Chapters 4 - 11 From Presentations Flashcards
1
Q
Upper respiratory tract
A
Nose Septum Pharynx (throat) Larynx (voice box) Trachea (windpipe)
2
Q
Lower respiratory tract
A
• Lungs ‒ Alveoli • Bronchi ‒ Bronchioles Diaphragm • Lungs extend from collarbone to diaphragm in thoracic cavity. • Muscular partition separating thoracic cavity from abdominal cavity.
3
Q
Nose
A
Air enters and leaves.
‒ Cilia sweep foreign material
toward throat for
elimination.
4
Q
Pharynx (throat)
A
Airway connection to larynx.
‒ Serves as passageway for air
from nose and food from
mouth.
5
Q
• Larynx (voice box)
A
Contains structures that
make vocal sounds possible.
‒ Connected to the trachea.
6
Q
Trachea (windpipe)
A
Branches in two tubes called
bronchi.
‒ Serves as passageway for air
to the bronchi.
7
Q
Lungs
A
Left lung has two lobes.
‒ Right lung has three lobes.
8
Q
Bronchi enter a lung and
subdivide into smaller
branches called
bronchioles
A
Bronchioles are the smallest
branches of the bronchi and
terminate at the alveoli.
9
Q
Alveoli
A
Air sacs of lungs provide breathing (ventilation).
10
Q
Diaphragm
A
Aids in the process of breathing.
‒ Contracts and descends with each inhalation
(inspiration).
11
Q
Respiration
A
• External, exchange of air at the lungs.
• Internal, exchange of gases at the cellular level
within organs of the body.
12
Q
Other functions, with help of cardiovascular
system
A
Provides oxygen to body cells.
• Eliminates the waste product carbon dioxide (C O2
)
13
Q
What is the main function of the respiratory
system?
A
Provides oxygen (O2
) and removes C O2
from body cells.
14
Q
2. Name the structures of the upper respiratory tract (U R T).
A
- Nose, pharynx, larynx, and trachea
15
Q
- What are the structures of the lower
respiratory tract ?
A
- Bronchi, bronchioles, alveoli, and lungs
16
Q
- Name the smaller branches of the bronchi.
A
- Bronchioles
17
Q
What are the tiny air sacs in the lungs
called?
A
Alveoli (alveolus, singular)
18
Q
What do abbreviations O2
and C O2
mean?
A
O2
means oxygen; C O2
means carbon
dioxide.
19
Q
What other body system helps the respiratory system transport O2 and remove C O2 from body cells?
A
Cardiovascular system helps transport O2
and remove C O2
from body cells.
20
Q
Define Combining Forms
nas/o, rhin/o:
A
nose
21
Q
Define Combining Forms
tonsill/o:
A
tonsils
22
Q
Define Combining Forms
adenoid/o:
A
adenoid
23
Q
Define Combining Forms
pharyng/o:
A
pharynx (throat)
24
Q
Define Combining Forms
laryng/o:
A
larynx
25
Define Combining Forms
| trache/o:
trachea
26
Define Combining Forms
| pneum/o, pneumon/o:
air, lung
27
Define Combining Forms
| pulmon/o:
lung
28
# Define Combining Forms
bronch/o, bronchi/o:
10. bronchiol/o:
11. thorac/o:
12. phren/o:
bronchus (plural, bronchi)
10. bronchioles
11. chest
12. diaphragm
29
# Define Suffixes
- ectasis:
14. -osmia:
15. -pnea:
dilation, expansion
14. smell
15. breathing
30
The plural form of alveolus is ________.
2. The plural form of bronchus is _______.
3. The plural form of pleura is __________.
alveoli
2. bronchi
3. pleurae
31
Build Medical Words
1. inflammation of the bronchi: /
2. paralysis of the larynx (voice box): /o/
3. visual examination of the bronchi: /o/
4. incision of the trachea: /o/
1. bronch/itis
2. laryng/o/plegia
3. bronch/o/scopy
4. trache/o/tomy
32
Build Medical Words
5. instrument for examining the larynx:
/o/
6. disease of the chest: /o/
7. rapid breathing: tachy/
5. laryng/o/scope
6. thorac/o/pathy
7. tachy/pnea
33
Build Medical Words
8. excision of tonsils:
9. resembling mucus:
10. surgical repair of the nose:
11. specialist in (treatment of) lungs:
8. tonsill/ectomy
9. muc/oid
10. rhino/plasty
11. pulmon/o/logist
34
Build Medical Words
12. swallowing air:
13. without (absence of) breathing:
14. creation of an opening (mouth) in the
trachea (windpipe):
15. excision of the larynx (voice box):
12. aer/o/phagia
13. a/pnea
14. trache/o/stomy
15. laryng/ectomy
35
Sleep Apnea
| Signs and Symptoms
Potentially life-threatening condition.
• During normal nocturnal sleep, person’s breathing
ceases, followed by snorting and gasping.
Occurs more often in men than in women.
• Associated with obesity, hypertension, or an
airway-obstructive condition.
• Can be categorized as obstructive or central.
‒ Most common is obstructive sleep apnea in which air
is unable to flow in or out of the upper airway.
‒ In central sleep apnea, the brain does not send proper
signals to the muscles that control breathing.
36
In obstructive sleep apnea
the person stops
breathing multiple times each night. Causes
include:
‒ airway obstruction resulting from a soft palate
‒ excess neck tissue
‒ tonsil enlargement
37
Sleep Apnea in premature infants
the immature central nervous
system (C N S) fails to maintain a consistent
respiratory rate, and there are long pauses
between regular breathing.
38
Sleep Apnea Treatment
Weight loss is encouraged.
• Tonsillectomy and adenoidectomy (T&A).
• Uvulopalatopharyngoplasty (U P P).
• C P A P apparatus or dental appliances to keep
airway open in adults; home apnea monitor for
infants.
39
1. Mrs. J. is diagnosed with sleep apnea and
asks the nurse to explain this disorder.
```
2. Patient X presents for an excision of
tonsils and adenoids as a treatment of
sleep apnea. The abbreviation for the
surgical procedure to remove tonsils and
adenoids is .
```
1. The nurse explains that it is a temporary loss
of breathing resulting in brief or prolonged
absence of spontaneous respiration.
2. T&A
40
Mary is prescribed a C P A P machine for sleep apnea. The respiratory therapist explains that this machine will help keep her airway open at night so that she can breathe normally. The medical term to breathe normally is .
Mr. M. presents with complaints of excessive snoring at night that awakens him and also results in him gasping for breath. The physician explains that he has a common condition that occurs in middleaged, obese men and that it causes temporary cessation of breathing. This condition is known as sleep (apnea, dyspnea, eupnea).
3. eupnea
| 4. apnea
41
Lung Cancer
| Signs and Symptoms
• Early-stage lung cancer usually produces no
symptoms and is difficult to detect.
• When symptoms appear, they may include
smoker’s cough, wheezing, chest pain, dyspnea,
and hemoptysis.
• Risk factors include chemical exposure or history
of smoking or exposure to second-hand smoke.
42
Lung Cancer Treatment
• Combination of surgery, radiation therapy, and
chemotherapy, depending on whether the
malignancy is localized or metastasized.
• Chest radiography, sputum cytology test, and
bronchoscopy with tissue biopsy are required for
definitive diagnosis.
43
```
Lung Cancer Surgery Treatment
A. Wedge resection:
B. Segmented resection:
C. Lobectomy:
D. Pneumonectomy:
```
A. Wedge resection: excision of a small portion of the lung along with healthy tissue that surrounds the lung.
B. Segmented resection: excision of a portion of a lobe of a lung; also called segmentectomy
C. Lobectomy: excision of one lobe of the lungs.
D. Pneumonectomy: excision of a lung or a portion of the lung.
44
eg. Types of Pneumonectomies.
wedge resection
segmental resection
lobectomy
pneumonectomy
45
1. Mr. O. works for a collision repair shop
and sprays paint on cars. He is also a two
pack/day smoker for 15 years. He is
concerned about his risk for lung cancer
and asks the nurse if it is preventable.
1. She explains that lung cancer is
preventable if one avoids smoking and
inhaling toxic substances.
46
A one pack/day smoker for the past 8
years is diagnosed with lung cancer. She
asks the doctor if her cancer will be cured
if she stops smoking.
The doctor explains that if smokers stop
smoking during early precancerous cellular
changes, damaged bronchial lining tissues
often return to normal.
47
The patient presents for visual examination
of his interior bronchi with biopsy analysis
to confirm a diagnosis of lung cancer. The
physician documents the visual
examination of the bronchi as a .
3. bronchoscopy
48
The patient is diagnosed with advanced
lung cancer and asks why it was not
detected last year during her annual
physical examination.
```
The nurse explains that early-stage lung
cancer usually produces no symptoms and
is difficult to detect. When symptoms
appear, cancer often has metastasized to
other areas of the body, such as the brain,
liver, and bone.
```
49
Upper Airway Obstruction
Signs and Symptoms
Treatment
• Symptoms vary, depending on the cause.
‒ Cyanosis of the skin
‒ Difficulty breathing, choking, confusion, panic,
unconsciousness
Treatment
• Depends on the cause of the blockage.
• Objects lodged in airway may be removed with a
laryngoscope or bronchoscope.
• A tube may be inserted into the airway (endotracheal tube or nasotracheal tube).
• Opening is made directly into the airway (tracheostomy), if needed
50
1. Doctor X is concerned that Mrs. T. has an airway blockage. The patient asks if there is a test to confirm a blockage.
2. John’s radiograph shows a small foreign object lodged in his larynx. The physician removes the object with an instrument called a .
1. The doctor states tests may include bronchoscopy, laryngoscopy, and radiography.
2. laryngoscope
51
3. A patient presents for an opening to be made into the trachea. This surgical procedure is documented in the medical record as a .
4. The anesthesiologist inserts a tube directly into the patient’s trachea so that the patient will be able to breathe while under general anesthesia. This tube is known as an .
3. tracheostomy
| 4. endotracheal tube
52
Pneumothorax
| Signs and Symptoms
• Increased air pressure on affected side causes a
mediastinal shift to the unaffected side.
• Collapse of a lung causes severe shortness of
breath, sudden sharp chest pain, falling blood
pressure, rapid weak pulse, and shallow and
weak respirations.
• Patient may be cyanotic and appears anxious.
53
Pneumothorax (continued_3)
| Treatment
* Patient is more comfortable in the Fowler or semi-Fowler position and may require oxygen.
* Thoracostomy is performed to withdraw air from the cavity.
* Closed drainage system is established if air continues to leak into the pleural space, to allow expansion and healing of the lung.
54
1. The physician instructs the nurse to place
the bedridden patient in the Fowler
position. What does the nurse do?
1. The nurse adjusts the bed so that the
patient is in the semi-sitting position. This
position is used to facilitate breathing and
drainage and for the comfort of the
bedridden patient while talking or eating.
55
2. Cyanosis indicates that tissues have a lack of (C O2
, O2 , glucose).
3. Patient is diagnosed with pneumothorax. The physician performs the procedure to withdraw air from the lung and
documents it as .
2. O2
| 3. thoracostomy
56
Bronchiectasis
| Signs and Symptoms
• Widening and destruction of the large airways or
bronchi, usually in the lower lung portions, as shown in the illustration.
• Symptoms develop gradually and include a chronic cough producing large amounts of foulsmelling sputum as the main symptom.
• Hemoptysis, dyspnea, wheezing, fever, and general malaise as the disease progresses.
• Patient may experience halitosis.
57
Bronchiectasis
| Treatment
• Control of infections and bronchial secretions
• Relieve airway obstruction
• Regular, daily drainage to remove bronchial
secretions
• Antibiotics, bronchodilators, mucolytics, and
expectorants may be prescribed
58
1. Mr. M. has poorly controlled asthma and difficulty breathing, especially during the past 4 months. Besides retaining mucus, his bronchial passages are infected. The
recurrent inflammation or infection of the airways has resulted in a condition known as (atelectasis, bronchiectasis, pleuroclysis).
1. bronchiectasis
59
2. Ms. J. is diagnosed with bronchiectasis,
which resulted from a chronic respiratory
condition known as cystic fibrosis. She has
difficulty coughing up bacterial secretions
and has now developed a lung (compliance,
infection, tumor).
2. infection
60
Pulmonary Embolism
| Signs and Symptoms
• Blood clot (embolism) lodges in and occludes an artery in the pulmonary vasculature (as shown in the illustration)
• Depend on the size and location of the embolus
• Symptoms do not appear until the embolism has lodged in an artery and interrupts blood flow.
• Patient with small uncomplicated embolism experiences a cough, chest pain, and a low-grade fever.
• Patient with a more extensive infarction experiences dyspnea, tachypnea (with respiratory rate of at least 20 breaths/min), chest
pain, and occasionally hemoptysis.
• Massive embolism leads to onset of cyanosis, shock, and death.
61
Pulmonary Embolism
| Treatment
* Goals are to prevent a potentially fatal episode and to maintain cardiopulmonary integrity and adequate ventilation and perfusion.
* O2 therapy and anticoagulants are administered to meet these goals.
* Thrombolytic drugs may be administered to dissolve a clot, especially when low blood pressure or cardiac arrest occurs.
62
1. Mr. P. presents to the emergency department (E D) and is diagnosed with a pulmonary embolism. His chief complaint
is that he spits up blood in his sputum. This condition is charted as (hemolysin, hemoptysis, hemolysis).
2. Mr. L. has undergone knee replacement. He is advised that a complication of this surgery is the development of blood clots
that may break loose and travel to the lungs. This is a serious condition known as pulmonary (aneurysm, edema, embolism).
1. hemoptysis
| 2. embolism
63
```
3. The pulmonologist prescribes thrombolytic drug therapy to treat Ms. C.’s pulmonary embolism. The doctor explains that these
drugs will (prevent, produce, dissolve) blood clots.
```
3. dissolve
64
Vocabulary Challenge Exercise
1. empyema:
2. emphysema:
3. epistaxis:
4. ischemia:
5. rhonchi:
6. tubercle:
1. pus in a body cavity, especially in the pleural cavity (pyothorax)
2. chronic disease characterized by overexpansion and destruction of alveoli; commonly associated with cigarette smoking
3. bleeding from the nose; also called nosebleed, nasal hemorrhage, or rhinorrhagia
4. inadequate supply of oxygenated blood to a body part resulting from interruption of blood flow
5. abnormal respiratory sound resembling snoring, caused by blockage in the larger airways
6. small lesions that appear in the lungs when a person is infected with tuberculosis (T B)
65
Diagnostic Procedures
| Bronchoscopy
```
• Tissue biopsy for cancer
detection of lungs
• Removal of obstruction
(tissue or other), or direct
observation for
pathological changes
```
66
Diagnostic Procedures
| Polysomnography
```
• Diagnoses sleep disorders.
• Records various aspects of
sleep, such as eye and
muscle movements,
respiration, and
electroencephalographic
patterns.
```
67
Diagnostic Procedures
| Spirometry
```
• Common lung function
test
• Measures capacity of lungs
and volume of air during
inhalation and expiration
```
68
Diagnostic Procedures
| Thoracentesis
• Removes fluid from pleural
space for diagnostic or
therapeutic purposes
69
Diagnostic Procedures
Arterial blood gas (A B G)
Pulmonary function tests (P F T's)
• Measures O2 and C O2 content of arterial blood
by various methods
• Measure the capacity of lungs and volume of air
during inhalation and exhalation
70
Build Medical Words
1. visual examination of bronchi:
2. surgical puncture of chest:
3. forming an opening (mouth) in the trachea:
1. bronchoscopy
2. thoracentesis or thoracocentesis
3. tracheostomy
71
Build Medical Words
4. visual examination of the larynx:
5. instrument for measuring breathing:
6. instrument for examining the larynx:
4. laryngoscopy
5. spirometer
6. laryngoscope
72
Medical and Surgical Procedures
Endotracheal intubation
• Tube placed through the mouth or nose into the trachea just above the bronchi
• Provides air to patients who are unable to breathe on their own because of respiratory failure, as well as to administer O2,
medication, or anesthetic
73
Medical and Surgical Procedures
Laryngectomy
• Excision of all or part of
| the larynx
74
Medical and Surgical Procedures
Lavage
Postural drainage
• Irrigation of paranasal sinuses to remove
mucopurulent material.
• Body is positioned so gravity helps remove
secretions from the lung or bronchi. Coughing
usually expels secretions from trachea.
75
Medical and Surgical Procedures
Tracheostomy
```
• Opening into trachea
with placement of
indwelling tube.
• Allows air to flow
into lungs.
• Aids in removal of
secretions (mucus) from
bronchial
tubes.
```
76
Medical and Surgical Procedures
Oxygen therapy
```
• O2
administration most
commonly via nasal
cannula
‒ O2
delivery through a flexible
catheter that has two short
nasal prongs.
```
77
1. Mr. J. has a history of smoking two packs/day for 30 years. He is diagnosed with throat cancer and presents to the hospital for excision of the larynx. What is this surgical procedure called?
2. Mr. M. has thick mucous secretions from a prolonged respiratory infection. His bed is positioned upright to 90 degrees so that he
can easily cough up mucus. This type of therapeutic drainage is known as postural .
1. laryngectomy
| 2. drainage
78
3. Mrs. S. presents to the E D with cyanosis caused by an bstructed airway. The physician incises the trachea to open it below the blockage and restore breathing. The physician documents the incision into the trachea as (tracheocentesis, tracheostenosis, tracheotomy)
4. Mrs. C. is diagnosed with emphysema and is prescribed O2
therapy during her hospital stay. The O2 will be delivered through a twoprong flexible catheter into the nose that is
known as a nasal .
3. tracheotomy
| 4. cannula
79
5. Mr. J. is in respiratory failure. The doctor inserts a tube through the mouth into the trachea, just above the bronchi, to administer O2 . This medical procedure is documented as (bronchial, pneumatic, endotracheal) intubation.
6. A patient diagnosed with chronic sinusitis is prescribed an irrigation of the paranasal sinuses to remove mucopurulent material. The physician documents the procedure as .
5. endotracheal
| 6. lavage
80
Pharmacology
Bronchodilators
Drugs that dilate
constricted airways
via a metered-dose
inhaler (M D I).
81
Pharmacology
| Corticosteroids
```
M D I's
Nebulized mist
treatments (N M T's)
• Administer medications
directly into lungs via a
nebulizer.
```
82
1. To reduce airway inflammation in an patient with asthma, the doctor prescribes a/an (antibiotic, corticosteroid, expectorant).
2. Ms. C. presents with a chief complaint of shortness of breath upon exertion. Medication is prescribed to expand the bronchial airways. It is known as a/an (bronchodilator, corticosteroid,
expectorant) .
3. Upon inhalation, a fine spray delivers medication into the lungs. The device used is known as a/an (bronchoscope,
intubator, nebulizer).
4. To reduce sputum thickness and ability to cough it up, the physician prescribes a/an (antibiotic, corticosteroid, expectorant).
