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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

NOUNS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Classification of Nouns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Verbals that Function as Noun . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Forms of Compound Nouns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Pluralization of Nouns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

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

Derivational Suffixes of Adjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Kinds of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Derivational Suffixes of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Position of Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Conjunctive Adverbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
CONJUNCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Coordinating Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Correlative Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Subordinating Conjunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

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 glass
needle plate

B. Abstract Nouns They refer to ideas comprehensible through their

manifestation to the senses. They are formless and cannot
be counted.

pain happiness
love hatred

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

medicine nurse
doctor 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 Ms. Anne Gonzales

Dr. John Perez 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 bouquet of flowers

team school of fish
audience board
N committee couple
Family staff
group team

• 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.)

• The couple were injured in a plane crash.

• (but) The couple has an appointment with the geneticist.

B. Mass Nouns Refer to objects with fine composition that tend to form
cohesive units.

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 rice salt
coffee sugar

III. 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 - Her dream is to become a medical transcriptionist.

Complement

c. Direct Object - She wants to become a medical transcriptionist.

2. Gerund - Verb in form (verb + ing), but it functions as a noun.

a. Subject - 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 PLDT services

St. John Don Bosco church American institute

2. Common Adjectives
It expresses the ordinary qualities of a noun or pronoun. It begins with a small
letter.

coronary care unit routine followup

staff evaluation emergency room

3. Descriptive Adjectives
It describes a noun or pronoun.

long rough
soft painful

4. Numeral Adjectives
It denotes exact number.

BUN was 22 32-French chest

11.2 ECG 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

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

my pen his schedule

your son her bag

7. Demonstrative Adjectives

this book these umbrellas

that car those flowers

8. Indefinite Adjectives

some people any patient

few mess 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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 • H
• 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 or
indefiniteness of the noun that follows.

a. Definite Article (the)

the chair : 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 : We will do a CBC.

Optional : She was admitted to the ICU.
(or) 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. Noun + y - muddy, stony, dreamy, sleepy

2. Noun + ful - faithful, beautiful, harmful, painful
3. Noun + less - faithless, timeless, flawless, guideless
4. ;Noun + en - rotten, golden, wooden
5. Noun + ive - permissive, constructive, excessive, decisive
6. Noun + ous - vigorous, nervous, horrendous, marvelous
7. Noun + ish - mannish, selfish, Danish
8. Noun + al - symmetrical, bilateral, neurological, mental, facial
9. Noun + ary - elementary, secondary, tertiary,
10. N oun+ some - lonesome, tiresome, handsome, bothersome
11. Noun + ly - queenly, priestly, princely
12. Noun + ic - historic, dramatic, tragic
13. Noun or V + able/ible - payable, desirable, likeable, permissible

LIST OF MEDICAL TERMS THAT FUNCTION AS ADJECTIVES

POSTURE-BASED TERMS MEANING

anterior nearer the front
posterior nearer the rear
superior nearer the top
inferior nearer the bottom

REGION BASED TERMS MEANING

cranial, cephalic nearer the head
caudal nearer the tail or lower end
dorsal nearer the back
ventral 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 - There is only one condition, although
present
in both lungs at the same time.
• bilateral mastectomies - There are two breasts and both are
removed,
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 rough edge

my pen his schedule
that car those flowers
few mess all nurses
newborn baby

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 : She reports over 5 operations but is unclear about the

precise
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 SUPERLATIVE

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Good Better best
Bad Worse worst
Little less/lesser least
Old Older oldest
Near Nearer nearest
Far Farther farthest
Late Later latest
Many More most

PRONOUNS
Pronouns are used as noun substitute.

KINDS OF PRONOUNS
1. Personal pronouns – They function as a subject or object

PERSON PERSONAL PERSONAL

PRONOUNS PRONOUNS
(SUBJECT) (OBJECT)
SINGULAR
1st person I me
2nd person you you
3rd person he, she, it him, her, it
PLURAL
1st person we us
2nd person you you
3rd person they Them

• Subject - He will return in 3 weeks for followup

• Object - The doctor will give you intravenous aminophylline
• Subj. & Obj. - He rarely recognizes us.

2. Possessive pronouns – They denote ownership.

PERSON POSSESSIVE PRONOUNS

SINGULAR
1st person my mine
2nd person your yours
3rd person his, her, its his, hers, its
PLURAL

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 1st person our ours
2nd person your yours
3rd person their 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 : The patient will be seen by Dr. Smith in 1 week and by myself in
2 weeks.
Transcribed : The patient will be seen by Dr. Smith in 1 week and by me in 2
weeks.

PERSON REFLEXIVE/
INTENSIVE
PRONOUNS
SINGULAR
1st person myself
2nd person yourself
3rd person herself, himself, itself,
oneself
PLURAL
1st person ourselves
2nd person yourselves
3rd person themselves

3. Interrogative pronouns – They are used to ask questions.

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

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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

INDEFINITE PRONOUNS
All each other nobody
any either none
anybody everybody no one
anyone everyone one
anything everything others
Both few some
Each many somebody
each one 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 singular I

second person singular you (one only)
third person singular he, she, it

first person plural we

second person plural you (more than one)
third person plural 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 : The patient is a 40-year-old white female complaining of nausea

and vomiting.
Rule 2: 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 : The abdomen is soft. There was a scar in the lower right
quadrant.

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.

21
 • 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

22
 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 I will/shall be working this weekend.

