anxious, violent or
confused
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http://www.oxfordlearnersdictionaries.com/definition/english/landmark
1
2
3
4
5
6
7
8
9
10
READING
3.7.3 Common mental illnesses (R)
Which disease is described below? Match the names 1-6 with the explanations A-F.
1.
2.
3.
4.
5.
6.
Bipolar disorder
Obsessive-compulsive disorder
Panic disorder
Major depression
Borderline Personality Disorder
Schizophrenia
A. ______________________________
It is a mood state that goes well beyond temporarily feeling sad or blue. It affects one’s thoughts,
feelings, behavior, mood and physical health. It is a life-long condition in which periods of wellness
alternate with recurrences of illness. It involves some combination of the following symptoms:
depressed mood (sadness), poor concentration, insomnia, fatigue, appetite disturbances, excessive
guilt and thoughts of suicide. Left untreated, it can lead to serious impairment in daily functioning
and even suicide.
http://www.nami.org/template.cfm?section=Depression
B. ________________________________
It is a serious mental illness. It most often appears in men in their late teens or early twenties, while
it appears in women in their late twenties or early thirties. Interfering with a person's ability to think
clearly, manage emotions, make decisions and relate to others, it impairs a person's ability to
function to their potential when it is not treated, because the illness may cause unusual,
inappropriate and sometimes unpredictable and disorganized behavior. The apparent erratic
behavior is often caused by the delusions and hallucinations that are symptoms of this condition.
http://www.nami.org/Template.cfm?Section=schizophrenia9
84
C. ________________________________
It is a chronic illness with recurring episodes of mania and depression that can last from one day to
months. It causes unusual and dramatic shifts in mood, energy and the ability to think clearly. Cycles
of high (manic) and low (depressive) moods may follow an irregular pattern that differs from the
typical ups and downs experienced by most people. The symptoms of this disorder can have a
negative impact on a person’s life. Damaged relationships or a decline in job or school performance
are potential effects, but positive outcomes are possible.
http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/Bipolar1/Home_-_What_is_Bipolar_Disorder_.htm
D. _______________________________
It is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized
behaviors you feel compelled to perform. If you have this condition, you probably recognize that
your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to
resist them and break free. It causes the brain to get stuck on a particular thought or urge.
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=142546
E. _______________________________
It is an uncontrollable and terrifying response to ordinary, nonthreatening situations. People have
recurrent panic attacks, persistent anxiety or fear regarding their panic attacks and change their
behavior in an attempt to avoid further panic attacks. Individuals with this disease are likely to
experience some combination of the following symptoms during a panic attack: sweating, hot or cold
flashes, choking or smothering sensations, racing heart, labored breathing, trembling, chest pains,
faintness, numbness, nausea or disorientation. They may feel like they are dying, losing control or
losing their mind.
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=23050
F. ______________________________
It is a mental illness that causes intense mood swings, impulsive behaviors, and severe problems with
self-worth. It can lead to troubled relationships in every area of a person's life. Most of the time,
signs of the disorder first appear in childhood. But problems often don't start until early adulthood.
The most common symptoms include:




Harmful, impulsive behaviors. These may include things like substance abuse, binge eating,
out-of-control spending, risky sexual behavior, and reckless driving.
Relationship problems. You may see others as either "good" or "bad" and may shift from one
view to the other suddenly, for minor reasons.
Low self-worth.
A frantic fear of being left alone (abandoned).
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

Aggressive behavior.
Hurting yourself, such as cutting or burning yourself.
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=44780
READING
3.7.4 Tourette syndrome (R)
Read the text about Tourette syndrome and answer the questions!
1. What are the typical features of the disease?
2. Where does its name come from?
3. When does Tourette syndrome first appear?
4. When are the worst tics experienced?
5. What makes the symptoms worse?
6. Can tics be controlled?
7. What other problems may people with Tourette syndrome have?
Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped,
involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de
la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86year-old French noblewoman.
The early symptoms of TS are typically noticed first in childhood, with the average onset between the
ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to
four times more often than females. It is estimated that 200,000 Americans have the most severe
form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic
motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most
people with the condition experience their worst tic symptoms in their early teens, with
improvement occurring in the late teens and continuing into adulthood.
Motor and vocal tics are classified as either simple or complex. Tics are often worse with excitement
or anxiety and better during calm, focused activities. Certain physical experiences can trigger or
worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throatclear may trigger similar sounds. Tics do not go away during sleep but are often significantly
diminished.
Although the symptoms of TS are involuntary, some people can sometimes suppress, or otherwise
manage their tics in an effort to minimize their impact on functioning. However, people with TS often
report a substantial buildup in tension when suppressing their tics to the point where they feel that
the tic must be expressed (against their will). Tics in response to an environmental trigger can appear
to be voluntary or purposeful but are not.
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Many individuals with TS experience additional neurobehavioral problems that often cause more
impairment than the tics themselves. These include inattention, hyperactivity and impulsivity
(attention deficit hyperactivity disorder—ADHD); problems with reading, writing, and arithmetic;
and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors.
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm
&ContentID=23053
VOCABULARY DEVELOPMENT
3.7.5 List of tics (V)
This is a list of some tics. Decide which one is a motor (write M) or a vocal (write V) tic.
motor tics = short-lasting sudden movements
vocal tics = short-lasting uttered sounds
Tics
clapping
kicking
muttering
spitting
hiccupping
swearing
blinking
chewing clothes
licking things
offensive gestures
somersaulting
M/V
Tics
belching
stuttering
shivering
shouting
sniffing
throwing things
sticking out the tongue
making faces
scratching
smelling things
frowning
M/V
http://www.tourette-london.ca/ae0016.htm
LISTENING
3.7.6 Seasonal Affective Disorder (L)
Listen to the following text on Seasonal Affective Disorder and decide if the following statements are
true (write T) or false (write F)!
Source: https://www.youtube.com/watch?v=JP7T2q3yeUM
1. In autumn when days get shorter people may experience seasonal depression.
2. The main symptoms are high energy and bad mood, sadness, lethargy, apathy.
3. 10-15% of Canadian people suffer from a severe form of seasonal affective disorder.
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4. Those who have the ’winter blues’ feel that winter is a terrible time and they want to
stay at home.
5. There are more women than man suffering from seasonal affective disorder.
6. Light therapy is the least commonly used type of treatment option for this condition.
7. Exposure to natural light can be very effective to treat winter mood changes if it is
feasible.
8. Doing sport is not considered a preventative or maintenance treatment if patients are
better.
9. Seasonal depression can be linked with the obesity epidemic.
10. It is better to see a doctor, if you experience signs of depression at this time of the
year.
SPEAKING
3.7.7 Stigma of Mental Illnesses (S)
1. Do you know these people? What is common in all of them?
http://www.health.com/health/gallery/0,,20526304_6,00.html
http://www.health.com/health/gallery/0,,20526304_9,00.html
http://www.health.com/health/gallery/0,,20526304_15,00.html
2. In small groups discuss the questions below.
1. What is mental health stigma?
2. Why are people with mental illness stigmatized?
3. What kinds of characteristics are attributed to a person with mental illness?
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4. How can people who are stigmatized feel?
5. Can famous people help remove this stigma of mental illness?
6. Are there any psychiatric illnesses in your country which are stigmatized?
7. Are public attitudes changing or have they been the same for a long time?
8. How would you change people’s opinion to look at mental illnesses in a more positive way as
a health care professional?
http://apt.rcpsych.org/content/6/1/65.full
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3.8 VOCABULARY
abducens nerve
amygdala
anticonvulsant
anulus
arachnoid mater
atlas
autonomic nervous system
axon
basal ganglion - ganglia
brain stem
bundle
cartilage
caudate
cerebellum
cerebralcerebrospinal fluid (CSF)
cerebrum
cervical
cervix
cingulate gyri
circadian rythm
clumsiness
coccygeal
coccyx
compromise
corpus callosum
cortex
cranial nerve
cushion
dendrite
dermatome
dorsal (back) root
dura mater
endocrine
facial nerve
frontal lobe
ganglion/ganglia
globus pallidus
glossopharyngeal nerve
gray matter/substance
gyrus
hemisphere
hemorrhagic stroke
hippocampus
hypoglossal nerve
hypothalamus
szemtávolító ideg
amygdala (a szociabilitásért felelős agyi terület)
görcsoldó
körgyűrű
pókhálóhártya
atlascsigolya
vegetatív, autonóm idegrendszer
efferens nyúlvány
bazális ganglion
agytörzs
köteg
porc
farok
kisagy
agy
gerincfolyadék
agy
nyaki
nyak
gyrus cinguli, övtekervény
napi ritmus
ügyetlenség, balkezesség
farokcsonti
farokcsont
veszélyeztet
kérgestest
kéreg
agyi ideg
kipárnáz, beágyaz
afferens nyúlvány
bőrszelvény, dermatoma
dorsális gyökér
kemény agyhártya
belső elválasztású, endokrin
arcideg
homloklebeny
idegdúc, központ
globus pallidus/pallidum
nyelv- és garatideg
szürkeállomány
agytekervény
agyélteke
haemorrhagiás stroke (vérzéssel járó)
hippocampus
nyelv alatti ideg
hipotalmusz
90
iliac
innervate
interpretative
intervertebral disc
intervertebral foramen
ischemic stroke
limbic system
lumbar
lumbar puncture
mastication
medulla oblongata
melatonin
meninges
meningitis
meninx
motor nerve
motor neurone
myelin
myelin sheath
myelogram
nerve root
neuron
neurotransmitter
node
nucleus - nuclei
nucleus pulposus
nucleus/nuclei
oblique muscle
occipital lobe
occipital lobe
oculomotor nerve
odontoid
olfactory nerve
optic nerve
parasymphatetic nervous system
parietal lobe
pedicle
peg
pia mater
pineal gland
pituitary gland
plaque
plexus
pons
process
putamen
reabsorb
rear
csípőstimulál
értelmező
porckorong
csigolyák közötti nyílás, foramen intervertebrale
ischaemiás stroke
limbikus rendszer
ágyéki
lumbálpunkció, gerinccsapolás
rágás
nyúltagy, nyúltvelő
melatonin
agyhártyák
agyhártyagyulladás
agyhártya
mozgató ideg
mozgató sejt
mielin, velő, (Schwannsejtek hártyájának anyaga
mielinhüvely, idegrostot körülvevő védőburok
csontvelő sejtjeinek megoszlása
ideggyök
idegsejt
neurotranszmitter
csomó
sejtmag
csigolák kozti lemezek rostos porcos központja
sejtmag
ferde hasizom
tarkólebeny
nyakszirti lebeny
szemmozgató ideg
fog alakú
szaglóideg
látóideg
paraszimpatikus idegrendszer
fali lebeny
kocsány
ék
lágy agyhártya
tobozmirigy
hipofízis
plakk
idegfonat
pons, híd
nyúlvány
belső hártya
elnyel
hátsó része valaminek
91
ribosome
sacral
sacrum
sciatica
seizure
somatic nervous system
spasm
spinal accessory nerve
spinal cord
spinal nerve
spinous process
subarachnoid space
sulcus
symphatetic nervous system
synapse
temporal lobe
thoracic
transient ischemic attacks
transient
transverse process
trigeminal nerve
trochlear nerve
vagus/vagi
ventral root
ventricle
vertigo
vestibulocochlear nerve
viscera
visceral
waste away
white matter/substance
wreak havoc
riboszóma
keresztcsonti
keresztcsont
ischias syndroma
roham
szomatikus idegrendszer
görcs
járulékos ideg
gerincvelő
gerincvelői ideg
csigolya-tövisnyúlvány, processus spinosus
subarachnoidalis tér
agybarázda
szimpatikus idegrendszer
szinapszis
halántéklebeny
mellkasi
tranziens ischaemiás attack
átmeneti, múló, tranziens
csigolya-harántnyúlvány, processus transversus
háromosztatú ideg
sodorideg
bolygóideg
ventrális gyökér
agykamra
szédülés
egyensúly- és hallóideg
zsiger
zsigeri
elsorvad
fehérállomány
elpusztít
92
UNIT 4. RESPIRATORY SYSTEM
Aims of the Unit
In this unit you will learn about:



the anatomy of the respiratory system,
muscles of respiration, physiology of the respiratory system and
diseases of the respiratory system such as lung cancer, COPD, asthma etc.
93
4.1 ANATOMY OF THE RESPIRATORY SYSTEM
LISTENING
4.1.1 Introduction to the Respiratory System (L)
Listen to recording about the respiratory system and complete the text with the missing words. Then
watch the video.
Source: https://www.youtube.com/watch?v=o2OcGgJbiUk
The respiratory system moves air
through the nose, pharynx, larynx,
trachea and bronchus to the alveoli
where the gas exchange between
oxygen and carbon dioxide occurs. 1.
____________ are the openings to the
nose. The nasal cavity is lined with 2.
___________, mucous membranes and
blood capillaries. The air is filtered by
cilia, 3. __________ by mucous
membranes and warmed by the blood.
Air moves into the pharynx or throat,
the common passageway for food and
air. Air continues on to the larynx. The epiglottis, a 4. ____________ of tissue in front of the larynx,
closes off the larynx when swallowing to prevent food from entering. The larynx or voice box
contains the 5. ___________ __________. The trachea or windpipe connects the larynx to the 6.
__________ __________. The cartilage rings of the trachea prevent the trachea from collapsing.
Lungs are spongy tissue with alveoli and blood capillaries. Breathing occurs because of the expansion
and 7. ___________ of the lungs. The bronchi carrying the air subdivide into smaller branches called
8. __________. At the end of each bronchiole are the alveolar sacs. The alveolar sacs are surrounded
by blood capillaries and contain millions of single layer 9. __________ __________ where the gas
exchange takes place. Oxygenated air goes through the nose to the pharynx, larynx, trachea,
bronchus and alveoli. By the process of the fusion, oxygen in the air moves from the alveoli to the
capillaries. Carbon dioxide moves from the capillaries into the alveoli and is 10. ___________. This
process is called respiration.
There are 3 major parts of the respiratory system: the airway, the lungs, and the muscles of
respiration. The airway, which includes the nose, mouth, pharynx, larynx, trachea, bronchi, and
bronchioles, carries air between the lungs and the body’s 11. ___________ . The lungs act as the
functional units of the respiratory system by passing oxygen into the body and carbon dioxide out of
the body. Finally, the muscles of respiration, including the diaphragm and intercostal muscles, work
together to act as a 12. ___________, pushing air into and out of the lungs during breathing.
http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/P/Pulmonary.html
94
READING
4.1.2 Organs of the respiratory system (R)
Write the letter of the most suitable sentence (1-8) in the text below. There is one extra sentence,
which you do not need.
1)
2)
3)
4)
5)
6)
7)
8)
the structure of the walls of the airway begins to change
due to the heart pointing to the left side of the body
allow it to remain open to air at all times
but the oral cavity can be used to supplement or replace the nasal cavity’s functions
which is often referred to as the Adam’s apple
the sinuses provide resonance for the voice
to warm, moisturize, and filter air entering the body before it reaches the lungs
that acts as a switch between the trachea and the esophagus
Nose and Nasal Cavity
The nose is a structure of the face made of cartilage, bone, muscle, and skin that supports and
protects the anterior portion of the nasal cavity. The nasal cavity is a hollow space within the nose
and skull that is lined with hairs and mucus membrane. The function of the nasal cavity is 1.
________________________________ . Hairs and mucous lining the nasal cavity help to trap dust,
mold, pollen and other environmental contaminants before they can reach the inner portions of the
body. Air exiting the body through the nose returns moisture and heat to the nasal cavity before
being exhaled into the environment.
http://www.naturalhealthschool.com/nose_sinuses.html
Mouth
The mouth, also known as the oral cavity, is the secondary external opening for the respiratory tract.
Most
normal
breathing
takes
place
through
the
nasal
cavity,
2.
________________________________ when needed. Because the pathway of air entering the body
from the mouth is shorter than the pathway for air entering from the nose, the mouth does not
95
warm and moisturize the air entering the lungs as well as the nose performs this function. The mouth
also lacks the hairs and sticky mucus that filter air passing through the nasal cavity.
Pharynx
The pharynx is a muscular funnel that extends from the posterior end of the nasal cavity to the
superior end of the esophagus and larynx. The pharynx is divided into 3 regions: the nasopharynx,
oropharynx, and laryngopharynx. The epiglottis is a flap of elastic cartilage 3.
________________________________ . Because the pharynx is also used to swallow food, the
epiglottis ensures that air passes into the trachea by covering the opening to the esophagus. During
the process of swallowing, the epiglottis moves to cover the trachea to ensure that food enters the
esophagus and to prevent choking.
http://en.wikipedia.org/wiki/Pharynx
Larynx
The larynx is a short section of the airway that connects the laryngopharynx and the trachea. The
larynx is located in the anterior portion of the neck, just inferior to the hyoid bone and superior to
the trachea. Several cartilage structures make up the larynx and give it its structure. Inferior to the
epiglottis is the thyroid cartilage, 4. ________________________________ as it is most commonly
enlarged and visible in adult males. The thyroid holds open the anterior end of the larynx and
protects the vocal folds. Inferior to the thyroid cartilage is the ring-shaped cricoid cartilage which
holds the larynx open and supports its posterior end. In addition to cartilage, the larynx contains
special structures known as vocal folds, which allow the body to produce the sounds of speech and
singing. The vocal folds are folds of mucous membrane that vibrate to produce vocal sounds.
Trachea
The trachea is a 5-inch long tube made of C-shaped hyaline cartilage rings. The trachea connects the
larynx to the bronchi and allows air to pass through the neck and into the thorax. The rings of
cartilage making up the trachea 5. ________________________________. The main function of the
trachea is to provide a clear airway for air to enter and exit the lungs. In addition, the epithelium
lining the trachea produces mucus that traps dust and other contaminants and prevents it from
reaching the lungs. Cilia on the surface of the epithelial cells move the mucus superiorly toward the
pharynx where it can be swallowed and digested in the gastrointestinal tract.
96
http://www.webmd.com/lung/picture-of-the-trachea
Bronchi and Bronchioles
At the inferior end of the trachea, the airway splits into left and right branches known as the primary
bronchi. The left and right bronchi run into each lung before branching off into smaller secondary
bronchi. The secondary bronchi carry air into the lobes of the lungs - 2 in the left lung and 3 in the
right lung. The secondary bronchi in turn split into many smaller tertiary bronchi within each lobe.
The tertiary bronchi split into many smaller bronchioles that spread throughout the lungs. Each
bronchiole further splits into many smaller branches less than a millimeter in diameter called
terminal bronchioles. Finally, the millions of tiny terminal bronchioles conduct air to the alveoli of the
lungs. As the airway splits into the tree-like branches of the bronchi and bronchioles, 6.
______________________________. The primary bronchi contain many C-shaped cartilage rings
that firmly hold the airway open and give the bronchi a cross-sectional shape like a flattened circle or
a letter D. As the bronchi branch into secondary and tertiary bronchi, the cartilage becomes more
widely spaced and more smooth muscle and elastin protein is found in the walls. The main function
of the bronchi and bronchioles is to carry air from the trachea into the lungs.
http://www.nytimes.com/health/guides/disease/asthma/print.html
97
Lungs
The lungs are a pair of large, spongy organs found in the thorax lateral to the heart and superior to
the diaphragm. Each lung is surrounded by a pleural membrane that provides the lung with space to
expand as well as a negative pressure space relative to the body’s exterior. The negative pressure
allows the lungs to passively fill with air as they relax. The left and right lungs are slightly different in
size and shape 7. ______________________________. The left lung is therefore slightly smaller than
the right lung and is made up of 2 lobes while the right lung has 3 lobes.
The interior of the lungs is made up of spongy tissues. The alveoli are cup-shaped structures found at
the end of the terminal bronchioles and surrounded by capillaries. The alveoli are lined with thin
simple squamous epithelium that allows air entering the alveoli to exchange its gases with the blood
passing through the capillaries.
http://www.innerbody.com/anatomy/respiratory
http://www.abc.net.au/health/library/stories/2010/07/29/2967396.htm
WRITING
4.1.3 Summary of the Respiratory System (W)
Complete the summary of respiratory system with the help of the text above. Then talk about it in
your own words.
1) The nasal cavity is lined with ______________________________________.
2) The functions of the nasal cavity ______________________________________.
3) The pathway of air from the mouth to the lung ____________________________________
and as opposed to the nose ______________________________________.
4) The mouth also lacks the hairs and sticky mucus that ________________________________.
5) The pharynx is divided into 3 regions: ______________________________________.
6) The epiglottis is ______________________________________.
7) The larynx connects ______________________________________.
8) Vocal folds are special structures within the larynx, which ____________________________.
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9) The trachea connects the larynx to the bronchi and its main function is _________________.
10) Furthermore, the epithelium lining the trachea produces mucus that ___________________.
11) The trachea splits into left and right branches, the primary bronchi. The left and right bronchi
branch off into smaller secondary bronchi. The secondary bronchi in turn split into many
smaller tertiary bronchi within each lobe. The tertiary bronchi split _____________________
and further splits into ______________________________________. Finally, ___________.
12) The lung is made up ______________________________________.
13) The interior of the lungs is made up of spongy tissues containing ______________________.
VOCABULARY DEVELOPMENT
4.1.4 Medical terms vs. common English names about the respiratory system (V)
Match the medical terms and common English names about the respiratory system.
A
B
1)
2)
3)
4)
5)
6)
7)
8)
nasal cavity
oral cavity
trachea
pharynx
larynx
thyroid cartilage
thorax
pulmonary
a)
b)
c)
d)
e)
f)
g)
h)
mouth
throat
Adam’s apple
nose
chest
lung
windpipe
voice box
2. Work in pairs.
Student A reads out the description in Column A for Student B. Student B has to find out which word is
meant. The solutions can be found in the Answer Key.
Student B reads out the description in Column B for Student A. Student A has to find out which word is
meant. The solutions can be found in the Answer Key.
One correct answer is worth one score. The one who has more scores is the winner.
Column A
1. LINED WITH MUCOUS MEMBRANE AND FINE HAIRS. IT ACTS LIKE A FILTER TO MOISTEN AND
WARM THE ENTERING AIR.
2. PARTITION SEPARATING THE RIGHT AND LEFT NASAL CAVITIES.
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3. SERVES AS FOOD AND AIR PASSAGEWAY. AIR ENTERS FROM THE NASAL CAVITIES AND PASSES
THROUGH THE PHARYNX TO THE LARYNX. FOOD ENTERS THE PHARYNX FROM THE MOUTH AND
PASSES INTO THE ESOPHAGUS.
4. LYMPHOID TISSUE LOCATED BEHIND THE MOUTH.
5. LOCATION OF THE VOCAL CORDS. AIR ENTERS FROM THE PHARYNX (VOICE BOX).
6. FLAP OF CARTILAGE THAT AUTOMATICALLY COVERS THE OPENING OF AND KEEPS FOOD FROM
ENTERING THE LARYNX DURING SWALLOWING.
7. ONE OF TWO BRNACHES FROM THE TRACHEA THAT CONDUCTS AIR INTO THE LUNGS, WHERE IT
DIVIDES AND SUBDIVIDES. THE BRANCHINGS RESEMBLE A TREE; THEREFORE, THEY ARE REFERRED
TO AS A BROCHIAL TREE.
Column B
1. SMALLEST SUBDIVISION OF THE BRONCHIAL TREE.
2. AIR SACS AT THE END OF THE BRONCHIOLES. OXYGEN AND CARBON DIOXIDE ARE EXCHANGED
THROUGH THE ALVEOLAR WALLS AND THE CAPILLARIES.
3. TWO SPONGE LIKE ORGANS IN THE THORACIC CAVITY. THE RIGHT LUNG CONSISTS OF THREE
LOBES, AND THE LEFT LUNG HAS TWO LOBES.
4. DOUBLE-FOLDED SEROUS MEMBRANE COVERING EACH LUNG AND LINING THE THORACIC
CAVITY WITH A SMALL SPACE BETWEEN, CALLED THE PLEURAL CAVITY, WHICH CONTAINS SEROUS
FLUID.
5. MUSCULAR PARTITION THAT SEPARATES THE THORACIC CAVITY FROM THE ABDOMINAL
CAVITY. IT AIDS IN THE BREATHING PROCESS BY CONTRACTING AND PULLING AIR IN, THEN
RELAXING AND PUSHING AIR OUT.
6. PASSAGEWAY FOR AIR TO THE BRONCHI
7. THE LARGEST CARTILAGE OF THE LARYNX, HAVING TWO BROAD PROCESSES THAT JOIN
ANTERIORLY TO FORM THE ADAM’S APPLE
http://www.cram.com/flashcards/2010-respiratory-therapist-kaplan-medical-terminology-organs-of-therespiratory-system-chapter-5-1263039
SPEAKING
4.1.5 Identifying and speaking about the structures of the respiratory system (S)
Identify the structures at number 1-10 then speak about how the air travels in the body.
sinuses
trachea
bronchus
pharynx
nasal passages
diaphragm
lung
external nares
larynx
epiglottis
100
http://www.highlands.edu/academics/divisions/scipe/biology/faculty/hargett/b2122/2122rev3/rspdia.htm
4.2 MUSCLES OF RESPIRATION, PHYSIOLOGY OF THE RESPIRATORY SYSTEM
READING
4.2.1 Respiration (R)
Read the text and answer the questions below.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
Define the diaphragm in simple terms.
What are the sections of the intercostal muscles?
How do the sections of the intercostal muscles work?
Define pulmonary ventilation in simple terms.
What is used to achieve pulmonary ventilation?
What is gas exchange facilitated by?
What happens during inspiration?
Is expiration an active or passive process? Why?
What is external respiration in simple terms?
What is internal respiration in simple terms?
101
Surrounding the lungs are sets of muscles that are able to cause air to be inhaled or exhaled from the
lungs. The principal muscle of respiration in the human body is the diaphragm, a thin sheet of
skeletal muscle that forms the floor of the thorax.
Between the ribs are many small intercostal muscles that assist the diaphragm with expanding and
compressing the lungs. These muscles are divided into 2 groups: the internal intercostal muscles and
the external intercostal muscles. The internal intercostal muscles are the deeper set of muscles and
depress the ribs to compress the thoracic cavity and force air to be exhaled from the lungs. The
external intercostals are found superficial to the internal intercostals and function to elevate the ribs,
expanding the volume of the thoracic cavity and causing air to be inhaled into the lungs.
http://paramedicine101.com/2010/10/17/respiratory-system/
Pulmonary Ventilation
Pulmonary ventilation or breathing is the process by which gases are exchanged between the
atmosphere and lung alveoli. The exchange of gases is facilitated by changes in pressure between the
atmosphere and the lung alveoli. The respiratory system uses both a negative pressure system and
the contraction of muscles to achieve pulmonary ventilation. The volume of the lungs is increased
during inspiration. During inspiration;




