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9th Edition
Medical Terminology
for Health Professions
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9th Edition
Medical Terminology
for Health Professions
Carol L. Schroeder
Laura Ehrlich
Katrina Schroeder Smith
Ann Ehrlich
Australia ● Brazil ● Canada ● Mexico ● Singapore ● United Kingdom ● United States
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CONTENTS
Preface xiii
To the Learner / xiii

Changes to the Ninth Edition / xv
About the Authors / xvi
Acknowledgements / xviii
How to Use This Book / xix
-ology Chapter 1: Introduction to Medical Terminology 1

a
-os
i
-alg ab-
is
Primary Medical Terms / 3

-itis
leu
Word Parts Are the Key / 3

rhin
k/o
Word Roots / 4
-
pre-
/o-
neu Suffixes / 5
r/o-
gastr Prefixes / 8
/o- b- Determining Meanings on the Basis of Word Parts / 9
su
Medical Dictionary Use / 10
Pronunciation / 11
hypo-
Spelling Is Always Important / 12
Singular and Plural Endings / 12
Basic Medical Terms to Describe Diseases / 12
Look-Alike, Sound-Alike Terms and Word Parts / 12
Using Abbreviations / 16
Learning Exercises / 17
The Human Touch: Critical Thinking Exercise / 26
Chapter 2: The Human Body in Health

and Disease 27
Anatomical Reference Systems / 29

Structures of the Body / 34
Cells / 34
Genetics / 36
Tissues / 38
Glands / 39
Body Systems and Related Organs / 39
vi CONTENTS
Pathology / 41
Aging and Death / 43
Health Care Professionals / 43
Abbreviations Related to the Human Body in Health and Disease / 45
Word Part Review WPR1
Word Part Practice Session / WPR1

Word Part Post-Test / WPR4
Chapter 3: The Skeletal System 56
Structures and Functions of the Skeletal System / 58

The Structure of Bones / 58
Joints / 59
The Skeleton / 61
Medical Specialties Related to the Skeletal System / 70
Pathology of the Skeletal System / 70
Diagnostic Procedures of the Skeletal System / 77
Treatment Procedures of the Skeletal System / 77
Abbreviations Related to the Skeletal System / 81
The Human Touch : Critical Thinking Exercise / 91
Chapter 4: The Muscular System 92
Functions of the Muscular System / 94

Structures of the Muscular System / 94
Types of Muscle Tissue / 95
Muscle Contraction and Relaxation / 95
Contrasting Muscle Motion / 96
How Muscles Are Named / 98
Select Muscles and Their Functions / 101
Medical Specialties Related to the Muscular System / 102
Pathology of the Muscular System / 102
Diagnostic Procedures of the Muscular System / 108
Treatment Procedures of the Muscular System / 108
Abbreviations Related to the Muscular System / 110
The Human Touch: Critical Thinking Exercise: / 121
CONTENTS vii
Chapter 5: The Cardiovascular System 122
Functions of the Cardiovascular System / 124

Structures of the Cardiovascular System / 124
The Blood Vessels / 130
Blood / 132
Medical Specialties Related to the Cardiovascular System / 135
Pathology of the Cardiovascular System / 135
Diagnostic Procedures of the Cardiovascular System / 145
Treatment Procedures of the Cardiovascular System / 146
Abbreviations Related to the Cardiovascular System / 151
Chapter 6: The Lymphatic and Immune

Systems 162
Functions of the Lymphatic System / 164

Structures of the Lymphatic System / 164
Additional Structures of the Lymphatic System / 167
Medical Specialties Related to the Lymphatic and Immune Systems / 171
Pathology and Diagnostic Procedures of the Lymphatic System / 171
Pathology and Diagnostic Procedures of the Immune System / 172
Treatment of the Immune System / 175
Pathogenic Organisms / 176
Oncology / 180
Cancer Treatments / 185
Abbreviations Related to the Lymphatic and Immune Systems / 186
Chapter 7: The Respiratory System 198
Functions of the Respiratory System / 200

Respiration / 205
Medical Specialties Related to the Respiratory System / 206
Pathology of the Respiratory System / 206
Upper Respiratory Diseases / 208
Diagnostic Procedures of the Respiratory System / 215
Treatment Procedures of the Respiratory System / 216
Abbreviations Related to the Respiratory System / 219
viii CONTENTS
Chapter 8: The Digestive System 229
Structures of the Digestive System / 231

Digestion / 239
Medical Specialties Related to the Digestive System / 240
Pathology of the Digestive System / 240
Diagnostic Procedures of the Digestive System / 250
Treatment Procedures of the Digestive System / 251
Abbreviations Related to the Digestive System / 254
Chapter 9: The Urinary System 264
Functions of the Urinary System / 266

Structures of the Urinary System / 266
The Excretion of Urine / 270
Medical Specialties Related to the Urinary System / 270
Pathology of the Urinary System / 270
Diagnostic Procedures of the Urinary System / 276
Treatment Procedures of the Urinary System / 278
Abbreviations Related to the Urinary System / 283
Chapter 10: The Nervous System

and Mental Health 295
Functions of the Nervous System / 297

Structures of the Nervous System / 297
The Central Nervous System / 300
The Peripheral Nervous System / 305
The Autonomic Nervous System / 306
Medical Specialties Related to the Nervous System and Mental Health / 307
Pathology of the Nervous System / 307
Diagnostic Procedures of the Nervous System / 315
Treatment Procedures of the Nervous System / 315
Mental Health / 317
Abbreviations Related to the Nervous System / 322
CONTENTS ix
Chapter 11: Special Senses: The Eyes and Ears 334
Functions of the Eyes / 336

Structures of the Eyes / 336
Medical Specialties Related to the Eyes and Vision / 340
Pathology of the Eyes and Vision / 341
Diagnostic Procedures for Vision and the Eyes / 345
Treatment Procedures of the Eyes and Vision / 346
Functions of the Ears / 348
Structures of the Ears / 348
Medical Specialties Related to the Ears and Hearing / 350
Pathology of the Ears and Hearing / 350
Diagnostic Procedures of the Ears and Hearing / 352
Treatment Procedures of the Ears and Hearing / 352
Abbreviations Related to the Special Senses / 355
Chapter 12: Skin: The Integumentary System 366
Functions of the Integumentary System / 368

The Structures of the Skin and Its Related Structures / 368
Medical Specialties Related to the Integumentary System / 371
Pathology of the Integumentary System / 372
Diagnostic Procedures of the Integumentary System / 384
Treatment Procedures of the Integumentary System / 384
Abbreviations Related to the Integumentary System / 386
Chapter 13: The Endocrine System 397
Functions of the Endocrine System / 399

Structures of the Endocrine System / 399
The Pituitary Gland / 399
The Pineal Gland / 401
The Thyroid Gland / 401
The Parathyroid Glands / 402
The Thymus / 402
The Pancreas / 402
The Adrenal Glands / 403
The Gonads / 404
x CONTENTS
Medical Specialties Related to the Endocrine System / 405

Pathology of the Endocrine System / 405
Diagnostic Procedures Related to the Endocrine System / 411
Treatment Procedures Related to the Endocrine System / 412
Abbreviations Related to the Endocrine System / 413
Chapter 14: The Reproductive Systems 424
Terms Related to the Reproductive Systems of Both Sexes / 426

Functions of the Male Reproductive System / 426
Structures of the Male Reproductive System / 426
Medical Specialties Related to the Male Reproductive System / 428
Pathology of the Male Reproductive System / 428
Diagnostic Procedures of the Male Reproductive System / 430
Treatment Procedures of the Male Reproductive System / 430
Sexually Transmitted Diseases / 431
Functions of the Female Reproductive System / 432
Structures of the Female Reproductive System / 432
Terms Related to Pregnancy and Childbirth / 435
Medical Specialties Related to the Female Reproductive System
and Childbirth / 440
Pathology of the Female Reproductive System / 440
Pathology of Pregnancy and Childbirth / 443
Diagnostic Procedures of the Female Reproductive System / 444
Treatment Procedures of the Female Reproductive System / 445
Abbreviations Related to the Reproductive Systems / 448
Chapter 15: Diagnostic Procedures,

Pharmacology, and Complementary Medicine 460
Diagnostic Procedures / 462

Recumbent Examination Positions / 466
Laboratory Tests / 466
Endoscopy / 469
Centesis / 470
Biopsy / 471
Imaging Techniques / 471
Nuclear Medicine / 476
Pharmacology / 478
REVIEW SESSION CONTENTS xi
RS.1. An abnormally rapid rate of respiration RS.7. The abnormal development or growth of
usually of more than 20 breaths per minute cells is known as _______________________.
is known as _______________________. a. anaplasia
a. bradypnea b. dysplasia
b. eupnea c. hyperplasia
c. hyperventilation Non-Medication Prescriptions / 481
d. hypertrophy
d. tachypnea
Complementary and Alternative Medicine / 482
Medical Specialties
RS.8. Which Relatedistoa genetic
form of anemia Diagnostic Procedures, Pharmacology, and
RS.2. An abnormally slow heart rate of less Complementary
disorder? Medicine / 484
than 60 beats per minute is known as Abbreviations Related to Diagnostic Procedures, Nuclear Medicine, and
a. aplastic
_______________________. Pharmacology / 484
b. hemolytic
a. atrial fibrillation Learning Exercises / 486
c. megaloblastic
b. bradycardia The Human Touch: Critical Thinking Exercise / 497
d. sickle cell
c. palpitation
d. tachycardia RS.9. The processes through which the body
Comprehensive Medical
maintains a constant Terminology Review
internal environment 498
RS.3. The suffix _______________________ means are known as _______________________.
surgical fixation. a. hemothorax
Study Tips / 499
a. -desis b. homeostasis
Review Session Answer Sheet / 500
b. -lysis c. hypophysis
Simulated Medical Terminology Final Test Answer Sheet / 501
c. -pexy Reviewd.Session / 502
metabolism
d. -ptosis Review Session Answer Key / 511
RS.10. _______________________ is an inflammation
Simulated Final Test / 512
RS.4. The presence of glucose in the urine is of the myelin sheath of peripheral nerves,
known as _______________________. Simulated Medical by
characterized Terminology Final Test
rapidly worsening Answer Key / 521
muscle
a. albuminuria APPENDIX
weakness that can lead A 523
to temporary
Appendix A: Prefixes, Combining Forms, and Suffixes / 522
paralysis.
b. calciuria
A Appendix
amyl/o B: Abbreviations
a. Bell’s and Their Meanings / 534
palsycarbohydrate
starch,
c. glycosuria an- Appendix C: Terms Related
not, without
b. Guillain–Barré syndrometo Diagnosis, Pathology, and Procedures / 548
a- d. hematuriano, not, without, away from, negative ana- up, apart, excessive
-a noun ending an/o c. Lou Gehrig’s
anus, ring disease
ab-
RS.5. A collection of away from, negative, absent
pus within a body cavity is -an Index / 591 characteristic of, pertaining to
abdomin/o abdomen d. Raynaud’s disease
known as a/an _______________________. -ancy Flash Cards / state 626 of
-able capable of, able to andr/o male, masculine
abrad/oa., abras/o
cyst rub or scrape off RS.11. The term
aneurysm/o
_______________________ describes
aneurysm
abrupt/o broken away from angi/o weakness or wearing
blood away of body tissues
or lymph vessel
b. empyema
abs- away from anis/o and structuresunequal caused by pathology or by
c. hernia collection of pus
abscess/o ankyl/o disuse ofcrooked, bent, stiff
the muscle over a long period of
-ac pertaining to anomal/o irregularity
d. tumor time.
-acious characterized by ante- before, in front of, forward
acous/o, acoust/o hearing, sound anter/o a. adhesion before, front
RS.6.
acr/o
The grating sound heard when the
extremities (hands and feet), top,
ends of
anti- against
a broken boneextreme move together
point is known as b. ankylosis
anxi/o anxiety, anxious, uneasy
actin/o_______________________.
light aort/o c. atrophy aorta
acu/o sharp, severe, sudden ap- toward, to
a. closed reduction d. contracture
ad- toward, to, in the direction of -apheresis removal
aden/ob. amputation gland aphth/o ulcer
adenoid/o adenoids apic/o apex, tip
c. callus
adhes/o stick to, cling to ap-, apo- separation, away from, opposed,
adip/od. crepitationfat detached
adnex/o bound to append/o, appendix
adren/o, adrenal glands appendic/o
adrenal/o aque/o water
aer/o air, gas -ar pertaining to
af- toward, to -arche beginning
affect/o exert influence on areat/o occurring in patches or
-ago abnormal condition, disease circumscribed areas
agor/a marketplace areol/o little open space, space around the
-agra excessive pain, seizure nipple
-aise comfort, ease -aria connected with
-al pertaining to arter/o, arteri/o artery
alb/o, albin/o white arthr/o joint
albumin/o albumin, protein articul/o joint
alg/o, alges/o
Editorial reviewpain, relationship
has deemed to pain
that any suppressed -ary
content does not materially affect pertaining
the overall learning experience. to reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Cengage Learning
PREFACE
TO THE LEARNER
Welcome to the world of medical terminology! Learning this special language is an important
step in preparing for your career as a health care professional. Here’s good news: learning medical
terms is much easier than learning a foreign language because you are already familiar with quite
a few of the words, such as appendicitis and tonsillectomy. Understanding new words becomes
easier with the discovery that many of these terms are made up of interchangeable word parts
that are used in different combinations. Once you understand this, you’ll be well on your way to
translating even the most difficult medical terms, including words you have never seen before.
You’ll be amazed to see how quickly your vocabulary will grow!
This book and the accompanying learning materials are designed to make the process as
simple as possible. Review the “How to Use This Book” section so you can find your way around
easily. Once you become comfortable with the format, you’ll discover you are learning faster than
you ever imagined possible.
CHAPTER ORGANIZATION
The text is designed to help you master medical terminology. It is organized into 15 chapters, the
Word Part Review, the Comprehensive Medical Terminology Review, three appendices, an index,
and removable flashcards. To gain the most benefit from your use of this text, take advantage of
the many features, including the Learning Exercises plus the Human Touch stories and discussion
questions that are included at the end of each chapter.
Primary terms are the most important terms in a chapter. When first introduced, the term
appears in boldface and, if appropriate, is followed by the “sounds-like” pronunciation. Only
primary terms are used as correct answers in the exercises and tests.
Secondary terms appear in orange italics. These terms, which are included to clarify the
meaning of a primary term, are sometimes used as distracters, but not as correct answers, in
exercises or tests.
Each chapter begins with a vocabulary list consisting of 15 word parts and 60 medical terms
selected from among the primary terms in the chapter. Note: If your instructor is using the Simplified
Syllabus version of this course, these are the terms that you will be expected to learn for all quizzes,
tests, and exams.
xiii

xiv PREFACE
Introductory Chapters and Word Part Review

Chapters 1 and 2 create the foundation that enables you to master the rest of the book. Chapter
1 introduces key word parts—the building blocks of most medical terms.
Chapter 2 introduces more word parts and provides an overview of basic terms used
throughout the medical field, as well as some of the many career options open to you in
health care.
After studying these chapters, complete the Word Part Review that follows Chapter 2. These
practice activities and the accompanying test will help you determine whether you’ve mastered
the concept of these all-important building blocks. If you are having trouble here, it is important
to put more effort into learning these basics.
Body System Chapters

Chapters 3 through 14 are organized by body system. Because each body system stands
alone, you can study these chapters in any sequence. Each chapter begins with an overview of
the structures and functions of that system so you can relate these to the medical specialists,
pathology, diagnostics, and treatment procedures that follow.
Chapter 15 introduces basic diagnostic procedures, examination positions, imaging techniques,
laboratory tests, nuclear medicine, and pharmacology. It also includes a section on alternative
and complementary medicines. This chapter can be studied at any point in the course.
Comprehensive Medical Terminology Review

This section, which follows Chapter 15, is designed to help you prepare for your final examination.
It includes study tips, practice exercises, and a simulated final test; however, be aware that none
of these questions are from the actual final test.
Appendices
Appendix A: Prefixes, Combining Forms, and Suffixes is a convenient alphabetic reference
for the medical word parts. When you don’t recognize a word part, you can look it up here.
Appendix B: Abbreviations and Their Meanings is an extensive list of commonly used
abbreviations and their meanings. Abbreviations are important in medicine, and using them
accurately is essential!
Appendix C: Terms Related to Diagnosis, Pathology and Procedures gives the definitions
of all the primary terms in the text relating to diagnosis, pathology, and medical procedures.
Instructor & Student Resources

