English as a World Language

-6000+ languages in the world; approximately 375 million native English speakers; English is the official
language in around 80 territorial entities; about 80% of the English speakers in the world are non-native
speakers

 What is a lingua franca?

“A language used for communication between groups of people who speak different languages.”
e.g. The international business community sees English as a lingua franca.
 What is English as a lingua franca (ELF)?
It is a contact language between persons who share neither a common native tongue nor a common
(national) culture, and for whom English is the chosen foreign language of communication.
 So English serves as a medium or a contact language for intercultural communication. But, of course,
native speakers of English are not the majority of ELF users. It's important to distinguish English as a
Lingua Franca from some of the other fields of study that are related to English globally. And ELF and
English as an International Language, or EIL, have sometimes been used interchangeably. And that
helps people understand what English as a lingua franca is and also look at implications for language
policy and language teaching.
 English for specific purposes (ESP) refers to the teaching and learning of English as a second or
foreign language where the goal of the learners is to use English in a particular domain.
 EAP – English for Academic Purposes
o Learning English in order to perform academic tasks

o Reading scientific publications

o Publishing scientific articles

o Gaining education abroad

 EOP – English for Occupational Purposes

 EST - English for Science and Technology
 EBP – English for Business Purposes
 ELP – English for Legal Purposes
 EMP – English for Medical Purposes - “Language plays a significant role in most professions but
perhaps nowhere more so than in medicine, where effective communication is widely recognized as
important to clinical outcomes.”
o English for doctor – patient consultations

o English for medical congresses

o English for report/journal article writing, etc.

 EDP – English for Dental Purposes

 (dental) floss n. - Waxed or unwaxed thread or tape used to remove plaque and food debris from the
interproximal spaces between the teeth.
 floss v. – to clean between your teeth using dental floss
 Medical Terminology: Basic Word Structure
Word Analysis
1) Analyse words by dividing them into component parts

2) Relate the medical terms to the structure and function of the human body

 Medical terms explained in their proper context will be easier to remember.

HEPATITIS -> HEPAT / ITIS -ITIS = inflammation HEPAT = liver -> HEPATITIS =
inflammation of the liver
3) Be aware of spelling and pronunciation problems - Some medical terms have: the same
pronunciation, different spelling and different meaning.

e.g. ilium /ˈɪliəm/ - a part of the hip bone = ilijum, slabine, bedrena kost = ilijačna kost, slabine,
bedrena kost

ileum /ˈɪliəm/ - a part of the small intestine = ileum, deo tankog creva od jejunuma do slepog
creva

urethra /jʊəˈriː.θrə/ - a tube of the urinary system between the urinary bladder and the outside of
the body = uretra, mokraćni kanal

ureter /jʊəˈriː.tər/- a tube of the urinary system; there are two such tubes of the urinary system
between the kidneys and the urinary bladder = ureter, mokraćovod

 The important elements of medical terms are: Root - foundation of the term; Suffix
- word ending; Prefix - word beginning; Combining vowel - vowel (usually o) that
links the root to the suffix or the root to another root; Combining form - combination of the
root and the combining vowel

 H(A)EMATOLOGY -> H(A)EMAT / O/ LOGY -LOGY  SUFFIX (= process of study) H(A)EMAT  ROOT (= blood)
O  COMBINING VOWEL H(A)EMATOLOGY = process of study of blood
 ELECTROCARDIOGRAM -> ELECTR/O/CARDI/O/GRAM -GRAM  SUFFIX (= record) ELECTR  ROOT (=
electricity) O  COMBINING VOWEL CARDI  ROOT (= heart) ELECTROCARDIOGRAM = record of the
electricity in the heart
 GASTROENTEROLOGY -> GASTR/O/ENTER/O/LOGY -LOGY  SUFFIX (= process of study) GASTR ROOT (=
stomach) O  COMBINING VOWEL ENTER ROOT (= intestines, usually the small intestine)
GASTROENTEROLOGY = study of the stomach and intestines
 HYPO/GASTR/IC vs. EPI/GASTR/IC HYPO-  PREFIX (= below) EPI-  PREFIX (= above)

HYPOGASTRIC = pertaining to below the stomach EPIGASTRIC = pertaining to above the stomach

 Locative prefixes - (indicating the place/position): exo, extra – outside; endo, intra – inside; inter
– between; para – beside; peri – around; sub, infra – below; supra – above; retro – behind
  Suffixes for medical specialties: -ian, -ist = a specialist in a field of study; -iatrics, -iatry, -ics =
medical specialty

 Suffixes meaning “pertaining to”: -ac, -al, -ar, -ic, -ory, -ous...

Plurals

Exercise - provide the plural forms of the following medical terms

larynx, iris, thorax, dentinoma, biopsy, foot, fungus, syringe, tooth, analysis

Abbreviations

CBC Complete blood count; WBC White blood cell count; RBC Red blood cell count; HGB

H(a)emoglobin ; HCT Hematocrit; MCV Mean corpuscular volume; MCH Mean corpuscular

h(a)emoglobin; MCHC Mean corpuscular h(a)emoglobin concentration; RDW Red cell distribution

width; ESR Erythrocyte sedimentation rate; PLT Platelets / Thrombocyte s; MPV Mean

platelet volume; PDW Platelet Distribution Width; PCT Plateletcrit; Neu Neutrophil;

Lymph Lymphocyte; Mon Monocyte; Eos Eosinophil; Bas Basophil; Gran

Granulocyte; Mid Mid-sized cells; Neu% Neutrophil percentage; Lymph% Lymphocyte

percentage; Mon% Monocyte percentage; Eos% Eosinophil percentage; Bas% Basophil

percentage; Mid% Mid cells percentage; Gran% Granulocyte percentage

 The Human Body: Directional Terms and Organisation

1. Directional Terms - The three main parts of the human body are the head, the trunk and the limbs
or extremities.
 What is the anatomical position? The body in the anatomical position is upright, with face front,
arms at the sides with palms forward and feet parallel.

f
d
a
e
c

1. Frontal (Coronal)
2. Sagittal
3. Transverse (Horizontal)
 2. Body Cavities - A body cavity is a space within
the body that contains internal organs (viscera).
Internal organs are located within dorsal and
ventral cavities.

