The Muscular System

1
 Resume 2
Medical conditions associated with the muscular system can be classified as neuromuscular, motor end
plate, or myopathies. Diseases such as polio and cerebral palsy, Parkinson's disease, and conditions such
as strokes are examples of neuromuscular diseases. Finally, the muscle can be affected by chemicals or
toxins that act on the motor endplate or the neuromuscular pathway. The motor end plate is the place where
the skeletal muscle cell communicates with motor neurons. Neurons are not in direct contact with skeletal
muscle cells; They are found in structures called synapses. Any disease or chemical that interferes with the
transfer of information across the synapse will cause dysfunction of the affected skeletal muscle.
Glossary
1. muscles: are structures or tissues existing in humans and in most animals that can generate
movement by contracting and relaxing.
2. Cartilage: White, solid, resistant, and elastic connective tissue that forms the skeleton of some
vertebrates
3. Poliomyelitis: is a viral disease that can affect the spinal cord causing muscle weakness and
paralysis-
4. Minerals: Inorganic substance existing in the earth's crust that is made up of one or more
chemical elements.
5. Axial: it is used as an adjective that refers to relative to an axis, related to the axis or having the
shape of an axis.
6. Skeleton: is the structure of bones and cartilage that supports and protects the soft tissues and
internal organs of the body.
7. Pelvis: Area of the body below the abdomen that contains the iliac bones of the hips, bladder,
and rectum.
8. Myopathies: is the medical term that refers to muscle disease.
9. Neurons: are the specific cells of the nervous system, which are capable of transmitting nerve
impulses or the other cells of the body.
10. Synapse: Region of communication between the neurite or cytoplasmic prolongation of one
neuron and the dendrites or the body of another.

2
 Resume 1
When people talk about the muscular system, they are most often referring to the skeletal muscles. It is
important to recognize that skeletal muscles are only one part of the hierarchy of the muscular system.
Muscle tissue is sometimes described as striated or non-striated muscle tissue or as voluntary or involuntary
muscle. function within the body. Organs called muscles (skeletal), like other organs, consist of the four
primary types of tissues. however, muscle tissue predominates in these organs, and skeletal muscle tissue
in particular. When we talk about the muscular system, we are generally referring to the collection of skeletal
muscles in the body and the specialized elements of connective tissue, tendons, that connect muscles to
bones. Checkpoint: Work with a partner and discuss and decide which is the best classification for the
muscles identified by the letters and numbers on the muscle figures.

Glossary
1. muscles: are structures or tissues existing in humans and in most animals that can generate
movement by contracting and relaxing.
2. Cartilage: White, solid, resistant, and elastic connective tissue that forms the skeleton of some
vertebrates
3. Minerals: Inorganic substance existing in the earth's crust that is made up of one or more
chemical elements.
4. Neurons: are the specific cells of the nervous system, which are capable of transmitting nerve
impulses or the other cells of the body.
5. Synapse: Region of communication between the neurite or cytoplasmic prolongation of one
neuron and the dendrites or the body of another.
6. Skeleton: is the structure of bones and cartilage that supports and protects the soft tissues and
internal organs of the body.
7. Fabric: Material that results from weaving or interlacing threads, especially that made with textile
fibers that is used to make clothes of any kind.
8. Organs: Functional unit of a multicellular organism that constitutes a structural unit and performs
a specific function.
9. Tendons: are fibrous connective tissue that joins muscles to bones.
10. Axial: it is used as an adjective that refers to relative to an axis, related to the axis or having the
shape of an axis.

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 Translation # 1
Cuando la gente habla sobre el sistema muscular, lo más frecuente es que se refieran a los músculos
esqueléticos. Es importante reconocer que los músculos esqueléticos son solo una parte de la jerarquía del
sistema muscular. El cuerpo está compuesto por cuatro tipos de tejidos primarios: (1) tejido epitelial, (2)
tejido conectivo, (3) tejido nervioso y (4) tejido muscular. Cada uno tiene sus propias características
únicas que lo distinguen de los demás tejidos. Los tejidos se unen, tanto estructural como funcionalmente,
para formar órganos. Los órganos que tienen funciones relacionadas se agrupan y se describen como un
sistema de órganos.
El tejido muscular se distingue y se caracteriza por: (1) contractilidad, (2) elasticidad. (3) excitabilidad y
(4) extensibilidad. El tejido muscular se subdivide en tres categorías (1) tejido de músculo esquelético, (2)
tejido de músculo cardíaco y (3) tejido de músculo liso, según su estructura celular y bioquímica.
Adicionalmente
El tejido muscular a veces se describe como tejido muscular estriado o no estriado o como músculo
voluntario o involuntario.
función dentro del cuerpo. Los órganos denominados músculos (esqueléticos), al igual que otros órganos,
constan de los cuatro tipos de tejidos primarios. sin embargo, en estos órganos predomina el tejido
muscular, y en particular el tejido del músculo esquelético. Cuando hablamos del sistema muscular,
generalmente nos referimos a la colección de músculos esqueléticos en el cuerpo y los elementos
especializados del tejido conectivo, los tendones, que conectan los músculos con los huesos. La mayoría
de los autores de libros de texto rara vez conceden un número exacto de músculos en el cuerpo humano.
Dependiendo del libro que esté utilizando, el número generalmente se indica como menos de 700 o más
de 700. Probablemente sea seguro decir que el número es alrededor de 700.
Las funciones colectivas del sistema muscular se pueden resumir de la siguiente manera: (1) movimiento,
(2) apoyo, (3) forma esfínteres en las entradas y salidas del cuerpo. (4) postura. (5) y la homeostasis de la
temperatura, y cada músculo contribuye, en diversos grados, a estas funciones. Al igual que el sistema
esquelético, es lógico subdividir el sistema muscular en el músculo axial y los músculos apendiculares.
Punto de control: trabaje con un compañero y discuta y decida cuál es la mejor clasificación para los
músculos identificados por las letras y números en las figuras musculares.

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 Translation # 2
Las condiciones médicas asociadas con el sistema muscular se pueden clasificar como (1) neuromuscular,
(2) placa motora terminal o (3) miopatías. Enfermedades como la poliomielitis y la parálisis cerebral, la
enfermedad de Parkinson y afecciones como los accidentes cerebrovasculares son ejemplos de
enfermedades neuromusculares. La miastenia gravis es un ejemplo de enfermedad de la placa motora
terminal, mientras que la distrofia muscular es un ejemplo de miopatía del músculo esquelético. Otras
afecciones están asociadas con daño o falla de un músculo o grupo de músculos o tendones. Las lesiones
como distensiones, tendinitis, calambres musculares, síndrome compartimental y hernias entran en esta
categoría. Por último, el músculo puede verse afectado por sustancias químicas o toxinas que actúan en la
placa motora terminal o en la vía neuromuscular. La toxina del tétanos, la toxina del botulismo, el veneno
de la araña viuda negra y los anestésicos generales son algunos ejemplos. Canal de calcio activado por
Yotage
La placa motora terminal es el lugar donde la célula del músculo esquelético se comunica con las
neuronas motoras. Las neuronas no están en contacto directo con las células del músculo esquelético; se
encuentran en estructuras llamadas sinapsis. En cambio, se comunican mediante la liberación de
mensajeros químicos que se difunden a distancias cortas (hendidura sináptica) y se unen a receptores en la
superficie de la célula muscular en regiones especializadas llamadas placa motora terminal. Cualquier
enfermedad o sustancia química que interfiera con la transferencia de información a través de la sinapsis
provocará la disfunción del músculo esquelético afectado.

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 Reading# 2

Medical conditions associated with the muscular system can be classified as (1)
neuromuscular, (2) motor endplate, or (3) myopathies. Diseases such as polio and cerebral
palsy, Parkinson's disease, and conditions such as strokes are examples of neuromuscular
diseases. Myasthenia gravis is an example of end-plate disease, while muscular dystrophy
is an example of skeletal muscle myopathy. Other conditions are associated with damage
or failure of a muscle or group of muscles or tendons. Injuries such as strains, tendonitis,
muscle cramps, compartment syndrome, and hernias fall into this category. Finally, the
muscle can be affected by chemicals or toxins that act on the motor endplate or the
neuromuscular pathway. Tetanus toxin, botulism toxin, black widow spider venom, and
general anesthetics are some examples. Yotage Activated Calcium Channel
The motor end plate is the place where the skeletal muscle cell communicates with motor
neurons. Neurons are not in direct contact with skeletal muscle cells; They are found in
structures called synapses. Instead, they communicate by releasing chemical messengers
that diffuse short distances (synaptic cleft) and bind to receptors on the muscle cell
surface in specialized regions called motor endplates. Any disease or chemical that
interferes with the transfer of information across the synapse will cause dysfunction of the
affected skeletal muscle.

6
 Reading# 1

When people talk about the muscular system, they are most often referring to the skeletal muscles. It is
important to recognize that skeletal muscles are only one part of the hierarchy of the muscular system.
The body is made up of four primary tissue types: (1) epithelial tissue, (2) connective tissue, (3) nerve
tissue, and (4) muscle tissue. Each has its own unique characteristics that distinguish it from other fabrics.
Tissues join, both structurally and functionally, to form organs. Organs that have related functions are
grouped together and described as an organ system.
Muscle tissue is distinguished and characterized by: (1) contractility, (2) elasticity. (3) excitability and (4)
extensibility. Muscle tissue is subdivided into three categories (1) skeletal muscle tissue, (2) cardiac
muscle tissue, and (3) smooth muscle tissue, based on their cellular structure and biochemistry. further
Muscle tissue is sometimes described as striated or non-striated muscle tissue or as voluntary or
involuntary muscle.
function within the body. Organs called muscles (skeletal), like other organs, consist of the four primary
types of tissues. however, muscle tissue predominates in these organs, and skeletal muscle tissue in
particular. When we talk about the muscular system, we are generally referring to the collection of
skeletal muscles in the body and the specialized elements of connective tissue, tendons, that connect
muscles to bones. Most textbook authors rarely attach an exact number of muscles in the human body.
Depending on the book you are using, the number is usually stated as less than 700 or more than 700. It is
probably safe to say that the number is around 700.
The collective functions of the muscular system can be summarized as follows: (1) movement, (2)
support, (3) form sphincters at the entrances and exits of the body. (4) posture. (5) and temperature
homeostasis, and each muscle contributes, to varying degrees, to these functions. Like the skeletal
system, it is logical to subdivide the muscular system into the axial muscle and the appendicular muscles.
Checkpoint: Work with a partner and discuss and decide which is the best classification for the muscles
identified by the letters and numbers on the muscle figures.

7
8
Check Point – Work with a partner and discuss and decide on the best classification for the muscles
identified by the letters and numbers on the muscle figures.

Axial: Appendicular:
3. External Oblique 1.Detoid
7. Frontal 2. Biceps Brachii
8. Zygomaticus majar 4. Trapazuis
9. Star nocleidomastoid 5. Pectoralis majajr
10.RactusAbdominis 6. Rectus Femus
G. Extemal Oblique A. Trapecius
H. Lotissimus dorsi B. Deltoid
C.Triceps Brachii
D. Gluteus Maximus
E.Semitendinosus
F.Gastrocnemius

Check Point – Vocabulary

Instructions: work with a partner and based on their use in the two texts above, match the terms in column
A with the meaning in column B.

A B
1. hierarchy A. is made up of 3
2. distinguish B. to admit something is true 6
3. consist C. an order to things 1
4. predominates D. to prevent something from working properly 9
5. rarely E. something that does not happen often 5
6. concede F. to be able to tell one thing from another 2
7. subdividing G. to put things into groups based on some characteristic 8
8. categorized H. in larger quantities compared to other things 4
9. interferes I. to create 2 or more groups of things from a larger group 7

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 Check Point –
Vocabulary
Technical Vocabulary Specialized Vocabulary
Cardiac muscle tissue Tejido muscular cardiaco Categorized categorizado
Connective tissue Tejido conectivo Concede concede
Contractility Contactilidad Consist consiste
Elasticity Elastisidad Distinguish distinguir
Epithelial tissue Tejido epitelial Dominates dominantes
Excitability Exitabilidad Hierarchy jerarquia
Extensibility Extensibilidad Interferes Interferir
Motor Neuron Neurona motora Involuntary involuntario
Muscle tissue Tejido Non-striated Rarely
muscular No estriado rara
Myopathy Miopatia Rarely Raramente
Nerve tissue Tejido Striated Estriado
nervioso Subdividing
Sarcolemma Sarcolema Subdividir
Skeletal muscle tissue Tejido muscular esqueletico Voluntary
Voluntario
Smooth muscle tissue Tejido muscular liso
Synapse Sinopsis
Synaptic cleft Sinapsis Quimica
Synaptic End Bulb Bulbo sinaptico

Check Point – Common Names for Muscles

Instructions: Work with a partner and match the number with the common name.

Common Names

D six pack 4
D lats 5
D quadriceps 3
D groin 6 _
D hamstrings 1
D butt 7
D calf 2

4
Reading

Muscles in Motion

Muscles are named based on several criteria. They can be named based on (1) the shape of the
muscle, (2) special feature of the size of the muscle, (3) the location of the muscle in the body, (4) origin
of the muscle, (5) orientation of muscle relative to axis of the body and (6) action of the muscle.
Frequently when a muscle name has more than one part it is because the muscles name is based on more
than one criterion i.e. Rectus (orientation) abdominis (location). In English, muscle names are often
Americanized Latin.

Check Point – Comprehension

Instructions: work with a partner and match the muscle with its criterion or criteria. More than one blank
indicates more than one criterion.

Muscle Name Criteria for Naming

1. Tibialis anterior C E A. the shape of the muscle
B. special feature of the size of the muscle
2. Gluteus medius C B
C. the location of the muscle in the body
3. Deltoid A D. origin of the muscle
E. orientation of muscle relative to axis of
4. Pectorialis major B C
the body
5. Rectus femoris D C F. action of the muscle
6. Triceps brachii D
7. Trapezius A
8. Frontalis E
9. Flexor carpi ulnaris F D E
10. Vastus medialis C D

Instructions: Work with a partner and match the muscle actions in column A with the general
descriptions in column B. Discuss the meanings of the words in bold print and create your own sentences
using these words.

A B

1. Abduction D A. Bending over at the waist to pick up something from the

2. Adduction F floor. (vertebral column)
3. Extension A B. Turing your head from left to right to say “no.” (vertebral column)
4. Flexion C C. Bringing your hand up to rub your eye. (elbow)
5. Rotation B D. Lifting a bag of groceries out from your side. (shoulder)
6. Pronation E E. Turing a knob on a radio counter clockwise. (wrist)
7. Supination G F. Pushing a door open. (elbow)
G. Turing a knob on a radio clockwise. (wrist)

5
Check Point – Muscles in
Action
Instructions: Work with a partner and examine the four pictures and then decide which of the descriptions
below match what is seen in the pictures. Discuss with your partner the exact meaning of the words in
bold print. Number 1 has been done as an example.

