ZDRAVSTVENO VELEUILITE, ZAGREB

Petar Rei
Srebrenka uri Havelka

Izdava
ZDRAVSTVENO VELEUILITE
Mlinarska cesta 38, 10000 Zagreb
http://www.zvu.hr
Za izdavaa
Prof. dr. sc. Mladen Havelka
Biblioteka
"Udbenici i prirunici Zdravstvenog veleuilita
Svezak 42.
Urednik biblioteke
Prof. dr. sc. Predrag Keros
Lektor
Nitor usluge d.o.o.
Recenzenti
Prof. dr. sc. Miljenko Marotti
Prof. dr. sc. Marija Frkovi

Copyright 2013.
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ISBN 978-953-6239-34-4
Grafiko oblikovanje i tisak "Offset NP GTO tisak d.o.o.", 2013.

II

Petar Rei
Srebrenka uri Havelka

Introduction to Basic
Medical Terminology
for Health Professions
A textbook for students of health studies

ZDRAVSTVENO VELEUILITE
Zagreb, 2013

Contents
PREDGOVOR.................................................................................................. VII
INTRODUCTION - Hypocratic Oath 1
About the English Language..................................................................... 3
01. Basic elements of a medical word Grammar revision
the passive voice..................................................................................... 6
02. The Most Common Suffixes and Prefixes................................................ 12
03. Body as a Whole
For further practice: translate into English (the cell)............................. 22
04. Integumentary System............................................................................. 35
05. Musculoskeletal System.......................................................................... 49
06. Gastrointestinal System........................................................................... 70
07. Respiratory System.................................................................................. 87
08. Cardiovascular System............................................................................ 98
09. Urinary System...................................................................................... 111
10. Nervous System..................................................................................... 121
11. Blood and Lymphatic System................................................................. 138
12. Endocrine System.................................................................................. 158
13. Female Reproductive System................................................................ 176
14. Male Reproductive System.................................................................... 191
15. Sense Organs......................................................................................... 204
SUPPLEMENT
16. Oncology Cancer Medicine.................................................................. 219
17. General Care of the Patient .................................................................. 227

18. British Medical Training and Registration ............................................ 233

19. Smoking Hazardous Adaptation......................................................... 237
20. AIDS........................................................................................................ 253
21. Stress Management .............................................................................. 261
22. Radiology and Nuclear Medicine .......................................................... 275
23. Pharmacology ....................................................................................... 281
24. Psychiatry............................................................................................... 285
GLOSSARY.................................................................................................... 296
REFERENCES.............................................................................................. 398

VI

Predgovor
Ovaj je udbenik - prirunik namijenjen studentima preddiplomskih i specijalistikih diplomskih studija strunih zdravstvenih studijskih programa
medicinskim sestrama, fizioterapeutima, radnim terapeutima, radiolokim
inenjerima, medicinsko-laboratorijskim inenjerima, sanitarnim inenjerima, primaljama i drugim zdravstvenim strukama, npr. lijenicima. Udbenik
obuhvaa tematske nastavne jedinice utvrene nastavnim programom za
predmet Engleski jezik na zdravstvenim studijima, a temelji se na tjelesnim
sustavima.
Veina poglavlja ukljuuje leksiko-gramatike skupine zadataka vezane
uz odreeni tjelesni sustav te skraene popularne i strune tekstove koje
studenti trebaju prevesti s engleskog na hrvatski ili s hrvatskog na engleski
jezik. Sastavni dio udbenika su sadraji vezani uz tvorbu (morfologiju) medicinskog nazivlja pomou prefiksa i sufiksa latinskog odnosno grkog podrijetla
te njihovi ekvivalenti u engleskom strukovnom i kolokvijalnom nazivlju. Glavni
izvor za engleske tekstove posluio je udbenik The Language of Medicine,
autorice D. A. Chabner, 5. i 7. izdanje, kao i Medical English, tree izdanje iz
1982. godine (autorice: V. Mominovi, V. Tanay i S. uri Havelka).
Dodatak ovom udbeniku (Supplement) su tekstovi koji bi studentima mogli
biti zanimljivi kao dopunske teme u sluaju njihova posebnog interesa.
Nadamo se da e priruni Glosar biti od pomoi naim studentima i svima
zainteresiranima za sadraje iz ovog prirunika.
Autori

VII

Introduction
HIPPOCRATIC OATH
Life is short, and the Art long; the occasion fleeting;
experience fallacious, and judgment difficult. The
physician must not only be prepared to do what is right
himself, but must also make the patient, the attendants, and externals cooperate.
(Hippocrates: Aphorisms)

HIPPOCRATES (late 5th century B.C.), generally regarded as the Father

of Medicine, son of a priest-physician, was born on the island of Cos. By
stressing that there is a natural cause for disease he did much to dissociate
the care of the sick from the influence of magic and superstition. His carefully kept records of treatment and solicitous observation of the ill provided
a foundation for clinical medicine in the case report; and by reporting also
unsuccessful methods of treatment he anticipated the modern scientific attitude. The way for the professional nurse was prepared by his emphasis on
the importance of skilled bedside care, and his bedside care example demonstrated the value of clinical instruction.
Many of the writings of Hippocrates and his school have survived - it is the
so-called Corpus Hippocraticum, although it is not certain which parts were
written by Hippocrates himself. These writings are usually characterized by
the stress laid on treatment and prognosis. A moral code for medicine has
been established by his ideal of ethical conduct and practice as embodied in
the Oath, generally taken by students receiving a medical degree. The Oath
sets forth an ethical code for medical profession.
1

Hippocratic Oath
I swear by Appolo1, the physician, and by Asklepios2, Hygeia3, and Panacea4,
and all the gods and goddesses, and call them to witness that I will keep this
oath and contract to the best of my ability and judgment; to regard him who
teaches me this art as equal to my own parents; to share my living with him,
and provide for him in need; to treat his children as my own brothers, and
teach them this art if they wish to learn it, without payment or contract; to give
guidance, lectures, and every other kind of instruction to my own sons and
those of my teacher, and to students bound by contract and oath to medical
law, but to nobody else.
I will prescribe treatment at the best of my ability and judgment for the good
of the sick, and never for a harmful or illicit purpose. I will give no poisonous
drug, even if asked to, nor make any such suggestions; and likewise, I will
give no woman a pessary5 to cause abortion. I will both live and work in purity
and godliness. I will not operate, not even on patients with stone, but will give
way to specialists in this work. I will go into the houses that I visit in order to
help the sick, and refrain from all deliberate harm or corruption, especially
from sexual relations with women or men, free or slave. Anything I see or hear
about people, whether in the course of my practice or outside it, that should
not be made public, I will keep to myself and treat as an inviolable secret.
If I abide by this oath, and never break it, let all men honour me for all time
on account of my life and work; but if I transgress and break my oath, let me
suffer the reverse.

Appolo - Greek god of the arts, prophecy, medicine and light, protector of herds and
flocks, son of Zeus and Leto, brother of Artemis. His principal sanctuary and oracle
were at Delphi. In art he is presented as the ideal of young male beauty.
2
Asklepios, also spelt Asclepius, hero and Greek god of healing; he corresponds to
Aesculapius, Roman god of medicine
3
Hyg(i)ea - in Greek mythology, the goddess of health; daughter of Asklepios.
4
Panacea in Greek mythology, the goddess of healing; sister of Hygea; the word
literally means a cure for all ills, a universal remedy or medicine for all diseases. In
English it is also called an All-heal.
5
pessary (Lat. pessarium) an instrument placed in the vagina to support the uterus or rectum or as a contraceptive device.
1

For further reading:

ABOUT THE ENGLISH LANGUAGE
English is not the language that has always been spoken in the British
Isles, nor indeed is it the only language that is spoken there today. English was
originally a foreign language, imported by foreign invaders. These invaders
were two Germanic tribes living in what is now Northern Germany, along the
North Sea coast. They were called the Angles and the Saxons, and they spoke
different dialects of the same language. It is from these dialects that modern
English has descended.
Anglo-Saxon, or Old English, as historians of the language prefer to call
it, remained the language of England from about A.D. 450 to about A.D. 1150.
The reason why it is not still the language of England is that there were two
more foreign invasions of the island by people speaking different tongues
first the Northmen or Vikings from Denmark, and then the Normans from
Normandy in France.
The result of these further invasions, particularly the second by the Frenchspeaking Normans in A.D. 1066 (William the Conqueror), was to modify Old
English very considerably, and turn it, in the course of the next three centuries, into a compound language which we know as Middle English. Middle
English is recognizably the ancestor of the English we speak today (which Old
English is not), and it was the common tongue of the inhabitants of England
from about A.D. 1150 to about A.D. 1500.
As there were no more foreign conquests of the island the language was
thenceforward able to develop as it were under its own impetus. There
were no more radical changes and so Middle English merged imperceptibly
into the Early Modern English of Shakespeares age and then into the language
we speak now.
The reference has so far been made only to England and not to Britain. The
distinction is important because England is only a part of Britain - the biggest
part, it is true, but still only a part whereas Britain includes also Wales and
Scotland. The Anglo-Saxons after conquering England never succeeded in
penetrating to these remote parts of Britain, so that the English language was
never implanted there. The inhabitants, known as Celts, who were independent
of the English for many years, kept their own language, Celtic, various dialects
of which are still spoken today in these parts of Britain and in Ireland. Welsh
is spoken in Wales, Gaelic in Scotland, and Erse in Ireland. A fourth Celtic
dialect, Cornish, used to be spoken in the south-west corner of England, the
Cornwall, but it became extinct about 200 years ago.

Anglo-Saxon is now, of course, a dead language, but a good deal of its

vocabulary has survived, in one form or another, to the present day. Most of
the very common words in modern English are Anglo-Saxon in origin: nouns
like father, mother, food, drink, bed, most of the prepositions and conjunctions,
and nearly all of the strong verbs. When it was mixed with Norman French
there were three main results: the grammar was simplified, the pronunciation
and spelling became (and still are) much more complicated, and the vocabulary was enormously extended. French is a Latin language, so the part of
our vocabulary is now Latin in origin. That is also one reason why we have so
many synonyms. In pair of words like wed and marry, fat and corpulent, lively and vivacious, the first word is derived from Anglo-Saxon, the
second from Latin.
A language never stands still. It is always changing and developing. These
changes are rapid in primitive societies, but slow in advanced ones, because
the invention of printing and the spread of education have fixed a traditional
usage. The only important change that English has undergone since the
sixteenth century is a very large increase in its vocabulary. It is interesting
to trace the different ways in which new words are adopted or invented. Let
us take just four English words and see how they were made; admiral, yacht,
sandwich, and television.
Admiral was introduced into England from France in the fifteenth century.
It was then spelt amiral and was derived by the French from a compound
Arabic word amir-al-bahr meaning Prince of the Sea. Some time later
certain misguided English scholars, looking at this word, assumed that it was
a corruption of Latin word admirare, meaning to wonder at, and proceeded
to replace- as they thought- the d in first syllable. So out of this confusion,
involving three languages, we have the present word admiral.
Yacht is a Dutch word, which accounts for its unusual spelling. The first
yacht was given by the Dutch to King Charles II as a wedding present in 1662.
The name is derived from the Dutch word for hunting (Germ. Jagd), and yachts
were so named for their speed. As a matter of fact many nautical words come
from Dutch, just as many words connected with music and painting come
from Italian.
Sandwich, which is now no longer a purely English word, but almost international, comes from the fourth Earl of Sandwich (died 1792), who invented
this particular form of quick meal so that he could go on gambling all through
the nights without stopping for dinner. Many names of things are, in fact, taken
from the names of their first inventors, e.g. the electrical terms watt and volt.

Television is typical of many new scientific words which are deliberately

invented from Old Greek and Latin words. In this case the prefix tele is Greek
and means far (cf. telephone, telegram), while the root vision is derived
from the Latin verb meaning to see.
Answer these questions:
1. When was Anglo-Saxon spoken in England?
2. Why is Anglo-Saxont not like modern English?
3. What happened to the language as a result of Norman Conquest?
4. Which countries form part of the British Isles?
5. Which other languages are spoken in Britain today?
6. Why is English not spoken as a first language in parts of Wales and Scotland?
7. Why does language tend to change more rapidly in a primitive society than
in an advanced one?
8. What kind of words in modern English are derived from Anglo-Saxon?
9. Why does English have such a large vocabulary?
10. What is the origin of the word yacht?
From: D.H. Spencer & A.S. Hornby: An Intermediate English Course for
Adult Learners. Oxford University Press.

CHAPTER 1

BASIC ELEMENTS OF A MEDICAL WORD:

WORD ROOTS, COMBINING FORMS, SUFFIXES, PREFIXES
There are several important reasons for studying word elements related
to medical terminology:
1. To be able to analyze all elements of a specific word and understand more
complex terminology and expressions used in medicine and other allied
health professions.
2. Define and provide several examples of word roots, combining forms,
suffixes, and prefixes.
3. Divide the words into their component parts.
4. Describe and explain how medical and other words are formed.
To analyze words mostly used in medical and allied health professions, the
four elements that may be used to form a word need to be identified.
1. WORD ROOTS
The main part or stem of a word is called a word root (WR). A WR is usually
derived from the Greek or Latin language and frequently indicates a body
part. The words can be composed of one, two, or more roots. When a term
is composed of more than one word root it is referred to as a combined or a
compound word.
Examples of Word Roots
Greek Word
kardia (heart)
gaster (stomach)
hepat (liver)
nephros (kidney)
osteon (bone)

Word Root
cardi
gastr
hepat
nephr
oste

Meaning
heart
stomach
liver
kidney
bone

2. COMBINING FORMS
The combining form (CF) is a WR plus a combining vowel, usually an o.
Examples of Combining Forms
Word Root + Combining Vowel
cardi
o
gastr
o
arthr
o
derm
o
cyt
o
cephal
o
cerebr
o

= Combining Form
cardi/o
gastr/o
arthr/o
derm/o
cyt/o
cephal/o
cerebr/o

Meaning
heart
stomach
joint
skin
cell
head
brain

3. SUFFIXES
A suffix is a word ending. In the words tonsill/itis and tonsill/ectomy, The
suffixes are itis (inflammation) and ectomy (excision, removal). Changing a
suffix gives the word a new meaning. In medical terminology a suffix usually
indicates a procedure, condition, disease, or part of speech. Many suffixes are
derived from Greek and Latin words.
Examples of Suffixes
Combining Form + Suffix
=
arthr/o
-centesis
(joint)
(puncture)

Medical Word
arthrocentesis

Meaning
puncture of a joint

thorac/o
(chest)

-tomy
(incision)

thoracotomy

incision of the chest

gastr/o
(stomach)

-megaly
gastromegaly
(enlargement)

enlargement of the
stomach

erythr/o
(red)

-cyte
(cell)

erythrocyte

red blood cell

cyt/o
(cell)

-logy
(study)

cytology

study of a cell

4. PREFIXES
A prefix is a word element located at the beginning of a word. When a
medical word contains a prefix, the meaning of the word is changed. The prefix
usually indicates a number, time, position, direction, colour, or negation.

Examples of Prefixes
Prefix + Word Root + Suffix =
hyper
therm
-ia
(excessive) (heat)
(condition)

Medical Word
hyperthermia

Meaning
condition of
excessive heat

intra
(in, within)

muscul
(muscle)

-ar
intramuscular
(relating to)

within the muscles

macro
(large)

gloss
(tongue)

-ia
(condition)

macroglossia

condition of a large
tongue

micro
(small)

card
(heart)

-ia
(condition)

microcardia

condition of a small
heart

Defining Medical and Other Words

The word is usually defined by first identifying its suffix, or ending, then
the prefix, or word beginning, and finally the middle part, i.e. the word root.
For Example:
gastr/o
stomach
(2)

enter/
intestine
(3)

itis
inflammation
(1)

Read as follows:
1. Inflammation of (suffix)
2. Stomach and (first part of the word)
3. Intestine (middle)
GRAMMAR REVISION: THE PASSIVE VOICE
Elementary
Note: appropriate tense of verb to be with the past participle of the main
verb.
Example: Someone has stolen my books My books have been stolen.
No agents with by are required in the following sentences.
Turn the following sentences into the passive voice:
1. People always admire this picture.
2. He hurt his leg in an accident.
3. No one has opened that box for the last hundred years.
4. People formerly used the Tower of London as a prison.
5. Someone has broken two of my dinner plates.
6. They fought a big battle here two hundred years ago.
7. People will forget this play in a few years time.
8

8. No one has ever beaten my brother at tennis.

9. People speak English all over the world.
10. Did anyone ask any questions about me?
11. People mustnt take these books away
12. They punished me for something I didnt do.
13. Someone wants you to help lay the table.
14. Somebody left the dog in the garden.
15. We shall discuss the matter tomorrow.
16. Nobody heard a sound.
17. What have people done about this?
18. Has anybody answered your question?
19. They made this gun in Birmingham.
20. They make a book of paper.
Elementary and intermediate
Note: When the verb in the active voice has two objects, it is more usual in
English to have the personal object as the subject of the passive voice.
Example: Someone gave me a book. --- I was given the book.
Put the following sentences into the passive voice with a personal subject:
1. They gave my little sister a ticket, too.
2. People will show the visitors the new buildings.
3. Someone has already paid the electrician for his work.
4. They promise us higher wages.
5. They will allow each boy a second plate of ice-cream.
6. They will ask us all several questions.
7. Someone will read you another chapter next time.
8. They have made my uncle a captain.
9. The others told the new students where to sit.
10. They still deny women the right to vote in some countries.
11. Somebody will tell you what time the train leaves.
12. Somebody has recommended me another doctor.
13. Someone taught him French and gave him a dictionary.
14. They asked the rest of us to be there at eight oclock.
Note: The use of by with an agent should always be avoided, except when
it is necessary to complete the sense of the sentence. For example: This poem
was written by Shakespeare.
Note: Prepositions or adverb particles must not be left out with verbs
requiring them. For example: They will look after you well --- You will be well
looked after
9

Intermediate and advanced

Turn the following sentences into the passive voice as appropriate:
1. Someone has asked the student a very difficult question.
2. We must look into this matter.
3. People speak well of my friend Peter.
4. Someone reads to the old lady every evening.
5. You must work for success.
6. They gave me two shillings change at the shop.
7. She promised him a book.
8. It is time they brought the cows in.
9. Nobody has slept in that room for years.
10. The teacher promised Mary a prize if she worked well.
11. A friend told me the news this morning.
12. Unkind remarks easily upset my friend Maisie.
13. What ought we to do about this?
14. What questions did the examiner set?
15. Nobody has made any mistakes.
16. Beethoven composed this piece.
17. A guide pointed out the Pyramids to me.
18. Somebody must do something for these poor men.
19. Nobody has answered my question properly.
20. They didnt tell me the truth about the situation.
21. People ought not to speak about such things in public.
22. An unseen hand opened the window.
23. They had eaten all the dinner before they finished the conversation.
24. Somebody left the light on all night.
25. We shall lock the house up for the summer and the old gardener will look
after it.
26. Has someone mended that chair yet?
27. Nobody has ever spoken to me like that before.
28. Didnt they tell you to be here by six oclock?
29. Id like someone to read to me.
30. No one has drunk out of this glass.
31. The fire destroyed many valuable paintings.
32. I hate people looking at me.
33. Do you intend us to take your remark seriously?
34. This is a good idea, but one cannot carry it out in practice.
35. People shant speak to me as if I were a child.
36. Somebody has locked the box and I cannot open it.

10

37. Somebody must have taken it while I was out.

38. Did the noise frighten you?
39. Dont let the others see you.
40. Did anybody ever teach you how to behave?
41. They did nothing until he came.
42. I can assure you I will arrange everything in time.
43. A sudden increase in water pressure would break the dam.
44. One cannot eat an orange if nobody has peeled it.
45. Her beauty struck me deeply.
46. People generally assume that money brings happiness.
47. You must account for every penny.
48. People say tortoises live longer than elephants.
49. I should love to be taken out to dinner.
50. Naturally one expects you to interest yourself in the job they have offered
you.
51. It must have disappointed him terribly that people told him they didnt
want him.
52. They must have given you the paper (that) they meant for the advanced
candidates.
53. Someone had already promised me a watch for my birthday when they
presented me with one as a prize.
54. It surprised me to hear someone had robbed you.
55. People say that figs are better for us than bananas.
56. We havent moved anything since they sent you away to cure you.
57. Nobody would have stared at him if they had told him beforehand what
clothes one had to wear in such a place.
58. People will laugh at you if you wear that silly hat.
59. People ought to tell us how much they expect of us.
60. When I was a child, people used to read to me out of a book of fairy tales
someone had given me for my birthday.

--------------------------------------------

11

CHAPTER 2

THE MOST COMMON SUFFIXES AND PREFIXES

1. SURGICAL PROCEDURE SUFFIXES
a) Incision
-ectomy surgical removal, excision; example: appendectomy,
hemorrhoidectomy
-centesis surgical puncture; example: amniocentesis, arthrocentesis
-stomy forming an opening; example: bronchostomy
-tome instrument used for cutting; example: osteotome
-tomy cutting; example: gastrotomy
b) Plastic operation, reconstruction, loosening, refracturing
-clasis breaking, refracturing; example: osteoclasis
-desis bindig, stabilization; example: arthrodesis
-lysis loosen, free from adhesions, destruction; example: enterolysis,
thrombolysis
-pexy fixation, suspension; example: nephropexy
-plasty plastic repair; example: rhinoplasty
-rrhaphy suture; example: splenorrhaphy
-tripsy to crush; example: neurotripsy, lithotripsy
2. DIAGNOSTIC, SYMPTOMATIC AND OTHER COMMON SUFFIXES

-algia pain; example: myalgia, dorsalgia, gastralgia

-cele hernia, swelling; example: nephrocele, cystocele, rectocele
-dyna pain; example: splenodynia, otodynia
-ectasis dilatation, expansion; example: bronchiectasis
-emia blood condition; example: leukemia
-gen beginning, origin; example: pathogen- any diseaseproducing
microorganism
-gram a writing, record; example: cardiogram (written record of the
heart rate)
12

 -graph to write, record; example: cardiograph (an instrument for the

measurement of heart rate)
-iasis condition, formation of, presence of; example: nephrolithiasis
(kidney stones)
-sis state of, condition; example: prognosis (foreknowledge)
-itis inflammation; example: nephritis
-logy study of; example: biology
-malacia softening; example: osteomalacia
-megaly enlargement; example: acromegaly (enlargement of the
extremities)
-oid resemble; example: rheumatoid
-oma tumour; example: hepatoma
-osis abnormal condition; example: neurosis
-pathy disease; example: adenopathy
-penia decrease, deficiency; example: erythropenia
-phagia eating; example: polyphagia
-plegia paralysis, stroke; example: paraplegia
-phobia morbid fear; example: claustrophobia
-rrhea discharge, flow; example: diarrhea
-sclerosis hardening; example: arteriosclerosis
-scope instrument to visually examine; example: gastroscope
-scopy examination, view; example: gastroscopy
3. ADJECTIVE ENDINGS
The most common adjective endings (meaning related to or pertaining to)
are the following:

-ac cardiac
-al carpal
-ary hereditary
-ical physiological
-ous serous
-tic mycotic
-ic splenic

13

4. PLURAL ENDINGS
RULE
Singular
Plural
Retain a and add e
-ae
Drop x and add ces
-ax
Drop en and add ina
-en
Drop ex and add ices
-ex
Drop is and add es
-is
Drop ix and add ices
-ix
Retain ma and add ta
-ma
Drop on and add a
-on
Drop um and add a
-um
Drop us and add i
-us
Drop y and add ies
-y

EXAMPLE
Singular
Plural
pleura
pleurae
thorax
thoraces
lumen
lumina
apex
apices
diagnosis
diagnoses
appendix
appendices
carcinoma
carcinomata
ganglion
ganglia
bacterium
bacteria
bronchus
bronchi
deformity
deformities

5. PREFIXES
A prefix is a word element located at the beginning of a word. Most prefixes
in medical and other terminology are of Greek or Latin origin. A prefix cannot
stand alone and is used in conjunction with combining form or a combining
form and a suffix. Here follows a list of the most common prefixes used not
only in medical terminology, but also in the formation of words frequently used
in other allied health professions.
a) Prefixes of position and direction

14

ab- (away from)

ad- (toward, near)
ambi- (both)
ante- (in front of, before)
antero- (the front, toward the front side)
circum- (around)
dextro- (right, to the right side)
dia- (through)
dorso- (back)
ec-, ecto- (out, outside)
endo- (in, within)
epi- (above)
ex-, exo-, extra- (out, outside, outward)
hyper- (above)

hypo-, infra-, sub- (deficient, under, below)

inter- (between)
intra- (inside)
latero- (side)
meso-, medio- (middle)
meta (change, beyond)
para- (near, beside)
per- (through)
peri- (around)
post-, postero- (after, behind)
pre- (before)
retro- (behind, backward)
sinistro- (left)
super-, supra- (upper, above)
trans- (across)
ultra- (beyond, excess)

b) Prefixes of colour

albino-, albumino-, leuko- (white)

chloro- (green)
cirrho-, jaundo-, xantho- (yellow)
cyano- (blue)
erythro-, roseo- rubeo- (red)
glauco-, polio- (grey)
melano- (black)

c) Prefixes of number and measurement

primi- (first)
uni-, mono- (one)
bi-, di- (two)
hemi-, semi- (half)
macro- (large)
micro- (small, minute)
multi-, pan-, poly- (many, all, much)
tri- (three)
quadri- (four)

d) Prefixes of negation
a-, an-, ar- (without, not)
im-, in- (no, not)

15

e) Miscellaneous prefixes

anti-, contra- (against)

brady- (slow)
dys- (painful, difficult)
eu- (good)
hetero- (different)
hydro- (water)
homeo-, homo- (same)
neo- (new)
mal- (bad, insufficient)
pseudo- (false)
sym-, syn- (together)
tachy- (rapid)

EXERCISES -suffixes
1. Find the suffixes in the following words and give the meaning of the entire term:
1.1. leukemia............................................................................................................................................
1.2. gastrectomy.....................................................................................................................................
1.3. hematoma.........................................................................................................................................
1.4. nephritis.............................................................................................................................................
1.5. gastroscope......................................................................................................................................
1.6. dermatosis........................................................................................................................................
1.7. psychogenic.....................................................................................................................................
1.8. neuralgia............................................................................................................................................
2. Define the suffixes for the following terms and give example of a medical term:
2.1. inflammation...................................................................................................................................
2.2. resection or surgical removal...............................................................................................
2.3. section.................................................................................................................................................
2.4. condition (usually abnormal).................................................................................................
2.5. process of study.............................................................................................................................
2.6. instrument to examine visually............................................................................................
2.7. instrument to cut..........................................................................................................................
2.8. one who specializes in...............................................................................................................
16

2.9. pertaining to.....................................................................................................................................

2.10. blood condition............................................................................................................................
2.11. tumour..............................................................................................................................................
2.12. pain.....................................................................................................................................................
2.13. record ...............................................................................................................................................
2.14. cell......................................................................................................................................................
2.15. process of viewing ....................................................................................................................
3. Test your knowledge by giving the meaning of the following suffixes:
3.1. -gram...........................................................

3.11. -coccus.....................................................

3.2. -plasty..........................................................

3.12. -trophy......................................................

3.3. -osis..............................................................

3.13. -tomy.........................................................

3.4. -itis................................................................

3.14. -ectomy ...................................................

3.5. -genic...........................................................

3.15. -stomy.......................................................

3.6. -graphy........................................................

3.16. -megaly....................................................

3.7.-oma..............................................................

3.17.-malacia....................................................

3.8. -tome...........................................................

3.18. -dynia........................................................

3.9. -graph..........................................................

3.19. -poiesis.....................................................

3.10. -emia.........................................................

3.20. -centesis..................................................

4. Construct medical words:

4.1. earache...............................................................................................................................................
4.2. enlargement of the liver...........................................................................................................
4.3. incision of the chest....................................................................................................................
4.4. deficiency of white blood cells .............................................................................................
4.5. softening of the brain.................................................................................................................
4.6. one who specializes in the study of the eye..................................................................
4.7. new opening of the kidney.......................................................................................................
4.8. fear of light.......................................................................................................................................

17

4.9. formation of red blood cells (RBCs)..................................................................................

4.10. prolapse of the kidney.............................................................................................................
4.11. fixation of the internal organs (viscera)........................................................................
4.12. formation of bone.......................................................................................................................
4.13. condition of hardening of arteries....................................................................................
4.14. removal of tonsils......................................................................................................................
4.15. resembling a stone...................................................................................................................
4.16. small vein.......................................................................................................................................
4.17. small artery...................................................................................................................................
4.18. small bronchus...........................................................................................................................
4.19. tumour of the liver.....................................................................................................................
4.20. surgical repair of nerves........................................................................................................
EXERCISES - prefixes
1. Define the prefix and give the meaning of the entire term:
1.1. inter/dental between..................................................................................................................
1.2. hypodermic.......................................................................................................................................
1.3. sinistrocardia...................................................................................................................................
1.4. epigastrium......................................................................................................................................
1.5. dorsalgia............................................................................................................................................
1.6. retrocervical.....................................................................................................................................
1.7. subnasal.............................................................................................................................................
1.8. cyanoderma.....................................................................................................................................
1.9. albuminosis......................................................................................................................................
1.10. melanocarcinoma......................................................................................................................
1.11. quadriplegia..................................................................................................................................
1.12. hyperliposis...................................................................................................................................
1.13. primipara........................................................................................................................................
1.14. ultraviolet........................................................................................................................................
1.15. polydipsia........................................................................................................................................
18

1.16. suprasternal..................................................................................................................................
1.17. perirenal..........................................................................................................................................
1.18. anacidity..........................................................................................................................................
1.19. macrocephaly...............................................................................................................................
1.20. cirrhotic...........................................................................................................................................
2. Fill in the correct medical word that matches the definitions below:
2.1. ........................................................... morbid fear of water.
2.2. ........................................................... abnormally slow breathing.
2.3. ........................................................... rapid breathing.
2.4. ........................................................... difficult or bad breathing.
2.5. ........................................................... condition of hardening.
2.6. ........................................................... poor or bad nutrition.
2.7. ........................................................... good, easy breathing.
2.8. ........................................................... condition of sweating.
2.9. ........................................................... false encephalitis.
2.10. ......................................................... abnormal fear of everything.
3. Fill in the correct medical term for the definitions below:
3.1. ........................................................... left-footed.
3.2. ........................................................... vision in which objects appear blue.
3.3. ............................................................ located behind and at the inner side of a part.
3.4. ........................................................... destroying (poisoning).
3.5. ........................................................... back of the colon.
3.6. ........................................................... abnormal redness of skin.
3.7. ........................................................... pertaining to both sides.
3.8. ........................................................... before birth.
3.9. ........................................................... below the axilla.
3.10. ......................................................... pain in the back.
3.11. ......................................................... black tumour.

19

3.12. ......................................................... between the ribs.

3.13...................................................... near the middle.
3.14...................................................... in the middle of the sternum.
3.15. ......................................................... pertaining to the region above the stomach.
4. Give the meaning of the following prefixes:
4.1. anti- .............................................................

4.11. hypo- ........................................................

4.2. pro- ..............................................................

4.12. peri- ..........................................................

4.3. sub-...............................................................

4.13. im- .............................................................

4.4. ab- ................................................................

4.14. dia- ............................................................

4.5. para- ............................................................

4.15. endo- ........................................................

4.6. retro- ...........................................................

4.16. ecto- ..........................................................

4.7. contra- .......................................................

4.17. brady- ......................................................

4.8. amphi- ........................................................

4.18. syn- ...........................................................

4.9. semi- ...........................................................

4.19. homo- ......................................................

4.10. poly- ..........................................................

4.20. primi-........................................................

FURTHER PRACTICE
1. Give the meaning of the following combining forms:
1.1. aden/o ........................................................

1.12. physi/o .....................................................

1.2. leuk/o ..........................................................

1.13. path/o .......................................................

1.3. cephal/o ....................................................

1.14. rhin/o ........................................................

1.4. arthr/o ........................................................

1.15. nephr/o ...................................................

1.5. cerebr/o .....................................................

1.16. carcin/o ...................................................

1.6. cyt/o .............................................................

1.17. gnos/o ......................................................

1.7. oste/o ..........................................................

1.18. onc/o .........................................................

1.8. dermat/o ...................................................

1.19. tom/o ........................................................

1.9. erythr/o ......................................................

1.20. gynec/o ....................................................

1.10. encephal/o ............................................

1.21. hepat/o ....................................................

1.11. bi/o .............................................................

1.22. cyst/o ........................................................

20

2. Build medical terms for the following:

2.1. blood mass (tumour) .................................................................................................................
2.2. inflammation of a gland ..........................................................................................................
2.3. record of the electricity of the heart ................................................................................
2.4. abnormal condition of clotting cells
(slight increase in numbers) .................................................................................................
2.5. pertaining to across the stomach ......................................................................................
2.6. study of the skin (and its diseases) ...................................................................................
2.7. head pain ..........................................................................................................................................
2.8. instrument to cut bone .............................................................................................................
2.9. removal of the stomach ...........................................................................................................
2.10. instrument to visually examine the eye .......................................................................
2.11. to view life (removal of living tissue
for microscopic examination) ............................................................................................
2.12. inflammation of bones and joints ....................................................................................
2.13. one who specializes in the study of tumours ...........................................................
2.14. pertaining to producing disease ......................................................................................
2.15. incision of the stomach .........................................................................................................
2.16. process of viewing the urinary bladder .......................................................................
3. Give the meaning for the following terms:
3.1. autopsy ......................................................

3. 8. cystitis......................................................

3.2. nephrotomy..............................................

3.9. hepatoma.................................................

3.3. erythremia................................................

3.10. anemia....................................................

3.4. oncogenic..................................................

3.11. leukemia................................................

3.5. cephalic......................................................

3.12. carcinoma.............................................

3.6. gastric incision.......................................

3.13. thrombosis...........................................

3.7. gastric excision......................................

3.14. sarcoma ................................................

21

CHAPTER 3

BODY AS A WHOLE
1. Structural Organization
Cell
The cell is the fundamental structural and functional unit of every living
being. The study of cells is called cytology. Cells are everywhere - every organ
is made up of these individual units. They are responsible for all activities associated with life, for instance: utilizing food, eliminating waste, reproducing.
All cells are similar in that they contain a gelatinous substance called the
protoplasm. It is composed of water, protein, sugar, acids, fats, and various
minerals. However, cells are different, or specialized, throughout the body in
order to carry out their individual functions.
The following are among the major parts of the cell.
1. Cell membrane. This structure surrounds and protects the internal environment of the cell, determining what passes in and out of the cell.
2. Nucleus. The nucleus is the controlling structure of the cell. It controls the
way in which a cell reproduces and contains genetic material that determines the functioning and structure of the cell. All the material within the
nucleus is called nucleoplasm or karyoplasm (kary/o = nucleus, pl. nuclei).
3. Chromosomes. These are 23 pairs of thin strands of genetic material (DNA)
located within the nucleus of each cell in a human body, except in sperm
and egg cells, which contain only half of the genetic material each. Chromosomes contain regions known as genes which determine our hereditary
makeup. The DNA within chromosomes regulates the activities of each cell
by guiding the formation of another substance called RNA, which can leave
the cell nucleus, enter the cytoplasm, and direct the activities of the cell.
In the human there are about 31 000 genes that determine unique human
characteristics.
Chromosomes can be studied and classified as to size, arrangement,
and number. This classification is called a karyotype. Karyotyping of chro-

22

mosomes is useful in determining whether chromosomes are normal in

number and structure.
4. Cytoplasm. Cytoplasm is all the protoplasmic material outside the nucleus.
It carries on the work of the cell and contains various structures called organelles (in a muscle cell, it does the contracting; in a nerve cell, it transmits
impulses). Nucleus is the largest cell organelle. Some other organelles
are:
a) Mitochondria (sg. mitochondrion) - small bodies which carry on the
production of energy in the cell by burning food in the presence of oxygen.
This process is called catabolism. During catabolism complex food materials are broken down into simpler substances and energy is released.
b) Endoplasmic reticulum - a series of canals within the cell. Some canals
contain small bodies called ribosomes which help make substances
(proteins) for the cell. This synthesizing (building-up) process is called
anabolism.
c) Golgi apparatus (complex, or body) among other functions serves as
a site of formation of primary lysosomes, which are responsible for the
breakdown of particles entering the cell.
d) Centrioles participate in cell division.
Together the processes of catabolism and anabolism constitute the total
metabolism of the cell. Metabolism means the sum of the building-up
processes (anabolism) and breaking-down processes (catabolism) in a cell.
Figure 3.1. The Cell

23

Tissue
A tissue is a group of similar cells working together to do a specific job.
The study of tissues is called histology. A histologist is one who specializes
in the study of tissues. More than 200 cell types compose four major tissues
of the body:
Epithelial Tissue. Epithelial tissue is located all over the body as lining for
internal organs, cavities and canals, as secreting portions of exocrine and
endocrine glands, at the outer surfaces of the skin covering the body. It is
composed of cells arranged in sheets consisting of one or more layers.
Muscle Tissue. Voluntary, or skeletal, muscles are groups of muscles
attached to bones and they are responsible for the movement of the body in
its external environment. Involuntary, or visceral muscles are those muscles
responsible for the movement of internal organs and their functioning is said
to be involuntary, i.e. not under conscious control. Basic function of muscle
tissue is to provide for the contraction and relaxation of all muscle groups.
Connective Tissue. This is the tissue that supports and connects other
tissues and organs. It is composed of different cell types, e.g. fibroblasts, fat
cells, bone and cartilage cells, blood cells.
Nerve Tissue. Nerve tissue conducts electrical impulses as it relays information throughout the entire body.
Organ
These structures can be made of several types of tissue. For example,
an organ like the stomach is composed of muscle tissue, nerve tissue, and
glandular epithelial tissue. The medical term for internal organs is viscera
(singular: viscus). Examples of abdominal viscera (organs located in the
abdomen) are the liver, stomach, intestines, pancreas, spleen, and gallbladder.
System
These can be briefly defined as groups of organs working together to
perform complex functions. For example, the mouth, esophagus, stomach,
and small and large intestines are organs of the digestive system. Here follows
the list of body systems and their major organs:
1. Gastrointestinal, or digestive system - mouth, pharynx, esophagus,
stomach, intestines (small and large), liver, gallblader, pancreas.
2. Urinary, or excretory - kidneys, ureters, urinary bladder, urethra.
3. Respiratory nose, pharynx, larynx, trachea, bronchi, left and right lung
lobes, alveoli.
4. Musculoskeletal muscles, bones, joints, tendons, ligaments.
5. Integumentary skin, sebaceous and sweat glands, hair, nails.
24

6. Cardiovascular heart, blood vessels (arteries, veins capillaries), lymphatic

vessels and nodes, spleen.
7. Endocrine endocrine glands (hypophysis, thyroid g., parathyroid g.,
adrenal, gonads, pancreas islets of Langerhans, thymus, pineal g.).
8. Nervous neurons and neuroglial cells (brain, spinal cord, nerves, collections of nerves)
9. Reproductive
a) Female: ovaries, fallopian tubes, uterus, vagina, mammary g.
b) Male: testes and associated tubes, urethra, penis, prostate g.
10. Special senses the eye and the ear.
Organism
Organism is defined as the highest level of organization i.e. as a complete
living entity capable of independent existence. All complex organisms,
including humans, are made up of several body systems that work together
to sustain life.
2. Body cavities
A body cavity is a space within the body which contains internal organs
(viscera). The names of the body cavities and important organs contained
within them are listed below.
Cavity
1. Cranial
2. Thoracic

3. Abdominal

Organs
Brain
Lungs, heart, esophagus, trachea, thymus gland, aorta
The thoracic cavity can be divided into two smaller cavities:
a) The pleural cavity - the areas surrounding the lungs.
Each pleural cavity is lined with a double-folded
membrane called pleura; visceral pleura is closest to
the lungs and parietal pleura is closest to the outer wall
of the cavity.
b) The mediastinum- the area between the lungs.
It contains the heart, aorta, trachea, esophagus, and
thymus gland.
Stomach, small and large intestines, spleen, liver,
gallbladder, pancreas. The peritoneum is the
double-folded membrane surrounding the abdominal
cavity. The kidneys are two bean-shaped organs situated
at the back (retroperitoneal area) of the abdominal cavity
on either side of the backbone.

25

4. Pelvic
5. Spinal

Urinary bladder, urethra, ureters; uterus and vagina in the

female.
Spinal cord and spinal nerve roots.

The cranial and spinal cavities are considered dorsal body cavities because
of their location on the back portion of the body. The thoracic, abdominal, and
pelvic cavities are considered ventral body cavities because they are on the
front, or belly side, of the body.
The thoracic and abdominal cavities are separated by a muscular partition
called the diaphragm. The abdominal and pelvic cavities are not separated by a
partition and together they are usually referred to as the abdominopelvic cavity.
3. Anatomical divisions of the abdomen 9 regions and 4 quadrants
These divisions are used in anatomy texts to describe the regions in which
organs and structures are found. The following are 9 abdominal regions
1. Hypochondriac regions (two upper lateral regions beneath the ribs)
2. Epigastric region (region of the stomach)
3. Lumbar regions (two middle lateral regions)
4. Umbilical region (region of the navel or umbilicus)
5. Inguinal (iliac) regions (two lower lateral regions)
6. Hypogastric region (lower middle region, below the umbilicus)
Figure 3.2. Anatomical divisions of the abdomen 9 regions & 4 quadrants

Right upper
quadrant

Left upper
quadrant

Right lover
quadrant

Left lover
quadrant

Right
hypochondriac
region

Epigastric
region

Left
hypochondriac
region

Right lumbar
region

Umbilical
region

Left lumbar
region

Right inguinal Hypogastric Left inguinal

(iliac) region
region
(iliac) region

26

4. Anatomical division of the back (spinal column)

The back is divided into segments that correspond to regions of the spinal,
or vertebral,column. The spine is composed of a series of bones extending
from the neck to the tail bone (coccyx). Each bone is called a vertebra (plural:
vertebrae).
Division of the back
1. Cervical

Abbreviation
C

2. Thoracic

T or D
(D = dorsal)

3. Lumbar

4. Sacral

5. Coccygeal

Cg

Location
Neck region. There are 7 cervical
vertebrae (Cl-C7).
Chest region. There are 12 thoracic
vertebrae (T1-T12). Each bone is
joined to a rib.
Loin or flank region (between the
ribs and the hip bone). There are
5 lumbar vertebrae (L1-L5).
Five bones (s1-S5) are fused to
form one bone the sacrum.
The coccyx (tailbone) is a small
bone composed of 4 fused pieces.

An important distinction should be made

between the spinal column (the vertebrae) and
the spinal cord (nerves running through the
column). The former is bone tissue, while the
latter is composed of nerve tissue.
The spaces between the vertebrae (intervertebral spaces) are identified according to the two
vertebrae between which they lie; e. g. LS-Sl
lies between the 5th lumbar and the 1st sacral
vertebrae. An intervertebral cartilaginous (made
of cartilage) disk (or disc) lies between each
vertebra and acts as a pad to absorb shock and
make movement easier.

Figure 3.3. Anatomical divisions of the back

(spinal column)
27

5. Positional and directional terms

afferent

Conducting toward a structure. Example: veins are

called afferent vessels since they take blood toward
the heart.

efferent

Conducting away from a structure. Example: arteries

are efferent blood vessels since they take blood away
from the heart.

anterior (ventral)

Front of the body. Example: the abdomen is located

anterior to the spinal cord. Ventral and anterior mean
the same position in the human.

posterior (dorsal)

Back of the body. Example: the posterior lobes of the

brain are in the back of the head and are called the
occipital lobes. Dorsal means the same position as
posterior.

central

Pertaining to the centre. Example: the heart is located

in the central portion of the thoracic cavity between
the lungs and the mediastinum.

deep

Away from the surface. Example: the lesion penetrated

deep into the abdomen, away from the surface of the
body.

superficial

Near the surface. Example: the wound was a superficial one, just penetrating the skin.

distal

Away from the beginning of a structure; away from

the centre. Example: at its distal end, the thigh bone
(femur) joins with the knee cap (patella).

proximal

Pertaining to the beginning of a structure. Example:

the proximal proximal end of the femur joins with the
pelvic (hip) bone.

inferior (caudal)

Away from the head; situated below another structure.

Example: the feet are the caudal parts of the human
body.

superior (cephalic)

Pertaining to the head; situated above another structure. Example: in a cephalic presentation of the fetus,
the head comes through the birth canal first.

lateral

Pertaining to the side. Example: the little toes are

lateral to the big toes.

28

medial

Pertaining to the middle or nearer the median plane of

the body. Example: in the anatomical position the palms
of the hands are facing outward and the fifth finger lies
medial to the other fingers.

supine

Lying on the back facing upward.

prone

Lying on the belly (abdomen) facing downward.

6. Planes of body
A plane is an imaginary flat surface that anatomists use to identify different
sections of the body. The following are the most commonly used body planes
and their anatomical divisions.
1. frontal coronal vertical plane dividing the body or structure into anterior and posterior portions
2. midsagittal median lengthwise vertical plane dividing the body or structure into right and left portions or into right and left halves.
3. transverse - horizontal - Plane running across the body parallel to the
ground (horizontal).
It divides the body or structure into upper and lower portions.
Figure 3.4 Planes of the Body

29

7. Medical word elements

Combining form
acr/o
adip/o
chondr/o
cyt/o
eti/o
hist/o
idi/o
kary/o
morph/o

Meaning
extremity
fat
cartilage
cell
cause
tissue
unknown
nucleus
shape, form

nucle/o
path/o
somat/o
son/o

nucleus
disease
body
sound

viscer/o

int. organ

Terminology
acromegaly = enlargement of extremities
adipose = pertaining to fat (tissue)
chondritis = inflammation of cartilage
cytology = the study of cells
etiology = study of the cause of diseases
histology = the study of tissues
idiopathic = of unknown cause
karyolysis = destruction of the nucleus
morphology = the study of shape, form,
or structure
nuclear = pertaining to the nucleus
pathology = the study of diseases
somatic = pertaining to the body
sonography = the process of recording
sound
visceral = pertaining to internal organs

8. Diagnostic and Therapeutic Procedures and Related Terms

Terms
adhesion
dehiscence
febrile
homeostasis
inflammation
morbid
sepsis
suppurative
Procedures
anastomosis
biopsy
cauterize
endoscopy
resection
30

Definition
fibrous band holding together tissues that are normally
separated
bursting open of a wound
pertaining to a fever; feverish
relative balance of internal environment of the body
body defence against injury, infection etc.
pertaining to a diseases (morbus = lat. disease)
the presence of pathological microorganisms or their
toxins in the bloodstream
associated with the production of pus (purulent)

surgical joining of two ducts, vessels, bowel segments, etc.

removal of living tissue for microscopic examination
destroy tissue by electricity, freezing, corrosive chemicals
or heat
visual examination of a hollow organ or body cavity with a
specialized instrument called an endoscope
partial excision of a bone, organ or other structure

EXERCISES
1. Answer the following questions:
1.1. Where is the mediastinum?
..........................................................................................................................................................................

What organs are contained within the mediastinum?

..........................................................................................................................................................................

1.2. What does sacroiliac mean? .................................................................................................

1.3. Where are the inguinal regions of the abdomen? ....................................................
1.4. What is adipose tissue? ...........................................................................................................
1.5. What is epithelial tissue? ........................................................................................................
1.6. What is the endoplasmic reticulum? ...............................................................................
1.7. What are ribosomes? ................................................................................................................
1.8. Describe the location and function of chromosomes.
..........................................................................................................................................................................

2. Give the opposites of the following terms:

2.1. deep..............................................................

2.5. posterior.....................................................

2.2. afferent.......................................................

2.6. caudal..........................................................

2.3. proximal.....................................................

2.7. supine..........................................................

2.4. ventral.........................................................
3. Identify the following planes:
3.1. Which plane divides the body into anterior and posterior portions?
..........................................................................................................................................................................

3.2. Which plane divides the body into upper and lower portions?
..........................................................................................................................................................................

3.3. Which plane divides the body into left and right halves?
..........................................................................................................................................................................

31

4. Complete the following sentences using medical terms expressing position or

direction:
4.1. The left lung lies ........................................................... to the heart.
4.2. The upper arm (humerus) joins at its ................................. end with the elbow.
4.3. The humerus joins at its............................................... end with the shoulder.
4.4. The pelvic cavity is ................................................................ to the abdominal cavity.
4.5. The head is .................................................................... to the feet.
4.6. The chest is bordered on the ..................................................... region by vertebral
column and associated muscles.
4.7. The fingers are found at the ............................................................. end of the hand.
4.8. A tube within the liver is called the ..................................................... hepatic duet.
4.9. In the abdominal position the thumb is on the ................................................ side
of the hand.
4.10. The fluid between cells is called ...................................................... cellular fluid.
4.11. The stomach is situated ........................................................................... to the heart.
5. From the following list of terms, pick the one, which fits the definition best:
ribosomes
mediastinum
mitochondria
diaphragm

pleural cavity
endoplasmic reticulum
chromosomes
catabolism

anabolism
metabolism

Structures in the cytoplasm of the cell which produce energy by chemically

burning food in the presence of oxygen.
..........................................................................................................................................................................

Contains the hereditary material (DNA) of the cell.

..........................................................................................................................................................................

Building-up, or synthesizing, process in the cell.

..........................................................................................................................................................................

32

Contains the heart and other structures between the lungs in the thoracic
cavity.
..........................................................................................................................................................................

Process in the cell whereby food is burned to release energy.

..........................................................................................................................................................................

Structures in cytoplasm of cell which are the site of protein synthesis.

..........................................................................................................................................................................

Surrounds the lungs in the thoracic cavity.

..........................................................................................................................................................................

Network of canals in the cytoplasm of a cell.

..........................................................................................................................................................................

Total of building-up and breaking-down processes in the cell.

..........................................................................................................................................................................

Muscular wall dividing the abdominal and thoracic cavities.

..........................................................................................................................................................................

6. Translate the following text into English: the Cell

Prouavanje bolesnih stanja ivih orrganizama temelji se na istraivanju
promjene oblika pojedinih njihovih sastavnih dijelova. Razvoj razliitih biolokih
znanosti meusobno je usko povezan, pa je tako otkrie mikroskopa (17.
stoljee) omoguilo spoznaju da su svi ivi organizmi graeni od mikroskopski
vidljivih sastavnih dijelova, koji su nazvani stanicama (R. Hooke, 1635-1703).
U drugoj polovici 19. stoljea, uz daljnji razvoj fizike i kemije, prouavanje
stanica postaje predmet medicinskog istraivanja i tako nastaje znanost koja
se naziva citologija (gr. xutos /kitos/ = upljina; gr. logos = govor, raspravljanje, izuavanje).
R. Virchow (1821-1902), njemaki lijenik i istraiva, osniva je tzv. celularne patologije (lat. cellula = stanica), koja smatra da patoloke promjene
stanica dovode do pojave bolesti tkiva i organa, odnosno da su patoloka stanja
33

organizma posljedica patolokih promjena na stanicama. Prouavanje izgleda

stanice moe, prema tome, posluiti u svrhu postavljanja dijagnoze; radi toga
se citodijagnostika primjenjuje u razliitim medicinskim podrujima.
Za promatranje stanica najee slui obian svjetlosni mikroskop. Osim
njega upotrebljava se i mikroskop s faznim kontrastom te fluorescentni i
elektroniki mikroskop.
Napredak kemije doveo je do razvitka posebne grane citologije, citokemije,
koja omoguuje prikazivanje pojedinih kemijskih elemenata. Ova grana
citologije omoguuje prikazivanje pojedinih kemijskih elemenata ili reakcija
unutar stanica.
Za promatranje stanica moe posluiti materijal izluen iz pojedinih dijelova
tijela, u kojem se nalaze stanice odljutene s povrine razliitih organa to
je tzv. citodijagnostika.
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34

CHAPTER 4

SKIN - INTEGUMENTARY SYSTEM

Skin is the outer covering of the body. Skin and its accessory organs
comprising hair, nails and glands, are known as the integumentary system
of the body. The word integument stems from the Latin word which means
a covering. Skin is the largest organ of the body and it performs a number of
vital functions. It is a complex system of specialized tissues. It contains glands
which secrete several types of fluids, nerves which carry impulses, and blood
vessels which aid in the regulation of body temperature. The main functions
of the skin are as follows:
it serves as a protective barrier against microorganisms due to the
acidity of its secretions;
it helps shield the delicate, sensitive tissues underneath from
mechanical and other injuries;
it acts as an insulator against heat and cold, and helps eliminate body
wastes in the form of perspiration;
it guards against excessive exposure to the ultraviolet rays of the sun by
producing a protective pigmentation, and it helps produce the body s
supply of vitamin D;
its sense receptors enable the body to feel pain, cold, heat, touch and
pressure.
Structure of the Skin
The skin consists of two main layers and a subcutaneous fat layer:
(1) Epidermis - the outermost layer of the skin which is a thin cellular
membrane made up of several layers of different kinds of cells, is composed
of squamous epithelium. The cells of squamous epithelium are flat and scalelike and are arranged in several layers (strata), therefore called stratified squamous epithelium. The deepest layer is called basal layer. The cells in this layer
are constantly growing and multiplying and give rise to all other cells in the
epidermis. As the basal layer cells divide they are pushed upward toward
35

the most superficial layer of the epidermis, called the stratum corneum. On
this way they become flatten, lose their nuclei and die, becoming filled with
a protein called keratin. Then these cells are called horny cells, because of
the hard protein material they are composed of. Finally, within 3 to 4 weeks
after beginning as a basal cell in the bottom part of the epidermis, the horny,
keratinized cell is sloughed off or shedded from the surface of the skin. In
this way the epidermis is constantly renewing itself, cells dying at the same
rate at which new cells are born. The cells of the protective, horny layer are
nonliving and require no supply of blood for nourishment. As long as the horny
outer layer remains intact, microorganisms cannot enter.
The basal layer of the epidermis contains special cells called melanocytes
which form and contain a black pigment melanin. The amount of melanin
accounts for the colour differences among the races. Also, the presence of
melanin in the epidermis is vital for the protection against the harmful effects
of ultraviolet radiation which can manifest themselves as skin cancer.
(2) Corium, or dermis, is the thicker part of the skin underneath the
epidermis and is made up of connective tissue that contains blood vessels and
nerves. The corium projects into the epidermis in ridges called papillae of the
corium. Lymph vessels and the accessory organs of the skin, which are hair
follicles, sebaceous glands and sweat glands are also located in the dermis.
There are several types of connective tissue cells in the dermis; fibroblastscells that are active in repair of injury, histiocytes (macrophages) - phagocytic
cells that protect the body by devouring foreign substances, and mast cells specialized cells containing histamine and heparin.
Collagen, a fibrous protein material, found also in bone, cartilage, tendons
and ligaments, is another important structural component of the dermis. It is
tough and resistant, yet flexible. Collagen fibres support and protect the blood
and nerve networks that pass through the corium.
(3) Subcutaneous Layer - beneath the corium is a layer of subcutaneous
tissue, which is another connective tissue layer specialized for the formation
of fat. Lipocytes (fat cells) prevail in the subcutaneous layer and they manufacture and store large amounts of fat. This tissue helps insulate the body
against heat and cold and cushions it against shock.

36

Figure 4.1. The three layers of the skin and their structure
Touch receptor
Hair shaft

Sweat gland
pore

Stratum
corneum

Epidermis

Basal layer

Sebaceous
(oli) gland

Dermis

Hair follicle
Subcutaneous
tissue

Adipose tissue

Papilla

Arteriole Venule

Nerve

Sudoriferous
(sweat) gland

Accessory Organs of the Skin

Hair
Hair is distributed over the entire body, except the bottom of the feet (soles)
and palms of the hands. The roots of the hair lie in follicles, or pockets of
epidermal cells situated in the corium. At the bottom of the follicle is a loop
of capillaries enclosed in a covering called the papilla. The cluster of epithelial cells lying over the papilla reproduces and is responsible for the eventual
formation of the hair shaft a visible part of the hair. As long as these cells
remain alive, hair will regenerate even though it is cut or plucked or otherwise removed.
Hair is kept soft and flexible by sebaceous glands which secrete varying
amounts of oily sebum into the upper part of hair follicle located near the
surface of the skin. The growth of hair is similar to the growth of the epidermal
layer of the skin: deep-lying cells in the hair root produce horny cells which
move upward through the hair follicles which hold the hair fibres. Melanocytes are located at the root of the hair follicle, and they support the melanin
pigment for the horny cells of the hair fibre. Hair turns gray when the melanocytes stop producing melanin.

37

Nails
Nails are hard keratin plates covering the dorsal surface of the most distal
phalanges of each finger and toe. They are composed of horny cells that are
cemented together tightly and can extend (grow) indefinitely unless cut or
broken. The nails grow in much the same way as the hair. The nail bed, like
the hair root, is situated in the corium. The pink colour of the nails is due to
their translucent quality which allows the underlying vascular tissue to show
through.
The semilunar (half-moon) white region at the base of the nails is called
lunula. It has a whitish appearance because the vascular tissue underneath
does not show through. The narrow band of epidermis that extends from nail
wall on to the surface is called the cuticle or eponychium (onych means nail).
The average growth rate for fingernails is around l mm per week and it is
somewhat slower for toenails. The major function of the nails is to protect the
tips of the fingers and toes from bruises and other kinds of injuries.
Glands
1. Sebaceous Glands
The sebaceous glands produce on oily secretion called the sebum and
are located in the corium layer of the skin. These glands are filled with cells,
the centres of which are saturated with fatty droplets. As these cells disintegrate they yield the sebum. They are closely associated with hair follicles and
their ducts open into the hair follicle through which the sebum is released.
The acidic nature of sebum helps destroy harmful organisms on the surface
of the skin and, thus, prevents infection. Sebum also lubricates the skin and
minimizes water loss.
Sebaceous glands are present over the entire body except the soles of the
feet and palms of the hands. They are influenced by sex hormones, which
cause them to hypertrophy at puberty and atrophy in old age.
2. Sweat Glands
Sweat glands are also called sudoriferous glands (sudor - sweat). They
are located deep in the corium and are found on almost all body surfaces.
They collect fluid containing water, salt and waste products from the blood
and carry it away in canals that end in pores on the skin surface, where it is
deposited as sweat.
The milk producing mammary gland is another type of modified sweat
gland; it secretes milk only after the birth of a child.

38

Sweat, or perspiration, helps regulate body temperature as well, because

cooling of the skin occurs when sweat evaporates. The odour produced when
sweat accumulates on the skin is due to the action of bacteria on sweat.
Key Terms

albino a person with deficient pigment in skin, hair and eyes.

basal layer the deepest layer of the epidermis.
collagen structural protein found in the skin and connective tissue.
corium the middle layer of the skin.
cuticle band of epidermis at the base and side of the nail plate.
dermis the corium.
epidermis the outermost layer of the skin.
epithelium the layer of skin cells forming the outer and inner surfaces
of the body.
hair follicle the sac or tube within which each hair grows.
horny cell a keratin-filled cell in the epidermis.
keratin hard protein material found in the epidermis, hair, and nails;
commonly found in the horns of animals.
lesion pathological alteration of tissue.
lipocyte a fact cell.
lunula the half-moon-shaped white area at the base of the nail
(crescent).
melanin black pigment formed by melanocytes in the epidermis.
sebum an oily substance produced by sebaceous glands.
squamous epithelium flat, scale-like cells composing the epidermis.
stratum (pl: strata); stratified a layer of cells; arranged in layers.
stratum corneum horny layer; outermost layer of the epidermis.
subcutaneous tissue innermost layer of the skin, containing fat tissue.
sudor sweat, a product of sweat (sudoriferous) glands.

Combining Forms
adip/o
lip/o
steat/o

Meaning
fat

Terminology
adiposis
lipocele
steatoma

cutane/
dermat/o
derm/o

skin

subcutaneous
dermatology
hypodermic

hidr/o
sudor/o

sweat

hidroadenitis
sudoresis (diaphoresis)

39

Combining Forms
ichthy/o
xer/o

Meaning

kerat/o

horny tissue

keratosis

melan/o

black

melanoma

myc/o

fungus

dermatomycosis

onych/o
ungu/o

nail

onychomycosis
subungual

phyt/o

plant

dermatophytosis

pil/o
trich/o

hair

pilonidal
trichopathy

scler/o

hardening

scleroderma

seb/o

sebum

seborrhea

squam/o

scale

squamous

xanth/o

yellow

xanthemia

xen/o

foreign

xenograft

dry, scaly

Terminology
ichthyosis
xeroderma

Disorders of the Skin

1. Cutaneous Lesions
A lesion is a pathological or traumatic alteration of tissue. The following
terms describe the most common skin lesions;
macule
papule
wheal

vesicle

pustule

40

nonpalpable, discoloured (especially reddened) flat spots or

patches (examples: measles, rash, flat moles, freckles.)
small, solid, circumscribed raised areas of skin (examples:
warts, pimples)
vascular eruption of the skin often characterized by smooth,
slightly elevated, edematous area that is redder or paler than
the surrounding skin usually accompanied by itching (examples: allergic reactions to insect bites, hives)
circumscribed collection containing serous fluid (blisters)
(examples: burns, dermatitis, scabies, smallpox) bullae
(singular: bulla) are large blisters.
circumscribed collection of pus (abscess of the skin); (examples: vesicles that contain pus; the term vesicopustular is
common).

polyp

ulcer

cyst
fissure

a mushroom-like growth extending on a stalk from the

surface of a mucous membrane; polyps are most frequently
found in the uterus, nose, mouth, urinary bladder, and tubes
of the digestive tract.
an open sore or erosion of the skin or mucous membrane;
ulcers usually involve loss of tissue substance and formation
of pus (abscess).
a closed sac or pouch containing fluid or semisolid material.
(examples: pilonidal cyst, follicular cyst).
a groove or cracklike sore resembling ulcer-like sores can
occur in the anal region (naturally occurring fissures are
found in the brain, the spinal cord and liver).
Figure 4.2. Lesions of the Skin

2. Symptoms and Pathological Skin Conditions

acne

a chronic inflammatory disease of the sebaceous

glands and hair follicles of the skin characterized by
papular and pustular eruptions of the skin.

acne vulgaris
(ordinary)

a common variety of acne. It is characterized by

the formation of blackheads (comedones, singular:
comedo); papules, nodules and pustules usually
appear on the face, neck and upper part of the trunk.

41

albinism

absence of pigment in the skin, hair and eyes.

alopecia

natural or abnormal baldness or deficiency of hair,

partial or complete, localized or generalized.

athlete s foot

fungal infection of the foot; also called tinea pedis.

basal cell carcinoma malignant tumour of the basal cell layer of the
epidermis. This is the most frequent type of skin
cancer. It is a slow- growing tumour of the basal
layer of the epidermis and usually occurs on
the upper half of the face, near the nose, and is
nonmetastasizing.
Bowen disease

intraepidermal carcinoma (squamous cell)

characterized by red-brown scaly or crusted lesions
that resemble a patch of psoriasis or dermatitis
(precancerous dermatosis).

burns

thermal injuries to the outer surfaces of the body.

They are usually classified into three types: first
degree burns (no blisters; superficial lesions mainly
in the epidermis; hyperesthesia and erythema);
second degree burns (damage to the epidermis and
corium, blisters, erythema, hyperesthesia); and third
degree burns (both the epidermis and corium are
destroyed and subcutaneous layer is damaged; scar
formation results; if more than two thirds of the skin
is destroyed death is the most probable outcome).

cellulitis

a spreading infection, especially of the subcutaneous

tissue.

chloasma

pigmentary skin discolorations, usually those

occurring in yellowish-brown patches or spots.

cicatrix

scar left by a healed wound; keloids are abnormally

raised, thickened scars that form in the skin after
trauma or surgical incision.

comedo

typical small skin lesion of acne vulgaris caused

by accumulation of keratin, bacteria, and dried
sebum plugging an excretory duct of the skin. (pl.
comedones)

decubitus ulcer
(bedsore)

decubitus means lying down; ulcers occur over

bony areas that have been subjected to pressure
against a hard external object such as a bed.

42

dermatitis

inflammation of the skin.

discoid lupus

benign dermatitis confined to the skin, marked by

a scaly rash, usually in a butterfly pattern over the
nose and cheeks, sometimes extending to the scalp
and causing baldness.

ecchymosis

a bruise or purple spot on the skin caused by escape

of blood from injured vessels.

eczema

a chronic moist dermatitis caused by a number

of external and internal factors acting singly or
in combination; these areas may be dry or have a
watery discharge; it is a common allergic reaction
in children, but can also occur in adults; often, it is
accompanied by pruritus.

eschar

damaged tissue following a severe burn.

exanthematous viral eruption (exanthema) of the skin due to a viral

disease
infection; examples are: rubeola-measles; rubella German measles; and varicella-chickenpox.
gangrene

death of tissue associated with loss of blood supply.

In this condition, ischemia resulting from injury,
inflammation, frostbite, diseases such as diabetes,
or arteriosclerosis can lead to necrosis of tissue,
followed by bacterial invasion and putrefaction.

hemangioma

an area in which the blood vessels form an

abnormally excessive network in the skin. They
usually occur as birthmarks and some disappear
with age; others can be treated surgically, with
medications or with irradiation.

hirsutism

condition characterized by the excessive growth of

hair in unusual places, especially in women.

impetigo

bacterial inflammatory skin disease marked by

isolated vesicles, pustules and crusted-over lesions.

keratosis

thickened areas of the epidermis; some keratoses

are pigmented and due to excessive exposure to
sunlight (actinic keratosis); seborrheic keratoses are
called senile warts and occur in older patients.

43

lentigo

leukoplakia

pediculosis
systemic lupus
erythematosus
(SLE)

small brown macules (esp. on the face and arms)

caused by sun exposure; it is a benign lesion
requiring no treatment.
white, thickened patches on mucous membrane
tissue of the tongue or cheek; this may be a
precancerous lesion; it is common in smokers, and
may be caused by chronic inflammation.
infestation with lice, transmitted by personal contact
or common use of brushes, combs, or headgear.
a chronic inflammatory disease of the joints and
collagen of the skin and other organs of the body; it
is commonly marked by erythematous rash on the
face and other areas exposed to sunlight; it involves
the vascular and connective tissues of many organs,
resulting in a multiplicity of local and systemic
manifestations; etiology is unknown, but incidence is
highest in females between puberty and menopause;
it is an autoimmune condition and often fatal.

melanoderma

abnormal brown or black pigmentation of the skin.

melanoma,
malignant

cancerous tumour composed of melanocytes;

the tumours often metastasize to the lungs, liver,
and brain after arising in areas of the body where
pigmented cells occur.

nevus; nevi

congenital proliferation of blood vessels or

pigmented cells on the skin surface (moles and
hemangiomas are examples).

onychia

inflammation of the nail bed, frequently with loss of

the nail.

pemphigus

blistering (bullous) eruptions affecting the skin

and mucous membranes of unknown etiology; the
disease may be acute or chronic and affects adults;
the lesions appear asymptomatically and leave
pigmented spots.

petechiae

small, purplish, hemorrhagic spots on the skin;

smaller versions of ecchymoses.

pruritus

itching, associated with most forms of dermatitis and

other conditions as well.

44

psoriasis

a discrete pink or dull red lesion surmounted by

characteristic silvery scaling; the condition may
begin at any age as flat-topped papules covered with
thin, greyish- white scales; under the dry scales
are red bleeding points; its etiology is not yet fully
explained.

purpura

merging ecchymoses and petechiae over any part of

the body.

rash

an outbreak of lesions on the skin.

scabies

a contagious parasitic infection of the skin with

intense pruritus caused by scabies mite (itch mite).

scleroderma

a chronic disease of the skin caused by infiltration

of fibrous or scar tissue into the skin; scleroderma
leads to hardening, pigmentation, and atrophy of the
skin and internal organs, such as the kidneys, lungs,
and esophagus.

squamous cell
carcinoma

malignant tumour of the squamous epithelial cells of

the epidermis; the tumour may grow in places other
than the skin and can metastasize to lymph nodes.

tinea

any fungal skin disease, especially ringworm,

occurring in various parts of the body.

urticaria

hives; this condition is basically a localized edema

(swelling) in association with itching; etiology may be
allergy to foods or drugs or psychological stimuli.

vitiligo

loss of pigment in areas of the skin (milk -white

patches). The condition is often found in the tropics
and the etiology is unknown.

wart (verruca)

epidermal growth caused by a virus.

EXERCISES
1. a) The functions of the integumentary system are: ....................................................
b) The accessory organs of the skin are: ...........................................................................
2. Complete the following sentences:
2.1. A fat cell is known as a .............................................................................................................

45

2.2. The half-moon-shaped white area at the basis of a nail is called the
..........................................................................................................................................................................

2.3. The sebaceous glands are located in the.......................................................................

2.4. Sweat, or ............................................................... helps regulate body temperature.
2.5. Hair is distributed over .......................................... except .................................................
and ...............................................................................................
3. Give the opposite of each term:
3.1. animate ......................................................

3.6. life .................................................................

3.2. material .....................................................

3.7. thin ...............................................................

3.3. organic .......................................................

3.8. upward .......................................................

3.4. visible ..........................................................

3.9. rational ......................................................

3.5. sensitive ....................................................

3.10. hard ...........................................................

4. Match the following terms with their meanings:

4.1. alopecia .....................................................

a) inflammation of the nail bed

4.2. impetigo ....................................................

b) eponychium

4.3. onychia .......................................................

c) baldness

4.4. scabies .......................................................

d) skin infection marked by pustular

vesicles

4.5. cuticle .........................................................

e) contagious skin disease

transmitted by the itch mite

5. Give the meaning of the following terms:

5.1. acne .....................................................................................................................................................
5.2. albinism ............................................................................................................................................
5.3. eczema ...............................................................................................................................................
5.4. epidermis .........................................................................................................................................
5.5. basal layer .......................................................................................................................................
5.6. horny cells .......................................................................................................................................
5.7. mast cells .........................................................................................................................................

46

5.8. melanocytes ...................................................................................................................................

5.9. macule ...............................................................................................................................................
5.10. ulcer ..................................................................................................................................................
6. Provide the plural form for the following nouns:
6.1.keratosis ....................................................

6.6. epithelium ................................................

6.2. bacillus ......................................................

6.7. stratum ......................................................

6.3. louse ............................................................

6.8. fungus ........................................................

6.4. nevus ...........................................................

6.9. squama ......................................................

6.5. petechia .....................................................

6.10. papilla ......................................................

7. Provide the noun form for the following adjectives:

7.1. allergic .......................................................

7.6. effective .....................................................

7.2. epithelial ...................................................

7.7. present .......................................................

7.3. bullous .......................................................

7.8. dermal ........................................................

7.4. scaly .............................................................

7.9. distant ........................................................

7.5. ulcerative ..................................................

7.10. superficial .............................................

8. Give appropriate medical word for the following skin conditions:

8.1. bullous eruptions on the skin ..............................................................................................
8.2. bedsore ..............................................................................................................................................
8.3. necrosis of skin tissue resulting from ischemia .......................................................
8.4. cancerous tumour composed of melanocytes ...........................................................
8.5. fungal skin infection ..................................................................................................................
8.6. abnormal brown or black pigmentation of the skin ...............................................
8.7. absence of pigment in the skin ...........................................................................................
8.8. fungus infection of the foot ....................................................................................................
8.9. excessive growth of hair ..........................................................................................................
8.10. severe itching of the skin .....................................................................................................

