bladder.

3. Where may the infection spread?

• uretgrs; prostate;

• seminal^ vesicles•

3. What is genital tuberculosis evidenced by?

• pain;

• nodules in the_prostate^

• weight loss.

10. Translate into English.

    1. Нирки регулюють склад крові.

    2. Інфікована нирка може викликати дуже тяжке захворювання.

    3. Наявність спазмів свідчить про погіршення стану хворого.

    4. Туберкульоз простати дуже важко диференціювати.

    5. Нирки - це парні органи, які утворюють та виділяюсь сечу.

    6. Нирки виводять з організму кінцеві продукти обміну\речовин.

Text 1

FUNCTIONS OF KIDNEYS^ IN THE HUMAN BODY

The body depend^on the kidneys to excrete many waste products and to т^Шші the cdrrec-t balance of water and salts, and any kidney der intexferes with these important functiogg, The symptoms qf .kidney disease

MSSS

on the underlying cause. They are owS МШ'ёлй :Щ|^ипШ a late stage in the disease. Kidney disease may cause an increased amount of urine to be formed, leading to abnormally frequent urination. Or the formation of urine may be dimin­ished, leading to abnormally infrequent urination.

Some kidney diseases, such as acute nephritis, may cause blood in the urine. Other symptoms of kidney disease include acute abdominal pain, and generalized оШета, which is swelling due to the accumulation of water in the body tissues. If both kidneys stop working completely, waste products accumulate in the body and poison the patient. This can be fatal and requires jurgenl,medical attention.

Kidney disease may be caused by many factors, such as injury, infec- tion, cancer or disorders in other parts of the body. In some cases, kid­ney disease may occur without apparent cause.

The kidney may be damaged in a serious accident, causing a jrupture of its surrounding capsule and leading to severe hemorrhage. The dam­aged laffiieyTfUyTmve to be surgically removed. Rarely, the kidney may be damaged by radiotherapy treatment carried out for the cancer. This may eventually result in high blood pressure and kidney failure. Stones may term in the kidneys and cause kidney damage. This may occur with­out apparent cause, or it may be due to an underlying metabolic disorder. Occasionally, microscopic crystals form in the kidney substance itself ^nephrocalcinosis). These may occur for the some reasons as do stones, or, rarely, in babies who are given excessive amounts of vitamin D.

The kidney may become infected and inflamed. This may result in various kidney diseases, such as nephritis, glomerulonephritis, or pyelo­nephritis. Infection of the kidneys often results from the spread of infec­tion from the bladder. Cancer of the kidney may occur in the renal pelvis, the collecting area for urine, or in the kidney itself. Many disorders in other parts of the body gave an effect on the kidney. High blood pressure gradually damages the kidney. Because of such damage, high blood pres­sure often continues to be a problem after the original cause has been found and treated. Various hormone disorders, su,ch as parathyroid gland hyperactivity, Cushing^^raidrome. and diabetes^li^ipiШм/шіес{ kidney function. Diabetes Щіщиз not only causes sugar in the urine but may _eyenjtnally_r cause damage to the glomeruli or to the blood supply to the kidney. A stone in the ureter may cause urinary obstruction. This may result in reverse pressure of the urine into the kidney, producing disten- tion^gjd progressive loss of function.

^ _»jJ|x№cted kidney disease can be investigated in various ways. Chemi­cal testing of the urine detects the presence of any abnormal substances. ^Examination of urine through a microscope may detect blood or white blood cells resulting from infection. Tests that jneasure the amount of urea and creatinine in the blood help detect kidney disease.

The treatment of kidney diseases depends on their cause, and may involve the skilled care of a nephrologist, a specialist in kidney diseases.

POST-TEXT ASSIGNMENTS

1. Read the text and say whether the following statements are true:

   1. Some kidney diseases, such as acute nephritis may cause blood in the urine.

   2. If both kidneys stop working completely, waste products do not accumulate in the body.

   3. Kidney disease may be caused only by one factor, (such as) name­ly - infection, —•

{ 4. The damaged kidney may have to be surgically removed. ^ 5. Stones may form in the kidneys and cause kidney damage. » 6. Infection of the kidneys often results from the spread of infection

from the liver. ■ 7. Low blood pressure gradually damages the kidney. у-8. A stone in the ureter may cause urinary obstruction.

9. X-ray examination may detect blood or white blood cells resulting from infection.

Д-40. Chemical testing of the urine detects the presence of the abnormal substances.

2. Answer the questions, using given words and word combinations:

Injury; infection; cancer; oedema; acute abdominal pain; accident; rupture; diabetes insipidus; cause; nephritis; glomerulonephritis.

1. What may cause kidney damage?

2. What does the treatment of kidney diseases depend on?

3. What affect kidney function?

4. What are the symptoms of kidney disease?

5. What kidney diseases do you know?

1. Complete the following sentences, using active vocabulary.

   1. Microscopic crystals form in the kidney ... .

   2. The body depends on the kidneys to £> П ФЩ/

   3. Kidney diseases may be caused by majiy factors, such asI'WJA

   4. A stone in the ureter may cause . І^^О^Щ [y^ ^

   5. Kidney disease may cause an ... .

   6. Many disorders in other parts of the body

   7. High blood pressure often continues rP. Г С {^МШ^

   8. Diabetes mglitus not only causes 4ШЫ Щ Щ &fj)lҐЩ* ^JJ ^Jj'J)

9. M фя

   Suspected kidney disease can be ... . * 10. Examination of urine through a ... .Key: acute abdominal pain; and generalized oedema; blood in urine; vari­ous hormone disorders; Cushig's syndrome, and diabetes insipidus; if both kid­neys stop working completely, waste produce accumulate in the, body and poi son the patient; their cause; the kidney may be damaged in a serious accident, causing a rupture of is surrounding capsule and leading to severe hemorrhage; radiotherapy treatment carried out for cancer; sffrnes; high blood pressure, metabolic disorders, etc.

1. Say, what is wrong or right in the following statements and why:

   1. High blood pressure gradually damages the kidney.

   2. The damaged kidney may not be surgically removed.

   3. Stones may be formed in the kidneys and cause kidney damage.

   4. A stone in the ureter may cause urinary obstruction.

   5. The kidneys may become only infected.

2. Translate into Ukrainian; define Participle.

   1. Many people do not appreciate the important difference between retaining health and regaining it.

   2. Every may enjoy perfect health, by conforming to a fat rational regulations.

   3. Restoring health is much more difficult task than retaining it.

   4. Healing slowly the wound continued to bleed.

   5. Bleeding small wound disturbed him very much.

   6. He continued applying anesthesia.

3. Make up sentences of your own with the following word combinations:

as far as; into a state of; in respect of; along with; compared with; in honour.

7. Fill in the prepositions where it is necessary, translate the sentences:

Cystitis rarely is a primary condition. It usually is a secondary ... an infection of the kidney, prostate or urethra. The bladder epithelium nor­mally is highly resistant ... infection. Following major surgical proce­dures, childbirth and prolonged bed rest lowered resistance, plus inade­quate bladder emptying, predispose to the development ... cystitis.

