Urinary and Reproductive Systems Lecture 7 of the Course “Medical English” for Sophomore Medical Students of Taipei Medical University

School of Medicine Taipei Medical University

Winston W. Shen, M.D.

Professor and ChairmanDepartment of Psychiatry

Taipei Medical University College of Medicine and

Chief, Department of Psychiatry TMU-Wan Fang Medical Center

Taipei, TAIWAN

E-mail address: Shenwinw@gmail.com

The Schedule for the Course “Medical English” (Version of 3/29/07) Week 1 (March 1) The Digestive System

Week 2 (March 8) The Respiratory System Week 3 (March 15) The Cardiovascular System Week 4 (March 22) The Musculoskeletal System (Turning in a 400-word essay on “My Visit to the Clinic (Hospital)” (in double-line space hard copy)

Week 5 (March 29) The Central Nervous System Week 6 (April 5) No class (Spring break) Week 7 (April 12) Urinary and Reproductive Systems Week 8 (April 19) The First Examination Week 9 (April 26) Medical Records (Turning in a 400-word essay on “My Favorite Book” (in double-line space hard copy)

Week 10 (May 3) Scientific Papers Week 11 (May 10) Hematology Week 12 (May 17) Infectious Diseases Week 13 (May 24) The Second Examination Week 14 (May 31) Endocrinology (Turning in a 400-word essay on “How to Be a Good Physician” (in double line space hard copy)

Week 15 (June 7) Immunology Week 16 (June 14) Oncology Week 17 (June 21) No Class Week 18 (June 28) Final (The Third) Examination

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Kidney(Gr, die Niere;Fr. nein

(c.1325, of unknown origin, originally kidenere, perhaps a compound of O.E. cwið "womb" + ey "egg," in reference to the shape of the organ. Fig. sense of "temperament“ is from 1555. Kidney bean is from 1548.)

Ureter(New Latin ūrētēr, fromGreek ourētēr, from ourein, to urinate)

Bladder(Gr. die Blase;Fr. vessie)(Origin: bef. 900; ME; OE blǣddre, blǣdre bladder, blister, pimple; c. ON blāthra, dial. D bladder, G Blatter; akin to Blow2)

The Urinary System (Kidney, Ureter, Bladder and Urethra)

Cortex (pl.ces)

MedullaAnatomy. a.the marrow of the bones. b.the soft, marrowlike center of an organ, as the kidney or adrenal gland. c.medulla oblongata.

(L: bark, rind, shell, husk)

Adj. renal

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Glomerulus (pl. -li)

Glomerular capillary

Bowman’s capsule Capsular (Bowman’s) space

Mesangial cells

Podocyte An epithelial cell of the renal glomerulus, attached to the outer surface of the glomerular capillary basement membrane by cytoplasmic foot processes

( NL. equiv. to L. glomer- [s. of glomus] ball-shaped mass + -ulus –ule)

(< F. < L. capsula, equiv. to caps (a) box (see case 2) + -ula -ule ]

Proximal collecting tube

Proximal tubule (where reabsorption takes place)

Distal tubule(where secretion takes place)

Glomerulus (where filtration takes place)

Collectingtube

Urine Formation in the Nephron

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Penis (noun, plural - nis·es, -nes)

(From Fr. pénis or directly from L. penis “penis,” earlier “tail” (cf. Eng tail in both senses, the sexual one slang), from PIE *pes-/*pesos- "penis“ (cf. Skt. pasas-, Gk. peos, posthe "penis," probably also OE. fæsl “progeny, offspring,” ON. fösull, Ger. Fasel “young of animals, brood”). The proper plural is penes. The adj. is penial. In psychological writing, penis envy is attested from 1924.)

Urinary bladder

(Vesica urinaria)

Male Lower Urinary Tract

Urethra(Late L. ūrēthra, from Gk. ourēthra, from ourein, to urinate.)

