An Introduction to Medical Terminology for Health Care PDF

An Introduction to Medical Terminology for Health Care For Churchill Livingstone: Senior Commissioning Editor: Sarena Wolfaard Project Development Manager: Derek Robertson Project Manager: Andrea Hill Design Direction: Judith Wright An Introduction to Medical Terminology for Health Care A SELF-T...

An Introduction to Medical Terminology for Health Care For Churchill Livingstone: Senior Commissioning Editor: Sarena Wolfaard Project Development Manager: Derek Robertson Project Manager: Andrea Hill Design Direction: Judith Wright An Introduction to Medical Terminology for Health Care A SELF-TEACHING PACKAGE Andrew R. Mutton BSc MSc Lecturer in Life Science Edinburgh's Telford College, Edinburgh, UK THIRD EDITION CHURCHILL LIVINGSTONE EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2002 CHURCHILL LIVINGSTONE An imprint of Elsevier Limited © Elsevier Limited 2002. All rights reserved. The right of Andrew R. Hutton to be identified as the author of this work has been asserted by him in accordance with the Copyright, designs and Patents Act 1988 No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London WIT 4LP. Permissions may be sought directly from Elsevier's Health Sciences Rights Department in Philadelphia, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com), by selecting 'Customer Support' and then 'Obtaining Permissions'. First edition 1993 Second edition 1998 Third edition 2002 Reprinted 2002 (twice), 2003. 2004 ISBN 0 443 07079 2 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Note Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The author and the publishers have taken care to ensure that the information given in this text is accurate and up to date. However, readers are strongly advised to confirm that the information, especially with regard to drug usage, complies with the latest legislation and standards of practice. your source for books. ELSEVIER Journals and multimedia In the health sciences www.elsevierhealth.com The publisher's policy is to use paper manufactured from sustainable forests Printed in China P/05 Contents Introduction 1 UNIT ] Levels of organization 5 UNIT 2 The digestive system 13 UNIT 3 The breathing system 27 UNIT 4 The cardiovascular system 41 UNIT 5 The blood 55 UNIT 6 The lymphatic system and immunology 65 U NIT 7 The urinary system 75 U N I T 8 The nervous system 89 UNIT 9 The eye 107 U N I T 10 The ear 123 U N I T 11 The skin 135 U N I T 12 The nose and mouth 147 U N I T 13 The muscular system 161 U N I T 14 The skeletal system 169 UN IT 15 The male reproductive system 181 U N I T 16 The female reproductive system 193 U N I T 17 The endocrine system 213 U N I T 18 Radiology and nuclear medicine 225 U N I T 19 Oncology 235 U N I T 20 Anatomical position 243 U N I T 21 Pharmacology and microbiology 257 Answers to word exercises 275 Answers to self-assessment tests 299 Abbreviations 307 Glossary 319 About this book This book is designed to introduce medical terms to students who have little prior knowledge of the language of medicine. Included in the text are simple, nontechnical descriptions of pathological conditions, medical instruments and clinical procedures. The medical terms are introduced within the context of a body system or medical specialty and each set of exercises provides the student with the opportunity to learn, review and assess new words. Each unit includes a case history exercise that outlines the presentation, diagnosis and treatment of a specific medical condition. Once complete, the exercises will form a valuable reference text. No previous knowledge of medicine is required to follow the text and, to ensure ease of use, the more complex details of word origins and analysis have been omitted. The book will be of great value to anyone who needs to learn medical terms quickly and efficiently. Edinburgh 2002 Andrew Hutton Acknowledgements We are grateful to Aesculap Ltd incorporating Downs Surgical for permission to reproduce Figures 17,18, 56 and 57. Figure 23 was redrawn from a catalogue supplied by A.C. Cossor & Son (Surgical) Ltd. How to use this book Before you begin working through the units, read through the introduction which explains the basic principles of reading, writing and understanding medical terms. Once you have understood the elementary rules of medical word building, complete Units 1-21, which are based on different medical topics. The units can be studied in sequence or independently. For ease of use each unit has the same basic plan and is arranged into: WORD EXERCISES AN ANATOMY EXERCISE A CASE HISTORY A WORD CHECK A SELF-ASSESSMENT The different parts of each unit are indicated by icons. The word exercise icon indicates a written exercise that can be completed using the Exercise Guide at the beginning of each unit or knowledge acquired during this course of study. The answers to the word exercises are on p. 275. The anatomy exercise icon indicates you should complete the anatomy exercise relating to a body system. In this exercise you relate combining forms of medical roots to their position in the body. Check the meanings of the root words using the Quick Reference box. The case history icon indicates an account of a medical case history. The purpose of this exercise is to understand the medical terms associated with disease presentation, investigation and treatment. Some of the case histories may seem difficult to follow because of the terminology used when doctors write formal reports. To assist your understanding, a Word Help box is included with each case listing the meanings of difficult or unfamiliar words. In each case history, try to gain an overall picture of the health care required for successful treatment of the patient. Answers to the exercise that accompanies each case can be found with the answers to the word exercises on p. 275. viii AN INTRODUCTION TO MEDICAL TERMINOLOGY The word check icon indicates you should complete the Word Check that lists all prefixes, combining forms and suffixes used in a unit. Try to do this from memory and then correct any errors you have made. Errors can be corrected using the Exercise Guide or the Quick Reference box that follows each Case History. The glossary on p. 319 can also be used. The self-assessment icon indicates a series of self-assessment tests. Aim to complete the tests using knowledge gained from studying each unit and record your score in the boxes provided with each test. Check your answers on p. 299. Introduction Example 1 GASTROTOMY Objectives First we can split the word and examine its individual components: Once the introduction is complete you should be able to: name and identify components of medical words split medical words into their components build medical words using word components. The word root Students beginning any kind of medical or paramedical Roots are the basic medical words. Most are derived course are faced with a