Pathology may vary ... slight increase vascularity of the trigonal region ... generalized oedema and ulceration. Cystitis ... long duration may produce a thickwalled, contracted bladder ... small capacity. Calcareous incrustations ... the epithelium result chronic infections dye

§1 cfoM'jtf К tf3gl у/ірі/... the ureasplitting bacteria. Pain is present ... the perineal and supra­pubic regions. Chills, fever and systemic manifestations, when present, may be ... bacteremia. Symptoms and signs are the same ... chronic cysti­tis, but are ... lesser degree.

8. Form Present Participle (active) from the verbs given in the brackets:

   1. The patient (to complain) of severe headache asks for some medicine.

   2. (To suffer) from acute pain in the abdomen he couldn't fall asleep.

   3. Blood (to come) from all parts of the body enters the right auricle through the two veins.

   4. (To examine) the patient, the doctor asked him to breathe deeply.

   5. The rash (to appear) the entire trunk in scarlet fever extends rapidly all over the body.

9. Form Present Participle (passive) from the verbs given in brackets:

   1. (To send) to the sanatorium, he could not finish his work.

   2. (To treat) at the hospital, he recovered quickly.

   3. (To admit) to the hospital, the patient is given immediately some treatment.

   4. (To wound) he was taken to the hospital.

(To swell) and tense his left arm gives him much trouble.

X. Choose the proper answer on

1. What is cystic disease?

2. What damage the kid­neys?

3. What may cause urinary obstruction?

4. What symptoms of kidney disease do you know?

5. What helps to detect kid­ney disease?

6. What do the symptoms of kidney disease depend on?

7. What may cause blood in the urine?

the right.

1. Yes, they have.

2. A stone in the ureter may cause urinary obstruction.

3. Some kidney disease, such as acute nephritis, may cause blood in the urine.

4. The symptoms of kidney disease depend on the underlying cause.

5. The kidney may become infected and inflamed.

6. High blood pressure gradually da­mages the kidney.

7. Examination of urine through a microscope may detect blood or white blood cells resulting from infection.

8. What do you know about radiotherapy treatment?

9. Many disorders in other parts of the body have an effect on the kidney, have not they?

10. May the kidney become inflamed?

8. Rarely, the kidney may be dam­aged by radiotherapy treatment' carried out for cancer.

9. It is usually relating to or charac­terized by cysts and relating to the gall bladder or urinary blad­der.

10. Other symptoms of kidney disease include acute abdominal pain, and generalized oedema

.

Key: 1-9, 2-6, 3-2, 4-10, 5-7, 6-4, 7-3, 8-8, 9-1, 10-5.

11. Try to continue the following dialogue, using active vocabulary from the Text № 1.

    1. Question: What are the symptoms of kidney disease? Answer: ....

Question: What cause kidney disease? Answer: ....

Question: What tests are carried out to diagnose kidney disease?

2. Questipk: ....

Answer: The treatment of kidney disease depends on their cause, and may involve the skilled care of a nephrologist, a specialist in kidney disease?

11. Do you know that

Uremia is a toxic condition in which waste products of protein diges­tion, such as urea, are retained in the blood instead of being excreted in the urine.

Nocturia commonly occurs in the elderly because the kidneys are less able to concentrate urine, and it becomes necessary to empty the bladder once or twice a night.

Oliguria is the excretion of abnormally small amounts of urine. It may occur as the result of a high fever, poisoning, or shock. Oliguria may also be a symptom of a kidney disorder such as nephritis, pyelonephritis, or uremia.

11. Remember the following proverbs; find adequate equivalence in Ukrainian; give your own equivalents:

"Habit cures habit".

"Many words hurt more than swords".

"No pains, no gains".

"Wealth is nothing without health".

V/Text 2

fThe&ize of a calcuLu^ari^s^frorg^^py small gravefto a large stag- horn tffone which m&vjnuthe ^тді ■ pelvik, Саіиийі oxalate stones usual­ly are

Ша. ft

rough and liara, while calcium phosphate stones tend to be soft, white, chalky and frequently stag-horn in shapejMigration of a stone may cause obstruction with resultant stasis, infection and clinical manifestations.fPersistent or repeated obstruction leads to pyonephrosis or hydronephrosis. When a stone enters and obstructs the ureter renal colic occurs.fThere is excruciating pain which originates in the back of flank and radiates across the abdomen and into the groin, genitalia and inner aspect of the thigh. There may be nausea, vomiting, sweating, fre­quency, urgency, chills and shocktf Examination reveals slight soreness over the involved kidney and ureter, spasm of the abdominal muscles, albuminuria and microscopic haematuria. - ^ ^

Intermittent or persistent obstruction to the flow of urine leads to stasis, infection, hydronephrosis and renal destruction if the obstruction is bilateral, anuria and uremia ensue.

1. Read the text "calculi" and say whether the following statements are true to the text.

--Л. When a stone enters and obstructs the ureter, renal colic does not occur.

-f-2. Intermittent or persistent obstruction to the flow of urine leads to stasis, infection, hydronephrosis and renal destruction.

—3. Calcium oxalate stones usually are small, white, rough and not hard.

4 4. The pain in case of calculi originates in the back or flank and radi­ates across the abdomen and into the groin.

—5. There may be only nausea and vomiting in calculi.

2. Answer the following questions on text "calculi" and check yourself using the key, given below:

   1. What may cause obstruction with resultant stasis?

   2. Does persistent obstruction lead to pyonephrosis?

Where does the pain radiate across

?

4. When does renal colic occur?

5. Is persistent obstruction a cause of stasis?

6. Is passage of vesical calculi usually complicated?

7. What may be produced by vesical calculi?

8. Is it easy to reveal cysteine stones by X-ray examination? Key:

Usually, pain radiates into the groin, genitalia and inner aspect of f the thigh. 92. No, it is not. Yes, it does.

АЛ. Migration of the stone may cause obstruction with resultant stasis. Renal colic occur when a stone enters and obstructs the ureter. Vesical calculi may produce bladder irritation with resultant pain frequency, haematuria, pyuria and albuminuria. p7. No, it is not. Yes, it is.

III. Choose the correct definitions to the following terms:

obstruction and infection of the kidney in pus resulting formation;denoting stoppage of a flow of liquid, stagnation;a term indicating the blockage of a body vessel. It may by caused by foreign objects by naturally formed "stones" (gallstones);relating to or affecting the kidney;£

1. calculus

2. obstruction

3. renal (adj.)

4. pyelonephritis stasis

a storie a hard pebble-like mass formed within the body, particularly in the gall bladder or in the urinary tract

.

IV. S$y it in one word.

1. Electromagnetic radiation of extremely short wavelength, with great penetration power in matter opaque to light.

2. The main breakdown product of protein metabolism.

3. The presence of excessive amounts of urea and other nitrogenous waste compounds in the blood.

4. The active unit of excretion in the kidney.

5. The branch: of medicine concerned with the study, investigation, and management of diseases of the kidney.

Key: urea; uremia, X-rays; nephron; nephrology

.

V. Read and translate the text (case report). Describe the

patient's condition before and after the treatment, name all kinds of medical procedures which were made; state the diagnosis.

