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Second Edition

Medical Language
A C C E L E R AT E D

Steven L. Jones, PhD


Rice University

Andrew Cavanagh, MD
Texas A&M College of Medicine

jon17737_fm_i-xvi.indd i 11/07/19 08:39 PM


Learning Outcome 4.2 Exercises Final PDF to printer
EXERCISE 4 Multiple-choice questions. Select the correct 3. Select the term that means muscle pain.
answer(s). a. arthralgia d. arthrodynia
1. Select the term that means bone pain. b. myalgia e. osteodynia
a. arthralgia d. arthrodynia c. ostealgia
b. myalgia e. osteodynia
c. ostealgia
2. Select the term that means joint pain.
a. arthralgia d. arthrodynia
First Pages
b. myalgia e. osteodynia
c. ostealgia

UBJECTIVE BJECTIVE
4.2 Patient History, Problems, Complaints 4.3 Observation and Discovery
Pain is the most common musculoskeletal medical typical signs of inflammation: redness, swelling,
complaint. A patient could have pain in a bone (oste-
joints heat, and pain. Any of these symptoms can indicate
algia), joint (arthralgia/arthrodynia), tendon (tenal- TERM WORD ANALYSIS that an infection or inflammation is present.
gia), or muscle (myalgia/myodynia). A patient may arthralgia arthr / algia There are not many skills that are specific to eval-
also notice a change in a muscle’s appearance—a ar-THRAL-jah joint / pain uating bones. Patients with fractured bones may pres-
DEFINITION joint pain
muscle may be wasting away (atrophy) or abnormally ent with a limp or pain upon touching or pressure.
large (hypertrophy). Most of the other problems peo- arthrodynia arthro / dynia Much evaluation of bone issues is performed
ple experience relate to a change in how their mus- ar-throh-DAI-nee-ah joint / pain
with imaging. The bread-and-butter imaging method
cles or joints are working. DEFINITION joint pain for bones is the simple x-ray. An x-ray can reveal
fractures, bone destruction (osteolysis), and even
extra bone growth (exostosis). More involved imag-
ing methods include computed tomography (CT),
computed axial tomography (CAT), or magnetic
resonance imaging (MRI).
Examining a patient’s joint is usually more
involved. While the health care provider also checks
cervicodynia cervico / dynia for the same signs of inflammation, the joint’s abil-
sir-vih-koh-DAI-nee-ah neck / pain
ity to move also needs to be checked. This is called
DEFINITION neck pain
the joint’s range of motion (ROM). The provider
also checks to make sure the joint is not moving in a
Martin Barraud/Getty Images
Feliz Aggelos/Getty Images direction that it’s not supposed to move in. This extra
Evaluation of bone issues is commonly performed with
movement is called joint laxity. The provider also
Pain is the most common musculoskeletal medical muscles imaging, including MRI.
checks for fluid around the joint (effusion). There are
First Pages
complaint. TERM WORD ANALYSIS When a patient with musculoskeletal problems is several diagnostic procedures specific to the joints. To
bradykinesia brady / kinesia evaluated, the physical exam is very important. The get a better view, the health care provider can inject
bones bray-dih-kih-NEE-zhah slow / movement exam of the muscles and bones focuses mainly on dye into the joint and perform an MRI. Other means
TERM WORD ANALYSIS DEFINITION slow movement

costalgia cost / algia dyskinesia dys / kinesia


kaws-TAL-jah rib / pain dis-kih-NEE-zhah bad / movement First Pages
84
LAN
MEDICAL L ANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics

DEFINITION rib pain DEFINITION inability to control movement

ostealgia dystaxia
4.5 Treatments and Therapies
oste / algia dys / taxia
aw-stee-AL-jah bone / pain dis-TAK-see-ah bad / coordination
v
DEFINITION bone pain DEFINITION poor coordination
jon17737_ch04_075-098.indd 84 07/11/19 08:54 PM
osteodynia osteo / dynia dystonia dys / tonia before new bone (graft) or artificial hardware (pros-
SSESSMENT
aw-stee-oh-DAI-nee-ah
DEFINITION bone pain
bone / pain dis-TOH-nee-ah
DEFINITION poor muscle tone
bad / muscle tone thesis) can be installed. This reconstruction of bone
procedure is called osteoplasty.
spondylodynia spondylo / dynia hyperkinesia hyper / kinesia Similar procedures exist for joints. Sometimes,
4.4 Diagnosis and Pathology
spawn-dih-loh-DAI-nee-ah vertebra / pain
DEFINITION vertebra pain
hai-per-kih-NEE-zhah over / movement
DEFINITION increase in muscle movement or activity
removal of a diseased joint (arthrectomy) is neces-
sary, followed by a reconstruction of the joint with
tibialgia tibi / algia hypotonia
to move. This is a very hypocommon
/ tonia reason for a joint a prosthesis (arthroplasty). These are common treat-
tih-bee-AL-ja tibia / pain hai-poh-TOH-nee-yah under / muscle tone ments for diseased knees and hips. A less aggressive
replacement surgery.
DEFINITION tibia (shin) pain DEFINITION decrease in muscle tone or tigtness surgery for fixing diseased joints, chondroplasty,
Other causes of arthritis include infection (septic
arthritis) and a disease of joint inflammation (rheuma- involves fixing the bad cartilage of a joint. It is very
82 MEDICAL L ANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics common in athletes and older patients with chronic
toid arthritis). Other parts of the joint area that can cause
problems are the bursa (bursitis) and tendon (tendon- osteoarthritis.
itis). These are not usually caused by an injury; instead, Not all orthopedic surgery involves complete
they are a result of normal wear and tear over time. reconstruction of a bone or joint. Sometimes some-
Unusual inflammatory conditions also08:54
affect thing that has snapped must be repaired, as in
jon17737_ch04_075-098.indd 82 07/11/19 PM the
muscles. Muscles can become inflamed (myositis). a tendon repair (tenorrhaphy) or a muscle repair
Sometimes this can involve the skin as well (derma- (myorrhaphy). Other times, new attachments must
tomyositis). General problems with all the muscles be made. This can involve attaching leftover muscle
are called myopathies. Myasthenia gravis and mus- Dr. P. Marazzi/Science Photo Library/Getty Images to bone (myodesis) after an amputation or fixing two
cular dystrophy are two of the most common types Common procedures for the musculoskeletal bones surrounding a joint (arthrodesis). While the
Image Source/Getty Images
of myopathy. system include knee and hip replacements. latter procedure results in immobility of the joint, it
Like any system in the body, the musculoskeletal may be necessary to relieve pain.
As mentioned earlier, fractures are a common reason
why patients see health care providers. Fractures are system can develop tumors. Tumors can develop in The medicines used to treat musculoskeletal problems
more common in people with weaker bones. Bone the bones (osteosarcoma, osteocarcinoma, osteochon- are designed to decrease pain (analgesic) or inflam-
Pharmacology
everything in the record will be intelligible to
loss (osteopenia) can be related to age or to a diet that
is deficient in calcium. Osteopenia leads to soft bones
droma), or they can spread to the bones from other
parts of the body. Your muscles can get tumors
(myoma) as well—one example is a myosarcoma.
intimidated by the prospect of seeing words
mation (anti-inflammatory). The most commonly
used medicines for both are known as nonsteroidal TERM WORD ANALYSIS
in children (osteomalacia) or weak, frail bones in anti-inflammatory drugs (NSAIDs). Ibuprofen is a com- analgesic an / alge / sic

