ТЕМА 1. The Skeleton.

The human body consists of three parts. They are the head, the trunk and
the limbs. There are many bones of different sizes and shapes in the
skeleton. In the adult the skeleton has over 200 bones. Bones are
connected together by cartilages, ligaments and joints. Joints allow bones
to move.
The main part of the head is called the skull. The bones of the skull are
composed of cranial and facial parts. There are 26 bones in the skull. The
skull encloses the brain. The forehead, the temples, the cheeks, the
cheekbones, the two jaws and the mouth compose the face. The teeth and
the tongue are lodged in the mouth. A person chews food with the teeth
and tastes food with the tongue. The lips are the two margins of the
mouth. We see with the eyes, breathe and smell with the nose and hear
with ears.
The trunk consists of the spine (or the spinal column), the chest (ribs
and breastbone) and the pelvic bones. In the spine there are many
vertebrae. The vertebra is a small bone, which is formed by the body and
the arches. There are 32 or 34 vertebrae in the spine of the adult. In the
spinal column there are seven cervical vertebrae, twelve thoracic
vertebrae, five lumbar, five sacral vertebrae and from one to five vertebrae
which form the coccyx. The cervical part of the spine is formed by seven
cervical vertebrae. Twelve thoracic vertebrae have large bodies. The
lumbar vertebrae are the largest vertebrae in the spinal column. They have
oval bodies.
The chest (thorax) is composed of 12 thoracic vertebrae, the breastbone
and 12 pairs of ribs. The breastbone is a long bone in the middle of the
chest. It is composed of three main parts. The basic part of the chest is
formed by the ribs. On each side of the chest seven ribs are connected
with the breastbone by cartilages. The cartilages of three other ribs are
connected with each other and with the seventh rib. But the cartilages of
these ribs are not connected with the breastbone. The eleventh and the
twelfth ribs are not connected with the breastbone either. They are not
connected with other ribs, they are free. Each rib is composed of a head,
neck and body.
The trunk is divided into two large cavities by the diaphragm. The
upper cavity of the trunk is called the thorax and the lower one is called
the belly (or abdomen). In the middle of the thorax (the chest) there is a
long bone which is called the breastbone. The ribs are connected with the
breastbone by cartilages. The lungs and the heart are located above the
diaphragm the upper cavity. In the lower cavity (abdominal cavity) there
are such interior organs as stomach, liver, urinary bladder, gallbladder,
kidneys, spleen and intestines (bowels). There are two nipples on the
chest. There is the navel in the middle of the abdomen. At the lowest part
of the abdomen there are genitals (the external reproductive organs).
The upper limb (extremity) is divided into the shoulder, the upper arm,
the forearm and the hand. The joint between upper arm and forearm is
called the elbow. The wrist is the joint between the forearm and hand.
Each hand has five fingers: a thumb, index finger (fore-finger), middle
finger, ring finger, and little finger (or pinky).
The lower limb consists of the thigh-bone (the femur), the shin-bone
(the tibia) and the fibula. The back of the lower leg is called the calf. The
joint between the femur and the lower leg is called the knee-joint. This
joint is protected by the knee-cap (the patella). The joints between lower
legs and feet are the ankles. The foot consists of the heel, sole and toes.
ТЕМА 2. Bones and Muscles
Bone is a unique connective tissue in that it not only has cells and
ECMcalled osteoid, including type I collagen and GAGs, but also the
matrix iscalcified andrigid.Osteoblasts secrete bone extracellular matrix
(osteoid).Osteoblasts arespecialized to synthesize and secrete the
components of osteoid, type Icollagen, and GAGs.Osteoclasts are
responsible for the breakdown of bone matrix, with releaseof calcium. All
bone, regardless of formation, undergoes remodeling throughout life. All3
processes-bone formation, bone growth, and bone remodeling-
havesimilarities. Inintramembranous bone formation, primitive
mesenchyme can give risedirectly to bone. In endochondral bone
formation, bone is formed on thetem plate of preexisting hyaline cartilage.
Endochondral bone formation occurs in long bones of the extremities and
vertebrae and bones of the pelvis, and starts as a hyaline cartilaginous
template.An osteon is a Haversian canal with its surrounding lamellae
constituentsand forms the basic unit of mature lamellar bone. Trabeculae
of cancellousbone are similarly remodeled. The process takes place
mostly at the surface of the trabeculae, carried out by osteoclasts and
osteoblasts from the adjacent marrow.
Muscles are classified as skeletal, cardiac, or smooth.Skeletal muscle
has 3 levels of connective tissue: endomysium, perimysium, and
epimysium. Skeletal muscle is composed of long cylindrical fibers that
have dark (A) bands and light (I) bands. A dark transverse line, the Z line,
bisects each I band. Skeletal muscle fibers contain myofibrils, which in
turnare composed of sarcomeres.Sarcomeres have thick and thin
filaments. Thick filaments are centrallylocated in sarcomeres, where they
interdigitate with thin filaments. The I band contains thin filaments only,
the H band contains thick filaments only, and the A bands contain both
thick and thin filaments.Thin filaments contain 3 proteins: actin,
tropomyosin, and troponin.Actin forms a double helix, whereas
tropomyosin forms an a-helix. Troponin includes 3 polypeptides: TnT,
which binds to tropomyosin; TnC, which binds to calcium ions; and Tnl,
which inhibits actin-myosin interaction. Thick filaments are composed of
myosin. Myosin has 2 heavy chains with globularhead regions. The heads
contain actin-binding sites and have ATPase activity. The transverse
tubular system (T-tubule system) surrounds each myofibril and facilitates
excitation-contraction coupling.Cardiac muscle has an arrangement of
sarcomeres similar to that in skeletalmuscles, but the fibers are coupled
through gap junctions.Smooth muscle is found in the walls of blood
vessels and hollow viscera.Gap junctions couple them electrically.
Myofilaments of smooth muscles arenot arrayed like in skeletal muscles;
they are obliquely placed in order toform a latticework. Electrical or
chemical signaling via hormones can triggersmooth muscles.
ТЕМА 3. Hospital. Emergency Department.
The state has established the wide network of the medical institutions.
One of them is the regional hospital. It is multistory building with all
modern conveniences. There are some departments in this hospital. One
can see surgical, cardiological, pulmonological, gastroenterological and
other departments. There are many light and cozy wards in each
department. In every ward one can see some beds, bed-side tables and
chairs. Each department houses approximately 50 patients. The work at
the hospital begins early. First of all the nurses take the patients’
temperature and fulfill the doctor’s prescriptions. If it is necessary, they
give intramuscular and intravenous injections, cup the patients, apply
mustard plasters, make compresses, and give the prescribed medicines.
Every day the doctors make the morning round. They examine the
patients, listen to the heart and lungs, palpate the abdominal parts, feel the
pulse, and measure blood pressure. They make the diagnosis and prescribe
proper treatment to every patient. I should like to note that our physicians
and nurses pay much attention to the treatment of the patients. There are
large and small wards and a large, light operating theatre here. In this
department there are patients with surgical diseases, such as: appendicitis,
hernia, gastric and duodenal ulcers, cholecystitis and others. The most
common operations are appendectomy, vagotomy, stomach resection,
cholecystectomy and operations on the thorax and thoracic organs. The
operations are performed under general or local anaesthesia. The
anaesthetist gives the patient anaesthesia and when the patient falls asleep
the surgeon begins to perform the operation. The assistant and surgical
nurses help the surgeon during the operation. They give the necessary
surgical instruments and control the patient’s condition. After the
operation special attention is paid to the postoperative condition of the
patient. The surgeon prescribes a proper treatment and definite diet. Every
day the surgeon makes the morning round, and examines the patients. The
nurse takes the patient’s temperature, dresses the wounds, gives injections,
and fulfills the doctor’s prescriptions.
An emergency department (ED), also known as an accident &
emergency department (A&E), emergency room (ER), emergency ward
(EW) or casualty department, is a medical treatment facility specializing
in emergency medicine, the acute care of patients who present without
prior appointment; either by their own means or by that of an ambulance.
The emergency department is usually found in a hospital or other primary
care centre.
Due to the unplanned nature of patient attendance, the department must
provide initial treatment for a broad spectrum of illnesses and injuries,
some of which may be life-threatening and require immediate attention. In
some countries, emergency departments have become important entry
points for those without other means of access to medical care.
The emergency departments of most hospitals operate 24 hours a day,
although staffing levels may be varied in an attempt to reflect patient
volume.

