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(BQ) Part 1 book Medical language for modern health care has contents: The anatomy of medical terms, word analysis and communication, the body as a whole, integumentary system, digestive system, urinary system, male reproductive system,... and other contents.
Medical Language For Modern Health Care Fou rth Ed it ion David M Allan, MA, MD Rachel C Basco, MS, RRT Bossier Parish Community College MEDICAL LANGUAGE FOR MODERN HEALTH CARE, FOURTH EDITION Published by McGraw-Hill Education, Penn Plaza, New York, NY 10121 Copyright ©2019 by McGraw-Hill Education All rights reserved Printed in the United States of America Previous editions ©2014, 2011, and 2008 No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning Some ancillaries, including electronic and print components, may not be available to customers outside the United States This book is printed on acid-free paper LMN 21 20 19 18 ISBN 978-0-07-782072-5 MHID 0-07-782072-X Portfolio Manager: William Mulford Product Developers: Christine Scheid Marketing Manager: Valerie Kramer Content Project Managers: Jessica Portz, Brent dela Cruz, Sandra Schnee Buyer: Susan K Culbertson Design: Tara McDermott Content Licensing Specialist: Melissa Homer Cover Image: ©MedicalRF.com Compositor: Spi Global All credits appearing on page or at the end of the book are considered to be an extension of the copyright page Library of Congress Cataloging-in-Publication Data Names: Allan, David, 1942- author Title: Medical language for modern health care / David M Allan, MA, MD, Rachel C Basco, MS, RRT, Bossier Parish Community College Description: Fourth edition | New York, NY : McGraw-Hill Education, [2019] | Revised edition of: Medical language for modern health care / David M Allan, Karen D Lockyer 3rd ed c2014 Identifiers: LCCN 2017051852 | ISBN 9780077820725 (alk paper) Subjects: LCSH: Medicine—Terminology—Programmed instruction Classification: LCC R123 A43 2019 | DDC 610.1/4—dc23 LC record available at https://lccn.loc.gov/2017051852 The Internet addresses listed in the text were accurate at the time of publication The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill Education does not guarantee the accuracy of the information presented at these sites www.mhhe.com ABOUT THE AUTHORS David Allan David Allan received his medical training at Cambridge University and Guy’s Hospital in England He was Chief Resident in Pediatrics at Bellevue Hospital in New York City before moving to San Diego, California Dr Allan has worked as a family physician in England, a pediatrician in San Diego, and Associate Dean at the University of California, San Diego School of Medicine He has designed, written, and produced more than 100 award-winning multimedia programs with virtual reality as their conceptual base Dr Allan resides happily in San Diego and enjoys the warmth of the people, the weather, and the beaches Rachel Curran Basco Rachel Basco earned her BS in Cardiopulmonary Science and MS in Health Sciences from Louisiana State University Health Science Center, School of Allied Health Professions (SAHP) She worked as a registered respiratory therapist for ten years and then began her career in college instruction in respiratory therapy at LSU-SAHP in Shreveport, LA She then found her interest to be in nonclinical education and began instructing biology courses at Bossier Parish Community College (BPCC) in Bossier City, LA Ms Basco’s interest in online learning developed, leading to the completion of a graduate certificate in Instructional Design from the University of Wisconsin–Stout She is employed full-time as a project director but also as an online adjunct instructor in medical terminology at BPCC She is in the dissertation phase for her EdD at Louisiana Tech University in Ruston, LA, with a focus on higher education policy analysis Ms Basco resides in Shreveport with her husband and children While very busy with her family, work, and studies, Rachel always finds time to visit her relatives in her home state of Wisconsin iii BRIEF CONTENTS Welcome W-1 The Anatomy of Medical Terms 2 Word Analysis and Communication 18 The Body as a Whole 32 Integumentary System 62 Digestive System 100 Urinary System 154 Male Reproductive System 184 Female Reproductive System 210 Nervous System 266 10 Cardiovascular System 320 11 Blood 364 12 Lymphatic and Immune Systems 398 13 Respiratory System 426 14 Skeletal System 460 15 Muscles and Tendons, Physical Medicine and Rehabilitation (PM&R) 512 16 Special Senses of the Eye and Ear 538 17 Endocrine System 588 18 Mental Health 630 19 Geriatrics 658 20 Cancer 678 21 Radiology and Nuclear Medicine 704 22 Pharmacology 722 iv DETAILED CONTENTS Welcome W-1 CHAPTER The Anatomy of Medical Terms: The Foundation of Medical Language 2 Lesson 1.1 Lesson 1.2 The Construction of Medical Words Unique Medical Words 12 Chapter Review 14 ©2014 Nucleus Medical Media CHAPTER Word Analysis and Communication: The Language of Health Care 18 Lesson 2.1 Word Analysis and Definition 20 Lesson 2.2 Plurals and Pronunciation 22 Lesson 2.3 Precision in Communication 24 Chapter Review 26 ©2014 Nucleus Medical Media CHAPTER The Body as a Whole: The Language of Anatomy 32 Lesson 3.1 Lesson 3.2 Lesson 3.3 Lesson 3.4 ©2014 Nucleus Medical Media Organization of the Body 34 Basic Genetics 46 Genetic Medicine 48 Anatomical