Mt Grammar Essentials Lecture

MT GRAMMAR ESSENTIALS LECTURE

Juliet O. Menor, MA English (MT Faculty Head/Grammar Instructor)

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TABLE OF CONTENTS

CHAPTER 1. PARTS OF SPEECH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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NOUNS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Classification of Nouns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Verbals that Function as Noun . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Forms of Compound Nouns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pluralization of Nouns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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ADJECTIVES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Kinds of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Verbals that Function as Adjective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Derivational Suffixes of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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List of Medical Terms that Function as Adjective . . . . . . . . . . . . . . . . . . . . 11 Position of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Degrees of Comparison of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Classification of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Order of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

PRONOUNS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Kinds of Pronouns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Pronoun and Antecedent Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 VERBS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Simple Tenses of Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Perfect Tenses of Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Progressive Tenses of Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Voice of Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Forms of Verbs in Active Voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Forms of “Have” Verbs in Active Voice . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Forms of “Be” Verbs in Passive Voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Forms of “Have” Verbs in Passive Voice . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Linking Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 The Emphatic Forms of Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Principal Parts Verbs . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 26 Irregular Verbs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Subject-Verb Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

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ADVERBS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kinds of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Derivational Suffixes of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Position of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conjunctive Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CONJUNCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Coordinating Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Correlative Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subordinating Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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PREPOSITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 One-word Prepositions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Two-Word Prepositions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Three-Word Prepositions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 What Prepositions Indicate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Correct Usage of Prepositions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

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CHAPTER I PARTS OF SPEECH NOUNS Nouns are the names or labels given to people, places, animals, things and ideas or concepts. Nouns usually are subjects or objects of a sentence. Sometimes, they may be modifiers. CLASSIFICATION OF NOUNS I.

A. Concrete Nouns They refer to anything that is perceptible to the senses. They have form and can be counted syringe needle B. Abstract Nouns

glass plate

They refer to ideas comprehensible through their manifestation to the senses. They are formless and cannot be counted. pain love

II.

happiness hatred

A. Common Nouns They stand for the general concept of things, persons, places, etc. They are not capitalized. medicine doctor • • •

nurse city

She was seen in the emergency room of St. Mary’s Hospital. In order for this patient to receive proper health care, he should be seen on a monthly basis. This healthcare facility is not equipped to deal with these sorts of patients.

Note:

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While some authors write health care as two words for every usage, AMT’s preference is that healthcare is written as one word when used as an adjective, two words (health care) when used as a noun. B. Proper Nouns

They refer to names of particular things, persons, places, etc. They are capitalized. Biogesic Dr. John Perez •

Ms. Anne Gonzales Valenzuela

He was admitted to St. Mary’s Hospital.

III. A. Collective Nouns They refer to organized group of persons or things taken as a unit. They represent collection of persons or things regarded as a unit. Usage determines whether the collective noun is singular or plural. It is singular and takes a singular verb when the total group it represents is emphasized. It is plural and takes a plural verb when the individuals making up the group are emphasized. committee team audience committee Family group

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The group is meeting frequently throughout its stay. The group of patients were female. (each was female)

•

A number of adhesions were present. (individual adhesions were present, not a collective adhesion) The number of adhesions was minimal. (The subject the number of always takes a singular verb.)

• • • B. Mass Nouns

bouquet of flowers school of fish board couple staff team

The couple were injured in a plane crash. (but) The couple has an appointment with the geneticist. Refer to objects with fine composition that tend to form cohesive units.

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rice coffee

III.

salt sugar

VERBALS THAT FUNCTION AS NOUN 1. Infinitive

- Verb in form (to + base form of verb), but it functions as a noun.

a. Subject

- To become a medical transcriptionist is her dream.

b. Subjective Complement

- Her dream is to become a medical transcriptionist.

c. Direct Object

- She wants to become a medical transcriptionist.

2. Gerund a. Subject

- Verb in form (verb + ing), but it functions as a noun. - Transcribing medical reports is not an easy task. NOTE: Use the possessive form for a noun or pronoun that precedes a gerund (verb ending in -ing and used as a noun). - His dieting is a problem. - The patient’s screaming disturbed other patients

b. Subjective Complement

- Her dream is transcribing medical reports.

c. Object of the Preposition

- She passed the MT course by transcribing accurately.

FORMS OFCOMPOUND NOUNS A. Closed Form notebook sunrise B. Open Form post office comfort room

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C. Hyphenated Form son-in-law editor-in-chief PLURALIZATION OF NOUNS 1. Add s girl – girls nurse – nurses 2. For words ending in s, ch, sh, & x add es ax – axeschurch – churches 3. for words ending in o , add es tomato – tomatoes potato – potatoes 4. For words ending in y preceded by consonant, change y to i and add es philosophy – philosophies trophy – tropies 5. For words ending in y preceded by a vowel, add es way – ways tray – trays 6. For words ending in f or fe, change f or fe into v and add es knife – knives life - lives

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ADJECTIVES An adjective modifies a noun or pronoun. It can be a single word, phrase, or a clause. Adjectives are also called modifiers. KINDS OF ADJECTIVES 1. Proper Adjectives It is formed from a proper noun. It starts with a capital letter. Japanese woman St. John Don Bosco church

PLDT services American institute

2. Common Adjectives It expresses the ordinary qualities of a noun or pronoun. It begins with a small letter. coronary care unit staff evaluation

routine followup emergency room

3. Descriptive Adjectives It describes a noun or pronoun. long soft

rough painful

4. Numeral Adjectives It denotes exact number. BUN was 22 11.2 ECG

32-French chest 92-year-old female

5. Possessive Adjectives (nouns) Use the possessive form for a noun involving time, measurement, or money that is used as a possessive adjective. Use ’s or s’, whichever is appropriate, with units of time or currency used as possessive adjectives. • • •

2 months’ history 3 days’ time 1 dollar’s worth

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2 cents’ worth

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The pain was of 3 months’ duration. She became ill while attending an educators conference. (not educators’ conference) 6. Possessive Adjectives (pronouns) my pen your son

his schedule her bag

7. Demonstrative Adjectives this book that car

these umbrellas those flowers

8. Indefinite Adjectives some people few mess

any patient all nurses

9. Compound Adjectives newborn baby first born child Note: Do not use the possessive form with compound adjectives. a 2-dollar bill Examples of Compound adjectives • 15-year-old boy • 2-year 5-month-old child • 51⁄2-year-old girl or 5-1/2-year-old girl • • • • • • • • •

5 x 3 x 2-cm mass The abdomen shows a 4-1/4-inch scar. 3- to 4-cm lesion 1-month course .38-caliber pistol two-thirds full one-half normal saline half-normal saline Stool is heme-negative.