 The dorsal cavity contains the brain in the cranial

cavity and the spinal cord in the spinal cavity.
 The ventral cavity contains the thoracic cavity, the
abdominal cavity and the pelvic cavity.

 The thoracic cavity is separated from the

abdominal cavity by the diaphragm.
 There is no anatomical separation between
the abdominal cavity and the pelvic cavity

 The large membrane that lines the abdominopelvic

cavity and covers the organs within it is => the
peritoneum

3. Body Regions - the abdomen can be divided

by a single vertical line and a single horizontal line
into 4 sections:

• the right upper quadrant (RUQ)

• the left upper quadrant (LUQ)

• the right lower quadrant (RLQ)

• the left lower quadrant (LLQ)

 The abdomen can be divided by imaginary lines into 9

regions:

 The sections down the midline: epigastric region

(above the stomach), umbilical region (named after
the umbilicus or navel), hypogastric region (below
the stomach).
 The lateral regions: right and left hypochondriac
regions (near the ribs, particularly near the cartilages
of the ribs; chondr/o = pertaining to cartilage), right
and left lumbar regions (near the small of the back, i.e.
the lumbar region of the spine), right and left iliac
regions (named after the upper bone of the hip – the
ilium).

Exercise

True or False?

If the statement is false,

replace the underlined word.
4. The Cell - the basic unit of living organisms

 Cells carry out metabolism – the sum of all of the physical and chemical activities that occur in the
body.

 The chemical ATP (adenosine triphosphate) provides the energy for metabolic reactions. It is
commonly described as the energy compound of the cell.

 All cells are similar in that they contain a gelatinous substance composed of water, protein, sugar,
acids, fats, and various minerals.

 The main categories of organic compounds in the body are:

 Proteins - include the enzymes, some hormones, and structural materials.

 Carbohydrates - include sugars and starches. The main carbohydrate is the sugar glucose,
which circulates in the blood to provide energy for the cells.

 Lipids - include fats. Some hormones are derived from lipids, and adipose (fat) tissue is
designed to store lipids.

 The nucleus is the control region of the cell. It directs cell division and determines the structure and
function of the cell. It contains the chromosomes, which carry genetic information.

 Each human cell, except for the sex cells, contains 46 chromosomes (23 pairs). Chromosomes are
rod-like structures which are composed of a complex organic substance – DNA (deoxyribonucleic
acid), which is organized into separate units called genes.

 The sex cells are the egg and the spermatozoon. Human sex cell contains 23 unpaired
chromosomes.

 Genes control the formation of enzymes, the catalysts for metabolic reactions. To help manufacture
enzymes, the cells use a compound called RNA (ribonucleic acid).

 When a body cell divides by the process of mitosis, the chromosomes are doubled and then equally
distributed to two daughter cells. Sex cells divide by the process of meiosis which halves the
chromosomes in preparation for fertilisation.
  Complete the following gaps with the exact words.

All cells have a cell membrane which separates the inside of the cell from its environment. Prokaryotic cells
are always one-celled or unicellular organisms such as bacteria. After ribosomes leave the nucleus, they will
have the important job of synthesizing or making proteins. There are two types of ER: rough and smooth
endoplasmic reticulum. Lysosomes are the garbage collectors and are filled with enzymes that break down
the cellular debris. Cells that need more energy have more mitochondria.

5. Tissues - Cells are organized into four basic types of tissues that perform specific functions:

1) Epithelial tissue covers and protects body structures

and lines organs, vessels, and cavities.
2) Connective tissue supports and binds body structures.
It contains fibers and other nonliving material between
the cells. Included are adipose (fat) tissue, cartilage,
bone and blood.
3) Muscle tissue contracts to produce movement. There
are three types of muscle tissue:
 Skeletal - voluntary muscle, moves the skeleton.
 Cardiac muscle forms the heart. It functions without
conscious control and is described as involuntary.
 Smooth, or visceral, muscle forms the walls of the
abdominal organs; it is also involuntary.

4) Nervous tissue makes up the brain, spinal cord and

nerves. It coordinates and controls body responses by
the transmission of electrical impulses.

6. Organs and Organ Systems - Tissues are arranged into organs, which serve specific functions.

e.g. An organ such as the stomach is composed of muscle tissue, nerve tissue, and glandular
epithelial tissue.

• The organs are grouped into systems. Yet, the body functions as a whole—no system is independent of
the others. They work together to maintain the body's state of internal stability, termed homeostasis.
 The Musculoskeletal System

Basic Features of the Musculoskeletal System

 The skeletal system forms the framework of the body and provides support and protection for softer
organs and tissues.

 e.g. The skull forms a protective encasement for the brain, as does the rib cage for the lungs.

 The skeletal system works with the muscular system to produce movement.

 The musculoskeletal system includes the bones, muscles, and joints.

Bones
 The axial skeleton consists of the skull, the spinal column, the ribs and the sternum (breastbone).

 The appendicular skeleton consists of the bones of the pectoral (shoulder) and pelvic girdles,
and the upper and lower limbs, i.e. arms and legs.

