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5'$1=(',7,21 3HWHU+DUULV•6XH1DJ\•1LFKRODV9DUGD[LV Sample proofs © Elsevier Australia MOSBY’S DICTIONARY OF MEDICINE, NURSING & HEALTH PROFESSIONS 3RD AUSTRALIAN AND NEW ZEALAND EDITION EDITORS-IN-CHIEF Peter Harris MBBS, FRACGP; Senior Lecturer in Medical Education, University of New South Wales, New South Wales Sue Nagy RN, BA(Hons), PhD, FCN; Adjunct Professor, Faculty of Health, University of Technology, Sydney, New South Wales Nicholas Vardaxis BSc(Hons), PhD; Executive General Manager, Courses and Quality, Open Universities Australia Sydney Edinburgh London New York Philadelphia St Louis Toronto Sample proofs © Elsevier Australia Contents Preface vi Specialist Consultants vii Appendix Consultants ix Reviewers x Editorial Board Members x Consultants xi Guide to the Dictionary xii Pronunciation Key xv Colour Atlas of Human Anatomy A-1 Skeletal system A-2 Muscular system A-8 Circulatory system A-12 Endocrine system A-19 Lymphatic system A-21 Nervous system A-24 Respiratory system A-29 Digestive system A-33 Reproductive system A-36 Urinary system A-40 Special senses A-43 Dictionary entries A–Z 1–1853 Appendices 1 Units of measurement 1857 2 Symbols and abbreviations 1869 3 Medical terminology 1880 4 Normal reference values 1900 5 Nutrition 1916 6 Medication: clinical calculations, interactions, issues of safety, and usage rates 1944 7 Infection control 1980 8 Health of Aboriginal, Torres Strait Islander and Māori people 1992 9 Tabular atlas of human anatomy and physiology 1998 Picture credits 2035 The following appendices are available at http://evolve.elsevier.com/AU/ANZMD/ 10 Assessment guides 2035 11 Health promotion and immunisation 2044 12 Complementary and alternative medicine 2054 13 Herbs and natural supplements 2065 14 Health organisations and resources 2081 Sample proofs © Elsevier Australia v Skeletal system SKELETAL SYSTEM POSTERIOR VIEW OF SKELETON ANTERIOR VIEW OF SKELETON Frontal bone Parietal bone Nasal bone Orbit Maxilla Mandible Clavicle Zygomatic bone Manubrium Scapula Sternum Costal cartilage Ribs Xiphoid process Humerus Vertebral column Radius Ulna Coxal (hip) bone Ilium Sacrum Coccyx Occipital bone Cervical vertebrae (7) Clavicle Acromion Scapula Thoracic vertebrae (12) Ribs Humerus Lumbar vertebrae (5) Coxal (hip) bone Ulna Radius Carpal bones Metacarpal bones Phalanges Carpal bones Metacarpal bones Phalanges Pubis Ischium Greater trochanter of femur Coccyx Ischium Sacrum Femur Femur S R L Patella I Axial skeleton Appendicular skeleton Tibia Tibia Fibula Fibula Tarsal bones Metatarsal bones Phalanges Sample proofs © Elsevier Australia A-2 Tarsal bones Phalanges Metatarsal bones Calcaneus Skeletal system ANTERIOR VIEW OF SKULL Frontal bone Squama of frontal bone Frontal eminence Coronal suture Parietal bone Superciliary ridge Supraorbital foramen Orbital plate of frontal bone Sphenoid (greater wing) Superior orbital fissure Optic foramen Lacrimal bone Inferior orbital fissure Infraorbital foramen Glabella Supraorbital margin Zygomatic process of frontal bone Temporal bone Nasal bone Zygomatic bone Nasal cavity Maxilla Middle and inferior nasal conchae Ramus of mandible Body of mandible Mental foramen Anterior fontanel Parietal bone Frontal bone Parietal eminence FETAL SKULL Frontal suture Frontal eminence Sphenoid fontanel Nasal bone Lacrimal bone Sphenoid Maxilla Posterior fontanel Occipital bone Mastoid fontanel Zygomatic bone Temporal bone (petrous portion) Mandible Tympanic ring Temporal bone (squamous portion) External auditory meatus Coronal suture Frontal bone Superior temporal line Inferior temporal line Superciliary ridge Splenoid (greater wing) Supraorbital foramen Nasal bone Lacrimal bone Infraorbital foramen Sagittal suture Parietal bone Squamosal suture Temporal bone Occipital bone Lambdoidal suture External occipital protuberance Zygomatic bone Maxilla Mastoid process External auditory meatus Styloid process Zygomatic process of temporal bone Mandible RIGHT LATERAL VIEW OF SKULL Mental foramen Sample proofs © A-3 Elsevier Australia Skeletal system THORAX AND RIBS Costosternal articulation Clavicle C7 T1 1 2 3 True ribs Manubrium 4 Body Sternum Xiphoid process 5 6 7 False ribs 8 11 9 12 Costal cartilage L1 10 Floating ribs PELVIS MALE FEMALE Pelvic inlet Pelvic outlet Subpubic angle Pelvic inlet Sacral promontory Iliopectineal line Pubic crest Symphysis pubis Pelvic inlet Pelvic outlet Ischial spine Coccyx Symphysis pubis Pelvic outlet Subpubic angle RIB Tubercle INDIVIDUAL VERTEBRA Angle Head Neck Internal surface Costal groove Costal cartilage Transverse process Spinous process Superior view Sample proofs © Elsevier Australia A-4 External surface Skeletal system Atlas Axis VERTEBRAL COLUMN Cer vical cur vature Cervical vertebrae cic curvature (7) Thora Thoracic vertebrae ar cur vature Lumb Lumbar vertebrae (5) Sa c ral curva tur e Intervertebral foramina (12) Sacrum Coccyx Right lateral view Anterior view Sample proofs © A-5 Elsevier Australia Skeletal system SECOND CERVICAL VERTEBRA (AXIS) FIRST CERVICAL VERTEBRA (ATLAS) Superior articular facet Anterior tubercle Anterior arch Facet for dens Lateral mass Dens Transverse process Impressions for alar ligaments Transverse foramen Facet for occipital condyle Posterior arch Vertebral foramen Posterior tubercle Spinous process THORACIC VERTEBRA FIFTH CERVICAL VERTEBRA Transverse foramen Vertebral body Vertebral body Superior demifacet Transverse process Vertebral foramen Pedicle Vertebral canal Spinous process Spinous process Facet for articulation with tubercle of rib Lamina Transverse process SACRUM AND COCCYX Ala LUMBAR VERTEBRA Promontory Vertebral body Pedicle Anterior sacral foramina Transverse process Vertebral arch Lamina Cornua Coccyx Transverse process Spinous process Sample proofs © Elsevier Australia A-6 Skeletal system MICROSCOPIC STRUCTURE OF BONE Osteon Concentric Circumferential Central (Haversian system) lamellae lamellae (Haversian) canal Interstitial lamellae Lacunae containing osteocytes Blood vessels within central (Haversian) canal Periosteum Blood vessel within transverse (Volkmann) canal Osteons (Haversian systems) Endosteum Periosteum Inner layer Outer layer Trabeculae Compact bone Cancellous (spongy) bone Central (Haversian) canals Transverse (Volkmann) canals Medullary (marrow) cavity Sample proofs © A-7 Elsevier Australia Muscular system MUSCULAR SYSTEM ANTERIOR VIEW Facial muscles Sternocleidomastoid Trapezius Deltoid Pectoralis major Serratus anterior Biceps brachii Rectus abdominis Linea alba Flexors of wrist and fingers Extensors of wrist and fingers External abdominal oblique Adductors of thigh Tensor fasciae latae Retinaculum Vastus lateralis Sartorius Rectus femoris Vastus medialis Patella Patellar tendon Gastrocnemius Tibialis anterior Extensor digitorum longus Peroneus (Fibularis) longus Soleus Peroneus (Fibularis) brevis Superior extensor retinaculum Sample proofs © Elsevier Australia A-8 Muscular system POSTERIOR VIEW Sternocleidomastoid Seventh cervical vertebra Splenius capitis Trapezius Deltoid Infraspinatus Teres minor Teres major Triceps brachii Latissimus dorsi External abdominal oblique Extensors of the wrist and fingers Gluteus maximus Semitendinosus Hamstring group Adductor magnus Biceps femoris Semimembranosus Gracilis Iliotibial tract Gastrocnemius Calcaneal tendon (Achilles tendon) Peroneus (Fibularis) longus Soleus Peroneus (Fibularis) brevis Sample proofs © A-9 Elsevier Australia Muscular system LATERAL AND ANTERIOR VIEWS OF MUSCLES OF THE FACE AND ANTERIOR CRANIUM AND SEVERAL MUSCLES OF MASTICATION Frontalis Galea aponeurotica Orbicularis oculi Temporalis Corrugator Temporalis fascia Procerus Auricularis superior Levator labii superioris alaeque nasi Levator labii superioris Auricularis anterior Occipitalis Zygomaticus minor Auricularis posterior Levator anguli oris Zygomaticus major Masseter Orbicularis oris Risorius (cut) Mentalis Sternocleidomastoideus Depressor labii inferioris Depressor anguli oris Trapezius Buccinator Omohyoideus Sternohyoideus Galea aponeurotica (frontal portion) Medial palpebral ligament Epicranius (frontal belly) Orbicularis oculi (orbital portion) Orbicularis oculi (palpebral portion) Levator labii superioris Zygomaticus minor Parotid gland Zygomaticus (major) Risorius Levator anguli oris Procerus Temporalis Corrugator Levator labii superioris alaeque nasi Zygomaticus minor and major (cut) Nasalis Levator anguli oris (cut) Masseter Buccinator Orbicularis oris Depressor anguli oris Mentalis Depressor labii inferioris Platysma (part) Sample proofs A-10 © Elsevier Australia Muscular system Splenius capitis Dotted line indicates outline of trapezius Levator scapulae Rhomboid minor Rhomboid major Supraspinatus Infraspinatus Teres minor Dotted line indicates attachment of latissimus dorsi to humerus Serratus posterior superior Rhomboids (cut edge) Dotted line indicates outline of trapezius Longissimus thoracis Teres major Thoracolumbar fascia Latissimus dorsi 12th thoracic vertebra Iliocostalis thoracis Spinalis thoracis Serratus posterior inferior Internal oblique External oblique Erector spinae SOME SUPERFICIAL MUSCLES OF THE BACK Sternocleidomastoid tendon (cut) Semispinalis capitis CLINICAL NOTE: Chest wall muscles The many insertions of dorsal muscles into the ribs and vertebrae allow for precision in control and flexibility in twisting and turning movements of the trunk. The fibres of the intercostal muscles run obliquely, but some are at right angles to others; they play an important part in increasing thoracic volume during respiration. Splenius capitis Sternocleidomastoid Levator scapulae (cut) Trapezius Splenius cervicis 7th cervical vertebra Rhomboid minor Rhomboid major Deltoid (cut) Coracobrachialis Deltoid Pectoralis major SUPERFICIAL MUSCLES OF THE POSTERIOR NECK AND UPPER BACK Serratus anterior Biceps brachii SUPERFICIAL MUSCLES OF THE UPPER CHEST AND SHOULDERS Long head of the triceps Sample proofs ©A-11 Elsevier Australia Circulatory system CIRCULATORY SYSTEM PRINCIPAL ARTERIES Occipital Facial Internal carotid External carotid Right common carotid Right subclavian Left common carotid Left subclavian Arch of aorta Pulmonary Brachiocephalic Right coronary Left coronary Axillary Aorta Splenic Brachial Renal Superior mesenteric Coeliac Abdominal aorta Inferior mesenteric Common iliac Radial Internal iliac (hypogastric) Ulnar External iliac Deep medial circumflex femoral Deep palmar arch Superficial palmar arch Digital Descending branch of lateral circumflex femoral Deep artery of thigh Perforating arteries Femoral Popliteal Anterior tibial Peroneal Posterior tibial Arcuate Dorsal pedis Sample proofs A-12 © Elsevier Australia Circulatory system PRINCIPAL VEINS Occipital Angular Facial External jugular Internal jugular Left brachiocephalic Left subclavian Right brachiocephalic Right subclavian Superior vena cava Axillary Right pulmonary Cephalic Great cardiac Small cardiac Inferior vena cava Basilic Hepatic Long thoracic Splenic Hepatic portal Superior mesenteric Inferior mesenteric Median cubital (basilic) Common iliac Common iliac Internal iliac External iliac Digital Femoral Femoral Great saphenous Small saphenous Popliteal Fibular Anterior tibial Posterior tibial Venous dorsal arch Digital Sample proofs ©A-13 Elsevier Australia Circulatory system MAJOR ARTERIES OF THE HEAD AND NECK Superficial temporal artery Posterior auricular artery Occipital artery Maxillary artery Lingual artery Internal carotid artery Ascending pharyngeal artery Facial artery External carotid artery Superior thyroid artery Vertebral artery Subclavian artery Common carotid artery Brachiocephalic artery Superior sagittal sinus Inferior sagittal sinus Straight sinus Transverse sinus Occipital sinus Cavernous sinus Superior petrosal sinus Sigmoid sinus Ophthalmic veins Facial vein Inferior petrosal sinus S P A Internal jugular vein I (oblique) Sample proofs A-14 © Elsevier Australia Circulatory system VEINS FORMING THE SUPERIOR VENA CAVA Retromandibular vein Internal jugular vein External jugular vein Internal jugular vein Facial vein Lingual vein Superior thyroid vein Subclavian vein Right brachiocephalic vein Superior vena cava Azygos vein S Intercostal veins R L I (oblique) Sample proofs ©A-15 Elsevier Australia Circulatory system ANTERIOR VIEW OF THE HEART Left common carotid artery Left subclavian artery Brachiocephalic trunk Arch of aorta Superior vena cava Ligamentum arteriosum Auricle of left atrium Ascending aorta Pulmonary trunk Conus arteriosus Left pulmonary veins Right pulmonary veins Great cardiac vein Circumflex artery Auricle of right atrium Anterior interventricular branches of left coronary artery and cardiac vein Right coronary artery and cardiac vein Left ventricle Right ventricle Apex POSTERIOR VIEW OF THE HEART Left common carotid artery Left subclavian artery Left pulmonary artery Left pulmonary veins Auricle of left atrium Left atrium Great cardiac vein Brachiocephalic trunk Aortic arch Superior vena cava Right pulmonary artery Right pulmonary veins Right atrium Inferior vena cava Coronary sinus Posterior artery and vein of left ventricle Left ventricle Posterior interventricular branch of right coronary artery Middle cardiac vein Posterior interventricular sulcus Right ventricle Apex Sample proofs A-16 © Elsevier Australia Circulatory system MAJOR ARTERIES OF THE UPPER EXTREMITY Thyrocervical trunk Subclavian artery Common carotid artery Brachiocephalic artery Internal thoracic artery Lateral thoracic artery Axillary artery Vertebral artery Thoracoacromial artery Humeral circumflex arteries Subscapular artery Deep brachial artery Brachial artery Radial artery Ulnar artery Deep palmar arch Superficial palmar arch Digital arteries MAJOR ARTERIES OF THE LOWER EXTREMITY Inferior vena cava Common iliac artery External iliac artery Superior gluteal artery Ascending branch of lateral circumflex femoral artery Lateral circumflex femoral artery Perforating arteries Descending branch of lateral circumflex artery Popliteal artery Abdominal aorta Median sacral artery Internal iliac artery Lateral sacral artery Inferior gluteal artery Internal pudendal artery Obturator artery Deep artery of thigh Medial circumflex femoral artery Femoral artery Deep artery of thigh Genicular arteries Fibular artery Anterior tibial artery Lateral plantar arch Plantar arch Digital arteries Sample proofs ©A-17 Elsevier Australia Posterior tibial artery Dorsalis pedis artery Medial plantar artery Circulatory system MAJOR VEINS OF THE UPPER EXTREMITY Internal jugular vein Brachiocephalic vein Subclavian vein Axillary vein Cephalic vein Brachial veins Basilic vein Median cubital (basilic) vein Ulnar vein Radial vein Digital veins MAJOR VEINS OF THE LOWER EXTREMITY Inferior vena cava Common iliac vein External iliac vein Internal iliac vein Femoral vein Great saphenous vein Popliteal vein Fibular (peroneal) vein Small saphenous vein Posterior tibial vein Great saphenous vein Anterior tibial vein Dorsal veins of the foot Dorsal venous arch Digital vein Sample proofs A-18 © Elsevier Australia Endocrine system ENDOCRINE SYSTEM GLANDS OF THE ENDOCRINE SYSTEM Hypothalamus Pineal Pituitary Parathyroids Thyroid Thymus Adrenals Pancreas (islets) Ovaries (female) Testes (male) Sample proofs ©A-19 Elsevier Australia Endocrine system system LOCATION OF THE PITUITARY AND PINEAL GLANDS Cerebral cortex Cerebrum Intermediate mass of thalamus Corpus callosum Right lateral mass of thalamus Fornix Pineal body Third ventricle Midbrain Diencephalon Hypothalamus Optic chiasm Pituitary