Elsevier's Medical Terminology for the Practicing Nurse In English (with definitions)

144

complete hemianopsia Total blindness in one- hemignathia Congenital absence of half of the

half of both eyes. mandible.

heteromynous hemianopsia Either bitemporal hemihepatectomy Surgical excision of less than

or binasal blindness. half of the liver.

homonymous hemianopsia Loss of vision in hemihyperesthesia Abnormal tactile hyperacuity

the left halves of both eyes (OU), or in the right with pain over half of the body.

halves, OU. hemihyperplasia One-sided hypertrophy.

quadrant hemianopsia Loss of sight in a sym- Hypertrophy of half of an organ/body.

metrical visual field, bilaterally. hemihypertonia Exaggerated, one-sided tonicity.

unilateral hemianopsia That in which only one hemilaminectomy Surgical excision of the uni-

eye is affected. lateral vertebral arch(es).

hemiarthroplasty The surgery of choice in hemilaryngectomy Preservation of the voice by

patients with a necrotic head of the femur. excising only half of the larynx.

Replacement of the femoral head with a metal hemimandibulectomy Surgical excision of half

prosthesis leaves the acetabulum intact. of the mandible.

hemiarthrosis Synchondrosis — false articula- hemimelus That malformed fetus with defective

tion between the surfaces of two bones. extremity development.

hemiataxia Impaired unilateral coordination. heminephrectomy Excision of renal tissue.

hemiballism Hemichorea, hemiepilepsy, unilater- hemineurasthenia Unilateral neurasthenia.

al seizures. hemiopalgia Unilateral pain in the eye and head.

hemicanites Unilateral graying. hemipagus Conjoined twins fused at the thorax

hemicephalia Congenital absence of half of the and umbilicus.

brain and cranium. hemiparalysis Hemiparesis, unilateral paralysis,

hemicephalus That congenital anomaly in which hemiamyosthenia, hemiplegia.

the infant has only one cerebral hemisphere. hemiparesthesia Unilateral numbness/tingling.

Hemicerebrum. hemipelvectomy That mutilative surgical proce-

hemicolectomy Surgical excision of less than dure in which half of the pelvis is diagonally

half of the large intestine. amputated with the leg. The prosthetic needs

hemicorporectomy Amputation of the caudad and adjustment are extraordinary.

half of the body. hemiplegia Paresis of half the body, due to a

hemicrania That congenital anomaly with only brain lesion caused by cerebral thrombosis,

one-half of the fetal skull developed. tumor, embolism, hemorrhage.

hemicraniectomy Exposure of half of the brain capsular hemiplegia That caused by a lesion

by a midline surgical dissection of the cranial of the internal capsule within the brain.

vault from the frontal to occipital regions. cerebral hemiplegia Paralysis caused by a

hemicraniosis Hypertrophy of half of the brain lesion.

face/skull. facial hemiplegia Bell's palsy — unilateral

hemidysthesia Unequal sensations between the paralysis of the face (usually residual).

sides of the body. spastic hemiplegia Infantile spasms which are

hemidystrophy That unequal development of the unilateral.

sides of the body. spinal hemiplegia Paralysis caused by a lesion

hemiectromelia Unilateral, deformed extremities. of the spinal cord.

hemigastrectomy Surgical excision of one-half, hemisomus That fetus in which the lateral half of

or less, of the stomach. the body is malformed/absent.

hemiglossal The unilateral tongue. hemistrumectomy Surgical excision of half of

hemiglossectomy Surgical excision of half of the the goiter.

tongue. hemisynergia Hemidysergia — unilateral dysco-

hemiglossitis That herpetic, vesicular eruption ordination.

on the inner cheek and adjacent tongue. hemodialysis "Artificial kidney" — provision of

145

renal function by the circulation of blood term. The erythroblastotic neonate should

through a semi-permeable membrane, to immediately be evaluated for exchange transfu-

achieve excretion and cleansing — a life-saving sion (of his/her entire blood). Rh mothers must

procedure for those patients whose kidney(s) is receive RhoGAM following each birth/abortion.

defective/absent. This may be used to "buy hemolytic transfusion reaction Even when spe-

time" for the patient awaiting a donor kidney, et cialling the transfusion at the outset and

al. throughout the infusion, sudden, drastic reac-

hemodilution The infusion of plasma to reduce tions may occur. Chest/back/flank pain, chilling,

erythrocyte (RBC) concentration. dyspnea, flushing, headache, hypotension, nau-

hemoglobin (Hgb, Hbg) That protein found in sea with vomiting, and tachypnea are classic

erythrocytes — which transports oxygen. examples of that response which may occur

hemoglobin AA The normal genotype. early in the transfusion. Discontinue the infusion

hemoglobin AS Sickle cell trait — in which a STAT, notify the supervisor and physician, infuse

normal beta globin gene has been inherited normal saline through a new line, and inform

from one parent, and a beta globin gene from the lab. The immediate goal becomes that of

the other. reversing the hypotension, to prevent acute

hemoglobinopathy Disorders of erythrocytic renal tubular necrosis. This is the same reaction

structure. which occurs when blood has been incorrectly

hemoglobinuria Presence of urinary hemoglobin matched, and has hemolyzed. The chance of

after voiding. subsequent transfusions affecting the patient

epidemic hemoglobinuria Winckel's disease — adversely increases with each transfusion s/he

hemoglobin in neonatal urine, accompanied by receives... with risk of death.

cardiac/hepatic degeneration of the neonate — hemolytic uremic syndrome (HUS) An acute

cyanosis, and/or jaundice. pediatric condition of unknown etiology, charac-

intermittent hemoglobinuria Paroxysmal, noc- terized by hemolytic anemia, microangiopathic

turnal attacks of blood in the urine. hemolytic anemia, neuropathy, thrombocytope-

malarial hemoglobinuria Blackwater fever. nia. Following diarrhea, gastroenteritis, upper

march hemoglobinuria That which follows respiratory infection (URI), purpura/hemor-

strenous physicial exertion, in those with fragile rhage, lethargy, irritability, and/or oliguria may

erythrocytes. be seen. Acute stages include anuria, car-

paroxysmal hemoglobinuria Recurrent, inter- diomegaly, jaundice, pulmonary edema, spleno-

mittent attacks of erythrocytes in the urine. hepatomegaly, and/or seizures. These children

toxic hemoglobinuria That resulting from a are treated by protocols for anemia and renal

poisonous substance, or a foreign protein, such failure. The child may recover, or go on to

as an incompatible transfusion of blood/blood develop end-stage renal disease — even while

product(s). If a patient receiving a blood prod- on renal/peritoneal dialysis. Plasmapheresis is

uct should void blood, discontinue the transfu- used in France, Canada, and America.

sion STAT! hemopericardium Cardiac tamponade — that

hemolysin Isolysin — that agent in the blood life-threatening emergency of pericardial hemor-

serum which is erythroclastic. rhage.

hemolytic crisis Hemoclasia, hemoclasis. hemoperitoneum Effusion of blood in the

hemolytic disease of the newborn abdominal cavity.

Erythroblastosis fetalis, Rh incompatibility hemophilia A sex-linked, hereditary condition of

which includes anemia, jaundice, splenohep- prolonged coagulation — for which there is no

atomegaly, hydrops fetalis, and/or demise. known cure. Trauma is always a life-threatening

Amniocentesis, Rh titre of the mother, and event for these patients. It is essential to be

bilirubin level of the fetus indicate whether to extremely conservative in the administration of

induce premature labor, administer intrauterine intravenous blood coagulation factor VIII —

transfusion, or permit the pregnancy to go to which could place the patient at risk for HIV dis-

146

ease. Assess each patient for hemarthrosis, a respirations, paralysis, death.

common complication of hemophilia — in gastric hemorrhage Hematemesis (coffee

which hemorrhagic effusion may seriously dam- ground emesis). A Levine tube may be ordered.

age the joint(s). The patient/parent may be (It is risky to pass a gastric tube in the presence

taught to administer cryoprecipitate(s) at home, of ulceration.) If esophageal varices are present,

to arrest an event of bleeding. the physician may choose to intubate with a

hemophilia A That caused by deficiency of blood Sengstaken-Blakemore tube, in order to com-

coagulation factor VIII. press the varicosities and decompensate the

hemophilia B Christmas disease — that caused stomach.

by deficient factor IX. intracranial hemorrhage Bleeding within the

hemophthalmia Hemophthalmus — effusion of skull.

blood into the eye(s). intrapartum hemorrhage Bleeding during labor.

hemopleura Bleeding into the pleural space. postmenopausal hemorrhage Uterine bleeding

hemopneumopericardium Air and blood in the within menopause. Since this could be a symp-

pericardial sac. tom of carcinoma, it needs to be carefully evalu-

hemopneumothorax The presence of air in the ated.

pleural cavity — as a result of disease, injury, or postpartum hemorrhage That occurring due to

therapeutic induction to collapse the lung. retained placental tissue. Despite surgery and

hemoptysis Emptysis — coughing spasms transfusion(s), the mother could expire.

which are productive of bright red blood (which primary hemorrhage Bleeding at the time of

was not vomited). Discourage coughing, and trauma.

position the patient onto the side of bleeding, if secondary hemorrhage That occurring 24

known. If coughing cannot be suspended, ask hours following the primary hemorrhage —

the patient to cough with an open mouth. Save which could be caused by sepsis.

all sputum. typhoid hemorrhage Bleeding between the 2nd

endemic hemoptysis Paragonimiasis — infes- and 3rd weeks of this disease may progress to

tation causing paralysis, hemoptysis, epilepsy, gastrointestinal ulceration, leading to death.

abdominal mass, et al. unavoidable hemorrhage The painless, unre-

parasitic hemoptysis Seen in infestation by lenting bleeding of placenta previa. An emer-

parasites. gency Cesarean section will be required to save

hemorrhage Abnormal bleeding from which the the mother, irregardless of the prematurity of

patient may be in shock. Antishock (MAST) the fetus.

trousers/pneumatic splints may support the uterine hemorrhage That caused by retained

bleeding and severe hypotension until arrival at products of conception following flaccid uterus,

the hospital. The antishock apparatus must not coagulation defects, criminal or therapeutic

be removed, until directed by a physician. abortion, hematoma, laceration(s), uterine rup-

accidental hemorrhage Any event in which ture. Emergency hysterectomy may be manda-

unexpected bleeding threatens the recovery/sur- tory.

vival of the patient. hemorrhagic disease of the newborn Due to

antepartum hemorrhage Bleeding which is inadequate prothrombin, this bleeding tendency

incurred prior to the onset of labor. is corrected by the administration of vitamin A.

arterial hemorrhage Bleeding from an artery. hemorrhagic inflammation The presence of ery-

(A tourniquet may be needed to control the throcytes in the exudate.

bleeding.) hemorrhagic nephrosonephritis Korean hemor-

carotid artery hemorrhage These patients may rhagic fever, for which there is no cure.

exsanguinate — especially if the jugular vein is Epidemic hemorrhagic fever presents with an

involved. abrupt onset of fever, followed by injected con-

cerebral hemorrhage That which causes junctivae, prostration, anorexia, and emesis.

bradycardia, loss of consciousness, stertorous Renal involvement may progress to acute renal

147

shutdown. hepatic abscess A critical infection of the liver, in
hemorrhoidectomy Excision of anorectal vari- which chilling, diaphoresis, fever, and pain fluc-
tuate. Those cases caused by amebic dysentery
cosities by cryotherapy, excision, or ligation. or trauma may recover following aspiration of
hemosiderosis Deposits in the liver and/or the suppurative material.

spleen, of hemosiderin — an iron-containing hepatic coma Hepatic encephalopathy —
pigment. This may be seen in those conditions impaired central nervous system functioning
in which there is marked lysis of erythrocytes. due to pathology of the liver. As venous blood
hemostasis Hemostasia — the arrest of free bypasses portal circulation in these cases,
bleeding. ammonia accumulates. Circulatory build up of
hemostat An instrument which controls bleeding unmetabolized products may be caused by anal-
by its clamping function. These forceps have a gesia, anesthesia, diuresis, electrolyte/fluid
multitude of other purposes. imbalance, ethel alcohol ingestion, gastrointesti-
hemothorax Hematothorax — blood in the pleu- nal hemorrhage, infection, ketogenetic (high
rae due to carcinoma, pneumonia, or vessel protein) dieting, sedation, and tranquilization.
rupture. Signs may include altered deep tendon reflexes,
hemothymia An irresistible impulse to commit asterixis ("liver flap" of the hands), ataxia, diffi-
murder. culty with simple mentation, coma, confusion,
hemotympanum The presence of bleeding in the fetor hepaticus ("mouse breath"), impaired
middle ear. speech, clouded consciousness, inability to
Henoch-Schb'nlein purpura Anaphylactoid pur- draw elementary figures, stupor, lethargy.
pura — that multisystem pediatric disease Exchange transfusions have been ineffective.
which may strike adults. In this order, the diag-
nostic picture is that of purpura, arthralgia, hepaticoduodenostomy Creation of a lumen
abdominal pain, and hematuria. Diagnosis is between the hepatic duct and the duodenum.
confirmed by punch biopsy with an immunoflu-
orescent study. Gastrointestinal involvement hepaticoenterostomy Surgical anastomosis
may require surgical intervention. Renal symp- between the hepatic duct and the intestines.
tomatology may be treated by plasmapheresis.
The prognosis is good with symptomatic treat- hepaticogastrostomy Surgical creation of com-
ment. munication between the hepatic duct and the
Henoch's chorea Progressive electric chorea — stomach.
a rare nervous condition with involuntary mus-
cle twitching. hepaticojejunostomy Surgical anastomosis
heparin sodium An anticoagulant with many between the jejunum and the hepatic duct.
uses for its properties. Preoperatively, intraoper-
atively, and postoperatively, this is given to pre- hepaticolithotripsy The surgical procedure of
vent embolism and thrombosis, and to treat crushing biliary calculi within the hepatic duct.
other clotting disorders. Heparin has a multitude
of medical indications. hepaticostomy Surgically forming a fistula into
heparinization The technique of delaying coagu- the hepatic duct.
lation by "thinning the blood" with heparin sodi-
um. hepatitis Portal inflammation, caused by a com-
hepatalgia Hepatodynia — pain related to the bination of invasive agents — bacterial, chemi-
liver. cal, physical, or viral. Clinical signs include
hepatatrophia Atrophy affecting the liver. fever, hepatomegaly, and jaundice.
hepatauxe Hepatic hypertrophy. acute anicteric hepatitis That marked by the
hepatectomization Excision of the liver. absence of jaundice, anorexia, gastrointestinal
hepatectomy Partial/total excision of the liver. distress, low-grade fever.
hepatic In referenceto the liver. acute viral hepatitis Causative agents are
hepatitis A, B, non-A, non-B viruses, and delta
agents. This disease extends from mild to termi-
nal. The initial symptoms resemble influenza.
Cervical adenopathy may be seen. The specific
modes of transmission include sexual contact,
homosexuality of males with male contacts,

148

INTRAVENOUS HEPARIN

By Sally Vanderwerf, R.N., B.S.

20,000 units of Heparin per 1,000cc of solution or 10,000 units of Heparin per 500 cc of solution
both deliver

2,000 units/hour @ 100cc/hour 1,000 units/hour @ 50 cc/hour
1,980 99 980 49
1,960 98 960 48
1,940 97 940 47
1,920 96 920 46
1,900 95 900 45
1,880 94 880 44
1,860 93 860 43
1,840 92 840 42
1,820 91 820 41
1,800 90 800 40
1,780 89 780 39
1,760 88 760 38
1,740 87 740 37
1,720 86 720 36
1,700 85 700 35
1,680 84 680 34
1,660 83 660 33
1,640 82 640 32
1,620 81 620 31
1,600 80 600 30
1,580 79 580 29
1,560 78 560 28
1,540 77 540 27
1,520 76 520 26
1,500 75 500 25
1,480 74 480 24
1,460 73 460 23
1,440 72 440 22
1,420 71 420 21
1,400 70 400 20
1,380 69 380 19
1,360 68 360 18
1,340 67 340 17
1,320 66 320 16
1,300 65 300 15
1,280 64 280 14
1,260 63 260 13
1,240 62 240 12
1,220 61 220 11
1,200 60 200 10
1,180 59 180 9
1,160 58 160 8
1,140 57 140 7
1,120 56 120 6
1,100 55 100 5
1,080 54 80 4
1,060 53 60 3
1,040 52 40 2
1,020 51 20 1

(Heparin is unstable in dextrose solutions.)

The above units are calibrated in multiples of 20 U
for use with infusion pumps which require settings at whole cc levels.

©1980

149

Recommended doses of currently licensed hepatitis Bvaccines

Recombivax HB1 Engerix-B1

Group Dose (mg) (ml) Dose (mg) (ml)

Infants of HbsAG2-negative 2.5 (0.25) 10 (0.5)
mothers and children 5 (0.5) 10 (0.5)
< 11 years

Infants of HbsAG-positive
mothers; prevention of
perinatal infection

Children and adolescents 5 (0.5) 20 (1.0)
11-19 years 10 (1.0) 20 (1.0)

Adults > 20 years

Dialysis patients and other 40 (1.0)3 40 (2.0)4
immunocompromised
persons

Both vaccines are routinely administered in a three-dose series. Engerix-B has also been licensed for a four-dose
series administered at 0,1, 2, and 12 months.
2HbsAG = Hepatitis B surface antigen.
3Special formulation
4Two 1.0-ml doses administered at one site, in a four-dose schedule at 0,1, 2, and 6 months.
Centers for Disease Control and Preventions,USA.

Guide to postexposure immunoprophylaxis for exposure to hepatitis B virus

Type of exposure Immunoprophylaxis

Perinatal Vaccination + HBIG1
Sexual-acute infection HBIG ±Vaccination
Sexual-chronic carrier Vaccination
Household contact — chronic carrier Vaccination
Household-contact — acute case None unless known exposure
Household-contact — acute case, known exposure HBIG + vaccination
Inadvertent/percutaneous/permucosal Vaccination ± HBIG

1HBIG = Hepatitis B Immune Globulin.
Centers for Disease Control and Preventions, USA.

multiple homosexual partners, parenteral drug abuse, the pregnant, and those with sexu-
(injectable) drug abuse, occupational accidents, ally-transmitted diseases. Those with occupa-
households with an acute carrier/infected mem- tional risk (psychiatric, dialysis, emergency
ber, recipient of blood products or dialysis. room staffs) should receive this vaccine.
Testing for immunity is declined for the general Medical and nursing students should be protect-
public, in preference of their receiving the vac- ed while still in school. Prison employees need
cine. Vaccinating teenagers hepatitis B is espe- to accept vaccination to protect themselves
cially urged for among those with parenteral because of inmates' histories of high risk behav-

150

Recommended schedule of Hepatitis B immunoprophylaxisto prevent perinatal transmission of hepatitis B
virus infection

Vaccine dose1 Age of infant

Infant born to mother known to be HBsAg2 positive

First Birth (within 12 hours)
HBIG3
Birth (within 12 hours)
Second
Third 1 month
6 months 4

Infant born to mother screened for HBsAg

First Birth (within 12 hours)
HBIG3
If mother is found to be HbsAG positive,
Second administer dose to infant as soon as
Third possible, not later than 1 week after birth
1-2 months6
6 months

1See table at top of page 149 for appropriate vaccine dose.
2HbsAg = Hepatitis B surface antigen.
3Hepatitis B immune globulin (HBIG) 0.5 ml administered intramuscularly at a site different from that used for vac-
cine.
4lf four-dose schedule (Engerix-B) is used, the third dose is administered at 2 months of age and the fourth dose at
12-18 months.
5First dose = dose for infant of HbsAg-positive mother (see table at top of page 149). If mother is found to be
HbsAg positive, continue that dose; if mother is found to be HbsAg negative, use appropriate dose from table at
top of page 149.
6Infantsof women who are HbsAg negative can be vaccinated at 2 months of age.
Centers for Disease Control and Preventions, USA.

Recommended schedulesof hepatitis B vaccination for infants born to HbsAg'-negative mothers

Hepatitis B vaccine Age of infant

Option 1 Birth- before hospital discharge
Dose 1 1-2 months2
6-18 months2
Dose 2

Dose3

Option 2 1-2 months2
Dose 1 4 months2
Dose 2 6-18 months2
Dose 3

1HbsAg= Hepatitis antigen.

2Hepatitis B vaccine can be administered simultaneously with diphtheria-tetanus-pertussis, Haemophilus influenzae
type b conjugate, measles-mumps-rubella, and oral polio vaccines at the same visit.
Centers for Disease Control and Preventions, USA.