them, the goal is to expose students to the context


adults (osteoporosis). Some patients suffer from infec-
tions of the bone (osteomyelitis), a serious illness that
they are unfamiliar with. We have seen this help
mon example of this type of medicine. Other nonsurgi-
cal treatments include physical therapy, in which patients
A-nal-JEE-zik
DEFINITION a drug that
no / pain / agent

relieves pain
in which they will see medical terminology. students glean information from the chart byv
often requires hospitalization. exercise and stretch in order to heal injuries, or wear-
bones
The vertebral column of bones is susceptible to ing a device used to relieve tension on a joint (orthotics).
TERM WORD ANALYSIS
injury. Gymnasts, football players, or weight lifters Shoe inserts are a very common type of orthotic.

This process will encourage students not to feel using the skills they are acquiring in translating
who bend their backs too far can suffer small stress osteitis oste / itis When nonsurgical treatment fails, surgery may be
First Pages AW-stee-AI-tis bone / inflammation
necessary. Orthopedic surgery deals with joints and
fractures of their vertebra (spondylolysis). If the frac-
DEFINITION bone inflammation
ture is severe, the vertebrae can slip onto one another bones. Many of the tools used in orthopedic surgery

medical terminology.
Burazin/Getty Images
(spondylolisthesis). A very serious version of this con- osteochondritis osteo / chondr / itis look like they came from a home improvement store—
dition can advance to problems with a narrowing of AW-stee-oh-kon-DRAI-tis bone / cartilage / inflammation
including drills, saws, and hammers. These tools are antiarthritic anti / arthri / tic
the space for the spinal cord (spinal stenosis). DEFINITION inflammation of bone and cartilage v used to cut into bone (osteotomy), joints (arthrotomy), or AN-tee-ar-THRIH-tik against / joint (pain) / agent

You move your joints all the time. They act as osteomalacia osteo / malacia
AW-stee-oh-mah-LAY-shah bone / softening 4. Practice Exercises: Each section ends with
muscle (myotomy). Sometimes they remove part or all DEFINITION a drug that opposes joint inflammation

anti-inflammatory anti / inflammatory


4.6 Electronic Health Records
shock absorbers for your body, and they take a lot of these structures (osteectomy, arthrectomy, myectomy).
DEFINITION softening of the bone AN-tee-in-FLA-mah-TOR-ee against / inflammation
of abuse. It should come as no surprise, then, that When defective areas or cancer are present in a
joint problems are a very common medical concern.
A swollen, painful joint (arthritis) can have many
Orthopedic Clinic Note
osteomyelitis osteo / myel / itis
AW-stee-oh-MAI-eh-LAI-tis bone / marrow / inflammation an abundance of practice exercises, giving
bone, the diseased area of bone must be removed DEFINITION a drug that opposes inflammation

DEFINITION inflammation of the bone and bone marrow

students the opportunity to practice and


causes—the most common being excessive wear and MEDICAL L ANGUAGE ACCELERATED 4.5 Treatments and Therapies 93
tear. This type is called osteoarthritis. As the cartilage osteopenia osteo / penia
between the bones in a joint breaks down, the bones AW-stee-oh-PEE-nee-yah bone / deficiency

apply what they have just learned. Exercises


History DEFINITION reduction in bone volume
Subjective
eventually rub together and theofjoint
Present Illness:
becomes painful
Mrs. Maureen Goldman presented to the orthopedic clinic with a chronic
jon17737_ch04_075-098.indd 93 07/11/19 08:54 PM
history of arthralgia. She was previously diagnosed with osteoarthritis. She
was initiallyMEDICAL
treated Lwith NSAIDs
ANGUAGE and an orthotic
ACCELERATED that helped
4.4 Diagnosis for a time;
and Pathology

however, Mrs. Goldman’s condition worsened and was eventually treated with
89
are grouped into categories: Pronunciation,
an intraarticular steroid injection. She reported improved pain and range of
motion. The knee pain returned last year, however, and she was treated in our Translation, and Generation. This progression
89clinic with arthroscopic surgery. While it helped some, she reports it didn’t

and repetition allows students to gradually


jon17737_ch04_075-098.indd 07/11/19 08:54 PM

completely get rid of her symptoms, and she returns today for evaluation.
PMHx: Septic arthritis requiring hospitalization and IV antibiotics 4 years ago.
Objective Physical Exam:
RR: 16; HR: 70; Temp: 98.6; BP: 110/60
build their skills—and their confidence—as
Gen: Alert, oriented.
CV: RRR, no murmurs. they learn to apply their medical language
Resp: CTA.
Musculoskeletal: Crepitation in right knee, decreased ROM. Mild effusion.
Mild muscular atrophy of right quadriceps muscle compared to left.
skills. Abundant Chapter Review exercises, W
Labs: ESR normal, joint aspiration normal.
X-ray: Subchondral cysts, subchondral sclerosis, joint space narrowing. as well as additional labeling and audio
Assessment DDx: Includes osteoarthritis, rheumatoid arthritis, and
bursitis. Given her history of osteoarthritis on exam and the
results of the x-ray and joint aspiration, I believe Mrs. Goldman
exercises, are available through McGraw-Hill
has OA that has failed to respond to previous treatments.
I have discussed
Connect®.
Plan
treatment options, First Pages
and the patient prefers
surgery. I have explained
the risks and benefits of
a total knee replacement
arthroplasty, and she Learning Outcome 5.2 Exercises
understands. I have
scheduled her for
PRONUNCIATION
surgery next month.
—Electronically signed EXERCISE 1 Indicate which syllable is emphasized when
pronounced.
by Ricchelle Mitchell,
MD 01/26/2015 EXAMPLE: bronchitis bronchitis
3. aphasia
11:22 AM Yok_onepiece/Shutterstock
1. paresis 4. paralysis
2. neuralgia 5. dysphasia

96 MEDICAL L ANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics


TRANSLATION
EXERCISE 2 Break down the following words into their EXERCISE 4 Match the term on the left with its definition

viii MEDICAL L ANGUAGE ACCELERATED Preface


EXAMPLE:
component parts.

nasopharyngoscope
on the right.

