Ingles Medico

MEDICAL ENGLISH 1

Autores:

Verónica Clavijo Bazalar.

Fernando Cornejo Sánchez.

UNIT

1
Booking a Doctor's Appointment
Receptionist: Doctor's office. Jane speaking. How can I help you?

Caller: I need to make an appointment with Dr. Harris.

Receptionist: Do you know your chart number?

Caller: No, sorry. It's at home and I'm at work right now.

Receptionist: No problem. What's your name, please?

Caller: George Mason.

Receptionist: Okay Mr. Mason. Hold one moment while I grab your chart, please.

Caller: Sure.

Receptionist: Thanks for waiting. Now, what do you need to see the doctor about?

Caller: Well, I am fighting a cold these days, and I think I have a chest infection or something. My
cough is getting worse each day.

Receptionist: Hmm. Doctor Harris is off tomorrow. Do you think it can wait until Wednesday?

Caller: Oh, it is urgent. I feel bad

Receptionist: No problem, I will help you.

Check your understanding

1. Why does the caller phone the doctor's office?

a) He's running late for his appointment. c) He can't remember his chart number.

b) He's booking an appointment with Dr. d) His medication ran out.
Harris.

Medical English 1 Page 1

2. Which is true about George Mason?

a) He has a bad cold. c) His cough is better.

b) He's running a fever. d) He's off on a sick day.

SIMPLE PRESENT TENSE

TO HAVE

Affirmative statements

SUBJECT VERB COMPLEMENT
I have fever
You have a cold stiff neck
We have a sunburn
They have
He has fever
She has a cold
It has a stiff neck


1. Have a headache 14. Have a sunburn
2. Have an earache 15. Have a stiff neck
3. Have a toothache 16. Have a runny nose
4. Have a stomachache 17. Have a bloody nose
5. Have a backache 18. Have a cavity
6. Have a sore throat 19. Have a wart
7. Have fever 20. Have (the) hiccups
8. Have a cold 21. Have (the) chills
9. Have a cough 22. Have cramps
10. Have a virus 23. Have diarrhea
11. Have an infection 24. Have chest pain
12. Have a rash 25. Have shortness of breath
13. Have an insect bite 26. Have laryngitis
NEGATIVE STATEMENTS

SUBJECT AUXILIARY VERB COMPLEMENT
I do not / don’t have fever
You have a cold
We have a stiff neck
They have a sunburn
He does not / have fever
She doesn’t have a cold
It have a stiff neck


INTERROGATIVE STATEMENTS

AUXILIARY SUBJECT VERB COMPLEMENT QUESTION
MARK
Do I have fever ?
you have a cold
we have a stiff neck
they have a sunburn
Does he have fever ?
she have a cold
it have a stiff neck
“WH” AUXILIARY SUBJECT VERB COMPLEMENT QUESTION
QUESTION MARK
WORDS
How often do I have fever ?
you have a cold
we have a stiff neck
they have a sunburn
When does he have fever ?
Why does she have a cold
it have a stiff neck


TO BE

27. Be faint/weak 30. Be bloated
28. Be dizzy 31. Be congested
29. Feel nauseous 32. Be exhausted

TYPE OF SENTENCE SUBJECT AUXILIARY VERB NEGATIVE FORM COMPLEMENT

+ I am a patient.

+ You are a physician.

- She is not insane.

- We are not swollen.

? Is he weak.

? Are they vitamins?


OTHER VERBS

33. Cough 42. Scratch
34. Sneeze 43. Scrape
35. Wheeze 44. Bruise
36. Burp 45. Burn
37. Vomit/throw up 46. Break
38. Bleed 47. Hurt
39. Twist 48. Cut
40. Sprain 49. Swell
41. Dislocate 50. Itch


ACTIVITIES

A. CHANGE THE FOLLOWING SENTENCES INTO THE APPROPRIATE FORM.

+ affirmative sentences

- negative sentences

? interrogative sentences

1) She has a cold or allergies (?)

_______________________________________________________________________

2) They sneeze every minute (-)

__________________________________________________________________

3) My sister doesn’t cough (+)

________________________________________________________________________

4) My husband is dizzy (?)

________________________________________________________________________

5) Does he feel nauseous? (+)

__________________________________________________________________

6) His brother is exhausted (-)

_________________________________________________________________

7) You aren’t a good dentist (?)

_______________________________________________________________________

8) I don’t wait for anybody (+)

_________________________________________________________________


9) It itches badly (-)

_____________________________________________________________________

10) They aren’t here (+)

________________________________________________________________

B. PUT IN ORDER THE FOLLOWING SENTENCES.

1. in / friends / I / have / don’t / class/ this / many.

________________________________________________________________

2. hospital / to / go / to / They / the / want.

_____________________________________________________________________

3. aren’t / These / your / patients.

_____________________________________________________________________

4. need / I / a / don’t / psychologist

_____________________________________________________________________

5. burp / he / vomit /?/ Does / and/ often

_______________________________________________________________

C. FIND THE MISTAKES IN THE FOLLOWING SENTENCES AND REWRITE THEM.

1. He don’t eat fish __________________________________________________

2. The children is tired _____________________________________________

3. My patients isn’t there ____________________________________________

4. We has a sunburn and you feel nauseus ________________________________

5. Do she work in those medical facility? ____________________________________


Medical Specialists

Medical specialists are experts in certain fields of medicine. They treat specific parts of the body,
such as the stomach or the heart, or they specialize in certain diseases, such as AIDS. Family
doctors keep a list of local specialists and can help patients choose the right specialist for each
medical issue. In many cases, specialists require a referral from a family doctor before they will see
a patient.

Here is a list of the most common types of specialists. Study the list and then check your
understanding by taking the quiz.

Allergist: specializes in determining food and environmental allergies

Anesthesiologist: specializes in pain prevention during surgery

Cardiologist: heart specialist

Chiropractor: back specialist

Dentist: tooth specialist

Dermatologist: skin specialist

Fertility specialist: helps people who have difficulty getting pregnant

Gynecologist: specializes in women's needs

Massage therapist: specializes in muscle relaxation

Midwife: helps women deliver babies in a natural way

Naturopath: specializes in natural cures and remedies

Neurologist: brain specialist

Obstetrician: specialist for pregnant women

Occupational therapist: specializes in workplace health

Oncologist: tumor specialist, including cancer

Ophthalmologist: specializes in eye diseases

Pediatrician: specialist for babies and children


Physical therapist: specializes in the body's movement

Podiatrist: foot specialist

Psychiatrist: specialist in mental health

Radiologist: specializes in imaging tests

ACTIVITIES

A. Read the patient complaints and say which specialist each patient needs.

1. I have a terrible rash on my arms and legs. I think I'm allergic to dairy food, but it also might be
grass.

a) chiropractor c) allergist

b) ophthalmologist d) psychiatrist

2. My husband and I just took a home pregnancy test, and it came out positive. We want to know
when we are due and we want to make sure the fetus is healthy.