 The skull consists of 8 cranial bones and 14 facial bones. Skull

bones are joined by non-movable joints (sutures), except for the
joint between the lower jaw (mandible) and the temporal bone of
the cranium, the temporomandibular joint.

 The spinal column consists of 26 vertebrae which are divided into 5 regions:

a) cervical (7) C1-C7

b) thoracic (12) T1-T12

c) lumbar (5) L1-L5

d) the sacrum (5 fused)

e) the coccyx (4 to 5 fused)

 Bone Formation - Bone is formed by the gradual addition of calcium and phosphorus salts to
cartilage - a type of dense connective tissue. This process of ossification (= okoštavanje, osifikacija)
begins before birth and continues to adulthood. Although bone appears to be inert, it is actually living
tissue that is constantly being replaced and remodeled throughout life.

Match the following foreign medical terms to their English equivalents:

1) scapula a. vertebral column
2) femur b. breastbone
3) tibia c. collarbone
4) spine d. shoulder blade
5) clavicle e. shin bone
6) sternum f. thigh bone
7) coccyx g. long bone of the upper arm
8) humerus h. arm
9) patella i. tailbone
10) brachium j. kneecap
Joints - (articulation) is a coming together of two or more bones
 Immovable joints (suture) - e.g. the joints between the skull bones

 Partially movable joints - e.g. such as those between the vertebrae

 Freely movable joints - e.g. the hip and shoulder joints, elbow, knee, and ankle joints

 Tendons attach muscles to bones to produce movement at the joints.

 Freely movable joints are subject to wear and tear, and they therefore have some protective
features - synovial fluid cushions and lubricates the joint; the ends of the articulating bones are
cushioned and protected by cartilage.

 Synovial joints are stabilized and strengthened by ligaments, which connect the articulating bones.

 A bursa is a small sac of synovial fluid that cushions the area around a joint. Bursae are found at
stress points between tendons, ligaments, and bones.

Muscles
There are 3 types of muscles in the body:

1) Striated muscle makes up the voluntary or skeletal muscles that move all bones, as well as
controlling facial expression and eye movements. Through the central and peripheral nervous
systems, we have conscious control over these muscles.

2) Smooth muscle makes up the involuntary or visceral muscles that move internal organs such as
the digestive tract, blood vessels, and secretory ducts leading from glands. These muscles are
controlled by the autonomic nervous system.

3) Cardiac muscle is striated in appearance but is like smooth muscle in its action. Its movement cannot
be consciously controlled.

WORD FORMATION: Use the words in capitals to form an adjective in each of the following:

1) The skeletal system forms the framework of the body. SKELETON

2) The skull consists of the cranial and the facial bones. CRANIUM, FACE

3) The thorax has a protective function. PROTECT

4) The elbow and wrist are movable joints. MOVE

5) The length of the muscle is changed by muscular contraction. MUSCLE

6) Cartilage is less resistant than bone. RESIST

7) The spinal column is also referred to as the vertebral column. VERTEBRA

The Musculoskeletal System – Pathology

 Osteoporosis: Decrease in bone density (mass); thinning and weakening of bone.

 Arthritis: Inflammation of any joint.

 Dislocation: Displacement of a bone from its joint (e.g. shoulder dislocation, hip dislocation).

 Lyme disease (Lyme arthritis): disorder marked by arthritis, myalgia and malaise.
 Sprain/Strain: an injury involving the overstretching of muscle.

 Fracture: Traumatic breaking of a bone.

Find the words in the text and match them to the

following definitions:

1) having bone protruding through the skin

________________ ;
2) a minor crack in a bone _______________ ;
3) the breakage of a young, soft bone
__________________ ;
4) a strong, hard part of a body’s structure
___________ ;
5) having parts crushed together
__________________ ;
6) a soft substance with immune functions
____________ ;
7) being broken into several pieces
_________________ ;
 The Cardiovascular System

 Blood circulates throughout the body in the cardiovascular system, which consists of the heart and
the blood vessels.

 This system forms a continuous circuit that delivers oxygen and nutrients to all cells and carries away
waste products.

 Also functioning in circulation is the lymphatic system, which drains fluid and proteins from the
tissues and returns them to the bloodstream.

The Heart
 The heart is located between the lungs, with its point or apex directed toward the left.

 The thick muscle layer of the heart wall is the myocardium. This is lined on the inside with a thin
endocardium and is covered on the outside with a thin epicardium.

 The heart is contained within a fibrous sac, the pericardium.

 Each of the upper receiving chambers of the heart is an atrium (Pl. atria). Each of the lower pumping
chambers is a ventricle (Pl. ventricles).

 The chambers of the heart are divided by walls, each of which is called a septum.

 The heart pumps blood through two circuits:

 The right side pumps blood to the lungs to be oxygenated through the pulmonary circuit.

 The left side pumps to the remainder of the body through the systemic circuit.

 Each contraction of the heart, termed systole is followed by a relaxation phase – diastole during
which the chambers fill. Each time the heart beats, both atria contract and immediately thereafter both
ventricles contract. The wave of increased pressure produced in the vessels each time the ventricles
contract is the pulse.

 Contractions are stimulated by a built-in system that regularly transmits electrical impulses through
the heart. The sinoatrial (SA) node is called the pacemaker because it sets the rate of the heartbeat.

 Although the heart itself generates the heartbeat, factors such as nervous system stimulation,
hormones, and drugs can influence the rate and the force of heart contractions.
Blood Pressure - the force that the blood exerts on the arterial walls

 This pressure is measured with a sphygmomanometer.

