Investigación

Investigación
 Basic investigations
Ophthalmoscopy
An ophthalmoscope allows rhe doctor to
examine all parrs of the eye: the iris, lcns,
retina and optic disc. Fo, besr resulrs,
the exarnination is done wirh dimmed,
or lowercd. lighrs ro allow thc pupil ro
maximally dilate or widen. A topical
mydriatic solution may be applied to thc
cyc ,o aid dilation. The paticnt is rhen
asked ro fixatc on a targct for rhe duration
oí thc tcsr. Dirttt ophthalmoscopy

Blood pressure
A sphygmomanomctcr A sterhoscopc
.,,...
gaugc

A stethoscopc is uscd ro hear thc sound oí

blood rushing back through thc artery.
The first thumping sound is thc systolic
blood prcssure (SBP). When thc thumping
S(>tmd is no longer heard, that's rhe diastolic
blood pressurc (DBP).

- Taking blood
Ouring venipuncrure, rhe phlcbotomist, a technician who rakes blood, inscrrs a needle
into a vcin and wirhdraws blood into a specimen tubc, which is scm to rhe haematology
laboratory for analysis. Usually thc phlebotomist can lind a vein in thc inner part of the
elbow, rhc antccubiral fossa, rhar is easily accessible. She may apply a 1ournique1 - a right
band - abovc the site, or rhe paticnt may be asked to dench their hand to make a lis,, in
order to make thc vein more prominenr. Afterwards, 1he patient may be asked to press
lightly on a dressing, usually a picce of gauzc, 10 hclp ,he blood ro clot and 10 prcvent
swelling and a haemaroma (a black and blue mark, ora bruisc) wherc 1he vein was
puncrurcd.
Note: A bruise is a specific mark. Bruising can be used to describe a number of bruises or a larger
area - The potient exhibited bruising on /he right foreorm.

76 Professionol English in Use Medio'ne

34.1 A doctor is ralking to a patient during an ophthalmoscop¡•. Match thc underlined
cxprc-ssions shc uses ( t-4) t0 expressions wifh similar meanings from A opposirc (a-d}.

Righr, Mr Gold, because you've been having rhcse headaches l'm going to have a look
at your eycs, particularly thc back oí your cyc - the retina. l'm going to put ( 1la cwo!e
of drons in your eye, (2) whicb will make ir easier for me ro u:e rhe retina . After a fcw
minutes you may find your vision a bir blurry. This will wcar off aftcr about an hour.
(3) I uced ro gcr rid oí as much externa! light as possible. T his mcans closing rhc blinds.
a,
Now, l'd like you to (4) look straight :¡head 1h31 clock. T his takcs a fcw minutes and
your eyes might feel a bit rired so you can blink if you nced ro. 1 don't wanr you ro look at
me, look at the dock.

a rhe examination is done wirh dimmed lights

b a ropical mydriaric solution
e t(>aid dilarion
d fixare on a rarget

34.2 Complete rhe instrucrions. Look ar B oppositc to help you.

1 Wrap rhe ................................ around thc patient's uppcr arm.
2 Place rhe ...... _ ___ ,., over rhe arca oí the brachial arrery. Raise rhe patient's arm so
that the brachial artery is ar the samc hcight as the hearr.
3 Close the valve on the ....,., _ _ _ _
4 Pump up the prcssurc to >t least 150 mm Hg. Open rhc ..,_ _ _ _ a linlc and
slowly dcAarc thc cuff while listening and watching rhe pressure .........,,.. _ __
5 The firsr sound you hear is the ílow oí blood through the brachial artery. The value
on the gauge ar that poim is rhe _ _ _ _ _ ,............................... _ _ __
6 Conrinue listening while you slowly ................................ the cufí.
7 The - - - - - blood pressure is measured when the sound complerely disappears.

