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

44

English Braille

45

short digits. of the brain are revealed by the intravenous
brachygnathia Abnormally short mandible. uptake of radioactive isotopes, as confirmed by
brachymorphic A broad, short body type. computerized axial tomography (CAT).
brachytherapy The use of radioactive implants in brain tumor That generalized term referring to
any intracranial mass — cystic, inflammatory,
radiation therapy. neoplastic, syphilitic. Often painless, the most
bradyacusia Bradyecoia, partial deafness. malignant pediatric tumor is the neuroglioma.
bradyarrhythmia An irregular, slowed heart beat. These neoplasms are classified by sites/tumors:
bradycardia A heart beating less than 60 beats congenital angioma, craniopharyngioma, chor-
doma, dermoid cyst, germinoma, hemangioma,
per minute. hemangioblastoma; cranial nerves glioma,
sinus bradycardia A slow sinus rhythm with an schwannoma; meninges gliomatosis, menin-
atrial rate less than 60 beats per minute. gioma, sarcoma; neuroglia ependymoma; pitu-
(Children 70, fetus 100.) itary adenoma pinealoma; skull/cranium granu-
bradydiastole Prolonged diastole as seen in loma, hemangioma, osteitis deformans, osteo-
myocardial infarction. ma, xanthoma.
bradyglossia Bradyphrasia, bradylalia — abnor- brainwashing Intense psychological pressure to
mally slowed speech. change another's attitudes and beliefs.
bradykinesia Pathological retardation of move- Brandt-Andrews' maneuver Crede's method of
ment. expressing the placenta from the uterus, post-
bradylexia Of normal intelligence, a child's diffi- delivery.
culty in learning to read and decode the printed Braxton Hicks' contractions Braxton Hicks' sign
word. — intermittent, painless uterine contractions felt
bradylogia Bradylalia — slowed speech of the after the third month, in most pregnancies.
mentally handicapped patient. breast carcinoma The most common cancer to
bradyphagia Abnormally slow eating. strike females. Monthly self-examination of the
bradypnea An abnormally depressed respiratory breast is mandatory. Annual mammography is
rate. recommended, and may be obtained without a
bradyrhythmia Brain waves of 1-6 per second. physician's order in many hospitals.
Heart rate less than 60 beats/minute. bregmocardiac reflex Pressure on the posterior
bradyspermatism Pathologically slow ejacula- fontanel will reduce the neonate's heart rate.
tion. Breisky's disease Genitalia atrophic disease of
bradystalsis Abnormally prolonged peristalsis. geriatric women. Characterizedby pruritus and
bradytachycardia An erratic heart rate, incorpo- excoriation, malignant degeneration may
rating tachycardiac/bradycardiac features — as progress, especially without medical interven-
seen in sick sinus syndrome. tion (because of embarassment). Leokoplakia
bradytocia Delayed parturition. vulvae, krarurosis vulvae causes many to suffer
bradyuria Hesitant micturation. in silence.
Braille English Braille — a thermofaxed repro- Brenner's tumor An ovarian fibroepithelioma,
duction of a raised code which permits the blind which is benign.
to read by tactile sensation. The production of brevicollis Possession of a shorter neck than
Braille requires that it be hand-transcribed average.
before it can be reproduced. brevilineal Brachymorphic — the broad/short
brain death Failure of the brain to respond to body type.
stimuli. Absence of respirations and all reflexes. Briquet's syndrome Somatization disorder —
An isoelectric electroencephalogram (EEG) that which integrates alcoholism and somatiza-
which remains unchanged for 30 minutes. If tion in its diagnostic criteria.
hypothermia is a factor, pronouncement is not brisement The therapeutic fracturing of bones
attempted until the body temperature has been which need to be surgically realigned.
restored to normal.
brain scan Abnormal structures and functioning

46

The definition of brain death

Here are generally agreed upon guidelines used to establish brain death.

Several doctors must review the case. One should be a specialist with exp
tise in intensive care of severely brain-damaged patients. No doctor associat
with the transplant team should participate.

The problem is considered irreversible when the physicians have to establ
the cause of the patient's coma, when that cause insufficient to account for tt
loss of brain function, when there is no chance any brain function will return,
when all brain functions have been absent for an appropriate period (usually
hours or more).

There are cases that require special consideration: when drug intoxication,
hypothermia or shock are involved, and when the patient is a
child.

Physicians look for the absence of cerebral and
brain stem functions to determine brain death:

There must be deep coma, meaning there is no
brain response to stimuli. Confirmation may
require use of a brain blood-flow study and/or an
electroencephalogram (EEG), which measures
electrical activity in the brain.

An experienced physician using adequate
stimulation finds no responses to eye, ear,
and throat tests.

Breathing must be absent (apnea).

There should be no reflexes, no spontaneous
movements, no motor responses of any kind
to pain or other stimulus.

KEVIN BOYD - MEDICAL INFORMATION SERVICE
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Broadbent's sign Left costal retraction between bral vascular accident not only leaves the patient
the last ribs — synchronous with cardiac sys- without control of tongue, lips, and vocal cords,
tole, as seen in adhesive pericarditis. it may paralyze the hand, arm, and leg as well.
At risk of aspiration, rehabilitation might achieve
Broca's aphasia Hemorrhage into the his/her safety as well as regained functioning,
motor/speech area of the left brain renders the Brodie'sabscess Severely infected bone (often
right-handed patient unable to speak. This cere-

47

the tibial head) by subacute staphlococcal or USA England
tubercular etiology.
bromide poisoning Bromism, brominism. Morphine S04 (MS) X X
Inhalation of a bromide requires reversal by Cocaine X X
oxygen therapy and subsequent treatment of Ethanol (ETOH) X
pulmonary edema. Ingestion of this central ner- Distilled water X X
vous system depressant may cause serious Heroin X
mental deficits. Lavage, treatment of cyanosis, Simple syrup X X
tachycardia, and shock will be attended simulta- Chloroform H2O (CHCI3)
neously.
bromidrosiphobia An exaggerated fear of per- Chloroform is banned in the United States as
sonal odors — some of which may be delusion- potentially carcinogenic. Val Steck solution sub-
al. stitutes methadone for the morphine, allowing
bromhidrosis Excessive perspiration with objec- the dosing to be q 6° (every 6 hours) because
tionable odors, despite careful hygiene. of the longer duration of action. A Canadian
Iontophoresis with low current has proven to be study, et al. has cited dramatic analgesia and
of benefit. patient mobilization in their use of this agent for
bromoiodism Poisoning by iodine/bromine, this patient population.
and/or their compounds. bronchial washing Irrigation of the
bromomania The disorder caused by bronchus/bronchi for the purposes of cleaning,
chronic/excessive abuse of bromides (headache and for cytologic examination.
remedies, Bromo-Seltzer, et al.) — which leave bronchiarctia Bronchiostenosis — stricture of a
some with mental aberrations. bronchus.
Brompton's cocktail Brompton's Mix(ture) — bronchiectasis Chronically dilated bronchi — a
that analgesic syrup which is administered to super-imposed infection, congenital or acquired,
terminal carcinoma (CA) patients (pts). When unilateral or bilateral. These patients need to be
correctly dosed, every 4 hours around the clock, assessed for airway obstruction. Pulmonary
not PRN (pro re nata), awakening the patient for resection may be indicated if the condition is
doses, s/he will remain alert when awake, free resistant to antibiotics. Smoke cessation is
of pain. Most essential, s/he will be free of mandatory.
his/her fearful anticipation of impending agony bronchiloquy That foreign vocal resonance heard
— that anxiety which delays the analgesic effect during auscultation over consolidated bronchial
of traditional agents. This liquid form allows tissue.
titration, and is that in typical usage. bronchiolitis A bronchial inflammation which
Concomitant medications may be ordered. The may be exudative or vesicular.
development of tolerance has not been a prob- bronchitis Inflammation of the mucous mem-
lem, since the dosage is started high and titrat- branes of the bronchial tree. The cough may be
ed down. The solution should be swished so constant, it may be difficult for the patient to
around the mouth to permit absorption by the talk. Smoke cessation is required.
mucous membranes prior to being swallowed. bronchoadenitis Inflammation of the bronchial
This topical effect is especially indicated for tissues.
patients with oropharangeal CA. Originally for- bronchoblennorrhea Chronic bronchitis accom-
mulated by chest surgeons at the Brompton's panied by tenacious sputum.
Hospital in England, Brompton's Mixture has bronchocele Bronchiocele — the dilated
been adjusted over time, and from country to bronchus.
country. Representative formulae: bronchography Bronchogram — X-rays of the
bronchial tree following instillation of a
radiopaque medium.
broncholithiasis Obstruction/inflammation

48

caused by a bronchial calculus. bronchial tree by passage of the bronchoscope.

bronchomycosis A fungal infection within the Tissue biopsies may be obtained, as well as for-

bronchus. eign body extraction.

bronchoplasty Surgical repair of a bronchial bronchosinusitis A concurrent infection of

anomaly. bronchi/sinus.

bronchoplegia Paralysis of the bronchial mus- bronchospasm Bronchiospasm — that life-

cles. threatening contraction of the peribronchial

bronchopneumonia Inflammation of the terminal muscle.

alveoli and bronchioles. bronchospirachetosis Bronchopulmonary spiro-

bronchopulmonary dysplasia Neonatal lung chetosis — hemorrhagic bronchitis.

damage with respiratory insufficiency, as con- bronchostenosis The stricture of a bronchus,

firmed by X-ray. Respiratory impairment may within the bronchial tree.

vary from mild tachypnea to long-term need for bronchostomy A surgical opening developed into

oxygenation by mechanical ventilatory support. the bronchus.

These infants may also present with nutritional brontophobia A morbid fear of thunder.

problems, developmental delays, a high inci- bronzed skin That which may be seen in chronic

dence of airway reactivity, neurological compro- adrenocortical insufficiency — Addison's dis-

mise, retrolental fibroplasia, cor pulmonale. ease, diabetes mellitus, hemochromatosis,

They have a history of prematurity with respira- hepatic cirrhosis.

tory distress syndrome. Fluid overload must be Brown-Sequard's syndrome Hemisection of the

guarded against, as one attempts to meetthese spinal cord may be noted with the neurological

patients' metabolic needs. Calorically-dense change of paralysis on the side with the lesion.

feedings per gastrostomy may be required. A Loss of vibratory sense, ataxia, and/or loss of

prominent management error is to take these pain/temperature sense will be on the opposite

infants/children off oxygen. (Chronic hypoxemia side to the lesion.

impairs growth and development, and may lead brucellosis Malta/Mediterranean/Gibraltar/undu-

to pulmonary hypertension, and eventually, right lant fever, melintensis — an infectious, febrile

heart failure.) Children on diuretics need elec- disease. The onset may be acute, with fever,

trolyte monitoring. They must also be watched rigor, abdominal pain, anorexia, constipation,

for development of renal calculi. Prevention of depression, diaphoresis, diarrhea, emotional

respiratory infections is of paramount impor- instability, insomnia, lymphadenopathy, muscle

tance. The transition to home is often problem- aching, headache, irritability, malaise, nuchal

atical. The parents may have unrealisticexpecta- rigidity, weight loss, splenomegaly. Undulations

tions of their own, while nurses who have bond- or remissions may recur cyclically, for years.

ed with the children will feel anxiety in turning Complications including bone lesions, cholecys-

over their care. Critical infants on oxygen need titis, encephalitis, hepatic involvement, meningi-

also to be on a tachycardia monitor. Family and tis, hepatic suppuration, meningism, neuritis,

financial stresses may remain high. A psychi- orchitis may distantly appear. Intradermal test-

atric consultation may be an appropriate sug- ing of this rural occupational disease is ineffec-

gestion to stressed parents. tive. Universal precautions are mandatory.

bronchopulmonary lavage Irrigation of the Bruck's disease That rare affliction resulting in

bronchi and bronchioles, to removetenacious ankyloses, multiple fractures, skeletal disorders,

mucus. muscular atrophy.

bronchorrhagia Hemorrhage from bronchial tis- Brudzinski's sign Involuntary flexion of the knee

sue. and hip, upon passive flexion of the neck.

bronchorrhaphy Suturing of the bronchus. bruissement That purring hum heard upon aus-

bronchorrhea Abnormal bronchial secretions. cultation.

bronchorrhoncus Bronchial rales. bruit A blowing sound heard upon auscultation.

bronchoscopy Examination of the tracheo- placental bruit When auscultating the pregnant

49

uterus, a soft purr is heard in synchrony with abuse. Some patients will also suffer from the

the maternal pulse. comorbidity of anorexia nervosa. Affected are

Brushfield spots Yellow or pale spots at the those young women with a history of childhood

peripheral iris of some children with Down's maladjustment, depression, family conflict, obe-

syndrome. sity, impulse control problems, and/or compul-

brushing The rehabilitative technique to achieve sive traits. As many as 20,000 calories may be

tactile stimulation of patients with central ner- ingested at one sitting. Most bulimics are near

vous system damage. normal weight, or above. Psychotherapy is the

Bruton's immunodeficiency X-linked agamma- treatment of choice.

globulinemia. bullae Of multiple etiology, this may be serous

bruxism Grinding the teeth, either in tension or or hemorrhagic, leading to hemolysis, edema,

in sleep. This habit, which may be unconscious- hypoalbuminemia, and hemoconcentration.

ly done, often damages dental tissue, requiring Shock, hypotension, lactic acidosis, and/or

that a dental appliance be worn at night. hemolysis lead to anemia. A bullus is a vesicle

Bryant's traction On a Bradford frame, weights >1/2 cm.

pull the supine child's legs vertically, with bullous pemphigoid Benign, autoimmune vesi-

his/her weight as countertraction. These chil- cles which erupt on geriatric skin and in serum.

dren, under 2 years of age, should not be over- Oral lesions may appear, and pruritus is com-

pulled. mon. Prednisone is the drug of choice.

bubonic plague A highly-infectious disease, Bunnell block An orthotic device which prevents

characterized by lymph adenopathy, pneumonia, the flexion of selected joints during postopera-

severe toxic symptoms, and a high fatality rate. tive rehabilitation.

The "Black Death" reached epidemic proportions buphthalmia Buphthalmos — congenital infantile

in the Middle Ages. glaucoma which may arrest itself, or cause

bucardia Cor bovinum — severe cardiomegaly. blindness.

buccula A double chin. Redundant obesity Burkitt's lymphoma Seen in Central Africa, a

beneath the chin. malignant growth which causes bone-damaging

Buck's extension Traction, using adhesive mole- tumors of the jaw.

skin on the lower legs, to achieve force in the burning foot syndrome That noted in chronic

long axis of the limbs. renal failure or vitamin deficiency.

bucnemia Tense, inflammatory edema of the burn Tissue injury from chemical, electric,

leg(s). radioactive, or thermal agents. Shock must be

Budd-Chiari syndrome Abdominal pain, ascites, diligently guarded against, regardless of the

hepatomegaly, nausea with emesis, degree. All victims should receive tetanus pro-

splenomegaly — seen with occlusion of hepatic phylaxis. The first aid of choice is ice water

veins. immersion. If school children find themselves

Buerger's disease Thromboangiitis obliterans — on fire, all are taught to: "STOP, DROP, AND

a chronic, occlusive condition, seen in males ROLL!" Shock is the complication which leads

with tobacco abuse. Symptoms of thrombosis, to the expiration of these patients. Transfer to a

exquisite pain in peripheral, cyanotic extremities burn center is the intervention of choice. (The

(which worsens at night), and diminished tem- Shriner's Hospitals in the U.S. are known for

perature perception may lead to gangrenous their state-of-the-art pediatric burn care — at no

involvement. Many must undergo amputation. charge.)

bulbomimic reflex Contraction of facial muscles chemical burn That caused by caustic, corro-

in response to pressure on the ophthalmic sive agents (acid or alkali).

globe(s). electric burn Voltage often causesextensive

bulimia nervosa Bulimarexia, lycorexia. A psy- internal damage. If not lethal, amputation may

chiatric disorder in which binge eating is fol- be required.

lowed by self-induced vomiting and/or laxative fireworks burn Needless, extensive damage

50

which may progress to tetanus and/or amputa-
tion.
ophthalmic burn Contact burn from chemical,
electrical, radioactive, or thermal agents.
radiation burn That caused by overexposureto
X-rays and energy rays.
respiratory burn That resulting from the inhala-
tion of hot gases/flames. Arterial blood gases
(ABGs) with carboxyhemoglobin greater than 5
requires that the patient receive intubation with
ventilatory management and positive airway
pressure.
thermal burn The result of contact with hot flu-
ids/items/flames.
burnout Emotional despair and physical exhaus-
tion — which often leads to illness. Nurses are
at increased risk for mounting stress, as height-
ened technology, home health, liability, and staff
cuts compromise quality care. This response is
more frequently seen among those who do shift
work. Radiographic overexposure compromis-
ing the sharpness of the X-ray.
bursa A cavity or pad in the connective tissue of
the joint.
Burton's line In chronic lead poisoning, that blue
line bordering the gums.
butyroid Consistency resembling butter.
bypass That route which circumvents the usual
pathway. The shunt or heart-lung machine
which diverts circulation in open-heart proce-
dures.

c 51

cachexia Malnutrition which has reached the sta- chamber — where relief may be felt at once.

tus of syntexis — tissue destruction. calcaneodynia Calcanodynia, pain in the heel(s).

cancerous cachexia That seen in malignancy. calcaroid Calcium deposit(s) in the brain.

hypophysiopriva A result of pituitary loss of calcemia Hypercalcemia — increased calcium in

function in the cachectic patient. the blood.

lymphatic cachexia That state seen in calcicosis Pneumoconiosis caused by the inhala-

Hodgkin's disease. tion of marble dust.

pituitary cachexia Simmond's disease — that calcification Organic tissue hardened by lime

caused by atrophy of the pituitary. salts.

strumipriva cachexia Thyroidectomy-related arterial calcification Calcium deposits on arte-

syntexis. rial walls.

cachinnation Hysterical laughter to excess. metastatic calcification Seen in parathyroid

cacogeusia An objectionable taste in the mouth. disease and osteomalacia, soft tissue hardened

cacoplastic That initiating morbid growth, inca- by transfer of calcium from bone tissue.

pable of normal formation. Monckeberg's calcification Calcium deposits

cacorhythmic That which is irregular in rhythm. within the arterial walls.

cacosmia Kakosmia — an odor which is objec- calcific tendinitis Calcium deposits in a chroni-

tionable. cally painful tendon(s) of the shoulder.

cacotrophy Malnutrition. calciprivia Absence or deficiency of calcium.

cadaver The body which has expired. calcium channel blockers Calcium channel

cadaverine That malodorous product of bacterial antagonists, medications which decrease the

decomposition of proteins — as in cystinuria. influx of calcium into muscle cells — thereby

cadmiosis Pneumoconiosis caused by the decreasing arterial resistance and myocardial

inhalation of cadmium dust. This may be an demand for oxygen. This group of drugs is valu-

occupational hazard. able in treating chronic effort-associated angina

caduceus The insignia of the medical profession. pectoris, as well as angina pectoris with coro-

caelotherapy That therapy which utilizes reli- nary artery spasms. Rebound hypotension

gious symbolism and concepts. should be carefully monitored.

cafe au lait spots Patchy areas of skin, which calculifragous Disintegration of a pathological

are suggestive of neurofibromatosis when concretion (a stone composed of mineral salts).

greater than six. calculosis The tendency to develop stones.

caffeine intoxication Caffeine poisoning with calculus A stone, a pathological formation within

symptoms of nervousness, facial flushing, the human body.

insomnia, palpitations, anxiety, trembling, biliary calculus Cholelithiasis, gallbladder

and/or depression. stone(s).

Caffey's disease Infantile cortical hyperostosis, dental calculus Dental plaque.

and abnormal growth of subperiosteal bone hemic calculus A blood clot.

occurring with systemic manifestations. renal calculus Urolithiasis, nephrolithiasis.

caintophobia Cenotophobia — a morbid fear of calefacient That which provides warmth to the

creativity. body, calorifaciert.

caisson disease Decompression illness, bends, caliectasis Calicectasis, dilation of the renal

diver's paralysis. Rapid ascension by deep sea calyx.

divers places them at risk for this condition — callomania Delusional belief in one's own beau-

when nitrogen saturates their tissues. ty. The unrealistic attraction to an object or to

Neurological symptoms accompany excruciating another because of its/his/her beauty.

joint pain, burning pruritus, coughing with a caloricity That power of developing and main-

burning sensation in the lungs. The treatment of taining body heat and energy.

choice for this lethal disease is calyx A cup/tulip-shaped cavity or organ, a calix.

recompression/decompression in a hyperbaric camphoromania A pathological obsession for

52

camphor. gases in premature neonates.
camptocormia Campospasm, camptospasm — capital In reference to the head.
Caplan's syndrome Rheumatoid arthritis,
that habitual flexion of the trunk when erect.
camptodactylia The permanent flexion contrac- rheumatoid pneumoconiosis, as seen in coal
miners, accompanied by anergy, diabetes melli-
tion of the digits. tus, progressive, massive pulmonary fibrosis.
camptomelic dwarfism Craniofacial anomalies, capotement A splashing sound heard upon aus-
cultation.
costal defects, scapular hypoplasia of the capsitis Inflamed capsulitis of the crystalline
neonate. Etiology unknown, death occurs in lens.
infancy. capsulectomy Surgical excision of a capsule.
Camurati-Engelmann disease Diaphyseal dys- capsuloplasty Plastic surgery of a joint capsule.
plasia. capsulorrhaphy The suturing of a joint capsule,
cancellated Reticulated, porous, perforated. or tear.
cancericidal That which kills malignant cells.
cancerophobia An exaggeratedfear of cancer, by capsulotome An instrument for incising the crys-
one who is well. talline lens capsule.
cancrum Gangrenous oral, nasal, or pudenda!
membranes. caput Head — the chief extremity of an organ-
candidiasis Moniliasis, mycodermomycosis — ism.
an infection involving the bronchi, esophagus,
trachea, mouth, lungs, nails, skin, vagina by any caput gallinaginis Colliculus seminalis — the
Candida species. Involvement of the trachea round extension on the urethral floor.
becomes definitive for HIV disease.
cannabis Marijuana — an illicit street drug. caput medusae Venous plexus encircling the
cannibalism The ultimate psychotic aberration umbilicus — as seen in portal vein obstruction.
— in which a human consumes human flesh,
following its demise. This fusion of self rarely caput succedaneum Temporary edema occurring
occurs in prolonged starvation states with no on the presenting part in childbirth.
hope of survival.
cannulation The insertion of tubing into a body carbohydrate loading Dietary manipulation to
orifice — an invasive procedure. achieve an enhanced amount of glycogen in ath-
cantholysis Widening the palpebral slit with an letes' muscle tissue, preparatory to high-intensi-
incision at the optic canthus. ty enduranceevents.
Cantor tube Introduction of a radio-opaque tube
into the intestinal tract, via the nasogastric carbon dioxide (C02) inhalation therapy A respi-
route. A mercury-filled tip weights the tube, ratory stimulant when mixed with oxygen (02).
facilitating its placement. Intestinal decompres-
sion is the goal. carbonemia Excessive carbonic acid in the circu-
capacitation Enabling one to achieve his/her lation.
potential.
Capgras' syndrome The "illusion of doubles" — carbon monoxide poisoning Carboxyhemoglobin
the delusion that one's true self has been (COHb) forms in the circulation because carbon
replaced by impostors, resulting indefensive, monoxide (CO) has a greater affinity for hemo-
negativistic reactions toward others. This may globin (Hgb) than does oxygen (02). Death may
be noted in those with organic brain and schizo- occur in one minute to two hours, depending on
phrenic pathology. the concentration. Cherry red coloring is the
capillariasis Philippine infestation of the small pathognomonic sign. Dilated pupils, dizziness,
intestines by roundworms. dyspnea, headache, prominent heartbeat, nau-
capillaritis Telangiitis — capillary inflammation. sea, throbbing temples, tinnitus, syncope,
capillary blood gases Estimated arterial blood and/or weakness may be observed. Oxygen
should be administered — under hyperbaric
pressure if available. It may be necessary to
transfuse the patient. Neurological involvement
may persist indefinitely (aberration of the sens-
es, blindness, brain damage, muscle spasms,
obsessive compulsive disorder, paralysis). If
this was psychiatrically judged to be a lethal sui-

53

cide attempt, the patient must be confined to a both carcinomatous and sarcomatous features.
psychiatric unit until psychiatric evaluation can cardiac arrest Asystole — sudden cardiac stand-
be conducted.
carbon tetrachloride (CCI4) poisoning Inhalation still.
of this cleaning agent may cause death. Artificial cardiac atrophy Fatty degeneration of heart tis-
respiration with oxygen is to be given STAT, and
contaminated clothing removed. Acute atrophy sue.
of the kidneys and liver becomes the major cardiac compensation That reserve power of the
damage from this toxicity.
carbonuria Carbon excretion/presence in the heart to make up for impaired valvular function-
ing.
urine. cardiac cycle The entire function of the heart —
carcinelcosis A malignant ulcer. from one atrial systole to the beginning of the
carcinogen That which causes cancer. next.
carcinogenic Cancerogenic, cancerigic — that cardiac failure That which follows the heart's
inability to sustain circulation.
which produces cancer. cardiac insufficiency Failure of the heart to pro-
carcinoid syndrome Symptoms produced by vide adequate circulatory output.
cardiac neurosis Preoccupation that one has
cancer-causing tumors following metastasis, heart disease — in the absence of medical con-
may include signs of abdominal pain, diarrhea, firmation.
facial flushing extending to the neck, facial/peri- cardiac reflex Change in heart rate. (No cardiac
orbital edema, hypoproteinemia, hypotension, thrill is ever "innocent".)
tachycardia, valvular lesions, weight loss. cardiac standstill Asystole (often preceded by
carcinolysis Destruction of malignant cells. ventricular fibrillation). Cardiac arrest.
Extirpation of accessible malignant tumors is cardiac tamponade Constriction of the pericardi-
mandatory. um by inflammatory changes or fluid accumula-
carcinoma (CA) Cancer — malignancy, a cancer- tion. These anxious, confused, and even com-
ous growth. bative patients will present with profound dysp-
bronchogenic carcinoma A pulmonary malig- nea — even with normal breath sounds. In
nancy originating in the bronchus. The etiology medical conditions, the blood pressure remains
is tobacco abuse. within normal limits. That which is due to trau-
embryonal carcinoma A malignant teratoma. ma or rupture of the aorta/myocardium will
result in profound hypotension. Pulsus para-
epidermoid carcinoma A surface malignancy. doxus is the most significant clinical sign.
glandular carcinoma An adenocarcinoma. Pericardiocentesis is the emergency treatment
lipomatous carcinoma Fatty tissue cancer. (and confirmatory sign) of this life-threatening
medullary carcinoma A soft malignancy with a complication.
predominance of cells lacking in fibrous tissue. cardiac tumors Those malignant neoplasms
melanotic carcinoma Highly malignant cancer which include angiosarcoma, fibrosarcoma,
which contains melanin cells. leiomyosarcoma, liposarcoma, lymphoma,
pancreatic carcinoma Among the prominent malignant fibrous histiocytoma, malignant ter-
risk factors for this form of cancer, tobacco atoma, neurogenic sarcoma. Primary benign
abuse has been firmly established, in those with cardiac tumors include fibroma, hemangioma,
a history of smoking. lipoma, lymphangioma, myxoma, neurofibroma,
carcinoma in situ (CIS) A nonextensive epithelial papillary fibroelastoma, rhabdomyoma, ter-
malignancy, confined to its cells, within the atoma. Fibroma, rhabdomyoma, and teratoma
basement tissue. are generally pediatric tumors.
carcinomatophobia That exaggeratedfear of cardialgia Paroxysmal, substernal or epigastric
malignancy in the well patient (pt). pain.
carcinomatosis Carcinosis — widespread dis- cardiasthenia Neurasthenia with chest com-
semination of malignancy throughout the body. plaints.
carcinosarcoma That malignancy which includes

54

cardiasthma Dyspnea caused by cardiopathy. to contract efficiently. This is classified as Class

cardiectasia Cardiectasis — dilatation of the I: Asymptomatic; Class II: Fatigue/dyspnea upon

heart. moderate exertion; Class III: Fatigue/dyspnea

cardiectomy Fundusectomy — gastrectomy of upon minimal exertion. Improvement follows

the cardiac portion of the stomach. rest; Class IV: Symptomatic at rest.

cardinal Of vital importance, essence. alcoholic cardiomyopathy Dilatation attributed

cardinal symptoms Blood pressure, temperature, to alcohol abuse.

pulse, respirations (BP,TPR). congestive cardiomyopathy That associated

cardiocatheterization An invasive, diagnostic with congestive heart failure and left ventricular

examination of the heart structures and func- hypertrophy.

tioning. Cardiac catheterization assesses each dilated cardiomyopathy That rare, lethal effect

chamber's pressure, cardiac output, and oxy- to chemotherapy which may have been received

genation. years prior to the present myocardial anomalies.

cardiocele Herniation of the heart through the These patients may present with chest com-

diaphragm or wound. plaints, exertional dyspnea, fatigue, hypoten-

cardiocentesis That surgical incision or stab sion, palpitations, premature ventricular con-

wound of the heart developed in an attempt to tractions, left ventricular "heave" (abnormal pul-

intervene in cardiac tamponade or other cardiac sations). These patients are at high risk for con-

crises. gestive heart failure, and their prognoses are

cardiocirrhosis Cardiopathy complicated by por- guarded. Jugular vein distention/peripheral

tal cirrhosis. edema are signs of right-sided heart failure.

cardiodilator That instrument which dilates the Heparinization is indicated to prevent thrombus

cardia of the gastroesophageal junction. formation. (Poor organ perfusion affects other

cardiodynia Mediastinal pain. systems as well.) A heart transplant may

cardioesophageal reflux Gastric regurgitation become necessary.

into the esophagus due to obesity, pregnancy, hypertrophic cardiomyopathy Idiopathic hyper-

or incompetent esophageal sphincter (which trophic subaortic stenosis (IHSS). Often familial,

may present with only respiratory symptomatol- this syndrome includes atrial fibrillation, chest

ogy). Esophagitis often results. pain, congestive heart failure, dyspnea, dizzi-

cardiogenic shock The lethal syndrome of inade- ness, fatigue, syncope. Half of these patients

quate circulation because of deficient cardiac expire.

output. At risk for cardiomyopathy, cardiac trau- parasitic cardiomyopathy That caused by the

ma, heart failure, hypoxemia, impaired cellular infestation by vectors of the myocardium.

metabolism, left ventricular failure, diminished restrictive cardiomyopathy The rarest form —

tissue perfusion, poor cardiac output, and aci- constrictive inflexibility of heart muscle, seen

dosis, these patients are candidates for multiple more commonly in Africa. Signs and symptoms

systems organ failure (MSOF). of heart failure may develop as the ventricular

cardiolysis The surgical ligation of constrictions walls hypertrophy. Supportive therapy includes

in adhesive mediastinopericarditis, with costal anticoagulation (if indicated), diuresis, and corti-

and sternal resection. costeroid therapy. Surgical procedures may be

cardiomalacia Softening of the myocardium. appropriate for some patients.

cardiomegaly Megacardia, megalocardia — cardiomyotomy The surgical approach to car-

enlargement of the heart. diospasm (achalasia of the cardia).

cardiomotility Contractility of the heart. cardionecrosis Necrobiosis of heart tissue.

cardiomyoliposis Fatty degeneration of the Degeneration of cardiac tissue.

myocardium. cardiopathy All of the heartdiseases.

cardiomyopathy Irreversible disease of the heart cardiopericarditis Inflammation of the pericardi-

muscle. Often, the left ventricle becomes so um and myocardium.

dilated, it leaves this muscle too thin and weak cardiophobia An exaggerated fear of cardiopa-

55

thy, in the status of confirmed health. (other than ventricular fibrillation). It is possible
for the cardioverter to induce lethal ventricular
cardioplegia Cardiac arrest achieved surgically fibrillation resistant to further cardioversion.
under cardiopulmonary bypass — in order to There will remain an amnestic effect from the
decrease the oxygen demands of the myocardi- conscious sedation.
um. Cargile membrane Rarely used, this material
may be required to completely close a defect in
cardioptosis Coronary prolapse. the dura mater of the patient undergoing neuro-
cardiopulmonary arrest An abrupt cessation of surgery.
caries Tooth decay.
heartbeat and spontaneous respirations. The carminative That agent which prevents the for-
sudden absence of effective ventilation and sys- mation of digestive gas.
temic perfusion. carnophobia An exaggerated aversion to meat.
irreversible cardiopulmonary arrest The pres- Caroli syndrome That characterized by segmen-
ence of decomposition, dependent lividity, rigor tal cystic dilatation of intrahepatic bile ducts,
complicated by cholangitis, cholecystitis, and
mortis. rare cystic neoplasm.
cardiopulmonary bypass (CPBP) Employed in carotenemia Xanthemia, carotinemia, carotinosis
— the benign condition of pseudojaundice, in
open heart surgery, when a bloodless field is which the conjunctivae are not jaundiced.
required, this heart-lung machine enables the carotid The artery (2) which arises from the
circulation and oxygenation to continue func- aorta to supply the head and neck.
tioning. carotid cavernous fistula The cause of fibromus-
cardiopulmonary resuscitation (CPR) Basic life cular dysplasia, iatrogenic complications (cra-
support. If available in the community, first acti- nial dissections), ruptured cavernous aneurysm.
vate the emergency medical service. In order to The optic findings are visual loss or blindness,
oxygenate the heart, brain, and other vital with dilated ophthalmic veins.
organs, one or two rescuers provide mouth-to- carpal tunnel syndrome Weakness and pain
mouth artificial respiration in conjunction with caused by abnormal pressure (from any
external chest compression. Interruptions may source), on the median nerve of the hand. This
not exceed 6 seconds. These efforts are main- condition does not represent pathology. The
tained until the patient recovers,the EMS predisposing conditions are those of being
arrives, the victim is pronounced to have female, having arthritis, or diabetus mellitus.
expired, or the rescuer(s) is completely exhaust- Following surgery, the patient should not return
ed and unable to continue. In terms of survival to the aggravating, repetitive stress occupation
with quality of life, CPR is a desperate effort which produced this problem. Occasionally,a
which saves only a limited few. CPR is unsuc- secondary gain may encourage these symptoms
cessful in most cases. Potentially lifesaving, this (sx).
technique is often revised, and continues to pre- carphology Carphologia, floccillation, floccillita-
sent ethical dilemmas for medicine and for soci- tion. These moribund signs often may be seen
ety. in patients with extreme exhaustion and/or in
cardiorrhexis Herniation of the heart. extremis — involuntary picking at the bed-
cardiothyrotoxicosis Cardiomyopathy attributed clothes, delirium, et al.
to hyperthyroidism. carpopedal spasm Extension of the feet, legs,
cardiovalvulotome That instrument used for the and elbows, accompanied by flexion of the fin-
surgical excision of valvular tissue. gers at the metacarpal, phalangeal joints.
cardioversion Elective defibrillation under oxy- carpoptosis Wrist drop.
gen and amnestic sedation to convert cardiar- Carrel-Dakin treatment Intermittent wound irri-
rhythmias to normal sinus rhythm, with atrial gations, using Dakin's solution.
and ventricular synchronization. This should be
administered only in emergencieswhen potassi-
um and other methods have failed.
Cardioversion is contraindicated in sinus tachy-
cardia or arrhythmias caused by digitalis toxicity

56

carrier An organism, asymptomatic, or diseased catatonia A severe, stuporous state, in which the
person who harbors a communicable organism. patient may be unresponsive with psychomotor
genetic carrier Chromosomal inheritance. deficits - even if up andabout. The etiology
incubatory carrier One who harbors and trans- may be medical or schizophrenic.
mits micro-organisms during his/her incubation waxy catatonia If the limb(s) of a catatonic
period. patient are positioned, this position will be
maintained.
Carrion's disease That infectious disease seen in Stauder's catatonia Neuroleptic malignant syn-
South America. Acute, febrile anemia is followed drome (NMS), malignant hyperpyrexia, malig-
by a nodular, dermal eruption. Bartonellosis is nant hyperthermia — an extremely critical reac-
transmitted by the sandfly. tion to neuroleptic agents (antipsychotics).
Stupor, catatonic rigidity, labile blood pressure,
cartidynia Carotodynia — pain elicited by the profuse diaphoresis, hyperthermia, inconti-
application of pressure to the carotic artery. nence, and dyspnea may progress to death.

cascade A series of stages. catatonic rigidity Rigid posturing resists all out-
cast Plaster (or other molded material) immobi- side efforts to be moved.

lization for many purposes. An extremity can be catatonic stupor Marked reduction in activity,
lost if assessment of the circulation within the spontaneity, and reactivity to one's environment.
cast is not accurate — which becomes litigious.
body cast Applied from the chest to the hips, catatricrotism That cardiac condition which
these patients may be confined to bed. reveals a third impulse manifested on the elec-
spica cast That applied to both legs to keep trocardiogram, following the heartbeat.
them in abduction (apart). The abduction bar
must never be used to lift the patient. If plaster, catchment area That geographical area served
this cast should be petalled. In all casts, any by a given health facility.
bleeding should be noted, and a line drawn in
ink, at the edges of the blood. Later, this will catharsis Purgative laxation. The verbal release
indicate if the bleeding has stopped (no blood is of deep feelings, accompanied by appropriate
noted outside the line), or if bleeding continues. affect, guided by a qualified therapist.
castration anxiety Exaggeratedconcern about
injury to the genitalia. catheter Invasive tubing inserted into the body to
casualty Accidents leading to death of the vic- achieve instillation or drainage.
tims. arterial catheter That which measuresarterial
casuistics The use of moral ethics to determine pressure and obtains arterial blood samples.
right and wrong. The statistics of central venouscatheter That situated in the
morbidity/mortality (M&M). superior vena cava to monitor centralvenous
catabolism The destruction of tissue in reverse pressure, to obtain venous samples, and/or to
metabolism, as may be seen in anorexia ner- administer hyperalimentation.
vosa, and starvation states. double channel catheter A double lumen tube
catalepsy A trance in which the psychotic patient which permits simultaneousdrainageand
fails to respond to the environment. intake.
catalyst That agent which stimulates a reaction, Foley catheter Indwelling drainage tubing with
but does not enter into it. a 5-30cc balloon, to secure positioning. The
catamenia Menstruation. balloon is inflated with 5 or 30 cc sterile water
cataplexy The loss of muscle control which lasts (H20), through the lumen which does nor drain
briefly while one is in the midst of a strong urine. To remove this catheter, aspirate the cor-
emotion. This is seen when one is "weak with rect amount of water from the balloon. Never
laughter". cut off the end! Some hospitals routinely culture
cataract Opacity of the lens of the eye. Following all catheter tips.
surgical excision, the patient may be given an intravenous catheter Angiocatheter for intra-
intraocular lens (IOL) as an implantation. venous infusions and bolus medications.
male catheter Urinary drainage tubing with a
tapered tip.

57

pacing catheter Arterio/venous catheter with celiohysterectomy Development of an incision
pacemaker leads. into the uterus, via an abdominal approach.
pulmonary artery catheter Facilitates measure-
ment of cardiac output, pulmonary artery pres- celioma A tumor within the abdomen.
sure(s), and pulmonary capillary wedge pres- celiomyalgia A rheumatic, abdominal pain.
sure. celiomyositis Inflammation of the abdominal
suprapubic catheter Closed urinary drainage
system, surgically inserted above the symphysis muscles.
pubis, and sutured into place. celiopathy Any abdominal pathology.
Swan-Ganz catheter Floated into position in the celiorrhaphy Laparorrhaphy — suturing the
pulmonary artery, the balloon obstructs blood
flow from the right heart to the lungs. Pressure abdominal wall.
readings are transmitted back from the left atri- celiosalpingectomy Excision of the fallopian
um.
Tenckhoff peritoneal catheter Utilized for peri- tubes via an abdominal approach.
toneal dialysis and continuous ambulatory peri- celioscope An endoscope — which visualizes a
toneal dialysis, this catheter is sutured into the
peritoneum. body cavity.
triple-lumen catheter A central catheter with celiotomy A laparotomy — in which prompt
three channels.
vertebrated catheter Sectioned tubing which diagnosis and treatment of
becomes flexible when fitted together. intraperitoneal/retroperitoneal abnormality is
catheterization Insertion of a tube into cardio- imperative.
vascular organs, or into the bladder (an invasive cell-mediated immunity A component of the
procedure). immature response is interpreted through spe-
cathexis Mental/emotional energy used in con- cific activated lymphocytes.
centration. celosomia Congenital herniation of fetal viscera,
catlin A double-edged scalpel. in the patient with a fissured sternum.
catoptrophobia An exaggerated fear of reflecting Celsius scale The centigrade scale used to
surfaces. denote temperature. Both centigrade and
cat-scratch fever Pasteurella multocidan infec- Fahrenheit scales are used in hospitals. To con-
tion. Febrile lymphadenitis, transmitted by cats. vert a centigrade reading to a Fahrenheit transla-
Caucasian The white race of Europe, Africa, and tion, multiple it by 9/5, and add 32. To trans-
Asia. pose a Fahrenheit fever to Celsius, subtract 32,
causalgia Damage to the nerve fibers, which then multiply by 5/9. "C" or "F" follows the
produces extreme pain of organic or psycholog- reading.
ic origin. cenesthesia The sensation of well-being — that
caustic That alkali agent which destroys tissue. of being alive and well.
cauterization Destruction of tissue by caustic cenesthopathia Cenesthopathy— general
chemicals, electrocautery, or freezing. malaise.
celiac sprue A chronic pediatric disease with an cenotophobia Cainotophobia — an exaggerated
intestinal mucosal lesion. Known also as celiac aversion to that which is new.
disease, or gluten-induced enteropathy, compli- censor A psychic inhibition that prevents abhor-
ance with the ordered gluten-free diet is difficult rent, subconscious ideas/impulses from being
to maintain, but a therapy of choice. Non-tropi- expressed, unless in a recognized form.
cal sprue, gluten intolerance, gluten-sensitive central core disease A rare form of benign
enteropathy. polymyopathy. Characteristics of this inherited
celiocentesis That surgical puncture of the condition include delayed walking, hypotonia,
abdomen. Paracentesis may be performed. nonprogressive weakness.
central line An intravenous access device which
permits immediate entry into the circulatory
system of the critical patient.
central venous pressure (CVP) Pressure within
the superior vena cava. When low, reduced
blood volume suggests fluid loss or hemor-

58

rhage. When high, circulatory overload might are contraindicated in the presence of markedly

signal congestive heart failure. impaired renal function or colitis. Glucosuria

centrosclerosis Bone tissue within the bone may register a false positive. Anaphylaxis

marrow space. remains a lethal risk among the

cephalalgia Cephalodynia, headache. cephalosporins/penicillins.

cephaledema Cephalomegaly — swelling of the cephalothoracopagus Conjoinedtwins fused at

head. the head/thorax.

cephalhematocele A tumor containing blood, cephalotome An instrument used in cephaloto-

which communicates with the dural sinus(es). my — cranial dissection of the expired fetus in

cephalic Cranial, superior. utero, to facilitate delivery of the impacted

cephalocaudal pattern of development That infant.

maturation principle that coordination, motor cephalotrypesis Trephination of the skull to

development, and control progress cephalocau- extract a portion of the cranium.

dally (from the head down). ceratome A scalpel used to divide the cornea(e).

cephalocele Herniation of the brain from the cra- cerea flexibilitas Waxy flexibility seen in patients

nium. with catatonic schizophrenia.

cephalocentesis Surgical puncture of the skull. cerebellitis Cerebellar inflammation.

cephalohemometer An instrument which indi- cerebellar degeneration Bilateral arm/leg ataxia,

cates changes in intracranial blood pressure diplopia, dysarthria, or vertigo may be initial

(ICP). symptoms. Nervous signs may demonstrate

cephalomeningitis Inflammation of the cerebral dementia, extensor plantar signs, nystagmus,

meninges — a mandatory, reportable disease in ophthalmoplegia. Cerebellar atrophy may pre-

the United States. cede the advent of carcinoma.

cephalonia Cephalomegaly accompanied by cerebral anoxia Insufficient oxygen to the brain,

mental retardation. resulting in brain damage if not reversed in 5

cephalopathy Any pathology of the brain/head. minutes.

cephalopelvic disproportion That status in cerebral concussion A "bruised brain" with

which the fetus' head is larger than the mother's symptomatology which spans from vertigo to

pelvic outlet. unconsciousness to shock. Report unequal

cephaloplegia Muscular paralysis of the head pupils at once.

and/or neck. cerebral hemorrhage Bleeding into the brain —

cephaloscope That instrument used for ausculta- the result of a rupture of diseased/sclerotic

tion of the head. blood vessels, in the presence of hypertension.

cephalosporin That class of antibiotics which is cerebral palsy (CP) Little's disease, cerebral

potent and readily available within the circula- spastic infantile paralysis. The loss of one's abil-

tion soon after intravenous administration. The ity to control movements, due to symmetrical,

cross-allergenicity of penicillin and bilateral, nonprogressive paralysis as a result of

cephalosporin places patients sensitive to one at developmental defects in the brain, or of trau-

risk for the other. Patients receiving any of the matic brain damage. This impairment may be

broad-spectrum antibiotics may develop life- spastic, athetoid, ataxic, or mixed. These chil-

threatening pseumembranous colitis. These dren are often remarkably patient.

patients should be followed closely for idiosyn- cerebration Mental activity.

crasies. These medications should be discontin- cerebritis Inflammation of the cerebrum.

ued if any of these symptoms appear. cerebromeningitis Inflammation of the cerebrum

Antihistamines, corticosteroids, etc., may be and membranes — a reportable disease in the

indicated. Nephrotoxic/ototoxic side effects may United States.

be crucial — destructive of kidney tissue and cerebropathy Cerebrosis— any disease of the

the hearing at the same time. Superinfection brain.

may also occur in prolonged use. These drugs cerebropsychosis Mental illness caused by cere-

59

bral lesions. postmortem Cesareansection Surgical deliv-
cerebroscope An ophthalmoscope capable of ery of an unborn fetus immediately following
maternal demise. This must be performed with-
diagnosing pathology of the brain. in 15 minutes of death, in order to save the
cerebrospinal axis The central nervous system unborn infant.
Cestan-Chenais syndrome That neurological dis-
(CNS). order produced by a pontobulbar lesion of the
cerebrotomy Incision and drainage of an abscess brain.
cestodiasis Tapeworm infestation.
in the brain. Dissection of the brain. Chaddock's reflexes Extension of the great toe
cerebrovascular accident (CVA) Apoplexy, when the outer dorsum of the foot is stroked —
indicative of corticospinal tract pathology.
stroke. That pathology within the brain which Fanning of the fingers with flexion of the wrist
accompanies hemorrhagic/ischemic disorders, may be elicited upon pressure of the palmaris
in the presence of hypertension. longus tendon.
cerebral hemorrhage Intracerebral hemor- Chagas' heart disease American trypsanosomia-
rhage; Subarachnoid hemorrhage. sis is rare in the United States, but may be seen
cerebral infarction Atherothrombotic event; in Latin Americans who come from areas where
Cardioembolic thrombus. this is endemic. This condition presents with
transischemic attack (TIA) That in which all arterioventricular block, congestive heart failure,
symptoms are promptly reversed. This should angina pectoris, conduction abnormality(s), ven-
be regarded as a serious warning of an impend- tricular tachycardia, sudden death. The subtle
ing cerebral vascular event. clinical picture may mimic myocardial infarction,
cervical cerclage Ligation of an incompetent aneurysm, coronary artery disease, and/or idio-
cervix during pregnancy to prevent spontaneous pathic cardiomyopathy. Late manifestations may
abortion, or premature delivery prior to viability include achalasia, megacolon, cardiac patholo-
of the fetus. gy, chronic myocarditis. Cardiac involvement
cervical fat pad The "buffalo hump" noted at the may progress to complete atrioventricular block.
upper back, caused by the excessive production Akinesia/dyskinesia may be noted. When
of adrenocortical hormone. myocardial involvement is widespread, dilated
cervical spondylosis Osteoarthritis/degenerative cardiomyopathy may appear. Life-threatening
arthritis — of the vertebra(e) of the neck. ventricular arrhythmias (and sudden death) may
cervicectomy Surgical excision of the uterine be the first manifestation of this complicated
cervix, the cervix uteri. infectious process.
cervicitis Inflamed cervix uteri. chalcosis Chronic copper poisoning with
cervicocolpitis Cervicovaginitis — infection of deposits in the tissues and lungs.
the cervix and vagina. chalicosis Pneumonoconiosis caused by stone
cervicodynia Cervical neuralgia — cramping cutting dust. Flint disease.
neck pain. chalinoplasty Plastic surgery of the lips/mouth.
Cesarean hysterectomy Resection of the uterus challenge A trial of medication, antigen — espe-
immediately following the Cesarean delivery of cially that to which the patient, by history, has
the baby. reacted.
Cesarean section Porro's operation, cesarotomy. chalazion A meibomian cyst on the eyelid.
cervical Cesareansection Surgical delivery of chancre Ulcus induratum, chancroid — a highly
the infant, placenta and membranes, through an communicable syphilitic ulcer.
extraperitoneal incision immediately above the Chandler's disease Venous occlusion — bilater-
cervix. al idiopathic, aseptic necrosis of the adult
classic Cesarean section Surgical delivery of femur(s). This ischemic compression may result
the baby, placenta, and membranes via an from fluid retention.
intraperitoneal abdominal incision.
low transverseCesarean section A pelvic
approach in which there is decreasedincidence
of fetal and maternal morbidity/mortality.

60

charcoal hemoperfusion That inert, adsorbent chemocautery Chemosurgery — cauterization by
material which is administered to those who are chemical(s).
suffering from drug toxicity/overdosage.
chemocoagulation Clotting achieved by chemical
Charcot-Leyden crystals Those found in asth- agents.
matic sputum, and in the feces of ambiasis.
chemonucleolysis Spinal fusion surgically
Charcot-Marie-Tooth disease A hereditary dis- achieved by the injection of chymopapain
ease with muscular, neural, progressive atrophy ("meat tenderizer") into the herniated disks.
of the distal extremities. Peroneal muscular This usually eliminates the need for spinal
atrophy develops in pediatric boys. Although fusion and other surgical procedures on the
severely disabling, this disease is not fatal. The spine.
etiology is unknown.
chemoradiotherapy Adjunct treatment of malig-
Charcot's joint Joint pathology, characterized by nant disease by drug/radiation protocols.
hypermobility, associated with injury/disease to
the spinal cord. Joint instability and deformity chemoserotherapy Combination of serum and
are seen in this neurogenic arthropathy — in medication, in prescription.
which decalcification occurs, and pain is rare.
chemosis Conjunctiva! edema in the area of the
Charcot's triad Intention tremor, nystagmus, and cornea.
scanning speech as seen in some cases of mul-
tiple sclerosis. chemothalamectomy Administration of toxic
chemicals which have a specific lethal effect
check To verify and confirm the status. To arrest upon the microorganism causing the brain
the course of an event or phenomenon. pathology.

Chediak-Higashi syndrome An inherited, lethal, cherophobia An aversion to, or fear of, gaity.
metabolic, pediatric disorder which presents Cheyne-Stokes respirations A terminal, cyclical
with photophobia, pale optic fundi, and partial
albinism. Symptoms progress as lymphoma, breathing pattern characterizedby increasing
with death occurring between the ages of 5-10 frequency and depth of respirations, until a peri-
years. od of apnea ensues. Then the pattern resumes.
This signals diencephalic dysfunction with
cheilectomy Surgical excision of the lip(s). depression of the frontal lobe, but may be pre-
Facilitation of joint mobility by surgical excision sent as a normal finding in pediatric patients.
of abnormal bone tissue. Chiari-Frommel syndrome Amenorrhea coexist-
ing with galactorrhea, following pregnancy. This
cheilitis Chelitis — inflammation of the lips. may be associatedwith a pituitary adenoma,
cheilognathopalatoschisis That developmental androgen excess, and/or endocrine imbalance.
childhood disintegrative disorder Clinical loss of
anomaly with cleft palate(s), maxilla, upper lip. skills acquired prior to age 10 years — lan-
cheilophagia Habitually biting one's lip. guage, motor, play, sociality, toileting, et al.
cheiloplasty Plastic surgery on the lip(s). Abnormal functioning seen in the areas of social
cheilorrhaphy Surgical repair of cheiloschisis interaction, communication, and behavior, are
early signs.
(cleft lip). Chinese restaurant syndrome Transient symp-
cheilostomatoplasty Restoration of the mouth toms of chest pain, diaphoresis, facial pressure,
headache, and/or epigastric distress experi-
through plastic surgery. enced with intake of excessivemonosodium
cheilotomy Chilotomy — partial excision of the glutamate.
chiralgia Neuralgic, painful hand(s), in the
lip(s). absence of trauma.
cheirospasm Writer's cramp — chirospasm of chirismus Spasm of the hand muscles.
chiromegaly Hypertrophied wrists, hands,
muscles of the hand. ankles, feet.
chemabrasion Chemexfoliation — the eradica- chiroplasty Plastic surgery of the hand.

tion of scars and abnormal pigmentation
through destruction of superficial skin layers by
chemosurgery.
chemobiotic Combination chemotherapeutic
agent/antibiotic preparation.

61

Chlamydia(e) That genus of microorganisms cholecystolithotripsy Pulverizing calculi within
once thought to be viruses, and which cause a the intact gallbladder — with/without a bath.
wide scope of pathology, such as genital infec-
tions (resulting in sterility), inclusion conjunc- cholecystopathy All pathology involving the gall-
tivitis, trachoma, lymphogranuloma venereum, bladder.
ornithosis. The most prevalent sexually-trans-
mitted disease (STD), a resurgence of neu- choledocholithiasis A calculus within the com-
rosyphilis, is appearing. A lumbar puncture mon bile duct.
must be performed if any neurological sympto-
matology is noted. choledocholithotripsy Crushing calculi in the
intact common bile duct.
chloral hydrate poisoning The syndrome of toxi-
city includes depression/paralysis of the central cholelithiasis Formation of calculi in the gall-
nervous system, and hepatic toxicity. bladder/common bile duct (some of which may
Emergency measures may involve be asymptomatic).
Trendelenburg positioning, gastric lavage with
coffee/tea (to provide caffeine), respiratory cholemesis Vomitus which contains bile.
assist, and intravenous (IV) dextrose. cholemia Bile pigments in the circulation.
cholera Asiatic cholera — acute, bilious, and
chlorhydria Excessive gastric hydrochloric acid.
chloridemia Chlorides in the circulation. endemic diarrhea in 4 stages: 1. cholerine stage:
chloriduria Excessive urinary chlorides. Anorexia, fever, general malaise, headache; £
chloroma "Green" cancer — periosteal sarcoma evacuation stage: Abdominal cramping, copious
emesis from intractable vomiting, electrolyte
within the cranial bones. imbalance, singultus, depression; 3. stage of
chloropenia Hypochloremia — a deficiency in collapse: Anuria, choleromania, coma, dehydra-
tion, falling blood pressure, profuse diaphoresis,
chlorine. marked weight loss with cachexia, tachypnea
chlorophane A yellow-green coloring of the reti- with weak pulse; 4. stage of reaction: Erythema
with urticaria. Unless complete recovery occurs
na(e). from this stage, death ensues from dehydration
cholangiectasis Dilatation of the bile ducts. and/or electrolyte imbalance.
cholangiocarcinoma Malignant bile duct tissue. choleric Unpredictably temperamental and irrita-
cholangitis Angiocholitis — inflammation of the ble.
cholestasis Cholestasia — a blocked excretion
biliary vessels. Cholangiolitis. of bile.
primary sclerosingcholangitis A chronic cholesterol A vital factor in metabolism and
inflammatory disorder of the billiary system, nutrition. At significant risk are those with famil-
resulting in fibrotic structures and dilatation. ial history of premature coronary heart disease,
This may result secondary to hepatic failure, hypertension, tobacco abuse, low high-density
and/or cholangiocarcinoma. lipoproteins, cerebrovascular events, diabetes
cholasma gravidarum Pigmentary skin discol- mellitus, morbid obesity.
oration occurring in pregnancy or in women on cholesteroluria The urinary presenceof choles-
progestational agents for oral contraception. terol.
cholecystalgia Biliary colic. choleverdin Biliverdin — that which imparts the
cholecystectasia Dilation of the gallbladder. appearance of jaundice.
cholecystectomy Surgical excision of the acutely chondralgia Chondrodynia — painful cartilage.
or chronically inflamed gallbladder, caused by chondralloplasia Cartilage found in abnormal
lithiasis, bacteria, and/or chemical irritants. sites.
Cholecystectomy/cholecystostomy are the surgi- chondrectomy That surgical excision of cartilage.
cal procedures of choice. chondritis Cartilaginous inflammation.
cholecystitis Acute/chronic inflammation of the chondrocalcinosis Pseudogout — a chronic,
gallbladder. Symptoms may include abdominal recurrent arthritis biochemically different than,
pain (referred to the right shoulder), cholecys- but clinically similar to, gout. In contrast, small
tolithiasis, nausea, and/or jaundice. joints are not involved, as is the knee.

62

chondrodysplasia Ollier's disease, chondropla- noted. There is no effective therapy for loss of
sia, dyschondroplasia. This is an inherited cognitive functioning. Death ensues during an
growth disorder, characterized by bony growth intercurrent infection, or by suicide.
at the epiphyses of the fingers, toes, long mimetic chorea Imitative movements noted in
bones. Joint deformities, dwarfism, skeletal the bizarre movements.
anomalies may be noted. pseudochorea A hysterical state in which chor-
eiform movements are exhibited, but the dis-
chondroma A painless, slow-growing, benign ease is not present.
tumor of cartilage. Syndenham's chorea Chorea minor, gravi-
darum chorea, St. Vitus' dance. An acute pedi-
chondromalacia Softening of articular cartilage. atric disease which might also be seen during
chondromatosis That slowly-growing, painless, pregnancy. Associated with rheumatic fever,
contractions of the extremities and trunk impair-
cartilagenous tumor of the feet and/or hands. ment with speech or memory impairment may
chondro-osteodystrophy Congenital epiphyseal occur. Anxiety is prominent. The child may
remain in school as long as advisable, while
deformity which produces dwarfism, kyphosis, protected from injury.
"pigeon breast". choreoacanthocytosis Neurocanthocytosis —
chondropathy Any cartilagineous disease. chorea, dementia, dysphagia, lip-biting, obses-
chondrosarcoma A rare, malignant cartilaginous sive compulsive disorder, peripheral neuropathy,
tumor of the head/neck which grows slowly but and mood changes may accompany these psy-
aggressively. chopathological alterations.
chondrosternoplasty Surgical repair of a sternal choreoathetosis An extreme range of motion
deformity. with abrupt, involuntary movements varying
chondrotome A scalpel used to incise cartilage. from hypertonia to hypotonia — as seen in
Chopart's amputation Disarticulation between cerebral palsy.
the tarsal row of foot bones. choreiform movements Rapid, interruptive, non-
chorditis Inflammation of the vocal or spermatic repetitive motions.
cords. choreophrasia Repetition of meaningless phras-
chordoma A rare, vertebral neoplasm which may es/words.
be fatal because of its hypertrophy and surgical chorioamnionitis Inflammation of the mem-
inaccessibility. Bone tissue is relentlessly erod-
ed. branes adjacent to the fetus in utero.
chordotomy Cordotomy — surgical relief of choriocarcinoma Chorioma, chorionepithelioma,
severe pain, through the sectioning of any cord.
A lateral spinal cord division. deciduocarcinoma, deciduosarcoma, tro-
chorea Involuntary, muscular, purposeless phoblastoma — a rare and extremely malignant
movements of many types — bizarre, dancing, uterine neoplasm, etiology unknown.
imitative, intoxicated, mild, sudden, twitching, choriocele Herniation of the ophthalmic choroid
vermiform, violent. Some patients may have to coat through a defect in the sclera(e).
be sedated. choriomeningitis Cerebral meningitis with cellu-
Dubini's disease Bergeron's chorea, electric lar infiltration.
chorea, spasmus Dubini. This rare form is char- lymphocytic choriomeningitis Acute central
acterized by sudden, rhythmic contractions with nervous system pathology of vital symptomatol-
violent movements, as though the patient has ogy — which may progress to acute septic
received an electric shock. meningitis.
Henoch's chorea A hereditary central nervous chorioretinitis Inflammation of the choroid and
system disease with progressive dementia and retinal tissues of the eye. Choroidoretinitis.
choreiform posturing. Prior to the onset of choroideremia A hereditary sex-linked character-
dementia, addictive behavior, checking rituals, istic in which progressive night-blindness is
depression, distrust, eccentricity, personality manifested by the male members of the extend-
changes (irritability, impulsivity), sexual promis-
cuity, and other losses of self-control may be

63

ed family. phatic leukemia (CLL); chronic B cell lymphatic
choroidocyclitis Inflammation of the leukemia (B cell CLL); chronic T cell lymphatic
leukemia (T cell CLL); chronic myelomonocytic
ciliary/choroid processes of the eye. leukemia (CMML); hairy cell leukemia (HCL);
choroidoiritis Inflammation of the iris and prolymphocytic leukemia PLL); Sezary syn-
drome.
choroid process. chronic obstructive pulmonarydisease (COPD),
Christian-Weber disease Nonsuppurative, nodu- chronic obstructive airways disease (COAD),
chronic obstructivelung disease (COLD) The
lar, febrile panniculitis. diagnostic criterion is that history of exertional
Christmas disease Hemophilia B — a hereditary, dyspnea, allowing less than half of the normal
maximum breathing capacity. Chronic diseases
sex-linked characteristic, seen in males. which lead to this decreasedability of the lungs
chromaturia Abnormally-colored urine. to ventilate, include asthma, bronchiolitis, bron-
chromium poisoning Cramping diarrhea, pain, chitis, pulmonary emphysema — all of which
are exacerbated by tobacco abuse.
oral distaste. If medical intervention fails, death chronological Ordered sequencing, according to
will occur due to uremia. date and time.
chromosome analysis Testing to determine a Churg-Strauss syndrome Allergic granulomato-
genetic disorder(s). This should be done in the sis/angiitis with respiratory tract involvement.
presence of multiple anomalies of unknown eti- This systematic, severe necrotizing vasculitide
ology — especially if growth/mental retardation with pulmonary involvement, may be represent-
is noted. (All pediatric heights/weights must be ed by a symmetrical neuropathy or mononeuri-
graphed, if deviations are to be caught.) Girls tis multiplex. Eosinophilia, necrotizing granulo-
with unexplained stature deficiency should be ma, and severe asthma may be seen.
checked for Turner syndrome. In the face of Chvostek's sign A tetanic reflex — a tap over the
appropriate family history and clinical findings, facial nerve elicits a spasm of the facial mus-
boys should be assessedfor fragile X. A nega- cles. This should be assessed in the postopera-
tive chromosome analysis does not rule out tive patient who has undergone parathyroidecto-
genetic disorders. my.
chronic disease The prolonged course of a con- cibistome That scalpel used to incise the capsule
dition with little progress/change in the disease of the crystalline lens.
state. The longer the duration without a diagno- cibophobia That morbid aversion to food — a
sis (dx), the more dismal the outcome. psychiatric aberration.
chronic fatigue syndrome Epstein-Barr virus, cicatricotomy Uletomy — revision of a scar
Lyndonville syndrome, myalgic under tension.
encephalomyelitis have all been identified as the cicatricotomy pemphigold Benign mucosal pem-
same condition. Common symptoms include phigold, marked by extensive lesions of any/all
cytomegalovirus, diminished intelligence, lym- mucosa(e). Blindness may result from conjunc-
phatic edema, elevated antibodies, fever, herpes tiva! involvement. Scarring may require surgical
simplex, interstitial pneumonitis, joint pain, release.
myalgia, night sweats, pancytopenia, panic ciguatera Paradoxical, West Indies' fish poison-
attacks, uveitis, visual problems, wide mood ing, due to unpredictable anticholinesterase lev-
swings. els. Although the fish do not taste tainted,
chronic myelogenous leukemia (CML) An adult symptoms of abdominal cramping, diarrhea,
form of the myriad leukemias. Distinctive to this nausea, and vomiting may appear within 2
category is the pathognomonic chromosomal hours. Respiratory therapy should stand by. I1
anomaly Ph1 (the Philadelphia chromosome). the patient has not vomited, gastric lavage must
Unaware of illness, some of these patients may be performed. Later, facial pain, headache,
learn of their neoplastic pathology following a
complete blood count (CBC). The treatment of
choice includes cytotoxic chemotherapy in con-
junction with bone marrow transplantation
(BMT). There are various forms: chronic lym-

64

myalgia, parathesias, pruritus, reversal of ammonia toxicity. Advanced stages have an

hot/cold sensations, and persistent sensory unfavorable prognosis as the disease may

phenomena may persist. progress to complete hepatic failure.

ciliarotomy Surgical sectioning of the ciliary alcoholic cirrhosis Micronodular cirrhosis —

zone in glaucoma. that form which occurs in patients with alcohol

ciliectomy Partial excision of the ciliary abuse.

border/body. cardiac cirrhosis Seen in those with congestive

ciliospinal reflex Stroking the neck stimulates heart failure, who have suffered passive hepatic

the pupils to dilate. congestion.

cillosis Twitching spasms of the eyelid. infantile cirrhosis The result of protein malnu-

cinclisis Any swift spasmodic movement. trition, Kwashiokor, in impoverished African

cingulotomy Surgical intervention within the nations.

brain, to alleviate intractable pain. macronodular cirrhosis May follow idiopathic

circulation Those systems in which movement and viral hepatitis.

runs a complete circular course, including the metabolic cirrhosis Due to diseases which are

arterial, collateral, coronary, fetal, lymphatic, related to metabolism — Wilson's disease,

portal, pulmonary, systemic, and venous circu- glycogen storage disease, hemochromatosis.

latory systems. obstructive biliary cirrhosis Marked by pro-

circulatory arrest surgery Profound hypothermia longed jaundice, chronic retention of bile with

to 70° F — induced to reducethe risk of hemor- inflammation of the ducts by tumor or calculus.

rhage during precarious brain surgery. The primary biliary cirrhosis A rare and progres-

patient must be rewarmed every 20 minutes. sive form characterized by pruritus, jaundice,

circumcision Excision of penile tissue. and hepatomegaly.

female circumcision Infundibulation — mutila- pseudocirrhosis Cirrhotic symptoms of ascites.

tive practices performed on prepubertal girls in dyspnea, and cyanosis due to any process

Africa. This is outlawed in the USA. which causes obstruction of venous return from

male circumcision That performed at birth, or the liver. Constriction pericarditis may be sus-

as indicated in adulthood. pect.

circumoral Perioral — encircling the mouth. toxic cirrhosis Caused by poisoning by an

circumoral pallor A cyanotic/white border agent. When a patient has no history of alcohol

around the mouth — a significant finding in cir- ingestion, this points to a hepatotoxic agent in

culatory compromise. his/her environment.

circumstantiality Tedious speech which is indi- cirsotome Scalpel for incising varicoseveins.

rect, with unnecessary details andparenthetical cirsotomy Ligation and stripping of varicose

remarks. In order to obtain an interview from veins.

these patients, they must be interrupted and cisplatin An antineoplastic agent prominent in

reminded of the subject to which they are the chemotherapy of gonadal carcinoma. Its

responding. Common in obsessive-compulsive severe nephrotoxicity may be relieved when a

disorder, this differs from loosening of associa- diuresis of 150cc/hour is maintained.

tions — in which those patients lose the direc- cisvestitism The wearing of a uniform one is not

tion of their conversations. The above patients qualified to wear.

remain aware of the original goal of their ram- Citelli's syndrome The inalert. somnolent lack of

bling discourses. Digression of thought and attention span, coupled with intelligence disor-

speech, in which the central idea may appear ders, of children with sinus and adenoid condi-

demented, disordered, or schizophrenicand dis- tions.

turbed, may have psychotic qualities. citrullinemia Aminoaciduria, increased citrulline

cirrhosis Chronic degenerativepathology of the in the urine, blood, and spinal fluid. Clinically,

liver, in which the structure and functioning are failure to thrive, ammonia intoxication,

impaired. This leads to portal hypertension and hepatopathology. vomiting, convulsions, and

65

mental retardation may be seen. processes which failed to fuse.
clang association Pathological choice of words cleft foot A bipartite foot due to developmental

only for their sounds (often rhyming), not failure.
meanings. This psychiatric phenomenon is cleft hand A congenital, bipartite hand.
observed most often in mania and schizophre- cleft lip A vertical division of the upper lip which
nia, during which the patient is clanging.
clapotage Clapotement, the splashing sound by may be unilateral/bilateral and may involve the
succussion from a dilated stomach. palate.
clapping Cupping, tapping techniques of chest cleft palate A complete/incomplete,
percussion. unilateral/bilateral split of the palate(s). This
clarification Freedom from turbidity. A psychi- congenital anomaly communicates with the
atric confrontation used to assist the patient in nasal cavity. If not surgically closed before the
recognizing his/her inconsistent statements. infant begins to form sounds, the severe speech
Clarke-Hadfield syndrome Pediatric infantilism impediment will remain into maturity.
caused by pancreatic insufficiency. These chil- cleft sternum A congenially divided breastbone.
dren are underweight and fail to grow. Parental cleft tongue An innate bifid tongue.
neglect is sometimes suspected without cause. cleidocranial dysostosis Cleidocranial dysplasia
Claude's syndrome Paralysis of the oculomotor — a rare condition in which there is defective
nerve, due to a brain lesion. Tremor with con- ossification of the cranial bones with large
tralateral ataxia may be noted. fontanels, delayed closure of the sutures, partial
claudication Limping. or complete absence of the clavicles, wide pubic
intermittent claudication Severe calf cramping symphysis, short medial fifth phalanges, verte-
which subsides with rest. Arterial spasm, occlu- bral anomalies, and dental abnormalities.
sion, or atherosclerosis may cause this inade- cleidorrhexis Bending/fracturing the clavicle(s)
quate blood supply. Tobacco abuse is absolutely of an impacted fetus to facilitate delivery.
contraindicated. click A brief, percussive sound, auscultated in
claustrophilia A morbid desire to be shut in with the heart, or in the joint during articulation.
windows and doors shut, because of the dread climacteric That period which signals the lessen-
of being in an open space. ing of sexual activity in the male or female's
claustrophobia That fear of confinement in reproductivity.
enclosed spaces. clinical Firsthand findings on actual patients.
clean-catch The method of obtaining mid-stream Guard against one's reports becoming "hearsay"
voided specimens. This eliminates bacterial con- information.
tamination in culturing urine for sensitivity stud- clinical judgment Reliance upon experience and
ies. knowledge when treating patients.
clean room A controlled environment in which clinical pathology The use of analysis and labo-
all incoming air is filtered, with temperature, ratory procedures in the diagnosis and treat-
pressure, and humidity controlled. These rooms ment of disease.
are used to prevent infection in immunocompro- clinical trial Formally designed and executed
mised patients and in children born without studies of drug effects on human subjects.
immune defenses. Interactions, incompatibilities, side effects and
cleft Fissured, split, divided tissue. toxicities are carefully defined in a double-blind
macrostomia Transverse facial cleft of the technique as follows: Phase I study: To check
cheek — a congenital anomaly. the best way to manage a new protocol. Phase
oblique facial cleft A nasolacrimal split extend- II trials: To check tumor response. Phase III tri-
ing from the base of the nose (which may be als: To check a large group of patients on an
contiguous with a cleft lip). investigational drug. Adjuvant trials: To deter-
transverse facial cleft That extending from the mine whether additional modalities will be effec-
angle of the mouth — the result of embryonic tive. Neither the test groups nor clinicians know
who is receiving the test medication, or placebo.

66

If it becomes a matter of urgency, the blind will which large, white masses develop deep in this

be broken, and this revealed. That subject will vascular area.

not be returned to the clinical trial. cocaine hydrochloridepoisoning Central ner-

clinometer Clinoscope — that instrument which vous system (CNS) stimulation with excitement,

measures paralysis of the ocular muscle, tor- hallucinations, incoherence, restlessness are

sional deviation of the eyes, and/or the weak- noted. Profound depression follows cardiac

ness of ocular muscles. arrhythmias, collapse, convulsions, dizziness,

clithrophobia An exaggerated fear of being fever, hypertension, dizziness, fever, hyperactivi-

locked in. ty, nausea, paresthesias of the hands/feet, respi-

clouding of consciousness The confusional ratory arrest — which may progress to death.

state, characterized by amnesia, impaired atten- cocaine psychosis Idiosyncratic consequences

tion, and perception. This phenomenon is noted caused by cocaine abuse. This transient/pro-

in toxic/delirious patients, as well as in those longed departure from reality may be difficult to

with oxygen deficits. differentiate from schizophrenia. Adverse reac-

clubbing Digital clubbing — widening/thickening tions compound in proportion to the age of the

of the ends of the fingers and/or toes, with con- patient and potency of the narcotic.

vex nails. This may be noted in familial condi- cocainomania An intense craving for cocaine

tions, infective endocarditis, pulmonary patholo- and its effects. "Coke nose" must be considered

gy, steatorrhea. in the patient who presents with a cocaine histo-

clubfoot Talipes — any congenital foot deformity. ry.

These may be successfully casted in early infan- coccidioidomycosis Coccidioidal granuloma,

cy. desert fever, desert rheumatism, valley fever.

clubhand Talipomanus — A congenital anomaly This may present with manifestations of erythe-

of the hand. ma nodosum, and/or pleural effusion.

clumping Agglutination. Coccidioidal meningitis is extremely resistant

cluster headache(s) Histamine headache(s) — and should be treated intrathecally. Some of

that recurring under emotional trauma, over- these patients go on to die.

work, stress. These may appear without warn- coccydynia Coccyalgia, coccygodynia — a

ing, with throbbing pain behind the eyes/nos- painful coccyx injury which may resolve in 4-6

trils. weeks without intervention. Coccygectomies

cluttering That speech impediment in which let- have been abandoned.

ters and/or syllables are omitted. cochlear implantation Cochlear prosthesis — an

cnemitis Tibial inflammation. electric receptor/transmitter imbedded into the

cnemoscoliosis Lateral curvature of the leg(s). cochlea to enhance impaired hearing.

coadaptation The mutual adjustment of two cochleitis Cochlitis — inflammation of the inner

independent organs, organisms, systems, per- ear.

sons. cocoa butter Theobroma oil used as a topical

coagulation The clotting of blood. lubricant and base in the suppository forms of

coagulation time The length of time blood takes drugs.

to clot — (Normal: 6-17 minutes). coconsciousness Fringe states of consciousness

coarctation Compression/stricture of the walls of (of which one is unaware).

a blood vessel. codeine That analgesic/sedative resembling mor-

coarctation of the aorta Aortarctia — congenital phine in effect. A controlled substance which is

constriction of the aorta. The hypertension of frequently abused, codiene is especially effective

these pediatric patients is often treated medical- as an antitussive.

ly (if possible) — to buy time for a surgical revi- codeine poisoning Potentially lethal as a depres-

sion of the aorta when the child is a better sur- sor of the central nervous system (CNS), and in

gical risk for a coarctotomy. control the vital signs. Emetics are contraindi-

Coat's disease Any of six retinal disorders, in cated in the treatment of overdoses.

67

codependency The relationship with a dysfunc- "cold sore" Herpes simplex eruption of the
tional person(s). This involves the inability to lip/face. When lesions are sprinkled with
self-actualize. Obsessedwith the needs of oth- Eskalith powder (from within the capsule), they
ers, a care giver may show little regard for dry and heal promptly.
his/her own welfare. There may be a tendency
to project one's deficiencies onto another, creat- colectomy Laparocolectomy — partial/total
ing the opportunity to "fix" and/or control that resection of the colon.
person/situation. The codependent person's
weak self-identity may leave him/her vulnerable coleocystitis Colpocystitis — inflammation of
for abuse, depression, neglect, and/or the the bladder. Vaginal inflammation.
"patient" in a compromised status.
coleoptosis Vaginal prolapse.
coffee-ground vomitus Emesis which resembles coleotomy Colpotomy — incision into the vagina
coffee grounds — a serious sign of hemateme-
sis. or pericardium.
colic That painful spasm within a hollow organ,
Cogan's syndrome Interstitial keratitis — inflam-
mation of the cornea seen in patients age 5-15. referred to as biliary colic, dysmenorrheal/uter-
Symptoms of photophobia, pain, lacrimation, ine colic, infantile colic, intestinal colic, lead
and visual impairment are associated with hear- colic, renal colic.
ing loss, tinnitus, vertigo. colicoplegia Severe abdominal spasms with
paralysis and erythrocytic stippling caused by
cognition Normally functioning mental processes lead poisoning. At high risk are ghetto children.
of alert perception, judgment, reasoning, intu- colicystitis That bladder infection caused by bac-
ition, memory, with the ability to comprehend teriocin Escherichia coli (normal intestinal flora).
and acquire knowledge. colicystopyelitis A urinary tract infection from E.
coli.
cognitive dissonance Incongruity of actions, colinephritis A kidney infection caused by E. coli
philosophy, thought. contamination.
coliplication Surgical repair of a dilated colon.
cogwheeling Interrupted articulation caused by colipuncture Colocentesis— a surgical colonic
coexistent tremor with rigidity. Seen in tap to relieve severe distention.
Parkinson's syndrome, this phenomenon may colipyuria Coluria, colibacilluria — urine conta-
also appear as an extrapyramidal side effect in minated by E. coli.
patients on antipsychotic therapy. colisepsis Bacteriocin-caused infection.
colitis Inflammation within the colon.
cogwheel respirations Repetitious interruptions amebic colitis Amebiasis.
of both inspirations and expirations — as fre- cathartic colitis Dysfunction of intestinal motil-
quently seen in bronchitis, cachectic disease, ity caused by laxative abuse.
pulmonary tuberculosis. mucosa colitis That caused by genetic factors
— the cardinal symptom is hemorrhagic diar-
coilonychia Koilonychia — dystrophy of the fin- rhea. Paradoxically, a number of patients suffer
gernails, associated often with chlorotic anemia, from constipation — even during active disease.
iron-poor anemia. Involvement appearing late in life is more exten-
sive and refractory. Enterostomy may be
coin counting That rapid, sliding, repetitious required.
movement of the thumb tip over the 5th, 4th, pseudomembraneous colitis That associated
3rd and index fingertips — seen in parkinson- with antibiotic therapy. This may cause death
ism and paralysis agitans. A pill-rolling tremor. due to the killing of normal flora in the colon.
ulcerative colitis Colonitis — defecation of
coitus Copulation, coition, sexual intercourse. malodorous, watery stools. Patients (pts) with
colalgia Colonic discomfort, distress. abdominal pain, fever, perforation, hemorrhage
colauxe Colonic distention. may go on to die.
cold agglutinin disease That syndrome of colitoxemia Poisoning from Escherichia coli.

either/both hemolytic anemia and microcircula-
tory obstruction. The cause may be idiopathic or
a transient infectious disease, usually seen in
female patients beyond age 50.

68

colitoxicosis Systemic poisoning caused by E. colovesical Communication between the colon

coli. and the bladder.

collagen vascular disease Connective tissue colpatresia Vaginal atresia, occlusion of the

diseases of unknown etiology. Generalized vagina.

inflammation of blood vessels and connective colpectasia Dilation of the vagina without

tissues is noted in these conditions which bear surgery.

guarded prognoses — dermatomyositis, pol- colpectomy Surgical excision of the vagina.

yarteritis nodosa, polymyositis, progressive sys- colpeurysis Surgical dilation of the vagina.

temic sclerosis, rheumatoid arthritis, scleroder- colpitis Kysthitis, vaginitis.

ma, systemic lupus erythematosus (SLE), and colpocele Herniation into the vagina.

Wegener's granulomatosis. Most of these dif- colpoceliotomy Surgical approach to the

fuse, connective tissue diseases have poor abdomen via the vagina.

prognoses. colpocleisis Surgical occlusion of the vagina.

collateral circulation Superficial anastamoses colpocystitis Vaginal/bladder infection.

which branch around a vascular obstruction. colpocystocele Bladder prolapse into the vagina.

Colles' fracture Transverse fracture of the radius colpocystosyrinx Communication of the bladder

with outward and backward displacement of the and vagina by fistula.

hand. Following reduction, the wrist is casted in colpocystotomy The development of an incision

this position. into the bladder via the vagina.

collodion baby A macerated neonate covered colpomyomectomy Surgical excision of a fibroid

with desquamated skin. The causes may be uterine tumor by vaginal approach.

postmaturity or ichthyosis congenita/fetalis/vul- colpoperineoplasty Vaginal/perineal plastic

garis. Ichthyosis lamellar of the newborn is a surgery.

rare and severe form which will not improve. colpoperineorrhaphy Surgical repair of per-

coloenteritis Mucoid inflammation of the entire ineal/vaginal lacerations.

intestine(s). colpoplasty Vaginal plastic surgery.

colofixation Surgical suspension to treat ptosis colpoptosis Vaginal prolapse.

of the bowel. colporrhagia Vaginal hemorrhage, excessive dis-

colonalgia Colonic pain. charge.

colonorrhagia Colonic hemorrhage. colporrhaphy Vaginal suturing.

colopexostomy Bowel resection and fixation to colporrhexis Ruptured/lacerated vagina.

the abdominal wall, with the formation of a colpospasm Colpospasmus. vaginal spasm.

colostomy. colpostenosis Stricture(s) of the vagina.

coloplication Surgical reduction of megacolon. colpostenotomy Surgically incising the vagina to

coloproctitis Colorectitis — rectal and colonic release strictures.

inflammation. colpotomy Surgical incision into the vaginal wall.

coloptosis Coloptosia — colonic prolapse of the colpoureterocystotomy Surgical exposure of the

transverse bowel. ureteral orifice(s) via a vaginal/vesicular

colorrhaphy Suturing of the colon, in order to approach.

unite the pelvic and descending bowel. colpoureterotomy Surgical incision into the

colosigmoidostomy Surgical anastamosis of the ureter by the vaginal approach.

pelvic colon to the descending colon. colpoxerosis Excessive dryness of the vaginal

colostomy Laparocolostomy, an artificial anus mucosa.

temporarily established to divert feces during coma Inability to be aroused by external stimuli.

healing, or permanently created during surgical Causes may be abscess formation, acute

eradication of bowel. A double barrel colostomy meningeal infection, arteriosclerosis, bacterial

has two stomata, and may also be temporary or intoxication, brain tumor, carbon dioxide or

permanent. monoxide poisoning, cerebral thrombosis, cra-

colotomy Laparocolotomy. nial trauma, electrocution, hemorrhage, hyper-

69

tension, hypoxia. limb, and/or renal failure which may follow.
combination chemotherapy Mixed antineoplastic complete lesion There is no response below the

agents employed in the treatment of malignan- level of vertebral injury. Bradycardia associated
cy. Some protocols require the use of a rescue by hypotension often indicates cervical spine
drug. injury. The nursing goal becomes that of raising
commissurotomy Surgical release of the midline each patient one functional level higher in recov-
band between two tissues. In mitral stenosis, ery.
adhesions of the mitral orifice are incised. In complex Multiple. Intricate ideas which carry
selected psychiatric conditions, the anterior heavy emotional overtones.
commissure of the brain is incised. compliance The extent to which the patient's
commitment Court order for hospitalization of a behavior, ideas, and sensations join his/her
patient who refuses to be hospitalized, and who medical regimen. (The amount of noncompli-
might be dangerous to him/herself and/or oth- ance is staggering.) Added to this picture is the
ers. Authorization may be petitioned from a escalating cost of polypharmacy. Patient educa-
judge to procede with emergency care, surgery, tion continues to address this situation.
transfusion of a child or dependent adult when complication An unexpected reversal of the
appropriate authorization cannot be obtained or patient's condition, which causes his/her recov-
is contested. Emergency court orders in the ery to be delayed by comorbidity or a more seri-
U.S. are effective for approximately 48 hours, ous prognosis.
excluding weekendsand holidays. Longer com- component blood therapy The administration of
mitments require a Court hearing. In many specific cells and/or plasma in lieu of whole
states, the patient is not billed for the attorney blood — reducing the risk of reaction or over-
nor hospitalization, as the State pays for these loaded circulation. Specific component transfu-
involuntary charges. sions are more efficient, as each unit can be uti-
communicable diseases Those illnesses trans- lized for many patients.
mittable to others: Acquired immunodeficiency compound Each substance composed of more
syndrome, ancylostomiasis, cholera, diphtheria, than one element/part by proportionate weight.
gonococcal disease, hepatitis, influenza, Organic compounds contain carbon, inorganic
Hansen's disease (leprosy), meningococcal compounds do not.
meningitis, mumps, ophthalmia neonatorum, compound heterozygote One who has inherited
pertussis, pneumonia, poliomyelitis, rubella, two different, abnormal genes as characteristics.
rubeola, streptococcal pharyngitis, syphilis, compulsion A repetitive behavior — washing,
tetanus, trachoma, tuberculosis, typhoid fever, checking, praying, mental acts, counting, num-
vaccinia (smallpox), et al. ber rituals, et al. An excessive,stereotypical
comorbidity That complicated treatment/out- mentation which may counter one's intrusive
come in the presence of a dual diagnosis. thoughts. Rigid practices may help one cope
compartment syndrome A limb-threatening with compulsive acts.
orthopedic emergency which occurs when tis- computerized axial tomography (CAT) Radiation
sues become compressed within the fascia, directed at many angles/planes as a diagnostic
constricting circulation and innervation. modality. Serial images are reconstructed in
Excessive pain is the primary chief complaint, cross-sectional views. Injected contrast material
for which immediate intervention is mandatory. provides vascular delineation. This is being
Notify the physician STAT, monitor the blanching joined/replaced by magnetic resonance imaging
sign (capillary refill), pulse, range of motion, in many hospitals. These and ultrasonography
sensation, temperature — anticipating emer- may be difficult to interpret when anatomic
gency cast removal/change and/or fasciotomy. landmarks are not predictable. Computed
Irreversible damage to blood vessels, muscles, tomography (CT).
and nerves may occur at once. Litigious circum- conation One's ego, drive, initiative, impulse —
stances follow the muscle necrosis, loss of which become diminished/lost in cerebral

70

pathology. their play and assume a unique, squatting posi-
concentric Sharing a common center. tion. Never taught to them, this is essential to
conchitis Infection within a concha — auricular their cardiopulmonary survival. This phenome-
non is pathognomonic.
or nasal. transposition of the great vessels The pul-
conchoscope An instrument for the examination monary artery connects the left ventricle, and
the aorta connects the right. Instead of oxy-
of nasal tissues. genated blood circulating through the aorta to
conchotome A scalpel for excision of the the tissues, this reverses back to the lungs.
ventricular septal defect An opening in the
turbinate(s). septum between the ventricles, which permits
conchotomy Surgical incision into the nasal con- blood to be shunted between the ventricles and
into the lungs, from the left ventricle.
cha(e). congenital hip dislocation Misalignment of the
femur at the hip joint — which is easily treated
concomitant Simultaneous. if detected in early infancy. Abduction of the
concurrent infection Comorbidity. Secondary hips may be achieved by triple diapering, pelvic
splinting, casting, et al. Untreated, permanent
sepses existing at the same time as the primary damage of the hip(s) will leave the patient with a
illness. grotesque limp and scoliosis.
conditioning Classical conditioning — improve- congenital hyperammonemia Systemic accumu-
ment through a program of education, training, lation of ammonia due to enzymedeficiency.
discipline. Clinical signs of ammonia toxicity are present
conduct disorder Persistent violation of societal — lethargy, nausea with emesis, coma leading
norms — aggressive acts toward animals, peo- to death.
ple, property. The rules these patients seriously congenital hypomyelination(CH) Neonates may
disregard may include assault, elopement, theft, suffer dyspnea and/or dysphagia, due to abnor-
truancy. mal formation of peripheral nerve myelination.
confabulation Fabrication of events or facts to congenital ichthyosiform erythroderma This
construct the responses which the patient real- rare dermatitis is taut and shiny. Desquamation
izes he should know and fails to remember. yields an inflamed dermis over the entire body.
confluent The change in a rash from discrete to Glylorin lotion is applied topically, in one investi-
merged lesions. gational treatment.
congenital That which is present at birth, innate. congenital megacolon Hirschsprung'sdisease.
congenital anomaly An abnormality which congestive heart failure Abnormal functioning
appears at birth. resulting from accumulation of fluid. New onset
congenital heart disease The most common in young patients suggests myocarditis. An
major anomaly/category, compatible with life. abnormal EKG,distended neck veins, dyspnea
coarctation of the aorta Aortartica — stricture with rales, pericardial effusion, substernal pre-
of the aorta, which limits the supply of blood to cordial aching, and/or "recreational" drug abuse
the lower body. may be part of this picture. All patients are at
patent ductus arteriosus Failure of this struc- risk for sudden death from tachyarrhythmias.
ture to close after birth permits circulation from Oxygen therapy and cardiac monitoring may be
the aorta to enter the pulmonary artery. This required.
condition has been successfully treated in pre- coniasis Pulverized calculi in the gallbladder
emies by the use of drugs which inhibit the syn- and/or bile ducts.
thesis of prostaglandins. coniofibrosis Pneumonoconiosis caused by sili-
pulmonary stenosis Narrowing of the pul- ca or asbestos dust, which produces pulmonary
monary valve/upper right ventricle — thereby fibrosis.
reducing circulation to the lungs.
tetralogy of Fallot Four defects are present —
dextroposition of the aorta, interventricular sep-
tal defect, pulmonary stenosis, and right ven-
tricular hypertrophy. When physiologically chal-
lenged, these small children will abruptly stop

71

coniosis Koniosis — all conditions which are lowing exposure to a specific topical irritant.
caused by dust inhalation. continuous passive motion That which enables

conjunctival reflex Immediate closure of the surgical and burn patients to regain mobility
eyelids whenever the conjunctivae are threat- through early movement. These patients experi-
ened (even by audible stimuli). Tearing may also ence less discomfort, pain, and edema.
occur. Postoperative patients receiving prosthetic
knee(s) replacement are also given this appara-
conjunctivitis Inflammation from bacteria, light tus. This does not negate active exercising, but
rays, foreign bodies, environmental tempera- prevents adhesions and contractures. If bilateral
ture, chemical substances, viral agents, hyper- extremities are involved, these are exercised in
emia, hemorrhage, gonococcal contamination, opposition.
allergic reactions, ultraviolet rays. continuous renal replacement therapy(CRRT)
The alternative form of renal dialysis adminis-
conjunctivoma Conjunctival tumor. tered temporarily to the hemodynamically unsta-
conjunctivoplasty Excision of corneal tissue with ble patient.
continuous subcutaneous insulin infusion (CSSI)
grafting of conjunctival flaps. An implanted pump (electrical device) which can
Conn's syndrome Primary hyperaldosteronism in be programmed to deliver a precise amount of
insulin subcutaneously into the abdominal wall.
which is seen the clinical picture of polyuria, continuous venovenous hemofiltration (CVVH)
muscle weakness, hypertension, alkalosis, A form of continuous renal replacement therapy
hypokalemia with excessive secretion of aldos- (CRRT). Administered to the patient in acute
terone. renal failure who is not a candidate for peri-
conscience The superego — that quality of self toneal dialysis because of abdominal surgery, or
which embraces values, thereby enabling one to one who cannot tolerate renal dialysis because
distinguish good from evil, right from wrong. of hemodynamic instability et al., this modality
consciousness State of awareness with orienta- holds a lower infection rate. These critical
tion to 4 spheres — person, place, time, and patients must be constantly monitored with fre-
situation. Although consciousness normally dis- quent neurological checks, as well as calculation
appears in sleep, this state may easily be of the fluid balances hourly (q1°).
aroused. In encephalitis lethargica, the patient contra-aperture A second opening developed
lapses back into stupor. Clouding of conscious- into an abscess.
ness may be seen, or the patient may appear contraception An agent/method which prevents
inalert, without alteration of attention and con- fertilization. When referring to contraception,
sciousness, impaired memory and orientation. use of the term "birth control" is an inaccuracy.
Still, brutal acts have been committed by those It is conception, not birth, which is being con-
in quiet delirium as they acted within a state of trolled.
automatism. barrier contraception Intrauterine device (IUD)
"coma vigil" Unconsciousness with an alert — a diaphragm, cervical cap, impregnated
expression and open eyes. sponge, condom, et al.
disintegration of consciousness The cause of chemical contraception Spermicidal methods
most nonorganic mental disorders. used in proximity with coitus. (Douching is not
levels of consciousness May vary from alert to mentioned, becausethis is completely unreli-
comatose: alert waketulness: Oriented x 4; able.)
comatose: Oblivious of environment, to intense natural "contraception" Other than abstinence
stimulation; any response will be rudimentary; from sexual intercourse (the most, and only,
drowsiness: Patient responds appropriately, accurate method), such techniques are regarded
slowly, with delays; S/he may be lethargic with to be highly unreliable. Coitus interruptus,
obtundation; stuporous: Aroused only by painful rhythm method, et al., have high rates of failure.
stimuli.
consensual reflex Any response occurring else-
where, to the point of stimulation.
contact dermatitis An eruption of the skin, fol-

72

permanent contraception In the female, fallopi- convergent That towards a common end.

an tubal ligation. In the male, vasectomy. conversion Deficits/syndromes of a medical

steroidal contraception Almost 100% effective and/or neurological problem. A mathematical

when taken as prescribed. Diethylstilbesterol deduction. A total change to the opposite pole.

may be indicated in cases of incest and/or rape. conversion disorder That in which

contracture A permanent deformity of stressors/conflicts produce the symptomatology

muscular/fibrotic tissue, due to paralysis or — which are neither feigned, nor intentionally

spasm. raised. These pseudoneurological findings are

Dupuytren's contracture Flexion deformity of a clinically significant — aphonia, deafness, dys-

finger/hand, due to joint fibrosis. phagia, hallucinatory, imbalance, paralysis,

functional contracture Lessened spasms under seizure activity, urinary retention. The present-

anesthesia/sleep. ing impairment/symptom becomes more

ischemic contracture Replacement of injured impressive in the patient who is clinically naive.

muscle tissue by fibrous cells. With the male patient, dysfunctioning may be

physiological contracture Extension of con- seen in relation to military, or industrial inci-

tractility, induced by chemicals/heat. dents. The female patient may have left-sided

Volkmann's contracture Caused by serious involvement.

injury to the radial artery, this "too tight cast conversion reaction disorder Hysterical neurosis

case" has become a classic liability illustration — in which functioning is affectedby

that circulatory assessment was "too little, too medical/neurological changes. Marked distress

late". Remain alert to the blanching sign, is prominent. Pseudoneurologically, many sys-

cyanosis, edema, pain, pallor, and temperature tems may be affected. This diagnosis refers only

adjacent to the cast or immobilizing bandages. to patients experiencing clinically significant dis-

The resultant injury includes a flexed hand with tress.

pronation, and adjacent, atrophied hand. conversion symptom The evolution of an emo-

contradiction Any reason which suggests the tionally enhanced symptom to a somatic com-

proposed/ordered procedure could be inadvis- plaint.

able or inappropriate for the specific patient. convulsant poison A toxic agent which produces

This concern is usually held to be firm. dyspnea and painful tetanic contractions.

contralateral Contrecoup, contrafissura — origi- Cyanosis, tachycardia, cyanosis may be seen.

nating in, and affecting the opposite side of the An exhaustive demise follows asphyxia.

body. convulsions Involuntary paroxysms of

contrecoup injury An accident occurring in the tonic/clonic activity. Lay the patient down, and

cranial vault, opposite to the primary point of insert a padded tongue blade (unless the jaws

impact. are engaged). Keep the airway patent, and pro-

contralateral reflexes Passive movement is imi- tect the patient from injury.

tated by the opposite extremity. "Motion never eclamptic convulsions Life-threatening compli-

lost need never be regained." cations which might suddenly occur in the tox-

contrast medium That medical substance which emic, hypertensive, pregnant patient.

renders organs/tissues to be radiopaque on X- febrile convulsions A complication of fever —

ray. These could produce serious reactions (rarely) seen between 6 months/8 years.

(especially the intravenous compounds) in sen- Pediatric care should be sought.

sitive patients. hysterical convulsions A criterion for the

controlled substancelaw The United States authenticity of seizures is whether or not the

mandates all abusive (or potentially abusive), patient bit his/her mouth, and/or was inconti-

centrally-acting, depressant, sedative, stimulant nent. (This is not always valid.)

drugs, and prescription refills to be under its toxic convulsions That caused by a poison act-

control, when on its soil. ing on the nervous system.

contusion A minor injury without broken skin. uremic convulsions That seen in toxic uremia.

73

coping mechanism The psychological adjust- corrosive poisoning Oral contact with caustic
acids, alkalies which cause burns and necrosis
ment by which one successfully adapts to a of all tissues. Absolutely contraindicated are the
challenge. inductions of emesis, gastric lavage, and other
copodyskinesia Occupational fatigue. When ill- attempts to neutralize the corrosive agent.
qualified for the work actually exacted/finished, Tracheotomy may be required if there is tracheal
occupational neurosis may be seen. involvement. Death may occur rapidly from
copper sulfate poisoning (CuS04.5H20) These edema of the oropharynx.
patients are at risk for hepatic and/or renal fail-
ure. Treatment includes gastric lavage, vital corticectomy Surgical excision of a portion of
signs monitoring, oxygen (02) therapy, combat- the cerebral cortex.
ing shock, seizure control, the monitoring of
electrolytes. corticopleuritis Inflammation of the costal pleu-
copper toxicosis Wilson's disease. ra(e).
copremesis Fecal emesis, a critical sign.
coprolagnia An erotic, a pathological response to costalgia Pain in or between the ribs, costal neu-
the odor/sight of excreta. ralgia, intercostal neuralgia.
coprolalia Eschrolalia: the meaningless use of
obscene, sacriligious language — as noted in costectomy Costotomy — surgical
Gilles de la Tourette's syndrome (and some excision/resection of a rib(s).
schizophrenic states).
coprophagy That perverted, adult interest in fecal costopneumopexy Surgical attachment of a rib
matter. Coprophilia, rhypophagy, coprohagia, to its adjacent lung.
scatophagy.
cor Heart. costosternoplasty That surgical use of a portion
corneal dystrophy An inherited alteration in the of rib to support the sternum in the revision of
cornea which is bilateral, unrelated to systemic pectus excavatum ("funnel chest").
disease.
corneal transplantation The surgical procedure costotome The instrument used to cut through
rib/cartilage.
of choice for patients with corneal edema,
Fuchs' dystrophy, keratoconus, or scarring. costotomy Costectomy — rib
coronary angioplasty Percutaneous transluminal division/excision/incision.
coronary angioplasty (PTCA) — a vital revascu-
larization technique. cotinine The metabolite of nicotine which is
coronary artery bypass grafting (CABG) excreted in the urine — biochemical evidence of
Indicated for many cases of multiple vessel recent tobacco abuse.
stenoses — even in the pediatric patient. This
CABG bears a high operative mortality when cough A pronounced and sudden expiratory
performed as emergency cardiac surgery. The effort.
long-term survival of postinfarction patients aneurysmal cough That brassy sound from
(pts) is high. Many procedures have to be pressure on the left recurrent laryngeal nerve,
repeated beyond 10 years postoperative. as noted in cases of aortic aneurysm.
coronary artery spasm That reversible, segmen- bronchial cough That provoked by postural
tal narrowing of a coronary artery. changes and production of sputum/speech.
cor pulmonale (CP) Right ventricular diphtherial cough Highly communicable,
failure/hypertrophy caused by pulmonary accompanied by strident respirations.
pathology. Sudden death may occur. metallic cough Harsh sounds heard with laryn-
Corrigan's pulse Waterhammer pulse (bounding, gitis.
quick, rapid) — associated with aortic insuffi- paroxysmal cough A sudden, periodic attack of
ciency. coughing noted in communicable bronchiectasis
and pertussis.
productive cough An effective cough which
produces sputum/exudate. Because sputum
specimens are mostly saliva, it may be neces-
sary for respiratory therapists/technicians to
obtain a specimen which can be cultured.
reflexive cough That stimulated by irritation of
the middle ear, pharynx, stomach, intestine,

74

uterus. seen in rickets.
whooping cough Pertussis — a communicable craniostenosis A compacted skull due to prema-
disease which may be fatal if aspiration occurs
during coughing paroxysms. ture closure of the cranial sutures.
counterimmunoelectrophoresis (CIE) A rapid craniostosis Ossification of the cranial sutures.
and specific diagnostic method to detect pneu- craniosynostosis Premature closure of the
monococcal, capsular, polysaccharide antigens
in various specimens including blood, urine, sutures of the skull.
pleural fluid and peritoneal fluid. Sensitivity is craniotome Instrument for dividing and perforat-
highest in cerebrospinal fluid (CSF). There are
no false positives. ing the expired fetal skull in order to facilitate an
counterincision A second incision developed to impacted delivery.
lessen suturing stress on the primary wound, or craniotomy Incision through the skull.
to permit drainage. craniotrypesis The drilling of burr/trephine holes
counterphobia A search for that which is feared. through the skull.
Intentionally confronting one's fears. creatinemia Excessive creatinine in the blood.
countertraction Active tension applied in the creatorrhea The presence of muscle fibers in
opposite direction, to achieve reduction of a feces — as seen in pancreatic disease.
fracture(s). An infant's/child's weight may be Crede's method Pressure over the symphysis
used as countertraction, if his/her body is pubis to express urine from a paralyzed bladder.
supine. Treatment of the newborn infant's eyes with sil-
countertransference Subjective emotional rela- ver nitrate to prevent ophthalmia neonatorum.
tionship of the therapist toward the patient in Pressure on the newly delivered uterus to expel
psychoanalysis, which could threaten the pro- the placenta — if performed incorrectly, this
fessional's objectivity. could cause inversion of the uterus. (Never pull
coup de soleil Sunstroke. on the cord!)
coupling Normal systolic beat which follows pre- cremains The cremated body prior to burial/dis-
mature systole. tribution of the ashes.
couvade Confinement in bed of the father during cremasteric reflex Retraction of the testis when
the mother's labor and delivery — as is custom- the inner, anterior thigh is stroked.
ary in some primitive cultures. cremation Tephrosis — burning the expired
coxalgia Coxodynia, coxitis — hip pain. body in the crematorium.
coxitis Hip joint disease. crepitation Crepitus (a crackling sound) heard in
coxotuberculosis A tuberculous/tubercular hip. temporomandibular joint dysfunction, rales of
cranioclasty Crushing of the expired fetal head in pneumonia, the movement of fractured bone
fetal-maternal dystocia. ends, air beneath the skin.
craniocleidodysostosis Craniofacial dystosis, cresomania Croesomania — hallucinations of
defective ossification of the face, head, clavi- affluence and wealth.
cle(s) — a congenital anomaly. CREST syndrome Progressive systemic sclero-
craniodidymus Congenital deformity of the sis, scleroderma. Calcinosis, Raynaud's phe-
neonate with two heads. nomenon, Esophageal dysfunction,
craniomalacia Softening of the bones of the Sclerodactyly, Telangiectasis.
skull. cretinism Congenital myxedema with
craniopagus Conjoined twins attached at the mental/growth retardation, osseous dystrophy,
skulls. Brissaud's infantilism, multiple anomalies,
cranioplasty Plastic surgery on the skull. myxedematous infantilism.
craniopuncture A stab wound/puncture into the Creutzfeldt-Jakob disease (CJD) That profound
skull. neurological infection related to the bovine
craniosclerosis The thickening of skull bones, as spongiform encephalopathy, "Mad Cow
Disease". At the time of this writing, an outbreak
in the United Kingdom has been attributed to
these animals. Victims are dying from this

75

grotesque illness — in which their speech is Crohn's disease Regional enteritis/ileitis — a
slurred, ambulation greatly impaired (if at all genetic, chronic inflammatory lesion of the
possible). Death follows dementia and ileum. Patients present with an exacerbation of
myoclonus. abdominal pain, anemia, diarrhea, fistula(e),
cricoidectomy Dissection of the thyroid/cricoid weight loss, and/or symptomatology of obstruc-
cartilage. tion. Crohn's disease has been directly associat-
cricotracheotomy Closure of the glottis by divi- ed with tobacco abuse. Exploratory laparotomy
sion of the upper trachea and the cricoid carti- may be indicated.The definitive diagnostic sign
lage. includes caseation necrosis with acid-fast bacil-
cri-du-chat syndrome Characterized by the li. Antibiotics, corticosteroids, and/or bowel
infant's cry which resembles that of a cat. An resection is the therapeutic regimen of choice.
inherited chromosomal anomaly which includes
microencephaly, mental retardation, dwarfism, cross-dressing Wearing clothing of the opposite
laryngeal defect, epicanthal folds. sex. This is required for an extended length of
Crigler-Najjar syndrome Congenital hyperbiliru- time, to fulfill the diagnosis and to qualify for
binemia in association with brain damage. Death sexual reassignment.
may come in the child's second year.
crisis The turning point of a critical illness. The crossmatching The establishment of blood com-
sudden fall of a high fever to normal. patability, prior to transfusion or organ trans-
Paroxysms of pain. Psychiatric inability to cope plantation.
with an intolerable scene.
abdominal crisis Severe abdominal pain. Crouzon's disease Congenital anomalies of cran-
Addisonian crisis Acute adrenal gland failure. iofacial dysostosis, divergent strabismus,
celiac crisis Rapid onset of malnutrition in celi- exophthalmos, hypertelorism, optic atrophy.
ac disease. Vigorous nutritional and antibiotic Cranialfacial specialists and surgeons should
therapy is essential. follow each child — to monitor revisions, hear-
Dietl's crisis A sudden, severe attack of chill- ing, and all findings.
ing, collapse, gastric pain, nausea, fever with
rigor, renal colic. crowning That stage of delivery when the largest
salt-losing crisis Acute hyperemesis, cardiac diameter of the fetal head presents.
arrest, dehydration, hypotension — due to
marked hyponatremia. This may be seen in salt- Cronkhite-Canada syndrome A mucosal poly-
losing nephritis, adrenal hyperplasia, and gas- poid protein-depleting condition — which
trointestinal disease. affects the bowel with diarrhea and alactasia.
sickle cell crisis Interference with oxygenation, Hypoalbuminemia requires gastric resection.
obstruction with capillary flow. Fever and severe Medical treatment is of little help.
abdominal/joint pain are caused by sickled ery-
throcytes. crush syndrome Edema, oliguria, renal failure,
tabetic crisis The abdominal pain of syphilis. and shock may occur in those patients with
thyroid crisis Thyrotoxicosis with fever and severe local injuries and/or crushed legs —
extreme tachycardia. Thyroid storm (fatal if not especially those who have been partially buried.
judiciously treated) may follow.
true crisis That concurrent fall in pulse and Crutchfield tongs The skeletal attachment which
temperature. enters the cranial bones to connect and exert
crisis intervention Problem-solving with those cervical traction — thereby achieving/maintain-
who seek and accept guidance regarding life's ing spinal alignment.
major problems.
critical illness polyneuropathy The most com- Cruveilhier-Baumgarten syndrome Cirrhosis of
mon cause of intractable ventilator dependency. the liver, caused by collateral umbilical circula-
tion. Splenomegaly, liver atrophy, portal hyper-
tension may be seen.

cry An emotional response to despair, fear, joy,
pain, sadness — which may be audible/inaudi-
ble.
cephalic cry A sudden, shrill infant sound —
which may be pathognomonic of cerebral
pathology.

76

cri-du-chat syndrome An inherited, chromoso- tion, who is too medically unstable to undergo

mal anomaly, in which the infant's cry resem- surgery, may be ordered on bedrest, with the

bles that of a cat. Significant impairment fol- gangrenous limb packed in solid carbon dioxide.

lows. Guard against a rebound phenomenon leading

epileptic cry That aura of a loud, sudden out- to shock.

burst prior to a grand mal seizure. (Not all cryptesthesia Extrasensory comprehension of

epileptics experience auras. Those who do, will data such as clairvoyance and intuitive under-

tend to have a similar pattern with each seizure standing.

— which will be specific to the patient, and an cryptocephalus That congenital deformity, in

indication that a convulsion is impending.) Each which the fetus' head is hidden.

aura is distinctive, and should be documented. cryptococcal meningitis An opportunistic infec-

night cry That caused by acute joint spasm. tion often seen in those with HIV (human

cryocautery An instrument which applies cold — immunodeficiency virus) disease. Control of

extreme enough to kill living tissue. cryptococcal disease in patients with the comor-

cryoextraction That procedure by which the bidity of acquired immunodeficiency syndrome

coolant, liquid nitrogen, is introduced into the (AIDS) is exceedingly difficult.

crystalline lens to permit cataract extraction. cryptococcosis European blastomycosis, torulo-

cryoglobulinemia The presence of an abnormal sis — a systemic fungal infection of the

protein in the blood — which coagulates at low brain/meninges. Symptomatology of headache,

temperatures. Seen in certain forms of nuchal rigidity, or vertigo may be misdiagnosed

leukemia, multiple myeloma, pneumonia, cryo- as brain tumor. The prognosis is poor — those

globulinemia produces a sensorimotor neuropa- cases with cerebral and/or meningeal involve-

thy. This first presents with Raynaud's phenom- ment in coma with respiratory failure, may go

enon. on to die.

cryohypophysectomy Cryotherapeutic excision of cryptomerorachischisis Spina bifida with

the pituitary gland via the transphenoidal osseous deficit — but without tumor formation.

approach. cryptomnesia Cryptanamnesia — the subcon-

cryophilic Crymophilic, psychrophilic — prefer- scious memory.

ence for cold. cryptophthalmus Congenital adhesion of the eye-

cryosurgical ablation An alternative to radiation lid(s) to the globe(s).

and/or radical surgery. The use of temperatures cryptorchidectomy Surgical repair of an unde-

below freezing arrests bleeding, controls pain in scended testicle.

malignant tumors, and produces selective cryptosporidiosis A severe, diarrhea! condition

lesions in the brain. fatal to immunocompromised patients. Stools

cryothalamotomy Use of the cryoprobe to from these patients are highly communicable,

destroy the thalamus of patients suffering and require strict enteric precautions.

marked tremors from Parkinson's disease. This cry reflex That normal response of the neonate

extraordinary cure is evident to the patient and — which may be absent in preemies.

operating staff before s/he leaves the operating crystalloiditis An inflamed crystalline lens.

suite! crystallophobia An exaggerated fear of glass.

cryotherapy Crymotherapy — the therapeutic crystalluria Urinary crystals appearing after sul-

application of cold water, ice water, solid carbon fonamide therapy.

dioxide. In burns, ice water immersion reduces cubital tunnel syndrome Ulnar compression at

the pain from an excruciating level to tolerable. the elbow. This is the second most common

If pain develops from the severe cold, remove nerve compression in the upper extremity. The

the site from the ice water. When pain from the best results are obtained by a submuscular

thermal injury returns, reapply the ice water. By transposition by the musculofascial-lengthening

this method, healing is enhanced, and scarring technique.

diminished. The patient in need of an amputa- cuffed endotracheal tube An airway placed in

77

the trachea to prevent aspiration by the bronchi. (ACTH) by the adrenal cortex. An adrenal tumor,
Prior to gastric lavage of the obtunded patient, prolonged use of ACTH, or excess stimulation of
this airway should always be inflated — once it the adrenal gland by the pituitary gland, may be
is in place. the cause(s). Symptomatology of this pituitary
culdocentesis Diagnostic/therapeutic aspiration basophilism includes adiposity, amenorrhea,
of cells from the cul-de-sac of the female pelvis. capillary fragility, diabetes mellitus, edema,
culdoscopy Examination of the pelvic organs by fatigue, hirsutism, "moon face", impotence,
use of an endoscope. osteoporosis, plethora, protein depletion, purple
Cullen's sign Cyanotic skin around the umbilicus striae, urinary incontinence.
due to intraperitoneal hemorrhage from a possi- Cushing's ulceration Stress ulcers which may
ble acute pancreatitis or ruptured ectopic preg- appear in patients with central nervous system
nancy. trauma. These ulcers are at a greater risk of per-
cumulative drug action Those medications foration.
which are not eliminated from the system, but cutis laxa A rare condition, in which the skin
remain in small amounts with prolonged half- hangs in folds. This hereditary, fatal disorder
lives to endanger the patient. includes cardiorespiratory complications, devel-
cuneohysterectomy Wedge excision of the cervix opmental retardation, and joint laxity.
to correct an anteflexion abnormality. cyanephidrosis Cyanhidrosis — excretion of
cunnilingus Oral stimulation of the female geni- blue perspiration.
talia. cyanide poisoning The presenting victim voices
cup arthroplasty Surgical revision of the arthritic distress, loses consciousness, and collapses.
hip involving protection of the femoral head with Respirations are convulsive and rapid, then
a Vitallium cup. Total hip replacement is the pro- gasping and slow. The pulse is rapid, weak, and
cedure of choice in geriatrics. irregular. Death ensues at once. Prompt rescue:
cupulolithiasis Calculi in the middle ear which forced emesis, amyl nitrate inhalations, sodium
may be associated with positional vertigo. nitrite intravenously, followed by sodium thio-
curarization The administration of curare to sulfate as per protocol. Oxygen should be
lessen the severity of seizures in electroconvul- administered at 100%, as artificial respiration.
sive therapy, to enhance relaxation in tetanus, cyanosis Excess carbon dioxide with deficient
and as an adjunct to anesthesia. Curarized oxygen from asphyxiation, produces a dusky
patients may demonstrate an inability to raise ("black") cast to the skin, cyanoderma,
the head/extremities, a hoarse voice due to cyanopathy. Remove any obvious causes, and
weak throat muscles (and an endotracheal tube administer artificial respiration/rescue breath-
— if used), weak jaw muscles, and/or nystag- ing/oxygen (02) as indicated.
mus with ptosis. congenital cyanosis Apparent at delivery due
curettage Currettement of an organ cavity. to ductus arteriosus, patent foramen ovale, ven-
Debridement to remove growths, debris, and/or tricular septal defect, and/or pulmonary steno-
specimens for analysis. sis.
Cushing's reflex Bradycardia coexisting with enterogenous cyanosis That induced by intesti-
hypertension. nal absorption of drugs/toxins.
Cushing's response Cushing's reaction — late tardive cyanosis Compromised respirations
signs of increased intracranial pressure: caused by intraventricular/interatrial septal
Bradycardia, increasing blood pressure, slowing defect(s).
respirations, widening pulse pressure. This cen- cyanosis retinae Blue-tinged retinae as seen in
tral nervous system response protects the brain those with dinitrobenzol poisoning, poly-
by increasing the systemic blood pressure when cythemia vera, congenital cardiopathy, osteoge-
beneath that of the cerebrospinal fluid. nesis imperfecta.
Cushing's syndrome/disease Results from cyanuria Urine with a blue cast.
hypersecretion of adrenocorticotropic hormone cyberphobia Marked stress, anxiety, tension at

78

the computer. prognosis. Right heart failure may occur.

cyclicotomy Cylicotomy, cyclotomy, cyclectomy cysticotomy Choledochotomy, surgical incision

— incision into the ciliary muscle. into the cystic bile duct.

cyclodialysis Surgical intervention to permit cystinosis Cystine storage disease, a hereditary

drainage of aqueous humor in certain cases of metabolic anomaly. Disordered renal tubular

glaucoma. function results in recurrent development of uri-

cyclokeratitis Cycloceratitis — inflammation of nary calculi, rickets, acidosis, corneal opacities.

the ciliary body, cornea. cystistaxia Slow bleeding from the mucous

cyclophoria Periphoria — deviation of the ocular membrane lining the urinary bladder.

axis, due to weakness of the oblique muscle(s). cystitis Endocystitis, ascending urinary tract

cycloplegia Paralysis of the ciliary muscle — an infection causing inflammation of the bladder.

anticholinergic side effect of antidepressants This chronic/acute process may involve the ure-

and antipsychotics. thra, prostate, and/or kidney(s), caused by

cyclops A fetal anomaly with only one eye. obstruction or calculi. Burning upon frequent

cyclothymia A chronic mood disturbance which micturation and hematuria are often seen. If

does not meet the criteria for other psychiatric "honeymoon cystitis" is suspected, voiding after

diagnoses. coitus may prevent this. Chronic cystitis may

cyclotropia The permanent state of cyclophoria. respond to a urinary antiseptic on maintenance

cyesis Pregnancy, gravidity. basis.

pseudocyesis That psychiatric condition in cystocarcinoma Malignant adenoma filled with

which the man or woman demonstrates signs of glandular secretion.

pregnancy in the absence of pregnancy. cystocele Vesicocele — herniation of the blad-

Phantom pregnancy, pseudopregnancy may be der into the vagina.

be seen in those desperateto become pregnant, cystodiaphanoscopy Abdominal transillumination

or to avoid pregnancy. by inserting a cystoscopic light into the urinary

cyllosis Clubfoot, a congenital foot deformity. bladder.

cynanthropy A psychiatric disorder in which the cystodynia Cystalgia, bladder pain/spasm.

patient assumes canine characteristics. cystoelytroplasty Surgical repair of a vesicovagi-

cystadenocarcinoma Cyst-forming glandular nal fistula.

malignancy. cystolithectomy Excision of a calculus from the

cystalgia Bladder pain. urinary bladder.

cystathioninuria Hereditary enzymedeficiency cystolithiasis Calculi formation in the urinary

preventing the metabolism of cystathionine — bladder.

resulting in acidosis, thrombocytopenia purpura, cystoplasty Plastic surgery on the urinary blad-

and mental retardation. der.

cystauxe Hypertrophy of the urinary bladder. cystoplegia Paralyzed urinary bladder.

cystectasy Surgical dilation of the bladder. cystopyelitis Ascending inflammation of the

cystectomy Laparocystectomy — partial/total bladder and renal pelves.

excision of the bladder. Surgical excision of a cystopyelonephritis Infection of the bladder,

cyst, the gallbladder, the cystic duct. ureter(s), and kidney(s).

cystelcosis Ulceration of the bladder. cystorrhagia Hemorrhage from the bladder.

cysticercosis Infestation with tape worm larvae. cystorrhaphy Suturing of the urinary bladder.

cystic fibrosis Mucoviscidosis — fibrocystic dis- cystoscopy Surgical examination of the bladder

ease of the pancreas. An inherited disease utilizing a cystoscope.

affecting the exocrine glands, respiratory sys- cystospasm Painful contractions of the bladder.

tem, and pancreas. The course involves chronic cystostomy Surgical incision into the urinary

respiratory infections, electrolyte imbalance, bladder, creating an alternative opening.

meconium ileus, pancreatic insufficiency. Since cystotome An instrument which develops an

there is no cure, these patients have a poor incision in the bladder.

79

cystotomy Laparocystotomy, a surgical incision
of the urinary bladder.

cystotrachelotomy An incision into the neck of
the bladder.

cystoureteritis An inflammation of the urethra
and the urinary bladder which ascends to the
ureter(s).

cystourethrocele Prolapse of the female urethra
and urinary bladder.

cystourethroscope Instrument for the surgical
examination of the urinary bladder and urethra.

cytomegalic inclusion disease A neonatal infec-
tion which includes fever, hepatosplenomegaly,
microcephaly, motor/mental retardation. This
condition may occur prenatally, postnatally, or
later — subsequently activated by immunosup-
pression. Since there is no therapy of choice,
these infants may go on to die.

cytomegalovirus Cytomegalovirus infection,
cytomegalovirus disease. This life-threatening
condition may compromise more than one body
system in the patient who is immunosup-
pressed.

cytomegalovirus retinitis The most common
intraocular inflammation seen in patients with
acquired immune deficiency syndrome.
Untreated, this progressive infection may lead to
blindness.

cytotherapy Organotherapy, treatment by organic
extracts. The use of toxic serum/substance may
be followed by a rescue medication — which
must be administered precisely as ordered.

cyturia Those cells present in the urine.

D

dacnomania That homicidal hostility/impulsivity dactylion Webbed digits.

which is irrational. dactylitis A pediatric condition of inflamed digits.

Da Costa'ssyndrome "Soldier's Heart" — neuro- sickle cell dactylitis Hand and foot syndrome

circulatory asthenia secondary to hyperventila- — painful edema of the extremity(s) of the child

tion and/or anxiety. with sickle cell disease. Osteolitis, periosteal ele-

dacryelcosis Lacrimal ulceration. vation, and/or bone infarction may be evident on

dacryoadenectomy Excision of the lacrimal X-ray. Hydration with analgesia may bring relief.

gland(s). dactylocampsodynia Painful contraction of a fin-

dacryoadenitis Dacryadenitis, the acute/chronic ger(s). Dactylogryposis refers to the permanent

inflammation of the lacrimal gland — a rare contracture.

complication of epidemic parotitis. dactylology Cheirology — the use of sign lan-

dacryoblennorrhea Dacryocystoblennorrhea — guage. Aphasic children/adults with various

chronic inflammation of the lacrimal sac, with diagnoses (some able to hear) may learn to

discharge. communicate by signing.

dacryocystalgia Dacrycystalgia — lacrimal sac dactylolysis Spontaneous amputation of a

pain. digit(s) — seen in utero with banded constric-

dacryocystitis Inflammation of the lacrimal sac, tion around a digit(s), in ainhum caused by a

progressing to cellulitis (secondary to pro- fissured constriction, in Hansen's disease, and

longed nasal/lacrimal duct obstruction). in Raynaud's disease.

Epiphora, erythema may extend to the conjunc- dactylomegaly Pathologically hypertrophied dig-

tiva(e) and eyelid(s). Dacryocystorhinostomy its.

may be required. dactylospasm Cramping of a digit(s).

dacryocystocele Herniation of the lacrimal sac. Damocles' syndrome That sense of impending

dacryocystography X-ray studies of the naso- doom, that one's malignancy will recur.

lacrimal drainage system, following instillation Dandy-Walker syndrome Congenital hydro-

of contrast medium. cephalus caused by obstructed cerebrospinal

dacryocystoptosis A prolapsed lacrimal sac. fluid (CSF). Atresia of the foramina of Luschka

dacryocystorhinostenosis Stricture/obliteration and Magendie prevent CSF drainage to the sub-

of the lacrimal canal, resulting in a communicat- arachnoid space, resulting in life-threatening

ing nasal cavity with the lacrimal sac. macroencephaly.

dacryocystorhinotomy Dacryocystosyringotomy, dangling Sitting on the edge of the mattress.

surgical achievement of dacryocystorhinosteno- This is ordered as progressive activity for those

sis. on prolonged bedrest, and postoperative

dacryocystotome Scalpel for incising the lacrimal patients, prior to ambulating.

sac. Darier's disease Keratosis follicularis — a famil-

dacryohelcosis Ulceration of the lacrimal ial dermatitis which coalesces into plaques on

duct/sac. the axillae, face, neck, scalp, and trunk.

dacryohemorrhea Tears which include blood Darling's disease Histoplasmosis.

cells. Davidsohn's sign The absenceor lessening of

dacryolithiasis Lacrimal calculi. pupillary light reflex. Tested with a light held in

dacryoma A lacrimal tumor. the closed mouth, this will reveal or rule out

dacryopyorrhea Suppurative discharge from the fluid/tumor in the maxillary sinus.

lacrimal apparatus — dacryopyosis. dawn phenomenon Marked hyperglycemia

dacryorrhea Dacryops — a constant flow of between 6 and 9 a.m. — in contrast to the pre-

tears. ceding 6 hours.

dacryostenosis A narrowed nasal/lacrimal duct, dead space That which does not normally occur

which may be obstructed. in the body. This becomes a potential for bacter-

dacryosyrinx Lacrimal fistula(e). ial overgrowth.

dactyledema Swelling of a digit(s). deafferentation Denervated, incised, blocked, or

81

Decision tree autopsy. Consent of the Medical Examiner must
be obtained for all procedures after death, in
excised afferent nerve supply. That condition in deaths under this jurisdiction.
which the efferent and afferent nerves are sev- debouchement The emptying/opening of an
ered. organ or part into another.
deaf-mutism Deafness compounded by aphasia. debridement Excision of burned, damaged, or
deafness Loss of hearing/diminished ability to necrotic tissue by currettage, or by proteolytic
hear. If the deaf person experiences hallucina- enzymes which spare viable tissue.
tions of music, this is not psychosis. The etiolo- decanoate A parenteral, long-acting form of con-
gy of hearing loss may be to injury, disease, centrated medication, intended for depot injec-
brain lesion, ototoxic antibiotics, extremely loud tion. This may be Court-ordered to enable non-
sounds, psychiatric conditions, congenital compliant, psychotic patients to be free of insti-
anomaly. tutionalization.
death That irreversible cessation of cardiac, cere- decerebrate posturing Sustained rigidity with
bral and/or respiratory functioning. stiffened, extended limbs and head — sugges-
cadaveric spasm The clenched fist which tive of brain lesion.
grasps a note/object, following a violent or sud- decidophobia That exaggerated fear of making
den death. decisions.
decapitation Detruncation — a beheading. deciduoma A uterine tumor of cells arising from
algor mortis Loss of temperature after death. retained postabortal tissue. These tumors may
rigor mortis Post mortem rigidity (which may evolve into choriocarcinoma, chorioepithelioma,
be broken). or deciduosarcoma.
livor mortis The pooling of blood in dependent decision tree A graphic scheme, by which a
areas of the cadaver. physician arrives at the patient's diagnosis.
death with dignity "I request that I be allowed to decorticate posturing The diagnostic sign of a
die and not be kept alive by artificial means or lesion at/above the upper brainstem. Full-body
heroic measures. I ask also that drugs be merci- rigidity accompanies clenched fists, flexion of
fully administered to me, to alleviate terminal the everted arms, extension of the legs. This
suffering, even if they may hasten the moment may persist through rehabilitation and beyond.
of death." (Signed.) Although the expiring decrudescence Decreasedseverity in the course
patient makes this statement with intent, it may of a disease.
be reversed by law, the family, or physician, at decubitus ulcer Necrosis of the skin, due to an
any point. If the harvesting of organs has been avascular state. Prevention should begin as
included, this takes a back seat to a medicolegal soon as circulation is noted to be compromised
to an area over a bony prominence — even if
the skin is intact.
deep vein thrombosis That condition of trapped
blood within the deep veins of the leg(s) and/or
the pelvis. This can develop into chronic venous
insufficiency, pulmonary embolism, post-
phlebitic syndrome, destruction of the vein
valve(s). Bedrest is required, with elevation of
the legs. Pillows should never be placed
beneath the legs of any patient. Anticoagulation
will be aggressive. If the thrombus reaches the
popliteal vein, surgery may be required.
Circulatory assessment needs to be made every
4 hours, noting color, edema, leg circumference,
temperature, turgor. Symptoms of pulmonary

82

embolism include cough, dyspnea, fever, episode — when the affect is held from con-

hemoptysis, restlessness, substernal pain. Later, scious acknowledgement.

the patient will receive antiembolic stockings. passive aggression That mechanism in which

Strict rules will guard against a relapse — aggression is indirectly expressed.

which occurs in 1/3 of these cases. projection False attribution of one's unacknowl-

defecalgesiophobia A morbid fear of defecation, edged thoughts, impulses, feelings to others.

in anticipation of pain. rationalization That by which the patient con-

defecation syncope Transient shock and loss of structs a self-serving, reassuring (however

consciousness during/following fecal elimina- incorrect) rationale for his/her behavior.

tion — which may be idiopathic, or postopera- reaction formation Substitution of feelings,

tive rectal surgery. Some non-surgical male thoughts, behaviors that are diametrically

patients have been noted to experience mictura- opposed to one's unacceptable

tion syncope at early morning voiding. This phe- feelings/thoughts/behaviors.

nomenon may point to pathology of cerebrovas- repression Inability to recall disturbing experi-

cular, gastrointestinal (Gl), cardiovascular sys- ences, thoughts, feelings, or wishes.

tems. somatization Preoccupation with symptomatol-

defense injury That sustained by an attacker ogy disproportionate to medical findings.

when his victim struck out in selfdefense. Some splitting Viewing others and oneself as all good

convictions have been supported by the pres- or all bad. Failure to integrate negative and posi-

ence of defense injuries. tive qualities into cohesive images. Nursing staff

defense mechanisms Involuntary feelings, members may be alternately devalued and ideal-

behaviors, or thoughts which arise in response ized by the splitting patient — which disrupts

to perceptions of psychic risk. These may be the therapeutic cohesion of the staff. This is

adaptive/maladaptive. pathognomonic of borderline personality disor-

acting out That in which the patient responds der.

without thinking of, nor caring about, negative suppression Intentional avoidance of thoughts

consequences. about disturbing experiences, feelings, desires,

autistic fantasy Daydreaming as substitution problems.

for problem solving, direct/effective action, rela- undoing Behavior designed to symbolically

tionships. compensate for unacceptable thoughts, feelings,

denial That mechanism in which the patient actions.

fails to acknowledge obvious reality. defibrillation Electrical shock administered to

devaluation The exaggeratedattribution by the convert a heart rhythm which is fibrillating, out

patient, of negative qualities to others, or to of control, or asystolic.

him-/herself. definitive A premise not to be debated.

displacement That mechanism in which the deformity Congenital or acquired alteration/dis-

patient redirects threatening feelings onto a less figurement/distortion of the body.

threatening object. degeneration Impairment or deterioration of tis-

dissociation A temporary alteration in the inte- sue.

grative functions of identity and/or conscious- ascending degeneration Neural deterioration

ness. progressing from the periphery to the center.

idealization That mechanism in which the congenital macular degeneration Progressive

patient attributes exaggerated, positive qualities deterioration of the macula since birth.

to him-/herself or others. descending degeneration Neural deterioration

intellectualization The use of excessive from the lesion to the periphery.

abstract mentation to avoid dealing with disturb- hepatolenticular degeneration Wilson's dis-

ing feelings and issues. ease.

isolation Inability to experience simultaneously parenchymatous degeneration Cloudiness of

the affective and cognitive features of an protein tissue occurring in inflamed tissue.

83

senile degeneration Physical and/or mental sions. The cause may be drug abuse, over-
decline in the geriatric population. dosage, anxiety, exhaustion, shock, fever.
spongy degeneration Demyelination of the delirium tremens (DTs) — acute alcohol with-
deep cerebral cortex — seen as a familial trait. drawal occurring after abstinence from drinking
This terminal condition includes blindness, flac- (often because of imprisonment or hospitaliza-
cidity, cranial hypertrophy, mental retardation, tion). This dramatic clinical picture includes
and death by age eighteen months. auditory/visual/tactile hallucinations, confusion,
deglutition The swallowing reflex. disorientation, generalized convulsions, inces-
degustation The response of tasting. sant incoherence, insomnia, irritability, tremors,
dehiscence Evisceration, exenteration — sudden and violence. Overactivity of the autonomic ner-
rupture of the surgical abdominal wound, espe- vous system presents as diaphoresis, dilated
cially in the obese or malnourished patient. pupils, fever, and tachycardia. Forced fluids
Cover the wound with moist, sterile, saline must be maintained. These patients may
dressings. Keep the patient supine with knees become irrationally violent. They could abruptly
flexed, reassuring him/her that an immediate expire.
return to surgery will restore this complication. delivery Childbirth, parturition followed by the
Prepare the patient for the operating room. expulsion of the placenta.
dehumanization That state bereft of human qual- abdominal delivery Cesareansection.
ities — as seen in psychotic patients, and those forceps delivery The use of instrumentation to
who were normal prior to their imprisonment facilitate the birth of an impacted infant.
and/or torture. postmortem delivery Induced or surgical deliv-
dehydration Extraction/loss of electrolytes and ery of an expired mother.
water. That state in which the output exceeds precipitate delivery That spontaneous and
intake, especially in the presence of diarrhea, sudden birth out of asepsis (BOA) without med-
fever, vomiting. This status may also be seen ical assistance — often of a multipara who
with the intravenous infusion of hypertonic solu- delivers abruptly. This baby could suffer injury
tions. as well as contamination, and may be admitted
deinstitutionalization The discharge/placement to the pediatric nursery instead of the obstetric
of hospitalized psychiatric patients into the com- nursery.
munity — to live in boarding houses, group premature delivery The infant born prior to the
homes, residential hotels, and to work in shel- 37th week of gestation, with a weight of less
tered workshops if needed. than 5 pounds.
deja entendu The illusion that one is hearing that delusion The psychotic phenomenon in which
which s/he has heard before. the patient fails to distinguish reality from false
deja vu The illusion that one is experiencing that beliefs. This may provoke the patient to vio-
which s/he has experienced before. lence, or to suicide.
Dejerine's disease Interstitial neuritis of infancy. depressive delusion That involving irrational
Dejerine-Sottas' atrophy Dejerine-Sottas' dis- guilt.
ease, Dejerine-Sotta's syndrome (DSS) — expansive delusion An inaccurate,elevated
hypertrophic, progressive, interstitial neuritis of assessment of one's importance/power/intelli-
infancy, with markedly reduced innervation of gence. This may occur in a manic state.
the extremities. fixed delusion An unchangeable, false belief.
Delhi abscess Aleppo abscess, seen in India. fleeting delusion A transient, false belief which
delire de toucher An abnormal impulse to is unstable.
feel/touch. nihilistic delusion The belief of negation —
deliriant Delirifacient — that agent which pro- that one/all has ceasedto exist.
duces delirium. Othello delusion The false belief that one's
delirium Confusion, disorientation, excitement, spouse has been unfaithful.
incoherence accompanied by hallucinations/illu- delusions of control The conviction that one's

84

subjective ideas, emotions, impulses, actions the central nervous system by drugs in abuse,
and feelings are controlled by an external force. "over the counter", or prescribed.
somatic delusion The exaggerated false belief dementia paralytica Neurosyphilis with irritation
in one's symptomatology and/or imperfections. and deterioration of concentration and memory.
systematized delusions An elaborate, false Emotional instability develops as behavior dete-
theme that one's problems correspond to race, riorates. Lack of insight accompanies delusions
age, religion, et al. of grandeur. Depression and neurasthenia may
delusion(s) of grandeur Belief in one's nonexis- be noted.
tent wealth, false power, megalomania, mes- dementia praecox Early loss of cognition and
sianic complex, brilliance, expertise. skills.
delusions of grandiosity The belief in one's own demise Expiration, death.
inflated importance, intelligence, power. denarcotize The withdrawal of narcotics from an
delusions of persecution "Everyone is against addicted patient.
me." Dengue hemorrhagic fever (DHF) Breakbone
delusions of poverty Belief in one's hemorrhagic fever — an acute tropical/subtropi-
current/future impoverishment — which seems cal myocarditis, presenting abruptly with lym-
contrary to fact and situation. phadenopathy, severe muscle/joint pain,
cyanosis, hematemesis, hepatomegaly, chilling,
delusion(s) of reference The patient reads unin- fever, prostration, headache, petechiae, retro-
tended negative meanings/messages into oth- orbital pain, hemorrhagic manifestations. This
ers' acts/words. The belief that others have a disease is spread by the female tiger mosquito
unique significance to oneself. (attracted by human excreta). Overhydration and
aspirin are contraindicated. Transfusions may be
demarcation A boundary, limit. ordered. Convulsions, shock, and circulatory
dementia A global impairment of cognition collapse precede death from this communicable
disease — for which there is neither vaccine nor
which is progressive and interferes with perfor- cure.
mance, due to loss of functioning. This may denial A subconscious refusal to accept egodys-
include memory deficits, impaired tonic facts (those contrary to the patient's
judgment/abstraction. Fundamental skills and goals/wishes).
activities of daily living may be lost. Clouding of denial and isolation That identification by
orientation and consciousness may not be seen Elisabeth Kubler-Ross, MD — as initial reac-
until the patient becomes terminal. tions by patients, when told of their impending
alcoholic dementia Delirium tremens. deaths. That refusal to acknowledge painful real-
apoplectic dementia That following cerebral ity.
tremors/vascular accidents. dentalgia Toothache.
postfebrile dementia That which may follow a dental prostheses Dentures.
severe infective illness, fever. dentulous One's intact teeth.
presenile dementia Beginning in middle age, edentulous One who no longer has his/her
cerebral arteriosclerosis may present with apa- teeth.
thy, gait/speech disturbances, so well as symp- depancreatize To surgically resect the pancreas.
toms of memory deficits. dependence Reliance upon another or upon a
primary dementia That associated with substance.
Alzheimer's disease/dementia. dependent personality disorder An excessive,
pseudodementia Masked indifference to the pervasive need to be nurtured. This patient
environment (in the presence of normal cogni- demands that others guide him/her, and to
tion). assume those responsibilities which are
senile dementia Geriatric mental deterioration his/hers. Lacking in self-confidence, emptiness
signified by intercurrent periods of excitation is experiencedwhen alone, as well as a feeling
and short-term memory deficits. Some patients
may become assaultive.
toxic dementia That caused by poisoning of

85

of desertion. pain is to be relieved.

depersonalization disorder That dissociative de Quervain'sthyroiditis A viral infection of the

condition which includes psychogenic thyroid — in which ear/jaw/neck pain may be

fugue/amnesia. This alteration in normal identi- transient.

ty, memory, consciousness may result in frag- deradelphus Conjoined twins with fusion above

mentation. Persistent feelings of the thorax. The anomalies noted may be varia-

estrangement/detachment from oneself may be tions of shared head(s) and/or chest(s).

realized, as well as unreality. Brain lesions may Dercum's disease Adiposis delorosa — painful

produce depersonalization symptoms as aura, cutaneous nodules/fat deposits in the

deja vu, visual distortion, disturbed sense of menopausal woman.

time. The detachment may be understood as the derealization Detachment from one's reality.

egodystonic feeling that one is observing one's dereism Thought and activity based on

own actions and thoughts. Reality testing wishes/fantasy, rather than on reason/logic.

remains intact. derencephalus A congenitally-deformed fetus

deposition In these litigious times, more and with bifid, cervical vertebra(e) and rudimentary

more hospital professionals are being required, brain and skull.

under oath, to answer lawyers' questioning dermabrasion A plastic surgery procedure of

regarding cases to whom they have given care. abrading (sanding) scars, nevi, tattoos, wrin-

This legal testimony is transcribed stenographi- kles, et al.

cally, to be admissible in Court. dermadrome A systemic disease manifested by

depot Storage. That intramuscular injection of an dermatitis.

extended action preparation, to be administered dermal Integumentary, cutaneous — related to

to a noncompliant patient on a regular basis the skin.

(perhaps under Court order). dermalaxia Pathological loss of skin turgor.

depressant An agent which decreasesa nervous dermalgia Dermatalgia — paresthesia associat-

or somatic function/activity. ed with dermal pain.

cardiac depressant That medication which dermapostasis Dermatitis associated with

decreases contractility and the heart rate. abscess formation.

cerebral depressant A drug which slows brain dermatatrophia Shrinking of the skin.

function, rendering the patient inactive, slow dermatauxe Hypertrophy of the skin.

and dull. Larger amounts may act as soporifics. dermatitis Skin rash, lesions, or any skin condi-

motor depressant That which decreases the tion which may be topical.

contractility of non-striated muscles. actinic dermatitis X-ray dermatitis, cutaneous

respiratory depressant Any drug which lowers reaction to photochemical activity — ultraviolet

the depth and/or rate of the patient's respiration. light, irradiation, sunlight.

secretory depressant That agent which lessens allergic dermatitis Hypersensitive response to

the production of endocrine hormones. allergens, manifested by skin inflammation.

depression Major depression is a recurrent atopic dermatitis Pruritus of unknown etiology.

affective disorder, which may be endogenous Patients should be protected from secondary

(chemical) or exogenous(environmental). infection.

Clinical depression may be chronic. Dysphoric contact dermatitis Dermatitis venemata — pru-

hypomania is assessedas energized depression. ritus and irritation of the skin following contact

deprivation Pathological deterioration of secre- with an allergen specific to the patient.

tion, functioning, quality, et al. cosmetic dermatitis A form of contact dermati-

depth psychology The study of unconscious tis in which the allergen is an ingredient(s) in

behavior. the patient's cosmetics.

de Quervain's disease Tenosynovitis of the exfoliative dermatitis Infection of the entire

thumb/wrist, due to constriction of the tendon body surface with desquamation. Antibiotic and

sheath. Repetitive stress must be reduced if corticosteroid therapy are often required to treat

86

this chronic, resistant condition. Depression dermatoplasty Helcoplasty — skin grafts trans-

may coexist. planted to conceal skin defects.

primary dermatitis A direct skin eruption in dermatorrhagia Hemorrhage from/into the skin.

contrast to a systemic, allergic response. dermatosclerosis Fibrous infiltration of the skin.

radiation dermatitis That caused by irradiation. dermatosis A skin condition which does not

stasis dermatitis Chronic inflammation, edema, become inflamed.

pigmentation caused by impaired circulation. progressive pigmentary dermatosis Slow, pro-

dermatitis herpetiformis Duhring's disease — a gressive eruption of red papules on the skin of

chronic, inflammatory condition unrelated to the legs.

herpes involvement, not communicable. This is dermatosis papulosa nigra That facial eruption

characterized by pruritus, of multiple miliae or tiny tumors on the facial

pustular/bullous/vesicular/papular/erythematous skin of some Africans.

lesions. Some patients may experience asymp- dermatoxerasia Xeroderma, roughened skin.

tomatic gluten-sensitive enteropathy. dermatozoonosis Any dermatitis attributed to

dermatitis medicamentosa Cutaneous eruption infestation by a parasite(s) of animals.

attributed to a drug side effect. dermatrophia Cutaneous atrophy.

dermatoautoplasty Skin grafting using the dermoidectomy Excision of an ovarian teratoma

patient as the donor. — a dermoid cyst.

dermatocellulitis Inflammation of subcutaneous dermolipoma Growth of fatty neoplasm beneath

connective tissue(s). the dermis.

dermatoconiosis An occupational condition dermopathy Dermatopathy — any dermatitis.

involving dermatitis caused by dust. dermosynovitis Skin inflammation over an

dermatofibrosarcoma Fibrous carcinoma of the inflamed tendon/bursa.

skin, fibrosarcoma. derodidymus Dicephalus — a deformed fetus

dermatoheliosis That solar-induced degeneration possessing two heads and necks.

of the skin — atrophy, hyper-/hypomelanotic Desault's apparatus The bandaging/splinting

macules, keratoses, telangiectasia, wrinkling, technique for a fractured clavicle.

yellow plaques/papules. desensitization The alleviation of an emotional

dermatoheteroplasty A skin graft from another upset through the method of failing to react, or

species. of reacting contrary to one's feelings. The

dermatolysis Cutis laxa, cutis pendula, pachy- antianaphylaxis of allergies.

dermatocele — the tendency of desmalgia Desmodynia, ligamental pain.

subcutaneous/hypertrophied skin to hang in desmitis Ligament inflammation.

folds. desmocytoma Malignant sarcoma formed of

dermatome That instrument which slices supporting tissue cells.

extremely thin slivers of skin for transplantation desmopathy Any pathology involving ligaments.

as grafts. Segmental skin areas with various desmoplasia Abnormal formations of adhesive

spinal cord innervation. bands or fibrous tissues.

dermatomucosomyositis An inflammation of desmoplastic That which forms or causes adhe-

muscular and mucosal tissues. sions.

dermatomyoma Muscle tissue tumor of the skin. desmorrhexis A ruptured ligament.

dermatomyositis Polymyositis, a connective tis- desmosis Connectivetissue pathology.

sue disease of unknown etiology. Muscular desquamation Keratolysis, peeling, scaling.

inflammation, edema, dermatitis, and/or dys- desynchronosis A conflict with one's internal

phagia may be seen. biological clock — "jet lag".

dermatophobia Morbid fear of contracting a dis- deterioration Regression of physical and/or

ease of the skin. mental functioning. Worsening of the clinical

dermatophytosis Fungal infection of fingers condition.

and/or toes. detersive Purging, cleansing.

87

Diabetes mellilus Symptoms Insulin shock

Diabetic coma Abdominal pain Absent
Blood pressure Normal
Common, acute Below 50 mg
Low Blood sugar Acetone rare
Over 200 mg Breath odor Normal
Acetone Orbital tension Recent insulin,
Low Recent history Inadequate meal,
Acute infection, Excessive exercise
Insufficient insulin Onset Sudden
Respirations Shallow
Gradual
Kussmaul Pulse Full
Tachycardia Skin Diaphoretic
Dry, flushed Thirst
Intense Tongue Absent
Dry, coated Urine Moist
Positive for sugar, Negative for sugar,
Positive for acetone Vomiting Negative for acetone
Common Rare

detortion Detorsion — surgical therapy for any depression. An evening dose of dexamethasone
torsion organic anomaly. The reduction of a cur- will suppress the cortisol level in the morning. If
vature deformity. the patient's response is elevated, s/he has
major depression.
detoxification Reduction of toxicity. That process dextrality Right-handedness.
of combating the physiological effects of a toxic dextrinuria The presence of urinary dextrin.
substance in an addicted patient. dextrocardia That heart which is misplaced to
the right side of the chest.
detritus Any by-product of disintegration. dextrocardiogram That EKGwhich reveals the
detruncation Decollation, decapitation of an action of the right ventricle.
dextrogastria Positioning the stomach on the
impacted, expired fetus to facilitate delivery. right side.
detumescence Subsidence of edema. Gradual dextrosuria Urinary dextrose.
dextrotropic Dextrotropous, dextroverted —
decline of the genital organs, following orgasm. located or turned to the right.
deuteropathia Deuteropathy — diseases in asso- diabetes mellitus (DM) Hypoinsulinism — dis-
ordered carbohydrate metabolism demonstrated
ciation with each other, or secondary to each by glycosuria, polyphagia, hyperglycemia, poly-
other. dipsia, polyuria, and inadequate production/uti-
devasation Obliteration of a blood vessel(s). lization of insulin. Neglected, untreated disease
devascularization Loss of circulation from a may lead to diabetic coma and death. Intelligent
body part. Decrease in blood supply. management of this incurable disease involves
developmental delay Failure of the infant/child insulin (for many), blood sugar determinations,
to reach established milestones. diet, hygiene guidance, and exercise — for life.
deviation Departure from the norm. brittle diabetes mellitus Wide swings in a
axis deviation Alteration in the direction of the hypoglycemia/hyperglycemic continuum due to
major electrical cardiac axis. a tendency to ketosis and variable response to
conjugate deviation Eversion of the facial fea- insulin. To assist a reacting diabetic without
tures to the same side. knowing whether s/he is in diabetic coma or
devil's grip Epidemic pleurodynia. insulin shock, offer a sugar product (if s/he is
deviometer That instrument which calculates the
degree of strabismus.
dexamethasone suppressiontest "Dex test" —
a measurement which rules out/determines the
presence of major (endogenous/chemical)

88

able to swallow safely). When diabetic coma is mellitus is obscure.
the situation, this won't make it appreciably diabetes insipidus Polydipsia and polyuria
worse. If impending insulin shock is the prob-
lem, this more dangerous condition may be caused by pituitary/cranial trauma or tumor.
temporarily reversed by the ingested carbohy- When on fluid restrictions, watch that these
drate. Seek prompt medical attention for both desperately thirsty patients do not drink from
situations and for all diabetic children. their toilets. (The water to these patients' rooms
bronze diabetes Hemochromatosis, a rare con- may have to be turned off, to protect the testing
dition characterized by hematomegaly, bronze from becoming skewed.)
skin, diabetes mellitus, cardiac failure. nephrogenic diabetic insipidus This kidney
chemical diabetes mellitus All blood testing malfunction is usually congenital, may be
except fasting are abnormal. The fasting blood acquired during lithium therapy, and will not
sugar is abnormal in the absence of clinical respond to desmopressin. Some of these
symptoms. patients do not perceivethirst, and dangerously
endocrine diabetes mellitus That caused do not realize when to drink fluids.
and/or aggravated by the adrenal/pituitary/thy- diabetic center The region of the brain in the 4th
roid glands. ventricle.
gestational diabetes mellitus (GDM) The type diabetic ketoacidosis (DKA) That syndrome in
first diagnosed during pregnancy. which hyperglycemia is mild to severe, bicar-
iatrogenic diabetes mellitus Disease associat- bonate less than 15 meq/l, urine/serum ketones
ed with oral contraceptives, diuretics, corticos- are large, and arterial pH less than 7.25.
teroids, or other causative agents. Acidosis takes 12-24 hours to correct. The pre-
insulin-dependent diabetes mellitus (IDDM) cipitating cause of diabetic ketoacidosis (DKA)
These patients require daily insulin for life. may be omission of insulin, infection, myocar-
juvenile diabetes mellitus That with onset in dial infarction (Ml), coexisting illness, or new
childhood. onset diabetes mellitus (DM). A diabetic in fever
latent diabetes mellitus That complication is highly unstable. Hypophosphatemia can
which develops in response to the stressors of cause insulin resistance, amyotonia, paralytic
trauma, pregnancy, infectious disease, or obesi- ileus, or obtundation, following protracted vom-
iting and dehydration. Avoid overcorrecting
ty. potassium phosphate (KP04) beyond the normal
non-insulin-dependent diabetes mellitus of 4.5, because of the risk of seizures and
(NIDDM) Insulin produced by the patient is hypocalcemia. In patients with renal insufficien-
insufficient to meet the needs of the body, even cy, P04 retention occurs, requiring that the
though it prevents ketoacidosis. Insulin and diet replacement be significantly reduced.The
may be prescribed to achieve this balance, but patient should be NPO except for ice chips.
patients who are compliant and not obese, may Treatment for hyperosmolar hyperglycemic non-
be controlled by oral hypoglycemicagents ketotic coma (HHNC) is identical, with the
and/or by diet alone. exception that ketosis is absent, and bicarbon-
pancreatic diabetes That associated with ate (HC03) is required at a lesser amount,
pathology of the gallbladder. unless significant lactic acidosis is present.
proximal neuropathy of diabetes The early or diabetic neuritis Inflammation of nerves, as
presenting manifestation of diabetes. This dia- seen in complicated diabetes mellitus.
betic amyotrophy (also known as asymmetric diabetic neuropathy Traditional medicine has
diabetic neuropathy), starts with a painful weak- taught that this is a progressive and irreversible
ness in the pelvic girdle or femur. The reflexes loss of sensation in the hands and feet. (The
show marked reduction in chronic inflammatory nerves of a diabetic are susceptible to compres-
demyelinating polyneuropathy. sion.) It has now been demonstrated that, by
renal diabetes Glycosuria due to a low renal the decompression of multiple peripheral nerves
threshold for sugar. Any symptom of diabetes in a given extremity, sensation can be. and is

89

being, surgically restored. trolyte, fluid, and acid-base balance in patients
diabrotic An escharotic, corrosive agent. with absent/impaired kidneys.
diacetemia Acetoacetic acid present in the continuous ambulatory peritoneal dialysis
(CAPD) Maintenance diffusion via an implanted
blood. peritoneal catheter. Gravity is the force used in
diaceturia Diacetonuria, diaceturia — ace- this less expensive option.
peritoneal dialysis That process utilizing the
toacetic acid found in the urine of diabetics in peritoneum as the semipermeable membrane.
acidosis. This also occurs in starvation states, The solution remains for a "dwell time" before
and with persistent vomiting. draining. These patients are at risk for peritoni-
diaclast That instrument used to perforate the tis.
expired fetus' skull in utero — to facilitate its renal dialysis Purification of toxins in the
extraction. This procedure is controversial. patient who lacks kidney function.
diadochokinesia The capacity to make rapid, dialysis dementia A neurological syndrome seen
antagonistic movements. in some long-term dialysis patients. Myoclonus,
diagnosis The use of science and skill to estab- speech impairment, dementia, and seizures may
lish the nature of a patient's illness. In so deter- precede death.
mining, other possibilities will be ruled out. dialysis disequilibrium Rapid pH changes in the
antenatal diagnosis The determination of the blood, higher urea in the brain than in the blood
fetus' status in utero. serum, and decrease in the osmolarity of the
clinical diagnosis The conclusion following extracellular fluid may cause nausea with eme-
examination, tests, laboratory work, X-rays. sis, headache, somnolence, and seizures at the
differential diagnosis The comparison of simi- outset of hemodialysis.
lar pathological states. diaminuria Amino compounds present in the
dual diagnosis That comorbidity of mental ill- urine.
ness compounded by substance abuse and/or diaphanoscopy Transillumination — examination
other habituating disorders. of body cavities by diaphanoscope.
medical diagnosis Clinical assessment aug- diaphoresis Profuse perspiration — a significant
mented by radiological and laboratory surveys. sign.
nursing diagnosis Specialized nursing judg- diaphragmalgia Diaphragmatic pain/discomfort
ments assigned to address the total needs of — diaphragmodynia.
patient care. (Only physicians may diagnose.) diaphragmatocele Diaphragmatic herniation.
pathological diagnosis That derived from diaphragmitis Diaphragmatic inflammation —
analysis of abnormal findings. which irritation may be felt in the shoulder(s) as
physical diagnosis Those findings evaluated referred pain.
from the external examination and assessment diaphysectomy Partial excision of the shaft of a
of the patient. long bone.
radiographic diagnosis Roentgenographic diaphysitis Infection of the shaft of a long bone.
(including scanning and imaging) interpretations diarrhea Defecation of frequent liquid stools. The
suggest and confirm findings. patient should be evaluated for signs/symptoms
diagnosis by exclusion That derived by disquali- of metabolic acidosis and dehydration —
fication. depressed fontanel(s) in the infant, lethargy,
diagnostic peritoneal lavage (DPL) Widely used headache, altered level of consciousness, com-
as a diagnostic tool in the assessment of blunt pensatory hyperventilation. The trilogy of vomit-
abdominal trauma — this invasive procedure is ing and diarrhea with fever may cause the
highly sensitive. Positive results register patient to deteriorate rapidly.
100,000 ABCs/mm. This is the modality of diastole Relaxation of the heart, in contrast to
choice for adult victims, to avoid unwarranted systole. Failure of the diastolic pressure to drop
exploratory laparotomy. proportionately to the systolic pressure is a sig-
dialysis Hemodialysis, the process of diffusing
blood to extract toxins while maintaining elec-

90

nificant sign. Augmented diastolic pressure is Differential Diagnosis of Dementia
achieved by invasive instrumentation.
dicephalus That congenital deformity of the con- i
joined fetus with two heads — diplocephaly. I. CongenitalDisorders
Extremely rare, the United States' press recently II. Psychiatric Disorders
featured the extraordinary coping of such 6 III. Focal Brain Syndromes
year-old twin girls, who are alive and well. IV. Medical Disorders: (Delirium)
dichotomy Bifurcation, dichotomization — dis-
A. Major organ dysfunction
section into 2 portions. 1. Cardiopulmonary
dicoria Diplocoria — a double pupil in each eye. 2. Hepatic
dicrotic That double pulse which transmits 2 3. Renal

arterial pulsations for each heartbeat. B. Endocrine/metabolic
didactylism The congenital anomaly of only 2 1. Thyroid
2. Diabetes mellitus
digits on an extremity. 3. Vitamin B12 deficiency
didelphic Dihysteria, dimetria — a double
C. Inflammatory
uterus. 1. Vasculitis
didymalgia Didymodynia — testicular pain. 2. Neurosyphilis
diet A prescribed, designated allowance for
V. Focal Brain Disorders
intake. A. Korsakoff's amnesia
Dietl's crisis Renal colic caused by obstruction B. Stroke
C. Mass
and/or kinking of the ureter. D. Other
Dieulafoy's vascular malformation Dieulafoy's
VI. Dementia
anomaly/ulcer — cirsoid aneurysm, gastric arte- A. Cortical
riosclerosis, peptic ulcer of irregular locations,
primary arterial vascular deformity. A hyper- 1. 1. Alzheimer's disease
trophic, submucosal, tortuous artery may cause 2. Pick's disease
recurrent, massive hematemesis. If the patient 3. Frontal lobe dementia
survives this bleed, repeat bleeds are common. 4. Other
Gastrointestinal symptoms are typically absent.
Wide-wedge resection is the surgical protocol B. Subcortical
for this life-threatening disorder. 1. Huntington's disease
differential diagnosis That assigned to the 2. Parkinson's disease
patient (pt) following consideration of other 3. Other - AIDS
pathology with similar symptomatology.
differentiation An outline of distinguishing fea- C. Mixed/Variable
tures. In psychiatry, intellectual and emotional 1. Multi-infarct dementia
functioning within the person. 2. Prion disease
Di George'ssyndrome That in which the 3. Lewy's body disease
parathyroid and thymus glands remain 4. Trauma
hypoplastic. This severe pediatric form in which
the immune system is left vulnerable to life- i 5. Hydrocephalus
threatening infection. 6. Other
digitalis toxicity Digitalis intoxication presents
with the symptomatology of asystole, atrioven- dia. Ventricular extrasystole mandates that the
tricular block, diarrhea, headache, hyperkalemia, patient must be assessed and watched with
irregular pulse, bradycardia, mental changes, acute care. Upon discharge, the patient on digi-
nausea with emesis, partial heart block, sinus talis needs to be able to take his/her own pulse
bradycardia, supraventricular arrhythmia, ven- before each dose, to hold the dose with a pulse
tricular fibrillation, and/or ventricular tachycar- of 60 or below, and to be knowledgeable of
adverse signs/symptoms. The diet should be
abundant in potassium.
digitalization Placing the patient on digitalis

91

Dosage of antitoxin recommended for various types ofdiphtheria

Type Dosage Route
20,000 to 40,000 units Intravenous
Pharyngeal 20,000 to 40,000 units Intravenous
(48 hour duration) 40,000 to 60,000 units Intravenous

Laryngeal
(48 hour duration)

Nasopharyngeal

therapy. spastic diplegia Congenital spasticity of the
diglossia A double tongue. extremities.
diktyoma Dictyoma — a ciliary tumor. diplococcemia Diplococci in the circulation.
dilatation and curettage (D and C) Surgical dila- diplogenesis Doubling of creation — double
fetus, double heads, double limbs, et cetera.
tion of the uterine cervix to permit curettement diplomellituria The phenomenon of nondiabetic
(scraping) of specimens, growths, polyps, and diabetic glysosuria occurring in the same
retained placental tissue, or the products of an patient.
incomplete abortion. diplopagus Conjoined twins who share an
dimple sign That phenomenon which distin- organ(s).
guishes a benign dermatofibroma from a malig- diplopia Double vision.
nant nodular melanoma. When pressure is diplosomatia Diplosomia — the fusing of con-
applied laterally, the benign lesion will dent or joined twins at one or more points.
dimple. Normal skin and malignant lesions will dipping While placing the examiner's hand flat
rise. on the abdomen, the liver can be palpated by
Diogenes' syndrome Disinterest in one's own quickly depressing the fingers. (Nurses should
hygiene, accompanied by malnourishment, as defer the palpation of pediatric livers to the
may be seen in advanced geriatrics. physician.)
diphonia Diplophonia, the simultaneous produc- diprosopus That fetal anomaly of a double face.
tion of two separate voices. dipsesis Dipsosis, exaggeratedthirst, a craving
diphtheria An acute communicable disease with for abnormal fluids.
severe adenitis, myocarditis, and/or neuritis. dipsogen That which induces thirst.
Patients should be admitted to the intensive dipsomania An uncontrollable craving for ethyl
care unit under respiratory precautions, and alcohol.
given testing to rule out sensitivity to diphtheria dipsophobia That exaggerated fear of ethyl alco-
toxin. Diphtheria antitoxin should be adminis- hol (ETOH).
tered intravenously even before the diagnosis is directionality A sense of direction. Children with
confirmed by culture. If the patient tests sensi- impaired directionality may need to be evaluated
tive to the antitoxin, desensitization will be for minimal brain dysfunction.
required. Surgical intervention may be neces- director The grooved instrument which guides a
sary in laryngeal diphtheria with intubation or a scalpel or probe.
tracheotomy. Patients are at risk of expiring if direct reflex Response and stimulus remain on
diphtheria antitoxin is delayed past the first day. the same side.
If the patient survives, the neuritis and disarticulation Amputation through the joint.
myocarditis will completely resolve. discharge Emission, excretion, secretion.
diplacusis That disturbed perception of pitch in cerebrocortical discharge Violent action of a
which two tones are heard for each sound pro- malfunctioning or damaged portion of the cere-
duced. bral cortex, as prelude to an epileptic seizure.
diplegia Bilateral paralysis. convective/disruptive discharge Electrical
infantile diplegia Birth palsy.

92

energy. injury, prenatal disease, or due to heredity.
lochial discharge That postpartum excretion demyelinating disease Neural disturbance due
from the uterus. to the destruction of myelin sheaths of nerve
discharging lesion That anomaly of a cerebral cells.
nerve center — which abruptly transmits motor endemic disease That which is present and
stimuli. reappearing in a given locality.
dischronation The lack of a sensation of relation- extrapyramidal disease A degenerativecondi-
ship to time/timing. tion of the nervous system involving the basal
discoid eczema Nummular dermatitis. ganglion of the brain and the extrapyramidal
disconnection syndrome Disturbed system. Symptoms include dystonia, athetosis,
language/visual functioning because of trauma chorea, and tremors.
or occlusive tumor/hypoxia. Signs and symp- familial disease Noncommunicable pathology
toms may present as ability to speak normally which is seen in members of the same family.
with auditory aphasia; an ability to perform a focal disease A localized disease process.
task with the left hand, but not the right; inabili- heavy chain disease Affecting immunoglobu-
ty to execute tasks equally by each hand; differ- lins with symptoms of malabsorption, abdomi-
ence in discrimination of objects by right and nal lymphoma, lymphadenopathy, Bence Jones
left hands when the eyes are covered. proteinuria, spleen/liver/bacterial infections,
discordance That genetic expression of a trait in weight loss, and/or marked weakness.
only one twin. hemolytic disease of the newborn
disdiadochokinesia The inability to execute Erythroblastosis fetalis, a hemolytic condition
rapid, highly-coordinated, alternating move- signaled by generalized edema, splenomegaly,
ments. hepatomegaly, jaundice, and anemia.
disease Dyscrasia — a pathological condition. A HIV disease Acquired immune deficiency syn-
syndrome of laboratory results, radiological drome (AIDS) caused by the human immunode-
findings, signs, and symptoms. ficiency virus.
acute disease That with a rapid onset and hypokinetic disease Mental and/or physical
course. symptoms caused by insufficientexercise.
autoimmune disease A condition in which the iatrogenic disease That inadvertently caused
body produces disordered immunological by surgical or medical intervention.
responses against itself. This system becomes idiopathic disease A condition for which a
defective, producing antibodies against normal cause cannot be identified.
tissue. Glomerulonephritis, hemolytic anemia, iron storage disease Hemochromatosis.
myasthenia gravis, rheumatoid arthritis, sclero- malignant disease Carcinoma (CA) or any con-
derma fall in this category. dition which progresses at an extreme pace, and
chronic disease That having a slow onset, with from which the patient goes on to die.
a prolonged, lifelong course. metabolic disease That due to abnormal
chronic granulomatous disease (CGD) A chemistry within the body.
genetic defect in the ability to kill bacteria. Brain motor neuron disease Amyotrophic lateral
abscess, dermatitis, diarrhea, sclerosis (ALS), progressive bulbar palsy, pro-
hepatosplenomegaly, osteomyelitis, pulmonary gressive muscular atrophy. These conditions
disease, suppurative lymphadenitis, et al., may present with degeneration of the motor cranial
be clinically noted in the male infants attacked nerve nuclei, of the anterior horn cells of the
by this rare disease. Bone marrow transplanta- spinal cord, and of the pyramidal tracts. This
tion and continuous antibiotic regimens have disease occurs principally in male patients.
proven to beeffective. occupational disease That associatedwith the
complicating disease Secondary disease. work place.
congenital disease A diseased condition pre- organic disease The result of organ/tissue
sent at birth due to transplacental penetration, changes within the body.

93

pandemic disease A world-wide epidemic. Monteggia's dislocation Displacement of the
parasitic disease Illness caused by infestation. femur from the acetabulum (hip joint).
self-limited disease That illness which runs its Nelaton's dislocation That ankle displacement
course, ending without medical intervention. in which the talus is forced between the fibula
sexually transmitted disease (STD) Conditions and the tibia.
acquired through coitus. pathologic dislocation Displacement caused by
storage disease A disorder caused by abnor- joint disease, malignancy, or paresis.
mal deposition of substance in body tissues. subastragalar dislocation Separation of the
subacute disease That which is more serious talus from the scaphoid and calcaneum.
than chronic disease and milder than acute ill- traumatic dislocation That caused by violence
ness. or accident.
thyrotoxic heart disease Thyrotoxicosis caused disomus Fetal malformation of a double trunk.
by hyperthyroidism, cardiomegaly, cardiac fail- disorientation That state of being unaware of
ure, and atrial fibrillation. any of 4 spheres — person, place, time, and/or
disequilibrium Imbalance — unstable, unequal situation.
balance. displacement Transference of emotion from one
disinhibition Conduct devoid of cultural/social theme to another, thereby avoiding acknowl-
constraint. edgement of the original, threatening idea —
disinsertion Peripherally detached retina. the dystonic material.
diskectomy Surgical excision of a herniated disseminated intravascular coagulation (DIC)
intervertebral disk. Pathological, diffuse clotting characterizedby
diskitis Inflammation of an interarticular cartilage gangrene of the extremity(s), a high frequency
or disk — meniscitis. of bleeding, renal dysfunction. This complication
dislocation Displacement of any body part. may follow incomplete abortion or surgical pro-
closed dislocation Simple displacement of a cedures involving the brain, lung, prostate.
bone within the joint. Only a physician should dissociative disorder
manipulate a dislocated joint. Sudden/gradual/transient/chronic alteration of
complete dislocation Total separation of the consciousness, memory, and/or identity. Such a
joint. patient may be best discerned by the clinician's
complicated dislocation That displacement of high degree of suspicion — because s/he con-
bones in conjunction with major injuries. ceals symptoms and fails to present clearly.
compound dislocation That open to the air. Usually female, she may regard her symptoms
congenital dislocation Displacement(s) present to be demented and shameful. These patients
at birth. are commonly misdiagnosed because of their
consecutive dislocation Redislocation of the acting-out behaviors, anxiety, depression, eating
subluxated (dislocated) bone. disorders, panic, post-traumatic symptoms,
divergent dislocation Separate subluxation of somatoform symptoms, substance abuse, etc.
both the radius and ulna, or the tibula and fibu- Psychotic features may complicate and confuse
la. the diagnostic picture.
habitual dislocation Recurrent disarticulation depersonalization disorder Loss of one's own
— especially of the mandible. This dislocation reality. Sensory anesthesia and fear of not being
can even occur upon yawning. in control of one's speech and/or actions are
incomplete dislocation Partial displacement, often present. These feelings are ego-dystonic
subluxation of a joint. (unfriendly to the psyche). Intact reality testing
metacarpophalangeal joint dislocation is maintained.
Displacement of a finger(s), usually aggravated dissociative amnesia Psychogenic amnesia —
by tendon interposition. Upon reduction, redis- multiple episodes of stressful inability to bring
location may occur promptly. This should be significant personal details to recall. These laps-
managed only by a physician. es in memory are too extensive to be attributed