Ebook English for nursing and health care: Part 2

UNIT

THE HUMAN BODY
Inside and Out


3A
U N IT

------------------------------------------------- ®

----------------------

LEVELS OF ORGANISATION
£Q
E veryone is in te rested in th e h u m a n [hju:man]
body, w hat happens w hen it is affected by disease
[dazi:z] and how to stay healthy [heiei]. A rticles on
h ealth and m edicine appear daily in newspapers
and m agazines. O rd in a ry people w ho are n o t
specifically train ed in science are freq u en tly
asked to m ake decisions o n scientific m atters
w hich affect society.
T h e scientific [saian'tifikl term for th e study of
body stru c tu re is anatom y |on'a?tomi|. Part of this
word m eans to ‘c u t’ because early an ato m ists
dissected (cut) the hum an body to learn about

its stru ctu re. T h e p ractice of any h e a lth care
professional requires a basic u n d e rstan d in g of
a n ato m y a n d m ost an ato m ic d a ta

o b tain e d

th ro u g h

th e

use

of

is now

c o m p u te d

tom ography, m agnetic resonance im aging and
p o sitro n em issio n to m o g ra p h y , ra th e r th a n
through experim ental studies.
Physiology [fiziWadji] is th e study of how body

p a rts fu n c tio n , including th e ir chem ical and
physical processes. A natom y and physiology are
closely related. A n y th in g th a t d isturbs th e
no rm al w orking o f th e body is co n sid ered a
disease |dazi:z] and is studied as th e science of
pathology [paB'oladjil.

A ll living things are organised from very simple
levels to m ore com plex levels. L iving m a tte r
begins w ith sim ple ch em icals [kemikalzl w hich
are form ed in to th e com p lex substances th a t

m ake living cells, w hich are th e basic u n its of
life |l,iif|. G ro u p s of specialised cells form tissues
and differen t tissues fu n c tio n to g eth e r to form
o rg a n s. V arious organs fu n c tio n to g e th e r to
m,ike up th e system s ot the h u m an body.
All the human sciences study different aspects of
th e hum an body, its structure and function, its
b e h av io u r

and

its

a sso c iatio n

w ith

its

Dover Pictorial Archive Serie> 11982) - Margaret Mitt Human
Anatomv Coloring IWk


e n v iro n m e n t. To study th e awesom e com p lex ities of the
hum an body, it is necessary to break it dow n into sections
th a t can be exam ined in detail, rem em bering th a t all the
parts must interact w ith one a n o th er successfully to ensure
our survival.
To study different parts of the body, we can divide the body
in various ways to give us po sitio n or lo ca tio n . G e n era l

divisions are th e head, the th o rax , the abdom en, th e pubes
and the lim bs o r extrem ities.
Diagram s are show n w ith th e figure sta n d in g in the
anatom ical p o sitio n unless stated otherw ise. T h e pictures
show figures in th e anatom ical position w ith hands facing
the front and feet slightly apart.
NB S tanding in this way, the anatom ical right is on th e left
of the diagram and the anatom ical left is on your right!
T h e hum an body is marvellously com plex and it is amazing
how well it works m ost of the tim e. How does it start and
how does it develop?
T h e h u m an gam etes or germ cells are th e ova (p i.) ovum
(s .)

in

th e

fem ale

and

th e

sp e rm

cells

(sperm ato zo a/sp erm ato zo o n ) in the m ale. M eiosis occurs
during th eir form ation (oogenesis) w hen these germ cells

d evelop w ith a haploid number (h a lf th e n u m b er) of
chromosomes. A ll o th e r cells in the body c o n tain th e full num ber of chrom osom es and are called
diploid cells.

During fe rtilisa tio n , th e 2 hap lo id cells fuse to g eth er and becom e a zygote w ith the com plete
num ber of chrom osom es, so a fem ale germ cell + m ale germ cell = zygote = the beginnings of a
hum an life.
O th e r cells reproduce by m itosis, w hich is the equal division of nuclear m aterial ( karyokinesis),
followed by division of the cell body (cytokinesis). T h e result of this division is 2 daughter cells, each
containing 23 pairs of chrom osom es (i.e. 46 chrom osom es altogether).
Because all tissues increase in size during childhood, a lot more cells divide in a growing child th an
in an adult.

Specialised groups
of cells form tissui

[ti/u:z]

Tissues functioning together
are organs [sgsnzl

O rgans functioning together for the same
general purpose = body system [sisom)

cell + cell = tissue

tissue + tissue = organ

organ + orSan = ^

sVstem


THE STRUCTURE AND FUNCTION
OF BODY SYSTEMS
STRUCTURE
S tructure
refers to th e arrangem ent of parts, organs, tissues, cells or particles.

Function
is th e norm al, unique

[ju:ni:k]

activity.

A cell
is the basic structural and functional unit of any living organism . C ells may be
different shapes and sizes and perform a variety o f functions.

Tissue
is m ade up o f a specialised group o f cells. T h e re are 4 basic types of tissue:

• Epithelial [epi’eirUsl] tissue forms th e skin th a t covers th e body, lines cavities and
forms glands.

• Connective [kanektiv] tissue is extensive and forms th e support and framework of
the w hole body. Bone, cartilage, tendons, fat, blood and lym ph are all made up of
different types of connective tissue.
• M uscle [mAsal] tissue is designed to produce m ovem ent by forcible c o n tra c tio n and

includes 3 different groups: skeletal muscle, sm ooth (or visceral [visarall) muscle
and cardiac muscle.

• N ervous

[ra iv a s ]

tissue m akes up th e com m u n icatio n netw o rk o f th e body. The

c e n tra l agency is th e b ra in a n d e a c h stru c tu re in th e body is in direct
com m unication w ith th e b rain by nerves w h ic h come to g eth e r to form the spinal
cord.
A n organ
is m ade up o f groups of specialised tissues, w orking together
w ith a specific function.
A system
is a group o f organs w orking to gether w ith th e sam e specialised function.


©

C a n you na m e a n y o f the m ajor organs in the h u m a n body?

s

M atching Exercise.

