Urinary system Anatomy and Functions of Urinary System

Task 1 Pronounce and memorize the words and expressions:

Urea - сечовина

Nitrogen - азот

Ureter — сечівник

Urethra - уретра

Urine — сеча

Bladder - сечовий міхур Kidney — нирка

Bean-shaped — схожий на квасолю

Adipose tissue - жирова тканина

Outer cortex part - зовнішня частина кори

Ammonia — аміак

Renal ducts - сечівники

Inner medulla part - внутрішній мозковий шар нирки

Tiny tubules - крихітні канали

То ensure smth. - забезпечити щось

Depending on - залежно від

Biliary bilirubin - жовчний пігмент, білірубін

Diuresis - діурез (виділення сечі)

Urobilin — уробілін

Urochrome - урохром (пігмент сечі)

Renal pelvis - ниркова миска

Baroreceptors — барорецептори

Ureteral lumen - порожнина (просвіт) трубчастого органа Micturition — сечовипускання

Task 2 Read and comprehend the text "Anatomy and Functions of Urinary System ".

The main function of the urinary system is to excrete urea, which is nitrogen-containing waste product of protein metabolism. Urea is formed in the liver from ammonia, which is derived from the breakdown of amino acids (simple proteins) in the body cells. The urea is carried in the bloodstream to the kidneys.

The urinary system includes the kidneys, right and left; the ureters (renal ducts), muscular tubes from each kidney lined with mucous membrane, which convey urine to the urinary bladder; the urinary bladder which is a hollow muscular sac for temporary collection of urine and the urethra which is a tube through which urine is discharged from the urinary bladder and passed out of the body.

The kidneys are bean-shaped organs embedded in a cushion of adipose tissue and located behind the abdominal cavity. They consist of an outer cortex part and an inner medullar part. The kidneys can be compared with filters because they perform the filtration of waste products from the blood. These waste products are brought to the kidneys via the renal arteries which branch into the kidneys and are rather short and thick.

The process of filtration and formation of urine takes place within the tiny tulubes of the kidney. Besides, renal functions include participation in the control of: volume of blood and other fluids of the body; protein, lipid and carbohydrate metabolism; arterial pressure; erythropoesis; coagulation of blood and some more functions. Thus, the kidney is an organ that participates in ensuring the constancy of the main physico-chemical constants of the blood and other fluids within the body and contributes to the regulation of metabolism of various organic substances. Depending on the water balance in the organism, the kidneys produce diluted and ' concentrated urine. The urine may contain many substances found in the blood plasma, as well as some compounds synthesized in the kidney itself.

The volume of urine discharge by a healthy individual may vary widely and depends on the condition of water balance. The color of the urine depends on the diuresis and the excretion of pigments; it changes from light yellow to orange. The pigments are formed by biliary bilirubin in the intestine where it is converted to urobilin and urochrome which are partely absorbed in the intestine and excreted by the kidneys. Some of the urinary pigments are products of haemoglobin breakdown oxidized in the kidney. Urine formed in the renal tulubes passes into the renal pelvis and fills it

gradually. When the filling threshold is reached, the signal of which is given by the baroreceptors the pelvis muscles contract, the ureteral lumen opens and the urin£ flows into the urinary bladder. With the gradual increase of the volume of urine the walls of the bladder are stretched. In the initial stage of filling the tension of the walls does not change, and pressure in the bladder does not grow. When the volume of the urine reachbs a definite level, tension of the smooth muscle walls of the bladder increases sharply, the pressure of fluid in its cavity rises, and complex reflex act of micturition occurs. Movement of urine along; the urethra plays an important role in the act of micturition as it stimulates contraction of the bladder by reflex.

Task 3 Choose the answers to the questions:

1. What is the main function of the urinary system?

1. Why does the body excrete nitrogeneous waste in the form of a soluble (dissolved in water) waste substance called urea?

