Diseases of the upper respiratory tract (tonsillitis, pharyngitis, laryngitis).

Tonsillitis, pharyngitis and laryngitis are clinically similar acute infectious diseases. They are the most common ailments among both children and adults.

Most of the time, especially if treated, we recover from these infections without permanent harm. But occasionally an infection will be more serious, even life-threatening. Anything that blocks the airways may be hazardous. Sometimes chronic infections cause permanent tissue damage. Factors predisposing to upper respiratory infections are smoking, breathing particle - laden air - coal dust, air pollution, climate and seasons (in the autumn or early spring), i.e. they depend on chilling.

Tonsillitis is inflammation of the tonsils, especially the palatine tonsillitis, depending on the nature of the lesion: acute or true, catarrhal, follicular and lacunar tonsillitis.

The most widespread is acute tonsillitis which is a definite systemic infection characterized by an acute inflammatory process, primarily in the area of the tonsils. These are at least 200 viruses that can give rise to acute tonsillitis. The bacteria may be inhaled into respiratory passages during contact with patients or they may be acquired through the patient's things (cups, plates, spoons, etc.). When these viruses penetrate into the body of the person with decreased immunity, he develops acute tonsillitis. The most vivid and constant symptom of tonsillitis is pain in the throat. However, this illness may have a drastic effect on many vital organs of the body. There may be enlargement and tenderness of the cervical and submaxillary lymph glands. Catarrhal condition of the throat and larynx are manifested by a coarse, barking cough and hoarseness. The patient feels discomfort on swallowing and earache. The discharges from the throat become purulent causing unpleasant odour from the patient's mouth. This disease is characterized by general weakness, headache and an increase of body temperature to a suffebrile level-37.1—37.5 °C. It decreases the patient's work capacity.

The most frequent complications of acute tonsillitis are rheumatic fever and kidney trouble.

Pharyngitis is inflammation of the pharynx or sore throat. There are various forms of pharyngitis: acute or catarrhal pharyngitis, atrophic, chronic and hypertrophic.

The patient with acute pharyngitis usually complains of slight tenderness or tention in the throat, especially on swallowing. He feels a dry scratchy and burning sensation in the throat and has fever. On examination the physician usually notes redness, swelling and edema of the uvula. Mucous membrane is red and covered with mucopurulent secretion. Acute pharyngitis often preceeds acute tonsillitis or is accompanied by it.

Laryngitis is inflammation of the larynx, a condition attended with dryness and soreness of the throat, hoarseness, cough and dysphagia.

There are different types of laryngitis: acute, catarrhal, croupous, diphtheric, membranous, necrotic, phlegmonous, subglottic, syphilitic, tuberculous and vestibular one.

Acute catarrhal laryngitis is a form characterized by aphonia or hoarseness, pain and dryness of the throat, dyspnea, a wheezy cough and more or less fever.

Treatment of the respiratory diseases of the upper respiratory tract.

The patient is allowered to follow home treatment. He is recommended to take antipyretics, sulfonamides and expectorants, not to speak for 5-7 days and to gargle his throat with a warm solution of sodium bicarbonate, to use inhalations several times a day. The patient must follow salt-free diet, avoid cold food. It must be warm (but never hot). Pungent, coarse, spicy or acid food is not allowered. When the patient suffers from high fever he needs more liquids than usually and is recommended to take sudorific (sweatinducing drinks), such as tea with honey and warm milk with honey.

POST-TEXT ASSIGMENTS.

Exercise 8. Answer the questions:

In what forms does tonsillitis occur?

What are the causative agent of tonsillitis?

How do acute respiratory disorders of the upper respiratory system spread?

Who spreads the disease?

What are complications of acute tonsillitis?

What is pharyngitis?

What common symptoms of acute catarrhal pharyngitis can you name?

What forms of pharyngitis do you know?

What is laryngitis?

What are the doctor's recommendations for the treatment of tonsillitis, pharyngitis and laryngitis?

Exercise 9. Translate into English:

Заболевания верхних дыхательных путей часто происходят в дождливую, сырую погоду.

Боль в горле - это самый яркий и постоянный симптом при остром тонзиллите.

Больной жалуется на острую боль при глотании и ощущение першения, жжения в горле.

Острый ларингит - это вторичное заболевание, характеризующееся острым катаром (catarrh) носа и носоглотки (nasopharynx).

Больной должен полоскать горло тёплым раствором питьевой соды.