P u t the words in the
box below in the space
provided to com plete

1. T h e process o f cell division involving th e D N A w hich
doubles itself to produce identical daughter cells is called

the definition.
2. A group o f specialised cells w ith th e sam e fu n c tio n is
c a lle d ...................................
3. T h e th ick , m uscular [mAsk'ju:ia] layer of th e h e a rt wall is
know n as t h e ..................................

cartilage [kaitalid^]
tissue [ti/u:]
myocardium
[mai'aukaidiam]

4. T h e largest mass o f nerve tissue in th e body - th e ‘central
agency’ for co m m unication w ith th e rest of th e body - is
an organ called t h e .....................
5. A type of hard c o n n ec tiv e [kanektiv] tissue th a t acts as a

epithelium [epiffcWam]

shock absorber a n d reduces fric tio n b e tw ee n b ones in

cell [sell

m oveable jo in ts (or a rticu la tio n s) o f th e body is called

function [fAgk/an]
brain [brein]

organ b:gan]
smooth muscle

6. T h e tissue th a t forms a protective covering for th e body
and also lines th e intestinal [intest'ainall tract, th e respiratory
[ra'spira'tri] trac t and th e urinary [jurranril passages is called

[smu8 mAsl]

mitosis [mai'taosis]
7. T h e basic u n it o f life is t h e ..................
8. D ifferent tissues working together w ith th e same function
form a n .......................
9. T h e a ctio n o f peristalsis [peri'stolsisl - th e m o v em en t of
food dow n th e oesophagus [a'sDfagasl a n d th ro u g h th e
intestine - is formed by involuntary o r ...................................
10. T h e norm al, unique [ju:ni:k] activity of various body parts

is its .........................

A lth o u g h each body sy ste m can n o t u w k independently, w e can look a t the stru c tu re of each a n d
its various com plicated fu n ctio n s to see how the body w orks as a single u n it.


3B
U N IT

iy
Study the pictu re w ith the body system s m a rked w ith nu m b ers 1 to 11 on page 124 and
n a m e th e m u sin g th e follow ing nam es: (W rite th e m again u n d e r N a m e of S y stem below .)

r—i [n3:vas]

RESPIRATORY [ra'spira'tri] SYSTEM

[di'djestiv] I C j

drcuiatm ry [ssikyieitni System
"
„

-

t

i -git*?
w

V,fltvCv'
M uscular ImAskHida) System
Cl

U rinary [ju:ranril System

' ' sM i ,// c
I
_
.
J >Sfem ' T
R e p r o d u c tiv e [ripra'd/iktiv) S y s te m
0 ■*

,n ^ ntegUm

f

entary

•V.

&

8,u^

System)

JL

STRUCTURE (is m ade u p o f..)

NAME OF SYSTEM
1

^

eletal

E n d o crin e lendaJkrin] System

...b ones [baonzl (+ cartilage, ligam ents)

Function(s):
2

... skeletal, cardiac a n d sm o o th m uscles [nusslz] (+ ten d o n s)

Function(s):
3

h e a rt [ha:t] a n d blood vessels (a rte rie s, v ein s a n d capillaries)

F unction(s):
4
Function(s):

lu n g s [Lujz] a n d a ir p assag es. N a s a l p a ssa g es, u v u la [jurv'juia],
p h a ry n x [fce'rinks], lary n x [laerinks], tra c h e a [traTdal, b ro n c h i fbrngld],
bron ch io les [brogki'Dlz], alveoli [alViWiMair sacs)

5

b ra in , spinal co rd a n d nerves

Function(s):
6
Function(s):

m o u th (te e th , to n g u e a n d salivary glands), epiglottis, oesophagus
[a'sofagas], s to m a c h [stAmak], in te s tin e s 111140513112] + accessory
o rg a n s: liv e r [liva], g a llb la d d e r [go l'blaeda], p a n c re a s [paerfkhas).

P a rts of this system are sometimes referred to as the gut.
7
Function(s):
8
F unction(s):

k id n ey s [kidnizl, u re te rs [jutrataz], b lad d e r [blaeda], u r e th r a [juAiAal

M a le: te s te s , d u c ts /s e m in a l v e sic le s, p ro s ta te g la n d , penis
F e m ale : o v a rie s, F a llo p ia n tu b e s (o v id u c ts ), u te r u s [ju.-ta'rasl,
vagina lvald3aina], b re asts Ibrests)

9
Function(s):

G la n d s: p itu ita ry [pitju.Jitri]I p in e a l [pm'ial], th y ro id lea?™!] and
p a ra th y r o id

[paera^ai'rad], th y m u s

[Oaimas], a d re n a l

[adrimal],

p an creas [paegk'rias], ov aries [auva'riz] a n d te ste s [testizl
1 0
F unction(s):
1 1
F unction(s):

128

lym ph nodes (to n sils a n d a denoids [aeda 'noidz]), ly m p h vessels,
valves [vaelvz], th e spleen [spli:n]
e p id e rm is, d e rm is, se b a ce o u s M xi/as] (o il-p ro d u c in g ) glands,
su d o rife ro u s |su:daWaras] (sw eat-producing) glands

L istening 1 7 - Body sy ste m s

L isten to th e recording and c h ec k your a n sw ers.


UNI T

GRAMMAR NOTES
T a lk in g a b o u t s t r u c tu r e

3B

‘to be m ade up o f ’, ‘consists o f ’ or ‘to be com posed o f ’
T h e re are subtle differences in the use of th e above phrases:
‘to be m ade up o f’ is used for a detailed breakdown of a part or a structure
e.g. The joints (or articulations) are made up of bones, cartilage and ligaments.
‘consists o f’ is used in a general way w hen all the m ain parts of a structure are nam ed
e.g. The respiratory tract consists of the pharynx, trachea, lungs, bronchi, bronchioles and alveoli.

‘to be com posed o f’ is used w hen the m aterials or substances from w hich the structure is formed,
are nam ed
e.g. Both the brain and the spinal cord are composed of nerve cells and fibres.

/y

Now, com plete th e follow ing sentences.