gland Infundibulum GROSS ANATOMY OF THE THYROID GLAND Epiglottis Hyoid bone Larynx (thyroid cartilage) Superior parathyroid glands Pyramidal lobe Lateral lobe Thyroid gland Inferior parathyroid glands Thyroid gland Isthmus of thyroid gland Trachea Tail of pancreas PANCREAS Bile duct Accessory pancreatic duct Main pancreatic duct Minor duodenal papilla Major duodenal papilla Hepatopancreatic ampulla Head of pancreas Sample proofs A-20 © Elsevier Australia Lymphatic system LYMPHATIC SYSTEM ORGANS OF THE LYMPHATIC SYSTEM Tonsils Cervical lymph node Entrance of thoracic duct into subclavian vein Thymus gland Axillary lymph node Right lymphatic duct Thoracic duct Superficial cubital (supratrochlear) lymph nodes Spleen Cisterna chyli Aggregated lymphoid nodules (Peyer patches) in intestinal wall Red bone marrow Inguinal lymph node S R L I Right lymphatic duct Right subclavian vein Thoracic duct Left subclavian vein Drained by thoracic duct Drained by right lymphatic duct STRUCTURE OF THE LYMPHATIC CAPILLARY Overlapping endothelial cells Interstitial fluid (IF) entering lymphatic capillary Valve closed Valve open Direction of flow Anchoring fibres Sample proofs ©A-21 Elsevier Australia Lymphatic system STRUCTURE OF THE SPLEEN Anterior margin Trabecula Capsule Gastric surface Renal surface Splenic artery Hilum Splenic vein Artery Vein Pancreatic surface Red pulp White pulp Venous sinuses GROSS ANATOMY OF THE THYMUS Right internal thoracic artery Left internal thoracic artery TIV/V vertebral level Thymus Pericardial sac Sample proofs A-22 © Elsevier Australia Lymphatic system LYMPHATIC DRAINAGE SYSTEM OF THE HEAD AND NECK Posterior auricular (mastoid) nodes Preauricular nodes Parotid nodes Occipital nodes Sternomastoid nodes Facial nodes External jugular node Submandibular nodes Retropharyngeal (tonsillar) node Posterior cervical spinal nerve chain Submental nodes Sublingual node Posterior superficial cervical chain Suprahyoid node Thyrolinguofacial node Anterior deep and superficial cervical nodes Internal jugular chain Supraclavicular nodes SCHEMATIC SECTION OF A LYMPH NODE Lymph Capsule Afferent lymph vessels Sinuses Germinal center Cortical nodules Trabeculae Medullary cords Hilum Medullary sinus Efferent lymph vessel Sample proofs ©A-23 Elsevier Australia Nervous system NERVOUS SYSTEM SIMPLIFIED VIEW OF THE NERVOUS SYSTEM Cerebrum Cerebellum Brachial plexus Musculocutaneous nerve Intercostal nerves Spinal cord Cauda equina Femoral nerve Ischial nerve Femoral cutaneous nerve Saphenous nerve Tibial nerve Peroneal nerve Digital nerves Sample proofs A-24 © Elsevier Australia Nervous system GROSS ANATOMY OF THE SPINAL CORD C1 C2 C3 C4 C5 Cervical nerves C6 Cervical plexus Cervical vertebrae C1 C2 C3 C4 C5 C6 C7 Brachial plexus C7 C8 Lumbar vertebrae T1 T2 T3 T3 T4 T4 T5 T5 T6 T6 T7 T7 T8 T9 T8 T9 T10 T10 T11 T11 T12 T12 L1 L1 L2 L2 L3 L3 L4 L4 L5 L5 Thoracic nerves Dura mater Cauda equina Lumbar nerves Lumbar plexus Thoracic vertebrae T1 T2 Sacrum S1 Sacral nerves S3 S4 S5 Coccyx Coccygeal nerve Filum terminale Sample proofs ©A-25 Elsevier Australia Sacral plexus S2 Nervous system CEREBRAL NUCLEI Lentiform nucleus Basal nuclei Caudate nucleus Thalamus Amygdaloid nucleus Substantia nigra (in midbrain) Body of caudate nucleus Corpus striatum Internal capsule Lentiform Putamen nucleus Pallidum Putamen Thalamus Mamillary body Head of caudate nucleus RETICULAR ACTIVATING SYSTEM Radiations to cortex FUNCTIONAL AREAS OF THE CEREBRAL CORTEX Precentral gyrus (primary somatic motor area) Premotor area Prefrontal area Motor speech (Broca) area Auditory Transverse association area gyrus Primary auditory area Central sulcus Postcentral gyrus (primary somatic sensory area) Primary taste area Somatic sensory association area Visual association area Visual impulses Reticular formation Visual cortex Sensory speech (Wernicke’s) area Sample proofs A-26 © Elsevier Australia Auditory impulses Projection to Ascending spinal cord sensory tracts Nervous system BASE OF THE BRAIN CRANIAL NERVES ARTERIES (Circle of Willis) Olfactory n. (I) Anterior cerebral a. Optic n. (II) Middle cerebral a. PITUITARY GLAND Internal carotid a. Oculomotor n. (III) Posterior communicating a. Trochlear n. (IV) Posterior cerebral a. Superior cerebellar a. Trigeminal n. (V) TEMPORAL LOBE Basilar a. Abducens n. (VI) Facial n. (VII) Internal auditory a. Anterior inferior cerebellar a. Vertebral a. Posterior inferior cerebellar a. Anterior spinal a. Posterior cerebral a. Vestibulocochlear n. (VIII) Glossopharyngeal n. (IX) Vagus n. (X) Hypoglossal n. (XII) Accessory n. (XI) Right lobe of cerebellum removed CEREBELLUM MEDULLA BRAINSTEM AND DIENCEPHALON Intermediate mass Thalamus Optic chiasma Hypothalamus Cerebral peduncle Thalamus Pineal body Diencephalon Superior colliculi Midbrain Inferior colliculi Pons Olive Medulla oblongata Diencephalon Midbrain Cerebral peduncle Pons Superior cerebellar peduncles Middle cerebellar peduncle of pons Diencephalon Fourth ventricle Inferior cerebellar peduncles of pons Pyramid Olive Medulla oblongata Brainstem Sample proofs ©A-27 Elsevier Australia Nervous system BASIC STRUCTURE OF THE NEURON Dendrite Golgi apparatus Endoplasmic reticulum Mitochondrion Cell body (soma) Nucleus Axon hillock Axon Schwann cell Myelin sheath Axon collateral Node of Ranvier Synaptic knobs Telodendria MYELINATED AXON Nucleus of Schwann cell Node of Ranvier Myelin sheath Plasma membrane of axon Neurilemma (sheath of Schwann cell) Neurofibrils, microfilaments, and microtubules Sample proofs A-28 © Elsevier Australia Respiratory system RESPIRATORY SYSTEM ORGANS OF THE RESPIRATORY SYSTEM Nasal cavity Nasopharynx Oropharynx Laryngopharynx Upper respiratory tract Pharynx Larynx Trachea Left and right primary bronchi Lower respiratory tract Alveolar duct Alveoli Bronchioles Bronchioles Capillary Alveolar sac NASAL PASSAGES AND THROAT Cranial cavity Cribriform plate of ethmoid bone Frontal sinus Nasal bone Superior nasal concha of ethmoid Middle nasal concha of ethmoid Vestibule Inferior concha Anterior naris Hard palate Lingual tonsil Hyoid bone Thyroid cartilage (part of larynx) Larynx Vocal cords (part of larynx) Trachea Sample proofs ©A-29 Elsevier Australia Sphenoid sinus Sella turcica Pharyngeal tonsil (adenoids) Posterior naris Opening of auditory (eustachian) tube Nasopharynx Soft palate Uvula Palatine tonsil Oropharynx Epiglottis (part of larynx) Laryngopharynx Oesophagus Respiratory system NASAL SEPTUM Frontal sinus Cribriform plate of ethmoid bone Nasal bone Perpendicular plate of ethmoid Sphenoid sinus Septal cartilage Pharyngeal tonsil Vomer Vomeronasal cartilage Incisive foramen Maxilla Palatine bone NASAL CAVITY Cribriform plate of ethmoid bone Sphenoid sinus Sella turcica Frontal sinus Posterior naris Superior turbinate Pharyngeal tonsil Middle turbinate Inferior turbinate Vestibule Anterior naris Hard palate Soft palate Uvula Opening of auditory (eustachian) tube BONES OF THE NASAL CAVITY Crista galli of ethmoid bone Olfactory foramina Frontal bone Cribriform plate of Sella turcica ethmoid bone of sphenoid bone Frontal sinus Nasal bone Sphenoid bone Perpendicular plate of ethmoid bone Sphenoid sinus Vomer Septal cartilage Greater alar cartilage Horizontal plate of palatine bone Anterior nasal spine Palatine process of maxilla Incisive canal Central incisor Sample proofs A-30 © Elsevier Australia Respiratory system LUNGS Trachea First rib Sternum (manubrium) Right superior lobe Left superior lobe Right primary bronchus Left primary bronchus Horizontal fissure Body of sternum Right middle lobe Oblique fissure Oblique fissure Seventh rib Right inferior lobe Left inferior lobe Sternum (xiphoid process) Right lung Left lung Apical segment Superior lobe Anterior segment II Inferior lobe Superior segment Posterior basal X segment Lateral basal segment Apicoposterior segment I I Posterior segment Anterior segment Superior lingular Superior segment lobe III II III IV Superior segment VI VI IV VII IX VIII Anterior basal segment V Middle lobe Inferior lingular segment Medial segment Lateral segment Medial basal (cardiac) segment V Medial basal (cardiac) segment Anterior basal segment Inferior lobe VII VIII IX X Posterior basal segment Lateral basal segment LARYNX AND UPPER TRACHEA Hyoid bone Superior thyroid notch Epiglottis Thyrohyoid ligament Thyroid cartilage Corniculate cartilage Arytenoid cartilage Cricothyroid ligament Cricoid cartilage Thyroid gland Parathyroid gland Trachea Membranous part of trachea Tracheal cartilage Sample proofs ©A-31 Elsevier Australia Respiratory system GAS-EXCHANGE STRUCTURES OF THE LUNG Surfactant-producing (type II) cell Basement membranes Fluid containing surfactant layer Red blood cell Macrophage Alveolus Capillary endothelium Fluid containing surfactant RBC Alveolar epithelium O2 O2 O2 Capillary CO2 Alveolar epithelium CO2 CO2 Interstitial space Basement membrane Basement membrane Capillary Alveolus Respiratory membrane LARYNX Epiglottis Tongue Epiglottis Vestibule Hyoid bone Vestibular fold (false vocal fold) Ventricle Vocal fold Vestibule Cuneiform cartilage Thyroid cartilage (Adam’s apple) Corniculate cartilage Vestibular fold (false vocal fold) Arytenoid muscle Vocal ligament Thyroarytenoid muscle Thyroid cartilage (Adam’s apple) Cricoid cartilage Cricothyroid muscle Lumen of trachea Cartilages of trachea Thyroid gland Rima glottidis Ventricle Vocal fold Vocalis muscle Infraglottic cavity Cricoid cartilage S S A P Tracheal cartilage I Sample proofs A-32 © Elsevier Australia L R I Digestive system DIGESTIVE SYSTEM ORGANS OF THE DIGESTIVE SYSTEM AND SOME ASSOCIATED STRUCTURES Parotid gland Submandibular gland Tongue Sublingual gland Pharynx Cystic duct Larynx Hepatic duct Trachea Spleen Liver Oesophagus Stomach Liver Diaphragm Stomach Transverse colon Gallbladder Spleen Hepatic flexure Duodenum Pancreas Splenic flexure Ascending colon Ileum Descending colon Caecum Sigmoid colon Vermiform appendix Anal canal Rectum Mesentery Blood vessels Nerve Myenteric plexus Intramural plexus Submucosal plexus Submucosa Gland in submucosa Duct from gland WALL OF THE GASTROINTESTINAL TRACT Mucosa Mucous epithelium Lamina propria Serosa Muscularis mucosae Connective tissue layer Muscularis Peritoneum Circular muscle layer Longitudinal muscle layer Sample proofs ©A-33 Elsevier Australia Lymph nodule Digestive system LOCATION OF THE SALIVARY GLANDS Parotid gland Parotid duct Sternocleidomastoid muscle Buccinator muscle Masseter muscle Tongue Frenulum of tongue Mandible (cut) Submandibular duct (Wharton's duct) Minor sublingual ducts Major sublingual ducts Sublingual gland Submandibular gland Mandible (cut) Mylohyoid muscle Left portion of mandible has been removed Digastric muscle SOURCES OF INTESTINAL SECRETIONS Bile from the bladder, pancreatic juice from the exocrine pancreas, and mucus secretion from Brunner's glands in the duodenal wall. Stomach Cystic duct Common hepatic duct Gallbladder neck Gallbladder Pancreas (tail) Common bile duct Pancreas (head) Villi Brunner's glands Ampulla Pancreatic duct Duodenum Sample proofs A-34 © Elsevier Australia Spleen Digestive system LARGE INTESTINE Enlarged detail of the large intestine, rectum, and anus shows the junction between the large and small intestines and the valve-like entry of the ileum into the caecum. Portal vein Inferior vena cava Aorta Transverse colon Splenic vein Superior mesenteric artery Splenic (left colic) flexure Taeniae coli Hepatic (right colic) flexure Inferior mesenteric artery and vein Ascending colon Descending colon Mesentery Ileocaecal valve Ileum Sigmoid artery and vein Caecum Vermiform appendix Haustra Rectum Superior rectal artery and vein External anal sphincter muscle Anus CAECUM AND TERMINAL ILEUM Ascending colon Ileum Ileocaecal fold flaps Caecum Appendix Sample proofs ©A-35 Elsevier Australia Sigmoid colon Reproductive system REPRODUCTIVE SYSTEM Suspensory ligament (of uterine tube) Ovarian ligament Body of uterus Fundus of uterus Round ligament Vesicouterine pouch Parietal peritoneum Sacral promontory Uterine tube Ureter Uterosacral ligament Rectouterine pouch LATERAL VIEW OF FEMALE (of Douglas) REPRODUCTIVE ORGANS AND Cervix Fornix of vagina ASSOCIATED STRUCTURES Coccyx Urinary bladder Pubic symphysis Urethra Clitoris Labium minus Anus Vagina Labium majus Location of pubic symphysis Foreskin (prepuce) EXTERNAL GENITALS OF THE FEMALE Labium minus External urinary meatus Hymen Orifice of vagina Vestibule Opening of greater vestibular gland Labium majus (without pubic hair) Urogenital triangle Perineal body Anal triangle Anus ANTERIOR VIEW OF PELVIC FEMALE ORGANS Mons pubis (without pubic hair) Clitoris (glans) Fundus of uterus Location of ischial tuberosity Location of coccyx Isthmus of uterine tube Ovarian ligament Ampulla of uterine tube Body of uterus Uterine body cavity Endometrium Myometrium Cervix of uterus Internal os of cervix Cervical canal Fornix of vagina External os of vaginal cervix Ovary Infundibulum of uterine tube Infundibulopelvic ligament Fimbriae Broad ligament Uterine artery and vein Vagina Sample proofs A-36 © Elsevier Australia Reproductive system FEMALE BREAST Clavicle Intercostal muscle Fascia of pectoral muscles Pectoralis major muscle Alveolus Ductule Duct Lactiferous duct Pectoralis major muscle Alveoli Areola Lactiferous sinus Nipple Nipple pores Adipose tissue Suspensory ligaments (of Cooper) LYMPHATIC SYSTEM AND THE FEMALE BREAST Supraclavicular nodes Interpectoral (Rotter) nodes Midaxillary nodes Lateral axillary (brachial) nodes Subclavicular nodes Subscapular nodes Internal mammary nodes Anterior axillary (pectoral) nodes Cross-mammary pathways to opposite breast Pathways to subdiaphragmatic nodes and liver Sample proofs ©A-37 Elsevier Australia Reproductive system MALE REPRODUCTIVE ORGANS AND ASSOCIATED STRUCTURES Ureter Seminal vesicle Urinary bladder Ejaculatory duct Pubic symphysis Prostate gland Ductus (vas) deferens Rectum Urethra Bulbourethral (Cowper’s) gland Penis Anus Epididymis Testis Foreskin (prepuce) Scrotum EXTERNAL GENITALS OF THE MALE Location of pubic symphysis Urogenital triangle Location of ischial tuberosity Anal triangle Anus Location of coccyx Sample proofs A-38 © Elsevier Australia Reproductive system Acrosome TUBULES OF THE TESTIS AND EPIDIDYMIS Nerves and blood vessels Epididymis in the spermatic cord Efferent ductules Seminiferous tubules Head Midpiece Testis Rete testis Ductus (vas) deferens Nucleus Centrioles Mitochondria Tail Tail Tunica Septum Lobule albuginea ANTERIOR VIEW OF MALE REPRODUCTIVE STRUCTURES Ureter Ampulla of vas (ductus) deferens Ductus (vas) deferens Seminal vesicle Urinary bladder Ejaculatory duct Prostate gland Inguinal canal Prostatic portion of urethra Cremaster muscle Internal spermatic fascia Ductus (vas) deferens Bulbourethral gland Spongy portion of urethra Testicular artery Venous plexus Genital nerve Ductus (vas) deferens Penis Cremaster muscle Head of epididymis Epididymis Body of epididymis Tunica vaginalis Testis Tail of epididymis Glans penis External urinary meatus Scrotum (skin) Dartos fascia and muscle Sample proofs ©A-39 Elsevier Australia Spermatic cord Urinary system URINARY SYSTEM URINARY SYSTEM AND SOME ASSOCIATED STRUCTURES Adrenal gland Spleen Renal artery Liver Renal vein Twelfth rib Left kidney Right kidney Abdominal aorta Ureter Inferior vena cava Urinary bladder Common iliac artery and vein Urethra Inferior vena cava Peritoneum Peritoneal cavity Renal fat pad Renal vein Renal artery Abdominal aorta Left kidney Muscle Spinous process of vertebra Sample proofs A-40 © Elsevier Australia Urinary