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• She was panic-stricken • mucus-coated throat • 20-pack-year history • self-medicated • shell-like 10. Articles  Articles are modifiers that are used to indicate the definiteness indefiniteness of the noun that follows. a. Definite Article (the) the chair

or

: a specific, or definite, chair

b. Indefinite Articles (a, an) a chair : may be any chair  The use of articles with abbreviations varies. Sometimes the article is required. Sometimes it is optional. Sometimes it should be omitted. Required Optional (or)

: We will do a CBC. : She was admitted to the ICU. She was admitted to ICU.

Omission required : CPR was done... (not) : The CPR was done... A  Articles are frequently dropped in dictation. They may be transcribed or not (whether dictated or not) provided their presence or absence does not substantially change the meaning or style of the originator.  When dropped in transcription, it is usually because they were not dictated, they were not heard by the transcriptionist, or they were not dictated elsewhere in the report and the transcriptionist is attempting to achieve some consistency within the document. Articles are more apt to be included in correspondence than in reports. VERBALS THAT FUNCTION AS ADJECTIVE 1. Present participle (verb + ing) • •

The patient had recurring infection. The swinging couples burned time and money the whole night.

2. Past participle (verb + d/ed – regular)

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Our finished products in ceramics compare favorably with those of other countries. Defeated and frustrated, the patient committed suicide. The sunken treasure has been the object of an endless search.

DERIVATIONAL SUFFIXES OF ADJECTIVES Most adjectives are derived from the following suffixes 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Noun + y Noun + ful Noun + less ;Noun + en Noun + ive Noun + ous Noun + ish Noun + al Noun + ary N oun+ some Noun + ly Noun + ic Noun or V + able/ible

- muddy, stony, dreamy, sleepy - faithful, beautiful, harmful, painful - faithless, timeless, flawless, guideless - rotten, golden, wooden - permissive, constructive, excessive, decisive - vigorous, nervous, horrendous, marvelous - mannish, selfish, Danish - symmetrical, bilateral, neurological, mental, facial - elementary, secondary, tertiary, - lonesome, tiresome, handsome, bothersome - queenly, priestly, princely - historic, dramatic, tragic - payable, desirable, likeable, permissible

LIST OF MEDICAL TERMS THAT FUNCTION AS ADJECTIVES POSTURE-BASED TERMS anterior posterior superior inferior

MEANING nearer the front nearer the rear nearer the top nearer the bottom

REGION BASED TERMS cranial, cephalic caudal dorsal ventral

MEANING nearer the head nearer the tail or lower end nearer the back nearer the belly side or anterior surface

Note:  Adjective may modify either a plural or a singular noun, depending upon the meaning. •

bilateral decision

- A decision made by people on both [usually opposing] sides of an issue acting together.

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bilateral pneumonia present

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bilateral mastectomies removed,

- There is only one condition, although in both lungs at the same time. - There are two breasts and both are so it’s plural.

•

bilateral tympanostomies and Teflon tube insertions

POSITION OF ADJECTIVES 1. Before a noun • She had a transient episode of numbness. • She has recurrent TIAs 3 times a day 2. After a linking verb • She is not dysphasic. • Her speech is normal and clear. 3. After an intensifier • The patient is very silent. • He is often late. 4. After an object (it functions as objective complement) • We consider that doctor upright. • We find the examination difficult. CLASSIFICATIONS OF ADJECTIVES 1. Single-word modifiers They are one-word modifier or adjective. long report my pen that car few mess newborn baby

rough edge his schedule those flowers all nurses

2. Phrase modifiers They are often introduced by a preposition and are called prepositional phrase. • •

She is an 80-year-old female with a history of GI bleed. He complains of a sore on the bottom of his right foot.

3. Clause modifiers They are introduced by a relative pronoun and are called subordinate clause.

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Achromatin is found in a cell nucleus which lacks staining properties. Dr. Johnson is one of the surgeons who studied at Harvard University

ORDER OF ADJECTIVES A -- article N -- number S -- size, shape Q -- quality C -- color N -- noun NOTE: 1) same  Do not transcribe “same” when dictated for the discharge diagnosis (meaning same as admission diagnosis) or for the postoperative diagnosis (meaning same as preoperative diagnosis). Repeat the diagnosis in full. Dictated

: Admission diagnosis: Cholelithiasis. Discharge diagnosis: Same.

Transcribed : ADMISSION DIAGNOSIS: Cholelithiasis. DISCHARGE DIAGNOSIS: Cholelithiasis. Dictated

: Preoperative diagnosis: uterine fibroid. Postoperative diagnosis: same.

Transcribed : PREOPERATIVE DIAGNOSIS: Uterine fibroid. POSTOPERATIVE DIAGNOSIS: Uterine fibroid. 2) more than  When over means more than, replace it with more than. Dictated precise

: She reports over 5 operations but is unclear about the

number. Transcribed : She reports more than 5 operations but is unclear about the precise number.  When over may mean more than or for a period of and you can determine the intended meaning, replace over with the more precise term. Dictated : The rash persisted over 2 weeks. Transcribed : The rash persisted for over 2 weeks. (or) The rash persisted over a 2-week period. DEGREES OF COMPARISON OF ADJECTIVES POSITVE

COMPARATIVE 13

SUPERLATIVE

Good Bad Little Old Near Far Late Many

Better Worse less/lesser Older Nearer Farther Later More

best worst least oldest nearest farthest latest most

PRONOUNS Pronouns are used as noun substitute. KINDS OF PRONOUNS 1. Personal pronouns – They function as a subject or object PERSON SINGULAR 1st person 2nd person 3rd person PLURAL 1st person 2nd person 3rd person • • •

Subject Object Subj. & Obj.

PERSONAL PRONOUNS (SUBJECT)

PERSONAL PRONOUNS (OBJECT)

I you he, she, it

me you him, her, it

we you they

us you Them

- He will return in 3 weeks for followup - The doctor will give you intravenous aminophylline - He rarely recognizes us.