1. T he p h a ry n x .....................................the naso-pharynx, the oro-pharynx and the laryngo-pharynx.
2. T h e brain s t e m ......................................the m id-brain, the pons and the m edulla.
3. T h e in te stin e s....................................... 2 parts, the large and the small intestine.
4. T he duodenum , the jejunum and the ile u m ............................ the small intestine.
5. W h at does th e skeletal sy s te m .................................. ? Bones, joints and ligaments.
6. T he female reproductive system .............................the ovaries, the oviducts, the uterus and the vagina.
7. T h e s k i n ...............................epithelial tissue, collagen fibres, nerves, blood vessels and glands.
©
W ith a partner, look a t questio n 5 . M ake questions for the other sentences.
Using the information you have, ask your partner some questions about the structure of other systems.

VERBS AND NOUNS
f

C om plete th e table w ith the m issing w ord.
Verb

N oun

Verb

transport

transportation

circulate tek'juleit]

form ation

remove

digestion

regulate Ireg1juleit]

secrete (d irectly in to

e lim ination

the bloodstream )
destruction

filter

reproduction

conceive

cover(ing)

develop

storage

situate

excrete (in to a duct)

production

defend

lining

provide

dilate

N oun

p rotection

function(ing)

129


FUNCTION
fe z

N ow m a ke som e sentences usin g this form at:
e.g. The circulation of blood to the tissues is the function of the heart.

T h e excretion of waste products
th e liver

Blood circulation
is a/the* function o f

W aste excretion

th e kidneys
th e h e art

W ater regulation
Production of bile
Storage of protein and glycogen

(*T hc function is used when it is the only function, a function indicates one of several functions)

F u n c tio n (s):
R ea d the

(a)
T h e purpose o f this system is to take in air, filter it and take it to the
tissues responsible for gas exchange. O xygen [nksi'djan] is th e n transported

description o f the

by th e blood to all th e tissues in th e body. C a rb o n dioxide, a waste

fu n ctio n s of each
body system .
Identify the system
and label each.

[weist] product, is re-absorbed in to th e blood and th e n excreted from the
body.
(b)

N ow tu rn back to

T h is system forms th e basic fram ew ork o f th e body - it supports and

page 128 a n d w rite
a b rief su m m a ry of

protects all th e in tern al organs. Bones serve as levers (w ith th e attached
m uscles) for m ovem ent, produce blood cells and store calcium [luel'siaml
salts w hich c an be absorbed in to th e blood w h en th ere is n o t enough
calcium in th e diet.

the fu n ctio n (s) of
each body system .
(c)

T h e se c re tio n o f h o rm o n es Ih^'maunz], w h ic h re g u la te th e body's
functions chem ically, is th e fun ctio n o f this system.
(d)
T h is system is also called th e excretory system and filters body liquids,
e lim inating chem icals and excess fluids from th e body.
(e)
T h is system c o n ta in s a n im p o rtan t organ w hich pum ps blood round the
e n tire body. T h is is necessary to supply cells w ith n u trie n ts and oxygen
and to transport waste products for excretion.

(f)
T h is system is e sse n tia l for re p ro d u c tio n a n d th e p ro d u c tio n of
horm ones, sex cells (gam etes) [gsmi:ts] and it also enables conception
[kon’sepjan] and perm its th e carrying and b irth of babies (offspring).
(g)
T h e system w hich converts (changes) food in to sim pler substances for
th e cells to use for energy also takes away (or elim inates) waste products
from th e body.


sensory receptor.

3B

body from disease, helps to regulate body tem perature a n d acts as a

UNI T

(h) I
1
T h is com plex system, w hich is also th o u g h t of as a n organ, protects the

(0
A system w hich runs parallel w ith th e veins th roughout th e body, drains
fluid from th e tissues and helps to defend th e body against infection and
disease.

(j)
W e n e ed th is system to p roduce m ov em en t, b o th v o lu n ta ry a n d
involuntary, and to keep our hearts beating to keep us alive [alaiv].

(k)
T his is th e m ost com plex system in th e body and its functions are to
regulate all th e o th er systems in th e body, to receive and send messages
and to provide us w ith inform ation about our e n v iro n m en t len'vai'ran'mant].

Complete

1. T h e .................... c a rrie s ...................through the arteries to the body cells.
2. O n e function of t h e ............................ is t o ......................the am ount o f w ater

the sentences
using the correct
Miordfs.) from the
box.

in the body.
3. T h e .................................. also ....................... urea [ju:ri:a] (a n itro g e n waste
product) from the body.

ovaries
eproduc
lines
ire situate

4- T h e ...............................functions as b oth an organ of digestion and excretion.
5. T h e ............................. is an accessory organ of digestion.
6. T h e ............................. beats 80 tim es per m inute on average.
7. T h e ........................... are only found in females. T hey are endocrine glands

nary syste
blood
pancreas
cartilage

w h i c h ........................horm ones and o v a ....................................................... here.
8. A n accessory lask'sesa'ri] organ of d igestion, w h ich is also an e n d o crin e
g la n d ,..................... insulin and is called t h e ...............................

on ceptior
regulate

9. A ll th e bones in th e skeletal system ............. from a fibrous c o n n ec tiv e
tissue c a lle d ...............................T h is tissue eventually hardens w ith calcium

covers
bone
kidneys ( x 3 )
; liver (x2)

deposits to b e c o m e .............................
10. T h e ................ the ureters, the urinary bladder and u reth ra m ake up the
..........................................w hich can also be called t h e ...........................................

secrete

11. B oth the spinal cord and the b r a i n ......................................... nerve cells.

oxygen

12. C e l l s .................................. b y .................................... - a process called mitosis.

excrete
h e art

13. T h e skin w h ic h ........................the outside of the hum an b o d y ............................

ire produced ■

cells, sw eat glands, oil-producing glands, blood vessels and nerve endings.

form
: com posed <|

E pithelial tissue a l s o ..................... all the systems th a t have tracts opening

division

!

o n to th e surface of the body.

J t e t o r y systen

14. T h e h e art and lu n g s ...................................................... jn the thoracic cavity.

[is m ade up o f
secretes 4

15. A zygote is form ed at the tim e o f ................................. - it is the unio n of the

m ale and female sex cells, or gametes.

