Body Structure - Chapter 5 PDF

Body Structure Chapter Outline Objectives Introduction Body Structure Key Terms Levels of Organization Cell Cell Membrane and Cytoplasm Nucleus Tissue Organ System Organism Anatomical Position Planes of the Body Body Cavities Abdominopelvic Divisions Quadrants Regions Spine Directional Terms Medical Word Elements Pathology Diagnostic, Symptomatic, and Related Terms Diagnostic and Therapeutic Procedures Abbreviations Learning Activities Medical Record Activities Radiological consultation letter: Cervical and lumbar spine Radiology report: Injury of left wrist, elbow, and humerus CHAPTER 4 Objectives Upon completion of this chapter, you will be able to: List the levels of organization of the body. Define and identify the three planes of the body. Identify the cavities, quadrants, and regions of the body. List and identify the terms related to direction, position, and planes of the body. Recognize, pronounce, spell, and build words related to body structure and identify common abbreviations. Describe diagnostic and therapeutic procedures and other terms associated with body structure. Demonstrate your knowledge of this chapter by completing the learning and medical record activities. 40 CHAPTER 4 Body Structure Introduction This chapter provides the basic foundation for understanding the body system chapters that follow. It presents the basic structural and functional organization of the body—from the cellular level to the organism level. It also presents terms used to describe planes of the body, body cavities, quad- rants and regions of the abdominal cavity, and divisions of the spinal column. These terms are an essential part of medical terminology and are used in all body systems. General concepts of pathology and terminology associated with the disease process are also provided. Finally, this chapter presents and describes terms associated with diagnostic and therapeutic procedures. Body Structure Key Terms This section introduces important terms associated with body structure, along with their definitions and pronunciations. Word analyses are also provided for selected terms. Term Definition chromatin Structural component of the nucleus, composed of nucleic acids and proteins Chromatin condenses to form chromosomes during cell division. KRŌ-mă-tı̆n chromosome KRŌ-mō-sōm cytoplasm SĪ-t ō-plăzm cyt/o: cell -plasm: formation, growth deoxyribonucleic acid (DNA) dē-ok-sē-rē-b¯ō-noo-KLĒ-ı̆k ĂS-ı̆d diaphragm DĪ-ă-frăm metabolism mĕ-TĂB-ō-lı̆zm organelle or-găn-ĔL pathology pă-THŎL-ō-jē path/o: disease -logy: study of Threadlike structures within the nucleus composed of a deoxyribonucleic acid (DNA) molecule that carries hereditary information encoded in genes Each sperm and each egg has 23 unpaired chromosomes. After fertilization, each cell of the embryo then has 46 chromosomes (23 pairs). In each pair of chromosomes, one chromosome is inherited from the father and the other from the mother. Jellylike substance found within the cell membrane composed of proteins, salts, water, dissolved gases, and nutrients All cellular structures, including the nucleus and organelles, are embedded in cytoplasm. Molecule that holds genetic information capable of replicating and producing an exact copy whenever the cell divides Muscular wall that divides the thoracic cavity from the abdominopelvic cavity Alternating contraction and relaxation of the diaphragm is essential to the breathing process. Sum of all physical and chemical changes that take place in a cell or an organism Metabolism includes the building up (anabolism) and breaking down (catabolism) of body constituents. Cellular structure that provides a specialized function, such as the nucleus (reproduction), ribosomes (protein synthesis), Golgi apparatus (removal of material from the cell), and lysosomes (digestion) The membranes of many organelles act as sites of chemical reactions. Study of the nature of diseases, their causes, development, and consequences. Pathology as a branch of medicine includes the use of laboratory methods rather than clinical examination of signs and symptoms to study the causes, nature, and development of diseases. Levels of Organization 41 Body Structure Key Terms—cont’d Term Definition peristalsis Rhythmic contraction and relaxation of the walls of a tubular organ to propel its contents onward pĕr-ı̆-STĂL-sı̆s Pronunciation Help Long Sound Short Sound ā—rate ă—alone ē—rebirth ĕ—ever Levels of Organization The body is made up of several levels of structure and function. Each of these levels builds on the previous level, and contributes to the structure and function of the entire organism. (See Figure 4–1.) The levels of organization from least to most complex are: cell tissue organ system organism. Cell The study of the body at the cellular level is called cytology. The cell is the structural and functional unit of life. Body cells perform all activities associated with life, including utilizing food, eliminating waste, and reproducing. Cells consist of a cell membrane that encloses cytoplasm and a nucleus. Cell Membrane and Cytoplasm The cell membrane acts as a barrier that encloses the entire cell. It controls the transport of many substances to and from the cell. Within the cell membrane is a jellylike matrix of proteins, salts, water, dissolved gases, and nutrients called cytoplasm. Inside the cytoplasm are various structures called organelles that provide specialized functions for the cell. The largest cell organelle is the nucleus. Nucleus The nucleus is responsible for metabolism, growth, and reproduction. It also carries the genetic blueprint of the organism. This blueprint is found in a complex molecule called deoxyribonucleic acid (DNA) that is organized into threadlike structures called chromatin. When the cell is ready to divide, chromatin forms chromosomes, which carry thousands of genes that make up our genetic blueprint. In the human, there are about 31,000 genes that determine unique human characteristics. Genes ı̄—isle ı̆—it ō—over ŏ—not ū—unite ŭ—cut pass biological information from one generation to the next. This biological information includes such traits as hair color, body structure, and metabolic activity. In the human, all cells except sperm cells and egg cells contain 23 pairs, or 46 chromosomes. Tissue Groups of cells that perform a specialized activity are called tissues. The study of tissues is called histology. Between the cells that make up tissues are varying amounts and types of nonliving, intercellular substances that provide pathways for cellular interaction. More than 200 cell types compose four major tissues of the body: Epithelial tissue covers surfaces of organs, lines cavities and canals, forms tubes and ducts, provides the secreting portions of glands, and makes up the epidermis of the skin. It is composed of cells arranged in a continuous sheet consisting of one or more