Using New Words in Sentences.

Use the words in parentheses plus a few of your own to

create a new sentence.
1) Cassandra has an (beat, disease, irregular)
2) Devon has suffered two minor . He has and is on the
. (heart, cardiac care unit, attacks, atherosclerosis)

SPEAKING EXERCISE
Go back to the reading entitled Angina and Myocardial Infarction. Read it aloud to yourself first
slowly and then again and again with increasing speed. This exercise will help with fluency as
well as help you overcome any hesitation you may have with speaking new vocabulary aloud.
The Pronunciation Hints section below will help.

PRONUNCIATION HINTS
infarction – ˘ı n-
f˘ark’shu˘n angina –
˘an-j¯ı ’n˘a

LISTENING EXERCISE
If you would like to hear more native English speakers from the United States talking about
the aspects of the cardiovascular and circulatory systems, pulses, and blood pressure, search the
television networks. There are many news and documentary shows dealing with this subject,
as well as whole television series based on situations in hospitals that often reflect this subject
matter. Listen carefully to hear many of the words you have just learned as well as the context
of when, where, and how they are spoken. Listen for content, context, and structure of speech.

WRITING EXERCISE: A SHORT PERSONAL NARRATIVE

Use new vocabulary to write a short story about the last time you had your pulse and blood pres-
sure taken. Where were you (the context) and who did the assessment?

SECTIO N THREE Treatments, Interventions,

and Assistance
Unit 3 has introduced the language of the cardiovascular/circulatory system and included vocabulary,
grammar, and information on structure and function to assist health professionals in assessing
signs and symptoms of healthy and unhealthy systems. In this section, that theme continues
while it moves the reader into the language of care for an emergency cardiac case. Critical
reflection reinforces a holistic perspective of care. Through a case study, language skills
including reading comprehension; identifying salient features in assessment data; word
expansion; vocabulary building; adjectives, adverbs, and descriptors for the patient chart;
answering (short, specific, and long answer); and reporting clearly, concisely, and specifically
are addressed. The process of assessment is introduced when the patient is admitted to hospital.
Reading Selection 3-7
Read the following in preparation for the exercises that follow. If possible, have a friend or classmate
read one role while you read the other.
CALLING 911 FOR HELP
Operator: 911. What is your emergency?

Patient: Hello . . . I . . . um . . . I . . . uh . . . I’m having some bad pain in my chest.

Operator: Describe your chest pain to me, sir.

Patient: Oh . . . it’s awful. Oh, it hurts . . . it’s like . . . uh . . .

Operator: Are you having trouble breathing, sir?

Patient: Yes . . . oh, I’m sick. Help me.

Operator: Yes sir, I will. Have you been diagnosed with a heart problem?

Patient: No. Oh, please . . . help me!

Operator: Where are you calling from, sir?

Patient: I . . . um . . . uh . . . I’m at home at . . . um . . . 6565-188 Street.

Operator: 6565-188 Street? Is that correct, sir?

Patient: Yes.

Operator: All right. I’m going to send an ambulance right now. It’s on its way. Try to
remain calm.

Patient: Please . . . hurry . . . please!

Operator: Do you have any other symptoms, sir?

Patient: My arm . . . it’s going numb.

Operator: Which arm, sir?

Patient: My left arm . . . oh . . . it’s hard to catch my breath.

Operator: Try to remain calm. The ambulance will be there in a couple of minutes.

Patient: Yes, I’m trying.......sick.........I feel sick. Hurts.

Operator: Are you alone, sir? Is there anyone there who can help you?

Patient: No. My wife is out.

Operator: Is the door unlocked? Is your front door unlocked so the paramedics can get in?

Patient: No . . . um . . . I don’t know.....um........I can’t remember. I can’t think

straight! Oh.........please hurry!
 Operator: Listen carefully, sir. Are you listening?

Patient: Yes, oh . . . yes. . . .

Operator: I want you to go to the front door and open it. Leave it open. Then
come right back to me. Don’t hang up the phone. Do you understand?