131


3C
UNI T

©
DIRECTIONAL TERMS

Id

is necessary to have special words to talk about the position or location of organ*
and parts and to talk about d irection in th e h u m an body. T h e words 'left' and 'right',

‘back’ or ‘fro n t’ are n o t specific enough and th e use o f ‘north’ and ‘south’ would be
inappropriate! T h e d irectional term s used refer to the body in th e anatom ic position.
T hree imaginary planes are used to describe the structural plan of th e body and the
anatom ic relationship of one p art to another. T hese planes cut through th e body at
right angles to each other.

PLANES OF DIVISION

M idsagittal Plane
Divides the body into front
and back halves.

Divides the body in to right

Divides th e body in t.' pans

and left halves.

above or below.

Directional terms used:

Directional terms used:

Directional terms used:

F ro n ta l / V entral or Dorsal

M edial or L a te ra l

Superior or Inferior

A Sagittal plane lies away

C ra n ia l or C audal

A n te rio r or Posterior

from th e m idline and divides
the bodv into right and left
parts

132

Transverse Plane

D raw a cross-section o f each o f the planes o f division.


DIRECTIONAL TERMS
✓

N o w label th e diagram below w ith all the follow ing directional term s, m a tc h in g th e words

th a t have opposite m eanings.
D raw the m idline ( 1) - an imaginary line close to the middle of the body - there is no opposite to thisl
a n terio r/v en tral (towards the front)

lateral (further from the m idline/tow ards the side)

distal (farther away from the body)

superior/cranial (above or in a higher position)

inferior/caudal (below or lower th an ...)
medial (nearer to an imaginary m idline plane)

proxim al (nearer to the m ain part of the body)
p osterior/dorsal (towards the back)

ty

Study the directional term s and com plete the following

sentences.
e.g. The hand is d istal to the shoulder.

1. T h e thorax i s ..................... to the abdom en.
2. T he nose and the m outh are in a ..........position on the face.
3. T h e elbow i s ..................... to the wrist.
4. T h e knee i s ........................to th e back o f the thigh.
5. T h e ears are i n ........................positions on the head.
6. T h e buttocks a r e ..................... to the pubic region.
7. T h e navel (or um bilicus) is at t h e ..............................
8. T h e femur (th e long bone in the th ig h ) i s ................... to
the tibia and hbula.
9. T h e knees a r e .................................to th e hips.
10. T h e brain i s ...................... to the spinal cord.
11. T h e oesophagus i s ........................... to th e stom ach.

A lot o f muscles and blood vessels are nam ed
using directional terms so th a t th eir location and
relationship to o th er parts are easily understood.

J *

O n these 2 diagram s, label

1. the rig h t eye: (a) Interior rectus muscle

(b) S uperior rectus muscle
(c) M edial rectus muscle
(d) L ateral rectus muscle
2 . th e heart:

( a ' Interior vena cava
(b) S uperior vena cava


U N IT

3C

BODY CAVITIES
A c av ity is any ho llo w space. Body cavities are areas w hich confine o rg a n s and
systems th a t h ave related functions. T h e 2 m ajor body cavities are the d o n a l cavity
and th e ventral cavity.
T h e dorsal cavity is subdivided in to the cranial cavity (c o n ta in in g th e brain) and the
spinal cavity (con tain in g th e spinal cord).

T h e ventral cavity is divided in to 3 parts: th e thoracic cavity, th e abdominal cavity
and th e pelvic cavity. T h e abdom inal a n d pelvic cavities together are called the
abdominopelvic cavity.

$

L abel th e body cavities

and th e organs situ a te d in the
abdom inopelvic cavity.

C om plete th ese sen ten ces.
1. T h e h eart and the lungs are situated in the

2. T h e d om e-shaped m uscular organ th a t separates this
cavity from the abdom inal cavity is t h e ............................
3. T h e spinal cord is located in t h e .........................................
4- T h e brain and th e spinal cord are situated in a space
know n as t h e ...........................................
5. T h e abdom inal and pelvic cavities to g eth er are known
as t h e ..................................................
1

_
6. W h ere are th e differen t parts o f th e digestive system
located? Look at th e diagram of organs located in the
abdom inal cavity and w rite an approxim ate position for
each o n th e list using d ire c tio n a l term s (e.g. The
oesophagus passes through the diaphragm and its inferior end
lies medially in the abdominal cavity):
• The stomach [st.unak] ............................

• The liter [livs] .......................................
• The appendix [sp'endiks] .......................
• The pancreas [pan'kriss] .......................
• The transverse colon |tra?nzlv3:s kaulon]
• The duodenum [diu:a'di:ndm] ................
• The ascending colon [ei'sendip kaulnn] .
• The descending colon [dii'sendip kaulnnl
• The gallbladder [grdtiteda] ...................
• The bile dllCt [baial'd.vkt] .......................

134

• The aecum [stkaml ..............................


CLINICAL DIVISIONS OF THE ABDOMEN
m

For th e purpose o f clinical exam ination
a n d reporting, th e abdom en is divided
in to 4 co rre sp o n d in g regions called
quadrants. T h e um bilicus [Amba'laikas] (or
n avel) is th e intersecting point.

O n diagram I , m ark:
the R ight U pper Q uadrant (R U Q )
the R ight Lower Q uadrant (RLQ )
th e Left U pper Q u ad ran t (L U Q )
the Left Lower Q u ad ran t (LLQ)

G>

^

Listening 18 - E xercise

P ractise saying th e words in

the box before lis te n in g to th e d ic ta tio n . N ow , liste n to the
recording. Use it as a d icta tio n to help you label diagram 2.

T h e U m bilicus

[Am'bilikas] o r [Amba'laikasJ

T h e U m bilical
N ow , test yo u rself and m a rk the anatom ic regions in the

[Am'bilikl] o r [Amba'laiklJ

Region

box on the diagram .

T h e P elvic/P ubic [pjufcik) o r
©

Do you k n o w how the w ord ‘hypochondriac’ [haipau'kDndriaek]

is usually u se d ? W h a t do you th in k is the reason?

H ypogastric

[haipaiygasstrik]

R egion
T h e R ight and L eft

©

T h in k o f som e questioris to ask your partner. Look a t the

examples a n d fo rm u la te some questions before you start.