Exercise 10. Make up questions to the underlined words:

Mucous membrane is red and covered with mucopurulent suretion.

Bad teeth and chronic inflammation of the tonsils should receive timely treatment.

Acute tonsillitis may have a drastic effect on many vital organs of the body.

The germs may be inhaled into the respiratory passages during contact with patients.

Catarrhal condition of the troat decreases the patient's work capacity.

Exercise 11. Explain the process taking place in the organism of the patient suffering from acute tonsillitis.

Exercise 12. Make up a summary of the text.

Exercise 13. Speak on the following items:

The cardinal symptoms of acute tonsillitis.

The main symptoms of acute pharyngitis.

The course of acute laryngitis treatment.

TEST

1. Tonsillitis, pharingytis and laryngitis are clinically similar acute ... disease.

a) nervous

b) psychic

c) allergic

d) infectious

e) mental

2. They ... the most common ailments among both children and adults.

a) are

b) am

c) have

d) has

e) were

3. Especially if treated, we ... from these infections diseases without permanent harm.

a) recovered

b) was recovering

c) had been recovering

d) recover

e) were recovering

4. Tonsillitis is inflammation of the ...

a) larynx

b) toes

c) tonsils

d) head

e) pharynx

5. This disease is characterized by an increase ... body temperature to a subfebrile level.

a) at

b) of

c) under

d) for

e) on

6. Pharyngitis is inflammation of the pharynx or ... thoat.

a) wide

b) almost

c) normal

d) regular

e) sore

6) Most surgical procedures... at this level.

a) may carry out

b) may be carried out

c) is allowed to carry out

d) might carry out

e) must carry out

7. The roving movements of eyeballs gradually diminish until they are lost... the end of this plane.

a) at

b) in

c) by

d) from

e) of

8. Loss of consciousness results... the reversible reduction of the activity in the reticular activating system.

a) of

b) in

c) from

d) at

e) by

9. When... the second stage of anesthesia...

a) do... begin

b) does... begin

c) begins

d) were... beginning

e) have... begun

10. How many stages of anesthesia are known for us?

a) 1

b) 2 c) 4

d) 5

e) many stages

9. D I S E A S E S O F T H E L O W E R

R E S P I R A T O R Y T R A C T

PRE-TEXT ASSIGNMENT

Exercise 1. Practice the pronunciation:

pneumonia [ nju:məunjə ], bronchitis [ brəῃ'kaitis ], bronchi ( bronkia – pl ) [`brəῃkai (`brənkiə)], exudate [ eksju:'deit ], coarse [ kə:s ], hoarseness [hə:snis],

tenacious [ ti'nei∫əs ], exposure [ iks'pəuʒə ], sinusitis [ 'sainəsaitis ], indulgence [ in'dΛldʒəns ], warrant [ wərənt ], residual [ ri'zidjuəl ], annoying [ ə'nə:iŋ ], majority [ mə'dʒəriti ].

Exercise 2. Topic vocabulary:

edematous – отечный

tenacious – вязкий, липкий

coarse – грубый, жесткий

atelectasis – ателектаз, коллапс ( острая сосудистая недостаточность)

to encounter – встретить(ся)

indulgence – увлечение

exposure- подвергание (риску)

warrant – являться основанием

residual – остаточные явления

annoying - беспокоящий, раздражающий

Exercise 3. State the suffixes in the following words and translate them.

the nouns: efficiency, slowness, division, usage, inhibition, tiredness, significance, development, difference, infancy, closure, passage;

the adjectives: medical, pulmonary, different, cortical, respiratory, various, specific, primary, considerable, effective, extensible, Italian;

the verbs: summarize, communicate, analyse, dilate.

Exercise 4. Match the following English word combinations with the Russian ones:

1. congestive heart failure – стадия, предшествующая заболеванию

2. residual bronchitis – общее недомогание

3. prodromal stage – застойная сердечная недостаточность

4. general malaise – неотъемлемая часть

5. integral part - остаточный брoнхит

Exercise 5. Translate into your native language paying attention to the modal verbs.

1.You can see the patient in the consulting room. 2. She must be on a strict diet to be strong and healthy. 3. The bad tooth had to be filled in time. 4. Local tenderness may occur in pleurisy. 5. We will be able to rest on Sunday. 6. The patient is allowed to walk about the room. 7. The students were not able to make the diagnosis themselves. 8. We had to summarize and analyze all the findings of our observations. 9. The consolidation in the lung could be revealed by X-ray examination. 10. One should remember that most viruses are destroyed at the temperature of 50-60 within 30-60 minutes.