a) podiatrist c) obstetrician

b) pediatrician d) pharmacist

3. I still can't walk and it's been three months since my accident. I hate being stuck in a
wheelchair.

a) anesthesiologist c) radiologist

b) physical therapist d) dentist

4. The test results show that I have an advanced form of blood cancer.

a) oncologist c) midwife

b) neurologist d) allergist

5. My left eye has an infection that won't go away and my vision has been blurry for two weeks
now.

a) podiatrist c) ophthalmologist

b) massage therapist d) radiologist


6. I don't want to take any drugs that will cause me to become addicted to them, but I do need
some sort of pain relief.

a) naturopath c) cardiologist

b) dentist d) dermatologist

7. I've been having major chest pains this week. I'm also having trouble breathing.

a) gynecologist c) oncologist

b) cardiologist d) dermatologist

8. I get terrible acne and I have tried all of the products in the pharmacy. I don't know what to do
now.

a) massage therapist c) occupational therapist

b) podiatrist d) dermatologist

9. My baby is not developing properly. She hasn't put on any weight in two months and she keeps
getting ear infections.

a) anesthesiologist c) midwife

b) pediatrician d) massage therapist

10. My husband and I have been trying to get pregnant for three years. We have tried everything
that the books suggest.

a) fertility specialist c) psychiatrist

b) oncologist d) dentist

B. Which are they specialties? Choose the right word for each number.

X-ray technician; gynecologist; psychiatrist; emergency medical technician; surgeon; pediatrician;
cardiologist; optometrist, obstetrician; dentist; doctor; nurse; lab technician.


UNIT

Head
2
Read the text below and answer the questions

Inside the head is the brain, which is responsible for thinking. The top of a person's scalp
is covered with hair. Beneath the hairline at the front of the face is the forehead.
Underneath the forehead are the eyes for seeing, the nose for smelling, and the mouth
for eating. On the outside of the mouth are the lips, and on the inside of the mouth are
the teeth for biting and the tongue for tasting. Food is swallowed down the throat. At the
sides of the face are the cheeks and at the sides of the head are the ears for hearing. At
the bottom of a person's face is the chin. The jaw is located on the inside of the cheeks
and chin. The neck is what attaches the head to the upper body.

1. Where is the brain?
___________________________________________________________________
2. Where is the forehead?
___________________________________________________________________


3. Where are the lips?
__________________________________________________________________
4. What can you do with your teeth?
__________________________________________________________________
5. Where are the ears?
__________________________________________________________________
6. Where is the chin located?
__________________________________________________________________
7. Where is the jaw located?
_________________________________________________________________

Present Progressive

We use the present continuous tense to talk about:

 action happening now
 action in the future

SUBJECT AUXILIARY VERB MAIN VERB COMPLEMENT

+ I am examining a patient.

+ You are prescribing the medicine

- She is not sleeping in the hospital.

- We are not coughing

? Is he vaccinating the children?

? Are they taking vitamins?

ACTIVITIES

A. Complete the following sentences with the present continuous.

1. The doctors _______________ (vaccinate) the children right now.
2. The gynecologist ________________________ (examine) Lucia these days.
3. The doctor __________________ (prescribe) medicines right now.
4. Listen! Michael_____________________ (cough) a lot.


5. I ______________________ (drink) cough syrup at this moment.
6. Jake _________________________ (suffer) a terrible disease.
7. Doctor, ______________________ you ________________ (cure) Mr. Baker?
8. Look! A biologist _____________________ (analyze) a microbe.
9. My children __________________________ (catch) a cold.
10. _______________ you _______________(arrange ) an appointment?

B. Decide which of the choices below would best complete the article if inserted in the

blanks. Circle the appropriate letters.

Too Much Fast Food?

According to a recent survey, these days Hong Kong consumers (1)_______ more money on
convenience foods since the economic downturn. Because companies are trying to make more
with fewer staff, employees (2) ________ harder than ever before. More women (3)__________
the workforce as well. They (4) _________less time to prepare nutritious home-cooked meals for
their families. Instead, families (5)_________ out or (6) ________ convenience foods, such as
frozen pizzas and instant noodles. These foods (7) …………more fat, salt and sugar than home-
cooked meals. Experts say that eating too much of them (8)………… the risk of serious health
problems, including diabetes and heart disease.
However, the current trend towards convenience foods (9) ………benefitting some business
sectors. Supermarkets (10)………….. to the higher demand for quick, easy-to-serve meals by
increasing their selection of convenience and pre-packaged foods. These products (11) ………. for
higher prices than fresh food. Restaurants also (12)…………. from the trend: most Hong Kong
people now (13)………… out at least once a day.
Is convenience food just a fad or is home-cooked food (14)…………. a thing of the past?
How (15) …………………….this trend affecting our health?

1. A are spending 3. A joins
B spends B are joining
C spend C join

2. A work 4. A has
B works B have
C are working C had


5. A are eating 10. A respond
B eats B responded
C eat C are responding

6. A bought 11. A sells
B buys B are sold
C buy C sell

7. A containing 12. A profit
B are profiting
B contains C profits
C contain
13. A eat
8. A increase B ate
B increasing C were eating
C increases
14. A become
9. A is B became
B are C becoming
C be

15. A does
B is
C have

C. Supplies and Tools.
Here is a list of some of the most common supplies found in doctor's offices, operating
rooms, and medical kits. Study the vocabulary and try the matching exercise.

1. Antiseptic a) thin, netted material used for dressing wounds
2. Bandage b) an instrument used to check a person's body temperature
3. Forceps c) liquid used to sterilize (clean) the surface of the skin
4. Gauze d) a cylinder-shaped piece that attaches to a needle and can be filled with liquid
5. Microscope e) a cloth covering that is placed over a wound to prevent bleeding, swelling and
infection
6. Oxigen mask f) glass cylinder that is filled with blood or other liquids and can be capped and
placed in a storage area
7. Scales g) equipment that fits over the nose and mouth and supplies oxygen
8. Syringe h) instrument used during operations and medical procedures (assists the
doctor in pulling, holding, and retrieving)
9. Test tube i) a device that measures a person's weight
10. Thermometer j) equipment that makes small things appear larger than they are

ADDITIONAL INFORMATION

http://www.hospitalenglish.com/flashcards/files/procedures_flash.pdf
Explain: take blood pressure, give a shot, listen to lungs, check ears, check eyes, start an IV, look at an MRI scan,
take temperature, take pulse, prep for surgery, operate, bandage, write in the chart, pay the bill, take the patient to...


