Medical Terminology

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Transcript Medical Terminology

Medical Terminology
Chapter 7
Body Fluids and Immunity
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Cellular Needs and
Body Fluids
Water is most important body fluid
Cells require water, oxygen, and
nutrients to survive.
Hydr(o) means water
-ous means pertaining to
hydrous means pertaining to water
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Cellular Needs and
Body Fluids
-hidr(o), sweat or perspiration
Sweat excreted through pores in the
skin
mucus is the slimy material
produced by mucous membranes
mucoid means resembling mucus
pus is the result of tissue breakdown
because of infection
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Cellular Needs and
Body Fluids
A localized collection of pus in a
cavity formed by the disintegration of
the tissue is called an abscess
hematoma is a localized collection of
blood, usually clotted, in an organ,
space tissue, resulting from a break in
the wall of a blood vessel.
Hematomas can occur anywhere in
the body, but are most dangerous
when
in the head
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Cellular Needs and
Body Fluids
Body Fluids are found:
– within the cells - intra/cellular
– outside the cells - extra/cellular
intra- within
cellul(o) little cell or compartment
-ar, pertaining to
extra- outside
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Cellular Needs and
Body Fluids
1/4th of extracellular fluid is plasma
(the liquid portion of the blood)
Blood remains inside blood vessels.
Blood is intravascular
intra- within
vascul(o) vessel
-ar pertaining to
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Cellular Needs and
Body Fluids
Remaining extracellular fluid is
between cells and tissue space
Interstitial fluid
inter- means between
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Cellular Needs and
Body Fluids
More than half of all body fluid is
contained within cells and is called
intracellular fluid.
Body fluid is classified as either
intracellular or extracellular fluid.
Majority of extracellular fluid is
found between cells and tissue
spaces and is called interstitial fluid.
Plasma is an extravascular fluid.
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Cellular Needs and
Body Fluids
Regulation of the amount of water in
the body is called fluid balance.
The intake and output must be
balanced.
Intake too low - dehydration
Output too low - edema
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Fluid Balance
 Total Intake – 2500
ml
 Water (beverages) –
1600 ml
 Water (moist foods)
– 700 ml
 Metabolism – 200
ml
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 Total Output – 2500
ml
 Urine – 1500 ml
 Skin – 550 ml
 Lungs – 300 ml
 Feces – 150 ml
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Cellular Needs and
Body Fluids
hydrocephaly is more commonly
called hydrocephalus
hydrocephalus means a condition
characterized by abnormal
accumulation of cerebrospinal fluid
within the skull, enlargement of the
head, mental retardation, and
convulsions.
A shunt is placed to redirect the
fluid
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Cellular Needs and
Body Fluids
Calculus or stone
Formed in body tissues by an
accumulation of mineral salts in the
body tissues.
Nephro/lith/iasis – kidney stones
Litho/tripsy – crushing of a stone
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Composition of Blood
Study of Blood is Hematology
Hemat(o) means blood and blood
forming tissues
Hemato/logic means pertaining to
hematology
Hematologist is one who studies blood
-poiesis means production
hematopoiesis - formation and
development
of
blood
cells
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Composition of Blood
Coagul(o) refers to coagulation
Coagulation is the formation of a clot
A coagulant promotes or accelerates
clotting
-ant means that which causes
An Anticoagulant is used to prevent
blood from clotting
-ate means to cause an action or the
result
of
an
action
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Composition of Blood
Nucle(o) and kary(o) mean nucleus
nucleoprotein is a protein found in the
nucleus
karyomegaly indicates a large
nucleus or an abnormal enlargement
of a cell nucleus
A normal red cell in the circulating
blood has matured and lost its
nucleus
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Composition of Blood
A normal white cell in the circulating
blood has lost its nucleus
-oid means like or resembling
nucle/oid means resembling a nucleus
morph(o) means form or shape
poly- means many
poly/morpho/nuclear is the most
abundant type of leukocyte
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Composition of Blood
Polymorphonuclear is a leukocyte
with a nucleus that is divided in such
a way that it appears as multiple. (PMN)
polymorph
cytoplasm of a polymorph typically
contains small granular structures
these cells may be referred to as
granulocytes
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Composition of Blood
Coagulopathy means any disease of
coagulation
Blood coagulation is a series of
chemical reactions in which special
fibers(fibrin) entrap blood cells
resulting in a blood clot.
