HB 30084

Introduction into Human Body
Check Up. Work in groups and describe the word cloud.
1. Find the four major

structures of the human body.
2. Find two adjectives to
describe the human body.
3. Find two components that
allow animals to move.
4. Search for three functions of
the nervous system.
5. Find the major components
of circulation.
6. People breathe with these
organs.
7. Identify two organs of the
digestive system.
8. Find two bodily fluids.
Pronunciation. Listen and repeat the words and word combinations.

blood muscular
cardiovascular nervous
cartilage oxygen
digestive pancreas
endocrine pH
esophagus pharynx
gallbladder respiratory
gastrointestinal (GI) tract stomach
heart tissue
homeostasis tongue
kidneys urethra
lymphatic urinary
Reading. Read the text. Find answers to the following questions.
1. Why is the Human Body a complex living system?
2. What are the major human systems?
3. What are the functions of each body system?
4. What are the main organs of each body system?
5. What is the most important organ system?
The human body is a single structure but it is The muscular system is composed of specialized
made up of billions of smaller structures of four cells called muscle fibers. Muscles, attached to
major kinds: cells, tissues, organs, and systems. bones or internal organs and blood vessels, are
Cells, the basic building blocks of the human responsible for movement. The integrated action
body, make up tissues, which form specialized of joints, bones, and skeletal muscles produces
structures called organs. Organ systems are obvious movements such as walking and
groups of organs and tissues that all function running. Each organ or muscle consists of
together towards a single purpose. Ten major skeletal muscle tissue, connective tissue, nerve
systems include the skeletal, muscular, nervous, tissue, and blood or vascular tissue.
endocrine, cardiovascular, lymphatic, The nervous system is the major controlling,
respiratory, digestive, urinary, and the regulatory, and communicating system in the
reproductive system. Body functions are the body. It is the center of all mental activity
physiological or psychological functions of body including thought, learning, and memory.
systems. Human life process includes Together with the endocrine system, the nervous
organization, metabolism, responsiveness, system is responsible for regulating and
movements, reproduction, growth, maintaining homeostasis. Through its receptors,
differentiation, respiration, digestion, and the nervous system keeps us in touch with our
excretion. All these processes work together for environment, both external and internal.
the well-being of the individual and to maintain The cardiovascular system is sometimes called
life. the blood-vascular, or simply the circulatory,
The human skeletal system consists of bones, system. It consists of the heart, which is a
cartilage, ligaments and tendons and accounts for muscular pumping device, and a closed system
about 20 percent of the body weight. Bones of vessels called arteries, veins, and capillaries.
provide a rigid framework, known as the skeleton Blood contained in the circulatory system is
that support and protect the soft organs of the pumped by the heart around a closed circle or
body. Bones work together with muscles as circuit of vessels as it passes again and again
simple mechanical lever systems to produce through the various "circulations" of the body.
body movement.
When the respiratory system is mentioned, teeth are accessory structures located in
people generally think of breathing, but the mouth. The salivary glands, liver,
breathing is only one of the activities of the gallbladder, and pancreas are major accessory
respiratory system. The body cells need a organs that have a role in digestion. These organs
continuous supply of oxygen for the metabolic secrete fluids into the digestive tract.
processes that are necessary to maintain life. The The principal function of the urinary system is to
respiratory system works with the circulatory maintain the volume and composition of body
system to provide this oxygen and to remove the fluids within normal limits. One function is to rid
waste products of metabolism. It also helps to the body of waste products that accumulate as a
regulate pH of the blood. result of cellular metabolism, and, because of
The digestive system includes the digestive tract this, it is sometimes referred to as the excretory
and its accessory organs, which process food into system. The urinary system consists of the
molecules that can be absorbed and utilized by kidneys, ureters, urinary bladder, and urethra.
the cells of the body. The digestive tract, also The kidneys form the urine and account for the
called the alimentary canal or gastrointestinal other functions attributed to the urinary system.
(GI) tract, consists of a long continuous tube that The study of the human body
extends from the mouth to the anus. It includes involves anatomy, physiology, histology and
the mouth, pharynx, esophagus, stomach, small embryology.
intestine, and large intestine. The tongue and
I. Comprehension Check. Read the text again. Agree or disagree on these

statements.
1. The human being is a multiple complex structure.

2. Systems are groups of organs and tissues that have the same function.
3. Each organ has a specific role, which contributes to the overall wellbeing of the human
body.
4. The skeleton makes up almost one-fifth of a healthy body's weight.
5. Each organ or muscle have an abundant supply of blood vessels and nerves.
6. The vascular system is made up of the veins that carry blood and lymph through
the body.
7. Heart is responsible for regulating the core temperature of the body.
8. The respiratory system is the only body system to dispose the waste products of
metabolism.
9. Accessory organs of digestion include the liver, gall bladder, pancreas and salivary
glands.
10. The major function of the urinary system is to excrete metabolic wastes.
II. Comprehension Check. Guess the organ.
A hollow muscular organ

One of a pair of organs
of the body that expands
in the chest that supplies
and contracts to move
the body with oxygen.
blood through the vessels.
They remove waste and Any of the hard pieces that

extra water from the blood. form your body.
An organ that controls your An organ in the body that

body's activities. produces insulin.
A fleshy movable part of the

mouth used in tasting.
Vocabulary. Choose the correct variant.

1. I think that having a big heart/kidney/brain means that you are a very caring and loving
person. (Idiom)
2. A person will feel heartburn when stomach acid flows back up into the
gallbladder/liver/esophagus.
3. Muscles/bones/cartilage provide a rigid framework that supports and protects the body organs.
4. We put a lot of nerves/lymph/blood, sweat, and tears into fixing our old house. (Idiom)
5. My heart/muscles/stomach/ has been hurting for the past few days after eating spicy foods.
6. A fake smile is smiling with your mouth but not with your eyes, just showing your
teeth/tongue/gums. (Idiom)
7. Anatomy/physiology/embryology focuses on how organisms, organ systems, individual organs,
cells function.
8. Histology/anatomy/physiology is a field in the biological sciences concerned with the description of
the body structures.
Language Spot. How important are the accurate patient records?

Asking short and gentle questions.
TAKING PATIENT’S
✓ Ask gentle questions to put the patient HISTORY
at ease. Taking a history from a patient is a skill
Can you tell me who/what +noun +verb? necessary for examinations and
What’s your name/surname? afterwards as a practicing doctor, no
Can you tell me what’s your matter which area you specialize in. It
name/surname? tests both your communication skills as
✓ Remove words to make questions
well as your knowledge about what to
ask. Specific questions vary depending
shorter.
on what type of history you are taking
What’s your first name? Your first name?
but if you follow the general framework
Any other names? It’s Mary Jones, isn’t you should gain good marks in these
it?” stations.
Listening. Listen to a conversation between the receptionist and Mr. Karlson.

Examine the chart including personal details. Correct the wrong personal data.
Surname: Karlson
First Name: Dave Ian
Address: 3 Park View Avenue
Admission Details: Duncan Ward at 4 p.m.
on 9 Octomber 2008.
Hospital No. 19736045
DOB: 27 10 53
Phone number: 0177 405 7006
Marital Status: Married
Occupation: Postman
GP: Dr. Khan
C/o: (think of a possible chief complaint)
Speaking. Work in pairs. Role-play Dr. Nesbitt (Student A) and take the history
from the patient Mrs. Oldman (Student B), as in the exercise above. Remember to
be patient-centred and ask short and gentle questions.
Checklist. Assess your progress in this unit. Tick (✓) the statements which are true.
 I can identify and use new vocabulary about the human body.
 I can skip through the text for necessary details.
 I can explain the idioms and give my own examples.
 I can ask and deal with short and gentle questions.
 I can speak and use new information in my own dialogues.
Key Words.
Verbs
to account for gallbladder
to attach gastrointestinal tract
waste product
to provide growth
well-being
to remove heart
to rid homeostasis
to secrete kidney Adjectives
oxygen
pancreas accessory
Nouns
pH cardiovascular digestive
blood
pharynx endocrine
body weight
reproduction excretory
building block
responsiveness lymphatic
cartilage
stomach major
cell
supply muscular
device
tissue nervous
esophagus
tongue respiratory
fiber
fluid urethra
framework urine
responsible
soft
specialized
urinary
The Skeletal system
9. Find three
functions of the
skeletal system.
10. Find the
structural
components of
the
musculoskeletal
system.
11. Search for 3
types of bones.
12. The bony
framework of the
head.
13. Find two
finger names.
14. Find three
parts of the
arms.
15. Find three
parts of the legs.
16. Synonym of
chest.

femur periosteum
appendicular phalanges
axial fibula radius
calcium girdle. sacrum
cartilage humerus skull
clavicle marrow sternum
coccyx musculoskeletal tibia
column patella torso
The Skeletal system
ulna vertebrae via

1. What are the major functions of the skeletal system?
2. How many bones are there?
3. What does the axial skeleton consist of?
4. What does the appendicular skeleton comprise?
5. Describe types of bones and give examples.
The skeletal system works as a support structure There are 206 bones in an adult human
for the body. It gives the body its shape, allows skeleton. Infants are born with about 300
movement, makes blood cells, provides separate bones, fused together until growth stops.
protection for organs and stores minerals. The Each bone has three main layers:
skeletal system is also called the musculoskeletal • Periosteum: The periosteum is a tough
system. The skeletal system is the body’s central membrane that covers and protects the outside of
framework. It consists of bones and connective the bone.
tissue, including cartilage, tendons, and • Compact bone: Below the periosteum,
ligaments. It’s also called the musculoskeletal compact bone is white, hard, and smooth. It
system. provides structural support and protection.
The skeletal system has many functions. Besides • Spongy bone: The core, inner layer of
giving us our human shape and features, it: the bone is softer than compact bone. It has small
• Allows movement: The skeleton holes called pores to store marrow.
supports body weight to help us stand and move. Our bones are separated into two categories
Joints, connective tissue and muscles work based on the purpose and location of the bones:
together to make our body parts mobile. The axial skeleton and the appendicular skeleton.
• Produces blood cells: Bones contain The axial skeleton contains 80 bones, including
bone marrow. Red and white blood cells are the skull, spine and rib cage. It forms the central
produced in the bone marrow. structure of the skeleton, with the function of
• Protects and supports organs: The skull protecting the brain, spinal cord, heart and lungs.
shields the brain, while ribs protect the heart and Skull bones. The adult skull comprises 22 bones,
lungs, and backbone protects the spine. namely: cranial bones (8 bones that help to
• Stores minerals: Bones hold the body’s protect brain), facial bones (14 bones found on
supply of minerals like calcium, phosphorus and the front of the skull and make up the face).
vitamin D. The vertebral column is made up 26 bones. The
first 24 are all vertebrae (cervical vertebrae-
The Skeletal system
seven bones found in the head and neck),

thoracic vertebrae (12 bones are found in the
upper back), lumbar vertebrae (5 five bones The pelvic girdle, commonly known as
found in the lower back), followed by the sacrum the hips, is where the legs attach to the axial
and coccyx (tailbone). skeleton. It’s made up of two hipbones — one for
The thoracic cage is made up of the sternum each leg. Each lower extremity is composed of
(breastbone) and 12 pairs of ribs. These bones 30 bones, known as the:
form a protective cage around the organs of the • Femur. The femur is the large bone of
upper torso, including the heart and lungs. Some the upper leg.
of the ribs attach directly to the sternum (true • Tibia. The tibia is the main bone of the
ribs), others are linked to the sternum via lower leg. It forms the shin.
cartilage (false ribs), while some have no • Fibula. The fibula is the second bone in
attachment point (floating ribs). the lower leg, found in the outer leg.
The remaining 126 bones make up the • Patella. The patella is also called the
appendicular skeleton; they include the upper kneecap.
limbs, lower limbs, shoulder girdle and pelvic • Tarsals. The tarsals are the seven bones
girdle. The pectoral( shoulder) girdle is where the that make up the ankle.
arms attach to the axial skeleton. It’s made up of • Metatarsal. The metatarsals are the five
the clavicle (collarbone) and scapula (shoulder bones that make up the middle area of the foot.
blade). Each upper extremity contains 30 bones, • Phalanges. The phalanges are 14 bones
known as the: that comprise the toes.
• Humerus. The humerus is the long bone Bones are further classified by their shape: long,
of the upper arm. short, flat, irregular or sesamoid:
• Radius. The radius is one of two long • Long bones are found in the arms, legs,
bones of the forearm, found on the thumb side. fingers and toes.
• Ulna. The ulna is the second long bone • Short bones are found in the wrists and
of the forearm, found on the pinky finger side. ankles.
• Carpals. The carpals are a group of eight • Flat bones make up the skull, shoulder
bones found in the wrist area. blades, sternum and ribs.
• Metacarpals. The metacarpals are five • Irregular bones are those in the spinal
bones found in the middle area of the hand. cord and face.
• Phalanges. The phalanges are 14 bones • Sesamoid bones are found in the hands,
that make up the fingers. wrists, feet, ears and knees.
The Skeletal system

statements.
11. The skeleton provides a framework for your muscles and other soft tissues.
12. Tendons, ligaments and fibrous tissue bind the bones together to create stability.
13. Calcium and vitamin D are produced in the bone marrow.
14. Newborns can have less than 206 distinct bones.
15. Compact bone is a very porous and highly vascularized type of bone.
16. Shoulder girdle is a complex of bones that connects the trunk and the lower limbs.
17. Fibula is the largest, strongest, and most anterior of the two lower bones.
18. Each arm and leg include 30 bones.
II. Comprehension Check. Divide the bones into axial and appendicular skeleton.
Carpals Radius
Coccyx Ribs
Femur Shoulder girdle
Fibula Skull
Humerus Patella
Metacarpals Spine
Pelvic girdle Sternum
Tarsals Tibia
Metatarsals Ulna
Vocabulary. Find synonyms for the following words.

9. Joints, connective tissue and muscles work together to make our body parts mobile.
10. The skull shields the brain, while the backbone protects the spine.
11. Infants are born with about 300 separate bones, fused together until growth stops.
12. The thoracic cage is made up of the sternum and 12 pairs of ribs.
13. The appendicular skeleton include the upper limbs, lower limbs, shoulder girdle and
pelvic girdle.
The Skeletal system
14. The axial skeleton is made up of the clavicle and scapula.

Language Spot. How important are accurate patient records?
Asking short and gentle questions.
ASKING ABOUT CHIEF
✓ Opening questions: COMPLAINTS -CC (PARTI)
What problems have brought you here One of the most important components
today? of the medical interview is the chief
Tell me what problems you’ve been complaint. The CC is a brief statement
having. that describes the symptom, problem,
Tell me what you’ve come to see me about. diagnosis, or other reason for the
What’s brought you to the hospital today? patient encounter (patient-centered;
What’s been troubling you? attentive listening to ensure accurate
How can I help you? and efficient information gathering with
I see that you have backache. Please tell facilitative responses: ‘uh-huh,’ ‘Go on,’
‘I see’).
me more about it.
Listening. Spot the difference between these 2 conversations.
✓ Write down details of what the patient said.