Patient: Oh . . . I don’t know. I’m dizzy . . . it’s hard.

Operator: Sir? Bear with me, sir. You’ve got to open the front door so the paramedics
can get to you. Do you understand?

Patient: Uh, yes . . . paramedics . . . the door . . .

Operator: Yes, sir. Put the phone down and do that now. Open the door. Don’t hang
up. Come back and tell me.

Patient: Uh . . . oh. . . . OK. . . . um..................I did it . . . oh, the pain. I think I’m
going to pass out . . . oh . . . they’re here! Oh, thank God!

READING EXERCISES
While understanding the general meaning of a reading passage or conversation is important, it
is also essential to be able to ask specific pertinent questions and respond appropriately to the
answers given. These exercises will help you to do so.

Understanding the General Meaning

Read the text again. Think about it. Do you understand it? What is the general theme or
subject of the text?
 The general theme or subject of the text is about an emergency call to the ambulance
service due to severe pain in the patient's chest.

Answering Closed Questions

Understanding questions and the answers provided by patients and other health-care profession-
als is a very important part of effective communication. Table 3-2 summarizes the structure and
function of questions. After looking at the table, take a moment to review the reading selection
and answer the following questions.

GRAMMAR ALERT: CLOSED QUESTIONS Closed questions are those that ask for a
yes, no, I don’t know, or sometimes response only.

1) Who is having chest pain?

 A patient
2) What does the 911 operator do for a living?
 A 911 operator’s job is that of an emergency dispatcher who receives
emergency medical calls required by the public.

Table 3-2 Structure and Function of Questions

QUESTION WORD AUXILIARY VERB SUBJECT MAIN VERB
Who did he/she/it call
Where does he/she/it live
Why has he/she/it called?
When will he/she/it arrive?
 3) The patient has numbness. Where?
 At home
4) Who is on the way to the house?
 A Paramedic
5) What is on the way to the house?
 Ambulance
6) Who can’t think clearly?
 A patient
7) What does the operator want the patient to do to help himself?
 The operator tells the patient to go to the front door and open it, then return to him. Do not hang up the
phone
8) What number do you call for fire, police, or medical emergencies?
 Calling 911
9) Where is the patient’s wife?
 Going out
10) How is the 911 operator?
 Worry
11) How is the patient when he is on the phone?
 Her condition worsened as she felt severe pain in her chest and found it
difficult to catch her breath.
12) What sex is the patient?
 Men
13) Has the patient been diagnosed with a heart condition?
 No
14) Does the patient get rescued?
 Yes

Building Vocabulary
To build vocabulary, study the words or terms taken from this text. It is important to understand
different words that may have the same meaning or a very similar meaning. It is also
important to understand the difference between words that may seem similar (because of
spelling or pronunciation). The following exercises will help you learn about similarities and
distinctions between words.
Mix and Match. The mix-and-match exercise in Box 3-6 will help you learn about
synonyms, or words with similar meanings.

BOX 3-6 Mix and Match: Synonyms

Find the synonym or description for the following words. Draw a line to connect them.

TERM FROM TEXT SYNONYM OR DESCRIPTION

paramedic pain
911 operator
difficulty shortness of breath
Recognizing Related Words. Find three words that relate to the word printed in boldface.
Be careful. Not all words belong.
1) chest thoracic breast deltoid dorsal
upper body
2) pain ouch sleepy hurt throbs aches badly
 3) operator construction telephone switchboard phone
worker employee person attendant
4) right now tomorrow sooner later right away
immediately stat
5) anyone everyone someone somebody whomever any person
6) numb paresthesia dull ache frozen no sensation
no feeling
7) dizzy crazy vertigo unbalanced sense of spinning
8) hurry go quickly be happy proceed rapidly
move quickly congratulations
9) short of can’t catch apnea no oxygen running rapid,
breath my breath shallow
breathing
10) bear please be stand by hold this lean on be patient
with me patient and with me me a moment
wait

Recognizing Word Distinctions. Accuracy in reading and writing is essential for health-
care professionals. Do you know the difference between these words that look or sound
very similar? Explain the following. Try to do so without the aid of a dictionary. Test
yourself.
1) What is the difference between sweet and sweat?

