Overview

    **  WELCOME TO LAFOURCHE PARISH CORONER'S OFFICE RESERVE INVESTIGATORS PROGRAM!  
        TODAY WE WILL BE LEARNING MEDICAL TERMINOLGY.  HANG ON, THIS WILL BE A FAST COURSE!**

Every profession has its jargon, a specialized language that allows for quick, efficient communication between members of the same profession while minimizing the potential for misunderstandings. Jargon is not unique to professions. Have you ever tried to understand two teenagers talking to each other? Adolescent slang serves some of the same purposes as a professional jargon including identifying “insiders” and excluding “outsiders.” However, it is in everyone’s interest to be an insider when it comes to medical terminology, the jargon of medicine. Being familiar with medical words makes your visit to the doctor less intimidating and, more importantly, enables you to make sound decisions about your health care in consultation with your family physician.

Health Care PractitionersHealth care practitionersMedical terminology is a specialized language used by health care practitioners. And, just like a foreign language, it has its own vocabulary and ways of stringing together words in an acceptable, i.e., understandable to everyone, format. But, unlike a foreign language, you come across medical terminology every day in magazines and newspapers with articles about new drugs, diets, new medical treatments and on television medical dramas.

Who else may find this presentation useful? Applying to a medical professional school or recently accepted to one: medical, nursing, physical therapy? This program will provide you with a head start in learning “medical lingo.” Are you an attorney or legal assistant specializing in personal injury? What an advantage to be able to better communicate with clients and physicians! Work for an insurance company? Need I say more!

What follows is a mini-course in medical terminology. You will learn approximately 300 words. This may seem like a lot, but it is only a fraction of the words you would learn in a full academic course in the subject. However, the goal is not to learn a bunch of new words to impress your friends, but to learn the basics of what makes up medical terms so you can not only use and understand them yourself, but be able to recognize and learn new terms when you come across them in the future. Most of all, believe it or not, you are going to have fun! Many medical terms have interesting, even weird meanings or stories behind their evolution as words.

I will bet you already know some medical terms! Have you heard of an esophagus, the tube that connects your throat with your stomach? Esophagus comes from Greek words meaning “that which swallows what we eat.” How about Fallopian tubes? They are named after a 16th century Italian anatomist, Gabriello Fallopio. Okay, surely you have heard of a placenta! Placenta means a “flat cake” in Greek, simply describing its shape.

Eponyms

There are two major categories of medical terms: descriptive – describing shape, color, size, function, etc, and eponyms, literally “putting a name upon”. The latter has been used to honor those who first discovered or described an anatomical structure or diagnosed a disease or first developed a medical instrument or procedure. Some examples of eponyms are fallopian tubes (uterine tubes-Gabriello Fallopio) and eustachian tubes (auditory tubes-Bartolommeo Eustachii). The problem with eponyms is that they give no useful information about what is or where to find the item named. The duct of Wirsung? Oh, you mean the pancreatic duct!

In recent times, the trend has been toward replacing eponyms with descriptive names. For this reason, we will not spend time learning them. However, some things are known almost exclusively by their eponym. Would you recognize “paralysis agitans” as Parkinson’s disease? Also, some descriptive terms have been deemed offensive or stigmatizing. As examples, “mongolism” is currently called Down’s syndrome and “leprosy” has all but been replaced with Hansen’s disease. Want to bet that AIDS will take on a new name in the future?

Basics

Before we can start in with some new and interesting medical terms, you need to learn a few fundamentals of how medical terminology is constructed as a language.

There are three basic parts to medical terms: a word root (usually the middle of the word and its central meaning), a prefix (comes at the beginning and usually identifies some subdivision or part of the central meaning), and a suffix (comes at the end and modifies the central meaning as to what or who is interacting with it or what is happening to it). An example may make better sense. Word root

therm = heat hypothermia (less heat), thermometer (measuring heat)

Let’s look at a real medical term and take it apart. Myocarditis (prefix) (root) (suffix) myo = muscle card = heart itis = inflammation

Don’t get blown away by that big, intimidating word! We haven’t introduced word roots yet. I just wanted to demonstrate the major parts of a medical term. Let’s see how prefix and suffix changes can alter the meaning of a term without changing its central meaning by keeping the root the same. Prefix change: myocarditis = muscle layer of heart inflamed pericarditis = outer layer of heart inflamed endocarditis = inner layer of heart inflamed Suffix change: cardiologist = a physician specializing in the heart cardiomyopathy = damage to heart muscle layer cardiomegaly = enlargement of the heart

Again, we haven’t introduced heart terms yet. These basics are just to introduce the parts of medical terms and demonstrate how moving the parts around modifies the central meaning without changing the “root” (cardio).

Useful prefixes and suffixes

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Following, in no particular order, are frequently used word beginnings (prefixes) and word endings (suffixes) used to make up many medical terms. You don’t need to memorize whether an item is a prefix or suffix, or even if it is a word root, just what it means! I know this is all “Greek” to you (and some of it really is!), but there will be so much reinforcement as we go along that you can’t help but remember meanings. Be patient with yourself.

-itis = inflammation tonsillitis, appendicitis (you know these!)
-osis = abnormal condition cyanosis (of blueness, due to cold or low oxygen)
-ectomy = to cut out (remove) appendectomy, tonsillectomy (you know these too!)
-otomy = to cut into tracheotomy (to cut into the windpipe,
temporary opening)
-ostomy = to make a
“mouth”
colostomy (to make a permanent opening in colon)
a/an = without, none anemia (literally no blood but means few red cells)
micro = small microstomia (abnormally small mouth, see “stomy” in colostomy above?)
macro = large macrostomia (abnormally large mouth)
mega/ -megaly = enlarged megacolon (abnormally large colon = large intestine)
-scopy/ -scopic = to look, observe colonoscopy (look into colon)

Just a few more that you will see and hear over and over again.

-graphy/ -graph = recording
an image
mammography (imaging the breasts)
-gram = the image (X-ray) mammogram

Whenever you see these endings, -graphy, -graph, -gram, they relate to recording an image such as an X-ray, CT or MRI scan or a written recording with pen and moving paper. Mammography is the process of recording, i.e. the machine and procedure. Mammogram is the image itself, the X-ray. A recording of heart activity is called an electrocardiogram using an electrocardiograph. A recording of brain activity is an electroencephalogram and the medical procedure and machine is called electroencephalography (whew, what a mouthful!).

-ology/ -ologist = study, specialize in cardiologist, nephrologist (study
the heart, the kidneys)

To see a lung specialist, you would visit a pulmonologist. To see a specialist in nerve and brain disease, make an appointment with a neurologist. If you have a bad eye infection, you may be referred to an ophthalmologist. Your rheumatism acting up? You would want to find a physician specializing in rheumatology.

Word roots for organs

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Before we start learning specific medical terms for various systems of the body, we need to know word roots that identify major organs in the body. Note in each example, I have used some prefix or suffix you have already been introduced to. I am not going to give you the meanings! If you are unsure, go back and review and return to this page.

Stomato = mouth stomatitis
Dento = teeth dentist
Glosso/linguo = tongue glossitis, lingual nerve
Gingivo = gums gingivitis
Encephalo = brain encephalitis
Gastro = stomach gastritis
Entero = intestine gastroenteritis
Colo = large intestine colitis, megacolon
Procto = anus/rectum proctitis, proctologist
Hepato = liver hepatitis, hepatomegaly
Nephro/rene = kidney nephrosis, renal artery
Orchido = testis orchiditis, orchidectomy
Oophoro = ovary oophorectomy
Hystero/metro =uterus hysterectomy,
endometritis
Salpingo = uterine tubes hysterosalpingogram
Dermo = skin dermatitis
Masto/mammo = breast mammography, mastectomy
Osteo = bones osteoporosis
Cardio = heart electrocardiogram (ECG)
Cysto = bladder cystitis
Rhino = nose rhinitis (runny nose!)
Phlebo/veno = veins phlebitis, phlebotomy
Pneumo/pulmo = lung pneumonitis, pulmonologist
Hemo/emia = blood hematologist, anemia

Note that some organs have more than one word root. Example: “masto” and “mammo”. Typically, one is derived from the Greek and one from Latin. Go figure! But, you need to know both roots because you may see either of them used.

The word ending “-itis” is going to be used repeatedly. It means inflammation, and I want to make sure you know what that means. An infected cut is an inflammation. “Pink eye” is an
inflammation. But, four things must be present to define inflammation: pain, redness, heat and swelling (dolor, rubor, calor and tumor in Latin!). But, inflammation of an internal organ such as the stomach or kidney must be defined by a physician relying on signs and symptoms, and, possibly, the need for a biopsy (tissue sample) to examine under a microscope by a specialist in identifying the causes of diseased tissues, a pathologist.

Are we learning anything yet? Take the self-assessment quiz that I will email you. Print it out and send it back to me. Before you do, you might want to back up and review, especially, all those organ word roots. You will see them again soon!

Odds and ends

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Anxious to find out what those big words your doctor tells you about with that worried look on his face? Well, we need to cover a few more items that don’t fit into any particular system. Next, we start organ systems!

Technicolor terms

Leuk/o = white leukemia (overabundance of white blood cells)
melan/o = black melanoma (black tumor of the skin)
cyan/o = blue cyanosis (blueness may be due to cold or not enough oxygen in blood)
xanth/o = yellow xanthoma (yellow tumor)

Tumor talk

Adding – oma (a swelling) to organ and tissue word roots names tumors. Not all tumors are malignant (cancerous). Many are benign (not life-threatening).

Aden/o = gland adenoma
Lip/o = fat lipoma
My/o = muscle myoma
Lymph/o = lymph tissue lymphoma
Carcin/o = malignant carcinoma
Osteo/o = bone osteoma

Directions, please?

Endo = within, inside of endoscopy (to inspect the inside of an organ or space with a lighted instrument)
Peri = around perianal (around the anus)
Circum = around circumcise (cut around)
Retro = behind retrosternal (behind the breastbone)
Epi = upon, on top epidermis (the top or outermost layer of skin)
Trans = through transurethral (through the urinary exit duct)
Intra = within intravenous (inside the veins, e.g. IV fluids)
Sub = below subclavian (below the clavicle = collar bone)

In review, the word parts that make up medical terminology are prefixes, suffixes and word roots. The most typical sequence is prefix, word root, suffix with the word root being central but this is not always the case. In the interests of simplification, I have taken some liberties with formal construction, putting a hyphen in front of a suffix to indicate it is added to the end of a word, example, -itis. Prefixes and word roots I have shown as freestanding word parts. You may have noticed that sometimes I have added a slash and a vowel, example, melan/o. These are called combining forms which make it easier to attach to other word parts, and, hopefully, making them easier to pronounce. Just so you know!

Signs and symptoms – (Ever wonder what’s the difference?)

A symptom is something you observe and complain about to the physician. “Doctor, I have a fever”.

A sign is something the physician observes and/or can measure. “Mrs. Smith, you are running a temp of 102”.

Circulatory system

Circulatory system terms

Circulatory system diseases

Atherosclerosis– Literally, “hardening of the fatty stuff.” High fat diets can lead to formation of fatty plaques lining blood vessels. These fatty areas can become calcified and hard leading to arteriosclerosis, hardening of the arteries. When blood vessels become less stretchable, blood pressure rises and can result in heart and kidney damage and strokes. Double cheese bacon burger, anybody?

Heart monitorMyocardial infarction (MI)– You know we are talking about heart muscle, right, myocardial? An infarction is blockage of blood flow resulting in death of muscle tissue. Layman’s language for this is a “heart attack.” The blockage occurs in one of the arteries of the heart muscle itself, a coronary artery. Depending upon how much tissue dies, a victim of an MI may survive and undergo cardiac rehabilitation, strengthening the remaining heart muscle, or may die if too much muscle tissue is destroyed. Did you exercise at the gym this week?

Mitral prolapse, stenosis, regurgitation– Blood flows through four chambers in the heart separated by one-way valves. A major valve is the one separating the upper and lower chambers on the left side of the heart. The left side is especially important because freshly oxygenated blood returning from the lungs is circulated out of the heart to the rest of the body. The left valve, called atrioventricular, for the chambers it separates, is also called the mitral valve, because it is shaped like an upside down Bishop’s hat, a miter. If the flaps of this valve tear away due to disease, the process is called prolapse, “a falling forward.” This results in leakage and backward flow called “regurgitation” (get the picture?). Sometimes a valve is abnormally narrow causing partial obstruction constricting flow. Stenosis means “a narrowing.”

Angina pectoris– Literally, “pain in the chest.” But, this is a special kind of pain associated with the heart and is distinctive as “crushing, vise-like”, and often accompanied by shortness of breath, fatigue and nausea. Anginal pain indicates not enough blood is getting to the heart muscle, and the heart is protesting and begging for more. People with a history of angina often take nitroglycerine tablets to relieve the pain by increasing blood flow to the heart muscle.

Doctor listening to a patient's heartbeatArrhythmia/dysrhythmia– Abnormal heart rates and rhythms all have special names like ventricular tachycardia, fibrillation, but generically are termed arrhythmias or dysrhythmia, meaning “no rhythm” and “abnormal rhythm.” There are fine distinctions between the two, but they are often used interchangeably.

Ischemia– Sometimes the heart muscle is not getting enough blood flow, more importantly, the oxygen the blood carries is insufficient to sustain muscle which has a very high metabolic rate, and oxygen demand. The term loosely means “not quite enough blood.” Typically, the patient suffers angina pain (see above) and they may think they are having a heart attack. And, they may be!

Circulatory system procedures

Cardiologist – a physician specializing in the diagnosis and treatment of diseases of the circulatory system, especially, the heart. However, after diagnosis, he/she may refer to a cardiovascular surgeon. A cardiologist does not do surgery.

Hematologist – a physician specializing in diseases of the blood.

Doctors tools and medicineElectrocardiogram (ECG/EKG) – a printout recording of the electrical activity of the heart. A frequently used instrument in the hands of a cardiologist.

Echocardiography – using ultra high frequency sound waves (beyond human hearing), similar to “sonar,” to form an image of the inside of the heart. This procedure can demonstrate valve damage, congenital (before birth) defects and other abnormalities.

Cardiac catheterization – a long hollow tube, a catheter, can be threaded into an artery up into the heart. Then material opaque to X-rays can be released into the blood flow through the heart imaging the details of coronary arteries. Typically used to identify a blockage and location in the coronary circulation.

Phlebotomist/venipuncturist – the specially trained nurse or technician draws blood for lab tests and may also start IV’s (intravenous fluids). The Greek and Latin versions of “cutting into a vein.”

Nervous system

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Nervous system terms

Cardi/o = heart Endocarditis, myocarditis, pericarditis (inflammation of the lining, the muscle layer, the outer layer of the heart)
Brady/tachy = slow/fast Bradycardia (rate<60) tachycardia (rate>100)
Angi/o = vessel Angiography, angiogram (X-ray of artery)
Veno/phlebo = vein Venogram (X-ray of veins), phlebitis (inflammation of veins)
-stasis = to stop Hemostasis (to stop bleeding), hemostat (a clamp-like instrument)
-cyte = cell Erythrocytes, leukocytes (red, white blood cells)
Hem/o, -emia = blood Hypoxemia (low oxygen), hematosalpinx (blood in the uterine tubes)
                        <h1>Nervous system diseases</h1>
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Multiple Sclerosis – Literally, “many hardenings,” MS is a disease of unknown cause that manifests as multiple hard plaques of degeneration of the insulating layer of nerve fibers in the central nervous system. The loss of insulation allows “short circuiting” of nerve impulses. Depending upon where the degeneration occurs, patients may suffer paralysis, sensory disturbances or blindness.

Nervous proceduresCerebrovascular accident (CVA) – the fancy name for a “stroke”. A blood vessel in the brain may burst causing internal bleeding. Or, a clot may arise in a brain blood vessel (a thrombus), or arise elsewhere (embolus) and travel to get stuck in a brain vessel which then deprives brain tissue of oxygen. Depending upon the area of the brain involved, the patient may suffer paralysis, loss of speech or loss of vision.

Transient Ischemic Attack (TIA) – “Ischemia” was introduced previously in the circulatory diseases module referring to the heart. It literally means “not quite enough blood”. A short period of insufficient blood supply to the brain can have the same signs and symptoms as a stroke such as weakness in an arm, a partial loss of vision, but the problem lasts less than 24 hours. People who get TIA’s are at increased risk of having a stroke in the future.

Epilepsy – a Greek word for “seizure.” Convulsions is another term used. Seizures may have many causes and not all seizures are epilepsy. High fevers in young children may trigger seizures which are short in duration, easily controlled and, typically, have no permanent aftereffects. Epilepsy is a specific condition which may occur at any age, seizures are more intense, longer lasting in duration, and recur with some frequency. The condition may be controlled with medication, or if unresponsive to drugs, may require surgery.