Compare your notes with a partner.
✓ Listen to another version of the same

conversation. Which details are different?
What is the difference in the questions that
the doctor uses in each conversation?
✓ Which technique is better for the patient?
✓ Which approach do you find easier to use?
Speaking. Work ln pairs. Student A take a history from Student B. What the
patient's complaint is? Use open questions. Your notes:
The Skeletal system
30 years of age male/female, pain in the elbow,

left handed, goes to the gym, plays squash, when
at work, pains in the wrist, doesn’t use support,
not go to the gym, walks in the park, flare-up
joints.
Checklist.
Assess your progress in this unit. Tick (✓) the statements which are true.
 I can identify and use new vocabulary in various drills.
 I can paraphrase the new words.
 I can ask patients about their chief complains.
 I can roleplay by using different types of questions and using colloquial language.
 I can persuade patients without upsetting them.
Key Words.
Verbs column tibia

core toe
to allow
feature torso
to comprise
femur tough
to link
fibula ulna
to make up
framework vertebrae
to provide
girdle wrist
to shield
growth
to store
humerus
to supply Adjectives
limb
patella appendicular
periosteum axial
Nouns
phalange inner
ankle pinky lower
blade radius musculoskeletal
bone marrow sacrum outer
calcium shin upper
cartilage skull
clavicle spine
coccyx
Preposition
sternum
collarbone via
thumb
The Muscular System
17. How do
muscles work
together?
18. What does
muscular system
provide (four
functions)?
19. Types of
muscular movements.
20. Physical
conscious actions.
21. What
muscle tissue is found
in the heart?
22. Muscles are
attached to the bones
by ………
23. The muscles
attached to the bones
of the skeletal system
are called………
24. Find two
movements of the
joint.
abduction extensibility
autorhythmic flexion
conscious glycogen
contractibility hypertrophy
elasticity inversion
The Muscular System
irritability striated
myocardium unconscious
smooth visceral

1. What are the major functions of the muscular system?
2. How many muscles are there?
3. Describe the properties of the muscle tissue.
4. What are the three types of muscle tissue?
5. What are voluntary and involuntary movements? Give examples.
There are about 600 muscles in the • Elasticity - Whenever a muscle has been
human body. Muscles have a range of functions shortened or lengthened, it has the ability to
from pumping blood and supporting movement return to its resting shape and length.
to lifting heavy weights or giving birth. Muscles • Adaptability – Muscle will hypertrophy
work by either contracting or relaxing to cause (enlarge) in response to increased work.
movement. This movement may be voluntary Conversely, it will atrophy (waste away) if it is
(meaning the movement is made consciously) or deprived of work.
done without our conscious awareness When discussing the skeletal system the
(involuntary). Besides its main function to movements that can occur at joints are the
provide the body with stability, shape, support flexion, extension, abduction, inversion etc.
and mobility, it stores the majority of the body's Skeletal muscles produce these movements by
carbohydrates in the form of glycogen. All pulling bones in different directions.
muscle types share the following unique There are three types of muscle tissue, based on
properties that allow them to function properly. which all the muscles are classified into three
• Irritability – They are capable of groups:
receiving and responding to stimulation from • Cardiac muscle forms the muscular
nerves. layer of the heart (myocardium). Found only in
• Contractibility – Once they have the heart, cardiac muscle is responsible for
received stimulation, the muscle is capable of pumping blood throughout the body. Cardiac
actively shortening (contracting). muscle tissue cannot be controlled consciously,
• Extensibility – With the application of so it is an involuntary muscle. The natural
force, muscle can be stretched without damage. pacemaker of the heart is made of cardiac muscle
tissue that stimulates other cardiac muscle cells
The Muscular System
to contract. Because of its self-stimulation, physical action that a person
cardiac muscle is considered to be autorhythmic consciously performs (e.g. speaking, walking, or
or intrinsically controlled. The cells of cardiac writing) requires skeletal muscle. The function of
muscle tissue are striated—that is, they appear to skeletal muscle is to contract to move parts of the
have light and dark stripes when viewed under a body closer to the bone that the muscle is
light microscope. Striations indicate that a attached to. Most skeletal muscles are attached to
muscle cell is very strong, unlike visceral two bones across a joint, so the muscle serves to
muscles. move parts of those bones closer to each other.
• Smooth muscle comprises the walls of Striated just like cardiac muscle, these skeletal
blood vessels and hollow organs (viscera). muscle fibers are very strong. Skeletal muscle
Visceral muscle is found inside of organs like the derives its name from the fact that these muscles
stomach, intestines, and blood vessels. The always connect to the skeleton in at least one
weakest of all muscle tissues, visceral muscle place.
makes organs contract to move substances Muscles cannot move the body on their own.
through the organ. Because visceral muscle is They need the skeletal system to act upon. The
controlled by the unconscious part of the brain, it two systems together are often referred to as the
is known as involuntary muscle—it cannot be musculoskeletal system. Skeletal muscles are
directly controlled by the conscious mind. The attached to the skeleton by tough connective
term “smooth muscle” is often used to describe tissues called tendons. Many skeletal muscles
visceral muscle because it has a very smooth, are attached to the ends of bones that meet at a
uniform appearance when viewed under a joint. The muscles span the joint and connect the
microscope. This smooth appearance starkly bones. When the muscles contract, they pull on
contrasts with the banded appearance of cardiac the bones, causing them to move. The skeletal
and skeletal muscles. system provides a system of levers that allow
• Skeletal muscle attaches to the bones body movement. The muscular system provides
and provides voluntary movement. Skeletal the force that moves the levers.
muscle is the only voluntary muscle tissue in the
human body—it is controlled consciously. Every

statements.
19. Muscles play a key role in the movement of blood around the body.
20. Muscles can only contract.
21. Contractibility is the ability of a muscle to extend to a predetermined endpoint.
The Muscular System
22. Extensibility the natural ability of your musculoskeletal system to 'return to its
original state'.
23. The muscles that move our body parts are called skeletal muscles.
24. Smooth muscle makes up the thick middle layer of the heart.
25. Visceral muscle are found in most organs and are under involuntary control.
26. Cartilages are tough, fibrous cords of connective tissue that link skeletal muscles to bones.
II. Comprehension Check. Match the beginnings with their endings.
1. Muscles have various functions from
to move substances through the organ.
2. All muscle types share unique properties
cardiac muscle cells to contract.
3. Muscle will hypertrophy
consciously performs requires skeletal
4. Conversely, it will atrophy
muscle.
5. The musculoskeletal system movements
flexion, extension, abduction, inversion etc.
include
to two bones across a joint
6. The three types of muscle tissue are
if it is deprived of work.
7. Every physical action that a person
in response to increased work.
8. The natural pacemaker of the heart
pumping blood to giving birth.
stimulates
skeletal, cardiac and smooth.
9. Visceral muscle makes organs contract
that allow them to function properly.
10. Most skeletal muscles are attached
15. The voluntary movement is made consciously/unconsciously/ subconsciously.

16. Muscular system delivers/provides/stores most body's carbohydrates in the form of
glycogen.
17. Flexion/abduction/inversion is the medical term for bending an arm or leg.
18. The cardiac muscle is responsible for pumping blood within/throughout/in the body.
19. The cells of cardiac muscle tissue are striated/non-striated/smooth.
20. Smooth muscle comprises the walls of blood vessels and hello/hallo/hollow organs.
21. Skeletal muscles are attached to the skeleton by strong/tough/flexible connective
tissues.
22. The muscular system provides/gives/supplies the force to move.
The Muscular System
Language Spot. Work in pairs. Decide which of these instructions are
inappropriate to use with a patient.
• Could you clench your right hand for me?

GIVING INSTRUCTIONS
• If you could just pop off your clothes and….. REQUESTS ) PART I
(POLITE
• Take off your T-shirt. Giving instructions to a patient can
• soundknees
Can you just lie on your back with your very harsh
bent?at times. To soften
• imperatives,
I’d like you to stand up for me, if you can. add for me, please.
Ex. Undress for me, please.
• Turn on your right side.
✓ Use can/could to make the
• Just bring your legs to your chest and then relax. Yes,
instruction softerthat’s it!
by changing it
into request.
Giving instructions and polite ✓ Use If you can/could you just ….
requests ✓ You can also use I’d like you to
+verb
✓ Would you mind taking your
✓ Useful expressions for softening:
temperature?
Now just that’s it fine
✓ Bend your head forward for Ok good that’s fine
me, please.
✓ Could you just stretch your
hand forward? ✓ If you can/could slowly
✓ Could you lean backward for me, move your hands forward and up,
please? for me?
Listening. Listen to the following conversations and complete the sentences.
Make tilt, pop, keep, stand up, cough, turn.
 Can………..the screen and undress for me, please?
 I need to examine your lower back , so if you……
 Just …………………….for me. And again. That’s fine.
 I’d like……….. Do you need any help getting up?
 Could………………..head to the left? Yes. That’s it.
 Can you……………………. tight fist for me? Fine.
 I…………………………….. still for me if you can? Ok.

The Muscular System
Speaking.
Work in pairs. Make a
list of instructions you’d
give the child to carry
out the whole procedure.
Checklist. Assess your

progress in this unit. Tick (✓) the statements which are true.
 I can identify and use new vocabulary.
 I can decide if statements are appropriate to use with a patient.
 I can speak polite requests.
 I can give basic instructions to patients.
 I can roleplay by using polite instructions.
Key Words.
Nouns stripe
Verbs abduction
to allow awareness uniform
to derive carbohydrates viscera
to comprise contractibility
to lengthen damage. Adjectives
to perform elasticity autorhythmic
to pump extensibility conscious
to require flexion hollow
to respond glycogen light
to share hypertrophy smooth
to shorten inversion striated
to stretch irritability visceral
myocardium
pacemaker Prepositions
response throughout
The Muscular System
Useful References
Tony Grice, Oxford English for Careers: Nursing 1, OUP Oxford, 2007, p. 135 , ISBN-13 978-
0194569774
https://www.kenhub.com/en/library/anatomy/the-musculoskeletal-system
https://content.byui.edu/file/a236934c-3c60-4fe9-90aa-
d343b3e3a640/1/module7/readings/function_muscle_tissue.html
https://www.ptdirect.com/training-design/anatomy-and-physiology/the-muscular-system-2013-an-
overview
25. Name three

major components of
the Nervous System.
26. The
Nervous System
divides into 2 types…
27. Voluntary
actions include…
28. Involuntary
actions are …
29. Brain is a
complex organ that
controls…
30. What are
the three types of the
brain?
31. Define the
brain lobes.
32. … can
operate on brain tissue.
The Human Nervous System
autonomic gray matter

axons hemisphere
brainstem medulla oblongata
cell neuron
cerebellum nucleus
cerebral cortex occipital
cerebrum parietal
CNS PNS
corpus callosum pons Varolii
dendrites soma
foramen magnum white matter
1. What are the major functions of the nervous system?
2. What does CNS/PNS comprise?
3. Describe the white/gray matter.
4. What is the function of the brainstem/cerebellum/cerebrum?
5. Describe the spinal cord.
The nervous system is an organ system includes the cell nucleus, and special extensions
that coordinates voluntary and involuntary called axons and dendrites. Axons and dendrites
actions and responses by transmitting signals allow neurons to communicate, even across long
between different parts of our bodies. distances.
Specifically, the nervous system extracts The human nervous system is very
information from the internal and external complex. It has multiple divisions, beginning
environments, using sensory receptors. Usually, with its two main parts, the central nervous
it then sends signals encoding this information to system (CNS) and the peripheral nervous system
the brain, which processes the information to (PNS). The CNS includes the brain and spinal
determine an appropriate response. Finally, the cord, and the PNS consists mainly of nerves,
brain sends signals to muscles, organs, or glands which are bundles of axons from neurons. The
to bring about the response. The signals sent by nerves of the PNS connect the CNS to the rest of
the nervous system are electrical signals called the body.
nerve impulses, and they are transmitted by The brain is an immensely compound
special nervous system cells called neurons (or structure, but there are ways we can divide up its
nerve cells). A neuron has a cell body, which anatomical structure into more discrete parts; the
left and right hemisphere, parietal, temporal, autonomic activities, such as
occipital and frontal lobes. Another common heartbeat and respiration.
divider is to separate the brain’s gray and white The cerebellum, which stands for “little
matter. The central nervous system is made up of brain”, is a structure of the central nervous
grey matter and white matter. Gray matter system. It has an important role in motor control,
consists primarily of neuronal cell bodies, or with cerebellar dysfunction often presenting with
soma. This a spherical structure that houses the motor signs. In particular, it is active in the
neuron’s nucleus. White matter areas of the brain coordination, precision and timing of
mainly consist of myelinated axons, which are movements, as well as in motor learning. The
long relays that extend out from the soma, and cerebellum consists of two hemispheres, which
which are whitish in color due to the relatively are connected by the vermis, a narrow midline
high lipid fat content of the myelin protein. area. Like other structures in the central nervous
The brain is the headquarters of the system, the cerebellum consists of grey matter
entire nervous system and it is here that most of and white matter.
your sensing, perception, thinking, awareness, The cerebrum (also called the “cerebral
emotions, and planning take place. Among the cortex”) is the most advanced portion of the
simplest ways to organize the brain is to consider brain. The cerebral hemispheres (the left and
the brain stem, the Cerebellum, and the right hemispheres that make up each side of the
Cerebrum. top of the brain) are in charge of the types of
The brainstem is the most basic structure processes that are associated with more
of the brain and is located at the top of the spine awareness and voluntary control such as
and bottom of the brain. It is in charge of a wide speaking and planning as well as contain our
range of very basic “life support” functions for primary sensory areas (such as seeing, hearing,
the human body including breathing, digestion, feeling, and moving). These two hemispheres are
and the beating of the heart. Medulla oblongata connected to one another by a thick bundle of
is the lowest part of the brain and the lowest axons called the corpus callosum.
portion of the brainstem. The medulla oblongata Besides looking at the brain as an organ,
is connected by the pons Varolii to the midbrain it is also associated with specific functions of the
and is continuous posteriorly with the spinal brain lobes. The occipital lobe, located at the
cord, with which it merges at the opening back of the cerebral cortex, is the house of the
(foramen magnum) at the base of the skull. The visual area of the brain. The temporal lobe,
medulla oblongata plays a critical role in located on the underside of the cerebral cortex, is
transmitting signals between the spinal cord and where sounds and smells are processed. The
the higher parts of the brain and in controlling parietal lobe, at the upper back of the cerebral
cortex, is where touch and taste are processed.
Finally, the frontal lobe, located at the forward down through the spinal nerves.
part of the cerebral cortex is where behavioral The 31 pairs of peripheral spinal
motor plans are processed as well as a number of nerves emerge from the spinal cord through
highly complicated processes occur including spaces between the vertebrae.
speech and language use, creative problem The primary role of the PNS is to
solving, and planning and organization. connect the CNS to the organs, limbs, and skin.
The spinal cord connects to the brain at The peripheral nervous system itself is divided
the medulla oblongata and runs down the into two parts: the somatic nervous system and
vertebral column, the hollow tunnel enclosed the autonomic nervous system.
within the vertebrae of the spine. Sensory
information and motor commands travel up and

statements.
27. The nervous system coordinates involuntary actions.
28. Sensory receptors detect changes, which occur inside and outside the body.
29. Neurons carry messages in the form of electrical signals called nerve cells.
30. The central nervous system consists of the brain and neurons.
31. The brain is divided into the left and right halves.
32. The lowest portion of the brainstem is called medulla oblongata.
33. The primary role of the CNS is to connect the PNS to the organs, limbs, and skin.
34. A total of thirty-one pairs of spinal nerves control motor, sensory, and other functions.
II. Comprehension Check. Identify the parts of the Nervous System.