The diaphragm contracts and flattens which increases the vertical dimension of
the thoracic cavity.
The chest wall lifts up and out increasing the horizontal dimension of the thoracic cavity.
In turn the pleural cavity increases causing a drop in intrapleural pressure. Therefore the
parietal pleura are pulled outwards by the expanding thoracic cavity.
The parietal pleura also pull the visceral pleura and the lungs out with them.
102
Expiration
Expiration or breathing out also occurs due to changing pressure gradients. For expiration to occur
the opposite conditions to inspiration must occur, i.e. the pressure in the lungs must be greater than
the atmospheric pressure. Expiration, unlike inspiration, is a passive process, i.e. no muscle
contractions are involved. Expiration therefore occurs due to the elastic recoil of the chest wall and
lungs, both of which spring back to their original shape after being stretched.
http://everything2.com/title/Pulmonary+ventilation
http://g09respirationr3a.wikispaces.com/(4)%09+Breathing+%26+gas+exchange
External Respiration
External respiration is the exchange of gases between the air filling the alveoli and the blood in the
capillaries surrounding the walls of the alveoli. The net result of external respiration is the movement
of oxygen from the air into the blood and the movement of carbon dioxide from the blood into the
air. The oxygen can then be transported to the body’s tissues while carbon dioxide is released into
the atmosphere during exhalation.
Internal Respiration
Internal respiration is the exchange of gases between the blood in capillaries and the tissues of the
body. The net result of internal respiration is the diffusion of oxygen into the tissues and the diffusion
of carbon dioxide into the blood.
http://everything2.com/title/Pulmonary+ventilation
103
SPEAKING
4.2.2 Health effects of smoking (S)
1. What is the connection between the pictures? Work in pairs. You should talk about your ideas. You
can develop a talk by commenting the pictures or raising problems related to them.
http://www.livescience.com/26063-smokers-quit-new-years-resolution.html
http://en.wikipedia.org/wiki/Tobacco_smoking
http://diseasespictures.com/lung-cancer/
http://dailymuslims.com/wp-content/uploads/2013/07/smoking-danger.jpg
http://www.sharp-smoker.com/e-cigarette-dangers-s/128.htm
2. With a partner answer the following questions.









