Chapter 1 Key terms. Medical terminology: A living language. Fourth edition.

Question 0

ambulatory care center
“aka”
surgical center or outpatient clinic

Answer 0

ambulatory care center

A facility that provides services that do not require overnight hospitalization. The services range from simple surgeries, to diagnostic testing, to therapy.

Also called Surgical center or outpatient clinic.

Question 1

acute care hospital
“aka”
general hospital.

Answer 1

acute care hospital

Hospitals that typically provide services to diagnose (laboratory, diagnostic imaging) and treat (surgery, medications, therapy) diseases for a short period of time. In addition, they usually provide emergency and obstetrical care.

Also called general hospital.

Question 2

ancillary report

Answer 2

ancillary report

Reports in a patient’s medical record from various treatments and therapies the patient has received, such as rehabilitation, social services, respitory therapy, or from the dietician.

Question 3

anesthesiologist’s report

Answer 3

anesthesiologist’s report

A medical record document that related the details regarding the drugs given to a patient and the patient’s response to anesthesia and vital signs during surgery.

Question 4

combining form

Answer 4

combining form

The word root plus the combining vowel. It is always written with a / between the word root and the combining vowel. For example, in the combining form cardi/o, cardi is the word root an /o is the combining vowel.

Question 5

combining vowel

Answer 5

combining vowel

A vowel inserted between word parts that makes it possible to pronounce long medical terms. It is usually the vowel o.

Question 6

consultation report

Answer 6

consultation report

Documents in a patients’s medical record. They are the reports given by specialists who the physician has requested to evaluate the patient.

Question 7

diagnostic reports

Answer 7

diagnostic reports

Found in a patients medical record. It consist of the results of all diagnostic tests performed on the patient, principally from the lab and medical imaging (for example, X-ray and ultrasound).

Question 8

discharge summary

Answer 8

discharge summary

Parts of a patient’s medical record. It is a comprehensive outline of the patient’s entire hospital stay. It includes condition at time of admission, admitting diagnosis, test results, treatments and patient’s response, final diagnosis, and follow-up plans.

Question 9

general hospital
“aka”
acute care hospital

Answer 9

general hospital

Hospitals that typically provide services to diagnose (laboratory, diagnostic imaging) and treat (surgery, medications, therapy) diseases for a short period of time, In addition, they usually provide emergency and obstetrical care.

Also called an acute care hospital.

Question 10

heath maintenance organization (HMO)

Answer 10

heath maintenance organization (HMO)

An organization that contracts with a group of physicians and other health care workers to provide care exclusively for its members. The HMO pays the health care workers a prepaid fixed amount per member whether that member requires medical attention or not.

Question 11

History and physical

Answer 11

History and physical

Medical record document written by the admitting physician’s. It details the patients history, results of the physician’s examination, initial diagnoses, and physician’s plan of treatment.

Question 12

home healthcare

Answer 12

home healthcare

Agencies that provide nursing, therapy, personal care, or housekeeping services in the patient’s own home.

Question 13

hospice

Answer 13

hospice

An organized group of heath care workers that provide supportive treatment to dying patients and their families.

Question 14

informed consent

Answer 14

informed consent

A medical record document, voluntarily signed by the patient or a responsible party, that clearly describes the purpose, methods, procedures, benefits, and risks of a diagnostic or treatment procedure.

Question 15

long-term care facilities
“aka”
nursing home

Answer 15

long-term care facilities

A facility that provides long-term care for patients who need extra time to recover from an illness or accident before they return home or for persons who can no longer care for the selves.

Also called a nursing home.

Question 16

medical record
“aka”
chart

Answer 16

medical record

Documents that details of a patient’s hospital stay. Each health care professional that has contact with the patient in any capacity completes the appropriate report of that contact and adds it to the medical chart. This results in a permanent physical record of the patients’s day to day condition, when and what services he or she receives, and the response to treatment.

Also called a chart.

Question 17

nurse’s notes

Answer 17

nurse’s notes

Medical record document that records the patients care throughout the day. It includes vital signs, treatment specifics, patient’s response to treatment, and patient’s condition.

Question 18

nursing homes
“aka”
long-term care facility

Answer 18

nursing homes

A facility that provides long-term care for patients who need extra time to recover from an illness or accident before they return home or for persons who can no longer care for the selves.

Also called a long-term care facility.

Question 19

operative report

Answer 19

operative report

A medical record from the surgeon detailing an operation, It includes a pre- and post-procedure itself, and how the patient tolerated the procedure.

Question 20

outpatient clinics
“aka”
ambulatory care center or a surgical center.

Answer 20

outpatient clinics

A facility that provides services that do not require overnight hospitalization. The service range from simple surgeries to diagnostic testing to therapy.

Also called an ambulatory care center or a surgical center.

Question 21

pathologist’s report

Answer 21

pathologist’s report

A medical record report given by a pathologist who studies tissue removed from the patient (for example: bone marrow, blood, or tissue biopsy).

Question 22

physicians’ office

Answer 22

physicians’ office

Individual or groups of physicians providing diagnostic and treatment services in a private office setting rather than a hospital.

Question 23

physician’s orders

Answer 23

physician’s orders

Medical record document that contains a complete list of the care, medications, tests, and treatments the physician orders for the patient

Question 24

physician’s progress notes

Answer 24

physician’s orders

Part of a patients’s medical record. It is the physician’s daily record of the patient’s condition results of the physician’s examinations, summary of test results updated assessment an diagnoses, and further plans for the patient’s care.

Question 25

prefix

Answer 25

prefix

A word part added in front of the word root. It frequently gives information about the location of the organ, the number of parts or the time (frequency). Not all medical terms have a prefix.

Question 26

rehabilitation center

Answer 26

rehabilitation center

Facilities that provide intensive physical and occupational therapy. They include inpatient and outpatient treatment.

Question 27

specialty care hospitals

Answer 27

specialty care hospitals

Hospitals that provide care for specific types of disease, A good example is a psychiatric hospital.

Question 28

suffix

Answer 28

suffix

A word part attached to the end of a word. It frequently indicates a condition, disease, or procedure. Almost all medical terms have a suffix.

Question 29

surgical center
“aka”
ambulatory care center or and outpatient clinic

Answer 29

surgical center

A facility that provides services that range form simple surgeries to diagnostic testing to therapy and do not require overnight hospitalization.

Also called and ambulatory care center or and outpatient clinic.

Question 30

word root

Answer 30

word root

The foundation of a medical term that provides the basic meaning of the word, In general, the word root will indicate the body system or part of the body that is being discussed . A word may have more than one word root.