Integumentary System Anatomy and Diseases (PDF)

INTEGUMENTARY SYSTEM ANATOMY OF THE SKIN The integumentary system consists in the skin (integument), nails, sweat glands (or sudoriferous glands) and oil glands (also called the sebaceous glands). The components of this system have several functions among which protection of our body against exter...

INTEGUMENTARY SYSTEM ANATOMY OF THE SKIN The integumentary system consists in the skin (integument), nails, sweat glands (or sudoriferous glands) and oil glands (also called the sebaceous glands). The components of this system have several functions among which protection of our body against external factors such as bacteria, viruses, sunlight and trauma; regulation of the inner temperature; excretion of some waste products and detection of sensations. The specialist dealing with skin conditions is called dermatologist and the science which studies skin diseases is termed dermatology. The skin has three main layers: the epidermis, the dermis (corium), and the subcutaneous layer (hypodermis). Epidermis The epidermis represents the outer layer and has several strata (sublayers). It is a nonvascular layer as it does not contain any blood vessels. The cells that make up the epidermis are termed squamous epithelium and they are flat, scaly cells. Epidermis acts like a barrier against external pathogens and water and it is made up of melanocytes, keratinocytes and Langerhans. The stratum corneum is the top sublayer and contains dead cells arranged in parallel rows. New cells are produced all the time and the dead cells are shed. During the process of dying, cells fill up with keratin and eventually are replaced with cells arising from the layers below. These dead cells can be removed by exfoliation or desquamation. Stratum lucidum is very thin, almost transparent and it can be found on palmar and plantar areas. The stratum granulosum consists in granular keratinocytes. The stratum spinosum is five to ten cell thick. The deepest layer, stratum germinativum, consists in new cells that are produced all the time thus insuring the regeneration of the epidermis. Melanocytes are located in the stratum basale and produce melanin, a pigment that gives the colour of our skin, eyes, and hair. Melanin is a complex polymer that absorbs UV rays. Dermis The dermis (corium) is placed between epidermis and subcutaneous tissue. It consists in two layers: a thin top one called the papillary layer, and a thicker one called the reticular layer. It is made up of connective tissue and contains mechanoreceptors, capillaries, lymph cells, nerve endings, sebaceous and sweat glands, and hair follicles. When the collagen fibers in the skin stretch, they form striae or stretch marks. Common sites of these striae are abdomen, buttocks, breasts, and hips. Subcutaneous Layer or Hypodermis (superficial fascia) The subcutaneous layer is the innermost layer, and it consists of adipose (fatty) tissue and some layers of fibrous tissue. Within the subcutaneous layers there are blood vessels and nerves. The fatty tissue within it insulates the body, maintains the temperature, stores energy, protects the inner organs and muscles below it. Associated Skin Structures The sudoriferous (sweat) glands have a role in regulation of body temperature as they secrete a watery fluid which, by evaporation, cools the body. Sweat exists the body through pores (tiny openings) in the skin surface. Sweat (perspiration) is mainly composed of water and sodium chloride. Excessive sweat is termed diaphoresis (hyperhidrosis). Eccrine sweat glands are mainly found on the palms, soles, and scalp. Apocrine sweat glands appear during and after puberty and they are mainly found in the axillae, nipples, ear canal, eyelids, and perineal area. Sebaceous glands open in hair follicles and secrete an oily fluid (sebum), thus lubricating the hair and skin and preventing drying. Ceruminous glands are modified apocrine glands in the surface of external auditory canal which produce cerumen, a waxy substance. Cerumen plays a role in lubrication and protection of the ear against microbes. Hair is spread all over the body. Each hair develops within a sheath or hair follicle. Both hair and nails have a protection role and consist of keratin. Nails are keratinous and translucent and consist of specialized epithelial cells. Nails develop from a growing region at the proximal end. The cuticle (eponychium) is an extension of the epidermis onto the surface of the nail plate. The area at the base of the nail is called the lunula because it looks like a half-moon. Here the underlying skin is thicker, and blood does not show as much through the nail. The perionychium is the skin surrounding the nail. The word derma (from Greek) means "skin" and it is used as a suffix in words pertaining to the skin, such as xeroderma (dryness of the skin) and scleroderma (hardening of the skin). The adjective cutaneous refers to the skin and is from the Latin word cutis for skin. CLINICAL ASPECTS The skin can be affected by various diseases or by trauma and injury. The medical science that studies the skin and its diseases is termed dermatology. The specialist who treats such diseases is called a dermatologist. When the physician examines the skin, he should take into account several aspects, such as its color, any possible unusual pigmentation, and lesions. When evaluating the status of the skin, the physician palpates it in order to assess its texture, temperature, moisture, firmness, and any tenderness. WOUNDS Any trauma can lead to occurrence of wounds which can be caused by accidents, burns, operations or any therapeutic or diagnostic procedure or treatments. Complications of wounds can involve other organs or structures such as dehiscence (splitting of a wound), evisceration (removing organs), protrusion of internal organs through the lesion. As the body tries to heal a wound, the skin produces a fluid, called exudate, draining from the injury site. This exudate can be clear, bloody (sanguinous), or pus-containing (purulent). Wound drainage can be performed with the help of tubes or dressing, and it is vital to maintain cleanliness of the lesion in order to heal up easier. If the dead tissue cannot be removed otherwise, the skin can be cleaned by debridement (removal of dead or damaged tissue from a wound). An escharotomy is the removal of a dark crust or scab (eschar). Sometimes skin grafting might be necessary to promote healing. The instrument used in cutting skin is termed dermatome. BURNS Burns can be life threatening because they disrupt the protecting layer that keeps pathogens away from the body. Burns can be caused by different factors: explosions, scalding, electrical malfunctions, contact with chemicals, or abrasion. Burns can be evaluated in terms of the depth and the percentage of body surface involved. From the depth of tissue destruction point of view, burns can be: Superficial partial-thickness, involving the epidermis and probably a portion of the dermis. The tissue is bit redder, and blisters might appear, as in cases of sunburn. Deep partial-thickness, which involves the epidermis and portions of the dermis. The tissue is blistered and disrupted. Causes of such burns include scalding and flame. Full thickness, involves all layers of skin and sometimes subcutaneous tissue as well as tissues beneath. The tissue is broken and is dry and pale or charred, even resulting in loss of fingers or limbs and these injuries might require skin grafting. The classification above replaces an older system of ranking burns as first-, second-, and third-degree according to the depth of tissue damage. https://respondandrescue.com/first-aid-for-burns/ In terms of body area affected physicians use the rule of nines, in which areas of body surface are assigned percentages in multiples of nine. https://medical-dictionary.thefreedictionary.com/rule+of+nines A severe complication of burns, which might even jeopardize the patient's life, is an infection. As skin acts as a barrier against microorganisms, an infection means this barrier is destroyed, leaving the patient unprotected against pathogens. There also can be respiratory complications and shock. PRESSURE ULCERS Other terms for pressure ulcers are decubitus ulcer and bedsore. People who stay in bed (confined to bed) are more prone to develop such skin lesions especially in the areas that cover bony projections (such as the sacrum, heel, elbow, ischial bone of the pelvis, or greater trochanter of the femur). The pressure on these areas leads to thrombus formation (thrombosis), ulceration and necrosis (death of the tissue). The first phase of the lesion is redness of the skin (erythema). The next phase is the progression of such lesions into the deeper tissues, underlying muscle, extending even to bone. Healing can take a long time and the most common ways to treat such lesions are cleaning it thoroughly, drying of the skin, frequent change in position, the use of mattresses in order to reduce pressure on these areas. Dermatitis Dermatitis is a general name for inflammation of the skin. It can be acute or chronic. Symptoms of eczema (atopic dermatitis) are dry, itchy, cracked, and red skin. It is caused by a combination of immune factors, external triggers and genetics. The condition worsens if the patient suffers from allergies, infections, if there are temperature extremes, and skin irritants. Contact dermatitis, on the other hand, is caused by chemical irritants. There are several types of dermatitis: seborrheic dermatitis (affecting areas with large numbers of sebaceous glands such as the scalp and face), s tasis dermatitis (caused by poor circulation), discoid eczema or nummular dermatitis (which appears as circular or oval spots) and dyshidrotic eczema (which appears on fingers, palms and soles). Psoriasis Psoriasis appears as patches especially on knees, elbows, trunk and scalp. It manifests as a chronic overgrowth (hyperplasia) of the epidermis, producing large, erythematous (red) plaques with silvery scales. Psoriasis is caused by an overactive immune system in which the dead skin accumulates. It is usually treated with topical corticosteroids, vitamin D supplements and with exposure to ultraviolet (UV) light. Autoimmune Disorders Certain autoimmune diseases can have symptoms at the skin level. Such diseases can be identified by biopsy of lesions or by antibody assessment. Pemphigus has as main symptoms the formation of blisters (bullae) usually in the oral cavity or in the genital area. Blisters break and leave painful sores, thus increasing the chance of infection. Pemphigus is an autoimmune disorder, and its treatment includes immunosuppressive medication, thorough cleaning of wounds and corticosteroid drugs. Another autoimmune disease is lupus erythematosus. Being a chronic inflammatory disease, it can affect a wide range of tissues such as skin, joints, blood vessels and even internal organs. When it involves vital organs, it is termed systemic lupus erythematosus. Discoid lupus erythematosus affects only the skin and it appears as rough, raised, violet-tinted papules, usually limited to the face and scalp. There may also be a butterfly-shaped rash across the nose and cheeks. The UV light can worsen these skin lesions. (systemic sclerosis) can involve, among other structures, the skin. Skin symptoms are swelling (inflammation), itching (pruritus), thickening and tightening of the skin in fingers, hands, feet and face area. Because it can manifest as an overproduction of collagen, scleroderma can be associated with dermis fibrosis. In this case its manifestations are swelling of sweat glands and hair follicles. Scleroderma can also be an early sign of Raynaud\'s syndrome in which blood vessels in the fingers and toes constrict in the cold; thus, causing numbness, pain, coldness, and tingling. Skin Cancer is one of the most common types of human cancer and dangerous due to its tendency to metastasize. An increased number of melanocytes in epidermis