47

9. Translate into Croatian:

Disease Descriptions
1. Candidiasis (Candida is a yeastlike fungus): This fungus is normally found
on mucous membranes, skin, and vaginal mucosa. Under certain circumstances (excessive warmth, administration of birth control pills, antibiotics and
corticosteroids, debilitated states, infancy) it can change to a pathogen and
cause localized or generalized mucocutaneous disease. Examples are paronychial lesions, lesions in areas of the body where rubbing opposed surfaces
is common (groin, perianal, axillary, inframammary, and interdigital), and
vulvovaginitis.
2. Cellulitis: This is a common nonsuppurative infection of connective tissue
with severe inflammation of the dermal and subcutaneous layers of the skin.
Cellulitis appears on an extremity as a reddish brown area of edematous skin.
A surgical wound, puncture, skin ulcer, or patch of dermatitis is the usual
means of entry for bacteria (most cases are caused by streptococci). Therapy
entails rest, elevation, hot wet packs, and penicillin. Any cellulitis on the face
should be given special attention because the infection may extend directly
to the brain.
(From: D. E. Chabner: The Language of Medicine)
..........................................................................................................................................................................
..........................................................................................................................................................................
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..........................................................................................................................................................................
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..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
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48

CHAPTER 5

MUSCULOSKELETAL SYSTEM
1. Introduction
The musculoskeletal system includes the bones, muscles and joints. Each
has several important functions in the body.
Bones, by providing the framework around which the body is constructed,
protect and support our internal organs. Also, by serving as a point of attachment for muscles, bones assist in body movements. The inner core of bones
is composed of hematopoietic tissue (red bone marrow manufactures blood
cells), while other parts are storage areas for minerals necessary for growth,
such as calcium and phosphorus.
Joints are the places where bones come together. Several different types
of joints are found within the body. The type of joint found in any specific location is determined by the need for greater or lesser flexibility of movement.
Muscles, whether attached to bones or to internal organs and blood vessels,
are responsible for movement. Internal movement involves the contraction
and relaxation of muscles that are a part of viscera, and external movement is
accomplished by the contraction and relaxation of muscles that are attached
to the bones.
2. Formation and structure of bones
Bones are organs chiefly composed of connective tissue called osseous
(bony) tissue plus a rich supply of blood vessels and nerves. Osseous tissue is
a dense connective tissue that consists of osteocytes (bone cells) surrounded
by a hard, intercellular substance filled with calcium salts.
During fetal development, the bones of the fetus are composed of cartilage
tissue, which resembles osseous tissue but is more flexible and less dense
because of a lack of calcium salts in its intercellular spaces. As the embryo
develops, the process of depositing calcium salts in the soft, cartilaginous
bones occurs, and continues throughout the life of the individual after birth.
49

The gradual replacement of cartilage and its intercellular substance by immature bone cells and calcium deposits is called ossification (bone formation).
Figure 5.1. Skeletal System

ACROMION

CLAVICLE
SCAPULA
STERNUM
RIBS

XIPHOID PROCESS
COSTAL CARTILAGE

HUMERUS

ILIUM

ULNA

ISCHIUM
PUBIS

SACRUM
RADIUS
CARPALS
METACARPLAS
PHALANGES
FEMUR

PATELLA
TIBIA

FIBULA
TARSALS
METATARSALS
PHALANGES

Osteoblasts are the immature osteocytes that produce the bony tissue that
replaces cartilage during ossification. Osteoclasts (-clast means to break) are
large cells that function to reabsorb, or digest, bony tissue. Osteoclasts (also
called bone phagocytes) digest dead bone tissue from the inner sides of bones
and thus enlarge the inner bone cavity so that the bone does not become overly
thick and heavy. When a bone breaks, osteoblasts lay down the mineral bone
matter (calcium salts) and osteoclasts remove excess bone debris (smooth out
the bone). The formation of bone is dependent to a great extent on a proper
supply of calcium and phosphorus to the bone tissue. These minerals must
be taken into the body along with a sufficient amount of vitamin D. Vitamin
50

D helps the passage of calcium 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 causes the formation of a calciumphosphate compound giving bone its characteristic hard quality.
Not only are calcium and phosphorus part of the hard structure of bone
tissue, but calcium is also stored in bones and small quantities are present in
the blood. If the proper amount of calcium is lacking in the blood, nerve fibers
are unable to transmit impulses effectively to muscles; heart muscle becomes
weak and muscles attached to bones undergo spasms. The necessary level of
calcium in the blood is maintained by the parathyroid gland, which secretes
a hormone to release calcium from bone storage. Excess of the hormone
(caused by tumour or other pathological process) will raise blood calcium at
the expense of the bones, which become weakened by the loss of calcium.
3. Types of bones

Bones all over the body are of several different types.

Long bones are found in the thigh, lower leg, and upper and lower arm.
These bones are very strong, are broad at the ends where they join with
other bones, and have large surface areas for muscle attachment.
Short bones are found in the wrist and ankle and have small, irregular
shapes.
Flat bones are found covering soft body parts. These are the shoulder
bone, ribs, and pelvic bones.
Sesamoid bones are small, rounded bones resembling a grain of sesame
in shape. They are found near joints; the knee cap is the largest example
of this type of bone.

The shaft, or middle region, of a long bone is called the diaphysis. Each end
of a long bone is called an epiphysis. The epiphyseal line or plate represents an
area of cartilage tissue which is constantly being replaced by new bony tissue
as the bone grows. Cartilage cells at the edges of the epiphyseal plate form
new bone and this is responsible for the lengthening of bones during childhood and adolescence. The plate calcifies and disappears when the bone has
achieved its full growth.
The periosteum is a strong, fibrous, vascular, membrane that covers the
surface of a long bone, except at the ends of the epiphyses. Bones other than
long bones are completely covered by the periosteum. Beneath the periosteum
is the layer of osteoblasts which deposit calcium-phosphorus compounds in
the bony tissue. The ends of long bones are covered by a thin layer of cartilage called articular cartilage. It cushions the bones at the place they meet
with other bones (joints).
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Figure 5.2. Structure of a long bone

EPIPHYSIS

SHAFT
DIAPHYSIS
(CORPUS)

EPIPHYSIS

Compact (cortical) bone is a layer of hard, dense tissue that lies under the
periosteum in all bones and chiefly around the diaphysis of long bones. Within
the compact bone is a system of small canals containing blood vessels that
bring oxygen and nutrients to the bone and remove waste products such as
carbon dioxide. These channels are called haversian canals. Compact bone
is tunnelled out in the shaft of the long bones by a central medullary cavity
which contains yellow bone marrow. Yellow bone marrow is chiefly composed
of fat cells.
Cancellous bone, sometimes called spongy bone, is much more porous and
less dense than compact bone. The mineral matter in it is laid down in a
series of separated bony fibres called a spongy latticework or trabeculae. It is
found largely in the epiphyses of long bones and in the middle portion of most
other bones of the body as well. Spaces in cancellous bone contain red bone
marrow. This marrow, as opposed to a yellow marrow which is fatty tissue, is
richly supplied with blood and consists of immature and mature blood cells
in various stages of development. In an adult, the ribs, pelvic bone, sternum
(breastbone) and vertebrae, as well as the epiphyses of long bones, contain
red bone marrow within cancellous tissue. The red marrow in the long bones
is plentiful in young children, but decreases through the years and is replaced
by yellow marrow.

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4. Processes and Depressions in Bones

Bone processes are enlarged tissues which normally extend out from bones
to serve as attachments for muscles and tendons. The shapes of some of the
common bony processes are:
1. bone head - rounded end of a bone separated from the body of the bone
by a neck.
2. tubercle - small, rounded process for attachment of tendons or muscles.
3. trochanter - large process on the femur for attachment of muscles.
4. tuberosity - large, rounded process for attachment of muscles or tendons.
5. condyle - rounded, knuckle-like process at the joint.
Bone depressions are the openings or hollow regions in a bone which help
to join one bone to another and serve as passageways for blood vessels and
nerves. The names of some common depressions in bone are:
1. fossa (pl. fossae) - depression or cavity in or on a bone.
2. foramen (pl. foramina) - opening for blood vessels and nerves.
3. fissure - a narrow, deep, slitlike opening.
4. sulcus (pl. sulci) - a groove or furrow.
5. sinus - cavity within a bone.
5. Cranial Bones
The bones of the skull, or cranium, protect the brain and its related structures, such as the sense organs. Muscles for controlling head movements
and chewing motions are attached to the cranial bones. The cranial bones of
a newborn child are not completely joined. There are gaps of unossified tissue
in the skull at birth. These are called soft spots, or fontanelles (little fountains). The pulse of blood vessels can be felt under the skin in those areas.
Here is a list of major cranial bones:
1. frontal bone - forms the forehead and bony sockets that contain the eyes.
2. parietal bone - there are two parietal bones which form the roof and upper
part of the sides of the cranium.
3. temporal bone - two temporal bones form the lower sides and base of the
cranium. Each bone encloses an ear and contains a fossa for joining with
the mandible (lower jaw bone). The mastoid process is a round process of
the temporal bone behind the ear.
4. occipital bone - forms the back and base of the skull and joins the parietal
and temporal bones, forming a suture (juncture line of cranial bones). The
inferior portion of the occipital bones has an opening called the foramen
magnum through which the spinal cord passes.
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5. sphenoid bone - this bat-shaped bone extends behind the eyes and forms
part of the base of the skull. Because it joins with the frontal, occipital, and
ethmoid bone, it serves as an anchor to hold those skull bones together
(sphen/o means wedge.)
6. ethmoid bone - this thin, delicate bone is composed primarily of spongy,
cancellous bone. It supports the nasal cavity and forms part of the orbits
of the eyes (ethm/o means sieve).
6. Facial Bones
All of the facial bones, except one, are joined together by sutures so that
they are immovable. The mandible (lower jaw bone) is the only facial bone
capable of movement. This ability is necessary for activities such as mastication (chewing) and speaking.
The facial bones are:
1. nasal bones - two slender nasal (nas/o = nose) bones support the bridge
of the nose. They join with the frontal bone superiorly and form part of the
nasal septum.
2. lacrimal bones - two paired lacrimal (lacrim/o = tear) bones are located
one at the corner of each eye. These thin, small bones contain fossae for
the lacrimal gland (tear gland) and canals for the passage of the lacrimal
duct.
3. maxillary bones - two large bones compose the massive upper jaw bones
(maxillae). They are joined by a suture in the median plane. If they are not
joined together normally before birth, the condition known as cleft palate
results.
4. mandibular bone (mandible) - this is the lower jaw bone. Both the maxilla
and mandible contain the sockets called alveoli in which the teeth are
embedded. The mandible joins the skull at the region of the temporal bone,
forming the temporomandibular joint (TMJ) on either side of the skull.
5. zygomatic bones - two bones, one on each side of the face, form the high
portion of the cheek.
6. vomer- this thin, single flat bone forms the lower portion of the nasal
septum.
Sinuses, or air cavities, are located in specific places within the cranial and
facial bones to lighten the skull and warm and moisten air as it passes through.
7. Vertebral column and structure of vertebrae
The vertebral, or spinal, column is composed of 26 bone segments, called
vertebrae, which are arranged in five divisions from the base of the skull to
the tail bone (coccyx).
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The first seven bones of the vertebral column, forming the neck bone, are
the cervical (Cl-C7) vertebrae. These vertebrae do not articulate (join) with
the ribs. The second set of 12 vertebrae are known as the thoracic (Tl-T12 or
Dl-Dl2), or dorsal vertebrae. These vertebrae articulate within the 12 pairs of
ribs. The third set of five vertebral bones are the lumbar (Ll-LS) vertebrae.
They are the strongest and largest of the backbones. The sacrum is a slightly
curved, triangularly shaped bone. At birth it is composed of five separate
segments (sacral bones); these gradually become fused in the young child.
The coccyx is the tailbone, and it, too, is a fused bone, having been formed
from four small coccygeal bones.
Although the individual vertebrae in the separate regions of the spinal
column are all slightly different in structure, they do have several parts in
common. A vertebra is composed of an inner, thick, disk-shaped portion called
the vertebral body. Between the body of one vertebra and the bodies of vertebrae lying beneath and above are cartilaginous disks which help to provide
flexibility and cushion most shocks to the vertebral column. The vertebral
arch is the posterior part of the vertebra, and consists of a spinous process,
transverse processes, and laminae. The neural canal is the space between the
vertebral body and the vertebral arch through which the spinal cord passes.
8. Bones of the thorax, pelvis, and extremities
Bones of the thorax:
1. clavicle:- collar bone; a slender bone, one on each side of the body,
connecting the breastbone to each shoulder bone.
2. scapula - shoulder bone; two flat, triangular bones, one on each dorsal
side of the thorax. The extension of the scapula which joins both the clavicle to form the joint of the shoulder is called the acromion (acr/o means
extremity; om/o means shoulder).
3. sternum - breastbone; a flat bone extending down the midline of the chest.
The uppermost part of the stern um articulates on the sides with the clavicle and ribs, while the lower, narrow, portion is attached to the diaphragm
and abdominal muscles. The lower portion of the sternum is called the
xiphoid process (xiph/o means sword).
4. ribs - there are 12 pairs of ribs. The first seven pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages. Ribs 1-7
are called true ribs. They join with the sternum anteriorly and with the
vertebral column in the back. Ribs 8-10 are called false ribs. They join with
the vertebral column in the back but join the 7th rib anteriorly, instead of
attaching to the sternum. Ribs 11 and 12 are the floating ribs because they
are completely free at their anterior extremity.
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Bones of the arm and hand

1. humerus upper arm bone; the large head of the humerus is rounded and
joins with the scapula and clavicle.
2. ulna medial lower arm bone; the proximal bony process of the ulna at the
elbow is called the olecranon (elbow bone).
3. radius lateral lower arm bone.
4. carpals wrist bones; there are two rows of four bones each in the wrist.
5. metacarpals these are five radiating bones to the fingers.
6. phalanges (singular: phalanx) - finger bones, each finger (except the thumb)
has three phalanges; a proximal, middle and distal phalanx. The thumb has
only two phalanges.
Bones of the pelvis
The pelvic girdle, or hip bone, supports the trunk of the body and articulates with the thigh bone and sacrum. The adult pelvic bone is composed of
three pairs of fused bones: the ilium, ischium, and pubis.
1. ilium is the uppermost and largest portion. Dorsally, the two parts of
the ilium do not meet. Rather, they join the sacrum on either side. The
connection between the iliac bones and the sacrum is so firm that they
are commonly spoken of as one bone: the sacroiliac. The superior part of
the ilium is known as the iliac crest. It is filled with red bone marrow, and
serves as an attachment for abdominal wall muscles.
2. ischium is the posterior part of the pelvis. The ischium and the muscles
attached to it are what you sit on (Lat. gluteus = buttocks).
3. pubis is the anterior part and contains suture marks where the two pubes
join by way of a cartilaginous disk. This area of fusion is called the pubic
symphysis.
The region within the ring of bone formed by the pelvic girdle is called the
pelvic cavity. The rectum, sigmoid colon, bladder, and female reproductive
organs lie within the pelvic cavity.
Bones of the leg and foot
1. femur- thigh bone; this is the longest bone in the body. At its proximal end it
has a rounded head which fits into a depression, or socket, in the hip bone.
This socket is called the acetabulum. The acetabulum was named because
of its resemblance to a rounded cup the Romans used for vinegar (acetum).
2. patella - kneecap; this is a small, flat bone which lies in front of the articulation between the femur and one of the lower leg bones called the tibia. It is
surrounded by protective tendons and held in place by muscle attachments.
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3. tibia -largest of two lower bones of the leg; the tibia (meaning flute)
runs under the skin in the front part of the leg. It joins with the femur
at the patella, and at its distal end (ankle) forms a swelling which is the
bony prominence (medial malleolus) at the inside of the ankle. The tibia is
commonly called the shin bone.
4. fibula - smaller of two lower leg bones; this thin bone, well hidden under
the leg muscles, joins at its proximal end with the tibia laterally, and joins
at its distal end with the tibia and ankle bones to form the bony prominence
(lateral malleolus) on the outside of the ankle.
5. tarsals - ankle bones; these are seven short bones which resemble the
carpal bones of the wrist but are larger. The calcaneus is the largest of
these bones and is also called the heel bone.
6. metatarsals - there are five metatarsal bones- each leads to the phalanges
of the toes.
7. phalanges of the toes - there are two phalanges in the big toe and three in
each of the other four toes.
9. Joints
1.Types of Joints
A joint (articulation) is a place in the body where two or more bones come
together. Some joints are immovable, such as the suture joints between the
skull bones. Other joints, such as those between the vertebrae, are partially
movable. Most joints, however, allow considerable movement. These freely
movable joints are called synovial joints. Examples of synovial joints are the
ball and socket type (hip joint; the head of the femur fits into the acetabular
fossa of the ilium) and hinge type (elbow, knee, and ankle joints). The bones in
a synovial joint are separated by a joint capsule composed of fibrous cartilage
tissue. Ligaments (fibrous bands, or sheets, of connective tissue) often anchor
the bones together around the joint capsule to strengthen it. The surface of
the bones at the joint is covered with a smooth cartilage called the articular
cartilage.
The synovial membrane lies under the joint capsule and lines the synovial cavity between the bones. The synovial fluid contains water and nutrients
which nourish and lubricate the joints so that friction on the articular cartilage is minimal.
2. Bursae
Bursae are closed sacs of synovial fluid lined with a synovial membrane.
They are formed in the spaces between tendons (connective binding bones to
bones), and bones. Bursae lubricate these areas where friction would normally
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develop close to the joint capsule. Some common bursae locations are at the
elbow joint (olecranon bursa), knee joint (patellar bursa), and shoulder joint
(subacromial bursa).
Figure 5.3. a synovial joint

10. Muscles
There are three types of muscles in the body. Striated muscles, also called
voluntary or skeletal muscles, are the muscle fibres that move all bones, as
well as the face and eyes. We have conscious control over the activity of this
type of muscle.
Striated muscle fibres (cells) have a pattern of dark and light bands,
or fibrils, in their cytoplasm. A delicate membrane called a sarcolemma
surrounds each skeletal muscle fibre. Fibrous tissue that envelops muscles
is called fascia.
Smooth muscles, also called involuntary or visceral muscles, are those
muscle fibres which move our internal organs such as digestive tract, blood
vessels, and secretory ducts leading from glands. We have no conscious control
over these muscles. They are called smooth because they have no dark and
light fibrils in their cytoplasm. While skeletal muscle fibres are arranged in
bundles, smooth muscle forms sheets of fibres as it wraps around tubes and
vessels.
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Cardiac muscle is striated in appearance but like smooth muscle in its

action. Its movement cannot be consciously controlled. The fibres of cardiac
muscle are branching fibres and are found in the heart.
Figure 5.4. selected muscles of the body

ORBICULARIS OCULI
MASSETER
STERNOCLEIDOMASTOID

PectoraLIS MAJOR
Triceps brachii
Biceps brachii

rectus abdominus

11. Actions of Skeletal Muscles

Skeletal (striated) muscles are the muscles that move the bones of our
body. When a muscle contracts, one of the bones to which it is joined remains
virtually stationary as a result of other muscles that hold it in place. The point
of attachment of the muscle to the stationary bone is called the origin (beginning) of that muscle. However, when the muscle contracts, another bone to
which it is attached does move. The point of junction of the muscle to the bone
that moves is called the insertion of the muscle.
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There can be more than one origin for a muscle, as is the case with the
upper arm muscle (biceps brachii) where one origin is at the upper end of the
humerus near the shoulder joint and a second origin is above the scapula. The
insertion of the biceps brachii is at the upper end of the radius near the elbow.
Near the point of insertion, a muscle narrows and is connected to the bone by
way of a tendon. One type of tendon that helps attach muscles to larger bone
areas is called an aponeurosis.
Muscles can perform a variety of actions. Some of the terms used to
describe them are listed below:
abduction
adduction
dorsiflexion
extension
plantar flexion
pronation
rotation
supination
torsion

- movement away from the midline of the body

- movement toward the midline of the body
- bending foot backward, decrease the angle of the ankle
joint
- straightening out a limb, increase the angle between two
bones
- extending the foot downward, as when pointing the toes
- facing downward
- circular movement around an axis
- facing upward
- a rotary movement of the trunk; twisting.

Key Terms

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appendage any body part attached to a main structure

articulation place of union between two or more bones; a joint
bursa a fluid filled sac near a joint
calcium one of the mineral constituents of bones
cancellous spongy or porous structure
cartilage flexible connective tissue found on joint surfaces and
embryonic skeleton
cranium a skull
diaphysis shaft, corpus, or midportion of a long bone
disk (disc) flat, plate-like structure of fibrocartilagenous substance
between the vertebrae
epiphysis the end of a long bone
fascia fibrous membrane separating and enveloping muscles
hematopoiesis production and development of blood cells, usually in
the bone marrow
fissure narrow, slit-like opening between bones

 fontanelle soft spot (incomplete bone formation) between the skull

bones of an infant
foramen opening or passage in bones where blood vessel and nerves
enter and exit an organ
fossa shallow cavity in a bone
ligament connective tissue bands binding bones to other bones,
supporting and strengthening the joint
medullary cavity central hollowed-out area in the shaft of a long bone
ossification the process of bone formation
osteoblast bone cell that helps form bone tissue
osteoclast bone cell that absorbs and removes excess bone tissue
periosteum membrane surrounding bone
red bone marrow site of hemopoiesis in cancellous bone
sequestrum a fragment of necrosed bone
sinus cavity within a bone
sternum breastbone
sulcus groove-like depression
synovial fluid viscous fluid within the synovial cavity produced by
synovial membrane and contained in joint cavities, bursae and tendon
sheath
tendon connective tissue that binds muscles to bones
vertebra back bone
yellow bone marrow fatty tissue found in the diaphyses of long bones
Combining Forms Meaning

Terminology

ankyl/o

stiff, bent

ankylosis = abnormal condition of stiffness

articul/o
arthr/o

joint

articular = pertaining to a joint

arthritis = inflammation of a joint

burs/o

bursa

bursitis = inflammation of a bursa

calc/o
calci/o

calcium

hypercalcemia = excess calcium (in

bloodstream) decalcification = loss of
calcium

chondr/o

cartilage

chondroma = tumour of a cartilage

cost/o

rib

costal= pertaining to a rib

dactyl/o

finger, toe

dactylitis = inflammation of fingers or toes

fasci/o

band

fascioplasty = surgical repair of fascia

kyph/o

humpback

kyphosis = a humpback posture (posterior

curvature in the thoracic region)

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Combining Forms Meaning

Terminology

leiomy/o

smooth
muscle

leiomyoma = tumour of a smooth muscle

lord/o

swayback

lordosis = a swayback posture (anterior

curvature in the lumbar region)

muscul/o
my/o
myos/o

muscle

muscular = pertaining to a muscle

myoma = tumour of a muscle
myositis = inflammation of a muscle

myel/o

bone
marrow,
spinal cord

myelopoiesis = formation of bone marrow

orth/o

straight

orthopaedics = specialty for bone diseases

osse/o
oste/o

bone

osseous = pertaining to bone

osteitis = inflammation of bone

rachi/o

spine

rachitis = inflammation of the spine

rhabd/o

striated

rhabdomyoma = tumour of a striated

muscle

scoli/o

crooked,
bent

scoliosis = lateral bent of the spine

spondyl/o

vertebra

spondylosis = degeneration of
intervertebral disks

syndesm/o

ligament

syndesmoplasty = surgical repair of a

ligament

ten/o, tend/o
tendin/o

tendon

ten(din)oplasty = surgical repair of a

tendon tendinitis = inflammation of a
tendon

Disorders of the Musculoskeletal System

Pathological Conditions of the Skeletal System and Fractures
ankylosing spondylitis chronic, progressive arthritis with stiffening of joints,
primarily of the spine
arthritis

inflammation of joints

bunion

abnormal prominence with bursal swelling at the

metatarsophalangeal joint near the base of the big
toe

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bursitis

inflammation of bursae

crepitation

crackling sensation felt and heard when the ends of

a broken bone move together

Ewing sarcoma

malignant bone tumour involving the shaft of a long

bone

exostoses

bony growths (benign tumours) arising from the

surface of the bone

fracture

sudden breaking of a bone. Some terms describing

fractures and related injuries are:
a) closed f.: a bone is broken but there is no open
wound in the skin (simple fracture)
b) open f.: a broken bone with an open wound in the
skin (compound fracture)
c) complicated f.: a broken bone has injured an
internal organ
d) comminuted f.: a bone has broken, splintered, into
pieces
e) impacted f.: one end of a broken bone is wedged
into the interior of another bone
f) incomplete f.: fracture line does not transverse the
entire bone
g) g reenstick f.: a bone is partially broken and
partially bent
h) Colles f.: a break at the lower end of the radius
(typical radial f.)
Treatment of fractures involves reduction, which is
the restoration of the fracture to its normal position.
A closed reduction is manipulative reduction without
an incision; in an open reduction an incision is made
into the fracture site. A cast (solid mould of the body
part) is applied to fractures to immobilize the injured
area.

dislocation

displacement of a bone from its joint

gouty arthritis (gout)

inflammation of joints caused by excessive uric acid

in the body. An inherited defect in metabolism causes
too much uric acid to accumulate in blood (hyperuricemia), joints, and soft tissues near joints. The
uric acid crystals destroy the articular cartilage and
damage the synovial membrane. A joint
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chiefly affected is the big toe; hence the condition is

often known as podagra (pod = foot -agra = excessive pain). Treatment consists of drugs to lower uric
acid production and prevent inflammation, and a diet
avoiding foods rich in uric acid (red meat).
osteitis fibrosa cystica inflammation of bone with fibrous changes in the
bone tissue When the parathyroid gland produces
an excess of parathyroid hormone (hyperparathyroidism), calcium is removed from the bones and
appears in the blood. The bones become porous
(osteoporosis) and decalcified, leading to curvature and cyst formation as well as fractures. Blood
calcium accumulation may lead to renal and cystic
calculi (stones).
osteoarthritis

chronic inflammation of bones and joints due to

degenerative changes in cartilage

osteoporosis

decrease in bone density; thinning and weakening of

bone due to loss of calcium salts

osteogenic sarcoma

malignant tumour arising from bone. Osteoblasts

multiply without control and form large tumours,
especially at the ends of long bones.

osteomyelitis

inflammation of the bone and bone marrow due to a

pyogenic infection

sprain

trauma to a joint, with pain, swelling, and injury to

ligaments; sprains may also involve damage to blood
vessels, muscles, tendons and nerves

strain

less serious injury with overstretching of muscles

protrusion of an
intervertebral disc

abnormal extension of cartilaginous intervertebral

pad into the neural canal (slipped disc)

rickets (rachitis)

inflammation of the spinal column characterized

by osteomalacia (softening of bone tissue) due to
improper absorption of calcium and phosphorus.

Disorders of the spine and muscles

Because of various conditions, the normal curvature of the s pine may
become abnormally bent or slope away. These cases are referred to as curvatures of the spine. When a lateral curvature (usually consisting of two curves)
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of the spine takes place, the disorder is identified as scoliosis (bent). Scoliosis
may be congenital, or it may develop in the early teens. Poor posture over a
long period of time is a contributing factor, and it may be accompanied by
lack of muscle tone and general physical inactivity. Surgery, braces, casts and
corrective exercises may eliminate this condition.
Abnormally increased convexity in the curvature of the thoracic spine as
viewed from the side is referred to as kyphosis (hunchback or humpback). This
condition may be caused by rheumatoid arthritis, rickets, chronic respiratory
diseases or a congenital disorder. It never develops from poor posture. There
are no specific symptoms of kyphosis besides back pain and increasing immobility of the spine. Symptoms vary with the cause, and any back pain or injury
should be investigated.
Lordosis (swayback) is a forward curvature of the lumbar spine. I may be
caused by increased weight of the abdominal contents. This could be due to
obesity or excessive weight gain during pregnancy.
Amyotrophic lateral sclerosis is a specific type of movement disorder
(muscles atrophy) with degeneration of nerves in the spinal cord and lower
region of the brain (brain stem). Early symptoms include difficulty in swallowing
and talking, and weakness in the arms and legs. As the disease progresses
there is increased spasticity and atrophy of muscles. Etiology and effective
treatment are unknown.
Muscular dystrophy includes a group of inherited diseases characterized
by progressive weakness and degeneration of muscle fibres without involvement of the nervous system.
Pseudohypertrophic (Duchenne) muscular dystrophy is the most common
form. Muscles enlarge as fat replaces functional muscle cells that have atrophied.
Myasthenia gravis is briefly defined as the lack of muscle strength marked
by paralysis. This condition is characterized by extreme weakness of the
muscles of the face, jaw, and eyelids and difficulty in swallowing. The etiology
is unknown, but it is thought that there is some defect at the myoneural junction where the nerve enters the muscle fibre to stimulate muscle contraction. There is either a lack of acetylcholine to help transmit the impulse across
the myoneural junction or an increase in cholinesterase, which is an enzyme
released at the junction to destroy whatever acetylcholine remains after the
impulse has passed. Treatment consists of giving a drug to interfere with
cholinesterase production. Some cases are associated with benign tumours
of the thymus (thymoma), and thymectomy is found to be beneficial.

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Polymyalgia rheumatica is characterized by muscle pain, primarily of the

shoulder and pelvis, with absence of arthritis and signs of muscle distress.
Treatment with low doses of corticosteroids may relieve symptoms.
Other related terms
Claudication = lameness, limping
Contracture = fibrosis of connective tissue in the skin, fascia, muscles or joint
capsule
Exacerbation = increase in severity of a disease or symptoms (aggravation)
Ganglion cyst = tumour of tendon sheath of joint capsule (commonly in the
wrist)
Hemarthrosis = effusion of blood into a joint cavity
Hypotonia = loss or diminishing of muscle tone
Multiple myeloma = primary malignant tumour that infiltrates the bone and red
bone marrow Osteophyte = bony outgrowth, also called
bony spur
Phantom limb = perceived sensation, following amputation of a limb, that it
still exists
Prosthesis = r eplacement of a missing part by an artificial substitute
Subluxation = p
 artial or incomplete dislocation
EXERCISES
1. List some functions of the skeletal system:
...................................................................................................................................................................................

2. Fill in the correct term:

2.1. The inner core of bones is composed of ........................................................ tissue.
2.2. Spongy or ................................................. bone is less dense than compact bone.
2.3. Freely movable joints are called ........................................................................... joints.
2.4. A delicate membrane surrounding each skeletal muscle is referred to
as a........................................................................................................................................................
2.5. The point of attachment of the muscle to the stationary bone is the
..........................................................................................................................................................................

3. Give the opposite of each term:

3.1. abduction ..................................................

66

3.6. anterior ......................................................

3.2. pronation ..................................................

3.7. backward ..................................................

3.3. distal ............................................................

3.8. superior .....................................................

3.4. depression ...............................................

3.9. normal ........................................................

3.5. movable .....................................................

3.10. malignant ..............................................

4. Match the following terms with their meanings:

4.1. costal ..........................................................

a) a type of tendon that helps attach

muscles to bones

4.2. fossa ............................................................

b) inflammation of joints

4.3. fracture ......................................................

c) pertaining to the ribs

4.4. arthritis ......................................................

d) a broken bone

4.5. aponeurosis ............................................

e) a depression in a bone surface

5. Give the meanings of the following terms:

5.1. ossification .......................................................................................................................................
5.2. osteoblasts ......................................................................................................................................
5.3. insertion ............................................................................................................................................
5.4. diaphysis ...........................................................................................................................................
5.5. exostoses ..........................................................................................................................................
5.6. bursitis ...............................................................................................................................................
5.7. haversian canals ..........................................................................................................................
5.8. sprain ..................................................................................................................................................
5.9. kyphosis .............................................................................................................................................
5.10. acetabulum ...................................................................................................................................
6. Provide the plural form of the following nouns:
6.1. vertebra .....................................................

6.6. diaphysis ...................................................

6.2. pelvis ...........................................................

6.7. toe .................................................................

6.3. foramen .....................................................

6.8. radius...........................................................

6.4. phalanx ......................................................

6.9. fossa.............................................................

6.5. process ......................................................

6.10. femur.........................................................
67

7. Provide the adjective form for the following nouns:

7.1. muscle .......................................................

7.6. fibre ..............................................................

7.2. joint ..............................................................

7.7. ilium ............................................................

7.3. bone .............................................................

7.8. patella ........................................................

7.4. skeleton .....................................................

7.9. humerus ...................................................

7.5. pubis ............................................................

7.10. cranium ..................................................

8. Give appropriate term for the following:

8.1. decrease in bone density ........................................................................................................
8.2. the shaft of the long bone .......................................................................................................
8.3. t he extension of the scapula which joins with the clavicle to form the
joint of the shoulder....................................................................................................................
8.4. the second cervical vertebra ................................................................................................
8.5. the posterior bone of the pelvis............................................................................................
8.6. large process on the femur for attachment of muscle .........................................
..........................................................................................................................................................................

8.7. fibrous tissue that envelops muscles ..............................................................................

8.8. a fibrous attachment spanning over a large area of bone ..................................
..........................................................................................................................................................................

8.9. malignant bone tumour involving the entire shaft of a long bone
......................................................................................................................................................................... .

8.10. lack of muscle strength marked by paralysis...........................................................

......................................................................................................................................................................... .

9. Translate into Croatian:

Backache is one of the most common physical complaints, experienced by
millions of people every day. Many victims of lower back pain - spasmodic pain
near the inward curve of the back above the base of the spine - are stricken
while simply reaching to pick something up. The pain may disappear as spontaneously as it came, or last for days, and commonly it will reappear periodically. Almost anything can cause pain in the back, from sudden stop in a car,
to athletic overexertions, to a reflex action like sneezing. The lower portion of
68

the spine is the site of most back pain which may simply develop from overworked or underexercised muscles. Strains are especially common when tired
or weak back muscles are called upon to do more than they are capable of
doing. The muscles will then suddenly go into spasm - an involuntary contraction - and become a knotty mass while the body sends out a signal of sharp
pain. Other muscles nearby will also go into spasm in an effort to protect the
strained muscles and prevent further damage.
(From: Ellis, J. W. Medical Symptoms and Treatments)

..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
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69

CHAPTER 6

GASTROINTESTINAL SYSTEM
Functions
The gastrointestinal system is also called the digestive or alimentary
system. It begins with the mouth or the oral or buccal cavity where food enters
the body, and terminates at the anus where solid waste materials leave the
body. The functions of the digestive system are threefold: ingestion of food,
absorption of nutrients, elimination of solid metabolic waste material.
When food is ingested it is in a form that cannot reach the cells because
of its inability to pass through the intestinal mucosa into the bloodstream.
Therefore, the consumed food must be prepared for absorption. Digestive
enzymes are substances that speed up chemical reactions and help in the
breakdown (digestion) of complex nutrients. Complex proteins are digested to
simpler amino acids, complicated sugars are reduced to simple sugars, such
as glucose; and large fat molecules are broken down to fatty acids and triglycerides. Thus, digestion can be defined as a complete process of changing the
chemical and physical composition of food in order to facilitate assimilation
of the nourishing ingredients of food by the cells of the body.
Anatomy of the Digestive System
The gastrointestinal (GI) tract begins at the oral cavity or mouth. The structures within the oral cavity are the cheeks or bucca and the tongue and its
muscles, which extend across the floor of the mouth. The main functions of
the tongue are manipulation of food during the chewing process, speech,
deglutition or swallowing, speech production, and determination of taste.
The surface of the tongue has rough elevations; these elevations are taste
buds. These sense organs are called papillae and are capable of perceiving
a variety of flavours found in our foods, such as bitterness, sweetness, saltiness, and sourness.

70

The teeth are also found in the oral cavity and play an important role in the
initial stages of digestion. The teeth that are located in front of the oral cavity,
the incisors and cuspids, cut and tear the food into small pieces. The teeth
located in the rear of the mouth are called molars. They further crush and grind
the food into finer particles. Teeth are covered by hard enamel, which gives
them a white and smooth appearance. The enamel is the hardest substance
in the body. Beneath the enamel is the main structure of the tooth, the dentin.
It is yellowish and is composed of bony tissue which is softer than enamel.
Dentin is surrounded by a thin layer of modified bone called cementum. In the
innermost part of the tooth is the pulp, a soft, delicate layer, which stores the
nerves and blood vessels of the tooth. The teeth are embedded in pink fleshy
tissue known as gums, or gingiva.
Figure 6.1. Anatomy of a tooth

Some of the other structures located within the mouth are the hard and soft
palates. The hard palate lies in the anterior portion of the roof of the mouth,
while the soft palate lies in its posterior portion. The soft palate forms a partition between the mouth and nasopharynx and is continuous with the hard
palate. Rugae are the irregular ridges in the mucous membrane covering the
anterior portion of the hard palate. The entire buccal cavity, like the rest of
the digestive tract, is lined with mucous membrane.

71

After the food is chewed, it is formed into a round, sticky mass called a
bolus. The bolus is pushed by the tongue from the mouth into the pharynx. Its
downward movement is guided into the pharynx or throat by the soft, fleshy
V-shaped tissue called the uvula. The uvula hangs from the soft palate and also
functions to aid in producing sounds and speech. The pharynx is a muscular
tube which serves as a common passageway for air from the nasal cavity to
the larynx (voice box), as well as for food going from the mouth to the esophagus. The pharynx is divided into three major sections:
1. The nasopharynx or epipharynx (the throat behind the nose)
2. The oropharynx or mesopharynx (the throat behind the mouth)
3. The laryngopharynx or hypopharynx (the throat above the larynx)
The laryngopharynx is further divided into two tubes; one which leads to
the lungs, called the trachea (wind pipe), and one which leads to the stomach,
called the esophagus (gullet). A small flap of tissue, the epiglottis, covers the
trachea. The main function of the epiglottis is to prevent food from entering
the trachea, thus allowing all food to be channelled to the stomach through
the esophagus.
Stomach
The stomach is a saclike structure located in the abdominal cavity directly
below the diaphragm. It is continuous with the esophagus. Thus, food continues
its descent down the esophagus in peristaltic, or wavelike, movements until
it reaches the stomach. The stomach mixes the undigested food with gastric
juices to further break it down for digestion. Within the stomach there are a
considerable number of folds called rugae. The rugae appear only when the
stomach is empty. As the stomach fills, the interior walls become smooth.
The interior lining of the stomach is composed of mucous membranes and
contains the glands that secrete hydrochloric acid (HCl) and gastric juices.
Once the food or bolus is mixed with gastric juices and HCl, it forms a semicreamy fluid called chyme.
There are two valves in the stomach. The first valve is called the cardiac
valve, or cardiac sphincter, and is located at the top or fundus of the stomach. It
connects the esophagus to the stomach. The second valve is called the pyloric
valve, or pyloric sphincter, and is located at the base or antrum of the stomach.
It connects the stomach to the small intestine. Both valves are composed of a
round band of muscles called sphincters which contract and expand to allow
food to enter and leave the stomach.

72

Figure 6.2. Organs of the digestive system

Tongue
Mouth (oral cavity)

Parotid gland
Submandibular
gland
Sublingual gland

Salivary
gland

Pharynx
Esophagus
Food bolus

Liver
Gallbladder
Duodenum
Hepatic flexure
Pancreas
Jejunum

Stomach
Spleen
Splenic flexure
Transverse colon
Descending colon

Ascending colon
Ileum
Cecum
Appendix

Sigmoid colon
Rectum
Anus

Small Intestine (Small Bowel)

The small intestine is approximately one inch in diameter and is a continuation of the gastrointestinal tube. It extends from the pyloric sphincter to
the first part of the large intestine. The small intestine is 20 feet long and has
three parts:
1. The duodenum, the uppermost division which is about ten inches long.
2. The jejunum, which is approximately eight feet long.
3. The ileum, which is about twelve feet long.
Most of the absorption of food takes place in the ileum by tiny fingerlike
projections called villi. Inside the villi one finds a network of fine capillaries,
veins, and arteries. There are also many other digestive glands located in the
mucous membrane lining of the small intestine. These microscopic glands
secrete additional digestive juices.
The pancreas and liver produce digestive secretions, and these secretions
are added to the chyme at the beginning of the small intestine. With the exception of some forms of fat, water, and waste products, all food ingested into the
body is absorbed through the walls of the small intestine.
73

Large Intestine (Large Bowel)

The large intestine extends from the end of the ileum to the anus. It is
divided into four parts: cecum, colon, sigmoid colon, and rectum. The large
intestine is a continuation of the gastrointestinal tube and is attached to the
ileum by ileocecal valve. This valve is composed of sphincter muscles that
serve to close the ileum at the point at which the small intestine is connected
to the colon. The large intestine has an average diameter of two-and-half
inches and is approximately five feet long. The cecum is the first two or three
inches of the large intestine. It is a pouch on the right side. Attached to the
cecum is a wormlike (vermiform) projection - the appendix, which performs
no function in the digestive tract and only causes problems when infected.
The colon consists of the following parts:
1. The ascending colon, which extends from the cecum to the lower border of
the liver - hepatic flexure
2. The transverse colon, which passes horizontally across the abdomen to the
left toward the spleen - splenic flexure
3. The descending colon, which continues down to form the sigmoid colon
(shaped like an S - sigma).
4. The rectum, which serves as a storage area for the waste products of digestion, and is approximately five inches long. The terminal inch of the rectum
is referred to as the anal canal. The canal is kept closed by internal and
external sphincters except during the process of defecation (elimination
of feces).
Three important additional organs of the digestive system are the liver,
pancreas, and gallbladder. Although food does not pass through these organs,
each plays a crucial role on the pro per digestion and absorption of nutrients.
Liver
The liver is the largest glandular organ in the body and weighs approximately three to four pounds. It is located beneath the diaphragm in the right
upper quadrant (RUQ) of the abdominal cavity. The liver produces so many vital
functions that the human organism cannot survive without it. The following
are some of its more important functions:
1. Produces bile, which is used in the small intestine to emulsify and absorb
fats. Bile is a thick, yellowish brown, sometimes greenish, fluid. It contains
cholesterol (a fatty substance), bile acids, and several bile pigments. One of
these pigments is called bilirubin. Bilirubin is a waste product of hemoglobin
destruction (which occurs in the liver as red blood cells are destroyed).
2. Removes glucose (sugar) from blood, which it synthesizes and stores as
glycogen (starch) in liver cells. This is called glycogenesis.
74

3. Stores vitamins, such as B12, A, D, E, and K.

4. Breaks down or transforms some toxic products into less harmful
compounds.
5. Maintains normal level of glucose in the blood.
6. Destroys old erythrocytes and ingests bacteria and foreign particles from
the blood by phagocytes.
7. Produces various blood proteins, such as prothrombin and fibrinogen, which
aid in the clotting of blood (coagulation).
Pancreas
The pancreas secretes and produces pancreatic juices that help break down
all types of food during the digestive process. These juices empty into the
pancreatic duct and eventually are absorbed by the small intestine. Insulin is
another hormone that is secreted by the pancreas and exerts major control
over carbohydrate metabolism or the utilization of sugar in the body. Insulin
is produced by the cells located within the tissue of the pancreas. These cells
are called the islands of Langerhans. The pancreas is both an exocrine and
endocrine organ. It is also discussed in chapter 13 - The Endocrine System.
Gallbladder
The gallbladder serves as the storage area for bile. It is a pear-shaped sac
under the liver. During the process of digestion, when there is a need for some
bile, gallbladder releases it into the duodenum through the common bile duct.
Bile is also drained from the liver through the hepatic ducts. The hepatic ducts
connect with the cystic duct from gallbladder and form the common bile duct
(choledochus).
Figure 6.3. liver, pancreas and gallbladder

75

Key Terms
absorption passage of materials through the intestinal walls into the
bloodstream
alimentary canal the digestive tract
amino acids building blocks of proteins, produced when proteins are
digested
amylase pancreatic enzyme for digestion of starch
bile digestive juice produced by the liver and stored in the gallbladder
bilirubin pigment resulting from destruction of hemoglobin, released
by the liver
bolus mass of masticated food ready to be swallowed
bowel intestine
canine teeth pointed dog-like teeth
cecum (blind) first part of the large intestine
colon large intestine
deglutition swallowing
dentin basic tissue composing the tooth
digestion breakdown of complex foods into smaller forms
emulsification breakdown of large fat globules into smaller ones
enamel hard outer covering of a tooth
enzyme a chemical that speeds up digestion
esophagus gullet
fatty acids substances produced when fats are digested
feces solid wastes; stools
gingiva gums
glucose simple sugar; blood sugar
glycogen animal starch; glucose is stored in the form of glycogen in
liver cells
hydrochloric acid a substance produced by the gastric mucosa
necessary for digestion of food
incisors front teeth in the dental arch (cutters)
insulin pancreatic hormone important for carbohydrate metabolism
lipase pancreatic enzyme needed in the digestion of fats
mastication chewing
palate roof of the mouth
papilla(e) small elevations on the surface of the tongue; any nipple-like
elevation
parotid gland salivary gland near the ear
peristalsis rhythmic contractions of digestive tubes and other tubular
structures

76

pharynx throat
pulp soft inner part of a tooth containing blood vessels and nerves
ruga(e) folds on the hard palate and gastric walls
saliva digestive juice produced by the salivary glands
sphincter circular muscles inside a tube
triglycerides large fat molecules
villi (sg. villus) microscopic projections in the walls of the small
intestine (blood vessels) through which nutrients are absorbed into the
bloodstream

Combining Forms Meaning

Terminology

an/o

anus

perianal = around the anus

append/o

appendix

appendectomy = removal of the appendix

bucc/o

cheek

buccal = pertaining to the cheek

celi/o
lapar/o

abdomen

celiac = pertaining to the abodmen

laparoscopy = endoscopic examination
of parts of the abdominal cavity

cheil/o
labi/o

lip

cheiloplasty = surgical repair of lips

labial = pertaining to the lips

cholecyst/o

gallbladder cholecystectomy = removal of the gallbladder

choledoch/o

bile duct

choledochotomy = incision into the bile

duct

col/o
colon/o

large
intestine

colonic = pertaining to the large intestine

colonoscopy = visual examination of the
colon

dent/o
odont/o

tooth

dental = pertaining to teeth

orthodontist = dental specialist for
correction and prevention of dental
abnormalities

enter/o

small
intestine

enteropathy = disease of the small intestine

faci/o

face

facial = pertaining to the face

gastr/o

stomach

gastralgia = pain in the stomach

(stomach-ache)

gingiv/o

gums

gingivitis = inflammation of the gingiva

77

Combining Forms Meaning

Terminology

gloss/o
lingu/o

tongue

hypoglossal = under the tongue

sublingual =

hepat/o

liver

hepatomegaly = enlargement of the liver

mandibul/o

lower jaw
(mandible)

submandibular = under the lower jaw

or/o
stomat/o

mouth

oral = pertaining to the mouth

stomatitis = inflammation of oral mucosa

proct/o

anus,
rectum

proctologist = specialist in the diseases of

the anorectal region

sial/o

saliva, sali- sialolith = calculus formed in a salivary

vary gland duct or gland

Disorders of the Gastrointestinal System

Hemorrhoids
The enlargement of the veins of the anal canal causes hemorrhoids or piles.
The two kinds of hemorrhoids involving the anal canal are internal and external
hemorrhoids. These are the enlarged veins in the mucous membrane, either
inside or just outside the rectal area.
Hemorrhoids are usually caused by straining to evacuate hard, dry stools.
They sometimes occur in pregnancy because of pressure on the veins caused
by the enlarged uterus. They may also result from pressure on the veins caused
by a disorder of the liver or the heart or may be symptomatic of a tumour that
may exert pressure against the veins.
Temporary relief from hemorrhoids can usually be obtained by cold
compresses, sitz baths, fecal softeners, or analgesic ointment. Treatment
of an advanced hemorrhoidal condition is by surgical removal (hemorrhoidectomy).
Hernias
A hernia is an abnormal protrusion or projection of an organ or tissue
through the structures that normally contain them. They may be abdominal, inguinal, or umbilical. Even though hernias occur most commonly in the
abdominal region, they may develop in the diaphragm (diaphragmatic) or in
the form of a hiatus. When this condition occurs, the lower end of the esophagus and the adjacent part of the stomach herniate into the thorax (gastroesophageal). The strangulated hernia cuts off circulation and the herniated
blood vessel is likely to become gangrenous. This is also known as an incar78

cerated hernia, as it result in complete bowel obstruction. The inguinal hernia

occurs in the groin where the abdominal folds of flesh meet the thighs. Inguinal
hernias account for about 80 percent of all hernias. In the initial stages such
a hernia may be hardly noticeable and appears as a soft lump under the skin,
no larger than a marble. There may be little pain. As time passes, the pressure of the contents of the abdomen against the weak abdominal wall may
increase the size of the opening and accordingly, the size of the hernia lump.
The protrusion of part of the intestine at the navel (umbilical hernia) is more
frequent in women than men and is treated surgically. Hernias may also be
found in newborns (congenital) or can be acquired at an early age.
Ulcers
An open sore or the lesion of the skin or mucous membrane, producing loss
of substance, and sometimes accompanied by formation of pus, is characteristic of ulcers. The peptic ulcers occur in the digestive tube that is exposed to
the action of the acidic gastric juice. It is noted that peptic ulcers occur most
commonly in the first portion of the duodenum, next most frequently in the
stomach, and rarely in the lower portion of the esophagus.
They may be of long duration (chronic) or arise suddenly (acute). It is also
observed that chronic ulcers are more common in the duodenum, while acute
ulcers are usually found in the stomach.
Inflammation of the colon, with formation of ulcers in the lining of the
intestine (ulcerative colitis), can occur at any age but is most common in young
adults. The chief symptom is severe diarrhea, which is often accompanied by
blood and mucus in the stool. The patient may feel very weak, lose weight, and
sometimes experience anemia. He may also suffer from pains in the joints
(arthralgia).
Other terms related to pathology of the digestive system:
achlorhydria

lack of hydrochloric acid in the stomach. This condition

may be produced by chronic gastritis or carcinoma of
the stomach.

anal fistula

abnormal tubelike passageway near the anus which

may communicate with the rectum

anorexia

lack or loss of appetite

ascites

abnormal accumulation of fluid in the peritoneal cavity

borborygmus

the rumbling and gurgling sound made by the

movement of gas in the intestine

79

cachexia

general ill health, wasting of tissues, malnutrition,

profound and marked state of constitutional disorder

cholelithiasis

presence and formation of gallstones in the gallbladder

cirrhosis

chronic disease of the liver with degeneration of liver

cells

cleft palate

congenital split in the roof of the mouth; lip may also be

affected

colic

spasm in any hollow or tubular soft organ

colonic polyposis

polyps (small growths) protrude from the mucous

membrane of the colon

constipation

difficult and delayed defecation (opstipation)

Crohn disease

Inflammation of the intestinal tract, commonly of the

terminal (end)portion of the ileum. Crohn disease
is a chronic relapsing inflammation with diarrhea,
abdominal cramping, and fever. It is similar to
ulcerative colitis and both are considered types of
inflammatory bowel diseases (IBD). Crohn disease,
believed to be caused by virus or autoimmunity
(antibodies attack the bodys own cells), is treated with
drugs (anti- inflammatory steroids) to promote healing
of lesions. Surgical removal of the diseased portion,
with anastomosis of the remaining intestinal parts, may
be needed.

dental caries

tooth decay

diverticula
(sg.diverticulum)

abnormal side pockets in a hollow structure such as

the intestine common sites are the sigmoid colon and
duodenum.

dysentery

severe bacterial (shigellae) infection of the large

intestine

dyspepsia

difficult digestion, indigestion

dysphagia

difficulty or inability in swallowing

eructation

belching or raising from the stomach

esophageal
varices

swollen, twisted veins around the distal end of the

esophagus

flatus

gas expelled through the anus

80

gallstones

hard collections of bile that form in the gallbladder and

bile ducts

gastroesophabackflow of gastric contents into the esophagus due to

geal reflux disease a malfunction of the sphincter muscle at the inferior
(GERD)
portion of the esophagus
halitosis

offensive, or bad, breath

heartburn
(pyrosis)

a burning sensation caused by reflux (backflow) of acid

from the stomach into the esophagus

hematemesis

vomiting blood

hepatitis

inflammation of the liver caused by virus or damage

to the liver from toxic substances. There are 3 most
common types of viral hepatitis:
Hepatitis A (caused by type A virus and formerly called
infectious hepatitis) is spread through water and food,
and the virus is excreted in feces.
Hepatitis B (caused by type B virus and formerly called
serum hepatitis) is acquired from transfusions and via
body fluids such as tears, saliva, and semen.
Hepatitis C is transmitted by blood or blood products
and close personal contact.

icterus

jaundice

ileus

intestinal obstruction

intussusception

telescoping of the intestines

irritable bowel
syndrome

a group of symptoms associated with stress and

tension; spastic colon

jaundice (icterus)

yellow-orange discoloration of skin or other tissues; it

results from excessive accumulation of bilirubin in the
bloodstream and can occur in three major ways:
1. obstruction of bile passageways prevents bilirubin
from leaving the body in bile (i.e. cholelithiasis);
2. malfunction of liver cells, as in cirrhosis, hepatitis,
or hepatic carcinoma, impairs the livers ability to
combine bilirubin with bile; bilirubin thus remains in
the bloodstream;
3. excessive destruction of erythrocytes, as in
erythroblastosis fetalis and other anemias, creates
abnormally high levels of bilirubin in the blood.

81

laxative

a medication promoting defecation

melena

black stools; feces containing blood

nausea

unpleasant sensation from the stomach with a

tendency to vomit

oral leukoplakia

white plaques on the oral mucosa; a precancerous

lesion

pancreatitis

inflammation of the pancreas

regurgitation

return of solids and fluids to the mouth from the

stomach (vomiting)

steatorrhea

excessive amount of fat in the feces, often seen in

pancreatic disease

volvulus

twisting of the intestine upon itself; an operation can be

performed to untwist the loop of the bowel.

EXERCISES
1. What are the three functions of the digestive system?
1.1. .................................................................................................................................................................
1.2. .................................................................................................................................................................
1.3...................................................................................................................................................................
2. Fill in the correct term:
2.1. One of the main functions of the tongue is swallowing or ................................. .
............................................

speech production and ..................................................... of taste.

2.2. The incisors and ......................................... cut and ......................................... the food
into small pieces.
2.3. The teeth are embedded in pink fleshy tissue known as gums or
..........................................................................................................................................................................

2.4. Within the stomach there are many folds called ......................................................
2.5. Bile is also .............................. from the liver through the ............................................
3. Give the opposite of each term:
3.1. hard palate ..............................................

3.6. rough ...........................................................

3.2. floor of the mouth ...............................

3.7. bitter ............................................................

82

3.3. upper ...........................................................

3.8. empty ..........................................................

3.4. descending ..............................................

3.9. harmful ......................................................

3.5. innermost .................................................

3.10. sufficient ................................................

4. Match the following terms with their meanings:

4.1. chyme .........................................................

a) the inner part of the tooth

4.2. bolus ............................................................

b) a semi-creamy fluid formed in the

stomach when food is mixed with
gastric juices and HCl

4.3. taste buds .................................................

c) a round, sticky mass formed after

the food is chewed

4.4. peristalsis ................................................

d) rough elevations on the surface of

the tongue

4.5. pulp ..............................................................

e) wavelike movement of digestive

tubes

5. Give the meanings of the following terms:

5.1. colitis ..........................................................

5.6. anorexia .....................................................

5.2. hernia .........................................................

5.7. ascites ........................................................

5.3. umbilical ...................................................

5.8. hypoglycemia .........................................

5.4. hemorrhoidectomy .............................

5.9. constipation ............................................

5.5. melena .......................................................

5.10. ileus ..........................................................

6. Provide the adjective form for each of the following:

6.1. abdomen ...................................................

6.6. stomach .....................................................

6.2. ulcer ............................................................

6.7. saliva ...........................................................

6.3. liver ..............................................................

6.8. bucca ...........................................................

6.4. intestine ....................................................

6.9. face ...............................................................

6.5. tongue ........................................................

6.10. pain ............................................................

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7. Give the plural of the following nouns:

7.1. trachea .......................................................

7.6. bucca ...........................................................

7.2. ruga .............................................................

7.7. cavity ...........................................................

7.3. villus ............................................................

7.8. appendix ....................................................

7.4. tooth ............................................................

7.9. speech ........................................................

7.5. calculus .....................................................

7.10. mass .........................................................

8. Give appropriate medical terms for the following:

8.1. complete process of changing the chemical and physical composition of
food.................................................................................................................................................................
8.2. enlargement of the spleen .....................................................................................................
8.3. process of visually examining the stomach .................................................................
8.4. enzyme to digest fats ................................................................................................................
8.5. congenital split in the roof of the mouth .......................................................................
8.6. the musculomembranous partition separating the abdominal and
thoracic cavities .....................................................................................................................................
8.7. abnormal frequency and liquidity of fecal discharges............................................
8.8. the major fuel-regulating hormone in humans ........................................................
8.9. a practitioner who specializes in diseases of the digestive tract
..........................................................................................................................................................................

8.10. pertaining to the stomach and the heart ....................................................................

9. Translate into Croatian:
Appendicitis is an inflammation of the appendix resulting from a bacterial infection. Located at the juncture of the small and large intestines, the
appendix is a small, worm-like piece of intestinal tissue with no known function in humans. It is called a vestigial organ because, although it may have
previously served some function, it has no function now. The appendix can
be the source of a serious or, at times, even fatal illness. When it becomes
swollen and filled with pus from bacteria, it may form an abscess or may
break, allowing the infection to spread to the surrounding organs. Rupture
may lead to peritonitis, an inflammation of the lining of the abdominal cavity

84

(peritoneum). The infection can spread so quickly that gangrene and rupture
may occur within a matter of hours from the first symptoms.
(From: Ellis, J. W. Medical Symptoms and Treatments)
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10. Translate into English

Bol u trbuhu: je li rije o bolesti?
Boli u trbuhu mogu nastati naglo (akutno) ili traju dugo, mjesecima pa ak
i godinama. Vano je takoer znati opetuje li se bol u pravilnim ili nepravilnim
vremenskim razmacima, te postoje li uz bol jo i druge tegobe, primjerice
munina, povraanje, proljev, zaep, ili vruica.
Nagla bol u trbuhu moe biti uzrokovana razliitim bolestima trbunih
organa. Takva bol esto je uzrokovana boleu koja zahtijeva hitnu lijeniku
pomo jer moe biti ugroen bolesnikov ivot.
Akutna upala crvuljka (akutni apendicitis) bolest je na koju uvijek valja
pomisliti pri boli u trbuhu, napose u mlaih ljudi. Napadaj boli zbog upale
crvuljka najee zapone u gornjem dijelu trbuha ili oko pupka. Bol moe
biti grevita (kolike) i u naletima se pojaava i slabi. Nakon nekoliko sati bol
se sputa u donji desni dio trbuha, gdje je i smjeten crvuljak. Bolesnici esto

85

povraaju zbog podraaja potrbunice, a esto postoji i malo poviena tjelesna

temperatura. Neki bolesnici i stariji ljudi mogu imati manje izraene znakove
upale crvuljka, to moe stvoriti tekoe u pravodobnu prepoznavanju bolesti.
(From: eljko Reiner, Praktina medicina)
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86

CHAPTER 7

RESPIRATORY SYSTEM
Respiration is usually thought of as being a mechanical process of
breathing, that is the repetitive and, for the most part, unconscious exchange
of air between the lungs and the external environment. Respiratory activity
consists of two separate, simultaneous operations that involve the exchange
of oxygen (O2) and carbon dioxide (CO2).
The first operation, external respiration, refers to the exchange of O2 and
CO2 between the organism and the external environment. In this operation
oxygen-rich air from the environment is brought into the lungs during inspiration (inhaling) and CO2 is removed from the body during expiration (exhaling).
Air inhaled contains about 21 percent oxygen. Oxygen is inhaled into the air
spaces (sacs) of the lungs and immediately passes into tiny capillary blood
vessels surrounding the air spaces. Simultaneously, carbon dioxide, a gas
produced when oxygen and food combine in cells, passes from the capillary blood vessels into the air spaces of the lungs to be exhaled (exhaled air
contains about 16 % of oxygen). More familiarly, external respiration is called
lung breathing.
The second operation, internal respiration (also called cellular respiration), refers to the exchange of O2 and CO2 at the tissue or cellular level. This
exchange is also called tissue breathing. Just as the organism as a whole
requires the exchange of gases to maintain life, each individual cell of the
organism must likewise receive oxygen for the metabolic process and expel
waste gases that have accumulated in the cell. During internal respiration
the red blood cells transport O2 from the lungs to body tissues. They deposit
O2 with the tissue as they remove CO2. The red blood cells return to the lungs
where they finally expel CO2 during external respiration. For example, red
blood cells transport O2 to liver cells and, in turn, receive CO2 from the liver
cells. The CO2 is then expelled from the lungs during external respiration.

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Anatomy and Physiology of Respiration

Figure 7.1. Respiratory tract

Adenoids

Nasal cavity

Nasopharynx

Nose

Oropharynx

Palatine tonsils

Laryngopharynx

Epiglottis

Larynx
Glottis and vocal cords

Thyroid cartilage

Trachea

Apex of lung

Bronchi

Bronchiole

Mediastinum
Right lung

Left lung

Visceral pleura
Pleural cavity

Diaphragm

Base of lung

Parietal pleura

During the breathing process, air from the environment is drawn in through
the nose and passes through the nasal cavity to the pharynx (throat). The nasal
cavity is lined with a mucous membrane and fine hairs (cilia) to help filter out
foreign bodies, as well as to warm and moisten the air. Paranasal sinuses are
hollow, air-containing spaces within the skull that communicate with the nasal
cavity. They also have a mucous membrane lining and function to provide the
lubricating fluid mucus, to lighten the bones of the skull and help produce
sound. The pharynx is a muscular tube and consists of three major divisions:
1. the nasopharynx, or epipharynx, posterior to the nose and the nearest to
the nasal cavity;
2. the oropharynx or mesopharynx, posterior to the mouth;
3. the laryngopharynx (also called hypopharynx), posterior to the larynx.
Within the nasopharynx there is a collection of lymphatic tissue known as
adenoids or pharyngeal tonsils. They are more prominent in children, and if
88

enlarged can obstruct air passageways. Another collection of lymphatic tissue

called palatine tonsils, or more commonly tonsils are located in the oropharynx.
It is in the hypopharyngeal region that the pharynx, serving as a common
passageway for food from the mouth and air from the nose, divides into two
branches, the larynx (voice box) and the esophagus. The larynx is responsible
for sound production or phonation. It contains vocal cords and is surrounded
by pieces of cartilage for support. Sounds are produced as air is expelled past
the vocal cords and the cords vibrate. The tension of the vocal cords determines the high or low pitch of the voice.
A leaf-shaped structure in the larynx, the epiglottis, seals off the air passage
to the lungs during swallowing. This structure insures that food or liquids
do not obstruct the flow of air and thus cause the individual to choke. The
epiglottis is attached to the root of the tongue and acts like a lid over the larynx.
On its way to the lungs, air passes from the larynx to the trachea (wind pipe),
a vertical tube about 4.12 inches long and an inch in diameter. The trachea is
kept open by 16 to 20 C-shaped cartilage rings separated by fibrous connective tissue which stiffen the front and sides of the tube. In the region of the
mediastinum the trachea divides into two branches called bronchi. One bronchus leads to the right lung and the other to the left lung. Like the trachea,
the bronchi contain C-shaped cartilage rings. These rings provide the necessary rigidity to keep air passage open at all times. Without them the trachea
or bronchi may possibly collapse and endanger life.
Each bronchus divides into smaller and finer tubes, somewhat like the
branches of a tree, called bronchioles (little bronchi). At the end of them are
clusters of air sacs called alveoli. An alveolus resembles a small balloon
because it expands and contracts with inflow and outflow of air. Capillary
beds of the circulatory system lie adjacent to the thin tissue membranes of the
alveoli. Carbon dioxide passes from the red blood cells of the pulmonary capillaries into the alveolar spaces, while O2 from the alveoli passes into the blood.
After the blood becomes oxygenated, it returns to the heart. The heart pumps
blood to all body tissues. At the tissue level O2 from the blood is exchanged for
tissue CO2. This exchange of gases is called internal respiration.
The lungs are divided into lobes: three lobes in the right lung and two lobes
in the left lung. It is possible for one lobe of the lung to be removed without
damage to the rest, which can continue to function normally. The uppermost
part of the lung is called the apex, and the lower area is the base. The haulm
of the lung is the midline region where blood vessels, nerves, and bronchial
tubes enter and exit the organ. The space between the right and left lung is the
mediastinum. It contains the heart, aorta, esophagus (gullet) and the bronchi.

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A double fold of serous membrane, the pleura, surrounds the lungs. The
innermost layer is the visceral pleura; the outermost, the parietal pleura. The
small space between these membranes is the pleural cavity, which contains
a small amount of lubricating fluid permitting the visceral pleura to glide
smoothly over the parietal pleura during respiration.
The ability of the lungs to fill with air and to expel it depends upon a
pressure differential between the atmosphere and the chest cavity. A large
muscular partition, the diaphragm, lies between the chest cavity and abdominal cavity. By contracting and relaxing, the diaphragm produces the needed
pressure differential for respiration. When the diaphragm contracts, it partially
descends into the abdominal cavity, decreasing the pressure within the chest.
This allows the air to enter the lungs. When the diaphragm begins to relax, it
slowly re-enters the thoracic cavity. This increases the pressure within, and air
slowly passes from the lungs. The intercostal muscles assist the diaphragm
in changing the volume of the thoracic cavity. As the diaphragm contracts, the
intercostal muscles elevate the rib cage (chest). Both of these activities result
in enlarging the thoracic cavity. Consequently, the air from the environment
passes into the lungs. The reverse activity causes air to pass from the lungs
into the environment.
Key Terms
adenoids collections of lymphatic tissue in the nasopharynx;
pharyngeal tonsils
alveolus (pl. alveoli) air sac in the lung
apex of the lung the uppermost portion of the lung
bronchioles smallest branches of the bronchi
bronchus (pl. bronchi) branch of the trachea that acts as a passageway
into the air spaces of the lung; bronchial tube
cilia (sg. cilium) thin hairs in the mucous epithelium lining the
respiratory tract
epiglottis a lid-like piece of cartilage covering the larynx
exhalation breathing out (expiration)
glottis the opening to the larynx
inhalation breathing in (inspiration)
larynx voice box
pharynx throat
pleura double-folded membrane surrounding each lung
pulmonary parenchyma cells of the lung performing its main function
trachea windpipe

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Combining Forms Meaning

Terminology

adenoid/o

adenoids

adenoidectomy = surgical removal of

adenoids

alveol/o

alveolus

alveolar = pertaining to the alveoli

bronch/o
bronchi/o

bronchial tube bronchospasm = spasm of the bronchi

bronchiectasis = dilation of the bronchi

capno/o

carbon dioxide hypercapnia = excessive amount of CO2

in the blood

coni/o

dust

lob/o

lobe of the lung lobectomy = removal of a lung lobe

nas/o
rhin/o

nose

nasal = pertaining to the nose

rhinoplasty = repair of the nose

pector/o
steth/o
thorac/o

chest

pectoral = pertaining to the chest

stethoscope = instrument for
examining the chest
thoracodynia = pain in the chest

phon/o

voice (sound)

dysphonia = voice impairment

phren/o

diaphragm;
mind

phrenic = pertaining to the diaphragm

or the mind

pneum/o
pneumon/o

air, lung

pneumothorax = air in the chest cavity

pneumonitis = inflammation of the
lung; pneumonia

pulmon/o
spir/o

coniosis = lodging of dust particles in

the lungs

pulmonary = pertaining to the lungs

breathing

spirometer = instrument for the

measurement of breathing, or lung,
capacity

Disorders of the Respiratory System

Atelectasis is a condition in which the lung is collapsed, or more simply,
in an airless state. The prefix atel- means incomplete - hence the definition
of imperfect expansion of the air sacs, functionless, airless lung or portion
of a lung. The bronchioles and alveoli (pulmonary parenchyma) resemble a
collapsed balloon. Common causes of atelectasis include blockage of a bronchus or smaller bronchial tube after general anesthesia for surgery and a
chest wound that permits air to leak into the pleural cavity. Acute atelectasis requires removal of the underlying cause (tumour, foreign body, excessive secretions) and therapy to open airways. Chronic atelectasis may neces91

sitate lobectomy and antibiotics to combat infection of the lung. Atelectasis

may occur at birth (congenital) when the lungs fail to inflate properly in the
newborn infant (neonate).
Chronic Obstructive Lung Disease (COLD)
Chronic obstructive lung disease or chronic obstructive pulmonary disease
(COPD) includes respiratory diseases characterized by obstructions in the
bronchi or bronchioles that inhibit the flow of air into and out of the alveoli.
These diseases include bronchial asthma, chronic bronchitis, pulmonary
emphysema, and bronchiectasis. Chronic obstructive lung disease cause difficulty in breathing (dyspnea) and is associated with and overdevelopment of tissue
(hyperplasia) within the lungs and bronchi.
Bronchial asthma often results as a response to an allergen. Etiology may
involve infection, or be related to nervous tension and emotional problems.
With this condition there is a narrowing or constriction of the bronchi, accompanied by a sudden or violent attack (paroxysm) of dyspnea, wheezing, gasps,
and cough. Treatment includes the use of agents that loosen and break down
mucus (mucolytics) in order to facilitate the obstructed air passages. Oxygen
therapy may be also needed.
Chronic bronchitis is an infection of the bronchi. A thickening of the bronchial walls occurs, decreasing the inner diameter (lumen) of the bronchi. Associated with chronic bronchitis is a heavy and productive cough which facilitates
the expelling of mucus from the lungs (expectoration of sputum).
Pulmonary emphysema is a disease in which the alveoli lose elasticity. The
air sacs expand (dilate) but are unable to contract to their initial form. Air is
trapped in the alveoli, and many bronchioles are obstructed by mucorrhea.
Consequently, the patient must actively engage in exhaling (expiration) in order
to force the air from the lungs. Frequently, the patient experiences discomfort in breathing in any but the erect, sitting or standing positions (orthopnea).
As a result of dyspnea and hypoxemia, the heart must work harder to pump
blood and this leads to right-sided heart failure (cor pulmonale).
In bronchiectasis there is a dilation of the bronchus or bronchi that results
in the production of large amounts of sputum mixed with pus (purulent
sputum). Treatment of this condition includes the use of agents that relax
the smooth muscles of the bronchi (bronchodilators) and loosen sputum in
the chest (expectorants).

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Pleural effusion is a disorder in which fluids or air escape into the pleural
cavity. Two techniques used in the diagnosis of the pleural effusion include
listening to the sounds of the chest cavity with or without a stethoscope
(auscultation) or gently tapping the chest cavity with the fingers to determine
the position, size, or consistency of the underlying structures (percussion).
Pleural effusion may include the escape of pus (pyothorax, empyema), serum
(hydrothorax), blood (hemothorax), air (pneumothorax), or mixture of pus and
air (pyopneumothorax), into the pleural cavity of the chest.
Pneumoconiosis is a condition in which small particles of dust lodge in
the lung. Various forms of pneumoconioses are named according to the type
of dust particle inhaled:
silicosis - silica dust or glass (grinders disease)
anthracosis - coal dust (black-lung disease in coal miners)
asbestosis - asbestos particles (in shipbuilding and construction
industry)
byssinosis - cotton, flax, and hemp (brown-lung disease)
chalicosis - lime stone
siderosis - iron
volcanoconiosis -volcanic ash
Pneumonia is an inflammatory disease of the lungs and infection of the
alveoli. It may be caused by a variety of agents including bacteria, viruses,
chemicals, or other substances. Infection damages alveolar membranes so
that fluid, blood cells, and debris consolidate in the alveoli. Chest pain (thoracodynia), purulent sputum, and coughing up of blood (hemoptysis) are frequent
symptoms of pneumonia. Lobar pneumonia involves one or more lobes of a
lung associated with consolidation.
Bronchopneumonia begins in the terminal bronchioles. Bed rest and antibiotics are important in therapy.
Other Pathological and Related Terms
anosmia

absence or lack of the sense of smell

apnea

temporary loss of breathing

asphyxia

insufficient supply of oxygen

atelectasis

airless state of lungs

auscultation

listening to sounds in the chest cavity

bronchogenic
carcinoma

cancerous tumour arising from a bronchus; lung

cancer
93

compliance

ease with which lung tissue can be stretched

coryza

head cold; upper respiratory infection (URI)

crackle

abnormal respiratory sound; rale

croup

acute respiratory syndrome in children and

infants; characterized by obstruction of the larynx,
barking cough, and stridor

cystic fibrosis

hereditary disorder of exocrine glands causing

the secretion of thick mucus that clogs ducts of
respiratory and digestive tracts

diphtheria

acute bacterial infection of the throat and upper

respiratory tract

epistaxis

nasal hemorrhage; nosebleed

hypoxemia

oxygen deficiency in the blood

hypoxia

oxygen deficiency in tissues sign of respiratory

insufficiency

pertussis

whooping cough a contagious bacterial infection

of the upper respiratory tract

pleurisy

inflammation of the pleural membrane

pulmonary abscess

localized area of pus in the lungs

pulmonary edema

swelling and fluid in the air sacs and bronchioles

pulmonary embolism

floating clot (embolus) or other material blocking

the blood vessels of the lung

sputum

material expelled from the chest by coughing or

clearing the throat

stridor

a strained, high-pitched noisy breathing associated with obstruction of the larynx and bronchus

sudden infant death

unexpected and unexplained death of an apparently normal, healthy infant usually less than 12
months of age; crib death

syndrome (SIDS)
tuberculosis

an infectious disease due to Mycobacterium tuberculosis

wheeze

whistling or sighing sound heard on auscultation

resulting from narrowing of the lumen of respiratory passageways

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EXERCISES
1.1. The main organs in the respiratory system are: .......................................................
1.2. The respiratory system provides the following functions:
..........................................................................................................................................................................

2. Fill in the correct term:

2.1. Within the nasopharynx there is a collection of lymphatic tissue known
as adenoids or ........................................................................................................................................
2.2. A leaf-shaped structure in the larynx the......................................... seals off the
air passage to the lungs during ...................................................................................................
2.3. A double-fold serous membrane that surrounds the lungs is called
..........................................................................................................................................................................

2.4. A large muscular partition, the ...................................... lies between the chest
cavity and abdominal cavity.
2.5. Pulmonary emphysema is a ................................................... in which alveoli lose
..........................................................................................................................................................................

3. Give the opposite of each term:

3.1. external .....................................................