system BLADDER Ureter Cut edge of peritoneum Smooth muscle (detrusor) Trigone Opening of ureter Opening of ureter Rugae Prostate gland Pelvic floor External urethral sphincter Internal urethral sphincter Prostatic urethra Bulbourethral gland INTERNAL STRUCTURE OF THE KIDNEY Interlobular arteries and veins Interlobar arteries and veins Lobar arteries and veins Segmental arteries and veins Renal artery Renal vein Ureter Lobar arteries and veins Renal pyramid Sample proofs ©A-41 Elsevier Australia Arcuate arteries and veins Urinary system NEPHRON Bowman’s capsule Glomerulus Distal convoluted tubule (DCT) Renal corpuscle Proximal convoluted tubule (PCT) Cortex Medulla Descending limb of Henle (DLH) Renal tubule Collecting duct (CD) Thick ascending limb of Henle (TAL) Henle (nephron) loop Thin ascending limb of Henle (tALH) Papilla of renal pyramid Sample proofs A-42 © Elsevier Australia Special senses SPECIAL SENSES GROSS ANATOMY OF THE EAR External ear (not to scale) Auricle (pinna) External acoustic meatus Middle ear Temporal bone Inner ear Tympanic membrane Semicircular canals Oval window Facial nerve Vestibular nerve Cochlear nerve Vestibulocochlear nerve (CN VIII) Cochlea Vestibule Round window Malleus Incus Stapes Auditory (eustachian) tube Auditory ossicles STRUCTURE OF THE SKIN Openings of sweat ducts Hair shaft Stratum corneum Stratum granulosum Epidermis Stratum spinosum Stratum germinativum Stratum basale Dermal papilla Dermis Meissner corpuscle Sebaceous (oil gland) Subcutaneous layer (hypodermis) Hair follicle Papilla of hair Sweat gland Cutaneous nerve Pacinian corpuscle Arrector pili muscle Sample proofs ©A-43 Elsevier Australia Special senses CROSS-SECTIONAL VIEW OF THE EYE Cornea (transparent) Visual (optic) axis Lens Anterior chamber (contains aqueous humor) Pupil Iris Lower (inferior) lid Lacrimal caruncle Fibrous layer Ciliary body Suspensory ligament Vascular layer Retina Choroid Sclera Inner layer Posterior chamber (contains vitreous humour) Optic disc Central artery and vein Optic nerve Fovea Macula centralis Sclera Choroid Scleral venous sinus (canal of Schlemm) Iris Posterior chamber Anterior chamber Cornea Retina Ciliary muscle Ciliary ring Ciliary processes Ciliary body Suspensory ligaments Lens Sample proofs A-44 © Elsevier Australia Kk k, abbreviation for kilo, 1000 or 103. K, 1. symbol for ionisation constant. 2. symbol for Kelvin scale. 3. symbol for the element potassium (kalium). 4. abbreviation for kilobyte. 5. symbol in electronics for 1024 (210). 6. abbreviation for katal. kA, abbreviation for kiloampere. -kacin, suffix for antibiotics derived from Streptomyces kanamyceticus. kainate kƯ‫މ‬nƗt, a non10'$ (NmethyldasSartate) receStor aJonist. 7he natural mineral is used as a fertiliser. kak-, combininJ form meaninJ µbad¶ kakidrosis, kakosmia. kakosmia. See cacosmia. kala-azar kl‫މ‬l‫ۑ‬āl]lr‫> މ‬+indi, kala, black $ssamese, azar, fever@, a disease caused by the Sroto]oon Leishmania donovani, transmitted to humans, Sarticularly to children, by the bite of the sandfly. .alaa]ar occurs Srimarily in $sia, Sarts of $frica, several South and &entral $merican coun tries, and the 0editerranean reJion. 7he liver and sSleen are the main sites of infection siJns and symStoms include anaemia, heSatomeJaly, sSlenomeJaly, irreJular fever and emaciation. 3atients Zith kalaa]ar are also susceStible to secondary bacterial infections. Untreated, the disease has an extremely hiJh mortality. 7reatment includes sodium antimony Jluconate, blood transfusions (for anaemia), bed rest and adeTuate nutrition. $lso called Assam fever, black fever, dumdum fever, ponos, visceral leishmaniasis. See also leishmaniasis. Kala-azar (Cohen et al, 2010) kalaemia k‫ۑ‬lƝ‫މ‬mƝā‫ۑ‬, the Sresence of Sotassium in the blood. kali-, combininJ form meaninJ µSotassium¶ kaligenous, kalinite, kalium. kaliopenia. See hypokalaemia. kalium (K) kƗ‫މ‬lƝā‫ۑ‬m >$r, al qaly, Sotash@, Sotassium. kaliuresis kal‫މ‬iyo଱ orƝ‫މ‬sis, increased excretion of Sotassium in the urine. kallikrein-kinin system kalik‫މ‬rƝāin, a SroSosed hormonal system that functions Zithin the kidney, Zith the en]yme kallikrein in the renal cortex mediatinJ Sroduction of bradykinin, Zhich acts as a vasodilator SeStide. .allikrein is Sresent in blood Slasma, urine and tissues in an inactive state. $lso sSelt kallikren-kinin system. Kallmann’s syndrome >)ran] -. .allmann, $merican Ssychiatrist, 1±1@, a condition characterised by the absence of the sense of smell. ,t is caused by aJenesis of the olfactory bulbs and secondary hySoJonadism related to a fall in luteinisinJ hormonereleasinJ hormone levels. kampo medicine kam‫މ‬Sǀ, traditional -aSanese medicine. 7he Sractice of kamSo medicine in -aSan is reJulated. kanamycin, an aminoJlycoside antibacterial substance derived from Streptomyces kanamyceticus. kanamycin sulfate, an aminoJlycoside antibiotic. Q INDICATIONS ,t is Srescribed in the treatment of certain severe JramneJative infections and those resistant to other antibiotics. Q CONTRAINDICATIONS &oncomitant administration of ototoxic druJs or knoZn hySersensitivity to this druJ or to other aminoJlycoside antibiotics Srohibits its use. ,t is used Zith caution in Satients havinJ imSaired renal function and in the elderly. Q ADVERSE EFFECTS $monJ the more serious are neShro toxicity, vestibular and auditory ototoxicity, neuromuscular blockade and hySersensitivity reactions. kangaroo care, a bioloJically sound aSSroach to restore the mother±infant bond folloZinJ the sudden seSaration durinJ the birth exSerience for term and esSecially Sreterm babies. ,t has tZo essential comSonents skintoskin contact and breastfeedinJ. $lso knoZn as kangaroo mother care (KMC). Kanner’s syndrome >/eo .anner, $ustrianborn $merican child Ssychiatrist, b. 14@. See autism disorder spectrum. kaodzera. See Rhodesian trypanosomiasis. kaolin kƗ‫ۑމ‬lin >&hin, kaoling, hiJh ridJe@, an adsorbent used internally to treat diarrhoea, often in combination with Sectin. .aolin in an ointment base is also used toSically as an absorbent and a Srotective emollient. kaolinosis kƗ‫ۑމ‬linǀ‫މ‬sis, a form of Sneumoconiosis acTuired by inhalinJ clay dust (kaolin). .aolin is used in the manu facture of SaSer, ceramics, heatresistant wood, soaSs, toothSaste, and some medicines. Kaposi’s sarcoma (KS, ks) >0orit] .. .aSosi@, a maliJnant, multifocal neoSlasm of vascular oriJin and reticuloendo thelial cells that beJins as soft, brownish or SurSle SaSules Sample proofs © Elsevier Australia 950 Kaposi’s sarcoma-associated herpesvirus karyomorphism 951 on the feet and slowly sSreads in the skin, metastasisinJ to the lymSh nodes and viscera. ,t is caused by a herSesvirus known as human herSesvirus (++9), occurs most often in men and is associated with diabetes, maliJnant lymShoma, acquired immunodeficiency syndrome or other disorders. 5adiotheraSy and chemotheraSy are usually recommended. $lso called idiopathic multiple pigmented haemorrhagic sarcoma, multiple idiopathic haemorrhagic sarcoma. Kaposi’s sarcoma (Swartz, 2010) Kaposi’s sarcoma-associated herpesvirus. See human herpesvirus 8. Kaposi’s varicelliform eruption. See eczema herpeticum. kappa kaS‫ۑމ‬, Ȁ, ț, the tenth letter of the *reek alShabet, used to denote (in chemistry) the tenth carbon atom in a chain one of two liJht chains in an immunoJlobulin molecule a tySe of killer Sarticle Sresent in certain strains of Paramecium and a visual axis anJle. See also lambda (Ȝ) light chain. kaps-. See caps. karakia, (1ew =ealand 0Ɨori) traditional ancient rite, charm or sSell, variations of which would be used on every imSortant occasion from JreetinJ the new day to farewellinJ voyaJers or beJinninJ a new SroMect or undertakinJ. Used in modern times to denote a Srayer, or worshiS. See mihi, wairua. karaya powder klr‫މ‬lyl >+indi, karayal, resin /, pulvis, dust], a dried form of Sterculia urens or other sSecies of Sterculia, used as a bulk cathartic. 7he use of such a bulk forminJ cathartic may also increase the loss of sodium, Sotassium and water. :ith some individuals the use of karaya Sowder may cause allerJic reactions such as urti caria, rhinitis, dermatitis and asthma. 0ethylcellulose has larJely reSlaced this druJ in modern use. (xternally it is used as a dryinJ aJent for staJe , and staJe ,, Sressure ulcers. Kardex, trademark for a cardfilinJ system that allows quick reference to the Sarticular needs of each Satient for certain asSects of nursinJ care. ,ncluded on the card may be a schedule of medications, level of activity allowed, ability to Serform basic selfcare, diet, any sSecial Sroblems, a schedule of treatments and Srocedures, and a care Slan. 7he .ardex is uSdated as necessary and is usually keSt at the nurses¶ station. ,t is now larJely reSlaced by comSuterised systems. karyenchyma. See karyolymph. karyo-, caryo-, combininJ form meaninJ µnucleus¶ karyochrome, karyokinesis, karyolymph. karyoclasis kar‫މ‬Ɲāok‫މ‬l‫ۑ‬sis >*k, karyon + klasis, breakinJ], 1. the disinteJration of a cell nucleus or nuclear membrane. 2. the interruStion of mitosis. $lso sSelt karyoklasis. —karyoclastic, adj. karyocyte a normoblast, or develoSinJ red blood cell with a nucleus condensed into a homoJeneous staininJ body. ,t is normally found in the red bone marrow. $lso sSelt caryocyte. karyogamy kar‫މ‬ƝāoJ‫ۑމ‬mƝ >*k, karyon, nut + gamos, marriaJe], the fusion of cell nuclei, as in conMuJation and ]yJosis. —karyogamic, adj. karyogenesis kar‫މ‬ƝāǀMen‫ۑމ‬sis >*k, karyon + genein, to Sroduce], the formation and develoSment of the nucleus of a cell. —karyogenetic, adj. karyokinesis kar‫މ‬ƝāǀkinƝ‫މ‬sis >*k, karyon + kinƝsis, motion], the division of the nucleus and equal distribution of nuclear material durinJ mitosis and meiosis. 7he Srocess involves the four staJes of SroShase, metaShase, anaShase, and telo Shase it Srecedes the division of the cytoSlasm. $lso called karyomitosis. See also cytokinesis. —karyokinetic, adj. karyoklasis, karyoklastic. See karyoclasis. karyology kar‫މ‬Ɲāol‫ۑމ‬MƝ >*k, karyon + logos, science], the branch of cytoloJy that concentrates on the study of the cell nucleus, esSecially the structure and function of the chromo somes. —karyological, adj., karyologist, n. karyolymph kar‫މ‬Ɲā‫ۑ‬limf‫*> މ‬k, karyon + /, lympha, water], the clear, usually nonstaininJ, fluid substance of a cell nucleus. ,t consists Srimarily of Sroteinaceous colloidal material in which the nucleolus, chromatin, linin and various submicroscoSic Sarticles are disSersed. $lso called karyenchyma, nuclear hyaloplasm, nuclear sap, nucleochyme. —karyolymphatic, adj. karyolysis kar‫މ‬Ɲāol‫މ‬isis >*k, karyon + lysis, looseninJ], the dissolution of a cell nucleus. ,t occurs durinJ the Jeneration of new cells throuJh mitosis and meiosis, but also in Satho loJical conditions, cell inMury, and necrosis. Dissolution of nuclear structure Rupture of cell membrane Karyolysis (Huether and McCance, 2008) karyolytic kar‫މ‬Ɲā‫ۑ‬lit‫މ‬ik, 1. SertaininJ to karyolysis. 2. some thinJ that causes the destruction of a cell nucleus. karyomegaly kar‫މ‬ƝāǀmeJ‫ۑމ‬lƝ >*k, karyon, nut + megas, larJe], an increase in the nuclear si]e of tissue cells. karyomere kar‫މ‬Ɲā‫ۑ‬mir‫*> މ‬k, karyon + meros, Sart], 1. a saclike structure containinJ an unequal Sortion of the nuclear material after atySical mitosis. 2. a seJment of a chromosome. See also chromomere. karyometry kar‫މ‬Ɲāom‫ۑމ‬trƝ, the measurement of the nucleus of a cell. —karyometrical, adj. karyomit kar‫މ‬Ɲā‫ۑ‬mit‫*> މ‬k, karyon + mitos, thread], 1. a sinJle chromatin fibril of the network within the nucleus of a cell. 2. a chromosome. karyomitome kar‫މ‬Ɲāom‫މ‬itǀm >*k, karyon + mitos, thread], the fibrillar chromatin network within the nucleus of a cell. $lso called karyoreticulum. karyomitosis. See karyokinesis. karyomorphism m{r‫މ‬fi]‫ۑ‬m >*k, karyon + morphƝ form], Sample proofs © Elsevier Australia K karyon katadidymus 952 karyotin. See chromatin. karyotype kar‫މ‬Ɲā‫ۑ‬tƯS‫*> މ‬k, karyon + typos, mark], 1. the number, form, si]e and arranJement within the nucleus of the somatic chromosomes of an individual or sSecies, as determined by a microShotoJraSh taken durinJ metaShase of mitosis. 2. a diaJrammatic reSresentation of the chromo some comSlement of an individual or sSecies, in which the chromosomes are arranJed in Sairs in descendinJ order of si]e and accordinJ to the Sosition of the centromere. See also chromosome, Denver classification. —karyotypical, adj. Kasabach Merritt syndrome. See haemangioma± thrombocytopenia syndrome. Kasabach method kas‫ۑމ‬bak, (in radioloJy) a technique for SositioninJ a Satient for radioJraShic examination of the odontoid Srocess. ,t involves an $3 oblique SroMection with the central ray anJled 10±1 deJrees caudad at a central Soint midway between the outer canthus of the eye and the external auditory meatus. Kasai operation. See portoenterostomy. Kashin-Bek disease >1ikolai ,. .ashin, 5ussian orthoSae dist, 12±12 (.9. %ek /, dis + )r, aise, ease], a form of osteoarthrosis afflictinJ mainly children livinJ in &hina, Korea, and eastern Siberia. It is believed to be caused by eatinJ foods made with wheat contaminated by a funJus, Fusarium sporotrichiella. $lso sSelt Kaschin-Beck disease. $lso called osteoarthritis deformans endemica. kat, abbreviation for katal. katadidymus kat‫ۑމ‬did‫ۑމ‬m‫ۑ‬s >*k, kata, down + didymos, twin], conMoined twins united in the lower Sortion of the body and seSarated at the toS. the shaSe or form of a cell nucleus, esSecially that of a leuco cyte. —karyomorphic, adj. karyon kar‫މ‬Ɲāon >*k, nut], the nucleus of a cell. —karyontic, adj. karyophage kar‫މ‬ƝāǀfƗM‫*> މ‬k, karyon + phagein, to eat], an intracellular Sroto]oan Sarasite that destroys the nucleus of the cell it infects. —karyophagic, karyophagous, adj. karyoplasm. See nucleoplasm. karyoplasmic ratio. See nucleocytoplasmic ratio. karyopyknosis Siknǀ‫މ‬sis >*k, karyon + pyknos, thick], the state of a cell in which the nucleus has shrunk and the chro matin has condensed into solid masses, as in cornified cells of stratified squamous eSithelium. —karyopyknotic, adj. karyoreticulum. See karyomitome. karyorrhexis rek‫މ‬sis >*k, karyon + rhƝ[is, ruSture], the fraJmentation of chromatin and distribution of it throuJhout the cytoSlasm as a result of nuclear disinteJration. —karyorrhectic, adj. karyosome kar‫މ‬Ɲā‫ۑ‬sǀm‫*> މ‬k, karyon + sǀma body], a dense, irreJular mass of chromatin filaments in a cell nucleus. ,t is often seen durinJ interShase and may be confused with the nucleolus because of similar staininJ SroSerties. $lso called chromatin nucleolus, chromocentre, false nucleolus, prochromosome. karyospherical sfer‫މ‬ik >*k, karyon + sphaira, ball], 1. a sSheric nucleus. 2. SertaininJ to such a nucleus. karyostasis kar‫މ‬Ɲāos‫މ‬t‫ۑ‬sis >*k, karyon + stasis, standinJ], the restinJ staJe of the nucleus between cell division. See also interphase. —karyostatic, adj. karyotheca. See nuclear envelope. 2 1 3 6 7 8 13 14 15 19 20 4 9 10 16 5 11 12 17 18 21 22 Sex chromosomes Normal male karyotype (Martin, Fanaroff and Walsh, 2011) Sample proofs © Elsevier Australia katal (K, kat) 953 katal (K, kat) kat‫މ‬al >*k, kata, down], an en]yme unit in moles Ser second defined by the SI system 1 K . î 10 U. It is used to exSress catalytic activity, which is a SroSerty of the catalyst. katipo spider, Latrodectus katipo, a sSecies of sSider native to 1ew =ealand from the /atrodectus family of sSiders. It is found amonJ the Jrasses and driftwood lininJ sandy beaches, and is the most venomous creature in 1ew =ealand. It is closely related to the $ustralian redback sSider. (nven omation may result in latrodectism, and is treated with redback sSider antivenom. See also latrodectism, redback spider, redback spider antivenom. kat-, kata-, cat-, cata-, Srefix meaninJ µto Jo down, to Jo aJainst, or to reverse¶ katadidymus, katakinetomeric, katolysis. kaumātua, (1ew =ealand 0Ɨori) an elder, elderly, old man. 7he holder of wisdom, a suSSortive role and a symbolic one. KaumƗtua will often accomSany the family into healthcare settinJs and may sSeak for the family on imSortant matters. 