Exercise 6. Put in the modal verbs or their equivalents and translate them.

1. If you have a bad headache you … take some medicine.

2. The doctor … have your blood analyses to be sure of your diagnosis.

3. For what time … I have an appointment with the doctor?

4. Pulpitis … result in gangrene.

5. What … save a patient’s life in cardiac arrest?

6. The operation … be performed at 10 o’clock yesterday.

7. In order to relieve pain doctors … use pain-killers/

8. As my sister caught a cold she … stay in bed.

9. What … cause serious complications after grippe?

10. The operating-room … be well lighted and ventilated.

Exercise 7. Translate into English:

1.Чтобы бороться с любым инфекционным заболеванием успешно, доктор должен знать его происхождение. 2. Покраснение на боковой поверхности руки может исчезнуть после лечения. 3. Доктору следует знать все свойства лекарства до того как назначать его больному. 4. Студентам-медикам будет разрешено оперировать больных только на пятом курсе. 5. Нужно помнить, что количество лейкоцитов возрастает почти при всех заболеваниях.

Exercise 8. Read and translate the text:

DISEASES OF THE LOWER RESPIRATORY TRACT

The classic bacterial infections of the lungs are bronchitis and pneumonia which are caused by a variety of microorganisms most of which can be treated effectively now.

B R O N C H I T I S

ACUTE BRONCHITIS. Acute bronchitis is occasionally a primary disease but usually develops as a secondary infection following the common cold, sinusitis, measles, whooping cough, or some other acute illness. It consists of diffuse inflammation of the bronchi, the mucous membrane of which are injected, edematous and covered with a sticky, grayish, mucoid exudates. Productive cough, hoarseness, chills, sweats, fever and general malaise are usually present. They may develop suddenly or gradually. The sputum, at first mucoid, usually becomes purulent and tenacious. Examination of the chest often reveals coarse or fine moist rales and sometimes sonorous sibilant ones. Occasionally there are small areas of atelectasis over which the breath sound may be diminished in intensity. Sometimes there are no physical signs at all. The fever usually subsides within a few days. Its failure to do so brings up for different complications such as sinusitis, bronchopneumonia, measles, whooping cough, typhoid and paratyphoid fevers, chills, sweats and cough.

CHRONIC BRONCHITIS. A chronic cough, productive of mucoid or purulent sputum, with little impairment of the general health, is not uncommonly encountered in persons with asthma, sinusitis, emphysema, over-indulgence in smoking, exposure to dusty atmospheres, or with heart disease producing early manifestations of congestive failure. Chronic bronchitis is never a primary disease and it always warrants determining of its primary cause.

The physical signs of chronic bronchitis consist chiefly of coarse or fine moist rales in addition to signs characteristic to the associated primary condition. Some persons have a predisposition to residual bronchitis of this type which follows every attack of respiratory infection. In persons in later life suffering from the prodromal stages of congestive heart failure “winter-cough” is frequently seen with freedom from symptoms during the summer months.

The prognosis in young persons when the primary cause can be determined and eradicated is favorable but beyond middle life chronic bronchitis is a persistent and annoying disease.

P N E U M O N I A

Pneumonia is an acute inflammatory condition of the lungs caused by bacteria and marked by formation of an exudate in the lung tissue.

The symptoms of pneumonia are following: fever and temperature changes have an irregular course and are caused by the appearance of new foci of inflammation in the pulmonary tissue. Fever persists several weeks and then decreases gradually. The patient”s breathing is rapid with 30-40 respirations per minute. There are breathlessness and cyanosis of the face. The patient complains of the pain in the chest particularly on deep breathing in and cough with purulent sputum. The pulse rate is accelerated and the arterial pressure is reduced. The blood analysis reveals leucocytosis and an accelerated ESR. The urine may contain a small amount of protein and erythrocytes. The X-ray examination of the lungs reveals numerous foci of inflammations. But after a course of treatment the prognosis is favourable.

In recent years the introduction of specific means of therapy for the majority of cases pneumonia has brought about a profound change in thought concerning the acute pulmonary infections.

A few years ago primary emphasis was placed upon the pathologic changes which developed in the lung. Today these changes are considered much less important than the accurate determination of the etiologic agent.

Except in acute lobar pneumonia, clinical findings rarely permit an etiologic diagnosis to be made at the bedside. Even in lobular pneumonia when the pneumococcus may logically be suspected in most cases, anyone of forty-one different types of pneumococci may be responsible.

