#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

B

␤ (ba¯Јta˘) Beta, second letter of the Greek protected from tick exposure. Asplenic alphabet. SEE: beta. persons should avoid endemic areas. Af- ␤-glucan (ba¯Јta˘-glooЈka˘n) Any one of a ter possible exposure, removal of ticks class of complexcarbohydrate nutri- or their nymphs may prevent infection. ents, derived from yeast, with immune- TREATMENT: Drugs used include stimulating and antimicrobial activity atovaquone and quinine plus clinda- in laboratory experiments. They are mycin or azithromycin, both given promoted as dietary supplements. orally. Asplenic patients may require ␤-glucuronidase (ba¯Јta˘-glooЉku¯-ro˘nЈ˘-ı exchange transfusion. da¯s) An enzyme found in lysosomes. It Babinski’s reflex (ba˘-bı˘nЈske¯z) [Joseph is involved in the breakdown of glycos- Babinski, Fr. neurologist, 1857–1932] aminoglycan. Dorsiflexion of the great toe when the B 1. Symbol for the element boron. 2. Ba- sole of the foot is stimulated. Normally, cillus; Balantidium; barometric; base; when the lateral aspect of the sole of the bath; behavior; buccal. relaxed foot is stroked, the great toe Ba Symbol for the element barium. flexes. If the toe extends instead of BAAM Beck airway airflow monitor. flexes and the outer toes spread out, Ba- Babcock’s operation (ba˘bЈko˘ks) [Wil- binski’s reflexis present. It is a normal liam Wayne Babcock, U.S. surgeon, reflexin infants under the age of 6 1872–1963] Extirpation of the saphe- months but indicates a lesion of the py- nous vein; a treatment for varicose ramidal (corticospinal) tract in older in- veins. dividuals. Care must be taken to avoid Babesia (ba˘-be¯Јze¯-a˘) [Victor Babe`s] Ge- interpreting voluntary extension of the nus of protozoa of the family Babesiidae toe as Babinski’s reflex. that causes babesiosis, a febrile illness Babinski’s sign Loss of or diminished that causes symptoms similar to those Achilles tendon reflexin sciatica. found in influenza, accompanied by he- baby [ME. babie] Infant. molytic anemia. Babesia microti is the battered b. A baby or child whose principal human pathogen, transmitted body provides evidence of physical to humans by tick bite. Other hosts in- abuse such as bruises, cuts, scars, frac- clude cattle, sheep, horses, and dogs. tures, or abdominal visceral injuries B. bigemina The causative organism that have occurred at various times in of Texas fever in cattle. the past. SEE: battered child syndrome. B. bovis The causative organism of blue b. An infant born with cyanosis, hemoglobinuria and jaundice (red-wa- which may be caused by anything that ter fever) in cattle. prevents proper oxygenation of the babesiosis (ba˘-be¯-ze¯-o¯Јsı˘s) A rare, usu- blood, esp. a congenital anomaly that ally self-limited disease caused by an in- permits blood to go directly from the traerythrocytic protozoan, Babesia mi- right to the left side of the heart without croti, and perhaps other Babesia going through the lungs. The most com- species. The disease is transmitted by mon cyanotic congenital heart defects deer ticks, and occurs most often in New are tetralogy of Fallot, transposition of England in the U.S. It has also been re- the great vessels, and hypoplastic left ported elsewhere. Severe forms are heart syndrome. most likely to occur in elderly people boarder b. An infant kept in a hos- and in people without functioning pital nursery until status permits dis- spleens. Rarely, the infection is trans- charge to family care or transfer to an- mitted by blood transfusion from an other agency for maintenance or asymptomatic carrier. The incubation adoption. period may last from weeks to months. collodion b. A newborn covered with SYMPTOMS: Symptoms include fe- a collodion-like layer of desquamated ver, chills, headache, sweats, myalgia, skin; may be due to ichthyosis vulgaris. arthralgia, and nausea and vomiting. baby bottle syndrome Decay of primary DIAGNOSIS: The diagnosis is sug- teeth in older infants and toddlers re- gested when a patient with an appro- lated to taking a bottle of punch or other priate outdoor exposure presents with sweet liquid to bed and retaining the liq- typical symptoms, plus hemolytic ane- uid. This creates massive caries. SYN: mia. Thick and thin blood smears and bottle mouth caries; nursing-bottle syn- other laboratory techniques (e.g., the drome. polymerase chain reaction) may be used Baby Doe regulations Federal, state, and for definitive confirmation. hospital policies insuring that handi- short PREVENTION: The skin should be capped infants will receive nourish- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh baby lung hypothesis 228 back board base of rh

ment, warmth, and life-saving treat- ment without regard to the quality of life. baby lung hypothesis In neonatal criti- cal care medicine, the loss of functioning alveoli in acute lung injury or the acute respiratory distress syndrome. In both of these diseases large sections of the lungs lose their compliance, collapse, or fill with fluids, leaving only a remnant of the lung available for ventilation. Ventilatory strategies designed for fully operational, adult-sized lungs may pro- vide too much air at too high a volume BACILLUS and pressure to the limited lung tissue Gram stain of Bacillus species (spores that can be potentially recruited. This visible in upper left quadrant) hypothesis suggests that overtaxing an infant-sized lung with adult ventilation can result in further injury to an al- more likely to cause the type 1 syn- ready damaged lung. drome. The emetic toxin may not be de- BAC blood alcohol concentration. stroyed by brief cooking. Type 2, the di- bacciform (ba˘kЈsı˘-form) [Љϩforma, arrheal syndrome, is caused by form] Berry-shaped; coccal. production of the heat-labile enterotox- Bach flower therapy [Edward Bach, Brit- ins hemolysin BL and nonhemolytic en- ish physician, 1886–1936] A form of terotoxin. These enterotoxins stimulate aromatherapy in which the essences of the adenylate cyclase-cyclic adenosine wildflowers are used to promote well- monophosphate system in intestinal ep- ness. ithelial cells, leading to profuse watery Bacillaceae (ba˘s-ı˘-la¯Јse¯-e¯) A family of diarrhea. Foods commonly associated rod-shaped, usually gram-positive bac- with type 2 syndrome are meat and veg- teria of the order Eubacteriales that etables. produce endospores and are commonly bacillus pl. bacilli 1. Any rod-shaped mi- found in soil. Genera of this family in- croorganism. 2. A rod-shaped microor- clude Bacillus and Clostridium. ganism belonging to the class Schizo- bacillar, bacillary (ba˘sЈı˘l-a˘r, ba˘sЈı˘l-a˘r-e¯) mycetes. SEE: Bacillus; bacterium. 1. Pert. to or caused by bacilli. 2. Rod- acid-fast b. ABBR: AFB. A bacillus like. not readily decolorized by acids or other bacille Calmette-Gue´rin (ba˘-se¯lЈ) An or- means when stained. Mycobacterium ganism of the strain Mycobacterium tuberculosis is one example of an acid- bovis, weakened (attenuated) by long- fast bacillus. term cultivation on bile-glycerol-potato Bacillus species ABBR: Bacillus spp. medium. SEE: BCG vaccine. All of the species of Bacillus. bacillemia (ba˘s-ı˘-le¯Јme¯-a˘) [L. bacillus, Bacillus stearothermophilus A spore- rod, ϩ Gr. haima, blood] The pres- forming bacillus that may survive dis- ence of rod-shaped bacteria in the blood. infection or sterilization. Its presence on bacilli (ba˘-sı˘lЈı¯) Pl. of bacillus. a clinical instrument or surface is used bacilliform (ba˘-sı˘lЈı˘-form) [Љϩforma, as an indicator of inadequate sterility. form] Resembling a bacillus in shape. bacitracin (ba˘s-ı˘-tra¯Јsı˘n) An antibiotic bacillosis (ba˘sЉı˘-lo¯Јsı˘s) [ЉϩGr. osis, in- obtained from a strain of Bacillus sub- fection] Infection by rod-shaped bacte- tilis. Its antibacterial actions are simi- ria. lar to those of penicillin. It treats gram- Bacillus (ba˘-sı˘lЈu˘s) [L.] A genus of gram- positive cocci and bacilli and some positive, spore-forming, often aerobic, gram-negative organisms. Because bac- rod-shaped bacteria in the family Bacil- itracin is toxic when used parenterally, laceae; they grow singly or in chains. it is usually applied topically in oint- Most inhabit soil and water. Some, such ment form. as Bacillus anthracis and Bacillus ce- back 1. The dorsum. 2. The posterior re- reus, cause serious human diseases. gion of the trunk from neck to pelvis. SEE: illus.; bacterium. Health care workers often strain their B. cereus A gram-positive spore- backs; therefore, it is important to learn forming food pathogen that causes two basic concepts in back care. SEE: illus.; types of food poisoning syndromes: em- back pain. esis and diarrhea. Type 1, the emetic backache (ba˘kЈa¯kЉ)[ЉϩЉ] Back pain. syndrome, is caused by the production back board A stiff board on which a of a heat-stable cereulide (a small, heat- spine-injured patient is secured so that stable dodecadepsipeptide), which can the patient’s back, neck, and head are damage the host cell mitochondria and maintained in-line during transport to in rare cases cause liver damage. Foods the hospital. This device should be used short containing large amounts of rice are with a head immobilization device and standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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physics, the deflection of ionizing radi- ation back more than 90Њ from interac- tions with intervening matter. Use of a back school A term for educational pro- footrest relieves grams, often sponsored by industry, swayback. that emphasize body mechanics and er- gonomic principles with the goal of pre- venting initial or recurring injuries to Bend the the spine. knees and backup Anything that serves to replace a hips, not the function or system that fails. waist. backwash A reverse flow; reflux. bactam (ba˘kЈta˘mЉ) [Fm b(eta) ϩ (l)actam(ase)] A suffixused to desig- Hold heavy nate an antibiotic that inhibits bacterial objects close beta lactamase. to you. bacteremia (ba˘k-te˘r-e¯Јme¯-a˘) [Gr. bakter- ion, rod, ϩ haima, blood] Bacteria in the blood. SEE: sepsis. Never bacteri- SEE: bacterio-. bend over bacteria (ba˘k-te¯Јre¯-a˘) [Gr. bakterion, without rod] Pl. of bacterium. bending the heterotrophic b. Bacteria that rely knees. on organic compounds (compounds con- taining carbon molecules) to grow and HOW TO STAY ON YOUR FEET WITHOUT reproduce. bacterial (−a˘l), adj. TIRING YOUR BACK bacterial interference The limitation of the growth of one bacterium by another, a cervical collar. SYN: spine board. e.g., in a culture or in a susceptible or- SEE: Philadelphia collar for illus. ganism. long b.b. A flat or slightly concave bacterial plasmid SEE: plasmid. board approx. 6 ft long and 2 ft wide, bacterial synergism The interaction of often made of laminated wood or plastic, indigenous flora to allow a strain of bac- that is used to immobilize a patient with teria to become pathogenic when it a mechanism for a potential neck or would normally be harmless. back injury. This device is used in com- bacterial vaginosis (va˘jЉı˘-no¯Јsı˘s) ABBR: bination with a cervical/head immobili- BV. Inflammation of the vagina and zation device or blanket roll and a rigid upper genital tract caused by Gardner- extrication collar. ella vaginalis. Previously referred to as short b.b. A flat board, approx. 3 ft “gardnerella” or nonspecific vaginitis, long and 2 ft wide, often made of lami- BV is the most common form of vaginitis nated wood or plastic that is used to im- in the United States and is character- mobilize a seated patient with a mech- ized by vaginal discharge with the ab- anism for a potential neck or back sence of lactobacilli and an overgrowth injury. This device is used in combina- of anaerobic bacteria. tion with a cervical/head immobilization Diagnosis is confirmed by character- device or blanket roll and a rigid extri- istic “fishy” odor produced when the cation collar. The short backboard is vaginal discharge is mixed with 10% po- used to remove a stable injured patient tassium hydroxide. A wet smear reveals from a vehicle onto a long backboard. vaginal epithelial cells that are heavily Most ambulance services have moved to stippled with bacteria, called clue cells. a more modern vest-style device such as The pH of the discharge is always a KED. greater than 5.5. Treatment is with backbone (ba˘kЈbo¯nЉ) The vertebral col- metronidazole or clindamycin, antibiot- umn; spinal column. SEE: vertebra. ics which in pill, cream, or gel form, are backcross (ba˘kЈkro˘sЉ) In genetics the pairing of a first filial generation hybrid effective against anaerobes, while main- with an organism whose genotype is taining lactobacilli. Asymptomatic bac- identical to the parental strain. terial vaginosis during pregnancy has backflow Abnormal backward flow of flu- been implicated in causing preterm la- ids. bor. Treatment during pregnancy to re- background level The concentration of a duce preterm delivery is controversial substance in the air, soil, or water; in- and is not recommended during the first dependent of or prior to any artificial trimester. SEE: Gardnerella vaginalis contamination of the environment. vaginitis. back pain SEE: under pain. bactericidal (ba˘kЉte˘r-ı˘-sı¯Јda˘l) Capable of backrest An adjustable device that sup- killing bacteria. ports the back in bed. bactericide (ba˘k-te˘rЈı˘-sı¯d) [Gr. bakter- short backscatter (ba˘kЉska˘tЈe˘r) In radiation ion, rod, ϩ L. caedere, to kill] An standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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agent that destroys bacteria, but not bacteriostasis (ba˘k-te¯Љre¯-o˘sЈta˘-sı˘s) [Љϩ necessarily their spores. stasis, standing still] The arrest of bac- bactericidin (ba˘k-te˘rЉı˘-sı¯dЈı˘n) Anything terial growth. lethal to bacteria. bacteriostatic (ba˘k-te¯-re¯-o¯-sta˘tЈı˘k) In- bacteriemia (ba˘k-te˘r-e¯-e¯Јme¯-a˘) Bactere- hibiting or retarding bacterial growth. mia. bacteriotoxic (ba˘k-te¯Љre¯-o¯-to˘kЈsı˘k) bacterio-, bacteri- (ba˘k-te¯Јre¯-o¯) Combin- 1. Toxic to bacteria. 2. Due to bacterial ing forms meaning bacteria. toxins. bacterioagglutinin (ba˘k-te¯Љre¯-o¯-a˘-glooЈtı˘- bacteriotoxin (ba˘k-te¯Љre¯-o¯-to˘kЈsı˘n) [Љϩ nı˘n) [ЉϩL. agglutinans, gluing] An toxikon, poison] Toxin specifically pro- antibody in serum that causes aggluti- duced by or destructive to bacteria. nation, or clumping, of bacteria in vitro. bacteriotropin (ba˘k-te¯Љre¯-o˘tЈro¯-pı˘n) [Љϩ bacteriocidal (ba˘kЉte˘r-e¯-o¯-sı¯Јda˘l) Bacte- tropos, a turn] An opsonin or a sub- ricidal. stance that enhances the ability of bacteriocin (ba˘k-te¯Јre¯-o¯-sı˘n) Protein phagocytes to engulf bacteria. produced by certain bacteria that exerts bacteristatic (ba˘k-te¯rЉe¯-sta˘tЈı˘k) Inhibit- a lethal effect on closely related bacte- ing the growth of bacteria. SEE: bacte- ria. In general, bacteriocins are more ricidal. potent but have a narrower range of ac- bacterium (ba˘k-te¯rЈe¯-u˘m) pl. bacteria A tivity than antibiotics. SEE: colicin. one-celled organism without a true nu- bacteriogenic (ba˘k-te¯Љre¯-o¯-je˘nЈ˘k)ı [Љϩ cleus or cell organelles, belonging to the gennan, to produce] 1. Caused by bac- kingdom Procaryotae (Monera). The cy- teria. 2. Producing bacteria. toplasm is surrounded by a rigid cell bacteriohemagglutinin (ba˘k-te¯Љre¯-o¯- wall composed of carbohydrates and he˘mЉa˘-glooЈtı˘-nı˘n) [Љϩhaima, blood, other chemicals that provide the basis ϩ L. agglutinans, gluing] A bacterial for the Gram stain. Some bacteria pro- toxin that clumps (agglutinates) red duce a polysaccharide or polypeptide blood cells. capsule, which inhibits phagocytosis by bacteriohemolysin (ba˘k-te¯Љre¯-o¯-he¯-mo˘lЈı˘- white blood cells. Bacteria synthesize sı˘n) [ЉϩЉϩlysis, dissolution] A DNA, RNA, and proteins, and they can bacterial toxin that destroys (lyses) red reproduce independently but may need blood cells. a host to provide food and a favorable bacteriologic, bacteriological (ba˘k-te¯Љre¯- environment. Millions of nonpathogenic o¯-lo˘jЈ˘k,ı −a˘l) [Љϩlogos, word, reason] bacteria live on human skin and mucous Pert. to bacteriology. membranes; these are called normal bacteriologist (ba˘k-te¯rЉe¯-o˘lЈo¯-jı˘st) An in- flora. Bacteria that cause disease are dividual trained in the field of bacteri- called pathogens. SEE: table. ology. CHARACTERISTICS: Shape: There bacteriology (ba˘k-te¯rЉe¯-o˘lЈo¯-je¯) Scien- are three principal forms of bacteria. tific study of bacteria. Spherical or ovoid bacteria occur as sin- bacteriolysin (ba˘k-te¯Љre¯-o˘lЈı˘-sı˘n) [Љϩ gle cells (micrococci) or in pairs (diplo- lysis, dissolution] A substance, esp. an cocci), clusters (staphylococci), chains antibody produced within the body of an (streptococci), or cubical groups (sarci- animal, that is capable of bringing nae). Rod-shaped bacteria are called ba- about the lysis of bacteria. cilli, more oval ones are called coccoba- bacteriolysis (ba˘k-te¯Љre¯-o˘lЈı˘-sı˘s) The de- cilli, and those forming a chain are struction or dissolution of bacteria. bac- called streptobacilli. Spiral bacteria are teriolytic (−o¯-lı˘tЈı˘k), adj. rigid (spirilla), flexible (spirochetes), or bacteriophage (ba˘k-te¯Јre¯-o¯-fa¯jЉ) [Gr. curved (vibrios). SEE: illus. bakterion, rod, ϩ phagein, to eat] A Size: On average, bacilli measure virus that infects and lyses bacteria. It about 1 ␮m in diameter by 4 ␮min consists of a head that contains either length. They range in size from less DNA or RNA and a tail by which it at- than 0.5 to 1.0 ␮m in diameter to 10 to taches to the host cell. SYN: bacterial 20 ␮m in length for some of the spirilla. virus; phage. SEE: virus for illus. Reproduction: Binary fission is the bacteriophytoma (ba˘k-te¯Љre¯-o¯-fı¯-to¯Јma˘) usual method of reproduction, but some [Љϩphyton, plant, ϩ oma, tumor] A bacteria exchange genetic material with tumor-like growth caused by bacteria. members of the same species or differ- bacterioprecipitin (ba˘k-te¯Љre¯-o¯-pre¯-sı˘pЈ˘-ı ent species. Reproductive rate is af- tı˘n) Antibodies that bring about precip- fected by changes in temperature, nu- itation of bacterial antigens. trition, and pH. If the environment bacterioprotein (ba˘k-te¯Љre¯-o¯-pro¯Јte¯-ı˘n) becomes unfavorable, some bacilli form Any of the proteins within the cells of spores, in which their genetic material bacteria. is condensed and surrounded by a thick bacteriopsonin (ba˘k-te¯Љre¯-o˘pЈso¯-nı˘n) An wall. Spores are highly resistant to opsonin, acting on bacteria. heat, drying, and disinfectants. When bacteriosis (ba˘k-te¯Љre¯-o¯Јsı˘s) [Љϩosis, the environment again becomes favor- condition] Any disease caused by bac- able, the spores germinate. short teria. Mutation: Bacteria, like all living standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Common Bacterial Infections Organism Type and/or Site of Infection Gram-Positive Bacteria Clostridium difficile Pseudomembranous colitis Staphylococcus aureus Pneumonia, cellulitis, boils, impe- tigo, toxic shock, postoperative bone/joints, eyes, peritonitis Staphylococcus epidermidis Postoperative bone/joints, IV line– related phlebitis Streptococcus pneumoniae (pneumococcus) Pneumonia, meningitis, otitis media, sinusitis, septicemia Streptococcus pyogenes Scarlet fever, pharyngitis, impetigo, rheumatic fever, erysipelas viridans group streptococci Endocarditis

Gram-Negative Bacteria Campylobacter jejuni Diarrhea (most common worldwide cause) Escherichia coli Urinary tract, pyelonephritis, septi- cemia, gastroenteritis, peritonitis Haemophilus influenzae Pneumonia, meningitis, otitis media, epiglottitis Klebsiella pneumoniae Pneumonia, wounds Legionella pneumophilia Pneumonia Neisseria gonorrhoeae Gonorrhea Neisseria meningitidis (meningococcus) Meningitis Pseudomonas aeruginosa Wounds, urinary tract, pneumonia, IV lines Salmonella enteritidis Gastroenteritis, food poisoning Salmonella typhi Typhoid fever Shigella dysenteriae Dysentery Vibrio cholerae Cholera

COCCUS BACILLUS SPIRILLUM

BACTERIAL CAPSULES FLAGELLA BACTERIAL SPORES BACTERIA short Bacterial shapes and specialized structures (ϫ1000) standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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BACTERIA

(A) Group A streptococci; beta-hemolysis on blood agar; (B) Salmonella; H2Sproduction (black) on SS (Salmonella-Shigella) agar

things, undergo mutations, and the en- enzymes that are released by bacteria vironment determines which mutations into their host, and endotoxins, which are beneficial and have survival value. are parts of the cell walls of gram-neg- Certainly beneficial to bacteria, though ative bacteria and are toxic even after not at all to humans, are the mutations the death of the cell. Exotoxins include that provide resistance to the poten- hemolysins, leukocidins, coagulases, tially lethal effects of antibiotics. and fibrinolysins. Endotoxins stimulate Motility: None of the cocci are capable production of cytokines that can pro- of moving, but most bacilli and spiral duce widespread vasodilation and forms can move independently. Loco- shock. SEE: endotoxin; sepsis. motion depends on the possession of one Miscellaneous: Some bacteria produce or more flagella, slender whiplike ap- pigments; some produce light. Soil bac- pendages that work like propellers. teria are essential for the nitrogen cycle Food and oxygen requirements: Most in the processes of nitrogen fixation, ni- bacteria are heterotrophic (require or- trification, and denitrification. ganic material as food). If they feed on IDENTIFICATION: Several methods living organisms, they are called para- are used to identify bacteria in the lab- sites; if they feed on nonliving organic oratory: SEE: illus. material, they are called saprophytes. Culture: Bacteria are grown on vari- Bacteria that obtain their energy from ous culture media; a visible colony con- inorganic substances, including many of taining millions of cells may be visible the soil bacteria, are called autotrophic within several hours. A colony is usually (self-nourishing). Bacteria that require composed of the descendants of a single oxygen are called aerobes; those that cell. Each species of bacteria grows in grow only in the absence of oxygen are colonies with a characteristic color, called anaerobes. Bacteria that grow shape, size, texture, type of margin or both with and without oxygen are fac- edge, and particular chemical features. ultative anaerobes. Most bacteria in the Groups of cells can then be examined human intestines are anaerobic. SEE: under a microscope, usually with infection, opportunistic. Gram’s stain. In addition, colonies can Temperature requirements: Although be separated and antibiotics applied to some bacteria live at very low or very assess their sensitivity to different high temperatures, the optimum tem- drugs. perature for most human pathogens is Hanging drop: Unstained bacteria in 97Њ to 99ЊF (36Њ to 38ЊC). a drop of liquid are examined under or- ACTIVITIES: Enzyme production: dinary or dark-field illumination. Bacteria produce enzymes that act on Gram’s stain: Gram-positive bacteria complexfood molecules, breaking them retain dye, turning purple; gram-nega- down into simpler materials; they are tive bacteria can be decolorized by al- the principal agents of decay and putre- cohol and colored red by a second dye; faction. Putrefaction, the decomposition acid-fast bacteria retain the dye even of nitrogenous and other organic mate- when treated with an acid alcohol de- rials in the absence of air, produces foul colorizer. Bacteria are often described odors. Decay is the gradual decomposi- by a combination of their response to tion of organic matter exposed to air by Gram’s stain and their appearance. For bacteria and fungi. example, “gram-positive staphylococ- Toxin production: Cell wall molecules cus” indicates a cluster of spheres that called adhesins bind bacteria to the host stain purple, whereas gram-negative cells. Once attached, the bacteria may bacilli are rod-shaped and pink. produce poisonous substances called Immunofluorescence: Bacteria stained short toxins. There are two types: exotoxins, with fluorescein and examined under a standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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microscope equipped with fluorescent lum, staff, walking stick ϩЉ] A dou- light appearing yellow-green. ble-stranded DNA virus that infects in- antibody-coated b. 1. A bacterium sects. It has been used experimentally coated with an antibody that acts as an in recombinant DNA technology, e.g., in opsonin to make the bacterium more manufacturing vaccines. susceptible to phagocytosis. 2. A labo- bad breath SEE: under breath. ratory test using fluorescein-labeled an- Baer’s plane [Karl Ernst von Baer, Prus- tibodies to locate antigens with which sian-Estonian anatomist, 1792–1876] the antibody links. SEE: opsonin. A plane through the upper border of the flesh-eating b. A colloquial name zygomatic arches. given in the popular media to a rare in- baffle (ba˘fЈı˘l) In respiratory care, a com- vasive infection of the skin and under- ponent of a nebulizer designed to re- lying soft tissue by group A streptococ- move large aerosol particles. cus. The infection is difficult to treat bag [ME. bagge] A sack or pouch. with antibiotics alone because it pro- colostomy b. Colostomy pouch. gresses rapidly through tissue planes. Douglas b. SEE: Douglas bag. Emergency surgical debridement is re- b. of waters Amnion. quired. SEE: necrotizing fasciitis. Politzer b. SEE: Politzer bag. probiotic b. A bacterium that pre- bagassosis (ba˘g-a˘-so¯Јsı˘s) [Sp. bagazo, vents illness, e.g., the Lactobacillus. husks, ϩ Gr. osis, condition] A form species found in yogurt. of hypersensitivity pneumonitis, due to bacteriuria (ba˘k-te¯Љre¯-u¯ Јre¯-a˘) [Gr. bak- inhalation of bagasse dust, the moldy, terion, rod, ϩ ouron, urine] The pres- dusty fibrous waste of sugar cane after ence of bacteria in the urine. removal of the sugar-containing sap. asymptomatic b. Bacteria in the The dust contains antigens from ther- urine without symptoms of urinary mophilic actinomycetes. tract infection or pyelonephritis. This bag mask device A manually operated condition may occasionally precede resuscitator used to ventilate a non- symptomatic urinary tract infection. It breathing patient or assist the ventila- is common in elderly women and in pa- tion of a patient who is not breathing at tients with indwelling urinary cathe- an effective rate or tidal volume. The de- ters. In children, it may be a sign of un- vice consists of a bag, an oxygen reser- derlying urinary tract abnormalities. voir system, a one-way flow valve, and Screening for asymptomatic bacteriuria a clear face mask. It is designed to be is recommended for pregnant women at attached to an oxygen source by tubing 12 to 16 weeks’ gestation. Screening to deliver concentrations approaching school-age children is not beneficial. 100%. SEE: illus. significant b. Concentration of path- Bailey, Harriet (ba¯Јle¯) [U.S. nurse edu- ogenic bacteria in the urine of 105 per cator, b. 1875] The first nurse educator ml or greater. Concentrations above this to write a textbook on psychiatric nurs- level have been thought to represent ev- ing. Nursing Mental Diseases was pub- idence of urinary tract infection, al- lished by Macmillan in 1920 and was though infection may be present at the standard text for psychiatric nurs- much lower levels. ing for two decades. bacteroid (ba˘kЈte˘r-oyd) [Љϩeidos, Bainbridge effect (ba¯nЈbrı˘jЉ) Bainbridge form, shape] 1. Resembling a bacte- reflex. rium. 2. A structurally modified bacte- baker [AS. bacan, cook by dry heat] Two rium. or more electric lamps mounted in semi- Bacteroides (ba˘k-te˘r-oydЈe¯z) A genus of circular containers used for applying gram-negative, anaerobic, non–spore- heat to various parts of the body. They forming bacilli that forms most of the in- are also called electric light bakers. testinal flora and may be found in Baker’s cyst [William M. Baker, Brit. smaller numbers on the oral, upper res- surgeon, 1839–1896] A synovial cyst piratory, and genital mucous mem- (pouch) arising from the synovial lining branes. Members of the species release of the knee. It occurs in the popliteal an endotoxin that contributes to tissue fossa. destruction. They are often found in ab- BAL British antilewisite; bronchoalveolar scesses or in infections in which gas is lavage. found, e.g., on radiographic studies. All Balamuthia mandrillaris (ba˘lЉa˘-moothЈe¯- species multiply rapidly in necrotic tis- a˘ma¯nЉdrı˘l-a¯rЈı˘s) [NL.] An opportun- sue; infections that start in the colon, istic amoeba that lives in soil and water. e.g., may spread to neighboring tissues It can cause a potentially fatal infection or the bloodstream producing intra-ab- of the brain and meninges, esp. in those dominal abscesses, peritonitis or septi- with immunosuppressive illnesses. cemia. balan- SEE: balano-. B. fragilis A species that may pro- balance (ba˘lЈa˘ns) [L. bilanx] 1. Scale; a duce life-threatening infections in blood device for measuring weight. 2. A state vessels, the peritoneum, or the pelvis. of equilibrium; condition in which the short baculovirus (ba˘kЉu¯-lo¯-vı¯Јru˘s) [L. bacu- intake and output of substances such as standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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ONE WAY VALVE

O2 RESERVOIR MASK

BAG

O2 SUPPLY

BAG MASK DEVICE

water and nutrients are approx. equal. take and excretion of a specific nutrient. SEE: homeostasis. 3. Coordination and The balance may be negative when an stability of the body in space. Normal excess of the nutrient is excreted or pos- balance depends on information from itive when more is taken in than ex- the vestibular system in the inner ear, creted. from other senses such as sight and nitrogen b. The difference between touch, from proprioception and muscle the amount of nitrogen ingested and movement, and from the integration of that excreted each day. If intake is these sensory data by the cerebellum. greater, a positive balance exists; if less, acid-base b. The chemical equilib- there is a negative balance. rium that maintains the body’s pH at balance beam SEE: under beam. about 7.40; i.e., at the concentration of balance board A device usually consist- hydrogen ions that is most favorable to ing of a padded platform mounted on a routine cellular metabolic processes. curved base. It is commonly used in The equilibrium is maintained by the therapy with children having central action of buffer systems of the blood and nervous system deficits to facilitate the the regulatory (homeostatic) functions development of appropriate equilib- of the respiratory and urinary systems. rium-related postural reflexes. It is also Disturbances in acid-base balance re- used in patients/clients of all ages to sult in acidosis or alkalosis. SEE: pH. stimulate lower extremity and trunk analytical b. A very sensitive scale proprioception and kinesthetic sense. used in chemical analysis. balance disorder Any condition that af- fluid b. Regulation of the amount of fects a person’s ability to feel steady liquid in the body. A negative fluid bal- while walking, sitting, standing, rest- ance (a “fluid deficit”) may occur when ing, working, or turning. Some common fluids are lost by vomiting, diarrhea, examples include disease of the laby- bleeding, or diaphoresis. Fluid overload rinth of the ear, cerebellar strokes, and may result from the excessive adminis- seasickness. tration of intravenous fluids, or in dis- Balance Error Scoring System ABBR: eases marked by impaired fluid excre- BESS. A modification of the Romberg tion, such as congestive heart failure, test that assesses a patient’s ability to cirrhosis, or renal failure. SEE: dehy- maintain postural stability following dration; diuresis; fluid replacement; and traumatic brain injury. The test is per- entries beginning with the words fluid formed in two stages. The first is per- volume. formed on a solid surface; the second is Treatment of fluid imbalances de- performed on a soft surface such as pends on the cause; the patient’s car- thick foam. Points are deducted for “er- diac, renal, and hepatic function; mea- rors” (loss of balance or sway) during sured serum electrolytes; and acid-base testing. Pretest results are compared to balance. post-test results to determine the mag- Useful means of gauging changes in nitude of impairment following injury. fluid balance are 1) to measure fluid in- balance training Exercises that improve puts and outputs; or 2) to measure day- a person’s agility and gait stability to-day variations in body weight. while preventing falls. These include short metabolic b. Comparison of the in- stepping over obstacles on a rough or standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh balanic 235 Balint’s syndrome base of rh

random surface, rapidly shifting direc- tion while walking, developing core muscle strength, and improving ankle strength and lower extremity proprio- ception. balanic (ba˘-la˘nЈı˘k) [Gr. balanos, glans] Pert. to the glans clitoridis or glans pe- nis. balanitis (ba˘l-a˘-nı¯Јtı˘s) [Љϩitis, inflam- mation] Inflammation of the skin cov- ering the glans penis. b. xerotica obliterans Sclerotic and atrophic patches on the skin of the penis that can cause narrowing of the urinary meatus and phimosis. The cause is chronic balanoposthitis, and the condi- tion is associated with penile lichen sclerosis (e.g., circumcision for phimo- sis). ϫ TREATMENT: High-dose topical ster- BALANTIDIUM COLI ( 400) oids or long courses of antibiotics are Edge of cell appears indistinct because of given. cilia (ϫ400) balanitis circinata A clearly defined, painless red lesion on the skin of the glans penis. It often accompanies poly- out hair] Lack of or partial loss of hair arthritis and conjunctivitis as part of a on the head. SEE: alopecia. triad sometimes seen in Reiter’s syn- male pattern b. Baldness in the male drome. SEE: Reiter’s syndrome. due to influence of the male hormone balano-, balan- (ba˘lЈa˘-no¯) [Gr. balanos, testosterone. Genetic predisposition is glans] Combining forms meaning glans also a factor, and baldness does not usu- penis or glans clitoridis. ally occur in males having no familial balanocele (ba˘lЈa˘-no¯-se¯lЉ)[Љϩkele, tendency to become bald. Minoxidil or tumor, swelling] Protrusion of the finasteride has helped stimulate glans penis through a rupture of the growth of hair in some individuals. prepuce. SEE: illus. balanoplasty (ba˘lЈa˘-no¯-pla˘sЉte¯) [Љϩ plassein, to form] Plastic surgery of the glans penis. balanoposthitis (ba˘lЉa˘-no¯-po˘s-thı¯Јtı˘s) [Љ ϩ posthe, prepuce, ϩ itis, inflamma- tion] Balanitis. balanopreputial (ba˘lЉa˘-no¯-pre¯-pu¯ Јshe¯-a˘l) Pert. to the glans penis and prepuce. balanorrhagia (ba˘lЉa˘-no˘-ra¯Јje¯-a˘) [Љϩ rhegnynai, burst forth] Balanitis with pus formation. balantidial (ba˘l-a˘n-tı˘dЈe¯-a˘l) Pert. to Bal- antidium, a genus of protozoa. balantidiasis (ba˘lЉa˘n-tı˘-dı¯Јa˘-sı˘s) Infec- tion of the large intestine by Balanti- dium coli. SYMPTOMS: Symptoms include ab- dominal pain, diarrhea, vomiting, weakness, and weight loss. TREATMENT: Treatment consists of tetracyclines, metronidazole, or paro- momycin. SYN: balantidal dysentery. Balantidium (ba˘l-a˘n-tı˘dЈe¯-u˘ m) [Gr. bal- antidion, a bag] A genus of ciliated pro- tozoa. A number of species are found in the intestines of both vertebrates and invertebrates. MALE PATTERN BALDNESS B. coli A normal parasite of swine and the largest protozoan parasite of humans. Balint’s syndrome (ba˘lЈı˘nts) [Rudolph It causes balantidiasis. SEE: illus. Balint, Hungarian physician, 1874– balanus (ba˘lЈa˘-nu˘s) [Gr. balanos, glans] 1929] Inability to scan the peripheral The glans penis or glans clitoridis. visual field and to grasp an object under short baldness (ba˘ldЈne˘s) [ME. ballede, with- visual guidance, and visual inattention; standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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usually due to bilateral occipitoparietal expand it or at the end of a catheter to lesions of the brain. prevent its removal. SEE: catheter; per- Balke test (ba˘lk) [Bruno Balke, contem- cutaneous transluminal coronary angio- porary Ger.-born U.S. physician] A test plasty. to determine maximum oxygen utiliza- balloon tamponade, nasal SEE: nose- tion. The subject walks on a flat (0% bleed for illus.; epistaxis. grade) treadmill at a constant rate of 3.5 ballottable (ba˘-lo˘tЈa˘-bl) Capable of iden- miles/hr for 2 min. The treadmill is in- tification by ballottement. clined 1% each successive minute until ballottement (ba˘l-o˘t-mo˘nЈ) [Fr. balloter, the subject is exhausted and unable to to toss about] 1. A palpatory technique continue. Oxygen utilization is mea- used to detect or examine a floating ob- sured throughout the test. ject in the body, such as an organ. It is used in examining the abdomen esp. The test is not suitable for those when ascites is present, and joint effu- with impaired musculoskeletal, sions. 2. A diagnostic maneuver in preg- cardiovascular, or respiratory systems. nancy. The fetus or a fetal part re- bounds when displaced by a light tap of the examining finger through the va- ball A spherical object. gina. b. of the foot The padded portion of balm (ba˘lm) [Gr. balsamon, balsam] the anterior extremity of the sole of the 1. Balsam. 2. A soothing or healing oint- foot. ment. b. of the thumb The thenar emi- b. of Gilead 1. Mecca balsam from nence of the thumb. Commiphora opobalsamum, probably Ј Ballard tool, Ballard score (ba˘l a˘rd) biblical myrrh. 2. Balsam fir, source of [Jeanne Ballard, American neonatolo- Canadian balsam. 3. Poplar bud resin. gist] A system for estimating newborn balneology (ba˘l-ne¯-o˘lЈo¯-je¯) [L. balneum, gestational age by rating physical and bath, ϩ Gr. logos,word, reason] The neuromuscular characteristics of matu- science of baths and bathing. rity. For infants born between 20 and 28 balneotherapy, balneotherapeutics weeks’ gestation, Ballard tools are more (ba˘lЉne¯-o¯-the˘rЈa˘-pe¯, −the˘rЉa˘-pu¯ Јtı˘ks) [Љ accurate than other systems of estimat- ϩ Gr. therapeia, treatment] The use of ing gestational age. Sixneuromuscular baths in treatment of disease. markers are assessed: posture, square Balo disease A rare, rapidly progressing window (degree of wrist flexion), arm re- form of multiple sclerosis. It differs from coil, popliteal angle (degree of knee flex- other multiple sclerosis variants, in that ion); scarf sign (ability to extend infant’s it is not characterized by relapses and arm across the chest past the midline); remissions. and heel-to-ear extension. Seven physi- balsam (bawlЈsa˘m) [Gr. balsamon, bal- cal characteristics are also evaluated: sam] A fragrant, resinous, oily exudate skin; lanugo; plantar creases; breast; from various trees and plants. It is used eye and ear; and genitals. Each factor is in topical preparations to treat irritated scored independently, and then an over- skin or mucous membrane. all sum is used to determine the gesta- A dark brown, viscid, res- tional age. The tool is most accurate if b. of Peru performed within the first 12 to 20 hr of inous liquid obtained from the bark of life or as soon as the baby’s condition the tree Myroxylon perierae or M. bal- stabilizes. samum. ball bearing feeder Mobile arm support. BALT bronchus-associated lymphoid tis- Ј sue. ballistics (ba˘-lı˘s tı˘ks) [Gr. ballein, to Ј Љ Ј throw] The science of the motion and Bancroft’s filariasis (ba˘n kro˘fts ,ba˘ng ) trajectory of projectiles, including bul- [Joseph Bancroft, Brit. physician, lets, bombs, rockets, and guided mis- 1836–1894] A filarial infection caused siles. by Wuchereria bancrofti. SEE: elephan- ballistocardiograph (ba˘-lı˘sЉto¯-ka˘rЈde¯-o¯- tiasis. gra˘f) [Љϩkardia, heart, ϩ graphein, band 1. A cord or tapelike tissue that con- to write] A mechanism for measuring nects or holds structures together. SEE: and recording the impact caused by the bundle; ligament; tract. 2. Any appli- discharge of blood from the heart at ance that encircles and applies pressure each beat and the resulting recoil. The around a body part or structure. 3. A minute movements of the body with segment of a myofibril. 4. A metal strip each heartbeat are recorded as they are or seamless band for attaching ortho- transmitted to the special platform that dontic appliances to teeth. 5. An imma- supports the subject. ture, unsegmented neutrophil seen in balloon [Fr. ballon, great ball] 1. To ex- some illnesses on a peripheral blood pand, dilate, or distend, as to expand a smear. An increase in bands indicates cavity by filling it with air or water in a that all mature neutrophils have been bag. 2. A flexible, expandable object that released from the bone marrow, usually short can be placed inside a vessel or cavity to during severe inflammation or infec- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh band 237 bandage base of rh

tion, and that the marrow is releasing applied to the distal, rather than the immature cells. proximal, portion of the limb. Ab. A dark-staining area in the cen- ankle b. Bandage in which one loop ter of a sarcomere in skeletal or cardiac is brought around the sole of foot and muscle, composed of overlapping myo- the other around the ankle; it is secured sin and actin filaments. SYN: aniso- in front or on the side. tropic disk. axilla b. A bandage with a spica-type Hb. A narrow band in the center of turn starting under the affected axilla, the A band of a sarcomere; it contains crossing over the shoulder of the af- only thick (myosin) filaments and is bi- fected side, and making the long loop sected by the M line. SYN: Engelmann’s under the opposite armpit. disk; H zone. back b. Open bandage to the back; Ib. In muscle fibers, the light band applied the same as a chest bandage, segment of a sarcomere, containing lat- the point being placed above the scapula eral ends of thin (actin) filaments. There of the injured side. is one to either side of the medial A Barton b. A double figure-of-eight band. SYN: isotropic b. bandage for the lower jaw. iliotibial b. A thick, wide fascial layer breast b. Suspensory bandage and from the iliac crest along the lateral compress for the breasts. thigh to the fascia around the lateral as- butterfly b. An adhesive bandage pect of the knee joint. Fibers from the formerly used in place of sutures to hold tensor fascia lata and gluteus maximus wound edges together. The application muscles insert into the proximal band. of filmy sterile adhesive strips has re- isotropic b. I band. placed this entity (e.g., Steri-Strips) bandage (ba˘nЈda˘j) [ME. bande, a band] buttocks b. T bandage. 1. A piece of soft, usually absorbent capeline b. A bandage applied to the gauze or other material applied to a head or shoulder or to a stump like a cap limb or other part of the body as a dress- or hood. ing. 2. To cover by wrapping with a chest b. Figure-of-eight (spica), piece of gauze or other material. many-tailed (Scultetus), or triangular Bandages are used to hold dressings (open-chest) bandage for the chest. in place, apply pressure to a part, im- circular b. A bandage applied in cir- mobilize a part, obliterate cavities, sup- cular turns about a part. port an injured area, and check hemor- cohesive b. A bandage made of ma- rhages. Types of bandages include terial that sticks to itself but not to roller, triangular, four-tailed, many- other substances; used to bandage fin- tailed (Scultetus), quadrangular, elastic gers and extremities or to build up pads. (elastic knit, rubber, synthetic, or com- cravat b. A triangular bandage binations of these), adhesive, elastic ad- folded to form a band around an injured hesive, newer cohesive bandages under part. various proprietary names, impreg- cravat b. for clenched fist A hand nated bandages (plaster of Paris, water- bandage to arrest bleeding or to produce glass [silica], starch), and stockinet. Use pressure. The wrist is placed on the cen- of a self-adhering, form-fitting roller ter of the cravat, one end is brought bandage facilitates bandaging by elimi- around over the fist and back to the nating the special techniques needed starting point, and the same procedure when ordinary gauze roller bandages is then repeated with the other end. The are used. SEE: illus.; sling. two ends are pulled tight, twisted, and carried around the fist again so that pressure is placed on the flexed fingers. Skin-to-skin contact will, if contin- cravat elbow b. A bandage in which uous, cause ulceration or infection. the elbow is bent about 45Њ and the cen- ter of the bandage is placed over the abdomen b. A single wide cravat or point of the elbow. One end is brought several narrow ones used to hold a around the forearm and the other end dressing in place or to exert a moderate around the upper arm; the bandage is pressure. pulled tight and tied. SEE: sling. Ace b. Trade name for a woven elas- cravat b. for fracture of clavicle A tic bandage available in various widths bandage in which one first puts a soft and lengths. It provides uniform pres- pad 2 ϫ 4 in (5.1 ϫ 10.2 cm) in the sure, yet permits joint movement. forepart of the axilla. A sling is made by adhesive b. A bandage made of ad- placing the point of the open bandage on hesive tape. the affected shoulder, the hand and amputation-stump b. An elastic wrist laid on it and directed toward the bandage applied to an amputation opposite shoulder, the point brought stump to control postoperative edema over and tucked underneath the wrist and to shape the stump. The elastic and hand. The ends are then lifted and bandage is applied in a recurrent or fig- the bandage is laid flat on the chest, the short ure-of-eight fashion with more pressure covered hand is carried up on the shoul- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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FIGURE-OF-EIGHTRECURRENT SPIRAL REVERSE

BANDAGE OF SHOULDER RECURRENT B. OF HEAD

TRIANGULAR BANDAGE OF ELBOW AND ARM TYPES OF BANDAGES

der, the ends are brought together in cravat b. sling A bandage used for the back and tied, the tightness being support of the hand or a fractured upper decided by how high the shoulder arm. The wrist is laid upon the center of should be carried. A cravat bandage is the cravat bandage, the forearm being then applied horizontally above the held at right angle, and the two ends are broad part of the elbow and tied over a carried around the neck and tied. SEE: pad on the opposite side of the chest. binder. Tightening this cravat retracts the crucial b. SEE: Tb. short shoulders and scapulae. demigauntlet b. A bandage that standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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BARTON

BUTTERFLY STRIPS

ANKLE STRAPPING

PILLOW SPLINT WRIST BANDAGE TYPES OF BANDAGES

covers the hand but leaves the fingers It usually is made of special weaves or uncovered. of material containing rubber and is ear b. T bandage for the ear. A piece used on swollen extremities or joints, on is sewn across the right angle of the T the chest in empyema, on fractured ribs, bandage. or on the legs to support varicose veins. elastic b. A bandage that can be Esmarch b. 1. Triangular bandage. short stretched to exert continuous pressure. 2. A rubber bandage wrapped about an standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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extremity, after elevation, from its pe- heel b. A triangular bandage used riphery toward the heart to force blood for the heel. out of the extremity prior to surgery or hip b. A triangular open bandage of to increase circulating blood. When it is the hip. A cravat bandage or other band removed for surgery, a proximal band is tied around the waist; the point of an- (e.g., pneumatic tourniquet) is left in other bandage is slipped under and place to prevent blood from returning to rolled or pinned directly above the po- the extremity. sition of the wound. The base is rolled up and the ends are carried around the thigh, crossed, and tied. If bandage is applied too tightly or immovable b. A bandage for immo- for a prolonged period, tissue dam- bilizing a part. age may occur because of decreased blood impregnated b. A wide-meshed supply to the part. bandage used to make molds or immo- bilize parts of the body. The material is eye b. A bandage for retaining dress- impregnated with a substance such as ings. The simple roller bandage for one plaster of Paris, which is applied wet eye or the monocle or crossed bandage. and hardens after drying. The binocular or crossed bandage for knee b. The knee cravat; triangular both eyes is 2 in ϫ 6 yd (5.1 and the figure-of-eight bandages are cm ϫ 5.49 m). used. figure-of-eight b. A bandage in leg b. A bandage applied by fixing which the turns cross each other like the the initial end by a circular or oblique figure eight; used to retain dressings, to fixation at the ankle or with a figure-of- exert pressure for joints (or to leave the eight of the foot and ankle. joint uncovered), to fixsplints for the many-tailed b. A bandage with split foot or hand, for the great toe, and for ends used for the trunk and limbs; a sprains or hemorrhage. piece of roller to which slips are stitched finger b. A roller bandage with in an imbricated fashion. SEE: four- oblique fixation at the wrist. tailed b.; Scultetus b. foot b. A triangular bandage in Martin’s b. SEE: Martin’s bandage. which the foot is placed on the triangle neck b. Neck spica: Bandage 21⁄2 with the base of the bandage backward in ϫ 8 yd (6.4 cm ϫ 7.3 m). Bandage and behind the ankle; the apexis car- following thyroid gland surgery: Roller ried upward over the top of the foot. The bandage 21⁄2 in ϫ 9 yd (6.4 cm ϫ 8.2 ends are brought forward, folded once or m). Adhesive plaster bandage for thy- twice, crossed and carried around the roidectomy: Used to hold dressing on foot, and tied on top. wound in place. A small dressing is ap- forearm b. A triangular open sling plied to center of strip and then applied bandage for support of the forearm. to back of neck. Special bandage: A dou- four-tailed b. A strip of cloth with ble-loop bandage of the head and neck each end split into two. The tails are made by using a figure-of-eight turn. used to cover prominences such as el- oblique b. A bandage applied bow, chin, nose, or knee. obliquely to a limb, without reverses. Fricke’s b. SEE: Fricke’s bandage. plaster b. A bandage stiffened with a groin b. A special bandage that is paste of plaster of Paris, which sets and most easily applied with the patient becomes very hard. SEE: cast (4). standing or lying on a pelvic rest. A pressure b. A bandage for applying spica bandage encircles the trunk and pressure; usually used to stop hemor- the crossing is placed either anteriorly rhage or prevent edema. or laterally. To bandage both groins, the protective b. A bandage that covers double spica is used. Such a double a part or keeps dressings in place. bandage is used principally in applying quadrangular b. A towel or large a plaster cast. handkerchief, folded variously and ap- hand b. A demigauntlet bandage plied as a bandage of head, chest, that secures a dressing on the back of breast, or abdomen. the hand. For thumb and hand, the as- recurrent b. A bandage over the end cending spica of the thumb, with spiral of a stump. of the hand, is used. A triangular band- reversed b. A bandage applied to a age is used for an open bandage of the limb in such a way that the roller is in- hand. A descending spica is used for the verted or half twisted at each turn so as thumb and figure-of-eight bandage for to make it fit smoothly and resist slip- an amputation stump or clenched fist. ping off the limb. SEE: spiral reverse b. head b. Any bandage applied to the roller b. A long strip of soft material, head, usually by wrap-around tech- usually from1⁄2 to 6 in (1.3 to 15.2 cm) nique, that uses bony prominences as wide and 2 to 5 yd (1.83 to 4.57 m) long, anchors or stays, and that carefully and rolled on its short axis. When rolled completely covers the site of injury or from both ends to meet at the center, it short the suture line. is called a double-headed roller. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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STEPS IN MAKING SLING FOR ARM

TRIANGULAR BANDAGES

rubber b. A rubber roller bandage porting any part but esp. the breast or used to apply pressure to prevent swell- scrotum. ing or hemorrhage of a limb. SEE: Es- Tb. A bandage shaped like the letter march b. T and used for the female perineum Scultetus b. A many-tailed bandage; and, in certain cases, the head. SYN: a succession of interlocking, overlap- buttocks b; T binder. ping bands originally used to enclose a tailed b. A bandage split at the end. rigid support against a fractured ex- triangular b. A square bandage tremity but now used without the splint folded diagonally. When folded, the or impregnated as a supporting band- several thicknesses can be applied to age of the abdomen or lower extremity. afford support. SYN: Esmarch b (1). SEE: Scultetus binder for illus. SEE: illus. shoulder b. An open bandage of the Velpeau b. A special immobilizing shoulder (spica bandage); a shawl band- roller bandage that incorporates the age of both shoulders and neck. shoulder, arm, and forearm. spica b. A bandage in which a num- bandemia (ba˘n-de¯Јme¯-a˘) [Band shape of ber of figure-of-eight turns are applied, cell nucleus ϩ Gr. haima, blood] The each a little higher or lower, overlap- presence of more than 6% of immature ping a portion of each preceding turn so neutrophils (band cells) in the blood. as to give an imbricated appearance. This finding indicates infection, inflam- This type of bandage is used to support, mation, or some other significant phys- to exert pressure, or to retain dressings ical stress. on the breast, shoulder, limbs, thumb, banding 1. The use of chemicals to stain great toe, and hernia at the groin. chromosomes so that the characteristic spiral b. A roller bandage to be ap- bands may be visualized. 2. The use of plied spirally. an appliance to encircle and apply pres- spiral reverse b. A technique of sure around a body part or structure. twisting, in its long axis, a roller band- Bandl’s ring (ba˘nЈd’ls) [Ludwig Bandl, age on itself at intervals during appli- Ger. obstetrician, 1842–1892] Ringlike cation to make it fit more uniformly. thickening and indentation at the junc- These reverse folds may be necessary tion of the upper and lower uterine seg- every turn or less often, depending on ments that obstructs delivery of the fe- the contour of the part being bandaged. tus. SEE: pathologic retraction ring. stellate b. A bandage that is bandwidth 1. In electronics the range of wrapped on the back, crossways. frequencies within which performance short suspensory b. A bandage for sup- with respect to some characteristic falls standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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HEAD EYE