2. Possessive pronouns – They denote ownership. PERSON SINGULAR 1st person 2nd person 3rd person PLURAL

POSSESSIVE PRONOUNS my your his, her, its

mine yours his, hers, its

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1st person 2nd person 3rd person • • •

our your their

ours yours theirs

His x-ray was not in the jacket. Her postoperative pain has been minimal. He was initially treated with oxygen, requiring four liters to keep his saturations above 90%.

3. Reflexive/Intensive pronouns – Reflexive pronouns are pronouns combined with -self or -selves. They refer to and emphasize the subject of the verb or they refer back to the noun or pronoun they follow or stress the importance of nouns or pronouns. • • •

She herself made the reports on 5 operations. The patient came into the emergency room herself, and she was treated for tachycardia that had resisted conversion in her physician’s office. She insisted on feeding herself.

Note: Avoid other uses of reflexive pronouns. Dictated Transcribed

: The patient will be seen by Dr. Smith in 1 week and by myself in 2 weeks. : The patient will be seen by Dr. Smith in 1 week and by me in 2 weeks.

PERSON SINGULAR 1st person 2nd person 3rd person PLURAL 1st person 2nd person 3rd person 3. Interrogative pronouns •

REFLEXIVE/ INTENSIVE PRONOUNS myself yourself herself, himself, itself, oneself ourselves yourselves themselves – They are used to ask questions.

Who was the patient who said that she was weak and lazy? 15

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Who made the incision over the symphysis pubis? What did he say about the food? INTERROGATIVE PRONOUNS Who Whom Whose What Which

4. Relative pronouns – They refer to the noun or pronoun they follow. They introduce subordinate clauses. RELATIVE PRONOUNS that whosoever who whoever whom whomever what whatever which whichever • • •

Who was the patient who said that she was weak and lazy? The patient is a 67-year-old white female who injured her back after strenuous exercise. The patient was told to return in one week, during which time she improved.

NOTE: - Relative pronouns may function as conjunctions when they join two or more clauses. RELATIVE PRONOUNS that what whom which who • •

AP, lateral, and oblique x-rays of the right hand reveal what appears to be a residual of a well-healed fracture with a large ball of mature callus. Acetabulum refers to the cavity in the hip bone which receives the head of the femur or thigh bone.

 Use who or whom to introduce an essential clause referring to a human being or to an animal with a name. Do not use commas to set off essential subordinate clauses.

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Dr. Johnson is one of the surgeons who studied at Harvard University.

 Use that to introduce an essential clause referring to an inanimate object or to an animal without a name. Exception: When that as a conjunction is used elsewhere in the same sentence, use which, not that, to introduce an essential clause. • The nurse did a localized collection of purulent matter in any part of the body that may cause pain or swelling. • The patient came into the emergency room, and she was treated for tachycardia that had resisted conversion in her physician’s office. • He had 2 large wounds that were bleeding profusely and several small bleeders. • She said that the dog which bit her was a miniature poodle. • Achromatin is found in a cell nucleus which lacks staining properties • P  Use which to introduce a nonessential clause referring to an inanimate object or to an animal without a name. Precede and follow a nonessential clause with a comma or closing punctuation. • The surgery, which had been postponed 3 times, was finally performed today. • The patient’s parents, who had been summoned from Europe, were consulted about her past history. 5. Demonstrative pronouns – used to point out persons, places or objects this that these those • • •

These symptoms worsened progressively over the next several days. I instructed those patients to return tomorrow. That is the surgeon who operated my mother.

6. Indefinite pronouns – refer to no one in particular

All any anybody anyone anything Both Each each one

INDEFINITE PRONOUNS each other nobody either none everybody no one everyone one everything others few some many somebody neither someone

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• • • •

The CBC revealed a hemoglobin of 8 and a hematocrit of 24, both of which are below normal. Every physician and nurse has an ethical responsibility to keep patient information confidential. All of the patient’s lunch was eaten. Each patient was complaining of...

Note:  Replace both with either if the meaning is one or the other  Replace either with both if that is the meaning intended. Dictated : There were wounds on either leg. Transcribed : There were wounds on both legs. PRONOUN AND ANTECEDENT AGREEEMENT Antecedent is the noun to which the pronoun refers.

RULES: Rule 1: A personal pronoun must agree with its antecedent (noun or pronoun to which it refers) in number, person and gender. • •

The girl in the blue maxi-dress is my friend. She goes to an exclusive school. Her every wish is granted by her parents.

•

The patient was sent to the postpartum floor. She improved steadily.

PERSON & NUMBER  Person expresses the entity (first, second, or third) that is acting or being.  Number expresses whether the person is singular or plural.  Gender expresses whether the person is feminine or masculine. first person second person third person

singular singular singular

I you (one only) he, she, it

first person second person third person

plural plural plural

we you (more than one) they

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NOTE: Pronoun without antecedents Text with a pronoun that does not have a preceding noun or pronoun should be edited to identify the pronoun’s antecedent. Dictated

: She is a 40-year-old white female complaining of nausea and vomiting. (first sentence of report)

Transcribed Rule 2: • •

: The patient is a 40-year-old white female complaining of nausea and vomiting. The relative pronouns, who, which, whom, what, and that always have antecedents to which they agree in person, gender, and number. This is the girl who lent me her notes. He is one of those patients who demand constant reassurance. (The subject of demand is who, referring to patients, not he.)

Rule 3: The masculine pronoun is used when the antecedent is the indefinite pronoun one. •

One should do his level best.

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VERBS Verbs are words that express action or a state of being. Verbs have tense, person and number, tense, and mood

TENSES OF VERB  Use verb tense to communicate the appropriate time of the action or being: past, present, future, past perfect, present perfect, and future perfect. SIMPLE TENSES OF VERBS 1. Simple Present Tense - It is used to express current situation or action taking place at the present, habitual or customary action, permanent condition, permanent location, general truths or universal facts, or timelessness. • • •

I work as a medical transcriptionist. You work as a medical transcriptionist. He/She works as a medical transcriptionist.