34.3 Complete rhc tcxt. Look ar C opposite to help you.

( 1) - - - - - are specially trained in taking blood. Thcy are skilled at (2) .............
puncruring the vein to rakc a blood samplc. The wrisr, hand and foo t can be used but more
often a vein in the inner pan of rhe elbow is used. H it is diíliculr ro locare a suirable vcin, the
patient may be asked ro make a (3l - - -- -, ora (4) _ _ ___ may be applied on rhe
upper arm ro make the vein more apparent. Afrerwards, a (5) ..- - - - - is applicd and the
patienr is asked to press gcntly. This hclps ro stop thc bleeding and prevenr (6) .......... _ _ _ at
rhe site. lt is imporranr rhar (7) _ _ _,,........................................... are labelled correctly beíore they are
senr to the haematology (8) _ _ _ __ , where a íull blood count or other invcsrigations will
be carried our.

OVe-r +o 11ou ~
Prarlisr talking a p.Jlil·nt through an inVl''iotiga tion tha t you rarry out rrgularly.

Pro(tffionol Engti.sh in Use Mtdant 77

 Laboratory tests
A Microbiology request form
A Microbiology reques1form uses a number of abbreviarions for specimcn types (sec
Appendix U on page 131 for an explanation of thcse abbrcviations).

Date collected .. ./.. ./...

Time collected ............ (24hr)
0 MSU O Nose sw 0 Blood Culture
o csu 0 Throat sw 0 Clotted Blood
O Urine - Other, specífy O Axíllasw o EDTAblood
O Urine first voided - br chlamydia O Groinsw 0 CSF
O Faeces O Eyesw
O Sputum O Endoce,vical sw
O NP secretions O Sw in Virus TM' (give site)
0 BAL O Sw for chlamydia (give site)
O lnduced sputum ·special medium
Other:

A Biochemistry and Haematology lab report

Valuc R.tl'lgC Unit VaJue Ron¡;< Unit
Full blood coun1(FBC) Urc.'l :1nd dccrrolyrC$
HaCmóglobin (Hb) , 43 115- 165 gil, (U«E)
Hacmatocrit {HCI') 0.224 0.37-0.47 1./L Utca 4.5 2.5-6.6 mmol/l
Mt."An cdl i·olumc (MCV) n .5 78.0-98.O fl. Crcarininc 58 60-120 umol/l
Wh.itc t.·tll l-OUnt (\VCC) :'.4 4.0-11.0 IO'IL Sodium (Na) 138 13$-145 mmoVL
Powsium (K) 4.$ 3.6-5 mmoVL
Lin.•:r funaion 1cst (Lfi')
llilirubin 7 3-16 umoVL
ALT 9 10-50 U/L
AlkaUnc Phosphatasc 131 40-125 U/L
(Alk.Phos)

Terms used to describe lab results

up ~ high low
down
ckvatcd ~ raiscd rcduccd
When the results are within the normal
range, doctors say: within normal limiu.
Porassimn is nor1.nal.
unrcmarkablc.

U111t ahhrt·v1at1on Full form

g/L grams per litre
UL litres pcr ~trc
109/L rimes ten to the power nine per litre
fL fcmtolitrcs
mmol/L millimols per lirre
umol/L or ¡11nol/L micromols per litre
U/L units per litre

78 Professionol English ;n Use Medicine

35.1 Write the namc of thc specimen for each of the suspected conditions. Look at A oppositc
to help you.

Susp~ctcd cond1t1011 Sp,Tinwn

anaemia
bacrerial conjuncriviris
genital herpes
meni.ngiris
scpticacmia
urinary infccrion
urinary infecrion (cathctcr in place)

35.2 Complete the senrences describing rhe resulrs of rhc rcporr in B opposite. Look at C oppositc to
help you.
1 Haemoglobin is ________ _ _ ............................, one hundred and forty-rhree
............................. per litre.
2 Crcatininc is slighrly ............................ , fifry-eighr ............................. _ _ _ ........ litre.
3 Alkaline Phospharnse is _ _ _ _ , one hundred and thirry-one - - - - - ········--····..............

