Avulsion

An avulsion is a nasty …in the tissue. It is where a section of the … has either been completely or mostly torn off the body. In the case of a partial avulsion, the tissue … for vascular supply. If it is… , it will be cleaned and reattached. If it is not, it will be … and a graft or other closing option explored. In the case of a total avulsion, the part has been ripped completely off and will need to be examined carefully for its… . If it is possible, it will be re-grafted onto the body; if not, it will not be salvaged. An example of this is an amputated … . In some cases, it can be reattached, in some cases, this is not a … .

Exercise 8. Read and translate the text paying attention to Complex Subject Constructions. Put questions to the underlined words.

From the Classical Period to the Medieval Period, the body and the soul were believed to be intimately connected, based on several theories put forth by the philosopher Plato. Wounds on the body were believed to correlate with wounds to the soul and vice versa; wounds were seen as an outward sign of an inward illness. Thus, a man who was wounded physically in a serious way was said to be hindered not only physically but spiritually as well. If the soul was wounded, that wound may also eventually become physically manifest, revealing the true state of the soul. Wounds were also seen as writing on the "tablet" of the body. Wounds acquired in war, for example, told the story of a soldier in a form which all could see and understand, and the wounds of a martyr told the story of their faith.

*a martyr ['ma:t ə ] мученик

Exercise 9. Complete the text with the prepositions from the box below. Open the brackets and use verbs in the correct tense and voice. Translate the text into Ukrainian.

First Case of Type E Wound Botulism (severe poisoning from ingestion of botulin, which affects the central nervous system producing difficulty in swallowing, visual disturbances, and respiratory paralysis: often fatal) Diagnosed Using Real-Time PCR-based method for the diagnosis of wound botulism caused by Clostridium botulinum.

1. The patient was a 24-year-old homeless woman who (to inject) heroin and amphetamine … over 2 years. Previously, she (to treat) for recurrent skin and soft-tissue abscesses following intramuscular and subcutaneous injections. Ten days before hospital admission, an abdominal wall abscess (to incise) … a general practitioner, and antibiotic therapy with flucloxacillin had been prescribed. The culture of wound secretions yielded growth of Staphylococcus aureus, beta-hemolytic group G streptococci, and unspecified anaerobic bacteria.

2. Eight days later, the patient (to start) to experience dysphagia and throat pain and sought medical care …. an emergency room 1 day after the onset of these symptoms. At that time, she (to complain) … generalized weakness and difficulty in speaking, swallowing, and holding her head upright. She was afebrile and manifested a normal level of consciousness. A psychogenic cause for her symptoms was suspected, and she (to refer) for psychiatric assessment. Antibiotic therapy was changed to clindamycin due … persistent purulent drainage from multiple gluteal and abdominal wall abscesses.

3. … the following day, the patient's condition worsened with progressive cranial nerve symptoms and weakness of all extremities. She (to admit) for observation in a neurological ward. One day after this admission, she (to develop) respiratory arrest, after which she was intubated and transferred … an intensive care unit (ICU).

4. … ICU admission, the patient was tetraplegic and had bilateral ptosis and facial paralysis but was fully conscious with intact sensorium. Lumbar puncture and brain-imaging studies not (to reveal) any pathological changes. An electromyogram showed a nonspecific pattern. A clinical diagnosis of wound botulism was made, but antitoxin was not administered due to the extended duration of symptoms before the diagnosis was considered. A tracheostomy (to perform) 2 days … ICU admission. A chest X- ray obtained after tracheal intubation showed right-lower-lobe infiltrates compatible with aspiration pneumonia, and antibiotic therapy cefuroxime (to start).

Exercise 10. Translate the following sentences into English:

1.Відомо, що рана – це пошкодження шкіри, слизової оболонки чи глибокої тканини, що супроводжується болем та кровотечею і має вигляд зяючого отвору.

2.Рани бувають: вогнепальні, різані, рубані, колоті, вдарені, рвані, вкушені, розміжчені.

3.Вогнепальні рани виникають внаслідок кульового або осколкового поранення. Вони бувають: наскрізні, якщо є вхідні і вихідні ранові отвори; сліпі, якщо куля або осколок застряє у тканині тіла та дотичні, якщо куля або осколок пошкоджує шкіру і м’які тканини тіла, але не застряє в них.

4.Різані і колоті рани мають невелику зону пошкоджень, рівні краї, стінки ран зберігають життєздатність, дуже кровоточать, менше піддаються інфікуванню.