layers. Connective tissue supports and connects other tissues and organs. It is made up of diverse cell types, including fibroblasts, fat cells, and blood. Muscle tissue provides the contractile tissue of the body, which is responsible for movement. Nervous tissue transmits electrical impulses as it relays information throughout the entire body. Organ Organs are body structures that perform specialized functions. They are composed of at least two or more tissue types. For example, the stomach is made up of connective tissue, muscle tissue, epithelial tissue, and nervous tissue. Muscle and connective tissue form the wall of the stomach. Epithelial and connective tissue cover the inner and outer surfaces of the stomach. Nervous tissue 42 CHAPTER 4 Body Structure Organism level Cellular level Tissue level System level Organ level Figure 4-1. Levels of organization of the human body. Abdominopelvic Divisions penetrates the epithelial lining of the stomach and its muscular wall to stimulate the release chemicals for digestion and contraction for peristalsis. System A body system is composed of varying numbers of organs and accessory structures that have similar or related functions. For example, organs of the gastrointestinal system include the esophagus, stomach, small intestine, and bowel. Some of its accessory structures include the liver, gallbladder, and pancreas. The purpose of this system is to digest food, remove and use its nutrients, and expel waste products. Other body systems include the reproductive, respiratory, urinary, and cardiovascular systems. Table 4-1 43 Planes of the Body This table lists planes of the body and their anatomical divisions. Plane Anatomical Division Midsagittal (median) Right and left halves Coronal (frontal) Anterior (ventral) and posterior (dorsal) aspects Transverse (horizontal) Superior (upper) and inferior (lower) aspects The highest level of organization is the organism. An organism is a complete living entity capable of independent existence. All complex organisms, including humans, are made up of several body systems that work together to sustain life. (MRI) and computed tomography (CT), produce three-dimensional images on more than one plane. Thus, structural abnormalities and body masses that were previously not found using a standard single plane x-ray are now detected with scanning devices that show images taken in several body planes. Anatomical Position Body Cavities The anatomical position is a body posture used to locate anatomical parts in relation to each other. In this position, the body is erect and the eyes are looking forward. The upper limbs hang to the sides, with the palms facing forward. The lower limbs are parallel, with toes pointing straight ahead. No matter how the body is actually positioned—standing or lying down, facing forward or backward—or how the limbs are actually placed, the positions and relationships of a structure are always described as if the body were in the anatomical position. Medical professionals locate structures or abnormalities by referring to the body cavity in which they are found. (See Figure 4–3.) The body has two major cavities: Organism Planes of the Body To identify the different sections of the body, anatomists use an imaginary flat surface called a plane. The most commonly used planes are midsagittal (median), coronal (frontal), and transverse (horizontal). (See Table 4–1.) The section is named for the plane along which it is cut. Thus, a cut along a transverse plane produces a transverse, or horizontal, section. (See Figure 4–2.) Prior to the development of modern imaging techniques, standard x-ray images showed only a single plane, and many body abnormalities were difficult, if not impossible, to see. Current imaging procedures, such as magnetic resonance imaging dorsal (posterior), including the cranial and spinal cavities ventral (anterior), including the thoracic and abdominopelvic cavities. (See Table 4–2.) Abdominopelvic Divisions The abdominopelvic area of the body lies beneath the diaphragm. It holds the organs of digestion (abdominal area) and the organs of reproduction and excretion (pelvic area). Two anatomical methods are used to divide this area of the body for medical purposes: quadrants regions. Quadrants Quadrants are four divisions of the lower torso used to show topographical location. They provide a means of locating specific sites for descriptive and diagnostic purposes. (See Table 4–3.) The 44 CHAPTER 4 Body Structure Superior Posterior Midsagittal (median) plane Anterior Coronal (frontal) plane Transverse (horizontal) plane Medial Lateral Inferior Figure 4-2. Body planes. Note that the body is in the anatomical position. divisions of quadrants are used in clinical examinations and medical reports. Pain, lesions, abrasions, punctures, and burns are commonly described as located in a specific quadrant. Incision sites are also identified by using body quadrants as the method of location. An imaginary cross passing through the navel identifies the four quadrants. (See Figure 4–4A.) Regions Whereas the quadrants of the body are used primarily to identify topographical sites, the abdominopelvic regions are used mainly to identify the location of underlying body structures and visceral organs. (See Table 4–4.) For example, the stomach is located in the left hypochondriac and epigastric region; the appendix is located in the hypogastric region. (See Figure 4–4B.) Spine The spine is divided into sections corresponding to the vertebrae located in the spinal column. These divisions are: cervical (neck) thoracic (chest) lumbar (loin) sacral (lower back) coccyx (tailbone) Directional Terms Directional terms are used to show the position of a structure in relation to another structure. For example, the kidneys are superior to the urinary bladder. The directional phrase superior to denotes above. This example indicates that the kidneys are located above the urinary bladder. (See Table 4–5.) Directional Terms 45 Cranial Dorsal Spinal Thoracic Diaphragm Abdominal Ventral Abdominopelvic Pelvic Figure 4-3. Body cavities. Table 4-2 Body Cavities This table lists the body cavities and some of the major organs found within them. The thoracic cavity is separated from the abdominopelvic cavity by a muscular wall called the diaphragm. Table 4-3 Cavity Major Organ(s) in the Cavity Dorsal Cranial Brain Spinal Spinal cord Ventral Thoracic Heart, lungs, and associated structures Abdominopelvic Digestive, excretory, and reproductive organs and structures Body Quadrants This table lists the quadrants of the body, their corresponding abbreviations, and their major structures. Quadrant Abbreviation Major Structures Right upper RUQ Right lobe of liver, gallbladder, part of pancreas, part of small and large intestines Left upper LUQ Left lobe of liver, stomach, spleen, part of pancreas, part of small and large intestines Right lower RLQ Part of