Test yourself

1. What disorders of the respiratory system do you know?

2. How are the respiratory diseases classified?

3. What are the most common causes of these disorders?

4. What are the clinical manifestations of the respiratory diseases?

5. What methods of examination are used for detecting the respiratory pathology?

6. What data are revealed by each investigation?

7. What is the role of smoking in the development of the respiratory diseases?

UNIT III GASTROINTESTINAL DISORDERS

Skim the text and speak on the location, structure and functions of organs of the digestive system.

Reviewing anatomy and physiology of gastrointestinal tract

The GI tract, also known as the alimentary canal, is a long, hollow, musculomembranous tube consisting of glands and accessory organs (salivary glands, liver, gallbladder, and pancreas).

The GI tract includes the mouth, pharynx, esophagus, stomach (fundus, body), small intestine (duodenum, jejunum and ileum), and large intestine (cecum, colon, rectum, and anal canal).

Digestion begins in the mouth through chewing and through the action of an enzyme secreted in saliva — ptyalin (amylase) — which breaks down starch. Digestion continues in the stomach, where lining secretes gastric juice that contains hydrochloric acid and the enzymes pepsin.

Through a chewing motion, the stomach breaks food into tiny particles, mixes them with gastric juice, and pushes the mass toward the pylorus. The liquid portion (chyme) enters the duodenum in amounts; any solid material remains in the stomach until it liquefies( usually from 1 to 6 hours). The stomach also produces an intrinsic factor necessary for the absorption of vitamin B12. Although limited amounts of water, alcohol, and some drugs are absorbed in the stomach, chyme passes unabsorbed into the duodenum.

Most digestion and absorption occur in the small intestine, where the surface area is increased by millions of villi in the mucous membrane lining. For digestion, the small intestine relies on a vast array of enzymes produced by the pancreas or by the intestinal lining itself. Pancreatic enzymes include trypsin, which digests protein to amino acids; lipase, which digests fat to fatty acids and glycerol; and amylase, which digests starches to sugars. Intestinal enzymes include erepsin, which digests protein to amino acids; lactase, maltase, and sucrase, which digest complex sugars like glucose, fructose, and galactose; and enterokinase, which activates trypsin.

In addition, bile, secreted by the liver and stored in the gallbladder, helps neutralize stomach acid and aids the small intestine to emulsify and absorb fats and fat-soluble vitamins.

By the time ingested material reaches the ileocecal valve (where the small intestine joins the large intestine), all its nutritional value has been absorbed through the villi of the small intestine, into the bloodstream.

The large intestine, so named because it's larger in diameter than the small intestine, absorbs water from the digestive material before passing it on for elimination. Rectal distention by feces stimulates the defecation reflex, which, when assisted by voluntary sphincter relaxation, permits defecation.

Throughout the GI tract, peristalsis (a coordinated, rhythmic contraction of smooth muscle) propels ingested material along; sphincters prevent its reflux.

PART I

List of words to be learned .

1. anorexia [ֽænə'reksiə] – n, анорексия;

2. belching ['belt∫iŋ] – n, отрыжка;

3. benign [bi'nain] – adj, доброкачественный;

4. bulimia [bu'limiə] – n, булимия;

5. constipation [ֽkonsti'pei∫(ə)n] – n, запор;

6. diarrhea [ֽdai ə 'ri:ə] – n, диарея;

7. dysphagia [dis'feidʒiə] – n, дисфагия, затруднение при глотании;

8. eructation [ֽi:r٨k'tei∫ən] – n, отрыжка;

9. exacerbation [ig'zæsəbei∫n] – n, обострение;

10. faeces ['fi:si:z] – n, кал, фекалии;

11. heartburn ['ha:tbз:n] – n, изжога;

12. hernia ['hз:niə] – n, грыжа;

13. indigestion [ֽindi'dʒest∫ən] – n, несварение, дисперсия;

14. malignant [mə'lignənt] – adj, злокачественный;

15. nausea ['no:siə] – n, тошнота;

16. neoplasm ['ni:ouplæzm] – n, новообразование;

17. regurgitation [riֽgз:dʒi'tei∫n] – n, срыгивание;

18. tumour ['tju:mə] – n, опухоль;

19. vomiting ['vomitiŋ] – n, рвота.