Present Perfect
Progressive I have been working harder than usual lately.
Past Perfect
Progressive I had been working nights until the new schedule was
announced.
Future Perfect I will/shall have been working on this project a month
Progressive 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 PHRASE
THE ACTION (Past Tense) THE ACTION MODIFIER
SINGULAR
The director gave me an instruction
The president appreciated you very much

23
 The principal assigned him at the new branch
PLURAL
The doctors diagnosed us with a gadget
Your parents transferred you to other school
The judges tallied them immediately
FORMS OF “HAVE” VERBS IN ACTIVE VOICE
(PRESENT/PAST PERFECT TENSE)
DOER AUXILIARY MAIN RECEIVER PHRASE
OF THE VERB VERB OF THE MODIFIERS
ACTION (Present / Past ) (Past Participle) ACTION
SINGULAR
The nurse has / had given me an instruction
The doctor has / had appreciated you very much
The director has / had assigned you at the new
branch
PLURAL
The doctors have / had diagnosed us with a gadget
Your parents have / had transferred you to other school
The technician have / had tallied them 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.

FORMS OF “BE” VERBS IN PASSIVE VOICE

(PRESENT/PAST TENSE)
RECEIVER AUXILIARY MAIN VERB PHRASE DOER OF THE
OF THE VERBS (Past MODIFIER ACTION
ACTION (Be) Participle)
SINGULAR
I am / was given an instruction by the nurse
You are / were appreciated very much by the doctor
He/She Is / was assigned at the new branch by the director
PLURAL
We are / were diagnosed with a gadget by the doctor
You are / were transferred to other school by your mother
They are / were tallied immediately 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 been given an instruction by the nurse
You have / had been appreciated very much by the doctor
He/She has / had been assigned at the new by the director
branch
PLURAL
We have / had been diagnosed with a gadget by the doctor
You have / had been transferred to other school by your mother
They have / had been tallied immediately by the judges

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.

FORMS OF “BE” VERBS

am am being has been can be
is is being have been could be could have been
are are being had been may be may have been
was was being might be might have been
were were being will be
would be would have been

25
 shall be shall have been
should be should have been
must have been

 Others include the following words:

act get
appear grow
feel seems
look smell
remain sound
become 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

THE TWO PRINCIPAL PARTS OF THE PAST TENSE

TENSES REGULAR VERBS IRREGULAR VERBS
Past worked drew

26
Past Participle worked drawn

IRREGULAR VERBS

IRREGULAR VERBS WITH THE SAME

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

27
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.

28
 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 Verb of Relative

Pronoun Pronoun
We who are about to graduate.
He has one candidate who 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)

31
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 Verb Plural Verb

ala nasi is alae nasi are
diverticulum is diverticula are
genitalis is genitalia are
naris is nares are
medium is media are
labium is labia are
majus is majora are
minus is minora are

32
 lentigo is lentigines are
focus is foci are
fossa is fossae are
decubitus ulcer is decubitus ulcers 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 ENGLISH TRANSLATION

a.c. before meals
a.m. morning
h.s. bedtime
p.c. after meals
p.m. afternoon
p.r.n. 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 -WISE ADVERB

Length -wise lengthwise
Clock -wise clockwise
ADJECTIVE -LY ADVERB
Sensible -ly sensibly
Mere -ly merely
NOUN -WARD ADVERB
Home - ward homeward
ADVERB -WARD ADVERB
Back -ward backward

35
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 likewise as a result

afterwards meanwhile at last
again moreover at the same time
anyhow namely for example
besides nevertheless for instance
consequently next for this reason
doubtless otherwise in addition
eventually perhaps in any case
evidently possibly in fact
finally similarly in like manner
furthermore still in short
hence subsequently on the contrary
however then on the other hand
indeed therefore that is
instead thus 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 nor
but so
for yet
or

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

Transcribed: He wanted to improve so he could attend his daughter’s wedding.
Or 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 : His condition was improved, so he could attend his daughter’s
wedding.
Or 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 that provided unless

although how since until
as if than while
because in order that though when
before in as much through 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.

The patient said she was weak and dizzy.

or The patient said that she was weak and dizzy.
but The patient said today that she would exercise.
not 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 before durin off to
e behin g on toward
abou d exce onto under
t below pt out underne
acros benea for outside ath
s th from over until
after besid in past up
again e insid since upon
st betwe e through with
along en into through within
amid but like out without
a beyon near
mon d of
g by
arou down
nd
at

43
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 instead of
to
across from except for

along with inside of

apart from instead of
aside from
away from out of
because of outside of
47
 contrary to regardless
down from of
due to 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 life-
threatening.

THREE-WORD PREPOSITIONS
(PHRASAL PREPOSITIONS)

along side in contrast

of to
by means in control
of of
by reason in front of
of in place of
by virtue of in respect
by way of to
for the sake in spite of
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 in
across beneath near
along beside through
around between under
at by

1. There was stenosis across his

distal artery
2. She experienced 8/10 pain
between her shoulder blades.
3. Abdomen is an area of the body
between thorax and pelvis.
4. Acetone, a volatile, colorless and
inflammable liquid, is a useful
solvent. This is found in the blood
and urine of diabetics.
5. 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. He drew away an extremity away

from the body.
2. Abrasion means scraping injury to
the outer layer of the skin.
3. Achilles tendon connects the
muscles of the calf of the leg to
the heel bone
4. The surgeon is about to start the
operation.
5. He went across the street.

3.Time
about during throughout
52
after for till
at in while
before on
by through

1. Accouchement means the act of

delivery in childbirth or
confinement.
2. Acid-fast pertains to bacteria
which are not easily decolorized
after staining.
3. The surgeon will start the
operation at 3:00 p.m.
4. He had shown an excellent
performance through the years.
5. 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 subject-
verb 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.

61