small and large intestines, appendix, right ovary, right fallopian tube, right ureter Left lower LLQ Part of small and large intestines, left ovary, left fallopian tube, left ureter 46 CHAPTER 4 Body Structure A. B. Right hypochondriac region Right upper quadrant Left upper quadrant Right lower quadrant Left lower quadrant Right lumbar region Epigastric region Left hypochondriac region Umbilical region Left lumbar region Right inguinal Hypogastric Left inguinal (iliac) region region (iliac) region Figure 4-4. Quadrants and regions. (A) Four quadrants of the abdomen. (B) Nine regions of the abdomen. Table 4-4 Abdominopelvic Regions This table lists the names of the abdominopelvic regions and their location. Region Location Left hypochondriac Upper left region beneath the ribs Epigastric Region above the stomach Right hypochondriac Upper right region beneath the ribs Left lumbar Left middle lateral region Umbilical Region of the navel Right lumbar Right middle lateral region Left inguinal (iliac) Left lower lateral region Hypogastric Lower middle region beneath the navel Right inguinal (iliac) Right lower lateral region It is time to review the planes of the body and quadrants and regions of the abdominopelvic area by completing Learning Activities 4–1 and 4–2. Table 4-5 Directional Terms This table lists directional terms along with their definitions. In this list, opposing terms are presented consecutively to aid memorization. Term Definition Abduction Adduction Movement away from the midsagittal (median) plane of the body or one of its parts Movement toward the midsagittal (median) plane of the body 47 Directional Terms Table 4-5 Directional Terms—cont’d Term Definition Medial Lateral Pertaining to the midline of the body or structure Pertaining to a side Superior (cephalad) Inferior (caudal) Toward the head or upper portion of a structure Away from the head, or toward the tail or lower part of a structure Proximal Distal Nearer to the center (trunk of the body) or to the point of attachment to the body Further from the center (trunk of the body) or from the point of attachment to the body Anterior (ventral) Posterior (dorsal) Front of the body Back of the body Parietal Visceral Pertaining to the outer wall of the body cavity Pertaining to the viscera, or internal organs, especially the abdominal organs Prone Supine Lying on the abdomen, face down Lying horizontally on the back, face up Inversion Eversion Turning inward or inside out Turning outward Palmar Plantar Pertaining to the palm of the hand Pertaining to the sole of the foot Superficial Deep Toward the surface of the body (external) Away from the surface of the body (internal) It is time to review body cavity, spine, and directional terms by completing Learning Activity 4–3. Medical Word Elements This section introduces combining forms, suffixes, and prefixes related to body structure. Word analyses are also provided. Element Meaning Word Analysis cyt/o cell cyt/o/logist (sı̄-TŎL- ō-jı̆st): specialist in study of cells -logist: specialist in the study of Cytologists study the formation, structure, and function of cells. hist/o tissue hist/o/logy (hı̆s-TŎL-ō-jē): study of tissues -logy: study of Histology is the branch of science that investigates the microscopic structures and functions of tissues. kary/o nucleus kary/o/lysis (kăr- ē- ŎL-ı̆-sı̆s): destruction of the nucleus -lysis: separation; destruction; loosening Karyolysis results in death of the cell. Combining Forms Cellular Structure nucle/o nucle/ar (NŪ-kl ē-ăr): pertaining to the nucleus -ar: pertaining to (continued) 48 CHAPTER 4 Body Structure Medical Word Elements—cont’d Element Meaning Word Analysis anter/o anterior, front anter/ior (ăn-TĒR-ē-or): pertaining to the front -ior: pertaining to caud/o tail caud/ad (KAW-d ăd): toward the tail -ad: toward Caudad is opposite of craniad. crani/o cranium (skull) crani/al (KR Ā-nē-ăl): pertaining to the cranium -al: pertaining to dist/o far, farthest dist/al (DĬS-tăl): pertaining to the farthest (point of attachment) -al: pertaining to Distal refers to the point furthest from the center (trunk) of the body or from the point of attachment to the body. Thus, the f ingers are distal to the wrist. dors/o back (of body) dors/al (DOR-săl): pertaining to the back (of the body) -al: pertaining to infer/o lower, below infer/ior (ı̆n-FĒR-rē-or): pertaining to a lower (structure or surface) -ior: pertaining to The inferior surface is the undersurface of a structure or organ, or a place below a structure or organ. later/o side, to one side later/al (LĂT-ĕr-ăl): pertaining to a side -al: pertaining to medi/o middle poster/o back (of body), poster/ior (pōs-TĒR-ē-or): pertaining to the back (of the body) behind, posterior -ior: pertaining to proxim/o near, nearest proxim/al (PRŎK-sı̆m-ăl): pertaining to the nearest (point of attachment) -al: pertaining to Proximal refers to the point closest to the center (trunk) of the body or to the point of attachment to the body. Thus, the elbow is proximal to the wrist. ventr/o belly, belly side ventr/al (VĔN-trăl): pertaining to the belly side (front of the body) -al: pertaining to abdomin/o abdomen abdomin/al (ăb-D ŎM-ı̆-năl): pertaining to the abdomen -al: pertaining to cervic/o neck; cervix uteri (neck of uterus) cervic/al (SĔR-vı̆-kăl): pertaining to the neck -al: pertaining to Position and Direction medi/ad (MĒ-d ē-ăd): toward the middle -ad: toward Regions of the Body 49 Directional Terms Medical Word Elements—cont’d Element Meaning Word Analysis crani/o cranium (skull) crani/al (KRĀ-nē-ăl): pertaining to the cranium -al: pertaining to gastr/o stomach hypo/gastr/ic (hı̄-pō-G ĂS-trı̆k): pertaining to (the area) below the stomach hypo-: under, below -ic: pertaining to ili/o ilium (lateral, flaring portion of hip bone) ili/al (ĬL-ē-ăl): pertaining to the ilium -al: pertaining to inguin/o groin inguin/al ( ĬNG-gwı̆-năl): pertaining to the groin -al: pertaining to The groin is the depression located between the thigh and trunk. lumb/o loins (lower back) lumb/ar (LŬM-băr): pertaining to the loins (lower back) -ar: pertaining to pelv/i pelvis pelv/i/meter* (p ĕl-V ĬM- ĕ-t ĕr): instrument for measuring the pelvis -meter: instrument for measuring pelv/ic (PĔL-vı̆k): pertaining to the pelvis -ic: pertaining to spin/o spine spin/al (SPĪ-năl): pertaining to the spine -al: pertaining to thorac/o chest thorac/ic (th ō-RĂS-ı̆k): pertaining to the chest -ic: pertaining to umbilic/o umbilicus, navel umbilic/al (ŭm-BĬL-ı̆-kăl): pertaining to the navel -al: pertaining to pelv/o Color albin/o white leuk/o albin/ism ( ĂL-bı̆n-ı̆zm): condition of whiteness -ism: condition Albinism is characterized by a partial or total lack of pigment in the skin, hair, and eyes. leuk/o/cyte (LOO-kō-sı̄t): white cell -cyte: cell A leukocyte is a white blood cell. chlor/o green chlor/opia (klō-RŌ-p ē-ă): green vision -opia: vision Chloropia is a disorder in which viewed