can lead to malignant melanoma. Melanoma appears as an irregular lesion or a mole (nevus) varying in colour. In initial stages, it spreads superficially. Afterwards, it starts to affect deeper tissues and metastasizes through blood and lymph. If the lesions are removed surgically in the initial phase, melanoma has a good prognosis. Another common type of skin cancer is squamous cell carcinoma. It occurs as a result of UV light exposure and the symptoms are painless, firm, red nodules or plaque which evolves into scales, ulceration, or crusting. Since it has a lower tendency to metastasize, it can be easily managed with surgery x-irradiation or chemotherapy. Basal cell carcinoma is the most widespread type of skin cancer and it manifests as smooth, pearly papules. https://www.everydayhealth.com/skin-cancer/types/ Kaposi sarcoma, is associated with and with organ transplant suppressed immune system. This type of cancer occurs in the lining of blood and lymph vessels and initially appears as brown spots on calves and these spots become more and more rigid as the disease progresses. DIAGNOSTIC PROCEDURES AND TESTS The first step in assessing skin conditions is visual examination. Afterwards, the dermatologist establishes what tests are appropriate to determine the real cause of the disease. The physician can send to the laboratory samples of exudate (a liquid material produces by the body in lesions or wounds) or pus in order to be examined. The result can show what type of pathogen is located in the lesion. Scraping of a wound (a small piece of skin from within the lesion) can be examined under a microscope for any fungi that might be present. Many tests for allergies are performed on the skin. The allergen (i.e. the substance causing allergy) is mixed with another substance (this way creating the antigen). Afterwards, it is introduced into the skin. Skin tests are performed in three ways: The patch test -the antigen is placed on a piece of gauze (dressing), and it is applied onto the skin. In case rashes, eczema or wheal and flare occur, the test is thought to be positive. The scratch test -the antigen is scratched onto the skin. In a few minutes signs of edema or erythema appear if the test is positive. The intradermal test -the antigen is inserted into the skin. This test is used to detect infections as well as allergies. Other common intradermal tests are: The Mantoux test -used to diagnose tuberculosis. PPD (a purified protein derivative of tuberculin) is injected intradermally. In case the test is positive, a bump appears in the area where PPD was inserted. This means that the patient has a latent (dormant) form of TB. The tine test (also called TB tine) is another test for tuberculosis. In the case of this test, the tuberculin is injected using a tine (an instrument with a number of pointed ends). The Schick test, developed in 1913, is a test to detect diphtheria. A small amount of toxin is injected into the skin on one arm skin and a small amount of deactivated toxin is injected into the skin of the other arm. The test is considered positive if the skin gets red and swollen. PATHOLOGY OF THE INTEGUMENTARY SYSTEM The Sebaceous Glands Acne vulgaris (acne) affects the pilosebaceous area. It is a chronic inflammation induced by excessive sebum production around the hair shaft. Generally speaking, acne can be inflammatory (characterized by occurrence of papules, pustules, nodules, and cysts) or non- inflammatory (comedones). A comedo (plural, comedones) is accumulation of sebum and keratin in a hair follicle (sebaceous plugs). A comedo which has an obstructed opening is called a whitehead (a closed comedo). If the sebum plug is exposed to air, it oxidizes gives rise to a blackhead (an open comedo). A sebaceous cyst (a bump) is usually closely associated with a sebaceous gland. It consists in yellow, fatty material and areas where it appears are the face, neck, or trunk. Seborrhea is over production of the sebaceous glands leading to excessive production of sebum (seb/o =sebum, and -rrhea = flow or discharge). It can affect any area but if it occurs on the scalp, its manifestations are scaly patches, inflamed skin, and dandruff. Seborrheic dermatitis is an inflammation which leads to scaling and pruritus of the upper epidermis or scalp. Extensive dandruff (flakes) is one sign of it. If the dandruff is not so serious, the condition is induced by yeast-like fungus (pl. fungi). Seborrheic dermatitis can be caused by stress, hormonal changes or chemicals used on a regular basis. The Sweat Glands Anhidrosis means lack of sweating. Diaphoresis is excessive sweating. It can have a normal trigger such as heat or overexertion, but it can also be caused by emotional or physical distress. Heat rash (prickly heat) has as cause sweat trapped into the skin and its evolution is to an itchy rash due to the bacteria and dead cells blocked within the skin. Hyperhidrosis is excessive perspiration involving one area or the entire body. Sleep hyperhidrosis (night sweats) is hyperhidrosis occurring during sleep. It can be induced by many causes such as menopause, the use of certain drugs, and even certain infections. The Hair Folliculitis is hair follicles inflammation. Common sites are arms, legs, and in the beard area of men. Trichomycosis axillaris is the hair shafts superficial bacterial infection in areas with sweat glands (armpits or pubic area). It occurs as yellow, black or red granular nodules. Excessive Hairiness is excessive hair in women usually on the face. It is linked to increase in male hormones (androgens). Abnormal Hair Loss Alopecia (baldness) can be a partial or a complete, temporary or permanent loss of hair. Alopecia areata is an autoimmune disorder. Areas without hair appear mainly on the scalp. As well as on other areas on the body. Alopecia totalis (alopecia capitis totalis) is a chronic condition. It is characterized by the loss of all the hair on the scalp. Alopecia universalis is the total loss of hair all over the body. The pattern is different for men and women. In females, the hair starts to get thinner in the frontal area and on the sides and rarely on the crown. In males, the hair starts to be lost from front to the rear area leaving only a horseshoe-shaped area of hair in the back and on the temples. The Nails Clubbing (Hippocratic fingers) is characterized by curved nails and enlargement of the fingertips. Usually, it is a sign of a more serious condition-oxygen deficiency and is associated with coronary or pulmonary disease. Koilonychia (spoon nail) means concave or scooped out nails. It can be a sign of iron- deficiency anemia. Onychia (onychitis) is nail inflammation and can lead to loss of the nail. Onychocryptosis (ingrown toenail) is curving of the toenail edges. If not managed in due time, it can develop into infections. Onychomycosis is a nail fungal infection. The nail gets coloured in white, yellow, green, or black. The nail can also become thick or brittle. Onychophagia is nail biting or nail eating. It is a habit induced by anxiety. Paronychia is inflammation and infection of the skin around a nail. Skin Pigmentation Age spots (solar lentigines or liver spots) are spots of darker colour occurring on areas exposed to UV. Albinism is a genetic condition in which the skin, hair, and irises of the eyes lack melanin. A person suffering from such a condition is called an albino. Chloasma (melasma or the mask of pregnancy) is a hyperpigmentation. It appears as brownish spots on the face in pregnant women, but the spots disappear after parturition (childbirth). Vitiligo is characterized by destruction of the melanocytes. It is an idiopathic disease, causing irregular patches of white skin (depigmentation). Even the hair growing in an affected area may become white. https://www.istockphoto.com/ro/vector/boli-de-piele-infec%C8%9Bie-curma-eczeme-%C8%99i-psoriazis- ilustra%C8%9Bie-vectorial%C4%83-dermatologie-gm1262261870-369328850 Bleeding into the Skin Contusion is a trauma to tissues beneath the skin, without breaking the skin. The main symptoms are discoloration, inflammation, rigidity, and pain. Ecchymosis, also called bruise, is a purplish discoloration induced by hemorrhage under the skin. The plural is ecchymoses. Purpura appears as multiple purple spots on the skin induced by hemorrhages into the skin. Purpura is smaller than an ecchymosis but larger than petechiae. Petechia (plural petechiae) are tiny hemorrhages (less than 2 mm in diameter). These sports can be red, brown, or purple. A hematoma is hemorrhaging outside blood vessels. The body can reabsorb this blood. Its name depends on the area affected. In case of hemorrhaging under a finger or toenail, we speak of subungual hematoma. Surface Lesions A lesion is a pathologic change of the tissues. It can be induced by disease or trauma. When examining it, the dermatologist takes into account the aspect, location, color, and size in centimeters. A crust (scab) is cellular debris on top of the skin. Beneath it, the new skin is formed. Erosion is the wearing away of a skin or mucosa. A macule (macula) is a discolored flat spot less than 1 cm. Examples of macules include freckles, or flat moles. A nodule is a raised, solid skin lesion. A papule is a tiny, raised lesion smaller than 0.5 cm. Good examples of papules are insect bites. A plaque is a scaly, solid elevated area. An example of a plaque is psoriasis. The term can also describe deposits of tartar on teeth or fat deposits on arteries. Scales are flakes or dry patches. Because of excess dead epidermal cells the skin desquamates. Verrucae (warts) are small, hard skin lesions caused by the human papillomavirus (singular, verruca). A wheal (welt) is a small skin bump that is inflamed and itches. Wheals accompany urticaria, or hives as a symptom of an allergic reaction. Fluid-Filled Lesions An abscess is a pus collection due to a bacterial infection. Purulent is the adjective and it means producing or consisting in pus. An exudate is a fluid, such as pus, that accumulated in a wound. A cyst is a sac containing gas, fluid, or a semisolid matter. A pustule is a circumscribed lesion containing pus. A vesicle is a small blister containing fluid. A bulla is a large blister (plural, bullae). away. https://study.com/academy/lesson/exudate-definition-types.html Lesions Through the Skin An abrasion is an injury of skin, and it appears as the outer layers are scraped or rubbed A fissure is a groove or crack in the skin. It can be superficial or deep. A laceration is skin tearing. A pressure sore (decubitus ulcer or bedsore) is an open ulcerated wound. It is triggered by poor blood circulation in areas such as the back, hips, heels. Pressure sores can be complicate into infection and necrosis. An ulcer is an open skin lesion. Tissue around it is lost. Birthmarks A birthmark (mole or blemish) is congenital. Some birthmarks might disappear as the person gets older. Pigmented birthmarks include nevi (moles) as well as café-au-lait spots, or any other irregularities in the colour of the skin. A capillary hemangioma (strawberry birthmark) is a raised, pink or red vascular birthmark. A port-wine stain is a flat vascular birthmark caused by dilated blood capillaries. It appears as a large, reddish-purple discoloration usually on the face or neck. General Skin Conditions Dermatosis is a skin inflammation caused by lesions or eruptions. Ichthyosis (Greek "ichthys"=fish) is a group of genetic disorders in which the skin becomes thickened, dry and scaly. Lipedema (painful fat syndrome) is a chronic condition characterized by fat and fluid accumulation the tissues just under the skin. Common sites are the hips and legs. Systemic lupus erythematosus (SLE), also known as lupus, is an autoimmune disorder. It appears as a red, scaly rash on the face and upper trunk. The condition can affect connective tissue within other body systems. Rosacea (adult acne) appears as small red pimples and broken blood vessels. It develops during adult life. Bacterial