TEMPLE

OPEN HAND

HIP GROIN

PALM

FOOT FIST STUMP

TRIANGULAR BANDAGES

within specified limits. 2. A measure- bank A stored supply of body fluids or tis- ment describing how much information sues for use in another individual (e.g., can be transmitted at once through a blood bank, eye bank, kidney bank, tis- communications medium. sue bank). Banisteriopsis caapi A tropical vine in- blood b. A place in which whole digenous to South America whose bark blood and certain derived components is boiled with other plants to make hal- are processed, typed, and stored until lucinogenic drinks, such as ayahuasca, needed for transfusion. Blood is mixed short or yage. with adenine-supplemented citrate standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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phosphate dextrose and is stored at 4ЊC the proximal phalanges to prevent hy- (39ЊF). Heparin may be used as a pre- perextension of the metacarpophalan- servative. Banked blood should be used geal joints. as soon as possible because the longer it median b. Contracture or constric- is stored, the fewer red blood cells sur- tion of the vesical neck of the bladder vive in usable form. Ninety percent of caused by benign hypertrophy or fibro- the red cells survive up to 14 days of sis of the prostate. It may obstruct the storage, but only 70% remain after 24 flow of urine from the bladder. days. bar- SEE: baro-. baragnosis (ba˘r-a˘g-no¯Јsı˘s) [Gr. baros, weight, ϩ a-, not, ϩ gnosis, knowl- It is mandatory that appropriate edge] The inability to estimate quality assurance measures are un- weights; the opposite of barognosis. It is dertaken to ensure that patients are prop- indicative of a parietal lobe lesion. SYN: erly identified at the bedside and at the abarognosis. blood bank, to prevent the transfusion of Ba´ra´ ny’s caloric test [Robert Ba´ra´ny, mismatched blood. Blood banking mea- Austrian physician and physiologist, sures are designed to minimize the risk of 1876–1936. Awarded Nobel Prize in communicable illnesses, including hepa- medicine in 1914] Evaluation of vestib- titis viruses and the human immunodefi- ular function by irrigation of the ear ca- ciency virus. nal with either warm or cold water. Nor- mally when warm water is used, cell b. A facility for keeping cells fro- rotatory nystagmus toward the irri- zen at extremely low temperatures. gated ear is observed; with cold water, These cells are used for investigating the normal response is rotatory nystag- hereditary diseases, human aging, and mus away from the irrigated ear. If ves- cancer. Collections of banked cells are tibular function is impaired, the re- kept by the National Institutes of sponse may be absent or diminished. If Health (the Human Genetic Mutant one ear is normal and the other is not, Cell Repository and the Aging Cell Re- a comparison between the two may be pository) and at the Cornell Institute for made. Medical Research. -barb (ba˘rb) [Fm. barb(iturate)] A com- sperm b. A repository for the storage bining form used in pharmacology to of semen used for artificial insemina- designate a barbiturate. tion. In some banks the specimen is fro- barbiturate poisoning SEE: poisoning, zen. SEE: Standard Precautions Appen- barbiturate. dix. barbiturates (ba˘r-bı˘tЈu¯-ra¯ts, ba˘r-bı˘- Bankart lesion (ba˘nЈka˘rt) An avulsion tu¯ Јra¯ts) A group of organic compounds injury of the anterior capsule and la- derived from barbituric acid (e.g., amo- brum of the glenoid rim of the gleno- barbital, phenobarbital, secobarbital) humeral joint. This lesion is a common that are used to treat and prevent con- reason for recurrent anterior glenohu- vulsions, relieve anxiety, or aid sleep. meral dislocations or anterior glenohu- Side effects include drowsiness, de- meral instability. pressed respirations, decreased blood Banna virus (ba˘nЈa˘, bahnЈnahЉ) [Fm. pressure, and decreased body tempera- Xishuang Banna (Yunnan province, ture. These drugs can also cause toler- China)] ABBR: BAV. The type species ance and dependence. SEE: Poisons and of the genus Seadornavirus (family Reo- Poisoning Appendix. viridae), isolated in Asia. It is transmit- barbotage (ba˘r-bo¯-to˘zhЈ) [Fr. barboter, ted to humans by tick bite and is impli- to dabble] Repeated injection and with- cated in some cases of encephalitis. drawal of fluid, as in gastric lavage, or Banting, Sir Frederick Grant (ba˘nЈtı˘ng) the administration of an anesthetic into Canadian scientist, 1891–1941; co-dis- the subarachnoid space by alternate in- coverer of insulin, with Charles Herbert jection of anesthetic and withdrawal of Best and John J. R. Macleod in 1922; cerebrospinal fluid into the syringe. Nobel laureate 1923. barbula hirci (ba˘rЈbu¯-la˘hı˘rЈsı¯) [L. bar- Banti’s syndrome (ba˘nЈte¯z) [Guido bula, little beard, ϩ hircus, goat] Banti, It. physician, 1852–1925] A syn- 1. Hairs present on the ears. 2. Axillary drome combining anemia, splenic en- hair. largement, hemorrhage, and, ulti- bar code SEE: under code. mately, cirrhosis; secondary to portal bar code-enabled point of care technol- hypertension. ogy ABBR: BPOC. A form of keyless bar 1. A metal piece attaching two or data entry facilitating automatic iden- more units of a removable dental pros- tification and collection of data and al- thesis. 2. A rigid component of a splint lowing real-time confirmation of patient or brace. 3. A section of tissue that con- identity, medication taken, and dosage, nects two similar structures. time, and route of administration of the lumbrical b. A component of a hand medication. short splint that rests on the dorsal surface of baresthesia (ba˘r-e˘s-the¯Јze¯-a˘) [Gr. baros, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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weight, ϩ aisthesis, sensation] Sense plements of vitamin C. SEE: scurvy, in- of weight or pressure; pressure sense. fantile. bariatrics (ba˘rЉe¯-a˘Јtrı˘ks) [Љϩiatrike, TREATMENT: Therapy includes vita- medical treatment] The branch of med- min C and adequate daily intake of fruit icine that deals with prevention, con- juices (orange, grapefruit, tomato). trol, and treatment of obesity. Barlow’s test A maneuver designed to baricity (ba˘-rı˘sЈı˘-tı˘) The relative pres- detect subluxation or dislocation of the sure, density, or concentration of a gas hip. The examiner adducts and then ex- or a solution. Hyperbaric solutions have tends the legs. The examiner keeps his an increased density relative to a ref- or her fingers over the heads of the fe- erence substance (e.g., hyperbaric oxy- murs. A dysplastic joint will be felt to gen has a greater oxygen concentration dislocate as the femur leaves the ace- than the air we normally breathe). Hy- tabulum. pobaric solutions are less concentrated Barmah Forest virus (ba˘rЈma˘) [Barmah than a reference solution (e.g., an in- Forest, southeastern Australia] A virus jected drug can be made hypobaric rel- transmitted by mosquito bite that ative to serum or plasma by diluting it causes rash, fever, joint pain, and stiff- with sterile water). ness. It is found mostly in Australia and baritosis (ba˘rЉı˘-to¯Јsı˘s) Pneumoconiosis neighboring islands. caused by inhalation of barium dust. barn (ba˘rn) [Special use of barn] ABBR: barium (ba˘Јre¯-u˘ m) SYMB: Ba. A soft me- bn. A unit of area, employed chiefly in tallic element of the alkaline earth chemistry and physics, approximating group; atomic mass 137.373, atomic the size of the nucleus of a uranium number 56. atom. One barn ϭ 10-24 sq cm. b. sulfate A radiopaque contrast me- baro-, bar- [Gr. baros, weight] Combin- dium used in radiographic studies of the ing forms meaning weight or pressure. gastrointestinal tract. barognosis (ba˘r-o˘g-no¯Јsı˘s) [Љϩgnosis, barium compounds SEE: under com- knowledge] The ability to estimate pound. weights; the opposite of baragnosis. barium meal The ingestion of barium sul- barograph (ba˘rЈo¯-gra˘fЉ) A device used to fate to outline the esophagus, stomach, measure and record changes in atmo- and small intestines during x-ray or flu- spheric pressure. oroscopic examination. The exam may baroreceptor (ba˘rЉo¯-re¯-se˘pЈtor) A sen- be used as an alternative to endoscopy sory nerve ending stimulated by to diagnose reflux, dysphagia, peptic changes in pressure. Baroreceptors are disease, or other upper gastrointestinal found in the walls of the cardiac atria, conditions. Also called upper G.I. series. the vena cava, aortic arch. The barore- PROCEDURE: If the exam or proce- ceptors of the lung are stretch receptors dure does not follow a barium enema, that are stimulated by inflation. SYN: the patient should receive nothing by barostat; pressoreceptor. mouth after midnight on the night be- baroreflex (ba˘rЉo¯-re¯Јfle˘ks) [ЉϩL. re- fore the test. No food or liquids should flexus, bent back] Any of the reflexes be taken by mouth until the last image mediated or activated through a group is produced. If the test is done within a of nerves located in various blood ves- few days after a barium enema exami- sels in the intrathoracic and cervical ar- nation, it is important to be sure the co- eas and in the heart and its great ves- lon is free of barium, which could inter- sels. fere with visualization of the stomach baroscope (ba˘rЈo¯-sko¯p) [Љϩskopein, to and intestines. A cleansing enema the examine] An instrument that registers evening before the test may remove re- changes in the density of air. sidual barium from the colon. barostat (ba˘rЈo¯-sta˘tЉ) Baroreceptor. barium swallow Radiographic examina- barotitis (ba˘rЉo¯-tı¯Јtı˘s) Aerotitis. tion of the esophagus during and after barotrauma (ba˘rЉo¯-trawЈma˘) [Љϩ introduction of a contrast medium con- trauma, wound] Any injury caused by sisting of barium sulfate. Structural ab- a change in atmospheric pressure be- normalities of the esophagus (such as tween a potentially closed space and the strictures or tumors) and vessels (such surrounding area. SEE: aerotitis; baro- as esophageal varices) may be demon- titis; bends. strated. barratry (ba˘rЈa˘-tre¯) The practice of en- barium test SEE: enema, barium; barium couraging or sponsoring legal actions, meal;barium swallow. esp. frivolous or unnecessary lawsuits. Barlow’s disease (bahrЈlo¯z dı˘-ze¯zЈ) [Sir Barr body (ba˘r) [Murray L. Barr, Cana- Thomas Barlow, Brit. physician, 1845– dian anatomist, b. 1908] Sexchromatin 1945] A deficiency disease due to lack mass seen within the nuclei of normal of vitamin C (ascorbic acid). It occurs in female somatic cells. According to the both breast-fed and bottle-fed babies Lyon hypothesis, one of the two X chro- (usually between 6 and 12 months of mosomes in each somatic cell of the fe- short age) who fail to receive adequate sup- male is genetically inactivated. The standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Barr body represents the inactivated X barrier cream A topical compound for chromosome. limiting or preventing contact with ir- barrel chest SEE: under chest. ritants such as allergens, parasites, or barren [O. Fr. barhaine, unproductive] toxins. Sterile; incapable of producing off- barrier-free design An approach to plan- spring. ning and designing living environments Barrett’s esophagus (ba˘rЈe˘ts) [Norman that emphasizes accessibility and use R. Barrett, Brit. surgeon, 1903–1979] by persons with functional limitations. Replacement of the squamous epithe- SEE: universal design. lium of the distal esophagus with met- Barthel index (ba˘rЈthe˘l) A widely used aplastic columnar epithelium as a re- functional assessment of activities of sult of chronic exposure of the daily living. It assesses a person’s abil- esophagus to stomach acid. The patho- ity to perform feeding, transfers, per- logical changes usually occur after sonal grooming and hygiene, toileting, many years of gastroesophageal reflux walking, negotiating stairs, and con- disease and are occasionally followed by trolling bowel and bladder functions. adenocarcinoma of the distal esopha- Bartholin’s abscess (ba˘rЈto¯-lı˘nz) [Cas- gus. SEE: gastroesophageal reflux dis- par Bartholin, Danish anatomist, 1655– ease. 1738] An abscess that develops when barrier (ba˘rЈe¯-e˘r) [O. Fr. barriere] 1. An Bartholin’s glands become occluded in obstacle, impediment, obstruction, an acute inflammatory process. boundary, or separation. 2. A device Bartholin’s cyst Cyst commonly formed (e.g., a glove, mask, or drape) used to in chronic inflammation of Bartholin’s limit potentially infectious contact be- glands. tween health care providers and pa- Bartholin’s ducts Large ducts of the sub- tients. lingual salivary gland. They parallel architectural b. Any limitation in the Wharton’s duct. design of facilities that restricts their Bartholin’s gland One of two small com- access and use by persons with disabil- pound mucous glands located one in ities. each lateral wall of the vestibule of the blood-brain b. ABBR: BBB. Special vagina, near the vaginal opening at the characteristics of the capillary walls of base of the labia majora. the brain that prevent potentially bartholinitis (ba˘rЉto¯-lı˘n-ı¯Јtı˘s) [Bartholin harmful substances (including many ϩ Gr. itis, inflammation] Inflamma- medications) from moving out of the tion of Bartholin’s gland. bloodstream into the brain or cerebro- Barth’s syndrome (ba˘rth) [P.G. Barth, spinal fluid. It consists of either the b. 1944] A rare X-linked disorder in perivascular glial membrane or the vas- which affected boys have reduced mus- cular endothelium or both. cle tone, cardiomyopathy, learning dis- chemical b. 1. The chemical charac- abilities, a low white blood cell count, teristics of certain areas of the body that and a diminished ability to fight infec- oppose colonization by microorganisms. tions. Examples are the acidity of gastric juice Bartlett-Biedel syndrome (ba˘rtЈle˘t- and urine, which prevent colonization be¯dЈı˘l) An inherited cause of obesity by most disease-causing germs. 2. A that usually manifests itself in child- contraceptive cream, foam, jelly, or sup- hood. It is caused by a mutation in a sin- pository that contains chemical sper- gle gene. micides. Barton, Clara (ba˘rЈto˘n) U.S. nurse, placental b. The selective ability of 1821–1912. Founder of the American the placental membranes to limit the National Red Cross. She aided the exchange of substances between the wounded in the Civil War and was a maternal and fetal circulations. Al- contemporary of Florence Nightingale. though water, oxygen and other gases, Bartonella (ba˘rЉto¯-ne˘lЈa˘) [A. L. Barton, drugs, needed nutrients (e.g., glucose S. Amer. physician, 1871–1950] A ge- and amino acids), maternal antibodies, nus of gram-negative bacteria of the and viruses cross the barrier unimpai- family Rickettsia, that cause infections red, large molecules, red blood cells, that are transmitted to humans from bacteria, and protozoa cross it only animal hosts (zoonoses). through breaks in placental integrity. B. bacilliformis A species that causes primary radiation b. A wall or par- bartonellosis. tition that shields the radiographer and B. elizabethae The organism previ- others from direct exposure to x-rays. It ously known as Rochalimaea elizabe- must be capable of adequate lead equiv- thae. It causes an infection that has alency to reduce the maximum possible been identified most often in immuno- x-ray beam strength to the level of back- compromised patients with HIV infec- ground exposure. tion. It has been implicated as a cause secondary radiation b. A wall or par- of bacteremia and endocarditis. tition that shields against scattering or B. henselae A species that, together short leakage of x-rays. with B. quintana, causes acute and per- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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sistent bacteremia and localized tissue reasonable fear that one’s child will be- infection, which may lead to bacillary come obese. The allowed diet may be in- angiomatosis, bacillary peliosis, and sufficient to support the child’s growth other inflammatory responses. This in- and development needs. fection can occur in immunocompro- basal (ba¯Јsa˘l) 1. Pert. to the base. 2. Of mised and immunocompetent individu- primary importance. 3. Continuously als but is seen most frequently in active or present (e.g., in insulin secre- patients with HIV infection. B. hense- tion). lae, previously named Rochalimaea basal body A small granule usually henselae, is the causative agent of cat present at the base of a flagellum or cil- scratch disease. Therapy for bacillary ium in protozoa. SYN: basal granule; angiomatosis is oral antibiotics. SEE: blepharoplast. bacillary angiomatosis; disease, cat basal cell nevus syndrome A rare auto- scratch; peliosis, bacillary. somal dominant disorder which causes B. quintana The species previously basal cell carcinomas to develop at an known as Rochalimaea quintana; it is early age, a propensity for medulloblas- spread by the body louse. During World tomas, skeletal anomalies, and other War I, it caused epidemics of trench fe- findings. ver in battlefield troops. Together with basal ganglia Four masses of gray matter B. henselae, it may cause bacillary an- located deep in the cerebral hemi- giomatosis, bacillary peliosis, and other spheres: caudate, lentiform, and the inflammatory diseases. Treatment in- claustrum. Parkinsonism and Hunting- cludes oral antibiotics. SEE: trench fe- ton’s chorea are diseases of the basal ver. ganglia, which are key components in bartonellosis (ba˘rЉto¯-ne˘l-o¯Јsı˘s) [Barto- the formation of habits and unconscious nella ϩ Gr. osis, condition] A disease motor programs. The caudate and len- caused by Bartonella bacilliformis.Itis tiform nuclei and the fibers of the inter- transmitted by female sandflies (Phle- nal capsule that separate them consti- botomus) endemic in the valleys of the tute the corpus striatum. The function Andes Mountains in Peru, Ecuador, and of the basal ganglia is complex. They southwest Colombia. It occurs in two contribute to some of the subconscious clinical forms: Oroya fever, which, if un- aspects of voluntary movement such as treated, has a 10% to 90% fatality rate; accessory movements and inhibiting and verruga peruana. SYN: Carrion’s tremor. They do not initiate movement disease. but rather provide coordination of com- TREATMENT: The causative organ- plexmotor circuits. Neurotransmitters ism responds to several antibiotics, but that affect the basal ganglia are acetyl- erythromycin, azithromycin, or doxycy- choline, dopamine, gamma-aminobu- cline are often used as first line thera- tyric acid (GABA), and serotonin. pies. Quinolones and sulfa drugs are basal metabolic rate ABBR: BMR. The also effective. metabolic rate as measured 12 hr after Bartter’s syndrome (ba˘rЈte˘rz) [Frederic eating, after a restful sleep, no exercise Crosby Bartter, U.S. physician, 1914– or activity preceding testing, elimina- 1983] Hyperplasia of the juxtaglomer- tion of emotional excitement, and in a ular cells of the kidney, hypokalemic al- comfortable temperature. It is usually kalosis, and hyperaldosteronism with- expressed in terms of kilocalories per out a rise in blood pressure. It usually square meter of body surface per hour. occurs in children and may be accom- It increases, for example, in hyperthy- panied by growth retardation. Etiology roidism. is unknown. Affected patients are basal rate In patient-controlled analgesia treated with potassium supplements (PCA), the amount of pain reliever that and angiotensin-converting enzyme in- is infused independent of any demands hibitors or potassium-sparing diuretics. made by the patient. The basal rate of Baruch’s law (ba˘rЈooks) [Simon Baruch, drug infusion in PCA is often set at zero Ger.-born U.S. physician, 1840–1921] to ensure that all doses of pain medica- The theory that water has a sedative ef- tion are dictated by the patient’s indi- fect when its temperature is the same vidual needs for pain control. High as that of the skin and a stimulating ef- basal rates may occasionally result in fect when it is below or above the skin narcotic overdose. Basal rates above temperature. zero are used under carefully controlled bary- [Gr. barys, heavy] Prefixindicat- circumstances to facilitate rest or sleep. ing heavy, dull, hard. basal ridge An eminence on the lingual baryglossia (ba˘r-ı˘-glo˘sЈe¯-a˘) [Gr. barys, surface of the incisor teeth, esp. the up- heavy, ϩ glossa, tongue] Slow, thick per ones. It is situated near the gum. utterance of speech. SYN: cingulum (2). barylalia (ba˘r-ı˘-la¯Јle¯-a˘) [Љϩlalia, base [Gr. basis, base] 1. The lower part speech] Indistinct, husky speech due to of anything; the supporting part. 2. The imperfect articulation. principal substance in a mixture. 3. Any short baryophobia (ba˘rЉ˘-oı ¯-fo¯Јbe¯-a˘) The un- substance that combines with hydrogen standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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ions (protons); a hydrogen ion acceptor mostly from Africa, South America, and (Bronsted base). Strong bases (such as tropical Asia. sodium hydroxide or lye) are corrosive Basidiomycetes (ba˘-sı˘dЉe¯-o¯-mı¯-se¯Јte¯z) to human tissues. Whether an unknown In one system of taxonomy, a class of the chemical compound is a base or an acid true fungi that contains mushrooms, may be determined by the color pro- bracket fungi, the plant parasites rusts duced when it is added to a solution con- and smuts, and the human parasite taining an indicator. SYN: alkali. SEE: Cryptococcus. This class is equivalent to acid; pH. 4. A substance that can donate the phylum Basidiomycotina in another a pair of electrons (Lewis base). system of taxonomy. Mushroom toxins cavity b. In dentistry, the lining ma- may be lethal to humans if ingested, terial placed in a cavity preparation, and spores of these fungi may cause al- such as zinc phosphate cement, zinc ox- lergic asthma. ide-eugenol cement, glass ionomer ce- Basidiomycotina (ba˘sЉı˘d-e¯-o¯-mı¯Љko¯- ment, or calcium hydroxide along with te¯nЈa˘) [NL.] In one system of taxon- small amounts of other medicinal or ad- omy, a phylum of the true fungi. It is hesive materials. equivalent to the class Basidiomycetes denture b. That part of the denture in another system of taxonomy. made of metal or resin, or both, that basilar (ba˘sЈı˘-la˘r) [L. basilaris] Basal supports the artificial teeth and rests on (1). abutment teeth or the residual alveolar basilateral (ba¯Љse¯-la˘tЈe˘r-a˘l) [ЉϩL. lat- ridge. eralis, pert. to the side] Both lateral nucleic b. In molecular biology, a and basilar. ring-shaped chemical (either a purine or basilic (ba˘-sı˘lЈı˘k) [L. basilicus] Promi- a pyrimidine) that specifies the coded nent, important. genetic structure of DNA and RNA. b. vein The large vein on the inner DNA is made up of the bases adenosine, side of the biceps just above the elbow. cytosine, thymine, and guanine; RNA It is usually chosen for intravenous in- contains uracil, in place of thymine. jection or withdrawal of blood. Basedow’s disease (ba˘zЈe¯-do¯z) [Karl A. basin An open, bowl-like container for von Basedow, Ger. physician, 1799– holding liquids. It may be shaped to fit 1854] Graves’ disease. around a structure. baseline (ba¯sЈlı¯n) A known or initial emesis b. A kidney-shaped basin value with which subsequent determi- that can fit close to the neck so vomitus nations of what is being measured can may be collected. be compared (e.g., baseline temperature basio-, basi- [Gr. basis, base] Combining or blood pressure). forms meaning base or foundation. baseplate (ba¯sЈpla¯t) A temporary, pre- basion (ba¯Јse¯-o˘n) The midpoint of the formed shape made of wax, metal, or anterior border of the foramen mag- acrylic resin that represents the base of num. a denture; used in assessing the rela- basiphobia (ba¯Љse¯-fo¯Јbe¯-a˘) [Gr. basis, a tions of maxillary-mandibular teeth or stepping, ϩ phobos, fear] Fear of for placement of artificial teeth in den- walking. ture preparation. basis (ba¯Јsı˘s) pl. bases [L., Gr.] The basi- [Gr. basis, base] SEE: basio-. base of a structure or organ. basiarachnoiditis (ba¯Љse¯-a˘-ra˘kЉnoy-dı¯Јtı˘s) basket [ME.] A netlike terminal arbori- [Gr. basis, base, ϩ arachne, spider, ϩ zation of an axon (or its collateral) of a eidos, form, shape, ϩ itis, inflamma- basket cell that forms a network about tion] Inflammation of the arachnoid the cell body of a Purkinje cell. membrane at the base of the brain. basophil, basophile (ba¯Јso¯-fı˘l, −fı¯lЉ) [Gr. basic 1. In chemistry, possessing the basis, base, ϩ philein, to love] 1. A properties of a base. 2. Fundamental. cell or part of a cell that stains readily Basic Trauma Life Support ABBR: with basic dyes such as methylene blue. BTLS. A continuing education course 2. A type of cell found in the anterior sponsored by the American College of lobe of the pituitary gland. It usually Emergency Physicians for emergency produces corticotropin (ACTH), the hor- medical providers to develop the skills mone that stimulates the adrenal cortex of rapid initial assessment, manage- to secrete cortisol. 3. One type of gran- ment of life-threatening injuries, and ulocytic white blood cell. Basophils early transport of the traumatized pa- make up less than 1% of all leukocytes tient to the most appropriate facility. but are essential to the innate immune Basidiobolus (ba˘sЉı˘d-e¯-o˘bЈo˘-lu˘s) [NL] A response of inflammation because they genus of filamentous fungi (of the class release histamine and other chemicals Zygomycetes) found in soil, decaying that dilate blood vessels and make cap- vegetation, and the spore of amphibi- illaries more permeable. SYN: baso- ans, bats, and reptiles. It can cause cu- philic leukocyte. SEE: blood for illus. taneous, subcutaneous, gastrointesti- basophilia (ba¯-so¯-fı˘lЈe¯-a˘) 1. A pathologi- nal, and blood vessel infections in cal condition in which basophilic eryth- short humans. Human infections are reported rocytes are found in the blood. 2. A con- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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dition marked by a high number of bed b. A bath for a patient confined basophilic leukocytes in the blood. to bed. basophilic (ba¯-so¯-fı˘lЈı˘k) Pert. to baso- PATIENT CARE: All necessary equip- phils or to the propensity to stain with ment is assembled, the room tempera- basic dyes. ture is adjusted to a comfortable level, basophilism (ba¯-so˘fЈı˘-lı˘zm) A condition and the room is checked for drafts. marked by an excessive number of ba- While shielding the patient, the health sophils in the blood. care provider removes the top covers pituitary b. Cushing’s syndrome. and replaces them with a bath blanket Bassen-Kornzweig syndrome (ba˘sЈe˘n- for the patient’s physical warmth. The ko˘rnЈzvı¯g) [Frank A. Bassen, U.S. phy- patient’s ability to bathe independently sician, b. 1903; Abraham L. Kornzweig, is assessed, and the patient is encour- U.S. physician, b. 1900] Abetalipopro- aged to do so to the extent possible and teinemia. permitted. Bathing may be accom- Bassini’s operation (ba˘-se¯Јne¯z) plished using prepackaged disposable [Edoardo Bassini, It. surgeon, 1844– cloths impregnated with a no-rinse 1924] A specific surgical procedure for cleansing agent (heated in the micro- inguinal hernia. wave), various sized towels wet in warm BAT brown adipose tissue. water and wrung well prior to applica- batch analysis An analysis in which all tion or a basin of water which should be of the samples collected for a specific, comfortably warm, 110Њ to 120ЊF (43.3Њ nonemergent assay undergo the same to 48.1ЊC), and changed as often as nec- testing process at the same time or se- essary to maintain the desired temper- quentially. By contrast, samples col- ature and to permit thorough rinsing. lected for stat analyses are not saved in The entire body, including the perineal batches. These analyses are performed area and genitalia, is washed, rinsed (if instead whenever individual specimens soap used), and dried thoroughly, one are received. area at a time. Although traditional Bates exercises [William H. Bates, U.S. bathing has been done from the head ophthalmologist, 1881–1931] A series downward toward the toes, with geni- of systematic vision exercises devised in talia bathed last, use of prepared dis- the 19th century to relax, tone, and posable cloths or towels for separate ar- strengthen the eye muscles. eas allows the care provider to bath the bath [AS. baeth] The medium and patient in any order desired. (e.g., pa- method of cleansing the body or any tients with dementias may become up- part of it, or treating it therapeutically set by face-washing, but accept bathing as with air, light, vapor, or water. The that begins with upper or lower extrem- temperature of the cleansing bath for a ities). Whatever method is employed, bed patient should be about 95ЊF (35ЊC) the patient should remain covered ex- with a room temperature of 75Њ to 80ЊF cept for the area being bathed. After the (23.9Њ to 26.7ЊC). bath, lotion may be applied to the skin THERAPEUTIC EFFECT: Warm and (if not contraindicated), a clean gown is hot baths and applications soothe both applied, and the patient’s hair is the mind and the body. Gradually ele- combed or brushed. Oral hygiene is per- vated hot tub and vapor baths relaxall formed in conjunction with bathing. The the muscles of the body. Hot baths pro- bed is usually remade with clean linens mote vasodilation in the skin, drawing at this time or following removal of the blood from the deeper tissues, and also patient from bed to chair. The health help to relieve pain and stimulate care provider assists as needed with any nerves. Cold baths and applications ab- part of this care. When bathing obese stract heat and stimulate reaction, esp. patients, drying of skin folds may be fa- if followed by brisk rubbing of the skin. cilitated by using a hand-held hair dryer Cold constricts small blood vessels on warm, taking care not to injure the when applied locally. SEE: hydrother- skin in any way. Research has shown apy. that bathing patients in ICU settings alcohol b. Application of a diluted al- with disposable clothes saturated with cohol solution to the skin as a stimulant 2% chlorhexidine gluconate reduces and defervescent. contamination rates from vancomycin- alkaline b. A bath in which 8 oz (227 resistant enterococci (VRE), a common g) of sodium bicarbonate or washing nosocomial infection, for both patients’ soda is added to 30 gal (114 L) of water. skin and the ICU environment (object alum b. A bath using alum in wash- surfaces, health-care providers’ hands, ing solution as an astringent. et al), leading to less frequent infection. aromatic b. A bath to which some Additional hair care (shampoo, wet and volatile oil, perfume, or some herb is dry shampoo products, styling) is pro- added. vided as necessary, following protocols. astringent b. Bathing in liquid con- bland b. Bath containing substances short taining an astringent. such as starch, bran, or oatmeal for the standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bath 249 bath base of rh

relief of skin irritation; an emollient in water from 105Њ to 120ЊF (40.6Њ to bath. 48.9ЊC) for 1 to 2 min. brine b. Saline b. kinetotherapeutic b. A bath given bubble b. A bath in which the water for underwater exercises of weak or par- contains many small bubbles produced tially paralyzed muscles. mechanically as by an air pump or lukewarm b. A bath in which the pa- chemically by bubble bath preparations. tient’s body except the head is im- mersed in water from 94Њ to 96ЊF (34.4Њ to 35.6ЊC) for 15 to 60 min. Perfumes used in bubble baths are medicated b. A bath to which sub- frequently the cause of vaginitis stances such as bran, oatmeal, starch, and skin irritation, esp. in children. sodium bicarbonate, Epsom salts, pine products, tar, sulfur, potassium per- carbon dioxide b. An effervescent manganate, and salt are added. saline bath consisting of water, salts, milk b. A bath taken in milk for emol- and carbon dioxide (CO2). The natural lient purposes. CO2 baths are known as Nauheim mud b. The use of mud in order to baths. apply moist heat. cold b. A bath in water at a temper- mustard b. A stimulative hot foot ature below 65ЊF (18.3ЊC). bath consisting of a mixture of 1 table- colloid b. Emollient bath. spoon (15 ml) of dry mustard in a quart complete bed b. A bath in which the (946 ml) of hot water added to a pail or entire patient is bathed. SYN: full bath. large basin filled with water of 100Њ to continuous b. A bath administered 104ЊF (37.8Њ to 40ЊC). for an extended period but seldom for Nauheim b. A bath in which the body longer than several hours. It is used in is immersed in warm water through treating hypothermia or hyperthermia which carbon dioxide is bubbled. and certain skin diseases. needle b. Whirlpool bath. contrast b. Alternate immersion of neutral b. A bath in which no circu- hands or feet in hot water (1 min) then latory or thermic reaction occurs, tem- cold water (30 sec) for a prescribed perature 92Њ to 97ЊF (33.3Њ to 36.1ЊC). length of time to promote circulation. neutral sitz b. Same as sitz bath, ex- The initial water temperature should be cept temperature is 92Њ to 97ЊF (33.3Њ to maintained throughout the bath, and 36.1ЊC) or for foot bath 104Њ to 110ЊF the bath should end with immersion in (37.8Њ to 40ЊC), duration 15 to 60 min. cold water. oatmeal b. A bath consisting of 2 to emollient b. A bath used for irrita- 3 lb (907 g to 1.4 kg) oatmeal added to tion and inflammation of skin and after 30 gal (114 L) water. erysipelas. SYN: colloid bath. SEE: glyc- oxygen b. A bath given by introduc- erin b.; oatmeal b.; powdered borax b.; ing oxygen into the water through a spe- starch b. cial device that is connected to an oxy- foam b. A tub bath to which an ex- gen tank. tract of a saponin-containing vegetable paraffin b. A bath used to apply top- fiber has been added. Oxygen or carbon ical heat to traumatized or inflamed dioxide is driven through this mixture limbs. The limb is repeatedly immersed to create foam. in warm paraffin, 118Њ to 126ЊF (47.8Њ to foot b. Immersion of the feet and legs 52.2ЊC), and quickly withdrawn until it to a depth of 4 in (10 cm) above the an- is encased in layers of the material. Par- kles in water at 98ЊF (36.7ЊC). affin may be applied with a paintbrush full b. Complete bed bath. for larger joints. glycerin b. A bath consisting of 10 oz powdered borax b. Bath consisting (300 ml) of glycerin added to 30 gal (114 of1⁄2 lb (227 g) added to 30 gal (114 L) L) water. water; 5 oz (150 ml) glycerin may be herb b. A full bath to which is added added. a mixture of 1 to 2 lb (454 to 907 g) of saline b. Bath given in artificial sea- herbs such as chamomile, wild thyme, water made by dissolving 8 lb (3.6 kg) of or spearmint tied in a bag and boiled sea salt or a mixture of 7 lb (3.2 kg) of with 1 gal (3.8 L) of water. sodium chloride and1⁄2 lb (227 g) of mag- hip b. Sitz bath. nesium sulfate in 30 gal (114 L) of wa- hot b. A tub bath with the water cov- ter. SYN: brine bath; salt bath; seawater ering the body to slightly above the nip- bath. ple level. The temperature is gradually salt b. Saline bath. raised from 98ЊF (36.7ЊC) to the desired sauna b. A hot, humid atmosphere degree, usually to 108ЊF (42.2ЊC). created in a small enclosed area by hot air b. Exposure of the entire body pouring water on heated rocks. except the head to hot air in a bath cab- seawater b. Saline b. inet. sedative b. A prolonged warm bath. hyperthermal b. A bath in which the A continuous flow of water as well as an short whole body except the head is immersed air cushion or back rest may be used. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bath 250 bay base of rh

sheet b. A bath given by wrapping thos, deep, ϩ phobos, fear] Abnormal the patient in a sheet previously dipped fear of depths; commonly refers to fear in water 80Њ to 90ЊF (26.7Њ to 32.2ЊC), of height or of looking down from a high and by rubbing the whole body with vig- place. orous strokes on the sheet. bathyanesthesia (ba˘th-e¯-a˘nЉe˘s-the¯Јze¯-a˘) shower b. Water sprayed down upon [Љϩan-, not, ϩ aisthesis, sensation] the body from an overhead source. Loss of deep sensibility. sitz b. The immersion of thighs, but- bathyesthesia (ba˘thЉe¯-e˘s-the¯Јze¯-a˘) [Љϩ tocks, and abdomen below the umbilicus aisthesis, sensation] A consciousness or in water. In a hot sitz bath the water is sensibility of parts of the body beneath first 92ЊF (33.3ЊC) and then elevated to the skin. 106ЊF (41.1ЊC). SYN: hip bath. bathyhyperesthesia (ba˘th-e¯-hı¯Љpe˘r-e˘s- sponge b. A bath in which the pa- the¯Јze¯-a˘) [Љϩhyper, above, ϩ ais- tient is not immersed in a tub but thesis, sensation] Excessive sensitivity washed with a washcloth, sponge, or an- of muscles and other deep body struc- tibacterial wipes. tures. starch b. A bath consisting of 1 lb bathyhypesthesia (ba˘thЉe¯-hı¯pЉe˘s-the¯Јze¯- (454 g) of starch mixed into cold water, a˘) [Љϩhypo, under, ϩ aisthesis, sen- with boiling water added to make a so- sation] Impairment of sensitivity in lution of gluelike consistency, then muscles and other deep body structures. added to 30 gal (114 L) of water. Batten disease (Ba˘tЈe˘n) [Frederick E. stimulating b. A bath that increases Batten, English ophthalmologist, 1865– cutaneous blood flow. SEE: cold b.; mus- 1918] The most common of the neuro- tard b.; saline b. nal ceroid lipofuscinoses (NCLs). This sun b. Exposure of all or part of the eponym is sometimes used as a syn- nude body to sunlight. onym for the entire class of NCLs. The disease is an autosomal recessive, neu- rodegenerative disorder that results Direct exposure of the skin to sun- from the excessive accumulation of light or other sources of ultraviolet lipid-protein complexes in the brain and energy increases the risk of skin cancer. eye. Early symptoms include the sud- den onset of visual impairment and sei- sweat b. A bath given to induce per- zures in childhood. Regression of devel- spiration. opmental milestones and dementia towel b. A bath given by applying precede premature death. towels dipped in water 60Њ to 70ЊF (15.6Њ battered child syndrome Physical abuse to 21.1ЊC) to the arms, legs, and anterior of a child by an adult or older sibling. and posterior surfaces of trunk, and SEE: abuse, child; shaken baby syn- then removing the towels and drying drome; Nursing Diagnoses Appendix. the parts. battered woman A woman who has been whirlpool b. A therapeutic stainless physically or sexually assaulted by her steel, fiberglass, or plastic tank that husband, partner, or former partner. uses turbines to agitate and aerate wa- Typically verbal abuse precedes physi- ter into which the body, or part of it, is cal violence. An escalating pattern of in- immersed. Tanks come in various sizes timidation and injury often results, to accommodate treatment of different sometimes ending in death. Frequently body parts (Hubbard and “low boy” women are reluctant to report this type tanks for full-body treatments or ex- of abuse because they feel trapped or tremity tanks for arm or leg treat- isolated. Women from any socioeco- ments). Water temperature selection nomic level may be affected. Shelters varies depending on the condition of the and support for battered women are patient and the desired therapeutic out- available in many locations. come. Cold whirlpools (ranging from battery [Fr. battre, to beat] 1. A device 50Њ–79ЊF) are useful in treating acute for generating electric current by chem- inflammation. Tepid whirlpools (79Њ– ical action. 2. A series of tests, proce- 92ЊF) are used to facilitate early thera- dures, or diagnostic examinations given peutic exercise. Neutral temperatures to or done on a patient. 3. The unlawful (92Њ–96ЊF) are generally indicated for touching of another without consent, treatment of wounds or for patients who justification, or excuse. In legal medi- have circulatory, cardiac, or sensory dis- cine, battery occurs if a medical or sur- orders or neurological changes in mus- gical procedure is performed without cle tone. Hot whirlpools (99Њ–110ЊF) are proper consent. SEE: assault; sexual ha- beneficial in relieving pain, increasing rassment. soft tissue extensibility, and treating Battle sign (ba˘tЈe˘l) [William Henry Bat- chronic conditions such as arthritis. In tle, Brit. surgeon, 1855–1936] Ecchy- general, whirlpool temperatures should mosis behind the ear; a physical finding not exceed 110Њ to 115ЊF because of risk in patients with basilar skull fracture. of burns. SYN: needle bath. bay (ba¯) An anatomical recess or depres- short bathophobia (ba˘thЉo¯-fo¯Јbe¯-a˘) [Gr. ba- sion filled with liquid. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh Bayes’ theorem 251 beat base of rh

Bayes’ theorem (ba¯z) [Thomas Bayes, sterilization equipment and in some di- Brit. mathematician, 1702–1761] A agnostic and therapeutic injections. statistical theorem concerned with an- beaded (be¯dЈe˘d) Referring to disjointed alyzing the probability that a patient colonies along the inoculation line in a may have a specific condition after di- streak or stab culture. agnostic testing. The theorem states beading (be¯dЈı˘ng) Alternating stretches that if a disease is very rare (the pretest of dilation and stenosis within an ar- probability is low), the patient is un- tery, usually only seen during angiog- likely to have that condition even with raphy. a positive diagnostic test. Conversely, beads, rachitic (be¯dz) Visible swelling when the pretest probability of a specific where the ribs join the costal cartilages, condition is very high, a negative test seen in rickets. SYN: rachitic rosary. result does not rule out the condition. beaker (be¯Јke˘r) A widemouthed glass Bayley Scales of Infant Development vessel for mixing or holding liquids. (Ba¯Јle¯) A standardized battery of tests beam 1. In nuclear medicine and radiol- used to provide information about the ogy, photons or atomic particles directed developmental status of children aged 2 from a point-source toward an object in to 42 months. The battery is designed to order to image or treat the object. 2. The indicate motor, mental, and behavioral part of an analytical balance to which levels based on performance and paren- the weighing pans are attached. 3. A tal reports. long, slender piece of wood, metal, or Baylisascaris procyonis (ba¯Љlı˘s-a˘sЈka˘-rı˘s plastic resin that acts as a support, e.g. pro¯Љse¯-o¯nЈ˘s,ı se¯Јo˘n) [NL. procyon, rac- in a dental appliance or other applica- coon, fm. Gr.] The raccoon roundworm. tions. Accidental consumption of roundworm balance b. In occupational and phys- eggs (e.g., by children who put contam- ical therapy, a 4-in-wide plank used to inated soil in their mouths) can result assess and improve balance and motor in encephalitis. coordination; it is usually elevated sev- Bazin’s disease (ba˘-za˘nzЈ) [Antoine P. E. eral inches from the floor. Bazin, Fr. dermatologist, 1807–1878] beam nonuniformity ratio ABBR: BNR. A chronic skin disease occurring in A measure of the homogeneity of a ther- young adult females; characterized by apeutic ultrasound wave, expressed as hard cutaneous nodules that break a ratio between the ultrasound unit’s down to form necrotic ulcers that leave average intensity (the metered output) atrophic scars. The disease is almost in- and the peak intensity within the out- variably preceded by tuberculosis, but put wave. A completely homogeneous the etiological relationship to that dis- wave is represented by a 1:1 BNR. ease is debated. SYN: erythema indur- atum. FDA regulations require that the BBT basal body temperature. BNR be clearly labeled on thera- BCAA branched-chain amino acids. peutic ultrasound units. A BNR of greater B-cell–mediated immunity SEE: immu- than 8:1 is considered to be potentially nity, humoral. harmful. BCG bacille Calmette-Gue´rin. bcl-2 Member of a family of oncogenes beard The hair on the face and throat. that is involved in tumor suppression. bearing down The expulsive effort of a Bcl-2 is an oncogene that is responsible parturient woman in the second stage of for some of the ability of certain tumors labor. Valsalva’s maneuver is used, to elude the host organism’s defenses. causing increased pressure against the Bcl-2 suppresses apoptosis, permitting uterus by increasing intra-abdominal the metastasis of tumors. When refer- pressure. ring to the protein product of the gene, beat [AS. beatan, to strike] A pulsation the term “Bcl-2” is used. SEE: apoptosis; or throb (e.g., as in contraction of the oncogene. heart). b.d. L. bis die, twice a day. apex b. The impulse of the heart felt Љ Ј Љ Bdellovibrio (de˘l o¯-vı˘b -re¯-o¯ ) [Gr. by the hand when held over the fifth or bdello, leech, ϩ vibrio] A genus of sixth intercostal space in the left mid- gram-negative bacteria that parasitize clavicular line. other bacteria by living and reproducing artificially paced b. A heartbeat inside them. stimulated by an artificial pacemaker. B.E. below elbow, referring to the site of captured b. A ventricular contrac- amputation of an arm; barium enema. tion directly stimulated by an electrical Be Symbol for the element beryllium. impulse either from the sinus node or bead (be¯d) [ME. bede, prayer, prayer from the pulse generator of a pace- bead (on a rosary), bead] A small spher- maker. ical object, typically made of glass, plas- dropped b. A single interruption in tic, or metal. Beads have numerous uses the regular pacing of the electrical and short in health care. They are employed in mechanical activity of the heart. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh beat 252 bed base of rh

ectopic b. An electrical impulse that neous nuclear transition, i.e., begins at any place in the heart other disintegrations, per second. One curie than the sinoatrial node. has 3.7 ϫ 1010 transitions per second. escape b. A depolarization of the Thus, one curie is equivalent to heart that occurs after a prolonged 3.7 ϫ 1010 becquerels. SEE: curie; SI pause or after failure of the sinus node Units Appendix. to generate an electric impulse. Most es- bed [AS. bedd] 1. A supporting structure cape beats are generated in the ventri- or tissue. 2. A couch or support for the cles. body during sleep. forced b. Extrasystole brought on by air b. 1. Large inflated cushion used artificial heart stimulation. as a mattress. 2. Air-fluidized bed. premature b. An electrical impulse air-fluidized b. A bed consisting of a that arises from a site other than the mattress filled with tiny glass or ce- sinus node in the heart, occurring before ramic spheres that are suspended by a the expected sinus beat. continuous flow of warm air. The pa- Beau’s lines (bo¯z) [Joseph Honore´Simon tient “floats” on the mattress with only Beau, Fr. physician, 1806–1865] minimal penetration. Because of the White lines across the fingernails, usu- even distribution of weight, the bed is ally a sign of systemic disease. They particularly useful in treating or pre- may be due to trauma, coronary occlu- venting pressure sores. sion, hypercalcemia, or skin disease. capillary b. A network of capillaries. The lines are visible until the affected circular b. A bed that allows a pa- area of the nail has grown out and been tient to be turned end-over-end while trimmed away. held between two frames. This permits Bechterew’s reflex, Bekhterev’s reflex turning the patients without disturbing (be˘kЈte˘r-e˘vs) [Vladimir Mikhailovich them by turning the two frames inside von Bechterew, Russ. neurologist, a circular apparatus that holds the ends 1857–1927] 1. Contraction of the facial of the frames. It is useful in treating muscles due to irritation of the nasal paralyzed or immobilized patients. mucosa. 2. Dilatation of the pupil on ex- Gatch b. SEE: Gatch bed. posure to light. 3. Contraction of the hydrostatic b. Water b. lower abdominal muscles when the skin kinetic b. A bed that constantly turns on the inner thigh is stroked. patients side to side through 270Њ.Itis Beck airway airflow monitor (be˘k) used to prevent the hazards of immobil- ABBR: BAAM. A device that is at- ity in patients requiring prolonged bed- tached to the nasotracheal tube to help rest, as in multiple trauma and some the intubator locate the sound of the neuromuscular diseases. air movement through the vocal low air-loss b. A mattress composed cords. of inflatable air cushions that is used to Becker muscular dystrophy (be˘kЈe˘r) relieve pressure on body parts, esp. in [Peter E. Becker, German geneticist, patients who are being hospitalized for 1908–2000] ABBR: BMD. An X- a long time or who have skin break- linked recessive form of muscular dys- down. trophy, typically first becoming evident metabolic b. A bed arranged to facil- in adolescence as difficulty with gait or itate collection of feces and urine of a with pelvic girdle muscle strength. It is patient so that metabolic studies can be characterized pathologically by inade- done. quate production of dystrophin and thus nail b. The skin that lies beneath a is similar to, but usually milder than, nail at the tip of a digit. Duchenne muscular dystrophy. open b. A bed available for assign- Beck’s triad (be˘ks) The physical findings ment to a patient. in cardiac tamponade: hypotension, dis- rocking b. A device used to create ab- tended neck veins, and muffling of the dominal displacement ventilation in pa- heart sounds. tients with respiratory failure. Beckwith-Wiedeman syndrome (be˘kЈwı˘th- surgical b. A bed equipped with ve¯dЈe˘-ma˘n) An autosomal dominant syn- mechanisms that can elevate or lower drome whose hallmarks are enlargement the entire bed platform, flexor extend of the tongue and visceral organs, gigan- individual components of the platform, tism, and umbilical hernia, often with neo- or raise or lower the head or the feet of natal hypoglycemia. the patient independently. beclomethasone dipropionate (be˘kЉlo¯- tilt b. SEE: table, tilt. me˘thЈa˘-so¯nЉ) A corticosteroid drug. tonsillar bed The mucosal layer be- Trade names are Vancenase and Be- tween the palatoglossal and palatophar- clovent. yngeal arches that is filled with the pal- becquerel (be˘kЈre˘l) [Antoine Henri Bec- atine tonsil. querel, Fr. physicist, 1852–1908] water b. A rubber mattress partially SYMB: Bq. An SI-derived unit of activ- filled with warm water (100ЊFor ity of a radionuclide equal to the quan- 37.8ЊC). It is used to prevent and treat short tity of the material having one sponta- pressure sores. SYN: hydrostatic bed. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bedbug 253 behavior base of rh bedbug A flat, reddish-brown insect, Ci- conflicts with the child over bedtime and mex lectularius of the family Cimicidae. creates a more rapid onset of sleep be- Its bite causes an itchy, red, hive-like cause the late hour at which the child is rash and, occasionally, other allergic re- initially put to rest means he or she will actions. The adult bugs are about 5 to 7 go to bed tired. mm long and survive for up to a year bedtime resistance Misbehavior, stalling without feeding. Bedbugs may transmit tactics, or temper tantrums used by bloodborne infections (such as hepatitis children to avoid adhering to a struc- B or Chaga’s disease) to humans. Treat- tured sleep schedule. Bedtime resis- ment for bites consists of application of tance (also known as “bedtime refusal”) antipruritic lotions. In heavy infesta- may be caused by a variety of condi- tions, an appropriate insecticide should tions, including fear of the dark, loneli- be used to spray furniture, mattresses, ness, or the desire for more attention, floors, baseboards, and walls. among many other conditions. bedewing Clouding of vision resulting bedwetting Enuresis. from edema of the cornea. BEE basal energy expenditure. bedfast Unable or unwilling to leave the bee [AS. beo, bee] An insect of the order bed; bedridden. Hymenoptera and superfamily Apoidea. bed hold A reservation that allows one to Included is the common honeybee, Apis stay in a care facility. The reservation is mellifera, which produces honey and usually made just before relocation to beeswax. SEE: sting, bee. the facility or during furloughs away Beer’s law (be¯rz, ba¯rz) [August Beer, from it (e.g., in hospital or on family vis- Ger. physicist, 1825–1863] The basic its). law that is the foundation for all absorp- bedlam [From Hospital of St. Mary of tion photometry. It predicts the linear Bethlehem, pronounced “bedlem” in relationship between the monochro- Middle English.] 1. An asylum for the matic light absorbance (A) of a solution insane. 2. Any place or situation char- and its concentration (c). The law is acterized by a noisy uproar. given as A ϭ ⑀lc, where A ϭ absorbance, bed mobility, impaired Limitation of in- ⑀ ϭ molar absorptivity, l ϭ path dis- dependent movement from one bed po- tance, and c ϭ concentration. It is also sition to another. SEE: Nursing Diag- known as the Beer-Lamber or Bougher- noses Appendix. Beer law. Bednar’s aphthae (be˘dЈna˘rz) [Alois Bed- Beer’s operation [Georg Joseph Beer, nar, physician in Vienna, 1816–1888] Ger. ophthalmologist, 1763–1821] A Infected, traumatic ulcers appearing on flap operation for cataract or artificial the hard palate of infants; usually pupil. caused by sucking contaminated ob- bee sting therapy Apitherapy. jects. beeswax (be¯zЈwa˘ks) Yellow waxob- bedpan [AS. bedd, bed, ϩ panna, flat tained from the honeycomb of bees. A vessel] A pan-shaped device placed un- purified form is used in ointments. der a bedridden patient for collecting fe- beeturia (be¯t-u¯ Јre¯-a˘) Deep red or pink cal and urinary excreta. coloration of urine caused by betanin, NOTE: In general, because bedpan the pigment in beets. This condition is use is uncomfortable and awkward, it common in iron-deficient adults and requires more exertion on the patient’s children and can occur after ingestion of part than using a bedside toilet. Pa- even one beet. tients, esp. those recovering from myo- Beevor’s sign (be¯Јve˘rz) [C. E. Beevor, cardial infarction, should not be forced Brit. neurologist, 1854–1908] Upward to use a bedpan if it is possible for them (cephalad) movement of the umbilicus to use a bedside toilet. when the neck of a patient with paral- bedrest 1. A device for propping up pa- ysis of the lower rectus abdominis mus- tients in bed. 2. The confining of a pa- cles is flexed. It is one marker of fas- tient to bed for rest. cioscapular muscular dystrophy and is bedridden Unable or unwilling to leave found in other conditions (e.g., in some the bed; bedfast. patients who have suffered trauma to Bedsonia (be˘d-so¯Јne¯-a˘) [Sir Samuel the trunk, abdomen, or spinal cord). Phillips Bedson, Brit. bacteriologist, behavior (bı˘-ha¯vЈye˘r) [ME. behaven, to 1886-1969] A term formerly used for hold oneself in a certain way] 1. The the genus Chlamydia. manner in which one acts; the actions bedsore [AS. bedd, bed, ϩ sare, open or reactions of individuals under specific wound] Pressure sore. circumstances. 2. Any response elicited bedtime fading A behavioral treatment from an organism. for childhood insomnia, in which the caring b. The actions or responses of sleep-resistant child is allowed to go to providing patient services. sleep late for a few nights and then PATIENT CARE: The following are gradually guided to sleep at earlier and the 10 highest-ranked caring behaviors, earlier hours until the desired time of derived from nursing literature, then short sleep is reached. The treatment limits selected by nurses as evident in caring standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh behavior 254 Bell, Sir Charles base of rh

situations with patients: attentive lis- Behc¸et’s syndrome (ba¯Јse˘ts) [Hulusi tening, comforting, honesty, patience, Behc¸et, Turkish dermatologist, 1889– responsibility, providing information so 1948] A rare, multisystem, chronic, re- the patient can make an informed de- current disease of unknown cause, cision, touch, sensitivity, respect, ad- marked by ulceration of the mouth and dressing the patient by name. genitalia and by uveitis. The central illness b. The ways in which an in- nervous system, blood vessels, joints, dividual acts or reacts to his or her own and intestinal tract may be involved. It illness or the illness of a family member. is genetically associated with HLA-B51. Common reactions include frustration, The disease occurs worldwide but is anxiety, denial, anger, and withdrawal. most common in the eastern Mediter- self-consoling b. The self-quieting ranean area and eastern Asia. In these actions of infants, such as sucking on areas it occurs mostly in young men and their fists and watching mobiles and is a leading cause of blindness. In the other moving objects. Western world, where the disease is less self-injurious b. ABBR: SIB. Mal- severe, it affects men twice as fre- adaptive behaviors of various types, in- quently as it does women but is not a cluding self-scratching, illicit drug use, leading cause of blindness. The period head banging, and tobacco use. The between attacks is irregular but may be cause is unknown, but one theory is that as short as days or as long as years. The the behaviors are self-stimulatory. syndrome is also known as Behc¸et’s dis- type Ab. A behavior pattern marked ease, or cutaneomucouveal syndrome. by the characteristics of competitive- TREATMENT: Therapy depends on ness, aggressiveness, easily aroused the severity of the clinical findings. Mild hostility, and an overdeveloped sense of disease of skin and joints may be urgency. Although some studies have treated with topical steroids or nonste- suggested that this behavior pattern is roidal anti-inflammatory drugs. In- important in coronary artery disease volvement of the central nervous system and hypertension, the evidence support- or gastrointestinal tract may require ing this claim is controversial. The risk high dose steroids or cytotoxic drugs, of accidents, suicide, and murder is such as chlorambucil, cyclophospha- higher in type A individuals. mide, or methotrexate. type B b. A behavior pattern marked bejel (be˘jЈe˘l) A nonvenereal form of by the lack of competitiveness, hostility, syphilis endemic in Central and West- and time pressure. ern Africa and Eastern Mediterranean behavioral genetics The study of the in- countries; children are especially sus- herited basis for animal behavior and ceptible. the impact that environment has on be- bel (be˘l) SYMB: B. A unit of measure- havioral phenotypes. The field inquires ment of the intensity of sound. It is ex- into the influence of genes on addiction, pressed as a logarithm of the ratio of aggression, intelligence, personality, two sounds of acoustic intensity, one of sexuality, and sociability, among other which is fixed or standard; the ratio is realms of animal and human experi- expressed in decibels. ence. belay (be˘-la¯yЈ) To protect with a rope. A behavioral science The science con- rescuer can belay a stokes basket as it cerned with all aspects of behavior. is being lowered to a safe position. behavioral system model A conceptual Bell, Sir Charles (be˘l) Scottish physiolo- model of nursing developed by Dorothy gist and surgeon, 1774–1842. Johnson. The person is regarded as a be- B.’s palsy Unilateral facial paralysis havioral system with seven subsys- of sudden onset. The paralysis involves tems—attachment, dependency, inges- both the upper and lower halves of the tion, elimination, sexuality, aggression, face, distinguishing it from the facial achievement. The goal of nursing is to paralysis associated with some strokes, restore, maintain, or attain behavioral which affect the muscles of the mouth system balance and stability. SEE: more than those of the eye or forehead. Nursing Theory Appendix. Bell’s palsy is usually caused by a re- behaviorism (be¯-ha¯vЈyo˘r-ı˘zm) A theory activation of herpes simplexvirus, al- of conduct that regards normal and ab- though other infections (e.g., syphilis or normal behavior as the result of condi- Lyme disease) are sometimes impli- tioning rather than choice or will. cated. Complications may include cor- behavior therapy Techniques used to neal drying and ulceration and mild change maladaptive behaviors, based dysarthria. Either side of the face may on principles of learning theory. Ciga- be affected. Attacks recur in about 10% rette smoking, eating disorders, and al- of cases. cohol abuse are commonly treated SYMPTOMS: The paralysis distorts through behavior therapy, which may smiling, eye closure, salivation, and tear include the use of positive reinforce- formation on the affected side. ment, aversive conditioning, discrimi- TREATMENT: Tapering doses of short nation, and modeling. prednisone without antiviral drugs pro- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh Bell, Sir Charles 255 bentonite base of rh