2) What is the difference between palpation and palpitation?

 Palpation is a physical examination procedure that involves touching the skin or body tissues to detect
changes in the structure or function of internal organs.
Palpitations are a health symptom associated with an abnormal heart rate.

3) What is the difference between pallor and cyanosis?

 Pallor usually means there is a lack of oxygen in the blood. Cyanosis is when the skin and
mucous membranes are bluish in colour due to low oxygen levels in the blood.

4) Grammatically, what is the difference between breathe and breath?

 “Breathe” is a verb in the form of a noun, meaning “the process of taking in air”. When “breathe” is
used as a noun, it means “the process of taking in air”.

5) What is the difference between numbness and tingling?

 Numbness is a condition where certain parts of the body are unable to feel any stimuli. Tingling, on the
other hand, is an uncomfortable sensation that occurs when prolonged pressure on a certain part of the
body blocks the passage of oxygen, causing discomfort.

6) What is the difference between nausea and vomiting?

 Nausea is a feeling of discomfort in the stomach that is usually accompanied by the urge to
vomit, while vomiting is the process of emptying the stomach contents through the mouth.

7) What is the difference between an ache and a pain?

 Pain can medically mean any disorder or injury to the body. Pain, on the other hand, is the
discomfort experienced by the body in response to a disturbance or injury.

8) What is the difference between anxiety and apprehension?

 Anxiety can medically mean a long-term response that is future-orientated and the threat can
be diffuse, whereas fear is a short-term response that is present due to a clearly identifiable
threat.
SPEAKING EXERCISE
Go back over the eight sentences you have just been working on. Read them aloud, paying strict
attention to your pronunciation. Use the Pronunciation Hints below to help.

PRONUNCIATION HINTS
anxiety – ¯ang-z¯ı ’e˘-
te¯ sweat – swe˘t
pallor – p˘al’or
numbness – n U˘m-
ne˘s

LISTENING EXERCISE
Go back and record yourself doing the last exercise, then listen. Do not let the written words be
your guide. Close your book while you listen. Evaluate yourself.
• What do you notice about your open pronunciation?
• Are you speaking clearly? Y e s
• Are you speaking at a normal rhythm and rate? Yes
If you have not recorded yourself, ask a peer to read any part of this section aloud to you. Do
NOT read along with them. Listen only. What do you notice about the way he or she speaks?
What lesson do you learn from listening to another?

WRITING EXERCISE
Use words from the previous exercises to create new sentences.
1) The gentleman is experiencing Heart attack.
2) Because the man is frightened, he cannot Think clearly.
3) Paramedics don’t work in hospitals; they
Reading Selection 3-8
The following reading is a continuation of the last dialogue. Now, it is written as a case study in narrative
form. Follow the story of the patient with chest pain.
ANGINA
On Friday, October 5th, Mr. Moore, a 56-year-old married man, was experiencing a
great deal of pain in his chest. He was afraid he was having a heart attack. He was not
sure. He knew that he had never been diagnosed nor treated for cardiovascular disease.
Mr. Moore knew enough to call 911 for emergency help. He gave his address as
6565-188 Street, Surrey, BC. While speaking with the operator, he was able to tell her
he had numbness and tingling down his left arm, tightness and pain in his chest, and
was having difficulty breathing. Mr. Moore reported that he was alone in the home,
with no one to help him. The 911 operator advised him to put down the phone but
not to hang it up. She directed him to unlock the door so the paramedics could get into
the house without breaking the door down. He complied. The patient also mentioned
that he was confused and unable to think clearly. He thought he was going to pass out.
Luckily, the ambulance arrived in time to take him to the hospital.
READING EXERCISES
The following exercises will help you understand the narrative genre.