• • •

We work as a medical transcriptionist. You work as a medical transcriptionist. They work as a medical transcriptionist.

a) Universal Present Uses the present tense to state something that is universally true or that was believed to be true at the time. The universal present is not the same as the historic present. •

Traditional treatment modalities were used because they are so effective.

b) Historic Present

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Uses the present tense to relate past events in a more immediate manner. In dictation, it is common to use the historic present tense to describe patient information or treatment in the present rather than in the past. If this is done, be consistent. The historic present is not the same as the universal present. • •

The patient says she has pain over the right abdomen. Upon examination, there is rebound tenderness.

2. Simple Past Tense - It is used to express an action or situation in the past and habitual or repeated action in the past • • •

I worked as a medical transcriptionist. You worked as a medical transcriptionist. He/She worked as a medical transcriptionist.

• • •

We worked as a medical transcriptionist. You worked as a medical transcriptionist. They worked as a medical transcriptionist.

3. Simple Future Tense - It is used to express an action at a future time. The verb form is a combination of either will or shall and the simple present tense of the verb. • • •

I will work as a medical transcriptionist. You will work as a medical transcriptionist. He/She will work as a medical transcriptionist.

• • •

We will work as a medical transcriptionist. You will work as a medical transcriptionist. They will work as a medical transcriptionist.

NOTE: 1. Maintain uniformity of tense, but keep in mind that tense may vary within a single report or even a single paragraph, depending on the time being referenced. •

Dictated quadrant.

: The abdomen is soft. There was a scar in the lower right

Transcribed : The abdomen is soft. There is a scar in the lower right quadrant. V 2. Tenses may appropriately vary within a single paragraph and certainly within a report.

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She was admitted from the emergency room at 8:30 p.m. She is afebrile at present. She will be given IV antibiotics, nevertheless.

NOTE: shall, will The usage distinctions between shall and will are lessening except in legal documents. Transcribe as dictated. should, would Should expresses obligation. • He should discontinue smoking. Would expresses usual action • He would light up a cigarette automatically after meals. Use would in conditional past tense. • If he had not smoked for so many years, it would not be so difficult for him to quit. PERFECT TENSES OF VERBS 1. Present Perfect Tense (has/have + past participle) - It expresses an action that started in the past and continues up to the present. - It also expresses an action started in and ended in the past. - The expressions used in the present perfect are the following: since, for, already, yet, ever, and never. • •

Many doctors have worked in this hospital for almost a decade now. I have worked for almost a decade now.

2. Past Perfect Tense (had + past participle) - It expresses an action or state of being completed in the past before some other past actions or state of being. - The earlier of the two past actions is expressed in perfect tense while the latter past action is expressed in the simple past tense. • •

The doctor had started the operation when the call came. I had worked only on weekends until this past month.

3. Future perfect Tense (will have/shall have + past participle) - It expresses an action or state of being to be completed in the future before some other future actions or state of being • •

Carmen shall have conducted seminars before the year ends. I will have worked for one year by the end of this month.

PROGRESSIVE TENSES OF VERBS

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1. Present Progressive Tense (is/are + present participle) - It shows continuous action. •

She is transcribing medical reports.

2. Past Progressive Tense (was/were + present participle) - It shows an action happening at the time of speaking. •

She was transcribing medical reports the other day.

3. Future Progressive Tense (will be/shall be + present participle) - It shows a future action in progress at a certain period of time in the future. Example: • She will be transcribing medical reports next week. THE PROGRESSIVE FORMS OF THE SIX TENSES Present Progressive

I am working right now.

Past Progressive

I was working when you called.

Future Progressive Present Perfect Progressive Past Perfect Progressive

I will/shall be working this weekend.

Future Perfect Progressive

I have been working harder than usual lately. I had been working nights until the new schedule was announced. I will/shall have been working on this project a month before it is done.

VOICE OF VERBS - The voice of the verb is determined by the function of the subject, whether it is the doer or the receiver of the action 1. Active Voice - The subject is the doer of the action • The doctor gave the stubborn patient an ultimatum. • The nurse brought the medicines of the patients on time. FORMS OF VERBS IN ACTIVE VOICE (SIMPLE PAST TENSE) DOER OF MAIN VERBS RECEIVER OF THE ACTION (Past Tense) THE ACTION SINGULAR The director gave me The president appreciated you

23

PHRASE MODIFIER an instruction very much

The principal PLURAL The doctors Your parents The judges

assigned

him

at the new branch

diagnosed us with a gadget transferred you to other school tallied them immediately FORMS OF “HAVE” VERBS IN ACTIVE VOICE (PRESENT/PAST PERFECT TENSE) AUXILIARY MAIN RECEIVER PHRASE VERB VERB OF THE MODIFIERS (Present / Past ) (Past Participle) ACTION

DOER OF THE ACTION SINGULAR The nurse The doctor The director

has has has

/ / /

had had had

given appreciated assigned

me you you

an instruction very much at the new branch

PLURAL The doctors Your parents The technician

have have have

/ / /

had had had

diagnosed transferred tallied

us you them

with a gadget to other school immediately

2. Passive Voice – The subject is the receiver of the action • •

The stubborn patient was given an ultimatum by the doctor. The medicines of the patients were brought by the nurse on time.

RECEIVER OF THE ACTION SINGULAR I You He/She PLURAL We You They

FORMS OF “BE” VERBS IN PASSIVE VOICE (PRESENT/PAST TENSE) AUXILIARY MAIN VERB PHRASE VERBS (Past MODIFIER (Be) Participle)

DOER OF THE ACTION

am / was given are / were appreciated Is / was assigned

an instruction by the nurse very much by the doctor at the new branch by the director

are / were diagnosed are / were transferred are / were tallied

with a gadget to other school immediately

by the doctor by your mother by the technician

FORMS OF “HAVE” VERBS IN PASSIVE VOICE VERBS (PRESENT/PAST PERFECT TENSE) RECEIVER AUXILIARY AUXILIARY MAIN VERB PHRASE DOER OF THE OF THE VERB VERB (Past MODIFIER ACTION ACTION (Present / Past) (Be) Participle) 24

SINGULAR I have / had You have / had He/She has / had

been been been

given an instruction by the nurse appreciated very much by the doctor assigned at the new by the director branch

PLURAL We You They

been been been

diagnosed with a gadget by the doctor transferred to other school by your mother tallied immediately by the judges

have / had have / had have / had

NOTE:  Most communication guidelines urge the use of the active voice except when it is more important to emphasize what was acted on and that it was acted on.  In medical transcription, the active voice is more common in reporting observations, e.g., in history and physical exam reports.  The passive voice is more common in describing healthcare providers’ actions, e.g., hospital treatment and surgery. • • •

The abdomen is soft, nontender. The patient was given intravenous aminophylline. The incision was made over the symphysis pubis.