bewildering number of complex from Greek and Roman (Latin) words. Others have their medical terms. Surprisingly it is possible to understand origins in Arabic, Anglo-Saxon and German. Some early many medical terms and build new ones by learning Greek words have been retained in their original form relatively few words that can be combined in a variety whilst others have been latinized. In their migrations of ways. Even the longest medical terms are easy to throughout Europe and America many words have understand if you know the meaning of each compon- changed their spelling, meaning and pronunciation. ent of the word. For example, you may never have heard of laryngopharyngitis but if you learn that -itis In our first example we have used the root gastr which always means inflammation, laryng/o refers to the lar- always means stomach. ynx or voice box and pharyng/o refers to the throat or pharynx, its meaning becomes apparent, i.e. inflamma- tion of the pharynx and larynx. Laryngopharyngitis is Jhe combining vowel an inflammation of the upper respiratory tract with Combining vowels are added to word roots to aid pro- symptoms of sore throat and loss of voice. nunciation and to connect the root to the suffix. In our first example the combining vowel o has been added to Most doctors, however, do not use precise medical ter- join the root and suffix. All the combining vowels a, e, i, minology when conversing with patients. If patients o and u are used but the most commonly used is o. hear a complex medical description of their illness, they may become frightened rather than reassured. In our first example we have added the combining Precise medical terms are used when medical records vowel o to the root gastr. and letters are completed. They are also used when doctors discuss a patient and when medical material is published. Jhe suffix The terms you will use in this book describe common The suffix follows the word root and is found at the end diseases and disorders, instruments, diagnostic tech- of the word. It also adds to or modifies the meaning of niques and therapies. the word root. In our first example we have used the suffix -tomy which always means to form an incision. The components of medical words We can now fully understand the meaning of our first medical word: In this introduction you will learn how to split medical terms into their components and deduce their mean- ings. Skills developed here will enable you to derive the meanings of unfamiliar medical words and improve your ability to understand medical literature. Let us begin by using a medical word associated with an organ with which you are familiar, the stomach:  2 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE The meaning of gastrotomy is - incision into the stom- Key Point ach. Gastrotomy is a name used by surgeons to describe The components of medical words are: an operation in which a cut is made into the wall of the stomach. Jhe combining form In our first example the root gastr can be combined with the vowel o to make gastro. This word component is called a combining form of a word root, i.e. The use of prefixes, combining Word root + combining vowel = combining forms and suffixes form There are certain simple 'rules' which need to be gastr + o = gastro applied when building and analysing medical words. Most combining forms end in o and we will be using To practise using these rules, some new combining many of them in the exercises that follow. forms are introduced. Don't worry about their mean- ings at the moment, we will study them in a later unit. Now we have learnt the meaning of our first root we can use it again with a new word component: Example 2 EPIGASTRIC Rule /: Joining a combining form to a suffix If we add the suffixes -logy, meaning study of, and -algia, meaning condition of pain, to the combining form gastr/o we can make two new words: gastr/o + -logy = gastrology (study of the stomach) Here we have split the word into its components and gastr/o + -algia = gastralgia (condition of we can see it begins with a prefix that appears before pain in the the root gastr. stomach) Notice that in gastrology the combining vowel o has been left in place whilst in gastralgia it has been The prefix dropped. The o has been dropped in gastralgia because -algia begins with a, a vowel. Gastroalgia is not used The prefix precedes the word root and changes its and it would be more difficult to pronounce. meaning. The prefix epi- means upon and so it modifies the word to mean upon or above the stomach. Prefixes, like roots and suffixes, are also derived from Greek and Key Point Latin words. When a combining form of a root is joined to a suffix, the combining vowel is left in place if the suffix begins with a The suffix -ic meaning pertaining to was also used in letter other than a vowel. our second example so we can now write the full mean- ing of epigastric: Here are some more examples where the vowel is left in place because the suffix begins with a letter other than a vowel: gastr/o + -tomy = gastrotomy (incision into This is a word root This is a suffix meaning the stomach) upon/above meaning stomach pertaining to gastr/o 4- -scope = gastroscope (instrument to view the stomach) Here are some examples where the vowel is dropped: The full meaning of epigastric is - pertaining to above or upon the stomach. gastr/o + -itis = gastritis (inflammation of the stomach) gastr/o + -ectomy = gastrectomy (removal of the stomach)  INTRODUCTION 3 Example 3 GASTROENTEROLOGY WORD EXERCISE I GASTR/O ENTER/0 LOGY Use Rule 1 to join the combining forms of word roots and suffixes to make medical words. The meanings of Combining form Combining form Suffix the words will be studied in following units. The first of word root of word root meaning has been completed for you. meaning meoning study of stomach intestine Combining form Suffix Medical word of word root The full meaning of gastroenterology is the study of the (a) gastr/o + -pathy — gastropathy intestines and stomach. Notice that the vowel between the two roots gastr and enter is left in place. (b) gastr/o + -scopy = (c) hepat/o + -itis = Key Point When the combining forms of two roots are joined, the combining vowel of the first root is kept in place. (d) hepat/o + -megaly = (e) hepat/o + -oma = Here are some more examples: pylor/o + gastr/o + ectomy = pylorogastrec- Rule 2: Joining the combining forms of tomy duoden/o + enter/o + stomy = duodeno- two word roots enterostomy Some medical words contain two or more combining forms of roots, as in Example 3. WORD EXERCISE 2 Use Rules 1 and 2 to join the combining forms of two roots with suffixes to make medical words. The meanings of the words will be studied in following units. The first has been completed for you. Combining form Combining form Suffix Medical word of word root of word root (a) duoden/o + jejun/o + -stomy = duodenojejunostomy (b) trache/o + bronch/o + -itis = (c) gastr/o + enter/o + -stomy = (d) laryng/o + pharyng/o + -ectomy = (e) oste/o + arthr/o + -pathy = Note. There are a few exceptions to this rule which are hyphenated e.g. pharyngo-oral.  4 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Rule 3: Joining a prefix to a root Reading and understanding medical When a prefix that ends in a vowel is added to a root words that begins with a vowel or 'h', the vowel of the prefix is Now you have learnt the basic principle of building dropped. medical words, you should be able to deduce the mean- If we examine our second example, epigastric, again, ing of an unfamiliar word from the meaning of its com- here the vowel Y of epi- was retained because the root ponents. To illustrate this we will use two examples. gastr begins with 'g' which is not a vowel. Example 1: Gastroenterology Consider another example, which may be familiar to you - antacid, a drug used to neutralize stomach acid. First This word is made from: Split the word into its components gastro/entero/logy. anti + acid = antacid Then (prefix meaning (root meaning Think of or look up the meaning of these components. against) acid) Finally The T is dropped because acid begins with the vowel 'a'. Read the meaning of the word beginning with the Here are some more examples, we will learn their suffix and reading backwards: e.g. gastr/o3, enter/o2, -logy1 meanings later. 1 study of Here the vowel of the prefix is retained: 2 the intestines and 3 the stomach. hemi + col/o + ectomy — hemicolectomy We read the full meaning of gastroenterology as - the study of the intestines and stomach. Here the vowel of the prefix is dropped: endo + arter/i + ectomy = endarterectomy Example 2: Pararectal anti + helminth + ic = anthelminthic Here the prefix para- has modified the meaning of the Note. This is not a strict rule and there are many exceptions root red I to mean beside the rectum. to it, e.g. periosteitis. First Split the word into its components para/rect/al. Key Point When a prefix that ends in a vowel is joined to a root, the Then vowel of the prefix is dropped if the root begins with a Think of or look up the meaning of these components. vowel or 'h'. Finally Read the meaning of the word beginning with the suffix followed by the meaning of the modified root e.g. +pararect2, al1 WORD EXERCISE 3 1 pertaining to 2 beside the rectum. We read the full meaning of pararectal as pertaining to Use the rules we have just described to join prefixes, beside the rectum. combining forms of roots and suffixes to make medical words. The meanings of the words will be studied in following units. The first has been completed for you. Key Point Prefix Combining Suffix Medical word When deducing the meanings of compound medical form of words, begin with the meaning of the suffix followed by those of the root(s) and prefix (from right to left). word root (a) endo- + odont/o + -ic = endodontic Once you have an understanding of these simple rules you should be able to complete the exercises in Units (b) prostho- + odont/o + -ist = 1-21. Each unit introduces different medical terms asso- ciated with a body system or medical specialty. The (c) para- + rect/o + -al = units can be completed in an order that complements your studies in anatomy, physiology and health care. (d) mono- + ocul/o + -ar = (e) peri- + splen/o + -itis =  UNIT 1 Levels of organization Objectives Exercise Guide Once you have completed Unit 1 you should Use this list of word components and their meanings be able to: to complete the word exercises in this unit. understand the meaning of medical words relating to levels of organization build medical words relating to levels of Prefixes organization micro- small understand medical abbreviations relating to cells and tissues. Roots/Combining forms bi/o life/living chem/(istry) chemicals (study of) chondr/o cartilage erythr/o red fibr/o fibre granul/o granule haem/o blood hem/o (Am.) blood leuc/o white leuk/o (Am.) white lymph / o lymph melan/o pigment/melanin oo egg/ovum path/o disease spermat/o sperm tox/o poisonous Suffixes -blast immature germ cell/cell that forms... -genie pertaining to formation/genesis -genesis formation of -ic pertaining to -ist specialist -logist specialist who studies... -logy study of -lysis breakdown/disintegration -pathy disease of -scope instrument to view/examine -scopist specialist who uses viewing instrument -scopy technique of vie wing/examining -trophic pertaining to nourishing  6 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Reading from the suffix back, cytology means the study Levels of organization of cells. The human body consists of basic units of life known as (Remember when trying to understand medical words, cells. Groups of cells similar in appearance, function first split the word into its components, then think of and origin join together to form tissues. Different tis- the meaning of each component and finally write the sues then interact with each other to form organs. meaning beginning with the suffix.) Finally groups of organs interact to form body systems. Thus there are four levels of organization in the human Cytology is a very important topic in medicine as many body: cells, tissues, organs and systems. Let us begin by diseases and disorders can be diagnosed by studying examining the first level of organization. cells. Cells removed from patients are sent for cytologi- cal examination to a hospital cytology laboratory where they are examined with a microscope. (In the word Cells cytological, -icol is a compound suffix meaning pertain- ing to or dealing with.) The cell is the basic unit of life and the bodies of all plants and animals are built up of cells. Your body The exercises that follow rely on the use of the Exercise consists of millions of very small specialized cells. It is Guide which appears at the beginning of this unit; use interesting to note that all non-infectious disorders and the guide to look up the meaning of path/o and -pathy diseases of the human body are really due to the and then try Word Exercise 1. abnormal behaviour of cells. Body cells are all built on the same basic plan. Figure 1 represents a model cell. WORD EXERCISE 1 (a) Name the components of the word and give their meanings: CYT 0 PATHY Figure 1 A cell Most cells have the same basic components as are shown in the model but they are all specialized to carry (b) Reading from the suffix back, the meaning of out particular functions within the body. In your studies cytopathy is: you will come across many terms that relate to different types of cell. Now we will examine our first word root which refers to cells: The root -path- can be used at the beginning and in the middle of a compound word as in the next two Cyt examples. Write the meaning of these words: (From a Greek word kytos, meaning cell.) Combining forms Cyt/o. a/so used as the suffix -cyte (c) path/o/logy (Remember from our introduction that combining forms are made by adding a (d) cyt/o/path/o/logy