1. corticosteroid
2. bronchodilator
3. nebulize
4. expectorant
83
Cardiovascular System (C V) composed of
Layers and membranes of the heart
heart and blood vessels
• Arteries
• Capillaries
• Veins
Endocardium, innermost layer that lines the heart and heart valves.
Myocardium, muscular layer.
Pericardium, outermost layer
84
Pericardium, outermost
| layer
• Membrane that surrounds the heart as the pericardial sac and
secretes pericardial fluid.
• The heart is located within the pericardial sac.
• Pericardial cavity contains serous fluid, which reduces friction between the pericardial membranes as the heart moves
(contracts and relaxes) within them.
85
Function of Cardiovascular System
Right side
Left Side
Circulates blood and delivers oxygen (O2 ) and
nutrients to cells
* Right side for circulating blood to lungs for oxygenation (pulmonary circulation)
* Left side for circulating blood to all body systems (systemic circulation)
Disposes of waste products
Aids lymphatic system in circulating substances
86
1. What is the main function of the heart?
2. What heart structures control blood flow to and from the heart?
3. List two major functions of the C V system.
4. What function does the C V system perform for the lymphatic system?
1. Pump blood through blood vessels to all the cells of the body.
2. Heart valves
3. Delivers oxygen, nutrients, and other essential substances to body cells and removes waste products of cellular metabolism.
4. Transports excess fluid from interstitial spaces in tissues and returns it to blood.
87
# Define Combining Forms
1. angi/o:
2. aneurysm/o:
3. aort/o:
4. arteri/o:
5. arteriol/o:
6. ather/o:
7. atri/o:
8. cardi/o, coron/o:
9. phleb/o, ven/o:
10. thromb/o:
11. varic/o:
12. vas/o:
1. vessel (usually blood or lymph)
2. widened blood vessel
3. aorta
4. artery
5. arteriole
6. fatty plaque
7. atrium
8. heart
9. vein
10. blood clot
11. dilated vein
12. vessel; vas deferens; duct
88
# Define Suffixes
13. -cardia:
14. -gram:
15. -graph:
16. -megaly:
17. -graphy:
18. -oma:
19. -stenosis:
20. -ectasis:
13. heart condition
14. record, writing
15. instrument for recording
16. enlargement
17. process of recording
18. tumor
19. narrowing, stricture
20. dilation, expansion
89
Build Medical Words
1. rapid heart rate: tachy/
2. suture of a widened blood vessel: aneurysm/o/
3. inflammation of an arteriole: /itis
4. pertaining to the atrium and ventricle: /o/ventricul/
5. abnormal condition of fatty plaque hardening: ather/o/ /osis
6. destruction or loosening of a thrombus: /o/
7. tumor of fatty plaque:
8. narrowing or stricture of an artery:
9. medical specialist in heart (disease):
1. tachy/cardia
2. aneurysm/o/rrhaphy
3. arteriol/itis
4. atri/ar ???? DOUBLE CHECK THIS ONE
5. scler
6. thromb/lysis
7. ather/oma
8. arteri/o/stenosis
9. cardi/o/logist
90
Build Medical Words
10. enlargement of the heart:
11. process of recording the electrical activity of the heart:
12. excision of an embolus:
10. cardi/o/megaly
11. electr/o/cardi/o/graphy
12. thromb/ectomy
91
Deep Vein Thrombosis (D V T)
| Signs and Symptoms
Formation of a thrombus, usually in calf or thigh muscle
Part or complete block of blood flow
May cause pain, but often asymptomatic
92
Deep Vein Thrombosis (D V T)
| Treatment
Anticoagulants
• Prevent future thrombi formation
Thrombolytics
• Dissolve blood clots
93
1. Mr. X. is a postsurgical patient who complains of soreness in his right calf muscle. The doctor assesses the right calf and finds it to be warm and red. What is the likely diagnosis for Mr. X.?
2. The physician prescribes medication for Mr. X. to dissolve his D V T. This type of medication is called a ________.
1. Deep vein thrombosis (D V T)
| 2. thrombolytic
94
Coronary Artery Disease (C A D)
| Signs and Symptoms
Angina
Shortness of breath (S O B)
Accumulation of plaque in arterial walls causing them to harden.
Complete blockage of arterial wall caused by blood clot formation or ruptured plaque.
Pieces of plaque break free, travel to the brain, and block the blood vessels that supply blood to the brain
95
Coronary Artery Disease (C A D)
Risk factors
* Smoking
* Hypertension, stress
* Physical inactivity
* Family history
* Diabetes
* Obesity
* High cholesterol
96
Coronary Artery Disease (C A D)
| Treatment
Lifestyle changes: smoking cessation, low-fat diet, regular exercise, weight reduction, and stress reduction.
Pharmacological treatment to control angina, hypertension, triglyceride levels, and blood clots.
Surgical intervention includes percutaneous transluminal coronary angioplasty (P C T A).
97
1. Mrs. T. presents with chest pain that radiates to her left arm. She is pale and is perspiring profusely. Electrocardiography (E C G) reveals necrosed heart tissue. The physician diagnoses Mrs. T. with (fibrillations, myocardial infarction [M I], palpitations).
2. The nurse explains to Mr. X., who is diagnosed with coronary artery disease (C A D), that lifestyle changes could reduce the
risk of further heart complications. Lifestyle changes include exercising regularly, losing weight, quitting smoking, reducing stress, and maintaining a diet low in saturated
________.
1. myocardial infarction (M I)
| 2. fat
98
3. A 50-year-old male presents to the clinic complaining of pressure and pain in his chest. After a brief examination, the
doctor concludes that his symptoms are caused by lack of oxygen to the heart. This condition is called angina _______.
4. Mr. S. complains of chest pain, nausea, and shortness of breath (S O B). A diagnostic test to record the electrical activity of his
heart is ordered. This diagnostic test is called .
5. Walter is scheduled for balloon angioplasty to crush fatty deposits in the coronary vessel and improve blood flow. He is told this is known as P C T A, the abbreviation for .
3. pectoris
4. electrocardiography (E C G)
5. percutaneous transluminal coronary
angioplasty
99
Aneurysm
| Signs and Symptoms
Local dilation of an artery or chamber of the heart caused by weakening of its walls.
May cause thrombus formation, hemorrhage from rupture, or ischemia.
Symptoms may include mild to severe weakness, sweating, tachycardia, and hypotension.
May be asymptomatic, but if the person is slender, a pulsating middle and upper abdominal mass may be detected on routine
physical examination.
100
Three types of Aneurysms
Fusiform – dilation of entire circumference.
Saccular – shaped like a sac, bulging on only one side.
Dissecting – inner layer tear causes a cavity to form that fills with blood with each heartbeat).
101
Aneurysm
| Three common types:
abdominal,
thoracic,
peripheral artery aneurysms.
102
Aneurysm
| May be asymptomatic, but if the person is slender
a pulsating middle and upper abdominal mass may be detected on routine physical examination.
103
Aneurysm
| Treatment
Depends on the size, location, and the likelihood of rupturing of the aneurysm, as well as the general physical status of the
individual.
Most are treated surgically.
104
1. An aneurysm may cause weakness, sweating, tachycardia, and low blood pressure, also known as (hypotension, hypertension, hypothymia).
2. During physical examination, the doctor palpates and feels an abnormal dilation of a blood vessel. This may be diagnosed as
a/an (aneurysm, carcinoma, tumor).
3. Mr. J. is advised that he needs to have his aneurysm removed. The surgical procedure to excise an aneurysm is known as _______.
4. During surgery, the doctor discovers a spindle-shaped aneurysm in the patient’s artery. This type of aneurysm is known as a/an (dissecting, fusiform, saccular) aneurysm.
1. hypotension
2. aneurysm
3. aneurysmectomy
4. fusiform
105
Varicose Veins
| Signs and Symptoms
Defective or incompetent valves in veins prevent blood
from flowing freely toward the heart.
• Buildup of pressure in superficial veins causes varicosities.
Could be caused by inherited defect or venous diseases.
May occur as a result of such conditions as pregnancy or work requiring prolonged standing or heavy lifting.
Person may be asymptomatic, even though the varicose vein condition is severe.
Swollen, tortuous, and knotted veins, usually occur in the lower legs.
As the condition progresses, veins thicken and feel hard to the touch.
Develop gradually, with a feeling of fatigue in the legs followed by a dull ache.
106
Varicose Veins
| Treatment
Compression stockings.
Sclerotherapy, injection into varicose veins with a solution that scars and closes the veins.
Laser treatments, which use strong bursts of light into the vein to close off varicose veins to make the vein slowly fade and disappear.
107
1. After four pregnancies, Mrs. X. noticed twisted enlargements of the veins in her lower legs. She complains of pain that is not relieved, even when she elevates her legs or uses compression stockings. Dr. D. recommends a chemical injection into the
varicosities to destroy and close the veins. This procedure is known as (sclerotherapy, ligation and stripping, laser ablation).
1. sclerotherapy
108
2. An 87-year-old nursing home resident has a history of vascular problems and dependent edema. Recently, he developed skin ulcers on his lower legs. His daughter asks what causes the ulcers.
The nurse explains that skin ulcers are a complication associated with (varicose veins, advanced age, skin allergies).
2. varicose veins
109
Vocabulary Challenge Exercise
1. arrhythmia:
2. bruit:
3. heart block:
4. heart failure (H F):
5. hypertension:
6. ischemia:
1. irregularity or loss of rhythm of the heartbeat; also called dysrhythmia
2. soft blowing sound heard on auscultation; it is caused by turbulent blood flow
3. interference with normal transmission of electrical impulses through the conducting system of the heart
4. inability of the heart to circulate blood effectively enough to meet the body’s metabolic needs
5. consistently elevated blood pressure that is higher than 140/90 millimeters of mercury, causing damage to the blood vessels and
ultimately to the heart
6. inadequate supply of oxygenated blood to a body part as a result of interruption of blood flow
110
Diagnostic Procedures
Cardiac catheterization
Cardiac enzymes
Catheter is guided into the heart via a vein or artery.
Test to measure levels of enzymes released into blood during an M I.
111
Diagnostic Procedures
| Holter monitor
Records E C G readings, usually for 24 hours, on a portable tape recorder to document arrhythmias and link them to activities or to
symptoms, such as chest pain.
112
Diagnostic Procedures
| Stress test
Exercise tolerance test to determine the heart’s response to physical exertion (stress).
E C G is performed under controlled exercise stress conditions with use of a treadmill.
Nuclear stress test uses a radioisotope to evaluate coronary blood flow.
113
Diagnostic Procedures
Doppler Ultrasonography
(U S)
U S used to assess blood flow through the blood vessels and the heart.
Handheld U S transducer emits sound waves as it is placed on the carotid artery to produce images of blood flow.
Carotid Doppler U S creates detailed images of the inside of the
carotid arteries in the neck to check interruption of blood flow caused by plaque or blood clots.
114
Diagnostic Procedures
Troponin I
E K G, E C G
Blood test that measures levels of proteins released into blood when myocardial cells die (damaged heart muscle).
Recording of electrical activity of the heart
115
Build Medical Words (continued_8)
1. record of electrical (activity) of the heart:
2. tumor (composed of) fatty plaque:
3. process of recording (radiography) blood flow in a vein:
4. separation or destruction of a blood clot:
5. process of recording (radiography) blood flow in the aorta:
6. abnormal condition of arterial (walls) hardening:
7. process of recording (radiography) blood flow in vessels (after injection of a contrast dye):
1. electrocardiogram
2. atheroma
3. venography, phlebography
4. thrombolysis
5. aortography
6. arteriosclerosis
7. angiography
116
Medical and Surgical Procedures
| Automatic implantable cardioverter-defibrillator (A I C D)
Device implanted in a patient who is at high risk for developing serious arrhythmia
117
Medical and Surgical Procedures
Angioplasty
Any endovascular procedure that reopens narrowed blood vessels.
• Restores blood flow, usually with use of balloon dilation.
118
Medical and Surgical Procedures
Coronary artery bypass graft (C A B G)
Vein taken from leg or other part of the body is grafted onto the heart to circumvent an obstruction in a coronary artery
119
Medical and Surgical Procedures
Valvuloplasty
Surgical repair or replacement of a valve.
If a balloon is used to open a defective valve, it is called balloon
valvuloplasty.
120
1. Mr. T. is scheduled for surgery to bypass one or more of his blocked coronary arteries to restore blood flow. This surgery
is charted as coronary artery surgery.
```
2. Mr. D. is diagnosed with C A D. Treatment for his condition involves an endovascular procedure that will reopen the narrowed
blood vessels and restore blood flow. The blocked vessel is usually opened by balloon dilation. This surgical procedure is
known as (anastomosis, angioplasty, endartotomy).
```
1. bypass
| 2. angioplasty
121
3. Lily is scheduled to have surgery on her mitral valve. The surgeon charts surgical repair of the valve as .
4. Ms. B. is diagnosed with ventricular fibrillation. The treatment of choice is to implant a battery-powered device that monitors and automatically corrects tachycardia by sending electrical impulses
to the heart. The abbreviation for this defibrillator is .
3. valvuloplasty
| 4. A I C D
122
Pharmacology
| Beta blockers
Decrease heart rate and dilate arteries by
blocking beta receptors.
Treat angina pectoris and hypertension.
123
Pharmacology
| Nitrates
Treat angina pectoris.
Dilate veins, which decreases the amount of
work the heart must do.
Dilate arteries to decrease blood pressure.
124
Pharmacology
| Statins
Lower cholesterol levels in blood.
Reduce cholesterol production in the liver.
• Block the enzyme that produces cholesterol.
125
Pharmacology
| Thrombolytics
Lyse (break apart) blood clots.
Used in acute management of myocardial
infarction (M I).
Used to treat ischemic stroke.
126
1. Mrs. T. is diagnosed with D V T in her lower leg. She is prescribed a drug that dissolves a blood clot. It is known as a
(beta blocker, nitrate, thrombolytic).
2. Mr. B. is diagnosed with hypercholesterolemia and advised to
follow a low-fat diet. He is prescribed a drug that reduces cholesterol levels and is known as a (beta blocker, nitrate, statin).
1. thrombolytic
| 2. statin
127
3. Mrs. S. presents with angina pectoris and is prescribed a drug to relieve her pain. It is called a (beta blocker, nitrate, statin).
4. To lower blood pressure, the doctor prescribes a (beta blocker, nitrate, statin).
3. nitrate
| 4. beta blocker
128
Lymphatic system
```
Lymph nodes
Lymph vessels and lymph fluid
Lymphatic organs
• Tonsils, thymus, and
spleen
```
Network of vessels that depends on the pumping action of the
heart to circulate its substances throughout the body.
129
Function
Lymphatic System
Main functions
1. Drain excess interstitial fluid from tissues and return it to the circulating blood.
2. Absorb and transport digested fats to venous circulation.
3. Produce lymphocytes and other immune cells that protect the body from injury and disease, such as bacteria, viruses, and cancerous cells.
130
Lymph nodes
Function
Small masses of lymph tissue, also called lymph gland.
• Tend to occur in clusters or chains.
Major groups of nodes are located in the cervical (neck), axillary (armpit), and inguinal (groin) regions of the body.
• Lymph is filtered through these nodes as it passes through lymph vessels.
• When bacteria accumulate in lymph nodes (as in a bacterial infection), nodes become swollen and tender.
131
Spleen
Function
Organ similar in structure and function to a
lymph node, but is much larger.
Filters lymph.
Manufactures lymphocytes and monocytes.
Destroys old erythrocytes.
Stores new erythrocytes for release into the
bloodstream, as needed.
Not essential to life.
• If spleen is removed, other organs take over its
function.
132
Function
| Thymus
Secretes a hormone called thymosin.
• Thymosin stimulates red bone marrow to produce T lymphocytes (T cells).
• T cells provide defense against disease.
‒ Attack and destroy foreign or abnormal cells.
133
Function
| Tonsils
Filter lymph.
| Destroy bacteria entering the mouth and throat.
134
1. What is the purpose of the lymphatic system?
2. What is the purpose of leukocytes?
3. What role does the hormone thymosin play in the lymphatic system?
4. What organ destroys bacteria entering the mouth and throat?
1. Transports excess fluid from interstitial spaces in tissues and returns it to blood and defends the body against foreign invaders and harmful substances.
2. Defend the body against foreign invaders and harmful agents.
3. Thymosin stimulates the red bone marrow to produce and is important in the immune process.
4. Tonsils
135
# Define Combining Forms
1. tonsill/o:
2. cervic/o:
3. thym/o:
4. splen/o:
5. lymphangi/o:
6. agglutin/o:
7. immun/o:
8. lymphaden/o:
9. gland:
10. lymph:
11. phag/o:
1. tonsil
2. neck
3. thymus
4. spleen
5. lymph vessel
6. clumping, gluing
7. immune, immunity, safe
8. lymph gland (node)
9. aden/o
10. lymph/o
11. swallowing, eating
136
# Define Suffixes
12. -oma:
13. -phylaxis:
14. -poiesis:
12. tumor
13. protection
14. formation, production
137
Build Medical Words
1. tumor of the thymus gland: /
2. cell that swallows or eats (ingests): / /
3. formation or production of lymph: / /poiesis
4. tumor of a lymph vessel: /
5. process of clumping, gluing: /ation
6. study of immunity: / /logy
7. enlargement of the spleen:
8. tumor (composed of) lymph:
9. inflammation of a lymph gland (node):
1. thym/oma
2. phag/o/cyte
3. lymph/o/poiesis
4. lymphangi/oma
5. agglutin/ation
6. immun/o/logy
7. splen/o/megaly
8. lymph/oma
9. lymphaden/itis or lymph/aden/itis
138
Build Medical Words (continued_6)
10. disease of lymph glands:
11. specialist in the study of immunity:
12. tumor of the thymus gland:
10. lymphaden/o/pathy or lymph/aden/o/pathy
11. immun/o/logist
12. thym/oma
139
Lymphedema
| Signs and Symptoms
Abnormal accumulation of lymph, usually in the
extremities.
Symptoms eventually include pallor, weakness, lymph node
enlargement, fatigue, fever, and weight loss.
Affected limb, in part or whole, is typically swollen and hypertrophied with thickened and fibrotic skin.
As disease progresses, tachycardia, palpitations, and an increased incidence of infections are common.
140
Lymphedema
| Treatment
Control pain.
Lessen swelling by moving lymph out of the affected limb.
• Gentle exercise, massage, bandaging, compression garments.
Surgery to correct lymphatic obstruction and promote drainage may be necessary in some instances.
141
1. Mr. G. presents with swelling and excessive accumulation of lymph in his right leg. The physician diagnoses this condition as (lymphoma, lymphomegaly, lymphedema).
2. Dr. J. detects lymphedema as he examines Mrs. L. after her surgery. Dr. J. explains that this condition is caused by blockage
in the lymphatic system, preventing drainage of lymph fluid. It is also a common complication after removal of the breast, a surgical procedure called ______________.