Position, Planes, and Directions 50 Chapter Review 54 CHAPTER Integumentary System: The Language of Dermatology 62 ©2014 Nucleus Medical Media Lesson 4.1 Lesson 4.2 Lesson 4.3 Lesson 4.4 Lesson 4.5 Functions and Structure of the Skin 64 Disorders of the Skin 70 Accessory Skin Organs 78 Burns and Injuries to the Skin 84 Procedures and Pharmacology 90 Chapter Review 94 v CHAPTER Digestive System: The Language of Gastroenterology 100 ©2014 Nucleus Medical Media The Digestive System 102 Mouth, Pharynx, and Esophagus 108 Digestion—Stomach and Small Intestine 116 Digestion—Liver, Gallbladder, and Pancreas 124 Absorption and Malabsorption 132 Elimination and the Large Intestine 136 Procedures and Pharmacology of the Digestive System 140 Chapter Review 146 Lesson 5.1 Lesson 5.2 Lesson 5.3 Lesson 5.4 Lesson 5.5 Lesson 5.6 Lesson 5.7 CHAPTER Urinary System: The Language of Urology 154 Urinary System and Kidneys 156 Ureters and Associated Disorders 164 Urinary Bladder and Urethra 166 Diagnostic Procedures and Pharmacology 170 Chapter Review 180 Lesson 6.1 Lesson 6.2 Lesson 6.3 Lesson 6.4 ©2014 Nucleus Medical Media CHAPTER Male Reproductive System: The Language of Reproduction 184 Male Reproduction 186 Spermatic Ducts and Accessory Glands 192 The Penis and Its Disorders 198 Procedures and Pharmacology 202 Chapter Review 204 Lesson 7.1 Lesson 7.2 Lesson 7.3 Lesson 7.4 ©2014 Nucleus Medical Media CHAPTER Female Reproductive System: The Languages of Gynecology and Obstetrics 210 External Genitalia and Vagina 212 Ovaries, Uterine Tubes, and Uterus 220 Disorders of the Female Reproductive Tract 226 Gynecologic Diagnostic and Therapeutic Procedures and Pharmacology 234 Lesson 8.5 Obstetrics: Pregnancy and Childbirth 242 Lesson 8.6 Obstetrical Diagnostic and Therapeutic Procedures and Pharmacology 252 Lesson 8.7 Breast 254 Lesson 8.8 Diagnostic and Therapeutic Procedures and Pharmacology of Disorders of the Breast 258 Chapter Review 260 Lesson 8.1 Lesson 8.2 Lesson 8.3 Lesson 8.4 ©2014 Nucleus Medical Media vi CHAPTER Nervous System: The Language of Neurology 266 ©2014 Nucleus Medical Media Lesson 9.1 Lesson 9.2 Lesson 9.3 Lesson 9.4 Lesson 9.5 Functions and Structure of the Nervous System 268 The Brain and Cranial Nerves 276 Disorders of the Brain and Cranial Nerves 284 Disorders of the Spinal Cord and Peripheral Nerves 298 Procedures and Pharmacology 306 Chapter Review 314 CHAPTER 10 Cardiovascular System: The Language of Cardiology 320 Lesson 10.1 Lesson 10.2 Lesson 10.3 Lesson 10.4 ©2014 Nucleus Medical Media Heart 322 Disorders of the Heart 330 Circulatory Systems 338 Cardiovascular Procedures and Pharmacology 348 Chapter 10 Review 356 CHAPTER 11 Blood: The Language of Hematology 364 ©2014 Nucleus Medical Media Lesson 11.1 Lesson 11.2 Lesson 11.3 Lesson 11.4 Lesson 11.5 Lesson 11.6 Components of Blood 366 Red Blood Cells (Erythrocytes) 370 White Blood Cells (Leukocytes) 374 Hemostasis 380 Blood Groups 384 Procedures and Pharmacology 388 Chapter 11 Review 392 CHAPTER 12 Lymphatic and Immune Systems: The Language of Immunology 398 Lesson 12.1 Lymphatic Systems 400 Lesson 12.2 Immune System 408 Lesson 12.3 Procedures and Pharmacology 416 Chapter 12 Review 420 ©2014 Nucleus Medical Media CHAPTER 13 Respiratory System: The Language of Pulmonology 426 Lesson 13.1 Lesson 13.2 Lesson 13.3 Lesson 13.4 ©2014 Nucleus Medical Media Respiratory System 428 Upper Respiratory Tract 430 Lower Respiratory Tract 436 Procedures and Pharmacology 446 Chapter 13 Review 452 vii CHAPTER 14 Skeletal System: The Language of Orthopedics 460 ©2014 Nucleus Medical Media Lesson 14.1 Lesson 14.2 Lesson 14.3 Lesson 14.4 Lesson 14.5 Functions of the Skeletal System 462 Joints 470 Axial Skeleton 476 Appendicular Skeleton 480 Procedures and Pharmacology 500 Chapter 14 Review 504 CHAPTER 15 Muscles and Tendons, Physical Medicine and Rehabilitation (PM&R): The Languages of Orthopedics and Rehabilitation 512 Lesson 15.1 Muscles and Tendons 514 Lesson 15.2 Muscles and Tendons of the Shoulder Girdle, Trunk, and Upper Limb 518 ©2014 Nucleus Medical Media Lesson 15.3 Muscles and Tendons of the Pelvic Girdle and Lower Limb 522 Lesson 15.4 Procedures and Pharmacology 524 Lesson 15.5 Physical Medicine and Rehabilitation (PM&R) 528 Chapter 15 Review 532 CHAPTER 16 Special Senses of the Eye and Ear: The Languages of Ophthalmology and Otology 538 ©2014 Nucleus Medical Media Lesson 16.1 Lesson 16.2 Lesson 16.3 Lesson 16.4 Lesson 16.5 Accessory Structures of the Eye 540 The Eyeball and Seeing 546 Procedures and Pharmacology for the Eye 556 The Ear and Hearing 562 Procedures and Pharmacology for the Ear 574 Chapter 16 Review 580 CHAPTER 17 Endocrine System: The Language of Endocrinology 588 Lesson 17.1 Endocrine System Overview: Hypothalamus, Pituitary, and Pineal Glands 590 ©2014 Nucleus Medical Media Lesson 17.2 Thyroid, Parathyroid, and Thymus Glands 600 Lesson 17.3 Adrenal Glands and Hormones 608 Lesson 17.4 Pancreas 616 Chapter 17 Review 624 viii CHAPTER 18 Mental Health: The Languages of Psychology and Psychiatry 630 Lesson 18.1 Lesson 18.2 Lesson 18.3 Lesson 18.4 ©2014 Nucleus Medical Media Mental Health and Affective Disorders 632 Anxiety Disorders 636 Schizophrenia and Personality Disorders 640 Procedures and Pharmacology for Mental Disorders 644 Chapter 18 Review 652 CHAPTER 19 Geriatrics: The Language of Gerontology 658 Lesson 19.1 Aging and Senescence 