vide the most effective results. In addi- the subject copies a series of patterns. tion, the affected eye should be pro- The results vary with the type of psy- tected from drying with artificial tears chiatric disorder present. or unmedicated ointments. Some prac- bends, the (be˘ndz) A lay term for decom- titioners advise wearing sunglasses pression illness. SEE: decompression ill- during the palsy or patching the eye to ness; hyperbaric chamber. protect it from foreign bodies or drying. Benedict’s solution (be˘nЈe˘-dı˘kts) [Stan- PROGNOSIS: Partial facial paralysis ley R. Benedict, U.S. chemist, 1844– is usually resolved within several 1936] A solution used to test for the months. The likelihood of complete re- presence of sugar. To 173 g sodium or covery after total paralysis varies from potassium citrate and 100 g anhydrous 20% to 90%. sodium carbonate (dissolved in 700 ml B.’s phenomenon Rolling of the eye- water) is added 17.3 g crystalline copper ball upward and outward when an at- sulfate that has been dissolved in 100 tempt is made to close the eye on the ml of water. Sufficient water is added to side of the face affected in peripheral fa- the mixture to make 1000 ml. SEE: Ben- cial paralysis. edict’s test. belladonna (be˘lЉa˘-do˘nЈa˘) [It., beautiful Benedikt’s syndrome (be˘nЈa˘-dı˘kts lady] An anticholinergic derived from sı˘nЈdro¯mЉ) [Moritz Benedikt, Austrian Atropa belladonna, a poisonous plant physician, 1835–1920] Hemiplegia with reddish flowers and shiny black with oculomotor paralysis and clonic berries. Belladonna is the source of var- spasm or tremor on the opposite side. ious alkaloids (stramonium, hyoscy- Benedikt’s syndrome is caused by le- amus, scopolamine, and atropine) and is sions that damage the third nerve and used mainly for its sedative and spas- involve the red nucleus and corticospi- molytic effects on the gastrointestinal nal tract. tract. All alkaloids derived from bella- beneficence (be˘n-e˘fЈa˘-se˘ns) 1. An ethi- donna are toxic. SEE: atropine in Poi- cal principle that emphasizes doing sons and Poisoning Appendix. what is best for the patient. 2. Choosing Bellini’s tubule (be˘-le¯Јne¯z) [Lorenzo Bel- to do good; acting kindly or charitably. lini, It. anatomist, 1643–1704] A pap- benefit 1. Something that promotes illary duct of the kidney; the union of health. 2. A term for service stipulations several collecting tubules. of an insurance policy, esp. a medical Bellocq’s cannula (be˘l-o˘ksЈ) [Jean policy. Jacques Bellocq, Fr. surgeon, 1732– benefit trigger, trigger A set of conditions 1807] An instrument for drawing in a or self-care deficits used by a health in- plug through the nostril and mouth to surer as criteria for the initiation of in- control epistaxis. surance payouts. In the care of elderly belly [AS. baelg, bag] 1. The abdomen or patients, benefits for certain residential abdominal cavity. 2. The fleshy, central services may be linked to the documen- portion of a muscle. tation of new deficits in self-care, e.g., belly button An informal term for the na- the inability to perform two or more ac- vel or umbilicus. tivities of daily living. Belmont report A national commission benevolence (be˘-ne˘vЈo˘-le˘ns) [L. benevo- that promulgated the basic ethical lentia, good will] The desire to act in a guidelines and principles for human re- good, kindly manner toward others. search in the U.S. benign (be¯-nı¯nЈ) [L. benignus, mild] Not belonoskiascopy (be˘lЉo¯-no¯-skı¯-a˘sЈko¯-pe¯) recurrent or progressive; nonmalignant. [Gr. belone, needle, ϩ skia, shadow, ϩ benign forgetfulness A memory defect skopein, to examine] Subjective reti- marked by the inability to immediately noscopy by means of shadows and move- recall a name or date. The item, ments to determine refraction. whether recent or remote, is eventually benazepril An ACE inhibitor used to recalled. Also known as benign senes- treat hypertension and congestive heart cent forgetfulness. failure. Bennett double-ring splint (Be˘nЈe˘t) A Bence Jones protein (Be˘ns Jo¯nz) metal splint that slips on the finger and [Henry Bence Jones, Brit. physician, limits hyperextension of the proximal 1814–1873] The light chain portion of interphalangeal joint. immunoglobulin molecules that may be Bennett’s fracture An intra-articular deposited in the renal tubules and ex- fracture at the base of the first metacar- creted in the urine of patients with mul- pal with subluxation of the carpometa- tiple myeloma. The protein is involved carpal joint due to traction of the ab- in renal amyloidosis and renal failure. ductor pollicis longus muscle on the first benchmark (be˘nchЈma˘rk) A criterion of metacarpal. This fracture usually re- quality or service in health care, usually quires percutaneous pinning to main- expressed as a measurable standard. tain reduction. Bender’s Visual Motor Gestalt test bentonite (be˘nЈto˘n-ı¯t) [Fort Benton, (be˘nЈde˘rz) [Lauretta Bender, U.S. psy- U.S.] A hydrated aluminosilicate that short chiatrist, 1897–1987] A test in which forms a thick, slippery substance when standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh benzaldehyde 256 Bernard-Soulier syndrome base of rh

water is added. It is used as a suspend- b. benzoate An aromatic, clear, col- ing and clarifying agent. It may be heat- orless oily liquid with a sharp, burning sterilized. taste. It is used as a topical scabicide. benzaldehyde (be˘n-za˘lЈde˘-hı¯d) A phar- benzylpenicillin procaine (be˘nЉzı˘l-pe˘n-ı˘- maceutical flavoring agent derived from sı˘lЈı˘n) Penicillin G procaine. oil of bitter almond. Be´rard’s aneurysm (ba¯-ra˘rzЈ) [Auguste benzene, benzin, benzine (be˘nЈze¯n, be˘n- Be´rard, Fr. surgeon, 1802–1846] An ze¯nЈ,be˘nЈzı˘n) [benz(oin) ϩ Gr. ene, arteriovenous aneurysm in the tissues suffixused in chemistry to denote un- surrounding an injured vein. Ј saturated compound] C6H6; a highly bereavement (be¯-re¯v me˘nt) The ex- flammable, volatile liquid that is the pected reactions of grief and sadness simplest member of the aromatic series upon learning of the loss of a loved one. of hydrocarbons. It is immiscible with The period of bereavement is associated water, and it dissolves fats. It is used as with increased mortality. It is useful for a solvent and in the synthesis of dyes those who care for the bereaved to em- and drugs. The phenyl radical, C6H6, phasize human resilience and the power will be recognized in the formulae of life rather than the stress that accom- for phenol, dimethylaminoazobenzene panies bereavement. (SEE: under azo compounds), and ben- Berg balance test (be˘rg) A physical per- zoic acid. It is a carcinogen. SYN: benzol. formance evaluation of fourteen activi- SEE: Poisons and Poisoning Appendix. ties including; sit-to-stand, reaching, benzoate (be˘nЈzo¯-a¯t) A salt of benzoic turning, and single leg stance. The ac- acid. tivities are rated on a 0 to 4 scale. This benzocaine (be˘nЈzo¯-ka¯n) Ethyl amino- test has been shown to be highly predic- benzoate, a local anesthetic used topi- tive of patient falls. Significance: Scores: cally. less than 36 ϭ 100% fall risk; less than benzodiazepine (be˘nЉzo¯-dı¯-a˘zЈe˘-pe¯n) or equal to 46 ϭ 78% fall risk. Any of a group of chemically similar psy- Bergeron’s chorea (be˘rЈja˘-ro˘nzЉ ko¯-re¯Јa˘) chotropic drugs with potent hypnotic Electric chorea. and sedative action; used predomi- Bergmeister’s papilla (be˘rgЈmı¯s-te˘rz) A nantly as antianxiety and sleep-induc- veil in front of the retina of the eye. It is ing drugs. Side effects of these drugs made of a conical mass of glial remnants may include impairment of psychomo- that are the developmental tissue of the tor performance; amnesia; euphoria; de- eye that has not been reabsorbed. pendence; and rebound (i.e., the return beriberi (be˘rЈe¯-be˘rЈe¯) [Singhalese beri, of symptoms) transiently worse than be- weakness] A disease marked by pe- fore treatment, upon discontinuation of ripheral neurologic, cerebral, and car- the drug. diovascular abnormalities and caused Ј benzoic acid (be˘n-zo¯ ı˘k) C7H6O2; a white by a lack of thiamine. Early deficiency crystalline material having a slight produces fatigue, irritability, poor mem- odor. It is used in keratolytic ointments ory, sleep disturbances, chest pain, an- and in food preservation. Saccharin is a orexia, abdominal discomfort, and con- derivative of this acid. stipation. Beriberi is endemic in Asia, benzoin (be˘nЈzoyn, −zo¯-ı˘n) [Fr. benjoin] the Philippines, and other islands of the A balsamic resin. It is used as a solution Pacific. SYN: kakke. applied to the skin to prepare it for ap- ETIOLOGY: Deficiency is caused by plication of adhesives, esp. adhesive subsistence on highly polished rice, tapes. which has lost all thiamine content benzol (be˘nЈzo˘lЉ) Benzene. through the milling process. Secondary benzonatate (be˘n-zo¯Јna˘-ta¯t) A sub- deficiency can arise from decreased ab- stance chemically related to procaine sorption, impaired absorption, or im- and used to suppress cough. paired utilization of thiamine. benzoylecgonine (be˘n-zoyl-e˘kЈgo¯-nı¯n) TREATMENT: Treatment consists of The principal metabolite of cocaine. oral or parenteral administration of thi- Screening tests for cocaine determine amine and eating a balanced diet. its presence or absence. berkelium (be˘rkЈle¯-u˘ m) [U. of California benzoyl peroxide (be˘nЈzo˘wlЉ) A topical at Berkeley, where first produced] agent used for the treatment of acne SYMB: Bk. A transuranium element; vulgaris. It is usually considered as a atomic weight 247, atomic number 97. first-line treatment for mild to moderate Berlin edema [R. Berlin, German eye acne. Common side effects include dry- physician, 1833–1897] Commotio reti- ing of the skin and skin discomfort. nae. benztropine mesylate (be˘nzЈtro¯-pe¯n) An berloque dermatitis SEE: dermatitis, antiparasympathomimetic agent usu- berlock. ally used with other drugs in treating Bernard’s glandular layer (be˘r-na˘rzЈ, parkinsonism. −na˘rdzЈ) The layer of cells lining the ac- Ј Љ benzyl (be˘n ze¯l )C6H5COOCH2C6H5;the ini of the pancreas. hydrocarbon radical of benzyl alcohol Bernard-Soulier syndrome (be˘r-na˘rЈsool- short and various other compounds. ya¯Ј) [Jean A. Bernard, Fr. hematolo- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh Bernhardt-Roth syndrome 257 beta-lactamase resistance base of rh

gist, 1907–2006; Jean-Pierre Soulier, beta-adrenergic blocking agent SEE: Fr. hematologist, 1915–2003] An au- under agent. tosomal recessive bleeding disorder beta-adrenergic receptor SEE: under re- marked by an inherited deficiency of a ceptor. platelet glycoprotein. The platelets are beta blocker Beta-adrenergic blocking large. Bleeding results from defective agent. adhesion of platelets to subendothelial beta-carboline alkaloids (ka˘rЈbo˘-le¯nЉ)A collagen and is disproportionate to the group of neurologically active com- reduction in platelets. pounds similar in chemical structure to Bernhardt-Roth syndrome Meralgia pa- the amino acid L-tryptophan, the neu- resthetica. rotransmitter serotonin, and the hallu- Bernstein test (Be˘rnЈstı¯n) [Lionel Bern- cinogen dimethyltryptamine. They in- stein, U.S. physician, b. 1923] Test to crease levels of serotonin in the central reproduce the pain of heartburn. This is and peripheral nervous system and in- done by swallowing a dilute solution hibit the action of monoamine oxidase. (0.1 N) hydrochloric acid. This is com- beta carotene A yellow-orange pigment pared with a placebo infusion of normal found in fruits and vegetables; it is the saline into the esophagus. The latter most common precursor of vitamin A. does not cause heartburn. The daily human requirement for vita- berylliosis (be˘rЉı˘l-le¯-o¯Јsı˘s) [beryllium ϩ min A can be met by dietary intake of Gr. osis, condition] Beryllium poison- beta carotene. ing, usually of the lungs. The beryllium TOXICITY: Ingestion of large doses of particles cause fibrosis and granulo- vitamin A either acutely or chronically mata at any site, whether inhaled or ac- causes skin and liver damage, among cidentally introduced into or under the other injuries. Beta carotene supple- skin. ments increase the risk of death among beryllium (be˘-rı˘lЈe¯-u˘ m) [Gr. beryllos, smokers and have no known beneficial beryl] A metallic element, symbol Be, effects on nonsmokers. atomic weight 9.0122, atomic number 4, BENEFITS: A diet rich in beta caro- specific gravity 1.848. It is used as a tene has been associated with a de- window in some x-ray tubes to produce creased risk of certain cancers. a soft (low kilovoltage) beam appropri- DOSING: Vitamin A activity in foods ate for imaging soft tissue (mammog- is expressed as retinol equivalents (RE). raphy or specimen radiography) or for Sixmg of beta carotene equals 1 ␮gof forensic and industrial radiography of retinol or 1 RE. SEE: vitamin A; retinol. extremely thin objects (e.g., a postage beta cells 1. Basophilic cells in the ante- stamp or fingerprint). rior lobe of pituitary that give a positive Best’s disease (be˘st) [Franz Best, Ger. periodic acid stain reaction. 2. Insulin- pathologist, 1878–1902] An autoso- secreting cells of the islets of Langer- mal-dominant form of macular dystro- hans of the pancreas. phy in which central, noncorrectable, betacism (ba¯Јta˘-sı˘zm) [Gr. beta, the let- and progressive visual loss begins in ter b, ϩ −ismos, condition] Speech in childhood or adolescence and worsens in which other letters of the alphabet are adulthood. The disease is characterized inappropriately pronounced like the let- by degeneration of the pigment epithe- ter b. lium of the macula. SYN: vitelliform de- beta cryptoxanthin Cryptoxanthin. generation. SEE: macular dystrophy. beta-lactam (ba¯Јta˘la˘kЈta˘m) Beta-lac- bestiality (be˘s-te¯-a˘lЈı˘-te¯) [L. bestia, tam antibiotic. beast] The use of animals (e.g., snakes, beta lactamase (ba¯-ta˘la˘kЈta˘-ma¯z) An poultry, and nonhuman mammals) for enzyme that destroys the beta lactam sexual enjoyment. ring of penicillin-like antibiotics and best interest standard The ethical re- makes them ineffective. quirement that people who care for oth- extended-spectrum b. l. ABBR: ers will do so in good faith, placing their ESBL. Any enzyme that makes bacte- assessment of that person’s best inter- ria (esp. gram-negative bacteria such as ests above their own. The standard par- the Enterobacteriaceae) resistant to the ticularly applies to the care of incom- effects of broad-spectrum beta-lactam petent or dependent people, e.g., infants antibiotics. or patients who are so ill that they can- beta-lactamase resistance (la˘kЈta˘-ma¯sЉ) not make decisions on their own. The ability of microorganisms that pro- beta (ba¯Јta˘) 1. Second letter of Gr. al- duce the enzyme beta-lactamase (peni- phabet, written ␤. 2. In chemistry, a cillinase) to resist the action of certain prefixto denote isomeric variety or po- types of antibiotics, including some but sition in compounds of substituted not all forms of penicillin. groups. extended-spectrum b.l.r. ABBR: beta-adrenergic agent A synthetic or ESBL. An enzymatically mediated natural drug that stimulates beta (sym- type of antibiotic resistance found in pathetic) receptors, e.g., epinephrine gram-negative bacilli (e.g., Klebsiella short and norepinephrine. pneumoniae, Enterobacter cloacae, and standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

beta-lactamase-resistant top of rh antibiotics 258 bibulous base of rh

Pseudomonas aeruginosa), that make that is, koilocytosis. High-grade squa- these bacteria resistant to cephalospo- mous intraepithelial neoplasia includes rins and penicillin antibiotics. what was once identified as CIN 2 and beta-lactamase-resistant antibiotics An- CIN 3. SEE: cervix, cancer of; cervical tibiotics that are resistant to the action intraepithelial neoplasia. of beta lactamase. This property makes Bethlem myopathy A rare, autosomal them effective against microbial orga- dominant form of limb-girdle muscular nisms that produce beta lactamase. dystrophy that becomes clinically obvi- SEE: beta-lactamase resistant penicil- ous in early childhood. It is usually lin. slowly progressive, gradually resulting betamethasone (ba¯Љta˘-me˘thЈa˘-so¯n) A in weakness that may limit the ability powerful, synthetic glucocorticoid used to walk independently. Muscle contrac- to treat many conditions including der- tures, e.g., of the hands, ankles, and el- matitis, arthritis, inflammatory bowel bows, are characteristic. disease, reactive airways disease, and Betula verrucosa (be˘chЈoo-la˘,be˘Јtu¯-la˘ve˘- respiratory distress syndrome in pre- roo-ko¯Јsa˘) [L. “rough birch”] The sci- term infants, among others. entific name for the European white Љ Ј beta2 microglobulin (mı¯ kro¯-glo˘b u¯-lı˘n) birch tree. European white birch pollen, ␤ ABBR: 2-m. A polypeptide that is one abbreviated Bet by the World Health of the class I major histocompatibility Organization, contains allergens that markers on cell surfaces; it is grouped cause allergies in the spring in the into chains of low molecular weight northern hemisphere. ␤ called light chains. The 2-m chain may Betz cells (Be˘ts) [Vladimir A. Betz, be affected by the nef gene in HIV, pre- Russ. anatomist, 1834–1894] A type of venting CD8ϩ T lymphocytes from rec- giant pyramidal cell in the cortical mo- ognizing the virus. SEE: acquired im- tor area of the brain. The axons of these munodeficiency syndrome; major cells are included in the pyramidal histocompatibility complex. tract. beta subunit Glycoprotein hormones con- bevel (be˘vЈe˘l) 1. A surface slanting from taining two different polypeptide sub- the horizontal or vertical. 2. In den- units designated ␣ and ␤ chains. Anal- tistry, to produce a slanting surface in ysis of the units of these hormones (e.g., the enamel margins of a cavity prepa- follicle-stimulating, luteinizing, chori- ration, named according to the surface onic gonadotropin, and thyrotropin) en- resulting. ables early diagnosis of such conditions bezoar (be¯Јzor) [Arabic bazahr, protect- as pregnancy and ectopic pregnancy. ing against poison] A hard mass of en- betatron (ba¯Јta˘-tro˘n) A circular electron tangled material sometimes found in accelerator that produces either high- the stomachs and intestines of animals energy electrons or x-ray photons. and humans, such as a hairball (tricho- betel nut (be¯tЈı˘l) [Portuguese betele] bezoar), a hair and vegetable fiberball The nut of the tropical Asian palm Areca (trichophytobezoar), or a vegetable food- catechu, chewed for its stimulant and ball (phytobezoar). euphoric effects. SYN: areca nut. BFP biologically false positive. Bi Symbol for the element bismuth. bi- (bı¯) [L. bis, twice] Prefixmeaning Chewing betel nut causes cholin- two, double, twice. ergic effects, which some people biarticular (bı¯Љa˘r-tı˘kЈu¯-la˘r) [Љϩarticu- may not tolerate well. Chewing betel nut lus, joint] Pert. to two joints; diarthric has also been associated with oral and (e.g., temporomandibular joints). esophageal cancers, esp. in those who also bias (bı¯Јu˘s) In experimental medicine, smoke cigarettes or drink alcohol. statistics, and epidemiology, any effect or interference at any stage of an inves- Bethesda System, The (be˘-the˘zЈda˘ tigation tending to produce results that sı˘sЈte˘m) ABBR: TBS. A system for re- depart systematically from the true porting cervical or vaginal cytologic di- value. agnoses. Use of TBS replaces the nu- bibasic (bı¯-ba¯Јsı˘k) [ЉϩGr. basis, foun- merical designations (Class 1 through 5) dation] Pert. to an acid with two hydro- of the Papanicolaou smear with descrip- gen atoms replaceable by bases to form tive diagnoses of cellular changes. Cel- salts. lular changes are identified as benign; bibasilar (bı¯-ba˘sЈı˘-la˘r) Pertaining to both reactive, such as those due to inflam- lung bases. mation, atrophy, radiation, or use of an bibliocounseling (bı˘bЉle¯-o¯-kownЈse˘l-ı˘ng) intrauterine device; or malignant. Hor- [Gr. biblion, book ϩЉ] bibliotherapy. monal evaluation of vaginal smears is bibliographic manager (bı˘bЉle¯-o¯-gra˘fЈ˘kı provided. Low-grade squamous intra- ma˘nЈa˘-je˘r) Software products to man- epithelial lesions include what was pre- age textbook and journal references, viously called grade 1 cervical intraepi- create databases, and format informa- thelial neoplasia (CIN 1) and cellular tion for search and retrieval. short changes due to human papilloma virus, bibulous (bı˘bЈu¯-lu˘s) [L. bibulus, from bi- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bicameral 259 Bifidobacteria base of rh

bere, to drink] Absorbent. SYN: hy- drophilous; hygroscopic. bicameral (bı¯-ka˘mЈe˘r-a˘l) [L. bis, twice, ϩ camera, a chamber] Having two cav- LIGHT RAYS ities or chambers. bicarbonate (bı¯-ka˘rЈbo¯-na¯t) Any salt Ϫ containing the HCO3 (bicarbonate) an- ion. SEE: carbonic acid. Ϫ blood b. Measured HCO3 in the blood. The amount present is an indi- cator of the alkali reserve and is best un- LIGHT RAYS derstood when comparison is made of the blood bicarbonate, pH, PCO2, and base excess, using the Henderson-Has- selbalch equation. BICONCAVE LENS b. of soda Sodium bicarbonate. bicellular (bı¯-se˘lЈu¯-la˘r) [Љϩcellularis, little cell] 1. Composed of two cells. 2. Having two chambers or compart- ments. biceps (bı¯Јse˘ps) [Љϩcaput, head] A muscle with two heads. b. brachii The muscle of the upper arm that flexes the elbow and supinates the forearm. b. femoris One of the hamstring muscles lying on the posterior lateral side of the thigh. It flexes the leg and rotates it outward. Ј bichloride of mercury (bı¯-klo¯ rı¯d) HgCl2; BICONVEX LENS corrosive mercuric chloride; a crystal- line salt. SEE: mercuric chloride; mer- BICONCAVE LENS/BICONVEX LENS curic chloride poisoning; mercuric chlo- ride in Poisons and Poisoning Appendix. bidet (be¯-da¯Ј) [Fr., a small horse] A ba- bicipital (bı¯-sı˘pЈı˘-ta˘l) [L. biceps, two sin used for cleaning the perineum. heads] 1. Pert. to a biceps muscle. bidi (be¯Јde¯) A hand-rolled and often fla- 2. Having two heads. vored cigarette imported from India or bicistronic (bı¯Љsı˘s-tro˘nЈı˘k) [Љϩcistron] Southeast Asia. It is popular with young Capable of making two proteins from a smokers, but has a higher nicotine and single messenger RNA molecule. tar content than most commercially biconcave (bı¯-ko˘nЈka¯v) [L. bis, twice, ϩ available cigarettes in the U.S. Like concavus, concave] Concave on each other brands of tobacco in the U.S., it side, esp. as a type of lens. SEE: illus. causes cancers, an increased risk of fetal biconvex (bı¯-ko˘nЈve˘ks) [Љϩconvexus, death during pregnancy, heart disease, rounded raised surface] Convexon two peripheral vascular disease, chronic ob- sides, esp. as a type of lens. SEE: bicon- structive lung disease, and genetic mu- cave for illus. tations. bicornate, bicornis (bı¯-korЈna¯t, −nı˘s) [Љ Bietti’s crystalline dystrophy (be¯-e˘tЈe¯z) ϩ cornutus, horned] Having two pro- [G. B. Bietti, 20th-cent. Italian ophthal- cesses or hornlike projections. mologist] A rare, autosomal-recessive bicoronal (bı¯Љko˘rЈa˘-na˘l) [ЉϩL. corona, eye disease that causes gradually wors- garland, crown fr. Gr. korone, curved ob- ening night blindness and peripheral vi- ject, crown] 1. Pert. to both areas of the sion loss. It results from the deposition corona radiata. 2. Pert. to the articula- of crystals in the cornea and retina, with tions on either side of the skull that join gradual atrophy of the choroid and ret- to form a crown-shaped structure dur- ina. This condition is more common in ing normal fetal development. Asians than in other ethnic groups. bicorporate (bı¯-korЈpo˘-ra¯t) [Љϩcorpus, SYN: corneoretinal dystrophy. body] Having two bodies. bifacial (bı¯-fa¯Јsha˘l) [Љϩfacies, face] bicuspid (bı¯-ku˘sЈpı˘d) [Љϩcuspis, point] Having similar opposite surfaces. Having two cusps or projections or hav- bifid (bı¯Јfı˘d) [Љϩfindere, to cleave] ing two cusps or leaflets. Cleft or split into two parts. b. tooth A premolar tooth; a perma- Bifidobacteria (bı¯Љfı˘d-o¯-ba˘k-te¯rЈe¯-a˘) [Љϩ nent tooth with two cusps on the grind- Љ] A genus of gram-positive, lactic acid ing surface and a flattened root. There producing bacteria that normally live in are four premolars in each jaw, two on the gut of healthy mammals and consti- each side between the canines and the tute part of the normal flora of the lower molars. SEE: tooth. gastrointestinal tract. Bifidobacteria short b.i.d. L. bis in die, twice daily. and Lactobacillus species are consid- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bifocal 260 bile base of rh

ered probiotic bacteria, i.e., bacteria their two hydrophilic (water-soluble) that contribute to human health. They sides face the interior and the exterior are also used to produce fermented of the cell, and their hydrophobic (non- milks and yogurt The use of antibiotics polar) core is in between. The mem- to treat infectious diseases may de- brane is relatively impermeable to mol- crease the concentration of Bifidobac- ecules such as glucose and amino acids teria in the gastrointestinal tract, allow- but very permeable to lipid-soluble mol- ing disease-causing bacteria to ecules such as oxygen, carbon dioxide, multiply. and alcohol. SEE: cell for illus. bifocal (bı¯-fo¯Јka˘l) [Љϩfocus, hearth] bilberry (bı˘lЈbe˘rЉe¯) The European huck- Having two foci, as in bifocal eyeglasses. leberry (Vaccinium myrtillus). It is pro- bifocal eyeglasses A corrective lens con- moted as a treatment for ocular and cir- taining upper and lower segments, each culatory disorders and as a treatment with a different power. The main lens is for diarrhea. Its mechanisms of action for distant vision; the secondary lens is are: antioxidant, astringent, collagen for near vision. stablizer, and vasoprotector. bifurcate, bifurcated (bı¯Јfu˘r-ka¯t, bı¯- bile (bı¯l) [L. bilis, bile] A thick, viscid, fu˘rЈka¯t’d) [Љϩfurca, fork] Having bitter-tasting fluid secreted by the liver. two branches or divisions; forked. It passes from the hepatic duct of the bifurcation (bı¯-fu˘r-ka¯Јshu˘n) 1. A sepa- liver either to the cystic duct of the gall- ration into two branches; the point of bladder or to the common bile duct to forking. 2. Furcation. the duodenum. The bile from the liver bigemina (bı¯-je˘mЈı˘-na˘) [L.] Pl. of bigem- is straw-colored; that from the gallblad- inum. der varies from yellow to brown to Ј bigeminal (bı¯-je˘m ı˘-na˘l) [L. bigeminum, green. twin] Double; paired. Bile is stored in the gallbladder, Ј bigeminum (bı¯-je˘m ı˘-nu˘m) pl. bigemina where it is concentrated, and dis- [L.] A bigeminal body. charged into the duodenum when fatty Ј bigeminy (bı¯-je˘m ı˘-ne¯) Occurring in chyme enters from the stomach. Con- pairs or couplets. bigeminal, adj. traction of the gallbladder is brought junctional b. Cardiac arrhythmia in about by cholecystokinin-pancreozymin which every other beat is a junctional (a hormone produced by the duodenum); ectopic or premature junctional contrac- its secretion is stimulated by the en- tion. SYN: nodal bigeminy. trance of fatty foods into the duodenum. nodal b. Junctional b. Added to water, bile decreases surface ventricular b. Cardiac arrhythmia in tension, providing a foamy solution fa- which every other beat is a ventricular voring the emulsification of fats and ectopic or premature ventricular con- oils. This action is due to the bile salts, traction. mainly sodium glycocholate and tauro- biguanide (bı¯-gwo˘nЈı¯dЉ) A member of the cholate. class of oral antihyperglycemic agents COMPOSITION: Bile pigments (prin- that works by limiting glucose produc- cipally bilirubin and biliverdin) are re- tion and glucose absorption, and by in- sponsible for the variety of colors ob- creasing the body’s sensitivity to insu- lin. Glucophage is one member of this served. In addition, bile contains drug class. cholesterol, lecithin, mucin, and other bi-ischial (bı¯-ı˘sЈke¯-a˘l) Concerning both organic and inorganic substances. ischial tuberosities of the pelvis. FUNCTION: The function of bile in di- bilabe (bı¯Јla¯b) [L. bis, twice, ϩ labium, gestion is to emulsify fats, facilitating lip] A long, thin device equipped with a their digestion in the small intestine by hinged lower jaw. It is inserted into the pancreatic lipase. Bile also stimulates bladder via the urethra to remove small peristalsis. Normally the ejection of bile calculi from the bladder. occurs only during duodenal digestion. bilateral (bı¯-la˘tЈe˘r-a˘l) [Љϩlatus, side] About 800 to 1000 ml/24 hr are secreted Pert. to, affecting, or relating to two in the normal adult. SEE: gallbladder. sides. PATHOLOGY: Interference with the b. carotid body resection ABBR: flow of bile causes jaundice and the BCBR. A rarely used method of treat- presence of unabsorbed fats in the feces. ing carotid sinus syncope that relies on SEE: jaundice. the bilateral surgical removal of the ca- b. acid SEE: under Acid. rotid bodies. SEE: carotid body; carotid cystic b. Bile stored in the gallblad- sinus syncope. der. It is concentrated, as opposed to he- bilateralism (bı¯-la˘tЈe˘r-a˘l-ı˘zm) [ЉϩЉϩ patic bile. Gr. −ismos, condition] Bilateral sym- b. ducts Any of the intercellular pas- metry. sages that convey bile from the liver to bilayer (bı¯Љla¯Јe˘r) A two-component layer. the hepatic duct, which joins the duct lipid b. The outer membrane of most from the gallbladder (cystic duct) to cells includes two layers of phospholipid form the common bile duct (ductus cho- short molecules. These layers are arranged so ledochus), and which enters the duode- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bile 261 bilirubin base of rh

num about 3 in (7.6 cm) below the py- biliflavin (bı˘lЉı˘-fla¯Јvı˘n) [Љϩflavus, yel- lorus. SEE: illus. low] A yellow pigment derived from bil- iverdin. bilifuscin (bı˘lЉı˘-fu˘sЈ˘n)ı [Љϩfuscus, brown] A dark brown pigment from bile BILE DUCTS and gallstones. (IN RELATION TO biligenesis (bı˘lЉı˘-je˘nЈe˘-sı˘s) [ЉϩGr. gen- DUODENUM AND esis, generation, birth] The formation GALLBLADDER) of bile. bilingual (bı¯Јlı˘ngЈgwı˘l) Being able to speak and write in a semantically cor- FROM LIVER rect and fluent style in two languages. Љ HEPATIC DUCTS FROM biliopancreatic diversion (bı˘l e¯-o¯- CYSTIC DUCT STOMACH pa˘nЉkre¯-a˘tЈ˘k)ı [ЉϩЉ] ABBR: BPD. A bariatric surgical treatment for obesity in which most of the stomach is re- moved. The small pouch that remains is connected to a small segment of the du- GALLBLADDER odenum, which is linked directly to the cecum, bypassing the rest of the small COMMON intestine. The procedure restricts the BILE DUCT intake of nutrients and causes malab- DUODENUM sorption, both of which lead to weight loss. Successful procedures result in AMPULLA OF VATER sustained weight loss of about 25% of TO body weight, a result as good as any PANCREATIC DUCT JEJUNUM other surgical treatment for overweight. Common complications of the procedure BILE DUCTS include iron-deficiency anemia, defi- hepatic b. Bile secreted by the liver ciencies in the absorption of vitamins A, cells. It is relatively dilute, is collected D, E, and K and the minerals calcium in the bile ducts, and flows to the gall- and magnesium, gradual bone loss, foul- bladder. smelling stools, and failure of surgical lithogenic b. Bile that favors gall- anastomoses. The operation takes more stone production. This may be associ- time to perform than other bariatric ated with several conditions: the most surgeries and tends to have more im- important is increased secretion of cho- mediate postoperative complications. lesterol in the bile (e.g., in obesity, high- bilious (bı˘lЈyu˘s) [L. bilosus] 1. Pert. to caloric diets, or drugs such as clofi- bile. 2. Afflicted with biliousness. brate). biliousness (bı˘lЈyu˘s-ne˘s) 1. An obsolete b. pigment Any of the complex, term for symptoms ascribed to liver dis- highly colored substances (e.g., bilirubin orders. 2. An excess of bile. and biliverdin) found in bile derived bilirubin (bı˘l-ı˘-rooЈbı˘n) [Љϩruber, red] from hemoglobin. They give a brown C33H36O6N4; the orange-colored or yel- color to intestinal contents and feces. lowish pigment in bile. It is derived from Van den Bergh’s test is used to detect hemoglobin of red blood cells that have the type of bilirubin in the blood serum. completed their life span and are de- b. salt Any of the alkali salts of bile stroyed and ingested by the macrophage sodium glycocholate and sodium tauro- system of the liver, spleen, and red bone cholate. Ј marrow. When produced elsewhere, it is Bilharzia (bı˘l-ha˘r ze¯-a˘) [Theodor Maxi- carried to the liver by the blood. It is milian Bilharz, Ger. helminthologist, changed chemically in the liver and ex- 1825–1862] Former name for Schisto- creted in the bile via the duodenum. As soma, the human blood fluke. SEE: it passes through the intestines, it is Schistosoma. converted into urobilinogen by bacterial bilharzial, bilharzic (bı˘l-ha˘rЈze¯-a˘l, −zı˘k) Pert. to Bilharzia (Schistosoma). enzymes, most of it being excreted bilharziasis (bı˘lЉha˘r-zı¯Јa˘-sı˘s) Schistoso- through the feces. If urobilinogen passes miasis. SEE: Bilharzia. into the circulation, it is excreted bili- [L. bilis] Combining form meaning through the urine or re-excreted in the bile. bile. The pathological accumulation of biliary (bı˘lЈe¯-a¯r-e¯) Pert. to bile. bilirubin leads to jaundice in many biliary apparatus Structures concerned cases, such as physiological jaundice of with secretion and excretion of bile; in- the newborn. SEE: illus. cludes liver, gallbladder, and hepatic, direct b. Bilirubin conjugated by the cystic, and common bile ducts. liver cells to form bilirubin diglucuron- bilicyanin (bı˘lЉı˘-sı¯Јa˘-nı˘n) [L. bilis, bile, ide, which is water-soluble and excreted ϩ cyaneus, blue] A blue or purple pig- in urine. short ment, an oxidation product of biliverdin. indirect b. Unconjugated bilirubin standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bilirubinate 262 binder base of rh

B. I operation Gastroduodenostomy. B. II operation Gastrojejunostomy. bilobate (bı¯-lo¯Јba¯t) [L. bis, twice, ϩ lo- bus, lobe] Having two lobes. bilocular (bı¯-lo˘kЈu¯-la˘r) [Љϩloculus, cell] 1. Having two cells. 2. Divided into compartments. biloma An abnormal collection of bile outside the gallbladder, usually result- ing from injury to the right upper quad- rant during trauma or surgery. bimanual (bı¯-ma˘nЈu¯-a˘l) [Љϩmanus, hand] With both hands, as in bimanual palpation. bimaxillary (bı¯-ma˘kЈsı˘-le˘rЉe¯) [Љϩmax- illa, jawbone] Pert. to or afflicting both jaws. bimodal (bı¯-mo¯Јda˘l) [Љϩmodus, mode] BILIRUBIN CRYSTALS (ϫ400) Pert. to a graphic presentation that con- tains two peaks. binary (bı¯Јna¯r-e¯) [L. binarius, of two] that is present in the blood. It is fat-sol- 1. Composed of two elements. 2. Sepa- uble. rating into two branches. bilirubinate (bı˘l-ı˘-rooЈbı˘n-a¯t) A salt of b. acid An acid containing hydrogen bilirubin. and one other element. bilirubinemia (bı˘lЉı˘-roo-bı˘n-e¯Јme¯-a˘) [Љϩ b. code SEE: b. system. ruber, red, ϩ Gr. haima, blood] Bili- b. system A numbering system par- rubin in the blood, usually in excessive ticularly well suited to use by comput- amounts. Bilirubin normally is present ers. All of the information placed into a in the blood in small amounts. It in- computer is in binary form, i.e., num- creases, however, in diseases in which bers made up of zeros and ones (0’s and there is excessive destruction of red 1’s). In this system each place in a bi- blood cells or interference with bile ex- nary number represents a power of 2 cretion; the amount is also increased (i.e., the number of times 2 is to be mul- when the liver is diseased or damaged. tiplied by itself). Also called hyperbilirubinemia. SEE: binaural (bı¯ЈnawrЈa˘l) [L. bis, twice, ϩ jaundice. auris, ear] Pert. to both ears. bilirubinometry (bı˘lЉı˘-roo-bı˘n-o˘mЈı˘-tre¯) binauricular (bı˘nЉaw-rı˘kЈu¯-la˘r) [Љϩau- The laboratory technique of measuring ricula, little ear] Binaural; pert. to both bilirubin levels in blood, skin, cerebro- auricles of the ear. spinal fluid, or urine. These measure- bind 1. To fasten, wrap, or encircle with ments are used esp. in the treatment of a bandage. 2. In chemistry and immu- hyperbilirubinemia in neonates. SEE: nology, the uniting or adherence (i.e., hyperbilirubinemia; kernicterus. bonding) of one molecule or chemical en- bilirubinuria (bı˘lЉı˘-roo-bı˘n-u¯ Јre¯-a˘) [ЉϩЉ tity to another (e.g., the joining of a ϩ Gr. ouron, urine] Presence of bili- toxin to an antitoxin or of a hormone to rubin in urine. SYN: biliuria. its receptor on a cell surface). biliuria (bı˘l-ı˘-u¯ Јre¯-a˘) Bilirubinuria. binder (bı¯ndЈe˘r) [AS. bindan, to tie up] biliverdin (bı˘l-ı˘-ve˘rЈdı˘n) [Љϩviridis, 1. A broad bandage most commonly green] C33H34O6N4; a greenish pigment used as an encircling support of the ab- in bile formed by the oxidation of bili- domen or chest. SEE: bandage. 2. In rubin. dental materials, a substance that holds Billings method (bı˘lЈı˘ngz) [John Bil- a mixture of solid particles together. lings, Australian neurologist, 1918– abdominal b. A wide band fastened 2007] A method of family planning in snugly about the abdomen for support. which observations about the thickness chest b. A broad band that encircles and slipperiness of cervicovaginal mu- the chest and is used for applying heat, cus are used to determine when a dressings, or pressure and for support- woman is more (or less) likely to con- ing the breasts. Shoulder straps may be ceive a child. used to keep the binder from slipping. billion [Fr. bi, two, ϩ million, million] double-T b. A horizontal band about 1. In the U.S., billion is a number equal the waist to which two vertical bands to 1 followed by 9 zeros (1,000,000,000) are attached in back, brought around or (109). 2. In Europe, billion is a num- the leg, and again fastened to the hori- ber equal to 1 followed by 12 zeros (1012), zontal band. that is, bi-million, or twice the number obstetrical b. A binder that extends of zeros in a million (106). from the ribs to the pelvis, providing Billroth, Christian A.T. (Bı˘lЈ-ro˘th) Aus- support for a markedly pendulous ab- short trian surgeon, 1829–1894. domen. Such support may be rarely re- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh binder 263 bioclimatology base of rh

quired for severe diastasis recti or for bioactive food component A compound marked separation and mobility of the occurring in food that brings about a pubic symphysis during pregnancy. physiological effect. phosphate b. Any of various medi- bioartificial (bı¯Љo¯-a˘rЉtı˘-fı˘shЈa˘l) [ЉϩЉ] cations used to prevent hyperphospha- Composed of both living and manufac- temia in patients with end-stage renal tured components, typically a collection disease. Calcium carbonate taken with of cells held within a scaffolding or meals is the most commonly employed membrane. Bioartificial organs can be agent. In the past aluminum-containing used to assist patients with organ fail- antacids were used for this purpose, but ure (e.g., end-stage heart, kidney, liver, this practice is now avoided because of or pancreatic disease). the toxic accumulation of aluminum in bioassay (bı¯Љo¯-a˘sЈa¯) [ЉϩO. Fr. asaier, patients with renal failure. to try] In pharmacology, the determi- Scultetus b. SEE: Scultetus binder. nation of the strength of a drug or sub- Tb. T bandage. stance by comparing its effect on a live towel b. A towel that encircles the animal or an isolated organ preparation abdomen or chest and whose ends are with that of a standard preparation. pinned together. bioastronautics (bı¯Љo¯-a˘sЉtro¯-nawЈtı˘ks) Binder’s syndrome A syndrome related The study of the effects of space travel to facial growth, with hypoplasia of the on living plants and animals. maxillae and nasal bones resulting in a bioavailability (bı¯Љo¯-a˘-va¯lЉa˘-bı˘lЈı˘-te¯) The flattened face, elongated nose, and rate and extent to which an active drug smaller maxillary arch with crowding of or metabolite enters the general circu- the teeth and malocclusions. lation, permitting access to the site of binge drinking (bı˘nj) The consumption action. Bioavailability is determined ei- of more than four or five alcoholic drinks ther by measurement of the concentra- in a row (the lower number applies to tion of the drug in body fluids or by the women; the higher number applies to magnitude of the pharmacologic re- men). The behavioral consequences of sponse. bioavailable (−a˘-va¯lЈa˘-bı˘l), adj. this practice include impaired driving, biobank (bı¯Јo¯-ba˘ngkЉ)[ЉϩЉ] An insti- sexual assaults, and other forms of vio- tution that stores human tissues, e.g., lence. SEE: alcoholism. autopsy specimens, blood, or organ bi- binge eating An eating disorder marked opsies, for research. by rapid consumption of large amounts bioburden (bı¯Јo¯-bu˘rЈde˘n) The number of of food in a short period of time. SEE: contaminating microorganisms present bulimia. on an object (e.g., on the surface of a sur- bingo card A method of packaging med- gical glove, endoscope, or body part). Re- ications in which a blister pack is en- duction of the bioburden is the goal of closed in a folded-over card, usually infection control programs and proto- printed with proprietary advertising for cols. the medication inside. biocatalyst (bı¯-o¯-ka˘tЈa˘-lı˘st) [Љϩkata- binocular (bı˘n-o˘kЈu¯-la˘r) [L. bis, twice, ϩ lyein, to dissolve] An enzyme; a bio- oculus, eye] Pert. to both eyes. Ј Љ chemical catalyzer. binocularity (bı˘n-o˘k-u¯-la˘r ı˘-te¯) [ ] The Ј coordinated use of both eyes. It is also biochemical (bı¯-o¯-ke˘m ı˘-ka˘l) Of or rel. to known as eye teaming. biochemistry. binomial (bı¯-no¯Јme¯-a˘l) [Љϩnomen, b. marker Any biochemical com- name] In mathematics and statistics, pound such as an antigen, antibody, ab- an equation containing two variables. normal enzyme, or hormone that is suf- binotic (bı˘n-o˘tЈ˘k)ı [ЉϩGr. ous, ear] ficiently altered in a disease to serve as Pert. to or having two ears. an aid in diagnosing or in predicting Ј susceptibility to the disease. binovular (bı˘n-o˘v u¯-la˘r) Biovular. Љϩ binuclear, binucleate (bı¯-nu¯ Јkle¯-a˘r, −a¯t) biochemistry [ chemeia, chemistry] [Љϩnucleus, kernel] Having two nu- The chemistry of living things; the sci- clei. ence of the chemical changes accompa- bio- (bı¯Јo¯) [Gr. bios, life] Combining nying the vital functions of plants and form indicating relationship to life. animals. bioabsorbable (bı¯Љo¯-a˘b-so˘rbЈı˘-bı˘l) [Љϩ biochemorphology (bı¯Љo¯-ke˘-mor-fo˘lЈo¯-je¯) Љ] Capable of being assimilated by the [ЉϩЉϩmorphe, shape, ϩ logos, body, first, because it is relatively easy word, reason] The science of the rela- to implant and second, because it de- tionship between chemical structure grades within the body and gradually and biological action. SEE: stereochem- transfers physical loads to living tissue. istry. bioaccumulation (bı¯Љo¯-a˘-ku¯ Љmu¯-la¯Јshu˘n) biocide (bı¯Јo¯-sı¯d) [ЉϩL. caedere, to The gradual incorporation of chemicals, kill] A substance, esp. a pesticide or an drugs, pollutants, or other agents into antibiotic, that destroys living orga- living cells. nisms. bioactive (bı¯Љo¯-a˘kЈtı˘v) Affecting living bioclimatology (bı¯Љo¯-klı¯-ma˘-to˘lЈo¯-je¯) [Љ short tissues. ϩ klima, climate, ϩ logos, word, rea- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh biocolloid 264 biologic base of rh

son] Study of the relationship of cli- inquiry into issues raised by life sci- mate to life. ences. biocolloid (bı¯Љo¯-ko˘lЈoyd) [Љϩkollodes, bioethics committee Any local, regional, glutinous] A colloid from animal, veg- national, or international group that re- etable, or microbial tissue. views the moral implications of biomed- biocompatibility (bı¯Љo¯-ko˘m-pa˘tЉa˘-bı˘lЈı˘-te¯) ical research, e.g., research into cloning, The condition of being harmonious with human enhancement, biotechnology, or living systems. life extension. biocontainment (bı¯Љo¯-ko˘n-ta¯nЈ-me˘nt) In biofeedback (bı¯Љo¯-fe¯dЈba˘kЉ) A training infectious disease laboratories, the pro- program designed to develop one’s abil- cess and procedures used to confine ity to control the autonomic (involun- harmful microorganisms to the areas in tary) nervous system. After learning the which they are being investigated. The technique, the patient may be able to precise regulations vary with the path- control heart rate, blood pressure, and ogenicity of the organisms. SEE: bio- skin temperature or to relaxcertain safety level. muscles. The patient learns by using biodefense (bı¯Љo¯-de˘-fe˘nsЈ)[ЉϩЉ] Na- monitoring devices that sound a tone tional or international efforts to prevent when changes in pulse, blood pressure, the spread of biologically destructive brain waves, and muscle contractions agents, esp. when they are used in ter- occur. Then the patient attempts to re- rorism or warfare. produce the conditions that caused the biodegradable (bı¯Љo¯-de¯-gra¯dЈ-a˘-be˘l) Sus- desired changes. ceptible to degradation by biological biofilm (bı¯Јo¯-fı˘lmЉ) A thin coating of bac- processes, such as bacterial or enzy- teria embedded in a moist, adhesive ma- matic action. trixthat may cover mucous membranes biodegradation (bı¯Љo¯-de˘gЉre˘-da¯Јshu˘n) and devices placed inside the body, in- The breakdown of organic materials cluding catheters and stents. Bacteria into simple chemicals by biochemical thriving in a biofilm are resistant both processes. Also called biological degra- to phagocytosis by white blood cells and to destruction by antibiotics. dation. Љ Ј Љϩ biodynamics (bı¯Љo¯-dı¯-na˘mЈı˘ks) [Gr. bios, biogenesis (bı¯ o¯-je˘n e˘-sı˘s) [ genesis, life, ϩ dynamis, force] Pertaining to generation, birth] The theory that life the kinetics of chemical or mechanical can originate only from pre-existing life processes in biological systems. and never from nonliving material. Љ Ј biogenetic (−je˘-ne˘tЈı˘k), adj. bioelectrical (bı¯ o¯-e˘-le˘k trı˘-kı˘l) Pert. to Ј the electrical activities of living orga- biogenic (bı¯-o¯-je˘n ı˘k) Produced by living nisms. organisms. bioelectrical impedance analysis (bı¯Љo¯-ı˘- b. amines A group of chemical com- pounds, most of which are important in le˘kЈtrı˘-kı˘l) ABBR: BIA. A method of neurotransmission. Included are nor- body composition analysis useful in epinephrine, histamine, serotonin, and measuring the total body water and dopamine. other components. BIA relies on the biogerontology (bı¯Љo¯-je˘-ro˘n-to˘lЈo˘-je¯) [Љ changes in electrical current as it trav- ϩЉ] The study of the fundamental bio- els through body fluids and tissues. The logical processes that result from aging. results obtained may vary with ambient biohazard (bı¯Љo¯-hazЉe˘rd) Anything that temperature and humidity, the subject’s is harmful or potentially harmful to hu- hydration, and other variables. Љ Љ Ј mans, other species, or the environ- bioelectronics (bı¯ o¯-e¯ le˘k-tro˘n ı˘ks) The ment. SEE: biosafety level. study of the transfer of electrons be- bioidentical (bı¯Јo¯-ı¯-de˘nЈtı˘-kı˘l) [ЉϩЉ] tween molecules in biological systems. Љ Љ Ј Having the same chemical structure bioenergetics (bı¯ o¯-e˘n e˘r-je˘t ı˘ks) The and function as a molecule found in na- study of energy transfer and relation- ture. ships among living systems. (bı¯Љo¯-ı˘n-e¯-kwı˘vЈa˘-le˘nt) Љ Љ Ј bioinequivalent bioengineering (bı¯ o¯-e˘n jı˘-ne¯r ı˘ng) The Differing in physiological or pharmaco- application of engineering concepts, logical action from another agent. equipment, skills, and techniques to bioinstrument (bı¯Љo¯-ı˘nЈstroo-me˘nt) A de- solving medical problems. SEE: biomed- vice placed in the body to record or ical engineering. transmit data. bioequivalent (bı¯Љo¯-e¯-kwı˘vЈa˘-le˘nt) biokinetics (bı¯Љo¯-kı˘-ne˘tЈı˘ks) [Љϩkine- 1. Biologically equivalent to another tikos, moving] The study of growth agent, esp.another drug or therapeutic changes and movements in developing agent. 2. A drug whose effects on the organisms. body are indistinguishable from the ef- biologic (bı¯Љo¯-lo˘jЈı˘k) [Љϩlogos, word, fects of another. reason] 1. Pert. to biology. 2. An agent bioesthesiometer (bı¯Љo¯-e˘s-the¯zЉe¯-o˘mЈa˘- derived from or made of living tissues or te˘r) An instrument used to measure vi- cells and used in health care. bration perception. b. half-life The time required to re- short bioethics (bı¯Љo¯-e´thЈı˘ks) [ЉϩЉ] Moral duce the concentration of a drug in the standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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blood, plasma, or serum by 50%. This is biome (bı¯Јo¯m) [Љϩoma, mass] A ma- a measure of the rate of drug distribu- jor type of environment, such as tundra, tion and elimination. SEE: half-life; forest, or swamp, marked by its climate, pharmacokinetics. flora, fauna, and pathogens. biological (bı¯Љo¯-lo˘jЈı˘k-a˘l) 1. Pert. to biol- biomechanics (bı¯Љo¯-me˘-ka˘nЈı˘ks) The ap- ogy. 2. A medicinal compound (such as plication of engineering and physical a serum, vaccine, antigen, or antitoxin) science to the movement of living orga- prepared from living organisms and nisms. SEE: kinesiology. their products. biomedical (bı¯Јo¯-me˘dЈı˘-kı˘l) Biological b. armature SEE: armature (1). and medical; pert. to application of nat- b. degradation The breakdown of or- ural sciences to the study of medicine. ganic materials into simple chemicals b. engineer A certified design engi- by biochemical processes. neer, usually with a Bachelor of Science b. fitness SEE: fitness, biological. degree, who designs and/or maintains b. warfare ABBR: BW. Warfare in medical equipment. Also referred to as which disease-producing microorga- a clinical engineer. nisms, toxins, or organic biocides (e.g., b. engineering Application of the anthrax, brucellosis, plague) are delib- principles and practices of engineering erately used to destroy, injure, or im- to biomedical research and health care, mobilize livestock, vegetation, or hu- as seen in the development of devices man life. SYN: biowar. SEE: chemical such as cardiac pacemakers, hearing warfare. aids, and artificial limbs and joints. biological intelligence Those compo- b. engineering technologist A certi- nents of intelligence that can be directly fied technical specialist who repairs and attributed to the anatomy and physiol- maintains medical equipment. ogy of the central nervous system. Bio- biometeorology (bı¯Љo¯-me¯Љte¯-or-o˘lЈo˘-je¯) [Љ logical intelligence is sometimes distin- ϩ meteoros, raised from off the ground, guished from artificial intelligence, i.e., ϩ logos, word, reason] The study of the intelligence demonstrated by computer effects of weather on living organisms. behavior, and from psychometric intel- biometric identifier (bı¯Љo¯-me˘Јtrı˘k¯- ı ligence or intelligence as documented by de˘nЈtı˘-fı¯Љe˘r) Biologically unique data the performance of subjects on IQ tests. (e.g., fingerprint data, genetic data, and biological therapy Therapy with immu- voiceprints) that identify a person. Un- nologically active agents. der provisions of the Health Insurance biologist (bı¯-o˘lЈo¯-jı˘st) A specialist in bi- Portability and Accountability Act, bio- ology. metric identifiers are protected health biology (bı¯-o˘lЈo¯-je¯) [Gr. bios, life, ϩ lo- information that must be held in strict gos, word, reason] The science of life confidence by health care agencies and and living things. professionals. molecular b. The study of DNA, pro- biometrics (bı¯Љo¯-me˘tЈrı˘ks) Biometry (1). teins, and other molecular constituents biometry (bı¯-o˘mЈe˘-tre¯) [Љϩmetron, of cells. measure] 1. The application of statis- radiation b. The study of the effects tics to biological science. SYN: biomet- of radiation on living organisms. rics; biostatistics. 2. The computation of bioluminescence (bı¯Љo¯-looЉmı˘-ne˘sЈe˘ns) [Љ life expectancy. 3. Identification of liv- ϩ L. lumen, light] Emission of visible ing things by precise anatomical or light from living organisms, (e.g., cold physiological measurements. light produced by fireflies). ophthalmic b. Measurement of any biolysis (bı¯-o˘lЈı˘-sı˘s) [Љϩlysis, dissolu- part of the eye, from the cornea to the tion] The chemical decomposition of retina, with an ophthalmic ultrasound. living tissue by the action of living or- biomicroscope (bı¯Љo¯-mı¯Јkro˘-sko¯p) A mi- ganisms. biolytic (bı¯-o¯-lı˘tЈı˘k), adj. croscope used with a slit lamp for view- biomarker (bı¯Јo¯-mahrkЈe˘r) 1. A signal ing segments of the eye. that serves as an indicator of the state biomicroscopy (bı¯Љo¯-mı¯-kro˘sЈko˘-pe¯) [Љ of a living organism. 2. A biochemical, ϩЉ] The examination of tissues with genetic, or molecular indicator that can an illuminated low-powered micro- be used to screen diseases, such as can- scope, e.g., in slit lamp examinations of cer. the eyes or in cervical colposcopy. biomarker of susceptibility A biomarker bion (bı¯Јo˘n) [Gr. bios, life] Any living or- used to indicate that a cell, organism, or ganism. tissue can be influenced by a specific bionics (bı¯-o˘nЈı˘ks) The study of biologi- agent or toxin. cal functions and mechanisms and the biomass (bı¯Јo¯-ma˘s) [ЉϩL. massa, application of these findings to the de- mass] All of the living organisms in a sign of machines, esp. computers. specified area. biopharming (bı¯Јo¯-fa˘rmЉı˘ng) [ЉϩGk. biomaterial (bı¯Љo¯-ma˘-te¯rЈe¯-ı˘l) [ЉϩЉ] pharmakon, poison ϩ pun on farming] An inert substance used to replace a The genetic alteration of a plant or an- body part or to be made compatible with imal so that its cells can be used to man- short living tissue. ufacture medications. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh biophysics 266 biopsy base of rh biophysics (bı¯Љo¯-fı˘zЈı˘ks) [Љϩphysikos, breast tissue through a single point of natural] Application of physical laws to insertion. This minimally invasive pro- biological processes and functions. bio- cedure is usually performed under local physical (−ı˘-ka˘l), adj. anesthesia, using stereotactic imaging biopolymer (bı¯Љo¯-po˘lЈı˘-mı˘r) [ЉϩЉ]A or real-time ultrasonography. polymer made of biologically compatible percutaneous renal b. Obtaining re- or biodegradable components. nal tissue for analysis with a needle in- biopsy (bı¯Јo˘p-se¯) [Љϩopsis, vision] A serted through the skin, usually done tissue sample removed from the body after the kidney has been localized by for microscopic examination, usually to ultrasound, computed tomography, or establish a diagnosis. The tissue can be angiography. This technique is used to obtained surgically or by aspiration. establish a diagnosis of renal dysfunc- The procedure can be guided by com- tion, determine prognosis in patients puted tomography, ultrasonography, with renal disease, evaluate the extent magnetic resonance imaging, or radi- of renal injury, and determine appro- ography, or it can be performed without priate therapy. The most common com- imaging (i.e., “blindly”). plication is urinary bleeding, which aspiration b. The removal of tissue tends to clear gradually over several with a needle and syringe, for example, days. from a cyst or the bone marrow. percutaneous transthoracic needle brush b. The removal of cells from an aspiration b. Use of a radiographically organ by rubbing them loose. guided aspiration needle to obtain a cone b. Removal of a cone shaped sample of tissue in cases of suspected piece of tissue from the uterine cervixto pulmonary malignancies or other un- diagnose or treat cervical diseases. The known lesions. Because of the risk of procedure may be performed with a sur- pneumothorax, the procedure is usually gical knife (scalpel), carbon dioxide contraindicated in patients receiving (CO2) laser, or Loop Electrosurgical Ex- mechanical ventilation. cision Procedure (LEEP). punch b. The removal of a small endometrial b. The removal of a piece of tissue (usually of the skin) with sample of uterine endometrium for mi- a hollow, round cutting tool. SEE: illus. croscopic study. The procedure is com- monly used in fertility assessment to confirm ovulation and to determine the cause of dysfunctional or postmenopau- sal bleeding. fine needle aspiration b. ABBR: FNA biopsy. The removal of tissue through a long needle with or without radiological guidance. SEE: illus.

