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Chapter 3 – Selected Topics: Tri-State Business Institute MD000 Medical Terminology 1 Micheal H. McCabe, EMT-P Overview: Most of chapter 3 concerns suffixes commonly used in medicine; regardless of the particular body system or medical specialty. Chapter 3 is of great value, but is selfexplanatory and does not require much lecture. Students are required to read through chapter 3 and complete the exercises therein. Appendices to Chapter-3: Appendix A: Hernia Appendix B: Amniocentesis Appendix C: Plurals Appendix D: Streptococcus & Staphylococcus Appendix E: Blood Cells Appendix G: Anemia Appendix H: Ischemia Appendices, Continued: Appendix Appendix Appendix Appendix Appendix J: Acromegaly K: Splenomegaly L: Leukocytosis M: Achondroplasia O: Laparoscopy Hernia: Hernia means “bulging forth.” In medicine, a hernia is the protrusion of an organ or muscle from the cavity that normally contains it. Examples: – Hiatal Hernia: the stomach protrudes up through the diaphragm into the mediastinum. – Inguinal Hernia: a loop of intestine protrudes downward into the groin through the abdominal wall. Hernia, Continued: – Umbilical Hernia (omphalocele): A loop of intestine protrudes through the abdominal wall in the area of the umbilicus. – Rectocele: A portion of the rectum protrudes through a weakened portion of the vaginal wall. – Cystocele: A portion of the urinary bladder protrudes the vaginal wall. Hernias, Continued: Amniocentesis: The amnion is a sac (membrane) that surrounds the embryo (called the fetus after the 8th week) in the uterus. Amniotic fluid is contained within the sac and serves as developmental environment for the fetus. Amniocentesis is a procedure where fluid is aspirated using a needle and syringe in order to study the fluid itself and the cells of the developing fetus. Amniocentesis, Continued: Under guidance provided by continuous sonography, a needle is inserted through the uterine wall and amnion into the amniotic cavity. Amniotic fluid, containing fetal cells is withdrawn for analysis. Risks include infection, spontaneous abortion, hemorrhage, and fetal trauma. Amniocentesis, Continued: Amniocentesis is normally done in between the 12th and 18th week of gestation. Fetal cells are isolated and cultured for study in the laboratory. A karyotype is made to study the chromosome structure of the fetal cells. This is a diagnostic test used to detect Down’s Syndrome and other genetic diseases. Chemical analysis of the amniotic fluid can indicate potential defects in the neural tube. Amniocentesis Diagram: Pluralization: Words ending in –us commonly form their plural by dropping the –us and addid –i. Thus, nucleus becomes nuclei and coccus becomes cocci. A guide to forming plurals can be found in Appendix 1, Page 903. Streptococcus: One of my favorite bacteria! Streptococcus is a berry-shaped bacterium that grows in twisted chains. There are several types of streptococcus and many unique strains. One major type of streptococcus causes conditions known as “strep” throat, tonsillitis, rheumatic fever, and certain kidney ailments. A second major type causes infections in teeth, sinusitis, and sometimes in heart valves. Staphylococcus: Another perennial favorite! Staphylococci are bacteria that grow in small clusters, like grapes. Staphylococcal lesions may be external (skin abscesses, boils, or styes) or internal (abcesses in bone and kidneys.) An abscess is a collection of pus, white blood cells, and protein that is present at the site of infection. Diplococci: Two common types of Diplococci: – Pneumococci – Gonococci Pneuomococci is the most common cause of bacterial pneumonia in adults. Gonococci invades the reproductive organs and causes gonorrhea. Pneumococci: Gonococci: Blood Cells: There are three basic types of blood cells. – Erythrocytes – Leukocytes – Thrombocytes Erythrocytes are red blood cells. Leukocytes are white blood cells. Thrombocytes (Platelets) are clotting cells. Red Blood Cells: Are made in the red bone marrow. Function is to carry oxygen from the lungs to cells located throughout the body. Hemoglobin is an iron-based protein in erythrocytes that chemically binds with oxygen to form oxyhemoglobin (known to the rest of the world as “rust.”) Red blood cells “retire” to the spleen where they are stored in reserve in case of hemorrhage. Ultimately, old erythrocytes are destroyed in the liver – blood pigments including hemoglobin are recycled. Leukocytes: Leukocyte literally means “white cells” Leukocytes are “soldiers” of the immune system and play a part in the inflammatory response. Leukocytes are divided into two types: – Granulocytes (cells with dark-staining granules in their cytoplasm) – Agranulocytes (cells with no dark-staining granules in the cytoplasm.) Granulocytes: Three types of granulocytes: Eosinophils – stain red when using an acidic stain. Play some role in the inflammatory response and are elevated during allergic conditions such as asthma. Basphils – stain blue when using an alkali (basic) stain. Function is not clear, but they play some roll in inflammation. Neutrophils – granules stain blue and red when using a neutral stain. Neutrophils are phagocytes – they engulf and digest bacteria. Eosinophil: Basophil: Neutrophil: Agranulocytes: Agranulocytes lack dark-staining granules in the cytoplasm. They are produced by lymph nodes and in the spleen. There are two main types of agranulocytes: 1. 