4 ALT is slightly reduced, nine _ _ _ _............................... _ _ __

5 Bilirubin is ............................. , se ven .

35. 3 WaiLe íull Jé~C1Íplion.s of thc foUo,ving results from a case history. Look ar B and C
opposite and ar 35.2 above 10 help you.

Na 138, K 4.5, WCC 12.2, HCf 0.224, MCV 72.5, Alk.Phos 72, ALT 9
.;.;.oo:Mm.~.ruil.l!l,11!,.®.c..ll~.111<1~.,1.~_...bir1.Y.:.~i0.bf..mi!!imºJ.!!.f.ª-.li~..........................___ .___ ._ _

_________________________.......................................
..........,--···..····........... ______________
- - -- - - - - - - - - - - - -- ......................... ___________

ov~r .f-o f10l.l "

Orsrrihl' the lah rt·sult'i nf a n:n:nt l'él\l' you'v,· hl"l·n involwd in,

Pro(essionol Engfóh in U.e Med,dne 79

 Endoscopy
Functions of endoscopy
Endoscopy is a way oí rxamining parts of the body which are 1101 visible from rhe
ourside. A typical cndoscope is a ílexible tube which is ioserted through one oí the natural
orífices - openings - such as rhe anus or mouth. Rigid cndoscopcs, which cannor be bcnr,
are also used but are inserred through small incisions - surgical curs. The shafr conrains
severa! channcls ro transmir light from rhe ourside and images from inside and ro allow
differenr instrumenrs tO be used.
Endoscopes can be used for rhe following: flexible tip fitted with
•lilli-...:._lcens or camera
• ro provide diagnostic information
• ro excisc - cut our - discased rissue or
growrhs sud, as polyps
• rodear obstrucrions
flexible shaíl containing
• ro rake a biopsy image channel and
channels ror light, air
• ro cautcrizc a sirc of blecding by and water. instrumc::nts
applying hear. and wires

Enteroscopy
Or Jardine is ralking her patient dtrough an enreroscopy.

Now, l'm jusr lubricaring rhc rube with a jclly which conrains a local anaes1hcric. lt'II help
ro ensure a smoorh passage as ir passes down and you shouldn't fcd roo much.

l'm going t<>fecd che rubc rhrough your nose. This is 1he most uncomfortable part <lf rhc
procedure but it's ver1 bricí. You'II gc1 uscd to rhc tubé in a few minutes' time. OK, when it
hirs the back of your rhroar, rakc a deliberare swallow. 1'11 rell you when.

I
Now! Swallow, swalbw, That's it, Well done.

Report of a diagnostic endoscopy

El'AMINAlllN Pl!OlDICAllON Elll05CJf[

lnformed consent was obtained from lhe palieot after Throat spray Olympus GIF-XQ240
discussing risks and benefils of the p,ocedure. Thepalien! was
connected lo lhe pulse oximeter and placed in the left lateral
posítion. Oxygen was provided through a nasal cannula and
the premedication administered as stated. The endoscope was
introduced ínto lheoesophagus. Al lhe end of the examinalioo
lhe patient was transferredto the recovery area to recuperate.

80 Pro(essionol Engfish in Ust Medicine

3 6.1 Complete the table with words from A, B and C opposite.

\krb Noun
consent
cxcision
incise
insertion
recovcr
swallow

36. 2 Find words in A and 8 opposire wirh rhe followi ng meanings.