151

iors. The younger the child when s/he contracts created to allow free drainage of bile.
hepatitis B, the more likely that child will hepatocholangitis Cellular inflammation of the
become a carrier. Those who develop "chronic
active hepatitis", often come down with cirrho- liver/bile ducts.
sis, and may succumb eventually to hepatic car- hepatocirrhosis Hepatopathology in which there
cinoma. The countries in Asia, Africa, South
America, the South Pacific Islands, and in east- are alteration, degeneration, resistance features.
ern/southern Europe have greater incidence of hepatoduodenostomy Hepaticoduodenostomy —
hepatitis B. This disease is endemic in Alaska,
Native and Pacific Island groups. All neonates that creation of an opening from the liver into
should be vaccinated against this disease. The the duodenum.
universal screening of pregnant women is cur- hepatogastric Referring to the stomach and liver.
rently being conducted in Hawaii, some hepatogenous Originating in hepatic tissue.
Canadian provinces, Italy, West Germany, New hepatohemia Circulatory congestion of the liver.
Zealand, Australia, Japan, Alaska, American hepatojugular reflex In patients in right-sided
Samoa, Korea, Taiwan, Singapore, and the cardiac failure, pressure on the liver will cause
People's Republic of China. increased cervical venous pressure.
alcoholic hepatitis The great mimic of biliary hepatolenticular degeneration Wilson's disease
pathology, this may be caused by bacterial — an inherited syndrome caused by accumulat-
infection, in the presence of alcohol abuse. ed copper in the brain, cornea, kidneys, liver.
amebic hepatitis That caused by intestinal tract Pathognomonic is the pigmented Kayser-
infestation. If a liver abscess develops, its walls Fleisher ring at the corneal margin. This syn-
contain amoebae. Requiredtoxic drugs should drome includes emaciation, progressive weak-
be administered only under cardiac monitoring. ness, dysphagia, psychopathy, spastic contrac-
These are contraindicated for the patient with tures, involuntary movements, muscular rigidity,
cardiopathology, and also for the gravid patient. tremor, splenomegaly, cirrhosis, cerebral degen-
fulminant hepatitis That lethal form in which eration. Dietary therapy and D-penicillamine
sudden onset of rigor, chilling, nausea with may be required for life.
emesis, and severe jaundice evolve rapidly into hepatolienography X-ray of the liver/spleen fol-
convulsions, shock, coma, and death. lowing intravenous administration of the con-
non-A/B hepatitis Post-transfusion hepatitis trast medium.
caused by unidentified agents. hepatonecrosis Hepatolysis from gangrenous
toxic hepatitis Drug-induced hepatitis — invasion of the liver.
toxin/drug-induced liver disease caused by com- hepatonephritis That inflammatory process
mon chemicals, medications, or agents in the involving the liver/kidneys.
work place. When cirrhosis is seen in one who hepatonephromegaly Hypertrophy of the liver
has never consumed alcohol, it is presumed and/or kidneys.
that s/he once had undiagnosed hepatitis. hepatonephromegaly glycogenica von Gierke's
hepatization The hepatic appearance of consoli- disease — accumulation of glycogen accompa-
dated lung tissue in lobar pneumonia. nied by hypertrophy of the liver, in the absence
hepatocarcinoma Metastatic hepatopathy. of glycogenolysis.
hepatocholangiocystoduodenostomy The surgi- hepatoperitonitis Perihepatitis — that inflamma-
cal establishment of bile duct drainage into the tion of the peritoneal surface of the liver.
duodenum, via the gallbladder. hepatopneumonic Referring to the liver/lungs.
hepatocholangioenterostomy Creation of com- hepatoptosis Hepatoptosia — that caudad dis-
munication between the liver and the intestines. placement of the liver.
hepatocholangiogastrostomy Surgical achieve- hepatorrhaphy Suturing of the liver.
ment of bile drainage into the stomach. hepatorrhexis Rupture of the liver.
hepatocholangiostomy An opening surgically hepatosis Any non-inflammatory pathology of
the liver.
hepatosplenitis That inflammation of the
liver/spleen.

152

hepatosplenomegaly Splenohepatomegaly — acquired hernia That which occurs following

hypertrophy of the liver/spleen. childbirth, surgery, or injury.

hepatostomy That surgical creation of an open- complete hernia The entire organ has ruptured

ing into the liver which terminates externally. into the adjacent tissue.

hereditary hemochromatosis(HH) concealed hernia That which is imperceptible

Hematochromatosis, bronze diabetes, iron stor- to palpation.

age disease. That rare pathology of iron metab- congenital hernia That present at birth.

olism in which iron accumulates in the tissues. incarcerated hernia A surgical emergency

Bronze pigmentation, cardiac failure, diabetes involving a strangulated obstruction (usually

mellitus, or hepatosplenomegaly may compli- bowel). This will become gangrenous and fatal

cate any recovery/progress. The treatment of without surgical intervention.

choice is phlebotomy — by which iron (Fe) is incisional hernia That occurring through the

removed from the cirulation. surgical scar.

heredoataxia Priedreich's ataxia — an inherited incomplete hernia Partial herniation of an

condition in which discoordination is prominent. organ.

Hereditary spinal ataxia. internal hernia That occurring intra-abdominal-

hermaphroditism Hermaphrodism — a rare phe- ly — retroperitoneally or intraperitoneally.

nomenon in which male and female gonadal tis- irreducible hernia Herniation which cannot be

sue is present in the same person. manually returned to its original location.

bilateral hermaphroditism Both an ovary and reducible hernia That which can be manually

testicle are present bilaterally. reduced to its original site.

complex hermaphroditism External secondary sliding hernia An abdominal herniation which

sexual characteristics and gonadal development may spontaneously occur and viscerally reduce

include those of both sexes. itself.

dimidiate hermaphroditism Lateral hermaph- herniation of nucleus pulposus Prolapsed inter-

roditism — that presence of an ovary on one vertebral disk into the spinal canal with risk of

side and a testis on the opposite side. neural damage.

pseudohermaphroditism False hermaphro- herniolaparotomy Major abdominal surgery to

ditism, transverse hermaphroditism — sec- reduce and reconstruct a herniation.

ondary sexual characteristics of one sex present herniorrhaphy Surgical repair/revision of a herni-

with gonads of the opposite sex. This congenital ation.

anomaly may leave the newborn with ambigu- herniotomy Surgery to correct an

ous genitalia, and at risk for incorrect sexual incarcerated/strangulated/gangrenous/irre-

assignment. ducible herniation. A herniorrhaphy.

true hermaphroditism The presence of both heroin toxicity Acute poisoning which could

testes/ovaries. progress to cyanosis and coma leading to

unilateral hermaphroditism An ovotestis or death. Secure the airway, confirm cardiac func-

testis and ovary present on one side. tion, and administer an opiate antagonist as

hernia Rupture/protrusion of an organ through ordered. (A long-acting narcotic may out-sus-

its wall from coughing, lifting, exertion, intra- tain a short-acting antagonist.) If the patient

abdominal pressure, pregnancy, prolonged dis- fails to respond, the coma may be of another

tention, injury, advancedage, debilitating illness, etiology.

weakness, congenital anomaly. Herniation may herpangina That pediatric infectious disease

involve the abdominal wall, bladder, cerebrum, caused by Coxsackie virus — which may reach

diaphragm, epigastrium, fatty tissue, intestine, epidemic proportions. There is only

labia, mesocolon, muscle, omentum, ovary, supportive/symptomatic therapy for this sudden

peritoneum, pleura, scrotum, spermatic cord, onset of pharyngitis with fever, nausea, emesis,

stomach, umbilical cord/umbilicus, uterus, vagi- and vesicles in the posterior oropharynx —

na. which rupture and ulcerate.

153

herpes An inaccurate term referring to a vesicu- Hers' disease Acidosis. growth retardation,
lar eruption. Thus, "herpes" needs to be quali- hepatomegaly, and hypoglycemia — as seen in
fied by a second, descriptive term, as follows: the storage of liver phosphorylase in glycogen
neonatal herpes Herpes simplex may appear storage disease.
as panvisceral infection/meningoencephalitis of
the newborn. Herter's infantilism Celiac disease — an intesti-
ocular herpes Involvement which spreads to nal malabsorption syndrome characterized by
the eyes. bleeding tendencies, diarrhea, hypoglycemia,
traumatic herpes Lesions which erupt at the and malnutrition.
the site of injury.
hesitation marks Spurious, lacerated scratches
herpes corneae Viral inflammation of the made with or without a stabbing — confirmato-
cornea(e). ry that the wounds were self-inflicted in a vacil-
lating mood.
herpes facialis Herpes simplex of the face.
herpes febrilis That of the facial mucosa. heteradelphia Uterine steal — twin fetuses, one
herpes genitalis That sexually-transmitted viral of which is far less developed than its sibling.

involvement which may also infect the neonate heterocephalus A conjoined fetus with unequal
during delivery. Acyclovir is the drug of choice. heads.
herpes menstrualis This eruption appears during
the menses, in susceptible females. heterolalia Heterophemia, heterophasia — the
herpes praeputialis Herpes simplex affecting the unintended use of nonsense words.
male genitalia.
herpes progenitalis Vulvar involvement of her- heterolateral Ipsilateral — that occurring on the
pes simplex. opposite side.
herpes simplex Viral ulceration in which vesicles
appear at the same site(s) — the junctions of heterometropia Heteropsia — inability of the
mucous membranes and epidermis. These may eyes to refract equally, thereby causing the
be limited to the conjunctivae, oropharynx, or patient to perceive images of different sizes.
gingivae. Erythematous eyes need to be seen by S/he may be unaware of this.
an ophthalmologist. The use of corticosteroids
places these patients at risk of blindness. The heteroplasia Alloplasia — development of tissue
direct antiviral effect of lithium reduces and at an inappropriate site for those cells.
heals oral herpes. As soon as lesions become
evident, sprinkle Eskalith directly onto the heteroprosopus The congenital deformity in
lesion, right from the capsule. which a fetus has 2 faces and 1 head.
herpes zoster An acute, infectious disease char-
acterized by a vesicular eruption which unilater- heterotopic ossification Formation of new bone
ally follows a cranial/spinal nerve. The course of tissue in soft tissue — complicating fracture,
shingles is painful and prolonged, but abbreviat- head injury, HIV disease, prolonged coma,
ed in children — most of whom have a history spinal cord injury, total hip arthroplasty. Such
of varicella. The child may return to school ossifications may be misdiagnosed as
when free of herpetic neuralgia. Unvaccinated hematomas, inflammatory conditions, neo-
classmates who have not had chickenpox will plasms, or thrombophlebitis. Maintenance of
contract this disease, if exposed to herpes affected joint functioning is essential.
zoster.
herpes zoster ophthalmicus Lesions following heterotropia Strabismus — deviation of the
the ophthalmic nerve, affecting the face, eye, eyes, caused by binocular disequilibrium.
and nose. An ophthalmologist should see these
patients in consultation, because of the serious Heubner-Herter disease Infantile, nontropical
sequelae. Treatment is essential. sprue.

Heubner's disease Cerebral endarteritis of
syphilitic derivation.

hexadactylism The presence of 6 digits on an
extremity.

hiccoughs Spasms of the diaphragm. If pro-
longed, these can be interrupted by touching the
uvula with a tongue depressor, handle of a
spoon, et al.

hierarchy of command The professional order in

154

Recommendations for routine immunization of HIV-infected children

Vaccine HIV infection
Known asymptomatic
Symptomatic

Diphtheria/Tetanus/Pertussis Yes Yes

Oral Polio Vaccine Contraindicated Contraindicated
Inactivated Polio Virus Yes Yes
Measles-Mumps-Rubella Yes Yes, should be considered
Haemophilus Influenza type B Yes Yes
Pneumococcal Yes Yes
Influenza Yes Yes
Hepatitis B Yes Yes

Centers for Disease Control and Preventions, USA.

which nursing personnel confer with each other the involved foot everted.

(and in reverse): nurse's aide LVN/LPN total replacement of the hip Surgical replace-

RN unit manager supervisor director ment of the head of the femur and acetabulum

of nursing. with a prosthetic articulation.

hierolisthesis A sacral dislocation. Hippel's disease Angiophacomatosis,

hierophobia Pathological fear of religious per- retinocerebral hemangiomatosis, von Hippel-

sons and objects. Lindau disease — multiple angiomas involving

high altitude pulmonary edema That form of the viscera(e), spinal cord, central nervous sys-

noncardiogenic disease which may develop after tem, retina(e).

rapid ascent to extreme heights. These victims hippocratic facies That facial facade of the mori-

may suffer cyanosis, dyspnea, frothy pink- bund patient in impending death.

tinged sputum, rales, severe headache(s).This Hirschberg's reflex Stimulation of the sole at the

disordered pulmonary circulation resembles base of the great toe results in adduction of the

adult respiratory distress syndrome/pneumonia. foot.

The fatality rate is 50% for mountaineers who Hirschsprung's disease Enteromegalia,

do not have access to oxygen, and for whom enteromegaly, megacolon — for which surgical

descent is impossible. intervention may include enterostomy. This con-

Hill sign That indicative of aortic regurgitation — genital anomaly might not be diagnosed until

the blood pressure in the leg is 20-40 mm high- late infancy or in childhood.

er than in the arm. toxic megacolon Acute colonic dilation which

himantosis The uvula is of abnormal length. is at risk of rupture. That occurring in acute

Hines and Brown test That cold pressor test ulcerative colitis.

which measures the blood pressure response to hirsutism Excessive facial growth of hair in

immersion of one hand in ice water. An exces- females (hormonal).

sive increase indicates latent hypertension. histamine cephalgia An intenseheadache

Hinton's test A serological determinator of caused by injected histamine or by ingestion of

syphilis. wine containing histamine.

hip Os coxae — those areas lateral to the pelvis. histaminemia Histamine in the circulation.

congenital dislocationof the hip Failure of the histaminia Histamine-induced shock.

head of the femur to engage in the acetabulum. histidinemia That hereditary, metabolic condition

This must be screened in early infancy. caused by a deficiency of histidase.

dislocation of the hip Often accompanied by Symptomatology varies from patient to patient.

fracture, these injuries are difficult to diagnose histidinuria Histadine present in the urine.

from pure dislocations, and must be confirmed histiocytosis That rare pediatric condition char-

by X-ray. Suspected is the patient who lies with acterized by excessivehistiocytes. The 3 syn-

155

dromes of this diagnosis include: eosinophilic errors. If chest films reveal anomalies, chest

granuloma of bone with osteolytic lesions; tomography is indicated, as mediastinal

Hand-Schuller-Christian disease with exophthal- adenopathy is seen in half of these patients. The

mos, bone defects, diabetes insipidus as char- need of initial staging laparotomy is in dispute.

acteristic findings; Letterer-Siwe disease repre- Osteolytic lesions may be noted as painful verte-

sented by disseminated involvement of visceral bral lesions, or as a compression fracture. Bone

organs. One syndrome may evolve into the clini- marrow invasion may be attributed to pancy-

cal/pathological features of each other. topenia, and could cause paraplegia. Tumor

Adenopathy, hepatosplenomegaly, and a macu- masses obstructing the bile duct produce jaun-

lopapular, xanthomatous dermatitis are promi- dice. Severe tracheobronchial compression may

nent. The acute form of this syndrome often progress to dyspnea with rales. Cutaneous, gas-

involves bone marrow, liver, lungs, lymph tric, or intracranial lesions may occur.

nodes, and/or spleen. Pulmonary parenchyma may become infiltrated

histocompatibility Of essence in transplantation because of abscess/cavitation. Secondary renal

and transfusion therapy is that ability of cells to failure may be the result of urinary obstruction.

survive without immunological interference. (A Because of newer treatment modalities, the

histocompatible donor is a matching donor.) prognosis is more positive for those who suffer

histodiagnosis Microscopic designation of varia- this illusive and viscious disease.

tions from normal findings. holoprosencephaly A congenital deficiency in the

histodialysis Histolysis — tissue destruction. frontal lobe, attributed to an extra chromosome.

histonuria Histories (simple proteins) present in Homan's sign Passive dorsiflexion of the ankle

the urine. will read positive for deep vein thrombosis,

histoplasmosis Darling's disease — general when calf pain is elicited.

malaise followed by fever, chills, headache, homeostasis Dynamic equilibrium.

chest complaints, an unremarkable cough. homicide Murder. Patients who voice intentions

Chest X-rays may reveal patchy pneumonitis — to kill, should be placed on homicide precau-

self-limiting unless complicated by tions. Adolescents (and any others) who threat-

chronicity/anomalies. In disseminated disease en to kill, should be referred to the psychiatrist

(usually seen in the immunocompromised at once. (Their hostility should not be dismissed

patient), oral ulceration is common. An accurate as a stage of immaturity.)

diagnosis requires a biopsy, since this disease homocystinuria A hereditary disease character-

mimics tuberculosis. ized by a hormonal absence with inability to

histotoxic A poisonous state within the cell itself. metabolize homocystine, failure to thrive,

histotribe That instrument which arrests hemor- hepatopathy, seizures, subluxation of the crys-

rhage by crushing tissue. talline lens(es), mental retardation.

histrionic mania Hysterical speech, expressions, homogenous Uniformly consistent.

emotions, and gestures (in excess). homogentisuria Alkaplonuria — that rare, inher-

Hodgkin's disease Of unknown etiology, this ited disorder resulting from incomplete metabo-

syndrome may be revealed by history and an lism of some of the amino acids, as revealed in

alcohol intolerance. There may be painless the urine.

hypertrophy of axillary, cervical, inguinal, medi- homograft Allograft — tissue obtained from the

astinal, and/or mesenteric lymph nodes. Of same species, for the purpose of transplanta-

extreme discomfort is the sign of intense pruri- tion. That from cartilage, artery, bone, cornea,

tus. Lymphoid infiltration of circulatory vessels, transplants with greater success than from

anemia/bone marrow, liver and spleen may pro- other sources.

duce anorexia, chilling, fever of undetermined homolateral Ipsilateral — on the same side.

orgin, night sweats, and/or weight loss. It is homologous Those tissues which are similar in

essential that the hematology slides be read by origin and fundamental structure.

an expert hematopathologist, to avoid lymphatic homophobia A repulsion toward homosexuals.

156

homosexuality The sexual orientation in which neurologic manifestations is attributed to the

the libido is directed toward another of the same loss of lymphocytes' defense and protection.

sex. Good nursing demands conscientious aseptic

homozygote One who inherits the same (abnor- technique in the presence of all body fluids, for

mal/normal) gene from both parents. all patients. Still, there are many unanswered

hopelessness That affect of depression or anxi- questions regarding the transmission of this

ety, (medically warranted or not), which holds virus. Needlesticks of staff, unprotected coitus,

the patient in despair. homosexuality, and hemophilia begin the list of

Homer's syndrome Exophthalmos, ptosis, and concerns. Although some cases lie dormant,

constriction of the pupil on the paralyzed side of there is "no cure, no vaccine,and only one out-

the face — due to cervical, sympathetic paresis. come—death".

hospice A hospital/institution-based residential human prion disease Creutzfeldt-Jakobdisease

plan that offers an innovative program of sup- (CJD). Gerstmann-Straussler-Scheinker syn-

portive services and palliative nursing care for drome (GSS). Kuru disease.

terminal patients. The spiritual, economic, med- humoral immunity A circulating antibody.

ical, and social needs of these patients are fully Hunter's syndrome X-linked mucopolysacchari-

addressed, with the primary goal of quality of dosis (MPS). Iduronosulfate is the deficient

life for the limited time which may be left. enzyme. Mental retardation and retinal degener-

hostility An unprovoked manifestation of ani- ation are two of the serious conditions within

mosity. This is a symptom of depression — this chromosomal affliction.

even when inanimate objects are attacked — Huntington's chorea/disease A hereditary condi-

and a sign that counselling is neededfor the tion of the central nervous system. This severe

anger which may be turned inward. disorder is characterized by choreic movements,

Howship's symptom Pain/paresthesia at the site personality/psychiatric deterioration, postural

of the obturator hernia. defects, and progressive dementia. Death from

Huhner test Determination of sperm motility. in this slowly degenerative, progressive affliction

the workup to rule out infertility in the male. results from intercurrent infections and/or sui-

human bite A severe, necrotizing wound which cide.

may result from the contamination, by both aer- Hunt's neuralgia/syndrome Herpes zoster of the

obic/anerobic bacteria, in the oral cavity. Such facial nerve/ganglion, manifested by painful,

wounds should not be sutured. Penicillin and serosanguinous otic drainage, paralysis, loss of

betalactamase-resistant penicillin should both taste. Involvement is unilateral.

be administered. Hurler's syndrome Lipochondrodystrophy — a

human granulocyticehrlichiosis That morbidity congenital anomaly of cartilagenous/osseous

adjacent to, or separate from, Lyme disease — tissue, with deranged metabolism of

which may become lethal. Resembling influenza, mucopolysaccharides, dwarfism, kyphosis,

diagnostic testing of this condition is still being mental deficiency, cloudy corneas.

developed. Hutchinson-Gilford syndrome Progena —

human herpesvirus 6 A newly-discovered extreme premature aging in the pediatric

viremia which is a major cause of acutefebrile patient. Growth, health, and quality of life are

illness in young children. severely compromised.

human immunodeficiency virus (HIV)disease Hutchinson's pupil That unilaterally-dilated pupil,

Acquired immune deficiency syndrome, AIDS. secondary to a central nervous system lesion.

That syndrome which may cause malignancy, Hutchinson's triad Hutchinson's teeth (notched

neurologic disease, opportunistic infection(s). and pegged), deafnessand interstitial keratosis

Sudden cognitive impairment may be the first — as seen in congenital syphilis.

sign of involvement. These retroviruses attack hyalinuria Urine containing hyalin.

the T cells of myriad systems. Loss of immunity hyalitis Hyaloiditis — inflammation of the

to resist infection, malignant syndromes, and/or hyaloid membrane of the vitreous humor.

157

asteroid hyalitis Stellar/spherical bodies pre- external hydrocephalus Accumulation of cere-
sent in the vitreous humor. brospinal fluid (CSF) in the subdural spaces.
hyalitis punctata Inflammation of the vitreous internal hydrocephalus CSF accumulation in
humor, marked by minute opacities. the ventricles.
hyalitis suppurativa A purulent infection of the noncommunicating hydrocephalus Obstructed
vitreous humor. ventricular system which prevents cerebrospinal
hyalophagia Hyalophagy — the psychopathic fluid from circulating to the subarachnoid space.
ingestion of glass. normal pressure hydrocephalus That in which
hydatid disease Echinococcosis — tapeworm the cerebrospinal fluid (CSF) is not obstructed
infestation. in the presence of dilated ventricles. Shunting is
hydatidostomy Surgical evacuation of a hydatid the corrective procedure of choice.
cyst. secondary hydrocephalus That which follows
hydramnios Hydramnion — an extreme excess infections/injury/neoplasm.
of amniotic fluid, often due to fetal anomaly or hydrodiascope An instrument which treats astig-
multiple pregnancy. These babies may deliver matism.
prematurely, or expire. hydrodictiotomy Surgical correction of a dis-
hydranencephaly Congenital hydrocephalus due placed retina.
to absent cerebral hemispheres. hydroencephalocele Hydrencephalocele — her-
hydrarthrosis Serous effusion in a joint cavity for niation of cerebraltissue and fluid through a
which there is no effective therapy. defect in the cranial vault.
hydration The addition of water. hydroencephalomeningocele The herniated tis-
hydrocalycosis Obstruction causing cystic dila- sues within the hydroencephalocele include
tion of the renal calyx. meningeal tissue.
hydrocele Cavitary accumulation of serous fluid hydroglossa Ranula — a sublingual cystic
— often testicular. tumor.
acute hydrocele The form which is most com- hydrohematonephrosis Distention of the renal
mon. pelvis by urine-containing blood cells.
cervical hydrocele Within the neck — as the hydrohymenitis A serous membrane inflamma-
result of a cervical cleft/duct. tion.
chronic hydrocele That seen in geriatric men hydrolabile That tendency to drop weight
from middle age on. because of gastrointestinal disease, decreased
congenital hydrocele That which is present at intake of carbohydrates/salt, loss of fluids.
birth. hydromelia Hydrorrhachis — increased cere-
hydrocelectomy Surgical repair of a hydrocele. brospinal fluid (CSF) between the spinal cord
hydrocephaloid disease Dehydration-caused canal/space and the membranes.
hydrocephalus with depressedfontanels. hydromeningitis Infection of Descemet's mem-
hydrocephalus Hydrencephalus — That lethal brane. Inflammation with serous effusion into
increase of cerebrospinal fluid (CSF) within the the membranes of the brain.
ventricles, resulting from brain tumor, injury, hydromeningocele Herniation of the spinal cord
infection, developmental anomaly. Treatment and/or meninges into a fluid-filled sac.
offers an excellent prognosis if a shunt is surgi- hydrometrocolpos Distention of the uterus by
cally implanted to drain ventricular fluid into the fluid.
peritoneal cavity. However, cranial deformities hydromicrocephaly Hydrocephalus within a
are irreversible. small cranium.
communicating hydrocephalus That in which hydromyelocele Herniation of a cerebrospinal
normal communication is maintained between sac through a defect in the spine.
the subarachnoid space and the 4th ventricle. hydromyelomeningocele Spina bifida — hernia-
congenital hydrocephalus Chronic disease tion of a fluid-filled sac (with spinal cord tissue)
appearing in infancy. through a defect in the spine. This congenital

158

anomaly leaves the child paralyzed. the urine.
hydromyoma A fluid-filled cystic fibroid (usually hydrothorax Accumulation of noninflammatory

uterine). fluid in the pleura. The chest sounds will be dull
hydronephrosis Kidney obstruction by urine in over areas with fluid, dyspnea will be apparent,
and vesicular breath sounds will be absent.
the renal pelvis — uronephrosis, nephrohydro- hydrotis Serous effusion in the inner ear and/or
sis. This distended kidney may atrophy. tympanum.
hydroparotitis Fluid accumulated in the parotid hydrotomy Dissection by injection under force.
gland(s). hydroureter Obstructed distention of the ureter.
hydropericarditis Infection of the pericardium hydruria Excessive production/excretion of nor-
with serous effusion.
hydropericardium That accumulation of fluid in mal, dilute urine.
the pericardial sac in the absence of infection. hygroscopic Readily absorbent, hydrophilous.
Paracentesis pericardii is the therapy of choice. hygrostomia Ptyalism — Excessive salivation as
hydroperinephrosis Collection of serum within
the connective tissue encompassing the kidney. seen in some drug side effects, gastrointestinal
hydroperitoneum Ascites — accumulated serum disorders, nervous conditions, epilepsy,
in the peritoneum. menses, exophthalmic goiter, rabies, pregnancy.
hydrophilia Hydrophilism — that tendency of hymenectomy Surgical/gynecological
cells to attract/retain fluid. incision/excision of the hymen.
hydrophobia Rabies, lyssa — anexaggerated hymenorrhaphy Plastic repair of the damaged
fear of water. That acute, infectious, lethal dis- hymen to restore it to its unruptured state.
ease, transmitted by rabid animals, which hymonymous diplopia Mirror vision.
attacks the central nervous system. hyoscine chorea Those movements which imi-
hydrophobophobia An hysterical fear of contract- tate chorea and occur in acute scopalomine
ing rabies. This may present as hydrophobia. intoxication.
hydrophthalmos Fluid distention of the eye from hypacousia Hypacusia, hypacusis — the impair-
within the globe. ment of hearing.
hydropneumatosis Interstitial air/fluid causing hypalbuminosis Deficiency of circulatory albu-
edema, distention as emphysema. min.
hydropneumopericardium Serous effusion with hypalgesia Reduced sensitivity to pain.
air in the pericardial sac. hypamnios A deficient amount of amniotic fluid.
hydropneumothorax Pneumohydrothorax — hyperacusis Oxyacusis — exquisite, enhanced
pleural effusion with air in the chest cavity. otic perception which may be attributed to an
hydrorrhachitis Spinal effusion affecting the hysterical state.
spinal cord tissues. hyperalbuminemia Increased albumin in the cir-
hydrorrhea Serum discharge. culation.
hydrorrhea gravidarum Vaginal discharge during hyperalgesia Hyperalgia — excessive sensitivity
pregnancy — which may be misidentified as to pain. A low threshold for pain.
amniotic fluid. hyperalimentation Suralimentation, superali-
hydrostatic test That postmortem examination in mentation — intravenous nourishment with a
which the neonate's lungs are submerged. If hypertonic formula containing sufficient nour-
they float, the infant was alive following delivery. ishment (electrolytes, vitamins, glucose, amino
hydrosyringomelia Distention of the central acids) to maintain life, development, growth.
spinal cord with cavitation and serous effusion. This hypertonic solution is so highly enriched
hydrothioammonemia Contamination of the for these patients with nonfunctioning gastroin-
blood with ammonium sulfide. testinal tracts and/or those in cachectic states, it
hydrothionemia Hydrogen sulfide in the circula- is irritating to the vascular system. It must be
tion. administered via a subclavian cutdown into the
hydrothionuria Presenceof hydrogen sulfide in superior vena cava, in order to be promptly
diluted by the circulation.

159

hyperaminoacidemia Abnormally elevated levels bed/sofa, as these moments provide relief from
of amino acids in the circulation. discomfort. At risk for spontaneous fractures
and renal calculi/damage, these patients require
hyperamylasemia Elevated amylase level in the close follow-up. The immediate treatment objec-
blood. tives include hydration, diuresis, correction of
electrolyte imbalance, as this condition is life-
hyperanakinesis Hyperanacinesia, hyperanacine- threatening. Parathyroidectomy is the procedure
sis — excessive functioning of an organ/part. of choice.
idiopathic hypercalcemia That caused by vita-
hyperaphia Exaggerated sensitivity to touch. min D intoxication in infants.
hyperazotemia Increased blood level of nitroge- hypercalcuria Excessive calcium found in the
urine.
nous components. hypercapnia Hypercarbia — elevated serum car-
hyperazoturia The presence of excessive urinary bon dioxide.
hypercellularity Excessivecells found in the
nitrogen. body, especially in the bone marrow.
hyperbaric oxygenation(HBO) Hyperbarism — hyperchloremia An elevated serum chloride.
hyperchlorhydria Hyperacidity due to an excess
oxygen, at greater than absolute atmospheric of hydrochloric acid in gastric secretions.
pressure, is used to treat selected patients with hypercholesterolemia Excess cholesterol in the
severe, life-threatening conditions. Among these circulation.
are air embolism, carbon monoxide poisoning, familial hypercholesterolemia Associated with
compromised skin flaps/grafts, congenital cyan- markedly high cholesterol levels and premature
otic heart disease, decompression illness, gas coronary heart disease, this presents a critical
gangrene, ischemic crush injuries, necrotizing situation — especially for pediatric patients.
fasciitis, smoke inhalation, soft tissue radiation hypercholesterolia Elevated levels of cholesterol
necrosis, burns. This modality has demonstrat- in the bile.
ed success as a final effort for patients who hyperchromatopsia That visual defect in which
have failed to heal under other forms of therapy. all that is seen appears to be abnormally col-
Hyperbaric oxygenation is contraindicated for ored.
premature neonates, and for patients with pneu- hyperchromatosis Hyperchromasia, hyperchro-
mothorax. matism, hyperchromia, overpigmentation.
hyperbilirubinemia An excessive level of biliru-
bin in the circulation. hyperchylia Excessivesecretion of gastric acids.
hyperbulia An exaggerated amount of will power. hyperchylomicronemia That accumulation of
hypercalcemia Excessive levels of serum calci-
um. Increased numbers of cases are being iden- chylomicrons (fat molecules) in the circulation.
tified by the sophisticated laboratory techniques hypercoagulability An increased ability to coagu-
in use today. The etiology includes benign famil-
ial hypocalciuric hypercalcemia, Paget's disease, late.
immobilization, dysproteinemias, idiopathic hypercorticism That elevated production of
hypercalcemia of infancy, vasoactive intestinal
polypeptide, secreting tumors. If the patient is adrenal cortical hormones.
on lithium (Li), this is regarded as a cause, hypercrinism Excessivefunctioning of any of the
since this drug decreases the urinary excretion
of calcium. Hypercalcemic symptomatology endocrine glands.
includes acute pancreatitis (rare), anorexia, apa- hypercryalgesia Hypercryesthesia— cold intol-
thy, cognitive difficulties, coma, constipation,
depression, delirium, hypertension, hypotonia, erance.
hypoactive reflexes, nephrocalcinosis, lethargy, hypercupremia Elevated serum copper.
obtundation, polydipsia, polyuria, sensitivity to hypercyanosis Profound cyanopathy.
digitalis. Some may experiencefew symptoms, hypercyesis A multiple pregnancy, superfetation.
others will note complaints changing every few hypercythemia Excessive erythrocytes in the cir-
days. The fatigue/lethargy is so overwhelming,
these patients lie down whenever they pass a culation.
hypercytosis Leukocytosis — an abnormal

160

increase in white blood cells. inward/upward.

hyperdactylia Supernumerary toes/fingers. hyperesthesia Hyperacuity, oxyesthesia —

hyperdontia An excessive number of teeth. enhanced tactile perception.

hyperdynamia Extreme violence. acoustic hyperesthesia Hyperacusis.

hyperdynamia uteri Abnormal labor contrac- cerebral hyperesthesia That caused by a brain

tions. tumor.

hyperdynamic neck pulsations A serious symp- gustatory hyperesthesia Hypergeusia, hyper-

tom of impending cardiac crisis. geusesthesia.

hypereccrisia Hypereccrisis — abnormal, exces- optic hyperesthesia Oxyblepsia.

sive excretions. tactile hyperesthesia Hyperaphia.

hyperemesis gravidarum Prenatal nausea with hyperesthesia sexualis Abnormally heightened

emeses of such duration/severity that systemic libido.

effects are noted. Treatment consists of bedrest, hyperexplexia The exaggerated startle response.

small feedings of carbohydrates, mild sedation, hyperextension Extension of a joint beyond

and/or antiemetics. Hospitalization with restrict- range of motion.

ed visitors may be required temporarily. If hyperferremia Excess iron in the circulation.

symptomatology persists, nothing by mouth hyperfibrinogenemia Increased circulatory fibro-

(NPO) for 24 hours, parenteral restoration of gen.

electrolytes and nutritional balance, gavage hyperflexion That traumatic closing of a joint.

feedings, and/or total parenteral nutrition (TPN) hypergalactia Excessive production of milk.

might be ordered for extreme cases. The retinae hypergammaglobulinemia An elevated level of

should be examined for signs of hemorrhagic gamma globulin in the circulation.

retinitis. Hepatic pathology may also be ruled hypergenesis Hyperplasia — overproduction of

out. cells.

hyperemia Increased circulation, producing cuta- hyperglycemia Hyperglycosemia — elevated

neous erythema. blood sugar/glucose.

arterial hyperemia Active hyperemia from hyperglycinemia That congenital inability to

increased circulation. metabolize the amino acid glycine, accompanied

Bier's hyperemia Constriction hyperemia. by mental/growth retardation.

leptomeningeal hyperemia That caused by hyperglycoplasmia Elevated glucose level in the

congestion within the pia-arachnoid. plasma.

venous hyperemia That caused bydecreased hyperglycorrhachia Excessiveglucose in the

circulation. cerebrospinal fluid (CSF).

hyperemization Therapeutic, artificially-produced hyperglycosuria Presenceof urinary sugar

erythema. ("spilling sugar"), glycosuria.

hypereosinophilic syndrome Eosinophils infil- hypergnosia That exaggerated/distorted level of

trate organs, causing anorexia, cough, fever, perception due to subjective, emotional input.

weight loss — which in turn, produce hyperhedonia Hyperhedonism — Excessive,

cardiac/neural defects. This incurable dyscrasia abnormal pleasure, orgiastic activity.

is characterized by marked bone marrow and hyperhidrosis A pathologic level of perspiration

blood eosinophilia. Encephalopathy or central — which may require cervical sympathectomy,

nervous system emboli may occur, causing a electrophoresis.

rare form of dementia, and expiration. hyperinosemia That excessivefibrinogen level

hyperepinephrinemia A marked increase in cir- causing abnormal coagulability.

culatory levels of epinephrine. hyperinsulinism Excess insulin in the circulation.

hypererethism Exaggeratedirritability. This could lead to insulin shock — which has a

Heightened reactivity to allergens. greater mortality than diabetic coma.

hyperesophoria Heterophoria — imbalance of hyperinvolution Superinvolution — uterine

the ocular muscles — in which the gaze drifts reduction following hypertrophy.

161

hyperinvolution uteri Marked uterine atrophy fol- hypernephroma Epinephroma, renal cell carcino-
lowing severe puerperal sepsis or prolonged ma, malignant kidney tumor.
lactation.
hypernormal Abnormal.
hyperirritability Heightened response to an irri- hyperonychia Hypertrophy of the nails.
tant or stimulus. hyperorexia Excessive hunger — which may be

hyperkalemia Hyperkaliemia — excess potassi- seen in gastric pathology, brain tumor, hyper-
um in the circulation. thyroidism, hysteria, psychosis, diabetes melli-
tus, helminthiasis.
hyperkeratosis Keratosis, keratodermia. hyperosmia Heightened sensitivity to scents.
hyperkeratosis congenitalis Ichthyosis foetalis, hyperosmolar hyperglycemia nonketotic coma
(HHNC) In the absence of ketoacidosis, coma
icthyosiform erythroderma of the neonate. The appearing in the presence of elevated blood
skin is deeply fissured and erythematous. These osmolarity and hyperglycemia as high as
infants may expire within days. 1,000mg! In addition to their diabetes, these
hyperkeratosis epidermolytic This congenital patients are extremely dehydrated, and may also
disorder presents with bullae, erythema, kerato- present with cognitive impairment, cardiovascu-
dermia. lar pathology, infection, pancreatitis, and/or
hyperketosis A pathologically high formation of renal complications. This metabolic crisis may
ketones in the body. be noted in patients on renal dialysis, receiving
hyperkinesis Hyperkinesia, hyperactivity due to hyperalimentation, or with serious burns. On all
minimal brain dysfunction. The psychiatric ter- patients with diabetes, it is necessary to keep in
minology for this syndrome is attention-deficit mind that fever and/or infection may upset well-
hyperactivity disorder (ADHD). ordered diabetic balance into an erratic and dan-
hyperlactation Superlactation, excessive milk gerous imbalance/shock/coma. The treatment of
production in the lactating female. choice is the intravenous (IV) replacement of
hyperlipedemia Excessfat in the circulation. electrolytes and insulin, with correction of the
hyperlipoproteinemia Familial hypercholes- total water deficit.
terolemia, hyperbetalipoproteinemia. hyperostosis Exostosis, torus, overgrowth of
bone tissue.
hyperliposis Adiposity. diffuse idiopathic skeletal hyperostosisSevere
hypermastia Unilateral/bilateral breast develop- myelopathic symptoms caused by an obscure
lesion.
ment in excess. Gynecomastia, polymastia, frontal internal hyperostosis Morgagni's
polymazia, idiopathic mammary augmentation. hyperostosis — osteoma arising from the inter-
hypermelanosis Melanoderma, disordered pig- nal frontal surface.
mentation. infantile cortical hyperostosis Overgrowth of
hypermetabolic state That abnormal state of subperiosteal bone within the
increased metabolism as in high fever, burns, clavicles/mandible. Systemic manifestations
salicylate poisoning. accompany these findings.
hypermetropia Hyperopia, farsightedness. hyperoxaluria Elevated urinary oxalic acid. A
hypermimia Excessivegesturing while speaking. genito-urinary disorder brought byexcess
hypermnesia Exquisite recall of detail, exaggera- absorption of oxalate, bacterial overgrowth —
tion of details in recalled experiences — seen in as seen in patients with chronic biliary disease,
manic phase of bipolar disorder, in life-threaten- pancreatic disorder, or those with small intestine
ing situations, and during some neurological pathology.
procedures. enteric hyperoxaluria The occasional result of
hypermobility Excessive joint relaxation as seen pathology/surgical procedure(s) on the ileus.
in pediatric cases of Ehlers-Danlos/ Marfan's primary hyperoxaluria A hereditary metabolic
syndromes. disease which produces renal pathology.
hypermotility Hyperkinesia.
hypermyotonia Excess muscle tone.
hypernatremia Excessivesodium in the circula-
tion.