660 Lesson 19.2 Dying and Death 670 Chapter 19 Review 674 ©2014 Nucleus Medical Media CHAPTER 20 Cancer: The Language of Oncology 678 Lesson 20.1 Types of Cancer 680 Lesson 20.2 Detecting Cancer 688 Chapter 20 Review 696 ©2014 Nucleus Medical Media CHAPTER 21 Radiology and Nuclear Medicine: The Language of Medical Imaging 704 Lesson 21.1 Production of X-ray Images 706 Lesson 21.2 Nuclear Medicine 712 Chapter 21 Review 716 ©2014 Nucleus Medical Media ix LO 11.8, 11.A Word Analysis and Definition WORD S = Suffix P = Prefix R = Root R/CF = Combining Form PRONUNCIATION ELEMENTS coagulopathy coagulopathies (pl) koh-ag-you-LOP-ah-thee disseminate dih-SEM-in-ate embolus EM-boh-lus extravasate eks-TRAV-ah-sate hematoma hee-mah-TOH-mah bruise (syn) BROOZ hemophilia hee-moh-FILL-ee-ah petechia petechiae (pl) S/ R/CF DEFINITION -pathy disease coagul/o- clotting Disorder of blood clotting -ate composed of, pertaining to dis- apart -semin- scatter seed Widely scatter throughout the body or an organ Greek plug, stopper Detached piece of thrombus, a mass of bacteria, quantity of air, or foreign body that blocks a blood vessel -ate composed of, pertaining to extra- out of, outside -vas- blood vessel To ooze out from a vessel into the tissues -oma mass, tumor hemat- blood Old English to bruise Collection of blood that has escaped from the blood vessels into tissue -philia attraction hem/o- blood An inherited disease from a deficiency of clotting factor VIII peh-TEE-kee-ah peh-TEE-kee-ee Latin spot on the skin Pinpoint capillary hemorrhagic spot in the skin purpura PUR-pyu-rah Greek purple Skin hemorrhages that are red initially and then turn purple thrombocytopenia THROM-boh-sigh-tohPEE-nee-ah -penia deficiency thromb/o- clot -cyt/o- cell Deficiency of platelets in circulating blood S/ P/ R/ S/ P/ R/ S/ R/ S/ R/CF S/ R/CF R/CF Exercises A Fill in the blank with the correct medical term related to disorders of coagulation. LO 11.8 A decrease in the number of thrombocytes in the circulating blood: A thrombus that has detached and lodged in another blood vessel: A pinpoint hemorrhage: B Match the term in the first column to its correct definition in the second column. LO 11.8 1 hematoma a widely scatter throughout the body _ 2 extravasate b bleeding into the skin from arterioles _ 3 petechia c escape from a blood vessel _ 4 purpura d collection of blood that has escaped from a blood vessel _ 5 disseminate e small capillary hemorrhage C Choose the correct abbreviation. From the given description, choose the correct abbreviation of the described conditions. LO 11.8, 11.F Loose strands of fibrin are deposited in numerous small blood vessels: a DIC b ITP c TTP d vWD b ITP c TTP d vWD Deficiency of factor VIII: a DIC LESSON 11.4 Hemostasis 383 Lesson 11.5 BLOOD Blood Groups Lesson Objectives To make an appropriate decision, it is critical that you are able to use correct medical terminology to: Case Report (CR) 11.4 You are 11.5.1 List the different blood . an emergency medical technician–paramedic (EMT-P) working in the Level One Trauma Unit at Fulwood Medical Center 11.5.2 Explain what determines Your patient is groups a person’s ABO blood type and how this relates to transfusion compatibility 11.5.3 Describe the effect of an incompatibility between mother and fetus in the rhesus (Rh) blood type Red blood cell Antibody anti-B Antigen A (a) Type A blood Red blood cell Antibody anti-A Antigen B . Ms Joanne Rodi, an 18-year-old student Ms Rodi has been admitted to the unit from the operating room after surgery for multiple fractures in a car accident She is receiving a blood transfusion You document that her temperature has risen to 102°F and her respirations to 24 per minute and she has chills You take her BP; it has fallen to 90/60 What should you do? LO 11.9 Red Cell Antigens On the surfaces of red blood cells are molecules called antigens In the plasma, antibodies are present Each antibody can combine with only a specific antigen If the plasma antibodies combine with a red cell antigen, bridges are formed that connect the red cells together This is called agglutination, or clumping, of the cells Hemolysis (rupture) of the cells also occurs The antigens on the surfaces of the cells have been categorized into groups, of which two are the most important These are the ABO and Rhesus (Rh) blood groups ABO Blood Group Figure 11.14 shows the different combinations of antigens and antibodies in the different blood types The two major antigens on the cell surface are antigen A and antigen B (b) Type B blood Red blood cell Antigen A A person with only antigen A has type A blood A person with only antigen B has type B blood Antigen B A person with both antigen A and antigen B has type AB blood and is a universal recipient who can receive blood from any other type in the ABO system (c) Type AB blood Antibody anti-A Antibody anti-B Red blood cell A person with neither antigen has type O blood and is a universal donor, able to give blood to any other person no matter what that person’s blood type is Case Report 11.4 (continued) (d) Type O blood ▲ Figure 11.14 ABO Blood Types Keynotes In Miss Rodi’s case, she has type A blood and, by mistake, received type AB blood, which agglutinated in the presence of her anti-B antibodies Your immediate response is to stop the transfusion, replace it with a saline infusion, call your supervisor, and