Unit 1
Pre-text assignments
1 Learn the key words:
ligament, cartilage, joint, framework, tendon, bone, lever, limb
2 Translate the following phrases:
a set of interrelated organs, specialized functions, protective
shields, rigid structures, longitudinal axes, expanded ends, platelike
structures
3 Choose the correct definition of the following terms:
1) bone
a) an aggregate of cells together with their
intercellular substance
2) limb
b) the point of contact between elements of the
skeleton
3) tissue
c) the hard largely calcareous tissue
4) joint
d) a leg or arm of a human being
Skeletal System
The human organism consists of several organ systems. Each
system includes a set of interrelated organs that work together to
provide specialized functions.
The organs of the skeletal and muscular systems function to
support and move body parts.
The skeletal system consists of the bones as well as the ligaments
and cartilages that bind the bones together at joints. These parts
provide frameworks and protective shields for softer tissues, serve as
attachments for muscles, and act together with muscles when body
parts move. Tissues within bones also function to produce blood cells
and store inorganic salts.
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Bones
Bones are composed of several kinds of tissues, and thus they are
the organs of the skeletal system.
Because bones are rigid structures, they provide support and
protection for softer tissues, and they act together with skeletal
muscles to make body movements possible. They also house the
tissue that produces blood cells, and they store inorganic salts.
The shapes of individual bones are closely related to their
functions. Projections provide places for the attachment of muscles,
tendons, and ligaments; openings serve as passageways for blood
vessels and nerves; and the ends of bones are modified to form joints
with other bones.
Bones can be classified according to their shapes - long, short, flat,
or irregular.
Long bones have long longitudinal axes and expanded ends.
Examples are the arm and leg bones.
Short bones are somewhat cube like, with their lengths and widths
roughly equal. The bones of the wrists and ankles are examples of
this type.
Flat bones are platelike structures with broad surfaces, such as the
ribs, scapulae, and bones of the skull.
Irregular bones have a variety of shapes and are usually connected
to several other bones. Irregular bones include the vertebrae that
comprise the backbone and many of the facial bones.
In addition to these four groups of bones, some authorities
recognize a fifth group called the round or sesamoid bones. The
bones of this group are usually small, and they often occur within
tendons adjacent to joints, where the tendons undergo compression.
The kneecap (patella) is an example of a very large sesamoid bone.
Functions of Bones
Skeletal parts provide shape, support, and protection for body
structures. They also act as levers that aid body movements, house
tissues that produce blood cells and store various inorganic salts.
Bones give shape to structures such as the head, face, thorax, and
limbs. They also provide support and protection. For example, the
bones of the feet, legs, pelvis, and backbone support the weight of
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the body. The bones of the skull protect the eyes, ears, and brain.
Those of the rib cage and shoulder girdle protect the heart and lungs,
while bones of the pelvic girdle protect the lower abdominal and
internal reproductive organs.
Although the number of bones in a human skeleton is often
reported to be 206, the actual number varies from person to person.
Some people lack certain bones, while others have extra ones. For
example, the flat bones of the skull usually grow together and
become tightly joined along irregular lines called sutures.
Occasionally extra bones called wormian or sutural bones develop in
these sutures. Also, extra small, round sesamoid bones may develop
in tendons, where they function to reduce friction in places where
tendons pass over bony prominences.
Post-text assignments
1 List four groups of bones, based upon their shapes, name an
example from each group.
2 Build medical terms. Choose them from the list below:
1 Abnormal condition of porous bones. 2 Inflammation of bone and
bone marrow. 3 Dead bone tissue. 4 A disease in which there is
enlargement of the bones of the head, hands and feet resulting from a
tumor of the putuitary gland that causes overproduction of growth
hormone. 5 An instrument for recording muscular contractions.
(a – ...graph; b – osteomyel...; c – ...porosis; d – sequestrum; e –
...megalia)
3 Match the descriptions and functions listed in column 1 with
bones listed in column II (Drawings 1, 2):
I
II
1) coronoid process
a) ethmoid bone
2) cribriform plate
b) frontal bone
3) foramen magnum
c) mandible
4) mastoid process
d) maxillary bone
5) palatine process
e) occipital bone
6) sella turcica
f) temporal bone
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the
7) supraorbital notch
8) temporal process
9) acromion process
10) deltoid tuberosity
11) greater trochanter
12) lateral malleolus
13) medial malleolus
14) olecranon process
15) radial tuberosity
16) xiphoid process
g) sphenoid bone
h) zygomatic bone
i) femur
j) fibula
k) humerus
l) radius
m) scapula
n) sternum
o) tibia
p) ulna
Unit 2
Pre-text assignments
1 Learn the key words and phrases:
joint, junction, lever system, to bend, to straighten, rigid structure,
fibrous joints, cartilaginous joints, synovial joints, immovable,
slightly movable, freely movable joints
2 Build medical terms:
1 Inflammation of joints. 2 Inflammation of bone and joints. 3
Abnormal condition of pus in a joint. 4 Any of various immovable
articulations, or joints (as in suture joints of the skull). 5 A freely
movable joint; any articulation, as of the hip, permitting free
movement in any direction. 6 Neuralgic pain in a joint or joints.
(a – synarthr...; b – ...itis; c – ...arthritis; d – arthro...osis; e –
dia…osis; f – arthr...ia)
Joints of the Skeletal System
Joints are the junctions between the bones of the skeletal system.
That is, a joint occurs wherever two or more bones come together.
Most joints function in lever systems that make movements possible
by bending or straightening. Others, however, are relatively rigid
structures that help hold bones in place or enable bones to grow.
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Wherever two or more bones meet, a joint is formed. Such joints,
or articulations, represent the functional junctions between bones.
They bind various parts of the skeletal system together, allow bone
growth to occur, permit certain parts of the skeleton to change shape
during childbirth, and enable body parts to move in response to
skeletal muscle contractions.
Classification of Joints
Although joints vary considerably in structure and function, they
can be classified according to the type of tissue that binds the bones
together at eachjunction. On this basis, three general groups can be
identified - fibrous joints, cartilaginous joints, and synovial joints.
Joints can also be grouped according to the amount of movement
possible at the bony junctions. In this scheme, joints are classified as
immovable (synarthrotic), slightly movable (amphiarthrotic), and
freely movable (diarthrotic).
Types of Joint Movements
Movements at synovial joints are produced by actions of skeletal
muscles. Typically, one end of a muscle is attached to a relatively
immovable or fixed part on one side of a joint, and the other end of
the muscle is fastened to a movable part on the other side. When the
muscle contracts, its fibers pull its movable end (insertion) toward its
fixed end (origin), and a movement occurs at the joint.
Post-text assignments
1 Give full answers to the following questions:
1 How would you explain to an athlete why damaged joint
ligaments and cartilages are so slow to heal following an injury?
2 Compared to the shoulder and hip joints, in what way is the knee
joint poorly protected, and thus especially vulnerable to injuries?
3 Based upon your knowledge of joint structures, which do you
think could be most satisfactorily replaced by a prosthetic device, a
hip joint or a knee joint? Why?
4 If a patient's lower arm and elbow were immobilized by a cast for
sevcral weeks, what changes would you expect to occur in the bones
of the arm?
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5 Why is it important to encourage an inactive patient to keep all
joints mobile, even if it is necessary to have another person or a
device move the joints (passive movement)?
6 How would you explain to a person with a dislocated shoulder
that the shoulder is likely to become dislocated more easily in the
future?
2 Match the movements in column I with the descriptions in column
II:
I
II
1) rotation
a) turning palm upward
2) supination
b) decreasing angle belween parts
3) extension
c) moving part forward
4) eversion
d) moving part around an axis
5) protraction
e) turning sole of foot outward
6) flexion
f) increasing angle between parts
7) pronation
g) lowering a part
8) abduction
h) turning palm downward
9) depression
i) moving part away from midline
3 Render the text Skeletal System: Bones and Joints.
Use some of the following expressions:
The Plan for Rendering the Text
The main idea of the text is...
The text is about...
The text is devoted to...
The text deals with...
The purpose of the text is to give the reader some information on...
The aim of the text is to provide the reader with some material
(data) on...
Much attention is given to...
It should be stressed that...
Special attention is paid to...
(Your opinion on the text)
I found the text interesting (important, of no value, informative,
useful).
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It gives the reader some information on...
We have come to know and understand a lot of things.
Unit 3
Pre-text assignments
1 Learn the key words and phrases:
axial skeleton, appendicular skeleton, cartilaginous part, thoracic
cage, hyoid bone, larynx, vertebral column, tailbone, sternum,
pectorial girdle, pelvic girdle
2 Use the following expressions in the sentences of your own to show
that you understand their meaning and use:
1 It includes ... 2 Scientists consider that ... 3 It performs (they
perform) the function of ... 4 The investigators determined ... 5 The
most complicated structure ... 6 They are transmitted from ... 7 It
depends upon ...
The Skeleton
For purposes of study, it is convenient to divide the skeleton into
two major portions—an axial skeleton and an appendicular skeleton.
The axial skeleton consists of the bony and cartilaginous parts that
support and protect the organs of the head, neck, and trunk. These
parts include the following:
1 Skull. The skull is composed of the cranium (brain case) and the
facial bones.
2 Hyoid bone. The hyoid bone is located in the neck between the
lower jaw and the larynx. It does not articulate with any other bones,
but is fixed in position by muscles and ligaments. The hyoid bone
supports the tongue and serves as an attachment for certain muscles
that help move the tongue and function in swallowing. It can be felt
approximately a finger’s width above the anterior prominence of the
larinx.
3 Vertebral column. The vertebral column, or backbone, consists of
many vertebrae separated by cartilaginous intervertebral disks. This
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column forms the central axis of the skeleton. Near its distal end,
several vertebrae are fused to form the sacrum, which is part of the
pelvis. A small, rudimentary tailbone called the coccyx is attached to
the end of the sacrum.
4 Thoracic cage. The thoracic cage protects the organs of the
thorax and the upper abdomen. It is composed of twelve pairs of ribs,
which articulate posteriorly with thoracic vertebrae. It also includes
the sternum, or breastbone, to which most of the ribs are attached
anteriorly.
The appendicular skeleton consists of the bones the limbs and the
bones that anchor the limbs to the axial skeleton. It includes the
following:
1 Pectoral girdle. The pectoral girdle is formed by a scapula, or
shoulder blade, and a clavicle, or collarbone, on both sides of the
body. The pectoral girdle connects the bones of the arms lo the axial
skeleton and aids in arm movements.
2 Upper limbs (arms). Each upper limb consists of a humerus, or
upper arm bone, and two lower arm bones—a radius and an ulna.
These three bones articulate with each other at the elbow joint. At the
distal end of the radius and ulna, are eight carpals, or wrist bones.
The bones of the palm are called metacarpals, and the finger bones
are called phalanges.
3 Pelvic girdle. The pelvic girdle is formed by two coxal, or
innominate bones (hipbones), which are attached to each other
anteriorly and to the sacrum posteriorly. They connect the bones of
the legs to the
axial skeleton and, with the sacrum and coccyx, form the pelvis,
which protects the lower abdominal and internal reproductive organs.
4 Lower limbs (legs). Each lower limb consists of a femur, or
thighbone, and two lower leg bones—a large tibia, or shinbone, and
a slender fibula, or calf bone. These three bones articulate with each
other at the knee joint, where the patella, or kneecap covers the
anterior surface. At the distal ends of the tibia and fibula, are seven
tarsals, or anklebones. The bones of the foot are called metatarsals,
and those of the toes (like the fingers) are called phalanges.
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Post-text assignments
1 Distinguish between the axial and appendicular skeletons.
2 List the bones of the axial skeleton; of the appendicular skeleton
(Drawings 1,2).