UNIT

3
Main Structures of the Digestive System
The digestive tract is a long continuous tube that starts with the mouth and ends with the anus. It
includes the mouth, pharynx, esophagus, stomach, small intestine, and large intestine. The tongue
and teeth located in the mouth are accessory structures. The salivary glands, gallbladder, liver, and
pancreas are the other accessory organs of the digestive system that secretes digestive enzymes
into the digestive tract that are involved in the process of digestion.

Mouth: The mouth contains tongue and teeth. With the help of these the food is chewed (broken
into tiny pieces) and mixes with saliva (secreted by salivary glands)

Pharynx: Is a funnel shaped opening through which the food from mouth passes to esophagus.

Esophagus: Is a long tubular structure that with the help of peristalsis movement passes food to
the stomach.

Stomach: A large sac-like structure that holds the food for a while where it gets mixed with the
hydrochloric acid and gastric juice.

Small intestine: It is a long muscular tube that is divisible into the duodenum, the jejunum, and
ileum. Secretions of liver, gallbladder, and pancreas are passed into the small intestine, where the
major part of the digestion occurs.

Large intestine: Minor part of the digestion occurs in large intestine and is divisible into cecum,
colon, and rectum. Reabsorption of water and absorption of food material takes place in large
intestine.

Anus: The indigested food is excreted out through anus.

Liver: Liver is the largest organ of the human body and it is involved in synthesis and secretion of
bile that plays a role in emulsification of fats. Liver secreted from live is stored in gallbladder, from
which it flows into small intestine.

Pancreas: Pancreas secretes pancreatic juice.


PLURAL FORM OF NOUNS
CASE DESCRIPTION OF THE STRUCTURE EXAMPLE
RULE
General rule The plural form of NOUN + “-S” minute - minutes
most nouns is created
simply by adding the
letter “s” to the end of
the word.
When nouns end in The plural is formed NOUN + “-ES” church - churches
-ch, -x, -s, -sh, -z or by adding “es” box -boxes
s-like sounds index -= indexes ( also indices)
gas - gases
bush - bushes
ass -asses
quiz – quizzes
Nouns ending in “o” When they are NOUN + “-ES” potato - potatoes
preceded by a tomato – tomatoes
consonant. volcano - volcanoes

Except: newly created NOUN + “-S” photo - photos
words or words with piano - pianos
Spanish or Italian portico - porticos
origin.
Noun ending in “y” When they are NOUN – “Y” +” IES” party - parties
preceded by a lady - ladies
consonant, they drop
the “y” and add “ies”

When they are NOUN + “-S” Boy - boys
preceded by a Toy - toys
VOWEL, add a “s” Ray – rays
Noun ending in “f” or “fe” Drop the “f” or “fe” NOUN – “F” + VES calf – calves
and add “ves” half - halves
wolf - wolves

NOUN – “FE” + VES wife – wives
Nouns ending in “is” Drop the “-is” and add NOUN – IS + ES crisis - crises
“-es” hypothesis - hypotheses
oasis - oases
Irregular plural Some nouns change ODD PLURAL FORM child - children
their structure to form ox - oxen
their plural form. man – men
woman - women
person - people
foot - feet
tooth - teeth


mouse - mice
louse - lice

Identical singular and Some nouns have NO CHANGE aircraft - aircraft
plural form identical plural and fish - fish
singular forms, sheep - sheep
although they are still deer - deer
considered to have a species - species
plural form. headquarters - headquarters
Collective words or nouns These nouns ONLY PLURAL FORM cattle
associated with two exist only in the plural scissors
parts. form and take a plural trousers
verb. tweezers
congratulations
pajamas
Compound nouns In compound nouns MAIN NOUN + -S court martial - courts martial
the plural ending is son-in-law - sons-in-law
usually added to the passer-by - passers-by
main noun.
Uncountable noun Uncountable nouns NO PLURAL FORM advice
on the other hand information
have no plural form luggage
and take a singular headquarters - headquarters
verb (is / was ...). news - news


CASE DESCRIPTION OF THE STRUCTURE EXAMPLE
RULE
Latin or Greek origin These nouns maintain NOUN – US + I nucleus = nuclei
their Latin or Greek syllabus = syllabi
form in the plural. focus = foci
fungus = fungi
cactus = cacti (cactuses is
acceptable)

NOUN – ON + A phenomenon = phenomena
criterion = criteria

NOUN - UM + A datum = data
medium= media

NOUN + E alumna = alumnae
trachea=tracheae

NOTES:

Third person of singular in simple present tense conjugation uses the same rules that plural forms.


ACTIVITIES
1. PRONUNCIATION
A. Say the plural nouns. Then write them in the correct columns.

/S/ /Z/ /IZ/
actress dictionary roommate carrots boys actresses
box girl son _____________ ______________ _____________
boy house state _____________ ______________ ______________
carrot lemon student _____________ _____________ ______________
class notebook watch _____________ ______________ ______________

B. Simple present tense conjugation. Say the third person conjugations. Then write them in
the correct columns.
/S/ /Z/ /IZ/
kiss work like It knocks She studies He kisses
watch touch stay _____________ ______________ _____________
study cough clear _____________ ______________ ______________
knock sneeze put _____________ _____________ ______________
clean _____________ ______________ ______________

2. GRAMMAR
A. Write the s plural form of the following words.

1. thesis ____________ 11. watch ______________
2. stimulus ____________ 12. mountain ______________
3. alumnus ____________ 13. louse ______________
4. loaf ____________ 14. family ______________
5. medium ____________ 15. shelf ______________
6. crisis ____________ 16. cloud ______________
7. veto ____________ 17. area ______________
8. fireman ____________ 18. photo ______________
9. diagnosis ____________ 19. home ______________
10. ox ____________ 20. logo _______________


B. Next to each word in the list, write correctly the plural for that word. If that word cannot
be pluralized because it's a non-count noun, write the letter X.
1. man ______________ 16. dancing ______________
2. furniture ______________ 17. 1990 ______________
3. experience ______________ 18. aluminum ______________
4. Kennedy ______________ 19. fax ______________
5. ski ______________ 20. roof ______________
6. gas ______________ 21. fish ______________
7. box ______________ 22. child ______________
8. peace ______________ 23. difficulty ______________
9. cactus ______________ 24. knowledge ______________
10. criterion ______________ 25. goose ______________
11. baby ______________ 26. video ______________
12. memo ______________ 27. curriculum ______________
13. work ______________ 28. biology ______________
14. self ______________ 29. URL ______________
15. applause ______________ 30. dish ______________

C. Write the plural form of the following medical nouns.
1. mouth ______________
2. pharynx ______________
3. anus ______________
4. trachea ______________
5. pancreas ______________
6. enzyme ______________
7. duodenum ______________
8. cecum ______________
9. rectum ______________
10. bronchus ______________

D. What are MASS (NON-COUNT or UNCOUNTABLE) NOUNS?
Here is a list of MASS NOUNS for you to consider.
 Can you count any of these things?
 Do we use the plural form of any of these words in common speech and writing?
 What do the things in the first column have in common? The second column?


wood oxygen dancing English
cloth water soccer luggage
ice milk hockey equipment
plastic wine weather furniture
wool beer heat experience
steel cake sunshine applause
aluminum sugar electricity photography
metal rice biology traffic
glass meat history harm
leather cheese mathematics publicity
porcelain flour economics homework
hair reading poetry advice
dust boating Chinese
air smoking Spanish


READING COMPREHENSION
Read the following text and answer the questions below.