Muscle Actions

A B C D

1. Elbows fully extended. A, B, C (not D) 10. Spine flexed laterally. C

2. Knees flexed. A D 11. Arms abducted. D B

3. Spine extended. B C 12. Digits of the hand flexed. A

4. Neck rotated. C 13. Neck partially flexed. C

5. Digits of the hand extended. B A 14. Thighs flexed. D A

6. Knees flexed. A D 15. Thighs extended. D

7. Spine flexed anteriorly. A 16. Digits of the hand abducted. C A

8. Wrists hyper-extended. B C 17. Digits of the hand adducted. B D

9. Neck partially hyper-extended. C

6
Clinical Corner
Botulism: Caused by a neurotoxin of
the anaerobic bacteria Clostridium
botulinum. The toxin binds to motor
neurons supplying the muscle of the
respiratory system and the other skeletal
muscles of the body and prevents
normal impulse transmission from
reaching the muscles. The paralysis of
respiratory muscles leads to death.
Botulism is generally a food borne
illness, however in rare cases it can
grow in release toxin in the digestive
tract infants who have consumed C.
botulinum spores, leading to Infant
Botulism. {botulus = sausage}
Cerebral palsy: A non-progressive
non-contagious impairment of the
muscle function stemming from
damage
to the motor cortex of the brain. Damage
can occur during fetal development
(most common), during childbirth (least
common) or during early post-natal
development. {palsy = paralyzed}
Charlie horse: A common non-
technical name for a muscle cramp,
especially of the leg and frequently
associated with the calf muscle at night.
The most common causes are mineral or
vitamin deficiencies.
Compartment Syndrome: A condition
in which a muscles ability to swell or
hypertrophy is limited by its outer
connective tissue covering (sheath). The
sheath effectively creates a compartment
in which the muscle is located. When
swelling or hypertrophy occurs the
muscle is compressed which results in
decreased blood supply and can also
compress nerves leading to the muscle.
Muscle cramp: A forceful, sustained
spasm of a muscle or a part of a muscle.
Muscle spasm: A temporary
involuntary contraction of a skeletal
muscle.
Muscle strain: An over extension or
over exertion injury in which the muscle
is torn. There is usually some degree of
bleeding into the injured tissue.
{stringere = to draw tight}
Muscular dystrophy: A genetic
condition in which there is progressive
destruction of muscle tissue which is
replaced by scar (connective) tissue.
Myasthenia gravis: An autoimmune tetani entering a deep wound. Once in
disease in which the body’s immune the wound the spores germinate
system attacks the acetylcholine producing a colony of growing bacteria.
receptors at the neuromuscular junction. The bacteria release neurotoxin as they
The loss of receptors results in muscle grow. The neurotoxin prevents the
weakness and easy fatigability of the release of inhibitory neurotransmitter
involved muscles. The condition is most substances within the CNS. This results
pronounced in facial muscles, muscles in a state of contraction in the major
that move the jaw, the tongue and the muscle groups of the body. This
muscles involved with respiration. condition is prevented with the Tetanus
{my/myo = muscle; asthenia = vaccine and is first given as part of the
weakness} DPT vaccine, with the “T” standing for
Tetanus. Booster vaccinations should be
Myositis: Inflammation of skeletal given every 10 years to maintain
muscle tissue. protection. This condition is also called
Pinched nerve: When a nerve is “lockjaw.”
compressed between two structures it
can be referred to as a pinched nerve. If Tendon: Connective tissue (dense
a motor nerve exiting the spinal cord is regular connective tissue)
pinched between two vertebral vertebrae structure which attaches muscles
the nerve can become inflamed and can to bones.
lead to muscle spasms of the affected {tendere = to stretch}
muscles. Vertebral compression of
spinal nerves is often due to collapsing Tendonitis: Inflammation of a tendon.
intervertebral discs. {myo = muscle; itis
= inflammation} Torticollis: A contracted state of the
muscle associated with the cervical
Parkinson’s Disease: A progressive spine. The chronic contraction can
neurological disease that affects muscle cause an unnatural position of the neck
movement. The disease is caused by a or it can cause pain whenever the head
loss of neurons in the substania nigra of is moved. {tort = twist; coll = neck}
the brain. These cells produce the
neurotransmitter dopamine. Symptoms
Wry Neck Syndrome: Common name
include muscle tremors, slowed
for Torticollis. “Wry” means
movement, difficulty in initiating
abnormally bent or distorted.
purposeful movement, partial paralysis
of the facial muscles and a shuffling
gait. The condition usually occurs after
age 50.
Pulled muscle: Another term for a
muscle strain.
Rigor mortis: A post mortem condition
in which the skeletal muscles
temporarily contract as the endoplasmic
reticulum breaks down releasing calcium
ions into the myoplasm. The Ca++ ions
lead to a short burst of contractile
activity. However, the burst of activity
uses up the limited amount of available
ATP there is no ATP left to initiate
muscle relaxation. Therefore the
muscles remain contracted until the
contractile proteins begin to break down.
{rigor = stiffness; mortis = death}
Tetanus: Caused by the neurotoxin
from the anaerobic bacteria
Clostridium tetani. This condition (not
a disease) is
7
{dys = bad; trophy = nourishment} most commonly caused by spores of C.

8
 Check Point –
Vocabulary
Instructions: Work with a partner and match the terms in column A (taken from Clinical Corner) with
descriptions in column B.

A B
1. Binds A. to attach to
2. Break down B. originating from / coming from
3. Burst C. unusual / uncommon
4. Fatigability D. to increase in size
5. Gait E. covering / shroud
6. Pinched F. tendencies to get tired easily or quickly
7. Progressive G. obvious / most visible
8. Pronounced H. squeezed
9. Rare I. get worse with time
10. Sheath J. uncontrolled, rhythmic muscle movements
11. Shuffling K. walking without completely picking up the feet between steps
12. Stemming L. the manner or way a person walks or runs
13. Swell M. sudden event / something that happen quickly
14. Tremors N. to become dysfunctional

Check Point – Articles

Instructions: Fill in the blanks with articles ‘a’ / ‘an’ / ‘the’ – in some cases no article is needed.