What kind of addictions do you know?
Why do people smoke? Give reasons.
What diseases can be related to the harmful effects of smoking?
What should be done to reduce smoking among young people?
What is an E-cigarette? What do you think about it?
Do you think that ’no-smoking days’ and anti-smoking campaigns are
effective? Justify your opinion.
What would you do to prevent your children from smoking?
What tips would you give to smokers to help them quit smoking?
What is nicotine replacement therapy?
104
WRITING
4.2.3 Decreasing smoking rates (W)
Read and discuss the following text in groups of 3, then make and write suggestions on how to
decrease smoking rates. Each group will then write 2 of their suggestions on the board when ready.
Tobacco is the single largest avoidable health risk in the EU, accounting for nearly 700 000
premature deaths each year. Around 50% of smokers die prematurely (on average 14 years
earlier).
In addition, smokers have more life years in poor health. Many cancers, cardiovascular and
respiratory diseases are linked to tobacco use, which causes more problems than alcohol,
drugs, high blood pressure, excess weight or high cholesterol.
Despite considerable progress, the number of smokers in the EU is still high – 28% of the
population and even 29% of young Europeans aged 15-24.
Because tobacco is so addictive and 94% of smokers start smoking before they turn 25,
policy should focus on preventing young people from starting smoking.
http:/ec.europa.eu/health/tobacco/introduction/index_en.htm
SPEAKING
4.2.4 Types of cough (S)
Read the text about cough then with a partner discuss what the common causes for acute, subacute
and chronic coughs are? Write your ideas into the table.
A cough is a natural reflex that protects your lungs. Coughing helps clear your airways of lung
irritants, such as smoke and mucus. This helps prevent infections. A cough can also be a symptom of
a medical problem. A cough can be acute, subacute, or chronic, depending on how long it lasts. An
acute cough lasts less than 3 weeks. A subacute cough lasts 3 to 8 weeks. A chronic cough lasts more
than 8 weeks.
Types of caugh
acute
Conditions
subacute
chronic
http://www.nhlbi.nih.gov/health/health-topics/topics/cough/
105
4.3 DISEASES OF THE RESPIRATORY SYSTEM
READING
4.3.1 Lung cancer (R)
1. Read the text and fill in the table with the most important information about lung cancer.
Lung cancer is surely deadliest of all other types of
cancer and each year thousands of people die of
lung cancer. Very often it develops on adults who
are above 50 years. Lung cancer has every possibility
to spread to brain, adrenal glands and liver causing
death. The types of lung cancer are small celled lung
cancer and non-small cell lung cancer. Non small
type of cancer develops in almost 85% of lung
cancer people. Metastatic lung cancer is the one
which starts in any part of the body and
subsequently spreads to lungs.
The main cause of lung cancer is smoking. Smoking tobacco in any form can cause lung cancer. But
there are thousands of people with lung cancer who have not even smoked once in life. Working in
asbestos prone environment and exposure to strong chemicals like beryllium, gasoline, nickel
chromates and chloro-methyl ether certainly will increase the risk of lung cancer. People who have
COPD (Chronic Obstructive Pulmonary Disease) have increased chance of getting lung cancer.
People who are subjected to a high level of air pollution, who drink water that has high arsenic
content are at risk of developing lung cancer.
Lung cancer will not produce symptoms initially. Some people may get chest pain, persistent cough,
and blood with cough. Loss of appetite, loss of weight, wheezing and breathing problems are
common later. During advanced stages there may be joint pains, facial paralysis, eyelid drooping,
bone pains, should and nail problems. Since these signs are also indicative of other small diseases,
you need to consult your doctor for preventing the risk.
Doctors will ask you to take X-ray and CT scan or bronchoscopy for checking the lung cancer.
Treatment is available in several forms like surgery, radiotherapy, chemotherapy, photo dynamic
therapy and radiofrequency ablation. Surgery involves removal of cancer causing tumor from the
lungs. Depending on the size of tumor and its position, surgeons will open the chest wall and will
remove the cancer portion of the lobe and also the lymph nodes in the lungs.
Radiation therapy is best suited for both types of lung cancer, which uses high power radiation for
killing cancerous cells inside. Radiation therapy is combined with surgery or chemotherapy for
getting the best results. In chemotherapy drugs are given for stopping the growth of cancerous cells
inside.
http://diseasespictures.com/lung-cancer/
http://kisbyto.blogspot.hu/2012/11/lung-cancer-awareness-month.html
106
Risk group
Types of lung cancer
Causes of lung cancer
Symptoms
Diagnosis
Treatment
2. With the help of your notes above talk about lung cancer.
VOCABULARY
4.3.2 COPD (V)
Match the words (1-6) with the definitions (a-f).
1)
2)
3)
4)
5)
6)
springy __________
inflate __________
deflate__________
ephysema __________
chronic bronchitis __________
ebolectomy__________
a) in this disorder any irritant reaching the bronchi and bronchioles will stimulate an increased
secretion of mucus, the air passages become clogged with mucus, and this leads to a
persistent cough
b) in this disorder the delicate walls of the alveoli break down, reducing the gas-exchange area
of the lungs
c) emergency surgical removal of emboli which are blocking blood circulation
d) to become filled with gas or air
e) returning quickly to the original shape after being pushed, pulled, stretched
f) to become smaller because of air or gas coming out
http://en.wikipedia.org/wiki/Embolectomy
107
LISTENING
4.3.3 Chronic Obstructive Pulmonary Disease causes (L)
Watch the video and answer the questions.
Source: https://www.youtube.com/watch?v=2nBPqSiLg5E
1. What is COPD?
2. What are your airways and alveoli normally like?
3. What do the air sacs do when you inhale and exhale?


4. What is the leading cause of COPD?
5. What are the other causes of COPD?
6. What are the 2 main conditions of COPD?
7. What are the symptoms of emphysema?



8. What are the symptoms of chronic bronchitis?



9. Is damage done to the lung by COPD reversible?
10. What is the treatment for COPD?





http://www.tabletsmanual.com/wiki/read/pulmonary_emphysema_and_bronchitis
108
READING
4.3.4 COPD Quiz (R)
Test your knowledge about COPD. Circle the correct letters.
Question 1. COPD is a lung disease that:
A. usually starts during childhood and develops quickly
B. makes it hard to breathe and gets worse over time
C. is passed from person to person
Question 2. In the United States, the term "COPD" describes two main conditions in the
lungs:
A. emphysema and pulmonary hypertension
B. cystic fibrosis and chronic bronchitis
C. emphysema and chronic bronchitis
Question 3. The most common lung irritant that causes COPD is:
A. allergens
B. cigarette smoke
C. air pollution
Question 4. Common signs and symptoms of COPD include:
A. fever
B. an ongoing cough, or a cough that produces large amounts of mucus, and shortness of
breath
C. a racing heartbeat
Question 5. If you have COPD, which steps can you take to prevent complications and slow
the progress of the disease?
A. quit smoking and avoid secondhand smoke
B. avoid other lung irritants, such as air pollution, chemical fumes, and dust
C. follow your treatment plan for COPD exactly as your doctor prescribes
D. all of the above
http://www.nhlbi.nih.gov/health/health-topics/quizzes/copd-quiz.html
109
SPEAKING
4.3.5 Doctor- Patient conversation (S)
With a partner, act out the roles below.
Student A: You are a doctor.
Student B has been diagnosed
with COPD. You have to explain:




the condition
the severity of the
disease (Student B has
been a chain smoker for 5
years)
treatment options
tips to help him/her give
up smoking (nicotine
replacement therapy etc.)
Student B: You are a patient. You
are at your doctor’s office. You
want to know the diagnosis for
your constant cough, wheezing
and chest tightness. You ask
about:




the condition
the severity of the
disease
if the disease can be
healed
advice on how to give up
smoking
4.4 OTHER LUNG CONDITIONS AND ASTHMA
READING
4.4.1 Other lung conditions (R)
Read the description of the following lung conditions and match them with their names.
asthma
pulmonary embolism
tuberculosis
bronchiectasis
pneumonia
110
1.____________________ It is an infection in one or both of the lungs. Many germs—such as
bacteria, viruses, and fungi—can cause it. The infection inflames your lungs' air sacs. The air
sacs may fill up with fluid or pus, causing symptoms such as a cough with phlegm, fever, chills,
and trouble breathing.
http://www.nhlbi.nih.gov/health/health-topics/topics/pnu/
2.____________________ is a sudden blockage in a lung artery. The blockage usually is
caused by a blood clot that travels to the lung from a vein in the leg. A clot that forms in
one part of the body and travels in the bloodstream to another part of the body is called an
embolus.
http://www.nhlbi.nih.gov/health/health-topics/topics/pe/
http://healthcare.utah.edu/healthlibrary/related/doc.php?type=85&id=P01308
3. ____________________ chronic (long-term) lung disease that inflames and narrows the
airways. It causes recurring periods of wheezing (a whistling sound when you breathe),
chest tightness, shortness of breath, and coughing. The coughing often occurs at night or
early in the morning
http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/
111
4. ____________________ is a bacterial infection that can spread through the lymph
nodes and bloodstream to any organ in your body. It is most often found in the lungs.
The bacteria causing the disease can live in an inactive form in the body. But if the
immune system weakens, these bacteria can become active. In their active state, they
cause death of tissue in the organs they infect. Common symptoms include: a cough with
thick, cloudy, and sometimes bloody mucus from the lungs for more than 2 weeks, fever,
chills, and night sweats.
http://www.webmd.com/lung/tc/tuberculosis-tb-symptoms
5.____________________ This is a condition in which damage to the airways
causes them to widen and become flabby and scarred. This prevents the airways
from properly moving mucous out of your lungs. An infection or other condition
that injures the walls of the airways usually causes this disease .
http://www.nhlbi.nih.gov/health/health-topics/topics/cough/causes.html
Asthma
http://www.nlm.nih.gov/medlineplus/magazine/issues/fall11/articles/fall11pg4.html
112
LISTENING
4.4.2 Asthma (L)
1. Listen to the recording about asthma. Number the prompts in the order you hear them in the text.
Source: https://www.youtube.com/watch?v=7EDo9pUYvPE
_______ severity of symptoms
_______ asthmatic triggers
_______ the part of the body asthma affects
_______ what asthma causes
_______ onset of asthma
_______ what happens during breathing
2. Listen again and complete the sentences with the missing information.
a) Asthma is a 1._________________________, long-term condition that can be managed but
2. _________________________
b) It causes 3. _________________________ resulting in wheezing and difficulty breathing.
c) In asthma the airways are 4. _________________________ and easily irritated by certain
triggers called asthmatic triggers.
d) Most people with asthma are described 5. _________________________ meaning they have
an allergic-type reaction to external triggers.
e) External triggers are 6. _________________________, pollen, cigarette smoke, animal fur
and chest infections.
f) For some people the onset of asthma is 7. _________________________ and may be caused
by anxiety, stress or even laughter.
g) An asthmatic trigger causes the airway walls to swell and the muscles around the airways to
8. _________________________.
h) The airways narrow and breathing through them produces a whistling sound called 9.
_________________________.
i) Symptoms of asthma can be 10. _________________________ or life threatening, where
hospital treatment is needed.
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SPEAKING
4.4.3 Doctor-Patient conversation (S)
With a partner, act out the roles below.
Student A: You are a family
doctor. Your patient seems to
have asthma. You ask him/her
about:




family history of asthma
when and how often the
symptoms occur
what factors seem to
trigger the symptoms
recommend some tests
which are needed to
make a diagnosis (x-ray,
ECG, allergy test,
spirometry*
Student B: You turn to your family
doctor with asthma symptoms.
You are especially worried as your
mother has asthma, too. Talk
about:


your complaints
(wheezing, caugh,
difficulty breathing, 4
times a week, after doing
physical exercise or when
you are
stressed)
treatments to diagnose
your problem
*spirometry: Spirometry measures how much air you breathe in and out and how fast you blow it out. This is measured
two ways: peak expiratory flow rate (PEFR) and forced expiratory volume in 1 second (FEV 1). PEFR is the fastest rate at
which you can blow air out of your lungs. FEV1 refers to the amount of air you can blow out in 1 second. During the test, a
technician will ask you to take a deep breath in. Then, you'll blow as hard as you can into a tube connected to a small
machine. The machine is called a spirometer.
http://www.nhlbi.nih.gov/health/health-topics/topics/lft/types.html
114
4.5 VOCABULARY
ablation
air passages
alveolar
alveolus/alveoli
benign
bronchial
bronchiole
bronchitis
bronchus/bronchi
cartilage
cilium/cilia
cricoic cartilage
diaphragm
elastin
emphysema
epiglottis
epithelium
esophagus
flabby
frontal sinus
glottis
hyaline
hyoid bone
intercostal muscles
larynx
malignant
metastatic
mucous membrane
nares
nostril
pharynx
pleura
pus
ribcage
scarred
sinus
sphenoid
sphenoid sinus
squamous
sternum
superior concha
tertiary
eltávolítás
légutak
léghólyagocskákra vonatkozó
léghólyagocska
jóindulatú
hörgőbronchiolus, apró hörgő
hörghurut
hörgő
porc
csilló
gyűrűporc
rekeszizom
elasztin
tüdőtágulás
gégefedő
hám
nyelőcső
ernyedt
homloküreg
hangrés
hialin
nyelvcsont
bordaközti izmok
gége
rosszindulatú
áttétes
nyálkahártya
orrlyuk
orrlyuk, orrcimpa
garat
mellhártya
genny
bordakosár
forradásos, sebhelyes
melléküreg
ékcsont
sinus sphenoidalis
pikkelyes
szegycsont
felső orrkagyló
harmadlagos, tercier
115
thorax
thyroid cartilage
trachea
tuberculosis
turbinates
mellkas
pajzsporc
légcső
gümőkór
orrkagylók
116
UNIT 5. THE IMMUNE SYSTEM
Aims of the Unit
In this unit you will learn about:





the immune system,
autoimmune diseases,
organ transplantation,
celiac disease and
AIDS.
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5.1 OVERVIEW OF THE IMMUNE SYSTEM
VOCABULARY DEVELOPMENT
5.1.1 Brainstorming – Immune System (V)
In pairs, collect ideas to the topic ’Immune System’.
IMMUNE SYSTEM
VOCABULARY DEVELOPMENT
5.1.2 Basic terms (V)
Match the words (1-10) with the definitions (a-j)
1
2
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
3
4
5
6
7
8
9
10
11
immune response
natural killer cell (NK cell)
stem cells
immunocompromised
extracellular fluid
lymphocytes
B cell
thymus
T cell
immunological memory
immune tolerance
autoimmune disease
a) A state in which a person's immune system is weakened or absent.
b) A small white blood cell (leukocyte) that plays a large role in defending the body against
disease. They are responsible for immune responses.
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c) A type of white blood cell and, specifically, a type of lymphocyte. These cells make antibodies
that attack bacteria and toxins.
d) A type of white blood cell that attacks body cells themselves.
e) Any reaction by the immune system
f) A cell that can react against and destroy another cell without prior sensitization to it, it is part
of our first line of defense against cancer cells and virus-infected cells.
g) They are primitive cells that have the potential to differentiate, or develop into, a variety of
specific cell types.
h) The capacity of the body's immune system to remember an encounter with an antigen due
to the activation of B cells or T cells having specificity for the antigen and to react more
swiftly to the antigen by means of these activated cells in a later encounter.
i) An organ that is located in the upper chest behind the breastbone and in front of the lower
neck in which the immune cells called T lymphocytes mature and multiply in early life.
j) Body fluid that is not contained in cells. It is found in blood, in lymph, in body cavities lined
with serous membrane, in the cavities and channels of the brain and spinal cord, and in
muscular and other body tissues.
k) An illness that occurs when the body tissues are attacked by its own immune system. Some
examples
include
systemic lupus erythematosus,
Sjogren
syndrome,
Hashimoto thyroiditis, rheumatoid arthritis, juvenile (type 1) diabetes etc.
l) A state of unresponsiveness to a specific antigen or group of antigens to which a person is
normally responsive. It is achieved under conditions that suppress the immune reaction. The
T cell "tolerates" the antigen.
http://www.medicinenet.com/stem_cells/article.htm#what_are_stem_cells
http://search.medicinenet.com
http://www.britannica.com
READING
5.1.3 Function and location of the Immune System (R)
Read and complete the text with the missing words from the box.
pervasive
lymphocytes
immune response
innate immune cells
release
microbes
stems cells
infection
immunocompromised
autoimmune disease
lymph
precursors
The immune system is a network of cells, tissues, and organs that work together to protect the body
from 1. ____________________. The human body provides an ideal environment for many 2.
____________________, such as viruses, bacteria, fungi, and parasites, and the immune system
prevents and limits their entry and growth to maintain optimal health.
The overall function of the immune system is to prevent or limit infection. An example of this
principle is found in 3. ____________________ people, including those with genetic immune
disorders, immune-debilitating infections like HIV, and even pregnant women, who are susceptible to
a range of microbes that typically do not cause infection in healthy individuals.
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The immune system can distinguish between normal, healthy cells and unhealthy cells by recognizing
a variety of "danger" cues called danger-associated molecular patterns (DAMPs). Cells may be
unhealthy because of infection or because of cellular damage caused by non-infectious agents like
sunburn or cancer. Infectious microbes such as viruses and bacteria 4. ____________________
another set of signals recognized by the immune system called pathogen-associated molecular
patterns (PAMPs). When the immune system first recognizes these signals, it responds to address the
problem. If an 5. ____________________ cannot be activated when there is sufficient need,
problems arise, like infection. On the other hand, when an immune response is activated without a
real threat or is not turned off once the danger passes, different problems arise, such as allergic
reactions and 6. ____________________.
The immune system is complex and 7. ____________________. There are numerous cell types that
either circulate throughout the body or reside in a particular tissue. Each cell type plays a unique
role, with different ways of recognizing problems, communicating with other cells, and performing
their functions.
All immune cells come from 8. ____________________in the bone marrow and develop into mature
cells through a series of changes that can occur in different parts of the body.
Skin: The skin is usually the first line of defense against microbes. Skin cells produce and secrete
important antimicrobial proteins, and immune cells can be found in specific layers of skin.
Bone marrow: The bone marrow contains 9. ____________________ that can develop into a variety
of cell types. The common myeloid progenitor stem cell in the bone marrow is the precursor to 10.
____________________ —neutrophils, eosinophils, basophils, mast cells, monocytes, dendritic cells,
and macrophages—that are important first-line responders to infection.
The common lymphoid progenitor stem cell leads to adaptive immune cells—B cells and T cells—that
are responsible for mounting responses to specific microbes based on previous encounters
(immunological memory). Natural killer (NK) cells also are derived from the common lymphoid
progenitor and share features of both innate and adaptive immune cells, as they provide immediate
defenses like innate cells but also may be retained as memory cells like adaptive cells. B, T, and NK
cells also are called 11. ____________________.
Bloodstream: Immune cells constantly circulate throughout the bloodstream, patrolling for
problems. When blood tests are used to monitor white blood cells, another term for immune cells, a
snapshot of the immune system is taken. If a cell type is either scarce or overabundant in the
bloodstream, this may reflect a problem.
Thymus: T cells mature in the thymus.
Lymphatic system: The lymphatic system is a network of vessels and tissues composed of 12.
____________________, an extracellular fluid, and lymphoid organs, such as lymph nodes. The
lymphatic system is a conduit for travel and communication between tissues and the bloodstream.
Immune cells are carried through the lymphatic system and converge in lymph nodes, which are
found throughout the body. Lymph nodes are a communication hub where immune cells sample
information brought in from the body.
Spleen: It is important for processing information from the bloodstream. Immune cells are enriched
in specific areas of the spleen, and upon recognizing blood-borne pathogens, they will activate and
respond accordingly.
Mucosal tissue: Mucosal surfaces are prime entry points for pathogens, and specialized immune
hubs are strategically located in mucosal tissues like the respiratory tract and gut.
http://www.niaid.nih.gov/topics/immuneSystem/Pages/overview.aspx
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http://jo-dieta-sikeres-fogyas.hupont.hu/8/immunrendszer
LISTENING
5.1.4 Immune Response to Bacteria (L)
Listen to the recording and decide if the following statements are true (T) or false (F).
Source: http://www.youtube.com/watch?v=skPtWocTKdU
1)
2)
3)
4)
5)
6)
7)
8)
Tiny cuts on the skin can start an infection. _____
Inflammation at the wound site releases chemical signals. _____
Inflammation is a type of defense. _____
One layer below the damaged skin we can find neutrophils, which are a type of red blood
cells. _____
Neutrophils circulate in the blood stream looking for signals of infection and kill harmful
bacteria. _____
Outside the phagosome, the isolated bacteria are surrounded by swirling granules which
release killing elements into the phagosome. _____
Protein complexes generate clouds of deadly agents to help kill the bacteria, while other
granules continue to fuse with the phagosome, releasing many other different agents that
also contribute to killing the bacteria. _____
Within some minutes, the immediate threat to the body has been eliminated. _____
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SPEAKING
5.1.5 Immune System Boosters and Busters (S)
In pairs, discuss the following questions.
1. What kind of good habits can help keep your immune system healthy?
2. What are immune-boosting foods? Can you name them? Can you list some more?
1. _________________________
2. _________________________
3. _________________________
4. _________________________
5. _________________________
6. _________________________
http://www.webmd.com/cold-and-flu/10-immune-system-busters-boosters
3. Why does our immune system get weak?
4. What nutrients boost the immune system?
5. What nutrients make harm to the immune system?
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5.2 AUTOIMMUNE DISEASES
READING
5.2.1 Getting to know about autoimmune diseases (R)
1. How much do you know about autoimmune diseases? Can you name the conditions in the pictures?
http://www.bing.com/images/search?q=psoriasis&FORM=HDRSC2#view=detail&id=D5D6CBE6B85FB900930AB6FFFBC4BE79D5954AF7&selectedIndex=8
http://healthtohappinies.blogspot.hu/2012/02/identify-disease-diabetes-mellitus-dm.html
http://www.bing.com/images/search?q=First+Symptoms+Lupus&Form=IQFRDR#view=detail&id=592A25FA45B8DF714218296CBC4F67454867FA4A&selectedI
ndex=0
http://www.bing.com/images/search?q=Graves%27+Disease+Eye+Symptoms&Form=IQFRDR#view=detail&id=C895FCD242198623996DF1E1E1269CC2B483E9
91&selectedIndex=12
2. Can you name some more autoimmune diseases?
3. Test your knowledge about autoimmune diseases. Do the quiz below.
1. Which of these is an autoimmune disease?
A. Type 1 diabetes
B. Rheumatoid arthritis
C. Psoriasis
D. AIDS
E. A, B, and C
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2. If a person has an autoimmune disease, what happens with the immune system?
A. The person's immune cells die
B. Antibodies from the person's immune system mistakenly attack tissues in the body
C. The person's immune system produces too many immune cells
D. None of the above
3. Autoimmune diseases strike which group more often?
A. Children younger than 12
B. Men older than 40
C. Women of childbearing age
D. Women older than 50
4. What tissues, organs, or body systems can be affected by autoimmune diseases?
A. Skin
B. Joints
C. Thyroid
D. All of the above
5. Lupus is more common among women in which ethnic group?
A. Caucasians
B. African-Americans
C. Hispanics
D. B and C
6. How does a person develop an autoimmune disease?
A. It may be triggered by a virus, such as mumps
B. It may be a complication of an existing infection, such as strep throat
C. It may be caused by exposure to an environmental agent
D. Most do not have an obvious cause
E. All of the above
7. Why are some autoimmune diseases difficult to diagnose?
A. Symptoms may be vague
B. No specific lab tests exist to confirm a diagnosis
C. Symptoms may come and go, making it hard to pinpoint the problem
D. All of the above
8. Which of these autoimmune diseases can be cured?
A. Lupus
B. Multiple sclerosis
C. Scleroderma
D. None of the above
http://www.urmc.rochester.edu/encyclopedia/document.aspx?ContentTypeID=40&ContentID=AutoimmuneDiseaseChrQui
z
124
http://maciociaonline.blogspot.hu/2013/01/the-treatment-of-autoimmune-diseases.html
LISTENING
5.2.2 Multiple sclerosis (L)
1. Read the text about multiple sclerosis and try to complete it with the missing words. Then listen to
the recording and check your answers.
Source: https://www.youtube.com/watch?v=qgySDmRRzxY
Multiple sclerosis, MS is a disease that affects the central nervous system, the CNS, which consists of
the 1. _______________ , spinal cord, optic nerves. Everything we do, whether taking a step, solving
a problem or simply breathing relies on the proper functioning of the CNS. To understand how MS
may impact the CNS, we must explore the disease at the 2. _______________ level. In the brain
millions of nerve cells called 3. _______________ continually send and receive signals. Each signal is
a minute but necessary part of intricate CNS orchestrations that culminate in the actions, sensations,
thoughts and 4. _______________ that comprise the human experience. Normally, the path over
which a nerve signal travels is protected by a type of insulation called the myelin sheath. This
insulation is essential for nerve signals to reach their 5. _______________ . In MS the myelin sheath
is eroded and the underlying wirelike nerve fiber is also damaged. This leads to a breakdown in the
ability of the nerve cells to 6. _______________ signals. It is believed that the loss of the myelin is
the result of mistaken 7. _______________ by immune cells. Immune cells protect the body against
foreign substances such as bacteria and 8. _______________, but in MS something goes awry.
Immune cells infiltrate the brain and spinal cord, seek out the myelin and attack as ongoing
125
inflammation and tissue 9. _______________ occurs. Nerve signals are disrupted, this causes
unpredictable symptoms that range from numbness to blindness and paralysis. These losses may be
temporary or 10. _______________ .
2. What is MS due to? Explain it in your own words.
3. Read the text below about types and diagnosis of MS then sum it up in your own words.
Types of Multiple Sclerosis
Multiple sclerosis may appear in several forms. The types of MS include:
Relapsing-remitting: This form of multiple sclerosis comes and goes over time. Symptoms can be
severe for a time but then disappear. About 85 percent of multiple sclerosis patients develop onset
of the disease in this manner (Murray, T., et al., 2013).
Secondary-progressive: After the initial attack, the disease may begin to progress in a more
deliberate way. In this type of MS, symptoms do not subside. Before new therapies were created,
about 50 percent of people with multiple sclerosis entered a progressive stage. However, the
effectiveness of the new therapies has not been fully evaluated (Murray T., et al, 2013).
Primary-progressive: People who develop this form of the disease generally do so later in life. They
decline slowly, without many ups and downs.
Progressive relapsing: In this form of multiple sclerosis, symptoms initially progress slowly but
eventually worsen over time.




