cardiovascular system -...
TRANSCRIPT
207
CHAPTER
5Cardiovascular
System
CARDIOVASCULAR SYSTEM OVERVIEWThe cardiovascular system consists of the heart (Fig. 5-1) and blood vessels, which work togetherto transport blood throughout the body.
The heart is a muscular organ that pumps blood throughout the body.The heart consists of four chambers: the right atrium and left atrium (upper chambers), andthe right ventricle and left ventricle (lower chambers).The heart is divided into right and left portions by the interatrial septum and the interven-tricular septum.
Heart valves open and close to maintain the one-way flow of blood through the heart.The heart has three layers: the endocardium, which lines the interior cavities of the heart; themyocardium, which is the thick, muscular layer; and the epicardium, which is the outermembrane.Enclosing the heart is a loose, protective sac called the pericardium.
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Read Chapter 5: Cardiovascular System and complete all programmed pages 207-250review segments.
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208 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
Aortic arch
Aorta
Lung
Capillaries
Vein Artery
Upper extremity
Lung
Superior vena cava
Pulmonaryveins
Interatrial septum
STRUCTURES OF THE HEART (arrows indicate path of blood flow)
BLOOD CIRCULATIONECHOCARDIOGRAMNormal, two- dimensional, apical four-chamber view
Pulmonaryartery
Lower extremity
Left ventricle
Aortic valve
Mitral valve
Left atrium
Interventricular septum
Pericardium
Epicardium
Myocardium
Endocardium
Pulmonary semilunar valve
Pulmonary veins
Tricuspid valve
Right atrium
Inferior vena cava
Right ventricle
FIGURE 5-1 ■ Structures of the heart.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 209
Blood, which transports essential elements within the body, flows through the heart as follows:
Deoxygenated blood from the body enters the heart through the superior vena cava andinferior vena cava into the right atrium.During atrial contraction, the tricuspid valve opens to allow blood to flow into the right ventricle.Contraction of the ventricle pushes blood through the pulmonary semilunar valve into the pul-monary artery.The pulmonary artery carries the blood to the lungs and through the pulmonary circulation(a network of arteries, capillaries, air sacs, and veins in the lung), where it is oxygenated.Oxygenated blood returns to the heart via the pulmonary veins into the left atrium.With atrial contraction, the mitral (or bicuspid) valve opens to allow blood to flow into the leftventricle.Contraction of the left ventricle pushes blood through the aortic valve into the aorta and on toall parts of the body through the systemic circulation (a network of arteries, arterioles, capil-laries, and veins throughout the body).The heart is the first to receive oxygenated blood via the right and left coronary arteries, whichdistribute blood throughout the entire heart (Fig. 5-2).
Self-Instruction: Combining FormsStudy the following:
COMBINING FORM MEANING
angi/o, vas/o, vascul/o vessel
aort/o aorta
arteri/o artery
ather/o fatty (lipid) paste
atri/o atrium
cardi/o heart
coron/o circle or crown
my/o muscle
pector/o, steth/o chest
sphygm/o pulse
thromb/o clot
ven/o, phleb/o vein
varic/o swollen, twisted vein
ventricul/o ventricle (belly or pouch)
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Predilation angiogram revealing 99% stenosis of the right coronary artery (RCA).
PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA)
Post-PTCA angiogram showing successful dilation.
Catheter and wire placement with balloon inflation.
PTCA procedure showing catheterplacement and straddling of the balloon at the occluded site.
ANTERIOR VIEW OFCORONARY ARTERIES
POSTERIOR VIEW OFCORONARY ARTERIES
Superior venacava
Superior venacava
Diagonal artery
Left marginal artery
Left anteriordescending
artery
Left coronary artery
Pulmonary trunk
Arch of aorta
Right marginalartery
Rightcoronaryartery
Sinoatrialnodalartery
Right pulmonary veins
Left anteriordescendingartery
Posteriorinterventricularartery
Atrioventricularnodal artery
Circumflex branch
FIGURE 5-2 ■ Coronary arteries and angiograms illustrating angioplasty.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 211
Programmed Review: Combining Forms
ANSWERS REVIEW
5.1 A cardiologist is a physician who specializes in the study of
heart the __________.
angiogram 5.2 Formed from angi/o, an ______________ is an x-ray record of a
blood vessel.
vessel 5.3 A vasospasm is an involuntary contraction of a blood _________.
Cardiology 5.4 ___________________ is the medical specialty dealing with the
study of the heart.
Thromb/o 5.5 ____________, the combining form meaning clot, is the subject
breaking down or dissolution of thrombolysis, a term referring to the ______________ __________
of a clot or clots.
5.6 Someone with a congenital ventricular defect is born with an
ventricle imperfection of a _____________ in the heart. (The combining form
ventricul/o in this term is _______________.) That person would likely be under
cardiologist the care of a _________________.
fatty or lipid 5.7 Atherosclerosis is a condition in which hardened ____________
paste ____________ builds up inside blood vessels.
5.8 A phlebotomist is someone trained to draw blood samples
veins from the ___________. This term comes from the combining form
phleb/o, vein _____________, meaning __________.
varic/o 5.9 Varicose veins, from the combining form ______________,
are so named because they are swollen and twisted.
ven/o 5.10 Veins (named from the combining form __________) return
blood to the heart from all around the body. Based on the root arteri/o,
arteries ________________ carry blood in the other direction (from the heart
to the body or lungs).
5.11 The heart is located in the chest, behind the area of the
pectoral muscle. The pectoral muscles get their name from the
pector/o combining form ______________, which means chest. Another
steth/o combining form that means chest is ___________, which is the subject
of the term stethoscope, an instrument used to listen to the heart or
to breathing within the chest.
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ANSWERS REVIEW
atria 5.12 The heart has four chambers: two ventricles and two ________,
which is the plural form of atrium. Atrium comes from the
atri/o combining form __________, and ventricle comes from the combining
ventricul/o form _________________.
aorta 5.13 The __________, from the combining form aort/o, is the large
blood vessel through which blood leaves the heart for delivery to all
parts of the body. The coronary arteries branch from the aorta and
myocardium supply the heart’s muscular tissue, or the ________________, with
circle or crown blood. The original meaning of coron/o refers to a _____________.
coronary The _________________ arteries are so named because they seem to
encircle the heart like a crown.
5.14 Each beat of the heart produces a pulse. The combining form
sphygm/o that means pulse is ________________. This is the key combining
form in the term sphygmomanometer, an instrument that measures
blood pressure (BP) based on its pressurized pulse through an artery.
veins Arteries and _________ are the two types of larger blood vessels. Along
with the capillaries, they are sometimes referred to collectively as the
vascul/o vasculature, from the combining form _______________, meaning
vessel.
Self-Instruction: Anatomic TermsStudy the following:
TERM MEANING
SEPTA AND LAYERS OF THE HEART (see Fig. 5-1)
atrium upper right or left chamber of the hearta�tre-um
endocardium membrane lining the cavities of the hearten-do-kar�de-um
epicardium membrane forming the outer layer of the heartep-i-kar�de-um
interatrial septum partition between the right and left atriain-ter-a�tre-al sep�tum
interventricular septum partition between the right and left ventriclesin-ter-ven-trik�yu-lar sep�tum
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 213
TERM MEANING
myocardium heart musclemı�o-kar�de-um
pericardium protective sac enclosing the heart composed of two layersper-i-kar�de-um with fluid between
visceral pericardium layer closest to the heart (visceral � pertaining to organ)vis�er-al per-i-kar�de-um
parietal pericardium outer layer (parietal � pertaining to wall)pa-rı�e-tal per-i-kar�de-um
pericardial cavity fluid-filled cavity between the pericardial layersper-i-kar�de-al kav�i-te
ventricle lower right or left chamber of the heartven�tri-kel
VALVES OF THE HEART AND VEINS (see Fig. 5-1)
heart valves structures within the heart that open and close with thehart valvz heartbeat to regulate the one-way flow of blood
aortic valve heart valve between the left ventricle and the aortaa-or�tik valv
mitral valve heart valve between the left atrium and the left ventriclemı�tral valv (cuspis � point)bicuspid valvebı-kus�pid valv
pulmonary semilunar valve heart valve opening from the right ventricle to the pulmonarypul�mo-nar-e sem-e-lu�nar valv artery (luna � moon)
tricuspid valve valve between the right atrium and the right ventricletrı-kus�pid valv
valves of the veins valves located at intervals within the lining of veins, especiallyvalvz of the vanz in the legs, which constrict with muscle action to move the
blood returning to the heart
BLOOD VESSELS (Fig. 5-3)
arteries (Fig. 5-4) vessels that carry blood from the heart to the arteriolesar�ter-ez
aorta large artery that is the main trunk of the arterial system a-or�ta branching from the left ventricle
arterioles small vessels that receive blood from the arteriesar-ter�e-olz
capillaries tiny vessels that join arterioles and venuleskap�i-lar-ez
venules small vessels that gather blood from the capillaries intoven�ulz the veins
veins (Fig. 5-5)vanz vessels that carry blood to the heart from the venules
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Arteriole
Venule Lymph node
Lymphcapillaries
Tissue cells Blood capillaries
Lymph vessels
Lungs
Valve
Vein
Heart
Artery
ArterioleVenule
Deoxygenated blood
Oxygenated blood
Valve
FIGURE 5-3 ■ Blood and lymph circulation.
TERM MEANING
CIRCULATION
systemic circulation circulation of blood throughout the body via arteries,sis-tem�ik sır-kyu-la�shun arterioles, capillaries, venules, and veins to deliver oxygen and
nutrients to body tissues
coronary circulation circulation of blood through the coronary blood vessels to kor�o-nar-e sır-kyu-la�shun deliver oxygen and nutrients to the heart muscle tissue
(see Fig. 5-2)
pulmonary circulation circulation of blood from the pulmonary artery through thepul�mo-nar-e sır-kyu-la�shun vessels in the lungs and back to the heart via the pulmonary
vein, providing for the exchange of gases
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 215
Endothelium
Subendothelial layerTunicaintima
Internal elastic lamina
Tunica media
Tunica externa
Artery
ARTERIAL BLOOD CIRCULATION
Carotid artery
Arteries (carry blood from the heart)
Brachialartery
Arch of aorta
Pulmonaryartery
Aorta
Femoralartery
Normal Doppler color flow study ofinternal carotid artery
Abnormal Doppler color flow studyshowing occlusion of carotid artery
FIGURE 5-4 ■ Arteries.