4. The First aid

First aid is an emergency measure, generally consisting of simple, often
life-saving techniques that most people can train to perform with minimal
equipment and no previous medical experience.
 The term usually refers to administering care to a human, although it
can also be performed on animals.
It is not classed as medical treatment and does not replace interventions
from a trained medical professional.
First aid is a combination of simple procedures and common sense.
The aims of first aid are:
• To preserve life: Saving lives is the main aim of first aid.
• To prevent further harm: The person who has experienced the
injury must be kept stable, and their condition must not deteriorate before
medical services arrive. This may include moving the individual away
from harm, applying first aid techniques, keeping a victim warm and dry,
and applying pressure to wounds to stop any bleeding.
• Promote recovery: Taking steps to promote recovery may include
applying a bandage to a wound.

How to practice first aid

The most common term referred to in first aid is ABC. This stands for
airway, breathing, and circulation. A fourth step will appear in the
emergency procedures for some facilities.
• Airway: Make sure the airway is clear. Choking, which results
from the obstruction of airways, can be fatal.
• Breathing: Once the airways are confirmed to be clear, determine
whether the person can breathe, and, if necessary, provide rescue
breathing.
• Circulation: If the person involved in the emergency situation is
not breathing, the first aider should go straight for chest compressions and
rescue breathing. The chest compressions will promote circulation. This
saves valuable time. In emergencies that are not life-threatening, the first
aider needs to check the pulse.
 • Deadly bleeding or defibrillation: Some organizations consider
dressing severe wounds or applying defibrillation to the heart a separate
fourth stage, while others include this as part of the circulation step.
Evaluating and maintaining ABC with a patient depends on the training
and experience of a first aider. As soon as ABC has been secured, the first
aider can then focus on any additional treatments.
The ABC process must be carried out in that order.
However, there are times when a first aider might be performing two
steps at the same time. This might be the case when providing rescue
breathing and chest compressions to an individual who is not breathing
and has no pulse.
It is important to use a primary survey to make sure the scene is clear
of threats before stepping in to help:
• Danger: Check for dangers to the injured person and yourself. If
there is danger, can it be cleared, or can the individual be moved away
from further harm? If there is nothing you can do, stand clear, and call for
professional help.
• Response: Once it is clear that all danger has ceased, check if the
patient is conscious and alert, ask questions, and see if you get a response.
It is also important to find out whether they respond to your touch and are
aware of their pain.
• Airway: Check whether the airway is clear and, if not, try to clear
it. Have the injured person lying on their back, and then place one hand on
the forehead and two fingers from the other hand on the chin. Gently tilt
the head back while slightly raising the chin upwards. Any obstructions
need to be removed from the mouth, including dentures. Only insert
fingers into the mouth of the injured individual if an obstruction is present.
• Breathing: Is the individual breathing effectively? The first aider
should examine the chest for movement and the mouth for signs of
breathing. Afterward, get close to the person to see if air can be felt on the
cheek from breathing.
The first aider then needs to carry out a secondary survey, checking for
deformities, open wounds, medic alert tags, and swellings.
If the injured person is breathing safely, carry out a rapid whole-body
check for the following:
• openwounds
• deformities
• medical alert tags advising of underlying conditions
• swellings
This is known as a secondary survey. As soon as this has been
completed, place the individual in a recovery position. At this point, the
first aider should call for an ambulance.
Recovery position
Even if the individual is breathing but is unconscious, there is still a
significant risk of airway obstruction. The recovery position reduces the
risk to the patient. A first aider should do the following:
• If the individual is wearing glasses, remove them.
• Kneel next to the person, and place the arm nearest to you at a
right angle to the body.
• Bring the other arm across the chest. Hold the back of your hand
against their nearest cheek.
• With your other hand, hold the thigh furthest from you and pull up
the knee. Makesurethefootisflatontheground.
• Slowly pull down on the raised knee, and roll the body over
towards you.
• Move the upper leg slightly, so that the hip and knee are bent at
right angles. This makes sure that they do not roll onto their face.
• Gently tilt the head back so that the airway is kept open.
 5. Types of Healthcare
Every individual has required different care depending upon his health
problems: some people require common care and others require extra
special care. So on the basis of patients’ condition healthcare is divided
into various types. Following types of healthcare are explained below:
(i) Primary Healthcare:
Primary health care mainly focuses on health equity. Professionals
related to primary care are generalists, dealing with a broad range of
psychological, physical and social problems etc. rather than specialists in
any particular disease area. Primary care services are rapidly increasing in
both developed and developing countries resulting from the increasing
number of adults at greater risk of chronic non-communicable diseases
like diabetes, asthma, back pain, hypertension, anxiety, depression etc.
(ii) Secondary Healthcare:
This healthcare is provided by medical specialists who do not have
direct contact with a patient like urologists, dermatologists, cardiologists
etc. According to National health system policy, the patient requires
primary care professional’s referral to proceed further for secondary care.
The patient cannot directly take secondary care because sometimes health
system imposes a restriction of referral on a patient in terms of payment.
The systems coming under this category are known as District Health
system and County Health system.
(a) District Health system : This system mainly focuses on child health
and maternity care. People population of this system is about 25000 to
50000 and includes various healthcare centers and district hospitals.
Healthcare centers receive referrals from various primary health care
institutions and remain open for 24 hours every day. District hospitals
include emergency services, neonatal care, comprehensive emergency
obstetric etc. and remain open for 24 hours every day.
 (b) County Health system: Into this system, hospitals receive referrals
from the District & community health systems. County hospital provides
gynecologic services, general medicine, obstetrics, general surgery etc.
and remains open for 24 hours every day.
(iii) Tertiary Healthcare:
This type of healthcare is known as specialized consultative healthcare
usually for inpatients and on referral from primary and secondary
healthcare for advanced medical investigation and treatment. Following
examples of tertiary care services are plastic surgery, burn treatment,
cardiac surgery, cancer management, neurosurgery, complex medical and
surgical interventions etc.
The main provider of tertiary care is national Health system consisting
of Regional hospitals and National Hospital. Regional hospitals receive a
reference from various county hospitals and serve as training sites
complementary to the National referral hospital. They also provide
additional care services and remain open for 24 hours every day.