162

hyperpancreatism That caused by the excessive sorption intervenes, a parathyroidectomy may

secretions of this gland. be advised.

hyperparacalcemia Osteitis fibrosa cystica gen- hyperpathia Hyperalgesia, allodynia, hyperesthe-

eralisata — recognized more commonly in this sia — exaggeratedsensitivity to stimuli.

decade because of enhanced diagnostic screen- hyperpepsia Hyperchlorhydria-produced dyspep-

ing. Hypercalcemia reveals the presence of sia/indigestion.

hyperparathyroidism, which carries the threat of hyperphagia Excessive over-eating.

kidney damage and spontaneous fractures. hyperphalangism Polyphalangism — an extra

Hypertension, peptic ulceration, psychopatholo- bone within a digit.

gy, and renal deterioration call for long-term hyperphasia Press of speech.

management, unless a parathyroidectomy is hyperpnonia The explosive impact heard with

opted. stuttering.

advanced hyperparathyroidism Skull films of hyperphoria Anophoria, anoopsia — the upward

these patients will demonstrate a "moth-eaten, turning of an eye.

ground glass" loss of density. Rarely,this condi- hyperphosphatasemia Elevatedblood alkaline

tion may be seen in the pediatric patient, or in phosphatase.

the neonate, as familial disease. hyperphosphatemia An abnormal level of blood

primary hyperparathyroidism That abnormal phosphorous.

secretion of parathormone in the presenceof hyperphosphaturia Urinary phosphates in

hypercalcemia, adenoma, and/or carcinoma. excess.

Neuromuscular dysfunction may appear. The hyperphospheremia Hyperphosphatemia — an

saying "Painful bones, renal stones, abdominal abnormal level of serum phosphorus (P).

groans, and psychic moans." illustrates the hyperphrenia Hyperpragia — that expansive

many facets of this endocrine disease. mental capacity/activity/ability seen in patients

Hypercalcemia is the classic sign, in conjunction with elation of mood, as in bipolar disorder in

with fatigue, weakness, depression, polyuria, manic phase.

polydipsia, arthralgia, constipation, osteoporo- hyperpiesia Hyperpiesis — extreme hyperten-

sis, and/or the oversecretion of parathormone. sion.

(Aluminum intoxication mimics hyperparathy- hyperplasia Hypergenesis — excessive prolifera-

roidism.) tion of cells.

pseudohyperparathyroidism Ectopic hyper- hyperploidy Trisomy 21 — unbalanced chromo-

parathyroidism — that clinical syndrome of a somes, representing serious anomalies, as in

tumor associated with hypophosphatemia and Down's syndrome.

hypercalcemia, but not a parathyroid neoplasm. hyperpnea Deep tachypnea experiencedduring

secondary hyperparathyroidism The over- normal activity.

secretion of parathormone accompanies a hyperpotassemia Hyperkalemia — elevated

depressed serum calcium (Ca) from renal serum potassium (K).

pathology in malabsorption states. Parathyroid hyperpraxia Excessive physical activity noted

hyperplasia may appear with osteomalacia with disordered mentation.

and/or rickets. (Lithium affects calcium metabo- hyperprolactinemia Excess prolactin, due to

lism — which improves when the lithium is dis- hypothalamic-pituitary dysfunctioning.

continued.) Patients on chronic hemodialysis, Amenorrhea with/without galactorrhea may be

and who are hyperparathyroid, may exhibit associated with this condition.

chronic renal failure in co-morbidity. hyperproteinemia Excessiveserum protein.

tertiary hyperparathyroidism Medical interven- hyperproteinuria Urinary protein in excess.

tion should be considered before surgical proce- hyperpselaphesia Hyperaphia — an abhorrence

dures. The question in consideration of comor- to touch.

bidity is: Which disease is primary, and which hyperptyalism Excess production of saliva.

secondary (or tertiary)? When intestinal malab- Hypersalivation may be caused by drug side

163

effects, gastrointestinal conditions, nervous dis- pathology, this comorbidity includes the liver
orders, hysteria, epilepsy, menstruation, goiter, with its severe vascular damage.
rabies, stomatitis, or pregnancy. hyperthecosis Ovarian hyperplasia, in which
hyperpyrexia Critical temperature elevations. amenorrhea and/or hirsuitism may be noted.
malignant hyperpyrexia Malignant hyperther- hyperthelia A supernumerary nipple(s).
mia — a fatal complication of general anesthe- Accessory nipple.
sia, when administered in conjunction with hyperthermalgesia Hyperthermoesthesia —
muscle relaxants. A hereditary trait, signs of exaggerated heat intolerance.
muscle metabolism occur with an escalating hyperthermia Hyperpyrexia — escalatedfever.
fever to 106° and beyond (when such a ther- malignant hyperthermia Malignant hyperpyrex-
mometer can be found). This ascension is ia — that rare, lethal crisis associated with gen-
immediate and fatal. The anesthesia of choice eral anesthesia in those who carry an inherited
for patients with such a history, is a neurolep- trait for this response. A rapid escalation of
tic/local form. fever to 106° F is followed by circulatory col-
hyperreaction An exaggerated response to a lapse. Many patients die. If the patient survives,
brain damage may ensue. The operating room
stimulus.
hyperreflexia Heightened reflexes, hypersensitiv- (OR) must have an emergency protocol in place
for STAT implementation.
ity. hyperthermia chemotherapy The adjunctive
hypersensibility Anaphylaxis. treatment of microwave heat 104-113° F, direct-
hypersomnolence Sleep in excess of 2 hours of ed to malignant tumors, to kill these carcinoma
(CA) cells. Although hyperthermia cannot cure
the patient's usual (non-depressive) require- CA alone, it enables lower doses of radiation to
ments. Total daily sleep which exceeds 10 hours be more effective, with fewer side effects.
daily. Hypersomnia. Administered under local anesthesia or by
hypersplenism Enhanced deletion of blood cells epidural nerve block, treatment sessions may
from the circulation, caused by excessive last an hour, scheduled for twice a week.
splenic activity. Indications for this modality are malignancies
hypersthenia Abnormal tension/strength. which have failed to respond to surgery, radia-
hypersystole Extraordinary duration/force of the tion, and/or chemotherapy.
cardiac contraction. external hyperthermia This method can effec-
hypertelorism An abnormality in the width tively treat superficial tumors, and those up to 4
cm deep. It is delivered through cannulation
between paired organs. beneath the skin.
hypertension High blood pressure, in which the hyperthermic intraarterial perfusion Regional
perfusion chemotherapy which acts on the prin-
systolic readings are 150+mm Hg, and the dias- ciple that a number of melanoma and other car-
tolic readings 90+mm Hg. Polycythemia, renal cinoma cells are intolerant of high temperatures
pathology, psychogenic stresses, pheochromo- (Ts). Amputation has been avoided by this
cytoma, arteriovenous fistula(e), patent ductus modality. Isolating the major artery and vein
arteriosus, and coarctation of the aorta are a few supplying the limb, perfusion is achieved with
of many causes. oxygenated, heated blood — to which
benign hypertension A slowly progressing ele- chemotherapeutic agents have been added.
vation in blood pressure. Palliation is obtained, with increased survival
essential hypertension Primary hypertension time for many patients (pts).
which develops without identifiable cause. interstitial hyperthermia Delivered by the
Goldblatt hypertension That similar to high implantation of cannulation through body tissue,
blood pressure within the kidney — produced directly into the tumor, superficial or deep.
when its circulation is reduced. intracavitary hyperthermia Catheterization of a
malignant hypertension Accompanied by
severe vascular damage, rapid progression may
lead to death.
portal hypertension In conjunction with kidney

164

body orifice enables localized cancerous tumors bers.

to be treated within the body. Cervical, rectal, compensatory hypertrophy That occurring

and bladder cancers can be treated, as well as because of increased organic dysfunction or

others. impaired functioning of the paired organ.

hyperthrombinemia Excessive thrombin in the concentric hypertrophy The walls of the organ

circulation places the patient at risk for intravas- enlarge in layers, as the organ capacity dimin-

cular coagulation. ishes.

hyperthymia Pathological excitability/ Marie's hypertrophy Chronic periostitis in

sensitivity/sudden foolishness/ cruelty, due to which soft tissues enlarge around joints.

lack of impulse control. In the high-functioning physiological hypertrophy That due to physio-

patient without depression, this may be diag- logical factors, rather than pathological causes.

nosed as mild bipolar illness. This patient (pt) pseudomuscularhypertrophy

may not require treatment unless manic depres- Pseudohypertrophy — a pediatric disease with

sion appears, or psychotherapeutic intervention paralysis which begins as difficulty in ambula-

is indicated. tion. The stance is wide-based with protuberant

hyperthyroidism Parry's disease — abdomen, spinal curvature, waddling gait. The

emotional/personality changes, goiter, fine child assists his/her weakened back muscles by

tremor of the tongue and/or fingers, hyperthyro- counterbalancing the body with the arms, when

sis, increased metabolic rate, weight loss, ner- arising from the floor. This gives theappearance

vousness, sexual dysfunction, and/or tachycar- of "walking up the legs" with his/her hands —

dia may be seen. the diagnostic sign of muscular dystrophy, to

hypertonia Hypertonicity — abnormal muscu- which this condition progresses. There is only

lar/arterial tonus and/or intraocular pressure. symptomatic therapy with the unfavorable prog-

hypertonic Hyperisotonic — that with increased nosis of early death.

osmotic pressure. vicarious hypertrophy Increased size of an

hypertrichophobia An exaggeratedfear of body organ because of the dysfunction of another.

hair. hyperuricemia Abnormal levels of circulatory

hypertrichosis Polytrichosis, trichauxe, trichaus uric acid.

— an hereditary overgrowth of hair, which may hyperuricuria Elevated levels of urinary uric acid.

be related to an endocrine disorder. The face is hypervalinemia An hereditary, pediatric condi-

covered entirely with hair — as is much of the tion caused by essential enzyme deficiencies.

body. These mentally deficient children fail to thrive,

hypertriglyceridemia Elevated blood triglyc- and experience nystagmus.

erides. hyperventilation Tachypnea accompanied by

hypertrophic cardiomyopathy The most com- vasoconstriction, falling blood pressure, marked

mon etiology of sudden death among young anxiety, syncope. The intervention of choice is

athletes. An increase in the size of the heart to calmly have the person rebreathecarbon

muscle, but not of the chambers, has been iden- dioxide by breathing into a paper bag.

tified. In asymptomatic patients, the only clue hypervigilance The abnormal state of feeling on

may be the warning of a family physician of pal- guard, with tension involving the circulatory/

pitations/syncope. These patients need to be nervous systems, et al.

disqualified from sports because of the risk of hyperviscosity Excessadhesive properties of

silent cardiac arrest. Only echocardiomyography secretions.

may reveal an increased mass of cardiac tissue hyphedonia Increasing anhedonia (the mood in

— confirmatory of this diagnosis. which nothing brings pleasure).

adaptive hypertrophy That increase which hyphema Traumatic hyphema — hemorrhage

occurs out of physiological demand. into the anterior chamber of the eye. This

cardiac hypertrophy Increased heart muscle requires immediate ophthalmologic intervention,

which does not increase the size of the cham- the occlusion of both eyes, total bed rest.

165

hypinosis Hypoinosemia — deficiency of blood findings (although a coexisting disorder may be
fibrin. present). The hypochondrical patient is not
relieved by medical reassurance.
hypnagogic state A hypnotic state. That transi- hypochromasia Hypochromia — deficient hemo-
tional state between sleeping/awakening, from blobin in the erythrocytes.
which delusions may be experienced. hypochromatosis Chromatolysis — absent
nucleus/chromatin in the erythrocyte(s).
hypnoanesthesia Anesthesia achieved through hypocorticism Decreased secretion of adrenal
hypnosis. cortical hormone.
hypocrinism Insufficient glandular secretion.
hypnolepsy Narcolepsy. hypocupremia Diminished blood copper.
hypnonarcoanalysis Psychiatric interview which hypocyclosis Deficient ophthalmic accommoda-
tion.
combines drug-induced sedation with hypnosis. ciliary hypocyclosis Weakness of the ciliary
Hypnonarcosis. muscle(s).
hypnophobia An exaggerated fear of falling lenticular hypocyclosis Deficient elasticity in
asleep. the crystalline lens.
hypnosis That subconscious state in which the hypocystotomy A perineal opening into the uri-
mind is receptive to suggestions by the hypno- nary bladder.
tist. This modality may be especially effective in hypocythemia Decreased erythrocytes.
the treatment of anxiety, phobias, and pain man- hypodactylia Hypophalangism — the absence of
agement. (The unlicensed use of this modality finger(s)/toe(s).
for entertainment is psychiatrically risky.) hypodermic injection A medication administered
hypnotic A controlled substance which induces parenterally.
sleep. intracutaneous injection That which is given
hypoadrenalism Adrenal insufficiency. intradermally.
hypoaffectivity A muted response to emotional intramuscular injection Administration into the
stimuli. muscle mass.
hypoalbuminemia Decreased albumin in the cir- intrathecal injection That administered
culation. intraspinally as the route of choice for selected
hypoaldosteronism Hypotension with salt reten- chemotherapeutic or anesthetic agents.
tion — accompanied by a lowered level of intravenous injection When immediate inter-
aldosterone. vention is required, a bolus of medication will
hypoallergenic That agent with adecreased
potential for causing allergic reaction(s). be given by vein. (Entry into the vein is always
hypobulia Impaired impulse control. confirmed by aspiration of blood, before the
hypoactive sexual desire disorder Absent/defi- drug is given.)
cient libido, causing marked distress and/or subcutaneous injection That administered
interpersonal difficulty. hypodermically.
hypocalcemia Abnormal deficiency of blood cal- hypodermoclysis Hypodermatoclysis — the sub-
cium. cutaneous infusion of fluid into bilateral
hypocalciuria Decreased urinary calcium. thighs/the backs of neonates. This permits fluid
hypocapnia Hypocarbia — a deficient level of to be maintained in the tissues to sustain hydra-
carbon dioxide in the circulation. tion/metabolism. This procedure is no longer in
hypochloremia Decreased blood chloride. popular use.
hypochlorhydria Diminished secretion of hypodipsia Lack of thirst resulting in decreased
hydrochloric acid (HCI) — suggesting the pres- fluid intake and possible dehydration.
ence of anemia and/or carcinoma. hypodontia The absence of teeth, retarded denti-
hypochloruria Decreased urinary chlorides. tion.
hypocholesteremia Lowered cholesterol level in hypodynamia Adynamia — diminished energy,
the circulation.
hypochondriasis Preoccupation with the fear that
one is genuinely ill — in the absence of medical

166

no energy. hypoglycorrtiachia Occurring in meningitis, a

hypoendocrinism Insufficiency of glandular decreased level of glucose in the cerebrospinal

secretion(s), hypoendocrisia, hypoendocrinism. fluid.

hypoeosinophilia Diminished number of hypognathous That deformity in which the maxil-

eosinophil leukocytes. la is larger than the mandible.

hypoepinephria A decreased secretion of epi- hypohepatia Impaired liver functioning.

nephrine. hypohidrotic ectodermal dysplasia (HED) A

hypoergasia Diminished functioning. hereditary, sex-linked absence of the sweat

hypoexophoria Outward/downward deviation of glands, teeth, and/or hair. This pediatric condi-

the eye — hypoesophoria. tion places the child at risk for cerebral vascular

hypoferremia Iron-poor anemia. events and heat exhaustion. Most childhood

hypofibrinogenemia Diminished fibrinogen in activities are life-threatening for these children.

the circulation. hypokalemia Hypopotassemia — profound

hypogalactia Inadequate milk production. depletion of potassium in the circulation, caus-

hypogammaglobulinemia Acquired/congenital ing muscular weakness, paralysis, postural

decrease of gamma globulin in the blood, caus- hypotension, tetany.

ing immunodeficiency. hypokinesia Hypocinesis, hypomotility,

hypogenesis Ateliosis — arrested growth/devel- hypopraxia — that diminished muscular reac-

opment in infancy/childhood, which causes tion to stimuli in the form of a slow-moving,

deformity. sluggish response.

hypogenitalism Underdevelopment of the genital hypologia Inadequate speech which signals cere-

organs, undescendedtesticle(s), incomplete bral symptomatology.

maturity of secondary sexual characteristics. hypomagnesemia That deficient blood level of

Hypogonadism. magnesium which increases neuromuscular irri-

hypoglossal Sublingual — beneath the tongue tability with life-threatening results.

(an area of heightened circulation). hypomania "Little mania, little madness." An ele-

hypoglycemia Glycopenia — inadequate blood vated, expansive, irritable mood which does not

dextrose. This precarious condition occurs in produce impairment of occupational/social func-

the presence of inadequate carbohydrate to tioning. Delusions are not present, nor is inter-

cover the insulin in the body. Or, when exer- vention required.

cise/activity has exceeded the patient's hypomanic episode Elation is expansive. An irri-

allowance. Or, when the patient has a fever table affect includes grandiosity. There is a

and/or infection. (The conditions vary with each decreased need to eat or sleep. Press of speech,

diabetic.) This may also be the result of hyper- distractibility, flight of ideas, psychomotor agita-

functioning of the islets of Langerhans, from tion may be seen, with a high involvement in

which insulin is produced. If a comatose person activities with painful consequences, indicating

is discovered still able to swallow, carefully help poor judgment and poor impulse control.

him/her drink a glass of orange juice — whatev- Delusions may be present.

er the reason (probably unknown) for his/her hypomastia Hypomazia — the premature arrest

condition. If hypoglycemic, s/he may be revived. of breast tissue development.

If in diabetic coma, little harm will be done. hypomelanosis Leukoderma —

fasting hypoglycemia A serious excess of absent/decreased pigmentation of the epider-

insulin, which may proceed to death. mis.

hypoglycemic shock Artificially produced insulin hypomenorrhea Regular menses with scanty

shock — that psychiatric modality for major flow.

depression and other serious mental conditions, hypomnesia Hypomnesis — memory impair-

achieved by intravenous infusion of insulin suffi- ment.

cient to cause coma. This risky technique is sel- hypomorph One whose legs are disproportion-

dom, if ever, used today. ately short, in comparison to length of the trunk.

167

hyponanosoma Marked dwarfism. itary gland.

hyponatremia A diminished level of the elec- transphenoidal hypophysectomy That anterior,

trolyte, sodium. surgical approach over the maxillary teeth in the

hyponoia Delayed mental responsiveness. mouth, to the basal skull, where the pituitary

hypopallesthesia The inability to perceive vibra- gland is resected.

tions. hypophysitis Inflammation of the pituitary gland.

hypoparathyroidism Hypoparathyreosis — that hypopinealism Inadequate pineal secretion.

condition caused by insufficient hormone pro- hypopituitarism Insufficient secretion from the

duction by the parathyroid glands. The treat- hypophysis of the pituitary gland.

ment includes vitamin D and synthetic parathor- hypoplasia Di George syndrome — atrophy of

mone. tissue.

iatrogenic hypoparathyroidism That postoper- hypoplastic left heart syndrome That congenital

ative status following inadvertent excision of the and fatal heart defect in which the left ventricle

parathyroid glands (4-12), during thyroidecto- and aorta are malformed. Only the ductus arte-

my. riosus links the aorta to the pulmonary artery.

idiopathic hypoparathyroidism Of unknown Biologically, this seals the first week of life.

etiology, these patients present with antibodies Cardiac surgery remains the intervention of

against adrenal, gastric, parietal, and/or thyroid choice.

glands at a young age. hypopnia Deficient respiratory depth/rate.

pseudohypoparathyroidism An inherited dis- hypopotassemia Hypokalemia.

ease caused by an inadequate response to a hypoproteinemia Insufficient serum protein.

sufficient supply of parathormone. The patient hypoproteinosis Deficient protein in the body

may present with cataracts, convulsions, mental and/or diet.

retardation, "moon face", muscular cramping, hypoprothrombinemia Insufficient circulatory

obesity, short stocky build, strabismus, stridor, prothrombin in order to safely coagulate the

tetany. blood.

pseudo-pseudohypoparathyroidism hyposalaphesia Dulling of the tactile sense.

