Lección 9.

Cohesión y coherencia
¡Domínalo!
Médico cirujano

Nombre del alumno: Pérez González José Daniel

Instrucciones:

 Este documento incluye la tarea que debes hacer para la lección 9.

 Lee las instrucciones cuidadosamente antes de elaborarla.
 Antes de enviar tu actividad, toma en cuenta que debes tenerla totalmente conformada por
todos los elementos solicitados, mismos que se encontrarán en la rúbrica.
 Una vez terminada tu actividad, guárdala en el portafolio de aprendizaje y sigue las
instrucciones de la guía académica.

Valor de la tarea: 13 puntos. Se tomará en cuenta para la evaluación de esta tarea:

- PARTE A. Diagrama: Tras leer el texto Pancreas: Function, Location & Diseases, completa con
vocabulario relacionado a esta lectura el diagrama posterior; con ello se confirma que reconoces
la cohesión del texto.
- PARTE B. En un siguiente espacio lee los tres textos; identifica aquél que no posee cohesión ni
coherencia y en un máximo de 80 palabras en español justifica tu respuesta; apóyate en los
elementos revisados en la lección.
- PARTE C. Redacta la idea principal de cada uno de los textos en español.

PARTE A

Pancreas: Function, Location & Diseases

The pancreas is an abdominal organ that is located behind the stomach and is surrounded by other
organs, including the spleen, liver and small intestine. The pancreas is about 6 inches (15.24
centimeters) long, oblong and flat.

The pancreas plays an important role in digestion and in regulating blood sugar. Three diseases
associated with the pancreas are pancreatitis, pancreatic cancer and diabetes.

Function of the pancreas

The pancreas serves two primary functions, according to Jordan Knowlton, an advanced registered
nurse practitioner at the University of Florida Health Shands Hospital. It makes "enzymes to digest
proteins, fats, and carbs in the intestines" and produces the hormones insulin and glucagon, he said.

Dr. Richard Bowen of Colorado State University's Department of Biomedical Sciences wrote in
Hypertexts for Pathophysiology: Endocrine System, "A well-known effect of insulin is to decrease the
concentration of glucose in blood." This lowers blood sugar levels and allows the body's cells to use
glucose for energy.

Insulin also allows glucose to enter muscle and other tissue, works with the liver to store glucose and
synthesize fatty acids, and "stimulates the uptake of amino acids," according to Bowen. Insulin is
released after eating protein and especially after eating carbohydrates, which increase glucose levels
in the blood. If the pancreas does not produce sufficient insulin, type 1 diabetes will develop.
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Unlike insulin, glucagon raises blood sugar levels. According to the Johns Hopkins University Sol
Goldman Pancreatic Cancer Research Center, the combination of insulin and glucagon maintains the
proper level of sugar in the blood.

The pancreas' second, exocrine function is to produce and release digestive fluids. After food enters
the stomach, digestive enzymes called pancreatic juice travel through several small ducts to the main
pancreatic duct and then to the bile duct, according to the Medical University of South Carolina’s
Digestive Disease Center. The bile duct takes the juice to the gallbladder, where it mixes with bile to
aid in digestion.

Location of the pancreas

"The pancreas is located in the upper abdomen behind the stomach," Knowlton said. The right end of
the pancreas is wide and called the head. From the head, the organ tapers to the left. The middle
sections are called the neck and body, while the narrow end on the left side of the body is called the
tail.

The Hume-Lee Transplant Center at Virginia Commonwealth University described the pancreas as "j-
shaped." The portion of the pancreas called the uncinate process bends backward from the head and
underneath the body, according to the Pancreatic Cancer Action Network.

Pancreas pain

Intense pancreatic pain is usually associated with acute pancreatitis. It can be hard to identify
pancreas pain and evaluate pancreas diseases because the organ sits deep in the abdomen,
according to The National Pancreas Association. Other signs that the pain may be pancreatic include
jaundice, itchy skin and unexplained weight loss. If you are experiencing pancreas pain, consult your
doctor.

Pancreatitis

The National Institutes of Health defines pancreatitis as inflammation of the pancreas, happening
when "digestive enzymes start digesting the pancreas itself." It can be acute or chronic, but both
forms should be taken seriously and may lead to additional health problems.

Chronic pancreatitis

There are up to 23 cases of chronic pancreatitis per 100,000 people per year worldwide. In just the
United States, it results in more than 122,000 outpatient visits and more than 56,000 hospitalizations
per year, according to the Cleveland Clinic.

"Chronic pancreatitis is a persistent inflammation (greater than three weeks) of the pancreas that
causes permanent damage," Knowlton said. The condition is often caused by "heavy, ongoing"
alcohol consumption, but she added that there are other causes, including "those that cause acute
pancreatitis attacks." Other causes may be cystic fibrosis, high levels of calcium or fat in the blood
and autoimmune disorders.
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Symptoms include upper abdominal pain, nausea, vomiting, weight loss, and oily stools. According to
Peter Lee and Tyler Stevens, in an article for the Cleveland Clinic, "clinically apparent" oily stools
(steatorrhea) do not appear until "90 percent of pancreatic function has been lost."

"Chronic pancreatitis requires dietary modifications, including a low-fat diet and cessation of alcohol
[intake] and smoking," Knowlton said. Chronic pancreatitis does not heal and tends to worsen with
time, and "treatment options are mostly for pain relief." She added that treatments "may include a
pancreas stent or, for severe cases, surgery (either a lateral pancreaticojejunostomy, or a Whipple
procedure)." Pancreatiocojejunostomies are designed to decrease pancreatic leakage while the
Whipple procedure removes the head of the pancreas where, according to the Mayo Clinic, most
tumors occur.

There may be a link between chronic pancreatitis and pancreatic cancer. According to the University
of California Los Angeles Center for Pancreatic Diseases, "Recent studies reveal a 2-5 times
increase in the incidence of pancreatic cancer in patients with chronic pancreatitis from a variety of
causes."

Acute pancreatitis

"Acute pancreatitis is inflammation of the pancreas (lasting less than three weeks), that is most often
caused by gallstones," said Knowlton. It usually comes on suddenly and disappears within a few days
of treatment. In addition to gallstones, Knowlton said that causes "may include medications, high
triglycerides, high calcium in the blood and high alcohol consumption."

Pancreas pain is the chief symptom of acute pancreatitis, according to Medscape. The pain is usually
severe and sudden. It increases in severity until it becomes a constant ache. This pancreas pain is
felt in the upper abdomen. The Mayo Clinic noted that the pain can radiate through to the back, and
Knowlton pointed out that it might be worse after eating. Other symptoms of acute pancreatitis include
nausea, vomiting, fever and diarrhea.

According to Knowlton, "This patient often looks acutely ill, and requires hospitalization (typically for
three to five days), intravenous (IV) hydration, nothing by mouth (for bowel rest), pain medication,
treatment of underlying conditions, and possibly a radiologic procedure called an endoscopic
retrograde cholangiopancreatography (ERCP), which can more specifically target the problem." If the
acute pancreatitis was caused by gallstones, doctors may recommend removing the gallbladder.

Pancreatic cancer

It is hard to diagnose pancreatic cancer early. The Mayo Clinic noted that symptoms typically don't
occur until the cancer has advanced. Knowlton said, "Unfortunately, symptoms can be vague, but can
include abdominal pain, jaundice, severe itching, weight-loss, nausea, vomiting, and digestive
problems."
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Making matters even more complicated is the pancreas' deep-in-the-abdomen location. The NIH
pointed out that as a result, tumors cannot usually be felt by touch. Because of the difficulty of early
diagnosis and the rapidity with which pancreatic cancer spreads, the prognosis is often poor.

Risk factors for pancreatic cancer include smoking, long-term diabetes and chronic pancreatitis,
according to the National Cancer Institute.

According to the American Cancer Society, pancreatic cancer usually begins in the cells that produce
pancreatic (digestive) juices or in the cells that line the ducts. In rare occasions, pancreatic cancer will
begin in the cells that produce hormones.

According to the University of Texas MD Anderson Cancer Center, to diagnose pancreatic cancer,
doctors typically conduct physical exams, blood tests, imaging tests, endoscopic ultrasounds and
tests and biopsies. Treatment options include surgery, radiation, chemotherapy and therapies
targeted to attack cancer cells without harming normal cells.

Artificial pancreas

When a person's pancreas isn't functioning properly or has to be removed, doctors may replace or
supplement it with an artificial pancreas. These devices that automatically monitor blood glucose and
provide the appropriate insulin doses are often called closed-loop systems, automated insulin delivery
systems, or autonomous systems for glycemic control, according to the Food and Drug
Administration.

In a 2014 study published in the journal The Lancet Diabetes & Endocrinology, researchers found
that an artificial pancreas offer people with type 1 diabetes a reliable way to keep glucose levels in
check, when compared to other treatments. "Our study confirms that both artificial pancreas systems
improve glucose control and reduce the risk of hypoglycemia compared to conventional pump
therapy," study author Ahmad Haidar, of Institut de Recherches Cliniques de Montreal, said in a
statement.