Aphasia – loss of speech. The speech centers are located on the left side of the brain in a majority of people. If someone suffers a “stroke” (cerebrovascular accident-CVA), or traumatic brain injury, and it involves the left side of the brain, they may suffer speech impediments that vary over a spectrum of problems from difficulty in finding the right word, speaking slowly and with difficulty, or complete loss of speech. Actually, there are two speech centers. Injury described above involves the motor speech area, the area of the brain that produces language by integrating thoughts of speech with the movements of the larynx, lips and tongue. There is a second speech area, the receptive or sensory area, that enables us to understand speech. Injury to the latter results in still fluent speech, but the individual does not understand what they are hearing.

Nervous system procedures

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BrainNeurologist – a physician specializing in diseases of the brain, spinal cord and nerves. He/she may refer a patient to a neurosurgeon. Neurologists do not do surgery.

Lumbar (spinal) puncture or tap (LP) – introducing a needle between the lower bony vertebrae of our spinal column allows a physician to sample the fluid, cerebrospinal fluid (CSF), surrounding the brain and spinal cord. Lab tests on the fluid are used for diagnostic purposes such as presence of bacteria in meningitis, special proteins in multiple sclerosis, or blood cells.

Brain scan – introducing a radioactive element into the blood can image possible tumors in the brain. The radioactive dose is very low and detectable only with special, very sensitive instruments that are much more sophisticated than the old Geiger counters.

Electroencephalography (EEG) – Wow, what a mouthful, but take it apart. Starting at the end of the word: an image (in this case a written recording) of the brain’s electrical activity. EEGs are used to diagnose different types of seizure disorders such as epilepsy, brain tumors, and are used in sleep research to identify stages of sleep.

Computed tomography (CT) – a specialized X-ray machine that takes multiple images of a body area from different angles and has a computer that integrates the multiple images into “slices” of the body. The resolution is much better than standard X-rays and there is better differentiation of types of tissue (bone, air, solid organ).

Magnetic Resonance Imaging (MRI) – Although the image produces the “slices” through the body seen by CT (see above), no X-rays are involved. The patient’s body is placed in a strong magnetic field. Radio pulses affect the resonance or “spin” of atoms in the tissues. A computer analyzes this information to show subtle differences in tissue molecular structure producing very high resolution and better differentiation of soft tissue, such as a tumor within the liver.

Digestive system

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Digestive system terms

Cephal/o Head Cephalgia (a headache)
Encephal/o Inside the head (brain) Encephalitis (inflammation of the brain) Anencephalic (born without a brain)
Mening/o Membranes surrounding the brain and spinal cord Meningitis (inflammation of the membranes)
Myel/o Spinal cord Myelogram (X-ray of the spinal cord)
Neur/o Nerve Neuroma (tumor) Neuritis (inflammation)
Dys Difficult, painful, abnormal Dyslexia (difficulty reading)
-cele Hernia, abnormal protrusion of structure out of normal anatomical position Meningomyelocele (protrusion of membranes and spinal cord)
-pathy Disease, abnormality Encephalopathy (disease of the brain) Neuropathy (disease of the nerves)
-plasia Development, formation, growth Aplasia (no development) Hyperplasia (over development)
-plegia Paralysis Hemiplegia (paralysis of one side of the body) Quadriplegia (paralysis of all four limbs)
                        <h1>Digestive system diseases</h1>
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Gastroesophageal Reflux Disease (GERD) –Severe “heartburn” in laymen’s language. Weakness of the valve between the esophagus and stomach may allow stomach acid to reflux (regurgitate, backup) into the esophagus and irritate and inflame the lining. This results in chest pain which can mimic that of angina (pain of cardiac ischemia or an MI).

Jaundice – Literally means “yellow” in French. Yellowing of the skin and whites of the eyes from a backup of bile metabolic by-products from the blood into body tissues. May result from blockage of the ducts draining bile from the liver into the intestines or excessive breakdown of red blood cells. Hemoglobin from destroyed RBCs is broken down, and in part, ends up in bile secretions.

Diverticulosis/diverticulitis – Small pouches may form along the walls of the large intestine called diverticuli which if symptomatic, causing discomfort to the patient, is called diverticulosis. These abnormal outpocketings may collect and not be able to empty fecal material which can lead to inflammation, diverticulitis.

Cirrhosis – Literally, “orange-yellow” in Greek. A degenerative disease of the liver that often develops in chronic alcoholics, but can have other causes. The name refers to the gross appearance of the organ.

Portal hypertension – A potential complication of chronic alcoholism resulting in liver damage and obstruction of venous blood flow through the liver. The rising blood pressure in the veins between the gastrointestinal tract and liver causes engorgement of veins around the umbilicus (navel). The characteristic radiating pattern of veins is called a “caput medusae” (head of Medusa). Medusa was the “snake-haired lady” in Greek mythology.

Esophageal varices – bulging, engorged veins in the walls of the esophagus are often a complication of chronic alcoholism (see portal hypertension). The thin-walled, swollen veins are at risk of tearing resulting in severe, possibly fatal, bleeding.

Dysphagia – Difficulty swallowing. May be related to GERD (see above), esophageal tumor or other causes.

Crohn’s Disease – a chronic inflammatory disease primarily of the bowel. Typical symptoms are abdominal pain, weight loss, diarrhea. There may also be rectal bleeding that can lead to anemia. Special X-rays and tests are needed to differentiate Crohn’s from other diseases with similar symptoms.

Peritonitis – Inflammation of the lining of the abdominal cavity. Before antibiotics, people would die from peritonitis if an inflamed appendix burst. Indications of peritonitis are called “peritoneal signs”: tender abdomen, rebound pain (pain when manual pressure released from examining abdomen), board-like rigidity of abdominal muscles, no bowel sounds (gurgles). The peritoneal membrane is very sensitive to exposure to foreign substances. Contact with blood, bile, urine, pus will cause peritoneal signs.

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                        <h1>Digestive system procedures/specialists</h1>
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Gastroenterologist – a physician specializing in diseases of the digestive system including esophagus, stomach and intestines. These specialists do not do surgery. Patients needing surgery are referred to a general surgeon.

Proctologist – a physician specializing in diseases of the rectum and anus. Proctology is a surgical subspecialty.

Guaiac test (Hemoccult, Fecult) – a special chemical test to identify blood in the stool (feces). Blood in the stool may have many causes including cancer and hemorrhoids.

Upper GI series – a series of X-rays of the esophagus and stomach and small intestines having the patient swallow a “milkshake” of barium. The element barium is opaque, i.e. blocks , X-rays. This procedure may be used to identify problems with swallowing, stomach ulcers, twisting of the small intestines.

Lower GI series – a series of X-rays using a barium enema to show the large intestine and rectum. This procedure can be used to identify problems such as diverticulitis/diverticulosis, and tumors.

Endoscopy – use of a flexible fiberoptic instrument attached to a video camera that can be used to directly visualize the esophagus, stomach and large bowel. Special names may be used for each area explored such as colonoscopy.

Ultrasonography (ultrasound) – a procedure using high frequency sound waves to visualize internal organs. Primarily used to visualize abdominal and pelvic organs, such as the pregnant uterus.

Digestive system medical record

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You should be getting pretty good at making sense of medical terminology. But, nothing beats practical application! Following is an abstract of a simulated patient’s medical record. Note words in italics. Take them apart. Look for the “root” meaning. Read the record and answer the questions that follow to yourself. If you can’t think of the meaning, hover your cursor over the word for a tip.

A 48 year old male complains of abdominal discomfort after meals, especially, high fat meals. At those times he also has aching in his right shoulder and back. An  ultrasound of the upper abdomen revealed cholelithiasis. A consult with a gastroenterologist determined that cholelithotripsy was considered but it was decided that a laparoscopic cholecystectomy would be the first procedure attempted. If complications were encountered then an open cholecystectomy would be performed.

Significant medical history: patient had a coronary angiography performed at age 46 following suspected myocardial infarct.

In plain English

A 48-year-old male complains of abdominal discomfort after meals, especially, high fat meals. At those times he also has aching in his right shoulder and back. A procedure using high frequency sound waves to image the upper abdomen revealed stones in the gallbladder. A consult with a specialist in diseases of the digestive tract determined that crushing the gallbladder stones with sound waves was considered but it was decided that a removal of the gallbladder using a scope and instruments inserted into the abdominal wall would be the first procedure attempted. If complications were encountered then opening up the abdomen and removing the gallbladder would be performed.

Significant medical history: The patient had a heart attack. The patient’s heart arteries were imaged by injecting a dye opaque to X-rays into an artery to show area of blockage of blood flow to heart muscle.

Surprised at how much you understood? I’m not!

Before taking the quiz, you may want to check back to “Basics” and review the word stems for mouth, tongue, gums, stomach, small and large intestines and liver.