Mind the pronunciation:

proctitis [prok`taitis]

gastritis [gæ'straitis]

peptic ulcers [ֽpeptik '٨lsə(r)]

enterocolitis [`entərəu`kolaitis]

intestinal obstruction [in'testinəl əb'str٨k∫n]

hiatal hernia [hai'eitəl 'hз:niə]

inguinal hernia [`ingwinəl 'hз:niə]

appendicitis [əֽpendi'saitis]

peritonitis [ֽperitə'naitis]

Ex.1. Find the synonyms:

belching stool

nausea neoplasm

anorexia sickness

faeces eructation

growth swelling

tumour dyspepsia

indigestion loss of appetite

Ex.2. Find the antonyms:

bulimia reduced (failing)

diarrhea weight loss

excessive malignant

weigh gain constipation

benign anorexia

Ex.3. Match the terms with their descriptions.

Anorexia, appetite, belching, bulimia, constipation, faeces, diarrhea, heartburn,

nausea, neoplasm, dysphagia.

1. a feeling that you want to vomit;

2. loss of appetite;

3. difficulty in swallowing;

4. a physiological condition in which a person eats too much and incapable of controlling his eating;

5. the feeling of wanting food;

6. waste matter passed from the bowels through the anus;

7. indigestion which causes a burning feeling in the stomach and esophagus;

8. the action of allowing air in the stomach to come up through the mouth;

9. a condition in which someone fragrantly passes liquid faeces;

10. difficulty in passing faeces [`fi:si:z];

11. any new and morbid formation of tissue.

Ex.4. Read and translate the words and their derivatives:

malignancy - malignant

neoplasia [¸ni:oupleiziə] – neoplasm – neoplastic

digest – digestion – digestive – indigestion

nausea – nauseate – nauseating – nauseous

morbid ['mo:bid] – morbidity – morbidly

tolerate – tolerant – tolerance – intolerance

Ex.5. Make up word-combinations and translate them:                                                                    dull                          sharp                          burning

aching     pain          spasmodic                          intermittent erosive/ulcerative

   severe                          despise                          colicky                          hungry

forceful

   prolonged                                                                         blood habitual                                          vomiting ( of ) bile recurrent food (многократная) erosive/ulcerative anacidic atrophic hypoacidic gastritis hyperacidic catarrhal chronic

asymptomatic (немая) bleeding/ active complicated ulcer peptic perforating

Ex.6. Give Russian equivalents:

Feeling of fullness and distention, abdominal rigidity, intolerance for spicy or fatty food, bowel movements, a chronic course with remissions and exacerbations, intestinal motility, abdominal distention, small-bowel obstruction, to induce vomiting, coated tongue.

Ex.7. Give English equivalents.

Pезкое повышение аппетита, чувство полноты в желудке, отрыжка воздухом, чувство жжения в надчревной области, полное отсутствие аппетита, "голодные" боли, учащенный стул, хронический запор, обложенный язык, вызывать рвоту.

Ex. 8. Make up sentences.

                                           is accompanied by                                            is focused                                            radiates The pain     begins                                           is worse                                            is relieved by                                             is localized                                             lasts

Ex.9. Complete the sentences and translate them.

1. (Изжога и диспепсия) usually signal the beginning of a gastric ulcer attack.

2. About 80% of all peptic ulcers are duodenal ulcers and occur most commonly (у мужчин в возрасте от 20 до 50 лет).

3. Duodenal ulcers usually follow a chronic course (с ремиссиями и обострениями).

4. Other typical effects of gastric ulcers include (потеря веса и повторяющиеся случаи кровотечения).

5. Gastric ulcers, (которые поражают слизистую желудка) are most common in middle-age and elderly men, especially in chronic users of alcohol or tobacco.

6. Duodenal ulcers produce heartburn, well-localized midepigastric pain relieved by food), weight gain (больной ест, чтобы уменьшить боль).

7. In gastric ulcers (приступы боли возникают после еды) or after consumption of orange juice, coffee, aspirin or alcohol.

8. (Возможными осложнениями язв желудка являются) perforation, hemorrhage and pyloric obstruction.

9. (Психическая травма, стресс, старение) are additional predisposing conditions.

10. Researchers recognize (основные причины возникновения язвы желудка): infection with Helicobacter pylori and pathologic hypersecretory disorders.

Ex. 10. Translate into English.

1. Изжога - это чувство неприятного жжения, которое возникает в желудке и поднимается вверх по пищеводу.

2. Существуют продукты, которые могут вызвать это недомогание у 90% всех пациентов.