FINE NEEDLE BREAST BIOPSY liver b. The removal of tissue from the liver with a large-bore needle that captures a core of tissue. muscle b. The removal of muscle tis- sue for microscopic examination and PUNCH BIOPSY chemical analysis. needle b. The removal of cells or tis- sentinel node b. A technique for sue with a needle by aspiration. identifying the initial site of cancer me- percutaneous breast b. Use of a di- tastasis. After injection of a radioactive rectional, high-speed, rotating cutter at- tracer directly into the tumor mass, the tached to a vacuum source to gather tissue is massaged to encourage uptake short multiple contiguous core samples of of tracer by lymphatic vessels. A nega- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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tive biopsy of the first node infiltrated biosynthesis (bı¯Љo¯-sı˘nЈthe˘-sı˘s) [Љϩsyn- by the tracer suggests that the malig- thesis, a putting together] The forma- nancy has not yet spread to neighboring tion of chemical compounds by a living regional lymph nodes. organism. suction b. A technique for obtaining biota (bı¯-o¯Јta˘) [Gr. bios, life] The com- tissue by aspiration; e.g., to obtain tis- bined animal and plant life in an area. sue from the mucosa of the stomach and biotaxis (bı¯Љo¯-ta˘kЈsı˘s) [Љϩtaxis, ar- intestines. rangement] Movement of an organism biopsychosocial (bı¯Љo¯-sı¯Љko¯-so¯Јsha˘l) Bio- in response to an external stimulus. logical, psychological, and social; pert. Biot’s breathing (be¯-o¯zЈ) [Camille Biot, to the application of knowledge from the Fr. physician, b. 1878] Breathing biological and behavioral sciences to marked by several short breaths fol- study or solve human problems. lowed by long, irregular periods of ap- biopterin (bı¯-o˘pЈte˘r-ı˘n) 2-amino-4-hy- nea. It is seen in patients with increased droxy-6-(1,2-hydroxypropyl) pteridine, intracranial pressure. SEE: Cheyne- important in metabolizing phenylala- Stokes respiration. nine. A deficiency of biopterin is a rare biotechnology (bı¯Љo¯-te˘k-no˘lЈo¯-je¯) The cause of phenylketonuria. use of living organisms or biological pro- bioptome (bı¯-o˘pЈto¯m) A tool used to ob- cesses in technical industrial applica- tain biopsies of the endomyocardium. It tions. consists of a forceps (with small tissue- biotelemetry (bı¯Љo¯-te˘l-e˘mЈe˘-tre¯) [Gr. cutting jaws) that is advanced into the bios, life, ϩ tele, distant, ϩ metron, ventricle along a catheter or guidewire. measure] Recording physiological pa- bioremediation (bı¯Љo¯-re˘-me¯Љde¯-a¯Јshu˘n) rameters such as temperature, heart The conversion of hazardous wastes and rate, ECG, and EEG in subjects remote pollutants into harmless materials by from the investigator. This is done by microorganisms. transmitting and receiving by telephone biorhythm (bı¯Јo¯-rı˘thЉu˘m) [Љϩrhyth- or other electronic methods. mos, rhythm] A cyclic phenomenon bioterrorism (bı¯Љo¯-te˘rЈo˘-rı˘Љzı˘m) [Љϩ (e.g., circadian rhythm, sleep cycle, and terrorism] The use of biological warfare menstrual cycle) that occurs with estab- agents against civilian rather than mil- lished regularity in living organisms. itary targets. SEE: clock, biological. biotherapy (bı¯Јo¯-the˘rЈa˘-pe¯) In comple- bios (bı¯Јo˘s) [Gr., life] 1. Organic life. mentary medicine and in oncology, the 2. A group of substances (including in- use of biological response modifiers ositol, biotin, and thiamine) necessary (e.g., interleukins, phytochemicals, or for the most favorable growth of some phytonutrients) to enhance the immune yeasts. response, alter hormone levels, or assist biosafety level (bı¯Јo¯-sa¯fЈte¯le˘vЈı˘l) ABBR: in the treatment of cancer. BSL. A classification system to indicate biotics (bı¯-o˘tЈı˘ks) [Gr. biotikos, living] the safety precautions required for The science that deals with the func- those investigating microorganisms tions of life. (esp. viruses known to be dangerous or biotin (bı¯Јo¯-tı˘n) A vitamin that is a co- lethal to those exposed to them). There enzyme involved in gluconeogenesis are four BSLs, with BSL-4 requiring the and fat synthesis. It is commonly found highest level of security. in egg yolks, peanut butter, liver, kid- bioscience (bı¯Љo¯-sı¯Јe˘ns) [Gr. bios, life, ϩ ney, cauliflower, and yeast. Deficiencies L. scientia, knowledge] Life science. occur when people consume large biosensor (bı¯Јo¯-se˘nЉsor) [Gr. bios, life, amounts of raw egg white, which con- ϩ sensor] A device that senses and an- tains avidin. Deficiency is also common alyzes biological information, including among alcoholics. Children with biotin temperature, heart rate, blood pressure, deficiency have delayed mental and or the chemical composition of body flu- physical development, alopecia, im- ids. paired immunity, and anemia. SYN: vi- biospectrometry (bı¯Љo¯-spe˘k-tro˘mЈe˘-tre¯) tamin H. [ЉϩL. spectrum, image, ϩ Gr. met- biotoxin (bı¯-o¯-to˘kЈsı˘n) [Gr. bios, life, ϩ ron, measure] Use of a spectroscope to toxikon, poison] A toxin produced by or determine the amounts and kinds of found in a living organism. substances in tissues. biotransformation (bı¯Јo¯-tra˘nsЉfo˘r- biospectroscopy (bı¯Љo¯-spe˘k-tro˘sЈko¯-pe¯) ma¯Јshu˘n) The chemical alteration that [ЉϩЉϩGr. skopein, to examine] Ex- a substance undergoes in the body. amination of tissue by use of a spectro- biotrauma (bı¯Љo¯-trawЈma˘) [ЉϩЉ] In- scope. jury to the lungs during mechanical biosphere (bı¯Јo¯-sfe¯rЉ)[Љϩsphaira, ventilation resulting from excessive in- ball] The parts of earth’s land, water, flammation (i.e., from the systemic and atmosphere in which living orga- release of damaging cytokines). Bio- nisms can exist. trauma is one type of ventilatory-in- biostatistics (bı¯Љo¯-sta˘-tı˘sЈtı˘ks) Biometry duced lung injury. SEE: inflammation short (1). for illus. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh biotype 268 birth base of rh biotype (bı¯Јo¯-tı¯p) [Љϩtypos, mark] other anticonvulsant agents may be 1. Individuals possessing the same tried. genotype. 2. In microbiology, the former name for biovar. SEE: biovar. Bipolar disorder should not be biovar (bı¯Јo¯-va˘r) [biological variation] managed with agents that solely In microbiology, a term for variants treat unipolar depression. Such treatment within a species. These are usually may trigger manic or hypomanic epi- distinguished by certain biochemical or sodes. physiological characteristics. SEE: morph- ovar; serovar. biovular (bı¯-o˘vЈu¯-la˘r) [L. bis, twice, ϩ Bipolaris (bı¯Љpo¯-la¯rЈ˘sı [ЉϩL. polaris, po- ovum, egg] Derived from or pert. to two lar]) A genus of filamentous pigment- ova. SYN: binovular. producing fungi that can cause disease biowar (bı¯-o˘-wa˘rЈ) Biological warfare. in immunosuppressed and immunocom- BiPAP A form of noninvasive ventilation petent patients. Bipolaris species are supplied by facial or nasal mask in found in soils and vegetation, have been which both inspiratory and expiratory identified in brain, lung, and sinus in- pressures are set above atmospheric fections, and resist treatment with cur- levels. This type of ventilatory support rent antifungal medications. assists patients with sleep apnea, con- BIRADS (bı¯Јra˘dzЉ) [Acronym fm. Breast gestive heart failure, hypoventilation, Imaging Reporting and Data System]A and other forms of respiratory insuffi- classification system developed by the ciency. American College of Radiology to char- bipara (bı˘pЈa˘-ra˘) [Љϩparere, to bring acterize findings obtained during breast forth, to bear] A woman who has given imaging. Breast imaging may be done birth for the second time to an infant or by mammography, magnetic resonance infants, alive or dead, weighing 500 g or imaging, and/or ultrasonography. Cat- more. SYN: secundipara. egory 1 findings are considered normal. biparental (bı¯Љpa˘-re˘nЈta˘l) [Љϩparere, Categories 2 and 3 are considered to to bring forth, to bear] Derived from have minor abnormalities, and those in two parents, male and female. category 3 require follow-up testing biparietal (bı¯Љpa˘-rı¯Јe˘-ta˘l) Concerning the within a half year. Categories 4 and 5 parietal bones or their eminences. are “suspicious” and “worrisome” for biparous (bı˘pЈa˘-ru˘s) Producing two ova cancer, respectively. or offspring at one time. biramous (bı¯-ra¯Јmu˘s) [Љϩramus, a biped (bı¯Јpe˘d) [Љϩpes, foot] An ani- branch] Possessing two branches. mal with two feet. birefractive (bı¯Љre¯-fra˘kЈtı˘v) [Љϩrefran- bipenniform (bı¯-pe˘nЈı˘-form) [Љϩ gere, to break up] Pert. to or having bi- penna, feather, ϩ forma, shape] Mus- refringence. cle fibers that come from each side of a birefringence (bı¯Љre¯-frı˘nЈje˘ns) The split- tendon in the manner in which barbs ting of a ray of light in two. birefringent come from the central shaft of a feather. (−je˘nt), adj. biphasic (bı¯-fa¯zЈı˘k) Consisting of two birth [Old Norse burdhr] The act of be- phases. SYN: diphasic. ing born; passage of a child from the bipolar (bı¯-po¯lЈa˘r) [Љϩpolus, a pole] uterus. 1. Having two poles or processes. cesarean b. Cesarean section. 2. Pert. to the use of two poles in elec- complete b. The instant of complete trotherapeutic treatments. The term bi- separation of the body of the infant from terminal should be used when referring that of the mother, regardless of to an alternating current. 3. A two-poled whether the cord or placenta is de- nerve cell. 4. A term used as a synonym tached. for the more formal psychiatric term, cross b. Crossbirth. mood disorder, bipolar. dry b. A colloquial and imprecise bipolar disorder A psychological disorder term for a birth that follows premature marked by manic and depressive epi- rupture of membranes. sodes. Bipolar disorders are divided into live b. An infant showing one of the four main categories: bipolar I, bipolar three evidences of life (breathing, heart II, cyclothymia, and nonspecified disor- action, movements of a voluntary mus- ders. Mania is the essential feature of cle) after complete birth. In some coun- bipolar I, whereas recurrent moods of tries a live birth is considered not to both mania and depression mark bipo- have occurred if the infant dies during lar II. SYN: manic-depressive psychosis. the 24 hr following delivery. Which of SEE: mood disorder; Nursing Diagnoses these two definitions is used has consid- Appendix. erable effect on various vital statistics TREATMENT: Often the first-line concerned with the viability of the fetus choice of medication is lithium carbon- at time of delivery. ate. If there are concerns about the side multiple b. The birth of two or more effects of lithium or it is found to be in- offspring produced in the same gesta- short effective, valproate, carbamazepine, or tion period. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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premature b. Preterm birth. mortality in the U.S. and most devel- preterm b. Delivery occurring be- oped countries. Each year in the U.S. tween 20 and 38 weeks’ gestation. Neo- about 150,000 babies are born with se- natal morbidity and mortality are high rious birth defects. Known causes in- because of physiological immaturity. clude human teratogens, chromosomal Preterm neonates are at high risk for defects, and single-gene defects. The developing respiratory distress syn- cause is unknown in about two thirds of drome; intraventricular hemorrhage; the cases. SEE: table. sepsis; patent ductus arteriosus; reti- birthing chair (bı˘rthЈı˘ng) A chair de- nopathy of prematurity; and necrotizing signed for use during childbirth. The enterocolitis. SYN: premature birth. mother is in a sitting or semireclining SEE: prematurity; preterm labor. position, which facilitates the labor pro- TREATMENT: When there is a risk of cess and is more comfortable than the birth occurring between 24 and 34 supine position. weeks’ gestation, corticosteroid therapy birthmark (bı˘rthЈmarkЉ) Nevus (1). to stimulate fetal lung maturation and birth mother SEE: under mother. production of pulmonary surfactant birth parent(s) SEE: under parent. should be considered; however, birth birth spacing The time between the birth must occur in no less than 24 hr after of one child and the birth of the next administration. Therapy should be re- one. Parents often manage the interval peated weekly until 34 weeks’ gestation. between births for a variety of personal, There is no evidence that this treatment psychological, or economic reasons. In- is harmful to fetuses of either gender. tervals of less than 17 months or more CONTRAINDICATIONS: Corticoste- than 5 years increase the risk of certain roid therapy should not be administered maternal and child health problems, if the mother has chorioamnionitis or if such as pre-eclampsia, eclampsia, low there is evidence that the drug will have birth weight, preterm birth, and mater- an adverse effect on the mother. Cau- nal mortality.interpregnancy interval. tion is recommended in women who birth weight SEE: weight, birth. have diabetes mellitus and/or hyperten- extremely low b.w. ABBR: ELBW. sion. A birth weight of less than 1000 g (2.2 birth canal SEE: under canal. lb). birth center An alternative nonhospital very low b. ABBR: VLBW. Having facility that provides family-oriented a body weight at delivery of less than maternity care for women judged to be 1500 g (but more than 500 g). Newborns at low risk of experiencing obstetrical that are this small make up about 1% of complications. all births in the U.S. but account for birth certificate A legal written record of about 60% of deaths in the first month the birth of a child, as required by U.S. of life. law. bisacodyl (bı˘s-a˘kЈo¯-dı˘l; bı˘sЉa˘-ko¯Јdı˘l) A birth control Prevention of conception or cathartic drug that acts by its direct ef- implantation of the fertilized ovum, or fect on the colon. It may be adminis- termination of pregnancy. Methods of tered orally or by rectal suppository. birth control may be temporary and re- Trade names are Dulcolaxand Thera- versible or permanent. Temporary lax. methods to avoid conception include bisection (bı¯-se˘kЈshu˘n) [Љϩsectio, a physical barriers (e.g., male and female cutting] Division into two parts by cut- condoms, diaphragms, cervical caps, ting. and vaginal sponges) that are most ef- bisexual (bı¯-se˘ksЈu¯-a˘l) [Љϩsexus, sex] fective when used in conjunction with 1. Hermaphroditic; having imperfect chemical barriers (such as spermicidal genitalia of both sexes in one person. vaginal suppositories, creams, jellies, or 2. An individual who is sexually active foams). Hormonal methods include oral with others of either sex. SEE: hetero- contraceptive pills and progestin im- sexual; homosexual; lesbian. plants to suppress ovulation. Fertility bisferious (bı˘s-fe˘rЈe¯-u˘s) [Љϩferire, to awareness methods, such as rhythm, in- beat] Having two beats; dicrotic. volve identification of and abstinence Bishop’s score (bı˘shЈo˘ps) A system for during ovulation, graphing basal body evaluating the potential for successful temperature and changes in cervical elective induction of labor. Factors as- mucus consistency and estimation of sessed include fetal station, cervical po- the day of ovulation. Intrauterine de- sition, effacement, dilation, and consist- vices (IUD) prevent zygote implanta- ency. Each factor receives a score of 0, tion. Sterilization techniques include 1, 2, or 3, for the maximum predictive male vasectomy and female tubal liga- total score of 15. The lower the score, the tion. Sterilization usually is permanent greater the possibility that labor induc- but may be reversible. tion will fail. birth control pill SEE: under pill. bisiliac (bı˘s-ı˘lЈe¯-a˘k) [Љϩilium, ilium] birth defect A congenital anomaly. Birth Pert. to the two iliac crests or any cor- short defects are a leading cause of infant responding iliac structures. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bis in die 270 bite base of rh

Common Birth Defects Approximate Prevalence per Type of Defect Examples 10,000 Births Comments Chromosomal Down syndrome (tri- 13 Increases with somy 21) maternal age over 35 years Trisomy 18 2.3 Infectious Varicella-zoster infec- 7 tion (chickenpox) Metabolic Phenylketonuria 3.5 (PKU) Structural Cleft lip and/or palate 10 Neural tube defects, 3 Folate supple- including anenceph- mentation dur- aly and spina bifida ing pregnancy prevents neural tube defects. Transposition of the 5 great vessels Toxic Fetal alcohol spectrum 2 - 15 Varies with prev- disorders alence of alco- hol use in the community; preventable with abstinence Isotretinoin (acne med- Avoid all preg- ication) nancies during therapy with is- otretinoin.

bis in die (bı˘s˘n ı dı¯Јe¯, de¯Јa¯) [L.] ABBR: bisulfate (bı¯-su˘lЈfa¯t) An acid sulfate in b.d.; b.i.d. Twice in a day. which a monovalent metal and a hydro- bismuth (bı˘zЈmu˘th) [Ger. Wismuth, gen ion are combined with the sulfate white mass] SYMB: Bi. A silvery me- radical. SEE: disulfate. tallic element; atomic weight 208.980, bite (bı¯t) [AS. bitan, to bite] 1. To cut atomic number 83. Its compounds are with the teeth. 2. An injury in which the used as a protective for inflamed sur- body surface is torn by an insect or an- faces. Its salts are used as an astringent imal, resulting in abrasions, punctures, and as a treatment for diarrhea. or lacerated wounds. There may be ev- bisphenol A (bı˘s-fe¯nЈo˘l) [L. bis, twice ϩ idence of a wound, usually surrounded Љ] ABBR: BPA. A chemical used in by a zone of redness and swelling, often many consumer products to increase accompanied by pain, itching, or throb- their durability and toughness. Its bing. This type of wound often becomes chemical formula is 2,2–bis (4,4Ј-hy- infected and may contain specific nox- droxyphenyl) propane. It is used prin- ious materials such as bacteria, toxins, cipally in manufacturing polycarbon- viruses, or venom. SEE: sting. 3. In den- ates and epoxy resins. It has tistry, the angle and manner in which estrogen-like effects in animal tissue. the maxillary and mandibular teeth oc- Some studies have suggested that BPA clude. SEE: occlusion. has negative hormonal effects on adults balanced b. Balanced occlusion of the and the developing fetus. teeth. bisphosphonate (bı˘s-fo˘sЈfo¯-na¯t) Any of cat b. A wound inflicted by the teeth a class of medications that inhibit the of a cat; typically a puncture wound on resorption of bones by osteoclasts. Med- the hand or the arm. A cat bite is usu- ications in this class are used to treat ally infected with multiple aerobic and osteoporosis, hypercalcemia, and meta- anaerobic organisms, including Pasteu- static bone cancers. Examples include rella multocida. Broad-spectrum anti- pamidronate, etidronate, clodronate, biotics are required. About 20% of the and alendronate. time, the wound does not respond to an- tibiotic therapy and needs incision and Drugs from this class occasionally drainage or de´bridement. cause osteonecrosis of the jaw, esp. closed b. Overbite. in cancer patients. cross b. A form of dental malocclusion short in which the cusps of one tooth, e.g., standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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arising from the maxilla, close within beta-lactamase inhibitor usually pro- the cusps of the tooth arising in the vides adequate antibiotic coverage. mandible (or vice versa). insect b. An injury in which the body dog b. A lacerated or punctured surface is torn by an insect, resulting in wound made by the teeth of a dog. The abrasions, punctures, or lacerated dog should be observed for 10 days to wounds. Insect bites cause more deaths determine the presence of rabies. SEE: than do snake bites. For more informa- Capnocytophaga canimorsus; rabies. tion, see entries for individual insects. TREATMENT: The wound must be SYMPTOMS: The reaction of a previ- cleansed thoroughly. It should be ously sensitized person is a potentially washed vigorously with soap and water life-threatening medical emergency for at least 10 min to remove saliva. that requires prompt, effective therapy. Flushing with a viricidal agent should Symptoms may include hives, itching be followed with a clear rinse. Unless and swelling in areas other than the site massive, bleeding should not be stopped of the bite, tightness in the chest and because blood flow helps to cleanse the difficulty in breathing, hoarse voice, wound. Routine tetanus prophylaxis swelling of the tongue, dizziness or hy- should be provided and information ob- potension, unconsciousness, and car- tained about the animal, its location, diac arrest. and its owner. These data should be in- FIRST AID: If the wound is suspected cluded in a report to public health au- of containing venom, a bandage suffi- thorities. Appropriate antirabies ther- ciently tight to prevent venous return is apy must be initiated if the animal is applied if the bite is on an extremity. known to have rabies. The wound is washed with saline solu- end-to-end b. A bite in which the in- tion thoroughly and a dry sterile dress- cisors of both jaws meet along the cut- ing is applied. Appropriate antitetanus ting edge when the jaw is closed. therapy is applied. Treatment for shock fire ant b. Injury caused by fire ant may be needed. venom, resulting in local redness and Some insect bites contain an acid sub- tenderness, and occasional episodes of stance resembling formic acid and con- life-threatening anaphylaxis. sequently are relieved by topically ap- TREATMENT: The area, which may plied alkalies, such as ammonia water contain multiple bites, should be or baking soda paste. For intense local washed with soap and water. Epineph- pain, injection of local anesthetic may rine, 0.3 to 0.5 ml of a 1:1000 aqueous be required. Systemic medication may solution, should be given subcutane- be needed for generalized pain. ously every 20 to 30 min in cases com- Individuals who have had an allergic plicated by anaphylaxis. Use of a tour- reaction to an insect bite may benefit niquet slows absorption of the venom. from venom immunotherapy. This Application of ice packs to the area re- treatment involves administration of lieves pain. Oxygen, endotracheal intu- very small amounts of the insect venom bation, and vasopressors, as well as cor- over several weeks until immunity de- ticosteroids and antibiotics, may be velops. Immunity is then maintained by required. periodic venom boosters. flea b. A hemorrhagic punctum sur- Persons who have a history of an an- rounded by erythematous and urticarial aphylactic reaction to insect bites patches and caused by the injection of should avoid exposure to insects by flea saliva. wearing protective clothing, gloves, and TREATMENT: Ice applied to the site shoes. Cosmetics, perfumes, and hair decreases the pain. Application of a cor- sprays should be avoided because they ticosteroid cream may decrease the in- attract some insects, as do brightly col- flammatory response. ored and white clothing. Because foods PREVENTION: Flea bites serve as and odor attract insects, care should be vectors for Yersinia pestis, the bacte- taken when cooking and eating out- rium that causes plague. The skin doors. should be treated with an insect repel- open b. A bite in which a space exists lent available as a powder, spray, or oil between the upper and lower incisors for topical use. when the mouth is closed. human b. A laceration or puncture snake b. A puncture wound made by wound caused by the teeth of a human. the fangs of a snake. All snakes should The aerobic and anaerobic organisms be considered poisonous, although only transmitted from the mouth may cause a few secrete enough venom to inoculate cellulitis, and, occasionally, infections of poison deeply into the tissues. other soft tissues and bones. PATIENT CARE: When snake bite, TREATMENT: The wound should be especially from a venomous snake, is irrigated thoroughly and may require confirmed or strongly suggested, the pa- surgical de´bridement. A moist dressing tient’s airway, breathing, and circula- should be applied and tetanus prophy- tion should be assessed, and he or she short laxis administered. A penicillin with a should be transported immediately to a standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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medical facility equipped and staffed to FIRST AID: The patient should be handle snake bites. In the hospital, the transported immediately to a medical patient is attached to a cardiac monitor, facility equipped and staffed to handle an automatic noninvasive blood pres- snake bites. In the hospital, an intra- sure monitoring machine, and a pulse venous infusion of Ringer’s lactate or oximeter. If necessary, oxygen admin- normal saline should be started. istered at 4 L/min via nasal cannula, A polyvalent antivenin serum for and an intravenous infusion of Ringer’s bites by pit vipers is prepared by Wyeth lactate or normal saline should be Lab. Inc. Antivenin for coral snake bite started. Pulses below the wound and is also available from Wyeth. The use of capillary refill time in the wounded limb antibodies to treat pit viper bites is be- are assessed and compared to the un- ing used experimentally. affected limb. The circumference of the affected limb should be measured at the Alcoholic stimulants must not be bite and at equal distances above and taken, and nothing should be done below it, to monitor the spread of edema to increase circulation. One should not and inflammation. Lung sounds are cauterize with strong acids or depend on auscultated for clarity, and the patient home remedies. Tetanus prophylaxis is es- is asked about medical history, aller- sential. gies, and history of previous snakebite. Snakebite symptoms can range from mild swelling, pain, and erythema to hy- spider b. Punctures of the skin and/or potension, shock, and a disseminated envenomation by the fangs of a spider. intravascular coagulation-like syn- SEE: black widow spider; brown recluse drome. In all cases the affected limb spider. should be placed in a neutral, resting stork b. Colloquial term for telangi- position. ectasia. If the patient has actually received tick b. A wound produced by a blood- venom from the snake bite (only about sucking tick. Adult ticks (and immature 50% of patients have), the appropriate nymphs) may be vectors for infectious antivenin should be administered intra- diseases, including Rocky Mountain venously, appropriately diluted. If the spotted fever, Q fever, tularemia, bor- required antivenin is prepared from reliosis, babesiosis, ehrlichiosis, ana- horse serum, the patient should be plasmosis, and Lyme disease. They can tested for sensitivity before administer- also produce tick paralysis, a disease ing the antivenin. The antivenin should that may mimic Guillain-Barre´ syn- be infused slowly, over about an hour in drome. most cases, and the patient monitored The bite itself may produce a localized for adverse reactions for at least an- reddened area of skin, which is typically other hour. Resuscitation equipment for of little importance. This area may be treating anaphylaxis should be readily raised or slightly itchy. available throughout the infusion. Chil- FIRST AID: Ticks should be removed dren require a higher dosage of anti- from the skin by taking a pair of small venin than do adults. A blood sample tweezers or forceps, grasping the tick should be drawn from the patient for firmly by the mouth parts, and pulling complete blood count, coagulation pro- the insect directly out of the skin, leav- file, BUN, creatinine, creatine kinase, ing no body parts embedded. and blood type and cross-match. A urine specimen should be obtained to test for Ticks should not be removed by myoglobinuria. burning them with matches, soak- The wound should be cleaned with ing them in petroleum jelly, or injecting cool soap and water. Analgesics and the subcutaneous tissue beneath their other prescribed treatments (antibiot- mouth parts with lidocaine. None of these ics, methylprednisolone, antihista- methods is effective, and some may be mines) should be administered, as well hazardous. as tetanus prophylaxis if indicated. Snake antivenin information is available from the nearest Poison Con- bitelock (bı¯tЈlo˘k) A device used in den- trol Center. The patient should be ob- tistry for retaining bite rims outside the served for potential complications such mouth in the same position as they were as compartment syndrome, coagulop- inside the mouth. athy, rhabdomyolysis, renal failure, and bitemporal (bı¯-te˘mЈpo¯-ra˘l) [L. bis, twice, wound infection. Prior to discharge, the ϩ temporalis, pert. to a temple] Pert. signs and symptoms of delayed adverse to both temples or temporal bones. reactions to antivenin should be ex- biteplate (bı¯tЈpla¯t) A dental device used plained to the patient, and he or she to correct or diagnose malocclusion. It is should be advised to immediately report worn in the palate, usually on a tempo- fever, malaise, joint pain, rash, or un- rary basis. short usual body bruising. Bitot’s spots (be¯Јto¯z) [Pierre A. Bitot, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Fr. physician, 1822–1888] Triangular ABBR: BB-MR. Imaging of arterial shiny gray spots on the conjunctiva seen walls with magnetic resonance for evi- in vitamin A deficiency. dence of atherosclerosis. Blood flow, bitrochanteric (bı¯Љtro¯-ka˘n-te˘rЈı˘k) Pert. which normally gives off a bright signal to both greater trochanters of the two during magnetic resonance imaging, femurs. can be made to appear dark to distin- bitter (bı˘tЈe˘r) [AS. biter, strong] Having guish it from the walls of blood vessels a disagreeable taste. that surround it. This enhancement in bitter melon A bitter-tasting tropical magnetic resonance imaging can be vegetable (Momordica charantia) pop- used noninvasively to show where ar- ular in Asian countries, also known as teries are obstructed and to determine balsam apple, balsam pear, bitter the components of the plaque in those gourd, cerasee, karela, ku gua, and arteries. squirting cucumber. It is promoted in black box warning A written advisory complementary and alternative medi- supplied by a pharmaceutical company cine for its effects on diabetes mellitus, to health care professionals whenever a HIV infection, and obesity. SYN: karela. medication causes any serious side ef- biuret (bı¯Јu¯-re˘t) [L. bis, twice, ϩ urea] fect(s). Under U.S. federal regulations, 1. NH2CONHCONH2; a crystalline de- this advisory is mandatory and must be composition derivative of urea. 2. A highlighted by “a prominently displayed technique used to determine the protein box.” content or the presence of protein in a black cohosh Cimicifuga racemosa (also solution, e.g., of a body fluid such as the Actacea racemosa), a perennial herb cerebrospinal fluid. whose rootstock preparations are pro- biuret reaction Biuret test. moted as a treatment for menstrual and biuret test (bı¯Љya˘-re˘tЈ) A method for menopausal discomforts. Black cohosh measuring protein in the serum. The is also known as black snakeroot and presence of biuret can be detected by the bugbane. addition of sodium hydroxide and cop- blackhead An open comedo. SEE: com- per sulfate solutions to the sample. A edo. rose to violet color indicates the pres- black heel Subcutaneous bleeding into ence of protein, and a pink and finally the skin behind the calcaneus typically blue color indicates the presence of caused by repetitive trauma, for exam- urea. ple, in runners or other athletes. bivalent (bı¯-va¯Јle˘nt) [Љϩvalens, pow- black membrane An artificially con- erful] 1. In chemistry, having an va- structed membrane made of lipids ar- lence of two. 2. In cytology, a structure ranged in a bilayer. consisting of two paired homologous blackout (bla˘kЈowtЉ) Sudden loss of con- chromosomes, each split into two sister sciousness. SYN: syncope. SEE: red-out. chromatids during meiosis. alcoholic b. An episode of forgetting bivariate (bı¯-va˘rЈe¯-ı˘t, a¯tЉ)[ЉϩЉ] Per- all or part of what occurred during or taining to two variables. following a period of alcohol intake. bixel (bı˘ksЈe˘l) [Fr. b(eam) ϩ (pi)xel]A blackwater fever Bloody urine (hemoglo- beam element or ray in radiation oncol- binuria) that occurs as a complication of ogy. falciparum malaria infection. It is the bizygomatic (bı¯Љzı¯-go¯-ma˘tЈı˘k) Pert. to result of red blood cell destruction and the most prominent point on each of the the release of hemoglobin. It occurs two zygomatic arches. most commonly in patients who have Bjerrum’s screen (bye˘rЈoomz) [Jannik P. been treated with drugs derived from Bjerrum, Danish ophthalmologist, quinine. SEE: falciparum malaria. 1827–1892] A 1-m square planar sur- SYMPTOMS: The illness is marked by face viewed from a distance of 1 m and high fevers, dark urine, epigastric pain, consisting of a large square of black vomiting, jaundice, and shock. Physical cloth with a central mark for fixation. It findings include enlargement of the is used to plot the physiological blind liver and spleen. Laboratory hallmarks spot, the central and paracentral scoto- include severe anemia and, occasion- mata, and other visual field defects. ally, renal failure. SYN: tangent screen. bladder (bla˘dЈde˘r) [AS. blaedre]A Bjerrum’s sign A sickle- or comet-shaped membranous sac or receptacle for a se- blind spot usually found in the central cretion, as the gallbladder; commonly zone of the visual field; seen in glau- used to designate the urinary bladder. coma. SEE: bladder, urinary; genitourinary BK below knee, a term used to refer to the system. site of amputation of a lower extremity. atony of b. Inability to urinate due Bk Symbol for the element berkelium. to lack of muscle tone. It is frequently black (bla˘k) [AS. blaec] 1. Devoid of seen after traumatic deliveries or after color or reflecting no light. 2. Marked by the use of epidural anesthesia. dark pigmentation. autonomous b. A bladder in which short black blood magnetic resonance imaging there is interruption in both the afferent standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Parietalperitoneum Ureter Detrusormuscle

Openingsof ureters

Rugae Ureter Trigone Male

Prostategland

Prostaticurethra

Trigone Internal Membranous urethralsphincter Female urethra

External urethralsphincter Cavernous(spongy) urethra Urethra

Urethralorifice Cavernous(erectile) tissueof penis

URINARY BLADDER

and efferent limbs of the reflexarcs. form there is difficulty in urinating, Bladder sensation is absent; dribbling is which may lead to recurrent urinary constant; residual urine amount is tract infections. large. nervous b. A condition marked by cord b. Distention of the bladder the repeated desire to urinate, but doing without discomfort. Symptoms include so fails to empty the bladder. a tendency to void frequently and drib- neurogenic b. Any dysfunction of the bling after urination. The condition is urinary bladder caused by lesions of the caused by a lesion affecting the poste- central nervous system or nerves sup- rior roots of the spinal column at the plying the bladder. level of bladder innervation above the spastic b. Neurogenic bladder due to sacrum. complete transection of the spinal cord exstrophy of b. Congenital eversion above the sacral segments. of the urinary bladder. The abdominal urinary b. A muscular, membranous, wall fails to close and the inside of the distensible reservoir that holds urine bladder may protrude through the ab- situated in the pelvic cavity. It receives dominal wall. urine from the kidneys through the ure- hypertonic b. 1. A bladder with ex- ters and discharges it from the body cessive muscle tone. 2. Increased mus- through the urethra. SEE: illus.; uri- cular activity of the bladder. nary system. irritable b. Bladder condition ANATOMY: The bladder is situated in marked by increased frequency of con- the anterior inferior portion of the pelvic traction with an associated desire to uri- cavity. In the female it lies in front of nate. the anterior wall of the vagina and the motor paralytic b. A neurogenic uterus; in the male it lies in front of the bladder caused by defective nerve sup- rectum. The lower portion of the blad- ply to the bladder. In the acute form uri- der, continuous with the urethra, is short nation is not possible. In the chronic called the neck; its upper tip, connected standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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with the umbilicus by the median um- urine, the rounded superior margin is bilical ligament, is called the apex. The easily made out by observing the tym- region between the openings of the two panic sound of the intestines on one ureters and the urethra is the trigone. hand and dull sound of the bladder on The wall of the bladder has three major the other. layers. The mucous membrane lining is bladder drill Bladder training. transitional epithelium. The middle bladder infection An infection of the layer is three sheets (longitudinal, cir- lower urinary tract, typically caused by cular, longitudinal) of smooth muscle, gram-negative bacteria such as Esche- called the detrusor muscle. The outer richia coli, Klebsiella species, or Pseu- layer on the superior surface is the vis- domonas and occasionally caused by ceral peritoneum; on the lateral and in- gram-positive bacteria such as the en- ferior surfaces it is areolar connective terococci. tissue. The bladder is supported by nu- bladder training A technique used to merous ligaments; it is supplied with treat stress urinary incontinence in blood by the superior, middle, and infe- women in which the patient charts the rior vesical arteries, and drained by nu- number of urinations, the intervals be- merous veins and lymphatics; and it is tween urination, and the volume of innervated by branches of the third and urine passed. She also notes the degree fourth sacral nerves by way of the hy- and frequency of incontinence. The in- pogastric plexus. tervals between urinations are gradu- The bladder has a normal storage ca- ally increased. SYN: bladder drill. pacity of 500 ml (about 16 oz) or more. bladder tumor antigen ABBR: BTA. A In disease states it may be greatly dis- protein released into the urine by ma- tended. A frequent cause of distention of lignant cells in the bladder, studied as the bladder in older men is interference a possible marker of cancer of the uri- with urination due to hypertrophy of the nary bladder. Because of the low prev- prostate gland, which surrounds the alence of bladder cancer in the popula- urethra and neck of the bladder. tion at large, and the low positive PHYSIOLOGY: An average of 40 to 50 predictive value of the test, the U.S. oz (about 1.2 to 1.5 L) of urine is ex- Preventive Services Task Force (2006) creted in a 24-hr period, but this varies discouraged health care professionals with the amount of fluid ingested and and patients from using this screening the amount lost through exhalation, test. sweat, and the bowels. Inability to bladder worm Cysticercus. empty the bladder is known as retention bladderwrack, bladder wrack (bla˘dЈe˘r- and may require catheterization. ra˘kЉ) A yellow-brown seaweed, Fucus Sphincter muscles are part of the mech- vesiculosus, which contains significant anism that controls retention within the quantities of iodine. It is used as an al- bladder. ternative medicine for a variety of pro- For patients who need help in man- posed cures, e.g., of hypothyroidism, but aging bladder elimination problems its effectiveness has not been docu- there are a variety of options: indwell- mented in controlled trials. SYN: Fucus ing urethral catheters, Kegel exercises, vesiculosus. intermittent catheterization, suprapu- Blalock-Hanlon procedure (bla¯Јlo˘kЉ- bic indwelling catheters, external col- ha˘nЈlo˘n) [Alfred Blalock, U.S. surgeon, lecting devices (urinals and specially de- 1899–1965; C. Rollins Hanlon, U.S. sur- signed bedpans), medications for geon, b. 1915] The surgical creation of promoting bladder emptying (such as an atrial septal defect or enlargement of bethanechol, phenoxybenzamine, diaz- the foramen ovale in an infant with epam, dantrolene, or baclofen), and transposition of the great arteries. This medicines to promote bladder storage procedure helps to improve oxygenation (such as imipramine, oxybutynin, pro- until total repair is undertaken. panthelene, pseudoephedrine, or phen- Blalock-Taussig shunt (bla¯Јlo˘kЉ-ta˘wЈsigЉ) ylpropanolamine). For men, a condom [Alfred Blalock, U.S. surgeon; 1899– designed to collect and contain urine is 1965; Helen B. Taussig, U.S. pediatri- available. SEE: bladder training. cian; 1898–1986] ABBR: B-T shunt. The force of urination is much greater An anastomosis of a subclavian artery in a child than in an adult because in to the pulmonary artery on the same the child the bladder is more an abdom- side. This procedure increases blood inal organ than a pelvic one. The child’s flow to the lungs in children with car- abdominal muscles help to expel the diac defects. The modified Blalock- urine. Taussig shunt involves the use of syn- EXAMINATION: Palpation: The blad- thetic graft material to create the der cannot be palpated when empty. anastomosis. When full it appears as a tumor in the blanch (bla˘nch) 1. To lose color, esp. of suprapubic region that is smooth and the face, usually suddenly and in the oval on palpation. context of being frightened or saddened. short Percussion: When it is distended with 2. To briefly scald a vegetable or nut- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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fruit in order to facilitate removal of the duces diarrhea, abdominal pain, bloat- skin, peel, or covering. 3. To bleach. ing, and weight loss in some people. blanch test, blanching test A test of the blastocystosis (bla˘sЉto¯-sı˘s-to¯Јsı˘s) Intes- integrity of the circulation performed by tinal infection with Blastocystis hom- applying and then quickly releasing inis. pressure to a fingernail or toenail. After blastocyte (bla˘sЈto¯-sı¯t) [Љϩkytos, cell] losing color, the blanched nail normally An undifferentiated embryonic cell. regains a pink appearance within 2 sec- blastocytoma (bla˘s-to¯-sı¯-to¯Јma˘) [ЉϩЉ onds or less. Failure to do so suggests ϩ oma, tumor] Blastoma. impaired blood flow to the extremity. blastoderm (bla˘sЈto¯-de˘rm) [Љϩderma, SYN: capillary nail refill test. skin] A disk of cells (germinal disk or blank (bla˘nk) A surrogate analytical blastodisk) that develops on the surface sample that either has no analyte of the yolk in an avian or reptilian egg present or is subject to only part of the from which the embryo develops; also, analytical process. The purpose of the in mammalian embryos a disk of cells blank is to assess the contribution of lying between the yolk sac and the am- nonspecific effects on the final reaction, niotic cavity from which the embryo de- and thus be able to eliminate those ef- velops. From the blastoderm, the three fects from the final analytical results. germ layers (ectoderm, mesoderm, and The term “blank” may be modified by a endoderm) arise. word indicating the type of effect being blastokinin (bla˘sЉto¯-kı¯Јnı˘n) A globulin evaluated, with the resultant complete found in the uterine lumen of some term being, for example, “reagent mammals near the time of blastocyst blank,” a blank containing only rea- implantation. gents. blastolysis (bla˘s-to˘lЈı˘-sı˘s) [Љϩlysis, blast A cell that produces something dissolution] Lysis or destruction of a (e.g., osteoblast, fibroblast). germ cell or a blastoderm. blast [AS. bloest, a puff of wind] A sud- blastoma (bla˘s-to¯Јma˘) pl. blastomata [Љ den, violent movement of air such as ac- ϩ oma, tumor] A neoplasm composed companies the explosion of a shell or of immature, undifferentiated cells de- bomb; a violent sound, as the blast of a rived from the blastema of an organ or horn. It often causes damage to blast- tissue. SYN: blastocytoma. SEE: blas- sensitive organs such as the tympanic tema. membrane, lung, or colon. It may also blastomere (bla˘sЈto¯-me¯r) [Љϩmeros, a forcibly move people and objects, result- part] One of the cells resulting from the ing in unpredictable injuries to unpro- cleavage of a fertilized ovum. tected body parts. SYN: blast wind. blastomerotomy (bla˘sЉto¯-me¯r-o˘tЈo¯-me¯) -blast (bla˘st) [Gr. blastos, germ] Com- [ЉϩЉϩtome, incision] Destruction bining form used as a suffixindicating of blastomeres. an embryonic state of development. Blastomyces (bla˘st-o¯-mı¯Јse¯z) [Gr. blas- blastema (bla˘s-te¯Јma˘) [Gr. blastema, tos, germ, ϩ mykes, fungus] A genus sprout] The undifferentiated cells from of yeastlike budding fungi pathogenic to which the specialized tissues of organs humans. At room temperature these are formed. fungi grow in a moldlike mycelial form, blastid (bla˘sЈtı˘d) [Gr. blastos, germ] and at body temperature in a yeastlike The site of the nucleus of a fertilized form. ovum. B. brasiliensis Paracoccidioides bra- blast lung A colloquial term for pulmo- siliensis. nary barotrauma. B. dermatitidis The species that blastocele, blastocoele (bla˘sЈto¯-se¯l) [Љ causes North American blastomycosis, ϩ koilos, hollow] The cavity in the a rare fungal infection in humans. SEE: blastula of the developing embryo. illus. blastochyle (bla˘sЈto¯-kı¯l) [Љϩchylos, blastomycete (bla˘sЉto¯-mı¯Јse¯t) Any or- juice] Fluid contained in the blastocele. ganism of the genus Blastomyces. blastocyst (bla˘sЈto¯-sı˘st) [Љϩkystis, blastomycosis (bla˘sЉto¯-mı¯-ko¯Јsı˘s) [Љϩ bag] In mammalian embryo develop- mykes, fungus, ϩ osis, condition] A ment, the stage that follows the morula. rare fungal infection caused by inhala- It consists of an outer layer, or tropho- tion of the conidia of Blastomyces der- blast, and an inner cell mass, from matitidis. This infection may produce which the embryo will develop. The en- inflammatory lesions of the skin (cuta- closed cavity is the blastocele. At this neous form) or lungs or a generalized in- stage, implantation in the endometrium vasion of the skin, lungs, bones, central (lining of the uterus) occurs. SEE: fertil- nervous system, kidneys, liver, and ization for illus. spleen. SYN: North American b.; Gil- Blastocystis hominis (bla˘sЈto¯-sı˘sЉtı˘s christ’s disease. ho˘mЈı˘n-ı˘s) A protozoan once thought to TREATMENT: Treatment consists of be a harmless commensal in the human amphotericin B or the less toxic itracon- gastrointestinal tract but now believed azole. short to be an intestinal parasite that pro- North American b. Blastomycosis. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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mophilia. 2. A colloquial term for a small artery that has been cut or torn. bleeding (ble¯dЈı˘ng) [AS. bledan, to bleed] 1. Emitting blood, as from an in- jured vessel. 2. The process of emitting blood, as a hemorrhage or the operation of letting blood. Normally, when blood is exposed to air, it changes to allow fibrin to form. This entangles the cells and forms a blood clot. SEE: coagulation, blood; co- agulation factor; hemorrhage. arterial b. Bleeding in spurts of bright red blood, from an artery. EMERGENCY CARE: Arterial bleed- ing may be controlled by applying pres- BLASTOMYCES DERMATITIDIS IN sure with the fingers at the nearest CULTURE pressure point between it and the heart. Fungal form at room temperature The artery is located and digital pres- sure is applied above it until bleeding stops or until the artery is ligated or re- paired. An arterial tourniquet rarely South American b. Paracoccidioido- should be used. SEE: table. mycosis. breakthrough b. Intermenstrual blastopore (bla˘sЈto¯-por) [Љϩporos, spotting or bleeding experienced by passageway] In the embryo of mam- some women who are taking oral con- mals, the small opening into the archen- traceptives. teron made by invagination of the blas- dysfunctional uterine b. ABBR: tula. DUB. A diagnosis of exclusion in which blastospore (bla˘sЈto¯-spor) [Љϩsporos, there is abnormal bleeding from the seed] A spore formed by budding from uterus not caused by tumor, inflamma- a hypha, as in yeast. tion, or pregnancy. These causes of blastula (bla˘sЈtu¯-la˘) pl. blastulae [L.] bleeding must be ruled out before DUB An early stage in the development of a may be diagnosed. The condition may zygote into an embryo; it consists of a occur with ovulatory cycles, but most of- hollow sphere of cells enclosing a cavity, ten occurs with anovulation. It is com- the blastocele. In large-yolked eggs, the mon in women with polycystic ovary blastocele is reduced to a narrow slit. In syndrome. Endometrial hyperplasia fol- mammalian development, the blasto- lowed by sloughing of the endometrium cyst corresponds to the blastula of lower may occur in women with repeated an- forms. ovulatory cycles. blast wind blast ETIOLOGY: The absence of the luteal Blatta, Blatella (bla˘tЈa˘) [L.] A genus of progesterone phase interferes with nor- insects (that includes the cockroaches) mal endometrial preparation for im- of the order Orthoptera. plantation or menstruation. Prolonged B. germanica The German cockroach constant levels of estrogen stimulate or croton bug. uneven endometrial hypertrophy so B. orientalis The Oriental cockroach, that some areas slough and bleed before also known as the black beetle, a com- others, causing intermittent bleeding. mon European house pest. functional b. 1. Loss of blood from Blau’s syndrome (blow) A rare autoso- the uterus caused by an organic lesion, mal dominant disease characterized by such as a cyst, fibroid, or malignant tu- camptodactyly and granulomatous in- mor. 2. Metrorrhea. volvement of joints, skin, and uvea. gastrointestinal b. Gastrointestinal bleb (ble˘b) An irregularly shaped ele- hemorrhage. vation of the epidermis; a blister or a herald b. Spontaneous hemorrhage bulla. Blebs may vary in size from less from the gastrointestinal tract in a pa- than 1 cm to as much as 5 to 10 cm; they tient with an aortic bypass graft. The may contain serous, seropurulent, or hemorrhage typically stops suddenly, bloody fluid. Blebs are a primary skin only to recur massively days or weeks lesion that may occur in many disor- later. It is sometimes a clinical hall- ders, including dermatitis herpeti- mark of bleeding from an aortoenteric formis, pemphigus, and syphilis. SEE: fistula. bulla. internal b. Hemorrhage from an in- bleeder (ble¯dЈe˘r) [AS. bledan, to bleed] ternal organ or site, esp. the gastroin- 1. A colloquial term for one whose abil- testinal tract. ity to coagulate blood is either deficient menstrual b. SEE: menstruation. or absent, so that small cuts and inju- nasal b. Epistaxis. short ries lead to prolonged bleeding. SEE: he- occult b. Inapparent bleeding, esp. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Control of Arterial Bleeding Artery Course Bone Involved Spot to Apply Pressure For Wounds of the Face