combining vowel to the word root.) Using the Exercise Guide again find the meaning of -ic, Here we have a word that contains the root cyt: -ist, tox/o, and -lysis and write the meaning of the words below. Remember to read the meaning from the suffix back to the beginning of each word: CYT 0 LOGY (e) cy to/lysis This is a root This is a This is a suffix (f) cyto/tox/ic meaning combining meaning cell vowel study of (g) cy to/legist  LEVELS OF ORGANIZATION 7 In the above examples, cyt/o was used at the beginning (ii) This cell produces white collagen fibres that give of words. It can also be used at the end of words in the skin support. combination with other roots, its meaning remaining the same. Remember, when two roots are joined the combining vowel remains in place. WORD EXERCISE 2 Figure 3 A fibre cell Here we have an example of two roots joined to make a compound word: Use your Exercise Guide to find the combining forms of melanin and fibre to build words that name these cells. LEUC 0 CYTE (a) A cell containing melanin (b) A cell that produces fibres This is a root This is a This is a root meaning combining meaning (c) Complete the table by looking up the combining white vowel cell forms of the following roots in your Exercise Guide and building words that refer to cell types. The meaning of leucocyte is therefore: white cell (actu- ally a type of blood cell) (Am. leukocyte). Root Combining form Name of cell oste osteo osteocyte (bone cell) (a) Name the components of the following word and lymph use your Exercise Guide to find their meanings. spermat ERYTHR 0 CYTE oo granul chondr (b) The meaning of erythrocyte is: All of the above examples show how the combining vowel is retained when two roots are joined. Now we will examine another root that also refers to cells: WORD EXERCISE 3 Blast (A Greek word meaning bud or germ. It is Figure 2 and Figure 3 show two specialized cells, each used to denote an immature stage in cell one carrying out a different function. development or a cell that is forming something.) (i) This cell produces the pigment melanin that gives the dark colour to black or brown skin. Combining forms Blast/o, a/so used as the suffix -blast WORD EXERCISE 4 Without using your Exercise Guide, write the meaning of: (a) osteo/blast Figure 2 A pigment cell (b) fibro/blast  8 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Using your Exercise Guide, write the meaning of: Cells and tissues are very small and need to be exam- ined using an instrument known as a microscope. (c) haemo/cyto/blast (Am. hemo/cy to/blast) Tissues i I WORD EXERCISE 6 As cells become specialized, they form groups of cells known as tissues. A definition of a tissue is a group of Using your Exercise Guide, find' the meaning of: cells similar in appearance, function and origin. There are four basic types of tissue: epithelial, muscle, connec- (a) micro- tive and nervous tissue; these form the second level of organization in the body. Figure 4 illustrates how cells (b) micro/scope form a tissue. Here we can see a cuboidal epithelium from the kidney. (c) micro /scopy (d) micro/scop/ist Note carefully the differences between -scope, -scopy and -scopist. (e) micro/bio/logy Figure 4 Cuboidal epithelium The study of tissues is known as histology, the combin- Organs ing form coming from a Greek word histos meaning web (web of cells). Histology is an important branch of biol- Groups of different tissues interact to produce larger ogy and medicine because it is used to identify diseased structures known as organs; these form the third level tissues. The histology and cytology laboratories are of organization. A familiar example is the heart (Fig. 5), usually sections of the pathology laboratory of a large which consists of muscle tissue, a covering of epi- hospital. thelium, nerve tissue and connective tissue. All these tissues interact so that the heart pumps blood. Hist (From a Greek word histos, meaning web. It is used to mean the tissues of the body.) Combining forms Hist/i/o WORD EXERCISE 5 Using your Exercise Guide, find the meaning of: (a) histo/chemistry Figure 5 The heart Without using your Exercise Guide, write the meaning of: (b) histo/patho/logy Organ (From a Greek word organon, meaning tool. Here we are using it to mean body (c) histo/logist organs). (d) histo/lysis Combining forms Organi/o  LEVELS OF ORGANIZATION 9 A sample of the biopsy material was sent for culture and sensitivity testing to the microbiology laboratory. WORD EXERCISE 7 The report was positive for encapsulated fungal yeast forms morphologically compatible with pathogenic Using your Exercise Guide, find the meaning of: cryptococcus species (Cryptococcus neoformans). Mr A's diagnosis was cryptococcosis, a condition seen mainly (a) organo/genesis in AIDs patients and others with compromised immune (synonymous with organogeny) systems. (b) organo/genie WORD HELP (c) organo/trophic AIDs acquired immune deficiency syndrome aspect part of a surface facing a designated direction aspiration withdrawal by suction of a fluid Body systems biopsy removal and examination of living tissue Groups of organs interact to form the fourth level of budding performing asexual reproduction by producing organization, the system, e.g. the stomach, duodenum, buds that grow into new cells colon, etc. interact to form the digestive system that cellularity state/condition of being made up of cells digests and absorbs food. Units 2-17 introduce medical compromised lacking the ability to mount an adequate terms associated with the main body systems. immune response cryptococcus a yeast-like fungus that causes disease in humans cryptococcosis abnormal condition of infection with cryptococcus CASE HISTORY 1 CT computed tomography, a technique of using X-rays to image a slice or section through the body The object of this exercise is to understand words culture & sensitivity testing growing microorganisms in the laboratory and testing them for sensitivity to associated with a patient's medical history. antibiotics To complete the exercise: effusion a fluid discharge into a part/escape of fluid into an enclosed space read through the passage on diagnosis of an AIDs encapsulated enclosed on a capsule or sheath related infection; unfamiliar words are underlined histiocytes the word means a tissue cell (actually a large and you can find their meaning using the Word Help cell found in connective tissue that helps defend against write the meaning of the medical terms shown in infection) bold print. HIV-positive presence of antibodies to the human immunodeficiency virus in the blood, it indicates the virus has infected the body lobe a division of an organ into smaller sections, here a Diagnosis of an AIDs related lobe of the lung infection malignant dangerous, life threatening mass lump/collection of cohering cells Mr A, a 34-year-old HIV positive patient with symptoms morphologically referring to the form and structure of