How Is Multiple Sclerosis Diagnosed?
There is no definitive diagnosis for multiple sclerosis. Doctors determine whether you have it by
ruling out other illnesses. They do this by evaluating your symptoms, performing a clinical exam, and
ordering tests. Tests that may point to a possible multiple sclerosis diagnosis include:
Magnetic resonance imaging (MRI): MRIs allow doctors to identify lesions in your brain or spinal
cord, which could indicate myelin loss.
Spinal tap: The fluid in your spine can offer clues about whether your body is experiencing an
immune response. Spinal fluid abnormalities are often present in a diagnosis of the disease.
Evoked potential test: This test uses visual cues or electrical impulses to determine how efficiently
your brain responds to stimuli.
Blood tests: Blood tests may rule out other disorders.
http://www.healthline.com/health/multiple-sclerosis
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http://www.medimiss.net/2013/12/common-symptoms-of-multiple-sclerosis.html
http://www.jennifersweeney.ca/2013/09/14/my-first-clear-sign-of-multiple-sclerosis/
127
4. Listen to the recording about ’How to manage symptoms of relapsing-remitting MS’ and fill in the
table with the information from the audio.
Source: http://www.youtube.com/watch?v=sOKKT--eC4c
Symptoms
The most common
form of MS/severity of
symptoms
Areas of life MS may
affect
Treatment
Activities to help ease
MS
Most important things
to do
5. With the help of your notes speak about ’How to manage relapsing-remitting MS’.
SPEAKING
5.2.3 Living with MS (S)
In pairs, discuss the following questions.





How can people feel diagnosed with MS?
What can their reactions be?
How can their parents, partners, children react to the diagnosis?
Is there a right/wrong time or way to tell the diagnosis to parents, partners and children?
What kind of questions would you expect as a doctor from your patient after being
diagnosed with MS?
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LISTENING
5.2.4 Coping with MS diagnosis (L)
1. Watch the video about ’Coping with a diagnosis of MS’. What do the people in this video talk
about?
Source: https://www.youtube.com/watch?v=_cyjphUUNVE#t=210
2. Watch the video again and answer the questions below!

How did the people in the video react to the diagnosis? Give examples.

How did their family members, friends react?

What kind of changes did they have to do in their lives?
3. Was there anything in the video that surprised you? If yes, what?
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WRITING
5.2.5 Giving advice (W)
You have just read Lucy’s letter on Patient.co.uk discussion forum. She finds it very difficult to tell her
parents that she has MS. Reply to her in 170-180 words.
Mention
 the reasons why she should tell her parents that she has MS
 the possible reactions that her parents might have
 the changes she will have to make over time in her life and the role of the family in that
 some good advice on how to relate to her condition
Ok, this is what I'm most concerned about for a different reason to what you may all be
thinking!!
I've had severe arthritis in my knees and spine for the last 32yrs, since I was a child - it
absolutely disables and floors me, completely!! Turns out, that this could actually have been
MS all along....now along the way I've had a few problems with my health and whenever I've
actually tried to say anything to my parents - They've always been sicker than me, in more pain
than me, on more pills than me....it has got to the point where I haven't even told them about
all of my tests over the last 3 years; the biopsies due to bleeding and pain 'downstairs', the XRays, the ECG's, the many different Specialists appointments....and lastly, the more scary....the
Brain Scan!! Very Scary!! I have my Husband with me at every appointment, which is all I
need.....but I'm working myself up about telling my Parents!! My whole life I've been talked
over by her & ignored and it has left me not wanting to tell them anything really! I've been left
with no choice because I know that she is talking about me behind my back to the family - that
I don't do anything to help them etc., but I'm in such a state every time I've helped them - even
the 3hr round trip to see them makes me so ill......what do you all suggest....I've already got it
into my head to tell them not to interrupt me while I tell them something......it's driving me
insane!
Lucy 523
http://www.patient.co.uk/forums/discuss/how-did-you-all-tell-your-parents-that-you-had-ms-145026
130
SPEAKING
5.2.6 Talking about MS (S)
With the help of the prompts, talk about Multiple Sclerosis.







part of the body it affects
damage done to the nerves
types of MS
common symptoms
diagnosis
treatment
recommended activities for MS patients to ease the symptoms
5.3. ORGAN TRANSPLANTATION
VOCABULARY DEVELOPMENT
5.3.1 Background Vocabulary (V)
Match the words (1-9) with the definitions (a-h).
1
1)
2)
3)
4)
5)
6)
7)
8)
9)
2
3
4
5
6
7
8
9
transplantation
donor
recipient
graft/transplant
implantation
HLA (human leukocyte antigen) antigen
„match”
rejection
donation
a. The insertion of an organ or tissue in a new site in the body.
b. They are proteins that are located on the surface of the white blood cells and other tissues in the
body, determining graft/host tissue compatibility (by identification of ’self’ or ’non self’ tissue
moieties) and allowing tissue typing.
131
c. When two people share the same Human Leukocyte Antigens, that is, their tissues are
immunologically compatible with each other.
d. To transfer tissue or an organ from one body or body part to another.
e. One who receives a blood transfusion, or a tissue or organ graft.
f. Any tissue or organ for implantation or transplantation.
i. An individual from whom blood, tissue, or an organ is taken for transfusion, implantation, or
transplantation.
g. The act of giving.
h. The immune reaction of a recipient to a graft after transplantation.
http://medical-dictionary.thefreedictionary.com
SPEAKING
5.3.2 Organ Transplantation - Frequently Asked Questions (S)
In pairs, discuss the following questions.