2. Why can the kidneys be compared with the filters?

2. What does the production of diluted or concentrated urine depend upon?

3. What is urinalysis (urine test) necessary for?

3. Why are ketone bodies quite dangerous if they accumulate in the body?

4. What does urinary bladder serve as?

5. What does rennin stimulate?

4. Why is the specific gravity of urine low in such kidney disease as nephritis?

5. What purpose are the kidneys in a cushion of adipose tissue for?

* a) water balance

b) for determining the presence of abnormal elements - c) because water is unable to be reabsorbed by the

tulubes and this dilutes the wastes and minerals in the urine d) for protection > e) because protein foods contain carbon, hydrogen, oxygen, nitrogen and other elements and the waste

that is produced and can not be excreted from the

body simply by exhalation f) as a temporary reservoir for urine — g) it stimulates the contraction of arterioles so that blood

pressure is increased and blood flow in the kidneys is

restored to normal h) because their presence can increase the acidity of the

blood, coma, unconsciousness may follow and a

patient can die

« i) because they perform the filtration of waste products from the blood ( j) to remove urea from the bloodstream so that it does not accumulate in the body and become toxic

Task 4 You can't do without these terms while dealing with the texts about urinary system. Study their meaning and get ready to use them in speech:

Uric acid — a white odorless crystalline nitrogenous substance found in urine

Suppuration - formation or discharge of pus

Retention - holding back, the retaining within the body of matter

normally excreted urine; the inability of the urinary bladder to expel

urine

Rennin - a substance formed in the kidney which contracts blood vessels and increases blood pressure

Ketone bodies - (Calcium + acetone), breakdown products including acetone which are the results of fat metabolism Enuresis - inability to hold back urine, to control urination; involuntary bed-wetting

Dialysis - artificial filtration of waste materials from the blood by the greater diffusibility of the smaller molecules through a special membrane used during kidney failure

Createnine - a nitrogen compound found in blood muscle and especially urine, where measurement of its excretion is used to evaluate kidney function

Specific gravity - the specific gravity of urine reflects the amount of wastes, minerals and solids in the urine

Task 5 Choose the proper terms for the definitions and statements:

1. An examination of urine to detennine the presence of abnormal elements.

2. It may be caused by infection of the kidney, pyelonephritis, cystitis or stone in! the kidney or bladder.

1. They are quite dangerous if they accumulate in the body.

2. It is a symptom of diabetes mellitus.

3. Materials which are thrown off into the urine in kidney disease are of different (pus, waxy, blood, fatty, etc.) origins and types.

3. It is not normally found in the urine.

4. Cuplike divisions of the renal pelvis are called ....

4. Another important function of the ... besides removing urea from the blood is to maintain the proper balance of water, salts and acids in the body fluids.

5. Tube for giving and withdrawing fluids.

6. A protein found in the blood.

a) b) c)

d) e)

ketone bodies

casts sugar

calyces pyuria

6. urinalysis

7. acetonuria

h) catheter

i) albuminuria j) kidneys

Task 6 Study pathological terminology and get ready to build medical terms:

Hypernephroma - renal malevolent tumor of the kidneys which occurs in adults. It usually metastasizes to the bene, blood and lungs. Glomerulonephritis - inflammation of the kidneys, primarily involving the glomerula; this disease causes destruction of gromerular capillary walls; the complications are renal failure, retention of urea in the bloodstream (uremia).

Hydronephrosis — enlargement and distention (swelling) of the kidney due to block of urine outflow, caused by renal calculi, tumors, hypertrophy of prostata or narrowing of the ureters. Pyelitis — inflammation of a kidney pelvis

Nephrolithiasis — the formation of renal calculi (stones) in the renal pelvis, which is followed by obstruction of the kidney, ureter or bladder

Pyelonephritis — bacterial infection of one or both kidneys usually involving both the pelvis and the functional tissue. Pyuria is found in urinalysis

Polycystic kidney — the formation of numerous fluidfilled sacs upon and within the kidneys

Gout — a disease resulting from a disturbance of uric acid metabolism, characterized by an excess of uric acid in the blood and deposits of uric acid salts in various tissues, especially in the joints of the feet and hands. It causes swelling and severe pain, notably in the big toe.

Task 7 Choose the proper terms for the definitions:

1. displacement of the kidney

2. necrosis (death) of the cortex region in both kidneys

3. excessive development or growth of the kidney(s)

4. the presence of protein (albumin) in urea

5. stones in kidneys

6. blood in the urine

7. dilatation of the calices of the renal pelvis

8. a method of removing the toxic materials from the blood in case the kidneys fail to perform their function

9. abnormal (small amount) of urine flow

a) b) c) d)

e)

dialysis oliguria caliectasis renal calculi

uremia

f) renal ectopia

g) bilateral cortical

renal necrosis

h) renal hyperplasia

i) albuminuria

Task 8 Study the following expressions to the article from "Herald Tribune ":

to use high-energy shock Waves - використати ударні хвилі струму

to remove kidney stones - (видалити ниркові конкременти

to reduce the recovery period - зменшити період видужування

excruciating pain — нестерпний біль

to do away with something - покінчити з чимось

to inject a chemical dye - впорскнути хімічний барвник

to insert a tube (a wire) into the kidney — вставити трубочку (дріт)

у нирку

to pulverize stones - подрібнювати конкременти

a suction device - пристрій для всмоктування дрібних

конкрементів

Task 9 Read and comprehend the article "Kidney Stones: 2 new treatments": '

West German doctors developed two new techniques, one using high-energy shock waves, to remove kidney stones much less painfully and without the customary major surgery.

