Текст книги "Английский язык для медиков"

Автор книги: Елена Беликова

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9. Muskular system

Skeletal (voluntary) system.

The dermomyotome further differentiates into the myo—tome and the dermatome.

Cells of the myotome migrate ventrally to surround the in—traembryonic coelom and the somatic mesoderm of the ventrolateral body wall. These myoblasts elongate, become spindle—shaped, and fuse to form multinucleated muscle fibers.

Myofibrils appear in the cytoplasm, and, by the third month, cross—striations appear. Individual muscle fibers increase in diameter as myofibrils multiply and become arranged in groups surrounded by mesenchyme.

Individual muscles form, as well as tendons that connect muscle to bone.

Trunk musculature: By the end of the fifth week, body—wall musculature divides into a dorsal epimere, supplied by the dorsal primary ramus of the spinal nerve, and a ventral hypomere, supplied by the ventral primary ramus.

Epimere muscles form the extensor muscles of the vertebral column, and hypomere muscles give rise to lateral and ven tral flexor musculature.

The hypomere splits into three layers. In the thorax, the three layers form the external costal, internal intercostal, and transverse thoracic muscle.

In the abdomen, the three layers form the external oblique, internal oblique, and transverse abdomii muscles.

Head musculature.

The extrinsic and intrinsic muscles of the tongue are thought to be derived from occipital myotomes that migrate forward.

The extrinsic muscles of the eye may derive from preop—tic myotomes that originally surround the prochordal plate.

The muscles of mastication, facial expression, the pharynx, and the larynx are derived from different pharyngeal arches and maintain their innervation by the nerve of the arch of origin.

Limb musculature originates in the seventh week from soma mesoderm that migrates into the limb bud. With time, the limb musculature splits into ventral flexor and dorsal extern groups.

The limb is innervated by spinal nerves, which penetrate the limb bud mesodermal condensations. Segmental branches of the spinal nerves fuse to form large dorsal a ventral nerves.

The cutaneous innervation of the limbs is also derived from spinal nerves and reflects the level at which the limbs arise.

Smooth muscle: the smooth muscle coats of the gut, trachtea, bronchi, and blood vessels of the associated mesenteries are derived from splanchnic mesoderm surrounding the gastrointestinal tract. Vessels elsewhere in the body obtain their coat from local mesenchyme.

Cardiac muscle, like smooth muscle, is derived from splanchnic mesoderm.

New words

ventral – брюшной

somatic – соматический

cytoplasm – цитоплазма

cross—striations – поперечные бороздчатости

extensor – разгибающая мышца

dorsal – спинной

ivertebral – позвоночный

arche – дуга

abdomen – живот

facial – лицевой

branch – ветвь

10. Skeleton

The bones of our body make up a skeleton. The skeleton forms about 18 % of the weight of the human body.

The skeleton of the trunk mainly consists of spinal column made of a number of bony segments called vertebrae to which the head, the thoracic cavity and the pelvic bones are connected. The spinal column consists of 26 spinal column bones.

The human vertebrae are divided into differentiated groups. The seven most superior of them are the vertebrae called the cervical vertebrae. The first cervical vertebra is the atlas. The second vertebra is called the axis.

Inferior to the cervical vertebrae are twelve thoracic vertebrae. There is one rib connected to each thoracic vertebrae, making 12 pairs of ribs. Most of the rib pairs come together ventrally and join a flat bone called the sternum.

The first pairs or ribs are short. All seven pairs join the sternum directly and are sometimes called the «true ribs». Pairs 8, 9, 10 are «false ribs». The eleventh and twelfth pairs of ribs are the «floating ribs».

Inferior to the thoracic vertebrae are five lumbar vertebrae. The lumbar vertebrae are the largest and the heaviest of the spinal column. Inferior to the lumbar vertebrae are five sacral vertebrae forming a strong bone in adults. The most inferior group of vertebrae are four small vertebrae forming together the соссуж.

The vertebral column is not made up of bone alone. It also has cartilages.

