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Ausculationa & percussion
- Listening for sounds within the body, esp. from the chest, neck, or abdomen.
- A stethoscope is typically used.
- An Immunoglobulin produced by B lymphocytes in response to a unique antigen. Each Ab molecule combines with a specific antigen to destroy or control it.
- All antibodies, except naturall antibodies (e.g., antibodies to different blood types), are created by B cells linking with a foreign antigen, typically a foreign protein, polysaccharide, or nucleic acid.
Antibodies neutralize or destroy antigens in several ways. They can initiate lysis of the antigen by activating the complement system, neutralizing toxins released by bacteria, coating (opsonizing) the antigen or forming a complex to stimulate phagocytosis, promoting antigen clumping (agglutination), or preventing the antigen from adhering to host cells.
An antibody molecule consists of four polypeptide chains (two light & two heavy), which are joined by disulfide bonds. The heavy chains from the complement-binding site, and the light & heavy chains form the site that binds the antigen. See Illus.;
Aspiration, biopsy, cytology
- Aspiration - 1. Drawing in or out by suction. Foreign bodies may be aspirated into the nose, throat, or lungs on inspiration.
- 2. Withdrawal of fluid from a cavity by suctioning with an aspirator. The purpose of aspiration is to remove fluid or air from an affected area. (as in pleural effusion, pneumothorax, ascites, or an abscess) or to obtain specimens (such as blood from a vein or serum from the spinal canal).
- Biopsy - The obtaining of a representative tissue sample for microscopic examination, usually to establish a diagnosis. The tissue may be obatined surgically or by using a syringe & needle. The procedure can be guided by computed tomography, ultrasonography, magnetic resonance imaging, ultrasouns or radiography, or it can be performed without imaging (i.e., "blindly")
- aspiration b. The removal of tissue by use of a needle & syringe, for example, from a cysts or the bone marrow.
- The science that deals with the formation, structure, and function of cells.
- The portion of the trunk lying behind the thorax & the pelvis. It contains the stomach, lower part of the esophagus, small & large intestines, liver, gallbladder, spleen, and internal genitalia. The peritoneum, a serous membrane, lines the abdomen but envelops all of the organs in it. The kidneys, adrenal glands, ureters, prostate, seminal vesicles, and greater vascular structures are located behind the peritoneum (retroperitoneal or extraperitoneal). See: abdominal quadrants for illus.
Angiotensin-converting enzyme inhibitor
Any of the theraputic agents that inhibit conversion of angiotensin I to angiotensin II. As a result, blood pressure falls. ACE inhibitors are used to treat hypertension, heart failure, and other diseases.
- Acute coronary syndromes.
- Angiotensin - A vasopressor produced when renin is released from the kidney. Renin is formed by the juxtaglomerular apparatus of the kidney. See: apparatus juxtaglomerulara. I Physiologically inactive form of angiotensin; converted to angiotensin II in the lungs.
- a. II Physiologically active form of angiotensin; a powerful vasopressor and stimulator of aldosterone production & secretion.
- a. amide A vasoconstricting compound of angiotensin.
Anterior cruciate ligament
(ACL) is one of the four major ligaments of the human knee. In the quadruped stifle (analogous to the knee), based on its anatomical position, it is referred to as the cranial cruciate ligament.
- The ACL originates from deep within the notch of the distal femur.
- Its proximal fibers fan out along the medial wall of the lateral
- femoral condyle. There are two bundles of the ACL—the anteromedial and
- the posterolateral, named according to where the bundles insert into
- the tibial plateau. The ACL attaches in front of the intercondyloid eminence of the tibia, being blended with the anterior horn of the lateral meniscus. These attachments allow it to resist anterior translation of the tibia, in relation to the femur.
- Anterior cruciate ligament injury is the most common knee ligament injury especially in athletes.
- cruciate I. 1. The ligament of the ankle passing transversely across the dorsum of the foot that holds the tendons of the anterior muscle group in place.
- 2. A cross-shaped ligament of the atlas consisting of the transverse ligament and superior & inferior bands, the former passing upward & attaching to the margin of the foramen magnum, the latter passing downward & attaching to the body of the atlas.
- 3. The ligament of the knee that originates on the anterior portion of the femur in the intercondylar notch & inserts on the posterior aspect of the tibial plateau. It prevents posterior translation of the tibia on the femur and, in combination with the anterior crucial ligament, provides rotary stability to the knee.
- anterior - Before or in front of; in anatomical nomenclature, refers to the ventral or abdominal side of the body.
posterior - Toward the rear or caudal end; opposite of the anterior. 2. In humans, towards the back, dorsal. 3. Situated behind; coming after.
Acute coronary syndromes
A range of conditions that reflect reduced or absent blood flow to the heart muscle; includes angina (stable and unstable) and heart attack.
A hormone secreted by the anterior lobe of the pituitary that controls the development & functioning of the adrenal cortex, inculding it's secretion of glucocorticoids and androgens. SYN: Corticotropin
Attention deficit disorder
A peptide hormone that plays a crucial role in limiting the amount of water excreted by the kidneys. Deficiencies of this hormone result in central diabetes insipidus. Excesses cause water retention and hyponatremia. SYN: vasopressin
The hormone is produced by the hypothalamus and stored in the posterior pituitary gland; it is secreted when the osmolarity of plasma rises. Secretion of the ADH increases the concentration of the urin by preventing water losses from the renal tubules. The hormone also causes constriction of arterioles (raising blood pressure) and increases levels of clotting factor VIII.