The following resources are included with your textbook to provide even more help as you study.
◾ Flashcards. Improve your knowledge and test your mastery by using the flashcards provided in
the last section of the book. Remove these perforated pages carefully and then separate the cards.
Flashcards are an effective study aid for use even when you have only a small amount of time.
◾ Additional Online Resources. Additional instructor and student resources for this product
are available online. Instructor assets include an Instructor’s Manual, Educator’s Guide,
PowerPoint® slides with art and answer keys, and a test bank powered by Cognero®, as well as a
transition guide, correlations to two exams, and spreadsheets detailing media assets, time on
task, and MindTap customization. Student assets include PowerPoint® slides with art. Sign up
or sign in at www.cengage.com to search for and access this product and its online resources.
PREFACE xv
CHANGES TO THE NINTH EDITION

New techniques and terminology were carefully and thoroughly researched to make this latest
edition as up-to-date as possible. Terms that are no longer in common use have been eliminated,
and countless new terms and definitions have been added.
A detailed conversion guide that helps instructors make the change from the eighth to the
ninth edition is available on the at http://www.cengage.com. A brief summary of some of the
changes follows:
◾ Chapter 2: New section on advance directives
◾ Chapter 3: Expanded section on medications
◾ Chapter 6: Added COVID-19; new Human Touch story
◾ Chapter 8: Expanded dental procedures; added new section on nutrition support
◾ Chapter 12: New section on viral skin infections
◾ Chapter 13: Expanded coverage of diabetic pathology and treatment
◾ Chapter 14: New section on gender identity
◾ Chapter 15: Chapter title changed to Diagnostic Procedures, Pharmacology, and
Complementary Medicine; new sections on stool analysis and durable medical equipment
ABOUT THE AUTHORS
CAROL L. SCHROEDER, UNIVERSITY OF WISCONSIN

Carol L. Schroeder has over 20 years of experience in finding innovative ways to present medical
terminology at a level appropriate for this text’s readers. Her background in technical writing,
translating, and research is invaluable in continuously updating the content and in creating
innovative activities and approaches—such as the Simplified Syllabus and Human Touch stories—
that enable instructors to present engaging courses that help all students succeed.
LAURA EHRLICH, UNIVERSITY OF ROCHESTER

SCHOOL OF NURSING
Laura Ehrlich, a registered nurse, enjoys the fast-paced, challenging environment of the
emergency department as well as the knowledge that her skills save lives. She excels at explaining
medical terminology to patients and training other nurses on new procedures, equipment, and
technology. She is also a board-certified emergency nurse (CEN).
KATRINA SCHROEDER SMITH,

BOSTON CHILDREN’S HOSPITAL
Katrina Schroeder Smith is a registered dietitian who trained and works at Boston Children’s
Hospital, a Harvard Teaching Hospital. After finishing her dietetic internship at Simmons College,
she completed the prestigious LEAH (Leadership Education in Adolescent Health) Fellowship in
the adolescent department at Boston Children’s Hospital. Currently she is a clinical dietitian in
the adolescent clinic there, specializing in the nutritional care of young adults with HIV, eating
disorders, elevated body weight, and polycystic ovarian syndrome (PCOS). She also writes guides
and blogs for the Center for Young Women’s Health and runs a small private practice in Brookline,
Massachusetts.
ANN EHRLICH, GODDARD COLLEGE

Ann Ehrlich, who founded this series in 1988, was an experienced teacher, professional author and
lifelong student. Considered one of the leading experts in the field of medical terminology, she
wrote numerous books on such health topics as dental assisting, practice management, speech
therapy and lymphedema.
xvi
ACKNOWLEDGEMENTS
Medical Terminology for Health Professions recently celebrated its 30th anniversary as one
of the leading texts in the healthcare field. We are honored to carry on the work that Ann Ehrlich
started in the 1980s, following her high standards for continuously updating every aspect of the
book’s content and the accompanying instructional materials.
We are very grateful for the input of the many reviewers and instructors who volunteer
feedback, all of whom are an invaluable resource in guiding this book as it evolves. Their insights,
comments, suggestions, and attention to detail are very important in making the text, and its
many resources, up-to-date and accurate. Special thanks to Adam Lindsey, Ben Ehrlich, and Elise
Anderson for their input on this edition. We would each especially like to thank our families for
their support throughout the research, writing, and editing process.
Thanks also to the editorial and production staff of Cengage Learning for their very
professional and extremely helpful assistance in making this revision possible, especially our
editors, Deb Myette-Flis and Laura Stewart. We are very fortunate to have had Deb Myette-Flis
providing her expertise to this project for the past six editions.
Please note that a portion of the royalties for this textbook provide scholarships for
lymphedema therapists, helping to address a nation-wide shortage in this field.
Carol L. Schroeder,
Laura Ehrlich, and
Katrina Schroeder Smith
REVIEWERS
Raymond A. Faber, Ph.D. Melinda Rhynes

Professor of Biology Program Director and Practicum Coordinator
Medical Assisting
Dr. Kimberly Head
Director of Healthcare Programs - CE Health Marketa Schublova, Ph.D., LAT, ATC, DNSET
Sciences Athletic Trainer
Associate Professor, Exercise and Rehabilitative
Rachel Houston, B.S., CMA (AAMA) Sciences
Program Chair, Medical Assisting
Becky Skudlarek, RHDS
Irene Kokkala, M.Sc., Ph.D. Medical Office/Medical Scribe Instructor
Director and Professor of Biology
xviii
HOW TO USE THIS BOOK CHAPTER 3
THE SKELETAL
SYSTEM
Medical Terminology for Health Professions, Ninth Edition, is

designed to help you learn and remember medical terms with
Overview of
surprising ease. The key lies in the following features. STRUCTURES, COMBINING FORMS, AND FUNCTIONS
OF THE SKELETAL SYSTEM
Major Structures Related Combining Forms Primary Functions
BODY SYSTEM OVERVIEW

Bones oss/e, oss/i, oste/o, ost/o Act as the framework for the
body, protect the internal
organs, and store calcium.
Bone Marrow myel/o (also means spinal cord) Red bone marrow helps form red
blood cells. Yellow bone marrow 57
stores fat. STEM
L SY
Cartilage chondr/o ELETAsurface for
Creates aKsmooth
The first page of each body system chapter is a chart giving THE Swithin the joints and
motion
protects the ends of the bones.
Joints arthr/o Work with the muscles to make a
an overview of the structures, related combining forms, and Ligaments ligament/o
variety of motions possible.
Connect one bone to another.
EM
functions most important to that system. Synovial Membrane
SYST
synovi/o, synov/o Forms the lining of synovial joints
ETAL
-sis)
HROH
and secretes synovial fluid.
SKEL synovi/o, synov/o
)
-ar-Tmakes -poy-
et-ick
THE
Synovial Fluid
s (hem that A
Lubricant
H-toh
smooth
to hrosijoint movements
hee-M possible.
te d h emart c (
Rela Bursa burs/o □ ti
topoieCushions areas subject to friction -ee-o
h -
ulary hema tionmovement. tis (id
Vocab al fixa arthri
ical during
d med □
intern iodiopathic -tis)
arts an portan
t
w ord p im □ n il e R IG H
VOCABULARY LIST
tial oth er ju ve -TH
essen d the ughou
t
-ick ar )
st con
tains ese an ce thro
□
PATH H-sis) h-mee
This li ter. Th oldfa ye-FO CK-to
is chap n in b pear in osis (k (lam-ih-NE
for th e show hich ap rms. kyph y
terms s ar s , w ar y te □ e ct o m is )
ry term ondary term ing of prim lamin (lor-DOH-s
prima Sec mean □ sis AY-go
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apter. y the lordo um-B h-lus)
the ch 56 alics, clarif □ ago (l -LEE-o m)
lumb
The second page of each chapter is a 75-item vocabulary ora n ge it
t s
□
m a ll e olus (m
m (m
ah
ah - NEW-b alz)
ree-u
d P a r t, st if f □
anu b ri u h - KAR-p z)
W o r d , ben m (m et-a R -s al
list. This list includes 15 key word parts with their ankyl
/o cr
o o
t
ke □
meta
carp a
rsals
ls
(met-a
h-TA
H
y-eh-
LOH-m
ah)
□ o join □
etata ma (m
arthr/ a il ag e m
le m ye lo k)
meanings and 60 important terms for the chapter with □
burs/o
burs
dr/i, ch
ondr/
o cart
□
□
multip
fractu
re (or-th
oh-PE
E-dic
rgeon
□
chon open ic su
rib □ ped -ick)
ortho
their pronunciations. This immediately alerts you to the
□
cost/o skull THOT -tis)
togeth
er □ tic (or- YE-tis
)
RIGH
ortho
□ o
-ar-TH
)
crani/ d, tie -tee-E -mah
□ si s to bin p
□
st e it is (oss (oss-tee-oh -kon-DROH h)
key terms in the chapter and acts as a review guide. Next □
-d e
kyph
/o b en t, hu
e, sw
m
ayb ac k, bent
ac k
□
o
oste o art hritis
n d ro ma ( o ss -t ee-oh
h -m ah-L A Y -s
E
hee-a
-t is )
□ curv , lower marrow
b □ cho ss-tee
-o
y-eh-
LY
lord/o osteo cia (o
mbar -oh-m
to each term is a box so you can check off each term when □
58 □CHAPTER
/o lu
Lumb 3 inal cord
, bone
bone
□
osteo
mala
litis (o
ss-tee
-PEE
-nee-a
h)
OH-sis
)
ye l/ o sp /o , o ste/o □
o st eomye (oss-tee-oh o h - R ah-
m /i , ost n , □ e n ia -o h-p -oh-p
you’ve learned it. □
□
oss/e
o li
, o
/o
ss
cu rv ed , ben
ra
t
e, ve rt eb ral co
lu m
□
oste
o st
o p
eopo ro si s (oss
h ip
-t ee
fract u re (oss-t
ee
sc vert eb c
yl/o brane, □ poroti
osteo
□
LEARNING spond
one
OBJECTIVES ovial
mem □ ck) J-its)
□
backb o syn ROT-i se (PA
/o , synov/ g e t’ s disea re (per-k
you-
On completion synoviof this u chapter,
id you should be able to: Pa
g ic fractu plasty
□
synovi
al fl □
patho
lo
u s ve rtebro h-plas-tee)
neospecialists ee-bro treat
LEARNING OBJECTIVES
□
1. Identify and describesthe major functions um) and 4. Identify the rcuta
pemedical VER-t who
althe rm
Teskeletal -you-l □ ee-us -ah-tri
st)
y-AL-j
ee-
-TAB -DYE
Medic bulum (ass-eh -ick)
structures of system. disorders ofTthe AY-n skeletal hsystem. ol-ee-m
O H -sing d ia tr ist (po u m a tica (p
2. Describe athree ceta types JE N
ofh-joints. ih- L 5. Recognize, o
pdefine, e
ia rhand pronounce the
spell,
enic (
al-o (ang-k □ myalg ih-kah)
□
allogbetween ylitis
ondaxial primary□terms poly related to-t the pathology h-ee)
3. Differentiate g spthe and roo-M
A E-sis) and H-pat
□ ylosin YE-tis)
ankskeletons. ah s-THE u-LO
E -s is) the diagnostic and s (pro procedures
treatment
si ick-yo of yd ar-
The beginning of each chapter lists learning objectives to help appendicular
□ ih -L
spon-d s (ar-throh -koh-pee)
desi ROS
-D E
the skeletal □ system.
p rosth
e
ulopa
th y (rah-d
tis (R
O O -m ah-to
arthro opy (ar-TH radic arthri

uss) - □ atoid
L-uh-g ler neh rheum
you understand what is expected of you as you read the text and □
□ lo
sc
arthro us (aw-TO
g o s (a y-VAS
-cue- □
T H RIGH
-tis)
ts )
auto ecrosi ICK-e )
OH-sis -dah)
STRUCTURES □
avasc
AND ular n The Tissues of rick Bone
ets (R h-lee-
complete the exercises. These objectives are set off with a FUNCTIONS □ OF KROH THE
-sis)
o w transp
lant Although
h ee
□
-ah) it is a□dense scoand
s (sko
liosirigid
if id (SPY-nboneOis
atissue,
ah BIF
N
-ih
H-s is)
also
rr b -
SKELETAL SYSTEM bone
ma ah
-s
-LAYcapable of growth, healing, spina andnoreshaping si
h
s (ste itself EE-sis
)
colored bar for easy identification. □
call u s ( K AL-u s)
a( k
malaciboneumarrow,
o n -d roh -m
M-ih - n e w t-ed )
(Figure 3.1).
□
sp in a l ste
l fract
ure n-dih
-loh-l
iss-TH
re (KO is (spo OH-sis)
□
The skeletal system consists □ of thero
chond
bones,
fr a ct ) spira list h es L
uted RIGH
-tis □
spond
ylo -dih -
hun)
inmembranes, (spon
cartilage, joints, ligaments, □ synovial ure
synovial
comm n fract -toh-kon-D ylosis SAY-s )
fluid, and bursae. This □ ressio (kos
□
spond -luck- h-mee
body system comp hasnmany tisimportant un) n (sub h-VECK-to
□ o ch o dri h -T AY-sh rp -shee
- □
b lu xatio in -o
functions: cost -i so su (s
□ ti o n (krep m e tr y (ab -
□ o ve ct omy -b ra y)
pitabody. bsorptio syn -teh
(VER
ART PROGRAM
■■ Bones act as the frameworkcr ofethe Articular cartilage brae
-ray a
□
□
dual x -tre e) verte
■■ Bones support and protect □ the internal
OM-e
h organs. h-lus) □
s ( E M-bo
bolu ) Proximal
fat em ligaments, -guss Red bone marrow
■■ Joints work in conjunction with muscles, and
WT) s VAL epiphysis
tendons, making possible□the wide t (GO of body
gouvariety L-uck
Amove-
□ valgin us (H
ments. (Muscles and tendons allux
arehdiscussed Chapter 4.)
Our art program includes hundreds of photos and full-color □
■■ Calcium, a mineral required for normal nerve and Spongy bone
(contains red marrow)
muscle function, is stored in bones.
illustrations that help clarify the text and contain important ■■ Red bone marrow, which plays an important role in the
formation of blood cells, is located within spongy bone.
additional information. Review each illustration and read its Medullary cavity
Artery
The Formation of Bones
caption carefully for easy and effective learning. A newborn’s skeleton begins as fragile membranes and Compact bone tissue
cartilage, but after three months it starts turning into bone Diaphysis
Endosteum
in a process called ossification (oss-uh-fih-KAY-shun),
which continues through adolescence. Yellow bone marrow
Even after growth is completed, this process of new
bone formation continues as osteoclast cells break down
old or damaged bone and osteoblast cells help rebuild
Periosteum
the bone. Ossification repairs the minor damage to the
skeletal system that occurs during normal activity and also
repairs bones after injuries such as fractures.
THE STRUCTURE OF BONES