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Veins (carry blood to the heart)
Tunica intima
Endothelium
SubendotheliallayerInternal elasticlamina
Tunica media
Tunica externa
Vein
VENOUS CIRCULATION
Color flow Doppler showing femoral vein thrombus
FEMORAL THROMBUS
Artery
Vein
Thrombus
Jugular vein
Subclavian vein
Superiorvena cava
Inferiorvena cava
Cephalicvein
Femoralvein
FIGURE 5-5 ■ Veins.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 217
Programmed Review: Anatomic Terms
ANSWERS REVIEW
atri/o 5.15 The term atrium is from the combining form __________.
atria The plural form of this word is __________. The right and left atria
upper are the ______________ chambers of the heart.
within 5.16 Recall that the prefix endo- means ____________. Combined
heart with cardi/o, it refers to something within the ___________. The
tissue endocardium is the structure or _____________ that lines the cavities
-ium of the heart. The suffix denoting structure or tissue is _______.
epi- 5.17 A common prefix that means upon is ________. Combined
suffix with cardi/o and the ___________ -ium, it forms the term epicardium,
structure, tissue which is the ________________ or _____________ forming the outer
layer of the heart.
muscle 5.18 My/o is a combining form meaning ____________. The term
myocardium for heart muscle tissue is ________________.
around 5.19 Peri- is a prefix that means _____________. The pericardium
heart is a protective sac that encloses the ___________. It has two layers
with fluid between. Using the term that means pertaining to organ,
the layer closest to the heart is called the visceral pericardium. The
outer layer uses the term that means pertaining to wall and is called
pericardium the parietal ________________. Using the term that means pertaining
to the pericardium, the fluid-filled space between these two layers is
pericardial called the _______________ cavity.
5.20 The ventricles of the heart are so named from the combining
ventricul/o form ________________, meaning belly or pouch. The ventricles are
lower the two __________ chambers of the heart.
5.21 The term septum refers to an anatomic partition. The
between interatrial septum is the partition ______________ the left and right
atria __________. Between the left and right ventricles is the
interventricular _____________________ septum. The two atria and two ventricles are
chambers the four _____________ of the heart.
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ANSWERS REVIEW
5.22 The one-way blood flow from one heart chamber to another,
or from a heart chamber to an artery, is regulated by heart
valves ____________, which open and close as the heart beats. The valve
aortic between the left ventricle and the aorta is called the ____________
valve.
bicuspid 5.23 The mitral, or _______________, valve is between the left
atrium and the left ventricle. The tricuspid valve is between the
right, right ____________ atrium and the ____________ ventricle.
5.24 The pulmonary semilunar valve is between the right ventricle
pulmonary and the _________________ artery.
5.25 Other valves that open and close with muscle action to move
veins blood back to the heart are known as the valves of the ___________.
5.26 The names of blood vessels are easy to remember because
arteries they are similar to the combining forms. The ______________, which
carry blood from the heart, get their name from the combining form
arteri/o. The veins, which carry blood to the heart, are so named from
ven/o the combining form __________.
arterioles 5.27 The ________________, also from the combining form arteri/o,
are the small vessels that receive blood from the arteries. The blood
capillaries then flows to the ____________________, the tiniest vessels. Next, the
venules blood is gathered from the capillaries into the _____________,
which are small vessels that connect to the veins. The suffixes -ole
small and -ule are used to indicate something __________.
5.28 As blood leaves the heart to be distributed to the rest of the
aorta body, it first passes through the __________, a large artery that leads
to the arteries that will carry the blood throughout the body.
5.29 The term circulation refers to the flow of blood through the
vessels. Blood flow through the body (except the lungs) is called
systemic _______________ circulation. Pulmonary circulation is blood flow
lungs through the ____________. Blood flow to the heart muscle, based on
coronary the combining form coron/o, is called _________________
circulation.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 219
Self-Instruction: Blood Pressure TermsStudy the following:
TERM MEANING
diastole to expand; period during the cardiac cycle when blood entersdı-as�to-le the relaxed ventricles from the atria
systole to contract; period during the cardiac cycle when the heart issis�to-le in contraction and blood is ejected through the aorta and the
pulmonary artery
normotension normal blood pressurenor-mo-ten�shun
hypotension low blood pressurehı�po-ten�shun
hypertension (HTN) high blood pressurehı�per-ten�shun
Programmed Review: Blood Pressure Terms
ANSWERS REVIEW
BP 5.30 Blood pressure, which is abbreviated as _________, is a
measurement of the pressure on the walls of the arteries during
systole, diastole contraction (_____________) and relaxation (________________) of
the heart (Fig. 5-6).
FIGURE 5-6 ■ Blood pressure determination.
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ANSWERS REVIEW
blood pressure 5.31 When BP, or ____________ _____________, is recorded, the
systole contraction phase, or ____________, is written first, followed by a
diastole slash, followed by the relaxation phase, or ______________. The
suffix, pertaining ____________ -ic is used to modify the terms to mean _______________
to ____. The term that means pertaining to the contraction phase is
systolic _____________, and the term that means pertaining to the relaxation
diastolic phase is _______________.
5.32 A blood pressure of 120/80 or below is considered to be a
normo normal blood pressure and is termed _________tension. The numbers
120, 80 reflect a systolic reading of ______ and a diastolic reading of ______.
hyper High blood pressure is called __________tension, and low blood
hypo pressure is called __________tension.
CARDIAC CONDUCTIONCardiac conduction provides the electrical stimulus that is necessary to cause the heart muscle topump blood by the continual contraction (systole) and relaxation (diastole) of myocardial cells(Fig. 5-7).
Repeated electrical impulses are conducted:
from the sinoatrial (SA) node (the pacemaker of the heart)T
to the atrioventricular (AV) nodeT
to the bundle of HisT
to the left and right bundle branchesT
to the Purkinje fibers
The impulses cause each myocardial cell to change:
from a resting state (polarized)T
to a state of contraction (depolarized)T
then back to a resting state by recharging (repolarizing)
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 221
A
SA node
Right bundle
Left bundle
Purkinje fibers
Bundle of His
AV node
B
SAnode
Firing from SA node across atria (contraction of atria) to AV node
Firing from AV node to bundle of His,down right and left bundle branches
Firing of Purkinje fibers showing contraction of ventricles
AV node
Purkinjefibers
Bundle of His
FIGURE 5-7 ■ Cardiac conduction. A. Anatomy. B. Path of conduction. (AV � atrioventricular; SA � sinoatrial.)
Self-Instruction: Cardiac Conduction TermsStudy the following:
TERM MEANING
sinoatrial (SA) node the pacemaker; highly specialized, neurological tissue sı�no-a�tre-al nod impeded in the wall of the right atrium; responsible for initiat-
ing electrical conduction of the heartbeat, causing the atria tocontract and firing conduction of impulses to the AV node
atrioventricular (AV) node neurological tissue in the center of the heart that receives anda�tre-o-ven-trik�yu-lar nod amplifies the conduction of impulses from the SA node to the
bundle of His
bundle of His neurological fibers extending from the AV node to the rightbun�de l of hiz and left bundle branches that fire the impulse from the AV
node to the Purkinje fibers
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TERM MEANING
Purkinje fibers fibers in the ventricles that transmit impulses to the right andper-kin�je f ı�berz left ventricles, causing them to contractPurkinje networkper-kin�je net�work
polarization resting; resting state of a myocardial cellpo�lar-i-za�shun
depolarization change of a myocardial cell from a polarized (resting) state tode-po�lar-i-za�shun a state of contraction (de � not; polarization � resting)
repolarization recharging of the myocardial cell from a contracted state backre�po-lar-i-za�shun to a resting state (re � again; polarization � resting)
normal sinus rhythm (NSR) regular rhythm of the heart cycle stimulated by the SA nodenor�mal sı�nus rith�um (average rate of 60–100 beats/minute) (see Fig. 5-11)
Programmed Review: Cardiac Conduction Terms
ANSWERS REVIEW
5.33 Review Figure 5-7. The term SA node refers to the
sinoatrial ______________ node, which is where the heart’s electrical impulse
originates. This impulse is conducted to the atrioventricular, or
AV, atri/o _____, node, a term made from the combining forms _________
ventricul/o and ________________.
5.34 The impulse then moves from the bundle of His down the
Purkinje right and left bundle branches to the ________________ fibers, which
contract transmit impulses to the ventricles and cause them to _____________.
This rhythmic contraction is the heartbeat.
muscle 5.35 The combining form my/o means ___________, and the
heart combining form cardi/o means _____________. Myocardial cells
heart muscle comprise the __________ _______________.
5.36 The resting state of the myocardial cells is called polarization.
depolarization When each cell contracts, it changes to a state of __________________.
repolarization The stage of _________________ is the change back to a resting state.