Skin Infections A carbuncle is a bunch of connected furuncles (boils) filled with pus. Cellulitis is a bacterial infection of the connective tissues. Some of the most important symptoms are malaise, inflammation, warmth, and red streaks. Furuncles (boils) are inflamed areas due to a staphylococcal infection around hair follicles or sebaceous glands. Gangrene (tissue necrosis/death) is caused by a lack of circulation towards the affected tissues. Impetigo is a highly contagious bacterial skin infection occurring mostly in children. It manifests as pustules and honey-coloured crusts. Pyoderma is any acute, inflammatory, pus-forming bacterial skin infection such as impetigo. https://www.physio-pedia.com/Systemic\_Lupus\_Erythematosus Fungal Skin Infections Mycosis any skin condition caused by a fungus. Tinea (ringworm) is a fungal infection affecting the skin, hair, or nails. Tinea capitis is found on the scalp of children. Tinea corporis is a fungal infection spread on the body skin. Tinea cruris is found in the genital area. Tinea pedis (athlete's foot) can be found between the toes. Tinea versicolor (pityriasis versicolor) is a fungal infection leading to painless, discolored areas on the skin. Pediculosis is an infestation with lice (sg louse) Scabies is a skin infection caused by an infestation of itch mites. Skin Growths A callus is a thickening of the skin. As it can be caused by the pressure applied to a specific area, it can appear on the hands or feet. A clavus (corn) is a callus covering the joints of the toes. A cicatrix (plural, cicatrices) is a scar and appears as healing of a wound. A keratosis is an overgrowth of the skin, as in the example of a wart or a callus. Nevus (mole) (plural, nevi) is a small, dark, skin growth due to accumulation of melanocytes. Polyp is a growth of a mucous membrane. Such growths can have various etiologies/causes and not all the time are malignant (cancerous). Cold sore (fever blister) is a lower or upper lip lesion or on the oral mucous membrane caused by type I herpes simplex virus (HSV). It can be transmitted by contact with the infected patient or by respiratory exposure. Eczema (atopic dermatitis) is a noncontagious inflammatory condition which produces itchy, red vesicular lesions. In time they can become crusty or scaly. https://www.shutterstock.com/search/telangiectasia Erythema is redness of the skin. Telangiectasia (spider veins) is an area with a permanent dilation of capillaries. Frequent sites are the legs. VOCABULARY EXERCISES ROOT MEANING EXAMPLE derm/o, dermat/o skin dermatitis kerat/o keratin keratogenesis melan/o melanin, dark, black melanocyte hidr/o sweating hidradenitis seb/o sebum, sebaceous seborrhea trich/o hair trichophagia onych/o nail onychomycosis Define the following words: hyperhidrosis seborrheic hypomelanosis hyperkeratosis anhidrosis hypotrichosis Fill in the blanks: The study of the diseases of the skin is termed.......................... The specialist in skin diseases is called.......... A is a cell that contains melanin. is branch of medicine concerned with the hair and diseases associated to it. is softening of a nail. 6\. Hidropoesis is formation of............... 7 is inflammation of the skin. Select from the following terms to complete the sentences below adipocyte basal layer collagen cuticle dermis keratin lunula melanin sebum stratum corneum Cells containing fat are termed. The part of the nail which resembles a half moon is called. is the protein found in the epithelial and connective tissues. is the pigment which colours skin, eyes and hair. The deepest layer of the epidermis is the. is the outermost layer of the epidermis. Sebaceous glands produce this substance. The layer of the epidermis found in the middle is the. is a fibrous protein which gives strength to skin, hair, and nails. The layer of skin around the nails of the fingers and toes is the. Complete the following terms: the farthest out layer of skin: epi exaggerated sweating: dia excessive production of sebum: sebo swollen cuticle: par skin infection caused by fungi: dermato pain of the skin: dermo Build medical terms based on the definitions and word parts given. the area under the skin: sub total absence of sweating: an overproduction of keratinized cells: ichthy nail infection caused by fungi: osis fragile and blistering skin: epidermo yellow tumor: oma lack of skin pigmentation: a increased hair growth in women: hir absence of hair: ia skin infection caused by bacteria: itis Give the medical terms for the following. portions of skin without pigmentation itchy hair loss reddened and raised circular wheals on the skin pimple violet coloration of the skin after a traumatic event Circle the term that best fits the definition given. skin infection with itch mite: (scleroderma, scabies) measles: (rubella, rubeola) chickenpox: (varicella, eczema) thickening of the skin as in the case of a scar/cicatrix: (tinea, keloid) white patches on the oral mucosa: (leukoplakia, albinism) being characterized by a rash: (gangrene, exanthematous) thickening of epidermis after overexposure to UV light: (actinic keratosis, callus) tiny hemorrhages: (psoriasis, petechiae) large blisters: (bullae, pustules) mole: (nevus, verruca) rash as a result of an allergic reaction: (vitiligo, urticaria) Match the following medical terms with their more common meanings below. alopecia comedones decubitus ulcer ecchymosis exanthem nevi verrucae pruritus vesicles seborrheic dermatitis tinea pedis urticaria moles blackheads warts blisters hives rash baldness athlete's foot dandruff "black-and-blue" mark itching bedsore Circle the term that best completes the meaning of the sentence. The patient complains of red, scaly patches on elbows and the front of his knees. The dermatologist made the diagnosis as (vitiligo, impetigo, psoriasis). A rash across the bridge of the nose and aching in the joints were the patient's symptoms. The physician diagnosed this condition as (rheumatoid arthritis, systemic lupus erythematosus, scleroderma). The rashes appear after eating chocolate and peanuts. After several tests, the dermatologist diagnosed it as (seborrhea, acne, urticaria). After exposure to cleaning products, the patient complains of skin discomfort and the physician considers it is (pruritus, calluses, keratosis). The baby had high fever for a few days, accompanied by a red rash spread all over the body. The pediatrician established (rubeola, impetigo, scabies) as diagnosis. The patient suffering from anxiety usually bites the nails and the (follicle, cuticle, subcutaneous tissue). This habit is accompanied by infection of the skin around the nails, known as (onychomycosis, onycholysis, paronychia). The patient noticed a wart on her hand. The patient's went to see a(n) (oncologist, dermatologist, psychologist) who termed it as a (pustule, polyp, verruca) induced by a (bacterium, virus, toxin). The teenage patient had on his face. She noticed blackheads or (wheals, bullae, open comedones) and whiteheads (closed comedones). The dermatologist prescribed systemic antibiotics and topical anti-inflammatory creams in order to treat the (acne vulgaris, scleroderma, gangrene) Multiple choice Select the best answer and write the letter of your choice to the left of each number: follicle a. the outermost stratum of the skin stratum corneum b. subcutaneous tissue sebum c. the deepest layer of the skin hypodermis d. connective tissue around the root of a hair stratum basale e. a secretion of the skin exudate a. scar formation pruritus b. atopic dermatitis eczema c. fluid secreted by the skin erythema d. itching cicatrization e. red skin diaphoresis a. excess perspiration nevus b. caused by radiation actinic c. mole alopecia d. blackhead comedo e. baldness rosacea a. sweat with a foul smell tinea b. infection of the tissue around a nail bromhidrosis c. deficit of melanin albinism d. fungal infection of the skin paronychia e. redness of the face skin Complete in the gaps with the most appropriate word Cutaneous or dermal refers to the............... An oily/sebaceous gland produces.............................. A sudoriferous or sweat gland produces..................... The pigment colouring the skin is............................... The deepest layer of the skin is....................... The protein that rigidizes the skin, hair and nails is...................... Schizonychia is the medical term for.............................. Decide if the following sentences are true or false: The skin along with associated structures are termed integumentary system. The Greek root onycho- refers to nails. The Greek root trich/o- refers to skin. The dermis is under the epidermis. Sebum is a product of sudoriferous glands. Hirsutism is excessive growing of skin. Sunburn is a condition in which the skin gets red due to excessive UV exposure. A synonym for atopic dermatitis is eczema. Rosacea is scaling of the skin. Shingles is a reactivation of the varicella-zoster virus (chickenpox). Kaposi sarcoma represents cancerous lesions in immunocompromised patients. Urticaria is similar to genital or oral herpetic strains. Redness of the skin or mucous membranes is termed medically erythema. Impetigo is a skin infection occurring in children. Petechiae are small, intradermal hemorrhages. Define each of the following words: percutaneous keratocyte trichoglossia onychology melanin xerostomia pachyderma hypotrichosis xeroma onychology Give the plural for form for each of the integumentary terms below. fungus abscess ecchymosis cicatrix eczema nevus bulla verruca diaphoresis epidermis staphylococcus comedo macula lunula exanthem callus erythema melanoma sarcoma corium derma petechia stratum hypodermis spinosum corneum epithelium fascia lucidum germinativum dermis GRAMMAR FOCUS ADJECTIVES+PREPOSITIONS IN She is interested in learning new treatments. The hospital manager wants someone who\'s experienced in the new procedures. The residents want to get involved in consulting patients. AT The new medical team is good at endoscopies. The physician was amazed at the patient's recovery. The nurse is terrible at sampling blood. The new obstetrician is good at delivering babies. He is brilliant at surgeries. ABOUT The infant is angry about the way he was treated. The patient is nervous about the operation scheduled tomorrow. We are excited about the new cure. The physician is worried about the disease outcome. OF The child was afraid of the injection. She is frightened of finding out the blood tests results. Everybody is scared of undergoing surgery. The medical team should be proud of their results. TO The man is getting married to the young lady next week. Children are addicted to sweets. The lady is allergic to nuts. The CT scan is similar to the MRI. This medical procedure is similar to the one we used last year The hospital staff were really friendly to the patient's caretakers. The dermatologist was nice to the infant when consulting him. The nurse is always polite to everyone. It is not nice to be rude to the patients. FOR Physical exercise is good for keeping fit. Stress, a bad diet and sedentarism are bad for you. The hospital is famous for its ICU staff. It is difficult to be responsible for the life of your patients. MUSCULOSKELETAL SYSTEM The musculoskeletal system consists of the bones, muscles, and joints. All have important functions in the body. Its main functions are to offer structure and support for the body as well as allowing movements. Bones make up the framework of the body is constructed. There are 206 bones of various types in the body. They offer protection and support to internal organs. Bones also help the body in movement, as they serve as a point of attachment for muscles. Bones are made up mainly of connective tissue called osseous (bony) tissue, plus a rich supply of blood vessels and nerves. Osseous tissue consists of a combination of osteocytes (bone cells), dense connective tissue strands known as collagen, and intercellular calcium salts. The bones of