1. lymphedema
| 2. mastectomy
142
3. The patient has a history of lymphedema and presents with a swollen, red area of skin that feels hot and tender in the right
arm. The physician diagnoses this as a skin infection called (cellulitis, hepatitis, lymphadenitis).
4. Mary is diagnosed with lymphedema in her right arm and asks the nurse what can be done to lessen the swelling.
3. cellulitis
4. The nurse explains that swelling can be decreased by moving lymph out of the right arm through gentle exercise, massage, bandaging, and wearing compression garments.
143
Systemic Lupus Erythematosus (S L E)
| Signs and symptoms
Chronic inflammatory autoimmune disease.
Characterized by unusual antibodies in blood targeting tissues
of the body.
Butterfly-shaped rash or erythema on the face.
Inflames and damages connective tissue anywhere in the body.
Most commonly produces inflammation of skin, joints, nervous system, kidneys, lungs, and other organs.
• Degree to which these tissues are involved varies from patient to patient.
Similar rashes may appear on other exposed areas of the body.
Exposure to sun can aggravate the rash.
Fever, fatigue, joint pain, and malaise may begin acutely or develop slowly over a period of years.
Occurs most often in young women in their 20’s or 40’s
144
Systemic Lupus Erythematosus (S L E)
Treatment
Anti-inflammatory drugs, including aspirin.
Corticosteroids for severe cases.
Sometimes antimalarials are added.
Immunosuppressive agents when lifethreatening or severe crippling disease is present.
145
1. Ms. Z. is diagnosed with systemic lupus erythematosus. The medical assistant charts it with the abbreviation .
2. The patient asks the physician about the typical symptoms of systemic lupus erythematosus.
1. S L E
2. The physician explains that more noticeable symptoms include fever, fatigue, joint pain, and malaise. These symptoms develop over a period and may appear suddenly. Symptoms may include rashes on exposed areas of the body, including a “butterfly” rash on the face.
146
3. Ms. Z. suffers from S L E and states that aspirin is no longer working. The physician prescribes other drugs to reduce
inflammation that are called (analgesics, antithyroids, corticosteroids).
4. When S L E becomes life threatening, the physician may order drugs to suppress the immune system. These drugs are called (antithyroids, immunosuppressives, nonsteroidal antiinflammatory drugs [N S A I D’s]).
3. corticosteroids
| 4. immunosuppressives
147
Kaposi Sarcoma
| Signs and Symptoms
Lymphatic malignancy.
Composed of multiple red or purple macules, papules, or nodules on skin and mucous membranes.
First appear on lower extremities, but spread to upper body, face, mucous membranes of throat, and internal organs.
Closely associated with H I V infection and is considered an “AIDS-defining condition.”
148
Kaposi Sarcoma
| Treatment
Depends on stage of H I V infection and degree of metastasis.
Common treatment modalities include radiation therapy, chemotherapy, surgery, and immunotherapy.
Palliative treatment and good oral hygiene are essential.
149
1. John is diagnosed with Kaposi sarcoma (K S) and asks the medical assistant to explain this disease.
2. Mr. Z. with a history of H I V+ presents with purplish brown papules on both arms and legs. The doctor suspects he has a cancer that is associated with AIDS. This type of cancer is known as Kaposi .
1. He explains that it is a malignancy of connective tissues, especially the tissues found under the skin, mucous membranes,
and the lining of lymph vessels; usually associated with H I V.
2. sarcoma
150
3. The patient is diagnosed with K S and asks the physician what type of medical treatment is needed.
```
3. The physician explains that treatment
depends on the stage of H I V infection and
degree of metastasis. Some common
treatment modalities include radiation
therapy, chemotherapy, surgery, and
immunotherapy.
```
151
Vocabulary Challenge Exercise
1. Hodgkin disease:
2. lymphadenitis:
3. lymphocyte:
1. malignant disease characterized by painless, progressive enlargement of lymphoid tissue, splenomegaly, and the
presence of unique Reed-Sternberg cells in the lymph nodes
2. inflammation and enlargement of lymph nodes, usually a result of infection
3. type of white blood cell (leukocyte) that is responsible for immune responses in defending the body against disease
152
Vocabulary Challenge Exercise
4. mononucleosis:
5. pathogen:
6. phagocyte:
4. acute infection caused by the Epstein-Barr virus (E B V) and characterized by sore throat, fever, fatigue, and enlarged lymph
nodes
5. any disease-producing microorganism, such as a virus, bacterium, or fungus
6. cells that protect the body by ingesting harmful foreign substances
153
Diagnostic Procedures
| Bone marrow aspiration
Withdrawn for microscopic evaluation
(usually from pelvic bone)
• Used for stem cell transplantation or chromosomal analysis.
Used to determine if a known cancer, such as Hodgkin and nonHodgkin lymphoma, has spread to bone marrow.
• Part of staging process to determine if cancer has spread and how much it has spread.
154
Diagnostic Procedures
E L I S A (Enzyme-Linked Immunosorbent Assay)
Tissue typing
Blood test that detects antibodies in blood
Screening for an antibody to the AIDS virus
Used to determine histocompatibility of tissues.
Used in grafts and transplants with recipient’s tissues and cells.
Also known as histocompatibility testing
155
Build Medical Words (continued_8)
1. disease of a lymph gland:
2. fleshy tumor of lymph (cancerous):
3. process of recording lymph vessel(s):
4. process of recording lymph gland(s):
5. surgical fixation of the spleen:
6. specialist in study of immunity:
1. lymphadenopathy
2. lymphosarcoma
3. lymphangiography
4. lymphadenography
5. splenopexy
6. immunologist
156
Medical and Surgical Procedures
Bone marrow transplantation
Lymphangiectomy
Infusion of healthy bone marrow stem cells after diseased bone marrow is destroyed by chemotherapy or radiation.
• Used to treat aplastic anemia, leukemia, and certain cancers.
Excision of one or more lymphatic vessels, usually as a result of cancer
157
1. Magnetic resonance imaging (M R I) reveals a lymphangioma. The physician explains that the tumor needs to be excised. The term for excision of a lymph vessel is .
2. Bill is diagnosed with leukemia. His physician recommends irradiation and chemotherapy of thebone marrow, followed by replacement with healthy blood cells. This type of treatment is called (bone marrow aspiration, bone marrow biopsy, bone marrow transplantation).
3. Jason undergoes M R I, which reveals a tumor composed of lymph vessels. This tumor is known as a .
1. lymphangiectomy
2. bone marrow transplantation
3. lymphangioma
158
Pharmacology
Antivirals
Immunosuppressants
Inhibit development of specific viruses.
• Used to treat H I V infection and AIDS.
Suppress immune response to prevent organ rejection after transplantation.
Slow progression of autoimmune disease.
159
1. To prevent rejection of Mary’s recently transplanted kidney, the physician prescribed a/an (anticoagulant, immunosuppressant, thrombolytic).
2. The American Medical Association (A M A) recommends vaccination with immune globulins to induce immunity to certain
infectious diseases. These vaccinations are known as (anticoagulants, immunizations, immunosuppressants).
3. To prevent the patient from contracting a viral infection, the physician prescribed a/an (corticosteroid, antiviral, immunosuppressant).
4. Treatment of H I V infection and AIDS includes the use of (corticosteroids, antivirals, immunosuppressants).
1. immunosuppressant
2. immunizations
3. antiviral
4. antivirals
160
Digestive System Structure
```
Oral cavity
• Teeth
• Salivary glands
Pharynx
Esophagus
Stomach
• Pyloric sphincter
Small intestine
• Duodenum, jejunum, ileum
Large intestine
• Cecum is connected to small intestine by
ileocecal valve.
‒ Appendix hangs from cecum.
• Ascending colon, transverse colon, and descending colon
‒ Sigmoid colon
‒ Rectum
‒ Anus
```
161
Digestive System Accessory Organs
* Liver
* Gallbladder
* Pancreas
162
Function
Oral cavity
Pharynx (throat)
Esophagus
Food enters the body.
Teeth crush food into smaller pieces.
Food passageway from mouth to esophagus.
Air passageway from nose to larynx (voice box).
Food is pushed toward stomach by peristalsis.
163
Function
Stomach
Small intestine (small bowel)
Food transformed into chyme.
Pyloric sphincter allows chyme to pass into small intestine.
Duodenum, jejunum, ileum
• Digestion of food (chyme) is completed with aid of enzymes secreted by liver, gallbladder, and pancreas.
• Nutrients absorbed into bloodstream through tiny fingerlike projections, villi.
164
Function
Large Intestine
Fluid waste from small intestine passes through various sections of colon.
• Water is reabsorbed into body.
‒ As a result, previously fluid waste turns into solid material (feces or stool).
‒ Rectum, reservoir for feces.
‒ Anus, external opening through which feces are excreted.
165
Function
Accessory organs
Liver
* Largest glandular organ in the body.
* Manufactures blood proteins.
* Destroys old erythrocytes.
* Removes toxins from blood.
* Manufactures bile that aids in digestion of fats.
* Stores and releases glycogen as needed by body.
166
Function
Accessory organs
Gallbladder
‒ Stores and releases bile it receives from liver.
167
Function
Accessory Organs
Pancreas
• Produces enzymes that aid in digestion of proteins, starches, and
fats.
• Secretes insulin and glucagon.
‒ Hormones that help regulate carbohydrate metabolism and blood glucose levels
168
Function Summary of Digestive System
Organs of digestion break down food physically and chemically.
• Prepare food for absorption by cells of the body.
Digestive system eliminates waste substances.
169
1. What is the oral cavity, and what is its function?
2. Name the three parts of the small intestine, and describe their locations.
3. Name the first four sections of the colon.
4. Describe the shape and location of the pancreas.
1. The mouth is the first part of the digestive tract. It is where the chemical and mechanical processes of digestion begin, with the actions of teeth and salivary glands.
2. First segment, the duodenum, is about 10 inches long. Second segment, the jejunum, is approximately 8 feet long. Third segment, the ileum, is about 12 feet long.
3. Ascending colon, transverse colon, descending colon, and sigmoid colon
4. Elongated, somewhat flattened organ that lies posterior and slightly inferior to the stomach
170
5. What are the main functions of the pancreas?
| 6. Describe the location and main function of the gallbladder.
5. It secretes insulin and glucagon, hormones that help regulate carbohydrate metabolism and blood glucose levels.
6. It is located on the inferior surface of the liver. It stores and releases bile into the duodenum for digestion.
171
# Define Combining Forms
1. or/o, stomat/o:
2. dent/o, odont/o:
3. gloss/o, lingu/o:
4. gingiv/o:
5. esophag/o:
1. mouth
2. teeth
3. tongue
4. gum(s)
5. esophagus
172
# Define Combining Forms
6. pharyng/o:
7. splen/o:
8. hepat/o:
9. gastr/o:
10. pancreat/o:
6. pharynx
7. spleen
8. liver
9. stomach
10. pancreas
173
Defining Combining Forms
11. cholecyst/o:
12. chol/e:
13. choledoch/o:
14. duoden/o:
15. jejun/o:
11. gallbladder
12. bile, gall
13. bile duct
14. duodenum
15. jejunum
174
# Define Combining Forms
16. ile/o:
17. enter/o:
18. col/o, colon/o:
19. sigmoid/o:
20. rect/o:
21. an/o:
22. proct/o:
16. ileum
17. intestine (usually small intestine)
18. colon
19. sigmoid colon
20. rectum
21. anus
22. anus, rectum
175
Build Medical Words
1. discharge or flow through: dia/
2. without an appetite: an/
3. swallowing, eating (that is) painful or difficult: /phagia
4. after a meal: post/
5. pertaining to under or below the tongue: /lingu/
6. visual examination within or in (an organ): /scopy
1. dia/rrhea
2. an/orexia
3. dys/phagia
4. post/prandial
5. sub/lingu/al
6. endo/scopy
176
Build Medical Words
7. vomiting blood:
8. tumor of the pancreas:
9. instrument for examining the stomach:
10. enlargement of the liver:
11. disease of the intestine (usually small intestine):
12. inflammation of the gum(s):
7. hemat/emesis
8. pancreat/oma
9. gastr/o/scope
10. hepat/o/megaly
11. enter/o/pathy
12. gingiv/itis
177
Appendicitis
| Signs and symptoms
Inflammation of appendix
• Usually resulting from obstruction or infection caused by a fecalith, foreign body, or bacteria.
Pain, usually becoming localized to right lower quadrant (R L Q)
Sudden spontaneous relief of pain indicates a ruptured appendix.
Fever, malaise, diarrhea, or constipation, and tachycardia (later
signs and symptoms).
178
Appendicitis
| Treatment
Appendectomy
Surgery within 24 to 48 hours of first symptoms. Delay can result in rupture and peritonitis as fecal matter is released into peritoneal cavity.
179
1. A 35-year-old man presents to the emergency department with R L Q pain, rigid abdomen with increased tenderness, and abdominal cramping. The physician suspects he is suffering from an inflammation of the appendage located off the cecum. An inflammation of the appendix is known as .
2. The physician recommends appendectomy and explains that a delay in surgery may result in rupture of the appendix. This can cause a serious infection of the abdominal cavity or peritoneum called .
1. appendicitis
| 2. peritonitis
180
3. Dr. G. charts removal of the appendix as
.
4. Dr. J. informs Joan that her appendicitis may have resulted from an obstruction or infection caused by a hard mass of fecal matter. This type of mass is known as a
.
3. appendectomy
| 4. fecalith
181
Diverticulitis
| Signs and Symptoms
Acute inflammation of diverticula.
Tenderness and pain in lower left quadrant (L L Q) of abdomen.
Intensity of pain can fluctuate.
Cramping, nausea, vomiting, fever, chills, or a change in bowel habits may also be experienced.
Eventually, abscess may form in tissues surrounding the colon.
182
Diverticulitis
| Treatment
Focuses on clearing up inflammation and infection, resting the colon, and preventing or minimizing complications.
Severe cases with acute pain and complications require a hospital stay. Most cases of severe diverticulitis are treated with
intravenous (IV) antibiotics and going without food or drink for a few days to rest the colon.
Some cases may require colon resection with a temporary colostomy while the colon heals.
183
1. Dr. X. tells Ann that she has small, blisterlike pockets in the inner lining of her large intestine. He tells her that these pockets are known as .
2. The nurse charts Mr. J.’s complaint of extreme constipation as .
3. Mr. F. is diagnosed for the third time with a severe case of diverticulitis. The physician explains that surgery is needed
to remove the diverticula. This surgical procedure is called .
4. Joe presents to the emergency department with cramping, nausea, vomiting, fever, chills, and diarrhea. Upon abdominal palpation, Joe experiences pain with tenderness in the L L Q. The
resident recognizes these symptoms as typical of (appendicitis, diverticulitis).
1. diverticula
2. obstipation
3. diverticulectomy
4. diverticulitis
184
Cholelithiasis ( Cholelithiasis and choledocholithiasis)
What is it
Signs and Symptoms
• Formation or presence of gallstones within the gallbladder or bile ducts.
Individuals with gallstones may remain asymptomatic.
Bile duct obstruction may result in a classic “gallbladder attack”; commonly referred to as “biliary colic.
Acute onset of upper right quadrant (U R Q) abdominal pain that radiates to the shoulder and back.
Nausea and vomiting may accompany the attack.
Attacks typically tend to follow ingestion of large meals or fatty foods.
185
Cholelithiasis
| Treatment
Cholecystectomy is the treatment of choice for symptomatic cholelithiasis.
If condition is asymptomatic, treatment is nonsurgical, unless symptoms reappear or there is a history of previous gallstones with complications.
Extracorporeal shock-wave lithotripsy, a nonsurgical treatment.
Insertion of a flexible catheter, guided by fluoroscopy, directly to the stone. A Dormia (stone) basket is threaded through the
catheter, opened, and twirled to entrap the stone. It is then closed and withdrawn.
Dissolving cholesterol-based stones by bile acid therapy. Existing stones may be decreased in size or dissolved completely.
186
1. Ms. G. presents with an acute onset of U R Q abdominal pain that radiates to the shoulder and back, and she complains of nausea and vomiting. Dr. J. suspects a formation of gallstones in the gallbladder. The medical term for an abnormal condition of
gallbladder stones is .
2. The doctor explains that removal of the gallbladder is the treatment of choice for symptomatic cholelithiasis. The surgical
procedure for excision of the gallbladder is .
1. cholecystolithiasis
| 2. cholecystectomy
187
3. Mr. F. is scheduled for ultrasonography to pulverize his gallstones. This nonsurgical treatment, which is abbreviated ESWL, is defined as .
4. Mrs. C. was diagnosed with choledocholithiasis 3 years ago. She remains asymptomatic and attributes this to adhering to a diet that is low in (sugar, fat, salt).
3. extracorporeal shock wave lithotripsy
| 4. fat
188
Vocabulary Challenge Exercise
1. ascites:
2. dysentery:
3. fistula:
4. hemorrhoid:
1. abnormal accumulation of serous fluid in the peritoneal cavity
2. inflammation of the intestine, especially the colon, which may be caused by chemical irritants, bacteria, protozoa, or parasites
3. abnormal passage from one organ to another, or from a hollow organ to the surface
4. mass of enlarged, twisted varicose veins in the mucous membrane inside (internal) or just outside (external) the rectum; also called piles
189
Vocabulary Challenge Exercise
5. polyp:
6. volvulus:
5. small tumorlike, benign growth that projects from a mucous membrane surface
6. twisting of the bowel on itself, causing obstruction
190
Diagnostic Procedures
| Endoscopy
• Visual examination of the interior of organs and cavities with a
specialized lighted instrument called an endoscope.
191
Diagnostic Procedures
Sigmoidoscopy
Colonoscopy
Examination of only the lower third of the colon.
Examination of entire length of the colon.
192
Diagnostic Procedures
Upper gastrointestinal series (U G I S)
Lower gastrointestinal series
Radiographic images of esophagus, stomach, and small intestine after oral ingestion of barium.
Identifies ulcers, tumors, or obstruction in esophagus, stomach, or intestine.
Radiographic images of rectum and colon following administration of barium enema into the rectum.
Identifies obstructions, tumors, or other abnormalities of the
colon.
193
Build Medical Words (continued_8)
1. visual examination of the sigmoid colon:
2. instrument for examining interior organs and cavities:
3. visual examination of the colon:
4. visual examination of the interior of organs and cavities:
5. surgical fixation of the liver:
6. suture of a bile duct:
1. sigmoidoscopy
2. endoscope
3. colonoscopy
4. endoscopy
5. hepatopexy
6. choledochorrhaphy
194
Medical and Surgical Procedures
Bariatric surgery - Vertical banded gastroplasty
Vertical banded gastroplasty
• Vertical stapling of upper stomach near esophagus.
• Reduces stomach to a small pouch.
• Band restricts food consumption and delays its passage.
‒ Causes feeling of fullness.