objects appear green. It is associated with a toxic reaction to digitalis. chrom/o color hetero/chrom/ic (hĕt-ĕr-ō-KRŌ-mı̆k): pertaining to different colors hetero-: different -ic: pertaining to Heterochromia is associated with the iris or sections of the iris of the eyes. Thus, the individual with heterochromia may have one brown iris and one blue iris. (continued) 50 CHAPTER 4 Body Structure Medical Word Elements—cont’d Element Meaning Word Analysis cirrh/o yellow cirrh/osis (sı̆r-RŌ-sı̆s): abnormal yellowing -osis: abnormal condition; increase (used primarily with blood cells) ln cirrhosis, the skin, sclera of the eyes, and mucous membranes take on a yellow color. Cirrhosis of the liver is usually associated with alcoholism or chronic hepatitis. jaund/o jaund/ice ( JAWN-dı̆s): yellowing -ice: noun ending Jaundice is caused by an abnormal increase of bilirubin (a yellow compound formed when red blood cells are destroyed) in the blood. xanth/o xanth/o/cyte (Z ĂN-thō-sı̄t): yellow cell -cyte: cell cyan/o blue cyan/o/tic (sı̄-ăn-ŎT-ı̆k): pertaining to blueness -tic: pertaining to Cyanosis is associated with lack of oxygen in the blood. erythr/o red erythr/o/cyte (ĕ-RĬTH-r ō-sı̄t): red cell -cyte: cell An erythrocyte is a red blood cell. melan/o black melan/oma (mĕl-ă-NŌ-mă): black tumor -oma: tumor Melanoma is a malignancy that arises from melanocytes. poli/o gray; gray matter (of brain or spinal cord) poli/o/myel/itis (pōl-ē-ō-mı̄-ĕl-Ī-tı̆s): inflammation of the gray matter of the spinal cord myel: bone marrow; spinal cord -itis: inflammation acr/o extremity acr/o/cyan/osis (ăk-rō-sı̄-ă-NŌ-sı̆s): abnormal condition in which the extremities are blue cyan: blue -osis: abnormal condition; increase (used primarily with blood cells) eti/o cause eti/o/logy (ē-t ē-ŎL-ō-j ē): study of the causes of disease -logy: study of idi/o unknown, peculiar idi/o/path/ic (ı̆d-ē-ō-PĂTH-ı̆k): pertaining to an unknown (cause of ) disease path: disease -ic: pertaining to morph/o form, shape, structure morph/o/logy (mor-FŎL-ō-j ē): study of form, shape, or structure -logy: study of path/o disease path/o/logist (pă-THŎL-ō-jı̆st): specialist in the study of disease -logist: specialist in the study of Pathologists examine tissues, cells, and body fluids for evidence of disease. Other 51 Directional Terms Medical Word Elements—cont’d Element Meaning Word Analysis radi/o radiation, x-ray; radi/o/logist (rā-dē-ŎL- ŏ-jı̆st): specialist in the study of radiation radius (lower -logist: specialist in the study of arm bone on Radiologists are physicians who employ imaging techniques for diagnosing and thumb side) treating disease. somat/o body somat/ic (s¯ō-MĂT-ı̆k): pertaining to the body -ic: pertaining to son/o sound son/o/graphy (s ō-NŎG-ră-f ĕ): process of recording sound; also called ultrasonography -graphy: process of recording Sonography employs ultrasound (inaudible sound) to produce images. It is a painless, noninvasive imaging technique that does not use x-rays. viscer/o internal organs viscer/al (VĬS-ĕr-ăl): pertaining to internal organs -al: pertaining to xer/o dry xer/osis (z ē-RŌ-sı̆s): abnormal condition of dryness -osis: abnormal condition; increase (used primarily with blood cells) Xerosis refers to abnormal dryness of the skin, mucous membranes, or conjunctiva. -genesis forming, producing, origin path/o/genesis (păth-ō-JĔN-ĕ-sı̆s): origin of disease path/o: disease Pathogenesis refers to the origin or cause of an illness or abnormal condition. -gnosis knowing pro/gnosis (pr ŏg-NŌ-sı̆s): knowing before pro-: before, in front of Prognosis is the prediction of the course and end of a disease and the estimated chance of recovery. -gram record, writing arteri/o/gram (ăr-TĒ-r ē-ō-grăm): record of an artery An arteriogram is an x-ray f ilm of an artery taken after injection of a radiopaque contrast medium. -graph instrument for recording radi/o/graph (RĀ-dē-ō-grăf ): instrument for recording x-rays radi/o: radiation, x-rays; radius (lower arm bone on thumb side) -graphy process of recording arthr/o/graphy (ăr-THRŎG-ră-f ē): process of recording a joint arthr/o: joint Arthrography is an x-ray examination of a joint, such as the knee, shoulder, or elbow, usually with the use of a contrast medium. -logist specialist in the dermat/o/logist (dĕr-mă-TŎL-ō-jı̆st): specialist in the study of the skin dermat/o: skin study of -logy study of hemat/o/logy (hē-mă-TŎL-ō-jē): study of blood hemat/o: blood -meter instrument for measuring therm/o/meter (thĕr-MŎM-ĕ-tĕr): instrument for measuring heat therm/o: heat Suffixes (continued) 52 CHAPTER 4 Body Structure Medical Word Elements—cont’d Element Meaning Word Analysis -metry act of measuring ventricul/o/metry (v ĕn-trı̆k-ū-LŎM- ĕ-tr ē): act of measuring the ventricles ventricul/o: ventricle (of heart or brain) -pathy disease gastr/o/pathy (g ăs-TRŎP-ă-th ē): disease of the stomach gastr/o: stomach ab- from, away from ab/duction (ăb-DŬK-shŭn): act of bringing away from (midline of the body) -duction: act of leading, bringing, conducting Abduction is the movement of a limb or body part away from the midline of the body. ad- toward ad/duction (ă-DŬK-shŭn): act of bringing toward (midline of the body) -duction: act of leading, bringing, conducting Adduction is the movement of a limb toward the midline of the body. hetero- different hetero/morph/ous (hĕt-ĕr-ō-MOR-f ŭs): different form or shape morph: form, shape, structure -ous: pertaining to Heteromorphous refers to any deviation from a normal type or shape. homeo- same, alike homeo/plasia (hō-m ē-ō-PLĀ-z ē-ă ): formation of same (tissue) -plasia: formation, growth Homeoplasia is the formation of new tissue similar to that already existing in a part. infra- below, under infra/cost/al (ı̆n-fră-KŎS-tăl): pertaining to (the area) below the ribs cost: ribs -al: pertaining to peri- around peri/cardi/al (pĕr-ı̆-KĂR-dē-ăl): pertaining to (the area) around the heart cardi: heart -al: pertaining to super- upper, above super/ior (soo-PĒ-r ē-or): pertaining to the upper (area) -ior: pertaining to trans- across, through trans/abdomin/al (trăns-ăb-DŎM-ı̆-năl): pertaining to (a direction) across or through the abdomen abdomin: abdomen -al: pertaining to ultra- excess, beyond ultra/son/ic (ŭl-tră-S ŎN-ı̆k): pertaining to beyond (audible) sound son: sound -ic: pertaining to Ultrasound includes sound frequencies too high to be perceived by the human ear. Prefixes *The i in pelv/i/meter is an exception to the rule of using the connecting vowel o. It is time to review medical word elements by completing Learning Activity 4–4. Pathology Pathology All body cells require oxygen and nutrients for survival. They also need a stable internal environment that provides a narrow range of temperature, water, acidity, and salt concentration. This stable internal environment is called homeostasis. When homeostasis is disrupted and cells, tissues, organs, or systems are unable to function