 Both systolic and diastolic pressures are measured and

reported as systolic then diastolic separated by a slash,
such as 120/80 (one hundred and twenty over eighty).

 Pressure is expressed as millimeters of mercury (mm Hg),

that is, the height to which the pressure can push a
column of mercury in a tube.

 Blood pressure is a valuable diagnostic measurement that

is easily obtained.

 Hypertension is defined as a systolic pressure greater

than 140 mm Hg or a diastolic pressure greater than 90
mm Hg.

Circle the correct answer:

1) About 50% of the population will suffer from hypertension over the age of:

a) 16 b) 60 c) 66

2) As we start to age our arteries become:

a) wider b) more elastic c) narrower

3) The body can regulate blood pressure by:

a) altering the heart rate b) reducing the blood volume c) both answers are correct

4) The specialised cells that can sense changes in blood pressure are called:

a) blood flow b) carotid body c) carotid arch

The Vascular System

 The vascular system consists of:

1) Arteries - carry blood away from the heart. Arterioles - small arteries that lead into the capillaries.

2) Veins - carry blood back to the heart. The small veins that receive blood from the capillaries and drain
into the veins are venules.

3) Capillaries - the smallest vessels, through which exchanges take place between the blood and the
tissues.

The Lymphatic System

  The lymphatic system consists of lymphatic vessels, lymph fluid, lymph nodes, and other
lymphoid organs.

 The fluid carried in the lymphatic system is called lymph.

 The lymphatic system protects the body from disease by purifying lymph and supporting
lymphocytes – the white blood cells that produce antibodies.

 Along the path of the lymphatic vessels are small masses of lymphoid tissue, the lymph nodes which
filter the lymph as it passes through.

 They are concentrated in the: cervical (neck), axillary (armpit), mediastinal (chest) and inguinal
(groin) regions.

 Other organs and tissues of the lymphatic system include: the tonsils (located in the throat), the
thymus gland in the chest, and the spleen in the upper left region (LUQ) of the abdomen.

Heart Disease
Coronary artery disease (CAD), which results from atherosclerosis of the vessels that supply blood to
the heart muscle, is a leading cause of death in industrialized countries. An early sign of CAD is the type
of chest pain known as angina pectoris. Often there is anxiety, diaphoresis (profuse sweating) and
dyspnoea (difficulty in breathing).

Arrhythmia is any irregularity of heart rhythm, such as a higher-than-average or lower-than-average heart

rate, extra beats, or an alteration in the pattern of the beat. Bradycardia is a slower-than-average rate,
and tachycardia is a higher-than-average rate.

Heart failure - the general term heart failure refers to any condition in which the heart fails to empty
effectively. The resulting increased pressure in the venous system leads to oedema (=swelling), often in
the lungs (pulmonary oedema), and justifies the description congestive heart failure (CHF). Other
symptoms of congestive heart failure are: cyanosis (=bluish discoloration of the skin), dyspnoea, and
syncope (= temporary loss of consciousness).

Major risk factors (that cannot be changed):

o Increasing age

o Male sex (Gender)

o Heredity (including race)

Major risk factors (that you can modify, treat or control):

o Tobacco smoke (including passive smoking)

o High blood cholesterol & triglycerides

o High blood pressure

o Physical inactivity

o Obesity & overweight

o Diabetes mellitus

Other factors that can contribute to heart disease risk:

o Stress;
 o Alcohol;

o Diet & Nutrition

Match the following to their corresponding roles:

1. Lymph nodes A. absorb fat from the digestive system and collect excess tissue fluid
2. The lymphatic system B. remove cellular debris and microorganisms
3. Lymphatic vessels C. protects the body from disease

Doctor: What seems to be the problem? A 60-year-old woman attended her CP's
Patient: I've been getting (1) _____________ surgery complaining of breathlessness on (1)
_____________. This had been increasing
Doctor: How long have you had them?
over the previous eight months until it was
Patient: For about six months. But I've had producing problems at around 500 metres
heart problems for years, with tiredness and walking on the level. There was no history of
(2) __________ of (3) ______________ chest pain. She had had several (2)
__________ of fast (3) ________ which
In the end I couldn't walk more than a
lasted 20-30 minutes and were associated
hundred metres without having to stop. I had
with some (4) __________ of breath. She
to sleep on three (4) ___________ I had a (5)
had noticed some (5) __________of her
____________ replacement three years ago,
ankles by the end of the day. This
and that improved things for a while.
disappeared overnight.
 The Respiratory System

 The main function of the respiratory system

is to provide oxygen to body cells for
energy metabolism and to eliminate carbon
dioxide, a byproduct of metabolism.

 Because these gases must be carried to and

from the cells in the blood, the respiratory
system works closely with the
cardiovascular system to accomplish gas
exchange.

 Exchange of gases between the atmosphere

and the blood takes place in the lungs - two
organs located in the thoracic cavity.

 A double membrane, the pleura (= pleura,

plućna maramica), covers the lungs and
lines the thoracic cavity.

Upper Respiratory Passageways

 Air enters through the nose through two openings called nostrils or nares, where it is warmed,
filtered and moistened as it passes over the hair-covered mucous membranes of the nasal cavity.

 Cilia, microscopic hairlike projections from the cells that line the nose, sweep dirt and foreign material
toward the throat for elimination.

 Material that is eliminated from the respiratory tract by coughing or clearing the throat is called
sputum.

 Paranasal sinuses are hollow, air-containing spaces within the skull that communicate with the nasal
cavity. They, too, have a mucous membrane lining. Besides producing mucus – a lubricating fluid, the
sinuses lighten the bones of the skull and help produce sound.

 They are named specifically for the bones in which they are located, such as the sphenoid, ethmoid,
and maxillary sinuses.