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Urinary bladder

(Vesica urinaria)

Female Lower Urinary Tract

Urethra(Late L. ūrēthra, from Gk. ourēthra, from ourein, to urinate.)

Urethral orifice

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Penis (Gr. der Penis; Fr. Pénis) (noun, plural - nis·es, -nes)

(1676, perhaps from Fr. pénis or directly from L. penis "penis,“ earlier “tail” (cf. Eng tail in both senses, the sexual one slang), from PIE *pes-/*pesos- “penis” (cf. Skt. pasas-, Gk. peos, posthe “penis,” probably also O.E. fæsl “progeny, offspring,” O.N. fösull, Ger. Fasel “young of animals, brood”). The proper plural is penes. The adj. is penial. )

The Male Reproductive Organs (1/3)

(pl. testes) (from L. testis "testicle," usually regarded as a special application ofTestis "witness,“ presumably because it "bears witness" to virility, the power of procreation (cf. Gk. parastates, lit. "one that stands by;“ and Fr. slang témoins, lit."witnesses").

Testis, testicle

Prostate (M.Fr. prostate, from M.L. prostata “the prostate,” from Gk. prostates (aden) “prostate (gland),” from prostates “one standing in front,” from proistanai "set before," from pro- "before“ + histanai "cause to stand" from PIE base *sta- "to stand.” So called from its position at the base of the bladder.)

Seminar vesicle

Vas deferens (NL. vās déferéns lit., vessel for carrying off. )

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The Male Reproductive Organs (2/3) Corpora cavernosa

Corpus spongiosa

Urethra (passes urine or ejaculate) Epididymis

Scrotum

an elongated organ on the posterior surface of a testis that constitutes the convoluted beginning of the vas deferens.

(that which is on the testicles” from Gk. epididymis, aword probably coined by Gk. anatomist Herophilusfrom epi “on” + didymos “testicle,” lit. “double, twofold.”

(pl. scrotums or scrota)The external sac of skin that encloses the testes in most mammals. The scrotum keeps the testes at the optimal temperature (slightly below body temperature) for producing sperm.

Cavernous = (1) Filled with caverns. (2) Resembling a cavern, as in depth, vastness, or effect: a cavernous yawn; cavernous echoes. (3) Anatomy Filled with cavities or hollow areas; porous

Spongiose \Spon"gi*ose`\, Spongious \Spon"gi*ous\, a. [L. spongious, spongeosus: cf. F. spongieux. Somewhat spongy; spongelike; full of small cavities like sponge; as, spongious bones.

(Sing. corpus; pl. corpora)

The Male Reproductive Organs (3/3)

Ejaculate has spermatozoa (pl.) , -zum (sig.)

prostate fluid and seminal fluid

A sperm cell attempts to penetrate an ovum coat to fertilize it.

Tail

Head

The Female Reproductive Organs (1/4)

Uterus (Gr. der Uterus; Fr. utérus

Ovary

Fallopian tube

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( L. the womb, matrix; akin to Gk. hystéra womb, Skt udara belly)

(From Mod.L. ovarium "ovary" from M.L. ovaria “the ovary of a bird,” from L. ovum “egg,” from PIE *owyo-/*oyyo- “egg.” In classical L., ovarius meant “egg-keeper.” Ovarian (adj.) is attested from 1840.)

(Described by or attributed to Italian anatomist Gabriello Fallopio)

c.f. Hysterectomy

The Female Reproductive Organs (2/4)

(Coined in Mod. L., from Gk. kleitoris, a diminutive, but the exact sense is uncertain. Probably from Gk. Kleiein“to sheathe,” also “to shut,” in reference to its being covered by the labia minora)

Clitoris

Labia majora

Labia minora

Sing. labium majus (NL. greater lips)

Sing. labium minus(NL. lesser lips)

Vagina (L. vāgīna, sheath) The passage leading from the opening of the vulva to the cervix of the uterus in female mammals; “the vagina receives the penis during coitus”; “the vagina is elastic enough to allow the passage of a fetus.” 