Temporal Upward1⁄2 in (13 mm) Temporal bone Against bony prominence in front of ear immediately in front of ear or on temple Facial Upward across jaw di- Lower part of 1 in (2.5 cm) in front of agonally lower maxilla angle of lower jaw For Wounds of the Upper Extremity Axillary Downward across Head of hu- High up in armpit outer side of armpit merus against upper part of to inside of humerus humerus Brachial Along inner side of hu- Shaft of hu- Against shaft of humerus merus under edge of merus by pulling aside and biceps muscle gripping biceps, press- ing tips of fingers deep down against bone For Wounds of the Lower Extremity Femoral Down thigh from pel- Brim of pelvis Against brim of pelvis, vis to knee from a midway between iliac point midway be- spine and symphysis tween iliac spine and pubis symphysis pubis to inner side of end of femur at knee joint Posterior Downward to foot in Inner side of For wounds in sole of tibial hollow just behind tibia, low foot, against tibia in prominence of inner down above center of hollow behind ankle ankle inner ankle

that which occurs into the intestines vein will provide immediate control of the and can be detected only by chemical blood loss. The patient should be taken to tests of the feces. a health care provider as soon as possible uterine b. Bleeding from the uterus. if bleeding does not stop. Physiological bleeding via the vagina oc- curs in normal menstruation. Abnormal blenn- SEE: blenno-. forms include excessive menstrual flow blennadenitis (ble˘nЉa˘d-e˘-nı¯Јtı˘s) [Љϩ (hypermenorrhea, menorrhagia) or too aden, gland, ϩ itis, inflammation] In- frequent menstruation (polymenorrhea). flammation of the mucous glands. Nonmenstrual bleeding is called metror- blenno-, blenn- [Gr. blennos, mucus] rhagia. Pseudomenstrual or withdrawal Combining forms meaning mucus. bleeding may occur following estrogen blennoid (ble˘nЈoyd) [Љϩeidos, form, therapy. Breakthrough bleeding is the shape] Mucoid (2). term used for intermenstrual bleeding blennorrhagia (ble˘nЉo¯-ra¯Јje¯-a˘) [Љϩ that sometimes occurs in women who take rhegnynai, to break forth] Any exces- progestational agents such as birth con- sive discharge from mucous mem- trol pills or receive estrogen-progesterone branes. replacement therapy. SEE: amenorrhea; blennorrhea (ble˘nЉo¯-re¯Јa˘) [Gr. blennos, dysfunctional uterine bleeding; menstrua- mucus, ϩ rhoia, flow] Any discharge tion; Nursing Diagnoses Appendix. from mucous membranes. SYN: blen- venous b. A continuous flow of dark norrhagia. red blood. inclusion b. Chlamydial conjunctivi- FIRST AID: Venous bleeding may be tis. controlled by firm, continuous pressure blennothorax (ble˘nЉo¯-tho¯Јra˘ks) [Љϩ applied directly to the bleeding site. If thorax, chest] The accumulation of mu- bleeding is from an area over soft tis- cus in the bronchial tubes or alveoli. sues, a large, compress bandage should blephar- SEE: blepharo-. be held firmly against the site. blepharadenitis (ble˘fЉa˘r-a˘d-e˘-nı¯Јtı˘s) [Gr. blepharon, eyelid, ϩ aden, gland, ϩ A tourniquet should not be used. If itis, inflammation] Inflammation of the the bleeding is over a bony area, as meibomian glands. in the case of a ruptured varicose vein of blepharal (ble˘fЈa˘r-a˘l) Pert. to an eyelid. short the leg, pressure held firmly against the blepharectomy (ble˘fЉa˘-re˘kЈto¯-me¯) [Љϩ standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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ektome, excision] Surgical excision of blepharochalasis (ble˘fЉa˘r-o¯-ka˘lЈa˘-sı˘s) [Љ all or part of an eyelid. ϩ chalasis, relaxation] Hypertrophy of blepharedema (ble˘fЉa˘r-e˘-de¯Јma˘) [Љϩ the skin of the upper eyelid due to loss oidema, swelling] Edema of the eyelids, of elasticity following edematous swell- causing swelling and a baggy appear- ings as in recurrent angioneurotic ance. edema of the lids. The skin may droop blepharism (ble˘fЈa˘r-ı˘-zı˘m) [Љϩ−ismos, over the edge of the eyelid when the eyes condition] Twitching or blinking of the are open. eyelids. SEE: blepharospasm. blepharoclonus (ble˘fЉa˘-ro˘kЈlo¯-nu˘s) [Љϩ blepharitis (ble˘fЉa˘r-ı¯Јtı˘s) [Љϩitis, in- klonos, tumult] Clonic spasm of the flammation] Ulcerative or nonulcera- muscles that close the eyelids (orbicu- tive inflammation of the hair follicles laris oculi). and glands along the edges of the eye- blepharoconjunctivitis (ble˘fЉa˘-ro¯-ko˘n- lids. ju˘nkЉtı˘-vı¯Јtı˘s) [ЉϩL. conjungere, to SYMPTOMS: The eyelids become red, join together, ϩ Gr. itis, inflamma- tender, and sore with sticky exudate tion] Inflammation of the eyelids and and dry or waxy scales on the edges; conjunctiva. there may be itching or burning, water- blepharodiastasis (ble˘f-a˘-ro¯-dı¯-a˘sЈta˘-sı˘s) ing of the eyes and loss of eyelashes. [Љϩdiastasis, separation] Excessive Styes and meibomian cysts are associ- separation of the eyelids, causing the ated with the condition. eyes to open wide. ETIOLOGY: The ulcerative type is blepharoncus (ble˘fЉa˘-ro˘nЈku˘s) [Љϩon- usually caused by infection with staph- kos, tumor] A tumor of the eyelid. ylococci. The cause of the nonulcerative blepharopachynsis (ble˘fЉa˘-ro¯-pa˘-kı˘nЈsı˘s) type is often unknown; it may be due to [Љϩpachynsis, thickening] Abnormal allergy or exposure to dust, smoke, or thickening of the eyelid. irritating chemicals, or in association blepharoplast (ble˘fЈa˘-ro¯-pla˘st) Basal with seborrhea of the scalp, eyebrows body. and ears. blepharoplasty (ble˘fЈa˘-ro¯-pla˘sЉte¯) Plas- PATIENT CARE: Patients are taught tic surgery upon the eyelid. how to keep their scalp, eyebrows, and blepharoplegia (ble˘fЉa˘-ro¯-ple¯Јje¯-a˘) [Gr. eyelids clean and to avoid rubbing their blepharon, eyelid, ϩ plege, a stroke] eyes with their hands. Warm com- Paralysis of an eyelid. presses four times a day, lid hygiene, blepharoptosis (ble˘fЉa˘-ro¯-to¯Јsı˘s) [Љϩ and antibiotic ointment at bedtime will ptosis, a dropping] Drooping of the up- improve symptoms with two weeks. In per eyelid; may be congenital or ac- severe cases, systemic antibiotics are in- quired. dicated, with culture of the lid margin blepharopyorrhea (ble˘fЉa˘-ro¯-pı¯-o¯-re¯Јa˘) [Љ and antibiotic sensitivity studies are ϩ pyon, pus, ϩ rhoia, flow] Purulent used to determine the appropriate reg- discharge from the eyelid. imen. blepharorrhaphy (ble˘fЉa˘-rorЈa˘-fe¯) [Љϩ angular b. Blepharitis in which the rhaphe, seam, ridge] Tarsorrhaphy. lacrimal ducts of the lateral canthi of blepharorrhea (ble˘fЉa˘-ro¯-re¯Јa˘) [Љϩ the eye are involved; often caused by rhoia, flow] Discharge from the eye- Morexella. lid. b. ciliaris Inflammation affecting the blepharospasm (ble˘fЈa˘-ro¯-spa˘sm) [Љϩ ciliary margins of the eyelids. SYN: spasmos, a convulsion] A twitching or blepharitis marginalis. spasmodic contraction of the orbicularis b. marginalis Blepharitiss ciliaris. oculi muscle due to tics, eyestrain, or b. parasitica Blepharitis caused by nervous irritability. SEE: Marcus Gunn parasites such as mites or lice. syndrome. seborrheic b. A nonulcerative form essential b. Blepharospasm of un- of blepharitis in which waxy scales form known cause. It may be so severe as to on the eyelids. It is usually associated be debilitating. Surgery has helped with seborrheic dermatitis of the sur- some patients. Botulinum toxin A in- rounding skin. jected into the muscles that control the b. squamosa Chronic blepharitis spasm has been of benefit. This treat- with scaling. ment will need to be repeated after 2 to b. ulcerosa Blepharitis with ulcer- 3 months. ation. blepharosphincterectomy (ble˘fЉa˘-ro¯- blepharo-, blephar- [Gr. blepharon, eye- sfı˘nkЉte˘r-e˘kЈto¯-me¯) [Љϩsphinkter, a lid] Combining form meaning eyelid. constrictor, ϩ ektome, excision] Exci- blepharoadenoma (ble˘fЉa˘r-o¯-a˘d-e˘- sion of part of the orbicularis palpebra- no¯Јma˘) [ЉϩЉϩoma, tumor] A rum to relieve pressure of the eyelid on glandular tumor of the eyelid. the cornea. blepharoatheroma (ble˘fЉa˘r-o¯-a˘thЉe˘- blepharostat (ble˘fЈa˘-ro¯-sta˘t) [Љϩhis- ro¯Јma˘) [Љϩathere, thick fluid, ϩ tanai, cause to stand] A device for oma, tumor] A sebaceous cyst of the separating the eyelids during an oper- short eyelid. ation. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh blepharostenosis 280 blindness base of rh blepharostenosis ( ble˘fЉa˘-ro¯-ste˘n-o¯Јsı˘s) blind during life. In the U.S., blindness [Љϩstenosis, act of narrowing] Nar- due to infection is rare, but worldwide rowing of the palpebral slit due to an in- diseases like trachoma and onchocer- ability to open the eye normally. SYN: ciasis are relatively common causes of blepharophimosis. severe visual impairment. In malnour- blepharosynechia (ble˘fЉa˘-ro¯-sı˘-ne¯Јke¯-a˘) ished persons, vitamin A deficiency is [Љϩsynecheia, a holding together] another important cause of blindness. Adhesion of the edges of the upper eye- A variety of free services are available lid to the lower one. SYN: ankyloble- for the blind and physically handi- pharon. capped. Talking Books Topics published blepharotomy (ble˘f-a˘-ro˘tЈo¯-me¯) [Љϩ bimonthly in large-print, cassette, and tome, incision] Surgical incision of the disc formats is distributed free to blind eyelid. and physically handicapped individuals Bleuler, Eugen (bloyЈle˘r, oyЈge˘n) [1857– who participate in the Library of Con- 1939] Swiss psychiatrist known for gress free reading program. It lists re- studies on schizophrenia. corded books and magazines available blind [AS.] 1. Without sight. 2. In re- through a national network of cooper- search, a study in which the subjects ating libraries and provides news of de- and/or the researchers are unaware of velopments and activities in library ser- which group is receiving active treat- vices. Subscription requests may be ment and which is receiving a placebo. sent to Talking Books Topics, CMLS, Blinding reduces the potential for P.O. Box9150, Melbourne, FL 32902- bias. 9150. blind bronchoalveolar lavage The use amnesic color b. An inability to re- of a catheter inserted without bron- member the names of colors. choscopic visualization into the tra- color b. SEE: color blindness. cheobronchial tree to obtain lower res- cortical b. Blindness due to lesions in piratory specimens of fluid for culture. the left and right occipital lobes of the A relatively low-cost alternative to brain. The eyes are still able to move bronchoscopically obtained cultures or and the pupillary light reflexes remain, brushings in patients suspected of but the blindness is as if the optic nerves having ventilator-associated pneumo- had been severed. The usual cause is oc- nia. clusion of the posterior cerebral ar- blinded Pert. to a method, study, or clin- teries. Transitory cortical blindness ical trial in which neither the subject may follow head injury. nor the investigator knows the hypoth- day b. An inability to see in daylight; esis, problem, or condition being tested. hemeralopia. Blinding reduces the potential for bias. eclipse b. Blindness due to burning SEE: double-blind; single-blind. the macula while viewing an eclipse blind loop syndrome A condition caused without using protective lenses. Look- by intraluminal growth of bacteria in ing directly at the sun anytime can dam- the upper portion of the small intes- age the eyes. SYN: solar blindness; solar tine. Conditions associated with this maculopathy. syndrome are anatomical lesions that lead to stasis such as diverticula or sur- green b. Aglaucopsia. gically created blind loops; diseases as- hysterical b. An inaccurate term for sociated with motor function of the functional blindness (i.e., blindness small intestine; and any condition that caused by psychological disorders decreases gastric acid secretion. The rather than demonstrable organic pa- syndrome is diagnosed by the clinical thology). signs and symptoms of malabsorption legal b. A degree of loss of visual acu- and the use of breath tests for detect- ity that prevents a person from perform- ing overgrowth of bacteria in the intes- ing work requiring eyesight. In the U.S. this is defined as corrected visual acuity tine. Њ TREATMENT: Antimicrobial therapy of 20/200 or less, or a visual field of 20 and nutritional support are needed. or less in the better eye. In the U.S. Surgery may be indicated to correct cer- there are about three quarters of a mil- tain anatomical presentations. lion blind people, and about 8 or 9 mil- blindness (blı¯ndЈne˘s) Inability to see. lion people with significant visual im- The leading causes of blindness in the pairment. U.S. are age-related macular degenera- letter b. An inability to understand tion, diabetic retinopathy, and glau- the meaning of letters; a form of apha- coma. sia. Blindness may be caused by diseases night b. Nyctalopia (1). of the lens, retina, or other eye struc- note b. The inability to recognize tures; diseases of the optic nerve; or le- musical notes, due to a lesion of the cen- sions of the visual cortexor pathways of tral nervous system. the brain. A small number of infants are object b. A disorder in which the short born blind, but far more people become brain fails to recognize things even standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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though the eyes are functioning nor- cleansed with mild soap and a protec- mally. SEE: apraxia. tive dressing applied. Unless a blister is psychic b. Sight without recognition painful or interferes with function due due to a brain lesion. to its size, it should not be punctured. If red-green color b. Inability to see puncturing is needed, it should be done red hues; the most frequent type of color aseptically, with the skin left in place. blindness. A sterile pressure bandage should be river b. SEE: onchocerciasis. applied. SEE: Standard Precautions snow b. Blindness, usually tempo- Appendix. rary, resulting from the glare of sun- light on snow. It may result in photo- If infection develops, treatment is phobia and conjunctivitis, the latter the same as for any other wound, resulting from effects of ultraviolet ra- including tetanus prophylaxis or booster diation. as required. solar b. Eclipse b. transient monocular b. A temporary loss of vision affecting one eye. In older blood b. A small subcutaneous or in- adults it is usually a form of transient tracutaneous extravasation of blood due ischemic attack, caused by carotid ath- to the rupture of blood vessels. erosclerosis, and is therefore a harbin- TREATMENT: A firm dressing should ger of stroke. In young adults it may be be applied with moderate pressure to caused by migraine. SYN: amaurosis fu- prevent extravasation and hasten ab- gax. sorption. In some cases it is desirable to ETIOLOGY: In older adults, causes of puncture aseptically and aspirate. carotid atherosclerosis include smoking, fever b. A vesicular rash usually ap- diabetes mellitus, hypertension, obe- pearing on the lips or mucous mem- sity, and hypercholesterolemia. When brane of the mouth during another in- atherosclerotic plaques form within the fectious illness. The rash is caused by carotid artery, they may ulcerate. The herpes simplexvirus. SEE: cold sore. exposed endothelium within the artery fly b. A blister produced by applica- becomes a focus of inflammation and tion of cantharides to the skin. blood clotting. Blindness occurs when blister pack, blister package A method of tiny clots from the carotid arteries em- protecting individual doses of medica- bolize to the ophthalmic arteries. tions within a transparent cavity or cell SYMPTOMS: Patients often describe made from a dome-shaped plastic bar- a dark shade descending into the field of rier. The barrier separates one dose vision. At the same time they may have from another, protects the medication other stroke symptoms, such as diffi- from moisture, and keeps it from being culty with speech or weakness of the crushed or damaged during transpor- hand on the side opposite the affected tation or storage. Each dose of the med- eye. ication can be individually released or TREATMENT: A patient who may unwrapped without affecting the integ- have carotid atherosclerosis should be- rity of the neighboring doses. gin taking aspirin or other antiplatelet bloated (blo¯tЈe˘d) [AS. blout] Swollen or drugs if these are tolerated. Blood pres- distended beyond normal size as by se- sure and lipid levels should be con- rum, water, or gas. trolled. The patient should be referred bloating (blo¯t) Abdominal discomfort re- for noninvasive evaluation of blood flow lated to disorders of intestinal motility through the carotid arteries (e.g., ultra- and intestinal sensitivity to distention. sonography). If the carotid arteries are This symptom is often presumed to be significantly blocked, the patient and related to the retention of fluid or gas in physician should consider the risks and the bowel, but it also may be produced benefits of carotid endarterectomy. by disorders of the ovaries or other gen- violet b. Inability to see violet tints. itourinary organs. word b. Word blindness. block [MD. blok, trunk of a tree] 1. An blink To open and close the eyes invol- obstruction or stoppage. 2. SEE: anes- untarily; to wink rapidly. Blinking, thesia. 3. To obstruct any passageway or which normally occurs about 12 to 20 opening. A method of regional anesthe- times a minute, helps protect the cornea sia used to stop the passage of sensory against microscopic injury. It occurs less impulses in a nerve, a nerve trunk, the often in neurodegenerative diseases, dorsal root of a spinal nerve, or the spi- such as Parkinson’s disease, and more nal cord, thus depriving a patient of sen- often in meningitis and corneal irrita- sation in the area involved. tion. SEE: reflex, blink. air b. Leakage of air from the respi- blister (blı˘sЈte˘r) [MD. bluyster, a swell- ratory passageways and its accumula- ing] 1. A collection of fluid below or tion in connective tissues of the lungs, within the epidermis. 2. To form a blis- forming an obstruction to the normal ter. flow of air. short TREATMENT: The area should be alveolar-capillary b. Impaired ability standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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of gases to pass through the pulmonary impulses from reaching the central ner- alveolar-capillary membrane. vous system. This is usually done by in- atrioventricular b. A condition in jecting an anesthetic solution (e.g., lid- which the depolarization impulse is de- ocaine) into a peripheral nerve or by layed or blocked at the atrioventricular electrically stimulating the nerve. (A-V) node or a more distal site, as in neuromuscular b. A disturbance in the A-V bundle or bundle branches. A- the transmission of impulses from a mo- V block can be partial or complete. tor endplate to a muscle. It may be There are several degrees: First-degree caused by an excess or deficiency of ace- block is due to prolonged A-V conduc- tylcholine or by drugs that inhibit or de- tion; electrocardiograms show a char- stroy acetylcholine. acteristic prolonged PR interval. Sec- paravertebral b. Infiltration of the ond-degree blocks are intermittent (i.e., stellate ganglion with a local anesthetic. some, but not all, A-V impulses are saddle b. SEE: anesthesia, saddle transmitted to the ventricles). Third- block. degree block, also known as complete A- second division b. Regional anesthe- V block, is present when no atrial im- sia of the upper face and maxillary tis- pulses are conducted to the ventricles. sues by infiltration of the maxillary di- A-V block may be caused by age-re- vision of the trigeminal nerve. SYN: lated degenerative changes; drugs such maxillary block. as digoxin, beta blockers, and calcium sinoatrial b. Sinoatrial heart block. channel blockers; hyperkalemia; hypo- Heart block in which there is interfer- kalemia; increased vagus nerve activity; ence in the passage of impulses between local hypoxia; and scarring from myo- the sinus node and the atria. cardial infarction. spinal b. Blockage in the flow of cere- A-V b. Atrioventricular block. brospinal fluid within the spinal canal. bed b. Blocks made of sturdy mate- subarachnoid b. Spinal anesthesia. rial, such as wood, to elevate one end of ventricular b. Interference in the a bed relative to the other. Bed blocks flow of cerebrospinal fluid between the may be used in the home, e.g., to treat ventricles or from the ventricles people with gastroesophageal refluxdis- through the foramina to the subarach- ease. Most beds in health care institu- noid space. tions are built with devices that sepa- blockade (blo˘k-a¯dЈ) Prevention of the ac- rately raise or lower the feet, legs, tion of something, such as a drug or a trunk, or head. body function. bite b. 1. A wedge of sturdy material adrenergic b. Inhibition of responses used to maintain space between the two to adrenergic sympathetic nerve im- jaws. 2. A film holder held between the pulses and to agents such as epineph- teeth for stable retention of the film rine. packet during dental radiology. cholinergic b. Inhibition of choliner- bundle branch b. SEE: bundle gic nerve stimuli or cholinergic agents. branch block. lymphatic b. A local defense mecha- Bunnell b. SEE: Bunnell block. nism in which minute bits of material, digital b. The injection of a regional such as fibrinous exudate from injured anesthetic into the proximal portion of tissue, enter local lymphatic vessels, ob- a finger or toe. structing them and preventing foreign ear b. Blockage of the auditory tube substances, esp. bacteria, from passing to the middle ear. It may result from through them. trauma, infection, or an accumulation of block design A neuropsychological test cerumen. SEE: aerotitis; otitis media. involving the placement of wooden epidural b. SEE: anesthesia, epidu- blocks according to three-dimensional ral. drawings. The test assesses the pres- field b. Regional anesthesia in which ence of constructional apraxia, often ex- a limited operative area is walled off by hibited in patients with brain lesions. an anesthetic. blocker (blo˘kЈe˘r) A drug that prevents first-degree atrioventricular b. De- the normal action of a system or cell re- layed conduction through or from the ceptor. SEE: antagonist; blockade; in- atrioventricular node, marked on the hibitor. electrocardiogram by a prolonged PR in- beta b. Beta-adrenergic blocking terval. Usually no treatment is neces- agent. sary. SYN: first-degree heart block. blocking (blo˘kЈı˘ng) 1. Obstructing. 2. In heart b. SEE: bundle branch block. psychoanalysis, a sudden break in free mandibular b. Regional anesthesia association as a defense against un- of the lower face and mandibular tissues pleasant ideas. by infiltration of the mandibular divi- Blomia tropicalis (blo¯Јme¯-a˘ tro˘p-ı˘-ka˘lЈ˘s)ı sion of the trigeminal nerve. The scientific name for a common house maxillary b. Second division block. mite found in South and Central Amer- nerve b. The induction of regional ica. Allergens derived from this mite short anesthesia by preventing sensory nerve cause allergic reactions, including standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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BLOOD OTHER BODY TISSUES AND FLUIDS 92% TOTAL BODY WEIGHT 8%

BLOOD PLASMA 52–62% BLOOD CELLS 38–48% BLOOD VOLUME

WATER 91.5% ERYTHROCYTES 4.5–6.0 MILLION BLOOD CELLS (PER CUBIC MILLIMETER) THROMBOCYTES 150,000–300,000 OTHER SUBSTANCES PROTEINS LEUKOCYTES 5,000–10,000 1.5% 7%

BASOPHILS 0.5–1.0% FIBRINOGEN 7% NUTRIENTS EOSINOPHILS 1–3% MONOCYTES 3–8% GLOBULINS HORMONES 38% LYMPHOCYTES 20–35% NITROGENOUS WASTES

RESPIRATORY ALBUMINS GASES NEUTROPHILS 55% 55–70%

ELECTROLYTES

OTHER SUBSTANCES PROTEINS LEUKOCYTES BLOOD COMPOSITION Components of blood and relationship to other body tissues

asthma and atopy. It is abbreviated Blot The cellular components are the eryth- by the World Health Organization. rocytes (red blood cells [RBCs]), leuko- blood [AS. blod] The cell-containing cytes (white blood cells [WBCs]), and fluid that circulates through the heart, thrombocytes (platelets). The leuko- arteries, veins, and capillaries, carrying cytes comprise neutrophils, eosinophils, nourishment, electrolytes, hormones, basophils, lymphocytes, and monocytes. vitamins, antibodies, heat, and oxygen SEE: illus. (Blood Composition) and to the tissues and taking away waste (Types of Blood Cells); buffy coat; matter and carbon dioxide. SEE: eryth- plasma; serum. ropoietin. An adult weighing 70 kg has a blood CHARACTERISTICS: Blood has a dis- volume of about 5 L or 70 ml/kg of body tinctive, somewhat metallic, odor. Ar- weight. Blood constitutes about 7% to terial blood is bright red or scarlet and 8% of the body weight. The pH of the usually pulsates if the artery has been blood is from 7.35 to 7.45. The specific cut. Venous blood is dark red or crimson gravity of blood varies from 1.048 to and flows steadily from a cut vein. 1.066, the cells being heavier and COMPOSITION: Human blood is plasma lighter than this. Blood is of about 52% to 62% plasma and 38% to slightly higher specific gravity in men 48% cells. The plasma is mostly water, than in women. Specific gravity is short ions, proteins, hormones, and lipids. higher after exercise and at night. SEE: standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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EOSINOPHIL (ϫ640) BASOPHIL (ϫ640)

L L E E

P N

N

MONOCYTES (ϫ640) ERYTHROCYTES (E), PLATELETS (P), NEUTROPHILS (N), AND LYMPHOCYTES (L) (ϫ640) TYPES OF BLOOD CELLS Cellular elements in blood include red blood cells (erythrocytes), white blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils), and platelets (thrombocytes).

blood count; cell; erythrocyte; leukocyte; bilical vessels connecting the placenta plasma; platelet. to the fetus. Because cord blood is im- FUNCTION: In passing through the munologically immature, it is esp. use- lungs, the blood gives up carbon dioxide ful in transfusion therapy and hemato- and absorbs oxygen; after leaving the logical transplantation. heart, it is carried to the tissues as ar- defibrinated b. Whole blood from terial blood and then returned to the which fibrin has been removed. It does heart in the venous system. It moves in not clot. the aorta at an average speed of 30 cm/ formed elements of b. Blood cells, as sec, and it makes the circuit of the vas- opposed to blood proteins or other chem- cular system in about 60 seconds. RBCs ical constituents of blood. carry oxygen; WBCs participate in the fresh b. Blood that has been collected immune response to infection; platelets less than 48 hours prior to its use in a are important in blood clotting. The transfusion. plasma transports nutrients, waste occult b. SEE: under occult. products, hormones, carbon dioxide, predonation of b. The collection of a and other substances, and contributes patient’s own blood before surgery, to be to fluid-electrolyte balance and thermal used if the patient needs a transfusion regulation. during or after the surgery, to reduce FORMATION: RBCs are produced in the possibility of needing banked blood, the red bone marrow at the rate of about and with it the risk of having a trans- 2,400,000/sec, and each RBC lives for fusion reaction or contracting a trans- about 120 days. In healthy individuals, missible infection. the concentration of RBCs in the blood PATIENT CARE: The usual blood remains stable over time. Platelets and transfusion checks are performed: 1. WBCs are also produced in the red bone The patient’s armband name and num- marrow, and agranular WBCs are pro- ber are verified by comparing them with duced in lymphatic tissue. those on the chart. 2. The number and arteriolized b. Blood that has been blood type of the unit of blood are exposed to oxygen in the lung. checked against those of the patient. 3. clotting of b. SEE: coagulation, The number and blood type of the unit blood. of blood should match that information short cord b. The blood present in the um- on all the paperwork. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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reconstituted blood A blood product ger an adverse reaction, esp. in patients used in transfusion therapy composed of with a history of hypersensitivity reac- components of blood (packed red blood tions to blood transfusions, even when cells plus plasma), which have been re- given antihistamine prophylaxis. combined after their separation and Washed RBCs must be given within 24 storage. hours because the risk of bacterial con- sludged b. Hemagglutinated blood. tamination is increased when the saline unit of b. Approx. 1 pint (473 ml) of is injected into the bag of RBCs. blood, the usual amount used in adult Use of leukocyte-poor blood reduces transfusion. the risk of unwanted responses to WBCs blood alcohol concentration ABBR: (leukocytes), antibodies, and cytokines BAC. SEE: under concentration. by the recipient. WBCs can be elimi- blood bank SEE: under bank. nated by using special filters in the in- blood bank technologist A technologist travenous line or through aphoresis. trained in blood banking and transfu- The process is used for patients with a sion services. Areas of expertise include history of allergic reactions to blood the collection of blood; the analysis of products or those expected to require blood types with blood group antigen multiple transfusions. It also prevents testing; the typing of tissues for organ transmission of cytomegalovirus (CMV) transplantation; and the use of blood to immunocompromised patients. components in patients with coagula- Screening blood for CMV and RBC tion disorders. antigens helps to identify CMV-nega- blood cell casts SEE: under cast. tive blood, which is needed for high-risk blood component therapy Transfusion patients. More than half of persons over of one or more of the components of 35 years of age have been infected with whole blood. The blood components may CMV. However, this screened blood is have been taken from the patient pre- beneficial for premature infants; infants viously (autologous transfusion) or do- under age 4 weeks; recipients of intra- nated by someone else (homologous uterine transfusion regardless of the transfusion). Except in the case of acute mother’s CMV status; any patient who hemorrhage, the transfusion of whole requires a bone marrow or organ donor blood is rarely needed. Use of a compo- transplant if the marrow or organ donor nent rather than whole blood permits also is CMV-negative; and CMV-nega- several patients to benefit from a single tive patients who are potential trans- blood donation. Blood components used plant candidates, pregnant, about to un- in clinical medicine include packed red dergo splenectomy, or have AIDS/HIV blood cells (RBCs); leukocyte-poor or congenital immune deficiency. SEE: RBCs; frozen glycerolized RBCs; table; blood transfusion; Standard Pre- thawed deglycerolized RBCs; washed cautions Appendix. RBCs; whole blood; heparinized whole blood corpuscle An old term for a blood blood; granulocytes; platelets; and cell. plasma and plasma fractions. The latter blood count The number of red cells and include antihemophilic factor (Factor leukocytes per microliter (␮l) of whole VIII), prothrombin complex(Factors blood. Normally, the number of eryth- VII, IX, and X), gamma globulin, and al- rocytes in men averages 5 million/␮l; in bumin. women, 4.5 million/␮l. Prolonged expo- Irradiation of blood by gamma rays sure to high altitude increases the num- (gamma irradiation) incapacitates do- ber. Leukocytes average 5000 to 10,000/ nor lymphocytes in whole blood, RBCs, ␮l. Platelets range from 140,000 to platelets, or granulocytes. These lym- 400,000/␮l. Hemoglobin (12 to 18 g/100 phocytes are blocked from proliferating ml) and hematocrit (38% to 48%) are de- in response to foreign antigens, esp. termined from samples of whole blood. those in the bone marrow, of immuno- differential b.c. The number and compromised recipients, causing trans- type of white blood cells as determined fusion-associated graft-versus-host dis- by microscopic examination of a thin ease. In patients who are not layer of blood on a glass slide after it has immunocompromised, the donor white been suitably stained to show the shape blood cells (WBCs) are destroyed. Irra- of the various cells. The number and va- diated blood is given to patients who are riety of white cells in a sample of a given donating or receiving bone marrow size are obtained. Even though the red transplants or who have hematological cells are not counted by this method, or lymphatic cancers. In addition, blood their shape, size, and color can be eval- used for intrauterine or neonatal ex- uated. Some blood diseases and inflam- change transfusions and blood donated matory conditions may be recognized in by a biological relative also is irradi- this way. In a differential count, the va- ated. rieties of the leukocytes and their per- Washing blood (RBCs, platelets) in centages normally should be: neutro- 0.9% sodium chloride removes most, but phils (segmented), 40% to 60%; short not all, of the antibodies that could trig- eosinophils, 1% to 3%; basophils, 0.5% standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Blood Components Used in Transfusion Therapy Approximate volume (in ml) infused or When it is typical Storage/ Expected Component used preparation viability outcome Packed red When needed 470 Refrigerated An increase in blood cells to restore or frozen; hemoglobin the oxygen- may last as of 1 g/dL carrying ca- long as 42 pacity of days the blood of the patient Platelets In severely “Five-pack” Stored at An increase in thrombocy- (i.e., a room tem- platelet topenic pa- pooled con- perature counts of Ͼ tients, e.g., centrate (72Њ F); 20,000/dL Ͻ 40,000/ from five needs con- dL in hem- donors); stant agita- orrhaging single-do- tion; may patients, or nor aphere- last 5 days Ͻ 10,000, in sis pack patients who are not yet bleeding Fresh-frozen To replace 225 Must be fro- Improvement plasma missing co- zen within in pro- (FFP) agulation 6 hours of thrombin factors donation; time/INR useful for up to a year Cryoprecipi- To supply Prepared Can be re- Increase in fi- tate blood com- from the in- frozen and brinogen ponents; soluble pro- stored after level by 2-5 esp., fibrin- teins that use of FFP; mg ogen, Fac- remain usually use- tors VIII when FFP ful for 28 and XIII, fi- is thawed days bronectin, for use. and von Ten-donor Willebrand pack usu- Factor ally used

Abbreviations: dLϭdeciliter; INRϭinternational normalized ratio; mlϭmilliliter

to 1%; lymphocytes, 20% to 40%; mono- only arterial blood gas analysis evalu- cytes, 4% to 8%. ates lung function; the specimen may be blood crossmatching Crossmatching. obtained from numerous sites. Mixed blood donation, preoperative The collec- venous samples may be obtained from tion of blood before surgery from the pa- the right atrium of the heart. The blood tient, or a crossmatched donor, to be sample is usually collected in a hepar- used if needed during an elective oper- inized syringe, with care being taken to ation or during the postoperative recov- ensure that the specimen is immedi- ery period. ately placed on ice (to avoid misinter- blood donor deferral (dı˘-fu˘rЈa˘l) [L. de- pretations caused by metabolism) and ferre, to carry down, report, accuse] The not exposed to air (to prevent oxygena- postponement or permanent exclusion tion of the sample). SEE: Allen test; of blood donation by a person suspected blood gases. of having an infectious or hematological disease. Rarely, arterial punctures taken blood gas analysis Chemical analysis of from the wrist may damage the ra- the pH, carbon dioxide and oxygen con- dial artery or compromise the blood sup- centrations, and oxygen saturation of ply of the hand. the blood. This analysis is used to di- agnose serious metabolic and respira- tory disorders. It may be performed us- blood gases SEE: under gas. short ing arterial or venous blood, although blood glucose, unstable, risk for Risk for standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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variation of blood glucose/sugar levels gen on red cells; AB group has A and B from the normal range. SEE: Nursing antigens on red cells; and O group has Diagnoses Appendix. neither A nor B antigens on red cells. blood group A genetically determined The individuals in each group have in system of antigens located on the sur- their sera the corresponding antibody to face of the erythrocyte. There are a the red cell antigens that they lack. number of human blood group systems; Thus, a group A person has the anti-B each system is determined by a series of antibody; group B has anti-A antibod- two or more genes that are allelic or ies; group AB has no antibodies for A closely linked on a single autosomal and B; and group O individuals have chromosome. The ABO system (discov- anti-A and anti-B antibodies in their ered in 1901 by Karl Landsteiner) is of sera. prime importance in blood transfusions. Blood group factors are important in The Rhesus (Rh) system is esp. impor- blood banking and transfusion medi- tant in obstetrics. There are about 30 cine. Analysis of blood groups also is im- Rh antigens. SEE: illus.; Rh factor. portant in identification of bloodstains The population can be phenotypically for medicolegal purposes, in genetic and divided into four ABO blood groups: A, anthropological studies, and in the past B, AB, and O. Individuals in the A group in determination of the probability of fa- have the A antigen on the surface of therhood in paternity suits. their red cells; B group has the B anti- bloodless (blo˘dЈle˘s) Without blood.

ABO BLOOD TYPES short Schematic representation of antigens on RBCs and antibodies in plasma standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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SYSTEMIC BLOOD PRESSURE Systemic BP changes through the vascular system; systolic and diastolic pressures merge as blood enters capillaries bloodletting (blo˘dЈle˘tЉı˘ng) Removal of I hypertension (high blood pressure) is blood from the body as a therapeutic present. SEE: illus. measure, usually by venipuncture. It is Low blood pressure is sometimes used to treat hemochromatosis, polycy- present in healthy individuals, but it in- themia vera, and infants born with ex- dicates shock in patients with fever, ac- cessively high hemoglobin levels. tive bleeding, allergic reactions, active blood level The concentration of any- heart disease, spinal cord injuries, or thing, esp. a drug, in the plasma, serum, trauma. Blood pressure should be or blood. checked routinely whenever a patient blood-nerve barrier A physiological bar- sees a health care provider because con- rier between nerves and capillaries that trolling abnormally high blood pressure partially blocks the flow of ions from the effectively prevents damage to the heart blood across the perineurium. and circulatory system as well as the blood patch SEE: under patch. kidneys, retina, brain, and other organs. blood pressure ABBR: BP. The tension Many factors can result in erroneous exerted on the walls of arteries by the BP recordings. If the BP cuff is too small strength of the contraction of the heart; or the cuff is placed over a shirt sleeve the resistance of arterioles and capil- before it is inflated, the pressure may be laries; the elasticity of blood vessels; the falsely elevated. If the BP is checked in blood volume; and blood viscosity. SEE: only one arm, falsely high or low values arterial pressure; chronic low blood may be recorded (the pressure in the pressure; end-diastolic pressure; normal arms may differ because of subclavian blood pressure. artery atherosclerosis). The BP may be Normal blood pressure is defined as a increased if measured while the patient systolic BP between 100 and 120 mm Hg is talking or just after the patient has and a diastolic BP below 80 mm Hg (in had coffee or smoked a cigarette. When adults over age 18). Prehypertension is the pressure is taken in a clinic or by a present when measured blood pressures physician, it may be temporarily ele- are between 120 and 140 mm Hg sys- vated owing to patient anxiety. This tolic or between 80 and 90 mm Hg dia- phenomenon, called “white coat hyper- stolic. When either the systolic pressure tension,” resolves when the patient exceeds 140 mm Hg or the diastolic ex- measures his or her own pressure in a ceeds 90 mm Hg, and these values are less stressful setting. Devices for am- short confirmed on two additional visits, stage bulatory BP monitoring are available standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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for home use by patients suspected of duced into the organ and attached to a having this problem, as well as for pa- pressure-monitoring transducer. It is tients in whom detailed BP records are done by placing a sterile needle or small needed. They are easy to use, and the catheter inside an artery and having the information they provide is valuable to blood pressure transmitted through patients and health care providers in that system to a suitable recorder. As guiding therapy. SEE: hypertension; the blood pressure fluctuates, the shock. changes are recorded graphically. TREATMENT: Elevated blood pres- high b.p. Hypertension. sures should first be addressed by giv- indirect measurement of b.p. A sim- ing advice to patients about lifestyle ple external method for measuring modifications, such as limiting the in- blood pressure. take of alcohol, following a diet ap- Palpation method: The same arm, proved by the American Heart Associa- usually the right, should be used each tion, and increasing the level of physical time the pressure is measured. The arm exercise. Weight loss in obese patients should be raised to heart level if the pa- is also advisable. Medications are added tient is sitting, or kept parallel to the to lifestyle instructions most of the time. body if the patient is recumbent. The Antihypertensive medications are used patient’s arm should be relaxed and according to evidence-based guidelines supported in a resting position. Exer- and the side effects these drugs may tion during the examination could re- cause in particular patients. Diuretics, sult in a higher blood pressure reading. for example, are esp. helpful in blacks Either a mercury-gravity or aneroid- and elderly patients (but may be inad- manometer type of blood pressure ap- visable in patients with gout); beta paratus may be used. The blood com- blockers are the drugs of choice in pa- pression cuff should be the width and tients with a history of myocardial in- length appropriate for the size of the farction (but would be contraindicated subject’s arm: narrow (2.5 to 6 cm) for in patients with advanced heart block); infants and children and wide (13 cm) alpha blockers are well suited for men for adults. The inflatable bag encased in with prostatic hypertrophy; and angio- the cuff should be 20% wider than one tensin-converting enzyme inhibitors third the circumference of the limb prevent kidney disease in patients with used. The deflated cuff is placed evenly diabetes mellitus. Other antihyperten- and snugly around the upper arm so sive drug classes include the angioten- that its lower edge is about 1 in above sin II receptor antagonists, centrally ac- the point of the brachial artery where tive alpha antagonists, and calcium the bell of the electronic sensor will be channel blockers. Low blood pressure is applied. While feeling the radial pulse, not treated in healthy patients; in pa- inflate the cuff until the pressure is tients with acute illnesses, it is often about 30 mm above the point where the corrected with hydration or pressor radial pulse was no longer felt. Deflate agents. the cuff slowly and record as accurately augmented diastolic b.p. An in- as possible the pressure at which the crease in diastolic pressure, usually by pulse returns to the radial artery. Sys- an artificial device, such as an intra-aor- tolic blood pressure is determined by tic balloon pump. SEE: intra-aortic bal- this method; diastolic blood pressure loon counterpulsation. cannot be determined by this method. central b.p. Blood pressure in the This method is used for both contin- heart chambers, in a great vein, or close uous and intermittent readings, and to the heart. If determined in a vein, it while it formerly was used primarily in is termed central venous pressure; if in ICUs, it now is used routinely by nurs- the aorta or a similar large artery close ing assistants on units throughout to the heart, it is designated central ar- health care agencies and in clinics and terial pressure. physicians’ offices. Measuring blood chronic low b.p. A condition in pressure at the wrist is more comfort- which the systolic blood pressure is con- able than a conventional BP cuff be- sistently less than 100 mm Hg. In the cause it derives readings without pump- absence of associated disease, low blood ing a bladder full of air, and with pressure is often a predictor of longevity accuracy rivaling direct measurement and continued health. SEE: hypoten- from an arterial catheter. The sensor is sion; orthostatic hypotension. placed directly over the radial artery diastolic b.p. The blood pressure and connected to an electronic monitor. when the ventricles of the heart are fill- Pressure is monitored every 15 heart- ing with blood. In health this equals beats and systolic, diastolic, mean ar- about 60 to 80 mm Hg. terial pressure, waveforms, and pulse direct measurement of b.p. Deter- rate are displayed. The first reading ap- mination of the blood pressure within pears in 15 seconds, and the sensor the lumen of an artery or within a cham- measures pressures from 40 to 240 mm short ber of the heart with a catheter intro- Hg, with preset alarms to alert the standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh blood pressure 290 blood transfusion base of rh

nurse to extreme highs and lows. Re- geries so that after appropriate filtra- sults are not affected by low cardiac out- tion it may be returned to the patient. put, arrhythmias, hypothermia, or obe- SEE: autologous blood transfusion; cell sity, and this method is being used saver. increasingly on adults in hospital spe- bloodshot (blo˘dЈsho˘tЉ) Local congestion cial care units where frequent serial of the smaller blood vessels of a part, as readings are required. when the vessels of the conjunctiva are Auscultatory method: Begin as above. dilated and visible. After inflating the cuff until the pres- blood shunting Shunting. sure is about 30 mm above the point bloodstream (blo˘dЈstre¯mЉ) The blood where the radial pulse disappears, place that flows through the circulatory sys- the bell of the stethoscope over the bra- tem of an organism. chial artery just below the blood pres- blood test A test to determine the chem- sure cuff. Then deflate the cuff slowly, ical, physical, or serological character- about 2 to 3 mm Hg per heartbeat. The istics of the blood or some portion of it. first sound heard from the artery is re- blood thinner A popular but erroneous corded as the systolic pressure. The name for an anticoagulant. point at which sounds are no longer blood transfusion The replacement of heard is recorded as the diastolic pres- blood or one of its components. Effective sure. For convenience the blood pres- and safe transfusion therapy requires a sure is recorded as figures separated by thorough understanding of the clinical a slash. The systolic value is recorded condition being treated. Most patients first. require blood components rather than Sounds heard over the brachial artery whole blood. Administering a specific change in quality at some point prior to component decreases the risk of adverse the point the sounds disappear. Some reactions from unnecessary compo- physicians consider this the diastolic nents. SEE: illus. blood component pressure. This value should be noted therapy; autologous blood transfusion; when recording the blood pressure by exchange transfusion; transfusion reac- placing it between the systolic pressure tion; Standard Precautions Appendix. and the pressure noted when the sound The following measures should be disappears. Thus, 120/90/80 indicates a taken during transfusion therapy: systolic pressure of 120 with a first di- 1. screen donors for transmissible astolic sound change at a pressure of 90 diseases; and a final diastolic pressure of 80. The 2. test blood for pathogens; latter pressure is the point of disap- 3. ensure that cross-matched blood pearance of all sounds from the artery. products are given to correctly identi- When the values are so recorded, the fied patients; physician may use either of the last 4. intervene promptly in transfusion two figures as the diastolic pressure. reactions; When the change in sound and the dis- 5. avoid unnecessary transfusions; appearance of all sound coincide, the re- 6. avoid volume overload during sult should be written as follows: 120/ transfusions; 80/80. 7. avoid hypothermia, electrolyte, mean b.p. The sum of twice the dia- and clotting disorders. stolic blood pressure plus the systolic Administration of a single unit may blood pressure, all divided by 3. be indicated in young or old surgical pa- negative b.p. Blood pressure that is tients, in persons with coronary disease, less than atmospheric pressure, as in and in patients who have an acute blood the great veins near the heart. loss of several units but whose blood normal b.p. A blood pressure be- pressure, pulse, and oxygen are stabi- tween 100 and 120 mm Hg systolic and lized by use of one unit. Ͻ 80 mm Hg diastolic. The risk of HIV, hepatitis B or C vi- systolic b.p. Blood pressure during rus, West Nile virus, or other pathogens contraction of the ventricles. It is nor- from blood collected and distributed in mally 100 to 120 mm Hg. Higher sys- the U.S. and other industrialized tolic blood pressures are found in pre- nations is very low but finite. The risk hypertension and hypertension. SYN: in other geographical areas varies. systolic pressure. PATIENT CARE: The patient is iden- blood pressure monitoring, ambulatory tified from both the hospital identifica- The measurement with a portable blood tion band and blood bank band. Two pressure monitor of blood pressure of health care professionals (one the ad- outpatients. It is used to record the pa- ministering nurse) verify the patient’s tient’s diastolic and systolic pressures ABO and Rh blood type and its compat- during activity and rest throughout the ibility with the unit of blood or packed day. cells to be administered as well as the blood salvage A collection of the si- unit’s expiration date and time. Out- phoned blood that has escaped from the dated blood is not used; it is returned to short operative site of non-contaminated sur- the blood bank for disposal. The blood standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh blood transfusion 291 blood transfusion base of rh

BLOOD TRANSFUSION Acceptable transfusions are diagrammed and presuppose compatible Rh factors.

or blood product is retrieved from the ature of more than 1.8ЊFor1ЊC, chills, blood bank refrigerator immediately be- pain at the infusion site, tachycardia, fore administration because blood tachypnea, wheezing, cyanosis, urti- should not be stored in other than ap- caria, or rashes. If any of these occurs, proved refrigerators. Also, it cannot be the transfusion is stopped immediately, returned to blood bank storage if the the vein is kept open with physiological unit’s temperature exceeds 50ЊF (10ЊC), saline solution, and the patient’s phy- a change that will occur within about 30 sician and the blood bank are notified. min of removal from storage. Health If incompatibility is suspected, the blood care providers should check the shelf and set are returned to the blood bank; life of irradiated blood, which is limited samples of the patient’s blood and urine to 28 days, because irradiation damages are obtained for laboratory analysis; cells and reduces their viability. The and the data are recorded from the unit. shelf life of platelets and granulocytes is If no symptoms occur in the first 15 min not affected because they are not dam- and vital signs remain stable, the trans- aged by irradiation. fusion rate is increased to complete the Before the transfusion is started, the transfusion within the prescribed time, patient’s vital signs (including temper- or (if necessary) the transfusion is ad- ature) are checked and documented. ministered as fast as the patient’s over- The blood is inspected visually for clots all condition permits. Once the trans- or discoloration, and then the transfu- fusion begins, the blood is administered sion is administered through an ap- within a maximum of 4 hr to maintain proved line containing a blood filter, biological effectiveness and limit the preferably piggybacked through physi- risk of bacterial growth. (If the patient’s ological saline solution on a Y-type condition does not permit transfusing blood administration set. No other IV the prescribed amount within this time solutions or drugs may be infused with frame, arrangements are made to have blood (unless specifically prescribed) be- the blood bank split the unit and prop- cause of potential incompatibility. In erly store the second portion.) The pa- the first 15 min the blood flow rate is tient’s vital signs and response are mon- limited to 50 ml, except when treating itored every 30 min throughout the massive trauma, when rapid infusions transfusion and 30 min afterward; of blood are always appropriate. A stated precautions are observed, and health care professional remains with caregivers monitor for indications of vol- the patient during this time and in- ume overload (distended neck veins, structs the patient to report any adverse bounding pulse, hypertension, dys- reactions, such as back or chest pain, pnea). Blood should not be administered short hypotension, fever, increase in temper- through a central line unless an ap- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh blood typing 292 Blumberg’s sign base of rh

proved in-line warming device is used. worsens after the first 2 years of life and A warmer also should be used whenever is often unilateral. The condition is multiple transfusions place the patient more common in girls than in boys and at risk for hypothermia, which can lead more common in blacks than in Euro- to dysrhythmias and cardiac arrest. pean Americans. Most cases occur in the Transfusion-related lung injury first 2 or 3 years of life, but a juvenile (TRALI) is a rare but serious and poten- form (onset at age 4 to 10 years) and an tially lethal response to allogenic blood. adolescent form (onset at 11 years or SEE: transfusion-related acute lung in- older) are recognized. SYN: tibia vara. jury. DIAGNOSIS: Diagnosis is based on blood typing The classification of red clinical presentation and x-ray of the blood cells by the proteins and carbo- leg. hydrates (antigens) found on the sur- TREATMENT: In the early stages, face of the erythrocyte membrane. simple bracing and splinting may be all blood urea nitrogen ABBR: BUN. Nitro- that is necessary. If the disease has gen in the blood in the form of urea, the gone undetected or untreated, or if it is metabolic product of the breakdown of one of the later-onset forms, surgery amino acids used for energy production. may be required. The normal concentration is about 8 to blowfly (blo¯Јflı¯Љ) One of the flies belong- 18 mg/dl. The level of urea in the blood ing to the family Calliphoridae. Most provides a rough estimate of kidney blowflies are scavengers. Their larvae function. Blood urea nitrogen levels live in decaying flesh or meat, although may be increased in the presence of de- occasionally they may live in decaying hydration, decreased renal function, up- or suppurating tissue. However, one per gastrointestinal bleeding, or treat- species, the screw-worm fly, Callitroga ment with drugs such as steroids or hominivorax, attacks living tissue, lay- tetracyclines. SEE: creatinine. ing its eggs in the nostrils or open blood vessels The veins, arteries, and wounds of its domestic animal or human capillaries. host, giving rise to myiasis. SEE: Calli- blood warmer A device that raises refrig- phora vomitoria; myiasis. erated blood or intravenous fluids to a blowpipe (blo¯Јpı¯pЉ) A tube through desired temperature, usually 37.0ЊC, or which a gas or current of air is passed a little above. under pressure and directed upon a Bloom’s syndrome [David Bloom, Am. flame to concentrate and intensify the dermatologist, b. 1892] An autosomal heat. recessive disease, found predominantly BLS basic life support. but not exclusively in persons of Jewish blue (bloo) [O. Fr. bleu] 1. A primary ancestry, marked by chromosomal ab- color of the spectrum; sky color; azure. normalities, facial rashes, dwarfism, 2. Cyanotic. and a propensity to develop leukemia. blue bloater A person with chronic bron- blotch (blo˘tch) A blemish, spot, or area chitis who demonstrates evidence of cy- of discoloration on the skin. anosis and pedal edema. SEE: chronic blotting method A technique for analyz- bronchitis. ing a tiny portion of the primary struc- ETIOLOGY: It is most often the result ture of genomic material (DNA or RNA). of long-term cigarette smoking. Northern b.m. A blot analysis tech- TREATMENT: The patient often ben- nique for analyzing a small portion of efits from oxygen therapy, bronchial hy- RNA. Operationally, this test is identi- giene (e.g., clearing of the lungs), and cal to Southern blotting except for the smoking cessation. target (RNA) and the specific reagents bluebottle fly SEE: under fly. used. Blue Cross A nonprofit medical care in- Southern b.m. A technique used in surer in the U.S. The insurance is molecular genetics to analyze a small mostly for hospital services. SEE: Blue portion of DNA first by purifying it, then Shield. by controlled fragmentation, electro- blue diaper syndrome A rare autosomal phoretic separation, and fixing the frag- recessive syndrome in which the amino ment identity using specific DNA acid tryptophan is not absorbed from probes. It is used most commonly for G the gastrointestinal tract. cell and T cell rearrangement analysis, blues A colloquial term for depression or bcr gene rearrangement analysis, and a depressed mood. fragile X syndrome analysis. Blue Shield A nonprofit medical care in- Western b.m. A technique for ana- surer in the U.S. The insurance is for lyzing protein antigens. that part of medical care provided by Blount’s disease [Walter Putman health care professionals. SEE: Blue Blount, Am. surgeon, 1900–1992] A Cross. pathological bowing of the leg (genu Blumberg’s sign (blu˘mЈbe˘rgs) [Jacob varum). Unlike the physiological bow- Moritz Blumberg, Ger. surgeon and legs of the infant and toddler, the bow- gynecologist, 1873–1955] Rebound short ing in Blount’s disease progressively tenderness. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh blunt end 293 body piercing base of rh blunt end In a health care institution, the any structure. 4. The largest or most im- administrative or bureaucratic appa- portant part of any organ. SEE: aortic ratus that supports and often directs body; foreign body; ketone body. patient care. Individuals actually pro- body armor Clothing designed to resist viding the care (aides, midlevel peson- blast waves, blunt force trauma, heat, nel, nurses, and physicians) are said to penetrating objects, shrapnel, and other work at the “sharp end” of health care. potential sources of physical injury. blush (blu˘sh) [AS. blyscan, to be red] body burden The amount of a substance Redness of the face and neck due to va- present in an organism. The term is sodilation caused by emotion or heat. usually reserved for descriptions of Blushing may also be associated with infectious or toxic substances. It may certain diseases, including carcinoid be represented arithmetically as the syndrome, pheochromocytoma, and Zol- concentration of the substance multi- linger-Ellison syndrome. plied by the mass of the tissues that BMA British Medical Association. store it. BME Biomedical Engineer. body composition The relative percent- BMET Biomedical Engineering Technol- ages of bony minerals, cell mass, lean ogist. body mass, body fat, and body water in BMI body mass index. an organism, and their distribution B-mode (brightness mode) display B- through the body. Determination of the mode ultrasound. specific gravity of the body is done to es- BMR basal metabolic rate. timate the percentage of fat. This may BMT bone marrow transplant. be calculated by various methods, in- BNA Basle Nomina Anatomica. cluding underwater weighing, which de- board (bo¯rd) 1. A long, flat piece of a sub- termines the density of the individual; stance such as wood or firm plastic. 2. A use of radioactive potassium, 40K; mea- governing or oversight committee, such suring the total body water by dilution as one that directs the affairs of a hos- of tritium; and use of various anthro- pital, clinic, company, or other organi- pometric measurements such as height, zation. weight, and skin fold thickness at vari- arm b. 1. A board placed under and ous sites. None of these methods is free attached to the arm for stabilization of the potential for error. Underwater during intravenous administration. weighing is useful but may provide mis- 2. A device attached to the sides of a leading information when used in ana- wheelchair to permit support or posi- lyzing body composition of highly tioning of the arm, esp. for persons with trained athletes. The obese person has upper-extremity paralysis. a lower body density than does the lean bed b. A firm board placed beneath person, because the specific gravity of a mattress to keep it from sagging. It is fat tissue is less than that of muscle tis- used to treat some persons with back sue. The fat content for young men will difficulties. It is also used in cardiopul- vary from about 5% to 27% and for monary resuscitation to improve the ef- women from about 18% to 35%. fectiveness of chest compressions. body dysmorphic disorder ABBR: BDD. board eligible In medicine, a designation A preoccupation with one or more imag- that signifies that a physician has com- ined defects in appearance. pleted all the requirements for admis- body image, disturbed Disruption in the sion to the medical specialty board cer- way one perceives one’s body image tification examination but has not yet (e.g., after an injury or illness) or an in- taken and passed the examination. congruity between one’s actual appear- SEE: certification, board. ance and the way one perceives it (e.g., boarder A patient no longer requiring in anorexia nervosa). SEE: body dys- hospitalization who is provided with morphic disorder; Nursing Diagnoses meals and lodging in a hospital, usually Appendix. until other living arrangements can be body language The revelation of attitude made. or mood through physical gestures, pos- Bochdalek’s ganglion (bo˘kЈda˘l-e˘ks) ture, or proximity; nonverbal commu- [Victor Bochdalek, Czech. anatomist, nication. SEE: kinesics. 1801–1883] A ganglion of the plexus of body map A drawing of a patient’s inju- the dental nerve in the maxilla above ries, lesions, or wounds, used to record the canine tooth. maltreatment by another person in a Bodo (bo¯Јdo¯) A genus of nonpatho- case of physical abuse or violence. genic, flagellate protozoa of the family body packer syndrome Drug overdose as Bodonidae often found in stale feces or a result of the ingestion of multiple urine and sometimes in the urinary small packages, usually containing bladder. drugs of abuse (esp. cocaine), to trans- body (bo˘Јde¯) [AS. bodig] 1. A complete port them illegally. Inadvertent over- organism, living or dead; the sum of its dose may occur if the packages rup- physical components. SYN: soma (1). ture. short 2. Trunk (1). 3. The principal mass of body piercing Placing an object, usually standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh body rocking 294 bond base of rh

a metal or plastic ornament, into a body local cellulitis. Incision and drainage is part such as the ears, navel, nose, lips, sometimes needed. tongue, nipple, or genitalia. Piercing boiling (boylЈı¯ng) Process of vaporizing a may be associated with problems such liquid. Boiling water destroys most mi- as local skin infections, the transmis- croorganisms (but may not destroy sion of blood-borne infections, and aller- spores or viruses), solidifies (denatures) gic reactions to the object. albumin, weakens fibrin and muscle body rocking SEE: under rocking. proteins in meat, bursts starch gran- body scheme Knowledge of one’s body ules, and softens cellulose in cereals and parts and their relative positions. SEE: vegetables. proprioception. -bol, bol- (bo˘l) [Fm. (ana)bol(ic)] A com- body snatching Robbing a grave of its bining form used in pharmacology to body, which was done in the past to ob- designate an anabolic steroid. tain bodies for anatomical study in med- bolus (bo¯Јlu˘s) [L., from Gr. bolos, a ical schools. lump] 1. A mass of masticated food body temperature, risk for imbalanced ready to be swallowed. 2. A rounded At risk for failure to maintain body tem- preparation of medicine for oral inges- perature within normal range. SEE: tion. 3. A concentrated mass of a diag- Nursing Diagnoses Appendix. nostic substance given rapidly intra- body type SEE: under type. venously, such as an opaque contrast body weight ratio Body weight in grams medium, or an intravenous medication. divided by body height in centimeters. 4. In radiology, a tissue-equivalent ma- body work Musculoskeletal manipula- terial placed on the surface of the body tions such as massage, stretching, pos- to minimize the effects of an irregularly tural alignment, and breathing exer- shaped body surface. The dose at the cises that are used to relieve stress, skin surface tends to increase, minimiz- treat pain, and promote a sense of well- ing the skin-sparing effect of megavol- ness. tage radiation. Boeck’s sarcoid (be˘ks) [Caesar P. M. alimentary b. A mass of masticated Boeck, Norwegian dermatologist, 1845– food in the esophagus that is ready to be passed into the stomach. 1917] Former name for sarcoidosis. Ј Boerhaave syndrome (boorЈha˘-ve˘) [Her- bombesin (bo˘m be˘-sı˘n) ABBR: BBS. A mann Boerhaave, Dutch physician, neuropeptide present in the gut and 1668–1738] Spontaneous rupture of brain tissue of humans. It has antiulcer, the esophagus usually associated with anti-inflammatory, appetite-suppress- violent retching or vomiting. SEE: Mal- ing, and trophic effects. It has been lory-Weiss syndrome. identified in a number of malignancies Bohr effect (bo¯r) [Christian Bohr, Dan- and has been used in oncology as an bio- ish physiologist, 1855–1911] The effect logical marker of disease progression. bona fide (bo¯Јna˘, bo˘Јna˘, fı¯d, fı¯dЈe¯, fe¯Јda¯) of an acid environment on hemoglobin; [L.] Carried out in good faith; honest, hydrogen ions alter the structure of he- without fraud or deception. moglobin and increase the release of bond 1. A force that binds ions or atoms oxygen. It is esp. important in active tis- together. It is represented by a line sues producing carbon dioxide and lactic drawn from one molecule or atom to an- acid. other as in H9O9H. 2. An interper- boil (boyl) [AS. byl, a swelling] A ten- sonal connection or tie. der, dome-shaped skin lesion, typically covalent b. Chemical bond formed caused by infection around a hair follicle when atoms share one, two, or three with Staphylococcus aureus. Boils usu- pairs of electrons. This is the type of ally arise on the face, neck, axilla, or bond found in organic molecules. buttocks (i.e., on body surfaces that fre- disulfide b. A covalent bond between quently perspire and chafe). When they two sulfur-containing amino acids, first appear they are often superficial, which helps maintain the shape of pro- but as they mature they form localized teins such as insulin, keratin, and an- abscesses with pus and necrotic debris tibodies. SYN: disulfide bridge. at their core. On rare occasions they hydrogen b. The weak attraction of spread to deeper tissues, sometimes a covalently bonded hydrogen to nearby with tragic consequences (e.g., a boil on oxygen or nitrogen atoms in the same or the neck or face may spread to the brain a different molecule. Hydrogen bonds or meninges). SYN: furuncle. SEE: car- give water its cohesiveness and its sur- buncle. face tension. These bonds also help TREATMENT: Warm moist com- maintain the three-dimensional shape presses relieve pain and encourage of proteins and nucleic acids; such shape drainage of the infected nodule to the is essential to their functioning. skin surface. Oral antistaphylococcal ionic b. A chemical bond formed by antibiotics, such as trimethoprim/sul- the loss and gain of electrons between famethoxazole or clindamycin, are atoms. This type of bond is found in in- short given when the lesion is surrounded by organic acids, bases, and salts. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bond 295 bone base of rh