1 to pass (an insrrumenr rhrough an orífice)
2 a subsrance used in procedurcs for lubricarion
3 rhe ílexible part of rhe mdoscope
4 ro srop something bleeding by appl)•ing heat
5 a growrh rhar prorrudes from a mucous membrane
6 to remo\1e diseascd rissuc
7 taking a sample of a rissue for analysis
8 nor ílexi ble
9 a drug thar numbs a particular part of rhe body
10 become accusromed to

36.3 Reploce rhe underlined ·w ords and phrascs wirh altcrnativc words and phr,,.scs from C oppositc.
Afrer connccting rhc parienr roan {1) instrumcnr which measures levelsof oxyge:n in tJe
blood ,md pulse care and placing him (2) on bis lefr sjde. oxygen was provided through
H (3) tubr in his nosc and me (4) dcur: rceacmcnrprior ro che procedure admi11iscered as
stared. Shortly afrerward, the endoscope was (5) inserred inro rhe oesophagus. After rhe
examinarion, the paricnr was (6) ~ ro rhe recovery area.

Nasal cannula

Over .f-o 110/J ~

What would you !>ay to a pal il·nl duri ng a bronchoscopy, or during anothl·r intnnal
investigation whirh you rnrry out regularly?

Pro(essionol fngJJsh in Use Me<kine 81

 X-ray and CT
Radiography and radiology
Radiography involves exposing a parr of ,he body to a small dose of radiario n ro produce
an image oí rhe interna! organs. Organs with high densiry such as the ribs and spine are
radiopaque, meaning they do not absorb radiarion, and appear w hire or lighr grey on rhe
image. Lung rissue is radio lucent - absorbs radiarion - and appears dark 0 11 the inuge.
Bcfore sorne types oí X-rays, paticnts are given a liquid callcd a contras, mcdium, such
as barium o r ind ine, which is radiopaquc and allows rhc organ o r rissuc ir fills ro be
examined. The conrrast medium may be swallowed, inrroduced through the anus asan
e.nema, or given as an irjcction.
Radiology is thc use of radiariún in thc diagnosis and trtatmcnt of discascs such as canccr.

X-ray examination
The chesr X-ray is the commonesr diagnosric X-ray examinarion. Normally a frontal
(ameroposrerior) view is obrained. T hc paticm stands faci ng thc photographic plate with
the chest pressed to rhc ?lare, with hands on hips and elbows pushed out in fronr. The
radiographer, thc rechnician w ho rakcs thc X-ray, asks thc patient not to movc, thcn to
brearhe in deeply and not to breatl,e out. T his makes a blurred. unclear X-ray image less
likcly and improvcs the qua liry of thc irnagc, as it is casicr to see abnormalitics in air-filled
(inAated) lungs than in deflated lungs.

( Keep •b Now, cake a dccp brcath a,id hold your brcath.

For a side, or lateral view, the paticnt is asked to srand sidcways to the photographic plate
wirh arms raiscd. A chcst X-ray may be rcpcated ar inrervals to track fo r any changes.
Thesc rcpcatcd cxa111ina1ions are called serial chcst X-rays.

Computed Tomography
riere is an extraer írom a hospital's prcss release.

The Western Genera! has installed a new GE LightSpeed 16 Computed Tomography

(CT) Scanner. CT uses an X-ray source which rotales around !he body to produce
cross-sectional images.
Toe new scanner takes up to 16 simultaneous cross-sectional images (slices) and
transmits more data in less time than ever before. Each slice can be less !han one
millimetre thick, mak ng it possible to find very
small abnormalities.
Toe scanner will be used for:
• diagnosing muscle and bone disorders
• locatlng tumours, infections and c lots
• monitoring the progress of malignan! diseases
and the l9IIPOM9 to therapy (treatment)
• providing accurate guidance for interventional
INOCllldl... such as biopsies, and drainage
- rwnovlng fluid from the site of an injury or

82 Professiono/ Engli,h in Use Medidne

3 7 .1 Choose the correcr word or phrase to complete each senrence. Look ar A and B opposite
to help you.
1 In radiography, barium is uscd as a comrasr _ _ _ _ _ (image/medium).
2 Tíssue which absorbs radiarion and appears dark on an X-ray is _ _ _ __
(radiolucent/radiopaquc).
3 An - - -- ···· (enema/injecrion) is a liquid introduccd into the bowel by way oi rhe anus.
4 X-rays used ro measure rhe progress oí a disease are callcd - - - -
(rcpeated/serial) X-rays.
5 lf a ¡>atient moves during an X-ra)', the image may be .............................. (blurred/abnormal).
6 lt's easier to see abnormalirics whcn thc lungs are _ _ _ _ _ (deílated/inflared).