Distal
Bone is the form of connective tissue that is the second epiphysis

hardest tissue in the human body. Only dental enamel is xix
harder than bone. FIGURE 3.1 Anatomic features of a typical long bone.
similar muscular dis
orders in which the
functio reitiswas
then.Greek for word for cuckoo, because a loss of
thought
■■ An occ that its shape resembled a cuckoo’s beak.
upational therapist Pubic bone
(OT) helps enable
patients to participat
xx
lifeThe
HOW TO
Pelvis USE
e in the THIS
activit BOOK
ies of dai ly
, including self-care,
education, work, or Head
inteThe
raction
pelvis socialinter- Acetabulum
. , also known as the bony pelvis, protects
■■ A phnal
ysiorgans
atristand supports the lower extremities. In addition
(fiz-ee-AT-rist) is a Femoral neck
to the sacrum and coccyx, phythe
it includes sicipelvic
an whgirdle
o ,
specia lizes in physical me
dic
atine
theand reh
witha the
cup-shaped ring of bone
focus on
lower end
abioflita
the trunk
tion
consisting of theres toring
ilium, functio
ischium, n. Reh
and pubisabi
(Figures
litatio3.12 Femur
is restoration, follow n
through 3.14). ing disease, illness,
the ability to functio or injury,
of
4 n-ee-um)
ER(ILL in a noris
104
ma CHAPT
■■ The
nner.
ilium ma l orbroad,
the near-nblade-shaped
ormal
bone that forms the back and sides of the pubic “SOUNDS-LIKE” PRONUNCIATION SYSTEM
FIGURE 3.13 Structures of the proximal end of the femur
also
A physica
■■
l therapist (PT) provid ■■
-per-kye-NEE-zee-ah),
and the acetabulum (hip socket).
Hyperkinesia (high
bone. nective eased mus-
disabili
skin tythat urs when normally trea
occore
or sacroiliac
rest
es elastmetic con
nt to prevent known as hypera(assctivity, is abnormally incr
■■ The fun(ctio
say-kroh-
n thro ILL -ee-ack) tissu
is the es. The
slightly ■■ The acetabulum -eh-TAB-you-lum),exce alsossiv e, kines
known
heat,tissu
mamovable
ssa areor
es ge, repl aced with non ugh
elas tic
the fibr
useous
of exe rcise, as
The
func
clethe hip
sounds-like
tion or acti
socket vity (hyp pronunciation
er- mea ns
, is the large circular cavity inn).
each
system makes pronunciation easy by
other techni
articulation between s. the
quetrac turesacrum and
s are scar ring or
pos- ns con ditio
cau ses of con nt, and -ia meawith
■■ A spo mos com
rtsterior mon
tme portion of the ilium (sacr/o means sacrum,
dicine physi cia obil izat ion or inactivity. ili
side respelling
meaof mov
nsthe emethat
pelvis the word with
articulates syllables
the head of the you can understand—and say—at a
the due to imm n spe
use and -ac means pertaining
lack ofilium, cia lizes into).
the femur to form the hip joint (Figures 3.12 through 3.14).
preven means
tion and treatme nt oftion
dica inju(ries
klawof-dih the-KAY
bon
-shun) glance.
Myast avis pronounce the term just as it appears in parentheses,
Simply
henia Gr
join
■■ts,Inte
■and rmi tten
ischium t clau
(ISS es, )
■ The mu scles for -kee-um),
athmus
lete s
which forms
occ urs the
durlower
ing exer- THEE-nee-ah GRAH-vis) (MG
individ (IC)
ual s. pain in
is
posterior the leg
portion
and
cles that
oth
of the pubic bone, bears
er activethe ns
weight
comof- Myasthe accenting
nia gravis (my the
-as-syllables as
cts
follows:
the neuro-
rmi tten t mea dise ase that affe
cise theandbodyis relie
when ved by rest. Inte
sitting. is a chronic autoimmune
ns s the mus cle
ing g at inte rval s, and clau dica
goin (PEW-bis), which forms the anterior por-
andpubis
tion mea
mus
Primary
Pelvic◾bones
cular junc tion (where (strongest)
the neu ron acti accent:
vate capital letters and bold type
■ The circula- and rapid fatigue of
PATH O
■
LO n, which is due to poor uce s wea kne ss
limptioning. G
This
of the Y conditio
pubicObone,
F TH E
is located just below the dise urinary
ase to contract) and
◾ Secondary
prod
ciallaccent:
y in the eye, lowercase
face and thro letters and bold type
at.
M U SCtion, is associated with peri
Ubladder.
LA R SY ST EM phe ral vasc ular
voluntary muscles, espe wing, talk-
5). and eyel id mov eme nt, facial expression, che
■(see Chapter Eye
Fibers, Fascia, any ■ At birth, the ilium, ischium, and pubis are three sepa-
contraction of ing are ofte n affe cted by this condition.
is an involuntary
d
sudTe
dennd, matures, ing, and swa llow
spasm
■■ A rate bones. As the child onsrepethese bones fuse to n
ated spasm, ofte cle weakness (my means
muscle,
Myasthenia means mus
Fas ciitisone is a tic bones, which are held
WORD PARTS
■■ . Apubic
fasor
(form h-eethe
mor e mus
-left
EY -tiscles
Eand right
) is infl of strength ). Gravis
amma tion nts are dif- kness or lack
and -asthenia means wea
se movof a eme fasc ia Femur
(fasci means securely
fascgia, eyel
together
the ids
by theor face
pubic . Thesymphysis. A symphysis
invo lvin and -iti s means infl am ma tion ). the Latin wor d mea ning grave or serious.
Note the dou is able
ficu ltplace imp
or“ii” where
ossi
tha twoto
ble control
bones are. closely joined. comes from
t res ults from the suffix -itik, involuntary
being add -nu-bik s) is SIM quics is the
the -fih-sis)
■■ ed
■■ Myo The pubic
toclonthe uswosymphysis
(my
rd roo -OK -luh
t fas(ci PEW Because word parts are so important to learning medical terminology,
■■ Fibrom cartilaginous
yaljerk
giaing of a-brmus joint or grou
clethat
.
unites p of the musleftcles
my/o means
and(right pubic Muscular Dystrophy
(figh oh-my-AL-jee-ah) on, -us is a sin- whenever a term made as muscu uplarofdys trophyparts is introduced, the definition is
word
means violent acti is aand ly known
bilitating chr bones.
mus onicle,c conclon de- The condition common
dition characterized may occur normally erly refe rred to in the plural,
s a parts highlighted in magenta and
diffuse or spe ending) . Myo clon us by fati gue ; (DISfollowed
-troh-fe e) (MD ) is prop
(in parentheses) by the ribe word
gula cifi munscle
r cnou , joint, or bone pai theand jerkas, shakes, or ies. This general term desc
as n;
wide range as a pers on is falling asleep or which is muscular dystroph
of oth er sym ptoms (fibr/o me gica l diso rder such defined.
Patella etic dise ases that are cha racterized
tissue, my me spa anssms Sacrum
resu lting from a neurolo ans fibrous group of more than 30 gen
mu scle, and -algia meditio n, or a response to eneration of the skeletal
degPatellar
Debilitatingasme epil eps y, a metabolic con ans pain). by progressive weakness and ligament
ans a condition causing titive contraction of the
is a repeweakness. mov eme nt, with out affecting the ner-
■■ Tenosynov medication. Clonus muscles Tibiathat control
itis (ten-oh-sin-oh-VY ankles associated with cerebral specific trea tme nt to stop or reverse
cles of the knees or E-tis) is an vous system. There is no
inflammationmus of the sheath surrou sclerosis, and other neurological
palsy, stroke, mul tiple ndi ng a tendon PRIMARY AND SECONDARY TERMS
Fibula
muscular dyst roph y. Two of the mos t common forms are:
the most
conditions. ■■ Duchenne muscul
ar dystrophy (DMD) is
), also kno wn as hicc ups , is
of mus cula r dyst roph y in children. This
Singultus (sing-GUL -tus comP
◾ monrimary
form termsboy are the most important medical words in a chapter.
s with onset between the
■■Ilium Coccyx er-
m that causes the charact condition affects primarily
myoclonus of the diaphrag so
rapidlyappears
each spasm. When first introduced,
ages of 3 and 5 years. The
disorder progthe ressesterm in boldface and, if appropri-
istic hiccup sound with
Pubis Acetabulum ble to walk by age 12
spa sm ofte n e chil dren are una
■■ A cramp is a pain ful loca lize d muscle that ate,
most is
Malleolus of followed by the sounds-likease.
thes
dise pronunciation. These are the words
- difficulties and heart
menstrual cramps or writ later develop breathing
ed for its cause, such as and
Tarsal bones Metatarsals
namIschium p, students need to concentrate on
sim ilarlearning.
to, Only primary terms are
se is a slang term for a cram ■ Becker muscular dys
trophy (BMD) is very
er’s cramp. A charley hor Pubic symphysis 1880s ■Calcaneus Phalanges
cula r dyst rophy.
FIGURE usu3.12 the leg,view
ally inAnterior that came into use
of the pelvis.
in the
FIGURE but
used
3.14less
seveasrecorrect
than, Duc answers in the exercises and tests.
hen ne mus
Lateral view of bones of the lower extremity.
among baseball players.
wryneck, ◾ Secondary terms appear orders in orange italics. These terms are included
■■ Torticollis (tor-tih
-KOL-is), also known as
traction of the neck
Repetitive Stress Dis
is a stiff neck due to spa smo dic con to clarify the meaning
rs (RSD), also ofkno
a wnprimary
as term. Although used as distracters
d toward the affected side
. Repetitive stress disorde of muscular con-
muscles that pull the hea CHAPTER 4 in eexercises, rde rs , are a
motion diso the secondary termsinare
vari ety
not used as correct answers in
repetitiv ed the
that result from repeated motions perform
LEARNING EXERCISES ditions exercises or tests. such as
Muscle Function or recr eati on
daily activities,
extreme course of normal work,
d-ee-kih-NEE-zee-ah) is frequently repeated
■■ Bradykinesia (bra es spo rts. The sym ptoms caused by these
nt (bra dy- mea ns slow, kin ons , nerv es, and joints.
slowness in moveme is motions involve muscles
, tend
-ia means condition). This the compression
means movement, and
MATCHING WORD PARTS 1
sym
Write the correct answer in the middle column.
one of the ptom s of Park inso n’s disease, which is LEARNING EXERCISES
■■ Compartment syn
dro me invo
els due
lves
to swe lling within the
of nerves and blood vess
ce created by the fascia
Definition Correct Answer Possible Answers
discussed in Chapter 10. compartme nt, an enc lose d spa
-cele
distortion in the arm or leg. This
-kih-NEE-zee-ah) is the
4.1. abnormal condition ________________________________________
fascia■ Dys
■ kinesia (dis fasci/o lting in Each that chapter
separates grou ps of muscles
includes 100 Learning Exercises in a variety of formats that
nt resu tight bandages or
4.2. ________________________________________
of volu ntar y mov eme by trau ma,
or impairment________________________________________ fibr/o bad, kines syndrome can be caused
4.3. fibrous tissue
jerky motions (dys - mea ns require a one- or two-word s such as run written answer. Writing terms, rather than
ning .
fragmented or________________________________________ casts, or repetitive activitie
-ia means condition).
4.4. hernia, swelling -ia
4.5.
means movement, and
movement ________________________________________ kines/o, kinesi/o
just circling a multiple-choice option, reinforces learning and provides
practice in writing and spelling the terms.
4.6. coordination ________________________________________ my/o
4.7. muscle ________________________________________ -rrhexis
4.8. set free ________________________________________ tax/o
4.9. tendon ________________________________________ tend/o
4.10. tone ________________________________________ ton/o
MATCHING MUSCLE DIRECTIONS AND POSITIONS
4.11. crosswise ________________________________________ lateralis
112 4.12. ring-like ________________________________________ oblique
HOW TO USE THIS BOOK xxi
THE MUSCULAR SYSTEM 121
THE HUMAN TOUCH: CRITICAL

THINKING EXERCISE
The Human Touch
CRITICAL THINKING EXERCISE
A real-life short story that involves patients and pathology,
along with related critical thinking questions, at the end of each
The following story and questions are designed to stimulate critical thinking through class discussion
chapter helps you apply what you are learning to the real world. or as a brief essay response. There are no right or wrong answers to these questions.
There are no right or wrong answers, just questions to get “Leg muscles save back muscles … Mandatory OSHA meeting Tuesday at noon. Bring lunch,”
states the company memo. Sandor Padilla, a 28-year-old cargo loader, sighs, “Third meeting this
you started thinking about and using the new terms you have year, and it’s not even June yet!” He has only two minutes to reach the tarmac. “Oh well, cargo
waits for no man,” he thinks as he jogs off to work.
learned. Sandor enjoys his job. It keeps him fit but lets his mind follow more creative avenues. Today, his
thoughts stray to his daughter Reina’s fifth birthday party, just two weeks away. “A pony or a
clown? Hot dogs or tacos?” he muses. Single parenting has its moments. As he is busy thinking
of other things, the heavy crate slips, driving him into a squatting position that injures his thigh
muscles. His cry of pain brings Janet Wilson, his supervisor, running to help.
The first aid station ices his leg to reduce swelling and pain. After the supervisor completes the
incident report, Sandor is taken to the emergency room. Dr. Basra, the orthopedic specialist on
call, diagnoses a tendon strain resulting in a torn left rectus femoris. A myorrhaphy is required to
treat this injury. After several days in the hospital, Sandor is sent home with a Vicodin prescrip-
tion for pain and orders for physical therapy sessions three times a week. He is not expected to
return to work for at least 90 days.
AirFreight Systems receives the first report of injury and compares it with the supervisor’s inci-
dent report. Ruling: Safety Violation. No Liability. Return to work in 30 days or dismissal.
Suggested Discussion Topics