PROXIMAL EPIPHYSIS

HAVERSIAN CANAL HAVERSIAN SYSTEM ENDOSTEUM CONCENTRIC RINGS OF OSTEOCYTES

MARROW

DIAPHYSIS YELLOW BONE MARROW

DISTAL MARROW EPIPHYSIS (MEDULLARY) ARTERIOLE CAVITY VENULE CANALICULI SPONGY PERIOSTEUM OSTEOCYTE FIBROUS LAYER BONE OSTEOGENIC LAYER PERIOSTEUM COMPACT BONE (OSTEOBLASTS)

BONE TISSUE (Left) Femur with distal end sectioned; (Right) compact bone with haversian systems

nonpolar covalent b. A covalent mother relationship in both the short- bond in which the pair of electrons is and long-term periods after childbirth. shared equally between two atoms. For that reason, the initial contact be- polar covalent b. A covalent bond in tween mother and infant should be in which one atom attracts the shared pair the delivery room and the contact of electrons more strongly than does the should continue for as long as possible other atom, and thus has a slightly neg- in the first hours after birth. It is also ative charge. The atom with the weaker called mother-infant attachment. attraction has a slightly positive charge. bone [AS. ban, bone] 1. Osseous tissue, bonding (bo˘ndЈı˘ng) 1. In dentistry, the a specialized form of dense connective use of a low-viscosity polymerizable ad- tissue consisting of bone cells (osteo- hesive to provide mechanical retention cytes) embedded in a nonliving matrix. of cast restorations, autopolymerizing Bone matrixis made of calcium carbon- restorations, and orthodontic appli- ate, calcium phosphate, and collagen fi- ances. 2. Development of a strong emo- bers. SYN: os. SEE: illus. (Bone Tissue). tional attachment between individuals 2. A unit of the skeleton; the human (e.g., a mother and child) after frequent skeleton has 206 bones. Bones surround or prolonged close contact. and protect some vital organs, and give mother-infant b. The emotional and points of attachment for the muscles, physical attachment between infant serving as levers and making movement and mother that is initiated in the first possible. In the embryo, the bones of the hour or two after normal delivery of a skull are first made of fibrous connective baby who has not been dulled by anes- tissue, which is gradually replaced by thetic agents or drugs. It is believed that bone matrix. The remainder of the skel- the stronger this bond, the greater the eton is first made of hyaline cartilage, short chances of a mentally healthy infant- which is also replaced by bone matrix, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bone 296 bone base of rh

beginning during the third month of alveolar b. The bony tissue or pro- gestation. The outer surface of a bone is cess of the maxilla or mandible that sup- compact bone, and the inner more po- ports the teeth. SYN: alveolar process. rous portion is cancellous (spongy) bone. breast b. Sternum. The shafts of long bones are made of brittle b. Bone that is abnormally compact bone that surrounds a marrow fragile, as in osteogenesis imperfecta. canal. Compact bone is made of haver- cancellous b. A spongy bone in which sian systems, which are precise ar- the matrixforms connecting bars and rangements of osteocytes, blood vessels, plates, partially enclosing many inter- and lymphatics within the bony matrix. communicating spaces filled with bone All of these contribute to the mainte- marrow. SYN: spongy bone. nance and repair of bone. The perios- carpal bone One of the eight wrist teum is the fibrous connective tissue bones, which are aligned in two rows. membrane that covers a bone. It has The proximal row contains (from the blood vessels that enter the bone, and it thumb to the little finger) the scaphoid, provides a site of attachment for ten- lunate, triquetral, and pisiform bones. dons and ligaments. Bones are classified The distal row contains (from thumb to according to shape as long, short, flat, or little finger) the trapezium, trapezoid, irregular. In the elderly, esp. women, capitate, and hamate bones. osteoporosis may develop, a condition in cartilage b. A bone formed by endo- which bones become brittle and break chondral ossification developing from easily. SEE: illus. (Bony Structures of the primary centers of bone formation. the Thorax, Abdomen, and Pelvis); skel- SYN: endochondral bone. eton for names of principal bones. cavalry b. Rider’s b.

MANUBRIUM OF STERNUM 4TH, 5TH, AND 6TH RIBS BODY OF STERNUM

10TH THORACIC XIPHOID PROCESS VERTEBRA OF STERNUM

12TH RIB COSTAL CARTILAGES

INTERVERTEBRAL DISK TRANSVERSE PROCESSES OF LUMBAR VERTEBRA CREST OF ILIUM WING (ALA) OF ILIUM SACRUM ANTERIOR SUPERIOR GREATER SCIATIC ILIAC SPINE NOTCH

SPINE OF ISCHIUM SACROTUBEROUS LIGAMENT GREATER TROCHANTER LESSER SCIATIC NOTCH HEAD OF FEMUR SACROSPINOUS NECK OF FEMUR LIGAMENT

COCCYX LESSER TROCHANTER OF FEMUR ISCHIAL TUBEROSITY PUBIC BONE SYMPHYSIS PUBIS short BONY STRUCTURES OF THE THORAX, ABDOMEN, AND PELVIS standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bone 297 bone base of rh

collar b. Clavicle. hyoid b. The horseshoe-shaped bone compact b. The hard, dense bone at the base of the tongue. It is mobile made of haversian systems that forms and its ends hang by the stylohyoid lig- the surface layer of all bones and the aments from the styloid process on each shafts of long bones, in contrast to side of the base of the skull. The hyoid spongy bone that forms the bulk of the bone is suspended by many muscles (the short, flat, and irregular bones and the hyoid muscles): the suprahyoid muscles ends of long bones. (geniohyoid, mylohyoid, digastric, and cotyloid b. A bone that forms a part hyoglossus) attach the hyoid bone to the of the medial portion of the acetabulum mandible and the floor of the mouth; the during fetal development. It subse- infrahyoid muscles (omohyoid, sterno- quently fuses with the pubis. hyoid, and thyrohyoid) attach it to the cranial b. A bone of the skull or brain larynxand the thoracic cage. The hyoid case. bone anchors and moves with the jaw, cuboid b. The outer bone of the in- tongue, pharynx, and larynx. SEE: illus. step bones of the foot that articulates innominate b. The hip bone or os posteriorly with the calcaneus and an- coxae, composed of the ilium, ischium, teriorly with the fourth and fifth meta- and pubis. It is united with the sacrum tarsals. and coccyxby ligaments to form the pel- cuneiform b. One of the bones of the vis. SYN: pelvic bone; os coxae. internal, middle, and external tarsus. interradicular b. The alveolar bone dermal b. Membrane b. between the roots of multirooted teeth. ear b. One of the ossicles of the tym- intramembraneous b. Membrane panic cavity: the malleus, incus, and bone. stapes. SEE: ear for illus. ivory b. Marble b. endochondral b. Cartilage b. lacrimal b. A thin, irregularly shaped ethmoid b. A complexthin-walled bone on the medial side of the orbit. bone, roughly cuboidal in shape, located lesser multangular b. The second in in the middle of the skull above the na- distal row of carpal bones. SYN: trape- sal cavities and below the anterior fossa zoid bone. of the cranial cavity. Its flat upper sur- lunate b. Semilunar b. face is the cribriform plate, which forms malar b. A four-pointed bone on each much of the roof of the nasal cavities; its side of the face, uniting the frontal and upper surface has a midline bony keel superior maxillary bones with the zy- that projects up into the cranial cavity gomatic process of the temporal bone. and on both sides of which are perfora- SYN: cheekbone; zygoma; zygomatic ted valleys through which the olfactory bone. nerves project up from the olfactory ep- ithelium. In the midline under the crib- riform plate is a mirror-image (to the crista galli) keel, the perpendicular plate, which projects down between the nasal cavities as part of the bony nasal septum. The right and left sides of the ethmoid bone are the ethmoidal laby- rinths, composed of ethmoidal air cells; the inner surfaces of the labyrinths form the middle nasal conchae, while the lat- eral surfaces form the orbital plates, which are part of the mosaic of bones that form the inner walls of the orbits. frontal b. The forehead bone. funny b. A colloquial term for the groove along the inner back side of the elbow (behind and underneath the me- dial epicondyle of the humerus) in which the ulnar nerve runs. Pressure on the groove compresses the ulnar nerve, producing a tingling discomfort on the inside of the forearm as well as the 4th and 5th fingers. hamate b. The most medial wrist (carpal) bone in the distal row. It has a hooked process on its palmar side. The hamate articulates with the 4th and 5th metacarpals. SYN: hamatum; os ha- matum; unciform bone. heel b. Calcaneus. short hip b. Innominate b. HYOID BONE standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

bone fracture, nonunion, electrical top of rh bone 298 stimulation for base of rh

marble b. An abnormally calcified curring in the hands and feet and em- bone with a spotted appearance on a ra- bedded in tendons or joint capsules. diograph. SYN: ivory bone. SEE: osteo- Soemmering’s b. SEE: Soemmer- petrosis. ing’s bone. membrane b. Bone formed within sphenoid b. The large bone at the embryonic fibrous connective tissue, in base of the skull that has the ethmoid which fibroblasts differentiate into os- bone in front of it, the occipital bone be- teoblasts. Such bone is formed without hind it, and the parietal and temporal a cartilage model and includes the bones at the sides. It is shaped like a bones of the face and cranium. SYN: large moth. Its two broad, curved wings dermal bone; intramembraneous bone. form the front walls of the middle cra- mosaic b. Bone appearing as small nial fossae, and its two “tails,” the pter- pieces fitted together, characteristic of ygoid processes, which hang in front of Paget’s disease. the neurocranium in the pterygoid fossa nasal b. Either of the two small behind the facial skeleton. Between the bones forming the bridge of the nose. wings, in the center of the body of the occipital b. The bone that forms the sphenoid bone, there is a deep, concave lower, posterior skull; it articulates with pocket (the sella turcica), in which the the parietal and temporal bones ante- pituitary gland lies. riorly, and the atlas inferiorly. spongy b. Cancellous b. orbicular b. The rounded end of the squamous b. The upper anterior long process of the incus, a middle ear portion of temporal bone. ossicle. It probably represents a second- sutural b. Wormian bone. ary ossification center in the long or len- tabular b. A flat bone, or one with ticular process. two compact bone portions enclosing a palate b. Palatine bone. center of spongy bone. palatine b. One of the bones forming tarsal b. One of the seven bones of the posterior part of the hard palate and the ankle, hind-foot, and midfoot, con- lateral nasal wall between the interior sisting of the talus, calcaneus, navicu- pterygoid plate of the sphenoid bone lar, cuboid, and three cuneiform bones. and maxilla. SYN: palate bone. temporal b. A bone on both sides of parietal b. One of two bones that to- the skull at its base. It is composed of gether form the posterior roof and sides squamous, mastoid, and petrous por- of the skull. tions, the latter enclosing the receptors pelvic b. Innominate b. for hearing and equilibrium. SYN: os perichondrial b. Bone formed be- temporale. SEE: Arnold’s canal; mas- neath the perichondrium. toid; petrosa; styloid process. periosteal b. Bone formed by osteo- thigh b. Femur. blasts of the periosteum. trapezoid b. The second bone in the ping pong b. A thin shell of osseous distal row of carpal bones. It lies be- tissue covering a giant-cell sarcoma in a tween the trapezium and capitate bone. bones. plastic deformation of b. A bow- triquetral b. The third carpal bone in shaped deformity of bone from trauma the proximal row, enumerated from the strong enough to cause the bone to bend radial side. SYN: triquetrum. but not break. It is typically seen in chil- wormian b. (wu˘rЈme¯-a˘n) [Ole Worm, dren, esp. in the ulna or fibula. SYN: Danish physician, 1588–1654] One of bend fracture. the small, irregular bones found along pubic b. The lower anterior part of the cranial sutures. SYN: sutural bone. the innominate bone. It is a separate woven b. Embryonic or rapidly bone at birth; it begins to fuse with the growing bone characterized microscopi- ischium by age 8, and it is fully fused cally by a prominent fibrous matrix. with the ischium and ilium by 16-18 zygomatic b. The cheekbone; the years of age. SYN: os pubis. bone on either side of the face below the replacement b. Any bone that devel- eye. SYN: malar bone. ops within cartilage. bone densitometry A method of deter- rider’s b. Ossification of the distal mining the density of bone by use of ra- end of the adductor muscles of the thigh, diographic techniques. The use of dual as may be seen in horseback riders. photon absorptiometry provides density SYN: cavalry bone. data of the axial skeleton with a preci- sacral b. Sacrum. sion of 97% to 98%. It is used in testing scaphoid b. The largest carpal bone for degree of osteoporosis. SEE: osteo- in the first row of wristbones. It is on the porosis; dual energy x-ray absorptiome- thumb side of the hand and articulates tryetry. directly with the radius. SYN: os sca- bone fracture, nonunion, electrical stim- phoideum. ulation for A method of stimulating a semilunar b. Crescent-shaped bone nonunion bone fracture to heal through of the carpus. SYN: lunate bone. an invasive or noninvasive electromag- short sesamoid b. A type of short bone oc- netic field. Invasive electrical stimula- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bonelet 299 booster base of rh

tion involves the implantation of elec- and promptly transported to the labo- trodes into the bone proximal and distal ratory. Postprocedure pain intensity is to the fracture site. Surface electrodes assessed, and analgesia is provided as are placed on the skin over the area of prescribed. The patient is advised to fracture for the noninvasive technique. watch for and report any signs of infec- SEE: nonunion. tion, and warned to avoid any drugs bonelet (bo¯nЈle˘t) Ossicle. containing aspirin, as these may poten- bone marrow The soft tissue in the mar- tiate bleeding. row cavities of long bones (yellow mar- Specimens of marrow and aspirate row) and in the spaces between trabec- are sent to the cytology or pathology ulae of spongy bone in the sternum and laboratory for microscopic analysis; to other flat and irregular bones (red mar- microbiology (if cultures are needed); row). Yellow marrow is mostly fat, and/or the clinical laboratory for chro- stored energy. Red marrow produces all mosomal analysis or staining. A biopsy the types of blood cells. or aspirate that does not yield adequate b.m. aspiration and biopsy The re- material for analysis is known colloqui- moval of a small amount of tissue (bone ally as a dry tap. marrow biopsy) and fluid filled with bone mineral density ABBR: BMD. The blood cells (bone marrow aspiration) average mineral concentration of a spec- from the central core of a bone, used to imen of bone; skeletal mass. Bone min- diagnose blood disorders such as ane- eral density is reduced in osteopenia mias and cancers; or infectious diseases and osteoporosis. A reduction in BMD that affect the marrow; or to gather cells predisposes patients to fractures. SYN: for later infusion into a patient (e.g., in density, bone mass. bone marrow transplantation). PATIENT CARE: BMD can be mea- PATIENT CARE: The purpose of the sured by techniques such as dual x-ray test is explained to the patient (and absorptiometry (DEXA). Women who family as necessary). The patient is ad- are postmenopausal should be assessed vised that some discomfort or pressure for osteoporosis risk and receive some may be felt, and a crunching or popping form of BMD measurement so that if in- sound may be heard as the needle pen- adequate bone density is present, they etrates the bone. A signed, informed can be given treatment to lower the risk consent must be obtained prior to the of fractures. Any postmenopausal procedure. The patient’s bleeding risk is woman with risk factors for osteoporosis assessed, reviewing his or her history, or who has sustained an osteoporotic coagulation studies, platelet count, an- fracture should undergo BMD testing. ticoagulant therapy, and use of drugs or bone morphogenetic protein (morЉfo¯-ge˘- supplements that interfere with clot- ne˘tЈı˘k) A bone graft substitute. ting. The patient also is assessed for al- bone paste One of several composite ma- lergies to antiseptic or anesthetic solu- terials that can be used to repair defects tions. The patient is advised that he or in bones during orthopedic surgery. she must remain still throughout the bone–patellar tendon–bone ABBR: B- procedure, and his or her ability to do so PT-B. An autologous graft used to re- is assessed. Baseline vital signs are re- pair a ruptured anterior cruciate liga- corded and a sedative administered as ment. It consists of the central portion prescribed. The patient is assisted to of the patellar tendon linked to a seg- the appropriate position for the inser- ment of bone taken from the patella (col- tion site: lateral decubitus for the pos- loquially the kneecap) and a segment terior iliac crest; supine for the sternum extracted from the tibia (the shin). or anterior iliac crest. The health care bony (bo¯Јne¯) Resembling or of the na- provider assists the patient to maintain ture of bone. SYN: osseous. the desired position. The patient is en- bonzo (bo˘nЈzo¯) A receptor found on the couraged to take deep breaths and use surface of cellular membranes that fa- relaxation techniques during the pro- cilitates the entry of the human immu- cedure. nodeficiency virus. A sterile prepackaged set is used for Boophilus (bo¯-o˘Јfil-u˘s) [L. bos, ox, cow, the aspiration, and the practitioner is Gr. philein, to love] A genus of ticks assisted as necessary. The patient is as- that parasitizes humans and cattle and sessed throughout for pallor, diaphore- other animals. SEE: Ixodes. sis, or other changes. Following the as- boost (boost) In radiation oncology the piration, direct pressure is applied to delivery of a large dose of radiation to a the puncture site for 5 to 10 minutes or tumor in addition to the radiation sup- according to agency policy until bleed- plied by an external beam. ing is controlled, then the wound is cov- booster (booЈste˘r) An additional dose of ered with a sterile dressing. The patient an immunizing agent to increase the is assisted to a position of comfort, and protection afforded by the original se- vital signs are checked. The puncture ries of injections. The booster is given site is reassessed as necessary for bleed- some months or years after the initial short ing. All specimens are properly labeled immunization. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh booster effect 300 Boston Naming Test base of rh booster effect 1. A strong immune re- tient’s shortness of breath using num- sponse generated by a second exposure bers anchored with verbal descriptions to an antigen. 2. An increase in the size (e.g., 10 ϭ completely out of breath; 5 ϭ of the reaction to intradermally injected somewhat breathless; 1 ϭ breathing tuberculin when a second injection is easily). The patient or athlete chooses given 7 to 21 days after the first. the number that best corresponds to his BOOSTRIX (boosЈtrı˘ks) Tetanus toxoid, or her current perceived respiratory ef- reduced diphtheria toxoid, and acellular fort. pertussis vaccine, adsorbed. boric acid poisoning SEE: under poison- boot A special shoe, brace, or bandage for ing. covering, protecting, and/or immobiliz- borism (bawrЈı˘-zı˘m) The symptoms ing the foot, ankle, and lower leg. caused by the internal use of boraxor borate (bo¯Јra¯t) Any basic salt of boric boron compounds. These include dry acid. SEE: Poisons and Poisoning Ap- skin, eruptions, and gastric distur- pendix. borated, adj. bances. borax (borЈa˘ks) [L., from Arabic, from Bornholm disease (bornЈho¯m) [named Persian burah] Sodium borate, used as for the Danish island Bornholm] An a detergent, a water softener, and a epidemic disease marked by sudden in- weak antiseptic. tense pleuritic or abdominal pain and borborygmus (borЉbo¯-rı˘gЈmu˘s) pl. bor- fever. It is caused by various coxsackie borygmi [Gr. borborygmos, rumbling viruses. SYN: devil’s grip; epidemic in the bowels] A gurgling, splashing pleurodynia. sound normally heard over the large in- TREATMENT: Nonsteroidal anti-in- testine; it is caused by passage of gas flammatory agents and local application through the liquid contents of the intes- of heat may control symptoms. tine. Its absence may indicate paralytic boron (bo¯rЈo˘n) [borax ϩ carbon] ileus or obstruction of the bowels due to SYMB: B. A nonmetallic element found torsion, volvulus, or strangulated her- only as a compound such as boric acid nia. or borax; atomic weight 10.81, atomic border (bawrЈde˘r) The outer part or number 5. edge; boundary. Borrelia (bor-re¯Јle¯-a˘) A genus of spiro- brush b. The microvilli on the free chetes, some of which cause disease in surface of the cells lining the small in- humans. testine and the proximal convoluted B. burgdorferi The causative agent portion of the renal tubules. Microvilli of Lyme disease. are folds of the cell membrane and B. duttonii The causative agent for greatly increase the surface area for ab- East African tick-borne relapsing fever. sorption. Other causes of endemic relapsing fever vermilion b. The red boundary of the include Borrelia hermii. lips that represents the highly vascular, B. lonestari The causative agent of hyalinized, keratinized epithelial cov- Southern tick-associated rash illness. ering between the outer skin and the B. recurrentis The causative agent of moist oral mucosa of the mouth. louse-borne relapsing fever. borderline (borЈde˘r-lı¯nЉ) An incomplete borreliosis (bo-relЉe¯-o¯Јsı˘s) Any of several state, as in a borderline diagnosis, in a arthropod-borne diseases caused by spi- patient who has some of the require- rochetes of the genus Borrelia. ments for a definite diagnosis but not boss (bo˘s) [O. Fr. boce, a swelling] A enough for certainty; a condition judged round circumscribed swelling or growth numerically (e.g., high blood pressure in (e.g., a tumor) that becomes large which the value is close to a hyperten- enough to produce swelling. sive level but not at a diagnostic level). bosselated (bo˘sЈe˘-la¯t-e˘d) Marked by nu- Bordetella (borЉde˘-te˘lЈla˘) [Jules Bordet, merous bosses. Belg. physician, bacteriologist, and bossing (bo˘sЈı˘ng) Protuberance of the physiologist, 1870–1961] A genus of frontal areas of the skull. hemolytic gram-negative coccobacilli of Boston arm A myoelectric prosthesis for the family Brucellaceae. Some species above-the-elbow amputations. The el- are parasitic and pathogenic in warm- bow is powered by a small battery- blooded animals, including humans. driven motor, activated in proportion to B. pertussis The causative agent of the strength of contraction detected in whooping cough. SEE: pertussis. the control muscle. SYN: Boston elbow; bore 1. The internal diameter of a tube. Liberty Mutual elbow. 2. To drill, e.g. into the surface of a bone Boston brace A low-profile plastic thor- or tooth. acolumbosacral orthosis (spinal jacket) boredom (borЈdo˘mЉ) A feeling of fatigue, with no metal suprastructure, used to depression, or disinterest caused by a treat mild to moderate lower thoracic lack of challenging or meaningful work and lumbar scoliosis. or stimulation. SEE: apathy. Boston elbow Boston arm. Borg’s dyspnea scale (bo˘rgz) A system Boston Naming Test ABBR: BNT. A short used to document the severity of the pa- neuropsychiatric test to measure apha- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh Boswellia 301 botulism base of rh

sia and naming ability. In the test the autonomic and respiratory systems may subject must name 60 line drawings of occur; however, gastrointestinal symp- common and rarely seen objects. It is toms are likely only in foodborne out- frequently used to assess patients with breaks. autism, brain injuries, or strokes. The poison responsible for botulism Boswellia (bo˘s-we˘lЈe¯-a˘, bo˘z) A genus of damages the nervous system by block- trees found in the Middle East and In- ing the release of acetylcholine at the dia. The trees produce an oleoresin used neuromuscular junction. This is the in ayurvedic medicine as antiinflam- cause of the paralysis associated with matory treatment for arthritis and the illness. asthma. SYMPTOMS: Nausea, diarrhea, vom- Botallo’s duct (bo¯-ta˘lЈo¯z) [Leonardo Bo- iting, ptosis, double vision, slurred tallo, It. anatomist, 1530–1600] Duc- speech, and swallowing difficulties are tus arteriosus. all common in adults. Constipation, botanical (bo¯-ta˘Јnı˘-kl) 1. Relating to bot- poor feeding, and flaccidity (floppy baby any or plants. 2. A plant extract used to syndrome) may occur in children. The maintain health, treat, or prevent ill- spectrum of illness is broad; some pa- ness. tients suffer other complications, in- botany (bo˘tЈn-e¯) [Gr. botanikos, pert. to cluding generalized paralysis and res- plants] The study of plants; a division piratory failure, the usual cause of of biology. death (25% mortality). botfly (bo˘tЈflı¯) pl. botflies Dermatobia. DIAGNOSIS: Positive serum, gastric botryoid (bo˘tЈre¯-oyd) [Gr. botrys, bunch contents, stool, or suspected food cul- of grapes, ϩ eidos, form, shape] Re- tures for botulinum toxin, or a positive sembling a bunch of grapes. SYN: sta- mouse inoculation test (using samples phyline. from suspected food sources), will make botryomycosis (bo˘Љtre¯-o¯-mı¯-ko¯Јsı˘s) [Gr. the diagnosis in patients in whom other botrys, bunch of grapes ϩЉ] A boil or neurological evaluations are negative. furuncle, resembling an actinomycotic Because the clinical presentation is sim- mass, but composed instead of bacteria, ilar to stroke and Guillain-Barre´ and specifically Staphylococcus aureus. Eaton-Lambert syndromes, neural im- botuliform (bo˘-chu¯ Јlı˘-formЉ) [L. botulus, aging and spinal fluid analysis are gen- sausage, ϩЉ] Shaped like a sausage. erally performed; results are negative in botulin (bo˘ch-a˘-lı˘n) The protein neuro- botulism. toxin that causes the clinical disease TREATMENT: Trivalent antitoxin botulism. It may be used to efface skin (ABE), an antitoxin made from horses, wrinkles, and to treat neurological con- should be administered IV or IM early ditions such as torticollis. in patients suspected of having botu- botulinic acid (bo˘ch-a˘-lı˘nЈı˘k) A toxin lism. Early usage decreases mortality found in putrid sausage. and morbidity associated with the ill- botulism (bo˘tЈu¯-lı˘zm) [ЉϩGr. −ismos, ness. Botulinum antitoxin is available condition] A paralytic and occasionally from the Centers for Disease Control fatal illness caused by exposure to tox- and Prevention by calling (404) 639- ins released from Clostridium botuli- 2206 (daytime) or (404) 639-2888 (eve- num, an anaerobic, gram-positive bacil- ning). SEE: Poisons and Poisoning Ap- lus. In adults, the disease usually occurs pendix. after food contaminated by the toxin is PATIENT CARE: Patients who have eaten, after gastrointestinal surgery, or ingested tainted foods may benefit from after the toxin is released into an in- gastrointestinal decontamination (lav- fected wound. In infants (usually be- age and enema to remove unabsorbed tween 3 and 20 weeks of age), the illness toxin). IV fluids provide hydration. Very results from intestinal colonization by close monitoring of affected patients, clostridial spores (perhaps related to preferably in intensive care units, is in- honey or corn syrup ingestion), then dicated so that prompt intubation and production of the exotoxin within the in- mechanical ventilation can begin if res- testine. Because the toxin is extraordi- piratory failure develops. Vital signs, narily lethal and easy to manufacture respiratory effort, and respiratory dis- and distribute, concern has been raised tress are documented and reported. Ar- regarding its use as an agent of biolog- terial blood gases are monitored. Neuro- ical warfare. motor function is carefully and Foodborne botulism may result from repeatedly assessed. Before botulinum consumption of improperly cooked and antitoxin is administered, a history of canned meals, in which the spores of the the patient’s allergies, esp. to horse se- bacillus survive and reproduce. Wound rum, is obtained and a skin sensitivity botulism may begin in abscesses, where test performed. After antitoxin admin- an anaerobic environment promotes the istration, the patient must be closely proliferation of the bacterium and ab- watched for anaphylaxis. Epinephrine sorption of its poison. In either case cra- 1:1,000 (SC) and airway equipment short nial nerve paralysis and failure of the should be readily available for such an standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh botulism 302 Bowman’s capsule base of rh

emergency. Other hypersensitivity re- ter or bunch of structures, esp. blood actions and serum sickness can also oc- vessels. cur. Bourdon gauge A low-pressure flow me- If relatives or other close contacts of tering device. the patient have eaten similar foods or Bourneville disease Tuberous sclerosis. shown similar symptoms, they should boutonneuse fever, Boutonneuse (boo- be carefully assessed and treated. Bot- to˘n-oozЈ) Mediterranean spotted fever. ulism is a reportable illness in every boutonnie`re (boo-to˘n-ya¯rЈ) [Fr., button- state in the U.S. Health care profession- hole] A surgically produced buttonhole- als can help to prevent botulism by ex- like opening in a membrane. plaining proper food processing and pre- boutonnie`re deformity SEE: under de- serving techniques. Food obtained from formity, boutonnie`re; illus. a bulging container or food with a pe- culiar odor should always be avoided. infant b. A form of botulism that af- fects infants less than 1 year old who ingest soil or food (esp. honey) contain- ing Clostridium botulinum spores. The infant’s protective intestinal flora is not yet established, and the spores germi- nate into active bacteria that produce the neurotoxin. It is treated with oral amoxicillin. SYMPTOMS: The symptoms include constipation, lethargy, listlessness, poor feeding, ptosis, loss of head control, dif- ficulty in swallowing, hypotonia, gener- alized weakness, and respiratory insuf- ficiency. The disease may be mild or BOUTONNIERE DEFORMITY severe. Ј Ј intestinal b. Botulism caused by pro- boutons terminaux (boo-to˘n te˘r-mı˘-no¯ ) duction of botulinum toxin in the colon [Fr., terminal buttons] The bulblike ex- following ingestion of spores of Clostrid- pansions at the tips of axons that come ium botulinum. Most cases occur in in- into synaptic contact with the cell bod- ies of other neurons. fants. SEE: infant b. Ј wound b. Botulism acquired when Bouveret syndrome (boo-vra¯ ) [Leon spores of the bacteria contaminate an Bouveret, French internist, 1850-1929] anaerobic wound, germinate, and pro- Gastric outlet obstruction resulting from impaction of a gallstone in the du- duce the neurotoxin. odenum. bouba Yaws. bovine (bo¯Јvı¯n) [L. bovinus] Pert. to cat- Bouchard’s nodes (boo-sha˘rzЈ, sha˘rdz) − tle; derived from cattle. Bony enlargements or nodules, located bovine somatotropin A ABBR: BST A. at the proximal interphalangeal joints, A growth hormone used to increase milk that result from osteoarthritis or degen- production in cows. erative joint disease. Ј Ј bowel (bow e˘l) [O. Fr. boel, intestine] bougie (boo zhe¯) [Fr. bougie, candle] A Intestine. slender, flexible instrument for explor- bowel bypass syndrome A febrile illness ing and dilating tubal organs, e.g., the occurring after intestinal bypass sur- male urethra. gery for morbidly obese patients. Af- gum elastic b. A small, flexible in- fected patients typically report aching strument used to locate the trachea. It joints and muscles, and have pustules is used as an intubation aid, esp. when and papules on the arms, legs, and or intubation with standard techniques is chest. difficult. bowel incontinence Change in normal Ј bouillon (boo-, bool-yo˘n ) [Fr.] A clear bowel habits characterized by involun- broth made from meat or vegetables. It tary passage of stool. SEE: Nursing Di- may be used as a culture medium for agnoses Appendix. bacteria. bowel rest The intentional restriction of Bouin’s fluid (boo-a˘nsЈ) [Paul Bouin, Fr. oral nutrition, typically used with other anatomist, 1870–1962] A fixative for therapies for patients with gastrointes- embryological and histological tissue. It tinal diseases such as bowel obstruc- consists of formaldehyde, glacial acetic tion, ileus, pancreatitis, or acute abdo- acid, trinitrophenol, and water. men. bound (bownd) 1. In chemistry, the bowel sounds SEE: under sound. holding in combination of one molecule bowel training SEE: under training. by another. SEE: bind (2). 2. Contained, bowleg (bo¯Јle˘g) A bending outward of not free. the leg. SYN: bandy leg. short bouquet (boo-ka¯Ј) [Fr., nosegay] A clus- Bowman’s capsule (bo¯Јma˘ns) [Sir Wil- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh Bowman’s lamina 303 Brachyspira base of rh

liam Bowman, Brit. physician, 1816– tients with deformity and pain caused 1892] Part of the renal corpuscle. It by osteoarthritis of the knee. consists of a visceral layer of podocytes brachi- SEE: brachio-. closely applied to the glomerulus and an brachial (bra¯Јke¯-a˘l) [L. brachialis] Pert. outer parietal layer. The podocyte layer to the arm. is part of the filter for the formation of brachialgia (bra¯Љke¯-a˘lЈje¯-a˘) [L. brachi- renal filtrate in the space between the alis, brachial, ϩ Gr. algos, pain] In- two layers. SEE: kidney for illus. tense pain in the arm. Bowman’s lamina Bowman’s membrane. brachialis (bra¯Љke¯-a˘lЈı˘s) [L. brachialis, Bowman’s membrane The thin homo- brachial] A muscle of the arm lying im- geneous membrane separating the cor- mediately under the biceps brachii. It neal epithelium from the corneal sub- flexes the forearm. stance. SYN: anterior elastic lamina; brachio-, brachi- [L. bracchium, arm] Bowman’s lamina. Combining forms meaning arm. box and block test A standardized, timed brachioplasty (bra˘kЉe¯-o¯-pla˘sЈte¯) [ЉϩЉ] test of manual dexterity and endurance, Cosmetic surgery to remove unwanted used in rehabilitation, in which the sub- skin and fat from the upper arm. SEE: ject transfers small blocks from one side arm lift. of a boxto another. brachioradialis (bra¯Љke¯-o¯-ra¯Љde¯-a˘Јlı˘s) [Љ boxing (bo˘ksЈı˘ng) In dentistry, the ϩ radialis, radius] A muscle lying on building up of vertical walls, usually in the lateral side of the forearm. It flexes wax, around an impression to produce the forearm. the desired size and form of the base of brachium (bra¯Јke¯-u˘m) pl. brachia [L., the cast and to preserve certain land- arm, from Gr. brakhion, shorter, hence marks of the impression. “upper arm” as opposed to longer fore- box-note In emphysema, a hollow sound arm] 1. The upper arm from shoulder heard on percussion. to elbow. 2. Anatomical structure re- Ј Boyden chamber (boyd e˘n) A chamber sembling an arm. used to measure chemotaxis. Cells are b. conjunctivum Superior cerebellar placed on one side of a membrane and peduncle. chemotactic material on the other. The b. pontis Middle cerebellar pedun- number of cells migrating to the filter cle. quantitates the chemotactic effect. brachy- [Gr. brachys, short] Combining Boyer’s cyst A painless and gradual en- form meaning short. largement of the subhyoid bursa. brachybasia (bra˘k-e¯-ba¯Јse¯-a˘) [Љϩba- Boyle’s law (boylz) [Robert Boyle, Brit. sis, walking] A slow, shuffling gait. physicist, 1627–1691] A law stating brachycardia (bra˘k-e¯-ka˘rЈde¯-a˘) [Љϩ that, at a constant temperature, the vol- kardia, heart] Bradycardia. ume of a gas varies inversely with the brachycephalic, brachycephalous pressure. SEE: Charles’ law; Gay-Lus- (bra˘kЉe¯-se˘-fa˘lЈ˘k,ı se˘fЈa˘-lu˘s) [Љϩkeph- sac’s law. − ale, head] Having a cephalic indexof Bozeman-Fritsch catheter (bo¯zЈma˘n- 81.0 to 85.4. This is considered a short frı˘tch) [Nathan Bozeman, U.S. sur- head but not necessarily abnormal, as geon, 1825–1905; Heinrich Fritsch, Ger. gynecologist, 1844–1915] A dou- this indexfalls within the standard range of variation among humans. ble-lumen uterine catheter with several Љ Ј Љϩ openings at the tip. brachycheilia (bra˘k e¯-kı¯ le¯-a˘) [ chei- BP blood pressure; British Pharmaco- los, lip] Abnormal shortness of the lips. poeia. Љ Ј Љϩ b.p. boiling point. brachydactylia (bra˘k e¯-da˘k-tı˘l e¯-a˘) [ BPD biparietal diameter; bronchopulmo- daktylos, finger] Abnormal shortness of the fingers and toes. nary dysplasia. Ј Љϩ BPH benign prostatic hypertrophy. brachygnathia (bra˘k-ı˘g-na¯ the¯-a˘) [ BPP Biophysical profile. gnathos, jaw] Abnormal shortness of Bq becquerel. the lower jaw. Љ Ј Љϩ Br 1. Symbol for the element bromine. brachymorphic (bra˘k e¯-mor fı˘k) [ 2. Brucella. morphe, form] Shorter and broader brace (bra¯s)pl. braces 1. Any of a variety than usual, with reference to body of devices used in orthopedics for hold- type. ing joints or limbs in place, as a Boston brachyphalangia (bra˘kЉe¯-fa˘-la˘nЈje¯-a˘) [Љ brace, Milwaukee brace, Taylor brace, ϩ phalanx, closely knit row] Short- or Yale brace. 2. A colloquial term for ness of a bone or bones of a finger or temporary dental prostheses used to toe. align or reposition teeth. Brachyspira (bra¯Љke¯-spı¯Јra˘) [Љϩ Boston b. SEE: Boston brace. spir(ochete)] A genus of spirochete that unloader knee b. A brace that pro- occasionally colonizes the lower gastro- duces a valgus force on the knee to re- intestinal tract. It causes dysentery in duce compressive forces on the medial animals such as dogs or pigs and has short articular surfaces. It is used to treat pa- been identified as a cause of human dis- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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ease, e.g., abdominal cramping, diar- fetal b. Persistent fetal heart rate rhea, and rectal bleeding. slower than 110 beats per minute. brachytherapy (bra˘kЉe¯-the˘rЈa˘-pe¯) [Љϩ relative b. A heart rate that is too therapeia, treatment] In radiation slow for a person’s immediate physiolog- therapy, the use of implants of radioac- ical needs, although it may be more tive materials such as radium, cesium, than 60 beats per minute. Heart rates iridium, or gold at the treatment site are said to be relatively slow when they (e.g., an internal organ with a malig- do not allow adequate circulation of nant lesion). blood to the brain, coronary arteries, or other vital organs. The treated patient can emit radi- sinus b. A slow sinus rhythm with an ation and can endanger others. If atrial rate below 60 beats per minute in the radiation source is dislodged, it is re- an adult or 70 beats per minute in a moved by a radiation safety officer using child. Љ Ј Љϩ special long-handled tongs and is placed bradycrotic (bra˘d e¯-kro˘t ˘k)ı [ kro- in a lead container. All linens and dress- tos, pulsation] Pert. to slowness of ings are considered contaminated. Preg- pulse. Љ Ј Љϩ nant women and children younger than 16 bradydiastole (bra˘d e¯-dı¯-a˘s to¯-le¯) [ should not visit the patient. diastole, dilatation] Prolongation of the diastolic pause. bradydysrhythmia (bra˘dЉe¯-dı˘s-rı˘thЈme¯-a˘) bracket (bra˘Јke˘t) A support of wood, Bradyarrhythmia. metal, or some durable material. In or- bradyecoia (bra˘dЉe¯-e¯-koyЈa˘) [Gr. brad- thodontics, brackets may be bonded to yekoos, slow to hear] Partial deafness. teeth or attached to them indirectly. Or- bradyesthesia (bra˘dЉe¯-e˘s-the¯Јze¯-a˘) [Љϩ thodontic brackets are used to attach aisthesis, sensation] Slowness of per- arch wires, which apply pressure to the ception. teeth to realign them. bradykinesia (bra˘dЉe¯-kı˘-ne¯Јse¯-a˘) [Љϩ Braden scale A validated assessment kinesis, movement] Extreme slowness tool commonly used to quantify a pa- of movement. tient’s degree of risk for developing a bradykinin (bra˘dЉe¯-kı¯Јnı˘n) A plasma ki- pressure ulcer. Each assessment pa- nin. SEE: kinin. rameter is measured on a scale from bradylexia (bra˘dЉe¯-le˘ksЈe¯-a˘) [Gr. bradys, high risk of 1 to low risk of 3 or 4. The slow, ϩ lexis, word] Abnormal slow- parameters include sensory percep- ness of reading that cannot be attrib- tion, moisture, activity, mobility, nu- uted to lack of intelligence. SEE: dys- trition, and friction and shear, with a lexia. possible total score range of 4 to 23. bradylogia (bra˘dЉe¯-lo¯Јje¯-a˘) [Љϩlogos, The lower the total score, the higher word, reason] Slow speech due to men- the risk for pressure ulcer develop- tal impairment. ment. Individuals are at risk for devel- bradyphagia (bra˘dЉe¯-fa¯Јje¯-a˘) [Љϩ oping pressure ulcers if the total score phagein, to eat] Abnormal slowness in is less than 17. Ј eating or swallowing. Bradford frame (bra˘d fe˘rd) [Edward H. Љ Ј Љϩ Bradford, U.S. orthopedic surgeon, bradyphrenia (bra˘d e¯-fre¯n e¯-a˘) [ Gr. 1848–1926] An oblong frame, about phren, mind] Slowness of thought and 7 ϫ 3 ft (2.13 ϫ 0.91 m), that allows information processing, seen in some patients with fractures or disease of the forms of dementia. bradypnea (bra˘dЉı˘p-ne¯Јa˘, bra˘dЉı˘-ne¯Јa˘) [Љ hip or spine to urinate and defecate ϩ without moving the spine or changing pnoe, breathing] Abnormally slow breathing. position. The frame is made of 1 in (2.5 Љ Ј Љϩ cm) pipe covered with movable canvas bradyrhythmia (bra˘d e¯-rı˘th me¯-a˘) [ strips that run from one side of the rhythmos, rhythm] 1. Slowness of frame to the other. heart or pulse rate. 2. In electroenceph- brady- [Gr. bradys, slow] Combining alography, slowness of brain waves (1 to form meaning slow. 6 per sec). Љ Љ Ј bradyacusia (bra˘dЉe¯-a˘-kooЈse¯-a˘) [Љϩ bradytachycardia (bra˘d e¯-ta˘k e¯-ka˘r de¯-a˘) akouein, to hear] An abnormally dimin- [Љϩtachys, swift, ϩ kardia, heart] ished hearing acuity. Increased heart rate alternating with bradyarrhythmia (bra˘dЉe¯-a˘-rı˘thЈme¯-a˘) [Љ slow rate. SEE: sick sinus syndrome. ϩ a-, not, ϩ rhythmos, rhythm] A Bragard’s test [K. Bragard, 20th century heart rate of less than 60 beats per min- German orthopedic surgeon] Lase`gue’s ute found in an adult. SYN: bradydys- sign. rhythmia. braille (bra¯l) [Louis Braille, blind Fr. ed- bradycardia (bra˘dЉe¯-ka˘rЈde¯-a˘) [Љϩkar- ucator, 1809–1852] A system of read- dia, heart] A slow heartbeat marked by ing and printing that enables the blind a pulse rate below 60 beats per minute to read by using the sense of touch. in an adult. SEE: arrhythmia; dysrhyth- Raised dots arranged in patterns rep- short mia. resent numerals and letters of the al- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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CORPUS CALLOSUM PARIETAL LOBE FRONTAL LOBE

OCCIPITAL LOBE

CHOROID PLEXUS MIDBRAIN IN THIRD VENTRICLE

THALAMUS CEREBELLUM

OPTIC NERVE CHOROID PLEXUS IN FOURTH VENTRICLE HYPOTHALAMUS PITUITARY GLAND PONS TEMPORAL LOBE MEDULLA

SPINAL CORD BRAIN Midsagittal section of brain as seen from left

phabet and can be identified by the fin- arachnoid (middle), and pia mater (in- gers. ternal). Nerves: Cranial. SEE: illus. contracted b. A version of braille in (Brain); cranial nerve for illus. which abbreviations, contractions and Subdivisions of the brain are (1) di- other short forms of words are used in encephalon, including the epithala- addition to the use of the standard al- mus, thalamus, and hypothalamus (op- phabet and standard punctuation tic chiasma, tuber cinereum, and marks. mammillary bodies); (2) myelencepha- noncontracted b. A type of braille in lon, including the corpora quadrigem- which only the regular alphabet and ina, tegmentum, crura cerebri, and the punctuation marks are used. SEE: con- medulla oblongata; (3) metencephalon, tracted b. including the cerebellum and pons; (4) brain (bra¯n) [AS. braegen] A large soft telencephalon, including the rhinen- mass of nerve tissue contained within cephalon, corpora striata, and cere- the cranium; the cranial portion of the brum (cerebral cortex). central nervous system. SYN: encepha- Ventricles: The cavities of the brain lon. are the first and second lateral ventri- ANATOMY: The brain is composed of cles, which lie in the cerebral hemi- neurons (nerve cells) and neuroglia or spheres, the third ventricle of the dien- supporting cells. The brain consists of cephalon, and the fourth ventricle gray and white matter. Gray matter is posterior to the medulla and pons. The composed mainly of neuron cell bodies first and second communicate with the and is concentrated in the cerebral cor- third by the interventricular foramina, texand the nuclei and basal ganglia. the third with the fourth by the cerebral White matter is composed of axons, aqueduct (of Sylvius), the fourth with which form tracts connecting parts of the subarachnoid spaces by the two fo- the brain with each other and with the ramina of Luschka and the foramen of spinal cord. Magendie. The ventricles are filled with The major parts of the brain are the cerebrospinal fluid, which is formed by cerebrum, thalamus, hypothalamus, the choroid plexuses in the walls and cerebellum, and brain stem (medulla, roofs of the ventricles. SEE: illus. (Vas- pons, and midbrain). The weight of the cular Anatomy of Brain). brain and spinal cord is about 1350 to PHYSIOLOGY: The brain is the pri- 1400 g, of which 2% is the cord. The mary center for regulating and coordi- cerebrum represents about 85% of the nating body activities. Sensory im- weight of the brain. Lobes: Frontal, pa- pulses are received through afferent rietal, occipital, temporal, insular. nerves and register as sensations, the Glands: Pituitary, pineal. Membranes: basis for perception. It is the seat of con- short Meninges—the dura mater (external), sciousness, thought, memory, reason, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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VENTRAL VIEW

OLFACTORY BULB

MIDDLE CEREBRAL ANTERIOR ARTERY COMMUNICATING ARTERY

POSTERIOR COMMUNICATING INTERNAL ARTERY CAROTID ARTERY

SUPERIOR CEREBELLAR ARTERY

POSTERIOR ANTERIOR INFERIOR CEREBRAL CEREBELLAR ARTERY ARTERY

POSTERIOR INFERIOR BASILAR ARTERY CEREBELLAR ARTERY

VERTEBRAL ARTERIES

LATERAL VIEW MEDIAL VIEW

BRANCHES OF ANTERIOR CEREBRAL ARTERY ANTERIOR CEREBRAL ARTERY

BRANCHES OF MIDDLE POSTERIOR MIDDLE POSTERIOR CEREBRAL CEREBRAL CEREBRAL CEREBRAL ARTERY ARTERY ARTERY ARTERY VASCULAR ANATOMY OF BRAIN (VENTRAL, LATERAL, AND MEDIAL VIEWS)

judgment, and emotion. Motor impulses tension of the flexed arm when the are discharged through efferent nerves quadrupedal posture is assumed. to muscles and glands initiating activi- brainstem (bra¯nЈste˘mЉ) The stemlike ties. Through reflexcenters automatic part of the brain that connects the cere- control of body activities is maintained. bral hemispheres with the spinal cord. It The most important reflexcenters are comprises the medulla oblongata, the the cardiac, vasomotor, and respiratory pons, and the midbrain. SEE: illus. centers in the medulla, which regulate brainstem auditory evoked potential circulation and respiration. SEE: cen- ABBR: BAEP. Brainwaves that are tral nervous system; spinal cord. produced in response to sounds, i.e., brain attack SEE: under attack. stimulation of the cochlear nerve. Tests Brain’s reflex (bra¯nz) [Walter Russell of auditory evoked potential are used short Brain, Brit. physician, 1895–1966] Ex- to determine the threshold of sound standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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BRAINSTEM Ventral surface of the brainstem and surrounding structures

required to produce a brainstem re- vent or treat constipation. SEE: dietary sponse, e.g., in people with hearing loss fiber. or brain death. SEE: auditory evoked branch (bra˘nch) In anatomy, a subdivi- response; evoked potential; somatosen- sion arising from a main or larger por- sory evoked response; visual evoked re- tion, esp. of an artery, vein, nerve, or sponse. lymphatic vessel. brainstem implant, auditory brainstem branchial (bra˘ngЈke¯-a˘l) [L. branchia, implant A device that helps the hear- gills] Pert. to or resembling gills of a ing-impaired hear. The implant is used fish or a homologous structure in higher for those who cannot benefit from coch- animals. lear implants because of lesions of the branchioma (bra˘ngЉke¯-o¯Јma˘) [ЉϩGr. cochlea and/or auditory nerve. The im- oma, tumor] A tumor derived from the plant electrode is inserted directly into branchial epithelium. the auditory brainstem. It has been branchiomeric (bra˘ngЉke¯-o¯-me˘rЈ˘k)ı [Љϩ used to treat patients who have under- Gr. meros, part] Pert. to the branchial gone surgical excision of an acoustic arches. neuroma. Brandt-Andrews maneuver (bra˘ndt- brainstorming A free and uncritical ex- a˘nЈdre˘wz) A technique for expressing change of ideas about potential solu- the placenta from the uterus during the tions to a problem. third stage of labor. One hand puts gen- brain tumor SEE: under tumor. tle traction on the cord while the other brainwashing (bra¯nЈwa˘sh-ı˘ng) Intense presses the anterior surface of the psychological indoctrination for the pur- uterus backward. SEE: Crede´’s method. pose of displacing the individual’s pre- Brandt-Daroff maneuvers (bra˘ntЈ da˘rЈo˘f) vious thoughts and attitudes with those A series of exercises for patients with re- selected by the regime or person inflict- fractory positional vertigo. Patients are ing the indoctrination. repeatedly asked to assume the posi- bran The outer covering of cereal tions that typically trigger attacks. Af- grains, such as wheat, oats, and rice, ter multiple attempts, habituation to which are rich in hemicellulose. Some the vertigo occurs, and the symptoms of this fiber is insoluble and may be are relieved. The maneuvers are effec- short used to add bulk to the diet to help pre- tive in about 80% of patients. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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Branham’s sign (bra˘nЈha˘mssı¯n) In a pa- breakthrough disease (bra¯kЈthrooЉ) Any tient with an arteriovenous fistula, the disease that occurs in spite of adequate slowing of the heart rate that occurs vaccination to prevent it, (e.g., “break- when the fistula is compressed. through varicella” or “breakthrough in- brash (bra˘sh) A burning sensation in the fluenza”). stomach sometimes accompanied by breakthrough pain Transient episodes of belching of sour fluid. SYN: heartburn; pain that occur in patients with chronic pyrosis. pain that has been previously reduced water b. Reflexsalivary hypersecre- to tolerable levels. The term is often tion in response to peptic esophagitis. used to describe painful episodes that brass chills SEE: metal fume fever. disrupt the well-being of cancer or hos- brassica (bra˘sЈı˘-ka˘) [L. “cabbage”] The pice patients who have been prescribed family of vegetables that includes broc- regular doses of narcotic analgesics. The coli, Brussels sprouts, cabbage, and cau- painful episodes may occur as a previ- liflower. ous dose of pain-relieving medication Braxton Hicks contractions (bra˘kЈsto˘n- wears off (so-called “end-of-dose” pain), hı˘ksЉ) [John Braxton Hicks, Brit. gyne- or after unusual or unanticipated body cologist, 1823–1897] False labor. movements (“incident pain”). These contractions are not true labor breast [AS. breost ] 1. The upper ante- pains because they do not cause dilation rior aspect of the chest. 2. The mam- and effacement of the cervix, but are of- mary gland, a compound alveolar gland ten interpreted as such. SYN: Hicks consisting of 15 to 20 lobes of glandular sign. tissue separated from each other by in- Brazelton Neonatal Assessment Scale terlobular septa. Each lobe is drained by (bra¯Јze˘l-to˘nЉ) [T. Berry Brazelton, a lactiferous duct that opens onto the tip American pediatrician, b. 1918] A scale of the nipple. The mammary gland se- for evaluating the behavior and re- cretes milk used for nourishment of the sponses of the newborn infant. It is infant. For purposes of description, the based on four dimensions: interaction female breast is divided into four quad- with the environment; motor processes, rants: upper inner (the top medial quar- including motor responses, general ac- ter), lower inner (the bottom medial tivity level, and reflexes; control of phys- quarter), upper outer (the top lateral iological state as determined by reaction quarter), and the lower outer (the bot- to a distinct stimulus such as a rattle, tom lateral quarter). The tail of the bell, light, or a pinprick; and response to breast extends up and away from the stress as judged by tremulousness, star- upper outer quadrant. SEE: illus.; tle reaction, and change in skin color- mammary gland; milk. ation. The test has been used as late as DEVELOPMENT: During puberty, es- 1 week after birth to demonstrate alter- trogens from the ovary stimulate ation in an infant’s behavior due to growth and development of the duct sys- drugs administered to the mother while tem. During pregnancy, progesterone the infant was in utero. secreted by the corpus luteum and pla- BRCA1 A breast cancer gene that is found centa acts synergistically with estro- in a small percentage of patients with gens to bring the alveoli to complete de- this malignancy, and carried by some velopment. Following parturition, individuals who will develop breast can- prolactin in conjunction with adrenal cer later in life. steroids initiates lactation, and oxytocin BRCA2 A breast cancer gene found in a from the posterior pituitary induces small number of patients with breast ejection of milk. Sucking or milking re- and ovarian cancers, and carried by flexly stimulates both milk secretion some individuals who will develop and discharge of milk. breast cancer later in life. CHANGES IN PREGNANCY: During break (bra¯k) 1. In orthopedics, a frac- the first 6 to 12 weeks, there is fullness ture. 2. To interrupt the continuity in a and tenderness, erectile tissue develop tissue or electric circuit or the channel in the nipples, nodules are felt, pigment of flow or communication. is deposited around the nipple (primary breakage, chromosomal (bra¯kЈa˘j) The areola) (in blondes the areolae and nip- disruption of a chromosome (e.g., by ra- ples become darker pink and in bru- diation or toxic chemicals). When this nettes they become dark brown and in occurs, the two fragments may rejoin or some cases even black), and a few drops a fragment may rejoin another broken of fluid may be squeezed out. During the chromosome. Unrepaired chromosome next 16 to 20 weeks, the secondary are- breaks are associated with many malig- ola shows small whitish spots in pig- nant and premalignant conditions. mentation due to hypertrophy of the se- breakaway (bra¯kЈa˘-wa¯Љ) In orthodon- baceous glands (glands of Montgomery). tics, a device to apply tension or force to caked b. An accumulation of milk in a facebow. the secretory ducts of the breast follow- breakdown, nervous SEE: nervous ing delivery, causing a large area to be- short breakdown. come inflamed, hard, and tender. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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SKIN