CASE REPORT

J. S., a 60-year-old white woman was in good health until April 4, 1989 when severe pain developed in the back and right flank, associated with nausea and vomiting. She was admitted to the hospital and exami­nation of the abdomen revealed a large mass and tenderness in the right flank. The remainder of the physical examination was unremarkable. An excretory urogram (IVP) revealed a large mass in the upper portion of the right kidney compressing the caliceal system. Multiple gallstones were noted. On April 10 she underwent an exploratory operation. A large tumor of the right kidney measured 5 by 8 cm was discovered. The tumor bled easily. No metastases were noted in the abdomen. A biopsy was per­formed and pathological examination revealed a well differentiated lipo- sarcoma of the kidney. No attempt was made to remove the tumor and the patient was treated postoperatively with 2,440 rads of cobalt-60 radiation therapy during the following 3 weeks.

On November 1 she was readmitted to the hospital for further evalu­ation. An arteriogram showed a large mass in the upper pole of the right kidney. There was stretching and displacement of the intravenal arterial branches. Neovascularity and pooling of the contrast material were noted in portions of the tumor. An inferior venacavogram was performed. The tumor displaced the vena cava but did not invade it. The patient was started on chemotherapy consisting of 600 mg cyclophosphamide, 1 mg cosmegen and 2 mg vincristine. She received 2 courses of this regimen and on January 9 and March 4, 1995 received a repeated course with the addition of adriamycin. On June 4 a repeated arteriogram showed con­siderable shrinkage of the tumor. The patient was reexplored on June 25 and residual tumor could be seen on the upper lateral aspect of the right kidney although the biopsies of this area revealed no evidence of tumor. Convalescence has remained uneventful. Key: renal liposarcoma.

CONTROL ASSIGNMENTS

I. Ask another student:

1. About the function of kidneys.

2. About the location of the kidneys in the human body.

3. About the diseases of kidneys and the causes of them.

4. About the treatment of kidney diseases.

   2. Explain the following conditions:

      1. The patient was a well-developed middle-aged male.

      2. This patient underwent the chemotherapy.

      3. The outlook is favorable in children who have no mental deficien­cy or severe organic disease.

   3. A friend of yours has told you that he has had some trouble with his kidneys, give him advices, using active words and word combinations from the topic "KIDNEY DISEASES".

   4. The followiig are terms referring to some types of diseases. Combine the corresponding ones:

      1. inflammation of the urethra;

      2. bacterial infection of the kidney substance;

      3. a disease of the kidneys resulting in the syndrome of acute nephritis;

      4. an inherited disorder, transmitted as an autosomal dominant, in which the substance of both kidneys is largely replaced by numerous cysts

   5. Put in the suitable words in the following sentences: use the key below.

      1. Pelvic kidney, usually lying over the sacral promontory, may com-

/

plicate pregnancy because of outflow ....

2. The congenitally solitary kidney usually is both hyperplastic and hypertrophic, maintaining normal ....

3. Diagnosis of kidney disease in early childhood may be difficult in the absence of a positive ....

4. The prognosis is limited, whether hepatic or renal ... predominates.

5. Although the liver is abnormal, death occurs from ... within 6 to 8 wk after birth.

1. glomerulonephritis;

2. pyelonephritis;

3. urethritis;

4. polycystic disease of the kidney.

Key: dysfunction; renal function; renal failure; obstruction; family history.

TEXTS FOR INDIVIDUAL READING

ACUTE RENAL FAILURE

( The term acute renal failure has been used loosely to include all fornix of acute urinary suppression, generally secondary to acute parenchym.nl damage.'Acute tubular necrosis (or lower nephron nephrosis) indicates the clinical and pathologic syndrome which results when renal excretory func tion is temporarily lost because of renal tubular degeneration caused by renal ischemia or toxic agents./

In the majority of cases, acute tubular necrosis is characterized by a period of oliguria and increasing clinical and chemical evidence of renal failure lasting from a few days to as long as 6 to 8 weeks, averaging about 10 to 14 days. This is succeeded by a period of relatively rapid return of urine flow and improvement in renal function, while water and metabo­lites accumulated during the oliguric phase are excreted.

\ During first few days of oliguria, the clinical picture is dominated by the underlying illness; The urine is scanty and usually bloody. Although the specific gravity may be high owing to the presence of red blood cells and protein, its freezing point, is close to that of plasma, and sodium con­centration is usually over 50 meq per liter. Traces of glucose may appear in the urine, complete anuria for more than 24h is infrequently encoun­tered, though it is common to see less than 30 to 40 ml urine for several days. If the condition is not recognized early, edema and/or hyponatrem­ia may develop as a result of the unrestricted intake of fluids. If this pit­fall is avoided and shock is successfully treated, the only symptoms dur­ing the first week may be lethargy and nausea. The latter is related par­tially to the development of metabolic acidosis. Fever is uncommon after the first day or two. Leukocytosis, on the other hand, is the rule with or without infection, it should be emphasized that severe systemic symptoms during the first several days are usually, a result not of renal failure but of associated conditions.

f Cardiovascular complications arise in most patients during the olig­uric phase of acute renal failure'.) Although overhydration is the most important cause of pulmonary edema, signs of pulmonary congestion and cardiac failure may appear even in patients who have not gained weight, probably because water has been added to the extracellular fluid from the dissolution of tissue. Pulmonary edema may develop in the absence of hypertension and without peripheral edema. Diastolic hypertension becomes evident in about 25 percent of patients during the second week

Is the, mc©rfrequent cotnplicatio

^Xnfec^tion^ is the, m^^f rfe^i^ntccHrnplication ^of acut£ tubular necrosis n dlgf' most commSon ca^use of deaths Sepsis may often be overlooked

Sepsis may

■ipMtf, 'іш шт^ ч-гл*' Ac&w* 7

l>ecau£&_P$f соптвіод with uremic symptoms. Pulmonary алеї bloodstream іorganisms IrequehC i^^xmmSted, 'lem^co- matc^l \pafieiits/ Common predisposing' factors £&e iS^&of*'ability, "to coilg;n dr change position/ during drying of the pharyngeal mucosa from constant mouth breathing, and the aspiration of inspissated mucous plugs or vomitus.

I Neurologic manifestations are common, the two most important being coma and convulsions^ Hyponatremia may be responsible for somnolence or seizures early in the course of acute renal failure and may be correct- ed by hypertonic saline solution, with proper regard for the complications of overhydration and heart failure. Hypocalcemia may also predispose to

с °

convulsions, as may too vigorous administration of alkali without accom­panying calcium in the treatment of acidosis. /

Anemia usually appears in the second week, even without bleeding,

і " a

presumably as a result of a mild increase in erythrocyte destruction and a deficiency in red blood cell production. Defects in hemostasis are com­monly encountered and include thrombocytopenia abnormal prothrombin if"¹

consumption time, and other less well-defined coagulation deficiencies.