1. On what basis do you think AirFreight determined that this was a safety violation?
2. Use lay terms to explain Sandor’s injury and the treatment that was required.
3. Sandor knows how to handle heavy loads safely; however, the crate may have slipped because
he was busy thinking about his daughter’s birthday party and not about his work. Could the
responsibility for this accident be considered negligence on Sandor’s part? Do you think Sandor
should be held responsible or is blameless in this situation?
4. It was determined that AirFreight was not responsible for the accident. Therefore, do you think
the company should take away Sandor’s job if he does not return in 30 calendar days?
13699_ch04_rev05.indd 121 29/09/20 11:44 AM
CHAPTER 1
INTRODUCTION
TO MEDICAL
TERMINOLOGY
Overview of
INTRODUCTION TO MEDICAL TERMINOLOGY
Primary Medical Terms rimary terms enable you to give priority to the most important
P
words in your study of medical terminology. These terms are
shown in black boldface.
Word Parts Are the Key n introduction to word parts and how they are used to create
A
complex medical terms.
Word Roots he word parts that usually, but not always, indicate the part of the
T
body involved.
Combining Form word root that has a vowel, usually the letter “o,” put on the
A
end before the addition of another word root or suffix.
Suffixes he word part attached at the end of word that usually, but not
T
always, indicates the procedure, condition, disorder, or disease.
Prefixes he word part attached at the beginning of word that usually, but
T
not always, indicates location, time, number, or status.
Determining Meanings on Knowledge of word parts helps decipher medical terms.
the Basis of Word Parts
Using a Medical Dictionary Guidelines to help make looking up terms online or in a medical
or Online Resource dictionary easier.
Pronunciation Learn how to pronounce words correctly using the “sounds-like”
pronunciation system and audio files.
Spelling Is Always Important A single spelling error can change the entire meaning of term.
Singular and Plural Endings Unusual singular and plural endings used in medical terms.
Basic Medical Terms Terms used to describe disease conditions.
Look-Alike, Sound-Alike Clarification of confusing terms and word parts that look or sound
Terms and Word Parts similar.
Using Abbreviations Caution is always important when using abbreviations.
2 CHAPTER 1
Vocabulary Related to THE INTRODUCTION TO MEDICAL TERMINOLOGY
This list contains essential word parts and medical □ fistula (FIS-chuh-lah)
terms for this chapter. These and the other important □ gastralgia (gas-TRAL-jee-ah)
primary terms are shown in boldface throughout □ gastritis (gas-TRY-tis)
the chapter. Secondary terms, which appear in □ gastroenteritis (gas-troh-en-ter-EYE-tis)
orange italics, clarify the meaning of primary terms. □ gastrosis (gas-TROH-sis)
□ hemorrhage (HEM-or-idj)
Word Parts □ hepatomegaly (hep-ah-toh-MEG-ah-lee)
□ hypertension (high-per-TEN-shun)
□ -algia pain, suffering □ hypotension (high-poh-TEN-shun)
□ -dynia pain □ infection (in-FECK-shun)
□ -ectomy surgical removal, cutting out □ inflammation (in-flah-MAY-shun)
□ -gram picture or record □ interstitial (in-ter-STISH-al)
□ hyper- excessive, increased □ intramuscular (in-trah-MUS-kyou-lar)
□ hypo- deficient, decreased □ laceration (lass-er-AY-shun)
□ -itis inflammation □ lesion (LEE-zhun)
□ -osis abnormal condition, disease □ malaise (mah-LAYZ)
□ -ostomy the surgical creation of an artificial □ mycosis (my-KOH-sis)
opening to the body surface □ myelopathy (my-eh-LOP-ah-thee)
□ pre- before, in front of □ myopathy (my-OP-ah-thee)
□ -plasty surgical repair □ natal (NAY-tal)
□ -rrhage bleeding, abnormal excessive fluid □ neonatology (nee-oh-nay-TOL-oh-jee)
discharge □ neurorrhaphy (new-ROR-ah-fee)
□ -rrhaphy surgical suturing □ otorhinolaryngology (oh-toh-rye-noh-lar-in-
□ -rrhea flow or discharge GOL-oh-jee)
□ -sclerosis abnormal hardening □ palpation (pal-PAY-shun)
□ palpitation (pal-pih-TAY-shun)
Medical Terms □ pathology (pah-THOL-oh-jee)
□ abdominocentesis (ab-dom-ih-noh-sen- □ phalanges (fah-LAN-jeez)
TEE-sis) □ poliomyelitis (poh-lee-oh-my-eh-LYE-tis)
□ acronym (ACK-roh-nim) □ prognosis (prog-NOH-sis)
□ acute □ pyoderma (pye-oh-DER-mah)
□ angiography (an-jee-OG-rah-fee) □ pyrosis (pye-ROH-sis)
□ appendectomy (ap-en-DECK-toh-mee) □ remission
□ arteriosclerosis (ar-tee-ree-oh-skleh-ROH-sis) □ sign
□ arthralgia (ar-THRAL-jee-ah) □ supination (soo-pih-NAY-shun)
□ colostomy (koh-LAHS-toh-mee) □ suppuration (sup-you-RAY-shun)
□ cyanosis (sigh-ah-NOH-sis) □ supracostal (sue-prah-KOS-tal)
□ dermatologist (der-mah-TOL-oh-jist) □ symptom (SIMP-tum)
□ diagnosis (dye-ag-NOH-sis) □ syndrome (SIN-drohm)
□ diarrhea (dye-ah-REE-ah) □ tenorrhaphy (ten-OR-ah-fee)
□ edema (eh-DEE-mah) □ tonsillitis (ton-sih-LYE-tis)
□ endarterial (end-ar-TEE-ree-al) □ trauma (TRAW-mah)
□ eponym (EP-oh-nim) □ triage (tree-AHZH)
□ erythrocyte (eh-RITH-roh-sight) □ viral (VYE-ral)
□ fissure (FISH-ur)
INTRODUCTION TO MEDICAL TERMINOLOGY 3
LEARNING OBJECTIVES
On completion of this chapter, you should be able to:
1. Identify the roles of the four types of 5. Use the “sounds-like” pronunciation system
word parts used in forming medical and audio files to correctly pronounce the
terms. primary terms introduced in this chapter.
2. Use your knowledge of word parts to analyze 6. Recognize the importance of spelling
unfamiliar medical terms. medical terms correctly.
3. Describe the steps in locating a term in a 7. State why caution is important when using
medical dictionary or online resource. abbreviations.
4. Define the commonly used word roots, 8. Recognize, define, spell, and correctly
combining forms, suffixes, and prefixes pronounce the primary terms introduced in
introduced in this chapter. this chapter.
PRIMARY MEDICAL TERMS ■■ Secondary terms appear in orange italics. Some of these
terms are the “also known as” names for conditions or
In this textbook, you will be introduced to many medical procedures. Other secondary terms clarify words used in
terms; however, mastering them may be easier than you the definitions of primary terms.
anticipate because Medical Terminology for Health
Professions has many features to help you learn.
Primary terms appear in boldface. Learning these
■■
WORD PARTS ARE THE KEY
terms should be your highest priority as only primary
terms are used as correct answers in the Learning Learning medical terminology is much easier once
Exercises and tests. you understand how word parts work together to form
■■ A vocabulary list with 15 essential word parts and 60 medical terms (Figure 1.1). This textbook includes
key primary terms (and their pronunciations) is at the many aids to help you reinforce your word-building
beginning of each chapter. skills.
-ology
ia
-os
-alg ab-
is
-itis
leu
rhin
k/o
-
pre-
/o-
neu
r/o-
gastr
/o - b-
su
hypo-
FIGURE 1.1 Word parts (word roots, combining forms, suffixes, and prefixes) make up most medical terms.
4 CHAPTER 1
■■ The types of word parts and the rules for their use are 3. A suffix usually, but not always, indicates the procedure,
explained in this chapter. Learn these rules and follow condition, disorder, or disease.
them. ■■ A suffix always comes at the end of the word.
■■ When a term is made up of recognizable word parts, these ■■ You’ll know a word part is a suffix when it is shown
word parts and their meanings are included with the defi- with a hyphen (-) in front of it. For example, the
nition of that term. These word parts appear in magenta. suffix -itis means inflammation.
■■ The majority of the word parts used in medical 4. A prefix usually, but not always, indicates location,
terminology are of Latin origin, some are derived from time, number, or status.
Greek, and a few are from other languages.
■■ A prefix always comes at the beginning of a word.
■■ The Learning Exercises for each chapter include a
■■ You’ll know a word part is a prefix when it is shown
“Challenge Word Building” section to help develop
with a hyphen (-) after it. For example, hyper-
your skills in working with word parts.
means excessive or increased.
■■ A Word Part Review follows Chapter 2. This section
provides additional word part practice and enables
you to evaluate your progress toward mastering the WORD ROOTS
meaning of these word parts. Word roots act as the foundation for most medical terms.
They usually, but not always, describe the part of the body
The Four Types of Word Parts that is involved (Figure 1.2). As shown in Table 1.2, some
The four types of word parts used to create many medical word roots indicate color.
terms are word roots, combining forms, suffixes, and
prefixes. Guidelines for their use are shown in Table 1.1.
1. A word root contains the basic meaning of the term.
In medical terminology, this word part usually, but not
Spinal cord
always, indicates the involved body part. For example, (myel/o)
the word root meaning stomach is gastr.
Bone
2. A combining form is a word root with a combining (oste/o)
Muscle
vowel added at the end. It is used when two word roots (my/o)
are combined or when a suffix beginning with a conso-
nant is added. When a combining form appears alone,
it is shown with a back slash (/) between the word root
and the combining vowel. For example, the combining
form of the word root gastr is gastr/o. Note: a, e, i, o, u,
and sometimes y are vowels. All the other letters in the
alphabet are consonants.
Nerve (neur/o)
TABLE 1.1
Word Part Guidelines Joint (arthr/o)
1. A word root cannot stand alone. A suffix must
always be added at the end of the word to
complete the term.
2. The rules for creating a combining form by

adding a vowel apply when a suffix beginning
with a consonant is added to a word root.
3. If a prefix is added, it is always placed at the

beginning of the word. FIGURE 1.2 Word roots, shown here as combining forms,
usually indicate the involved body part.
TABLE 1.2
Word Roots and Combining Forms Indicating Color
cyan/o means blue Cyanosis (sigh-ah-NOH-sis) is blue discoloration of the skin caused by lack of
adequate oxygen in the blood (cyan means blue, and -osis means abnormal condition
or disease).
erythr/o means red An erythrocyte (eh-RITH-roh-sight) is mature red blood cell (erythr/o means red, and
-cyte means cell).
leuk/o means white A leukocyte (LOO-koh-sight) is white blood cell (leuk/o means white, and -cyte
means cell).
melan/o means black Melanoma (mel-ah-NOH-mah) is a type of skin cancer (melan means black, and -oma
means a tumor).
poli/o means gray Poliomyelitis (poh-lee-oh-my-eh-LYE-tis) is viral infection of the gray nerve tissue
of the spinal cord (poli/o means gray, myel means spinal cord, and -itis means
inflammation).
Combining Forms Vowels joined with the suffix -plasty (surgical repair) or -rrhaphy
(surgical suturing), the combining vowel o is used because
A combining form includes a vowel, usually the letter
-plasty and -rrhaphy both begin with a consonant.
o, added to the end of a word root. It is usually added to
make the resulting medical term easier to pronounce. ■■ Neuroplasty (NEW-roh-plas-tee) is the surgical repair
The rules for the use of a combining vowel are as of a nerve.
follows: ■■ Neurorrhaphy (new-ROR-ah-fee) is suturing together
■■ When two word roots are joined, a combining vowel is the ends of a severed nerve.
always added to the first word root. A combining vowel A combining vowel is not used when the suffix begins
is used at the end of the second word root only if the with a vowel. For example, the word root tonsill means
suffix begins with a consonant. tonsils. No combining vowel is needed when adding either
■■ For example, the term gastroenteritis combines -itis (inflammation) or -ectomy (surgical removal) to
two word roots with a suffix: when gastr (stomach) tonsill, because they both start with a vowel (Figure 1.3).
is joined with the word root enter (small intes- These suffixes complete the term and tell us what is
tine), a vowel is used to make the combining form happening to the tonsils.
gastr/o. ■■ Tonsillitis (ton-sih-LYE-tis) is an inflammation of the
■■ The word root enter is joined to -itis without a com- tonsils.
bining vowel because this suffix begins with a vowel. ■■ A tonsillectomy (ton-sih-LECK-toh-mee) is the
Gastroenteritis (gas-troh-en-ter-EYE-tis) is an surgical removal of the tonsils.
inflammation of the stomach and small intestine.
Suffixes as Noun Endings

SUFFIXES A noun is a word that is the name of a person, place, or
thing. In medical terminology, some suffixes change
A suffix is always added at the end of a word to complete the word root into a noun. For example, the cranium
that term. In medical terminology, suffixes usually, but not (KRAY-nee-um) is the portion of the skull that encloses
always, indicate a procedure, condition, disorder, or disease. the brain (crani means skull, and -um is a noun ending).
A combining vowel is used when the suffix begins Suffixes that are commonly used as noun endings are
with a consonant. For example, when neur/o (nerve) is shown in Table 1.3.
6 CHAPTER 1
TONSILL + -ITIS = TONSILLITIS

(tonsil, tonsils) (inflammation) (inflammation of the tonsils)
FIGURE 1.3 The term tonsillitis is created by adding the suffix -itis to the word root tonsill.
Suffixes Meaning “Pertaining To” gastrosis (gas-TROH-sis) means any disease of the
stomach (gastr means stomach, and -osis means
An adjective is a word that defines or describes. In
abnormal condition or disease). Commonly used suffixes
medical terminology, many suffixes meaning “pertain-
meaning abnormal condition or disease are shown in
ing to” are used to change the meaning of a word root
Table 1.5.
into an adjective. For example, the word root cardi
means heart, and the suffix -ac means pertaining to.
Once combined, they form the term cardiac (KAR-dee- Suffixes Related to Pathology
ack), an adjective that means pertaining to the heart. Pathology (pah-THOL-oh-jee) is the study of all aspects
Commonly used suffixes meaning pertaining to are of diseases (path means disease, and -ology means study
shown in Table 1.4. of ). Suffixes related to pathology describe specific disease
conditions.
Suffixes Meaning “Abnormal ■■ -algia means pain and suffering. Gastralgia (gas-TRAL
Condition or Disease” -jee-ah), also known as a stomachache, means pain in
In medical terminology, many suffixes, such as -osis, the stomach (gastr means stomach, and -algia means
mean “abnormal condition or disease.” For example, pain).
■■ -dynia is another suffix meaning pain. Gastrodynia
(gas-troh-DIN-ee-ah) also means pain in the stomach
TABLE 1.3 (gastr/o means stomach, and -dynia means pain).
Although gastrodynia has the same meaning as
Suffixes as Noun Endings
gastralgia, it is not used as commonly (Figure 1.4).
-a -um -y ■■ -itis means inflammation. Gastritis (gas-TRY-tis) is an
-e -us inflammation of the stomach (gastr means stomach,
and -itis means inflammation).
■■ -megaly means enlargement. Hepatomegaly
TABLE 1.4 (hep-ah-toh-MEG-ah-lee) is abnormal enlargement of
Suffixes Meaning “Pertaining To”

TABLE 1.5
-ac -eal -ior
Suffixes Meaning “Abnormal Condition
-al -ical -ory
or Disease”
-an -ial -ous
-ago -iasis -osis
-ar -ic -tic
-esis -ion -pathy
-ary -ine -ia -ism
Abdominocentesis (ab-dom-ih-noh-sen-TEE-sis)
is the surgical puncture of the abdominal cavity to
remove fluid (abdomin/o means abdomen, and
-centesis means a surgical puncture to remove
fluid).
■■ -graphy means the process of producing a picture or
record. Angiography (an-jee-OG-rah-fee) is the
process of producing an x-ray, or radiographic study,
of blood vessels after the injection of a contrast
Krakenimages.com/Shutterstock.com
medium to make these blood vessels visible (angi/o
means blood vessel, and -graphy means the process of
recording).
■■ -gram means a picture or record. An angiogram
(AN-jee-oh-gram) is the resulting film that is produced
by angiography (angi/o means blood vessel, and
FIGURE 1.4 Gastralgia and gastrodynia are both terms
meaning stomach pain. -gram means a picture or record).
■■ -plasty means surgical repair. Myoplasty (MY-oh-
plas-tee) is the surgical repair of a muscle (my/o
the liver (hepat/o means liver, and -megaly means means muscle, and -plasty means surgical repair).
enlargement). ■■ -scopy means visual examination. Arthroscopy
■■ -malacia means abnormal softening. Arterio (ar-THROS-koh-pee) is the visual examination of the
malacia (ar-tee-ree-oh-mah-LAY-shee-ah) is the internal structure of a joint (arthr/o means joint, and
abnormal softening of the walls of an artery or -scopy means visual examination).
arteries (arteri/o means artery, and -malacia means
abnormal softening). Notice that -malacia is the
opposite of -sclerosis. The “Double R” Suffixes
■■ -necrosis means tissue death. Arterionecrosis (ar-tee- Medical terminology suffixes beginning with two of
ree-oh-neh-KROH-sis) is the tissue death of an artery or the letter r, often referred to as the double Rs, can be
arteries (arteri/o means artery, and -necrosis means particularly confusing. These word parts are of Greek
tissue death). rather than Latin origin. They are grouped together
here to help you understand them and to remember the
■■ -sclerosis means abnormal hardening. Arterio
differences.
sclerosis (ar-tee-ree-oh-skleh-ROH-sis) is the ab-
normal hardening of the walls of an artery or arteries ■■ -rrhage and -rrhagia mean bleeding; however, they are
(arteri/o means artery, and -sclerosis means abnor- most often used to describe sudden, severe bleeding. A
mal hardening). Notice that -sclerosis is the opposite hemorrhage (HEM-or-idj) is the loss of a large amount
of -malacia. of blood in a short time (hem/o means blood, and
-rrhage means bleeding or abnormal excessive fluid
■■ -stenosis means abnormal narrowing. Arteriostenosis
discharge).
(ar-tee-ree-oh-steh-NOH-sis) is the abnormal narrowing
of an artery or arteries (arteri/o means artery, and ■■ -rrhaphy means surgical suturing to close a wound
-stenosis means abnormal narrowing). and includes the use of sutures, staples, or surgical
glue. Tenorrhaphy (ten-OR-ah-fee) is the surgical
suturing of a tendon (ten/o means tendon, and -rrhaphy
Suffixes Related to Procedures means surgical suturing).
Some suffixes identify the procedure that is performed on ■■ -rrhea means flow or discharge and refers to the flow
the body part indicated by the word root. of most body fluids. Diarrhea (dye-ah-REE-ah) is the
■■ -centesis is a surgical puncture to remove fluid frequent flow of loose or watery stools (dia- means
for diagnostic purposes or to remove excess fluid. through, and -rrhea means flow or discharge).
8 CHAPTER 1
PRE NAT AL PRENATAL

+ (birth) (pertaining =
(before) (the time and events before birth)
to)
FIGURE 1.5 The term prenatal is created by joining the suffix -al to the word root nat and then adding the prefix pre-.
PREFIXES
A prefix is sometimes added to the beginning of a word
to influence the meaning of that term. Prefixes usually,
but not always, indicate location, time, or number.
See Table 1.6 for a list of prefixes describing direction,
quantity, size, and amount. The term natal (NAY-tal)
means pertaining to birth (nat means birth, and -al
means pertaining to). The following examples show
iStock.com/Chris Downie
how prefixes change the meaning of this term
(Figures 1.5–1.8).
■■ Prenatal (pre-NAY-tal) means the time and events
before birth (pre- means before, nat means birth, and FIGURE 1.6 The prenatal development of a fetus (baby).
-al means pertaining to).
■■ Perinatal (pehr-ih-NAY-tal) refers to the time and
events surrounding birth (peri- means surrounding,
nat means birth, and -al means pertaining to).
Szasz-Fabian Jozsef/Shutterstock.com
This is the time just before, during, and just after
birth.
TABLE 1.6
Prefixes Describing Direction, Quantity,
Size, and Amount FIGURE 1.7 A perinatal event of the umbilical cord being
cut immediately after the baby is born.
ab- away from, negative, ad- toward, to, in the
absent direction of
dextro- right side sinistro- left side

ex- out of, outside, away in- in, into, not, without
from
macro- large, abnormal micro- small

size, long
mega-, megalo- large, oligo- scanty, few

great
pre- before post- after, behind FIGURE 1.8 A happy postnatal moment as the parents
bond with their new baby.
■■ Postnatal (pohst-NAY-tal) refers to the time and ■■ As you separate the word parts, identify the meaning of
events after birth (post- means after, nat means birth, each. Identifying the meaning of each part should give
and -al means pertaining to). you a definition of the term.
Memory aid: you may know some prefixes already by ■■ Because some word parts have more than one mean-
using your prior knowledge and experiences. For example, ing, it also is necessary to determine the context in
a postgame press conference happens after a game, and a which the term is being used. As used here, context
preshow reception happens before a performance. means to determine which body system this term is
referring to.
■■ If you have any doubt, use your medical dictionary
Contrasting and Confusing Prefixes or a trusted online resource to double-check your
Some prefixes are confusing because they are similar in spell- definition.
ing but opposite in meaning. The more common prefixes of ■■ Be aware that not all medical terms are made up of
this type are summarized in Table 1.7.
word parts.
An Example to Take Apart

DETERMINING MEANINGS
Look at the term otorhinolaryngology (oh-toh-rye-noh-
ON THE BASIS OF WORD lar-in-GOL-oh-jee) as shown in Figure 1.9. It is made up
PARTS of two combining forms, a word root, and a suffix. This is
Knowing the meaning of the word parts often makes it how it looks when the word parts have been separated by
possible to figure out the definition of an unfamiliar working from the end to the beginning.
medical term. ■■ The suffix -ology means the study of.
■■ The word root laryng means larynx or throat. The
combining vowel is not used here because the word
Taking Terms Apart root is joining a suffix that begins with a vowel.
To determine a word’s meaning by looking at the compo- ■■ The combining form rhin/o means nose. The com-
nent pieces, you must first separate it into word parts. bining vowel is used here because the word root
■■ Always start at the end of the word, with the suffix, and rhin is joining another word root beginning with a
work toward the beginning. consonant.
TABLE 1.7
Contrasting Prefixes: Opposites
ab- means away from. ad- means toward or in the direction of.
Abnormal means not normal or away from normal. Addiction means being drawn toward or having a
strong dependence on a drug or substance.
dys- means bad, difficult, or painful. eu- means good, normal, well, or easy.
Dysfunctional means an organ or body part that is Eupnea means easy or normal breathing.
not working properly.
hyper- means excessive or increased. hypo- means deficient or decreased.

Hypertension is higher-than-normal blood pressure. Hypotension is lower-than-normal blood pressure.
inter- means between or among. intra- means within or inside.

Interstitial means between, but not within, the Intramuscular means within the muscle.
parts of a tissue.
sub- means under, less, or below. super-, supra- mean above or excessive.
Subcostal means below a rib or ribs. Supracostal means above or outside the ribs.
10 CHAPTER 1
OTORHINOLARYNGOLOGY
OT/O RHIN/O LARYNG -OLOGY
(study of the ears, = + + +
(ear) (nose) (throat) (study of)
nose, and throat)
FIGURE 1.9 To determine the meaning of a medical term, the word parts are separated working from the end of the word
toward the beginning.
■■ The combining form ot/o means ear. The combin- MEDICAL DICTIONARY USE
ing vowel is used here because the word root ot is
joining another word root beginning with a Learning to use a medical dictionary and other resources
consonant. to find the definition of a term is an important part of
■■ Together they form otorhinolaryngology, which is the mastering the correct use of medical terms. The following
study of the ears, nose, and throat (ot/o means ear, tips for dictionary use apply whether you are working with
rhin/o means nose, laryng means throat, and -ology a traditional book-form dictionary or with electronic dic-
means study of ). Note: laryng/o also means larynx and tionary software, websites, or applications on your com-
is discussed in Chapter 7. puter or handheld device.
■■ Because this is such a long term, this specialty is
frequently referred to as ENT (ears, nose, and throat). If You Know How to Spell the Word
■■ A shortened version of this term is otolaryngology When starting to work with a printed dictionary, spend
(oh-toh-lar-in-GOL-oh-jee), which is the study of the a few minutes reviewing its user guide, table of contents,
ears and larynx or throat (ot/o means ears, laryng and appendices. The time you spend reviewing now
means larynx, and -ology means study of ). will be saved later when you are looking up unfamiliar
terms.
On the basis of the first letter of the word, start in the ap-
Guessing at Meanings ■■
propriate section of the dictionary. Look at the top of the

When you are able to guess at the meaning of a term on page for clues. The top left word is the first term on the
the basis of its word parts, you must always double-check page. The top right word is the last term on that page.
for accuracy because some terms have more than one
■■ Next, look alphabetically for words that start with the
meaning. For example, look at the term lithotomy (lih-
first and second letters of the word you are researching.
THOT-oh-mee):
Continue looking through each letter until you find the
■■ On the basis of word parts, a lithotomy is a surgical term you are looking for.
incision for the removal of a stone (lith means stone,
■■ When you think you have found it, check the spelling very
and -otomy means a surgical incision). This meaning
carefully, letter by letter, working from left to right. Terms
is discussed further in Chapter 9.
with similar spellings have very different meanings.
■■ However, lithotomy is also the name of an examina-
■■ When you find the term, carefully check all of the
tion position in which a female patient is lying on her
definitions.
back with her feet and legs raised and supported in
stirrups. The term is used to describe this position be-
cause in the early days, this was the preferred position If You Do Not Know How to Spell
for lithotomy surgery. This term is discussed further in the Word
Chapter 15. Listen carefully to the term, and write it down. If you can-
■■ This type of possible confusion is one of the many not find the word on the basis of your spelling, start look-
reasons why a medical dictionary or trusted online ing for alternative spellings based on the beginning sound
resource is an important medical terminology tool. as shown in Table 1.8. Note: All of these examples are in
TABLE 1.8
Guidelines to Looking Up the Spelling of Unfamiliar Terms
If it sounds like It may begin with Example
F F flatus (FLAY-tus), see Chapter 8

PH phlegm (FLEM), see Chapter 7
J G gingivitis (jin-jih-VYE-tis), see Chapter 8

J jaundice (JAWN-dis), see Chapter 8
K C crepitus (KREP-ih-tus), see Chapter 3

CH cheilitis (kye-LITE-is), see Chapter 8
K kyphosis (kye-FOH-sis), see Chapter 3
QU quadriplegia (kwad-rih-PLEE-jee-ah), see Chapter 4
S C cytology (sigh-TOL-oh-jee), see Chapter 2

PS psychologist (sigh-KOL-oh-jist), see Chapter 10
S serum (SEER-um), see Chapter 5
Z X xeroderma (zee-roh-DER-mah), see Chapter 12

Z zygote (ZYE-goht), see Chapter 14
this textbook. However, you could practice looking them conditions and terms; however, it is important that you
up in the dictionary! rely on websites, such as the National Institutes of Health
(NIH) website (http://www.nih.gov), which are known to
Look Under Categories be reputable information sources.
Most printed dictionaries use categories such as Diseases ■■ For better results, an Internet search should include
and Syndromes to group disorders with these terms in visits to at least two reputable sites. If there is a major
their titles. For example: difference in the definitions, go on to a third site.
Sometimes search engine results will include a site
■■ Sexually transmitted disease would be found under
that is not necessarily trustworthy but has paid for
Disease, sexually transmitted.
good placement.
■■ Fetal alcohol syndrome would be found under
■■ Beware of suggested search terms. If you do not spell
Syndrome, fetal alcohol.
a term correctly, a website may guess what you were
■■ When you come across such a term and cannot find it searching for. Make sure to double-check that the term
listed by the first word, the next step is to look under you are defining is the intended term.
the appropriate category.
The same caution applies to medical dictionary
applications on handheld devices. Make sure that the
Multiple-Word Terms
application comes from a reputable source, and always
When you are looking for a term that includes more than double-check that this definition is for the term that you
one word, begin your search with the last term. If you do intended to look up.
not find it there, move forward to the next word.
For example, congestive heart failure is sometimes
PRONUNCIATION
■■
listed under Heart failure, congestive.

A medical term is easier to understand and remember
Searching for Definitions on the when you know how to pronounce it properly. To help you
Internet master the pronunciation of new terms, a commonly ac-
Online search engines such as Google are valuable re- cepted pronunciation of that word appears in parentheses
sources in finding definitions and details about medical next to the term.
12 CHAPTER 1
The sounds-like pronunciation system is used in alternative spellings used in other English-speaking
this textbook. Here the word is respelled using normal countries such as England, Australia, and Canada.
English letters to create sounds that are familiar. To
pronounce a new word, just say it as it is spelled in the
SINGULAR AND PLURAL
parentheses.
ENDINGS
■■ The part of the word that receives the primary (most)
emphasis when you say it is shown in uppercase bold- Many medical terms have Greek or Latin origins. As a re-
face letters. For example, edema (eh-DEE-mah) is sult of these different origins, there are unusual rules for
swelling caused by an abnormal accumulation of fluid changing a singular word into a plural form. In addition,
in cells, tissues, or cavities of the body. English endings have been adopted for some commonly
■■ A part of the word that receives secondary (less) used terms.
emphasis when you say it is shown in boldface ■■ Table 1.9 provides guidelines to help you better under-
lowercase letters. For example, appendicitis (ah- stand how these plurals are formed.
pen-dih-SIGH-tis) means an inflammation of the ■■ Also, throughout the text, when a term with an unusual
appendix (appendic means appendix, and -itis singular or plural form is introduced, both forms are
means inflammation). included. For example, the phalanges (fah-LAN-jeez)
are the bones of the fingers and toes (singular, phalanx)
(Figure 1.10).
A Word of Caution
Frequently, there is more than one correct way to pro-
nounce a medical term. BASIC MEDICAL TERMS
■■ The pronunciation of many medical terms is based on TO DESCRIBE DISEASES
their Greek, Latin, or other foreign origin. However,
Some of the medical terms that are used to describe dis-
there is a trend toward pronouncing terms as they
eases and disease conditions can be confusing. Some
would sound in English.
of the most commonly confused terms are described in
■■ The result is more than one “correct” pronunciation for Table 1.10. You will find that studying the groups of three
a term. The text shows the most commonly accepted as they are shown in the table makes it easier to master
pronunciation. these terms.
■■ If your instructor prefers an alternative pronunciation,
follow the instructions you are given.
LOOK-ALIKE, SOUND-ALIKE
TERMS AND WORD PARTS
SPELLING IS ALWAYS This section highlights some frequently used terms and
IMPORTANT word parts that are confusing because they look and
Accuracy in spelling medical terms is extremely sound alike. However, their meanings are very differ-
important! ent. It is important that you pay close attention to these
terms and word parts as you encounter them in
■■ Changing just one or two letters can completely
the text.
change the meaning of a word—and this difference
literally could be a matter of life or death for the
patient. arteri/o, ather/o, and arthr/o
■■ The section “Look-Alike, Sound-Alike Terms and Word ■■ arteri/o means artery. Endarterial (end-ar-TEE-ree-
Parts” later in this chapter will help you become aware al) means pertaining to the interior or lining of an
of some terms and word parts that are frequently artery (end- means within, arteri means artery, and
confused. -al means pertaining to).
■■ The spelling shown in this text is commonly ac- ■■ ather/o means plaque or fatty substance. An atheroma
cepted in the United States. You may encounter (ath-er-OH-mah) is a fatty deposit within the wall of an
TABLE 1.9
Guidelines to Unusual Plural Forms
Guideline Singular Plural
If the singular term ends in the suffix -a, the plural is usually formed by bursa bursae
changing the ending to -ae. vertebra vertebrae
If the singular term ends in the suffix -ex or -ix, the plural is usually appendix appendices
formed by changing these endings to -ices. index indices
If the singular term ends in the suffix -is, the plural is usually formed by diagnosis diagnoses
changing the ending to -es. metastasis metastases
If the singular term ends in the suffix -itis, the plural is usually formed by arthritis arthritides
changing the -is ending to -ides. meningitis meningitides
If the singular term ends in the suffix -nx, the plural is usually formed by phalanx phalanges
changing the -x ending to -ges. meninx meninges
If the singular term ends in the suffix -on, the plural is usually formed by criterion criteria
changing the ending to -a. ganglion ganglia
If the singular term ends in the suffix -um, the plural usually is formed by diverticulum diverticula
changing the ending to -a. ovum ova
If the singular term ends in the suffix -us, the plural is usually formed by alveolus alveoli
changing the ending to -i. malleolus malleoli
artery (ather means fatty substance, and -oma means

tumor).
Phalanges ■■ arthr/o means joint. Arthralgia (ar-THRAL-jee-ah)
(plural)
means pain in a joint or joints (arthr means joint, and
-algia means pain).
Phalanx
(singular) -ectomy, -ostomy, and -otomy
■■ -ectomy means surgical removal. An appendectomy
(ap-en-DECK-toh-mee) is the surgical removal of the
appendix (append means appendix, and -ectomy
means surgical removal).
■■ -ostomy means the surgical creation of an artificial
opening to the body surface. A colostomy (koh-LAHS-
toh-mee) is the surgical creation of an artificial excre-
tory opening between the colon and the body surface
(col means colon, and -ostomy means the surgical
creation of an artificial opening).
■■ -otomy means cutting or a surgical incision.
Pyelotomy (pye-eh-LOT-oh-mee) is a surgical
FIGURE 1.10 Singular and plural endings. A phalanx is incision into the renal pelvis to remove obstructions
one finger or toe bone. Phalanges are more than one fin- such as a kidney stone (pyel means the renal pelvis,
ger or toe bones. and -otomy means surgical incision).
14 CHAPTER 1
TABLE 1.10
Basic Medical Terms to Describe Disease Conditions
A sign is objective evidence of A symptom (SIMP-tum) is subjective A syndrome (SIN-drohm) is a set
disease, such as a fever. Objective evidence of a disease, such as pain of signs and symptoms that occur
means the sign can be evaluated or or a headache. Subjective means together as part of a specific
measured by the patient or others. that it can be evaluated or measured disease process.
only by the patient.
A diagnosis (dye-ag-NOH-sis) (DX) A differential diagnosis (D/DX), A prognosis (prog-NOH-sis) is a

is the identification of a disease also known as a rule out (R/O), prediction of the probable course
(plural, diagnoses). To diagnose is is an attempt to determine which and outcome of a disease (plural,
the process of reaching a diagnosis. one of several possible diseases is prognoses).
causing the signs and symptoms
that are present.
An acute condition has a rapid A chronic condition is of long A remission is the temporary,
onset, a severe course, and a duration. Although such diseases partial, or complete disappearance
relatively short duration. can be controlled, they are rarely of the symptoms of a disease
cured. without having achieved a cure.
A disease is a condition in An eponym (EP-oh-nim) is a An acronym (ACK-roh-nim) is a

which one or more body parts disease, structure, operation, or word formed from the initial letter
are not functioning normally. procedure named for the person of the major parts of a compound
Some diseases are named for who discovered or described it first. term. For example, the acronym
their signs and symptoms. For example, Alzheimer’s disease laser stands for light amplification
For example, chronic fatigue is named for German neurologist by stimulated emission of radiation
syndrome is a persistent, Alois Alzheimer (see Chapter 10). (see Chapter 12).
overwhelming fatigue of unknown
origin (see Chapter 4).
Fissure and Fistula example is meningitis (mening means the menin-

ges and -itis means inflammation), in which the
■■ A fissure (FISH-ur) is a groove or crack-like sore of the
cause of the inflammation is an infection. Another
skin (see Chapter 12). This term also describes normal
example is tendinitis (tendin means tendon and
folds in the contours of the brain.
-itis means inflammation). The inflammation of
■■ A fistula (FIS-chuh-lah) is an abnormal passage, usu- tendinitis is usually caused by overuse rather than
ally between two internal organs or leading from an infection.
organ to the surface of the body. A fistula may be due to
■■ An infection (in-FECK-shun) is the invasion of the
surgery, injury, or the draining of an abscess.
body by a pathogenic (disease-producing) organism.
The infection can remain localized (near the point of
Ileum and Ilium
entry) or can be systemic (affecting the entire body).
■■ The ileum (ILL-ee-um) is the last and longest portion Signs and symptoms of infection include malaise,
of the small intestine. Memory aid: ileum is spelled with chills and fever, redness, heat and swelling, or exudate
an e as in intestine. from a wound.
■■ The ilium (ILL-ee-um) is part of the hip bone. Memory ■■ Malaise (mah-LAYZ) is a word of French origin refer-
aid: ilium is spelled with an i as in hip (Figure 1.11). ring to a feeling of general discomfort or uneasiness
that is often the first indication of an infection or other
Infection and Inflammation disease.
■■ Although the suffix -itis means inflammation, it ■■ Exudate (ECKS-you-dayt) is any fluid, such as pus,
also is commonly used to indicate infection. An that leaks out of an infected wound.
Ilium
a part of the
hip bone
Ileum
a portion of the
small intestine
FIGURE 1.11 There is only one letter difference between ileum and ilium, but they are very different parts of the body.
■■ Inflammation (in-flah-MAY-shun) is a localized re- (myel/o means spinal cord or bone marrow, and
sponse to an injury or to the destruction of tissues. The -pathy means disease).
key indicators of inflammation are (1) erythema (red- ■■ my/o means muscle. The term myopathy (my-OP-
ness), (2) hyperthermia (heat), (3) edema (swelling), ah-thee) describes any pathologic change or disease of
and (4) pain. These are caused by extra blood flowing muscle tissue (my/o means muscle, and -pathy means
into the area as part of the healing process. disease).
Laceration and Lesion -ologist and -ology

■■ A laceration (lass-er-AY-shun) is a torn or jagged ■■ -ologist means specialist. A dermatologist (der-mah-
wound or an accidental cut. TOL-oh-jist) is a physician who specializes in diagnos-
■■ A lesion (LEE-zhun) is a pathologic change of the ing and treating disorders of the skin (dermat means
tissues due to disease or injury. skin, and -ologist means specialist).
■■ -ology means the study of. Neonatology (nee-oh-nay-
Mucous and Mucus TOL-oh-jee) is the study of disorders of the newborn
(neo- means new, nat means birth, and -ology means
■■ The adjective mucous (MYOU-kus) describes the spe-
study of).
cialized membranes that line the body cavities.
■■ The noun mucus (MYOU-kus), which is pronounced
the same way, refers to the fluid secreted by these Palpation and Palpitation
mucous membranes. ■■ Palpation (pal-PAY-shun) is an examination tech-
nique in which the examiner’s hands are used to feel
myc/o, myel/o, and my/o the texture, size, consistency, and location of certain
body parts.
■■ myc/o means fungus. Mycosis (my-KOH-sis) de-
■■ Palpitation (pal-pih-TAY-shun) is a pounding or
scribes any abnormal condition or disease caused by a
racing heart.
fungus (myc means fungus, and -osis means abnormal
condition or disease).
■■ myel/o means bone marrow or spinal cord. The term pyel/o, py/o, and pyr/o
myelopathy (my-eh-LOP-ah-thee) describes any ■■ pyel/o means renal pelvis, which is part of the kidney.
injury, degeneration or disease in the spinal cord Pyelitis (pye-eh-LYE-tis) is an inflammation of the
16 CHAPTER 1
renal pelvis (pyel means renal pelvis, and -itis means ■■ Virile (VIR-ill) means having the nature, properties, or
inflammation). qualities of an adult male.
■■ py/o means pus. Pyoderma (pye-oh-DER-mah) is
any acute, inflammatory, pus-forming bacterial skin in-
USING ABBREVIATIONS
fection such as impetigo (py/o means pus, and -derma
means skin). Abbreviations are frequently used as a shorthand way to
■■ pyr/o means fever or fire. Pyrosis (pye-ROH-sis), also record long and complex medical terms; Appendix B con-
known as heartburn, is discomfort due to the regurgi- tains an alphabetized list of many of the more commonly
tation of stomach acid upward into the esophagus (pyr used medical abbreviations.
means fever or fire, and -osis means abnormal condi- ■■ Abbreviations can also lead to confusion and errors!
tion or disease). ■■ Therefore, it is important that you use caution when
using or interpreting an abbreviation.
Supination and Suppuration ■■ For example, the abbreviation BE means both “below
■■ Supination (soo-pih-NAY-shun) is the act of rotat- the elbow” (when describing an amputation) and “bar-
ing the arm so that the palm of the hand is forward or ium enema,” which is an x-ray examination of the large
upward. intestine using a contrast medium injected into the
■■ Suppuration (sup-you-RAY-shun) is the formation rectum. Just imagine what a difference a mix-up would
of pus. make for the patient!
■■ Most clinical agencies have policies for accepted
Triage and Trauma abbreviations. It is important to follow this list for the
■■ Triage (tree-AHZH) is the medical screening of pa- facility where you are working.
tients to determine their relative priority of need and ■■ If there is any question in your mind about which
the proper place of treatment (Figure 1.12). abbreviation to use, always follow this rule: When in
■■ Trauma (TRAW-mah) means wound or injury. These doubt, spell it out.
are the types of injuries that might occur in an accident, The Joint Commission, an organization founded
shooting, natural disaster, or fire. in 1910 to standardize medical practices, publishes an
official list of commonly confused “Do Not Use” abbre-
Viral and Virile viations to prevent potentially fatal medical errors. The
■■ Viral (VYE-ral) means pertaining to a virus (vir means full list is available at www.jointcommission.org (see
virus or poison, and -al means pertaining to). Table 1.11 for examples). Many medical facilities have
their own suggested “Do Not Use” abbreviation list.
TABLE 1.11
Examples of “Do Not Use” Abbreviations
©MonkeyBusinessImages/Shutterstock.com.
Abbreviation Potential Problem

MS can mean either morphine
sulfate or magnesium sulfate
QD and QOD mean daily and every other

day, respectively; sometimes
mistaken for each other
FIGURE 1.12 Triage describes the process through which
emergency personnel arriving on an accident scene iden- U means unit, sometimes
tify which of the injured require care first and where they
mistaken for 0 or 4
can be treated most effectively.
CHAPTER 1
LEARNING EXERCISES
1.1. bad, difficult, painful _________________________________________ -algia
1.2. excessive, increased _________________________________________ dys-
1.3. enlargement _________________________________________ -ectomy
1.4. pain, suffering _________________________________________ -megaly
1.5. surgical removal _________________________________________ hyper-
1.6. abnormal condition or disease _________________________________________ hypo-
1.7. abnormal softening _________________________________________ -itis
1.8. deficient, decreased _________________________________________ -malacia
1.9. inflammation _________________________________________ -necrosis
1.10. tissue death _________________________________________ -osis
17
18 CHAPTER 1 LEARNING EXERCISES
bleeding, abnormal
1.11. _________________________________________ -ostomy
excessive fluid discharge
1.12. surgical creation of an _________________________________________ -otomy

artificial opening to the
body surface
1.13. surgical incision _____________________________________________ -plasty
1.14. surgical repair _____________________________________________ -rrhage
1.15. surgical suturing _____________________________________________ -rrhaphy
1.16. visual examination ____________________________________________ -ac
1.17. pertaining to ____________________________________________ -rrhea
1.18. abnormal narrowing ____________________________________________ -sclerosis
1.19. abnormal hardening ____________________________________________ -scopy
1.20. flow or discharge ____________________________________________ -stenosis
DEFINITIONS
Select the correct answer, and write it on the line provided.
1.21. The term describes any pathologic change or disease in the spinal cord.
myelopathy myopathy pyelitis pyrosis
1.22. The medical term for higher-than-normal blood pressure is .
hepatomegaly hypertension hypotension supination
1.23. The term means pertaining to birth.
natal perinatal postnatal prenatal
1.24. Pain is classified as a .
diagnosis sign symptom syndrome
1.25. In the term myopathy, the suffix -pathy means .
abnormal condition disease inflammation swelling
MATCHING TERMS AND DEFINITIONS 1
1.26. white blood cell _________________________________________ acute
1.27.
prediction of the probable course _________________________________________ edema
and outcome of a disorder
1.28. swelling caused by an abnormal _____________________________________ leukocyte

accumulation of fluid in cells,
tissues, or cavities of the body
1.29. rapid onset _____________________________________ prognosis
1.30.
turning the palm of the hand _____________________________________ supination
upward
MATCHING TERMS AND DEFINITIONS 2
1.31. examination procedure _______________________________________ laceration
1.32. fluid, such as pus, that leaks out _______________________________________ lesion

of an infected wound
1.33. pathologic tissue change _______________________________________ palpitation
1.34. pounding heart _______________________________________ palpation
1.35. torn or jagged wound, or an _______________________________________ exudate

accidental cut wound
20 CHAPTER 1 LEARNING EXERCISES
WHICH WORD?
1.36. The medical term describes an inflammation of the stomach.
gastritis gastrosis
1.37. The formation of pus is called .
supination suppuration
1.38. The term meaning wound or injury is .
trauma triage
1.39. The term means pertaining to a virus.
viral virile
1.40. An is the surgical removal of the appendix.
appendectomy appendicitis
SPELLING COUNTS
Find the misspelled word in each sentence. Then write that word, spelled correctly, on the line provided.
1.41. A disease named for the person who discovered it is known as an enaponym.
1.42. A localized response to injury or tissue destruction is called inflimmation.
1.43. A fisure of the skin is a groove or crack-like sore of the skin.
1.44. The medical term meaning suturing together the ends of a severed nerve is neurorraphy.
1.45. The medical term meaning inflammation of the tonsils is tonsilitis.
MATCHING TERMS
1.46. inflammation of a tendon _______________________________________ syndrome
1.47. a set of signs and symptoms _______________________________________ gastralgia
1.48. the surgical suturing of a tendon _______________________________________ tendinitis
1.49. stomach pain _______________________________________ pyoderma
1.50. any acute, inflammatory, _______________________________________ tenorrhaphy

pus-forming bacterial
skin infection
TERM SELECTION
1.51. The abnormal hardening of the walls of an artery or arteries is called .
arteriosclerosis arteriostenosis arthrostenosis atherosclerosis
1.52. A fever is considered to be a .
prognosis sign symptom syndrome
1.53. An inflammation of the stomach and small intestine is known as .
gastralgia gastroenteritis gastritis gastrosis
1.54. The term meaning pain in a joint or joints is .
arthralgia arthritis arthrocentesis atherosclerosis
1.55. A is a physician who specializes in diagnosing and treating diseases and

disorders of the skin.
dermatologist dermatology neurologist neurology
Another random document with
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Another patient aged twenty-seven had whooping cough, which
lasted six weeks, and was followed by severe pain in the back. For
this she consulted various physicians, being treated for Pott's
disease and spinal irritation. She, however, continued to grow worse,
and every jar and twist gave severe pain. At this time she had lost
much flesh, had pain in her back and elsewhere, and was subject to
numerous and violent spasms. When first seen by the physician who
consulted me she was complaining of pains in her legs, hips, and left
shoulder, which she considered rheumatic, and with pain in the
abdomen. Examination of the back with the patient on her side
showed a slight prominence over the position of the first or second
lumbar vertebra. The spot was painful on pressure, and had been so
ever since the attack of whooping cough three years before. A tap on
the sole of either foot made her complain of severe pain in the back.
The same result followed pressure on the head. The patient was
unable to stand or walk, but occasionally sat up for a short time,
although suffering all the time. There was no muscular rigidity. The
limbs and body were quite thin, but, so far as could be detected, she
had no loss of motor or sensory power. At times, when the pains
were worse, the arms would be flexed involuntarily, and she stated
that once the spine was drawn back and a little sideways. The pain
in the hips was augmented by pressure. During the application of a
plaster bandage she had a sort of fit and fainted, and the application
was suspended. She soon recovered consciousness, but refused to
allow the completion of the dressing. I diagnosticated the affection as
largely hysterical, and a few months later received word that the
patient was on her feet and well.
Kemper109 relates the case of a lady who eventually died of sarcoma

of the vertebræ, the specimens having been examined by J. H. C.
Simes of Philadelphia and myself. She was supposed at first and for
some time to be a case of hysteria with spinal irritation. In the case
of a distinguished naval officer, who died of malignant vertebral
disease after great suffering a short time since, this same mistake
was made during the early stages of the disease: his case was
pronounced to be one of neurasthenia, hysteria, etc. before its true
nature was finally discovered. The absence of muscular rigidity in the
back and extremities is the strongest point against vertebral disease
in these cases.
109 Journal of Nervous and Mental Diseases, vol. xii., No. 1, January, 1885.
In hysterical hemianæsthesia, ovarian hyperæsthesia, hystero-

epileptic seizures, ischuria, and other well-known hysterical
symptoms have usually been observed. The anæsthesia in
hysterical cases is most commonly on the left side of the body, but it
may happen to be so located in an organic case, so that this point is
only one of slight value.
Some older observers, as Briquet, who is quoted and criticised by

Charcot, believed that hemianæsthesia from encephalic lesions
differed from hysterical hemianæsthesia by the fact that in the former
case the skin of the face did not participate in the insensibility, or that
when it existed it never occupied the same side as the insensibility of
the limbs. Recently-reported cases have disproved the accuracy of
this supposed diagnostic mark. In his lectures, delivered ten years
ago, Charcot observed that up to that period anæsthesia of general
sensibility alone appeared to have been observed as a consecutive
on an alteration of the cerebral hemispheres, so that obtunding of
the special senses would remain as a distinctive characteristic of
hysterical hemianæsthesia. He, however, expected that cases of
cerebral organic origin would be reported of complete
hemianæsthesia, with derangements of the special senses, such as
is presented in hysteria. His anticipations have been fulfilled. In the
nervous wards of the Philadelphia Hospital is now a typical case of
organic hemianæsthesia in which the special senses are partially
involved.
Paralysis and contractures, if present, are apt to be accompanied in

cases of organic hemianæsthesia, after time has elapsed, by marked
nutritive changes, by wasting of muscle, and even of skin and bone.
This is not the case in hysteria.
The subsequent history of these two conditions is different. The

hysterical patient will often recover and relapse, or under proper
treatment may entirely recover; while all the treatment that can be
given in a case of organic hemianæsthesia will produce no decided
improvement, for there is a lesion in the brain which will remain for
ever. Hemianopsia, so far as I know, has not been observed in
hysterical hemianæsthesia.
In the monograph of Shaffer, with reference to both true and false

knee-joint affections certain conclusions are drawn which I will give
somewhat condensed:
Chronic synovitis produces very few if any subjective symptoms;

hysterical imitation presents a long train of both subjective and
objective symptoms and signs, the former in excess. Chronic ostitis
may be diagnosticated if muscular spasm cannot be overcome by
persistent effort; when the spasm does not vary night nor day; when
it is not affected by the ordinary doses of opium or chloral; when
reaction of the muscles to the faradic current is much reduced; when
a local and uniform rise of temperature over the affected articulation
is present; when purely involuntary neural symptoms, such as
muscular spasm, pain, and a cry of distress, are present. Hysterical
knee-joint is present, according to this author, when the muscular
rigidity or contracture is variable, and can be overcome by mildly
persistent efforts while the patient's mind is diverted, or which yields
to natural sleep, or which wholly disappears under the usual doses
of opium or chloral; when the faradic response is normal; when rise
of temperature is absent or a reduced temperature is present over
the joint; when variable and inconstant, emotional, and semi-
voluntary manifestations are present.
To recognize the neuromimesis of hip disease Shaffer gives the

following points: The limp is variable and suggests fatigue; it is much
better after rest; it almost invariably follows the pain. Pain of a
hyperæsthetic character is usually the first symptom, and it is found
most generally in the immediate region of the joint. “In place of an
apprehensive state in response to the tests applied will be found a
series of symptoms which are erratic and inconstant. A condition of
muscular rigidity often exists, but, unlike a true muscular spasm, it
can in most cases be overcome in the manner before stated. A very
perceptible degree of atrophy may exist—such, however, as would
arise from inertia only. A normal electrical contractility exists in all the
muscles of the thigh.”
In the neuromimesis of chronic spondylitis or hysterical spine the

pain is generally superficial, and is almost always located over or
near the spinous processes; it is sometimes transient, and frequently
changes its location from time to time; a normal degree of mobility of
the spinal column under properly directed manipulation is preserved;
the nocturnal cry and apprehensive expression of Pott's disease are
wanting.
With reference to the hysterical lateral curvature, Shaffer, quoting

