Medical Terminology -2

29

Third Lecture

3. Digestive System: Medical, Surgical, and Diagnostic Procedures

3.1. Pathology34

Although some digestive disorders do not manifest symptoms (asymptomatic),

many are associated with nausea, vomiting, bleeding, pain, and weight loss.

Clinical signs, such as jaundice and oedema35, may indicate a hepatic disorder.

Severe infection, drug toxicity, hepatic disease, and changes in fluid and

electrolyte balance can cause behavioural abnormalities. Disorders of the GI

tract or any of the accessory organs (liver, gallbladder, and pancreas) may result

in far-reaching metabolic or systemic problems that can eventually threaten life

itself. Assessment of a suspected digestive disorder includes a thorough history

and physical examination. A range of diagnostic tests assist in identifying

abnormalities of the GI tract, liver, gallbladder, and pancreas.

For diagnosis, treatment, and management of digestive disorders, the medical

services of a specialist may be warranted. Gastroenterology is the branch of

medicine concerned with digestive diseases. The physician who specializes in

the diagnoses and treatment of digestive disorders is known as a

gastroenterologist. Gastroenterologists do not perform surgeries; however,

under the broad classification of surgery, they do perform such procedures as

liver biopsy and endoscopic examination.

3.2. Medical, Surgical, and Diagnostic Procedures36

This section introduces medical, surgical, and diagnostic procedures used to

treat and diagnose digestive system disorders. Descriptions are provided as well

as pronunciations and word analyses for selected terms.

34 Medical Terminology Systems - A Body Systems Approach: Digestive System – Pathology p. 135 35 Oedema: /ɪˈdiːmə/ (AmE edema) a condition in which liquid collects in the spaces inside the body and makes

it swell 36 Medical Terminology Systems - A Body Systems Approach: Digestive System – Medical, Surgical, and

Diagnostic Procedures p. 144

Medical Terminology -2

30

Procedure Pronunciation37 Arabic38 Meaning

Medical

nasogastric

intubation

nas/o: nose

gastr: stomach

-ic: pertaining

to

ˌneɪzəʊˈɡæstrɪk

ˈɪntjubeɪʃn

أنفي تنبيب

معدي

Insertion of a nasogastric tube through the

nose into the stomach to relieve gastric

distention39 by removing gas, food, or

gastric secretions; instil40

medication, food, or fluids; or obtain a

specimen for laboratory analysis

Surgical

anastomosis

ileorectal

ile/o: ileum

rect: rectum

-al: pertaining

to

intestinal

əˌnæstəˈməʊsɪs

ˌɪliəʊˈrektəl

ɪnˈtestɪnl

،تفاغر

مفاغرة

مفاغرة

لفائفية

مستقيمية

مفاغرة

معوية

Surgical joining of two ducts, vessels, or

bowel segments to allow flow from one to

another

Surgical connection of the ileum41 and

rectum42 after total colectomy43, as is

sometimes performed in the treatment of

ulcerative colitis

Surgical connection of two portions of the

intestines; also called

Enteroenterostomy44

bariatric

surgery

vertical

banded

gastroplasty

ˌbærɪˈætrɪk

ˈsɜːdʒəri

ˈvɜːtɪkl bændɪd

ˈɡæstrəʊˌplæsti

جراحة

منة الس

رأب

المعدة

العلوي

بط الر

Group of procedures that treat morbid

obesity, a condition that arises from severe

accumulation of excess weight as fatty

tissue, and the resultant health problems

Commonly employed bariatric surgeries

include vertical banded gastroplasty and

Roux-en-Y gastric bypass. (See Figure 3-

1).

Bariatric surgery that involves vertical

stapling of the upper stomach near the

oesophagus to reduce it to a small pouch45

and insertion of a band that restricts food

consumption and delays its passage from

the pouch, causing a feeling of fullness

37 Oxford Advanced Lerner’s Dictionary, 9th ed. or: http://dictionary.reference.com/ 38 http://www.emro.who.int/Unified-Medical-Dictionary.html 39 Distend: /dɪˈstend/ (distension or distention / dɪˈstenʃn/) to swell or make something swell because of pressure

from inside 40 Instil: /ɪnˈstɪl/ (AmE instill) to pour in drop by drop 41 Ileum: /ˈɪliəm/ (pl. ilea /ˈɪliə/; ileal /ˈɪliəl/ adj) the third part of the small intestine 42 Rectum: /ˈrektəm/ the opening through which solid waste leaves the body 43 Colectomy: /kəˈlektəmi/ surgical removal of part or all of the colon 44 Enteroenterostomy: /ˈentərəʊˈentərɒstəmi/ a surgical connection between two segments of intestine 45 Pouch: /paʊtʃ/ a small bag, usually made of leather, and often carried in a pocket or attached to a belt

Medical Terminology -2

31

Figure 3-1: Bariatric surgery: (A) Vertical banded gastroplasty. (B) Roux-en-

Y gastric bypass

Roux-en-Y

gastric

bypass

(RGB)

ruːen-ˈwaɪ

ˈɡæstrɪk

ˈbaɪpɑːs

Bariatric surgery that involves stapling the stomach to

decrease its size and then shortening the jejunum46 and

connecting it to the small stomach pouch, causing the

base of the duodenum leading from the non-functioning

portion of the stomach to form a Y configuration, which

decreases the pathway of food through the intestine, thus

reducing absorption of calories and fats

RGB can be performed laparoscopically or as an open

procedure (laparotomy), depending on the health of the

patient. RGB is the most commonly performed weight-

loss surgery today.

colostomy

col/o:

colon

kəˈlɒstəmi

فغر

القولون

Creation of an opening of a portion of the colon through

the abdominal wall to its outside surface in order to

divert faecal flow to a colostomy bag (See Figure 3-2).

46 Jejunum: /dʒɪˈdʒuːnəm/ the second part of the small intestine

Medical Terminology -2

32

Figure 3-2: Colostomy

lithotripsy

lith/o: stone,

calculus

-tripsy: crushing

extracorporeal

shock-wave

lithotripsy

ˈlɪθəʊˌtrɪpsi

ˌekstrəkɔːˈpɔːriəl

ʃɒkweɪv

تفتيت

الحصاة

تفتيت

الحصاة

بأمواج

صدم

خارج

الجسم

Procedure for crushing a stone and

eliminating its fragments surgically or

using ultrasonic shock waves

Use of shock waves as a non-invasive

method to break up stones in the

gallbladder or biliary ducts (See Figure

3-3.)

In extracorporeal shockwave lithotripsy

(ESWL), ultrasound is used to locate the

stone(s) and to monitor their destruction.

polypectomy

polyp: small

growth

-ectomy:

excision,

removal

ˈpɒliˈpektəmi استئصال

السليلة

Excision of a polyp47

When polyps are discovered during

sigmoidoscopy or colonoscopy, they are

excised for microscopic tissue

examination for abnormal or cancerous

cells. (See Figure 3-4)

47 Polyp: /ˈpɒlɪp/ a small lump that grows inside the body, especially in the nose, that is caused by disease but

is usually harmless

Medical Terminology -2

33

Figure 3-3: Extracorporeal shock-wave lithotripsy

pyloromyotomy

pylor/o: pylorus

my/o: muscle

-tomy: incision

paɪˈlɔːrɒmaɪətəmi بضع عضل

اب البو

Incision of the longitudinal and

circular muscles of the

pylorus, which is used to treat

hypertrophic48 pyloric stenosis

Figure 3-4: Polypectomy

48 Hypertrophy: /haɪˈpɜːtrəfi/ an increase in the size of an organ or tissue because its cells grow in size

Medical Terminology -2

34

Diagnostic

Endoscopic

gastrointestinal

endoscopy

endo-: in, within

-scopy: visual

examination

ˌɡæstrəʊɪnˈtestɪnl

enˈdɒskəpi

تنظير داخلي

معدي معوي

Visual examination of the

gastrointestinal tract using a flexible

fibre-optic instrument with a

magnifying lens and a light source

(endoscope) to identify

abnormalities, including bleeding,

ulcerations49, and tumours

In endoscopy of the oesophagus

(oesophagostomy), stomach

(gastroscopy), and duodenum

(duodenoscopy), the endoscope is

inserted through the nose or mouth.

In endoscopy of the colon

(colonoscopy) and sigmoid colon50

(sigmoidoscopy) the endoscope is

inserted through the rectum. (See

Figure 3-5).

Figure 3-5: Colonoscopy and sigmoidoscopy

49 Ulceration: /ˌʌlsəˈreɪʃn/ the fact of becoming covered with ulcers 50 Sigmoid colon: /ˈsɪɡmɔɪd ˈkəʊlən/ the S-shaped section of the colon between the pelvic brim (the upper edge

of a bowl-like structure) and the third sacral (sacrum: /ˈseɪkrəm/ a bone in the lower back, between the two hip

bones of the pelvis) segment, continuous with the rectum. Also called sigmoid flexure /ˈflekʃə/

Medical Terminology -2

35

Imaging

computed

tomography

(CT)

tom/o: to cut

-graphy: process

of recording

kəmˈpjuːtɪd

təˈmɒɡrəfi

تصوير

مقطعي

محوسب

Imaging technique achieved by rotating

an x-ray emitter around the area to be

scanned and measuring the intensity of

transmitted rays from different angles

In CT scanning, a computer is used to

generate a detailed cross-sectional image

that appears as a slice. (See Figure 1-2

D.) In the digestive system, CT scans are

used to view the gallbladder, bowel, liver,

bile ducts, and pancreas. They are also

used to diagnose tumours, cysts51,

inflammation, abscesses52, perforation,

bleeding, and obstruction.

sialography

sial/o: saliva,

salivary glands

-graphy: process

of recording

ˌsaɪəlɒɡrəfi تصوير

القناة

اللعابية

Radiologic examination of the salivary

glands and ducts

Sialography may be performed with or

without a contrast medium.

ultrasonography

(US)

ultra-: excess,

beyond

son/o: sound

-graphy: process

of recording

abdominal

abdomin:

abdomen

-al: pertaining to

ˌʌltrəsəˈnɒɡrəfi

æbˈdɒmɪnl

تخطيط

دى الص

تخطيط

دى الص

البطني

High-frequency sound waves (ultrasound)

are directed at soft tissue and reflected as

“echoes” to produce an image on a

monitor of an internal body structure; also

called ultrasound, sonography, and echo

US is a non-invasive procedure that does

not require a contrast medium. It is used

to detect diseases and abnormalities in the

digestive organs, such as the gallbladder,

liver, and pancreas. It is also used to

locate abdominal masses outside the

digestive organs.

Ultrasound visualization of the abdominal

aorta, liver, gallbladder, bile ducts,

pancreas, kidneys, ureters, and bladder

An abdominal US is used to diagnose and

locate cysts, tumours, and

malformations53 as well as document the

progression of various diseases and guide

the insertion of instruments during

surgical procedures.

51 Cyst: /sɪst/ a growth containing liquid that forms in or on a person's or an animal's body and may need to be

removed 52 Abscess: /ˈæbses; -sɪs/ a collection of pus formed by tissue destruction in an inflamed area of a localized

infection 53 Malformation: /ˌmælfɔːˈmeɪʃn/ a part of the body that is not formed correctly

Medical Terminology -2

36

endoscopic enˈdɒskəpik تخطيط

دى الص

التنظيري

Combines endoscopy and ultrasound to

examine and obtain images of the

digestive tract and the surrounding

tissue and organs

In endoscopic US, a long, flexible tube

(endoscope) inserted via the mouth or

rectum emits high-frequency sound

waves (ultrasound) that produce images

of the organs and structures.

For more information see Ref1, Pages: 135, 144-149

Student Notes:

Medical Terminology -2

37

Fourth Lecture

4. Respiratory System: Medical, Surgical, and Diagnostic Procedures

4.1. Pathology54

Common signs and symptoms of many respiratory disorders include cough (dry

or productive55), chest pain, altered breathing patterns, shortness of breath

(SOB), cyanosis56, fever, and exercise intolerance. Many disorders of the

respiratory system, including bronchitis57 and emphysema58, begin as an acute

problem but become chronic over time. Chronic respiratory diseases are usually

difficult to treat. Their damaging effects are commonly irreversible.

For diagnosis, treatment, and management of respiratory disorders, the medical

services of a specialist may be warranted. Pulmonology is the medical specialty

concerned with disorders of the respiratory system. The physician who treats

these disorders is called a pulmonologist.

4.2. Medical, Surgical, and Diagnostic Procedures59

This section introduces medical, surgical and diagnostic procedures used to treat

and diagnose respiratory disorders. Descriptions are provided as well as

pronunciations and word analyses for selected terms.

54 Medical Terminology Systems - A Body Systems Approach: Respiratory System – Pathology p. 176 55 Productive cough: /prəˈdʌktɪv kɒf/ a cough that expels mucus or sputum /spjutəm/ from the respiratory tract 56 Cyanosis: /ˌsaɪəˈnəʊsɪs/ a bluish discoloration of the skin and mucous membranes resulting from inadequate

oxygenation of the blood 57 Bronchitis: /brɒŋˈkaɪtɪs/ an illness that affects the bronchial (bronchus: /ˈbrɒŋkəs/ any one of the system of

tubes which make up the main branches of the windpipe through which air passes in and out of the lungs) tubes

leading to the lungs 58 Emphysema: /ˌemfɪˈsiːmə/ a condition that affects the lungs, making it difficult to breathe 59 Medical Terminology Systems - A Body Systems Approach: Respiratory System – Medical, Surgical, and

Diagnostic Procedures p. 186

Medical Terminology -2

38

Procedure Pronunciation60 Arabic61 Meaning

Medical

aerosol

therapy

ˈeərəsɒl ˈθerəpi المعالجة

بالرذاذ

Lung treatment using various techniques to

deliver medication in mist form directly to the

lungs or air passageways

Techniques include nebulizers, metered-dose

inhalers (MDIs), and dry powder inhalers

(DPIs). Nebulizers change liquid medications

into droplets to be inhaled through a

mouthpiece. (See Figure 4-1.) MDIs deliver a

specific amount when activated. Children and

the elderly can use a spacer to synchronize

inhalation with medication release. (See Figure

4-2). A DPI is activated by a quick inhalation

by the user.

Figure 4-1: Nebulizer

Figure 4-2: Metered-dose inhaler

60 Oxford Advanced Lerner’s Dictionary, 9th ed. or: http://dictionary.reference.com/ 61 http://www.emro.who.int/Unified-Medical-Dictionary.html

Medical Terminology -2

39

antral62 lavage ˈæntrəl ˈlævɪdʒ رحض

أو غسل

غاري

Washing or irrigating of the paranasal

sinuses to remove mucopurulent63 material

in an immunosuppressed patient or one

with known sinusitis that has failed

medical management

oximetry

ox/i: oxygen

-metry: act of

measuring

ˌɒksɪˈmetri قياس

التأكسج

Non-invasive method of monitoring the

percentage of haemoglobin (Hb) saturated

with oxygen; also called pulse oximetry

In oximetry, a probe attached to the

patient’s finger or ear lobe links to a

computer that displays the percentage of

haemoglobin saturated with oxygen.

polysomnography

poly-: many,

much

somn/o: sleep

-graphy: process

of recording

ˌpɒliˈsəˈmnɒɡrəfi Test of sleep cycles and stages using

continuous recordings of brain waves

(EEGs), electrical activity of muscles, eye

movement, respiratory rate, blood pressure,

blood oxygen saturation64, heart rhythm

and, sometimes, direct observation of the

person during sleep using a video camera

(See Figure 4-3).

postural65

drainage

ˈpɒstʃərəl

ˈdreɪnɪdʒ

نزح

وضعي

Method of positioning a patient so that

gravity aids in the drainage of

secretions from the bronchi and lobes of

the lungs

pulmonary

function tests

(PFTs)

pulmon: lung

-ary: pertaining to

ˈpʌlmənəri

ˈfʌŋkʃn tests

اختبارات

وظيفة

الرئة

Variety of tests used to evaluate respiratory

function, the ability of the

lungs to take in and expel air as well as

perform gas exchange across the

alveolocapillary66 membrane

Measurement of different portions of lung

volume provides an indication of breathing

impairments67, as does measurement of the

volume of air expelled during a rapid,

vigorous exhalation.