5.37 The normal regular heart rhythm produced by this continued
simulation of heart muscle by electrical impulses originating in
sinoatrial, normal the ______________, or SA, node is called _____________
sinus ___________ rhythm, or NSR.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 223
Self-Instruction: Symptomatic TermsStudy the following:
TERM MEANING
aneurysm (Fig. 5-8) a widening; a bulging of the wall of the heart, aorta, or arteryan�yu-rizm caused by a congenital defect or acquired weakness
saccular aneurysm a sac-like bulge on one sidesak-yu-lar an�yu-rizm
fusiform aneurysm a spindle-shaped bulgefyu�si-form an�yu-rizm
dissecting aneurysm a split or tear of the vessel walldi-sek�ting an�yu-rizm
angina pectoris chest pain caused by a temporary loss of oxygenated blood toan�ji-na pek�to-ris heart muscle; often caused by narrowing of the coronary
arteries (angina � to choke)
arteriosclerosis thickening, loss of elasticity, and calcification (hardening) of ar-ter�e-o-skler-o�sis arterial walls
atherosclerosis a form of arteriosclerosis characterized by the buildup of fattyath�er-o-skler-o�sis substances that harden within the walls of arteries
atheromatous plaque a swollen area within the lining of an artery caused by the(Fig. 5-9, A) buildup of fat (lipids)ath-er-o�ma-tus plak
claudication to limp; pain in a limb (especially the calf) while walking thatklaw-di-ka�shun subsides after rest; caused by inadequate blood supply
constriction (see Fig. 5-9, A) compression of a part that causes narrowing (stenosis)kon-strik�shun
diaphoresis profuse sweating (perspiration)dı�a-fo-re�sis
Normal artery
Common types of aneurysms
Saccular Fusiform Dissecting
Artery with aneurysm
FIGURE 5-8 ■ Common types of aneurysms.
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FIGURE 5-9 ■ A. Examples of conditions causing a reduction in blood flow.B. Effects of reduced blood flow.
Constriction Atheromatous plaque
Thrombus Embolus
A
B
Ischemia
Oxygen-deficient tissue cells
Obstruction
Dead tissue cellsOxygenated tissue cells
Oxygenatedtissue cells
Occlusion
Infarction
TERM MEANING
embolus (see Fig. 5-9, A) a clot (e.g., air, fat, or a foreign object) carried in theem�bo-lus bloodstream that obstructs the flow of blood when it lodges
(embolus � a stopper)
heart murmur an abnormal sound from the heart produced by defects in thehart mur�mur chambers or valves
infarct (see Fig. 5-9, B) to stuff; a localized area of necrosis (condition of tissue death)in�farkt caused by ischemia resulting from occlusion of a blood vessel
ischemia (see Fig. 5-9, B) to hold back blood; decreased blood flow to tissue caused byis-ke�me-a constriction or occlusion of a blood vessel
perfusion deficit lack of flow through a blood vessel caused by narrowing,per-fyu�zhun def �i-sit occlusion, etc.
occlusion (see Fig. 5-9, B) plugging; an obstruction or a closing offo-klu�zhun
palpitation subjective experience of pounding, skipping, or racingpal-pi-ta�shun heartbeats
stenosis condition of narrowing of a partste-no�sis
thrombus (see Fig. 5-9, A) a stationary blood clotthrom�bus
vegetation (Fig. 5-10) to grow; an abnormal growth of tissue around a valve,vej-e-ta�shun generally as a result of infection
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 225
FIGURE 5-10 ■ The mitral valve shows destructivevegetations, which have eroded through the free mar-gins of the valve leaflets in a patient with bacterialendocarditis.
Programmed Review: Symptomatic Terms
ANSWERS REVIEW
hard 5.38 Scler/o, a combining form meaning __________, is a key
component in the term arteriosclerosis, which refers to thickening,
artery or arterial loss of elasticity, and hardening of ____________ walls. Ather/o, a
fatty or lipid combining form meaning ___________ paste, is used in the term that
specifically describes a condition or increase of hardened fatty
atherosclerosis substances built up within the walls of arteries: ____________________.
embolus 5.39 An ____________ is a clot of any sort carried in the bloodstream
that obstructs the flow of blood when it lodges. A thrombus, on the
stationary other hand, is a _______________ blood clot.
5.40 Blood flow through a vessel can be affected by various kinds
of restrictions. A condition or increase of narrowing is called
stenosis ___________. Stenotic conditions can be the result of a compression
constriction or ______________of a vessel. A buildup of atherosclerotic substances
narrowing can also cause stenosis, a condition of _______________. An
plugging or obstruction occlusion, which is the ________________ of a vessel, also might occur.
ischemia 5.41 If blood flow is reduced to tissue, ____________ occurs. When
diagnostic tests detect the lack of blood flow from a vessel to tissue
deficit cells, it is called a perfusion ___________. Perfusion refers to tissues
with an adequate circulation of blood.
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226 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
ANSWERS REVIEW
5.42 A heart condition of chest pain may occur when a temporary
or transient restriction of blood flow to heart muscle occurs, which is
angina called ____________ pectoris. Recall that the combining form
pector/o _____________ refers to the chest. Therefore, this chest pain is called
angina pectoris.
5.43 When prolonged or total ischemia occurs in an area, tissue
death necrosis or _________ results. The area of scarring from necrosis is
infarct called an ____________.
5.44 An aneurysm can occur in the heart or a blood vessel because
bulge or widen of a weakness in the wall. This causes the wall to ___________. The
saccular type of aneurysm with a sac-like bulge is called a ______________
aneurysm. If the bulge causes a split or tear of the vessel wall, it is
dissecting, fusiform called a _______________ aneurysm. The bulge of a ______________
aneurysm is spindle-shaped.
5.45 Various symptoms help cardiologists to determine what
pain condition a patient is experiencing. Claudication is ________ in a
limb, sometimes causing a limp, that results during movement
because of an inadequate blood supply to the limb.
5.46 The subjective symptom of the heart pounding, skipping,
palpitation or racing is called _________________. Be careful not to confuse
this term with palpation, the word meaning to touch or feel.
5.47 Sweating brought on by physical activity or a high-
temperature environment is perfectly normal; however, profuse
diaphoresis sweating, known as ________________, accompanied by chest pain,
shortness of breath, or heart palpitations, is a significant symptom
of heart disease.
5.48 The physician, when listening to the heart through a
stethoscope, might hear an abnormal sound, called a
murmur heart ___________, which is produced by a defect in the heart
chambers or valves.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 227
Self-Instruction: Diagnostic TermsStudy the following:
TERM MEANING
RELATED TO THE HEART AND ARTERIES
acute coronary signs and symptoms indicating an active process ofsyndrome (ACS) atherosclerotic plaque buildup or formation of a thrombus,a-kyut� kor�o-nar-e sin�drom or spasm within a coronary artery, causing a reduction or loss
of blood flow to myocardial tissue; includes unstable angina and other pathological events leading to myocardial infarction (MI); early diagnosis and rapid treatment are critical to avoid or minimize damage to heart muscle
arrhythmia (Fig. 5-11) any of several kinds of irregularity or loss of rhythm of thea-rith�me-a heartbeatdysrhythmiadis-rith�me-a
bradycardia slow heart rate (less than 60 beats/minute)brad-e-kar�de-a
fibrillation chaotic, irregular contractions of the heart, as in atrial orfi-bri-la�shun ventricular fibrillationpremature ventricular a ventricular contraction preceding the normal impulsecontraction (PVC) initiated by the SA node (pacemaker)pre-ma-tur� ven-trik�u-lar kon-trak�shun
tachycardia fast heart rate (greater than 100 beats/minute)tak-i-kar�de-a
bacterial endocarditis a bacterial inflammation that affects the endocardium or thebak-ter�e-al en�do-kar-dı�tis heart valves
cardiac tamponade compression of the heart produced by the accumulation of kar�de-ak tam-po-nad� fluid in the pericardial sac, as results from pericarditis or
trauma, causing rupture of a blood vessel within the heart (tampon � a plug)
cardiomyopathy a general term for disease of the heart muscle, such as kar�de-o-mı-op�a-the alcoholic cardiomyopathy (damage to the heart muscle caused
by excessive consumption of alcohol)
congenital anomaly of malformations of the heart that are present at birth the heart (congenital � born with; anomaly � irregularity)kon-jen�ı-tal ah-nom�ah-le of the hart
atrial septal defect (ASD) an opening in the septum separating the atriaa�tre-al sep�tal de�fekt
coarctation of the aorta narrowing of the descending portion of the aorta, resulting in ko-ark-ta�shun of the a-or�ta a limited flow of blood to the lower part of the body
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228 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
Bradycardia
Fibrillation (ventricular)
Tachycardia (sinus)
Flutter (atrial)
Normal sinus rhythm (NSR)
Premature ventricular contraction (PVC)
FIGURE 5-11 ■ Electrocardiogram (ECG or EKG) tracings showing common typesof arrhythmia.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 229
TERM MEANING
patent ductus arteriosus an abnormal opening between the pulmonary artery and the(PDA) aorta caused by failure of the fetal ductus arteriosuspa�tent duk�tus ar-te’re-o�sus to close after birth (patent � open)ventricular septal defect an opening in the septum separating the ventricles(VSD)ven-trik�yu-lar sep�tal de�fekt
congestive heart failure failure of the left ventricle to pump an adequate amount of(CHF) blood to meet the demands of the body, resulting in a kon-jes�tiv hart fal�yur “bottleneck” of congestion in the lungs that may extend to left ventricular failure the veins, causing edema in lower portions of the bodyleft ven-trik�yu-lar fal�yur
cor pulmonale enlargement of the right ventricle, resulting from chronickor pul-mo-na�le disease within the lungs, that causes congestion within theright ventricular failure pulmonary circulation and resistance of blood flow to therıt ven-trik�yu-lar fal�yur lungs (cor � heart)
coronary artery disease a condition affecting arteries of the heart that reduces the flow (CAD) (Fig. 5-12) of blood and the delivery of oxygen and nutrients to the kor�o-nar-e ar�ter-e di-zez� myocardium; most often caused by atherosclerosis
hypertension (HTN) persistently high blood pressurehı�per-ten�shun
essential hypertension high blood pressure attributed to no single cause;e-sen�shal hı�per-ten�shun risks include smoking, obesity, increased salt intake,primary hypertension hypercholesterolemia, and hereditary factorsprı�mar-e hı�per-ten�shun
secondary hypertension high blood pressure caused by the effects of anothersek�on-dar�e hı�per-ten�shun disease (e.g., kidney disease)
Left anterior descendingartery
Plaque buildup in arterial wall
FIGURE 5-12 ■ Coronary artery disease (CAD).