37 .2 Complete rhe words. Each bcgins wirh rodio. Look ar A and B opposire ro help )'O\I.

1 Using radiation ro diagnosc and trcar disease is radio......... - - -

2 Using radiarion to make images is r;,1dio.......... _ __
3 Using radiarion ro providc trcatmenr is rodjo... _ _ __
4 lf something is nor penmable by radiation, it is radio _ __
5 lf somcthing is penetrable by radiarion, ir is radio. - - -- ·
6 A rechnician who adm inisrcrs X-rays is a radio.....................

37 .3 Complere rhe radiographer s instructions. Look ar B opposire ro help you.

Please srand (1) ..,,., _ _ __ this board.
Pur your hands on rhc back of your hips and your elbows forwa rd . 1'11 help you.
(2) ............................... your elbows (3) .............................. .
Keep (4) _ _ __
In a momenr 1'11 ask you 10 (5) .......... .. .. a deep brea d, in and hold it.
llrearhe in, (6) _ _ ___ it.
That's ir. Fine. You can brearhe our now.
Thank you. 1'11 need to check rhe film.
Now l'rn going ro rake a side view.
Can you stand (7) ____ ....... wirh your righr side close to the machine and your arms raised?

07.4 Complete rhe table with words from B and C opposire.

Verh Noun AdjerliV('
abnormal
brcarhe
drain
inrervcnc intervention
thcrapeutic

Pro(essionof EngNsh m Use Med,cine 83

 MRI and ultrasound
Magnetic Resonance lmaging (MRI)
MRI is safcr than X-rays because it <loes nor use radiarion. Ir provides more ínformation
rhan Compmed Tomography (sce Unir 37) about some head, neck and spinal disorders
because rhe images are more derniled and havc more contrast, meaning the differences
berwcen dark and light areas are srronger. Unlike CT, rhe images can be takcn on any
plane - any surfacc of 1he body seen from an angle. lt is now used for imaging - raking
images of - rhe brain and heart, and in oncology.
Con1raindicarions, cases in which ir should nor be uscd, include paticnrs with merallic
forcign bodies in 1he orb.rs, and paticnrs wirh pacemakers - electronic devices surgically
implanred ro regulare hearrbear. MR I is also not approved d uring the firsr rrimes1er of
prcg:nancy.

- - Ultrasound
Ulrrasound exarni narion uses high-frequcncy sound wavcs to view organs and struc1ures
inside the body. The wavcs are generated and received hy a hand-held device called a
rransducer. T he reílected waves are processed by a coinputer which produces derailed
imagcs for display on a monitor. Ultrasound is safe as it does nor employ ionizing
radiarion like X•rays. Ir is a cheap, quick and non-invasive investiga.rion - wirh no
surgical procedurc - for a wide range of referrals, alrhough r<'Sulrs can be unsarisfactory
in obesc (overweight) patienrs.