Respiratory system

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Respiratory system terms

Gastr/o Stomach Gastritis, Gastrectomy
Hepat/o Liver Hepatitis (inflammation of), hepatoma (tumor of)
Chol/e Gall, bile Cholecystitis, cholecystectomy (inflammation of, removal of gallbladder)
Cyst/o Bladder, sac (see above)
Emes/o Vomit Emesis (vomiting), emetic (stimulating vomiting), antiemetic (stopping vomiting)
Lith/o Stone Cholelithotomy (removal of gall stones)
Lapar/o Abdominal wall Laparotomy (cutting into the abdomen)
-centesis To puncture Abdominocentesis (puncturing and draining)
-tripsy To crush Cholelithotripsy (smashing gall stones with sound waves)
-rrhea Flow, discharge Diarrhea
-iasis
(-osis)
Abnormal condition Cholelithiasis (presence of gall stones causing symptoms)
Rhin/o Nose Rhinitis, rhinorrhea (inflammation of and “runny” nose)
Laryng/o Larynx, “voice box”* Laryngotomy, Laryngectomy (cutting into, surgically removing the larynx)
Trache/o Trachea, “windpipe” Tracheotomy, tracheostomy (temporary and permanent openings)
Bronch/o Lung air passageways Bronchoscopy (looking into the bronchi)
Pne/u, -pnea Breath, air, lung Tachypnea, dyspnea, apnea (accelerated, difficult/painful, cessation of breathing)
Pulmo/o Lung Pulmonary artery
-ptysis Spitting (coughing) Hemoptysis (spitting or coughing up blood from lungs)
-plasty Reconstruction Rhinoplasty (surgical reconstruction of nose)

*Adam’s apple – Everyone is familiar with the bulge in the front of the neck we call an ‘Adam’s apple.’ This structure, termed the laryngeal prominence, is a cartilage in the ‘voice box’ or larynx. Testosterone, the male hormone, enlarges the larynx in males which also lengthens the vocal cords lowering the voice at puberty. Folklore has it that the “forbidden fruit” offered by Eve got stuck in Adam’s throat. The fruit is not identified in Genesis. However, in art it is traditionally portrayed as an apple. Why? The forbidden fruit was from the tree of knowledge of good and evil. The Latin word for evil, malum, also means apple. The Latin root is found in such words as malady and malignant.

Respiratory system diseases

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Pneumoconiosis – literally, “an abnormal condition of dust in the lungs.” A generic name for conditions where toxic particles become trapped in the lungs and cause symptoms and disability such a “black lung” or “miner’s lung” disease. Terms specific to the particulate matter may be given such as asbestosis.

Coughing while smokingEpistaxis – want a fancier name for a “nosebleed?” You got it!

Cystic fibrosis – an inheritable disease that affects not only the lungs but other systems producing mucous such as the digestive system. Patients suffer frequent lung infections that are hard to treat because mucous is thick and sluggish and result in increased scarring (fibrosis) of the lungs. They also take multiple enzyme pills because of digestive abnormalities related to abnormal mucous production.

Emphysema (COPD) – Chronic Obstructive Pulmonary Disease, of which emphysema is one of, results in progressive destruction of the air sacs in the lungs and loss of respiratory membrane for oxygen exchange. The bane of long term smokers.

Atelectasis – a collapsed lung. Literally, “an imperfect expansion” in Greek.

Respiratory system procedures

Pulmonologist – a physician specializing in diseases of the lungs. Patients needing surgery are referred to a general surgeon.

Respiratory x-rayRespiratory Therapist – a specially trained technician who administers, among other treatments, inhalation therapy to patients with lung disease.

Pulmonary angiography – special X-rays of the vessels of the lungs.

Laryngoscopy – visual examination of the larynx.

Endotracheal intubation – passing a special air-tube into the trachea so oxygen can be reliably supplied directly to the lungs without risk of inhaling vomit from the stomach. Typically done for surgery or whenever general anesthesia is administered among other situations where the patient’s airway must be secured.

Urinary system

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Urinary system terms

Urinary system diseases

Urine specimenNephrosis – a noninflammatory disease of kidneys.

Nephrolith – a kidney stone.

Urethritis – inflammation of the urethra, the final pathway for urine in both sexes, and the common pathway for urine and semen in the male.

Nocturia – frequently getting up and urinating during the night.

Enuresis – involuntary release of urine, most often in reference to “bedwetting.”

Urinary system procedures

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Nephrologist – I am hoping by now, you would know this is a physician specializing in kidney diseases.

Urologist – a physician specializing in the genitourinary tract, which includes kidneys, urinary bladder and urethra of both men and women and the prostate and testes in men.

Cystoscopy – looking into the urinary bladder with a fiberoptic instrument.

Intravenous pyelogram – special X-rays showing the drainage pattern of the kidneys. A dye opaque to X-rays is injected into a vein. After a waiting period for the blood and dye to pass through the kidneys, X-rays can be taken of the collecting system of the kidney, ureter and bladder.

Retrograde pyelogram – personally, I prefer the former procedure! In this procedure a dye opaque to X-rays is flushed backwards up the urethra and bladder and up the ureters to the kidneys.

Voiding cystourethrogram – take this apart starting at the end of the word: an imaging technique (X-ray) displaying the urethra and bladder while urinating! How did the opaque dye get into the bladder? One guess then see retrograde pyelogram above.

Dialysis – a procedure for cleansing the blood of waste products in individuals with complete kidney failure or who have had kidneys removed by surgery. With the in-hospital procedure, the patient’s blood is circulated through a machine that removes waste products. The blood is recirculated back into the patient.

Lithotripsy – Crushing kidney stones with sound waves. Unlike cholelithotripsy (crushing of gallstones), which is no longer done, the sludge from crushing kidney stones has an easy direct pathway out of the body (down the ureter to the bladder and out the urethra). Nephrolithotripsy is an elective procedure that may spare a patient surgery.

Male reproductive system

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Male reproductive system terms

Nephr/o, ren/o Kidney Nephritis, renal artery
Hydro/o Water Hydronephrosis (abnormal condition involving back up of urine into the kidney
Cyst/o Bladder Cystitis, cystectomy (inflammation of, removal of bladder)
Pyel/o Renal collecting ducts Pyelogram (X-ray of the collecting ducts)
Ur/o, -uria Urine Polyuria, anuria (frequent urination, no urine formation)
Olig/o Scanty, less than normal Oliguria (reduced urine formation)
-pexy To surgically reattach, fix in normal position Nephropexy (surgically attach kidney in normal anatomical position)
Orchid/o, test/o Testes (male gonad) * Orchiditis, orchidectomy, testicular artery, testosterone (male sex hormone)
Balan/o Head of the penis Balanitis
Andr/o Male Androgenic (stimulating maleness), androgynous (characteristics of male and female appearance)
Prostat/o Prostate Prostatitis, prostatectomy
Vas/o Vessel, duct Vas deferens, vasectomy (duct carrying semen from testes, cutting the duct)
-rrhaphy To suture Herniorrhaphy (surgical correction of inguinal hernia)

*Testis – Did you know that testis, testify, testimonial and testament all share a common root meaning? Testis means “witness” in Latin. As the testis witnesses to manhood, you may witness to the truth at trial, proclaim your favorite brand of corn flakes or witness to your final wishes in your will. If you die without a will, you die “intestate,” without having witnessed.

Male reproductive system diseases

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Hypospadias – literally “below the fleshy spike.” A condition in which the external urinary meatus (opening) opens anywhere below the tip of the penis rather than at the tip.

Hydrocele – a fluid filled sac partially surrounding the testis. Manifests itself as a swelling on the side of the scrotum. May cause discomfort. Can be surgically corrected. And, who would most likely be doing the surgery? A urologist!

Varicocele – dilated and twisted veins of the testis, sort of “hemorrhoids” of the scrotum! Manifests itself as a swelling on the side of the scrotum which may look and feel like a “bag of worms.” May be surgically corrected if causing discomfort. This condition may also cause reduced sperm count and male sterility due to sluggish blood flow elevating testicular temperature.

Cryptorchidism – literally “hidden testicle.” A condition of lack of descent of one or both testes into the scrotum. If not corrected, usually by surgery, before puberty, can lead to sterility and increased risk of testicular cancer.

Benign prostatic hypertrophy (BPH) – swelling of the prostate gland which surrounds the base of the male bladder and urethra causing difficulty urinating, dribbling, and nocturia (remember that word? See urinary system). The bane of old men! BPH becomes more common as men age.

Transurethral resection of the prostate (TURP) – the surgical cure for BPH. An instrument inserted through the penile urethra is used to partially cut away the prostate to relieve obstruction of the urinary tract.

Prostate Specific Antigen (PSA) – PSA is a marker protein for prostate cell secretions which can be detected with a lab test. A rising PSA may be an early sign of prostate cancer, although there may be other causes including false positive tests. How often should men get a PSA test? Check in with The Prostate Cancer Foundation.