1. paralysis a. fear of heights


jon17737_ch04_075-098.indd 96 07/11/19 08:54 PM
naso | pharyngo | scope 2. acrophobia b. fainting; losing con-
sciousness due to
1. dementia temporary loss of
blood flow to the
2. pyromania
brain
3. hydrophobia
3. syncope c. from Greek, for to
4. dysphasia disable; complete
5. neuralgia loss of sensation
and motor function
EXERCISE 3 Underline and define the word parts from this
chapter in the following terms. 4. paresis d. from Greek, for to let
go; partial paralysis
jon17737_fm_i-xvi.indd viii 1. neurasthenia 11/07/19 08:39 PM
characterized
2. cephalalgia by varying degrees of
sensation and motor
3. kleptomania
function
Learning Outcome 5.2 Exercises Final PDF to printer
PRONUNCIATION
EXERCISE 1 Indicate which syllable is emphasized when
pronounced.

EXAMPLE: bronchitis bronchitis


3. aphasia
1. paresis 4. paralysis
2. neuralgia 5. dysphasia

TRANSLATION 2. Decontextualized Language Techniques


EXERCISE 2 Break down the following words into their EXERCISE 4 Match the term on the left with its definition

EXAMPLE:
component parts.

nasopharyngoscope
on the right.

1. paralysis a. fear of heights


(academic/grammar exercises)
naso | pharyngo | scope 2. acrophobia b. fainting; losing con-
sciousness due to a. Use repetition. The students are exposed
1. dementia temporary loss of
2. pyromania
blood flow to the
brain to roots, prefixes, and suffixes multiple
3. hydrophobia
4. dysphasia
3. syncope c. from Greek, for to
disable; complete
loss of sensation
times and in multiple ways. Roots are
5. neuralgia

EXERCISE 3 Underline and define the word parts from this


chapter in the following terms. 4. paresis
First Pagesfunction
and motor
d. from Greek, for to let
changed by the addition of prefixes or
go; partial paralysis
1. neurasthenia
2. cephalalgia
characterized
by varying degrees of
suffixes. Familiar prefixes and suffixes
are applied to new roots. This way, the
sensation and motor
Learning Outcome 5.2 Exercises
3. kleptomania
function
4. agoraphobia

word components are continuously


GENERATION EXERCISE 5 Translate the following terms as literally as possible.
5 aphasia
EXERCISE 66. Multiple-choice
dementia questions. Select the correct c. problems speaking
EXAMPLE: (phaso)
nasopharyngoscope an instrument
answer(s). d. abnormal fear (phobia)
reinforced.
for looking at the nose and throat
1. The main 7. categories
dysphasia for nerve complaints are e. paralysis (plegia)
a. peripheral and central nervous system 5. Which 1.
of the following means fear of heights?
aphasia
problems
b. Use translation. Students are asked to
a. hydrophobia c. acrophobia
b. central nervous system and psychiatric 2. neuralgia
b. agoraphobia d. photophobia
problems 3. hydrophobia

provide literal definitions of medical


c. peripheral and psychiatric problems EXERCISE 74. Build a medical term from the information
pyromania
d. autonomic and pyramidal problems provided.
2. Select the terms that pertain to peripheral
nerve problems. example: 5.2inflammation
MEDICAL L ANGUAGE ACCELERATED
a. sending painful signals to the brain (algia)
b. excessive desire (mania)
of the sinuses
Patient History, Problems, Complaints
sinusitis
107
terms, which provides practice in
c. problems speaking (phaso)
d. abnormal fear (phobia)
1. bad speaking condition
2. nerve weakness
breaking down words into their
e. jon17737_ch05_099-122.indd
paralysis (plegia) 107 07/11/19 09:00 PM

3. Select the terms that pertain to central nervous


system problems.
3. fear of outdoor spaces
4. excessive sensitivity to light
component parts and determining their
a. sending painful signals to the brain (algia)
b. excessive desire (mania)
c. problems speaking (phaso)
5. desire to steal
meaning.
EXERCISE 8 Briefly describe the difference between each pair

c. Use generation. Students are asked to


d. abnormal fear (phobia) of terms.
e. paralysis (plegia)
1. paralysis, paresis
4. Select the terms that pertain to psychiatric
problems. 2. neuralgia, cephalalgia
produce medical terms based on the
To the Instructor
a. sending painful signals to the brain (algia)
b. excessive desire (mania)

literal definition provided. Though


To teach medical terminology as a language, we this is only an academic exercise, such
adopt BJECTIVE
techniques employed in second-language v
practice reinforces material learned
acquisition. This helps
5.3 Observation students not just learn the
and Discovery by reversing the cognitive process of
roots, but also adopt a way of thinking and speak-
When a health care professional sees a patient with
a neurologic or psychiatric problem, the exam is
contraction that bypasses the brain. When certain
tendons are tapped, an impulse flows directly to
translation.
often quite involved. The neurologic exam involves the spinal cord, which sends a quick command to

ing that enables them to communicate using the


checking the patient’s muscle strength and coordi-
nation, sensation, and reflexes. A reflex is a muscle
the nearby muscle to contract. Checking sensation
involves studying afferent nerve paths, which are

language of medicine. Cognitive and educational


108 MEDICAL L ANGUAGE ACCELERATED Chapter 5 The Nervous System—Neurology and Psychiatry
As you use this text, here are some things to keep
psychologists divide language instruction techniques in mind:
into two primary categories: contextualized (“real-
jon17737_ch05_099-122.indd 108 07/11/19 09:00 PM

1. B reakdown Is the Key—the goals of this


world” exercises) and decontextualized (academic/ approach to medical terminology are to
grammar exercises). help students internalize the word parts
Using this framework, some of the techniques (roots, prefixes, suffixes) and to reinforce
employed in Medical Language Accelerated include: the concept that medical terms are not to
1. Contextualized Language Techniques (“real- be memorized but to be translated.
world” exercises) 2. Words Are Practice—the words in each
a. Link new language to old language. chapter are a chance to practice breaking
Pointing out instances of medical terms down terms into their component parts,
or roots in everyday use enables the identifying the roots, and learning to define
students to connect new information the terms using this translation method.
they are studying with information they Because of that, each chapter contains four
already possess. classes of words.
b. Use new language in context. Using the a. Essential words that break down—Each
“card” system to introduce the root chapter contains words that are essential
words enables students to understand for students to know AND that break
word parts in the context of larger body down easily using this method. The
systems and in relation to other word core of each chapter is words like this.
parts. Using realistic medical charts The goal is to show students that the
enables students to see the terms they vast majority of medical terms are
use not as lists but as parts of a system of translatable using the method taught by
communication. this book.