• с

Diuresis is usually associated with a striking weight loss, represent­ing loss of fluid accumulated during the period of oliguria. The urinary concentration of sodium usually varies from 50 to 75 meq per liter. Some of the excreted sodium is derived from edema fluid, but if the remainder is not replaced, hyponatremia may ensue. Elevated levels of serum sodi­um and chloride are observed during the diuretic phase when water replacement is inadequate and the patient is allowed to dehydrate himself through the obligatory excretion of a large volume of urine containing

sodium at a lower concentration than plasma. Occasionally, urinary lass­ie І es of potassium so greatly exceed intake that the serum potassium level

falls below normal. Once established, diuresis proceeds smoothly unless

interrupted by urinary obstruction or shock, and azotemia regresses over

the course of I to 3 weeks. If diuresis is interrupted by a second period

of oliguria and rising blood urea concentration, obstruction to bladder or

ureters must be seriously considered, although volume depletion rather

than obstruction, is a more common cause of a plateau or decrease in

urine volume during recovery phase of acute renal failure.

1. Skim through the text and find part of it dealing with the clinical picture and changes which may take place in the organism.

2. Divide the text into several logical parts. Choose the key sentences and translate them.

3. Entitle each of the logical parts of the text.

4. Give a written translation of the paragraph dealing with the clinical picture of the disease during the first few days of oliguria.

5. Approve or contradict:

   1. in the majority of cases, acute tubular necrosis is characterized by a period of oliguria and decreasing clinical and chemical evidence of renal failure only a few days;

   2. leukocytosis is without infection. Diuresis is usually associated with a striking weight increase representing loss of fluid accumu­lated during the period of oliguria.

6. Comment on the title of the text.

7. Write a short annotation of the text.

GLOMERULAR DISEASE

If The patient with glomerular disease may seek a physician's advice because of several clinical problems. For example, the onset of the acute nephritic syndrome may be dominated by the occurrence of gross hema­turia or smoky urine. The hematuria, however, may be microscopic, in which case the patient may present because of the occurrence of perior­bital edema or edema of the distal extremities. Symptoms of hypertension and circulatory overload also may dominate the clinical presentation of the acute nephritic syndrome. Many attempts have been made to correlate the clinical presentation of acute nephritis with the histologic renal dis­ease and its natural history. Such correlations have shown that the acute nephritic syndrome may be associated with a variety of morphologic changes in the kidney each of which has a profoundly different progno­sis. For example a patient may present with gross, hematuria as a mani­festation of idiopathic recurrent hematuria with focal glomerulonephri­tis. On the other hand, gross hematuria can be the initial manifestation of rapidly progressive diffuse proliferative glomerulonephritis and exten­sive epithelial crescent formation. While long-term prognosis of idio­pathic recurrent hematuria is excellent, prognosis of rapidly progressive glomerulonephritis is dismal. Yet the patient with either disease may pre­sent with gross hematuria.

The secondary clinical manifestations of the acute nephritic syndrome also may be misleading respect to the morphology and prognosis of the renal disease. While hypertension and circulatory fluid overload may occur in the acute nephritic syndrome associated with acute poststrepto­coccal glomerulonephritis, these manifestations also may be the dominat­ing features of end stage chronic glomerulonephritis. The prognosis of acute poststreptococcal glomerulonephritis in general is good (see below), while the patient with bilaterally shrunken kidneys consisting of many sclerotic glomeruli obviously has a poorer prognosis. Here again, the clin­ical manifestations causing the patient to seek the physician's advice may be identical, yet the renal morphology and prognosis may be poles apart.

The occurrence of hematuria and red blood cell casts generally indi­cates the presence of either diffuse or focal proliferative glomeru­lonephritis. The proliferation may involve the mesangium the endothelial or epithelial capillary cells, or a combination thereof. Infiltration of the glomeruli with polymorphonuclear leukocytes also may occur and has been termed exudative glomerulonephritis. It should be emphasized, how­ever, that microscopic hematuria may occur in a significant percentage (30 to 50 percent) of patients whose kidneys do not have the morpholog­ic appearance of proliferative glomerulonephritis but of membranous glomerulopathy or focal glomerulosclerosis. Again, this represents an obvious deficiency in clinico-pathologic correlations.

A number of patients with glomerular disease may not have any man­ifestations of the acute nephritic syndrome but have symptomless urinary abnormalities on routine examination. The urinary abnormalities associ­ated with glomerular disease may include red blood cells, red blood cell casts, and proteinuria. With symptomless urinary abnormalities the renal function as measured by endogenous creatinine clearance may be normal, supernormal, or moderately impaired. With severe renal impairment the patient is generally symptomatic,

When thp proteinuria is profuse, the presence of edema and other manifestations of the nephrotic syndrome may dominate the clinical pre­sentation. As with the acute nephritic syndrome, the renal morphology and natural history may be considerably different in patients presenting with the same clinical features of the nephrotic syndrome. If the glo­meruli appear normal on light microscopy (minimal change, nil disease or lipoid nephrosis), corticosteroid therapy causes a remission of the disease in the large majority of patients while corticosteroids are generally inef­fective in patients with nephrotic syndrome secondary to membranous glomerulopathy or proliferative glomerulonephritis. In general the longer the persistence of the nephrotic syndrome, the worse the prognosis.

1. Skim through the text and choose sentences containing

information about.

1. the correlation of the clinical presentation of the acute nephritis with the histologic renal disease and its natural history,

2. what signs of the disease may be in a number of patients with glomerular disease;

3. the occurrence of hematuria and red blood cells.

1. Choose from the text and translate all the sentences containing

the root "glomer".

3. Make up a plan of the text.

4. Approve or contradict:

f 1) when tl^e proteinuria is profuse, the absence of edema and other manifestations of nephrotic syndrome may be as the clinical pre­sentation;

2. symptoms of hypertension and circulatory overload also may dom­inate the clinical presentation of the acute nephritic syndrome;

3. small hematuria can be the single manifestation of rapidly pro­gressive diffuse proliferative glomerulonephritis and extensive epithelial crescent formation;

4. in general the longer the persistence of the nephrotic syndrome, the best the prognosis;

5. the urinary abnormalities associated with glomerular disease may include red blood cells, red blood cell casts, and proteinuria.

   5. Write a short annotation of the text.

RENAL ARTERIAL OCCLUSION

Arterial infarction of the kidney is usually attended by sudden sharp unremitting pain in the upper part of the abdomen or flank. The most common cause is embolic occlusion. Fever and moderate leukocytosis are common, especially when a major branch of the renal artery has been occluded. Gross hematuria is not unusual, and microscopic hematuria is present in more than half the cases. The blood urea nitrogen usually is not abnormal unless there is contralateral disease. Shortly after a renal infarct the kidney may not function on intravenous pyelography although it appears normal in size and retrograde pyelograms are normal. During the ensuing days or weeks, function is slowly regained.

When occlusion of the renal artery is incomplete as a result of ather­osclerotic narrowing, or if a branch of the main renal artery is occluded and viability of kidney tissue is preserved by collateral circulation, hyper­tension way ensue which is often of the rapidly progressive type, though reversible by nephrectomy. In such patients, intravenous pyelogram car­ried out at 1 and 2 min characteristically show differences in filling times between the affected kidney and the uninvolved one. In a significant minority of cases, albuminuria is absent and the urinary sediment may be completely normal. The diagnosis may be made by studies of the volume and composition of urine obtained on bilateral ureteral catheterization, by aortography, and by measurement of renal venous renin. Often the affect­ed kidney is contracted.