1. … are cells within the nervous system that transmit information to other nerve cells,
muscle, or gland cells.
2. … is part of a highway-like structure between the brain and the body known as the
brainstem.
3. … contains the major lobes of the brain and is responsible for receiving and giving
meaning to information from the sense organs.
4. … is a tail-like structure at the base of the brain that connects the brain to the spinal cord.
5. … is like a “mini-brain” when it comes to movement and plays an important role in
coordination, posture, and balance.
6. … ensures that both sides of the brain can communicate and send signals to each other.
23. Usually, the nervous system sends signals/ signs encoding this information to the brain.
24. The central nervous system is made up/ is done/ is formed of grey matter and white
matter.
25. The brain processes the information to determine an appropriate impulse/ response.
26. The hemispheres are associated with more awakeners/ awareness/alertness and voluntary
control.
27. The temporal lobe, located on the underside/downside/upside of the cerebral cortex
28. The parietal lobe is where touch and taste created/ processed/ facilitated.
29. The frontal lobe is where highly complicated processes derive/follow/occur.
30. Peripheral spinal nerves emerge/ appear/ exit from the spinal cord.
Language Spot. Why do you think it is important to know information
about the patient’s lifestyle or patient’s family?
 Social History:
✓ Physician-centered approach: GATHERING
“Do you smoke?” BACKGROUND
“Do you drink?” INFORMATION (PART I)
“Do you use illicit drugs?”
✓ Patient-centered approach: To get to know a new patient as a person,
“Where were you born?” it may be helpful to begin the history
“What is a typical day like for you? taking by asking questions related to the
“How much do you smoke?” social and family history. This may help
“How much do you drink?” the patient feel more at ease and can help
you in understanding risk factors and
 Family History:
background information that may be
✓ Physician-centered approach: essential in formulating a differential
“Do you have any family history of diagnosis. This includes:
heart attack, stroke, cancer, diabetes, ✓ Social History (to ask about
hypertension?” smoking, alcohol, and drug use, etc.)
✓ Patient-centered approach: ✓ Family History (to illicit information
“Tell me about your mother.” each first-degree relative or any in
“How old is she?” other family member).
“What medical problems does she
have?”
Listening. a) Listen to the nurse taking personal details. As you listen, think of the
following details. Take notes. b) Listen again and complete questions.
1. What…you? 5. …smoke?
2. …..date of birth? 6. …allergic to…?
3. Where…born? 7. Do any of your…..from…?
4. …married?
PATIENT RECORD
Surname ____________________________
First Name ____________________________
Gender M F
DOB ____________________________
Place of Birth ____________________________
Occupation ____________________________
Marital Status ____________________________
Next of kin ____________________________
Smoking intake
____________________________
Alcohol intake ____________________________
Allergies ____________________________
Reason for admission
Family history
 Mental illness
 Diabetes
 Tuberculosis
I. Speaking. Read the summary written by the nurse about the patient. Find
3 mistakes.
Mustapha Hussein was admitted to the hospital with possible

concussion after falling from a ladder and hitting his head. Mr. Hussein
was born in 1982. He is divorced and works as a painter. His next of kin
is his brother Yusuf. Mr. Hussein smokes 40 cigarettes a day. He does
not drink alcohol. He is allergic to nuts. There is a family history of
Diabetes from his father’s side.
II. Speaking. Write a similar summary using the information about S.Green.
PATIENT RECORD
Surname Green First Name Sarah____
Gender F DOB 15/1/89_________
Occupation accountant Marital Status Married_________
Next of kin sister Amy____________________________________________________
Smoking intake n/a Alcohol intake 10 units per
week
Reason for admission high blood pressure_______________________________
Family history stroke (mother’s side) Allergies_________________honey____
 I can explain and describe functions of the brain.
 I can take notes of the patient’s personal details.
 I can ask questions on patient’s social and family background.
 I can write a summary using the patient’s medical record.
Key Words.
Verbs cerebrum spinal
to admit CNS cord
to be in charge concussion top
to beat corpus callosum white matter
to breathe dendrite
to coordinate environment Adjectives
to enclose foramen magnum advanced
to encode gray matter autonomic
to extend headquarter entire
to house heartbeat hollow
to merge hemisphere multiple
to occur matter occipital
to runs down medulla oblongata parietal
to stand for neuron
nucleus Adverbs
Nouns PNS besides
awareness pons Varolii immensely
axon range mainly
bottom receptor underside
brainstem response
cell sign Prepositions
cerebellum signal within
cerebral cortex soma
Useful References
Sam McCarter , Medicine 1. Student's Book , Oxford University Press España, S.A. , 2009 , p.144, ISBN-13: 978-0194023009
What is Blood ?
33. Identify
three word
compounds with
“blood”.
34. What are
the colors associated
with blood?
35. There are 3
main blood
components …
36. About 55%
of our blood is …
37. A person
who provides blood is
a blood …
38. Foods to
help increase blood
circulation include…
39. Blood
deficiency is called…
40. … is a routine medical procedure.
anemia hormones
antibodies T-lymphocytes
arteries neutrophil
bacteria plasma
capillaries platelets
carbon dioxide RBC
CBC Rh factor
erythrocytes thrombocytes
erythropoietin transfusion
fibrin virus
hematocrit WBC
hemoglobin wound
What is Blood ?

1. What are the functions of blood?
2. What is plasma?
3. What is the function of RBCs?
4. What is the function of WBCs?
5. What do platelets help in?
Blood is a specialized body fluid. It has Red Blood Cells (also called
four main components: plasma, red blood cells, erythrocytes or RBCs), known for their bright red
white blood cells, and platelets. Blood has many color, are the most abundant cell in the blood,
different functions, including: accounting for about 40 to 45 percent of its
✓ transporting oxygen and nutrients to the volume. The shape of a red blood cell is a
lungs and tissues biconcave disk with a flattened center.
✓ forming blood clots to prevent excess blood Production of red blood cells is controlled by
loss erythropoietin, a hormone produced primarily by
✓ carrying cells and antibodies that fight off the kidneys. Red cells contain a special protein
infection called hemoglobin, which helps carry oxygen
✓ bringing waste products to the kidneys and from the lungs to the rest of the body and then
liver, which filter and clean the blood returns carbon dioxide from the body to the lungs
✓ regulating body temperature so it can be exhaled.
The blood that runs through the veins, White Blood Cells (also called
arteries, and capillaries is known as whole blood, leukocytes or WBCs) protect the body from
a mixture of about 55 percent plasma and 45 infection. They are much fewer in number than
percent blood cells. About 7 to 8 percent of your red blood cells, accounting for about 1 percent of
total body weight is blood. your blood. Leukocytes are primary players in
The liquid component of blood is called the body’s defense mechanism. This process of
plasma, a mixture of water, sugar, fat, protein, engulfing and destroying materials is called
and salts. The main job of the plasma is to phagocytosis. The most common type of white
transport blood cells throughout your body along blood cell is the neutrophil, which is the
with nutrients, waste products, antibodies, "immediate response" cell and accounts for 55 to
clotting proteins, chemical messengers such as 70 percent of the total white blood cell count. The
hormones, and proteins that help maintain the other major type of white blood cell is a
body's fluid balance. lymphocyte. There are two main populations of
What is Blood ?
these cells. T lymphocytes help regulate the antigens can trigger a patient's
function of other immune cells and directly immune system to attack the transfused blood,
attack various infected cells and tumors. B- safe blood transfusions depend on careful blood
lymphocytes make antibodies, which are typing and cross-matching. There are four major
proteins that specifically target bacteria, viruses, blood groups determined by the presence or
and other foreign materials. absence of two antigens, A and B, on the surface
Platelets (also called thrombocytes) are of red blood cells. In addition to the A and B
not actually cells but rather small fragments of antigens, there is a protein called the Rh factor,
cells. Platelets help the blood clotting process (or which can be either present (+) or absent (–),
coagulation) by gathering at the site of an injury, creating the 8 most common blood types (A+, A-
sticking to the lining of the injured blood vessel, , B+, B-, O+, O-, AB+, AB-).
and forming a platform on which blood Complete Blood Count (CBC) test gives
coagulation can occur. This results in the important information about the types and
formation of a fibrin clot, which covers the numbers of cells in your blood, especially the red
wound and prevents blood from leaking out. blood cells and their percentage (hematocrit) or
Fibrin also forms the initial scaffolding upon protein content (hemoglobin), white blood cells,
which new tissue forms, thus promoting healing. and platelets. The results of a CBC may diagnose
Blood types are determined by the conditions like anemia, infection, and other
presence or absence of certain antigens – disorders.
substances that can trigger an immune response
if they are foreign to the body. Since some

statements.
35. Plasma is the largest part of your blood, which makes up more than half of its overall
content.
36. The main role of plasma is to remove wastes from the body.
37. Red Blood Cells account for about 30 to 35 percent of blood amount.
38. Hemoglobin in blood carries oxygen from the respiratory organs to the rest of the body.
39. RBCs are the cells of the immune system.
40. White blood cells make up the most percentage of all blood cells.
41. Platelets are small, colorless cell fragments in our blood that prevent bleeding.
42. Blood types are determined by antibodies found in red blood cells.
43. Blood types must be carefully matched before a transfusion.
44. A complete blood count (CBC) is a test used to evaluate your blood type.
What is Blood ?
II. Comprehension Check. Guess the words.
1. the red coloring substance of erythrocytes –
2. a fluid tissue with many different functions –
3. the most numerous cellular elements of blood –
4. the “immune response” cells –
5. they make antibodies –
6. formation of clots –
7. the process of catching and destroying microbes by leukocytes –
8. the percentage of red cells in your blood –
III. Comprehension Check. Identify each type of blood cell under the microscope. Find
mistakes in the description above.
circular
There are many rectangular
red blood cells spreading easily
in the plasma. The red blood
cells appear to be bright blue
disks with pale centres and the
cells are of different size. There
are numerous white blood cells
in the sample. They are more
regular in shape than the red
blood cells. There is a high
number of platelets in this drop
of blood. They look like large,
oval -shaped cell fragments.

31. Antibodies help the body to fight up/off/down microbes or the toxins (poisons) they
produce.
32. Hormones and proteins help sustain/maintain/pertain the body's fluid balance.
33. RBCs may count for/calculate for/account for about 40 to 45 percent of the whole
amount.
34. Phagocytosis is when the WBCs surround, engulf/enlarge/enter, and destroy foreign
substances
35. Antibodies are proteins that specifically take/target/ strike bacteria, viruses, and other
foreign materials.
36. Blood clotting prevents excess blood loss/lose/loose.
What is Blood ?
Language Spot. a) Read the information and examples below. Why is it
so important for the doctor to give clear info?
✓ “This is a new diagnosis for you, so I EXPLANATION AND

want to make sure you understand. PLANNING
The teach-back method is used to
✓ “Will you tell me in your own words?” confirm the patients’ understanding.
✓ “I want to make sure I explained this To provide correct amount and type of
info the healthcare provider should:
clearly. “
✓ Give info in manageable chunks,
✓ “Okay, how do you see that?” check understanding (breaking
✓ “That would be a good plan, right?” down information into smaller
pieces rather than providing a
✓ “Just I’d like to tell you a little bit more large amount all at once)
about...” ✓ Ask patient what info would be
helpful (people have a broad
✓ “Just to make sure I've covered
range of information preferences
everything I need to ..” that may differ).
✓ “The last thing I’d like to know …” ✓ Avoid giving advice and
explanation prematurely
b) Make up a dialogue between the doctor and a patient. Use information to explain.
Doctor: Hi Jessica. (Ask about her condition).

Patient: A bit better.
Doctor: That's good to hear. (Ask if she still feels the same symptoms of…).
Patient: No, I haven't felt sick since you switched my medication.
Doctor: Great. (Say that you received the CBC results).
Patient: It's about time. Is it good news or bad?
Doctor: I guess it's a bit of both. (Explain the test results. The primary diagnosis is anemia).
Patient: Well, Doctor… it doesn’t seem good to me.
Doctor: Okay. (Say that she needs to have a few more blood tests just to exclude leukemia).
Patient: I was afraid you were going to say that.
Doctor: Now for the good news. (Explain that the blood indices are getting better and that she
needs to keep to a rich-iron diet).
Patient: Wow, that's a good thing! Thanks Doctor.
Doctor: Don't get too excited. There is a lot of work to be done.
Patient: All right. Thanks.
What is Blood ?
Listening. a) Listen to a nurse taking a blood test. Take notes. b) Listen again and
answer the questions.
1. How does the patient feel?

2. How much blood is the nurse going to take?
3. What problem does the test result show?
4. How many million red blood cells per
microliter does it show?
5. How can the patient correct the problem?
6. What is the shape of the red cells?
7. How is the patient’s white blood cell count?
8. How are the platelets?
9. How did the nurse calm the patient?
Speaking. Discuss the situation below. Give pro and con arguments.
A family was seriously injured in a car accident. A 12-years-

old girl, Sally Cook and her parents were in that car. Sally
has lost a lot of blood and needs a transfusion. Sally’s
parents belong to a religious group, which is against organ
and blood donation. They do not want their daughter to
have someone’s blood. Should the hospital respect their
wishes, or should they give a transfusion?
What is Blood ?
 I can I can talk about composition of blood
 I can describe the functions of blood components
 I know what the complete blood count includes
 I can explain information to patients
 I can skim and scan for the necessary information
Key Words.
Verbs carbon dioxide salt

to account for CBC scaffolding
to engulf clot sugar
to fight off clotting thrombocyte
to heal cross-matching T-lymphocyte
to leak out defense transfusion
to maintain erythrocyte virus
to regulate erythropoietin waste product
to result in excess WBC
to run through fat wound
to target fibrin
to trigger hematocrit Adjectives
hemoglobin specialized
hormone abundant
Nouns
injury foreign
anemia
lining flattened
antibody
neutrophil
artery
oxygen
bacteria Adverbs
plasma
balance. specifically
platelet
blood loss
RBC
capillary
Rh factor
Useful References
Tony Grice, Oxford English for Careers: Nursing 1, OUP Oxford, 2007, p. 135 , ISBN-13 978-0194569774
The Respiratory System
41. Organs of
breathing…
42. The 2
processes of the
respiratory system
are called …
43. The
respiratory system
breathes in …, and
breathes out …
44. The air is
inhaled by .. and …
45. The lungs
are covered by ..
46. This large
muscle aids in
breathing.
47. These can
affect your lungs.
48. Identify the most common lung diseases.
alveoli exchange
bronchioles exhale
diaphragm fissures
dome-shaped glucose
environment inhale
epiglottis larynx
mouth
pharynx
process tiny
pleura trachea
whereas
windpipe

1. What are the functions of the respiratory system?
2. Describe the structure of the lungs.
3. What is the role of pleura?
4. How does the diaphragm work?
5. Describe the air pathway.
The respiratory system is the network of are found in the thoracic cavity of our body
organs and tissues that help you breathe. (chest region). The left lung is slightly smaller
The respiratory system has many than the right lung due to the heart taking up extra
functions. Besides helping you inhale (breathe space on the left side of the chest.
in) and exhale (breathe out), it: The pleura is a slippery membrane that
• Allows you to talk and to smell. covers the lungs as well as the inside of the chest
• Warms air to match your body temperature wall. It allows the lungs to move smoothly during
and moisturizes it to the humidity level breathing and as the person moves. Normally, the
your body needs. two layers of the pleura have only a small amount
• Delivers oxygen to the cells in your body. of lubricating fluid between them.
• Removes waste gases, including carbon The diaphragm, located below the lungs,
dioxide, from the body when you exhale. is the major muscle of respiration. It is a large,
• Protects your airways from harmful dome-shaped muscle that contracts rhythmically
substances and irritants. and continually, and most of the time,
It consists of specialized structures involuntarily. Upon inhalation, the diaphragm
whose function is to take in oxygen from the contracts and flattens and the chest cavity
surrounding environment and expel carbon enlarges.
dioxide from the body. The primary organ The respiratory system starts at the nose
involved in this process is the lung and each and mouth and continues through the airways
individual contains a right and a left lung. The and the lungs. Air enters the respiratory system
right lung consists of three lobes: the superior, through the nose and mouth and passes down the
middle, and inferior, and two fissures while the throat (pharynx) and through the voice box, or
slightly smaller left lung contains two lobes the larynx. The entrance to the larynx is covered by
superior and inferior and one fissure. The lungs a small flap of tissue (epiglottis) that
automatically closes during swallowing, thus The word respiration
preventing food or drink from entering the describes two processes.
airways. Internal or cellular respiration is the process by
The windpipe (trachea) is the largest which glucose or other small molecules are
airway. The trachea branches into two smaller oxidised to produce energy: this requires oxygen
airways: the left and right bronchi, which lead to and generates carbon dioxide. External
the lungs. The bronchi (sg. bronchus) respiration (breathing) involves simply the stage
themselves branch many times into smaller of taking oxygen from the air and returning
airways, ending in the narrowest airways carbon dioxide to it.
(bronchioles), which are as small as one half of The main difference between internal
a millimeter across. The bronchial airways respiration and external respiration is
resemble an upside-down tree, which is why this that internal respiration refers to the gas
part of the respiratory system is often called the exchange across the respiratory membrane in the
bronchial tree. The walls of the smaller airways metabolizing tissues whereas external
have a thin, circular layer of smooth muscle. The respiration refers to the gas exchange across the
airway muscle can relax or contract, thus respiratory membrane of lungs.
changing airway size. Under normal conditions, the average
Thousands of small air sacs (alveoli) adult takes 12 to 15 breaths a minute. A breath is
are at the end of each bronchiole. Together, the one complete respiratory cycle that consists of
millions of alveoli of the lungs form a surface of one inspiration and one expiration.
more than 100 square meters. Within the alveolar Factors such as age, sex, body build, and
walls is a dense network of tiny blood vessels physical conditioning have an influence
called capillaries. The extremely thin barrier on lung volumes and capacities. Lungs usually
between air and capillaries allows oxygen to reach their maximum capacity in early adulthood
move from the alveoli into the blood and allows and decline with age after that.
carbon dioxide to move from the blood in the
capillaries into the air in the alveoli.

statements.
45. The respiratory system includes your airways, lungs and heart.
46. The functions of the respiratory system include gas exchange, phonation, pulmonary
defense and metabolism.
47. The lungs are a pair of spongy, air-filled organs located underneath the chest.
48. When you inhale through your nose or mouth, air travels down the throat
and then through your larynx.
49. The trachea conducts air into the lungs through two tubular branches, called bronchioles.
50. Gas exchange happens between the alveoli and a network of arteries.
51. Cellular respiration is the metabolic process in which cells obtain energy.
52. Our respiratory rate at rest increases, as we grow older.
II. Comprehension Check. Guess What I Am.