195
Medical and Surgical Procedures
Bariatric surgery - Roux-en-Y gastric bypass (R G B)
* Stapling of stomach to decrease its size.
* Shortens jejunum and connects it to small stomach pouch.
* Decreases pathway of food through intestine, thus reduces absorption of calories and fats.
196
Medical and Surgical Procedures
Colostomy
Creation of an opening into the colon (through the surface
of the abdomen).
May be permanent or temporary.
Performed as treatment for cancer or diverticulitis.
Colostomy allows elimination of feces into a bag attached through the skin
197
Medical and Surgical Procedures
Polypectomy
Excision of small tumorlike, benign growths (polyps) that
| project from a mucous membrane surface.
198
1. Ms. K. is diagnosed with colorectal cancer. The physician explains that an opening of the colon through the abdominal wall to the outside surface will be created. This enables fecal matter to be collected in an attached pouch. The surgical procedure to
create an opening (mouth) of the colon is called .
2. Dr. Jones discovers polyps during a colonoscopy. What surgical procedure does the doctor perform to remove the polyps?
1. colostomy
| 2. Polypectomy
199
3. The nurse explains to the weight-loss group that surgical procedures are available to treat morbid obesity. The surgical specialty that treats morbid obesity is called .
4. The nurse explains to the bariatric surgical patient the procedure for a Roux-en-Y gastric bypass. What is the abbreviation
for this weight-loss surgery?
5. The doctor explains one option to treat morbid obesity. The surgeon staples the upper stomach near the esophagus to reduce it to a small pouch followed by the insertion of a band to restrict food consumption. This is known as .
3. bariatric surgery
4. R G B
5. vertical banded gastroplasty
200
Pharmacology
Antacids
Antidiarrheals
Counteract or neutralize acidity, usually in the stomach.
Control loose stools.
Relieve diarrhea.
• Absorb excess water in bowel.
• Slow peristalsis in intestinal tract.
201
Pharmacology
Antiemetics
Laxatives
Control nausea and vomiting.
• Block nerve impulses to vomiting center of brain.
Treat constipation.
• Increase peristaltic activity in large intestine.
• Increase water and electrolyte secretion into bowel to induce defecation.
202
1. Mrs. J. complains of nausea and vomiting for the past 3 days. The medication prescribed will control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain. This
medication is known as a/an (antacid, antidiarrheal, antiemetic).
2. Mrs. S. is diagnosed with irritable bowel syndrome. She is instructed to increase fluid intake and is prescribed a drug that
will control her loose bowel movements. The drug is known as a/an (antacid, antidiarrheal, antiemetic).
1. antiemetic
| 2. antidiarrheal
203
3. A patient diagnosed with excessive stomach acid is treated with a/an (antacid, laxative, antiemetic).
4. Mr. Smith complains of constipation over the past 4 days. The medication prescribed by the nurse practitioner will increase peristaltic activity in the large intestine to produce a bowel movement. This medication is known as a/an (antacid,
antidiarrheal, laxative).
3. antacid
| 4. laxative
204
Urinary System Structure and Function -Kidneys
Kidneys
• Primary functional organs of the urinary system.
• Filter urea and other waste products from blood.
• Shaped like a kidney bean.
• Maintain proper balance of water and electrolytes in the body.
‒ Maintain balance by removing waste products of metabolism from blood through urine formation.
• Each kidney comprises an outer layer, the renal cortex; and an inner layer, the renal medulla.
• Blood enters the kidney through the renal artery.
205
Renal artery
• Branches into smaller and smaller arteries, eventually leading to
microscopic filtering units called nephrons.
206
Structure and Function
| Nephron
• Microscopic functional unit of the kidney.
• Forms urine in renal corpuscles and tubules by process of filtration, reabsorption, and secretion.
• Renal corpuscle is the site of blood filtration in the nephron and consists of the glomerulus and the Bowman capsule.
• Glomerulus, a cluster of capillaries.
‒ Waste-containing fluids (filtrate) are absorbed into the
Bowman capsule.
Filtrate flows from the capsule into the renal tubule.
• Renal tubule
‒ Urine formation is completed in the tubules.
‒ Urine flows from renal tubule to the renal pelvis.
Each renal pelvis (one from each kidney) narrows to form a
ureter.
207
Structure and Function
| Ureters
* Approximately 12-inchlong tube that connects renal pelvis of kidney to bladder.
* When muscles of ureters contract, urine is pushed from kidneys into urinary bladder.
208
Structure and Function
| Bladder
• Hollow, muscular sac in pelvic cavity.
• Serves as a temporary reservoir for urine.
‒ Expands as urine collects; contracts when urine is excreted.
209
Structure and Function
| Urethra
• Tube extending from the bladder to the external opening, urinary meatus.
• Serves as a passageway for excretion of urine from bladder.
‒ Process of excreting urine is called voiding or micturition.
210
1. Name four organs of the urinary system.
2. What is the name of the structure that stores urine until it is voided?
3. What is the main function of the kidneys?
1. Kidneys, ureters, bladder, and urethra
2. Urinary bladder
3. Remove toxic products from blood by forming urine
211
4. What structure in the nephron forms urine?
5. Urine is transported from the kidneys into the urinary bladder via the .
6. Urine is formed through the process of filtration, reabsorption, and .
4. Renal tubule
5. ureters
6. secretion
212
# Define Combining Forms
1. nephr/o, ren/o:
2. pyel/o:
3. ureter/o:
4. cyst/o, vesic/o:
5. ur/o, urin/o:
6. urethr/o:
7. meat/o:
8. glomerul/o:
1. kidney
2. renal pelvis
3. ureter
4. bladder
5. urine, urinary tract
6. urethra
7. meatus, opening
8. glomerulus
213
# Define Suffixes
9. -emia:
10. -iasis:
11. -lysis:
12. -pathy:
13. -pexy:
14. -ptosis:
15. -tripsy:
9. blood
10. abnormal condition (produced by something specified)
11. separation; destruction; loosening
12. disease
13. fixation (of an organ)
14. prolapse, downward displacement
15. crushing
214
Build Medical Words
1. instrument to examine the bladder: cyst/o/
2. inflammation of the renal pelvis: pyel/
3. expansion of the ureter: /ectasis
4. narrowing or stricture of the urethra: /o/
5. incision of the meatus: meat/o/
6. crushing of a calculus or stone: lith/o/
7. inflammation of the glomerulus and kidney: /o/nephr/
8. fixation of a kidney: /o/pexy
1. scope
2. itis
3. ureter
4. urethr/stenosis
5. tomy
6. tripsy
7. glomerul/itis
8. nephr
215
Build Medical Words (continued_4)
9. excessive urination: poly/
10. scanty urine: olig/
11. stone or calculus in urinary tract: /o/
12. disease of the renal pelvis:
13. tumor of the kidney:
14. urine with blood:
15. urine with pus:
9. uria
10. uria
11. ur/lith
12. pyel/o/pathy
13. nephr/oma
14. hemat/uria
15. py/uria
216
End-Stage Renal Disease (E S R D)
| Signs and Symptoms
* Irreversible stage with gradual, progressive deterioration of kidney function.
* Kidneys lose ability to excrete nitrogenous end products of metabolism.
* Progressive weakness, anorexia, diarrhea, pruritus, and polyuria.
* Severity of signs and symptoms varies, depending on extent of renal damage and remaining function.
* Usually result of chronic renal failure (C R F), the gradual, progressive deterioration of kidney function to the point that the kidneys cannot sustain their necessary day-to-day activity.
217
End-Stage Renal Disease (E S R D)
Treatment
* Dietary restriction of protein, sodium, and potassium intake
* Antiemetics for nausea
* Control of hypertension
218
1. Mr. J. requires renal transplantation because his kidneys no longer filter toxic wastes from blood. His disease is charted
as E S R D, or .
2. Mrs. M. is diagnosed with E S R D. Her symptoms include progressive weakness, diarrhea, pruritus, polyuria, and loss of
appetite. The medical assistant charts her loss of appetite as .
3. Mrs. M. is diagnosed with E S R D and is given dietary restrictions of food with protein, potassium, and .
4. A 38-year-old female is admitted with pyonephrosis. A key finding of the inflammatory condition is the accumulation
of in the kidneys.
1. end-stage renal disease
2. anorexia
3. sodium or salt
4. pus
219
Renal Calculi
| Signs and Symptoms
• Concentration of mineral salts in renal pelvis, in
calices of kidney, or in urinary tract.
• Renal calculi patients may remain asymptomatic for
long periods.
• If stone or calculus fragment lodges in a ureter, there may be intense pain and urinary urgency.
• If calculi are in renal pelvis and calices, pain is duller and more constant.
• Back pain and severe abdominal pain may occur. • Other symptoms include nausea, vomiting, chills and fever, hematuria, and abdominal distention.
220
Renal Calculi
| Treatment
* Remove stones and prevent new formations.
* Enhance elimination of stones and increase fluid intake.
* Small stones pass spontaneously without treatment. Large stones may require surgical intervention.
* Antibiotics may be prescribed if calculus buildup is caused by bacterial infection.
* Strong analgesics are prescribed for relief of intense pain.
* Ultrasonography is used to locate and monitor calculi as they are being destroyed.
221
1. Mrs. J. has developed kidney stones, even though various treatments were provided. The patient must undergo a surgical
procedure in which an incision is made to remove the stones. This procedure is called .
2. A patient diagnosed with renal calculi presents to the office complaining of pain in the kidney area. The medical term for this
symptom is .
3. Upon diagnosis of ureterolithiasis, the doctor informs Mrs. S. that she may experience pain and have difficulty urinating. The medical term for painful or difficult urination is .
1. lithotomy
2. nephralgia or nephrodynia
3. dysuria
222
4. Mrs. H. presents with complaints of pain, nausea, and hematuria. On the basis of her past history of nephrolithiasis, the
physician orders an imaging technique that utilizes high-frequency sound waves to detect presence of calculi. This imaging procedure is called .
4. ultrasonography
223
Hydronephrosis
| Signs and Symptoms
• Distention of renal pelvis and calices caused by pressure from
accumulating urine.
• Pressure impairs, and may eventually interrupt, kidney function.
• If obstruction is above bladder opening, only one kidney may be affected and person may be asymptomatic for a prolonged period.
• If both kidneys are affected, symptoms may include intense pain, nausea, vomiting, oliguria or anuria, and hematuria.
224
Hydronephrosis)
| Treatment
* Remove obstruction, prevent complications, and treat underlying disorders.
* Catheterization for immediate relief of urinary pressure.
* Analgesics may be prescribed.
* Antibiotics are required if infection occurs.
* If needed, surgery to dilate a ureteral stricture.
225
1. Mary presents at the clinic concerned because she only urinated once in the past 24 hours. The medical term for this symptom is (anuria, dysuria, enuria).
2. Mrs. M. presents because her urine is red. The nurse documents this finding as .
3. Joan is diagnosed with nephrosis and has swelling in the ankles, feet, and around the eyes. The medical term for swelling is .
1. anuria
2. hematuria
3. edema
226
4. Radiographic studies of a patient’s kidneys reveal enlargement of the right kidney. The radiologist documents this as .
5. Mr. J. is undergoing surgical repair of the renal pelvis. Before obtaining informed consent, the physician charts this surgical
procedure as .
4. nephromegaly
| 5. pyeloplasty
227
Vocabulary Challenge Exercise
1. azoturia:
2. diuresis:
3. hypospadias:
4. polycystic kidney disease:
5. uremia:
6. Wilms tumor
1. increase of nitrogenous substances, especially urea, in urine
2. increased formation and secretion of urine
3. abnormal congenital opening of the male urethra on the undersurface of the penis
4. hereditary condition in which the kidneys are enlarged and contain many cysts that develop over time, requiring dialysis or
kidney transplantation
5. increase in concentration of urea and other nitrogenous wastes in blood
6. malignant neoplasm of the kidney that occurs in young hildren, usually before age 5 years
228
Diagnostic Procedures
| Cystoscopy
• Examination of urinary bladder
‒ Obtain biopsy specimens of tumors; remove polyps.
‒ Obtain evidence of a pathology.
229
Diagnostic Procedures
| Bladder ultrasonography
• High-frequency sound waves produce images of
the bladder.
• Determines bladder volume.
• Identifies incomplete bladder emptying.
230
Diagnostic Procedures
Blood urea nitrogen (B U N)
Urinalysis
* Laboratory test that determines amount of nitrogen in blood that comes from urea.
* Used as an indicator of kidney function.
* Urine screening test.
* Includes physical observation, chemical tests, and microscopic evaluation.
231
Diagnostic Procedures
| Voiding cystourethrography (V C U G)
* Radiography of the bladder and urethra.
| * Performed before, during, and after voiding using a contrast medium to enhance imaging.
232
Build Medical Words
1. visual examination of the bladder:
2. process of recording (radiography) the bladder and urethra:
3. process of recording (radiography) the renal pelvis:
4. surgical repair of the renal pelvis:
5. incision of the urethra:
6. protein in urine:
1. cystoscopy
2. cystourethrography
3. pyelography
4. pyeloplasty
5. urethrotomy
6. proteinuria
233
Medical and Surgical Procedures
| Catheterization
• Insertion of a catheter into a body cavity or organ.
• Used to instill a substance or remove fluid.
• Most commonly performed through urethra into bladder to
withdraw urine.
234
Medical and Surgical Procedures
Hemodialysis
• Patient’s blood is diverted into a dialysis machine for filtering.
235
Medical and Surgical Procedures
Peritoneal dialysis
• Dialysis in which patient’s own peritoneum is used as
the dialyzing membrane. Contaminated fluid drains
out and is replaced with fresh solution.
• Illustration:
(A) Introducing dialysis fluid into peritoneal cavity.
(B)Draining dialysate with waste products from peritoneal cavity.
236
Medical and Surgical Procedures
Extracorporeal shockwave lithotripsy (E S W L)
* Powerful sound-wave vibrations break up calculi in urinary tract or gallbladder.
* Administration of an oral dissolution drug removes stones and their fragments during urination.
237
Medical and Surgical Procedures
Renal transplantation
• Diseased kidneys replaced by healthy transplanted kidney.
238
1. Mrs. C. is unable to urinate after surgery, so a catheter is inserted through the urethra and into her bladder to remove urine. This
therapeutic procedures is known as .
2. Mr. G. is diagnosed with nephrolithiasis. The medical assistant explains that the kidney stones need to be crushed into smaller
pieces so that they can be expelled in urine. Crushing of stones is a surgical procedure called .
3. Mr. M. is diagnosed with multiple renal calculi. The doctor explains that the treatment of choice is to use powerful sound-wave vibrations to break up the kidney stones. The abbreviation for this procedure is .
4. Mrs. A. has a history of bladder carcinoma and presents for endoscopy of the urinary bladder. Any growths that are present will be removed and biopsy performed. This visual examination
of the bladder is a medical procedure called .
1. catheterization
2. lithotripsy
3. E S W L
4. cystoscopy
239
5. The patient is in E S R D and requires his blood to be diverted into a machine and filtered, twice a week, because his kidneys
are no longer functioning. The procedure to have blood filtered outside of the body by a dialysis machine is called .
6. Mrs. M. is diagnosed with kidney failure and must receive peritoneal dialysis. She asks the doctor what the difference is between peritoneal dialysis and hemodialysis.
5. hemodialysis
6. Peritoneal dialysis uses the patient’s own peritoneum as the dialyzing membrane. Hemodialysis uses a dialysis machine as the dialyzing membrane
240
Pharmacology
Antibiotics
* Treat bacterial infection of urinary tract.
* Act on the bacterial membrane or one of its metabolic processes.
* Type of antibiotic prescribed depends on the infecting organism and the type and extent of infection.
241
Pharmacology
Antispasmodics
Diuretics
• Suppress spasms in ureter, bladder, and urethra by
relaxing smooth muscles lining their walls.
‒ Allow normal emptying of the bladder.
• Promote and increase excretion of urine.
242
1. Chest radiography reveals accumulation of fluid in the lungs. The doctor prescribes a drug to stimulate production and flow of
urine. The drug is a/an (antispasmodic, antidiuretic, diuretic).
2. Mr. Q. was catheterized for surgery and now experiences spasms in the urethra and bladder. To decrease the spasms and allow normal emptying of the bladder, the doctor prescribes
a/an (antispasmodic, antidiuretic, diuretic).
1. diuretic
| 2. antispasmodic
243
3. Mrs. T. has been diagnosed with a urinary tract infection. To treat the bacterial infection, the physician prescribes an
(analgesic, antibiotic, antispasmodic).
4. To relieve the patient’s nephralgia, the physician prescribes an (analgesic, antibiotic, antispasmodic).
3. antibiotic
| 4. analgesic
244
Reproductive System-Female
Structure
```
Ovaries
Fallopian tubes
Uterus
Vagina
Clitoris
Vulva
Mammary glands
```
245
Function
| Fallopian tubes
* Extend laterally at superior angle from uterus
* Pathway of ovum into uterus
* Fimbria ― fingerlike projections that propel ovum into oviduct
246
Function
| Ovaries
• Two ovaries located on each side of the uterus within the pelvic cavity
• Production of estrogen and progesterone, which affects puberty,
menstruation, and pregnancy
247
Function
| Uterus
* Muscular, hollow, pearshaped structure suspended by ligaments in pelvic cavity (see illustration)
* Responsible for housing and nourishing embryo from implantation of fertilized egg until birth
248
Function
| Vagina
• Muscular tube extending from cervix to exterior of
body
• Organ of sexual intercourse
• Passageway for delivery of fetus
249
Function
| Clitoris
* Located anterior to vaginal orifice
* Organ of sexual response in females
* Composed of erectile tissue with sensory nerve endings
250
Function
| Vulva
* Structures of external genitalia
* Labia majora—thicker, outermost structures
* Labia minora—smooth, thin, inner structures
* Responsible for protecting inner genitals
251
Function
| Mammary glands
* Glandular lobes located in breasts of females; contain milk ducts, which lead to opening in nipple of breast
* Not directly involved in reproduction
* More important after delivery
* Production of milk to nourish neonate after birth
252
Function
| Female Reproductive System
Organs and glands produce and unite female sex cells (ova or egg cells).
Transport ova to site of fertilization.
Perpetuate species.
Pass genetic material from generation to generation.
253
1. Where are the ovaries located?
2. What is the biological role of the mammary glands?
3. What do the terms gestation and parturition mean?
4. What structure is known as the birth canal?
1. Pelvic cavity, one on each side of the uterus
2. Secrete milk for nourishment of the newborn
3. Gestation is the period from the fertilization of the ovum until birth; parturition refers to the process of giving birth.