When the artery to a single functioning kidney becomes narrowed, or when both renal arteries are occluded, renal failure is likely to progress rapidly usually accompanied by hypertension. This form 4f renal failure can be diagnosed by renal arteriography and can be reversed by surgical­ly bypassing the occlusion. Plasma renin is usually low or normal, owing to the retention of salt and water, in contrast to hypertension due to uni­lateral renal arterial occlusion.

1. Look for the answers to the following questions:

   1. When is renal failure likely to progress rapidly?

   2. What is the most common cause in case of arterial infarction of the kidney?

   3. In what case is the affected kidney contracted?

   4. What form of renal failure can be diagnosed by renal arteriogra­phy and can be reversed by surgically bypassing the occlusion?

   5. What can you tell about plasma renin?

2. Choose, from the text and translate all the sentences containing

the word "kidney".

3. Try to grasp the main idea of the text. Write it in some

sentences.

ACUTE PYELONEPHRITIS

The symptoms of acute pyelonephritis generally develop rapidly over a period of a few hours or a day or two. The characteristics are aching pain in the lumbar region and fever which may be high, often with shak­ing chills. There may be nausea, vomiting, and diarrhea or, occasionally, constipation. Dysuria and frequency are also common.

On physical examination in addition to fever and some generalized tenderness of the muscles, the key finding is tenderness on deep pressure in one or both of the costovertebral areas or on bimanual palpation of the kidney region. Occasionally, this sign is absent.

Except in individuals with papillary necrosis or urinary obstruction the manifestation of acute pyelonephritis usually subside within days, even without specific antibacterial therapy. The patient becomes symp­tom-tree although laboratory tests may show that bacteriuria with or without pyuria is still present. When pyelonephritis is severe, fever sub­sides more slowly and may not disappear for several days even after appropriate antibiotic treatment has been started.

Most persons recover completely and permanently after and attack of acute pyelonephritis, but in a considerable proportion of cases there are repeated attacks, at irregular intervals, sometimes over a period of many years; between these attacks the patient may be symptom-free. Bacteriuria and pyuria are often demonstrable during these symptom-free intervals. Infection in any part of the urinary tract is capable of subclin­ical continuation for months or years, during which a patient may have no symptoms and may live an apparently normal life, even though urine cultures provide continuing evidence of active infection.

1. Approve or contradict:

   1. the patient becomes symptom free - although laboratory tests may show that bacteriuria with pyuria is still present;

   2. the symptoms of acute pyelonephritis are: fever, vomiting and aching pain in the lumbar region;

   3. when pyelonephritis is severe, fever subsides more slowly and may not disappear for several days, even after appropriate antibiotic treatment has been started;

   4. bacteriuria and pyuria are absent in case of acute pyelonephritis;

   5. infection in any part of the urinary tract is capable of subclinical continuation for months or years.

2. Skim through the text and choose the sentences containing the

word "bacteriuria".

3. Give a written translation of the sentences dealing with the

manifestation of acute pyelonephritis.

CHRONIC PYELONEPHRITIS

I Chronic pyelonephritis is that variety of chronic interstitial nephritis resulting from bacterial infection of the kidney.] But unlike urinary tract infections, for which simple diagnostic criteria are available, the diagno­sis of chronic pyelonephritis is reached only after careful consideration of various nonpathognomonic clinical and pathologic findings data, are dif­ficult to obtain and are too often available for only a fraction of the patients illness. As a consequence there are no reliable data concerning the prevalence of chronic nonobstructive pyelonephiritis.

/Urinary obstruction is a common accompaniment of chronic pyelo­nephritis but in a large proportion of cases obstruction cannot be demon­strated anatomically./ Most patients with renal lesions which fulfill crite­ria for chronic pyelonephritis at autopsy have sterile kidney cultures and were not known to have had clinical episodes of bacterial urinary infec­tion. These observations have stimulated investigations into factors other than obstruction which make the kidney susceptible to infection and into, other injuries which may result in morphologic changes in the kidney resembling those produced by bacterial infection.

( Many patients with chronic pyelonephritis develop hypertension at some time in the course of their illness^ It has been suggested that this is related to the contraction of scar tissue and to endarteritis obliterans with focal renal ischemia, rather than to diffuse renal damage. Occa­sionally, the blood pressure may become elevated long before there is mea­surable impairment of renal function, and only a persistently positive urine culture or characteristic changes in the intravenous pyelogram may distinguish the clinical picture from that of "essential" or "malignant" hypertension.

f In general, glomerular filtration and renal blood flow decline togeth­er and proportionally as the disease progresses^ As might be expected, there is usually more disparity between the function of the right and left kidneys than is generally the case in diffuse diseases of the kidney such as glomerulonephritis or nephrosclerosis. Maximum concentraing ability tends to become impaired earlier in the course of the disease than in pa­tients with chronic glomerulonephritis. Occasional patients with advanced azotemia may excrete a urine hypotonic to plasma, even when they are dehydrated. Many patients are unable to conserve sodium on a lowsalt diet, even when only mild azotemia is present. Polyuria and nocturia are prominent in such cases. Hyperchloremic acidosis as a result of impaired renal excretion of acid and reabsorption of bicarbonate is more often a feature of chronic pyelonephritis than of glomerulonephritis. Proteinuria is usually less than 2 g (rarely as much as 4 to 6 g) daily, except when congestive heart failure supervenes.

When pyelonephritis is not accompanied by hypertension, the course may be prolonged and compatible with comfortable and useful life even after considerable encreachment upon renal function in perhaps no other disease of the kidneys can fluctuations in renal function be so marked or so frequent. During acute infections or episodes of dehydration, renal decompensation may progress to the stage of advanced uremia; yet the patient may be able to recover and carry on with adequate though impaired renal function for years. Nonspecific complaints of fatigue, anorexia, and weakness often remit remarkably when the urine is steril­ized by an appropriate course of antibiotics and when acidosis, dehydra­tion, and salt depletion are adequately treated.

The problem of recurrent infections, sometimes with resistant bacte­ria, is important and unsolved. An effort should be made to treat urinary tract obstruction and to improve bladder emptying, when residual urine is present. Reducing the bacterial population of bladder urine by the pro­longed administration of urinary antiseptics may offer some hope for halting the indolent progression of the disease.

Even when one kidney appears small and the other normal in size, pyelonephritis is in most instances bilateral. Nephrectomy which is under­taken in the hope of eradicating infection is generally doomed to failure.

This general view of the frequency of asymptomatic destruction of the kidney in pyelonephritis may be incorrect, since some of the patients may have had some other form of chronic interstitial nephritis; rather than pyelonephritis. Proper understanding of the problem requires continued careful study with clear recognition of the possible error of traditional concepts.

I. Look for the answers to the following questions.

1. Is pyelonephritis accompanied by hypertension?

2. What is more often a feature of chronic pyelonephritis then of glomerulonephritis?

3. What is difficult to obtain and why?

4. In what cases are polyuria and nocturia prominent?

5. What may offer hope for halting the indolent progression of the disease?

6. What reason (aim) is nephrectomy undertaken with?

7. What may occasional patients excrete with advanced azotemia?

8. What problem is unsolved?

9. In what instances is pyelonephritis bilateral?

10. What is a common accompaniment of chronic pyelonephritis?

2. Give a written translation of the paragraph:

   1. dealing with the problem of recurrent infections;

   2. dealing with patients with chronic pyelonephritis and hyperten­sion.