effectively, the condition is called disease. From a clinical point of view, disease is a pathological or morbid condition that presents a group of signs, symptoms, and clinical findings. Signs are objective indicators that are observable. A palpable mass and tissue redness are examples of signs. A symptom is subjective and is experienced only by the patient. Dizziness, pain, and malaise are examples of symptoms. Clinical findings are the results of radiologic, laboratory, and other medical procedures performed on the patient or his specimens. Etiology is the study of the cause or origin of a disease or disorder. Some possible causes of 53 diseases include: metabolic (such as diabetes) infectious (such as measles and mumps) congenital (such as cleft lip) hereditary (such as hemophilia) environmental (such as burns and trauma) neoplastic (such as cancer) Establishing the cause and nature of a disease is called diagnosis (Dx). Determining a diagnosis helps in the selection of a treatment. A prognosis is the prediction of the course of a disease and its probable outcome. Any disease whose cause is unknown is said to be idiopathic. A variety of diagnostic procedures are used to identify diseases and determine their extent or involvement. Diagnostic tests can be simple, such as listening to chest sounds with a stethoscope, or complex, such as a biopsy. Many of the diagnostic tests listed in this text can be categorized as surgical, clinical, endoscopic, laboratory, and radiological. Some tests include more than one testing modality. Abbreviations Diagnostic, Symptomatic, and Related Terms This section introduces diagnostic, symptomatic, and related terms and their meanings. Word analyses for selected terms are also provided. Term Definition adhesion Abnormal fibrous band that holds or binds together tissues that are normally separated Adhesions may occur within body cavities as a result of surgery. ăd-HĒ-zhŭn analyte ĂN-ă-lı̄t contrast medium KŎN-trăst M ĒD- ē-ŭm dehiscence Substance analyzed or tested, generally by means of laboratory methods In a glucose tolerance test, glucose is the analyte. Substance injected into the body, introduced via catheter, or swallowed to facilitate radiographic images of internal structures that otherwise are difficult to visualize on x-ray films Bursting open of a wound, especially a surgical abdominal wound dĕ-H ĬS-ĕns febrile Feverish; pertaining to a fever FĒ-brı̆l homeostasis hō-mē-ō-STĀ-sı̆s homeo-: same, alike -stasis: standing still Relative constancy or balance in the internal environment of the body, maintained by processes of feedback and adjustment in response to external or internal changes In homeostasis, such properties as temperature, acidity, and the concentrations (continued) of nutrients and wastes remain relatively constant. 54 CHAPTER 4 Body Structure Diagnostic, Symptomatic, and Related Terms—cont’d Term Definition inflammation Body defense against injury, infection, or allergy that is marked by redness, swelling, heat, pain and, sometimes, loss of function Inflammation is one mechanism used by the body to protect against invasion by foreign organisms and to repair injured tissue. ı̆n-flă-MĀ-shŭn morbid Diseased; pertaining to a disease MOR-bı̆d nuclear medicine NŪ-klē-ăr radiology r ā-dē-ŎL-ō-jē radi/o: radiation, x-ray; radius (lower arm bone on thumb side) -logy: study of Branch of medicine concerned with the use of radioactive substances for diagnosis, treatment, and research Medical specialty concerned with the use of electromagnetic radiation, ultrasound, and imaging techniques for diagnosis and treatment of disease and injury (See Figure 4-5.) interventional ı̆n-t ĕr-VĔN-shŭn-ăl Radiological practice that employs fluoroscopy, CT, and ultrasound in nonsurgical treatment of various disorders Examples of interventional radiology include balloon angioplasty and cardiac catheterization. therapeutic thĕr-ă-P Ū-tı̆k therapeut: treatment -ic: pertaining to Use of ionizing radiation in the treatment of cancer; also called radiation oncology (A) Radiographic film. (D) CT scan. (B) Ultrasonography. (E) MRI scan. Figure 4-5. Medical imaging. (C) Nuclear scan. (F) PET scan of brain. 55 Pathology Diagnostic, Symptomatic, and Related Terms—cont’d Term Definition radionuclides Substances that emit radiation spontaneously; also called tracers The quantity and duration of radioactive material used in these tests are safe for humans and should not have harmful effects. rā-dē-ō-NŪ-klı̄dz radiopharmaceutical r ā-dē-ō-f ărm-ă-SŪ-tı̆-kăl scan SKĂN sepsis SĔP-sı̆s suppurative SŬP-ū-ră-t ı̆v Radionuclide attached to a protein, sugar, or other substance used to visualize an organ or area of the body that will be scanned Term used to describe a computerized image by modality (such as CT, MRI, and nuclear imaging) or by structure (such as thyroid and bone) Pathological state, usually febrile, resulting from the presence of microorganisms or their products in the bloodstream Producing or associated with generation of pus Diagnostic and Therapeutic Procedures This section introduces procedures used to diagnose and treat a variety of disorders. Specific examples of these procedures are found in the body systems chapters. Descriptions are provided as well as pronunciations and word analyses for selected terms. Procedure Description Diagnostic Procedures Endoscopic endoscopy ĕn-D ŎS-k ō-p ē endo-: in, within -scopy: visual examination Visual examination of a body cavity or canal using a specialized lighted instrument called an endoscope Endoscopy is used for biopsy, surgery, aspirating fluids, and coagulating bleeding areas. The endoscope is usually named for the organ, cavity, or canal being examined, such as gastroscope and sigmoidoscope. (See Figure 4-6.) A camera and video recorder are commonly used during the procedure to provide a permanent record. Biopsy device Fiberoptic lights Figure 4-6. Endoscopy (gastroscopy). (continued) 56 CHAPTER 4 Body Structure Diagnostic and Therapeutic Procedures—cont’d Procedure Description laparoscopy Visual examination of the organs of the pelvis and abdomen through very small incisions in the abdominal wall lăp-ăr-ŎS-kō-pē lapar/o: abdomen -scopy: visual examination thoracoscopy thor-ă-KŎS-k ā-pē thorac/o: chest -scopy: visual examination Examination of the lungs, pleura, and pleural space with a scope inserted through a small incision between the ribs Thoracoscopy is an endoscopic procedure usually performed for lung biopsy, repairing perforations in the lungs, and diagnosing pleural disease. Laboratory complete blood count (CBC) Common blood test that enumerates red blood cells, white blood cells, and platelets; measures hemoglobin (the oxygen-carrying molecule in red blood cells); estimates red cell volume; and sorts white blood cells into five subtypes with their percentages CBC can be performed using a manual or automated method. urinalysis (UA) Common