Review for Final Examination Definitions

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Definitions biopsy ‐ excision of a small piece of living tissue for microscopic examination edema ‐ the presence of abnormally large amounts of fluid in the tissues Review for Final Examination emesis ‐ another name for vomiting neoplasm ‐ a new growth of tissue homeostasis ‐ equilibrium of the internal environment Medical Terminology of the body peritoneum ‐ membrane that lines the abdominopelvic cavity and enfolds the internal organs

Definitions Definitions cerebrospinal fluid ‐ liquid that circulates throughout lymphoma ‐a general term for cancer that originates the brain and spinal cord in the lymphatic system angina pectoris ‐ severe chest pain and constriction pleura ‐ the membrane that surrounds each lung caused by insufficient blood supply to the heart calculi – another name for stone vasodilation ‐ increase in the diameter of a blood endometriosis – a condition in which tissue vessel resembling the endometrium is found abnormally fibrillation ‐ severe cardiac arrhythmia where in other locations in the pelvic cavity contractions are too rapid and uncoordinated for debridement ‐ removal of foreign material and dead effective blood circulation or damaged tissue from a wound tachycardia ‐ increased pulse rate thyrotoxicosis ‐ morbid condition caused by excessive bradycardia – decreased pulse rate thyroid secretion

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Suffixes: “Pertaining to” Suffixes: Specialists or Specialties, cont. • an, ‐ar, ‐ary, ‐eal, ‐ive, ‐tic, ‐logist one who studies; specialist ‐ous , ‐ac, ‐al,‐ic = pertaining to

ex: cardi/o=heart cardiac ‐logy study or science of neur/o=nerve neural gastr/o=stomach gastric ex:skin= derm/a, derm/o, dermat/o, cutane/o ‐logic, ‐logical = pertaining to the study of ex: dermatologic dermatologist, dermatology dermatological

scope: instrument used to view scopy: process of visually examining • ‐tome = instrument used for cutting • ‐tomy = incision (cutting into tissue) meter: instrument used to measure • ‐stomy = formation of an opening metry: process of measuring

graph: instrument for recording graphy: process of recording gram: a record

y=process

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Enzymes ‐ase = enzyme lact/o = milk (lactase is an enzyme that acts on the milk sugar lactose) amyl/o = starch (amylase is an enzyme that breaks down starch) prote/o = protein (protease or proteinase are enzymes that break down Fig. 2‐2 Measuring the head of a newborn. This is the appropriate protein. placement of the measuring tape to obtain the head circumference of a newborn. Neonatology focuses on care of the newborn. lip/o = fat( lipase is an enzyme that From Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s guide to physical examination, ed 4, breaks down fat) St Louis, 1999, Mosby.

Needle Insertion for injection

A. subcutaneous= a small amount of medication is placed under the skin, into the subcutaneous tissue

B. intramuscular= medication is deposited within the muscular layer

C. intradermal= small amts of medication injected within the outer layers of the skin (test for allergic reactions)

D. intravenous= administers medications directly within the blood stream for Fig. 3‐6 Cyanosis. This bluish discoloration of the skin is caused by a deficiency immediate effect. of oxygen in the blood. Cyanosis is generally not as obvious as it is in this patient. From Kamal A, Brockelhurst JC: Color atlas of geriatric medicine, ed 2, St Louis, 1991, Mosby.

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•Electrocardiography‐ the process of recording the electrical activity of the heart

•The instrument used is an electrocardiograph

Fig. 3‐7 Jaundice. Note the contrast in the examiner’s hand and the yellow discoloration of the skin of a patient with an acute liver disorder. From Emond RT, Welsby PD, Rowland HA: Colour atlas of infectious diseases, ed 4, London, 2003, Mosby, Ltd. •The record produced of the tracing is called an electrocardiogram, or ECG. Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 26 Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 32

Basic Examination Procedures blood pressure (BP):The pressure exerted by the circulating volume of blood on the walls of the arteries and veins and on the chambers of the heart BP consists of 2 numbers expressed as a fraction. ex: 120/80 mm Hg •Electroencephalography‐ the process of recording the electrical impulses of the brain systolic (top number, the first sound heard) : pressure on the arteries when the heart is •The instrument used is an electroencephalograph contracted diastolic(bottom number, the last sound •The record produced is an electroencephalogram heard) : the pressure on the arteries when Copyright © 2011, 2007, 2003 Copyright © 2011, 2007, 2003 by Saunders, an by Saunders, an imprint of the heart is relaxed Slide 35 imprint of Elsevier Inc. . Elsevier Inc.