the fetus are composed of cartilaginous tissue. It is more flexible and less dense as it lacks calcium salts in its intercellular spaces. As the embryo develops, the process of depositing calcium salts starts and continues during the life of the individual after birth. The process of replacing cartilage. The gradual replacement of cartilage and its intercellular substance by immature bone cells and calcium deposits is ossification (bone formation). Osteoblasts are immature osteocytes (bone cells). They produce the bony tissue that replaces cartilage during ossification. Osteoclasts (-clast is from the Greek word meaning to break) are bone cells which reabsorb and degrade bony tissue. Osteoclasts are also called bone phagocytes. When a bone breaks, osteoblasts lay down the calcium salts and osteoclasts remove excess bone debris (smooth out the bone). Osteoblasts and osteoclasts work together is tearing down processes (osteoclasts) and rebuilding processes (osteoblasts). This makes bones to be a living tissue, constantly rebuilding and renewing itself. Bone formation depends extensively on a proper supply of calcium and phosphorus to the bone tissue. These minerals should be introduced into the body along with a sufficient amount of vitamin D. Vitamin D is the one which helps calcium to pass through the lining of the small intestine and into the bloodstream. Once calcium and phosphorus are in the bones, osteoblastic activity produces an enzyme that forms calcium phosphate, a substance that gives bone its characteristic high density and hardness. The skeleton is divided into axial one (consisting in the thorax and skull) and appendicular (consisting in the bones of the four limbs and their girdles-pectoral and pelvic). The inner structure of bones is made up of hematopoietic tissue (red bone marrow, which manufactures blood cells). However, the other parts of bone store minerals necessary for growth, such as calcium and phosphorus. Spaces in cancellous bone contain red bone marrow. The red marrow consists of immature and mature blood cells. Hematopoiesis is the formation of all types of blood cells in the bone marrow. As time passes, the red marrow changes into yellow marrow. According to their shape, bones are of five types: flat, long, short, irregular, and sesamoid. Flat bones ensure protection to viscera, and they are found in the skull (occipital, parietal, frontal, nasal, lacrimal, and vomer), the thoracic cage (sternum and ribs), and the pelvis (ilium, ischium, and pubis). Long bones facilitate movement and include the femur (the longest bone in the body) and small bones in the fingers. Long bones are found in the thigh, lower leg, and upper and lower arm. Short bones offer stability and include the bones of the wrist and ankle joints. The carpals in the wrist (scaphoid, lunate, triquetral, hamate, pisiform, capitate, trapezoid, and trapezium) and the tarsals in the ankles (calcaneus, talus, navicular, cuboid, lateral cuneiform, intermediate cuneiform, and medial cuneiform) are all short bones. Irregular bones vary in shape and examples of irregular bones are the vertebrae (which protect the spinal cord) and the pelvis (pubis, ilium, and ischium). Sesamoid bones are embedded in tendons. They are usually small, round bones found in the tendons of the hands, knees, and feet. A good example is the patella (kneecap). A long bone consists of two parts: the diaphysis and the epiphysis. Bones which are subject to endochondral ossification also have a physis (growth plate). The diaphysis is the shaft between the proximal and distal ends of the bone. The physes (singular: physis) are growth plates and the epiphysis, the end of the bone which contributes to a joint. The epiphyseal line or plate represents an area of cartilage tissue that is constantly being replaced by new bone tissue as the bone grows; it also is commonly known as the growth plate. The periosteum is a strong, fibrous, vascular membrane covering the surface of bones, except the ends. Periosteum has nerves and blood vessels that cross it in order to nutrify the bone. https://commons.wikimedia.org/wiki/File:603\_Anatomy\_of\_Long\_Bone.jpg The hard outer part of the bone is made up of compact tissue, the inside part of the bone, containing the bone marrow is made up of cancellous tissue or trabecular bone (spongy, porous tissue) and subchondral tissue (smooth bone tissue of the joints). Joints are the places at which bones come together. They ensure flexibility of movement and stability. Joints can be classified on the basis of their structure or on the basis of their function. Depending on their structure, joints can be fibrous, cartilaginous, and synovial joints. Fibrous joints are kept together by fibrous connective tissue and can be sutures (between the bones of the skull), syndesmoses (in which bones are connected by a band of connective tissue), and gomphoses (between teeth and their sockets). Cartilaginous joints in which the bones are connected by cartilage can be: synchondroses (in the epiphyseal plates of growing bones in children) and symphyses (between body of vertebrae and between the pubic bones). Synovial joints are made up of synovial cavity, is filled with synovial fluid which lubricates. Good examples of synovial joints are knees, elbows, and shoulders. Depending on the degree of movement they allow, joints can be diarthrosis (a joint which moves freely), synarthrosis (immovable joint in which two bones are connected rigidly by fibrous tissue) and amphiarthrosis (slightly movable joints). Freely movable (diarthrosis) also called synovial joints can be divided into different types, according to the types of movements they allow: hinge allows movement in one plane. Most common examples are elbow, ankle, knee. saddle with opposing articular surfaces having a reciprocal concave-convex shape. For example, carpometacarpal joints. plane or gliding in which articular surfaces glide over one another. They are found in ankles, wrist, and spine pivot permit rotation. An example of pivot articulation is the one between the atlas and the axis. ball and socket (or spheroid joint) are ball shaped. The most common examples are the hip joint, shoulder joint. Muscles can be classified into skeletal, smooth and cardiac. Skeletal muscles (striated) are attached to bones and permit movement. Skeletal muscles and bones make up the musculoskeletal system (locomotor system). They are voluntary as are under conscious control. Smooth muscles are located in internal structures such as organs or arteries. They are involuntary because they move without our conscious awareness. Smooth muscles are responsible for peristalsis, the wavelike movements that propel materials through the systems. Cardiac muscle is responsible for heart contractions and it is involuntary. Skeletal muscles are stimulated to contract by motor neurons of the nervous system. At the neuromuscular junction (NMJ), the point where a branch of a neuron meets a muscle cell, the neurotransmitter acetylcholine is released, prompting contraction of the cell. Two special proteins in the cell, actin and myosin, interact to produce the contraction. ATP (the cell's energy compound) and calcium are needed for this response. Sometimes muscles are kept in a steady partially contracted state, to maintain posture, for example. This state of firmness is called tonus, or muscle tone. As one muscle, the prime mover, contracts, an opposing muscle, the antagonist, must relax. For example, when the biceps brachii on the anterior surface of the upper arm contracts to flex the arm, the triceps brachii on the posterior surface must relax. The point where the muscle is attached to a stable part of the skeleton is the origin; the point where a muscle is attached to a moving part of the skeleton is the insertion. Muscles are made up of fibers. These cells are held together in bundles by connective tissue. A sheath of connective tissue or fascia covers each muscle. These supporting tissues merge to form the tendon that attaches the muscle to a bone. Acetylcholine is a neurotransmitter found in the CNS and at neuromuscular junctions between peripheral nerves and muscles. https://www.sciencelearn.org.nz/resources/1917-muscle-structure-muscle-under-the-microscope Tendons are connective tissue that connect muscles to bones, while ligaments connect bones to other bones. Orthopedists are physicians who treat (with medication or surgically) bone, joint, and muscle conditions. Initially, orthopedics was a branch of medicine dealing with deformities of the skeletal parts in children (orth/o means straight, ped/o means child). Rheumatology is the branch of medicine dealing with joints problems. Specialists in this branch are called rheumatologists. Physiatrists are physicians who deal with rehabilitation after injury or illness to muscles, bones, and nerves. An osteopath treats musculoskeletal system ailments or injuries by using pressure and movement. A chiropractor (chir/o means hand) is a specialist in manipulative treatment of misalignments of the joints, spinal column and soft tissues. A physical therapist (physiotherapist) treats injuries or deformities by massage, heat treatment, and exercise. This specialist develops a treatment plan based on a physician's diagnosis. The main purpose is to relieve pain and regain mobility. BONES FORMATION AND STRUCTURE PATHOLOGY OF THE SKELETAL SYSTEM Joints Ankylosis refers to the loss or absence of mobility in a joint due to disease, injury, or a surgical procedure. Arthrosclerosis is rigidity (stiffness) occurring into the joints. It usually affects the elderly (arthr/o means joint, and -sclerosis means abnormal hardening). Bursitis is an inflammation of a bursa (a thin sac which cushions the articulation). Chondromalacia is the abnormal softening of cartilage (chondr/o means cartilage, and malacia means softening). A chondroma is a benign tumor originating from cartilage cells. Hallux valgus (bunion) is an abnormal enlargement of the joint at the base of the great toe. Smaller bunions (bunionettes) grow on the joint of the little toe. Hemarthrosis is blood within a joint and occurs frequently due to joint injury. It also can be the side effect of blood-thinning medications or in patients who suffer from blood clotting disorder such as hemophilia. Polymyalgia rheumatica (PMR) is an inflammatory disorder inflicting the elderly which affects the muscles and joints. Its main symptoms are pain and stiffness in the neck, shoulders, upper arms, and hips and thighs (poly- means many, my means muscle, and --algia means pain). Rheumatica comes from the Latin word for rheumatism. A sprain is a tear of a ligament connecting bones to a joint. Synovitis refers to inflammation of the synovial membrane. The main symptoms are swelling and pain of the affected joint. Causes can be an injury, arthritis or an infection. Dislocation (luxation) is the displacement of a bone. It can affect shoulders and fingers, but can also appear in elbows, knees and hips. Subluxation is the partial displacement of a bone. Arthritis is an inflammatory condition of one or more joints. There are over 100 types of arthritis and causes can vary widely. Some of the more common types of arthritis follow. Osteoarthritis (OA), also known as wear-and-tear arthritis. This form is associated with aging. It is a degenerative joint disease and it involves wearing away of the articular cartilage inside the joint. It is also characterized by hypertrophy (enlargement) of bone and the formation of osteophytes, also known as bone spurs. Spondylosis (spinal osteoarthritis) is an abnormal wear of the cartilage, especially in the cervical region. Gouty Arthritis (gout) is a type of arthritis characterized by deposits of uric acid in the joints. Uric acid is a by-product that is normally excreted by the kidneys. Gout develops when excess uric acid leads to creation of crystals in the joints of the feet and legs. Rheumatoid arthritis is a chronic autoimmune disorder in which the joints