MEDICAL L ANGUAGE ACCELERATED Preface ix

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Final PDF to printer

b. Non-essential words that break down— the term root has been used in its place.
Each chapter also contains words that Here are the reasons why we decided to do
are not necessarily essential for students this.
to know or common in the medical field, a. In the real world of medical language, the
but break down clearly and are easily classifications of “root” and “combining
translatable using the method taught by form” are nonexistent. The reason for
this book. We include them as chances this is that they mean virtually the same
to practice the concept of translating exact thing to healthcare professions
medical terms and to show how easy the in practice. The part of the term that
method is to apply. is defined as a combining form can be
c. Essential words that don’t benefit from used interchangeably with root without
breakdown—There are terms that can confusion. Also, word “roots” are more
be broken down but the breakdown commonly used outside the world of
doesn’t help you understand what the medical terminology instruction. For
word means. This can happen for a our approach, using “root” instead of
variety of reasons, such as the term “combining form” prepares students
describes a symptom rather than the better by presenting terminology as it
disease, reflects an outdated way of is commonly used in broader health
understanding the disease, is an ancient professions. If you were to hit “Ctrl+F”
term than just means what it means, or to find and replace all instances of the
is a very recent and technical term and word root with combining form in our
so there are no other words to compare text, nothing . . . NOTHING . . . is
it to. In these cases, even though the changed, lost, or unclear to the student.
method taught by this book may not be b. The importance of combining vowels
ideal in helping to learn these terms, we and forms deals with how they impact
still provide breakdowns and other notes pronunciation of terms, not definitions.
to help make the information stick in the Some instructors will argue, but there is
student’s memory. only a minimal difference in meaning,
d. Essential words that don’t break down—We if any. We feel that great confusion is
admit it. This method doesn’t work for created by insisting on and highlighting
every word. Some words essential for the difference as once a student completes
students to know do not break into word the med term class, being able to identify
components. They must be memorized. a component part as root or combining
We include those words because they are form is no longer practical. We do
crucial words for medical professionals recognize this difference between a root
to know. Our hope is that the inclusion and a combining form in Chapter 1 as
of these words in the real-life health follows: “When we say that a word part
records and other contextualized such as cardi/o is a root, we aren’t speaking
W
learning environments in this book will precisely. Technically, cardi/o is called
support students in internalizing these a combing form. A combining form is a
essential terms. combination of a root with a combining
3. The Use of “Roots” in Place of “Combining vowel.”
Forms”—We understand that it’s common c. The word root is shorter than combining
practice in medical terminology courses to form by more than a third of letters
teach students the difference between roots (4 letters vs. 13 letters). It may sound
and combining forms. This is not a part of silly, but to us the purpose of teaching
our approach, and you will see that in this medical terminology is to streamline
book, the term combining form is absent and communication. The use of combining

x MEDICAL L ANGUAGE ACCELERATED Preface

jon17737_fm_i-xvi.indd x 11/07/19 08:39 PM


Final PDF to printer

form is an unnecessary complication that c. For example—Consider the word


doesn’t bring value to the learner but may salpingoscope. The phonetic pronuncia­
add potential confusion. tion guide describes it as: sal-PING-goh-
4. Pronunciations are Challenging for Students. skohp. But how does that translate to
a. We all speak differently—English is an syllable breakdown? Why is the “g” is used
incredibly diverse language with numerous in two syllables? Shouldn’t it be either
dialects and accents from all over the “sal-pin-go-scope” or “sal-ping-o-scope”?
globe. One consequence of this is that we Well, a case can be made for either of
all speak in slightly different ways. Some those two choices. The truth of the
of us break words into syllables at slightly matter is that we all say the word slightly
different places or pronounce certain different. The word is most accurately
syllables differently. With that in mind, pronounced by leaving a little bit of the
the pronunciation guides given in the “g” in both syllables. Admit it, when you
book should be viewed as guidelines or drop the G from PIN, you end up saying
directions, not universal laws. PIN a little bit differently. We say this not
b. Phonetic versus non-phonetic syllable to complicate things but to encourage
breakdowns—In the exercises, we you to be flexible. We acknowledge that
frequently ask students to break words our pronunciation guides aren’t etched in
into syllables. When that happens, stone . . . more like etched in Silly Putty.
students might ask for guidance in In addition to providing innovative approaches
doing this. Though we didn’t explicitly to learning medical terminology, McGraw-Hill Edu-
break words into syllables, the syllable cation knows how much effort it takes to prepare
breakdown can be determined by for a new course. Through focus groups, symposia,
looking at the Phonetic Pronunciation reviews, and conversations with instructors like you,
guide provided for each word. Encourage we have gathered information about the materials
students to use critical thinking skills to you need to facilitate successful courses. We are
align letters in the term with syllables in committed to providing you with high-quality, accu-
the guides. rate instructor support.

MEDICAL L ANGUAGE ACCELERATED Preface xi

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A Note from the Authors: The water is always coldest when you first
jump in. You will get used to it. Be patient.
To the Student Follow the steps.
The purpose of this program is to equip you with 2. Eat the elephant. Do you know how to eat an
foundational skills as you prepare for a career in elephant? One bite at a time. One of the easiest
health and medicine. As you enter the culture of ways to keep from panicking is to break down
medicine, you will need to speak the language to things into easily digestible chunks. Don’t
understand what is going on around you and to focus on the total amount of information you
be understood by your colleagues and patients. have to learn; rather, focus on the bite in front
Though learning medical language can seem a of you.
daunting task, it is our hope that this program 3. Practice makes permanent. The easiest way
reduces some of the anxiety that accompanies to master medical language is to practice.
learning any new language. We hope this program You readily absorb what you are repeatedly
shows you how clear the language of medicine is exposed to. So practice. Repeat. Do it again.
to understand as you begin to master some key The more you do it, the more you will be able
concepts. As you get started, here are some helpful to do it, and the more you will enjoy doing it.
words of advice: 4. Build bridges. Medical language is everywhere:
1. Don’t panic. Immersing yourself in any new on TV shows, in the news, in your own life.
language can be intimidating. On occasion, Look for it. See if you can figure out the
you will probably feel overwhelmed, like you meaning of words you hear. Build connections
are being bombarded with information you between what you are learning and the world
don’t understand and don’t know how to make you live in. See how often you encounter these
sense of. Start by trying not to panic. Things words. The more you practice it, the more it
always look intimidating when you begin. will be burned into your memory.

Acknowledgments
Suggestions have been received from faculty and students throughout the country. This is vital feedback that
is relied on for product development. Each person who has offered comments and suggestions has our thanks.
The efforts of many people are needed to develop and improve a product. Among these people are the review-
ers and consultants who point out areas of concern, cite areas of strength, and make recommendations for
change. In this regard, the following instructors provided feedback that was enormously helpful in preparing
the book and related products.