urine screening test that evaluates the physical, chemical, and microscopic properties of urine Immediate UA can be performed with a dipstick test or the urine specimen can be sent to the laboratory for a full analysis. ū-rı̆-NĂL-ı̆-sı̆s Radiographic computed tomography (CT) kŏm-PŪ-t ĕd tō-MŎG-ră-f ē tom/o: to cut -graphy: process of recording Doppler DŎP-lĕr fluoroscopy floo-or-ŎS-kō-p ē fluor/o: luminous, fluorescent -scopy: visual examination Imaging technique achieved by rotating an x-ray emitter around the area to be scanned and measuring the intensity of transmitted rays from different angles; formerly called computerized axial tomography In a CT scan, the computer generates a detailed cross-sectional image that appears as a slice. (See Figure 4-5D.) Tumor masses, bone displacement, and accumulations of fluid may be detected. This technique may be used with or without a contrast medium. Ultrasound technique used to detect and measure blood-flow velocity and direction through the cardiac chambers, valves, and peripheral vessels by reflecting sound waves off moving blood cells Doppler ultrasound is used to identify irregularities in blood flow cause by blood clots, venous insuff iciency, and arterial blockage. Radiographic technique in which x-rays are directed through the body to a fluorescent screen that displays continuous motion images of internal structures Fluoroscopy is used to view the motion of organs, such as the digestive tract, heart, and joints, or to aid in the placement of catheters or other devices. 57 Pathology Diagnostic and Therapeutic Procedures—cont’d Procedure Description magnetic resonance imaging (MRI) Noninvasive imaging technique that uses radiowaves and a strong magnetic field rather than an x-ray beam to produce multiplanar crosssectional images (See Figure 4-5E.) MRI is used to diagnose a growing number of diseases because it provides superior soft tissue contrast, allows multiple plane views, and avoids the hazards of ionizing radiation. MRI commonly proves superior to CT scan for most central nervous system images, particularly those of the brainstem and spinal cord as well as the musculoskeletal and pelvic areas. The procedure usually does not require a contrast medium. măg-NĔT-ı̆k RĔZ-ĕn-ăns ĬM-ăj-ı̆ng nuclear scan NŪ-klē-ăr positron emission tomography (PET) P ŎZ-ı̆-trŏn ē-MĬSH-ŭn tō-MŎG-ră-f ē radiography rā-dē-ŎG-ră-f ē radi/o: radiation, x-ray, radius (lower arm bone on thumb side) -graphy: process of recording single photon emission computed tomography (SPECT) FŌ-t ŏn ē-M Ĭ-shŭn tō-MŎG-ră-f ē tom/o: to cut -graphy: process of recording tomography tō-MŎG-ră-f ē tom/o: to cut -graphy: process of recording Diagnostic technique that uses a radioactive material (radiopharmaceutical) called a tracer that is introduced into the body (inhaled, ingested, or injected) and a specialized camera to produce images of organs and structures (See Figure 4-5C.) A nuclear scan is the reverse of a conventional radiograph. Rather than being directed into the body, radiation comes from inside the body and is then detected by a specialized camera to produce an image. Scanning technique using computed tomography to record the positrons (positive charged particles) emitted from a radiopharmaceutical, that produces a cross-sectional image of metabolic activity in body tissues to determine the presence of disease (See Figure 4-5F.) PET is particularly useful in scanning the brain and nervous system to diagnose disorders that involve abnormal tissue metabolism, such as schizophrenia, brain tumors, epilepsy, stroke, and Alzheimer disease as well as cardiac and pulmonary disorders. Imaging technique that uses x-rays passed through the body or area and captured on a film; also called x-ray (See Figure 4-5A.) On the radiograph, dense material, such as bone, appears white, and softer material, such as the stomach and liver, appears in shades of gray. Radiological technique that integrates computed tomography (CT) and a radioactive material (tracer) injected into the bloodstream to visualize blood flow to tissues and organs SPECT differs from a PET scan in that the tracer remains in the blood stream rather than being absorbed by surrounding tissue. It is especially useful to visualize blood flow through arteries and veins in the brain. Radiographic technique that produces an image representing a detailed cross-section, or slice, of an area, tissue, or organ at a predetermined depth Types of tomography include computed tomography (CT), positron emission tomography (PET), and single photon emission computed tomography (SPECT). (continued) 58 CHAPTER 4 Body Structure Diagnostic and Therapeutic Procedures—cont’d Procedure Description ultrasonography (US) Imaging procedure using high-frequency sound waves (ultrasound) that display the reflected “echoes” on a monitor; also called ultrasound, sonography, echo, and echography (See Figure 4-5B.) US, unlike most other imaging methods, creates real-time moving images to view organs and functions of organs in motion. A computer analyzes the reflected echoes and converts them into an image on a video monitor. Because this procedure does not use ionizing radiation (x-ray), it is used for visualizing fetuses as well as the neck, abdomen, pelvis, brain, and heart. ŭl-tră-sōn-ŎG-ră-f ē ultra-: excess, beyond son/o: sound -graphy: process of recording Surgical biopsy (bx) BĪ- ŏp-s ē Representative tissue sample removed from a body site for microscopic examination, usually to establish a diagnosis frozen section (FS) Ultra-thin slice of tissue cut from a frozen specimen for immediate pathological examination FS is used primarily in oncological cases while the patient is still in the operating room. The evaluation by the pathologist helps determine if and how aggressively the surgeon will treat the patient. needle Removal of a small tissue sample for examination using a hollow needle, usually attached to a syringe punch Removal of a small core of tissue using a hollow instrument (punch) An anesthetic and suturing are usually required for a punch bx, and minimal scarring is expected. shave Removal of tissue using a surgical blade to shave elevated lesions Therapeutic Procedures Surgical ablation ăb-L Ā-shŭn anastomosis ă-năs-tō-MŌ-sı̆s Removal of a part, pathway, or function by surgery, chemical destruction, electrocautery, freezing, or radio frequency (RF) Surgical joining of two ducts, vessels, or bowel segments to allow flow from one to another (See Figure 4-7.) A. End to end anastomosis B. End to side anastomosis C. Side to side anastomosis Figure 4-7. Anastomoses. Pathology 59 Diagnostic and Therapeutic Procedures—cont’d Procedure Description cauterize Destroy tissue by electricity, freezing, heat, or corrosive chemicals KAW-t ĕr-ı̄z Scraping of a body cavity with a spoon-shaped instrument called a curette (curet) curettage kū-rĕ-TĂZH incision and drainage (I&D) ı̆n-SĬZH-ŭn, DRĀN-ı̆j