4. Vagina
254
# Define Combining Forms
1. oophor/o, ovari/o:
2. colp/o, vagin/o:
3. hyster/o, uter/o:
4. metr/o:
5. cervic/o:
6. salping/o:
7. mamm/o, mast/o:
8. vulv/o, episi/o:
1. Ovary
2. vagina
3. uterus
4. measure
5. cervix; cervix uteri (neck of uterus)
6. tube (fallopian or eustachian)
7. breast
8. vulva
255
# Define Combining Forms (continued_4)
9. nat/o:
10. galact/o:
11. gynec/o:
12. men/o:
9. birth
10. milk
11. woman, female
12. menstruation
256
# Define Suffixes
13. -arche:
14. -cyesis:
15. -gravida:
16. -para:
17. -salpinx:
18. -tocia:
13. beginning
14. pregnancy
15. pregnant woman
16. to bear (offspring)
17. tube (usually fallopian or eustachian [auditory] tubes)
18. childbirth, labor
257
Build Medical Words
1. pertaining to (the period) before birth: / /
2. pregnant woman (for the) first time: primi/
3. pregnancy (that is) false: /o/cyesis
4. hernia(tion) or swelling of a fallopian tube: salping/o/
5. bad, painful, or difficult labor or childbirth: /tocia
6. to bear (offspring) many times: /para
1. pre/nat/al
2. primi/gravida
3. pseud/o/cyesis
4. salping/o/cele
5. dys/tocia
6. multi/para
258
Build Medical Words (continued_4)
7. inflammation of the cervix uteri (neck of the uterus):
8. surgical puncture of the amnion (amniotic sac):
9. specialist in the study of female (disorders):
10. tumor of an ovary:
11. visual examination of the uterus:
12. excision or removal of the breast:
7. cervic/itis
8. amni/o/centesis
9. gynec/o/logist
10. oophor/oma
11. hyster/o/scopy, uter/o/scopy
12. mastect/omy
259
Build Medical Words (continued_8)
13. surgical repair of the vagina:
14. herniation of the uterus:
15. suture of the perineum:
13. vagin/o/plasty, colp/o/plasty
14. hyster/o/cele
15. perine/o/rrhaphy
260
Ectopic Pregnancy
| Signs and Symptoms
• Fertilized ovum implants and grows in places other
than the uterine cavity.
Common site is interior of the fallopian tube.
• Other sites include the ovary, wall of the uterus, or anywhere in the pelvic cavity.
• Signs of early pregnancy may be present.
• Abdominal pain and tenderness, as well as slight vaginal bleeding.
• Rupture of a fallopian tube is life threatening and may cause severe abdominal pain and intraabdominal bleeding.
261
Ectopic Pregnancy
| Treatment
* Laparotomy is done, with an attempt to save the ovary.
* Ruptured fallopian tube may require removal.
* All attempts are made to save the ovary.
* Blood transfusion may be necessary in severe intra-abdominal bleeding or hypovolemic shock.
262
1. Ellen presents to the emergency department complaining of abdominal pain. Computed tomography scan of the abdomen reveals an ovum has implanted in her fallopian tube. A pregnancy for an implanted ovum outside of the uterine cavity is known as an
2. The doctor diagnoses Heather with ectopic pregnancy. Heather asks her to explain what causes this condition.
1. ectopic pregnancy
2. The doctor explains that it is caused by a blockage or scarring of the tubes which prevents the fertilized egg from being transported to the uterus.
263
3. The nurse explains that a common cause of scarring or blockage of the fallopian tubes is infection, such as P I D. This abbreviation is defined as
4. Jean is diagnosed with ectopic pregnancy in the fallopian tube. The obstetrician informs her of the risks involved in this type of
pregnancy. What are some of these risks?
3. pelvic inflammatory disease
4. The fallopian tube may rupture, which is life threatening. It may also cause severe abdominal pain and intra-abdominal bleeding.
264
Breast Cancer
| Signs and Symptoms
* Early symptoms include swelling, lump, dimpling, retraction of nipple, discharge from nipple, and tenderness.
* Advanced symptoms include nodularity, redness, edema, ulceration of skin, and enlargement or shrinkage of breast.
* Most common malignancy of women in the United States.
* Appears to be associated with ovarian hormonal function.
* High-fat diet appears to increase the incidence of breast cancer.
* Family history of breast cancer
* Possibly use of hormone replacement therapy (H R T), especially for prolonged periods.
265
Breast Cancer
Treatment
• Lumpectomy
‒ Excision of a small primary breast tumor and some of the normal tissue that surrounds it
266
Breast Cancer
Treatment
Modified radical
mastectomy
‒ Excision of the entire breast,
including lymph nodes in the
underarm (axillary
dissection)
267
Breast Cancer Additional Treatment
* Adjuvant chemotherapy may be indicated after surgery if malignant cells are found in the lymph nodes.
* Any combination of surgery, radiation, chemotherapy, and hormonal therapy may be performed.
* Most women who have mastectomies today undergo modified radical mastectomies.
268
1. Mrs. S. had a mastectomy because of breast cancer. The doctor explains the postoperative adjuvant chemotherapy he is
recommending. Can you explain the purpose of adjuvant chemotherapy?
2. Lisa detects a lump in her breast while performing breast self-examination. After mammography shows a small tumor, an
excision of the breast tumor is performed. This is known as a .
3. Sasha is diagnosed with breast cancer and asks the doctor the types of treatments prescribed for breast cancer besides surgery.
1. Chemotherapy is used to enhance or extend the effects of surgery and to eliminate any possible metastasis.
2. lumpectomy
3. The physician explains that radiation, chemotherapy, and hormonal therapy are the treatments other than surgery.
269
4. Mary is scheduled for a modified radical mastectomy to treat her breast cancer. This surgical procedure involves removal of the
entire breast and excision of the underarm lymph nodes. The medical term for removal of the lymph node is .
4. lymphadenectomy
270
Endometriosis
| Signs and Symptoms
* Growth of endometrial tissue in areas outside the uterus
* Most commonly within the pelvic area
* Dysmenorrhea with pain in lower back and vagina
* Severity of pain not indicative of extent of the disease
* Dyspareunia, dysuria, and, sometimes, painful defecation
271
1. A 15-year-old arrives at the clinic for birth control counseling. After weighing her options, she decides that birth control pills
are her best option because they are highly reliable and easy to use. The abbreviation for the oral contraceptives is .
2. June comes into the clinic complaining of pain during sexual intercourse. The medical assistant documents this complaint as
(dysmenorrhea, dyspareunia, dysuria).
1. O C P's
| 2. dyspareunia
272
3. Joan, a 22-year-old, presents to the office with severe pain with menstruation. Her complaint is documented as .
4. During laparoscopy, ectopic deposits of endometrial tissue are noted within the pelvis. The doctor charts this condition of
endometrial tissue outside of the uterus as (endometritis, histometrial, endometriosis).
3. dysmenorrhea
| 4. endometriosis
273
Vocabulary Challenge Exercise
1. curet:
2. fistula:
3. gametes:
4. gestation:
1. instrument used to scrape the endometrium of the uterus during dilatation and curettage (D&C)
2. abnormal connection or passageway between two organs or vessels that do not normally connect
3. reproductive cells of the male and the female that fuse during fertilization; in the female, it is the ovum, and in the male, it is
the sperm
4. length of time from conception to birth; normally 36 weeks in humans
274
Vocabulary Challenge Exercise
5. retroversion:
6. sterility:
5. state of being turned back or a tipping, especially of an organ, such as the uterus
6. inability of the female to become pregnant or the male to impregnate the female
275
Diagnostic Procedures
Laparoscopy
Colposcopy
Hysterosalpingography
• Visual examination of abdominal cavity with a laparoscope through one or more small incisions in the abdominal wall,
usually at the umbilicus
• Examination of the cervix, vagina, and vulva with
a colposcope.
‒ Used to detect signs of disease
* Radiography, and usually fluoroscopy of the uterus and uterine tubes
* Radiography performed after injection of a contrast medium
276
Diagnostic Procedures
Mammography
Pap test
* Radiography of the breast to detect tumors, cysts, and microcalcifications and to locate a malignant lesion
* Detects abnormal cells in cervix and vagina
277
Build Medical Words
1. visual examination of the vagina:
2. process of recording (radiography) the uterus and fallopian tubes:
3. instrument to examine the abdomen:
4. incision of the vulva:
5. surgical repair of the breast:
6. visual examination of the abdomen:
7. excision or removal of the breast:
1. colp/o/scopy
2. hyster/o/salping/o/graphy
3. lapar/o/scope
4. episi/o/tomy
5. mamm/o/plasty, mast/o/plasty
6. lapar/o/scopy
7. mast/e/ctomy
278
Medical and Surgical Procedures
Dilation and Curettage
(D&C)
• Widening of cervical canal with a dilator
• Scraping the uterine endometrium with a curet
• Curettage (scraping) the uterine endometrium
with a serrated uterine curet.
279
Medical and Surgical Procedures
| Cerclage
• Sutures are used to close the cervix.
‒ Helps prevent premature birth
‒ Decreases chance of spontaneous abortion
‒ Sutures removed before delivery
280
Medical and Surgical Procedures
Amniocentesis
• Transabdominal puncture of the amniotic sac under
| ultrasound guidance to remove amniotic fluid
281
Medical and Surgical Procedures
Hysterectomy
```
Subtotal hysterectomy
(cervix not removed).
Total hysterectomy
(cervix removed)
Total hysterectomy
plus bilateral salpingooophorectomy
```
282
Medical and Surgical Procedures
Reconstructive breast
surgery
Tissue (skin) expansion
• Breast reconstruction in which a balloon expander
is inserted beneath skin and chest muscle.
• Saline solution is gradually injected to increase size,
and expander is replaced with a permanent implant.
283
Medical and Surgical Procedures
Transverse rectus abdominis muscle (T R A M) flap
• Surgical creation of a skin flap (using skin and fat from lower
half of abdomen), which is passed under skin to breast area,
shaped into a natural looking breast, and sutured in place
284
1. Mary presents to the obstetric clinic in her early third trimester with symptoms of premature labor. The physician recommends a procedure to suture the cervix to prevent premature labor and decrease the risk of a spontaneous abortion. This procedure is
called .
2. Patient is scheduled for removal of her uterus and both fallopian tubes. The physician charts this surgical procedure as total hysterectomy plus bilateral A: .
1. cerclage
| 2. salpingo-oophorectomy
285
3. The patient is scheduled for a transabdominal puncture of the amniotic sac under ultrasound guidance to remove amniotic fluid to find out if her baby has any genetic abnormalities. The physician documents this procedure as .
4. The patient is scheduled for removal of her uterus with the cervix, ovaries, and fallopian tubes intact. The physician charts
this surgical procedure as .
3. amniocentesis
| 4. subtotal hysterectomy
286
5. Ms. Y. presents with heavy bleeding over the last 6 months and is scheduled to have a scraping of uterine endometrium with a
curet after dilation of the cervix. The abbreviation for this procedure is .
6. After her mastectomy, Susan is considering reconstructive breast surgery with the TRAM flap procedure. What is the meaning
of the abbreviation T R A M?
5. D&C
| 6. transverse rectus abdominis muscle
287
Pharmacology
Topical antifungals
Estrogens
Hormone replacement therapy (H R T)
Used to treat vaginal yeast infections
Alter cell wall of fungi or disrupt enzyme activity
• Results in cellular death
Estrogen replacement therapy (E R T) to correct estrogen deficiency
Chemotherapy for some types of cancer
• Used to correct deficiencies of estrogen, progesterone, and testosterone
‒ Relieves symptoms of menopause
‒ Prevents osteoporosis in women
288
Pharmacology
Oral contraceptives (O C P's)
• Synthetic hormones used to prevent pregnancy
‒ Used to treat menstrual disorders
‒ Also known as birth control pills
289
1. The patient presents with a vaginal yeast infection. The physician prescribes a suppository (antifungal, estrogen, H R T).
2. Mrs. A. is menopausal and has symptoms of vaginal dryness and hot flashes. The physician writes her a prescription for an agent known as an (antifungal, estrogen, O C P).
3. Lauren, a 22-year-old, is sexually active with her husband but wants to wait a couple of years before having children. The nurse practitioner explains the most effective option to prevent conception is to use an agent known as an (antifungal, estrogen, O C P).
1. antifungal
2. estrogen
3. O C P
290
4. Mrs. C. has undergone total hysterectomy plus bilateral salpingo-oophorectomy. The gynecologist prescribes H R T now that the ovaries have been removed and estrogen and progesterone cannot be produced. The abbreviation H R T means .
4. hormone replacement therapy
291
Endocrine System - Structure
```
Pituitary gland
Thyroid gland
Parathyroid
Adrenal glands
Pancreas
Pineal and thymus glands
Ovaries and testes (Part of reproductive and endocrine systems)
```
292
Endocrine System - Function
Consist of endocrine (ductless) glands.
• Secrete chemicals called hormones directly into the bloodstream.
Control and integrate many bodily functions.
Action of hormones on target organs increase or decrease the target’s activity level.
• Maintains homeostasis.
‒ Together with the nervous system, the endocrine system controls many intricate activities of the body.
293
1. What is a target organ?
2. What are common conditions that result in various pathologies of the endocrine system?
3. Why is the pituitary known as a master gland?
4. The endocrine glands secrete chemicals into the bloodstream called .
1. The organ or tissue that responds to a hormone
2. Hypersecretion or hyposecretion of a hormone
3. Regulates many body activities; stimulates other glands to secrete specific hormones
4. hormones
294
# Define Combining Forms
1. pancreat/o:
2. thyr/o, thyroid/o:
3. thym/o:
4. aden/o:
5. adren/o, adrenal/o:
6. toxic/o, tox/o:
7. gluc/o, glyc/o, glycos/o:
8. home/o:
1. pancreas
2. thyroid gland
3. thymus gland
4. gland
5. adrenal glands
6. poison
7. sugar, sweetness
8. same, alike
295
# Define Combining Forms (continued_4)
9. calc/o:
10. crin/o:
11. ophthalm/o:
9. calcium
10. secrete
11. eye
296
# Define Suffixes
12. -dipsia:
13. -emia:
14. -genesis:
15. -trophy:
12. thirst
13. blood
14. forming, producing, origin
15. development, nourishment
297
Build Medical Words
1. excessive (many, much) thirst: poly/
2. pertaining to poisonous activity of the thyroid: / /toxic
3. sugar in urine: /uria
4. blood with excessive or abnormal glucose: / /emia
5. instrument to measure sugar: /o/
6. excessive (many, much) urination: poly/
7. condition of deficient insulin: hypo/ /
8. secrete within (internally): endo/
1. poly/dipsia
2. thyr/o/toxic
3. glycos/uria or glucos/uria
4. hyper/glyc/emia
5. gluc/o/meter
6. poly/uria
7. hypo/insulin/ism
8. endo/crine
298
Build Medical Words (continued_4)
9. specialist in the study of poisons:
10. inflammation of the pancreas:
11. enlargement of the extremities:
12. tumor of a gland:
13. tumor (composed of) insulin:
14. blood (with a) poison (toxic substance):
9. toxic/o/logist or toxic/o/log/ist
10. pancreat/itis
11. acr/o/megaly
12. aden/oma
13. insulin/oma
14. tox/emia
299
Graves Disease
| Signs and Symptoms
• Exophthalmos
• Common form of hyperthyroidism
• Production of thyroid hormone increases
• Enlarged thyroid (goiter).
• Elevated metabolic rate, abnormal weight loss, and
muscular weakness.
300
Graves Disease
| Treatment
* Depends on the patient’s age and the severity of the disease.
* Antithyroid agents to block hormone synthesis within the thyroid gland.
* Alteration in the structure of the thyroid gland through surgery or radioactive iodine therapy.
* Beta blockers in combination with one of the treatments listed above.
301
1. Mary is diagnosed with Graves disease and is concerned about the abnormal protrusion of her eyeballs. The doctor explains it is a
common symptom of Graves disease, and the protruding eyeballs is a condition called.
2. The patient is scheduled for excision of her thyroid gland. This surgical procedure is charted as .
3. Mrs. N. presents with hyperthyroidism. She states her mom had Graves disease and asks about the connection between Graves disease and hyperthyroidism.
1. exophthalmus
2. thyroidectomy
3. The doctor explains that Graves disease is the most common form of hyperthyroidism.
302
4. John is diagnosed with Graves disease and asks why his eyes are protruding.
4. The medical assistant explains that it is caused by an accumulation of cellular material behind the eyeballs, which is
stimulated by hypersecretion of thyroidstimulating hormone.
303
Cushing Syndrome
| Signs and Symptoms
* Hypersecretion of adrenal cortex, mainly cortisol.
* Round, “moon-shaped” face with acne.
* Muscle weakness, purple striated marks on skin, and hirsutism.
* Syndrome causes changes in multiple body systems.
* Head and trunk grossly exaggerated, with pencilthin arms and legs.
* “Buffalo” hump on upper back, peptic ulcer, hypertension, and susceptibility to infection.
* Anxiety and depression.
304
Cushing Syndrome
| Treatment
* Restore concentration of serum cortisol to normal levels.
* Varies according to the etiology.
* Drugs or radiation to suppress adrenocorticotropic hormone (A C T H) secretion.
* Total adrenalectomy.
* Lifelong treatments of cortisol replacement therapy.
* Surgery, followed by chemotherapy, when the syndrome is caused by tumors of the adrenal cortex.
305
1. Mary is diagnosed with Cushing syndrome and learns that it is caused by a tumor in her adrenal cortex. She is told the recommended treatment is surgery, followed by chemotherapy. The surgery to remove the adrenal gland(s) is known as .
2. Nancy presents with complaints of puffiness and water retention. The nurse explains that sodium retention causes increased fluid in tissues. The swelling is called .
1. adrenalectomy
| 2. edema
306
3. Jane is diagnosed with Cushing syndrome. The physician explains the goal of treatment is to restore concentration of normal levels of the principal steroid hormone produced
by the adrenal cortex. This hormone is known as (calcitonin, cortisol, oxytocin).
4. The doctor explains one of the complications of untreated Cushing syndrome is elevated blood pressure. The medical term for this complication is .
3. cortisol
| 4. hypertension
307
Growth Hormone Imbalance (G H I)
| Signs and symptoms
• Acromegaly
‒ Hypersecretion of growth hormone (G H) during adulthood.
‒ Fusion of growth plates at ends of long bones, which prevents person from growing taller.
‒ Widening and enlargement of facial features, jaw, hands, and feet.
• Gigantism
‒ Hypersecretion of G H during childhood.
‒ Excessive growth of bones and tissues due to high level of G H.
‒ Height changes of up to 6 inches in 1 year in children.
‒ Abrupt development, resulting in abnormally increased height.
• Dwarfism
‒ Hyposecretion of GH during childhood.
‒ Lack of growth and short stature but with normal body proportions.
308
Growth Hormone Imbalance (G H I)
Treatment
• Hyposecretion of G H
‒ Drug therapy with growth hormone.
‒ Surgery if a tumor is the cause.
• Hypersecretion of G H
‒ Drug therapy to suppress secretion of growth hormone.
‒ Surgery to remove an adenoma or radiation therapy to
destroy the adenoma.