1. I am an organ that sit at the back of the throat, above the windpipe and produce sounds.
2. I am a little wider than my pairmate, but also shorter.
3. I create a vacuum effect that pulls air into the lungs.
4. I may prevents food and water from entering into the lungs.
5. A protect your lungs and help them slide.
6. I highly resemble an inverted tree.
7. I look like a tiny, balloon-shaped pouch where gas exchange occur.
Vocabulary. Paraphrase the New Vocabulary.

37. When you inhale, air enters your lungs, and oxygen from ... moves from your
blood to the lungs and is exhaled.
38. The bloodstream delivers oxygen to cells and removes waste carbon dioxide
through internal respiration.
39. External respiration, involves both bringing air into the lungs and releasing air to
the atmosphere.
40. The respiratory system also performs other vital roles in your body, such
as moisturizing the air you breathe.
41. The resulting system of tubules and airways resembles an upturned tree.
42. Every part of your body needs oxygen from the air you breathe in order to
survive.
43. Each lung is enveloped in its own slippery double-membrane called the pleura.
44. Total lung capacity is the total amount of air your lungs can hold.
Language Spot. Why is it important to ask a patient about allergies before giving
a medication?
MEDICATIONS/ALLERGIES GATHERING
✓ Physician-centered approach: BACKGROUND
“Do you take any prescription medications?”
INFORMATION (PART II)
“Do you take any over-the-counter It is essential to obtain an accurate list of
medications?” all the medications that your patient is
“Do you have any allergies to any medications?” taking. Instead of using medical terms
✓ Patient-centered approach: such as prescription and over-the-counter
(asking for detail) What do you take? medications, it may be more helpful to
(dose) How many times a day do you take it? use words such as pills, eye drops, nasal
sprays, inhalers, ointments, injections, or
(compliance) Do you always remember to take it? suppositories, etc. It is also important to
(side effects) Do you have any side effects? know not only what your patient is allergic
to, but also the reaction he or she
What kind? experienced.
(allergies) Which drug are you allergic to?
What symptoms do you get?
Listening. a) Listen to Mrs. McGuire taking a call on the helpline. As you listen.
Fill in the information about the patient.
1. age of patient ❑
2. wheezes breathing in ❑ breathing out ❑
3. coughs up blood yes ❑ no ❑
4. vomits yes ❑ no ❑
5. allergies yes ❑ no ❑
6. fever yes ❑ no ❑
b) Finish the conversation. Use questions to ask about:

1. What kind of medication has the child mother used? Ask separately about eye
drops, nasal sprays, inhalers, injections, and suppositories.
2. Did she purchase it at a grocery store, drugstore, or health store or on the Internet
without a prescription?
3. Ask about the dose and frequency. (i.e. one tablespoon twice a day, etc.)
Speaking. Role-play. Mrs. Peters is in the waiting room with her grandson,
Jimmy. She seems worried as she approaches the assistant.
Patient: It's been 3 days since our last visit to Dr. Ching.
Assistant: …
Patient: I make sure Jimmy takes the medicine Dr. Ching prescribed every day,
three times a day, but his coughing seems worse.
Assistant: …
Patient: Not really. The cough comes and go…
Assistant: …
Patient: No, but fever is getting higher.
Assistant: …
Patient: I'm just worried about the possibility of complications.
Assistant: …
Patient: Ok, I hope we won’t have to be hospitalized…
 I can explain and describe functions of the brain.
 I can ask questions on patient’s social and family background.
 I can write a summary using the patient’s medical record.
Key Words.
Verbs to expel
to allow to flatten Nouns
to branch to inhale adulthood
to breathe to involve airways
to breathe in to lead to amount
to breathe out to lubricate breath
to cover to moisturize bronchial tree
to deliver to refer to environment
to enlarge to require fissure
to exhale to resemble flap
irritants narrow
layer slippery Adverbs
throat smooth continually
Adjectives surrounding rhythmically
dome-shaped tiny smoothly
harmful upside-down
Useful References
0194569774
1. Name the major

processes of the
Digestive System.
2. These structures
play a key role in the
first step of digestion.
3. A long tube, which
receives food.
4. A food “container”.
5. The intestine is
divided into …and ….
6. The largest gland
that produces insulin.
7. A large organ that
helps purify blood.
8. What is the other
name for the digestive
tract?
ascending carbohydrates colon

bile cecum descending
detoxify ileum anus
digestion insulin rectum
digestive jejunum saliva
duodenum J-shaped sigmoid
enzyme liver small intestine
epiglottis esophageal stomach
esophagus sphincter stool
gallbladder mouth tongue
gastric juice pancreas
gastrointestinal papillae
GI tract peristalsis

1. What are the most important functions of the digestive system?
2. What does the GI tract include?
3. What are the accessory organs?
4. What other structures help in digestion?
5. Describe the food pathway.
The digestive system is made up of the The mouth is the beginning of the
gastrointestinal (GI) tract and three accessory digestive tract. The food is ground up by the
organs liver, pancreas and gallbladder. The GI teeth and moistened with saliva to make it easy
tract is a series of hollow organs that are to swallow. The tongue is a collection of muscles
connected to each other from the mouth to the working together to manipulate food for chewing
anus. The organs that make up the GI tract, in the and swallowing. In addition to use in digestion,
order that they are connected, include the mouth, the tongue plays an important role in tasting food
esophagus, stomach, small intestine, large and during speech. The upper surface of the
intestine and anus. tongue is covered with papillae that provide
Digestion is important because the body friction and contain the taste buds. Saliva also
needs nutrients from the food we eat and the has a special chemical, called an enzyme, which
liquids you drink in order to stay healthy and starts breaking down carbohydrates into sugars.
function properly. Nutrients include The pharynx, or throat, is the
carbohydrates, proteins, fats, vitamins, minerals passageway leading from the mouth and nose to
and water. The digestive system breaks down and the esophagus and larynx. The pharynx permits
absorbs nutrients from the food and liquids we the passage of swallowed solids and liquids into
consume to use for important things like energy, the esophagus, or gullet. The esophagus
growth and repairing cells. receives food from the mouth when swallowed.
The epiglottis is a small flap that folds over your The pancreas secretes
windpipe as you swallow to prevent you from digestive enzymes into the duodenum that break
choking (when food goes into your windpipe). A down protein, fats and carbohydrates. The
series of muscular contractions within the pancreas also makes insulin, passing it directly
esophagus called peristalsis delivers food to your into the bloodstream. Insulin is the chief
stomach. A ring-like muscle at the bottom of hormone in your body for metabolizing sugar.
your esophagus called the lower esophageal The liver has many functions, but its
sphincter (LES) has to relax to let the food in. main job within the digestive system is to process
The sphincter then contracts and prevents the the nutrients absorbed from the small intestine.
contents of the stomach from flowing back into Bile from the liver secreted into the small
the esophagus intestine also plays an important role in digesting
The stomach is a muscular, J-shaped fat and some vitamins. The liver also detoxifies
hollow organ, situated in the upper part of the potentially harmful chemicals. It breaks down
abdomen. It is a "container," that holds food many drugs that can be toxic to the body.
while it is being mixed with stomach enzymes. The gallbladder stores and concentrates
These enzymes continue the process of breaking bile from the liver, and then releases it into the
down food into a usable form. Cells in the lining duodenum in the small intestine to help absorb
of your stomach secrete a strong acid (gastric and digest fats.
juice) and powerful enzymes that are responsible The large intestine, or colon, is
for the breakdown process. When the contents of responsible for processing waste so that
the stomach are processed enough, they’re emptying the bowels is easy and convenient. It’s
released into the small intestine. The size of the about 2-meter long muscular tube that connects
stomach varies from person to person and meal the small intestine to the rectum.
to meal. The large intestine is made up of the
Made up of three segments — the cecum, the ascending (right) colon, the
duodenum, jejunum, and ileum — the small transverse (across) colon, the descending (left)
intestine is a 7-meter long muscular tube that colon, and the sigmoid colon, which connects to
breaks down food using enzymes released by the the rectum. Stool, or waste left over from the
pancreas and bile from the liver. The duodenum digestive process, is passed through the colon by
is the first segment of the small intestine. It’s means of peristalsis, first in a liquid state and
largely responsible for the continuous breaking ultimately in a solid form.
g-down process. The jejunum and ileum lower in The rectum is a straight, 20-centimetre
the intestine are mainly responsible for the chamber that connects the colon to the anus. The
absorption of nutrients into the bloodstream. sphincters relax and the rectum contracts,
disposing its contents.
The anus is the last part of the digestive Digestive health is
tract. It consists of the pelvic floor muscles and important because without a healthy digestive
the two anal sphincters (internal and external). It system, the body cannot properly break down
lets the brain know whether the contents are and absorb nutrients from food. Nutrients like
liquid, gas or solid. amino acids from proteins, fatty acids from fats
The anus is surrounded by sphincter and simple sugars from carbohydrates provide
muscles that are important in allowing control of energy and materials for growth and cell repair.
stool. .

statements.
1. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small
intestine, large intestine, and anus.
2. Chemical digestion in the small intestine relies on the activities of three accessory digestive
organs: the liver, pancreas, gallbladder and salivary glands.
3. Peristalsis is a voluntary coordinated contraction and important process of the digestive
system.
4. The stomach is a muscular organ located on the left side of the lower abdomen.
5. Small intestine absorbs nutrients and water from food so they can be used by the body.
6. The beginning portion of the small intestine begins at the entrance of the stomach.
7. The large intestine turns food waste into stool and includes the colon, rectum and anus.
8. The Digestive System is important because your body needs nutrients from the food you eat
and the liquids you drink in order to stay healthy and function.
II. Comprehension Check. Paraphrase the words.

1. The digestive tract is a long twisting tube that starts in the
mouth.
2. The pharynx is a muscular tube that connects the nasal
cavities to the larynx.
3. A heartburn is caused when gastric acid from your
stomach flows back up into your gullet.
4. Swallowing is one of the most obvious functions the epiglottis serves, because it hoods
over the larynx, when you eat and drink.
5. Chyme is then passed down into the small intestine, where digestion of food continues.
6. The large intestine processes and directs waste into the rectum where it is expelled
during a bowel movement.
III. Comprehension Check. Digestion time varies among individuals
and between men and women. Describe the picture and reflect upon the questions
below.
a) How long does it take to digest different foods?
b) What groups of food digest the fastest?
c) What is the slowest digesting food?
d) Is Milk easy to digest?
e) How can I improve digestion?
1. We were taught to chew/ to swallow/ to ingest our food thoroughly before swallowing/
breaking down/ chewing.
2. First, you must bit/ bite/ bitten into your food, allowing your back teeth to grind/ to ground/ to
gird it.
3. When a child is chopping/ choking/ chucking, it means that an object — usually food or a toy
— is stuck in the trachea.
4. Usually, your stomach is likely to expel/ to empty/ to enlarge several hours after you have had
a meal.
5. Then LES closes to stop food and acidic stomach juices from flowing back/ up/ down.
6. Digestive System can purify/ cleanse /detoxify by eliminating noxious foods, by either
vomiting or diarrhea.
Language Spot. Why is sympathy important? Do you understand the

difference between sympathy and empathy? Which term is older?
✓ Examples of non-verbal sympathy:
Patting on the shoulder.
Putting a hand on patient's arm when
SHOWING SYMPATHY
you tell them bad news. TO THE PATIENT
Dropping your tone of voice when you Compassion is considered an essential
element in quality patient care. Sympathy,
speak.
empathy, and compassion are closely
✓ Examples of verbal sympathy related terms. One of the conceptual
“Oh, I hope you feel better.” challenges in healthcare literature is that
“I’m sorry you’re hurting.” compassion is often confused with
“I’m so sorry, this must be awful.” sympathy and empathy.
“I get the sense that you are feeling …” Sympathy involves understanding from
“I can see you’re upset / annoyed / your own perspective. Empathy involves
frustrated. “ putting yourself in the other person's
“I can understand why you’re upset / shoes and understanding WHY they may
annoyed / frustrated.” have these particular feelings. The feeling
of sympathy is what makes you able to say
“I can certainly understand that you’re
the most appropriate things to someone
angry about having to wait so long.”
who is suffering. For example, you might
“I can sense how angry you’ve been
tell a patient you know what they're going
feeling about your illness.” through is difficult.
“This must be very difficult for you.”
Listening. a) Look at these statements. What are the doctor and patient talking
about? Then listen and decide which statements are true.
1. The doctor says it isn’t easy to stick to the diet

because of so many various tasty foods.
2. The patient has never diet before.
3. The patient gave up on eating crisps and other
junk foods.
4. The doctor suggests a gradual approach.
5. The doctor can’t really understand the patient's
situation.
6. The patient is reluctant to try the approach
suggested by the doctor.
7. The doctor suggests taking up yoga as an
exercise.
8. The doctor says he was more active in the past.
b) How would you describe the doctor's approach: sensitive or annoying?
c) Would the doctor’s suggestions work in all cases?
Speaking. Role-play.
Take turns role-playing the

doctor and encouraging
Mr. Ford, who is 117 kg and
1.80 metres tall with a waist
size of 110 cm, to lose
weight through physical
exercise. Use the BMI chart
to help you explain.
 I can describe the structure of the Digestive System.
 I know how to show sympathy to patients.
 I can advise patients losing weight.
 I can read a BMI chart.
Key Words.
Verbs to hold bile

to moisten bowels
to break down
to surround breakdown
to chew
to swallow carbohydrate
to choke
to vary cecum
to detoxify
colon
to empty
contents
to flow back Nouns
digestion
to grind up anus
duodenum
enzyme pancreas
epiglottis papillae Adjectives
esophageal peristalsis accessory
sphincter rectum ascending
esophagus saliva descending
gallbladder sigmoid digestive
gastric juice small intestine gastrointestinal
GI tract stomach J-shaped
ileum stool usable
insulin taste bud
jejunum tongue
Adverbs
liver
properly
mouth
Useful References
Sam McCarter , Medicine 1. Student's Book , Oxford University Press España, S.A. , 2009 , p.144,
ISBN-13: 978-0194023009
9. The other names of
microorganisms are...
10. Microorganisms include…

Microorganisms
11. The study of microorganisms is called …
12. Identify three bacteria.
13. Bacteria are used in production of …
14. What fungi do you know?
15. The most common viruses are …
16. The first discovered antibiotic is …
AIDS comma protozoa

algae DNA RNA
antibiotics fungi spirochaetes
archaea microbe rusts
bacilli microbiology smuts
bacteria microorganism species
bacterium mildews synthesis
biofilm molds Virus
cellulose nitrogen yeast
chlorophyll nucleus
cocci prokaryotes