and some organs of other body systems are attacked. Ankylosing spondylitis is a form of rheumatoid arthritis causing inflammation of the joints between the vertebrae. Ankylosing refers to progressive stiffening of a joint, and spondylitis means inflammation of the vertebrae. A herniated disk (slipped or ruptured disk) is the breaking of an intervertebral disk. This causes pressure on spinal nerve roots. Lumbago (low back pain) is pain which occurs in the lumbar region of the spine Spondylolisthesis is the forward movement of the lower lumbar vertebrae on the vertebra or sacrum below it. Spina bifida is a congenital defect that occurs during early pregnancy when the spinal canal fails to close completely. https://www.istockphoto.com/ro/vector/etapele-hallux-valgus-gm1393002065-449059899 Neoplasms Osteogenic sarcoma (osteosarcoma) appears mostly in the growing region of a bone, especially around the knee. Although it is a highly malignant tumor requiring amputation, if it did not metastasize, it is curable. It mostly metastasizes to the lungs. Chondrosarcoma. This tumor occurs in cartilage. It may require amputation and most frequently metastasizes to the lungs. Main symptoms of these types of cancer are bone pain (ostealgia) or tenderness, a mass or lump (tumor) that is warm, inflammation and redness at the site of your tumor. Other signs of bone tumors are pain, easy fracture, and increases in serum calcium and alkaline phosphatase levels. Curvatures of the Spine Kyphosis is an increase in the outward curvature of the thoracic spine as viewed from the side. Kyphosis, also known as humpback or dowager's hump, is frequently associated with aging. https://www.news-medical.net/health/Pediatric-Spinal-Deformities.aspx Lordosis is inward curvature of the spine that typically affects the lower. It is also known as swayback Scoliosis is an abnormal lateral (sideways) curvature of the spine. Craniostenosis is a malformation, a congenital defect of the skull in which cranial sutures close too prematurely, before the brain is entirely formed. Fibrous dysplasia is a bone disorder which destroys normal bone structure and replaces it with fibrous (scarlike) tissue. The cause is not known. Main symptoms include uneven bone growth, brittleness, and deformity. Ostealgia, also known as osteodynia, means pain in a bone. Osteitis (ostitis) is an inflammation of a bone mainly in the cortex (non-medullary infection or infectious osteitis). In case of an infection involvement of the medullary cavity, this is termed osteomyelitis. The bacterial infection that causes osteomyelitis often originates in another part of the body and spreads to the bone via the blood. Osteomalacia, also known as adult rickets, is softening of bones in adults. This condition is usually induced by a lack of vitamin D, calcium, and/or phosphate. Osteonecrosis is the death of bone tissue due to insufficient blood supply. Osteoporosis is a serious loss of bone density and an increase in bone porosity. Its main cause is the aging but there are other conditions which can lead to osteoporosis. These include nutritional deficiencies; disuse, as in paralysis or immobilization in a cast; and excess steroids from the adrenal cortex. Overactivity of the parathyroid glands also leads to osteoporosis because parathyroid hormone releases calcium from bones to raise blood calcium levels. Certain drugs, smoking, lack of exercise, and high intake of alcohol, caffeine, and proteins may also contribute to the development of osteoporosis. Osteopenia is loss of bone mineral density. This condition affects people who do not yet have osteoporosis, but they are at risk for developing it. Main treatments include calcium intake, exercise, healthy diet, supplements of vitamin D. Paget's disease (osteitis deformans) is a bone disease of unknown cause. This condition is characterized by the excessive breakdown of bone tissue, bones become fragile and misshaped. The most affected bones are those in the pelvis, skull, spine and legs. Periostitis is an inflammation of the periosteum (the outer membrane of bones). Rickets is a deficiency disease occurring in children. Bones grow in a defective way as a result of vitamin D deficiency or insufficient exposure to sunlight. Nutritional ricket can be cured if measures are taken in due time. Dwarfism (nanism) is a condition resulting from the failure of the bones of the limbs to grow to an appropriate length. This condition can be genetic is it can be associated with insufficient amounts of growth hormone in the body (pituitary dwarfism). The opposite condition, high levels of growth hormone (GH) in their body, leads to gigantism. Acromegaly occurs when GH hypersecretion occurs after the fusion of the epiphysis leading to large extremities. The term talipes (clubfoot) describes any congenital deformity of the foot involving the talus (ankle bones). Fractures A fracture, a broken bone, is described in terms of its complexity. The simplest fracture is a stable one as the bones are barely displaced. A closed fracture, also known as a simple or complete fracture, is one in which the bone is broken, but there is no open wound in the skin. An open fracture, also known as a compound fracture, is one in which the broken bone is accompanied by a wound in the skin. A comminuted fracture is one in which the bone is splintered or crushed. Comminuted means to be crushed into small pieces. A greenstick fracture, or incomplete fracture, is one in which the bone is bent and only partially broken. This type of fracture occurs primarily in children. A linear fracture occurs when the break is parallel to the bone's long axis. An oblique fracture occurs at an angle across the bone. A pathologic fracture occurs when a weakened bone breaks under normal strain. This kind of fracture occurs in osteoporosis or a disease process such as cancer. A spiral fracture is a fracture in which the bone has been twisted. This type of fracture occurs as the result of a severe twisting motion, for example in the case of a sports injury. A stress fracture, which is an overuse injury, is a small crack in the bone which develops from chronic excessive impact. Buckled fracture (or impacted fracture) usually occur in children under 12. A transverse fracture appears across the bone. Treatment of fractures involves reduction. This means replacing the bone in its normal position. A closed reduction is manipulative reduction without a surgical incision; in an open reduction, the physician needs an incision in order to reach the site. A cast (solid mold of the body part) is applied to fractures to immobilize the injured bone after a closed reduction. https://www.topbonedude.com/types-of-broken-bones-symptoms-treatment-healing/ PATHOLOGY OF THE MUSCULAR SYSTEM CLINICAL ASPECTS Any disorder of muscles is described as a myopathy. There are several techniques which can be used for diagnosing muscle disorders. They include electrical studies of muscle in action, electromyography (EMG), and serum assay of enzymes released in increased amounts from damaged muscles, mainly creatine kinase (CK). However, muscle function may be affected by disorders in other parts of the body, particularly in the nervous system and connective tissue. Muscular Dystrophy represents a group of hereditary diseases leading to progressive, noninflammatory degeneration of muscles. The main symptoms associated to this are weakness and wasting of muscle tissue with gradual replacement by connective tissue and fat which leads to muscle pain, stiffness, difficulty moving or walking. There also may be cardiomyopathy (disease of cardiac muscle) and some degree of mental impairment. The most common form is Duchenne muscular dystrophy, a sex-linked disease passed from mother to son. This appears around the age 3 to 4, and patients are incapacitated by age 10 to 15. Death is commonly caused by respiratory failure or infection. Polymyositis is inflammation of skeletal muscle. This condition leads to weakness, frequently associated with dysphagia (difficulty in swallowing) or cardiac problems. The cause is unknown and may be related to viral infection or autoimmunity. In most cases, this condition is associated with some other systemic disease such as rheumatoid arthritis or lupus erythematosus. If the skin is affected too, the condition is termed dermatomyositis. Main symptoms are erythema (redness of the skin), dermatitis (inflammation of the skin), and a typical lilac-colored rash, predominantly on the face. In addition to enzyme studies and EMG, muscle biopsy is used in diagnosis. Myasthenia gravis is an acquired autoimmune disease in which antibodies interfere with muscle stimulation at the neuromuscular junction. There is a progressive loss of muscle power, especially in the external eye muscles and other muscles of the face. Lupus erythematosus (lupus Lat. means wolf) is an autoimmune disease in which the antibodies attack different organs or tissues. Some of the areas affected can be the skin and joints. Mild Lupus is associated with a distinctive butterfly-shaped rash over the nose and cheeks but other symptoms include myalgia and arthralgia. Severe or systemic lupus (SLE) involves other organs such as the heart, lungs, or kidneys. Study the table below Prefix Meaning Example ankylo- oste/o Stiff bone ankylosis osteocyte, osteosarcoma chondr/o cartilage chondrocyte, chondrosarcoma arthr/o articulation arthritis, arthropathy myel/o bone marrow myelocyte ten/o, tendin/o tendon tendonopathy ligament/o ligament ligamentous burs/o bursa bursotomy my/o, myos/o spondylo- muscle spine myositis spondylodynia Suffix -malacia Meaning softening Example chondromalacia -porosis porous, brittle osteoporosis -asthenia weakness myasthenia -trophy development atrophy -algia, algesia -dynia pain pain arthralgia arthrodynia VOCABULARY EXERCISES Fill in the blanks: Osteoid means resembling. Arthrodesis is fusion of a(n). A chondrocyte is a cell of the. Bursitis is inflammation in a(n). Arthroplasty is surgical repair of a. Osteomalacia is of a bone. Neuralgia is in a nerve. Inflammation of a muscle is termed. Increase of a muscle volume is called. Inflammation and infection of a bone s termed. Define each of the following words: osteogenesis chondritis arthrodynia periscapular myelocyte Write the word that best fits the following definitions: deficiency of bone tissue inflammation of bone and bone marrow tumor of bone like cartilage tumor of cartilage narrowing of an articulation inflammation of a bursa disease of a tendon pain in an articulation Define the following medical terms: craniosacral endocranial spondylitis prevertebral suprapelvic suprascapular submandibular infracostal intrathoracic myelopathy Write the adjective that fits each of the following definitions: pertaining to (-al) the sternum pertaining to (-al) the skull pertaining to (-ar) the clavicle pertaining to (-ic) the pubis pertaining to (-al) the vertebral column pertaining to (-al) the sacrum pertaining to (-ic) the pelvis pertaining to (-ar) the scapula pertaining to (-al) the humerus pertaining to (-ar) the ulna pertaining to (-al) the tarsus pertaining to (-al) the calcaneus pertaining to (-al) the coccyx pertaining to (-al) the neck pertaining to (-al) the femur pertaining to (-al) the tibia pertaining to (-ar) the fibula pertaining to (-ar) the patella pertaining to (-ar) the mandible pertaining to (-al) the occipital Multiple choice: bursa a. upper portion of the hip bone periosteum b. sac-like structure around a joint phalanges c. bones of the fingers and toes ilium d. bone of the cheek malar e. membrane around a bone patella a. area of a long bone where it grows symphysis b. kneecap osteoclasts c. breakdown and removal of bone tissue metaphysis d. fusion between two bones resorption e. cells that break down bone polyarticular a. bone marrow formation hemarthrosis b. rigidity of a joint ankylosis c. loss of bone mass myelopoiesis d. presence of blood in a joint cavity osteoporosis e. related to more joints