3.6. single ..........................................................

3.2. receive ........................................................

3.7. inhibit ..........................................................

3.3. posterior ...................................................

3.8. palpable .....................................................

3.4. rigidity ........................................................

3.9. frequent .....................................................

3.5. expand ........................................................

3.10. always ......................................................

4. Match the following terms with their meanings:

4.1. dyspnea .....................................................

a) lodging of small particles of dust

in the lungs

4.2. bronchodilator .......................................

b) coughing up of blood

4.3. empyema (pyothorax) .......................

c) accumulation of pus in the

thoracic cavity

4.4. hemoptysis ..............................................

d) an agent that causes relaxation of

the smoothmuscles of the bronchi
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4.5. pneumoconiosis ...................................

e) difficulty in breathing

5. Give the meanings of the following terms:

5.1. orthopnea .................................................

5.6. pleurisy ......................................................

5.2. pertussis ...................................................

5.7. embolism .................................................

5.3. epistaxis ....................................................

5.8. pneumoconiosis ...................................

5.4. pleura .........................................................

5.9. mediastinum ..........................................

5.5. alveolus .....................................................

5.10. larynx .......................................................

6. Provide the singular form of the following nouns

6.1. lumina ........................................................

6.6. feet ...............................................................

6.2. sputa ...........................................................

6.7. allergies ....................................................

6.3. thoraces ....................................................

6.8. pharynges ................................................

6.4. alveoli .........................................................

6.9. chalicoses ................................................

6.5. bronchi .......................................................

6.10. pleurae ....................................................

7. Provide the noun form for the following adjectives:

7.1. hyperplastic ............................................

7.6. removed ....................................................

7.2. orthopnic ..................................................

7.7. oxygenated ..............................................

7.3. pulmonary ................................................

7.8. pharyngeal ...............................................

7.4. purulent .....................................................

7.9. cartilagenous .........................................

7.5. environmental .......................................

7.10. costal ........................................................

8. Give appropriate medical term for the following:

8.1. breathing is only possible in an upright position ......................................................
8. 2. coughing up of blood ................................................................................................................
8. 3. condition of pus in a pleural cavity ..................................................................................
8. 4. high pitched, harsh sound heard during inspiration .............................................
8. 5. listening to sounds with a stethoscope .........................................................................

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8. 6. incision of a bronchus .............................................................................................................

8. 7. surgical repair of the nose ....................................................................................................
8. 8. absence of the sense of smell ............................................................................................
8. 9. normal (good) breathing ........................................................................................................
8.10. surgical puncture of the chest ..........................................................................................
9. Translate into Croatian:
Pleurisy is a general term for any inflammation of the pleura, the membrane
that covers the outside of the lungs and lines the chest cavity. The more
common simple inflammation of the pleura is called dry pleurisy. When the
inflamed pleura also has fluid oozing from it, the condition is called wet pleurisy. The fluid produced in wet pleurisy often compresses the lungs. Pleurisy
may be a complication of other diseases such as an upper respiratory tract
infection, pneumonia, tuberculosis, or a tumour. Dry pleurisy can be caused
by any type of infection of the lungs; however, it most often follows viral or
bacterial pneumonia. It may also accompany acute bronchitis, or be a complication of tuberculosis or tumour. Wet pleurisy can also be caused by infection, tuberculosis, or tumour, as well as by injury or liver disease. Certain liver
diseases may inflame the diaphragm and thus inflame the part of the pleura
that covers the diaphragm.
(From: Ellis, J.W. Medical Symptoms and Treatments)
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CHAPTER 8

CARDIOVASCULAR SYSTEM
The cardiovascular system is composed of the heart, blood vessels and
blood. The principal function of the system is to provide all body tissues and
cells with adequate amounts of oxygenated blood and to return blood laden
with cellular metabolic wastes to proper excretory organs. The pumping action
of the heart muscle is of utmost importance in performing these functions.
The Vascular System
Three types of vessels carry blood throughout the body. Each differs in
structure depending on its function. These vessels include the arteries, capillaries and veins.
Arteries
Arteries carry blood from the heart to body tissues and organs. The blood
is propelled by the pumping action of the heart. Consequently, arterial walls
are thick and muscular and capable of expanding to accommodate the surge
of blood that results when the heart contracts. The expansion of the arterial
walls at each heartbeat is referred to as a pulse. Because of the pressure
against the arterial walls associated with the pumping action of the heart, a
cut or severed artery is a serious condition.
Blood in all arteries contains a high concentration of oxygen (02), except
for the blood in the pulmonary artery. Blood that is rich in 02 is referred to as
oxygenated blood. Arteries branch to form smaller vessels called arterioles
(little arteries). Eventually, the arterioles branch to form the smallest vessels
of the circulatory system, the capillaries.
Capillaries
Capillaries are microscopic vessels that join the arterial system with the
venous system. Although seemingly the most insignificant of the three types

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because of size, they are functionally the most important. The walls of the
capillaries are composed of a single layer of endothelial cells. The thinness of
these walls makes it possible for the substances to pass quite readily into and
out of the vessels. Consequently, the primary function of the vascular system
- providing cells with vital products - is accomplished by the capillaries.
It is important to note that the vast number of capillaries makes their
combined diameter so great that blood tends to flow through them very slowly.
This allows sufficient time for the exchange of materials to occur between
blood and body cells. The pathway for this exchange is as follows:
Vital Products Blood to Body Cells Waste Products Blood to Excretory Organs
Veins
All veins carry blood back to the heart from body organs and tissues.
Veins are formed from smaller vessels called venules (little veins). Capillaries connect arterioles to venules. This connection provides a gateway for
the return of blood back to the heart. The extensive network of capillaries
throughout the body absorbs the propelling pressure exerted by the heart.
Blood in veins now must rely on other methods of propulsion in order to
return to the heart. These methods include muscular contraction (especially
in the legs), gravity (in the upper areas of the body), respiratory activity (in
the thoracic area), and valves. Valves are small structures within the vessels
that prevent the backflow of blood. Valves are especially important in the legs
where blood, in order to reach the heart, must travel long distances against
the force of gravity. The blood carried in veins contains high concentrations of
CO2 (except for the blood in the pulmonary vein). The CO2 is a waste product of
cell metabolism and is carried back to the heart. From the heart it is transported to the lungs where it is expelled.
The Heart
The heart is a hollow, muscular organ that pumps blood through the blood
vessels. It is enclosed in a fibroserous sac called the pericardium. The heart
has three distinctive layers of tissue:
1. the endocardium, a serous, innermost membrane which lines the four chambers of the heart and valves and is continuous with the arteries and veins;
2. the myocardium, the muscular, middle layer of the heart;
3. the epicardium, the outermost (external) layer of the heart.
The heart is divided into four chambers. These chambers are the right
atrium, right ventricle, left atrium and left ventricle. The two upper chambers,
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the atria, collect blood. The two lower chambers, the ventricles, pump blood
from the heart. The right side of the heart provides for oxygenation of blood
(pulmonary circulation), and the left side is responsible for transportation of
blood to and from body cells (systemic circulation). The muscular wall dividing
the right side of the heart from the left is called the septum. Body cells produce
waste substances during metabolism. These waste products include carbon
dioxide (CO2), a gas that must be removed from the cells or tissue death will
occur. Red blood cells accept the CO2 from body cells and transport it to the
heart by way of two large veins: the superior vena cava, a vein which collects
and carries blood from the top portion of the body, and the inferior vena cava,
a vein that collects and carries blood from the lower portion of the body. The
presence of CO2 gives the blood in veins a purple-red colour.
Blood is collected in the top right chamber of the heart, the right atrium.
From the right atrium blood passes through the tricuspid valve to the right
ventricle. The tricuspid valve prevents blood from returning to the right atrium
during contraction of the ventricles. When the heart contracts, blood leaves
the right ventricle by way of the pulmonary artery. This artery branches into
millions of capillaries within the lungs. At this point, CO2 in the red blood cells
is replaced by O2 that has been drawn into the lungs during inspiration. The
oxygenated blood takes on a bright red appearance.
The pulmonary capillaries unite to form the pulmonary veins which carry
blood back to the heart. The right and left pulmonary veins enter the left
atrium of the heart carrying oxygenated blood. This blood passes from the
left atrium through the bicuspid valve (also called the mitral valve) to the left
ventricle. Upon contraction of the heart, the oxygenated blood leaves the left
ventricle through the largest artery of the body, the aorta. Within the aorta
is a valve called the semilunar valve or aortic valve. This valve permits blood
to flow in only one direction - from the left ventricle to the aorta. The aorta
branches into many smaller arteries that carry blood to all parts of the body.
Some arteries derive their name from the organs or areas of the body they
vascularize. For example, the coronary arteries vascularize the heart muscle,
the renal arteries vascularize the kidneys, and so on.
It is important to note that the O2 present in the blood passing through the
chambers of the heart cannot be used by the myocardium. Consequently, an
arterial system called the coronary arteries, which branch from the aorta,
provides the heart with its own blood supply. If, for any reason, the flow of
blood in the coronary arteries is diminished, myocardial damage may result.
If severe damage occurs, death results.

100

Figure 8.1. The heart and its components.

Blood Pressure (BP)

Each heartbeat is composed of two phases, the contraction, phase, or
systole, when the blood is forced out of the heart, and the relaxation phase,
or diastole. A blood pressure measures the force exerted by the blood against
the artery walls during these two phases. Systole indicates the maximum
force exerted by the blood against the artery walls; diastole, the weakest.
These are recorded as two figures separated by a slant (/); the systolic pressure is given first, followed by the diastolic pressure. For example, a blood
pressure may be recorded as 120/80; 120 is the systolic pressure, and 80 is
the diastolic pressure.
Blood pressure is measured by a device called a sphygmomanometer.
Several factors influence the blood pressure, including the resistance of blood
flow in the blood vessels, the pumping action of the heart, the viscosity or
thickness of blood, the elasticity of the arteries, and the quantity of blood, in
the vascular system. An elevated pressure is called hypertension; a decreased
pressure is called hypotension.
The Conductive System of the Heart
Within the heart there is a specialized cardiac tissue known as conductive tissue. Its sole function is the initiation and propagation of contraction
impulses. The conductive tissue consists of four masses of highly specialized cells:
1. sinoatrial node (S-A node)
2. atrioventricular node (A-V node)
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3. bundle of His
4. Purkinje fibers
The S-A node, located in the upper portion of the right atrium, possesses
its own intrinsic rhythm. Without any stimulation by external nerves, it has
the ability to initiate and propagate each heartbeat, thereby setting the basic
pace for the cardiac rate. For this reason, it is commonly known as the pacemaker. This rate may be altered, however, by impulses from the autonomic
nervous system. Such an arrangement allows outside influences to accelerate or decelerate the rate of the heartbeat. For example, during a period
of physical exertion, the heart beats faster, and during a restful interval the
rate becomes slower.
Each electrical impulse discharged by the S-A node is transmitted to the
A-V node causing the atria to contract. The A-V node is located at the base of
the right atrium. From this point a tract of conducting fibres called the bundle
of His, composed of a right and left branch, relays the impulse to both the
right and left ventricles, causing them to contract. The blood is now forced
out of the heart through the pulmonary artery and the aorta. In summary, the
sequence of involvement of the four structures in the heart that are responsible for the conduction of a contraction impulse is as follows:
S-A node - A-V node - Bundle of His - Purkinje fibres
Impulse transmission through the conduction system generates weak electrical currents which can be detected on the surface of the body. These electrical impulses can be recorded on an instrument called electrocardiograph
Figure 8.2. The Conductive System of the Heart

102

(ECG). The record used to detect these electrical changes in heart muscle as
the heart beats is called an electrocardiogram (ECG) or EKG. The deflection of
the needle of the electrocardiograph produces waves or peaks designated by
the letters P, Q, R, S and T, each of which is associated with a specific electrical event (impulse). The P wave is the depolarization of the atria, and the
QRS complex is the depolarization of the ventricles. The T wave, which appears
a short time later, is the repolarization of the ventricles.
Key Terms

aorta largest artery in the body

arteriole small artery
atrium (pl. atria) upper chamber of the heart
capillary smallest blood vessel
coarctation narrowing (of the aorta)
cor the heart
coronary arteries blood vessels that carry oxigen-rich air to the heart
diastole relaxation phase of the heartbeat
endocardium inner lining of the heart
endothelium innermost lining of blood vessels
infarction area of dead tissue
mitral valve a valve between the left atrium and the left ventricle of the
heart
murmur abnormal heart sound
myocardium muscle layer of the heart
occlusion closure of a blood vessel
pacemaker special tissue in the right atrium that begins the heartbeat
(SA node)
palpitation uncomfortable sensation in the chest related to cardiac
arrhythmia
patent - open
pericardium sac-like membrane surrounding the heart
pulmonary circulation the flow of blood from the heart to the lungs and
back to the heart
pulse heartbeat
systemic circulation the flow of blood from body cells to the heart and
back, i.e. from the heart to the body cells
systole contraction phase of the heartbeat
valve a structure in the heart and in veins that temporarily closes an
opening so that blood flows in one direction only
ventricle lower and larger chamber of the heart
venule small vein
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Combining Forms Meaning

Terminology

angi/o

vessel (artery) angioplasty = repair of a severed blood

vessel

aort/o

aorta

aortostenosis = narrowing of the aorta

arter/o
arteri/o

artery

arteriosclerosis = hardening of an
artery

atrio/o

atrium

atrial = pertaining to the atrium

brachi/o

arm

brachial artery = artery in the upper

arm

cardi/o

heart

cardiomegaly = abnormally large heart

coron/o

coronary artery arteries supplying the heart muscle

with blood

hemangi/o

blood vessel

hemangiona = tumour of a blood vessel

phleb/o
ven/o

vein

phlebitis = inflammation of a vein

venous = pertaining to a vein

scler/o

hardening

arteriosclerosis = hardening of an
artery

sphygm/o

pulse

sphygmomanometer = instrument for

the measurement of blood pressure

sten/o

narrowing

aortostenosis = narrowing or stricture

of the aorta

steth/o

chest

stethoscope = instrument for the

listening of sounds in the chest cavity

thromb/o

clot

thrombolysis = destruction of a blood

clot

valvul/o
valv/o

valve

valvuloplasty = repair of a valve

valvotomy = incision into a valve

vas/o
vascul/o

vessel

vasodilation = expanding of blood

vessel
vascular = pertaining to blood vessel

ven/o

vein

venous = pertaining to a vein

ventricul/o

chamber of the ventricular = pertaining to the chamber

heart or brain of the heart or brain
(also: stomach)

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Pathological Conditions of the Cardiovascular System

Coronary Artery Disease (CAD)
Coronary artery disease is a condition in which the coronary arteries fail to
deliver the amount of blood that is required by the heart muscle. As a result,
localized areas of the heart experience a decrease in blood supply (ischemia).
Usually, coronary artery disease is a result of a thickening and hardening of
the inner wall of the coronary arteries (arteriosclerosis). Myocardial ischemia
causes the patient to experience a suffocating chest pain (angina pectoris or
angina) and difficulty in breathing (dyspnea). An attack of angina is generally
associated with physical exertion or emotional stress. It generally lasts about
five minutes and is relieved upon resting. The use of nitroglycerine, a medication that dilates the blood vessels (vasodilator), also brings relief. If pain
cannot be controlled with medication, a surgery designed to circumvent the
obstruction (by-pass surgery) may be required. Coronary artery disease may
ultimately produce an acute myocardial infarction (AMI). In this life-threatening
condition, blood supply in the coronary artery is totally suppressed, causing
tissue death (necrosis or infarction) in a portion of the myocardium.
Valvular Heart Disease
The valves of the heart are generally thin, smooth structures that permit
the flow of blood through the chambers of the heart. Birth defects or certain
infections, especially those caused by scarlet fever or rheumatic fever, may
produce scarring of the valves. When this occurs, there may be a narrowing
of the valves (stenosis) or an inability of the valves to close properly, which is
referred to as valvular insufficiency.
Varicose Veins
Varicose veins develop when damage occurs to the valves of the veins. A
backflow of blood, especially in the legs, causes the veins to enlarge. Stagnation of the blood in varicose veins may cause the formation of a blood clot
(thrombus). A more serious condition may subsequently develop when the
thrombus breaks loose from the vein wall and begins to travel in the vascular
system (embolism). Death may result if the embolus lodges in a vital organ.
In extreme cases, the affected vein is tied off (ligated) and removed (stripped).
Occasionally, varicose veins lead to a condition called phlebitis. If the infection occurs in a deep vein and involves the inner layer of vein tissue, clots may
form resulting in a condition known as thrombophlebitis.

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Other Related Terms

aneurysm localized abnormal dilation of an arterial blood vessel
angina pectoris chest pain
arrest loss of effective cardiac function; cessation of blood circulation
arrhythmia abnormal heart rhythm; some examples are:
1. heart block (atrioventricular block)
2. flutter (up to 260 beats per minute)
3. fibrillation (350 and more beats per minute)
bruit heart murmur
cardiomyopathy any disease or weakening of heart muscle that diminishes
its function
congenital heart disease abnormalities in the heart at birth; some examples are:
1. coarctation of the aorta (narrowing of the aorta)
2. patent ductus arteriosus (small duct between the aorta and pulmonary
artery remains open after birth)
3. septal defects (small holes in the septa between the atria or the ventricles)
congestive heart failure failure of the heart to supply adequate amount of
blood to tissues and organs
heart murmur an extra heart sound heard between normal sounds of the
heart
hemostasis arrest of bleeding or blood circulation
hyperlipidemia excessive amounts of lipids in the blood
hypertension elevated blood pressure; essential and secondary
hypertensive heart disease heart disorder caused by prolonged hypertension
infarct (infarction) area of tissue that undergoes necrosis as a result of cessation of blood supply
ischemia local and temporary deficiency of blood supply resulting from circulatory obstruction
perfusion circulation of blood or fluids through vessels of tissues and organs
Raynaud phenomenon - short episodes of pallor and numbness in the fingers
and toes due to temporary constriction of arterioles in the skin.

106

rheumatic heart disease heart disease caused by rheumatic fever

stent slender device used to support, or hold open tubular structures or
arteries
tetralogy of Fallot a congenital malformation of the heart involving four
distinct defects (1. pulmonary artery stenosis; 2. ventricular septal defect; 3.
shift of the aorta to the right; 4. hypertrophy of the right ventricle)
vegetations collections of platelets, clotting proteins, microorganisms, and
red blood cells that attach to the endoradium in conditions such as bacterial
endocarditis and rheumatic heart disease.
EXERCISES
1. The cardiovascular system is composed of: ............................................................................
2. What are the arteries, capillaries and veins responsible for? ......................................
...................................................................................................................................................................................

3. Fill in the correct term:

3.1. Blood that is rich in O2 is referred to as ............................................................. blood.
3.2. The vas t number of capillaries makes their combined ................................... so
great that blood tend to flow through them very ...................................................................
3.3. The extensive network of capillaries throughout the body absorbs the
..........................................................................................................

pressure exerted by the heart.

3.4. Within the aorta is a valve called the ..................................................................... valve.

3.5. An elevated blood pressure is called ....................................................................................
4. Match the following terms with their meanings:
4.1. pericardium .............................................

a) inflammation of a vein

4.2. S-A node ...................................................

b) slow heart action

4.3. bradycardia ..............................................

c) a fibroserous sac enclosing the

heart

4.4. diaphoresis ..............................................

d) profuse sweating

4.5. phlebitis .....................................................

e) pacemaker

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5. Give the meanings of the following terms:

5.1. systole ................................................................................................................................................
5.2. ischemia ............................................................................................................................................
5.3. angina pectoris .............................................................................................................................
5.4. fibrillation..........................................................................................................................................
5.5. arteriosclerosis ............................................................................................................................
5.6. arrhythmia .......................................................................................................................................
5.7. sphygmomanometer .................................................................................................................
5.8. heart murmur ................................................................................................................................
5.9. bacterial endocarditis ...............................................................................................................
5.10. aneurysm .......................................................................................................................................
6. Provide the plural form of the following nouns:
6.1. atrium .........................................................

6.6. vena cava ..................................................

6.2. aorta ............................................................

6.7. thrombus ..................................................

6.3. stenosis .....................................................

6.8. artery ..........................................................

6.4. embolus ....................................................

6.9. ventricle ....................................................

6.5. capillary .....................................................

6.10. emphysema ..........................................

7. Provide the adjective form for the following nouns:

7.1. vein ...............................................................

7.6. breathing ..................................................

7.2. insufficiency ............................................

7.7. inflation .....................................................

7.3. artery ..........................................................

7.8. heart ............................................................

7.4. dilation .......................................................

7.9. inflammation ..........................................

7.5. lungs ...........................................................

7.10. constriction ...........................................

8. Give appropriate medical term for the following:

8.1. short episodes of pallor and numbness in the fingers and toes .....................
..........................................................................................................................................................................

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8.2. the varicose vein which is tied off ......................................................................................

..........................................................................................................................................................................

8.3. a medication that dilates the blood vessels ................................................................

..........................................................................................................................................................................

8.4. an electrical device used to restore normal heart rhythm..................................

..........................................................................................................................................................................

8.5. failure of proper conduction of impulses through the A-V node to the
bundle of His ............................................................................................................................................
8. 6. drugs promoting loss of fluid ..............................................................................................
8. 7. surgical removal of an aneurysm .....................................................................................
8. 8. tissue death ...................................................................................................................................
8. 9. the external layer of the heart ............................................................................................
8.10. the valve which prevents blood from returning to the right atrium
during contraction of the ventricles .........................................................................................
..........................................................................................................................................................................

9. Translate into Croatian:

The metal-and-plastic heart whirred and clicked in an eerie, mechanical
rhythm as Dr. William DeVries, 40, removed the tracheal tube from his patients
throat. For the first time since his artificial heart has been implanted about 36
hours earlier, William Schroeder, 52, could breathe on his own and speak.
Can I get you something to drink? the doctor asked. Replied Schroeder: Id
like a beer. It was, De Vries admitted afterward, one of the high points of the
tension-filled hours following his second successful attempt to implant an artificial heart. By weeks end the worlds second recipient of an artificial heart
was getting out of bed and sitting in a chair, eating solid foods and sipping
that longed-for beer. On Friday Schroeder tested a new portable power system
for the artificial heart. For 22 minutes in the afternoon, and an hour later that
evening, he was free of the 323-1 b. air-driven unit that normally runs the
heart, and was hooked up to small, 11-lb. device encased in a leather shoulder
bag. The portable system worked flawlessly though there were two breathless 3-sec. intervals when the heart stopped beating, as technicians switched
from one system to the other. Afterward, Schroeder thanked the inventor of
the device, Engineer Peter Heimes of Aachen, West Germany, and shook his
hand. From the beginning, Schroeders treatment seemed to go more smoothly

109

than that of his predecessor, Seattle Dentist Barney Clark, the worlds first
recipient of a permanent artificial heart. Clark s surgery and his 112 days of
life with the man-made pump were fraught with life-and-death crises. I felt
certain that he would die on the operating table, reflected Dr. Robert Jarvik,
38, designer of the Jarvik-7 heart used in both patients. This time, he said,
I felt the opposite.
(TIME, No. 50, December 10, 1984)
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................

110

CHAPTER 9

URINARY SYSTEM
In both males and females the urinary system consists of four major structures a pair of kidneys, two ureters, a bladder, and a urethra. The urinary
system acts as the regulator of extracellular products of the body. Protein
foods that we eat contain carbon, hydrogen, and oxygen plus nitrogen and other
elements. The waste that is produced when proteins combine with oxygen is
called nitrogenous waste, and it is more difficult to excrete it (to separate out)
from the body than are gases like carbon dioxide and water vapour.
The body cannot efficiently put the nitrogenous waste into a gaseous form
and exhale it, so it excretes it in a form of a soluble (dissolved in water) waste
substance called urea. Urea is an undesirable substance produced when body
cells metabolize protein. Urea and other waste materials are collected from
body tissues by the blood and are conveyed to the kidneys. The kidneys, in
turn, filter these products from the blood as they form a complex solution
called urine. Urine is eventually expelled from the body. Failure to eliminate
urea may actually result in death.
The major function of the urinary system is to remove urea from the bloodstream so that it does not accumulate in the body and become toxic. Urea is
formed in the liver from ammonia, which in turn is derived from the breakdown of simple proteins (amino acids) in the body cells. The urea is carried in
the bloodstream to the kidneys, where it passes with water, salts, and acids
out of the bloodstream and into the kidney tubules as urine.
Besides removing urea from the blood, another important function of the
kidneys is to maintain proper balance of water, salts, and acids in the body
fluids. Salts (sodium and potassium) and some acids are known as electrolytes
(molecules which can conduct an electrical charge). Electrolytes are necessary
for the proper functioning of muscles and nerve cells. The kidneys adjust the
amounts of water and electrolytes by secreting some substances into urine
and holding back others in the bloodstream for use in the body.

111

In addition to forming urine and eliminating it from the body, the kidneys
also act as endocrine organs, secreting into the bloodstream substances that
act at some distant site in the body. Examples of the kidneys endocrine function include the secretion of the renin, a substance important in the control of
the blood pressure, and erythropoietin, a material that regulates the production
of red blood cells. The kidneys also secrete an active form of vitamin D, necessary for the absorption of calcium from the intestine. In addition, hormones
such as insulin and parathyroid hormone are degraded and extracted from
the bloodstream by the kidney.
Figure 9.1. Anatomy of the major organs of the urinary system

112

Kidneys and Associated Tubes

(the macroscopic structures of the urinary system)
Two kidneys, each about the size of a fist, are located in the retroperitoneal area of the abdominal cavity on either side of the vertebral column in
the lumbar region of the spine. A concave medial borders gives the kidney
its beanlike shape. The kidneys are embedded in a cushion of adipose tissue
and surrounded by fibrous connective tissue for protection. They weigh about
half a pound each. Near the medial border is a slitlike aperture, the hilus or
hilum. It serves as an opening for a renal vein and a renal artery to enter the
kidney. The renal artery carries the blood that is laden with waste products
to the microscopic filtering tubules located within the kidney for purification.
After the blood is cleansed, it leaves the kidney by way of the renal vein. The
waste material now in the form of urine, is carried to a hollow chamber, the
renal pelvis, that is located at the hilus. The chamber is an enlarged funnelshaped extension of the ureter at the entrance to the kidney.
The kidneys consist of an outer cortex region (cortex means outer portion
or bark, as in bark of a tree) and an inner medulla region (medulla means
marrow or inner portion).
Each ureter is a slender tube about ten to twelve inches in length and
conveys urine, in peristaltic waves, to the bladder. Urinary bladder is an expandable (distensible) hollow, muscular sac in the pelvic cavity. It serves as a
temporary reservoir for urine.
The trigone is a triangular space at the base of the bladder where the
ureters and the urethra lead out.
Urethra is membranous tube through which urine is discharged from the
urinary bladder. The process of expelling (voiding) urine through the urethra
is called micturition. The external opening of the urethra is called the urethral
or urinary meatus. The urethra is approximately one and one-half inches in
the female and about seven inches in the male.
Nephrons (the microscopic structures of the urinary system)
Microscopic examination of the kidney reveals the presence of approximately one million tiny funnel-shaped structures called nephrons. Nephrons
are responsible for maintaining homeostasis or a stable optimal internal environment by continually adjusting the conditions that are necessary for survival.
When the level of various products in the blood elevates beyond a normal
range, nephrons selectively remove them from the blood and re-establish a
level that can sustain life. The substances that are removed by nephrons are
the end products of metabolism - urea, uric acid, and creatinine.

113

Nephrons also extract any excess sodium, chloride, and potassium ions
which are referred to as electrolytes. Some pathological states may cause the
appearance in the blood of certain undesirable substances which may also be
removed by the nephrons. For example, when the blood sugar level becomes
elevated, as in diabetes mellitus, the excess sugar is filtered from the blood
and is removed from the body in the urine.
Figure 9.2. Glomerulus and Bowmans Capsule

Each nephron includes a renal corpuscle and a renal tubule. The renal
corpuscle is composed of a tuft of capillaries, the glomerulus, and a modified,
funnel-shaped end of the renal tubule, Bowmans capsule. This capsule encases
the glomerulus. An afferent vessel (arteriola glomerularis afferens) conveys
blood to the glomerulus and a smaller efferent vessel (arteriola glomerularis efferens) carries blood away from the glomerulus. As the efferent vessel
passes behind the renal corpuscle, it forms the peritubular capillaries. Each
renal tubule consists of four sections: the proximal tubule, followed by the
narrow loop of Henle; then, a larger portion, the distal tubule, and finally the
collecting tubule.
Removal of waste products from the blood by the nephron is accomplished
by three physiological activities: filtration, absorption, and secretion. All of these
activities are performed by different sections of the nephron.
The first phase of urine production, filtration, occurs in the renal corpuscle.
Here, water, electrolytes, sugar, amino acids, and other compounds pass from
the blood plasma in the glomerulus into Bowmans capsule. The fluid that is
formed is called filtrate. The next phase of urine production starts with passing

114

of filtrate through the four sections of the tubule. As it travels the long and
twisted pathways, most of the water and some of the electrolytes and amino
acids are absorbed by the peritubular capillaries, and thus re-enter the circulating blood. The final stage of urine production occurs when specialized cells
of the collecting tubules secrete ammonia, uric acid, and other substances
directly into the lumen of the tubule. Now the formation of urine is completed,
and it passes from the collecting tubules to the renal pelvis, or basin of the
kidney.
Key Terms
ammonia a pungent colourless gaseous alkaline compound of nitrogen
and hydrogen easily soluble in water (NH3)
calix (calyx), pl. calices a cup-shaped collecting region of the renal
pelvis
catheter a tube for injecting or removing fluids
cortex, pl. cortices outer region of an organ (like a bark of a tree)
creatinine nitrogenous metabolic waste excreted in urine
erythropoietin a hormone secreted by the kidney that stimulates red
blood cell production
filtration a process by which some substances pass through a filter
glomerulus, pl. glomeruli tiny ball of microscopic blood vessels in
kidney cortex
hilum, or hilus a concave borderline or depression in an organ where
blood vessels and nerves enter and exit the organ
meatus opening or canal
medulla the inner region of a structure or organ
micturition urination, passing urine
nitrogenous wastes substances containing nitrogen (wastes produced
in muscle metabolism
renal pelvis central collecting region in the kidney
renal tubules microscopic tubes in the kidney where urine is formed as
water, sugar, and salts are secreted back into the bloodstream
rennin a hormone synthesized, stored and secreted by the kidney
trigone triangular area in the bladder where the ureters enter and the
urethra exits
urea major nitrogenous waste product excreted in urine
ureter one of two tubes leading from the kidney to the bladder
urethra a tube leading from the bladder to the outside of the body
uric acid nitrogenous waste excreted in the urine
voiding expelling urine (micturition)

115

Combining Forms Meaning

Terminology

cali/o
calic/o

calyx

caliectasis (dilation of the kidney calices)

caliceal (pertaining to the kidney calyx)

cyst/o
vesic/o

urinary
bladder

cystitis (inflammation of urinary bladder)

perivesical (around the urinary bladder)

lith/o

stone,
calculus

lithotripsy (crushing of a stone)

nephr/o
ren/o

kidney

nephritis (inflammation of the kidney)

renal (pertaining to the kidney)

pyel/o

renal
pelvis

pyelolithotomy (removal of calculus that

blocks the flow of urine)

ur/o

urine,
urinary

urolith (stone formation in the urinary

tract)

Disorders of the Urinary System and Other Pathology Related Terms

anuria

absence of urine production or urinary output

azotemia (uremia)

retention of excessive amounts of nitrogenous

compounds in the blood

bacteriuria

presence of bacteria in the urine

bladder neck
obstruction (BNO)

occurs when there is a blockage of the bladder

outlet; the obstruction may be the result of an
enlarged prostate gland (prostatic hypertrophy),
or the presence of any obstructive masses
(calculi, blood clots, tumour)

dysuria

difficult or painful urination

enuresis (incontinence) involuntary discharge of urine

essential hypertension high blood pressure without an apparent cause
leading to the narrowing and thickening of
arterial walls in the kidney
frequency

voiding urine at frequent intervals

glomerulonephritis

inflammation of the kidney glomerulus (Bright

disease)

hematuria

presence of blood in the urine

hesitancy

involuntary delay in initiating urination

116

hydronephrosis

enlarged and distended kidney resulting from the

obstruction of urine flow (water in the kidney)

interstitial nephritis

inflammation of connective tissue between the

renal tubules (renal interstitium)

nephrolithiasis
(renal calculi)

kidney stones, usually composed of uric acid or

calcium salts

nephritic syndrome
(nephrosis)

a group of symptoms caused by excessive protein

loss in the urine

nocturia

excessive or frequent urination after going to bed

oliguria

diminished urine production

polycystic kidney

multiple fluid-filled sacs (cysts) within and upon

the kidney

pyelonephritis

inflammation of the renal pelvis

renal failure

failure of the kidney to excrete urine

renal hypertension

high blood pressure resulting from kidney

disease; the most common type of secondary
hypertension

urgency

feeling of the need to void immediately

urinary retention

blockage in the passage of urine from the

bladder

EXERCISES
1.1. List some functions of the urinary system: ..........................................................................
...................................................................................................................................................................................

1.2. What are the macroscopic structures of this system? ..........................................

..........................................................................................................................................................................

2. Fill in the correct term:

2.1 After the blood is ................................................ , it leaves the kidneys by way of
the renal vein.
2.2. The renal pelvis is located at the.........................................................................................
2.3. When .......................................... or a desire to urinate is experienced, the urine
is expelled from the .............................................................................. through the urethra.
2.4. Nephrons are responsible for maintaining ..................................................................

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2.5. Glomerulonephritis is an .......................................................................... of the kidney

3. Give the opposite of each term:
3.1. soluble .......................................................

3.6. sufficiency ................................................

3.2. eventually .................................................

3.7. common ....................................................

3.3. failure .........................................................

3.8. loss ...............................................................

3.4. destruction ..............................................

3.9. widening ....................................................

3.5. outside .......................................................

3.10. accelerate ..............................................

4. Match the following terms with their meanings:

4.1. hematuria .................................................

a) a slitlike aperture

4.2. glycosuria .................................................

b) protein in the urine

4.3. pyuria ..........................................................

c) blood in the urine

4.4. proteinuria ...............................................

d) sugar in the urine

4.5. hilus .............................................................

e) pus in the urine

5. Give the meanings for the following terms:

5.1. nephrorraphy .........................................

5.6. essential hypertension .....................

5.2. pyeloplasty ...............................................

5.7. hematuria .................................................

5.3. nephrectomy ..........................................

5.8. polydipsia .................................................

5.4. albuminuria ............................................

5.9. micturition ...............................................

5.5. uremia ........................................................

5.10. urethra ....................................................

6. Provide the adjective form for each of the following:

6.1. meatus .......................................................

6.6. glomerulus ..............................................

6.2. tube ..............................................................

6.7. night ............................................................

6.3. nephrosis ..................................................

6.8. excess .........................................................

6.4. urine ............................................................

6.9. blockage ....................................................

6.5. ischemia ....................................................

6.10. acid ............................................................

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7. Provide the plural form of the following nouns:

7.1. calyx/calix .................................................

7.6. nephrosclerosis ....................................

7.2. proteinuria ...............................................

7.7. abscess ......................................................

7.3. glomerulus ..............................................

7.8. nephroma .................................................

7.4. kidney .........................................................

7.9. biopsy ..........................................................

7.5. nephropexy ..............................................

7.10. meatus ....................................................

8. Give appropriate medical term for the following:

8.1. inflammation of the walls of the glomeruli .................................................................
8.2. kidney stones .................................................................................................................................
8.3. surgical removal of renal calculi ........................................................................................
8.4. inflammation of the renal interstitium ...........................................................................
8.5. thickening of the arteriole walls of the kidney ...........................................................
8.6. cup-shaped capsule surrounding each glomerulus ...............................................
8.7. a small molecule that carries an electrical charge ................................................
8.8. opening or canal............................................................................................................................
8.9. central collecting region in the kidney ............................................................................
8.10. sac which holds urine ............................................................................................................
9. Translate into Croatian:
Urination is a complex process controlled by several sets of muscles,
including the internal and external sphincters, which are circular muscles
surrounding the urethra; they have the power to contract and prevent flow
through it. The internal sphincter is at the outlet of the bladder and works
automatically. The external sphincter, situated along the urethra below the
prostate in males and at an equivalent position in females, is controlled voluntarily. As the bladder fills, the bladder muscles tend to contract automatically. The urge to urinate enters consciousness, but voiding may be controlled
consciously to some extent. When the person decides to urinate, the bladder
muscle contracts and both sphincters relax.
(From: Miller & Keane: Encyclopedia and Dictionary of Medicine, Nursing
and Allied Health)
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CHAPTER 10

NERVOUS SYSTEM
The nervous system is one of the most complicated systems in both structure and function. Along with the endocrine system it controls many bodily
activities that maintain a stable and suitable environment for all of the body
cells - a situation known as homeostasis. The nervous system senses changes
in both the internal and external environment, interprets these changes, and
then coordinates responses that maintain homeostasis.
The central nervous system (CNS) is composed of the brain and spinal cord.
These structures receive, coordinate and transmit nervous impulses. The
peripheral nervous system (PNS) is composed of all other nervous tissue found
outside of the CNS. It includes 12 pairs of cranial nerves, which emerge from
the base of the skull, and 31 pairs of spinal nerves, which emerge from the
spinal cord. These nerves may be sensory or motor, or a mixture of both
sensory and motor fibres.
Figure 10.1. The divisions of the nervous system

Sensory nerves receive impulses from the sense organs, such as the eyes,
ears, nose, tongue, and skin and transmit them to the CNS. These sensory
nerves are also known as afferent nerves, because they conduct impulses
toward a specific site, the central nervous system.
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Figure 10.2 Transmission of an impulse to the CNS and from the CNS

Motor nerves conduct impulses away from the CNS, thus they are known
as efferent nerves. These impulses travel to muscles and other body organs
causing them to respond in some manner. If the response is under the control
of the individual, such as walking or talking, the impulse is relayed by voluntary or somatic nerves. If the response is involuntary or nonthinking, such as
digesting food or secreting hormones, the impulse is relayed by autonomic
nerves.

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Nerves composed of both sensory and motor fibres are called mixed nerves.
For example, when the facial nerve supplies the facial muscles with motor
impulses, such as for smiling or frowning, it is functioning as a motor nerve.
But when the tongue transmits a taste impulse to the brain, the facial nerve
is functioning as a sensory nerve.
The autonomic nervous system is responsible for the control of the internal
environment: heart rate, peristaltic movement of the stomach and intestines, constriction of the iris, and other involuntary activities. This system is
composed of a sympathetic and parasympathetic division. The two divisions are
largely antagonistic to each other, although in certain instances they exhibit
independent activity. Generally, sympathetic nerves initiate or accelerate an
autonomic function, and parasympathetic nerves decelerate or stop the initiated activity. For example, in situations of fear or fright, sympathetic nerve
fibres produce vasoconstriction and an increased heart rate and depress
gastrointestinal activity. When the danger is passed, the parasympathetic
system conveys impulses to bring about vasodilation, a slower heart rate, and
a return to normal gastrointestinal activity.
Nervous Tissue
In spite of its complexity, the nervous system is composed of only two principal types of nerve cells, neurons and neuroglia. Neurons, the functional cells
of the nervous system, are responsible for impulse conduction. All neural
circuits are composed of neuron chains. In contrast to neurons, neuroglia
does not transmit impulses. It is specialized nervous tissue that functions as
connective tissue that supports and binds neurons. During infection, neuroglia is capable of performing certain phagocytic activities.
Neurons
Neurons consist of three major sections: the dendrites, which receive
impulses and transmit them to the cell body; the cell body, which contains
the cell nucleus; and the axon, a long single projection, which transmits the
impulse from the cell body. Many axons in both the PNS and CNS are covered
with a white, lipoid sheath called myelin. This wrapping accelerates the
impulses that travel down the axon. The presence of myelin on axons in the
brain and spinal cord gives a white appearance to these structures and makes
up what is called the white matter of the CNS. Unmyelinated fibres, dendrites,
and nerve cell bodies make up the gray matter. On peripheral nerves, a thin
cellular membrane called neurolemma, or neurolemmal (Schwann) sheath,
wraps around the myelin sheath. The neurolemmal sheath may allow a
damaged axon to regenerate. Since no neurolemma can be found in the CNS,
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injured nerves in the system cannot regenerate. Their nerve function is permanently lost.
Neurons are not continuous with one another. Instead, a small space known
as a synapse is found between the axon of one neuron and the dendrite or
cell body of another. In order for the impulse to travel along a nerve path, the
impulse must be transmitted at the synapse. This transmission is facilitated
by certain chemical substances called neurotransmitters.
Figure 10.3. A neuron, neuroglial cells

Neuroglia
The term neuroglia literally means nerve glue. It was once believed that
neuroglia served only a supporting role for neurons. But it is now known that
different shaped neuroglia cells, perform many other functions.
Astrocytes, as their name suggests, are star-shaped neuroglia and are
believed to be involved in the transfer of substances from the blood to the brain.
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Oligodendroglia are cells with only a few processes. They are believed to help
in the development of myelin on neurons of the CNS. Microglia, the smallest
of the ncuroglia, possess phagocytic properties and may become very active
during times of infection.

The Brain
In addition to being one of the largest organs of the body, the brain is
also the most complex in structure and function. It integrates almost every
physical and mental activity of the body. This organ is also the centre for
memory, emotion, thought, judgment, reasoning and consciousness. The brain
is composed of four major sections: the cerebrum, cerebellum, diencephalon
(interbrain), and brain stem.
Figure 10.4. Sections of the brain

The cerebrum is the largest and uppermost portion of the brain. It consists of
two hemispheres divided by a deep longitudinal fissure or groove. The fissure
does not completely separate the hemispheres. A structure called the corpus
callosum joins them medially on their inferior surfaces. Each hemisphere is
further divided into five lobes. Four of these lobes are named after the bones
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that lie directly above them. A fifth lobe of the cerebrum is hidden from view
and can only be seen upon dissection.
Numerous folds, or convolutions, called gyri (singular: gyrus) are found
in the cerebral surface. These are separated by furrows called fissures or
sulci (singular: sulcus). A thin layer of gray matter called the cerebral cortex,
composed of millions of cell bodies covers the entire cerebrum and is responsible for its gray colour.
The remainder of the cerebrum is composed of white matter (myelinated
axons). Major functions of the cerebrum include sensory perception and interpretation, muscular movement, and the emotional aspects of behaviour and
memory.
The second largest part of the brain, the cerebellum, occupies the back
portion of the brain. lt is attached to the brain stem. When the cerebrum initiates muscular movement, the cerebellum coordinates and refines the movement. The cerebellum also maintains the equilibrium, or balance of the body.
The diencephalon, or interbrain, is composed of many smaller structures,
two of which are the thalamus and the hypothalamus. All sensory stimuli, except
olfactory, are received by the thalamus. Here they are processed and transmitted to the proper area of the cerebral cortex. In addition, impulses from
the cerebrum are received by the thalamus and relayed to efferent nerves.
Beneath the thalamus is a small structure, the hypothalamus. Its chief function is the integration of autonomic nerve impulses and the regulation of
certain endocrine functions.
The brain stem completes the last major section of the brain. It is composed
of three structures: the medulla oblongata, the pons, and the midbrain (mesencephalon). In general, the brain stem serves as a pathway for impulse conduction between the brain and the spinal cord. The brain stem also serves as the
origin for 10 of the 12 pairs of cranial nerves.
Spinal Cord
The spinal cord conveys to the brain sensory impulses from different parts
of the body and also transmits motor impulses from the brain to all muscles
and organs. The sensory nerve tracts are also called ascending tracts, since
the direction of the impulse is upward. Conversely, motor nerve tracts that
relay motor impulses to muscles and organs are called descending tracts,
since they carry impulses in a downward direction. A cross-section of the
spinal cord reveals an inner gray area composed of cell bodies and dendrites,
with an outer area composed of the myelinated tissue of the ascending and
descending tracts.

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The entire spinal cord is located within the spinal cavity of the vertebral
column. Thirty-one pairs of spinal nerves exit from between the intervertebral spaces almost throughout the entire length of the spinal column. Unlike
the cranial nerves, which have specific names, the spinal nerves are known
by the region of the vertebral column from which they exit.
Meninges
Both the brain and the spinal cord are protected against injury by bones.
The brain is enclosed within the skull and the spinal cord is enclosed within
the vertebral column. In addition, both the brain and spinal cord receive limited
protection from a set of three coverings called meninges (singular: meninx).
The outermost coat, the dura mater, is tough and fibrous. Immediately beneath
the dura mater is a cavity called the subdural space. It is filled with serous
fluid. The next layer of the meninges is the arachnoid. As its name suggests,
the arachnoid has a spider-web appearance. A subarachoid space, filled with
cerebrospinal fluid, provides additional protection for the brain and spinal cord
by acting as a shock absorber. Finally, the innermost layer, the pia mater,
contains numerous blood vessels and lymphatics, which provide nourishment
for the underlying tissues.
Cerebrospinal fluid circulates around the spin al cord and the brain and
through spaces called ventricles. These ventricles are located within the inner
portion of the brain.
Key Terms
acetylcholine neurotransmitter chemical released at the ends of some
nerve cells
afferent nerves nerves that carry impulses toward the brain and spinal
cord; sensory nerves
blood-brain barrier blood vessels that selectively let certain
substances enter the brain tissue and keep other substances out
cauda equina horses tail; a collection of spinal nerves below the end of
the spinal cord at the level of the second lumbar vertebra
cell body part of the nerve cell that contains the nucleus
cerebral cortex outer region of the cerebrum; the gray matter of the
brain
cerebrospinal fluid (CSF) liquid that circulates throughout the brain
and the spinal cord
convolution elevated portion of the cerebral cortex; gyrus
efferent nerves nerves that carry impulses away from the brain and
spinal cord to the muscles, glands, and organs; motor nerves
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 ependyma a membrane lining the fluid-filled cavities of the brain

ventricles and central canal of the spinal cord
gait a manner of walking
microglial cell one type of neurglial cell
neurotransmitter a chemical substance (chemical messenger)
released at the end of a nerve cell, that stimulates or inhibits another
cell
palliative relieving symptoms but not curing
plexus a large interlacing network of nerves
receptor an organ that receives a nervous stimulation and passes it on
to nerves within the body
stimulus (pl. stimuli) a change in the internal or external environment
that can evoke a response
ventricles of the brain canals (reservoirs) in the interior of the brain
that are filled with cerebrospinal fluid
Combining Forms Meaning

Terminology

alges/o

pain

analgesia = no sensitivity to pain

cerebr/o

cerebrum

cerebrotomy = incision of the cerebrum

crani/o

skull
(cranium)

craniomalacia = softening of skull bones

dendr/o

tree

dendroid = resembling a branching tree

esthesi/o

nervous
sensation

anesthesia = no nervous sensation (no

feeling)

feeling
encephal/o

brain

encephalitis = inflammation of the brain

gli/o

glu;
neuroglia

glioma = tumour of neuroglial tissue

kinesi/o

movement

bradykinesia = condition of slow movement

lept/o

thin, slender leptomeningitis = inflammation of the pia

and the arachnoid membranes

lex/o

word,
phrase

mening/o

membranes meningocele = herniation of the

covering
meninges
brain and
spinal cord

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dyslexia = difficulty or inability in using

words when reading or writing

myel/o

spinal cord

myelocele = herniation of the spinal cord

narc/o

stupor;
numbness;
sleep

narcotic = pertaining to or producing

narcosis

neur/o

nerve

neurology = the study of nerves

radicul/o

nerve root

radiculopathy = disease of the nerve

root(s)

sthen/o

strength

asthenia = lack of strength

tax/o

order,
ataxia = persistent unsteadiness on the
coordination feet

vag/o

vagus nerve vagotomy = incision of the vagus nerve

(10th cranial nerve)

narcolepsy = uncontrollable compulsion

to sleep

Disorders and Pathological Conditions of the Nervous System

agnosia

inability to comprehend auditory, visual, spatial, or

other sensation

Alzheimer disease

brain disorder marked by deterioration of mental

capacity beginning at middle age; the disorder
develops gradually, and early signs are loss of
memory for recent events followed by impairment
of judgment, comprehension, and intellect.

amyotrophic lateral

progressive disorder characterized by degeneration

of motor neurons in the spinal cord and brain stem
(Lou Gehrig Disease).

sclerosis (ALS)
ataxia

failure of muscular coordination; irregularity of

muscular action.

aura

premonitory awareness of an approaching physical

or mental disorders; particularly sensation
preceding seizures.

autism

developmental disorder characterized by extreme

withdrawal and an abnormal absorption of fantasy;
inability to communicate even on a basic level.

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Bell palsy

facial paralysis due to a functional disorder of

the seventh cranial nerve; it produces weakness
(asthenia) and numbness (anesthesia) of the face,
corneal infection (keratitis), speech difficulties
(dysphasia), pain behind the ear or in the face,
overflow of tears down the cheek (epiphora) due
to keratitis; often there appears grotesque facial
disfigurement and facial spasms; it may result in
unilateral paralysis (plegia) of facial muscles and
distortion of taste perception.

cerebral palsy

partial paralysis and lack of muscular coordination

due to damage to the cerebrum during gestation or
in the perinatal period

cerebrovascular
accident (CVA)

damage to the brain caused by a disorder within

the blood vessels of the cerebrum, also known as a
stroke or apoplexy; it is the result of a localized area
of ischemia,in the brain; it may be caused by:
1. thrombosis - blood clot (thrombus) in the
arteries leading to the brain, resulting in occlusion
(blocking) of the vessel. This is the most common
type of stroke, and may lead to paralysis. 2.
embolism - a piece of clot (embolus) breaks off from
its place or origin and occludes a cerebral artery.
This type of stroke occurs very suddenly.

cerebral contusion

bruising of brain tissue as a result of direct trauma

to the head; neurological deficits persist longer
than 24 hours; a contusion is usually associated
with a fracture of the skull.

coma

a state of unconsciousness from which the patient

cannot be aroused; irreversible coma is one in
which there is complete unresponsitivity to stimuli,
no spontaneous breathing or movement brain
death.

concussion of the
brain

temporary brain dysfunction after injury, usually

clearing within 24 hours; there is no evidence
of structural damage to the brain tissue; severe
concussions may lead to coma.

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convulsion

any sudden and violent contraction of one or more

muscles.

dementia

a broad term referring to cognitive deficit, including

memory impairment.

dyslexia

inability to learn and process written language.

epilepsy

sudden transient brain dysfunction due to

disturbances in discharging electrical brain
impulses; two main types are: 1. grand-mal
seizures, or tonic-clonic seizures that are
manifested by severe convulsions and
unconsciousness; and 2. petit-mal seizures, or
absence seizures, characterized by momentary
lapse of consciousness.

glioma

malignant tumour of the brain arising from glial

cells.

Guillain-Barr
syndrome

autoimmune condition that causes acute

inflammation of peripheral nerves in which myelin
sheaths are destroyed, resulting in decreased
nerve impulses, loss of reflex response and sudden
muscle weakness.

hemorrhage
(bleeding)

bursting forth of blood from a cerebral artery.

herpes zoster
(shingles)

viral disease affecting peripheral nerves.

Huntington chorea

hereditary nervous disorder involving bizarre,

abrupt, involuntary movement.

hydrocephalus

abnormal accumulation of fluid in ventricles of the

brain.

lethargy

abnormal inactivity or lack of response to normal

stimuli.

meningioma

benign tumours of the brain.

meningitis

inflammation of brain meninges caused by viruses

or bacteria.

multiple sclerosis
(MS)

destruction of myelin sheath (demyelination)

and replacement by neurological scar tissue that
prevents the conduction of nerve impulses.

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myasthenia gravis

neuromuscular disorder characterized by relapsing

weakness of skeletal muscles; it is a chronic
autoimmune disorder in which the ability of
acetylcholine (a neurotransmitter) is blocked

neuroblastoma

malignant tumour arising from immature nerve

cells.

neurosis

non-psychotic mental illness that triggers feelings

of distress and anxiety and impairs normal
behaviour.

paralysis

loss or impairment of motor, or also sensory,

function due to lesion of neural or muscular
mechanism.

paraplegia

paralysis of the lower limbs or lower trunk.

paresis

slight or incomplete paralysis.

Parkinson disease

degeneration of nerves in the brain, occurring in

later life, leading to tremors, weakness of muscles,
and slowness of movement.

poliomyelitis

viral inflammation of the gray matter of the spinal

cord.

Reye syndrome

acute encephalopathy and fatty infiltration of the

brain, liver and lymph nodes (at times pancreas
heart, kidney and spleen are involved).

sciatica

severe pain in the leg along the course of the sciatic

nerve felt at the base of the spine, down the thigh,
and radiating down the leg due to a compressed
nerve.

seizure

sudden attack or recurrence of a disease.

spina bifida

congenital defect of the spinal column due to

imperfect union of the vertebral parts; the most
common types are: spina biffida occulta - vertebral
lesion covered with skin and evident only on x-ray
spina bifida with meningocele meninges protrude
through the vertebral defect spina bifica with
meningomyelocele the spinal cord and meninges
herniated through the vertebral lesion

syncope

fainting; sudden loss of consciousness.

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Tourette syndrome

neurological disorder marked by involuntary,

spasmodic, twitching movements; uncontrollable
vocal sounds and inappropriate words.

transient ischemic
attack

temporary interference with blood supply to the

brain lasting (TIA) from a few minutes to a few
hours.

EXERCISES
1.1. The functions of the nervous system are:......................................................................
..........................................................................................................................................................................

1.2. The nervous system is divided as follows: ...................................................................

..........................................................................................................................................................................

2. Complete the following sentences:

2.1. Sensory nerves ......................................................................... from the sense organs.
2.2. Motor nerves ......................................................................................away from the CNS.
2.3. The autonomic nervous system is responsible for ..................................................
2.4. The two principal types of nerve cells are ....................................................................
2.5. The brain is composed of ........................................................................................................
3. Give the opposite of each term:
3.1. peripheral ................................................

3.6. convergence ............................................

3.2. voluntary ...................................................

3.7. attraction ..................................................

3.3. afferent ......................................................

3.8. ancestry .....................................................

3.4. ascending .................................................

3.9. elastic .........................................................

3.5. progress ....................................................

3.10. proceed ...................................................

4. Match the following terms with their meanings:

4.1. thalamotomy ..........................................

a) neurotoxin

4.2. asthenia .....................................................

b) trembling

4.3. tremor ........................................................

c) incision into the thalamus

4.4. clonic spasm ..........................................

d) weakness

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4.5. nerve poison ...........................................

e) excessive loss of muscle tone

5. Give the meanings of the following terms:

5.1. anesthesia .......................................................................................................................................
5.2. apoplexy ............................................................................................................................................
5.3. encephalocele ................................................................................................................................
5.4. neuralgia ..........................................................................................................................................
5.5. craniomalacia ................................................................................................................................
5.6. neurotripsy ......................................................................................................................................
5.7. gangliectomy ..................................................................................................................................
5.8. dysrhythmias ..................................................................................................................................
5.9. ataxia ..................................................................................................................................................
5.10. hemiplegia ....................................................................................................................................
6. Provide the plural forms of the following nouns:
6.1. meningococcus .....................................

6.6. sulcus .........................................................

6.2. cranium .....................................................

6.7. gyrus ...........................................................

6.3. cerebellum ..............................................

6.8. cortex ..........................................................

6.4. cerebrum ..................................................

6.9. equilibrium ..............................................

6.5. nucleus ......................................................

6.10. epilepsy ...................................................

7. Provide the noun form for the following adjectives:

7.1. neural .........................................................

7.6. sensory ......................................................

7.2. cerebral .....................................................

7.7. neuroglial .................................................

7.3. spinal ..........................................................

7.8. fibrous ........................................................

7.4. autonomic ................................................

7.9. emotional .................................................

7.5. central ........................................................

7.10. cranial ......................................................

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8. Give appropriate medical word for the following terms:

8.1. inflammation of the meninges ............................................................................................
8.2. abnormal accumulation of fluid in the brain ..............................................................
8.3. muscle weakness marked by progressive paralysis ..............................................
8.4. inability to speak ..........................................................................................................................
8.5. slowness of movement ............................................................................................................
8.6. inflammation of nerves ............................................................................................................
8.7. measurement of the skull ......................................................................................................
8.8. hardening of the spinal cord .................................................................................................
8.9. x-ray picture of the brain ......................... : .............................................................................
8.10. softening of nerve tissue ......................................................................................................
9. Translate into Croatian:
Case Report
The patient was admitted on January 14 with a history of progressive right
hemiparesis for the previous l to 2 months, fluctuating numbness of the right
arm, thorax and buttocks, jerking of the right leg, periods of speech arrest,
diminished comprehension in reading, and recent development of a spastic
hemiplegic gait (partial hemiplegia with spasmodic contractions of muscles
when walking). He is suspected of having a left parietal tumour.
Examinations done prior to hospitalization included skull films, EEG, brain
scan and CSF analysis, which were all normal. Following admission the brain
scan was abnormal in the left parietal region, as was the EEG.
Left percutaneous common carotid angiographywas attempted, but the
patient became progressively more restless and agitated after receiving the
sedation, so that it was impossible to do the procedure. During the recovery
phase from the sedation the patient was alternatively somnolent and violent,
but it was later apparent that he had developed almost a complete aphasia
and right hemiplegia. In the next few days he became more alert although he
remained dysarthric and hemiplegic.
Bilateral carotid angiograms under general anesthesia on January 19
showed complete occlusion of the left internal carotid artery with cross-filling
of the left anterior and middle cerebral arteries from the right internal carotid
circulation.

135

Final diagnosis: Left cerebral infarction due to left internal carotid artery
occlusion.
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Autopsy Report: Brain and Meninges

Meninges were clear and adherent to underlying brain. The brain was
grossly without evidence of metastases. There was questionable evidence of
herniation bilaterally over the sphenoid ridge and herniation of the cerebellum.
The brain was edematous. On the lateral surface of the pons there is small
(less than l cm), brownish-red lesion located below the arachnoid thought to
be hemorrhage vs. metastasis. Microscopically, the cerebral cortex over the
sphenoid ridge did not demonstrate evidence of herniation; however, grossly
nonpigmented area of necrosis in the cerebellum revealed metastatic melanoma. On the right lateral surface of the pons, the grossly pigmented lesion
was on microscopic examination metastatic melanoma.
Diagnosis:
1. Brain, edema.
2. Metastatic melanoma, pons, cerebellum.
(From: Chabner D. E.: The Language of Medicine)
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CHAPTER 11

BLOOD AND LYMPHATIC SYSTEMS

Blood and lymph are specialized liquid tissues of the body. They circulate
through the whole body and thus represent the chief means of transport within
the body. Each is composed of cells that are suspended in a liquid medium. The
blood and lymphatic systems have many functions. Blood transports oxygen
from the lungs to the body tissues, and carbon dioxide from the tissues to the
lungs. It carries nutrients and hormones to the tissues, removes waste products to the kidneys and carries fluid to and from the tissues, helping to maintain the fluid balance of the body. Lymph transports needed proteins that have
leaked out of the blood capillaries back to the bloodstream via the veins. Both
blood and lymph protect the body by carrying disease-fighting cells (phagocytes) and protein substances called antibodies that combat infection. Also,
plasma proteins and blood clotting cells (platelets) contribute in the important coagulation (clotting) function of the blood.
1. Blood System
Blood is composed of a liquid medium called plasma and a solid portion
that consists of three major blood cells: red blood cells (erythrocytes), white
blood cells (leukocytes) and platelets (thrombocytes). Blood cells account for
about 45 percent and plasma accounts for about 55 percent of the total blood
volume.
All blood cells originate from unspecialized, immature cells called stem
cells or hemocytoblasts (hemoblast or formative cell). They mature in the red
bone marrow of adults (ribs, stern um, skull, vertebrae, pelvic bone and the
ends of the long bones of the limbs) and the liver and spleen of the fetus. From
the initial undifferentiated form blood cells change into specialized or differentiated cells which involves alterations in their size and shape. They change
from large (immature cells) to small or mature forms; the size of the cell
nucleus decreases (in red cells, the nucleus practically disappears).

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Blood plasma consists mainly of water in which are dissolved the substances
carried by the blood to and from the tissues.
Erythrocytes (Red Blood Cells)
The great majority of the cells in the blood are red blood cells. There are
about 5 million red blood cells in a s peck of blood the size of a pin-head, and
about 35 trillion of them in the average adult. Although microscopic in size,
these cells have a total surface area almost the size of a football field. This
vast surface area is important in the bloods task of carrying oxygen from the
lungs to the tissues, because the exchange of oxygen in both places takes
place across the cell surface and must be accomplished quickly as the blood
flows by.
Figure 11.1. The maturation of blood cells-hematopoiesis
Stem cell

Bone marrow

Erythroblast

Myeloblast

Myelocyte
Normoblast
Metamyelocytes

Mature cells

Reticulocyte
Circulating
bloodstream

Monoblast

Megakaryoblast
Lymphoblast

Erythrocyte

Megakaryocyte
Prolymphocyte
Promonocyte

Band cells
Segmented

Basophilic
Eosinophilic
granulocyte
granulocyte
Neutrophilic
granulocyte

Monocyte

Lymphocyte

Platelets

Agranulocytes

The erythrocytes owe their oxygen-carrying ability to the nonprotein heme,

which contains iron and gives the blood its red colour. Heme combines with
another protein, globin, and forms hemoglobin, a major part of the red blood
cell. Hemoglobin has the special ability of attracting and forming a loose
connection with free oxygen, and its presence enables blood to absorb about
60 times the amount of oxygen that the plasma by itself absorbs.

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Red blood cells are stored in the spleen, which acts as a reservoir for the
blood system and discharges the cells into the blood as required. The spleen
also discharges extra red blood cells into the blood during emergencies such
as hemorrhage or shock. Red blood cells mature from undifferentiated reticuloendothelial cells and they live on the average about 110 to 120 days. Then
red blood cells disintegrate and are removed in the spleen and the liver. About
180 million red blood cells are destroyed every minute. Since the number of
cells in the blood remains more or less constant, this means that about 180
million red blood cells are manufactured every minute. The hemoglobin of
destroyed cells is decomposed and carried to the liver. There the iron is stored
and the rest of the chemicals are passed on to be excreted from the body in
the bile, the feces and the urine.
Leukocytes (White Blood Cells)
The leukocytes are the bodys primary defence against infections. They
have no hemoglobin and thus are colourless and, unlike red blood cells, they
can move about under their own power. White blood cells are larger than red
blood cells and fewer in number. Normally the blood has about 8000 white
blood cells per cubic millimeter. Leukocytes also play a role in tissue repair
but this activity is not yet fully understood.
Leukocytes are classified into granulocytes (those with granules in the cytoplasm) and agranulocytes (those without granules). Granulocytes are further
subdivided into neutrophils, eosinophils and basophils. These names are derived
from the dye which stains their cytoplasmic granules. Agranulocytes include
both monocytes and lymphocytes.
Of the several types of leukocytes, the neutrophils are the most numerous,
forming about 70 percent of the total number; lymphocytes make up about 20
percent of the total. The neutrophils, the lymphocytes and most other white
blood cells are phagocytic that is, they have the ability to engulf and destroy
bacteria. Leukocytes multiply rapidly when the body is invaded by infective
microorganisms. The cells migrate rapidly to the site of the infection, surround
the infective agent and overwhelm it. Under a microscope, as many as 15 or
20 bacteria can be seen within a single white blood cell.
The exact function of basophils is unknown, but their numbers are increased
in leukemia.
Eosinophils are increased in allergic conditions and parasitic infections
and phagocytize antigen-antibody combinations.
Monocytes also fight against disease by phagocytosis. They dispose of dead
and dying cells and other debris by engulfing and swallowing the cells.

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Platelets (thrombocytes)
Platelets are small, clear, disk-shaped bodies about one-third the size of
red blood cells or even smaller, which initiate blood clotting and are concerned
in contraction of a clot. When they encounter a leak in a blood vessel, they
disintegrate and adhere to the edges of the injured tissue. There are about
25.000 platelets per cubic millimeter of blood.
Plasma
Plasma is the liquid part of the blood which consists of about 90 percent
of water, 7 percent proteins and less than l percent inorganic salts, organic
substances other than proteins, dissolved gases, hormones, antibodies and
enzymes. Plasma from which the fibrinogen and prothrombin have been
removed is called serum.
Dissolved in the plasma are many important proteins such as serum
albumin, gamma globulin and fibrinogen. Serum albumin is important in
the nutrition of the body. It probably originates in the liver, as does fibrinogen. Fibrinogen is essential in the clotting process. Gamma globulin, which
is formed in the lymphoid tissues and reticuloendothelial system, contains
almost all of the antibodies important in establishing immunity.
Blood Groups (Blood Types)
Blood group means the phenotype of erythrocytes defined by one or more
antigenic determinants. Under the usual system of blood typing there are four
main blood types or blood groups: A, B, O and AB. Each of the blood groups has
a specific combination of factors (antigens and antibodies) which are inherited. These antigen (also called agglutinogen) and antibody (also called agglutinin) factors of the various blood types are:

Type A, containing A antigen and anti-B antibody

Type B, containing B antigen and anti-A antibody
Type AB, containing A and B antigens and no anti-A or anti-B antibodies
Type O, containing no A or B antigens and both anti-A and anti-B
antibodies.

The ABO blood typing system was first introduced in 1900 by Karl Landsteiner and is still generally used today as the basis for transfusing whole
blood. It is now known, however, that many different antigens exist in the red
blood cells, and that as many as 11 or more different antigenic systems of
grouping blood can be recognized. Correct typing and cross-matching of blood
are extremely important clinically in the prevention of transfusion reaction. The
adverse reaction is called agglutination, or clumping, of the recipients blood.
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Damage to the erythrocytes also occurs, so that hemoglobin leaks out of the
cell (hemolysis). The agglutination is fatal to the recipient because it stops the
flow of blood. Similar problems can occur in other transfusions if the donors
antigens are incompatible with the recipients antibodies.
People with type O blood are known as universal donors because their
blood contains neither A nor B antigens. Those with type AB blood are known
as universal recipients because their blood contains neither anti-A nor anti-B
antibodies. Another important factor, called the Rh factor (named so because
it was first found in the blood of a rhesus monkey) must also be considered
in blood typing. This is a very complex system: eight principal variants of the
Rh factor are known, and there are others not yet identified and grouped. For
practical purposes there are two main groups of Rh types. Persons with the
Rh factor present in the blood are referred to as Rh positive those without are
Rh negative. This particular factor may be involved in hemolytic diseases of the
newborn because of an incompatibility existing between the maternal blood
and the fetal blood.
Figure 11.2. Composition of blood

Blood clotting
Blood clotting or coagulation, is a complicated process involving many
different substances and chemical reactions. The end result of the process
is the formation of a fibrin clot from the plasma protein fibrinogen. Platelets
are important in initiating the process, which, stated more simply, involves
the following steps:
1. When a blood vessel is damaged or breaks, a prothrombin activator is
released into the blood in response to special factors from platelets and
tissues. One of these factors is the protein that is missing in patients
suffering from hemophilia.
2. The prothrombin activator, along with calcium and other plasma factors,
helps to convert prothrombin (a plasma protein) into an enzyme called
thrombin.
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3. Thrombin then couverts fibrinogen, a soluble blood protein, into fibrin

threads (insoluble protein) which trap red blood cells, platelets, and plasma
to form the clot.
Normally clots (thrombi) do not form in blood cells unless the vessel is
damaged or the flow ofblood is impeded. Anticoagulant substances in the
bloodstream inhibit blood clotting so thrombi or emboli (floating dots) do not
form. Heparin, produced by specialized tissue cells, is an example of an anticoagulant.
Figure 11.3. General sequence of events in blood clotting

2. Lymphatic System
Lymphatic system is composed of lymph fluid, lymph capillaries, lymphatic
vessels, lymphatic ducts and lymph nodes. The main function of this system is
to transport fluid from the tissues back to the bloodstream. It also aids in the
control of infection caused by microorganism and in conveyance of lipids or
fats away from the digestive organs. Lymph originates from blood plasma. It is
clear and colourless and contains less protein than blood plasma. Other noncellular constituents of lymph are water, salts, sugar and metabolic wastes,
such as urea and creatinine. The cells of the lymph include lymphocytes,
monocytes and a few platelets and erythrocytes.

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The fluid filling the spaces between the tissue cells is called the interstitial fluid. It cleanses the body tissues through which it circulates and collects
cellular debris, bacteria, and particulate matter. Eventually the interestitial
fluid enters into open-ended vessels called lymph capillaries. This fluid is now
called lymph. Lymph passes from the capillaries to larger vessels and finally
to lymph nodes which serve as depositaries for cellular debris.
Lymph vessels from the right chest and arm join the right lymphatic duct.
This duct drains into the right subclavian vein a major vessel in the cardiovascular system. Lymph from all other parts of the body joins the thoracic duet,
which drains lymph into another large blood vessel, the left subclavian vein.
In this way lymph is redeposited into the circulating blood in order to begin
the cycle again.
Three organs are associated with the lymphatic system: the spleen, thymus
gland, and tonsils.
Spleen
The spleen acts as a filter for blood. Phagocytic cells within the lining of the
spleen remove cellular debris, bacteria, parasites, and other infectious agents
thereby cleansing the lymph. Although the spleen is not essential to life it is
important for its hemolytic activity, filtration of microorganisms, production
of antibodies and immunity, chiefly by leukocytes, for production of lymphocytes and monocytes and as a storage of blood, especially red blood cells.
Also, the spleen seems to have a stimulatory effect on the production of blood
from the bone marrow.
Thymus Gland and Immunity
The thymus gland is located in the mediastinum, posterior to the breastbone and between the lungs. It plays an important role in the bodys immunologic system, especially in fetal life and the early years of growth. It is known
that thymectomy performed in animals during the first few weeks of life im
pairs the ability of the animal to make antibodies to fight against foreign antigens.
The immunological activity of an organism involves the production of two
types of lymphocytes, B-cells and T-cells, and is basically divided into two
categories: humoral immunity and cell-mediated immunity.
Humoral immunity is provided by B-lymphocytes. B-cells are produced in
bone marrow. Humoral immunity involves the production of a substance called
an antibody which seeks out and renders harmless the invading substance
called an antigen. As a general rule, the antigen-antibody reaction is a specific

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reaction; that is, the antibody reacts only with the antigen that induced its
formation. For example, if the body has developed antipolio antibodies in
response to the presence of polio antigens (a situation that occurs after the
administration of polio vaccination), these polio antibodies provide no protection against any other antigen except polio. In order to produce antibodies, the
B-cells are activated in the p resen ce of an antigen to become plasma cells.
Plasma cells synthesize and export antibodies. Some activated B-cells do not
develop into plasma cells but remain as memory cells. These cells stay in
the lymphoid tissue. In the event of a future encounter by the same antigen,
the memory cells immediately produce the plasma cells that are capable of
manufacturing a specific antibody. The antibodies that are made by plasma
cells are called immunoglobulins.
Cell-mediated immunity is dependent on T-cell lymphocytes and is seen
in the fight against chronic bacterial infectious (such as tuberculosis), viral
and fungal diseases, malignant cell growth, and cells of transplanted organs.
T-cells mature in the thymus gland and are active in destruction of foreign
materials, such as bacteria, viruses, and foreign tissues such as skin grafts.
When they encounter an antigen, T cells become sensitized and change
into killer cells. They produce a lymphotoxin or cytotoxin (lymphokines)
that damages or ruptures the cell membranes of the antigen and that helps
the macrophages (large phagocytes found in lymph nodes and other body
tissues) do their job. T-cells also aid in the production of interferon, a protein
released from cells that have been invaded by a virus or other antigen. Interferon induces non-infected cells to form an antiviral protein that inhibits viral
multiplication within the cell.
Tonsils
There are three different kinds of tonsils: palatine tonsils are oval-shaped
structures partially embedded in the mu co us membrane, one on each side
of the back of the throat; below them, at the base of the tongue, are the
lingual tonsils; and on the upper rear wall of the mouth cavity are the pharyngeal tonsils, or adenoids, which are of fair size in childhood but which usually
shrink after puberty.
These tissues are part of the lymphatic system and help to filter the circulating lymph of bacteria and any other foreign material that may enter the
body, especially through the mouth and nose. In the process of fighting infection the palatine tonsils and the adenoids sometimes become enlarged and
inflamed (tonsillitis).

