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U. Rendell, M.A., M.D.

Associate Professor, Yale School of Medicine

To build a working vocabulary of medical terms and understand how those terms are used in the healthcare industry, it is important that you complete these exercises. If you are not satisfied with your level of comprehension, review the common prefixes tables. The complexity of each level increases from one to the next, because the higher level incorporates the structures and functions of the previous level or levels. Eventually, all levels contribute to the structure and function of the entire organism. Review the ta ble a nd pronounce each wo rd in the word analysis column aloud before you begin to work in t he fr ames. The nucleus is the control center of the cell and is responsible for reproduction. This spherical unit contains genetic codes for maintaining life systems of the organism and for issuing commands for growth and reproduction. Examples of nucle/o/toxic drugs are those administered to cancer patients during chemotherapy. Using cyt/o, build a word that means study of cells: / /. Identify word elements in hist/o/logist that mean specialist in the study of: tissue: / ! Included are directional terms that describe a structure in relation to some defined center or reference point. These suffixes help describe position, direction, body divisions, and body structures. Use the adjective ending -al to form words that mean pertaining to the back (of body): dors / side, to one side: later / belly, belly side: ventr / Boldface indicates a word root or combining form. Four addi- -ac -al -ar -ary -eal -iac -ic -ior -ous -tic tional adjective suffixes meaning pertaining to that are common in medical terms are -ary, -eal, -ous, and -tic. However, if you are in doubt about meanings of any word elements, refer to Appendix A: Glossary of Medical Word Elements. To guarantee consistency in descriptions of location, the anatomic/al position is used as a reference point to describe the location or direction of a body structure. The arms hang to the sides, with palms facing forward; the legs are parallel with the toes pointing straight ahead. However, their descriptions of any region or part of the human body assume that it is in anatomic/al position. In anatomical position, the terms anter/ior and ventr/al refer to the front of the body or the front of any body structure. The terms poster/ior and dors/al refer to the back of the body or the back of any body structure. Identify the elements in this frame that refer to the front of the body: / and / back of the body: / and / Boldface indicates a word root or combining form. In an anter/o/poster/ior projection, the beam enters the body anteriorly and exits posteriorly. A poster/o/anter/ior projection indicates that the beam enters the body on the side and exits on the side. The shoulder blades are located on the / side of the body. However, when used in a medical report, it designates a position or direction meaning lower, below. Combine infer/o (lower, below) +-ior (pertaining to) to form a directional term that literally means pertaining to lower or below.

The patient is currently admitted for gynecological laparoscopy and diagnostic D&C to rule out the possibility of a neoplastic process. The patient had a large preulcerating lesion of the left breast with metastases to the axilla, liver, and bone. Bilateral Vasectomy Patient was placed on the table in supine position and prepped, scrotum shaved, and draped in the usual fashion. A segment of the right vas was removed, and both ends were cauterized and tied independently with 3-0 silk suture. Postoperative care instruction sheet was given along with prescription of Darvocet-N 100 mg, 1 q4h as required for pain. Study the word elements and their meanings before completing the Word Elements Chapter Review that follows. Endocrinologists treat such disorders as diabetes, osteoporosis, and other disorders of the endocrine glands. When surgery is required, the endocrinologist works closely with the surgeon to provide the most beneficial patient care. Endocrinologists also play important roles related to their field of expertise in university academic research and in the pharmaceutical industry. Neurology Neurology is the medical specialty concerned with the diagnosis and treatment of diseases of the nervous system, which includes the brain, spinal cord, and peripheral nerves. Neurologists use specialized examination procedures and employ diagnostic tests, medical and surgical procedures, and drugs to treat nervous system diseases. The branch of surgery involving the nervous system, including the brain and spinal cord, is called neurosurgery. Together they monitor changes in the body and in the external environment, interpret these changes, and coordinate appropriate responses to reestablish and maintain a relative equilibrium in the internal environment of the body (homeostasis). The endocrine system consists of a network of glandular structures that slowly discharge hormones into the bloodstream. In contrast, the nervous system is designed to act instantaneously by transmitting electrical impulses to specific body locations, which helps control all critical body activities and reactions. Although hormone production occurs at one site, the effects of these hormones take place at various other sites in the body. Processes under direct endocrine control include growth, reproduction, cellular metabolism, and the regulation of blood levels of many important nutrients. The tissues or organs that respond to the effects of a hormone are called target tissues, or target organs. Included are key suffixes; pr efixes are defined in t he right-hand column as needed. Review the following table, and pronounce each word in t he w ord analysis column alo ud b efore you begin to work the frames. Word Element Meaning Word Analysis Combining Forms aden/o adren/o adrenal/o gland aden/oma (d-N-m): tumor composed of glandular tissue -oma: tumor adren/al (d-R-nl): pertaining to the adrenal glands -al: pertaining to adrenal/ectomy (d-r-nl-K-t-m): excision of adrenal gland(s) -ectomy: excision, removal Adrenalectomy involves surgical removal of one or both adrenal glands to remove a tumor, aid in correcting a hormone imbalance, or prevent metastasis. However, only target organs contain receptors that recognize a particular hormone. These secretions are regulated by the body to prevent overproduction (hyper/secretion) or underproduction (hypo/secretion). If the hormone has a specific effect on the heart, the target organ is the.

