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K. Iomar, M.B.A., M.D.

Medical Instructor, Alabama College of Osteopathic Medicine

Testing Testing 349 Across 3 tissue that reflects less sound back to the transducer than the surrounding tissues; appears dark 8 number of leukocytes per cubic milliliter of blood 10 ultrasound property of producing adequate levels of reflections (echoes) when sound waves are returned to the transducer and displayed 11 number of cycles per unit of time 17 high pH property 18 spiral-shaped bacteria 20 concentration of hydrogen ions 22 diagnostic evaluation of blood to determine the number of rbc, wbc, and thrombocytes per cubic milliliter of blood 23 rod-shaped bacteria 25 combining form for chain 26 loss of intensity of the ultrasound beam as it travels through tissue 27 tissue that reflects more sound back to the transducer than the surrounding tissues; appears bright Down 1 ability to separately identify different structures on radiograph or ultrasound 2 international unit of radiation 5 path of the X-ray beam 6 ultrasonic term for when waves are transmitted to deeper tissue and none are reflected back 7 microscopic living organism 9 plant-like eukaryotic organism without chlorophyll 12 budding form of fungus 13 combining form for grapelike clusters 14 speed at which something travels through an object 15 tissue that has the same ultrasonic appearance as that of the surrounding tissue 16 low pH property 19 specified body position and the part of the body closest to the film 21 length that a wave must travel in one cycle 24 intensity of an ultrasound wave Copyright 2009 Cengage Learning, Inc. Some drugs are dispensed only by a licensed professional, and e other drugs are not. A prescription (pr-skrihp-shuhn) drug is a medicaoth tion that may be purchased by prescription or from a licensed professional. An over-the-counter (-vr theh kount-r) drug is a medication that may ov be purchased without a prescription. A generic (jehn-r-ihck) drug is a medication not protected by a brand name or trademark. In this example, water moves across the membrane to equalize the concentration of particles. Medication is stored in a patch placed on the skin, and the medication is absorbed through the skin. Drug Categories analgesic (ahn-ahl-j-zihck) = substance that relieves pain without affecting consciousness. Antibiotics can be bacteriostatic (bahck-t-r-stah-tihck), which means controlling bacterial growth (inhibiting bacterial replication), or bactericidal (bahck-t-r-s-dahl), which means killing bacteria. Positive chronotropes increase heart rate, while negative chronotropes decrease heart rate. Positive inotropes increase myocardial contractility, while negative inotropes decrease myocardial contractility. Surgical Terms T Surgery is the branch of science that treats diseases, injuries, and deformities by manual or operative methods. Some surgical terms include the following: appositional (ahp-sih-shuhn-ahl) = placed side to side. An allograft (ah-l-grahft) is a graft from another individual of the same species. An isograft (-s-grahft) is a graft from genetically identical animals, such as twins or inbred strains. Drugs, Diseases, and Dissection 357 postop (pst-ohp) = common term for after surgery; postoperatively. Resect is used in reference to holding tissue or an organ out of the surgical field. Transfixion sutures are used for large, isolated vessels and organs to prevent slippage of the ligature. The fluid does not drain through the center of the tubing, but is allowed to leak from the skin openings. Hand chuck Ronquer Gelpi retractor Kern bone holding clamp Periosteal elevator (a) Emasculator Emasculatome Scalpel handle Halsted mosquito hemostatic forcep Adson Brown thumb tissue forcep Surgical Approaches In surgery, the specific procedure by which an organ or a part is exposed is called the approach (ah-prch).

These molecules can act as an acid by losing a Hydrogen atom and can also possibly polar too. The process needs water (hydroxyl and hydrogen) to fill the open bonds on the monomers. The chemical composition is: Carbon = Oxygen; 2X as much Hydrogen is also present. Carbohydrates serve as the raw building materials for the other 3 Organic Molecules. Lipids are mainly composed of Hydrocarbons (All the Hydrogens means lipids have 2x the E of Carbs. Lipids use a covalent bond called an Ester Linkage to hold the fatty acid and glycerol together. An Ester linkage is a Carboxyl of the Fatty Acid paired with a hydroxyl of the glycerol molecule. These have double or triple bonds that "could be broken" to add more Hydrogen to the fatty acid. Remember, water is polar, so the negative Phosphate will be attracted to the positive Hydrogen portion of water. Phospholipid Bi-layers (having 2 layers) are common for cell and organelle membranes. Cholesterol is also a steroid molecule, but it helps with cell membrane flexibility. These macromolecules make up greater than 50% of an organisms dry weight, called biomass. The monomer "building blocks" are called Amino Acids (There are 20 different Amino Acids that can be involved in making proteins. Proteins and enzymes usually have hundreds to thousands of Amino acids in their structure. R group - this is the most important part as it gives each amino acid its distinctly different property. Individual Amino Acids (monomers) are bonded together by a covalent bond called a peptide bond. An amine end of one amino acid is positioned to combine with the Hydroxyl on the Carboxyl end of the second amino acid. The open bonds left behind, by removing to make water in the dehydration reaction, allows for a bond between the Carbon and Nitrogen to be created. Arrangement and Quantity of Amino acids affect the structure and function of that protein or enzyme. Just look at the difference between Sickle-Cell Disease and normal red blood cells. Denaturing can be caused by ph changes, salt concentration changes, and temperature changes. Protective structures that allows proteins to fold inside without water being present. A "Chaperone" is a person who watches over a function or date to make sure nothing terrible happens. They consume the Nitrates and break it down into Oxygen gas (O2) and Nitrogen gas (N2) and both are returned to the air to be used again. The Ammonia is converted by bacteria into Ammonium to be used again by plants and bacteria. The phosphate of one nucleotide is joined with the 5 Carbon Sugar of the previous nucleotide. Structure = Function and Emergent Properties are themes related to Nucleic Acids too. One side has information to make proteins and enzymes (The Million Dollar Blueprint); other side is a protective cap for the Million Dollar Blueprint. The more Nucleotide sequence "genes" in common; the more closely related the organisms are. The fewer Nucleotide sequence "genes" in common: the more distantly related they are.