Understanding the General Meaning

A narrative tells a story. It is usually written in chronological order and tells about something
that has happened, is happening, or will happen. A central feature of the narrative is that it
has a plot that engages the reader and makes them want to read on to find out how the story
concludes.
1) What is the purpose of this narrative? What is the plot?
 The purpose of this narrative is to describe the emergency situation when Mr Moore had a heart attack
and how he sought help by calling 911.

2) How does the plot conclude in this narrative?

 The storyline in this narrative ends with the ambulance arriving in time to take Mr Moore to the
hospital.

3) In which tense is this narrative written?

 This narrative is written in prose

Understanding Specific Facts in a Reading

Take a moment now to review what you have just read. Answer the following questions.
1) What is the patient’s name?
 Mr.Moore
2) Was the patient able to provide his address?
 Yes
3) Was the patient coherent?
4) Who was the operator speaking to?
 To 911 for emergency assistance
5) Who might break down the front door?
 Paramedics
6) Why might they break down the door?
 Because Mr Moore reported that he was home alone, with no one to
help him.
7) Where was Mr. Moore going to be going?
 To hospital
8) How was the patient going to get to where he was going?
9) What were the patient’s acute signs and symptoms?
 Experienced numbness and tingling in his left arm, tightness and pain

System
The Cardiovascular
in his chest, and difficulty breathing.
10) Has Mr. Moore ever had a heart attack?
 No

11) Mr. Moore was thinking clearly enough to do something. What was that?

Building Vocabulary
It is important to learn not only new vocabulary words, but also to become familiar with
commonly used terms and expressions.

Determining Meaning from Context. To build vocabulary, study the following words or
expressions taken from this text. Discover all you can about them by looking at them in context.
Next, choose the correct meaning of the word. Notice how many words expand but most expres-
sions do not.

UNIT
3
Throughout the three sections of Unit 3, there are multiple opportunities
to acquire vocabulary and grammar as well as to practice communication
within the health context of the cardiovascular system. The unit
progresses from a review of basic anatomy and physiology to
identification, naming, and describing the normal functions of the systems
and the failures/disorders that can affect them. There is an introduction to
the language of diagnostics and assessments related to cardiovascular health
and disease. Finally, the language of treatments, interventions, and
assistance are explored through a case study of a patient with chest pain.

SECTIO N ONE Anatomy and Physiology

In preparation for language studies of the anatomy and physiology of the cardiovascular and
circulatory systems, the context of heart health in the United States and Canada is introduced.
Culture, cultural context, and language cannot be separated and are important considerations
when providing health care. This section offers exercises in medical and common terminology as
it reviews the anatomy and physiology of the systems and the epidemiology of diseases affecting
the systems.
Reading Selection 3-1
Read the following aloud or silently to yourself in preparation for the questions that follow.
 NORTH AMERICAN HEALTH CONCEPTS
Heart disease in North America is a leading cause of death for men and women. Heart
disease was once thought to affect men much more often than women, but this has
changed dramatically over the past 50 years, affected by the changing lifestyles of
women.
Coronary artery disease, commonly known as “hardening of the arteries,” is a
common disease/disorder of the cardiovascular system. It often leads to angina (chest
pain) and to myocardial infarction (heart attack).
Many cases of cardiovascular diseases can be prevented. To maintain a healthy
heart, physicians recommend limiting salt intake, quitting smoking, and eating a
healthy diet full of fruits, vegetables, grains, fish, meats, and dairy products that are
low in fat. In addition, a healthy weight and lifestyle should be maintained through
inclusion of a program of regular exercise. Personal health promotion activities should
include stress reduction exercises that help us cope with the increasingly busy and
stressful demands of life in the 21st century.

READING EXERCISES
Understanding the general meaning of a reading passage and using it to increase your vocabu-
lary are important steps in improving your use of the English language in health-care settings.
Understanding the General Meaning
Read the text again. Think about it. When you are ready, answer the following questions to
ensure you have understood.
1) A myocardial infarction is sometimes referred to as an MI. What else is it called?