rachiocentesis a. bone inflammation spondylolisthesis b. spinal tap osteitis c. uric acid accumulation in joints comminuted d. displacement of a vertebra gout e. crushed bone in a fracture coxalgia a. lumbar curvature of the spine scoliosis b. pain in the hip intraosseous c. cartilage abnormal growth lordosis d. inside bone achondroplasia e. spine sideways curvature calvaria a. knee subluxation b. partial dislocation genu c. upper area of the skull olecranon d. resembling a cross cruciate e. bony prominence at the elbow atlas a. triangular bone in the lower spine foramen b. first cervical vertebra exostosis c. opening/hole sacrum d. great toe hallux e. bone outgrowth Match the words with the definitions: gastrocnemius; Achilles tendon; bursa; talocrural joint; malleolus; plantarflexion; calcaneus; hyaline cartilage; greater trochanter; piriformis; greater sciatic notch; zygomatic bone; internal auditory meatus; pectoralis major; ribs; deltoid muscle; teres major; latissimus dorsi; suprascapular notch; foramen; humerus; clavicle; sternum; deltoid tuberosity; ilium; gluteus maximus; tibia; fibula; iliopsoas; coccyx; cruciform ligaments (cruciate ligaments) round opening; a hole is a long bone in the upper arm from the shoulder to the elbow is a membrane that covers a joint and has a liquid which lubricates it muscle in the back part of the lower leg (the calf) synovial hinge joint connecting distal ends of the tibia and fibula with the proximal end of the talus bone in the foot main muscles of the buttocks a thick, fan-shaped muscle, situated at the chest shankbone; shinbone the muscle forming the rounded contour of the shoulder heel bone translucent cartilage is the compositions of the larynx, trachea, and bronchi calf bone is the movement increasing the approximate 90 degree angle between the front part of the foot and the shin a muscle in the gluteal region of the lower limb large, regular, quadrilateral eminence of the femur a tendon which connects the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone the uppermost bone of the pelvis canal in the petrous bone of the temporal bone bony prominence on each side of the ankle converted into a foramen by the sacrospinous ligament cheekbone, malar bone a notch on upper border of the scapula curved bones which form the ribcage a muscle of the upper limb and one of six scapulohumeral muscles the larger, dorso-lateral muscle on the trunk collar bone breastbone the region on the shaft of the humerus to which the deltoid muscle attaches dorsal hip muscles or inner hip muscles tailbone pairs of ligaments arranged like a letter X Complete the sentences in a suitable way:... the fossa located at the back of the knee-joint.... are the string-like tendons at the back of the knee.... the lower and back part of the hip bone (os coxae).... are layers of flat broad tendons with a shiny, whitish- color, and are histologically similar to tendons... an adjective referring to the area between the diaphragm and the sacrum or lower spine... the largest and the most superficial of the three flat muscles of the lateral anterior abdomen.... is the superior border of the wing of ilium.... is a paired muscle running vertically on each side of the anterior wall of the human abdomen.... is the midline cartilaginous joint uniting the superior rami of the left and right pubic bones.... is a layer of dense irregular connective tissue which surrounds the cartilage of developing bone.... is a hyaline cartilage plate in the metaphysis at each end of a long bone.... a state in which muscles are floppy.... is the wasting away of a normally developed organ or tissue due to degeneration of cells.... is prolonged painful involuntary contraction of skeletal muscle.... is inflammation of muscle fibers... represents a sustained involuntary muscular contraction; too much muscle tone.... is injury to a ligament, caused by overstretching. Match the terms with their definitions 1\. tarsals a. bones of the ankle 2\. phalanges b. bones of the wrist 3\. axis c. socket femur head 4\. carpals d. second cervical vertebra 5\. acetabulum e. bones of the fingers and toes 6\. occipital a. anterior bone of the pelvis 7\. pubis b. malar bone 8\. patella c. kneecap 9\. zygomatic d. bones of the hand 10\. metacarpals e. posterior bone of the cranium 11\. exostosis a. outgrowth of bone 12\. osteopenia b. lack of bone tissue 13\. olecranon c. cell that destroys bone 14\. periosteum d. projection of the elbow 15\. osteoclast e. membrane around bone 16\. malleolus a. puncture in the spine 17\. myelopoiesis b. inflammatory disease affecting vertebra 18\. spondylitis c. bony projection at the ankle 19\. ankylosis d. stiffness of a joint 20\. thoracocentesis e. formation of bone marrow Fill in the blanks: The neurotransmitter released at the neuromuscular junction is \...\...\...\...\...\...\..... Lack of muscle tone is\...\...\...\...\...\...\..... Any muscle that produces flexion at a joint is called a(n) \...\...\...\...\...\...\..... Muscle that runs vertically at the center of the trunk\...\...\...\...\...\...\..... Main muscle of the buttocks\...\...\...\...\...\...\..... The quadriceps femoris muscle has attachment points. Oxygen-storing pigment in muscle\...\...\...\...\...\...\..... The sheath of connective tissue that covers a muscle is called \...\...\...\...\...\...\..... A band of connective tissue that attaches a muscle to a bone is a(n) \...\...\...\...\...\...\..... Large muscle across the back\...\...\...\...\...\...\..... Lack of muscle coordination\...\...\...\...\...\...\..... Wryneck \...\...\...\...\...\...\..... Too much muscle movement\...\...\...\...\...\...\... Inflammation of a muscle\...\...\...\...\...\...\... Death of the muscle\...\...\...\...\...\...\... Related to the facial muscles\...\...\...\...\...\...\... Pain in the muscle \...\...\...\...\...\...\... Inflammation of fascia\...\...\...\...\...\...\... Pertaining to cartilage\...\...\...\...\...\...\... Pertaining to a tendon\...\...\...\...\...\...\... Poor muscle tone................ Give the opposites of the following words antagonist insertion adduction pronation dorsiflexion flexion eversion external rotation smooth muscle elevation protraction GRAMMAR FOCUS Cleft sentences Cleft sentences shift the attention from one sentence by highlighting a specific element. Cleft sentences begin with pronouns such as it, this, that, those, these, here and there. The pronoun is followed by a form of be. Be + relative clause. The relative pronoun may or may not be included. Original sentence: Subject + verb + object The patient followed a diet. Cleft sentence: Pronoun + be + emphasized phrase (usually a noun phrase) + relative clause It was the patient who followed a diet. It was a diet that the patient followed. Types of cleft sentences It + be + relative clause + that/who clause e.g. It was the surgeon who operated on him. What + subject + do/does/did/ + is/was + (to) infinitive e.g. What the surgeon did was to operate on him. What happens is (that)... / What happened was (that) e.g. What happened was that the surgeon operated on him. The reason, the thing that, the people who, the place where, the day when... e.g. The person who operated on him was the surgeon. EXERCISES Read the information and complete the replies: The patient turned up at the hospital with a bruise on his forehead and a simple fracture. He had fallen off his bike. Luckily, the fracture was not severe and required only some cast on it while the bruise needed only a cold-water compression on it. The physician decided not to put him to hospital. Some antibiotics were prescribed to him though. The patient came to the hospital because he was seriously injured, didn't he? No, it that he had a concussion and a fracture. How on earth did he get the fracture? Well, what Wasn't the patient roller skating when the accident happened? No, that he fell off. The physician had to hospitalize the patient, didn't she? No, what she. Didn't the patient break his arm ice skating? No, it he got the fracture. We understand that the patient was in severe condition. No, she wasn't in a serious state. What ! Rewrite the following sentences with the word given: The surgeon need only an hour to repair surgically his hernia. ALL I am not questioning the usefulness of the treatment. ISN'T These new medications are too strong. WHAT They recovered entirely except the remnant headache. ONLY THING The chief nurse told her subordinates to be on time on duty. THAT'S We are taking drugs to reduce the pain. DOING Complete the sentences: You should give up on smoking. What you \... smoking. Ana started the diet. It was \... the diet. The physician needs ten minutes to finish the procedure. All \... ten minutes to finish the procedure. The patient doesn't like to have taken the pulse. What the patient doesn't like \... He studied Medicine at Minneapolis university. It was at Minneapolis university \... Medicine. I had blood taken early in the morning, not in the evening It was \... I had blood taken. CARDIOVASCULAR SYSTEM The circulatory system is made up of two systems: the cardiovascular one and the lymphatic one. The cardiovascular system consists of the heart, blood vessels, and blood, whereas the lymphatic system is composed of lymphatic vessels and lymphoid tissues (the spleen, thymus, tonsils, and lymph nodes). The heart is the main organ of your cardiovascular system. It is the size of a fist and propels blood throughout our body by controlling the pulse and maintaining the blood pressure. It has four chambers: 2 atria (sg. atrium=auricle) and 2 ventricles. The cone-shaped part of the heart sits behind the sternum, and the great vessels enter or leave this area. The tip (apex) of the heart is just above the diaphragm to the left of the midline and is placed downwards. Systole is the heart contraction phase. In contrast, the relaxation period is termed diastole. In an adult, the heart can pump about 5 liters per minute. But it takes only one minute for this quantity to be circulated to extremities and back. Mediastinum consists of large blood vessels, the trachea, the esophagus, the thymus, and lymph nodes and it can be divided into prevascular, visceral, and paravertebral compartments. The three structures of the heart are: The protective sac surrounding the heart is termed pericardium (plural pericardia). Its main function is to lubricate the heart membranes. The pericardium has two layers: visceral pericardium (the inner one) also termed epicardium (epi-=above; upon) and the parietal pericardium (the outer portion of it). The second layer is the myocardium (plural myocardia). It is made up of involuntary, striated muscle that makes up the heart. The innermost layer, the endocardium (plural endocardia), creates a membranous lining (mucosa) for the heart chambers and valves. It consists of endothelial cells and it controls myocardial functions. The valves push the blood towards heart and they prevent regurgitation (backward flow of blood). There are four main types of valves: tricuspid valve (between the right atrium and the right ventricle); mitral valve (between the left atrium and the left ventricle); pulmonary valve (between the right ventricle and the pulmonary artery) and aortic valve (between the left ventricle and the aorta). The first two propel blood from atria towards the ventricles while the other two valves propel blood to the lungs and the rest of the body through the ventricles. Valves have cusps (flaps or leaflets) that open and close. For example, the tricuspid valve has three cusps and the bicuspid aortic valve has two cusps. Blood vessels move the blood around the body, and they form a tubular network. There are three main types of blood vessels: arteries (carry blood away from the heart), veins (return blood to the heart) and capillaries (connect arteries and veins). Arteries subdivide into smaller vessels called arterioles whereas small veins are called venules. Arteries distribute oxygen-rich blood to your entire