- antidiuretic - Lessening urine formation. 2. A drug that decreases urine formation.
Acquired immunodeficiency syndrome
One of a group of simple proteins widely distributed in plant and animal tissues; it is found in the blood as serum albumin, in milk as lactalbumin, and in the white of eggs as ovalbumin. In the blood, albumin acts as a carrier colecule and helps to maintain blood volume and blood pressure. In humans, the principle function of albumin is to provide colloid osmotic pressure, preventing plasma loss from the cappilaries. Albumin, like all the plasma proteins, can act as a source for rapid replacement of tissue proteins. It is soluble in cold water; when coagulated by heat it is no longer dissolved by cold or hot water. In the stomach, coagulated albumins are made soluble by peptidases, which breaks them down to smaller polypeptides and amino acids. In general, albumins from animal sources are of higher nutritional quality than those from vegetable sources because animal proteins contain greater quantities of essential amino acids. SEE; amino acid; peptone
(ALP) (EC 220.127.116.11) is a hydrolase enzyme responsible for removing phosphate groups from many types of molecules, including nucleotides, proteins, and alkaloids. The process of removing the phosphate group is called dephosphorylation. As the name suggests, alkaline phosphatases are most effective in an alkaline environment. The optimal pH for the activity of the E. coli enzyme is 8.0 while the bovine enzyme optimum pH is slightly higher at 8.5.
- It is sometimes used synonymously as basic phosphatase.
- phosphotase - One of a group of enzymes that catalyze the hydrolysis of phosphoric acid esters. They are of importance in absorption & metabolism of carbohydrates, neucleotides, and phospholipids and are essential in the calcification of a bone.
- alkaline p. And enzyme, present in the liver, kidneys, intestines, teeth, plasma, and developing bone. Alkaline phosphotase levels greater than 300% of normal usually signify cholestatic disorders like obstructive jaundice or intrahepatic biliary disease.
Acute Lymphocytic Leukemia
(ALL), is a form of leukemia, or cancer of the white blood cells characterized by excess lymphoblasts.
- Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. ALL causes damage and death by crowding out normal cells in the bone marrow, and by spreading (metastasizing)
- to other organs. ALL is most common in childhood with a peak incidence
- at 2-5 years of age, and another peak in old age. The overall cure rate
- in children is 85%, and about 50% of adults have long-term disease-free
- Acute refers to the relatively short time course of the
- disease (being fatal in as little as a few weeks if left untreated) to
- differentiate it from the very different disease of Chronic Lymphocytic Leukemia
- which has a potential time course of many years. It is interchangeably
- referred to as Lymphocytic or Lymphoblastic (although lymphoblastic is
- becoming the preferred term). This refers to the cells that are
- involved, which if they were normal would be referred to as lymphocytes but are seen in this disease in a relatively immature (also termed 'blast') state.
AP or A/P
Anterior and posterior
- For other uses, see Anterior (disambiguation) and Posterior (disambiguation).
- The most obvious end-points are the "nose" and "tail" (see Fig. 2). Anatomically, the nose is referred to as the anterior end (Latin ante; before). In organisms like vertebrates, that have distinct heads, the anterior end is sometimes referred to as the rostral end (Latin rostrum; beak), the cranial end (Greek kranion; skull), or the cephalic end (Greek kephalē; head). For reasons of broader applicability, especially in organisms without distinct heads (many invertebrates), "anterior" is usually preferred.
- The polar opposite to the anterior end is the posterior end (Latin post; after). Another term for posterior is caudal (Latin caudum; tail, though in humans this refers to the feet i.e. inferior rather than posterior)—a term which strictly applies only to vertebrates, and therefore less preferred, except in veterinary medicine where these terms are standard.
- By drawing a line connecting these two points, we define the anteroposterior axis
- (sometimes written antero-posterior). Caudal and Posterior (back end)
- are often used interchangeably. In veterinary medicine, caudo-cranial
- is preferred between head and tail, and rostro-caudal between nose and
- neck. Less-used synonyms would be rostrocaudal or cephalocaudal axes
- (see Table 1). For brevity, the term anteroposterior is often
- abbreviated to read AP (or A-P) axis. As well as defining the anteroposterior axis, the terms "anterior" and "posterior" also define relative positions along the axis. Thus, in the fish in Fig. 2, the gill openings are posterior relative to the eyes, but anterior to the tail.
Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis is a form of motor neuron disease. ALS, sometimes called Maladie de Charcot, is a progressive, fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement. The condition is often called Lou Gehrig's Disease in North America, after the New York Yankees
- baseball icon who was diagnosed with the disease in 1939 and died from
- it in 1941, at age thirty-seven. Today, renowned physicist Stephen Hawking, British historian Tony Judt, guitar virtuoso Jason Becker and bass virtuoso Mike Porcaro are among the best-known living ALS patients. The disorder causes muscle weakness and atrophy throughout the body as both the upper and lower motor neurons degenerate, ceasing to send messages to muscles. Unable to function, the muscles gradually weaken, develop fasciculations (twitches) because of denervation, and eventually atrophy
- because of that denervation. The patient may ultimately lose the
- ability to initiate and control all voluntary movement; bladder and
- bowel sphincters and the muscles responsible for eye movement are
- usually (but not always) spared.