The Limbic System the limbic system is probably the most primitive region of the cerebrum and hence is involved in some of the basic survival functions of the brain, namely; memory, reproduction and nutrition. This system is composed of several nuclei (clusters of cell bodies), the most conspicuous of which are the hippocampus, the cingulate gyrus and the amygdala. It is linked to the diencephalon and most of the output from the limbic system passes through the hypothalamus. The limbic system functions as our emotional center, and yes, guys have a limbic system as well. As mentioned above, the limbic system also plays a role in the formation of memories. It is thought to play a role in remembering where food is found and the pleasure associated with eating. Additionally it remembers the pleasure from sex as damage to this area results in voracious appetites for food and/or sex. The functions of two important structures of the limbic system, the hippocampus and the amygdala are explained below. Hippocampus: the hippocampus is involved in various processes of cognition and spatial memory, or the what, when, and where of memory. In addition, the hippocampus is very important in learning, in fact neurologists have observed increases in neuron numbers in response to training of a task which ultimately resulted in vast improvement in the learning of the task. Amygdala: the amygdala is also involved in many cognitive processes and memory, but in contrast to the hippocampus the amygdala functions in episodic and autobiographical types of memories. In addition, the amygdala is important in maintaining attention, in fact if you have gotten this far in your reading you are probably not amygdala challenged. A function that appears to be specific to the amygdala is social processing, in particular facial recognition and the evaluation of first impressions. The Basal Nuclei Another key group of nuclei found in the cerebrum are basal nuclei (also referred to as the basal ganglia). Key nuclei of this group include the caudate nucleus, the putamen and the globus pallidus. The basal nuclei also receive input from the 277 substantia nigra of the midbrain. Although the precise details are not fully understood, it seems to play a key role in preventing incorrect and/or inappropriate movements. It seems to be key in regulating what are referred to as stereotyped movements such as swinging the arms when walking. Additionally, it is thought to play a key role in initiating, stopping and monitoring the intensity of voluntary motor movements. Output from this system does not go to the muscles themselves, rather output is sent to the motor centers in the frontal cortex where adjustments and corrections can be made to the outgoing signals. It includes the reticular formation that originates in the brain stem and radiates into the cerebrum. Functionally this network of neurons is called the name reticular activating system. The primary function of this system is to maintain the brain in a state of alertness or arousal. If the system is suddenly shut down, like from a blow to the head, the victim will loss consciousness. Caffeine has the effect of exciting the reticular formation fibers so that one "feels" more awake or as if they have more energy. The Reward Center Because addictions are becoming such a problem in modern society we have added the following section to describe the physiology of addiction. This structure has also been linked to addiction and depression as damage to the nucleus accumbens results in lack of motivation and loss of addictive behaviors. The nucleus accumbens uses dopamine and serotonin as the preferred neurotransmitters.