Male reproductive system medical record

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Following is an abstract of a simulated patient’s medical record. Read the record and define each term in italics. If you can’t think of the meaning, hover your cursor over the word for a tip.

A 55 year old male complains of nocturia, three to four times a night.He also states that he has difficulty getting urination started, has a small stream, and dribbles after he finishes. Sometimes he has feelings of urgency. A review of organ systems reveals that his angina, which he treats with nitroglycerine tablets, is increasing in frequency.

A rectal exam reveals prostatic hypertrophy without nodules, most likely BPH. Patient was scheduled for an ECG and coronary angiography. A referral was made to a urologist for evaluation for a TURP.

Recent medical history: hemoptysis two months ago. Bronchoscopy was unremarkable.

Past medical history: cholelithiasis treated with cholelithotripsy at age 52. Varicocelectomy at age 28. Appendectomy at age 24.

In plain English

A 55 year old male complains of having to get up at night to urinate, three to four times a night. He also states that he has difficulty getting urination started, has a small stream, and dribbles after he finishes. Sometimes he has an urgent need to urinate. A review of organ systems reveals that his cardiac related chest pain, which he treats with nitroglycerine tablets, is increasing in frequency.

A rectal exam reveals an enlarged prostate without nodules, most likely Benign Prostatic Hypertrophy (nonlife-threatening enlargement of the prostate). Patient was scheduled for an electrocardiogram (recording of the electrical activity of the heart) and X-rays of the arteries of the heart. A referral was made to a specialist in diseases of the male reproductive system and lower urinary tract for possible transurethral resection of the prostate (partial internal removal of prostatic tissue).

Recent medical history: spitting up blood from the lungs two months ago. Passing a fiberoptic instrument into the lung passageways did not determine a cause.

Past medical history: gallstones treated with high frequency sound waves smashing stones to small particles that can pass in the stool at age 52. Removal of enlarged testicular veins at age 28. Removal of appendix at age 24.

Male reproductive system mythology

Greek and Roman mythology is alive and well!

Term Description God/godess
Hymen Membrane surrounding entrance of vagina Hymen – the Greek god of marriage
Aphrodisiac A chemical purported to stimulate sexual desire Aphrodite- The Greek goddess of love
Venereal disease A sexually transmitted infectious disease Venus – the Roman goddess of love
Hermaphroditism A condition where both ovarian and testicular tissue are found in the same individual Hermaphroditus* – the offspring of Hermes and Aphrodite who looked female but had male genitalia
Priapism A continuous, painful erection Priapus – the Roman god of male potency
Satyriasis A condition of compulsive sexual desire in men. Satyr- a woodland deity part man and part goat. Most notable for chasing nymphs.

Hermaphroditus*

Hermaphroditus
Hermaphroditus

In Greek mythology, Hermaphroditus was the son of Hermes, messenger of the gods, and Aphrodite, the goddess of love. He was a handsome young man. One day while swimming in a woodland pool, one of the Naiads, nymphs of wells, springs and ponds, spied him and instantly fell in love with him. She swam out to him, embraced him professing her love. He rejected her advances. Angry at being rejected, she prayed to the gods that they never be separated again. The ancient gods had a whimsical, sometimes cruel, sense of humor and bound their bodies into one, ever inseparable. Be careful what you ask for? The curse of the answered prayer?

In classic art, Hermaphroditus is portrayed as a woman with male genitalia. True hermaphrodites exist, although they are rare, but most commonly have a male-type body with ambiguous genitalia. Internally, both ovarian and testicular tissue are present either as separate organs or an ovotestis. Related sex structures are poorly developed or absent.

Female reproductive system

Female reproductive system terms

Female reproductive system diseases

Endometriosis – a condition involving colonization of the abdominal/pelvic cavity with islands of endometrial tissue. Endometrium is the lining layer of the uterus which sloughs off with each menstruation. If endometrial tissue flushes up the uterine tube and spills into the abdomen (peritoneal cavity), the clots of endometrial tissue can attach to abdominal organs such as the bladder, rectum, intestinal loops and then cycle along with the uterus in response to monthly changes in ovarian hormones. Bleeding into the abdomen irritates the lining membrane, the peritoneum, and causes abdominal pain.

Pelvic inflammatory disease (PID) – although males have a closed abdominal cavity, the female abdominal cavity has a direct anatomical path from the outside world via the female reproductive tract. Bacteria can make their way up the vagina, through the uterus, and traverse the uterine tubes which open into the abdominal cavity. Inflammation of the lining of the abdominal cavity, the peritoneum, causes abdominal pain. Although there are many potential causes of PID, gonorrheal infection is one of them. Chronic Inflammation of the uterine tubes can occlude them resulting in infertility.

Prolapsed uterus – the uterus is almost directly above the vagina. In fact, the cervix, the neck region, of the uterus extends into the upper vagina. Ligaments hold the uterus in proper position so that it does not prolapse or herniate into the vagina. Severe prolapse can result in the uterine cervix protruding from the vaginal opening. Surgical repair is typically required to restore the uterus to its proper anatomical position.

emale reproductive system procedures

Obstetrician – literally “midwife” in Latin. A physician specializing in the diagnosis and management of pregnancy and delivering babies.

Gynecologist – a physician specializing in diseases of the female reproductive system and surgery of this area. Most physicians currently specialize in combined practice of OB/GYN.

Episiotomy – a surgical procedure cutting into the perineal area, the area between the vagina and anus in order to prevent tearing of tissues when the baby’s head traverses the vaginal opening.

Hysterosalpingogram – special X-rays of the uterus and uterine tubes involving passing an opaque dye backwards up through the uterus to determine if the tubes are patent. Since the tubes are open into the abdominal (peritoneal) cavity, if patent, dye should spill out of the end of the tubes and be manifest on the X-ray.

Colposcopy – using a magnifying instrument to inspect the interior of the vagina and cervix, the entrance to the uterus.

Dilation and curettage (D & C) – dilating the cervix, the entrance into the uterus, and passing instruments that enable scraping off superficial layers of the endometrium. May be done as an early therapeutic abortion, or following a normal pregnancy to remove residual tissue remaining in the uterus, or may be done as a diagnostic procedure to examine lining tissue of the uterus.

Mammoplasty – Surgical reconstruction of the breast may involve breast enlargement or reduction or cosmetic reconstruction after mastectomy. What are the risk factors of developing breast cancer?  Check out this women’s health link for answers.

Pudendal block – An anesthetic administered to block sensation around the lower vagina and perineum. This facilitates performing an episiotomy (see above) allowing passage of the baby’s head while avoiding uncontrolled tearing of tissues. By the way, pudendal, an ancient name for external genitalia, means “that which we should be ashamed of” in Latin. Even Adam and Eve wore fig leaves!

Female reproductive system terms of pregnancy

Hyster/o, metr/ Uterus Hysterectomy, endometritis (inflammation of the lining of uterus)
Salping/o, -salpinx Uterine tube Salpingitis, hematosalpinx (blood in the uterine tube)
Colp/o Vagina Colporrhaphy (suturing a tear), colpoplasty (surgical reconstruction), colposcopy (viewing the interior)
Oophor/o Ovary Oophorectomy, oophoropexy (surgery fixation, reattachment)
Men/o Menstruation Menarche (first), dysmenorrhea (painful menstruation)
Mamm/o, mast/o Breast Mammogram, mastectomy
-pareunia, coitus Intercourse Dyspareunia (painful intercourse), precoital, postcoital (before and after intercourse)
-gravida Pregnancy Nulligravida (never pregnant), primigravida (first-time pregnant), multigravida (many pregnancies)
-para Live birth Nullipara (no live births), multipara (many live births)
Part/o, toc/o Labor/birth/delivery Prepartum, postpartum (before and after delivery), dystocia (difficult delivery)

EXAMPLE: On an OB patient’s chart you may see the abbreviations: gravida 3, para 2. This means three pregnancies, two live births. The OB patient, currently pregnant with her third baby, will become a Gravida 3, Para 3 after giving birth.

Complications of pregnancy

Abruptio placentae– (Latin, “breaking off”). Premature separation of a normally implanted placenta before full term. Occurs in only about 1% of pregnancies. However, it has a 20-40% fetal mortality rate and is a significant contributor to maternal mortality.

Placenta previa– (Latin, “leading the way”). A placenta implanted over the cervical region of the uterus blocking the entrance to the birth canal. Occurs in less than one percent of pregnancies, but can cause significant bleeding and require a complicated delivery.

Eclampsia (toxemia of pregnancy )- a serious and life-threatening condition that may develop during pregnancy involving hypertension, convulsions and coma. A less severe form, preeclampsia, may develop but can be managed if identified and treated early.