0ay be referred to as µuncle¶. &omSare kuia. Kaunihera o Nga Nēhi Māori o Aotearoa (National Council of Māori Nurses), established in 13, the only mandated body by Iwi (0Ɨori tribe or social JrouS) to reSresent 0Ɨori on health issues. :orkforce develoSment is one of the core issues for the &ouncil. kava kava >3olynesian, bitter], a ceremonial, nonalcoholic beveraJe SreSared from the root of Piper methysticum. It is cultivated throuJhout the South 3acific and the name refers to the Slant, the beveraJe SreSared from the Slant, and the ceremony associated with drinkinJ the beveraJe. 7his Ssychoactive substance has been used socially, cere monially and medicinally for thousands of years by many Pacific island societies. It has more recently found favour as a dietary suSSlement, due to its Srofound diuretic SroSerties. InJestion has varyinJ effects, ranJinJ from a numbinJ of the tonJue to mild euShoria. &hronic inJestion has been asso ciated with anorexia, bloodshot eyes, letharJy, restlessness, stomach Sains and scalinJ of the skin. It enhances the effects of alcohol and other &1S deSressants. $lso called kava. Kawasaki disease. See mucocutaneous lymph node syndrome. Kayser-Fleischer ring kƯ‫ ۑ]މ‬flƯ‫މ‬sh‫> ۑ‬%ernhard Kayser, *erman oShthalmoloJist, 1±14 %runo )leischer, *erman oShthalmoloJist, 14±104], a JreyJreen to redJold SiJmented rinJ at the outer marJin of the cornea, SathoJno monic of heSatolenticular deJeneration, a rare SroJressive disease caused by a defect in coSSer metabolism and transmit ted as an autosomalrecessive trait. 7he disease is characterised by cerebral deJenerative chanJes, liver cirrhosis, sSlenomeJ aly, involuntary movements, muscle riJidity, SsycholoJical disturbances and dysShaJia. See also Wilson’s disease. Kayser-Fleischer ring (Zitelli et al, 2012) keloid acne Kazanjian’s operation kasan‫މ‬MƝā‫ۑ‬n] >9ara]tad -. Ka]an Mian, $rmenianborn maxillofacial surJeon in United States, 1±14], a surJical Srocedure for extendinJ the vestibu lar sulcus to imSrove the Srosthetic foundation of toothless dental ridJes. kb, 1. abbreviation for kilobase. 2. abbreviation for kilobit. kbe, abbreviation for keyboard entry. kbp, abbreviation for kilobase pair. kbs, abbreviation for kilobits per second. $lso kbps. kcal, abbreviation for kilocalorie. K cell. See null cell. kCi, abbreviation for kilocurie. KDOQI, abbreviation for kidney disease outcome quality initiative. KE, abbreviation for kinetic energy. Kearns-Sayre syndrome kern]āsƗr >7homas P. Kearns, $merican oShthalmoloJist, b. 122 *eorJe P. Sayre, $merican SatholoJist, b. 111], SroJressive oShthalmo SleJia, SiJmentary deJeneration of the retina, myoSathy, ataxia, and cardiac conduction defect onset is before aJe 20. $lmost all Satients have larJe mitochondrial '1$ deletions, and raJJed red fibres are seen on muscle bioSsy. $lso called ophthalmoplegia plus. Kedani fever. See scrub typhus. keel, (in Srosthetics) a device in a storedenerJy foot Sros thesis that bends the foot uSwards when weiJht is aSSlied to the toe. See also carina, Seattle Foot, stored-energy foot. kefir kef‫> ۑމ‬5uss, fermented milk], a sliJhtly effervescent, acidulous beveraJe SreSared from the milk of cows, sheeS or Joats throuJh fermentation by kefir Jrains contains yeasts and lactobacilli. It oriJinated in the &aucasus 0ountains and is a source of menaquinones, Srobably derived from the bacterial fermentation. %acterial fermentation in the *I tract synthesises vitamin K2. $lso sSelt kephir. See vitamin K2. Kegel exercises. See pubococcygeus exercises. Keith-Wagener-Barker classification system >1orman 0. Keith, &anadian Shysician, b. 1 +enry P. :aJener, $merican Shysician, b. 10 1.:. %arker, 20thcentury $merican Shysician], a method of classifyinJ the deJree of hySertension in a Satient on the basis of retinal chanJes. 7he staJes are JrouS 1, identified by constriction of the retinal arterioles JrouS 2, constriction and sclerosis of the retinal arterioles JrouS 3, characterised by haemor rhaJes and exudates in addition to JrouS 2 conditions and JrouS 4, SaSilloedema of the retinal arterioles. kel-, combininJ form meaninJ µtumour or fibrous Jrowth¶ kelectome, keloid, keloplasty. Kelly clamp >+oward $. Kelly, $merican JynaecoloJist, 1±143 $S, clam, to fasten], a curved haemostat without teeth, used mainly in JynaecoloJical Srocedures for JrasSinJ vascular tissue. Kelly’s pad, a horseshoeshaSed inflatable rubber drainaJe Sad used in a bed or on the oSeratinJ table. keloid kƝ‫މ‬loid >*k, kƝlis, sSot + eidos, form], an overJrowth of collaJenous scar tissue at the site of a skin inMury, Sarticu larly a wound or a surJical incision. 7he new tissue sSreads outside the confines of the oriJinal wound, may not diminish in si]e without intervention and may recur. 7he tissue is elevated, rounded, and firm. %lackskinned individuals are Sarticularly susceStible to keloid formation. 7ySes of theraSy include cryotheraSy, intralesional corticosteroid inMections, radiation, silicone Jel, and surJery. 7reatment may worsen the condition and should be Serformed only by skilled Srofessionals. $lso sSelt cheloid. —keloidal, adj. keloid acne >*k, kƝlis, sSot + eidos, form + akmƝ, Soint], keloid scarrinJ arisinJ from inflammatory acne lesions. &omSare folliculitis keloidalis nuchae. Sample proofs © Elsevier Australia K keloidal 954 Keloids (Zitelli et al, 2012) keloidal. See keloid. keloidal scar. See keloid scar. keloidosis kƝ‫މ‬loidǀ‫މ‬sis >*k, kƝlis + eidos, form + osis, condition], habitual or multiSle formation of keloids. $lso sSelt cheloidosis. keloid scar >*k, kƝlis, sSot + eidos, form eschara, scab], an overJrowth of tissue in a scar at the site of skin inMury, Sarticularly a wound or a surJical incision. 7he amount of tissue Jrowth is in excess of that necessary to reSair the wound and is Sartially caused by an accumulation of collaJen at the site. $lso called keloidal scar. kelp, the marine brown alJae fronds of Laminaria digitata, L. japonica, Macrocystis pyrifera. Q INDICATIONS &laimed uses are for the treatment of obesity and underactive thyroid states, hySertension, antitumour, anticoaJulant, abortifacient and antirheumatic states. 1o evidence exists for the use of kelS other than for thyroid function. Q CONTRAINDICATIONS Use cautiously in SreJnant women. $s kelS contains siJnificant amounts of iodine, it should be used with caution in SeoSle with thyroid disorders. Q ADVERSE EFFECTS $bnormal erythroSoiesis, acneform eruStions, autoimmune thrombocytoSenia and bleedinJ. KelS may be contaminated with arsenic. In healthy volun teers hiJh doses of kelS reduce 73 levels and elevate 7S+ levels and 75+ resSonse after 4 weeks. Kelvin scale (K) >/ord Kelvin (:illiam 7homson), %ritish Shysicist, 124±10], an absolute temSerature scale calcu lated in &elsius units from the Soint at which molecular activity aSSarently ceases, ±23.1&. 7o convert &elsius deJrees to Kelvin, add 23.1. Kennedy classification >(dward Kennedy, $merican dentist, b. 13], a method of classifyinJ Sartial edentulous conditions and Sartial dentures, based on the Sosition of the sSaces once occuSied by the missinJ teeth in relation to the remaininJ teeth. Kenny treatment. See Sister Kenny’s treatment. keno-, combininJ form meaninJ µemSty¶ kenophobia, kenoto[in, kenotron. kenogenesis. See caenogenesis. kenophobia kƝ‫މ‬nǀfǀ‫މ‬bƝā‫*> ۑ‬k, kenos, emSty + phobos, fear], the morbid fear of larJe and oSen sSaces aJoraShobia. $lso sSelt cenophobia. Kent bundle >$lbert ).S. Kent, (nJlish ShysioloJist, 13±1 $S, byndel, to bind], an accessory Sathway between an atrium and a ventricle outside the conduction keratoacanthoma system. 7his conJenital anomaly causes :olffParkinson :hite syndrome. 7he term µaccessory Sathway¶ is Sreferred because the one Kent described had a Srecise location (anterior and near the fibrous rinJ of the tricusSid valve). Kenya fever. See Marseilles fever. kephal-. See cephalo. kephir. See kefir. kera-, combininJ form meaninJ µhorn¶ keraphyllocele, keratosis, keratin. kerasin ker‫ۑމ‬sin >*k, kƝros, wax], a cerebroside, found in brain tissue, that consists of a fatty acid, Jalactose and sShinJosine. keratectomy ker‫ۑމ‬tek‫މ‬t‫ۑ‬mƝ >*k, keras, horn + ektomƝ, excision], surJical removal of a Sart of the cornea Serformed to excise a small, suSerficial lesion that does not warrant a corneal Jraft. /ocal anaesthesia is used. 7he scar is excised, and an antibiotic is inMected under the conMunctiva. $ toSical steroid is Jiven and a liJht Sressure dressinJ aSSlied. $fter surJery, the dressinJs are chanJed daily. &orneal eSithelium Jrows raSidly, fillinJ a small surJical area in about 0 hours. keratic k‫ۑ‬rat‫މ‬ik >*k, keras, horn + /, icus, like], 1. Sertain inJ to keratin. 2. SertaininJ to the cornea. keratic precipitate, a JrouS of inflammatory cells deSos ited on the endothelial surface of the cornea after trauma or inflammation, sometimes obscurinJ vision. keratin ker‫ۑމ‬tin >*k, keras, horn], a fibrous sulfurcontaininJ Srotein that is the Srimary comSonent of the eSidermis, hair, nails, enamel of the teeth, and horny tissue of animals. 7he Srotein is insoluble in most solvents, includinJ Jastric Muice. )or this reason, it is often used as a coatinJ for Sills that must Sass throuJh the stomach unchanJed to be dissolved in the intestines. keratin cyst, an eSithelial cyst containinJ keratin. keratinisation Ư]Ɨ‫މ‬sh‫ۑ‬n >*k, keras + izein, to cause], a Srocess by which eSithelial cells lose their moisture and are reSlaced by horny tissue. keratinise ker‫ۑމ‬tinƯ], to make or become horny tissue. keratinocyte kerat‫މ‬inǀsƯt‫*> މ‬k, keras + kytos, cell], an eSidermal cell that synthesises keratin and other Sroteins and sterols. 7hese cells constitute of the eSidermis, beinJ formed from undifferentiated, or basal, cells at the dermal±eSidermal Munction. In its various successive staJes, keratin forms the squamouscell or Sricklecell layer and the Jranularcell layer, in which the cells become flattened and slowly die to form the horny layer, the stratum corneum, which Jradually exfoliates. keratinophilic kerat‫މ‬inǀfil‫މ‬ik, describinJ a tySe of funJus that uses keratin as a substrate. keratitis ker‫ۑމ‬tƯ‫މ‬tis, any inflammation of the cornea. Kinds of keratitis include dendritic keratitis, interstitial keratitis, keratoconjunctivitis sicca and trachoma. &omSare keratopathy. —keratic, adj. kerat-, kerato-, 1. combininJ form meaninJ µhorny, corni fied¶ keratolysis, keratoma, keratonosis. 2. combininJ form meaninJ µcornea, corneal¶ keratoiritis, keratoleukoma, keratome. keratoacanthoma ker‫ۑމ‬tǀāak‫މ‬anthǀ‫މ‬m‫*> ۑ‬k, keras + akantha, thorn + oma, tumour], a raSidly JrowinJ, flesh coloured SaSule or nodule of the skin with a central SluJ of keratin. 7he lesion is most common on the face or the back of the hands and arms. It Jrows raSidly, then may disaSSear sSontaneously in 4 to months, leavinJ a sliJhtly deSressed scar. (xcision is necessary as it can be difficult to differentiate from squamous carcinoma. )erJusonSmith and *rw]ybowski syndromes are rare diseases characterised by multiSle eruStive keratoacanthomas. Sample proofs © Elsevier Australia keratocele keratolysis exfoliativa 955 Keratoacanthoma (Courtesy Department of Dermatology, School of Medicine, University of Utah) keratocele ker‫ۑމ‬tǀsƝl‫މ‬, a hernia of 'escemet¶s membrane throuJh an ulcer in the outer layers of the cornea. keratoconjunctivitis ker‫ۑމ‬tǀk‫ۑ‬nMunJk‫މ‬tivƯ‫މ‬tis >*k, keras + /, conjunctivus, connectinJ + *k, itis, inflammation], inflammation of the cornea and the conMunctiva. Kinds of keratoconMunctivitis include eczematous conjunctivitis, epidemic keratoconjunctivitis and keratoconjunctivitis sicca. keratoconjunctivitis sicca, dryness of the cornea caused by a deficiency of tear secretion in which the corneal surface aSSears dull and rouJh and the eye feels Jritty and irritated. 7he condition may be associated with erythema multiforme, SM|Jren¶s syndrome, trachoma, and vitamin $ deficiency. $rtificial tears, Jel and ointment may Jive some relief. In severe cases Sunctal occlusion, toSical corticosteroids and cyclosSorin may be used. keratoconus ker‫ۑމ‬tǀkǀ‫މ‬n‫ۑ‬s >*k, keras + kǀnos, cone], a noninflammatory Srotrusion of the central Sart of the cornea. It is more common in females and may cause marked astiJmatism contact lenses usually restore visual acuity. ProJression can be slowed by use of riboflavin droSs with ultraviolet liJht which induces crosslinkinJ of stromal collaJen. Severe forms may require corneal JraftinJ. 7he cause of the condition is unknown. keratocyst ker‫ۑމ‬tǀsist‫މ‬, a thinwalled, toothforminJ cyst lined by keratinisinJ eSithelium. It may be solitary or Sart of a multiSle lesion, most frequently in the Sosterior body or ramus of the mandible, and may or may not be associated with teeth. keratocyte. See corneal corpuscle. keratoderma ker‫ۑމ‬ātǀādur‫މ‬m‫*> ۑ‬k, keras, horn + derma, skin], 1. a horny skin or coverinJ. 2. hySertroShy of the horny layer of the skin the term is most often aSSlied to thickened skin of Salms and soles. See also callus, hyperkeratosis. keratoderma blennorrhagica dur‫މ‬m‫ۑ‬, the develoSment of hySerkeratotic skin lesions of the Salms, soles, and nails. 7he condition occurs in some Satients with 5eiter¶s syndrome. keratoectasia ker‫ۑމ‬tǀāektƗ‫]މ‬ha, a forward bulJinJ or Srotru sion of the cornea. $lso called kerectasis. keratoepithelioplasty, a surJical Srocedure for the reSair of corneal eSithelial defects. 7he defective cornea is removed and reSlaced with small Sieces of donor cornea, which Sroliferate and reSlace the oriJinal tissue. keratogenesis Men‫ۑމ‬sis, the formation of horny tissue caused by the Jrowth of keratinSroducinJ cells. Keratoderma blennorrhagica (Callen, 2000) keratogenic Men‫މ‬ik, SertaininJ to an aJent that induces a Jrowth of horny tissue. keratogenous ker‫ۑމ‬toM‫ۑމ‬n‫ۑ‬s, SertaininJ to develoSment of the horny layer of the skin or its Jrowth. keratoglobus Jlǀ‫މ‬b‫ۑ‬s, a conJenital anomaly characterised by distension of the eyeball or the anterior seJment of the eye. $lso called megalocornea. keratohyalin hƯ‫ۑމ‬lin >*k, keras + hyalos, Jlass], a substance in the Jranules found in keratinocytes of the eSidermis. 