2) What is another name for heart disease?

 Hardening of the arteries
3) Do women suffer from heart attacks?
 Yes

Building Vocabulary
Take a moment now to review what you have just read. Circle any words that are new to
you. Write them down here for your own reference. In a moment, you may see them again in
exercises that will help you understand their meaning. If not, at the end of this section, feel free
to use your dictionary.

Determining Meaning from Context. To build vocabulary, study the following words or
terms taken from this text. Discover all you can about them by looking at them in context. Next,
choose the correct meaning. Finally, take a look at how these words or terms expand in English.

1. Demographic (adjective, sometimes used as noun)

In context:
a) The current national demographic for heart disease identifies women over age 50 as at
increasing risk for this diagnosis.
b) Demographic data for health and illness in the United States can be found through a vari-
ety of governmental and public resources.
Meaning: The word demographic can best be explained as meaning
a) types
b) data based on population size, characteristics, and vital statistics
c) criteria for distinguishing abnormalities
d) none of the above
Word expansion:
a) Demography is the study of traits within a population. (noun)
b) Demographically speaking, there are more French language speakers in the province
of Quebec than anywhere else in Canada. (adverb)
c) Demographic studies show that the birth rate among native Europeans is declining.
(adjective)
d) What are the demographics of the people living on this small island? (noun)

2. Coronary (adjective)
a) The patient had a major coronary and was admitted to the cardiac care unit this morning.
b) Diets high in fats can lead to blockage of the coronary arteries.
Meaning: The best description for the word coronary is
a) circular; a symbol of the shape of an artery
b) circular-shaped, hollow vessel, not flat
14 The Cardiovascular
System
c) description of the arteries that supply the heart
d) both (a) and (b)
 Word expansion:
a) The word corona refers to a circular shape that encircles an object. Its synonym is the
word crown. (noun)
b) A coroner is a specialized health professional who investigates sudden, unusual, and/or
suspicious deaths. The modern term for this person is medical examiner. (noun)

3. Cases (noun, plural)

In context:
a) Each year there are multiple cases of coronary occlusion diagnosed in this country.
Surgery is often performed to treat the condition.
b) Severe cases of cardiovascular disease put the patient at risk for heart attack.
Meaning: The word cases can best be described as
a) types
b) incidents
c) crates
d) portables
Word expansion:
a) Mr. Brown’s blocked arteries are a good case study for the medical students. (adjective
mod- ifying noun “study,” but the two words together—case study—function as a noun, a
term)
b) In case the coronary bypass surgery is not successful, Mr. Smith will have to return to the
cardiac unit on life support equipment. (noun, object of preposition)

Using New Words in Sentences. Use a key word from the previous exercise to create a
new sentence.
1) The acronym CAD stands for Coronary Artery Disease, which refers to coronary artery disease, where
plaque builds up inside the walls of the arteries (the heart’s main blood vessels).
2) They proper medical terminology for an MI is M y o c a r d i a l I n f a r c t i o n
3) To prevent coronary artery disease, people should get involved in Keeping up with vaccinations
promot- ing activities.
4) People who sit around a lot and do not get any exercise live a sedentary lifestyle. They are
candidates for having coronary artery disease
5) What would you as a health professional recommend to a patient who is quite sedentary
Participating in health programmes

SPEAKING EXERCISE
Read the following completed sentences aloud. Ask a peer or teacher to help you with pronun-
ciation. Proceed to the Pronunciation Hints section following. This will also help.
Coronary artery bypass surgery is sometimes called CABG. This abbreviation is pro-
nounced “cabbage,” just like the vegetable. The surgery is done to clear or re-route
blood around blocked arteries.