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Key Terms
acquired immunity formation of antibodies and lymphocytes after
exposure to an antigen
agglutination clumping of recipients blood cells when incompatible
bloods are mixed
albumin protein found in blood; also called serum albumin
antibody a protein substance developed by lymphocytes in the presence
of antigen
antigen foreign material causing the production of an antibody
cell-mediated immunity an immune response involving T cell
lymphocytes
coagulation the process of blood clotting
corpuscle little body (refers to a blood cell)
cytotoxic cells T cells that directly kill foreign cells (killer cells); also
called T8 cells
fibrin protein threads that form the basis of a blood clot
fibrinogen plasma protein that is converted to fibrin in the clotting
process
globin the protein part of haemoglobin
globulin plasma protein (alpha, beta, gamma)
helper cells T cells that aid B cells in recognizing antigens and
stimulating antibody production; also called T4 cells
heme iron-containing non-protein portion of the haemoglobin molecule
haemoglobin blood protein enabling the red blood cell to carry oxygen
heparin an anticoagulant produced by liver cells and found in blood and
tissues
humoral immunity immune response in which B cells transform into
plasma cells and secrete antibodies
immune reaction reaction between an antigen and an antibody
immune response or immunity the bodys capacity to resist all types of
organisms and toxins that can damage tissue and organ
immunoglobulin a protein (globulin) with antibody activity
interferons antiviral proteins secreted by T cells
interleukins proteins that stimulate the growth of T cell lymphocytes
macrophages large phagocytes that destroy old red blood cells
megakaryocyte platelet precursor (forerunner) formed in the bone
marrow
myeloid derived from bone marrow cells
natural immunity ones own genetic ability to fight off disease
plasma liquid portion of blood

146

platelet smallest formed element in the blood; a thrombocyte

reticulocyte developing red blood cell
serum plasma minus clotting proteins in cells
stem cell a cell in bone marrow that gives rise to different types of
blood cells
suppressor cells T cell lymphocytes that inhibit the activity of B cell
lymphocytes
T cells lymphocytes formed in the thymus gland
thrombin an enzyme that helps convert fibrinogen to fibrin during
coagulation
thromboplastin a clotting factor that promotes the formation of a fibrin
clot.

Combining Forms Meaning

Terminology

chrom/o

colour

hypochromia = reduction in haemoglobin

in red blood cells

coagul/o

clotting

coagulation = blood clotting

hem/o
hemat/o
sanguin/o

blood

hemolysis = destruction of red blood cells

hematology = the study of blood
sanguinous = pertaining to blood
(haemic)

immun/o

protection

immunology = the study of immune

system

lymphaden/o

lymph node lymphadenitis = inflammation of a lymph

lymph gland gland

lymphangi/o

lymph vessel lymphangiogram = radiography of lymph

vessels

phag/o

eat, swallow phagocyte = a cell capable of ingesting

particulate matter

poikil/o

varied,
irregular

poikilocytosis = irregularity in the shape

of red blood cells

sider/o

iron

sideropenia = iron deficiency (anemia)

spher/o

globe, round spherocytosis = a round shape of erythrocytes

splen/o

spleen

thym/o

thymus gland thymoma = tumour of the thymus gland

tox/o

poison

splenectomy = removal of the spleen

toxic = poisonous

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Disorders of the Blood and Lymphatic Systems

AIDS (acquired
immunodeficiency
syndrome)
anemia

148

a disease marked by a decrease in the immune

response (for more detailed description see the
Chapter on AIDS in the Supplement)

deficiency in erythrocytes or haemoglobin; it

implies reduction in red blood cells; the most
common type is iron deficiency, or sideropenic,
anemia caused by a lack of iron; some other
types include:
aplastic anemia results from bone marrow failure;
pancytopenia occurs as stem cells fail to produce leukocytes,
platelets and erythrocytes; it is treated with blood transfusions
and bone marrow transplants (usually conducted with marrow
from an identical twin);
haemolytic anemia reduction in red cells due to excessive
destruction; hemolysis may be due to exposure to chemicals
and toxic substances, or it may be congenital; jaundice may be
a symptom in addition to usual symptoms of anemia; treatment
includes blood transfusions and sometimes splenectomy;
pernicious anemia (macrocytic) a deficiency in the absorption of
vitamin B12 or folic acid; vitamin B12 is a common constituent
of food but it cannot be absorbed into the bloodstream without
the aid of a special substance called intrinsic factor, which
is normally found in gastric juice. Individuals with pernicious
anemia lack this factor in their gastric juice, and the result
is unsuccessful maturation of red cells, with an excess of
large, immature, nucleated, and poorly functioning red cells
(megaloblasts) in the circulation; the treatment consists in the
administration of vitamin B12 for life;
sickle-cell anemia - a genetically determined defect of
hemoglobin synthesis associated with poor physical
development and skeletal anomalies, occurring usually in
Negroes;
thalassemia an inherited defect in the ability to produce
hemoglobin, usually seen in persons of Mediterranean
background; this condition, consisting of various forms and
degrees of severity (the most severe form is called Cooley
anemia), usually leads to hypochromic anemia (diminished
hemoglobin content in red cells).

graft rejection

Destruction of transplanted organ or tissue by

the recipients immune system.

graft-versus-host
disease (GVHD)

Condition that occurs following bone marrow

transplant or blood transfusion; in this
condition the immune cells in the transplanted
marrow produce antibodies against the hosts
tissues; the condition may be acute or chronic.

granulocytosis

abnormal increase in granulocytes in the blood

as a response to infection or inflammation.

haemophilia

Excessive bleeding caused by a congenital

lack of substance necessary for blood clotting.
The disease is sex-linked and is most often
found in males. The female is the carrier of the
trait and generally does not have symptoms
of the disease; while the platelet count of a
hemophiliac is normal, there is a marked
deficiency in a plasma clotting factor (factor VIII)
which results in a very prolonged coagulation
time; in addition to excessive bleeding, joints
and muscles may likewise be affected; if blood
collects in the joints (hemarthrosis), permanent
crippling may result.

Hodgkin disease

Malignant tumour arising in lymphatic

tissue such as lymph nodes and spleen.
This disease of unknown origin produces
lymph node enlargement, and weight loss. A
malignant cell, called a Reed-Stenberg cell,
is characteristically found in the lymph nodes.
There may be metastases to other organs in the
more advanced stages of the disease. Radiation
and chemotherapy are effective methods of
treatment.

leukemia

Leukemias are malignant disease of the bloodforming organs (spleen, lymphatic system, and
bone marrow). Numerous malignant leukocytes
spread and proliferate throughout the bone
marrow. The cells are immature (blastic) and
unable to function in a normal manner. Since

149

the leukemic process drastically reduces the

ability of the body to produce normal blood cells,
it results in anemia and increased susceptibility
to infections. There are many clinical
manifestations in leukemia. The major treatment
for leukemia is chemotherapy. Four major types
of leukemia are:
a
 cute myelogenous (myelocytic) leukemia (AML) immature
granulocytes predominate; platelets and erythrocytes are
diminished;
a
 cute lymphocytic leukemia (ALL) immature lymphocytes
predominate this form is seen most often in children and
adolescents; the onset is sudden;
c hronic myelogenous leukemia (CML) - mature and immature
granulocytes are present in the marrow and bloodstream; this
is a slowly progressive illness;
c hronic lymphocytic leukemia (CLL) abnormal numbers of
relatively mature lymphocytes predominate in the marrow,
lymph nodes and spleen; it occurs later in life and follows a
slowly progressive course.
lymphadenitis

inflammation of lymph nodes, usually due to

infection.

lymphocytosis

increased number of lymphocytes in the blood

and bone marrow.

lymphosarcoma
(lymphoma)

Malignant tumour of lymph nodes which closely

resembles Hodgkins disease. It affects the
lymph nodes, spleen, bone marrow and other
organs. There are several types of lymphoma
(lymphocytic, histiocytic, etc.). Chemotherapy
and radiation are used in treatment.

mononucleosis

Acute infectious disease with enlarged lymph

nodes and spleen and increased numbers of
lymphocytes and monocytes in bloodstream. The
disease is caused by virus. Lymphadenopathy is
present, with sore throat and enlarged, tender
nodes in the cervical and sometimes axillary and
inguinal regions, splenomegaly, hepatomegaly,
and marked asthenia (weakness) are also
present.

150

multiple myeloma

A primary malignant tumour of bone marrow.

This is a progressive malignancy of antibodyproducing cells. The condition often leads to
osteolytic lesions, anemia, hypercalcemia,
renal damage, and increased susceptibility to
infection. Treatment is with analgesics,
radiotherapy, chemotherapy, and special
orthopedic supports.

polycythemia
(primary or vera)

purpura

Abnormal increase in the erythrocyte count

or in hemoglobin concentration. The cause of
the disease is not fully understood. There is
hyperplasia of the cell-forming tissues of the
bone marrow, with resultant elevation of the
erythrocyte count and hemoglobin level, and
platelets. The condition has been compared
to leukemia and regarded as a malignant
neoplastic disease. Treatment is aimed at
reducing the red cell count and decreasing
the blood volume. It includes both the modern
techniques of radiation therapy and the ancient
practice of bloodletting.
A hemorrhagic disease characterized by
extravasation of blood into the tissues, under the
skin and through the mucous membranes, and
producing spontaneous ecchymoses (bruises)
and petechiae (small red patches) on the skin.
The disorder is accompanied by a marked
decrease in circulating platelets and hence is
sometimes called thrombocytopenic purpura.
Primary or idiopathic purpura is of unknown
cause while the secondary or symptomatic
purpura may be associated with exposure
to drugs or other chemical agents, systemic
diseases such as anemia and leukemia, diseases
affecting the bone marrow or spleen and
infectious diseases such as rubeolla. Treatment
is aimed at the cause of disease. Splenectomy
and drug therapy are used.

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sarcoidosis

Inflammatory disease of unknown etiology in

which small nodules, or tubercles, form in lymph
nodes and other organs. Besides spleen and
lymph nodes, lesions also develop in lungs and
liver.

septicemia

Serious life-threatening bloodstream infection

that may arise from other infections in the
body; also called sepsis, blood infection, blood
poisoning.

EXERCISES
1.1. The main functions of the blood are: ...............................................................................
1.2. The function and the accessory organs of the lymphatic system are as
follows: ........................................................................................................................................................
2. Fill in the correct term:
2.1. Blood is composed of ............................. called .......................................................... and
....................................................

that consists of .................................................................................

2.2. The erythrocytes owe their ...................................................... ability to the protein

.............................................................

which contains .........................................................................

2.3. Leukocytes also play a role in ...................................................... but this activity is

2.4. Lymph .................................................................................................... from blood plasma.
2.5. The fluid between the tissue cells is called..................................................................
3. Give the opposite of each term:
3.1. early .............................................................

3.6. continuance .............................................

3.2. past ..............................................................

3.7. conversion ................................................

3.3. permanence ............................................

3.8. strong .........................................................

3.4. sharp ...........................................................

3.9. fertile ..........................................................

3.5. cause ...........................................................

3.10. dry ..............................................................

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4. Match the following terms with their meanings:

4.1. albumin .....................................................

a) red blood cell

4.2. thrombocyte ............................................

b) iron-containing non-protein
portion of the hemoglobin
molecule

4.3. heme ...........................................................

c) antiviral protein secreted by

T-cells and other cells

4.4. interferon ..................................................

d) platelet

4.5. erythrocyte ..............................................

e) protein found in blood

5. Give the meanings of the following terms:

5.1. antigen ...............................................................................................................................................
5. 2. antibodies .......................................................................................................................................
5. 3. cell-mediated immunity..........................................................................................................
5. 4. interstitial fluid ............................................................................................................................
5. 5. globin .................................................................................................................................................
5. 6. bilirubin ............................................................................................................................................
5. 7. coagulation ....................................................................................................................................
5. 8. fibrinogen ........................................................................................................................................
5. 9. globulin ............................................................................................................................................
5.10. immune reaction .......................................................................................................................
6. Provide the plural forms of the following nouns:
6.1. thymus .......................................................

6.6. hematoma ................................................

6.2. nucleus ......................................................

6.7. antigen .......................................................

6.3. edema .........................................................

6.8. lymphadenoma .....................................

6.4. serum .........................................................

6.9. anemia .......................................................

6.5. hemolysis .................................................

6.10. albumin ...................................................

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7. Provide the adjective form of the following nouns:

7.1. spleen .........................................................

7.6. thymus .......................................................

7.2. blood ............................................................

7.7. albumin .....................................................

7.3. hemostasis ..............................................

7.8. fibre ..............................................................

7.4. lymph ..........................................................

7.9. cell ................................................................

7.5. nucleus ......................................................

7.10. genesis ....................................................

8. Give appropriate medical term for the following:

8.1. stringy substance in clots .......................................................................................................
8.2. liquid part of blood without fibrinogen ...........................................................................
8.3. provide cell-mediated immunity ........................................................................................
8.4. inflammation of lymph nodes ..............................................................................................
8.5. increased numbers of lymphocytes in the blood and bone marrow
..........................................................................................................................................................................

8.6. removal of the thymus ..............................................................................................................

8.7. inflammation of the thymus ..................................................................................................
8.8. deficiency in erythrocytes or hemoglobin .....................................................................
8.9. disease-fighting cells ...............................................................................................................
8.10. deficiency in the absorption of vitamin B12 ..............................................................
9. Translate into Croatian:
Allergy
Allergy is usually defined as abnormal and individual hypersensitivity to
substances that are ordinarily harmless. Basically it develops like immunity
to disease, which is one of the natural defence mechanisms of the human
body resulting in antigen-antibody reaction, but to an exaggerated degree.
An allergy cannot occur on the first contact with a potential allergen, i.e. a
substance capable of inducing hypersensitivity, because antibodies have not
yet been produced by the body. It may occur on the second contact, when antibodies have been produced and are in reserve in the body tissues, but it does
not necessarily do so. In some cases it may not occur until late in life when,
after repeated contact with the allergen, a person suddenly develops a sensi-

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tivity. Although anyone can develop an allergy after repeated exposure to some
offending allergen, it is believed that some individuals inherit the tendency
or predisposition.
In addition to microorganisms, dust, dog dander, pollens, grasses, mol
d spores, and practically any substances in the environment - collectively
termed allergens - may function as antigens and stimulate the production
of antibodies within the host. Allergens can enter the body by being inhaled,
swallowed, touched or injected. The allergen is not directly responsible for the
allergic reaction, but sets off the chain of events that brings it about.
A variety of allergic reactions can take place almost anywhere in the body;
the cell affected may be destroyed or injured, and they release powerful defensive chemicals such as heparin, leukotaxine and especially histamine that
cause systemic symptoms which may range from sneezing, slight local edema
and numerous other discomforting signs and symptoms to fatal anaphylactic
shock (dyspnea, cyanosis, rapid drop of blood pressure, weakening of pulse,
convulsions and loss of consciousness). Emotional factors such as anxiety,
fear, anger and strong excitement are also known to have a role in allergy,
not exactly as causes but mostly in view of evidence that emotional upset may
set off an allergic attack.
Common allergic diseases include hay fever, asthma, allergic dermatitis
(eczema), allergic contact dermatitis, urticaria (hives), food allergies, drug
allergies, and allergies to insect bites.
In most cases allergy is dealt with by identifying the responsible allergen
and then avoiding it. An allergy that is resistant to cure may be controlled with
medication (antihistamines, epinephrine, ephedrine, aminophylline and varieties of steroids of the cortisone and ACTH type). In many instances the patient
can be cured of the allergy by a series of desensitization treatments, in which
the patient is exposed to gradually increasing amounts of the allergen until
his resistance is built up to immunity.
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Common Allergens
inhaled substances: pollens from weeds, grasses, treed, and plants;
dusts, mold spores, animal skin/hair, feathers, hair
lotions, kapok, tobacco.
foods:

lobster, crab, shellfish and fish; meats, fowl, chocolate, nuts, spices, eggs, milk and grains.

skin contact
substances:

plastics, certain metals, rubber, fabrics, dyes,

cosmetics, resins, drugs, and plant foliage.

injected drugs:

antibiotics, certain serums, hormones, liver extract,

and insulin.

drugs given by
mouth:

aspirin, laxatives, sedatives, sleeping pills, tranquilizers, and antibiotics.

(From: Charles Carroll and Dean Miller: Health, the Science of Human
Adaptation; and Miller-Keane: Encyclopedia and Dictionary of Medicine and
Nursing.)

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CHAPTER 12

ENDOCRINE SYSTEM
The endocrine and nervous systems comprise the two major systems of the
body. The first one functions by means of chemical reactions and the second
one by means of electrical impulses. Once the nervous system receives either
an internal or external stimulus, the stimulus produces a series of electrical
impulses, which are then transmitted to the brain via neurons.
The endocrine system works differently. It affects bodily activities by
releasing chemical messengers, or hormones, into the bloodstream. These
chemical substances can regulate the many and varied functions of an
organism. The word hormone is of Greek origin and means urging on. The
hormones, produced by various glands, stimulate or inhibit activities of the
body. For example, one hormone stimulates the growth of bones, another
causes the maturation of sex organs and reproductive cells, and another
controls the metabolic rate (metabolism) within all individual cells of the body.
Hormones produce their effects by binding to receptors, which are recognition sites in the various target tissues upon which the hormones act. The
receptors initiate specific biological effects when the hormones bind to them.
Each hormone has its own receptor, and binding of receptor by hormone is
much like the interaction of a key and a lock.
It is important to distinguish the two different types of glands within our
body. The exocrine glands, which are not part of the endocrine system, secrete
their products directly into ducts, which carry them to specific places within
the body. Examples of exocrine glands are sweat, mammary, mucous, salivary,
digestive, and lacrimal (tear) glands. Endocrine glands are ductless glands, and
their products are hormones, which are released directly into the bloodstream.
The ductless, internally secreting endocrine glands are the following:
1. Thyroid gland
2. Parathyroid glands (four glands)
3. Adrenal glands (one pair)

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4. Pancreas (islands of Langerhans)

5. Pituitary gland (hypophysis)
6. Thymus and pineal gland
7. Ovaries in female (one pair)
8. Testes in male (one pair)
The last two glands are called sex glands or gonads. The pineal and thymus
gland, are included as endocrine glands because they are ductless, although
little is known about their endocrine function in the human body.
Thyroid Gland
The largest gland of the endocrine system is the thyroid gland. It is located
in the neck just below the larynx. This gland is composed of two fairly large
lobes - a right and left lobe that are separated by a strip of tissue called an
isthmus. The thyroid gland is located on either side of the trachea, below a
large piece of cartilage called the thyroid cartilage. This cartilage covers the
larynx and produces the prominence on the neck known as the Adams apple.
The main function of the thyroid gland is to produce the hormones thyroxine
and triiodothyronine. These hormones are synthesized in the thyroid gland from
iodine, which is picked up from the blood circulating through the gland, and
from an amino acid called tyrosine. Thyroxine is vital in maintaining normal
growth and metabolism. It is responsible for a persons energy level. This
gland also influences skeletal growth and sexual development. A more recently
discovered hormone produced by the thyroid gland is called calcitonon (thyrocalcitonin). Calcitonin is secreted when calcium levels in the blood are high. It
stimulates the passage of calcium into bones from the blood.
Parathyroid Glands
The parathyroid glands are four small oval bodies located on the dorsal
aspect of the thyroid gland or are embedded within it. They occur in a variable number of pairs, commonly two. Parathyroid glands secret e a parathyroid hormone (PTH), which regulates calcium and phosphorus metabolism fur
blood, bones, and teeth. Normally, calcium in the food we eat is absorbed from
the intestine and carried, by the blood, to the bones, where it is stored. The
adjustment of the level of calcium in the blood is a good example of the way
hormones in general control the homeostasis (equilibrium or constancy in the
internal environment) of the body. If there is a decrease in blood calcium (as
in pregnancy or rickets, a vitamin D deficiency disease), parathyroid hormone
is secreted in larger amounts to cause calcium to leave the bones and enter
the bloodstream. Thus, blood calcium levels are brought back to normal.

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Conversely, any situation of increase in calcium in the bloodstream, such as

excess quantity of calcium or vitamin D in the diet, will lead to decreased parathyroid hormone secretion, decreasing blood calcium so that homeostasis is
again achieved.
Adrenal Glands
The adrenal glands, also called the suprarenal glands, are two small glands
situated one on top of each kidney. Each gland consists of two parts, an outer
portion called the adrenal cortex and an inner portion called the adrenal
medulla. The cortex and medulla are two glands in one, each secreting its
own different endocrine hormones. The cortex secretes hormones called steroids (complex chemicals derived from cholesterol), and the medulla secretes
hormones called catecholamines (chemicals derived from an amino acid).
The adrenal cortex secretes three types of steroid hormones:
1. Mineralocorticoids - these hormones are essential to life because they regulate the amounts of mineral salts (also called electrolytes) that are retained
in the body. A proper balance of water and salts in the blood and tissues is
essential to the normal functioning of the body.
The most important mineralocorticoid is called aldosterone. The secretion
of aldosterone by the adrenal cortex increases the reabsorption of sodium
(a mineral electrolyte commonly found in salts) by the kidney tubules. At
the same time, aldosterone stimulates the excretion of another electrolyte
called potassium. The secretion of aldosterone increases manyfold in the
face of a severe sodium restricted diet, thereby enabling the body to hold
needed salt in the bloodstream.
2. Glucocorticoids - these hormones have an important influence on the
metabolism of sugars, fats, and proteins within all body cells.
Cortisol (also called hydrocortisone ) is the most important glucocorticoid
hormone. Cortisol increases the ability of cells to make new sugars out of
fats and proteins (gluconeogenesis) and regulates the quantity of sugars,
fats, and proteins in the blood and cells.
Cortisone is a hormone very similar to cortisol and can be prepared synthetically.
Cortisone is useful in treating inflammatory ailments such as rheumatoid
arthritis.
3. Androgens, Estrogens, and Progestins - these are male and female hormones
that maintain the secondary sex characteristics, such as beard and breast
development, and are necessary for reproduction. Most of these hormones
are also produced in the ovaries and testes. Excess adrenal androgen secre160

tion in females leads to virilism (development of male characteristics),

and excess adrenal estrogen and progestin secretion in males produces
abnormal feminine characteristics (feminism).
The adrenal medulla secretes two types of catecholamine hormones:
1. Epinephrine (adrenaline) - this hormone increases cardiac activity, dilates
bronchial tubes, and stimulates the production of glucose from a storage
substance called glycogen when glucose is needed by the body. Epinephrine is often referred to as the fight or flight hormone, because of its effect
during stress. Epinephrine causes the involuntary muscles to contract and
produces an increase in blood pressure. It converts glycogen into blood
sugar for use by the voluntary muscles to perform extra work.
2. Norepinephrine (noradrenaline) - this hormone constricts vessels and raises
blood pressure.
Both epinephrine and norepinephrine are called sympathomimetic agents
because they mimic, copy, the actions of the sympathetic nervous system.
During times of stress, these hormones are secreted by the adrenal medulla
in response to nervous stimulation. They help the body respond to crisis
situation by raising blood pressure, increasing heartbeat and respiration,
and bringing sugar out of storage in the cells.
Pancreas (Islands of Langerhans)
The pancreas, located behind the stomach in the region of the 1st and 2nd
lumbar vertebrae, produces both external and internal secretions. The external
secretion, called pancreatic juice, is produced by the cells of the acini. Pancreatic juice passes through the pancreatic ducts into the duodenum where it
plays an important role in the digestion of various foods.
The specialized cells in the pancreas that produce hormones are called the
islets of Langerhans. They produce two hormones called insulin and glucagon.
Both of these hormones play a role in the proper metabolism of sugars and
starches in the body. Insulin is necessary in the bloodstream so that sugars can
pass from the blood into the cells of the body where they are burned to release
energy. When blood sugar (glucose) is above normal, insulin is released by the
island cells of the pancreas. The insulin causes sugar to enter body cells to
be burned and stimulates the conversion of glucose (a starch-storage form of
sugar) in the liver. Thus, sugar can leave the blood to be stored (as glycogen)
or used to release energy. Glucagon, the opposite twin of insulin, is released
into the blood when sugar levels are below normal. It causes the breakdown
of liver glycogen to sugar (glucose), so that there is a rise in the sugar content
of blood leaving the liver.
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The islands of Langerhans include two major types, containing granules

that stain differently. The alpha cells (10 to 30 percent of the cells) stain red
and produce glucagon. The beta cells (60 to 90 percent of the cells) stain blue
and produce insulin. While the islands of Langerhans carry on the endocrine
functions of the pancreas, other cells within the organ carry on its exocrine
functions. These cells secrete digestive enzymes and juices into the gastrointestinal tract.
Pituitary Gland (Hypophysis)
All the endocrine glands interact with one another to some extent, but
only the pituitary gland has the special function of stimulating other endocrine glands to produce their own particular hormones. Because of this, the
pituitary gland (also called hypophysis) is known as the master gland. It is
small, no larger than a pea, and is attached to the base of the brain in a small
pocket-like depression of the skull called the sella turcica. The pituitary gland
is connected to the hypothalamus by the hypophyseal stalk.
Even though the pituitary gland looks like a single gland, it actually consists
of two separate glands the adenohypophysis, or anterior lo be; and the neurohypophysis or posterior lobe. These two glands are formed from different embryonic structures and secrete different hormones. Signals transmitted from the
hypothalamus control almost all secretions by the pituitary gland. Secretion
from the neurohypophysis is controlled by nerve fibers originating in the hypothalamus and ending in the neurohypophysis. Secretion by the adenohypophysis is controlled by special hormones called releasing and inhibiting factors.
These hormones are secreted by the hypothalamus and pass to the adenohypophysis by way of special capillaries.
The adenohypophysis produces several hormones:
1. Growth hormone (GH or HGH in humans, also called somatotropin) - this
hormone acts on bone tissue to accelerate its growth in the body.
2. Thyroid-stimulating hormone (TSH, also called thyrotropin) - this hormone
stimulates the growth of the thyroid gland and its secretion of thyroxine.
3. Adrenocorticotropic hormone (ACTH) - this hormone stimulates the growth
of the adrenal cortex and increases its secretion of steroid hormones
(primarily cortisol).
4. Gonadotropic hormones - there are several gonadotropic hormones that
influence the growth and hormone secretion of the ovaries in females and
testes in males. In the female, follicle-stimulating hormone (FSH) stimulates the growth of eggs in the ovaries, and luteinizing hormone (LH) induces
the secretion of progesterone (pregnancy-sustaining hormone) from the
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ovaries. In the male, gonadotropins (FSH and LH) from the adenohypophysis influence the development of spermatozoa and testes.
5. Prolactin (PRL) - this hormone promotes the growth of breast tissue and
stimulates and sustains milk production after birth.
6. Melanocyte-stimulating hormone (MSH) - this hormone influences the
formation of melanin and causes increased pigmentation of the skin. This
effect is observed only when hypersecretion of the hormone occurs.
The neurophypophysis secretes two important hormones. They are formed
in the hypothalamus but secrete through the posterior pituitary gland:
1. Antidiuretic hormone (ADH) - this hormone, also known as vasopressin, stimulates the reabsorption of water by the kidney tubules. In addition, ADH
can also increase blood pressure by constricting arterioles.
2. Oxytocin - stimulates the uterus to contract during childbirth and maintains labour during childbirth. Oxytocin is also secreted during suckling,
and causes the production of milk from the mammary glands.
Thymus and Pineal Gland (Cerebral Epiphysis)
Both the thymus and pineal glands are regarded as endocrine glands,
because they are ductless. However, little is known about their endocrine
function in the human organism.
The thymus gland is an unpaired organ located in the upper mediastinal
cavity, anterior to and above the heart. It consists of two flattened symmetrical lobes, each enclosed in a capsule. The thymus gland is prominent in the
child but tends to a trophy in the adult. Since the function of the thymus is
concerned with immunity, its major contribution is stimulation of the lymphoid
organs to produce T-lymphocytes for immunological activity.
The pineal gland is shaped like a pine con e and is attached to the posterior part of the third ventricle of the brain. Although the exact functions of this
gland have not been established, there is evidence that it secretes the melatonin hormone. It is believed that melatonin may inhibit the activities of the
ovaries. When melatonin production is high, ovulation is b locked, and there
may be a delay in puberty development. The pineal gland starts to degenerate
at about 7 years of age and in the adult it consists mostly of fibrous tissue.
Sex Glands (Gonads)
The ovaries are the female sex organs. They produce estrogen, which aids
in the development of secondary sex characteristics. Ovaries also produce
progesterone, which assists in the normal development of pregnancy.

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The male sex glands, or testes, produce testosterone. This hormone aids
in the development of secondary sex characteristics in the male.
For quick reference please refer to the table below:
Comparison Between the Endocrine and Nervous Systems
Endocrine System
Secretes hormones that are carried
in body fluids

Nervous System
Transmits nerve impulses via nerve
fibres

Causes changes in the metabolic

activities of target tissues

Causes muscles to contract or

glands to secrete

Effects exerted relatively slowly

Effects exerted relatively rapidly

Effects generally prolonged

Effects generally brief

Key Terms
antagonistic acting in opposition; mutually opposing g
catecholamines hormones derived from an amino acid and secreted by
the adrenal medulla (e.g. epinephrine)
corticosteroids hormones produced by the adrenal cortex (e.g.
glucocorticoids)
homeostasis a constant internal environment
hormone a substance produced by an endocrine gland and carried
through the blood to a target organ
sella turcica (Turkish saddle) a cavity in the skull where the pituitary
gland is located
steroid a complex chemical related to fats (oil) and derived from a
sterol (e.g. cholesterol)
sympathomimetic an agent that mimics or copies the effect of the
sympathetic nervous system (e.g. adrenaline)
target a structure, organ or tissue to which something is directed.

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Combining Forms Meaning

Terminology

aden/o

gland

adenectomy = removal of a gland

adren/o
adrenal/o

adrenal
gland

adrenal = pertaining the adrenal gland

adrenalectomy = removal of the adrenal
gland

andr/o

male

androgen = male sex hormone

cortic/o

cortex, outer cortical = pertaining to the outer region

region

crin/o

secrete

endocrine = internally secreting (gland)

dips/o

thirst

polydipsia = excessive thirst

(e.g. in diabetes mellitus)

estr/o

female

estrogen = female sex hormone

gluc/o
glyc/o
Glycos/o

sugar,
sweetness

glucogenesis = producing sugar

hypoglicemia = lower than normal blood
sugar
glycosuria = abnormal amount of glucose
in the urine

kal/i

potassium
(an
electrolyte)

hypokalema = decrease in blood potassium level

lact/o

milk

prolactin = a hormone that promotes

lactation

myx/o

mucus

myxedema = decreased thyroid function

natr/o

sodium (an
electrolyte)

hyponatremia = decreased sodium

content in the blood

phys/o
physi/o

growth,
natural
process

hypophysis = growing from the undersurface of the brain

physiology = the study of natural
processes

somat/o

body

somatotropin = growth hormone

toc/o

childbirth dystocia = difficult childbirth.

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Disorders of the Endocrine System

Disorders of the endocrine system are based on underproduction (hyposecretion) or overproduction (hypersecretion) of hormones. Most deficiencies
result from genetic disorders, surgical removal of the gland, or production of
poor-quality hormones.
Thyroid Gland
Thyrotoxicosis (exophthalmic goitre) is a condition marked by protrusion
of the eyeballs, increased heart action, enlargement of the thyroid gland,
weight loss, and nervousness. This condition is due to hypersecretion of
thyroxine, a thyroid hormone. One of the early symptoms of this disorder is an
enlarged thyroid (goitre) and edema behind the eye, which causes the protrusion of the eyes, (exophthalmos). Exophthalmic goitre is also known as Graves
disease. Thyrotoxicosis is usually treated by administering drugs that suppress
thyroxine synthesis or by surgically removing part of the gland (thyroidectomy).
Thyroid deficiency during adulthood (myxedema) results in physical changes
such as puffiness of the skin, swollen lips, thickened nose, and loss of hair.
Hyposecretion of the thyroxine, especially during infancy, results in cretinism.
With this disorder, every aspect of the childs development is affected. The
child exhibits dwarfism and mental retardation. Both cretinism and myxedema can also occur when the thyroid gland atrophies or when it is surgically removed.
Thyroid gland enlargement may be a symptom of many different conditions. Examples of two types of goitre are:
Endemic goitre - This condition, prevalent in certain regions and peoples
and marked by accumulation of colloid (gluelike or gelatinous) material in the
thyroid gland, causes hypertrophy of the thyroid. The etiology is deficiency of
iodine in the diet, which causes the thyroid to work harder to make hormone
and thus enlarge as compensation for the scarcity of iodine. Treatment is to
increase the supply of iodine in the diet.
Nodular or adenomatous goitre - This form of goitre is marked not only by
enlargement (hyperplasia) of the thyroid, but by the formation of nodules or
adenomas. Some patients develop hyperthyroidism with the symptoms such as
rapid pulse, tremors, nervousness, and excessive sweating. Treatment consists
of use of thyroid hormone to suppress the normal thyroid gland functioning.
Thyroid carcinoma - cancer of the thyroid gland. Some tumours are very
slow in growing and others may metastasize widely. Adenomas (noncancerous
growths) are distinguished from carcinomas in radioactive tracer studies. Hot
tumour areas (those collecting more radioactivity than surrounding tissues)
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usually indicate benign growths; cold nodules can be either benign or malignant.
Parathyroids
Hypoparathyroidism or hyposecretion of the parathyroids results in neuromuscular hyperexcitability manifested by convulsions, muscle twitches and
spasms (tetany). Blood calcium decreases and blood phosphorus rises. The
decrease of calcium in the bones results in increased bone fragility. Other
symptoms include cataract, teeth defects, bone lesions, maldevelopment of
hair and nails and skin disturbances.
Hyperparathyroidism causes demineralization of bones (osteitis fibrosa
cystic, or von Recklinghausen disease of bone). The parathyroid hormone draws
calcium from bones marking them highly susceptible to fracture and deformity.
This condition can be the result of a benign tumour of the parathyroid gland
(adenoma) and is treated by surgical removal.
Adrenals
Adrenal cortex
Addison disease results from a deficiency in the secretion of adrenocortical
hormones (adrenal cortical hypofunction). Although it is known to be due to
a failure of the adrenal glands, the cause of this failure is not always certain.
Tuberculosis of the adrenals accounts for less than half the cases and idiopathic atrophy of the glands for the remainder. If untreated, the disease will
continue a chronic course with progressive but relatively slow deterioration. In
some patients the deterioration may be repaid. Patients treated early, usually
with adrenocortical hormones, have an excellent prognosis.
Cushing syndrome is caused by hypersecretion of the adrenal cortex and
results in excessive production of glucocorticoids. This overactivity is commonly
due to an abnormal growth of the adrenal cortices. It may also be caused by a
benign or malignant tumour of one of the adrenal glands. Symptoms include
fatigue, weakness, edema, excessive hair growth in unusual places (hirsutism)
in females, high blood pressure, and purplish markings (striae) of
the skin. Treatment of the disorder is partial removal of the adrenal gland
(adrenalectomy) or removal of the tumour, if that is the source of the problem.
Adrenal Medulla
Pheochromocytoma is a tumour occurring in the adrenal medulla. The
tumour cells (which stain dark) produce excess secretion of the epinephrine
and norepinephrine. The excess catecholamines produce hypertension, palpi167

tations, severe headaches, sweating, flushing of face, and muscle spasms.

Surgery to remove the tumour and administration of antihypertensive drugs
are possible courses of treatment.
Pituitary Gland (Hypophysis)
Adenohypophysis
The anterior the adenohypophysis, produces a number of hormones that
directly control the activities of other endocrinc glands. However, human
growth hormone (HGH) is produced in the anterior lobe and does not control
the activities of other glands. Instead, HGH is the hormone that builds bone
tissue during the growth years. If there is hypersccretion of HGH before the
closure of epiphyseal plates a generalized increase in body size takes place,
particularly in the long bones of children (gigantism). This condition is also
known as hyperpituitarism. It can be correctcd by early diagnosis in childhood.
On the other hand, excessive HGH secretion after the epiphyseal closure
will cause a chronic disease characterized enlargements of bones and soft
tissues of the extremities (acromegaly).
If HGH is normal childhood hut low in adult life (hypopituitarism ), the
individual will not receive enough hormone needed to stimulate the protein
building activities of the body. This results in wasting away of tissues (atrophy),
which may lead to a rare condition called Simmond disease, or pituitary cachexia.
Neurohypophisis
The principal abnormality associated with the dysfunction of the posterior
lobe, the neurohypophysis, is diabetes insipidus. Damage of the hypothalamus
can result in hyposecretion of ADH - antidiuretic hormone, or vasopressin.
Deficient antidiuretic hormone causes the tubules to fail in reabsorbing the
needed water and salts. Clinical symptoms include excretion of large amounts
of urine (polyuria) and subsequent excessive thirst Treatment includes administration of synthetic preparations of ADH into the nose several times a day.
This disease should not be confused with diabetes a disorder of the pancreas
which involves sugar metabolism.
Inappropriate ADH (IADH,) or excessive secretion of antidiuretic hormone
produces excess water retention in the body. Treatment consists of dietary
water restriction. Tumour, drug reactions, and head injury are some of the
possible factors.

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Pancreas
Diabetes mellitus is a disorder of carbohydrate metabolism, characterized
by increased blood sugar (hyperglycemia) and the presence of glucose in the
urine (glycosuria).
In most cases diabetes mellitus is the result of a genetic disorder. The
basic cause is still unknown but the direct cause is failure of the pancreas
to secrete an adequate amount of insulin (hypoinsulinism). Another cause of
diabetes may be an inadequate utilization of insulin. Besides hyperglycemia
and glycosuria other symptoms include excessive urine production (polyuria),
increase in food intake (polyphagia), and excessive thirst (polydipsia).
When severe diabetes is allowed to progress without proper treatment, a
sweet breath odour may be noted along with other progressive symptoms of
intoxication and delirium. All of these are followed by a deep coma and finally
death.
There are two major types of diabetes mellitus:
Type I diabetes, insulin dependent (IDDM or juvenile-onset diabetes), seen
mostly in children and adolescents, involves destruction of the beta cells of the
islets of Langerhans with complete deficiency of insulin in the body. Patients
are usually thin and require frequent injections of insulin to maintain a normal
level of glucose in the blood.
Type II diabetes, non-insulin dependent (NIDDM or adult- onset diabetes),
is a separate disease from Type I, with a different inheritance pattern. Patients
are usually older, and obesity is very common. The islets of Langerhans are
not destroyed, and there is a relative deficiency of insulin secretion with resistance of target tissue to the action of insulin. Treatment is with diet, body weight
reduction, and, when necessary, administration of insulin or oral hypoglycemic agents that can stimulate the release of insulin from the pancreas and
improve the bodys sensitivity to insulin.
Diabetes is associated \with both primary and secondary complications:
Primary complications include ketoacidosis (fats are improperly burned
leading to accumulation of ketons in the body) and hyperosmolar coma, a condition when blood sugar concentration (osmolarity) gets too high or the patient
receives insufficient amounts of insulin. Hypoglycemia can occur when too
much insulin is taken by the patient.
Secondary (long-term) complications occur many years after the patient
develops diabetes. These include destruction of the blood vessels of the retina
169

of the eyes (diabetic retinopathy), causing visual loss and blindness; destruction of the kidneys (diabetic nephropathy), causing renal insufficiency and often
requiring haemodialysis or renal transplantation; destruction of blood vessels,
with atherosclerosis; and destruction of nerves (diabetic neuropathy) involving
pain or loss of sensation, most commonly in the extremities.
Hyperinsulinism is an excess of insulin. This condition may be caused by a
tumour of the pancreas (benign adenoma or carcinoma) or overdose of insulin.
Excess insulin draws sugar out of the bloodstream, resulting in hypoglycemia.
Fainting spells, convulsions, and loss of consciousness are common because
a minimum level of blood sugar is necessary for proper mental functioning.
Reactive hypoglycemia occurs after ingestion of glucose or a meal. This is
due to an abnormality in the timing of insulin secretion in response to a meal,
and is distinct from the type of hypoglycemia seen with hyperinsulinism.
Other Related Terms
diuresis

increased formation and secretion of urine

hirsutism

abnormal hairiness, especially in women

hypervolemia

abnormal increase in the volume of circulating fluid in

the blood

insulinoma

tumour of the islets of Langerhans of the pancreas

obesity

excessive accumulation of fat above the bodys physical

standards

thyroid storm

crisis of uncontrolled hyperthyroidism; thyrotoxic crisis

virilism

masculinisation in a woman; development of male

secondary sex characteristics in a woman.

170

For brief reference to abnormal conditions of the endocrine glands, refer

to the table below.

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EXERCISES
1.1. The endocrine system is made up of the following glands: ...............................
..........................................................................................................................................................................

1.2. Make a comparison between the endocrine and nervous systems:

..........................................................................................................................................................................

2. Fill in the correct term:

2.1. Some examples of exocrine glands are sweat, digestive, and .........................
........................................................................................................................................................

glands.

2.2. The ............................................................ gland is referred to as the master gland.

2.3. Ovaries produce .......................................... while the testes secrete ..........................
2.4. The thymus gland is an ................................................ organ located in the upper
mediastinal ...............................................................................................................................................
3. Give the opposite of each term:
3.1. hypersecretion ......................................

3.6. infancy ........................................................

3.2. endocrine .................................................

3.7. deterioration ...........................................

3.3. prolonged .................................................

3.8. to lose .........................................................

3.4. goitre ...........................................................

3.9. complicated ............................................

3.5. inhibit ..........................................................

3.10. minimum ................................................

4. Match the following terms with their meanings:

4.1. hypoparathyroidism ...........................

a) protrusion of the eyes

4.2. hirsutism ..................................................

b) removal of the adrenal gland

4.3. adrenalectomy .......................................

c) hyposecretion of the parathyroids

4.4. exophthalmos ........................................

d) excessive hair growth

4.5. pheochromocytoma ...........................

e) tumour occurring in the adrenal

medulla

5. Give the meanings for the following terms:

5.1. hirsutism ..........................................................................................................................................
5. 2. cretinism .........................................................................................................................................
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5. 3. myxedema ......................................................................................................................................
5. 4. Cushing disease ..........................................................................................................................
5. 5. diabetes mellitus ........................................................................................................................
5. 6. progesterone .................................................................................................................................
5. 7. vasopressin ....................................................................................................................................
5. 8. acromegaly ....................................................................................................................................
5. 9. thymitis .............................................................................................................................................
5.10. exacerbation ................................................................................................................................
6. Provide the adjective form for each of the following:
6.1. hormone ...................................................

6.6. exophthalmos ........................................

6.2. metabolism .............................................

6.7. cretinism ...................................................

6.3. responsibility ..........................................

6.8. fatigue ........................................................

6.4. resorption .................................................

6.9. kidney .........................................................

6.5. pancreas ...................................................

6.10. diabetes ..................................................

7. Provide the singular form of the following nouns:

7.1. hormones .................................................

7.6. striae ...........................................................

7.2. ovaries ........................................................

7.7. adenomata ...............................................

7.3. medullae ...................................................

7.8. leaves ..........................................................

7.4. cortices ......................................................

7.9. negroes ......................................................

7.5. thyroidectomies ....................................

7.10. hypophyses ...........................................

8. Give appropriate medical term of the following:

8.1. inflammation of the adrenal glands .................................................................................
8.2. any disease of the adrenal glands .....................................................................................
8.3. pertaining to the formation of glycogen .........................................................................
8.4. excessive presence of hair in unusual places ............................................................
8.5. an excessive amount of insulin in the blood ................................................................

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8.6. surgical fixation of an enlarged thymus in a new position ..................................

8.7. increase in food intake .............................................................................................................
8.8. excessive urine production ....................................................................................................
8.9. a test measuring the glucose levels in a blood sample from a fasting
patient ..........................................................................................................................................................
8.10. pictures obtained from ultrasound waves .................................................................
9. Translate into Croatian:
Hypoglycemia is an abnormally low level of sugar (glucose) in the blood.
Anyone who has not eaten for quite a while may experience the symptoms o
flow blood sugar. True chronic hypoglycemia, however, is not very common.
There are two types of hypoglycemia. The most common form is reactive
hypoglycemia. In this condition, the blood sugar level drops sharply several
hours after a large portion of sugar or starches has been consumed. When
sugar is eaten, the pancreas is normally stimulated to produce the hormone
insulin which enables the body to use the sugar. However, in reactive hypoglycemia the pancreas continues to produce insulin long after the need has
passed. The result is abnormally low blood sugar levels.
The other type of hypoglycemia, fasting hypoglycemia, may occur during
pregnancy, strenuous exercise, and infectious accompanied by fever. All of
these situations increase the bodys need for sugar; if sugar intake is not
increased, temporary hypoglycemia may result. Disorders of the liver may
also lead to fasting hypoglycemia. This is especially common in heavy drinkers,
since alcohol upsets the sugar release response in the liver. Consequently,
alcoholics are at a greater risk of developing fasting hypoglycemia.
(From: Ellis, J. W. Medical Symptoms and Treatments)
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174

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CHAPTER 13

FEMALE REPRODUCTIVE SYSTEM

1. Reproduction
Reproduction means the process by which a living entity or organism
produces a new individual of the same kind. The gonads, or sex glands - the
ovaries in the female and the testes in the male - produce the germ cells
(gametes) that unite and grow into a new individual. Reproduction begins when
the germ cells unite, which is a process called fertilization.
The germ cells are the male spermatozoon and the female ovum, or egg.
These are specialized cells differing primarily from normal body cells in one
important way. Each sex cell contains exactly half the number of chromosomes that a normal body cell contains. When the ovum and spermatozoon
unite, the cell produced receives half of its genetic material from its female
parent, and half from its male parent; thus it contains a full, normal complement of hereditary material.
Maturation of an ovum is a process controlled by hormones secreted by the
females endocrine glands. An ovum, after leaving the ovary, travels down a
duct (uterine or fallopian tube) leading to the uterus (womb). If coitus (copulation, sexual intercourse) has occurred and sperm cells are present in the
uterine tube, union of the ovum and spermatozoon may take place. Ordinarily
only one ovum matures alternatively from each ovary during one menstrual
cycle. However, if by chance two eggs have been released and are fertilized
by two sperm, fraternal twins are formed. Identical twins are reproduced by
a single fertilized egg that divides into two eggs early in its development.
Fertilization can occur only on the average of 4 days of every menstrual
cycle. The mature ovum lives only l or 2 days after ovulation, and the sperm
have about the same amount of time before they perish in the female reproductive tract. The fertilized egg, which is now called the embryo (and fetus
after the second month) then begins a 9-month period of development (gestation, pregnancy) within the uterus.
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The female reproductive system consists of organs that produce ova and
provide a place for the growth of the embryo. In addition, the female reproductive organs supply important hormones that contribute to the development
of secondary sex characteristics (body hair, breast development, structural
changes in bones and fat).
Ova are produced by the ovary from the onset of puberty (beginning of
the fertile period when secondary sex characteristics develop) to menopause
(cessation of fertility and diminishing of hormone production). If fertilization
occurs at any time during the years between puberty and menopause, the
fertilized egg may grow and develop within the uterus. Various hormones are
secreted from the ovary and from a blood-vessel-filled organ, placenta, that
grows in the wall of the uterus during pregnancy. If fertilization does not occur,
hormone changes result in the shedding of the uterine lining, and bleeding,
or menstruation, occurs.
Ovarian hormones that play important role in the process of menstruation
and pregnancy, and in the development of secondary sex characteristics, are
estrogen and progesterone. Other hormones that arc responsible for the functions of the ovaries, breasts and uterus, are secreted by the pituitary gland.
Gynecology is the study of the female reproductive system (organs,
hormones, and diseases); obstetrics is a specialty concerned with pregnancy
and delivery of the baby; and neonatology is the study and treatment of the
newborn child.
2. Major Organs of the Female Reproductive System
The female reproductive system consists of internal and external organs
of reproduction. The internal or essential organs for reproduction are the
ovaries, fallopian tubes, uterus, and vagina or birth canal. The external genitalia include the labia majora, labia minora, clitoris, vestibule of the vagina,
and the greater vestibular glands or Bartholin glands. The combined structures of the external genitalia are known as the vulva.
Both the cervix of the uterus and vagina are lubricated by the mucous secretions of Bartholin glands. A fold of membrane, the hymen, is sometimes found
partially covering the orifice of the virginal vagina. A hymen may be ruptured
at the first sexual intercourse, even though there have been cases in which
pregnancies have occurred without any ruptures.
Ovaries
The reproductive system is linked to the bodys system of endocrine glands
by the ovaries. Besides producing the ova, the ovaries secrete the female sex

177

hormones estrogen and progesterone. These hormones influence the bodys

development and general functioning as well as the sexual function.
The two ovaries, each about the size of a small plum, lie on each side of
the pear-shaped uterus at its wider upper part. Within each ovary are thousands of small sacs called graafian follicles. Each graafian follicle contains an
ovum. When an ovum is mature, the graafian follicle ruptures to the surface
of the ovary, breaks through its own outer covering, and is released. Release
of an egg cell, called ovulation, occurs about once in 28 days. The ruptured
follicle fills first with blood, and then with a yellow fatlike material. It is then
called the corpus luteum (yellow body).
Figure 13.1. Female reproductive organs

Fallopian tubes
Fallopian tubes, oviducts, salpinges (sg. salpinx), or uterine tubes, extend
laterally from superior angles of the uterus. They transport the ovum from the
ovary to the uterus by rhythmic contractions of the tube walls and by the cilia of
the mucous membrane lining. The opening of the tubes near the ovaries o pens
directly into the uterus. Each oviduct is a muscular tube and consists of the
same three layers found in the uterus: mucosa, serosa and a layer of smooth
muscle. In addition to conveying the ovum, an oviduct provides a passageway
through which sperm travel from the uterus toward the ovary. It is within the
uterine tube that fertilization takes place while the ovum is moving through
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the tube. It usually takes the ovum about 5 days to pass through the uterine
tube. If coitus takes place near the time of ovulation and no contraception is
used, there is a likelihood that sperm cells will be in the uterine tube when
the egg cell is passing through. If fertilization has not occurred, the ovum
remains unfertilized and, after a day or two, disintegrates.
Uterine tubes and ovaries are called the adnexa (accessory structures) of
the uterus.
Uterus and Vagina
Uterus is a hollow muscular pear-shaped organ, with muscular walls and
mucous membrane lining filled with a rich supply of blood vessels. This organ
is capable of stretching to contain a fertilized ovum as it grows through the
9 months of pregnancy. The uterus is located in the pelvic area between the
bladder and rectum. The rounded upper portion of the uterus is called the
fundus, while the larger central section is the corpus (body of the organ). The
specialized epithelial mucosa of the uterus is called the endometrium; the
middle, muscular layer is the myometrium; and the outer membraneous tissue
layer is the perimetrium. The uterus is also adapted to hold the unborn infant
securely and to nourish it. When the ovum arrives, the hormones estrogen and
progesterone produced in the ovary have previously stimulated the uterus to
prepare its lining with extra blood. If the egg has not been fertilized it loses
its vitality, the hormone supply ceases, and the extra blood and tissues are
discharged from the body through the vagina in the menstrual flow. The lower
end of the uterus forms an opening called the cervix, or neck, which protrudes
into the birth canal or vagina.
Vagina is a muscular tube about seven and one-half cm long, and its lining
consists of a mucous membrane fold that gives the organ its elastic quality.
It extends from the cervix to the exterior of the body. Besides serving as the
organ of sexual intercourse, and receptor of semen, the vagina discharges
the menstrual flow. Like the uterus, the vagina undergoes changes during
pregnancy that enable it to stretch to many times its usual size, allowing the
infant to pass through it in childbirth (parturition).
3. Breasts - Accessory Organ of Reproduction
The breasts or mammary glands are located in the upper anterior aspect
of the chest. During puberty the glands begin to develop as they are exposed
to periodic stimulation of two ovarian hormones, estrogen and progesterone.
Estrogen is responsible for the fatty growth and increased size of the mammary
glands as they reach full maturity. The size of the breast is basically determined by the amount of fat around the glandular tissue and is not indicative
179

of its functional ability. The other ovarian hormone progesterone forms the
lobules that are present in the breast. Each mammary gland has approximately
20 lobes of glandular tissue. These lobes raise nipple. Circling the nipple, there
is a border of slightly darker skin referred to as the areola.
Full development of the breasts is achieved by the time female reaches
the age of sixteen. The main purpose of the mammary glands is secretion of
milk for nourishment of the newborn infant. During pregnancy, the hormones
from the ovaries and the placenta stimulate glandular tissue in the breasts to
their full development. After parturition (childbirth) hormones from the pituitary gland stimulate the production of milk (lactation).
Figure 13.2. View of sagittal cut through breast

4. Menstrual Cycle and Menopause

The menstrual cycle consists of a series of events that are associated with
the maturation of the ovum. Approximately every 28 days the endometrium,
the lining of the uterus, is prepared to receive a fertilized egg. If no fertilization, or conception occurs, the endometrium along with the unfertilized ovum
is released from the body. The periodic discharge from the vagina of blood
and tissues from a nonpregnant uterus is called menstruation. Menstruation
occurs monthly, actually every 28 days or so from puberty to menopause. If
the mature egg is fertilized, menstruation will not take place and the ferti180

lized ovum implants itself upon the uterine wall and continues to develop
within the uterus.
Menopause is the span of time during which the menstrual cycle diminishes and gradually stops. It is also called climacteric. During this period the
ovaries stop functioning and therefore menstruation and childbearing cease.
It is a natural physiologic process that results from the normal aging of the
ovaries and occurs when the ovaries can no longer perform the function of
ovulation and estrogen production. It usually begins between 40 and 50 years
of age and its duration varies from 6 months to 3 years.
5. Pregnancy and Labour
If fertilization does occur in the uterine tube, the fertilized egg begins to
change immediately after. Soon the egg is dividing into a cluster of two, then
four, then more cells, as it makes its way down the uterine tube toward the
uterus for implantation. By the time the egg reaches the uterus, in 3 to 5 days,
the cells are formed in the shape of a minute ball, hollow on the inside with
an internal bump at one side where the embryo will form. This aggregation
of cells, called a blastocyst, quickly buries itself in the lining of the uterus,
which is the process known as implantation.
As soon as the blastocyst is implanted, its wall begins to change into a
structure that eventually develops into the placenta. Through the placenta the
fetus secures nourishment from the mother and rids itself of waste products.
Essentially the placenta is a filtering mechanism by which mothers blood is
brought close to the fetal blood without the actual mixing of blood cells.
The outermost membrane which surrounds the developing embryo is called
the chorion and the innermost is the amnion. The amnion contains the fetus
surrounded by the amniotic fluid. The amnion and fluid are sometimes known
as the bag of water which breaks to signal the onset of labour.
The placenta, also known as the afterbirth because it becomes detached
from the uterus after delivery, produces its own hormone as it develops in the
uterus. This hormone is called human chorionic gonadotropin HCG, or pregnancy hormone, and it stimulates the corpus luteum to continue producing
hormones until about the third month of pregnancy, when the placenta itself
takes over the endocrine function and releases estrogen and progesterone.
During the early stages of pregnancy, the future child grows at an extremely
rapid rate. The mothers body must undergo profound changes to support
this organism. The muscles of the uterus grow, the blood volume expands,
the work of the heart increases, the breasts prepare for lactation and other
adjustments are made throughout the mothers body.

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The average duration of pregnancy or the gestation period is about 280 days,
or 9 calendar months, although it may vary considerably from that average.
The events of menstruation and pregnancy are dependent not only upon
hormones from the ovary (estrogen and progesterone) but also on hormones
from the pituitary gland. These pituitary gland hormones are follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These two hormones
stimulate the development of the ovum and ovulation. After ovulation, LH in
particular influences the maintenance of the corpus luteum and its production of estrogen and progesterone.
Labour, or childbirth, is the physiologic process by which the fetus is
expelled from the uterus. It occurs in three stages: (l) opening or dilation of
the cervix is the time from the onset of labour to complete dilation of the cervix
(about 10 cm); (2) the second stage is called the expulsion stage during which
the baby must be pushed through and out of the vagina; (3) the third stage is
the stage of separation and expulsion of the placenta; in this final stage the
placenta detaches itself from the uterine wall and is expelled.
Key Terms
adnexa accessory parts of the uterus: the fallopian tubes and the
ovaries
amnion the innermost membrane around the developing embryo
areola dark-pigmented area around the breast nipple
chorion outermost layer of the two membranes surrounding the
embryo; it is part of the placenta
cyesis - pregnancy
embryo stage in development from fertilization of the ovum through
the 2nd month of pregnancy
endometrium the inner mucous membrane lining the uterus
estrogen ovarian hormone responsible for secondary sex
characteristics
fallopian tubes ducts through which the egg travels after its release
from the ovary (oviducts, uterine tubes, salpinges)
fertilization union of the sperm and the ovum (fusion of two nuclei
occurs)
fetus the embryo from the 3rd month (after 8 weeks) to birth
fimbriae (pl. fimbria) finger-like ends of the fallopian tubes)
gamete sex cell; the sperm and the ovum
gestation pregnancy
gonads organs in the male and female that produce gametes; ovaries
and testes
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 graafian follicle developing sac enclosing each ovum within the ovary;
only about 400 of these sacs will mature in a womans lifetime
lactiferous ducts tubes that carry milk within a breast
menarche the beginning of the first menstrual period during puberty
myometrium the muscle layer lining the uterus
ovaries female gonads
ovulation release of the ovum from the ovary
ovum (pl. ova) egg cell; female gamete
parturition the act of giving birth
perimetrium the membrane surrounding the uterus
perineum in females, the area between the anus and the vagina
placenta vascular organ that develops during pregnancy in the uterine
wall and serves as a communication between the maternal and the fetal
bloodstream
progesterone hormone produced by the corpus luteum in the ovary and
the placenta of pregnant women
puberty beginning of the fertile period when gametes are produced and
secondary sex characteristics appear
tocia - childbirth
uterus womb; muscular organ in which the embryo develops
vagina birth canal; a tube extending from the uterus to the exterior of
the body
Combining Forms Meaning

Terminology

amni/o

amnion

amniocentesis = surgical puncture of

amniotic sac

colp/o
vagin/o

vagina

colposcopy = visual examination of birth

canal
vaginocele = vaginal hernia

galact/o
lact/o

milk

galactorrhea = persistent discharge of

milk
lactogen = forming or producing milk

gynec/o

woman,
female

gynecology = specialisation in female

reproductive system

hyster/o
metr/o
metri/o
uter/o

womb,
uterus

hysterectomy = removal of the uterus

metrorrhagia = excessive uterine
bleeding
uterine = pertaining to the uterus

183

mamm/o
mast/o

breast

mammogram = radiograph of the breast

mastitis = inflammation of breast tissue

men/o

menstruation menorrhagia = escessive menstrual flow

myom/o

muscle
tumour

myomectomy = removal of fibroids from

uterus

nat/o

birth

prenatal = before birth

obstetr/o

midwife

obstetric = pertaining to midwifery

o/o
ov/o
ovul/o

egg

oogenesis = formation of an egg cell

ovum = egg
ovulation = release of the egg

oophor/o
ovari/o

ovary

oophorectomy = removal of the ovary

ovarian = pertaining to the ovary

salping/o

uterine tubes salpingoplasty = surgical repair of a fallooviducts

pian tube
fallopian
tubes

Disorders of the Female Reproductive System

1. Breast and Gynecological Conditions
amenorrhea

absence of menstrual flow

breast cancer

malignant tumour of the breast; the most common

type of canceramong women

cervical cancer

malignant tumour of the uterine cervix; one of the

most common malignancies affecting women

cervicitis

inflammation of the cervix

chronic cystic mastitis inflammation of the breast tissue; fibrocystic

breast disease
dysmenorrhea

painful menstruation

endometrial carcinoma malignant tumour of the inner lining of the uterus

endometriosis

endometrial tissue found in abnormal locations

(e.g. ovaries, cul-de-sac, pelvic peritoneum, small
intestine)

fibroids

benign tumours of the uterus; leiomyomas

menorrhagia

excessive bleeding during regular menstrual flow

184

metrorrhagia

significant uterine bleeding between menstrual

periods

ovarian carcinoma

malignant tumour of the ovary

ovarian cysts

collections of fluid within a sac (cyst) in the ovary

pelvic inflammatory
disease (PID)

inflammation of the pelvic region; salpingitis

2. Pregnancy and Childbirth

abortion

termination of pregnancy before the embryo or

fetus is capable o of surviving outside the uterus

abruption placentae

premature separation of a normally situated

placenta

breech presentation

abnormality of delivery in which the fetal buttocks

or feet present first rather than the head

caesarean section

removal of the fetus by abdominal incision into the

uterus

Down syndrome
trisomy 21

congenital condition characterized by physical

malformations and certain degree of mental retardation (three rather than two copies of chromosome 21)

dystocia

difficult labour

eclampsia

serious form of toxaemia during pregnancy

ectopic pregnancy

implantation of the fertilized egg in any site other

than the normal uterine lining

fetal erythroblastosis

haemolytic disease of the newborn due to Rh

incompatibility

gravida

pregnant woman

hydrocephalus

accumulation of fluid in brain ventricles (chambers)

kernicterus

high levels of bilirubin in the bloodstream of

neonates

placenta praevia

placental implantation over the cervical opening

or the lower region of the uterine wall

premature birth

when a live infant is born between 20th and 35th

week of pregnancy

185

puerperium

the period of 42 days following childbirth and

expulsion of the placenta and membranes

pyloric stenosis

narrowing of the pyloric sphincter

3. Other Related Terms

atresia
dyspareunia
infertility
oligomenorrhea
parturition, partus
pyosalpinx
sterility

congenital absence or closure of a normal body

opening
painful sexual intercourse
inability or diminished capacity to produce
offspring
scanty or infrequent menstrual flow
childbirth, the process of giving birth; delivery
pus in the fallopian tube
inability of the female to become pregnant or the
male to impregnate the female

EXERCISES
1.1. The main functions of the female reproductive system are:
..........................................................................................................................................................................

1.2. The function of the breasts is ...............................................................................................

2. Complete the following sentences:
2.1. Fertilization can occur only on the average of 4 days of every .........................
..........................................................................................................................................................................

2.2. The germ cells are the male ....................... and the.......................................... female
2.3. Beside producing the ova, the ovaries secrete ..........................................................
2.4. The study of female reproductive system is called .................................................
2.5. Julius Cesar is said to have been born by ....................................................................
3. Give the opposite of each term:
3.1. similar ........................................................

3.6. give ...............................................................

3.2. resemble ...................................................

3.7. complete ...................................................

3.3. young ..........................................................

3.8. careful ........................................................

3.4. male .............................................................

3.9. complicated ............................................

186

3.5. health ..........................................................

3.10. wealth ......................................................

4. Match the following terms with their meanings:

4.1. mastitis ......................................................

a) muscular layer of the uterus

4.2. myometrium ...........................................

b) release of egg from ovary

4.3. menorrhagia ...........................................

c) union of egg and sperm cells

4.4. fertilization ..............................................

d) inflammation of the breast

4.5. ovulation ...................................................

e) excessive bleeding during

menstruation

5. Give the meaning of the following terms:

5. 1. ectopic pregnancy ......................................................................................................................
5. 2. placenta ...........................................................................................................................................
5. 3. breech presentation .................................................................................................................
5. 4. C-section .........................................................................................................................................
5. 5. areola ................................................................................................................................................
5. 6. menopause ....................................................................................................................................
5. 7. dystocia..............................................................................................................................................
5. 8. amnion ..............................................................................................................................................
5. 9. salpingitis .......................................................................................................................................
5.10. perineum .......................................................................................................................................
6. Provide the plural form of the following nouns:
6.1. ovum ............................................................

6.6. placenta .....................................................

6.2. uterus .........................................................

6.7. corpus ........................................................

6.3. salpinx ........................................................

6.8. endometrium .........................................

6.4. fetus .............................................................

6.9. body .............................................................

6.5. cervix ...........................................................

6.10. amnion ....................................................

187

7. Provide the adjective forms of the following nouns:

7.1. uterus .........................................................

7.6. amnion .......................................................

7.2. ovum ............................................................

7.7. ovary ............................................................

7.3. menstruation .........................................

7.8. cervix ...........................................................

7.4. breast ..........................................................

7.9. cortex ..........................................................

7.5. gamete .......................................................

7.10. labium ......................................................

8. Give appropriate medical word for the following:

8.1. pregnancy sustaining hormone ..........................................................................................
8.2. finger-like processes surrounding the abdominal opening of each
uterine tube ..............................................................................................................................................
8.3. removal of an ovary ....................................................................................................................
8.4. yellow body ......................................................................................................................................
8.5. mongolism .......................................................................................................................................
8.6. inflammation of an ovary ........................................................................................................
8.7. innermost embryonic membrane ......................................................................................
8.8. accessory parts of the uterus ..............................................................................................
8.9. cessation of a womans reproductive function ...........................................................
8.10. the embryo from the beginning of the third month...............................................
9. Translate into Croatian:
Drugs in Pregnancy
Since the tragic crippling of thousands of unborn children in the late 1950s
by the tranquilizer thalidomide, the use of drugs during pregnancy has
become a highly controversial issue. Thalidomide was prescribed as a mild
sedative for pregnant women until its disastrous side effects became obvious.
The history of this drug has shown why it is impossible to rely solely on animal
tests in studying the effects of drugs in pregnant women. Humans were found
to be over 700 times more sensitive to thalidomide than hamsters, for example.
Even enormous doses of the drug given to several species of animals failed to
produce the severe crippling, disfigurement, and limb deletion that the drug
causes in humans.

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The effects of drugs in the fetus depend upon the particular drug (or combination of drugs), the dosage, and most importantly, the stage of fetal development. Embryonic cells multiply and grow rapidly while food exchange and
waste elimination occur through simple diffusion. Therefore, drugs capable
of rapid cellular diffusion introduced during this period may cause significant
embryonic alterations. Between the fifth and eighth weeks, drug action can
cause abnormal tissue and/or organ differentiation. Timing is vital, with the
most severe effects occurring in the nervous system between days fifteen to
twenty-five; in the heart between days twenty to forty; in the legs between days
twenty-four to thirty-six; and in the eyes between days twenty-four to forty. The
major parts of the body have usually been differentiated by the eight week of
pregnancy, and the danger of drugs diminishes. Some effects, like smoking,
are cumulative, however. Most authorities now recommend that the ingestion of all drugs and medications, including over-the-counter and prescription
drugs, be kept to a minimum or totally eliminated during all stages of pregnancy, unless such medications are considered necessary by the physician.
Pharmacogenetics, the study of the interrelationship of hereditary constitution and drug responses, has become an important specialty as a result of
these concerns.
(From: Carrol Ch. and Miller D.: Health, the Science of Human Adaptation.)
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CHAPTER 14

MALE REPRODUCTIVE SYSTEM

Introduction
The male reproductive organs consist of the external genitalia: a pair of
testes, scrotum and penis; accessory glands that secrete special fluids: the
prostate, two seminal vesicles, a pair of bulbourethral glands known also as
Cowpers glands, and the ducts through which these organs and glands are
connected to each other and through which the spermatozoa are ejaculated
during coitus, seminiferous tubules, epididymis, vasa deferentia and urethra.
Apart from providing structures necessary to transport and maintain sperm
viable, the male reproductive system produces the male sex cells, spermatozoa or sperm, which contain one half of the genetic material necessary to
produce a living being.
The male sex cell, the spermatozoon (pl. spermatozoa = sperm cells) is
a microscopic, relatively uncomplicated cell, composed of a head region,
which contains nuclear hereditary material (chromosomes), and a tail region,
consisting o a flagellum, or a long whiplike tail used for locomotion. The s
perm cell contains relatively little food and cytoplasm, for it needs to live only
enough to travel from its point of release from the male to where the egg
cell lies within the female (uterine tube). Only one spermatozoon of about
200 to 500 million s perm cells which may be released during a single ejaculation (ejection of sperm and fluid from the male urethra) can penetrate a
single ovum and produce fertilization of the ovum. If more than one egg is
passing down the uterine tube when sperm are present, multiple fertilizations are possible, and twins, triplets, quadruplets, and so forth may occur.
Twins resulting from the fertilization of separate ova by separate sperm cells
are called fraternal twins. Fraternal twins, developing in utero with separate
placentas, have individual patterns of inheritance and resemble each other
no more than ordinary brothers and sisters.

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Identical twins are formed from the fertilization of a single egg cell by
a single sperm. As the fertilized egg cell divides and forms many cells, it
somehow comes a part and each part continues separately to undergo further
division, each producing an embryo. Both embryos share the same placenta.
Identical twins are always of the same sex and very similar in form and feature
(physique).
All body organs contain parenchyma (parenchymal cells or tissue) which
perform the essential functions of the organ. Organs also contain supportive,
connective, and framework tissue, such as blood vessels, connective tissues,
and sometimes muscles as well. This supportive tissue is called stroma
(stromal tissue).
Anatomy of the Male Reproductive System
The male gonads consist of a pair of testes, also called testicles, which
develop in the kidney region of the body before descending during fetal development into the scrotum, a sac enclosing the testes on the outside of the body.
The testes produce the sperm cells and the male hormone testosterone, which
gives a sexually mature male his distinctively masculine characteristics and
his sexual energy and drive (libido). The interior of a testis is composed of a
large mass of narrow, coiled tubules called the seminiferous tubules. These
tubules contain cells which manufacture spermatozoa.
The seminiferous tubules are the parenchymal tissue of the testis, which
means that they perform the essential work of the organ. Other cells in the
testis, called interstitial cells, manufacture the male hormone testosterone.
As soon as they are formed, sperm cells move through the seminiferous
tubules and are collected in ducts which lead to a large tube at the upper part
of each testis. This is the epididymis. The spermatozoa become motile in the
epididymis and are temporarily stored there. The epididymis runs down the
length of the testicle and then turns upward again and becomes a narrow,
straight tube called the vas deferens (seminal duct or ductus deferens). The
vas deferens carries the sperm up into the pelvic region, around the urinary
bladder, and then into a duct leading toward the urethra. It is the vas deferens that is cut or tied off when a sterilization procedure called a vasectomy
is performed.
The seminal vesicles are glands which are located at the base of the bladder
and they open into the vas deferens as it joins the urethra. The seminal vesicles secrete a thick, yellowish substance that nourishes the s perm cells and
forms much of the volume of ejaculated semen. Semen is a combination of
fluid and spermatozoa which is ejected from the body through the urethra.

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In the male, as opposed to the female, the genital orifice combines with the
urinary opening (meatus).
Figure14.1. The Male Reproductive System

Each epididymis is connected to a vas deferens, a part of the spermatic cord

that conducts the spermatozoa to the duet lying close to the bladder. The vasa
deferentia join with ducts leading from the seminal vesicles just before the
urethra. The combined duet is called the ejaculatory duct. This duct passes
through the prostate and joins with the urethra. The urethra then conducts
the semen through the penis.
The prostate gland secretes a thick fluid which, as part of semen, aids the
motility of the sperm. This gland is also supplied with muscular tissue which
aids in the expulsion of sperm during ejaculation. Cowper glands, or bulboure193

thral glands, are located just below the prostate and they secrete an alkaline
fluid into the urethra that is necessary for the viability of the sperm.
The urethra expels both semen and urine from the body, but during ejaculation, the sphincter at the base of the bladder is closed. This not only stops
the urine from being expelled with the semen, but also prevents the s perm
from entering the bladder.
The penis is the organ through which semen is transferred into the female
during coitus. The tissues that form the mass of the penis are called erectile tissue. This tissue is spongy in nature and filled with innumerable hollow
spaces. There is also a network of arteries and veins within the penis. Its tip
expands and forms a soft, sensitive region called the glans penis. Circumcision is the process whereby the foreskin is removed, leaving the glans penis
visible at all times.
Figure 14.2. The passage of sperm from the seminiferous
tubules in the testes to the outside of the body

Key Terms
flagellum (pl. flagella) hair-like process on a sperm cell enabling its
motility
parenchyma tissue composed of essential cells of an organ

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 perineum area between the anus and the scrotum in the male (vulva in
the female)
semen spermatozoa and fluid
seminiferous sperm-producing
sterilization any procedure rendering an individual incapable of
reproduction
stroma supportive, connective tissue of an organ.
Combining Forms Meaning

Terminology

cry/o

cold; ice

cryogenic surgery = surgical method

employing freezing

crypt/o

hidden

cryptorchism = undescended testicles

gon/o

seed

gonorrhoea = sexually transmitted

bacterial infection

gonad/o

sex glands

gonadopathy = disease of the sex glands

olig/o

scanty

oligospermia = decreased production of

sperm cells

orch/o
orchi/o
orchid/o
test/o

testis (pl.
testes)

orchitis = inflammation of testes

orchialgia = pain in the testes
orchidoptosis = prolapsed of the testes
testectomy = surgical removal of a testis

prostat/o

prostate
gland

prostatomegaly = enlargement of the

prostate gland

py/o

pus

pyorrhoea = flow or discharge of pus

sperm/o
spermat/o

spermatozoa, spermic = pertaining to sperm cell

semen
spermatocele = swelling containing
spermatozoa

terat/o

monster

teratoma = a tumour composed of

different types of tissue (e.g. bone, hair,
cartilage, skin)

varic/o

dilated vein

varicocele = collection of varicose veins

above the testes

vas/o

vessel, duct

vasectomy = removal of vas deferens

zo/o

animal life

azoospermia = absence of sperm cells in

the semen

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Disorders and Pathological Conditions of the Male Reproductive System and

Sexually Transmitted Diseases
adenocarcinoma
of the prostate

malignant tumour of the prostate; this is the most

common cause of cancer in men over 50 years of age;
radical prostatectomy and radiotherapy are common
methods of treatment

anorchidism
(anorchia)

congenital absence of one or more testes

balanitis

inflammation of the skin covering the glans penis

benign prostatic
hyperplasia
(hypertrophy)

overgrowth of glandular tissue of the prostate, often

associated with the aging process; as urethral lumen
is decreased causing a number of urinary problems
(cystitis, nephritis, etc.); surgical methods of removal
of the prostate gland include:
1. perineal prostatectomy (removal through the
perineum)
2. transurethral resection (TUR excision through the
urethra)
3. suprapubic prostatectomy (removal through the
opening in the upper bladder)

cryptorchism,
cryptorchidism

undescended testicles; the testes descend into the

scrotal sac normally about 2 months before birth;
if not, the condition is referred to as chriptorchism;
if they do not descend on their ownby the end of a
childs first year of life, correction involves surgical
suspension (orchyopexy) of the testes in the scrotum;
the condition may be unilateral or bilateral

epispadia

congenital opening of the urethra on the upper

surface of the penis

hydrocele

sac (hernia) of clear fluid in the scrotum or in the

tubes leading from the testes

hypospadia

congenital opening of the urethra on the

undersurface of the penis

phimosis

narrowing or stenosis of the opening of the foreskin

over the glans penis; the condition may interfere with
urination; treatment is by circumcision

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testicular carcinoma malignant tumour of the testes and ovaries; these

tumours are classified according to the type of tissue
that is involved in the disease; examples of testicular
carcinomas are seminoma, embryonal carcinoma,
choriocarcinoma, and teratocarcinoma (malignant
teratoma); the last one is composed of embryonic
tissue such as bone, hair, cartilage, and skin cells
and has an unpleasant or monster-like appearance;
the tumours are treated by surgery, radiotherapy and
chemotherapy
varicocele

swollen, enlarged, herniated veins near the testicles;

the condition is often associated with oligospermia
and infertility; oligospermic men with varicoceles
and scrotal pain should have a varicocelectomy; in
this procedure, the internal spermatic vein is ligated
(piece is cut out and ends are tied off), leading to a
marked increase in fertility.