Unit 4
Pre-text assignments
1 Learn the key words and phrases:
broken, bone, blood clot, dilate, osteoblasts, multiply, fibroblasts,
fibrocartilage, affected, osteoclasts, callus, hyaline, cartilage,
endochondral bone, casts, metal pins
2 Match the terms to following definitions:
1) a tumour or swelling containing blood
2) one of the minute red granules of new
capillaries formed on the surface of a
wound in healing
3) a large amount of fibrocartilage fills
the gap between the ends of the broken
bone
4) the remains of something broken
down or destroyed
5) a rigid dressing of gauze impregnated
with plaster of Paris for immobilizing a
diseased or broken part
a) debris
b) granulation
c) cast
d) hematoma
e) cartilaginous callus
Fractures
Although a fracture may involve injury to cartilaginous structures,
it is usually defined as a break in a bone. A fracture can be classified
according to its cause and the nature of the break sustained. For
example, a break due to injury is a traumatic fracture, while one
resulting from disease is a spontaneous or pathologic fracture.
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If a broken bone is exposed to the outside by an opening in the
skin, the injury is termed a compound fracture. Such a fracture is
accompanied by the added danger of infection, since microorganisms
almost surely enter through the broken skin. On the other hand, if the
break is protected by uninjured skin, it is called a simple fracture.
Repair of a Fracture
Whenever a bone is broken, blood vessels within the bone and its
periosteum are ruptured, and the periosteum is likely to be torn.
Blood escaping from the broken vessels spreads through the
damaged area and soon forms a blood clot, or hematoma. As vessels
in surrounding tissues dilate, those tissues become swollen and
inflamed.
Within days or weeks, the hematoma is invaded by developing
blood vessels and large numbers of osteoblasts, originating from the
periosteum. The osteoblasts multiply rapidly in the regions close to
the new blood vessels, building spongy bone nearby. Granulation
tissue develops, and in regions further from a blood supply,
fibroblasts produce masses of fibrocartilage.
Meanwhile, phagocytic cells begin to remove the blood clot as well
as any dead or damaged cells in the affected area. Osteoclasts also
appear and resorb bone fragments, thus aiding in "cleaning up"
debris.
In time, a large amount of fibrocartilage fills the gap between the
ends of the broken bone, and this mass is termed a cartilaginous
callus. The callus is later replaced by bone tissue in much the same
way that the hyaline cartilage of a developing endochondral bone is
replaced. That is, the cartilaginous callus is broken down, the area is
invaded by blood vessels and osteoblasts, and the space is filled with
a bony callus.
Usually more bone is produced at the site of a healing fracture than
is needed to replace the damaged tissues.
However, osteoclasts are able to remove the excess, and
the final result of the repair process is a bone shaped very much like
the original one.
The rate at which a fracture is repaired depends on several factors.
For instance, if the ends of the broken bone are close together,
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healing is more rapid than if they are far apart. This is the reason for
setting fractured bones and for using casts or metal pins to keep the
broken ends together. Also, some bones naturally heal more rapidly
than others. The long bones of the arms, for example, may heal in
half the time required by the long bones of the legs. Furthermore, as
age increases, so does the time required for healing.
Post-text assignments
1 Answer the following:
1 Define between traumatic and spontaneous fracture. 2 Define
between simple and compound fracture. 3 What is hematoma? 4
What is cartilaginous callus?
2 Pick out the nouns that can combine with the given verbs:
to control, to move, to send:
findings, head, disease, pain, hands, movements, patient,
respiration, letter, heartbeat, order, vision, legs
3 Pick out the verbs to be used together with the given nouns:
the pain can (be discharged, be estimated, be controlled); the area
can (be extended, be published, be pumped); the smell can (be
covered, be entered, be felt); the vision can (be breathed in, be
investigated, be complicated)
4 Respond to the questions:
1 What steps do you think should be taken to reduce the chances of
persons accumulating abnormal metallic elements such as lead,
radium, and strontium in their bones?
2 Why do you think incomplete, longitudinal fractures of bone shafts
(greenstick fractures) are more common in children than in adults?
3 When a child's bone is fractured, growth may be stimulated at the
epiphyseal disk of that bone. What problems might this extra growth
create in an arm or leg before the growth of the other limb
compensates for the difference in length?
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4 How would you explain the observation that elderly persons often
develop bowed backs and appear shorter than they were in earlier
years?
5 How might the condition of an infant's fontanels be used to
evaluate its development? How might the fontanels be used to
estimate intracranial pressure?
6 Why are women more likely to develop osteoporosis than men?
What steps might be taken to reduce the risks of developing this
condition?
Unit 5
Pre-text assignments
1 Learn the key words and phrases:
muscles, contract, contraction, attach, resist, fascia, connective
tissue, tendon, fibrous, fascicle, network, subcutaneous fascia,
subserous fascia, cavity
2 Memorize the explanation to the terms:
fascia (pl. fasciae) a sheet of connective tissue covering or binding
together body structures
fascicle
a small bundle
subcutaneous
being under the skin
fibrous
containing or consisting of fibers
Muscular System
Muscles, the organs of the muscular system, consist largely of cells
that are specialized to undergo contractions. During these
contractions, chemical energy from nutrients is converted into
mechanical energy, or movement.
When muscle cells contract, they pull on the body parts to which
they are attached. This action usually causes movement, as when
joints of the legs are flex and extended during walking. But at other
times, muscular contractions resist motion, as when they help hold
body parts in postural positions. Muscles are also responsible for the
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movement of body fluids such as blood and urine. In addition, they
function in heat production, which helps maintain body temperature.
Structure of a Skeletal Muscle
A skeletal muscle is an organ of the muscular system composed of
several kinds of tissue, including skeletal muscle tissue, nerve tissue,
blood, and various connective tissues.
An individual skeletal muscle is separated from adjacent muscles
and held in position by layers of fibrous connective tissue called
fascia. This connective tissue surrounds each muscle and may project
beyond the end of its muscle fibers to form a cordlike tendon. Fibers
in a tendon intertwine with those in the periosteum of a bone, thus
attaching the muscle to the bone. In other cases, the connective
tissues associated with a muscle form broad fibrous sheets called
aponeuroses, which may be attached to the coverings of adjacent
muscles.
The layer of connective tissue that closely surrounds a skeletal
muscle is called the epimysium. Other layers of connective tissue,
called the perimysium, extend inward from the epimysium and
separate the muscle tissue into small sections. These sections contain
bundles of skeletal muscle fibers called fascicles (fasciculi). Each
muscle fiber within a fascicle is surrounded by a layer of connective
tissue in the form of a thin, delicate covering called endomysium.
Thus, all parts of a skeletal muscle are enclosed in layers of
connective tissue. This arrangement allows the parts to move
independently. Also, numerous blood vessels and nerves pass
through these layers.
The fascia associated with the individual organs of the muscular
system is part of a complex network of fasciae that extends
throughout the body. The portion of the network that surrounds and
penetrates the muscles is called deep fascia. It is continuous with the
subcutaneous fascia that lies just beneath the skin, forming the
subcutaneous layer. The network is also continuous with the
subserous fascia that forms the connective tissue layer of the serous
membranes covering organs in various body cavities and lining those
cavities.
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Post-text assignments
1 Respond to the following tasks:
1 List the three types of muscle tissue.
2 Describe the connective tissue coverings of a skeletal muscle.
3 Describe how connective tissue is associated with a skelelal
muscle.
4 Distinguish between deep fascia, subcutaneous fascia, and
subserous fascia.
5 Describe the major events that occur when a muscle fiber
contracts.
2 Fill in the blanks with the words given below:
1 There are many ..in the spine. 2 We use the ... and the tongue when
we speak 3 There are a great number of ... ... ... in the muscles. 4 The
cells are connected by connective ... . 5 ... ... ... move our internal
organs such as the digestive tract, blood vessels and secretory ducts.
6 The teeth and a tongue are located in ... ... . 7 The skull encloses ...
... . 8 We chew our food with the ... . 9 The joints allow the bones ...
... . 10 The bones are of various sizes and .... .
(a – the smooth muscles; b – shapes; c – vertebrae; d – lips; e –
teeth; f – nerves and blood vessels; g – to move; h – the brain; i –
tissue; j – the mouth)
3 Read and retell the article:
Experience floating muscles. Stand in a doorway with your hands
pressing on the door frame as hard as you possibly can. Hold it for a
full minute. Walk away from the door. Your muscles memory will
keep pushing your arms out, and they will float up without any effort
on your part.
4 Translate in writing:
There are two main varieties of muscle: voluntary and involuntary.
Voluntary muscle is striated in appearance and may be contracted at
will. It is usually attached at each end to different bones, which it
brings closer together (e. g. in bending the arm) when it contrasts.
Involuntary muscle is smooth in appearance and may not be
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contracted at will. It is found chiefly in internal organs, such as the
intestine wall and the heart, whose function is automatic.
Unit 6
Pre-text assignments
1 Learn the key words and phrases:
disuse, enlarge, hypertrophy, atrophy, mitochondria, resist fatigue,
fatigable fibers, filaments of actin and myosin, discontinued,
reduction, capillary networks, motor neurons, reinnervate
2 Memorize the explanation to the terms:
increase
becoming greater in size, amount, etc.
decrease becoming gradually less, smaller, etc.
Atrophy and Hypertrophy of Skeletal Muscles
Skeletal muscles are very responsive to use and disuse. For
example, those that are forcefully exercised tend to enlarge. This
phenomenon is called muscular hypertrophy. Conversely, a muscle
that is not used undergoes atrophy – that is, it decreases in size and
strength.
The way a muscle responds to use also depends on the type of
exercise involved. For instance, when a muscle contracts relatively
weakly, as during swimming and running, its slow, fatigue-resistant
red fibers are most likely to be activated. As a result, these fibers
develop more mitochondria, and more extensive capillary networks
develop around the fibers. Such changes increase the fibers' abilities
to resist fatigue during prolonged periods of exercise, although their
sizes and strengths may remain unchanged.
Forceful exercise, such as weight lifting, in which a muscle exerts
more than 75% of its maximum tension, involves the muscle's fast,
fatigable white fibers. In response, existing muscle fibers develop
new filaments of actin and myosin, and as their diameters increase,
the whole muscle enlarges. However, no new muscle fibers are
produced during hypertrophy.
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Since the strength of a contraction is directly related to the
diameter of the muscle fibers, an enlarged muscle is capable of
producing stronger contractions than before. However, such a change
does not increase the muscle's ability to resist fatigue during
activities such as running or swimming.
If exercise is discontinued, there is a reduction in the capillary
networks and in the number of mitochondria within the muscle
fibers. Also, the size of the actin and myosin filaments decreases, and
the entire muscle atrophies. Such atrophy commonly occurs when
limbs are immobilized by casts or when accidents or diseases
interfere with motor nerve impulses. A muscle that cannot be
exercised may decrease to less than one-half its usual size within a
few months.
The fibers of muscles whose motor neurons are severed not only
decrease in size, but also may become fragmented and, in time, be
replaced by fat or fibrous connective tissue. However, if such a
muscle is reinnervated within the first few months following an
injury, its function may be restored. Meanwhile, atrophy may be
delayed by treatments in which electrical stimulation is used to cause
muscular contractions against loads.
Post-text assignments
1 Respond to the following tasks:
1 Explain how muscles may become fatigued and how a person's
physical condition may affect tolerance to fatigue.
2 Explain the differerence between atrophy and hyperthrophy of
skeletal muscles
2 Choose the proper term to the identification:
1 The way (route) of administration of drugs. 2 The science dealing
with the effect of drugs on living organisms. 3 Conditions which ban
(forbid) the use of a drug. 4 The science that deals with medicinal
products of plant, animal, or mineral origin in their crude or
unprepared state. 5 The branch of pharmacology that deals with the
effect and the reactions of drugs within the body. 6 Pertaining to
against pain.