7he keratohyalin Jranule develoSs within and around the fibrillar Srotein, contributinJ in an unknown manner to the functional maturity of keratin. keratoiritis ker‫ۑމ‬tǀāƯrƯ‫މ‬tis, an inflammation of the cornea in association with iritis. keratolysis ker‫ۑމ‬tol‫ۑމ‬sis >*k, keras + lysis, looseninJ], the looseninJ and sheddinJ of the outer layer of the skin, which may occur normally by exfoliation or as a rare conJenital condition in which the skin is shed at Seriodic intervals. —keratolytic, adj. K Keratolysis (Lawrence and Cox, 2002) keratolysis exfoliativa, uninflamed condition affectinJ Salms and soles characterised by localised SeelinJ. $lso called exfoliative keratolysis, focal palmar peeling. Sample proofs © Elsevier Australia keratolytic Kessler 10 956 keratolytic, an aJent or druJ that Sromotes the softeninJ and SeelinJ or removinJ of the horny (keratin) layer of skin used to treat skin disorders such as corns, callouses, warts, dandruff, and chronic, scaly lesions, esSecially in Ssoriasis. keratoma ker‫ۑމ‬tǀ‫މ‬m‫ۑ‬, a hard, thick eSidermal Jrowth caused by hySertroShy of the horny layer of the skin. See also callus. keratomalacia m‫ۑ‬lƗ‫މ‬sh‫*> ۑ‬k, keras + malakia, softness], a condition characterised by xerosis and ulceration of the cornea, resultinJ from severe vitamin $ deficiency. It commonly occurs as a secondary result of diseases that affect vitamin $ absorStion or storaJe, such as ulcerative colitis, coeliac syndrome, cystic fibrosis or sSrue. $lso at risk are infants and children who are Jiven dilute formula, who are malnourished, or who are allerJic to whole milk and fed skimmed milk, which is a Soor source of vitamin $. (arly symStoms include niJht blindness ShotoShobia swellinJ and redness of the eyelids and dryinJ, rouJhness, Sain and wrinklinJ of the conMunctiva. In advanced deficiency %itot¶s sSots aSSear the cornea becomes dull, lacklustre and ha]y, and without adequate theraSy it eventually softens and Serforates, resultinJ in blindness. 7reatment consists of vitamin $ suSSlements determined by the severity of the condition, althouJh SrolonJed daily administration of larJe doses, esSecially to infants, may result in hyServitaminosis. $n adequate diet containinJ whole milk and foods hiJh in vitamin $ or carotenes Srevents the condition. See also vitamin A. keratometer, an instrument for measurinJ the curves of the cornea. keratomycosis mƯkǀ‫މ‬sis, a funJal disease of the cornea. keratopathy ker‫ۑމ‬toS‫ۑމ‬thƝ >*k, keras + pathos, disease], any noninflammatory disease of the cornea. &omSare keratitis. keratophakia fƗ‫މ‬kƝā‫ۑ‬, the surJical imSlantation of donor cornea to the anterior cornea to modify a refractive error. keratoplasty. See corneal transplantation. keratosis ker‫ۑމ‬tǀ‫މ‬sis >*k, keras + osis, condition], a scaly skin lesion in which there is overJrowth of the cornified eSithelium. Kinds of keratosis include actinic keratosis, keratosis senilis, and seborrhoeic keratosis. —keratotic, adj. keratosis follicularis. See Darier’s disease. Keratosis follicularis (Hordinsky, Sawaya and Scher, 2000) keratosis pilaris, a common skin condition in which there are multiSle tiny follicular scaly SaSules on the uSSer arms and thiJhs, sometimes also on cheeks and elsewhere. :hen there is Serifollicular erythema, it is called keratosis rubra pilaris. 7reatment includes emollients and toSical retinoids. See also ulerythema ophryogenes. keratosis seborrhoeica. See seborrhoeic keratosis. kerauno-, combininJ form meaninJ µliJhtninJ¶ keraunoneurosis, keraunophobia. kerectasis. See keratoectasia. kerion kir‫މ‬Ɲāon >*k, honeycomb], an inflamed, boJJy Jran uloma that develoSs as an immune reaction to a suSerficial funJus infection, Jenerally in association with Tinea capitis of the scalS. 7he lesion heals within a short time without treatment. Systemic treatment with Jriseofulvin, itracona ]ole or terbinafine may be required and Sermanent aloSecia of the affected reJion may result. Prednisone can also be used to lessen local inflammation. Kerion (Cordoro and Ganz, 2005) Kerley lines kur‫މ‬lƝ >Peter -. Kerley, Irish radioloJist, 100±1], lines resemblinJ interstitial infiltrate that aSSear on chest xray imaJes and that are associated with certain disease conditions, such as conJestive heart failure and Sleural lymShatic enJorJement. 7hey are several centi metres lonJ and may be oriented in many directions. $lso called everywhere lines. KERMA, abbreviation for kinetic energy released in the medium, a quantity that describes the transfer of enerJy from a Shoton to a medium as the ratio of enerJy transferred Ser unit mass at each Soint of interaction. Used in radiation oncoloJy. kernicterus k‫ۑ‬rnik‫މ‬t‫ۑ‬r‫ۑ‬s >*er, kern, kernel *k, ikteros, Maundice], an abnormal toxic accumulation of bilirubin in central nervous system tissues caused by hySerbilirubinae mia. See also hyperbilirubinaemia of the newborn. Kernig’s sign ker‫މ‬niks >9ladimir 0. KerniJ, 5ussian Shysi cian, 140±11], a diaJnostic siJn for meninJitis, marked by a loss of the ability of a suSine Satient to comSletely straiJhten the leJ when it is fully flexed at the knee and hiS. Pain in the lower back and resistance to straiJhteninJ the leJ constitute a Sositive KerniJ¶s siJn. Usually the Satient can extend the leJ comSletely when the thiJh is not flexed on the abdomen. kerosene poisoning ker‫ۑމ‬sƝn >*k, kƝros, wax /, potio, drink], a toxic condition caused by the inJestion or inhalation of the aliShatic hydrocarbon mixture kerosene. SymStoms after inJestion include drowsiness, fever, tachycardia, tremors, and severe Sneumonitis if the fluid is asSirated. 9omitinJ is not to be induced. See hydrocarbon toxicity. See also petroleum distillate poisoning. Kessler 10 >5onald &. Kessler, $merican socioloJist, 14±], a screeninJ tool desiJned to detect distress that can indicate hiJh Srevalence mental disorders. 7he K10 has 10 items, can Sample proofs © Elsevier Australia ketamine 957 Assessing for Kernig’s sign (Marshall and Ruedy, 2011) be comSleted by the individual client, and is widely used as a routine mental health outcome measure. ketamine kƝ‫މ‬t‫ۑ‬mƝn, a Sotent nonbarbiturate Jeneral anaesthetic aJent that antaJonises 1methyl'asSartate (10'$) receStors also interacts with muscarinic receStors, descendinJ monoaminerJic Sain Sathways, voltaJesensitive calcium channels and oSioid receStors in the brain and sSinal cord. It does not cause muscle relaxation. Q INDICATIONS Induction and maintenance of anaesthesia, suSSlement to lowSotency aJents such as nitrous oxide. It is also used as an analJesic in Sainful Srocedures. Q CONTRAINDICATION $llerJy to ketamine. Q ADVERSE EFFECTS &ommon effects include hySertension, increased Sulse rate, increased muscle tone, lacrimation, hySersalivation, raised intraocular and intracranial Sres sures, emerJency reactions. +allucinations, confusion and disorientation may occur on emerJence from anaesthesia. See also dissociative anaesthesia. keto- kƝ‫މ‬tǀ, combininJ form indicatinJ Sossession of the carbonyl (&2) JrouS ketoheptose, ketolysis, ketonuria. ketoacidosis as‫މ‬idǀ‫މ‬sis >*er, keton, form of acetone /, acidus, sour, osis, condition], acidosis accomSanied by an accumulation of ketones in the body, resultinJ from extensive breakdown of fats because of faulty carbohy drate metabolism. It occurs Srimarily as a comSlication of diabetes mellitus and is characterised by a fruity odour of acetone on the breath, mental confusion, dysSnoea, nausea, vomitinJ, dehydration, weiJht loss and, if untreated, ketone coma. (merJency treatment includes the administration of insulin and I9 fluids and the evaluation and correction of electrolyte imbalance. 1asoJastric intubation and bladder catheterisation may be required if the Satient is comatose. %efore discharJe of the Satient from the hosSital, the nurse carefully reviews the diet, activity, blood Jlucose and urine ketone monitorinJ and insulin schedule Srescribed, emShasisinJ to the Satient that ketoacidosis may be life threateninJ and is larJely avoidable by strict adherence to the Satient¶s diabetes schedule, monitorinJ, and aSSroSriate action for illness or stress. See also diabetes mellitus, ketosis. —ketoacidotic, adj. ketoaciduria as‫މ‬ido଱ or‫މ‬Ɲā‫*> ۑ‬er, keton + /, acidus, sour *k, ouron, urine], Sresence in the urine of exces sive amounts of ketone bodies, occurrinJ as a result of uncontrolled diabetes mellitus, starvation, or any other metabolic condition in which fats are raSidly catabolised. 7he condition can be diaJnosed with a diSstick reaJent or acetone test tablet. $lso called ketonuria. See also ketosis. —ketoaciduric, adj. 17-ketoandrosterone andros‫މ‬t‫ۑ‬rǀn, a metabolite of a sex hormone secreted by the testes and adrenal Jlands that may be measured in the urine to assess hormonal and adrenal functions. 1ormal amounts in the urine of men after 24hour collection are 0.2±1 mJ in women, 0.2±0. mJ. ketoconazole, an antifunJal aJent. Q INDICATIONS It is Srescribed for the treatment of candidi asis, coccidioidomycosis, histoSlasmosis and other funJal diseases. It is also used toSically in a number of cream SreSarations for a variety of dermatoShytes as well as in a shamSoo for the treatment of dandruff. Q CONTRAINDICATIONS Known hySersensitivity to this druJ Srohibits its use. It should not be used for funJal meninJitis. Q ADVERSE EFFECTS 7he most serious are liver disorders. &ommon reactions include nausea, vomitinJ, abdominal Sain, constiSation, rash, headache, di]]iness. It has a number of druJ±druJ interactions as it is a Sotent inhibitor of the &<P3$4 metabolisinJ isoen]yme Sathway. ketogenesis Men‫ۑމ‬sis >*er, keton + *k, genein, to Sroduce], the formation or Sroduction of ketone bodies. ketogenic amino acid Men‫މ‬ik, an amino acid whose carbon skeleton serves as a Srecursor for ketone bodies. ketogenic diet, a diet hiJh in fats (often as mediumchain triJlycerides) and Sroteins, and low in carbohydrates. It was used in the treatment of eSileSsy until suSerseded by anticonvulsant druJs in the 130s, and has recently been revived. :hile clinical reviews of mainly SrosSective and observational studies reSort efficacy as a treatment for children with Soorly controlled sei]ures, a &ochrane review concluded that there was no reliable evidence from randomised controlled trials to suSSort the use of ketoJenic diets for SeoSle with eSileSsy. ketonaemia kƝ‫މ‬tǀnƝ‫މ‬mƝā‫*> ۑ‬er, keton + *k, haima, blood], accumulation of ketones in the blood. 7he main ketones are acetoacetate and betahydroxybutyrate (the anions of keto acids with four carbon atoms), and acetone, a breakdown Sroduct of acetoacetate. $cetone is volatile and Jives the breath of ketonaemic SeoSle a fruity odour. Some keto naemia is normal in the fastinJ state. In tySe 1 diabetes, insulin deficiency can result in excessive ketone Sroduction and an acidosis (ketoacidosis) that can be lifethreateninJ. See also diabetes mellitus, ketoacidosis, ketone. — ketonaemic, adj. ketone kƝ‫މ‬tǀn >*er, keton, form of acetone], an orJanic chemical comSound characterised by havinJ in its structure a carbonyl, or keto, JrouS (!& 2) attached to two alkyl JrouSs. It is Sroduced by oxidation of secondary alcohols. Sample proofs © Elsevier Australia K ketone alcohol 958 ketone alcohol >*er, keton + $r, alkohl, essence], an alcohol containinJ the ketone JrouS. ketone bodies, two Sroducts of free fatty acid metabolism, betahydroxybutyric acid and aminoacetic acid, from which acetone may arise sSontaneously. Ketone bodies are Sroduced via acetylcoen]yme $ in the liver and are oxidised by the muscles. (xcessive Sroduction leads to elevation in the blood and their excretion in urine, as in diabetes mellitus. $lso called acetone bodies. Measurement of ketone bodies (Belchetz and Hammond, 2003) ketone group, the chemical carbonyl JrouS with attached hydrocarbons. See also ketone. ketonuria. See ketoaciduria. ketoprofen, a nonsteroidal antiinflammatory druJ (1S$I') with analJesic and antiSyretic actions. Q INDICATIONS It is Srescribed for the treatment of rheuma toid and osteoarthritis and related conditions. It is used in the form of oral tablets and toSically as a Jel formulation. Q CONTRAINDICATIONS +ySersensitivity to ketoSrofen or to asSirin or other 1S$I's Srohibits its use. Q ADVERSE EFFECTS $monJ the more serious are *I distur bances, includinJ SeStic ulcer and *I bleedinJ central nervous system effects of headache, di]]iness and drowsi ness and skin rash. &are in elderly Satients, Sarticularly if takinJ an $&( inhibitor and a diuretic can lead to kidney failure or the socalled triple whammy effect. ketorolac, an antiinflammatory indoleacetic acid. Q INDICATIONS 0ild to moderate SostoSerative Sain, Jiven either orally or by I0 inMection. Q CONTRAINDICATIONS 0oderate to severe renal imSairment, conditions where risk of bleedinJ is increased, dehydration or hyServolaemia, concurrent treatment with Srobenecid. Q ADVERSE EFFECTS &ommon effects are Sain at inMection site, itchinJ, sweatinJ, SurSura. ketose kƝ‫މ‬tǀs >*er, keton + glykys, sweet], the chemical form of a monosaccharide in which the carbonyl JrouS is a ketone. ketosis kitǀ‫މ‬sis >*er, keton + glykys, sweet, osis, condition], the accumulation of ketones in the body as a result of exces sive breakdown of fats caused by a deficiency or inadequate use of carbohydrates. )atty acids of metabolised ketones are Sroduced and accumulate. 7his condition is seen in star vation, occasionally in SreJnancy if the intake of Srotein and carbohydrates is inadequate, and most often in diabetes mellitus. It is characterised by ketonuria, loss of Sotassium in the urine, and a fruity odour of acetone on the breath. In tySe 1 diabetes, ketosis may SroJress to ketoacidosis, coma and death. See also diabetes mellitus, ketoacidosis, starvation. —ketotic, adj. ketosis-prone diabetes. See type 1 diabetes mellitus. kidney cancer ketosis-resistant diabetes. See type 2 diabetes mellitus. 17-ketosteroid kƝ‫މ‬tǀstir‫މ‬oid, kƝtǀ‫މ‬st‫ۑ‬roid, any of the adrenal cortical hormones, or ketosteroids, that has a ketone JrouS attached to its 1th carbon atom. 7hey are commonly measured in the blood and urine to aid the diaJnoses of $ddison¶s disease &ushinJ¶s syndrome stress and endocrine Sroblems associated with Srecocious Suberty, feminisation in men, and excessive hair Jrowth. It is usually measured on a 24 hour urine collection. /evels of 1ketosteroids increase by 0±100 after an inMection of $&7+. 17-ketosteroids (17-KS) test, a 24hour urine test that is useful in diaJnosinJ adrenocortical dysfunction. It is used to detect levels of 1KS, which are metabolites of the testosterone and nontestosterone androJenic sex hormones secreted from the adrenal cortex and the testes. ketotic kƝtot‫މ‬ik >*er, keton, form of acetone], 1. Sertain inJ to the Sresence of ketone in the body. 2. denotinJ the Sresence of a carbonyl JrouS in a chemical comSound. ketotifen, an +1 antihistamine and a mast cell stabiliser. Q INDICATIONS Seasonal allerJic conMunctivitis administered as eyedroSs. Q CONTRAINDICATIONS $llerJy to ketotifen. Q ADVERSE EFFECTS StinJinJ on instillation, mild eye irrita tion, headache. keV, an abbreviation for kiloelectron volts, an enerJy unit equivalent to 1000 electron volts. $lso abbreviated kev. Kew Gardens spotted fever. See rickettsial pox. key pinch. See lateral pinch. key points of control, areas of the body that can be handled by a theraSist in a sSecific manner to chanJe an abnormal Sattern, to reduce sSasticity throuJhout the body, and to Juide the Satient¶s active movements. 7he key Soints are the shoulder and Selvic Jirdles. key ridge, the lowest Soint of the ]yJomaticomaxillary ridJe. $lso called zygomaxillare. kg, abbreviation for kilogram. kG, abbreviation for kilogauss. kg cal, abbreviation for kilogram calorie. See calorie. KHA, abbreviation for Kidney Health Australia; formerly Australian Kidney Foundation. khat, a herbal Sroduct taken from the leaves of a tree, Catha edulis, found in $frica and the $rabian Seninsula. Q USES It has claimed uses for obesity and Jastric ulcers, and as a stimulant. Q CONTRAINDICATIONS It should not be used durinJ SreJ nancy and lactation, in children, or in those with known hySersensitivity. PeoSle with renal, cardiac or heSatic disease should also avoid its use. kHz, abbreviation for kilohertz. kidney, one of a Sair of beanshaSed, SurSlishbrown urinary orJans located dorsally between 712 and /3. Internally it is divided into a cortex, medulla and Selvis. 