Human Digestive System
How does food get digested?

Digestion involves mechanical as well as chemical changes in the food taken. Mechanical
alteration is brought about by teeth, grinding organs and muscular contraction of stomach and
intestinal walls. Breaking food into small pieces increases the surface area exposed to the enzymes
of digestive juices.

INTRODUCTION OF FOOD DIGESTION PROCESS

Chemical changes, whether in protozoans or in animals from sponges to man, involve cleaving of
complex, insoluble macro molecules into simpler, soluble sub units, and are brought about by the
action of enzyme.


Food Digestion Process
Food Intake: Different organisms obtain food in different ways but carry out similar reactions. To
take food, protozoans use pseudopodia, flagella or cilia; sponges and muscles use a current of
water; hydra uses tentacles beset with stinging cells; planarians and earthworms use a muscular
pharynx; flukes and leeches use oral succer.

Digestive System and process: Parts of the body concerned with the uptake and digestion of food
and elimination of indigestible remains from the digestive system, also called elementary system.
The digestive system consists of two sets of organs:

Alimentary canal: It is a tube comprising many specialized organs. It provides and helps in the
process of:

(i)An inlet, the mouth, to ingest food

(ii)A cavity, the lumen, where food is digested

(iii)A surface for the absorption of digested food

(iv)A space where indigestible remains are changed in to faeces

(v)An outlet the anus for elimination of faeces.

Digestive glands and their function in the process: These are the structures associated with the
different regions of the alimentary canal. They sent into the digestive track their secretions which
contains enzyme and other materials to help in the digestion of food. Most of the alimentary
canal and certain digestive glands are supported and held in place by mesenteries, the double
sheets of peritoneum with a layer of connective tissues in between.

Summary for Food Digestion Process

The digestive system serves three major functions are:

1. Nutrition: The digestive track primarily serves to provide food to the tissues to the body.

2. Breathing: The interior part of the alimentary canal also plays a role in respiration in the
chordates.

3. Excretion: The digestive system brings about sum excretion too. Excretion is the elimination of
unwanted materials from the body.


QUESTIONS
1. Does digestion only involve mechanical changes?
__________________________________________________________________________
___________________________________________________________________
2. Why are enzymes important during the digestion process?
__________________________________________________________________________
___________________________________________________________________
3. Which is the final step of the digestion process?
__________________________________________________________________________
___________________________________________________________________
4. How is the alimentary canal supported?
__________________________________________________________________________
__________________________________________________________________________
2. Matching
Match the numbers with the letters

1. Cleave a) excrement
2. Intake b) the cavity of a tubular organ or part
3. Lumen c) tube
4. Faeces d) the amount taken in
5. Canal e) divide

ON-LINE EXERCISES
The following links could provide you further information and resources on plural form.

Find mistakes

 http://www.englishteststore.net/index.php?option=com_content&view=article&id=707:Fi
nd-Mistakes-Basic-Level-Test-001&catid=117:find-mistakes&Itemid=365

Plural forms

 http://www.learnenglishfeelgood.com/english-grammar-nouns-plural3.html
 http://www.clafoti.com/Imagenes/PLURALNOUNS.htm
 http://grammar.ccc.commnet.edu/grammar/quizzes/cross/plurals_gap.htm
 http://www.caihometype.com/course.html
 http://www.learnenglish.de/grammar/pluraltext.htm#Irregula


UNIT
THE RESPIRATORY SYSTEM

4
What is the respiratory system?
Your respiratory system is made up of the organs in
your body that help you to breathe. Remember, that
respiration = breathing. The goal of breathing is to
deliver oxygen to the body and to take away carbon
dioxide.

Parts of the respiratory system

Lungs
The lungs are the main organs of the respiratory
system. In the lungs oxygen is taken into the body
and carbon dioxide is breathed out. The red blood
cells are responsible for picking up the oxygen in the
lungs and carrying the oxygen to all the body cells
that need it. The red blood cells drop off the oxygen
to the body cells, then pick up the carbon dioxide
which is a waste gas product produced by our cells.
The red blood cells transport the carbon dioxide back
to the lungs and we breathe it out when we exhale.

Trachea
The trachea (TRAY-kee-uh} is sometimes called the windpipe. The trachea filters the air
we breathe and branches into the bronchi.

Bronchi
The bronchi (BRAHN-ky) are two air tubes that branch off of the trachea and carry air
directly into the lungs.


Diaphragm
Breathing starts with a dome-shaped muscle at the bottom of the lungs called the
diaphragm (DY-uh-fram). When you breathe in, the diaphragm contracts. When it
contracts it flattens out and pulls downward. This movement enlarges the space that the
lungs are in. This larger space pulls air into the lungs. When you breathe out, the
diaphragm expands reducing the amount of space for the lungs and forcing air out. The
diaphragm is the main muscle used in breathing.

FREQUENTLY ASKED QUESTIONS

Why Do I Yawn?
When you are sleepy or drowsy the lungs do not take enough oxygen from the air. This
causes a shortage of oxygen in our bodies. The brain senses this shortage of oxygen and
sends a message that causes you to take a deep long breath - a YAWN.

Why Do I Sneeze?

Sneezing is like a cough in the upper breathing passages. It is the body's way of removing
an irritant from the sensitive mucous membranes of the nose. Many things can irritate the
mucous membranes. Dust, pollen, pepper or even a cold blast of air are just some of the
many things that may cause you to sneeze.

What Causes Hiccups?

Hiccups are the sudden movements of the diaphragm. It is involuntary. You have no
control over hiccups, as you well know. There are many causes of hiccups. The diaphragm
may get irritated, you may have eaten to fast, or maybe some substance in the blood
could even have brought on the hiccups.

Simple Present / Negative and Interrogative Sentences

Type of sentence Subject Auxiliary (-) Base form of the verb Complement

- She does not / operate a patient
He doesn’t

They do not/ take care of me
You don’t


Type of sentence Auxiliary Subject Base form of the Complement Question
verb mark

? Does she operate a patient ?
he

Do they take care of me ?
you

Type of sentence “Wh” Auxiliary Subject Base form Complement Question
question of the verb mark
words

? Why does she visit a patient ?
Where does he operate that boy ?
When Do they take care of me ?
How Do You heal them ?