Pseudohypoparathyroidism in which no bio- hyposarca Anasarca — marked subcutaneous

chemical changes are present, only clinical find- edema of connective tissue.

ings. hyposialadenitis Infection of the submandibular

hypophonia An abnormally weak voice, due to salivary gland(s).

impairment of the respiratory muscles, with hyposmia Hyposphresis, hyposphresia — defec-

dysfunctioning of the speech musculature. tive sense of smell.

hypophosphatasia That hereditary, metabolic hypospadias Hypospadia — that congenital

disease in which there is defective dentition, anomaly in which the urethra opens on the

osteomalacia, skeletal anomalies, urinary phos- under side of the penis or into the vagina.

phoethanolamine due to the cellular deficiency Plastic reconstruction may partially restore

of alkaline phosphatase, and a lack of calcium some of the abnormal features of this condition,

deposits in the bones. In addition to deformities, but the urethra will not exit the glans penis.

dwarfism, epiphyseal enlargement, failure to hypostasis Decreasedcirculation. Sedimentation

thrive remains without effective therapy. The from the diminished flow of body fluid.

hypophosphatasia lethalis form is autosomal, hyposthenia Weakness, subnormal strength.

and marked by many fractures. hypostheniant One whose vital forces and

hypophosphaturia The decreasedurinary excre- strengths are debilitated.

tion of phosphates. hyposthenuria That low specific gravity of urine

hypophrenia Mental deficiency. voided by chronic nephritics.

hypophrenic That which is positioned beneath hypostomia The congenital abnormality of a

the diaphragm. One who mentally handicapped. small mouth.

hypophysectomy Surgical excision of the pitu- hypostosis Deficient ossification.

168

hyposynergia Incoordination. hypotrichosis Abnormal hair loss.

hypotaxia That reduced control over one's volun- hypotrophy Atrophy, abiotrophy — that progres-

tary actions which occurs under hypnotism. sive, functional loss and degeneration of tissue.

Still, a subject will not betray his/her morals and hypotropia Vertical strabismus.

ethics. hypovaria Deficient ovarian secretion resulting in

hypotelorism Decrease in the space between the growth/developmental retardation in females.

eyes, or between other bilateral organs. hypovenosity Atrophy and/or degeneration

hypotension Systolic/diastolic blood pressure caused by inadequate venous development.

reading(s) below normal, which may be seen in hypoventilation Reduction in the depth/rate of

Addison's disease, anemia, cachexia, carcino- respirations.

matous states, debilitating conditions, fever, hypovolemia Oligohemia, oligemia —

hemorrhage, impending death, infection, Diminished volume of blood.

neurasthenia, shock, et al. hypoxemia Anoxia, hypoxia, hypoxemia — That

orthostatic hypotension Dizziness, syncope, or deficiency of oxygen/oxygen concentration.

other weakness experienced when the patient hypoxic lap swimming A risky technique used in

rises from a recumbent or sitting position. competitive swimming. Swimmers are trained to

These patients should be reminded to remain tolerate forced apnea to increase their tolerance

still following these position changes — until of oxygen debt during racing. This dangerous

circulatory strength has been re-established. practice has led to drownings.

hypothermia Body temperature below 90° hypsarrhythmia Abnormally slow brain waves

Fahrenheit (F)/32.5° Centigrade (C). with exceptionally high voltage — clinically

therapeutic hypothermia That induced to associated with infantile spasms and progres-

reduce oxygen demands during neurological sive mental deterioration. The etiology is

and cardiovascular surgery. Treatment for unknown.

hyperpyrexia. hypsokinesis That tendency to fall backwards

traumatic hypothermia That which occurs due when erect.

to exposure, and which could be lifesaving. hypsophobia An exaggerated fear of heights.

Dyspnea will occur upon entering frigid water. hysteralgia Hysterodynia — pain in the uterus.

This discomfort will lessen if the victim can hysterectomy Uterectomy, laparohysterectomy,

float. Unless absolutely essential, no attempts hysterolaparotomy — surgical excision of the

should be made to swim. Even accomplished uterus.

swimmers are likely to drown suddenly. Nor abdominal hysterectomy A common approach.

should one exercise in the water to keep warm Cesarean hysterectomy Removal of the uterus

— this exertion will have a paradoxical effect. following a Cesarean section.

Obese victims become dangerously cold when Porro hysterectomy Supracervical hysterecto-

submerged in freezing water more slowly than my, supravaginal hysterectomy — a subtotal

do thin victims. hysterectomy following the Cesarean section.

hypothrombinemia Inadequate circulatory radical hysterectomy Pan hysterectomy,

thrombin. Wertheim's hysterectomy — surgical excision of

hypothymia Diminished emotional response. the uterus, fallopian tubes, ovaries, partial vagi-

hypothyroidism That condition resulting in a na, and all adjacent lymph nodes.

reduced basal metabolic rate (BMR) due to defi- subtotal hysterectomy Supracervical hysterec-

cient production of thyroxin. Replacement thy- tomy, supravaginal hysterectomy — excision of

roid extract (synthetic) and iodized salt in gener- the uterus, sparing the cervix.

alized use have become the preventatives of total hysterectomy Surgical excision of the

choice. uterus and cervix uteri.

hypotonia Hypoisotonia — the lessened tonicity vaginal hysterectomy Excision of the uterus via

of intraocular pressure and muscles. Relaxed the vaginal approach.

arteries and reduced tension maya result. hysteria A temporary psychological disorder in

169

which the person episodically exhibits emotional
instability.
hysteritis Uterine infection/inflammation.
hysteroid dysphoric profile Panic attacks coex-
isting with depressive symptomatology — aner-
gia, hysteroid personality, interpersonal reactivi-
ty of mood, rejection sensitivity.
hysterolith Uterine calculi.
hysterolysis Surgical freeing of uterine adhe-
sions.
hysteropexy Laparohysteropexy, hysterofixation,
surgical fixation of the uterus, uteropexia,
uteropexy, hysterogastrorrhaphy.
hysteropsychosis A psychiatric disorder arising
from uterine pathology.
hysteroptosis Hysteropsia, procidentia — pro-
lapsed uterus.
hysterorrhaphy Suturing of the uterus.
hysterorrhaxis Rupture of the uterus — a surgi-
cal emergency which may be fatal.
hysterospasm Uterine cramping.
hysterostomatocleisis That surgical correction
of vesicovaginal fistula(e). Surgical closure of
the cervix with union of the vesical and uterine
cavities into one.
hysterotome An instrument which incises the
uterus.
hysterotomy Laparohysterotomy — incision into
the uterus.
hysterotrachelorrhaphy Plastic repair of a cervi-
cal laceration(s) by trimming, approximating,
and suturing the edges.
hysterovagino-enterocele Herniation encom-
passing the intestines, uterus, and vagina.

I

ianthinopsia Abnormal visual perception in icterohemoglobinuria Erythrocytes present in

which all is seen in shades of purple. the urine of jaundiced patients.

iatrogenic disorder An adverse condition which icterohepatitis Inflammation of the liver which

resulted from medical/surgical treatment. results in jaundice.

iatrogeny That unintended state, inadvertently icterus Jaundice of secretions, tissues, and

caused by the practitioner — which may be set- membranes from bile pigment.

tled in or out of Court. hemolytic icterus Nonobstructive icterus — a

iatrotechnique Medical/surgical arts. rare and chronic form of this occasionally con-

Iceland disease Epidemic neuromyasthenia. genital condition. Attacks of intense hemolysis

ice treatment Immersion of a burned area into may be seen to recur. Splenomegaly is present.

ice water for early control of thermal pain. When obstructive icterus That caused by obstructive

the coldness becomes painful, remove the part hepatic abscess, tumor, parasites, cysts, cirrho-

until the pain of the burn returns. Return to, and sis, cholelith(s), carcinoma, cholangitis. The

remove from this cryotherapy until interrupted patient's secretions, sclerae, mucous mem-

for examination. This relieves other injuries as branes and skin may all be jaundiced. The scler-

well. ae should always be observed as confirmation

ichthyism Ichthyismus — poisoning from the of icterus. (In black patients, it may be difficult

ingestion of toxic fish. to note jaundice except by the sclerae and

ichthyosis A chronic condition in which the skin secretions.) Clay-colored stools, dark urine,

is scaly and exceptionally dry. Some of these bradycardia, subnormal temperature may be

forms are hereditary, all leave the victim a life of seen, and in critical cases, seizure, delirium,

torment. Soap is contraindicated. and/or coma.

lamellar ichthyosis of the newborn A rare, pseudoicterus That yellow cast which is not

inherited form, in which desquamation appears jaundice.

in scales and thin plates. icterus gravis neonatorum Hemolytic jaundice of

xeroderma A mild form seen on the legs of the newborn — usually caused by Rh incom-

geriatric patients. Creams may be covered by patability. This significant form may respond to

dressings at HS (bedtime). bilirubin light, et al.

ichthyosis congenita Ichthyosis fetalis, harlequin icterus neonatorum A mild, self-limiting

fetus, Siemens' syndrome, ichthyosiform ery- hemolytic jaundice of the newborn, which

throderm — from which neonates expire within requires no intervention.

days. ictus A sudden attack.

ichthyosis vulgaris Hereditary forms of ictus cordis Cardiac arrhythmia.

ichthyosis. ictus epilepticus Seizure, convulsion.

dominant ichthyosis vulgaris That which ictus sanguinus Cerebrovascular accident (CVA).

appears between the ages of 1-4 years.Some ictus solis Sunstroke.

improve with growth/maturity. id That instinctive personality of the psyche in

sex-linked ichthyosisvulgaris Transmitted by which impulse and drive seekexpression.

females and borne by males, this onset within idea Mental conception, inspiration, creation.

infancy spares the face. Improvement may con- autochthonous idea An independent, sponta-

tinue. neous thought.

icing Cutaneousstimulation using ice to evoke compulsive idea A persistent impulse.

reflex response. Patients with dysfunctioning of dominant idea That which controls all

the central nervous system may receive a trial of thoughts/actions.

this modality. fixed idea Idee fixe — a delusion which per-

ictal A sudden attack. sists despite evidence to the contrary. An obses-

postictal That which follows a seizure. sion.

icteroanemia Jaundice associated with anemia, flight of ideas Flow of accelerated speech

hemolysis, splenomegaly. which abruptly changes topics, may be incoher-

171

"Obniti latrogenesi
is much akin to

Primum Non Nocere. "

("To strive against iatrogenesis is much akin to first do no harm.")

Billy F. Andrews, M.D.
Positive Aspects of Iatrogenesis, 1985

ent and/or disorganized. seizures.

ideas of reference The belief that others' genetous idiocy Severe mental deficiency,

actions/conversations have reference to oneself, which is congenital.

and that objects and events have a unique hemiplegic idiocy That which is accompanied

meaning for him/her. by one-sided paralysis.

ideal Standard of value. hydrocephalic idiocy That complicated by

identification A subconscious defense mecha- accumulation of cerebrospinal fluid, within the

nism which is essential in developing the per- cerebral ventricles.

sonality. intrasocial idiocy Mental deficiency which per-

identified patient (IP) In family counseling, this mits the child to become trainable.

refers to the patient known to the practice — for microcephalic idiocy That in which the patient

whom the intervention is taking place. S/he may also has a markedly diminished cranium.

not be the one most in need of counseling, but paraplegic idiocy That mental deficiency com-

the one who came into therapy, for guidance plicated by paresis.

with the family maladjustment. sensorial idiocy The mental deficiencywhich

identity One's concept of one's body in space. compromises the rehabilitation of blindness,

Those thought processeswhich relate to one's deafness, or other sensory handicap.

intellectual/social environment. One's traumatic idiocy That caused by injury.

mental/physical characteristics which are unique idiogenesis Pathology of self-origin, or of

to the individual. unknown etiology.

gender identity One's self-concept (or confu- idiopathic That condition apparently of sponta-

sion) about his/her sexual identity. neous origin, lacking clear cause/etiology/patho-

idiocy Severe mental deficiency — usually devel- genesis.

oped in utero. This may be hereditary, traumat- idiopathic hypercalcemia Vitamin D intoxication

ic, or related to severe pathology. This term is seen in infants.

rarely used. idiopathic hypogeusia That syndrome of

complete idiocy The absence of primitive unknown etiology, consisting of distorted

instincts — including self-preservation. taste/smell.

cretinoid idiocy Cretinism — endemic mental idiopathic inflammatory myopathy

deficiency in the presenceof goiter. Dermatomyositis, polymyositis.

epileptic idiocy That accompanied by epileptic idiopathic membranous nephropathy A primary

172

glomerulonephritis which usually causes a ileostomy bag will collect urine/loose feces.

nephrotic syndrome. The treatment is contro- ileus Acute intestinal obstruction — paroxysmal

versial, but methylprednisolone is of help to abdominal pain which becomes constant,

many. Those patients without nephrotic syn- accompanied by constipation, persistent fecal

drome have a favorable course without therapy. emesis, distention, and/or collapse.

idiopathic pulmonary fibrosis Interstitial pul- adynamic ileus Ileus paralyticus. caused by

monary disease presenting with a rapidly paralysis of the intestinal muscles.

degenerating clinical course because of fibro- dynamic ileus That caused by contractions of

sis/pneumonitis. Major pulmonary symptoms the intestinal musculature.

may not be evident at the outset, but anoxia, mechanical ileus Obstruction becomes the eti-

dyspnea, fatigue, tachypnea, weakness, and/or ology.

weight loss may. As the disease runs its course, meconium ileus That caused by a meconium

cardiac failure, clubbing of the fingers, cyanosis obstruction in the neonate.

may be seen. A definitive diagnosis may be con- postoperative ileus A surgical complication of

firmed only upon open biopsy. bowel manipulation, general anesthesia, wound

idiosyncrasy A special characteristic, opposite sepsis, and/or electrolyte imbalance — which is

reaction. Unusual susceptability to an a risk of all bowel procedures.

action/philosophy/substance. ileus subparta Pressure exerted on the colon by

idiosyncrasy of effect An absent, accelerated, the gravid uterus.

extraordinary, iatrogenic, inappropriate, para- iliocolotomy A surgical opening into the

doxical, or toxic, reaction. iliac/inguinal areas of the colon.

idiot-savant A single area of brilliance and capa- iliopagus Conjoined twins attached at the iliac

bility in the otherwise severely retarded person. region.

This term is seldom used. iliopsoas abscess Suppuration in the

igniextirpation Surgical excision by electric iliacus/psoas muscles.

cautery. iliothoracopagus Conjoined twins' attachment

ignis Sancti Antonii Erysipelas — that localized from the thorax to the pelvis.

inflammation accompanying acute febrile dis- ilioxiphopagus Conjoined twins fused from the

ease. These patients may go on to develop bul- xiphoid process to the pelvis.

lae, septicemia, nephritis. Ilizarov external fixator A limb-lengthening

ileal bypass Surgical anastomosis which device, designed to correct bone and soft tissue

bypasses a portion of the small intestine — a deformities/defects. This is utilized in the

treatment for morbid obesity. lengthening of extremities, congenital defects,

ileal conduit A surgical diversion of urine from nonunion fractures, and trauma. Up to a year

the bladder by inserting the ureter into the ileum later, the fixator is left on for one month past the

— which portion opens at the abdominal wall goal. It is vital that all pin sites be kept free of

for collection. infection, and pressure sores prevented.

ileectomy Surgical ablation of the ileum. illaqueation The technique of passing a thread

ileocolitis That inflammation of the mucosae of behind an inverted eyelash, to revert it.

the colon and ileum. illegitimate A birth occurring out of wedlock.

ileocystoplasty Implantation of the ileum to aug- That which is illegal.

ment the bladder. illness That condition of sickness/disease.

ileocystostomy That communication surgically catastrophic illness A complicated, complex,

established between the bladder and the ileum. prolonged costly disease course.

ileostomy That surgical construction of an outlet illuminism Psychotic delusions in which the

from the ileum to a stoma at the abdominal patient believes s/he is communicating with

wall. An ileostomy bag must be worn. exalted/supernatural beings.

urinary ileostomy The creation of a communi- illusion A misperception of sensory input, disor-

cation between the bladder and the ileum. The dered idealism. External stimuli may be produc-

173

tive of disordered ideation. When these become body formation.
fixed, they are delusions. immunosuppression That altered natural
optical illusion A misperceived visual stimulus.
image Reflection, mental picture. immune response to antigens.
body image One's concept of oneself (which immunosuppressive agent That drug(s) which
may be distorted).
latent image An undeveloped X-ray. enhances the survival of foreign transplants and
mirror image Identical twins in whom handed- grafts. Also, that used in the control of autoim-
ness, growth features, et al., are opposite — as mune disease.
though the twins were looking into a mirror, immunotherapy The induction of blocking anti-
when looking at each other. bodies. This creates a steroid effect in which
imagery A mental recall of sensory stimulation hyperreactivity returns to normal without the
— an auditory, olfactory, tactile, gustatory, or complications of steroid therapy.
visual image. immunotransfusion The infusion of blood with
imbalance Discoordination. Lacking equality.
autonomic imbalance Inequality between the known antibodies.
sympathetic and parasympathetic divisions in impaction The overloading of an organ. That
vasomotor reactions.
sympathetic imbalance Vagotonia — which is immovably compressed together.
increased vagus nerve excitability. impairment Physiological, psychological, func-
vasomotor imbalance Excessive
vasodilation/vasoconstriction, elicited by vaso- tional, or structural abnormality.
motor impulses. impalement The traumatic piercing of the trunk.
immature Undeveloped. impalpable Imperceptible to the touch/palpation.
immedicable Incurable. imparidigitate An uneven number of digits.
immobilization Prevention of motion — which impatent Closed, impenetrable.
may allow the development of complications. impedance Resistance.
This may be achieved by bedrest, confinement
to a wheelchair, bracing, casting, et al. acoustic impedance Resistanceto sound wave
immunocytochemistry Immunohistochemistry. transmission.
imperforate Lacking an opening.
immunity Protection from disease. imperforate anus Aproctia, which is a surgical
Immunization. emergency following birth.
acquired immunity That protection achieved imperforate hymen Atresia.
through disease (active immunity), or vaccina- imperious acts Involuntary
tion (passive immunity). actions/motions/movements.
cell-mediated immunity Delayed cellular impermeable That which is impenetrable, imper-
defenses. vious — an obstructed passage.
congenital immunity That acquired/natural pro- impetigo Inflammatory dermatitis which may be
tection present at birth. aggravated by emotions.
herd immunity That resistance of a group of impetigo contagiosa The communicable, pedi-
persons (family, race, etc.) to a disease. atric form of this eruption. The child may not
natural immunity Permanent protection against return to school until all lesions have healed.
disease, resulting from inherent factors. impetigo herpetiformis A rare form which may
be seen in pregnancy.
immunocompetence The capacity to develop implantation That graft, medication, or radioac-
antigenic response. tive device which has been inserted into the
body.
immunocompromised Those at risk for the implosion In behavioral therapy, the flooding of
development of medical complications because intense stressors, with the goal of desensitiza-
of an abnormal immune system. tion.
impotence Erectile dysfunction with organic/psy-
immunogenicity The potential to stimulate anti- chiatric overtones. Insulin-dependent diabetes
mellitus is a prominent cause, because of pelvic
neuropathy. The therapy may include medical,

174

Standards for Pediatric Immunization Practice

Guide to Contraindications and Precautions to Immunizations

Vaccine True Contraindications and Not True (Vaccines may be given)
Precautions

Anaphylaclic reaction to a vaccine contraindicates further doses Mild 10 moderate local reaction (soreness, redness,
of that vaccine
swelling) following a dose of an antigen
Anaphylaclic reaction to a vaccine constituentcontraindicates
GENERAL the use of vaccines containing that substance
FOR ALL
VACCINES Moderate or severe illnesses with or without a fever Mild acute illness with or without low-grade fever
[DTP/DTaP,
OPV, IPV, Current antimicrobial therapy
MMR, Hib,
HBV] Convalescent phase of illnesses

DTP/DTaP Prematurity (same dosage and indications as for normal,
full-term infant-s)
OPV***
Recent exposure to an infectious disease

History of penicillin or other nonspecific allergies or
fact that relatives have such allergies

Encephalopathy within 7 days of administration of previous Temperature of <40 5CC 1 105°Fl following a previous
dose of DTP dose of DTP
Family history of convulsions**
Fever of >40.5oC (105°F) within 48 hrs after Family history of sudden infant death syndrome
vaccination with a prior dose of DTP
Family history of an adverse event following DTP
Precautions* Collapse or shocklike slate (hypotonic- administration
hyporesponsive episode) within 48 hrs of
receiving a prior dose of DTP

Seizures within 3 days of receiving a prior dose
of DTP (see footnote** regarding management of
children with a personal history of seizures al any
time)

Persistent, inconsolable crying lasting >3 hrs.
within 48 hrs of receiving a prior dose of DTP

Infection with HIV or a household contact with HIV Breast feeding

Known altered immunodeficiency (hematologic and solid Current antimicrobial therapy
tumors; congenital immunodeficiency; and long term
immunosuppressive therapy)

Immunodeficient household contact

Diarrhea

Precaution* Pregnancy

psychiatric, and/or urological (surgical) inter- psychic impotence That due to mental disor-
vention. der/maladjustment/impairment.
symptomatic impotence Caused by disease,
anatomic impotence That caused by organic malnourishment, medication.
defect(s) in the genitalia. vasculogenic impotence That due to inade-
atonic impotence The result of genital nerve quate arterial supply to the corpora cavernosa.
paresis. impulse An instinctive urge. Spontaneous activi-
functional impotence Of psychogenic origin,
not due to anatomic/organic defect. ty.

175

Guide to Contraindications and Precautions to Immunizations

Vaccine True Contraindications and Not True (Vaccines may be given)
Precautions
IPV Tuberculosis or positive PPD
Anaphylactic reaction to neomycin or streptomycin Simultaneous TB skin testing*****
MMR*** Breast feeding
Precaution* Pregnancy Pregnancy of mother of recipient
Immunodeficient family member or household contact
Anaphylactic reactions to egg ingestion and to neomycin**** Infection with HIV
Nonanaphylatic reactions to eggs or neomycin
Pregnancy
Pregnancy
Known altered immunodeficiency (hcmatologic and solid
tumors; congenital immunodeficiency; and long term
immimosuppressive therapy)

Precauti.on* Recent (within 3 months) IG
administration

Hib
HBV

The events or conditions listed as precautions, although not contraindications, should be carefully reviewed. The benefits and risks of
administering a specific vaccine to an individual under the circumstances should be considered. If the risks are believed to outweigh the
benefits, the immunization should be withheld; if the benefits are believed to outweigh the risks (for example, during an outbreak or
foreign travel), the immunization should be given. Whether and when to administer DTP to children with proven or suspected
underlying neurologic disorders should be decided on an individual basis. It is prudent on theoretical grounds to avoid vaccinating
pregnant women. However, if immediate protection against poliomyelitis is needed, OPV, not IPV, is recommended.
**Acetaminophen given prior to administering DTP and thereafter every 4 hours for 24 hours should be considered for children with a
personal or with a family history of convulsions in siblings or parents.
***There is a theoretical risk that the administration of multiple live virus vaccines (OPV & MMR) within 30 days of one another if not
given on the same day will result in a suboptimal immune response. There are no data to substantiate this.
****Persons with a history of anapnylactic reactions following egg ingestion should be vaccinated only with extreme caution. Protocols
have been developed for vaccinating such persons and should be consulted (J Pediatr 1983;102:196-9, J Pediatr 1988;113:504-6).
*****Measles vaccination may temporarily suppress tuberculin reactivity. If testing can not be done the day of MMR vaccination, the
test should be postponed for 4-6 weeks.

This information is based on the recommendations of the Advisory Committee on Immunization Practices (ACIP) and those of the
Committee on Infectious Diseases (Red Book Committee) of the American Academy of Pediatrics (AAP). Sometimes these
recommendations vary from those contained in the manufacturer's package inserts. For more detailed information, providers
should consult the published recommendations of the ACIP, the AAP, the AAFP, and the manufacturer's package inserts.

With permission of: Centers for Disease Control, Atlanta, Georgia, USA.

impulse control disorder Failure to resist the tious setting of fires — often out of transfixed
drive/temptation to carry out a harmful/forbid- fascination.
den act. This may require psychiatric interven- trichotillomania Gratification and security are
tion. achieved from pulling out one's hair in signifi-
intermittent explosive disorder Serious cant amounts.
destructive/assaultive acts committed in a rage impulsion Negative ideas which impose them-
state — due to lack of impulse control. selves on the patient with obsessive insistence
kleptomania The spontaneous theft of that until the compulsive act has been completed.
which one does not need, and for which the Doubting mania (checking and rechecking),
perpetrator had funds with him/her. arithmomania, delirium of touch, dipsomania,
pathological gambling An addictive form of exhibitionism, homicidal impulses, kleptomania,
lack of impulse control. obsessive compulsions/fears, onomatomania,
pyromania That deliberate, obsessive, repeti- pyromania, and suicidal ideation are forms

176

which may be noted. choice.

inactivation Rendering something inert. incoherence The inability to express oneself

inadequacy Incompetency, insufficiency. meaningfully and concisely.

inadequate vasodilator reserve Seen in women incompatibility The status of unsuitability for

of >65 years, this syndrome presents with clas- chemical interaction, due to the

sic angina pectoris accompanying metabolic and insolubility/reactivity/toxicity of the

EKG (electrographic) anomalies. These signs are component(s).

consistent with myocardial ischemia. incompetency Inadequacy which may be aortic,

inanimate That which lacks animation, life. ileocecal, mental, muscular, palatal, pyloric, rela-

inanition Debilitation due to gastrointestinal mal- tive, valvular.

absorption/starvation. valvular incompetency Regurgitation permitted

inapparent process An asymptomatic/subclinical by leaking cardiac valves.

phenomenon without significant clinical signs. incompetent palatal syndrome Hypernasality

inarticulate Inability to speak distinctly and intel- and distortion of speech due to

ligently. ineffective/incomplete separation of the soft

in articulo mortis The precise moment of death. palate from the oropharynx. This may be caused

inborn Innate, inherent, inherited features. by acquired, congenital, and/or psychiatric fea-

inbreeding Marriage among blood relatives. tures.

incarceration Imprisonment, confinement. incontinence That inability to retain urine, saliva,

Strangulation of herniation — a surgical emer- milk, semen, or feces, due to a variety of caus-

gency. es.

incentive spirometry Vocal/visual encourage- giggle incontinence Urine loss during laughter

ment built into a breathing apparatus to stimu- — that which may be attributed to central ner-

late deep breathing in the postoperative period. vous system (CNS) pathology. This problem is

Some will challenge inhalation, and some exha- not related to stress incontinence.

lation in their operative guidelines. Small chil- stress incontinence That which occurs during

dren may be given bubbles to blow, or similar, coughing, vomiting, sneezing, laughing, or exer-

age-appropriate ideas. tion — even immediately following voiding, in

incest Coitus with blood relatives — all of whom the presence of residual urine in the bladder.

are vulnerable to revictimization. This psychopa- Kegel's exercises are advised, as well as urine

thy may be refractory to treatment until a sensi- culture.

tive professional explores these areas with the incoordination Disdiadochokinesia asynergy —

victim. Legal intervention of defiant, deviant, dysrhythmia and uneven movements, not attrib-

incestuous relationships may meet with the uted to weakness. These may be motor/sensory

patient's resistance. Some victims will protect in nature.

the perpetrator out of fear. incubation period That period of time lapsing

incise To cut with a scalpel. from an exposure to a communicable disease,

incision Surgical development of a wound into to its onset.

the body, with a scalpel. incudectomy Surgical excision (partial/total) of

incision and drainage (I & D) Surgical/incision the incus from the middle ear.

and drainage of suppurative material. incurable That which cannot be healed.

inclusion blenorrhea Bilateral conjunctivitis of index The norm. A fixed standard.

the newborn. Swimming pool conjunctivitis. index case/patient S/he whose symptomatic

inclusion-body myositis Diagnosed by muscle condition becomes the studied or investigated

biopsy, this idiopathic, inflammatory myopathy case.

remains subacute for weeks to years. Usually Indian childhoodcirrhosis An acquired toxico-

seen in male patients, this condition responds sis. The elevated hepatic levels of copper are

poorly to corticosteroids. However refractory, associated with the boiling, feeding, storage of

immunosuppresive therapy remains that of milk in copper and/or brass containers. There is

177

no definitive therapy. piratory independence. 3. Death must have been
indicanuria Urocyanosis.
indigestion Dyspepsia, nausea with/without attributed to willful neglect or intentional injury
(multiple stab wounds, asphyxia by strangula-
vomiting, esophageal reflux, pain. tion, laceration of the umbilical cord, drowning,
indigitation Invagination, intussusception of the et al.)
Realizing that the expired infants would only live
intestines. a life of repeated abuse, those in this work refer
indolaceturia Excretion of an elevated level of to these infants: "Those are the lucky ones."
infantilism Retardation of growth and mentation
urinary indolacetic acid — seen in patients with in any area.
phenylketonuria. A precise diet will be required angioplastic infantilism That caused by abnor-
to guard against brain damage. mal vasculature.
indolence Sluggish inactivity. Brissaud's infantilism Cretinism, myxedema-
indolent ulcer That which is painless, but slow tous retardation.
to heal. (Becausethis problem is free of pain cachectic infantilism That caused by poisoning
and bother, medical intervention might not be or infection.
sought until it is far advanced.) Grafting may be celiac infantilism Intestinal malabsorption
required. becomes the causative agent due to dietary
induction Evocation — the initiation of anesthe- intolerance of gluten.
sia, labor. dysthyroidal infantilism That caused by thyroid
induration Hardening. pathology.
inebriation Intoxication, drunkenness. hepatic infantilism That complicated by cirrho-
inertia Inactivity. sis.
uterine inertia Absent, weak, or nonproductive hypophyseal infantilism Hypophyseal
contractions in labor. This might be critical in dwarfism, pituitary immaturity.
the delivery room. idiopathic infantilism Arrested pediatric
in extremis The patient who is moribund, expir- growth of unknown etiology.
intestinal infantilism A chronic growth disor-
ing. der.
infanticide Neonaticide — homicidal violence, renal infantilism That caused by urological
dysfunctioning.
inflicted upon infants. The methods used in sexual infantilism Pervasive growth dysfunc-
such child abuse include manual/pedal/instru- tioning apparent in the secondary sex character-
mental assault, starvation, asphyxiation by plas- istics.
tic, carbon monoxide, drowning, et al. Blows to universal infantilism That characterized by
the infant's head may produce fatal trauma to absent secondary sexual characteristics, accom-
the skull (far greater than that which would be panied by dwarfism.
sustained by an older victim. Only autopsies can infarct Necrosis of tissue, following interruption
prevent such violence being explained away by of circulation by stenosis/occlusion of the ves-
the perpetrator.) Equally essential is that post sel. Hemorrhagic infarcts are likely to become
mortem examinations be performed on all sus- embolic.
picious coroners' cases. Although neonaticide is infarction The physiological process accompany-
usually wrought by the mother in solitude, all ing infarct formation
other posibilities must be considered. In the myocardial infarction That occurring in the
United States, all RNs are mandatory reporters coronary arterial system, such as an infarct in
to the authorities for any and all cases of child the myocardium. Patients may expire within the
abuse. They need not defend their concerns, nor early hours post-infarction.
does their report need to be correct, just suspi- pulmonary infarction Following pulmonary
cious/concerned. embolism, that occurring in lung tissue.
Infanticide/Neonaticide. Defined: Infanticide
must include the following conditions 1. The
baby must have been fully delivered. 2. The
neonate must have achieved circulatory and res-

178

infection Invasion by a pathogenic virus/micro- serum and blood cells, with vascular conges-

organism. Inflammation may be present tion.

with/without infection. This presents the classic granulomatous inflammation That involving

syndrome of discoloration, edema, limited func- production of granular tissue.

tioning, localized pain, erythema, and warmth. hyperplastic inflammation Proliferative of

contagious infection Communicable disease, excess fibrous tissue.

transmitted by direct contact with an infected parenchymatous inflammation That in which

patient(s). epithelial/glandular tissues are affected.

endogenous infection That caused by nonpath- pseudomembraneous inflammation That toxin

ogenic flora within the gastrointestinal (Gl) which is produced, necrotizes tissue, as occurs

tract. in diphtheria.

exogenous infection That caused by micro- purulent inflammation Suppurative infection.

organisms outside the body. ulcerative inflammation The formation of

metastatic infection The broadcasting of dis- ulceration over the area of infection.

ease from a focal source. inflammatory myopathies Dermatomyositis,

mixed infection Diseases caused by more than polymyositis. Prednisone is the drug of choice

one organism. for these autoimmune conditions.

nosocomial infection A hospital-acquired ill- inflammatory response Cellular tissue changes

ness. which attempt to produce a localized, protective

opportunistic infection Disease occurring in reaction to the invasion of infection.

the immunosuppressed patient. influenza La grippe — an acute, contagious,

subacute infection That illness less than acute, self-limiting respiratory infection. The prognosis

and greater than chronic. is guarded in cyanotic patients, those younger

subclinical infection That without clinical than 1 year, those older than 60 years, and

symptomatology. patients with chronic illness. Influenza is char-

superinfection Concurrent secondary patholo- acterized by an abrupt fever, myalgia, pharyngi-

gy. tis, and nonproductive cough. The malaise lasts

suppurative infection A pyogenic condition. many days. If primary influenza pneumonitis or

terminal infection An acute, septic complica- secondary bacterial pneumonia ensues, more

tion of end stage disease. severe complications may follow. It is advised

transplacental infection An inflammation tran- that the geriatric population, medical/nursing

scending the placenta. personnel, employees of chronic care facilities,

infectious arthritis That occurring from infected home health workers of high risk patients, and

synovial tissues. Microbes may reach the joint household members of patients at high risk, all

via surgery, injection, second degree to trauma, receive influenza vaccine.

or by the circulation. informed consent Voluntary and competent per-

infertility Those factors of emotional problems, mission to allow hospitalization, procedures,

endocrine dysfunctioning, immaturity of the research, experimental medication, donation of

reproductive system, venereal infection, pelvic organs, et al. Full understanding of the docu-

anomalies — any of which may prevent concep- ment is mandatory. Underage young people who

tion. Many may be reversible. are married, in the United States' armed ser-

secondary infertility That which occurs follow- vices, and emancipated minors, may give their

ing pregnancy carried to term. own consent, as per the above law.

inflammation The response of tissue to injury. infrapsychic Automatic behavior/response

This reaction may include edema, erythema, beneath the level of consciousness.

heat, and/or pain. infraversion Downward deviation of the eye(s).

catarrhal inflammation That which is mucus- infundibulation The genital mutilation of girls in

producing. Africa and elsewhere. Becausethis crude, bru-

exudative inflammation Accumulation of tal, unanesthetized, tribal custom is conducted

179

without protocol, each mutilation varies. That impulse, speech, thought, or denial of libido.
which is constant is the intergenerational abuse iniencephalus That congenital deformity in
which inflicts terror, deformity, and unmedicated
pain in this "female circumcision". which the brain and cerebral spinal cord occupy
infusion Therapeutic administration of parenteral the same occipital cavity.
fluids, medications. iniopagus Conjoinedtwins fused at the occiput.
continuous infusion Chemotherapy of a drug iniops That congenital deformity of conjoined
sustained at a constant intravenous (IV) rate — twins, fused from the thorax to facial anomalies.
preferably by an IV pump. In the precise treat- injection Parenteral administration of a fluid or
ment of neoplastic disease, an intravenous drug.
pump is mandatory! epidural injection Administration of an anes-
subclavian infusion A venous cutdown into a thetic into the spinal canal, outside the dura
major vessel in order to administer caustic con- mater.
centrations, total parenteral nutrition, and/or fractional injection Administration of a dose in
medications, guarding against toxicity by circu- micro-portions.
latory dilution. intracardial injection Administration of emer-
hypodermoclysis Administered into the sub- gency medications directly into the heart, by a
scapular region of infants, or into the lateral physician.
thighs of adults. This fluid replacement is sub- intradermal injection Intracutaneous adminis-
cutaneous, not intravenous, and rarely tration of vaccines and sera.
employed today. intralingual injection An emergency intra-
ingravescent An increase in severity. venous site used in circulatory collapse.
inguinodynia Inguinal pain. intramuscular injection (IM) Parenteral admin-
inhalant intoxication Intentional abuse of hydro- istration into the deltoid, gluteal muscles, et al.
carbon and volatile aerosols, with the end result intrathecal injection That instillation of anti-
of maladaptive mentation/behavior/social and neoplastic agents, anesthetics, analgesia, et al.,
occupational functioning. Vertigo, nystagmus, into the spinal canal.
euphoria, ataxia, psychomotor retardation, visu- intravenous injection (IV) A bolus of medica-
al distortion, may advance to coma. tion administered by vein for immediate effect.
inhalant dependence Diaphoresis, illusions, irri- jet injection The administration of agents as a
tability, nausea, sleep disturbances, and tremor high-speed aerosol, via an injection gun —
are seen. Recurrent abusive behavior may result which enters the dermis without disturbing its
in withdrawal, damage of the peripheral nervous continuity. This modality is especially efficient in
system, liver pathology, and clinical depression. vaccinating the masses because of its speed in
inhalation of flames The patient may present in the absenceof contamination.
shock, with marked limitation of respirations. sclerosing injection That into tissue or vessel
Smoke inhalation should be ruled out in all — to render sclerosis/obliteration of that tissue.
those who have been exposedto fire/smoke. subcutaneous injection (sub Q) Intradermal
Pulmonary edema and bronchospasm place administration beneath the epidermis. It is this
these victims at the top of triage determinations. route by which the hypodermoclysis is infused.
Tracheotomy may be indicated. Z-track injection A technique used with med-
inhalation therapy The administration of anes- ications which are irritating/staining to the tis-
thetic agents, gases, medications, water by neb- sues. The layers of the gluteal muscle are man-
ulization and other prescribed agents. ually displaced, while inserting the needle and
inherent Innate, intrinsic. injecting the drug. The needle is withdrawn
inhibited sexual excitement Sexual "frigidity". before the muscle is quickly released.
inhibition Restraint/repression of an action, injury That which interrupts the integrity of the
function, mental process. body.
psychic inhibition Suppressed/arrested action, internal injury That not visible — an organic
wound. Although s/he may not appear to be

180

severely injured, this patient may be in life- tomatology — agitation, anorexia, cardiar-

threatening shock. rhymias, gastrointestinal problems, and visual

steering wheel injury Trauma to the ribcage halos. Weight gain (> 3 Ibs), pedal edema, nau-

may involve a cardiac contusion. sea and vomiting, and bradycardia may also be

innate Intrinsic, inherent. seen. African, geriatric, and female patients are

innervation Functioning of the nerves. at greatest risk for digitalis toxicity. Epinephrine

collateral innervation Distribution of the is often the first potent cardiac stimulant/vaso-

nerves to augment damaged and destroyed constrictor administered in cardiac arrest, and is

nerves. rapidly metabolized. Alcohol is strictly con-

double innervation That supplied by both sym- traindicated.

pathetic and parasympathetic nerve fibers. inquest Forensic investigation into a death which

reciprocal innervation Induction of neural was unexpected, occurred on the operating

action, followed by inhibition of opposing table, occurred within 24 hours of admission to

action. a hospital. Many are considered to be coroner's

innidiation The multiplication of metastasized cases, and require autopsies (especially as edu-

cells. cational procedures), with/without consent.

innocent Benign, clinically insignificant, harm- insatiable One incapable of being satisfied.

less, innocuous, innoxious. insecurity That inability to cope with apprehen-

innominate Unnamed, such as artery, bone, vein. sion, feelings of vulnerability, helplessness,

inoculation Immunization by jet injector, by nee- fears, people, situations, et al.

dle and syringe, or by scarification. insemination Fertilization, copulation.

inomyxoma Fibromyxoma — that mixed tumor artificial insemination Clinical impregnation.

of degenerated fibroma (fibromyxoma) and heterologous artificial insemination

mucous connective tissue (myxoma). Impregnation in which the semen used is not

inoperable Surgery is contraindicated because of that of the husband.

the patient's fragile status, comorbidity, homologous artificial insemination Clinical

metastatic status, or general medical concern impregnation in which the semen donor is the

for the patient's palliative status, his/her termi- husband. Sometimes, poor viability/motility of

nal status. the husband's sperm requires that his semen be

inopexia Coagulation of blood within the ves- mixed with another donor's (whose identity is

sel(s). never revealed).

inoscopy Body fluids assessed for fibrinous insidious That which appears without symp-

deposits, as a diagnostic tool. toms/warning.

inosculation Anastomosis. insight An understanding of one's attitudes and

inositis Inflamed fibrous tissue. behavior, as well as psychiatric status.

inotropic agents Antiarrhythmic agents — in situ That which is in position without invasion

bipyridene derivatives, catecholamines. Those of adjacent tissue(s).

administered to patients with angina pectoris, insomnia Hyposomnia — an inability to sleep.

cardiac emergencies, congestive heart failure — initial insomnia Difficulty falling asleep.

who have failed to respond to first-line medica- middle insomnia Awakening for a period of

tions (ACEinhibitors and diuretics). Those with time after falling asleep. The person eventually

severe cardiac failure and left ventricular sys- returns to sleep.

tolic dysfunction need digoxin as well as adjunc- terminal insomnia Awakening at least two

tive medications. This enhanced strength of car- hours early, unable to return to sleep. This is a

diac contractions (increased stroke volume) classic symptom of major depression.

raises the cardiac output. Despite normal digi- inspection Visual examination.

talis levels, these patients may develop cardiac inspiration Inhalation — costal or abdominal. A

toxicity in the presence of renal impairment, creative idea.

demonstrated by central nervous system symp- forced inspiration Labored inhalations requir-

181

ing the assistance of accessory muscles. insuloma Pancreatic tumor of the islets of
full inspiration That in which the lungs are
filled involuntarily or voluntarily. Langerhans.
internal inspiration Cellular interchange. integumentary system One of the largest organ
stridor That crowing inspiratory sound heard in
croup. systems in the body — the epidermis and the
instinct An intrinsic reaction, drive. corium (cutis vera). From this, safety is given
death instinct An unconscious will to suicide. the body against parasitic invasion/injury, and
herd instinct The basic drive to be gregarious. temperature deregulation. Absorption of vitamin
instrumentation The employment of instruments D from the sun,cutaneous sensations, elimina-
tion, prevention from dehydration, storage of
to perform a procedure. hydration/nourishment are also achieved.
insufficiency Inadequacy of an organ — Integumentary diseases can be a major medical
problem.
described as adrenal, aortic, cardiac, coronary, intellectualization A defense mechanism which
gastric, hepatic, ileocecal, mitral, muscular, employs reasoning to confront the stressful
myocardial, ocular, pulmonary, renal, respirato- emotions caused by unconscious conflicts and
ry, thyroid, valvular, venous insufficiency, et al. hidden agendae.
insufflation Instillation of a aerosolized gas,liq- intelligence quotient (IQ) That index which
uid, or powder into a body cavity. places the tested person in relation to others of
perirenal insufflation That instillation by an similar chronologicalage.
insufflator of air into the perirenal space to intensity Force/strength.
enhance the radiologic visualization of the intention A goal/purpose. The process of heal-
adrenal glands. ing.
tubal insufflation Rubin's test — transuterine first intention Healing, free of
insufflation with carbon dioxide to assess paten- suppuration/granulation.
cy of the fallopian tube(s). In some patients pre- second intention Healing achieved by the adhe-
senting for fertility testing, this procedure may sion of granulated surfaces.
prove to be therapeutic by opening occludedfal- third intention Healing of a cavity/wound/ulcer
lopian tubes. by granulation tissue, cicatrization.
insulinemia Excessive insulin in the circulation. intention tremor That involuntary trembling
insulin lipodystrophy Hypertrophy/atrophy pre- which is intensified by effort.
sent in the tissues of many insulin-dependent intercillium The space between the eyebrows —
pediatric and female diabetics. glabella.
insulin pump A programmable reservoir which intercricothyrotomy Surgical dissection of the
delivers insulin as per the diabetic's changing cricothyroid membrane to facilitate incision of
needs. This is implanted. the larynx.
insulin shock A life-threatening reaction to interference of impulses When two cardiac exci-
hyper-insulinemia. If the diabetic can safely tation waves meet in any part of the heart, they
swallow, assist him/her to drink orange juice, are both cancelled.
preferably with added sugar. If nonresponsive, interferon Proteins formed when cells are
prepare 50cc of 50% dextrose as an intravenous exposed to foreign/viral nucleic acids. These
bolus to be administered by a physician. Often, perform a vital role in immunity and antitumor
the patient will respond dramatically by opening activity.
his/her eyes and speaking — even before the interictal Between seizures.
injection is completed! Insulin shock is more interlobitis Inflammation of the pleura(e) sepa-
lethal than diabetic coma. For this reason, it is rating the lobes of the lung(s).
advised that a symptomatic diabetic be given a interlobular emphysema Air between the pul-
glucose preparation as an emergency protocol monary lobes.
even prior to obtaining over the diabetic status. intermarriage Marital union between relatives,
(That will be determined next.) races.

182

The international symbol of access nonsurgically with pathology of the internal
organs. The physician practicing this specialty is
intermission A pause between paroxysms. The an internist.
temporary cessation of symptomatology.
interoceptive Those nervous sensations arising
intermittence Skipped pulse beats. within the body.
intermittent claudication Exercise-related leg
international symbol of access This symbol sig-
pain, attributed to peripheral arterial occlusion. nifies barrier-free facilities throughout the world:
This arterial insufficiency is caused by arte- drinking fountains, parking spaces, ramped
riosclerosis. The risk factors are well known — entryways, restroom facilities, telephone.
obesity, familial cardiovascular disease, hyper-
tension, elevated cholesterol, tobacco abuse, interosseous Tissues located between the bones.
diabetes mellitus. The periodic cramping mid- interpalpebral Between the eyelids.
walking is relieved by a short rest. With the interpersonal rejection sensitivity Consistent,
patient standing, assess his/her legs in entirety,
including the feet, front and back. If the leg pain functional impairment which may include an
increases to pain at rest, surgery may be indi- inability to sustain relationships. Work difficul-
cated for this occlusive problem. ties, substance abuse and/or other clinically
intermittent explosive disorder That category of maladaptive responses may persist.
psychiatric patient who is frequently unable to interpolation The surgical transposition of tis-
resist aggression leading to serious sue.
assault/destruction. interposed abdominal counterpulsation A sim-
intermittent positive pressure breathing (IPPB) ple variation in cardiopulmonary resuscitation.
Assisted respirations in which increased pres- Increased cardiac flow will be achieved with less
sure inflates the lungs, and decreased pressure force, and need not be applied on each heart
assists exhalations. beat. Three rescuers provide this manipulation
intermittent pulse Regularly-dropped heart of abdominal/thoracic pressure.
beats. interpretation Psychotherapeutic analysis of the
intermural Between the sides/walls of an organ. significance and meaning of the patient's
internal bleeding Hemorrhage from an organ actions/words. This is imparted to, interpreted
(more frequently the gastrointestinal tract). for, and ideally, voiced by the patient.
internalization Assuming the standards and val- interrenal Between the kidneys.
ues of one's parents/society as one's own. This interrogatory The pretrial discovery tool by
mental mechanism is subconscious. which written questions are presented to the
internal medicine That specialty which deals adversary — who must answer those questions
under oath, and in writing.
interscapilium Interscapular — the shoulder
area between the scapulae.
interstitial Spaces within a tissue/organ. That
which is between.
interstitial cystitis A bladder infection of
unknown etiology.
interstitial fluid That which surrounds the cells.
interstitial lung disorder (ILD) A pulmonary dis-
ease which is similar histologically, pathologi-
cally, and clinically, but dissimilar in etiology.
intersystole The period between atrial and ven-
tricular systoles.
intertrigo Dermatitis within the skin folds.
interval A span of time or space.
intervention Action taken to interrupt crises,
severe problems, and health needs with imple-

183

mentation of care. intrabuccal That between the gum and the
crisis intervention The psychiatric manage- cheek.
ment of events which place the patient and oth-
ers at risk. intracranial hematoma Hemorrhage beneath the
nursing intervention All aspects of the patient's cranium and/or within the brain, placing the
care requiring competent assessment and plan- patient at risk of disability/death.
ning skills. Included are concerns of hygiene,
environment, peace of mind, nourishment, intractable That which is resistant to therapy —
physical comfort, and recovery. incurable.
interventional neuroradiology The chemical
arrest of hemorrhage during tumor surgery of intracutaneous Intradermal.
the brain, head, and spine. In sealing these intraepidermal squamouscell carcinoma in situ
arteries under constant visualization, there is a
lower risk of a devastating bleed. Bowen's disease, resembling a dermatitis, der-
intestinal Referring to the colon and small matophyte infection, and/or psoriasis. The ther-
intestines. apy follows that for basal cell carcinoma (CA).
intestinal bypass surgery The treatment of mor- intragastric balloon The surgical treatment of
bid obesity, through the surgical establishment morbid obesity, in which this device is retained
of short bowel syndrome, which results in mal- in the stomach, to be inflated. This has met with
absorption. minimal success.
intestinal flora Bacteria which is normally pre- intralingual Within the tongue.
sent in that organ. intramural Within the walls of a cavity, or hollow
intestinal neuronal dysplasia That bowel disor- organ.
der associated with multiple endocrine neoplas- intraoperative autotransfusion That collection of
tic syndrome, neurofibromatosis, and blood from the patient's surgical wound or body
Hirschsprung's disease (intestinal pseudo- cavity. This is processed and returned via trans-
obstruction). These patients may fail to survive fusion. Autotransfusing unwashed blood may
their pathology. cause adverse effects because of the presence
intestinal obstruction An acute/fatal condition of free hemoglobin, anticoagulants, activated
caused by adhesions, foreign body, gallstones in factors, irrigating solutions and debris. Washing
the intestines, intussusception, strangulation, the erythrocytes significantly decreases bacteria,
strictures, volvulus. Auscultation of the but is expensive.
abdomen may yield absent bowel sounds — intraoperative awakening That required to
said to be "Silent as the tomb", since this is a assess neurological functioning during brain
critical finding. surgery.
intolerance A lack of compassion for the intoler- intraosseous infusion/transfusion An emergency
able. That inability to endure. infusion into the tibial bone marrow as a final,
intoxication Poisoning by substance. extreme measure to save a pediatric patient.
acute hyoscine intoxication Choreic move- intrapartum That which occurs during delivery.
ments with/without delirium. intrapsychic Originating in the mind.
water intoxication Retention of excess water intrathecal Within the spinal canal.
and sodium. Excessivewater intake. intratubal Intraluminal.
intra-aortic balloon counterpulsation (IABC) intrauterine fetal demise Expiration of the fetus
That invasive procedure in which helium inflates prior to birth. This tragedy is felt by all within
a catheter which is threaded into the descending the obstetrical unit.
thoracic artery via the femoral artery. This intravasation The passage of material from
increases the circulation of the coronary arter- pathological/traumatic lesions into blood ves-
ies, and diminishes the cardiac effort. This is an sels.
effective treatment for cardiogenic shock. intravenous cutdown The surgical procedure by
which access to a vein/artery is obtained for
infusion or bolus administration. This is espe-
cially valuable for infants, children, and patients
in vascular collapse, shock.

184

intravenous infusion pump A computerized sexual involution Climacteric/menopause.

instrument which governs the rate of flow of uterine involution Postpartum return of the

intravenous fluids/medications. Antibiotics, et uterus to its non-pregnant state.

al., are administered by piggyback. iodism Iodine poisoning caused by anexcessive

intravesical Within the bladder. exposure to iodine (I).

intra vitam During life. iodization Impregnation with iodine. Use of

intrinsic That which is inherent, innate, essential. iodized salt for a household's food preparation

intrinsic muscles Those with an origin/insertion will prevent goiter formation for all.

entirely within the same organ/structure. iodotherapy The medicinal use of iodine prepara-

introitus An entrance/opening into a cavity/canal. tions.

introjection Identification of the self with an iontophoresis Ionic medication — electrical

object or another person. introduction of ions into tissue, lontotherapy.

introspection Contemplation of one's own ipecac Emetine from the Brazilian ipecacuanha.

thoughts, motives, and mind. Administered in the emergency room to many

introversion Preoccupation with oneself. overdose and poisoning cases.

Inversion of an organ. ipsilateral Homolateral — referring to the same

intubation The insertion of a tube into apassage, side.

to achieve therapeutic access. iralgia Iridalgia — pain in the iris.

intuition Knowledge without cognition. irascible Outbursts of impatient irritability.

intumescence Tumefaction — edema,enlarge- iridadenosis Glandular pathology affecting the

ment. iris.

intussusception Indigitation, introsusception, iridectome That instrument used in an iridecto-

invagination of the intestine. Telescoping of the my to incise the iris.

bowel upon itself. This life-threatening surgical iridectomesodialysis Surgical formation of an

emergency must be operated upon within twen- artificial pupil.

ty-four hours. iridectomy Corectomy — A surgical partial/total

inustion Deep cauterization. excision of the iris.

in utero That within the gravid uterus. optical iridectomy Surgical creation of an artifi-

in vacuo That within a vacuum. cial pupil.

invalid One confined to bed. iridectropium Partial iridal eversion.

invasive That which spreads/metastasizes. iridemia Iridic hemorrhage.

invasive procedure That in which a needle, iridencleisis A surgical procedure which

device, tube, or radiation, et al. is inserted into decreases intraocular pressure in patients with

the body. glaucoma.

inversion Reversal, invagination. iridentropium Partial iridal inversion.

inviscation The mixing of food with saliva while irideremia Aniridia — congenital partial/total

masticating. absence of the iris.

in vitro That occurring in a test tube. iridesis Iridodesis — artificial creation of an iris.

in vitro fertilization: partial zona dissection An iridoavulsion Traumatic tearing of the iris.

incision is developed into an ovum to facilitate iridocapsulitis Iridochoroiditis — iritis accompa-

fertilization by the sperm; subzonal sperm inser- nied by an inflamed lens capsule.

tion Placement of the sperm within the ovum. iridocoloboma Congenital defect of the iris/iri-

in vivo That occurring in a living organism. des.

involuntary That which is against one's will, or is iridoconstrictor That which constricts the pupils.

implemented without consulting the patient. iridocyclectomy Surgical excision of the ciliary

involution Retrogressive, degenerative evolution body and the iris.

of an organ/system after it has fulfilled its physi- iridocyclitis Inflammation of the ciliary body/iris.

ological functioning. heterochromic iridocyclitis Inflammation of the

senile involution Geriatric atrophy. iris, leading to depigmentation.

185

iridocystectomy Surgical excision of an iridal injected intramuscularly by deep Z technique in
cyst. the treatment of pernicious anemia. To adminis-
ter intravenously, 2 drops are given over 5 min-
iridodiagnosis Examination of the iris to assess utes to rule out anaphylactoid sensitivity.
disease/injury. iron poisoning Ingestion of adult iron prepara-
tions by infants and children may be acute or
iridodilator That agent which dilates the pupil. fatal. It is essential that these children be seen
iridodonesis Iridal tremor seen in an eye with a in the emergency room.
irradiation The therapeutic application of radia-
subluxated (dislocated) crystalline lens. tion — radium, radiothermy, ultraviolet rays, X-
iridokinesis Inflammation of the cornea/iris. rays, et al.
iridoleptynsis Iridal atrophy. irrational That conduct by a patient who is out of
iridoncus Tumor development involving the iris. control. Impassioned speech which fails to
make sense. That which defies normal menta-
Intumescence of the iris. tion.
iridoplegia Paralysis of the iris/irides. irrational guilt As seen in major depression —
the introjection of the patient's aggression and
Iridoparalysis of the iridal sphincter. unacceptable hostility onto him-/herself. These
accommodative iridoplegia Inability of the iris delusional proportions may evolve into suicidal
to react to accommodation. ideation.
complete iridoplegia That in which the iris fails irreducible That which is incapable of being
to react to any stimulus — Adie's pupil. reduced — whether a fraction or a fracture.
reflex iridoplegia Argyll Robertson pupil — irrelevant Inappropriate, unrelated.
intact accommodation reflex with absent light irreversible That which is impossible to turn
reflex. around or to undo.
iridoptosis Iridal prolapse. irrigation To lavage with fluid. This may be
iridorrhexis Traumatic avulsion of the iris from accomplished by forcing fluids per os, by irriga-
its attachment. tion set-up, or by flooding.
iridosteresis Partial/total excision of the iris. irritability Annoyance,excessive reaction,
iridotomy Corotomy, iritomy, irotomy. Incision of excitability, impatience — which may be mask-
the iris in an eye which is sightless due to irido- ing anxiety/depression.
cyclitis. irritable bowel syndrome Mucous colitis, spas-
iris bombe Seen in annular posterior synechia tic colon. That motility disorder involving the
— pressure placed on the iris by the aqueous gastrointestinal tract in its entirety. Symptoms
humor. are elicited by ingestion and/or stress — when
irisopsia That visual defect in which rainbow awake. Although no anatomic etiology is known,
halos are seen around lights — a symptom of emotionality, hormones, drugs, and diets may
glaucoma. stimulate Gl motility. Psychostressorsexacer-
iritis Iridal inflammation (which is edematous bate symptoms. Frequent mucorrhea results
and dull, the pupil irregular, contracted and from increased colonic irritation, or from exces-
sluggishly reactive) — of unknown etiology. sive parasympathomimetic stimulation.
primary iritis That in which the inflammation Abdominal pain may be prominent. Incontinence
develops in the iris. This also may be seen in might occur, but diarrhea does not appear in
generalized disease— infectious disease, puru- sleep. Full bowel studies with proctosigmoi-
lent infectious processes, sympathetic oph- doscopy will be required. Regular check-upsare
thalmia, trauma, tuberculosis, veneraldisease. essential to these patients' emotional support.
purulent iritis Iridal infection(s) with a suppu- Behavioral modification and psychotherapy are
rative exudate. valuable adjuncts.
secondary iritis That in which infection has ischemia Insufficient circulation.
spread from adjacent, diseased ophthalmic tis-
sue.
iritoectomy In cataract therapy, partial excision
of an inflamed iris which is occluding the pupil.
iron dextran injection Imferon, which must be

186

intestinal ischemia Postprandial abdominal
pain caused by deficient circulation.
myocardial ischemia Inadequate circulation to
the myocardium.
ischialgia Neuralgic sciatica.
ischiodynia Ischial pain, ischioneuralgia.
isoimmunization Rh immunization against Rh
agglutinogens.
isolation Limitation of patient exposure in the
presence of communicable disease. A defense
mechanism emotionally separating one from
that which is unacceptable.
reverse isolation Protective isolation of
immunocompromised patients, and those at risk
of developing life-threatening infections in their
debilitated states.
isologous Syngeneic, isogenic, genetically identi-
cal — that status which is sought for transplan-
tation.
isometropia Isopia — equal refraction of both
eyes.
isoserotherapy Treatment with serum from
another patient with the same disease.
isothenuria That sign of marked renal impair-
ment — unchanging urinary osmolarity/specific
gravity regardless of varied intake. This is a sign
of severe renal pathology.
isotonic Isometric — that equal in concentration,
pressure.
isotope A series of near-equal chemical elements
— many of which are radioactive.
isotope cisternography The study of cere-
brospinal fluid circulation following an injection
of a radioactive tracer into the subarachnoid
space. This serial scintillation scan is used to
diagnose/rule out (RO) hydrocephalus.
isovalericacidemia A hereditary, metabolic dis-
ease resulting in the malfunctioning of leucine
metabolism. These patients may slip into coma
and die.
isthmus A constriction, narrow passage, or stric-
ture between two parts.
ithyokyphosis Ithycyphosis — kyphosis (severe
spinal flexion) in which a spinal projection is
noted.
ixodiasis Any lesion/disease caused by ticks.
ixomelitis Inflammation of the lumbar spinal
cord.

J 187

jacket A therapeutic garment applied to the a disease — signalling both malignant/benign

trunk. disease. To accurately assess jaundice, the scle-

Sayre's jacket A plaster cast applied to the rae must be examined. In the Black patient, this

trunk, in order to support an impaired spinal is the only dependable sign without lab studies.

column. congenital jaundice Icterus neonatorum, hem-

strait-jacket A restraint used to confine the orrhagic icterus, hemorrhagic jaundice caused

arms and hands of a violent psychiatric patient. by immaturity/maldevelopment of the biliary

(The extended sleeves are long enough to wrap system. Physiologic jaundice requires no treat-

around the body and secure.) Leather restraints ment.

which lock, are preferred. These may also be hemolytic jaundice A rare form caused by

used to transport those who may be actively hemolysis. Splenomegaly will be noted.

dangerous to themselves and/or others. hepatogenous jaundice Parenchymatous jaun-

Jacob's ulcer A malignant epithelioma which dice caused by hepatopathology.

slowly erodes the face, causing devastating malignant jaundice Acute atrophy of the liver.

deformity with minimal pain. obstructive jaundice Obstructive icterus —

jactitation The restless thrashing about, as seen that due to mechanical obstruction of bile.

in acutedisease. posthepatic jaundice That following

jamais vu That subjective sensation of being in a complete/incomplete obstruction of the bile

foreign environment — while actually in entirely ducts.

familiar surroundings. This phenomen may be toxic jaundice Icterus following poisoning by

seen in some with temporal lobe lesions. carbon tetrachloride, arsphenamine, phospho-

janiceps An embryonic anomaly in which a face rous, bacterial toxins.

appears on both the anterior and posterior head. jaw(s) The framework of the mouth — principal-

Jansen's disease Hyaloideo-retinal changes in ly, the maxilla and the mandible.

the presenceof retinal detachment, with absent cleft jaw Embryonic failure of the left and right

systemic findings. mandibles to fuse.

