Lección 9.

Cohesión y coherencia
¡Domínalo!
Médico cirujano

Nombre del Villeda Cabrera Isaac Elohí.

alumno: 26/04/2023
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.
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

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.
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

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."
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

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

Diagrama

(Puedes utilizar el sugerido o puedes incluir uno propio)

Valor: 1 punto por cada respuesta correcta.


Functions
Pancreas
Locations
Disease
PARTE B
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 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
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
Insulin and
Glucagon
Energy
Blood sugar
Fatty acids
Behind the
stomach
Neck, body
and tail
Pain
Pancreatitis
Cancer
Valor: 4 puntos por respuesta correcta.
Justificación
El texto posee tanto cohesión como coherencia.
Si bien se compone de un gran número de
ideas acerca de la conformación (estructura),
importancia, clasificación y división del sistema
nervioso (que poco a poco se van desglosando)
para que el lector pueda comprender el tema
fácilmente, todas ellas están relacionadas
entre sí y desembocan en el objetivo primordial
del mismo.
Por otra parte, la cohesión se justifica debido a
que las palabras utilizadas en el mismo,
pertenecen a un campo semántico común que
coincide con el tema principal. En la gramática
del texto podemos encontrar elementos como
ellipsis o anaphoric reference. Por último, a lo
largo de su estructura se destaca la idea
principal (conformación e importancia del
sistema nervioso.), un progreso rítmico
adecuado para adentrar al lector poco a poco
al tema, así como ejemplos mencionados para
reforzar el entendimiento de los argumentos
dados.
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

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
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]
 Lección 9. Cohesión y coherencia
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Médico cirujano

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 Definitivamente el texto no presenta
human nervous system. The human brain coherencia ni cohesión.
receives signals from the body's sensory La falta de coherencia se ve evidenciada por la
organs and outputs information to the muscles falta de claridad de la idea principal, además,
and body. The human brain has the same basic al leer el contenido del mismo, no es nada fácil
structure as other mammal brains but is larger comprenderlo, sino todo lo contrario; al inicio
and amazing in relation to body size than any comienza diciendo de forma trivial la función
other brains when it receives several del cerebro, después compara dicho órgano
commands. con el de otros mamíferos, más tarde nos da
datos sobre el cerebro humano y su
Numbers about the human brain superioridad sobre el de
• The human brain is the largest brain of otras especies.
all vertebrates relative to body size. Posteriormente nos habla de la posición de
• It weighs about 3.3 lbs. (1.5 kilograms). dicho órgano, después menciona la división
• The average male has a brain volume of anatómica del mismo y termina hablando de
1,274 cubic centimeters (cm3). los ventrículos cerebrales.
• The average female brain has a volume Por otra parte, la falta de cohesión la notamos
of 1,131 cm3. por un deficiente o mal progreso del contenido
• The brain makes up about 2 percent of a del texto, falta de claridad de la idea principal
human's body weight. del mismo y el uso de palabras un tanto fuera
• The cerebrum makes up 85 percent of del campo semántico en cuestión.
the brain's weight. Oraciones como “The cerebrum makes up 85
• It contains about 86 billion nerve cells percent of the brain's weight” ó “The largest
(neurons) — the "gray matter." part of the human brain is the cerebrum” nos
• It contains billions of nerve fibers (axons hacen darnos cuenta de la falta de cohesión.
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
 Lección 9. Cohesión y coherencia
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Médico cirujano

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 Podemos darnos cuenta que el texto presenta
Around one billion adults worldwide smoke,1 una perfecta coherencia y cohesión en su
with high prevalence in developing countries, contenido.
where 49% of men and 11% of women use Es fácil de entender debido a que tiene una
tobacco.2 Although the prevalence of current buena distribución de la información. Vemos
smokers has decreased over time in several que los campos semánticos que utiliza es la
countries, the global absolute number of medicina cardiovascular, la epidemiología y el
smokers has increased owing to population tabaquismo; en dichos campos caen todas las
growth.3 Policies have successfully encouraged palabras utilizadas en el mismo. Encontramos
people to quit, using aids such as nicotine elementos como “Cataphoric reference” y
replacement therapy and electronic cigarettes “ellipsis”. Es muy clara la idea principal del
(e-cigarettes). texto: Mostrar la relación no lineal similar entre
el accidente cerebrovascular, enfermedad
In the Health Survey for England (2013 and coronaria y el consumo de cigarrillos, incluso
2014), 26% of current smokers reported that fumando pocos cigarrillos.
they wanted to cut consumption down but were El progreso que sigue es característico de un
not trying to stop, and 40-41% said that they trabajo de investigación; se presentarán
smoked less than in the previous year.5 The resultados de la investigación y una
percentage of smokers who consume one to interpretación a los mismos.
five cigarettes per day has steadily risen (from Por lo anterior, podemos concluir que se
18.2% to 23.6% between 2009 and 20145), cumple con la coherencia y cohesión.
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 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
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

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 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 del Sistema nervioso como su conformación, importancia y división
anatómica
 Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano

Texto 2 Composición del cerebro humano con superioridad en estructura y función en

comparación con otros mamíferos
Texto 3 La relación entre el accidente cerebrovascular, la enfermedad coronaria y el
consumo de cigarros

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