The techniques also promise to reduce by several weeks the recovery period for tens of thousands of patients. In one of the new methods, the kidney stone is extracted directly through the skin, but the patient still must undergo general anesthesia. The other method, generally painless, involves no surgery at all. It relies on the delivery of high-energy electric shock waves monitored by X-rays.

The overwhelming majority of kidney stones pass out of the body on their own, often accompanied by excruciating pain. Surgery is necessary in about 20 per cent of kidney stone cases. In the operation that has been used for decades, the surgeon cuts through layers of tissue to reach into the organ to remove the stone by hand and with forcepts. Patients usually stay in the hospital for one or two weeks, and are limited in the amount of physical activity and work they can undertake for another four or five weeks.

In most cases the new techniques should do away with this major operation. But people who develop one kidney stone often develop another, and neither technique prevents the formation of new stones.Doctors first inject a chemical dye to outline the kidneys in X­rays. Then they insert a wire, much like a needle, into the kidney. This part of procedure requires no anesthesia. The next day, the surgeon uses the wire as a guide to insert a tube into the kidney. The tube which contains instruments and fiberoptical devices enables doctors to see the kidney both directly and on a television screen. Depending on the circumstances in each case, the doctors can then remove the stone under direct vision or they can pulverize it by sending ultrasound through the tube. The small pebbles are then removed with a suction device. This procedure usually takes no more than 90 minutes and patient's hospital stays have averaged only four days. The technique was successful in 104 of 109 cases.

The second technique was developed in Munich. After a local anesthetic is injected into the back, the patient sits in a tank filled with water in such a position that the kidney stone is at the focal point of a Shockwave generator. Then from 500 to 1,500 shocks are given to destroy the stone.

The timing of the shocks is coordinated with an electrocardiogram to prevent cardiac arrest. The number of shocks generally depends on the size of the stone. Within two days after the treatment the patient passes the pulverized stones in his urine.

The stones were entirely removed in 90 per cent of the patients. Pieces of stone were left in 9 per cent and surgery had to be done in 1 per cent.

Task 10 Read the statements to the article above and either support or challenge them by putting plus and minus signs:

1. A new technique uses high energy shock waves to remove kidney stones.

2. The recovery period will be prolonged because of the new technique.

3. The patient does not have to undergo general anesthesia when the kidney stone is extracted through the skin.

4. One of the techniques prevents the formation of new stones.

5. A chemical dye is injected to outline the kidneys in X-rays.

6. The tube inserted into the kidney does not enable doctors to see the kidney directly and on a television screen.

7. The timing of the shocks is coordinated by means of X-rays.

INFECTION Unitl

Task 1 Pronounce and memorize the meaning of the following words

and expressions:

Ailment - недуга, хвороба

Cholera - холера

Conspicuous — помітний

Contagious — інфекційний, заразний

Consequence - наслідок

Enteric fever - черевний; кишковий тиф

Eruption — висип

Hepatitis - інфекційний гепатит

Influenza, flu - грип

Jail fever - в'язнична лихоманка

Jaundice - жовтяниця

Natural disaster — лихо, катастрофа

Profuse - надмірний

Pustule — пустула, гнійник

Quarantine - карантин

Sporadic - поодинокий, спорадичний

Spottedfever — висипний тиф

То take a toll - "збирати жниво"

Elevated temperature — підвищена температура

Step-ladder temperature - поступове підвищення температури

Transmissible - заразливий; той, що передається...

Typhoid fever - черевний тиф

Variola — віспа

Virulent - вірулентний, заразний

Task 2 Read the following sentences and translate them into Ukrainian:

1 An attack of smallpox can have an extremely disfiguring effect as it invariably leaves pock-marks all over the victim's face.

2. The anti-polio campaign in our country has been a very spectacular success, indeed.

3. As for infective hepatitis, virus SH differs from virus IH in having a much longer incubation period.

4. Both types of catarrhal jaundice may have extremely unpleasant consequences.

5. Polio may lead to paralysis because the virus invades the motor neurons in the brain stem and spinal cord.

6. We have achieved a most satisfactory results with the Sabin vaccine.

7. The Sabin vaccine seems to be better than the Salk killed-virus vaccine in the sense that it gives more protection against paralytic polio.