Incision made to allow the free flow or withdrawal of fluids from a wound or cavity Surgical technique employing a device that emits intense heat and power at close range to cut, burn, vaporize, or destroy tissues laser surgery L Ā-zĕr ¯ SŬR-j ĕr-ē radical dissection RĂD-ı̆-kăl dı̄-SĔK-shŭn resection Surgical removal of tissue in an extensive area surrounding the surgical site in an attempt to excise all tissue that may be malignant and decrease the chance of recurrence An example of a radical dissection procedure is radical mastectomy, in which the entire breast, surrounding lymph nodes, and sometimes adjacent muscles are removed. Partial excision of a bone, organ, or other structure r ē-SĔK-shŭn It is time to review diagnostic and therapeutic terms and procedures by completing Learning Activity 4–5. Abbreviations This section introduces body structure abbreviations and their meanings. Abbreviation Meaning Abbreviation Meaning ant anterior MRI magnetic resonance imaging AP anteroposterior PET positron emission tomography Bx, bx biopsy post posterior CBC complete blood count RF rheumatoid factor; radio frequency CT computed tomography RLQ right lower quadrant DNA deoxyribonucleic acid RUQ right upper quadrant DSA digital subtraction angiography sono sonogram Dx diagnosis SPECT single photon emission computed tomography FS frozen section Sx symptom I&D incision and drainage Tx treatment LAT, lat lateral UA urinalysis LLQ left lower quadrant U&L, U/L upper and lower LUQ left upper quadrant US ultrasound ultrasonography 60 CHAPTER 4 Body Structure LEARNING ACTIVITIES The following activities provide a review of the body structure terms introduced in this chapter. Complete each activity and review your answers to evaluate your understanding of the chapter. Learning Activity 4-1 Identifying Body Planes Label the following illustration using the terms below. anterior lateral posterior coronal (frontal) plane medial superior inferior midsagittal (median) plane transverse (horizontal) plane ✓ not answer correctly. Check your answers by referring to Figure 4–2 on page 44. Review material that you did Learning Activities Learning Activity 4-2 Identifying Abdominopelvic Divisions Label the quadrants on Figure A and regions on Figure B using the terms below. A. B. epigastric region left lumbar region right lower quadrant hypogastric region left upper quadrant right lumbar region left hypochondriac region right hypochondriac region right upper quadrant left iliac region right iliac region umbilical region left lower quadrant your answers by referring to Figure 4–4A and 4–4B on page 46. Review material ✓ Check that you did not answer correctly. 61 62 CHAPTER 4 Body Structure Learning Activity 4-3 Matching Body Cavity, Spine, and Directional Terms Match each term on the left with its meaning on the right. 1. 2. 3. abdominopelvic adduction cervical 4. 5. 6. 7. 8. 9. coccyx deep eversion inferior (caudal) inversion lumbar 10. 11. 12. 13. plantar posterior (dorsal) prone proximal 14. 15. superficial thoracic a. pertaining to the sole of the foot b. tail bone c. ventral cavity that contains heart, lungs, and associated structures d. toward the surface of the body (external) e. lying horizontal with face downward f. turning outward g. nearer to the center (trunk of the body) h. ventral cavity that contains digestive, reproductive, and excretory structures i. turning inward or inside out j. part of the spine known as the neck k. movement toward the median plane l. away from the head; toward the tail or lower part of a structure m. away from the surface of the body (internal) n. part of the spine known as the loin o. near the back of the body ✓ Check your answers in Appendix A. Review any material that you did not answer correctly. Correct Answers ⫻ 6.67 ⫽ % Score Enhance your study and reinforcement of word elements with the power of DavisPlus. Visit www. davisplus.fadavis.com/gylys/systems for this chapter’s flash-card activity. We recommend you complete the flash-card activity before completing Activities 4–4 and 4–5 below. Learning Activities Learning Activity 4-4 Matching Word Elements Match the following word elements with the definitions in the numbered list. Combining Forms Suffixes Prefixes caud/o kary/o -genesis ad- dist/o leuk/o -gnosis infra- dors/o morph/o -graphy ultra- eti/o poli/o hist/o somat/o idi/o viscer/o jaund/o xer/o 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. nucleus far, farthest process of recording knowing white internal organs yellow tissue forming, producing, origin below, under excess, beyond tail back (of body) gray cause form, shape, structure dry unknown, peculiar toward body ✓ Check your answers in Appendix A. Review any material that you did not answer correctly. Correct Answers ⫻5⫽ % Score 63 64 CHAPTER 4 Body Structure Learning Activity 4-5 Matching Diagnostic and Therapeutic Terms and Procedures Match the following terms with the definitions in the numbered list. ablation fluoroscopy radionuclide cauterize morbid resection Doppler nuclear scan suppurative endoscopy punch biopsy thoracoscopy febrile radiology ultrasonography 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. specialty concerned with the use of electromagnetic radiation, ultrasound, and imaging techniques measurement of blood flow in a vessel by reflecting sound waves off moving blood cells imaging technique that employs high-frequency sound waves visual examination of the lungs, pleura, and pleural space with a scope inserted through a small incision between the ribs excision of a core sample of tissue for examination visual examination of a cavity or canal using a special lighted instrument use of a radioactive material and scanning device to determine, size, shape, location, and function of various organs and structures radiographic technique that directs x-rays to a fluorescent screen and displays “live” images on a monitor disease, or pertaining to disease substance that emits radiation spontaneously; also called tracer feverish; pertaining to a fever partial excision of a bone, organ, or other structure producing or associated with generation of pus destruction of tissue by electricity, freezing, heat, or corrosive chemicals removal of a part, pathway, or function by surgery, chemical destruction, electrocautery, freezing, or radiofrequency (RF) ✓ Check your answers in Appendix A. Review any material that you did not answer correctly. Correct Answers ⫻ 6.67 ⫽ % Score Medical Record Activities 65 MEDICAL RECORD ACTIVITIES The two medical records included in the following activities use common clinical scenarios to show how medical terminology is used to document patient care. Complete the terminology and analysis sections for each activity to help you recognize and understand terms related to body structure. Medical Record Activity 4-1 Radiological Consultation Letter: Cervical and Lumbar Spine Terminology Terms listed below come from the Radiological Consultation Letter: Cervical and Lumbar Spine that follows. Use a medical dictionary such as Taber’s Cyclopedic Medical Dictionary, the appendices of this book, or other resources to define each term. Then review the pronunciations for each term and practice by reading the medical record aloud. Term Definition AP atlantoaxial ăt-lăn-t ō-ĂK-s ē-ăl cervical SĔR-vı̆-kăl lateral LĂT-ĕr-ăl lumbar LŬM-băr lumbosacral junction l ŭm-bō-SĀ-krăl odontoid ō-DŎN-toyd sacral SĀ-krăl scoliosis skō-lĕ-Ō-sı̆s spasm SPĂZM spina bifida occulta SPĪ-nă BĬF-ı̆-dă ŏ-KŬL-tă vertebral bodies VĔR-tĕ-brăl (( )) Listen and Learn Online! will help you master the pronunciation of selected medical words from this medical record activity. Visit www.davisplus.com/gylys/systems to find instructions on completing the Listen and Learn Online! exercise for this section and to practice pronunciations. 