Paget, says “ether or chloroform will help. You can straighten the
mimic contracture when the muscles cannot act; you cannot so
straighten a real curvature.”
In the diagnosis of local hysterical affections one point emphasized

by Skey is well worthy of consideration; and that is that local forms of
hysteria are often not seen because they are not looked for. “If,” says
he, “you will so focus your mental vision and endeavor to distinguish
the minute texture of your cases, and look into and not at them, you
will acknowledge the truth of the description, and you will adopt a
sound principle of treatment that meets disease face to face with a
direct instead of an oblique force.” According to Paget, the means for
diagnosis in these cases to be sought—(1) in what may be regarded
as the predisposition, the general condition of the nervous system,
on which, as in a predisposing constitution, the nervous mimicry of
disease is founded; (2) in the events by which, as by exciting
causes, the mimicry may be evoked and localized; (3) in the local
symptoms in each case.
Local symptoms as a means of diagnosis can sometimes be made

use of in general hysteria. A case may present symptoms of either
the gravest form of organic nervous disease or the gravest form of
hysteria, and be for a time in doubt, when suddenly some special
local manifestation appears which cannot be other than hysterical,
and which clinches the diagnosis. In a case with profound
anæsthesia, with paraplegia and marked contractures, with recurring
spasms of frightful character, the sudden appearance of aphonia and
apsithyria at once cleared all remaining doubt. Herbert Page
mentions the case of a man who suffered from marked paraplegia
and extreme emotional disturbance after a railway collision, who,
nine months after the accident, had an attack of aphonia brought on
suddenly by hearing of the death of a friend. He eventually
recovered.
To detect hysterical or simulated blindness the methods described by

Harlan are those adopted in my own practice. When the blindness is
in both eyes, optical tests cannot be applied. Harlan suggests
etherization.110 In a case of deception, conscious or unconscious, he
says, “as the effect of the anæsthetic passed off the patient would
probably recover the power of vision before his consciousness was
sufficiently restored to enable him to resume the deception.”
Hutchinson cured a case of deaf-dumbness by means of
etherization. For simulated monocular blindness Graefe's prism-test
may be used: “If a prism held before the eye in which sight is
admitted causes double vision, or when its axis is held horizontally a
corrective squint, vision with both eyes is rendered certain.” It should
be borne in mind that the failure to produce double images is not
positive proof of monocular blindness, for it is possible that the
person may see with either eye separately, but not enjoy binocular
vision, as in a case of squint, however slight. Instead of using a
prism while the patient is reading with both eyes at an ordinary
distance, say of fourteen or sixteen inches, on some pretext slip a
glass of high focus in front of the eye said to be sound. If the reading
is continued without change, of course the amaurosis is not real.
Other tests have been recommended, but these can usually be
made available.
110 Loc. cit.
The diagnosis of hysterical, simulated, or mimetic deafness is more

difficult than that of blindness. When the deafness is bilateral, the
difficulty is greater than when unilateral. The method by etherization
just referred to might be tried. Politzer in his work on diseases of the
ear111 makes the following suggestions: Whether the patient can be
wakened out of sleep by a moderately loud call seems to be the
surest experiment. But, as in total deafness motor reflexes may be
elicited by the concussion of loud sounds, care must be taken not to
go too near the person concerned and not to call too loudly. The
practical objection to this procedure in civil practice would seem to
be that we are not often about when our patients are asleep. In
unilateral deafness L. Müller's method is to use two tubes, through
which words are spoken in both ears at the same time. When
unilateral deafness is really present the patient will only repeat what
has been spoken in the healthy ear, while when there is simulation
he becomes confused, and will repeat the words spoken into the
seemingly deaf ear also. To avoid mistakes in using this method, a
low voice must be employed.
111 A Textbook of the Diseases of the Ear and Adjacent Organs, by Adam Politzer,
translated and edited by James Patterson Cassells, M.D., M. R. C. S. Eng., Philada.,
1883.
Mistakes in diagnosis where hysteria is in question are frequently

due to that association with it of serious organic disease of the
nervous system of which I have already spoken at length under
Complications. This is a fact which has not been overlooked by
authors and teachers, but one on which sufficient stress has not yet
been laid, and one which is not always kept in mind by the
practitioner. Bramwell says: “Cases are every now and again met
with in which serious organic disease (myelitis and poliomyelitis,
anterior, acute, for example) is said to be hysterical. Mistakes of this
description are often due to the fact that serious organic disease is
frequently associated with the general symptoms and signs of
hysteria; it is, in fact, essential to remember that all cases of
paraplegia occurring in hysterical patients are not necessarily
functional—i.e. hysterical; the presence of hysteria or a history of
hysterical fits is only corroborative evidence, and the (positive)
diagnosis of hysterical paraplegia should never be given unless the
observer has, after the most careful examination, failed to detect the
signs and symptoms of organic disease.”
PROGNOSIS.—Hysteria may terminate (1) in permanent recovery; (2)

in temporary recovery, with a tendency to relapse or to the
establishment of hysterical symptoms of a different character; (3) in
some other affection, as insanity, phthisis, or possibly sclerosis; (4) in
death, but the death in such cases is usually not the direct result of
hysteria, but of some accident. Death from intercurrent disorders
may take place in hysteria. It is altogether doubtful, however,
whether the affection which has been described as acute fatal
hysteria should be placed in the hysterical category. In the cases
reported the symptom-picture would in almost every instance seem
to indicate the probability of the hysteria having been simply a
complication of other disorders, such as epilepsy, eclampsia, and
acute mania.
As a rule, hysterical patients will not starve themselves. They may

refuse to take food in the presence of others, or may say they will not
eat at all; but they will in some cases at the same time get food on
the sly or hire their nurses or attendants to procure it for them. In
treating such cases a little watchfulness will soon enable the
physician to determine what is best to be done. By discovering them
in the act of taking food future deception can sometimes be
prevented. Hysterical patients do sometimes, however, persistently
refuse food. These cases may starve to death if let alone; and it is
important that the physician should promptly resort to some form of
forcible feeding before the nutrition of the patient has reached too
low an ebb. I have seen at least two cases of hysteria or hysterical
insanity in which patients were practically allowed to starve
themselves to death, but an occurrence of this kind is very rare.
Feeding by means of a stomach-tube, or, what is still better, by a
nasal tube, as is now so frequently practised among the insane,
should be employed. Nourishment should be administered
systematically in any way possible until the patient is willing to take
food in the ordinary way. In purposive cases some methods of
forcible feeding may prove of decided advantage. Its unpleasantness
will sometimes cause swallowing power to be regained.
Wunderlich112 has recorded the case of a servant-girl, aged nineteen,

who, after a succession of epileptiform fits, fell into a collapse and
died in two days. Other cases have been recorded by Meyer. Fagge
also speaks of the more chronic forms of hysteria proving fatal by
marasmus. He refers to two cases reported by Wilks, both of which
were diagnosticated as hysterical, and both of which died. Sir
William Gull describes a complaint which he terms anorexia nervosa
vel hysterica. It is attended with extreme wasting; pulse, respiration,
and temperature are low. The patients were usually between the
ages of sixteen and twenty-three: some died; others recovered under
full feeding and great care. In many of the reported fatal cases
careful inquiry must be made as to this question of hysteria being
simply a complication.
112 Quoted in The Principles and Practice of Medicine, by the late Charles Hilton
Fagge, M.D., F. R. C. P., etc., vol. i. 1886, p. 736.
Are not hysterical attacks sometimes fatal? With reference to one of

my cases this view was urged by the physician in attendance.
Gowers113 on this point says: “As a rule to which exceptions are
infinitely rare, hysterical attacks, however severe and alarming in
aspect, are devoid of danger. The attacks of laryngeal spasm
present the greatest apparent risk to life.” He refers to the paroxysms
of dyspnœa presented by a hemiplegic girl as really alarming in
appearance, even to those familiar with them. He refers also to a
case of Raynaud's114 in which the laryngeal and pharyngeal spasm
coexisted with trismus, and the patient died in a terrible paroxysm of
dyspnœa. The patient presented various other hysterical
manifestations, and a precisely similar attack had occurred
previously and passed away, but she had in the interval become
addicted to the hypodermic injection of morphia, and Raynaud
suggested that it might have been the effect of this on the nerve-
centres that caused the fatal termination. Such cases have been
described in France as the hydrophobic form of hysteria.
113 Epilepsy and Other Chronic Convulsive Diseases, by W. R. Gowers, M.D.,
London. 1881.
114 L'Union médical, March 15, 1881.
Patients may die in hysterical as in epileptic attacks from causes not

directly connected with the disease. One of these sources of danger
mentioned by Gowers is the tendency to fall on the face sometimes
met with in the post-epileptic state. He records an example of death
from this cause. He also details a case of running hysteria or
hystero-epilepsy, in which, after a series of fits lasting about four
hours, the child died, possibly from some intercurrent accident.
TREATMENT.—Grasset,115 speaking of the treatment of hysteria, says

that means of treating the paroxysm, of removing the anæsthesia, of
combating single symptoms, are perhaps to be found in abundance,
but the groundwork of the disease, the neurosis or morbid state, is
not attacked. Here he indicates a new and fruitful path. In his own
summing up, however, he can only say that the hysterical diathesis
offers fundamental grounds for the exhibition of arsenic, silver,
chloride of gold, and mineral waters!
115 Brain, January, 1884.
No doubt can exist that the prophylactic and hygienic treatment of

hysteria is of paramount importance. To education—using the term
education in a broad sense—before and above all, the most
important place must be given. It is sometimes better to remove
children from their home surroundings. Hysterical mothers develop
hysterical children through association and imitation. I can scarcely,
however, agree with Dujardin-Beaumetz that it is always a good plan
to place a girl in a boarding-school far from the city. It depends on
the school. A well-regulated institution may be a great blessing in
this direction; one badly-managed may become a hotbed of hysteria.
Recently I made some investigations into the working of the public-

school system of Philadelphia, particularly with reference to the
question of overwork and sanitation.116 I had special opportunities
during the investigations to study the influences of different methods
of education, owing to the fact that the public-school system of
Philadelphia is just now in a transition period. This system is in a
state of hopeful confusion—hopeful, because I believe that out of its
present condition will come eventually a great boon to Philadelphia.
At one end of the system, in the primary and the secondary schools,
a graded method of instruction has been introduced. The grammar
and the high schools are working on an ungraded or differently
graded method. I found still prevailing, particularly in certain of the
grammar schools for girls, although not to the same extent as a few
years since, methods of cramming and stuffing calculated above all
to produce hysteria and allied disorders in those predisposed to
them.
116 The results of these investigations were given in a lecture which was delivered in
the Girls' Normal School of Philadelphia before the Teachers' Institute of Philadelphia,
Dec. 11, 1885.
Education should be so arranged as to develop the brain by a

natural process—not from within outward; not from the centre to the
periphery; not from above downward; but as the nervous system
itself develops in its evolution from a lower to a higher order of
animals, from the simple to the more complex and more elaborate.
Any system of education is wrong, and is calculated to weaken and
worry an impressionable nervous system, which attempts to overturn
or change this order of the progress of a true development of the
brain. To develop the nervous system as it should be developed—
slowly, naturally, and evenly—it must also be fed, rested, and
properly exercised.
In those primary schools in which the graded method was best

carried out this process of helping natural development was pursued,
and the result was seen in contented faces, healthy bodies, and
cheerful workers. In future the result will be found in less chorea,
hysteria, and insanity.
To prevent the development of hysteria, parents and physicians

should direct every effort. The family physician who discovers a child
to be neurotic, and who from his knowledge of parents, ancestors,
and collateral relatives knows that a predisposition to hysteria or
some other neurosis is likely to be present, should exercise all the
moral influence which he possesses to have a healthy, robust
training provided. It is not within the scope of an article of this kind to
describe in great detail in what such education should consist.
Reynolds is correct when he says that “self-control should be
developed, the bodily health should be most carefully regarded, and
some motive or purpose should be supplied which may give force,
persistence, unity, and success to the endeavors of the patient.” In
children who have a tendency to the development of hysteria the
inclinations should not always or altogether be regarded in choosing
a method or pursuing a plan of education. It is not always to what
such a child takes that its mind should be constantly directed; but, on
the contrary, it is often well to educate it away from its inclination.
“The worst thing that can be done is that which makes the patient
know and feel that she is thought to be peculiar. Sometimes such
treatment is gratifying to her, and she likes it—it is easy and it seems
kind to give it—but it is radically wrong.”
In providing for the bodily health of hysterical children it should be

seen that exercise should be taken regularly and in the open air, but
over-fatigue should be avoided; that ample and pleasant recreation
should be provided; that study should be systematic and disciplinary,
but at the same time varied and interesting, and subservient to some
useful purpose; that the various functions of secretion, excretion,
menstruation should be regulated.
The importance of sufficient sleep to children who are predisposed to

hysteria or any other form of nervous or mental disorder can scarcely
be over-estimated. The following, according to J. Crichton Browne,117
is the average duration of sleep required at different ages: 4 years of
age, 12 hours; 7 years of age, 11 hours; 9 years of age, 10½ hours;
14 years of age, 10 hours; 17 years of age, 9½ hours; 21 years of
age, 9 hours; 28 years of age, 8 hours. To carefully provide that
children shall obtain this amount of sleep will do much to strengthen
the nervous system and subdue or eradicate hysterical tendencies.
Gymnastics, horseback riding, walking, swimming, and similar
exercises all have their advantages in preventing hysterical
tendencies.
117 Education and the Nervous System, reprinted from The Book of Health by
permission of Messrs. Cassell & Co., Limited.
Herz118 has some instructive and useful recommendations with

reference to the treatment of hysteria in children. It is first and most
important to rehabilitate the weakened organism, and especially the
central nervous system, by various dietetic, hygienic, and medicinal
measures. It is important next to tranquillize physical and mental
excitement. This can sometimes be done by disregard of the
affection, by neglect, or by removal or threatened removal of the
child from its surroundings. Such treatment should of course be
employed with great discretion. Anæmia and chlorosis, often present
in the youthful victims of hysteria, should be thoroughly treated. Care
should be taken to learn whether children of either sex practise
masturbation, which, Jacobi and others insist, frequently plays an
important part in the production of hysteria. Proper measures should
be taken to prevent this practice. The genital organs should receive
examination and treatment if this is deemed at all necessary. On the
other hand, care should be taken not to direct the attention of
children unnecessarily to those organs when they are entirely
innocent of such habits. Painting the vagina twice daily with a 10 per
cent. solution of hydrochlorate cocaine has been found useful in
subduing the hyper-irritation of the sexual organs in girls accustomed
to practise masturbation. Herz, with Henoch, prefers the hydrate of
chloral to all other medicines, although he regards morphine as
almost equally valuable, in the treatment of hysteria in children.
Personally, I prefer the bromides to either morphia or chloral. Small
doses of iron and arsenic continued systematically for a long period
will be found useful. Politzer of Vienna regards the hydrobromate
and bihydrobromate of iron as two valuable preparations in the
hysteria of children, and exhibits them in doses of four to seven
grains three to four times daily.
118 Wien. Med. Wochen., No. 46, Nov. 14, 1885.
Hysteria once developed, it is the moral treatment which often really