ADIPOSE TISSUE RIBS

PECTORALIS MAJOR MUSCLE

AREOLA

NIPPLE

INTERCOSTAL MUSCLES LACTIFEROUS DUCT

LACTIFEROUS GLANDS

BREAST Mammary gland in midsagittal section

chicken b. A deformity in which the amination is useful in the early detec- sternum projects anteriorly; caused by tion of breast cancer, esp. when rickets or obstructed respiration in combined with regular professional ex- childhood. SYN: pigeon breast. aminations and mammography. SEE: ductal carcinoma in situ of the b. illus.; mammography. ABBR: DCIS. A cluster of malignant breast cancer A malignant neoplasm cells in the mammary ducts. If left un- (usually an adenocarcinoma) of the treated, as many as 50% of patients breast; the most common malignancy of with DCIS will develop invasive cancer. American women and the leading cause Because these cells grow in the ducts, of death in American women aged 40 to they develop without forming a palpable 55. In 2006 the American Cancer Soci- mass. In its early stage this condition ety estimated that 212,920 women can be diagnosed through the use of would be newly diagnosed with invasive mammography. SYN: comedocarci- breast cancer and that 40,970 women noma. SEE: breast cancer; mammogra- would die of the disease. Breast cancer phy. usually presents as a dominant mass in pigeon b. Chicken b. one breast although the malignancy b. self-examination ABBR: BSE. A may first become evident when nipple technique that enables a woman to de- discharge, nipple retraction, skin dim- tect changes in her breasts. The accom- pling, or asymmetric swelling of the panying illustration explains the spe- breast occurs. In most cases breast can- cific steps to be followed. The cers are first identified by women per- examination should be done each month forming breast self-examination. A soon after the menstrual period ends, as smaller but considerable number are normal physiological changes that may detected by professional examination or confuse results occur in the premen- mammography. About 1000 men are di- short strual period. This method of self-ex- agnosed with breast cancer annually. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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4

GENTLY SQUEEZE OBSERVE FOR NIPPLE AND SYMMETRY, OBSERVE FOR LUMPS, DIMPLING, SECRETION, AND NIPPLE RETRACTION, NIPPLE ERECTION OR FAILURE OF AFTER EACH NIPPLE ERECTION NIPPLE IS GENTLY 1 STIMULATED

2 5

WHILE LEANING FORWARD, OBSERVE BREASTS AS THEY ARE REFLECTED IN MIRROR TO DETECT IRREGULARITY, RETRACTED AREAS, NIPPLE RETRACTION ESPECIALLY ON ONE SIDE ONLY 3

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FEEL FOR NODES, IRREGULARITY, AND TENDERNESS BOTH IN BREASTS AND AXILLARY AREAS BREAST SELF-EXAMINATION

Breast cancer has several pathological charge from a nipple; and/or breast no- variants. Carcinoma in situ, the most lo- dularity or lumpiness are the most com- calized form of the disease, represents a mon symptoms of breast cancer. preinvasive stage confined to a duct or DIAGNOSIS: Regular breast self-ex- lobule. Other presentations include lob- amination, professional breast exami- ular carcinoma, infiltrating ductal car- nation, and mammography are the keys cinoma, inflammatory carcinoma, and to screening for breast cancer. All these Paget’s disease of the nipple. SEE: illus. screenings identify many more benign ETIOLOGY: There are several known lesions than malignant ones, esp. in risk factors for breast cancer. SEE: ta- younger patients, and none of these ble. techniques can definitively exclude SYMPTOMS: A dominant breast breast cancer. Many mammographic- short mass; bloody, brown, or serous dis- ally detected lesions are benign, and standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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offered either modified radical mastec- tomy (removal of the breast and 20 to 30 axillary lymph nodes) or lumpectomy with sentinal node or axillary dissection (as required) and radiotherapy, pro- vided they have no contraindications to either of these choices. A variety of ra- diotherapy options are available, de- pending upon the individual patient’s cancer. In premenopausal women with tumors larger than a centimeter, adju- vant chemotherapy prolongs survival, probably by eliminating microscopic metastases. Chemotherapeutic regi- mens commonly used include CMF (cy- BREAST CANCER clophosphamide, methotrexate, and flu- Infiltrating ductal carcinoma orouracil), CAF (cyclophosphamide, doxorubicin [Adriamycin] and fluoro- uracil), AC (doxorubicin [Adriamycin] about 15% of the time mammography and cyclophosphamide), doxorubicin will fail to detect lesions that are truly (Adriamycin) followed by CMF, or FEC malignant. Digital mammography (a (fluorouracil, epirubicin, and cyclophos- computerized, electronic image) pro- phamide). All of these agents are given vides significantly better detection in several times in cycles of treatment. women with dense breasts, those under These same regimens are offered to vig- age 50, and those who are premenopau- orous postmenopausal women whose sal or perimenopausal. If a suspicious mass is identified, fine needle aspira- tion, core biopsy, or excisional biopsy Selected Risk Factors for Breast must be used to obtain tissue for anal- Cancer ysis. Ultrasonography can be used be- fore biopsy to identify solid masses and A personal history of breast cancer cysts. Solid breast masses have a much Age (the risk increases with age) greater chance of being malignant than Family history of breast cancer (in a cysts. Other imaging techniques used to mother, sister, daughter, or two or help identify breast cancers include: more close relatives such as cous- magnetic resonance imaging, positron ins) emission tomography, and ductal im- Age at first live birth (women who aging. SEE: breast self-examination; had their first child after age 30 double reading; mammography. and women who have never given STAGING: The size of tumors and birth are at higher risk) their possible metastasis to the chest Age at first menstrual period (women wall, skin, axilla, or distant sites all de- who had their first period before termine the stage of breast cancer. Lym- age 12 are at slightly higher risk) phatic mapping during cancer surgery Benign breast changes (atypical hy- can be used to find metastases to senti- perplasia) or two or more breast bi- nel lymph nodes and guide therapies. opsies even if no atypical cells were Staging provides important information found about the need for particular forms of Race (white women are more likely to therapy and the prognosis. SEE: illus. develop breast cancer than black women, but blacks are more likely than whites to die of it; Hispanic A biopsy (obtained by fine needle and Asian women have a lower risk aspiration, with a stereotactic core of developing the disease) needle, or by surgical lumpectomy) is usu- Genetics: Several genes (including ally recommended for any breast mass BRCA1 and BRCA2, among others) that does not resolve spontaneously increase a woman’s chance of devel- within one or two menstrual cycles and for oping breast cancer. all postmenopausal women. Negative re- Oral contraceptive pills and hormone sults from mammography and ultrasonog- replacement therapy may both raphy are not always accurate enough to slightly increase the risk of a rule out a malignant diagnosis. woman’s developing breast cancer. Obesity increases the risk of a TREATMENT: Combined modalities woman’s developing breast cancer. (including surgery, radiation, or drug Alcohol use: The greater the alcohol therapies) are offered to many women intake of a woman, the greater the with breast cancer, depending on their risk of breast cancer. menopausal status and the stage of their disease at the time of diagnosis. SOURCE: Adapted from the National Cancer short Patients with stage I or II disease are Institute and other sources. standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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APICAL NODES PECTORALIS MAJOR MUSCLE

DEEP CERVICAL NODES LOCATED LATERAL BEHIND CLAVICLE AXILLARY NODES

POSTERIOR AXILLARY INTERPECTORAL NODES NODES

LATISSIMUS DORSI MUSCLE

ANTERIOR AXILLARY NODES INTERNAL MAMMARY NODES

SERRATUS ANTERIOR MUSCLE

BREAST CANCER Possible paths of lymphatic spread

cancer has spread to axillary lymph ing), so that they can be managed early. nodes. Hormonal therapies like tamox- Weight and nutrition status are evalu- ifen or raloxifene (two estrogen-receptor ated. Skin is inspected for redness, ir- blockers) are also beneficial in patients ritation, or breakdown if radiation ther- with estrogen-receptor positive tumors. apy is prescribed, and aloe or a Aromatase inhibitors (e.g., letrozole), prescribed cream applied. Bisphosphate and monoclonal antibodies (e.g., tras- drugs (e.g., alendronate or zolendronic tuzumab) may be prescribed to selected acid) are administered to prevent or patients. After breast surgery, some treat bony metastases or hypercal- women choose to have cosmetic resto- cemia, but their use may be associated ration of the breast, either with saline- with osteonecrosis of the jaw. or silicone-filled implants or with tissue Comfort measures are used to pro- reconstructions made from the abdomi- mote relaxation and rest and to relieve nal muscles. If breast cancer recurs af- anxiety. If immobility develops late in ter treatment, very high-dose chemo- the disease, careful repositioning, excel- therapies are prescribed and peripheral lent skin care, respiratory toilet, and stem cell transplantation is occasionally low-pressure mattresses are used to considered, but only in research set- prevent complications (skin breakdown, tings. Bone metastases may be treated respiratory problems, pathological frac- with monthly dosing of intravenous zo- tures). The patient’s and family’s coping ledronic acid (Zometa). SEE: breast, abilities are evaluated, and referral for ductal carcinoma in situ of the. counseling and support services may be PATIENT CARE: The patient’s feel- necessary. End-stage disease patients ings and level of knowledge about her benefit from hospice care. Women disease are determined. She is encour- judged to be at high-risk for breast can- aged to express fears and concerns, and cer may have tamoxifen or ralozifene her family, supporters, or health care prescribed as preventative therapy. professionals stay with her during pe- breastfeeding (bre˘stЈfe¯dЉı˘ng) The giving riods of anxiety or anguish. If surgery is of mother’s milk to a newborn, infant, or planned, the procedure, postoperative child. Mature mother’s milk and its pre- care, and expected outcomes are ex- cursor, colostrum, are considered the plained. most balanced foods available for nor- While undergoing chemotherapy, the mal newborns and infants. Breast milk patient is monitored for adverse reac- is sterile, easily digested, and nonaller- tions (e.g., nausea, vomiting, anorexia, genic. It contains maternal antibodies stomatitis, GI ulceration, anemia, leu- that protect against many early child- short kopenia, thrombocytopenia, and bleed- hood illnesses and lipids that stimulate standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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early brain development. Suckling by is encouraged and is associated with the baby in turn stimulates release of longer periods of breast-feeding, better oxytocin, a pituitary hormone that stim- temperature regulation, less crying, en- ulates uterine contractions and pro- hanced maternal responsiveness, and motes the return of the uterus to a nor- skill competence. mal nongravid size and state. Positioning: Both mother and infant Breastfeeding may engender or should be positioned for comfort and strengthen early bonding. The World convenience of nursing. Mother and in- Health Organization and the American fant should face each other in the chest- Academy of Pediatrics (AAP) – among to-chest position. The mother’s nipple many other groups – encourage health should be at the level of the infant’s care professionals to promote, protect, nose. and support breastfeeding as the exclu- Latching-on: To elicit nipple erection sive nourishment for the first 6 months and to facilitate latch-on, the mother of life, followed by gradual supplemen- cups her hand under her breast and ei- tation with iron-rich foods for the next ther places her thumb (C-hold) or her 6 months, with continuation of breast- indexfinger (scissors-hold) above the feeding for as long as the mother and areola with the other three fingers be- child desire. low the areola, supporting the weight of PATIENT CARE: Prenatal prepara- the breast. The infant should grasp the tions: During the last trimester of preg- whole nipple with its gums on the are- nancy, techniques that increase the po- ola. Suckling then compresses the milk tential for successful breastfeeding are ducts and effectively ejects milk. Pre- discussed with women who have se- venting the infant from suckling only on lected that infant-feeding option. Lac- the end of the nipple reduces potential tation consultants commonly encourage for nipple soreness, erosion, and crack- nipple-rolling. The woman is instructed ing. to cup her breast in one hand, support- Feeding: Infants should be allowed to ing the weight with three fingers while feed until they exhibit signs of satisfac- grasping the nipple with the thumb and tion. Feeding from a single breast is al- forefinger, and gently rolling it between lowable as long as the infant nurses the two fingers. She should implement approximately every 2 hr and feeds ten to 20 repetitions of these actions until satisfied; this encourages the in- several times daily. Precoital suckling take of the higher-calorie, high-fat hind by the woman’s partner also helps in milk. preparing the nipples for breastfeeding. Disengaging: The mother should gen- Nipple shells or shields may be recom- tly insert her fingers between the in- mended for women whose nipples are ei- fant’s gums to break the suction and ther flat or inverted. Women who are at withdraw the breast from the baby’s high-risk for preterm labor are discour- mouth. aged from engaging in prenatal nipple Engorgement: Feeding the newborn stimulation. on demand usually prevents the devel- Postpartum breastfeeding: A success- opment of engorgement. Should it occur, ful breastfeeding experience is poten- the mother either may apply warm wet tiated by assisting the woman to de- compresses or stand beneath a shower velop confidence, comfort, and skill in of warm water to stimulate the let-down using techniques for appropriate infant reflexand initiate milk flow. The latch-on, feeding, and disengagement. mother also should be taught how to Basic breast care is described, dis- manually express enough milk to re- cussed, and demonstrated to minimize lieve the pressure and soften the areola the potential for discomforts that inter- to encourage latch-on when feeding. fere with successful breastfeeding, such Nipple soreness: Some discomfort is as nipple soreness. Washing the breasts common during the first few breastfeed- and nipples with clear water and avoid- ing days. The mother’s first actions ing the use of soap, which removes the should be to check the infant’s feeding natural breast lubricants that protect position and grasp of the nipple. Alter- the nipples against drying and cracking, ing her position for feeding also alters are recommended. Drying the nipples the stress points on the nipple as the in- thoroughly by exposing them to air, sun- fant suckles and enhances breast emp- light, or a hair dryer set on low heat pre- tying. If soreness is related to the new- vents excoriation. The woman should be born’s vigorous sucking because of encouraged to wear a nursing bra that hunger, the mother may elect to nurse effectively supports her breasts 24 hr a more frequently. The mother is encour- day. Soft disposable fabric pads may be aged to continue with breastfeeding; inserted to absorb any milk leakage; however, if the suggested measures however, plastic liners should be prove ineffective and discomfort per- avoided because they retain moisture sists throughout the feeding interval or and body heat, which softens and mac- does not subside by the end of the first short erates the nipple. Skin-to-skin contact postpartum week, the mother should be standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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assisted to seek consultation with a lac- breastfeeding process. SEE: Nursing tation specialist. When breastfeeding Diagnoses Appendix. must be interrupted for even a short breastfeeding, interrupted A break in time period, the breasts should be the continuity of the breastfeeding pro- pumped every 3 hr for 10 to 15 min to cess as a result of inability or inadvisa- preserve lactation, and the colostrum or bility to put a baby to breast for feeding. milk fed to the infant unless contrain- SEE: Nursing Diagnoses Appendix. dicated. Exclusive breastfeeding for 6 breast implant SEE: under implant. months helps to prevent infant ear in- breath (bre˘th) [AS. braeth, odor] The fections, diarrhea and other GI prob- air inhaled and exhaled in respiration. lems, and respiratory illness such as bad b. Halitosis. asthma and pneumonia. It also may re- liver b. The characteristic odor of the duce excessive childhood weight gain breath that accompanies severe liver and obesity, and reduce the mother’s disease. It has been described as risk for breast and ovarian cancer. “mousy.” SEE: hepatic coma. uremic b. The “fishy” or ammoniacal breath odor characteristic of individuals Women who are infected with the with uremia. human immunodeficiency virus breath actuation (a˘kЉchu¯-a¯Јshu˘n) The (HIV) may transmit it to their children by release by inspiration of a substance to breastfeeding. a patient. Breath-actuated inhalers are used in respiratory medicine to increase In most instances, however, maternal the probability that a patient will de- illness does not contraindicate breast- liver a dose of inhaled medication to the feeding, or does so only for a short time lungs when the airway is open. until treatment is initiated. If maternal breath-holding (bre˘th-ho¯lЈdı˘ng) The vol- surgery is anticipated, the mother can untary or involuntary stopping of be encouraged to pump and store milk breathing may be seen in children who in advance, then assisted to pump or use this to attempt to control the behav- breastfeed directly as soon as possible ior of their parents. after surgery. Many medications re- breath-holding attacks A benign condi- quired by mothers are safe for their in- tion that always has its onset with cry- fants either because drug concentration ing. The young child stops breathing in breast milk will be insignificant or be- and becomes cyanotic, the limbs become cause the infant’s gut will absorb only a rigid and extended, and consciousness minimal amount of the drug. Resources may be lost. This is followed by the body containing information on breastfeed- becoming limp, resumption of respira- ing and breastfeeding/medications in- tions and, after a few seconds, full al- clude: the AAP’s “Transfer of Drugs & ertness. This pattern of behavior usu- Other Chemicals into Human Milk” ally disappears spontaneously prior to (170 usually compatible drugs, effects school age. on milk production, minor adverse ef- breathing (bre¯thЉı˘ng) The act of inhaling fects on mother or infant, drugs requir- and exhaling air. SEE: chest; respira- ing temporary cessation of breastfeed- tion. ing, “caution” drugs) (http://aappolicy apneustic b. An abnormal breathing .aappublications.org/cgi/content/full/pe- pattern marked by prolonged inspira- siatrics:108/3/776); International Lac- tory pauses. This is usually associated tation Consultant Association (www with brainstem injuries. .ilca.org); National Center for Chronic assisted b. Any technique that im- Disease Prevention and Health Pro- proves respiration. Examples include: motion: Breastfeeding (www.cdc.gov/ the provision of supplemental oxygen; breastfeeding); La Leche League Inter- bag-valve-mask ventilation; BiPAP; me- national (www.la.echeleague.org). Health chanical ventilation; and mouth-to- care professionals should carefully exam- mouth ventilation. ine and question policies that limit asthmatic b. Harsh breathing with women’s rights, abilities, or opportunities prolonged wheezing heard throughout to breastfeed. expiration. breastfeeding, effective The state in ataxic b. An irregular, uncoordi- which the mother-infant exhibit appro- nated breathing pattern common in in- priate proficiency and satisfaction with fants. breastfeeding. Expected outcomes, in- Biot’s b. SEE: Biot’s breathing. cluding maternal nipple trauma and bronchial b. Bronchial sounds. soreness related to breastfeeding, are Cheyne-Stokes b. SEE: Cheyne- minimized. Infant weight gain proceeds Stokes respiration. within expected parameters. SEE: continuous positive-pressure b. A Nursing Diagnoses Appendix. method of mechanically assisted pul- breastfeeding, ineffective The state in monary inflation. A device administers which a mother, infant, or child experi- air or oxygen to the lungs under a con- short ences dissatisfaction or difficulty with tinuous pressure that is always greater standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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than zero. SYN: continuous positive- in the intestines, to investigate the pressure ventilation. causes of malabsorption, to detect Heli- frog b. A respiratory pattern in cobacter pylori in the stomach, and to which the air in the mouth and pharynx estimate alcohol in the tissues, due to is forced into the lungs by gulping and micro-organisms in the patient. swallowing it. This may be observed in carbon-urea b.t. A diagnostic test in patients whose respiratory muscles are which the patient ingests 13C-labeled weak or paralyzed. or 14C-labeled urea, which binds to and glossopharyngeal b. A technique of can be measured in exhaled carbon di- breathing in which the patient with in- oxide. It is used to diagnose infection spiratory muscle weakness increases with Helicobacter pylori, a common the volume of air breathed in by taking cause of peptic ulcer. SEE: Helicobacter several “gulps” of air, closing the mouth, pylori; peptic ulcer. and forcing air into the lungs. breath test for lactase deficiency The inspiratory resistive b. Inspiration measurement of hydrogen in the breath with an added workload to increase the after ingestion of 50 g of lactase. SEE: strength and endurance of the inspira- lactase deficiency syndrome. tory muscles. breech (bre¯ch) [AS. brec, buttocks] The intermittent positive-pressure b. nates, or buttocks. ABBR: IPPB. A mechanical method for bregma (bre˘gЈma˘) pl. bregmata [Gr., assisting pulmonary ventilation em- front of head] The point on the skull ploying a device that administers air or where the coronal and sagittal sutures oxygen for the inflation of the lungs un- join. The anterior fontanel in the fetus der positive pressure. Exhalation is and young infant. bregmatic (−ma˘tЈı˘k), usually passive. SYN: intermittent pos- adj. itive-pressure ventilation. Brenner’s tumor [Fritz Brenner, Ger. pa- Kussmaul b. A very deep, repetitive, thologist, 1877–1969] A benign tumor gasping respiratory pattern associated composed of fibrous and epithelial ele- with profound acidosis (e.g., diabetic ke- ments. toacidosis). Kussmaul’s respiration may brevicollis (bre˘vЉı˘-ko˘lЈı˘s) [L. brevis, be a sign of impending death. short, ϩ collum, neck] Shortness of periodic b. An irregular respiratory the neck. pattern marked by alternating periods bridge (brı˘j) [AS. brycg] 1. A narrow of rapid and slow respirations and by band of tissue. 2. A cast dental restora- apneic periods lasting 15 sec or less. tion that replaces missing teeth. The pursed-lip b. An expiratory maneu- restoration is usually made of gold alloy, ver in which the patient exhales with or without a porcelain exterior, through puckered lips to slow expira- and is attached to adjacent or abutment tory flow and to create slight back pres- teeth for support. Lay persons often call sure. This action may prevent prema- such a restoration a “bridge.” 3. A ture closure of intrapulmonary airways, temporary treatment used until a more esp. in the patient with chronic obstruc- durable one becomes available. tive lung disease. disulfide b. Disulfide bond. shallow b. Breathing in which the b. of nose The upper part of the ex- volume of inspired and expired air is di- ternal nose formed by the junction of the minished (e.g., 200 ml per breath in nasal bones. adults). It is common in elderly pa- bridgework (brı˘jЈwork) A partial den- tients, patients with rib or pleural pain, ture held in place by attachments other or restrictive lung diseases. than clasps. work of b. ABBR: WOB. The fixed b. A cast restoration or bridge amount of effort used to expand the cemented to natural teeth. lungs. It is determined by lung and tho- removable b. Partial denture. racic compliance, airway resistance, bridging (brı˘jЈı˘ng) A treatment activity and the use of accessory muscles for in- used to activate abdominal and hip ex- spiration or forced expiration. It is mea- tensor muscles. To bridge, a person lies sured in joules/L, joules/min and some- in a supine position with knees flexed times kg/m/min. and feet flat against a horizontal sur- yogic b. Pranayama. face, such as a floor, bed, or plinth breathing pattern, ineffective Inspira- (treatment table). The hips are then tion and/or expiration that does not pro- lifted, while the feet, shoulders, and vide adequate ventilation. SEE: Nurs- head maintain contact with the surface. ing Diagnoses Appendix. bridle (brı¯Јdl) In anatomy, a frenum. breathlessness (bre˘thЈle˘s-ne˘sЉ) Dys- Bright’s disease (brı¯ts) [Richard Bright, pnea. Brit. physician, 1789–1858] A vague breath test A test that may be used to and obsolete term for kidney disease. It detect a specific substance in the breath usually refers to nonsuppurative in- to help explain metabolic changes. flammatory or degenerative kidney dis- Breath tests are used, for example, to ease marked by proteinuria and hema- short detect evidence of bacterial overgrowth turia and sometimes by edema, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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hypertension, and nitrogen retention. this area. SYN: motor speech area; SEE: nephritis. speech center. SEE: motor aphasia. bright light therapy Treatment of sleep Brodie’s abscess (bro¯Јde¯z) [Sir Benja- and/or mood disorders by exposure to min Collins Brodie, Brit. surgeon, bright fluorescent lights (typically 1783–1862] A localized infection of 10,000 lux) for at least 2 hours a day. bone, esp. of one of the long bones of the Bright light therapy has been used as lower extremities. SYN: bone abscess. an alternative to drug therapy for sea- SEE: subperiosteal abscess. sonal affective disorder and insomnia brodifacoum A long-acting warfarin-like (e.g., in shift workers). anticoagulant used to kill mice and brightness gain SEE: under gain. other rodents. brim 1. An edge or margin. 2. The brim of Brodmann’s areas (bro˘dЈma˘nz) [Korbi- the pelvis; the inlet, or superior open- nian Brodmann, Ger. neurologist, ing, of the true pelvis. It is formed by the 1868–1918] The division of the cere- iliopectineal line of the innominate bone bral cortexinto 47 areas. This was orig- and the sacral promontory. It is oval- inally done on the basis of cytoarchitec- shaped in the female, heart-shaped in tural characteristics, but the areas are the male. now classified according to their func- Briquet’s syndrome (brı˘-ka¯zЈ) [Paul Bri- tions. quet, Fr. physician, 1796–1881] 1. A brom-, bromo- [Gr. bromos, stench] personality disorder in which alcohol- Combining forms indicating the pres- ism and somatization disorder occur. ence of bromine. 2. Somatization disorder. 3. An old term bromelain (bro¯Јme˘-la¯n) A group of pro- for hysterical personality disorder. tein-digesting enzymes derived from Brissaud’s reflex (brı˘s-so¯zЈ) [Edouard pineapples. Its applications include ten- Brissaud, Fr. physician, 1852–1909] derizing meat. Contraction of the tensor fasciae latae bromide (bro¯Јmı¯d) [Gr. bromos, stench] muscle when the sole of the foot is A binary compound of bromine com- stroked or tickled; a component of the bined with an element or a radical. It is extensor plantar response. a central nervous system depressant, British antilewisite ABBR: BAL. Trade and overdosage can cause serious men- name for dimercaprol, a compound used tal disturbance. as an antidote in poisoning due to heavy bromide poisoning SEE: under poison- metals such as arsenic, gold, and mer- ing. cury. bromidrosiphobia (bro¯Љmı˘-dro¯-sı˘-fo¯Јbe¯-a˘) British Pharmacopoeia ABBR: B.P. The [Љϩhidros, sweat, ϩ phobos, fear] standard reference on drugs and their An abnormal fear of personal odors, ac- preparations used in Great Britain. companied by hallucinations. British thermal unit ABBR: BTU. The bromidrosis, bromhidrosis (bro¯Љmı˘- amount of heat necessary to raise the dro¯Јsı˘s) Sweat that is fetid or offensive temperature of 1 lb of water from 39ЊF due to bacterial decomposition. It occurs to 40ЊF. mostly on the feet, in the groin, and un- brittle diabetes Diabetes, brittle. der the arms. broach (bro¯ch) [ME. broche, pointed rod] PATIENT CARE: The axillae, groin, 1. A dental device used to remove the and feet should be cleansed daily with arteries, veins, lymph vessels, and soap and water, rinsing well and drying nerves in the pulp of a tooth. 2. A tech- thoroughly. Deodorant preparations nique used for preparing the intramed- should be used; and clothing and shoes ullary canal of a bone by using a cutting changed, aired, and cleaned frequently. device. This is done in preparation for a SYN: kakidrosis. prosthetic replacement. bromine (bro¯Јme¯n, −mı˘n) [Gr. bromos, Broadbent’s sign (bro˘dЈbe˘nts) [Sir Wil- stench] SYMB: Br. A liquid nonmetal- liam Henry Broadbent, Brit. physician, lic element obtained from natural 1835–1907] A visible retraction of the brines from wells and sea water; atomic left side and back in the region of the mass 79.904, atomic number 35. Its 11th and 12th ribs synchronous with compounds are used in medicine and the cardiac systole in adhesive pericar- photography. SEE: bromide. ditis. bromism, brominism (bro¯Јmı˘zm, Broca’s aphasia Motor aphasia. bro¯Јmı˘n-ı˘zm) [Љϩ−ismos, condition] Broca’s area (bro¯Јka˘s) [Pierre Paul Poisoning that results from prolonged Broca, Fr. anatomist, anthropologist, use of bromides. SEE: Poisons and Poi- neurologist, and surgeon, 1824–1880] soning Appendix. The area of the left hemisphere of the bromobenzylcyanide A toxic gas used as brain at the posterior end of the inferior a riot control agent. frontal gyrus. It contains the motor bromocresol green (bro¯Љmo¯-kre¯Јso˘l) [Љ speech area and controls movements of ϩЉ] A stain used in histologic and tongue, lips, and vocal cords. Loss of pathologic studies to stain cellular com- short speech may follow any stroke affecting ponents with a pH of 3.8 to 5.4, and in standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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microbiology as a culture medium for the airways when heat energy is applied yeasts. to the airways bronchoscopically. The bromocriptine mesylate (bro¯Љmo¯- procedure uses heat energy generated krı˘pЈte¯n) An ergot derivative that sup- with radiofrequency technology to presses secretion of prolactin. It has ablate smooth muscle. It has been used been used to treat patients with hyper- as an experimental treatment for prolactinemia (e.g., in those with pitui- asthma. tary adenomas); to stimulate ovulation bronchial tube One of the smaller divi- in patients with amenorrhea; to treat sions of the bronchi. patients with acromegaly; and to treat bronchial washing Irrigation of one or patients with parkinsonism, as an ad- both bronchi to collect cells for cytologic junct to levodopa. Common side effects study or to help cleanse the bronchi. include nausea, dizziness, and head- bronchiectasis (bro˘ngЉke¯-e˘kЈta˘-sı˘s) [Љϩ ache. ektasis, dilatation] Chronic dilation of bromoderma (bro¯Љmo¯-de˘rЈma˘) [Љϩ a bronchus or bronchi, usually in the derma, skin] An acne-like eruption due lower portions of the lung, caused by the to allergic sensitivity to bromides. damaging effects of a long-standing in- bromoiodism (bro¯Љmo¯-ı¯Јo¯-dı˘zm) [Љϩ fection. ioeides, violet colored, ϩ −ismos, con- SYMPTOMS: Chronic cough, foul- dition] Poisoning from bromine and io- smelling, mucopurulent sputum pro- dine or their compounds. duction, dyspnea, and wheezing are bromomenorrhea (bro¯Љmo¯-me˘n-o¯-re¯Јa˘) common. [Љϩmen, month, ϩ rhoia, flow] ETIOLOGY: The condition may be ac- Menstrual discharge marked by an of- quired or congenital and may occur in fensive odor. one or both lungs. Bronchiectasis has bronch- SEE: broncho-. three forms (cylindrical, varicose, and bronchi (bro˘ngЈkı¯) sing., bronchus [L.] saccular), which may occur individually The two main branches leading from the or together. Acquired bronchiectasis trachea to the lungs, providing a pas- usually occurs secondary to an obstruc- sageway for air. The trachea divides op- tion or an infection such as broncho- posite the third thoracic vertebra into pneumonia, chronic bronchitis, tuber- the right and left main bronchi. The culosis, cystic fibrosis, or whooping point of division, called the carina tra- cough. The incidence has decreased chea, is the site where foreign bodies too with antibiotic treatment of acute infec- large to enter either bronchus would tions. rest after passing through the trachea. DIAGNOSIS: Radiography is used to The right bronchus is shorter and more assist in the diagnosis, either with chest vertical than the left one. After entering x-rays, or computed tomography of the the lung each bronchus divides further lung; the disease may be visualized and and terminates in bronchioles. SEE: cultures taken during bronchoscopy. bronchus for illus. TREATMENT: Therapy consists of foreign bodies in b. Any materials oral or IV antibiotics for 7 to 10 days, that are aspirated into the lower air- pulmonary hygiene, and postural drain- ways, such as beans, nuts, seeds, or age. Resection of affected areas may be coins. These items, which usually lodge done in selected patients. Aerosols may in the right bronchus because of its an- be useful for bronchodilation if broncho- atomical relation to the trachea, may spasm is present. SEE: postural drain- cause pneumonia, airway inflamma- age. tion, abscess formation, or atelectasis. PATIENT CARE: The patient is as- TREATMENT: They can be removed sessed for the presence or increased se- with postural drainage or bronchoscopy. verity of respiratory distress. Ventila- bronchi- SEE: broncho-. tory rate, pattern, and effort are bronchial (bro˘ngЈke¯-a˘l) Pert. to the bron- observed, breath sounds are auscul- chi or bronchioles. tated, and sputum is inspected for bronchial blocker ABBR: BB. A device changes in quantity, color, or viscosity. used to facilitate single-lung ventilation The respiratory therapist evaluates gas during thoracic surgery or thoracos- exchange by monitoring arterial blood copy. The bronchial blocker is placed gas values, and administers oxygen ac- into the mainstem bronchus on the side cording to protocol or as prescribed. The of the chest where the operation is being patient is observed for complications performed, and its balloon is inflated such as cor pulmonale. The patient within the airway. Potential complica- should increase oral fluid intake and be tions of the device include dislodge- shown how to use a humidifier or neb- ment, misplacement, or accumulation of ulizer to help thin inspissated secre- fluid behind the blockade. tions. The patient also is taught to bronchial breath sounds SEE: sound, breathe deeply and cough effectively. bronchial. Chest physiotherapy is most effective bronchial thermoplasty The reduction in and least disruptive if carried out in the short the amount of smooth muscle mass in morning, 1 or 2 hr before meals, and at standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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bedtime. The patient is taught to re- and continue to the alveolar ducts, main in each prescribed position for at which lead to the alveoli. least 10 minutes, then percussion is per- terminal b. The next-to-last subdivi- formed followed by two-stage coughing sion of a bronchiole, leading to the res- to remove secretions. The nurse or res- piratory bronchioles. piratory therapist suctions the orophar- bronchiolectasis (bro˘ngЉke¯-o¯-le˘kЈta˘-sı˘s) ynxif the patient is unable to clear the [ЉϩGr. ektasis, dilatation] Dilatation airway and teaches the patient and fam- of the bronchioles; capillary bronchiec- ily how to do this. The need for frequent tasis. oral hygiene to remove foul-smelling se- bronchiolitis (bro˘ngЉke¯-o¯-lı¯Јtı˘s) [Љϩ cretions and to help prevent anorexia is Gr. itis, inflammation] Inflammation of explained. The patient is taught to dis- the bronchioles, particularly as an acute pose of secretions, to cleanse items con- process in children during the first 2 taminated by secretions, and to wash years of life, with peak incidence around hands thoroughly to avoid spreading in- 6 months of age. Most cases occur dur- fections. Air pollutants and people with ing the winter and early spring months. upper respiratory infections should be ETIOLOGY: The respiratory syncytial avoided. If the patient smokes, he or she virus (RSV) accounts for 50% of cases. may need referral to a smoking cessa- Other viruses (parainfluenza, adenovi- tion program or nicotine patch therapy. ruses) and mycoplasma species make up Prescribed medications, such as antibi- the remaining cases. There is no evi- otics, bronchodilators, and expecto- dence that bacteria cause the illness, or rants, are given, and both patient and that antibiotics cure it. family are instructed in their use, ac- SYMPTOMS: URI symptoms (runny tion, and side effects. The patient is ad- nose, sneezing) appear first, quickly re- vised not to take over-the-counter drugs placed by the hallmarks of the disease, without the health care provider’s ap- respiratory distress, nasal flaring, re- proval, and to have respiratory infec- tractions, tachypnea, cyanosis, and tions treated promptly. Supportive care wheezing. The wheezing is what gives is provided to help the patient adjust to the disease its commonly used name, the lifestyle changes that irreversible “baby asthma.” Some infants, especially lung damage requires. Balanced, high- those a few months old, develop severe protein meals (in frequent, small respiratory distress with hypoxia and amount if necessary) aid tissue healing. gasping respirations, requiring hospi- If surgery is scheduled, the patient is talization, oxygen, and assisted venti- prepared physically and emotionally. lation. Chest x-ray films show hyperin- Preoperative and postoperative teach- flation of the lungs with scattered areas ing and care are conducted, and the pa- of pneumonia and/or atelectasis. tient’s status is monitored to prevent TREATMENT: Infants with moderate complications. or worse respiratory distress should be saccular b. Dilated bronchi that are admitted to the hospital for observation, of saccular or irregular shape. The prox- respiratory therapy, and oxygen. imal third to fourth branches of the Whether bronchodilators such as nebu- bronchi are severely dilated and end lized albuterol have any value in the blindly with extensive collapse. treatment is still debated, but they are varicose b. Dilated bronchi that re- often used. Ribavirin, a nebulized anti- semble varicose veins; irregular dilata- viral agent, is used in severe cases of tion and constriction as seen in cystic fi- bronchiolitis due to proven RSV infec- brosis. tion in children under age 2. bronchiloquy (bro˘ng-kı˘lЈo¯-kwe¯) [ЉϩL. PROGNOSIS: The case fatality rate is loqui, to speak] Unusual vocal reso- less than 1%, but a significant propor- nance over a bronchus surrounded by tion of affected infants develop reactive consolidated lung tissue. airway disease (i.e., asthma) in later bronchiocele (bro˘ngЈke¯-o¯-se¯l) [Љϩkele, childhood. tumor, swelling] Circumscribed dila- PREVENTION: Preventive drugs tation of a bronchus. have been developed for infants with bronchiogenic (bro˘ngЉke¯-o¯-je˘nЈ˘k)ı [Љϩ bronchopulmonary dysplasia and other gennan, to produce] Having origin in congenital cardiac or pulmonary dis- the bronchi. eases. These include palivizumab, a bronchiol- SEE: bronchiolo-. monoclonal antibody, and an RSV im- bronchiole (bro˘ngЈke¯-o¯l) pl. bronchioles mune globulin. [L. bronchiolus, air passage] One of the PATIENT CARE: The infant requires smaller subdivisions of the bronchial close observation regarding the de- tubes. Bronchioles have no cartilage in mands imposed by airway obstruction their walls; they also have few glands in at the bronchiolar level. The infant is their mucosa. observed for gradually increasing res- respiratory b. The last division of the piratory distress, paroxysmal cough, bronchial tree. Respiratory bronchioles dypsnea and irritability, as well as for short are branches of terminal bronchioles tachypnea with flaring nostrils and in- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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tercostal and subcostal retractions, and acute or chronic. SEE: Nursing Diag- shallow respiratory excursion. noses Appendix. The infant should be percussed for hy- ETIOLOGY: Bronchitis is caused by perresonance and scattered consolida- infectious agents such as viruses (esp. tion and auscultated for fine crackles, rhinoviruses, influenza A and B, para- prolonged expiratory phase, and dimin- influenza, adenoviruses, and respira- ished breath sounds by the nurse, res- tory syncytial virus) or, less often, my- piratory therapist, and physician. Au- coplasma, chlamydia, streptococcus, dible or auscultatory wheezing may be haemophilus, bramhamella, or staphy- present, as well as hyperinflation lead- lococcus. Infection is often indistin- ing to increased A-P diameter and de- guishable from the common cold and is pressed diaphragm. usually treated as such unless pneu- The parents are educated regarding monia is also present. Acute bronchial the need for hospitalization, and treat- irritation (noninfectious bronchitis) ments that will be employed are ex- may also be caused by exposure to var- plained. The use of a mist tent and oxy- ious physical and chemical agents such gen are discussed as well as assisted as dust, fumes, or pollens. Allergies and ventilation if this becomes necessary, pre-existing conditions such as asthma and the parents are taught how to main- or chronic obstructive lung disease may tain contact with their infant. The par- be important cofactors. ents also need to understand that tachy- PATIENT CARE: A history is obtained pnea, weakness, and fatigue limit the documenting tobacco use, including infant’s ability to obtain fluids in suffi- type, duration, and frequency. Calcula- cient amounts to provide adequate hy- tion of pack-year history gives useful in- dration, thus intravenous fluids will be formation. The health care provider as- used until symptoms abate. Since par- sesses for other known respiratory ents expect medications to be prescribed irritants and allergens, exertional or for their infant, the nurse explains why worsening dyspnea, and productive various drugs (antibiotics, bronchodila- cough. The patient is evaluated for tors, corticosteroids, cough suppres- changes in baseline respiratory function sants, and expectorants) are not em- such as the use of accessory muscles in ployed and helps them to understand breathing, cyanosis, neck vein disten- why sedatives are contraindicated al- tion, pedal edema, prolonged expiratory though rest is an important part of ther- time, tachypnea, and wheezes or crack- apy. Hospitalization of an infant is trau- les. The color (gray, white, or yellow) and matic to parents and to the child characteristics of sputum are often doc- depending on his or her age and severity umented (but may have little diagnostic of illness, so emotional support is pro- significance). Tests such as arterial blood gas analysis, chest x-rays, oxime- vided to all throughout this crisis. The try, peak flow measurements, pulmo- parents are helped to provide love, nary function testing, and sputum Gram touch, and care for their infant, are in- stain are occasionally employed. They structed on how they can contact the are explained to the patient if they have nurse if they must be absent from the been ordered. Prescribed antihista- crib-side, and are assisted to under- mines, bronchodilators, corticosteroids, stand and deal with behavioral regres- decongestants, expectorants, and other sion that may occur. medications are administered and the b. exudativa Bronchiolitis with fi- response is documented. Antibiotics are brinous exudation and grayish sputum; rarely indicated. Daily activities are in- often associated with asthma. terspersed with rest periods to conserve b. obliterans Bronchiolitis in which energy and to prevent fatigue. Patients the bronchioles and, occasionally, some with comorbid conditions should be hos- of the smaller bronchi are partly or com- pitalized, in which case all general pa- pletely obliterated by nodular masses tient care concerns apply. Patients that contain granulation and fibrotic needing help to quit smoking are given tissue. counseling and support and referred to bronchiolo-, bronchiol-, broncholio- [L. smoking cessation programs and for ad- bronchiolus, air passage] Combining junctive drug therapy when prescribed. forms meaning bronchiole. acute b. 1. An infection of the bron- bronchiolus (bro˘ng-ke¯Јo¯-lu˘s) pl. bron- chi that may be indistinguishable from chioli [L.] Bronchiole. the common cold, often associated with bronchiostenosis (bro˘ngЉke¯-o¯-ste˘n-o¯Јsı˘s) repetitive coughing or sputum produc- [Љϩstenosis, act of narrowing] Nar- tion. It is usually caused by viruses (esp. rowing of the bronchial tubes. rhinoviruses, influenza A or B, parain- bronchitis (bro˘ng-kı¯Јtı˘s) [Љϩitis, in- fluenza, adenoviruses, or respiratory flammation] Inflammation of the mu- syncytial virus) or less often by Myco- cous membranes of the bronchial air- plasma pneumoniae, Chlamydia, strep- ways, caused by irritation or infection, tococci, Haemophilus spp, Moraxella la- short or both, by pathogen. Bronchitis can be cunata, Bordetella pertussis, or standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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staphylococci. 2. Noninfectious inflam- tively late in the disease process. Over mation of the bronchi caused by expo- time, right-sided heart failure (cor pul- sure to such irritants as dusts, fumes, monale) develops, marked by dependent or pollens. edema, distended neck veins, pulmo- TREATMENT: Patients are treated nary hypertension, and an enlarged with bedrest, increased fluid intake, right ventricle. and antipyretics and analgesics for com- TREATMENT: Bronchodilators, in- fort. Vaporizers may be used to decrease haled steroids, and other drugs are used bronchial irritation. Antibiotics are to prevent bronchospasm, improve air- rarely indicated (even if purulent spu- flow, and aid in the removal of secre- tum is present), unless bacterial infec- tions. Increased fluid intake (about 3 L/ tion is determined by culture or the day), ultrasonic or mechanical nebulizer symptoms continue for more than 10 treatments, and chest physiotherapy days or there is an underlying disease may be needed to help thin, loosen and such as congestive heart failure, chronic remove secretions. Acute respiratory in- obstructive lung disease, or an immu- fections are treated with empirical an- nodeficiency. Some prolonged cases of tibiotics such as azithromycin or tri- acute bronchitis will eventually prove methoprim/sulfamethoxazole, among to be caused by pertussis, which will others. Patients with underlying respond to erythromycin-based drugs. chronic bronchitis should receive pneu- A chest x-ray examination to check mococcal and influenza vaccines. Other for pneumonia is indicated when clini- treatments are symptom based. Cessa- cally suspected (e.g., if severe respira- tion of smoking is an important part of tory symptoms, fever, tachycardia, hy- the overall treatment. Oxygen therapy poxia, or abnormal lung sounds are is frequently needed. present). PATIENT CARE: The initial history asthmatic b. Bronchitis compounded and assessment covers tobacco use, by wheezing, caused by spasm of hyper- presence of other known respiratory ir- reactive airways. ritants and allergens, degree of dys- chronic b. Bronchitis marked by in- pnea, use of accessory muscles for creased mucus secretion by the tra- breathing, presence of wheezes or rhon- cheobronchial tree. A productive cough chi, color, sputum characteristics, nutri- must be present for at least 3 months in tional status, and the effect of the dis- two consecutive years for the clinical di- ease on desired activity. Patients who agnosis of chronic bronchitis to be made; smoke are referred to a smoking cessa- also, other bronchopulmonary diseases tion program. The patient’s lungs are (e.g., bronchiectasis, tuberculosis, tu- auscultated before and after aerosol mor) must be excluded. SEE: chronic ob- therapy to assess the effectiveness of structive pulmonary disease. bronchodilators. ETIOLOGY: Chronic irritation by in- The patient/family need extensive ed- haled irritants (esp. cigarette smoking) ucation and ongoing psychosocial sup- and repeated infections are the primary port to cope with this chronic disease. risk factors. Chronic bronchitis is 4 to 10 Simple pathophysiology of the disease times more common in heavy smokers; process is taught and used as a basis for cigarette smoke interferes with the explanations about diagnostic tests movement of cilia and inhibits the activ- (e.g., pulmonary function tests) and all ity of white blood cells in the bronchi interventions to increase patient coop- and alveoli. The predominant patholog- eration in the complexcare regimen. ical changes are hypertrophy and hy- Written materials usually augment ver- perplasia of the mucus-secreting glands bal instruction. Patients and families of the large and small airways. Some pa- are taught how to ensure and document tients also have hyperreactive airways adequate fluid intake (about 3 L/day un- with widespread inflammation, narrow- less otherwise restricted) to loosen se- ing and distortion. The changes in the cretions; to schedule small, frequent, respiratory epithelium may increase high-protein meals to combat anorexia the risk of lung cancer. and weight loss; to use pursed-lip DIAGNOSIS: Diagnostic studies may breathing and controlled cough to in- include chest x-ray, pulmonary function crease airflow and prevent fatigue from or peak flow testing, arterial blood gas coughing spasms; to provide oral care studies, and ECG. frequently to minimize anorexia and the SYMPTOMS: Although the disease risk of infection; and to maintain muscle begins earlier, signs and symptoms may strength by continuing to exercise, but not appear until patients are 40 to 50 with a plan to pace activities to avoid years old. A chronic cough producing co- fatigue. They also are taught to watch pious amounts of sputum occurs early, for and report signs of possible heart and patients have frequent respiratory failure (e.g., dependent edema, or problems, often as a result of acute weight gain of more than 1 kg/day) or bronchopulmonary infections. Dyspnea acute respiratory infection (e.g., in- short is generally moderate and occurs rela- creased dyspnea and changes in sputum standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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characteristics such as color or amount). bronchodilator (bro˘ngЉko¯-dı¯-la¯Јtor) A As the disease progresses, the family is drug that expands the bronchi by relax- assisted to make decisions about how ing bronchial muscle. There are three routines may be modified to best meet classes of bronchodilators: beta2 adre- individual needs. nergic-receptor agonists, methylxanthi- The respiratory therapist delivers nes, and anticholinergic agents. The bronchodilators and humidity therapy beta2 adrenergic-receptor agonists pro- as indicated by the presence of wheez- duce the greatest bronchodilation in pa- ing or evidence of retained airway secre- tients with bronchial asthma. The beta2 tions. Chest physical therapy may prove adrenergic-receptor agonists are the useful when the patient cannot easily best drugs for patients with mild, inter- cough the secretions out. Oxygen ther- mittent asthma and for acute attacks of apy is administered based on evidence reactive airway disease. SEE: table. of hypoxemia, inadequate perfusion of bronchoedema (bro˘ngЉko¯-e˘-de¯Јma˘) [Љϩ vital organs, or cor pulmonale. oidema, swelling] Edematous swelling eosinophilic b. A condition marked of the mucosa of the bronchial tubes, re- by chronic cough, eosinophils in spu- ducing the size of air passageways and tum, and improvement in symptoms af- inducing dyspnea. ter the administration of corticoste- bronchogenic (bro˘ng-ko¯-je˘nЈ˘k)ı [Љϩ roids. It is similar to asthma, but there gennan, to produce] Having origin in a is no wheezing or airway reactivity, and bronchus. the airways are not infiltrated by mast broncholio SEE: bronchiolo-. cells. broncholith (bro˘ngЈko¯-lı˘th) [Љϩlithos, plastic b. Bronchitis marked by vio- stone] A calculus in a bronchus. lent cough and paroxysms of dyspnea in broncholithiasis (bro˘ngЉko¯-lı˘th-ı¯Јa˘-sı˘s) [Љ which casts of the bronchial tubes are ϩ lithos, stone, ϩ −iasis, state] Bron- expectorated. chial inflammation or obstruction putrid b. A chronic form of bronchitis caused by calculi in the bronchi. with foul-smelling sputum. bronchomotor (bro˘ngЉko¯-mo¯Јtor) [Љϩ vegetal b. Bronchitis resulting from L. motus, moving] Causing dilation or lodging of foods of vegetable origin in constriction of the bronchi. the bronchus. bronchomycosis (bro˘ngЉko¯-mı¯-ko¯Јsı˘s) [Љ broncho-, bronch-, bronchi- [Gr. bron- ϩ mykes, fungus, ϩ osis, condition] chos, windpipe] Combining forms Any fungal infection of the bronchi or meaning airway. bronchial tubes, usually caused by fungi bronchoblennorrhea (bro˘ngЉko¯-ble˘nЉo˘- of the genus Candida. re¯Јa˘) [Љϩblennos, mucus, ϩ rhoia, bronchopathy (bro˘ng-ko˘pЈa˘-the¯) [Љϩ flow] Chronic bronchitis in which spu- pathos, disease, suffering] Any patho- tum is copious and thin. logical condition involving the bronchi bronchocele (bro˘ngЈko¯-se¯l) [Љϩkele, or bronchioles. tumor, swelling] A localized dilatation bronchophony (bro˘ng-ko˘fЈo¯-ne¯) [Љϩ of a bronchus. phone, voice] An abnormal increase in bronchoconstriction (bro˘ngЉko¯-ko˘n- tone or clarity in vocal resonance. strı˘kЈshu˘n) [ЉϩL. constringere, to bronchoplasty (bro˘ngЈko¯-pla˘sЉte¯) [Љϩ draw together] Constriction of the plassein, to form] Surgical repair of a bronchial tubes. bronchial defect. bronchodilatation (bro˘ngЉko¯-dı˘l-a˘- bronchopneumonia (bro˘ngЉko¯-nu¯- ta¯Јshu˘n) [ЉϩL. dilatare, to open] Ex- mo¯Јne¯-a˘) [Љϩpneumonia, lung in- pansion or relaxation of the large air- flammation] A type of pneumonia ways. marked by scattered consolidation (areas