7he cortex contains the Jlomerular caSsule, Sroximal and distal convoluted tubules and Sart of the collectinJ ducts, while the medulla contains the looSs of +enle and other Sarts of the collectinJ ducts. 7hese ducts collect filtrate from a number of neShrons and drain into the renal Selvis. 7he kidneys have a number of imSortant functions, includinJ filterinJ the blood and removinJ wastes and toxins. 7hey also Slay an imSortant role in reJulatinJ fluid and electrolyte balance. kidney cancer, a maliJnant neoSlasm of the renal Sarenchyma or renal Selvis. 7here are about 2000 cases of kidney cancer in $ustralia every year and 0 deaths. )actors associated with an increased incidence of disease are exSosure to aromatic hydrocarbons or tobacco smoke and the use of druJs containinJ Shenacetin. $ lonJ asymStomatic Seriod Sample proofs © Elsevier Australia kidney dialysis kidney disease 959 Renal column Pyramid in renal medulla Renal cortex Major calyx Renal papilla Renal artery Renal sinus Hilum of kidney Renal vein Minor calyx Renal pelvis Ureter Kidney: coronal section (Drake et al, 2010) Kidney cancer (Kumar et al, 2013) may Srecede the onset of the characteristic symStoms, which include haematuria, flank Sain, fever and a SalSable mass. 'iaJnostic measures include urinalysis, excretory uroJraShy, neShrotomoJraShy, ultrasonoJraShy, renal arterioJraShy, and microscoSic and cytoloJical studies of cells from the renal Selvis. $denocarcinoma of the renal Sarenchyma accounts for 0 of kidney tumours, occurrinJ twice as often in men as in women; transitional cell or squamous cell carcinomas in the renal Selvis account for aSSroximately 1, and are equally frequent in men and women. 5adical neShrectomy with lymSh node dissection is usually recommended for tumours of the Sarenchyma; neShroureterectomy is usually recommended for oSerable tumours of the renal Selvis. 5adio theraSy may be used before or after surJery and as Salliation for inoSerable tumours. Palliative care is used for onJoinJ manaJement of symStoms associated with metastatic disease. &hemotheraSeutic aJents may induce temSorary remission. See also Wilms’ tumour. kidney dialysis. See haemodialysis. kidney disease, any one of a larJe JrouS of conditions, includinJ infectious, inflammatory, obstructive, vascular and neoSlastic disorders, of the kidney. &haracteristics of kidney disease are haematuria, Sersistent Sroteinuria, Syuria, oedema, dysuria and Sain in the flank. SSecific symStoms vary with the tySe of disorder. )or examSle, haematuria with severe, colicky Sain suJJests obstruction by a kidney stone; haema turia without Sain may indicate renal carcinoma; Sroteinuria is Jenerally a siJn of disease in the Jlomerulus, or filtration unit, of the kidney; Syuria indicates infectious disease; and oedema is characteristic of the neShrotic syndrome. 'iaJnosis of kidney disease is made after laboratory tests and other Srocedures have been Serformed. $monJ the sSecial tests for kidney disorders are excretory uroJraShy, I9 SyeloJraShy, tests of the Jlomerular filtration rate, bioSsy, and ultrasound examination. 7reatment deSends on the tySe of disease diaJ nosed. Some forms of advanced kidney disease may lead to renal failure, coma and death unless haemodialysis is started. Sample proofs © Elsevier Australia K kidney dish 960 See also glomerulonephritis, nephrotic syndrome, renal failure, urinary calculus. kidney dish, a kidneyshaSed basin commonly used to hold instruments, dressinJs and inMection devices. kidney failure. See renal failure. kidney machine. See artificial kidney, dialyser, def. 1. kidney punch, test for renal tenderness as found in renal infection; Jently strike renal anJle with closed fist. kidney stone. See renal calculus. Kielland forceps. See obstetric forceps. Kielland’s rotation kƝ‫މ‬land] >&hristian Kielland, 1orwe Jian obstetrician, 11±141], an obstetric Srocedure in which Kielland¶s forceSs are used in turninJ the head of the fetus from an occiSut Sosterior or occiSut transverse Sosition to an occiSut anterior Sosition. It is Serformed most commonly to correct an arrest in the active staJe of labour. 7he rotation is done at the midSlane of the Selvis. $s it is associated with increased harm to the mother and to the baby, caesarean section is often Sreferred instead. See also forceps delivery, obstetric forceps. Kiesselbach’s plexus kƝ‫މ‬s‫ۑ‬lblkhs‫މ‬, blks‫> މ‬:ilhelm Kies selbach, *erman larynJoloJist, 13±102], a converJence of small, fraJile arteries and veins located suSerficially on the anterosuSerior Sart of the nasal seStum. It is the commonest site of seStal bleedinJ. Kikuchi’s lymphadenitis kƝākoଲ o‫މ‬chƝ] >0. Kikuchi, -aSanese SatholoJist, 20th century], a beniJn, selflimited syndrome of lymShadenoSathy, usually in the neck, with a female Sredominance. &haracteristics include Satchy necrotisinJ lesions of the Saracortex and Sroliferation of distinctive histiocytes, Slasmacytoid monocytes and lymShoblasts surrounded by karyorrhectic debris. Some consider it a selflimited form of systemic luSus erythema tosus. $lso called histiocytic necrotising lymphadenitis, Kikuchi’s disease, subacute necrotising lymphadenitis. See also systemic lupus erythematosus. killed vaccine, a vaccine SreSared from dead micro orJanisms. Killed vaccines are Jenerally used to Srovide immunisation from orJanisms that are too virulent to be used in the livinJ attenuated state. 7he immune system reacts to the Sresence of the SathoJen in the same manner, whether the orJanism is live or dead. +owever, when Sossible, immunity Sroduced by a live, attenuated vaccine is usually more effective. killer cell, a small lymShocyte without the characteristic % or 7cell markers. It is the effector cell of antibodydeSendent cellmediated cytotoxicity, recoJnises antibodies on tarJet cells, and lyses those cells throuJh a cell±cell inter action that does not require comSlement. &omSare killer T-cells, natural killer (NK) cell. See also null cell. killer T-cells. See cytotoxic T-cell, natural killer (NK) cell. killer yeast, a strain of yeast cells containinJ a toxic Srotein that destroys other yeast strains. kilo- kil‫ۑމ‬, Srefix meaninJ µone thousand¶ kilocalorie, kilogram, kilometre. kilobase (kb), a lenJth of nucleic acid equal to 1000 bases or nucleotides. kilobase pair (kbp), a lenJth of '1$ or doublestranded 51$ equal to 1000 base Sairs. kilobyte (kB) bƯt, one thousand (or, more Srecisely, 1024) bytes. kilocalorie (kcal), 1. the amount of heat (enerJy) needed to raise the temSerature of 1 kJ of water by 1& at a Sressure of 1 atmosShere. 2. a unit, equal to 1000 calories, used to denote the heat exSenditure of an orJanism and the fuel or enerJy value of food. 1ow reSlaced by the kiloMoule 1 kilo calorie 4.1 kiloMoules. )or aSSroximate calculations, kinematic face-bow the conversion factor 4.2 k- 1 kcal may be used. &omSare calorie. See kilojoule. kilogram (kg) Jram >*k, chilioi, thousand; )r, gramme], a unit for the measurement of mass in the metric system. 2ne kiloJram is equal to 1000 Jrams or to 2.204 Sounds avoirduSois. kilohertz (kHz) hurts >*k, chilioi, thousand; hertz, +einrich 5. +ert], *erman Shysicist, 1±14], unit of frequency equal to 1000 (103) hert]. See also hertz. kilojoule (kJ) kil‫މۑ‬Moଲ ol/, equal to 103 Moules. +as reSlaced the kilocalorie 1 kilocalorie 4.1 kiloMoules. )or aSSrox imate calculations, the conversion factor 4.2 k- 1 kcal may be used. &omSare joule. kilolitre (kL) /lƝ‫މ‬t‫ۑ‬/ >*k, chilioi, thousand; )r, litre], unit of volume equivalent to 220 Jallons, 1000 litres. kilometre (km) /mƝ‫މ‬t‫ۑ‬/ >*k, chilioi, thousand, metron], measure equivalent to 1000 metres (about 0.2 miles). kilovolt (kV) /volt/ >*k, chilioi, thousand; volt, &ount $lessandro 9olta, Italian scientist, 14±12], measure of electrical Sotential, 1000 volts. kilovolt peak (kVp), a measure of the maximum electrical Sotential in kilovolts across an xray tube. 0ost diaJnos tic xray units have a k9S ranJe of 40±10. 'ental and mammoJraShic units may use k9S values lower than those used for Jeneral radioJraShy and &7. Kimmelstiel-Wilson syndrome >Paul Kimmelstiel, *erman SatholoJist in the US$, 100±10; &lifford :ilson, (nJlish Shysician, b. 10]. See intercapillary glomerulosclerosis. kinaesthesia /kin‫މ‬esthƝ‫]މ‬h‫ۑ‬/ >*k, kinƝsis, motion, aisthƝsis feelinJ], the SerceStion of one¶s own body Sarts, weiJht and movement. $lso sSelt kinesthesia. kinaesthetic memory /kin‫މ‬esthet‫މ‬ik/, the recollection of movement, weiJht, resistance and Sosition of the body or Sarts of the body. kinaesthetic sense >*k, kinƝsis, motion; /, sentire, to feel], an ability to be aware of muscular movement and Sosition. %y SrovidinJ information throuJh receStors about muscles, tendons, Moints, and other body Sarts, the kinaesthetic sense helSs control and coordinate activities such as walkinJ and talkinJ. kinanaesthesia /kin‫މ‬anesthƝ‫]މ‬h‫ۑ‬/, 1. an inability to Serceive the movement or Sosition of one¶s body Sarts. 7he condition is observed as a siJn of ataxia. 2. loss of movement sense. $lso sSelt kinanesthesia. kinase /kƯ‫މ‬nƗs/ >*k, kinƝsis, motion; ase, en]yme], 1. an en]yme that catalyses the transfer of a ShosShate JrouS or another hiJhenerJy molecular JrouS to an acceStor molecule. (ach of these kinases is named for its substrate, such as acetate kinase, fructokinase or hexokinase. 2. an en]yme that activates a Sreen]yme (]ymoJen). (ach of these kinases is named for its source, such as bacterial kinase, enterokinase, fibrinokinase, staShylokinase, streSto kinase, streStokinasestreStodornase or urokinase. kinase-linked receptors, hiJhaffinity cell surface receStors for many SolySeStide Jrowth factors, cytokines and hormones. 7hey are key reJulators of normal cellular Srocesses, but also have a role in the develoSment of cancer. $n examSle of a kinaselinked receStor is the insulin receStor. kind firmness, (in SsycholoJy) a direct, clear and confident aSSroach to a Satient in which rules and reJulations are calmly cited in resSonse to infractions and requests. kindred /kin‫މ‬drid/, a JrouS of Jenetically related individuals. kine-. See kinesio. kinematic face-bow /kin‫ۑމ‬mat‫މ‬ik/, an adMustable caliSerlike device used for Srecisely locatinJ the axis of rotation of a mandible throuJh the saJittal Slane. $lso called adjustable axis face-bow and hinge-bow. Sample proofs © Elsevier Australia kinematics 961 kinematics /kin‫ۑމ‬mat‫މ‬iks/ >*k, kinƝma, movement], the descriStion, measurement and recordinJ of body motion without reJard to the forces actinJ to Sroduce the motion. 5ecordinJs of body motions are defined in oneSlane rela tionshiSs, althouJh natural motions of the body often occur in more than one Slane. Kinematics considers the motions of all body Sarts relative to the seJments of the Sart involved in the motion and not necessarily in relation to the standard anatomical Sosition; for examSle, the movements of the finJers are considered in relation to the midline of the hand, not the midline of the body. 7he commonest tySes of motion studied in kinematics are flexion, extension, adduction, abduction, internal rotation and external rotation. Kinemat ics is esSecially imSortant in orthoSaedics, rehabilitation medicine and Shysical theraSy. $lso called cinematics. &omSare kinetics. kinesia /kƯnƝ‫]މ‬h‫ۑ‬/ >*k, kinƝsis, motion], a condition caused by erratic or rhythmic motions in any combination of directions, such as in a boat or a car. Severe cases are characterised by nausea, vomitinJ, vertiJo and headache; mild cases by headache and Jeneral discomfort. 9arious antihistamines are used SroShylactically. 0otion sickness includes air sickness, car sickness, and sea sickness (mal de mer). $lso sSelt cinesia. $lso called kinetosis, (informal) motion sickness. -kinesia, suffix meaninJ µmovement¶ hyperkinesia. kinesic behaviour /kƯnƝ‫މ‬sik/, nonverbal cues of commu nication that function to achieve and maintain bonds of attachment between SeoSle. kinesics /kƯnƝ‫މ‬siks/ >*k, kinƝsis, motion], the study of body Sosition, Sosture, movement and facial exSression in relation to communication. 7he observance of nonverbal interac tional behaviour is an inteJral Sart of health assessment and is used esSecially in mental health assessment as an obMective and measurable tool for diaJnosinJ disturbances of communication and behavioural disorders. See also body language, communication. kinesio-, kine-, combininJ form meaninJ µmovement¶ kinesiology, kinesioneurosis, kinesiotherapy. kinesiological electromyography, the study of muscle activity involved in body movements. kinesiology /ol‫ۑމ‬MƝ/ >*k, kinƝsis + logos, science], the scien tific study of muscular activity and the anatomy, ShysioloJy and mechanics of the movement of body Sarts. kinesiotherapist, 1orth $merican Srofessional Sosition. $ health Srofessional who, under the direction of a doctor, treats the effects of disease, inMury and conJenital disorders throuJh rehabilitative exercise and education alone. See also kinesiotherapy. kinesiotherapy, a sSecialised area of medicine in which exercise and movement are used as the main form of reha bilitation. It is tySically used in the treatment of amSutees. See also kinesiotherapist. kinesis /kƯnƝ‫މ‬sis, kinƝ‫މ‬sis/, Shysical movement or force, Sarticularly when induced by a stimulus. -kinesis, -kinesia, suffix meaninJ µactivation¶ angiokinesis, lymphokinesis, thrombokinesis. kinesthesia. See kinaesthesia. kinetic analysis /kinet‫މ‬ik/, analysis in which the chanJe of the monitored Sarameter with time is related to concentration, such as chanJe of absorbance Ser minute, to determine the rate of a reaction. kinetic ataxia. See motor ataxia. -kinetic, -cinetic, suffix meaninJ µmovement¶ akinetic, parakinetic, synkinetic. kinetic energy (KE) >*k, kinƝsis, motion, energeia], the enerJy Sossessed by an obMect by virtue of its motion. It is kinomere exSressed by the formula E (½)mv2, where m reSresents the mass of the obMect and v is its velocity. kinetic hallucination >*k, kinƝsis, motion; /, halucinari, wanderinJ mind], a false SerceStion of body movement. kinetic proofreading, 1. a molecular activity in which an en]yme distinJuishes correct substrates. 2. a mechanism that Sermits a ribosome to make correct codon±anticodon interactions. kinetic reflex >*k, kinƝsis, motion; /, reflectere, to bend back], a Sostural resSonse resultinJ from stimulation of the vestibular aSSaratus. $lso called labyrinthine reflex. kinetics /kinet‫މ‬iks/ >*k, kinƝsis + /, icus, like], the study of the forces that Sroduce, arrest, or modify the motions of the body. 1ewton¶s first and third laws of motion are esSecially aSSlicable to kinetics. 1ewton¶s first law states that bodies at rest stay at rest and bodies in motion keeS movinJ unless they are acted on by an unbalanced force. 1ewton¶s third law states that every action force has a reaction force that is equal in maJnitude but oSSosite in direction. 7hese two laws aSSly to the forces Sroduced by muscles that act on Moints. 7he reaction forces of the muscles contribute to equilibrium and the motion of the body. &omSare kinematics. kineto-, combininJ form meaninJ µmovable¶ kinetochore, kinetogenic, kinetoplasm. kinetochore. See centromere. kinetoplasm /kƯnet‫މ‬ǀSla]‫ۑމ‬m/, the most hiJhly contractile Sart of a cell. kinetosis. See kinesia. king brown snake antivenom, a Solyvalent snake anti venom used in the treatment of systemic kinJ brown snake envenomation. See antivenom. King, Imogene, a nursinJ theorist who introduced her theory of Joal attainment in her book, Toward a Theory of Nursing (11). KinJ¶s conceStual framework sSecifies three interact inJ systems Sersonal system, interSersonal system, and social system. KinJ defined nursinJ as a Srocess of human inter actions between nurse and clients who communicate to set Joals and then aJree to meet the Joals. She believes that the Satient is a Sersonal system within a social system, coexistinJ throuJh interSersonal Srocesses with other Sersonal systems. 