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H. Bufford, M.B. B.CH., M.B.B.Ch., Ph.D.

Assistant Professor, East Tennessee State University James H. Quillen College of Medicine

Facial expression can convey caring and reassurance or impatience and disapproval. What about the grim-faced professional who hurries the patient along to the radiographic room, gives rapidfire instructions on what to do while searching for missing markers and cassettes, tosses the patient about on the x-ray table, and finally dismisses the patient with a curt "you can go now"? Consider another patient, greeted by a smiling professional who introduces himself or herself and brings the patient to a neat and orderly radiographic room, where everything is in readiness for the procedure. At the end of the examination, the patient is escorted back to the waiting area and clear instructions are given for appropriate postprocedural care. Which leaves the hospital or clinic environment with a more favorable impression of his or her health care experience? The radiographer should face the patient and make eye contact during communication. They appreciate the radiographer who is compassionate enough to take the extra few minutes necessary for comfort. Some elderly patients are easily confused; it is best to address them by their full name and to keep instructions simple and direct. Communication difficulties can often be simply and significantly improved through explanation. Many patients are anxious about their illness/condition and unfamiliar with the procedure they are about to undergo. The radiographer who takes the time to explain the procedure, explain unfamiliar terminology, and answer patient questions will be longremembered and appreciated by that patient. Patients should be clear about what will be expected of them and what they may expect from the radiographer. Patients often have questions about other scheduled diagnostic imaging procedures such as mammography, computed tomography, magnetic resonance imaging, sonography, or nuclear medicine studies. Patients might not be knowledgeable about the length of an examination; they often have concerns/questions about safety or contraindications for an examination. The diagnostic radiographer must be able to respond knowledgeably to questions, or know where to get information, regarding diet restrictions or other preparation that might be needed for computed tomography or sonography, concerns or contraindications for some examinations such as magnetic resonance imaging, and positioning techniques such as compression used in mammography. The radiographer should also be able to help the patient obtain information about these and other services he or she might require, for example, social services, rehabilitation, etc. Patients sometimes need to repeat explanations or instructions (to the radiographer) to be certain they understand; some have an additional question or two they must ask to clarify their thoughts. Patients must be identified by checking their wristbands and requesting a second verification such as birth date. Verbal communication involves the tone and rate of speech as well as what is being said. Nonverbal communication involves facial expression, professional appearance, orderliness of the radiographic room, and the preparation and efficiency of the radiographer. The radiographer provides aftercare information and can ably address patient questions about other imaging studies. Can the part be imaged adequately and with less pain on the stretcher or in the wheelchair? Will the use of sponges and/or sandbags result in a more comfortable, safer, and better imaged examination? Paleness frequently indicates weakness; the diaphoretic patient has pale, cool skin. A patient who becomes cyanotic (bluish lips, mucous membranes, or nail beds) needs oxygen and requires immediate medical attention. Although checking vital signs is not a routine function, the radiographer should be proficient and confident if and when the need arises. Practicing vital signs during "slow" periods will benefit the patient who needs those skills during an emergency; also, those on whom you practice will learn their vital signs-valuable information for all. Obtaining vital signs involves the measurement of body temperature, pulse rate, respiratory rate, and arterial blood pressure. Body temperature can be measured via thermometer in the mouth, rectum, axilla, bladder, heart chamber, or external auditory canal. Symptoms of fever include general malaise, increased pulse and respiratory rates, flushed skin that is hot and dry to the touch, and occasional chills.

Diseases

• Idiopathic adolescent scoliosis
• Familial Mediterranean fever
• Hydatidosis
• Chromosome 18 long arm deletion syndrome
• Zinc toxicity
• Hypertrophic hemangiectasia
• Otodental dysplasia
• Gaucher ichthyosis restrictive dermopathy
• Piebaldism
• Elejalde syndrome