notify the doctor • All blood groups are inherited • Rh factor is an antigen on the surface of a red blood cell 384 CHAPTER 11 Blood The Language of Hematology LO 11.9, 11.A Word Analysis and Definition S = Suffix P = Prefix R = Root R/CF = Combining Form WORD PRONUNCIATION ELEMENTS DEFINITION agglutination ah-glue-tih-NAY-shun S/ P/ R/ -ation process ag- to -glutin- glue Process by which cells or other particles adhere to each other to form clumps antibody AN-tih-body P/ R/ anti- against -body substance Protein produced in response to an antigen antigen AN-tih-jen P/ R/ anti- against -gen to produce Any substance that can trigger an immune response infusion in-FYU-zhun P/ R/ in- in -fusion to pour Introduction intravenously of a substance other than blood Exercises A Review the elements in the above WAD before starting this exercise. Match the elements in the first column with the correct meanings in the second column. LO 11.9 _ 1 anti a condition _ 2 fusion b in _ 3 glutin c to pour _ 4 ation d glue _ 5 osis e against _ 6 in f process B Identify the components of blood typing. Choose the correct term in the parentheses that completes each statement. LO 11.9 It is the (antigen/antibody) on the erythrocyte that determines a person’s blood type It is the (red blood cells/plasma) that contains antibodies that seek out antigens A person with type B blood has B (antigens/antibodies) A person with type A blood has anti-B (antigens/antibodies) A person with type O blood has no (anti-A antibodies/antigens) LESSON 11.5 Blood Groups 385 Abbreviations LO 11.9 Red Cell Antigens (Continued) HDN Rhesus (Rh) Blood Group hemolytic disease of the newborn (erythroblastosis fetalis) Rh rhesus RhoGAM rhesus immune globulin If an Rh antigen is present on an RBC surface, the blood is said to be Rh-positive (Rh+) If there is no Rh antigen on the surface, the blood is Rh-negative (Rh–) The presence or absence of Rh antigen is inherited The antigen is named the Rhesus factor because it was first found on the red blood cell of a rhesus monkey If an Rh-negative person receives a transfusion of Rh-positive blood, anti-Rh antibodies will be produced This can cause RBC agglutination and hemolysis If an Rh-negative woman and an Rh-positive man conceive an Rh-positive child (Figure 11.15a), the placenta normally prevents maternal and fetal blood from mixing However, at birth or during a miscarriage, fetal cells can enter the mother’s bloodstream These Rh-positive cells stimulate the mother’s tissues to produce Rh-antibodies (Figure 11.15b) If the mother becomes pregnant with a second Rh-positive fetus, her Rh-antibodies can cross the placenta and agglutinate and hemolyze the fetal RBCs (Figure 11.15c) This causes hemolytic disease of the newborn (HDN, or erythroblastosis fetalis) Hemolytic disease of the newborn due to Rh-incompatibility can be prevented The Rh-negative mother should be given Rh immune globulin (RhoGAM) during pregnancy, or soon after giving birth to an Rh-positive child Other causes of hemolytic disease of the newborn include ABO incompatibility, incompatibility in other blood group systems, hereditary spherocytosis, and some infections acquired before birth Rh– mother Rh– mother Rh– mother Rh+ Rh+ Rh+ antigens antigens antigens Rh+ fetus Rh+ fetus Rh+ fetus Placenta Placenta Placenta Rh RhRh antibodies antibodies antibodies Uterus Uterus Uterus Second Second Second Rh+ fetus Rh+ fetus Rh+ fetus Amniotic sac sacsac Amniotic Amniotic First pregnancy (a) First pregnancy (a)(a) First pregnancy (b) Between Between pregnancies pregnancies (b)(b) Between pregnancies ▲ Figure 11.15 Hemolytic Disease of the Newborn 386 CHAPTER 11 Blood The Language of Hematology (c) Second Second pregnancy pregnancy (c)(c) Second pregnancy LO 11.9, 11.A Word Analysis and Definition WORD erythroblastosis fetalis S = Suffix P = Prefix R = Root R/CF = Combining Form PRONUNCIATION eh-RITH-ro-blasTOH-sis fee-TAH-lis Rhesus factor REE-sus FAK-tor spherocytosis SFEER-oh-sigh-TOH-sis ELEMENTS S/ R/CF R/ DEFINITION Hemolytic disease of the newborn due to Rh incompatibility S/ S/ R/ -osis condition erythr/o- red -blast- germ cell, immature cell -is belonging to -al- pertaining to fet- fetus R/ Rhesus Greek mythical king of Thrace factor maker Antigen on red blood cells of Rh-positive (Rh+) individuals It was first identified in the blood of a rhesus monkey -osis condition spher/o sphere -cyt- cell Presence of spherocytes in blood S/ R/CF R/ Exercises A Deconstruct medical terms to determine their meanings. Using the terms relating to rhesus factor, identify the meanings of the word elements. LO 11.9, 11.D In the medical term erythroblastosis fetalis, the condition affects which component of the blood? a white blood cells b plasma c coagulation d red blood cells In the medical condition erythroblastosis fetalis, who is harmed: the mother or the baby? a mother b baby B Explain the disorder erythroblastosis fetalis. Choose the correct answer for each question regarding this condition. LO 11.9 In order for this disorder to occur, the mother must have blood that is: a type A b type B c type O d Rh– e Rh+ d Rh– e Rh+ The trigger for this condition to occur is a baby with blood that is: a type A b type B c type O It is impossible for the first child to have this condition a True b False LESSON 11.5 Blood Groups 387 Lesson 11.6 BLOOD Procedures