Task 3 Read and comprehend the text. Get ready to answer the questions to the text and narrate it:

Infection is defined as the invasion, establishment and growth of a specific pathogenic organism in the tissues of the host. Infectious (contagious or communicable) diseases are those called by such microorganisms and capable of being transmitted to another individual by direct or indirect contact. As they are invariably " marked by a pyrexia! or febrile condition, i.e. elevated temperature, they are often referred to as fevers, and fever departments in hospitals are those where cases of infectious disease are kept in isolation.

In terms of hygiene and epidemiology most of the infectious fevers are subject to notification. Many of them attack humans in childhood and consequently come under the heading of children's ailments (particularly so: measles, German measles, chicken pox, mumps and whooping cough). An exanthem (skin eruption or rash) appears as a clinical manifestation of most of the infectious diseases. There are incubation and prodromal periods of varying duration.

Typhoid (or enteric) fever, a serious infectious febrile condition is spread mostly by food, milk or water contaminated by Salmonella typhosa present in sewage effluents, or indirectly by flies or by insufficient personal hygiene.

The germ may also be spread by symptomless carriers who harbor it in their digestive tracts, excreting it in their stools and thus contaminating sewage waters. The average incubation period is 10 to 14 days. A rose-colored exanthem usually appears on the upper abdomen and back at the end of the first week. The onset of the disease, which develops as| the germ invades lymphoid tissue, including that of the small intestine, is marked by progressive febrile illness (step-ladder temperature). Stools are profusely diarrhoeal and may culminate in intestinal haemorrhage and perforation as the sloughts separate during the third week, a stage of defervescence. Ultimate recovery usually begins at the end of the third week.

Typhus (or spotted) fever, an acute febrile infectious disease is normally associated with conditions of war, famine, concentration camps (jail fever) or natural disasters such as floods as it is usually spread by lice, ticks or fleas (tick-borne typhus fever). The invading microorganism is Rickettisia. Characteristic symptoms of typhus include high fever, skin eruptions coalescing to form blotches (hence: spotted fever), congested eyes and severe headache. Typhus fever is rather sporadic in developed countries nowadays, though it continues to take its toll in the developing world, particularly at times of natural disaster.

Smallpox or variola was a fiercely contagious disease caused by the same virus as that of vaccinia or cowpox which is transmissible to man but which confers immunity against true smallpox. The initial symptoms include extreme illness with severe headache and backache, vomiting and high fever. The patient then comes out in a widespread rash (except, usually, the axillae) which follows a regular pattern of dissemination, first appearing on the head and face. The rash is first popular, then vasicular and eventually pustular leaving disfiguring scars or pock-marks on the skin if and when the patient survives. The mortality rate among untreated cases is very high. Strict precautions are called for, including immediate isolation of the patient in a special fever hospital, destruction or disinfection of his fomites, the tracing of all contacts and keeping them under surveillance or in quarantine. Vaccination by a cowpox vaccine is the main prophylactic measure.

Cholera is an acute epidemic condition with an extremely high mortality rate. It is caused not only by the classical bacillus of the vibrio cholerae strain but also by the newer and far more virulent strain of the ELTor group of vibrios. It is spread mainly by contaminated water under conditions of overcrowding and general lack of sanitation. A recovered ELTor victim may remain a menace by continuing to excrete bacilli for as long as six months, unlike a mere three weeks after classical cholera. The principle symptoms are: a most severe diarrhoae (the evacuation of quantities of the so called rice-water stoolsywith an often fatal loss of up to 15 litres of fluid a day in an adult, little or no fever or even subnormal temperature, agonizing cramp and severe collapse. According to the latest theories, the diarrhoea results from a disturbance of what is known as the "sodium pump". Normally, sodium salts and other electrolytes pass in both directions, from the inside of the bowel into the blood plasma, and vice versa, and the movement is greater from the gut to the plasma. In cholera, the proportions are reversed. Hence, the aim of any successful treatment is to maintain the patient's balance of fluids. Vaccination consists in injections of killed bacilli but complete prevention of cholera can only be achieved by cleaning up or isolating contaminated water supplies.