Sexually Transmitted Diseases (STD, Venereal Diseases)

The following conditions, occurring in both men and women, are the most
communicable diseases in the world and are transmitted by sexual intercourse:
chlamydial
infection

bacterial infection of the urethra of men and the vagina

and cervix in women; men may experience dysuria and
a white or clear discharge from the penis; women may
develop a yellowish endocervical discharge, but often
the disease is asymptomatic

genital herpes

infection of the skin and mucosa of the genitals caused

by herpes virus (HSV) type II and sometimes type I; after
primary infection, numerous recurrent episodes of the
disease often follow; in more severe cases lesions may
occur within the vagina and cervix, with ulceration or
necrosis of tissue; in such cases there is higher incidence of cervical cancer; the disease is self-limiting and
there is no drug known to be effective as cure.

gonorrhoea

inflammation of the genital tract mucous membranes

caused by infection with gonococcus; other areas of the
body such as eye, oral mucosa, rectum, and joints may

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also be affected; symptoms include dysuria and yellow

mucopurulent discharge in men; some women carry
the disease asymptomatically, while others have pain,
vaginal and urethral discharge and salpingitis.
syphilis (lues)

chronic infectious disease affecting any organ of the

bodycaused by a spirochete Treponema pallidum
(spiral-shaped bacterium); it enters the body through
a break in the skin or mucous membrane; at the initial
stage the disease is referred to as primary syphilis;
about three weeks after exposure there is a development of a chancre, or a firm, hard, ulcerlike lesion;
in women the chancre usually appears on the labia or
within the vagina; secondary syphilis occurs about four
months after the disappearance of a chancre, which
may also appear on the lip, tongue, eyelid, or anus; the
secondary stage is characterized by a blotchy red rash
over the body; thin white sores appear on the mucosa
of the mouth, throat, and genital area; contagiousness
at this time is extremely high; tertiary syphilis, also
called late syphilis, may develop after the symptoms
of secondary syphilis disappear or it may lie dormant
for many years. Later stages include damage to the
brain, spinal cord, and heart. Syphilis (named after a
shepherd in an Italian poem) can be congenital in the
fetus if transmitted from the mother during pregnancy.

trichomoniasis

infection of the genitourinary tract of either sex, caused

by Trichomonas vaginalis, a one-celled organism. This
condition is more commonly found in women and causes
vaginitis, urethritis, and cystitis. In men, it causes prostatitis, cystitis, and urethritis, but most infected males
are asymptomatic carriers who are infectious to their
partners. Several medications are available for the
treatment of Trichomonas.

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EXERCISES
1.1. The organs of the male reproductive system are:.....................................................
..........................................................................................................................................................................

1.2. The main functions of the male reproductive system are:...................................

..........................................................................................................................................................................

2. Complete the following sentences:

2.1. Identical twins are formed from the fertilization of.................................................
.......................................................................................................................................................... sperm.

2.2. If more than one egg is passing down the uterine tube when s perm are
present.............................................................................................................................are possible.
2.3. Seminiferous tubules contain cells which produce ................................................
2.4. In the male the genital orifice combines with the ....................................................
2.5. The ejaculatory duet passes through the ......................................................................
and joins with the ..................................................................................................................................
3. Give the opposite of each term:
3.1. remember ................................................

3.6. humble .......................................................

3.2. start .............................................................

3.7. attach ..........................................................

3.3. guilt ..............................................................

3.8. true ...............................................................

3.4. accept .........................................................

3.9. identical .....................................................

3.5. implicit .......................................................

3.10. possible ...................................................

4. Match the following terms with their meanings:

4.1. testosterone ............................................

a) removal of the prepuce

4.2. circumcision ...........................................

b) prepuce

4.3. phimosis ...................................................

c) scanty sperm

4.4. oligospermia ..........................................

d) a hormone produced by
interstitial cells in testes

4.5. foreskin ......................................................

e) a narrowing or stenos is of
theprepuce

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5. Give the meaning of the following terms:

5.1. stroma ................................................................................................................................................
5.2. the prostate gland .......................................................................................................................
5.3. sperm cell ........................................................................................................................................
5.4. scrotum .............................................................................................................................................
5.5. Cowper glands ..............................................................................................................................
5.6. hypospadias ....................................................................................................................................
5.7. seminiferous tubules.................................................................................................................
5.8. teratocarcinoma of the testes ..............................................................................................
5.9. cryptorchism....................................................................................................................................
5.10. varicocele........................................................................................................................................
6. Provide the plural forms of the following nouns:
6.1. scrotum .....................................................

6.6. testis ............................................................

6.2. placenta .....................................................

6.7. vas deferens ...........................................

6.3. hernia .........................................................

6.8. teratoma ...................................................

6.4. epididymis ................................................

6.9. flagellum ..................................................

6.5. spermatozoon ........................................

6.10. semen ......................................................

7. Provide the adjective form of the following nouns:

7.1. embryo .......................................................

7.6. testis ............................................................

7.2. maturation ...............................................

7.7. prostate .....................................................

7.3. hernia .........................................................

7.8. syphilis .......................................................

7.4. ejaculation ...............................................

7.9. semen .........................................................

7.5. perineum ..................................................

7.10. urethra ....................................................

8. Give appropriate medical word for the following:

8.1. nuclear hereditary material ..................................................................................................
8.2. twins resulting from the fertilization of separate ova by separate sperm
cells................................................................................................................................................................

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8.3. the area between the anus and the scrotum at the floor of the pelvic
cavity..............................................................................................................................................................
8.4. the tubules containing cells which manufacture spermatozoa
..........................................................................................................................................................................

8.5. large tube at the upper part of each testis ...................................................................

8.6. a combination of fluid and spermatozoa which is ejected from the body
through the urethra .............................................................................................................................
8.7. congenital opening of the male urethra on the upper surface of the
penis .............................................................................................................................................................
8.8. a sac of fluid in the tubes leading from the testes ..................................................
8.9. chronic infectious disease caused by Treponema pallidum ..............................
..........................................................................................................................................................................

8.10. infection of the genitourinary tract caused by Trichomonas ..........................

..........................................................................................................................................................................

9. Translate into Croatian:

The Controversy of Sexually Transmitted Disease (STD)
Few diseases raise as much controversy as do the sexually transmitted
ones. In the mind of the general public, STD has become confused with the
method of its transmission. Indeed, we have so consistently identified this
disease with illegimate sex that anybody who gets it feels as though he were a
criminal, no matter how he got it. Some people claim there is never an innocent party to STD. But how else could we classify the husbands and wives
who contract STD from a cheating spouse? Some infected persons develop
so much guilt that they do not seek medical care. Others fear the public or
private censure sometimes dispensed by health professionals so they avoid
treatment. The tragedy of STD is two-fold: while many of the STDs are both
curable and preventable, they are not being cured in millions of cases, and
they are not being adequately prevented!
Many people are convinced that the epidemic of STD throughout the world
is evidence of widespread immorality and the decline of civilization. Some
are more concerned that hundreds of thousands of untreated individuals are
harbouring dangerous and damaging pathogens that possibly will be transmitted to unsuspected victims. Other view the increasing numbers of STD

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cases reported to public officials as evidence of increased personal and social

responsibility. It is hoped that infected people seek help because they want to
be cured and do not wish to give the disease to someone else. Still others look
upon the alarming statistics of incidence and attribute the current epidemic
to better case- finding and reporting techniques. Perhaps all viewpoints have
some merit. One thing is certain: most people are not going to stop having
sexual relations. If they do get STD and are not treated early, they are likely
to suffer severe physical damage, perhaps even death.
STD Warning Signals for Females
discharge: abnormal yellow or white vaginal discharge that causes
irritation or itching
burning upon urination: painful and frequent urination
sores: painless as well as painful sores or blisters in or around the
vagina, external sex organs, mouth, and rectum
bumps and lumps: painless vaginal warts, sometimes irritated by a
heavy discharge from the vagina
itching: intense itching in the genital area that may result in the
appearance of bumps and lumps
lower abdominal pain: with or without fever, this condition may indicate
serious pelvic inflammatory disease (PID)
STD Warning Signals for Males
- discharge: white, clear, or often thick yellowish discharge of pus from
the penis or from the rectum following anal intercourse
- burning upon urination: painful and frequent urination
- sores: painless as well as painful sores or blisters on the penis, around
the genital area, mouth, and rectum
- bumps and lumps: bumpy, painless warts; body rash; pimplelike
bumps on the penis, swelling of lymph nodes in the groin
- itching: intense itching particularly in the genital area.
(American Medical Association)
(From: Carrol Ch. and Miller D.: Health, the Science of Human Adaptation)
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CHAPTER 15

SENSE ORGANS THE EYE AND THE EAR

Both the eye and the ear are highly specialized sense organs. They provide
information regarding the external environment. The eye is the receptor for
light stimulation and is responsible for vision. The ear is the receptor of sound
stimulation and is responsible for hearing.
The Eye
The eye functions in a manner similar to that of a camera. Light rays
pass through a small opening and are focused by a lens upon photoreceptive surface. In a camera this surface is photographic film. In the eye, it is the
retina. The eye is a globe-shaped organ that is composed of three distinct
layers. Its outermost layer is the sclera. As the name suggests, it is a tough
fibrous tissue and serves as a protective shield for the more sensitive structures beneath.
The sclera is also known as the white of the eye. A highly vascular middle
layer, the choroid, provides a blood supply for the entire eye. The retina is the
innermost layer. It is chiefly composed of nerve endings that are responsible
for the reception and transmission of light impulses. A specialized portion of
the sclera, the cornea, passes in front of the lens. Rather than being opaque,
it is transparent in order to permit entrance of light into the interior of the eye.
One of the two major humours, or fluids of the eye is the aqueous humour.
The iris divides the aqueous humour into two small chambers, the anterior
chamber and the posterior chamber. A coloured, contractile membrane, the
iris, functions as a sphincter. Its perforated centre is the pupil. The amount of
light entering the eye is regulated by the size of the pupil. As the environmental
light increases, the pupil constricts; as the light decreases, the pupil dilates.
Located behind the posterior chamber is the lens. This crystalline structure
is suspended between the ciliary muscles. As the muscles relax or contract,
they alter the shape of the lens making it thicker or thinner, respectively, thus

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enabling the light rays to focus upon the retina. This process is called accommodation. The second major humour of the eye is the vitreous humour. This
clear jellylike fluid occupies the entire orbit of the eye behind the lens. The
vitreous humour, the lens and the aqueous humour are the refractive structures of the eye. They are responsible for the bending of light rays so that the
rays focus sharply upon the retina. If any of these structures do not function
properly, vision is impaired.
Figure 15.1. Components of the eye

OPTIC NERVE

RETINA

OPTIC DISC

CHOROID
SCLERA
IRIS
CORNEA
PUPIL
PATH OF LIGHT

MACULA

LENS

FOVEA
RETINAL ARTERIES
AND VEINS

VITREOUS CHAMBER

INSET

EYELID
SCLERA

PUPIL
IRIS

The retina is an extremely delicate eye membrane. It is continuous with

the optic nerve and has two types of light receptors upon its surface, rods and
cones. Rods function in dim light and provide black and white vision. Cones
function in bright light and provide colour vision. Rods and cones contain
chemicals called photo pigments. As light strikes the pigments, a chemical
change occurs that produces a nervous impulse. These impulses are then
transmitted to the brain through the optic nerve. The brain interprets them as
vision. Both the optic nerve and the blood vessels of the eye enter the eyeball
at the optic disc. Its centre is referred to as the blind spot, because the area
has neither rods nor cones.
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Six muscles control the movement of the eye: the superior, inferior, lateral
and medial rectus muscles, and the superior and inferior oblique muscles.
These muscles are coordinated to move both eyes in a synchronized manner.
The front of the eye is protected by two movable folds of skin, the eyelids.
Their edges are lined with two or three rows of eye lashes, which protect the
surface of the eye.
A thin mucous membrane called conjunctiva lines the inner surface of the
eyelids and passes over the cornea. Lying superior and to the outer edges of
each eye are the lacrimal glands. They produce tears to bathe and lubricate
the eyes. The tears collect at the inner edges of the eyes, the canthi (singular:
canthus), and pass through pinpoint openings, the lacrimal canaliculi, of the
nose.
The Ear
The ear is the sense organ of hearing. It consists of three major sections:
the external or outer ear; the middle ear or tympanic cavity; and the inner ear
or labyrinth. Although each of these sections transmits sound waves, each
accomplishes the task in a different way. The external ear conducts sound
waves through air; the middle ear, through bone; and the inner ear through
fluid. As will be subsequently explained, this series of transmissions play an
integral part in hearing.
The external ear is designed to channel sound waves from the environment to the middle and inner ears. An auricle or pinna is the external structure designed to collect waves travelling through air. The auricle channels
the waves through the ear canal, or slender tube that leads to the middle ear.
The canal is lined with glands that produce a waxy secretion called cerumen.
Cerumen prevents foreign particles from entering the ear. A flat membranous structure, the tympanum (tympanic membrane or eardrum), is drawn
over the end of the canal. Sound waves that enter ear canal strike against the
tympanum.
In the middle ear, vibrations of the tympanum are picked up by three
tiny bones called ossicles. They are responsible for transmission of sound
waves through the middle ear. The three articulating bones are the malleus
(hammer), the incus (anvil), and the stapes (stirrups). These bones form a
chain that stretches from the inner surface of the tympanum to an inner ear
structure called the cochlea.
A tube, called the Eustachian tube, connects the nose and the throat with
the cavity of the middle ear. Its purpose is to equalize pressure on the outer
and inner surfaces of the eardrum. In situations in which sudden pressure
changes occur, equalization of pressure is achieved by deliberate swallowing.
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INCUS

AURICLE

MALLEUS

Figure: Structures of the external, middle, and inner ear

SEMICIRCULAR CANALS
VESTIBULOCOCHLEAR NERVE
SEMICIRCULAR CANALS
VESTIBULE
EXTERNAL AUDITORY
CANAL

EUSTACHIAN TUBE

STAPES
OVAL WINDOW

TYMPANIC
MEMBRANE

COCHLEA

The inner ear, sometimes referred to as the labyrinth because of its complicated mazelike design, is composed of three structures: a snail-shaped
cochlea, the semicircular canals, and the vestibule, a chamber that joins the
cochlea and the semicircular canals. The cochlea is a triple-looped tube that is
filled with fluid. Lining its inner surface are tiny nerve endings called the hairs
of Corti. There is a membrane-covered opening on the external surface of the
cochlea called the oval window. That is precisely where the stapes is attached
to the cochlea. Transmission of sound along the ossicles in the middle ear
causes the stapes to exert a gentle pumping action against the oval window.
The pumping action forces the cochlea fluid to move. Disturbances of the fluid
stimulates the hairs of Corti, causing them to generate a series of nervous
impulses. The impulses are transmitted to the brain by way of the auditory
nerve, where they are interpreted as sound.
Key Terms the Eye
accommodation adjustment of the eye for seeing objects at various
distances
acuity clearness or sharpness of a sensory function
adnexa adjacent structures, e.g. extra ocular muscles, eyelids,
conjunctiva, orbits, lacrimal apparatus
207

 aqueous humour fluid in the anterior and posterior chambers of the

eye
biconvex having two rounded sides, like part of a sphere, e.g. the lens
of the eye
chiasm crossing
choroid the middle vascular layer of the eye; a dark brown membrane
cones photosensitive receptors; responsible for colour and central
vision
fovea tiny depression; in the eye it is the region of clearest vision
humour any fluid or semi fluid of the body
lacrimal tear producing; pertaining to tears
lens a transparent biconvex body behind the pupil of the eye; it bends
light rays
optic pertaining to the eye
opaque substance that does not allow the passage of light; not
transparent
photo pigment light-sensitive pigment in the retinal cones and rods;
visual pigment
pupil the dark opening of the eye surrounded by the iris
refraction bending of light rays by the cornea, lens, and fluids of the
eye to bring the rays into focus on the retina
rods photosensitive receptors responsible for peripheral vision and
vision in dim light
sclera tough, white, outer coat of the eyeball
tunic(a) layer of coat or tissue; a membrane layer
visual field area within which objects may be seen when the eye is in a
fixed position
vitreous humour soft, jelly-like material behind the lens
Combining Forms Meaning

Terminology

ambly/o

dull, dim

amblyopia = partial loss of vision

aque/o

water

aqueous = pertaining to water

blephar/o
palpebr/o

eyelid

blepharitis = inflammation of the eyelid

palpebral = pertaining to the eyelid

core/o
pupill/o

pupil

coreometer = instrument for measuring

the pupil
pupillography = recording eye movement

corne/o
kerat/o

cornea

corneal = pertaining to the cornea

keratotomy = incision of the cornea

208

cycl/o

ciliary body or cycloplegia = paralysis of the ciliary body

muscle of the
eye

dacry/o
lacrim/o

tear; lacrimal dacryoma = tumourlike edema of lacriapparatus

mal duct
lacrimotomy = incision of the lacrimal
duct

goni/o

angle

goniometry = examination of the angle

ir/o
irid/o

iris

iritis = inflammation of the iris

iridoplegia = paralysis of the iris

mydr/o

widen,
enlarge

mydriasis = enlargement of pupils

ocul/o
ophthalm/o

eye

oculomycosis = fungal infection of the

eye
ophthalmologist = eye specialist

opt/o
optic/o

eye, vision

optometry = measuring vision

optical = pertaining to the eye or vision

phac/o
phak/o

lens

phacocele = herniation (protrusion) of

the lens
aphakia = absence of lens

phot/o

light

photophobia = fear of light

presby/o

old age

presbyopia = poor vision due to old age

retin/o

retina

retinosis = abnormal condition of the

retina

scler/o

white of the
eye (sclera)

scleromalacia = softening of the sclera

scot/o

darkness

scotoma = area of diminished vision;

blind spot

uve/o

uvea;
uveitis = inflammation of part or all of
vascular
the uvea
layer of the
eye (choroid;
retina)

vitr/o

glassy

vitrectomy = removal of the vitreous

chamber (its contents)

209

Key Terms the Ear

auditory pertaining to hearing

auricle the flap of the ear; also called pinna
cerumen a waxy substance secreted by the external ear; ear wax
cochlea a shell-shaped tube in the inner ear
endolymph fluid within the labyrinth of the inner ear
Eustachian tube auditory tube
incus the second ossicle of the middle ear; the anvil
labyrinth a series of intricate communicating passages
malleus the first ossicle of the middle ear; the hammer
organ of Corti sensitive auditory receptor in the cochlea of the inner
ear
ossicle small bone
oval window a membrane between the middle and the inner ears
perilymph fluid contained in the labyrinth of the inner ear
pinna auricle
saccule little bag; organ in the inner ear associated with maintaining
equilibrium
semicircular canals passages in the inner ear associated with
maintaining equilibrium
stapes (pl. stampedes) the third ossicle of the middle ear; stirrup
tympanic membrane a membrane between the outer and the middle
ear; the eardrum
utricle a tiny sac-like structure in the inner ear; associated with
maintaining equilibrium

Combining Forms Meaning

Terminology

acous/o
audi/o
audit/o

hearing

acoustic = pertaining to hearing

audiometer = instrument to measure
hearing
auditory = pertaining to hearing

aur/o
auricul/o
ot/o

ear

aural = pertaining to the ear

auricular = pertaining to an auricle or
the ear
otalgia = earache

myring/o
tympan/o

eardrum

myringitis = inflammation of the

eardrum
tympanotomy = incision in the tympanic
membrane

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salping/o

auditory tube salpingoscopy = examination of the

Eustachian tube

staped/o

stapes

stapedectomy = excision of the stapes

Pathological Conditions of the Sense Organs

The Eye
Errors of Refraction
An error of refraction (ametropia) is caused when light rays are not brought
into proper focus upon the retina. This may be due to a defect in the lens or
cornea or a defect in the shape of the eyeball. If the eyeball is too long, the
image falls in front of the retina. This condition is called nearsightedness
(myopia). Correction is made by employing a concave lens. Farsightedness
(hyperopia, hypermetropia) is the opposite of myopia. In farsightedness the
eyeball is too short and causes the image to fall behind the retina. Correction
involves the use of a convex lens.
Another form of ametropia is a condition in which the cornea or lens has a
defective curvature. This causes the light rays to diffuse over a large area of
the retina, rather than being sharply focused on a given point. This gives rise
to a condition known as astigmatism. Lenses that compensate for the imperfect curvature of the cornea or lens are used to correct astigmatism.
Cataracts
Cataracts are opacities that form on the lens or the capsule that encloses
the lens. These opacities are produced by a build-up of protein, layer by layer,
until there is a loss of vision. The only effective treatment is removal of the
lens or capsule. Several techniques may be employed for cataract removal.
In one method, a super-cooled metal probe (cryoprobe) is placed upon the
cataract. The cataract bonds to the cold probe and the cataract and lens are
gently lifted from the eye (cryoextraction).
Another method of treatment is the removal of the entire Jens and its
capsule (intracapsular cataract extraction). This is usually the method of
choice when the cataract develops as a result of old age (senescent or senile
cataract).
Glaucoma
Glaucoma is an eye disease characterized by increased pressure within the
eyeball (intraocular pressure). This pressure leads to degeneration (atrophy) of
the optic nerve. Glaucoma may result in blindness if not successfully treated.
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The increased intraocular pressure is due to the failure of the aqueous humour
to drain from the eye through a tiny duct called the canal of Schlemm. Treatment for glaucoma involves the use of medications that cause the pupils to
constrict (myotics). This permits the escape of aqueous humour. If this treatment proves ineffective, surgery may be necessary. Three possible kinds of
surgery for glaucoma include puncturing of the cornea (paracentesis of the
cornea); the excision of a small portion of the iris (partial iridectomy); or separating the iris from its attachment (iridodialysis, coredialysis).
Glaucoma is diagnosed by the use of an instrument that measures internal
pressure of the eye (tonometer). This procedure is a simple, painless technique
and should be performed on all patients after the age of 35 during routine
eye examinations.
Strabismus
Strabismus is a condition in which the eyes turn from the normal position
so that they are not aimed in the same direction. If the eyes deviate outward
(exotropia), causing a divergent squint, the individual is said to be wall-eyed.
If the eyes turn toward each other (esotropia), causing a convergent squint,
the individual is said to be cross-eyed.
Strabismus may be due to poor vision (decreased visual acuity), un equal
ocular muscle tone, or an oculomotor nerve lesion. Eye testing (refraction) and
prescribing of corrective lenses, eye exercise (orthoptic training) and surgery
(strabotomy) in which the ocular tendons are cut, are the usual methods of
treatment.
Presbyopia
Impairment of vision due to old age. With increasing age, loss of elasticity
of the ciliary body impairs its ability to adjust the lens for accommodation to
near vision. The lens
of the eye cannot become fat to bend the rays coming from near objects
(less than 20 feet). The light rays focus behind the retina, as in hyperopia.
Therefore, a convex lens is needed to refract the rays coming from objects
closer than 20 feet.
Other Conditions and Related Terms
achromatopsia

severe congenital deficiency in colour perception;

colour blindness

chalaizon

small, hard, cystic mass on the eyelid as a result of

chronic inflammation of a sebaceous gland

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conjunctivitis

inflammation of the conjunctiva producing a red or

pink eye

diabetic
retinopathy

disorder occurring with the diabetes and

characterized by small haemorrhages, edema and
neovascularisation near the optic disc, leading to
scarring and eventual loss of vision

epiphora

abnormal overflow of tears

exophthalmos

protrusion of one or both eyeballs

hemianopia

loss of one half of the visual field, usually due to a

stroke or damage to a portion of the optic nerve or its
fibres

hordeolum (stye)

localized, circumscribed, purulent, inflammatory

bacterial infection of a sebaceous gland in the eyelid

macular
degeneration

deterioration of the macula lute of the retina; the

condition may be inherited, drug induced, or age
related and leads to severe loss of central vision;
peripheral vision is retained

metamorphopsia

visual distortion of objects

nyctalopia

impaired vision in dim light; night blindness

nystagmus

involuntary, rapid, rhythmic movement of the eyeball

retinal detachment two layers of the retina separate from each other as a
result of trauma to the eyeball, head injuries, bleeding,
scarring from infection, shrinkage of the vitreous
humour
retinitis
pigmentosa

progressive retinal sclerosis, pigmentation and

atrophy, characterized by the deposition of pigmented
scar on the retina

scotoma

area of depressed vision surrounded by an area of

normal vision caused by damage to the retina or optic
nerve

trachoma

chronic, contagious form of conjunctivitis usually

leading to blindness

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The Ear
Otitis Media
Otitis media is an infection of the middle ear, found most commonly in
infants and young children. It is frequently associated with an upper respiratory
infection (URI). Symptoms may include earache (otodynia, otalgia), draining of
pus from the ear (otopyorrhea), or rupturing of the eardrum (tympanorrhexis
or myringorrhexis). Treatment consists of bed rest, medications to relieve pain
(analgesics) and antibiotics. Occasionally, an incision of the eardrum (myringotomy, tympanotomy) may be necessary to relieve pressure and promote
draining of pus from the middle ear. If left untreated, otitis media may lead
to infection of the mastoid process (mastoiditis) or inflammation of the brain
tissue near the middle ear (otoencephalitis).
Otosclerosis
Otosclerosis is a condition characterized by the hardening of spongy bone
around the oval window. This decreases the ability of the stapes to move the
oval window (ankylosis). Consequently, there is a hearing loss. Occasionally the
individual perceives a ringing sound (tinnitus) within the ear. Surgical correction involves the removal of the stapes (stapedectomy) and reconstruction of
the oval window. Sometimes insertion of an artificial stapes is necessary in
order to restore hearing.
Other Conditions and Related Terms
acoustic neuroma

benign tumour arising from the acoustic nerve in

the bran; it causes tinnitus, vertigo and decreased
hearing

anacusia (anacusis) complete deafness; it may be unilateral or bilateral

cholesteatoma

collection of skin cells and cholesterol in a sac within

the middle ear

Meniere disease

disorder of the labyrinth in the inner ear due to

elevated endolymph pressure within the cochlea
leading to progressive loss of hearing; symptoms
include tinnitus, headache, hyper-sensitivity to loud
sounds nausea and vertigo

noise induced
loss of hearing due to excessive exposure to sounds
hearing loss (NIHL) that are too long, too loud and too close

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otitis media (serous, non-infectious inflammation of the middle

or suppurative)
ear characterized by accumulation of serum;
inflammation of the middle ear caused by bacterial
infection and with pus formation (suppurative)
otosclerosis

hardening of the bony tissue of the labyrinth of the

ear

presbycusis

hearing loss occurring with old age; it is the most

common form of nerve deafness resulting from
the physiological process of aging; hearing loss is
irreversible; sudden deafness may occur as a result
of in infectious illness, e.g. mumps or measles

tinnitus noise

(ringing, buzzing, roaring) sound in the ears

vertigo, dizziness

sensation of irregular or whirling motion either of

oneself or of external objects; it is often associated
with nausea and is due to a severe disturbance of
equilibrium organs in the labyrinth

EXERCISES
1. Explain how the eye functions: ...................................................................................................
2. The ear consists of the following three major sections: ................................................
..........................................................................................................................................................................

3. Fill in the correct term:

3.1. A highly vascular middle layer of the eye, the ..................................... provides a
blood .............................................................................................................................. for entire eye.
3.2. One of the two major fluids of the eye is the ............................................ humour.
3.3. The ................................................................. tube connects the nose and the throat
with the cavity of the middle ear.
3.4. Lining the inner surface of the cochlea are tiny nerve endings called the
..........................................................................................................................................................................

3.5. A pinna or an .................................................is the external structure designed to

..........................................................................................

sound waves travelling through air.

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4. Match the following terms with their meanings:

4.1. myopia ........................................................

a) the third ossicle of the middle ear

4.2. stapes .........................................................

b) nearsightedness

4.3. esotropia ...................................................

c) hearing loss occurring with old

age

4.4. myringotomy ..........................................

d) an incision of the eardrum

4.5. presbycusis .............................................

e) a convergent squint (cross-eyed)

5. Define the following terms:

5.1. otodynia .............................................................................................................................................
5.2. intraocular pressure ..................................................................................................................
5.3. paracentesis of the cornea ....................................................................................................
5.4. cerumen ............................................................................................................................................
5.5. oval window .....................................................................................................................................
5.6. cochlea ...............................................................................................................................................
5.7. blind spot ..........................................................................................................................................
5.8. lacrimal canaliculi ......................................................................................................................
5.9. chalazion ..........................................................................................................................................
5.10. microtia ...........................................................................................................................................
6. Provide the plural form of the following nouns:
6.1. disc ...............................................................

6.6. iris .................................................................

6.2. auricle ........................................................

6.7. tympanum ................................................

6.3. sclera ..........................................................

6.8. pinna ...........................................................

6.4. canthus ......................................................

6.9. lens ..............................................................

6.5. Conjunctiva ..............................................

6.10. focus .........................................................

7. Provide the adjective form for the following nouns:

7.1. vision ...........................................................

7.6. correction .................................................

7.2. receptor .....................................................

7.7. divergence ...............................................

216

7.3. cerumen ....................................................

7.8. capsule .......................................................

7.4. refraction ..................................................

7.9. impairment ..............................................

7.5. ophthalmology ......................................

7.10. crystal ......................................................

8. Translate into Croatian:

Conjunctivitis
Conjunctivitis is an infection or an inflammation of the conjunctiva, the delicate membrane that lines the eyelids and continues over the exposed surface
of the eye. Although conjunctivitis will generally run its course in about two
weeks and not cause permanent damage, some untreated cases of conjunctivitis may lead to more serious eye problems. Such complications may include
ulcers on the cornea, the transparent covering across the front of the eye. A
corneal ulcer is an eroded area of the cornea, which, if untreated, may leave
a scar that interferes with vision.
Most cases of conjunctivitis are caused by bacteria, viruses, or fungi. Allergies, chemicals, dust smoke, or foreign objects may also irritate the conjunctiva and lead to conjunctivitis. Measles, a childhood illness, is often accompanied by conjunctivitis. In addition, both children and adults who swim a great
deal may contract conjunctivitis - either from chlorine in the pool or from
contaminated water.
Symptoms
The symptoms of conjunctivitis include redness (pinkeye), burning, itching,
tearing, discharge (sometimes containing pus ), pain and sensitivity to light.
Sometimes the symptoms last a few days; at other times a severe case may
linger for two weeks.
Treatment
Treatment can range from symptom-relieving measures (symptomatic
therapy) to medication. Rest and shielding the eyes from bright light are often
helpful. If the conjunctivitis is caused by environmental irritants, eliminating
such factors may be sufficient. Antibiotic drops (or antiseptic, germ-killing)
may be prescribed.
(Ellis, J. W. Medical Symptoms and Treatments)
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SUPPLEMENT
CHAPTER 16

ONCOLOGY CANCER MEDICINE

Oncology is the study of tumours. It includes both malignant and nonmalignant growths, or neoplasms. Cancer is a disease generally characterized by uncontrolled and excessive growth of body cells. It may develop in
any body tissue and at any age, although more frequently in older people and
rarely in the young ones. As cancerous cell grow they eventually destroy their
surrounding normal tissue and they have also the ability to spread throughout
the body, either by bloodstream or by lymphatic system, and forms distant
sites of malignant growths, which often causes death.
Lung, breast and colorectal cancers rank highest in the percentage of
deaths for women, while lung, colorectal and prostate cancers are highest in
percentage of deaths for men.
Neoplasms
In healthy individuals cell division is an orderly process in which body cells
are produced for growth of the individual or for replacement of cells that are
destroyed or worn out. In some instances, however, cell division is without
purpose. The newly formed cells increase at an uncontrolled rate, producing a
lump or swelling known as a tumour or neoplasm. Neoplasms may be either
benign or malignant.
Benign neoplasms
Benign neoplasms are growths that occur in body tissues. They are
composed of the same cells as the tissue in which they are growing. For
example, a benign tumour of a gland is composed of the glandular tissue from
which it is developing. Benign neoplasms are contained within a capsule and
do not invade the surrounding tissue. They harm the individual only insofar
as they place pressure on surrounding structures. If the benign neoplasm

219

remains small and places no pressure on adjacent structures, it is not often

removed. If it becomes enlarged or places pressure on other organs or structures, it must be removed. Benign brain tumours are always very serious, since
the cranial cavity is enclosed and pressure on other parts of the brain inevitably results. As a general rule, however, benign tumours are not life-threatening. Once they are removed, they do not regrow.
Malignant neoplasms
The cells that compose a malignant neoplasm often do not resemble the
tissue in which they are growing. In such cases the tumour is said to be undifferentiated. The tumour cells lack specialization in both structure and function. More significantly, however, the cells of the malignant neoplasm are not
encapsulated and are able to spread to normal tissues. This invasive growth
occurs by direct extension or metastasis. In direct extension, the tumour grows
directly into normal tissue. This is called proliferation. With metastasis the
malignant cells from the primary tumour site find their way into lymph channels or blood vessels and are carried to remote body structures in which
secondary malignant neoplasms develop.
Nomenclature of Tumours
Tumour nomenclature is based, in part, upon the tissue from which the
tumour originates. This is referred to as histogenesis. For purpose of tumour
nomenclature, four types of tissue are identified: epithelial, connective
(including muscle), hematopoietic (blood and lymph), and nervous tissue. To
indicate a benign tumour that arises from epithelial or connective tissue add
the suffix -oma to the word root. An exception to this rule is melanoma, which
is a malignant tumour of epithelial origin.
There are certain characteristics of a tumour that help in diagnosing
whether it is benign (noncancerous) or malignant (cancerous). A benign
tumour is usually enclosed within a capsule, grows slowly, and does not invade
surrounding tissue (metastasize). A malignant tumour is not encapsulated,
grows rapidly, and metastasizes.
Staging
Staging is an attempt to define the extent of cancer by classifying it into
three categories: T, N and M. T represents the primary tumour site or place of
origin; N represents local or regional node involvement; and M tells whether
or not there is metastasis. When the primary site contains classifications of
Tl, T2, T3, or T4, the higher numbers would indicate progressive increase in
tumour size and involvement. Similarly, NO, Nl, N2, or N3 represents progres220

sively advancing nodular involvement. Finally, MO or M+ defines absence or

presence of metastasis, respectively.
Grading
Grading of a malignant tumour is an evaluation of the histological makeup
of the neoplasm. Generally, four grades are employed, Grade l to Grade 4.
Neoplasms that are composed of cells that closely resemble the tissue
from which they arise are given a Grade l rating. The tissue demonstrates a
minimum amount of anaplasia.
At the other extreme is Grade 4 in which there is a great deal of anaplasia
within the tumour. Such tumours are more serious and prognosis is very poor.
Grades 2 and 3 are intermediate grades between these two extremes.
HISTOGENESIS OF BENIGN AND MALIGNANT NEOPLASMS
HISTOGENESIS
TISSUE OF ORIGIN

BEHAVIOUR
BENIGN

MALIGNANT

1. Epithelial Tissue Tumours:

surface epithelium
glandular
papilloma
epithelium
adenoma

carcinoma
adenocarcinoma

2. Connective Tissue Tumours:

fibrous tissue
fibroma
cartilage
chondroma
bone
osteoma
fat
lipoma
blood vessels
hemangioma
lymph vessels
lymphangioma
smooth muscle
leiomyoma
striated muscle
rhabdomyoma

fibrosarcoma
chondrosarcoma
osteosarcoma
liposarcoma
hemangiosarcoma
lymphangiosarcoma
leiomyosarcoma
rhabdomyosarcoma

3. Hematopoietic Tissue Tumours:

lymphoid tissue
granulocytic tissue
erythrocytic tissue
plasma cells

myelocytic leukemia
erythroleukemia
multiple myeloma
plasmocytoma

4. Nerve Tissue Tumours:

glial tissue
meninges

glioma
meningeal sarcoma

meningioma

221

nerve cells

neuroma,
ganglioneuroma
nevus (nevocytoma)
neurilemoma

neuroectoderm
nerve sheaths
retina
adrenal medulla

5. Tumours Consisting of More than One Tissue:

breast
fibroadenoma
embryonic kidney
multipotent cells
teratoma
uterus

neuroblastoma,
melanoma
neurolymphoma
neurilemmic sarcoma
retinoblastoma
pheochromocytoma
cystosarcoma
nephroblastoma
choriocarcinoma
mixed mesodermal

6. Tumours that do not Fit into One of the Above Groups:

melanoblasts
pigmented nevus
melanoma
placenta
hydatidiform mole
choriocarcinoma
ovary
cystosarcoma
cell tumours
testis
teratoma
thymus
thymoma
The terms that are listed below describe the appearance of a malignant
tumour either on gross (visual) or on microscopic examination
Gross Descriptions
cystic

forming large open spaces filled with fluid; mucinous

tumours are filled with mucus, while serous tumours
are filled with watery fluid resembling serum; the most
common site is in ovaries

fungating

a mushroom-like pattern of growth during which

tumour cells pile one on top of the other; usually found
in colon

inflammatory

- having the features of inflammation: redness, swelling,

heat; usually occur in the breast

medullar

large soft fleshy tumours; usually occurring in the

thyroid and the breast

necrotic

containing dead tissue; any type of tumour can outgrow

its blood supply and undergo necrosis

222

polypoid

projections extending outward from a base, like

extending from a stem or stalk

ulcerating

characterized by an open, i.e. exposed surface resulting

from death of the overlying tissue; often found in the
stomach breast, colon, skin

verrucous

resembling a wart-like growth; tumours of the gingival

are usually of the verrucous type.

Microscopic Descriptions
alveolar

tumour cells look like microscopic sacs; commonly

found in tumours of the muscle, bone, fat and cartilage

carcinoma in situ localized tumour that has not invaded the adjacent
structures
diffuse

spreading evenly throughout the affected tissue; e.g.

malignant lymphomas areknown to have such spread

dysplastic

pertaining to abnormal cell formation, not clearly

cancerous; examples are dysplastic nevi

epidermoid

resembling squamous epithelial cells, often occurring

in the respiratory tract

follicular

forming small microscopic, gland-type sacs; e.g. the

thyroid cancer

nodular

forming multiple areas of tightly placked clusters of

cells (nodules); e.g. malignant lymphomas

papillary

small finger-like or nipple-like projections of cells; e.g.

bladder cancer

pleomorphic

composed of a variety of types of cells; e.g. mixed-cell

tumours

scirrhous

densely packed, hard tumours, overgrown with fibrous

tissue; e.g. breast or stomach cancers

undifferentiated

lacking microscopic structures typical of normal

mature cells.

Treatment
Malignant tumours cancers, are usually treated by three standard
methods either singly or in combination. These are: surgery, radiation and
chemotherapy. Besides these, new methods of treatment are being extensively
tested and gradually introduced. These include biological agents, e.g. mono223

clonal antibodies, and differentiating agents, e.g. those that cause tumour
cells to differentiate stop growing and die.
EXERCISES
1.1. What is oncology? ........................................................................................................................
1.2. Name four tissues from which the tumour originates...........................................
..........................................................................................................................................................................

2.1. In healthy ................................. cell division is an ............................................ process.

2.2. Benign neoplasms are ................................... within a ......................................................
2.3. Benign brain tumours are always very ..................................... : ...................................
2.4. Staging is an ................................................. to define the ............................ of cancer.
2.5. N represents ................................................. or ................................ node involvement.
3. Match the following terms with their meanings:
3.1. proliferation ............................................

a) a new growth of tissue

3.2. staging .......................................................

b) spread of malignant cells into the

surrounding tissue

3.3. sarcoma ....................................................

c) a method of classifying malignant

spread

3.4. neoplasm ..................................................

d) malignancy of connective tissue

origin

4. Give the meaning of the following term:

4.1. lethal ...........................................................

4.6. lipoma ........................................................

4.2. oncologist .................................................

4.7. meninges ..................................................

4.3. multicentric ............................................

4.8. hemangioma ..........................................

4.4. dormant .....................................................

4.9. melanoma ................................................

4.5. fibroma ......................................................

4.10. necrotic ...................................................

5. Give appropriate medical word for the following:

5. 1. the newly formed cells.............................................................................................................
5. 2. an undifferentiated tumour ..................................................................................................
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5. 3. an attempt to define the extent of cancer ....................................................................

5. 4. an evaluation of the histological makeup of the neoplasm ...............................
5. 5. epithelial tissue having velvety appearance ...............................................................
5.6. penetrating the spaces within tissues ............................................................................
5. 7. a cancerous tumour composed of cells of epithelial tissue .............................
..........................................................................................................................................................................

5. 8. tumour of a smooth muscle ................................................................................................

5. 9. pertaining to the marrow .......................................................................................................
5.10. tumour of the skeletal muscle ..........................................................................................
6. Provide the adjective forms of the following nouns:
6.1. cancer .........................................................

6.6. multiplication .........................................

6.2. lymph ..........................................................

6.7. genesis .......................................................

6.3. glioma ........................................................

6.8. ability ..........................................................

6.4. structure ...................................................

6.9. neoplasm ..................................................

6.5. predomination .......................................

6.10. granulocyte ...........................................

7. Provide the plural form of the following nouns:

7.1. melanoma ................................................

7.6. tremor ........................................................

7.2. nevus ...........................................................

7.7. loss ...............................................................

7.3. axilla ............................................................

7.8. neurosurgeon ........................................

7.4. radiotherapy ...........................................

7.9. disk ...............................................................

7.5. area ..............................................................

7.10. month .......................................................

8. Translate into Croatian:

A 37-year-old male underwent abdominal resection for a malignant melanoma arising in a nevus. One year later, he underwent bilateral axillary node
dissection, which indicated 2 of 23 left axillary nodes positive for tumour. Two
months later, his bone scan was positive at the right proximal humerus, and
a biopsy revealed metastatic melanoma. The patient began having symptoms

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of involvement of the fourth lumbar nerve roots and received radiotherapy to

the L-4 spine and the humerus with good response.
However, several weeks later, he noted progressive right leg weakness
and left leg sensory loss. Myelogram demonstrated two metastatic lesions
at 7 -12/L-1 and L-4 that were not thought to be accessible surgically. The
patient received further radiotherapy to the affected vertebral areas. The
patient received one course of BCNU (a chemotherapeutic drug) from another
physician who noted some optic disk edema. The patient was placed on dexamethasone (Decadron) therapy for 2 weeks, after which his course deteriorated progressively with numbness in his upper extremities bilaterally, left leg
hyperesthesia, and tremors. Decadron was continued and a neurosurgeon felt
that little could be done surgically to reverse the deficits.
(From The Language of Medicine Davi-Ellen Chabner)
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CHAPTER 17

GENERAL CARE OF THE PATIENT

The patient admitted to hospital enters a strange world and is apprehensive in case he or she has cancer or is to undergo an operation, and worries
about his family at home. The nurse should introduce herself and deal with
the patient calmly, tactfully, pleasantly and reassuringly. The patient should
be made comfortable. His/her name, age, address and the name, address
and telephone number of next-of-kin should be recorded. Rest in bed helps
to combat disease but predisposes, especially in the elderly, to stiff joints,
weak muscles, bedsores, constipation and venous thrombosis, which must all
be prevented. Noise disturbs rest and should be avoided. Cupboards, doors,
bedpans and trolleys should not be allowed to bang, and nurses shoes should
have rubber soles and heels.
Daily Routine
Each morning the patient should be bathed and the bed made. The hands
are washed in the middle of the day, after defecation and at night, and the hair
is brushed. The mouth, skin and bowels are cared for. The patient is assessed
for the intensity of treatment required on the grounds of age, general condition, degree of arterial disease and the disease causing admission. Thus an
elderly, poorly nourished patient with paralysis will need frequent turning and
care to pressure areas, whereas a young person with appendicitis will need
less intensive nursing.
Feeding
The patient should be positioned comfortably and be allowed to wash his/
her hands. The nurse washes her hands before handling crockery or cutlery or
serving food. Everything should be within easy reach of the patient. Helpings
should be small; more being given later if required. Only one course should
be served at a time. Plates, glasses and cups should not be too full.

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For recumbent patients a serviette is placed under the chin and the head is
raised by placing the hand beneath the pillow, not under the neck. The patient
is fed at his own pace. Liquids may be taken through a straw. The diet should
be adequate in joules, fat, protein, vitamins and minerals.
Moving the Patient
The patient who is weak or unable to move should be lifted, not dragged,
into position in bed. Dragging causes friction between the skin and the sheet
and predisposes to bedsores. Before lifting, the pillows should be tidied and
the bedclothes loosened. The nurse should not attempt to lift a heavy patient
without assistance, either from the patient, if permitted, or from a second
nurse. There are several ways of lifting. In the Australian lift each nurse places
her shoulder under the patients axilla and the arm below the thigh, grasping
the other nurses wrist. The nurse should keep her back straight, bending
from the hips so as to prevent injury to her back. To turn a patient the nurse
stands at the side to which the patient is to be turned; places his arm across
his chest and crosses his legs, reaches over him, and with one hand around
the pelvis and the other below the shoulder, turns him towards her.
To move a patient from a trolley to a bed, the two are placed at right angles
to each other, the head of one near the foot of the other. Three persons stand
on the same side of the patient and lift together.
Bathing in Bed (Blanket Bath)
Procedure: Explain the procedure to the patient. Screen the bed. Ask the
patient if he wishes to use a bedpan or urinal. Place clean nightwear on a
nearby radiator to warm. Turn the bedclothes back, leaving the patient covered
with his top sheet. A large bath towel is placed beneath him to prevent the
bedding from getting wet. Remove the patients nightwear, drape a blanket
over him if he is likely to feel cold, and wash him with soap and hot water,
starting with the face and neck, using the face flannel and towel, allowing the
patient to wash and dry his own face, if able. A second flannel is used for the
remainder of the body, only exposing those parts of the patient which are being
washed. When the arms, chest and abdomen have been washed and dried, the
water in the bowl is changed and the lower limbs, genitals and buttocks are
washed. The patient should wash and dry his own pubic area, if able. The feet
should be placed in the bowl of water, if possible. During bathing the patient is
unobtrusively examined, and any skin rashes, bruises, sacral edema or other
abnormality reported. The pressure areas are massaged during the bed bath,
the patient dressed in the warmed nightwear, the nails trimmed if necessary,

228

and the hair brushed or combed. The teeth or dentures are cleaned (the patient
may do this), and a mouthwash is given.
The bed is made with clean linen and the patient repositioned and asked
if he is comfortable.
Female patients may be helped with their cosmetics.
Care of the Skin (Pressure Areas)
Bedsores are gangrenous ulcers due to ischemic death of the skin. Causes:
exclusion of blood from the skin by prolonged pressure caused by immobility
(paralysis, stiff joints, sedation), lying or sitting on creases of linen, crumbs, or
hard pads, or a moist skin, e. g. incontinence of urine or feces, local sweating
(sitting on plastic). Rough handling easily damages skin which is inelastic
(elderly patients), has a poor circulation (atheroma), or is poorly nourished.
Edema and congestion prevent the exchange of metabolites between the blood
and the tissues. The areas to be treated are the elbows, shoulder blades, tips
of the shoulders, occiput, vertebrae, iliac crest, buttocks, knees, ankles and
heels.
Reassure the patient and explain the reason for the procedure. Close the
windows and screen the patient. Turn back the bedclothes, leaving a sheet
covering the patient. Clean the area with a damp wipe, especially the buttocks
if the patient is incontinent. Wash with soap and water, dry the area thoroughly but gently. Sparingly apply fine talcum powder or cream. Remake the
bed. Creams or sprays do not prevent bedsores, but if they are used the area
must be thoroughly washed and dried before they are applied or reapplied.
Pressure areas are treated two-hourly if the patient is confined to bed
or is incontinent. The patient is encouraged to move in bed and his position
should be regularly altered by turning. The sheet must be free from creases
and crumbs. Decubitus pads are aids to the prevention of pressure sores,
but the above procedure must also be used. Any indication of a pressure sore
commencing must be reported immediately to the sister in charge. The first
sign is a reddening of the skin, a burning feeling or irritation.
Care of the Nails and Hair
Fingernails should be trimmed with scissors to the shape of the fingertips. Toenails should be cut straight across (if cut short and curved, the free
margin of the nail may dig into the tissues as it grows, producing an ingrowing
nail). Nails are cut more easily after soaking in warm water. The hair should
be brushed or combed daily and washed weekly, observing for parasites and

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nits. If a man is too ill to shave himself, he may be shaved by a visiting barber,
convalescent patient, or the nurse.
(Harrison, R. Textbook of Medicine with Relevant Physiology and Anatomy)
EXERCISES
1. Fill in the correct term:
1.1. The nurse should ............................................................................................ the patients
name, age and address upon admission to the hospital.
1.2. Bed rest ................................................. the elderly to .............................................. joints.
1.3. Each morning the patient should be .............................................................. and the
bed .................................................................................................................................................................
1.4. An elderly, poorly ................................................................................... patient will need
frequent ......................................................................................................................................................
1.5. Only one course should be ................................................................................ at a time.
1.6. The patient is fed at his own .................................................................................................
1.7. Dragging causes ................................................................................and predisposes to
1.8. The nurse should not attempt to .................................................................................... a
heavy patient without .........................................................................................................................
1.9. During bathing the patient is ......................................................................... examined.
1.10. Decubitus .........................................................................are aids to the prevention of
................................................................................................................. sores.

2. Define the following terms:

2.1. hospitalization ...............................................................................................................................
2.2. next-of-kin .......................................................................................................................................
2.3. appendicitis .....................................................................................................................................
2.4. intensive nursing .........................................................................................................................
2. 5. helping(s) ........................................................................................................................................
2. 6. recumbent patient .....................................................................................................................
2. 7. joule ....................................................................................................................................................

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2. 8. screening ........................................................................................................................................
2. 9. (o)edema ..........................................................................................................................................
2.10. metabolite .....................................................................................................................................
3. Provide the plural form of the following nouns:
3.1. tissue ..................................................................................................................................................
3.2. extremity ...........................................................................................................................................
3.3. vertebra .............................................................................................................................................
3.4. ankle ....................................................................................................................................................
3.5. toenail .................................................................................................................................................
3.6. spray ....................................................................................................................................................
3.7. occiput.................................................................................................................................................
3.8. pelvis....................................................................................................................................................
3.9. trolley ..................................................................................................................................................
3.10. glass .................................................................................................................................................
4. Provide the adjective form for the following nouns:
4.1. muscle ...............................................................................................................................................
4.2. artery ..................................................................................................................................................
4.3. constipation ....................................................................................................................................
4.4. lifting ...................................................................................................................................................
4.5. abdomen ...........................................................................................................................................
4.6. joint ......................................................................................................................................................
4.7. gangrene ...........................................................................................................................................
4. 8. ulcer ...................................................................................................................................................
4. 9. congestion ......................................................................................................................................
4.10. incontinence .................................................................................................................................
5. Give appropriate medical term for the following:
5.1. a mass of plaque of degenerated, thickened arterial intima occurring in
atherosclerosis........................................................................................................................................
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5.2. an ulceration caused by prolonged pressure in a patient lying still in bed

for a long period of time ...................................................................................................................
5.3. a vessel for urine .........................................................................................................................
5.4. stools ..................................................................................................................................................
5.5. sweating ............................................................................................................................................
5.6. pain in a joint/joints ....................................................................................................................
5.7.lack of muscle strength ............................................................................................................
5.8. deficiency of blood in a body part.......................................................................................
5.9. reddening of the skin ................................................................................................................
5.10. any joint disease.........................................................................................................................
6. Circle the correct spelling:
6.1. tromboses ............................... thrombosis .......................... thrombozis ........................
6.2. peristalsis ............................... perastalsis ........................... parastalsis .........................
6.3. seedation ................................. cedation ................................ sedation...............................
6.4. convalescent .......................... convalesent ......................... konvalescent ...................
6.5. iritation ..................................... irritation ................................ eerritation .........................
6.6. symdrone ................................. sindrome .............................. syndrome ...........................
6.7. periferal .................................... peripheral ............................ peripherel .........................
6.8. appendix ................................... apendix .................................. appendiks ..........................
6.9. paralisis .................................... paralysis ............................... parelysis .............................
6.10. sweat ....................................... swet ......................................... swat ..................................... .

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CHAPTER 18

BRITISH MEDICAL TRAINING AND REGISTRATION

1. Undergraduate Training
There are not enough places at British medical schools for all those who
wish to study medicine. Consequently competition for places is very great and
it is almost impossible for a student from another country to get a place. The
study period normally lasts about six years. For the first three years of preclinical studies, the student is taught the scientific basis of his profession. He
is trained in such subjects as human anatomy, physiology, biology, biochemistry, bacteriology, elementary psychology and so on. Then follow three years
of clinical training during which time the student not only attends lectures
and classes but also progresses through a whole series of practical clinical
clerkships. In these clinical clerkships, he helps in hospital wards and outpatient clinics under the guidance of hospital doctors. He learns and practices the careful examination of patients, writes up their case histories and under supervision - learns the technique of a wide variety of diagnostic and
therapeutic procedures. He also has to attend the teaching ward rounds of
the consultant in charge of the department, help the surgeon in the operating theatre and be present, and help, at a required number of confinements
(births). At the end of his clinical years, he takes examinations which include
written, practical and oral examinations, known as the Finals. If successful,
he may acquire a University degree or one of the other, but lesser, basic registrable qualifications or licenses. He is then granted Provisional British Medical
Registration as a doctor. This newly qualified U. K. Doctor must then complete
satisfactorily two scheduled House Officer appointments as a resident hospital
doctor in medicine and surgery (or obstetrics and gynaecology) lasting six
months each before he can get Full British Medical Registration. Only after
he is fully registered may he enter any other form of medical employment,
become a trainee in general practice or start working towards any specialist
diploma.

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In Britain the University Diploma of M. D. (Doctor of Medicine) is not a basic

medical qualification but is a higher specialist degree in Internal Medicine
which is gained several years after getting a basic University medical degree.
The candidate must pass a difficult examination and/or write an acceptable
thesis. Normally an M. D. degree can only be gained at the same university
where the doctor gained his basic degree.
2. Medical Registration for Overseas Doctors
An overseas-qualified doctor must apply to the general Medical Council
for registration before engaging in any professional employment in the United
Kingdom. Registration gives a doctor the legal status necessary for carrying
out his professional duties.
There are three types of registration - full, provisional and limited. Full
registration may be granted by the General Medical Council if the doctor holds
qualifications recognized by the G.M.C. for the purpose. A doctor with such
qualifications may be granted provisional registration if, in the view of the
G.M.C., he lacks the necessary professional experience for full registration.
However, the number of posts in the U.K. suitable for doctors with provisional
registration is so limited that doctors from overseas are urged to gain the
required experience before coming to this country.
Limited registration may be granted to a doctor who holds a qualification, obtained overseas, which is accepted by the G.M.C. for this purpose.
Such registration may be held only in respect of supervised appointments in
approved hospitals or institutions and may be granted in relation to one particular employment or specified range of employment. Limited registration for
new entrants is subject to a time limit of five years.
The majority of overseas doctors who wish to apply for limited registration for the first time will be required to take and pass the PLAB test (Professional and Linguistic Assessments Board) which comprises both medical and
linguistic components. Limited registration is now granted, in the main, only
for employment in hospital posts or departments which have been approved
for educational and training purposes by one of the Royal Colleges or faculties.
3. Postgraduate Training in the UK
Overseas doctors should be fully medically qualified and registered in their
own country and must speak and write English fluently. They should not come
to Britain until they have completed at least two years of post qualification resident hospital appointments in their own country. Many British higher diplomas
prescribe definite periods of resident hospital appointments in recognized

234

hospitals which must be served before the examination can be attempted.

Very few overseas hospitals are recognized.
The amount of postgraduate medical training in Britain consisting of fulltime teaching courses is limited. Places on such courses are usually awarded
by selection to graduates who are fluent in English and who also have considerable recent clinical experience in major hospitals. Doctors accepted for
British Medical Registration who work in the British hospital service receive
postgraduate guidance and training and by using the postgraduate training
facilities available at the nearest Postgraduate Medical Centre, they can gain
considerable further training in the common specialties, internal medicine,
general surgery and so on. Over 260 large General Hospitals are graded as
District General Hospitals and have good libraries and Postgraduate Centres
where regular programmes of lectures, case-demonstrations and so on are
held. At many District General Hospitals, regular one-day-a-week courses,
known as day-release courses, are also held in preparation for a number of
postgraduate diplomas. To work in a small hospital, therefore, does not mean
that the graduate will be cut off from postgraduate training opportunities.
(Joy Parkinson: A Manual of English for the Overseas Doctor)
4. Nurse education programmes conditions required for UK registration
Duration of at least 3 years of full-time nursing studies and which
included at least 4600 hours of nursing education. This means that
unrelated subjects, such as foreign languages, sport or philosophy, do
not count towards the nursing education hours but applied subjects such
as healthcare ethics would be relevant.
The nursing programme does not have to be delivered at a degree
level, but it should be undertrained after completion of full secondary
education and after reaching the age of 17.
The nursing programme needs to be equally divided between theory and
practice and the programme must cover five main areas i.e. medical,
surgical. Women and children, mental health and community.
Upon completion of the nursing education programme, nursing students
should be considered to be fully qualified registerable first-level nurses
and fully capable of obtaining the nursing diploma and right to practise.
This implies that the nursing education programme is considered to
be complete in itself and without additional practice periods and/or
supervision, and that until nursing students obtain the nursing diploma
they are not considered to be fully qualified first-level nurses.

235

Apart from these requirements, the NMC (Nursing and Midwifery Council)
requests that nurses complete at least 6 months of nursing work in their home
country to consolidate their education experience. Nurses trying to obtain UK
registration without 6 months experience in their home country might experience problems getting onto the register.
(Joy Parkinson & Chris Brooker: Everyday English for International Nurses
- a guide to working in the UK. Churchill Livingstone, 2004)

236

CHAPTER 19

SMOKING - HAZARDOUS ADAPTATION

Since the beginning of time, human beings have searched for substances
that would not only sustain and protect them but also would act on their
nervous systems to produce pleasurable sensations. Among the things that
have been found to have a psychoactive effect - a temporary change in mood,
though t, feeling, or behaviour are ethyl alcohol, hemp and cactus plants,
mushrooms, poppies, and tobacco, a herb that has been smoked and sniffed
for more than 400 years.
People have been attracted to these psychoactive substances because they
have been useful in helping individuals adapt to an ever-changing environment.
Indeed, smoking, drinking, and drug taking have lightened the load of life;
reduced tensions, anxieties, and frustrations; counteracted boredom as well
as fatigue; enhanced the pleasures of the moments; and in some instances,
provided an escape from the harsh realities of existence. Chemical mood and
behaviour modifiers have also been employed to enhance self-image, build
confidence, gain approval or acceptance, and heal psychological hurts.
Use of substances for such personal gratification and temporary adaptation often carries a high price tag, such as various forms of drug dependency,
personal and social disorganization, and predisposition to serious and sometimes fatal diseases. These undesirable and health-threatening consequences
of adaptive and adjustive behaviour are referred to as maladaptations, which
usually occur as the remote consequences of behaviour that has an immediate beneficial effect.
Such is the case with cigarette smoking, now characterized as one of the
most serious and yet preventable health problems, a major international
threat, and suicide in slow motion. The dimensions of this adaptive, yet
disease-producing, activity are more easily recognized when one examines
the reasons for the inability to stop smoking. Two areas have often been cited
in which remedial action is more difficult to initiate.

237

1. The individual smoker who becomes hooked after taking 60.000 or more
puffs a year on a cigarette. The minor vice of smoking- that silly little ha
bit- has been well learned through repetitive practice. Habits well learned
are hard to break!
2. Our society at large which finds itself hooked - burdened with a king-sized
tobacco industry, mammoth agricultural enterprise, a considerable source
of governmental revenues, and a significant customer of the communications media.
Thus, we identify sociocultural and economic factors, in addition to personal
gratification, in the perpetuation of a learned, adaptive behaviour that is also
a primary health risk.
Prevalence of smoking
From its introduction into Western civilization by explorers returning
from the New World, smoking, until recently, was viewed almost exclusively
as a masculine activity. Before World War I, a woman who smoked usually
demeaned her femininity. During the past sixty years, however, women have
gradually cast aside the moral and social stigmas surrounding cigarette use,
and since World War II they have been smoking more and more like men- and
dying like men! Statistics for the United States show that for the generation
born between 1951 and 1960, the percentages of men and women smokers
are almost equal. Women are not only starting to smoke at younger age but
are also becoming heavier smokers. While many smokers eventually give up
the practice, once a woman takes up smoking, she is less likely to quit than a
man. According to the US government surveys, the number of men smokers
dropped from 53 percent in 1964 to 37 percent currently, but women smokers
declined from 32 percent in 1964 to only 28 percent at present.
It appears that attitudes toward smoking are becoming increasingly negative, even among smokers themselves. More than 70 percent of smokers
currently agree that smoking is harmful to their health and could lead to
disease and death. In addition, an estimated nine out of ten smokers would
like to quit, and a large percentage of smokers think that there should be some
regulations against smoking. At the same time, non-smokers are becoming
more and more forceful in their demands for pollution-free public environments. Evidently both smokers and non-smokers are becoming somewhat
less tolerant of smoking.
Surveys of teenage smokers reveal that nearly 12 percent of young persons
between twelve and eighteen years of age are current, regular smokers, i.e.,
they smoke at least weekly. This figure represents an actual decline over a
recent five-year period. But for the first time, more female than male teen238

agers are smoking, perhaps as an early sign of female social emancipation.

Surveys also indicate that nearly a million teenagers in the United States take
up smoking each year. The influence of peers who smoke and the role model
of smoking parents continue to attract new smokers despite the real health
hazards. In fact, most teenagers who smoke regularly are from families where
one or both parents smoke.
Personal Use vs. the Non-smoker
Until the invention of the cigarette manufacturing machine after the Civil
War, tobacco was principally consumed in pipes and cigars and in chewing
and sniffing. Once mass production of cigarettes was a reality and production
cost decreased, cigarettes became readily available Their pre-eminence as a
tobacco form has been traced to World War I where they found the favour of
the doughboys (soldiers).
Cigarettes have enjoyed an immense popularity because they provide the
user with certain personal gratifications unobtainable in other tobacco forms.
They can be smoked easily and quickly; they can be in haled; they are readily
available and relatively inexpensive; and they have been socially accepted or
at least tolerated.
Smoking has long been considered an individual right. However, little
thought or consideration has been given to what right the non-smoker has
to live and work in areas free from air polluted by smoke. It would seem as
though the non-smoker has a right to travel in an airplane, bus, or train; to
listen to a lecture or attend a concert in an auditorium; to work; or to eat at
a restaurant, without being exposed to air filled with the smoke from cigarettes, pipes or cigars. This calls for major changes as separate areas for the
smoker and the non-smoker arc increasingly demanded.
Recently the silent majority of non-smokers have become assertive in its
demands for plain, unpolluted air. Tired of being assaulted by tobacco smoke,
the vocal and visible non-smokers now proclaim that the smokers liberty ends
where their noses begin. Considerable number of organized groups of nonsmokers together with professional medical and dental associations, have
been successful in restricting smoking in public areas and in establishing the
legal right of non-smokers to be free of others cigarette smoke.
The non-smokers liberation movement has been successful in banning
cigarette commercials on television, limiting smoking in certain hospitals,
lobbying for laws and regulations that require health warnings on cigarette
packages and separate smoking and non-smoking sections on commercial
airlines and buses, and prohibiting smoking in trams, elevators, indoor theatres, libraries, art galleries, museums, and dining cars of passenger trains.
239

Not to be overlooked as a factor in cigarette consumption are the persistent promotional activities of tobacco companies and their advertising agencies. Agencies long ago discovered through motivational research that sales
could be increased if products were linked with basic human desires and
drives. Not content with assertions of mildness and good taste, advertisements soon depicted smokers as models of sophistication, eternal youth,
handsome ruggedness, enduring beauty, alluring sexuality, and determined
individualism, and with athletic prowess sufficient to walk at least a mile for
a favourite cigarette.
Smoking: An Adaptive Behaviour
These phenomena alone do not explain why people begin and continue
to smoke, especially when they frankly admit awareness of possible health
hazards. Many smokers express a desire to quit, but they just cannot manage
to do so. A consideration of smoking as adaptive behaviour may illuminate
the reasons and motivations involved in the use of cigarettes.
A Learned Behaviour
Smoking is a learned behaviour. No one is born a smoker, although the
new baby may interact with smokers and with smoke early in infancy - often
on the way home from the hospital after delivery. Curiosity and the desire to
imitate adults, especially smoking parents, probably encourage many children to experiment. The initial reaction, however, is likely to be unpleasant,
and usually there is no social approval forthcoming. It is not until adolescence
that smoking becomes a live option for most young persons. More time is now
spent away from home with peers; there is increased freedom from authority
figures who often discourage or forbid smoking; needs for security and acceptance through group conformity grow; and the demand or need for immediate
gratification flourishes. The psychological stage for smoking has been set
and is fertile enough to generate millions of new young smokers each year.
Psychological Rewards
The search for adulthood or maturity through the act of smoking appears
to be a primary factor in the initiation of cigarette use. Following the example
set by many adults and parents, adolescents partake of adulthood by smoking
- they feel older, more mature, and more important. Smoking may also help
them to overcome feelings of uncertainty and embarrassment in situations
that they find awkward. Thus, security is enhanced. There are other psychological rewards for the new smoker. Smoking may be the passport to acceptance
among ones peers; it may represent freedom or independence from restric240

tive home life or revolt against parental authority; it may be the result of an
unconscious desire to imitate esteemed smokers; it may be nothing more than
a soothing and pleasurable way to contract boredom. Because of the handto-mouth motions associated with lighting up, the cigarette may amount to a
convenient psychological recycling centre that provides a socially approved
and refreshing activity between environmental challenges. Some people like
the taste and smell of cigarettes, and a few get a kick out of watching the
smoke. In essence, the cigarette provides a smoker with a readily available
way to deal with a host of personal problems and needs.
Factors in Smoking Behaviour
1. Stimulation- If you score high or fairly high on this factor, it means that
you are one of those smokers who gets a lift from smoking - you feel that it
helps wake you up, organize your energies, and keep you going. The perkingup effect is due to nicotines temporary stimulation, which briefly relieves
fatigue. If you try to give up smoking, you may want a safe substitute: a brisk
walk or moderate exercise whenever you feel the urge to smoke.
2. Handling - Oral Gratification - Having something to handle, manipulate,
or fondle can be very satisfying. Additionally, having something in your mouth
to chew on, such as a toothpick, straw, or pencil, can fulfil certain emotional
needs. From a Freudian perspective, cigarette smoking may be seen as a
satisfaction of infantile needs to suck or chew - a fixation or libidinal energy
at the oral or mouth level. Why not try with a pen or pencil? Try doodling or
play with a coin, a piece of jewellery, or some other harmless object. If you
must put something in your mouth, use candy cigarettes or even a real cigarette if you can trust yourself not to light it.
3. Pleasurable Relaxation -About two-thirds of smokers score rather high
on the accentuation of pleasure. You smoke for positive feelings of contentment, achievement, victory, and satisfaction - such as upon completion of a
job well done or after a delicious, mouth-watering meal. Those who do get
real pleasure out of smoking often find that an honest consideration of the
harmful effect of their habit is enough to help them quit. They substitute eating,
drinking, social activities, and physical activities - within reasonable bounds
- and find they do not seriously miss their cigarettes.
4. Crutch-Tension Reduction - Many smokers use the cigarette to manage
negative effects, such as stressful situations and feelings of anger, fear, and
anxiety. Sometimes the cigarette is used as a tranquilizer or as an escape
vehicle from cares and worries. Thus, smoking represents a tension- reducing
activity. When the going gets rough, cigarettes can be a crutch, a comfort, and
a consolation. When it comes to quitting, this kind of smoker may find it easy
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to stop when everything is going well but may be tempted to start again in a
time of crisis. Again, physical exertion, eating, drinking, or social activity - in
moderation - may serve as useful substitutes in times of tension.
5. Craving- Psychological and Physical Addiction- Quitting smoking is difficult for the person who scores high on the factor of craving. For such an individual, the overpowering desire for the next cigarette begins to build up the
moment the old one is put out. A dependent or addicted smoker must have
a cigarette after a short period of time or otherwise experiences mild withdrawal symptoms - a nicotine fit with its uneasiness, restlessness, nervousness, anxiety, headache, digestive disturbances, and impairment of concentration, judgment, and psychomotor performance.
Peculiarly, the dependent smoker craves a cigarette, as in chain-smoking,
first to increase positive feelings and then to decrease negative feelings of
withdrawal. In essence, the smoker satisfies a need to smoke - a physical
need for more nicotine. Contrary to popular belief, research now suggests
that smoking does not reduce anxiety or calm nerves. Under stress, smokers
consume cigarettes heavily because stress depletes the bodys nicotine. Thus,
nicotine-deficient smokers smoke more under stress to maintain their usual
nicotine level.
Tapering off is not likely to work for dependent smokers. They must go
cold turkey. It may be helpful for them to smoke more than usual for a day
or two, so that the taste of cigarettes is spoiled, and then isolate themselves
completely from cigarettes until the craving is gone. Giving up cigarettes may
cause so much discomfort that once these persons quit, they will find it easy
to resist a return to smoking. Otherwise, they know that some day they will
have to go through the same agony again.
6. Habit-A behavioural pattern has been established almost involuntarily
by the habit smoker. This individual responds automatically to some cue - a
cup of coffee, getting into a car, or nearing the vicinity of an ashtray. Once
regarded as psychologically significant, smoking loses its former functions of
fulfilling status, relaxation, security, or other needs. Such a smoker no longer
gets much satisfaction from cigarettes.
Smoking: Agent of Maladaptation and Disease
From health point of view, personal gratification is acceptable for most
persons as long as it does not injure the individual or cause harm to other
persons. Unfortunately, smoking is now seen as a health threat to both.
Smokers, non-smokers, and even unborn children are caught up in this multifaceted problem leading to self indicated morbidity and premature mortality,

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increased health and welfare cost, added irritating effects of cigarette-induced

air pollution, and the mounting threat of home, commercial, and forest fires
caused by discarded cigarettes.
Figure 19.1. Diseases and conditions associated with smoking

tobacco
amblyopia
bronchitis
emphysema
coronary
heart disease
cirrhosis
of the liver
decreased
birth weight

lip, tongue,
gum cancer
larynx cancer
lung cancer
peptic ulcer
bladder cancer

accidents
Buerger's disease
peripheral
vascular
disease

Many diseases and conditions are associated with smoking. Not all are
causally related, but they should not be overlooked. For instance, accident
rates are higher for smokers than non-smokers. This includes fires in the
home caused by the smoker who dozes off with a lighted cigarette in hand.
The blood level of carbon monoxide is higher in smokers during the time they
are smoking. Increasing attention is being given to the question of whether
this carbon monoxide in the blood may be dulling the alertness of drivers to
the point where this is a contributory factor in auto accidents.