ON-LINE EXERCISES
Go to the following links to practice.
http://www.englischhilfen.de/en/exercises/tenses/simple_present_negation_long.htm
http://www.englisch-hilfen.de/en/exercises/questions/simple_present.htm

ACTIVITIES

A. Read carefully the following text.

I have a terrible stomachache.

Doctor: — Good morning. Please have a seat here. What´s the problem?
Paul Ryefield: — I have a terrible stomachache.
Doctor: — Do you have diarrhea?
Paul Ryefield: — Yes, I do.
Doctor: — Do you have any other symptoms?
Paul Ryefield: — Yes, I feel sick.
Doctor: — You mean you feel nauseous?
Paul Ryefield: — That´s right. I feel like vomiting. And right now I feel dizzy, too.
Doctor: — All right. Please take off your clothes to the waist and lie down there ... Just tell me if it


hurts when I do this.
Paul Ryefield: — It doesn´t hurt. ... Ouch. It hurts there.
Doctor: — Okay. Let´s hope it´s just indigestion, but we´ll need to run some diagnostic tests to be
sure. We´ll run a blood test and we´ll also need a urine sample.
Paul Ryefield: — Can you give me something for the time being?
Doctor: — Yes, I´ll give you a prescription for indigestion tablets.

B. Write a dialogue using the interrogative and negative sentences. Use the
vocabulary above
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C. VOCABULARY. Read the text then Work with a partner and match the term in
column A with its contextual meaning in column B.

Influenza is a viral infection of the respiratory tract that produces severe discomfort and
debilitation. Flu should not be confused with a cold. Influenza produces symptoms that require
bed rest for several days. There are several types of influenza virus and all have certain
characteristics: rapid transmission from person to person, an incubation period of few days, and
symptoms that become severe in a short time.
Symptoms are generally respiratory in nature but gastrointestinal involvement is common with
certain types of influenza. Headache and painful respiration are usually the first symptoms. Within
the first hours the body temperature increases and remains elevated for several days. Severe
muscle aches, headache, weakness, and chest discomfort accompany the fever. Throat
tenderness and episodes of coughing are present in most cases.
Symptoms are severe for 3 to 5 days, and then subside slowly. Weakness and coughing may
persist for 10 days to 2 weeks.

A B
1. debilitation a. abate / diminish
2. confuse b. acute / grave / critical
3. cold c. complement / to go together with something
4. require d. event / occurrence
5. severe e. higher than normal
6. involvement f. need or demand
7. increases g. pharynx
8. remain h. rhinovirus or coronavirus infection
9. elevated i. sensitive / painful
10. accompany j. to be mistaken for something else
11. throat k. to be part of / to be included in
12. tenderness l. to go up
13. episodes m. to incapacitate
14. subside n. to stay / to continue being

D. READING COMPREHENSION.
Instructions: Work with a partner. Discuss each question in English and decide if the
statements are T (true) or F (false.)

a. Influenza is caused either by virus or bacteria. T F
b. The flu is the same thing as a cold. T F
c. Fever is not a typical sign of the flu. T F
d. Some patients may develop gastrointestinal troubles during influenza. T F
e. Influenza is a very infectious disease. T F
f. The incubation period for the flu is usually about one month. T F


UNIT

5
THE CIRCULATORY SYSTEM

The circulatory system is made up of the vessels and the muscles that help and control the flow of
the blood around the body. This process is called circulation. The main parts of the system are the
heart, arteries, capillaries and veins.

As blood begins to circulate, it leaves the heart from the left ventricle and goes into the aorta. The
aorta is the largest artery in the body. The blood leaving the aorta is full of oxygen. This is
important for the cells in the brain and the body to do their work. The oxygen rich blood travels
throughout the body in its system of arteries into the smallest arterioles.

On its way back to the heart, the blood travels through a system of veins. As it reaches the lungs,
the carbon dioxide (a waste product) is removed from the blood and replace with fresh oxygen
that we have inhaled through the lungs.


Arteries
Arteries are tough, elastic tubes that carry blood away from the heart. As the arteries move away
from the heart, they divide into smaller vessels. The largest arteries are about as thick as a thumb.
The smallest arteries are thinner than hair. These thinner arteries are called arterioles. Arteries
carry bright red blood! The color comes from the oxygen that it carries.

Veins
Veins carry the blood to the heart. The smallest veins, also called venules, are very thin. They join
larger veins that open into the heart. The veins carry dark red blood that doesn't have much
oxygen. Veins have thin walls. They don't need to be as strong as the arteries because as blood is
returned to the heart, it is under less pressure


Heart
Did you know that your heart is the strongest muscle? Your heart is divided into two sides. The
right side pumps blood to your lungs where it picks up oxygen. The left side pumps oxygen-soaked
blood out to your body. They do not work on their own, but together as a team. The body's blood
is circulated through the heart more than 1,000 times per day. Between five and six thousand
quarts of blood are pumped each day. Your heart is about the same size as your fist.

Blood is thicker than water and has a little bit salty taste. In an adult body there is 10.6 pints of
blood circulating around. In their blood there is billions of living blood cells floating in a liquid
called plasma. If you took a small sample of this blood and poured it into a test tube and then put
it in a machine called a centrifuge, you would be able to see the layers of this blood. This machine
spins the blood around so fast that it separates the red blood cells, from the white blood cells,
from the platelets. The red blood cells sink to the bottom because they are the heavier, more solid
parts, but the plasma remains at the top because it is lighter. The plasma is 95% water and the
other 5% is made up of dissolved substances including salts.


PRONOUNS
A pronoun is a word that can be used instead of another word.

Examples:

The X-ray machine is automatic, so it does not need to be programmed.

Helen was diagnosed as hypertensive, so the doctor gave her some beta-blockers.

If you did not pass one or more laboratories, you must take them this semester.

SUBJECT PRONOUNS OBJECT PRONOUNS
I Me
You You
He Him
She Her
It It
We Us
You You
They Them

When pronouns are used as subjects of clauses they are called SUBJECT PRONOUNS (SP). Their
position is before verbs.
They have discovered the cure.
SP
We are wasting time.
SP
OBJECT PRONOUNS (OP) are located after verbs or prepositions.

They fight cancer They fight it. OP

I gave one scalpel and three tweezers to the surgeon I gave them to him OP

NOTE: OP
A pronoun acts as a subject or an object in a clause, so it is an error to repeat the noun it refers to
in the same clause.

Example

The administrators they are willing to discuss your queries.

Bottle-feeding them young children is as nutritious for them as breast feeding.


Demonstrative adjectives vs. demonstrative pronouns
DISTANCE SINGULAR PLURAL
NEAR This These
FAR That Those

This, that, these, those are words used to refer to nouns that are near or further away in time or
space.