Clots formed within blood vessels is a
serious condition that can result in
death
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Composition of Blood
A naturally occurring anticoagulant
keeps blood from clotting within the
body.
in vitro means occurring in a
laboratory test tube or occurring in an
artificial environment
in vivo means within the living body
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Composition of Blood
Laboratory blood tests often requires
treating blood with an anticoagulant
Hematocrit measures the percentage
of red blood cells in a volume of blood
hem(a) and hem (o) mean blood
A hemo/cyte is a blood cell
-cyte means cell
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Composition of Blood
Erythro/cytes are red blood cells (red
corpuscles) (RBC)
Erythro/cyt/ic means pertaining to
erythrocytes
Erythro/poiesis is the production of
erythrocytes
erythro/poietin stimulates the
production of erythrocytes
-poietin means a substance that
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causes
production
Composition of Blood
Leuk(o) means white
Leukocyte is a white blood cell (WBC)
Leukocytes protect the body against
pathogenic (disease causing)
organisms
Healthy people have normal numbers
of RBC and WBC in their blood
leukocyte count/ erythrocyte count
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Composition of Blood
thromb(o) means thrombus
A blood clot that obstructs a blood
vessel or cavity of the heart (clot
that occurs internally)
Thrombo/cyte is a blood platelet
Thrombo/lysis is a dissolution or
destruction of a clot formed inside
a vessel
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Composition of Blood
lys(o) means destruction or dissolving
-lysis describes the act of dissolving
or destruction
-lytic is a suffix to form adjectives
describing dissolution or destruction
thrombolytic
-lysin means a substance that
dissolves or destroys
thrombolysin
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Composition of Blood
Thrombosis is the presence of a
thrombus
Dissolving of a thrombus is
thrombolysis
-ectomy means surgical removal or
excision
to surgically remove a clot is called a
thromboectomy
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Composition of Blood
thrombolysis is destruction of a clot
hemolysis is destruction of blood
A hemolysin is a substance that
causes the destruction of red blood
cells
-emia is a suffix that means blood
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Composition of Blood
leuk/emia is white blood
Leukemia is a progressive, malignant
disease of the hematopoietic (blood
forming) organs, characterized by a
sharp increase in the number of
leukocytes, as well as the presence of
immature forms of leukocytes in the
blood and bone marrow
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Composition of Blood
An/emia means without blood
-penia means decreased or deficient
leukocytopenia - decrease or
deficiency in the number of
leukocytes (leukopenia)
erythro/cyto/penia is a decrease or
deficiency in the number of
erythrocytes (erythropenia)
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Composition of Blood
Anemia is a deficiency in the number
of red blood cells or a deficiency in
hemoglobin
hemoglobin is the red pigment of
blood
Anemia is not a disease but a sign of
various diseases
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Composition of Blood
Signs and Symptoms of Anemia
– tachycardia
– dyspnea
– syncope (fainting)
– tinnitus
– headache
– fatigue
– dizziness
– congestive heart failure
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Composition of Blood
Iron deficiency anemia results when a
greater demand for iron than the body
can supply.
It can be caused by blood loss or
insufficient intake intake or
absorption of iron from the intestinal
tract
Iron deficiency anemia is usually
successfully treated with iron tablets
and
a well balanced
diet
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Composition of Blood
Thrombocytopenia is a decrease in
the number of platelets
(thrombopenia)
Thrombocytes (platelets) are a key
component in the process of blood
clotting
Severe thrombocytopenia results in a
bleeding disorder
thrombocytosis is an increase in
platelets
in circulating
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Composition of Blood
Hemo/philia is a hereditary bleeding
disorder in which there is a deficiency
of one coagulation factor called
antihemophilic factor VIII.
Minor injuries can result in prolonged
bleeding which leads to anemia
-osis can mean more than a condition
erythrocytosis is increase in number
of red blood cells (erythrocytes)
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Composition of Blood
Leukocytosis is an increase in number
of leukocytes (white blood cells)
Increase in leukocytes as in leukemia
is not normal. Many of the leukocytes
in leukemia are abnormal or immature
white blood cells.
Increase in leukocytes in response to
an (infection) infecting organism is
normal.
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Composition of Blood
Infection vs. inflammation
– infection is the presence of living
microorganisms within the tissue
– inflammation is the body’s response to
injury.
– Inflammation is part of the body’s natural
defense
– Signs of inflammation are redness,
swelling and pain
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Composition of Blood
Poly- means many
cyto means cell
hem(o) means blood
-ia means condition
Polycythemia is a disorder in
which there is an increase in
erythrocytes
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Composition of Blood
primary - bone marrow over produces
many types of cells and is associated
with a chromosomal defect
secondary - as a physiologic response
to prolonged exposure to high
altitude, or heart or lung disease
leads to increased viscosity
(stickiness) of blood
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Composition of Blood
A coagulopathy is any defect in
coagulation
Disseminated intravascular
coagulation is a grave coagulopathy in
which there is generalized
intravascular clotting.
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Anemias and
Abnormal Hemoglobins
Micr(o) means small
microcyte is a small cell
microcytosis is an increase in the
number of under sized red blood cells
Macr(o) means large
macrocyte is a large cell
macrocytosis is an increase in larger
than normal erythrocytes
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Anemias and
Abnormal Hemoglobins
Scop(o) means to view or examine
-scopy means the act of viewing
microscopy is examining something
small
macroscopy is examining something
large
megal(o) means large or enlarged
megalocytes are large cells
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Anemias and
Abnormal Hemoglobins
Norm(o) means normal
normocytes are normal cells
is(o) means equal
iso/cyt/osis means cells that are of
equal size
anisocytosis are cells that are not of
equal size
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Anemias and
Abnormal Hemoglobins
isotonic means equal tension
an isotonic solution is a solution in
which body cells can be bathed
without damage to the cell through
diffusion of water in or out of cells
spher(o) means round
spherocyte is a round cell
spherocytosis means the presence of
spherocytes in the blood
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Anemias and
Abnormal Hemoglobins
Poikil(o) means irregular
poikilocyte is a blood cell with
abnormal shape
poikilocytosis is the presence of
poikilocytes in the blood
poikilocytes are present in sickle cell
anemia
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Anemias and
Abnormal Hemoglobins
Sickle cell anemia is a hereditary
anemia with an inherited abnormal
type of hemoglobin.
Blood cells are elongated and sickled
and are highly fragile
in vivo hemolysis occurs resulting in
hemolytic anemia
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Anemias and
Abnormal Hemoglobins
hyper- means excessive or more than
normal
hypo- means beneath or below
normal
chrom(o) means color
hypochromia in which blood cells
have below normal amount of color
hyperchromia in which blood cells
have above normal amount of color
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Anemias and
Abnormal Hemoglobins
Hemoglobin is the red pigment inside
erythrocytes
globin is a type of protein
hemoglobin is a type of protein found
in blood
hemoglobinopathy is any disease
associated with hemoglobin
hemolyze means that the
erythrocytes dissolve
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Anemias and
Abnormal Hemoglobins
Hemolytic anemia is characterized by
the premature destruction of
erythrocytes
plast(o) means repair
aplastic means having no tendency to
develop new tissue
In aplastic anemia the bone marrow is
diseased and produces few cells
dyscrasia is any disorder associated
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with
or
bone
marrow
Blood Coagulation
Fibrin is formed when blood clots
word part for fibrin is fibrin(o)
fibrin/oid means resembling fibrin
fibrinogen is a precursor of fibrin
fibrogen is a protein that is changed
to fibrin in the process of
coagulation
fibrinolysis is the destruction of
fibrin
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Blood Coagulation
A fibrinolysis can dissolve a thrombus
-stasis means stopping or controlling
hemostasis means stoppage of blood
flow
trans- means through or across
the introduction of whole blood or
blood components into the blood
stream is transfusion
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Blood Coagulation
Typing the blood is necessary for
transfusion
the typing process looks for
agglutination to specialized sera
agglutination is blood clumping
a transfusion reaction is an adverse
reaction the the received blood.
Blood group incompatibilities causes
hemolysis which is the destruction of
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erythrocytes
Blood Coagulation
Transfusion reaction results in
hemo/lysis of the erythrocytes.
Certain diseases can be transmitted
through a transfusion.
Donate your own blood would be an
autologous transfusion.
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Classification of
Disease
Organic diseases are associated
with a demonstrable physical
change in an organ or tissue.
Functional disorders are marked by
S & S’s, but no physical changes.
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Classification of
Disease
 Infectious
 Hereditary
 Degenerative
 Traumatic
 Autoimmune
 Nutritional deficiencies
 Idiopathic
 Iatrogenic
 Nosocomial
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Classification of
Disease
Infectious Diseases
Pathogenic organisms
Communicable = contagious
– Directly by contact
– Indirectly via substances
– Via vectors
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Classification of
Disease
Microorganisms
– Spheric (cocci)
– Rod-shaped (bacilli)
– Spiral (spirochetes and spirilla)
– Comma-shaped (vibrios)
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Classification of
Disease
Gram Stain
– Pink or red = gram negative
– Violet or purple = gram positive
Also classified by arrangement
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Classification of
Disease
Strepto/cocci appear to grow in
chains
Staphylo/cocci grow in grape
like clusters
Diplococci grow in pairs
Bacter/emia – presence of
bacteria in the blood
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Classification of
Disease
Aerobic – requires oxygen to
maintain life
Anaerobic – grows in complete
or almost complete lack of
oxygen
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Classification of
Disease
Antiseptic inhibits growth of
microorganisms
Bacteriostatic inhibits growth of
bacteria
Bactericidal kills bacteria
Botulism - Bacterial food
poisoning
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Classification of
Disease
Fungi are microorganisms that
feed by absorbing organic
molecules from their
surroundings.
They may be parasitic.
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Immune System
Pathogens are microorganisms that
are capable of causing disease
resistance is the body’s ability to
counteract the effects of foreign
invaders
susceptibility is lack of resistance
specific and non-specific resistance
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Immune System
Nonspecific defense mechanisms
are directed against all pathogens
–
–
–
–
–
–
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unbroken skin
phagocytes
inflammation
complement
interferon
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Immune System
Interferon is formed when cells are
exposed to a virus
phagocytosis is the ingestion and
destruction of microorganisms and
cellular debris by certain cells.
Phag(o) means to eat
macrophages and leukocytes are
the primary phagocytic cells
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Immune System
Specific defense mechanisms are
selective for particular pathogens
This specific resistance is called
immunity and protects from a specific
disease or condition
white blood cell and t-cells are
responsible for cell mediated
immunity
b-lymphocytes are responsible for
antibody
mediated
immunity
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Immune System
Antibodies are formed against foreign
substances
antibodies are formed to act against
other cells or substances that our
bodies recognize as being foreign
Immunoglobulins or antibodies are
found in the liquid part of the blood,
plasma
Immun(o) means immune
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globulins
are Medical
plasma
proteins
Immune System
Specific antibodies provide us with
immunity against disease causing
organisms
we generally acquire antibodies either
by having a disease or by receiving a
vaccination.
A vaccination causes our bodies to
produce antibodies
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Immune System
a foreign substance that induces the
production of antibodies is called an
antigen
polio vaccine contains polio antigen
after receiving polio vaccine, one is
immunized against polio
an excessive reaction to an antigen is
considered a hypersensitivity
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Immune System
-phylaxis means protection
anaphylaxis or anaphylactic reactions
are exaggerated, life threatening
hypersensitivity reactions to a
previously encountered antigen
anaphylactic reactions are severe and
can be fatal
insect stings and penicillin are
common causes of anaphylaxis
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Immune System
Allergies are conditions in which the
body reacts with an exaggerated
immune response to common,
harmless substances.
A substance that can produce an
allergic reaction but is not necessarily
harmful is called an allergen
in an allergic reaction, injured cells
release a substance called histamine
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Immune System
Histamine causes dilation of the
capillaries, an increase in gastric
secretions, and contraction of smooth
muscle of several internal organs
histamine is responsible the
symptoms of hay fever: teary eyes,
sneezing, and swollen membranes of
the upper respiratory tract.
Antihistamines act against histamine
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Immune System
Immunization is the process by which
resistance to an infectious disease is
induced or augmented
immunity that an individual develops
in response to a harmful antigen is
active immunity
borrowed immunity that is effective
for only a short time is passive
immunity
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Immune System
vaccination is a form of prophylaxis,
protection of or protection against
disease
toxoids contain toxins which are
antigens
toxoids cause our bodies to produce
antibodies, thus providing us with
immunity
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Immune System
a toxoid is a toxin that has been
treated to eliminate its harmful
properties without destroying its
ability to stimulate antibody
production
a toxoid is a helpful form of toxin
tox(o) which means poison is usually
harmful
a cytotoxin has harmful effects on
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cells
Immune System
Cytotoxicity means having a harmful
effect on cells
toxicity is the virulence of a toxin or
poison
toxic/osis is any disease condition
caused by poisons.
Virulence means the degree of
disease causing capability of
microorganisms
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Immune System
Immuno/compromised pertains to
immune response that has been
weakened by a disease or an
immuno/suppressive agent
radiation and certain drugs are
immunosupressants - meaning they
suppress the immune response
transplant rejection is an immune
reaction to the donors tissue cells
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Immune System
To transplant is to transfer tissue
Immunosupressants are given to
transplant recipients to prevent or
lessen the possibility of rejection
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Chapter 4
Class review exercises
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What is the meaning?
Hemato
blood
-cyte
cell
is(o)
equal
leuk(o)
white
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What is the meaning?
Kary(o)
nucleus
melan(o)
black
micr(o)
small
megal(o)
large or enlarged
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What is the meaning?
Phag(o)
to eat
ano, not, without
poly
many
phil(o)
attraction
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What is the meaning?
-lysis
destruction or dissolving
-penia
decreased or deficient
-poiesis
production
xanth(o)
yellow
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What is the meaning?
-erythr(o)
red
macr(o)
large or enlarged
cellul(o)
little cell or compartment
morph(o)
scope or form
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What is the Combining Form?
Hemoglobin
hemoglobin(o)
fibrin
fibrin(o)
water
hydr(o)
coagulation
coagul(o)
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What is the Combining Form?
Air
aer(o)
color
chrom(o)
green
chlor(o)
clot
thromb(o)
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What is the Combining Form?
Round
spher(o)
irregular
Poikil(o)
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Suffixes
An instrument used to view
-scope
blood
-emia
capable of destroying
-lytic
substance that dissolves or destroys
something
-lysin
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Prefixes
Across
transwithin
intra-
between
inter
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A or An
Traumatic
atraumatic
hydrous
anhydrous
uria
anuria
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A or An
toxic
atoxic
plastic
aplastic
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What is the Color?
Chloropia
green
melanocyte
black
cyanoderma
blue
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What is the Color?
xanthoderma
yellow
leukopenia
white
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Case Study
Word Meaning
A 23 year old female came to the
emergency room, complaining of
dizziness and headache. Examination
revealed pallor and tachycardia. The
patient had a history of dyspnea on
exertion, tinnitus, and syncope. Blood
tests and ECG were ordered.
Tachycardia was the only abnormality
demonstrated on the ECG. All blood
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Case Study
Word Meaning
Tests were normal except CBC, which
indicated a microcytic hypochromic
anemia. Additional tests were ordered
to determine the etiology of the
anemia.
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Case Study
Word Meaning
Pallor
paleness
tachycardia
increased pulse rate
dyspnea
difficult breathing
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Case Study
Word Meaning
Tinnitus
noise in the ears, such as ringing
syncope
fainting
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What is the Meaning?
Hemat(o)
blood
hem(a)
blood
hem(o)
blood
spher(o)
round
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What is the Meaning?
Poikil(o)
irregular
erythro(o)
red
poly-
many
cyan(o)
blue
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What is the Meaning?
Leuk(o)
white
melan(o)
black
chlor(o)
green
xanth(o)
yellow
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What is the Meaning?
-ectomy
removal of, incision
-cyte
cell
-ate
to cause an action or the
results of an action
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What is the Meaning?
-ar
pertaining to
-ant
that which causes
-emia
blood
is(o)
equal
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What is the Meaning?
Kary(o)
nucleus
morph(o)
shape or form
phag(o)
to eat
phil(o)
attraction
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What is the Meaning?
micr(o)
small
coagulation
blood clotting
poikilocyte
an erythrocyte of irregular shape
hematoma
a localized collection of blood
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What is the Meaning?
Thrombus
formation of a clot within a blood
vessel
cytologist
one who studies cells
leukocyte count
an evaluation of white cells
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What is the Meaning?
Thrombolytic
capable of dissolving a thrombus
thrombectomy
surgical removal of a blood clot
thromb(o)
clot
leukopenia
a decreased white cell count
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What is the Meaning?
Leukocyte
white blood cell that functions in
the body’s defense system
syncope
fainting
hematology
the study of blood
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What is the Meaning?
In vivo
in the body
antibiotic
substance commonly prescribed
in the treatment of bacterial
infections
erythropoiesis
production of red cells
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What is the Meaning?