of AIDs,' was admitted to the unit following o a chest an organism X-ray that revealed a left upper lobe mass. mucoid resembling mucus A CT scan confirmed the presence of a mass within the peripheral pertaining to the periphery i.e. the surface of an organ peripheral aspect of the left upper lobe, and a small left pleural effusion. CT guided fine needle aspiration of the pleural pertaining to the pleura/pleural membranes that surround the lungs left upper lobe mass was performed and the biopsy polymorphonuclear pertaining to or having nuclei of material sent to the histology laboratory for analysis by many shapes the duty pathologist. Cytological examination of direct smears using optical microscopy revealed a mucoid background, moder- Now write the meaning of the following words from ate cellularity, polymorphonuclear leucocytes (Am. the case history without using your dictionary lists: leukocytes), lymphocytes and histiocytes. A significant number of oval yeast-like cells were observed which (a) histology appeared to be budding. No malignant cells were observed. (b) pathologist  10 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE (c) cytological NOW TRY THE WORD CHECK (d) microscopy (e) leucocyte (Am. leukocyte) (f) lymphocyte WORD CHECK (g) microbiology This self-check exercise lists all the word components (h) pathogenic used in this unit. First write down the meaning of as many word components as you can. Then check your (Answers to the case history exercise are given in the answers using the Exercise Guide and Quick Reference Answers to Word Exercises beginning on page 275.) box or the Glossary of Word Components (pp. 319-341). Prefixes Quick Reference' micro- Combining forms relating to levels of organization: Blast/o immature cell/forming cell Combining forms of word roots Chondr/o cartilage Cyt/o cell bi/o Granul/o granule Hist/i/o tissue/web blast/o Lymph/o lymph Melan/o pigment/melanin chem/o Oo egg/ovum Organ/o organ chondr/o Oste/o bone Path/o disease cyt/o Spermat/o sperm erythr/o fibr/o Abbreviations granul/o Some common abbreviations related to cells and hist/i/o tissues are listed below. Note, some are not stan- dard and their meaning may vary from one health leuc/o care setting to another. There is a more extensive list for reference on page 307. lymph/o Diff differential blood count (of cell types) melan/o FBC full blood count (of cells) GCSF granulocyte colony stimulating factor Histo histology (lab) oo- HLA human lymphocyte antigen Lymphos lymphocytes organ/o NK natural killer (cells) Pap Papanicolaou smear test (of cervical oste/o cells) PCV packed cell volume path/o RBC red blood count/red blood cell RCC red cell count spermat/o WBC white blood cell/white blood count tox/o  LEVELS OF ORGANIZATION 11 Suffixes Column A Column B Column C -blast (d) granul/o 4. study of -genie (e) hist/i/o 5. pigment (black) -genesis (f) leuc/o 6. sperm cells -ic (g) -log(ist) 7. chemical -ical (h) -logy 8. tissue -ist (i) lymph /o 9. person who studies (specialist) -log(ist) (j) -lysis 10. small -logy (k) melan/o 11. specialist who -lysis views /examines -pathy (1) micro- 12. breakdown/ disintegration -scope (m) oo- 13. poisonous/ -scop (ist) pertaining to poison -scopy (n) oste/o 14. cell -tox(ic) (o) -pathy 15. visual examination -trophic (p) -scope 16. disease (q) -scop(ist) 17. lymph NOW TRY THE SELF-ASSESSMENT (r) -scopy 18. red (s) spermat/o 19. granule (t) -tox(ic) 20. viewing instrument SELF-ASSESSMENT Score Test 1A 20 Prefixes, suffixes and combining forms of word roots Match each word component in Column A with a mean- ing in Column C by inserting the appropriate number in Column B. Column A Column B Column C (a) chem/o 1. egg (b) cyt/o 2. bone (c) erythr/o 3. white  12 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Test IB Write the meaning of: (a) chondrolysis (b) leucocytolysis (c) histotoxic (d) osteopathy (e) lymphoblast Score 5 Test 1C This type of test may seem difficult at first but as the terms become familiar you will improve. Build words that mean: (a) small cell (b) person who specializes in the study of disease (c) person who specializes in the study of disease of cells (d) scientific study of cartilage (e) pertaining to disease of cells Score 5 Check answers to Self-Assessment Tests on page 299.  Mm 2 The digestive system Objectives Exercise Guide Once you have completed Unit 2 you should Use this list of word components and their meanings be able to: to complete the word exercises in this unit. understand the meaning of medical words relating to the digestive system build medical words relating to the digestive Prefixes system a- without associate medical terms with their anatomical endo- inside /within position epi- upon /above mega- large understand medical abbreviations relating to para- beside the digestive system. peri- around Suffixes -aemia condition of blood -al pertaining to -algia condition of pain -clysis infusion/injection into -ectomy removal of -emia (Am.) condition of blood -gram X-ray / tracing / recording -graphy technique of recording/making X-ray -ia condition of -iasis abnormal condition -ic pertaining to -ist specialist -itis inflammation of -lith stone -lithiasis abnormal condition of stones -logist specialist who studies... -logy study of -lysis breakdown / disintegration -megaly enlargement -oma tumour / swelling -pathy disease of -scope instrument to view /examine -scopy technique of viewing /examining -stomy formation of an opening into... -tomy incision into -toxic pertaining to poisoning -uria condition of the urine  14 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Figure 6 The digestive system ANATOMY EXERCISE When you have finished Word Exercises 1-12, look at the word components listed below. Complete Figure 6 by writing the appropriate combining form on each dotted line. (You can check their meanings in the Quick Reference box on page 23.) Appendic/o Gastr/o Pancreatic/o Caec/o, Cec/o (Am.) Hepat/o Proct/o Cholecyst/o Ile/o Pylor/o Choledoch/o Jejun/o Rect/o Col/o Oesophag/o, Esophag/o (Am.) Sigmoid/o Duoden/o Pancreat/o  THE DIGESTIVE SYSTEM 15 The digestive system The organs that compose the digestive system digest, WORD EXERCISE 2 absorb and process nutrients taken in as food. Materials not absorbed into the lining of the intestine form the Without using your Exercise Guide, write the meaning faeces and leave the body through the anus. of: Our study of the digestive system begins at the point where food leaves the mouth and enters the gullet or (a) gastro/scope oesophagus. (b) gastr/ectomy Use the Exercise Guide at the beginning of this unit to complete Word Exercises 1-12 unless you are asked to (c) gastro/tomy work without it. (d) gastr/itis Root Oesophag Using your Exercise Guide, build words that mean: (From a Greek word oisophagos, meaning oesophagus or gullet.) (e) disease of the stomach Combining forms Oesophag/o Esophag/o (Am.) (f) study of the stomach (g) pertaining