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Techniques used in a physical exam inspection: examiner uses the eyes and ears to observe and listen to patient

palpation: examiner feels the texture, size, consistency, and location of certain body parts with the hands.

percussion: examiner taps the body with fingertips or fist to evaluate size, borders, & consistency of internal organs, Fig. 4‐9 Computed tomography (CT) of the brain. Also called CAT scan for computed axial tomography.

and to determine amt of fluid in a body cavity Computed tomography: The use of ionizing radiation to produce a detailed image of a cross section of tissue, as if the body were actually cut into sections. It is painless and noninvasive. auscultation: examiner listen for sounds within the body A tomogram is the record produced. using a stethoscope A. Positioning of patient for CT.

Additional Imaging Procedures magnetic resonance imaging (MRI): uses magnetic properties of elements in the body to produce images

sonography: images deep structures of the body by sending and receiving high‐frequency sound waves that are reflected back as echoes from tissue interfaces

contrast imaging: uses radiopaque material to help outline Magnetic resonance imaging (MRI) ‐ uses magnetic structures so they are more visible on x‐ray properties of elements in the body to produce images fluoroscopy : provides continuous imaging of the motion of internal organs and immediate serial images A, From Mourad LA: Orthopedic disorders, St Louis, 1991, Mosby; B, courtesy Professor A. Jackson, Department of Diagnostic Radiology, University of Manchester; C, courtesy Siemens, Inc.

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Fig. 5‐4 Anatomic position with reference systems. The erect anterior view with palms forward is used as the point of reference in anatomic nomenclature. Fig. 4‐14 Radiation therapy. Also called radiotherapy or radiation oncology, radiation therapy treats neoplastic disease by using powerful x‐rays or gamma rays to prevent the malignant cells from increasing in A, Frontal or coronal plane: divides body into front and back number. portions B, transverse plane: divides body into upper & lower portions From Frank ED, Long BW, Smith BJ: Merrill’s atlas of radiographic positioning and radiologic procedures, ed 11, St Louis, 2007, Mosby‐Elsevier. C, midsagittal plane: divides body into two equal halves

Directional Word Parts and Terms Directional Word Parts and Terms, Cont.

• anter/o toward the front; ventral • super/o uppermost • poster/o toward the back, dorsal • infer/o lowermost

• ventr/o belly side • dors/o back side • proxim/o nearer the origin • dist/o far or distant (also tel/e) • medi/o middle • later/o toward the side • cephal/o toward the head • trans‐ across • caud/o toward the tail

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Positions

• practice with exercise 5 on page 103

Fig. 5‐6 Comparison of pronation and supination. A, Prone, lying facedown. B, Supine, lying on the back. (lying face up) C, Supination and pronation of the elbow and wrist joints, which permit the palm of the hand to turn up (supination) or down (pronation).

Fig. 5‐9 Abdominal paracentesis or abdominocentesis‐ Fig. 5‐14 Four‐month‐old child with hydrocephalus. is a surgical procedure that removes excess fluids Hydrocephalus is usually caused by obstruction of the from the abdomen, or injects a therapeutic agent flow of cerebrospinal fluid. If hydrocephalus occurs in an infant, the soft bones of the skull push apart as the

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• Practice with programed learning on page 137

Diseases and Disorders Blood components erythrocyte –red blood cell (RBC) • my/o=muscle • erythr/o= red leukocyte – white blood cell (WBC) • myolysis‐ degeneration of muscle tissue • leuk/o= white thrombocyte – blood platelets • myopathy‐ any disease of the muscle • thromb/o= clot (thrombus) • myalgia –muscle pain ‐osis increased or abnormal when cellular components • do not get confused with myel/o= bone marrow or spinal cord ‐penia deficiency