and Pharmacology Lesson Objectives The information in this lesson will enable you to use medical terminology to: 11.6.1 Explain the diagnostic procedures used for hematologic disorders 11.6.2 Discuss the therapeutic disorders used for hematologic disorders 11.6.3 Describe the pharmacologic agents used in the treatment of hematologic disorders Abbreviations CBC ESR complete blood count erythrocyte sedimentation rate INR International Normalized Ratio MCH mean corpuscular hemoglobin MCHC mean corpuscular hemoglobin concentration MCV mean corpuscular volume PT prothrombin time PTT partial thromboplastin time LO 11.10 Diagnostic Procedures A complete blood count (CBC) measures the following: • The number of red blood cells (RBC count) • The amount of hemoglobin in the blood • The percentage of the blood composed of red blood cells (hematocrit) • Average red blood cell size (MCV) • Hemoglobin amount per red blood cell (MCH) • Amount of hemoglobin relative to the size of the red blood cell (MCHC) • The number of white blood cells (WBC count) • The types of white blood cells (WBC differential) • Platelet count Serum iron is the amount of iron in the blood Serum ferritin is the amount in the blood of the iron-protein complex that regulates iron storage and transport Erythrocyte sedimentation rate (ESR) is a nonspecific measure of inflammation Bone marrow is found inside the larger bones and contains cells that produce RBCs, WBCs, and platelets Bone marrow biopsy and aspiration are performed in the investigation of anemias, polycythemia, cancers (to determine if the cancer has spread to the bones), and bone marrow diseases Prothrombin time (PT), partial thromboplastin time (PTT), and International Normalized Ratio (INR) are used to evaluate bleeding and clotting disorders and to monitor anticoagulation therapies (see Lesson 11.4) A Monospot test is used to diagnose infectious mononucleosis caused by the Epstein-Barr virus It detects the presence of antibodies that the body developed in response to external antigens LO 11.11 Therapeutic Procedures A transfusion of blood or packed red blood cells (Figure 11.16) replaces lost red blood cells to restore the blood’s oxygen-carrying capacity During autologous donation and transfusion, people donate their own blood ahead of time to be given to them if necessary during a surgical procedure Bone marrow transplant is the transfer of bone marrow from a healthy, compatible bone marrow donor to a patient with aplastic anemia, leukemia, lymphoma, multiple myeloma, or other disease Hematopoietic stem cells are found in the bone marrow and are capable of generating all our blood cells such as red cells, white cells, and platelets In hematology, clinical trials to treat hemophilia and thalassemia with gene therapy are underway using allogenic cells from a compatible donor Gene therapy is an experimental technique to treat or prevent disease by replacing a mutated gene with a healthy copy, by inactivating a mutated gene that is functioning improperly, or by introducing a new gene into the body. ▲ Figure 11.16 Patient receiving blood transfusion. ©Dave Moyer 388 CHAPTER 11 Blood The Language of Hematology LO 11.10, 11.11 Word Analysis and Definition WORD S = Suffix P = Prefix R = Root R/CF = Combining Form PRONUNCIATION allogen AL-oh-jen allogenic (adj) aspiration al-oh-JEN-ik AS-pih-RAY-shun autologous awe-TOL-oh-gus compatible kom-PAT-ih-bul corpuscle KOR-pus-ul corpuscular kor-PUS-kyu-lar ferritin FER-ih-tin gene Monospot test (Trade name) mutate mutation JEEN MON-oh-spot TEST transfusion trans-FYU-zhun transplant TRANZ-plant MYU-tayt myu-TAY-shun ELEMENTS P/ R/ S/ S/ R/ P/ R/ S/ P/ R/ S/ R/ S/ S/ S/ R/ S/ R/ P/ R/ P/ R/ DEFINITION allo- different -gen to produce -ic pertaining to -ion process aspirat- to breathe auto- self, same -logous relation -ible able to com- with -pat- lie together -cle small (can also be cule) corpus- body -ar pertaining to -cul- small -in chemical ferrit- iron Greek birth Antigen from someone else in the same species Latin to change -ion action, condition, process mutat- change trans- across -fusion to pour trans- across -plant plant Change the chemistry of a gene Change in the chemistry of a gene Pertaining to an allogen Removal by suction of fluid or gas from a body cavity Blood transfusion with the same person as donor and recipient Able to exist together with something else A blood cell Pertaining to corpuscle Iron-protein complex that regulates iron storage and transport Functional unit of heredity Detects heterophile antibodies in infectious mononucleosis Transfer of blood or a blood component from donor to recipient The tissue or organ used or the act of transferring tissue from one person to another Exercises A Identify the meaning of the word parts as they relate to hematology. Select the answer that correctly completes each statement. LO 11.10, 11.11, 11.C The word element that means different: a allo- b trans- c corpus- d -gen c iron d protein The word part ferrit- means: a blood b cell B Interpret abbreviations. Given the abbreviation, choose what the diagnostic test is measuring. LO 11.10, 11.F WBC differential a number of leukocytes c. types of leukocytes b measure of inflammation d. average red blood cell size PT a evaluates bleeding and clotting disorders c. counts the number of platelets b hemoglobin amount per erythrocyte