Thus, the bacteriologic examination of the sputum must be considered an integral part of the study of patients with pneumonia.

POST – TEXT ASSIGNMENTS

Exercise 9. Answer the questions:

1. What are the classic bacterial infections of the lungs?

2. Is acute bronchitis a primary disease?

3. What are symptoms of acute bronchitis?

4. What does the examination of the chest reveal?

5. What are complications following bronchitis?

6. What is the prognosis of bronchitis?

7. What is pneumonia caused and marked by?

8. Do the symptoms of bronchitis and pneumonia coincide? What is the difference?

9. How many types of pneumococci exist?

10. What is an integral part of the study of patients with pneumonia?

Exercise 10. Translate the following word combinations into English and make up 5 sentences of your own:

Вызывать заболевание, причина заболевания, значительное изменение, менее важный, поставить диагноз, в большинстве случаев, вторичная инфекция, влажный кашель, очаг воспаления, при глубоком вдохе, старше среднего возраста.

Exercise 11. Give the English equivalents of the words in brackets. Translate the sentences.

1. Bronchitis ( вызывать ) by a ( множество ) of microorganisms.

2. Acutе bronchitis is occasionally ( первичное заболевание ).

3. ( Мокрота ) usually becomes ( гнойной и вязкой ).

4. The symptoms of chronic bronchitis consist chiefly of ( жесткий или влажный ) rales.

5. The prognosis of the disease ( у молодых людей ) is favorable but (старше среднего возраста ) it has a persistent character.

6. Pneumonia is ( острый воспалительный ) condition of the lungs.

7. In acute lobar pneumonia ( клинические данные ) rarely permit (поставить диагноз ) at the bedside.

8. ( Сухие хрипы ) caused by diffuse bronchitis were heard all over the lungs.

9. The shadow at the base of the left lung was particularly marked due to the ( увеличение лимфатических желез ).

10. ( Тяжелые формы ) of pneumonia are difficult ( отличить от ) tuberculosis.

Exercise 12. Insert prepositions:

1. The patient complained … numbness in his right hand.

2. Scientists consider that poliovirus enters the body … mouth or nose.

3. Surface waters may be contaminated … chemical and biological substances.

4. Local anesthetics may be divided … two groups according … their action.

5. The patient survived the operation … cholecystitis well.

6. Cholera is an acute infection … alimentary tract due … the cholera vibrio.

7. She cares … Anatomy and pays great attention … this subject.

8. He graduated … the medical institute … last year.

Exercise 13. Speak on the following items:

The main symptoms of acute bronchitis.

The cardinal signs of chronic bronchitis.

The course of pneumonia.

Exercise 14. Give a summary of the text.

TEST

1. What are the symptoms of acute bronchitis?

a) inflammation of the abdomen, purulent sputum

b) inflammation of the tonsils and throat

c) general weakness, headache

d) productive cough, hoarseness, chills, fever, rales in the lungs

e) sore throat edema of the uvula

2. The physical sings of chronic bronchitis consist chiefly of ... in addition to signs characteristic to the associated primary conditions.

a) congestive heart failure

b) attack of respiratory infection

c) coarse or fine moist rales

d) sinusitis

e) emphysema of lungs

3. ... middle life chronic bronchitis is a persistent and annoying disease

a) in

b) at

с) after

d) on

e) beyond

4. In persons ... later life suffering from the prodromal stages of congestive heart failure "winter-cough" is frequently seen.

a) in

b) at

c) after

d) on

e) beyond

5. Acute bronchitis usually ... as a secondary infection.

a) developed

b) develops

с) has been developing

d) was developed

e) is developing

6. The sputum, at first mucoit, usually ... purulent and tenacious.

a) became

b) becomes

с) has become

d) had become

e) becoming

7. A few years ago primary emphasis ... upon the pathologic changes which developed in the lungs.

a) has been placed

b) had become

c) was placed

d) was placing

e) is placed

8. ... are the classical bacterial infections of the lungs?

a) where

b) when

c) who

d) what kind of

e) what

9. ... the symptoms of bronchitis and pneumonia coincide?

a) does

b) are с do

d) is

e) were

10. Except in acute lobar pneumona, clinical findings rarely permit an etiological diagnoses to be made ...

a) at a polyclinic

b) at the bedside

c) at a hospital

d) at a therapeutic department

e) at home