Referencia:

Szalay, J. (2018, April 12). Live Science. In Pancreas: Function, Location & Diseases. Consultado de
https://www.livescience.com/44662-pancreas.html
 Lección 9. Cohesión y coherencia
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Médico cirujano

Diagrama

(Puedes utilizar el sugerido o puedes incluir uno propio)

Valor: 1 punto por cada respuesta correcta.

Endocrine

Functions Exocrine

Head

Neck and
Pancreas Locations
body

Tail

Pancreatitis

Pancreatitis
Disease
cancer

Diabetes

PARTE B

Valor: 4 puntos por respuesta correcta.

TEXTO
The nervous system is a complex collection of
nerves and specialized cells known as neurons
that transmit signals between different parts of
the body. It is essentially the body's electrical
wiring.
Structurally, the nervous system has two
components: the central nervous system and the
peripheral nervous system. According to the
National Institutes of Health, the central nervous
system is made up of the brain, spinal cord and
nerves. The peripheral nervous system consists
of sensory neurons, ganglia (clusters of
neurons) and nerves that connect to one
Justificación
El texto presenta coherencia, ya que es fácil
de entender e identificar que es un texto
sobre el sistema nervioso, su clasificación y
funciones, describiendo cada una de ellas. El
texto tiene cohesión ya que utiliza las
palabras correctas para relacionar las ideas.
No hay elipsis, pero si hay referencia
anafórica y uso de la referencia catafórica.
Está bien organizado y tiene continuidad
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

another and to the central nervous system.

Functionally, the nervous system has two main

subdivisions: the somatic, or voluntary,
component; and the autonomic, or involuntary,
component. The autonomic nervous system
regulates certain body processes, such as blood
pressure and the rate of breathing, that work
without conscious effort, according to Merck
Manuals. The somatic system consists of nerves
that connect the brain and spinal cord with
muscles and sensory receptors in the skin.

Description of the nervous system

Nerves are cylindrical bundles of fibers that start
at the brain and central cord and branch out to
every other part of the body, according to the
University of Michigan Medical School.

Neurons send signals to other cells through thin

fibers called axons, which cause chemicals
known as neurotransmitters to be released at
junctions called synapses, the NIH noted. There
are over 100 trillion neural connections in the
average human brain, though the number and
location can vary. For example, a new study
published January 2018 in the journal
Proceedings of the National Academy of
Sciences found that out of the 160 participants
studied, the brains of highly creative people
have more connections among three specific
regions of the brain than less creative thinkers.

"You have these three different systems that are

all located in different parts of the brain, but they
are all co-activated at once," said lead study
author Roger Beaty, a postdoctoral fellow
studying cognitive neuroscience at Harvard
University. "People who are better able to co-
activate them [came] up with more-creative
responses."

A synapse gives a command to the cell and the

entire communication process typically takes
only a fraction of a millisecond. Signals travel
along an alpha motor neuron in the spinal cord
268 mph (431 km/h); the fastest transmission in
the human body, according to Discover
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magazine.

Sensory neurons react to physical stimuli such

as light, sound and touch and send feedback to
the central nervous system about the body's
surrounding environment, according to the
American Psychological Association. Motor
neurons, located in the central nervous system
or in peripheral ganglia, transmit signals to
activate the muscles or glands. [Here's What
You'd Look Like as Just a Nervous System]

Glial cells, derived from the Greek word for

"glue," are specialized cells that support, protect
or nourish nerve cells, according to the Oregon
Institute of Health and Science University.

The brain's connections and thinking ability grew

over thousands of years of evolution. For
example, a virus bound its genetic code to the
genome of four-limbed animals, and the code
can still be found in humans' brains today,
according to two papers published in the
January 2018 journal Cell. This code packages
up genetic information and sends it from nerve
cells to other nearby nerve cells, a very
important process in the brain.
The human brain is the command center for the El texto presenta falta de elipsis, hay
human nervous system. The human brain conceptos que se repiten (the human brain)
receives signals from the body's sensory organs por ende tampoco hay referencia anafórica,
and outputs information to the muscles and carece de estructura ya que no se encuentra
body. The human brain has the same basic bien organizado en oraciones ni párrafos y
structure as other mammal brains but is larger tampoco tiene continuidad, por lo tanto, el
and amazing in relation to body size than any texto carece de coherencia y cohesión lo que
other brains when it receives several dificulta su comprensión
commands.