W here would a p a tie n t
w'ith acute appendicitis
feel th e m ost pain?

T h e R ight a n d L eft
H y p o c h o n d riac

In th e R ight Lower
Q uadrant or the R ight Iliac
R egion of the abdom en...
W here is the liver located?

In the R ight H ypochondriac Region!
...W h a t organs are situated in the
H ypogastric (or Pubic Region)?

L ateral [tarsi! R egions

[h aip au 'k D n d ricek ]

R egions
T h e L eft and R ight
Ing u in al [iq'gwinai) o r
Iliac [ili:'*k] R egions
T h e E pigastric [epi'gastrik]
R egion


3D
U N IT

THE SKELETAL SYSTEM
R ead th e tex t before a tte m p tin g th e w ritte n exercises.

T h e skeletal system includes all of the
bones of the body show n on the right
and includes cartilage (fibrous connective
tissue), joints (articulations) and
ligam ents (fibrous tissue bands th at

Cranium
Zygomatic bom
Maxilla

Masai bone
Mandible

7 Cervical vertebm

co n n ect bones or cartilage). T h e study
of bones is called osteology'.

Clavicle

Manubrium

T here are 206 bones in the adult

Sternum

Humerut

hum an skeleton and their function is to
give the body its shape, to support the

Xiphoid process

body and protect all the delicate
internal organs. T h e skeleton also
provides places for the a tta ch m en t of
muscles and the bones act as levers to
provide m ovem ent of skeletal muscles.

5 Lumbar vtrubm
Iliac crest
Ulna

Iliac fossa

T h e cavities inside long bones store fat

Radius

Sacrum

in the yellow m arrow and bones also

Carpah

Coccyx

store the m inerals, calcium , magnesium ,

Ischium

phosphorous, potassium, sulphur and
sodium. Red blood cells are formed

Metacarpus
14 Phalanges

(haematopoiesis Ihem'atau'prfsisl) in the
bone marrow of c ertain bones.

Femur

Bones are individually classified as
organs and bone tissue is capable of a

Patella

process w hich forms new bone.
Osteoclasts are responsible for the

re-sorption (or breakdow n of bone) and
osteoblasts build it and assist in the
growth of bones.

Fibula

Bones are classified according to their
shape. T here are 5 m ain classifications:
long bones, e.g. hum erus, ulna, femur;
short bones, e.g. wrist & ankle bones;

Tarsab

Calcaneus

Metatarsals
14 Phalanges

flat bones, e.g. ribs, sternum ,
scapulae;
irreg u lar bones, e.g. vertebrae, face bone

136

sesam oid bones are small bones w hich
form in ten d o n s, e.g. patella.

L abel the scapulae (p i.) on th e diagram .
(scapula - singular)


C ancellous (spongy) bone filled

T h e Proxim al Epiphysis

3D

,w ith red bone marrow

U N IT

THE STRUCTURE OF A LONG BONE

G row th line or Epiphyseal line

(a'pifa'sis]

C om pact (hard) bone
Bone cavity containing
yellow bone m arrow
T he Diaphysis [dai'aefasis)
A rtery

or
Bone Shaft

E ndosteum lend'Dstam]

T h e Periosteum
(or covering of the bone)
T he Distal Epiphysis

is com posed of specialised

[a'pifa'sis]

fibrous connective tissue

Each bone can be
labelled using its
markings - that is,
the depressions,
grooves, openings
(foramina),
processes and
projections that
can be seen on the
surface of bones
and are used as
reference points.

C artilage (tough, resistant connective
tissue) covers the ends of long bones

D iv isio n s o f the Skeleton
1. T h e A xial [sksial] Skeleton:
is com posed o f th e skull, th e vertebral colum n and th e bones
o f th e thorax - th e rib cage and sternum .
2. T h e A p p e n d icu lar

(eipen'dikju:la)

Skeleton:

includes all th e bones o f th e ex trem ities (th e arm s a n d th e
legs) a n d th e bones these are co n n ec te d to, i.e. th e shoulder

girdle and th e pelvic girdle.

T h e skull includes all th e bones of the head: th e cranial bones and all th e facial bones.
T h e vertebral c o lu m n consists o f 26 irregular bones, th e vertebrae (pi.) divided in to
sections by th e ir p osition from the base of th e skull to th e caudal end: 7 cervical
vertebrae ( C l to C 7 ), 12 thoracic vertebrae (T1 to T 12), 5 lum bar vertebrae (L I to
L5), 5 fused vertebrae w hich m ake a triangular bone called th e sacrum (w hich also
m akes up part o f th e pelvic girdle or pelvis) and a sm aller triangular bone consisting
o f 4 fused vertebrae called the coccyx [koksiks].
T h e rib cage (or bony tho rax ) consists of th e 12 thoracic vertebrae dorsally, th e 12
pairs o f ribs laterally a n d th e sternum and costal cartilages anteriorly. T h e first 7 or
8 pairs o f ribs are c o n n e c te d to th e sternum by cartilage a n d are referred to as true
ribs. T h e rem aining 5 pairs of ribs are called false ribs.

137


C om plete th e follow ing sen ten ces.
1. T h e adult skeleton h a s .............hones.
2. Bones are a ‘storehouse’ f o r ............................................. and .
3. W h at are the functions o f the skeletal system?
4. List the 5 classifications of bone:

..........................................

5. A long hone is divided in to the shaft o r ...................................... and the
6. Nam e 2 types of bone tis s u e :.............................................................................
7. N am e the 2 m ain divisions of th e s k e le to n :............................................
8. T h e bones of the thorax include the 12 pairs of ..

the 1 2 ........................and the

9. Identify the site w here grow th occurs in long h o n e :......................................................
10. N am e th e 2 bones of the vertebral colum n th at are m ade up of fused vertebrae:

L istening 19 - The sk eletal sy stem

L isten to the recording a n d ch eck your answers.