New words

skeleton – скелет

make up – составлять

weight – вес

trunk – туловище

vertebrae – позвоночник

thoracic cavity – грудная клетка

pelvic – тазовый

cervical – шейный

atlas – 1 шейный позвонок

sternum – грудина

mainly – главным образом

axis – ось

spinal column – позвоночник

inferior – нижний

rib – ребро

pair – пара

sacral – сакральный

соссу«– копчик

floating – плавающий

forming – формирующий

cartilage – хрящ

lumbar – поясничный

adult – взрослый

11. Muscles

Muscles are the active part of the motor apparatus; their contraction produces various movements.

The muscles may be divided from a physiological standpoint into two classes: the voluntary muscles, which are under the control of the will, and the involuntary muscles, which are not.

All muscular tissues are controlled by the nervous system.

When muscular tissue is examined under the microscope, it is seen to be made up of small, elongated threadlike cells, which arc called muscle fibres, and which are bound into bundles by connective tissue.

There are three varieties of muscle fibres:

1) striated muscle fibres, which occur in voluntary muscles;

2) unstriated muscles which bring about movements in the internal organs;

3) cardiac or heart fibres, which are striated like (1), but are otherwise different.

Muscle consists of threads, or muscle fibers, supported by connective tissue, which act by fiber contraction. There are two types of muscles smooth and striated. Smooth, muscles are found in the walls of all the hollow organs and tubes of the body, such as blood vessels and intestines. These react slowly to stimuli from the autonomic nervous system. The striated, muscles of the body mostly attach to the bones and move the skeleton. Under the microscope their fibres have a cross – striped appearance. Striated muscle is capable of fast contractions. The heart wall is made up of special type of striated muscle fibres called cardiac muscle. The body is composed of about 600 skeletal muscles. In the adult about 35–40 % of the body weight is formed by the muscles. According to the basic part of the skeleton all the muscles are divided into the muscles of the trunk, head and extremities.

According to the form all the muscles are traditionally divided into three basic groups: long, short and wide muscles. Long muscles compose the free parts of the extremities. The wide muscles form the walls of the body cavities. Some short muscles, of which stapedus is the smallest muscle in the human body, form facial musculature.

Some muscles are called according to the structure of their fibres, for example radiated muscles; others according to their uses, for example extensors or according to their directions, for example, – oblique.

Great research work was carried out by many scientists to determine the functions of the muscles. Their work helped to establish that the muscles were the active agents of motion and contraction.

New words

muscles – мышцы active – активный

motor apparatus – двигательный аппарат

various – различный

movement – движение

elongated – удлиненный

threadlike – нитевидный

be bound – быть связанным

ability – возможность

capable – способность

scientist – ученый

basic – основной

12. Bones

Bone is the type of connective tissue that forms the body's supporting framework, the skeleton. Serve to protect the internal organs from injury. The bone marrow inside the bones is the body's major producer of both red and white blood cells.

The bones of women are generally lighter than those of men, while children's bones are more resilient than those of adults. Bones also respond to certain physical physiological changes: atrophy, or waste away.

Bones are generally classified in two ways. When classified on the basis of their shape, they fall into four categories: flat bones, such as the ribs; long bones, such as the thigh bone; short bones, such as the wrist bones; and irregular bones, such as the vertebrae. When classified on the basis of how they develop, bones are divided into two groups: en—dochondral bones and intramembraneous bones. En—dochondral bones, such as the long bones and the bones at the base of the skull, develop from cartilage tissue. Intra—membraneous bones, such as the flat bones of the roof of the skull, are not formed from cartilage but develop under or within a connective tissue membrane. Although en—dochondral bones and intramembraneous bones form in different ways, they have the same structure.

The formation of bone tissue (ossification) begins early in embryological development. The bones reach their full size when the person is about 25.

Most adult bone is composed of two types of tissue: anouter layer of compact bone and an inner layer of spongy bone. Compact bone is strong and dense. Spongy bone is light and porous and contains bone marrow. The amount of each type of tissue varies in different bones. The flat bones of the skull consist almost entirely of com pact bone, with very little spongy tissue. In a long bone, such as the thigh bone, the shaft, called the diaphysis, is made up largely of compact bone. While the ends, called epyphyses, consist mostly of spongy bone. In a long bone, marrow is also present inside the shaft, in a cavity called the medullary cavity.