- Cognitive function is generally spared except in certain situations such as when ALS is associated with frontotemporal dementia.
- However, there are reports of more subtle cognitive changes of the
- frontotemporal type in many patients when detailed neuropsychological
- testing is employed. Sensory nerves and the autonomic nervous system, which controls functions like sweating, generally remain functional.
Alanine transaminase or ALT is a transaminase enzyme (EC 18.104.22.168). It is also called serum glutamic pyruvic transaminase (SGPT) or alanine aminotransferase (ALAT).
- ALT is found in serum and in various bodily tissues, but is most commonly associated with the liver. It catalyzes the two parts of the alanine cycle.
Acute Myelocytic Leukemia
(AML), also known as acute myelogenous leukemia, is a cancer of the myeloid line of blood cells, characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells. AML is the most common acute leukemia affecting adults, and its incidence increases with age. Although AML is a relatively rare disease, accounting for approximately 1.2% of cancer deaths in the United States, its incidence is expected to increase as the population ages.
- The symptoms of AML are caused by replacement of normal bone marrow with leukemic cells, which causes a drop in red blood cells, platelets,
- and normal white blood cells. These symptoms include fatigue, shortness
- of breath, easy bruising and bleeding, and increased risk of infection.
- Although several risk factors
- for AML have been identified, the specific cause of the disease remains
- unclear. As an acute leukemia, AML progresses rapidly and is typically
- fatal within weeks or months if left untreated.
- AML has several subtypes; treatment and prognosis varies among
- subtypes. Five-year survival varies from 15–70%, and relapse rate
- varies from 78–33%, depending on subtype. AML is treated initially with
- chemotherapy aimed at inducing a remission; patients may go on to receive additional chemotherapy or a hematopoietic stem cell transplant.
- Recent research into the genetics of AML has resulted in the
- availability of tests that can predict which drug or drugs may work
- best for a particular patient, as well as how long that patient is
- likely to survive.
Atrial Septal Defect
Atrial septal defect (ASD) is a form of congenital heart defect that enables blood flow between the left and right atria via the interatrial septum. The interatrial septum is the tissue that divides the right and left
- atria. Without this septum, or if there is a defect in this septum, it
- is possible for blood to travel from the left side of the heart to the
- right side of the heart, or vice versa.
- Irrespective of interatrial communication bi-directions, this results
- in the mixing of arterial and venous blood. The mixing of arterial and
- venous blood may or may not be hemodynamically significant, if even
- clinically significant. This mixture of blood may or may not result in
- what is known as a "shunt". The amount of shunting present, if any,
- dictates hemodynamic significance (see Pathophysiology below). A
- "right-to-left-shunt" typically poses the more dangerous scenario (see
- Pathophysiology below).
- The right side of the heart contains venous blood with a low oxygen content, and the left side of the heart contains arterial blood with a high oxygen
- content. The construction of a heart void of an ASD prevents
- interatrial communication by means of an uncompromised interatrial
- septum. This prevents the atria from regular communication with each
- other, and thus oxygen-rich blood and oxygen-deficient blood do not mix
- together improperly.
- During development of the fetus, the interatrial septum develops to eventually separate the left and right atria. The foramen ovale (pronounced /fɒˈreɪmən oʊˈvɑːli/)
- remains open during fetal development to allow blood from the venous
- system to bypass the lungs directly and enter the circulatory system.
- This is because the oxygen content of the fetal arterial system is
- provided by the placenta,
- as the lungs of the fetus are nonfunctional when it comes to
- oxygenizing the blood. A layer of tissue begins to cover the foramen
- ovale during fetal development, in which typically, after birth, the
- pressure in the pulmonary circulatory system drops, thus causing the
- foramen ovale to close entirely. In approximately 25% of adults, the foramen ovale does not entirely seal. In this case, elevation of pressure in the pulmonary circulatory system (ie: pulmonary hypertension due to various causes, or transiently during a cough) can cause the foramen ovale to remain open. This is known as a patent foramen ovale (PFO).
- Arteriosclerotic heart disease
- Coronary disease (or coronary heart disease - CHD) refers to the failure of coronary circulation to supply adequate circulation to cardiac muscle and surrounding tissue.
- It is already the most common form of disease affecting the heart and
- an important cause of premature death in Europe, the Baltic states,
- Russia, North and South America, Australia and New Zealand. It has been
- predicted that all regions of the world will be affected by 2020.
- It is most commonly equated with atherosclerotic coronary artery disease, but coronary disease can be due to other causes, such as coronary vasospasm. It is possible for the stenosis to be caused by the spasm
Aspartate transaminase (AST) also called serum glutamic oxaloacetic transaminase (SGOT) or aspartate aminotransferase (ASAT/AAT) (EC 22.214.171.124) is similar to alanine transaminase (ALT) in that it is another enzyme associated with liver parenchymal cells.
- It facilitates the conversion of aspartate and alpha-ketoglutarate to oxaloacetate and glutamate, and vice-versa.
- Oxaloacetate + glutamate ⇌ aspartate + α-ketoglutarate
- Two isoenzymes are present in humans. They have high similarity.
- GOT1, the cytosolic isoenzyme derives mainly from red blood cells and heart.GOT2, the mitochondrial isoenzyme is predominantly present in liver.
- Clinical significance
- It is raised in acute liver damage. It is also present in red blood cells and cardiac muscle, skeletal muscle, and kidney and brain tissue, and may be elevated due to damage to those sources as well.
- AST was defined as a biochemical marker for the diagnosis of acute
- myocardial infarction in 1954. However the use of AST for such a
- diagnosis is now redundant and has been superseded by the cardiac troponins.
AST (SGOT) is commonly measured clinically as a part of diagnostic liver function tests, to determine liver health.
- both arterial and venous; pertaining to both artery and vein.arteriovenous anastomosisa
- direct connection between an artery and a vein that acts as a shunt to
- bypass the capillary bed. These occur in areas where a high volume
- blood supply is needed only intermittently, e.g. the intestine.arteriovenous fistulaan abnormal communication between an artery and a vein; includes cardiac defects such as ventricular septal defects and patent
- ductus arteriosus. Peripheral fistulae, especially in the extremities,
- may be localized, usually acquired and the result of trauma, while
- congenital defects tend to be more diffuse, involving a network of
- anastomosing vessels.The effects of
- arteriovenous fistulae are variable, depending on their location and
- the amount of blood carried. Within the liver they usually connect the
- hepatic artery and portal vein, causing portal hypertension and
- ascites. Small peripheral fistulae may be noticeable only as warm,
- reducible swellings, often with an audible thrill, or give rise to
- edema distal to the site. More severe effects are also possible.pulmonary arteriovenous fistulaa
- congenital anomalous communication between the pulmonary arterial and
- venous systems, allowing unoxygenated blood to enter the systemic
- Atrioventricular (having to do with an atrium and ventricle) can refer to:
- Left atrioventricular openingAtrioventricular fistulaAtrioventricular nodeThe term "Atrioventricular valves" is used to describe the mitral valve and tricuspid valve.
White Blood Cells
White blood cells (WBCs), or leukocytes (also spelled "leucocytes"), are cells of the immune system defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. Leukocytes are found throughout the body, including the blood and lymphatic system.
- The number of WBCs in the blood is often an indicator of disease. There are normally between 4×109 and 1.1×1010 white blood cells in a litre of blood, making up approximately 1% of blood in a healthy adult. An increase in the number of leukocytes over the upper limits is called leukocytosis, and a decrease below the lower limit is called leukopenia. The physical properties of leukocytes, such as volume, conductivity, and granularity, may change due to activation, the presence of immature cells, or the presence of malignant leukocytes in leukemia.
Bowel movement, Bone marrow
Bone Marrow Transplant
Blood pressure (BP) is a force exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. The mean BP, due to pumping by the heart and resistance in blood vessels, decreases as the circulating blood moves away from the heart through arteries. It has its greatest decrease in the small arteries and arterioles, and continues to decrease as the blood moves through the capillaries and back to the heart through veins.
- Gravity, valves in veins, and pumping from contraction of skeletal
- muscles, are some other influences on BP at various places in the body.
- The term blood pressure usually refers to the pressure measured at a person's upper arm. It is measured on the inside of an elbow at the brachial artery,
- which is the upper arm's major blood vessel that carries blood away
- from the heart. A person's BP is usually expressed in terms of the
- systolic pressure and diastolic pressure, for example 120/80.
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) also known as benign prostatic hypertrophy (technically a misnomer), benign enlargement of the prostate (BEP), and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate in middle-aged and elderly men. To be accurate, the process is one of hyperplasia rather than hypertrophy, but the nomenclature is often interchangeable, even amongst urologists (see Textbook of Benign Prostatic Hyperplasia,
- Roehrborn CG et al. 2002, Chapter 6 "The Pathology of Benign Prostatic
- Hyperplasia, Bostwick DG). It is characterized by hyperplasia of
- prostatic stromal and epithelial
- cells, resulting in the formation of large, fairly discrete nodules in
- the periurethral region of the prostate. When sufficiently large, the
- nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra, which interferes the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, dysuria (painful urination), increased risk of urinary tract infections, and urinary retention. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH is not considered to be a premalignant lesion.
Bronchoscopy, Bronchial, Bronchitis
- Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs.
- Bronchitis can be classified into two categories, acute and chronic,
- each of which has unique etiologies, pathologies, and therapies.
- Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis while bacteria account for less than 10%.
- Chronic bronchitis, a type of chronic obstructive pulmonary disease,
- is characterized by the presence of a productive cough that lasts for 3
- months or more per year for at least 2 years. Chronic bronchitis most
- often develops due to recurrent injury to the airways caused by inhaled
- irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants, and cold air.
- Bronchoscopy is a technique of visualizing the inside of the airways
- for diagnostic and therapeutic purposes. An instrument (bronchoscope)
- is inserted into the airways, usually through the nose or mouth, or
- occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation.
- Specimens may be taken from inside the lungs. The construction of
- bronchoscopes ranges from rigid metal tubes with attached lighting
- devices to flexible fibreoptic instruments with realtime video
Blood Sugar, bowel sounds, breath sounds
The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. Normally, in mammals the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM (mmol/L). It is tightly regulated as a part of metabolic homeostasis.