They work as adjectives when they modify a noun (the noun is written or pronounced in the same
clause). If they replace a noun these words work as pronouns.

Example:

 This chocolate tastes delicious. (ADJECTIVE)

This tastes delicious. (PRONOUN)

 I don't like this prognosis. (ADJECTIVE)

I don't like this. (PRONOUN)

 That athlete will run for an hour. (ADJECTIVE)

That will run for an hour (PRONOUN)

 Jim wrote that prescription. (ADJECTIVE)

Jim wrote that. (PRONOUN)

 These patients look good. (ADJECTIVE)

These look good. (PRONOUN)

Possessive adjective vs. possessive pronouns
Possessive adjectives modify a noun (that is written or pronounced in the clause) and show that
there is a possession relation.

Possessive pronouns are used when we want to substitute a group of words that are indicating a
possession relation.


POSSESSIVE POSSESSIVE
ADJECTIVE PRONOUN
My Mine
Your Yours
His His
Her Hers
Its Its
Our Ours
Your Yours
Their Theirs

For example:

 This is my book. (ADJECTIVE)
 This is mine. (PRONOUN)

 Their patients are in the intensive care unit (ADJECTIVE).
Theirs are in the intensive care unit. (PRONOUN)

 This is your disk and that's mine. (ADJECTIVE – PRONOUN)
 The smallest stethoscope is hers. (PRONOUN)

NOTE

Read the following sentence

When you drive to Manitoba, will you take your car or theirs?

 The possessive adjective "your" depends on the noun "car."
 The possessive pronoun, "theirs," stands in the place of the noun phrase, "their car."

ACTIVITIES
A. Underline the object in each sentence and replace it using an object pronoun.

a) Please help doctor Takashi.
_______________________________________________________________
b) Peter loves chemistry
_______________________________________________________________
c) Read page 104.
_______________________________________________________________


d) Ask doctor Huapaya and doctor Carhuancho.
_______________________________________________________________
e) Buy five syringes for Miss La Rosa.
_______________________________________________________________
B. Unscramble the words groups to write sentences. Use the correct punctuation and
capitalization.

a) lend / him / money / some / always / I
________________________________________________________________
b) the / showing / the / something / women / is / man / to.
________________________________________________________________
c) them / she / help / some / gives / rarely.
________________________________________________________________
d) you / tell / the / him / do / ? / answers
________________________________________________________________
e) this / us / does / explain / kind / exercises / of / she / not / to.

C. Fill in the blanks with the appropriate possessive adjective, then use possessive pronouns
to replace the group of words expressing possession relation.
1. What’s the boy’s name? _____________ name is Ben Scott.
__________________________________________________________________
2. Debbie has a dog. ____________ dog is very lively.
__________________________________________________________________
3. The dog is very lively. _____________ name is Ben.
__________________________________________________________________
4. We are at school. _______________ school is very nice.
__________________________________________________________________
5. I have a new laptop. _____________ laptop is white.
__________________________________________________________________
6. I'm from Chester. Most of ______________ friends are from Chester, too.
__________________________________________________________________
7. The Guptas have a restaurant. _____________ restaurant is great.
__________________________________________________________________


8. The rabbit is white. ______________ cage is in the garden.
__________________________________________________________________
9. You are not English. ______________ name is not an English name.
__________________________________________________________________
10. Sandra and Jenny are friends. ________________school is in Chester.
__________________________________________________________________
11. The Scotts have a new car. _________________ car is blue.
__________________________________________________________________
12. Emma Peel has a brother. ________________ name is Paul.
__________________________________________________________________
13. Nick Baker has a sister._______________ name is Debbie.
__________________________________________________________________
14. Yes, we have a dog. _____________ dog is very old.
__________________________________________________________________
15. The Snows have a tortoise. ____________ name is Trundle.
__________________________________________________________________
D. GROUP EXERCISE.
Create a logical secrete message using at least ten abbreviations showed next pages.
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ABBREVIATIONS
This is partial list of abbreviations used in medical prescriptions.

ABBREVIATIONS LATIN OR GREEK MEANING
ORIGIN
Aa Ana of each
Ad Ad up to
a.c. ante cibum before meals
a.d. auris dextra right ear
ad lib. ad libitum use as much as one desires; freely
admov. Admove apply
Agit Agita stir/shake
alt. h. alternis horis every other hour
a.m. ante meridiem morning, before noon
Amp Ampule
Amt Amount
Aq Aqua Water
a.l., a.s. auris laeva, auris left ear
sinistra
A.T.C. around the clock
a.u. auris utraque both ears
Bis Bis twice
b.d./b.i.d. bis in die twice daily
B.M. bowel movement
bol. Bolus as large as single dose(usually intravenously)
B.S. blood sugar
B.S.A body surface areas
BUCC Bucca inside cheek
cap., caps. Capsula capsule
c, c. Cum with (usually written with a bar on top of the"c")
cib. Cibus food
Cc cum cibo with food, (but also cubic centimeter)
Cf with food
comp. compound
cr., crm cream
CST continue same treatment
D5W dextrose 5% solution (sometimes written as D5W)
D5NS dextrose 5% in normal saline (0.9%)
D.A.W. dispense as written (i.e., no generic substitution)
dc, D/C, disc discontinue
dieb. alt. diebus alternis every other day
dil. dilute
disp. dispersible or dispense
div. divide


ORIGIN
d.t.d. dentur tales doses give of such doses
D.W. water distilled
elix. elixir
e.m.p. ex modo prescripto as directed
emuls. Emulsum emulsion
Et Et and
Eod every other day
Ex aq ex aqua in water
fl., fld. fluid
ft. Fiat make; let it be made
G gram
Gr grain
gtt(s) gutta(e) drop(s)
H hypodermic
h, hr hora hour
h.s. hora somni bedtime
ID intradermal
IM Intramuscular (with respect to injections)
inj. injectio injection
IP intraperitoneal
IV intravenous
IVP intravenous push
IVPB intravenous piggyback
L.A.S. label as such
LCD coal tar solution
Lin linimentum liniment
Liq liquor solution
lot. lotion
Mane mane in the morning
M. misce mix
m, min minimum a minimum
Mcg microgram
m.d.u. more dicto utendus to be used as directed
mEq milliequivalent
Mg milligram
mist. mistura mix
Mitte mitte send
mL milliliter
nebul nebula a spray
N.M.T. not more than
noct. nocte at night
non rep. non repetatur no repeats
NS normal saline(0.9%)
1/2NS half normal saline(0.45%)