5.Колоті проникаючі рани при невеликій зоні пошкодження шкіри чи слизової оболонки можуть мати значну глибину і бути дуже небезпечними через пошкодження внутрішніх органів і занесення до них інфекції.

6.Рубані рани бувають різної глибини, з удареними місцями і розміжченими м’якими тканинами тіла.

7.Вкушені рани завжди інфіковані слиною.

8.Рани можуть бути поверхневими або проникаючими в порожнину черепа, грудну клітку, черевну порожнину. Проникаючі рани найнебезпечніші.

Exercise 11. Explain the following term in English in 5 sentences:

Closed wound, contusion, hematoma.

TEST

1. Incised wounds are caused by …

a) a blunt force trauma b) a clean, sharp-edged object

c) a bullet d) a pointed object

2. Lacerations are caused by …

a) a blunt trauma b) a clean, sharp-edged object c) a bullet

d) a pointed object

3. Abrasions are caused by …

a) a blunt force trauma b) a clean, sharp-edged object

c) a sliding fall onto a rough surface d) a pointed object

4. Puncture wounds are caused by …

a) a blunt force trauma b) a clean, sharp-edged object

c) a bullet d) a pointed object

5. Gunshot wounds are caused by …

a) a blunt force trauma b) a clean, sharp-edged object

c) a bullet d) a pointed object

6. Contusions are caused by …

a) a blunt force trauma b) a clean, sharp-edged object

c) a bullet d) a pointed object

7. Hematomas are caused by …

a) damage to a blood vessel b) a sliding fall onto a rough surface

c) a blunt force trauma d) a bullet

8. Crush injury is caused by …

a) a sliding fall onto a rough surface b) a damage to a blood vessel

c) a great or extreme amount of force applied over a long period of time

d) a blunt force trauma

9. Abrasions are …

a) closed wounds b) superficial wounds c) deep wounds d) tear-like wounds

10. … wounds include pressure, venous, and diabetic ulcers.

a) Acute b) Open c) Chronic d) Penetration

11. The edges … the wound should be realigned to speed healing and lessen scarring.

a) to b) of c) in d) on

12. Abrasions … by a sliding fall onto a rough surface.

a) caused b) cause c) are caused d) are causing

13. Gunshot wounds are generally referred … as a "through-and-through".

a) at b) to c) on d) of

14. Cleansing of the wound and removal of any foreign material is important …

a) during the first 24 hours b) within c) In d) at

15. Open wounds can … according to the object that caused the wound.

a) classify b) classified c) be classified d) classifying

16. Contusions are more commonly known … bruises.

a) as b) of c) for d) in

17. Contusions are caused by a blunt force trauma that … tissue under the skin.

a) damages b) damaged c) damage d) is damaging

18. Most contusions should be monitored … symptoms of hematoma.

a) to b) for c) of d) on

19. Hematomas cause blood to collect … the skin.

a) on b) in c) under d) above

20. These symptoms … immediate medical treatment.

a) require b) required c) requiring d) are required

SHOCK - Шок

Exercise 1. Practice the pronunciation and translate the new words:

Insufficient [insʌ'fi:ʃiənt], throughout [Өru:̀aut], severe [si’vi:ə], lack of smth [‘læk], frightening [‘fraitniɳ], shallow [‘ʃæləu], clammy [‘klæmi], to stare [‘stɛə], anxiety [əɳg’zaiəti], agitation [,æʤi’teiʃn], bluish [blu:iʃ], dehydration [dihai’dreiʃn], consciousness [‘konʃəsnis].

Exercise 2. Learn the following words:

A lack of – брак чогось

Frightening – лякаючий, жахливий

Shallow – неглибокий, поверховий

Clammy – липкий; холодний та вологий на дотик

Fainting – непритомність

To stare – витріщатися

Agitation – хвилювання

Unresponsiveness - несприйнятність

Irreversible – незворотній

To mediate – бути проміжною ланкою

Exercise 3. Find the corresponding equivalents:

Exercise 4. Match the following terms with their definitions:

Exercise 5. Translate the word-combinations into your native language:

Insufficient blood flow, immediate treatment, a traumatic or frightening emotional event, shallow breathing, confusion or unresponsiveness, bluish lips and fingernails, intra-abdominal infections, allergy to insect stings, congestive heart failure, spinal cord injury, to identify the underlying cause, a poor prognosis, in minor cases, prompt treatment, damage to a person's vital organs.