N ow , m atch the following words w ith the correct definition.
1. T h e fatty substance inside the central cavity of long bones: ............................
2. T h e bones of the head and face together are called th e ....................................
epiphysi
3. T h e m aterial th at forms the skeleton in an embryo: ...........................................
4. T h e 5 biggest v erteb rae are located in th e ........................... region o f th e
vertebral colum n.
5. T h e tou g h (stro n g ) c o n n e c tiv e tissue th a t covers bo n es is called th e

6. Blood cells are produced in the ...................................................................................
7. T h e shaft of a long bone is also called th e .............................................................
radius
8. T h e lining (th e inside surface) of a bone cavity is called th e .........................
9. T h e tail part of the lower vertebral colum n, consisting of 4 or 5 small, fused
bones is called t h e ............................................................................................................
10. T h e bone located on the side of the thum b in th e forearm is the .................
11. T h e end of a long bone is i t s ........................................................................................
12. T h e scientific nam e for th e knee-cap is the ...........................................................
13. A n adjective w hich m eans ‘betw een th e ribs': ......................................................
14 T he type of connective tissue th at connects 1 bone to a n o th e r :.........................

si


JOINTS
R ead th e text.

Where 2 or more bones come together and usually need to move or articulate
[a:'tik'ju:leit]) there is a joint [dgamt] (or an articulation [a'tik'juiiei/an].) w hich is held
together w ith strong, flexible bands of fibrous connective tissue called ligam ents
[ligamants]. Joints are classified according to the amount of movement perm itted,
that is immovable - a synarthrosis (singular), slightly moveable - an amphiarthrosis
(singular) or freely moveable - a diarthrosis (singular).
1. IMMOVABLE or FIB R O U S jo in ts (sy n a rth ro ses [sinla:0lreusi:zl plural) are those
joints th a t are fixed, such as th e joining of th e skull bones - the lines a t these
joints are called sutures [su:t/az],

2. SLIGHTLY M OVEABLE or C A R T IL A G IN O U S joints (am phiarthroses
[amfi'a:0lrausi:z] plural) have only a m inim al am o u n t of m ovem ent - th e vertebrae
[ratabri] are examples o f these. Between the vertebrae, there are disks of another strong
connective tissue called cartilage [katiiidg]. This acts as a cushion, reducing friction and
w ear and tear of th e bones. (Cartilage is also found o n the ends of long bones.)
A n o th er example of these cartilaginous joints is the symphysis pubis [simfasas pjurbas) the anterior pelvic joint, w hich softens during pregnancy to allow more m ovem ent.

3. FREELY MOVEABLE o r SYNOVIAL joints (diarthroses [dai'a:0‘rai>si^l plural) have
a variety of different m ovem ents, so they can also be nam ed according to th e type of
m ovem ent. A freely m oveable joint is referred to as a synovial [sin'auvial] jo in t because
there is a cavity betw een th e joints containing a sticky synovial fluid (secreted by the
synovial m em branes lining the joint) w hich prevents friction betw een th e bones.

L istening 2 0 - Joints

Look a t the pictures of joints

below and listen carefully to th e recording to describe each one.

(a)
f

W h a t is it?

(b)

(c)

(d)

.........................................................

......................

..............

Medical name of joint

..................... ...................................

......................

..............

Type of joint

.........................................................

.....................

..............

Classification

.........................................................

......................

..............

Type of movement

..................... ...................................

......................

..............


U N IT

3E

Further classifications of

Freely Moveable (Synovial) Joints or Diarthroses
W rite a n exam ple of each on th e line.

B A L L A N D S O C K E T J O I N T S : T h ese give a lo t o f freedom and allow m o v em e n t on 2
planes.

H IN G E JO IN T S : T h is type of jo in t restricts m ovem ent to 1 plane.

P IV O T JO IN T S : T h is type of jo in t allows the bones to rotate o n one another.

&

L iste n again and ch eck your a nsw ers.

FRACTURES
A fracture [fraek't/a] is any break or rupture in a bone. Severe force can cause a fracture m
almost any bone. The word ‘fracture’ is often written as the symbol '# ’
e.g. # N O F = fractured N eck of Femur.
T h e bones of a baby or a young child are n o t as h a rd as a n a d u lt’s bones (because
th ere are less calcium salts and they consist of a lot o f cartilage). T h ey are softer and
m ore e lastic so do n o t break easily. Very o ften , th e injury seen in a c h ild is a
greenstick fracture, i.e. th e bone does n o t break right through but is only injured on
one side. Im agine bending a b ran ch o f a tree th a t is n o t dry or dead - it m ay bend
and partially split but does n o t separate in to 2 pieces.

There are 4 general classifications of fractures and a n u m b e r of more specific
classifications:
1. Sim ple - th e bone is broken b u t th ere is n o break in th e skin.
2. C om p o u n d - th e skin over th e fracture has b een pun ctu red or to m o r a n o th e r
organ is also damaged.

3. C o m m in u ted [kDminju:tidj - th e bone is fractured in one or m ore places, is splintered
or crushed.

4. G re e n stic k - th e bone does n o t break right through but is only injured o n one

140

side.


CAUSE AND EFFECT
W h a t happens in the h u m a n body w h e n a bone is fra c tu re d 1

S IG N O R SY M P T O M

C A U SE
A n increase in circulation to th e injured part

redness, a sensation of heat

Fluid and leucocytes (w hite blood cells) leave
the bloodstream and e n te r th e tissues - there may
also be bleeding in to th e tissues

swelling

T he pressure o n nerve endings increases

T he body attem pts to keep th e p art still

.>

loss of m obility (function)

Look at the follow ing example a n d make sentences to answ er the questions.

W h en a bone is fractured, why do you notice redness around the area.’
B eca u se redness is caused by an increase in circulation.
or

B eca u se an increase in circulation results in/causes/leads to redness.

1. W hy does the injured part start swelling?
2. W hy do you feel pain w hen a bone is fractured?
3. W hy is th ere a sensation of h eat w hen a bone is fractured?
4. W hy is there loss of fu n c tio n w hen a bone is fractured?
5. W h at does a deficiency in calcium cause?
6. W hy are th e bones o f old people m ore likely to break?
7. W hy is exercise im p o rtan t for the body, the skeletal system in particular?

©

A sk your p a r tn e r th ese

questions.