Numbers about the human brain

 The human brain is the largest brain of all
vertebrates relative to body size.
 It weighs about 3.3 lbs. (1.5 kilograms).
 The average male has a brain volume of
1,274 cubic centimeters (cm3).
 The average female brain has a volume
of 1,131 cm3.
 The brain makes up about 2 percent of a
human's body weight.
 The cerebrum makes up 85 percent of
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Médico cirujano

the brain's weight.

 It contains about 86 billion nerve cells
(neurons) — the "gray matter."
 It contains billions of nerve fibers (axons
and dendrites) — the "white matter."
 These neurons are connected by trillions
of connections, or synapses.
The largest part of the human brain is the
cerebrum, which is divided into hemispheres,
according to the Mayfield Clinic. Underneath lies
the brainstem, and behind that sits the
cerebellum. The outermost layer of the
cerebrum is the cerebral cortex, which consists
of four lobes.
Like all vertebrate brains, the human brain
develops from three sections known as the
forebrain, midbrain and hindbrain. Each of these
contains fluid-filled cavities called ventricles. The
forebrain develops into the cerebrum and
underlying structures; the midbrain becomes
part of the brainstem; and the hindbrain gives
rise to regions of the brainstem and the
cerebellum.
Introduction El texto presenta párrafos con coherencia y
Around one billion adults worldwide smoke,1 cohesión, pero en otros carece de ellas, lo
with high prevalence in developing countries, cual hace un poco difícil identificar y
where 49% of men and 11% of women use relacionar la idea principal con los demás
tobacco.2 Although the prevalence of current enunciados del texto. No hay elipsis ni
smokers has decreased over time in several referencia catafórica, pero si hay referencia
countries, the global absolute number of anafórica. El texto tiene falta de continuidad,
smokers has increased owing to population sin embargo contiene varios ejemplos que
growth.3 Policies have successfully encouraged ayudan a guiarte hacia la idea principal.
people to quit, using aids such as nicotine
replacement therapy and electronic cigarettes
(e-cigarettes).

In the Health Survey for England (2013 and

2014), 26% of current smokers reported that
they wanted to cut consumption down but were
not trying to stop, and 40-41% said that they
smoked less than in the previous year.5 The
percentage of smokers who consume one to five
cigarettes per day has steadily risen (from
18.2% to 23.6% between 2009 and 20145), with
a similar pattern in the US, where the proportion
of smokers who consume less than 10
cigarettes per day increased from 16% to 27%
between 2005 and 2014.6 A recent Cochrane
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review discussed the evidence for ways of

helping smokers who wish to reduce their
consumption.

Smoking few cigarettes is generally believed to

be relatively safe, as has been incorrectly
assumed for light/low nicotine cigarettes.8
Among 24 658 US adolescents, 10% thought
that light smoking was not harmful, and only
35% of light smokers considered their habits to
be associated with “a lot of harm.”9 Reducing
consumption might be expected to reduce harm
in a proportionate way—that is, that smoking
one instead of 20 cigarettes per day has about
one twentieth (5%) of the risk. This seems to be
the case for lung cancer, for which the large
American Cancer Society Prevention Study II
showed an approximately linear relation
between risk of lung cancer and number of
cigarettes smoked per day, but the dose-
response for cardiovascular disease is steep at
low consumption and then levels off,10
consistent with the shape reported previously.

In a seminal systematic review of second-hand

smoke and coronary heart disease among never
smokers published in the BMJ 20 years ago,
Law and colleagues drew attention to the 1.30
risk ratio being relatively large compared with
the 2-3 typically seen in studies of active
smokers.12 Their conclusions on second-hand
smoke were supported by a meta-analysis of
active cigarette smoking and risk of coronary
heart disease from five cohort studies, in which
the modelled relative risk for smoking one
cigarette per day (1.39) was consistent with that
for exposure to second-hand smoke.

Although the non-linear relation between

coronary heart disease and low cigarette
consumption has been reported before
(individual studies, as well as official reports
from the US Surgeon General), it still is still not
commonly known by the general public or health
professionals, particularly those not involved in
tobacco and health. We thus aimed to extend
the previous work on coronary heart disease,12
by using a systematic review to provide a major
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body of evidence. We also aimed to show that a

similar non-linear relation exists between stroke
and low cigarette consumption.

PARTE C

Valor: 1 punto cada una.

TEXTO IDEA PRINCIPAL

Texto 1 Descripción y clasificación del sistema nervioso según su estructura y función.

Texto 2 El cerebro humano es el centro de mando del sistema nervioso, recibe señales y
envía una respuesta a dicha señal.

Texto 3 Fumar pocos cigarrillos disminuye el daño que genera en el organismo de la persona,
particularmente la relación con la enfermedad coronaria.