What organs can be donated for transplantation?

Is there a need for organ and tissue donors?

Who can become a donor?

What is living donation and what organs can be donated while one is alive?

Is there an age limit for donating organs?

Will the identity of the recipients be revealed to the donor family?

What is meant by brain death?

What do you personally think about donating organs? Would you become a donor?
READING
5.3.3 The Immune System and Organ Transplant (R)
Read the text about ‘Organ Transplant’ and answer the questions below.
Some people may have diseases that lead to organ failure, or they may have suffered an injury that
would require an organ transplant. Major organs that may be transplanted include:




Heart
Lungs
Kidneys
Pancreas
132


Liver
Intestines
While many organ transplants are successful, there is still a chance that the recipient's immune
system will reject the transplanted organ. Before a patient can have an organ transplant, they will
take a blood test that will allow doctors to perform tissue typing. This lets doctors check the
compatibility between donor and recipient tissues by comparing HLA markers.
Because everyone’s HLA markers are different, with the exception of identical twins, matches must
be as close as possible. Without a close match, the organ will be rejected, and T cells will begin their
attack. There are three types of organ rejection:



Hyperacute rejection — Rare, but can occur within minutes of a transplant.
Acute rejection — Can occur a few weeks after a transplant, but the greatest risk is within the
first six months after the transplant.
Chronic rejection — Can occur months after a transplant. The cause is unknown, but it may be
linked to non-adherence to antirejection medications.
Regardless of how well-matched a donor and recipient are, the recipient’s body will still try to reject
the new organ since it is made completely of foreign cells. Fortunately, there are ways for patients
and doctors to work together to prevent rejection or infection. While treatments and health care will
vary depending on the organ transplanted and the patient, most recovery programs will involve
similar care.
To prevent rejection, immunosuppressant drugs will be given to decrease the body’s normal immune
response. These drugs will need to be taken for the rest of the patient’s life. Since these drugs reduce
the immune system’s ability to fight other types of infections, a combination of antiviral, antifungal,
and antibiotic medications may also be prescribed. Medications may have a number of side effects,
such as headache, nausea, and weight gain. They may also cause problems such as high blood
pressure or high cholesterol. There is also an increased risk of cancer as a result of suppressing the
immune system. However, the risk of cancer may vary depending on different factors such as which
medications are chosen, age, or whether there is a family history of cancer.
Some women worry about becoming pregnant after an organ transplant. While there are risks
involved, particularly during the first year after surgery when the risk of rejection is highest, many
women have successfully had children after their transplant. Those who plan to receive organ
transplants are required to stop smoking or using other drugs and alcohol in order to stay on the
waiting list for an organ transplant. After surgery, some may find it hard to avoid old habits.
http://www.med.nyu.edu/content?ChunkIID=524642
1) In what cases may an organ transplant be necessary?
2) What do doctors do before a patient can get an organ transplant?
3) Whose HLA markers are the same?
4) What kind of organ rejections are there?
5) What is expected after an organ transplant?
6) How is rejection pervented?
7) What are the dangers of immunosuppresant drugs?
8) What additional health concerns can occur after an organ transplant?
133
5.4 FOOD ALLERGY
VOCABULARY DEVELOPMENT
5.4.1 Major allergenic foods (V)
A group of the eight major allergenic foods is often referred to as the Big-8. What does it comprise?
Look at the pictures. Can you name them?
1. _________________
2. _________________
3. _________________
4. _________________
5. _________________
6. _________________
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7. _________________
8. _________________
http://farrp.unl.edu/informallbig8
LISTENING
5.4.2 Understanding food allergy (L)
1. Decide if the following statements are true (T) or false (F).
1) Food allergies are not real. _______
2) Food allergies are not life threatening. _______
3) Food additives and artificial flavors cause the majority of food allergic reactions. _______
4) Each allergic reaction to food becomes increasingly worse. _______
http://farrp.unl.edu/resources/gi-fas/food-allergy-myths
2. Listen to the following recording about ’food allergy’ and answer the questions below.
Source: http://www.youtube.com/watch?v=AKVjKC3u9hk
135
1) What kind of antibody does the immune system make if you have food allergy?
2) What kind of cells are mast cells or basophils?
3) What happens when a food allergen attaches to the IgE antibody?
4) When does an allergic reaction occur?
5) What is the most severe kind of allergic reaction is called?
6) Who are more susceptible to severe reactions?
7) What is an anaphylactic episode is treated with?
8) What kind of medical device is prescribed to people diagnosed with food allergy?
9) What is the best way to manage allergic reactions?
10) What should a patient do who is accidentally exposed to a food allergen?
READING
5.4.3. Food Allergy – Everything you need to know (R)
Read the text about ’Food Allergy’ and fill in the table below then talk about food allergy with the
help of your notes.
The job of the body’s immune system is to identify and destroy germs (such as bacteria or viruses)
that make you sick. A food allergy results when the immune system mistakenly targets a harmless
food protein – an allergen – as a threat and attacks it. Unlike other types of food disorders, such
as intolerances, food allergies are “IgE mediated.” This means that your immune system produces
abnormally large amounts of an antibody called immunoglobulin E — IgE for short. IgE antibodies
fight the “enemy” food allergens by releasing histamine and other chemicals, which trigger the
symptoms of an allergic reaction.
An allergic reaction to food can affect the skin, the gastrointestinal tract, the respiratory tract, and, in
the most serious cases, the cardiovascular system. Reactions can range from mild to severe, including
the potentially life-threatening condition known as anaphylaxis.
Symptoms typically appear within minutes to several hours after eating the food to which you are
allergic. A person with a food allergy cannot tolerate even small amounts of the culprit food, as is the
case with peanuts.
Mild symptoms may include one or more of the following: hives (reddish, swollen, itchy areas on
the skin), eczema (a persistent dry, itchy rash), redness of the skin or around the eyes, nausea or
vomiting, diarrhea, stomach pain, nasal congestion or a runny nose, sneezing, slight, dry cough, odd
taste in mouth, uterine contractions
136
Severe symptoms may include one or more of the following: obstructive swelling of the lips, tongue,
and/or throat, trouble swallowing, shortness of breath or wheezing, turning blue, drop in blood
pressure, loss of consciousness, chest pain.
The first step an allergist will take to diagnose a food allergy is a thorough medical history. The
allergist will ask questions to determine if food allergy may be causing your symptoms and to identify
the culprit food(s), and will then perform a physical exam. Next, the allergist may conduct tests to
help identify a food allergy. These tests may include:
 Skin prick test
 Blood test
 Oral food challenge
 Trial elimination diet
Several factors make diagnosis difficult. The reaction may depend on the amount of food consumed,
the presence of other foods that can slow digestion, and medications such as antihistamines that
may hide reactions. The proteins -- the antigens within the food or drink that cause the allergy -- may
be altered by cooking or processing in some way. The antigens may be in only part of the food, such
as the skin of an apple. Some are present only at a particular stage of ripeness.
The treatment or management of IgE-mediated food allergies can be approached in two different
ways. First, allergic reactions can be treated pharmacologically to resolve the symptoms. But, second
and preferably, the avoidance of the allergenic food(s) will prevent the occurrence of allergic
reactions. For patients at risk of experiencing a severe reaction (anaphylaxis), epinephrine is
prescribed. Epinephrine is the only medication that can reverse the symptoms of anaphylaxis.
From 3 percent to 8 percent of children have reactions to some foods. Only 1 percent to 2 percent
have true food allergies. Some children seem to grow out of their sensitivity to certain foods, often
by age 4. Allergies to peanuts, tree nuts and shellfish usually do not go away, though.
From 1 percent to 2 percent of adults have true food allergies. But people of any age can have
sudden allergic reactions to a food that had previously not been a problem for them.
http://www.aafa.org/display.cfm?id=9&sub=20&cont=286
http://www.foodallergy.org/diagnosis-and-testing
FOOD ALLERGY
Onset of symptoms
Amount of food eaten
Causes
Symptoms
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Severity of symptoms
Diagnosis
Treatment
Prevalence in population
LISTENING
5.4.4 Type-1 Hypersensitivity: IgE mediated food allergy (L)
Listen to the recording and complete the text with the missing words.
Source: https://www.youtube.com/watch?v=gafekFEbUg4
Some people develop an allergic reaction or hypersensitivity when exposed to substances such as
dust, pollens, 1. ____________________ or penicillin. This hypersensitivity is mediated by IgE.
Sensitization occurs when the antigen makes contact with some part of the body. The antigen is
taken up, processed by 2. ____________________ and presented on a class II MHC to T-helper cells.
Tissues under the mucous membranes are rich in B cells committed to IgE production and IgE
producing cells are more abundant in person 3. ____________________ to allergies. The T-helper
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cells produce cytokines which stimulate these B cells to 4. ____________________ and differentiate
into IgE producing plasma cells. As IgE is produced in different parts of the body, the IgE molecules
attached via their constant regions to 5. ____________________ on nearby mast cells. Mast cells
contain granules packed with chemicals that 6. ____________________ a hypersensitivity response.
Once attached to the IgE, molecules can survive for many weeks. The individual is now sensitized to
the antigen. When exposed to the antigen for a second time, the antigen binds to the IgE antibodies
on the mast cells. To trigger a response, two cell bound IgE molecules must react with a specific
antigen. Within seconds of the reaction, the mast cell 7. _____________________ histamine and
other mediators of the inflammatory response from the granules triggering a variety of symptoms:
capillary dilation, 8. _____________________, mucus secretion, pain, itching.
SPEAKING
5.4.5. Communicating with the patient (S)
1. Read the following sentences and write D after the ones that are said by a doctor or P said by a
patient.
Your test results have come in. _____
I'm afraid the prognosis isn't good. _____
You have a long road to recovery. _____
I don't understand what this means. _____
Am I going to need surgery? _____
We have several options to discuss. _____
When will the tests results come in? _____
How long do I have to stay in the hospital? _____
The blood test came back negative. _____
The transfusion was a success. _____
It looks like you're ready to go home. _____
Is it good news or bad? _____
I'd like to keep you here over night. _____
We'll know more in a few days. _____
You're not in the clear yet. _____
We've ruled out diabetes. _____
I'm hoping to get to the bottom of this soon. _____
What is the success rate? _____
Are they going to run more tests? _____
Is this a common problem for people my age? _____
I'm going to get a second opinion. _____
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2. Read the sample conversation and answer the questions below.
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Patient:
Doctor:
Hi Jessica. How are you feeling today?
A bit better.
That's good to hear. Are you still feeling nauseous?
No, I haven't felt sick to my stomach since you switched my medication.
Great. Say, your test results came in this morning.
It's about time. Is it good news or bad?
I guess it's a bit of both. Which do you want first?
Let's get the bad news over with.
Okay. It looks like you're going to need surgery to remove the tumour from your leg. After the
operation you're going to have to stay off your feet for at least three weeks. That means no
soccer.
I was afraid you were going to say that.
Now for the good news. The biopsy shows that the tumour is benign, which means it's not
cancerous. We're going to take it out anyway just to be on the safe side.
Wow, that's a load off my mind. Thanks Doctor.
Don't get too excited. We still need to get to the bottom of all of this weight loss.
I've probably just been so worried about this stupid lump.
These things often are stress related, but we're still going to do a few blood tests just to rule a
few things out.
Things like what? Cancer?
Actually, I'm thinking more along the lines of a food allergy.
1) Why did the woman have to switch medication?
2) What bad news does the doctor give the patient?
3) What medical procedure did the patient already undergo?
http://www.englishclub.com/english-for-work/medical-diagnosis.htm
3. With a partner, act out the roles below.
Student A: Miután tejtermékeket
fogyaszt erős hasi görcs,
hasmenés, hasfájás, puffadás
jelentkezik Önnél. A tünetek fél-2
óra elteltével jelentkeznek. Most
az orvosához fordul tanácsért.
Mondja el a panaszát és
érdeklődjön a lehetséges
vizsgálatok, kezelések felől.
Student B: Ön orvos. Betege
laktóz érzékenységre utaló
panaszokról számol be. Utalja be a
megfelelő vizsgálatokra, és amíg
az eredmények meg nem
érkeznek, javasoljon diétát. Kérje
meg betegét, hogy vezessen
naplót arról, amit eszik,
megjelölve a tünetek
jelentkezését, súlyosságát.
Mondja el, hogyan lehet a
tejtermékeket helyettesíteni, hol
lehet ilyen termékeket beszerezni.
*
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*Get a Diagnosis:

to keep a diary of the foods you eat

Hydrogen Breath Test: Normally, people have very little hydrogen in their breath. If your body doesn't
digest lactose, though, hydrogen builds in your intestines, and after a while it's in your breath. This
test measures how much hydrogen is in your breath after you have a lactose-loaded drink several
times in a few hours.

Lactose Tolerance Test: When your body breaks down lactose, it releases sugar into your blood. This
test shows how much sugar is in your blood.
http://www.webmd.com/digestive-disorders/lactose-intolerance-14/diagnosing
READING
5.4.6 Celiac disease (R)
Read the text below and complete it with the missing words from the box.
gluten-free
grow out
ingestion
epilepsy
dermatitis
herpetiformis
gluten
predisposed
villi
Celiac disease is an autoimmune disorder that can occur in genetically 1. ____________________
people where the 2. ____________________ of gluten leads to damage in the small intestine. When
eaten by someone with the disease, gluten damages the small finger-like protrusions, or 3.
____________________, that make up the lining of our small intestines (see illustration below).
Celiac disease can develop at any age after people start eating foods or medicines that contain 4.
____________________. Left untreated, celiac disease can lead to additional serious health
problems. These include the development of other autoimmune disorders like Type I diabetes and
multiple sclerosis (MS), 5. ____________________ (an itchy skin rash), anemia, osteoporosis,
infertility and miscarriage, neurological conditions like 6. ____________________and migraines,
short stature, and intestinal cancers. Currently, the only treatment for celiac disease is lifelong
adherence to a strict 7. ____________________ diet. The amount of time it takes to feel better after
going gluten-free is different for every person. Some people feel the results right away, but others
need weeks or months to feel results. Unfortunately, it is not possible to 8. ____________________
celiac disease.
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http://celiac.org/celiac-disease/what-is-celiac-disease/
http://archive.constantcontact.com/fs141/1102093008750/archive/1114178442128.html
SPEAKING
5.4.7 Celiac disease: giving advice (S)
With a partner, act out the roles below.
Student A: You are a doctor.
Student B’s child has been
diagnosed with celiac disease. Talk
to him/her about:






the disease
long term health effects
where to buy gluten-free
products
the importance of
avoidance diet*,
grains that have gluten
Student A should have a
gluten test himself/herself
Student B: Your child has been
diagnosed with celiac disease. You
consult your doctor about:






the disease
the diet (which grains have
gluten vs. safe grains)
where to buy such products
how much gluten is too
much
should you be tested
yourself
if the disease can be
outgrown
(*people with celiac disease can handle up to 10 milligrams of gluten — the equivalent of 1/8th of a
teaspoon of flour without any harm even on a daily basis, more than that on a daily basis can add up
142
causing severe diarrhea and vomiting, and increase villous atrophy. Wheat, barley, and rye should be
avoided.)
http://celiacdisease.about.com/od/PreventingCrossContamination/f/How-Much-Gluten-Can-Make-MeSick.htm
5.5. AIDS
SPEAKING
5.5.1 FAQ (S)
In small groups, discuss the following questions.
1) What does the abbreviation AIDS stand for?
2) What causes AIDS?
3) What is HIV?
4) What does HIV stand for?
5) How do you get HIV or AIDS? Look at the pictures. They can give you clues.
http://aids.gov/hiv-aids-basics/hiv-aids-101/how-you-get-hiv-aids/
6) How long does it take HIV to cause AIDS?
7) What is the connection between HIV and other sexually transmitted diseases?
8) What means would you use in order to minimize the risk of AIDS?
9) How many people have HIV and AIDS?
10) If a pregnant woman is HIV+, the baby will be HIV+ too. Is it true or false?
11) Can mosquitoes transmit the HIV virus?
12) When is World AIDS Day observed?
http://www.aids.org/topics/aids-faqs/
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VOCABULARY DEVELOPMENT
5.5.2 Frequent words in connection with AIDS (V)
Find the matching pairs. Write the correct numbers into the table below.
a
b
c
deficiency
needle
breastfeed
1
2
3
d
e
f
transmit
saliva
stage
4
5
6
g
lesion
7
h
affect
8
i
motor loss
9
j
dementia
10
a
b
c
d
a separate part that a process, etc. is divided into
to attack somebody or a part of the body
a serious mental disorder caused by brain disease or
injury, that affects the ability to think, remember
and behave normally
the state of not having something that is essential
it is a disorder that affects the ability to move
a very thin, pointed piece of steel used on the end
of a syringe for putting a drug into somebody's
body, or for taking blood out of it
the liquid that is produced in your mouth that helps
you to swallow food
when a woman feeds her baby with milk from her
breasts
damage to the skin or part of the body caused by
injury or by illness
to pass something from one person to another
e
f
g
h
i
j
LISTENING
5.5.3 Everything you need to know about AIDS (L)
Listen to the recording about AIDS and complete the sentences with the missing information. The
lines indicate the number of words missing.
Source: https://www.youtube.com/watch?v=rv0yIICeg-E
AIDS stands for ’Acquired Immune Deficiency Syndrome’, which means deficient immune system.
You get AIDS after becoming infected with the HIV virus. You get infected with the virus by unsafe
sex, 1. __________ __________ __________ of an infected person, for example by using a
contaminated injection needle. From mother to child during 2. _______________, childbirth or
breastfeeding. Because the virus is transmitted through: blood, sperm, vaginal fluids, pre-seminal
fluids,3. ________________. You don’t have the risk of becoming infected with the virus by saliva
or shaking hands. When you have HIV virus, but aren’t symptomatic yet, you are ’sero-positive’.
That means that there are HIV 4. __________ __________ ____________ __________. You don’t
need to have any signs of disease yet. An HIV infection passes through four stages. In the first
stage, the body can show signs of disease like 5. __________ __________ and swollen glands,
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while some people, who are infected, remain asymptomatic in the first stage. In the second stage,
recurring 6. __________ infections, skin, mouth, and genital lesions often occur. In the third
stage, you may have complaints like prolonged diarrhea, excessive 7. __________ __________,
tuberculosis in the lungs, and other serious infections like meningitis. Finally, besides serious
infections, the nervous system may be affected in the fourth stage, which can result in motor loss
or AIDS related dementia. It may take 8. ______ _______ ______ ______ before you know that
you have got AIDS. This is because it sometimes takes longer for symptoms to occur. HIV and AIDS
can be treated with 9. ___________ , but can’t be cured. Antiretrovirals slow down the
multiplication of the virus, but doesn’t kill it. To support the treatment, AIDS patients often get
medications to 10. ___________ the immune system and fight against infections. You can prevent
AIDS by having safe sex and using clean needles.
SPEAKING
5.5.4 Talking about AIDS (S)
With the help of the prompts talk about AIDS.







meaning of AIDS/HIV
route of transmission
risk groups
early symptoms
stages
treatment
prevention
145
5.6 VOCABULARY
animal dander
atrophy
basophil
converge
crustacean
define
dilation
extracellular fluid
food challenge
go awry
granule
hub
induce
ingestion
insulation
lupus
lymph
lymphocytes
lymphoid
mast cell
moiety
neutrophil
obstructive
optic nerve
phagocytosis
platelet
precursor
prevalence
prick
progenitor
proliferate
serous
susceptible
swirling
thymus
uterine
állati szőr
sorvadás
bazofil
összefut
héjas állat
korlátoz, határt szab
tágulás
extracelluláris folyadék
ételpróba, ételterhelés
fonákul üt ki, rosszul megy
granula, szemcse
csomópont
indukál, előidéz
fogyasztás, elfogyasztás
szigetelés, szigetelőanyag
lupus
nyirok
limfociták
nyirokhízósejt
felerész
neutrophil, neutrophil leukocyta
obstruktív, gátló, akadályozó
látóideg
fagocitózis
trombocita, vérlemezke
prekurzor, elővegyület
előfordulás gyakorisága, prevalencia
szúrás
ős, előd
osztódással szaporodik, osztódik
savós
hajlamos, fogékony
örvénylő
csecsemőmirigy
méh-
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147