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Barthlin’s gland (Named after Caspar Bartholin [1655–1738], Danish anatomist, who described them in 1637)

Either of two small compoundcompound racemose glands located on either side of the vaginal orifice that secrete a lubricating mucus and are homologous to the bulbourethral glands in the male

The Female Reproductive Organs (3/4)

( L: leg, shank)

Crus clitoris

Glans clitoris

Corpus cavernosum

(L. glāns, gland-, acorn, glans [from its shape])

a mass of erectile tissue with large interspaces capable of being distended with blood; Especially: one of those thatform the bulk of the body ofthe penis or of the clitoris

The Female Reproductive Organs (4/4)

Desire (libido)

Excitement (arousal) Orgasm

Desire

Desire

Erection

Vasocongestion/lubrication

Ejaculation

?

Refratory period

Male

Female

Shen, W.W., Sata, L.S., Hofstatter, L. (1984) Thioridazine and understanding sexual

phases in both sexes. Psychiatric Journal of the University of Ottawa 9:4:198-190.

Sexual Phases in Men and Women

Genitalias in Sexual Excitement Erection of the penis

Orgasm and Ejaculation

Vasocongestion and Lubrication

Orgasm

(the state marked by firm turgid form and erected position of previously flaccid bodily part containing cavernous tissuewhen that tissue becomes dilated with blood.

Clitoris becomes erected. Vagina increases in size. Uterus rises.

(NL. orgasmus; Gk. orgasmós, derivative of orgân to swell up, be excited)

the climax of sexual excitement that is usually accompaniedin the male by ejaculation)

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(adj. orgasmic or orgastic)

NO and cGMP in Penile / Clitoral Erection CNS

sexual stimulation

L-Arginnine

L-Citrulline

NO Synthase PGE1

(-) SSRI’s

NO

cGMP

Ca 2+ influx to smooth m. in corpora cavernosa

Musclerelaxation (penile or clitorial erection)

(-) high free Ca 2+

GTP

GMP

(-) Sildenafil

Guanylate cyclase

From: Shen WW, Urosevich Z, Clayton DO, Journal of Reproductive Medicine, 1999; 44: 535-542

PDE type 5

GTP, guanosine triphosphasecGMP, cyclic guanosine-3,5-monophosphase PGE1, prostaglandin1

PDE, phospho-di-eterase, type 5NO synthase, nitric oxide synthasePDE type 5 inhibitors= Viagra, Cialis

Tunica albuginea (Pl. Tunicae albugineae) tunica, [L. tunic; see tunic], layer, an enclosing membrane or layer of tissue; albuginea, whitish) The whitish membrane within the penis that surrounds

the corpora cavernosa in the penis and which helps to trap the blood.

The Anatomic and Physiologic Similarities and Differences between Clitoris and Penis

Characteristics Clitoris Penis

• Presence of corpus sponginosum No Yes • Presence of subalbugineal layer No Yes• The strength of tunica albuginea Weak Strong

• Ability to achieve tumescence Yes Yes• Ability to achieve rigidity No Yes• The intracorporal pressure from 2-fold 15-fold flaccid state measurements • Erection caused by injection of Yes Yes PGE1 (aprostadil) intracorporally• Presence of nitric oxide synthase Yes Yes isoforms in corpors cavernosa Shen WW, Urosevich Z, Clayton DO, Journal of Reproductive Medicine, 1999; 44: 535-542

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Femor Umbilical cord“Pertaining to the navel,” 1541, from M.L. umbilicalis “of the navel.”

Fetus

(From L. fetus “the bearing, bringing forth, or hatching of young,” from L. base *fe- "to generate, bear," also “to suck, suckle” (see fecund). In L., this was sometimes transferred figuratively to the newborn creature itself, or used in a sense of “offspring, brood” (cf. "Germania quos horrida parturit fetus," Horace), but this was not the basic meaning.