PRONUNCIATION HINTS
coronary – kor’o¯-n˘a-r e¯
myocardial – m¯ı -o¯-k˘ar’de¯-
˘al angina – ˘an-j¯ı ’n˘a
LISTENING EXERCISE
There are many American medical television shows. Some are fiction and others are documen-
taries. If you have access to these, please try to watch some. Invariably one of these shows will
deal with heart disease. Listen closely to the vocabulary that describes the anatomy and physiol-
ogy of the cardiovascular system.

WRITING EXERCISE—REFLECTIVE QUESTIONS

1) Use your new vocabulary. Write a sentence or two by combining new words and names
(use the Word Bank below) in a meaningful way.

W O RD B ANK

coronary

myocardial

infarction cases

demographic

coronary artery

disease angina

2) The text talks about the changing lifestyles of women in North America over the past
50 years and suggests that this has caused a greater incidence of coronary artery disease.
What are your thoughts about this? How does it compare with your country of origin?
Write your reflections here.

Reading Selection 3-2

Read the following and answer the questions.
THE CARDIOVASCULAR SYSTEM OR CIRCULATORY SYSTEM?
The cardiovascular system is sometimes also referred to as the circulatory system, al-
though they are not quite the same thing. The term cardiovascular speaks to the two
parts of the system: cardio meaning heart and vascular meaning vessels.
Anatomically, the major structures are the heart and blood vessels (arteries, veins,
capillaries), but it is difficult to think of this system without including reference to the
lungs (part of the respiratory system). The main function of the cardiovascular system
is to distribute blood through blood vessels throughout the body. The main function of
the heart is to pump the blood (to function as the engine of the cardiovascular system),
beginning the process of circulation.
The heart consists of myocardial tissue and is divided into four chambers: two
atria and two ventricles. The left and right atria are the two upper chambers of
the heart, the left and right ventricles the two lower chambers. Blood that is high in

96 The Cardiovascular
System
 oxygen (oxygenated) flows into the left atrium from the lungs through the pulmonary
veins. The left atrium then contracts to pump a supply of blood to the left ventricle.
The aorta is found in the left ventricle. It branches into a complex series of arteries that
bring oxygenated blood to all of the organs of the body. When the blood reaches the
capillar- ies, it delivers oxygen and in exchange picks up the waste product carbon
dioxide to carry away through veins back to the heart. This blood in the veins empties
first into the vena cava (the main vein in the human body), which then carries it to the
right side of the heart. Next, this blood is pumped through the pulmonary artery to the
lungs where it exchanges the carbon dioxide waste for a new supply of oxygen. The
cycle then repeats. This cycle is powered by the contraction of the heart, which is
caused by electrical impulses within the heart. The contraction of the heart is known as
the heartbeat.
The circulatory system is a subsystem of the cardiovascular system. It concerns it-
self with blood and the function of blood, but it is difficult to think of the circula-
tory system without thinking about the lymphatic system. They are essential to
each other. Lymph cells assist in cleansing the blood of dead cells and bacteria. Blood
is the mode of transport for lymph, nutrients, hormones, electrolytes, gases (oxygen
and carbon dioxide), water, and wastes to and from cells. The capillaries are the site of
this exchange between the blood and the tissues that surround them. Blood also helps
stabilize body temperature and the natural pH balance.
In summary, the cardiovascular system is most often thought of in terms of the
heart, blood vessels, and the lungs. The circulatory system is most often thought of as
the blood vessels, blood, lymph, and the heart.

Brachiocephalic Left common carotid

artery Left
artery Superior vena subclavian artery

cava
Right pulmonary Left pulmonary
artery
artery Left atrium
Left pulmonary veins
Right pulmonary
veins

Pulmonar Left ventricle

y semilunar
valve

Right atrium

Inferior vena cava

Right ventricle

READING EXERCISES
Asking and answering specific questions about the reading selection will help you realize how
much you have really understood as well as help you build your vocabulary.

Understanding the General Meaning

Read the text again. Think about it. Do you understand it? Try to answer the following questions
to see if you do.
1) What does the heart do?
 2) What is the function of the circulatory system?
3) What are the major structures of the cardiovascular system?

98 The Cardiovascular
System