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Components of Cigarette Smoke

The starches, proteins, sugars, and hydrocarbons of the tobacco leaf, when
burned, are converted into a complex aerosol mixture of gases, uncondensed
organic vapours, and particulate matter. The temperature of the smoke at
the burning zone is nearly 900C, although that which reaches the smokers
mouth is in a temperature range from 30-50C.
While scientists estimate the number of cigarette smoke components to be
several thousands, only 1,200 have been identified to date. These components
of smoke are sufficient to produce an extremely dense respiratory environment, more concentrated than the air pollution of major urban centres. The
smoke from an average, nonfiltered cigarette is composed of several types
of chemicals.
Gaseous Elements and Compounds - These elements and compounds,
notably nitrogen and its oxides, carbon dioxide, oxygen, and carbon monoxide,
combine with the hemoglobin in red blood cells and thereby reduce the oxygencarrying capacity of the blood. Also isolated in the fraction of smoke from
cigarettes arc small amounts of toxic chemicals, particularly acetaldehyde,
acetone, and hydrogen cyanide.
Particulate Matter - Particulate matter, containing tiny particles of tobacco
smoke, is a respiratory tract irritant. Investigations have shown that more
than 90 percent of these particles remain in the lungs of the smoker who
inhales. When condensed, the particles- regarded as lung-damaging in size
- form a yellowish brown sticky mass known as tobacco tar, The tar contains
several carcinogenic (cancer producing) hydrocarbons, especially benzopyrene
and chrysene; nitrosamines; nickel compounds; fatty acids; phenols, which have
tumour-promoting activity in addition to being toxic to the cilia; and nicotine,
a colourless, oily compound in commercial insecticides.
Nicotine - Identified as the addictive or dependency- producing component in tobacco smoke, nicotine is responsible for the temporary stimulation
following smoking. Nicotine initiates a series of nervous and endocrine functions that result in a release of glycogen from the liver. This causes the brief
kick and reduction of fatigue often reported by smokers. Once absorbed into
the bloodstream, nicotine is also responsible for raising blood pressure and
heart rate, causing the heart to work harder, and for vasoconstriction (blood
vessel narrowing) that in turn lowers skin temperature.
The list of serious health risks should be sufficient to discourage smokers
from continuing their life-threatening form of adaptive behaviour and to deter
new smokers. But the mere presentation of facts has little effect upon all but
a few smokers those who are highly motivated to reduce their exposure

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to smoking or to quit smoking entirely. Persistence in smoking might seem

contradictory in this enlightened, scientific area, but it is due in part to the
effectiveness of early learning reinforced thousands of times, puff after puff.
As a result of so many rewarding interactions with cigarettes, smoke, and
other smokers, the individuals personal values and basic attitudes about life
become so ingrained and inflexible that they cannot be cast aside, even when
the person recognizes and openly admits the errors of prior learning.
Other considerations play a role in maintaining the conflict between
smoking behaviour and possible health hazards. One, of course, is the fact
that not everyone who smokes becomes ill, incapacitated, or dies. Indeed,
certain of the cigarette-related diseases may require some genetic, biological, chemical, or physical factor to be operable before smoking takes its toll.
Then, too, rationalization is commonly employed to justify the smokers
action. We often hear these replies to probing inquiries: Just one cigarette
never hurts anybody. It wont happen to me because Im lucky. Why should
I quit since I dont feel sick? Many of these excuses are based on the remoteness, the delayed action of the possible harmful effects of smoking. If one
cigarette caused serious, immediate illness or instant death, smoking would
rapidly decline or become extinct.
Risk taking, a necessary component of daily living, compounds the smoking
problem. Certainly, people should avoid certain risks, but sometimes risks are
taken if they seem negligible or remote in anticipation of the possible, immediate rewards. Not to be overlooked as a further explanation for perpetuating
a disease and death-inducing adaptive behaviour is the very real reluctance
of individuals to acknowledge that their actions are stupid, irrational, or injurious to themselves.
There are many authors nowadays who have raised another dimension of
cigarette problem suggesting that some smokers really do not care if their
life expectancy is reduced. Such dangerous indifference may reflect an insensitivity to the fragility and preciousness of life and may correlate with the
spread of violence and our life-style of abundance. In essence, the real danger
beyond smoking may be a crisis in basic human values.
Cardiovascular Diseases and Smoking
Cigarette smoking is now recognized as a significant risk factor contributing
to the development of specific cardiovascular diseases, namely, coronary heart
disease, atherosclerosis, and peripheral blood vessel disease. It is an established
fact that nicotine is responsible for the near-instantaneous increase in heart
rate, blood pressure, cardiac output, heart contractions, and consumption of

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oxygen by heart muscle. Because of its blood vessel narrowing effect, nicotine can also decrease peripheral blood flow, thus placing added stress on the
smokers heart. In its adaptive response to smoking the heart requires more
oxygen for its function. But carbon monoxide from cigarette smoke tends to
displace oxygen from hemoglobin, thus interfering with the transportation of
oxygen and depriving the heart muscle of its needed oxygen supply.
Recent evidence suggests that absorbed nicotine and carbon monoxide
contribute to the development of atherosclerosis (clogging of the arteries
with fatlike substances). Cigarette smoking may also be a factor in increased
platelet adhesiveness, which predisposes to blood clot formation.
Smoking and Chronic Obstructive Lung Diseases (COLD)
Pulmonary emphysema and chronic bronchitis, two diseases that until
recently were infrequently reported in the population, today are reaching
epidemic proportions. They are jointly referred to as COLD and are an adaptive response to inhaled irritants and a maladaptation to smoking.
Cigarette smoking has been identified as the most important cause of
COLD and increases greatly the risk of dying from pulmonary emphysema
and chronic bronchitis. While other factors, including hereditary predisposition, may contribute to COLD, cigarette smoking is now recognized as the
major factor in the promotion of pulmonary patients.
Chemicals in inhaled cigarette smoke irritate the bronchial tubes and alveolar sacs over and over again with each puff. In time, the tissues lining the
bronchi thicken, the mucous glands enlarge, and the normal cleansing system
of the lungs, especially ciliary function, is impaired. The smoker is now more
predisposed to respiratory infectious and aggravation of existing ones than
is the non-smoker.
Smoking and Lung Cancer
Most lung cancers originate in the lining or epithelium of the bronchi.
Normal epithelium cleanses the lungs of foreign matter such as dust or smoke
particles. Mucus secreted onto the surface of the epithelium, traps foreign
substances. Cilia, extending from the columnar cells, continually move the
mucus from the bronchi, through the trachea, and into the mouth, where it is
either swallowed or expectorated.
Tobacco smoke contains, in addition to tumour initiators and promoters,
substances that affect the cleansing action of the bronchial cells, and thus
indirectly influence the induction of lung cancer. These agents may impair

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and destroy cilia and may affect the mucus layer so that smoke particles are
retained in the bronchi.
In lung cancer victims, cures are rare, and 95 out of 100 persons who
develop lung cancer will be dead within five years. In fact, the survival rate for
the first year after diagnosis of lung cancer is only 25 percent.
Studies of the frequency, distribution, causes, and control of cigaretterelated diseases have led an overwhelming number of scientists to conclude
that smoking is the major cause of lung cancer in men. It is also a cause of lung
cancer in women, but for a variety of possible reasons - genetic, hormonal,
and differences in dose and frequency of exposure - it accounts for a smaller
proportion of cases in women than in men. However, the percentage of women
is steadily increasing and it is expected that lung cancer will soon surpass
breast cancer as the leading cancer peril to women. It is estimated that the
risk of death from this disease is nearly ten times greater for smokers than
for those who do not use cigarettes.
This uncontrolled growth or malignant neoplasm in the lungs is termed
bronchogenic carcinoma because it arises in the lining of the bronchial tubes
through which air passes inwardly to various parts of the lungs. The chances
of sustaining lung cancer are enhanced with increased numbers of cigarettes
smoked per day, with the duration or length of smoking, and with earlier initiation of use. The risks are reduced when smoking ceases. Apparently, cigarette
smoking triggers a disease process (via the tobacco tars) in which continual
repair and recovery are possible up to some critical point. Beyond this point,
the process is not reversible.
EXERCISES
1. Review Questions:
1.1. How has smoking helped humans adapt to their environment?
..........................................................................................................................................................................

1.2. Explain what is meant by smoking is suicide in slow motion.

..........................................................................................................................................................................

1.3. According to health statistics, how do men and women differ in smoking
habits? .........................................................................................................................................................
1.4. How do cigarettes provide the smoker with personal gratifications that
are not found in other tobacco forms? .....................................................................................
..........................................................................................................................................................................

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1.5. How has motivational research increased the sale of cigarettes?

..........................................................................................................................................................................

1.6. Explain some of the psychological rewards obtained by smoking.

..........................................................................................................................................................................

1.7. What physiological effects does nicotine have on the body?

..........................................................................................................................................................................

1.8. How does cigarette smoking account for the higher incidence of
cardiovascular disease?.....................................................................................................................
..........................................................................................................................................................................

1.9. What is pulmonary emphysema? How does it affect airflow within the
lungs?...........................................................................................................................................................
..........................................................................................................................................................................

1.10. What are the effects of chronic bronchitis? Is this more serious than
emphysema?............................................................................................................................................
1.11. How does cigarette smoking promote the development of cancer in
various parts of the body? ...............................................................................................................
..........................................................................................................................................................................

1.12. Do you think that risk-taking behaviour is a valid excuse for smoking?
..........................................................................................................................................................................

1.13. Discuss the advantages of smoking vs. non-smoking.

..........................................................................................................................................................................

1.14. Although there is no safe way to smoke, discuss the recommendations

made to make cigarette use less hazardous?
..........................................................................................................................................................................

1.15. Discuss the many possible alternatives to smoking.

..........................................................................................................................................................................

2. Fill in the missing word(s):

2.1. Indeed, smoking, ................................. and ........................................... have lightened
the .............................................................. life.

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2.2. Two areas have often been ............................ in which remedial .............................
is more difficult to ..........................................................
2.3. Women are not only starting to smoke ................................................................... but
are also becoming ...................................................... smokers.
2.4. It appears that ............................................ toward ................................. are becoming
increasingly ...................................................................................
2.5. Many smokers ........................................... a desire to .................................................. but
they just cannot .................................................. to do so.
2.6. It is not until ................................................................... that smoking becomes a live
.........................................................................................

for most young persons.

2.7. Thus, smoking ......................................... a tension-reducing .........................................

2.8. In essence, a smoker .................................................................... a need to smoke- a
physical need for more ......................................................................................................................
2.9. Such a smoker no ....................................... gets much .......................................... from
cigarettes.
2.10. The smoke of an average ................................................... cigarette is composed
of .....................................................................................
3. Define the meaning of the following terms:
3.1. gratification .............................................

3.9. tar .................................................................

3.2. maladaptation .......................................

3.10. alertness ................................................

3.3. prevalence ................................................

3.11. aerosol ....................................................

3.4. sociocultural ..........................................

3.12. irritant .....................................................

3.5. perpetuation ...........................................

3.13. nicotine ...................................................

3.6. craving .......................................................

3.14. vasoconstriction ................................

3.7. hazard .........................................................

3.15. cardiac output .....................................

3.8. carbon monoxide .................................

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4. Explain the following phrases.

4.1. psychoactive effect .............................

4.9. psychological recycling centre

..................................................................................

4.2. load of life ................................................

4.10. the perking-up effect ......................

4.3. to become hooked ..........................

4.11. psychological and physical

addiction .............................................................

4.4. adaptive behaviour ..............................

4.12. escape vehicle .....................................

4.5. to call for ...................................................

4.13. a live option ..........................................

4.6. to lobby for ...............................................

4.14. handsome ruggedness ..................

..................................................................................

..................................................................................

4.7. when the going gets rough ............

4.15. cold turkey ............................................

..................................................................................

4.8. to get a kick out of something .....

..................................................................................

5. Find verbs and adjectives of the following nouns:

5.1. preference ........................................................................................................................................
5.2. initiation ............................................................................................................................................
5.3. risk .......................................................................................................................................................
5.4. estimate ............................................................................................................................................
5.5. deprivation .......................................................................................................................................
5.6. abundance .......................................................................................................................................
5.7. value ....................................................................................................................................................
5.8. interference ....................................................................................................................................
5.9. addiction ...........................................................................................................................................
5.10. affection ..........................................................................................................................................
6. Provide the nouns of the following adjectives:
6.1. morbid ........................................................

6.6. alveolar ......................................................

6.2. libidinal ......................................................

6.7. ciliary ..........................................................

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6.3. bronchial ...................................................

6.8. adaptive .....................................................

6.4. pulmonary ................................................

6.9. perilous .....................................................

6.5. foreign ........................................................

6.10. genetic .....................................................

7. Translate into Croatian:

If you smoke and you still dont believe that theres a definite link between
smoking and bronchial troubles, heart disease and Jung cancer, then you arc
certainly deceiving yourself. No one will accuse you of hypocrisy. Let us just
say that you are suffering from a bad case of wishful thinking. This neednt
make you too uncomfortable because you are in good company. Whenever
the subject of smoking and health is raised, the governments of most countries hear no evil, see no evil and smell no evil. Admittedly, a few governments
have taken timid measures. In Britain, for instance, cigarette advertising has
been banned on television. The conscience of the nation is appeased, while
the population continues to puff its way to smoky, cancerous death. You dont
have to look very far to find out why the official reactions to medical findings
have been so lukewarm. The answer is simply money. Tobacco is a wonderful
commodity to tax. Its almost like a tax on our daily bread. In tax revenue alone,
the government of Britain collects enough from smokers to pay for its entire
educational facilities. So while the authorities point out ever so discreetly that
smoking may, conceivably, be harmful, it doesnt do to shout too loudly about
it. This is surely the most short-sighted policy you could imagine. While money
is eagerly collected in vas t sums with one hand, it is paid out in increasingly
vaster sums with the other. Enormous amounts are spent on cancer research
and on efforts to cure people suffering from the disease. Countless valuable
lives are lost. In the long run, there is no doubt that everybody would be much
better off if smoking were banned altogether.
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CHAPTER 20

AIDS
Acquired immune deficiency syndrome, or AIDS, is a recently recognized
disease entity. It is caused by infection with the human immunodeficiency virus
(HIV), which attacks selected cells in the immune system and produces defects
in its function. These defects may not be apparent for years. They lead in a
relentless fashion, however, to a severe suppression of the immune systems
ability to resist harmful organisms. This leaves the body open to an invasion
by various infections, which are therefore called opportunistic diseases, and
to the development of unusual cancers. The virus also tends to reach certain
brain cells. This leads to the so-called neuropsychiatric abnormalities, or
psychological disturbances caused by physical damage to nerve cells.
Since the first AIDS cases were reported in 1981, through mid-1992, more
than 190,000 AIDS cases and more than 152,000 deaths had been reported
in the United States alone. This is only the top of the iceberg of HIV infection,
however. It is estimated that between 1 million and 1.5 million Americans had
been infected with the virus by the early 1990s but had not yet developed clinical symptoms. In addition, although the vast majority of documented cases
have occurred in the United States, AIDS cases have been reported in about
162 countries worldwide. Sub-Saharan Africa in particular appears to suffer
a heavy burden of this illness.
No cure or vaccine now exists for AIDS. Many of those infected with HIV
may not even be aware that they carry and can spread the virus. It is evident
that HIV infection represents an epidemic of serious proportions. Combating
it is a major challenge to biomedical scientists and health-care providers. HIV
infection and AIDS represent one of the most pressing public policy and public
health problems worldwide.

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Definition of AIDS
The U. S. CENTER FOR DISEASE CONTROL has established criteria for
defining cases of AIDS that are based on laboratory evidence, the presence
of certain opportunistic diseases, and a range of other conditions. The opportunistic diseases are generally the most prominent and life-threatening clinical manifestations of AIDS. It is now recognized, however, that neuropsychiatric manifestations of HIV infection of the brain are also common. Other
complications of HIV infection include fever, diarrhea, severe weight loss, and
swollen lymph nodes.
When HIV-infected persons experience some of the above symptoms but
do not meet full criteria for AIDS, they are given the diagnosis of AIDS-related
complex, or ARC. The growing feeling is that asymptomatic HIV infection and
ARC should not be viewed as distinct entities but, rather, as stages of an irreversible progression toward AIDS.
Historical Background
In the late 1970s, certain rare types of cancer and a variety of serious
infections were recognized to be occurring in increasing numbers of previously healthy persons. Strikingly, these were disorders that would hardly ever
threaten persons with normally functioning immune systems. First formally
described in 1981, the syndrome was observed predominantly to be affecting
homosexual and bisexual men. Soon thereafter, intravenous drug users,
hemophiliacs, and recipients of blood transfusions were recognized as being
at increased risk for disease as well. It was also noted that sexual partners
of persons displaying the syndrome could contract the disease.
Further study of AIDS patients revealed marked depletion of certain
white blood cells, called T4 lymphocytes. These cells play a crucial role in
orchestrating the bodys immune defences against invading organisms. It
was presumed that this defect in AIDS patients was acquired in a common
manner. Then, in 1983, a T-cell lymph tropic virus was separately discovered
by Robert Gallo at the U. S. National Institutes of Health and Luc Montaigne at
Frances Pasteur Institute. The virus was at first given various names: human
lymphotropic virus (HTLV) III, lymphadenopathy-associated virus (LAV), and
AIDS -associated retrovirus (ARV). It is now officially called human immunodeficiency virus (HIV), and considerable evidence demonstrates that it is indeed
the causative agent for AIDS. A second strain that has been identified, HIV-2,
is thus far relatively rare outside of Africa.
Little is known about the biological and geographical origins of HIV. Apparently, however, this is the first time in modern history that the virus has spread

254

widely among human beings. Related viruses have been observed in animal
populations, such as certain African monkeys, but these do not produce
disease in humans.
The Nature of the Virus
HIV is an RNA RETROVIRUS. Viewed in an electron microscope, it has a
dense cylindrical core that encases two molecules of viral RNA genetic material. A spherical outer envelope surrounds the core.
Like all retroviruses, HIV possesses a special enzyme, called reverse transcriptase, which is able to make a DNA copy of the viral DNA. This enables the
virus to reverse the normal flow of genetic information and to incorporate its
viral genes into the genetic material of its host. The virus may then remain
in a latent form for a variable and often lengthy period of time until it is reactivated. Further knowledge of the mechanisms and triggers of the activation
process is important to the efforts being made to control HIV infection.
A critical step in HIV infection is the binding of the virus to a host-cell
receptor, enabling it to gain entrance into the cell. Studies have demonstrated
that a molecule called CD4, expressed predominantly on the surface of the T4
cell, serves as this receptor. Although the T4 cell is a major HIV target, virtually any other cell also expressing the CD4 surface molecule is able to become
infected with HIV. Thus cells of the monocyte and macrophage type are very
important additional targets.
Modes of Transmission
Researchers have isolated HIV from a number of body fluids, including
blood, semen, saliva, tears, urine, cerebrospinal fluid, breast milk, and certain
cervical and vaginal secretions. Strong evidence indicates, however, that HIV
is transmitted only through three primary routes: sexual intercourse, whether
vaginal or anal, with an infected individual; nondigestive exposure to infected
blood or blood products; and from an infected mother to her child before or
during birth.
At least 97 percent of U.S. AIDS cases have been transmitted through one
of these routes, with transmission between homosexual men accounting for
about 60 percent of the cases. Heterosexual transmission in the United States
accounts for only about 5 percent of cases but is a significant mode of transmission in Africa and Asia. About 21 percent of AIDS cases occur in intravenous drug abusers exposed to HIV-infected blood through shared needles.
Current practices of screening blood donors and testing all donated blood
and plasma for HIV antibodies have reduced the number of cumulative cases
due to transfusion to about 1 percent.
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The number of new cases of AIDS in women of reproductive age is increasing

at an alarming rate. AIDS has become the leading cause of death for women
between the ages of 20 and 40 in the major cities of North and South America,
Western Europe, and sub-Saharan Africa. In the United States, AIDS has hit
hardest among black and Hispanic women. These women represent 17 percent
of the female population but make up 73 percent of women with AIDS. AIDS
is also having a devastating impact on infant mortality, since over 80 percent
of HIV-infected children under the age of 13 acquired HIV from their infected
mothers. Between 24 and 33 percent of children born to infected women will
develop the disease.
No scientific evidence supports transmission of AIDS through ordinary
nonsexual conduct. Careful studies demonstrate that despite prolonged
household contact with infected individuals, family members have not become
infected--except through the routes described above. Health-care workers
have been infected with HIV from exposure to contaminated blood or by accidentally sticking themselves with contaminated needles.
Clinical Signs
Following infection with HIV, an individual may show no symptoms at all,
or may develop an acute but transient mononucleosis-like illness. The period
between initial infection and the development of AIDS can vary greatly, apparently from about 6 months to 11 years. Various estimates indicate that somewhere between 26 to 46 percent of infected individuals will go on to develop
full-blown AIDS within a little more than 7 years following infection. Once AIDS
sets in, the clinical course generally follows a rapid decline; and most people
with AIDS die within 3 years.
Opportunistic Infections and Cancers
Because the T4 cell is involved in almost all immune responses, its depletion renders the body highly susceptible to opportunistic infections and
timorous growths. The most predominant and threatening is Pneumocystic
carinii PNEUMONIA, which is frequently the first infection to occur and is the
most common cause of death. Other infections include the parasites Toxoplasma gondii (TOXOPLASMOSIS) and Cryptosporidiosis; fungi such as Candida
(CANDIDIASIS) and Cryptococcus (FUNGUS DISEASES); mycobacteria such as
Mycobacterium avium, intracellulare, and tuberculosis (TUBERCULOSIS); and
viruses such as cytomegalovirus and herpes simplex and zoster. Increased
susceptibility to bacterial infection is noted particularly among children with
AIDS.

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Many AIDS patients develop cancers, including Kaposi sarcoma (KS), nonHodgkin lymphoma, and Hodgkin disease. KS occurs in patients who manifest hardly any evidence of immunological impairment, indicating that other
factors may also be at work in the development of such cancers. Among the
non-Hodgkin lymphomas are immunoblastic and Burkitt-type lymphomas as
well as primary brain lymphomas. These tumours tend to be unusually aggressive and poorly responsive to chemotherapy, particularly in AIDS patients who
have already experienced opportunistic infections.
Other HIV-Related Disorders and Co-Factors
Neuropsychiatric manifestations occur in about 60 percent of HIV-infected
persons. It is now well established that HIV can exist and proliferate within
the brain, spinal cord, and peripheral nerves. This results in a broad range of
symptoms, including meningoencephalitis and dementia. Evidence thus far
indicates that circulating HIV-infected monocytes may be responsible for the
initiation of infection in the brain, with little evidence to support direct infection of neuron tissue by HIV.
Blood-cell abnormalities of HIV patients include anemia, reduced white
blood-cell counts, and platelet deficiencies. Researchers have also been able
to show direct infection of bone-marrow cells--the precursors of circulating
blood cells-- and the proliferation of the virus within these cells. Thus bone
marrow may represent an important reservoir of HIV in an infected person
and provide a potential mechanism for dissemination of the virus through
the body. Other HIV-related syndromes include nephritis, arthritis, and lung
inflammation (pneumonitis).
Certain co-factors appear to play an important role in HIV infection and
AIDS by increasing susceptibility to infection and by enhancing viral-disease
activity. Other sexually transmitted diseases appear to be of particular significance. Damage to genital skin and mucous membranes may facilitate transmission of the virus. In addition, laboratory studies show that certain microbes
frequently found in AIDS patients, such as mycoplasmas, also probably act
as co-factors.
Treatment of HIV
Two major avenues are being pursued by biomedical scientists in the fight
against HIV infection and AIDS One strategy is to develop a vaccine that can
induce neutralizing antibodies against HIV and protect uninfected individuals
if exposed to the virus itself. The second approach involves the discovery and
development of therapeutic agents against HIV infection and AIDS.

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At present no vaccine exists to protect against infection, although recent

advances have led some experts to predict that a vaccine should be available
within the next 10 years. Obstacles still remain, however, primarily due to
the variability of the virus itself. Many different strains of HIV exist, and even
within a given individuals body the virus can undergo mutations rapidly and
easily. A number of candidate vaccines were in the early phases of testing in
human volunteers by the early 1990s around the world.
Dramatic strides are also being made in the treatment of HIV infection and
its complications. Efforts are being focused on two major areas: antiviral drugs
with a direct effect against the causative agent, and immunomodulators that
act to reconstitute or enhance immune-system function. Efforts to develop
and improve treatments of specific opportunistic infections and neoplasms
are also being made.
Because of the complex life cycle of HIV, however, the successful development of antiviral and immune-enhancement therapies represents an enormous scientific challenge. Unlike most known pathogens, HIV infects the very
cells that are intended to orchestrate and lead the immune systems attack
against invaders. This makes it technically very hard to kill the virus without
destroying the already threatened immune system. Furthermore, there may
be several important reservoirs in the body for HIV that will be difficult to deal
with while not causing fundamental damage to the host cells involved. For
example, macrophage cells can support HIV replication while harbouring the
virus from the bodys immune surveillance. Circulating macrophages appear to
play an important role in the propagation of HIV throughout the body, including
the brain.
In seeking effective therapies, other important considerations are involved.
Thus, since the brain is an important target of HIV infection, an effective antiHIV agent should be able to cross the blood-brain barrier. It would also be
desirable if therapies could be taken orally, since it is likely that AIDS drugs
would have to be taken for a long period and perhaps a lifetime. Dozens of
agents have been tested in humans, but only two have been licensed by the
U.S. Food and Drug Administration (FDA): azidothymidine (AZT) and dideoxyinosine (DDI). AZT interferes with virus replication and has been found to
prolong life significantly in some patients and delay the onset of full-blown
AIDS in persons with no symptoms, but its potentially toxic side effects may
preclude uses in many cases. DDI acts similarly but is recommended for those
who cannot tolerate AZT. Other promising drugs are in clinical trials. Some
drugs are available to fight major opportunistic illnesses. Eye infections can
be treated with ganciclovir or foscarnet, which also helps patients live longer,
while aerosolized pentamidine fights Pneumocystis carinii pneumonia and
protects the patient from AIDS dementia.
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The slow process of FDA approval of new AIDS drugs has developed into a
political issue. AIDS activists are demanding that the government speed up
authorization by postponing certain tests comparing efficacy and ability to
prolong life until after the drug is on the market. While a faster approval rate
may expose patients to unforeseen side effects, activists argue that patients
with life-threatening diseases who have no alternative therapy should still be
entitled to choose these drugs.
Efforts at Prevention
In the absence of an effective vaccine or therapy, education and risk reduction remain the most powerful tools in the fight against AIDS. Because of the
limited number of transmission routes, the further spread of AIDS could virtually be stopped by avoiding behaviours that place persons at risk. Education
can help to achieve this, through development and dissemination of materials
by local community groups, statewide organizations, and national governments. In 1988, for example, the U.S. Public Health Service produced a simple,
straightforward brochure containing information about HIV infection and AIDS.
The brochure was mailed to every household in the U.S.A.
A test to screen blood directly for antibodies to HIV was developed and
made available. The presence of antibodies, which generally takes weeks
or months to develop, means only that an individual has been exposed to the
virus. It does not indicate whether that individual has or will develop AIDS,
although this is almost certain.
All blood intended for use in transfusion or manufacture of blood products is now tested for the antibody. The standardized procedure involves the
use of the ELISA (enzyme-linked immunosorbent assay) screening test, with
confirmation of positive results with a more specific test known as the Western
Blot. Blood that tests positive on any of these is absolutely eliminated from
the blood-donation pool. Tissue and organ banks use a similar process. Blood
donations themselves pose no risk of HIV infection at all, because sterile equipment is always used.
Conclusion
The AIDS epidemic is having a profound impact on many aspects of medicine and health care. The U.S. Public Health Service estimates that the annual
cumulative lifetime cost of treating all persons with AIDS in the United States
in 1991 is $5.3 billion; this is expected to reach $7.8 billion by 1993. The Public
Health Service budget for AIDS research was $849 million in 1991. Persons
exposed to HIV are having difficulties in obtaining adequate health insurance
coverage. Year AZT expenses, for example, can average approximately $6,000,
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although in 1989 the drugs maker did offer to distribute AZT freely to HIVinfected children. The yearly expense for DDI is somewhat less at $2,000.
The effects of the epidemic on society at large are increasingly evident. AIDS
tests are now required in the military services. Various proposals have been
made for mandatory screening of other groups such as health-care workers,
especially since a Florida dentist who died of AIDS in 1990 is believed to have
infected five patients. A number of nations, including the United States, have
instituted stringent rules for testing long-term foreign visitors or potential
immigrants for AIDS, as well as testing returning foreign nationals. In the
United States one frequent phenomenon is the effort to keep school-age children with AIDS isolated from their classmates, if not out of school altogether.
Governmental and civil rights organizations have countered restrictive moves
with a great deal of success. There is little doubt that the ultimate physical
toll of the AIDS epidemic will be high, as will be its economic costs, however
the social issues are resolved. Concerted efforts are under way to address
the problem at many levels, and they offer hope for successful strategies to
combat HIV-induced disease.
Margaret A. Hamburg, M.D.

(Copyright - 1993 Grolier Electronic Publishing, Inc.)

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CHAPTER 21

STRESS MANAGEMENT FOR PATIENT AND PHYSICIAN

By David B. Posen, MD
The Canadian Journal of Continuing Medical Education, April 1995
One of the most important things we can do for patients is teach them
about stress management. Even better, we can learn these lessons ourselves
and then model them for our patients. Although there are many approaches
to stress management, this article lists 10 ways for reducing stress that are
practical, beneficial and which even busy physicians can start implementing
in their patients and their own lives.
Main Article
Stress is the most common cause of ill health in our society, probably
underlying as many as 70% of all visits to family doctors. It is also the one
problem that every doctor shares with every patient. This presents physicians
with two advantages:
It is an issue we can relate to experientially so we can use ourselves as a
reference point
In studying and better understanding stress, we can derive personal as
well as professional benefits.
The manifestations of stress are legion. Early in the 20th century, medical
students were taught that if you know syphilis (the great masquerader), you
know medicine. One could say the same about stress. It can contribute to or
mimic just about any symptom you can think of. However, the main presentations can be summarized under four headings: physical, mental, emotional
and behavioural.
The causes of stress are multiple and varied but they can be classified in two
general groups: external and internal. External stressors can include relatives
getting sick or dying, jobs being lost or people criticizing or becoming angry.

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However, most of the stress that most of us have is self-generated (internal).

We create the majority of our upsets, indicating that because we cause most
of our own stress, we can do something about it. This gives us a measure of
choice and control that we do not always have when outside forces act on us.
This also leads to my basic premise about stress reduction: to master
stress, you must change. You have to figure out what you are doing that is
contributing to your problem and change it. These changes fall into four categories: change your behaviour, change your thinking, change your lifestyle
choices and/or change the situations you are in. By getting to the root causes
of your stress, you can not only relieve current problems and symptoms but you
can also prevent recurrences. For example, if you keep becoming frustrated
over arguments with your children, you might discover that the cause of your
upset is not their behaviour but your unrealistic expectations. By modifying
your standards, you might find the childrens actions no longer bother you.
There are many ways to relieve stress, from going for a walk to quitting your
job. Here follows a list of 10 practical and down-to-earth strategies which I
have found helpful over the years for both myself and my patients. Some are
simple and can be implemented quickly; others are a bit more involved. All
are feasible and beneficial.
1. Decrease or Discontinue Caffeine
In terms of bang for the buck, it is hard to beat this simple intervention.
Most patients do not realize that caffeine (coffee, tea, chocolate and cola) is a
drug, a strong stimulant that actually generates a stress reaction in the body.
I tell patients that the best way to observe the effect of caffeine is to get it
out of the system long enough to see if there is a difference in how they feel.
Three weeks is adequate for this purpose and all my patients accept this
suggestion, especially
when I frame it as an experiment. (If you dont notice a difference, you can
go back to it; but if you feel better without it, you will probably want to stay
off it.) I would guess that 75% to 80% of my patients notice a benefit. They
feel more relaxed, less jittery or nervous, sleep better, have more energy (a
paradox, since you are removing a stimulant), less heartburn and fewer muscle
aches. Many patients feel dramatically better and cannot believe the difference.
One warning, however. Patients must wean themselves gradually or they
will get migraine-type withdrawal headaches. I suggest decreasing by one
drink per day until they are down to zero, then they should abstain for three
weeks. When they feel better, they will thank you. In fact, you will be a hero
because it is such an easy thing to do and delivers a big payoff Incidentally,

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I do not believe caffeine is a highly addictive substance. I have never met a

patient in 10 years who could not give it up within one week.
2. Regular Exercise
As a way of draining off stress energy, nothing beats aerobic exercise. To
understand why, we need to review what stress is. People often think of stress
as pressure at work, a demanding boss, a sick child or rush-hour traffic. All
these may be triggers but stress is actually the bodys reaction to factors such
as these. Stress is the fight-or-flight response in the body, mediated by adrenaline and other stress hormones, and comprised of such physiologic changes
as increased heart rate and blood pressure, faster breathing, muscle tension,
dilated pupils, dry mouth and increased blood sugar. In other words, stress
is the state of increased arousal necessary for an organism to defend itself
at a time of danger.
The stress reaction is in us, not out there. It provides us with the strength
and energy to either fight or run away from danger and is therefore selfprotective. There is only one problem: unlike a caveman being attacked by
a wild animal or warring tribesman, fighting and running away are rarely
appropriate responses to stressful situations in the modern world. The result
is that our bodies go into a state of high energy but there is usually no place
for that energy to go; therefore, our bodies can stay in a state of arousal for
hours at a time.
Exercise is the most logical way to dissipate this excess energy. It is what
our bodies are trying to do when we pace around or tap our legs and fingers. It
is much better to channel it into a more complete form of exercise like a brisk
walk, a run, a bike ride or a game of squash. During times of high stress, we
could benefit from an immediate physical outlet - but this often is not possible.
However, regular exercise can drain off ongoing stress and keep things under
control. I recommend physical activity every day or two. At the very least, it is
important to exercise three times per week for a minimum of 30 minutes each
time. Aerobic activities like walking, jogging, swimming, bicycling, racquet
sports, skiing, aerobics classes and dancing are suitable. Choose things you
like or they will feel like a chore and you will begin to avoid them. It is also
beneficial to have a variety of exercise outlets. I have never met a patient who
did not feel better with some form of regular exercise- and I know I could not
exist without it. For chronic or acute stress, exercise is an essential ingredient
in any stress reduction program.

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3. Relaxation/Meditation
Another way to reduce stress in the body is through certain disciplines
which fall under the heading of relaxation techniques. Just as we are all
capable of mounting and sustaining a stress reaction, we have also inherited
the ability to put our bodies into a state of deep relaxation which Dr. Herbert
Benson of Harvard University has named the relaxation response. In this
state, all the physiologic events in the stress reaction are reversed: pulse
slows, blood pressure falls, breathing slows and muscles relax.
Where the stress reaction is automatic, however, the relaxation response
needs to be brought forth by intention. Fortunately, there are many ways of
doing this. Sitting quietly by a lake or fireplace, gently petting the family cat,
lying on a hammock and other restful activities can generate this state. There
also are specific skills that can be learned which are efficient and beneficial.
A state of deep relaxation achieved through meditation or self-hypnosis is
actually more physiologically restful than sleep. These techniques are best
learned through formal training courses which are taught in a variety of places.
Books and relaxation tapes can be used when courses are not available or are
beyond the patients budget.
I can attest to the benefits of regular meditation from personal experience. And on days when exercise is not possible, relaxation techniques are an
excellent way to bring down the bodys stress level. Whereas exercise dissipates stress energy, relaxation techniques neutralize it, producing a calming
effect. As little as 20 minutes once or twice per day confers significant benefit.
4. Sleep
As mundane as it sounds, sleep is an important way of reducing stress.
Chronically stressed patients almost all suffer from fatigue (in some cases
resulting from stress-induced insomnia), and people who are tired do not cope
well with stressful situations. These dynamics can create a vicious cycle. When
distressed patients get more sleep, they feel better and are more resilient and
adaptable in dealing with day-to-day events. I always ask patients how much
sleep they are getting, whether they wake up rested or tired, and how much
sleep they generally need to function well. Most people know what their usual
sleep requirement is (the range is five to 10 hours per night; the average being
seven to eight), but a surprisingly large percentage of the population is chronically sleep deprived. I urge patients to go to bed 30 to 60 minutes earlier and to
monitor the results after a few days or a week. If they are still tired, I suggest
a bedtime 30 minutes earlier than this. Eventually, they find what works for
them. The three criteria of success are waking refreshed, good daytime energy
and waking naturally before the alarm goes off in the morning.
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Sleeping-in is fine but if you sleep too long, it throws off your body rhythms
during the following day. It is better to go to bed earlier. Daytime naps are an
interesting phenomenon. They can be valuable if they are short and timed
properly (i.e., not in the evening). The power nap or catnap is a short sleep
(five to 20 minutes) that can be rejuvenating. A nap lasting more than 30
minutes can make you feel groggy. Patients with insomnia should be discouraged from daytime naps. Beyond these cautionary notes, sleep can be key in
reducing stress and helping patients cope and function better.
5. Time-outs and Leisure
No one would expect a hockey player to play an entire game without taking
breaks. Surprisingly though, many otherwise rational people think nothing of
working from dawn to dusk without taking intermissions, and then wonder
why they become distressed. The two major issues are pacing and work/
leisure balance.
Pacing has two components: monitoring your stress and energy level, and
then pacing yourself accordingly. It is about awareness and vigilance; knowing
when to extend yourself and when to ease up. It is also about acting on the
information your body gives you. A diagram designed by Dr. Peter Nixon, a
British cardiologist, illustrates some important points:
Increased stress produces increased performance, initially.
Once you pass a certain point (the hump), any more stress results in
decreased performance. Trying harder at this point is unproductive or
even counterproductive. The only sensible move is to take a break.
We need a certain amount of stress to function well (healthy tension) this is called eustress (good stress). However, stress becomes harmful
(distress) when there is too much, when it lasts too long or when it
occurs too often.
One of the first symptoms of distress is fatigue, which we tend to ignore.
Dr. Nixon advocates a healthy respect for fatigue and doing something
about it before it becomes exhaustion.
An important key to pacing is taking periodic time-outs. Too many people
go far too long without breaks. Dr. Ernest L. Rossi wrote The 20-Minute Break,
an excellent book extolling the virtues of a short recess every couple of hours
throughout the day. Just as we all have cycles of deep sleep and dream sleep
throughout the night (at roughly 90- to 120-minute intervals), we also have
cycles through the day: peaks of energy and concentration interspersed with
troughs of low energy and inefficiency. These cycles are called ultradian
rhythms because they happen many times per day (as opposed to the 24-hour
circadian rhythm with which we are all familiar). The main point of the book
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is that we need to watch for these troughs and take 20 minute ultradian
healing breaks when they occur, as opposed to working through them and
building up stress.
It is not always convenient for people to take time-outs when nature tells
us to but we can all become better at this. A mid morning break, lunch, a mid
afternoon break and supper divide the day into roughly two-hour segments.
These time-outs can include power naps, meditation, daydreaming, a social
interlude, a short walk, a refreshment break, a change to low-concentration
tasks or listening to music. Since I (and some of my patients) have started to
work with this biologic pattern (instead of resisting it), the results have been
pleasing. Like the catnap, it is simply a good investment of time that pays itself
back quickly in increased productivity and reduced stress.
Work-leisure balance. Despite all our labour-saving devices, leisure is
still an elusive commodity for most people. Statistics show that the average
American (and probably Canadian) is working an extra three hours per week
compared with 20 years ago. That translates into an extra month of work each
year. Add to that the phenomenon of the two career family (which makes family
and leisure time even more scarce) and you start to get a picture of society on
an accelerating treadmill.
Leisure time and levels of distress are inversely proportional - the less
leisure, the more stress. I ask patients to fill in a chart so we can both see what
their work/leisure ratio looks like. I ask them to think of their lives (excluding
sleep time) in four compartments (work, family, community and self) and then
to assess what percentage of their time and energy in an average week goes
into each part. There is no normal range but I become concerned when work
is over 60% and/or when self is less than 10%. We all require time to meet
our own needs (self-care, self-nurturing, etc.) and when that is neglected,
trouble usually follows. Self directed activities can include exercise or recreation, relaxation, socializing, entertainment and hobbies. The word leisure
is derived from the Latin word licere which means permission. The main
reason so many people do not have enough leisure is that they are not giving
themselves permission to make the time to enjoy it.
Leisure is one of the most pleasant stress relievers ever invented. It is
strange that people resist it so much (e.g., feeling selfish, guilty). I am not
preaching hedonism - just a healthy amount of necessary respite from the
days pressures. We as doctors can give patients permission if they will not
give it to themselves. Once they experience a payoff, the benefits will reinforce
the behaviour. After that, they are usually able to give themselves permission.

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6. Realistic Expectations
A common source of stress is unrealistic expectations. People often become
upset about something, not because it is innately stressful, but because it
does not concur with what they expected. Take, for example, the experience
of driving in slow-moving traffic. If it happens at rush hour, you may not like
it but it will not surprise or upset you. However, if it occurs on a Sunday afternoon, especially if it makes you late for something, you are more likely to be
stressed by it.
When expectations are realistic, life feels more predictable and therefore
more manageable. There is an increased feeling of control because you can
plan and prepare yourself (physically and psychologically). For example, if you
know in advance when you have to work overtime or stay late, you will take it
more in stride than when it is dropped on you at the last minute.
There is much we can do to help patients by letting them know when their
expectations (of themselves and others) are unrealistic. I remember a patient
berating himself and feeling guilty because he did not love his stepdaughter
as much as his own biologic children. Blended families are common and I
suspect many people struggle with this issue of love and loyalty. I asked this
man where he got the idea that he would love his second wifes children as
if they were his own. He did not know. I suggested to him that his expectation was probably unrealistic, especially early in the new marriage. He felt
relieved by this idea and stopped putting pressure on himself to feel something he did not feel.
As for expectations of others, another patient said: Expect less from people
who cannot give you what you want. It makes it easier - not great, just less
upsetting.
7. Reframing
This is one of the most powerful and creative stress reducers of which I
know. Reframing is a technique used to change the way you look at things
in order to feel better about them. We all do this inadvertently at times. For
example, many people viewed the baseball, or football strikes as a personal
disaster whereas others immediately realized they were going to save a lot
of time and money by not hotfooting it down to the ballpark whenever their
favourite teams were in town.
The key to reframing is to recognize that there are many ways to interpret
the same situation. It is like the age-old question: Is the glass half empty or
half full? The answer of course is that it is both or either, depending on your
point of view. As Dr. Joel Goodman put it at The Power of Laughter and Play

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Conference, Toronto, 1986: There is more than one meaning to the same
reality. However, if you see the glass as half full, it will feel different than
seeing it as half empty because the way we feel almost always results from
the way we think. The message of reframing, then, is that there are many
ways of seeing the same thing - so you might as well pick the one you like.
One of the things we can do with patients is help them reframe stressful
situations. This most often involves helping them see positives in a negative
situation and assisting them in understanding the behaviour of other people.
It is best to get the patient to provide the input first (to which you can add
later) by asking certain questions. The information is more meaningful when
it comes from them. For example, I had a patient who lost her job because of
a chronic, though not life-threatening illness. I asked if anything positive had
come out of this experience and she came up with several things, including
It will make me a stronger person, I never liked the work I was doing
before. This gives me the chance to do what I really want to do, It has made
my marriage stronger, It has brought me closer to my family, and I have
learned to watch my money and spend more carefully, which I never had to
do before. I then asked her to focus on what is there (what she can still do)
rather than what is missing (due to the restrictions of her illness). She replied,
Most things - my hobbies, watch television, go to the cottage, socialize, go
out; although some things are still (physically) uncomfortable. By asking her
to think about her illness from a different perspective, she was encouraged to
reframe the situation and she felt better emotionally as a result.
In terms of reframing the behaviour of other people, ask patients why they
think someone did what they did. For example, a womans boss was acting
critical and domineering towards her. I said, Assuming your boss is not just
evil or malicious, why do you think she might be acting like this? Answers
included, She is probably insecure, She is under a lot of pressure2, and
She is having personal problems. Performing this exercise helped the patient
step outside herself and look at other possible interpretations of her bosss
behaviour. After that, her upset was considerably decreased. In fact, after such
a discussion some patients feel more compassion than anger for the person
who is bothering them.
Notice that reframing does not change the external reality but simply helps
people view things differently (and less stressfully). It should be done with a
bit of preamble to explain the premise (e.g., using the glass half empty as an
illustration) and only after you have acknowledged the validity of the patients
initial (stressful) interpretation. You are not trying to disrespect their point of
view but only to suggest there are other, less stressful ways of looking at the
same thing.
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8. Belief Systems
A lot of stress results from our beliefs. We have literally thousands of premises and assumptions about all kinds of things that we hold to be the truth
- everything from, You cant fight City Hall and The customer is always
right, to Men shouldnt show their emotions and Children should make
their beds. We have beliefs about how things are, how people should behave
and about ourselves (I can never remember peoples names). Most of our
beliefs are held unconsciously so we are unaware of them. This gives them
more power over us and allows them to run our lives.
Beliefs cause stress in two ways. The first is the behaviour that results from
them. For example, if you believe that work should come before pleasure, you
are likely to work harder and have less leisure time than you would otherwise.
If you believe that people should meet the needs of others before they meet
their own, you are likely to neglect yourself to some extent. Several patients
tell me, If you want something done right, you have to do it yourself They do
not delegate well and tend to get overloaded.
In the above three cases, the beliefs are expressions of peoples philosophy or value system, but all lead to increased effort and decreased relaxation - a formula for stress. There is no objective truth to begin with. These
are really just opinions but they lead to stressful behaviour. Helping patients
uncover the unconscious assumptions behind their actions can be helpful in
getting them to change.
The second way beliefs cause stress is when they are in conflict with those
of other people. One of my patients had a fight with his son because the child
wore the same clothes several days in a row. I asked why it bothered him
and he replied, Because you should change your clothes every day. I asked
him where this idea originated: Well, my mother taught me that. Everyone
knows you should change your clothes every day. I told him that this was not
the truth, but merely his opinion based on the way he was raised. I said I
had lived in cultures where people did not change clothes often and nothing
bad happened to them. I helped him see that this was a premise he held but
one which was not shared by his son. The argument was not over the clothes
themselves but merely about a difference of opinion. Once he recognized his
belief was not true, his anger diminished.
We can do much for patients by getting them to articulate their beliefs
and then to label them as such. Next, we need to help them acknowledge
that their assumptions are not truth but rather opinions and, therefore, they
can be challenged. Lastly, we can help patients revise their beliefs or at least
admit that the beliefs held by the other person may be just as valid as their

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own. This is a mind-opening exercise and usually diminishes the upset the
patient was experiencing.
9. Ventilation/Support System
We have all had patients who come into the office upset, talking incessantly about a problem, and feeling better when they are finished. They have
told their story, cried or made some admission, and the act of doing so in the
presence of a trusted and empathic listener has been therapeutic. We often
do not have to say much. We just have to be there, listen attentively and show
our concern and caring. On other occasions we might offer validation, encouragement or advice. But the combination of the patient being able to ventilate
and our support can be profoundly beneficial.
There is an old saying that a problem shared is a problem halved. People
who keep things to themselves carry a considerable and unnecessary burden.
We can do much for patients by allowing them to ventilate or encouraging
them to do so. We can also help by urging them to develop a support system
(a few trusted relatives, co-workers or friends to talk to when they are upset
or worried).
Another form of ventilation that many patients find helpful is writing, for
example in a private journal at home. Former tennis star Guillermo Vilas once
said: When my life is going well, I live it. When its not going well, I write it.
When patients are angry, I often suggest they write a letter to the person
at whom they are vexed. These letters are not for sending; they should be
destroyed once they are written- unread. The value is in expressing the feelings and getting them out. Rereading the letter just reinforces the upset and
fans the flames of anger all over again.
10. Humour
Humour is a wonderful stress reducer, an antidote to upsets. Laughter
relieves tension. In fact, we often laugh hardest when we have been feeling
most tense.
One of my patients was lamenting the 15 pounds she gained over the winter
and the fact that she could not get into her bathing suit. She had always
been sensitive about her weight. While talking about her upset she suddenly
stopped, her face softened and a smile came to her lips. You know what?
Ive just decided, she said. Ill swim in the dark this year. Another case
involved a man who worked in a busy company dealt with customers at the
counter, customers on the phone and staff members who needed his help.
He felt besieged often from several directions at once. He told me he started

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using a phrase which helped him cope and gave him a laugh; I love it when
they fight over me. In both cases, patients generated their own humour and
reduced their upset.
Humour is an individual thing- what is funny to one individual may be hurtful
to another. It is wonderful when patients can poke fun at themselves. We can
also do this with patients, but we have to be careful and respectful in what
we say. If you think of something funny that may help the patient, say it if you
feel it will ease their tension and not be offensive. I will often throw in a quip
or joke when I think it is appropriate. When it is done sensitively, laughter is
a great gift to people you care about.
Conclusion
One of the most important things we can do for patients is teach them about
stress management. Even better, we can learn these lessons ourselves and
then model them for our patients. Although there are many approaches to
stress management, this article has listed 10 ways for reducing stress that are
practical, beneficial and which even busy physicians can start implementing
immediately - for their patients and for themselves.
Reference
1. Schor, JB: The Overworked American. Basic Books, New York, 1991, p. 11.
Suggested Reading
1. Watzlawick, P, Weakland, J, Fisch, R: Change. Norton, New York, 1974.
2. Selye, H: Stress Without Distress. Signet, Scarborough, 1975.
3. Benson, H: The Relaxation Response. Avon, New York, 1975.
4. Freudenberger, HJ: Bum-Out. Bantam, NewYork,1980.
5. Eliot, RS: Is it Worth Dying For? Bantam, New York, 1984.
6. Borysenko, J: Minding the Body, Mending the Mind. Addison-Wesley, 1987.
7. Schor, JB: The Overworked American. Basic Books, New York, 1991.
8. Dominguez, J, Robin, V: Your Money or Your Life. Viking, New York, 1992.
9. Prochaska, J, Norcross, J, DiClemente, C: Changing For Good. Morrow,
New York, 1994.
10. Rainham, DC: Winning Your Battle With Stress. Optimum Health Resources,
900 King Street, W., Kitchener, Ontario, N2G 1G5,I994.
11. Posen, DB: Always Change a Losing Game. Key Porter, Toronto, 1994.
12. Presented at Tri-University Winter Medical Symposium St. Petersburg,
Florida March 11, 1995.
13. Dr. Posen practiced family medicine in Oakville, Ontario until 1985, when he
gave up his family practice to devote his time exclusively to stress manage271

ment, lifestyle counselling and psychotherapy. He has given seminars for

IBM, Motorola, Bell Canada, Peat Marwick and the
14. Royal Bank of Canada. His first book, Always Change a Losing Game, was
published in 1994 by Key Porter Books, and became a Canadian best seller.
He also presents seminars about stress management for McMaster University medical school and has given presentations for the Ontario Medical
Association and the Ontario College of Family Physicians. He received his
medical degree from University of Toronto in 1967.
INFORMATION FOR PATIENTS - STRESS MANAGEMENT
WHAT IS STRESS?
Dr. Hans Selye, the father of stress theory, defined stress as the nonspecific response of the body to any demand made upon it. The demand can be
a threat, a challenge or any kind of change which requires the body to adapt.
The response is automatic, immediate. Stress can be good (called eustress)
when it helps us perform better, or it can be bad (distress) when it causes
upset or makes us sick.
What Does the Stress Reaction Consist of?
The stress reaction results from an outpouring of adrenaline, a stimulant
hormone, into the bloodstream. This, with other stress hormones, produces a
number of changes in the body which are intended to be protective. The result
often is called the fight-or-flight response because it provides the strength
and energy to either fight or run away from danger. The changes include an
increase in heart rate and blood pressure (to get more blood to the muscles,
brain and heart), faster breathing (to take in more oxygen), tensing of muscles
(preparation for action), increased mental alertness and sensitivity of sense
organs (to assess the situation and act quickly), increased blood flow to the
brain, heart and muscles (the organs that are most important in dealing with
danger) and less blood to the skin, digestive tract, kidneys and liver (where
it is least needed in times of crisis). In addition, there is an increase in blood
sugar, fats and cholesterol (for extra energy) and a rise in platelets and blood
clotting factors (to prevent hemorrhage in case of injury).
What Are Common Symptoms of Stress?
Manifestations of stress are numerous and varied but they generally fall
into four categories (this is only a partial list of most common symptoms):
Physical: fatigue, headache, insomnia, muscle aches/stiffness (especially
neck, shoulders and low back), heart palpitations, chest pains, abdominal

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cramps, nausea, trembling, cold extremities, flushing or sweating and frequent

colds.
Mental: decrease in concentration and memory, indecisiveness, mind
racing or going blank, confusion, loss of sense of humour.
Emotional: anxiety, nervousness, depression, anger, frustration, worry,
fear, irritability, impatience, short temper.
Behavioural: pacing, fidgeting, nervous habits (nail-biting, foot-tapping),
increased eating, smoking, drinking, crying, yelling, swearing, blaming and
even throwing things or hitting.
What Are the Causes of Stress?
Dr. Selye called the causes of stress stressors or triggers. There are
two kinds of stressors: external and internal.
External stressors include:
Physical environment: noise, bright lights, heat, confined spaces.
Social (interaction with people): rudeness, bossiness or aggressiveness
on the part of someone else.
Organizational: rules, regulations, red tape, deadlines.
Major life events: death of a relative, lost job, promotion, new baby.
Daily hassles: commuting, misplacing keys, mechanical breakdowns.
Internal stressors include:
Lifestyle choices: caffeine, not enough sleep, overloaded schedule.
Negative self-talk: pessimistic thinking, self-criticism, over-analyzing.
Mind traps: unrealistic expectations, taking things personally, all-ornothing thinking, exaggerating, rigid thinking.
Stressful personality traits: Type A, perfectionist, workaholic, pleaser.
It is important to note that most of the stress that most of us have is actually self-generated. This is a paradox because so many people think of external
stressors when they are upset (it is the weather, the boss, the children, the
spouse, the stock market). Recognizing that we create most of our own upsets,
however, is an important first step to dealing with them.
What Are Some Ways to Master Stress?
The following are some categories that can be helpful in mastering stress:

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Change lifestyle habits

Decrease caffeine (coffee, tea, cola, chocolate).

Well-balanced diet.
Decrease consumption of junk food.
Eat slowly.
Regular exercise (at least 30 minutes, three times per week).
Adequate sleep (figure out what you need, then get it).
Leisure time (do something for yourself everyday).
Relaxation exercises (e.g., meditation, self-hypnosis).
Change stressful situations

Time and money management.

Assertiveness.
Problem-solving.
Possibly leaving a job or a relationship.
Change your thinking

Look at things more positively.

See problems as opportunities.
Refute negative thoughts.
Keep a sense of humour.

Diversion and distraction. Take a time-out (anything from a short walk to

a vacation) to get away from the things that are bothering you. This will not
resolve the problem, but it gives you a break and a chance for your stress levels
to decrease. Then, you can return to deal with issues feeling more rested and
in a better frame of mind.
Prepared by Dr. David B. Posen Lifestyle Counsellor and Psychotherapist,
and Author of Always Change a Losing Game Oakville, Ontario
May be copied and distributed to patients
Internet Mental Health (www.mentalhealth.com) copyright 1995-1996
by Phillip W. Long,
M.D.

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CHAPTER 22

RADIOLOGY AND NUCLEAR MEDICINE

Introduction
Radiology (also called roentgenology after its discoverer, Wilhelm Conrad
Roentgen) is the medical specialty concerned with the study of x-rays. X-rays
are invisible waves of energy that are produced by an energy source (x-ray
machine) and are useful in diagnosis and treatment of disease.
Nuclear medicine is the medical specialty that studies the characteristics and uses of radioactive substances in the diagnosis of disease. Radioactive substances are materials that emit high-speed particles and energycontaining rays from the interior of their matter. The emitted particles and
rays are called radioactivity and can be of three types: alpha particles, beta
particles, and gamma rays. Gamma rays are similar to x-rays in that they
have no mass and are used effectively as a diagnostic label to trace the path
and uptake of chemical substances in the body.
A radiologist is a physician who specialises in the practice of diagnostic,
therapeutic, and interventional radiology. A nuclear physician is physician
who specializes in the practice of administering diagnostic nuclear medicine
procedures.
Allied health care professionals who work with physicians in the field of
radiology and nuclear medicine are radiologic technologists. Types of radiologic technologists are: radiographers (aid physicians in administering diagnostic x-ray procedures) and nuclear medicine technologists, (attend to
patients undergoing nuclear medicine procedures and operate devices under
the direction of a nuclear physician).
1. Radiology
Several characteristics of x-rays are useful to physicians in the diagnosis
and treatment of disease.

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1. Ability to cause exposure of a photographic plate. If a photographic plate

is placed in front of a beam of x-rays, the x-rays, travelling unimpeded
through the air, will expose the silver coating of the plate and cause it to
blacken
2. Ability to penetrate different substances to varying degrees. If the x-rays
are absorbed (stopped) by the denser body substance (e.g. calcium in the
bones ), they do not reach the photographic plate held behind the patient,
and white areas are left in the x-ray film.
3. A substance is said to be radiolucent if it permits passage of most of the
x-rays. Radiopaque substances (bones) are those that absorb most of the
x-rays they are exposed to.
4. Invisibility. X-rays cannot be detected by sight, sound, or touch. Workers
exposed to x-rays must wear a film badge to detect and record the amount
of radiation to which they have been exposed.
5. Travel in straight lines. This property allows the formation of precise
shadow images on the x-ray plate and also permits x-ray beams to be
directed accurately at a tissue site during radiotherapy.
6. Scattering of radiation. Scattering occurs when x-rays come in contact
with any material. Greater scatter occurs with dense objects. Scatter can
blur images so a grid is placed in front of the film to absorb scattered radiation before it strikes the x-ray film.
7. Ionization. X-rays have the ability to ionize substances through which they
pass. Ionization is a chemical process in which the energy of an x-ray beam
causes rearrangement and disruption within a substance. In x-ray therapy,
the ionizing effect of x-rays can help kill cancerous cells and stop tumour
growth. Ionizing x-rays can also affect normal body cells, leading to tissue
damage and malignant changes. Thus, persons exposed to high doses of
x-rays are at risks of developing leukemia, thyroid tumours, breast cancer,
or other malignancies.
Diagnostic Techniques
X-rays
X-rays are used in a variety of ways to detect pathological conditions. The
most common use of the diagnostic x-ray is dental, to locate cavities in teeth.
Other areas examined include the digestive, nervous, reproductive, and endocrine systems and the chest and bones. Some special diagnostic x-ray techniques are the following:
Computed Tomography or Computerized Axial Tomography(CT, CAT).
Machines called CT scanners beam x-rays at multiple angles through a section
of a patients body. A computer creates a cross-sectional picture of the body
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section examined. The CT scanners are highly sensitive in detecting diseases

in bony structures and can provide images of internal organs that are impossible to visualize with ordinary x-ray technique.
Contrast Studies. In x-ray film, the natural differences in the density of
body tissues (e.g. air in lung) produce contrasting shadow images on the x-ray
film; however, when x-rays pass through two adjacent body parts composed
of substances of the same density, their images cannot be distinguished on
the film or on the screen. It is necessary, then, to inject a contrast medium
into the structure or fluid so that a specific part, organ, tube, or liquid can be
visualized.
The following are artificial materials used in diagnostic radiological studies.
Barium Sulphate. Barium sulphate is a metallic powder that is mixed in
water and used for examination of the upper and lower gastrointestinal tract.
An upper GI series involves oral ingestion of barium sulphate so that the
esophagus, stomach, and duodenum can be visualized. A small bowel followthrough traces the passage of barium in a sequential manner as it passes
through the small intestine. A barium enema (lower GI series) opacifies the
lumen of the large intestine. A double-contrast study uses both a radiopaque
and a radiolucent contrast medium. For example, the walls of the stomach or
intestine are coated with barium and the lumen is filled with air.
Iodine Compounds. Radiopaque fluids containing up to 50 percent iodine
are used in the following tests:
Angiography An x-ray image of blood vessels and heart chambers.
Arthrography Contrast or air, or both, is injected into a joint, and x-rays
are taken of the joint.
Pyelography X-ray images are made of the renal pelvis.
Fluoroscopy. This x-ray procedure uses a fluorescent screen instead of a
photographic plate to derive a visual image from the x-rays that pass through
the patient. The fact that ionizing radiation can produce fluorescence is the
basis for fluoroscopy. A major advantage of fluoroscopy over normal radiography is that internal organs, such as the heart and digestive tract organs,
can be observed in motion.
Interventional Radiology. Interventional radiologists perform invasive
procedures (therapeutic or diagnostic) under fluoroscopic, CT, and more
recently MR (magnetic resonance) guidance. Procedures include placement
of drainage catheters, drainage of abscesses, occlusion of bleeding vessels,
and installation of antibiotics or chemotherapy through catheters. In addition,
interventional radiologists perform thermal(heating or freezing) radiofrequency, and ultrasound ablation(destruction) of benign and malignant lesions.
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Ultrasound This technique employs high-frequency, inaudible sound waves

that bounce off the body tissues and are then recorded to give information
about the anatomy of an internal organ. An instrument called a transducer
or probe is placed near or on the skin, which is covered with a thin coating of
gel to assure good transmission of sound waves.
Ultrasound is used as a diagnostic tool not only by radiologists but also by
neurosurgeons and ophthalmologists to detect intracranial and ophthalmic
lesions, by cardiologists to detect heart valve and blood vessel disorders as
well as gastroenterologists, obstetricians and gynecologists. It is important
to know that sound waves are nonionizing and noninjurious to tissues.
Two ultrasound techniques, Doppler ultrasound and colour-flow imaging,
make it possible to record blood velocity, and to image major blood vessels in
patients at risk for stroke.
Magnetic Imaging or Magnetic Resonance Imaging This is a type of diagnostic radiography that uses electromagnetic energy rather than x-rays. The
technique produces sagittal, coronal (frontal), and axial(cross-sectional)
images.
MR examinations are performed with and without contrast. The contrast
agent most commonly used for MRI is gadolinium(Gd)..MRI is used for providing
soft- tissue images, detecting edema in the brain, projecting a direct image of
the spinal cord, detecting tumours in the chest and the abdomen, and visualizing the cardiovascular system.
X-Ray Positioning
In order to take the best view of the part of the body being radiographed,
the patient, film, and x-ray tube must be positioned in the most favourable
alignment possible. There are special terms used by radiologists to refer to
the direction of travel of x-ray through the patient.
1. Posteroanterior (PA) view. In this most commonly requested chest x-ray
view, x-rays travel from a posteriorly placed source to an anteriorly placed
detector.
2. Anteroposterior (AP) view. X-rays travel from an anteriorly placed source
to a posteriorly placed detector
3. Lateral view. In a left lateral view, x-rays travel from a source located to
the right of the patient to a detector placed to the left of the patient
4. Oblique view. X-rays travel in a slanting direction at an angle from the
perpendicular plane. Oblique views show regions ordinarily hidden and
superimposed in routine PA and AP views.

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2. Nuclear Medicine
Radioactivity and radionuclides
The emission of energy in the form of particles or rays coming from the
interior of a substance is called radioactivity. A radionuclide or radioisotope
is a substance that gives off high-energy particles or rays as it disintegrates.
Half-life is the time required for a radio-substance to lose half of its radioactivity by disintegration. The half-life must be long enough to allow for diagnostic imaging but as short as possible to minimize patients exposure to radiation. Radionuclides emit three types of radioactivity: alpha particles, beta
particles, and gamma rays. Gamma rays, which have greater penetrating
ability than alpha and beta particles, and more ionizing power, are especially
useful in both the diagnosis and the treatment of disease. Technetium-99m
is a pure gamma emitter with a half-life of 6 hours. Its properties make it the
most frequently used radionuclide in diagnostic imaging.
Nuclear medicine physicians use two types of tests in the diagnosis of
disease: in vitro (in the test tube) and in vivo (in the body). In vitro procedures
involve analysis of blood and urine specimens using radioactive chemicals.
RIA (radioimmunoassay) is an in vitro procedure to detect hormones and drugs
in a patients blood. In vivo tests trace the amounts of radioactive substance
within the body.
Examples of diagnostic procedures that utilize radionuclides.
1. Bone scan. 99mTc(technetium) is used to label phosphate substances and
is injected intravenously. The scan is useful in demonstrating malignant
metastasis to the skeleton.
2. Gallium scan. The radioisotope gallium-67 is injected intravenously and
has an affinity for tumours and non-neoplastic lesions such as abscesses.
3. Liver and spleen scan. To visualize the liver and spleen, a radiopharmaceutical (99mTc and sulphur colloid) is injected intravenously, and images
are taken with a scintiscanner (gamma camera).
4. Positron emission tomography (PET scan). Radioactive substances are
given intravenously and then emit positrons which create a cross-sectional
image of the metabolism of the body. PET scanning has determined that
schizophrenics do not metabolize glucose equally in all parts of the brain
and that drug treatment can bring improvement to these organs.
5. Single-photon emission computed tomography (SPECT). Clinical application includes detecting liver tumours, detecting cardiac ischemia, and
evaluating bone diseases of the spine.

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6. 99mTechnetium sestamibi scan. It is injected intravenously to study the

motion of the heart wall muscle and the ventricles ability to eject blood
(ejection fraction).
7. Thallium scan (TL). It is injected intravenously to allow for myocardial
perfusion. Infarcted or scarred myocardium does not extract any Tl, showing
up as cold spots.
8. Thyroid scan. Hyper functioning thyroid nodules (adenomas) accumulate
higher amounts of 131I radioactivity and are termed hot. Thyroid carcinoma does not concentrate radioiodine well and is seen as a cold spot
on the scan.
Abbreviations
Angio - angiography

AP - anteroposterior

Ba - barium

CAT- computerized axial tomography

CT - computerized tomography

CXR chest x-ray

Decub - lying down, decubitus

DI - diagnostic imaging

FDG - fluorodeoxyglucose (radiopharmaceutical)

67Ga - radioactive gallium

131 I radioactive iodine

IVP - intravenous pyelogram

KUB kidneys, ureters, bladder

LAT - lateral

MR or MRI magnetic resonance

MRA - magnetic resonance

angiography

PA - posteroanterior

PET positron emission

tomography computed

SPECT single photon emission

201Tl - radioisotope (thallium)

UGI - upper gastrointestinal (series)

Tomography.

US, U/S ultrasound VQ scan ventilation perfusion scan of

the lungs

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CHAPTER 23

PHARMACOLOGY
Introduction
Drugs (medicines) are substances used to prevent or treat a condition or
disease. Drugs are obtained from parts of plants, such as the roots, leaves, and
fruit. An example of a plant-derived drug is a cardiac medicine, digitalis (from
the foxglove plant). Other drugs (antibiotics such as penicillin) are obtained
from yeast, moulds, and fungi. Drugs are also obtained from animals; for
example, hormones are secretions from the glands of animals. Some drugs
are synthesized in a laboratory. Anticancer drugs, such as methotrexate and
prednisone, are laboratory synthesized drugs. Vitamins are drugs that are
isolated from plant or animal sources and are contained in foods.
A pharmacist prepares and dispenses drugs through a pharmacy (drugstore) on written orders from a physician. Currently, most schools/colleges
of pharmacy offer a Pharm. D. (Doctor of Pharmacy) degree after six or seven
years of study. As a health care professional, a pharmacist cooperates with,
and sometimes advices licensed practitioners concerning drugs. In addition,
the pharmacist answers patients questions concerning their prescription
needs.
Pharmacology is the study of the preparation, properties, uses, and action
of drugs. A pharmacologist is either an M.D.(Medical Doctor) or a Ph.D.(Doctor
of philosophy) who specializes in pharmacology. Pharmacology contains many
subdivisions of study: medicinal chemistry, pharmacodynamics, pharmacokinetics, molecular pharmacology, chemotherapy, and toxicology.
Medicinal chemistry is the study of new drug synthesis and the relationship between chemical structure and biological effect. Pharmacodynamics
involves the study of drug effects in the body. The mathematical description
of drug disposition (appearance and disappearance) in the body over time is
pharmacokinetics. Molecular pharmacology involves the interaction of drugs
and subcellular entities, such as DNA, RNA, and enzymes.
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Chemotherapy is the study of drugs that destroy microorganisms, parasites, or malignant cells within the body.
Toxicology is the study of the harmful effects of drugs and chemicals on
the body. A toxicologist is also interested in finding proper antidotes to any
harmful effects of drugs.
A drug can have three different names. The chemical name is the chemical formula for the drug; the generic name (shorter and less complicated)
identifies the drug legally and scientifically; the brand name or trademark is
the private property of the individual drug manufacturer
Chemical Name Generic Name Brand Name
Derivative of 6-aminopenicillanic acid ampicillin Omnipen
Polycillin
Principen
Totacillin
Administration of Drugs
How a drug is introduced into the body:
Oral administration. Drugs given by mouth are slowly absorbed into the
bloodstream through the stomach or intestinal wall. This method although
convenient for the patient, has several disadvantages: it can be destroyed in
the digestive tract or cannot pass through the intestinal mucosa. It is also not
good in case when time is an important factor in therapy.
Sublingual administration. Drugs placed under the tongue dissolve in the
saliva. Nitro-glycerine is administered in this way.
Rectal administration. Suppositories and aqueous solutions are inserted
into the rectum. Drugs are given by rectum when oral administration presents
difficulties, as when the patient is nauseated and vomiting.
Parenteral administration. Injection of drug from a syringe through a
hollow needle placed under the skin, into a muscle, vein, or body cavity. There
are several types of parenteral injections:
1. Intracavitary injection. This injection is made into a body cavity, such as
the peritoneal or pleural cavity.
2. Intradermal injections. This shallow injection is made into the upper layers
of the skin and is used chiefly in skin testing for allergic reactions.
3. Intramuscular injection (IM). The buttock or upper arm is usually the site
for this injection.

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4. Intrathecal injection. This injection is made into the space under the
membranes (meninges) surrounding the spinal cord and brain. Methotrexate is injected intrathecally for treatment of leukemia.
5. Intravenous injection. This injection is made directly into a vein. It is used
when an immediate effect from the drug is desired.
6. Subcutaneous injection. Introduction of a hypodermic needle under the
skin, usually on the upper arm, thigh, or abdomen.
Inhalation. Vapours, or gases, taken into the nose or mouth are absorbed
into the bloodstream through the thin walls of air sacs in the lungs.
Topical Application. Drugs are locally applied on the skin or mucous
membranes of the body. Antiseptics (against infection) and antipruritics
(against itching) are commonly used as ointments, creams, and lotions.
Terminology of Drug Action
When a drug enters the body, the target substance with which the drug
interacts to produce its effects is called a receptor. The following terms
describe the action and interaction of drugs in the body after they have been
absorbed into the bloodstream:
Additive Action. If the combination of two similar drugs is equal to the sum
of the effects of each, then the drugs are called additive. If two drugs give less
than an additive effect, they are called antagonistic. If they produce greater
than additive effect, they are called synergistic.
Synergism. A combination of two drugs can sometimes cause an effect that
is greater than the sum of the individual effects of each drug given alone. For
example penicillin and streptomycin produce a synergistic effect.
Tolerance. Tolerance is a feature of addiction to drugs such as morphine.
Addiction is the physical and psychological dependence on and craving for a
drug.
Drug Toxicity
Drug toxicity is the poisonous and potentially dangerous effect of some
drugs. Idiosyncrasy is an example of an unpredictable type of drug toxicity.
This is an unexpected effect that appears in the patient following administration of a drag. In some patients penicillin causes an idiosyncratic reaction,
such as anaphylaxis (acute hypersensitivity with asthma and shock).
Iatrogenic (produced by treatment) disorders can occur, however, as a
result of mistakes in drug use or in individual sensitivity to a given agent.
Side effects are toxic effects that routinely result from the use of a drug. For

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example, nausea, vomiting, and alopecia are common side effects of chemotherapeutic drugs used to treat cancer. Contraindications are factors in a
patients condition that make the use of a drug dangerous and ill advised.

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CHAPTER 24

PSYCHIATRY
Psychiatry (psych/o means mind, iatr/o means treatment) is the branch of
medicine that deals with the diagnosis, treatment, and prevention of mental
illnesses.
Psychiatrists complete the same medical training as other physicians and
receive an M.D. degree. Then they spend a varying number of years training in
the methods and practice of psychotherapy and drug therapy. Psychiatrists
can also take additional years of training to specialize in various aspects of
psychiatry. Child psychiatrists specialize in the treatment of children; forensic
psychiatrists specialize in the legal aspects of psychiatry, such as the determination of mental competence in criminal cases. Psychoanalysts complete 3
to 5 years of training in a special psychotherapeutic technique called psychoanalysis in which the patient freely relates her or his thoughts to the analyst,
who does not interfere in the flow of thoughts.
A psychologist is a non medical person who is trained in methods of psychotherapy, analysis, and research. A clinical psychologist, like a psychiatrist, can
use various methods of psychotherapy to treat patients, but, unlike the psychiatrists, cannot prescribe drugs or electroconvulsive therapy. Other nonphysicians trained in the treatment of mental illness are licensed clinical social
workers and psychiatric nurses. Clinical psychologists are trained in the use of
tests to evaluate various aspects of a patients mental health and intelligence.
Psychiatric Clinical Symptoms
These terms describe abnormalities in behaviour that are evident to an
examining mental health professional.
amnesia

Loss of memory.

anxiety 
Varying degrees of uneasiness, apprehension, or dread often
accompanied by palpitations, tightness in the chest, breathlessness, and choking sensations.
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apathy 
Absence of emotions ; lack of interest or emotional involvement.
autism 
Severe lack of responsiveness to others, preoccupation with
inner thoughts; withdrawal and retarded language development.
compulsion 
Uncontrollable urge to perform an act repeatedly.
conversion 
Anxiety becomes a bodily symptom, such as blindness, deafness, or paralysis, that does not have an organic basis.
delusion 
A fixed, false belief that cannot be changed by logical reasoning or evidence.
dissociation 
Uncomfortable feelings are separated from their real object.
In order to avoid mental distress, the feelings are redirected
toward a second object or behaviour pattern.
dysphoria 
Sadness, hopelessness; depressive mood.
euphoria 
Exaggerated feeling of well-being (high).
hallucination 
False or unreal sensory perception as, for example, hearing
voices none are present.
labile 
Unstable; undergoing rapid emotional change.
mania 
State of excessive excitability; hyperactivity and agitation.
mutism 
Nonreactive state; stupor.
obsession 
An involuntary, persistent idea or emotion.
paranoia 
Delusions persecution or grandeur or combination of the
two.
Psychiatric Disorders
Anxiety Disorders
These disorders are characterized by anxiety-the experience of unpleasant
tension, distress, troubled feelings, and avoidance behaviour. A panic attack,
marked by intense fear or discomfort and symptoms such as palpitations,
sweating, trembling, and dizziness, can occur on its own with no symbolic
meaning for the patient(i.e., it occurs out of the blue), or it can occur in
the context of the following anxiety disorders: phobic disorders, obsessivecompulsive disorder, and post-traumatic stress disorders.

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Phobic disorders are characterized by irrational or debilitating fears associated with a specific object or situation. The patient with a phobic disorder
goes to extreme lengths to avoid the object of her or his fear. Panic attacks
can occur in anticipation of the phobic situation.
Agoraphobia is the fear of being alone or in open, crowded, public places
from which escape would be difficult or in which help might not be available.
They may feel comfortable only by remaining at home or in the company of a
friend or relative.
A social phobia (social anxiety disorder) is the fear of situations in which
the individual is open to public scrutiny which could result in possible embarrassment and humiliation. Fear of speaking in public, using public lavatories,
or eating in public are examples of social phobias.
Other specific phobias are claustrophobia (fear of closed-in places); acrophobia (fear of heights); zoophobia (fear of animals).
O b s e s s i v e co m p u l s i v e d i s o rd e r ( O C D ) i n v o lv e s re c u r re n t
thoughts(obsessions) and repetitive acts (compulsions) that dominate the
patients behaviour. The patient experiences anxiety if he or she is prevented
from performing special rituals, which are used to shield against overwhelming
anxiety or fear. Often the OCD consumes time and significantly interferes with
the individuals social or occupational functioning.
Post-traumatic stress disorder is the development of symptoms (intense
fear, helplessness, insomnia, nightmares etc.) following exposure to a traumatic event. Many survivors of the September 11 attack experienced posttraumatic stress disorder.
Delirium and Dementia
Delirium and dementia are both disorders of abnormal cognition (mental
processes of thinking, perception, reasoning, judgement).
Delirium is acute, temporary disturbance of consciousness and mental
confusion. It is characterized by rambling, irrelevant, or incoherent speech,
sensory misperceptions, and disorientation as to time, place, or person and by
memory impairment. Delirium is caused by a variety of conditions, including
drug intoxication or withdrawal, seizures or head trauma, and metabolic
disturbances such as hypoxia, hypoglycemia, electrolyte imbalances, or hepatic
or renal failure. Delirium tremens is brought on by withdrawal after prolonged
periods of heavy alcohol ingestion.
Dementia is a general more gradual loss of intellectual abilities that
involves impairment of judgement, memory, and abstract thinking as well as
changes in personality. Dementia may be caused by conditions, some revers287

ible and some progressive, involving damage to the brain. The most common
cause is Alzheimer disease, but others are cerebrovascular disease (stroke),
central nervous system infection, brain trauma, tumours, and Parkinson and
Huntington disease.
Dissociative Disorders
Dissociative disorders are chronic or sudden disturbances of memory, identity, consciousness, or perception of the environment that are not caused by
the direct effects of brain damage or drug abuse. Symptoms hide the pain
and anxiety of unconscious conflicts. Examples of dissociative disorders are
dissociative identity disorder, which is the existence within the individual of
two or more distinct personalities that take hold of the individuals behaviour
(illustrated in literature by Dr. Jekyll and Mr. Hyde); dissociative amnesia
(inability to remember important personal information that is too extensive to
be explained by ordinary forgetfulness); and dissociative fugue (sudden, unexpected travel away from home or customary work locale). The fugue (flight)
disorder includes the assumption of a new identity and inability to recall ones
previous identity.
Eating Disorders
Eating disorders are severe disturbances in eating behaviour. Examples
are anorexia nervosa and bulimia nervosa. Anorexia nervosa is a refusal to
maintain a minimally normal body weight. An individual is intensely afraid of
gaining weight and has a disturbance in the perception of the shape or size
of her or his body. The condition predominantly affects adolescent females,
and its principal symptom is a conscious, relentless attempt to diet along with
excessive, compulsive overactivity, such as exercise, running, or gymnastics.
Most postmenarchal females with this disorder are amenorrheic.
Bulimia nervosa (bulimia means abnormal increase in hunger) is characterized by binge eating (uncontrolled indulgence in food) followed by
purging(eliminating food from the body). Bulimic individuals maintain normal
or nearly normal weight because after binging they engage in inappropriate
purging. Examples are self-induced vomiting and the misuse of laxatives or
enemas.
Mood Disorders
A mood disorder is prolonged emotion such as depression or mania (elation)
that dominates a patients entire mental life. Examples of mood disorders are
bipolar disorders and depressive disorders. Bipolar disorders (bi - two; pol/o
extreme) are characterized by one or more manic episodes alternating with

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depressive episodes. A manic episode is a period during which the predominant mood is excessively elevated (euphoria), expansive, or irritable. Associated symptoms include inflated self-esteem, or grandiosity, decreased need
for sleep, nearly continuous flow of rapid speech with quick changes of topic,
distractibility, an increase in goal-directed activity, and excessive involvement
in pleasurable activities that have a high potential for painful consequences.
Often there is increased sociability and participation in multiple activities
marked by intrusive, domineering, and demanding behaviour. Hypomania
describes a mood resembling mania, but of lesser intensity. Bipolar I is one
or more manic episodes, often alternating with major depressive episodes.
Bipolar II is recurrent major depressive episodes alternating with hypomanic
episodes.
Cyclothymic disorders (cycl/o cycle; thym/o mind) is a mild form
of bipolar disorder characterized by at least two years of hypomania and
numerous depressive episodes that do not meet the criteria that define a
major depressive episode.
Depressive disorders are marked by one or more major depressive
episodes without a history of mania or hypomania. Major depression involves
episodes of severe dysphoria (sadness, helplessness, worry, discouragement). Other symptoms are appetite disturbances and changes in weight,
sleep disorders such as insomnia or hypersomnia, fatigue or low energy, feelings of worthlessness, hopelessness, or excessive or inappropriate guilt, difficulty thinking or concentrating, and recurrent thought of death or suicide.
Dysthymia is a depressive disorder involving depressed mood that persists
over a 2-year period but is not as severe as major depression. Also there
are no psychotic features (delusion, hallucinations, incoherent thinking) as
are sometimes found in major depression. Dysthymic disorder can be very
impairing but commonly responds well to medications.
Physicians have noted a relationship between the onset of an episode
of depressive disorder and a particular 60-day period of the year. A regular
appearance of depression may occur between the beginning of October and
the end of November every year. This is referred to as a seasonal affective
(mood) disorder (SAD). A change from depression to mania or hypomania also
may occur within a 60-day period from mid-February to mid-April.
Personality Disorders
Personality traits are established patterns of thinking and ways of relating
to and perceiving the environment and ones self; however, when these traits
become inflexible and rigid, causing impairment of functioning, distress, and

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conflict with others, they constitute personality disorders. Examples of personality disorders are as follows:
antisocial 
No loyalty to or concern for others, and without moral standards; acts only in response to desires and impulses; cannot
tolerate frustration and blames others when he or she is at
false.
borderline 
Instability in interpersonal relationships and sense of self;
characterized by alternating involvement with and rejection
of people. Frantic efforts are made to avoid real or imagined
abandonment.
histrionic 
Emotional, attention-seeking, immature, and dependent; irrational outbursts and tantrums; flamboyant and theatrical;
having general dissatisfaction with ones self and angry feelings about the world
narcissistic 
Grandiose sense of self-importance or uniqueness and preoccupation with fantasies of success and power. Narcissism is
a pervasive interest in ones self with a lack of empathy for
others.
paranoid 
Continually suspicious and mistrustful of other people but not to
a psychotic or delusional degree; jealous and overly concerned
with hidden motives of others; quick to take offense.
schizoid 
Emotionally cold and aloof; indifferent to praise or criticism or
to the feelings of others; few friendships and rarely appears to
experience strong emotions, such as anger or joy.
IV. Therapeutic Terminology
Psychotherapy
This is the treatment of emotional problems by using psychological techniques. The following are psychological techniques used by psychiatrists,
psychologists, and other mental health professionals.
Cognitive Behaviour Therapy (CBT). Conditioning (changing behaviour
patterns and responses by training and repetition) is used to relieve anxiety
and treat phobias and other disorders.
Family Therapy. Treatment of an entire family to resolve and understand
their conflicts and problems.

290

Group Therapy. A group of patients with similar problems gains insight into
their own personalities through discussions and interaction with each other.
In psychodrama, patients express their feelings by acting out roles along with
other patients-actors on a stage. After a scene has been presented, the audience (composed of other patients)is asked to make comments and offer interpretations about what they have observed.
Hypnosis. A trance (state of altered consciousness) is created to increase
the speed of psychotherapy or to help recovery of deeply repressed memories.
Insight-Oriented Psychotherapy. Face-to-face discussion of life problems
and associated feelings.
Play Therapy. Therapy in which a child, through play, uses toys to express
conflicts and feelings that he or she is unable to communicate in a direct
manner.
Psychoanalysis. Developed by Sigmund Freud, this long-term and intense
form of psychotherapy seeks to influence behaviour and resolve internal
conflicts by allowing patients to bring their unconscious emotions to the
surface.
Sex Therapy. This form of therapy helps individuals overcome sexual
dysfunctions such as frigidity, impotence and premature ejaculation.
Supportive Psychotherapy. Offering encouragement, support, and hope to
patients facing difficult life transitions and events.
Electroconvulsive Therapy
A treatment in which an electric current is applied to the brain while the
patient is anesthetized, paralyzed, and being ventilated. This produces convulsions (involuntary muscular contractions) which, with modern techniques,
are usually observable only in the form of a twitching of the toe. It is chiefly
used for serious depression and depressive phase of bipolar (manic-depressive) disorder.
Drug Therapy
The following are categories of drugs used to treat psychiatric disorders.
Antianxiety and antipanic agents. These drugs lessen anxiety, tension, and
agitation, especially when they are associated with panic attacks. Example
benzodiazepines(BZDs).
Antidepressants. These drugs gradually reverse depressive symptoms
and produce feelings of well-being. The basis of depression is thought to be
an imbalance in the levels of neurotransmitters in the brain.

291

Anti-obsessive-compulsive disorder agents.(OCD). These drugs are

prescribed to relieve the symptoms of obsessive-compulsive disorder.
Antipsychotics (neuroleptics). These drugs modify psychotic symptoms and
behaviour. Examples are phenothiazines, which are tranquilizers that reduce
the anxiety, tension, agitation, and aggressiveness associated with psychoses
and modify psychotic symptoms such as delusions and hallucinations.
Hypnotics. These drugs are used to produce sleep and relieve insomnia.
Examples are sedatives and benzodiazepines.
Mood stabilizers. These drugs treat the manic episodes of bipolar illness.
Lithium is commonly used to reduce the levels of manic symptoms, such
as rapid speech, hyperactive movements, grandiose ideas, poor judgement,
aggressiveness, and hostility. Lithium is a simple salt that is thought to stabilize nerve membranes.
Stimulants. These drugs(amphetamines) are prescribed for attentiondeficit hyperactivity disorder in children. Common symptoms of ADHD are
having a short attention span and being easily distracted, emotionally unstable,
impulsive, and moderately to severely hyperactive.
Some Common Combining Forms, Suffixes, Prefixes, and Terminology
1.Combining forms:
anxi/o

uneasy, anxious, distressed anxiolytic .....................................................

hallucin/o hallucination

hallucinogen .............................................

hypn/o

sleep

hypnosis ......................................................

iatr/o

treatment psychiatrist ................................................

ment/o

mind mental ..........................................................

phil/o

attraction to, love

phren/o

mind schizophrenia ...........................................

psych/o

mind

psychosis ....................................................

schiz/o

split

schizoid ........................................................

somat/o

body psychosomatic ........................................

paraphilia ...................................................

somatoform disorder ..........................

2. Suffixes
-genic

292

produced by

psychogenic ..............................................

-leptic

to seize hold of

neuroleptic drugs ..................................

-mania

obsessive preoccupation

kleptomania ..............................................

-phobia fear (irrational and disabling)

agoraphobia ..............................................

-phoria feeling, bearing

euphoria ......................................................

-thymia mind

cyclothymia ...............................................

dysthymia ...................................................

3. Prefixes
a-, an- no,not

apathy ...........................................................

cata-

catatonic stupor ......................................

down

hypo- deficient, less than, below

hypomania .................................................

hypochondriasis .....................................

para-

abnormal paranoia ......................................................

--------------------------------------------

293

Glossary
A
abdomen

trbuh, trbuna upljina

abdominal

trbuni

abduction

odmicanje

ability

sposobnost, vjetina, umijee

abnormal

nenormalan, neprirodan

abnormality

nenormalnost, neprirodnost

abortion

pobaaj, abortus

abrupt

nagao, estok, iznenaen

abruptio placentae

abrupcija (odvajanje) posteljice

abscess

apsces

absorb

apsorbirati

absorption

apsorpcija

accelerate

ubrzati, poveati brzinu

acceleration

ubrzanje

accessory

dodatan, dopunski, pomoni

accommodation

akomodacija, prilagodba oka za gledanje

na daljinu

accumulate

nakupiti, skupiti

accumulation

nakupljanje, skupljanje

acetabulum, pl. acetabula

acetabulum, aica zdjeline kosti

acetylcholine

acetikolin

achlorhydria

aklorhidija (nestvaranje eluane kiseline)

294

acid

kiselina

acidic

kiseo

acidity

kiselost, aciditet

acidosis

acidoza

acinus, pl. acini

acinus, bobica; pluna jedinica

acne vulgaris

acne vulgaris

acoustic neuroma

neurom (tumor) slunog ivca

acquired

steen

acromegaly

akromegalija

acromion

akromion lopatice

act

djelovati, funkcionirati; in djelo

action

djelovanje, rad, utjecaj

acuity

otrina (vida), zaotrenost

acute

akutan

adenomatous goitre/goiter

adenomska guavost (struma)

Adams apple

Adamova jabuica

Addison disease

Addisonova bolest

aduction

primicanje

adenocarcinoma

adenokarcinom (zloudni ljezdani tumor)

adenohypophysis

adenohipofiza

adenoids

polipi (u nosu), adenoidi

adenopathy

adenopatija (bolest lijezda)

adhere

prijanjati, drati se (ega)

adhesion

prianjanje, adhezija

adipose tissue

masno (adipozno) tkivo

adjacent

susjedan, oblinji

administration of drugs.

davanje lijekova

adnexa

privjesci maternice, adneksa

(jajovodi i jajnici)

adolescence

mladost, adolescencija

adolescent

mladi, djevojka, adolescent

adrenal gland

nadbubrena lijezda

295

adrenalectomy

adrenalektomija (kirurko uklanjanje

nadbubrene lijezde)

adrenaline

adrenalin

adrenocorticotropic
hormone (acth)

adrenokortikotropni hormon, kortikotropin

adult

albuminurija

adulthood

odrasla ivotna dob

advancing age

poodmakla ivotna dob

adverse

suprotan, oprecan; tetan

affect

utjecati, tetno djelovati, zahvatiti

afferent

dovodan, aferentan

afterbirth

babinje, puerperij

agent

uzrocnik, lijek; agens

agglutination (clumping)

aglutinacija; nakupljanje

agglutinin (antibody)

aglutinin; protutijelo

agglutinogen

aglutinogen; tvar koja potie stvaranje

protutijela

aging

starenje

aid

pomoi, omoguiti, olakati

aids acquired
imunodeficiency syndrome

sindrom steene imunodeficijencije

ailment

bolest, tegoba

albinism

albinizam

albino

albino

albuminuria

albuminurija

alcohol abuse

prekomjerno uivanje alkohola

alcoholism

alkoholizam

aldosterone

aldosteron

alimentary

probavni

alkaline

luina, baza, lunat

allergen

alergen

allergic

alergian

296

allergologist

alergolog

allergology

alergologija

allergy

alergija

allopurinol

alopurinol; sredstvo za sniavnje razine

mokrane kiseline(kod gihta i sl.)

alopecia

elavost

alpha cell

alfa stanica

alter

promijeniti, izmijeniti

alteration

promjena, izmjena

alveolus, pl. alveoli

pluni mjehuri; zubna upljina

Alzheimer disease /
presenile dementia

Alzheimerova bolest; predsenilna demencija

am(o)eba, pl. am(o)ebae,

am(o)ebas

ameba

am(o)ebic

amebni

amenorrh(o)ea

amenoreja, izostanak mjesenice

ametropia

ametropija, poremeaj u lomu svjetlosnih

zraka

amino acid

aminokiselina

ammonia

amonijak

amniocentesis

amniocenteza, perkutana punkcija uterus

radi uzimanja plodne vode

amnion, pl. amnia,

amnions

vodenjak, plodni mjehur

amount

koliina, iznos

amyotrophic

amiotrofni, koji se odnosi na atrofiju

miinog tkiva

an(a)esthesia

anestezija

anabolism

anabolizam, gradbeni, ili pretvorbeni,

metaboliki proces

anal

marni, analni

anal canal

marni kanal

anal fistula

marna fistula

297

analgesic

analgetik, sredstvo protiv boli

anastomosis

anastomoza, premosnica

anatomy

anatomija

anchor, n.

sidro, kotva, drac

anchor, vb.

usidriti se

aneurysm/aneurism

aneurizma, proirenje (arterije)

aneurysmectomy

aneurizmektomija; kirurko uklanjanje

aneurizme

angina pectoris

angina pectoris; bol u prsitu

angiorrhexis

angioreksija; prsnue krvne ile

angle

kut (geometrijski)

angulation

nagib

ankle

noni zglob, gleanj

ankylosing spondylitis

ankilozni spondilitis; ukoenost kraljenice

anomaly

anomalija, nenormalnost

anorexia

anoreksija, manjak apetita

anosmia

anosmija, odsustvo osjeta mirisa (njuha)

antagonistic

suprotan, antagonistiki

anterior

prednji

anthracosis

antrakoza (bolest crnih plua)

anti-inflammatory

protuupalan

antibiotic

antibiotic, protubakterijski lijek

antibody

protutijelo

anticoagulant

antikoagulant, sredstvo protiv zgruavanja

krvi

antidiuretic hormone

antidiuretski harmon

antigen

antigen, bilo koja tvar koja potie

obrambenu reakciju

antitoxin

protuotrov

antrum of the stomach

baza eluca

anus

mar, anus

anvil

nakovanj; lat. incus

298

anxiety

tjeskoba, anksioznost

aorta, pl. aortae.

aorta

aortic

aortni

aortic valve

aortni zalistak

apex, pl. apices

vrh, apeks

aphasia

afazija, nemogunost govora ili

razumijevanja govora

aphonia

afonija, gubitak glasa

aplastic an(a)emia

aplasticna anemija

apn(o)ea

apneja, zastoj disanja

aponeurosis

aponeuroza, iroka plosnata tetiva

apoplexy (stroke)

modani udar, apopleksija, kap

appendectomy

apendektomija, uklanjanje crvuljka

appendicitis

upala crvuljka, apendicitis

appendix, pl. appendices

crvuljak

application

primjena

aqueous humo(u)r

ona vodica

arachnoid

pauinasta ovojnica, arahnoidea

arch

luk

area

podruje, regija

areola, pl. areolae, areolas

areola (dojke)

arise

nastati, proistjecati, potjecati

armpit

pazuh, aksila

arrhythmia

aritmija, poremeaj ritma (sranog)

arteriole

Arteriola, mala arterija

arteriosclerosis

arterioskleroza

artery

arterija

arthritis

artritis, upala zglobova

arthrodesis

artrodeza, fiksiranje nestabilnog zgloba

arthrotomy

artrotomija, punkcija zglobne tekuine

articular

zglobni

articulation

zglob

299

artifical

umjetan

asbestosis

azbestoza, nakupljanje azbestne praine u

pluima

ascending

uzlazan

ascites

ascites, nakupljanje tekuine u trbunoj

upljini

assimilation

asimilacija, upijanje

associated

povezan, pripadajui, pridruen

asthenia

astenija, tjelesna slabost

asthma

astma

astigmatism

astigmatizam

astrocyte

astrocit, jedan tip neuroglijalnih stanica

astrocytoma

Astrocitom, primarni modani tumor koji se

sastoji od astrocita

B
bacillary

bacilni

bacillus, pl. bacilli

bacil

backbone

kraljenica, hrptenica

backflow

vraanje, refluks (krvi, mokrae, itd.)

bacterium, bl. bacteria

bakterija

bacteriuria

bakteriurija; bakterije u mokrai

balance

ravnotea

ball and socket joint

kuglasti zglob

balloon, vb.

napuhati

band

miina tetiva, trak, vrpca, zavoj za rane

barium swallow/meal

barijeva kasa

bark

kora, npr. drveta; psei lave

barking cough

kaalj poput pseeg lavea

barrier

zapreka, prepreka

Bartholin glands

Bartholinove velike lijezde predvorja

rodnice

basal cell carcinoma

bazaliom, rak bazalnih stanica

300

basin

zdjelica, pelvis

basophil

bazofil, zrnati (granularni) leukocit

basophilia

bazofilija, znatan porast broja bazofila u krvi

bat-shaped

nalik krilima imia

bath

kupka, kupelj

bean-shaped

graholik, nalik zrnu graha

bed rest

mirovanje u postelji

belching

podrigavanje

Bell palsy/paralysis

Bellova kljenut (paraliza)

belly out

izboiti se, napuhati se

bend

svijati (se), flektirati, pognuti

bending

svijanje, fleksija

bending of light rays

lom (refrakcija) svjetlosnih zraka

benign

dobroudan, benigni

bent adj.

svijen, flektiran

bent n.

skolioza, lateralna svijenost (kraljenice)

benzene

benzol, bezbojna hlapljiva tekuina

beta blocker

beta blokator, regulator sranog ritma

beta cell

beta stanica Langerhansovih otoia

u guterai (izluuje inzulin)

biceps brachii

dvoglavi mii nadlaktice

bicuspid valve

bikuspidni (mitralni) zalistak

bile

bilirubin

uni pigment

bile pigment

bilirubin

bind

vezivati, spajati

biopsy

biopsija

birth canal

poroajni kanal, rodnica

birthmark

znamenka od roenja, hemangiom

bite

ubod (kukca); ugriz (npr. psa)

bizarre

udan, neobian

blackhead

sujedica, komedon

301

bladder

mjehur

bladder outlet

otvor mokranog mjehura

blastocyst

blastocista, rani stadij (postmorularni)

razvitka oploene stanice u sisavaca

blastoma, pl. blastomata

blastom, tumor koji je graen od zametnih

stanica

bleed

krvariti

bleeding, haemorrhage

krvarenje

blepharoptosis

blefaroptoza, sputene vjee

blind spot

slijepa pjega

blindness

sljepoa

blink reflex

refleks treptanja (vjeom)

blister

plik, mjehuri, ulj

bloating

napuhnutost (eluca)

blockage

zastoj, zaustavljanje, blokada

blood

krv

blood clot

krvni ugruak

blood clotting

zgruavanje krvi, koagulacija

blood count

krvna slika

blood group/type

krvna grupa

blood plasma

krvna plazma

blood pressure

krvni tlak

blood serum

krvni serum

blood sugar

eer (glukoza) u krvi

blood transfusion

transfuzija krvi

blood vessel

krvna ila

blood volume

volumen krvi

bloodletting

putanje krvi

bloodstream

optok krvi

blotchy

mrljast

bolus

bolus, homogeni zalogaj stvoren vakanjem

hrane

bond

prianjati, vezati se

302

bone

kost

bone cell

kotana stanica, osteocit

bone head

glava kosti

bone process

kotani nastavak

bone projection

izboenje na kostima

bony tissue

kotano tkivo

borborygmus, pl.
borborygmi

kruljenje (crijeva)

border

rub, granica

bowel

crijevo

braces

proteza

bradycardia

bradikardija,usporen rad srca

bradypn(o)ea

bradipneja, usporeno disanje

brain

mozak

brain stem

modano deblo

branch

ogranak, grana

branch, vb.

granati se, razgranati se, proiriti se

break off

osloboditi se, odvojiti se

break, n

lom (kostiju); ranica

break, vb

slomiti, prelomiti, razbiti, raskinuti

breakdown

razgradnja, propadanje

breast

dojka

breast plate

prsna kost

sternum, breastbone

prsna kost

breath

dah

breath odo(u)r

zadah

breathing

disanje, respiracija

breech birth

poroaj (novoroeneta) na zadak

bridge of the nose

hrbat nosa

bright light

jaka svjetlost

Bright disease

Brightova bolest

bring about

prouzroiti

303

bronchiectasis

bronhiektazija, proirenost bronha

bronchiole

bronhiola

bronchodilator

bronhodilatator, sredstvo za irenje bronha

bronhopneumonija

upala bronha i plua

bronchostomy

bronhostomija

bronchus,bl.bronchi

dunica,bronh

bruise

modrica, krvni podljev

bruising

nagnjeenje, oteenje

bucca, pl.buccae

obraz

buccal

obrazni, bukalni, koji se odnosi na usnu

upljinu

bulbourethral
bulla, pl. bullae
bump

bulbouretralan
mjehuri, bula
oteklina (od udarca), kvrga, voruga,
ispupenje

bundle of His

Hisov snop

bunion

izraslina na palcu ili stopalu

bunionectomy

bunionektomija

burden

teret, optereenje

Burkitt lymphoma

Burkittov limfom

burn, n.

opeklina

burn, vb.

sagorijevati, pei, ariti

burning

peenje, arenje, garavica

bursa, pl. bursae

bursa, vreica ili mjehuri ispunjen

elatinoznom tekuinom

bursitis

bursitis, upala burse

burst forth

izbiti, izai, probiti

bursting

rasprsnuce, probijanje

buttocks

stranjica

bypass

premosnica (npr. zaepljene arterije)

byssinosis

bisinoza, bolest dinih organa izazvana

prainom od vune i pamuka

304

C
c(a)ecum, pl. c(a)eca

slijepo crijevo

c(a)esarean section

carski rez

cachexia

kaheksija, opa slabost i atrofija

calcaneus, pl. calcanei

petna kost

calcification

ovapnjenje, kalcifikacija

calcify

ovapniti, kalcificirati

calcitonin

kalcitonin, tirokalcitonin; hormon titnjae

calcium

kalcij

calculus, pl. calculi

kamenac

calyx/calix, pl. calyces/

calices

vr, aica (bubrena)

canal

kanal

canal of Schlemm
canaliculus, pl. canaliculi

schlemmov kanal
kanali

cancellous

spuvast, spongiozan, porozan

cancer

rak, karcinom

cancerous

kancerozan

canthus, pl. canthi

ugao

capillary

kapilara

capsule

ahura

carbon

ugljik

carbon dioxide

ugljini dioksid

carbonic

ugljikov

carcinoma

rak, karcinom

carcinoma in situ

lokaliziran rak (karcinom)

cardiac

srani

cardiac valve

srani zalistak

cardiocairograph

kardiokairograf, tehnika rendgenskog

snimanja srca u svakoj fazi otkucaja

cardiologist

kardiolog

cardiology

kardiologija
305

cardioversion

kardioverzija, vraanje sranog ritma

u normalu

caries

karijes, kvarenje

carpal

karpalan, koji se odnosi na zapee

carpopedal spasm

karpopedalni spazam (zahvaa zapee

i stopalo)

carrier of the trait

nositelj znakova ili svojstava

cartilage

hrskavica

cartilage ring

hrskavini prsten

cartilaginous

hrskavian

cast

gipsani zavoj

catabolism

katabolizam, razgradbeni metaboliki

proces

cataract

mrena, katarakta

catecholamine

katekolamin (dopamin, noradrenalin,

adrenalin); simpatomimetici

cathartic

katartik, sredstvo za pranjenje crijeva

catheter

kateter

caudal

kaudalan, repni

cavity

upljina

cell

stanica

cell body

stanino tijelo

cell membrane

stanina opna (membrana)

cell-mediated immunity

stanina imunost

cellular

stanini

cellulitis

celulitis

cementum

zubni cement

cephalic

cefalian, kranijalan, koji se odnosi na glavu

cerebellum, pl. cerebella,

cerebellums

mali mozak

cerebral

modan, cerebralan

cerebral contusion

nagnjeenje (kontuzija) mozga

306

cerebral palsy

cerebralna kljenut (paraliza)

cerebrospinal fluid

modanokraljenika (cerebrospinalna)
tekuina, likvor

cerebrovascular accident

modani udar, cerebrovaskularni inzult,

apopleksija

cerebrum,pl. cerebra

veliki mozak

cerumen

una mast

cervical

vratni

cervix, pl. cervices

grlo (npr. maternice), vrat

cessation

prestanak, prekid

chain

lanac

chalazion, pl. chalazia

kalazion, jemenac

chalicosis

kalikoza, kamena praina u pluima

chamber

komora, klijetka

chancre

ir, ankir

channel

kanal

cheek

obraz

chemonucleolysis

kemonukleoliza, vraanje iskliznutog

meukraljeninog diska u normalan
poloaj

chemotherapy

kemoterapija

chest

prsni ko, toraks

chew

vakati

chewing, mastication

vakanje, mastikacija

childbirth, partus,
parturition, delivery

poroaj,raanje, partus

chill

zimica, tresavica

chloasma

kloazma, smee pigmentne pjege po licu

(u trudnoi i kaheksiji)

chloramphenicol

kloramfenikol

chloremia

kloremija, kloroza

307

cholecystectomy

kolecistektomija, odstranjenje unog

mjehura

choledocholithotomy

koledokolitotomija, incizija glavnog

uovoda (radi odstranjenja unog
kamenca)

cholelithiasis

kolelitijaza, stvaranje kamenca u unom

mjehuru

cholesteatoma

kolesteatom, cistina tvorba ilia benigni

tumor koji se razvija iz keratiniziranih
epidermalnih stanica

cholesterol

kolesterol

cholinesterase

kolinesteraza, enzim prisutan u jetri,

krvnom serumu i guterai

chorea

korea, diskinezija, nekontrolirani pokreti

choriocarcinoma

koriokarcinom, zloudna tvorba koja nastaje

iz placentalnog epitela

chorion

korion, vanjska ovojnica (omota) zametka

choroid

ilnica (oka)

chromosome

kromozom

chronic

kronian

chyme

kaa (probavljene hrane u elucu), kimus

cicatrix, pl. cicatrices

oiljak, brazgotina

ciliary muscle

cilijarni mii

cilium, pl. cilia

trepetljika, bi, cilija, trepavica

circle

krunica, krug, ciklus

circuit

krug (npr. strujni)

circular

kruan

circulate

kolati, cirkulirati

circulation

optjecaj (krvi), cirkulacija

circumcision

obrezivanje

circumscribed

zaokruen

cirrhosis

ciroza, bolest jetre

claustrophobia

klaustrofobija, strah od zatvorenog prostora

308

clavicle

kljuna kost, klavikula

clavicular

kljuni, klavikularni

cleanse

proistiti, oistiti

cleansing

proiavanje, isenje

cleft palate

rascijepljeno nepce

climacteric

klimakterij,menopauza

clitoris

draica

closure

zatvaranje

clot, n.

ugruak krvi

clot, vb.

zgruavati se, koagulirati

clotting

zgruavanje, koagulacija

clubfoot

zgreno stopalo (priroena deformacija),

talipes

clumping

aglutinacija, nakupljanje

cluster

nakupina, grozd

coagulate

zgruavati se, koagulirati

coagulation

zgruavanje, koagulacija

coat

ovojnica, omota

coccus, pl. cocci

kok

coccygeal

trtini

coccyx, pl. coccyges

trtina kost, trtica

cochlea

punica

coitus

odnoaj

colchicine

kolhicin, biljni preparat za lijeenje gihta

colitis

kolitis, upala debelog crijeva

collagen

Kolagen, izvanstanini protein glavni

sastojak vezivnog tkiva

collapse

kolaps, uruavanje, opi pad

collar bone

kljuna kost, klavikula

collect

skupljati, sabirati

collecting tubule

sabirni kanali (tubul)

collection

skupljanje, nakupljanje

309

colon

debelo crijevo, kolon

colonic polyposis

polipoza kolona

colpoplasty

kolpoplastika, plastina operacija rodnice

coma

koma, nepovratni gubitak svijesti

comatose

komatozan

combat

boriti se, suzbijati

comedo, pl.comedones

sujedica, komedon

comminuated

kominutivan (lom kosti)

common bile duct

glavni uovod

compact

vrst, kompaktan

compensation

nadoknada, kompenzacija

complement

potpuni broj (koliina), potpunost

composition

sastav, sastavljanje, ureenje

compound

spoj (kemijski)

compound fracture

sloen (kompliciran) lom

compress, n.

oblog, kompresa

compress, vb.

stisnuti, komprimirati

compression

pritisak, kompresija

concave

udubljen, konkavan

conception

zaee, zanoenje

concussion of the brain

potres mozga

condition

stanje, bolest

conduct

provoditi, voditi

conduction

provoenje, voenje

conductive

provodan

condyle

vor, kondil

cone

stoac, unj

congenital

prirodan, kongenitalan

congestive heart failure

srana dekompenzacija

conization

konizacija

conjunctiva

spojnica oka

connection

veza, spoj

310

connective

vezivan

conscious

svjestan, pri svijesti

consciousness

svijest, svjesnost

constipation

zatvor (stolice), opstipacija

constitutent

(bitan) sastavni dio, element

constrict

stezati

constriction

stezanje, suenje, konstrikcija

contagious

zarazan, infektivan

contagiousness

zaraznost, infektivnost

contraceptive

kontracepcijsko sredstvo

contract

stegnuti se, kontrahirati; navui na se

bolest, oboljeti

contraction

stezanje, kontrakcija

contusion

nagnjeenje, kontuzija

conversely

obratno, protivno, suprotno

conversion

pretvorba

convert

pretvoriti

convex

izboen, ispupen, konveksan

convey

prenositi, odailjati

conveyance

prijenos, odailjanje

convolution

vijuga

convulsion

grenje, gr, konvulzija

Cooley an(a)emia

Cooleyeva slabokrvnost

coordinate

uskladiti

coordination

usklaivanje

copulation

snoaj, kopulacija

cor pulmonale

pluno srce

core

jezgra

coredialysis

iridodijaliza

corium

usmina, korij, derma, koa

cornea

ronica

coronary artery

vjenasta (koronama) arterija

311

corpus callosum,
pl. corpora callosa

uljevito tijelo

corpus luteum,
pl. corpora lutea

uto tijelo

corpus, pl. corpora

tijelo, trup, korpus

corpuscle

tjelece

cortex, pl. cortices

kora, korteks

cortical

vrst kompaktan (kost)

corticosteroid

kortikosteroid, hormon kore nadbubrene

lijezde (adrenalni korteks)

cortisol

kortizol, hidrokortizon

cortisone

kortizon

cough, n. (bf)

kaalj

cough, vb. (bf)

kaljati

coughing

kaljanje

covering

ovojnica, omota

Cowper glands

bulbouretralne (Cowperove) lijezde

crackling

pucketanje (kostiju)

cramp

gr

cramping

grenje

cranial

lubanjski, kranijalni

cranium, pl. crania

lubanja

creatinine

kreatinin

crepitation

pucketanje, krepitacija (kostiju)

crest

greben, krista

cretinism

kretenizam, kronino stanje koje je

posljedica priroenog tekog hipotiroidizma

cripple

onesposobiti, osakatiti

crippling

invalidnost, onesposobljavanje

Crohn disease

Crohnova bolest, regionalni enteritis ili

ileitis

cross-section

presjek

crossmatching

unakrsna reakcija

312

croup

krup, akutna djelomina opstrukcija gornjih

dinih putova

crushed

zgnjeen, zdrobljen, smrvljen

crust

krasta

cryocauterization

kriokauterizacija

cryoextraction

krioekstrakcija

cryoprobe

kriosonda

cryptorchism/cryptorchidism kriptorhizam, nesputeni testisi

crystalline

kristalan, poput kristala

cul-de-sac

bilo koji oblik slijepog crijeva (cecum)

ili vreice; tobolac

curative

ljekovit, kurativan, izljeiv

cure

lijeenje, ozdravljenje, lijek

curettage

kiretaa, struganje

current

struja

curvature

zakrivljenost

curve

krivulja, zavoj

Cushing syndrome

Cushingov sindrom

cushion, n.

jastui

cushion, vb.

tititi, zatititi, ublaiti (udarac)

cuspid

onjak

cutaneous

koni, kutani

cuticle

pokoica, eponihij

cyanoderma

cijanoderma

cyanopia

cijanopija

cycle

ciklus, krug, razdoblje

cyclic

kruan, ciklican

cyst

cista, mjehur

cystadenocarcinoma

cistadenokarcinom

cystadenoma

cistadenom

313

cystic

cistian

cystic duct

cistiki vod

cystoscopy

cistoskopija, endoskopski pregled mjehura

cytologist

citolog

cytoplasm

citoplazma

cytotoxin

citotoksin

D
damage, n.

oteenje, teta

damage, vb.

otetiti, nakoditi

damaged

oteen

deaf

gluh

deafness

gluhoa

debris

otpad, otpadni proizvod

decay

raspadanje, truljenje

decelerate

usporiti

decline

opadanje, propadanje, pad

decompose

razgraditi, raspasti se

decomposition

razgradnja, propadanje

decrease, n.

smanjenje, snienje, opadanje

decrease, vb.

smanjiti, sniziti, opasti

decubitus

dekubitus, rane od leanja

def(a)ecation

pranjenje stolice, defekacija

defibrillation

defibrilacija

defibrillator

defibrilator

deficiency

pomanjkanje, manjak

deficient

manjkav

deflection

otklon, pomak

deformation

izoblienje, deformacija

deformity

nakaznost, izoblienost

degenerated

degeneriran

degeneration

degeneracija

314

degenerative

degenerativan

deglutition

gutanje, degluticija

degrade

umanjiti, opasti, sniziti se, razgraditi

deliberate

hotimian, namjeran

delirium

delirij

demineralization

demineralizacija

demyelination

demijelinizacija

dendrite

dendrit

dense

gust, vrst

density

gustoa, vrstoa

dentin

dentin

denture

umjetno zubalo

deoxyribonucleic acid

deoksiribonukleinska kiselina (dnk)

depletion

iscrpljenje, ispranjenje

depolarization

depolarizacija, neutralizacija polariteta

deposit

pohraniti, odloiti, uskladititi

depositing

pohranjivanje, odlaganje, uskladitenje

depository

spremite, skladite

depress

usporiti, smanjiti

depression

udubljenje, uleknue

dermatitis

dermatitis, upala koe

dermis

usmina, derma, korij, koa

descending

silazan

destruction

unitenje, razaranje

detach

odvojiti se, odijeliti se, otkinuti

detachment

odvajanje, otkidanje

detect

otkriti

detection

otkrivanje, detekcija

deteriorate

pogorati se, pokvariti se

deteriorated

pogoran

deterioration

pogoranje

development

razvoj

315

device

naprava, sprava, ureaj, sredstvo

devour

progutati, prodrijeti

diabetes insipidus

diabetes insipidus

diabetes mellitus

seerna bolest

diabetic nephropathy

dijabetika nefropatija

diabetic neuropathy

dijabetika neuropatija

diabetic retinopathy

dijabetika retinopatija

diagnosis, pl. diagnoses

dijagnoza

diagnostic

dijagnostiki

diagnostics

dijagnostika

dialysis, pl. dialyses

dijaliza

diameter

promjer, dijametar

diaphoresis

dijaforeza, pojaano znojenje

diaphragm

oit, pregrada, dijafragma

diaphysis, pl. diaphyses

srednji dio, tijelo, duge kosti, dijafiza

diarrh(o)ea

proljev

diastole

dijastola, oputanje sranog miia

diencephalon

meumozak

diet

prehrana, dijeta

digestion

probava, probavljanje

digestive

probavan, digestivan

digitalis

digitalis, sredstvo za jaanje sranog miia

dilated

proiren, dilatiran

dilation

irenje, dilatacija

dim light

prigueno svjetlo

diminished

smanjen, snien

diphtheria

difterija

disc/disk

kolut, disk

discharge

iscjedak; otpust bolesnika

discolo

promjena boje

discomfort

nelagoda, tegoba

discontinue

prekinuti, prestati

316

disease

bolest

disintegrate

razgraditi se, raspasti se

disintegration

razgradnja, raspadanje

dislocation

iaenje, dislokacija

dislodged

izbaen, istisnut, istjeran

disorder

poremeaj

dispose

ukloniti, odloiti, odbaciti

disproportion

nerazmjer, nesklad

disrupt

prekinuti

dissection

seciranje, sekcija

dissolution

rastvaranje, otapanje, otopina

distal

distalan, udaljen

distensible

rastezljiv

distention

irenje, rastezanje, napuhanost

distortion

uganue, distorzija

distress

tegoba, klonulost, bol

disturbance

poremeaj, smetnja

diuretic

sredstvo za izmokrivanje, diuretik

diverticulectomy

divertikulektomija, kirurko uklanjanje

divertikula

diverticulitis

divertikulitis, upala divertikula

diverticulum, pl. diverticula

divertikul

division

dioba, podjela, dio

dizziness

vrtoglavica

dizzy

koji osjea vrtoglavicu

donour

davatelj (krvi, organa)

dormant

pritajen, latentan

dorsal

leni, dorzalan

dorsiflexion

dorzifleksija

dosage

doziranje, dozaa

dose, n.

doza (lijeka)

dose, vb.

dozirati, davati u dozama

317

Down syndrome

Downov sindrom, trisomija 21

drag

vui, povlaiti, potezati

dragging

povlaenje, potezanje

drain

odvoditi, istjecati, prazniti se, drenirati

draining

odvodenje, praznjenje, dreniranje

drop

kap, kaplja

droplet

kapljica

dropsy

otok, edem; ascites

drug

lijek, droga (narkotik, opijat)

drug abuser/drug addict

ovisnik o narkoticima/lijekovima (narkoman)

drug-induced

prouzroen (izazvan) lijekovima

Duchenne disease

Duchenneova bolest

duct

vod

duodenal

duodenalni

duodenum, pl. duodena

dvanaesnik

dura mater

tvrda (modana) ovojnica

dwarf

patuljak

dwarfism

patuljast stas, nanosomija

dye

boja (sredstvo za bojenje)

dysentery

dizenterija

dysgerminoma

disgerminom, maligna neoplazma jajnika

dysmenorrhea

dismenoreja, bolna mjesenica

dyspareunia

dispareunija, bol pri snoaju

dysphagia

disfagija, otezano gutanje

dysphasia

disfazija, poremeaj govora

dysplasia

displazija, nenormalan razvoj (u veliini,

obliku i organizaciji tjelesnih stanica)

dyspn(o)ea

zaduha, dispneja, oteano disanje

dysrhythmia

disritmija

dystocia

distocija, otean poroaj

dystrophy

distrofija

dysuria

dizurija, bolno ili oteano mokrenje

318

E
ear

uho

ear canal

zvukovod

earache

uhobolja

eardrum, tympanum

bubnji

ecchymosis, pl. ecchymoses ehimoza, krvni podljev u koi

eclampsia

eklampsija

ectopic pregnancy

ektopijska (izvanmaterina) trudnoa

eczema

ekcem

edema

oteklina, edem

efferent

odvodan, eferentan

effusion of blood

izljev krvi

egg, ovum

jajace, ovum

ejaculation

ejakulacija

ejaculatory duct

ejakulatorni vod

ejection

izbacivanje

electric pacemaker

elektrini stimulator sranog ritma

electrical charge

elektrini naboj

electrocardiogram

elektrokardiogram

electrocardiograph

elektrokardiograf

electrolyte

elektrolit, element s elektrinim nabojem

elephantiasis

elefantijaza (tropska parazitarna bolest)

elevated

povean, povien, podignut

elevation

poveanje, povienje, podizanje

elimination

otklanjanje, odstranjivanje, izbacivanje

embedded

usaen, uloen, ugraen

embolism

embolija

embolus, pl. emboli

embolus

embryo

zametak, embrij

emerge

izlaziti, izranjati

emergency

hitan sluaj

empyema, pl. empyemata

empijem, nakupina gnoja u tjelesnoj upljini

319

emulsify

emulgirati, razgraditi

emulsion

emulzija

enamel

caklina

encapsulation

uahurenje, inkapsulacija

encase

omatati, obavijati

encephalitis

encefalitis, upala mozga

end product

krajnji (finalni) proizvod

endanger

ugroziti

endemic goitre/goiter

endemska gua(vost), struma

endocarditis

endokarditis, upala endokarda

endocardium

usrnica, endokard, unutarnja srana

ovojnica

endocervicitis

endocervicitis, upala sluznice grlia

maternice

endocrine

endokrini, s unutarnjim izluivanjem

endometriosis

endometrioza

endometritis

endometritis

endometrium

endometrij, sluznica maternice

endoscope

endoskop, instrument za vizualni pregled

unutranjosti bilo kojeg upljeg organa

engorgement

zaepljenje, opstrukcija

engulf

progutati

enlarged

povean, proiren

enlargement

poveanje, proirenje

enterolysis

enteroliza, oslobaanje od crijevnih

priraslica

entity

bie; sutina

envelop

omatati, obavljati

environment

okoli, sredina

enzyme

enzim

eosinophil

eozinofil

eosinophilia

eozinofilija

320

ependymoma, pl.
ependymomata,
ependymomas

ependimom

epidermis

pokoica, epiderma

epididymis

pasjemenik, epididimis

epiglottis

poklopac (grkljana)

epilepsy

padavica, epilepsija

epinephrine

adrenalin

epiphora

suzenje (oiju)

epiphyseal line/plate

epifizna crta (ploa)

epiphysis, pl. epiphyses

okrajina (kosti), epifiza

epispadia, pl. epispadias

epispadija, uretralni otvor na gornjoj strani

penisa

epistaxis

krvarenje iz nosa, epistaksa

epithelium

epitel

eponychium

epitelna pokoica, eponihij

equalization

izjednaenje, izjednaavanje

equalize

izjednaiti

equilibrium, pl. equilibria

ravnotea, ekvilibrij

erect

uspravan, ravan, uzdignut

erectile tissue

erektilno tkivo

erection

podizanje, ukruenje, erekcija

erode

nagrizati, izjedati, razarati, erodirati

erosion

nagrizanje, izjedanje, erozija (koe, sluznice)

error of refraction

pogreka refrakcije, ametropija

eructation

podrigivanje

erupt

izbiti, nicati, probiti

eruption

izbijanje, nicanje (zubi), provala, osipanje,

osip

erythema

crvenilo koe, eritem

erythroblast

eritroblast, nukleizirana crvena krvna

stanica

321

erythroblastosis

eritroblastoza, povean broj nukleiziranih

eritrocita

erythrocyte

crvena krvna stanica, eritrocit

erythropoietin

eritropoetin, hormon koji stimulira stvaranje

krvnih stanica

escape, n.

istjecanje (tekuine)

escape, vb.

istjecati, izlaziti

esophageal varices

proirenost (varikozitet) vena jednjaka

esophagus/oesophagus,
pl. esophagi; gullet

jednjak

essential hypertension

esencijalna hipertenzija (povien krvni tlak)

estrogen/oestrogen

estrogen, enski spolni hormon

ethmoid bone

reetnica, etmoidna (sitasta) kost

etiology/aetiology

etiologija

eupnea

normalno disanje, eupneja

Eustachian tube

sluna (Eustahijeva) cijev

evacuate

isprazniti

evacuation

pranjenje, ispranjavanje

evidence

dokaz

Ewing sarcoma

Ewingov sarkom

exacerbation

pogoranje (bolesti)

exanthem

egzantem

excess

viak, prekomjernost

exchange

izmjena, razmjena

excitation

razdraenost, uzbuenje, podraivanje

excrete

izluiti, izbaciti

excretion

izluivanje, izbacivanje

excretory

koji izluuje, ekskretoran

exert

obavljati, naprezati se

exertion

naprezanje, napor, obavljanje

exhalation

izdisaj, izdisanje

exhale

izdahnuti, izdisati

322

exit, n.

izlaz; smrt

exit, vb.

izai

exocrine

egzokrini, s vanjskim izluivanjem

exophthalmic goitre/goiter

tirotoksikoza, gua, struma

exophthalmos

buljookost, egzoftalmus

exostosis

kotana izraslina, egzostoza

expandable

rastezljiv

expectorant

sredstvo za iskaljavanje

expectoration

iskaljavanje

expel

izbaciti, istjerati

expiration

izdisaj, izdisanje

expire

izdahnuti, izdisati, umrijeti, ugasiti se

exposure

izlaganje, otkrivanje

expulsion of placenta

istiskivanje (ekspulzija) posteljice

extension

rastezanje, sirenje, ispruanje; nastavak

external

vanjski

extract

izvui, izvaditi, ekstrahirati, izluiti

extraction

vaenje (zubi), izluivanje, ekstrakcija

extradural

izvan tvrde modane ovojnice (dure mater)

extremity

ud, ekstremitet; kraj, vrh

exudate

izljev, eksudat

eye

oko

eye orbit/socket

ona upljina

eyeball

ona jabuica

eyebrow

obrva

eyelash

trepavica

eyelid

ona vjea, kapak

eyesight

vid

F
f(a)eces

stolica, fekalije

f(o)etus

edo, fetus

323

facilitate

olakati, omoguiti

facilitation

olakavanje, olakanje

failure

zatajenje, poremeaj, izostanak, propust,

neuspjeh

faint

onesvijestiti se, klonuti

fainting

nesvjestica

fallacious

varljiv, laan, koji obmanjuje

fallopian tube

fallopijeva cijev, jajovod

farsightedness

dalekovidnost

fascia

vezivna ovojnica, fascija

fat

mast, masnoa, lipid

fat cell, lipocyte

masna stanica, lipocit

fatal

smrtonosan, letalan

fatigue

umor, klonulost

fatty

mastan

fatty acid

masna kiselina

febrile

koji ima groznicu, febrilan

female, adj.

enski

female, n.

ena

femur

bedrena kost

fertile

plodan, fertilan

fertilization

oplodnja

fertilize

oploditi

fever

groznica, vruica

fibre/fiber

vlakno, nit

fibril

vlakance

fibrillation

treperenje, fibrilacija

fibrin

fibrin, netopiv protein - osnovica

za stvaranje krvnog ugruka

fibrinogen

fibrinogen, faktor zgruavanja

fibroadenoma

fibroadenom

fibroblast

fibroblast, stanica vezivnog tkiva

324

fibroid

fibroid, koji ima strukturu vezivnog trkiva

fibrosarcoma

fibrosarkom, zloudni tumor sastavljen

od stanica vezivnog tkiva

fibrosis

fibroza, stvaranje vezivnog tkiva

fibrous

vlaknast, fibrozan

fibula, pl. fibulae

lisna kost

filtrate

filtrat

fimbria, pl. fimbriae

trepetljika, resa

firing of nerve impulses

okidanje ivanih impulsa

fissure

pukotina, rascjep, fisura

fist-sized

veliine pesnice

flagellum, pl.flagella,
flagellums

bi:, rep (spermatozoida)

flank

slabina

flatus

crijevni vjetar, plin

flavour

okus, vrsta okusa, miris, zain

flax

lan

flexibility

savitljivost, elastinost, fleksibilnost

flexion

svijanje, pregibanje, fleksija

flexure

pregib, fleksura

floor of the mouth

dno usne upljine

flow of air

struja zraka

flushing

rumenilo, crvenjenje (lica), crvenilo

flutter

treperenje, vibriranje; undulacija

(pretklijetke ili klijetke)

focal

arini

focus, pl. foci, focuses

arite

focus, vb.

skupiti u aritu, fokusirati

fold

nabor

folic acid

folna kiselina

follicle

mjehuri, folikul

follow-up

praenje (bolesnika)

325

fontanelle

fontanela

foot, pl. feet

stopalo; stopa (30,48 cm)

foramen, pl. foramina

otvor

force

sila

forehead

elo

foreskin

prepucij, kona navlaka penisa

fossa, pl. fossae

jama

fracture

lom, prijelom (kosti)

fragile

lomljiv, krhak

fragility

lomljivost, krhost

framework

okosnica, okvir

fraternal twins

dvojajni blizanci

freckle

pjega, mrlja (na koi)

friction

trenje

fringe

resica, fimbrija

front

elo; prednja strana

frontal

eoni, frontalan, prednji

frontal bone

eona kost

frostbite

ozeblina

fulguration

paljenje (elektrinom strujom), fulguracija

fullness

ispunjenost, punoa, sitost

fundus

dno, pod

fundus of the stomach

svod eluca

fungal

gljivini

fungus, pl. fungi, funguses

gljivica, gljiva

funnel

ljevak

funnel-shaped

ljevkast

furrow

brazda

fused

sraten (kost)

fusion

srastanje (cijeljenje) kostiju, spajanje, fuzija

326

G
gait

hod, nain hoda

gall

gallbladder

uni mjehur

gallstones

uni kamenci

gamete

gameta, zametna stanica

gangrene

gangrena

gas

plin

gaseous

plinovit

gasp

dahtanje, soptanje, dahtaj, soptaj

gastric juice

eluani sok

gastritis

gastritis, upala eluane sluznice

gastroscope

gastroskop

gastroscopy

gastroskopija, endoskopski pregled eluca

gelatinous

elatinozan

gene

gen

genesis

geneza

genetic

genetski, genetiki

genetics

genetika

genital

genitalni, spolni; spolni organ

genitalia

spolni organi, genitalije

germ cell

zametna stanica, gameta

German measles

crvenka, rubeola

gestation

trudnoa, gestacija

gigantism

divovski stas, makrosomija

gingiva

desni, zubno meso

girdle

obru, pojas

gland

lijezda

glandular

ljezdast

glaucoma

zelena mrena, glaukom

glia

glija, potporno ivano tkivo

glial tissue

glijalno tkivo
327

glioblastoma multiforme

multiformni glioblastom

glioma, pl. gliomata, gliomas gliom, tumor sastavljen od glijalnih stanica

globin

globin, proteinski sastojak hemoglobina

globulin

globulin, svaki tip iz skupine porteina

netopivih u vodi

glomerulonephritis

glomerulonefritis, nefritis s upalom

kapilarnih petlji bubrenih glomerula

glomerulus, pl. glomeruli

glomerul, skupina kapilarnih krvnih ila

(npr. bubreni glomerul)

glucagon

glukagon, hormon alfa stanica

Langerhansovih otoia

glucocorticoid

glukokortikoid, steroidni hormon

glucose

glukoza, krvni eer

glue

ljepilo

gluelike

ljepljiv, poput ljepila

glycogen

glikogen, ugljikohidratna rezerva

pohranjena u jetri

glycogenesis

glikogeneza, stvaranje glikogena

glycosuria

glikozurija, eer u mokrai

goitre/goiter

gua, guavost, struma

gonad

spolna lijezda, gonada

gonadotropic hormone

gonadotropni hormon

gonadotropin

Gonadotropin, hormon koji stimulira rad

spolnih lijezda

gonococcus, pl. gonococci

gonokok

gonorrh(o)ea

kapavac, triper, gonoreja

gout

ulozi, podagra, giht

graafian follicle

graafov (ovarijalni) folikul

grading

stupnjevanje, gradiranje

graft

kalem, presadak, transplantat

grafting

presaivanje, transplantacija

grain

zrno

grand mal seizure

toniko-kloniki epileptiki napadaj

328

granule

zrnce, granula

granulocyte

granulocit, stanica koja sadri zrnca (npr.

granularni leukocit)

granulocytosis

granulocitoza, nenormalno velik broj

granulocita u krvi

Graves disease

Gravesova bolest, bazedov, tirotoksikoza

gravity

sila tea, gravitacija

gray matter

siva tvar

greenstick fracture

lom mlade (rahitine) kosti

grind

mrviti, mljeti, smrviti

groin

prepona

groove

brazda, lijeb

gross appearance

opi izgled (npr. tumora)

grow

rasti, razvijati se

growth

rast

growth hormone

hormon rasta, somatotropin

growth rate

brzina rasta

guaiac

smola trospkog stabla reagens za

testiranje krvi u stolici

guanethidine sulphate/
sulfate

gvanetidinski sulfat lijek protiv visokog

krvnog tlaka

guard

tititi, uvati

gullet

jednjak

gums

desni, zubno meso

gyn(a)ecologist

ginekolog

gyn(a)ecology

ginekologija

gynandroblastoma

ginandroblastom

gyrus, pl. gyri

vijuga (kore velikog mozga)

H
h(a)emangioma

hemangiom, benigna tvorba mree krvnih

ila

h(a)emarthrosis

hemartroza, krvarenje u zglobu

329

h(a)ematocrit

hematokrit

h(a)ematopoiesis

hematopoeza, tvorba krvnih stanica

h(a)ematosalpinx

hematosalpinks, krv u jajovodu

h(a)ematuria

hematurija, krv u mokrai

h(a)emianopia/h(a )
emianopsia

hemianopsija, ispad polovice vidnog polja

h(a)emodialysis

hemodijaliza

h(a)emoglobin

hemoglobin

h(a)emolysis

hemoliza, razgradnja crvenih krvnih stanica

h(a )emolytic an(a)emia

hemolitika anemija

h(a)emophilia

hemofilija, bolest zgruavanja krvi

h(a)emoptysis

hemoptiza, iskaljavanje krvi

h(a)emorrhoidectomy

odstranjenje hemoroida (uljeva),

hemoroidektomija

h(a)emorrhoids

uljevi, hemoroidi

h(a)emothorax

hemotoraks, krv u pleuralnoj upljini

hair

kosa, vlas, dlaka

hair shaft

vlas (vidljivi dio vlasi)

hairs of Corti

Cortijeve dlaice

hammer

eki, malleus

hard palate

tvrdo nepce

hardening

otvrdnue, skleroza

haversian canals

haversovi kanali

hazard

opasnost, pogibelj, rizik

hazardous

opasan, pogibeljan, riskantan

headache

glavobolja

heal

zacijeliti, izlijeiti

healing

cijeljenje, zacjeljenje

hearing

sluh

heart

srce

heart action

rad srca

heart block

srani blok, atrioventrikularni blok

330

heart failure

zastoj (arest) srca

heart murmur

srani um

heart rate

brzina otkucaja srca

heart valve

srani zalistak

heartburn

garavica

heel

peta

heel bone

petna kost, calcaneus

helping

porcija obroka

hemisphere

polutka (mozga)

hemp

konoplja

heparin

heparin, sredstvo protiv zgruavanja krvi

hepatitis

hepatitis, upala jetre

hepatocyte

hepatocit, jetrena stanica

hepatomegaly

hepatomegalija, poveanje jetre

hereditary

nasljedan, hereditaran

heredity

nasljednost, nasljee

hernia, pl. herniae hernias

kila, hernija

herpes

herpes, (virus)

herpes zoster

herpes zoster

hiatal hernia

hijatalna kila (hernija)

hiatus

otvor (nepravilnog oblika)

hidrosis

hidroza, prekomjerno znojenje

hilar cell tumour

hilusni tumor

hilum/hilus

vratnica; udubljenje u dijelu organa gdje

ulaze krvne ile i ivci

hinge

arka, arnir

hinge joint

kutni (valjkasti) zglob

hip

kuk

hip bone

zdjelina kost

hirsutism

hirzutizam, poveana dlakavost (npr. u ena)

histamine

histamin, produkt histidina (esencijalna

amino kiselina)

331

histogenesis

histogeneza, nastank ili razvitak tkiva

histological makeup

histoloki sastav (graa)

histology

histologija

hives

koprivnjaa, urtikarija

Hodgkin disease

Hodgkinova bolest

hollow

upalj

homeostasis

homeostaza, stabilnost tjelesnih funkcija

hordeolum, stye

jemenac, stafilokokna infekcija vjee

hormone

hormon

horn

rog, roevina

horny cells

ronate stanice

humerus

nadlaktina kost

humo(u)r

tekuina, vodica

humoral immunity

humoralna imunost

humpback

grbavost, kifoza

hunchback

grbavost, kifoza

Huntington chorea

Huntingtonova koreja

hyaline

hijalin, prozirna, staklasta opna

hydroc(o)ele

hidrokela, vodena kila

hydrocephalus

vodena glava, zastoj cerebrospinalne

tekuine u modanim komorama

hydrochloric acid

solna (klorovodina) kiselina

hydrocortisone

hidrokortizon

hydrogen

vodik

hydronephrosis

hidronefroza, iranje bubrenihn aica

i zdjelice zbog zadravanja mokrae uslijed
opstrukcije u mokraovodu

hydrophobia

hidrofobija, strah od vode

hydrothorax

hidrotoraks, nakupljanje sukrvice

u pleuralnoj upljini

hymen

djevinjak, himen

hyper(a)esthesia

hiperestezija, preosjetljivost na podraaj

332

hypercalc(a )emia

hiperkalcemija, poviena razina kalcija

u krvi

hyperexcitability

prekomjerna razdraljivost (podraljivost)

hyperfunction

prekomjerna (poveana) funkcija,

hiperfunkcija

hyperglyc(a)emia

hiperglikemija, povean sadraj eera

u krvi

hyperinsulinism

hiperinzulinizam

hypernephroma

hipernefrom, karcinom bubrnih stanica

hyperopia;hypermetropia

dalekovidnost, hipermetropija

hyperosmia

prekomjerna osjetljivost na mirise

hyperparathyroidism

hiperparatiroidizam

hyperpituitarism

hiperpituitarizam, prekomjerno izluivanje

hiofiznih hormona

hyperplasia

hiperplazija, poveanje broja tkivnih stanica

ili organa

hypersecretion

prekomjerno izluivanje, hipersekrecija

hypertension

hipertenzija, povean arterijski krvni tlak

hyperthyroidism

hipertiroidizam, prekomjerno izluivanje

hormona titnjae

hypertrophy

hipertrofija, nenormalno poveanje ili rast

tkiva odnosno organa

hyperuric(a)emia

hiperurikemija, prekomjerno poveanje

mokrane kiseline u krvi

hypoalbumin(a)emia

hipoalbuminemija

hypochromic an(a)emia

hipokromna anemija

hypofunction

smanjena funkcija, hipofunkcija

hypoglyc(a)emia

hipoglikemija, smanjen sadraj eera

u krvi

hypoinsulinism

hipoinzulinizam

hypoparathyroidism

hipoparatiroidizam

hypophyseal stalk

ljevkasti drak, infundibulum (hipofize)

hypophysis

hipofiza, modani privjesak

hypopituitarism

hipopituitarizam
333

hyposecretion

smanjeno izluivanje, hiposekrecija

hypospadia

hipospadija, uroena anomalija mokrane

cijevi mokrani otvor na donjoj povrini
penisa

hypotension

hipotenzija, smanjen arterijski krvni tlak

hypothalamus

hipotalamus

hypothyroidism

hipotiroidizam

hypox(a)emia

hipoksemija, smanjena oksigenacija krvi

hysterectomy

histerektomija, kirurko uklanjanje

maternice

I
iatrogenic

jatrogeni, koji je posljedica (nuspojava)

lijeenja

icterus

utica, ikterus

identical twins

jednojajni (identini) blizanci

idiopathic

spontan, primaran, etioloki nepoznat,

idiopatski

ileoc(a)ecal

Ileocekalan, koji se odnosi na tanko i prvi

dio debelog crijeva (cekuma)

ileum, pl. ilea

tanko (vito) crijevo, ileum

ileus

zapletaj crijeva, ileus

iliac

koji se odnosi na bonu kost, ilijakalni

iliac crest

ilijana krijesta (crista iliaca)

ilium, pl. ilia

bona kost, greben bone kosti

ill

bolestan; lo; pokvaren

illegitimate

nezakonit

illicit

nedoputen

illness

bolest

illuminate

osvijetliti; razjasniti

image
imaging technique

predodba, slika, lik

tehnika snimanja

imbalance

neravnotea

334

imitation

oponaanje

immature

nezreo; preuranjen

immediate

neposredan, izravan

immense

beskrajan, neizmjeran

imminent

prijetei, neizbjean

immobile

nepokretan, ukoen

immobilize

uiniti nepokretnim, imobilizirati

immovable

nepomian, nepokretan

immune

otporan, zatien, imun

immune response

reakcija protutijela na antigen

immunity

otpornost na bolest, imunost

immunodeficiency

manjak imunosti, imunodeficijencija

immunodiffusion

imunodifuzija

immunoglobulin

imunoglobulin

immunologist

imunolog

immunology

imunologija

impacted fracture

uklijeten lom kosti

impair

otetiti; pogorati; nakoditi

impairment

oteenje; slabljenje; pogoranje

impalpable

neopipljiv, sitan

impermeable

nepropustan

impetigo

impetigo, zarazna gnojna bakterijska

infecija koe

implant

usaen dio; usaditi

implantation

usaivanje, implantacija

impulse

podraaj, impuls, poticaj

in situ

na svom mjestu; in situ

inability

nesposobnost, nemonost

inacidity

manjak kiseline, osobito eluane (hcl)

inaction

nepokretnost, mirovanje

inactivate

uiniti nedjelotvornim, inaktivirati

inactivation

inaktivacija

335

inanimate

neiv

incapacitated

onesposobljen

incarcerated

uklijeten, inkarceriran

inch

in, palac (2,54 cm)

incidence

pojavnost, rasprostranjenost

incision

rez, rezanje, incizija

incisor

sjekuti, inciziv

inclination

sklonost; nagnutost

incompatibility

nespojivost, nepristajanje

incompatible

nespojiv; koji ne pristaje

inconclusive

neuvjerljiv, bez dokazane snage

incontinence

nesposobnost zadravanja mokrae

ili stolice, inkontinencija

incudal
incus, pl. incudes

koji se odnosi na nakovanj, inkudalni

nakovanj

indeks finger

kaiprst

indeks, pl. indices

kazalo, pokazatelj

indicate

pokazati, oznaiti, navesti

indication

znak; simptom; ukazivanje

indict

optuiti

individual

pojedinac; pojedinani

induce

izazvati; potaknuti

induction

uvod; navodenje; indukcija

inevitably

neizbjeno

infancy

novoroenaka dob

infant

malo dijete; dojene

infarct

kljenut, infarkt; nekrotizirano tkivo

infarction

proces nastajanja infarkta; infarkt

infect

zaraziti, inficirati

infection

zaraza, infekcija

infectious

zarazan (npr. bolest)

infective

zarazan (npr. mikroorganizam)

336

inferior

nii, donji, inferioran

infertility

neplodnost

infestation

napad, napadnutost (gamad i sl.),

zagaenost

infiltrating

infiltrirajui; prodirui

infiltration

prodiranje; infiltracija

inflame

upaliti

inflammmable

upaljiv, zapaljiv

inflammation

upala, upalni proces

inflammatory

upalni

inflation

napuhavanje

inflexible

neelastian

influence

utjecaj

influenza

gripa, influenza

inframammary

ispod dojke

infusion

ulijevanje; infuzija

ingest

uzimati (gutati) hranu

ingestion

uzimanje hrane (na usta ili umjetno)

ingrained

ukorijenjen

ingredient

sastojak

inguinal

preponski, ingvinalni

inhalation

udisanje, inhalacija

inhale

udisati, inhalirati

inherit

naslijediti

inheritance

batina, nasljee

inhibit

sprijeiti, zaustaviti

inhibition

sprjeavanje, koenje

initial

poetni, inicijalni

injection

utrcavanje, injekcija

injurious

tetan, poguban

injury

ozljeda, trauma

innate

uroen, priroen

337

innocent

neduan, nevin; dobroudan

innominate bone

zdjelina kost, bezimena kost

inoculation

cijepljenje, inokulacija

inorganic

anorganski, beivotan

insect

kukac

insecticide

insekticid

insemination

osjemenjivanje

insertion

hvatite (miia); umetak

insidious

podmukao, koji vreba

insipid

bez okusa, bljutav

insolation

izlaganje suncu; sunanje

insoluble

netopiv

insomnia

nesanica

inspection

nadziranje; razgledanje

inspiration

udisanje; nadahnue

inspire

udahnuti; nadahnuti

instant

trenutak, as

instantaneous

trenutan; istovremen

instinct

nagon; instinkt

instrument

sredstvo; instrument

insufficiency

manjkavost, slabost, nepravilan rad organa,

nedostatnost

insulate

odvojiti, izolirati

insulation

odvajanje, izoliranje

insulator

izolator, lo vodi

insulin

inzulin

insusceptibility

neosjetljivost

intake

unos, uzimanje, konzumacija (npr. hrane)

integument

opna, koa, prirodni ovoj, pokrov

integumentary

ovojni, pokrovni

intensive care

intenzivna njega

inter-

meu, izmeu

338

interact

meusobno djelovati

interaction

meusobno djelovanje, interakcija

interbrain

meumozak, diencefalon

intercellular

meustanini

intercostal

meurebreni

intercourse

snoaj

interdigital

izmeu prstiju

interferon

interferon

interior

unutranjost

intermediate

koji se nalazi izmeu; srednji; prijelazni

internal

unutranji, interni

internal medicine

interna medicina

interpretation

tumaenje, objanjenje

interseptal

meupregradni, interseptalni

interstitial fluid

intersticijska tekuina

interstitial nephritis

nespecifina upala bubrega, pijelonefritis

interstitium

meustanino vezivno tkivo

intestinal

crijevni, utrobni

intestine

crijevo

intima

unutarnja ovojnica krvne ile

intoxication

trovanje, intoksikacija

intra-

unutar, unutra

intracellular

unutarstanini

intracranial

unutar lubanje, intrakranijalni

intracutaneous

unutar koe, intrakutani

intraocular pressure

tlak u oima

intrauterine

unutar maternice, intrauterini

intravenous

unutar vene, intravenski

intrinsic factor

unutarnji, esencijalni imbenik, intrinzini

faktor

introduce

uvesti, uvoditi

intussusception

invaginacija, intususcepcija

339

invade

napadati; zahvaati (bolest)

invasive

nasilan, koji napada, invazivan

involuntary

nehotian, koji nije pod kontrolom volje

involvement

ukljuenost, zahvaenost

iodine

jod

ion

ion, estica s elektrinim nabojem

iridectomy

izrezivanje dijela arenice, iridektomija

iridodialysis

odvajanje baze arenice od hvatita,

iridodijaliza

iris, pl. irides

arenica

iron

eljezo

irradiation

obasjavanje, ozraivanje

irrational

neracionalan

irritant

koji izaziva upalu, koji drai, nadrauje

irritate

iritirati, nadraivati

irritation

nadraenost; upala

isch(a)emia

nedostatna opskrbljenost krvlju, ishemija

isch(a)emic

bez krvi, ishemian

ischiatic, ischial

koji se odnosi na kuk

ischium, pl. ischia

kost kuka, sjedna kost

isolate

izolirati, odvojiti

isolation

izolacija; karantena

isomer

izomer

isomerism

odnos izmeu dva izomera

isoniazid

tuberkulostatski lijek, izonijazid

isotope

izotop

issue

izlaenje, emitiranje; predmet

(npr. rasprave)

isthmic

koji se odnosi na prevlaku, suenje

isthmus

prevlaka, suenje, tjesnac

itch mite

grinja svraba, svrabac

340

itch n., vb.

svrbe (npr. od svraba); svrbjeti

itching

svrbjeti, svrbe, pruritus

J
jaundice

utica, ikterus

jaw

eljust

jawbone

donja eljust, mandibula

jejunum

tato crijevo, jejunum

jelly

ele, gel, elatina

jerk

trzaj; trzanje

joint capsule

zglobna ahura

joint n., adj.

zglob; zdruen, udruen

judge

ocjena; miljenje; sud

jugular

vratni, jugularni

juice

sok

junction

spoj; av; veza

juncture line

avni spoj; spojna crta

juvenile

mlad, mladenaki, malodoban

K
kapok

tropsko stablo iz porodice bambusa

Kaposi sarcoma

Kaposijev sarkom, idiopatski hemoragini

sarkom

karyoplasm

karioplazma, nukleoplazma

karyotype

kariotip

keloid

keloid, fibrozna hiperplazija, zadebljano

oiljno tkivo

keratin

keratin, ronato tkivo

keratinized

keratiniziran

keratitis

upala ronice

keratosis

keratoza

341

kernicterus

kernikterus, hiperbilirubinemija, utica

modanih jezgri

ketoacidosis

ketoacidoza, nakupljanje velikog broja

ketonskih tijela

ketosis

ketoza, prevelika koliina ketona u tijelu

kick

udarac; snaga; pokuaj

kidney

bubreg

killer cells

stanice ubojice

kin

srodan, blizak

kinesi(o)therapy

kineziterapija

kinesiology

kineziologija

kinetic

koji se odnosi na pokret, kinetiki

knee

koljeno

knee cap

iver, patela

knock

otkucaj (npr. srca); udarac

knot

vor; vezanje vora; uzao

knuckle

zglob prsta, lanak

kophemia

gluhoa, kofemija

kyphosis, pl. kyphoses

grbavost, kifoza

L
labium majus, pl. labia
majora

velika usna

labium minus, pl. labia

minora

mala usna

labo(u)r

trudovi (poroajni)

labo(u)r pains

poroajne boli

labyrinth

labirint (npr. uha)

lacrimal

suzni

lactation

dojenje, laktacija

lactiferous duct

mlijeni vod

laden

optereen, pun

lamina, pl. -ae

tanka ploa ili sloj

342

laminectomy

laminektomija

langerhans, the islands of,

the islets of

langerhansovi otoci, otoii

laparoscope

laparoskop, enoskopski instrument

za prelged unutranosti trbune upljine

laryngitis

upala grkljana (grla) laringitis

laryngopharynx

grkljan i drijelo

laryngoscopy

pregled unutarnjeg dijela grkljana,

laringoskopija

larynx, pl. larynges

larinks, grkljan

lateral

boni, lateralni

laxative

sredstvo za pospjeivanje stolice, laksativ

layer

sloj

lead

olovo

leak out

istjecati, proputati, curiti

leaky

koji curi, proputa, istjee

leg

noga

leiomyoma

leiomiom, vrsta benignog tumora

lens

lea

lesion

ozljeda, oteenje, lezija

lethal

smrtan, smrtonosan

leuk(a)emia

leukemija

leuk(c)ocyte

bijela krvna stanica, leukocit

leuk(c)ocytic

leukocitni

leuk(c)ocytosis

leukocitoza, broj leukocita iznad normalne

granice

leuk(c)openia

broj leukocita ispod normalne granice,

leukopenija

leuk(c)oplakia

leukoplakija

leuk(c)orhea

leukoreja

leuk(c)otaxis

svojstvo leukocita da se nakupljaju na

mjesta ozljede ili upale

libidinal

koji se odnosi na libido

343

libido

libido, spolna elja

lid

poklopac, zatvara

life-threatening

opasan po ivot, ugroavajui

ligament

veza, spona, ligament

ligation

vezanje, podvezivanje

light rays

svjetlosne zrake

limb

ud, ekstremitet

lime stone

kamen vapnenac

line

obavijati, obloiti, presvui

linger

oklijevati, zaostajati

lingual tonsil

jezini krajnik

lining

ovojnica, prevlaka

lipid

mast, lipid

lipocyte

masna stanica, lipocit

lipoid

lipoidan

lipoma, pl. -s, -ata

lipom

liposarcoma

liposarkom

lithoid

poput kamena

lithotomy

kirurko odstranjenje kamenca, litotomija

live

iv

liver

jetra

load of life

teret (teskoe) ivota

lobby

potajno se zalagati

lobe

reanj, resa

lobotomy

uklanjanje modanog tkiva, lobotomija

lobster

jastog

locomotion

pokretnost, micanje, kretanje

loin

slabine, kriza

loop of henle

henleova petlja

loose

slobodan, puten, osloboen, labav

loosening

oslobaanje; omekavanje, olabavljenje

lordosis

lordoza

344

louse, pl. lice

lubricate

mazati, podmazivati

lubricating fluid

tekuina za podmazivanje

lues

lues, sifilis

lumbar

slabinski, lumbalni

lumen, pl. lumina

upljina, lumen

lump

kvrica, gruda, izboina, lokalno oticanje

ili tumor

lumpectomy

uklanjanje kvrice

lung

plua

lung cancer

rak plua

lunula, pl. -ae

mali mjesec, lunula (nokta)

lupus

niz kroninih degenerativnih konih lezija

luteinizing hormone, lh

luteinizirajui harmon, lh

lymph

limfa

lymph(o)edema

zaepljenje limfne ile, limfedem

lymphadenitis

limfadenitis, upala limfnog vora

lymphatic, adj., n.

limfni, limfatiki; limfna ila

lymphocyte

limfocit

lymphocytosis

limfocitoza, povean broj limfocita

lymphoid cancer

limfni ili limfoidni karcinom

lymphokine

limfokin

lymphoma

limfom, maligni tumor limfnog tkiva

lymphotoxin

limfotoksin

lyse

razgradivati, otapati, osloboditi

(npr. od priraslica)

lysin

lizin

lysis, pl. -es

razgradnja; otapanje stanice, liza

lytic

koji se odnosi na lizu, lizni

M
macrocytic an(a)emia

makrocitna anemija

345

macrophage

makrofag, velika fagocitna stanica

macrotia

abnormalno veliko vanjsko uho, makrotija

macula lutea

uta pjega

macule

mrlja, pjega, makula

major

vei; punoljetan; glavni

maladaptation

loa, slaba prilagodba

malaise

slabost, mlitavost

maldevelopment

nedostatan iii nepravilan rast iii razvoj

male, adj., n.

muko, mukarac

malformation

nakaznost, malformacija

malfunction

nepravilan rad

malignant

zloudni, maligni

malleolus, pl. malleoli

gleanj; dio kosti koji ima oblik glave ekia

malleus, pl. mallei

eki (srednjeg uha)

mamma, pl -ae

dojka

mammary gland

mlijena zlijezda

mammectomy

amputacija dojke, mamektomija

mammillary

koji se odnosi na bradavicu dojke

mammography

radiografsko snimanje dojke, mamografija

mammoth

mamut

mandible

donja eljust

margin

rub, kraj, margina

marrow

kotana sr, modina

masculine

muki

mass

mnotvo, masa

massive

sveobuhvatni, veliki, masivni

mast cell

mastocit

mastectomy

amputacija dojke, mastektomija

mastication

vakanje

mastitis

upala dojke, mastitis

mastoid process

mastoidni nastavak

mastoiditis

upala mastoidnog procesa

346

matter

tvar, materija

mattress

strunjaa, madrac

maturation

dozrijevanje, sazrijevanje

maturity

zrelost

maxilla, pl. -ae

gornja eljust

maxillary

maksilaran

measles

ospice, morbilli

meatus

otvor, prolaz, hodnik

meconium

mekonij, stolica novoroeneta

(zelenkaste boje)

medial

srednji, medijalni

median

srednja crta (tijela, ake, stopala)

mediastinum, pl. mediastina sredoprsje

medical

lijeniki, medicinski, medikameotozni

medication

lijek; lijeenje

medicine

lijenitvo, medicina; lijek; arolija

medium, pl. media

sredstvo; orue; medij, hranilite

medulla oblongata, pl. -ai

produena modina

medulla, pl. -ae

modina, sr

medullary

medularan

medulloblastoma

meduloblastom, zloudni tumor malog

mozga

melanin

melanin

melanocyte

melanocit

melanoderma

melanoderma

melanoma

melanom

melatonin hormone

harmon melatonin

melena

crna stolica, melena

membrane

opna, membrana

membraneous

opneni, membranski

memory cells

stanice memorije (u imunosnim reakcijama)

menarche

prva menstruacija, menarha

347

Meniere syndrome

Menierov sindrom (bolest slunog aparata)

meningeal sarcoma

meningealni sarkom

meninges, sg. meninx

opne, ovojnice (modane)

meningioma

lokalni tumor szs-a, meningiom

meningitis

upala opni, meningitis

meningoc(o)ele

meningokela, hernija opni kroz kotano

oteenje

meningococcus

meningokok (neisseria meningitidis)

meningomyeloc(o)ele

meningomijelokela, hernija opni

i kraljenine modine

menopause

meonopauza, klimakterij

menorrh(o)ea

mjesenica, menstruacija

menorrhagia

preobilna mjesenica, menoragija

menstrual

menstruacijski, menstrualni

menstruation

mjesenica, menstruacija

mental

umni, duevni

mesencephalon

srednji mozak

mesenchyme

mezenhim, embrijsko vezivno tkivo

mesentery

trbuna opna, mezenterij

mesoderm

mezoderma, srednji zametni listi

metabolism

mijena tvari, metabolizam

metabolite

metabolit

metacarpal

koji se odnosi na kosti zapea,

metakarpalni

metastasis, pl. -ses

metastaza prijenos bolesti s jednog organa

na drugi (osobito svojstvo zloudnih stanica)

metastasize

metastazirati

metastatic

metastatski

metatarsal

koji se odnosi na kosti donoja, metatarzalni

metronidazol

metronidazol (vrsta antibiotika za lijeenje

infekcija anaerobnim mikroorganizmima)

metroptosis

prolaps maternice, metroptoza

metrorrhagia

krvarenje iz maternice, metroragija

348

microbe

mikrob, mikroskopski mali (osobito

patogeni) orgnaizam

microbiology

mikrobiologija

microglia

mikroglija, fagocitne stanice glijalnog tkiva

ivanog sustava

microorganism

mikroorganizam

microscope

mikroskop

microstaging method

metoda odreivanja mikrostadija

microtia

neprirodno mala vanjska uska, mikrotija

micturition

mokrenje

midbrain

srednji mozak, mezencefalon

middle ear

srednje uho

midline

sredinja crta (tijela)

midstagittal plane

sredinja (medijalna) sagitalna ravnina tijela

midwife

primalja, babica

mildness

blagost

milk teeth

mlijeni zubi

mind

um, svijest

mineral

ruda, mineral

mineralocorticoid

steroidni harmon kore nadbubrene lijezde

minor, adj., n.

manji, nii, donji; malodobnik, maloljetnik

minute

malen, siuan

miscarriage

pobaaj (spontani)

mite

grinja; svrabac

mitochondrion, pl. -a

mitohondrij

mitral

mitralan, dvokuspidni (npr. zalistak)

mo(u)ld

kalup, odljev; plijesan

mo(u)ld spore

spora (gljivice) plijesni

modifier

modifikator, izmjenjiva

moist

vlaan, mokar

molar

kutnjak (zub)

mole

made; zakrljali zametak; krtica

349

molecule

molekula

mongolism (obsolete)

Downov sindrom, trisomija 21

monitoring

praenje

monocyte

monocit

mononucleosis, infective

mononukleoza, infektivna
(uzronik Epstein-Barr virus)

monoxide

monoksid; popularni naziv za ugljini

monoksid

mood

raspoloenje

moral, n., adj.

moral; moralan, udoredan

morbid

izopaen, bolestan, morbidan

morbidity

pobol, morbiditet

morbilli

ospice, morbilli

mortality

smrtnost

morula

morula, kupinasta nakupina blastomera

u poetnoj diobi zigote

motile

gibljiv, pokretan

motility

gibljivost, pokretnost

motivation

motivacija

motivational

motivacijski

motor

motoriki, koji pokree

mounting

koji poveava, raste

mouth

usta

mucolytic

mukolitik, koji razgrauje sluz

(u dinim organima)

mucorrh(o)ea

mukoreja, prekomjerno stvaranje sluzi

mucosa

sluznica

mucous, adj.

sluzav, mukozan

mucus, n.

sluz

multicentric

koji ima mnoga sredita, multicentrian

multifaceted

koji ima mnogo ravnih povrina

(npr. neki uni kamenci)

multiform

raznolik, s mnogo oblika, polimorfan

350

multiple sclerosis

multipla skleroza

multiple, adj., n.

viestruk; viekratnik

multipotent

koji ima viestruku mo, djelovanje, uinak

mumps

zaunjaci

murine

miji

murmur

um (srani)

muscle

mii

muscular

miini, miiav

musculoskeletal

miinokotani

mushroom

gljiva

myalgia

bol u miiu, mialgija

myasthenia gravis

mijastenija gravis

myasthenic

koji boluje od miine slabosti, mijastenian

mycosis
myelin

bolest izazvana gljivinom infekcijom

mijelin

myelocytic leukemia

granulocitna leukemija

myeloma, multiple

mnogostruki mijelom, zloudni plazmacitom

myocardial

koji se odnosi na srani mii

myocarditis

upala sranog miia, miokarditis

myocardium

srani mii, miokard

myomectomy

kirurko odstranjenje mioma, miomektomija

myometrium

miini sloj maternice, miometrij

myoneural

koji pripada miiu i ivcu (odnosi se na

ivane zavretke u miinom tkivu)

myoneural junction

mioneuralni spoj

myopia

kratkovidnost, miopija

myringotomy

rez na bubnjiu, miringotomija

myx(o)edema

hipofunkcija titne lijezde, miksedem

N
nail

nokat

narcotic

opojno sredstvo, narkotik

351

narcotism

narkotiino stanje, odavanje narkoticima

naris, pl. nares

narrowing

nosnica
suenje, konstrikcija

nasal

nosni

nasopharynx

nosni dio drijela

natural defense mechanism prirodni obrambeni mehanizam

nausea

munina

navel, col. belly button

pupak

nearsightedness

kratkovidnost, miopija

neck

vrat, ija, grli (npr. maternice)

necrosis, pl. -ses

odumiranje tkiva, nekroza

necrotic

koji odumire, nekrotian

need

potreba

negligible

beznaajan, nevaan, zanemariv

neonatal

novoroenaki, neonatalan

neonate

novoroene

neonatology

neonatologija (izutavanje stanja djece

do 2 mjeseca starosti)

neoplasm

tumor, neoplazma

neoplastic

neoplastian, tumorski

neostigmine

neostigmin, vrsta neuroprijenosnika

nephritis, pl. nephritides

upala bubrega, nefritis

nephrolithiasis

bubreni kamenac, nefrolitijaza

nephrologist

nefrolog, specijalist za bubrene bolesti

nephrology

nefrologija

nephron

nefron, osnovna funkcionalna i anatomska

bubrena jedinica

nephropathy

bubrena bolest, nefropatija

nephrosclerosis

nefroskleroza

nephrosis

degenerativna bolest bubrega, nefroza

nephrotic syndrome

nefrotiki (nefropatski) sindrom

nephrotomy

nefrotomija

352

nerve

ivac

nervous

ivani, koji se odnosi na ivce, nervozan

nest, n., vb.

gnijezdo; ugnijezditi se

neural

neuralan, koji se odnosi na ivce

neuralgija

neuralgija, jaka bol u podruju inervacije

nekog ivca

neurilemma, neurolemma

neurolema, Schwannova ovojnica

neurilemmoma

neurilemom, tumor Schwannove ovojnice

neuritis
neuroblastoma

upala ivca
neuroblastom

neurocytoma

neurocitom

neuroectoderm

neuroektoderma

neuroglia

neuroglija, vezivno iano tkivo

neurohypophysis

neurohipofiza

neurologist

neurolog

neurology

neurologija

neuroma

neurom, tumor graen od ivanih stanica

i ivanih vlakana (neurogangliom)

neuron

ivana stanica, neuron

neurosis

neuroza

neurosurgeon

neurokirurg

neurotoxin

ivani otrov, neurotoksin

neurotransmitter

neuroprijenosnik

neurotripsy

drobljenje ivaca, neurotripsija

neutrophil

neutrofil

nevus, pl. nevi

made, znamenka, nevus

nickel

nikal (kem. el. ni)

nicotine

nikotin

nipple

bradavica, mamilla

nit

jajaca ili larva (ui), gnjida

nitrogen

duik

nitrogenous

duini, koji sadri duik

353

nitroglycerine

nitroglicerin

node

vor

nodular goitre/goiter

adenomska guavost (struma)

nodule

vori

nonmalignant

koji nije zloudan

nonsmoker

nepua

nonsuppurative

koji se ne gnoji; kirurki ist

noradrenaline

noradrenalin

norepinephrine

nos

nourish

hraniti, prehranjivati, jacati, uzgajati

nourishment

hrana, prehrana, hranjivi sastojak

nuclear

koji se odnosi na jezgru

nucleoplasm

nukleoplazma, karioplazma

nucleus, pl. nuclei

jezgra

numbness

ukoenost, omamljenost, obamrlost, tupost

nurse

medicinska sestra

nursemaid

dadilja, njegovateljica

nursery

djeja soba; djeji vrti

nursing

njega (bolesnika); dojenje

nutrient, n., adj.

hranjiva tvar, hrana; hranjiv

nutrition

prehrana; hranjenje

nyctalopia

nono sljepilo

nystagmus

nistagmus, nehoticne titrajue kretnje

oiju u jednom smjeru i natrag

O
oat cell carcinoma

oblik karcinoma (plua) kojeg su stanice

nalik zrnu zobi

oath

zakletva, prisega

obese

gojazan, debeo, pretio

obesity

gojaznost, debljina, pretilnost

objective, n., adj.

cilj, predmet; objektivan

354

oblique muscles

kosi miii

obstetrician

porodniar, opstetriar

obstetrics

porodnitvo, opstetricija

obtrusive

nametljiv

occipital

zatiljni, koji pripada zatiljku

occiput

zatiljak

occlusion

zatvorenost, zaepljenost, okluzija

occur

javiti se, nastati, dogoditi se

ocular tendon

ona tetiva

odo(u)r

miris, zadah

offending agent

tetna tvar, sredstvo

oil glands

lijezde lojnice

ointment

mast (za mazanje)

olecranon

vrh lakta

olfactory

koji se tie osjetila mirisa, njuni, olfaktorni

oligodendroglia

Oligodendroglija, vrsta neuroglijalnih

stanica

oligodendroglioma

oligodendrogliom

oligospermia

manjak spermija, oligospermija

oncogenic

koji se odnosi na stvaranje tumora, onkogeni

oncologist

onkolog, spicijalist za tumore

oncology

onkologija

onset

poetak, izbijanje (simptoma)

onychia

upala leita nokta, onihija

oophoritis

upala jajnika

opacity

neprozirnost, zamuenje

opaque

neproziran, zamuen

operable

koji se moe operirati, operabilan

operating theatre/room

operacijska dvorana (sala)

ophthalmologic

oni, oftalmoloki

ophthalmologist

specijalist za one bolesti, oftalmolog

ophthalmology

oftalmologija

355

ophthalmoscopy

oftalmoskopija

optic disc/disk

vidna ploa (disk)

optic nerve

vidni ivac

option

slobodan izbor, pravo izbora

oral

usni, usmen, oralan

oral cavity

usna upljina

orbit

ona upljina, orbita

orchi(d)opexy

Orhidopeksija, kirurko fiksiranje

nesputenih testisa u skrotum

orchitis

upala sjemenika (testisa)

ordinary

redovit, pravilan; uobiajen

organ

organ

organic

organski

organism

organizam

orifice

otvor, ue

origin

podrijetlo, ishodite

originate

uzrokovati, nastati, vui podrijetlo

oropharynx

usni dio drijela

orthop(a)edic
orthop(a)edics

ortopedski
ortopedija

orthopnea

ortopneja, oteano disanje osim u sjedeem

ili stojeem poloaju

orthoptic training
orthosis, brace, splint

ortoptike vjebe (onog miia)

ortopedsko omagalo ili aparat

osmolarity

osmolarnost, propusnost (npr. opne)

osseous

kotan; koat

ossicle

mala kost, koica

ossification

okotavanje, osifikacija

osteitis

upala kosti, osteitis

osteitis fibrosa cystica

fibrozna cistina upala kosti

(von Recklinghausenova bolest)

osteoarthritis

osteoartritis, upala kosti i zglobova

356

osteoblast

osteoblast, poetna (nezrela) kotana

stanica

osteochondroma

osteokondrom, benigna kotano-hrskavine

izraslina

osteoclasis

osteoklazija, kirurki prijelom kosti

osteoclast

osteoklast, kotani fagocit

osteolytic

koji se odnosi na degeneraciju kosti,

osteolitian

osteoma

osteom, benigni sporo rastui kotani tumor

osteomalacia

osteomalacija, rahitis odraslih

osteomyelitis

osteomijelitis, upala kosti i kotane sri

osteoporosis

osteoporoza, smanjenje kotane gustoe

osteosarcoma

osteosarkom, zloudni primarni tumor kosti

otalgia, otodynia

uhobolja

otitis media

upala srednjeg uha

otoencephalitis

otoencefalitis

Otopyorrh(o)ea

gnojni iscjedak iz uha, otopioreja

otosclerosis

otoskleroza

outbreak

poetak, nastup (bolesti)

oval window

ovalni otvor (prozor), fenestra vestibuli

ovarian

koji se odnosi na jajnike

ovary

jajnik

overcome

prevladati, nadjaati

overgrowth

prekomjeran rast

overpowering

pretean, kojemu se ne moe oduprijeti;

tegoban

overwhelming

silan, nadmoan, neodoljiv

oviduct

jajovod

ovulation

ovulacija, sazrijevanje jajaca

ovum, pl. -ova

jaje, jajace

oxide

oksid

oxidization

oksidacija; izgaranje

oxidize

oksidirati
357

oxigenate

obogatiti (spojiti sa) kisikom, oksigenirati

oxygen

kisik

oxygenation

obogaivanje (spajanje sa) kisikom,

oksigenacija

oxytocin

oksitocin

oyster

otriga (kamenica)

ozone

ozon

P
p(a)ediatric

pedijatrijski

p(a)ediatrician

pedijatar

p(a)ediatrics

pedijatrija

pace

korak; hod; brzina hoda; tempo

pacemaker, SA node

predvodnik; elektrini stimulator srca;

SA vor

pad

jastui (koji umanjuje trenje)

pain

bol

palate

nepce

palatine

nepani

pale

blijed

paleness

bljedilo, bljedoa

palliative

palijativan, koji ublauje, olakava

pallor

bljedilo, bljedoa, blijedost

palm

dlan

palpation

pipanje, pregled pipanjem, palpacija

palpitation

pojaano, prekomjerno udaranje bila,

treperenje, lupanje (srca)

palsy

kljenut, uzetost, paraliza

panacea

lijek protiv svih bolesti, panaceja

pancreas

guteraa

pancreatitis

upala guterae, pankreatitis

papanicolau test, pap.test

citoloki postupak (za otkrivanje raka

grlia maternice; papa-test)

358

papilla, pl. -ae

sitna izraslina, bradavica

papillary dermis

papilarni dermis

papilloma, pl. -s, -ata

Papilom, benigni epitelni tumor

papule

vori (na koi)

paracentesis of the cornea

paracenteza (punkcija) ronice

paralysis

kljenut, uzetost, paraliza

paranasal

paranazalni

paraplegia

kljenut (uzetost) donjih udova

parasite

nametnik, parazit

parasitic

nametniki

parasympathetic

parasimpatiki

parathyroid gland

paratiroidna (nustitna) lijezda

parenchymal

parenhimni

parenchyme

funkcionalni elementi tkiva, parenhim

parietal

zidni, parijetalni

parietal bone

tjemena kost

parietal pleura

porebrica, parijetalna pleura

Parkinson disease

Parkinsonova bolest

paronychial

koji se odnosi na rub nokta

parotid

zauna (parotidna) lijezda

parotitis

upala zaune lijezde, mumps

paroxysm

nenadano pojaanje boli,

nastup gra i sl., paroksizam

particle

estica

particulate matter

tvar u obliku estice

partition

dijeljenje, pregrada

parturition

poroaj, raanje

partus

poroaj

partus agrippinus

poroaj djeteta zatkom

atch
patella, knee cap

komadi; zakrpa; mrlja

iver, patela

pathogen

sve ono to izaziva bolest, patogen

359

pathologic

bolestan, patoloki

pathologist

patolog

patient

bolesnik

pattern

uzorak; model; nain; obrazac

peak

vrh, gornja granica (npr. krivulje)

pectoral

prsni

peculiar

svojstven, osobit, osebujan

peer

ravan nekomu po asti, poloaju, podrijetlu,

i sl.

pellucid

proziran, bistar, kristalan

pelvis, pl. pelvises, pelves

zdjelica

pemphigus

ir, pemfigus

penicillin

penicilin

penis

muko udo, penis

peptic ulcer

peptiki vrijed, ulkusna bolest

perceive

opaati, shvatiti, percipirati

perception

opaanje, percepcija

percussion

pregled kucanjem, perkusija, perkutiranje

percutaneous

koji se obavlja preko koe, perkutani

perianal

koji se nalazi ili nastaje u predjelu anusa,

perianalni

pericarditis

upala osrja, perikarditis

pericardium

osrje, perikard

peril

opasnost, pogibelj

perimetrium

serozni sloj maternice, perimetrij

perimisium

vanjska miina ovojnica, perimizij

perinatal

perinatalni

perineal

koji pripada meici, perinealni

perineum, pl. -a

meica

periosteum, pl. -a

pokosnica

perish

nestati, ieznuti, slabiti, propasti

peristalsis

peristaltika

360

peristaltic

peristaltiki

peritoneum

potrbunica

peritonitis

upala potrbunice, peritonitis

peritubular

peritubularni

perk up

dizati nos, razmetati se; razveseliti se,

ivnuti

pernicious an(a)emia

perniciozna anemija; nepostojanje

intrinzinog faktora za resorpciju
vitamina B12

perpetuation

neprekidno trajanje, produivanje

persistent

ustrajan, tvrdokoran

perspiration

znoj, znojenje

pertussis

hripavac

pessary

pesar; podupirajui prsten

petechia, pl. -ae

petehija

petit mal

napadaj gubitka svijesti, napadaj padavice

phagocyte

stanica dera, fagocit

phagocytic

fagocitni

phagocytosis

fagocitoza

phalanx, pl. phalanges

lanak (prsta)

pharyngeal tonsils

drijelni krajnici

pharynx, pl. pharynges

drijelo

phenol

fenol, otrovan bezbojni kristalinini spoj

phenomenon, pl. -a

pojava, fenomen

phenotype

fenotip

phenylketonuria

prisustvo fenilketona u mokrai

pheochromocytoma

tumor sri nadbubrene lijezde

phimosis

suenost udne navlake, fimoza

phlebitis

upala vene, flebitis

phlebotomy

otvaranje vene, flebotomija, venesekcija

phlegm

gusti sekret iz dinih putova

phobia

bolesni strah, fobija

361

phonation

stvaranje glasa, fonacija

phosphorus

fosfor

physical

tjelesni, fiziki; fizikalni

physician

lijenik

physiologic/al

fizioloki

physiology

fiziologija

pia mater

meka modana ovojnica, mozgovnica

pigmentation

pigmentacija

pigmented

pigmentiran

piles

uljevi, hemoroidi

pillow

jastuk; podloga, leaj

pilonidal cyst

pilonidna cista

pimple

bubuljica

pineal gland

cerebralna epifiza

pinkeye

akutni zarazni konjunktivitis; upala oiju

pinna, pl. pinnea

una koljka, uka

pituitary cachexia

hipopituitarizam, pituitarna kaheksija

pituitary gland

lijezda hipofiza

placenta

posteljica

placenta praevia

placenta previja

placental

koji se odnosi na posteljicu, placentaran

plant

biljka; postrojenje

plantar flexion

plantarna fleksija, fleksija tabana

plaque

ploa; naslaga

plasma

plazma (krvna)

platelet

krvna ploica, trombocit

pleasurable

koji prua zadovoljstvo, ugodu

plegia

uzetost, kljenut, paraliza

pleomorphic

pleomorfan, koji se javlja u mnogo razliitih

oblika

pleura, pl. pleurae

pluna maramica, porebrica, pleura

pleural effusion

pleuralni izljev (eksudat)

362

pleurisy, pleuritis

upala porebrice

pneumoconiosis

pneumokonioza, taloenje raznih vrsta

praine u plunom tkivu

pneumonia

upala plua, pneumonija

pneumothorax

zrak u prsitu, pneumotoraks

podagra

ulozi, podagra (bol u nozi), giht

poison

otrov

polio

djeja paraliza, poliomijelitis

pollen

pelud, cvjetni prah

polycentric

policentrian, koji ima vise sredita

ili jezgara

polycythemia

povean broj eritrocita, policitemija

polydipsia

prekomjerna e

polyp

peteljkasta izraslina, polip

polyphagia

prekomjerna glad, polifagija

polyuria

prekomjerno mokrenje, poliurija

pons, pl. pontes

most

poppy

mak; opijum koji se dobiva iz maka

pore

pora

portal vein

vena vratarnica

positioning

namjetanje

posterior

stranji

posture

poloaj, dranje (tijela)

potassium

kalij

potential

mogunost, potencijal, latentna sila

pouch

vreica

pound

funta, oko 1/2 kg

practice

obavljanje posla, praksa

predisposition

sklonost, predispozicija

preeminence

nadmo, superiornost, isticanje

pregnancy

trudnoa

premature birth

prijevremeni poroaj

363

prepuce

udna navlaka, prepucij

presby(a)cusis

staraka nagluhost, smanjenje sluha,

prezbiakuzija

presbyopia

staraka dalekovidnost, smanjenje vida,

prezbiopija

prescribe

propisati

prescription

recept (lijeniki); propis

primary health care

primarna zdravstvena zatita

primipara

ena koja prvi puta raa, prvorotkinja

probe, cryoprobe

tapi za irenje kanala, sonda; pipaljka;

sonda koja se primjenjuje u lijeenju ledom

probing

pretraivati sondom

process

nastavak, izdanak

productive cough

produktivni kaalj

profuse

obilan

progesterone

progesteron; glavni gestacijski hormon

prognosis

predvianje, prognoza

progressive

koji napreduje, iri se, dalje se razvija (npr.

bolest)

prolapse

sputanje, pad (npr. organa)

proliferate

rasti, mnoiti se

proliferation

nagli rast, bujanje

prominence

isticanje, izboina

pronation

leanje niice, potrbuke

prone

licem prema zemlji, potrbuke; sklon,

naklonjen

propel

potiskivati, tjerati naprijed

propelling pressure

potisni (propulzivni) tlak

prophylactic

zatitan, profilaktian

propulsion

potisak, propulzija, pogon

prostate gland

predstojna lijezda, prostata

prostatectomy

prostatektomija, kirurko uklanjanje

prostate

364

prostatic hypertrophy

hipertrofija prostate

protect

zatititi

protection

zatita

protein

bjelanevina

proteinuria

bjelanevine u mokrai

prothrombin

protrombin, faktor zgruavanja, faktor II

protoplasm

protoplazma

protrusion

izboenje, strenje

prowess

odvanost, junatvo, smjelost

proximal

blii, proksimalan

pruritus

svrbe

psoriasis

psorijaza

psyche

dua, psiha

psychiatrist

psihijatar

psychiatry

psihijatrija

psychologist

psiholog

psychology

psihologija

psychosis

psihoza

ptosis

sputanje, ptoza, prolaps

puberty

doraslost, pubertet

pubic

koji se odnosi na stidnu (preponsku) kost

pubis, pl. pubes

stidna (preponska) kost

puerperal

babinji, puerperalni

puerperium

babinje, puerperij

pulmonary

pluni

pulmonary emphysema

pluni emfizem

pulp

sr, pulpa (zuba)

pulse

bilo, puls

puncture

punkcija, ubod

pupil

zjenica

365

purification

proiavanje, ienje

purity

istoa, jasnoa

purpura

purpura, sitna potkona periferna krvarenja

purulent

gnojan

pus

gnoj

pustular

gnojan

pustule

gnojni mjehuri, pustula, priti

putrefaction

truljenje, gnjiljenje

pyelonephritis

pijelonefritis

pyeloplasty

pijeloplastika, plastina operacija bubrene

zdjelice

pyloric valve

piloriki zalistak, pilorus, vratarnik

pylorospasm

pilorospazam

pylorus

vratarnik, pilorus

pyogenic

gnojan, piogen

pyothorax

empijem, piotoraks, gnoj u grudnom kou

pyrosis, heartburn

garavica

pyuria

pijurija (bakterijska infekcija),

gnoj u mokrai

Q
quadrant

kvadrant

quadruplets

etvorke

quality

kakvoa, kvaliteta

quantity

koliina, kvantitet

quarter

etvrtina, kvartal; cca 1l

questionable

koji je pod znakom pitanja; sumnjiv

quinsy

gnojna upala krajnika; peritonzilarni apsces

quit

napustiti; prestati; ostaviti

quotient

kolinik, kvocijent

R
race

366

rasa, rod, vrsta

rachitis, rickets

rahitis

radial

zrakast, radijalan

radiate

zraiti, sjajiti se, iriti se (zrakasto)

radiation

zraenje, isijavanje

radical

temeljit, korjenit, radikalan, koji se odnosi

na korijen

radiologist

radiolog

radiology

radiologija

radiotherapy

radioterapija

radius, pl. radii

palana kost; polumjer

raised

izboen, uzdignut, ispupen

rale

hroptanje

random

sluajan

range

kretati se, varirati, javljati se; raspon

rarely

rijetko, neobino

rash

osip

rate

odnos, omjer, stupanj, brzina

rather

zapravo, stovie, prije (nego), radije

raw

ranjav, otvoren, bolan, upaljen, sirov

Raynauds phenomenon

Raynaudova pojava, fenomen

re-establish

opet uspostaviti, opet utvrditi

reach

doprijeti, dosezati, prodrijeti

rear

stranji dio, straznja strana, pozadina

receive

primati, prihvatiti, dobiti

recent

nedavni, skoranji, recentan

receptor

prihvata, receptor

recipient

primatelj

Recklinghausen disease

von Recklinghausenova bolest (osteitis

fibrosa cystica)

recognition

prepoznavanje, raspoznavanje, identifikacija

record, n.

biljeka, zapis, evidencija

record, vb.

biljeiti, zapisivati

367

recourse

rjeenje, izlaz

recovery

oporavak, rekonvalescencija

rectal

rektalan

rectum, pl. recta

ravno crijevo

rectus

ravan mii

recumbent

leei, poivajui, naslonjen

recurrent

povratan, recidivan

reduce

smanjiti; kir. reducirati, uzglobiti, uaiti

reduction

smanjenje, redukcija, uzglobljenje, ulaganje

refer to

odnositi se, ticati se (ega), upuivati (na)

refine

usavriti, poboljsati, dotjerati

reflux

tok unatrag, vraanje, povrat

refractive

refrakcijski

refracturing

kirurko lomljenje kosti

regard

smatrati, gledati, paziti, motriti

regarding

s obzirom na, u vezi sa

regenerate

obnavljati, regenerirati

region

podruje, mjesto, dio, regija

regress

vraati se, povratiti se (bolest, ponaanje)

regression

vraanje, povratak, regresija

regurgitation

povraanje, vraanje hrane iz eluca u usta,

bljuvanje

rehabilitation

oporavak, osposobljavanje za rad,

rehabilitacija

reinforce

pojaati

relapse

vratiti se, opetovati se, recidivirati

relapsing

koji vraa, opetuje, recidivan

relax

opustiti se, omlohaviti se, odmoriti se

relay

prenositi (impulse)

release

osloboditi, ispustiti, pustiti

relevance

znaajnost, vanost

relief

olakanje, smirenje

368

relieve

olakati, smiriti, ublaiti

reluctance

protivljenje, opiranje, nesklonost, odvratnost

remain

preostati, ostati

remainder

ostatak, preostali dio

remarkable

znatan, znaajan, jedinstven, zamjetan

remedy

lijek

remission

stadij mirovanja bolesti, privremeno

jenjavanje bolesti, remisija

remote

udaljen, dalek

removal

uklanjanje, odstranjenje

remove

ukloniti, odstraniti

renal

bubreni, renalan

renal calculus, pl. calculi

bubreni kamenac

renal pelvis

bubrena zdjelica

renal vein

bubrena vena

renew

obnavljati se

renewed

izlijeen, nanovo oivljen, obnovljen

renin

renin

repair

obnavljanje, regeneracija

repetitive

koji se opetuje, ponavlja

replacement

nadomjestak, nadopuna, zamjena

repolarization

repolarizacija

reproduction

umnaanje, razmnaanje, rasplodnja,

reprodukcija

reproductive

rasplodni, reprodukcijski

require

traiti, zahtijevati, iziskivati, trebati, biti

potreban

resection

isijecanje, resekcija, kirurko uklanjanje

resemblance

slinost

resemble

sliiti, biti slian, naliiti

reserpine

lijek protiv hipertenzije, reserpin

reservoir

spremite, spremnik

369

residual

preostali

residue

ostatak

resilient

savitljiv, podatan, otporan

resin

smola

resistance

otpornost, vrstoa, otpor

resolve

otopiti, rastvarati (se), rijeiti (problem)

respectively

odnosno, dotino

respiration

disanje

respiratory

dini

respond

odgovoriti, reagirati

response

odgovor, reakcija

responsible

odgovoran

restful

miran, spokojan, tih

restoration

obnavljanje, vraanje u prijanje stanje

restore

obnoviti (se), uspostaviti, vratiti u prijanje

stanje

restrictive

ogranien, koji ograniuje

retain

zadravati

retardation

zaostajanje, retardacija

retention

zadravanje, retencija (mokrae)

reticuloendothelial

retikuloendotelni

reticulum, pl. reticula

retikulum, mreica

retina, pl. retinae

mrenica

retinitis

upala mrenice

retinitis pigmentosa

upala mrenice s pigmentacijom na onoj

pozadini

retinoblastoma

retinoblastom, maligni tumor embrionalnih

stanica mrenice

retraction

uvlaenje, povlaenje, prevlaenje

retrograde

koji se povlai, koji se pogorava, koji

nazaduje

reveal

otkriti, pokazati

revenue

prihod, dohodak

370

reverse adj.

obratan, protivan, naopak, suprotan

reverse, vb.

okrenuti, promijeniti

rhabdomyoma

rabdomiom, tumor poprenoprugastog

miia

rhabdomyosarcoma

rabdosarkom

rhesus factor

rezus (rh) imbenik

rheumatic fever

reumatska groznica

rheumatoid arthritis

reumatoidni artritis

rhinitis

hunjavica, upala nosne sluznice

rhinology

rinologija

rib

rebro

rib cage

prsni ko

ribonucleic acid

ribonukleinska kiselina

ribosome

ribosom

rickets

rahitis

ridge

greben, hrbat, krijesta

rigidity

krutost, ukoenost, rigidnost

ring

prsten, kolut, obru

ringworm

liaj (kona bolest)

ripening

sazrijevanje

risk

pogibelj, opasnost, rizik

rod

tapi

rod-shaped

tapiast

rodent ulcer

nagrizajui ir, ulkus rodens

roentgen

rendgen

roentgenology

rendgenologija

role

funkcija, uloga

roof of the mouth

svod usne upljine

root

korijen, ila, sr

root canal work

lijeenje kanala zubnog korijena

rosacea

rozaceja (koni osip)

rotation

obrtanje, okretanje, vrtnja

371

rough

hrapav, grub, neravan, promukao (glas),

trpak

rubella

crvenka, rubeola

rubeola

trodnevne ospice

ruga, pl. rugae

nabor, bora

ruggedness

hrapavost

rumbling

kruljenje

rupture

prsnue, ruptura

S
sac

vrea

saclike

vreast

sacral

krini, koji pripada kriima

(krinim kraljecima)

sacroiliac

sakroilijakalni

sacrum, pl. sacra

krina kost

safe

siguran, bezopasan, nekodljiv

sagittal

usporedan s uzdunom sredinjom

ravninom, sagitalan

saliva

slina

salivary glands

lijezde slinovnice

salpingectomy

salpingektomija, kirurko uklanjanje

jajovoda

salpingitis

upala jajovoda

salpinx

jajovod, tuba uterina

salt

sol

sample

uzorak

sane

razuman, pametan, normalan

saphenous vein

povrinska vena (safena)nogu

sarcolemma

ovojnica miinog vlakna, sarkolema

sarcoma,pl.
sarcomas,sarcomata

sarkom

saturated

zasien, ispunjen

372

scab

krasta

scabies

svrab

scale

ljuska, ljuskica

scalelike

ljuskav

scaling

ljuska, ljuskica, stvaranje ljuskica

scalp

vlasite, kosom poikrivena koa lubanje

scan, vb.

podrobno ispitati, pregledati, radarski

pretraiti

scapula, pl. scapulae

lopatica; lopatina kost

scar

oiljak

scar tissue

oiljno tkivo

scarcity

oskudnost, nestaica, rijetkost

scarlatina, scarlet fever

arlah, skarlatina

scarring

stvaranje oiljaka odn. oiljka

scheme

shema, nacrt, plan

Schwann sheath

Schwannova ovojnica, neurilema

sciatica

iijas, bol du ivca ischiadicusa

sclera, pl. sclerae

bjeloonica

scleroderma

sklerodermija

sclerosis, pl. scleroses

skleroza

scoliosis, pl. scolioses

skolioza, postranino (lateralno)

iskrivljenje kraljenice

scotoma

tokasti ispadi u vidnom polju, skotom

scrape

strugati, ostrugati

scraping away

abrazija

screen

zakloniti, zatititi; prouavati

scrotum, pt. scrota

monje

seal off

zaepiti, zatvoriti (hermetiki)

search

traiti, istraivati

sebacious glands

lijezde lojnice

sebum

loj (ljudski)

secrete

izluivati

373

secretion

izluivanje

section

rez, presjek, dio, odsjek, sekcija

securely

sigurno, vrsto

sedation

lijeenje sedativima, stanje prouzrokovano

lijeenjem sedativima

seek

traiti, potraiti

seemingly

prividno

seep out

iscuriti, cijediti se

seizure

napadaj bolesti

self-limiting disease

bolest ogranienog trajanja

sella turcica

tursko sedlo

semen, pl. semina

sjeme

semicircular

polukruan

semilunar valve

polumjeseasti zalistak

seminal

sjemenski

seminal vesicle

sjemenski mjehuri

seminiferous tubules

sjemenski kanalci (tubuli)

seminoma

seminom, maligna neoplazma testisa

senescent

staraki

senile

staraki, senilan

sensation

osjet, osjeaj

sense organ

osjetilo, osjetni organ

sensitivity

osjetljivost, njenost

sensitized

osjetljiv, senzibiliziran

sensory

osjetni, osjetilni

separate

zaseban, odijeljen, razdvojen

separation

odjeljivanje, rastavljanje, separacija

septum, pl. septa

pregrada, pregradna stijenka

sequence of involvement

redoslijed ukljuivanja

sequestrum, pl. sequestra

mrtav dio tkiva ili organa, sekvestar

serosa

serozna opna, seroza

serosal

koji se odnosi na serozu

374

serous

sukrviast, koji proizvodi ili sadri serum,

serumski

serous fluid

serumska tekuina

serum, pl. sera

krvni serum

serve

posluiti, pomagati, koristiti, sluiti

serviette

ubrus

sesame

sezam

sesamoid bone

sezamska kost

set off

istaknuti, dati se (na posao)

several

nekoliko, nekolicina

sever

presjei, prekinuti, odrezati

severity

estina, teina, ozbiljnost (bolesti)

sew

ivati, saiti

sex cord

spolni snop u ranom fetal nom razvoju

sex glands

spolne lijezde, gonade

sex linked

spolno vezan

sexual climax

spolni vrhunac, orgazam

sexual intercourse

odnoaj

shaft

trup (kosti), dijafiza

shallow

plitak

shape

oblik

sharp

otar

sheath

ovojnica, omotac

shedding

ljutenje (koe)

sheet

plahta, ploha

shell-fish

koljka, rak, ljuskar

shepherd

pastir, ovar

shield, n.

titnik, zastita

shield, vb.

tititi, braniti

shigella, pl. shigellae

igela

shin bone

cjevasta kost

shingles

herpes zoster

375

shock

ok, udarac

shortsightedness

kratkovidnost, miopija

shoulder

rame

shoulder blade

lopatica, skapula

shoulder bone

lopatica, skapula

shrink

skvriti se, smanjiti se, skupiti se

shrinkage

skupljanje, smanjenje, stezanje

shuffling gate

teturav hod

shunt

spoj, skretaljka, premosnica

sickle-cell an(a)emia

anemija srpastih stanica

siderosis, pl. sideroses

pneumokonioza prouzroena udisanjem

eljezne praine, sideroza

sieve

sito, reeto

sigmoid colon

sigmoidno debelo crijevo

sign

znak

significant

znaajan, vaan, istaknut

signify

znaiti, oznaiti, naznaiti

silica

silicijski dioksid

silicon

silicij

silicon dioxide

silicijski dioksid

silicosis, pl. silicoses

pneumokonioza prouzrocena udisanjem

pjeane praine koja sadrzi silicijski
dioksid, silikoza

silvery

srebrnast, srebrene boje

similarity

slinost, istovrsnost

Simmonds disease

pituitarna kaheksija, Simmondsova bolest

simple fracture

jednostavan lom kosti (fraktura)

simultaneous

istodoban

single

jednostruk, pojedinacan

sinister

lijevi; zlokoban

sinistral

lijevi, usmjeren na lijevo

sinotrial node

sinuatrijski (SA) vor

376

sinus

zaton, sinus

sinusitis

upala sinusa

sip, n.

gutljaj, srkanje

sip, vb.

gucnuti, srknuti

sister in charge

deurna medicinska sestra

site

sijelo, lokalizacija (tumora)

size

veliina

skeletal

kosturni, skeletni

skeleton

kostur, skelet

skin

oteenje koe

skin rash

osip na koi

skull

lubanja

slant

kosa crta

slender

tanak, slab, njean, malen

slipped disk

iskliznue diska

slit

pukotina, prorez, rascjep, usjeklina

slitlike

poput pukotine (usjekline), uzak

slope-away

nagnuti se, ukoso se sputati,

biti nagnut, kos

slough

ljutiti se

slow-motion

usporen, usporeno snimljen

small intestine

tanko crijevo

smallpox, variola

crne kozice, velike boginje, variola

smell

osjet mirisa, njuh, miris

smooth muscle

glatki mii

snail -shaped

u obliku pueve kuice

snare

uhvatiti u omu (npr. polip)

soak

namakati (se), promoiti, upijati, proeti

(tekuinom)

socket

udubljenje, supljina (zglobna, ona)

sodium

natrij

soft palate

meko nepce

377

softening

omekavanje, smekavanje, ublaavanje

sole

potplat, on

sole of the foot

taban

solely

samo, jedino, iskljuivo

solid

krut, vrst

solidify

skrutnuti, ukrutiti, zgusnuti se

soluble

topiv

solution

otopina; rjeenje

somatic

tjelesan, somatian

somatotropin

somatotropin

somewhat

neto

somnolent

pospan, sanjiv, snen

sore

rana, bolno mjesto, ranjeno mjesto

sore throat

upala grla i krajnika, angina

sound

zvuk, um, glas

sound production

stvaranje glasova, fonacija

sound wave

zvuni val

source

izvor, podrijetlo, poetak

space

prostor, svemir

span, n.

vremenski razmak, raspon, trajanje, opseg

span, vb.

premostiti

sparingly

umjereno, tedljivo

spark

iskra, varnica

spasm

gr, napad kalja, spazam

spastic

grevit, spastiki

spastic colon

spastiki kolon

spasticity

zgrenost, spastinost

specialized

poseban, specijaliziran

speck

mrlja, tokica

spell

razdoblje, kratko vrijeme

spelling

sricanje, pravopis

sperm

sjeme, sperma

378

sperm viability

ivotna sposobnost, ivotnost spermija

spermatic cord

sjemeni snop

spermatozoon, pl.
spermatozoa

muka sjemenska stanica, spermij

sphenoid bone

klinasta (sfenoidna) kost

sphincter

kruni mii, sfinkter

sphygmomanometer

tlakomjer, sfigmomanometar

spider-web

pauinast, tanak; paukova mrea

spina bifida

rascjep kraljenice, spina bifida

spinal

kraljenini

spinal cord

kraljenina modina

spine

kraljenica

spinous process

iljasti, trnasti nastavak

spirochete

spiroheta

spit

ispljunuti, pljuvati

spleen

slezena

splenectomy

kirursko odstranjenje slezene,

splenektomija

splenodynia

bolovi u slezeni

splenomegaly

poveanje slezene, splenomegalija

splenopexy

splenopeksija

splenorrhaphy

splenorafija

splint

longeta, imobilizacija

splinter

smrskati, razmrviti

split

rascjep (usne)

spongy

spuvast, spongiozan

spontaneous

samonikao, sam od sebe, spontan

spot

mrlja, toka, pjega

sprain

iaenje, uganue, distorzija

spread

rasprostirati se, iriti se, protezati se

sputum

ispljuvak

squama, pl. squamae

ljuska

379

squamous

ljuskav, plosnat

squamous cell carcinoma

rak ploastih stanica, planocelularni

karcinom

squint

razrokost, kiljavost, strabizam

stabilization

uvrenje, stabilizacija

stable

vrst, stalan, stabilan

stage

stupanj, faza, stadij, razdoblje razvoja

stain

obojiti, bojati

stalk

drak, stalak, stabljika

stapedectomy

stapedektomija, kirurko uklanjanje

(ekscizija) stremena

stapes, pl. stapedes, stirrups stremen

staphyloccocus, pt.
staphylococci

stafilokok

star-shaped

zvjezdolik

starch

krob

steatorrh(o)ea

velika koliina masti u stolici

stem

stablo, stabljika, peteljka, korijen (rijei)

stem cell

hematoblast, osnovna (poetna) stanica

stenosis, pl. stenoses

suenje, stenoza

step

korak

sterilization

sterilizacija

sternum, pl. sterna

prsna kost

steroid

steroid

stethoscope

stetoskop

stiffen

ukrutiti se, ukoiti se, postati ukruen

stiffening

koenje, ukoenost, ukruenost

stiffness

ukoenost

stimulus, pl. stimuli

podraaj

stirrup

stremen

stomach

eludac

stones

kamenci

380

stool

stolica, feces

store

pohraniti, spremiti, uskladititi

strabismus

razrokost, kiljavost, strabizam

strabotomy

strabotomija, presjecanje tetive onog

miia

straighten out

izravnati

strain

napor, naprezanje; soj (bakterija);

istegnue (miia)

strand

vlakno, pramen

strangulated

uklijeten, udavljen

stratum, pl. strata

stratum corneum

sloj
ronati sloj

straw

slama, slamica

strengthen

pojaati, uvrstiti

streptococcal

streptokokni

streptococcus, pl.
streptococci

streptokok(i)

stress

udarac, potres, stres

stretch

rastezati, protezati, istezati

stretching

rastezanje, istezanje

stria, pl. striae

pruga, strija

striated muscle

popreno prugasti (kosturni) mii

stricture

suzenje

stridor

disanje poput itanja (zvidanje), stridor

strike

udariti, pogoditi

stringy

ilav, vlaknast, ljepljiv, viskozan

strip

uska vrpca, pojas, pruga

stroke

modani udar, kap, apopleksija

stroma, pl. stromata

potporno tkivo, stroma; tkivna matrica

structure

anatomska tvorba, graa, struktura

stupor

tupost, stupor

stye

jemenac, halazion

381

subarchnoid

ispod pauinaste ovojnice (mozga),

subarahnoidan

subclavian vein

potkljuna vena

subcutaneous

potkoan, supkutan

subsequent

sljedei, kasniji, naredni

subside

jenjavati, povui se (bolest)

substance

tvar

suckling

dojene

sudor

znoj

sudoriferous glands

lijezde znojnice

suffer from

trpjeti, bolovati, patiti (od ega)

suffice

dostajati, zadovoljavati

sufficient

dostatan, dovoljan

suffocating

guei, koji gui, zaguljiv

suitable

prikladan, pogodan, zgodan

sulcus, pl. sulci

brazda, lijeb

superficial

povrinski

superior vena cava

gornja uplja vena

supination

usporedan poloaj kostiju

podlaktice,supinacija

supine

leeci licem prema gore, supinacijski

supply

snabdijevati, opskrbiti

support

potporanj, oslonac, podupira, podloga

suppository

siljast epi, supozitorij

suppurative

gnojan

suprapubic

suprapubian

suprarenal gland

nadbubrena lijezda

supress

suzbiti, sprijeiti, potisnuti, zatomiti

surface

povrina

surge of blood

navala krvi

surgeon

kirurg

surgery

kirurki zahvat, kirurgija

382

surgical

kirurki

surrounded

okruen, opasan, obavijen

surroundings

okolina, okoli

survival

preivljavanje, opstanak

survival rate

stopa preivljenja

susceptibility

osjetljivost, prijemljivost, podlonost

susceptible

osjetljiv, prijemljiv, podloan (bolesti)

suspect, v.

sumnjati, posumnjati, nagaati

suspended

lebdeci, suspendiran

suspension

uvrenje, fiksacija, suspenzija

sustain

pretrpjeti (ozljedu); odrati (ivot)

suture, n.

av rane; kirurki konac; avni spoj kostiju;

sutura

suture, v.

spojiti avom, saiti ranu, vezati

swallow

gutati

swallowing

gutanje

sweat glands

lijezde znojnice

sweat, s.

znoj

sweat, vb.

znojiti se

sweating

znojenje

swelling

oticanje, otok, edem

swollen

oteen

sympathetic

koji pripada simpatikusu, simpatiki

sympodia

sratenost donjih ekstremiteta, simpodija

synapse

sinapsa, spojite ivanih stanica

synarthrosis

nepomian zglob, sinartroza

syncope

nesvjestica, sinkopa

synovial

koji pripada sinoviji

synovial capsule

zglobna ahura

synovial fluid

sinovijalna tekuina

synovial membrane

sinovijalna opna (membrana)

synthesis, pl. syntheses

spajanje, sastavljanje, sinteza

383

synthesize

sintetizirati; proizvesti

syphilis

sifilis, lues

syphilitic

sifilitian

syringe

trcaljka

system

sustav

systemic circulation

veliki krvotok

systole/sistole

stezanje (sranog miia), sistola

systolic

sistoliki

T
tachycardia

ubrzano bilo, ubrzani rad srca, tahikardija

tachypn(o)ea

ubrzano disanje, tahipneja

tag

navika, privjesak, pramen, prirepak, etiketa

tail

rep, kauda

tailbone

trtina kost

take over

preuzeti (funkciju)

take place

dogoditi se

talipes

uroeno zgreno (krivo) stopalo

tap

lupkati, perkutirati

tapper off

nestajati, prestajati, stanjivati (se)

tar

katran, smola

target tissue

ciljno tkivo

tarsal

kost korijena stopala (tarzusa)

task

zadatak, zadaa

taste

okus

taste buds

okusni pupoljci

tax

dravni porez, dabina, pristojba, taksa

tear gland

suzna lijezda

tear, n.

suza

tear, vb.

kidati, cijepati

technique

postupak, tehnika, nain obavljanja

telescope

teleskopirati

384

telescoping

teleskopiranje

temporal

sljepooni

temporal bone

sljepoona kost

temporary

privremen, prolazan

temporomandibular joint

eljusni zglob

tendency

sklonost, naklonost, naginjanje, tenja

tender

osjetljiv, mekan, bolan

tenderness

osjetljivost, mekoa

tendon

tetiva

tension

napetost, napregnutost, tenzija

teratocarcinoma

teratokarcinom

teratoma, pl. teratomata,

teratomas

uroena nakaznost, nakazna izraslina,

teratom

tertiary

trei po redu, tercijaran

test tube

epruveta

testicle

sjemenik, mudo, testis

testicular

koji se odnosi na testis

testicular carcinoma

rak sjemenika

testis, pl. testes

sjemenik, mudo

testosterone

testosteron, muki spolni hormon

tetanus

tetanus

tetany

tetanija

thalamotomy

talamotomija

thalamus

vidni humak, lonica, talamus

thalassemia

nasljedna hemolitika anemija, talasemija,

hemoglobinopatija

thick

gust (tekuina); debeo

thickened

zgunjavanje (tekuine); zadebljanje

thickness

debljina; gustoa (tekuine)

thigh

bedro

thin

rijedak, proziran (tekuina); tanak

thin sore

plitka ranica

385

thinness

rijetkoa (tekuine), tankoa

thinning

prorjedivanje, razrjedivanje, smanjenje,

opadanje (dlaka, kose)

thirst

thoracic

koji se odnosi na prsni ko, torakalni

thorax, pl. thoraces

prsni ko

thought

misao, miljenje, razmiljanje

thread

vlakno, nit, konac

threat

prijetnja, opasnost, ugroenost

thrive

rasti, razvijati se

throat

grlo, grkljan

thrombm:yte

krvna ploica, trombocit

thrombophlebitis

upala vena s trombozom, tromboflebitis

thrombosis, pl. thromboses

zaepljenje krvne ile ugrukom krvi,

tromboza

thrombus, pl. thrombi

krvni ugruak, tromb

thrush

upala usne sluznice

thumb

palac na ruci

thymectomy

kirurko uklanjanje prsne lijezde,

timektomija

thymitis

upala prsne lijezde, timitis

thymoma

timom, dobroudni i zloudni tumor timusa

thymus

prsna lijezda, timus

thyroid gland

titnjaa, titna (tiroidna) lijezda

thyroidectomy

kirurko odstranjenje titne lijezde,

tiroidektomija

thyrotoxicosis

tireotoksikoza, hipertireoza

thyroxine

hormon titne lijezde, tiroksin

tibia, pl. tibiae

goljenina kost, tibija

tick

krpelj

tied off

podvezan

timing

vremensko usklaivanje

tinea pedis

gljivina bolest stopala, portsko stopalo

386

tinge

preljev, (nijansa) boje

tinnitus

um u uhu

tiny

malen, sitan, siuan

tip

vrh, kraj, apeks

tiredness

sustalost, malaksalost, umor

tissue

tkivo

titre/er

titar

tobacco

duhan

toe

prst stopala

toenail

nokat na prstu stopala

toll

porez, carina, taksa, namet, danak

tongue

jezik

tonometar

mjera tlaka (krvnog), tonometar

tonsil

krajnik, abica, mandula

tonsillectomy

tonsilektomija, kirurko odstranjenje

krajnika

tonsillitis

upala krajnika, tonsilitis

tooth removal

vaenje zuba

tooth, pl. teeth

zub

toothpick

akalica

tough

ilav, vrst, krut

tox(a)emia

otrovanje krvi, toksemija

toxic

otrovan, toksian

toxin

otrov

trabecula, pl. trabeculae

gredica, traak, trabekula

trachea

dunik

tract

vod, sustav, trakt

trait

znaajka, osobina, karakteristika

tranquillizer

sredstvo za umirenje, trankvilizator

transaminase

transaminaza

transient

prolazan, kratkotrajan

translucent

proziran, providan

387

transmit

prenositi, prenijeti, iriti podraaje

transparent

proziran, providan

transplant, n.

kalem, transplantat

transplant, vb.

presaditi, transplantirati

transurethral resection

transuretralna resekcija

transverse colon

popreno (transverzalno) debelo crijevo

transverse process

popreni nastavak, (kraljeka)

trap

uhvatiti, uloviti

trauma, pl. traumata,

traumas

ozljeda, trauma

travel

putovati, kretati se

treatment

lijeenje, postupak, tretman

treponema pallidum

blijeda treponema (uzronik sifilisa)

triangular

trokutni, trouglast, trobridan

trichomonas vaginalis

trihomonas vaginalis

trichomoniasis

trihomonijaza

tricuspid valve

trolisni (trikuspidalni) zalistak

trigger

izazvati, prouzrociti

triglyceride

triglicerid

trigone

trokutasto podruje, trigon

triiodothyronine

trijodtironin, tironin (hormon titnjae)

triple-looped

trostruko zavijen

triplets

trojke

trochanter

kvrga

true ribs

prava rebra

trunk

trup, stablo

tube

cijev

tubercle

kvrica, tuberkulum

tuberculosis

suica, tuberkuloza

tuberosity

hrapavost

tubes

jajovodi

tubular

cjevast

388

tubule

cjevica, kanali, tubul

tuft of capillaries

mreza kapilara

tumo(u)r

novotvorevina, izraslina, tumor

turkey

puran, purica

twin

blizanac, dvojnik

twist

zavijati

twisted

uvojit, zavojit, spiralan

twitches

grevito trzanje (miia)

twitching

stezanje, kontrakcija, trzanje (udova)

tympanic cavity

bubnjite

tympanorrhexis

prsnue (razdor) bubnjia, timpanoreksija

tyrosine

tirozin

U
ulcer

vrijed, ir, ulkus

ulcerate

gnojiti se, prouzroiti ireve

ulceration

gnojenje, stvaranje vrijeda, ulceracija

ulcerative

gnojan, ulcerozan

ulcerative colitis

ulcerozna upala debelog crijeva

ulcerlike

poput ira

ulcerous

zahvaen ulceracijom

ulna, pl. ulnae

lakatna kost

ultrasound

ultrazvuk

ultraviolet

ultraljubiast

ultraviolet radiation

ultraljubiasto zraenje

umbilical

pupan

umbilical cord

pupkovina, pupana vrpca

umbilical hernia

pupana kila (hernija)

umbilicus

pupak

unable

nesposoban

unblinking

koji ne trepe

uncertainty

nesigurnost, neizvjesnost, nepouzdanost

389

uncondensed

nekondenziran

unconscious

nesvjestan, onesvijeten

unconsciousness

nesvjestica

undergo

pretrpjeti, prepatiti, podvri se

(pregledu, pretragama)

underlying

koji se nalazi ispod

underneath

dolje, ispod

undescending

koji se ne sputa

undesirable

nepoeljan, neugodan

undifferentiated

nediferenciran

unequal

nejednak, nerazmjeran

unfortunately

naalost

unicellular

jednostanian

unilateral

jednostran

union

veza, spoj

unit

jedinica, ureaj

unobtainable

koji se ne moe dobiti, nedokuiv,

nedostian, nedohvatljiv

unobtrusively

nenametljivo, edno

unossified

neokotan

unpaired

neparan, nesparen, jedan

unpleasant

neugodan, odvratan

unpolluted

ist, nezagaen

unresponsitivity

odsutnost reagiranja, reakcije

unspecialized

nespecijaliziran, koji nije pojedinacno

naveden

untwist

otplesti, rasplesti, razmrsiti

unusual

neobian, izvanredan

upper

vii, gornji

upper back

gornji dio lea

upper respiratory infection

infekcija gornjih dinih putova

uppermost

najvisi, gornji

390

urban

gradski

urea

mokraevina, urea

uremia

otrovanje mokranim sastojcima u krvi,

uremija

ureter

mokraovod, ureter

urethra

mokrana cijev, mokranica

urethritis

upala sluznice mokrane cijevi

urge

pospjeivati, pourivati, natjerati

uric acid

mokrana kiselina

urinary

mokrani

urinary bladder

mokrani mjehur

urinary meatus

mokrani prolaz

urinary passages

mokrani putovi

urinary retention

zastoj mokrae, zadravanje, zaustavljanje

urination

mokrenje, mikcija

urine

mokraa, urin

urinogenital

mokrano-spolni, urogenitalni

urogenital

urogenitalni

urologist

urolog

urology

urologija

urticaria

koprivnjaa, urtikarija

use, n.

primjena, namjena, upotreba

use, vb.

upotrebljavati, sluiti, primijeniti

usual

obian, uobiajen, redovan

usually

obino, pravilno, redovito, u pravilu

uterine

koji pripada maternici

uterus, pl. uteri

maternica

utilization

koritenje, potronja, uporaba

uvula, pl. uvulae

resica, uvula

V
vaccinate

cijepiti, vakcinirati

391

vaccination

cijepljenje, vakcinacija

vaccine, n.

cjepivo, vakcina

vagina, pl. vaginae

rodnica

vaginal

koji se odnosi na rodnicu, vaginalan

vaginismus

bolan gr rodnice, vaginizam

vaginitis

upala rodnice

valve

zalistak

valvula, pl. valvulae

malen zalistak

valvular

koji ima zaliske, koji se odnosi na zalistak

vapour

para, isparina, maglica

variable

promjenljiv, nestalan, kolebljiv, varijabilan

varicella

vodene kozice, variele

varices

vorasta proirena vena, varikozitet

varicoc(o)ele

oteklina od proirenih sjemenskih vena,

varikokela

varicose vein

proirena vena (varikozna vena)

varix, pl. varices

variks, proirena i iskrivljena vena,

arterija ili limfna ila

vary

mijenjati se, promijeniti se, razlikovati se

vas deferens, pl. vasa

deferentia

sjemenovod, vas deferens

vascular

koji se odnosi na krvne ile, vaskularni

vascularity

prokrvljenost

vascularize

snabdjeti krvlju

vasectomy

presijecanje sjemenovoda, vazektomija

vasoconstriction

vazokonstrikcija, suenje krvnih ila

vasodilator

sredstvo za irenje krvnih ila, vazodilatator

vasopressin

vazopresin, antidiuretski hormon

(oslobaa ga neurohipofiza)

vast

vrlo velik, golem, ogroman

vein

vena

vena cava

uplja vena

392

veneral disease; STD =

sexually tranmitted disease

spolna ili splno prenosiva (venerina) bolest

venous

venozan

ventral

trbuni

ventricle

srana klijetka; modana komora

venule

mala vena, venula

verruca

bradavica, bradaviasta izraslina

vertebra, pl. vertebrae

kraljeak

vertebral

koji se odnosi na kraljenicu

vertebral arch

luk kraljeka

vertebral body

tijelo kraljeka

vertebral column

kraljenica

vertigo

vrtoglavica

vesicle

mjehuri, vezikula

vesicular

mjehurast, mjehuricast

vessel

(krvna) ila

vestibule

predvorje, vestibulum

vestige

rudiment, zakrljalo udo ili organ

vestigial

rudimentaran, zakrljao

viability

ivotnost, ivotna sposobnost

viable

ivotan, koji ima ivotnu sposobnost

vibrate

titrati, odzvanjati, vibrirati

vice

porok, mana, zla navika, pogreka, zabuna

vicinity

blizina, susjedstvo, blii okoli

victim

rtva, stradalnik

victory

pobjeda

view

pregledati, ispitati, gledati, istraiti

vigorous

snaan, jak, energian, estok

villus, pl. villi

crijevna resica

vinegar

ocat, kvasina

violent

estok, nagao, nasilan

viral

virusni

393

virgin

djevica

virginal

djevianski, ist

virginity

djevianstvo

virilism

muevnost, mukost, virilizam

virtue

krijepost, vrlina

virus

virus

viscera, sg. viscus

utroba, unutarnji organi

visceral pleura

poplunica, visceralna pleura

visceropexy

visceropeksija fiksiranje sputenog

unutarnjeg organa (npr. sputenog bubrega
i dr.)

viscosity

viskoznost

visible

vidljiv, vidan, oevidan, jasan

vision

vid

visual

vidni, oni

vital

ivotni, vitalan

vitality

ivotna snaga, vitalnost

vitamin

vitamin

vitiligo

bjelkaste mrlje na koi, bolest

depigmentacije koe, vitiligo

vitreous

staklast, staklen

vitreous humour

tekuina staklastog tijela, humor vitreus,

staklievina

vocal

glasovni, usmen, govorni, vokalni, pjevni

vocal cords

glasnice

voice box

grkljan, larinks

void

isprazniti, izbaciti, izluiti

voiding

pranjenje (mjehura), mokrenje

volcanoconiosis

vulkanokonioza, pneumokonioza izazvana

vulkanskom prainom

voluntary

voljan, namjeran

voluntary muscle

prugasti mii

volvulus

zapletaj crijeva

394

vomer

ralo, leme

vomit

povraati

vomiting

povraanje

voracious

lakom, pohlepan, prodrljiv

vowel

samoglasnik, vokal

vulva, pl. vulvae

stidnica

vulvovaginitis

upala stidnice i rodnice, vulvovaginitis

W
wall

stijenka, zid

wall-eyed

kiljav, razrok

wane

slabiti, poputati, smanjivati se, nestajati,

ieznuti

ward

bolniki odjel

ward off

upozoriti, izbjei opasnost

warm, adj.

topao, zagrijan

warm, vb.

utopliti, grijati, zagrijati

wart

bradavica

waste-product

otpadni proizvod

watch for

pripaziti (na)

wave

val

wavelike

valovit

wax

vosak

weakened

oslabljen, neotporan, oputen

weakness

slabost, boleljivost, slabunjavost

wealth

izobilje, bogatstvo, imunost

wedge

klin, predmet klinasta oblika

wedged

uklijeten

weed

korov, trava, biljka, duhan, cigara,

marihuana

weigh

teiti

395

weight

teina

weight gain

povanje tjelesne teine, debljanje

weight loss

mravljenje, smanjenje tjelesne teine

welfare

dobra, dobrobit, srea; socijalna skrb

wet

mokar, vlaan

wheal

urtika

wheeze

soptati, dahtati, teko disati

wheezing

sipljiv, koji sope, dahe

whiplike

u obliku bia

whir

zujanje, cvranje

whirl

vrtnja, okretanje

white matter

bijela tvar

whitish

bjelkast

whooping cough, pertussis

veliki kaalj, hripavac, pertusis

wide

irok

Wilms tumour

Wilmsov tumor

windpipe

dunik, traheja

wipe

obrisati, izbrisati, osuiti

wishful

pun elja, eljan, poudan, koji ezne

withdraw

povui natrag, dii, povui se

within

u, unutra, u opsegu

womb

maternica, utroba

word root

korijen rijei

wormlike

crvolik

worn-out

istroen, iscrpljen, iznoen, izmoden

wound

rana, ozljeda

wrapping

ovojnica, omota

wrist

runi zglob, zglavak

wrong

pogrean, kriv, neprikladan

X
x-ray, v.

396

rentgenski snimiti

x-rays, n.

rentgenske zrake, x-zrake

xanthemia

prisustvo utog pigmenta (bilirubina) u krvi,

ksantemija

xenograft, heterofgraft
xiphoid

tkivni presadak od ruge ivotinjske vrste

u obliku maa, ksifoidan, maolik

xiphoid appendage

ksifoidni nastavak prsne kosti

Y
yawning
yaws

zijevanje
frambezija (endemska tropska kona
bolest), malinaste tropske boginje

yeast

kvas, kvasac, pjenica

yellow body

uto tijelo, corpus luteum

yellow fever

uta groznica; akutna virusna infekcija koju

penose komarci

yellow marrow

uta kotana modina (sr)

yield

proizvesti, ostvariti

yolk

umanjak, umanjce

yolk sac

umanjana vrea

Z
zone

pojas, podruje, predio, zona

zoster, herpes zoster

pojas, pojasni zoster

zygoma, pl. zygomata/

zygomas

sponina kost

zygomatic
zygote

sponini, zigomatini
oploeno jajace; stanica koja je rezultat
spajanja muke i enske spolne stanice

397

References
1. blakistons Gould Medical Dictionary, 4th ed., McGraw-Hill Book Company,
New York 1979
2. Bujas : Veliki hrvatsko-engleski i englesko hrvatski rjenik, 2. Izdanje,
Zagreb Globus 2001
3. Caroll, Ch. i Miller, D. Health, the Science of Human Adaptation, WBC, New
York, 1983
4. Chabner, D.E. The Language of Medicine, 5th and 7th eds., Saunders, Philadelphia 2001, 2004
5. Dorlands Illustrated Medical Dictionary, 30th ed., Saunders, Philadelphia 2003
6. Ellis, J.W. Medical Symptoms and Treatments, Beekman House, New York
1986
7. Gylys, B.A. & Wedding, M.W. Medical Terminology: A Systems Approach, 6th
ed., F.A. Davis, Philadelphia 2009
8. Keros, P., Bagi, . i Peina, M. Temelji anatomije ovjeka, Medicinski fakultet
Sveuilita u Zagrebu, Zagreb 1987
9. Loknar, V. Teme iz medicinskog nazivlja, Jumena, Zagreb, 1988.
10. Medicinski leksikon, Leksikografski zavod Miroslav Krlea, Zagreb
11. Merriam-Websters Collegiate Dictionary
12. Miller, B.F. & Keane, C.B. Encyclopedia and Dictionary of Medicine, Nursing
and Allied Health, W.B. Saunders Company
13. Mosbys Dictionary of Medicine, Nursing & Health Professions, Mosby
Elsevier, 2009
14. Parkinson, J. A Manual of English for the Overseas Doctor, 3rd ed., Churchill
Livingstone, Edinburgh, 1985
15. Parkinson J. & Brooker C: Everyday English for International Nurses A
guide to working in the UK. Churchill Livingstone 2004.
16. Websters Medical Desk Dictionary, Merriam-Webster, Inc., Springfield,
Mass.

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