Ectopic pregnancy– (Greek, “out of place”). A pregnancy implanted anywhere outside of the uterus. The uterine tube (Fallopian tube) is the most common location, also called a “tubal pregnancy”. The abdominal cavity is the least common location. Occurs in about 2% of pregnancies. When it occurs, it is a surgical emergency, because the uterine tube cannot sustain tremendous expansion like the uterus. Eventually, the uterine tube will rupture with severe, possibly fatal, hemorrhaging.

Musculoskeletal system

Musculoskeletal system terms

Oste/o Bone Osteitis, osteoma, osteocyte
Chondr/o Cartilage Chondritis, chondroma, chondrocyte
Arthr/o Joint Arthritis, arthroplasty
Myel/o Bone marrow Myeloma
Ten/o, tendin/o Tendon (binds muscle to bone) Tendonitis, tenorrhaphy
Ligament/o Ligament (binds bone to bone) Ligamentous injury
Burs/o Bursa, “bag”, (shock absorber between tendons and bones) Bursitis
My/o, myos/o Muscle Myoma, myositis
-malacia Softening Osteomalacia, chondromalacia
-porosis Porous Osteoporosis
-asthenia Weakness, loss of strength Myasthenia gravis
-trophy Development, stimulation, maintenance Atrophy (shriveling of muscles), hypertrophy  (increase in size and strength of muscles)
-algia, algesia Pain Myalgia, arthralgia, analgesia  (take away pain

I have long since stopped defining what “-itis” means, or “-oma.” Do you remember what “-plasty” means, or how about “-rrhaphy”? These word parts were introduced in previous modules. This program is all about building word roots, prefixes and suffixes into medical terms. The ultimate goal is for you to be able to figure out the meaning of new terms, or, at least, not be intimidated about looking it up in a medical dictionary.

Musculoskeletal system diseases

Arthritis – As we age, our joint tissues become less resilient to wear and tear and start to degenerate manifesting as swelling, pain, and oftentimes, loss of mobility of joints. Changes occur in both joint soft tissues and the opposing bones, a condition called osteoarthritis. A more serious form of disease is called rheumatoid arthritis. The latter is an autoimmune disease wherein the body produces antibodies against joint tissues causing chronic inflammation resulting in severe joint damage, pain and immobility.

Osteoporosis – “Porous bone.” The bane of the old, especially, women. The hard, rock-like quality of bone is dependent upon calcium. When too much calcium is dissolved from bones or not enough replaced, bones lose density and are easily fractured. Estrogen, the female sex hormone, helps maintain proper calcium levels in bones. Once the ovaries stop producing the hormone, women are at higher risk of developing osteoporosis. A collapse of bony vertebrae of the spinal column results in loss of height and stooped posture. Hip fractures are a common occurrence.

Osteomalacia – “Soft bones.” If not enough calcium is deposited during early childhood development, the bones do not become rock-hard, but rubbery. Both adequate calcium in the diet and vitamin D, primarily, from normal sunlight exposure or supplementation, are necessary for normal bone development. Before vitamin supplementation to milk, “rickets,” another name for osteomalacia in children, was common resulting in the classic bowed legs of the afflicted child.

Carpal tunnel syndrome – People whose job involves repeated flexing of their wrist (typing, house painting) may develop tingling and/or pain in their thumb, index and middle fingers along with weakness of movements of the thumb, especially, grasping an object. The main nerve for finely controlled thumb movements passes through a bony/ligamentous canal on the bottom of the wrist. Repetitive flexing movements may inflame and thicken the ligament over the “tunnel” through the carpal (wrist) bones trapping and compressing the nerve.

Tendonitis– Repeated strain on a tendon, attachment of a muscle to bone, can inflame the tendon resulting in pain and difficulty with movement involving the muscle. Tendons have a poor blood supply; therefore, they typically take a long time to heal on the order of six weeks or more.

Rotator cuff tear – Muscles surrounding the shoulder joint are involved in rotating the shoulder with upper arm and hand forward and backward, among other movements. The tendons of these muscles also contribute to the structural strength of the shoulder joint. Hard, fast movements, such as in tennis and baseball can tear one of these tendons resulting in pain and decreased mobility of the shoulder. Surgery may be needed to repair a torn tendon.

Bursitis – A bursa is a small, closed bag with a minimum amount of lubricatory fluid that serves as a shock absorber where bones make close contact and to minimize trauma and friction where tendons cross bones and joints. Inflammation leads to pain and immobility in a joint area.

Muscular dystrophy – Muscular dystrophy is a group of inherited diseases in which the muscles that control movement progressively weaken. The prefix, dys-, means abnormal. The root, -trophy, refers to maintaining normal nourishment, structure and function. The most common form in children is called Duchenne muscular dystrophy and affects only males.  It usually appears between the ages of 2 to 6 and the afflicted live typically into late teens to early 20s.

Myasthenia gravis – “Muscular weakness, profound”. This is an autoimmune disease that involves production of antibodies that interfere with nerves stimulating muscle contractions. Face and neck muscles are the most obviously affected, manifesting as drooping eyelids, double vision, difficulty swallowing and general fatigue. There is no actual paralysis of muscles involved, but a rapid fatiguing of function.

Lupus erythematosus – An autoimmune disease wherein the body produces antibodies against a variety of organs, especially connective tissues of skin and joints. Mild Lupus may involve a distinctive butterfly-shaped rash over the nose and cheeks. Mild lupus may also involve myalgia and arthralgia (remember these words?) Severe or systemic lupus (SLE) involves inflammation of multiple organ systems such as the heart, lungs, or kidneys. By the way, lupus means “wolf” in Latin. Maybe a reference to the facial rash that might give a patient a wolf-like appearance.

Musculoskeletal system procedures

Orthopaedist – “To straighten up children.” Orthopaedics is a surgical subspecialty that in the past devoted much of its time to treating musculoskeletal deformities in children. Now with improved prenatal diagnosis and better nutrition, orthopaedists still treat children with spine and limb deformities but also adults with complicated bone fractures, damaged tendons or ligaments, or needing surgery to replace a damaged hip or knee joint.

Rheumatologist – “To study the flux of fluids.” Say, what? Rheuma is an old medical term for a watery discharge. Among other diseases, rheumatologists treat joint diseases such as the various forms of arthritis including rheumatoid arthritis. Inflamed joints accumulate “fluid” and swell among other signs and symptoms. This medical subspecialty also evaluates and treats osteoporosis, tendonitis, gout and lupus among many other chronic musculoskeletal pain disorders.

Osteopath/osteopathic physician (D.O.) – The name sounds like a specialty limited to bone disease, but actually, osteopathic physicians are one of two arms of the medical profession that differ in history and philosophy. At one time there were many kinds of medical schools originating from various philosophies; allopathic, osteopathic, homeopathic. Osteopathy originated in the 1890s in response to despair at the lack of effectiveness of many forms of then primitive treatments. Osteopathy developed an emphasis on the influence of the musculoskeletal system and its interrelationship to other body systems. D.O.s make use of osteopathic manipulation (bones, ligaments, joints) along with medication, surgery and all other medical treatments used by M.D. physicians. Also, preventive care has always been a major emphasis of osteopathic care. M.D.s and D.O.s are licensed by all state medical boards. Learn about the doctor of osteopathic medicine program at Des Moines University.

Podiatrists, traditionally known as “foot doctors,” are surgical subspecialists in diseases and structural problems of the feet. They not only provide care for corns, calluses, ingrown toenails and heel spurs, but also treat foot and ankle injuries, deformities and diseases. Many systemic diseases manifest signs and symptoms in appearance of the feet such as poor wound healing in diabetes. They also can prescribe special shoes and inserts to treat chronic foot pain and walking problems. Podiatrists may further specialize in sports medicine, geriatrics or diabetic foot care.

Physical therapist – This health care professional has at least two years of specialized training beyond a college degree. PTs are rehabilitation specialists treating a multitude of medical problems including patients recovering from joint surgery, limb amputation, a stroke, heart attack and suffering with chronic neuromuscular diseases. In addition to other treatment modalities, they teach patients exercises to strengthen their body, increase mobility and how to prevent recurrence of injury.

Arthroscopy – A fiberoptic instrument is introduced into a joint cavity in order to visualize surfaces of bones entering into a joint, find tears in internal joint structures and evaluate sources of inflammation.

Bone scan – A radioactive element in very small amounts, not enough to cause any radiation injury to the patient, is introduced into the blood stream. The specially selected element accumulates in bone and using a much more sophisticated version of the old Geiger Counter instrument, the distribution of the element is used to diagnose potential bone tumors among other bone pathologies.