to upon/above the stomach Remember, when building words the combining vowel WORD EXERCISE 1 is usually dropped if the suffix begins with a vowel. Using your Exercise Guide, find the meaning of: Note. A naso gastric tube (nas/o meaning nose) that passes (a) oesophago/scope through the nose to the stomach can be used for suction, irrigation or feeding. (Am. esophago/scope) Remember that, to understand the meaning of these medical terms, we read the components from the suffix Enter towards the beginning of the word. (From a Greek word enteron, meaning intestine or gut.) (b) oesophag/ectomy Combining forms Enter/o (Am. esophag/ectomy) (c) oesophago/tomy (Am. esophago/tomy) (d) oesophag/itis WORD EXERCISE 3 (Am. esophag/itis) Without using your Exercise Guide, write the meaning Once you have learnt the suffixes in Word Exercise 1, it of: is easy to work out the meaning of other words with similar endings. Now we will use the same suffixes (a) enter/itis again with a different word root. (b) entero/pathy (c) entero/tomy Gastr (From a Greek word gaster, meaning Using your Exercise Guide, find the meaning of: belly or stomach.) Combining forms Gastr/o (d) entero/stomy  16 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Here you need to note the difference between: Between the stomach and the small intestine there is a sphincter muscle known as the pylorus. This acts as a -stomy valve which opens periodically to allow digested food This means a mouth or opening. Usually a stoma is to leave the stomach. formed by surgery, e.g. a colostomy is an opening or the formation of an opening into the colon. This word component is also used in anastomosis, an operation to Pylor form an opening/communication between two parts (From a Greek word pylouros, meaning (Fig. 7). A stoma can be temporary or permanent. gate-keeper. It is used to mean the pylorus.) -tomy Means an incision as at the beginning of an operation. Combining forms Pylor/o WORD EXERCISE 4 Without using your Exercise Guide, write the meaning of: (a) pyloro/gastr/ectomy (b) pyloro/scopy The small intestine Figure 7 Surgical anastomoses Now let us examine the small intestine which consists of three parts, the duodenum, jejunum and ileum. The duodenum is concerned mainly with digestion of food (e) entero/lith while the jejunum and ileum are specially adapted for the absorption of nutrients. Without using your Exercise Guide, build words that mean: Note. Although the root enter refers generally to intestines, it is often used to mean the small intestine. (f) study of the intestine However, there are special roots that describe the different regions of the intestine. We shall use these in the next three (g) a person who studies the intestines exercises. Now we can put two roots together to make a larger word. Although these words look complicated it is now quite easy to understand their meaning. Duoden (From a Latin word duodeni, meaning Without using your Exercise Guide, write the meaning of: twelve. It refers to the duodenum, which is the first 12 inches of the small intestine.) (h) gastro/entero/logy Combining forms Duoden/o (i) gastro/entero/pathy (j) gastro/enter/itis Jejun (k) gastro/entero/scopy (From a Latin word jejunus, meaning empty. It refers to the jejunum, part of the intestine between the duodenum and Note. When the two roots gastr/o and enter/o are joined ileum approx 2.4 m in length.) the combining vowel of the first root is retained. Combining forms Jejun/o  THE DIGESTIVE SYSTEM 17 After passing through the small intestine, any remaining lie material passes into the large intestine or large bowel. (From a Latin word ilia, meaning flanks. We use it here to mean the lower three-fifths of the small intestine.) Combining forms lle/o The large intestine The large intestine has a wider diameter than the small intestine and it is shorter. Its main function is to absorb water from the materials that remain after diges- tion and eject them from the body as faeces (Am. feces) WORD EXERCISE 5 during defaecation. The large intestine is made up of the caecum (Am. cecum), appendix, colon, rectum and anus (Fig. 9). Without using your Exercise Guide, write the meaning of: (a) duodeno/entero/stomy (b) jejuno/jejuno/stomy Using your Exercise Guide, find the meaning of: (c) duodeno/jejun/al Without using your Exercise Guide, build words that mean: (d) formation of an opening into the ileum (e) inflammation of the ileum Figure 9 TheThe large intestine large intestine (Exception - two vowels together.) The next six roots refer to the large intestine: A permanent opening or ileostomy is made when the - —————~—-———-—^^ whole of the large intestine has been removed. This acts Caec as an artificial anus. The ileum opens directly on to the (From a Latin word caecus meaning abdominal wall and the liquid discharge from it is blind. It refers to a blindly ending collected in a plastic ileostomy bag (Fig. 8). pouch, the caecum attached to the vermiform appendix and separated from the ileum by a valve, the ileocaecal valve.) Combining forms Caec/o Cec/o (Am.) Append (From a Latin word appendix, meaning appendage, the root refers to the appendix, a blindly ending sac attached to the caecum.) Combining forms Appendic/o Append/o (Am.) Col (From a Greek word kolon, meaning colon, the large bowel extending from caecum to rectum.) Figure 8 Ileostomy Combining forms Col/o, colon/o  18 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Rect WORD EXERCISE 6 (From a Latin word rectus, meaning straight. Here it refers to the last part of the large intestine, the rectum, which is Using your Exercise Guide, find the meaning of: straight.) Combining forms Rect/o (a) mega/colon Without using your Exercise Guide, write the meaning of: Proct (From a Greek word proktos, meaning (b) appendic/itis anus. It is used to mean the anus or rectum.) (c) col/ectomy Combining forms Proct/o (d) colo/stomy (see Fig. 10) A colostomy may be temporary or permanent and its WORD EXERCISE 7 effluent is discharged into a colostomy bag attached to the surface of the abdomen. Using your Exercise Guide, find the meaning of: (a) sigmoido/scopy (b) para/rect/al (c) peri/proct/itis (d) procto/clysis (e) proct/algia Without using your Exercise Guide, build words that mean: Figure 10 Common sites of stomas of large bowel (f) instrument to view anus/rectum (g) formation of an opening between Without using your Exercise Guide, build words that the caecum and anus mean: (h) formation of an opening between (e) formation of an opening into the sigmoid colon and caecum the caecum (Am. cecum) Sometimes the lining of the intestine develops enlarged (f) removal of the appendix pouches or sacs. Each is known as a diverticulum (pi. diverticulae). These can become inflamed as in (g) formation of an opening diverticulitis and may have to be removed by (anastomosis) between the colon diverticulectomy. and stomach The outer layer of the intestines and the lining of the cavity