Surrounding every bone, except at the surface where it meets another bone, is a fibrous membrane called the periosteum. The outer layer of the periosteum consists of a network of densely packed collagen fibres and blood vessels. This layer serves for the attachment of tendons, ligaments, and muscles to the bone and is also important in bone repair.

The inner layer of the periosteum has many fibres, called fibres of Sharpey, which penetrate the bone tissue, anchoring the periosteum to the bone. The inner layer also has many bone—forming cells, or osteoblasts, which are responsible for the bone's growth in diameter and the production of new bone tissue in cases of fracture, infection.

In addition to the periosteum, all bones have another membrane, the endosteum. It lines the marrow cavity as well as the smaller cavities within the bone. This membrane, like the inner layer of the periosteum, contains os—teoblasts, and is important in the formation of new bone tissue.

13. Bones. Chemical structure

Bone tissue consists largely of a hard substance called the matrix. Embedded in the matrix are the bone cells, or osteocytes. Bone matrix consists of both organic and inorganic materials. The organic portion is made up chiefly of collagen fibres. The inorganic portion of matrix constitutes about two thirds of a bone's total weight. The chief inorganic substance is calcium phosphate, which is responsible for the bone's hardness. If the organic portion were burned out the bone would crumble under the slightest pressure. In the formation of intramembraneous bone, certain cells of the embryonic connective tissue congregate in the area where the bone is to form. Small blood vessels soon invade the area, and the cells, which have clustered in strands, undergo certain changes to become osteoblasts. The cells then begin secreting collagen fibers and an intercellular substance. This substance, together with the collagen fibers and the connective tissue fibers already present, is called osteoid. Osteoid is very soft and flexible, but as mineral salts are deposited it becomes hard matrix. The formation of endochondral bone is preceded by the formation of a cartilaginous structure similar in shape to the resulting bone. In a long bone, ossification begins in the area that becomes the center of the shaft. In this area, cartilage cells become osteoblasts and start forming bone tissue. This process spreads toward either end of the bone. The only areas where cartilage is not soon replaced by bone tissue are the regions where the shaft joins the two epiphyses. These areas, called epiphyseal pla—res, are responsible for the bone's continuing growth in length. The bone's growth in diameter is due to the addition of layers of bone around the outside of the shaft. As they are formed, layers of bone on the inside of the shaft are removed. In all bones, the matrix is arranged in layers called lamellae. In compact bone, the lamellae are arranged concentrically around blood vessels, and the space containing each blood vessel is called a Haver—sian canal. The osteocytes are located between the lamellae, and the canaliculi containing their cellular extensions connect with the Haversian canals, allowing the passage of nutrients and other materials between the cells and the blood vessels. Bone tissue contains also many smaller blood vessels that extend from the periosteum and enter the bone through small openings. In long bones there is an additional blood supply, the nutrient artery, which represents the chief blood supply to the marrow. The structure of spongy is similar to that of compact bone. However, there are fewer Haversian canals, and the lamellae are arranged in a less regular fashion, forming spicules and strands known as trabeculae.

New words

bone – кость

internal – внешний

phosphorus – фосфор

atrophy – атрофия

spongy – губчатый

tendon – сухожилие

ligament – связка

flexible – гибкий

periosteum – надкостница

osteoblast – остеобласт (клетка, образующая кость)

rigidity – неподвижность

shape – форма

to crumble – крошиться

to congregate – собираться

epiphyseal – относящийся к эпифизу

shaft – ствол, тело (длинной) кости, диафиз

14. Skull

Bones of the skull: the neurocranium (the portion of the skull that surrounds and protects the brain) or the viscerocra—nium (i. e., the skeleton of the face). Bones of the neurocrani—um: Frontal, Parietal, Temporal, Occipital, Ethmoid, Sphenoid.