d. determines presence of bone cancer MCH a measures amount of iron in the blood c. measures the various blood cell components b determines amount of hemoglobin per erythrocyte d. used to monitor anticoagulation therapies LESSON 11.6 Procedures and Pharmacology 389 LO 11.12 Pharmacology Anticoagulants used to reduce or prevent blood clotting include: • Aspirin, which reduces platelet adherence and is used in small 81 mg doses to reduce the incidence of heart attack • Heparin, which prevents prothrombin and fibrin formation and is given parenterally; its dose is monitored by activated partial thromboplastin time (aPTT) • Warfarin (Coumadin), which inhibits the synthesis of prothrombin and others to act as an anticoagulant It is given by mouth and its dose is monitored by prothrombin times (PTs), which are reported as an International Normalized Ratio (INR) • Dabigatran etexilate (Pradaxa) and rivaroxaban (Xarelto), which inhibit the synthesis of thrombin and are given by mouth to reduce the risk of embolism and stroke in patients with nonvalvular atrial fibrillation (see Chapter 10) Idarucizumab (Praxbind injection) is available for patients using Pradaxa when reversal of its anticoagulant effects is needed for emergency surgery, for urgent procedures, or in life-threatening or uncontrolled bleeding • Streptokinase, derived from hemolytic streptococci, which dissolves the fibrin in blood clots Given intravenously within to hours of a heart attack, it is often effective in dissolving a clot that has caused the heart attack Recombinant Factor VIII, developed through recombinant DNA technology, is the main medication used to treat hemophilia A It is given intravenously through a vein in the arm or a port in the chest Desmopressin acetate (DDAVP) is a synthetic version of vasopressin that helps stop bleeding in patients with mild hemophilia Pernicious anemia is treated initially with injections of vitamin B12, and then the vitamin B12 can be given through a nasal gel Eltrombopag (Promacta) is available for pediatric patients with idiopathic thrombocytopenic purpura (ITP) who have not responded to corticosteroids, immunoglobulins, or splenectomy Most leukemias in both adults and children are treated with chemotherapy, often with added radiation therapy and a stem cell transplant 390 CHAPTER 11 Blood The Language of Hematology LO 11.12, 11.A Word Analysis and Definition WORD S = Suffix P = Prefix R = Root R/CF = Combining Form PRONUNCIATION adhere adherence add-HEER add-HEER-ents chemotherapy KEE-moh-THAIR-ah-pee embolism EM-boh-lizm parenteral pah-REN-ter-al recombinant DNA ELEMENTS DEFINITION Latin to stick to -ence forming, quality of adher- stick to To stick to something The act of sticking to something chem/o- chemical therapy treatment Treatment using chemical agents Greek a plug or patch A plug of tissue or air from afar that obstructs a blood vessel S/ P/ R/ -al pertaining to par- abnormal -enter- intestine Administering medication by any means other than the GI tract ree-KOM-bin-ant DEE-en-a S/ P/ R/ -ant forming re- again -combin- combine Deoxyribonucleic acid (DNA) altered by inserting a new sequence of DNA into the chain streptokinase strep-toh-KIE-nase P/ R/ strepto- curved -kinase enzyme An enzyme that dissolves clots vasopressin (also called antidiuretic hormone) vay-soh-PRESS-in S/ R/CF R/ -in chemical compound vas/o blood vessel -press- close, press Pituitary hormone that constricts blood vessels and decreases urinary output S/ R/ R/CF R/ Exercises A Describe the action of medications as they relate to hematology. Place the anticoagulant with the action it uses to prevent or reduce the formation of clots. LO 11.12, 11.A Pradaxa aspirin Coumadin streptokinase Xarelto heparin (has two actions, use the term twice) Dissolves fibrin in blood clots Decreases platelet adherence Inhibits synthesis of prothrombin Inhibits synthesis of thrombin B Match the therapy In the first column to the disorder it treats in the second column. LO 11.12 1 Vitamin B12 a idiopathic thrombocytopenic purpura 2 Promacta (eltrombopag) b mild hemophilia 3 desmopressin acetate c pernicious anemia 4 Recombinant Factor VIII d hemophilia A LESSON 11.6 Procedures and Pharmacology 391 Chapter 11 Review ©2014 Nucleus Medical Media Blood Challenge Your Knowledge A True or false. The following statements about blood are either true or false Choose T if the statement is true Choose F if the statement is false. (LO 11.1, 11.2) The formed elements of blood are RBCs, WBCs, platelets, and serum T F Buffer systems in the blood maintain the correct pH range T F Serum is identical to plasma except for the absence of clotting proteins T F Sickle cell anemia is a genetic disorder T F All cells exchange water by thrombosis T F Plasma is the fluid, noncellular part of blood T F The bloodstream is a liquid transport system T F Whole blood is less viscous than water T F Monocytes are the largest blood cells T F 10 Erythropoiesis occurs in bone spaces filled with red bone marrow T F B Medical terms may be similar in appearance. You need to use your knowledge of prefixes, roots, and suffixes to help determine the difference between similar terms Using the following terms, correctly insert them into the following paragraph Use the italicized words as a hint as to which term goes into the blank. (LO 11.3, 11.4) erythrocyte erythroblast erythroblastosis