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(a – contraindications; b – analgesic, analgetic; c – intramuscular;
d – pharmacology; e – pharmacognosy; f – pharmacodynamics)
Key:
1 – c (intramuscular); 2 – d (pharmacology); 3 –
a (contraindications); 4 – e (pharmacognosy); 5 –
f (pharmacodynamics)
Unit 7
1 Match the muscles in column I with the descriptions and functions
in column II (Drawings 3,4):
I
II
1) buccinator
a) inserted on the coronoid process of the
mandible
2) epicranius
b) draws the corner of the mouth
upward
3) medial pterygoid
c) can raise and adduct the
scapula
4) platysma
d) can pull the head into an
upright position
5) rhomboideus major e) consists of two parts – the
frontalis and the occipitalis.
6) splenius capitis
f) compresses the cheeks
7) temporalis
g) extends over the neck from
the chest to the face
8) zygomaticus
h) pulls the jaw to the side in
grinding movements
I
9) biceps brachii
10) brachialis
11) deltoid
12) latissimus dorsi
13) pectoralis major
II
i) primary extensor of the elbow
j) pulls the shoulder back and
downward
k) abducts the arm
l) rotates the arm laterally
m) pulls the arm forward and
across the chest
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14) pronator teres
15) teres minor
16) triceps brachii
I
17) biceps femoris
18) external oblique
19) gastrocnemius
20) gluteus maximus
21) gluteus medius
22) gracilis
23) rectus femoris
24) tibialis anterior
n) rotates the arm medially
o) strongest flexor of the elbow
p) strongest supinator of the
forearm
II
q) inverts the foot
r) a member of the quadriceps
femoris group
s) a plantar flexor of the foot
t) compresses the contents of
the abdominal cavity
u) largest muscle in the body
v) a hamstring muscle
w) adducts the thigh
x) abducts the thigh
2 Read the text and render its main idea:
ln the United States, approximately 3 million people present to
emergency departments for treatment of traumatic facial injuries
each year. Most of these injuries are relatively minor soft tissue
injuries that simply require first aid care or primary closures. A small
percentage of facial traumas (0.04-0.09%) require major repair with
possible bony reconstruction. Motor vehicle accidents (MVAs) were
the most frequent cause of facial injuries before 1970. In recent
years, with the institution of state seat belt laws, the number of
deaths from MVAs has declined along with the incidence of facial
injuries, although the prevalence of facial trauma has remained fairly
constant. This is due to the growing population and other human
factors, such as on-the-job accidents, sports-related injuries, domestic
interpersonal violence, self-inflicted wounds, and animal bites.
The mechanism of injury for facial trauma varies widely from one
locality to the next, depending significantly upon the degree of
urbanization, socioeconomic status of the population, and cultural
background of each region. MVAs continue to be a primary
contributor to significant facial injuries in rural areas. In contrast, in
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inner metropolitan areas, domestic violence is the leading cause of
facial trauma despite a denser population, a difference that may be
due to stricter enforcement of traffic laws.
Unit 8
Anatomical Terminology
Terms of relative position are used to describe the location of one
body part with respect to another. They include the following:
1 Superior means a part is above another part, or closer to the head.
(The thoracic cavity is superior to the abdominopelvic cavity).
2 Inferior means situated below another part, or toward the feet.
(The neck is inferior to the head).
3 Anterior (or ventral) means toward the front. (The eyes are
anterior to the brain).
4 Posterior (or dorsal) is the opposite of anterior; it means toward
the back. (The pharynx is posterior to the oral cavity).
5 Medial relates to an imaginary midline dividing the body into
equal right and left halves. A part is medial if it is closer to this line
than another part. (The nose is medial to the eyes).
6 Lateral means toward the side with respect to the imaginary
midline. (The ears are lateral to the eyes). Ipsilateral pertains to the
same side (the spleen and the descending colon are ipsilateral), while
contralateral refers to the opposite side (the spleen and the
gallbladder are contralateral).
7 Proximal is used to describe a part that is closer to a point of
attachment or closer to the trunk of the body than another part. (The
elbow is proximal to the wrist).
8 Distal is the opposite of proximal. It means a particular body part is
farther from the point of attachment or farther from the trunk than
another part. (The fingers are distal to the wrist).
9 Superficial means situated near the surface. (The epidermis is the
superficial layer of the skin). Peripheral also means outward or near
the surface. It is used to describe the location of certain blood vessels
21
and nerves. (The nerves that branch from the brain and spinal cord
are peripheral nerves).
10 Deep is used to describe parts that are more internal. (The dermis
is the deep layer of the skin).
Unit 9
Pre-text assignments
1 Learn the key words:
tongue, papilla, pharynx, throat, esophagus, gullet, enzyme, saliva,
antrum, ruga, bile, gallbladder, sodium, potassium, villus, cecum
2 Memorize the expressions to the text:
to be moistered with smth, taste receptors, mucous membrane, oral
cavity, gastric juice, further digestion, hydrochloric acid, peristaltic
waves, small intestine, the fluid by-products, large intestine, sigmoid
colon, vermiform appendix
3 Find substitutes for the following definitions:
1) pertaining to pepsin or to digestion
2) excessive formation of gases in stomach
or in testine
3) failure of digestive function
4) a lack or shortage
5) the conversion of food into material
assimilable by the body
a) digestion
b) deficiency
c) peptic
d) flatulence
e) indigestion
4 Translate the sentences:
1 The soft palate is a continuation of the soft tissues covering the
hard palate. 2 The small intestine composed of three main portions is
a thin-walled muscular tube. 3 The weight of the largest of the
salivary glands is 28 gr. 4 The liver consists of small lobules
connected together by connective tissue, different vessels and nerves.
5 The duodenum is called so because its length measures about
twelve fingers. 6 The liver consisting of five lobes is covered with a
fibrous coat.
22
Digestive System and Digestion
The human body needs energy for its functioning. Our body
assimilates proteins, fats, carbohydrates and other nutrients. The
digestion of the starchy parts of food begins in the mouth where it is
moistered with saliva. In the tongue papillae (lingual papillae) there
are the taste receptors. Over the mucous membrane of the oral cavity
there are many tactile, temperature and pain receptors. The teeth, the
gums, the soft and hard palates and the salivary glands are important
structures located in the oral cavity. In the oral cavity the food must
be well chewed between the teeth. Then the food passes through the
pharynx (throat) and down through the esophagus (gullet) into the
stomach which is a dilated portion of the alimentary truct pyriform in
shape. The stomach is composed of a fundus (upper part), a body
(middle part) and an antrum (lower, distal part). The upper opening
of the stomach is called the cardiac sphincter and the lower one –
pyloric. The folds in the mucous membrane lining the stomach are
called rugae.
In the stomach the components of food are dissolved and
hydrolysed by enzymes of saliva and gastric juice. Different gastric
glands are found in the stomach. They produce hydrochloric acid and
pepsin to digest food. The gastric juice secreted by the stomach
possesses antibacterial activity. Pepsin converts proteins to smaller
substances called peptones. But food does not enter the bloodstream
through the stomach.
Further digestion and absorbtion of food into the blood takes place
in the small intestine. After portions of the stomach contents enter
into the duodenum they turn acid, but then the reaction rapidly
changes because the hydrochloric acid of the gastric juice is
neutralized by the bile, the juice of the pancreas, the juice of the
duodenal glands and intestinal crypts. The bile comes from the liver
and gallbladder by means of special ducts. The pancreatic juice, a
colourless clear fluid contains sodium, potassium chlorides and is
rich in enzymes which digest proteins, fats and carbohydrates.
Food passes in peristaltic waves from the duodenum to the jejunum
and the ileum, which is attached to the large intestine. The entire
23
small intestine has many projections called villi. It is in the small
intestine where the so-called cavital.and membrane hydrolyses of
nutrients takes place. The products of digestion are absorbed into the
blood and lymph.
The remaining part of food (the fluid by-products of digestion)
from the small intestine pass into the large intestine which consists of
cecum, colon (ascending, transverse, descending), sigmoid colon and
rectum. The vermiform appendix hags from the cecum. The rectum
ends in the anus. The process of digestion is completed in the large
intestine by the absorption of water. The unabsorbed and undigested
components of food, the remains of the digesting fluids are evacuated
from the body.
Post-text assignments
1 Choose the anatomic terms for the following:
1 The organ of chewing and tasting. 2 The movable muscular
structure attached to the floor of the mouth; an important organ in the
articulation of speech sounds. 3 The muscular membranous cavity
leading from the mouth and nasal passages to the larynx and
esophagus. 4 The roof of the mouth. 5 The tube through which food
passes from the pharynx to the stomach. 6 Any of numerous hairlike
or fingerlike vascular processes in the small intestine. 7 The first
section of the small intestine between the stomach and the jejunum. 8
A large, elongated gland: some cells (beta cells) islets of Langerhans
in the gland produuce the hormone insulin. 9 The largest glandular
organ which secretes bile. 10 The organ for containing food and
digestion of it.
(a – palate; b – duodenum; c – stomach; d – pharynx; e –
esophagus; f – mouth; g – tongue; h – liver; i – pancreas; j – villus
(pl villi)
2 Say what organ is spoken about:
a) This organ is the largest gland in the human body. It is in the
upper part of the abdominal cavity under the diaphragm in the right
side of the abdomen. Its upper surface is convex. This organ consists
24
of small lobules connected together by connective tissue, different
vessels and nerves.
b) This organ is pyriform in shape. It is a dilated portion of the
alimentary canal. It is in the upper part of the abdomen under the
diaphragm. The liver is above this organ, and the colon is below it.
The pancreas is behind this organ.
3 Translate the following without consulting the dictionary:
1 Digestive juices are secreted into the alimentary canal by various
glands and accessory organs. 2 The digestive system includes the
organs that promote digestion and absorb the products of this
process. 3 The alimentary canal includes the mouth, pharynx,
esophagus, stomach, small intestine and large intestine. 4 The
accessory organs include the salivary glands, liver, gallbladder and
pancreas.
Unit 10
Pre-text assignments
1 Learn the key words and phrases:
innervation, distinct layers, innermost tissues, mucous membrane,
folds, lumen, tubular invaginations, visceral peritoneum
2 Memorize the explanation to the terms:
break
to separate into parts
absorb
to take in and use as nourishment
moist
to wet moderately
lubricate
to make smooth or slippery
The Alimentary Canal
The alimentary canal is a muscular tube about 9 meters long that
passes through the body's ventral cavity. Although it is specialized in
various regions to carry on particular functions, the structure of its
wall, the method by which it moves food, and its type of innervation
are similar throughout its length.
25
The wall of the alimentary canal consists of four distinct layers,
although the degree to which they are developed varies from region
to region. Beginning with the innermost tissues, these layers, include
the following:
1 Mucous membrane (mucosa). This layer is formed of surface
epithelium, underlying connective tissue (lamina propria), and a
small amount of smooth muscle. In some regions, it develops folds
and tiny projections that extend into the lumen of the digestive tube
and increase its absorptive surface area. It may also contain glands
that are tubular invaginations into which the lining cells secrete
mucus and digestive enzymes. The mucosa protects the tissues
beneath it and carries on absorption and secretion.
2 Submucosa. The submucosa contains considerable loose
connective tissue as well as blood vessels, lymphatic vessels, and
nerves. Its vessels nourish the surrounding tissues and carry away
absorbed materials.
3 Muscular layer. This layer, which is responsible for the
movements of the tube, consists of two coats of smooth muscle
tissue. The fibers of the inner coat are arranged so that they encircle
the tube, and when these circular fibers contract, the diameter of the
tube is decreased. The fibers of the outer muscular coat run
lengthwise, and when these longitudinal fibers contract, the tube is
shortened.