Reviewers
We’d like to thank the many reviewers and SMEs who have helped us with the first, and now this second
edition.

Dora P. Bailey, BS Mauri Brueggeman, MEd, Colleen L. Croxall, PhD


Durham Technical Community College MLS (ASCP)CM Eastern Michigan University
Mark Beck, BA, MA, PhD Northcentral Technical College Teresa Diana
University of South Gina Capitano MS, RT(R) Cape Fear Community College
Carolina at Columbia Misericordia University Stephanie Duncan,
Ranelle Brew, EdD, CHES Alice Clegg, MHEd, BS MSN, RN, CCRN
Grand Valley State University Dixie State University Marygrove College

xiv MEDICAL L ANGUAGE ACCELERATED Preface

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Mary Fabick, MSN, Tricia Leggett, DHEd, RT(R)(QM) Amy Bolinger Snow, MS
MEd, RN-BC, CEN Zane State College Greenville Technical College
Milligan College Kathryn R. Maxwell, MA BSN RN Charlene Thiessen, MEd,
Sandra Flynn, AS The Ohio State University BA, CMT, AHDI-F
Guilford Technical Community College of Medicine GateWay Community College
College Tammy McClish, MEd, Dr. Mimi Vaassen, PT,
Kenneth D. Franks CMA (AAMA) DPT, GCS, CLT
Bossier Parish Community College The University of Akron Assistant Professor of Physical Therapy
Dr. Joel Gluck, DPM Tabitha Mocilan Clarke University
Community College of ECPI University Amy Way, PhD
Rhode Island Lock Haven University of
Cynthia K. (Cindy) Moore, PhD, RDN
M.J. Hilliard BS, CST R & D Wellness & Nutrition, Pennsylvania
Healthcare Preparatory Institute Tyson Foods, Inc. Kari Williams, BS, DC
Amy Johns Mirella Pardee, MSN, MA, RN Front Range Community College
Moberly Area Community College University of Toledo Charles K. Williston, MS, BA, CPC
Judith Karls, RN, BSN, MSE Traviss Career Center
Constance Phillips, MA, MPH
Madison Area Technical College Boston University Luisa L. Zirkle, BS Medical
Tonya Kendrix, MSN, Technology, BS Biology,
Mary M. Prorok, RN, MSN
MBA, HCM, RN Master Ed
South Hills School of
South Arkansas Community College Tidewater Community College
Business & Technology

Digital Tool Development


Special thanks to the instructors who helped with the development of Connect, LearnSmart, and SmartBook.

Judith Karls, RN, BSN, MSE Jocelyn Lewis, PT, DPT, MS Mirella Pardee, MSN, MA, RN
Madison Area Technical College Community College of Philadelphia University of Toledo
Amy Kennedy, MSN, RN Dr. Vicky Navaroli, PhD Lorie Sablad, ARNP, MSN
Rhonna Krouse, MS., Goodwin College Valencia Community College
ACSM-EP-C, CISSN
College of Western Idaho

Acknowledgments Project Manager; David Hash, Lead Designer; and


Lorraine Buczek, Content Licensing Specialist.
from the Authors
We would like to thank the following individuals
who helped develop, critique, and shape our text-
Acknowledgments from
book, our digital materials, and our other ancillar- Steven L. Jones
ies. We are grateful for the efforts of our team at Above all, I am grateful for the love and support of
McGraw-Hill Education who made all of this come my family: my wife, Tamber, and our six children,
together. We would especially like to thank Michelle I am also thankful for the support of my colleagues at
Vogler, Director; William Lawrensen, Executive the universities where I worked while completing this
Portfolio Manager; Christine “Chipper” Scheid, project. At Rice University: Nicholas K. Iammarino,
Senior Product Developer; Roxan Kinsey, Executive Chair of the Department of Kinesiology; and
Marketing Manager; Ann Courtney, Senior Content Jennifer Zinn-Winkler, the program administrator. At
Project Manager; Brent dela Cruz, Lead Content Houston Baptist University: President Robert Sloan,

MEDICAL L ANGUAGE ACCELERATED Preface xv

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Christopher Hammons, Micah Mattix, Timothy A. Jack. I owe a great debt of gratitude to my mother,
Brookins, Evan J. Getz, Gary Hartenburg, Randy Katherine Cavanagh, who worked tirelessly to pro-
Hatchett, and Jerry Walls. In addition, I am deeply vide for me as I grew up and passed on to me her
indebted to my friends for their encouragement: admirable work ethic. I would also like to thank
Daniel Benton, Michael Bordelon, Michael Czapla, John Blevins for fostering my love of medicine
Nathan Cook, Russell Thompson, Dan Euhus, and and pediatrics and for being a great role model. I
Brad Flurry. would like to thank Caughman Taylor and the entire
residency training program at Palmetto Health
Richland, University of South Carolina, for their
Acknowledgments from amazing teaching and dedication to the lives of the
Andrew Cavanagh residents. I am grateful for Chisholm Trail Pediat-
I am most thankful for the loving support of my rics. It is a joy to practice medicine in such a posi-
wife, Ashley, and children, Katie, Nathaniel, and tive environment.

xvi MEDICAL L ANGUAGE ACCELERATED Preface

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Introduction to Medical
Language
Introduction
1
You’ve probably had conversations with people who
like to use big words. Maybe you’ve responded with a
blank expression and a sarcastic phrase—something
like, “Say it in English, please!” This happens all the
time in health care practices.
When a patient comes in for treatment, he or
she is often bombarded with unfamiliar words. The
patient leaves bewildered, wondering what the health
care professional just said. Sometimes patients do get
up the courage to ask what it all means, and health
care professionals explain in simpler terms. And
patients wonder, “Well, why couldn’t you have just
said that in the first place? Why did you have to use
all those big words?”

Ablestock.com/Getty Images

Learning Outcomes
Upon completion of this chapter, you will be able to:

1.1 Summarize the purpose of medical language.


1.2 Summarize the origins of medical language.
1.3 Summarize the principles of medical language.
1.4 Summarize how to pronounce terms associated with medical language.
1.5 Identify the parts used to build medical language.
1.6 Summarize how to put together medical terms.
1.7 Describe how medical terms are translated.