Exercise 6. Read and translate the text:

SHOCK

Shock is a life-threatening medical condition as a result of insufficient blood flow throughout the body. Shock often accompanies severe injury or illness. Medical shock is a medical emergency and can lead to other conditions such as lack of oxygen in the body's tissues (hypoxia), heart attack (cardiac arrest) or organ damage. It requires immediate treatment as symptoms can worsen rapidly.

Medical shock is different than emotional or psychological shock that can occur following a traumatic or frightening emotional event.

The main symptom of shock is low blood pressure. Other symptoms include rapid, shallow breathing; cold, clammy skin; rapid, weak pulse; dizziness, fainting, or weakness.

Depending on the type of shock the following symptoms may also be observed: eyes appear to stare, anxiety or agitation, seizures, confusion or unresponsiveness, low or no urine output, bluish lips and fingernails, sweating, chest pain.

There are several types of shock:

Septic shock results from bacteria multiplying in the blood and releasing toxins. Common causes of this are pneumonia, intra-abdominal infections (such as a ruptured appendix) and meningitis.

Anaphylactic shock is a type of severe hypersensitivity or allergic reaction. Causes include allergy to insect stings, medicines or foods (nuts, berries, seafood), etc.

Cardiogenic shock happens when the heart is damaged and unable to supply sufficient blood to the body. This can be the end result of a heart attack or congestive heart failure.

Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic injury, which makes the heart unable to pump enough blood to the body.

Neurogenic shock (spinal cord trauma) is caused by spinal cord injury, usually as a result of a traumatic accident or injury.

Treatment for shock depends on the cause. Tests will determine the cause and severity. Usually IV fluids are administered in addition to medications that raise blood pressure.

Septic shock is treated with antibiotics and fluids. Septic shock is a serious condition with a mortality rate of 24%-50%. The sooner the infection is treated and fluids are administered, the greater the chances of success.

Anaphylactic shock is treated with diphenhydramine (Benadryl), epinephrine (an "Epi-pen"), and steroid medications (solu-medrol).

Cardiogenic shock is treated by identifying and treating the underlying cause. Cardiogenic shock has a poor prognosis, with only 1/3 of patients surviving. Because this type of shock results from injury or dysfunction of the heart it is often difficult to treat and overcome.

Hypovolemic shock is treated with fluids (saline) in minor cases, and blood transfusions in severe cases. Hypovolemic shock and anaphylactic shock respond well to medical treatment if initiated early.

Neurogenic shock is the most difficult to treat as spinal cord damage is often irreversible. Immobilization, anti-inflammatories such as steroids and surgery are the main treatments. Spinal shock also has a very poor prognosis because the spinal cord mediates so many important bodily functions. There are currently very few effective treatments but medical research is making advances in the treatment of spinal injuries.

Shock prevention includes learning ways to prevent heart disease, injuries, dehydration and other causes of shock.

Medical shock is a medical emergency. If you suspect shock after an injury, even if the person seems stable get him to an emergency department immediately. Prompt treatment can save a person's life. The sooner shock is treated, the better. When treated quickly there is less risk of damage to a person's vital organs.

Self-Care at Home

· Call emergency for immediate medical attention any time a person has symptoms of shock. Do not wait for symptoms to worsen before calling for help. Stay with the person until help arrives.

· While waiting for help or on the way to the emergency room, check the person's airway, breathing and circulation (the ABCs). If the person is breathing on his or her own, continue to check breathing every 2 minutes until help arrives.

· Do NOT move a person who has a known or suspected spinal injury.

· Have the person lie down on his or her back with the feet elevated above the head (if raising the legs causes pain or injury, keep the person flat) to increase blood flow to vital organs. Do not raise the head.

· Keep the person warm and comfortable. Loosen tight clothing and cover them with a blanket.

· Do not give fluids by mouth, even if the person complains of thirst. There is a risk of sudden loss of consciousness.

· Give appropriate first aid for any injuries. Direct pressure should be applied to any wounds that are bleeding significantly.