62 Antrum: /ˈæntrəm/ (antral adj) a natural cavity, hollow, or sinus, especially in a bone 63 Mucopurulent: /ˌmjuːkəʊˈpjʊərələnt/ containing mucus and pus 64 Saturation: /ˌsætʃəˈreɪʃn/ the degree to which something is absorbed in something else, expressed as a

percentage of the greatest possible 65 Postural: /ˈpɒstʃərəl/ connected with the way you hold your body when sitting or standing 66 alveolocapillary /ælˈviːələʊkəˈpɪləri/ 67 Impairment: /ɪmˈpeəmənt/ the state of having a physical or mental condition which means that part of your

body or brain does not work correctly; a particular condition of this sort

Medical Terminology -2

40

Figure 4-3: Polysomnography

spirometry

spir/o: breathe

-metry: act of

measuring

spaɪˈrɒmetri قياس

التنفس

PFT that measures the breathing capacity of the

lungs, including the time necessary for exhaling

the total volume of inhaled air (See Figure 4-4).

A spirometer68 produces a graphic record of

spirometry results for placement in the patient’s

chart.

Figure 4-4: Spirometry

68 Spirometer: /spaɪˈrɒmɪtə/ an instrument for measuring the volume of air entering and leaving the lungs

Medical Terminology -2

41

Surgical

endotracheal

intubation

endo-: in, within

trache: trachea

-al: pertaining to

endəˈtrəkiːəl

ˈɪntjubeɪʃn

تنبيب

داخل

غامى الر

Procedure in which a plastic tube is inserted

into the trachea to maintain

an open airway

Endotracheal intubation is commonly

performed before surgery when the

patient is first placed under sedation69 or in

emergency situations to facilitate

ventilation if necessary. (See Figure 4-5).

pleurectomy

pleur: pleura

-ectomy:

excision, removal

ˈplʊərektəmi استئصال

الجنبة

Excision of part of the pleura70, usually the

parietal71 pleura

Pleurectomy is performed to reduce pain

caused by a tumour mass or to prevent the

recurrence of pleural effusion72 but is

generally ineffective in the treatment of

malignancy73 of the pleura.

pneumectomy

pneum: air; lung

-ectomy:

excision, removal

njuːˈmektəmi استئصال

ئة الر

Excision of a lung or a portion of the lung,

commonly for treatment of

cancer (See Figure 4-6).

Figure 4-5: Endotracheal intubation

69 Sedation: /sɪˈdeɪʃn/ the act of giving somebody drugs in order to make them calm or to make them sleep; the

state that results from this 70 Pleura: /ˈplʊərə/ one of the two membranes that surround the lungs 71 Parietal: /pəˈraɪɪtəl/ relating to or forming the wall of any cavity 72 Effusion: /ɪˈfjuːʒn/ something, especially a liquid, that flows out of sb/sth; the act of flowing out 73 Malignancy: /məˈlɪɡnənsi/ a malignant mass of tissue in the body; tumour

Medical Terminology -2

42

Figure 4-6: Types of pneumonectomies

septoplasty

sept/o: septum

-plasty: surgical

repair

septəʊˈplæsti رأب

الوتيرة

Surgical repair of a deviated nasal septum

usually performed when the septum is

encroaching74 on the breathing passages or

nasal structures

Common complications of a deviated

septum include interference with breathing

and a predisposition75 to sinus infections.