4 Serous layer (serosa). The serous, or outer covering of the tube is
composed of the visceral peritoneum, which is formed of epithelium
on the outside and connective tissue beneath. 6 The cells of the
serosa secrete serous fluid, which keeps the tube's outer surface
moist. This lubricates the surface so that the organs within the
abdominal cavity slide freely against one another.
Post-text assignments
1 Answer the following:
1 What is the alimentary canal?
2 Distingwish between mucosa and submucosa.
3 Distingwish between muscular layer and serous layer.
26
2 Ask questions using the parenthesized words:
1 The alimentary canal is a muscular tube about 9 maters long.
(What size) 2 The wall of the alimentary canal consists of four
disfinct layers. (How many) 3 Mucous membrane is formed of
surface epithelium and a small amount of smooth muscle. (What ...
of) 4 The mucosa protects the tissues beneath. (What) 5 The fibers of
the outer muscular coat run lengthwise. (How) 6 The cells of the
serosa secrete serous fluid. (What)
3 Summarize the characteristics of these layers:
Layer
Composition
Function
Mucous
membrane
Epithelium,
connective tissue,
smooth muscle
Protection, absorption,
secretion
Submucosa
Muscular
layer
Serous layer
Loose connective
tissue, blood vessels,
lymphatic
vessels, nerves
Smooth muscle fibers
arranged in circular
and
longitudinal groups
Epithetium,
connective tissue
27
Nourishes
surrounding
tissues,
transports
absorbed
materials
Movements of the tube
and its contents
Protection
Unit 11
Pre-text assignments
1 Learn the key words and phrases:
pouchlike organ, capacity, oblique fibers, cardiac, fundic, body,
pyloric regions, balloon, temporal storage area, swallowed,
regurgitation of food, stretch, chyme
2 Form new words by adding the prefixes. Define the part of speech
and translate them:
a) dis-: colouration, continue, like, appear
b) un-: natural, cured, cooled, conscious, treated
c) over-: use, strain, work, eating, dosage
d) intra-: venous, muscular, cellular, vascular
3 Read and translate the following terms. Memorize the meaning of
the term-element «gastro» – шлунок:
gastroenterologist, gastroenterology, gastrology, gastrotherapy,
gastrotomy, gastro-intestinal, gastromalacia, gastronephritis,
gastropancreatitis, gastropathy
Stomach
The stomach receives food, mixes it with gastric juice, carries on a
limited amount of absorption, and moves food into the small
intestine.
The stomach is a J-shaped, pouchlike organ, about 25-30
centimeters long, which hangs under the diaphragm in the upper left
portion of the abdominal cavity. It has a capacity of about one liter or
more, and its inner lining is marked by thick folds (rugae) that tend
to disappear when its wall is distended. The stomach receives food
from the esophagus, mixes it with gastricjuice, initiates the digestion
of proteins, carries on a limited amount of absorption, and moves
food into the small intestine.
In addition to the two layers of smooth muscle – an inner circular
layer and an outer longitudinal layer – found in other regions of the
28
alimentary canal, some parts of the stomach have another inner layer
of oblique fibers. This third muscular layer is most highly developed
near the opening of the esophagus and in the body of the stomach.
The stomach can be divided into the cardiac, fundic, body, and
pyloric regions. The cardiac region is a small area near the
esophageal opening (cardia), the fundic region, which balloons above
the cardiac portion, acts as a temporal storage area and sometimes
becomes filled with swallowed air. This produces a gastric air
bubble, which may be used as a landmark on an X-ray film of the
abdomen. The dilated body region, which is the main part of the
stomach, is located between the fundic and pyloric portions. The
pyloric region (antrum) narrows and becomes the pyloric canal as it
approaches the small intestine.
At the end of the pyloric canal, the circular layer of fibers in its
muscular wall is thickened, forming a powerful muscle, called the
pyloric sphincter (pylorus). This muscle serves as a valve that
prevents regurgitation of food from the intestine back into the
stomach.
Gastric glands secrete gastric juice. Gastric juice contains pepsin,
hydrochloric acid, lipase, and intrinsic factor. Gastric secretions are
enhanced by parasympathetic impulses and by gastrin, a hormone.
The three stages of gastric secretion are the cephalic, gastric, and
intestinal phases. The presence of food in the small intestine reflexly
inhibits gastric secretions.
The stomach is not well adapted for absorption. A few substances
such as water and other small molecules may be absorbed through
the stomach wall. As the stomach fills, its wall stretches, but its
internal pressure remains unchanged. Mixing movements aid in
producing chyme; peristaltic waves move the chyme into the pyloric
region. The muscular wall of the pyloric region pumps chyme into
the small intestine. The rate of emptying depends on the fluidity of
the chyme and the type of food present.
29
Post-text assignments
1 Add the necessary part of the clinical terms pertaining to the
pathology of stomach:
1 Gastro... (an instrument inserted through the mouth for visually
inspecting the inside of the stomach). 2 Gastr... (the surgical removal
of all, or especially part of the stomach). 3 Gastro... itis (an
inflammation of the stomach and the intestines). 4 Gastro... (a stony
concretion formed in the stomach). 5 Gastro... (a bleeding from the
blood vessels and the stomach lining). 6 Gastro... (a process of
softening of stomach lining because of poor blood supply or an
inflammation). 7 Gastro... (a prolapse, falling of the stomach downwards because of weakening of some muscles). 8 Gastroentero-.. (the
branch of medicine that is concerned with disorders of the digestive
system). 9 Gastr... (inflammation of the stomach lining). 10 Gastro ...
(surgical incisior into the stomach).
(a — ...tomy; b — ...logy; c — ...lith; d — ...ectomy; e —
...rrhagia; f — ...ptosis; g — ...scope; h — ...itis; i —...malacia;j —
...enter...)
2 Choose the words that correctly complete each of the following
sentences:
1 Alimentary canal begins at the (mouse, mouth) and ends at the
anus. 2 The (rough, roof, ruff) of the mouth is called palate. 3 By the
movements of the (tan, tang, tongue, ton, tone) and cheek the food is
turned about and chewed. 4 The (leaps, lips) form the opening to the
oral, cavity. 5 The pancreatic juice is (reach, rich) in enzymes which
digest proteins, fats and carbohydrates. 6 A soft tissue which hangs
from the soft palate is (cold, called) uvula. 7 The tongue has papilae
which contain (sells, seals, cells, seels) sensitive to the chemical
nature of food. 8 Pharynx is a passegeway for (ear, air, are) from the
nasal cavity to the larynx and for food going from the mouth to
esophagus.
3 Translate in writing the following abstract :
The rate at which the stomach empties is also related to age. An
infant's stomach which has a small capacity, empties very rapidly. As
30
a person grows, the stomach enlarges, and the emptying time
increases.
Unit 12
Pre-text assignments
1 Learn the key words and phrases:
deaminating amino acids, blood clotting, bile, fibrous capsule,
hepatic cells, gallstones
2 Use the following words and expressions in sentences of your own
to show that you understand their meaning and use:
use by expiration date; if pain persists; the advice of a health
professional; to depend on; reduced doses are recommended; rectal
route of administration; oral route of administration; intravenous
route of administration; subcutaneous route of administration; drug
introduction into
Liver
The liver is located in the upper right and central portions of the
abdominal cavity, just below the diaphragm. It is partially
surrounded by the ribs, and extends from the level of the fifth
intercostal space to the lower margin of the ribs. It is reddish brown
in color and well supplied with blood vessels.
The liver is the largest gland in the body, and it carries on many
important metabolic activities. For example, it plays a key role in
carbohydrate metabolism by helping maintain the normal
concentration of blood glucose.
The most vital liver functions are probably those related to protein
metabolism. They include deaminating amino acids; forming urea;
synthesizing various blood proteins, including several that are
necessary for blood clotting ; and converting various amino acids to
other amino acids.
The liver also stores a variety of substances, including glycogen,
iron, and vitamins A, D, and B12. Iron storage occurs when the
31
concentration of blood iron is excessive. The extra iron is combined
with a protein (apoferritin) in liver cells, and as a result, a substance
called ferritin is formed. The iron remains stored in this form until
the blood iron concentration reaches a certain low level. Then some
of the iron is released. Thus, the liver plays an important role in the
homeostasis of iron.
In addition to the above functions, various liver cells help destroy
damaged red blood cells and foreign substances by phagocytosis,
alter the composition of toxic substances such as alcohol
(detoxification), and secrete bile. The liver can also store from 200 to
400 milliliters of blood, thus it serves as a blood reservoir.
The liver is enclosed in a fibrous capsule and is divided by
connective tissue into lobes—a large, right lobe and, a smaller,
left lobe. Within the liver lobules, are many fine bile canals,
wich receive secretions from the hepatic cells. Bile is a yellowish
green liquid that is secreted continuously by the hepatic cells. It
is the only liver secretion that directly affects digestion. Bile
contains bile salts, bile pigments, cholesterol, and various
electrolytes. Only the bile salts have digestive functions. The
gallbladder stores bile between meals. Release of bile from the
common bile duct is controlled by a sphincter muscle. Gallstones
may sometimes form within the gallbladder.
Post-text assignments
1 Choose the proper terms for the definitions:
1 Yellow coloration of skin and tissues. 2 Lack of hydrochloric acid.
3 Lesion of the mucous membrane when it is injured and necrosed. 4
Collection of bile (calculi) which forms in the gallbladder and bile
ducts. 5 Protrusion of an organ or part of it through the wall of the
cavity which contains it. 6 Binding or twisting of the intestine upon
itself. 7 Removal of the gallbladder. 8 Inflammation of the pancreas.
9 Incision of the esophagus. 10 Visual examination of the stomach.
(a – gallstones; b – hernia; c – volvulus; d – gastroscopy; e – ulcer;
f – achlorhydria; g – pancreatitis; h – cholecystectomy; i –
esophagotomy; j – jaundice)
32
2 Translate in writing:
Gallstones may form if the bile is concentrated excessively, if the
hepatic cells secrete too much cholesterol, or if the qallbladder is
inflamed (cholecystitis). If such stones get into the bile duct, they
may block the flow of bile, causing obstructive jaundice and
considerable pain. Generally gallstones that cause obstructions are
surgically removed. At the same time, the gallbladder is removed by
a surgical procedure called cholecystectomy. Following such
surgery, the person is unable to produce gallstones or store bile.
However, bile continues to reach the intestine by means of the
hepatic and common bile ducts.
Unit 13
Pre-text assignments
1 Read the text. Write a plan of it in the form of questions:
Hepatitis
Hepatitis is an inflamation of the liver. Most commonly it is caused
by a viral infection, the presence of toxins, or the effects of various
drugs, including alcohol.
One form of viral hepatitis, called type A hepatitis (infectious
hepatitis), usualy occurs in children or young adults. It is sptead by
contract with food or objects, such as eating utensils or toys, that
have been contaminated with virus-containing faces. This form of
hepatitis is often mild, although itmay be accompanied by weakness,
abdominal discomfort, nausea, and jaundice. Usually the person
recovers completely, with no lasting damage to the liver.
Type B hepatitis (serum hepatitis) produces symptoms similar to
those of type A, but the effects may last for a much longer time. This
form of the disease is spread by contact with virus-containing body
fluids, such as blood, saliva, or seminal fluid. Thus, it may be
transmitted by means of blood transfusions, hypodermic needles, or
sexual activiti. Most victims recover completely from type B
hepatitis; however, some perons continue to harbor live viruses and
33
become “carriers” who may seem healthy, but can transmit the
condition to others.