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230 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
TERM MEANING
mitral valve prolapse protrusion of one or both cusps of the mitral valve back into (MVP) the left atrium during ventricular contraction, resulting inmı�tral valv pro�lapz incomplete closure and backflow of blood
myocardial infarction heart attack; death of myocardial tissue (infarction) caused by(MI) (Fig. 5-13) ischemia (loss of blood flow) as a result of an occlusionmı-o-kar�de-al in-fark�shun (plugging) of a coronary artery; usually caused by
atherosclerosis; symptoms include pain in the chest or upper body (shoulders, neck, and jaw), shortness of breath,diaphoresis, and nausea
myocarditis inflammation of myocardium; most often caused by viral ormı�o-kar-dı�tis bacterial infection
pericarditis inflammation of the pericardiumper�i-kar-dı�tis
rheumatic heart disease damage to heart muscle and heart valves by rheumatic feverru-mat�ik hart di-zez� (a streptococcal infection)
sudden cardiac arrest the abrupt cessation of any cardiac output (CO), most(SCA) commonly as the result of ventricular fibrillation; causessud�den kar�de-ak a-rest� sudden death unless defibrillation is initiated immediately
RELATED TO THE VEINS
deep vein thrombosis (DVT) formation of a clot in a deep vein of the body, occurring mostdep van throm-bo�sis often in the femoral and iliac veins
phlebitis inflammation of a veinfle-bı�tis
thrombophlebitis inflammation of a vein associated with a clot formationthrom�bo-fle-bı�tis
varicose veins (Fig. 5-14) abnormally swollen, twisted veins with defective valves; most var�ı-kos vans often seen in the legs
FIGURE 5-13 ■ Anterolateral myocardial infarction (MI) (darkenedarea), caused by occlusion of anterior descending branch of the leftcoronary artery.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 231
Valve open
A
C
B
Valve closed
Valve closed
Valve opened
Valve closed
Defective valve in varicose veincausing pooling of blood
FIGURE 5-14 ■ Varicose veins. A. Function of valves invenous system. B. Contraction of skeletal muscle causesvalves to open and close, preventing backflow of bloodreturning to heart. C. Varicose veins.
Programmed Review: Diagnostic Terms
ANSWERS REVIEW
inflammation 5.49 The suffix -itis refers to an ____________________. Myocarditis
myocardium therefore means an inflammation of the ___________________.
pericarditis Inflammation of the pericardium is called _________________.
Bacterial endocarditis is a bacterial inflammation affecting the
endocardium _________________ and heart valves.
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232 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
ANSWERS REVIEW
5.50 The condition of reduced blood flow through the arteries
coronary artery that supply the heart muscle is called _______________ _____________
disease ____________ (CAD). It most commonly results from a hardened
buildup of fatty substances within the lining of the arteries, a
atherosclerosis condition known as _____________________.
5.51 Atherosclerotic buildup within the wall of one or more
coronary arteries can lead to a partial or total obstruction, which is
occlusion called an ________________. The resulting loss of blood flow, or
ischemia ______________, deprives the affected heart muscle of the oxygen it
needs to survive. Prolonged ischemia leads to necrosis, the
death ____________ of myocardial tissue. The term describing the death
myocardial infarction of myocardial tissue is ___________________ _________________ (MI),
heart attack which is commonly known as a ____________ ______________.
chest Symptoms of myocardial infarction include angina (__________
pain _________), shortness of breath, nausea, and profuse sweating
diaphoresis (_________________). The abbreviation ACS, which stands for
acute coronary syndrome _______________ ______________ _____________, includes the signs
and symptoms that indicate an active process of the pathological
events leading to myocardial infarction.
muscle 5.52 Myopathy refers to a condition of diseased ____________. The
general term for a condition of diseased heart muscle is
cardiomyopathy __________________.
5.53 The word root tampon means a plug (obstruction), and the
term tamponade refers to an obstruction. A compression of the heart
produced by accumulated fluid in the pericardial sac is called a
tamponade cardiac ________________.
5.54 Another word root that means heart is cor. The condition
pulmonale called cor _______________ is caused by congestion in the pulmonary
circulation that results in right ventricular failure. The right ventricle
enlarged becomes _______________ because of the increased effort to pump
blood to the diseased lungs.
heart 5.55 Congestive _________ failure (CHF) is a failure of the left
ventricle to pump enough blood to the body. This condition is also
failure called left ventricular _______________.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 233
ANSWERS REVIEW
5.56 The term anomaly means irregularity (not normal). The term
with congenital pertains to something a person is born ________. There are
several congenital anomalies of the heart. An atrial septal defect
partition (ASD) is an irregularity in the septum, or ______________, which
atria, ventricular separates the __________. A _________________ septal defect (VSD)
is an opening in the septum separating the ventricles.
5.57 A narrowing of the descending portion of the aorta that
coarctation restricts blood flow to the lower body is called a ________________ of
the aorta.
5.58 Patent ductus arteriosus (PDA) is an abnormal opening
between the pulmonary artery and the aorta. The term patent means
close open. PDA results if the fetal ductus arteriosus fails to ___________
after birth.
5.59 The prefix a- means without. An arrhythmia is a heartbeat
without _____________ a normal rhythm. The synonym for arrhythmia, which
is formed using the prefix describing painful, difficult, or faulty, is
dysrhythmia _______________. There are several types of heart arrhythmias or
brady- dysrhythmias. The prefix meaning slow is __________. Therefore,
slow bradycardia is a condition of _________ heart rate. Tachy- is the prefix
fast, tachycardia meaning _________, so _________________ is a condition of fast
heart rate.
5.60 Fast, chaotic, irregular contractions of the heart occur in a
fibrillation condition called _____________________.
5.61 Another common arrhythmia is a premature ventricular
contraction __________________ (PVC). In this case, the contraction precedes the
node normal impulse initiated by the sinoatrial (SA) _________.
5.62 Ventricular fibrillation is a lethal arrhythmia that causes the
ventricles to quiver rapidly (to fibrillate) instead of contracting and to
be unable to pump blood. The term describing the abrupt cessation
of any cardiac output (CO) as caused by ventricular fibrillation is
sudden cardiac arrest ____________ _____________ ____________ (SCA).
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234 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
ANSWERS REVIEW
5.63 The condition of persistently high blood pressure is called
hypertension, HTN ______________________ and is abbreviated as _______. Primary, or
essential ______________, hypertension cannot be attributed to a single cause.
Secondary _________________ hypertension, however, is caused by another
condition, such as kidney disease.
5.64 Rheumatic fever can cause damage to heart muscle and valves.
rheumatic This is called _______________ heart disease.
vein 5.65 Phleb/o is a combining form for ________. Combined with the
phlebitis suffix for inflammation, this forms the term _________________,
which means inflammation of a vein. If that inflammation is
associated with a clot formation, the condition is called
thrombophlebitis ____________________.
5.66 The condition of a formed clot in a deep vein of the body is
deep vein thrombosis called __________ __________ ________________ (DVT). The
thrombus danger of any clot (_____________) formation in a vein is that it can
embolus break loose to become a traveling ______________.
Self-Instruction: Diagnostic Tests and ProceduresStudy the following:
TEST OR PROCEDURE EXPLANATION
auscultation (Fig. 5-15) physical examination method of listening to sounds withinaws-kul-ta�shun the body with a stethoscope (e.g., auscultation of the chest
for heart and lung sounds)gallop abnormal heart sound that mimics the gait of a horse; relatedgal�op to abnormal ventricular contraction
FIGURE 5-15 ■ Auscultating heart sounds.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 235
TEST OR PROCEDURE EXPLANATION
electrocardiogram (ECG an electrical picture of the heart represented by positive andor EKG) (Fig. 5-16; negative deflections on a graph labeled with the letters P, Q,see Fig. 5-11) R, S, and T, which correspond to events of the cardiac cyclee-lek-tro-kar�de-o-gram
stress electrocardiogram electrocardiogram (ECG or EKG) of the heart recorded during(stress ECG or EKG) the induction of controlled physical exercise using a treadmill(Fig. 5-17) or ergometer (bicycle); useful in detecting heart conditionsstres e-lek-tro-kar�de-o-gram (e.g., ischemia or infarction)Holter ambulatory portable electrocardiograph worn by the patient that monitorsmonitor electrical activity of the heart over 24 hours; useful inhol�ter am�byu-la-tor-e detecting periodic abnormalitiesmon�i-tor
intracardiac invasive procedure involving placement of catheter-guidedelectrophysiological electrodes within the heart to evaluate and map the electricalstudy (EPS) conduction of cardiac arrhythmias; intracardiac catheterin�tra-kar�de-ak ablation may be performed at the same time to treat the e-lek�tro-fiz�e-o-loj�i-kal stud�e arrhythmia
intracardiac catheter use of radiofrequency waves sent through a catheter withinablation the heart to treat arrhythmias by selectively destroyingin�tra-kar�de-ak kath�e-ter myocardial tissue at sites that generate abnormal electricalab-la�shun pathways
P
A
R
S-Tsegment
P-Rinterval
T
Q
QRScomplex
Q-T interval
S
U
B
FIGURE 5-16 ■ A. Electrocardiographic conduction. B. Resting electrocardiogram (ECG or EKG).