ORIGIN
N.T.E. not to exceed
o_2 both eyes, sometimes written as o2
o.d. oculus dexter right eye
D.W. water distilled
elix. elixir
e.m.p. ex modo prescripto as directed
emuls. emulsum emulsion
Et Et and
Eod every other day
Ex aq ex aqua in water
fl., fld. fluid
ft. fiat make; let it be made
G gram
Gr grain
gtt(s) gutta(e) drop(s)
H hypodermic
h, hr hora hour
h.s. hora somni bedtime
ID intradermal
IM Intramuscular (with respect to injections)
inj. injectio injection
IP intraperitoneal
IV intravenous
IVP intravenous push
IVPB intravenous piggyback
L.A.S. label as such
LCD coal tar solution
Lin linimentum liniment
Liq liquor solution
lot. lotion
Mane mane in the morning
M. misce mix
m, min minimum a minimum
Mcg microgram
m.d.u. more dicto utendus to be used as directed
mEq milliequivalent
Mg milligram
mist. mistura mix
Mitte mitte send
mL milliliter
nebul nebula a spray
N.M.T. not more than


ORIGIN
noct. nocte at night
non rep. non repetatur no repeats
NS normal saline(0.9%)
1/2NS half normal saline(0.45%)
N.T.E. not to exceed
o_2 both eyes, sometimes written as o2
o.d. oculus dexter right eye
o.p.d. once per day
o.s. oculus sinister left eye
o.u. oculus uterque both eyes
oz ounce
per per by or through
p.c. post cibum after meals
pig./pigm. pigmentum paint
p.m. post meridiem evening or afternoon
PRN, prn pro re nata as needed
p.o. per os by mouth or orally
p.r. by rectum
pulv. pulvis powder
PV per vaginam via the vagina
q quaque every
q.a.d. quoque alternis die every other day
q.a.m. quaque die ante every day before noon
meridiem
q.d.s. quater die sumendus four times a day
q.p.m. quaque die post every time after noon
meridiem
q.h. quaque hora every hour
q.h.s. quaque hora somni every night at bedtime
q.1h, q.1° quaque1 hora every 1 hour; (can replace “1” with other numbers)
q.d. quaque die every day
q.i.d. quater in die four times a day
q.o.d. every other day
qqh quater quaque hora every four hours
q.s. quantum sufficiat a sufficient quantity
QWK every week
R rectal
rep., rept. repetatur repeats
RL, R/L Ringer's lactate sine
s without (usually written with a bar on the top of the
“s”)
s.a. secundum artum use your judgment


ORIGIN
SC, subc, subcut, subq, SQ subcutaneous
Sig write on label
SL sublingually, under the tongue
Sol solutio solution
s.o.s., si op. sit si opus sit if there is a need
Ss semis one half
Stat statim immediately
Supp suppositorium suppository
Susp suspension
Syr syrupus syrup
Tab tabella tablet
tal., t talus such
Tbsp tablespoon
troche trochiscus lozenge
Tsp teaspoon
t.i.d. ter in die three times a day
t.d.s. ter die sumendum three times a day
t.i.w. three times a week
top. topical
T.P.N. total parenteral nutrition
tr, tinc., tinct. tincture
u.d., ut. dict.
ut dictum as directed
ung. unguentum ointment
U.S.P. United States Pharmacopoeia
Vag vaginally
W with
Wf with food (with meals)
w/o without
X times
Y.O. years old


UNIT

HOSPITAL FACILITIES
6
Melissa Memorial Hospital

Melissa Memorial Hospital is designed as a critical access hospital providing for 24
hour emergency care. The design is intended to present an image of a facility that
provides quality healthcare in a friendly environment. This facility focuses on healing
the body, mind and spirit by personalizing, humanizing, and demystifying the
healthcare experience for patients and their families.

Family Waiting Lounge – The family lounge sits immediately adjacent to the inpatient
bed wing, providing a bright and spacious place for families to gather.


Main Entry Lobby - The high ceiling main lobby space was designed with comfort in
mind. Its upper windows provide a beacon when lights are on at night and its
contemporary design and soft colors offer patients and their families a warm welcome
and an orientation point of reference.

Nursing Station - The nursing station is centrally located to offer overlapping access
and control of the inpatient bed wing, the labor and delivery suite, the emergency
department, the observation beds, the family lounge as well as the outpatient waiting
area.

Operating Room - The new surgical suite was designed primarily for outside specialists
that travel to Melissa Memorial for specialty surgeries. The new surgical area will help
to increase specialty surgery volumes.

Floor Plan - The Floor Plan emphasizes departmental adjacencies and clean and
separate corridor flows.


Pre-operative and Recovery Areas - The hospital provides pre-operative and recovery
areas adjacent to the operating room.

The total refurbishment of Melissa Memorial Hospital will be 2011. The roof will be replaced, the
wards partitioned into individual cubicles to provide privacy for patients, and new nursing stations
were constructed. Ceramic floor tiles give the wards a cool and clean appearance as do the
acoustic ceilings in all the General Wards corridors.

The next major development will be the building of an ultra-modern maternity wing. It will have
eighteen beds, five are sea-facing private rooms, four semi-private rooms and eight general ward
beds. It will also have its own operating theatre, a baby nursery, isolation rooms, delivery rooms,
family planning area, well-baby and well-woman clinics, pediatric cardiology.

The development of the hospital never really stops, because the pace of change always increases
and the hospital must keep up.


THERE IS/ THERE ARE
Both expressions are used to state the something exists or to point out something in the distance.

There is/There are can be used as the sentences subject.

1. "There is" - is used with the following subjects:
 Singular nouns
 Uncountable nouns
 3rd person singular (he, she, my physician, his outpatient, etc.).

Examples:

There is my specialist on the corner.

There is a lot of blood on the highway. There must have been an accident.

There is a fracture here.

2. "There are" - is used with the following subjects:
 3rd person plural (they, my doctors, the nurses, the practitioners, etc.)

Examples:

There are many nurses in this nursing station.

There are practitioners there.

There are three sites on the internet that are really good to study Medical English.

PREPOSITIONS


ACTIVITIES
A. THERE IS/THERE ARE. Choose the appropriate expression from the parentheses.

1. ___________ a fly in that doctor's soup.
(There is, There are)
2. ______________many health centers in Huaycan.
(There isn't, There aren't)
3. ________________ any viruses in this area.
4. _____________________ lots of clinics in big cities.
5. ______________ a blood bank here?
(Is there, Are there)
6. _________________ survivors in the mine?
7. _____________________ a blood donor I can call?
8. _______________ an important surgery tomorrow.
9. _____________________ 8 students in my Medical English class.
10._________________________ many inpatients in this hospital.


B. GROUP PROJECT. Look at the map below. Then write a description for the plan using
“there is”, “there are” and prepositions.