People who exhibit the symptoms of hepatitis for six months or
more are said to have chronic hepatitis. In such cases, there is danger
that the liver will be permanently damaged and its functions
impaired. In addition to being caused by viral infections, chronic
hepatitis maybe caused by the effects of certain drugs or by
autoimmune reactions.
2 Now that you have read the text and written the plan write an essay
on the topic Hepatits.
Unit 14
Pre-text assignments
1 Learn the key words and phrases:
ulcer, open sore, localized breakdown, buffer, unbuffered acid
2 Match the following phrases with Ukrainian ones:
1) life-threatening disease
a) м’язовий клапан
2) muscular valve
b) кислий сік
3) harmful effect
c) слизова оболонка кишечника
4) peptic ulcer
d) смертельне; небезпечне
5) immunosuppressive
захворювання
6) lining of the intestine
e) виразка дванадцятипалої кишки
7) acidic juice
f) пошкоджувальний ефект
8) duodenal e
g) пептична виразка
h) імуносупресорне лікування
3 Find descriptions of the following terms:
1) ulcer
a) splashing of the acidic juices from the
2) heartburn
stomach into the esophagus
3) digestion
b) the conversion of food into material
4) distress
assimilated by the body
5) stomach
c) open sore in the lining of the stomach or
6) esophagus
duodenum
34
7) valve
8) bile
9) acid
10) relapse
11) liver
d) the passage for food from the pharynx to
the stomach
e) the state of suffering, pain, misery
f) the large, saclike organ into which food
passes from esophagus or gullet for
storage while undergoing the early
processes of digestion
g) sour, sharp and biting to the taste
h) the bitter, greenish fluid secreted by the
liver and found in the gallbladder; it helps
digestion
I) (in anatomy) a membranous structure
which permits body fluids to follow in
one direction only
j) the largest glandular organ; it secrets bile
and has an important function in
metabolism
k) to slip back into a former condition,
especially after improvement or seeming
improvement
Ulcers
An ulcer is an open sore on the surface of an organ that results
from a localized breakdown of the tissues. Although ulcers may
occur in various parts of the alimentary canal, they often develop in
the stomach and are called gastric ulcers.
Ulcers are also common in the first portion of the small intestine,
the duodenum. Duodenal ulcers occur in regions that are exposed to
pepsin as the contents of the stomach enter the intestine. Because
gastric ulcers and duodenal ulcers are usually caused by pepsin, both
are commonly called peptic ulcers. Ulcers often develop in people
who are emotionally stressed and whose stomachs secrete increased
amounts of acidic gastric juice between meals, when the stomach is
essentially empty.
35
For example, some research suggest that smoking might increase a
person's risk of infection with the bacterium Helicobacter pylori
(H.pylori). Most peptic ulcers are caused by this bacterium.
Stomach acid is also important in producing ulcers. Normally, most
of this acid is buffered by the food we eat. Most of the unbuffered
acid that enters the duodenum is quickly neutralized by sodium
bicarbonate, a naturally occurring alkali produced by the pancreas.
Some studies show that smoking reduces the bicarbonate produced
by the pancreas, interfering with the neutralization of acid in the
duodenum. Other studies suggest that chronic cigarette smoking may
increase the amount of acid secreted by the stomach.
Whatever causes the link between smoking and ulcers two points
have been repeatedly demonstrated. People who smoke are more
likely to develop an ulcer, especially a duodenal ulcer, and ulcers are
less likely to heal quickly among smokers in response to otherwise
effective treatment. This research tracing the relationship between
smoking and ulcers strongly suggests that a person with an ulcer
should stop smoking.
Post-text assignments
1 What disease is this?
1 The disease, which causes pain and diarrhea, usually affects the
small intestine, but it can occur anywhere in the digestive tract.
2 It happens when acidic juices from the stomach splash into the
esophagus.
3 It is an open sore in the lining of the stomach or duodenum, the
first part of the small intestine.
4 Most cases of this disease are caused by the bacterium
Helicobacter pylori.
2 Say it in one word:
1) a small, solid mass sometimes formed in the gallbladder or bile
duct
2) the passage for food from the pharynx to the stomach
3) causing hurt, injury or damage
36
4) the large, sacljke organ into which food passes from esophagus
for storage while undergoing the early processes of digestion
5) the lower part of the alimentary canal, extending from the
stomach to the anus and consisting of a convoluted upper part and a
lower part of greater diameter
3 Give full answers:
If a patient has 95% of the stomach removed (subtotal gastrectomy)
as treatment for severe ulcers or cancer, how would the digestion and
absorption of foods be affected? How would the patient's eating
habits have to be altered? Why?
Unit 15
Pre-text assignments
1 Learn the key words and phrases:
cardiovascular system, circulatory system, nutrients, excretory
organs, target tissues, favourable cellular environment, viscous,
platelets, blood sample, cellular wastes
2 Match the following English word combinations with the Ukrainian
ones:
1) red blood cells
a) згортання крові
2) to combat infection
b) підтримувати
3) to destroy bacteria
потрібну кількість крові
4) the clotting of blood
с) червоні кров’яні тільця
5) to maintain an adequate
d) боротися з інфекцією
blood volume
e) знищувати бактерії
3 Translate the following:
1 The cellular fraction consists of red blood cells, white blood cells
and blood platelets. 2 The normal coagulation time is from three to
five minutes. 3 Plasma is the fluid portion of the blood.
37
Blood
The blood, heart, and blood vessels constitute the circulatory
system and provide a link between the body's internal parts and its
external environment. More specifically, the blood transports
nutrients from the digestive tract, oxygen from respiratory organs to
the body cells, and carries wastes from these cells to the respiratory
and excretory organs. It transports hormones from the endocrine
glands to target tissues and bathes the body cells in a liquid of
relatively stable composition. It also aids in temperature control by
distributing heat from the skeletal muscles and other active organs to
all the body parts. Thus, the blood provides vital support for cellular
activities and aids in maintaining a favorable cellular environment.
The heart and the closed system of blood vessels comprise the
apparatus that moves blood throughout the body. These organs
constitute the cardiovascular system.
Blood is a type of connective tissue whose cells are suspended in a
liquid intercellular material. It plays vital roles in transporting
substances between the body cells and the external environment, and
it aids in maintaining a stable cellular environment.
Whole blood is slightly heavier and three to four times more
viscous than water. Its cells, which are formed mostly in red bone
marrow, include red blood cells and white blood cells. The blood
also contains cellular fragments called platelets.
The volume of blood varies with body size. It also varies with
changes in the fluid and electrolyte concentrations and the amount of
fat tissue present. However, an average-sized male (70 kilograms)
will have a blood volume of about 5 liters.
If a blood sample is allowed to stand in a tube for a while, the cells
will become separated from the liquid portion of the blood and settle
to the bottom. This separation can be speeded by centrifuging the
sample so that the cells quickly become packed into the lower part of
the centrifuge tube. When the amounts of cells and liquid are
38
measured, the percentage of each in the blood sample can be
calculated.
A blood sample is usually about 45% cells. This percentage is
called the hematocrit (HCT), or packed cell volume (PCV). The
remaining 55% of a blood sample consists of clear, straw-colored
plasma.
In addition to red cells, which comprise over 99% of the blood
cells, the solids of the blood include white blood cells and blood
platelets. The plasma is composed of a complex mixture that
includes water, amino acids, proteins, carbohydrates, lipids, vitamins,
hormones, electrolytes, and cellular wastes.
Red blood cell production is significantly influenced by the
availability of two of the B-complex vitamins – vitamin B12 and
folic acid. These substances are required for the synthesis of DNA
molecules, so they are needed by all cells for growth and
reproduction. Since cellular reproduction occurs at a particularly
high rate in red blood-cell-forming tissue, this tissue is especially
affected by a lack of either of these vitamins.
Iron is also needed for the synthesis of hemoglobin. Although
much of the iron that is released during the decomposition of
hemoglobin is available for reuse, some iron is lost each day and
must be replaced.
White blood cells, or leukocytes, function primarily to control
various disease conditions. Although these cells do most of their
work outside the circulatory system, they use the blood for
transportation to sites of infection.
Normally, five types of white cells can be found in the circulating
blood. They are distinguished by their size, the nature of their
cytoplasm, the shape of their nucleus, and their staining
characteristics.
Post-text assignments
1 Complete the sentances:
1 The most numerous of the cellular elements of the blood are...
39
a) white blood corpuscles; b) red blood corpuscles; c) blood
platelets
2 The blood is...
a) connective tissue; b) muscular tissue; c) fluid tissue; d) nervous
tissue
2 Read the passages and answer the questions:
1 This substance is composed of plasma, red corpuscles, white
corpuscles and platelets. What substance is it?
2 These cellular elements are the most numerous in the blood. They
range from 4 to 5 million per cu mm in healthy adults. Their
colour(ing) is red. What cellular elements are they?
3 Answer the questions using the thematic words:
1 What is the main function of the blood?
2 How are the products of metabolism removed from the tissues?
3 What components does the blood consist of?
4 What is the chief constituent of the red blood cells?
5 What are the major components of blood?
6 What factors affect blood volume?
7 How is hematocrit determined?
8 What vitamins are necessary for red blood cell production?
9 Why is iron needed for the normal development of red blood
cells?
10 What are the primary functions of white blood cells?
4 Read and render the article:
Try this. Fill two caps half full with corn syrup. Stir two drops of red
food coloring in each cup, so it looks like blood. Sprinkle one
teaspoon of sugar in one cup and one teaspoon of flour in the other.
Record how long it takes for the "blood" to absorb the sugar and
flour. Which one was absorbed more quickly – the sugar or the
flour?
40
5 Read and translate the text:
One of the scientific research Institutes carried out an interesting
experiment. Six young persons – four men and two girls did not sleep
for 124 hours. They were under the constant observation of the
doctors who took their cardiograms, determined the pulse and blood
pressure and carried out many other investigations.
Not to fall asleep they were allowed to do physical exercises, dance
and play, but they were not allowed to take any stimulants. Vision,
hearing and muscular reflexes were often examined during the
experiment.
The experiment was successful. Its findings showed that prolonged
sleeplessness increases the amount of sugar in the blood, decreases
the level (amount) of vitamins B1 and B6, produces considerable
increase of white boood cells and decreases the amount of iron in the
blood.
Unit 16
Pre-text assignments
1 Learn the key words and phrases:
transmit, clump together, obstruct, agglutinogens, agglutinins,
dilute, adverse reaction, inherited trait
2 Translate and memorize the explanation to the terms:
transfusion
the act of transfusing fluid into a vein or
artery
precaution
a measure taken beforehand to prevent harm
or secure good
inheritance
the reception of genetic qualities by
transmission from parent to offspring
3 Find substitutes for the given phrases:
1) pertaining to injury
2) introduction of blood into the veins
3) inflammation of the bladder
4) high blood pressure in the arteries
41
a) transfusion
b) hypertension
c) traumatic
d) transplant
5) to remove and plant in another place
e) cystitis
Blood Groups and Transfusions
Early attempts to transfer blood from one person to another
produced varied results. Sometimes the person receiving the
transfusion was aided by the procedure. At other times, the recipient
suffered a blood reaction in which the red blood cells clumped
together, obstructing vessels and producing other serious
consequences.
Eventually, it was discovered that each individual has a particular
combination of substances in his or her blood. Some of these
substances react with those in another person's blood. These
discoveries led to the development of procedures for typing blood. It
is now known that safe transfusions of whole blood depend upon
properly matching the blood types of the donors and recipients.
Agglutinogens and Agglutinins
The clumping of red cells following a transfusion reaction is called
agglutination. This phenomenon is due to the presence of substances
called agglutinogens (antigens) in the red cell membranes and
substances called agglutinins (antibodies) dissolved in the plasma.