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The Heart

cardiomyopathy‐ any disease of the heart muscle cardi/o=heart , my/o= muscle, ‐pathy=disease

Each layer of the heart can be inflammed: endocarditis‐ inflammation of the endocardium 3 layers of the heart: (innermost layer) often caused by infection endocardium ‐ innermost layer myocarditis‐ inflammation of the mycoardium(heart myocardium ‐ middle layer = heart muscle muscle) epicardium (visceral pericardium) ‐ outermost pericarditis – inflammation of the outermost layer of (peri‐ means around) heart (pericardium) sometimes caused by infection or cancer Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 15 Slide 11

Diseases, Disorders, and Diagnostic Terms: The Heart, cont. ‐pnea=breathing fibrillation‐ severe cardiac arrythmia. The heart contracts too rapid and eupnea‐ normal respiration (eu‐ = normal) 15‐20 bpm uncoordinated for effective blood circulation dyspnea‐ labored/difficult breathing (dys‐ = bad/difficult)  defibrillator‐ electronic device that shocks the heart to reverse fibrillation and restore normal rhythm (de‐ means down from, apnea‐ temporary absence of breathing(a‐ = no/without) reversing) orthopnea‐ uncomfortable breathing in any position except sitting erect or standing (orth/o= straight) heart murmur – soft blowing or rasping sound heard when listening to heart with a stethoscope. (Not necessarily caused by disease) bradypnea‐ abnormally slow breathing (<12 bpm) (brady‐ = slow) hyperlipidemia – excessive lipids (fats) in blood esp. cholesterol tachypnea‐fast rate of breathing which may lead to hyperventilation (tachy‐ = fast) hypertension/hypotension‐high blood pressure/low blood pressure (hyper‐ = excessive) Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc.Copyright © 2011, 2007, 2003 by Saunders, an iif El i I

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Diseases, Disorders, and Diagnostic Terms

• pulmonologist‐a physician who specializes in the lungs. • Pneumon + ia,or pneumon + itis means Two abnormal conditions of the chest cavity. inflammation of the lungs. There are many causes of pneumonia, but it is caused A, Pneumothorax is air or gas in the chest primarily by bacteria, viruses, or chemical pneum/o= air or lungs thorax=chest irritants B, Hemothorax, or blood in the pleural cavity hem/o=blood thorax=chest

Diseases, Disorders, and Diagnostic Terms, cont.

• pneumocentesis‐surgical puncture of the lung • pulmonary edema‐ effusion (escape) of fluid which accumulates in the lungs. • edema is the abnormal accumulation of fluid in Fig. 8‐5 Pulmonary embolism. This blood clot broke loose and traveled tissue. from a lower extremity and is now located in a branch of the pulmonary artery. A pulmonary embolism obstructs blood flow in the pulmonary • rhinorrhea‐runny nose artery. embolus=foreign body or blood clot that travels in the bloodstream and then lodges in a blood vessel and obstructs circulation Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 15 Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 16

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Voice and Speech Disorders/Diseases

phon/o=voice laryngitis‐ inflammation of the larynx(voice box) dysphonia‐ difficultly speaking or weak voice (hoarseness) aphonia‐ absence of voice laryngitisdysphoniaaphonia

Fig. 8‐8 Bronchoscopy. Visual examination of the tracheobronchial phas/o=speech tree using a bronchoscope. Other uses for this procedure include dysphasia‐ speech impairment (difficult speech) resulting from brain suctioning, obtaining a biopsy specimen or fluid, or removing foreign lesion. bodies. aphasia – inability to communicate (absence of speech) caused by improper brain function bronch/o= bronchus ‐scopy= process of visually examining

• ‐tome=instrument • ‐tomy=incision • ‐stomy=formation of an aopning

Fig. 9‐6 Cholelithiasis, the presence of gallstones. After cholecystectomy, this photograph of an opened gallbladder shows several stones of different sizes.

From Damjanov I, Linder J: Pathology: a color atlas, St Louis, 2000, Mosby.