- Glucose is primarily a compact energy store, and is the primary source of energy for body cells, fats and oils (ie, lipids). It is transported from the intestines or liver to body cells via the bloodstream, and is absorbed by body cells with the intervention of insulin, which is a hormone normally naturally produced by the body.
- The mean normal blood glucose level in humans [The rest of this
- sentence seems to have a mistake, as the multiplicative factor in the
- conversion, given the molecular weight of 180, should be 18, not 14.
- Perhaps the "about 10" should really be "about 7.8"; but in any case,
- someone who really knows should fix this.] is about 4 mM (4 mmol/L or
- 140 mg/dL). However, the glucose level fluctuates during the day. It
- rises after meals for an hour or two by a few grams and is usually
- lowest in the morning, before the first meal of the day (termed "the
- fasting level").
- When a blood sugar level is outside the normal range, it may be an
- indicator of a medical condition. A persistently high level is referred
- to as hyperglycemia or if low as hypoglycemia. Diabetes mellitus
- is characterized by persistent hyperglycemia from any of several
- causes, and is the most prominent disease related to failure of blood
- sugar regulation. A temporary elevated blood sugar level may also
- result from severe stress, such as trauma, stroke, heart attack,
- or surgery; and also from illness. Alcohol, after an initial surge in
- blood sugar, tends to cause blood sugar to fall. Also, certain drugs
- can increase or decrease glucose levels
Breast Self Examination
Oophorectomy (or ovariectomy) is the surgical removal of an ovary or ovaries. In the case of non-human animals, it is also called spaying and is a form of sterilization. Removal of the ovaries in women is the biological equivalent of castration in males, and the term is occasionally used in the medical literature instead of oophorectomy.
- In the case of humans, oophorectomies are most often performed due to diseases such as ovarian cysts or cancer; prophylactically to reduce the chances of developing ovarian cancer or breast cancer; or in conjunction with removal of the uterus.
- The removal of an ovary together with a fallopian tube is called a salpingo-oophorectomy or unilateral salpingo-oopherectomy (USO). When both ovaries and both tubes are removed, the term bilateral salpingo-oophorectomy (BSO) is used. Oophorectomy and salpingo-oophorectomy are not common forms of birth control in humans; more usual is tubal ligation,
- in which the Fallopian tubes are blocked but the ovaries remain intact.
- In many cases, surgical removal of the ovaries is performed
- concurrently with a hysterectomy. The surgery is then called "ovariohysterectomy" casually or "total abdominal hysterectomy with bilateral salpingo-oophorectomy" (sometimes abbreviated TAH-BSO), the more correct medical term. However, the term "hysterectomy"
- is often used colloquially yet incorrectly to refer to removal of any
- parts of the female reproductive system, including just the ovaries.
Blood Urea Nitrogen
The blood urea nitrogen (BUN) test is a measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function. Urea is a substance secreted by the liver, and removed from the blood by the kidneys.
The liver produces urea in the urea cycle as a waste product of the digestion of protein. Normal human adult blood should contain between 7 to 21 mg of urea nitrogen per 100 ml (7-21 mg/dL) of blood. Individual laboratories may have different reference ranges, and this is because the procedure may vary.
- The most common cause of an elevated BUN, azotemia, is poor kidney function, although a serum creatinine level is a somewhat more specific measure of renal function (see also renal function).
- A greatly elevated BUN (>60 mg/dL) generally indicates a
- moderate-to-severe degree of renal failure. Impaired renal excretion of
- urea may be due to temporary conditions such as dehydration or shock, or may be due to either acute or chronic disease of the kidneys themselves.
- An elevated BUN in the setting of a relatively normal creatinine may reflect a physiological response to a relative decrease of blood flow to the kidney (as seen in heart failure or dehydration)
- without indicating any true injury to the kidney. However, an isolated
- elevation of BUN may also reflect excessive formation of urea without
- any compromise to the kidneys.
- Increased production of urea is seen in cases of moderate or heavy
- bleeding in the upper gastrointestinal tract (e.g. from ulcers). The
- nitrogenous compounds from the blood are resorbed as they pass through
- the rest of the GI tract and then broken down to urea by the liver. Enhanced metabolism of proteins will also increase urea production, as may be seen with high protein diets, steroid use, burns, or fevers.
- When the ratio of BUN to creatinine (BUN:Cr) is greater than 20, the patient is suspected of having prerenal azotemia. This means that the pathologic process is unlikely to be due to intrinsic kidney damage.
- A low BUN usually has little significance, but its causes include liver problems, malnutrition
- (insufficient dietary protein), or excessive alcohol consumption.
- Overhydration from intravenous fluids can result in a low BUN. Normal
- changes in renal bloodflow during pregnancy will also lower BUN.
- Urea itself is not toxic. This was demonstrated by Johnson et al. by adding large amounts of urea to the dialysate of hemodialysis patients for several months and finding no ill effects.. However, BUN is a marker for other nitrogenous waste. Thus, when renal failure leads to a buildup of urea and other nitrogenous wastes (uremia), an individual may suffer neurological disturbances such as altered cognitive function (encephalopathy), impaired taste (dysgeusia) or loss of appetite (anorexia).
- The individual may also suffer from nausea and vomiting, or bleeding
- from dysfunctional platelets. Prolonged periods of severe uremia may
- result in the skin taking on a grey discolouration or even forming
- frank urea crystals ("uremic frost") on the skin.