Blood typing involves identifying the agglutinogens that are present
in a person's red cells. Although many different agglutinogens are
associated with human erythrocytes, only a few of them are likely to
produce serious transfusion reactions. These include the
agglutinogens of the ABO group and those of the Rh group.
Avoiding the mixture of certain kinds of agglutinogens and
agglutinins prevents adverse transfusion reactions.
ABO Blood Group
The ABO blood group is based on the presence (or absence) of two
major agglutinogens in red cell membranes – agglutinogen A and
agglutinogen B – which are present at birth as a result of inheritance.
The erythrocytes of each person contain one of the four following
combinations of agglutinogens: only A, only B, both A and B, or
neither A nor B.
42
A person with only agglutinogen A is said to have type A blood; a
person with only agglutinogen B has type B blood; one with both
agglutinogen A and B has type AB blood; and one with neither
agglutinogen A nor B has type 0 blood (also called type H). Thus, all
humans have one of four possible blood types – A, B, AB, or 0.
Because an agglutinin of one kind will react with an agglutinogen
of the same kind and cause red blood cells to clump together, such
combinations must be avoided. The major concern in blood
transfusion procedures is that the cells in the transfused blood not be
agglutinated by the agglutinins in the recipient's plasma. For this
reason, a person with type A (anti-B) blood must not be given blood
of type B or AB, because the red cells of both types would be
agglutinated by the anti-B in the recipient's type A blood. Likewise, a
person with type B (anti-A) blood must not be given type A or AB
blood, and a person with type 0 (anti-A and anti-B) blood must not
be given type A, B, or AB blood.
Because type AB blood lacks both anti-A and anti-B agglutinins, it
would appear that an AB person could receive a transfusion of blood
of any other type. For this reason, type AB persons are sometimes
called universal recipients. It should be noted, however, that type A
(anti-B) blood, type B (anti-A) blood, and type0 (anti-A and anti-B)
blood still contain agglutinins (either anti-A or anti-B) that could
cause agglutination of type AB cells. Consequently, even for AB
individuals, it is always best to use donor blood of the same type as
the recipient blood. If the matching type is not available and type A,
B, or 0 is used, it should be transfused slowly so that the donor blood
is well diluted by the recipient's larger blood volume. This precaution
usually avoids serious reactions between the donor's agglutinins and
the recipients agglutinogens.
Similarly, because type 0 blood lacks agglutinogens A and B, it
would seem that this type could be transfused into persons with
blood of any other type. Therefore, persons with type 0 blood are
sometimes called universal donors. Type 0 blood, however, does
contain both anti-A and anti-B agglutinins, and if it is given to a
person with blood type A, B, or AB, it too should be transfused
slowly to minimize the chance of an adverse reaction.
43
Rh Blood Group
The Rh blood group was named after the rhesus monkey in which it
was first studied. In humans, this group includes several Rh
agglutinogens (factors). The most important of these is agglutinogen
D; however, if any of the Rh factors are present in the red cell
mernbranes, the blood is said to be Rh positive. Conversely, if the red
cells lack Rh agglutinogens, the blood is called Rh negative.
As in the case of agglutinogens A and B, the presence (or absence)
of an Rh agglutinogen is an inherited trait. Unlike anti-A and anti-B,
agglutinins for Rh (anti-Rh) do not appear spontaneously. Instead,
they form only in Rh-negative persons in response to special
stimulation.
If an Rh-negative person receives a transfusion of Rh-positive
blood, the recipients antibody – producing cells are stimulated by the
presence of the Rh agglutinogen and will begin producing anti-Rh
agglutinin. Generally no serious consequences result from this initial
transfusion, but if the Rh-negative person – who is now sensitized to
Rh-positive blood – receives another transfusion of Rh-positive
blood some months later, the donor's red cells are likely to
agglutinate.
Post-text assignments
1 Respond to the given assigments:
1 Distinguish between agglutinogens and agglutinins.
2 What is meant by blood type?
3 What is the main concern when blood is transfused
from one individual to another?
4 Why is a type AB person called a universal recipient?
2 Form sentences of your own using the following words and
phrases:
immunity to infection, on exertion, mistaken for plasma, life-span,
combatting infection, reversible function, responsible for, ulcerative
lesions, engulf, deficient in vitamin K, due to hemorrhage, to test for
the presence of, capillary fragility
44
3 Translate into English:
1 Кров - це рідка тканина, яка виконує багато різноманітних
функцій.
2 Рідка частина крові називається плазмою.
3 Кров насичується киснем у легенях.
4 У дорослих кров становить від 1/12 до 1/14 маси тіла.
5 Білірубін - продукт гемоглобіну.
6 Запальні стани характеризуються підвищенням ШОЕ, тобто
швидкості осідання еритроцитів.
7 Білі кров'яні тільця, або лейкоцити, відіграють важливу роль
у боротьбі з інфекціями.
8 Грунтовні знання про сумісність груп крові є необхідними
для переливання крові.
Unit 17
Pre-text assignments
1 Learn the key words and phrases:
leukocytes, myloid leukemia, red bone marrow, lymphoid
leukemia, lymph nodes, mature, neutrophils, crowd out, invade,
weaken, counteract
2 Find substitutes for the given phrases:
1) fatal disease with marked increase in
number of blood leukocytes
a) myeloma
2) inflammation of the skin
b) cytopenia
3) a tumour composed of cells of the
c) lupus erythematousus
type normally found in the bone
d) occult
marrow
e) merrow
4) deficiency in the cells of the blood
f) leukemia
5) obscure or hidden from sight
6) soft material filling most of
the cavities and cancel of the bones
45
Leukemia
Leukemia is a form of cancer characterized by an uncontrolled
production of specific types of leukocytes. There are two major types
of leukemia. Myeloid leukemia results from an abnormal production
of granulocytes by the red bone marrow, while lymphoid leukemia is
accompanied by increased formation of lymphocytes from lymph
nodes. In both types, the cells produced usually fail to mature into
functional cells. Thus, even though large numbers of neutrophils may
be formed in myeloid leukemia, these immature cells have little
ability to phagocytize bacteria, and the patient has a lowered
resistance to infections.
Eventually, the cells responsible for the overproduction of
leukocytes tend to spread (metastasize) from the bone marrow or
lymph nodes to other parts, and as a result white blood cells are
produced abnormally in tissues throughout the body. As with other
forms of cancer, the leukemic cells finally appear in such great
numbers that they crowd out the normal, functioning cells. For
example, leukemic cells originating in red bone marrow may invade
other regions of the bone, weakening its structure and stimulating
pain receptors. AIso, as the normal red marrow is crowded out, the
patient is likely to become anemic and develop a deficiency of blood
platelets (thrombocytopenia). The lack of platelets is usually
reflected in an increasing tendency to bleed.
Leukemias are also classified as either acute or chronic. An acute
condition appears suddenly, the symptoms progress rapidly, and
death occurs in a few months if the condition is untreated. Chronic
forms begin more slowly and may remain undetected for many
months. Without treatment, life expectancy is about three years.
The greatest success in treatment has been achieved with acute
lymphoid leukemia, which is the most common cancerous condition
in children. This treatment usually involves counteracting the side
effects of the condition, such as anemia, hemorrhaging, and an
increased susceptibility to infections, as well as administering
chemotherapeutic drugs.
46
Although acute lymphoid leukemia may occur at any age, the
chronic form usually occurs after fifty years of age. Acute myeloid
leukemia also may occur at any age, but it is more frequent in adults;
chronic myeloid leukemia is primarily a disease of adults between
twenty and fïfty years of age.
Post-text assignments
1 Answer the qustions using the topical unit:
1 What is leukemia?
2 Distinguish between myeloid and lymphoid leukemia.
3 Is acute leukemia easily found?
4 Where can the symptoms of the disease appear?
5 How is acute leukemia developed?
6 What factors are involved in the course of acute leukemia?
2 Translate the following terms and use them in making sentences of
your own:
chemotherapy, granulocytic, dysfunction, hematologist, marrow,
immunoglobulin, lymphatic, disorder
3 Discuss the problems of leukemia speculating about the chances of
finding an effective treatment in the foreseeable future.
Unit 18
Pre-text assignments:
1 Learn the key words and phrases:
ducts, pump, mediastinum, bluntly pointed apex, apical heartbeat,
atria, ventricles, septum, atrioventricular orifice, cardiac cycle
2 Choose the correct description of the following terms:
1) disease
a) the pressure exerted by the blood
against the inner walls of the blood
vessels
2) stroke
b) any departure from health, a
47
3) blood pressure
4) drug
5) fatigue
particular destructive process in an
organism
c) a sudden attack, especially of
apoplexy or paralysis
d) physical or mental exhaustion,
weariness
e) any substance used as a medicine;
narcotic
3 Translate the following expressions:
to be composed of smth; to be protected by smth; to be supplied
with smth; to distribute smth; by means of smth; to cause smth; any
interruption of smth; to be (not) equal in size;to be of vital
importance
Cardiovascular System
The cardiovascular system is the portion of the circulatory system
that includes the heart and blood vessels. It moves the blood between
the body cells and the organs of the integumentary, digestive,
respiratory, and urinary systems that communicate with the external
environment. In performing this function, the heart acts as a pump
that forces blood through the blood vessels. The blood vessels, in
turn, form a closed system of ducts, which transports the blood and
allows exchanges of gases, nutrients, and wastes between the blood
and the body cells.
A functional cardiovascular system is vital for survival, because
without circulation, the tissues lack a supply of oxygen and nutrients,
and waste substances accumulate. Under such conditions, the cells
soon begin to undergo irreversible changes, which quickly lead to
death of the organism.
Heart
The heart is a hollow, cone – shaped, muscular pump located
within the mediastinum of the thorax and resting upon the
diaphragm. Although heart size varies with body size, the heart of an
48
average adult is generally about 14 centimeters long and 9
centimeters wide.
The heart is located within the mediastinum, and is bordered
laterally by the lungs, posteriorly by the backbone, and anteriorly by
the sternum. Its base, which is attached to several large blood
vessels, lies beneath the second rib. Its distal end extends downward
and to the left, terminating as a bluntly pointed apex at the level of
the fifth intercostal space. For this reason, it is possible to
sense the apical heartbeat by feeling or listening to the chest wall
between the fifth and sixth ribs, about 7.5 centimeters to the left of
the midline.
Internally, the heart is divided into four hollow chambers, two on
the left and two on the right. The upper chambers, called atria (sing.
atrium), have relatively thin walls and receive the blood from veins.
The lower chambers, the ventricles, force the blood out of the heart
into arteries. (Note: Veins are blood vessels that carry the blood
toward the heart; arteries carry the blood away from the heart.)
The atrium and ventricle on the right side are separated from those
on the left by a septum. The atrium on each side communicates with
its corresponding ventricle through an opening called the
atrioventricular orifice, which is guarded by an atrioventricular valve
(A-V valve).
The wall of the heart is composed of three distinct layers: an outer
epicardium, a middle myocardium, and an inner endocardium.
The epicardium, which corresponds to the visceral pericardium,
functions as an outer protective layer. It is a serous membrane that
consists of connective tissue covered by epithelium, and it includes
blood capillaries, lymph capillaries, and nerve fibers.
The middle layer, or myocardium, is relatively thick and consists
largely of the cardiac muscle tissue responsible for forcing the blood
out of the heart chambers. The muscle fibers are arranged in planes,
separated by connective tissues that are richly supplied with blood
capillaries, lymph capillaries, and nerve fibers.
The inner layer, or endocardium, consists of epithelium and
connective tissue that contains many elastic and collagenous fibers.
49
The connective tissue also contains blood vessels and some
specialized cardiac muscle fibers called Purkinje fibers.
The endocardium lines all of the heart chambers and covers the
structures, such as the heart valves, that project into them. This inner
lining is also continuous with the inner lining of the blood vessels
(endothelium) attached to the heart.