Infective hepatitis is the inflammation of the liver caused by virus infection. Virus A or IH has an incubation period of two to six weeks and is spread by the diseased person's saliva, mucus, excrement or urine. In contrast, virus B or SH is spread only by direct contact or inoculation with human blood products and is the cause of serum hepatitis with a much longer incubation period ranging from six weeks to six months. Early symptoms are raised temperature, weakness, sleepiness and irritability, loss of appetite, sickness or even vomiting and in some cases catarrh of the bronchial tubes. These are followed by pain in the area of the liver and jaundice - a typical yellow coloration of the skin and the whites of the eyes due to a sudden increase in the level of bilirubin in the plasma. Hepatocellular jaundice is a disease of the cells which excrete bilirubin, while haemolytic jaundice is caused by increased breakdown of erythrocytes.

Poliomyelitis or infantile paralysis is an epidemic infection by poliovirus which invades the motor neurons of the anterior horns in the brain stem and spinal cord. An attack of polio may have a crippling effect in that it may lead to paralysis of the lower extremities with loss of muscular power and flaccidity.

The first major breakthrough in eradicating the disease came with the Jonas E. Salk killed-virus vaccine which gave 70-80% protection against paralytic polio. Better results have been achieved since the introduction of the Sabin live-virus vaccine despite initial fears that the live, though weakened, virus might mutate and regain its virulence to cause paralysis.

Task 4 Answer the following text-based questions:

1. How is infection defined?

2. Why are infectious diseases often referred to as fevers?

3. Which of the fevers are commonly associated with childhood?

4. What is the typical clinical manifestation of many contagious diseases?

5. Is exposure to an infectious pathogenic agent immediately followed by specific clinical manifestations? If not, why?

6. How is typhoid fever spread?

7. What is the clinical picture of enteric fever as the disease progresses?

8. What is meant by the term "step-ladder temperature"?

9. What is the difference between typhoid fever and typhus fever?

10. What kind of pathogenic microorganism is spotted fever caused by?

11. Why does variola continue to be a serious health hazard?

12. Give a clinical picture of smallpox.

13. What are the established prophylactic measures if a case of smallpox - even a suspected case - is detected?

14. What are the symptoms and the actual cause of death in cholera?

1. What is the difference between Vibrio cholerae and the ELTor strains?

2. What is the principle of the "sodium pump" theory as regards the treatment of cholera?

3. Which is the more effective way of combating cholera -vaccination or high standard of hygiene and sanitation?

4. What is the difference between virus A and virus B types of infective hepatitis?

5. What are the signs of catarrhal jaundice?

6. What explains the yellow coloration of the skin in infective hepatitis?

7. What is the difference between hepatocellular and haemolytic types of jaundice?

8. Why is poliomyelitis also referred to as infantile paralysis?

9. What are the particular dangers of polio?

10. What is the difference between the Salk and Sabin anti-polio vaccines?

Task 5 Rearrange the sentence using the participle or verbal noun:

1. After my uncle had returned from the concentration camp he was found completely debilitated by a severe attack of jail fever.

2. We were watching the doctor just as he was giving the sick man an intravenous injection.

3. As the danger of an outbreak of cholera was imminent, strict precautions were taken in due time.

4. If we take all the facts into account, the possibility of a smallpox infection can safely be ruled out.

5. He recovered from an attack of cholera but he still remained a health risk for another five months.

6. Since the patient came out in wider-spread papular rash, we were left in no doubt as to the feet that this was a text-book case of variola.

Task 6 Match the terms with the definitions:

1 diarrhoea

a) the number of deaths in a particular situation or period of time

2. sporadic

3. mortality

4 proportion

2. a part or share of a whole

3. a result of something that has happened

4. happening only occasionally or at intervals that are not regular

5 consequence

e) an illness in which waste matter is emptied from the bowels much more frequently than normal, and in liquid form

Task 7 Give the opposites to the terms:

1

2 3 4 5

acute particular sporadic dead

separating

1. joining

2. alive

3. obtuse

4. regular

5. common

Task 8 Translate into English:

1. Висипка, яка виникає по всьому тілу пацієнта, є симптомом багатьох інфекційних хвороб.

2. 3 огляду на те, що температура тіла пацієнта поступово знижувалася, йому дозволили дещо змінити дієту.

3. Багато дитячих інфекційних хвороб мають подібні клінічні прояви - підвищення температури і висипку.

1. Бацилоносії тифу є загрозою для оточуючих, оскільки в їхньому травному тракті живуть збудники цього важкого захворювання,.

2. Для того щоб не виникали ускладнення такі, як запалення середнього вуха чи легенів, потрібно інтенсивно лікуватися від грипу.