3. Choose from the text and translate all the sentences containing the words "renal", "kidney".

4. Divide the text into 3-4 logical parts. Choose the key sentences and translate them.

5. Make up a plan of the text using the active vocabulary.

2. Write a short annotation of the text.

ш _t

14. thii

jet 'and^

varying

POLYCYSTIC KIDNEY

.isorcCeK jnoripdi rc^n'al tissue^ is gradually replace* ' Щ&фл^іе /cy^ts^f 1^M|eh^^nchyma of^

v

; cases

діІіаГ. The though one кіЙЙ^тйу

wit Befv

>fs а^гб . in 'adiilts

мШк ш

^^td fS^M Mes Щ^гЩёЩ^Шar<* Шеd ^

leys

pax^ncny-' not Жтпііі^ -

M

Ш he^Jt

high incidence of intracranial

^Є '^iVS^r:'J

ine

functional.

ally asymptomatic. Associated with aneurysm, and, death from cerebral hemorrhage occurs in about 10 per­cent of cases.s .... ■ ->-■ , , :^л

прїотШ(Гstage of Ш奴ал^ІїаІ disease, or an unrelated and nonpro­gressive disorder. The condition in the adult is commonly discovered in the fourth, fifth, or sixth decade, frequently in the course of a routine physical examination or- as part of an investigation of asymptomatic hematuria, proteinuria, or hypertension.

Both kidneys are usually palpable; in one-fifth of the cases, only one can be felt, and occasionally" no mass can be^palpated. In all instances, however, intravenous or retrograde pyelography demonstrates enlarged kidneys with elongation of the pelvis, flattening of the ^alyxes, and indentations due to the cysts. Urinary concentrating ability is impaired, even when the blood urea nitrogen is normal. Lumbar and abdominal ache is a frequent complaint, owing to the weight of the kidney which produces tension on the pedicle, to intracystic hemorrhages, or to pressure on other organs. The pain is often increased by exertion and relieved by lying down. Pain may also be colicky and associated with Ьедхаіигіа and the passage of clots or with concomitant renal calculi. Massive and prolonged bleeding into the urin^is" a distressing complication; it sometimes responds to a tight abdominal binder^ Hypertension appears in the third or fourth decade, when symptoms referable to high blood pressure may predominate. After the age of forty or forty five, the more common pre­senting complaints are those associated with renal insufficiency. When a patient comes to the physician with uremia and a palpable "liver" and "spleen", the diagnosis of polycystic kidneys must be considered. Polyuria is common and oliguria is rare, even terminally. The average age at death is between fifty and sixty years; several patients have lived past seventy. Although the rate of progression may be extremely slow, patients gener­ally do not live longer than 5 years after the blood urea nitrogen level rises above 50 mg per 100 ml. However, chronic dialysis or transplanta­tion may modify significantly the life expectancy in selected cases. Superimposed pyelonephritis occurs frequently and may induce renal decompensation, which can be reversed by appropriate treatment.

I. Approve or contradict:

1. massive and prolonged bleeding into the urine is a distressing com­plication;

2. urinary concentrating ability is impaired even when the blood urea nitrogen is not abnormal;

3. multiple cysts observed in adult kidneys in the presence of symp­toms and of a family history may represent the symptomatic stage of the familial disease, or an unrelated and nonprogressive disorder;polyuria is common and oliguria is frequent;

4. in infants the cysts are said to be closed and do not communicate with the renal pelvis;

5. in contrast, the adult familial disease is an autosomal dominant trait, with virtually complete penetrance if the bearers of the gene sur­vive to the ninth decade.

   2. Skim through the text and choose the sentences containing information about:

• pain (ache);

• high blood pressure,

  3. Choose from the text and translate all the sentences containing the word "cyst".

  4. Comment on the title of the text. Express the same meaning using another word.

  5. Give a written translation of the paragraph dealing with the hypertension.

  6. Write a short annotation of the text.

PRE-TEXT ASSIGNMENTS

I. Make up new terms from the main stems of the names of the organs and the suffixes.

Suffix -coele (hernia) -eith (deposit) -spasm (contraction)

2. Identify suffixes in the following terms:

carcinogenesis; biopsy; nephropexy; atrophy; leukocyte; arteriole; mucous; chronic; endoscope; laryngectomy; metastasis; hepatoma; venule; plastic.

2. Fill the blanks beside each word bellow with related words as indicated:

Name of organ bronchus pharynx larynx

DISEASES OF RESPIRATORY TRACT

Text 1: Respiration.

Text 2: Pulmonary Emphysema.

Grammar: Participle II.

Model: respire - respiration - respiratory.

Noun

Verb

Adjective

contract relax

expand ; &

inspire

inhale

exhale

m

breathe ^UX

IV. Learn the following words

:

клітиннии

respiration [,resp9reijn] дихання cellular ['seljub] клітинні oxygen ['oksid3an] кисень

absorb	[9b'so:b]	поглинати
inspire	[in'spaia]	вдихати
expire	[iks'pais]	видихати
exchange	[iks'tfernd3]	обмін
lung	[ІЛЧ]	легеня
trachea	[tra'kia]	трахея
pharynx	['faeriqks]	глотка
alveolus	[sel'vi:3bs]	альвеоляр
capillary	[ks'pilsri]	капіляр
bronchus	['brogkss]	бронх

1. V. Match the following English words and word combinations with Ukrainian ones:lung!

2. exchangi

3. capillarie;

4. protect

5. foreignbo

6. аііц^ ...

7. upper

8. branch^ .9. divide* 10. reach

. верхній повітря 3. легені .4. капіляри . досягати . обмінювати

7. захищати, обороняти

8. чужорідне тіло

9. галузь, розгалуження 0. розділяти, поділяти

VI. Match words with the proper definitions:

7. laryn:

8. lung

4. vocal cords

5. thorax f v.,

one of the pair organs of respiration, situated in the chest cavity on either side of the heart and enclosed by a serais piembr ane; a blihd-ended air sac of microscopic size; the organ responsible for the production of vocal sounds, also serving as an air passage conveying air from the pharynx to the lungs. It is situated in the front of the neck, above the trachea; a muscular tube, lined with mucous membrane, that Extends from the beginning of the esopftagu^' up to the,base of the skull;

he two fdids .of tissue which protrude "from the sides of the laitypx to form a narrow slit (glottis) across the air passage;

1. alveolu

s

the part of the body cavity between the neck and the diaphragm;

6. pharynx

7. trachea

8. bronchus

7.

8.

У

any of the air passages beyond the windpipe that has cartilage and mucous glands in its wall; the part of the air passage between the larynx and the main bronchi, from just below the Adam's apple, passing behind the notch of the sternum (breastbone) to behind the angle of the sternum.

VII. Choose the proper continuation

1. Respiratory Distress Syndrome (RDS) is & due to diffuse lung atelectasis that develops when pulmonary surfactants are deficient at ... .