- Because multiple variables can interfere with the interpretation of
- a BUN value, GFR and creatinine clearance are more accurate markers of
- kidney function. Age, sex, and weight will alter the "normal" range for
- each individual, including race. In renal failure or chronic kidney
- disease (CKD), BUN will only be elevated outside "normal" when more
- than 60% of kidney cells are no longer functioning. Hence, more
- accurate measures of renal function are generally preferred to assess
- the clearance for purposes of medication dosing.
A biopsy is a medical test involving the removal of cells or tissues
- for examination. It is the medical removal of tissue from a living
- subject to determine the presence or extent of a disease. The tissue is
- generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When only a sample of tissue is removed with preservation of the histological architecture of the tissue’s cells, the procedure is called an incisional biopsy or core biopsy.
- When a sample of tissue or fluid is removed with a needle in such a way
- that cells are removed without preserving the histological architecture
- of the tissue cells, the procedure is called a needle aspiration biopsy.
Culture And Sensitivity
- Collection of urine sample, blood sample or other body fluid samples
- cultured in medium and analysed it with antibiotics for sensitiveness.
This is a diagnostic lab procedure.
First, second cervical verebra
Variation among species
- In some species, some parts of the skull may be composed of vertebra-like elements, e.g. the occipital bone in humans is composed of four vertebra-like segments.
- In many vertebrate species, cervical vertebrae are variable in number; however, almost all mammals have seven (including those with very short necks relative to body size, such as elephants or whales, and those with very long necks, such as giraffes). The few exceptions include the manatee and the sloths, of which the two-toed sloth has six cervical vertebrae and the three-toed sloth has up to nine cervical vertebrae (Wetzel, 1985).
- In many species, though not in mammals, the cervical vertebrae bear ribs. In many other groups, such as lizards and saurischian dinosaurs, the cervical ribs are large; in birds they are small and completely fused to the vertebrae. The transverse processes of mammals are homologous to the cervical ribs of other amniotes.
- Thoracic vertebrae in all species are defined as those vertebrae which also carry a pair of ribs, and lie caudal to the cervical vertebrae.
- In humans, cervical vertebrae are the smallest of the true vertebrae, and can be readily distinguished from those of the thoracic or lumbar regions by the presence of a foramen (hole) in each transverse process, through which passes the vertebral artery.
- The remainder of this article focuses upon human anatomy.
- General characteristics (C3-C6)
- These are the general characteristics of the third through sixth
- cervical vertebrae. (The first, second, and seventh vertebrae are
- extraordinary, and detailed later.)
- The body of these four vertebrae is small, and broader from side to side than from front to back.
- The anterior and posterior surfaces are flattened and
- of equal depth; the former is placed on a lower level than the latter,
- and its inferior border is prolonged downward, so as to overlap the
- upper and forepart of the vertebra below.The upper surface is concave transversely, and presents a projecting lip on either side;the lower surface is concave from front to back, convex from
- side to side, and presents laterally shallow concavities which receive
- the corresponding projecting lips of the underlying vertebra.
- The pedicles
- are directed laterally and backward, and are attached to the body
- midway between its upper and lower borders, so that the superior
- vertebral notch is as deep as the inferior, but it is, at the same
- time, narrower.
- The laminae are narrow, and thinner above than below; the vertebral foramen is large, and of a triangular form.
- The spinous process is short and bifid, the two divisions being often of unequal size.
- The superior and inferior articular processes of cervical vertebrae have fused on either or both sides to form articular pillars, columns of bone which project laterally from the junction of the pedicle and lamina.
- The articular facets are flat and of an oval form:
- the superior face backward, upward, and slightly medially.the inferior face forward, downward, and slightly laterally.
- The transverse processes are each pierced by the foramen transversarium, which, in the upper six vertebrae, gives passage to the vertebral artery and vein, as well as a plexus of sympathetic nerves.
- Each process consists of an anterior and a posterior part. These two
- parts are joined, outside the foramen, by a bar of bone which exhibits
- a deep sulcus on its upper surface for the passage of the corresponding
- spinal nerve.
- The anterior portion is the homologue of the rib in the thoracic region, and is therefore named the costal process or costal element. It arises from the side of the body, is directed laterally in front of the foramen, and ends in a tubercle, the anterior tubercle.The posterior part, the true transverse process, springs from the
- vertebral arch behind the foramen, and is directed forward and
- laterally; it ends in a flattened vertical tubercle, the posterior tubercle.
- Special cervical vertebrae (C1, C2, and C7)
- C1 or atlas: The Atlas is the topmost vertebra, and – along with C2 – forms the joint connecting the skull and spine.
- Its chief peculiarity is that it has no body, and this is due to the
- fact that the body of the atlas has fused with that of the next
- C2 or axis: It forms the pivot upon which C1 rotates. The most distinctive characteristic of this bone is the strong odontoid process
- (dens) which rises perpendicularly from the upper surface of the body.
- The body is deeper in front than behind, and prolonged downward
- anteriorly so as to overlap the upper and front part of the third
- C7 or vertebra prominens: The most distinctive characteristic of this vertebra is the existence of a long and prominent spinous process, hence the name vertebra prominens. In some subjects, the seventh cervical vertebra is associated with an abnormal pair of ribs, known as cervical ribs. These ribs are usually small, but may occasionally compress blood vessels (such as the subclavian artery) or nerves in the brachial plexus, causing ischemic muscle pain, numbness, tingling, and weakness in the upper limb.