 Do not recast most dictation to change the voice except for those sentences that are especially awkward. • •

Dictated : The medication by him is taken irregularly. Transcribed : He takes the medication irregularly. LINKING VERBS

 Verbs that link the subject of a sentence to an adjective or other complement.  Most common examples are various forms of the verb to be. am is are was were

am is are was were

being being being being being

FORMS OF “BE” VERBS has been can have been could had been may might will would 25

be be be be be be

could may might

have have have

been been been

would

have

been

shall should

be be

shall have been should have been must have been

 Others include the following words: act appear feel look remain become

get grow seems smell sound taste

 Such verbs are followed by adjectives, not adverbs, because the subject, not the verb, is being described. • He says the food tastes bad. (NOT) He says the food tastes badly. EMPHATIC FORMS OF VERBS THE EMPHATIC FORMS OF THE PRESENT TENSE AND PAST TENSE Present emphatic I do work harder than you Past emphatic I did work last night • •

She did transcribe 30 medical reports in one day. Did she transcribe 30 medical reports in one day?

• •

She did go at the hospital for her check up. Did she go at the hospital for her check up? PRINCIPAL PARTS OF THE VERBS

THE TWO PRINCIPAL PARTS OF THE PRESENT TENSE TENSES REGULAR VERBS IRREGULAR VERBS Present work draw Present Participle working drawing

Past

THE TWO PRINCIPAL PARTS OF THE PAST TENSE TENSES REGULAR VERBS IRREGULAR VERBS worked drew 26

Past Participle

worked

drawn

IRREGULAR VERBS

PRESENT cost cut hit hurt let put set spread PRESENT bind ring find get hold keep lay say send

IRREGULAR VERBS WITH THE SAME PRESENT, PAST, AND PAST PARTICIPLE PRESENT PARTICIPLE PAST PAST PARTICIPLE Costing cost cost Cutting cut cut Hitting hit hit Hurting hurt hurt Letting let let Putting put put Setting set set Spreading spread spread IRREGULAR VERBS WITH THE SAME PAST AND PAST PARTICIPLE PRESENT PARTICIPLE PAST PAST PARTICIPLE Binding bound bound Bringing brought brought Finding found found Getting got got or gotten Holding held held Keeping kept kept Laying laid lain Saying said said Sending sent sent

IRREGULAR VERBS THAT DO NOT HAVE THE SAME PRESENT, PAST, AND PAST PARTICIPLE PRESENT PRESENT PARTICIPLE PAST PAST PARTICIPLE begin Beginning began begun bite Biting bit bitten break Breaking broke broken do Doing did done draw Drawing drew drawn give Giving gave given go Going went gone know Knowing knew known see Seeing saw seen S

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NOTE: Avoid using “type” in medical transcription. Use “transcribe” instead. Dictated : The MT typed the report. Transcribed : The MT transcribed the report. SPLIT VERBS A split verb is one in which a word (usually an adverb) has been inserted between its two parts. Splitting infinitives or other forms of verbs used to be considered a grave grammatical faux pas. Traditionalists still hold to this view, but pragmatists recognize that such splits are appropriate if they enhance meaning (or at least do not obstruct it). Transcribe split verbs as dictated provided they do not obstruct the meaning. • •

The test was intended to definitively determine... He will routinely return for followup.

MISPLACED VERBS In comparisons such as the following, the second verb is understood. The larger incision healed faster than the smaller one. If the second verb is dictated or added, be sure to place it at the end. • The larger incision healed faster than the smaller one did. (NOT) The larger incision healed faster than did the smaller one MOOD OF VERBS 1. The indicative mood - makes factual statements and is most common. • •

The patient returned on schedule for a followup visit. V He is a singer.

2. The imperative mood - makes requests or demands. • •

Come here now. Clean up your room.

3. The subjunctive mood - expresses doubt, wishes, regrets, or conditions contrary to fact. It is the most difficult and most formal mood and usually relates to the past or present, not the future. • •

If she were my patient, I would proceed with surgery. I wish I were a queen.

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SUBJECT-VERB AGREEMENT

1. The verb agrees with the subject and not the complement. • • • • •

This piano has good strings. The lungs have some expiratory ronchi. Mike does a good job in transcribing. Mary and John do a lot better than the rest of the class. Cathy is the official transcriptionist of the institute.

2. The indefinite words: each, every, everyone, someone, no one, and nobody take singular verbs. • • • • •

Each has a laboratory gown. No one is unhealthy. Everybody is going to see the doctor. Each of the tests was repeated. No one expects him to recover full use of the arm.

4. When either and neither are used as subjects, they always take singular verbs. • •

Neither of them is available to speak right now. Either of us is capable of doing the operation.

5. The words some, a few, several, many take the plural verbs. 29

• •

A few medical transcriptionists are qualified for US. Several students are interested in Grammar and Style Essentials.

7. When a relative pronoun, who, which, that is a subject, its verb has the same person and number as the antecedent Antecedent

Relative Pronoun We who He has one candidate who

Verb of Relative Pronoun are about to graduate. was able to graduate.

8. When used to introduce a sentence, it is followed by a singular verb •

It is the doctor who should give lessons in Anatomy

3. The word none may be singular (not one, no one, no single one) or plural (no two, no amount, not any), taking singular or plural verbs and pronouns as appropriate. Use context to determine if singular or plural form is intended. If either could be used,assume it is singular and use singular verbs and pronouns. • •

We tried to identify the bleeding site; none was found. (not one site was found) We found 4 bleeding sites; none were cauterized. (no sites were cauterized)

N  In the phrase none of, the object of the preposition of determines whether construction is singular or plural. • •

None of the findings are conclusive. None of it makes sense.