 After passing through the nasal cavity, the air next reaches the pharynx (throat).

 There are three divisions of the pharynx:

 Nasopharynx - contains the pharyngeal tonsils, or adenoids, which are collections of

lymphatic tissue. They are more prominent in children and, if enlarged, can obstruct air
passageways.
 Below the nasopharynx and closer to the mouth is the second division of the pharynx - the
oropharynx, which contains the palatine tonsils, two rounded masses of lymphatic tissue.
  The third division of the pharynx, the laryngopharynx, serves as a common passageway for
food from the mouth and air from the nose. It divides into the larynx (voice box) (= grkljan,
larinks) and the (o)esophagus (gullet=jednjak), which leads into the stomach and carries
food to be digested. The larynx contains the vocal cords and is surrounded by pieces of
cartilage for support.

Lower Respiratory Passageways and Lungs

 The pharynx conducts air into the trachea (windpipe= dušnik), a tube reinforced with C-shaped rings
of cartilage to prevent its collapse.

 The opening between the vocal cords is the glottis. The small leaf-shaped cartilage at the top of the
larynx is called the epiglottis. When one swallows, the epiglottis covers the opening of the larynx and
helps to prevent food from entering the respiratory tract.

 In the region of the mediastinum, the trachea divides into two branches, the right and left bronchial
tubes, or bronchi (singular: bronchus). The bronchi are tubes composed of delicate epithelium
surrounded by cartilage rings and a muscular wall. Each bronchus leads to a separate lung where it
divides and subdivides into smaller and finer tubes – bronchioles.

 Each terminal bronchiole narrows into alveolar ducts, which end in collections of air sacs called
alveoli (singular: alveolus). About 300 million alveoli are estimated to be present in both lungs. Each
alveolus is lined with a one-cell-thick layer of epithelium. This very thin wall permits an exchange of
gases between the alveolus and the capillary surrounding it.

 The two lungs are not quite mirror images of each other. The slightly larger right lung is divided into
three lobes, whereas the smaller left lung has two lobes.

 The lungs extend from the collarbone to the diaphragm in the thoracic cavity. The diaphragm is a
muscular partition separating the thoracic from the abdominal cavity and aiding in the process of
breathing.

Breathing
 Air is moved into and out of the lungs by the process of breathing, technically called ventilation. This
consists of a steady cycle of inspiration (inhalation) and expiration (exhalation), separated by a
period of rest.

 Breathing is normally regulated unconsciously by centers in the brainstem. These centers adjust the
rate and rhythm of breathing according to changes in the composition of the blood, especially the
concentration of carbon dioxide.

Clinical Aspects of Respiration

 Pneumonia is caused by several different microorganisms, most commonly bacteria and viruses. The
term pneumonia is also applied to inflammation of the lungs caused by noninfectious causes, such as
asthma, allergy etc. In these cases, however, the more general term pneumonitis is used.

 Emphysema is a chronic disease associated with overexpansion and destruction of the alveoli.
Common causes are exposure to cigarette smoke and other forms of pollution as well as chronic
infection.

 Attacks of asthma result from narrowing of the bronchial tubes. This constriction, along with
(o)edema (swelling) of the bronchial linings and accumulation of mucus, results in wheezing, extreme
dyspn(o)ea, and cyanosis. Asthma is most common in children. Although its causes are uncertain, a
main factor is irritation caused by allergy.

Fill in the blanks:

1) The dome-shaped muscle under the lungs that flattens during inspiration is the _____________.
2) The double membrane that covers the lungs and lines the thoracic cavity is the _____________.
3) The medical term for the throat is the _____________.
4) The small air sacs in the lungs through which gases are exchanged between the atmosphere and
the blood are the _____________.
5) The vocal cords are located in the _____________.

Key:
 Find the words in the text and match them to their meanings:
1) prolonged - lingering

2) with no recognisable cause - idiopathic

3) extreme tiredness - fatigue

4) not appreciate sth/sb - take sb/sth for granted

5) a specialist in diseases of the lungs and the respiratory system - pulmonologist

6) the act of a GP directing a patient to a medical specialist - referral

7) computerized tomography - CT

8) happening many times, or happening again - recurring

9) a fixed number of regular medical treatments - course

10) comforted sb and stopped them from worrying - reassured

The Respiratory System – Revision

1) Why does the air move in and out of the lungs?

- In this way, body cells are provided with oxygen necessary for energy metabolism and carbon
dioxide, a byproduct of metabolism, is eliminated.

2) Which organ controls breathing?

- The brain.

3) What happens in the alveoli?

- Gas exchange takes place in the alveoli.

4) What is the epiglottis?

 - The epiglottis is a small leaf-shaped cartilage that covers the opening of the larynx when one
swallows and helps to prevent food from entering the respiratory tract.

The Digestive System

 The function of the digestive system is to prepare food for intake by body cells.

 Nutrients must be broken down by mechanical and chemical means into molecules that are small
enough to be absorbed into the circulation.

 Within cells, the nutrients are used for energy and for rebuilding vital cell components.

 The four functions of the digestive system are ingestion, digestion, absorption, and elimination.

o First, complex food material taken into the mouth is ingested.

o Second, it is digested, or broken down, mechanically and chemically, as it travels through the
gastrointestinal tract. Digestive enzymes speed up chemical reactions and aid the
breakdown (digestion) of complex nutrients.
o Third, via absorption, digested food passes through the lining cells or epithelium of the small
intestine and into the bloodstream. Nutrients thus travel to all cells of the body. Cells then
break down nutrients in the presence of oxygen to release energy.
o The fourth function of the digestive system is elimination of the solid waste materials that
cannot be absorbed into the bloodstream.