Bones of the viscerocranium (surface): Maxilla, Nasal, Zy—gomatic, Mandible. Bones of the viscerocranium (deep): Ethmoid, Sphenoid, Vomer, Lacrimal, Palatine, Inferior nasal concha. Articulations: Most skull bones meet at immovable joints called sutures. The coronal suture is between the frontal and the parietal bones. The sagittal suture is between two parietal bones. The lambdoid suture is between the parietal and the occipital bones. The bregma is the point at which the coronal suture intersects the sagittal suture.

The lambda is the point at which the sagittal suture intersects the lambdoid suture. The pterion is the point on the lateral aspect of the skull where the greater wing of the sphenoid, parietal, frontal, and temporal bones converge. The temporomandibular joint is between the mandibular fossa of the temporal bone and the condylar process of the mandible.

The parotid gland is the largest of the salivary glands. Structures found within the substance of this gland include the following: Motor branches of the facial nerve. CN VII enters the parotid gland after emerging from the stylomastoid foramen at the base of the skull. Superficial temporal artery and vein. The artery is a terminal branch of the external carotid artery.

Retromandibular vein, which is formed from the maxillary and superficial temporal veins.

Great auricular nerve, which is a cutaneous branch of the cer vical plexus. Auriculotemporal nerve, which is a sensory branch of V3. It supplies the TMJ and conveys postganglionic parasympathetic fibers from the otic ganglion to the parotid gland. Parotid (Stensen's) duct, which enters the oral cavity at the level of the maxillary second molar. The facial artery is a branch of the external carotid artery in the neck. It terminates as the angular artery near the bridge of the nose.

The muscles of face

New words

brain – мозг

frontal – лобная

parietal – теменная

temporal – височная

occipital – затылочная

ethmoid – решетчатая

maxilla – верхняя челюсть

zygomatic – скуловой

mandible – нижняя челюсть

sphenoid – клиновидная

vomer – сошник

lacrimal – слезная

palatine – небная

nasal concha – носовая раковина

15. Neck. Cervical vertebrae, cartilages, triangels

Cervical vertebrae: There are seven cervical vertebrae of which the first two are atypical. All cervical vertebrae have the foramina transversaria which produce a canal that transmits the vertbral artery and vein.

Atlas: This is the first cervical vertebra (C1). It has no body and leaves a space to accommodate the dens of the second cervical vertebra. Axis: This is the second cervical vertebra (C2). It has odontoid process, which articulates with the atlas as a pivot joint. Hyoid bone is a small U—shaped bone, which is suspended by muscles and ligaments at the level of vertebra C3.

Laryngeal prominence is formed by the lamina of the thyroid cartilage.

Cricoid cartilage. The arch of the cricoid is palpable below the thyroid cartilage and superior to the first tracheal ring (vertebral level C6). Triangles of the neck: The neck is divided into a posterior and an arterior triangle by the sternocleidomastoid muscle. These triangles are subdivided by smaller muscles into six smaller triangles. Posterior triangle is bound by the sternocleidomastoid, the clavicle, and the trapezius. Occipital triangle is located above the inferior belly of the omohyoid muscle. Its contents include the following: CN XI Cutaneous branches of the cervical plexus are the lesser occipital, great auricular, transverse cervical, and supaclavicular nerves.

Subclavian (omoclavicular, supraclavicular) triangle is located below the inferior belly of the omohyoid. Its contents include the following: Brachial plexus supraclavicu—lar portion The branches include the dorsal scapular, long thoracic, subclavius, and suprascapular nerves.

The third part of the subclavian artery enters the subclavian triangle.

The subclavian vein passes superficial to scalenus anterior muscle. It receives the external jugular vein.