C. Draw three plans considering the vocabulary below. Then describe the plans using
“there is”, “there are” and prepositions.
1. Ultra-modern maternity wing: eighteen beds, five are sea-facing private rooms, four semi-
private rooms and eight general ward beds; one operating theatre; a baby nursery;
isolation rooms; delivery rooms; family planning area; well-baby and well-woman clinics;
pediatric cardiology.
2. Third floor: two lifts; a four-bed High Dependency Unit; Renal Dialysis Unit; Radiology
department.
3. Outpatient Department: Obstetrics; Gynecology; -Ear, Nose and Throat (ENT); -Dental
Surgery ; Orthopedics; Dermatology; Virology; Urology; Radiation, Oncology; Obstetrics;
Perinatology Consultation; Cardiology; Pathology; Psychiatry; Pulmonary Services;
Neurosurgery ; Pediatrics; Internal Medicine; Endocrinology; General Surgery; Geriatrics;
Gastroenterology; Electrophysiology; Neonatology; Nephrology; Rheumatology;
Ophthalmology; Plastic Surgery; Otolaryngology; Pathology.


UNIT

7
THE EXCRETORY SYSTEM
Excretion - Excretion is the removal of the metabolic wastes of an organism. Wastes that are
removed include carbon dioxide, water, salt, urea and uric acid. All excreted wastes travel at some
time in the blood.

Organs of the Excretory System

Lungs - removal of excess carbon dioxide

Liver - produces urea and uric acid as a by-product of the breakdown of proteins

Skin - removal of excess water, salt, urea and uric acid

Urinary System - kidneys filter the blood to form urine, which is excess water, salt, urea and uric
acid

THE SKIN

Layers of the skin

Epidermis - outer protective layer without blood vessels

Dermis - inner layer containing blood vessels, sensory nerve endings, sweat and oil glands, hairs,
and fat cells

Functions of the skin

Excretion - Wastes such as excess water, salt, urea and uric acid are removed from the body in
sweat.

Waterproofing - The skin with its oil glands prevents the entry of water into, and loss of water out
of the body.


Protection from disease - The intact skin prevents invasion of micro-organisms and dust into the
body.

Protection from ultraviolet rays - Pigments reduce the intake of UV rays.

Regulation of body temperature - The thin layer of fat cells in the dermis insulates the body.
Contraction of small muscles attached to hairs forms 'goosebumps' and creates an insulating
blanket of warm air. Also, sweat produced by sweat glands uses excess body heat to evaporate,
providing a cooling effect.

Sensory Detection - The nerve endings or receptors in the dermis detect heat, cold, touch,
pressure and pain.

SOME / ANY
STATEMENT SOME ANY
Affirmative I have some health nuisances. _
statement They will need some calories

Negative _ I do not need any blood transfusion.
statements
Interrogative _ Do you need any help?
statements Does she have any classmates?
Exception:
Offer: Would you like some help?
Request: Can you lend me some money?

QUANTIFIERS WITH COUNTABLE AND UNCOUNTABLE NOUNS
Some adjectives and adjectival phrases describe quantity. Some can only go with countable nouns
(nurses, inpatients, outpatients), and some can only go with uncountable nouns (sugar, fat, blood,
advice). However, there are quantifiers that can be used with both countable and uncountable
nouns.

ONLY WITH WITH UNCOUNTABLE ONLY WITH
UNCOUNTABLE NOUNS AND COUNTABLE NOUNS COUNTABLE NOUNS
How much? How much? or How many? How many?

a little no/none a few
a bit (of) not any a number (of)
- some (any) several
a great deal of a lot of a large number of

a large amount of plenty of a great number of

- lots of -


Notes:

1. Much and many are used in negative and question forms.

Example:

How much sugar do you consume?

How many cigarettes do you smoke?

There's not much blood in the blood bank.

There weren't many physicians at the meeting.

2. They are also used with too, (not) so, and (not) as :

Examples

There were too many physicians at the meeting.

It's a problem when there are so many patients.

There's not so much work to do this week.

3. In positive statements, we use a lot of:

Examples:

I have a lot of work this week.

There were a lot of physicians at the meeting.

4. A few (for countable nouns) and a little (for uncountable nouns) describe the quantity in a
positive way:
Examples:

I have a few patients (= maybe not many, but enough)

I have a little money (= I have enough to live on)

5. Few and little describe the quantity in a negative way:

Few people visited him in hospital (= he had almost no visitors)

He had little money (= almost no money)


ACTIVITIES

A. QUANTIFIERS. In the following sentences, fill in the gaps with one of the following
quantifiers:

much, many, a lot of, most, a little, little, a few, few

1. It seems to me that we haven't had ____________ assignments in English this term.

2. How _______________ material can we be expected to read in one week?

3. I've unfortunately had _________________ headaches already because of stress.

4. Our yard looks awful this summer. There are too _____________ weeds.

5. I didn't use _____________ fertilizer last spring, and that has made a difference.

6. Also, I've paid very_________________ attention to how rain we've had.

7. I'm afraid it's rained ________________ times this summer, and that is why the grass is turning
brown and dying. Farmers are very upset.

8. How _______________ good would it do if we watered the plants ourselves?

9. ________________ advice I have ever received from so-called "experts" has been useless.

10. They said that just _________________ help could make a big difference.

11.________________________ people know as much about computers as Tomas does.

12. It does us _________________________ good when the banking system collapses.


B. GROUP PROJECT. You are a doctor who needs to know your patient routine. Write a 30-
line dialogue using quantifiers in each sentence. Use affirmative, negative and
interrogative statements.

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________


UNIT

THE URINARY SYSTEM 8
Urine

The first nitrogenous waste to be formed from the breakdown of protein is ammonia, a highly
toxic chemical that is quickly converted by the liver to urea and uric acid. These are less toxic than
ammonia and are transported in the blood to the kidneys for excretion in urine. Urine consists of
excess water, excess salt, urea and uric acid.

Parts of the Urinary System


Renal Arteries

Two renal arteries constantly transport blood to the kidneys.

Renal Veins

Two renal veins return useful nutrients back into the bloodstream.

Ureters

Two ureters carry urine from the kidneys to the urinary bladder.

Urinary Bladder

The urinary bladder temporarily stores urine until it is released from the body.

Urethra

The urethra is the tube that carries urine from the urinary bladder to the outside of the body. The
outer end of the urethra is controlled by a circular muscle called a sphincter.

Kidneys

The human kidneys are the major organs of bodily excretion (see Figure 1.) They are bean-shaped
organs located on either side of the backbone at about the level of the stomach and liver. Blood
always enters the kidneys through renal arteries and leaves through renal veins. Tubes called
ureters carry waste products from the kidneys to the urinary bladder for storage or for release.

Figure 1. Details of the human excretory system. Position and allied structures of the kidneys (top). A cross section of
the kidney showing the two major portions (left). Details of the nephron, the functional unit of the kidney (right).


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