Coronary artery bypass graft
Coronary artery bypass surgery, also coronary artery bypass graft (CABG) surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery.
Coronary artery disease
Coronary artery disease (CAD)(or atherosclerotic heart disease) is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. It is sometimes also called coronary heart disease (CHD), but although CAD is the most common cause of CHD, it is not the only cause.
- CAD is the leading cause of death worldwide.
- While the symptoms and signs of coronary artery disease are noted in
- the advanced state of disease, most individuals with coronary artery
- disease show no evidence of disease for decades as the disease
- progresses before the first onset of symptoms, often a "sudden" heart attack, finally arises. After decades of progression, some of these atheromatous plaques may rupture and (along with the activation of the blood clotting system) start limiting blood flow to the heart muscle. The disease is the most common cause of sudden death, and is also the most common reason for death of men and women over 20 years of age.
- According to present trends in the United States, half of healthy
- 40-year-old males will develop CAD in the future, and one in three
- healthy 40-year-old women. According to the Guinness Book of Records, Northern Ireland is the country with the most occurrences of CAD. By contrast, the Maasai of Africa have almost no heart disease.
- As the degree of coronary artery disease progresses, there may be near-complete obstruction of the lumen
- of the coronary artery, severely restricting the flow of
- oxygen-carrying blood to the myocardium. Individuals with this degree
- of coronary artery disease typically have suffered from one or more myocardial infarctions (heart attacks), and may have signs and symptoms of chronic coronary ischemia, including symptoms of angina at rest and flash pulmonary edema.
- A distinction should be made between myocardial ischemia and
- myocardial infarction. Ischemia means that the amount of blood supplied
- to the tissue is inadequate to supply the needs of the tissue. When the
- myocardium becomes ischemic, it does not function optimally. When large
- areas of the myocardium becomes ischemic, there can be impairment in
- the relaxation and contraction of the myocardium. If the blood flow to
- the tissue is improved, myocardial ischemia can be reversed. Infarction
- means that the tissue has undergone irreversible death due to lack of
- sufficient oxygen-rich blood.
An individual may develop a rupture of an atheromatous plaque at any stage of the spectrum of coronary artery disease. The acute rupture of a plaque may lead to an acute myocardial infarction (heart attack).
Continuous ambulatory peritoneal dialysis
Peritoneal dialysis (PD) is a treatment for patients with severe chronic kidney failure. The process uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances (electrolytes, urea, glucose, albumin and other small molecules) are exchanged from the blood.
- Fluid is introduced through a permanent tube in the abdomen and flushed
- out either every night while the patient sleeps (automatic peritoneal
- dialysis) or via regular exchanges throughout the day (continuous
- ambulatory peritoneal dialysis). PD is used as an alternative to hemodialysis
- though it is far less common. It has comparable risks and expenses,
- with the primary advantage being the ability to undertake treatment
- without visiting a medical facility. The primary complication with PD
- is a risk of infection due to the presence of a permanent tube in the
Complete Blood Count
A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel, is a test requested by a doctor or other medical professional
- The cells that circulate in the bloodstream are generally divided into three types: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets (thrombocytes).
- Abnormally high or low counts may indicate the presence of many forms
- of disease, and hence blood counts are amongst the most commonly
- performed blood tests in medicine, as they can provide an overview of a patient's general health status. A CBC is routinely performed during annual physical examinations in some jurisdictions.
Coronary care unit, critical care unit
Congestive Heart Failure
cervical intraepithelial neoplasia
Chronic kidney disease
Chronic myelocytic leukemia
Central Nervous system
Chronic obstructive pulmonary disease
Cerebral palsy, chest pain
CT (CAT) Scan
Computed Axial Tomography
Cerebrovascular accident (Stroke)
Dialtaion & Curettage
disseminated intravascular coagulation
Dyspnea on exertion - (Shortness of Breath)
Emergency Cardiac Care
Extracorporeal membrane oxygenator
Estimated Date of Confinement
Eyes, ears, nose & throat
Enzyme-linked immunosorbent assay
Emergency Room, Estrogen Receptor
Endoscopic Retrograde Cholangiopancreatography
Erythrocyte sedimentation rate
End Stage Renal Disease
Extracorporeal shock wave lithotripsy
Exercise Tolerance Test, Endotracheal Tube
Food & Drug Administration
Forced Expiratory Volume
Follicle Stimulation Hormone
Fever of Unknown Origin
Gastroesophageal reflux disease
Grav. 1, 2, 3
First, second, third pregnancy
Glucose Tolerance Test
- (GVHD) is a common complication of allogeneic bone marrow transplantation
- in which functional immune cells in the transplanted marrow recognize
- the recipient as "foreign" and mount an immunologic attack. It can also
- take place in a blood transfusion under certain circumstances.
Hepatitis B Virus
Infects the liver of hominoidae, including humans, and causes an inflammation called hepatitis.