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Fig. 9‐9 Colonoscopy. (used to screen for colon cancer) A, Endoscopic examination of the colon using a flexible Fig. 10‐13 Normal bladder compared with cystocele. A, Normal position of the bladder colonoscope. in relation to other pelvic structures. B, A cystocele, herniation of the bladder. Note how B, Colonic polyps can often be removed with the use of a the bladder sags and protrudes into the vagina. snare (wire noose) that fits through the colonoscope.

Reproductive System

• gynecology‐ the study of diseases of the female reproductive system • obstetrics ‐ The branch of medicine that specializes in the care of women during pregnancy and childbirth Fig. 11‐2B Anterior view of the internal organs of the female reproductive system. The left ovary, the left uterine tube, and the left side of the uterus are sectioned to show their internal structure. ovary‐produces ova and hormones uterine tubes (fallopian tubes)‐transport ova to the uterus uterus‐provides nourishment from the time the fertilized egg is implanted to the time of birth of fetus cervix uteri (cervix)‐ the lowermost cylindrical part of the uterus vagina‐”the birth canal” Slide 9

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Layers of Uterine Tissue endometrium‐innermost layer myometrium‐ middle layer of thick muscular tissue perimetrium‐ membrane that surrounds the uterus

(endo‐)=inside (my/o)= muscle (peri‐) = around Fig. 11‐6 Hysteroscopy. Direct visual examination of the cervical (metr/o)= uterine tissue, or measurement canal and uterine cavity using a hysteroscope is performed to (‐ium)=membrane examine the endometrium to obtain a specimen for biopsy, to excise cervical polyps, or to

Copyright © 2011, 2007, 2003 by Saunders, remove an intrauterine device. an imprint of Elsevier Inc.Copyright © 2011, 2007, 2003 by Saunders, an imprint of Copyright © 2011, 2007, 2003 by Saunders, an imprint of Elsevier Inc. Slide 15 Elsevier Inc.

Fig. 11‐4 Colposcopy. The vagina and cervix are Fig. 11‐7 Hysterosalpingogram. This x‐ray image examined with a colposcope. of the uterus and uterine tubes was made after the introduction of a radiopaque substance through the cervix.

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Pregnancy and Childbirth, cont. Menstrual Irregularities • para I, II, etc. # pregnancies resulting • amenorrhea (a‐, without, + men/o, month, + ‐rrhea, in live births discharge): absence of menstrual flow when it is • ‐para a woman who has given normally expected. birth • dysmenorrhea (dys‐, difficult): painful menstruation. • unipara (uni‐, one) • menorrhagia (‐rrhagia, hemorrhage): excessive flow during menstruation. • secundipara (secundus is latin for second) • metrorrhagia (metr/o, uterine tissue): bleeding from • tripara (tri‐, three) the uterus at any time other than during the menstrual • nullipara a woman who has never period. Metrorrhagia literally means hemorrhage from given birth to a viable offspring the uterus. (nulli‐, none)

Pregnancy and Childbirth, cont. • gravida pregnant woman Word Parts, cont. seps/o infection • Prefix + ‐gravida # pregnancies • sepsis= infection or contamination • primigravida , gravida I = a woman who is pregnant • asepsis=absence of infection/germs for the first time (primi‐, first) • gravida II sept/o infection or septum • gravida III, etc. • septic=infected wound • ****Note that gravida refers only to pregnancy, • aseptic conditions=free of pathogenic organisms whereas para designates successful pregnancies resulting in live births. A woman could be gravida • a‐ = no, not, without III but para 0 (same as nullipara).

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Skin Injuries keloid: overgrowth of unsightly scar tissue laceration: torn, jagged wound incision: smooth‐edged wound produced by a sharp Fig. 13‐9 Meningocele. (above) The spinal meninges have formed a instrument hernial cyst that is filled with cerebrospinal fluid and is protruding through a defect in the vertebral column puncture: a wound made by piercing . encephalocele(below) –hernia of the brain through an opening of the abrasion: skin is scraped or rubbed away by friction skull contusion: a bruise that does not break the skin \

• phagia • phasia • dipsia