body. The carotid artery carries blood to the head and neck, the femoral artery delivers blood to the lower limb and located behind the knee and continuation of the femoral artery, the popliteal artery supplying blood to the soleus, gastrocnemius, plantaris, and distal portions of the hamstring muscles. Arteries can be elastic, closer to the heart, such as the aorta and the pulmonary artery or they can be muscular such as femoral, radial and brachial. Veins, on the other hand, can be of four types: pulmonary, systemic, superficial and deep. The two saphenous veins (great saphenous vein and small saphenous vein) bring blood from the lower part of the body back to the heart. The blood from the upper part of the body (above the diaphragm) is carried to the heart through a large vein called the superior vena cava (plural venae cavae). The blood from the lower part of the body (below the diaphragm) goes to the other large vein called the inferior vena cava and then to the heart. Placed in the epicardium of the right atrium, there is the (SA) node (synonym sinus node or the natural pacemaker). It is an oval structure generating an electrical signal, thus, contracting the upper atria. From the SA node, impulses for contraction travel to the atrioventricular (AV) node, located in the lower interatrial septum. Coronary vessels are major blood vessels which supply blood to the heart. There are two of them: right coronary artery (RCA) and a left main coronary artery (LMCA). If one of them is blocked (clogged, obstructed) with a thrombus, part of the heart muscle becomes ischemic. A synonym for ischemia is hypoperfusion. If ischemia lasts for too long, the tissue becomes necrotic (dead). The medical term for this is myocardial infarction (MI) or heart attack. The arterial and veinous walls are made up of three layers, The tunica externa (adventitia) is the outermost layer and it consists of loose connective tissue. The tunica media, which is the middle layer, consists of smooth muscle cells, elastic tissue and collagen. The tunica interna, which the innermost layer, is made up of flat epithelial cells and elastic fibers composed of elastin. The smoothness of this layer allows blood to flow. https://www.britannica.com/science/artery An anastomosis (plural anastomoses) is a connection of vessels. They can connect an artery to an artery (arterio arterial) or a vein to a vein (veno venous) or an artery to a vein (arterio venous). Their main purpose is to create a backup for the blood flow if one vessel becomes obstructed. Blood is specialized connective tissue. It consists of formed elements---erythrocytes, leukocytes, and platelets (thrombocytes)---that are suspended and carried in the blood plasma. These formed elements occupy about 45% of volume and plasma about 55% of volume. Erythrocytes transport oxygen, carbon dioxide and nutrients. They live for about 120 days. Leukocytes diminish inflammation and promote defense. Leukocytes are neutrophils, eosinophils, basophils, lymphocytes and monocytes. Neutrophils destroy invaders by phagocytosis and intracellular degradation. Eosinophils modulate inflammation and have bactericidal activity. Basophils are responsible for responses to pathogens and allergies. Lymphocytes produce antibodies. Monocytes turn into macrophages, killing the pathogens. Leukocytes travel the capillary walls into the tissues by a process termed diapedesis. Neutrophils, eosinophils, and basophils are granulocytes (produce granules). Monocytes and lymphocytes are agranulocytes (they do not produce granules). Thrombocytes (platelets) help in coagulation (clotting). The average blood volume in an adult is about 5 liters, and it makes up about 8% of the total body weight. Blood plasma is the fluid portion of the blood. It consists of 90% water, contains proteins and has a yellowish colour. Plasmapheresis is a medical therapy of removing plasma and replacement of it with a substitution fluid (mainly albumin solution). This intervention offers a good treatment in case of autoimmune disorders. Pulse (heartbeat) is throbbing of the arteries as they pump out the blood. When we feel the pulse, we actually feel the force being exerted by ventricles pumping transmitted through the walls of the arteries. This is why it cannot be felt in veins. Some of the most commonly used pulse sites are: Radial---felt on the thumb side of the wrist. Carotid---felt laterally to the larynx in the neck. Temporal---felt at the temple, in front of the ear. Femoral---felt at the top of the thigh. Popliteal---felt at the back of the knee in the popliteal fossa. Dorsalis pedis--- (commonly called the pedal pulse) is felt on top of the foot. DISEASES AFFLICTING THE CARDIOVASCULAR SYSTEM AND BLOOD An abnormally low hemoglobin concentration and/or erythrocyte number leads to a condition termed anemia. Some types of anemia can be caused by nutritional deficiencies such as pernicious anemia, iron-deficiency anemia and megaloblastic anemia. In pernicious anemia, the production of red blood cells is insufficient because of lack of a substance needed for the absorption of vitamin B12 at the intestine level. Iron-deficiency anemia is caused by a deficient intake (absorption) of iron or due to a loss of iron such is the case of an internal bleeding. Megaloblastic anemia is caused by an insufficient intake of vitamin B12 and/or vitamin B9. Other types of anemia are inherited. In sickle cell anemia the shape of red blood cells is changed. Fanconi anemia (FA) affects bone marrow and can lead to development of different types of cancer. Diamond-Blackfan anemia (DBA) prevents bone marrow from producing enough erythrocytes. Some types of anemia acre induced by abnormal red blood cells. Aplastic anemia can be caused by destruction of bone marrow by chemicals (such as benzene and arsenic) or by radiation. In hemolytic anemia, the rate of red blood cell destruction increases. Sideroblastic anemia manifests itself as too few red blood cells. Macrocytic anemia occurs when bone marrow produces abnormally large red blood cells and microcytic anemia occurs when they are too small in size. Some of the most common symptoms of anemia are paleness, headaches, pulsatile tinnitus (ringing in the ear), dizziness, dyspnea, arrhythmia. If plaques of cholesterol adhere to the walls of coronary artery disease, the condition is termed atherosclerosis. These deposits narrow the lumen (opening) creating a rough surface to which a clot (thrombus) may stick. When the blood does not flow smoothly into the heart, a heart murmur may appear. Usually, it is the sign of valve malfunction. As a valve does not close properly, it can allow blood to regurgitate (go backward); this turbulence can be heard with a stethoscope. Although it is not caused by a cardiac problem, rheumatic heart disease is a complication of a streptococcal infection. It is an immune condition which leads to stiffening of the heart valves. These valves become "leaky" and inefficient. The narrowing of a valve (stenosis) is a congenital condition. The main symptoms of this stenosis are angina, dyspnea, palpitations, extreme fatigue. https://www.heart-valve-surgery.com/aortic-stenosis-prognosis.php An irregular heartbeat is called arrhythmia (also termed dysrhythmias). There are two main types: tachycardia and bradycardia. Irregular heartbeats can have various causes: from damage to part of the conduction pathway, an ectopic focus (a beat generated in part of the myocardium other than the SA node) to certain conditions such as diabetes, hypertension and sleep apnea. https://www.thebeefoundation.org/brain-aneurysms-information-mount-sinai-hospital/ If the wall of an artery bulges out and reaches to form a balloon like structure greater than 50% of the diameter of the vessel, we speak of an aneurysm. A saccular aneurysm (berry aneurysm) is a round, blood-filled sac usually at the base of the brain. A fusiform aneurysm causes the entire length of the vessel to bulge out whereas a mycotic aneurysm is induced by an infection. Rupture of a cerebral aneurysm leads to a cerebrovascular accident (CVA). An aortic aneurysm is life-threatening but, if identified in due time, it can be surgically repaired. The main symptoms of aneurysms, if they occur in the brain, are severe headaches, diplopia, photophobia, loss of consciousness, seizures, vomiting, slurred speech, confusion. When heat beats faster than normal, in an uncoordinated manner, we can speak about fibrillation. It usually occurs as a result of high blood pressure (hypertension) and atherosclerosis. A life-threatening condition is hemorrhage. In case of an accident, it is important to stop the bleeding by applying pressure to curtail the flow of blood. These points of pressure are the brachial artery and the femoral artery in the groin. A tourniquet may have to be applied if bleeding is severe enough to endanger life. An inflammation of a vein is termed phlebitis. It mostly occurs in the veins of the lower limbs as they are under greater pressure because blood returns back to the heart, defying the force of gravity. Blood disorders, obesity, and various veins are some of the most encountered causes of phlebitis. In case of a superficial vein being affected, the blood flow is maintained due to anastomoses among these veins. Though, there might appear tenderness, pain, swollen and red area. In the case of deep vein phlebitis it is possible to be formed clots (thrombi) which is termed thrombophlebitis. If a clot gets loose, it can lead to the formation of an embolism (blockage of an artery). Twisted, swollen and enlarged veins appearing on the leg veins are termed varicose veins. If they appear in the anal canal, they are called hemorrhoids (piles). Some of the most frequent causes of piles are straining during defecation, severe constipation, chronic diarrhea, pregnancy. Sclerotherapy is a medical procedure which tries to treat blood vessels or blood vessel malformations (vascular malformations). It implies injecting medication into the vessels leading to their shrinkage. It is usually performed to treat spider veins (telangiectasia), smaller varicose veins, and hemorrhoids. Another procedure, termed endovenous ablation, uses radiofrequency or laser energy to cauterize and close varicose veins in the legs. en.wikipedia.org After a severe myocardial infarction or as a result of ventricular fibrillation it is possible to appear a cardiogenic shock. In this case, the heat does not pump out the blood properly. Hypovolemic shock appears as a result of a decrease of the blood volume, usually because of a hemorrhage. Though there can be other causes as well, such as extreme sweating (heat stroke) or extreme loss of water through the kidneys (diuresis) or intestines (diarrhea). The cardiac output decreases because of a diminishment in the blood volume. Anaphylactic shock is an extreme allergic reaction in which large quantity of histamine increase capillary permeability and vasodilation throughout the body. Septic shock is caused by septicemia, the presence of bacteria in the blood. The bacteria and damaged tissues release inflammatory chemicals that cause vasodilation and extensive loss of plasma into tissue spaces. The tetralogy of Fallot is a combination of four congenital defects. It induces cyanotic condition. The four characteristics of this condition are (1) a ventricular septal defect, (2) a misplaced aorta, (3) pulmonary stenosis, and (4) right ventricular hypertrophy. The first to describe this condition was the French physician Étienne-Louis-Arthur Fallot (1850-1911). An infection of the heart valves or of the lining of the heart is termed bacterial endocarditis. Bacteria, fungi or viruses can get into the bloodstream and can cause this condition. Myocardial disease is an inflammation of myocardium followed by cardiac enlargement and congestive heart failure. Pericarditis causes an inflammation of the pericardium. Myocardial ischemia is associated with increased concentrations of blood lactic acid. Main symptoms