Macropodia
increased size of the foot
macrodontia
increased size of the teeth
microcyte
a small cell
macrocyte
a large cell
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What is the Meaning?
Chromocyte
any colored cell
histocyte
a tissue cell
poikilocytosis
the presence of irregular shaped
erythrocytes in the blood
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What is the Meaning?
Spherocytosis
the presence of spherocytes in
the blood
thrombolysin
substance capable of dissolving
a thrombus
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What is the Meaning?
Macroscopy
examination with the naked eye
microscopy
examination of something small
transplant
a surgical procedure whereby living
organs are transplanted from one part
of the body to another or from one
individual
to another
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Matching
1.
2.
3.
4.
5.
6.
NWTC
Hydr(o)
hem(a)
aer(o)
clor(o)
chrom(o)
cyt(o)
 a. Air
 b. Green
 c. Color
 d. Cell
 e. Water
 f. blood
Medical Terminology 10-501-101
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Matching
1.
2.
3.
4.
5.
6.
NWTC
Erythr(o)
Is(o)
kary(o)
leuko(o)
macro(o)
hem(o)
 a. red
 b. hemoglobin
 c. nucleus
 d. equal
 e. large or enlarged
 f. white
Medical Terminology 10-501-101
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What is the Meaning?
Polymany
phil(o)
attraction
-lysis
destruction
-penia
decreased deficiency
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What is the Meaning?
-poiesis
production
xanth(o)
yellow
erythr(o)
red
macr(o)
large or enlarged
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What is the Meaning?
Antiagainst
morph(o)
shape or form
coagulopathy
any disease of coagulation
thrombolysis
dissolving of a thrombus
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What is the Meaning?
Leukocytosis
an increase in the number of
white blood cells
microencephaly
abnormal smallness of the head
ophthalmoscope
an instrument for examining the
eye
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What is the Meaning?
Toxicosis
any disease or condition caused
by poison
otoscopy
examination of the ear
cytoscopy
microscopic examination of
cells
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What is the Meaning?
Hypochromic
a condition in which erythrocytes
have a reduced hemoglobin
content (pigment)
poikilocyte
a cell having an abnormal shape
anemia
a decreased red blood cell count
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What is the Meaning?
Septicemia
a systemic infectious condition
caused by pathogenic
microorganisms, their enzymes, or
their toxins
pigment color of melanin
dark brown to black
cyanoderma
NWTC
blue skin Medical Terminology 10-501-101
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Matching
1.
2.
3.
4.
5.
NWTC
Morph(o)
-penia
Macr(o)
PolyErythr(o)
a.
b.
c.
d.
e.
Many
Shape or form
Decreased
Red
Large or enlarged
Medical Terminology 10-501-101
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Matching
1.
2.
3.
4.
5.
xanth(o)
-poiesis
-lysis
Phil(o)
Anti-
NWTC
a. attraction
b. destruction or
dissolving
c. production
d. yellow
e. against
Medical Terminology 10-501-101
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What is It?
The destruction of red blood cells
with the liberation of hemoglobin
hemolysis
the reduction in the number of red
blood cells, hemoglobin, r both red
cells and hemoglobin
anemia
a substance that causes hemolysis
NWTC
hemolysin Medical Terminology 10-501-101
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What is It?
A disorder in which there is an
increase in the number of red blood
cells
polycythemia
excessive urination
polyuria
a small cell
microcyte
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What is It?
A cell that engulfs other matter
phagocyte
a condition in which erythrocytes are
not of equal size
anisocytosis
any disease of coagulation
coagulopathy
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What is It?
The study of cells
cytology
dissolving of a thrombus
thrombolysis
an increase in the number of white
blood cells
leukocytosis
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What is It?
Abnormal smallness of the head
microcephaly
an instrument for examining the eye
ophthalmoscope
any disease condition caused by
poisons
toxicosis
examination of the ear
otoscopy
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What is It?
A decreased white cell count
leukopenia
cells that function in the body’s
defense system
leukocyte
fainting
syncope
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What is It?
The study of blood
hematology
in the body
in vivo
a substance commonly prescribed in
the treatment of bacterial infections
production of red cells
erythropoiesis
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Also Known As
Red blood cells
erythrocytes
white blood cells
leukocytes
thrombocytes
platelets
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Also Known As
bluish discoloration of skin
cyanoderma
difficult time breathing
dyspnea
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Questions?
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Chapter 4
Book CD review
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