erythropoiesis erythropoietin The immature RBC (1) ( ) undergoes the process of formation (2) ( ) in the red bone marrow Too many immature cells result in a condition known as (3) A mature RBC is called an (4) The hormone (5) controls the rate of RBC production C Pharmacology of blood clotting. Anyone working with patients must know about prescribed drugs and their function Match the drug action in the first column with the correct drug in the second column. (LO 11.12) Dissolves fibrin in blood clots a heparin 2 Reduces platelet adherence b Xarelto 3 Prevents prothrombin and fibrin formation c Coumadin 4 Inhibits formation of prothrombin d streptokinase 5 Inhibits synthesis of thrombin e aspirin 392 CHAPTER 11 REVIEW Blood D How well you understand what you read? First, read the paragraph aloud to check your pronunciation Enter the term found in the paragraph in the left column of the chart next to its correct meaning. (LO 11.A, 11.B) When a lab tech takes a blood sample, he spins it in a centrifuge Formed elements are separated from the colloidal suspension and are packed into the bottom of the tube The patient’s hematocrit can be determined from this test Whole blood contains all the formed elements Transfusions can be done with either whole blood or only certain portions of the formed elements—only transfusing RBCs or platelets, for instance The remaining part (55%) of a blood sample is the plasma, which is mostly water Plasma provides the fluid transport for the formed elements as well as nutrients, hormones, and enzymes for body cells Waste cell products dissolve in plasma and are excreted through the kidneys and liver Term Meaning 1 percentage of RBCs in the blood 2 liquid containing particles that not settle 3 introduction of blood or a blood component into a vein 4 something life sustaining 5 blood clotting cell 6 instrument for separating a blood sample 7 stimulates function of an organ or tissue 8 erythrocyte 9 liquid transport system 10 induces chemical changes in other substances E List the different blood types in the ABO blood group. Be sure to note which type is the “universal donor” and which type is the “universal recipient.” Fill in the blanks. (LO 11.9) The two major antigens on the cell surface are antigen A and antigen B A person with only antigen A has type blood A person with only antigen B has type blood A person with both antigen A and antigen B has type blood A person with neither antigen A nor antigen B has type blood Because the blood type in question has neither antigen, it is compatible with any blood type; therefore, it is the universal (donor/recipient) Because the blood type in question has both antigens, it is the universal (donor/recipient) CHAPTER 11 REVIEW Blood 393 Chapter 11 Review ©2014 Nucleus Medical Media Blood F Build medical terms from the following group of elements. The definition is given to you; fill in the medical term You will not use every element, and some you may use twice Fill in the blanks. (LO 11.A, LO 11.C) Use a combination of these elements to complete the terms: ic micro auto osis hypo crit ox ary cyte thrombo macro ar erythro cyt Another name for an RBC erythro/ Pertaining to a small cell /cyt/ Blood transfusion with the same person as both donor and recipient /logous Large RBC /cyte Percentage of RBCs in blood hemato/ Same as a platelet /cyte Formation of a clot thromb/ G Test your knowledge of blood, blood groups, and Rh factor by choosing the correct answer to the following questions. Select the answer that correctly completes each sentence. (LO 11.9) A person with both antigen A and antigen B will have Blood is said to be Rh-positive if a blood type O a the Rh antigen is present on the RBC surface b blood type A b the Rh antibody is present in the blood type c blood type B c the Rh antibody is present in the plasma d blood type AB d the Rh antigen is present on the WBCs e blood type B– e the blood type is AB Where are antibodies synthesized after birth? Agglutination occurs when a in the heart a you have not been vaccinated b in the blood b you are given the wrong blood type c in the arteries c your antibodies are low d in the plasma d your hematocrit is high e in the veins e you are Rh-positive What normally prevents maternal and fetal blood from The term transfusion is used only for mixing during pregnancy? a plasma a cell membranes b whole blood b the peritoneum c blood or a blood component c the placenta d saline solution d the amniotic sac e intravenous (IV) antibiotics e the matrix 394 CHAPTER 11 REVIEW Blood H Multiple choice. Use the language of hematology to answer the following questions Remember that in the case of multiple choice, there is only one best answer. (LO 11.1, 11.2, 11.5, 11.6, 11.10, 11.11 11.D) Blood volume varies with In the term erythrocyte, the combining form means a your body size a yellow b your weight b red c the amount of your connective tissue c white d the amount of your erythrocytes d black e your height e blue The percentage of erythrocytes in a blood sample is called the Heparin is an a hemoglobin a antidepressant b hematocrit b antihistamine c hematemesis c antibody d hemolysis d anticoagulant e hemostasis e antibiotic In the term hypochromic, the root means Which of these terms cannot be connected with blood? a blood a liquid matrix b center b complete blood count c color c formed elements