74 Encroach: /ɪnˈkrəʊtʃ/ to advance beyond proper, established, or usual limits 75 Predisposition: /ˌpriːdɪspəˈzɪʃn/ a condition that makes sb/sth likely to behave in a particular way or to suffer

from a particular disease

Medical Terminology -2

43

thoracentesis ˌθɔːrəsenˈtiːsɪ

s

بزل

در الص

Surgical puncture and drainage of the pleural

cavity; also called pleurocentesis or

thoracocentesis

Thoracentesis as a diagnostic procedure helps

determine the nature and cause of an effusion

and, as a therapeutic procedure, relieves the

discomfort caused by the effusion.

tracheostomy

trache/o: trachea

-stomy: forming

an opening

(mouth)

ˌtrækɪˈɒstəmi فغر

غامى الر

Surgical procedure in which an opening is

made in the neck and into the trachea into

which a breathing tube may be inserted (See

Figure 4-7).

Figure 4-7: Tracheostomy: (A) Lateral view with tracheostomy tube in place.

(B) Frontal view

Diagnostic

Endoscopy

bronchoscopy

bronch/o:

bronchus

-scopy: visual

examination

brɒŋˈkɒskəpi تنظير

القصبات

Visual examination of the bronchi using an

endoscope (flexible fibre-optic or rigid)

inserted through the mouth and trachea for

direct viewing of structures or for projection

on a monitor (See Figure 4-8).

Attachments on the bronchoscope can be

used to suction mucus, remove foreign

bodies, collect sputum76, or perform biopsy.

76 Sputum: /ˈspjuːtəm/ liquid from the throat or lungs, especially when it is coughed up because of disease

Medical Terminology -2

44

laryngoscopy

laryng/o: larynx (voice

box)

-scopy: visual examination

ˌlærɪŋˈgɒskəpi تنظير

الحنجرة

Visual examination of the larynx

to detect tumours, foreign bodies,

nerve or structural injury, or other

abnormalities

Figure 4-8: Bronchoscopy of the left bronchus

mediastinoscopy

mediastin/o:

mediastinum

-scopy: visual

examination

ˈmiːdɪeɪstənɒskəpi تنظير

المنصف

Visual examination of the

mediastinal77 structures, including the

heart, trachea, oesophagus, bronchus,

thymus78, and lymph nodes

The mediastinoscope is inserted

through a small incision made above

the sternum. The attached camera

projects images on a monitor.

Additional incisions may be made if

nodes are removed or other diagnostic

or therapeutic procedures are

performed.

77 Mediastinum: /ˌmiːdɪəˈstaɪnəm/ (mediastinal: /ˌmiːdɪəˈstaɪnl) the part of the thoracic cavity that lies between

the lungs, containing the heart, trachea, etc. 78 Thymus: /ˈθaɪməs/ an organ in the neck that produces lymphocytes (= cells to fight infection)

Medical Terminology -2

45

Imaging

computed tomography

pulmonary angiography

(CTPA)

tom/o: to cut

-graphy: process of recording

pulmon: lung

-ary: pertaining to

angi/o: vessel (usually blood

or lymph)

-graphy: process of recording

kəmˈpjuːtɪd

təˈmɒɡrəfi

ˈpʌlmənəri

ˌændʒiˈəʊɡrəfi

تصوير

األوعية

الرئوية

بالتصوير

يالمقطع

حوسبالم

Minimally invasive imaging

that combines computed

tomography scanning and

angiography to produce

images of the pulmonary

arteries

This test is highly sensitive

and specific for the presence

of pulmonary emboli79.

ventilation-perfusion (V-Q)

scan

ˌventɪˈleɪʃn

pəˈfjuːʒn skæn

تفريسة

التهوية

واإلرواء

Nuclear test scan that

evaluates both airflow

(ventilation) and blood flow

(perfusion) in the lungs for

evidence of a blood clot in

the lungs; also called V-Q

lung scan

For more information see Ref1, Pages: 176, 186-192

Student Notes:

79 Embolus: /ˈembələs/ (pl. emboli /ˈembəlaɪ/) a blood clot, air bubble, or small object that causes an embolism

(/ˈembəlɪzəm/ a condition in which a blood clot or air bubble blocks an artery in the body