The Mouth to the Small Intestine

 Digestion begins in the mouth, where food is chewed into small bits by the teeth.
  In the process of chewing, or mastication, the tongue and the palate (= nepce, palatum), the roof of
the mouth, help to break up the food and mix it with saliva, a secretion that moistens the food.

 The moistened food is then passed into the pharynx (throat) and through the (o)esophagus (gullet
=jednjak) into the stomach.

 The partially digested food passes through the lower portion of the stomach, the pylorus (pilorus,
donji otvor želuca), into the first part of the small intestine, the duodenum (dvanaestopalačno crevo).
As the food continues through the jejunum and ileum, the remaining sections of the small intestine,
digestion is completed.

The Accessory Organs

 The liver is a large gland with many functions. Its role in digestion is the secretion of bile (= žuč),
which breaks down fats. Bile is stored in the gallbladder until needed.

 The pancreas produces a mixture of digestive enzymes that is delivered into the duodenum through
the pancreatic duct.

The Large Intestine

 Undigested food, water, and digestive juices pass into the large intestine - colon. This part of the
digestive tract begins in the lower right region of the abdomen with a small pouch, the c(a)ecum, to
which the appendix is attached. The large intestine continues as the colon.

 As food is pushed through the colon, water is reabsorbed and stool or f(a)eces is formed. This waste
material passes into the S-shaped sigmoid colon and is stored in the rectum until eliminated through
the anus.

Clinical Aspects of Digestion

Infections:

 A variety of organisms can infect the gastrointestinal tract, from viruses and bacteria to protozoa and
worms.

 Some produce short-lived upsets with gastroenteritis, nausea, diarrh(o)ea, and emesis (vomiting).
  Others, such as typhoid, cholera, and dysentery, are more serious, even fatal.

Ulcers:

 An ulcer is a lesion of the skin or a mucous membrane marked by inflammation and tissue damage.

 Heredity and stress may be factors as well as chronic inflammation and exposure to damaging drugs,
or to irritants in food and drink.

 Ulcers can be diagnosed by endoscopy.

Match the common terms to the corresponding medical terms:

1) spit a) (o)esophagus
2) throat b) hard and soft palate
3) gullet c) colon
4) roof of the mouth d) pharynx
5) large intestine e) saliva

Complete the following gaps with the exact words you hear. Do NOT use more than two words.

1) So we can actually see part of the gastrointestinal tract in the ________________, and we
can do that by removing some of the _____________.
2) And what you can do when you remove _____________ is immediately see lying posterior
to the heart we have the _____________.
3) That's why we call it _____________ when you have that oesophageal reflux of acid from
the stomach into the oesophagus.
4) This is known as the _____________ curvature. It also has a shorter curvature here known
as the _____________ curvature.
5) It then ascends upwards to assume this inverted U-shaped path, but this portion is known
as the __________________.
6) They're the products that are leftover, and they're going to be expelled by
__________________.

Gastroscopy
 The Endocrine System

 The endocrine system consists of a widely distributed group of glands that secrete regulatory
substances called hormones.

 Because these substances are released directly into the blood, the endocrine glands are known as
the ductless glands.

 Despite the fact that hormones in the blood reach all parts of the body, only certain tissues respond –
target tissues.

Hormones
 Hormones are produced in extremely small amounts and are highly powerful.

 By means of their actions on various target tissues, they affect growth, metabolism, reproductive
activity, and behaviour.

The Endocrine Glands

1) The pituitary gland (hypophysis) is a small gland

beneath the brain. Although no bigger than a pea, the
pituitary gland is often called the “master gland” because
it makes hormones that control several other endocrine
glands. It is divided into an anterior lobe
(adenohypophysis) and a posterior lobe
(neurohypophysis). Both lobes are connected to and
controlled by the hypothalamus. The anterior pituitary
releases six hormones. One of these is growth hormone
(somatotropin - STH), which stimulates the growth of bones
and acts on other tissues as well. The remainder of the
pituitary hormones regulate other glands.

2) Thyroid and Parathyroids

The thyroid gland consists of two lobes on either side of the

larynx and upper trachea. It secretes a mixture of
hormones, mainly thyroxine (T4) and triiodothyronine (T3).
Because thyroid hormones contain iodine, their levels can
be measured and the activity of the thyroid gland can be
studied by following the uptake of iodine. On the posterior
surface of the thyroid are four to six tiny parathyroid
glands that affect calcium metabolism.

3) Adrenals are located atop each kidney.

4) Pancreas

The endocrine portions of the pancreas are the pancreatic

islets, small clusters of cells within the pancreatic tissue.
 Diabetes
 The most common endocrine disorder, and a serious public health problem, is diabetes mellitus, a
failure of the body cells to use glucose effectively. The excess glucose accumulates in the blood,
causing hyperglycemia.

 If untreated, diabetes will lead to starvation of the central nervous system and coma. Diabetic patients
are prone to cardiovascular, neurologic, and vision problems, infections, and, sometimes, renal
failure.

 There are two types of diabetes mellitus:

1. Type 1, also called juvenile-onset or insulin-dependent diabetes mellitus (IDDM),

usually appears in children and teenagers. It is caused by a failure of the pancreatic islets
to produce insulin, resulting, perhaps, from autoimmune destruction of the cells. Because
insulin levels are very low or absent, patients need careful monitoring and administration
of this hormone. Blood sugar level may be tested multiple times during the day, and
insulin may be given in divided doses by injection or by means of an insulin pump.