309
1. The physician explains to Mrs. J. that her son’s short stature is a condition known as dwarfism. This condition is caused by
(hyposecretion, hypersecretion, hypertrophy) of G H.
2. Mr. M. will undergo excision of his pituitary gland. The physician explains that he will require lifelong replacement of thyroid
hormone, corticosteroids, and sex hormones to maintain a stable internal environment. The regulation required to maintain this stable environment in the body is called (homogeneous, homeostasis, homologous).
1. hyposecretion
| 2. homeostasis
310
3. Mrs. P. is diagnosed with acromegaly caused by a pituitary tumor. The physician explains that surgery to remove the gland is
required and can be performed endoscopically (through the nose). This procedure is known as a(n) (hypophysectomy, adenectomy,
rhinectomy).
3. hypophysectomy
311
Diabetes Mellitus
| Signs and symptoms
• Group of metabolic diseases.
• Characterized by high glucose levels.
• Caused by defects in insulin secretion, action, or both.
• Two primary forms
‒ Type 1 (insulin-dependent) diabetes mellitus.
‒ Type 2 (non–insulin-dependent) diabetes mellitus.
312
Diabetes Mellitus
Signs and symptoms (continued)
Type 1 (insulin-dependent) diabetes mellitus
* Chronic metabolic disorder marked by hyperglycemia.
* Inability of the pancreas to produce enough insulin to properly control blood glucose levels.
* Most commonly diagnosed in children, adolescents, or young adults.
* Fatigue, polyphagia, polyuria, and polydipsia
* Unplanned weight loss
* Blurred vision (common in patients with hyperglycemia and polyphagia)
* Diabetic ketoacidosis with loss of metabolic control (for example, during periods of infection or noncompliance with therapy)
313
Diabetes Mellitus
Signs and symptoms Type 2 (non–insulin-dependent) diabetes
mellitus
* Gradual onset that occurs in middle age, commonly in overweight patients (because fat interferes with the body’s ability to use insulin).
* Characterized by high blood glucose levels that lead to a chronic, lifelong disease that requires medical management.
* Insulin resistance and inadequate insulin secretion to sustain normal metabolism.
* Commonly asymptomatic.
* Polyphagia, polydipsia, and polyuria.
* Frequent or slow-healing infections.
* Fatigue.
* Blurred vision (common in hyperglycemic patients).
314
Diabetes Mellitus
Treatment
Type 1
* Specialized diet and regular exercise.
* Intensive foot and eye care.
* Medications, including insulin to lower blood glucose levels.
315
Diabetes Mellitus
Treatment
Type 2
• Calorie-restricted diet with regular aerobic exercise.
• Oral drugs:
‒ Increase pancreatic secretion of or cellular sensitivity to
insulin.
‒ Decrease absorption of carbohydrates from the gastrointestinal (G I) tract.
• Insulin injections (if combinations of oral drugs fail to regulate blood glucose levels)
316
1. Mrs. Q. has symptoms of polyphagia, polydipsia, and polyuria. The physician explains that these are classic symptoms of
(ketosis, diabetes, myxedema).
2. Ms. V. has type 1 diabetes and complains of fluid retention and back pain. The physician explains kidney disease is a complication of untreated diabetes mellitus, and diagnoses her condition as diabetic (nephropathy, cystopathy, uropathy).
1. diabetes
| 2. nephropathy
317
3. Ms. T.’s fasting blood glucose laboratory result is 150. This abnormally elevated blood glucose level is charted as .
4. During a patient education session about diabetes, the nurse explains that exact insulin measurement is important. Too
much insulin will result in an abnormally low blood glucose level, a condition called
.
3. hyperglycemia
| 4. hypoglycemia
318
Vocabulary Challenge Exercise
1. hormones:
2. myxedema:
3. obesity:
4. osteoporosis:
1. specialized chemicals that are released directly into the bloodstream and travel to specific tissues or organs of the body called targets
2. advanced hypothyroidism in adults, causing edema and increased blood pressure
3. excessive accumulation of body fat that may lead to an adverse effect on health; body mass index (B M I) is greater than 30
4. abnormal loss of bone density and deterioration of bone tissue with an increased risk of fractures
319
Diagnostic Procedures
Fasting blood glucose (F B G)
Glucose tolerance test (G T T)
• Measures blood glucose levels following a fast of
at least 8 hours.
• Measures blood glucose levels at regular
intervals (usually 3 hours).
• Used to diagnose diabetes mellitus with higher
accuracy than other blood glucose tests.
320
Diagnostic Procedures
| Glucometer
* Monitors blood glucose levels (glycemia).
* Self-monitoring, usually done before meals and at bedtime.
* Piercing of skin, typically on the finger, to draw blood.
* Application of blood to a test strip.
321
Diagnostic Procedures
Radioactive iodine uptake (R A I U) test
Thyroid function test (T F T)
• Administration of R A I U in pill or liquid form.
‒ Used as a tracer to test how quickly the thyroid gland uptakes iodine from blood.
* Detects increase or decrease in thyroid function.
* Measures levels of thyroid-stimulating hormone, triiodothyronine (T3 ), and thyroxine (T4 ).
322
Build Medical Words (continued_8)
1. blood condition of deficient calcium:
2. blood condition of excessive calcium:
3. tumor of thymus gland
4. enlargement of the thyroid gland:
5. blood condition of excessive glucose:
6. urine that contains sugar:
1. hypocalcemia
2. hypercalcemia
3. thymoma
4. thyromegaly
5. hyperglycemia
6. glucosuria
323
Medical and Surgical Procedures
Transphenoidal DOUBLE CHECK - ONE PROCEDURE OR TWO
Hypophysectomy
• Endoscopic procedure to remove a pituitary tumor.
• Incision of the sphenoid sinus (transphenoidal)
without disturbing brain tissue.
324
Medical and Surgical Procedures
Thymectomy
• Excision of thymus gland.
• Used to remove tumors of thymus.
• Used in treatment of myasthenia gravis (M G).
‒ M G commonly causes abnormalities of the thymus
325
Medical and Surgical Procedures
Insulin delivery with an insulin pump
• Small pump device delivers insulin
subcutaneously.
• Typically worn on the abdomen or buttocks.
• Continuous delivery of small amounts of insulin via a tiny catheter, as illustrated.
• Bolus of insulin delivered with the push of a button before meals or snacks.
‒ Provides closer to normal insulin levels.
326
Medical and Surgical Procedures
Insulin injection sites
• Absorption and effectiveness are determined by the
injection site.
• Rapid absorption
‒ Abdomen and then upper arm and thigh areas.
• Slower absorption
‒ Subcutaneous fat and hip and buttock areas.
• No injection within 2 inches of the navel.
327
1. Mrs. J. is diagnosed with a thymoma. The physician informs her that he must excise it in a surgical procedure called .
2. Mr. X. is diagnosed with hyperthyroidism. The physician explains that excision of one lobe of the thyroid will stabilize his
condition. The surgical procedure to remove a lobe is called .
3. Ms. C. undergoes biopsy that reveals a malignant tumor of the adrenal gland. The physician charts this malignant tumor as an
adrenal .
4. Mr. K.’s magnetic resonance imaging (M R I) reveals a rare tumor of the adrenal glands composed of chromaffin cells. This type of
tumor is known as a(n) (cytoma, pheochromocytoma, adrenal sarcoma).
1. thymectomy
2. lobectomy
3. carcinoma
4. pheochromocytoma
328
5. Ms. R. will use an insulin pump to replace the multiple insulin injections she takes throughout the day. This pump delivers
insulin directly into her bloodstream via a small, hollow tube called a .
6. Ms. D. is diagnosed with diabetes. The nurse demonstrates how to get a blood sample and insert it into a device to measure blood
glucose. This device is called a .
5. catheter
| 6. glucometer
329
Pharmacology
Hormone replacement therapy (H R T)
Oral hypoglycemics
• Oral administration of injection of synthetic hormones.
‒ Corrects deficiency in estrogen, testosterone, or thyroid hormone.
• Stimulate insulin secretion from pancreatic cells in patients with non–insulin-dependent diabetes with some pancreatic function.
330
1. Mary is diagnosed with type 1 diabetes. To control her blood sugar levels, the physician prescribes (corticosteroids, insulin, thyroid hormones).
2. Susan is in menopause. To control her symptoms of hot flashes and vaginal dryness, the physician prescribes an oral synthetic hormone of (calcium, estrogen, testosterone).
1. insulin
| 2. estrogen
331
3. Tom has undergone thyroidectomy. To replace the production of hormones T3 and T4 , the doctor prescribes (calcium,
corticosteroids, thyroid supplements).
4. Connie is diagnosed as postmenopausal and finds she is at risk for osteoporosis. Her doctor recommends preventing bone loss
by taking a supplement called (calcium, sodium, thyroid).
3. thyroid supplements
| 4. calcium
332
Nervous System
Structure
```
Two main divisions of nervous system
Central nervous system (C N S)
• Brain
• Spinal cord
Peripheral nervous system (P N S)
• Cranial nerves
• Spinal nerves
```
333
Central nervous system (C N S)
| • Brain
‒ Highly complex in structure and function.
‒ Trillions of synapses work together to control every physical and mental activity of the body.
‒ Center for memory, emotion, thought, judgment, reasoning, and consciousness.
334
Central nervous system (C N S)
| • Spinal cord
‒ Long narrow column of neural tissue within the spinal
cavity of the vertebral column.
‒ Extends from brainstem to the second lumbar vertebra in the spinal column.
‒ Protected by bony structures of the vertebral column.
‒ Protected and nourished by the meninges.
* Three membranes covering spinal cord and brain.
‒ Transmits sensory impulses from the body to the brain.
‒ Transmits motor impulses from the brain to muscles and organs of the body.
335
Structure and Function
Peripheral nervous system (P N S)
* Cranial nerves
* Spinal nerves
‒ 12 pairs that emerge from the brainstem.
‒ Named for each pair that reflects its location or function.
‒ 31 pairs that emerge from the spinal cord.
‒ Named for each pair according to the vertebra next to it.
336
Structure and Function
Cellular structure of the nervous system
* Neurons
* Neuroglia
‒ Basic structural and functional units of nervous system.
‒ Interconnecting to form complicated networks called nerves that transmit electrical impulses throughout the body.
‒ Perform functions of support and protection.
‒ Do not transmit electrical impulses.
‒ Certain small glial cells are phagocytic cells.
*Protect C N S from disease by engulfing and digesting invading
microbes.
337
1. What are the two main divisions of the nervous system?
2. What are the cells that transmit impulses called?
3. What does the C N S consist of?
4. What does the P N S consist of?
5. What is the function of neuroglial cells?
1. Central nervous system (C N S) and peripheral nervous system
(P N S)
2. Neurons
3. Brain and spinal cord
4. Peripheral nerves that connect C N S to remote body parts to relay and receive messages
5. They perform the function of support and protection. Certain small glial cells are phagocytic cells and protect C N S from
disease by engulfing and digesting invading microbes.
338
# Define Combining Forms
1. cerebr/o:
2. encephal/o:
3. gli/o:
4. mening/o, meningi/o:
5. myel/o:
6. neur/o:
1. cerebrum
2. brain
3. glue, neurological tissue
4. meninges (membranes covering brain and spinal cord)
5. spinal cord
6. nerve
339
# Define Combining Suffixes
7. -paresis:
8. -phasia:
9. -plegia:
10. -asthenia:
7. partial paralysis
8. speech
9. paralysis
10. weakness, debility
340
Spinal Cord Injuries
| Signs and Symptoms
• Spinal cord injury resulting in paralysis
‒ Usually a consequence of fracture, dislocation, or both of the vertebral column.
• Location of spinal cord injury and severity of trauma determines whether paraplegia or quadriplegia results.
• In paraplegia, there is loss of motor and sensory functions in the legs and trunk.
• In paraplegia, bowel, bladder, and sexual function may be lost.
• Complete spinal cord injury renders no feeling or function beneath the injury.
• Incomplete spinal cord injury renders some feeling and function remains beneath the injury.
341
Spinal Cord Injuries
| Treatment
* Restoration and stabilization of the injured spinal area.
* Halo brace keeps head and neck immobile while fusion and healing takes place.
* Decompression of compressed neurological structures.
* Prevent progressive spinal cord tissue damage.
* Surgery, drugs, or cooling the affected portion of the spine.
342
1. Michelle’s daughter is diagnosed with a spinal cord injury and asks the nurse to explain its cause.
2. Jena has a loss of motor and sensory functions in the legs and trunk after an auto accident. This type of spinal injury is known as (paraplegia, quadriplegia, complete spinal injury).
3. The nurse explains that a C6 injury results in paralysis of all four extremities and usually the trunk. This type of impairment is called (paraplegia, quadriplegia, total paralysis).
4. The veteran presents to the clinic with paralysis of the lower portion of the body and both legs. The medical term in the chart for this spinal cord impairment is (paraplegia, quadriplegia, total paralysis).
1. Acute traumatic injury of the spinal cord that results from automobile accidents, sports injuries, falls, or violence
2. paraplegia
3. quadriplegia
4. paraplegia
343
Spina Bifida
| Signs and Symptoms
• Developmental defects of the first trimester of pregnancy, characterized by incomplete closure of the bones encasing the
spinal cord.
344
Spina Bifida
Signs and Symptoms
Spina Bifida Occulta
Spina bifida occulta is the most common and least severe spinal cord defect.
• Incomplete closure of one or more vertebrae without protrusion of spinal cord or meninges. Spinal cord is covered with a layer of skin.
345
Spina Bifida
Signs and Symptoms
Spina bifida cystica
has two classifications:
• Meningocele—sac contains only meninges and
cerebrospinal fluid (C S F).
• Meningomyelocele―sac contains meninges, C S F,
and a portion of the spinal cord.
346
Spina Bifida
Treatment
* Spina bifida occulta usually does not require treatment.
* Meningocele and meningomyelocele require surgical repair of sac and supportive measures to promote independence and decrease possibility of complications.
* Folic acid in diet of women in the childbearing age decreases risk of spina bifida.
347
1. Mrs. C. asks about the importance of taking a folic acid vitamin supplement during pregnancy.
2. Baby Smith is diagnosed with spina bifida cystica and the mother asks the physician to explain this congenital defect.
1. The medical assistant explains that folic acid intake decreases risk of the child being born with the congenital defect called
spina bifida.
2. The doctor states that spina bifida cystica involves protrusion of the meninges (meningocele), or spinal cord (myelocele), or both (meningomyelocele).
348
3. Mrs. J. asks the nurse to explain the treatment recommended for spina bifida occulta.
3. She explains that spina bifida occulta does not require surgery and there is little or no treatment.
349
4. Baby Mary is diagnosed with spina bifida that involves protrusion of the meninges. The medical term for this is (meningocele, meningomyelocele, myelocele).
5. Baby Mark is diagnosed with spina bifida cystica that involves the protrusion of the meninges and the spinal cord. This diagnosis is charted as (meningocele, meningomyelocele, myelocele).
4. meningocele
| 5. meningomyelocele
350
```
Cerebrovascular Accident (Stroke)
Two types of stroke
```
Type 1: Ischemic stroke
| Type 2: Hemorrhagic stroke
351
```
Cerebrovascular Accident (Stroke)
Type 1: Ischemic stroke
```
• Blood supply to brain is blocked or significantly slowed. It might be thrombotic or embolic.
‒ Thrombotic stroke occurs when an occlusion builds
up in an artery until it significantly decreases or stops blood flow to the brain.
* Thrombotic stroke most often occurs in the internal or common carotid arteries.
• Embolic stroke is caused by a blood clot that is created somewhere in the body and travels (embolism)
‒ Often within the heart, and travels through arteries until it becomes trapped in a smaller vessel, preventing passage of blood.
‒ Embolism travels and becomes lodged in middle, anterior, or posterior cerebral arteries.
352
```
Cerebrovascular Accident (Stroke)
Type 2: Hemorrhagic stroke
```
• Caused by rupture of a cerebral blood vessel that allows blood to escape into brain tissue and not travel beyond the point of rupture.
‒ Further classified as intracerebral hemorrhage and
subarachnoid hemorrhage.
• Intracerebral hemorrhage
‒ Rupture of vessels in the brain.
‒ Compression and destruction of brain structures from
released blood.
• Subarachnoid hemorrhage
‒ Release of blood into the space surrounding the brain.
‒ Commonly caused by a ruptured aneurysm.
‒ Usually fatal.
353
Cerebrovascular Accident (Stroke)
Signs and symptoms
* Symptoms vary and depend on the area of the brain affected.
* Visual disturbances and language disturbances.
* Weakness or paralysis on one side of the body.
* Drowsiness, severe headache, and dysphagia.
354
Cerebrovascular Accident (Stroke)
Treatment
* Initial emergency care is supportive while test results are pending.
* Laboratory tests, electrocardiography (E C G), and computed tomography scans, with results back within 4 minutes after assessment.
* Thrombolytic therapy within an hour of arrival.
* Careful serial neurological assessments to promptly detect changes.
355
1. Mr. C. is aware that strokes are commonly preceded by mild, stroke-like symptoms that usually resolve within 24 hours. His
physician advises him to seek medical attention if he experiences such symptoms, called T I A, which is the abbreviation for .
2. Mrs. L. suffered a stroke that affected the left side of her brain and resulted in a speech impairment. The physician charts this disorder as (aphasia, dysphagia, dysphasia).
1. transient ischemic attack
| 2. dysphasi
356
3. Mr. R. suffered a stroke 6 months ago. Today, he must use a cane to walk because of weakness in his left leg. The medical
term for this weakness is (paraplegia, hemiplegia, hemiparesis).
4. Ms. A. suffered a stroke and now has difficulty eating and swallowing. How should the nurse chart these difficulties?
3. hemiparesis
| 4. dysphagia
357
Alzheimer Disease
| Signs and symptoms
• Neuritic plaques and neurofibrillary tangles instead of normal orderly arrangements develop in the brain.
‒ Deficiency of function of neurotransmitters.
358
Alzheimer Disease
Signs and symptoms
Stages
• Stage 1: Increasing forgetfulness.
• Stage 2: Progressive cognitive deterioration causes difficulty doing simple calculations or answering questions.
• Stage 3: Progression to complete dependency.
‒ Ability to recognize that others are lost.
‒ Death occurs from complications of immobility.
359
Alzheimer Disease
| Treatment
• No known cure.
• Drugs to inhibit breakdown of the neurotransmitter acetylcholine.
‒ Increased levels of acetylcholine in the brain allow better functioning of the remaining neurons.
• Focuses on minimizing effects of the disease.
‒ Maintaining independence as long as possible.
• Antidepressants, antipsychotics, and antianxiety drugs may be used as last resort to control symptoms of depression and behavioral disturbances.
360
1. Mrs. A. is becoming forgetful and withdrawing from social interactions with her family. She loses track of time and commonly forgets to eat her meals. The physician diagnoses her disorder as
(deterioration, dyslexia, dementia).