2. The diagnosis of the respiratory diseases ^ based on the history, physical examination and ... .

3. Pleurisy is the inflammation of the pleura, L often characterized clinically by pain J worsened by ... .

4. To prevent complicating pneumonia, adequate bronchial drainage ....

5. Four histologic types of bronchogenic carcinoma usually are ... .

6. Metastases to the lungs are common from primary cancers of the breast, colon, prostate ....

Key: 1-е, 2-b, 3-f> 4-е, 5-а, 6-d.

a) distinguished;

b) laboratory's assessment;

c) birth;

4. kidney, thyroid, stomach, testis and bone;

5. must

be provided;

respiration and cough

.

VIII. Combine each pair of sentences into a single sentence according of the model.

Model: The pharynx is a muscular tube. The pharynx extends from the posterior nares to the top of the larynx.

The pharynx is a muscular tube extending from the posterior nares to the top of the larynx.

1. The lungs are light and spongy organs. The lungs are located in the thorax on either side of the hear

t

2. The alveoli are tiny, air sacs. The alveoli form the terminal portion of the respiratory tract.

3. The trachea is a median, elastic structure. The trachea extends from the larynx down through the neck into the thorax.

4. The nose is a respiratory organ. The nose is composed of an exter­nal portion that protrudes from the face and an internal portion underneath the cranium.

5. The bronchi are mobile, elastic structures. The bronchi branch into smaller and smaller organs which extend to all portions of the lung.

   9. Head and translate into Ukrainian.

The respiratory system is composed of the nose, pharynx, larynx, vocal cords, trachea, bifurcation of trachea, the main bronchi, the bron­chioles and the alveoli of the lungs.

The pharynx, or throat extends from the posterior nares to the top of the larynx and esophagus. The larynx, or voicebox, is located in the neck at the top of the passage leading to the lungs. It is formed by a number of cartilages, held together by ligaments and controlled by skeletal mus­cles. Its cavity is lined with the respiratory mucous membrane which becomes specialized to form the vocal cords.

The trachea, or windpipe, extends from the larynx down through the neck into the thorax.

The lungs are situated in the thorax on either side of the heart. Each lung is divided into lobes, the right lung consists of three lobes upper, middle and lower, and the left lung has two lobes: upper and lower.

9. Translate into English.

   1. Дихання - це сукупність процесів, які забезпечують надходжен­ня в організм кисню та видалення вуглекислого газу.

   2. Дихальна недостатність може бути наслідком порушення функ­ції зовнішнього дихання при легеневій та серцевій недостатності.

   3. При хронічному запаленні легень вражаються бронхи, судини та лімфатична система легенів.

   4. Основні причини виникнення бронхіту у людини - професійний ризик, падіння, охолодження.

Крізь стінки альвеол (у легенях людини їх понад 700 млн.) від­бувається газообмін.

Respiration is a term used to describe two different but interrelate I processes: cellular respiration and mechanical respiration. Cellular respi ration is the process in which cells derive energy by degradation of organ ic molecules. Mechanical respiration is the process by which oxygen required for cellular respiration is absorbed from the atmosphere into tho blood vascular system and the process by which carbon dioxide is excret ed into the atmosphere. The respiratory system has two functional com­ponents, a conducting system for transport of inspired and expired gasea between the atmosphere and the circulatory system, and an interface for passive exchange of gases between the atmosphere and blood.

The conducting system begins essentially as a single tube which divides repeatedly to form airways of ever decreasing diameter. The ter­minal branches of the conducting system open into blind-ended sacs called alveoli. The alveoli, which constitute the bulk of the lung tissue, are thin- walled structures enveloped by a rich network of capillaries, the pul­monary capillaries.

The respiratory system is divided anatomically into two parts, the upper and lower respiratory tracts, which are separated by the pharynx.

Upper respiratory tract comprises a system of interconnected cavities, the nose, paranasal sinuses and the nasopharynx, and is principally involved in filtering and adjusting the temperature of inspired air.

Lower respiratory tract begins at the larynx then continues into the thorax as trachea before dividing into numerous orders of smaller airways to reach the alveoli, there are about twenty orders of branches in man.

The vocal cords of the larynx protect the lower respiratory tract against the entry of foreign bodies, in addition to performing a vital function in speech.

POST-TEXT ASSIGNMENTS

I. Read the text and say whether the following statements are true:

44. The lungs are situated in the thorax on either side of the heart.

2. The trachea, or windpipe, extends from the pharynx down through the neck into the thorax.

Inspiration

The nasal septum divides the nose into two nasal cavities.

-4. The right lung consists of two lobes upper and lower and the left lung has three lobes: upper, middle and lower.

1. The portion of the pleura covering the outer surface of the lungs is called the visceral pleura.

2. The pharynx is divided into the nasopharynx the laryngopharynx and the oropharynx.

3. The lungs have a dual blood supply, the pulmonary system and the bronchial system.

4. Pulmonary artery is the artery that conveys blood from the heart to the lungs for oxygenation.

-9. Respiration is a term used to describe only one process - mechan­ical respiration.

/ 10. The respiratory system has two functional components: a conduct­ing system and the circulatory system.

2. Answer the following questions, using words and word combinations given below.

   1. How many functional components has the respiratory system?

   2. What is cellular respiration?

   3. The conducting system begins essentially as a single tube, does not it?

   4. What do we call alveoli?

   5. What do the vocal cords of the larynx protect?

Key; the terminal branches of the conducting system open into blind-ended sacs called alveoli; the process in which cells derive energy by degradation of organic molecules, yes, it does; conducting system for transport of inspired and expired gasses between the atmosphere and the circulatory system, and inter­face for passive exchange of gases between the atmosphere and blood; lower res­piratory tract against the entry of foreign bodies.

2. Complete the following sentences.

   1. The alveoli, which constitute the bulk of the lung tissue are ....

   2. Upper respiratory tract comprises a ...*.

   3. Mechanical respiration is the process by which ....

   4. The respiratory system is divided anatomically into two parts ....

   5. There are about twenty ....

   6. Respiration is a term used to describe ... .

3. 1. Voice

   Give the meaning of the following:

l.the parts of the body that together are responsible for bringing air into the lungs and for expelling car­bon dioxide from the body;2. pleurisy

3. respiratory system

4. resuscitation

5. vocal cords

6. pulmonary artery

2. artificial respiration which is used to restore breathing after drowning, electric shock or other conditions interfering with breathing;

З.ап inflammation of the pleura, the mem­brane that covers the lungs;

4. the large artery that conveys unoxygenated blood from the lower right chamber of the heart to the lungs;

5. Sounds produced by the vibration of the vocal cords;

6. tissue bands whose vibration causes speech.

V/ Translate the following sentences into Ukrainian, paying

attention to the Participles.

1. The flu is an infectious, wide-spread disease affecting ail ages.

2. The analysis made confirmed the diagnosis of pneumonia.

3. The powders prescribed relieved the cough caused by allergic asthma.

4. Having been treated with penicillin injections the case being pre­sented here showed a marked improvement in his condition,

5. When being at home the patient developed an acute pain.

6. If made in time a tracheotomy can save a patient's life.

   6. ' Fill the blanks with the verbs denoting structure.