2. Lymphocytes – fight disease by producing antibodies. Two types of lymphocytes are B lymphocytes that serve as “memory cells” and T lymphocytes that directly attack pathogens. Monocytes – engulf and destroy cellular debris after neutrophils have attacked foreign cells. Monocytes leave the bloodstream and enter tissues to become macrophages which are large phagocytes. Lymphocyte: Monocytes: Thrombocytes: Thrombocyte means “clotting cell.” Also known as platelets Resemble tiny fragments of blood cells. Are formed in the bone marrow. Are necessary for blood clotting. Thrombocyte: Anemia: Literal meaning of the term is “No blood.” Normal usage indicates a reduction in the number of normal erythrocytes or amount of hemoglobin in circulating blood. There are many different types of anemia, classified on the basis of how they occur. Aplastic anemia is a severe type in which the bone marrow fails to produce not only erythrocytes but leukocytes and thrombocytes as well. Ischemia: Ischemia means “to hold back blood.” Tissue that is ischemic loses its normal flow of blood and becomes deprived of oxygen. Death (necrosis) can result from ischemia. Ischemia can result from mechanical injury to a blood vessel, by clots lodging in a blood vessel, or from the gradual closing off (occlusion) of a vessel owing to a collection of fatty material. Tonsillitis: Tonsils are lymphatic tissue in the throat. They contain white blood cells (lymphocytes) and function to filter and fight bacteria, but they can also become infected and inflamed. Streptococcal infection of the throat can cause tonsillitis, which may require tonsillectomy. Adenoids: The adenoids are lymphatic tissue is the part of the pharynx near the nose and nasal passages. The literal meaning of the term is “gland like” – but they are neither endocrine or exocrine glands. Enlargement of this tissue may cause blockage of the airway from the nose to the pharynx and adenoidectomy may be advised. Tonsils and Adenoids: Acromegaly: Acromegaly is an example of an endocrine disorder. In acromegaly, the pituitary gland produces too much growth hormone after puberty. A person with acromegaly is of normal height, but has abnormally large growth of bones and tissues in the face, hands, and feet. Gigantism: Similar to acromegaly, but because the high levels of growth hormone present before the completion of puberty, the long bones continue to grow as well – producing abnormally tall stature. Features of acromegaly may also be present in gigantism – overly large face, hands, and feet. Splenomegaly: The spleen is an organ in the upper left quadrant of the abdomen. It is composed of lymph tissue and blood vessels. Its job is to store, and ultimately dispose of, dying red blood cells and manufacture of white blood cells. Splenomegaly is an abnormal enlargement of the spleen that may necessitate splenectomy. If splenectomy is required, other organs (including the liver) will carry out these functions. Leukocytosis: When –osis is used as a suffix with blood cells, it means an abnormal condition where there is a slight increase in number of normal, circulating blood cells. Thus, in leukocytosis, a slight elevation in the number of normal white blood cells occurs – usually as a response to infection by the body. When –emia is used as a suffix with blood cells, the condition is an abnormally high or excessive increase in the number of abnormal or cancerous blood cells. Leukemia is an example. Achondroplasia: Achondroplasia is an inherited disorder where the bones of the arms and legs fail to grow to normal size owing to a defect in cartilage and bone. It results in a type of dwarfism characterized by short limbs, a normal sized head and body, and normal intelligence. Laparoscopy: Laparoscopy is the visual examination of the abdominal cavity using a lighted instrument. The laparoscope is inserted through an incision in the abdominal wall near the umbilicus. Carbon Dioxide gas is used to “inflate” the abdomen and prevent injury to soft tissues where the laparoscope passes. Use of the laparoscope may be entirely diagnostic, or it may be used in surgical procedures. Laparoscopy: