443
contamination, inadequate sanitation, sexual has never consummated coitus.
contact, and/or intravenous (IV) drug abuse. virile Masculine.
hepatitis B (HBV) Clinical symptomatology virile reflex The bulbocavernosus reflex — an
includes anorexia, malaise, nausea, vomiting, abrupt, penile contraction elicited by compres-
abdominal pain, jaundice, et al. Extrahepatic sion of the glans penis.
manifestations (dermatitis, arthralgia, arthritis) virilescence Virilism — the development of sec-
may also appear. Chronic carriers include ondary masculine characteristics in the female.
children infected prior to age 5 years and, less virility Masculine sexual potency.
frequently, acutely infected adults. Intrauterine virilization Those male secondary characteristics
carriage of HBV results in the transmission to produced in the female patient who is suffering
90% of these neonates. Transmission of this from an excess of testosterone (or who is
disease also occurs via percutaneous and per- receiving anabolic steroids to illegally enhance
mucosal routes, infective body fluids/excreta, muscular development). An increase in
sexual contact, contaminated needles, as well as body/facial hair, penile (clitoral) growth, male-
situations of close, personal contact, exposure type baldness, lowered voice may be noted.
to lesions, and/or mucosal surfaces.Adherence virtual reality Computer simulation.
to aseptic technique is mandatory. Worldwide, virucidal Viricidal — that which is lethal to the
HBV is a major cause of acute/chronic hepatitis, virus.
cirrhosis, and primary hepatocellular carcinoma virulence The degree/power of pathogenicity.
(CA). The endemicity is low in the USA, Western viruria Urinary viruses.
Europe, and Australia. HBV infection is highly virus Arborvirus, attenuated virus, bacterial
endemic in China, Southeast Asia, most of virus, chikungunya virus, coxsackie virus,
Africa, most Pacific Islands, the Amazon Basin, cytomegalovirus, defective virus, enteric
parts of the Middle East, and among Alaskan cytopathogenic human orphan (ECHO) virus,
Natives. enterovirus (CMV), Epstein-Barr (EB) virus, fil-
hepatitis non-A/hepatitisnon-B Parenterally trable virus, fixe virus, helper virus, hepad-
transmitted, this strain is associated with both navirus, herpes virus, human immunodeficiency
post-transfusion and sporadic cases of acute virus (HIV), latent virus, lytic virus, masked
hepatitis. virus, neurotropic virus, parainfluenza virus,
hepatitis non-A/hepatitis non-B Enterically poxvirus, respiratory syncytial virus, tumor
transmitted, this strain, reported in parts of virus are commonly seen today.
Asia, Africa, and Mexico, is spread by the fecal- vis Energy, force, power, strength.
oral route. vis afronte An attractive force.
hepatitis C (HCV) The cause and virus of most vis formativa Energy which is produced by new
post-transfusion hepatitis, chronicity. tissue.
hepatitis D Delta hepatitis virus (HDV) — a vis medicatrix naturae The healing force of
defective virus that may cause infection only in nature.
the presence of active hepatitis B disease. viscera Those organs within cavities.
Fulminant hepatitis may result from the superin- visceralgia Organic neuralgia.
fection. The routes of transmission remain simi- visceral pain Dull aching, felt in the midline, and
lar to the above strains. Hemophilia victims and accompanied by autonomic symptomatology —
parenteral drug abusers are at highest risk. nausea, vomiting, diaphoresis, and/or restless-
There are no agents to prevent HDV infection at ness.
this time. visceromegaly Hypertrophy of the abdominal
hepatitis E Hepatitis E virus (HEV) — responsi- organs.
ble for some epidemics of acute hepatitis. visceromotor reflex Rigidity of the abdominal
viremia Virusemia — viral contamination of wall muscles, caused by visceral pain.
blood. viscerosensory reflex Referred pain caused by
virginity That status of a male or a female who visceral organic pathology.
444
viscerotome An autopsy instrument by which and respirations (BP, T P R). When vital signs
liver specimens are obtained. are taken every 15 minutes on an afebrile
viscerovisceral reaction That involuntary patient, some protocols permit the temperature
response of visceral receptors to stimulation. to be taken every 4 hours.
viscosity Viscidity, the tenacity of a fluid. Surface vital statistics Referenceto natality, health, mor-
tension. tality, marriage, morbidity. The statistics of birth
viscous Sticky, tenacious liquid of high viscosity and death are within the public domain, and are
and specific viscosity. not confidential at the time they occur.
visibility The state of being seen. vitamin An organic substance which acts princi-
high visibility Ease in being visualized. pally to regulate metabolic processes as coen-
vision The sense of sight. zymes, to maintain optimal health.
achromatic vision That inability to differentiate vitamin A Essential for normal development of
or perceive colors. bones and teeth, growth, and integrity of epithe-
artificial vision The goal of research — to lial tissues, this vitamin is stored in the liver.
develop the scientific means by which the blind vitamin A, That form found in fish liver oil.
may achieve sight. vitamin A2 That form with a different ultraviolet
binocular vision Three-dimensional sight. absorption spectra.
double vision Diplopia. The temporary occlu- vitamin B complex These affect appetite, biliary
sion of one eye may relieve the nausea and action, carbohydrate metabolism, diabetes, as
incapacitating symptomatology, permitting the well as the endocrine, gastrointestinal (Gl) and
patient to be up and about. nervous systems.
field of vision That range of direct and periph- vitamin B1 Thiamine hydrochloride (HCI).
eral sight. vitamin B2 Riboflavin.
monocular vision Sight in only one eye.
multiple vision Polyopia. vitamin B6 Pyridoxine.
vitamin B12 Essential for the formation of ery-
night vision Sight in minimal lighting/the dark. throcytes, cyanocobalamin is both prophylaxis
oscillating vision Oscillopsia. and treatment of pernicious anemia and other
peripheral vision Indirect sight. red blood cell defects.
phantom vision Transient visual stimulation vitamin C Ascorbic acid.
post-enucleation. vitamin D The antirachitic vitamin, necessary for
tunnel vision The absence of peripheral vision. efficient absorption of calcium (Ca) and phos-
visual acuity The accommodative power of each phorus (P) — as in normal mineralization and
eye. growth of the teeth and skeleton. When daily
visualization Sight perception. overdoses exceed 20,000 ILJ, vitamin D toxicity
visual point Central vision. reaches dangerous levels.
visuognosis Acknowledgement, appreciation, vitamin E Alpha tocopherol, an essential nutrient.
recognition of that which is seen. vitamin K That antihemorrhagic factor which
vital That which is essential for life/existence. assists in coagulation of blood.
vital capacity The volume of exhaled air which vitiation Contamination, injury, impairment.
follows full inhalation. vitiligo Of unknown etiology, demarcated patch-
timed vital capacity A test which limits the es of absent pigmentation. Systemic association
time of expiration. has been seen with hypo-/hyperthyroidism, dia-
vital center The medullary respiratory center. betes mellitus, pernicious anemia, Addison's
vitalism That philosophy that the force responsi- disease, et al. The treatment is predominantly
ble for life is neither mechanical nor chemical. cosmetic.
vitality The quality of having life. Animation — vitiligo capitis Depigmented hair at the area of
the state of being alive. involved scalp.
vitalize To instill life/vigor in another. vitiligoidea The formation of dermal xanthoma-
vital signs Blood pressure, temperature, pulse, ta.
445
vitium A defect, fault. Volkmann's contracture Ischemia leading to
vitium cordis A cardiac lesion. paralysis, secondary to a cast which was too
vitrectomy Surgical replacement of vitreous tight. The atrophy, contracture, degeneration,
humor with sterile normal saline. and/or fibrosis is caused by injury to a muscle's
vitreocapsulitis Hyalitis — that inflammation of circulation — and may be litigious.
vitreous humor. volsella Forceps with pointed, sharp hooks at
vitreous degeneration Retrogressive change of the ends of each blade.
tissue into translucent substance. volubility Speech in excess.
vitrescence Transformation into a hard, clear volume Occupied space.
substance. expiratory reserve volume The greatest
vitrium Glass. amount of air that can be expired following nor-
vitropression Pressure with a glass slide on mal exhalation.
hyperemic skin, in order to study unobscured, inspiratory reserve volume The greatest
discolorations and lesions without erythema. amount of air that can be inspired following nor-
vivification The trimming of wound edges to aid mal inhalation.
in their approximation. This is accomplished mean corpuscular volume (MCV) The average
with suturing. size of a patient's erythrocytes.
vivisection Investigational surgery on animals to minute volume The amount of blood ejected
enable medical science to progress with disease from a ventricle per minute.
research. These operations are conducted under packed cell volume The hematocrit.
anesthesia, in a sterile environment. residual volume The remaining volume of air
vivisepulture The burial of a living person. in the lungs following maximum exhalation.
vocal fremitus Chest vibrations which can be stroke volume That amount of blood ejected
palpated while the subject is speaking/singing. from a ventricle in one cardiac contraction.
vocal resonance While the patient is speaking, tidal volume The amount of air exchanged in a
that sound which is audible upon auscultation. respiratory cycle.
Vogt-Koyanagi-Harada syndrome Autoimmune voluntary That which is intended, willed.
posterior uveitis with choroidal infiltrate and voluntary health agency Each nonprofit, private
exudative serous retinal detachment. This may hospital, health campaign, mission, et al. Fees
be noted in cranial neuropathy and meningeal and contributions may be received if a profit is
inflammation. not realized.
voice That sound produced by vocal cord vibra- volvulus A bowel obstruction caused by a por-
tions. tion of intestine twisting upon itself. This blood
cavernous voice Amphoric voice — the auscul- vessel compression may result in bowel
tated voice as heard over a chest cavity. ischemia, infarction, perforation. Signs and
eunuchoid voice That characteristically high symptoms include abdominal distention with a
voice of adult males who did not achieve sexual palpable mass, abdominal pain, emesis, hyper-
maturity. (In Italy, generations ago, prepubertal dynamic bowel sounds, sudden attacks.
boys with exceptional singing promise were Profound dehydration can lead to hypovolemic
castrated. These castradi retained their tenor shock. Resectionwith anastamosis may be per-
ranges, were revered, and enjoyed handsome formed for an infarcted bowel. In the presence
operatic careers.) of gangrene, an ileostomy/colostomy will be
void The act of urinating. To nullify. required.
volatile That which is capable of evaporation, vomica Suppurative pulmonary cavitation.
vaporization. Sudden, profuse expectoration of purulent spu-
volatilization Conversion of a liquid or solid into tum.
a gas. vomiting Reverse peristalsis which may be
volition The power/act to choose or will. caused by carcinoma, medications, self-manipu-
volitional That which is willed by intention. lation, toxicity, or a multitude of conditions/dis-
446
eases. The latter must be surgically excised or irradiat-
cyclic vomiting Associated with acidosis, ed. These place the patient at risk for blindness,
recurrent episodes of emesis which may occur disability, CNStumors, hemiplegia, mental defi-
in the neurotic patient. ciency, quadriplegia, seizures. These vascular
dry vomiting That which occurs without eme- tumors are rare, but recurrent.
sis. von Jaksch'sdisease That symptom complex
epidemic vomiting Sudden viral gastroenteri- which includes anemia, chronic infections, mal-
tis. nutrition, tuberculosis, hepatosplenomegaly.
induced vomiting That elicited by emetics or von Recklinghausen's disease
manipulation of the posterior pharynx. Neurofibromatosis — the development of multi-
pernicious vomiting Hyperemesis gravidarum ple neuromas in any system. Tumors may grow
— "morning" sickness of pregnancy. on tumors as well as on visceral organs. These
projectile vomiting Projectile emesis — that may become hyperpigmented, malignant and
which is sudden and so forceful, it may hit the metastasize, may be painful due to
wall. This serious sign is seen in pyloric steno- cerebral/spinal pressure, and cause death.
sis and many forms of brain tumor. von Recklinghausen's tumor Recklinghausen's
stercoraceous vomiting Fecal emesis — an tumor — that adenoleiomyofibroma developing
irreversible, terminal sign. on fallopian/uterine tissue.
vomiturition Retching without emesis. von Willebrand's disease Vascular hemophilia
— a congenital bleeding dyscrasia appearing in
vomitus Emesis expelled from the gastrointesti- early childhood. The severity of these symptoms
nal (Gl) tract. diminishes as the patient ages. Factor VIII may
bilious vomitus Bile forced into the stomach, be required.
productive of green emesis. Voorhees' bag A rubber bag which, when inflat-
black vomitus That seen in severe yellow fever. ed, dilates the cervix to induce and facilitate
coffee-ground vomitus Coffee-ground emesis labor.
— that caused by gastrointestinal hemorrhage. vox Voice.
The dark red material actually appears like cof- vox abscissa Laryngitis.
fee-grounds. This critical sign needs to be vox capitus The falsetto voice — singing artifi-
reported. cially in a range higher than one's own.
vox cholerica That voice which is suppressed in
vomitus cruentus Frank blood appearing in the the end stages of cholera.
emesis. vox rauca The voice which is out of control, and
that has become hoarse.
vomitus marinus That of seasickness. voyeur The deviant who receives erotic pleasure
vomitus matutinus That of pernicious vomiting. from observing others' nudity and sexuality —
von Gierke disease Glycogen storage disease — on the condition that they are unaware they are
being watched.
type 1a, glyconeogenesis, hepatonephromegaly voyeurism Inspectionism — orgasm achieved by
glycogenica, glycogenosis. an erotic response to others' undressing and/or
von Graefe's sign Seen in exophthalmic goiter sexual activity. No sexual activity is sought,
— erratic movement of the eyelids, lid lag. except by fantasy. Onset of these symptoms
von Hippel-Lindau disease Angiophacomatosis, usually appears prior to age 15. The pathologi-
cal features of this disorder lie in the unsuspect-
Hippel's disease, retinocerebral hemangiomato- ing, "innocent" state of the illicitly-observed per-
sis, von Hippel's disease. A relentless neurologi- son(s). Such paraphilic activity progresses to
cal disorder in which the cerebellum and reti- significant impairment in other areas of func-
na(e) are vascularly malformed. The symptoma- tioning.
tology includes papilledema, headaches, pro- vuerometer An instrument which measures
gressive cerebellar ataxia, characterized by mul-
tiple angiomas of the retina(e), central nervous
system (CNS), and/or visceral organs. These
may be in the form of pheochromocytoma,
syringomelia, or cerebellar hemangioblastoma.
447
interpupillary distance.
vulnerable One who is emotionally or physically
liable to be victimized.
Vulpian-Heidenhain-Sherringtonphenomenon
When autonomic cholinergic cells are stimulat-
ed, denervated skeletal muscle contracts. This is
the result of blood vessel innervation.
vulsellum Vulsella, volsella — forceps which
have a hook on each blade.
vulvar leukoplakia Precancerous hypertrophy of
the vulvae.
vulvar vestibulitis syndrome Severe vaginal pain
upon touch/pressure. Of unknown etiology,
many therapeutic modalities (even surgery) may
prove ineffective.
vulvectomy Surgical excision of the vulva(e).
vulvismus Vaginismus — vaginal/vulval spasms.
vulvitis Inflammation of the vulva(e).
acute nongonorrheal vulvitis That infectious
process caused by deficient hygiene and/or con-
tact infection.
follicular vulvitis Infected pubic hair follicles.
gangrenous vulvitis Vulval necrosis and/or
necrosis of the vulva(e) produced by communi-
cable disease.
leukoplakic vulvitis Chronic atrophic vulvitis.
mycotic vulvitis That caused by fungi.
vulvovaginitis Infection of the vulva(e), vagina,
and/or vulvovaginal glands.
diabetic vulvovaginitis The mycotic inflamma-
tion which may appear opportunistically in com-
promised patients in poor diabetic control.
w
Waardenburg syndrome That congenital defect from its cell body. It is the neurilemma which
in pigmentation which includes also a broad enables the axon to regenerate.
nose, congenital deafness, cutaneous hypopig- wandering Aimless movement.
mentation, deficient fundal pigmentation, wandering abscess That which deepens and
heterochromic irides, dystopia canthorum, appears at a distant point from that of origin.
synophrys (merging of the eyebrows), and/or wandering kidney/spleen A floating organ which
vitiligo. has become dislocated.
Wagner's disease Hereditary hyaloideo-retinal Wangensteen suction Gastrointestional (Gl)
degeneration. Ocular findings include myopia, decompression achieved via Gomco intermittent
vitreous degeneration, retinal changes, presenile suction. This is used to relieve severe mechani-
cataracts, et al. cal bowel obstruction, post-operative abdominal
Wagstaffe's fracture A broken ankle complicated distention, nausea, vomiting.
by separation of the internal malleolus. waning immunity Loss of protective antibodies
Walcher's position That in which the dorsal overtime.
recumbent patient lies with legs dependent over ward A hospital room which accommodates over
the edge of the table or bed. 4 patients.
Waldenstrb'm's disease Osteochondritis Wardrop's disease Onychia maligna — an acute
deformans juvenilis. inflammation, ulceration, with loss of the nail.
Waldenstrom's macroglobulinemia An excess Wardrop's operation Ligation of an aneurysmal
of plasma cells, resulting in excessive IgM glob- artery.
ulin. Infiltration of the bone marrow by lympho- warfarin poisoning That accidental/cumulative/
cytes and plasma cells leads to anemia. Chronic intentional overdose of this anticoagulant. Signs
lymphocytic leukemia, hyperviscosity of the and symptoms which need to be monitored are
blood, and/or generalized lymphadenopathy may ecchymosis, epistaxis, hemorrhaging gums,
be noted. Bleeding dyscrasias, confusion, and hematuria, melena, petechia, purpura. Many
lassitude follow. drugs interfere with the action of anticoagulants.
Waldeyer's ring The circle of lymphatic tissue washout period That measure of time, in trans-
which encircles the oropharynx/nasopharynx. ferring a patient from one psychotropic drug to
This evolves into palatine tonsillar tissue. another, during which s/he must receive neither,
walker A frame with/without wheels which because they interact adversely with each other.
allows safer ambulation for unsteady patients. A drug holiday (in which all medications are
(They need to be reminded not to push the held) may be ordered to avoid triggering a
walker too far ahead of them — where it is less major/lethal adverse reaction — often for 2
able to support them.) weeks. These unmedicated patients bearclose
walking cast That which has been prepared for watching until they are re-establishedon a med-
ambulation by the addition of a walking pad and ical regimen.
reinforcement. The patient should never bear waste That which is excreted or discarded.
weight on an unprepared cast. hospital waste Medical refuse: blood and blood
walking well Those who are able to be up and byproducts; contaminated animal organs, tis-
about even though they are ill. sues, et al.; dialysis waste; emergency room
walking wounded Those who have been injured, waste; isolation excreta and waste; medical
but are able to be up and about. waste — excretafrom the diseaseprocess
Wallenberg's syndrome That symptomatology and/or the treatment of disease; metabolic
resulting from circulatory occlusion at the brain waste products; microbiological materials;
stem. Cerebellar dysfunction, dysphagia, impair- pathological tissues and discarded materials
ment of pain/temperature senses, and/or paraly- from the operating room.
sis may be seen. wasting palsy Progressive muscular atrophy.
Wallerian degeneration Axonal deterioration Chronic muscular atrophy accompanied by
results when the nerve fiber has beensevered paresis.
449
water (H20) That compound of hydrogen and taught to the patient. Under debate is the con-
oxygen which is essential for life. The universal cern about school attendance of children with
solvent of all body fluids. Excessive intake may open, chronic lesions (which should be cov-
cause H20 intoxication. ered).
deionized water Decontaminated water, dis- Wegener's granulomatosis Wegener's syndrome
tilled water, purified water. That which has been — a rare, systemic disease affecting organ vas-
purified via a still for use as/with medication, or culature. This is characterized by glomeru-
for use in instruments. lonephritis, granulomatous lesions of the respi-
ratory tract, necrotizing vasculitis. Patients may
water for injection The only type of water which present with signs of cough, epistaxis, fever,
can be used parenterally, since it has been dis- general malaise, hemoptysis, interstitial pul-
tilled and sterilized by pharmaceutical stan- monary edema, pericarditis, pharyngitis, pleuri-
dards. tis, polyarthritis, purulent rhinitis, renal disease,
rhinorrhea, sinusitis, ulceration of the nasal sep-
waterhammer pulse Corrigan's pulse — that tum, and/or weakness. The prognosis is hopeful
with a powerful, rapid beat which suddenly col- if the patient is diagnosed and treated early. If
lapses. not, the patient may expire within the year.
Weil's disease Severe leptospirosis, Weil's syn-
Waterhouse-Friderichsen syndrome Acute drome, Canicola fever, infectious (spirochetal)
jaundice. The abrupt leptospiremia phase pre-
adrenal insufficiency, secondary to hemorrhage sents with chilling, headache, spiking fever,
caused by meningitis. hepatomegaly, jaundice, muscular aching,
water intoxication This condition may present and/or splenomegaly. The immune phase coor-
with abdominal cramping, coma, convulsions, dinates with serum antibodies, while meningitis
dizziness, lethargy, and/or nausea with emesis. symptomatology may develop. This process
Cerebral concussion, excessive antidiuretic hor- may prove to be abortifacient. Nursing care
mone (ADH) secretion, copious intake of water, under enteric precautions includes massive
diabetes insipidus, excess intravenous (IV) doses of intravenous (IV) antibiotics. Rats are
hypotonic solutions, retention of sodium, and/or the vector.
excessive tap water enemata may be the cause Weissenbacher-Zweymuller syndrome
of water retention. If admitted for workup, the Chondrodysplasia with "dumbbeir-shaped
hospital room must have its water shut off, femora and humeri, hypoplasia of the
since the desperate patient may be driven to maxilla/mandible, and nonspecific ophthalmopa-
drink from the toilet. Close observation with thy. Cleft palate may be present.
precise intake and output must be kept to dis- Wellen's syndrome That electrocardiogram
cern the accurate diagnosis of these patients. (EKG, ECG)complex which includes a cardio-
Watson-Schwartz test That used in acute por- graphic warning that the left anterior, descend-
phyria to differentiate urobilinogen from porpho- ing coronary artery is becoming occluded. (By
bilinogen. this great vessel is supplied the left ventricle.)
Weber-Christian disease Febrile, nodular, Wenckebach's phenomenon Wenckebach's
relapsing, nonsuppurative, panniculitis — a pause, Wenckebach's period — the incomplete
generalized disorder of fat metabolism. heart block in which the PR interval lengthens,
Weber's paralysis Contralateral spastic hemiple- until the ventricular response fails to respond.
gia caused by a lesion of the crus cerebri. This is a repetitive cycle.
Weber test That performed with a tuning fork, to Werdnig-Hoffmann syndrome Werdnig-
determine or rule out (RO) unilateral deafness. Hoffmann disease, spinal muscular atrophy,
Wechsler Intelligence Scale for Children That infantile muscular atrophy, Hoffmann's syn-
instrument used to assess the intelligence quo- drome. This familial, infantile, progressive form
tient (IQ) of children, ages 5-16 years. of amyotonia congenita is attributed to spinal
weeping Tearful, moist.
weeping eczema An emotionally-enhanced der-
matitis in which the vesicles ooze serum.
Aseptic technique is required, and must be
450
cord degeneration. This is characterized by atro- wheelchair, may be be quadriplegic, et al.
phy, complete flaccid paresis, early onset, hypo- Motorized wheelchairs are extremely expensive,
tonia, death. Harrington rods may be implanted and provide quadriplegic patients their only
during childhood. Respiratory illness presents a hope for mobility. The international symbol of
major threat. These young children have a high access secures barrier-free facilities for the
intelligence quotient (IQ) and socialization, handicapped. By this regulation, those confined
despite severe hypotonia, scoliosis, and pro- to wheelchairs (and other disabled persons)
found weakness. enjoy the freedom to be fully independent.
Werlhoff's disease Idiopathic thrombocytopenic Whipple's disease Intestinal lipodystrophy —
purpura. characterized by abdominal pain, abnormal skin
Wermer's syndrome Multiple endocrineadeno- pigmentation, arthritis, diarrhea, a distinctive
matosis (MEA-I). This inherited diseaseinvolves lesion of the ileum/jejunum, fever, malabsorp-
neoplastic invasion of the pancreatic islets, tion syndrome, mesenteric lymph adenopathy,
parathyroid, and pituitary glands. These multiple steatorrhea, weakness,weight loss. This rare
endocrine neoplasia (MEN) become highly disease affects most organ systems, and can
extensive, and infrequently, malignant. The cause pericarditis.
patient and affected family members must be Whipple's operation Pancreatoduodenectomy.
surveyed biannually, excising tumors (when whistling face syndrome A congenital facial
prudent to do so). anomaly in which dysfunctional facial muscles
Wernicke's encephalopathy That pathology appear to be whistling, and in which the nasal
associated with chronic alcoholism, gastric car- bones are hypoplastic. These neonates may also
cinoma (CA), hyperemesis gravidarum, thiamine present with talipes deformities.
deficiency. This is prevented/treated by adminis- white coat phenomenon White coat hyperten-
tering thiamine intramuscularly (IM) or intra- sion — elevated blood pressure at clinic visits
venously (IV) to alcoholics (and others) in antic- in otherwise normotensive children/adults, who
ipation of, or in whom has been noted altered are in high weight percentiles.
mental status. white gangrene That caused by localized anemia.
Westphal-Stiimpell pseudosclerosis white leg Phlegmasia alba dolens — femoral
Hepatolenticular degeneration. Disseminated phlebitis, in which the leg(s) is blanched and
sclerosis with hysteria. There is no central ner- edematous.
vous system (CNS) pathology. Whitmore's disease Melioidosis.
Wetzel grid A developmental/growth graph used whooping cough Pertussis — this communica-
for children of ages 5-18 years. If the target ble disease features coughing spasms, during
child's height and weight are not being graphed which aspiration may be fatal. This serious syn-
regularly, significant abnormalities, deficiencies, drome may be seen in comorbidity with another
and deviations may typically be missed. communicable disease. A mandatory reportable
wheal Pruritic elevation of the skin as seen in disease in the United States, diligent vaccination
urticaria, angioneurotic edema, anaphylaxis, et practices have eradicated pertussis in that coun-
al. A wheal is intentionally developed during try.
intradermal testing. will That power which controls a person's emo-
wheelchair A vehicle used to transport patients tions, actions, goals, and decisions, et al.,
within the hospital, and for outpatients without through self-determination and commitment.
mobility, to use to regain functioning. These Williams' syndrome A genetic disorder with
wheelchairs are often customized to fit the mental deficiencyin comorbidity with cardiac
needs of individual patients — many of whom murmur, hypertension, peripheral pulmonary
are children. The patient may need to recline, stenosis, renal parenchymal disease,
may be unable to support his/her head, may be supravalvular aortic stenosis, vascular stenosis.
unable to sit unsecured, may be the incorrect The pediatric patient may present with growth
size for a standard pediatric, adult, oroversized and/or developmentaldelays, "elfin facies". et
451
al. This diagnosis (dx) is sometimes missed reduced bone fragments.
because of the engaging social/conversational circumferential wiring Immobilization of
skills of these children — in whom some anom- mandibular fractures, in which an oral splint is
alies may be spared. wired to the bone fragments. This may also be
Wilms' tumor Nephroblastoma, embryonal carci- employed in the repair of fractured facial bones.
nosarcoma. This fast-growing malignancy of the continuous loop wiring Stout's wiring — wire
neonatal (and others') kidney has been success- loops are placed on the mandibulary/maxillary
fully managed by recent methods, in many teeth, in order to stabilize the mandibular frac-
cases. Otherwise, the mortality is high. ture(s) with orthodontic bands to the maxillary
Wilson-Mikity syndrome Those signs/symptoms teeth.
(s/sx) which outline the pulmonary dysmaturity craniofacial suspension wiring That attach-
of preemies. An insidious onset of cyanosis, ment of wires to bones which are not contigu-
dyspnea, tachypnea may be seen in the first ous with the mouth. These are fastened to seg-
month of life. Emphysema will be radiologically ments of the fractured jaw.
evident. Cardiac failure, hyaline membrane dis- Gilmer wiring Mobilization employed to
ease, pulmonary insufficiency may lead to the achieve intermaxillary fixation.
expiration of these fragile infants. Kirschner wiring This steel wire is threaded
Wilson's disease Hepatolenticular degeneration through the fractured long bone, to facilitate the
— that inherited syndrome characterized by application of skeletal traction.
brain degeneration, cirrhosis, dysphagia, emaci- perialveolar wiring The attachment of a splint
ation, involuntary movements, Kayser-Fleisher to the mandible — through which the alveolar
rings, muscular rigidity, progressive weakness, process is wired from the palate to the buccal
psychopathy, splenomegaly, tremor. (The pig- plate.
mented ring at the lateral corneal margins is pyriform wiring Stabilization of a fractured
pathognomonic.) Despite aggressive treatment, maxilla by wiring the nasal bones.
this disease is eventually fatal. Wiskott-Aldrich syndrome That sex-linked disor-
Winckel's disease That lethal disease of der which may be complicated by bleeding,
neonates, in which collapse, convulsions, hema- eczema, otitis media, or superinfections. This
turia, jaundice, profuse hemorrhage, and disease has a variable severity. Treatment
splenomegaly are noted. includes antibiotic therapy, as well as the trans-
window Aperture. fer factor from activated lymphocytes. These
aortic window Radiologically, that view which young patients (pts) suffer premature deaths.
encompasses the aortic arch, tracheal bifurca- withdrawal Those symptoms experiencedwhen
tion, and pericardial border. a prescribed or illicit drug, to which one has
cochlear window The fenestra rotunda. become dependent, has been discontinued, or
window period A limited span of confirmability. becomes unavailable. Neonates of addicted
This may allow a period of delay. (That for HIV mothers also experience withdrawal.
disease may be 6 months.) The premise of ther- Wolff-Parkinson-White (WPW)syndrome
apeutic (or other) level determination, which Supraventricular tachycardia — ventricular pre-
confirms patient compliance, establishes drug excitation associated with paroxysmal tach-
efficacy, and may be used to maintain sustained yarrhythmias. In the absence of cardiopathy,
peaks of the agent of choice. This requires that WPW carries a benign prognosis in otherwise
the doses be precisely timed. healthy patients (usually male). When this con-
wire suture material That used to secure dition must be treated, this may be medically or
abdominal surgical wounds of the obese/mor- surgically managed by a pacemaker, or transve-
bidly obese. Threaded through short, rubber nous/open-heart procedure, et al.
straws, these may also be fastened with buttons Wolhynia fever Trench fever, a syndrome trans-
to prevent evisceration. mitted by lice.
wiring Metal thread used as reinforcement of Wolman's disease That inherited metabolic
452
fever, in which neonates develop adrenal gland wrist cannot be extended. This may result from
calcification and hepatosplenomegaly. non-preventable injury, non-compliance, radial
woolsorter's disease Pulmonary anthrax — the nerve problems, iatrogenic paralysis.
occupational hazard which affects workers who writing Communication using encoded charac-
handle contaminated wool. ters.
word blindness Alexia — an aphasic loss of dextrad writing That script which proceeds
decoding skills (as though the printed from left-to-right.
word/phrase were in a foreign language). mirror writing Reversed right-to-left script
word deafness A common word(s), heard by an which requires a mirror in order to be read.
aphasic patient, is responded to as one s/he had writing hand A contraction which may be pre-
never heard before. sent in paralysis agitans — the hand is con-
word salad A schizophrenic symptom in which tracted in a writing position.
the patient's spoken/written words are com- wuchereriasis Bancroft's filariasis, elephantiasis,
pletely out of context to the words adjoining mal de Cayenne, pachydermatosis. Obstruction
them, void of coherence/comprehension. If pos- of the lymphatic vessels resulting in marked
sible, write down this speech pattern exactly as hypertrophy of the skin and subcutaneous tis-
heard. (Do not trust your memory, as disor- sues of the scrotum and/or legs. This may be
dered speech defies recall.) Chart this dialogue chronic, congenital, infectious, inflammatory,
as indelible confirmation of the patient's symp- and/or malignant. The vector of this infestation
tomatology. (Psychotic patients often do not is filaria mosquitoes/worms.
realize, nor care, that their words are being
recorded in writing. Others may demand that
they be recordedfor posterity.) Unless ordered,
do not use a tape recorder. (This is confidential
material — only for staff report, the medical
record, and for the psychiatrist.)
work An expenditure of mental/physical energy.
Herein is achieved degrees of fulfillment.
working through Those psychotherapeuticefforts
of the psychiatrist/psychologist/psychotherapist
and their patients to arrive at the unconscious
source and meaning of their emotionaldysfunc-
tioning.
work-up A compilation of all diagnostic data per-
tinent to the patient's medical problem(s). This
cumulative effort includes the medical examina-
tion, history (family, patient, occupational,
social, surgical), laboratory findings, X-ray
results, consultations, et al.
wound Interruption in the continuity of tissue.
This may be the result of cellulitis, contusion,
crushing/avulsion, foreign body, fracture, inci-
sion, laceration, penetration, perforation, punc-
ture, thermal injury, et al.
W-plasty That plastic surgery technique which
prevents contractions in the scars of straight
incisions. Zig-zags are developed into the
wound edges, and sutured that way.
wrist drop A flexion contracture in which the
X 453
xanthelasma Small, yellow cutaneous tumors from another species. Sometimes this is used in
which may appear on the eyelids of geriatric the absence of the needed graft, as a desperate
patients. Xanthoma. attempt to "buy time" for a patient awaiting a
tissue donation.
xanthelasmoidea Urticaria pigmentosa, masto- xenomenia Vicarious menstruation which is not
cytosis. vaginal.
xenoperfusion Filtration of the blood through 2
xanthemia Carotenemia — pseudojaundice catheters placed in leg veins. The blood is
(dietary). pumped to the oxygenator and returned to the
patient via a porcine liver. These patients await
xanthinuria Xanthiuria, xanthuria — the excre- liver transplantation from cadavers.
tion of excess urinary xanthine (a nitrogenous xenophobia An exaggerated fear of strangers.
compound). xenophonia That distortion in intonation and
inflection, due to a speech defect.
xanthocyanopsia Xanthocyanopia, xan- xenophthalmia Ophthalmic infection secondary
thokyanopy — that form of color blindness in to a foreign body.
which red and green cannot be distinguished. xenorexia Pica — the abnormality of repeated
ingestion of inedible objects.
xanthogranuloma A tumor which is characteris- xenotransplantation The experimental science of
tic of a xanthoma, an infectious granuloma. transplanting animal tissues into humans. This
juvenile xanthogranuloma Congenital pediatric is especially valuable to "buy time" until a suit-
dermatitis in which the lesions resolve without able transplant organ can be obtained.
intervention. xerocheilia Cheilitis — excessive dryness of the
lips.
xanthogranulomatous pyelonephritis That renal xeroderma Mild ichthyosis.
condition which may present with a malignant xeroderma pigmentosum Melanosis lenticularis,
mass as well as calculi. Kaposi's disease — that rare pediatric disease
characterized by pigment dissemination, ulcera-
xanthoma Cutaneous involvement which may be tion, cutaneous/muscular atrophy, death.
seen in geriatric patients who are out of diabetic xerography Xeroradiography. Production of
control. evenly charged photographs which adjust to
various tissues.
xanthoma disseminatum Hand-Schuller- xeromenia Menstrual symptoms without a flow.
Christian disease. These cutaneous tumors may xeronosus Xerosis, xerotes — abnormal drying
spread throughout the body. of the conjunctivae epidermis, mucosae.
xerophthalmia Ophthalmoxerosis.
xanthoma palpebrarum Involvement is confined xerostomia Severe drying of the mouth caused
to the eyelids. by reduced saliva production. This may be seen
in cases of acute infection, diabetes mellitus,
xanthoma tuberosum Lesions are found on the facial paresis, side effects to medication, radia-
neck, extremities, trunk. tion, hysteria, neuroses. Products such as
Xerolube help.
xanthomatosis Lipoidosis, lipidosis — xerotocia Parturition in the presence of
deposit(s) of lipid matter in the tissues, accom- absent/diminished amniotic fluid.
panied by hyperlipidemia. Cholesterol accumu- xiphisternum The xiphoid process of the ster-
lates in histiocytes, reticuloendothelial cells, and num.
in xanthomas. xiphoiditis Inflammation of the xiphisternum.
xiphopagotomy That surgical separation of
xanthopsia That state in which everything xiphopagus (cojoined twins fused at the ster-
appears to be yellow.
xanthopsis Degenerating tissue, as well as some
carcinomas (CAs) which take on yellow pigmen-
tation.
xanthosis That insignificant, jaundiced appear-
ance caused by an excess of yellow foods.
Circulatory lipochromes causing this coloring
suggest the need to rule out (RO) diabetes mel-
litus and thyroiditis.
X-disease Aflatoxicosis — toxicity caused by
contaminated peanut products.
xenog raft Heterograft — that tissue transplant
454
num). xyster Raspatory — a rasp/file used in orthope-
X-linked Those traits which are attributed to the dic surgery.
X chromosomal genes.
X-linked chronic granulomatousdisease That
rare, inherited condition characterized by severe
fungal/bacterial infectious processes.
X-linked disorder That condition/disease which
is the result ot a gene(s) aligned on the X chro-
mosome.
X-linked hypophosphatemicrickets The syn-
drome of bowed legs, growth failure, hypophos-
phatemia, with changes demonstrated on X-ray.
(In any pediatric condition affecting growth, it is
essential to regularly graph the child's height
and weight — lest subtle deficiencies be
missed.) Nephrocalcinosis may develop into end
stage renal failure, as a complication of phos-
phate therapy. It may be necessary to discontin-
ue therapy in those who demonstrate adecrease
in renal function and/or completed growth.
X-radiation Irradiation, radiation — a treatment
modality which includes exposure to the effects
of X-ray energy/exposure.
X-ray X-radiation, roentgen ray, radiograph. That
diagnostic modality which confirms or rules out
pathology or healing.
chest X-ray (CXR) A scout film may diagnose
or rule out (RO) skeletal as well as organic
pathology within the thorax.
dual-energy X-ray absorptiometry scan (DXA)
Bone density X-rays to rule out (RO) or diag-
nose loss of bone tissue, osteoporosis, a risk
for fracturing, and to confirm that the concur-
rent regimen is preventive and/or therapeutic.
tension X-ray Strain X-ray — that which is
taken under muscle tension.
X-ray dermatitis Burns or irritation from radia-
tion therapy. Exquisite skin care is mandatory. If
the skin should break down, the radiation thera-
py may have to be discontinued — whatever the
prognosis.
X-ray ot the joint Arthropneumoroentgenography
— that view which follows instillation of helium
(He) or air into the joint space.
xyrospasm Occupational neurosis — spasms
involving the fingers and/or hands, arms. This
may occur among barbers, musicians, artists, et
al.
xysma Shreds seen in diarrhea! stools.
Y 455
Yag laser That used to fade defects in dermatol- leukemia, lymphoma, generalized malignancy, or
ogy, such as birthmarks, tattoos. Many treat- those who may be immunosuppressed by corti-
ments may be needed, since the lightening is costeroids, alkylating drugs, antimetabolites,
progressive. radiation. These patients (pts) should NOT be
yawning Oscitation — enhanced inspirations by vaccinated. If travel to/through yellow fever-
mouth, which may occur in air hunger, fatigue infected zones is essential, these patients
states and/or boredom. This also occurs invol- should be advised of the extreme risk, instruct-
untarily as the postexpiratory end phase (PEEP) ed about avoiding the vector mosquitoes, and
of the respiratory cycle in a normal physiologi- issued vaccination letters from the MD.
cal response. yellow vision Xanthopsia — people and objects
yaws Bouba, frambesia, parangi, plan, polypapil- are perceived to be yellow.
loma, tropica — an infectious equatorial disease yersiniosis Infection by a genus of gram-nega-
caused by the spirochete Treponema pertenue. tive bacteria, Yersinia may appear as enterocoli-
This tuberculous eruption on the face, feet, gen- tis, acute mesenteric lymphadenitis. Pediatric
italia, and/or hands may respond to the drug of septicemic forms of this infection are often
choice, Penicillin. The end stage of this destruc- lethal.
tive disease is ulcerative erosion of the nose and yin-yang That Chinese symbol which embodies
palate. complimentary and opposing concepts such as
Y chromosome Specific to the male gender — female/male, dark/light, et al. This medical phi-
each of whom possesses one X and one Y chro- losophy balances the forces, to control physio-
mosome. Since the female possesses only X logical phenomena.
chromosomes, it is the male's Y chromosome yoga Posturing with disciplined respirations,
which determines the conception of a son. while engaged in spiritual meditation.
yeast A minute fungus which causes activity, yohimbine That hypertensive/sympathicolytic
change, and fermentation. (cholinergic) agent which is sometimes sug-
yellow fever An acute communicable disease gested for male impotence. Its use is contraindi-
spread by the mosquito, which has been eradi- cated in cardiovascular, geriatric, pediatric,
cated in all continents except Africa and South pregnant, and psychiatric patients. This drug
America. There is no specific therapy. Signs and does not increase the libido.
symptoms include albuminuria, backache, chills, Young-Helmholtz theory The absence/loss of any
constricted pupils, epigastric tenderness,fever, primary perceptive element in the retina results
gastroenteritis, headache, injected conjunctivae, in the patient's inability to see pure/combined
oliguria. Convalescence may relapse into a stage color, which includes that element.
in which the paroxysmal fever spikes, and jaun- Young's rule A calculation formula for the pedi-
dice appears. Hematemesis and hemorrhagic atric reduction of an adult dose of
mucosae may be noted, as well as disseminated medication/radiation: (Child's age) % (Child's age
intravascular coagulation (DIC), frank oliguria, + 12) = Fraction of the adult dose to be adminis-
and tachycardia. Albuminuria may lead to death tered. OR (Child's age) % (Child's age + 12 x
from uremia. Adult dose) = Child's dose.
Those coming from countries even thought to youth Adolescence— those years between child-
harbor the yellow fever virus, may be required hood and maturity. This stage is unique in its
to present a valid International Certificate of special needs and evolving problems/adjust-
Vaccination to cross those borders. ments.
Infection with yellow fever vaccine virus poses a ypsiliform That which is in the form of a "Y".
theoretical risk of encephalitis to infants < 4 yushi Minamata disease — crucial neurological
months of age, patients with immunosuppres- poisoning by mercury. Ataxia, diaphoresis,
sion in association with acquired immunodefi- dysarthria, loss of peripheral vision, mental dis-
ciency syndrome (AIDS) or other manifestations turbance, paresthesia, sialorrhea, tremors may
of human immunodefiency virus (HIV) infection, herald the patient's expiration.
z
zafirlukast (Accolate) — a new class of asthma light. Shingles.
bronchoconstrictors. Because this drug is not a zona ciliaris Combined ciliary processes.
bronchodilator, it is not indicated in acute asth- zona facialis Facial distribution of herpes zoster.
matic episodes. This medication is contraindi- zona fasciculata The adrenal cortex.
cated in nursing mothers. zona pellucida Zona radiata, zona striata — the
Zeitgeist Cultural, intellectual ithemes represen- vitelline membrane of the ovum.
tative of an era. zone A circumscribed area.
zelotypia Irritational jealousy. Monomaniacal ciliary zone The periphery of the anterior iris.
obsession. Morbid zeal. comfort zone Those stated conditions (humidi-
Zenker's degeneration Zenkerism — the waxy ty, temperature, weather, et al.) in which a work-
hyaline breakdown of skeletal tissue in acute er wearing a specified garment can comfortably
communicable disease. work at a given rate.
Zenker's diverticulum Hypopharyngeal diverticu- epileptogenic zone That cerebral area(s) which
lum — that esophageal herniation at the point produces seizure activity upon stimulation.
of a defective wall. The treatment of choice is erogenous zone Those tissues of the body
surgical. which respond erotically when caressed.
zero population growth (ZPG) The point at which hypnogenic zone Hypnogenous zone — that
population neither decreases nor increases. area which, upon pressure, induces a hypnotic
zestocausis Steam cauterization. state.
Zieve's syndrome The ingestion of a large transitional zone The ophthalmic area of the
amount of alcohol (ETON) may cause abdominal ciliary lens where the epithelial capsule cells
pain, hemolytic anemia, hyperlipidemia, jaun- transform into lens fibers.
dice. Adolescents who consume a large bolus of zonesthesia The cincture sensation — the per-
alcohol may suddenly, and promptly, expire. ception that a cord is constricting the waist.
Unbelievably, college fraternities have killed initi- This is often interpreted as painful.
ates by force-feeding ETOH per gavaae. using zonifugal Radiation from within a region/zone.
veterinarian tubing, to achieve rapid flushing zonipetal Passage into a body zone from with-
and toxic blood levels! out.
zinc (Zn) salts poisoning That lethal toxicity zonula Zonule — a small, definedarea.
which may be characterized by immediate zonula ciliaris Zonule of Zinn — the suspensory
metallic taste with burns of the mouth, throat, ligament of the lens.
esophagus, stomach. Violent hematemesis, zonular cataract That with opacity confined to
siallorhea, pain, diarrhea may precede coma. certain strata of the crystalline lens.
zoacanthosis Dermatitis secondary to a foreign zonulitis An inflamed zonule of Zinn.
body. zonulotomy A surgical incision into the zonula
zoanthropy The delusional belief that one is an ciliaris.
animal. zonulysis Zonulolysis — enzymatic dissolution
zoetic That which is vital. of the zonule of Zinn.
Zollinger-Ellison syndrome That caused by gas- zoodynamics The physiology of animals.
trinomas (non-insulin-secreting tumors) of the zooerasty Bestiality. Human coitus with animals.
pancreas. The stomach is stimulated to secrete zoogenous Of animal derivation.
excess pepsin and hydrochloric acid (HCI) — zoogeny The developmental evolution of animals.
resulting in peptic ulceration of the small zoografting The use of animal tissue (usually
intestines and/or stomach. The outcomes may porcine) in grafting. Often, this technique is uti-
be malignancy, total gastrectomy, and/or exci- lized to buy time until autografts can be
sion of the tumor(s). secured.
zona Herpes zoster — an acute vesicular inflam- zoolagnia An erotic attraction of humans for ani-
mation with neuralgic pain which follows the mals.
nerve distribution. Pediatric involvement may be zoomania That excessive/morbid attraction to
457
animals.
zoonosis A disease contracted from animals to
humans.
zoophile An animal enthusiast.
zoophilism An abnormal level of attraction to
animals.
zoophobia That exaggerated/abnormal fear of
animals.
zooplasty The grafting of animal tissue to
humans.
zoopsia Hallucinations including animals.
zooscopy The scientific study of animals.
Zoopsia.
zoster Herpes zoster.
zoster auricularis Otic involvement of herpes
zoster.
zosteriform Zosteroid resembling herpetic erup-
tion.
zoster ophthalmicus Ophthalmic involvement of
shingles.
Z-plasty That plastic surgery technique in which
a Z-shaped incision is developed to achieve
release of tension from scar tissue.
Z-track A deep injection technique which is
essential in preventing reflux of tissue-
damaging/staining agents.
zygodactyly Syndactylism — fusion of the digits.
zygomatic reflex Percussion of the malar bone
causes the mandible to move toward that side.
zygomycosis Mucormycosis — that rare and
fatal infection which has an affinity for blood
vessels. Thrombosis/infarction may result,
affecting the face and/or head during ketoacido-
sis. Pulmonary infarcts may be caused by
inhalation of the fungus. The gastrointestinal
form may cause gastric gangrene and mucosal
ulcers, secondary to ingestion of the fungus.
The necrotic material must be resected. Diabetic
hyperglycemia is a predisposing condition for
involvement.
zygote Zygocyte — the fertilized ovum which
immediately begins to divide.
zymogen A catalyst, proenzyme.
zymogenic That which causes fermentation.
zymolysis Zymosis, fermentation. The changes
caused by a catalyst (which does not enter into
the reaction).
zymoprotein An enzymatic protein.
zymose The enzyme invertin. Zymohydrolysis.
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459
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