1. What does Microbiology deal with?
2. Describe the bacteria.
3. Give a simple definition of fungi.
4. What are the viruses?
5. What are the positive and negative effects of microorganisms?
Microbiology, study of Bacteria, singular bacterium, any of a
microorganisms, or microbes, a diverse group of group of microscopic single-celled organisms
generally minute simple life-forms that that live in enormous numbers in almost
include bacteria, archaea, algae, fungi, every environment on Earth, from deep-sea
protozoa, and viruses. The field is concerned vents to deep below Earth’s surface to the
with the structure, function, and classification of digestive tracts of humans. Bacteria lack a
such organisms and with ways of both exploiting membrane-bound nucleus and other internal
and controlling their activities. We are going to structures and are therefore ranked among the
describe the tree most important types. unicellular life-forms called prokaryotes.
Microorganisms
Prokaryotes are the dominant living creatures on (spirochaetes). They can exist as
Earth, having been present for perhaps three- single cells, in pairs, chains or clusters. Based on
quarters of Earth history and having adapted to planes of division, the coccus shape can appear
almost all available ecological habitats. As a in several distinct arrangements: diplococcus,
group, they display exceedingly diverse streptococcus, tetrad, sarcina, and
metabolic capabilities and can use almost staphylococcus. The bacillus shape can appear as
any organic compound, and some inorganic a single bacillus, a streptobacillus, or a
compounds, as a food source. Some bacteria can coccobacillus.
cause diseases in humans, animals, or plants, but A collective of one or more types of
most are harmless and are beneficial ecological microorganisms that can grow on many different
agents whose metabolic activities sustain higher surfaces is called a biofilm. One common
life-forms. Other bacteria are symbionts of example of a biofilm is the dental plaque, a slimy
plants and invertebrates, where they carry out buildup of bacteria that forms on the surfaces of
important functions for the host, such as nitrogen teeth.
fixation and cellulose degradation. Without Fungus, plural fungi, any of about
prokaryotes, soil would not be fertile, and dead 144,000 known species of organisms of the
organic material would decay much more slowly. kingdom Fungi, which includes the yeasts, rusts,
Prokaryotic and eukaryotic cells differ in many smuts, mildews, molds, and mushrooms. Fungi
other ways, including lipid composition, belong to eukaryotic organisms because they
structure of key metabolic enzymes, responses to lack chlorophyll and vascular tissue and live by
antibiotics and toxins, and the mechanism of decomposing and absorbing organic matter from
expression of genetic information. Eukaryotic dead or living sources. A critical role of many
organisms contain multiple linear chromosomes fungi in nature is breaking down and recycling
with genes that are much larger than they need to nutrients of dead plants. Other fungi are
be to encode the synthesis of proteins. Bacteria symbionts of plants and animals. One
may also be aerobic and anaerobic. Aerobic distinguishing feature of fungi is the nature of
bacteria refer to the group of microorganisms their cell wall that contains chitin, which is
that grow in the presence of oxygen and thrive in similar to the exoskeleton of insects and
an oxygenic environment. Anaerobic bacteria arachnids. In humans, fungal infections are
refer to the group of microorganisms that grow in generally considered challenging to treat. Unlike
the absence of oxygen. Bacteria are also bacteria, fungi do not respond to traditional
classified into five groups according to their antibiotic therapy. Fungal infections may prove
basic shapes: spherical (cocci), rod (bacilli), deadly for individuals with compromised
spiral (spirilla), comma (vibrios) or corkscrew immune systems. Fungi have many commercial
Microorganisms
applications. The food industry uses yeasts in outnumber bacteria by 10 to 1.
baking, brewing, and cheese and wine making. Because viruses don’t have the same components
Many industrial compounds are byproducts of as bacteria, they cannot be killed by antibiotics;
fungal fermentation. Fungi are the source of only antiviral medications or vaccines can
many commercial enzymes and antibiotics. eliminate or reduce the severity of viral diseases,
Virus, infectious agent of small size and including AIDS, COVID-19, measles and
simple composition that can multiply only in smallpox.
living cells of animals, plants, or bacteria. A Many innovative technologies are
virus is a small collection of genetic code, either making use of microbes today. They are
DNA or RNA, surrounded by a protein coat. A currently being explored for construction,
virus cannot replicate alone. Viruses must infect bioremediation, energy security and generation,
cells and use components of the host cell to make and much more. The future of our relationship
copies of themselves. Often, they kill the host with these industrially important organisms is
cell in the process, and cause damage to the host likely to be as intricate and intriguing as our long
organism. Viruses have been found everywhere history with microorganisms.
on Earth. Researchers estimate that viruses

statements.
9. Microbiology is the study of all living organisms that are can be visible with the naked eye.
10. Bacteria are multicellular organisms which live everywhere and perform a variety of functions.
11. Bacteria are part of the normal flora of human skin and mucosal membranes.
12. Anaerobic bacteria are widely distributed in nature in oxygen-free habitats.
13. The three basic bacterial shapes are coccus (spherical), bacillus (rod-shaped), and spiral
(twisted).
14. A biofilm is composed of living, reproducing microorganisms, such as bacteria, that exist as a
colony.
15. Fungi can be single celled or very complex multicellular organisms.
16. Some species of fungi are naturally resistant to treatment with antifungal drugs.
17. A virus is a small infectious agent that can replicate on its own.
18. Antibiotics so not work on viruses.
Microorganisms
II. Comprehension Check. Guess the words.
9. a scientist who studies microscopic life forms –
10. the most dominant living creatures on Earth –
11. the natural environment of an organism –
12. round-shaped bacteria –
13. without oxygen –
14. fungi that affect a wide range of plants –
15. natural compound present in green plants that gives
them their color –
16. the ribonucleic acid –
III. Comprehension Check. You are a microbiologist. Describe the pathogens below
according to their shape and distinct arrangements. Do you know what diseases these may
cause? Surf online to search for information.
Vocabulary. Paraphrase the words.
7. In order to be able to carry out a good analysis, there must be well over one
million bacteria in each collected air sample.
8. When any organism dies, fungi and bacteria decompose things.
9. Bacteria are single-celled microorganisms that lack a nuclear membrane.
10. Other microbes can only live and replicate within a certain range of environmental
conditions.
11. All eukaryotic organisms require oxygen to thrive. .
12. However, the treatment of viral infections has proved more challenging.
Microorganisms
13. Regular brushing and flossing removes plaque and prevents tartar buildup.
14. Gram stain helps scientists distinguish between bacteria types.
Language Spot. When the patient says something that indicates how they feel, it
is important to be able to acknowledge the cues given by the patient. These cues
may be verbal, visual, intuitive, or aural. You need to acknowledge them to show
that you are listening and then follow them up with reassurance.
USEFUL EXPRESSIONS
It sounds/ looks/ seems as if... REASSURING
You sound/ look/ seem. ..(if I am PATIENTS
Reassurance is the removal of fears
right?) and concerns about illness.
The treatment can make it look worse ✓ In medicine, reassurance can refer
than it is. to the behavior of a caregiver
✓ or to the response of a patient.
With children, it's difficult to stop
✓ reassurance is said to have been
them scratching. successful if a patient responds to
You must have (been itching a lot with a clinical consultation with less
fear and concern about their
this). illness.
‘I wouldn't worry if I were you.’ Why do we reassure patient?
Reassurance may help patients
‘There is nothing wrong with your decrease their stress and anxiety,
skin’ and thus reducing inappropriate
pain behavior and encouraging
“No need to worry about…”
proactive healthy behavior.
“No, I say there is no reason
whatsoever for you to be concerned.”
Speaking. a) Work in pairs. Make up a short dialogue based on the scenario

below. What advice/reassuring expressions do you think should have been
given?
A 16-year-old high school student, presented to the clinic

with spots on his face, neck, back, and chest. He stated that
he had been bothered by acne that began gradually, varied
in severity, and never completely cleared. He tried over-the-
counter creams, gels and washes, as well as multiple facial
cleansing products, without improvement. He eliminated
Microorganisms
Listening. Listen to an extract of the consultation based on the scenario above.

Compare your own dialogue with this one. Answer the questions and say how
the doctor does it in each case.
1. Is the doctor sympathetic?

2. Is the doctor reassuring?
3. Is the language simple?
4. Does the doctors seek cooperation?
5. Is the doctor convincing in his words?
6. Does the doctor warn the patient about the duration of the treatment?
7. Does the doctor seek to involve the patient in the management?
8. What reassuring expression does the doctor use?
 I can describe different types of microorganisms
 I know to distinguish different species of bacteria
 I can use expressions to reassure the patients
 I can understand simple patient language
Key Words.
Microorganisms
Verbs decay
to carry out degradation antiviral
to decompose feature beneficial
to display fungi challenging
to exploit habitat deadly
to lack host distinct
to outnumber measles distinguishing
to rank microbe dominant
to refer to mildews enormous
to replicate molds fertile
to thrive plaque harmless
protozoa living
rusts rod-shaped
Nouns
severity single-celled
algae
smallpox slimy
archaea
smuts
bacteria
virus Adverbs
biofilm
yeasts exceedingly
brewing
buildup
chlorophyll Adjectives
Useful References
ISBN-13: 978-0194023009
0194569774
The Immune System
17. The major
functions of the
immune system are
…
18. Organs and
tissues important to
the immune system
include …
19. What are
two types of immune
systems?
20. A weaker
immune system is
typically caused by ..
21. Things to
boost my immune
system include …
22. A substance
used to provide
immunity against
pathogens …
23. The process of becoming immune …
acquired immunization
adjuvant innate
antibody leukocyte
B-lymphocytes mucus
cancerous pathogen
cytokine phagocyte
exposure phagocytosis
failure survival
immune sweat
The Immune System
T-lymphocytes vaccination

1. What is the role of our immune system?
2. What is the difference between the innate and immune system?
3. What are the lines of defense of our immune system?
4. What does the adaptive immune system include?
5. Why is immunization important?
The immune system is a host defense defense consists of non-specific cells and
system. It comprises many biological structures, responses, which are also part of the innate
ranging from individual white blood cells to immune system. Phagocytes and cytokines are
entire organs, as well as many complex both examples of defenders.
biological processes. The function of the immune The barrier defenses are not a response to
system is to protect the host from pathogens and infections, but they are continuously working to
other causes of disease such as tumor cells. To protect against a broad range of pathogens. The
function properly, the immune system must be phagocytes are the body’s fast acting line of
able to detect a wide variety of pathogens. The immunological defense against organisms that
layered defenses of the human immune system have breached barrier defenses and have entered
are usually classified into two subsystems called the vulnerable tissues of the body. For example,
the innate (inborn) immune system and the certain leukocytes (white blood cells) engulf and
adaptive (acquired) immune system. destroy pathogens they encounter in the process
Any discussion of the innate immune called phagocytosis. The body's response again a
response usually begins with the physical pathogen's breach is also called inflammation.
barriers that prevent pathogens from entering the The adaptive immune system is activated
body, destroy them after they enter, or flush them if pathogens successfully enter the body and
out before they can establish themselves in the manage to evade the general defenses of the
hospitable environment of the body’s soft innate immune system. An adaptive response is
tissues. The body's first line of defense of the specific to the particular type of pathogen that
innate immune system consists of physical has invaded the body or to cancerous cells. It
barriers (such as the skin and mucous takes longer to launch a specific attack, but once
membranes). The secretions on these surfaces it is underway, its specificity makes it very
(tears, mucus, and sweat) are part of the first line effective. The body's third line of defense is
of defense as well. The body's second line of highly specific adaptive immune responses that
The Immune System
target the invading pathogen. Examples of cells organism’s body that can be
involved in adaptive immune responses include distinguished from foreign substances by the
T-lymphocytes and B-lymphocytes. An adaptive immune system.
response also usually leads to immunity. This is An immune response initially involves the
a state of resistance to a specific pathogen due to production of antibodies that can bind to a
the ability of the adaptive immune system to particular antigen and the activation of antigen-
“remember” the pathogen and immediately specific white blood cells. Normally, low levels
mount a strong attack tailored to that particular of antibodies circulate in the body tissue fluids.
pathogen if it invades again in the future. However, when an immune response is activated
In order to protect the individual effectively greater quantities are produced to specifically
against disease, the following tasks need to be target the foreign material. Vaccination increases
fulfilled: the levels of circulating antibodies against a
• Immunological recognition: presence of an certain antigen. Vaccines influence the immune
infection must be detected (by the innate and response through the nature of the antigens they
adaptive immune systems) contain, including number and characteristics of
• Immune regulation limits damage to the host the antigens, or through the route of
by the immune response to antigen. Failure administration, such as orally, intramuscular or
of this regulation contributes to disease subcutaneous injection. The use of adjuvants in
states including allergy and autoimmune vaccines can help to determine the type, duration
disease. and intensity of the primary response and the
• The adaptive immune system generates characteristics of resulting antigen-specific
immunological memory – exposure to an memory. The increase in life expectancy during
infectious agent produces an immune the 20th century is largely due to improvements
response that can persist, and protect the host in child survival; this increase is associated with
in a subsequent exposure. reductions in infectious disease mortality, due
Both innate and adaptive immune responses largely to immunization. However, infectious
depend on the ability of the immune system to diseases remain a major cause of illness,
distinguish between self and non-self-molecules. disability, and death. Immunization
Self-molecules are those components of an recommendations currently target 17 vaccine-
preventable diseases across the lifespan.
IV. Comprehension Check. Read the text again. Agree or disagree on these
statements.
19. The immune system protects your body from disease-causing agents.
The Immune System
20. The tears, sweat, saliva and mucous are part of the second-line defense.
21. The innate immune responses can fight off the cancerous cells.
22. Inflammation is the body's normal, protective response to injuries or infections,
triggered by the adaptive immune system.
23. Acquired immunity is triggered when a pathogen evades the innate immune system.
24. Foreign substances are also called antigens.
25. Cytokines are unique because they remember pathogens.
26.In autoimmune diseases, the body attacks itself.
27. The body produces huge amounts of different antibodies that help fight of diseases
independently.
28.Lifesaving vaccines have drastically increased longevity.
V. Comprehension Check. Identify the characteristics of each type immune

system.
Specific Recognizes and

immunity INNATE ADDAPTIVE fights particular
pathogens
Fights
foreign Includes
substances physical
barriers
Responds faster
and more Specific
effectively to immunity
the 2nd
exposure
Nonspecific
3rd line resistance
defence Inflammatory
responders
Vocabulary. Choose the correct variant, according to the meaning.
15. As the immune system works to overcome/ overuse/ overflow the infection, it targets/
marks/ develop one of its own components.
16. Neutrophils then engulf/ ingest/ swallow and destroy the cells/ agents/ pathogens.
17. It can destroy/ display/detect a long-term memory of exposure/ disclosure /revelation
to infectious agents.
The Immune System
18. Patients with slow/ devastated/ weakened immune system raise/ mount/
create a lower response to vaccines.
19. The "innate" first reaction/ response / answer can destroy and engulf a
large collection/ range/ array of foreign organisms.
20. To lunch/ unleash/ launch an immune response, your body has to be able to
distinguish/dispatch/ discriminate between cells or self-substances.
21. The immune system not only remembers/ recognizes/resembles/ the pathogen on its
second contact, but also generates/ regenerates/ restores a faster and stronger
response.
22. The antibiotics/ antibodies/ antigens would then attempt to flush out /back/ through
the virus.
Language Spot. Why is it important to communicate with patient’s family?

Read the information below.
TALKING TO RELATIVES
Communication is a key part of patient care. However, it is also a
very emotionally charged time for many families of your patients,
especially when an illness is sudden or a patient is reaching the
end of their life. They may have many questions, concerns and
information they want to share with you.
✓ Listen. Half of communicating effectively is listening.
✓ Look. Be mindful of nonverbal cues.
✓ Summarize and Ask. Be sure to ask follow up questions when
needed.
✓ Be Tactful and Honest. Honesty is always the best policy. You
may receive reactions of anger or sadness so be prepared to
stay calm.
Listening. Listen to a conversation between the nurse and Mr. Cohen who has
come to visit his elderly mother after a surgical intervention. Answer the following
questions.
9. Is the nurse sympathetic?