1. W h a t are the 3 m ain classifications of joints?
2. W h a t is the nam e ot the co n n ectiv e tissue th a t joins one
bone to another?
3. W h a t is the nam e ot the strong, connective tissue th a t

surrounds all bones?
4. W h a t are th e 4 m ain classifications o f fractures?
5. W h at has happened to a bone if it is classified as a
‘com m inuted [ k D m i n j u tid] fracture’?


3F
UNI T

--------------------------------------------- ®

---------------------------------------------

MOVEMENT, POSTURE AND LIFTING
S keleta l m u scles are a tta ch e d to bones and m ove the skeleton. T here are more than
650 in d iv id u al m uscles in th e skeletal m uscle system . Each muscle is a distinct
structure b u t muscles usually act in groups to execute body m ovem ents. Because it
is under conscious control, skeletal muscle is also called voluntary muscle.
A ll muscles in th e body n eed energy to contract or shorten. T h is energy is supplied
in th e form o f A T P (a d e n o sin e -tri-p h o sp h a te ) w h ic h is th e result o f th e cells
‘burning’ or using nu trien ts, causing oxidisation.
For the cells to produce ATP, they m ust h ave a n adequate supply o f oxygen, glycogen
and o th er nutrients.
If th e body uses m ore oxygen th a n is available for strenuous exercise, lactic acid (a
waste product of m etabolism ) builds up (or accum ulates) in th e m uscles, causing
cram ps and muscle fatigue. A fter strenuous exercise, we need to breathe faster and
our hearts beat faster so th a t m ore oxygen is pum ped to th e tissues. T h is helps th e
lactic acid to be re-absorbed and to be used for o th e r m etabolic activities.

POSTURE

IpDs't/a]

T h e way we stand, sit and m ove is im portant to our general good h e alth . For th e skeletal muscles
to strengthen and support the body and its in tern al organs, they have to function correctly. W hen
th e axis of the body and the axial skeleton are alm ost th e same, good posture is achieved.
L abel the figures.
©

1 standing straight with the shoulders pushed back and

the abdomen pushed forward

T his causes the abdom inal muscles to becom e weak
and may result in digestive, respiratory and/or back
problem s including an abnorm al curvature of th e spine
w ith an excessive lumbar curve, called lordosis.
©

2 with his head pushed forward to balance his body

He has to tilt his pelvis or hip girdle forward. T h is
results in rounded shoulders and strained back muscles
w h ic h p re v e n t co rre c t b re ath in g . T h is p osture can
lead to kyphosis (som etim es called hunchback) w hich
is an exaggerated curvature of the thoracic curve of the
spinal column.

©

142

3 standing with ,y>od posture

He is standing com fortably w ith his ear, h a n d and foot
on the same axis.


below

and

don’t move too quickly
don’t use je rk y movements

bending to pick so m e th in g up off th e floor,

>y o u r back (th e v ertebral colum n) sti

3F

W hen exercising or lifting heavy items or even

U N IT

L ook a t th e p ic tu re s
com plete this sen ten ce.

bend y o u r knees

w atch w h at you are doing
: yourself! w ith a h an d on y o u r th ig h if
necessary

©

W ith a p a rtn er, discuss good posture w h e n m oving, sittin g and lifting.

If unnatural m ovem ents are avoided - sudden twisting and turning - we avoid dam aging the delicate
alignm ent o f our bodies th a t keeps it functioning well.

Exercising regularly, a t least 3 tim es a w e ek , can improve our general h ealth by
strengthening muscles a n d bones, keeping blood p re ssu re a t a normal level and
lowering blood cholesterol levels. D u rin g exercise, the heart beats faster and the
volume of blood p u m p e d per beat (th e stroke v olum e) increases. T h e rate and
d e p th o f respiration also increase, filling the lungs com pletely a n d increasing the
amount of oxygen available to th e tissues. E xercise and training programmes also
increase the power a n d endurance of m uscles by repeating and p ra c tis in g complex
movements. O verall, the body reacts positively to regular, short periods of exercise
and it brings a feeling of well-being mentally an d physically.

143


3G
U NI T

DISEASE
Disease is a n abnormal state in w hich part or all of the body is not able to perform
its required functions.

C)^

C om m on m edical term inology used in the study of disease.

R e a d th e fo llo w in g te x t - th e w ords in ita lics are te r m s fr e q u e n tly u se d in E n g lish when
discussing disease.

To treat disease, the type of illness has to be assessed,
th a t is, a diagnosis is m ade according to the various
signs and symptoms. Signs are visible to the nurse or
physician and c an be observed (su ch as rashes,
oedem a, e tc .) w hereas sym ptom s are n o te d by the
individual him self (ch an g es in tem perature, weight,
pain, etc.). O ften a definite group o f signs and symptoms
accom panies a disease and this is called a sW rom e.
T h e nurse’s role in observing signs and finding out the
patient’s sym ptom s, re co rd in g th is in fo rm atio n and

re p o rtin g it to th e physician, is in valuable. The
inform ation available is assessed and the appropriate
therapy or treatment is ordered.
T h e study of the cause or the theory of the cause(s)
of disease is called etiology. W h e n th e origin of a
disease is n o t know n, it is term ed an idiopathic disease.
T h e study w hich relates b oth the physiologic aspects
and

th e p a th o lo g ic

aspects o f disease

is called

pathophysiology.

Diseases are often classified on th e basis ot seventy and
on how long they last. Acute illnesses are q uite severe but
usually only last a short tim e. Chronic illnesses may be less
severe b u t c o n tin u e for a long tim e, or recur o ver a long
period of tim e. Subacute illnesses are n o t as severe as acute
illnesses

nor

as

lo n g -la stin g

as

c h ro n ic

communicable (or infectious) disease is o n e

illnesses.

A

th a t can be

transm itted from one person to another. T h e infected person
is said to be contagious - usually before signs and symptoms
appear.