Signs and symptoms include swollen, twisted, and sometimes painful veins in the lower legs. Spider veins are small, dense networks of veins that appear as red or blue discolorations on the skin. An elastic bandage or support hose may increase circulation and provide relief from discomfort. Symptoms can be relieved by walking, elevating the legs when seated, and losing weight. A surgical procedure called surgical vein stripping is very successful and involves removing the veins and tying off the remaining open ends. Collateral circulation tends to develop to compensate for the loss of the vein segment. Another treatment is compression sclerotherapy, in which a strong saline solution is injected into specific sites of the varicose veins. The procedure is followed by uninterrupted compression for several weeks to prevent reentry of blood. A daily walking program during the recovery period is required to activate leg muscle venous pumps. However, the risk can be reduced by alternating long periods of sitting or standing with leg movement and exercise. Signs and symptoms include tissue edema, necrosis or skin atrophy, and pain during walking. Compression stockings squeeze the leg and prevent excess blood from flowing backward. Venous Thrombosis A clot, or venous thrombosis, can develop in the superficial or the deep veins of the lower extremities. However, risk factors are understood and include venous stasis, vascular trauma, and conditions that promote blood clotting. Older adults and postsurgical patients are at increased risk for venous thrombosis because immobility reduces blood flow in the extremities. When they do occur, signs and symptoms include inflammation, pain, swelling, and deep muscle tenderness. Early detection and prevention of venous thrombosis can prevent potentially fatal complications such as emboli, or clots that travel to vital organs such as the lungs. Prevention includes walking soon after surgery or childbirth, exercising the legs, and use of compression stockings. The risk factors include hypertension, family history, sedentary lifestyle, overweight, high blood lipid levels, atherosclerosis, and smoking. Crushing pain in the chest, shortness of breath, nausea, pallor, weakness, and faintness are among the symptoms of a myocardial infarction. Additional diagnostic tests include echocardiograms, stress tests, nuclear imaging, and angiography. Lifestyle changes, such as a healthy, low-salt diet and exercise, are important to prevent further progression of the disease. A stent, which is a cylindrical wire mesh of stainless steel or other alloy, surrounds the balloon. Expansion of the balloon forces the mesh into the lining of the vessel, which physically holds the lumen open. Because the vessels commonly become occluded again (restenosis) within months or a year, stents are coated with drugs that prevent restenosis. Coronary artery bypass surgery reroutes blood flow around the clogged arteries to improve blood flow and oxygen supply to the heart. A segment of a healthy blood vessel from another part of the body is attached or grafted from the aorta to the coronary artery below the blocked area.

Plaques grow gradually, and only when a lesion restricts blood flow by around 45% do symptoms develop as the tissues supplied by that artery become ischemic. For example, rupture of a vulnerable plaque is often associated with thrombus formation, leading to a heart attack or stroke. An artery wall weakened by atherosclerosis can rupture, leading to internal bleeding. Common sites of this complication include the aorta (an aneurysm) or an artery in the brain (a haemorrhagic stroke). The progression of the atherosclerotic process to the clinical horizon is shown schematically in Figure 4. The self-selection bias in such studies is obvious, however: did leaner, generally healthier men seek the more physically active jobs It appeared, therefore, that the protective effect of physical activity was independent of body fatness (at least as crudely assessed). The longshoremen (n = 6,351), whose exercise intensity at work was categorized as light, moderate or heavy according to measurements of oxygen uptake, were followed for 22 years (Paffenbarger and Hale 1975) (the steps by which oxygen uptake measurements were converted to rates of energy expenditure are shown in Box 4. The protective effect of heavy occupational work was evident at all ages, but greatest in the oldest men. Selection bias was not a major problem because men enrolling in the industry were not allowed to choose their job assignment. Eight-and-a-half years later the men who reported engaging in 30 or more minutes of vigorous exercise (estimated as entailing peak rates of energy expenditure of 31. One of the most comprehensive data sets derives from the Harvard Alumni Study referred to in Chapter 3. Information was obtained not only about current physical activity, but also about participation in student sport whilst at university. Researchers found that the risk of heart attack was inversely related to total energy expenditure in physical activity over the range <2. Playing vigorous sport some years earlier conferred no protection among men who did not continue to practise such exercise. Moreover, a report from the Netherlands found that light activities like walking, gardening or cycling were associated with a lower risk of acute coronary events only among men who pursued them all year round. Thus, confounding by known risk factors could not account for the effects of physical activity. During the 1970s and 1980s many other epidemiological studies of work and leisure-time physical activity were published. Incidence rate for heart attack (events per 10,000 man-years of observation) 70 60 50 40 30 20 10 0 Yes No Participation in university sport Source: Paffenbarger et al. For purposes of estimating and describing exercise intensity, metabolic rate has been defined as 3. If we assume that the civil servants typically weighed 78 kg, then an oxygen uptake of 1. Activities such as easy cycling or doubles tennis typically demand this rate of oxygen uptake. Other countries contributing to the studies were the United Kingdom, the Netherlands, Italy, Yugoslavia, Greece, Finland, Sweden, Israel and Puerto Rico. First, they have provided strong evidence that the benefit is also seen in women, in older men and in more racially diverse groups. Evidence on this topic, crucial for the development of promoting exercise as part of a public health strategy, is discussed here, after consideration of studies of fitness. Some investigators have sought to avoid these by measuring the characteristics exhibited by people who are physically active, that is, fitness, rather than the behaviour (physical activity/exercise) that leads to fitness. They argue that this reduces the chance of individuals being misclassified and, by increasing the precision of measurement, increases the likelihood that true findings will not be missed. The extent to which traditional measurements of fitness are independent of genetic factors is a matter of debate. However, some studies have found close relationships between physical activity and measures of fitness, suggesting that the environmental influence is dominant. Findings from the Aerobics Center Longitudinal Study (Dallas, Texas) constitute a major part of this literature (the results of this study with respect to all-cause mortality risk are described in the previous chapter).