6. The words all and some, are singular or plural according to the meaning of the sentence. When these words refer to a quantity or a mass taken as a whole, it is generally considered as singular. When it refers to a number, it is regarded as plural in number. • All of the gasoline has been sold. (mass or quantity) • All of the nurses are wearing uniforms. (more than one) • Some are going by plane. (more than one) • Some of the ice cream is left. (mass or quantity) 9. Words which come between subject and predicate do not affect the verb. • •

The mother with all her children is here. The doctor, along with the nurses, is expected in a short while. 30

•

Excitement as well as nervousness was the cause of her nervous breakdown.

10. The phrase average of takes a plural if preceded by an, singular if preceded by the. • An average of 10 tests were done on each patient. • The average of the results was 48.3%. 11. The phrase percent of takes a singular verb when the word following of is singular, a plural verb when the word following of is plural. • •

Ninety percent of the body was burned. Forty percent of the patients were in the control group.

 Percent takes a singular verb when it stands alone (not followed by of ). •

Fifty percent is adequate.

12. Compound subject connected by “and” takes a plural verb unless the subjects mean the same thing or as closely related in meaning. • • •

The doctor and the nurse are here. Oatmeal and milk is a wholesome food. My cousin and classmate is here.

13. Compound subject connected by either-or; neither-nor, and-or take a singular verb if the second member of the compound subject is singular. It takes a plural verb if the second member of the compound subject is plural. • • •

Either my father or my mother is going to undergo diagnosis. Either the boy or the girls are doing the work. Either my brothers or my sister is going to enroll in MT course.

14. The expression “there is” is followed by a singular noun; the expression “there are” is followed by a plural noun. • •

There is no one here. There are several doctors here.

15. Collective nouns, such as class, jury, team, crow, etc., take a singular or plural verb depending on whether the group is thought of as a whole or individuals. • •

The class in Medical Transcription is very quiet. The class do not agree on the answer. (They have different opinions)

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16. Some nouns retain the same form, whether singular or plural. ascites lues clothes riches goods scissors eyeglasses trousers news economics measles civics mumps acoustics biceps forceps • •

The ascites was tapped for the third time. The patient’s lues has progressed over many year’s time.

• •

A scissors was used to cut... Several different-sized scissors were used.

• •

The left biceps was weaker than the right. The left and right biceps were equally strong.

• •

An Allis forceps was used to grasp... Both forceps were required to grasp...

• •

A series of tests was conducted. Several series of tests were conducted.

17. Some nouns are singular in form but they take plural verbs. Adnexa • • •

The adnexa are normal. The right ocular adnexa are within normal limits. The left uterine adnexa were entirely involved with tumor.

18. Difficult singular and plural words and phrases Singular ala nasi diverticulum genitalis naris medium labium majus minus

Verb is is is is is is is is

Plural alae nasi diverticula genitalia nares media labia majora minora 32

Verb are are are are are are are are

lentigo focus fossa decubitus ulcer

is is is is

lentigines foci fossae decubitus ulcers

are are are are

19. Expressions indicating an amount of money, a space of time, or a unit of measurement take a singular verb even when the form is plural. • • •

Five pesos is not much. Three months’ pay was what he received. Two yards of material is not enough for a dress.

20. Monetary expressions take a singular verb when they are thought of as a sum, a plural verb when they are thought of as individual bills and coins. • •

A million dollars is a lot of money. The 50 quarters were stacked on the dresser.

21. Units of measure are collective singular nouns and take singular verbs • After the lab report came back, 20 mEq of KCl was added. 22. The expression “a number” takes a plural verb. The expression “the number” takes a singular verb. • •

A number of students are absent. The number of students present is small.

• •

The number of adhesions was minimal. A number of adhesions were present.

23. Use number to refer to persons or things that can be counted. Number tells how many; amount tells how much (mass). •

There was a small amount of bleeding, given the large number of wounds.

• •

A large number of people were present. (NOT) A large amount of people were present.

24. In arithmetical expressions, the following usage is accepted. • • • •

Six plus six is twelve. Five minus two is three. Five times two is ten. Three divided by three is one.

33

• One-fourth of twelve is three • Six and six are twelve. • 25. When the subject of a sentence is a title, a clause, a quotation or a group of words, the verb is singular. •

“To die is to rest” is a sentence of doubtful value.

ADVERBS Adverb modifies or describes a verb, an adjective or another adverb. It may be a single word, a phrase or a clause.

KINDS OF ADVERBS 1. Manner (How?) She dances gracefully. 2. Place (Where?) Come here. 3. Time (When?) He arrived this morning. DRUG-RELATED LATIN ABBREVIATIONS ABBREVIATION a.c. a.m. h.s. p.c. p.m. p.r.n.

ENGLISH TRANSLATION before meals morning bedtime after meals afternoon as circumstances may require 34

4. Degree (To what extent or How much?) He entered the room very conspicuously. 5. Frequency (How often?) She sees him often. DRUG-RELATED LATIN ABBREVIATIONS ABBREVIATION ENGLISH TRANSLATION b.i.d. twice a day p.r.n. as needed q.d. every day q.a.m. every morning q.h. every hour q.4 h. every 4 hours q.i.d. 4 times a day q.l. as much as desired q.p. as much as desired t.i.d. 3 times a day u.d. as directed 6. Duration (How long?) She was awake from night till morning. 7. Purpose (Why?) They came to confer with me. 8. Affirmation (Yes) /Negation (No) Yes, they are here. No, they are not correct. DERIVATIONAL SUFFIXES OF ADVERBS NOUN Length Clock ADJECTIVE Sensible Mere NOUN Home ADVERB Back

-WISE -wise -wise -LY -ly -ly -WARD - ward -WARD -ward

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ADVERB lengthwise clockwise ADVERB sensibly merely ADVERB homeward ADVERB backward

POSITION OF ADVERBS 1. Before an adjective Examples: • It is an exceedingly long story. • Jeff is an exceptionally bright student. • The cup is too big. 2. Between the linking verb and the adjective or after be-verbs Examples: • It is really hard. • It is usually good. 3. Before a verb Examples: • He often sings ballads. • Tom always fetches his children. 4. After an action verb Examples: • She left hurriedly. • The gift was wrapped attractively

5. After an object Examples: • They gathered the firewood quickly. • She wrapped the gift attractively 6. Between auxiliary verb and main verb Examples: • They had quickly picked the broken pieces of glass. • They have carefully done the operation. 7. At the beginning of a sentence Examples: • Quickly, they performed the steps. • Practically, his suggestion makes sense. CONJUNCTIVE ADVERBS (TRANSITIONAL WORDS)  They are called transitional words because they are not pure conjunctions. Some of these words have a slight connecting force. Others have some adverbial force. 36

 They are used to connect two independent clauses. Connectives that belong to this group are always preceded by a semicolon and followed by a comma.  When they are used to introduce a sentence, they are still followed by a comma. accordingly afterwards again anyhow besides consequently doubtless eventually evidently finally furthermore hence however indeed instead

likewise meanwhile moreover namely nevertheless next otherwise perhaps possibly similarly still subsequently then therefore thus

as a result at last at the same time for example for instance for this reason in addition in any case in fact in like manner in short on the contrary on the other hand that is yet

NOTE: (1) however  as an adverb However may be used to modify one or more adjectives. •

However resistant she may be, I will continue to advise her to quit smoking.

 as a conjunctive adverb Place a semicolon before and a comma after however when it is used to connect two complete, closely related thoughts in a single sentence. •

He is improved; however, he cannot be released.

H  Place a comma after however when it serves as a bridge between two sentences. •

The patient was released from care. However, his wife called to say his condition had worsened again.

37

 as an interruptive When however occurs in the second sentence and is not the first word, it is called an interruptive and requires a comma before and after it. There is disagreement among grammarians as to the best placement of this type of however. In medical transcription, place it as dictated provided such placement does not interfere with communication. Dictated & Transcribed: He is improved. He cannot, however, be released. Dictated & Transcribed: He is improved. He cannot be released, however. (2) since As an adverb, it means at some time between a point in the past and now. •

He moved away three years ago, but she has seen since.

CONJUNCTIONS Words that join words, phrases, or clauses, thereby indicating their relationship.

COORDINATING CONJUNCTIONS and but for or

nor so yet

. 1. Her heart has regular rate and rhythm. 2. LV-gram showed a large area of anterior apical dyskinesis and septal akinesis. 3. The wound was copiously irrigated and packed.

38

4. Abdomen is soft and nontender without palpable mass or hepatos splenomegaly. 5. The patient denied PND or pedal edema. 6. The breasts reveal no dominant mass, discrete calcification, or skin thickening. 7. He was anticoagulated with heparin, and a VQ scan was obtained. 8. The patient improved steadily throughout the hospital course, and on the sixth post operative day he was ready for discharge. 9. The exam reveals no tibiofibular pain, but the ankle itself is quite tender. 10. The lungs are clear without infiltrates, but the heart is slightly enlarged. 11. He was seen in the emergency room, but he was not admitted. 12. He was in great pain, yet he refused treatment. NOTE:  Do not use a comma before a coordinating conjunction that is followed by a second verb without a new subject. • •

The patient tolerated the procedure well and left the department in stable condition. The gallbladder was inflamed but without stones

NOTE: (1) So  When so means so that, introducing a clause describing purpose or outcome, it should not be preceded by a comma. It is acceptable but not required in such instances to change so to so that. Dictated: Transcribed: Or

He wanted to improve so he could attend his daughter’s wedding. He wanted to improve so he could attend his daughter’s wedding. He wanted to improve so that he could attend his daughter’s wedding.

 When so indicates therefore, precede so by a comma if it introduces a new independent clause. S  It is acceptable but not required in such instances to change so to and so. Dictated

: His condition was improved so he could attend his daughter’s wedding. 39

Transcribed Or

: His condition was improved, so he could attend his daughter’s wedding. His condition was improved, and so he could attend his daughter’s wedding.

CORRELATIVE CONJUNCTIONS either…or both…and whether…or neither…nor not only…but also NOTE:  Don’t use a comma before correlative conjunctions when they join independent clauses.  Match the number of the verb with the number of the nearest subject. 1. Neither the sister nor the brothers exhibit similar symptoms. 2. Neither the brothers nor the sister exhibits similar symptoms. 3. Either Dr. Hanz or Dr Kylle stayed out late after the meeting. 4. Neither the doctors nor the nurses were prepared for the operation. 5. I like not only rock music but also classical music. 6. Whether her physician is around or not, she has to report at the hospital. 7. Bob ordered both bacon and eggs. SUBORDINATING CONJUNCTIONS after although as because before

that how if in order that in as much

provided since than though through

unless until while when where

1. She had recurrent emesis since she returned home 2. She was taken to the emergency room where she received IV Morphine. 3. He was taken off Coumadin because he developed internal bleeding. 40

4. Even though he was frightened, he did it. 5. It was difficult for him. He did it though. 6. While the operation is going on, you may take a short nap. 7. He took the medication as he was instructed. (not like he was instructed) NOTE: (1) that  May be omitted after a verb such as said, stated, announced, argued, provided its absence will not confuse the reader about the intended meaning. or but not

The patient said she was weak and dizzy. The patient said that she was weak and dizzy. The patient said today that she would exercise. The patient said today she would exercise. (Without that, the reader cannot determine if the patient said it today or she is going to exercise today.)

 Use that to introduce an essential clause referring to an inanimate object or to an animal without a name. • •

The patient came into the emergency room, and she was treated for tachycardia that had resisted conversion in her physician’s office. She had 2 large wounds that were bleeding profusely and several small bleeders.

HINT:  To decide between that and which, remember that that is usually not preceded by a comma and which usually is.  When that as a conjunction is used elsewhere in the same sentence, use which, not that, to introduce the essential clause. •

It was determined that the dog which bit the child was rabid.

(2) Although, and though are considered interchangeable. However, when though is used as an adverb it cannot be replaced by although.  When although clause precedes the main clause, it is usually followed by a comma. Example: • Although he was frightened, the child cooperated with the exam.  When it follows the main clause, the comma may be omitted if it does not confuse the reader.

41

Examples: • The child cooperated fully with the exam although he was frightened.(or) • The child cooperated fully with the exam, although he was frightened. (3) because Means for the reason that. Denotes a specific cause-effect relationship. • He has been in pain because his arm was broken. B • She was late because her watch stopped. NOT She was late due to her watch stopping. (4) since  When it introduces a clause not set off by a comma, since means after the time that, indicating that an event follows another but was not caused by it. •

He has been in pain since he returned from vacation.