Focus on Myasthenia gravis:

Myasthenia gravis is anautoimmune disease in which thebody’s immune system attacks the acetylcholine
receptors located on _ the motor end plate. aneural message coming from _ the brain causes amotor neuron to
release acetylcholine which diffuses across synaptic cleft and binds to receptors on themotor end plate of
theskeletal muscle cells. thebinding between ACh and the receptors causes ion channels to open which, in turn,
initiates muscle contraction. With the reduced number of receptors, adepolarization of the motor end plate is
also reduced and thestrength of contraction is diminished. the_ loss of receptors results in muscle weakness
and quick fatigability of the involved muscles. _ the condition is most pronounced in facial muscles, muscles
that move the jaw, thetongue and themuscles involved with respiration.

8
 E
E

Cross Word E
E

Puzzle
Across Down
3. Connective tissue structure that attaches muscles to 1. inflammation of muscle tissue
bones 2. Cell membrane of a muscle cell.
4. Muscles on the back of the lower leg. 5. Do a push-up the elbow.
8. Property of skeletal muscle that refers to its ability 6. Microscopic features that appear as lines
to shorten in length. perpendicular to long axis of skeletal muscle
10. Name of the triangular should muscle. cells
11. Uncontrollable rhythmic contractions and relaxation 7. Touching your chin to your chest _
of skeletal muscles. your neck.
12. Turning the head from side to side 9. The T in the DPT vaccine.
14. Groups of muscles on the back of the thigh. 10. Deficient neurotransmitter associated with
16. The junction between two neurons. Parkinson's disease.
17. Property of skeletal muscle that refers to its ability to 13. Type of muscle tissue making up the heart.
stretch and then return to its original length. 15. Type of muscle tissue found in the walls of
18. Transmitter substance released by motor neurons at arteries.
neuromuscular junctions.

Cross Word Puzzle

Instructions: work with a partner to complete the crossword puzzle using the vocabulary from this unit.

12
 Check Point --
Grammar
Instructions: Work with a partner and fill in the blank in each sentence with “some” or “any”

Some / Any

Do you have somepain in your shoulders?

I think it will be helpful if you start doing any_ exercises.
somemuscle relaxants can make you very sleepy.
Is there _ anyone who can drive you home from the hospital?
Is there _ anyway you can start walking about 1 km per day?
You need to try to find sometime to relax. Stress is making your neck muscles stiff.
Do you have anyaspirin at home? You can take it to relieve the pain.
If you have someproblems with the medicine I want you to call me immediately.
In somecases recovery is complete and there are no further problems.

I will give you a double prescription – you can take the medicine if you have _ somefuture problems.

Check Point – Phrases

Instructions: Work with a partner and match the words in column A with the words in column B to make
meaningful combinations.

A B
1. Muscle A. Happens 3
2. Neuromuscular B. Muscle 4
3. Rarely C. Junction 1
4. Striated D. Cleft 5
5. Synaptic E. Relaxant 2
1. Hospital A. Cramp 2
2. Muscle B. Activity 3
3. Physical C. Admission 1
4. Stiff D. Tremor 5
5. Uncontrollable E. Muscle 4
1. Chronic fatigue A. Swing 3
2. Hot B. Flashes 5
3. Mood C. Weakness 4
4. Muscle D. Syndrome 1
5. Stiff E. Neck 2

13
Check Point – Prepositions

Instructions: Work with a partner and fill in the blanks with prepositions. Some prepositions can be used
more than once.

with, on, to, over, with, in, between, across, of, at, under, against, into

1. I have one or two glasses of wine whith my evening meal.

2. I like to play tennis on the weekends.
3. It has been over 10 years since I was diagnosed with high blood pressure.
4. My muscle pain started in my upper back to my shoulder blades.
5. Acetylcholine diffuses whith the synapse and binds with receptors in the
motor end plate of the muscle cell.
6. The DPT vaccine consists of a diphtheria vaccine, a pertussis vaccine and a
tetanus vaccine.
7. The muscle relaxants will make you sleepy, so you ought to take them on _bedtime.
8. The cell bodies of most motor neurons are into the ventral gray horn of the spinal cord.
9. How long have you been across Sortis for your high cholesterol?
10. I want you to take the muscle relaxant with an anti-inflammatory drug.
11. In the future you need to try to avoid repetitive motions _with your wrist.
12. I would like to see you again in 3 weeks.
13. The cold night air is part of the problem – you should move your bed from under the window.
14. You shouldn’t lift anything between 5 kg for the next month.
15. Lean on the wall – put one leg back, about a meter from the wall and force your heal
against the floor. This will stretch the muscles in the back of your leg.