2. Mr. F. is a resident in the Alzheimer unit. He no longer recognizes his wife and daughter when they come for a visit. In addition, he is completely dependent on his caregivers for
his daily needs. What stage of Alzheimer disease does Mr. F. suffer from?
1. dementia
| 2. stage 3
361
3. To alter the destruction of neurons in Alzheimer disease, pharmaceutical treatment involves prescribing drugs to
(increase, inhibit, promote) levels of acetylcholine in the brain.
3. inhibit
362
Vocabulary Challenge Exercise
1. cognition:
2. craniotomy:
3. epilepsy:
4. hydrocephalus:
1. the ability to think; includes attention, memory, learning, reasoning, problem solving, and decision making
2. incision of the skull to gain access to the brain during neurological procedures
3. disorder that affects the central nervous system (C N S) and is characterized by recurrent seizures
4. cranial enlargement caused by accumulation of fluid within the ventricles of the brain
363
Vocabulary Challenge Exercise
5. neuritic plaques:
6. sciatica:
5. sticky substance made of amyloid protein found in the gray matter of the brain; the plaques are frequently characteristic of
Alzheimer disease
6. severe pain in the leg along the course of the sciatic nerve, which travels from the hip to the foot
364
Diagnostic Procedures
| Lumbar puncture
• Needle puncture of spinal cavity to withdraw a sample of
cerebrospinal fluid.
‒ Used for biochemical, microbiological, and cytological laboratory
analysis.
‒ Introduces agents into spinal canal (anesthetics, radiopaque substances).
365
Diagnostic Procedures
| Electroencephalography (E E G)
• Recording and analysis of electrical activity of the brain.
‒ Record obtained is called an electroencephalogram
(paper strip tracings).
• Electrodes are placed on scalp.
• Helpful in studying epilepsy, convulsive disorders, and locating lesions in the cerebrum.
366
Diagnostic Procedures
| Electromyography (E M G)
* Recording and analysis of electrical activity of selected muscle groups while at rest and during voluntary contraction.
* Test determines whether muscle weakness is caused by a muscular disease or nerve damage.
* Aids in diagnosis of neuromuscular disorders
367
Diagnostic Procedures
| Positron emission tomography (P E T)
• Imaging procedure that records metabolic activity.
• Use of a tracer that emits positively charged molecules.
• Commonly used in conjunction with C T.
• Used to scan brain and nervous tissue.
‒ Identifies areas of abnormal activity that occur in schizophrenia, tumors, epilepsy, stroke, and Alzheimer disease.
368
Diagnostic Procedures
| Computed tomography (C T)
* Use of a computer to generate three-dimensional images.
* Especially effective in diagnosing disorders of the brain and spinal cord.
* Used to visualize tumors, abscesses, hemorrhage, and injury from trauma.
369
Build Medical Words
1. pertaining to the cerebrum and spine:
2. incision of the cranium (skull):
3. crushing a nerve:
4. hernia(tion) of meninges and spinal cord:
5. inflammation of gray matter of spinal cord:
6. paralysis of four (limbs):
7. tumor of nerve, embryonic cell:
1. cerebr/o/spin/al
2. crani/o/tomy
3. neur/o/tripsy
4. mening/o/myelocele
5. poli/o/myel/it is
6. quadri/plegia
7. neur/o/blast/oma
370
Build Medical Words (continued_4)
8. pertaining to the cerebrum:
9. condition of water in the head:
10. separation, destruction, or loosening of a nerve:
8. cerebr/al
9. hydr/o/cephal/us
10. neur/o/lysis
371
Medical and Surgical Procedures
| Craniotomy
Incision of the skull to gain access to the brain during neurological procedures.
Performed to control brain bleeds, relieve intracranial pressure (I C P), and remove brain tumors.
372
Medical and Surgical Procedures
Thalamotomy
Partial destruction of the thalamus portion of the brain.
| Used as a treatment for psychosis and intractable pain.
373
Medical and Surgical Procedures
Trephination
Excision of a circular disk of bone by using a specialized saw called a trephine.
Reveals brain tissue for neurosurgery.
Used to relieve I C P.
374
1. John suffers from chronic pain caused by an injury to his back from an auto accident 10 years ago. The doctor performs a partial
destruction of the thalamus to treat his chronic pain. This is charted in the medical record as .
2. Zia is having surgery to remove a brain tumor. The surgeon needs to create an opening in the skull to gain access to the
tumor. This surgery is known as (craniotomy, thalamotomy, tractotomy).
1. thalamotomy
| 2. craniotomy
375
3. The neurosurgeon performs a transection of a nerve tract in the spinal cord to resolve the patient’s chronic pain. This surgical procedure is charted as (craniotomy, thalamotomy, tractotomy).
4. What is the name of the specialized saw that can excise a circular disk of bone? (trephine, thalmine, L P)
3. tractotomy
| 4. trephine
376
Pharmacology
| Anesthetics
• Produce partial or complete loss of sensation, with or without loss of consciousness.
‒ General anesthetics act on brain to produce complete loss of consciousness.
‒ Local anesthetics act on nerves or nerve tracts to affect a local area only.
377
Pharmacology
Anticonvulsants
Antiparkinsonian agents
* Prevent or reduce severity of epileptic or other convulsive seizures; also called antiepileptics.
* Control tremors and muscle rigidity associated with Parkinson disease by increasing dopamine levels in the brain.
378
Pharmacology
Antipsychotics
• Alter neurotransmitters in the brain to alleviate symptoms of psychosis, paranoia, and schizophrenia.
379
1. To control parkinsonian tremors, the physician prescribes an (anticonvulsant agent, antibiotic agent, antiparkinsonian agent).
2. Pat is scheduled for craniotomy. The anesthesiologist informs her that she will be unconscious during the procedure and
a (general, central, local) anesthetic will be administered.
1. antiparkinsonian agent
| 2. general
380
3. To control seizures, the physician prescribes an (anesthetic, anticonvulsant, antiparkinsonian).
4. Mr. R. is diagnosed with paranoid schizophrenia. The psychiatrist prescribes an (anticonvulsant, antiparkinsonian,
antipsychotic) to the relieve the symptoms of paranoia.
3. anticonvulsant
| 4. antipsychotic
381
5. Mrs. C. is informed that she will be under local anesthesia for her minor procedure, and she asks if she will be unconscious.
5. The nurse explains that anesthetics that produce loss of feeling only affect a local area; there is no loss of consciousness.
382
Musculoskeletal System
Structure
Muscles
Human skeleton
Bones
383
Three types of muscles
* Skeletal
* Smooth
* Cardiac
384
Function of Muscles
Provide contraction that allows body movement.
Provide body posture.
Help passage and elimination of food.
Help propel blood through arteries and other vessels.
Provide contraction of bladder to eliminate urine.
385
Human Skeleton
```
Consists of 206 individual bones.
Axial skeleton is divided into three major regions.
Skull
rib cage
vertebral column.
```
386
Function
| Bones
Provide a skeletal framework to support and protect the body.
Point of attachment with muscles.
Store calcium and other minerals.
Produce blood cells within bone marrow.
387
Structure and Function
Bones
Four types
• Short
• Irregular
• Flat
• Long
‒ Diaphysis—shaft, or long portion, of the bone
‒ Distal and proximal epiphysis—two ends of the bone
388
1. What are the four principal types of bones?
2. Provide a few examples of long bones.
3. What are the terms given to the ends of a long bone?
4. Where is smooth muscle found in the body, and what are its functions?
5. What is the function of ligaments?
1. Short bones, flat bones, irregular bones, and long bones
2. Long bones are found in the extremities of the body, such as the legs, arms, fingers, and toes.
3. Distal epiphysis and proximal epiphysis
4. They are found in walls of arteries, respiratory passages, urinary and reproductive ducts, and visceral organs. Smooth muscles are those whose actions are involuntary.
5. They are flexible bands of fibrous tissue that hold bones close together at the joint.
389
```
Define Combining Forms Muscular System
muscul/o, my,o:
leiomy/o:
rhabd/o:
rhabdomy/o:
chondr/o:
```
```
muscle
smooth muscle (visceral)
rod-shaped (striated)
rod-shaped (striated) muscle
cartilage
```
390
# Define Combining Forms
6. crani/o:
7. femor/o:
8. patell/o:
9. tibi/o:
10. pelvis:
11. scapula:
12. vertebra:
13. sternum:
6. cranium
7. femur
8. patella
9. tibia
10. pelv/o, pelv/i
11. scapul/o
12. vertebr/o
13. stern/o
391
# Define Combining Forms
14. chondr/o:
15. cost/o:
16. arthr/o:
17. orth/o:
18. oste/o:
19. thorac/o:
20. spondyl/o, vertebr/o:
14. cartilage
15. ribs
16. joint
17. straight
18. bone
19. chest
20. vertebrae (backbone)
392
Build Medical Words
1. inflammation of ribs and cartilage: /o/ /itis
2. act of measuring the pelvis: /i/
3. malignant tumor of connective tissue and muscle: /o/sarcoma
4. cell that breaks down bone: /o/clast
1. cost/o/chondr/itis
2. pelv/i/metry
3. my/o/sarcoma
4. oste/o/clast
393
Build Medical Words
5. inflammation around bone: / /itis
6. pertaining to under or below the ribs: sub/ /al
7. pertaining to the sternum (breastbone) and ribs: /o/ /al
8. pain in the calcaneum (heel bone): /o/
5. peri/oste/itis
6. sub/cost/al
7. stern/o/cost/al
8. calcane/o/dynia
394
Build Medical Words
1. porous bone:
2. tumor (composed) of muscle:
3. binding, fixation (of a bone or joint):
4. rupture of muscle:
5. abnormal condition of being stiff, bent, or crooked:
6. weakness or debility of muscle:
7. softening of cartilage:
8. visual examination of a joint:
1. oste/o/porosis
2. my/oma
3. arthr/o/desis
4. my/o/rrhexis
5. ankyl/osis
6. my/asthenia
7. chondr/o/malacia
8. arthr/o/scopy
395
Build Medical Words
9. tumor (composed of) of smooth muscle:
10. pertaining to (the area) between (two) vertebrae:
9. leio/my/oma
| 10. inter/vertebr/al
396
Fractures
| Signs and Symptoms
Injury or breaking of a bone.
Pain, swelling, bruising, and deformity at site of fracture.
Loss of movement, function, muscle spasm, hemorrhage, and shock.
Depends on whether the fracture is caused by trauma from a fall, an accident (usually motor vehicle), or a crushing injury.
Depends on whether the fracture is the result of trauma from bone disease, such as osteoporosis, bone cancer, or some other
pathological condition of the bones.
397
Fractures
Signs and Symptoms
Common types
1. Closed
2. Open (compound)
1. Closed (simple)—break with no external skin wound.
2. Open (compound)— break with external wound.
‒ Leads to fracture site with piece of bone protruding through skin.
398
```
Fractures
Signs and Symptoms
Common types
3. Complicated
4. Comminuted
```
3. Complicated—broken bone injures an internal organ, such as the lung.
4. Comminuted—bone broken or splintered into pieces.
399
```
Fractures
Signs and Symptoms
Common types
5. Impacted
6. Incomplete
```
5. Impacted—end of broken bone wedged into interior of another bone.
6. Incomplete—fracture line does not include the whole bone.
400
Fractures
Signs and Symptoms
Common types
7. Greenstick
7. Greenstick—break in which bone is partially bent and split.
Occurs most commonly in children, especially those who have rickets, or in adults with soft bones
401
Signs and Symptoms
Common types
8. Colles
8. Colles—break in lower end of radius. Commonly occurs when
wrist is extended to break a fall.
402
Fractures
| Treatment
External immobilization of affected part using traction, casting, or splinting.
Open or closed reduction.
• May be required to realign bone for proper healing.
Analgesics or muscle relaxants to ease pain.
Open reduction (surgical) and external fixation or internal fixation by using metal plates, screws, or rods.
Possibly no treatment.
Bandaging or taping for support, immobilization, and pain control (as with rib fractures).
403
1. Mr. O. is involved in an automobile accident and presents to the emergency department with a broken rib that has pierced his lung.
The physician diagnoses this fracture as (closed, comminuted, complicated).
2. Mr. Q.'s radiograph shows a line of fracture on his femur that does not include the entire bone. The radiologist identifies this as
a/an (Colles, comminuted, incomplete) fracture.
1. complicated
| 2. incomplete
404
3. The doctor explains to Mrs. P. that he will immobilize and align the bones of her hip at the site of the fracture by inserting pins
and screws. This type of procedure is known as (internal fixation, osteoclasis, synovectomy).
4. The radiograph of 3-year-old Mike shows a bending of the femur following a car accident. The physician charts the break in
the bone as a fracture.
3. internal fixation
| 4. greenstick
405
5. Mary presents to the emergency department and is diagnosed with a broken arm. The physician explains that he will have to manipulate her arm to realign the bones before putting on a cast.
The physician charts the procedure as reduction.
5. closed
406
Herniated Disk
| Signs and Symptoms
Herniation of the nucleus pulposus (center of gelatinous
material within an intervetebral disk) between two vertebrae;
also called prolapsed disk.
Depend on the particular site of herniation.
Severe back pain that worsens with motion.
For cervical disk herniation, paresthesia and restricted mobility of the neck.
Coughing, sneezing, or bending intensifies the pain and discomfort.
Lumbar sciatic involvement begins as a dull ache and progresses to severe pain.
407
Herniated Disk
| Treatment
Bed rest and alternating heat and cold applied to the affected portion of the spine.
Muscle relaxants, salicylate, and/or analgesics.
Traction of lower extremities and a back brace.
Laminectomy may be required if conservative treatment is unsuccessful.
Spinal fusion may be necessary to stabilize the spine.
408
```
1. Joe presents to the clinic with a sensation of numbness and a burning feeling in his right foot. The physician diagnoses his
condition as (paraplegia, paresis, paresthesia).
```
2. Fred complains of pain emanating from his lower back that goes down to the left leg. The doctor suspects that it is a flare-up of
pain along the sciatic nerve known as .
1. paresthesia
| 2. sciatica
409
3. Mr. X. undergoes surgery to correct a herniated disk. The orthopedic surgeon removes the vertebral posterior arch in a
surgical procedure called (dislodgement, herniorrhaphy, laminectomy).
4. Treatment for a herniated disk is to relieve pain, treat muscle spasms, and relieve pressure. It includes use of weights and pulleys to immobilize the site and facilitate healing and is known as (traction, tractotomy, tractus).
3. laminectomy
| 4. traction
410
Rheumatoid Arthritis
| Signs and Symptoms
Autoimmune disease in which immune system attacks its own cartilage and connective tissues.
Results in crippling deformities.
Most commonly found in women between ages 23 and 35 years, but can affect people of any age group.
Muscles, bones, and skin adjacent to the affected joint atrophy.
411
Rheumatoid Arthritis
| Treatment
No specific cure, but medications can slow spread of the disease.
Less severe cases are treated with nonsteroidal anti-inflammatory drugs (N S A I D's), physical therapy, and orthopedic measures.
Surgery may reduce pain and improve mobility
412
1. Ms. T. has a recent diagnosis of an autoimmune disease in which the immune system attacks its own cartilage and connective tissues. This results in crippling deformities and causes muscles, bones, and skin adjacent to the affected joint to atrophy. This disease is known as rheumatoid .
2. The patient with a history of rheumatoid arthritis is concerned about its effects on joint cartilage and asks the nurse to explain the joint deterioration.
1. arthritis
| 2. The nurse states that joint cartilage is slowly destroyed by changes associated with the inflammatory process.
413
3. Michelle suffers from rheumatoid arthritis (R A) and presents with complaints of mild pain. The physician recommends an overthe-counter anti-inflammatory, such as ibuprofen. He explains that it is commonly used to relieve mild to moderate pain and
reduce inflammation. This type of drug is known as a/an (antibacterial, N S A I D, steroid).
4. The physician’s assistant is speaking to a support group of patients with R A. She explains the prognosis of R A and why it is
such a crippling disease.
3. N S A I D
4. The physician’s assistant explains that because there is no cure for R A, the disease progresses until the cartilage and connective tissues of joints are destroyed.
414
Talipes Equinovarus
| Signs and Symptoms
Congenital deformity.
Heel of the foot is unable to rest on the ground.
Also called clubfoot
415
Talipes Equinovarus
| Treatment
Applying casts to progressively straighten the foot.
| Surgical correction may be necessary for severe cases.
416
Osteomyelitis
| Signs and Symptoms
Inflammation, swelling, localized heat, redness, pain and local
tenderness.
• Occurs at and around the bone.
• Other symptoms include chills, fever, sweating, and malaise.
As infection progresses, an abscess may develop.
• Fractured dead pieces become surrounded by purulent material and form a sequestrum, as illustrated.
• Both acute and chronic forms can present the same clinical picture.
417
Osteomyelitis
| Treatment
Extensive, long-term antibiotic treatment.
• Follow-up care to prevent recurrent infections.
Surgical drainage to remove pus and necrotic bone tissue.
Tissue and bone grafts if necessary to restore blood flow to the site.
418
1. Mr. K. suffers from infected bone tissue that has become necrotic and results in a bone abscess. This infection of bone and
bone marrow is diagnosed as (osteoporosis, osteitis, osteomyelitis).
2. Mr. Z. is diagnosed with osteomyelitis. The physician explains that if the infection goes untreated, eventually, the bone tissue will die. This condition is known as (necatoriasis, necropsy, necrosis).
1. osteomyelitis
| 2. necrosis
419
3. Mrs. P. had hip surgery a few weeks ago and complains of pain around the incision site. After a series of tests, the physician
determines that there is local infection of bone and bone marrow, most likely as a result of bacteria introduced during her surgery. The physician diagnoses her condition as (osteomalacia, osteomyelitis, osteophlebitis).
3. osteomyelitis
420
```
4. Baby Mia is born with a condition in which the heels of the feet are unable to rest on the ground. The physician diagnoses her
condition as (osteomalacia, osteomyelitis, talipes equinovarus).
```
4. talipes equinovarus
421
Gout
| Signs and symptoms
Metabolic disease
• One or more severely inflamed joints because of deposits and buildup of uric acid crystals.
• Swollen joint that is hot, usually painful to the touch.
More common in middle-aged and older men.
Characterized by renal dysfunction (hyperuricemia) and renal calculi.
422
Gout
| Treatment
Bed rest to lessen pressure on affected joints.
N S A I D's and corticosteroids:
• Orally or injected into the gouty area to reduce inflammation.
• Applications of heat or cold with analgesics.
Gradual weight reduction for overweight patients.
Dietary modifications:
• Low-purine diet.
• Adequate fluid intake.
• Dairy products.
423
1. Mr. J.'s right great toe is swollen and painful. He suffers from a metabolic disease caused by accumulation of uric acid crystals in the blood. His condition is diagnosed as .