Pelvis

Placenta

(n. pl. fetuses) British English, foetus

The organ in most mammals, formed in the lining of the uterus by the unionof the uterine mucous membranewith the membranesof the fetus, that provides for the nourishment of the fetus and the elimination of itswaste products.

(NL. something having a flat, circular form, L: a cake. Gk. plakóenta, acc. of plakóeis flat cake, deriv. of pláx (gen. plakós) flat ]

(Pl.-tas, -tae)

The Fetus in UteroUterine wall

Original versions The doctor took my body temperature firstly,

and then asked me to open my mouth for examining my throat.

Under doctor’s indications, I finally recovered from the flu in a week.

She talked the patients in waiting, including me. The matter will be born in my mind.

Ten Commandments to Write Better English 1. Thou shalt always use correct grammar

Ten Commandments to Write Better English 2. Thou shalt use simpler sentences

Original versions When many patients flooded into the ER, or when the relatives accompanied patient to the ER, the space would definitely shrink much subsequently.

The unpleasant feeling made me sick and I would like to vomit.

Most time I stayed in the emergency room to help nurses care patients. Therefore, the emergency room room has imprinted in my mind and I want to share my experience of working in the emergency rooms. Emergency room, called “ER” is consisted of three sections. . .

Ten Commandments to Write Better English 3. Thou shalt vary your writing

Original version

I felt uncomfortable that the air filled my belly.

Ten Commandments to Write Better English 4. Thou shalt use more active voice

Original version

I was rushed to the ER, where I was then given a thorough physical examination by a doctor.

Ten Commandments to Write Better English 5. Thou shalt avoid redundancies

Original versions Looking on my past, I had a serious illness in my childhood, which impressed and scared me most. The doctor did not come, neither was the door open for one millimeter. The doctor prescribed the oral antibiotics for me to take for a period of a week.

Ten Commandments to Write Better English 6. Thou shalt avoid using Latinate words

Original version

The patient was brought into the emergency room via an ambulance.

Ten Commandments to Write Better English 7. Thou shalt use strong verbs

Original version

I joined an institute which has the purpose of volunteering services at a hospital and assisting in giving free medical treatments. I wish I could become a responsibility doctor and help others in the future. He is willing to be in the service of people. We had to do performance of three Latin dance shows.

Ten Commandments to Write Better English 8. Thou shalt use the parallel construction

Original versions

The medical services in Taiwan are efficient, fast and affordable.

The more time I stayed there, the more thing I understood the meaning of being a doctor.

The physician gave the hip injection instead of the arm injection.

Ten Commandments to Write Better English 9. Thou shalt avoid using empty phrases

Original versions

As a matter of fact, I hope that I do not have to go through it again. What to exaggerate, I also had fever with my body temperature being 40 degree Celcius.

One of the nurses told us her feeling of working there.

All of a sudden, my mother noticed an uncomfortable silence in the bathroom.

Ten Commandments to Write Better English 10. Thou shalt be specific in using words

Original versions She help me make a register for a doctor.

In addition to the space, I thought the quality of the ER should be improved too.

Even a delay within a second might cause an irretrievable harm to the patients.

My breaths became heavier and more frequent than usual.

Exercises V

13. Which of the following countries is NOT bordered with Indonesia: (A) Singapore, (B) Malaysia, (C) East Timor, or (D) Vietnam.

14. Which of the steps is NOT involved in the formation of urine in the nephons and tubules of the kidney: (A) Filtration, (B) Reabsorption, (C) Secretion, or (D) Diffusion.

15. With of the following has wrong information: (A) The penis and clitoris have similar structures histologically. (B) Urethra passes through and surrounded by glans penis and glans clitoris. (C) Female urethra from the bladder to the orifice is usually shorter than the male counterpart. And (D) Both the penis and clitoris can erect when excited.

Choosing the Most Appropriate Answers