Preparing for medica! imaging

Preparing for an MRI sean
You will nccd to have complctcd a safety questíonnaire and have it with you111• lt is
imporranr rhar rhcre is no mera! on your clorhing or personm. Prior ro rhe sean you can
car and d rink normall/31• Your derails and safety quesrionnairc will be chcckcd with you
by the radiographer, who will explain thc procedure and answer any questions you may
have1" . You will be asked to remove any merallic objects, as well as crcdit cards151 •
You wiJI be asked ro Iie cm thc MRI scanner cable and make yourself comforrable161. T he
radiographer will position rhe parr ro be seanncd carcfully in thc scanner'71 • During rhe
M RI sean you will nor feel anything but you will be required ro sray still 10 achieve the
best possible images<81 . The whole examination process 1akes approximately 45 minures191 .
You will nor requirc any injcctionsl 10l.
Preparing for an ullrJsound
You will be asked to lie on an examination rnble1111_ A spc.,cial gel is applied ro your
skin° 21• This ensurcs 1hcrc are no air pockers between the rransducer and your body1131•
The transducer is moved over the area to be cxa111ined 114>. You 1nay feel some pressure
and expcricncc somc discomfor1, espocially if rhe test requires you 10 ha ve a full
bladder' 151• You may be asked 10 changc your position for clearer picrures1' 61. When rhe
radiologis1 is satisfied with the picture quality, rhc test is done and the gel is wiped offl' 71•
A rypical test may rakc bctwc-en 20 minutes and one hour1181•

Describing medica! imaging

An ulrrasound sean of the liver An ultrasound sean of 1he abdomen
revealed reduction of n1erasrases. dcmonstra1ed a small right renal tumour.

An ultrasound sean showed an imra,abdominal abscess.

84 Profwionol English in Ust Medk"ine

3 8.1 Match thc two parrs of thc senrcnces. Look ar A opposite ro help you.
1 MRI provides more deiailed information than CT because
2 MRJ is nor approved for use in
3 MRJ is safcr than X·rays because
4 MIU allows imaging on many planes
a rhcrc is no radiation.
b unlike CT.
e oí high conrrasr sensitiviry.
d rhe first rhrcc monrhs of prcgnancy.

38.2 Match whar rhe radiographcr says during an MRI sean wirh a numbered poinr in C opposire.
a You don•r nced any injcctions.
b I want you ro lie down and just relax.
e lr's important that you try not to move.
d l'm going ro go rhrough your qucsrionnaire with you.
e Ir will be over in th ree-quarrers of an hour.
f lr's very imporranr that you put any meml objecrs into chis tray.

j]B.3 Match what thc radiographcr says during an ultrasound wirh a numbered poinr in C opposite.
a l'm going to pur sorne gel c)n your abdomen. You mighr find ir a bit cold.
b Tiiat's ir. AII done. 1'11 jusr clean you up.
e l'd likc yc¡u ro lic flar on your back on thc rabie.
d The gel is to make sure rhere's a good conracr wirh your skin.
e 1'11 movc this back and forwards ro covcr the whole oren.

118.4 Makc word combinations using a word from cach box. You may ne<:d to look ar Unirs
34 10 37. Then use some of the word combinaiions ro complete rhe sentences.

breathe anaesthetic
cxcisc your brcath
experience a-ea
forcign diseascd tissue
hold discomfort
informed in
introduce bodies
local consent
rccovcry thc cndoscope

t l'm going ro give you ª···--- - - - - - SO rha, you won't feel any pain.
2 With an MRI, ir's imporranr rherc are no mctallic __________ in rhc cyes.
3 After an operation. pariems are moved ro a - - - - · ···· ······-······.... -............. ro recuperare.
4 Endoscopes can be used to ................................................................................................ .
5 Bcforc an cndoscopy. r~.e parienr's ······--····························----···· musr be obtained.

Ove,r .f-o tfou ,,,

Expl;Jin to ,1 pat il·nl wh~· you ;:m· n:ft-rring hn for an ult rasou nd sran nr ;:m MRI \f;;n , and
wh~1 t slw ran cxpect to 'lappen during ttn~ proredurl'.

Pro(essionol English ,n Us, Mtd,an, 85

 ECG
Uses of an ECG
An dcctrocardiogram (ECG) is a rracing, or drawing. produced by an clectrocar diograph - a
device which records electrical acrivity in thc hcart. An ECG can be used fo r:
• deciding if the heart is performing no rmally or suffcring from abno rmaliries, for example
cardiac arrhyrhmia - extra o r skipped heartbcats
• indicaring damage ro heart muscle, such as hearr arracks, or ischaemia of hearr muscle
(angina)
• dctecting conduction abnormalitics: heart blocks and bundle branch blocks (BBB)
• screening for isthaemic hearr disease during an exercisc colerance test, often carricd out on
an exercise bi ke or rreadmill
• providing inform,uion on rhc physical condirion of the he;i n, for example in patiems wfrh
lefr ventricular hypertrophy (LVH )
• derecting elccrrolyrc disrurhances, for example low plasma potassium levels.