Electromyography – A big, scary word! But, you are experienced by now in taking them apart. I like to start at the end and work backward: “a recording of muscle electrical activity.” Fine needles are introduced into muscles in order to make recordings of contractile activity. This procedure is useful in evaluating causes of paralysis, diagnosing muscular dystrophy and other neuromuscular disorders.

Muscle biopsy – Cutting out a small tissue sample of muscle in order to examine it under a microscope. This procedure can be useful in diagnosing muscular dystrophy and other neuromuscular disorders.

Musculoskeletal system medical record

Following is an abstract of a simulated patient medical record. Identify each italicized word. If the meaning doesn’t come right away, take apart the word. If you recognize the organ involved, use the context to help you figure out the full meaning. Terms are not limited to musculoskeletal system. Remember, this is a cumulative exercise! If you can’t think of the meaning, hover your cursor over the word for a tip.

A 62 year old male comes to his family physician complaining of pain in his right knee. He walks with a limp which he says is getting worse and is related to an old football injury. During the course of the examination he reveals that he also suffers from a “nervous bladder” with polyuriadysuria and nocturia, but denies hematuria. He smokes two packs a day, breaths are wheezy and he is short of breath, but denies hemoptysis.

Physical exam: right knee was swollen, warm and had limited range of motion which was painful to perform. Mild exercise increases wheezing and causes dyspnea. Examination of the heart size reveals cardiomegaly. No hepatomegaly or splenomegaly was found upon abdominal examination.

Current medication: Prevacid for gastroesophageal reflux disease, nitroglycerine for angina pectoris.

Past medical history: GERD diagnosed with esophagogastroduodenoscopy (EGD). Angina pectoris diagnosed with treadmill test, cardiac scan and cardiac catherization.

Past surgical history: orchidopexy for cryptorchidism at age nine, tonsillectomyappendectomy.

Family medical history: mother has chronic nephritis; will be starting dialysis.

Recommended treatments: refer to pulmonologist to evaluate possible emphysema. Refer to orthopaedist for arthroscopic evaluation of knee. Refer to urologist to evaluate for prostatic hypertrophy, possible cystoscopy. Office phlebotomist drew specimens for lab work.

Get a piece of paper and pencil and write down two column headings: “Signs” and “Symptoms.” Then take the following items and put them under the proper heading. You remember the difference between a sign and a symptom, right? You might want to review the context of these items in the case above before deciding.

Item: cardiomegaly, pain in right knee, right knee is swollen, nervous bladder.pr

In plain English

A 62 year old male comes to his family physician complaining of pain in his right knee. He walks with a limp which he says is getting worse and is related to an old football injury. During the course of the examination he reveals that he also suffers from a “nervous bladder” with frequent urination, painful/difficult urination and getting up at night to urinate, but denies blood in the urine. He smokes two packs a day, breaths are wheezy and he is short of breath, but denies coughing up blood.

Physical exam: right knee was swollen, warm and had limited range of motion which was painful to perform. Mild exercise increases wheezing and causes difficulty breathing. Examination of the heart size reveals an enlarged heart. No enlargement of the liver or spleen was found upon abdominal examination.

Current medication: Prevacid for severe heartburn, nitroglycerine for chest pain related to the heart.

Past medical history: GERD diagnosed with visual examination of the esophagus, stomach and duodenum with a fiberoptic instrument. Angina pectoris diagnosed with treadmill test, injecting a radioactive element into blood stream to evaluate heart structure and function and threading a hollow tube through arteries to the heart to inject dye opaque to X-rays to demonstrate coronary arteries.

Past surgical history: surgical fixation of the testis for undescended testicles at age nine, removal of tonsils, removal of appendix.

Family medical history: mother has chronic inflammation of kidneys; will be starting medical procedure cleansing waste from blood in kidney failure.

Recommended treatments: refer to specialist in lung diseases to evaluate possible destruction of lung membranes needed for oxygen exchange. Refer to specialist in musculoskeletal diseases for visualization of joints with a fiberoptic instrument (evaluation of knee). Refer to specialist in lower urinary tract diseases and diseases of the male reproductive tract to evaluate for enlargement of the prostate, possible visualization of the interior of the bladder with a fiberoptic instrument. Office technician or nurse trained to “cut into veins” to draw blood drew specimens for lab work.

By the way, what the patient complains of or describes are symptoms: knee hurts, frequent urination. What the doctor observes and/or measures are signs: right knee is swollen, enlarged heart

Cancer terms

Cancer is a scary word, but as you have learned by now, words give you the information you need to make knowledgeable decisions in consultation with your family physician and oncologist (cancer specialist).

Many cancer terms are unique to the field of oncology (study of tumors) and don’t lend themselves easily to the prefix, root, suffix system used in the previous modules. Instead, terms will be grouped and defined in broad categories such as tumor types, causes and treatments. In place of a quiz there will be a simulated case that reinforces frequently used terms.

Cancer buzz words

Good news Bad news
Benign Malignant
Low grade High grade
Radiosensitive Radioresistant
No metastases metastases
Well differentiated Poorly differentiated
Negative nodes Positive nodes
In remission Relapse
Surgically resectable Inoperable

Tumor types

Malignant vs. benign (literally, “evil” versus “good”)

Tumors are masses of cells that have slipped the bonds of control of cell multiplication. Malignant tumors, cancers, are life-threatening because they are invasive (spread into surrounding organs) and metastasize (travel to other areas of the body to form new tumors). Specifically, invasiveness results in penetration, compression and destruction of surrounding tissue causing such problems as loss of organ function (liver, kidneys), difficulty breathing (lungs), obstruction (intestines), possible catastrophic bleeding and severe pain.

Carcinoma

Carcinoma is the most common form of cancer. Carcinoma develops from sheets of cells that cover a surface (example: skin) or line a body cavity (example: glandular lining of stomach). Some names for tumors of this type would be: adenocarcinoma of the prostate, adenocarcinoma of the lung, gastric adenocarcinoma, hepatocellular carcinoma (what organ is involved?). Note that the term carcinoma typically appears in the name.

Sarcoma

A rare form of cancer arises from connective and supportive tissues, examples: bone, fat, muscle, and other connective tissues. Some names of this type of tumor would be: osteosarcoma (malignancy of bone), liposarcoma (fat) and gastrointestinal stromal tumor. Note that the term sarcoma does not always appear in the name.

Grading and staging

Tumor biopsies (tissue samples) are examined microscopically to determine the type and degree of development. A grading scale is used, usually Grade I to Grade IV, to describe tissue differentiation. Tumors that are well differentiated (it still looks like the original source tissue) generally have a good clinical outcome. Tumors that are poorly differentiated (the tissue has taken on a more primitive structure and may not resemble its original tissue) generally have a poorer outcome. The clinical stage of a tumor is determined by physical exam (Can you feel the tumor? Can you palpate (feel) lymph nodes? Is the tumor fixed in place (adherent to other structures)? Imaging (CT, MRI) is also an essential tool. The stage of the tumor determines if the tumor has invaded surrounding tissue, involved lymphatics (drainage channels for cell fluids other than blood) and whether the cancer has metastasized to other sites in the body.

A staging system using the letters T, N, M is also used in conjunction with Grading. “T” indicates size of tumor; “N” whether the cancer has spread into lymph nodes; “M” whether cancer cells have metastasized to other organs and areas. For example, a melanoma T2N0M0 describes a skin cancer that is between 1.0 and 2.0 mm in thickness, but has not spread into lymph nodes or other areas of the body.

Grading and staging tumors are important ways to predict the “prognosis” (progress and outcome of the disease), and which types of treatments may most likely succeed. In general, low grade tumors that have not invaded tissues, have not involved lymph nodes (negative nodes) and have not metastasized would be expected to have a better prognosis than a high grade tumor that has invaded tissues, has invaded lymphatics (positive nodes) and has metastasized. However, the prognosis of any individual patient is much more complicated than described here. Complicating factors include the general health of the patient, the effectiveness of their immune system and available treatment options. Some tumor types are very “aggressive” and are highly resistant to treatment.

Causes of cancer

Any injury to DNA (the genetic code) may result in the loss of cell cycle control, leading to uninhibited cell division. Carcinogens are cancer causing agents. Broad categories include radiation, chemicals, drugs and viruses. Don’t panic! Your once a year dental X-ray and common cold and flu viruses will not cause cancer. However, excessive radiation from nuclear to sunlight can significantly increase your risk of malignancy. The Human Papilloma Virus (HPV) is the major cause of cervical cancer. Environmental chemicals found in tobacco smoke, automotive exhaust, toxic emissions from factory smokestacks and asbestos exposure are all carcinogenic.