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1.1 The Purpose of Medical Language


Why Is Medical Language
a little confused and worried about what is going on.
Necessary?
Using ­medical language reassures patients that the
“Why did you have to use all those big words?” is a health care professionals know what is going on and
good question. Why is medical language necessary? are in control. Sometimes a patient can be calmed
Following are a few reasons why medical language is and reassured that everything is OK by a health care
both necessary and useful. professional repeating the same symptoms the patient
First, medical language allows health care profes- reported—in medical language.
sionals to be clear. Ours is a multicultural society. For example, one of us once saw a doctor about
Many languages are spoken, each with their own a rapid heart rate. The doctor was very reassuring—it
words for illnesses and body parts. By using medical was just “tachycardia.” The doctor, however, didn’t
language, health care professionals are able to com- know he was talking to someone who was familiar
municate and understand one another clearly, no with medical language. Tachycardia breaks down to
matter what their first language is. tachy (fast, as in a car’s tachometer reports the engine’s
Second, medical language allows health care pro- revolutions per minute) + card (heart) + ia (condi-
fessionals to communicate quickly. Think about how tion). It literally means fast heart condition. The doctor
this works in English. Instead of saying “a tall thing in was just repeating what he had heard.
the yard with green leaves,” we just use the word “tree.” Here’s another example. Once, a young boy was
Instead of saying “a meal made up of a few slices of sick and his doctors performed a series of tests to find
meat and cheese, topped with lettuce, mustard, and out what was wrong. After receiving the test reports,
mayonnaise, and placed between two slices of bread,” the boy’s parents were reassured. The doctors had
we just say “sandwich.” Instead of having to use valuable diagnosed their child with an “idiopathic blood disor-
time describing the symptoms of a disease or the find- der.” The diagnosis was enough for them.
ings of an examination, a health care professional uses Because the doctors had attached a fancy medical
medical language in order to be clear and easily under- term to their son’s condition, the parents figured the doc-
standable to other health care professionals. tors knew what was wrong and how to treat it. In truth,
Third, medical language allows health care profes- the doctors hadn’t told them anything. Idiopathic breaks
sionals to comfort patients. This reason might seem down to idio (private or alone) + pathic (disease or suf-
kind of odd, but it is true. When patients first enter a fering). It literally means suffering alone. The boy’s con-
health care facility, they often don’t feel well and are dition was something the doctors had never seen before.

Medical language enables health care professionals Medical language is able to reassure patients that
to ­communicate quickly and easily no matter what health care professionals know what is going on
their ­specific specialty or native language. and are in control.
Jupiterimages/Getty Images Ariel Skelley/Blend Images LLC

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Additional exercises available in


Learning Outcome 1.1 Exercises

EXERCISE 1 Multiple-choice questions. Select the correct 3. Medical language allows health care profes-
answer. sionals to communicate quickly because
1. Which of the following is NOT a reason why a. it is a quick way to speak to other health
medical language is necessary and useful? care professionals without taking the time
a. Medical language allows health care to describe symptoms or examine findings
professionals to be clear. b. the patients are usually baffled by the
b. Medical language allows health care terminology and do not ask additional
professionals to comfort patients. questions
c. Medical language allows health care c. words with many syllables always communi-
professionals to communicate quickly. cate more information than words with few
d. Medical language allows health care syllables
professionals to intimidate their patients. d. none of these
2. Medical language allows health care profes- 4. Medical language allows health care profes-
sionals to be clear because sionals to comfort patients because
a. few people really understand medical a. it communicates a sense that the health
terminology, so at least everyone is speaking care professionals are in control of the
the same way situation
b. health care professionals are in control b. it lets the patients know that the health care
of the situation and don’t want to scare professionals are not caught off guard by
patients with a language that they could the symptoms at hand
understand c. it lets the patients know that the health care
c. we live in a multicultural society with a variety professionals know what is going on
of languages, and medical language is a way of d. all of these
speaking the same way about the same thing
despite your native language
d. none of these

1.2 The Origins of Medical Language


eponym is a word formed by including the name of
Where Does It Come From?
the person who discovered or invented whatever is
Medical language is made up primarily (but not being described. Sometimes, in the case of diseases,
exclusively) of words taken from two ancient lan- an eponym is named in honor of the disease’s first or
guages: Greek and Latin. Other words creep in from most noteworthy diagnosed victim.
other sources, but Greek and Latin serve as the foun- This reminds us of a great old joke.
dation of medical language. A doctor says to a patient, “I have good news and
Some of these other sources include: bad news. Which do you want first?”
Eponyms. The word eponym is derived from the The patient responds, “The good news.”
Greek words epi (upon) + onyma (name). It liter- The doctor replies, “Well, you are about to have a
ally means to put your name on something. Thus, an disease named after you.”

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One famous eponym is Lou Gehrig’s disease. The


neurological disease was named after the famous New
York Yankees first baseman who suffered from the
disease. The disease’s scientific name is amyotrophic
lateral sclerosis.
Acronyms. The word acronym is derived from the
Greek words acro (high, end) + onyma (name). It lit-
erally means to make a name with the ends. Thus, an
acronym is a word made up of the first letters of each
of the words that make up a phrase. One example is
the diagnostic imaging process called magnetic res-
onance imaging, or MRI. Remember that acronyms
are just shorthand—you still need to know what the
words mean.
Modern languages. Frequently, words from mod-
ern languages creep into the vocabulary of health
care professionals. These words tend to come from
whatever language happens to be most commonly
spoken by the majority of health care professionals.
In centuries past, German or French were the most
common languages, so they were the foundation of
many medical terms. Currently, the fastest-growing
and most-used language in the world is English.
Thus, English has also contributed a fair number of MRI, which stands for magnetic resonance imaging,
medical terms. is an example of an acronym.
Martin Barraud/Getty Images

about AD 217, made some of the greatest advance-


Why Greek and Latin?
ments of our understanding of the human body, how
Although the three previously mentioned sources disease affects it, and how drugs work.
have contributed a significant number of words to Medical advances began to occur with greater fre-
the language of medicine, Greek and Latin make quency during the scientific revolution, adding to an
up its foundation and backbone. Even eponym and already existing body of knowledge based on ancient
­acronym were derived from Greek! But why are Greek and Latin. In fact, some of the oldest terms
Greek and Latin so prevalent? There are at least have been in use for more than 2,000 years, such as
three r­ easons why. terms for the skin, because these body parts were
Reason 1: The foundations of Western medicine more easily viewed and studied.
were in ancient Greece and Rome. The first peo- Reason 2: Latin was the global language of the
ple to systematically study the human body and ­scientific revolution. The scientific revolution took
develop theories about health and disease were the place from the 16th through the 18th century. It
ancient Greeks. The Hippocratic Oath, the foun- was a time of enormous discoveries in physics, biol-
dation of modern medical ethical codes, is named ogy, chemistry, and human anatomy. This period
after and was possibly composed by a man named saw a rapid increase in human knowledge thanks to
Hippocrates who lived in Greece from about the scientific method, which is a set of techniques
460 BC to about 370 BC. Hippocrates is widely con- developed in this period and still in use today using
sidered to be the father of Western medicine. observation and experimentation for developing, test-
The development of the health care profession ing, and proving or disproving hypotheses.
began in ancient Greece and continued in ancient Medical research involving many different sub-
Rome. There, Galen, who lived from AD 129 to jects, peoples, and places occurred all over Europe.