Check Point – Giving Advice

Review the statements above. Work with a partner and complete the 3 tasks

below. List the sentences that give advice. 7,10,11,13,14

14
Check Point – Phrasal
Verbs
Instructions: Work with a partner and fill in the gaps with a phrasal verb from the box. Be sure to discuss
the vocabulary in bold print.

bear with flare up breakdown blow over

braking in bring up come around bring it off
calm down cut down burning up back out of
check with me call it off catch up blow in
close up count on move on

1. Please don’t calm down the promise you made – you need to start exercising 3 or 4 times
a week. Can I count on you?
2. You’re going to have to check with me the stiffness in your back for a few more days.
Therapy will take that long before in has positive effects.
3. I’m sorry I don’t have time to see you today – you can’t just call it of whenever you
feel like it. You need to make an appointment before you come.
4. I know this blow in _of your condition has been unpleasant, but I expect it to
Blow over in a few days.
5. Menopause can sometimes make you feel like you are having a breakdown _ , but it’s
just a feeling. The estrogen I prescribed should make you feel better soon.
6. This is a big change you have to make in your lifestyle. But it’s like bring it off a new pair
of shoes – it’s painful at first, but before long you are accustom to them and you don’t even
notice.
7. I think after you have tried exercising for a while you will close up to my point of view.
8. Reducing the amount of fat in your diet can be hard to do, but I think you can flare up .
9. I have finished my preliminary interview – is there anything you want to count on before
we catch up ?
10. It’s important that you come around on the number of cigarettes you are smoking.
11. A: Doctor! My son is extremely sick – feel his forehead – it feels like he’s bring up _. B:
Calm down Ms Smith – your son does appear to have a high fever but it is not as serious
when a child has a have fever as it is when an adult has a high fever. We will be able to bring it
down and treat the problem.
12. A: It’s the oncology department – they want to know if the meeting is still on? B: Please tell
them I’m too busy today – we will have to brear with for now.
13. Please schedule me for the conference on new treatments for asthma. I need to bring up the
latest advances in the area.
14. This is a strong mediation, so I want you to _ move on before taking any new medications
– even over the counter medications.
15. It’s been a long day – I think we saw 40 patients. It’s time to black out of and call it a day.

15
Check Point – Phrasal
Verbs
Instructions: Work with a partner and match the phrasal verbs in column A with their descriptions in
column B.

A B

1. back out of A. 8 to continue doing something that is difficult

2. bear with (something) B. 4 to do something until it is comfortable (shoes) or normal
3. blow in C. 11 to relax / to stop being excited
4. blow over D. 12 confirm something with someone before doing it
5. brake in E. 1 to temporarily quite or suspend some business activity
6. breakdown F. 18 an exacerbation
7. bring it off G. 10 to make a point during a conversation
8. bring up H. 14 to reduce the quantity of something
9. burning up I. 17 to cancel something
10. call it off J. 16 to depend on somebody for something
11. calm down K. 6 to lose control of ones mind
12. catch up L. 15 to eventually believe in something
13. check with me M. 9 being very warm or having a high temperature
14. close up N. 7 to learn the latest information about some topic
15. come around O. 13 for a problem or issue to be resolve or to pass by
16. count on P. 2 to succeed in doing something difficult
17. cut down Q. 19 to fail to complete some activity
18. flare up R. 3 to visit unexpectedly
19. move on S. 5 to continue with some activity

16
Check Point -- Pronunciation of words containing “C.”

Instructions: Review the list of words and pronounce each. Then put each word in the group that
corresponds with the sound of the “C” in the word. Some words have two “Cs” in them – in some cases
both have the same sound (the word only goes in one group) but in other cases each “C” has a different
sound (the word will go into two different groups.) Several have been done as examples.