in which they lie consist of serous membrane. This secretes a serum-like fluid, serous fluid, that acts as Sigm a lubricant. A film of serous fluid allows organs to slide (From a Greek word sigma, meaning the letter S. It refers to the last part of the over each other as they move by peristalsis. descending colon that resembles an 5-shape and is called the sigmoid colon.) Combining forms Sigmoid/o  THE DIGESTIVE SYSTEM 19 Peritone (From Greek words peri, meaning around, and teinein, meaning to stretch. It refers to the peritoneum, the serous membrane lining the abdominal and pelvic cavities and covering all abdominal organs.) Combining forms Periton/e/o WORD EXERCISE 8 Figure1 The liver and bile ducts Without using your Exercise Guide, write the meaning of: (a) periton/itis Hepat (From a Greek word hepatos, meaning (b) peritoneo/clysis the liver.) Combining forms Hepat/o A combining form hepatic/o is also derived from this root and is used to Accessory organs of the digestive mean the hepatic duct. system The pancreas WORD EXERCISE 9 This gland is found beneath the stomach (see Fig. 6). Its function is to produce pancreatic juice that is passed to the duodenum where it neutralizes acid and digests Using your Exercise Guide, find the meaning of: food. It can also produce the hormones insulin and glucagon which are secreted directly into the blood. (a) pancreato/lysis (b) hepato/megaly Pancreat (c) hepat/oma (From a Greek word pankreas, meaning the pancreas.) (d) hepato/toxic Combining forms Pancreat/o A combining form pancreatic/o is also Without using your Exercise Guide, write the meaning derived from this root. It is used to mean of: pancreatic duct. This duct transfers pancreatic juice containing digestive (e) hepatico/gastro/stomy enzymes from the pancreas to the duodenum. (f) pancreatico/duoden/al The liver choj The liver is the largest abdominal organ (Fig. 11). It is (From a Greek word chole, meaning bile.) located just beneath the diaphragm. It processes nutrients which it receives from the intestine, stores Combining forms Chol/e materials and excretes wastes in the form of bile back into the intestine. Liver cells produce a yellowish-brown waste known as bile. This drains through small canals and hepatic ducts  20 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE into a sac known as the gall bladder. Bile leaves the gall Here we need to distinguish between three suffixes that bladder through the common bile duct and enters the often cause some confusion: intestine. Although bile is a waste product, the bile salts it contains help to emulsify lipids (fats) in the intestine. -gram The structures in which bile is transported are referred This refers to a tracing. In practice in medicine it usually to as the biliary system (bill- meaning bile, -ary meaning refers to an X-ray picture, paper recording or to a trace pertaining to). on a screen. -graphy This refers to the technique or process of making a recording, e.g. an X-ray or tracing. It can also refer to a written description. WORD EXERCISE 10 -graph This means a description or writing but more often it is Using your Exercise Guide, find the meaning of: used in medicine for the name of an instrument that carries out a recording. Occasionally it is used to mean the recording itself. (a) a/chol/ia (b) chole/lith Lapar (c) chole/lith/iasis (From a Greek word lapara, meaning soft part between the ribs and hips, i.e. the (d) chol/aemia (Am. chol/emia) flank/abdomen.) Combining forms Lapar/o (e) chol/uria A word root commonly combined with chol/e is cyst/o, meaning bladder. Cholecyst/o refers specifically to the bile bladder, commonly called the gall bladder. WORD E X E R C I S E 11 Without using your Exercise Guide, write the meaning of: Without using your Exercise Guide, write the meaning of: (f) cholecysto/tomy (a) laparo/scopy (g) cholecyst/ectomy (b) laparo/tomy (h) cholecysto/lithiasis Laparotomy is an exploratory operation performed A second word root often combined with chol/e is angi/o when the diagnosis of an abdominal problem is uncer- meaning vessel. Cholangi/o therefore refers to the bile tain. With advances in diagnostic procedures such as vessels/ducts. CT scanning, ultrasonography and laparoscopy, it has become less common. Using your Exercise Guide, find the meaning of: Laparoscopy is performed using a laparoscope, a device consisting of a thin tube containing a lens system that (i) cholangio/gram can be passed through a small hole into the abdominal cavity. The laparoscope allows the internal organs (j) cholangio/graphy (viscera) to be viewed and manipulated by a surgeon. A third word root often combined with chol/e is doch/o, meaning to receive. Choledoch/o refers to the common bile duct, i.e. that which receives the bile. Medical equipment and clinical procedures Without using your Exercise Guide, write the meaning In this unit we have named several instruments. Let us of: review their names: (k) choledocho/lithiasis gastroscope gastroenteroscope (1) choledocho/litho/tomy sigmoidoscope  THE DIGESTIVE SYSTEM 21 colonoscope upper digestive system). Similarly, panendoscopy could proctoscope be performed on all of the large intestine via the anus. laparoscope In addition to viewing cavities, endoscopes can be fitted All of these instruments are used to view various parts with a variety of attachments, such as forceps and cath- of the digestive system. Now fibreoptic endoscopes have eters, and they can then be used for special applications. replaced some of the original viewing instruments. One such procedure is: Endoscope means an instrument to view inside (endo- ERCP or endoscopic, retrograde, cholangiopancreato- within/ inside). graphy Endoscopes utilize flexible/fibreoptic tubes (Fig. 12) Let us examine the words separately: that can be inserted into body cavities or into small incisions made in the body wall. Each is provided with endoscopic referring to an endoscope illumination and a system of lenses which enables the retrograde going backwards operator to view the inside of the body. The inclusion of chol bile electronic chips at the end of the fibreoptic tube allows angio vessel the view to be transmitted to a video screen. Sometimes pancreato pancreas the endoscope is used for photography and it is then graphy technique of making a tracing/X-ray known as a photoendoscope. recording The endoscope can be adapted to view particular areas of Although we cannot deduce the exact meaning from the the body. In the case of the digestive system, the words we can see why they have been used. Here is the fibreoptic tube can be passed into the mouth to examine meaning of ERCP: the oesophagus, stomach and intestine. Alternatively it A technique of making an X-ray (graphy) of the can be passed into the anus to view the rectum and colon. pancreatic vessels and bile duct (pancreat/chol/angio), Note that when an endoscope is adapted to examine the by passing a catheter (tube) backwards (retrograde) into stomach it may be referred to as a gastroscope. them using an endoscope. Dye is injected through the Often endoscopes are used to examine the oesophagus, catheter to outline the vessels and ducts on the X-ray. stomach and duodenum at the same examination. This procedure is panendoscopy (pan- means all, i.e. all the WORD EXERCISE 12 Match each term in Column A with a description from Column C by placing an appropriate number in Column B. Column A Column B Column C (a) enteroscope 1. instrument to view rectum (b) endoscope 2. technique of taking photographs using an endoscope (c) enteroscopy 3. visual examination of the colon (d) endoscopy 4. instrument to view the intestine (e) endoscopist 5. visual examination of all cavities, e.g. oesophagus, stomach and duodenum (f) colonoscopy 6. instrument to view body cavities (g) proctoscope 7. visual examination of the intestine (h) sigmoidoscopy 8. person who operates an Figure12 Fibreoptic endoscope used to view the colon endoscope  22 AM INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Column A Column B Column C An open cholecystectomy was performed and the inflamed gall bladder found to contain three gallstones (i) panendoscopy 9. visual examination each approximately 1.5cm in diameter. A bile sample of body cavities was sent for culture and sensitivity testing and a naso- (j) photoendoscopy 10. visual examination gastric tube passed. Antibiotic prophylaxis (cefurox- of S-colon ime) was administered prior to her operation and continued for 48 hours. Miss B also received low dose subcutaneous heparin injections as part of her throm- boembolic prophylaxis. ANATOMY EXERCISE The patient tolerated surgery well, PCA controlled her Now complete the Anatomy Exercise on page 14. pain and she was apyrexial. In the immediate post- operative period she received an intravenous (i.v.) infusion of dextrose 4%, NaCl 0.18%, KC1 0.05% at a rate of 125 ml/hour. On day four following her operation, the nasogastric tube and wound drains were removed and i.v. fluid CASE HISTORY 2 replacement ceased. Miss B left the unit on day six and was provided with diclofenac 50 mg analgesic tablets to be taken up to 3 times daily when required. She agreed The object of this exercise is to understand words to an appointment with the dietician to discuss the associated with a patient's medical history. To complete desirability of reducing her weight. the exercise: read through the passage on gallstones; unfamiliar words are underlined and you can find their meaning using the Word Help WORDHELP write the meaning of the medical terms shown in analgesic pain relieving drug bold print. apyrexial absence of fever culture and sensitivity testing growing microorganisms in the laboratory and testing them for sensitivity to Gallstones (Cholelithiasis) antibiotics dietician/dietitian specialist who plans and advises on Miss B, a 35-year-old, presented to her general practi- diet with the approval of medical staff tioner complaining of pain emanating from the elective voluntary/not an emergency/at a planned date epigastric and right hypochondrial regions radiating to GP general practitioner (family doctor) the back. The pain lasted for about 3 hours following heparin an anticoagulant drug that prevents blood each meal and was accompanied by nausea and clotting occasional vomiting. Her GP's initial diagnosis was hypochondrial the region to the side, just below the biliary colic, and he prescribed the analgesic pethidine. ribs The pain did not resolve and she was admitted to the intravenous pertaining to within a vein gastroenterology unit. open surgery via an incision (here into the abdomen) Initial ultrasound investigations revealed multiple peri-operative around the time of operation stones in the gall bladder and a dilated common bile post-operative pertaining to after/following operation duct. A date was set for early elective laparoscopic prophylaxis preventative treatment cholecystectomy. Miss B was counselled on her peri- regimen regulated scheme (e.g. of taking operative drug regimen and was introduced to the drugs/medication) concept of patient controlled analgesia (PCA) using a subcutaneous pertaining to under the skin syringe driver. Unfortunately, her elective procedure syringe driver motorized device that injects was delayed by an episode of acute cholecystitis. medication/drugs into the body thromboembolic thrombus or clot moving and blocking Once recovered Miss B was admitted again but, due another blood vessel to her excessive weight, laparoscopy was deemed inap- ultrasound using sound waves to produce an image propriate by the surgeon and she was advised of the associative risks of an alternative procedure. Vital signs on admission Now write the meaning of the following words from Pulse 90/minute Oral temp 37°C BP 140/70 the case history without using your dictionary lists: Height 1.52 m Weight 85 kg Smoker 25 / day Moderate drinker Medication None (a) cholelithiasis  THE DIGESTIVE SYSTEM 23 (b) epigastric (c) biliary Abbreviations (d) gastroenterology Some common abbreviations related to the digestive system are listed below. Note, some are (e) laparoscopic not standard and their meaning may vary from one health care setting to another. There is a more (f) cholecystectomy extensive list for reference on page 307. (g) cholecystitis Abdo abdomen CD Crohn's disease (h) nasogastric DU duodenal ulcer GI gastrointestinal (Answers to the case history exercise are given in the GU gastric ulcer Answers to Word Exercises beginning on page 275). IUC idiopathic ulcerative colitis LLQ left lower quadrant pr/PR per rectum PU peptic ulcer RE rectal examination UC ulcerative colitis Quick Reference UGI upper gastrointestinal Combining forms relating to the digestive system: Appendic/o appendix Bil/i bile Caec/o caecum NOW TRY THE WORD CHECK Cec/o (Am.) cecum Chol/e bile Cholangi/o bile vessel/duct Cholecyst/o gall bladder Choledoch / o common bile duct Col/o colon WORD CHECK Colon/o colon Diverticul/o diverticulum This self-check exercise lists all the word components Duoden/o duodenum used in this unit. First write down the meaning of as Enter/o intestine many word components as you can. Then check your Esophag/o (Am.) esophagus answers using the Exercise Guide and Quick Reference Gastr/o stomach box or the Glossary of Word Components (pp. 319-341). Hepat/o liver Hepatic/o hepatic duct Prefixes x/Ile/o ileum Jejun/o jejunum a- Lapar/o flank/abdominal wall Oesophag/o oesophagus endo- Pancreat/o pancreas Pancreatic/o pancreatic duct epi- Peritone/o peritoneum Proct/o anus/rectum mega- Pylor/o pyloric sphincter Rect/o rectum pan- Ser/o serous/serum Sigmoid/o sigmoid colon para- peri- retro-  24 AN INTRODUCTION TO MEDICAL TERMINOLOGY FOR HEALTH CARE Combining forms of word roots Suffixes angi/o -aemia (Am. -emia) appendic/o -al bil/i -algia caec/o (Am. cec/o) -ary chol/e -clysis choledoch/o -ectomy -grade col/o -gram colon/o -graph cyst/o