10. Is she explaining in simple terms?
11. Is the patient worried?
12. Is the nurse convincing in her words?
13. Does the patient understand the severity of situation?
Why?
The Immune System
14. What phrases does the nurse use to help
reduce the anxiety?
Speaking. You are Mr. Cohen, and you’ve been asked to fulfill a
questionnaire for the patient’s relatives about informing, empathy and trust
YES NO
1. I receive all possible information about my family

member.
2. The physician uses language that I can understand.
3. Physicians have difficulty explaining.
4. Physicians respond to all my questions.
5. I believe the physician cares about my family member.
6. I believe that the physician treats everyone equally.
7. Physicians are friendly and smiling.
8. I believe that I receive the necessary.
9. I feel peaceful after speaking to the physician.
10. I feel nervous while speaking to the physician.
11. I can access my family member whenever I need to.
12. When the physician tells me what to do, this makes things
easier for me.
The Immune System
13. Physicians are very reassuring.
14. While speaking, I trust in what he/she says.
 I can distinguish between Innate and Adaptive immune systems.
 I know how to talk with patient’s relatives
 I can help the patient’s relative understand the situation
 I can understand patient non-verbal language
Key Words.
Verbs damage
to bind defender Adjectives
to comprise exposure acquired
to detect failure cancerous
to engulf immunization entire
to flush out leukocyte hospitable
to generate life expectancy immune
to involve lifespan inborn
to launch mucus innate
to mount pathogen layered
to overcome phagocyte preventable
to range phagocytosis subsequent
to target response tailored
soft tissues vulnerable
Nouns survival
sweat
algae Adverbs
T-lymphocyte
adjuvant largely
tumor cells
antibody
vaccination
B-lymphocytes Preposition
variety
breach due to
cytokine
Useful References
In and Out Patient Care
ISBN-13: 978-0194023009
ISBN- 978-0194569569
0194569774
Tony Grice, James Greenan, Oxford English for Careers: Nursing 2, OUP, Oxford, 2009, p. 136, ISBN-
13: 978-0194569880
https://bio.libretexts.org/Bookshelves/Human_Biology/Book%3A_Human_Biology_(Wakim_and_G
rewal)/20%3A_Immune_System/20.2%3A_Introduction_to_the_Immune_System
https://www.cliffsnotes.com/study-guides/biology/microbiology/the-immune-system/introduction-to-
the-immune-system
https://www.immune.org.nz/immunisation/immune-system-vaccination
https://www.meddent.uwa.edu.au/__data/assets/pdf_file/0008/3038039/L2_Introduction-to-the-
Immune-System.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513098/
Check Up. Work in groups. Examine the picture carefully.
24. Where is the operating room? How many people are there? Who are they?
25. Find the patient’s ward. What do you think has happened to the patient?
26. How many people are in the waiting room?
27. Find the pregnant women. What is she doing?
28. Where is the department of functional diagnostics? Do you know what kind of
equipment is that?
29. Find the consulting room.
30. Guess what specialist works in the last room that has not been mentioned.

Accident and lab technician physiotherapy
Emergency oculist prophylaxis
ambulance otolaryngologist radiologist
anesthetist paediatrician receptionist
cardiologist paediatrics surgeon
consultant paramedic trauma
dermatologist pharmacist X-ray
diagnostics physiotherapist
1. What is an outpatient care?
2. What is the inpatient care?
3. Who are admitted to inpatient care?
4. Why are hospital department names confusing?
5. Name the responsibilities of doctors and nurses in the hospital.
There is a wide network of medical consulting rooms during the reception hours.
institutions to protect the health of people. The After the reception hours, district doctors also
most numerous type of them are the clinics or pay calls to their patients at home. The outpatient
polyclinics. These are called outpatient care departments have registry, consulting rooms,
facilities. chemical laboratories, X-ray and physiotherapy
Outpatient clinic is a medical institution sections, rooms for functional diagnostics and
that provides treatment by doctors of various dressing rooms. Entering the outpatient clinic a
specialties, follow-up services for chronic patient goes to the registry first.
patients, diagnostics of diseases, therapy and If a person falls ill, he/she will call in a
prophylaxis. It is a center of curative and doctor. When the condition isn’t very poor the
prophylactic work for a definite administrative patient will go to the local polyclinic and a
part of any town or city. physician will examine him/her there.
Different specialists like family doctors, Those patients, who are seriously ill, are
GPs, therapists, surgeons, otolaryngologists, examined by a district doctor at home. People
oculists, dermatologists and others work in the may also attend private clinics. However, not
outpatient clinics work from 8 a.m. to 7 p.m. everybody can afford it.
Specialists and district doctors see patients in
Inpatient care is the care department that treats illnesses of
of patients whose condition requires admission the kidney is sometimes called ‘the Renal Unit’.
to a hospital. Progress in modern medicine and Gastroenterology (digestive system) is
the advent of comprehensive outpatient sometimes ‘the Department of Hepatology’.
clinics ensure that patients are only admitted to a Hospital staff often use abbreviations for
hospital when they are extremely ill or have departments. For example, they refer to ‘Obs and
severe physical trauma. Patients enter inpatient Gynae’. This is a department combining
care mainly from previous ambulatory care such Obstetrics (pregnancy), and Gynaecology
as referral from a family doctor, or (women’s reproductive organs). They call
through emergency medicine departments. Otolaryngology, ‘ENT’ (ears, nose & throat),
Hospital is an institution whose primary mostly because it is much easier to say.
function is to provide in-patient services, At the in-patient departments of a
diagnostic and therapeutic, for a variety of both hospital, life begins early in the morning. The
surgical and non-surgical medical conditions. nurses on duty take the patients’ temperature;
Some hospitals specialize in particular give them injections and all the prescribed
conditions like cancer or psychiatric illness. remedies indicated by the ward doctors. At about
Other hospitals specialize in particular types of 9 o’clock in the morning the doctors begin the
patients like geriatrics, children or the terminally daily rounds of the wards during which they
ill. However, the best known type of hospital is examine all the patients. It is not only doctors and
the general hospital which deals with almost nurses who deliver treatment and care; there are
everything, has ambulance crews and beds for many other specialists too. For example, there
both intensive care and long stay. A big general are physiotherapists, who specialize in exercises
hospital has many different specialist to treat injury or dysfunction and occupational
departments. Identifying departments can be therapists, who help patients manage every-day
confusing because different hospitals use living. There are also many people the patient
different names for the same thing. For example, does not meet like lab technicians doing the tests
one hospital may have a ‘children’s unit’ which and pharmacists dispensing medicines. Like any
a different hospital calls ‘Paediatrics’. ‘Accident town, a hospital has teams of office staff and
and Emergency’ (A&E) in one hospital is called ancillary workers such as porters, orderlies,
‘Casualty’ in another. There are many other technicians, drivers, cleaners, receptionists and
examples. The department that specializes in cooks. Regardless of their position,
heart problems is sometimes called ‘Coronary everyone is responsible for the proper
Care’. Others call it ‘Cardiology’ or performance of their own duties. The specific
‘Cardiovascular medicine’. Nephrology, the responsibilities of hospital doctors vary greatly
depending on the area of specialism, but can • liaising daily with staff
include the following: including other doctors, non-medical
• undertaking patient consultations and management staff and healthcare
physical examinations professionals
• performing surgical procedures • writing reports and maintaining records
• providing general pre- and post-operative When the course of treatment is over,
care the patient is discharged from the hospital.
• monitoring and administering medication Follow-up appointments should also be
• assessing and planning treatment coordinated with the patient prior to discharge to
requirements monitor the patient's progress as well as any
potential complications that may have arisen.

statements.
29. Outpatient clinic is a medical institution, which provides emergency care.

30. Specialists and district doctors examine patients at consulting rooms.
31. If a patient’s condition is serious, he/she will go to the local polyclinic or clinic.
32. Only patients with referral letter are admitted to the inpatient care.
33. The General hospital treats general diseases.
34. Casualty departments deal with genuine life-threatening emergencies.
35. ‘ENT’ department is concerned with disorders of the intestinal tract, which means
enterology.
36. Nurses on duty perform a lot of routine medical procedures.
37. Doctors commonly start the day with the morning ward rounds.
38. The patient is discharged from the hospital when the patient wants to go home.
II. Comprehension Check. a) Identify the following specialists. Can
you guess them on the picture? Add other responsibilities and duties besides that
mentioned below.
I am the director of an
I diagnose
operating theatre
and treat nail
conditions
I support and care
for women during I treat all common
labor medical conditions
I administer and refer patients
medications to hospitals
I transfer patients
throughout the hospital
I conduct routine eye

examination
I perform diagnostic
tests such as
echocardiograms
I administer pre-
hospital emergency
medical care
b) Think of 3 other specialists and describe their duties and responsibilities. Do
they usually activate in inpatient or outpatient department?
I. Vocabulary. Find terms in the text that mean the same.
a) mental health problems psychiatric illness
b) elderly people ______________
c) people who are dying ______________
d) paramedics ______________
e) a serious life condition ______________
f) stomach and intestines ______________
g) uterus, ovaries and fallopian tubes ______________
II. Vocabulary. Verbs for describing jobs. Complete the descriptions of jobs
with the verbs below. Choose the correct specialist.
moves specializes puts
performs examines takes
gives prepares treats
attends responds
delivers
1. A pediatrician/obstetrician … children.
2. A radiologist /physiotherapist … x- rays and other images.
3. A (n) obstetrician/surgeon ….births and … babies.
4. A surgeon/midwife … operations in the operating theatre.
5. A technician/porter …equipment, furniture, patients. etc. around the hospital.
6. A cardiologist/anesthesiologist…. in illnesses of the heart and blood vessels.
7. A pharmacist/nurse ….medicines to give to medical staff or patients.
8. A receptionist/paramedic … to emergences and …. first aid.
9. A lab technician/pharmacist … samples and tissues under a microscope
10. A(n) anesthesiologist/ ENT doctor ….patients to sleep.
Language Spot.
GATHERING PAST
✓ General questions : MEDICAL HISTORY (PART I)
Have you had anything like this
A complete past medical history (PMH) of
before? your patient should include childhood,
Have you ever had a major illness? medical, surgical, obstetric, gynecologic,
and psychiatric illnesses and
Have you ever had a major injury? immunizations. It is helpful not just to list
Have you ever had major surgery / problems, but to include information such
as the date of diagnosis, baseline laboratory
operation?
data, complications, and treatments.
Have you ever had an X-ray before?
Listening. a) Listen to 5
short conversations and decide who is speaking to Mrs. Benson in each case.
Write 1-5.
_____a) receptionist _____a) paramedic
_____a) consultant _____a) radiologist
_____a) nurse
b) Listen again and disagree with the following sentences.
1. Mrs. Benson has had a heart attack

2. This is Mrs. Benson's first x-ray.
3. Mrs. Benson goes to the toilet.
4. The nurse days her blood pressure is high.
5. She has a heart problem.
6. Mrs. Benson feels worse now.
7. The consultant sends her to the inpatients.
8. Mrs. Benson's appointment is this week.
I. Speaking. Role-play a patient and a doctor. Decide the questions you

would ask patients about themselves or their family in the past to find out about:
o pain o headache
o nervous illness o food poisoning
o surgery
BEGIN: Have you /Has anyone an your family ever When /Where did you ...?
Did you /How often did you ...?
Did you...?
II. Speaking. At the reception office. Think of the receptionist’s statements.

Patient: I want to see a doctor.
Receptionist: ________________________?
Patient: Yes,I have an appoinment at 3 o’clock.
Receptionist: ________________________?
Patient: No,I would like to see Dr.Brown.
Receptionist: ________________________?
Patient: Yes. I am in a lot of pain. I need to see the doctor NOW!
Receptionist: ________________________.
 I can distinguish between inpatient and outpatient care
 I can talk about duties and regular activities
 I can give general questions to patients about their medical past history
 I can use new vocabulary in role-playing
Key Words.
Verbs duty ward

ENT X-ray
to afford
Gastroenterology
to assess
geriatrics
to deal with Adjectives
GP
to discharge
Gynaecology curative
to fall ill
Hepatology proper
to follow-up
inpatient care prophylactic
to liaise
medical staff psychiatric
to pay a call
Nephrology severe
to provide
oculist
to undertake
orderly
Adverbs
otolaryngologist
Nouns outpatient care seriously
ambulance crew paediatrics
appointment porter
prophylaxis Preposition
Casualty
Coronary Care referral prior to
consulting room registry
dermatologist rounds
district doctor surgeon
dressing room therapist trauma
Useful References
ISBN-13: 978-0194023009
0194569774
Check Up. Work in groups. Examine the picture carefully.
Hospital Admission
1. Why do you think these patients have arrived to hospital?
2. Listen to the patients problems and decide who is speaking.

3. Decide the order patients should be seen by the doctor
according to the severity of their condition.

birth insect bites procedure
blood loss intensive care unit self-harming
burns minor stretchers
comb nose bleeds subsequently
court of nursing care surgery
law occur transfusion
discharge overnight triage
first aid poisoning unconscious
guardian priority violence
Hospital Admission
Reading. Read the text. Discuss upon the following.

1. How many types of patients are there?
2. What is the difference between the elective and emergent admission?
3. Who are admitted to emergency department?
4. Describe the procedure of triaging.
5. What are the procedures in elective hospital admission?
There are three ways to admit a patient accident & emergency department (A&E),
to hospital: either as an outpatient, a day patient emergency room (ER), emergency ward (EW) or
or an inpatient. An outpatient needs treatment but casualty department, is a medical treatment
not a bed. A day patient needs a bed for a few facility, usually found in a hospital or other
hours, but doesn’t need to stay overnight. An primary care center. In some countries,
inpatient needs at least one overnight stay. emergency departments have become important
Hospital admission involves staying at a hospital entry points for those without other means of
for at least one night or more. Staying in the access to medical care. The emergency
hospital overnight is done because the individual departments of most hospitals operate 24 hours a
is too sick to stay at home, requires 24-hour day. Every day of the year, people come through
nursing care, and/or is receiving medications and the doors of A&E departments. Some walk and
undergoing tests and/or surgery that can only be some come on stretchers. They may be victims
performed in the hospital setting. Hospitals need of road traffic accidents, violence, accidents at
to plan for patient admissions. They have to home, self-harming, poisoning, burns, and so on.
predict how many beds they will need. It is quite A&E is for people who are seriously injured,
easy to predict referrals from doctors like perhaps unconscious or losing a lot of blood.
General Practitioners, but a larger number of Hospitals usually say that A&E departments are
patients come through A&E, and it is more only for critical or life-threatening situations.
difficult to plan for them. In general, there are Some people go to A&E with minor injuries like
two major types of hospital admissions, sprains, insect bites, cuts and nose bleeds. They
emergent and elective. Emergent hospital should not be there. Usually they have to wait a
admissions usually happen when a patient seen long time before they are examined and
in the emergency department is subsequently sometimes staff will send them away. When
admitted to the hospital. Elective hospital A&E departments have multiple casualties, after
admissions occur when a doctor requests a bed to a major incident like a train crash, they have to
be reserved for a patient on a specific day. An decide who is a priority and who can wait. To do
emergency department (ED), also known as an this they use a procedure called triage. They sort
Hospital Admission
patients into groups. There are those who need observation that can only be given in
immediate surgery, those who are stable but need specialized care unit, called an intensive care
hospital care, and those who only need first aid. unit. Once the person's condition improves, they
People who are going to die are not a priority for may then be transferred to a common room. If the
medical care. person entering the hospital is a child, the parents
Elective admissions make up the or guardian will fill out the hospital forms. Most
majority of hospital admissions, but this hospitals allow parents and guardians to stay
percentage varies markedly with some hospitals. overnight in the hospital with the child, and to be
It is very important to keep accurate records of with them 24 hours a day.
patients’ treatment, from admission through to If the hospital stay involves surgery in which
discharge and follow-up. Before the person is there is the potential for significant blood loss, it
taken to their room, admitting procedures are may be possible to arrange to have blood drawn
performed. The person's personal data is and stored so that in the event of a transfusion,
recorded and entered into the hospital's computer the individual receives his or her own blood. A
system. This data may include: small bag can be brought into the hospital that
✓ name contains:
✓ address ✓ night clothes (the hospital supplies their
✓ home and work telephone number own, but some people like to wear familiar
✓ date of birth clothing; some people use the hospital outfits
✓ place of employment to decrease the chance of staining their own
✓ next of kin
clothing or bringing germs home from the
✓ emergency contact information, or the
hospital)
names and telephone numbers of those
individuals the hospital should contact if the ✓ a robe
person being admitted needs emergency care ✓ slippers
or their condition worsens significantly ✓ reading material for the hospital stay
✓ reason for hospitalization ✓ hobby materials such as knitting or a book of
✓ allergies to medications or foods crossword puzzles
There may be several forms to fill out. One form ✓ reading glasses
✓ personal care items such as comb, brush, and
may be a detailed medical and medication
toothbrush (most hospitals supply these
history. This history will include past items, but many individuals prefer to have
hospitalizations and surgeries. Once all the their own from home).
Medical staff record all treatments, test results
admitting information has been completed, the
and correspondence. They try to record these
next step is usually being taken to a checking
things at the time they happen. This is important,
room. Sometimes when people are admitted to
and not only to ensure the correct treatment.
the hospital they need extremely close
Hospital Admission
Medical records are sometimes used for research,
or in a court of law.
VI. Comprehension Check. Read the text again. Agree or disagree on these
statements.
39. Admissions to hospital are only for inpatients.
40. There are more emergency admissions than referrals.
41. A hospital is like a small town because there are so many buildings.
42. Personal details are part of medical records.
43. Doctors and nurses are trained to manage a wide range of problems 24 hours a day.
44. People with minor injuries are admitted to hospital.
45. Triaging identifies what casualties are a priority for A&E department.
46. People who are going to die are given immediate medical care.
47. All elective inpatient hospital admissions require prior authorization.
48. Medical hospital recording stops at discharge.
VII. Comprehension Check. Match the terms with their definitions.
1. overnight stay a. when a patient is sent to hospital