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To allow people from England, Italy, Spain, Poland, in the phrase green energy. Before that, the term was
and elsewhere to talk with one another, Latin became widely understood to mean something different:
the language of scholarly discussion. It was already immature or inexperienced, such as “I just started this
the common language of the Holy Roman Empire job, so I am still a little green.” Dead languages, which
and Catholic Church, so many people already knew aren’t spoken anymore, have an advantage because
it well. they don’t change. There is no worry that words will
By using Latin to record and spread news of their change their meaning over time.
discoveries, scientists of this time were able to share
their new knowledge beyond the borders of their
countries. At the same time, the number of medical
words that sprang from Latin grew.
Reason 3: Dead languages don’t change. “Fine,”
you think. “The language of medicine is based on
Greek and Latin. But why do we keep using it? No
one speaks either of these languages anymore. Why
don’t we just use English?”
The reason we keep using Greek and Latin is
exactly that—no one speaks them anymore. All spoken
languages change over time. Take the English word
green, for instance, and its non-color-related meaning. The foundations of Western medicine were laid in
In the past 20 or so years, the word green has become Greece and Rome.
understood to mean environmentally responsible, as Marco Simoni/Getty Images

Learning Outcome 1.2 Exercises

EXERCISE 1 True or false questions. Indicate true answers 7. The first people to systematically study the
with a T and false answers with an F. human body and develop theories about health
1. Medical language is made up primarily, but not and disease were the ancient Greeks.
exclusively, of words taken from two ancient 8. Even though German was the global language
languages: Greek and Latin. of the scientific revolution, the Catholic
2. Some other sources of medical language Church forced all academics to use Latin, a
include eponyms, acronyms, and modern language unknown to most people.
languages.
9. During the scientific revolution, Latin was
3. An example of an eponym is a medical term used as the language of scholarly discussion in
named after a famous patient who had the order to allow people across Europe to share
disease. their knowledge more quickly despite their dif-
4. MRI is an example of an eponym. ferent native languages.
5. Acronyms are used to say things more 10. A dead language is a language that people do
quickly. not like to hear or speak anymore because it is
6. Greek and Latin provide the basis of the lan- no longer useful to a society.
guage of medicine because Western medicine 11. Latin and Greek provide an excellent basis for
has its foundations in the Greek and Roman medical terminology because dead languages
cultures. do not change.

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1.3 The Principles of Medical Language


How Does It Work?
for a while, you wouldn’t just try to memorize a few
Don’t think of medical language as words to be mem- stock phrases, you would try to learn the language
orized. Instead, they are sentences to be translated.1 so you could understand what other people were
Each medical word is a description of some saying.
aspect of health care. Think of it this way: If you The same is true of medical language. If you
were taking a trip to another country, you might try understand the way the language works, you will be
to memorize a few key words or phrases. It might be able not only to know the meaning of a few individual
useful to know how to say common things such as words but also to break down and understand words
“Where is the bathroom?” or “How much does this you have never seen before, and even generate words
cost?” But if you were going to live in that country on your own.

S. Olsson/PhotoAlto

1.4 How to Pronounce Terms Associated


with Medical Language
The first step in learning any language is learning languages (and not just any foreign languages, but
correct pronunciation. Like any other language, foreign languages no one speaks anymore). Second,
knowing and understanding medical terminology some of the words are really long.
is useless unless you pronounce the terms correctly. You probably have noticed the way native speak-
With medical terms, the matter is complicated by ers of other languages pronounce certain letters
two facts: First, many of the words come from foreign differently. Think of the word tortilla. It takes a

1
For more on this concept, see Lesley A. Dean-Jones, “Teaching Medical Terminology as a Classics Course,” Classical Journal
93 (1998), pp. 290–96.

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bit of experience with Spanish to know that two LETTER SOUND EXAMPLE
ls placed together (ll) are pronounced like a y. c (before a, o, u) k cardiac (KAR-dee-ak)
You say tor-TEE-yah, not ­tor-TILL-ah. The Spanish contra (KON-trah)
word for yellow, amarillo, follows this rule. It is cut (KUT)
pronounced ah-mah-REE-yoh. But the Texas town c (before e, i, y ) s cephalic (seh-FAL-ik)
of the same name is pronounced very differently: cilium (SIL-ee-um)
am-ah-RIL-oh. cyst (SIST)
The same is true for medical language. The best ch k chiropractor
(KAI-roh-PRAK-tor)
way to learn terms is by encountering them in con-
text. Once you get a little experience with the lan- g (before a, o, u) g gamma (GAM-ah)
goiter (GOI-ter)
guage, you will pick up the unique ways that certain gutta (GUT-tah)
letters are pronounced. In the meantime, refer to g (before e, i, y) j genetic (jeh-NEH-tik)
the accompanying chart of some commonly mispro- giant (JAI-int)
nounced letters. biology (bai-AW-loh-jee)
ph f pharmacy (FAR-mah-see)
Syllable Emphasis pn n pneumonia
(noo-MOHN-yah)
Every medical term is constructed from syllables. pt (initial) t pterigium (tir-IH-jee-um)
Another thing that can affect the way words are rh, rrh r rhinoplasty
pronounced is which syllable or syllables should be (RAI-noh-PLAS-tee)
stressed, or emphasized. You must always make sure hemorrhage (HEH-moh-rij)
to put the emphasis on the correct syllable. x (initial) z xeroderma
For example, consider that last phrase: Put the (ZER-oh-DER-mah)
emphasis on the right syllable. The correct way to pro-
nounce it would be:
PUT the EM-fah-sis on the RAIT Therefore, the word is pronounced
SIL-ah-bul. KAR / dee / ak.
It would sound funny to say: Cardiology is split into five syllables:
PUT the em-FAH-sis on the RAIT car / di / o / lo / gy.
si-LAH-bul. Count backward three syllables from the
Knowing which syllable to emphasize can seem end of the word to figure out which syllable
tricky but is actually pretty easy. Usually, for the sake gets emphasized: o.
of emphasis, the only syllables that you need to focus Therefore, the word is pronounced
on are the last three syllables. So, starting at the end
kar / dee / AW / loh / jee.
of the word, count back three syllables.
When it comes to emphasizing the correct sylla- It gets tricky when a word remains unchanged except
ble, the basic rule is this: In most words, the emphasis for the addition or subtraction of only a few letters.
usually falls on the third-to-last syllable (the antepe- Two good examples are the words colonoscopy and
nult, if you are keeping track). colonoscope.

Cardiac is split into three syllables: Colonoscopy is split into five syllables:
car / di / ac. co / lon / o / sco / py.
Count backward three syllables from the Count backward three syllables from the
end of the word to figure out which syllable end of the word to figure out which syllable
gets emphasized: car. gets emphasized: o.