d glue d infusion e air e transfusion How many types of leukocytes also qualify as granulocytes? The largest leukocyte is a one a monocyte b two b macrophage c three c eosinophil d four d basophil e five e neutrophil Myeloid leukemia is a disorder of 10 What is plasma minus its protein fibrinogen? a erythrocytes a hemoglobin b leukocytes b antithrombin c platelets c plasmin d plasma d serum e hemoglobin e a formed element CHAPTER 11 REVIEW Blood 395 Chapter 11 Review ©2014 Nucleus Medical Media Blood I There are many diseases associated with the various components of blood. Select the correct answer in the following descriptions; then, on the blanks, write in which blood component is associated with the disease you circled Use RBC, WBC, and P (for platelet) for blood component notations. (LO 11.4, 11.6, 11.8, 11.F) Blood Component Chronic bleeding from the gastrointestinal tract can cause a. iron-deficiency anemia b. pernicious anemia c. sickle cell anemia A deficiency of a specific protein of the factor VIII complex is a. thrombus b. von Willenbrand disease c. iron-deficiency anemia Cancer of the hematopoietic tissues is called a. leukemia b. lukemia c. lukemmia A disease resulting from vitamin B12 deficiency is a. pernicious anemia b. hemolytic anemia c. polycythemia vera A disease males inherit from their mothers is a. hemmaphilia b. hemophilia c. hemmophilia A hereditary disease found mostly in people of African descent is a. sickle cell anemia b. iron-deficiency anemia c. polycythemia vera In this disease, numerous small clots form and obstruct blood flow into organs: a. DIC b. vWD c. EBV This is seen in viral infections such as influenza: a. leukopenia b. leukocytosis c. leukemia Low blood cell count that produces a tendency to bleed is a. thrombocitopenia b. thrombocytopenia c. thrombocytopennia 10 Destruction of blood cells by toxic substances is a. polycythemia vera b. hemolytic anemia c. pernicious anemia J Demonstrate your knowledge of word elements by deconstructing the following medical terms. Place each word element from the medical term to its correct type If the term does not have a particular element, write n/a. (LO 11.D) Term agranulocyte hypochromic monocytosis poikilocytic precursor microcytic pancytopenia Prefix 1 4 7 10 13 16 19 Root/Combining Form 2 5 8 11 14 17 20 Suffix 3 6 9 12 15 18 21 K Write the terms next to the appropriate statement that follows. Fill in the blanks. LO 11.3, 11.4, 11.6, 11.12 That which comes before something Pertaining to a small cell Decreased number of erythrocytes Pigmented protein in erythrocytes Excessively high leukocyte count Deficiency of all formed elements in the blood Increase in the number of monocytes in the blood Pertaining to an erythrocyte of irregular shape 396 CHAPTER 11 REVIEW Blood L With the possible exception of the appendix, everything in the body has a function. The functions are listed as follows Assign each a letter for the blood component that performs the function. (LO 11.2, 11.3, 11.5, 11.7) Functions a A function of an erythrocyte b A function of a leukocyte c A function of a platelet d A function of plasma Assign one of the previous functions to each of the following statements: Fill in the blank with the correct letter that corresponds to each function Transport oxygen Help maintain hemostasis Migrate to damaged tissues and release histamine Carry nutrients, hormones, and enzymes to cells Dissolve cellular waste products Secrete lysozymes Transport carbon dioxide Seal off injury and hemorrhage Provide fluid environment to formed elements 10 Transport nitric oxide M After rereading Case Report 11.4, answer the following questions (LO 11.3, 11.4, 11.11, 11.A) Case Report (CR) 11.4 You are . an emergency medical technician–paramedic (EMT-P) working in the Level One Trauma Unit at Fulwood Medical Center Your patient is . Ms Joanne Rodi, an 18-year-old student Ms Rodi has been admitted to the unit from the operating room after surgery for multiple fractures in a car accident She is receiving a blood transfusion You document that her temperature has risen to 102°F and her respirations to 24 per minute and she has chills You take her BP; it has fallen to 90/60 What should you do? In Miss Rodi’s case, she has type A blood and, by mistake, received type AB blood, which agglutinated Your immediate response is to stop the transfusion, replace it with a saline infusion, call your supervisor, and notify the doctor What does it mean when blood has agglutinated? What specific antigen did Miss Rodi’s type A blood react to? Is her blood pressure within normal limits, too high, or too low? What medical term describes her blood pressure condition? What is the difference between a transfusion and an infusion? CHAPTER 11 REVIEW Blood 397 ... Pharmacology 348 Chapter 10 Review 356 CHAPTER 11 Blood: The Language of Hematology 364 ©2 014 Nucleus Medical Media Lesson 11 .1 Lesson 11 .2 Lesson 11 .3 Lesson 11 .4 Lesson 11 .5 Lesson 11 .6 Components of... Pharmacology 416 Chapter 12 Review 420 ©2 014 Nucleus Medical Media CHAPTER 13 Respiratory System: The Language of Pulmonology 426 Lesson 13 .1 Lesson 13 .2 Lesson 13 .3 Lesson 13 .4 ©2 014 Nucleus Medical. . .Medical Language For Modern Health Care Fou rth Ed it ion David M Allan, MA, MD Rachel C Basco, MS, RRT Bossier Parish Community College MEDICAL LANGUAGE FOR MODERN HEALTH CARE, FOURTH