The Heart and the Vascular system

The heart is a hollow muscle located in the thoracic cavity between the
lungs. The heart is responsible for the circulation of the blood. It is known
that the heart is a pump. But it is an extraordinary pump. It weighs only
about a pound but the heart of a healthy 70-kg person pumps about 7200 L
of blood each day at rate of 5 L per minute. If the heart loses its ability to
pump blood for even a few minutes, the life of the individual is in danger.
The heart actually has two pumps. Each pump consists of a pair of
chambers formed by muscles. The contraction of these muscles causes the
blood to be pumped. The lower chamber is called a ventricle and the
upper chamber is called an atrium. The four chambers of the heart are
separated by valves. Between the right atrium and the right ventricle there
is a one-way valve, called the tricuspid valve. The valve that separates the
left atrium from the left ventricle is called the mitral (or bicuspid) valve.
The left ventricle is separated from the right ventricle by the
interventricular septum. Venous blood from body flows through the
superior vena cava and inferior one into the right atrium, then through the
tricuspid valve into the right ventricle. The right ventricle pumps blood
through the pulmonary valve, via the pulmonary arteries, into the lungs.
From the lungs, blood enters the left atrium via the pulmonary veins and
flows through the mitral valve into the left ventricle. The left ventricle
pumps oxygen-enriched blood through the aortic valve into the aorta for
delivery to the body’s tissues. The tissue of the heart consists of three
layers. The exterior layer is the thin epicardium. The middle layer is the
myocardium, the heart muscle itself (from the Greek myo for "muscle"
and kardia for "heart"). The inner lining of the heart is the endocardium, a
thin, smooth structure. The pericardium is a fibrous sac that surrounds the
heart. In the space between the pericardium and the epicardium there is a
small amount of fluid. The heart rate varies depending on activity at any
given moment. The control mechanism for the heart rate involves
electrical impulses. One of the four chambers of the heart, the right
atrium, contains a group of cells called the sinus node. The sinus node
produces electrical impulses that signal the muscle of the heart to contract
in the pumping cycle. When a person is at rest, the heart pumps more
slowly and at a regular rate, about 60 to 80 beats per minute. When a
person runs, climbs stairs, or otherwise exert yourself, the sinus node
issues electrical “instructions” to increase the pace of the heart in order to
provide the muscles and other tissues with the necessary additional blood
and its supply of oxygen. The heart rate may increase up to 200 beats per
minute if you exert yourself strenuously. The heart rate may be affected
by various factors including tobacco use, caffeine-containing foods,
alcohol, and a number of drugs. In addition, the cardiac disorders may
produce heart rate problems.
 The vascular system consists of blood vessels. They carry blood from
the heart to all parts of the body. Blood vessels can be classified as
capillaries, arteries and veins. Arteries normally are classified as elastic
arteries, muscular arteries, and arterioles. The veins are classified as
venules, small veins, and medium-sized and large veins. The vessels
become smaller as they extend farther from the heart. The aorta (large
elastic artery) delivers blood to the large arteries. They, in turn, branch off
several times and eventually blood flows into smaller vessels called
arterioles. The arterioles supply the tiny capillaries (minute blood vessels)
that nourish tissue. Oxygen is given up from capillaries to the tissues, and
carbon dioxide from the tissue is taken up into the capillaries. The arteries
have to be strong as well as flexible. From the capillaries, the blood begins
its trip back to the heart by way of the venous system. The veins increase
in size closer to the heart. As part of circulation, the blood travels through
the liver and kidneys, which remove waste products. The veins, under less
pressure, are less muscular and less elastic than arteries. The entire
circulatory system is lined with simple squamous epithelium called
endothelium. Capillaries consist only of endothelium. The capillary walls
consist of endothelial cells, which rest on a basement. Venules are tubes
composed of endothelium resting on a delicate basement membrane. Their
structure is very similar to that of capillaries. The venules collect blood
from the capillaries and transport it to the small veins, which in turn
transport it to the medium-sized veins. Except for capillaries and venules,
blood vessels have three layers: the inner tunica intima (consisting of
endothelium, basement membrane, and internal elastic lamina), the tunica
media (containing circular smooth muscle and elastic fibers), and the outer
tunica adventitia (which is connective tissue). The relative thickness and
composition of each layer varies with the diameter of the blood vessel and
its type. The transition from one artery type or from one vein type to
another is gradual, as are structural changes. Vessels transporting blood
through essentially all parts of the body from the left ventricle and back to
the right atrium are called the systemic vessels. The pulmonary vessels
transport blood from the right ventricle through the lungs and back to the
left atrium.
The Lungs

I. Overview

The lungs are the center of the respiratory (breathing) system.