7he nurse and Satient Serceive each other and the situation, act and react, interact, and transact. )rom her maMor conceSts (interaction, SerceStion, communication, transaction, role, stress, Jrowth and develoSment, and time and sSace), she derived her theory of Joal attainment. KinJ describes nursinJ as a disciSline and an aSSlied science, with emShasis on the derivation of nursinJ knowledJe from other disciSlines. She suJJests that the Satient¶s and nurse¶s SerceStions, MudJments and actions lead to reaction, interaction and transaction, which she calls the Srocess of nursinJ. kin group, family members who are related Jenetically or by marriaJe. kinin /kƯ‫މ‬nin/, any of a JrouS of SolySeStides with varyinJ ShysioloJical activity, such as contraction of visceral smooth muscle, vascular Sermeability and vasodilation. 7wo Srinci Sal kinins, bradykinin and lysylbradykinin, are formed in the blood from Srecursor kininoJens by the action of kallikreins and kinases. kinky hair disease, an inherited condition characterised by short, sSarse, Soorly SiJmented hair with shafts that are twisted and broken. 2ther mental and Shysical disorders are usually associated with the disease. $lso called Menkes’ kinky hair syndrome. kino-, kinesi-, kinesio-, combininJ form meaninJ µmovement¶ kinematics, kinesiology, hyperkinesia. kinomere. See centromere. Sample proofs © Elsevier Australia K Kinsbourne syndrome Klippel-Feil syndrome 962 Kinsbourne syndrome /kin]‫މ‬born/, a neuroloJical disorder of unknown cause with onset between aJes 1 and 3 years, characterised by myoclonus of trunk and limbs and by non rhythmic hori]ontal and vertical oscillations of the eyes, with ataxia of Jait and intention tremor; some cases have been associated with occult neuroblastoma. $lso called myoclonic encephalopathy of childhood. kinship model family group, a family unit comSrisinJ the bioloJical Sarents and their offsSrinJ with various ties to an extended family deSendinJ on the cultural back Jround. &ultural diversity means that there is considerable variation in notions of kinshiS. )or examSle, kinshiS in $boriJinal terms of reference is a key conceSt of family and social orJanisation that has comSlex relationshiSs to birth, conceStion, marriaJe, land and social relations. In this context kinshiS includes the Sosition of a Serson within their social network and in relation to the land where they were conceived and born. Kirklin staging system, a system for determininJ the SroJnosis of colon cancer, based on the extent to which the tumour has Senetrated the bowel area. See also cancer staging, Dukes’ classification, TNM. Kirschner’s wire /kursh‫މ‬n‫ۑ‬r]/ >0artin Kirschner, *erman surJeon, 1±142; $S, wir], a threaded or smooth metallic wire. 7he wire is used in internal fixation of fractures or for skeletal traction. Kirschner’s wire (Elkin et al, 2012) kiting /kƯ‫މ‬tinJ/, informal, the imSroSer and illeJal Sractice of alterinJ a druJ SrescriStion to indicate that more of a druJ was Srescribed than was actually ordered by the doctor, and/ or to add an additional druJ. KitinJ may be done by a Satient seekinJ Jreater quantities of druJs, esSecially oSioids and ben]odia]eSines, than the doctor Srescribed, or by the Shar macist to increase reimbursement from a third Sarty, such as Jovernment aJencies. $lso known as forgery. KJ, abbreviation for knee jerk. kL, abbreviation for kilolitre. klang association. See clang association. Klebsiella /kleb‫]މ‬Ɲāel‫ۑމ‬/ >7heodore $.(. Klebs, *erman bacterioloJist, 134±113], a Jenus of nonmotile Jram neJative bacteria with Solysaccharide caSsules. Klebsiella sSecies are ubiquitous in nature. Klebsiella orJanisms can cause a wide ranJe of infections includinJ Sneumonia and urinary tract infections. Klebsiella pneumoniae >7heodore $.(. Klebs; *k, pneumǀn lunJ], a sSecies of bacteria found in soil, water, cereal Jrains, and the intestinal tract of humans and other animals. It is associated with many infections, includinJ Sneumonia. See also Friedländer’s bacillus. Klebs-Loeffler bacillus /kleb]‫މ‬lef‫މ‬l‫ۑ‬/ >7heodor $.(. Klebs, *erman bacterioloJist, 134±113; )riederich $.-. /oeffler, Klebsiella pneumonia (Belchetz and Hammond, 2003) *erman bacterioloJist, 12±11; /, bacillum, small rod], Corynebacterium diphtheriae. See also Corynebacterium. Kleeblattschädel deformity syndrome. See cloverleaf skull deformity. Kleine-Levin syndrome /klƯn‫މ‬lev‫މ‬in/ >:illi Kleine, 20th century *erman Ssychiatrist; 0ax /evin, 5ussianborn $merican neuroloJist, b. 101], a disorder of unknown cause, often associated with Ssychotic conditions, that is characterised by eSisodic sleeS, abnormal hunJer and hySer activity. 7he eSisodes of sleeS may last for several hours or days and are followed by confusion on awakeninJ. 7here is no sSecific treatment. &omSare narcolepsy. Klein-Waardenburg syndrome. See Waardenburg’s syndrome, def. 2. klepto-, Srefix meaninJ µtheft or stealinJ¶ kleptolagnia, kleptomania. kleptolagnia >*k, kleptein, to steal, lagneia, lust], sexual excitement or Jratification Sroduced by stealinJ. kleptomania /mƗ‫މ‬nƝā‫ۑ‬/ >*k, kleptein, to steal, mania, madness], an anxiety disorder characterised by an abnormal, uncontrollable and recurrent urJe to steal. 7he obMects are not taken for their monetary value or immediate need. 7hey are usually Jiven away, returned surreStitiously, or keSt and hidden. PeoSle who have the condition exSerience an increased sense of tension before committinJ the theft and intense Jratification durinJ the act. $fterwards they disSlay siJns of deSression, Juilt and anxiety over the Sossibility of beinJ aSSrehended and losinJ status in society. In less severe cases the imSulse is exSressed by continuously borrowinJ obMects and not returninJ them. 7reatment consists of Ssycho theraSy to uncover the underlyinJ emotional Sroblems. See also impulse control disorder. —kleptomaniac, n. Klinefelter’s syndrome /klƯn‫މ‬felt‫ۑ‬r]/ >+arry ). Klinefelter, $merican Shysician, b. 112], affects 1 in 00 males and is associated with the Sresence of an extra ; chromosome in at least one cell line. &haracteristics are small, firm testes, lonJ limbs and Jynaecomastia. :hile the ranJe of intellectual ability reSorted is from well above to well below averaJe, the averaJe I4 is ±0. Infertility is extremely common. 7he severity of the abnormalities increases with the numbers of ; chromosomes. 7he commonest abnormality is a 4 ;;< karyotySe. 0en with the karyotySe ;;;;< have marked conJenital malformations and intellectual disability. Klippel-Feil syndrome /kliSel‫މ‬fel‫މ‬, kliS‫ۑމ‬lfƯl‫މ‬/ >0aurice KliSSel, )rench neuroloJist, 1±142; $ndre )eil, )rench Sample proofs © Elsevier Australia Klippel-Trénaunay syndrome 963 Klinefelter’s syndrome (Patton and Thibodeau, 2010) Klippel-Feil syndrome (Zitelli et al, 2012) neuroloJist, b. 14], a condition of short neck and limited neck movements because of conJenital fusion of the cervical vertebrae or reduction in the number of cervical vertebrae. $lso called Klippel’s disease, Klippel-Feil disease, KlippelFeil malformation. See congenital short neck syndrome. Klippel-Trénaunay syndrome /kliāSel‫މ‬trƗānǀānƗ‫މ‬/ >0aurice KliSSel, )rench neuroloJist, 1±142; Paul 7rpnaunay, )rench Shysician, 20th century], a rare condition usually affectinJ one extremity, characterised by hySertroShy of the bone and related soft tissues, larJe cutaneous haemanJio mas, Sersistent naevus flammeus, and skin varices. Kloehn headgear, an extraoral orthodontic aSSliance consistinJ of a cervical straS and a lonJ outer bow. It is used to retract maxillary teeth or to reinforce tooth anchoraJe durinJ retraction. Klumpke’s palsy /klo଱ omS‫މ‬kƝ]/ >$uJusta 'pMprineKlumSke, )rench neuroloJist, 1±12], atroShic Saralysis of the forearm. It is Sresent at birth and involves the seventh and knee joint eiJhth cervical nerves and the first thoracic nerve. 7he condition may be accomSanied by +orner¶s syndrome, Stosis and miosis because of the involvement of symSathetic nerves. $lso called Déjérine-Klumpke’s paralysis. Km, symbol for Michaelis-Menten constant. See MichaelisMenten kinetics. km, abbreviation for kilometre. kneading /nƝ‫މ‬dinJ/, a JrasSinJ, rollinJ and SressinJ move ment which uses the whole hand while the finJers and thumb squee]e the tissues beneath, as is used in massaJinJ the muscles. See also massage. knee /nƝ/, a Moint comSlex that connects the thiJh with the lower leJ. It consists of three condyloid Moints, 12 liJaments, 13 bursae and the Satella. 7he motion of this Moint is not a simSle JlidinJ motion, because the articular surfaces of the bones involved are not mutually adaSted to each other. 9arious orthoSaedic conditions such as arthritis commonly affect the knee, esSecially in elderly individuals. 7he knee is relatively unSrotected by surroundinJ muscles and is often inMured by blows, sudden stoSs and turns, esSecially those associated with sSorts. /iJamental tears of the knee Moint are extremely common in athletes and Sroduce a variety of siJns and symStoms, such as effusion surroundinJ the knee Moint, varyinJ deJrees of oedema, differences in the shaSe of the knee Moint, tenderness on SalSation, creSitation, instability of the knee Moint, and Sossible ecchymosis. 7orn menisci are very common sSorts inMuries and can cause severe Sain, limSinJ, oedema, and Jreatly reduced motion. knee–ankle interaction, one of the five maMor kinetic deter minants of Jait, which helSs to minimise the disSlacement of the body¶s centre of Jravity durinJ the walkinJ cycle. 7he knee and the foot work simultaneously to lower the body¶s centre of Jravity. :hen the heel of the foot is in contact with the Jround, the foot is dorsiflexed, and the knee is fully extended so that the associated limb is at its maximum lenJth with the centre of Jravity at its lower Soint. Plantar flexion of the foot with the initiation of knee flexion maintains the centre of Jravity in its forward SroJression at about the same level, also helSinJ to minimise the vertical disSlacement of the centre of Jravity. Knee±ankle interaction is often a factor in the diaJnosis and treatment of various orthoSaedic diseases, deformities and abnormal conditions and in the analysis and correction of SatholoJical Jaits. &omSare knee±hip flexion, lateral pelvic displacement, pelvic rotation, pelvic tilt. kneecap. See patella. knee–chest position. See genupectoral position. knee–elbow position, a Sosition in which a Satient beinJ examined rests on the knees and elbows with the head suSSorted on the hands. knee–hip flexion, one of the five maMor kinetic determinants of Jait, which allows the SassaJe of body weiJht over the suSSortinJ extremity durinJ the walkinJ cycle. Knee±hiS flexion occurs durinJ the stance and swinJ Shases of the cycle. 7he knee first locks into extension as the heel of the weiJhtbearinJ limb strikes the Jround and is unlocked by final flexion and initiation of the swinJ Shase in the walkinJ cycle. +iS flexion is synchronised with these move ments, which helS minimise the vertical disSlacement of the body¶s centre of Jravity in the act of walkinJ. Knee±hiS flexion is often a factor in the diaJnosis and treatment of various orthoSaedic diseases, deformities and abnormal conditions, and in the analysis and correction of SatholoJi cal Jaits. &omSare knee±ankle interaction, lateral pelvic displacement, pelvic rotation, pelvic tilt. knee-jerk reflex. See patellar reflex. knee joint, the comSlex, hinJed Moint at the knee, reJarded as three articulations in one, comSrisinJ condyloid Moints Sample proofs © Elsevier Australia K knee replacement 964 Femur Articular cartilage Capsule Patella Joint cavity (filled with synovial fluid) Synovial membrane Lateral meniscus Tibia Knee joint (Herlihy, 2011) connectinJ the femur and the tibia and a Sartly arthrodial Moint connectinJ the Satella and the femur. 7he knee Moint and its liJaments Sermit flexion, extension and, in certain Sositions, medial and lateral rotation. It is a common site for sSrain and dislocation. $lso called articulatio genus. knee replacement, the surJical insertion of a Srosthesis Serformed to relieve Sain and restore motion to a knee severely affected by osteoarthritis, rheumatoid arthritis or trauma. :ith the Satient under Jeneral or sSinal anaesthesia, the diseased surfaces are removed and a twoSiece Srosthetic Moint is inserted into the medullary cavities of the femur and tibia. $fter surJery SroJressive exercise and whirlSool baths are Srescribed throuJh Shysical theraSy. Possible comSli cations include infection, fat embolism, thromboShlebitis, Seroneal nerve Salsy, looseninJ of the Srosthesis, and flexion contractures. 7o Srevent contractures the Satient is cautioned to keeS the leJ extended in bed; a blanket roll alonJ the femur Srevents external rotation. 7he mobility and ranJe of motion of the Moint imSrove slowly. See also arthroplasty, hip replacement, osteoarthritis. Knee replacement (Black and Hawks, 2009) knee sling, a leJ suSSort in slinJ form used under the knee for 5ussell¶s traction. See also Russell’s traction. knife needle /nƯf/, a slender surJical knife with a needle kon- Soint, used in the discission of a cataract and other oShthal mic Srocedures such as Joniotomy and JonioSuncture. knock-knee. See genu valgum. Knoop hardness test /noଲ oS/ >)rederick KnooS, 20th century $merican metallurJist], a method of assessinJ surface hardness by measurinJ resistance to the Senetration of an indentinJ tool made of diamond. 7he test is commonly used for testinJ the hardness of teeth. knot /not/, (in surJery) the interlacinJ of the ends of a liJature or suture so they remain in Slace without sliSSinJ or becominJ detached. 7he ends of the suture are Sassed twice around each other before beinJ Sulled taut to form a simSle surJeon¶s knot. )or additional stability the ends may be recrossed and a second simSle knot made over the first. knuckle /nuk‫ۑމ‬l/, the dorsal asSect of any ShalanJeal Moint, esSecially of the metacarSoShalanJeal Moints of the flexed finJers. %y extension sometimes aSSlied to any anatomical structure of similar aSSearance, such as an extruded looS of intestine in hernia. knuckle pads, skin thickeninJs over the knuckles, sometimes induced by trauma. Some are familial. Kocher’s forceps >(mil 7. Kocher, Swiss surJeon, 141±11], a kind of surJical forceSs that has notched Maws, interlockinJ teeth, and thick curved or straiJht Sowerful handles. Koch’s bacillus /koks/ >5obert Koch, *erman bacterioloJist, 143±110; /, bacillum, small rod], the Mycobacterium tuberculosis microorJanism. Koch’s phenomenon >5obert Koch; *k, phainomenon, anythinJ seen], a tuberculin reaction that occurs when a culture of tubercle bacilli is inMected into the skin of a subMect already infected with the disease. In humans a Sositive tuberculin reaction indicates sensitisation resultinJ from a tuberculosis infection. $lso called Koch’s reaction. Koch’s postulates >5obert Koch; /, postulare, to demand], the Srerequisites for exSerimentally establishinJ that a sSecific microorJanism causes a Sarticular disease. 