Exercise 7. Answer the questions:

1. What is shock?

2. What can medical shock lead to?

3. What is the main symptom of shock?

4. What other symptoms of shock can you name?

5. How many types of shock are there?

6. What does septic shock result from?

7. What is hypovolemic shock caused by?

8. What is a common treatment for shock?

9. Which two types of shock do not respond well to medical therapy? Why?

10. Which two types of shock respond well to medical therapy?

Exercise 8. Give the English equivalents:

Недостатній потік крові по тілу, супроводжувати важкі травми, брак кисню в тканинах тіла, швидко погіршуватися, поверхове дихання, спостерігати симптоми, синюшність губ та кінчиків пальців, відбуватися внаслідок, виділяти токсин, розрив апендикса, сильна чутливість, значна втрата рідини, підвищити кров’яний тиск, виявити першопричину, несприятливий прогноз, незначний та тяжкий випадки, підозрювати шоковий стан після травми, послабити щільний одяг, раптова втрата свідомості, відповідна невідкладна допомога.

Exercise 9. State whether the following statements true or false:

1. Shock often accompanies severe headache and migraine.

2. The main symptom of shock is low blood pressure.

3. Anaphylactic shock is a type of severe hypersensitivity or allergic reaction.

4. Hypovolemic shock is caused by severe weight loss.

5. There are currently very few effective treatments but medical research is making advances in space aircrafts.

6. Have the person sit straight with the feet elevated above the head to increase blood flow to vital organs.

Exercise 10. Translate into English the words given in Russian:

1. Shock often супроводжує важкі травми or illness.

2. Other symptoms include швидке, поверхове дихання; cold, clammy skin; rapid, weak pulse.

3. Septic shock results from bacteria що розмножуються в крові and releasing toxins.

4. Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic injury, що робить серце неспроможнім накачувати кров по тілу.

5. Cardiogenic shock has несприятливий прогноз with only 1/3 of patients surviving.

6. Hypovolemic shock and anaphylactic shock respond well to medical treatment якщо розпочато на ранніх стадіях.

7. Spinal shock also has a very poor prognosis because спинний мозок є проміжною ланкою багатьох важливих функцій тіла.

8. If you підозрюєте shock after an injury, even if the person seems stable get him to відділення невідкладної допомоги immediately.

Exercise 11. Fill in the table.

Exercise 12.

a). Read and translate the following text. Describe the patient in shock.

b). Make up 5 questions to the text in a written form.

The following is the description of shock made by the famous surgeon N. Pirogov: “You see a wounded soldier without an arm or leg lying still at the dressing station: he does not cry or moan or complain, but is indifferent to everything and does not ask for anything: his eyes are immovable and he gazes into the distance, his body being cold and his face pale as those of a corpse. His pulse is like a tread, barely noticeable. His wound and skin are almost completely insensitive, the patient displaying a sign of sensation only by contraction of the facial muscles. Sometimes this state passes off within a few hours, and sometimes it persists unchanged until death.”

Exercise 13. Translate the sentences into Russian paying attention to Complex Subject and Complex Object:

1. Blood transfusion is stated to be effective in acute anemia and shock.

2. Penicillin is considered to be the most effective drug in treatment of inflammation.

3. Vitamins are known to be divided into water-soluble and fat-soluble.

4. The patient seems to complain of pain in the left side of the lower jaw for a prolonged period.

5. The patient is expected to recover soon.

6. Everybody knows this disease to cause various complications.

7. The students listened to the professor delivering a lecture on viral diseases.

8. The physician has noticed the patients to develop serious lesions after a few weeks of active lung disease.

9. The students were watching the nurse to make a patient an intramuscular injection.

10. Everybody knows the rupture of spleen to be dangerous for life.

Exercise 14. Put questions to the underlined words:

1. The doctor usually begins his examination with questioning the patient carefully.

2. The doctor prescribed laxatives but they didn’t help.

3. The students will study Psychiatry next year.

4. The surgeon is making the limb immobile at the point of fracture at the moment.

5. The doctor was thinking what treatment to use in this case.

6. He hasn’t wiped the skin around the burn with alcohol yet.

7. They have been waiting here for over an hour.

8. By 2 o’clock the teacher had examined all the students.

9. Anemia improved and blood protein reached normal degree when plasma transfusion had been made.

10. All my friends were glad to hear that I had passed an exam in Chemistry.

*Exercise 15. Try to guess the equivalent Russian proverb:

1. Good health is above wealth.

2. The remedy is worse than the disease.

3. He is born with a silver spoon in one's mouth.

4. Prevention is better than cure.

5. Every family has a skeleton in the cupboard.

Exercise 16. Describe the following terms: cardiogenic shock, neurogenic shock, septic shock, anaphylactic shock, hypovolemic shock, clammy skin, agitation.

TEST

1. Shock is a life-threatening medical condition as a result of insufficient … flow throughout the body.

a) urine b) blood c) fluid d) fat

2. The main symptom of shock is … blood pressure.

a) low b) high c) moderate d) no

3. Septic shock … bacteria multiplying in the blood and releasing toxins.

a) leads to b) results in c) results from d) occurs to

4. Anaphylactic shock is a type of severe hypersensitivity or … .

a) accelerated pulse rate b) rash c) anxiety d) allergic reaction

5. … shock happens when the heart is damaged and unable to supply sufficient blood to the body.

a) cardiogenic b) anaphylactic c) neurogenic d) septic

6. Hypovolemic shock is caused by … blood and fluid loss.

a) little b) moderate c) no d) severe

7. Neurogenic shock (spinal cord trauma) is caused by … injury

a) bone marrow b) brain c) spinal cord d) heart

8. Treatment for shock depends … the cause.

a) of b) to c) on d) for

9. Cardiogenic shock has a … prognosis, with only 1/3 of patients surviving.

a) good b) strange c) unstable d) poor

10. There are currently … effective treatments but medical research is making advances in the treatment of spinal injuries.

a) very few b) many c) modern d) no

TYPES OF TUMOURS – Типи пухлин

Exercise 1. Learn the following words:

Exercise 2. Find corresponding equivalents:

Exercise 3. Match the following terms with their definitions:

Exercise 4. Give adjectives to the following nouns. Translate into Ukrainian.

Model: Cancer - cancerous

Exercise 5. Translate the word combinations into your language:

A malignant neoplasm; unregulated cell growth; to grow uncontrollably; to invade nearby parts of the body; spread to more distant parts of the body; through the lymphatic system or bloodstream; supportive tissues; benign tumors; to be non-cancerous; life- threatening; in the bone marrow; to afflict the human; environmental pollutants; existing genetic faults; faults within cells; to be entirely hereditary; screening tests; medical imaging; the likelihood of developing cancer; a current tobacco user; Breast self-examination; Pap smears; immune system tissue; the pituitary gland; approximately five to ten percent.

Exercise 6. Read and translate:

TYPES OF TUMOURS

Cancer /ˈkænsə/, known medically as a malignant neoplasm, is a broad group of various diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream. Not all tumors are cancerous. Benign tumors are considered to be non-cancerous. They rarely are life- threatening and do not spread to other parts of the body. They can often be removed.

There are over 200 different known cancers that afflict human the most of them may be classified into five broad groups:

1. Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.

2. Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.

3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.

4. Leukemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.

5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

Determining what causes cancer is complex. Many things are known to increase the risk of cancer, including tobacco use, certain infections, radiation, lack of physical activity, obesity, and environmental pollutants. These can directly damage genes or combine with existing genetic faults within cells to cause the disease. Approximately five to ten percent of cancers are entirely hereditary.

Cancer can be detected in a number of ways, including the presence of certain signs and symptoms, screening tests, or medical imaging. Once a possible cancer is detected it is diagnosed by microscopic examination of a tissue sample. Cancer is usually treated with chemotherapy, radiation therapy and surgery.

Most people don't realize that cancer is preventable in many cases. Learning what causes cancer and what the risk factors are is the first step in cancer prevention. Many cancer risk factors can be avoided, thus reducing the likelihood of developing cancer.

Cancers that are closely linked to certain behaviors are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer - most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumors as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

Exercise 7. Answer the questions:

1. What disease is medically known as a malignant neoplasm?

2. How may the cancer usually spread to more distant parts of the body?

3. What tumors are considered to be non-cancerous?

4. What groups are the known cancers that afflict a human classified into?

5. What is known to increase the risk of cancer?

6. What faults within cells to cause the disease?

7. In what ways can cancer be detected?

8. What is cancer usually treated with?

9. What is considered to be the first step in cancer prevention?

10. What are the most common screening methods for various cancers?

Exercise 8. Choose the proper continuation on the right:

Exercise 9. Memorize the meaning of the following term-elements.

*Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

· Adeno- = gland

· Chondro- = cartilage

· Erythro- = red blood cell

· Hemangio- = blood vessels

· Hepato- = liver

· Lipo- = fat

· Lympho- = white blood cell

· Melano- = pigment cell

· Myelo- = bone marrow

· Myo- = muscle

· Osteo- = bone

· Uro- = bladder

· Retino- = eye

· Neuro- = brain

Exercise 10. Complete the following sentences choosing suitable words from the box. Translate into Ukrainian.