Every cell of the body needs oxygen to stay alive and healthy.
Your body also needs to get rid of carbon dioxide. This gas is a
waste product that is made by the cells during their normal,
everyday functions. Your lungs are specially designed to
exchange these gases every time you breathe in and out.

Let’s take a closer look at this complex system.

II. Lung anatomy

This spongy, pinkish organ looks like two upside-down cones in

your chest. The right lung is made up of three lobes. The left
lung has only two lobes to make room for your heart.

The lungs are the principal organs of respiration. They occupy

the major part of the cavity on both sides of the chest. The two
lungs are not equal in size. The right lung is divided into three
lobes and is a bit larger. The left lung is divided into two lobes.
The lobes are separated by deep, prominent fissures on the
surface of the lung. Each lobe is divided into lobules that are
separated from each other by connective tissue. The primary
bronchi divide into secondary bronchi as they enter their
respective lungs. The point of entry for the bronchi, vessels, and
nerves in each lung is called the hilum, or root, of the lung. The
secondary bronchi, two in the left lung and three in the right
lung, conduct air to each lobe. The secondary bronchi, in turn,
give rise to tertiary bronchi, which extend to the lobules. The
bronchial tree continues to branch several times, finally giving
rise to bronchioles. The bronchioles 14 also subdivide numerous
times to become terminal bronchioles, which then divide into
respiratory bronchioles. Each respiratory bronchiole divides to
form alveolar ducts that end as clusters of air sacs called alveoli.
An alveolar sac is composed of two or more alveoli. Each lung
is surrounded by a separate pleural cavity, attached only along
its medial border at the hilum. Each pleural cavity is lined with a
serous membrane called the parietal pleura. At the hilum the
parietal pleura becomes continuous with a serous membrane, the
visceral pleura, which covers the surface of the lung. The pleural
cavity is filled with pleural fluid that is produced by the pleural
membranes. The pleural fluid performs two functions: it acts as
a lubricant, allowing the pleural membranes to slide past each
other as the lungs and thorax change shape during respiration;
and it helps hold the pleural membranes together. Deoxygenated
blood is transported to the lungs through the pulmonary arteries,
and oxygenated blood leaves through the pulmonary veins.
Oxygenated blood is mixed with a small amount of
deoxygenated blood returning from the bronchi.

Bronchial tree

The lungs begin at the bottom of your trachea (windpipe). The

trachea is a tube that carries the air in and out of your lungs.
Each lung has a tube called a bronchus that connects to the
trachea. The trachea and bronchi airways form an upside-down
“Y” in your chest. This “Y” is often called the bronchial tree.

The bronchi branch off into smaller bronchi and even smaller

tubes called bronchioles. Like the branches of a tree, these tiny
tubes stretch out into every part of your lungs. Some of them are
so tiny that they have the thickness of a hair. You have almost
30,000 bronchioles in each lung.

Each bronchiole tube ends with a cluster of small air sacs

called alveoli(individually referred to as alveolus). They look
like tiny grape bunches or very tiny balloons. There are about
600 million alveoli in your lungs. The small bubble shapes of
the alveoli give your lungs a surprising amount of surface area
— equivalent to the size of a tennis court. This means there’s
plenty of room for vital oxygen to pass into your body.

SUMMARY Each lung is divided into lobes. The bronchial tree

running through your lungs is made up of the windpipe, bronchi,
bronchioles, and alveoli.

III. The respiratory system

The lungs are the main part of the respiratory system. This
system is divided into the upper respiratory tract and the
lower respiratory tract.

The upper respiratory tract includes the:

 Mouth and nose. Air enters and leaves the lungs through

the mouth and nostrils of the nose.
 Nasal cavity. Air passes from the nose into the nasal
cavity, and then the lungs.
 Throat (pharynx). Air from the mouth is sent to the lungs
via the throat.
 Voice box (larynx). This part of the throat helps air to pass
into the lungs and keeps out food and drink.

The lower respiratory tract is made up of the:

 lungs
 trachea (windpipe)
 bronchi
 bronchioles
 alveoli

Other parts of the respiratory system help your lungs to expand

and contract as you breathe. These include the ribs around the
lungs and the dome-shaped diaphragm muscle below them.

IV. How your lungs work

WHAT IS RESPIRATION? Respiration is made up of two
phases called inspiration and expiration: You inhale (breathe in)
oxygen during inspiration. You exhale (breathe out) carbon
dioxide during expiration.

The pathway of a breath

When you breathe, air enters through your mouth and nose and
travels:

 down the throat into the trachea

 into the lungs through the right and left main bronchi
 into the smaller bronchi airways
 into the even smaller bronchiole tubes
 into the alveoli

Each alveolus is covered by a net of tiny blood vessels called

capillaries. Oxygen and carbon dioxide exchange happens here.
Your heart sends deoxygenated blood to the lungs. This is blood
that is carrying carbon dioxide rather than oxygen.
As the blood passes through the tiny, thin-walled capillaries,
they get oxygen from the alveoli. They return carbon dioxide
through the thin walls to the alveoli.

The oxygen-rich blood from your lungs is sent back to your

heart, where it’s pumped to your entire body. The carbon
dioxide is breathed out of the lungs and alveoli through your
mouth and nose.

V. How your lungs stay healthy

The alveoli stay partly inflated like a balloon even when you
exhale air. Your lungs make a fluid called surfactant to help
them stay open. Surfactant also contains fatty proteins that help
keep the lungs healthy.

Your lungs are self-cleaning.

They make mucus to trap germs and particles. The mucus is

then swept up by cilia, small hairs that line the airways.
Normally, you swallow this mucus without noticing. If you have
a respiratory illness, your lungs may make too much mucus.

The alveoli also contain immune cells called macrophages.

These cells “eat” germs and irritants before they can cause an
infection in your lungs.

DIGESTIVE SYSTEM
The digestive system consists of many parts. They are the oral
cavity, esophagus, stomach, small and large intestines, the liver,
the pancreas, gallbladder and others. The food we eat is
propelled through the digestive tract by muscular contractions.
The digestive tract is also called the alimentary tract or
alimentary canal. The term gastrointestinal tract technically only
refers to the stomach and intestines but is often used as a
synonym of the digestive tract. The first division of the digestive
tract is the mouth, or oral cavity. Important structures of the oral
cavity are the teeth, the tongue, the soft and hard palates, and
salivary glands. Digestion begins when the person chews the
food. The food is broken into smaller pieces by the teeth and is
mixed with saliva secreted by the salivary glands. From the
mouth food passes through the pharynx to the esophagus. The
major accessory structures of the pharynx and the esophagus are
mucous glands. The esophagus opens into the stomach. It rests
in the upper abdomen. It is a dilated portion of the digestive
tract. The stomach receives food from esophagus, and its mixing
action reduces the food to a semi-liquid mixture. The stomach
walls contain many glands from which acid and enzymes are
released into the stomach and mixed with ingested food. The
stomach opens into the small intestine. The small intestine is a
thin-walled tube approximately 6.5 meters long. It is located in
the lower and central portions of the abdominal and pelvic
cavities. It is composed of the duodenum, jejunum, and ileum.
The first segment of the small intestine is the duodenum. The
major accessory structures in this segment of the digestive tract
are the liver, the gallbladder, and the pancreas. The next
segment of the small intestine is the jejunum. Small glands exist
along its length, and it is the major site of absorption. The last
segment of the small intestine is the ileum, which is similar to
the jejunum except that fewer digestive enzymes and more
mucus are secreted and less absorption occurs in the ileum. The
last section of the digestive tract is the large intestine. It is
divided into cecum, colon, and rectum. Its major accessory
glands secrete mucus. It absorbs water and salts and
concentrates indigested food into feces. The first segment is the
cecum, with the attached vermiform appendix. The cecum is
followed by colon and rectum. The rectum joints the anal canal,
which ends at the anus.
The functions of the digestive system are to ingest food,
masticate the food, propel the food through the digestive tract,
add secretions to the food and digest the food; and absorb water,
electrolytes, and other nutrients from the digested food. Once
these useful substances are absorbed, they are transported
through the circulatory system to cells where they are used.
Undigested matter is moved out of the digestive tract and
excreted through the anus. The processes of propulsion,
secretion, and absorption are regulated by nervous and hormonal
mechanisms.

DIGESTIVE SYSTEM
The digestive system consists of many parts. They are the oral
cavity, esophagus, stomach, small and large intestines, the liver,
the pancreas, gallbladder and others. The food we eat is
propelled through the digestive tract by muscular contractions.
The digestive tract is also called the alimentary tract or
alimentary canal. The term gastrointestinal tract technically only
refers to the stomach and intestines but is often used as a
synonym of the digestive tract. The first division of the digestive
tract is the mouth, or oral cavity. Important structures of the oral
cavity are the teeth, the tongue, the soft and hard palates, and
salivary glands. Digestion begins when the person chews the
food. The food is broken into smaller pieces by the teeth and is
mixed with saliva secreted by the salivary glands. From the
mouth food passes through the pharynx to the esophagus. The
major accessory structures of the pharynx and the esophagus are
mucous glands. The esophagus opens into the stomach. It rests
in the upper abdomen. It is a dilated portion of the digestive
tract. The stomach receives food from esophagus, and its mixing
action reduces the food to a semi-liquid mixture. The stomach
walls contain many glands from which acid and enzymes are
released into the stomach and mixed with ingested food. The
stomach opens into the small intestine. The small intestine is a
thin-walled tube approximately 6.5 meters long. It is located in
the lower and central portions of the abdominal and pelvic
cavities. It is composed of the duodenum, jejunum, and ileum.
The first segment of the small intestine is the duodenum. The
major accessory structures in this segment of the digestive tract
are the liver, the gallbladder, and the pancreas. The next
segment of the small intestine is the jejunum. Small glands exist
along its length, and it is the major site of absorption. The last
segment of the small intestine is the ileum, which is similar to
the jejunum except that fewer digestive enzymes and more
mucus are secreted and less absorption occurs in the ileum. The
last section of the digestive tract is the large intestine. It is
divided into cecum, colon, and rectum. Its major accessory
glands secrete mucus. It absorbs water and salts and
concentrates indigested food into feces. The first segment is the
cecum, with the attached vermiform appendix. The cecum is
followed by colon and rectum. The rectum joints the anal canal,
which ends at the anus.
The functions of the digestive system are to ingest food,
masticate the food, propel the food through the digestive tract,
add secretions to the food and digest the food; and absorb water,
electrolytes, and other nutrients from the digested food. Once
these useful substances are absorbed, they are transported
through the circulatory system to cells where they are used.
Undigested matter is moved out of the digestive tract and
excreted through the anus. The processes of propulsion,
secretion, and absorption are regulated by nervous and hormonal
mechanisms.
TISSUES
Cells are grouped into tissues, and each tissue type is specialized
to perform specific functions. The four basic tissue types are
epithelial, connective, muscular, and nervous tissues. Epithelial
and connective tissues are the most diverse of the four tissue
types and are components of every organ. They are classified
according to the structure. Muscular and nervous tissues are
defined mainly according to their functions. Epithelium consists
of cells that have very little extracellular material between them.
Epithelium covers surfaces, e.g., the outside of the body and the
lining of the digestive tract, the vessels and many body cavities.
It also forms structures, e.g., glands. Most epithelia have
basement membranes. The basement membrane is a specialized
type of extracellular material. It is secreted by the epithelial cells
and attaches the epithelium to the underlying tissues. Blood
vessels do not penetrate the basement membrane to reach
epithelium. Epithelia are classified according to the number of
cell layers and the shape of the cells. Connective tissue consists
of cells separated from each other by nonliving extracellular
matrix. The extracellular matrix results from the activity of
specialized connective tissue cells. Connective tissue is
classified according to the type of protein and proportions of
protein and fluid in the matrix. Connective tissue is subdivided
into adipose tissue (fat), fibrous connective tissue, bone, and
blood. Connective tissue forms the dermis of the skin, inner
portion of the skin, bones, tendons, ligaments, the walls of large
arteries, bone marrow, liver and others. Blood is somewhat
unique among the connective tissues because the matrix
between the cells is liquid. Thus, although the cells of most
other connective tissues are more or less stationary within a
relatively rigid matrix, blood cells are free to move within a
fluid matrix. Muscular tissue has the ability to contract. The
three types of muscular tissue – skeletal, cardiac, and smooth
muscle – are classified according to both structure and function.
Skeletal (striated voluntary) muscles attach to bone and are
responsible for body movement. Cardiac (striated involuntary)
muscles are responsible for pumping blood through the
circulatory system. Smooth (nonstriated involuntary) muscles
form the walls of hollow organs, the pupil of the eye, and other
structures. Nervous tissue is characterized by the ability to
conduct electrical signals. It consists of neurons, or nerve cells,
which are responsible for conductive ability, and support cells
(neuroglia). Neuroglia (nerve glue) is the support cells of the
brain, spinal cord, and peripheral nerves.
Epithelial tissue is necessary for protection, diffusion, filtration,
secretion, absorption and others. Simple epithelium with its
single layer of cells is found in organs in which the principal
functions are diffusion (lungs), filtration (kidneys), secretion
(glands), or absorption (intestines). The selective movement of
materials through epithelium would be hindered by a stratified
epithelium, which is found in areas where protection is a major
function. The multiple layers of cells in stratified epithelium are
well adapted for a protective role. Damaged cells are replaced
by cells from deeper layers and a continuous barrier of epithelial
cells is maintained in the tissue. Stratified squamous epithelium
is found in areas of the body where abrasion can occur such as
the skin, mouth, throat, esophagus, and anus. Cells involved in
diffusion and filtration are normally flat and thin. For example,
simple squamous epithelium forms blood and lymph capillaries,
the alveoli of the lungs, and parts of the kidney tubules.
Connective tissue is found in tendons, ligaments, cartilages,
bones, dermis of skin, arteries, spleen and others. This tissue
produces new blood cells, allows growth of long bones,
connects different structures, provides great strength and support
for bones, transports oxygen, carbon dioxide, hormones,
nutrients, waste products and has some other functions.
Muscular tissue has the ability to contract. Muscles contract to
move the entire body, to pump blood through the heart and
blood vessels, and to decrease the size of hollow organs such as
the stomach. Skeletal muscles represent a large portion of the
human body's total weight. Skeletal muscle attaches to the
skeleton and by contracting causes the major body movements.
Cardiac muscle is the muscle of the heart. The contraction of the
cardiac muscle is responsible for pumping blood. Smooth
muscles are widespread throughout the body and are responsible
for a wide range of functions such as movements in the
digestive, urinary, and reproductive systems. Nervous tissue
conducts impulses all over the body. Nerve cells, or neurons,
located in the brain, spinal cord, and cell processes, conduct not
only impulses and store "information", and in some ways
integrate and evaluate data. Neuroglia support neurons and form
a selectively permeable barrier between neurons and other cell
types.
DRUGS
Everyone knows that medicines, or drugs are chemical
substances used to make you feel better when you are sick.
These chemical substances can come from many different
sources. Drugs are obtained from various parts of plants, such as
the roots, leaves, and fruit. Examples of such drugs are digitalis
(from the foxglove plant), and antibiotics such as penicillin and
streptomycin (from plants called molds). Drugs can also be
obtained from animals; for example, hormones are secretions
from the glands of animals. Drugs can be made from the
chemical substances which are synthesized in the laboratory.
Some drugs are contained in food substances; these drugs are
called vitamins. Every drug must have a nonproprietary name,
that is, a name that is available for each manufacturer of it to
use. These names are commonly called “generic names”.
Manufacturers often coin brand names to use in promotion of
their particular product. In general, brand names are shorter and
easier to use than the corresponding generic names. The route of
administration of a drug (how it is introduced into the body) is
very important in determining the rate and completeness of its
absorption into the bloodstream and speed and duration of the
drug’s action in the body. There are many routes of drug
administration. They are oral administration (by mouth); buccal
administration (a medicine is placed in the cheek pocket and
slowly absorbed); sublingual administration (for general effects
throughout the body, when a medicine is placed under the
tongue and slowly absorbed); rectal administration (for local and
in some cases systemic effects, when it is used in the rectum);
vaginal administration (for local and in some cases systemic
effects when used in the vagina); parenteral administration (in
the form of injection); inhalation (for local, and in some cases
systemic effects, when inhaled into the lungs); and topical
application (for local effects, when it is applied directly to the
skin). The dosage forms are the following: tablets, solutions,
capsules (for oral administration); suppositories (for rectal
administration); subcutaneous, intradermal, intramuscular,
intravenous, intrathecal, and intracavitary injections (for
parenteral administration); aerosols (for inhalation); lotions,
creams, and ointments (for topical application).
DRUG CLASSES. All drugs are grouped into several classes
depending on their pharmacological effects on the body, target
organs or systems, etc. For example, there is a wide variety of
cardiovascular drugs, gastrointestinal drugs,
neuropharmacological drugs, antibiotics, neoplastic drugs,
hormones, and others. Cardiovascular drugs may be divided into
three groups; drugs that affect the heart; drugs that affect blood
pressure; and drugs that prevent blood clotting. There is a wide
variety of gastrointestinal drugs. They have different
pharmacological activities and are used mainly to relieve
uncomfortable and potentially dangerous symptoms, rather that
as cures for diseases. Antibiotics are chemical substances
produced by microorganisms. Antibiotics have been synthesized
in the laboratory and are used to treat serious bacterial
infections. Neuropharmacological drugs act on the nervous
system. There are two major types of neuropharmacological
drugs: autonomic and central nervous system drugs.
Antihistamines are drugs, which block the action of chemicals
called histamines, which are found in the body. Histamine is
produced by most cells and especially by sensitive cells under
the skin and in the respiratory system. Antihistamines can
relieve the allergic symptoms, which histamine produces.
Vitamins are necessary for normal body functioning. They play
an important role in the metabolic processes of the body. The
other categories into which most of the commonly prescribed
medications are divided are the following: Analeptics: pain-
relieving drugs; Antacids (Antiacids): drugs used for relief of
symptoms of indigestion or disorders caused by excess acid.
These medications work to neutralizing stomach acids;
Antiarrhythmics: medications used to control unwanted
variations in heart rhythms; Anticoagulants: drugs prescribed to
prevent blood from clotting; Antidepressants: mood-lifting
drugs; Antidiabetic agents: drugs used in the treatment of
diabetes. Antidiabetics drugs are used to restore the body’s
ability to use sugar normally; Antifungals: drugs used to treat
infections caused by fungi; Antihypertensives: medications
prescribed to reduce high blood pressure; Anti-inflammatory
agents: drugs used to reduce inflammation; Antipyretics: fever-
reducing drugs. These drugs directly affect the temperature-
regulating centre in the brain and the hypothalamus; Antivirals:
drugs used to treat viral infections; Bronchodilators: drugs that
open (dilate) the main airways (bronchi) in the lungs. They are
primarily used to treat asthma; Corticosteroids are used
principally as anti-inflammatory drugs; Cough suppressants:
they are used to suppress cough; Diuretics: these drugs increase
the volume of urine and salt released by the kidneys; Hypnotics:
sleeping medications; Laxatives: constipation drugs; Nitrates:
heart drugs. They may increase blood flow through the coronary
arteries and often are used in patients with angina; Vasodilators:
heart drugs. These medications stimulate the arteries of the heart
to enlarge. They are used to treat angina pectoris or lower blood
pressure.
VITAMINS
Vitamins are substances that are essential in certain chemical
transformations in the human body. They help the body process
proteins, carbohydrates, and fats. Certain vitamins also
contribute to the production of blood cells, hormones, genetic
material, and chemicals of the nervous system. Vitamins exist in
minute quantities in food. Most vitamins cannot be produced by
the body and must be obtained through the diet. Since no single
food item or nutrient class provides all the essential vitamins, it
is necessary to eat a variety of foods. For example, vitamin A is
needed for the eyes and to keep the linings of the bronchial,
urinary, and intestinal tracts healthy; vitamin C is needed for the
development of bones, teeth, blood vessels, and other tissues;
vitamin K is necessary for blood clotting; and vitamin D is also
needed for the development of bones and teeth. The principal
vitamins are: vitamin A, vitamin B1, vitamin B2, pantothenic
acid (part of the B2 complex), vitamin B3, vitamin B6, folic
acid, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin H
(often considered part of the B-vitamin group), and vitamin K.
Some vitamins (e.g., vitamin K) are produced by intestinal
bacteria, and a few can be formed by the body from substances
 called provitamins (portions of vitamins that can be assembled
or modified by the body into functional vitamins). Carotene is
an example of a provitamin that can be modified by the body to
form vitamin A. Vitamins are used by the body in their original
or slightly modified forms. Once the chemical structure of a
vitamin is destroyed, its function is usually lost. The chemical
structure of many vitamins is destroyed by heat (e.g., when food
is overcooked). There are two major classes of vitamins: fat
soluble and water soluble. Fat-soluble vitamins such as vitamins
A, D, E, and K are absorbed from the intestine along with lipids,
and some of them can be stored in the body for a long period of
time. Because they can be stored, it is possible to accumulate an
overdose of these vitamins in the body (hypervitaminosis) to the
point of toxicity. Water-soluble vitamins such as the B complex
and C are absorbed with water from the intestinal tract and
remain in the body only a short time before excreted. The
absence of a specific vitamin in the diet can result in a specific
deficiency disease.