7he conditions are the followinJ (1) the microorJanism must be observed in all cases of the disease; (2) the microorJanism must be isolated and Jrown in Sure culture; (3) micro orJanisms from the Sure culture, when inoculated into a susceStible animal, must reSroduce the disease; and (4) the microorJanism must be observed in and recovered from the exSerimentally diseased animal. Koch’s reaction. See Koch’s phenomenon. Koebner phenomenon /kǀb‫މ‬n‫ۑ‬/ >+einrich Koebner, Polish dermatoloJist, 13±104; *k, phainomenon, somethinJ observed], the develoSment of isomorShic lesions at the site of an inMury occurrinJ in Ssoriasis, lichen nitidus, lichen Slanus, and verruca Slana. Koenen tumour, SeriunJal fibroma common in tuberous sclerosis. KOH, chemical formula for potassium hydroxide. Kohnstamm’s phenomenon. See aftermovement. koilo-, combininJ form meaninJ µhollow or concave¶ koilonychia, koilorrhachic, koilosternia. koilonychia /koi‫މ‬lǀnik‫މ‬Ɲā‫ۑ‬/ >*k, koilos, hollow, ony[, nail], sSoon nails; a condition in which nails are thin and concave from side to side. It is usually familial but may occur with trauma, iron deficiency anaemia, or as a result of oral retinoid theraSy. koinoni-, combininJ form meaninJ µcommunity¶ koinonia, koinoniphobia. kolpo-. See colpo. koly-, combininJ form meaninJ µto hinder¶ kolypeptic, kolyphrenia, kolyseptic. kon-, combininJ form meaninJ µdust¶ konometer, koniocorte[. Sample proofs © Elsevier Australia Kopan’s needle Krukenberg’s tumour 965 Koplik’s spots (Zitelli et al, 2012/Courtesy Robert Hickey MD, Children’s Hospital of Pittsburgh) Koebner phenomenon (Zitelli et al, 2012) Koilonychia (Hordinsky, Sawaya and Scher, 2000) Kopan’s needle /kǀ‫މ‬S‫ۑ‬n]/, a lonJ bioSsy needle used to locate the Sosition of a breast tumour on xray film. 7he needle is inserted into the aSSroximate location of the tumour and is left in Slace durinJ radioJraShy so that it can be reSositioned if necessary. In some cases the site is further identified for the surJeon by inMectinJ a coloured dye such as methylene blue. Koplik’s spots /koS‫މ‬liks/ >+enry KoSlik, $merican Saediatri cian, 1±12], small, red sSots with bluishwhite centres on the linJual and buccal mucosa, characteristic of measles. 7he rash of measles usually eruSts a day or two after the aSSearance of KoSlik¶s sSots. kopr-, kopra-. See copro. Korányi’s sign /k{r‫ۑމ‬nyƝ]/ >)riedrich von Korinyi, +unJar ian Shysician, 12±113; /, signum], a Saravertebral area of dullness found Sosteriorly on the side oSSosite a Sleural effusion. $lso called Grocco’s sign, Korányi-Grocco triangle, triangular dullness. Korean haemorrhagic fever. See epidemic haemorrhagic fever. Korotkoff sounds /k{rot‫މ‬k{f/ >1ickolai Korotkoff, 5ussian Shysician, 14±120], sounds heard durinJ the takinJ of a blood Sressure readinJ usinJ a sShyJmomanometer and stethoscoSe. $s air is released from the cuff, Sressure on the artery is reduced, and the blood is heard SulsinJ throuJh the vessel. See also blood pressure, diastole, sphygmomanometer, systole. Korsakoff’s psychosis /k{r‫މ‬s‫ۑ‬k{fs/ >SerJei S. Korsakoff, 5ussian Ssychiatrist, 14±100], a form of amnesia often seen in chronic alcoholics that is characterised by a loss of shortterm memory and an inability to learn new skills. 7he Serson is usually disoriented, may Sresent with delirium and hallucinations, and confabulates to conceal the condition. 7he cause of the condition can often be traced to deJener ative chanJes in the thalamus as a result of a deficiency of % comSlex vitamins, esSecially thiamine and %12. &omSare Wernicke’s encephalopathy. kosher >+eb, kasher, fit or SroSer], SertaininJ to the SreSara tion and servinJ of foods accordinJ to -ewish dietary laws. Inherently kosher foods include common fruits, veJetables, and cereals, as well as tea and coffee. )oods that are not kosher include Sork, birds of Srey, and seafood that lacks fins and scales, such as lobster and eels. 0ost Soultry and meat Sroducts, excludinJ Sork, are kosher if SroSerly Srocessed. 0eat and milk Sroducts should be SreSared seSarately. K+ pump. See potassium pump. Kr, symbol for the element krypton. Krabbe’s disease. See galactosyl ceramide lipidosis. Kraske position /kras‫މ‬k‫ۑ‬/ >Paul Kraske, Swiss surJeon, 11±130], an anatomical Sosition in which the Satient is Srone, with hiSs flexed and elevated, head and feet down. 7he Sosition is used for renal surJery, as it enlarJes the costoverte bral anJle, allowinJ the surJeon oStimal access to the kidneys. kraurosis vulvae, outdated terminoloJy. See lichen sclerosus. Krause’s corpuscles >:ilhelm -.). Krause, *erman anat omist, 133±110; /, corpusculum, little body], any of a number of sensory endorJans in the conMunctiva of the eye; mucous membranes of the liSs and tonJue; eSineurium of nerve trunks, the Senis and the clitoris; and synovial membranes of certain Moints. Krause¶s corSuscles are tiny, cylindrical, oval bodies with a caSsule formed by the exSansion of the connective tissue sheath of a medullated fibre. 7hey contain a soft, semifluid core in which the axon terminates either in a bulbous extremity or in a coiled mass. $lso called end bulbs of Krause. &omSare Golgi-Mazzoni corpuscles, Pacini’s corpuscles. Krebs cycle. See citric acid cycle. Krebs-Henseleit cycle. See urea cycle. Krukenberg’s tumour /kroଲ o‫މ‬k‫ۑ‬nb‫ۑ‬rJ]/ >)riedrich (. Kruken berJ, *erman SatholoJist, 11±14], a neoSlasm of the ovary that is a metastasis from a *I maliJnancy, usually stomach cancer. &ytoloJical examination often reveals Sample proofs © Elsevier Australia K krypto- 966 Krukenberg’s tumour (Fletcher, 2007) mucoid deJeneration and many larJe cells shaSed like siJnet rinJs. $lso called carcinoma mucocellulare. krypto-. See crypto. krypton (Kr) /kriS‫މ‬ton/, a Jenerally inert rare Jaseous element Sresent in air. Its atomic number is 3; its atomic mass is 3.0. KS, ks, abbreviation for Kaposi’s sarcoma. k-space, the mathematical sSace used in 05 to define the relative Sositions of frequency and Shase Soints in a Jiven sequence. Kt/V, a formula to measure the adequacy of dialysis reflectinJ clearances (K) of urea from the Satient¶s total body water (9) over a Seriod of time (t). $ value over 1.0 results in lower morbidity rates, althouJh many suJJest that Kt/9 1.2. See also adequacy, urea reduction ratio. KUB, abbreviation for kidney, ureter and bladder; a term used in a radioJraShic examination to describe the location, si]e, shaSe and malformation of the kidneys, ureters and bladder. Stones and calcified areas may be detected. Kuchendorf method /koଲ o‫މ‬k‫ۑ‬nd{rf/, (in radioloJy) a tech nique for SositioninJ a Satient for radioJraShic examination of the Satella. 7he Satella is Slaced aJainst the imaJe receStor and is moved laterally to reduce suSerimSosition. kudzu, a herb that Jrows in vine form, native to &hina and -aSan. Q USES It has claimed uses to reduce alcohol cravinJs and menoSausal symStoms. Q CONTRAINDICATIONS It should not be used durinJ SreJ nancy and lactation, in children, or in those with known hySersensitivity. It should be used with caution by SeoSle who have heart disease. Kufs’ disease /koଲ ofs/ >+. Kufs, *erman Ssychiatrist, 11±1; /, dis + )r, aise, ease], an adult form of hered itary cerebral sShinJoliSidosis (amaurotic familial idiocy), characterised by cerebromacular deJeneration, hySertonic ity, and SroJressive sSastic Saralysis. $lso called adult ceroidlipofuscinosis. Kugelberg-Welander syndrome. See juvenile spinal muscular atrophy. kuia, (1ew =ealand 0Ɨori) an elder, elderly, old woman. 7he holder of wisdom, a suSSortive role and a symbolic one. Kuia will often accomSany the family into healthcare settinJs and may sSeak for the family on imSortant matters. 0ay be referred to as µaunty¶. &omSare NDXPƗWXD. Kulchitsky cell carcinoma. See carcinoid. Kulchitsky’s cell. See argentaffin cell. Kümmell’s disease /kim‫ۑމ‬l]/ >+ermann Kmmell, *erman surJeon, 12±13; /, dis + )r, aise, ease], a set of symStoms that develoS after a comSression fracture of the kVp test cassette vertebrae with sSinal inMury. 7hey include sSinal Sain, inter costal neuralJia, kyShosis, and weakness in the leJs. $lso called Kümmell’s spondylitis, posttraumatic spondylitis, traumatic spondylopathy. kunitz inhibitor. See trypsin inhibitor. Kunjin virus, a flavivirus, first isolated from Cule[ annulirostris mosquitoes collected in northern 4ueensland in 10 near the 0itchell 5iver. It is named after the $boriJinal clan that lived nearby, and is closely related to the :est 1ile virus. Subclinical infection is common. 0ild disease consists of lymShadenoSathy, fever, letharJy and rash. (nceShalitis can occur but is rare. Infection is usually confirmed by blood samSles showinJ a siJnificant rise in antibody titre to the virus. In some reference laboratories the KunMin virus can be cultured or viral 51$ detected in clinical material. 7he virus is endemic in the troSical north of $ustralia and Sarawak, where it has cycles of infection between birds and mosquitoes in en]ootic foci. 7here is no evidence of SersontoSerson transmission. Küntscher nail /ko଱ on‫މ‬ch‫ۑ‬/ >*erhard Kntscher, *erman surJeon, 102±12; $S, naegel], the first stainless steel intramedullary nail used in orthoSaedic surJery for the fixation of fractures of the lonJ bones, esSecially the femur and tibia. Kupffer cells /ko଱ oS‫މ‬f‫ۑ‬r/ >Karl :. von KuSffer, *erman anatomist, 12±102], larJe, ShaJocytitic cells of the reticuloendothelial system lininJ the sinusoids of the liver. kuru /koଲ o‫މ‬roଲ o/ >1ew *uinea, tremblinJ], a slow, SroJres sive, fatal Srion infection of the central nervous system that was endemic to natives of the 1ew *uinea hiJhlands. 7he incubation Seriod could be 30 or more years, but death usually occurred within months of the onset of symStoms. &haracteristic of kuru are ataxia and decreased coordination SroJressinJ to Saralysis, dementia, slurrinJ of sSeech and visual disturbances. 'isease was transmitted by ritual canni balism of brain tissue durinJ funeral rites. 1o new cases have been recorded since cessation of the cannibalism. See Creutzfeldt-Jakob disease. Kussmaul breathing /ko଱ os‫މ‬moul/ >$dolf Kussmaul, *erman Shysician, 122±102; $S, braeth], abnormally deeS, very raSid siJhinJ resSirations associated Sarticularly with diabetic ketoacidosis and other causes of metabolic acidosis. +yServentilation reduces carbon dioxide and induces resSiratory comSensation for the acidosis. $lso called Kussmaul respiration. Kussmaul’s coma >$dolf Kussmaul; *k, kǀma deeS sleeS], a diabetic coma characterised by acidosis and deeS breathinJ or extreme hySerSnoea. Kussmaul’s sign >$dolf Kussmaul; /, signum, mark], 1. a Saradoxical rise in venous Sressure with distension of the MuJular veins durinJ insSiration, as seen in constrictive Seri carditis or mediastinal tumour. 2. conditions of convulsions and coma associated with a *I disorder caused by absorStion of a toxic substance. kV, abbreviation for kilovolt. Kveim reaction >0orten $. Kveim, 1orweJian Shysician, 12±1; /, re, aJain, agere, to act], a reaction used in a diaJnostic test for sarcoidosis, based on an intradermal inMection of antiJen derived from a lymSh node known to be sarcoid. If a noncaseatinJ Jranuloma aSSears on the skin at the test site in 4 to weeks, the reaction is said to be Sositive evidence that the Satient has sarcoidosis. 7his test is now rarely Serformed. kVp, abbreviation for kilovolt peak. kVp test cassette, (in radioloJy) a liJhtSroof box containinJ a coSSer filter, a series of steSwedJes and an oStical atten uator, used to test the accuracy of k9S settinJs for Seak electrical Sotential across an xray tube. Sample proofs © Elsevier Australia kwashiorkor kyphosis 967 kwashiorkor /kwl‫މ‬shƝā{r‫މ‬k{r/ >$fr], a malnutrition disease, Srimarily of children, caused by severe Srotein deficiency that usually occurs when the child is weaned from the breast. 7he child does not lose weiJht as dramatically and is not as wasted as a marasmic child, who lacks Srotein and calories. 7he main siJn of kwashiorkor is oedema. (ventually the followinJ symStoms occur retarded Jrowth, chanJes in skin and hair SiJmentation, diarrhoea, loss of aSSetite, nervous irritability, letharJy, anaemia, and fatty deJeneration of the liver, often accomSanied by infection and multivitamin defi ciencies. Initial stabilisation is followed by rehabilitation. 'ietary treatment is usually based on milk (whole or skim), Jiven as small frequent feeds. 'ietary fats and/or lactose may be Soorly tolerated, in which case a lowlactose milk substitute may be used. 9itamin and mineral suSSlements are imSortant. 7hese initial feedinJs are followed by addi tional foods until a full, wellbalanced diet is achieved. See also marasmic kwashiorkor, marasmus, protein±energy malnutrition. kyphos /kƯ‫މ‬f‫ۑ‬s/ >*k, kyphos, hunchbacked], the exaJJera tion or anJulation from the normal Sosition of the thoracic vertebral column that is associated with kyShosis. See also kyphosis. kyphoscoliosis /kƯ‫މ‬fǀskǀ‫މ‬lƝāǀ‫މ‬sis/ >*k, kyphos, hunchbacked + skolios, curved + osis, condition], an abnormal condition characterised by an anteroSosterior and a lateral curvature of the sSine. It occurs in children and adults and is often associated with cor Sulmonale. &omSare kyphosis, scoliosis. —kyphoscoliotic, adj. Kyphoscoliosis (Swartz 2010) The child on the left has severe muscle wasting with oedema representing marasmic kwashiorkor. The other child pictured does not have a nutritional deficiency (Shetty, 2006) Kyasanur Forest disease, a flavivirus infection transmitted by the bite of a tick that is harboured by shrews and other forest animals in western troSical India. &haracteristics of the infection include fever, headache, muscle ache, couJh, abdominal and eye Sain, and ShotoShobia. 7reatment is symStomatic. $ vaccine is used in India. Kylie, an $ustraliandeveloSed bed sheet, similar in si]e to a draw sheet, which is used in incontinence. It is comSosed of a Sorous toS layer that allows urine to Sass freely into a hiJhly absorbent middle layer, Slus a moistureresistant backinJ, thereby helSinJ to keeS the Satient and the bed dry. kymo-, combininJ form meaninJ µwaves¶ kymograph, kymoscope, kymotrichous. kymography /kƝmoJ‫މ‬r‫ۑ‬fƝ/ >*k, kyma, wave + graphein, to record], a technique for JraShically recordinJ motions of body orJans, such as the heart and the blood vessels. kyno-, combininJ form meaninJ µdoJs¶ kynocephalus, kynophobia. kypho-, combininJ form meaninJ µhumS¶ kyphoscoliosis, kyphosis, kyphotone. kyphosis /kƯfǀ‫މ‬sis/ >*k, kyphos, hunchbacked], an abnormal condition of the vertebral column, characterised by increased convexity in the curvature of the thoracic sSine as viewed from the side. 7he sSinal saJittal contour ordinarily consists K Severe kyphosis of the thoracic spine (Zitelli et al, 2012) Sample proofs © Elsevier Australia Kyrle’s disease 968 of a lordosis in the lumbar and cervical sSinal seJments that balances the roundinJ, or the kyShosis, in the thoracic seJment. KyShosis describes this exSected roundinJ but it is also used to describe the abnormal condition of the vertebral column. It may be caused by rickets or tuberculosis of the sSine. $dolescent kyShosis is usually selflimitinJ and often undiaJnosed but, if the curvature SroJresses, there may be moderate back Sain. &onservative treatment consists of sSinestretchinJ exercises and sleeSinJ without a Sillow kyto- with a board under the mattress. $ modified 0ilwaukee brace may be used for severe kyShosis and, rarely, sSinal fusion may be required. $lso called humpback, roundback. —kyphotic, adj. Kyrle’s disease, chronic skin disease usually arisinJ in diabetes and chronic renal failure, characterised by hySer keratotic SaSules. kysth-, kystho-. See colpo. kyto-. See cyt. Sample proofs © Elsevier Australia

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