The soluble materials released from germinated grains and prepared as a microbial growth medium. The rate of microbial population growth expressed in terms of the number of generations per unit time. The use of a thin porous filter made from cellulose acetate or some other polymer to collect microorganisms from water, air and food. A condition that refers to inflammation of the brain or spinal cord meninges (membranes). The disease can be divided into bacterial (septic) meningitis and aseptic meningitis syndrome (caused by nonbacterial sources). Granules of polyphosphate in the cytoplasm of some bacteria that appear a different colour when stained with a blue basic dye. A bacterium that uses reduced one-carbon compounds such as methane and methanol as its sole source of carbon and energy. A microorganism that requires low levels of oxygen for growth, around 2 to 10%, but is damaged by normal atmospheric oxygen levels. The study of microorganisms in their natural environments, with a major emphasis on physical conditions, processes, and interactions that occur on the scale of individual microbial cells. The mineralization of organic matter synthesized by photosynthetic phytoplankton through the activity of microorganisms such as bacteria and protozoa. This process "loops" minerals and carbon dioxide back for reuse by the primary producers and makes the organic matter unavailable to higher consumers. A firm structure of layered microorganisms with complementary physiological activities that can develop on surfaces in aquatic environments. The use of microorganisms as a food source by organisms that can ingest or phagocytose them. The immediate environment surrounding a microbial cell or other structure, such as a root. An acute form of tuberculosis in which small tubercles are formed in a number of organs of the body because of disemination of M. The release of inorganic nutrients from organic matter during microbial growth and metabolism. The lowest concentration of a drug that will prevent the growth of a particular microorganism. It is constructed of an outer membrane and an inner membrane, which contains the electron transport chain. A process that takes place in the nucleus of a eucaryotic cell and results in the formation of two new nuclei, each with the same number of chromosomes as the parent. A type of fermentation carried out by members of the family Enterobacteriaceae in which ethanol and a complex mixture of organic acids are produced. Refers to microorganisms that combine autotrophic and heterotrophic metabolic processes (they use inorganic electron sources and organic carbon sources). Addition of gases such as nitrogen and carbon dioxide to packaged foods in order to inhibit the growth of spoilage organisms. Any of a large group of fungi that cause mold or moldiness and that exist as multicellular filamentous colonies; also the deposit or growth caused by such fungi. The statistical estimation of the probable population in a liquid by diluting and determining end points for microbial growth. The layer of cilia and mucus that lines certain portions of the respiratory system; it traps microorganisms up to 10 m in diameter and then transports them by ciliary action away from the lungs. The mechanism by which respiratory ciliated cells move material and microorganisms, trapped in mucus, out of the pharynx, where it is spit out or swallowed. A multi-drug-resistant strain is defined as Mycobacterium tuberculosis resistant to isoniazid and rifampin, with or without resistance to other drugs. An organism associated with another in an obligatory relationship that is beneficial to both. Complex 60 to 90 carbon fatty acids with a hydroxyl on the -carbon and an aliphatic chain on the -carbon, found in the cell walls of mycobacteria. Bacteria that are members of the class Mollicutes and order Mycoplasmatales; they lack cell walls and cannot synthesize peptidoglycan precursors; most require sterols for growth; they are the smallest organisms capable of independent reproduction. The region around ectomycorrhizal mantles and hyphae in which nutrients released from the fungus increase the microbial population and its activities.

On the posterior floor of the pharynx lies the glottis, a slit that leads into the trachea. The straight stomach has internal rugae and ends with a muscular pyloric sphincter. The small intestine is the duodenum anteriorly, and then a long coiled portion with internal small folds called plicae, which increase the surface area. The hepatic ducts and bile duct empties into the duodenum as in the shark, but may be difficult to see. The irregular pinkish mass of the pancreas lies on the hepato-duodenal ligament and is fused into one. The pancreas is both an exocrine gland, producing digestive enzymes and an endocrine gland regulating metabolism. Mammal Digestive Tract In mammals, the coelomic cavity is divided into thoracic and abdominal cavities by the diaphragm. Make an incision in the midventral line through the abdominal wall muscles of the cat or rat from the sternum to about an inch anterior to the clitoris or penis. Make lateral incisions at the extremities of this first incision and deflect the flaps. Between the diaphragm and the liver are three ligaments, the most prominent of which is the falciform ligament, which connects the right and left liver halves to the abdominal wall. It extends from the greater curvature of the stomach to the dorsal body wall and extends to the pelvic region covering and tucking under the intestine. The portion of this mesentery from the stomach to the spleen is the gastrosplenic ligament. From the lesser curvature of the stomach and duodenum to the liver is the lesser omentum. Table of Glands and Functions Gland Submaxillary Sublingual Parotid Lacrimal Lymph nodes Thymus Location central throat, large anterior on submaxillary, whitish Function salivary mucous towards ear, outside submaxillary, soft salivary below ear 4, above submaxillary, dark, round above heart, large on young animals Immunity side of larynx, dark red tears lymphocytes lymphatic-disease Thyroid ion and calcium Binding adrenalin or epinephrines Adrenal above kidney Digestive System the digestive tract starts with the mouth and its associated salivary glands. To view the inside of the mouth, cut through the left jaw after prying the mouth open with a folded paper towel over the teeth. Feel the roof of the mouth with its anterior hard palate and posterior soft palate. The pharynx extends from the oral cavity to the larynx and allows passage of food and air. The food, when swallowed, travels down the tubular esophagus, which lies dorsal to the larynx. The soft, distensible esophagus penetrates the diaphragm separating the 7 thoracic and abdominal cavities. The convex side is the greater curvature; the concave side is the lesser curvature. The small intestine starts at the pyloric sphincter with the duodenum a long curved piece, then begins looping back and forth, still descending as the jejunum. The ascending, looping portion is the ileum and it ends in a T-junction with the large intestine. The blind end of the this the caecum or appendix, large in the rat, small in cats and humans. The other end is the ascending portion of the large intestine or colon followed by a short transverse portion and a descending portion, which ends in a muscular rectum hidden under the pelvic girdle. Digestive Organs the dark reddish brown lobes of the liver (five in rat, six in cat) are attached to the diaphragm. The central lobe has a gall bladder in a cat, but it is absent in the rat, although both animals have a bile duct leading to the anterior duodenum. The mesentery called the greater omentum, stretching from the spleen to the duodenum contains the two lobes of the pancreas, which look like pink granular bubble gum. One lobe runs from the pyloric sphincter to the spleen, the other along the edge of the duodenum.

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