Cлова:
1. margin край
2. navel пупок
3. neck шия
4. jaw щелепа
5. skull череп
6. size розмір
7. coccyx куприк
8. forearm передпліччя
9. bone кістка
10. thumb великий палець (руки)
11. ligament зв’язка
12. breathe дихати
13. elbow лікоть
14. chest грудна клітка
15. cheekbone вилична кістка
16. shape форма
17. temple скроня
18. hand кисть руки
19. femur стегнова кістка
20. breastbone грудна кістка
21. smell відчувати запах
22. shin-bone велика гомілкова кістка
23. calf литка
24. cranial черепний
25. ankle щиколотка
26. joint суглоб
27. lower limb нижня кінцівка
28. toe палець (ноги)
29. adult доросла людина
30. heel п’ята
31. abdominal черевна порожнина
cavity хрящ
32. cartilage живіт
33. belly палець (руки)
34. finger зуб
35. tooth хребет
36. spine хребець
37. vertebra вухо
38. ear захищати
39. protect мізинець
40. pinky тулуб
41. trunk рот
42. mouth колінна чашечка
43. knee-cap ділитись на
44. be divided into поперековий
45. lumbar шийний
46. cervical обмежувати, закривати
47. enclose складатись з
48. consist of плече
49. upper arm язик
50. tongue

1. adjacent a. прилеглий
2. breakdown b. розчеплення
3. connective tissue c. сполучна тканина
4. lamellar bone d. ламелярна кістка
5. filament e. волокно
6. junction f. з’єднання
7. walls of blood vessels g. стінки кровоносних
8. latticework судин
9. trigger h. гратчаста конструкція
10. smooth muscle i. викликати
11. arrangement j. гладкий м’яз
12. bind k. упорядкування
13. chain l. зв’язувати
14. hollow m. ланцюг
15. interdigitate n. порожнистий
16. constituent o. переплітатися
17. undergo p. складова
 18. transverse q. зазнавати (впливу)
19. similarity r. поперечний
20. flat s. подібність
t. плоский

treat patients лікувати пацієнтів

health care охорона здоров'я
specialized staff кваліфікований персонал
equipment обладнання
be admitted to hospital поступити до лікарні
provide outpatient services забезпечити амбулаторні
urgent care послуги
delivery невідкладна допомога
emergency department постачати
unscheduled відділення невідкладної
injury допомоги
require immediate care позаплановий
life support травма
mental disorder потребувати негайної
specialize in допомоги
outpatient therapy життєзабезпечення
nurse психічний розлад
physician спеціалізуватися з
available амбулаторне лікування
acute медична сестра
surgery лікар; терапевт
obstetrics доступний, наявний
undergo physical therapy нагальний, гострий
health condition хірургія; хірургічна операція
twenty-four-hour basis акушерство
проходити фізіотерапію
стан здоров’я
цілодобово
conscious притомний
open wounds відкриті рани
injured травмований
make sure переконатись
carry out виконати, здійснити
ambulance машина швидкої допомоги
obstruction непрохідність;перешкода
alert жвавий, при тямі
reduce the risk зменшити ризик
swelling набряк
survey огляд, оглядання
signs of breathing ознаки дихання
bend at right angles зігнути під прямим кутом