      1. The nose ... of the external part visible on the face and the nasal cavity.

      2. The pharynx ... four main coats: mucous, fibrous, muscular and facial.

      3. The larynx ... the thyroid, cricoid, epiglottic, arytenoid, cornicu- late and cuneiform cartilages.

      4. The trachea ... the hyaline cartilage and fibromuscular tissue.

      5. The lungs are spongy organs ... numerous, minute air sacs.

   7. Fill the blanks with the verbs denoting relationship.

      1. The pharynx ... superiorly to the body of the sphenoid and the basi­lar part of the occipital bone; inferiorly it ... with the esophagus. Anteriorly, it ... into the nasal and are cavities and the larynx; posteriorly, ... to the prevertebral muscles, and the upper six cer­vical vertebrae.

The larynx is the organ that ... the lower part of the pharynx with the trachea. Posteriorly, it ... to the laryngopharynx. Laterally, it ... to the carotid sheath, the sternomastoid and the thyroid gland

.

3. Superiorly, the trachea ... with the cricoid cartilage of the larynx. Posteriorly, it ... from the lower cervical and upper dorsal verte­brae by the esophagus.

4. At the midsternal level the trachea ... into two bronchi.

5. The main bronchus ... from the bifurcation of the trachea to the hilus of the corresponding lung.

6. Combine each pair of sentences into a single sentence

according to the model.

Model:

The pharynx is a muscular tube. The pharynx extends from the pos­terior nares to the tap of the larynx.

The pharynx is a muscular tube extending from the posterior nares to the top of the larynx.

1. The alveoli are tiny, air sacs. The alveoli form the terminal portion of the respiratory tract.

2. The bronchi are mobile, elastic structures. The bronchi branch into smaller and smaller organs which extend to all portions of the lung.

3. The pleura is a thin, slippery membrane. The pleura covers the outer surface of each lung and liar tube extending from top of the nes the inner walls of the thoracic cage.

4. The nose is a respiratory organ. The nose is composed of an exter­nal portion that protrudes from the face and an internal portion underneath the cranium.

5. The lungs are light and spongy organs. The lungs are located in the thorax on either side of the heart.

6. Form Past Participle from the verbs, given in brackets.

   1. The patient (to operate on) some days ago feels much better.

   2. The tumor (to reveal) during the operation was not a malignant one.

   3. The heart is an organ (to compose) almost entirely of muscles.

   4. The drug (to prescribe) by the doctor, helped the patient.

   5. The technique of the eye surgery (to introduce) by Filatov is wide­ly adopted in medical practice.

7. Form Present or Past Participles of the verbs, given in brackets.

   1. When tachypnea (associate) with fever or with pulmonary rales is observed in an infant (have) congenital heart disease.

Ascending aorta to pulmonary artery anastomosis is an effective operation (increase) the blood supply to the lung.

3. The surgical techniques (use) at this Institute.

4. Many problems of infants' respiratory diseases (deal) with by the staff of this Experimental Research Institute.

5. The most common signs (see) before the operation are enlargement of the liver tachypnea at rest, cardiac enlargement oedema.

XI. Do you know that.

Pneumothorax is the abnormal entrance of air or gas into lung sacs, causing an imbalance of pressures and difficult respiration.

Sore Throat is the inflammation of pharynx, tonsils or larynx. "Strep" Throat is a common childhood illness caused by a bacterial infection, which is treated with antibiotics.

nfitfJtttc иоьл^л

disedse„ in, which the normal

. Jj.

J pulmonary e: lung stru6turfe, l^faj

odtLjpmon

f.fkt-їіЩ

±Ш

T. P.R. stands for temperature, pulse, respiration.

^emfr'z,: PULMONARY ,EMPHYSEMA

;ma is a clonic lu

Vrea:

are, i^^^thtlpJj^^esL^io^,

щуеь Шк

ЬегИп^йЙоЪе fcoi$lliig aftd of sputum. The patient feels geneyjally, ипдеЦ, v

area of the lungs

gases oxvgen

JThebMy. effective, wax, р|,Леа1іде

I.

Emphysema is often seen at alrTadV^fifc^cl stage <>f cfyonic bronchitis it is also associated with other factors, such as smoking, asthma, and var­ious respiratory and occupational> diseases. Heavily polluted air aggra­vates lung diso^eij -that lead to emphysema. Frequent coughing causes the alveoli to ^T^ptufe and they^ join; together, io

form larger sacs. This ?e of the

for the excj;

_{r t}

_pjBeti^. р^^еаііце ^t^/.tj^e condition is to treat fflfe ed^g/dis^ase befofe em^fry^eirta develops.

emphysema is

present, treatment is directed¹ toward preventing further lung d^nrtage,'" affected persons should stbp smoking, make sure that all respiratory " infections repeive mediqal,treatment ipanjediately, and. perfoipn breatfhjng exefpiseS^o clear, $hy Й^рий^ fjclmt lungs. People witJi s£v;ere, 'e&phy- skma may ^УгSquire oxygen before any" physic^^xm^^r 'sleep Ї fj / ■ •

гошм ⁱ«^T ' ⁽ к ■ " - "

Read the text and say whether the following statements are true to the text.

1. Emphysema is often seen at the initial stage of chronic bronchitis.

In pulmonary emphysema the sputum is absent.

^L 3. The only effective way of dealing with the condition is to treat the

preceding disease before emphysema develops. ~ 4. Pulmonary emphysema is a chronic heart disease. j> 5. Pulmonary emphysema is associated with such factors as: smoking, asthma, and various respiratory and occupational diseases.

2. Choose the sentences from the text reproducing the main information, translate them into Ukrainian.

3. Comment on the following statements.

   1. Pul^igaiao^mphysema is a chrojiiclung disease.

   2. Heavy ^ofltel" air always a^lfSlwitSes lung disorders and that can ^a<f4o%mphyse^. ^

   3. Preventive orraskrfes in dealing with/pulmonary emphysema.

4. Choose the sentences with words and word combinations connected with:

   1. description of the symptoms;

   2. recommendations as for the treatment;

   3. association with other diseases.

5. Render the text using the following key words as an outline. ^

Try to guess the name of the diseases. ^ л ** ,

УЬС'Хубе

Pulm^^ry^mphysema, chronic lung disease, increasing_чbreathless-j ness, ^pnstriic'¹ted feeling, coughing, production of sputum, advanced stage, pofruMt^a^r, гедріг^огу рссдраіїопаї diseases, rupture of the alveoli^ eMfaijfee oT\gksei, preCefytifjf disease, respiratory infections, breathing exercises, physical exertion.

CONTROL ASSIGNMENTS

Read and translate these pieces of information written below. Tr 1.

This .is, -a, disorder in which the patient experiences,, difficulty |;tl breathing,-accompanied Ъу' а sli^hjt wheezing and "a "tigbi" eltiA.' Additional syipptoms can be adr^c^ugh "and vomiting (usually in children). An (attaqlc may start ^suddenly, and the ⁴fear and worry '.that these .souses can prolong the attack. ,,, , ^, _c Cough, particularly in the morning, producing'clear sputuni, some- _/ times shortness qf breath, coughing during day. 'A slight fever, 37,8"C„to 38,9°C. The main symptom is a cough which is usually Worse in the morning, as the bronchi have АЫ drained overnight.

etfyteify *..." < • t

' • 229.

res: ■ >■