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236 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
TEST OR PROCEDURE EXPLANATION
magnetic resonance magnetic resonance imaging of the heart and blood vesselsangiography (MRA) for evaluation of pathology (see Fig. 8-15)mag-net�ik rez�o-nants an-je-og�ra-fe
nuclear medicine imaging radionuclide organ imaging of the heart after administrationnu�kle-ar med�i-sin im�a-jing of radioactive isotopes to visualize structures and to analyze
functionsmyocardial radionuclide scan of the heart made after an intravenous (IV) injection ofperfusion scan an isotope (e.g., thallium) as it is absorbed by myocardial cellsmı-o-kar�de-al ra�de-o-nu�klıd in proportion to blood flow throughout the heart; useful inper-fyu�zhun skan evaluating coronary artery disease (CAD)
myocardial nuclear perfusion scan of the heart that is made before andradionuclide after the induction of controlled physical exercise (treadmillperfusion stress scan or bicycle) or a pharmaceutical agent that produces the effect mı-o-kar�de-al of exercise stress in patients who are unable to ambulatera�de-o-nu�klıdper-fyu�zhun stres skan
multiple-gated nuclear image of the beating heart in motion made asacquisition (MUGA) scan radioactive isotopes are injected in the bloodstream andmul�ti-pul-gat�ed traced through the heart’s chambers; useful in evaluatingak-wi-zish�un skan the pumping function of the ventricles
FIGURE 5-17 ■ Stress electrocardiography.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 237
TEST OR PROCEDURE EXPLANATION
positron-emission use of specialized nuclear isotopes and computedtomography (PET) scan tomographic techniques to produce perfusion (blood flow)of the heart images and to study the cellular metabolism of the heart; canpoz�i-tron-e-mish�un be performed at rest or with stressto-mog�ra-fe skan of the hart
radiology x-ray imagingra-de-ol�o-je
angiography process of x-ray imaging a blood vessel after injection of an-je-og�ra-fe contrast medium, most commonly after catheter placementangiogram record obtained by angiographyan�je-o-gram
coronary angiogram x-ray image of the blood vessels of the heart using akor�o-nar-e an�je-o-gram catheter to inject contrast (see Fig. 5-2)arteriogram x-ray image of a particular artery (e.g., coronary arteriogramar-ter�e-o-gram or renal arteriogram)aortogram x-ray image of the aortaa-or�to-gram
venogram x-ray image of a veinve�no-gram
cardiac catheterization introduction of a flexible, narrow tube (or catheter) through(Fig. 5-18) a vein or artery into the heart to withdraw samples of blood,kar�de-ak kath�e-ter-ı-za�shun to measure pressures within the heart chambers or vessels,
and to inject contrast media for fluoroscopic radiographyand cine film (motion picture) imaging of the chambers of theheart and coronary arteries; often includes interventional pro-cedures, such as angioplasty and atherectomy (see percuta-neous coronary intervention [PCI] procedures listed underSelf-Instruction: Operative Terms)
left heart catheterization x-ray imaging of the left ventricular cavity and coronaryleft hart kath�e-ter-ı-za�shun arteriesright heart measurement of oxygen saturation and pressure readings ofcatheterization the right side of the heartrıt hart kath�e-ter-ı-za�shun
ventriculogram x-ray image of the ventriclesven-trik�u-lo-gram
stroke volume (SV) measurement of the amount of blood ejected from a ventriclestrok vol�yum in one contractioncardiac output (CO) measurement of the amount of blood ejected per minutekar�de-ak owt�put from either ventricle of the heartejection fraction measurement of the volume percentage of left ventriculare-jek�shun frak�shun contents ejected with each contraction
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238 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
Upper thigh insertion
Antecubitalvein
Brachial artery
Femoral vein
Femoral artery
Arm insertion
A
B
C
FIGURE 5-18 ■ Cardiac catheterization. A. Possible insertion sites for cardiac catheteriza-tion. B. Angiographic catheters. (Photo courtesy of Cook Incorporated, Bloomington, IN.) C. Cardiac catheterization laboratory.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 239
TEST OR PROCEDURE EXPLANATION
computed tomographic specialized, noninvasive, three-dimensional (3-D) computedangiography (CTA) tomographic scan of the heart and circulation of the(Fig. 5-19) “greater” blood vessels, such as the coronary arteries, aorta,kom-pyu�ted to-mo-graf�ik and pulmonary veins; performed with or without contrastan-je-og�ra-fe
sonography sonographic imagingso-nog�ra-fe
echocardiography recording of sound waves through the heart to evaluate(echo) (Fig. 5-20) structure and motion (see Fig. 5-1)ek�o-kar-de-og�ra-fe
stress echocardiogram echocardiogram of the heart recorded during the induction of(stress echo) controlled physical exercise (treadmill or bicycle) or astres ek-o-kar�de-o-gram pharmaceutical agent that produces the effect of exercise
stress in patients who are unable to ambulate; useful indetecting conditions such as ischemia or infarction
transesophageal echocardiogram of the heart after placement of an ultrasonicechocardiogram (TEE) transducer at the end of an endoscope inside the esophagustrans-e-sof�aj-e-al ek-o-kar�de-o-gram
Doppler sonography ultrasound technique used to evaluate blood flow todop�ler so-nog�ra-fe determine the presence of a deep vein thrombosis (DVT) or
carotid insufficiency, or to determine flow through the heart,chambers, valves, and so on (see Figs. 5-4 and 5-5)
FIGURE 5-19 ■ Computed tomographic angiography (CTA) of normalheart. Arrows point to right coronary artery (RCA), left main coronaryartery, diagonal artery, and left anterior descending artery (LAD)
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240 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
FIGURE 5-20 ■ Echocardiography (echo).
Programmed Review: Diagnostic Tests and Procedure
ANSWERS REVIEW
chest 5.67 Recall that the combining form steth/o means ____________,
stethoscope and that a __________________ is an instrument for listening to
sounds within the chest or elsewhere in the body. This procedure,
auscultation from the Greek word meaning to listen, is called __________________.
5.68 Auscultation can be used to detect a heart murmur or other
abnormal heart sound, such as that which mimics the gait of a horse,
gallop called a ____________.
record 5.69 The suffix -gram refers to a ____________. The combining
heart form cardi/o refers to the ____________. A record of the electrical
electrocardiogram conductivity of the heart is called an _________________________
(ECG or EKG). A special kind of electrocardiogram obtained during
stress the physical stress of exercise is called a ____________
electrocardiogram ________________________.
vessel 5.70 The combining form angi/o refers to a _____________. The
suffix -graphy refers to the diagnostic process of making a record,
such as by x-ray imaging. The process of x-ray imaging a blood
angiography vessel is called __________________, and the record itself is called an
angiogram __________________. A coronary angiogram is an x-ray image of
heart the blood vessels encircling the _____________.
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 241
ANSWERS REVIEW
5.71 An x-ray of a particular artery is called an arteriogram. An
aortogram x-ray image of the aorta is called an ________________. An x-ray
venogram image of a vein is called a ________________.
5.72 A catheter can be introduced into the heart for diagnostic
cardiac catheterization purposes. This process is called ____________ ____________________.
Left heart catheterization is usually done to obtain a radiograph of
right the left ventricular cavity and coronary arteries, and _________ heart
oxygen catheterization is usually done to measure ____________ saturation
and pressure.
ventriculogram 5.73 An x-ray image of the ventricles is called a _________________,
-gram from the combining form ventricul/o and the suffix _________.
5.74 Cardiac catheterization also allows for measurement of stroke
volume (SV), or how much blood is ejected from a ventricle in one
contraction, output ________________. Cardiac ____________ (CO) measures the amount
of blood ejected per minute from either ventricle; ejection fraction
left measures the volume percentage of the ________ ventricular contents
ejected _____________ with each contraction.
magnetic 5.75 The abbreviation MRI stands for _______________
resonance imaging _________________ _____________. The abbreviation MRA stands
angiography for magnetic resonance __________________, which is specialized
imaging of the heart and blood vessels. The abbreviation CT stands
computed tomography for ______________ _________________. The process abbreviated as
three-dimensional or 3-D CTA provides a specialized __________-_________________________
heart x-ray image of the ___________ and greater vessels.
radionuclide 5.76 Nuclear medicine imaging, or _________________
organ imaging ___________ ______________, uses radioactive isotopes to visualize
function body structures and to analyze ______________. A myocardial
radionuclide __________________ perfusion scan is made of the
heart, intravenous ___________ after __________________ (IV) injection of an isotope
myo, blood is absorbed by ______cardial cells in proportion to ___________ flow.
A MUGA scan provides a nuclear image of the beating heart in
motion, pumping __________ and is useful in evaluating the ____________ function of
positron the ventricles. The abbreviation PET stands for ______________
emission tomography ________________ __________________, which is a nuclear scan that
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242 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
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isotopes uses radioactive ______________ and computed tomographic (CT)
technology. PET is used in cardiology to study the cellular
metabolism of the heart. These scans can be made with the patient
stress at rest or after exercise or ___________.
ultrasound 5.77 Sonography, or diagnostic _________________, is the imaging
sound modality using high-frequency ____________ waves to visualize body
tissues. The recording of sound waves through the heart to evaluate
echo structure and motion is called _______cardiography.
5.78 A record of the heart made with echocardiography (echo) is
echocardiogram called an __________________________. If made during controlled
stress exercise, it is called a _____________ echocardiogram. If made after
passing the transducer through the esophagus, it is called a
transesophageal ________________________ echocardiogram (TEE).
5.79 The type of sonography that uses ultrasound to evaluate
Doppler blood flow is called _______________ sonography.
within, heart 5.80 Intracardiac means pertaining to ____________ the __________.
Physiological means pertaining to function. The invasive procedure
involving the placement of a catheter within the heart to map the
arrhythmias electrical conduction of cardiac dysrhythmias, or _________________,
electrophysiological is abbreviated as EPS, which stands for intracardiac _________________
study ___________. The myocardial tissue generating abnormal electrical
pathways can be treated at the time of an intracardiac
electrophysiological study by using high-frequency waves sent
through a catheter to ablate or destroy myocardial tissue responsible
for generating the abnormal conduction. This treatment is called
intracardiac, ablation _________________ catheter _______________.
Self-Instruction: Operative TermsStudy the following:
TERM MEANING
PROCEDURES PERFORMED IN THE TRADITIONAL OPERATING ROOM
coronary artery bypass grafting a portion of a blood vessel retrieved from anothergraft (CABG) (Fig. 5-21) part of the body (e.g., a length of saphenous vein from the legkor�o-nar-e ar�ter-e bı�pas graft or mammary artery from the chest wall) to bypass an occluded
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 243
A. Common sites for bypass grafts
B. Bypass process
Aorta Internal mammary artery graft
Internal mammary artery graft
Saphenous vein grafts
Chest incision
1. 2.
