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GRST 211Medical Terminology:From Head to ToeLesley BoltonCONTENTSMedical Terminology from Head to Toe Breaking Down Medical Terms, Building Up Medical Definitions Using Prefixes, Bases, and Suffixes to Describe the Body Head Skin, Hair, and Nails Eyes Review of Chapters 1– 5 Ears Nose Mouth Throat a...

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GRST 211 Medical Terminology: From Head to Toe Lesley Bolton

CONTENTS Medical Terminology from Head to Toe

1. Breaking Down Medical Terms, Building Up Medical Definitions 2. Using Prefixes, Bases, and Suffixes to Describe the Body 3. Head 4. Skin, Hair, and Nails 5. Eyes Review of Chapters 1–5 6. Ears 7. Nose 8. Mouth 9. Throat and Neck 10. Shoulders and Arms Review of Chapters 6–10 11. Hands and Fingers 12. Chest, Back, and Spine 13. Lungs 14. Heart, Blood, Lymph, and Spleen 15. Liver, Gallbladder, and Pancreas Review of Chapters 11–15 16. Stomach 17. Abdomen and the Digestive Organs 18. Kidneys and Bladder 19. Female Reproductive Parts 20. Male Reproductive Parts Review of Chapters 16 – 20 21. Hips and Legs 22. Feet and Toes 23. Greek and Latin Terminology: Singular and Plural Nouns 24. Latin Anatomical Terminology 25. Latin Anatomical Terminology Examples Review of Chapters 21 – 25 Final Review

CHAPTER 1

Breaking Down Medical Terms, Building Up Medical Definitions Medical terminology can be both intimidating and bewildering. It embraces more terms than anyone could likely ever memorize, many of them defying comprehension by their length and complexity. However, you should not despair, for there is a solution. Do not attempt to memorize them all. Instead, master a method of analysis that you can apply to all sorts of new terms that you might encounter, no matter how strange or how lengthy they are. Luckily, the method of analysis is not too difficult. It relies on the fact that many of the medical terms we have today were devised according to a regulated system of rules. If we know the rules, and we apply the system in reverse, we can simply break down troublesome terms into their basic building blocks and then build up the sense of them. Then, distinguishing cardiomalacia, cardiomegaly, and cardiometry becomes a breeze, and confronting a word such as hepatocholangioenterostomy no longer fills us with dread. You might wonder why terms were devised this way in the first place, if we have to break them down before we can make any sense of them. The answer lies in the history of how medical language and terminology evolved. A detailed knowledge of this is not necessary for our present task, but a summary will highlight some features that will make the task more understandable. Where Did Medical Terminology Come From? The earliest medical writings of the Western world date back to the ancient Greek world of Hippocrates in the fifth century BCE. While the Greeks did develop a medical terminology of a sort, much of it was based around commonplace language and ideas. The term catarrh, for instance, developed in Greek as a combination of the words for ‘down’ and ‘flow,’ while the term thorax originally described a piece of armor that covered the chest. When Greek medicine was transplanted to Rome in the first century CE, Roman writers wanted to compose medical texts in their own language, Latin. Like the Greeks, they had everyday words that served for some technical purposes, but they were hampered by not having an extensive medical language of their own. Their solution was to simply borrow Greek terms and Latinize them, or to take Greek concepts and equate them to Latin ones – for example, they mimicked the Greek idea that ‘mouth’ could be used to mean the opening of any body part and just substituted the Latin word for ‘mouth’ in place of the Greek one. Latin, along with its Latinized Greek elements, became the dominant medical language throughout Europe, at least in the written tradition, and continued to be so for many centuries. Throughout this time, more and more ordinary Latin and Greek words, but especially Latin, were given a specific medical meaning. Practitioners who could demonstrate mastery of the language might, whether rightly or not, claim some superiority or higher professionalism over those who could not. To be able to read and write Latin, and to some extent Greek, was the hallmark of an educated person. By the nineteenth century, however, Europeans started writing about medicine in their own languages in place of Latin, although they still incorporated the Latin and Latinized Greek medical terms, with only minor modifications. This era also witnessed a huge rise in ‘scientific medicine,’ which, combined with a steady increase in journal publication, encouraged the development of a fresh specialist medical vocabulary. Latin largely provided the basis for a new anatomical nomenclature, while Greek especially became the vehicle for a multitude of systematically developed compounded terms of the type hepatocholangioenterostomy. In a time when Greek and Latin were still believed to be important elements of a proper education throughout Europe, it made sense to develop new terminology in a language common to all. Gradually, however, beginning in the twentieth century, English started to dominate as the global language for international medical communication, and new terms are now generally based on everyday English, with some national variation. However, the older Greek and Latin terminology remains firmly entrenched in the medical discipline and shows no sign of going away soon. What do we learn from this history? Well, we learn that a huge percentage of medical terminology is derived from Greek and Latin. It falls basically into three types:

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i)

ii)

iii)

Greek and Latin terms that have entered the English language in an anglicized form. Some of them, for example sperm, artery, and nerve, were incorporated so long ago that we have ceased to think of them as foreign. Terms that have entered the English language in their original form. Some terms such as ganglion are Greek, but the majority are Latin terms used in anatomy, such as sacrum, vena cava, and fossa ovalis. Compound terms that were systematically devised. Many utilize Greek base words, as in oligomenorrhea, since the Greek language is particularly suited to forming compounds. However, Latin compounds, such as labiogingival, do occur, as do hybrid terms such as neonatal that mix Latin and Greek elements.

The first type should pose few problems, at least to English speakers. We will spend a little time on the second type, but concentrate mostly on the third type, the compound terms, since these are the most troublesome and the most numerous. So, on to compound medical terms, and our first objective; breaking them down into plain English that we can understand. Breaking Down Medical Terms Compound medical terms, no matter how long and how complex they are, can be reduced to individual word parts that are the building blocks of terminology. There are just three types of word part – the base, the suffix, and the prefix. Base The base carries the basic meaning and sense of a word. In the term psychiatry, for example, ‘psych’ is the base, with the meaning ‘mind.’ It has this same meaning whether we find it in psychology, psychopath, or psychic (a note to students of Greek and Latin, bases in medical terminology generally have only one meaning, perhaps two, not the many variants we see in the ancient languages). Bases always make some sort of sense on their own, since they are modified nouns (‘things’), adjectives (‘describing’ words), or verbs (‘doing’ words), but their endings are missing. They just need something added to them to make full sense again. Almost all medical terms include a base; those that do not are not derived from Greek and Latin, and do not concern us here. A term can include more than one base, as in psychosomatic, for example, where the bases are ‘psych’ and ‘som,’ meaning ‘mind’ and ‘body,’ respectively. Several bases may share the same meaning; ‘ment,’ for instance, also means ‘mind,’ but is derived from Latin, whereas ‘psych’ comes from Greek. Suffix The suffix is added to the end of the base to make meaningful sense. It can be as little as one letter, often a few letters, sometimes more. Just like the bases, almost all medical terms include a suffix, and those that do not are not derived from Greek and Latin, and do not concern us here. The suffix usually makes no sense on its own, but added to the end of the base it forms a complete noun, adjective, or verb. For example, the suffix ‘osis’ makes no sense on its own, but in combination means ‘abnormal condition of’; when added to the base ‘psych,’ we get psychosis, the noun that means ‘abnormal condition of the mind.’ Occasionally, a word might have two suffixes following each other. Several suffixes might have the same meaning; ‘ic’ and ‘al’ for example, both mean ‘pertaining to.’ These suffixes make adjectives when added to the end of the base, as in ‘psychic’ and ‘mental,’ each meaning ‘pertaining to the mind.’ Prefix A prefix can be added to the front of the base. It can be as little as one letter, often a few letters, sometimes more. Not all medical terms include a prefix. The prefix does not make sense on its own; it modifies or adds

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extra information about the base, telling us how, where, or to what degree something occurs. Prefixes are derived from Greek and Latin adverbs (tell us ‘how,’ ‘where,’ or ‘when’), or prepositions (tell us ‘where’). The prefix ‘endo,’ for example, means ‘within,’ so ‘endopsychic’ can be understood as ‘pertaining to within the mind.’ Occasionally, a word might have two prefixes following each other, but this is not common. The following table summarizes the prefix, base, and suffix, and their normal use in compound terms:

Position in word Is it essential? More than one? Function

prefix beginning no hardly ever adds extra information about the base – often how, where, or to what degree

base middle yes often carries the basic meaning – a modified noun, adjective, or verb with a bit missing

suffix end yes sometimes completes the sense of the base – in combination, the suffix and base make a noun, adjective, or verb

There is one more element of the compound term we need to consider. It is not a word part, but an aid to pronunciation; the combining vowel. Combining Vowel Consider the word psychotic. We saw above that ‘psych’ is a base that means ‘mind.’ We have not met it yet, but ‘tic’ is another suffix that means ‘pertaining to.’ Putting the two together would give us ‘psychtic,’ a rather difficult term to pronounce. Therefore, a combining vowel, ‘o’ in this case, is added to the end of the base to make pronunciation easier. This happens a lot, especially where the base ends with a consonant and the suffix (or another base) starts with a consonant, but in some other odd instances as well. The combining vowel is very often an ‘o,’ but sometimes it might be one of the other vowels (a, e, i, u) or y. It adds nothing at all to the meaning. The combining vowel is always considered as added to the end of the base, not the beginning of the suffix. Recognizing the Word Parts So, when faced with the compound medical term, what do you do? i) Identify all the parts. It is a good idea to write the term out, so that you can mark the parts (bracket them, circle them, whatever works for you) as you identify them. ii) You know that there will be at least one base and a suffix, so find them first. Mark them. Remember, there might be a combining vowel between the base and suffix. iii) Still have something left over? There probably is not a second suffix, but is there a second base (or even more)? Remember, there might be a combining vowel between the bases. Is there a prefix? Mark everything. iv) Make sure that nothing is left over. If you have extra letters after marking prefixes, bases, suffixes, and combining vowels, you have gone wrong somewhere and need to start again. v) When you have identified all the word parts, accounted for any combining vowels, and there is nothing left over, write down the meaning of each individual part. Then, go on to build up the definition. Building Up Medical Definitions So, you have all the word parts identified, and you have their meanings. Now you need to put them together. In many cases, you will have just one base and suffix, perhaps also a prefix. Remember, combining vowels do not have a meaning of their own, and do not alter the meaning of anything.

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i) ii) iii)

In all cases, BEGIN WITH THE SUFFIX. This is an important point, and it gets the definition off to the right start. It will tell you whether the whole medical term is a noun, an adjective, or a verb. If you only have a base and a suffix, then the base comes next. If you have a base, a suffix, and a prefix, then the prefix, since it modifies the base, usually comes next, then the base last of all.

You might need to add in little words, such as ‘the’ and ‘of,’ just to make the definition sound right. Here is an example with just a base and a suffix: prefix

combining vowel

base psych ‘mind’

psychosis

suffix osis ‘abnormal condition’

definition order = suffix-base = ‘abnormal condition of the mind’ Here, we have a base and a suffix, but also a combining vowel because the base ends with a consonant, and the suffix starts with a consonant: base

combining vowel

suffix

psych ‘mind’

o

tic ‘pertaining to,

combining vowel

suffix

prefix psychotic

definition order = suffix-base = ‘pertaining to the mind’ This example has a prefix, a base, and a suffix:

endopsychic

prefix

base

endo ‘within’

psych ‘mind’

ic ‘pertaining to’

definition order = suffix-prefix-base = ‘pertaining to within the mind’ So, the suffix always comes first in the definition, then generally the prefix if there is one, then the base. The combining vowels only help with pronunciation. What if there is more than one base? For the most part, terms with more than one base follow exactly the same rules. Break the word down into the word parts, build up the definition in the order suffix-prefix(if there is one)-bases. Sometimes, however, the exact relationship between the two bases requires a bit of common sense to be applied. We will meet some terms like this, and we will discuss the different ways of dealing with them as we come across them. Do not worry if this chapter is a little overwhelming at this stage. It will become a lot clearer when you have learned some prefixes, bases, and suffixes to practice with, but do make sure that you understand what prefixes, bases, and suffixes are, and what they contribute to a medical term, before moving on.

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CHAPTER 2

Using Prefixes, Bases, and Suffixes to Describe the Body Before we go on to look at the body from head to toe, we are going to look at how the body as a whole is described, imagining we are looking at someone standing in front of us, or lying on a hospital bed. This will give us the opportunity to go through how information is presented in the chapters, so that you know exactly what has to be memorized and what has to be understood. Most of the new prefixes and suffixes will be introduced in the first half of the book. These will be in tables at the beginning of the chapters. You must memorize all of the prefixes and suffixes, and all of their meanings. You will use them over and over again, not just in the chapter they are introduced. Whenever a new term is introduced, try and think of an everyday term that might help you remember the meaning. Write it in the margin of the page. Here are the prefixes and suffixes to learn for this chapter. Prefixes Remember, the prefix is added to the front of the base. It modifies or adds extra information about the base, telling us how, where, or to what degree something happens. Not all terms have a prefix. In the tables, the prefixes (italicized) are followed by a hyphen, because they go before another word part, almost always a base. Some prefixes have more than one meaning; you must learn all the prefixes and all of their meanings. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

ambi-, amboapocontraectoendointerintramesosubsupertrans-

‘both’ ‘away from’ ‘opposite,’ against’ ‘outside,’ ‘outer’ ‘inside,’ ‘inner’ ‘between’ ‘within’ ‘middle’ ‘below,’ ‘underneath’ ‘upper,’ ‘above,’ ‘beyond’ ‘across,’ ‘through’

Because we are looking at ways of describing the body, a lot of these prefixes tell us where something occurs. ambi- and ambo- are just alternative forms of the same prefix. Suffixes Remember, the suffix is added to the end of the base to make meaningful sense. The base and suffix together form a complete noun, adjective, or verb. All of the compound terms we will be looking at have a suffix. In the tables, the suffixes are preceded by a hyphen, because they go after another word part, almost always a base. Some suffixes have more than one meaning; you must learn all the suffixes and all of their meanings. 1. 2. 3.

-ad -an -al

‘toward’ ‘pertaining to’ ‘pertaining to’

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4. 5. 6. 7. 8. 9. 10. 11.

-ary -ial -ic -ion -ior -ous -tic -verse

‘pertaining to’ ‘pertaining to’ ‘pertaining to’ ‘action,’ ‘condition,’ ‘act of’ ‘pertaining to’ ‘pertaining to,’ ‘like,’ ‘full of,’ ‘having’ ‘pertaining to’ ‘to turn,’ ‘to travel,’ ‘turned’

You will find that a lot of suffixes mean ‘pertaining to.’ They form an adjective (‘describing’ word) when combined with a base. A suffix such as -ion forms a noun (‘thing’) when combined with a base. The suffix -verse is a little unusual, since it is actually a base (VERS-) and suffix (-e) combined, but we will treat it for the moment as if it is a regular suffix. It can form a verb or verb part (‘doing’ word) when combined with a base, but can also form a noun or an adjective. The suffix -e does not have a meaning of its own. Bases Every chapter introduces some new bases. The bases (capitalized) are followed by a hyphen, because they go before another word part, either another base or a suffix. Each base is then followed by a definition, or several related definitions. Then, below the entry, are one or more examples of its use in a compound term, showing how it can combine with other word parts, and sometimes some further explanation or comments. You do not need to memorize the compound terms, they are here as examples. If you learn all of your prefixes, bases, and suffixes, you will never need to memorize the meaning of compound terms. However, do make sure that you understand what the individual word parts are, and how they are combined. Some bases have two meanings that are entirely different – these are marked as (i) and (ii) in the definition line; you must learn all the bases and all of their meanings. 1.

VENTR- ‘front,’ ‘abdomen,’ ‘belly’ ventral (VENTR-al) – pertaining to the front ventrad (VENTR-ad) – toward the front

2.

DORS- ‘back’ mesodorsal (meso-DORS-al) – pertaining to the middle of the back dorsoventral (DORS-O-VENTR-al) – pertaining to the front and back dorsad (DORS-ad) – toward the back

The front side of the body is the ventral surface or ventral section. The back side of the body is the dorsal surface or dorsal section. Inside the body, there is the ventral cavity at the front of the body, and the dorsal cavity at the back. If you lie on your back, you are in a dorsal position. If you move toward the front, you are moving in a ventrad direction, and if you move toward the back, you are moving in a dorsad direction. 3.

ANTER- ‘front,’ ‘before’ anterior (ANTER-ior) – pertaining to the front

4.

POSTER- ‘back,’ ‘behind’ posterior (POSTER-ior) – pertaining to the back

5.

FRONT- ‘front,’ ‘forehead’ frontal (FRONT-al) – pertaining to the front

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Anterior and posterior also relate to the front and back of the body, just like ventral and dorsal, but they also have a special meaning. This is because they are o...