ECG procedure
Mere is an extraer fro m a mcdical rexrbook.

1 Tho paücm should l.ie clown und rola.,.

2 ('. alibrate U10 ECG machine - a standard signal of 1mV should move lhe stylus two large
squares (1 cm) vt;rlically.
3 Altach the Umb lcads: lelt arm OA). righl arrn (RA). lelt lcg O.L), and right leg (RL).
4 Record tJ1e six standard leads: J. U. 111, augrnontcd voltage right arm (AVII), augmcnlNJ
voltage left arm (AVL). and augmented vollagc foot (AVF)- three or four complex~,;¡
(see C below) for cach.
5 Apply tho electrode to t.be six chcst pos itions in turn, rccording three Lo fo ur complexcs
of each. lf the rhyúuu docs not appear LO be sinus (normal r hythm). a rhylhm strip ol'
(:,--10 complexas in a single load should be r ecorded.

A normal ECG
T he picture shows an ECG tracing ORS
of a normal heartbeat sl,owing a P complex
wave, a Q RS complex anda T wave. R
Each largc square is eq,úvalent ro
0.2 seconds. The R-R interval gives
,he heart rate, Ln this case 75/min. In
rhe case of abnormalitie;, the Q RS
complex can be widcncd o r too tall.
The ST segmcnt can be clevarcd
(,r dcpresscd. The T wa•e can be
, he right way up, or inverted - thc
¡) wavr
w rong way up.

PR interval 1 ~
0T nterval
s

86 Pro(es.sionot Et1glish in U!e Medicine

3 9 .1 l'ind words and phrases in A and B opposire wirh rhc following meanings.
1 the marks produccd by an l:CG stylus
2 a test which determines how well a paticnt copes with physic,I exercise
3 a misscd hearr bear
4 a change in rhc chemid composirion of body íluids
5 rhe ílow of elecrric cumnr in the heart
d - --
6 tesring for discase
7 check or adjust an instrumenr before use
8 thc pen which produces the drawing

39.2 L,bcl the limb leads {a-d) on rhe firsr

diagram, and wrire a ritle (e) for rhc
second diagram. Look ar B opposire
ro hclp you. e _ __

a ....... _ _ _
v,- -__,~ __.,..,. .___.
V2 •
V3 VG
b ......... _ __
V4 VS
c ............ _ __

39.3 Complete rhe texr using words from rhe box. Look ar C opposire to help you.
complexes leads wave inrcrval rare

This very abnormal ECG ¡hows a ( 1) _ _ _ .............. of approximarcly 33/min; a single

long pause of approximartly 4 scconds berween ventricular complexes wirh arria! acriviry:
widened QRS (2) .............._ _ in keeping wirh (R)lllíB. Dccp T (3) _ _ _ __
inversion in rt, 111, AVF and some chesr (4) ............................... (V4-V6). Deep QRS complexes
in V2 and V5 in keeping wirh LVl-1. One arria! ecropic. QT (5) _ _ _ _ _ is normal.

lnd 11

OVe-r .f-o 11ou ~

Describe an ECG tracing 11f one oí your patients to a collt-agur.

Professionol Englrsh rn Use Medoone 87

 Investigación

BIBLIOGRAFÍA
• GLENDINNING, E. H. y HOWARD, R. Investigation. En GLENDINNING, E. H. y
HOWARD, R. Professional English in use (pp: 76-87). Cambridge University Press.
Cambridge, Reino Unido.1

1
Uso con fines académicos