Bypass graft
Blocked artery
3. Bypass incisionsAn incision is made in the chest, dividing the sternum to allow access to the heart.
Bypass vesselsThe long saphenous vein in the leg can be used to make several bypasses, if needed. The internal mammary artery may also be used as a graft. Both are “excess” blood vessels the body does not need.
Bypass graftingGrafting is performed under magnification using extremelyfine sutures. Each graft is sewnto the aorta, except for the internal mammary artery, whichalready originates from a branchof the aorta. The other end is sewn to the artery below the blockage.
Saphenous vein
FIGURE 5-21 ■ Traditional method of coronary artery bypass graft (CABG). A. Common sites forbypass grafts. B. Bypass grafting.
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244 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
TERM MEANING
coronary artery, restoring circulation to myocardial tissue; thetraditional method includes temporary arrest of the heart withcirculation (bypass) of the patient's blood through a heart-lung machine during the procedure; an alternative, off-pumpapproach uses a stabilizer to perform the procedure on thebeating heart; the abbreviation CABG is pronounced“cabbage”
anastomosis opening; the joining of two blood vessels to allow flowa-nas�to-mo�sis from one to the other
endarterectomy surgical removal of the lining of an artery to clear a blockageend’ar-ter-ek�to-me caused by a clot or atherosclerotic plaque buildup
valve replacement surgery to replace a diseased heart valve with an artificialvalv re-plas�ment valve; there are two types of artificial valves: tissue valves, most
commonly made from animal tissue (e.g., porcine [pig] orbovine [cow]), and mechanical valves, made from syntheticmaterial
valvuloplasty surgical repair of a defective heart valveval�vyu-lo-plas-te
PROCEDURES PERFORMED IN A CATHETERIZATION LABORATORY
percutaneous coronary interventional procedures used to treat coronary arteryintervention (PCI) disease (CAD) performed at the time of cardiac(Fig. 5-22) catheterization in a specialized laboratory setting (or “cathper-kyu-ta�ne-yus kor�o-nar�e lab”) instead of the traditional operating roomin�ter-ven�shun
angioscopy use of a flexible fiberoptic angioscope (accompanied by anan-je-os�ko-pe irrigation system, camera, video recorder, and monitor) thatvascular endoscopy is guided through a specific blood vessel to visually assess vas�kyu-lar en-dos�ko-pe a lesion and to select the mode of therapyatherectomy excision of atheromatous plaque from within an artery(see Fig. 5-22, A) utilizing a device housed in a flexible catheter thatath-e-rek�to-me selectively cuts away or pulverizes tissue builduppercutaneous a method for treating the narrowing of a coronary artery bytransluminal coronary inserting a specialized catheter with a balloon attachment,angioplasty (PTCA) then inflating the balloon to dilate and open the narrowed(see Fig. 5-2) portion of the vessel and restore blood flow to theper-kyu-ta�ne-us myocardium; most often includes the placement of a stenttranz�lu-men�al kor�o-nar-e an�je-o-plas-te
intravascular stent implantation of a device used to reinforce the wall of aplacement vessel and assure its patency (openness); most often used to(see Fig. 5-22, B) treat a stenosis or a dissection (a split or tear in the wall ofin�tra-vas�kyu-lar stent a vessel) or to reinforce patency of a vessel after angioplastyplas�ment
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 245
Transluminalextraction catheter
A
Diamond-coated burr
Drive cable
Rotational catheter Directional catheter
Guide wire
Cutting blade
Guide wire
Balloon
Nose cone(collection chamber)
Cutter
Guide wire
B
Stent delivered Stent expanded Stent in place
Atheromatousdebris
FIGURE 5-22 ■ Examples of devices used in percutaneous coronary interventional proce-dures. A. Atherectomy devices. B. Intravascular stent.
Programmed Review: Operative Terms
ANSWERS REVIEW
5.81 The suffix -scopy refers to the process of examination.
vessel Angioscopy is the examination of a blood ___________ using a
angioscope fiberoptic _________________.
-ectomy 5.82 The suffix ___________ refers to removal or excision. Removal
atherectomy of an atheromatous plaque is called an ____________________. Using
the prefix endo-, the term for the surgical removal of the lining of an
endarterectomy artery is an ____________________.
bypass 5.83 CABG is the abbreviation for a coronary artery ___________
graft __________, in which a portion of a blood vessel is grafted in place to
bypass an occluded coronary artery.
vessels 5.84 An anastomosis is the joining of two blood _____________ to
allow flow from one to the other.
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5.85 The suffix -plasty refers to a surgical repair or reconstruction.
valvuloplasty A __________________ is the repair of a defective heart valve. Valve
replacement describes the replacement of a diseased heart valve with
an artificial valve. Types of artificial valves include mechanical ones,
tissue made from synthetic material, and ___________ valves made from
pig, cow animal tissue, such as porcine (_______) or bovine (________).
vessel 5.86 An angioplasty is the surgical repair of a blood ___________.
A specialized procedure called a percutaneous transluminal
coronary angioplasty ___________________ _____________________ (PTCA) is a treatment
for a narrowed coronary artery.
stent 5.87 An intravascular ___________ is implanted to keep a blood
vessel open and to reinforce the vessel’s wall.
Self-Instruction: Therapeutic TermsStudy the following:
TERM MEANING
defibrillation (Fig. 5-23) termination of ventricular fibrillation by delivering ande-fib-ri-la�shun electrical stimulus to the heart; most commonly, this is done
by applying the electrodes of the defibrillator externally to thechest wall, but it can also be performed internally, such asduring open heart surgery or via an implanted device
defibrillator device that delivers the electrical stimulus in defibrillationde-fib�ri-la-tor
cardioversion restoration of a fast or irregular heart rate to a normal rhythm,kar�de-o-ver�zhun either by pharmaceutical means or by delivery of electrical
energy
implantable cardioverter an implanted, battery-operated device with rate-sensing leads;defibrillator (ICD) the device monitors cardiac impulses and initiates anim-plan�ta-bel electrical stimulus as needed to stop ventricular fibrillation orkar�de-o-ver�ter tachycardiade-fib�ri-la-tor
pacemaker (Fig. 5-24) a device used to treat slow heart rates (bradycardia) bypas�ma-ker electrically stimulating the heart to contract; most often, it is
implanted with lead wires and battery circuitry under the skin,but it can also be placed on a temporary basis externally withlead wires inserted into the heart via a vein
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 247
FIGURE 5-23 ■ A. External defibrillation. B. Internal defibrillation performed inthe operating room.
TERM MEANING
COMMON THERAPEUTIC DRUG CLASSIFICATIONS
angiotensin-converting drug that suppresses the conversion of angiotensin in theenzyme (ACE) inhibitor blood by the angiotensin-converting enzyme (ACE); used inan-je-o-ten�sin-kon-vert�ing the treatment of hypertensionen�zım in-hib�i-tor
antianginal drug that dilates coronary arteries, restoring oxygen to thean�te-an�ji-nal tissues to relieve the pain of angina pectoris
antiarrhythmic drug that counteracts cardiac arrhythmiaan�te-a-rith�mik
anticoagulant drug that prevents clotting of the blood; commonly used in an�te-ko-ag�yu-lant the treatment of thrombophlebitis and myocardial infarction
antihypertensive drug that lowers blood pressurean�te-hı-per-ten�siv
beta-adrenergic agents that inhibit responses to sympathetic adrenergic nerve blocking agents activity, causing a slowing of electrical conduction and heartba�ta-ad-re-ner�jik rate and a lowering of the pressure within the walls of theblok�ing a�jentz vessels; used to treat angina pectoris and hypertension; thebeta-blockers Greek small letter beta is commonly used in the names ofba�ta-blok�erz these agents (i.e., �-blockers)
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248 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
A small incision is made in the upper chest, below the clavicle, to access a large vein nearby.
The pacemaker leads are then guided through the vein and into the heart. After proper placement is determined,the leads are secured in position.
A small “pocket” to house the pacemaker is created just under the skin at the incision site. The leads are connectedto the pacemaker that is secured inthe “pocket.” Finally, the incision is closedwith a few sutures.
PacemakerLeads
Small incision
Rightatrium
Pacemaker
Rightventricle
A
B
FIGURE 5-24 ■ Pacemaker. A. Endocardial pacemaker. B. Teleradiology/critical care workstation chestradiographs on screen show pacemaker placement.
TERM MEANING
calcium-channel blockers agents that inhibit the entry of calcium ions into heart musclekal�se-um-chan�el blok�erz cells, causing a slowing of the heart rate, a lessening of the
demand for oxygen and nutrients, and a relaxing of thesmooth muscle cells of the blood vessels to cause dilation;used to prevent or treat angina pectoris, some arrhythmias,and hypertension
cardiotonic drug that increases the force of myocardial contractions inkar�de-o-ton�ik the heart; commonly used to treat congestive heart failure
(CHF)
diuretic drug that increases the secretion of urine; commonlydı-yu-ret�ik prescribed in treating hypertension
hypolipidemic drug that reduces serum fat and cholesterolhı-po-lip�i-de�mik
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 249
TERM MEANING
thrombolytic agents drugs used to dissolve thrombi (blood clots) (e.g.,throm-bo-lit�ik a�jentz streptokinase or tissue plasminogen activator [TPA or tPA]);
used in acute management of myocardial infarction (MI) andischemic stroke; commonly called “clot busters”
vasoconstrictor drug that causes a narrowing of the blood vessels, therebyva�so-kon-strik�tor decreasing blood flow
vasodilator drug that causes dilation of the blood vessels, thereby va�so-dı-la�tor increasing blood flow
Programmed Review: Therapeutic Terms
ANSWERS REVIEW
bradycardia 5.88 The term for a condition of slow heart is __________________.