2. Type 2 diabetes mellitus, also called adult-onset or non-insulin-dependent diabetes

mellitus (NIDDM), accounts for about 90% of diabetes cases. Type 2 diabetes is initiated
by cellular resistance to insulin. Most cases of type 2 diabetes are linked to obesity,
especially upper body obesity. Although seen mostly in older people (hence the name
adult-onset diabetes), the incidence of type 2 diabetes is increasing among younger
generations, presumably because of increased obesity, poor diet, and sedentary habits.
Exercise and weight loss for the overweight are the first approaches to treating type 2
diabetes, and these measures often lead to management of the disorder. Drugs for
increasing insulin production or improving cellular responses to insulin may also be
prescribed, with insulin treatment given if necessary
Use ALL the words given to complete the text. Sometimes you will have to combine two
words to complete a gap.

SUGAR, DOWN, ENDOCRINE, BLOOD, RELEASED, GLAND, BROKEN, BLOODSTREAM

Hyperglycemia (high ______________) most frequently is associated with diabetes. People with diabetes
have high blood sugar levels because they lack insulin (in type 1 diabetes) or have ineffective insulin (in
type 2 diabetes). Insulin is the hormone normally ______________ by the pancreas (an______________
near the stomach) to “escort” sugar from the bloodstream into cells. Sugar (glucose) is then ______________
in cells to release energy. When insulin is not present, sugar cannot enter cells and builds up in the
______________ (hyperglycemia).

SECRETES, WEIGHT, INCREASED, TACHYCARDIA, LOSS, THYROXINE, HYPERACTIVE

In hyperthyroidism, a ______________ thyroid gland (an endocrine gland in the neck) ______________ a
greater than normal amount of ______________ (thyroid hormone, or T4). Because thyroxine causes cells to
burn fuel and release energy, signs and symptoms of hyperthyroidism are ______________ energy level and
nervousness, ______________ (increased heart rate), ______________ , and exophthalmos (bulging
eyeballs).
 Medical Education – General (Dental) Practitioners and (Dental)
Specialists

 Doctors a.k.a. medical practitioners must be qualified, i.e. have a university degree in medicine in
order to practise medicine.

 The basic requirement for admission to the university school of medicine is a special entrance
examination.

 Undergraduate education – 4 or 5 years at medical school - the section of university responsible for
medical education;

 A two-year Foundation Programme – provides training for new doctors after graduation through a
series of placements in different specialties;

 Postgraduate training which doctors take to become GPs or consultants (senior specialists); often
delivered through colleges for different specialties, e.g. the Royal College of Physicians

 Continuing professional development (CPD) – courses and seminars which doctors undertake
throughout their working lives to keep up to date.

 The medical curriculum consists of 3 courses:

 pre-med courses – the basic sciences of chemistry, biophysics and biology with human
genetics;

 pre-clinical sciences – anatomy, physiology, biochemistry, histology;

 clinical stage – medicine, surgery and specialties that go with them (students begin dealing
with patients)

 After graduating from medical school, the student has earned the title M.D. / D.M. (Doctor of
Medicine).

 After graduating from dental school, the student has earned the title D.M.D. (Doctor of Medicine in
Dentistry / Doctor of Dental Medicine).

 D.D.S – Doctor of Dental Surgery

 All newly-qualified doctors must spend at least a year in a hospital medical post before being fully
registered and entitled to start working in a state or private practice.

 An internship (hands-on hospital training) is an essential part of a physician’s training. A physician

in training may serve as an intern during the final year of med school or the first year of a residency
(specialty training).
 In order to practise medicine, a physician must take the state’s examination.

 To become a specialist a doctor must receive training in an accredited programme called a

residency. This training takes 3-5 years, depending on the field of specialisation (a surgical or
medical, i.e. non-surgical specialty).

 Residency training takes place in a hospital or ambulatory care setting, where a specialist-in-training,
i.e. a resident, cares for patients under the supervision of experienced teacher-specialists.

 After completing the training, specialists may then take an examination in front of the specialty board
they are applying to. Once they pass this examination, they become board-certified specialists.

 All physicians and doctors of dental medicine, specialists or not, are aware of the fact that their
education is lifelong. They must keep up with new developments by reading journals, attending
meetings, and learning to perform new types of operations and diagnostic procedures.

Medical Practitioners
 The two main branches in medicine are surgery (surgeon) and internal medicine (physician).

 Clinician is a doctor who treats patients.

 General Practitioner (GP) is a doctor who provides primary care for patients.

Medical Specialists and Specialties

  CT – computed tomography: the use of X-rays to make 3D images of internal organs, bones, soft
tissue, and blood vessels;

 MRI – Magnetic Resonance Imaging: a system for producing electronic pictures of organs by using
radio waves and a strong magnetic field.

 Names of specialties usually end in –ology;

 Names of specialists usually end in –ologist;

 If the name of a specialty ends in –ics, the name of the specialist ends in –ician.

 True or False?

If a statement is false, provide the correct

answer.

1) Physicians cannot practise as

specialists until they become
board-certified.

2) Geriatricians deliver babies.

3) A nephrologist administers agents

for loss of sensation.

Key:

1) T

2) F – treat elderly patients

3) F – treats kidney diseases

Dental Specialities
Endodontics, Oral and Maxillofacial Surgery, Oral Pathology, Orthodontics, Pediatric Dentistry, Periodontics,
Prosthodontics, Restorative Dentistry

General Dentistry
 A dentist who practices all phases of dentistry is referred to as a general dentist or a general dental
practitioner.

 General dental practitioner (GDP) - A person registered with a statutory authority to undertake the
practice of dentistry.

 Occasionally, when the treatment required exceeds the scope of his or her training, the general
dentist refers cases to a dental specialist.