3. Не рекомендуется злоупотреблять белым вином, жирной выпечкой и шоколадом.

4. Если человек имеет стул реже двух раз в день, то, возможно, он склонен к запорам.

5. Многие люди принимают слабительное (laxatives), чтобы справиться с этой проблемой.

6. Причинами запора могут стать переедание, малоподвижный образ жизни, пища, богатая протеином.

7. Тем, кто страдает спастическими жалобами, синдромом раздраженного желудка, рекомендуется освоить методику расслабления - йогу.

grammar

Complex Subject.

Сложное подлежащее.

Сложное подлежащее представляет собой сочетание именной части, выраженной существительным или местоимением в именительном падеже и глагольной части, выраженной инфинитивом. Сказуемое в таких предложениях, как правило, представлено глаголом в страдательном залоге и

располагается между частями сложного подлежащего.

Глаголы-сказуемые, употребляемые:

I. В страдательном залоге: to know, to believe, to consider, to expect, to suppose, to understand, to see, to hear, to announce, to report, to say, to tell, to state etc.

II. В действительном залоге: to seem, to happen, to prove, to appear.

III. Фразы: to be + likely, unlikely, sure, certain.

На русский язык предложения со сложным подлежащим переводятся сложно-подчиненными предложениями с придаточным дополнения. Перевод таких предложений следует начинать со сказуемого, которое переводится неопределенно-личным предложением. Части сложного подлежащего переводятся как главные члены придаточного предложения: именная часть - как подлежащее, а глагольная - как сказуемое. Время сказуемого зависит от формы инфинитива. Простой инфинитив переводим сказуемым настоящего времени, а сложный /перфектный/-сказуемым прошедшего времени. Если сказуемое выражено to be likely,to be unlikely, to be certain, to be sure- инфинитив будет переводиться сказуемым в будущем времени.

Examples:

The patient is thought to suffer from pneumonia. - Думают, что больной страдает пневмонией.

Leucocytosis is likely to develop in inflammation. -Вероятно, что лейкоцитоз разовьется при воспалении.

Ex.1. Choose sentences with Complex Subject and translate them.

1. He is supposed to discharge the patient from the hospital.

2. Academician A.N. Bakulev is considered to have been the founder of a new branch of surgery – cardiosurgery.

3. She appears to study at the Medical University.

4. He is known to be the most qualified specialist in this field of medicine.

5. They seem to study English for the first two years.

6. Renal and splenic infarctions are likely to occur in endocarditis.

Ex.2. Translate the following sentence into Russian.

1. Brain cortex stimuli are considered to send impulses to the stomach and duodenum.

2. On physical examination the liver was considered to have been enlarged.

3. The damage of the blood supply was supposed to have been present before the operation.

4. He is supposed to be discharged from the hospital.

5. Pain intermittent in occurrence is known to be characteristic of gastric or duodenal ulcers.

6. Chronic gastritis is known to occur as a separate or primary disease or it may be associated with other diseases, particularly chronic liver and kidney diseases.

7. Exacerbation of duodenal ulcers is known to occur in spring and autumn.

Ex.3. Translate the following sentences into English.

1.Известно, что операция прошла успешно.

2.Вероятно, у больного метастазы в печени вследствие рака желудка.

3. Было обнаружено, что у него язва желудка.

4.Оказалось, что больной был слишком слаб для такой операции

5.Сообщили, что пациент умер от отравления.

6.Считается, что он самый известный хирург в городе.

PART II

Your assessment of the patient with suspected gastrointestinal disease must begin with a careful history that includes occupation, family history, and recent travel. The medical history should include previous hospital admission; surgical procedures (including recent tooth extraction); family history of ulcers, colitis or cancer and current medications, such as aspirin, steroids, or anticoagulants.

Ex.1.

a) Ask the patient about his digestive complaints.

b) Put the words in the correct order to make questions.

Abdominal pain indigestion heartburn or rectal bleeding he does have?

Long how it has he had?

These symptoms relieves what or makes them worse?

Difficulty in swallowing recently has he experienced?

Any has recent weight he had loss or gain?

On special diet he is?

Alcoholic he does drink beverages or smoke?

If yes to either; how much and how often?

What bowel his habit is?

Nausea and vomiting he does experience?

He describe his can pain?

Is it where located?

Does it last how long?

Does when it occur?

Triggers what it?

It relieves what?

Ex.2. Read the text. Find the words describing the abdominal pain. Write them down in the order of gravity.