anxiety патологічний стан тривоги

relate to  стосуватися (чогось)
additional додатковий
receive a reference отримати рекомендації,
serve довідку
tertiary care слугувати
provide центри навчання
tertiary care забезпечити
burn treatment медична допомога третього
advanced medical рівня
investigation лікування опіків
impose a restriction передове медичне
maternity care дослідження
накладати обмеження
non-communicable disease піклування в період
surgical interventions вагітності і пологів
незаразна хвороба
хірургічне втручання
blood vessels кровоносні судини
deliver доставляти
ventricle шлуночок
venules маленькі вени
supply постачати
heart rate частота серцевих скорочень
valve клапан
enriched збагачений
lamina тонка пластинка
flexible гнучкий
thickness товщина
minute крихітний
atrium передсердя
remove waste products виводити відходи
cardiac disorders розлади серця

air flow потік повітря

exhale видихати

cause викликати

inflamed запальний

line вистилати

tiny крихітний

lobe частка

breathe дихати

contract скорочуватись

include включати

gallbladder жовчний міхур

major основний
bile duct жовчна протока
heat production вироблення тепла
harmful substances шкідливі речовини
injured tissue пошкоджена тканина
perform functions виконувати функції
repair відновлювати
sac мішечок
connective tissue сполучна тканина
attach прикріплювати(сь)
multiple layer багаторівневий шар
stratified стратифікований
cover покривати
conduct impulses проводити імпульси
occur відбуватися
permeable проникний
pupil зіниця
fluid рідина

prevent запобігти

solution розчин

dangerous symptoms небезпечні симптоми

blood clotting згортання крові

prescribe прописувати

relief полегшення

suppress cough зупинити кашель

unwanted небажаний
anti-inflammatory drugs протизапальні ліки

obtain отримувати

substances речовини

essential важливий, необхідний

development розвиток

store накопичувати

nutrient поживна речовина

remain залишатися

fat-soluble vitamins жиророзчинні вітаміни

water soluble водорозчинний

deficiency дефіцит

destroy руйнувати
Правила
Prepositions
We commonly use prepositions to show a relationship in space
or time or a logical relationship between two or more people,
places or things. Prepositions are most commonly followed by a
noun phrase or pronoun (underlined):
The last time I saw him he was walking down the road.

nea
about beside to
r

betwee
above of towards
n

across beyond off under

underneat
after by on
h

agains ont
despite unlike
t o

Although most prepositions are single words, some pairs and

groups of words operate like single prepositions:
They were unable to attend because of the bad weather in
Ireland.
The most common prepositions that consist of groups of words
are:
ahead of except for instead of owing to

apart in addition
near to such as
from to

on account thanks
as for in front of
of to

Prepositions and adjectives

We commonly use prepositions after adjectives. Here are the
most common adjective + preposition patterns.

adjectives preposition

aware, full of They weren’t aware of the time.

different, Is French very different

from from Spanish?
separate

This picture is similar to the one

due, similar to in our living room.

Prepositions and verbs

Many verbs go together with prepositions to make prepositional
verbs. These always have an object:
I just couldn’t do without my phone.
Robert accused her of stealing his idea.
Phrasal-prepositional verbs contain a verb, an adverb particle
and a preposition (underlined). We cannot separate the particle
and the preposition:
The taxi is due any minute. Can you listen out for it?
I can’t put up with this noise any longer.
Prepositions: position
Traditional grammatical rules say that we should not have a
preposition at the end of a clause or sentence. However, we
sometimes do separate a preposition from the words which
follow it (its complement). This is called preposition stranding,
and it is common in informal styles:

The Present Simple

The present tense is the base form of the verb:

But with the third person singular (she/he/it), we add an –s:

Present simple questions

We use do and does to make questions with the present simple.
We use does for the third person singular (she/he/it) and do for
the others before a subject. But questions with who don't
use do or does:

Present simple negatives

We use doesn't for the third person singular (she/he/it)
and don't for the others to make negatives with the present
simple.

We use the Simple Present to express a fact which stays the

same for a long time (a sate). We use the Simple Present to
express the idea that an action is repeated or usual. The action
can be a habit, a hobby, a daily event, or something that often
happens.

Adverbs of frequency

Adverbs of Frequency answer the question "How often?" or

"How frequently?" They tell us how often somebody does
something. They can occupy different positions in the sentence.
With most verbs, the normal position is between the subject and
the verb. With the verb "to be", the adverb normally comes after
the verb:

 Pedro occasionally visits us on Sundays.

 We usually go shopping on Saturday.
 I have often done that.
 Occasionally, sometimes, often, frequently and usually can
also go at the beginning or end of a sentence:
 Rarely and seldom can also go at the end of a sentence
(often with "very"):


Simple Present is used to talk about scheduled events in the

near future (e.g. public transportation, TV programs, timetables,
etc.)

We sometimes use the Simple Present to express the idea or an

action that is happening or is not happening now. This can only
be done with Statal Verbs certain Mixed Verbs.
Examples:

THE PAST SIMPLE

FORM
[VERB+ed] or irregular verbs
We use the Simple Past to express the idea that an action
started and finished at a specific time in the past. Sometimes, the
speaker may not actually mention the specific time, but they do
have one specific time in mind.

We use the Simple Past to list a series of completed actions

in the past.

The Simple Past can also be used to describe a habit which

stopped in the past. It can have the same meaning as "used to."
To make it clear that we are talking about a habit, we often add
expressions such as: always, often, usually, never, when I was a
child, when I was younger, etc.
The Simple Past can also be used to describe past facts or
generalizations which are no longer true.

THE PRESENT PERFECT

FORM
[has/have + past participle]

We use the Present Perfect to say that an action happened at an

unspecified time before now. The exact time is not important.
We CAN use the Present Perfect with unspecific expressions
such as: ever, never, once, many times, several times, before, so
far, already, yet, etc
TOPIC 1 Experience
You can use the Present Perfect to describe your
experience. It is like saying, "I have the experience of..." You
can also use this tense to say that you have never had a certain
experience. The Present Perfect is NOT used to describe a
specific event.
TOPIC 2 Change over time
We often use the Present Perfect to talk about change that
has happened over a period of time.
TOPIC 3 Achievements
We often use the Present Perfect to list the
accomplishments of individuals and humanity. You cannot
mention a specific time.

With Statal uses of Mixed Verbs, we use the Present

Perfect to show that something started in the past and has
continued up until now. "For five minutes," "for two weeks,"
and "since Tuesday" are all durations which can be used with
the Present Perfect.
The Present Perfect is often used with:
for, since, ever, never, already, recently, lately, in the last
decade, at last, just, so far, yet
Yet is usually placed at the end of the sentence.