Patterns of Organization and Signal Words

1. Patterns of Organization and Signal Words Allied Health Textbook Reading Strategy

2. Warm-up: • Read and Annotate the selections on Glucose Test and Blood Smear. Remember: • 1. Underline important details • 2. {Bracket main idea} • 3. Write key words in the margin to help you remember what you underlined.

4. These are visual notes: Mapping

5. annotation

6. MAPPING

7. What are Patterns? • Patterns are the structure of the major details in a reading • Patterns are like the blueprint of the reading • The organization of a reading and the main idea are closely intertwined.

8. Signal Words or Transitions • These are words that tell the reader that an important detail is coming in the text. • These words also indicate the relationship of ideas in the passage, or the organization. • Not all writers include signal words

9. Commonly Used Patterns in Allied Health Textbooks • Simple Listing • Time Order or Sequence • Definition • Cause and Effect • Lets take a closer look at these patterns and their signal words

10. Simple Listing • Items are listed in a series of major details or facts • Details are of equal importance, and the order of the details does not matter

11. Signal Words for Simple Listing • First, Second, • Also, • In addition • Another • In addition • Furthermore

12. Example of Simple Listing • p. 179 EMT text A partially obstructed airway can often be identified by the sounds of limited air movement. Understanding these sounds can help you better understand the pathophysiology of the obstruction. Stridor is typically caused by severely obstructed air movement in the upper airway. As air is forced by pressure through a partial obstruction, a high pitched almost whistling sound can sometimes be heard. Typically stridor indicates a severely narrowed passageway of air and suggests near obstruction. In stridor the obstruction can be a foreign body such as a toy or or it can be caused by swelling of the upper airway tissue as in infection. Next, the development of hoarseness is often an ominous sign. • (continued)

13. Simple Listing (continued) • For example, in a person whose airway is swelling after a burn, you may note a normal voice to begin with, but a raspy voice as swelling builds up around the vocal cord. Also, snoring is the sound of the soft tissue of the upper airway creating an impedance (or partial obstruction) to the flow of air. Many persons normally snore while asleep, but snoring in the case of injury or illness can often indicate a decrease in mental status such as airway muscle tone is diminished. It is also an indication that the airway needs to stay open. Gurgling is the sound of fluid obstructing the airway. As air is forced through the liquid, the gurgling sound is made. Common liquid obstructions include vomit, blood and other airway secretions. Gurgling is a sign that immediate suctioning is necessary.

14. practice • What would be a good title for this passage? • Underline the major details

15. ANSWERS: • TITLE: “Recognizing Sounds of Partially Obstructed Airway” • List of Details Stridor, Hoarseness, Snoring, Gurgling • Question: What are the sounds of a partially obstructed airway and what does each sound indicate?

16. Time Order or Sequence • Items or a Process are listed in chronological order. The steps must be followed in the correct order and cannot be changed.

17. Signal Words for Sequence • First, second • Finally • After • Before • Next • During • At Last

18. Examples of Sequence Organization EMT text p. In the upper airway, air first enters the body through the mouth and nose. The nose is specifically designed to accept air and through a series of turns and curves air is warmed and humidified as it proceeds through the nasal passages. The mouth is primarily designed to be the entrance to the digestive system, but is also an entryway for air, especially in an emergency situation. Next, distal to the mouth and nasal passages, air enters the throat or pharynx.

19. practice • What is the title? • Underline details

20. HOW AIR ENTERS THE BODY • Title is “How Air Enters the Body” • The sequence is _________________ • Nose or mouth • Nose warms air through turns and curves • Throat • Question: How does Air Enter the Body?

21. Key In the upper airway, air first enters the body through the mouth and nose. The nose is specifically designed to accept air and through a series of turns and curves air is warmed and humidified as it proceeds through the nasal passages. The mouth is primarily designed to be the entrance to the digestive system, but is also an entryway for air, especially in an emergency situation. Next, distal to the mouth and nasal passages, air enters the throat or pharynx.

22. Definition • Common in textbook reading is to define an important term • May be an entire paragraph • May include an example

23. Signal Words for Definition/Example • Can be defined • For example • Like • Term is usually in boldface

24. Example of Definition EMT text p. • Acute Coronary Syndrome(ACS) sometimes called cardiac compromise, is a blanket term that refers to any time the heart may not be getting any oxygen. There are many different ways in which patient’s hearts show that they are in trouble. For example, a coronary artery may become narrowed and blocked , or a one way valve may stop working properly, or the specialized tissues that carry electrical impulses may function abnormally.