 Since means because when it introduces a clause set off by a comma. • •

He has omitted his rofecoxib for the past 3 weeks, since it was upsetting his stomach. B

PREPOSITIONS A preposition is a word or group of words that are used to connect nouns or

ONE-WORD PREPOSITIONS 42

abov e abou t acros s after again st along amid a mon g arou nd at

before behin d below benea th besid e betwe en but beyon d by down

durin g exce pt for from in insid e into like near of

43

off on onto out outside over past since through through out

to toward under underne ath until up upon with within without

1.

There are tenderness and swelling of the right posterior scalp

2.

She is an 80-year-old female with a history of GI bleed.

3.

She was seen at a clinic and was referred here for evaluation.

4.

In medical transcription course, you will be accustomed to use different medical terms, both familiar and unfamiliar.

5.

She has inability to walk due to incoordination.

44

6.

Dr. Johnson is one of the surgeons who studied at Harvard University.

7.

Achromatin is found in a cell nucleus which lacks staining properties.

8.

The patient experienced decrease in severity of pain or other symptom

9.

The doctor will examine the abdominal cavity of the patient by a modern instrument.

10.

Abortion is the termination of pregnancy, spontaneous or induced. 45

11.

The surgeon removed a growth by surgical means.

12.

Albert diagnosed the patient with highly technical gadget.

13.

Acetic

acid

has

properties

of

vinegar and it is used as a reagent. 14.

Acetylcholine is an acid found in various

organs

and

tissues

necessary for the transmission of nerve impulses. 15.

The

inability

of

muscles

or

sphincters to relax is a symptom of achalasia. 46

NOTE: since  When it is used as a preposition, since means after the time that, indicating that an event follows another but was not caused by it. They had not met since childhood. TWO-WORD PREPOSITIONS (PHRASAL PREPOSITIONS) according to across from

instead of

along with apart from aside from away from because of

inside of instead of

except for

out of outside of 47

contrary to down from due to

regardless of sort of together with up to

NOTE NOTE: due to Means caused by or resulting from, not because. Her reaction was due to a penicillin allergy. Not Her reaction was because of a penicillin allergy. •



Due to is properly used after a linking verb (was due to), but the 48

verb may be omitted in an elliptical clause. •

His complications, though due to negligence, were not lifethreatening.

THREE-WORD PREPOSITIONS (PHRASAL PREPOSITIONS) along side of by means of by reason of by virtue of by way of for the sake of

in contrast to in control of in front of in place of in respect to in spite of in view of 49

in on accordance account of with on behalf in addition of to on top of in with apposition reference with to in case of with in regard to compliance with with respect to in connection with in consideratio n of WHAT PREPOSITIONS INDICATE 1.Place or position 50

above below across beneath along beside around between at by

1.

2.

3.

4.

5.

in near through under

There was stenosis across his distal artery She experienced 8/10 pain between her shoulder blades. Abdomen is an area of the body between thorax and pelvis. Acetone, a volatile, colorless and inflammable liquid, is a useful solvent. This is found in the blood and urine of diabetics. Achlorhydria is the absence of hydrochloric acid in the stomach. 51

2.Direction and motion about by to across down toward around from up at over

1.

2.

3.

4.

5.

He drew away an extremity away from the body. Abrasion means scraping injury to the outer layer of the skin. Achilles tendon connects the muscles of the calf of the leg to the heel bone The surgeon is about to start the operation. He went across the street.

3.Time about

during

throughout 52

after at before by 1.

2.

3.

4.

5.

for in

till while

on through

Accouchement means the act of delivery in childbirth or confinement. Acid-fast pertains to bacteria which are not easily decolorized after staining. The surgeon will start the operation at 3:00 p.m. He had shown an excellent performance through the years. While eating, he felt some abdominal pain.

53

NOTE: (1) off Do not follow by of. Dictated : He fell off of the roof Transcribed : He fell off the roof. (2) under Do not use to mean less than. If this meaning is intended, use less than instead. Dictated : She weighed under 80 pounds. Transcribed : She weighed less than 80 pounds. (3) as to 54

Acceptable when dictated at the beginning of a sentence, but when used elsewhere, remove it or replace it by a single word, e.g., about, in, regarding. • •

As to the lab results... He inquired [as to] whether he could drink alcohol. (as to can be deleted ) Dictated : She inquired as to the reasons for the procedure. Transcribed : She inquired about the reasons for the procedure. Dictated : Her concerns as to the prognosis... 55

Transcribed : Her concerns regarding the prognosis... (4) as well as  Prepositional phrase meaning in addition to (equivalent to besides). As well as often serves as a conjunction meaning and in addition (equivalent to and ), but in either case—even when its meaning is the same as and—as well as introduces a parenthetical statement that does not create a compound subject and therefore does not affect subjectverb agreement. 

Use commas to set off the parenthetical as well as statement only as necessary for clear communication. 56

•

•

The attending physician, as well as the nurses, says the patient is ready for discharge. MRI of the brain showed right temporal contusion as well as small hemorrhagic shear in the left temporal lobe. (no commas necessary)

Sometimes either choice (with or without commas) is acceptable. The patient’s sister, as well as her parents, was at the meeting. or The patient’s sister as well as her parents was at the meeting. CORRECT USAGE OF PREPOSITIONS 1.at, in 57

at – refers to a point of time & a small place in- refers to a larger space of time •

•

He came at 8 o’clock in the morning He lives at Kuala Lumpur in Malaysia

2.beside, besides beside – means “by the side of” besides – means “in addition to” • •

He sat beside his wife. There are others here besides you.

3.by, with by – generally used for person with – generally used for instrument 58

•

He was killed with a knife by his enemy.

4.between, among between –generally used for two among – generally used for more than two •

•

The money was divided between the two boys The sweats were divided among the ten children.

5.since, from since – used for a point of time from – can be used in any tense •

She has been ill since Monday. 59

•

•

We have lived here since the last war. She was ill from Monday to Friday

6.for, before for- used for a period of time before – used for a point of time •

•

She will not be here for an hour yet. She will not be here before five o’clock.

7.in, into in – denotes position or rest into – shows motion 60

• •

He came into the room. The bag is in my locker.

8.in, which in – when referring to time, it denotes the close of a period within – denotes a time less than the close of the period • •

I shall return in a year’s time. I shall return within a year.

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