include substernal pain (angina pectoris), which also may be radiate to the left shoulder and arm, poikilothermia (inability to maintain inner adequate temperature), paleness and paresthesia. Coarctation occurs as an abnormal development of the aorta before birth. It is frequently caused by tightening of remnant of the ductus arteriosus around the vessel. A low number of platelets, thrombocytopenia, can be induced by any impairment of the red bone marrow. Main causes of this condition are an autoimmune disorder or leukemia. Hemophilia is an inherited consisting in a deficiency in a clotting factor. Edema is localized swelling that occurs when tissue fluid accumulates. It can be induced by many conditions such as congestive heart failure, liver and/or kidney dysfunctions, deep vein thrombosis, severe lack of proteins. One dramatic cause of a blockage is the parasitic infection of lymphatic vessels by a small worm. An affected leg can become so large that the disease is called elephantiasis. Leukemia involves the white blood cells. It is cancer of the blood-forming tissues (bone marrow and the lymphatic system). Myeloid leukemia affects the myelocytes and lymphocytic leukemia develops from lymphoid cells. Symptoms can vary a lot and, therefore, they can be mistaken with other conditions. Some of the most common symptoms are fatigue, dyspnea, frequent infections, pallor, bone/joint pain, swollen lymph nodes, bruising and bleeding easily, petechiae. Leukemia can be treated with a combination of these treatments: chemotherapy, immunotherapy, stem cell or bone marrow transplant, radiation. Embolism is the sudden blockage of a blood vessel by an embolus. According to the cause of it, embolism can be of four types. It can be induces by a blood clot (thrombus), a fat globule (fat embolism), a bubble of air or other gas (gas embolism), amniotic fluid (amniotic fluid embolism), Blood Disorders Blood dyscrasia is a broad name that encompasses any disease inflicting blood, bone marrow, or lymph tissue. Hemochromatosis is a hyperproduction or deposition of iron. It is usually genetic and the main sites where the body stores iron are skin, heart, liver, pancreas, pituitary gland, and joints. The main symptoms are darkening of the skin, extreme tiredness, abdominal pains, usually in the liver area. Leukopenia is a decrease in the number of disease-fighting white blood cells circulating in the blood Polycythemia is an increase in the number of red cells in the blood due to excess production of these cells by the bone marrow. Hematocrit and/or hemoglobin concentration are increased. Main causes are sleep apnea, hypoventilation syndrome, and chronic obstructive pulmonary disease. Septicemia or sepsis is the presence of bacteria in the blood. Although it is termed bacteremia there is a difference between the two. Bacteremia is occurrence of bacteria in the bloodstream whereas septicemia is a multiplication of bacteria in the blood. Thrombocytosis is a higher number of platelets in the bloodstream. Thrombocytopenia is a low number of platelets. Main causes are a bone marrow condition (e.g. leukemia) or an immune system problem. It can be fixed by corticosteroid medication, immune suppressors or splenectomy. Main symptoms are abnormal bruising and bleeding in the skin, gums and epistaxis. Thalassemia occurs when the body does not produce enough hemoglobin. It is an inherited disorder. Hemophilia is also inherited. Its main symptom is blood which does not clot properly. Main symptoms are swelling and pain or tightness in the joints, build-up of blood in the muscles and soft tissues (hametoma). Leukemia is a form of cancer that generally increases in frequency with age because of both intrinsic (genetic) and extrinsic (environmental) reasons. Study the table below Prefix Suffix Meaning Example arter(o), angio cardi/o brady- tachy- artery vessel heart slow fast arteriography angiogram myocarditis bradycardia tachycardia veno- phlebo- vein venogram phlebitis -stasis to stop hemostasis -cyte cell erythrocytes hem/o, - sept(o) vetricul(o) valv(o) blood partition ventricle valve hemodialysis septum ventriculotomy valvulitis VOCABULARY EXERCISES Fill in the blanks: Cardiogenic is an adjective which refers to having origin in..... Between the atria is termed..... Ventriculotomy refers to an opening (a surgical incision) into a(n)..... The plastic repair of a valve is termed...\... Give the adjective for the following definitions. In brackets you are given the suffix ending Pertaining to a ventricle (-ar) Pertaining to the pericardium (-al) Pertaining to an atrium (-al) Pertaining to a valve (-ar) Pertaining to the heart (-ac) Pertaining to the myocardium (-al) Give the medical term that best fits these definitions: Inflammation of the heart muscle Inflammation of the heart's inner mucosa Inflammation of the membrane around the heart Give a definition of the following words: cardiovascular periaortic vasculitis arteriography thrombophlebitis By using the suffix -gram, give the right word: viewing blood vessels (use the prefix angi/o) viewing of the aorta visualizing veins Starting from the root angi/, give the words that fit the definitions: Creation (-genesis) of a blood vessel Enlargement (-ectasis) of a blood vessel A condition (-pathy) inflicting a blood vessel Surgical repair (-plasty) of a blood vessel Give the medical term matching the following meanings: Inside(intra-) a vein A cut into an artery (-tomy) Excision of a vein (-ectomy) Hardening (-sclerosis) of the aorta Find the best definition for the words on the left: Angiology a) any condition of an aorta Aortopathy b) calcification inside a vein Endoarterectomy c) study of blood vessels Venogram d) taking out deposits on an artery Phlebolith e) an X-ray of a vein Cardialgia f) ability of the heart to move Cardiograph g) the muscle of the heart Cardiomyophathy h) achy heart Myocardium i) condition affecting the heart muscle Cardiomotility j) a device registers heart beat Valvotomy k) opening of a narrowed valve Vasculitis l) excision of a valve Cardiovalvulotomy m) hardening of blood vessels Angiogram n) inflammation of blood vessels Angiosclerosis o) an X-ray image of blood vessels Dextrocardia p) repairing surgically of a heart valve Phonocardiography r) inflammation of the heart lining Endocarditis s) registering heart sounds Pericardium t) placement of the heart to the right Valvoplasty u) a fibrous sac around the heart Match the medical prefix to the meaning: heart aorto- aorta thrombo- vein phlebo- blood cloot haem(at)- blood cardio- Supply the medical term of the following afflictions: heart paralysis softening of the heart muscle location of the heart towards the right side bacteria in the blood the presence of calcification into a blood vessel inflammation of the heart muscle narrowing of a blood vessel under the sternum surgical repair of a valve puncture to remove fluid from pericardium pertaining to the heart and blood vessels incorrect opening of a valve Write the adjective of the following words: circulation; heart; pleurae; larynx; artery; meninges; lymph; nerve; anastomosis; dyspnea; blood vessel; valve; haemorrhagia; atrium; ventricle; vein; septum; atrium; varix; sclerosis Fill the gaps with the right word:...regulation of inner processes by changing to environmental conditions...cells which play a fundamental role in hemostasis.... a yellowish fluid in which formed elements are floating....a valve on the right side of the heart, placed between the right atrium and the right ventricle e)....is the large, inferior vein carrying de-oxygenated blood from the lower part of the body towards the right atrium.... is the phase of myocardium contraction.... is the impulse-generating (pacemaker) tissue located in the right atrium.... is a network of branches, such as blood vessels.... is the network of blood vessels connecting the hypothalamus and the anterior pituitary.... is the proportion of blood occupied by red blood cells..... is a cell which occurs in bone marrow...is a general term meaning any disease of the heart Inflammation of the tissue surrounding the heart is called... The inflammation of the heart middle layer is termed... The inflammation of the membranes inside the heart is................ n).... is a slower heart rate o)....is a higher heart rate p)....is an abnormal heart rhythm -also known as an arrhythmia..... are veins which can be seen on the legs and look like spider's web....are twisted veins that can be flesh-colored, dark purple, or blue. They are usually swollen and can be seen on the surface of the skin. Choose the most appropriate answer: A/An..................., that is a symptom of atherosclerosis, is a deposition within the arterial wall vasculitis angiostenosis arteriosclerosis atheroma 2 is a term referring to stopping the bleeding. hemochromatosis hemostasis plasmapheresis transfusion reaction Inflammation of a vein is called.............. arteriostenosis endocarditis phlebitis carditis Blood... is a general term referring to an affliction of the blood elements. anemia dyscrasia hemochromatosis septicemia Fill in the in the blanks with the proper word Blood vessels which transport oxygenated blood are. The membranous layer of tissue inside the heart is called the. The two atrioventricular valves regulate the blood flow between the and the. The main lifestyle factors that may result in high blood pressure are In fetal life, circulatory system does not include circulation. The inner lining of arteries is called the. Pulmonary circulation transports blood between the and. The blood vessels which supply oxygen-rich blood to the head are. are veins that take deoxygenated blood from the head back to the heart Give the medical term for the following definitions: Any condition of the heart muscle Medication which reduce ability of blood platelets to clot are Inflammation of the membrane around the heart Drugs which enlarge blood vessels are Viewing of a vein Vein inflammation Medication which increase urine production, relieving edema Drugs which reduce contraction of heart and slow heartbeat Originating into the heart Condition of the right heart Enlargement of the heart Inflammation of the artery Enlargement of an artery Pertaining to the heart Puncture of the pericardium Endocardium inflammation Pertaining to the heart muscle Pertaining to blood vessel An inflammation of a vein is. Hardening of arteries is. A venogram is an image of a(n). A medical term for heart attack is Are the following sentences True (T) or False (F)? The term atrioventricular relates to the blood vessels of the heart. Thrombocytosis is an abnormal low number of platelets in the blood. An X-ray of a blood vessel is called an angiography. A patient with an abnormally large heart is diagnosed with cardiomegaly. The outside lining of a blood vessel is endothelium. An abnormal heart rhythm is called arrythmia. Higher levels of troponin and creatinine phosphokinase (CPK) indicate a heart attack. An echocardiogram uses sound waves to create pictures of the heart. A device that measures and tape records your heart\'s activity (ECG) continuously for 24 to 48 hours is a Holter monitor. Match the following terms tricuspid a. lower area of the heart pericardium b. membrane around the heart SA node c. the natural pacemaker apex d. central opening of a vessel lumen e. right atrioventricular valve pulmonic valve a. retrosternal lymphatic organ vena cava b. vessel that opens into the right atrium thymus c. conductive fibers mitral valve d. valve that controls blood flow to the lungs Purkinje fibers e. left atrioventricular valve atherosclerosis a. absence of pulse aneurysm b. inflammation of the heart muscle ischemia c. when a blood vessel becomes bulged myocarditis d. blood deficiency towards a tissue asystole e. deposits inside an artery thrombosis a. swollen vessel especially on the legs occlusion b. backward flow varix c. death of tissue infarction d. obstruction regurgitation e. formation of a blood clot in a vessel