2. admission b. the sorting out of patients
3. referral c. treatment after a patient has been discharged from hospital
4. discharge d. time as an inpatient
5. follow-up e. letters, emails and messages
6. correspondence f. when you leave a hospital after treatment
7. triage g. the moment when a patient enters hospital
VIII. Comprehension Check. Identify the categories (colors) of the triage procedure?
 Lee Fenton was hit by a falling tree, which he was cutting down.
 Two-year-old Toby Smith fell into a neighbour's swimming pool.
 76-year-old Eric Baker slipped on a wet bathroom floor.
Hospital Admission
 One-year-old Ben Brown put a small toy in his mouth and it lodged in his
throat.
 Lasvinder Singh cut his hand badly while opening a tin of peaches.
 Ten-year-old Jason Gold swallowed some of his father's medicine.
 82-year-old Iris Watts dropped a pan of boiling water on her foot.
 Nick Young suffered cuts, bruises, and a broken arm when he was putting
up some shelves in his home.
Vocabulary. Choose the correct variant, according to the meaning.

23. Use a stretcher to bring in the next victim/ casualty/ sufferer, she can’t
walk.
24. This patient’s condition is stable/ critical/ normal at the moment, but she needs to see
a doctor soon.
25. He has minor/ major/ unimportant injuries, but they are not life-threatening.
26. This patient is in serious danger – his condition is crucial/ vital/ critical.
27. She has cuts and bruising to her face – I’m sure she’s a sufferer /victim/ patient of
violence.
28. This child is seriously ill – he’s a significance/ priority/ importance for immediate
treatment.
29. All patients are explicitly examined/ triaged/ checked up to the minors or majors area
before being admitted.
30. Cutting is a long-term/ self-harming/ life-threatening behavior in which teens
deliberately cut or scratch themselves.
Hospital Admission
Language Spot. Why is it important to communicate with patient’s
family? Read the information below.
How did that happen? ASKING ABO UT CHIEF

Have you noticed any strange COMPLAINTS
behavior before?
(PART II) DESCRIBING HOW
THINGS HAPPENED
How has she/he been feeling This is typically documented from the patient’s
recently? own words, but sometimes in emergency cases
patient cannot speak or is unconscious.
Has he/she been complaining
A collateral history from relatives or other
of anything? witnesses, including paramedics, is vital.
Did anything else happen? The patient's recent health, functional status
and previous medical history may provide
Has she ever had anything diagnostic clues as well as guiding decisions
like this before? regarding ongoing care, such as admission to a
critical care unit.
How fast did the paramedics
Previous hospital records must be requested
arrive? urgently and the next of kin contacted.
Can you tell me more about Bystanders may have witnessed the patient
collapse, while paramedics are skilled in
what you saw? surveying the scene for clues, such as empty
Have you dialed 999 drug packets, alcohol or a suicide note.
immediately?
Listening. a) Listen to a conversation between the doctor in the admission

office and Mr. Stone who is worried about his wife. Write down as many details
as you can .Compare your answers.
b) Adverbs: describing how things happened can help to make a diagnosis.

Look at these statements underline the most appropriate adverb in these
sentences.
1. The fainting? It just happened abruptly /gradually / slowly. The next thing I
knew she was lying completely flat on the pavement.
2. The patient suddenly became pale and started to sweat, but not profusely /
rapidly / enormously.
3. She was lying flat, but bystanders were trying to keep her upright, so she was
twitching slowly / convulsively / suddenly.
4. As he couldn't see good/ clearly / visually, he got quite frightened.
Hospital Admission
5. In a seizure, there is typically / rarely / seldom no prodrome, but this
is not always the case.
6. After collapsing, he didn't get better spontaneously / slowly/gradually. The
patient was a bit drowsy for quite a while afterwards.
7. He recovered completely / partially / poorly from the accident. Now he's
perfectly OK.
8. Fainting and vomiting don't reliably / partially / clearly discriminate seizures
from faints.
I. Speaking. Where do you think the majority of accidents occur: at home,

work, or in the street? Some accidents might happen in both or all situations.
Are these always a case of hospital admission?
II. Speaking. Describe an accident that happened to you.

a) What happened?
b) Have you been hospitalized?
c) What was the procedure for admission?
 I can understand hospital admission procedures
 I can distinguish between emergent and non-emergent conditions
 I can describe what happened
 I can talk about emergency cases
Key Words.
Verbs to stain comb

to admit to undergo court of law
to allow to worsen cuts
to discharge employment
to fill out Nouns entry
to occur birth kin
to operate blood loss first aid
to request burns guardian
Hospital Admission
hospital setting stretchers
insect bites surgery overnight
intensive care unit transfusion
means triage Adverbs
nose bleeds violence markedly
nursing care seriously
outfit Adjectives subsequently
priority accurate significantly
procedure elective
robe emergent Preposition
self-harming injured through
poisoning minor
slippers unconscious
sprains
Useful References
ISBN- 978-0194569569
0194569774
http://samples.jbpub.com/9781449652722/9781449645106_ch01_001_036.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330912/
I. Check Up. Look at the pictures below and say what is the healthcare
provider doing in each case.
31. Match the

picture with the
following vital sign:
a) 120 bpm
b) 38.5
c) 150/90
d) 18 bpm
32. Are these
indices normal?
33. What are
the normal ranges?
Monitoring the Patient’s Vital Signs
34. What other signs do you know?
II. Check Up. Listen to 4 short conversations and match to

the pictures above.
asthma oxygen saturation

betablockers pathophysiology
biopsy respiratory rate
blood pressure routine
cardiac arrest sepsis
checkup status
CT stool culture
diabetes systole
diastole temperature
escalation ultrasound
ESR urinalysis
homeostasis X-ray
hypoxemia
MRI

1. What are the two most important vital signs?
2. Why are these important?
3. Are these 100% reliable? Why?
4. What are some lab investigations?
5. When are the instrumental investigations used?
Monitoring vital signs is integral to deterioration, which, without identification and

patient care in acute conditions within hospitals intervention, can lead to adverse consequences
settings. Traditionally, the five vital signs are (this is called becoming acutely ill) or death.
blood pressure (BP), pulse, respiratory rate, There are certain times when this is more likely,
oxygen saturation (Sp O 2) and temperature. for example following an emergency admission
These signs are universally used to monitor to hospital, after surgery and after leaving critical
patients’ progress. Changing trends in patients’ care. However, it can happen at any stage of an
vital signs data can indicate clinical illness. Monitoring patients (checking them and
their health) regularly while they are in hospital betablockers) and fluid status
and taking action if they show signs of becoming (e.g. hyper/hypovolaemia). Pulse
worse can help avoid serious problems. should also not be considered the same as heart
Monitoring vital signs indicate a patient’s rate, which is actually a measurable pulse
clinical condition, which requires to calculate characteristic. A normal resting heart rate for
early warning scores and used to determine the adults ranges from 60 to 100 beats per minute,
monitoring, escalation and interventions that are but it may vary from person to person.
required subsequently. Vital signs monitors are BP is an important vital sign to measure
essential devices used by healthcare as it provides a reflection of blood flow when the
professionals to evaluate the overall health of a heart is contracting (systole) and relaxing
patient. Vital signs monitors enable clinicians to (diastole). Normal blood pressure for most adults
evaluate their patients in or outside a hospital is defined as a systolic pressure of less than 120
setting quickly and efficiently. Today, vital signs and a diastolic pressure of less than 80. Changes
monitors are portable devices with wireless or trends in BP may reflect underlying
capabilities. They collect a patient’s real-time pathophysiology or the body’s attempts to
data, and help healthcare professionals identify maintain homeostasis. A drop in BP, for
signs of patient deterioration. The device’s example, has been found to be a common sign in
sensors can be clipped to a patient’s fingers or patients prior to cardiac arrest, thus a more
patched to the skin. Changes or abnormalities in detailed assessment should be carried out.
vital signs indicate changes in the patient’s Respiratory rate is an important
condition. baseline observation and its accurate
When measuring body temperature, a measurement that serves a number of purposes,
number of factors must be considered. It may be such as being the most sensitive indicators of
affected by factors such as underlying critical illness. An increase from the patient’s
pathophysiology (e.g. sepsis), skin exposure (e.g. normal rate of even three to five breaths per
in the operating theatre) or age. It is generally minute is an early and important sign of
medically accepted that normal body respiratory distress and potential hypoxemia.
temperature ranges between 36.5 °C (97.7 °F) to Normal respiration rates for an adult person at
37.5 °C (99.5 °F). Fever is indicated when human rest range from 12 to 16 breaths per minute.
body temperature rises about one degree, or Respiration rates may increase with fever,
more. illness, and other medical conditions.
The pulse is also affected by many Monitoring body functions by checking
factors including age, existing medical vital signs helps to answer the question: what is
conditions (e.g. fever), medications (e.g. happening to this patient? However, they are not
100% reliable and stable vital signs do not a detailed diagnosis and an
always mean that everything is OK. Bodily appropriate therapy. And it is
tissues and fluids, including blood and urine and now possible to get images of what is going on
may also be helpful in diagnosing the patient’s inside the body using technological aids like X-
condition. These are usually analyzed in a rays and ultrasound scans. For more detailed
laboratory. Laboratory tests check the samples to information, there are endoscopes, which are
see if the results fall within the normal range. The used to look inside the body, MRI, CT scans and
tests use a range because what is normal differs biopsies where tissue is removed for
from person to person. Many factors affect test examination. Some patients with chronic
results. These include sex, age and race; what the illnesses like heart disease, diabetes and asthma
patient eats and drinks; medicines the patient can self-monitor. They communicate with
takes; how well the patient followed pre-test doctors and nurses by phone and online. Patients
instructions. Laboratory tests are often part of a can also be monitored from a distance using
routine checkup to look for health changes. They satellite technology and the internet. This has
also help doctors diagnose medical conditions, major advantages; the patient doesn’t have to
plan or evaluate treatments, and monitor keep visiting a hospital and it saves a lot of
diseases. The most common lab test performed money.
are Complete Blood Count, Stool Culture Tests,
Urinalysis, ESR (erythrocyte sedimentation
rate), respiratory specimen, skin scraping etc.
If clinically suspected, further
instrumental investigations are indispensable for
IX. Comprehension Check. Read the text again. Agree or disagree on these
statements.
49. Early detection of clinical deterioration of the patients may improve outcomes.
50. Vital Sign Monitors measure basic vitals of a patient accurately and efficiently.
51. The normal human body temperature is often stated as 36.5–37.0 °C
52. ‘What is happening to this patient?’ is a question, which only patients can answer.
53. Stable vital signs mean everything is probably OK.
54. Laboratory tests are more informative than the ultrasound scan.
55. Technological aids give information about bodily fluids.
56. All the lab tests are 100% accurate and 100% precise.
57. CT scans and MRIs are both used to capture images within your body.
58. Self-monitoring is carried out by doctors and nurses.
X. Comprehension Check. Which vital sign is being taken in each

case?
17. This may feel a bit cold on your chest.
18. Would you please lift up your tongue?
19. Miss Adams, I need you to lift your arm and relax.
20. Could you roll up your left sleeve?
21. Now, breathe in and out, hold your breath.
22. I am going to put a cuff on you to get a reading.
23. Could you please undo your shirt for me, please?
XI. Comprehension Check. Describing readings. Complete the sentences with

appropriate words.
1. Her heart rate …to 20 bpm, but now it's …again.
2. His blood pressure…from 120/80 to 160/100. Fell Stable
Up and down
3. Her pulse rate was extremely low, but now it’s …to Up Rising
70. Varies
Back to
4. His respiratory rate … between 10 and 25 bpm. Went up
5. He was running a fever, but his temperature's
…normal now.
6. His temperature was …all night, but now it's… at 37.5.
a) Look at the graph above. Which of the statements from exercise III match it?
b) Choose one of the readings and draw your own graph.
31. You may have a fever if your BP/ respiratory rate/temperature rises above this.
32. The average pulse/ heart/ respiratory rate in a healthy adult is between 12 and 18.
33. Blood/ systolic /diastolic pressure is the higher of the two values.
34. If you've been having stomach problems, the doctor might order a CBC/stool
culture /urinalysis.
35. In case of unknown rashes, you may also have a MRI/ skin scraping/biopsy.
36. However, a cancer diagnosis isn't a diagnosis until a(n) X-ray/ ESR/ biopsy says it is.
37. You usually don't need to do anything to prepare for a CBC/ X-ray/ ultrasound.
38. An ultrasound/ MRI/ CT scan uses high-frequency sound waves to create an image of the
inside of the body.
Language Spot. What do you know about physical
examination? What is the purpose of PE?
USEFUL TIPS TO CONSIDER
✓ Always wash your hands before PHYSICAL
examining the patient. EXAMINATION (PE)
✓ Explain what you are going to do Before modern technology, it was
important for healthcare providers to
and ask for permission to proceed
perfect their physical examination
with the physical exam. techniques, because x-ray machines,
scanners, and echocardiograms were
“Well, we'll have to take your non-existent.
temperature. Open your mouth. “ In a physical examination, there are
many things that your healthcare
“Follow me, this way.’ provider can find out by using their
“Close your mouth slowly and don't hands to feel (palpate), stethoscope and
ears to listen, and eyes to see. Findings
bite the thermometer. “
that are present on the physical exam
“Let’s see your abdomen.” may by themselves diagnose, or be
“Would you take off your shoes?” helpful to diagnose many diseases. The
components of a physical exam include:
“We’ll have to take your weight first.”
“You can hold it with your fingers. ✓ Inspection (skin, face, eyes, chest,
abdomen, legs , etc.)
Take it out in 2 or 3 minutes.”
✓ Palpation (lymph nodes, chest wall
“Good. You can hold it in place with and abdomen).
your fingers.” ✓ Percussion (abdomen, back or
chest wall, lungs).
“Hold out your arm. You'll feel some
✓ Auscultation (heart, lungs)
pressure on your arm.”
“You need to take off your clothes and
put it on.”
Speaking. Complete the scenario below. What physical examinations have
been carried out?
Doctor: …………. for a physical exam?