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Therefore, the word is pronounced master pronunciation is not to learn countless rules,
koh / lon / AW / skoh / pee. but instead to practice pronouncing words. Learn
this one rule—let’s call it the three-syllable rule—
Colonoscope is split into four syllables: and make sure you take note of the pronunciations
co / lon / o / scope. offered throughout the chapters. Don’t just read
them silently! Pronounce the words out loud. The
Count backward three syllables from the
more times you practice saying a word, the more
end of the word to figure out which syllable comfortable and natural you will feel when you have
gets emphasized: lon. to use it for real.
Therefore, the word is pronounced But make sure you are pronouncing correctly.
koh / LAWN / oh / skohp. Practice does not make perfect; practice makes
permanent. Whatever you do over and over will be
Notice how easy it is to spot the pronunciation cemented in your brain, so make sure you do it right.
change if you focus on counting backward from the Perfect practice makes perfect.
end of the word?
As with any rule, there are countless exceptions
and technicalities. That said, the easiest way to

Learning Outcome 1.4 Exercises

EXERCISE 1 Identify the correct pronunciation for the underlined syllable.

EXAMPLE: thoracocentesis answer: koh (the c is hard because it is followed by an o)


thoracentesis answer: sin (the c is soft because it is followed by an i)

1. gut a. jut b. gut


2. digit a. jit b. git
3. gag reflex a. jag b. gag
4. dermatology a. jee b. gee
5. geneticist a. jen b. gen
6. gonad a. joh b. goh
7. collagen a. jen b. gen
8. pharmacist a. par b. far
9. cuticle a. kyoo b. suh
10. cornea a. kor b. sor
11. catheter a. kath b. sath
12. oncology a. kaw b. saw

8 MEDICAL L ANGUAGE ACCELERATED Chapter 1 Introduction to Medical Language

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Learning Outcome 1.4 Exercises

13. geneticist a. kist b. sist


14. pharmacist a. kist b. sist
15. cystic fibrosis a. kis b. sis
16. cholera a. kawl b. chohl
17. psychosis a. koh b. choh
18. pneumatocele a. keel b. seel
19. rheumatoid arthritis a. roo b. rhee-yoo
20. pneumatocele a. noo b. puh-noo
21. pterion a. tir b. puh-tir
22. xerosis a. zer b. ex-er
23. encephalitis a. kep b. sef
24. cirrhosis a. kir-hoh b. sir-oh

EXERCISE 2 Indicate which syllable(s) is emphasized when pronounced.

EXAMPLE: bronchitis bronchitis

1. cholera 
2. cornea 
3. cuticle 
4. catheter 
5. collagen 
6. anemia 
7. oncology 
8. optometry 
9. rheumatoid 
10. geneticist 
11. dermatology 
12. psychotherapist 

MEDICAL L ANGUAGE ACCELERATED 1.4 How to Pronounce Terms Associated with Medical Language 9

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humorous susceptibilities, venture upon doubtful jests. Mr.
Tarkington knows very well that the spectacle of a boy dismembering
an insect calls for reprobation; but that if the boy’s experiments can
be described as “infringing upon the domain of Dr. Carrell,” they
make a bid for laughter. “Penrod’s efforts—with the aid of a pin—to
effect a transference of living organism were unsuccessful; but he
convinced himself forever that a spider cannot walk with a beetle’s
legs.” It is funny to those who relish the fun. If it does not, as Mr.
Pater advises, make suffering ridiculous, it makes sympathy
ridiculous, as being a thing more serious than the occasion warrants.
The reader who is not amused tries to forget the incident, and
hurries cheerfully on.
A more finished example of callous gaiety, and one which has
been more widely appreciated, may be found in a story called
“Crocker’s Hole,” by Blackmore. It tells how a young man named
Pike, whom “Providence” had created for angling (the author is
comfortably sure on this point), caught an old and wary trout by the
help of a new and seductive bait. The over-wrought, over-coloured
beauty of Blackmore’s style is in accord with his highly sophisticated
sense of humour:
“The lover of the rose knows well a gay, voluptuous beetle, whose
pleasure it is to lie embedded in a fount of beauty. Deep among the
incurving petals of the blushing fragrance he loses himself in his joys
till a breezy waft reveals him. And when the sunlight breaks upon his
luscious dissipation, few would have the heart to oust such a gem
from such a setting. All his back is emerald sparkles; all his front, red
Indian gold, and here and there he grows white spots to save the
eye from aching. Pike slipped in his finger, fetched him out, and gave
him a little change of joys by putting a Limerick hook through his
thorax, and bringing it out between his elytra. Cetonia aurata liked it
not, but pawed the air very naturally, fluttered his wings, and trod
prettily upon the water under a lively vibration. He looked quite as
happy, and considerably more active than when he had been cradled
in the anthers of a rose.”
The story is an angling story, and it would be unreasonable to spoil
it by sympathizing with the bait. But there is something in the
painting of the little beetle’s beauty, and in the amused description of
its pain, which would sicken a donkey-beating costermonger, if he
were cultivated enough to know what the author was driving at. It
takes education and an unswerving reverence for sport to save us
from the costermonger’s point of view.
There are times when it is easier to mock than to pity; there are
occasions when we may be seduced from blame, even if we are not
won all the way to approval. Mrs. Pennell tells us in her very
interesting and very candid life of Whistler that the artist gratified a
grudge against his Venetian landlady by angling for her goldfish
(placed temptingly on a ledge beneath his window-sill); that he
caught them, fried them, and dropped them dexterously back into
their bowl. It is a highly illustrative anecdote, and we are more
amused than we have any business to be. Mr. Whistler’s method of
revenge was the method of the Irish tenants who hocked their
landlord’s cattle; but the adroitness of his malice, and the whimsical
picture it presents, disarms sober criticism. A sympathetic setting for
such an episode would have been a comedy played in the streets of
Mantua, under the gay rule of Francesco Gonzaga, and before the
eyes of that fair Isabella d’Este who bore tranquilly the misfortunes of
others.
We hear so much about the sanitary qualities of laughter, we have
been taught so seriously the gospel of amusement, that any writer,
preacher, or lecturer, whose smile is broad enough to be infectious,
finds himself a prophet in the market-place. Laughter, we are told,
freshens our exhausted spirits and disposes us to good-will,—which
is true. It is also true that laughter quiets our uneasy scruples and
disposes us to simple savagery. Whatever we laugh at, we condone,
and the echo of man’s malicious merriment rings pitilessly through
the centuries. Humour which has no scorn, wit which has no sting,
jests which have no victim, these are not the pleasantries which
have provoked mirth, or fed the comic sense of a conventionalized
rather than a civilized world. “Our being,” says Montaigne, “is
cemented with sickly qualities; and whoever should divest man of the
seeds of those qualities would destroy the fundamental conditions of
life.”

THE END

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