A device that is surgically implanted to make a slow heart maintain
pacemaker an adequate pace is called a __________________.
fast 5.89 Tachycardia is a condition of _________ heart rate.
Version is a process of turning. The method of turning an
abnormally fast or irregular heart rate back to normal by use of a
cardioversion drug or delivery of electrical energy is called _________________.
5.90 Chaotic, irregular contractions of the heart are called
fibrillation, not _________________. The prefix de- means from, down, or _______.
A device used on a patient to stop ventricular fibrillation is called a
defibrillator _________________. The process of doing so is called defibrillation.
5.91 An implantable device that initiates an electrical stimulus to
implantable stop ventricular fibrillation or tachycardia is called an ______________
cardioverter defibrillator _______________________ _____________________ (ICD).
against or opposed to 5.92 The prefix anti- means ______________. Drugs in the class
coagulation or clotting known as anticoagulants work to prevent ________________. A drug
hypertensive that lowers high blood pressure is called an anti_________________.
chest pain 5.93 Recall that angina pectoris is ___________ _________. Drugs
antianginal that treat this pain are classified as ________________ drugs.
Nitroglycerin is a common antianginal medication. It acts as a
dilator vaso__________, causing the coronary arteries to expand and, thereby,
increasing the flow of blood to the heart muscle tissue, also known
myocardium as the ___________________.
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250 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
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5.94 A drug that counteracts a cardiac arrhythmia is called an
arrhythmic anti_________________.
5.95 A number of different drug classifications are used to treat
hypertension. Beta-adrenergic blocking agents, also called, more
beta-blockers simply, _________-______________, work by inhibiting responses to a
nerve activity and slowing electrical conduction and heart rate.
5.96 Another type of antihypertensive drug works by inhibiting the
entry of calcium ions into heart muscle cells, thereby slowing the
calcium- heart and causing other changes. These are called _______________-
channel ______________ blockers.
5.97 Another antihypertensive drug, called a diuretic, works by
urine increasing the secretion of ___________ from the body.
5.98 Congestive heart failure (CHF) is often treated with drugs that
increase the force of ventricular contractions. These drugs are
tonic called cardio__________ agents.
5.99 Recall that lipids are fats. Using the prefix hypo-, the term for a
drug that lowers the amount of fat in the blood is a
hypolipid ________________emic agent.
breaking down or dissolution 5.100 The suffix -lysis means _______________ _________. Drugs
clots that work to dissolve thrombi or ________ in the blood are called
thrombo ___________lytic agents. Thrombolytics, commonly known as
clot busters ________ ____________, are used in acute management of ischemic
myocardial infarction stroke and ________________ _______________ (MI).
CHAPTER 5 ACRONYMS AND ABBREVIATIONS
ABBREVIATION EXPANSION
ACE angiotensin-converting enzyme
ACS acute coronary syndrome
ASD atrial septal defect
AV atrioventricular
BP blood pressure
CABG coronary artery bypass graft
CAD coronary artery disease
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 251
ABBREVIATION EXPANSION
CHF congestive heart failure
CO cardiac output
CTA computed tomographic angiography
DVT deep vein thrombosis
ECG or EKG electrocardiogram
ECHO echocardiography
EPS electrophysiological study
HTN hypertension
ICD implantable cardioverter defibrillator
IV intravenous
MI myocardial infarction
MRA magnetic resonance angiography
MUGA multiple-gated acquisition (scan)
MVP mitral valve prolapse
NSR normal sinus rhythm
PCI percutaneous coronary intervention
PDA patent ductus arteriosus
PET positron-emission tomography
PTCA percutaneous transluminal coronary angioplasty
PVC premature ventricular contraction
SA sinoatrial
SCA sudden cardiac arrest
SV stroke volume
TEE transesophageal echocardiogram
tPA or TPA tissue plasminogen activator
VSD ventricular septal defect
CHAPTER 5 SUMMARY OF TERMS
The terms introduced in chapter 5 are listed below, followed by the page number on which eachterm can be found and its written pronunciation. For additional practice and reinforcement, writethe definition of each term on a separate piece of paper.
acute coronary syndrome (ACS)/227a-kyut� kor�o-nar-e sin�drom
anastomosis/244a-nas�to-mo�sis
aneurysm/223an�yu-rizm
angina pectoris/223an�ji-na pek�to-ris
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252 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
angiogram/237an�j e-o-gram
angiography/237an-je-og�ra-fe
angioscopy/244an-je-os�ko-pe
angiotensin-converting enzyme (ACE)inhibitor/247
an-je-o-ten�sin-kon-ver�ting en�zım in-hib�i-tor
antianginal/247an�te-an�ji-nal
antiarrhythmic/247an�te-a-rith�mik
anticoagulant/247an�t e-ko-ag�yu-lant
antihypertensive/247an�t e-hı-per-ten�siv
aorta/213a-or�ta
aortic valve/213a-or�tik valv
aortogram/237a-or�t o-gram
arrhythmia/227a-rith�me-a
arteries/213ar�ter-ez
arteriogram/237ar-ter�e-o-gram
arterioles/213ar-ter�e-olz
arteriosclerosis/223ar-ter�e-o-skler-o�sis
atherectomy/244ath-e-rek�t o-me
atheromatous plaque/223ath-er-o�ma-tus plak
atherosclerosis/223ath�er-o-skler-o�sis
atrial septal defect (ASD)/227a�tre-al sep�tal de�fekt
atrioventricular (AV) node/221a�tre-o-ven-trik�yu-lar nod
atrium/212a�tre-um
auscultation/234aws-kul-ta�shun
bacterial endocarditis/227bak-ter�e-al en�do-kar-dı�tis
beta-adrenergic blocking agents/247ba�ta-ad-re-ner�jik blok�ing a�jentz
beta-blockers/247ba�ta-blok�erz
bicuspid valve/213bı-kus�pid valv
bradycardia/227brad-e-kar�de-a
bundle of His/221bun�de l of hiz
calcium-channel blockers/248kal�se-um-chan�e l blok�erz
capillaries/213kap�i-lar-ez
cardiac catheterization/237kar�de-ak kath�e-ter-ı-za�shun
cardiac output (CO)/237kar�de-ak owt�put
cardiac tamponade/227kar�de-ak tam-po-nad�
cardiomyopathy/227kar�de-o-mı-op�a-the
cardiotonic/248kar�de-o-ton�ik
cardioversion/246kar�de-o-ver�zhun
claudication/223klaw-di-ka�shun
coarctation of the aorta/227ko-ark-ta�shun of the a-or�ta
computed tomographic angiography(CTA)/239
kom-pyu�ted to-mo-graf �ik an-je-og�ra-f e
congenital anomaly of the heart /227kon-jen�ı-tal ah-nom�ah-le of the hart
congestive heart failure (CHF)/229kon-jes�tiv hart f al�yur
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 253
constriction/223kon-strik�shun
cor pulmonale/229kor pul-mo-na�le
coronary angiogram/237kor�o-nar-e an�j e-o-gram
coronary artery bypass graft (CABG)/242
kor�o-nar-e ar�ter-e bı�pas graft
coronary artery disease (CAD)/229kor�o-nar-e ar�ter-e di-zez�
coronary circulation/214kor�o-nar-e ser-kyu-la�shun
deep vein thrombosis (DVT)/230dep van throm-bo�sis
defibrillation/246de-fib-ri-la�shun
defibrillator/246de-fib�ri-la-tor
depolarization/222de-po�lar-i-za�shun
diaphoresis/223d ı�a-f o-re�sis
diastole/219dı-as�to-le
dissecting aneurysm/223di-sek�ting an�yu-rizm
diuretic/248d ı-yu-ret�ik
Doppler sonography/239dop�l er so-nog�ra-f e
dysrhythmia/227dis-rith�me-a
echocardiography (echo)/239ek�o-kar-de-og�ra-f e
ejection fraction/237e-jek�shun frak�shun
electrocardiogram (ECG or EKG)/235e-lek-tro-kar�de-o-gram
embolus/224em�bo-lus
endarterectomy/244end�ar-ter-ek�to-me
endocardium/212en-do-kar�de-um
epicardium/212ep-i-kar�de-um
essential hypertension/229e-sen�shal hı�per-ten�shun
fibrillation/227fi-bri-la�shun
fusiform aneurysm/223fyu�si-form an�yu-rizm
gallop/234gal�op
heart murmur/224hart mur�mur
heart valves/213hart valvz
Holter ambulatory monitor/235hol�ter am�byu-la-tor-e mon�i-tor
hypertension (HTN)/219, 229hı�per-ten�shun
hypolipidemic/248hı-po-lip�i-de�mik
hypotension/219hı�po-ten�shun
implantable cardioverter defibrillator(ICD)/246
im-plan�ta-bel kar�de-o-ver�ter de-fib�ri-la-tor
infarct/224in�farkt
interatrial septum/212in�ter-a�tre-al sep�tum
interventricular septum/212in�ter-ven-trik�yu-lar sep�tum
intracardiac catheter ablation/235in�tra-kar�de-ak kath�e-ter ab-la�shun
intracardiac electrophysiological study(EPS)/235
in�tra-kar�de-ak e-lek�tro-fiz�e-o-loj�i-kal stud�e
intravascular stent placement/244in�tra-vas�kyu-lar stent plas�ment
ischemia/224is-ke�me-a
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254 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
left heart catheterization/237left hart kath�e-ter-ı-za�shun
left ventricular failure/229left ven-trik�yu-lar fal�yur
magnetic resonance angiography(MRA)/236
mag-net�ik rez�o-nants an-je-og�ra-f e
mitral valve/213mı�tral valv
mitral valve prolapse (MVP)/230mı�tral valv pro�laps
multiple-gated acquisition (MUGA)scan/236
mul�ti-pul-gat�ed ak-wi-zish�un skan
myocardial infarction (MI)/230mı-o-kar�de-al in-fark�shun
myocardial radionuclide perfusionscan/236
mı-o-kar�de-al ra�de-o-nu�klıd per-fyu�zhun skan
myocardial radionuclide perfusion stressscan/236
mı-o-kar�de-al ra�de-o-nu�klıd per-fyu�zhun stresskan
myocarditis/230mı�o-kar-dı�tis
myocardium/213mı�o-kar�de-um
normal sinus rhythm (NSR)/222nor�mal sı�nus rith�um
normotension/219nor-mo-ten�shun
nuclear medicine imaging/236nu�kle-ar med�i-sin im�a-jing
occlusion/224o-klu�zhun
pacemaker/246pas�ma-ker
palpitation/224pal-pi-ta�shun
parietal pericardium/213pa-rı�e-tal per-i-kar�de-um
patent ductus arteriosus (PDA)/229pa�tent duk�tus ar-te�re-o�sus
percutaneous coronary intervention(PCI)/244
per-kyu-ta�ne-yus kor�o-nar-e in�ter-ven�shun
percutaneous transluminal coronaryangioplasty (PTCA)/244
per-kyu-ta�ne-yus tranz�lu-men�al kor�o-nar-ean�je-o-plas-te
perfusion deficit/224per-fyu�zhun def �i-sit