144

It a disease is continuously found in a certain region, it is said
to be endemic and m ost c h ild h o o d diseases, -.uch a* m umps


Staphyloccal infection

%

(parotitis), chicken pox (varicella), measles (rubeola

2

*.
p

cancer

virus) and G e rm an m easles (ru b ella), fit in to this

category.
W h en a large num ber of people in a certain region get

rubella

SARS

a disease at th e same tim e, it is said to be epidemic (e.g.
outbreaks of the Ebola virus - in Zaire in Africa - have
b een acute and deadly b u t relativ ely sho rt-liv ed

^
T,U

STD s

jo

epidem ics. E bola causes haem o rrh ag ic fever and
im m ediate death ). Influenza, often endem ic, can also

°

often reach epidem ic proportions.
A disease found over a m uch wider area, throughout

an entire country, c o n tin e n t or the world, is pandemic - A ID S
is now pandem ic - and the recent SA R S outbreaks appear to
be pandem ic for several m onths.

a

%

vA

Promoting good h ealth and advertising dangers to healthy living
are the m odem techniques for preventing disease. T h e W orld
H ealth O rganisation takes responsibility on an in tern atio n al

.

level and all h e alth care workers and various o ther groups take
responsibility on a national and com m unity level.
There are marked variations in th e extent of a disease and its
effect on the individual. T hese depend on w here the organism
entered th e body - the portal of entry - th e virulence or
aggressiveness of th e organism , the ability of the organism to
produce toxins or poisons, the dose (or quantity) of the organism
and the condition or predisposition of the person.

£

C7 *
%

/
rin g w o rm
-5

^

o
x.

Cf
^

c
£
°+

%

o

How quickly can you complete the table w ith a w ord from the text in italics? D efine each word.

s

1

E

s

s

D

C

c

s

P

T

V

p

E

A

p

R

1

C

V

0

P

D

p

©

W ith a partner, discuss w h a t you know a bout some o f the diseases na m ed on this page.


PREDISPOSING FACTORS
IN THE OCCURRENCE OF DISEASE
T h e follow ing predisposing factors m a y not cause disease b u t can increase th e probability of
illness occurring.
Living C onditions and H abits
H eredity

J *
1

Physical Exposure

O c cu p atio n

Psychogenic Influences

Pre-existing Illness

Sex

Age

W rite th e correct predisposing facto r from above, next to its d efinition.
D egenerative processes in older people can be a direct cause of
disease, but certain age groups are often m ore likely to get a particular
disease - for exam ple, m easles |mi:zalz], caused by the rubeola virus,
is more com m on in children.

2

Males are m ore likely to develop h eart disease and tem ales are more
likely to develop diabetes.

3

Som e diseases seem to run in families - allergies, for exam ple, and
also diabetes.

4

People w ho are ‘w orkaholics’, d o n ’t get enough sleep, use drugs or
smoke or d o n ’t have a balanced diet, are at risk. A lso areas which
are overcrow ded and have poor san itatio n are predisposing factors.

5

C e rta in jobs may predispose p eople to disease. W orking with
chem icals, radiation, dust in coal m ines or asbestos (dust in building
m aterials), is hazardous to health.

6

Being exposed to b o th excessive h e a t or excessive cold for long
periods can be a starting factor of disease.

7

W h en the body’s im m une system is w eakened by an illness or even
a slight cold, the chances of c o n tractin g a n o th e r disease are much
higher.

8

E m otional stress and anxieties can affect th e psych

[saik]

(th e mind)

w hich can result in physical signs such as headaches, indigestion
and lethargy.

THE BODY'S LINES OF DEFENCE

Id i'fen s]

T he human body is very w ell organised to p rotect itself from disease and
disease-producing organisms.
The barriers (the things th at prevent disease from entering or attacking the body)
are considered as ‘lines of defence’ in an order that helps to protect us.

3G

The first lines of defence are:

UNI T

Chemical and Mechanical Defences Against Disease

SKIN: T h e skin and th e m ucous m em branes are mechanical barriers th a t prev en t disease from
entering th e body, b u t only w hen they are intact. A ll the m ucous m em branes (also epithelial
tissue) th a t line th e various tracts opening o n to th e body’s surface secrete m ucous w hich traps
(catches) any foreign m aterial and th e cilia (hairs) help to expel these im purities from the body.
S E C R E T IO N S : Tears, perspiration, saliva and gastric secretions h e lp to wash away diseasecausing organisms and m ost secretions c o n tain chem icals th a t can destroy th em .
R E F L E X A C T IO N S : Sneezing and coughing expel any m icro-organism s from the respiratory
tract and vom iting and diarrhoea expel them from th e digestive tract.

The next Unes of defence are the w hite blood cells:
P H A Q O C Y T O SIS : Som e o f th e w hite blood cells are able to absorb and destroy foreign and
waste m atter by a process called phagocytosis [fei'gau'sai'taosis]. T h is process is m ainly carried out by
cells called neutrophils |nju:ltraulfilz] and macrophages [m*krau'feidjiz].
N A T U R A L K IL L E R C E LL S (N K C E L L S ): T hese cells are a type o f lymphocyte [limWsait] th a t
can recognise cells w ith abnorm al m em branes, such as tum our cells or cells infected w ith a virus,
and can kill them o n contact.
IN F L A M M A T IO N : Inflammation is a reaction th a t assists th e body to expel an irritant, n o t only
infective m icro-organism s. O th e r irritants may be bum s, friction, cuts, X-rays or chem icals. A n
inflammatory reaction occurs w hen the irritan t is an infective organism and this is th e n called an
infection. A n in flam m atory re a c tio n show s 4 classic sym ptom s and th ese are: h e a t, redness,

swelling and pain.

FE V E R is an increase in body tem perature above th e norm al and is a sign th a t th e defence
m echanism s are in order because the phagocytes release substances th a t raise body tem perature.
IN T E R F E R O N : T h is is a substance released by infected cells w hich stops o th er cells becom ing
infected. It prevents viruses from m ultiplying and also stim ulates the body’s im m une system.

IM M U N IT Y : T h e body’s fin a l line o f defence.
Im m u n ity is th e body’s fin a l line o f defence a n d m a y be inborn or acquired (n a tu ra lly acquired
or artificially a c quired).
Im m unity is the individual’s personal ability to resist or fight off the effects o f a particular m icro­
organism or o th e r harm ful agent. It is a selective ability w hich may be successful against one agent
but n o t another.

J *

R ead the a b a te te.vt and look at the underlined words. P u t a circle around the words that

these refer to. N m r rew rite the sentence using the name instead of the pronoun or determ iner.

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