cures. The basis of this method of cure is to rouse the will. It is
essential to establish faith in the mind of the patient. She must be
made to feel not only that she can be helped, but that she will be.
Every legitimate means also should be taken to impress the patient
with the idea that her case is fully understood. If malingering or
partial malingering enters into the problem, the patient will then feel
that she has been detected, and will conclude that she had better get
out of her dilemma as gracefully as possible. Where simulation does
not enter faith is an important nerve-stimulant and tonic; it unchains
the will.
Many physicians have extraordinary ideas about hysteria, and

because of these adopt remarkable and sometimes outrageous
methods of treatment. They find a woman with hysterical symptoms,
and forthwith conclude she is nothing but a fraud. They are much
inclined to assert their opinions, not infrequently to the patient
herself, and, if not directly to her, in her hearing to other patients or
to friends, relatives, nurses, or physicians. They threaten, denounce,
and punish—the latter especially in hospitals. In general practice
their course is modified usually by the wholesome restraint which the
financial and other extra-hospital relations of patient and physician
enforce.
Although hysterical patients often do simulate and are guilty of fraud,

it should never be forgotten that some hysterical manifestations may
be for the time being beyond the control of patients. Even for some
of the frauds which are practised the individuals are scarcely
responsible, because of the weakness of their moral nature and their
lack of will-power. Moral treatment in the form of reckless harshness
becomes immoral treatment. The liability to mistake in diagnosis,
and the frequent association of organic disease with hysterical
symptoms, should make the physician careful and conservative. It is
also of the highest importance often that the doctor should not show
his hand. The fact that an occasional cure, which is usually
temporary, is effected by denunciation, and even cruelty, is not a
good argument against the stand taken here.
Harsh measures should only be adopted after due consideration and

by a well-digested method. A good plan sometimes is, after carefully
examining the patient, to place her on some simple, medicinal, and
perhaps electrical treatment, taking care quietly to prophesy a
speedy cure. If this does not work, in a few days other severe or
more positive measures may be used, perhaps blistering or strong
electrical currents. Later, but in rare cases only, after giving the
patient a chance to arouse herself by letting her know what she may
expect, painful electrical currents, the hot iron, the cold bath, or
similar measures may be used. Such treatment, however, should
never be used as a punishment.
The method of cure by neglect can sometimes be resorted to with

advantage. The ever-practical Wilks mentions the case of a school-
teacher with hemianalgesia, hemianæsthesia, and an array of other
hysterical symptoms who had gone through all manner of treatment,
and at the end of seven months was no better. The doctor simply left
her alone. He ordered her no drugs, and regularly passed by her
bed. In three weeks he found her sitting up. She talked a little and
had some feeling in her right side. She was now encouraged, and
made rapid progress to recovery. Neglect had aroused her dormant
powers. It must be said that a treatment of this kind can be carried
out with far more prospects of success in a general hospital than in a
private institution or at the home of a patient. It is a method of
treatment which may fail or succeed according to the tact and
intelligence of the physician.
I cannot overlook here the consideration of the subject of the so-

called faith cure and mind cure. One difference between the faith
cure as claimed and practised by its advocates, and by those who
uphold it from a scientific standpoint, is simply that the latter do not
refer the results obtained to any supernatural or spiritual agency. I
would not advise the establishment of prayer-meetings for the relief
of hysteria, but would suggest that the power of faith be exercised to
its fullest extent in a legitimate way.
A young lady is sick, and for two years is seen by all the leading
doctors in London; a clergyman is asked in and prays over her, and
she gets up and walks. The doctors all join in and say the case was
one of hysteria—that there was nothing the matter with her. Then,
says Wilks, “Why was the girl subjected to local treatment and doses
of physic for years? Why did not the doctors do what the parson
did?”
Tuke119 devotes a chapter to psychotherapeutics, which every

physician who is called upon to treat hysteria should read. He
attempts to reduce the therapeutic use of mental influence to a
practical, working basis. I will formulate from Tuke and my own
experience certain propositions as to the employment of
psychological measures: (1) It is often important and always
justifiable to inspire confidence and hope in hysterical patients by
promising cures when it is possible to achieve cures. (2) A physician
may sometimes properly avail himself of his influence over the
emotions of the patient in the treatment of hysterical patients, but
always with great caution and discretion. (3) Every effort should be
made to excite hysterical patients to exert the will. (4) In some
hysterical cases it is advisable to systematically direct the attention
to a particular region of the body, arousing at the same time the
expectation of a certain result. (5) Combined mental and physical
procedures may sometimes be employed. (6) Hypnotism may be
used in a very few cases.
119 Influence of the Mind upon the Body.
The importance of employing mental impression is thoroughly

exemplified, if nothing else is accomplished, by a study of such a
craze as the so-called mind cure. Not a few people of supposed
sense and cultivation have pinned their faith to this latest Boston
hobby. A glance at the published writings of the apostles of the mind
cure will show at once to the critical mind that all in it of value is
dependent upon the effects of mental impression upon certain
peculiar natures, some of them being of a kind which afford us not a
few of our cases of hysteria. W. F. Evans has published several
works upon the subject. From one of these120 I have sought, but not
altogether successfully, to obtain some ideas as to the basis of the
mind-cure treatment. It is claimed that the object is to construct a
theoretical and practical system of phrenopathy, or mental cure, on
the basis of the idealistic philosophy of Berkeley, Fichte, Schelling,
and Hegel. The fundamental doctrine of those who believe in the
mental cure is, that to think and to exist are one and the same, and
that every disease is a translation into a bodily expression of a fixed
idea of mind. If by any therapeutic device the morbid idea can be
removed, the cure of the malady is assured. When the patient is
passive, and consequently impressible, he is made to fix his
thoughts with expectant attention upon the effect to be produced.
The physician thinks to the same effect, wills it, and believes and
imagines that it is being done; the mental action to the patient,
sympathizing with that of the physician, is precipitated upon the
body, and becomes a silent, transforming, sanitive energy. It must
be, says Evans, “a malady more than ordinarily obstinate that is
neither relieved nor cured by it.”
120 The Divine Law of Cure.
Hysteria cannot be cured by drugs alone, and yet a practitioner of

medicine would find it extremely difficult to manage some cases
without using drugs. Drugs themselves, used properly, may have a
moral or mental as well as a physical influence. Among those which
have been most used from before the days of Sydenham to the
present time, chiefly for their supposed or real antispasmodic virtues,
are galbanum, asafœtida, valerian, castor and musk, opium, and
hyoscyamus. The value of asafœtida, valerian, castor, and musk is
chiefly of a temporary character. If these drugs are used at all, they
should be used in full doses frequently repeated. Sumbul, a drug of
the same class comparatively little used, is with me a favorite. It can
be used in the form of tincture or fluid extract, from twenty minims to
half a drachm of the latter or one to two drachms of the former. It
certainly has in many cases a remarkably calmative effect.
Opium and its preparations, so strongly recommended by some, and
especially the Germans, should not be used except in rare cases.
Occasionally in a case with sleeplessness or great excitement it may
be absolutely indispensable to resort to it in combination with some
other hypnotic or sedative. The danger, however, in other cases of
forming the opium habit should not be overlooked. According to
Dujardin-Beaumetz, it is mainly useful in the asthenic forms of
hysteria.
Of all drugs, the metallic tonics are to be preferred in the continuous

treatment of hysteria. Iron, although not called for in a large
percentage of cases, will sometimes prove of great service in the
weak and anæmic hysterics. Chalybeates are first among the drugs
mentioned by Sydenham. Steel was his favorite. The subcarbonate
or reduced iron, or the tincture of the chloride, is to be preferred to
the more fanciful and elegant preparations with which the drug-
market is now flooded. Dialyzed iron and the mallate of iron,
however, are known to be reliable preparations, and can be resorted
to with advantage. They should be given in large doses. Zinc salts,
particularly the oxide, phosphide, and valerianate; the nitrate or
oxide of silver, the ammonio-sulphate of copper, ferri-ferrocyanide or
Prussian blue,—all have a certain amount of real value in giving tone
to the nervous system in hysterical cases.
To Niemeyer we owe the use of chloride of sodium and gold in the

treatment of hysteria. He refers to the fact that Martini of Biberach
regarded this article as an efficient remedy against the various
diseases of the womb and ovaries. He believed that the
improvement effected upon Martini's patient was probably due to the
fact that this, like other metallic remedies, was an active nervine. He
prescribed the chloride of gold and sodium in the form of a pill in the
dose of one-eighth of a grain. Of these pills he at first ordered one to
be taken an hour after dinner, and another an hour after supper.
Later, he ordered two to be taken at these hours, and gradually the
dose was increased up to eight pills daily. I frequently use this salt
after the method of Niemeyer.
The treatment of hysteria which Mitchell has done so much to make
popular, that by seclusion, rest, massage, and electricity, is of value
in a large number of cases of grave hysteria; but the proper selection
of cases for this treatment is all important. Playfair121 says correctly
that if this method of treatment is indiscriminately employed, failure
and disappointment are certain to result. The most satisfactory
results are to be had in the thoroughly broken-down and bed-ridden
cases. “The worse the case is,” he says, “the more easy and certain
is the cure; and the only disappointments I have had have been in
dubious, half-and-half cases.”
121 The Systematic Treatment of Nerve-Prostration and Hysteria, by W. S. Playfair,
M.D., F. R. C. P., 1883.
Mitchell122 gives a succinct, practical description of the process of

massage: “An hour,” he says, “is chosen midway between two
meals, and, the patient lying in bed, the manipulator starts at the
feet, and gently but firmly pinches up the skin, rolling it lightly
between his fingers, and going carefully over the whole foot; then the
toes are bent and moved about in every direction; and next, with the
thumbs and fingers, the little muscles of the foot are kneaded and
pinched more largely, and the interosseous groups worked at with
the finger-tips between the bones. At last the whole tissues of the
foot are seized with both hands and somewhat firmly rolled about.
Next, the ankles are dealt with in the same fashion, all the crevices
between the articulating bones being sought out and kneaded, while
the joint is put in every possible position. The leg is next treated—
first by surface pinching and then by deeper grasping of the areolar
tissue, and last by industrious and deeper pinching of the large
muscular masses, which for this purpose are put in a position of the
utmost relaxation. The grasp of the muscles is momentary, and for
the large muscles of the calf and thigh both hands act, the one
contracting as the other loosens its grip. In treating the firm muscles
in front of the leg the fingers are made to roll the muscles under the
cushions of the finger-tips. At brief intervals the manipulator seizes
the limb in both hands and lightly runs the grasp upward, so as to
favor the flow of venous blood-currents, and then returns to the
kneading of the muscles. The same process is carried on in every
part of the body, and especial care is given to the muscles of the
loins and spine, while usually the face is not touched. The belly is
first treated by pinching the skin, then by deeply grasping and rolling
the muscular walls in the hands, and at last the whole belly is
kneaded with the heel of the hand in a succession of rapid, deep
movements, passing around in the direction of the colon.”
122 “Fat and Blood,” etc.
Massage should often be combined with the Swedish movement

cure. In the movement cure one object is to call out the suppressed
will of the patient. This is very applicable to cases of hysteria. The
cure of cases of this kind is often delayed by using massage alone,
which is absolutely passive. These movements are sometimes
spoken of as active and passive, or as single and duplicated. Active
movements are those more or less under the control of the individual
making or taking part in them, and they are performed under the
advice or direction, and sometimes with the assistance, of another.
They proceed from within; they are willed. Passive movements come
from without; they are performed on the patient and independently of
her will. She is subjected to pushings and pullings, to flexions and
extensions, to swingings and rotations, which she can neither help
nor hinder. The same movement may be active or passive according
to circumstances. A person's biceps may be exercised through the
will, against the will, or with reference to the will.
A single movement is one in which only a single individual is

engaged; speaking medically, single movements are those executed
by the patient under the direction of the physician or attendant; they
are, of course, active. Duplicated active movements require more
than one for their performance. In these the element of resistance
plays an important part. The operator with carefully-considered
exertion performs a movement which the patient is enjoined to resist,
or the latter undertakes a certain motion or series of motions which
the former, with measured force, resists. Still, tact and experience
are here of great value, in order that both direct effort and resistance
should be carefully regulated and properly modified to suit all the
requirements of the case. By changing the position of the patient or
the manner of operating on her from time to time any muscles or
groups of muscles may be brought into play. It is wonderful with what
ease even some of the smallest muscles can be exercised by an
expert manipulator.
The duplicated active movements are those which should be most

frequently performed or attempted in connection with massage in
hysterical patients. The very substance of this treatment is to call out
that which is wanting in hysteria—will-power. It is a coaxing,
insinuating treatment, and one which will enable the operator to gain
control of the patient in spite of herself. As the patient exerts her
power the operator should yield and allow the part to be moved.
Much of the value of massage and Swedish movements, in hysteria

as in other disorders, is self-evident. Acceleration of circulation,
increase of temperature, direct and reflex stimulation of nervous and
muscular action, the promotion of absorption by pressure,—these
and other results are readily understood. “The mode in which these
gymnastic proceedings exert an influence,” says Erb,123 “consists, no
doubt, in occasioning frequently-repeated voluntary excitations of the
nerves and muscles, so that the act of conduction to the muscles is
gradually rendered more facile, and ultimately the nutrition of the
nerves and muscles is augmented.”
123 Ziemssen's Cyclopædia.
The objects to be attained by the use of electricity are nearly the

same as from massage and duplicated active movements: in the first
place, to improve the circulation and the condition of the muscles;
and in the second place, to make the patient use the muscles. The
faradic battery should be employed in these cases, and the patient
should be in a relaxed condition, preferably in bed. A method of
electrical treatment introduced some years ago by Beard and
Rockwell is known as general faradization. This is sometimes used
in the office of the physician. In this method the patient is placed in a
chair with his feet on a large plate covered with chamois-skin; the

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To the Learner / xiii

-ology Chapter 1: Introduction to Medical Terminology 1

Primary Medical Terms / 3

Word Parts Are the Key / 3

Chapter 2: The Human Body in Health

Anatomical Reference Systems / 29

Word Part Review WPR1

Word Part Practice Session / WPR1

Chapter 3: The Skeletal System 56

Structures and Functions of the Skeletal System / 58

Chapter 4: The Muscular System 92

Functions of the Muscular System / 94

Chapter 5: The Cardiovascular System 122

Functions of the Cardiovascular System / 124

Chapter 6: The Lymphatic and Immune

Functions of the Lymphatic System / 164

Chapter 7: The Respiratory System 198

Functions of the Respiratory System / 200

Chapter 8: The Digestive System 229

Structures of the Digestive System / 231

Chapter 9: The Urinary System 264

Functions of the Urinary System / 266

Chapter 10: The Nervous System

Functions of the Nervous System / 297

Chapter 11: Special Senses: The Eyes and Ears 334

Functions of the Eyes / 336

Chapter 12: Skin: The Integumentary System 366

Functions of the Integumentary System / 368

Chapter 13: The Endocrine System 397

Functions of the Endocrine System / 399

Medical Specialties Related to the Endocrine System / 405

Chapter 14: The Reproductive Systems 424

Terms Related to the Reproductive Systems of Both Sexes / 426

Chapter 15: Diagnostic Procedures,

Diagnostic Procedures / 462

Introductory Chapters and Word Part Review

Body System Chapters

Comprehensive Medical Terminology Review

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CHANGES TO THE NINTH EDITION

CAROL L. SCHROEDER, UNIVERSITY OF WISCONSIN

LAURA EHRLICH, UNIVERSITY OF ROCHESTER

KATRINA SCHROEDER SMITH,

ANN EHRLICH, GODDARD COLLEGE

Raymond A. Faber, Ph.D. Melinda Rhynes

Medical Terminology for Health Professions, Ninth Edition, is

Major Structures Related Combining Forms Primary Functions

BODY SYSTEM OVERVIEW

arthro opy (ar-TH radic arthri

THE STRUCTURE OF BONES

Write the correct answer in the middle column.

Definition Correct Answer Possible Answers

4.6. coordination ________________________________________ my/o

4.7. muscle ________________________________________ -rrhexis

2. The rules for creating a combining form by

3. If a prefix is added, it is always placed at the