Curious about your risk for common cancers? Check in at Your Disease Risk at Washington University School of Medicine.

Cancer therapy

Tumor markers

Tumor markers are substances that are produced by tumors or the body’s response to presence of a tumor. Tumor markers found in various body fluids, such as the blood, can be useful in the detection and response to treatment of certain cancers. However, most tumor markers are not specific for cancer and they may be present or even elevated with benign diseases. The absence of a tumor marker can also be useful in confirming successful cancer treatment; whereas an increase in the tumor marker level may indicate recurrence. Two well known markers are Prostate Specific Antigen (PSA) for prostate cancer and CA-125 for ovarian cancer.

Radiation

It is ironic that the same agent that can cause cancer can be used to destroy cancer, but a common mechanism is at work. Fairly low to moderate doses of radiation can cause DNA damage, which may result in the malignant transformation of normal cells into cancer cells. But, high dose radiation focused on cells can destroy the cancerous cells. However, even with highly focused radiation treatment, normal surrounding tissues are exposed to the radiation and may lead to secondary cancers.

Some terms you will hear about are:

Radiosensitive – cancer degenerates in response to radiation

Radioresistant – the cancer may have a partial response or doesn’t respond at all

Fractionation – a treatment radiation dose is broken down into multiple exposures over several weeks to minimize side effects

Chemotherapy

Perhaps nothing short of surgery strikes fear into our hearts more than being told, “You’re going to need chemo”. Stories of hair falling out and nausea and/or diarrhea are awful. But, the essential action of most chemotherapeutic agents is to kill or stop the development of rapidly dividing cells. However, chemotherapy works systemically (affects the whole body) so any rapidly dividing cell, cancer or not, is affected by the medication; such as hair follicles and the lining cells of our stomach/intestines. Make sense?

Another side effect of chemotherapy is myelosuppression, where the rapidly dividing bone marrow cells are killed off. Patients may complain of extreme fatigue due to anemia (reduced number of erythrocytes) and can be at increased risk of infectious disease (reduced number of leucocytes).

Chemotherapeutic agents that you will likely hear about are: Cisplatin, Carboplatin, Bleomycin, 5-fluorouracil, methotrexate, Vincristine, Vinblastine, and Taxol. Since the same mechanism that kills a malignant cell or blocks development of a malignant cell can have similar effects on a normal, rapidly dividing cell, any of these agents can have unpleasant side effects. Some forms of cancer treated with chemotherapy may cause the cancer to “disappear” for awhile although not cured and the patient may be symptom free sometimes for months or years. This period of holding the cancer in check is called a “remission”. Unfortunately, many such cancers, such as leukemia, reoccur and the patient is said to have “relapsed”.

Every year, promising new treatments are being developed. One of the newest is an angiogenesis (blood vessel growing) inhibitor. Medications such as Avastin and Sutent block blood vessels from growing into a tumor thereby starving the growth.

Surgery

In my opinion, the best way to get rid of a cancer is cut it out. I want rid of it now! However, some tumors are so enmeshed in normal tissues that they cannot be safely cut out without severe damage to normal tissues, in other words, they are “inoperable”. And, depending upon the location (brain, prostate, etc) and the amount of excised tissue, one may be left with severe disability. However, surgery can be a complete cure for some types of tumors if done early, such as malignant melanoma (skin cancer). The probability of a cure may be enhanced after surgery by following up with additional treatments such as chemotherapy, radiation therapy or both. The term for this is “adjuvant therapy”.

Some surgical terms you will hear:

Cryosurgery – destroying malignant tissue by freezing it with a cold probe. Often used for soft tissues like liver or kidney.

Fulguration – “Lightning” in Latin. Malignant tissue is destroyed with an electrocautery instrument (electric current).

Excisional biopsy – simultaneous tissue sampling and removal of a tumor with a safe margin of normal tissue. Frequently done with suspicious skin lesions; example, malignant melanoma.

Resect- to cut and remove a segment of an organ containing a tumor.

En bloc resection – removal of the tumor and any surrounding organs or tissues that may be involved. This is often necessary for large abdominal sarcomas.

Unfortunately, not all cancer treatments are curative. Palliative treatment gives relief of symptoms, but does not cure and is reserved for advanced malignancy.

The following is a simulated patient case.

Cancer therapy

Tumor markers

Tumor markers are substances that are produced by tumors or the body’s response to presence of a tumor. Tumor markers found in various body fluids, such as the blood, can be useful in the detection and response to treatment of certain cancers. However, most tumor markers are not specific for cancer and they may be present or even elevated with benign diseases. The absence of a tumor marker can also be useful in confirming successful cancer treatment; whereas an increase in the tumor marker level may indicate recurrence. Two well known markers are Prostate Specific Antigen (PSA) for prostate cancer and CA-125 for ovarian cancer.

Radiation

It is ironic that the same agent that can cause cancer can be used to destroy cancer, but a common mechanism is at work. Fairly low to moderate doses of radiation can cause DNA damage, which may result in the malignant transformation of normal cells into cancer cells. But, high dose radiation focused on cells can destroy the cancerous cells. However, even with highly focused radiation treatment, normal surrounding tissues are exposed to the radiation and may lead to secondary cancers.

Some terms you will hear about are:

Radiosensitive – cancer degenerates in response to radiation

Radioresistant – the cancer may have a partial response or doesn’t respond at all

Fractionation – a treatment radiation dose is broken down into multiple exposures over several weeks to minimize side effects

Chemotherapy

Perhaps nothing short of surgery strikes fear into our hearts more than being told, “You’re going to need chemo”. Stories of hair falling out and nausea and/or diarrhea are awful. But, the essential action of most chemotherapeutic agents is to kill or stop the development of rapidly dividing cells. However, chemotherapy works systemically (affects the whole body) so any rapidly dividing cell, cancer or not, is affected by the medication; such as hair follicles and the lining cells of our stomach/intestines. Make sense?

Another side effect of chemotherapy is myelosuppression, where the rapidly dividing bone marrow cells are killed off. Patients may complain of extreme fatigue due to anemia (reduced number of erythrocytes) and can be at increased risk of infectious disease (reduced number of leucocytes).

Chemotherapeutic agents that you will likely hear about are: Cisplatin, Carboplatin, Bleomycin, 5-fluorouracil, methotrexate, Vincristine, Vinblastine, and Taxol. Since the same mechanism that kills a malignant cell or blocks development of a malignant cell can have similar effects on a normal, rapidly dividing cell, any of these agents can have unpleasant side effects. Some forms of cancer treated with chemotherapy may cause the cancer to “disappear” for awhile although not cured and the patient may be symptom free sometimes for months or years. This period of holding the cancer in check is called a “remission”. Unfortunately, many such cancers, such as leukemia, reoccur and the patient is said to have “relapsed”.

Every year, promising new treatments are being developed. One of the newest is an angiogenesis (blood vessel growing) inhibitor. Medications such as Avastin and Sutent block blood vessels from growing into a tumor thereby starving the growth.

Surgery

In my opinion, the best way to get rid of a cancer is cut it out. I want rid of it now! However, some tumors are so enmeshed in normal tissues that they cannot be safely cut out without severe damage to normal tissues, in other words, they are “inoperable”. And, depending upon the location (brain, prostate, etc) and the amount of excised tissue, one may be left with severe disability. However, surgery can be a complete cure for some types of tumors if done early, such as malignant melanoma (skin cancer). The probability of a cure may be enhanced after surgery by following up with additional treatments such as chemotherapy, radiation therapy or both. The term for this is “adjuvant therapy”.

Some surgical terms you will hear:

Cryosurgery – destroying malignant tissue by freezing it with a cold probe. Often used for soft tissues like liver or kidney.

Fulguration – “Lightning” in Latin. Malignant tissue is destroyed with an electrocautery instrument (electric current).

Excisional biopsy – simultaneous tissue sampling and removal of a tumor with a safe margin of normal tissue. Frequently done with suspicious skin lesions; example, malignant melanoma.

Resect- to cut and remove a segment of an organ containing a tumor.

En bloc resection – removal of the tumor and any surrounding organs or tissues that may be involved. This is often necessary for large abdominal sarcomas.

Unfortunately, not all cancer treatments are curative. Palliative treatment gives relief of symptoms, but does not cure and is reserved for advanced malignancy.

The following is a simulated patient case.

Wrap up

Final quiz

Hey! Are you up to the challenge of a 30 question cumulative quiz? I bet you are! Some terms have not been presented in this program, but all can be defined using the word parts (prefixes, roots, suffixes) that have been presented. Look at each word carefully, especially the root. Play the exam game! If I ask for an inflammation and there are only two choices ending in “itis”, well, that narrows the choices doesn’t it.