Even though a minor becomes the primary decision maker after high school graduation, he or she is not necessarily financially independent of the parents. A teenager may state he or she has separated from the parents, but unless the courts have approved a legal separation, merely saying she is "separated" from her parents is not enough; legally the parents are still financially responsible for the child until he or she turns 18. The study described here is a cohort study, because it includes a group with and a group without a given risk factor (fetal exposure to alcohol) and then looks at whether the risk factor changes the chances of offspring getting the disease (abnormalities). The study is prospective, because the group members are looked at before the disease (abnormality) develops in the offspring. Relative risk can be calculated from the results of a cohort study by comparing the rate of disease in the group with the risk factor to the rate of disease in the group without the risk factor. Attributable risk can be calculated from the results of a cohort study and describes the proportion of disease that is due to the risk factor under study. Although smoking behavior of the women is being recorded, the study is not designed to look at the impact of this risk factor on fetal abnormality; the rate of smoking in the two groups of women is unknown, and thus we do not know whether there are sufficient numbers of women in the "exposed" and "unexposed" groups when it comes to tobacco. An odds ratio is similar to relative risk, but it is calculated from the results of a case-control study, not from a cohort study. Because birth abnormality is a relatively rare outcome, the odds ratio from a case-control study would likely closely approximate the actual relative risk. Prevalence is a measure of how many cases of a given disease exist in a population that is at risk for that disease. This is not the best answer in this case, because there are no data to judge whether this group of 200 women represents the true prevalence of alcoholism during pregnancy in the community. Peak height velocity occurs approximately one year after the initiation of breast development. Obtaining informed consent from the patient means that the patient understands the risks, benefits, and alternatives to the study, and that the doctor relays to the patient pertinent matters about the plan of care. For the non-English-speaking patient, the consent is translated into the appropriate language and discussed with him/her through an interpreter. This allows the patient (or in this case, his parents) freedom to read and process the consent and to discuss it later. Whereas this option may not be possible for every language or reasonable for every study, it is appropriate in this non-emergent situation. With limited knowledge of Spanish, the doctor will unlikely be able to address all the important issues delineated in the consent form. Having someone other than an interpreter translate will be invading patient privacy, incomplete, and not perfectly accurate/reliable. In a non-emergent setting, the best approach is to allow the patient/ family to view a translated copy of the consent and consider all their options in an unbiased manner. Heart disease is the leading cause of death among the elderly (65 years old and older), as well as the leading cause of death if all ages are combined. The patient is at a particularly high risk for subsequent cardiac events due to his previous history of myocardial infarction. Other major risk factors for cardiac events are high blood pressure, hypercholesterolemia, and diabetes mellitus. However, they are the most common cause of death among children (1-14 years old) and adolescents (15-24 years old) and not among the elderly. Stroke is the third most common cause of death among the elderly, behind heart disease and then cancer. The mechanism of denial is when one fails to recognize the obvious implications or consequences of a thought, act, or situation. Displacement is a defense mechanism whereby ideas and feelings that a patient wishes to avoid are transferred to another person or object; for example, a patient who yells at the nurse because he is angry at news he has just received from the doctor.

Supernumerary teats is a condition in which an animal has more than the normal number of nipples (commonly seen in ruminants). Procedures: Reproductive System Procedures performed on the reproductive system include the following: assisted delivery = manual use of hands or equipment to aid in delivery of a fetus. An animal that is not neutered is intact (ihn-tahckt), or has reproductive capability. A condition of an individual having both ovarian and testicular tissue is called a. The term for surgical incision of the perineum and vagina to facilitate delivery of the fetus and to prevent damage to maternal structures is a. The female organ of mammals that develops during pregnancy and joins the mother and offspring for exchange of nutrients, oxygen, and waste products is known as the a. Substances that produce change or that create genetic abnormalities are known as a. Abdominal palpation yielded an enlarged uterus, and a purulent vaginal discharge was noted. On rectal palpation, the veterinarian discovered that the prostate gland was bilaterally enlarged. After a dx of prostatitis was made, the dog was scheduled to be neutered the next day. The farmer told the veterinarian that this cow had stepped on her teat previously, but it had appeared to be healing. Milk was expressed from each quarter, and the milk appeared more watery than normal. Antibiotic treatment was started pending culture results, and milking hygiene was discussed with the farmer. The mare had not moved since foaling, and the owner was concerned because the mare seemed quieter than normal. The owner was asked whether the mare had passed its placenta, and the owner did not know whether she had. The veterinarian was concerned that the mare had a retained placenta and that an infection was starting. The owner was advised to watch for the passing of the placenta, and general hygiene was discussed with the client. Sensory information such as sound and light is converted into electrical impulses so that the nerves can transport it. The parts of a neuron are the cell body, one or more dendrites, one axon, and terminal end fibers. The cell body, or soma (s-mah), has a nucleus and is responsible for maintaining the life of the neuron. The dendrites (dehn-drts) are rootlike structures that receive impulses and conduct them toward the cell body. The axon (ahcks-ohn) is a single process that extends away from the cell body and conducts impulses away from the cell body. The terminal end fibers are the branching fibers that lead the impulse away from the axon and toward the synapse. Bundles of nerve fibers bound together by specialized tissues are called nerves or nerve trunks. Nerve fibers are covered with a tubelike membrane called the neurolemma (n-rlehm-ah) or neurilemma (n-rih-lehm-ah). A synapse is the junction where neural impulses cause a release of a chemical substance called a neurotransmitter (n-r-trahnz-miht-r) that allows the signal to move from one neuron to another. Supporting Role the neuroglia (n-rohg-l-ah), or glial (gl-ahl) cells, are the supportive cells of the nervous system. Glial cells consist of astrocytes (ahs-tr-stz), microglia (m-krgl-ah), oligodendrocytes (ohl-ih-g-dehnd-r-stz), and Schwann (shwahn) cells.