Post-text assignments:
1 Say what heart valve is described in each sentence:
1 This valve connects the atrium and the ventricle of the left heart
chamber. 2 This valve connects the atrium and ventricle of the right
heart chamber. 3 This valve is located at the point of origin of the
aorta in the left ventricle. 4 This valve is located at the point of origin
of the pulmonary artery in the right ventricle.
2 Combine the nouns with appropriate verbs:
the heart, the blood, the artery;
contract, pass, dilate, bring, regulate, pump, vary, beat, compose,
work, consist of, discharge out, receive, enter, act, serve, send,
oxyginate, carry
3 Say what is meant in the following sentences:
1 This part of the heart discharges out the blood received from the
pulmonary circulation through the aorta to the systemic circulation.
2 This part of the heart discharges out the blood received from the
systemic circulation to the lungs through the pulmonary arteries.
3 These corpuscles have great elasticity and flexibility. These
features give them the possibility to pass through very small
capillaries. 4 The count of these corpuscles in the blood of a healthy
person is 5,000 to 7,000 per cu mm. The number of these corpuscles
increases when a person becomes ill.
4 Choose the anatomic terms for the following:
1 The valve between the left atrium and left ventricle of the heart,
preventing a flow of blood into the atrium during systole. 2 The flaps
on the valves. 3 A muscular wall which is between the two lower
chambers of the heart. 4 A septum which separates the two upper
50
chambers (atria) of the heart. 5 The middle, the thickest layer of the
heart wall. 6 A delicate membrane (double-folded) which surrounds
the heart like a sac. 7 A thin outer layer of the heart wall. 8 The vein
that carries (drains) blood from the upper part (portion) of the body.
9 The vein that carries blood from the lower part of the body. 10 A
blood vessel that carries blood from some part of the body toward the
heart. 11 A blood vessel that carries blood from the heart to the
principal parts of the body. 12 The usual contraction of the heart.
13 The usual dilatation of the heart. 14 The main artery of the body
which carries blood from the left ventricle of the heart to arteries in
all organs and parts.
(a – superior vena cava; b – systole; c – aorta; d – mitral valve; e –
vein; f – inferior vena cava; g – pericar-dium; h – interatrial septum; i
– cusps; j – epicardium; k – diastole; l – myocardium; m – artery; n –
interven-tricular septum)
5 Find the necessary word with a definition that best completes each
sentence:
1 The aorta is the main ... of the systemic arteries. 2 Most of the
arteries are composed of three ... .3 The blood vessels on the anterior
... of the arm were dilated. 4 The walls of the left ... are three times as
thick as the walls of the right one. 5 Blood pressure is measured by a
device called a .... 6 Diastole is the ... phase of the heartbeat.
7 Systole is the active ... phase of the heartbeat.
a) coats: the layers of a tissue; b) ventricle: either of the two lower
chambers of the heart which receive blood from the atria and pump it
into the arteries; c) surface: the outer face or exterior of an object;
d) relaxation: loosening, lessening of force, etc.; e) vessel: a tube or
duct containing or circulating a body fluid; f) sphygmomanometer:
an instrument consisting of a band wrapped around the upper arm to
compress the artery, and an attached manometer; g) contraction: the
drawing up and thickening of a muscle fiber or a muscle in action
6 What is it?
The innermost layer of the heart, consists of an endothelial lining
and its supporting connective tissue. The endothelium is a single
51
layer of flattened epithelial cells, which is continuous with the
endothelium of the vessels entering and leaving the heart.
The endothelium is supported by a delicate layer of fibreelastic
connective tissue which accomodates gross movements of the
myocardium without damage to the endothelium. The endocardium
contains blood vessels, nerves and branches of the conducting system
of the heart.
7 What it is?
Free surface of it is covered by a single layer of flattened epithelial
cells, the mesothelium; a similar mesothelial layer lines the opposing
parietal pericardial surface. The mesothelial cells secrete a small
amount of serous fluid which lubricates the movement of the
epicardium on the parietal pericardium. A thin layer of fibro-elastic
connective tissure supports the mesothelium; this layer is connected
to the myocardium by a broad layer of adipose connective tissue.
Unit 19
Pre-text assignments:
1 Learn the key phrases:
cardiac cycle, isolated pumps, the only route of communication,
well-oxygenated, continuous circulation
2 Remember the meaning of the term-element "cardio." Form new
words using it:
acceleration, active, dilator, thrombosis, inhibitory, kinetic,
muscular, necrosis, pneumatic, spasm, stimulator, valvulitis,
vascular, myopathy, circulation
3 Analyse the structure of the following terms:
bradycardia, tachycardia, cardiomegaly, angionecrosis,
angiospasm, angiography, angiostenosis, hemangioma,
arteriosclerosis, arterial, arteritis, ventriculotomy, ventricular,
atrioentricular, vasodilation, vasoconstriction
52
4 Give the meaning of the following:
l) vasoconstriction
a) inserting a catheter into the heart.
2) cardiac murmur
b) chest pain
3) cardiac catheterization c) tightening of a vessel
4) ischemia
d) abnormal sound in the heart
5) nitroglycerin
e) twisted, dilated veins
6) varicose veins
f) abnormal heart rhythm
7) infarction
g) drug given for the relief of angina
8) arrhythmia
pectoris
9) emboli
h) area of dead tissue
10) angina pectoris
i) closure of a blood vessel
11) occlusion
j) insufficient blood flow to a tissue
k) floating clots or other material carried
in the bloodstream
5 Tanslate the following:
1 The blood will have less oxygen combined with hemoglobin
because the need of the active muscles has withdrawn more oxygen
than in a restful state. 2 Cardiac failure may be present when the
heart is functioning at 90 per cent efficiency or any fraction of the
norma1 100 per cent effectiveness. 3 A drug extracted from a plant
of the digitalis group is indicated in almost all cases of heart failure.
Actions of the Heart
Although the previous discussion described the actions of the heart
chambers separately, they do not function independently. Instead,
their actions are regulated so that the atrial walls contract while the
ventricular walls are relaxed, and ventricular walls contract while the
atrial walls are relaxed. Such a series of events constitutes a complete
heartbeat or cardiac cycle. At the end of each cycle, the atria and the
ventricles remain relaxed for a moment, and then a new cycle begins.
During a cardiac cycle, the pressure within the chambers of the
heart rises and falls. For example, when the atria are relaxed, the
blood flows into them from the large, attached veins. As these
53
chambers fill, the pressure inside gradually increases. About 70% of
the entering blood flows directly into the ventricles through the
atrioventricular orifices before the atrial walls contract. Then, during
atrial contraction (atrial systole), the atrial pressure rises suddenly,
forcing the remaining 30% of the atrial contents into the ventricles.
Although the heart is a unit, anatomically and functionally, it can
be thought of as two isolated pumps – the "right heart" and the "left
heart". Normally the only route of communication between these two
parts of the heart is the lung. The right heart receives blood from the
veins and pumps it into the lung by way of the lesser circulatory
system. In the lung the blood is supplied with oxygen. Then it moves
into the left heart. From the left heart the well-oxygenated blood is
pumped into a large artery called the aorta, which distributes it to the
entire body by means of the greater circulatory system. The blood is
returned to the heart by means of the veins. A continuous circulation
is thus kept up.
Post-text assignments:
1 Respond to the following assignments:
1 Where is the heart located?
2 Name and locate the four chambers of the heart.
3 Name the structure that separates the right and left sides of the
heart.
4 Describe the pressure changes that occur in the atria and ventricles
during a cardiac cycle.
5 What causes heart sounds?
6 How do changes in body temperature affect the heart rate?
2 Add the proper combining form, suffix or prefix, to the parts of
medical terms so as to fit their definitions:
1 A thickening and loss of elasticity in the inner walls of arteries,
accompanied by the formation of the deposition of fatty compounds
(athero...). 2 A thickening and loss of elasticity of the walls of the
arteries, as in old age (...sclerosis). 3 Abnormal heart rhythms
(...rrhythmia). 4 Inflammation of the endocardium (endocard...). 5 A
narrowing or constriction of a passage, duct, opening (as in a mitral
54
valve of a heart (mitral .. osis). 6 High blood pressure affecting the
heart and blood vessels (...tension). 7 Inflammation of a vein (...itis).
8 Lack of oxygen in blood (de...genation). 9 The branch of medicine
dealing with the heart, its functions, and its diseases (cardio...).
(a – a...; b - ...sclerosis; c – arterio...; d – sten...; e – ...itis; f –
phleb...;g – hyper...; h – ...logia; i – oxy...)
3 Translate in writing:
The valves of the heart consist of leaflets of connective tissue, the
surfaces being invested with a thin endothelial layer continuous with
that of the heart chambers and great vessels. The connective tissue of
each leaflet forms a tough fibrous sheet, the lamina fibrosa. The
valve connective tissue also contains a significant amount of elastin.
At the attached margins of each valve, the collagenous tissue
becomes condensed to form a fibrous ring and the rings of 'the four
valves together form a central fibrous "skeleton" which is continuous
with the connective tissue of the myocardium, endocardium and
epicardium.
4 Do you know that:
normocardia – a heart rate 60-100 beats/min
tachycardia – a heart rate that exceeds 100 beats/min
bradycardia – a heart rate of less than 60 beats/min
5 Give extended answers:
1 What do the contractions of the heart produce? 2 What is the
cardiac cycle composed of? 3 What is the role of the ventricles and
atria? 4 Describe the pulmonary circulation. 5 Describe the systemic
circulations. 6 What are the corpuscular elements of blood? 7 What
are the heart sounds? 8 Where is the first (second, third) heart sound
heard? 9 What do heart sounds help the doctors to determine?
55
Unit 20
Pre-text assignments:
1 Learn the key words and phrases:
blood vessels, arteries, arterioles, capillaries, venules, veins,
extensions, squamous epithelial cells, semipermeable membranes
2 Match the blood vessel or heart condition with its description:
1) rheumatic heart disease a) damage of the normal heart rhythm
2) atrial fibrillation
b) a vessel which supplies blood to the
heart
3) coronary artery disease c) irregular contractions of the upper
chambers of the heart
4) arrhythmia
d) inflammation of the inner lining of the
heart
5) vein
e) bradycardia or tachycardia
Blood Vessels
The blood vessels are organs of the cardiovascular system, and
they form a closed circuit of tubes that carries blood from the heart to
the body cells and back again. These vessels include arteries,
arterioles, capillaries, venules, and veins. The arteries and arterioles
conduct blood away from the ventricles of the heart and lead to the
capillaries. The capillaries function to exchange substances between
the blood and the body cells, and the venules and veins return blood
from the capillaries to the atria.
Arteries are strong, elastic vessels that are adapted for
carrying the blood away from the heart under relatively high
pressure. These vessels subdivide into progressively thinner tubes
and eventually give rise to fine branches called arterioles.
Capillaries are the smallest blood vessels. They form the
connections between the smallest arterioles and the smallest venules.
Capillaries are essentially extensions of the inner linings of these
larger vessels, in that their walls consist of endothelium – a single
layer of squamous epithelial cells. These thin walls form the
56
semipermeable membranes through which substances in the blood
are exchanged for substances in the tissue fluid surrounding body
cells.
The distribution of blood in the various capillary pathways is
regulated mainly by the smooth muscles that encircle the capillary
entrances.
Venules are the microscopic vessels that continue from the
capillaries and merge to form veins. The veins, which carry blood
back to the atria, follow pathways that roughly parallel those of the
arteries.
The walls of veins are similar to those of arteries in that way they
are composed of three distinct layers. However, the middle layer of
the venous wall is poorly developed. Consequently, veins have
thinner walls that contain less smooth muscle and less elastic tissue
than those of comparable arteries.