Human chorionic gonadotropin
- (American English) or Human chorionic gonadotrophin (hCG) is a glycoprotein hormone produced in pregnancy that is made by the developing embryo soon after conception and later by the syncytiotrophoblast (part of the placenta). Its role is to prevent the disintegration of the corpus luteum of the ovary and thereby maintain progesterone production that is critical for a pregnancy
- in humans. hCG may have additional functions; for instance, it is
- thought that hCG affects the immune tolerance of the pregnancy. Early pregnancy testing, in general, is based on the detection or measurement of hCG. Because hCG is produced also by some kinds of tumor, hCG is an important tumor marker especially (with clinical significance) in Gestational trophoblastic disease, but it is not known whether this production is a contributing cause or an effect of tumorigenesis.
(Ht or HCT) or packed cell volume (PCV) or erythrocyte volume fraction (EVF) is the proportion of blood volume that is occupied by red blood cells. It is normally about 48% for men and 38% for women. It is considered an integral part of a person's complete blood count results, along with hemoglobin concentration, white blood cell count, and platelet count.
Hepatitis C virus
(HCV) is a small (55-65 nm in size), enveloped, positive sense single strand RNA virus in the family Flaviviridae. Although Hepatitis A virus, Hepatitis B virus, and Hepatitis C virus have similar names (because they all cause liver inflammation), these are distinctly different viruses both genetically and clinically.
is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure. Hemodialysis is one of three renal replacement therapies (the other two being renal transplant; peritoneal dialysis).
- Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose built room in a hospital or a dedicated, stand alone clinic. Less frequently hemodialysis is done at home.
- Dialysis treatments in a clinic are initiated and managed by
- specialized staff made up of nurses and technicians; dialysis
- treatments at home can be self initiated and managed or done jointly
- with the assistance of a trained helper who is usually a family member
- (HDL) is one of the five major groups of lipoproteins (chylomicrons, VLDL, IDL, LDL, HDL) that enable lipids like cholesterol and triglycerides to be transported within the water-based bloodstream. In healthy individuals, about thirty percent of blood cholesterol is carried by HDL.
- It is hypothesized that HDL can remove cholesterol from atheroma within arteries
- and transport it back to the liver for excretion or re-utilization,
- which is the main reason why HDL-bound cholesterol is sometimes called "good cholesterol", or HDL-C. A high level of HDL-C seems to protect against cardiovascular diseases, and low HDL cholesterol levels (less than 40 mg/dL or about 1mmol/L) increase the risk for heart disease. Cholesterol contained in HDL particles is considered beneficial for the cardiovascular health, in contrast to "bad" LDL cholesterol.
Head, ears, eyes, nose & throat
The Health Insurance Portability and Accountability Act
- (HIPAA) of 1996 (P.L.104-191) [HIPAA] was enacted by the U.S. Congress in 1996. It was originally sponsored by Sen. Edward Kennedy (D-Mass.) and Sen. Nancy Kassebaum (R-Kan.). According to the Centers for Medicare and Medicaid Services (CMS) website, Title I of HIPAA protects health insurance
- coverage for workers and their families when they change or lose their
- jobs. Title II of HIPAA, known as the Administrative Simplification
- (AS) provisions, requires the establishment of national standards for
- electronic health care transactions and national identifiers for
- providers, health insurance plans, and employers. This is intended to
- help people keep their information private, though in practice it is
- normal for providers and health insurance plans to require the waiver
- of HIPAA rights as a condition of service.
- The Administration Simplification provisions also address the
- security and privacy of health data. The standards are meant to improve
- the efficiency and effectiveness of the nation's health care system by
- encouraging the widespread use of electronic data interchange in the U.S. health care system.
Human immunodeficiency virus
- (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unsafe sex, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (vertical transmission).
- Screening of blood products for HIV has largely eliminated transmission
- through blood transfusions or infected blood products in the developed world.
- (HPV) is a member of the papillomavirus
- family of viruses that is capable of infecting humans. Like all
- papillomaviruses, HPVs establish productive infections only in the stratified epithelium of the skin or mucous membranes. While the majority of the nearly 200 known types of HPV cause no symptoms in most people, some types can cause warts (verrucae), while others can – in a minority of cases – lead to cancers of the cervix, vulva, vagina, and anus in women or cancers of the anus and penis in men. Most people who become infected with HPV do not know they have it.
- More than thirty to forty types of HPV are typically transmitted through sexual contact and infect the anogenital region. Some sexually transmitted HPV types may cause genital warts. Persistent infection with "high-risk" HPV types—different from the ones that cause warts—may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer; however, most infections with these types do not cause disease.
- Most HPV infections in young females are temporary and have little
- long-term significance. 70% of infections are gone in 1 year and 90% in
- 2 years.
- But when infection persists—in 5 to 10 percent of infected women—there
- is high risk of developing cervical precancer (lesions on the cervix),
- which can progress to invasive cervical cancer. This process usually
- takes 15–20 years, providing many opportunities for detection and
- treatment of the pre-cancerous condition, often with high cure rates.
Hormone replacement therapy
- (HRT) or in Britain, Hormone therapy (HT), is a system of medical treatment for surgically menopausal, perimenopausal and to a lesser extent postmenopausal women. It is based on the idea that the treatment may prevent discomfort caused by diminished circulating estrogen and progesterone hormones.
- It involves the use of one or more of a group of medications designed
- to artificially boost hormone levels. The main types of hormones
- involved are estrogens, progesterone or progestins, and sometimes testosterone. It often referred to as "treatment" rather than therapy.