Anterior triangle is bound by the sternocleidomastoid muse the midline of the neck, and the inferior border of the body of the mandible. Muscular triangle is bound by the sternocleidomastoid muscle, the superior belly of the omohyoid muscle, and the midline of the neck. Carotid (vascular) triangle is bound by the sternocleidomastoid muscle, the superior belly of the omohyoid muscle and the posterior belly of the digastric muscle. The carotid triangle contains the following: Internal jugular vein; Common carotid artery, bifurcates and form the internal and external carotid arteries. The external carotid artery has six branches (i. e., the superior thyroid; the ascending pharyngeal, the lingual, the facial, the occipital, and the posterior auricular arteries). Vagus nerve; hypoglossal nerve; internal and external laryngeal branches of the superior laryngeal branch of the vagus nerve. Digastric (sub—mandibular) triangle is bound by the anterior and posterior bellies of the digastric muscle and the inferi or border of the body of the mandible. It contains the submandibu—lar salivary gland. Submental triangle is bound by the anterior belly of the digastric muscle, the hyoid bone, and the midline of the neck. It contains the submental lymph nodes.

16. Neck. Root, fascies of the neck

Root of neck: This area communicates with the superior medi astinum through the thoracic inlet. Structures of the region include the following: subclavian artery and vein. The subclavian artery passes poste rior to the scalenus anterior muscle, and the vein passes ante rior to it. Branches of the artery include: vertebral artery; thyrocervical trunk, which gives rise to the inferior thyroid, the transverse cervical, and the suprascapular arteries; Internal thoracic artery.

Phrenic nerve is a branch of the cervical plexus, which arises from C3, C4, and C5. It is the sole motor nerve to the diaphragm. It crosses the anterior scalene muscle from lateral to medial to enter the thoracic inlet.

Recurrent laryngeal nerve is a branch of the vagus nerve. This mixed nerve conveys sensory information from the laryngeal; mucosa below the level of the vocal folds and provides motor innervation to all the intrinsic muscles of the larynx except the cricothyroid muscle.

Thoracic duct terminates at the junction of the left subcla—vian and the left internal jugular veins. On the right side of the body, the right lymphatic duct terminates in a similar fashion.

Fascias of the neck: Superficial investing fascia encloses the platysma, a muscle of facial expression, which has migrated to the neck.

Deep investing fascia surrounds the trapezius and ster—noclei – domastoid muscles.

Retropharyngeal (visceral) fascia surrounds the pharynx.

Prevertebral fascia invests the prevertebral muscles of the nee (i. e., longus colli, longus capitis). This layer gives rise to a derivative known as the alar fascia.

The major muscle groups and their innervations. A simple method of organizing the muscles of the neck is based on two basic principles: (1) The muscles may be arranged in group according to their functions; and (2) all muscles in a group share common innervation with one exception in each group.

Group 1: Muscles of the tongue. All intrinsic muscles plus all but one of the extrinsic muscles (i. e., those containing the suffix, glossus) of the tongue are supplied by CN XII. The one exception is palatoglossus, which is supplied by CN X.

Group 2: Muscles of the larynx. All but one of the intrinsic muscles of the larynx are supplied by the recurrent la—ryngeal branch of the vagus nerve. The sole exception is the cricothyroid muscle, which is supplied by the external laryngeal branch of the vagus.

Group 3: Muscles of the pharynx. All but one of the longitudinal and circular muscles of the pharynx are supplied by CNs X and XI (cranial portion). The sole exception is the stylopharyngeus muscle, which is supplied by CN IX.

Group 4: Muscles of the soft palate. All but one of the muscles of the palate are supplied by CNs X and XI (cranial portion). The sole exception is the tensor veli palatini, which is supplied CN V3.

Group 5: Infrahyoid muscles. All but one of the infrahyo—id muscles are supplied by the ansa cervicalis of the cervical olexus (C1, C2, and C3). The exception is the thy—rohyoid, which is supplied by a branch of C1. (This branch of C1 also supplies the geniohyoid muscle).

New words

neck – шея

cervical – цервикальный

vertebrae – позвоночник

cricoid cartilage – перстневидный хрящ гортани

scapulae – лопатка

scalene – лестничная мышца

brachial plexus – плечевое сплетение

vagus nerve – блуждающий нерв

hypoglossal nerve – подъязычный нерв

laryngeal branches – гортанные ветви