2. Mrs. R. has a history of “aches and pains” in her knees, and she has red, swollen, painful knees. The nurse charts her symptoms as (arthralgia, arthrodesis, arthrolysis).
1. gout
| 2. arthralgia
424
3. Mary is diagnosed with gout and is given instructions by the nurse to follow a lowpurine diet. The nurse explains that purines are found in (carbohydrates, fat, protein).
4. Mr. M.’s laboratory results indicate abnormally high levels of uric acid in the bloodstream. The medical word for this excess uric acid in the blood is .
3. protein
| 4. hyperuricemia
425
Vocabulary Challenge Exercise
1. contracture:
2. crepitation:
3. dystrophy:
4. kyphosis:
1. fibrosis of connective tissue in the skin, fascia, muscle, or joint capsule that prevents normal mobility of the related tissue or joint
2. grating sound made by movement of bone ends rubbing together, indicating a fracture or joint destruction
3. progressive degeneration of a body tissue, such as muscle, caused by inadequate nourishment of the affected area
4. increased curvature of the thoracic region of the vertebral column leading to a humpback posture; also called hunchback
426
Vocabulary Challenge Exercise
5. subluxation:
6. torticollis:
5. partial or complete dislocation
| 6. spasmodic contraction of the neck muscles causing stiffness and twisting of the neck
427
Diagnostic Procedures
| Arthroscopy
Visual examination of interior of a joint performed by inserting an endoscope through a small incision.
Performed to repair and remove joint tissue.
428
Diagnostic Procedures
Myelography
Rheumatoid factor
Radiography of spinal cord after injection of a contrast medium to identify and study spinal distortions caused by tumors, cysts, herniated intervertebral disks, or other lesions.
Blood test to detect presence of rheumatoid
factor, a substance present in patients with R A.
429
Build Medical Words
1. visual examination of a joint:
2. pertaining to the neck and face:
3. disease of bones and joints:
4. act of measuring the pelvis:
5. suture of muscle:
6. tumor of bone marrow:
7. sarcoma of bone marrow:
8. binding, fixation (of a bone or joint):
1. arthroscopy
2. cervicofacial
3. osteoarthropathy
4. pelvimetry
5. myorrhaphy
6. myeloma
7. myelosarcoma
8. arthrodesis
430
Medical and Surgical Procedures
| Total hip arthroplasty
Replacement of hip joint
• Damaged by degenerative disease, commonly arthritis.
Replacement of femoral head and acetabulum with a prosthesis
fastened into the bone, as illustrated.
431
Medical and Surgical Procedures
Amputation
Arthrocentesis
Laminectomy
Partial or complete removal of an extremity as a result of trauma or circulatory disease.
Puncture of a joint space using a needle to remove accumulated fluid.
Excision of the posterior arch of a vertebra.
432
1. A 19-year-old male sustains a knee injury in a high school football game. Radiographs reveal a torn ligament. The orthopedic surgeon recommends a procedure in which a small instrument is inserted into the joint to repair the ligament. This procedure is known as (arthroclasis, arthroplasty, arthroscopy).
2. The surgeon informs Wayne that he must undergo surgery to remove his herniated disk. The surgery is charted as a (traction,
herniorrhaphy, laminectomy).
1. arthroscopy
| 2. laminectomy
433
3. James injured his upper thigh muscle when he was stabbed in a street fight. Because of the severity of the injury, he must undergo a surgical repair of the muscle known as .
4. Melvin has a history of arthritis that has damaged his hip joint. The doctor recommends a surgical procedure to replace the hip. This procedure is known as total .
3. myoplasty
| 4. hip arthroplasty
434
Pharmacology
Bone reabsorption inhibitors
Gold salts
Reduce reabsorption of bone.
Used to treat weak and fragile bones as seen in osteoporosis and Paget disease.
Inhibit activity within immune system by preventing further disease progression.
Used to treat R A.
435
Pharmacology
Nonsteroidal anti-inflammatory drugs (N S A I D's)
Relieve mild to moderate pain.
Reduce inflammation.
Used to treat musculoskeletal conditions such as sprains; strains; and inflammatory disorders, such as rheumatoid arthritis,
osteoarthritis, bursitis, and tendinitis.
436
1. Dr. C. prescribes a nonsteroidal antiinflammatory drug to relieve pain and inflammation caused by tendinitis. The abbreviation for this drug is .
2. Mary is diagnosed with osteoporosis. To inhibit further breakdown of her bones, the physician prescribes a (bone
reabsorption inhibitor, gold salt).
1. N S A I D
| 2. bone reabsorption inhibitor
437
3. Joanne complains of morning pain and stiffness in her joints caused by arthritis. The doctor prescribes a (bone reabsorption
inhibitor, nonsteroidal anti-inflammatory drug).
4. Zoe is diagnosed with rheumatoid arthritis. The doctor prescribes a drug that inhibits activity within immune system by
preventing further disease progression called a .
3. nonsteroidal anti-inflammatory drug
| 4. gold salt
438
Special Senses—Ears
Structure
Each ear has three main subdivisions.
External ear
Middle ear
Inner ear
439
Structure
| External ear
Auricle
| External auditory canal
440
Structure
| Middle ear
Extends from tympanic membrane (eardrum) to oval window.
• Oval window is the membrane-covered opening to the inner ear.
Between tympanic membrane and oval window are three tiny
bones collectively known as ossicles.
• Malleus (hammer)
• Incus (anvil)
• Stapes (stirrup)
441
Structure (continued_4)
| Inner ear
Series of fluid-filled passages known collectively as the
labyrinth.
• Cochlea, front portion.
• Vestibular apparatus, rear portion.
442
Function
| External ear
Produces cerumen
• Cerumen acts as a filter by trapping dust and other foreign substances, preventing them from entering the internal structures.
• Indented shape of auricles act as highly effective receivers of sound waves.
‒ Directs sound waves toward inner structures.
443
Function
| Middle ear
Sound waves travel through auditory canal and strike the tympanic membrane (eardrum).
• As the eardrum vibrates, it moves the ossicles (malleus, incus, stapes) through the middle ear.
‒ As the stapes moves, it touches a membrane called the oval window, which separates the middle ear from the inner ear.
444
Function
| Inner ear
Sound waves reach inner ear, also called labyrinth, via fluctuations of the oval window (separates middle ear and inner
ear).
• Snail-shaped cochlea contains special auditory liquids through which vibrations travel.
‒ Also present in the cochlea is a sensitive auditory receptor area called the organ of Corti.
445
Function
Inner ear
Organ of Corti
• Tiny hair cells receive vibrations from the auditory liquids and relay the sound waves to auditory nerve fibers.
‒ Sound waves end in the auditory center of cerebral cortex, where these impulses are interpreted and “heard.”
446
1. What is the sequence of structures involved in the vibrations of sound wave transmission?
1. Sound waves enter the ear canal, and vibrations are transmitted by the eardrum, malleus, incus, stapes, oval window of the inner ear, perilymph and endolymph within the cochlea, and hair cells of the organ of Corti.
When hair cells bend, they generate impulses that are carried to the auditory areas of the brain. It is here that sounds are heard and interpreted.
447
2. What is involved in the process of hearing?
| 3. What is the cochlea?
2. Transmission of vibrations and generation of nerve impulses
3. Snail-shaped structure containing hair cells, which, when stimulated, transmit impulses to the brain for interpretation of sound.
448
# Define Combining Forms
1. ot/o:
2. myring/o, tympan/o:
3. labyrinth/o:
4. hearing:
5. mastoid/o:
6. salping/o:
1. ear
2. tympanic membrane
3. labyrinth (inner ear)
4. acous/o, audi/o, audit/o
5. mastoid process
6. tubes (usually fallopian or eustachian [auditory])
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# Define Suffixes
7. -acusis:
8. -opsia:
9. -stenosis:
10. -tropia:
7. hearing
8. vision
9. narrowing, stricture
10. turning
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Build Medical Words
1. discharge from the ear: /o/
2. specialist in the study of ear and throat (disorders): /o/laryng/o/
3. rupture of the eardrum: tympan/o/
4. discharge or flow of pus from the ear: / / / /rrhea
5. without or not hearing (deafness): an/
6. pain in the ear: /o/
1. ot/o/rrhea
2. ot/o/laryng/o/logist
3. tympan/o/rrhexis
4. ot/o/py/o/rrhea
5. an/acusia or an/acusis
6. ot/o/dynia
451
Build Medical Words
7. inflammation of the ear:
8. instrument to examine the ear(s):
9. inflammation of the mastoid process:
10. incision of the labyrinth (inner ear):
11. hearing (loss) as a result of old age:
12. instrument to measure hearing:
7. ot/itis
8. ot/o/scope
9. mastoid/itis
10. labyrinth/o/tomy
11. presby/cusis, presby/acusia
12. audi/o/meter
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Otitis Media
| Signs and Symptoms
Most common symptom is earache.
Accumulation of fluid within the structure of the middle ear.
Most common among infants and young children.
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Serous otitis
Suppurative otitis
Chronic form of serous otitis media may develop from acute condition, or it may result from overgrowth of adenoidal tissue or
chronic sinus infections.
Suppurative otitis media is caused by introduction of pyogenic microorganisms into the middle ear.
Often follow the mumps, influenza, or colds and may be induced by overly forceful nose blowing.
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Otitis Media causes
Swimming in contaminated water may result in middle ear infection.
If pus forms in the tympanic cavity, the eardrum may rupture, thereby relieving pressure and pain.
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Otitis Media
| Treatment
Antibiotics and analgesics to relieve pain.
In severe cases, drainage may be accomplished by myringotomy or needle aspiration.
Surgery, such as myringoplasty and tympanoplasty, to repair a ruptured tympanic membrane.
Pressure-equalizing (P E) tubes are inserted surgically into the tympanic membrane to equalize pressure between the atmosphere and the middle ear.
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Hearing Loss
Signs and Symptoms
Treatment
Temporary or permanent loss of hearing.
Varies with type and cause of impairment.
May include medication to treat infections and dissolve cerumen.
Stapedectomy, tympanoplasty, cochlear implantation, and myringotomy.
Hearing aids or other effective means of aiding communication.
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1. A 5-year-old is examined because of ear pain. The medical assistant charts this symptom as .
2. Baby Molly’s mother asks the physician why infants and young children are more at risk for developing otitis media.
1. otodynia or otalgia
2. The physician explains that the eustachian tubes of children and infants are shorter and narrower than those of adults, making
children more susceptible to blockages and retention of fluid when the eustachian tubes become inflamed from bacterial or
viral infection.
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3. The mother of a 3-year-old girl asks the nurse practitioner what complications can develop if otitis media is not treated.
4. Baby John has a history of chronic otitis media. The physician recommends that tubes be surgically placed into the tympanic membrane to equalize pressure between the atmosphere and the middle ear. The abbreviation for these tubes is tubes.
3. The nurse explains that untreated ear infections may lead to short- or long-term hearing loss, ruptured eardrum, or mastoiditis. Also, there is a risk of the ear infection traveling to other parts of the head.
4. P E
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Vocabulary Challenge Exercise
1. conductive hearing loss:
2. Ménière disease:
3. otosclerosis:
1. hearing loss caused by impairment in the transmission of sound because of an obstruction of the ear canal or damage to
the eardrum or ossicles
2. rare disorder of unknown etiology within the labyrinth of the inner ear; it can lead to progressive loss of hearing.
3. progressive deafness caused by ossification in the bony labyrinth of the inner ear
460
Vocabulary Challenge Exercise
4. presbycusis:
5. tinnitus:
6. vertigo:
4. impairment of hearing that results from the aging process
5. ringing or tinkling noise heard constantly or intermittently in one or both ears, even in a quiet environment
6. sensation of moving around in space or a feeling of dizziness or spinning
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Diagnostic Procedures
| Tuning fork test
Evaluation of sound conduction using a vibrating tuning fork.
• Rinne evaluates bone versus air conduction of sound.
Webber test evaluates bone conduction in both ears at same
time.
• Indication of normal hearing is when sound is heard equally in both ears.
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Diagnostic Procedures
| Audiometry
Test that measures hearing acuity at various sound-wave frequencies.
Audiometer delivers acoustic stimuli at different frequencies.
• Results are plotted on a graph called an audiogram.
463
Diagnostic Procedures
| Otoscopy
Visual examination of external auditory canal and tympanic membrane by using an otoscope.
Assesses ability of tympanic membrane to move in response to a change in air pressure.
• Lack of movement indicates increased impedance or eardrum perforation.
464
Build Medical Words
1. act of measuring hearing:
2. surgical repair of the tympanic membrane (eardrum):
3. surgical repair of the ear:
4. abnormal condition of ear hardening:
5. without hearing:
6. discharge or flow from the ear(s):
1. audi/o/metry
2. tympan/o/plasty or myring/o/plasty
3. ot/o/plasty
4. ot/o/sclerosis
5. an/acusis
6. ot/o/rrhea
465
Medical and Surgical Procedures
| Ear irrigation
Flushing of the external ear canal with sterile water or sterile saline.
Low-pressure stream of warm water is directed toward top of ear canal to flush out impacted cerumen or foreign body.
466
Medical and Surgical Procedures
Myringotomy
Incision of tympanic membrane followed by insertion of a P E
tube.
Used to treat chronic otitis media.
467
Medical and Surgical Procedures
Cochlear implants
All implants feature a microelectronic processor for converting sound to electrical signals.
Transmission system relays signals to the implanted parts.
Long, slender electrode placed in cochlea delivers the electrical stimuli directly to the auditory nerve.
468
1. Joe is diagnosed with an ear infection and is scheduled for surgery. An incision will be made into the ear followed by
insertion of P E tubes. Incision of the eardrum is charted as a .
1. myringotomy or tympanotomy
469
2. To restore hearing loss, an electronic transmitter will be surgically implanted inside the inner ear. The hearing device
produces sound by electrically stimulating nerves inside the inner ear. This surgical procedure is known as a (cochlear, auditory, P E) implantation.
2. cochlear
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4. Daniel requires surgery to repair a ruptured tympanic membrane. Surgical repair of the tympanic membrane is called .
5. John complains of wax buildup in his ears that is impeding his hearing. The physician explains that this is a common problem that can be resolved by a procedure performed in the office of flushing the ear with sterile water to dislodge the earwax. This
procedure is called (myringoplasty, ear irrigation, otoplasty).
4. myringoplasty or tympanoplasty
| 5. ear irrigation
471
Pharmacology
Vertigo and motion sickness drugs
Wax emulsifiers
Decrease sensitivity of inner ear to motion.
Prevent nerve impulses from inner ear reaching the vomiting center of the brain.
Loosen and help remove impacted cerumen (ear wax).
Excessive wax can be washed out, vacuumed out, or removed with the use of special instruments
472
1. To loosen and help remove impacted cerumen in 3-year-old Johnny, the physician uses a (vertigo and motion sickness drug, wax emulsifier).
2. To treat the patient for dizziness, the physician prescribes a (vertigo and motion sickness drug, wax emulsifier).
3. Barb informs the doctor that she is going on a cruise for a month and is concerned about motion sickness. To help Barb with her condition, the physician prescribes a drug called a (vertigo and motion sickness drug, wax emulsifier).
1. wax emulsifier
2. vertigo and motion sickness drug
3. vertigo and motion sickness drug
473
4. Barb asks the pharmacist to explain to her how the motion sickness drug works that she will be taking while on her cruise.
4. The pharmacist explains that the drug decreases the sensitivity of the inner ear to motion. It also prevents nerve impulses from the inner ear reaching the vomiting center of the brain.
474
Special Senses—Eyes
| Structure
Each eye is globe shaped and located within a hollow bony
socked (orbit) in the anterior cranium.
Each eyeball contains three distinct tunics (layers)
•Outermost layer, the fibrous tunic.
‒Sclera, cornea, conjunctiva.
•The middle layer, the vascular tunic, also called uvea
- Choroid, iris, ciliary body, lens.
• The innermost layer, the sensory tunic,
- Delicate, double layered retina.
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Middle Layer AKA vascular tunic or uvea
Choroid, iris, ciliary body, lens.
‒ In the center of the iris is the round opening, the pupil.
‒ Ciliary body, an extension of the choroid, attaches to
suspensory ligaments that hold the lens in place
behind the iris.
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The innermost layer, the sensory tunic, is the
| delicate, double layered retina.
• Two distinct landmarks on the retina: the optic
disk and the optic nerve.
• Retina contains two types of visual receipts: rods
and cones.
477
Eyes - Supporting structures
```
Eyelid and lacrimal glands.
• Eyelids and eyelashes
• Lacrimal gland
• Lacrimal ducts
• Nasolacrimal duct
‒ Drains tears from lacrimal sac to the nasal cavity.
```
478
Function
| Outermost layer, the fibrous tunic
Sclera, white opaque outer surface that protects inner structures of the eye and helps maintain its shape.
Sclera changes into a transparent layer, the cornea.
• Cornea allows light to enter the eye.
• Cornea bends (refracts) the rays of light.
Conjunctiva, a delicate, transparent mucous membrane that covers insides of eyelids.
• Produces watery, clear mucus that traps foreign substances on the surface of the eye.
479
Function
| Middle layer, the vascular tunic
Choroid supplies blood to the entire eye.
Iris is the center of the eyes whose color is determined by genetics.
Ciliary body
• Imbedded are smooth muscles that adjust shape of lens to enable eye to focus on objects at varying distances.
• Lens is suspended from the ciliary body.
480
Function
Innermost layer, the sensory tunic
Retina contains light sensitive receptor cells, rods and cones.
• Rods and cones contain photopigments capable of converting light energy into an electrical impulse that is transmitted to the brain for interpretation.
‒ Rods detect shades of gray at all levels of light.
‒ Cones detect color but operate only at high light levels.
Optic disk, area in the retina where nerve fibers (and blood vessels) enter and exit.
• Referred to as the blind spot because it has no rods or cones.
• Optic nerve (cranial nerve TWO) is formed from the nerve fibers of each eye.
‒ Carries impulses from the retina to areas of the brain responsible for processing visual information.
481
Supporting structures of the eye
Eyelids and eyelashes protect eyes and prevent foreign substances from entering.
Lacrimal glands continuously secrete tears that travel through lacrimal ducts.
Nasolacrimal duct drains tears from lacrimal sac to the nasal cavity.
-Drains into the canal of Schlemm , a circular channel around the iris.
• Absorbed into veins and taken away by blood.
DOUBLE CHECK LAST TWO POINTS
482
Aqueous humor
* Clear, watery fluid produced continuously by the ciliary body.
* Carries nutrients and oxygen (O 2 ) to the cornea and lens.
* Circulates through posterior chamber, through the pupil, and into the anterior chamber.
483
Vitreous humor
* clear, gel like substance that helps maintain the shape of the eye.
• Fills the posterior cavity (largest space in the eye).
• Lies between the lens and the back of the eye.
484
Extraocular muscles control eye movement.
• Under voluntary control.
• Attached to the sclera by tendons.