66 CHAPTER 4 Body Structure PATHOLOGY REPORT: RADIOLOGICAL CONSULTATION LETTER: CERVICAL AND LUMBAR SPINE Physician Center 2422 Rodeo Drive Sun City, USA 12345 (555) 333-2427 May 3, 20xx John Roberts, MD 1115 Forest Ave Sun City, USA 12345 Dear Doctor Roberts: Thank you for referring Chester Bowen to our office. Mr. Bowen presents with neck and lower back pain of more than 2 years’ duration. Radiographic examination of June 14, 20xx reveals the following: AP, lateral, and odontoid views of the cervical spine demonstrate some reversal of normal cervical curvature, as seen on lateral projection. There is some right lateral scoliosis of the cervical spine. The vertebral bodies, however, appear to be well maintained in height; the intervertebral spaces are well maintained. The odontoid is visualized and appears to be intact. The atlantoaxial joint appears symmetrical. Impression: Films of the cervical spine demonstrate some reversal of normal cervical curvature and a minimal scoliosis, possibly secondary to muscle spasm, without evidence of recent bony disease or injury. AP and lateral films of the lumbar spine, with spots of the lumbosacral junction, demonstrate an apparent minimal spina bifida occulta of the first sacral segment. The vertebral bodies, however, are well maintained in height; the intervertebral spaces appear well maintained. Pathological Diagnosis: Right lateral scoliosis with some reversal of normal cervical curvature. If you have any further questions, please feel free to contact me. Sincerely yours, Adrian Jones, MD Adrian Jones, MD aj:bg Pathology Report: Radiological Consultation Letter: Cervical and Lumbar Spine 67 Analysis Review the medical record Radiological Consultation Letter: Cervical and lumbar spine to answer the following questions. 1. What was the presenting problem? _____________________________________________________________________________________ 2. What were the three views of the radiological examination of June 14, 20xx? _____________________________________________________________________________________ 3. Was there evidence of recent bony disease or injury? _____________________________________________________________________________________ 4. Which cervical vertebrae form the atlantoaxial joint? _____________________________________________________________________________________ 5. Was the odontoid fractured? _____________________________________________________________________________________ 6. What did the AP and lateral films of the lumbar spine demonstrate? _____________________________________________________________________________________ Medical Record Activity 4-2 Radiology Report: Injury of Left Wrist, Elbow, and Humerus Terminology Terms listed below come from the Radiology Report: Injury of Left Wrist, Elbow, and Humerus that follows. Use a medical dictionary such as Taber’s Cyclopedic Medical Dictionary, the appendices of this book, or other resources to define each term. Then review the pronunciations for each term and practice by reading the medical record aloud. Term anterior AP distal DĬS-tăl dorsal DOR-săl epicondyle ĕp-ı̆-KŎN-dı̄l humerus H Ū-m ĕr-ŭs lucency LOO-sĕnt-s ē medial M Ē-d ē-ăl Definition 68 CHAPTER 4 Body Structure Term Definition mm posterior radius RĀ-dē-ŭs ulna ŬL-nă ventral-lateral VĔN-tr ăl-LĂT- ĕr-ăl (( )) Listen and Learn Online! will help you master the pronunciation of selected medical words from this medical record activity. Visit www.davisplus.com/gylys/systems to find instructions on completing the Listen and Learn Online! exercise for this section and to practice pronunciations. Radiology Report : Injury of Left Wrist, Elbow, and Humerus RADIOLOGY REPORT : INJURY OF LEFT WRIST, ELBOW, AND HUMERUS General Hospital 1511 Ninth Avenue Sun City, USA 12345 (555) 802-1887 RADIOLOGY REPORT Date: Physician: Examination: June 5, 20xx Adrian Jones, MD Left wrist, left elbow, and left humerus Patient: Hill, Joan DOB: 5/25/19xx X-ray No: 43201 LEFT WRIST: Images obtained with the patient’s arm taped to an arm board. There are fractures through the distal shafts of the radius and ulna. The radial fracture fragments show approximately 8-mm overlap with dorsal displacement of the distal radial fracture fragment. The distal ulnar shaft fracture shows ventral-lateral angulation at the fracture apex. There is no overriding at this fracture. No additional fracture is seen. Soft-tissue deformity is present, correlating with the fracture sites. LEFT ELBOW AND LEFT HUMERUS: Single view of the left elbow was obtained in the lateral projection. AP view of the humerus was obtained to include a portion of the elbow. A third radiograph was obtained but is not currently available for review. There is lucency through the distal humerus on the AP view along its medial aspect. It would be difficult to exclude fracture just above the medial epicondyle. On the lateral view, there is elevation of the anterior and posterior fat pad. These findings are of some concern. Repeat elbow study is recommended. Jason Skinner, MD Jason Skinner, MD JS: bg D: 6-05-20xx T: 6-05-20xx 69 70 CHAPTER 4 Body Structure Analysis Review the medical record Radiology Report: Injury of Left Wrist, Elbow, and Humerus to answer the following questions. 1. Where are the fractures located? _____________________________________________________________________________________ 2. What caused the soft-tissue deformity? ____________________________________________________________________________________ 3. Did the radiologist take any side views of the left elbow? _____________________________________________________________________________________ 4. In the AP view of the humerus, what structure was also visualized? _____________________________________________________________________________________ 5. What findings are cause for concern to the radiologist? _____________________________________________________________________________________

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