 The specialist works with the general dentist to provide the optimum oral health and patient care.
 During and once the speciality treatment is completed, the patient continues regular visits with his or
her general dentist.

Specialities:
 Endodontics
 endo- (inside; within) + odont (tooth)
 Endodontics is concerned with the pathology and morphology of the dental pulp and
surrounding tissues due to injury and disease.
 e.g. Patients referred for root canals would see the endodontist.

 Oral and Maxillofacial Surgery

 Oral and maxillofacial surgery is the speciality concerned with the diagnosis and surgical
treatment of the oral and maxillofacial region due to injury, disease or defects.
 e.g. A patient having third molars (wisdom teeth) removed may be referred to the oral and
maxillofacial surgeon.

 Oral Pathology

 Oral pathology is the speciality concerned with the diagnosis and nature of the diseases
affecting the oral cavity.
 e.g. A patient who has a lesion unknown to the general dentist may be referred to the oral
pathologist for further treatment and diagnosis.

 Orthodontics

 ortho- (straight; correct) + odont (tooth)

 Orthodontics is concerned with the diagnosis, supervision, guidance and correction of
malocclusion.
 e.g. Fixed/Removable orthodontic appliances (common term: braces) for straightening teeth
are placed by the orthodontist.

 Pediatric Dentistry

 Pediatric dentistry is concerned with the prevention of oral disease and the diagnosis and
treatment of oral disease in children, from birth through adolescence.

 Periodontics

 peri- (around) + odont (tooth)

 Periodontics is concerned with the diagnosis and treatment of the diseases of the supporting
and surrounding tissues of the tooth.
 The periodontist is also concerned with the prevention of disease in this area.
 e.g. Patients who have plaque and calculus buildup and patients who have lost some of the
bone around the tooth due to periodontal disease would be referred to the periodontist for
further evaluation and treatment.

 Prosthodontics

 prosth(esis) (replacement) + odont (tooth)

 Prosthodontics is concerned with the functional and aesthetic rehabilitation of the masticatory
system by artificial replacement of missing teeth and associated tissues.
  Restorative Dentistry is involved with the restoration of diseased, injured or abnormal teeth to
normal form, function, and aesthetics.

 Dental Public Health is the speciality concerned with the prevention of dental disease. The public
health dentist works with the community to promote dental health.

 Forensic Dentistry is a relatively new area that deals with a wide range of services, such as the
identification of bite marks on the body and/or the identification of an individual through tooth
restorations and morphology using dental records.

Dental Surgery (Office): Equipment and Basic Chairside Instruments

Dental Office / Surgery

 Most offices are designed with:
a reception area, a business area, treatment rooms, a sterilising area, a laboratory, an x-ray
processing room, a restroom / toilet, and the dentist’s office.
 Reception room: neat and clean; a convenient place for providing patient education materials for all
age groups.
 Sterilising area: should have good air circulation to protect everyone from the chemical fumes and
exhaust from the sterilisers. It is necessary to follow specific procedures in order to minimise the
chance of cross-contamination.
 Dental treatment rooms: also called operatories. The type and size of practice dictate the number
of operatories.
o A dental treatment room contains: a dental chair, a dental unit, operating stools, cabinets,
sinks, x-ray machine, mobile carts.

Dental Equipment
 Dental chair: the center of all clinical activity.
o The dental chair supports the patient’s entire body in either an upright, supine position
(reclined position with the nose and knees on the same plane) or a subsupine position
(reclined position with the head lower than the feet).

Patient in the supine position with nose Patient in the sub-supine position with
to knees level. the head below the plane of the nose to
knees.

 Dental unit: consists of handpieces, an air-water syringe a saliva ejector, an oral evacuator (HVE-
High Volume Evacuator), an ultrasonic scaling unit, etc.
 Air-water syringe, saliva
A dental handpiece / drill An air-water syringe
ejector, high-volume
evacuator (HVE)

 Saliva ejector: used for removing saliva and fluids from the patient’s mouth slowly. It has a low
volume suction that is used during certain procedures, such as fluoride treatments and under rubber
dams.
 Ultrasonic scaler: attached to the dental unit.
o The scaler is used during prophylaxis and periodontal procedures. The scaler is used for
removing hard deposits, such as calculus, and other debris from the teeth (scaling and root
planning).
 Dental curing light:
o used to “cure” or “set” light-cured materials

Dental Instruments
Match the words or phrases (1-8) with the definitions (A-H):

1) Operatory A. A space where surgical instruments are cleaned

2) Storage room B. A space where medical supplies are kept
3) Waiting room C. A unit where patients recover from anaesthesia
4) Radiology room D. A space where electrical equipment and heating devices are
5) Recovery room kept
6) Treatment room E. A dark room where medical professionals use imaging
7) Mechanical room technologies
8) Sterilization room F. A medical professional’s workspace
G. A space in which people wait to be served
H. A space in which medical professionals provide care to
patients

 The ultrasonic equipment would be  The patient is in the supine position when:
located in which of the following areas? a. The patient is sitting upright
a. Treatment room b. The patient is reclined so the head is lower than
b. Sterilizing area the rest of the body
c. Laboratory area c. The patient’s nose and knees are on the same
plane
d. X-ray processing area
d. The patient’s nose is a foot above the feet
  The function of the rheostat is to:  The saliva ejector is used:
a. Control the air-water syringe a. During fluoride treatments
b. Regulate the water reservoir b. Under rubber dams
c. Control the speed of the dental handpieces
c. For low volume suction
d. Control the overhead light
d. All of the answers are correct

Identify the dental instruments:

________________ ___________________ ____________________ _________________