Words in which “C” has several different sounds.

adduction C sounds like K -- cardiac
associated
back
calcium
cardiac
categories
cellular C sounds like S -- cellular
characterized
check
cholesterol
communicates
composed
concede C sounds like Sh -- associated
consist
deficiencies
elasticity
entrances
excitability
facial C is silent -- check

forceful
functionally
hacking (cough)
hierarchy
incontinence C+h sounds like K -- cholesterol
medications
muscles
neck
occur
recognize
schedule C+h is a single unique sound -- check
specialized
stomach
structurally
substances
vaccine

17
Check Point – Grammar (3rd Conditional)

Instructions: Work with a partner and fill in the blanks. Use a word from column A for the first blank in
each sentence and a word from column B for the second blank. Change the verbs to the correct tenses.

A B
Be Be
Break Be
Come down Compete
Eat Finish
Get Happen
Go Have
Pull Make
See Save
Sleep Survive
Take Swerve

1. If the operation had come down well, he would have be out of the hospital by now.
2. If he hadn’t break his leg, he would have compete in this year’s championship.
3. If he hadn’t pull his hamstring, he would have finish the race.
4. If I had see the ditch, I would have have to miss it.
5. If I had slup better the night before, I would have make such a stupid mistake.
6. If he had be _ younger, he would have probably swerved the operation.*
7. If she had not get with the Staph infection, she would have _ be an
uneventful recovery.
8. If he had take _ the medicine as prescribe, none of this would have happen .
9. If he had eat _ right, the diabetes would not have survive so hard to control.
10. If she had go to the hospital a little bit sooner, we could have saved her life.**

18
Self-test

Instructions: Work with a partner. Take turns asking and answering the questions. Discuss questions and
review wherever needed.
1. There are _ primary tissue types on the human body.
a. 2
b. 3
c. 4
d. 5
2. There are _ types of muscle in the body.
a. 2
b. 3
c. 4
d. 5
3. Both cardiac and skeletal are considered to be:
a. Striated
b. Voluntary
c. Non-striated
d. Involuntary
4. Both cardiac and smooth muscle are considered to be:
a. Striated
b. Voluntary
c. Non-striated
d. Involuntary
5. The main neurotransmitter between motor neurons and skeletal muscle cells is:
a. Dopamine
b. Serotonin
c. GABA
d. Acetylcholine
6. The reduction in the amount of is the underlying cause of Parkinson’s disease.
a. Dopamine
b. Serotonin
c. GABA
d. Acetylcholine
7. Sortis is used to
treat:
a. High blood pressure
b. Problems associated with menopause
c. High cholesterol
d. Headaches
8. Which of the following statements about the number of muscles in the human body is most accurate?
a. There are between 300 and 400,
b. The number depends on which book you read.
c. There are about 700.
d. There are more than 1000.
9. Myasthenia Gravis is a:
a. Degenerative muscle disease
b. An autoimmune disease
c. Is contagious
d. Can be prevented with a vaccine.

21
 10.
11. Which of the following statements about tetanus are true?
a. It is caused by a bacteria
b. The main symptoms are produced by a toxin
c. The diseases and its symptoms can be prevented with a vaccine.
d. All the above statements are true.
12. After exercising a person is most likely to use which of the following words to describe how
their muscles feel?
a. Sore
b. Stiff
c. Smooth
d. Painful
13. A person in their 70s is most likely to which of the following words to describe how their joints feel?
a. Sore
b. Stiff
c. Locked
d. Strained
14. A person who gets little exercise is said to be:
a. Lazy
b. Sedentary
c. Moody
d. Fatigued
15. ? involves mainly skeletal muscle and ? involves both skeletal and smooth muscle.
a. Chewing / swallowing
b. Swallowing / chewing
16. The part of the leg between the hip and the knee is the:
a. Calf
b. Neck
c. Thigh
d. Waist
17. Turing the head back-and-forth in a “no” motion is:
a. Flexion
b. Extension
c. Hyper-extension
d. Rotation
18. The Vulcan greeting is: (trick question)
a. Abduction of digits 3 and 4
b. Abduction of digits 1, 2 and 3
c. Adduction of digits 4 and 5
d. Adduction of digits 3 and 4
19. Lockjaw is a condition caused by:
a. Snake venom
b. Spider venom
c. Bacteria
d. A disease process
20. During a marathon in hot weather, which of the following would you most expect to see happen?
a. Wry neck syndrome
b. Pulled muscles
c. Charlie horses
d. Muscle strains
21. Which muscle is most likely to be associated with a stiff neck?
a. Trapezius
b. deltoid
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