Blood pressure is the force exerted by the blood against
the inner walls of the blood vessels. Although such a force occurs
throughout the vascular system, the term blood pressure most
commonly refers to systemic arterial pressure.
The arterial blood pressure rises and falls in a pattern
corresponding to the phases of the cardiac cycle. That is, when the
ventricles contract (ventricular systole), their walls squeeze the blood
inside their chambers and force it into the pulmonary trunk and aorta.
As a result, the pressures in these arteries rise sharply. The maximum
pressure achieved during ventricular contraction is called the systolic
pressure. When the ventricles relax (ventricular diastole), the arterial
pressure drops, and the lowest pressure that remains in the arteries
before the next ventricular contraction is termed the diastolic
pressure.
The surge of blood entering the arterial system during a ventricular
contraction causes the elastic walls of the arteries to swell, but the
pressure drops almost immediately as the contraction is completed,
and the arterial walls recoil. This alternate expanding and recoiling of
an arterial wall can be felt as a pulse in an artery that runs close to
the surface.
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Post-text assignments:
1 Answer the questions using the topical unit:
1 Distinguish between systolic and diastolic blood pressure.
2 What cardiac event is responsible for the systolic pressure? For the
diastolic pressure?
3 What causes a pulse in an artery?
2 Respond to the given questions:
1 Based on your understanding of the way capillary blood flow is
regulated, do you think it is wiser to rest or to exercise following a
heavy meal? Give a reason for your answer.
2 If a patient develops a blood clot in the femoral vein of the left leg,
and a portion of the clot breaks loose, where is the blood flow likely
to carry the embolus? What symptoms is this condition likely to
produce?
3 When a person strains to lift a heavy object, intrathoracic pressure
is increased. What do you think will happen to the rate of venous
blood returning to the heart during such lifting? Why?
4 Why is a ventricular fibrillation more likely to be life threatening
than an atrial fibrillation?
3 Choose the proper continuation:
1 the tunica intima the epicardium, surrounded by a space, the
pericardial cavity, enclosed by a fibrous sac;
2 the tunica demia endocardium, smooth layer of cells which lines
the interior of the heart;
3 the tunica adventitia myocardium, the thickest muscular layer.
4 What is characterized by the following features?
1The tunica consists of little more than the endothelial lining.
2 The tunica media is thin compared with that of arteries.
3 The tunica adventitia is the thickest layer-of the vessel wail and is
composed of longitudinally arranged thick collagen fibres which
merge with the surrounding connective tissue. (vein or aorta).
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Unit 21
Pre-text assignments:
1 Learn the key words and phrases:
pulmonary circuit, systemic circuit, pulmonary trunk, lobar
branches, pulmonary capillaries, pulmonary veins, vascular loop,
companion system of veins
2 Match the following English phrases with Ukainian ones:
1) red blood cells
a) згортання крові
2) to combat infection
b) забезпечувати необхідну кількість
крові
3) to destroy bacteria
c) червоні кров’яні тілця
4) clotting of blood
d) боротися з інфекцією
5) to maintain an adequate
blood volume
e) руйнувати бактерії
3 Match the words with the opposite meaning and use them in the
sentences of your own:
1) benign, to exclude, frequently, insufficiency, permanent, to
diminish, to improve, to appear, gradual
2) to increase, seldom, malignant, sufficiency, to aggravate, to
include, to be constant, sudden, to disappear
Paths of Circulation
The blood vessels of the cardiovascular system can be divided into
two major pathways – a pulmonary circuit and a systemic circuit.
The pulmonary circuit consists of those vessels that carry the blood
from the heart to the lungs and back to the heart. The systemic
circuit is responsible for carrying the blood from the heart to all
other parts of the body and back again.
Pulmonary Circuit
The blood enters the pulmonary circuit as it leaves the right
ventricle through the pulmonary trunk. The pulmonary trunk extends
upward and posteriorly from the heart, and about 5 centimeters above
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its origin, it divides into the right and left pulmonary arteries. These
branches penetrate the right and left lungs, respectively. Within the
lungs, they divide into lobar branches (three on the right side and
two on the left) that accompany the main divisions of the bronchi
into the lobes of the lungs. After repeated divisions, the lobar
branches give rise to arterioles that continue into the capillary
networks associated with the walls of the alveoly.
The blood in the arteries and arterioles of the pulmonary circuit has
a relatively low concentration of oxygen and a relatively high
concentration of carbon dioxide.Gas exchanges occur between the
blood and the air as the blood moves through the pulmonary
capillaries.
As a result of the gas exchanges occurring between the blood and
the alveolar air, the blood entering the venules of the pulmonary
circuit is rich in oxygen and low in carbon dioxide. Four pulmonary
veins, two from each lung, return blood to the left atrium, and this
completes the vascular loop of the pulmonary circuit.
Systemic Circuit
The freshly oxygenated blood received by the left atrium is
forced into the systemic circuit by the contraction of the left
ventricle. This circuit includes the aorta and its branches that lead
to all of the body tissues, as well as the companion system of veins
that returns the blood to the right atrium.
Post-text assignments:
1 Respond to the following tasks:
1 Distinguish between the pulmonary and systemic circuits.
2 Trace a drop of blood through the pulmonary circuit from the right
ventricle.
3 Explain why the alveoli normally remain dry.
2 What system is this?
A characteristic feature of the system is the numerous delicate
valves in small and medium sized vessels. The structure of these
valves is similar to that nerves in the venous system, but the
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connective tissue core consists merely of reticulum fibres and a little
ground substance. (venous or lymphatic)
3 Choose the proper answer:
1 What is called pulmonary circulation?
a) the circulation of blood from the body organs to the heart and
back again;
b) the circulation of blood from the heart to ttie lungs and back to
the heart.
2 Where does the left ventricle discharge out the blood?
a) to the lungs through the pulmonary arteries;
b) to the systemic circulation through the aorta.
3 What are the arteries characterized by?
a) carry blood away from the heart;
b) carry deoxygenated blood.
Unit 22
Pre-text assignments:
1 Learn the key words:
atherosclerosis, atheromatous, thrombosis, saturated, utilization
2 Translate the following phrases:
to cause death, utilization ofsmth, to elevate cholesterol level, to
reduce cholesterol in blood, to affect smth.
3 Match the terms to the following definitions:
1) hardening and degeneration of arterial walls a) atheroma
2) the formation or presence of a thrombus in
b) thrombosis
a blood vessel
c) cholesterol
3) the principal animal sterol
d) atherosclerosis
4) degeneration of coats of blood vessels
e) affection
5) morbid condition or diseased state
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Atherosclerosis
The diseases associated with the condition commonly known as
"hardening of the arteries" cause more deaths than any other group of
diseases. Atherosclerosis is the process and result of the
accumulation of fats and fatlike substances (lipoids or lipidis) within
the walls of arteries. Among these substances are cholesterol and
phospholipids, present also in the blood plasma of all persons. High
cholesterol levels are associated with increased amounts of the
atheromatous materials in the arterial walls and with the
complications of this pathological condition. The disease affects me
coronary arteries notably, giving rise to the angina pectoris, coronary
thrombosis, abnormal heart rhythms, as well as weakness and failure
of the heart.
The causes and methods of prevention ofafherogenesis have been
under increasingly intensive study for many decades. In recent years
it has been shown that cholesterol level in the blood rises with
increases in the amount of ordinary fats in the diet. Fats that contain
unsaturated fatty acids cause smaller increases in cholesterol blood
levels than do the fats composed of saturated fatty acids. Corn oil,
certain other vegetable or plant oils, and certain fish oils are example
of unsaturated fats containing unsaturated fatty acids and producing
smaller rises in blood cholesterol. Indeed, corn oil has been shown to
lower cholesterol levels and is now used by some individuals in the
belief that they may be spared much, if not all, of the atherosclerosis
they may ordinarily expect. The fats of animals (even in the "lean
meat"), milk and eggyolk products (including butter), and, to a
slightly lesser extent, shortenings such as oleomargarine are mainly
saturated or hard fats and definitely elevate cholesterol levels.
Several products containing plant oils with unsaturated fatty acids,
principally linoleic, have recently been made available. This and
cortam other acids have been shown in animals to be necessary
dietary factors, comparable to essential amino acids. Since
pyridoxine (vitamin B^) is required for the proper utilization of these
essential vegetable fatty acids, it is incorporated in many products
containing these acids. Among these are Linodoxine and Arcofac.
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Lenic capsules contain the fatty acids without piridoxine. These
products are of little value unless the saturated fat in the diet is
markedly reduced. This alone is usually somewhat effective.
Measures for Lowering Blood Cholesterol. An effective but not a
very extensively used agent for lowering blood cholesterol is
nicotinic acid or niacin (a vitamin of the B complex). It causes
flushing at first but doses of 3 to 6 mg daily in divided amounts
orally may be given for long periods of time with apparent safety and
continued effect.
Another agent for attempting to reduce blood cholesterol is a 20
per cent suspension ofbeta-sitosterols (Cytellin), the sterols of certain
plants. It is used in a dose of 15 to 30 ml before meals. It is thought
to suppress absorption of cholesterol from the intestines, but reports
have been conflicting and it is not widely used.
A new drug, triparanol, is now one of the leading agent for
reducing the cholesterol level in the blood.
Post-text assignments:
1 Answer the questions:
1 What is atherosclerosis caused by? 2 What are highcholesterol
levels associated with? 3 What does the disease affect? 4 When does
the cholesterol level rise? 5 What do fats cause? 6 What produces
smaller rises in blood cholesterol?
2 Name the agents lowering the blood cholesterol.
3 Translate the following:
1 Атеросклероз супроводжується відкладанням холестерину в
стінках артерій, що негативно позначається на їх еластичності.
2 Порушення жирового обміну є однією з причин розвігпсу
атеросклерозу. З Гіпертонічна хвороба може спричинятися
атеросклерозом. 4 Підвищення тиску крові створює сприятливі
умови для відкладання холестерину на внутрішніх стінках
артерій. 5 Розлад центральної нервової системи, яка регулює
обмін речовин, сприяє розвиткові атеросклерозу. 6 Підвищення
артеріального тиску і судинні спазми також можуть спричинити
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склеротичні зміни в судинах. 7 Наслідками атеросклерозу
можуть бути коронарний тромбоз, порушення ритму серця і
стенокардія.
4 Choose the word that correctly completes each of the following
sentences:
1 The atherosclerosis patient should ... at least 7 – 8 hours. 2 Those
who drink alcohol do a great damage (harm) to die .... 3 Vitamins are
most... in treating atherosclerosis. 4 Vitamins prevent tile ... from
getting fatty and improve the metabolic processes. 5 The patient has
a healthy heart, a healthy ... of lungs, and an adequate blood volume.
6 A doctor can ... heart.... 7 Do you know Ac expressions "... heart",
"to... heart"?
(a – deer, dear; louse, lose, loose; b – slip, sleep; c – lever, liver; d
– hair, hear, hare, here; noise, rales, clamour, murmur; e – hut, hat,
hurt, heart; f – important, impotent;g – peer, pear, pair, pyre)
5 Read the quotation. Interpret its meaning in 10-12 sentences:
"When you talk with the patient you should listen, firstly, for what
he wants to tell, secondly, for what he does not want to tell, thirdly,
for what he cannot tell.” (Z. Henderson)
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Додаток А
Drawing 1. Major bones of the skeleton
Anterior view
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Додаток Б
(обов’язковий)
Drawing 2. Major bones of the skeleton
Posterior view
66
Додаток В
(обов’язковий)
Drawing 3. Anterior view of superficial skeletal muscles
67
Додаток Д
(обов’язковий)
Drawing 4. Posterior view of superficial skeletal muscles
68
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