Patient: I had my last physical two years ago.
Doctor: ………….. blood work, an EKG or an ultra-sound?
Patient: Well, I had a few X-rays at the dentist.
Doctor: …………… in general?
Patient: Pretty well. No complaints, really.
Doctor: Could ………….? I'd like to take your blood pressure.
Patient: Certainly.
Doctor: That's ……... . Now, I'm going ……………...
Patient: Ooh, that's cold!
Doctor: Don't worry it's just my stethoscope. Now, breathe ……... Please
……….. shirt, and breathe deeply... Everything sounds good. Let's take a
I. Listening. The patient, Mr. Forrester is in coma because of a Traumatic

Brain Injury (TBI). He is now in an Intensive Care Unit (ICU). The doctor
is calling the nurse to elicit the patient’s progress. Are these sentences true
(T) or false (F)?
1. The patient is awake.
2. His BP is lower now.
3. The patient is getting worse.
4. An ICP of twenty-six is OK.
5. The doctor is going to go to the hospital.
II. Listening. Listen again and complete this table.

TIME BP ICP
2000
2100
2200
2300 170/120
 I can say measurements
 I know how to record vital signs
 I know how to perform physical examination
 I can understand vital signs readings
Key Words.
Verbs to clip to enable

to indicate homeostasis
to monitor hypoxemia
to patch MRI adverse
to require overall health antiviral
pathophysiology diastolic
respiratory rate integral
Nouns
oxygen saturation measurable
consequences
temperature portable
asthma
routine real-time
betablockers
sepsis reliable
biopsy
skin exposure systolic
blood pressure
stage vital
cardiac arrest
status warning
checkup
stool culture wireless
CT
deterioration urinalysis
device systole Adverbs
diabetes trend acutely
diastole ultrasound efficiently
escalation X-ray traditionally
ESR universally
fluid
Adjectives
Useful References
ISBN-13: 978-0194023009
0194569774
https://academic.oup.com/intqhc/article/28/4/515/2594957
https://publicationslist.org/data/m.elliott/ref-
22/The%20eight%20vital%20signs%20of%20patient%20monitoring.pdf
https://www.mindraynorthamerica.com/how-to-read-a-vital-signs-monitor/
Pain Management
Check Up. Group work. What do these people complain of? Share
your ideas.
✓ Listen to the conversations again. Write the types of pain these patients experience. Can you guess
how do they feel like? Discuss.
✓ What three questions are used by the doctor to ask about the patient’s complains?
What’s ___________________________________________?
What can _________________________________________?
Can you tell me what________________________________?

cancer Non-steroidal anti-
acupuncture carpal tunnel inflammatory drugs
anesthesiologist syndrome paracetamol
anesthetics ibuprofen technique
arthritis lethargy tension
aspirin massage debilitating
biofeedback frustrating
Pain Management
mild severe
subjective
fibromyalgia
1. Why do people feel pain?
2. Who are the pain management providers?
3. What is the difference between acute and chronic pain?
4. How do you describe pain?
5. What are the pain management therapies?
Living with pain can be extremely management therapy suffer from a varying
challenging, both physically and mentally. Pain degrees of pain. Some patients, for instance,
is one of the most common reasons why patients experience mild to moderate pain constantly;
see their doctors. And despite the advances in others, however, may experience unbearable or
technology and methods to relieve it, a lot of severe pain periodically. Headaches and back
patients still experience undertreatment. Pain can pain are the most common types of pain. Sports
be debilitating and frustrating and may interfere injuries, carpal tunnel syndrome, arthritis, and
with sleep, work, activities, and quality time with fibromyalgia are some of the most common
friends and family. Pain is the main symptom of causes for different types of pain. Pain
a wide range of injuries, infections and management doctors also care for patients who
diseases. Cancer pain can result from nearly are suffering from both acute and chronic pain.
every type of cancer. One of the first signs of Acute pain is a type of pain that comes on
a heart attack is often chest pain that may move suddenly and has a specific cause, usually an
to your arms, back or jaw. Pain management injury. The cause of chronic pain, on the other
provides relief so you can enjoy life. But hand, may or may not be known, and it may
treatment is complex and can lead to harmful linger long after an injury has healed. Acute pain
effects if not properly administered and is also somewhat sharp, whereas chronic pain
monitored. Pain management doctors are may be more of an ache and be accompanied by
physicians who specialize in the evaluation, other symptoms, such as muscle tension,
diagnosis, and treatment of pain – have advanced lethargy, and depression.
training in treatment of any type of pain Pain, however, is also highly subjective. What
occurring due to illness or injury. Pain your patient says about the pain he/she is
management may also require the involvement of experiencing is the best indicator of that pain. We
a physician anesthesiologist who specializes in can’t prove or disprove what the patient is
pain medicine. Patients seeking pain feeling. We also can’t assume. Pain is also
Pain Management
difficult to measure and describe. This is a In order to determine the
problem because it is an important symptom and severity and causes of pain, doctors will often
medics (medical staff) need information from physically examine patients and discuss their
patients about it. It is therefore common practice symptoms. They will also examine their patients’
to give patients lists of words and ask them to say medical histories and perform diagnostic tests,
which words best describe three things: the type such as x-rays. Helping patients ease and
of pain they are suffering, its intensity (how bad manage their pain, however, is a pain
it is ) and its frequency (how often they feel it). management provider’s biggest task. Today,
With some patients, such as children, words there are many medical and non-medicine
don’t work very well to describe intensity, so treatments available to help manage pain. A
medics use smiley faces or sometimes colors. For combination of treatments and therapies is often
example, blues mean a mild pain and reds mean more effective than just one. The main types of
severe pain. Some medics prefer a range of pain medicines include:
numbers; 0 is no pain and 10 is unbearable pain. • paracetamol (often recommended as the first
People don’t all feel pain in the same way. medicine to relieve short-term pain).
Researchers are trying to learn more about this • aspirin (for short-term relief of fever and
fact. Their experiments show that children are mild-to-moderate pain)
more sensitive to pain than adults, and that men • Non-steroidal anti-inflammatory drugs
can tolerate more pain than women. Pain does (NSAIDs), such as ibuprofen – these
not always show where an injury is. Internal medicines relieve pain and reduce
organs, for example, do not have many pain inflammation (redness and swelling)
receiving nerve endings, so internal injuries often • opioid medicines, such as codeine and
cause pain in a different part of the body. This is morphine (these medicines are reserved for
called ‘referred pain’. One example of referred severe or cancer pain).
pain is when someone suffering a heart attack • Local anesthetics (drops, sprays, creams or
feels pain in their left shoulder, arm or hand. injections) – used when nerves can be easily
Depending on the cause, location and severity of reached.
the pain, you may describe it as: Because many narcotic pain
• Aching, tingling, dull or nagging. medications are habit-forming and can cause
• Burning, stinging or pulsing (like electric additional health problems, pain management
shocks). doctors also try to help patients by introducing
• Sharp or shooting. them to alternative pain management techniques.
• Throbbing or pounding. Some of these techniques may include
Pain Management
biofeedback, acupuncture, massage, and
therapeutic exercises.
XII. Comprehension Check. Read the text again. Agree or disagree on these
statements.
59. Pain may not be physically or psychologically beneficial.
60. If you're experiencing unexplained aches and pains, it just might be linked to sleep loss.
61. Low back pain, headache, cancer pain, and pain associated with arthritis are some of the
most common types of pain.
62. Experiments show that children feel less pain than adults do.
63. Researchers are trying to find out why people experience pain differently.
64. Medics ask patients for a number to describe the kind of pain they have.
65. To describe pain, medics ask children to say how it feels.
66. You experience referred pain only in your internal organs.
67. Doctors will often order blood tests in order to determine the severity and causes of pain.
68. Side effects can be associated with any pain management treatment.
XIII. Comprehension Check. Describing types of pain. Choose the correct variant.
1. Five years into the chronic/ sharp/ acute pain in my back, I asked around on a free
medical forum and two pain specialists …
2. I'm currently experiencing a mild shooting/ tingling/ debilitating pain in my head
along with a mold headache that comes and goes.
3. I feel like a sharp shooting/chronic/moderate pain in my shoulder blade behind the
breast when the baby is feeding on.
4. For the last week once in a 24 hr. period, I get the most nagging /excruciating/dull
pain in my back. It makes me double up!
5. I feel a dropping stinging/ shooting/ burning sensation in my stomach; it felt like
hot…
6. For the past few months, I've been having near constant sharp/ dull/ excruciating
chest pain and tightness …I consider going to a doctor..
7. A dull/acute/pulsating mass around my navel was nearly felt through the skin …
8. I sometimes feel a nagging /burning/shooting sensation on the bottom of my right
foot, especially after a long walk. I can’t say it really bothers me, but…
Vocabulary. Guess the words and word combinations.

39. These drugs keep you from feeling pain during medical procedures…
40. Pain perceived at a location other than the site of the painful origin…
41. Widespread musculoskeletal pain …
42. Traditional Chinese medicine …
43. A group of diseases potentially spreading to other parts of the body…
Pain Management
44. Rubbing and manipulating your skin, muscles and tendons…
45. A common drug for relieving minor aches….
46. A mood disorder that causes a persistent feeling of sadness …
I. Language Spot. Why is it important for a doctor to obtain a complete

description of the patient's present illness? Read the useful phrases below and
determine which of the 6 componenents of HPI do they assess?
TAKING THE HISTORY USEFUL EXPRESSIONS

OF PRESENT ILLNESS Could you describe the pain? (quality)
( HPI - P AIN ASSESSMENT ) Does anything bring the pain on?
PART I Does the pain come on at any
The HPI is usually a chronological particular time?
description of the progression of the Does the pain come on gradually or all
patient’s present illness from the first of a sudden?
sign and symptom to the present. It Does the pain spread /move /travel
should include some or all of the anywhere else?
following elements:
How bad is the pain?
 Onset: When did the pain start? How long does the pain usually last?
 Location: What is the location of the How often do you have the pain?
pain?
How many times have you had the
 Quality: Include a description of the
pain?
quality of the symptom (i.e. sharp,
dull pain) Is the pain constant, or does it come and
 Severity: Degree of pain, for go?
example can be described on a scale Is the pain getting better or worse? Does
of 1 - 10 the pain come and go?
 Duration: How long have you had Show me where it hurts.
the pain? On a scale of 1 to 10, with 10 being the
 Timing: Describe when you have worst pain, how would you rate the
pain for example pain with exertion pain?
or pain in evening. What do you mean by ‘weird’ pain?
What does the pain feel like?
What is the pain like? Where does it hurt?
When did the pain first come on? Which part of your back is affected?
When did the pain start / begin?
II. Language Spot. Match the questions with the endings.

1. Where do you … …you up at night ?
2. Does the pain … …did it start?
3. Does it wake… …on?
4. Can you tell me what… …spread anywhere else?
5. Can you describe… …the pain is like?
6. How long have you… …had the pain?
…get the pain?
…the pain for me?
…had the pain before?
Pain Management
7. Is there anything which…
8. When…
9. Is the pain…
10. Have you…
Listening. Listen to a conversation between Dr. Martin, a doctor in A&E,

and Mr. Wood. Make your own notes about the patient’s presenting
complaint to discuss the following:
1. When did he feel the pain first?

2. Where does the patient feel the pain?
3. Describe the type of pain the patient is experiencing.
4. How severe is it?
5. How long has Mr. Martin had it?
6. What is the possible diagnosis for the shoulder pain?
Speaking. Work in pairs. Decide what questions has the doctor asked in both cases.
Pain Management
Severe unbearable A 2-day throbbing

abdominal pain, nausea; bilateral knee pain; I was
sharp lower abdominal working the night shift
pain that radiated to at a department store; a
the right; gradual onset; difficulty
makes me double up; sleeping; increase in
pain was sudden and severity to an 8/10
I did not take any today; pain worsens with
medications; I vomited six walking or standing; no
times that evening before recent trauma to the
going to sleep; did not eat knees; painkillers don’t
anything; overnight the relieve the pain…
abdominal pain worsened;
brought by the
ambulance..
 I know what pain management is
 I can describe and ask about pain
 I can ask questions about a patient presenting complain
 I know the steps of assessing HPI
Key Words.
Verbs acupuncture depression

to ache anesthesiologist fibromyalgia
to assume anesthetics ibuprofen
to interfere arthritis, lethargy
to linger aspirin massage
to relieve biofeedback Non-steroidal anti-
to specialize in cancer inflammatory drugs
carpal tunnel paracetamol
Nouns syndrome relief
Pain Management
technique mild
tension moderate subjective
undertreatment nagging throbbing
opioid tingling
Adjectives pounding. unbearable
aching pulsing
burning referred (pain) Adverbs
challenging severe constantly
debilitating sharp mentally
dull shooting periodically
frustrating smiley physically
stinging
Useful References
ISBN-13: 978-0194023009
0194569774
https://www.asahq.org/madeforthismoment/pain-management/
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pain-and-pain-management-
adults

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Introduction into Human Body

Check Up. Work in groups and describe the word cloud.

1. Find the four major

Pronunciation. Listen and repeat the words and word combinations.

I. Comprehension Check. Read the text again. Agree or disagree on these

1. The human being is a multiple complex structure.

A hollow muscular organ

They remove waste and Any of the hard pieces that

An organ that controls your An organ in the body that

A fleshy movable part of the

Vocabulary. Choose the correct variant.

Language Spot. How important are the accurate patient records?

Listening. Listen to a conversation between the receptionist and Mr. Karlson.

Check Up. Work in groups and describe the word cloud.

Pronunciation. Listen and repeat the words and word combinations.

ulna vertebrae via

seven bones found in the head and neck),

I. Comprehension Check. Read the text again. Agree or disagree on these

Vocabulary. Find synonyms for the following words.

14. The axial skeleton is made up of the clavicle and scapula.

Listening. Spot the difference between these 2 conversations.

✓ Write down details of what the patient said.

✓ Listen to another version of the same

✓ Which technique is better for the patient?

✓ Which approach do you find easier to use?

30 years of age male/female, pain in the elbow,

Verbs column tibia

Pronunciation. Listen and repeat the words and word combinations.

Reading. Read the text. Find answers to the following questions.

I. Comprehension Check. Read the text again. Agree or disagree on these

Vocabulary. Choose the correct variant.

15. The voluntary movement is made consciously/unconsciously/ subconsciously.

• Could you clench your right hand for me?

Listening. Listen to the following conversations and complete the sentences.

Make tilt, pop, keep, stand up, cough, turn.

 Can………..the screen and undress for me, please?

 I need to examine your lower back , so if you……

 Just …………………….for me. And again. That’s fine.

 I’d like……….. Do you need any help getting up?

 Could………………..head to the left? Yes. That’s it.

 Can you……………………. tight fist for me? Fine.

 I…………………………….. still for me if you can? Ok.

Checklist. Assess your

Check Up. Work in groups and describe the word cloud.

25. Name three

Pronunciation. Listen and repeat the words and word combinations.

autonomic gray matter

I. Comprehension Check. Read the text again. Agree or disagree on these

II. Comprehension Check. Identify the parts of the Nervous System.

Vocabulary. Choose the correct variant.

Mustapha Hussein was admitted to the hospital with possible

Pronunciation. Listen and repeat the words and word combinations.

Reading. Read the text. Find answers to the following questions.

I. Comprehension Check. Read the text again. Agree or disagree on these

Vocabulary. Choose the correct variant.

✓ “This is a new diagnosis for you, so I EXPLANATION AND

Doctor: Hi Jessica. (Ask about her condition).

1. How does the patient feel?

A family was seriously injured in a car accident. A 12-years-