Features of Bronchodilator Drugs Common Side Drug Class Route Uses Effects

Beta2 agonists Orally or by Intermittent attacks Palpitations, tachy- (e.g., albu- inhalation of wheezing; exer- cardia, nervous- terol, salme- cise-induced ness terol) asthma; Prevention of asthma Methylxan- Orally, intra- Asthma; COPD Palpitations, tachy- thines (e.g., venously cardias, nausea, theophylline) vomiting, seizures Anticholiner- By inhalation COPD; acute asthma Dry mouth, cough, gics (e.g., (when combined nausea ipratropium) with beta-agonist drug) short standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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filled with inflammatory exudate) in one staxis, dripping] Hemorrhage from the or more lobes of the lung. It occurs pri- walls of a bronchus. marily in infants and in elderly persons, bronchostenosis (bro˘ngЉko¯-ste˘n-o¯Јsı˘s) [Љ both of whom have decreased resistance ϩ stenosis, act of narrowing] Stenosis to bacterial and viral infections. It is often of a bronchus. a complication of bronchitis. bronchostomy (bro˘ng-ko˘sЈto¯-me¯) [Љϩ bronchopulmonary lavage Lavage, bron- stoma, mouth] The surgical formation choalveolar. of an opening into a bronchus. bronchorrhagia (bro˘ngЉkor-a¯Јje¯-a˘) [Љϩ bronchotomy (bro˘ng-ko˘tЈo¯-me¯) [Љϩ rhegnynai, to break forth] A bronchial tome, incision] Surgical incision of a hemorrhage. bronchus, the larynx, or the trachea. bronchorrhaphy (bro˘ng-korЈa˘-fe¯) [Љϩ bronchovesicular (bro˘ngЉko¯-ve˘-sı˘kЈu¯-la˘r) rhaphe, seam, ridge] The suturing of a [ЉϩL. vesicula, a tiny bladder] Pert. bronchial wound. to bronchial tubes and alveoli with spe- bronchorrhea (bro˘ng-ko¯-re¯Јa˘) [Љϩ cial reference to sounds intermediate rhoia, flow] An abnormal secretion between bronchial or tracheal sounds from the bronchial mucous membranes. and vescicular sounds. bronchorrhoncus (bro˘ngЉkor-o˘nЈku˘s) [Љϩ b. breath sounds SEE: sound, bron- rhonchos, snore] A bronchial crackle. chovesicular. bronchoscope (bro˘ngЈko¯-sko¯p) [Љϩ bronchus (bro˘ngЈku˘s) pl. bronchi [Gr. skopein, to examine] An endoscope de- bronchos, windpipe] One of the two signed to pass through the trachea for vi- large branches of the trachea. The tra- sual inspection of the tracheobronchial chea proper terminates at the level of tree. The device can be used for lavage, or the fourth thoracic vertebra. Each main to remove tissue for biopsy or foreign bod- (primary) bronchus enters the lung at ies from the tracheobronchial tree. its hilus. Inside the lung, the main bron- bronchoscopy (bro˘ng-ko˘sЈko¯-pe¯) Exam- chus branches into a bronchial tree (a ination of the bronchi through a bron- set of smaller bronchi and bronchioles). choscope. SEE: illus.; bronchi. autofluorescence b. Bronchoscopy broth (brawth) [ME.] 1. A liquid nutri- in which tissues are illuminated with ent made from simmering any food (ce- pure blue laser light. The wavelength of reals, meats, vegetables) in liquid. 2. A blue light enhances the difference in ap- liquid nutrient medium used to facili- pearance between normal and malig- tate the growth of microorganisms. nant tissues, since malignant and pre- brow The forehead. malignant surfaces glow (fluoresce) browlift (browЈliftЉ)[ЉϩЉ] A colloquial when compared with healthy tissues. term for ophryplasty. white light b. ABBR: WLB. Stan- brown baby syndrome The dark grayish dard bronchoscopy, i.e., bronchoscopy in brown skin color seen in infants under- which tissues are illuminated with the going extensive phototherapy for hyper- normal light spectrum available for use bilirubinemia. The condition may last in fiberoptic evaluation of tissues. The for months but is not known to produce term “white light bronchoscopy” is used permanent harm. to distinguish standard bronchoscopy brownian movement (browЈne¯-a˘n) from bronchoscopy performed with [Robert Brown, Brit. botanist, 1773– other light wavelengths. SEE: autoflu- 1858] The oscillatory movement of par- orescence b. ticles resulting from chance bombard- bronchosinusitis (bro˘ngЉko¯-sı¯Љnu˘s-ı¯Јtı˘s) ment by other particles. [ЉϩL. sinus, a hollow, ϩ Gr. itis, in- Brown-Se´quard’s syndrome (brownЈsa¯- flammation] Infection of a bronchus ka˘rzЈ) [Charles E. Brown-Se´quard, Fr. and a sinus at the same time. physician, 1817–1894] Hemisection of bronchospasm (bro˘ngЈko¯-spa˘zm) [Љϩ the spinal cord with: paralysis, loss of spasmos, a convulsion] An abnormal position and vibratory sense, and ataxia narrowing with partial obstruction of on the same side of the body as the lesion; the lumen of the bronchi due to spasm and loss of pain and temperature sensitiv- of the peribronchial smooth muscle. ity on the side opposite the lesion. Clinically this is accompanied by cough- Brucella (broo-se˘lЈa˘) [Sir David Bruce, ing and wheezing. Bronchospasm oc- Brit. physician and bacteriologist, 1855– curs in reactive airway diseases such as 1931] A genus of gram-negative, aerobic, asthma and bronchitis. Treatment may coccobacilli that are pathogenic to humans include bronchodilators and corticoste- and cause undulant fever and abortion in roids. SEE: asthma. cattle, hogs, and goats. SEE: brucellosis. bronchospirometer (bro˘ngЉko¯-spı˘-ro˘mЈe˘- brucella pl. brucellae pl. brucellas Any te˘r) [ЉϩL. spirare, to breathe, ϩ Gr. bacterium of the genus Brucella. bru- metron, measure] An instrument for cellar (broo-se˘lЈe˘r), adj. determining the volume of air inspired brucellin (broo-se˘lЈı˘n) A protein extract from one lung and for collecting air for of any species of Brucella. It formerly analysis. was used in human skin tests to diag- short bronchostaxis (bro˘ngЉko¯-sta˘kЈsı˘s) [Љϩ nose brucellosis and is still used for that standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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CRICOTHYROID THYROID CARTILAGE LIGAMENT CRICOID CARTILAGE

TRACHEAL ANNULAR CARTILAGES LIGAMENTS

RIGHT CARINA LEFT UPPER UPPER LOBE LOBE BRONCHUS BRONCHUS

MIDDLE LEFT LOBE AND RIGHT LEFT BRONCHUS PRIMARY LOWER BRONCHUS LOBE ANTERIOR VIEW BRONCHUS RIGHT LOWER LOBE BRONCHUS TRACHEA AND BRONCHI

purpose by veterinarians. Agglutination 1917] Flexion of the hips when the neck tests and cultures are now preferred for is flexed from a supine position. It oc- human testing. curs in patients with meningeal inflam- brucellosis (brooЉse˘l-o¯Јsı˘s) [Brucella ϩ mation. SEE: Kernig’s sign; meningitis. Gr. osis, condition] A widespread, in- Brugada syndrome (broo-go˘dЈa˘) A rare fectious disease affecting cattle, swine, hereditary syndrome, occasionally au- and goats, and sometimes other animals tosomal dominant, marked by right and humans. Human infection occurs bundle branch block, S-T segment ele- most commonly in ranchers, veterinar- vation in the right precordial leads of ians, and people who consume unpas- the ECG, and a high risk of sudden teurized dairy products. It is caused by death from ventricular arrhythmias. bacteria of several Brucella species. B. Brugia malayi (brooЈja˘mah-la¯Ј-ı¯) A fila- melitensis and B. suis cause brucellosis rial parasitic worm that can invade lym- in goats and swine, respectively, and B. phatics and cause massive swelling of abortus causes contagious abortion in the scrotum or of the lower extremities. cattle, dogs, and other domestic ani- The latter condition is called elephan- mals. The organisms are intracellular tiasis. SEE: elephantiasis; Wuchereria. parasites. Brucellosis is also known as Bruininks-Oseretsky Test of Motor Pro- Malta or Gibraltar fever. It produces an ficiency ABBR: BOTMP. A standard- influenza-like illness, with fevers, chills, ized test of gross and fine motor perform- headache, and body aches. It is a rare ance for children from 4 to 14 years of age. cause of endocarditis. SYN: Gibraltar fe- bruise (brooz) [O. Fr. bruiser, to break] ver; Mediterranean fever. A traumatic injury (usually to the skin TREATMENT: In adults, treatment but sometimes to internal organs) in consists of doxycycline and rifampin for 6 which blood vessels are broken but tis- weeks. In children and pregnant women sue surfaces remain intact. Discolor- tetracyclines should be avoided because ation, swelling, inflammation, and pain they damage developing teeth and bones. are typical signs and symptoms. Fresh Bruch’s membrane (brooks) [Karl W. L. bruises on the skin are often red or pur- Bruch, Ger. anatomist, 1819–1884] A ple. Older bruises may turn green and glassy membrane of the uvea of the eye, then yellow or brown, as the blood prod- lying between the choroid membrane ucts within them age and are reab- and the pigmented epithelium of the sorbed, but gauging the age of a bruise retina. SYN: lamina basalis choroideae; by its color is imprecise, at best. Bruis- vitreous lamella. ing in infants may suggest occult child Bruck’s disease (brooks) [Alfred Bruck, abuse. Bruising in the elderly is more Ger. physician, b. 1865] Osteogenesisis often an indication of the use of antico- imperfecta. agulant drugs than of physical mistreat- Brudzinski sign (bru-jinЈske¯) [Jo´sef ment. SYN: ecchymosis. short Brudzinski, Polish physician, 1874–- FIRST AID: Cold packs may reduce standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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swelling and discomfort, esp. when pro- The grinding of the teeth, esp. in chil- vided soon after injury. Twenty-four to dren, during sleep. 48 hr later, application of heat may be ETIOLOGY: Psychological stress or desirable, followed by gentle massage. abnormalities of tooth occlusion are the b. of head, chest, and abdomen A principal causes. bruise that may be associated with in- TREATMENT: If the condition is due to ternal injuries. SEE: ecchymosis. psychological causes, tension, anxiety, PATIENT CARE: Historical data are and stress should be reduced. The teeth collected regarding the exact cause and should be treated for caries, malocclusion, location of the injury. The possibility of or periodontal disease. Occlusal guards for an abusive injury is investigated if the his- the teeth may be of benefit. SYN: oroman- tory given does not seem consistent with dibular sleep movement disorder. the injury, or if the related details change. Bryant’s traction (brı¯Јa˘nts) [Sir Thomas The bruised area is inspected, and the lo- Bryant, Brit. surgeon, 1828–1914] Trac- cation, color, size, discomfort, and other tion applied to the lower legs with the pertinent characteristics are documented. force pulling vertically. It is used esp. in The patient is assessed for other injuries treating fractures of the femur in children. dependent on the specific location and se- B.S. Bowel sounds. verity of the original injury. Related skin BSE 1. Breast self-examination. 2. Bovine abrasions are cleansed thoroughly. Neu- spongiform encephalopathy. rological status (AVPU) is monitored BSI Body substance isolation. hourly or as needed for any patient with BTPS body temperature and pressure a suspected head injury. (saturated with water vapor). stone b. A pain perceived of the bot- BTU British thermal unit. Ј tom of the foot, often the result of me- bubo (boo bo¯) pl. buboes [Gr. boubon, tatarsalgia or plantar fasciitis. groin, swollen gland] An inflamed, bruit (brwe¯, broot) [Fr., noise] An ad- swollen, or enlarged lymph node often ventitious sound of venous or arterial exhibiting suppuration, occurring com- origin heard on auscultation. monly after infective disease due to ab- placental b. Placental souffle. sorption of infective material. The nodes Brunner’s glands (bru˘nЈe˘rz) [Johann C. most commonly affected are those of the Brunner, Swiss anatomist, 1653–1727] groin and axilla. Compound glands of the duodenum and axillary b. A bubo in the armpit. upper jejunum that are similar to the py- indolent b. A bubo in which suppu- loric glands of the stomach. They are em- ration does not occur. bedded in the submucosa and lined with inguinal b. A bubo in the region of columnar epithelium. They secrete alka- the groin. SYN: buboadenitis. line mucus which neutralizes the hydro- venereal b. A bubo resulting from a venereal disease. SEE: lymphogranu- chloric acid entering the duodenum from loma venereum. the stomach. SYN: duodenal glands. bubonadenitis (boo-bo˘n-a˘d-e˘-nı¯Јtı˘s) [Љ Brunner’s syndrome (bru˘nЈe˘r) [H.G. ϩ aden, gland, ϩ itis, inflammation] Brunner, D. geneticist] A rare X-linked Inguinal bubo. deficiency of monoamine oxidase A. bucc- SEE: bucco-. Mild mental retardation and impulsive bucca (bu˘kЈa˘) pl. buccae [L., cheek] or aggressive behaviors are character- The cheek. istically found in affected children. buccal (bu˘kЈa˘l) Pert. to the cheek or brush A tool with bristles on its end de- mouth. signed to remove debris or damaged bucco-, bucc- [L. bucca, mouth] Combin- cells from a body part. Ј ing forms meaning cheek. Brushfield spots (bru˘sh fe¯ld) [T. Brush- buccocervical (bu˘kЉko¯-se˘rЈvı˘-ka˘l) Con- field, Brit. physician, 1858–1937] Gray cerning the buccal surface and cervical or pale yellow spots sometimes present margin of a tooth. at the periphery of the iris. They may be Buck’s extension (bu˘ks) [Gurdon Buck, an isolated finding but are sometimes U.S. surgeon, 1807–1877] A method of found in Down syndrome. producing traction by applying regular Ј brushing (bru˘sh ı˘ng) 1. A technique of or flannel-backed adhesive tape to the tactile stimulation using small brushes skin and keeping it in smooth close con- over selected dermatomes to elicit mus- tact by circular bandaging of the part to cular responses in the rehabilitation of which it is applied. The adhesive strips persons with central nervous system are aligned with the long axis of the arm damage. 2. Cleaning with a brush, as in or leg, the superior ends being about 1 toothbrushing. 3. A clinical specimen in. (2.5 cm) from the fracture site. obtained by rubbing a body part with a Weights sufficient to produce the re- brush. The tissue or cells obtained are quired extension are fastened to the in- examined microscopically for evidence ferior end of the adhesive strips by a of disease. rope that is run over a pulley to permit bruxism (bru˘kЈsı˘zm) [Gr. brychein, to free motion. SYN: Buck’s traction. short grind the teeth, ϩ −ismos, condition] Bucky diaphragm, Potter-Bucky dia- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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phragm (bu˘kЈe¯) [Gustav P. Bucky, tremities causing decreased blood flow Ger.-born U.S. radiologist, 1880–1963; to the feet and legs. Occasionally the Hollis Potter, U.S. radiologist, 1880– hands are also affected, causing painful 1964] A specialized film holder with a ulceration of the fingertips. The disease moving grid located immediately be- is seen most commonly in males 20 to neath the radiographic table or upright 40 years of age who smoke cigarettes or apparatus. It decreases the effects of chew tobacco. SYN: thromboangiitis ob- scatter and secondary radiation during literans. a radiographic exposure. SYMPTOMS: Symptoms include par- Bucky factor A measure of the amount of esthesias of the foot, easy fatigability, radiation absorbed by the Bucky dia- and foot and leg cramps. In patients phragm. This indicates the amount by with severely limited blood flow to the which to increase the technical factors legs, skin ulceration or moist gangrene when a grid is being used. of the extremities may develop. Ampu- bud [ME. budde, to swell] 1. In anatomy, tation is sometimes needed to remove a small structure resembling a bud of a dead tissue. plant. 2. In embryology, a small protu- TREATMENT: Absolute, permanent berance or outgrowth that is the anlage abstinence from tobacco in all forms is or primordium of an organ or structure. crucial. The patient should avoid exces- limb b. In the embryo, a clump of sive use of the affected limb, exposure to cells that is the precursor of one of the temperature extremes, use of drugs that four limbs. diminish the blood supply to extremi- lung b. In the embryo, a pouch that ties, trauma, and fungus infections. As- grows out of each side of the developing pirin and vasodilators may be pre- foregut tube beginning at stage 12 (26 scribed. If gangrene, pain, or ulceration days). It pushes into the primitive pleu- is present, complete bedrest is advised ral coeloms and continues to elongate with a padded foot-board or bed cradle and branch to become the embryonic to prevent pressure on the extremities; lung. if these are absent, the patient should taste b. Any of the primary sensory walk at a comfortable pace for 30 min cells that are found mainly on the mar- twice daily. For arterial spasm, blocking gins and the back of the tongue and re- of the sympathetic nervous system by spond to a range of chemicals intro- injection of various drugs or by sympa- duced into the mouth. Sensory cells of thectomy may be done. the taste buds live for approx. 10 days PATIENT CARE: The history should and are then replaced from basal stem document occurrences of painful, inter- cells. SEE: taste. mittent claudication of the instep, calf, tooth b. The earliest evidence of or thigh, which exercise aggravates and tooth development. The tooth buds form rest relieves; the patient’s walking abil- in the dental lamina. Tooth buds for the ity (distance, time, and rest required); deciduous teeth develop first (6 weeks of the patient’s foot response to exposure gestation) and more superficially; tooth to cold temperatures (initially cold, buds for the permanent teeth develop numb, and cyanotic; later reddened, later (10 weeks of gestation) and deeper hot, and tingling); and any involvement in the dental lamina. SEE: enamel or- of the hands, such as digital ischemia, gan. trophic nail changes, painful fingertip Budd-Chiari syndrome (bu˘dЈke¯-a¯rЈe¯) ulcerations, or gangrene. Peripheral SEE: thrombosis, hepatic vein. pulses are palpated, and absent or di- budding (bu˘dЈı˘ng) A method of asexual minished radial, ulnar, or tibial pulses reproduction in which a small offshoot documented. Feet and legs are in- or sprout grows from the side or end of spected for superficial vein thrombo- the parent and develops into a new or- phlebitis, muscle atrophy, peripheral ganism, which in some cases remains ulcerations, and gangrene, which occur attached and in others separates and late in the disease. Soft padding is used lives an independent existence. Bud- to protect the feet, which are washed ding is common in sponges and coelen- gently with a mild soap and tepid water, terates. The budding of yeasts is mitosis rinsed thoroughly, and patted dry with with unequal division of cytoplasm. a soft towel. The patient is instructed in Buerger, Leo (bu˘rgЈe˘r) [Austrian-born this daily care routine and advised to in- U.S. surgeon, pathologist, and urologist, spect tissues for injury such as cuts, ab- 1879–1943] He was a professor of urol- rasions, and signs of skin breakdown ogy in New York City and Los Angeles. (redness or soreness) and to report all B.-Allen exercise Buerger’s postural injuries to the health care provider for exercise. treatment. The patient is advised to B.’s disease A chronic, recurring, in- avoid wearing tight or restrictive cloth- flammatory, but nonatheromatous vas- ing, sitting or standing in one position cular occlusive disease, chiefly of the pe- for long periods, and walking barefoot; ripheral small and medium-sized also, shoes and cotton or woolen stock- short arteries (and sometimes veins) of the ex- ings should be carefully fitted, but standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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stockings should not be tight enough to leukemia and leukemoid reactions, it is hinder venous return from the legs. He much larger. SEE: illus. should obtain medical care following any local trauma. Extremities must be protected from temperature extremes, esp. cold. The patient is taught Buer- ger’s postural exercises if prescribed and is cautioned to avoid use of over- the-counter drugs without the attend- ing health care provider’s approval. The patient who smokes is referred to a smoking cessation program, but nico- tine patch therapy should not be pre- scribed given the patient’s associated hypersensitivity to nicotine. For the pa- tient with ulcers and gangrene, bedrest is prescribed; a padded footboard or cra- BUFFY COAT dle is used to prevent pressure from bed linens. If hospitalization is required for Buffy coat (arrow) in leukemia treatment of ulcers or gangrene, or if bufotoxin (bu¯ Љfo¯-to˘ksЈı˘n) [L. bufo, toad, amputation is required, rehabilitative ϩ Gr. toxikon, poison] A general term needs are considered, esp. regarding for any toxin present in the skin of a changes in body image, and the patient toad. is referred for physical and occupational bug A term applied loosely to any small therapy and for social services as appro- insect or arthropod, esp. of the order priate. Hemiptera, that has sucking mouth B.’s postural exercise An exercise parts, incomplete metamorphosis, and used for circulatory disturbances of the two pairs of wings, the fore pair being extremities. SYN: Buerger-Allen exer- half membranous. SEE: bedbug; chig- cise. gers. B. test A noninvasive bedside test assassin b. A member of the family used to assess the adequacy of arterial Reduviidae. Many are predaceous; oth- blood flow into the legs. While the pa- ers are blood-sucking. Panstrongylus, tient is lying flat on his back, both legs Њ Triatoma, and Rhodnius are vectors of are elevated to an angle of 45 . Loss of trypanosome diseases (Chagas’ disease) the normal perfused color of either leg in humans. SEE: trypanosomiasis. suggests that its arterial blood flow is kissing b. Several species of the fam- compromised since a normal artery can ily Reduviidae. Melanolestes picipes is pump blood against gravity without dif- the common kissing bug, or black cor- ficulty. sair. buffalo hump A deposit of fat in the lower red b. Chiggers. midcervical and upper thoracic area of bugleweed (bu¯ Јg’l-we¯dЉ) A perennial the back. It is usually caused by exces- herb of the genus Lycopus, principally sive adrenocortical hormone production found in moist habitats in Europe and or therapy. North America. It is used mainly in ho- Ј buffer (bu˘f e˘r) [ME. buffe, to deaden meopathic remedies for cardiac and thy- shock of] 1. Any of several molecules roid disorders. It contains cardiac gly- that react with strong acids or bases to cosides and iodine. prevent large changes in the pH of body built environment The physical struc- fluids. 2. A substance tending to offset ture of cities, homes, and workplaces. reaction of an agent administered in How humans interact with the struc- conjunction with it. tures they design and construct influ- blood b. A chemical present in the ences a variety of health concerns, in- blood that prevents rapid changes in cluding accessibility, childhood and pH. The principal buffers are carbonic geriatric safety, the likelihood of inju- acid, carbonates and bicarbonates, mon- ries or illnesses, the mental health of obasic and dibasic phosphates, and pro- the population, and the quality of teins such as hemoglobin. shared environmental resources (such buffy coat A light stratum of blood seen as air and water). when the blood is centrifuged or allowed bulb (bu˘lb) [L. bulbus, bulbous root; Gr. to stand in a test tube. The red blood bolbos] Any rounded or globular struc- cells settle to the bottom and, between ture. the plasma and the red blood cells, a aortic b. The dilated portion of the light-colored layer contains mostly truncus arteriosus in the embryo that white blood cells. Platelets are at the top gives rise to the roots of the aorta and of this coat; the next layers, in order, are pulmonary arteries. lymphocytes and monocytes; granulo- duodenal b. The upper duodenal cytes; and reticulocytes. In normal area just beyond the pylorus. short blood, the buffy coat is barely visible; in hair b. The expanded portion at the standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

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lower end of the hair root. The growth ing in severity and duration or produc- of a hair results from the proliferation ing harm. of cells of the hair bulb. Health history includes a weight his- b. of the eye Eyeball. tory (frequency of weighing, premorbid b. of the urethra The posterior por- weight, menstrual threshold, history of tion of the corpus spongiosum found be- weight fluctuations). Changes are tween the two crura of the penis. graphed to help identify stress-related b. of the vestibule Bulbus vestibuli. patterns. The patient should be ques- olfactory b. An anterior enlargement tioned regarding perceptions of ideal of the olfactory tract. weight and total body appearance, as bulbar (bu˘lЈbar) Pert. to or shaped like a well as specific areas (e.g., hips, thighs, bulb. abdomen). Having the patient draw bulbitis (bu˘l-bı¯Јtı˘s) [ЉϩGr. itis, inflam- self-portraits may help to communicate mation] Inflammation of the urethra in this information. Any dieting behaviors its bulbous portion. are determined, including onset, type, bulbocavernosus (bu˘lЉbo¯-ka˘vЉe˘r-no¯Јsu˘s) frequency, and duration, what [Љϩcavernosus, hollow] A muscle en- prompted them, and the presence of ex- sheathing the bulb of the penis in the ternal influences, such as peer pressure. male or covering the bulbus vestibuli in Characteristically, patients with bu- the female. It is also called ejaculator limia demonstrate difficulty with im- urinae or accelerator urinae in males pulse control, chronic depression, poor and sphincter vaginae in females. self esteem, low frustration tolerance, bulboid (bu˘lЈboyd) [ЉϩGr. eidos, form, recurrent anxiety, alienation concerns, shape] Shaped like a bulb. self-consciousness, difficulty expressing bulbonuclear (bu˘lЉbo¯-nu¯ Јkle¯-a˘r) [Љϩ feelings of anger and impaired social or nucleus, kernel] Pert. to the nuclei in occupational adjustment. the medulla oblongata. Laboratory testing includes serum bulbospongiosus (bu˘lЉbo¯-spo˘nЉje¯-o¯Јsu˘s) electrolyte studies and complete blood One of the three voluntary muscles of count to detect hypochlorhidria, hypo- the penis. It acts to empty the canal of kalemia, metabolic acidosis, or dehydra- the urethra after urination and to assist tion. in erection of the corpus cavernosum Assessments for psychologic, sexual, urethrae. The anterior fibers contribute and physiologic manifestations of bu- to penile erection by contracting to com- limia, including depression, suicidal press the deep dorsal vein of the penis. ideation, and substance abuse, are im- bulbous (bu˘lЈbu˘s) [L. bulbus] Bulb- portant. Family history should include shaped; swollen; terminating in an en- information concerning psychiatric largement. problems, existence of physical or sex- bulbus [L.; Gr. bolbos] Bulb. ual abuse, communication patterns, and quality of relationships. b. corpus spongiosum Bulb of the The patient with bulimia nervosa urethra. A bulbous swelling of the cor- should be referred for counseling, cog- pus spongiosum penis at the base of the nitive behavioral therapy, or psycho- penis. therapy with emphasis placed on ways b. vestibuli Either of two oval masses to break the binge/purge cycle and to re- of erectile tissue lying beneath the ves- gain control over eating behaviors. The tibule and resting on the urogenital di- patient and family must recognize and aphragm. In the female they are homol- understand the need for inpatient or ogous to the bulbus spongiosum of the outpatient therapy, including behavior penis. modification, cognitive behavioral ther- bulimia (bu¯-lı˘mЈe¯-a˘) [Gr. boulimia, rav- ϩ apy, structured group therapy, and fam- enous hunger, fm. bous, ox limos, ily therapy. If antidepressants are used hunger] Excessive and insatiable ap- as adjunctive therapy, the dosing sched- petite. bulimic (−ı˘k), adj. ule and desired and adverse effects are b. nervosa A disorder marked by re- explained. current episodes of binge eating fol- bulk 1. In nutrition, a substance that ab- lowed by feelings of humiliation, guilt sorbs water in the intestinal tract. The and shame and self-deprecation, and re- increased mass helps to stimulate peri- sulting in self-induced vomiting and di- stalsis. Bulk materials include bran ce- arrhea, excessive exercise, strict dieting reals, cellulose, lignins, and psyllium. or fasting to reverse the effects of bing- They are used therapeutically to treat ing, and an exaggerated concern about constipation and other bowel disorders. body shape and weight. These behaviors 2. A mass; a large volume of cells, such must be present at least twice a week as might be found in a tumor. for 3 months to establish this diagnosis. bulla (bu˘lЈla˘) pl. bullae [L., a bubble] A SEE: anorexia nervosa. large blister or skin vesicle filled with PATIENT CARE: Early recognition fluid; a bleb. SEE: illus.; pompholyx. and intervention may sometimes pre- b. ethmoidalis A rounded, thin- short vent this eating disorder from increas- walled, bony projection into the middle standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bulla 328 Burch procedure base of rh

widened QS complexin lead V 1 (0.12 sec.). right b.b.b. ABBR: RBBB. Defect in the conductive system of the heart in which electrical conduction down the right bundle branch is delayed. On the 12-lead EKG, it gives the widened QRS complexan RSR appearance in leads V 1 and V2. bundling (bu˘nЈdlı¯ng) A mandatory sys- tem of drug distribution involving mon- itoring and reporting side effects to the U.S. Food and Drug Administration. bung (bu˘ng) [ME. bunge, stopper] A stopper or diaphragm that covers a vial and prevents fluids from escaping. bunion (bu˘nЈyu˘n) Inflammation and thickening of the first metatarsal joint of the great toe, usually associated with marked enlargement of the joint and lateral displacement of the toe. ETIOLOGY: Bunions may be caused BULLAE OF IMPETIGO by heredity, degenerative bone or joint diseases such as arthritis, but most of- meatus of the nose underneath the mid- ten are produced by tight-fitting shoes dle turbinate bone, formed by an ante- and high heels that force toes together rior ethmoid sinus. and displace weight onto the forefoot. b. ossea The dilated portion of the Bunnell block (bu˘nЈne˘l) An orthotic de- bony external meatus of the ear. vice used after surgical repair of flexor bullous (bu˘lЈu˘s) [L. bulla, bubble] Like tendon hand injuries. It prevents flexion a blister or vesicle. at joints proximal to the one being ex- bully A person who uses physical or psy- ercised during the rehabilitation regi- chological means or force to get his or men. her way, esp. by intimidating or hurting Bunsen burner (bu˘nЈse˘n) [Robert W. E. others who may be smaller or weaker. von Bunsen, Ger. chemist, 1811–1899] BUN Blood urea nitrogen. A gas burner used primarily in labora- bundle (bu˘nЈde˘l) A group of fibers. SYN: tories, in which gas and air are mixed fasciculus; fasciola. in variable concentrations to facilitate Arnold’s b. The frontopontile tract. combustion. It passes from the cerebral cortexof the Bunyaviridae (bu˘nЉya˘-vı˘rЈı˘-de¯) A family frontal lobe through the internal cap- of RNA viruses that are transmitted to sule and cerebral peduncle to the pons. people by insect bite and may cause fe- atrioventricular b. A bundle of fibers vers, rashes, central nervous system in- of the impulse-conducting system of the fections, and widespread bleeding. heart. From its origin in the atrioven- buphthalmia, buphthalmos (bu¯f- tricular node, it enters the interventric- tha˘lЈme¯-a˘, −mo¯s) [Gr. bous, ox, ϩ oph- ular septum, where it divides into two thalmos, eye] Enlargement of the eye, branches whose fibers pass to the right usually, but not exclusively, as a result and left ventricles respectively, the fi- of pediatric glaucoma. bers of each trunk becoming continuous bupropion (bu¯-pro˘pЈe¯-o˘n) An antide- with the Purkinje fibers of the ventri- pressant medication that is also mod- cles. SYN: A-V bundle. SEE: heart block. erately effective in aiding smoking ces- A-V b. Atrioventricular b. sation, esp. when used along with b. of His SEE: under His, Wilhelm Jr. cognitive and behavioral therapies. b. of Kent Kent’s bundles. bur, burr (bu˘r) A rotating tool that is bundle branch block ABBR: BBB. De- used to cut tissue, e.g. to shave fatty de- fect in the heart’s electrical conduction system in which there is failure of con- posits from arteries or to cut or abrade duction down one of the main branches tooth structure, bone, and other dental of the bundle of His. On the surface elec- materials. trocardiogram, the QRS complexis Burch procedure, Burch colposuspension Ͼ0.12 sec. and its shape is altered. SYN: (bu˘rch) Surgery in which a sling is su- bundle branch heart block; interventric- tured around the urethra and neck of ular heart block. the bladder to the iliopectineal liga- left b.b.b. ABBR: LBBB. Defect in ment. It is used to alleviate stress uri- the conduction system of the heart in nary incontinence in women. which electrical conduction down the PATIENT CARE: Vital signs, supra- left bundle branch is delayed. On the 12- pubic catheter, and wound drainage are short lead EKG, it gives the QRS complexa checked. The patient is helped to void as standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh buret 329 burn base of rh

needed. Fluid intake and output is mea- without scar formation. A common ex- sured and recorded. ample is sunburn. buret, burette (bu¯-re˘tЈ) [Fr.] 1. A spe- Second degree A burn that damages cial hollow glass tube usually with a partial thickness of the epidermal and stopcock at the lower end. It is used in some dermal tissues but does not dam- chemical analysis to measure the age the lower-lying hair follicles, sweat, amount of liquid reagent used. 2. A cal- or sebaceous glands. The burn is painful ibrated chamber used to ensure accu- and red; blisters form, and wounds may rate measurement of small amounts of heal with a scar. intravenous fluid and to prevent fluid Third degree A burn that extends infusion overload. The chamber is usu- through the full thickness of the skin ally connected to a larger container of and subcutaneous tissues beneath the fluid. SYN: volume controller. dermis. The burn leaves skin with a Burkholderia (be˘rkЉho¯l-da¯rЈe¯-a˘) [NL.] A pale, brown, gray, or blackened appear- genus of aerobic gram-negative rod- ance. The burn is painless because it de- shaped bacteria (family Pseudomona- stroys nerves in the skin. Scar forma- daceae) that includes some species that tion and contractures are likely are significant animal and plant patho- complications. SEE: illus. gens and many other species that are Fourth degree A burn that extends environmentally active in biodegrada- through the full thickness of the skin tion. and into underlying bone, fat, muscles, B. cepacia A species that causes and tendons. Third- and fourth-degree nosocomial infections, esp. in intensive burns are best managed at specialized care units. Most susceptible are pa- burn centers. tients on mechanical ventilation and COMPLICATIONS: Sloughing of skin, those with cystic fibrosis or chronic gangrene, scarring, erysipelas, nephri- granulomatous disease. It is resistant to tis, pneumonia, immune system impair- aminoglycosides and many cephalospo- ment, or intestinal disturbances are rin antibiotics. possible complications. Shock and infec- B. gladioli A species of multiply tion must always be anticipated with drug-resistant bacteria that may cause higher-degree or larger burns. The risk ocular infections, pneumonia (esp. in of complication is greatest when more patients with cystic fibrosis), skin ab- than 25% of the body surface is burned. scesses, and other infections. ETIOLOGY: Burns may result from B. mallei A species that causes glan- ultraviolet radiation, bursts of steam, ders and farcy. It has been used as a bio- heated liquids and metals, chemical logical weapon. It was formerly called fires, electrocution, or direct contact Pseudomonas mallei. with flame or flammable clothing. B. pseudomallei A species that PRECAUTIONS: A person in burning causes meliodosis. clothing should never be allowed to run. Burkitt’s lymphoma (bu˘rЈkı˘ts) [Denis P. The individual should lie down and roll. Burkitt, Ugandan physician, 1911– A rug, blanket, or anything within reach 1993] A rapidly growing, B-cell, non- can be used to smother the flames. Care Hodgkin’s lymphoma. It is rare in the must be taken so that the individual U.S. but common in equatorial Africa, does not inhale the smoke. The clothing where it often afflicts children aged 5 to should be cut off carefully so that the 10 years. There is a strong association of skin is not pulled away. Synthetic fab- this malignancy with Epstein-Barr virus. rics that have melted into the burn burn [AS. baernan, to burn] Tissue in- wound are best removed later in the jury resulting from excessive exposure emergency department or burn center. to thermal, chemical, electrical, or ra- Jewelry should be removed even if not dioactive agents. The effects may be lo- near the burn wounds due to concerns cal, resulting in cell injury or death, or for fluid shifts and swelling. Blisters both local and systemic, involving pri- should not be opened, as this increases mary shock (which occurs immediately the chance for infection. Patients with after the injury and is rarely fatal) or large burn areas or third- and fourth- secondary shock (which develops insid- degree burns must receive appropriate iously following severe burns and is of- tetanus prophylaxis. ten fatal). In the U.S. about 1.25 million NOTE: In severe, widespread burns, persons receive medical care for burns the patient must be transferred to a annually. More than 50,000 of these burn center as soon as is practical. burn victims are hospitalized as a result TREATMENT: The first responsibility of severe burn injury. Burns are usually in the care of the burn patient is to as- classified as: sess the patency of the airway and to en- First degree A superficial burn in sure that breathing is unimpaired. If which damage is limited to the outer smoke inhalation or airway injury is layer of the epidermis and is marked by suspected, intubation should be per- redness, tenderness, and mild pain. formed before edema makes this impos- short Blisters do not form, and the burn heals sible. Airway injury is most likely to occur standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh burn 330 burn base of rh

NORMAL SKIN

STRATUM CORNEUM STRATUM GERMINATIVUM

ARTERIOLE IN DERMIS

FIRST-DEGREE BURN

SLIGHT INFLAMMATION

SLIGHT VASODILATION SECOND-DEGREE BURN

INFLAMMATION

BLISTER

TISSUE DESTROYED IN ALL SKIN LAYERS

THIRD-DEGREE BURN

BURNS

after facial burns or smoke inhalation in pressor support for hypotension, or nu- closed spaces. A cough productive of soot tritional support may be needed. or charred material increases the likeli- Patients with large or complexburn hood of inhalational injury. injuries should be transferred to re- The second task in burn care is to en- gional burn centers or to the care of sur- sure cardiac output and tissue perfu- geons with special interest in burn man- sion. Volume resuscitation with crystal- agement. loid is given per standard protocols; at PATIENT CARE: During rehabilita- the same time, urinary output, blood tion, individually fitted elastic gar- pressure and pulse, body weights, and ments are applied to prevent hyper- renal function are closely monitored to trophic scar formation, and joints are ensure adequate hydration. exercised to promote a full range of mo- The immediate care of the burn itself tion. The patient is encouraged to in- involves the removal of any overlying crease activity tolerance, obtain ade- clothing and jewelry and the irrigation quate rest, strive for physical and of the affected tissues with cool water, emotional independence, and resume taking care to avoid excessively cooling vocational and social functioning. Refer- the body. To help prevent hypothermia rals for occupational therapy, psycho- and infection, cover the burn wounds logical counseling, support groups, or with sterile dressings if available, or a social services are often necessary. Re- clean sheet, separating burn wound sur- constructive and cosmetic surgery may faces. Gentle tissue de´bridement should be required. Support groups and ser- be followed by application of nonadher- vices are available to assist the patient ent dressings, skin substitutes, topical with life adjustments. antiseptics, or autografts, as dictated by Patients’ previous psychological circumstances. Tetanus prophylaxis is states may predispose them to injury routinely given, usually with both teta- and may have an adverse effect on re- nus toxoid and tetanus immune globulin. covery. Patients with burn injuries In specific circumstances, additional demonstrate a wide range of emotional interventions such as hyperbaric oxy- responses including anger, frustration, gen therapy for carbon monoxide intox- irritability, and psychological states ication, escharotomy for circumferential (delirium, anxiety, depression, and short burns, antibiotic therapy for infections, grief). Posttraumatic stress disorder standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh burn 331 burn base of rh

(PTSD) may occur after a burn injury. nols, pesticides, disinfectants, fertiliz- Often, the PTSD patient will need help ers, or chemical warfare agents. from primary or specialized care pro- TREATMENT: Irrigate with large viders to recover psychologically. Ex- quantities of water. plain patient needs and care concerns to electric b. Tissue destruction caused family to help alleviate their cares and by the passage of electrical current concerns (and varied psychological re- through the body, usually as a result of sponses). Involve them with you in pa- industrial accidents or lightning expo- tient care as permissible. Family mem- sures. Entry and exit wounds are usu- bers should be encouraged to sit with ally present; significant internal organ the patient, and to touch, speak to, read damage may be found along the path of to, and otherwise communicate with the the current through the body. patient. Providing patients with a sense b. of eye A burn of the eyeball due to of purpose will help to alleviate feelings contact with chemical, thermal, electri- of helplessness and will provide both pa- cal, or radioactive agents. tient and family with more comfortable EMERGENCY CARE: The eye should and comforting memories. SEE: Nurs- be washed immediately with the near- ing Diagnoses Appendix. est available supply of water, even if it acid b. A burn caused by exposure to is not sterile. Irrigation may need to be corrosive acids such as sulfuric, hydro- continued for hours if burn is due to lye. chloric, and nitric. Care must be taken to prevent runoff EMERGENCY CARE: The burn area from draining into the uninjured eye. should be washed with large volumes of fireworks b. Injury from explosives; water. For further details of definitive usually a burn, often with embedded treatment, see under sulfuric acid poi- foreign bodies and a high incidence of soning. infection and tetanus, which should be actinic b. Burns caused by ultravio- prevented by meticulous care of injury let or sun rays. Treatment is the same and use of antitetanus toxoid and im- as for dry heat burns. mune globulin. b. of aerodigestive tract Necrosis of flash b. A burn resulting from an ex- the oral mucosa, trachea, or esophagus plosive blast such as occurs from igni- due to the ingestion of caustic substances. tion of highly inflammable fluids, or in After an assessment of the patient’s air- war from a high-explosive shell or a nu- way, breathing, and circulation, the med- clear blast. ical team determines the severity of the gunpowder b. A burn resulting from exposure by physical examination or lar- exploding gunpowder, usually at very yngoscopy. Some patients may require close range. It is often followed by teta- hospitalization for local care and the ad- nus, which should be prevented by ad- ministration of intravenous steroids, his- ministration of antitetanus toxoid and tamine antagonists, and antibiotics. Late immune globulin and meticulous care of complications may include strictures of the injury area. the affected internal organs. inhalation b. Inhalation injury. alkali b. A burn caused by caustic al- radiation b. A burn resulting from kalies such as lye, caustic potash (po- overexposure to radiant energy as from tassium hydroxide), and caustic soda x-rays, radium or other radioactive ele- (sodium hydroxide), and marked by a ments, sunlight, or nuclear blast. painful skin lesion, often associated respiratory b. A burn to the compo- with gelatinization of tissue. nents of the respiratory system usually EMERGENCY CARE: The burn is ir- caused by inhaling superheated gases. rigated with large volumes of water and SEE: inhalation injury. dressed. thermal b. A burn resulting from contact with fire, hot objects, or fluids. SEE: illus. Be careful to brush dry powder off the skin before applying water, as some chemicals, such as lye, react with water.

brush b. A combined burn and ab- rasion resulting from friction. TREATMENT: Loose dirt is carefully brushed away and the area is cleansed with soap and water. An antiseptic so- lution or ointment is applied and cov- ered with a dressing. Tetanus toxoid or antitoxin is given if required. chemical b. Tissue destruction caused by corrosive or irritating chemi- BLISTERED PARTIAL THICKNESS short cals such as strong acids or bases, phe- THERMAL BURN standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh burn 332 bursectomy base of rh

x-ray b. SEE: radiation burn. wax b. Removal of an invested wax burn center A hospital-based health care pattern from a mold by heating, thereby facility staffed with specialists essential creating the mold space for casting to the comprehensive care of burn pa- metal. tients. Burow’s solution (booЈro¯z) [Karl August burner (bu˘rnЈe¯r) Trauma to the brachial von Burow, Ger. surgeon, 1809–1874] plexus, marked by a fiery sensation in A dilute solution of aluminum acetate; the neck that radiates down the arm, used in dermatology as a drying agent esp. when the neck is deviated from the for weeping skin lesions. involved side and the contralateral burp 1. To belch. 2. To hold a baby shoulder is depressed. This condition, against the chest and pat it on the back which is esp. prevalent in contact to induce belching. sports, causes the cervical nerve root to BURP maneuver The application of back- become compressed between two verte- ward, upward, and rightward pressure brae. Weakness and numbness follow to the larynxas part of an effort to fa- the burning sensation but are usually cilitate endotracheal intubation, e.g., transient. Repeated brachial plexus during advanced cardiac life support. trauma can result in permanent neu- burr SEE: bur. ropathy. SYN: stinger. burrow (bu˘rЈro¯) A tunnel made in or un- der the skin (e.g., by an insect or a para- site). SEE: cutaneous larva migrans; The presence of a vertebral fracture scabies. should be ruled out (e.g., with x- burrowing (bu˘rЈo¯-ı˘ng) The formation of rays) before testing for brachial plexus a subcutaneous tunnel made by a para- trauma. site or of a fistula or sinus containing pus. Burnett’s syndrome [Charles Hoyt Bur- bursa (bu˘rЈsa˘) pl. bursae [Gr., a leather nett, U.S. physician, 1913–1967] Milk- sack] 1. A padlike sac or cavity found alkali syndrome. in connective tissue usually in the vicin- burning foot syndrome A painful sensa- ity of joints. It is lined with synovial tion in the sole of the foot, usually membrane and contains a fluid (syno- caused by a peripheral neuropathy or via) that reduces friction between ten- myopathy. It occurs in certain vitamin don and bone, tendon and ligament, or deficiencies and in patients with chronic between other structures where friction renal failure, due to build-up of uremic is likely to occur. 2. A blind sac or cavity. waste products. SYN: Grierson-Gopalan Achilles b. A bursa located between syndrome. the Achilles tendon and the calcaneus. burning mouth syndrome A burning adventitious b. A bursa not usually sensation in one or several parts of the present but developing in response to mouth. It occurs in older adults and is friction or pressure. generally related to menopausal or psy- calcaneal b. The bursa between the chological factors. Identified causes are Achilles tendon and the heel bone. denture irritation, yeast infection, de- Calori’s b. SEE: Calori’s bursa. creased salivary production, systemic olecranon b. A bursa at the elbow factors such as nutritional and estrogen joint lying between the olecranon pro- deficiencies, and sensory neuropathies. cess and the skin. It is also called oral dysesthesia. Treat- omental b. The lesser peritoneal cav- ment consists of therapy for the causa- ity; the cavity of the great omentum. It tive condition. SYN: burning tongue; communicates with the greater or true glossopyrosis. peritoneal cavity via the vestibule and burnish (be˘rЈnı˘sh) To condense or polish epiploic foramen. a metal surface with a smooth metal in- patellar b. Formed by several bursae strument. located in the region of the patella; in- burnisher (be˘rЈnı˘sh-e˘r) An instrument cludes the suprapatellar, infrapatellar, with a blade or nib for smoothing the and prepatellar bursae. Some commu- margins of a dental restoration. nicate with the cavity of the knee joint. burnout (bu˘rnЈowt) 1. Rendering unser- pharyngeal b. A small, median, blind viceable by excessive heat. 2. Exhaus- sac found in the lower portion of the tion due to chronic job stress. It is char- pharyngeal tonsil. acterized by physical and emotional retrohyoid b. A bursa anterior to the fatigue and sometimes physical illness. thyrohyoid membrane. It was formerly Frustration from a perceived inability called Boyer’s bursa. to end the stresses and problems asso- subacromial b. The large bursa lying ciated with powerlessness in one’s job between the acromion and the coraco- contribute to loss of concern for patients acromial ligament above and the inser- or good job performance. Health care tion of the supraspinatus muscle below. professionals are esp. prone to burnout, It is also known as the subdeltoid bursa. particularly those working in highly bursal (bu˘rЈsa˘l) Pert. to a bursa. short stressful conditions. bursectomy (bu˘r-se˘kЈto¯-me¯) [Gr. bursa, standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bursitis 333 Byler’s disease base of rh

a leather sack, ϩ ektome, excision] Buschke’s scleredema (booshЈke˘z, ke¯z) Excision of a bursa. [Abraham Buschke, Ger. dermatologist, bursitis (bu˘r-sı¯Јtı˘s) [Љϩitis, inflam- 1868–1943] Generalized nonpitting mation] Inflammation of a bursa, esp. edema that begins on the head or neck between bony prominences and muscle and spreads to the body. This lasts a or tendon, as in the shoulder and knee. year or less and leaves no sequelae. The It is typically caused by repeated cause is unknown. SYN: scleredema ad- stresses placed on a joint during work ultorum. Ј or play, but sometimes results from sud- butane (bu¯ ta¯n) C4H10; a gaseous, in- den trauma, from inflammatory joint flammable hydrocarbon derived from disease, or bacterial invasion of the joint petroleum. (“septic bursitis”). Common forms in- butt [ME. butte, end] To join the ends of clude rotator cuff, miner’s or tennis el- two objects together. bow, and prepatellar bursitis. Fluid ac- butterbur (bu˘tЈe˘r-bu˘ r) An herb, Petasites cumulation in the bursa results in hybridus, from which an herbal remedy irritation, inflammation, and sudden or is made for treatment of migraine head- gradual pain, as well as symptoms such ache and allergic rhinitis. as impaired joint movement. SEE: butterfly (bu˘tЈe˘r-flı¯Љ) An adhesive band- Nursing Diagnoses Appendix. age used in place of sutures to hold TREATMENT: Therapy includes rest wound edges together. and immobilization of the affected part buttermilk (bu˘tЈe˘r-mı˘lkЉ) The liquid left during the acute stage. Active mobili- after the separation of butter from milk zation as soon as acute symptoms sub- or cream. It contains 2% fat. Cultured side will help to reduce the likelihood of buttermilk is made by adding strepto- adhesions. Nonsteroidal anti-inflam- cocci to milk to give it a sour flavor. matory drugs, analgesics, local applica- buttocks (bu˘tЈu˘ks) [AS. buttuc, end] tion of cold then heat, and diathermy The external prominences posterior to are helpful. Fluid removal (aspiration of the hips; formed by the gluteal muscles the bursa) and injection of local anes- and underlying structures. SYN: nates. thetics and cortisone into bursae may be button (bu˘tЈn) An anatomical or patho- required to reduce inflammation and re- logical structure that resembles a but- lieve pain. In chronic bursitis, surgery ton. may be necessary. buttonhole (bu˘tЈo˘n-ho¯lЉ) An incision PATIENT CARE: Rest is prescribed, (sometimes inadvertent) into the wall of and movement of the affected part is re- a cavity or membrane. This term may be stricted during the acute phase if pain applied to surgical procedures on hollow and limited range of joint motion are organ systems such as the gastrointes- present. If pain and loss of function are tinal, urinary tract, and cardiovascular severe and do not improve with rest, the systems and to some of myocutaneous patient is referred for medical evalua- grafts. tion; physical therapy may also be butylene (bu¯ Јtı˘-le¯n) A hydrocarbon gas, needed to maintain joint mobility and C4H8. prevent neighboring muscle atrophy. butyraceous (bu¯ Љtı˘-ra¯Јshu˘s) [L. bu- anserine b. Inflammation of the sar- tyrum, butter] Containing or resem- torius bursa located over the medial bling butter. side of the tibia just below the knee. butyrate (bu¯ Јtı˘-ra¯t) A salt of butyric bursolith (bu˘rЈso¯-lı˘th) [Љϩlithos, acid. stone] A calculus formed in a bursa. butyrin (bu¯ Јtı˘r-ı˘n) A soft, yellow semiliq- bursopathy (bu˘r-so˘pЈa˘-the¯) [Љϩpa- uid fat that is present in butter. thos, disease, suffering] Any patholog- butyroid (bu¯ Јtı˘-royd) [ЉϩGr. eidos, ical condition of a bursa. form, shape] Having the appearance or bursotomy (bu˘r-so˘tЈo¯-me¯) [Љϩtome, consistency of butter. incision] Incision of a bursa. butyrometer (bu¯ Љtı˘-ro˘mЈe˘-te˘r) [ЉϩGr. Burton’s line (bu˘rЈto˘ns) [Henry Burton, metron, measure] A device for estimat- Brit. physician, 1799–1849] A blue line ing the amount of butterfat in milk. along the margin of the gingiva visible butyrophenone (bu¯ Љtı˘-ro¯-fe¯Јno¯n) A class in chronic lead poisoning. of drugs, some of which are used to treat Buruli ulcer (bu˘-roolЈe¯) [Fm. the Buruli psychoses, acute agitation, Tourette’s (now Nakasongola) District in Uganda] syndrome, and other disorders. Tardive An infection of the skin and underlying dyskinesia may be a side effect of pro- tissues with Mycobacterium ulcerans. longed use. The infection, which is common in trop- BV Bacterial vaginosis. ical and subtropical nations, develops B virus Cercopithecine herpesvirus 1 slowly from a painless or minimally Byler’s disease (bı¯Јle˘rz) An inherited painful nodule on the skin into under- disorder with a defect on chromosome lying bone, which it gradually destroys. 18 in which infants develop cholestatic The spread of the disease may be pre- jaundice and eventually cirrhosis. A high vented with bacille Calmette-Gue´rin incidence of retinitis pigmentosa is asso- short (BCG) vaccine. ciated with this disease, and mental re- standard #49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FADavis

top of rh bypass 334 byssinosis base of rh

tardation is frequently seen in affected ECGs are routine aspects of care. The children. Death from liver disease occurs surgical wound is checked for bleeding by adolescence. SYN: progressive familial or hematoma formation, or signs of in- intrahepatic cholestasis. fection or dehiscence. Peripheral pulses bypass (bı¯Љpa˘sЉ) A means of circumven- are palpated using a doppler, if neces- tion; a shunt. It is used surgically to in- sary, to determine peripheral perfusion. stall an alternate route for the blood to gastric b. Any surgical procedure in flow past an obstruction if a main or vi- which the stomach, or most of the stom- tal artery such as the abdominal aorta ach, is isolated and disconnected from or a coronary artery becomes ob- the rest of the upper gastrointestinal structed. The various procedures are tract. SEE: Roux-en-y gastric bypass. named according to the arteries in- jejunoileal b. A surgical procedure volved (e.g., coronary artery, aortoiliac, for decreasing absorption of nutrients or femoropopliteal bypasses). The cir- from the small intestine by anastomos- culation of the heart may be bypassed ing the proximal jejunum to the distal by providing an extracorporeal device to ileum. Although it can be used to treat pump blood while a surgical procedure obesity, jejunoileal bypass has been re- is being done on the coronary arteries or placed by gastric bypass procedures be- cardiac valves. SEE: illus. cause of the significant complications of aortocoronary b. Coronary artery jejunoileal bypass surgery. bypass surgery. byssinosis (bı˘sЉı˘-no¯Јsı˘s) [Gr. byssos, cot- extra-anatomic vascular b. Surgical ton, ϩ osis, condition] Reactive air- revascularization for peripheral vascu- ways disease of cotton, flax, and hemp lar disease of the limbs, using a pros- workers. Byssinosis is caused by the in- thetic graft (e.g., axillofemorally or fe- halation of dust and foreign materials, morofemorally) to divert blood to a site including bacteria, mold, and fungi. The distal to an arterial obstruction. disease does not occur in textile workers PATIENT CARE: Postoperatively, it is who work with cotton after it is bleached. important to monitor the patient’s vital It is marked by symptomatic wheezing signs for changes, esp. of pulse and and tightness in the chest. Symptoms rhythm, and to assess the patient for are usually more pronounced at the be- symptoms of angina pectoris or arrhyth- ginning of each work week than later mias. Cardiac monitoring and frequent on. SEE: pneumonoconiosis.

LEFT SUBCLAVIAN ARTERY OFF AORTIC ARCH VEIN IS REMOVED INTERNAL MAMMARY FROM LEG AND ARTERY TRANSPORTED TO HEART

LEFT MAIN CORONARY EXPOSED ARTERY SAPHENOUS VEIN

BYPASS GRAFTS

MARGINAL BRANCH OF CIRCUMFLEX ARTERY

LEFT ANTERIOR DESCENDING RIGHT ANTERIOR CORONARY CORONARY ARTERY ARTERY CORONARY ARTERY BYPASS Anterior view of heart with sites of saphenous vein bypass grafts short standard