25. Practice • What term is being defined? • What examples are given?

26. ANSWERS • The term being defined is Acute Coronary Syndrome The examples are: • Artery narrowed or blocked, valve not working properly or electrical impulses are functioning abnormally • Question: What is acute coronary syndrome?

27. Cause and Effect • One element is shown as producing another element. The passage could focus on the causes of disease for example, or could focus on the effects of a trauma.

28. Signal Words for Cause and Effect • Because • For this reason • Consequently • Hence • As a result • Therefore

29. Example of Cause and Effect Passage • EMT text p. “Vital Signs” Chapter The color, temperature and condition of the skin can provide valuable information about your patient’s circulation. There are many blood vessels in the skin. Since the skin is not as important to survival as some of the other organs (like the heart and brain), the blood vessels in the skin will receive less blood when a patient has lost a significant amount of blood, or the ability to adequately circulate blood. Constriction (growing smaller) of the blood vessels causes the skin to become pale. For this reason, the skin can provide clues to blood loss as well as a variety of other conditions

30. practice • What would be a good title for this passage? • What is the cause effect relationship in this passage?

31. KEY • Importance of Skin changes in Assessment • Blood vessels of skin receive less blood after blood loss • Skin becomes pale and temperature may change • Question: What valuable information can the color, temperature and condition of the sking provide?

32. Mixed Organizational Patterns • Sometimes writers use more than one organizational pattern Examples • Organizations may be a listing of causes and effects • A listing of definitions • A sequence with causes or effects

33. What is the mixed organizational pattern in this passage • p. 159 The heart rate is the number of beats per minute. The normal adult rate averages 72 beats per minute. The volume of blood pumped in one minute is called the cardiac output and averages five liters per minute. An irregularity in the heart’s rate or rhythm is called arrhythmia. A slow rate, less than 60 beats per minute is calledbradycardia. A fast rate over 100 beats per minute is called tachycardia. Extra beats before the normal beat are calledextrasystoles. Rapid uncoordinated contractions are called fibrillations

34. Check your answers • Title/topic could be: Heart Rates and Cardiac Output • Listing of Definitions

35. More Practice • What is the organization or organizations in each passage?

36. Is the Airway Open? • p. 177 EMT text • Is the Airway Open? You can determine the presence or absence of airway in most patients simply by saying hello. The patient’s ability to speak is an immediate indicator that he is capable of moving air. At the same time a person who is unable to speak, or one who speaks in an unusually raspy voice may be indicating to you a difficulty moving air. ………. Often it is not immediately apparent if an airway is present. In your CPR class you learned about the Look, Listen and Feel method. If a person is unconscious, you may need to employ this method to ensure the airway is present. In this case, look at the chest to see if it is rising and falling. The airway should be visually inspected for foreign bodies including objects and fluids. You should listen at the mouth for sounds of breathing, while placing your hands on the chest to feel for movement

37. Read the passage and underline the major details. What is the organization? • From Phlebotomy text “CoagualationFactors and Pathways” • The Role of Thrombin (p. 180) • The enzyme, thrombin, plays the major role in coagulation. It is generated at the injured site from prothrombin (facot II), its precursor form present in the blood. The primary role of thrombin is to convert fibrinogen to soluble fibrin. Thrombin also amplifies(intensifies) coagulation, supports platelet plug formation, activates factor XIII to cross link fibrin, and controls its own formation and the coagulation process by activating protein C, a substance that helps stop thrombin formation. Once healing has occurred thrombin initiates the breakdown of the fibrin reinforced clot by its role in the production of an enzyme that causes clot lysis. Thrombin is also thought to play a role in inflammation and wound healing.

38. What is the organizational Pattern? Listing of the effects of Thrombin • Convert fibrogen to soluble fiber • Intensifies coagulation to support platelet • Formation • Activates factor XIII • Role in inflammation and wound healing

39. practice • What would be a good title? • Underline the details • What is the organization?

40. p. 166 Phlebotomy Related Vascular Anatomy • AntecubitalFossa • Antecubitalmeans in front of the elbow. Fossa means a shallow depression. The antecubital fossa is the shallow depression in the arm that is anterior to and below the bend in the elbow. It is the first choice location for venipuncture because several major arm veins lie close to the surface in this area, making them relatively easy to locate and penetrate with a needle. These major superficial veins are referred to as antecubital veins. The anatomical arrangement of antecubital veins varies slightly from person to person; however, two basic vein arrangements, referred to as the H-and M-shaped pattern are seen most often