Jansky-Bielschowsky syndrome Juvenile cere- crepitation of the jaw Disarticulation, subluxa-

bral sphingolipidosis of childhood. tion noted in temporomandibular joint disorder

Japanese encephalitis(JE) An arboviral infec- (TMJD).

tion, the leading cause of viral encephalitis in dislocation of the jaw This may be caused by

Asia. Culex mosquitoes are the principal vec- resuscitation efforts, extreme yawning, or laugh-

tors. JE acquired during the first and second ing, as well as by trauma. This condition can be

trimesters of pregnancy causes intrauterine chronic, and restored only by orthopedic reduc-

infection and miscarriage. Those cases occur- tion.

ring during the third trimester have not been jejunectomy Total or partial excision of the

associated with adverse neonatal outcomes. jejunum.

Japanese encephalitis vaccine is not recom- jejunitis Jejunal inflammation.

mended for all travelers to Asia (the People's jejunorrhaphy Surgical repair of the small intes-

Republic of China, Korea, Japan, Southeast tine between the ileum and the duodenum.

Asia, and parts of India, Oceania). A hypersensi- jejunostomy A permanent opening, surgically

tivity to thimerosal is a contraindication to this created in the jejunum.

vaccine. Jendrassik's maneuver That use of patient dis-

jargon Paraphrasia — unintelligible speech of traction to test deep leg tendon reflexes. The

another language or specialization. (Many con- subject is instructed to lock his/her fingers

sider medical terminology to be within this defi- together, and then to pull them apart. During

nition.) this effort, the Achilles/patellar reflexesare

jaundice Icterus, hyperbilirubinemia caused by elicited.

obstruction of bile, hemolysis, and/or hepatic jet injector That power instrument by which the

functioning. Jaundice is a symptom, rather than masses are immunized. Because no needle

188

pierces the skin, these immunization programs
(of the military, in epidemic situations, et al.)
proceed efficiently.
Joffroy's sign In exophthalmic goiter, the
absence of the facial muscle contraction is
noted when the patient glances upward. That
inability to work simple mathematics. In central
nervous system syphilis, this represents an
early sign of "paralysis of the insane".
jogging Running to maintain physical/cardiovas-
cular fitness.
Jones criteria That used to diagnose the
major/minor and chronic manifestations of
acute rheumatic fever.
jugulation That prompt arrest of a disease
process, by the employment of therapeutic mea-
sures.
Jumping Frenchmenof Maine That condition of
abrupt and solitary cry/movement (which may
be violent) in response to an unexpected
sound/touch. This chronic reaction is first noted
in childhood. There is no known etiology nor
therapy.
jurisprudence That scientific study/application of
justice and the law.
medical jurisprudence The principles of law as
applied to medical practice, professional obliga-
tions, colleagues, society, and the patient (pt).
jury-mast That apparatus which supports the
head in spinal pathology.
juvenile Immature, young.
juxta-articular That next to a joint.
juxtaposition Adjacent, contiguous, in apposi-
tion.
juxtaspinal Next to the spine.

K 189

Kader's operation Surgical implantation of a Kawasaki disease (KD) An acute, febrile, pedi-
gavage tube into a gastric fistula. atric condition. These children present with non-
suppurative cervical lymphadenitis and progres-
kainophobia Neophobia — an aversion to that sive dermal/mucosal/cardiac/arthritic changes.
which is new. Death may occur within 2 months. Infantile pol-
yarteritis nodosa (IPN), mucocutaneous lymph
kala-azar Visceral leishmaniasis — a tropical, node syndrome.
lethal, communicable disease.
Kegel exercises That method of strengthening
kaliemia Serum potassium. the pubococcygeal (pelvic) muscles to relieve
kaliopenia Hypokalemia — deficient serum stress incontinence. This series can also be
taught to enhance bladder retraining, and is the
potassium. treatment of choice for both of these conditions.
kaliuresis The urinary excretion of potassium. Keith-Wagener-Barker classification The stag-
kallman's syndrome That inherited condition, ing of progressive funduscopic findings in
hypertensive patients.
characterized by anosmia (inability to smell),
hypogonadism, and multiple anomalies. These keloidosis That hypertrophied scar formation
include cerebellar dysfunction; cleft lip/palate; seen more often in African patients.
color/vision disturbance; cryptorchidism; deaf-
ness; gaze-evoked horizontal nystagmus; horse- kelotomy Surgical repair of a strangulated herni-
shoe kidney; mental retardation; pes cavus; ation.
spastic paraplegia; spatial attention abnormali-
ties; synkinesia; and/or unilateral renal agenesis. Kempner rice diet That rigid sodium restriction,
Kanner's syndrome Infantile autism character- assigned to severe hypertensives. This diet
ized by self-asorption, inaccessibility, and/or (rarely ordered today) consists of sugar, fruit,
inability to relate to others. and rice, and meets with poor patient compli-
Kaposi's disease Melanosis lenticularis, xanthe- ance.
lasmoidea, xeroderma pigmentosum.
Kaposi's sarcoma (Kl) Multiple proliferation of keratalgia Corneal neuralgia.
sarcomatous lesions throughout body systems. keratectasia Corneal protrusion.
This rare malignancy develops secondary to keratectomy A partial excision of the cornea —
autoimmune disease.
Kaposi's syndrome Multiple cell proliferation keretectomy.
which becomes sarcomatous — especially in keratitis Corneitis — infection of the cornea.
immunocompromised patients. Skin lesions,
pulmonary densities, rales, hemoptysis, and herpetic keratitis Vesicular keratitis of herpes
high fever may be seen. zoster.
Kaposi's varicelliform eruption That dermatitis interstitial keratitis Deep, parenchymatous
associated with infected herpes simplex. keratitis, nonsuppurative keratitis with vascular-
Eczema in the presence of vaccinia virus. ization. This pediatric/adolescent form is noted
Karnofsky Index That scale rating a patient's in tuberculosis/syphilitic complications.
physical status, performance, and prognosis on xerotic keratitis Ulceration, dessication, soften-
a continuum of 100 (entirely well) to 0 ing of the cornea due to conjunctival drying.
(expired). keratocanthoma A benign, papular lesion which
Kartagener's syndrome A serious hereditary imitates squamous cell cancer (CA). This sub-
syndrome composed of visceral transposition, sides spontaneously.
sinus maldevelopment, bronchietasis. keratoconjunctivitis Corneal/conjunctival infec-
Kasabach-Merritt syndrome Hemangioma- tion.
thrombocytopenia syndrome. Giant heman- epidemic keratoconjunctivitis An acute disease
gioma compounded by thrombocytopenic coag- caused by a highly infectious virus. Viral kerato-
ulopathy. conjunctivitis is self-limiting.
Kashin-Beck disease Endemic polyarthritis — a flash keratoconjunctivitis Arc welders' condi-
form of mycotoxicosis. tion — acute, painful exposure to intense ultra-
violet irradiation when protective eyewear has
not been worn (Also, this injury may occur in

190

tanning booths when instructions to useeye tis. Pain is elicited upon extension of the fully

gear have been rejected.) flexed leg.

phlyctenular keratoconjunctivitis Eczematous ketoacidosis An acidotic state caused by exces-

conjunctivitis — an allergic response presenting sive accumulation of ketone bodies.

with diminished visual acuity, conjunctival injec- ketoaciduria Urinary presence of ketoacids.

tion, lacrimation, photophobia, and/or pain. ketogenesis Production of acetone

sicca keratoconjunctivitis Xerophthalmia. substances/ketones.

keratoconus Corneal protrusion — a painless ketogenic diet That which puts the patient into a

condition seen in pubescent female patients, mild acidosis — a high protein diet.

those with Down's/Ehlers-Danlos syndromes, ketolysis Dissolution of ketone bodies/acetone.

osteogenesis imperfecta. ketonemia Acidosis — acetone bodies in the

keratohelcosis Corneal ulceration. blood.

keratohemia Corneal inflammation with the pres- ketone threshold That blood level above which

ence of blood. urinary ketone bodies appear.

keratoiritis Infection of the cornea/iris. ketonuria Acetone bodies in the urine — an early

keratoleptynsis A plastic surgery procedure symptom of acidosis in the diabetic patient.

which is performed on a sightless eye for the ketosis That accumulation of ketone, resulting

purpose of cosmesis. from incomplete metabolism of fatty acids.

keratoleukoma That white opacity of the cornea. Ketosis is not acidosis, and may be observed in

keratomalacia Xerotic keratitis — pediatric soft- poorly controlled diabetes mellitus, pregnancy,

ening of the cornea, due to vitamin A deficiency. high fat diet, starvation, and/or following ether

keratome Keratotome — a scalpel used to incise anesthesia.

the cornea. kidney failure Acute,temporary, diminished kid-

keratomileusis Plastic revision of the cornea. ney functioning which may lead to renal shut

keratorrhexis Rupture of the cornea. down/failure.

keratoscleritis Scleral/corneal inflammation. Kienbock's disease Lunatomalacia — osteo-

keratosis Cornified epithelial tissue. chondrosis of the wrist — which is usually trau-

actinic keratosis Premalignant lesionscaused matic.

by exposureto the sun (or the tanning booth). Kilian's pelvis Pelvis spinosa — that infiltrated

seborrheic keratosis That of unknown etiology. by osteomalacia.

These tumors are not premalignant. Unless dis- Kimmelstiel-Wilson syndrome Those complica-

turbed, they need no intervention. tions which may be seen in long term diabetics

keratosis follicularis Darier's disease — a rare, — arteriosclerosis of the renal artery(s), retinal

inherited condition of lesions whichcoalesce lesion(s), edema, glomeruionephrosis, hyper-

into plaques on the upper body. tension.

keratosis nigricans A rare, inflammatory der- kinanesthesia Ataxia caused by an inability to

matitis which may be associated with internal perceive spacial/directional orientation.

carcinoma. kineplasty That version of amputation which

keratotomy Corneal incision. enables the remaining muscles to innervate the

radial keratotomy (RK) Surgical treatment for prosthesis.

myopia. Not always successful, complications kinesalgia Kinesialgia — muscular movement

include blindness. which is productive of pain.

keraunoneurosis Keraunophobia— A neurosis kinesia Kinetosis — motion/sea/car/air sickness.

caused by fear of electrical storms. kinesics Communication through body move-

kernicterus A form of icterus neonatorum in ments. The study of the body and its language

which bilirubin infiltration develops on the 2nd- through motion.

8th days postpartum. Without treatment, prog- kinesioneurosis A functional disorder which is

nosis is poor. distorted by spasms and tics.

Kernig's sign That which is positive for meningi- kinesis Movement.

191

kinesthesia Perception of weight, Klumpke's paralysis Atrophic paresis of the
direction/extent of movement. lower arm.

kinetics Those forces present during body move- Kliiver-Bucy syndrome Those behavioral symp-
ments. The interaction of sequential motion. toms which follow bilateral temporal lobectomy
— overreaction to stimuli, memory deficits,
kinetocardiography An electrocardiogram of excessive oral movements, hypersexuality, rage,
inaudible precordial beats. loss of appropriate fear, and/or loss of the ability
to recognize others.
kink That twist in a tube or duct. Knapp's forceps Hemostats with roller blades
kinky hair disease A congenital syndrome with which evert the eyelids, to allow access to the
palpebral conjunctivae.
metabolic defects and a lethal prognosis. knee pain, selective denervation Following total
Physical and mental development are retarded. joint arthroplasty or arthroscopy, pain or resid-
A metabolic defect causes sparse, kinky, poorly ual pain may be due to nerve injury. Nerves can
pigmented hair, and an abnormality in the fatty either be caught in the surgical incision, or
acid composition of the brain. Severedegenera- directly injured at the time of an athletic event.
tive central nervous system changes precede These nerves can be selectively blocked with
expiration. local anesthetic, then removed through relatively
kiotome Uvulotome, uvulatome — that instru- simple surgical procedures, with excellent relief
ment used to excise the uvula. of pain.
Kirshner's wire Skeletal traction applied via a knemometry That precisely accurate determina-
steel wire which has been threaded through the tion of the length of an extremity. This is of
fractured bone for immobilization and stability. essence in assessing the amount of medication
to be given in the pediatric treatment of growth
Kisch's reflex Auriculopalpebral reflex — closure hormone deficiency. Also, unequal leg lengths
of the eye(s) in response to stimulation of the must be precisely measured and compensated
external auditory meatus up to the tympanum. for, with lifts, et al.

kite apparatus That used in the rehabilitation of knitting The bonding of fractured bones.
weak and contractured arms, wrists, fingers. Kocher's reflex The contraction of abdominal

kleptolagnia Sexual gratification derived from muscles, in response to testicular compression.
the act of stealing. Kbhler's disease Osteochondrosis of the 2nd

kleptomania Impulsive stealing — not because metatarsal. Aseptic necrosis of the navicular
the patient values/needs the items, nor because bone.
s/he does not have the money (many have Kohnstamm's phenomenon That aftermovement
enough money at the time of the act). The following cessation of a stimulus.
unplanned theft is carried out without assis- koilonychia Dystrophy of the fingernails, associ-
tance. The tension prior to this act is relieved by ated with iron-poor anemia.
a sense of gratification as it is carried out. koilorrhachic The spinal curvature with an
Klieg eye Photophobia and conjunctivitis with excessive anterior curve.
lacrimation from the intense lighting of show koilosternia "Funnel chest". Depression of the
business. sternum.
Kondoleon's operation Surgical excision of sub-
Klinefelter's syndrome This congenital cutaneous layers in the treatment of elephantia-
endocrinopathy with primary testicular failure sis.
may not be evident prior to puberty. kopf-tetanus Development of tetanus, secondary
Gynecomastia, immature genitalia, abnormally to a head wound.
long legs, inadequate mental development may Koplik's spots Small, red spots on the oral
be noted in these male patients. mucosa — an infrequent and infrequently seen
diagnostic confirmation of rubeola.
Klippel-Feil syndrome That congenital anomaly
with involvement of the central nervous system,
a short, wide neck with low hairline, and fewer
cervical vertebrae which are fused.

Klippel's disease Pseudoparalysis/weakness
secondary to arthritis.

192

kopophobia An exaggerated fear of fatigue. tability, to mental deficiency, diarrhea, failure to
Koranyi's sign Increased resonance to dorsal grow, debilitation, edema, increased susceptibil-
ity, hepatomegaly, dermatitis, to impaired renal
spine percussion — a diagnostic finding of function, shock, death. Survivors may exhibit
pleural effusion. This accumulation can be com- mental/growth retardation.
posed of various fluids. Kyasanur Forest disease Tick-borne encephalitis
Korsakoff's syndrome Polyneuritic psychosis endemic to Russia.
with symptomatology of disorientation, deliri- kynocephalus That fetal deformity in which the
um, hallucinations, fabrication, illusions, and/or head resembles a dog's.
insomnia. This sequel to acute alcohol toxicity kyogenic That which induces pregnancy.
may include wrist/foot drop. kyphorachitis Spinal deformity secondary to
Krabbe's disease This fatal, pediatric condition rickets.
is caused by a deficiency of galactocerebrosi- kyphoscoliosis Lateral curvature(s) of the spine
dase. Marked mental deficiency, paralysis, in addition to anteroposterior curves.
cachexia, blindness, deafness,and seizures pre- kyphosis Anteroposterior spinal curvature due to
cede death by age 2 years. Globoid leukodystro- compression fracture(s), congenital anomaly,
phy. faulty posture, arthritis, rickets, malignancy,
syphilis, osteomyelitis, osteoporosis, tuberculo-
Krankheitswandel effects Change in the inci- sis. Therapy is rarely effective.
dence, form, dimension, shape, prevalence of an
established, known disease.

Krukenberg's tumor Ovarian malignancy.
kubisagari Bulbar weakness with ptosis in the

malnourished children of Japan. Parenteral thi-
amine is the therapy of choice.
Kuf's disease Cerebralsphmgolipidosis in the
adult. Blindness, dementia, myoclonic contrac-
tions, and retinitis pigmentosa confirm the diag-
nosis.
Kugelberg-Welander disease Juvenile spinal
muscular dystrophy. The "floppy baby" may fall
under this diagnosis.
Kummell's disease Spondylitis secondary to
vertebral compressionfractures.
kuru disease A prion diseasewhich is fatal and
rapidly progressive. The etiology is cannibalism,
as seen in New Guinea. Cerebellar ataxia is the
prominent neurological feature. As the gait atax-
ia increases, truncal instability heightens, with
an intention tremor. Depression may appear
with lability. Dysdiadochokinesis develops as
ambulation fails. The patient succums to respi-
ratory failure.
Kussmaul's respirations The heavy, comatose
expirations (exhalations) of patients in severe
diabetic acidosis.
Kussmaul's sign Neck vein distention during
inhalation.
kwashiokor That severe protein-deficient malnu-
trition of African children upon weaning. Clinical
signs advancefrom apathy, lethargy with irri-

L 193

la belle indifference A feature of conversion and diarrhea whenever the patient consumes
reaction. That remarkable symptom of hysterical lactose.
anesthesia. An unrealistic amount of indiffer- lactation Milk production following childbirth.
ence about one's anomaly(s), negative diag- lactic acidosis (LA) A disorder of acid-base
noses, et al. metabolism seen in many life-threatening ill-
nesses. Morbidity/mortality results from sepsis
labialism Defective speech in which lip sounds and/or hypotension. Coexistent hemorrhage,
are accentuated. myocardial failure and/or infection usually coex-
ist. Multiple organ system failure/insufficiency
lability Changeability, instability. may occur in the accumulation of LA.
emotional lability Wide mood swings, with lactocele Galactocele — a cystic tumor caused
excessive reactivity. by occlusion of a milk duct(s).
lactochrome Riboflavin, lactoflavin.
labiochorea Choreic lip spasms which cause lactogen That which stimulates lactation.
stammering. lactorrhea Galactorrhea — discharge of milk fol-
lowing nursing/weaning.
labiomatricectomy Excision of an ingrown toe- lactose intolerance Gastrointestinal symptoms
nail(s). caused by a congenital/acquired deficiency of
lactase — resulting in an inability to tolerate
labiomycosis Any fungal disease of the lips. milk products. Consultation with a dietitian may
labioplasty Cheiloplasty — plastic surgery of the provide specific ideas regarding nourishment
without lactose.
lips. lactosuria Urinary lactose which may be present
labiotenaculum A surgical instrument which during pregnancy/lactation.
lactotherapy Galactotherapy, milk diet.
secures the lips during surgery. Prescribed medications for the nursing infant
labor Childbirth, parturition. First stage: cervical which are given to the mother to be excreted in
her milk.
dilation, efacement; Second stage: delivery of lactotoxin That poisonous substance within
the fetus; Third stage: delivery of the placenta; decomposed milk.
Fourth stage: the first 4 hours postpartum. lacunar disease Occlusive brain disease result-
preterm labor Cervical dilation accompanied by ing in cerebral infarction and/or a transient
regular uterine contractions, prior to the esti- ischemic attack(s) (TIA) — from which many
mated date of confinement (EDC). recover.
Laborde's method Resuscitative stimulation of Laennec's cirrhosis That caused by alcohol
the asphyxiated respiratory center, with rhyth- (ETOH) abuse.
mic traction on the tongue. Laennec's pearls That mucous cast of asthmatic
labyrinthine That which is involved and intricate. sputum.
Description of the schizophrenic flight of Laetrile Unaccepted, unconventional, ineffective
speech. treatment purported for carcinoma. Acute
labyrinthitis Meniere's disease — characterized cyanide poisoning is an immediate risk. Use of
by extreme vertigo, nausea with emesis, nystag- this substance is not approved in the United
mus. States.
labyrinthotomy A surgical incision into the Lafora's disease Familial, progressive epilepsy in
labyrinth(s). which all functioning is lost as central nervous
laceration The severing of tissue. system involvement increases. This neurological
lacrimotome A scalpel used to incise the disease is gradually terminal.
lacrimal duct/sac. lagophthalmos Lagophthalmus — that incom-
lacrimotomy A surgical incision into the lacrimal plete closure of the eyes from scarring, atony,
duct.
lactacidemia Lacticemia — lactic acid in the cir-
culation (a normal state following energetic
exercising).
lactaciduria Urinary excretion of lactic acid.
lactase deficiencysyndrome A hereditary condi-
tion in which absent lactase in the intestinal
mucosa causes abdominal cramping, bloating,