pericardial cavity/213per-i-kar�de-al kav�i-te
pericarditis/230per�i-kar-d ı�tis
pericardium/213per-i-kar�de-um
phlebitis/230f le-bı�tis
polarization/222po�lar-i-za�shun
positron-emission tomography (PET)scan of the heart/237
poz�i-tron e-mish�un to-mog�ra-fe skan of the hart
premature ventricular contraction(PVC)/227
pre-ma-tur� ven-trik�u-lar kon-trak�shun
primary hypertension/229prı�mar-e hı�per-ten�shun
pulmonary circulation/214pul�mo-nar-e sır-kyu-la�shun
pulmonary semilunar valve/213pul�mo-nar-e sem-e-lu�nar valv
Purkinje fibers/222per-kin�j e f ı�berz
Purkinje network/222per-kin�je net�work
radiology/237ra-de-ol�o-je
repolarization/222re�po-lar-i-za�shun
rheumatic heart disease/230ru-mat�ik hart di-zez�
right heart catheterization/237r ıt hart kath�e-ter-ı-za�shun
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 255
right ventricular failure/229r ıt ven-trik�yu-lar fal�yur
saccular aneurysm/223sak-yu-lar an�yu-rizm
secondary hypertension/229se�kon-dar�e hı�per-ten�shun
sinoatrial (SA) node/221sı�no-a�tre-al nod
sonography/239so-nog�ra-f e
stenosis/224ste-no�sis
stress echocardiogram (stress echo)/239stres ek�o-kar�de-o-gram
stress electrocardiogram (stress ECG or EKG)/235
stres e-lek-tro-kar�de-o-gram
stroke volume (SV)/237strok vol�yum
sudden cardiac arrest (SCA)/230sud�den kar�de-ak a-rest�
systemic circulation/214sis-tem�ik sır-kyu-la�shun
systole/219sis�to-le
tachycardia/227tak-i-kar�de-a
thrombolytic agents/249throm-bo-lit�ik a�jentz
thrombophlebitis/230throm�bo-fle-bı�tis
thrombus/224throm�bus
transesophageal echocardiogram(TEE)/239
trans-e-sof �aj-e-al ek-o-kar�de-o-gram
tricuspid valve/213trı-kus�pid valv
valve replacement/244valv re-plas�ment
valves of the veins/213valvz of the vanz
valvuloplasty/244val�vyu-lo-plas-te
varicose veins/230var�i-kos vanz
vascular endoscopy/244vas�kyu-lar en-dos�ko-pe
vasoconstrictor/249va�so-kon-strik�tor
vasodilator/249va�so-dı-la�tor
vegetation/224vej-e-ta�shun
veins/213vanz
venogram/237ve�no-gram
ventricle/213ven�tri-kel
ventricular septal defect (VSD)/229
ven-trik�yu-lar sep�tal de�fekt
ventriculogram/237ven-trik�yu-lo-gram
venules/213ven�yulz
visceral pericardium/213vis�er-al per-i-kar�de-um
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PRACTICE EXERCISES
For each of the following words, write out the term components (prefixes [P], combining forms [CF], roots [R], and suffixes [S]) on the lines below the word. Then define the term according to the meaning of its components.
EXAMPLE:pericardial
peri cardi al _____ / _____ / _____P R S
DEFINITION: around/heart/pertaining to
1. angiography___________ / ___________
CF SDEFINITION: _______________________________________________________________________
2. varicosis___________ / ___________
R SDEFINITION: _______________________________________________________________________
3. pectoral___________ / ___________
R SDEFINITION: _______________________________________________________________________
4. vasospasm___________ / ___________
CF SDEFINITION: _______________________________________________________________________
5. venous___________ / ___________
R SDEFINITION: _______________________________________________________________________
6. thrombophlebitis___________ / ___________ / ___________
CF R SDEFINITION: _______________________________________________________________________
7. vasculopathy___________ / ___________ / ___________
CF R SDEFINITION: _______________________________________________________________________
8. atherogenesis___________ / ___________
CF SDEFINITION: _______________________________________________________________________
256
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 257
9. stethoscope___________ / ___________
CF SDEFINITION: _______________________________________________________________________
10. myocardium___________ / ___________ / ___________
CF R SDEFINITION: _______________________________________________________________________
11. aortoplasty___________ / ___________
CF SDEFINITION: _______________________________________________________________________
12. venostomy___________ / ___________
CF SDEFINITION:________________________________________________________________________
13. phlebotomy___________ / ___________
CF SDEFINITION: _______________________________________________________________________
14. ventriculography___________ / ___________
CF SDEFINITION:________________________________________________________________________
15. phlebitis___________ / ___________
R SDEFINITION:________________________________________________________________________
16. angioplasty___________ / ___________
CF SDEFINITION:________________________________________________________________________
17. endovascular___________ / ___________ / ___________
P R SDEFINITION: _______________________________________________________________________
18. arteriogram___________ / ___________
CF SDEFINITION: _______________________________________________________________________
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258 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
19. atherectomy___________ / ___________
R SDEFINITION:________________________________________________________________________
20. intracardiac___________ / ___________ / ___________
P R SDEFINITION: _______________________________________________________________________
Write the letter of the matching meaning in the space after the term.
21. atherosclerosis _____ a. high blood pressure
22. infarct _____ b. bulging of a vessel
23. hypotension _____ c. stationary clot
24. vegetation _____ d. cramp in leg muscle
25. embolus _____ e. normal blood pressure
26. occlusion _____ f. hard, nonelastic condition of arterial walls
27. hypertension _____ g. traveling clot that obstructs when it lodges
28. thrombus _____ h. buildup of fat
29. constriction _____ i. growth of tissue
30. normotension _____ j. a plugging
31. angina _____ k. loss of blood flow
32. claudication _____ l. compression that causes narrowing
33. ischemia _____ m. cramp in heart muscle
34. arteriosclerosis _____ n. low blood pressure
35. aneurysm _____ o. scar left by necrosis
Write the correct medical term for each of the following definitions:
36. ___________________________ malformations of the heart present at birth
37. ___________________________ thickening, loss of elasticity, and calcification (hardening) of arterial walls
38. ___________________________ irregularity or loss of rhythm of the heartbeat
39. ___________________________ a general term for disease of the heart muscle
40. ___________________________ joining of two blood vessels to allow flow from one vesselto the other
41. ___________________________ an abnormal heart sound that mimics the gait of a horse
42. ___________________________ a recording of sound waves directed through the heart toevaluate structure and motion
43. ___________________________ a condition of enlargement of the right ventricle as a resultof chronic disease within the lungs
44. ___________________________ an x-ray image of the blood vessels of the heart made withthe introduction of a catheter and the release of a contrastmedium
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 259
45. ___________________________ electrocardiogram of the heart recorded during controlledphysical exercise
Identify the structures of the heart by writing the missing words in the spaces provided:
Aortic arch
Aorta
Deoxygenated blood
Oxygenated blood
Pulmonaryartery
Superior vena cava
46. Atrial
47. Right
49. Right
Pulmonary veins
48. Tricuspid
Inferior vena cava
50. Left
53. Left
Mitral valve
Endocardium
Myocardium
Epicardium
Pericardium
51. Aortic
52. Pulmonary
54. Ventricular
valve
46.
47.
48.
49.
50.
51.
52.
53.
54.
Write out the expanded term for each abbreviation:
55. PVC _____________________________________________________________________________
56. PDA _____________________________________________________________________________
57. ACS ______________________________________________________________________________
58. ICD ______________________________________________________________________________
59. CHF _____________________________________________________________________________
60. CAD _____________________________________________________________________________
61. HTN _____________________________________________________________________________
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260 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
62. MVP _____________________________________________________________________________
63. PCI ______________________________________________________________________________
64. VSD _____________________________________________________________________________
Match the following abbreviations with their meanings:
65. EPS _____ a. balloon angioplasty
66. ECG _____ b. magnetic resonance of blood vessels
67. tPA _____ c. cessation of heart contractions
68. MRA _____ d. heart bypass surgery
69. PTCA _____ e. electrical picture of heart
70. MI _____ f. echocardiogram directed through the esophagus
71. DVT _____ g. left ventricular failure
72. ASD _____ h. thrombolytic drug
73. CABG _____ i. abnormal opening in the atrial septum
74. TEE _____ j. heart attack
75. CHF _____ k. cardiac catheter technique to map arrhythmias
76. SCA _____ l. clot in vein
Circle the correct spelling:
77. ventricel ventrical ventricle
78. aorta aorto aorrta
79. thrombos thrombus thrommbus
80. myocardial mycardial myocardiol
81. hypatension hyptension hypotension
82. diastolie diastoly diastole
83. ischemia ishchemia ishemia
84. oclusion occlusion ocllusion
85. infart enfarct infarct
86. anuerysm aneurysm annurysm
87. atherosclerotic atherosclerrotic atherasclerotic
88. thromboflebitus thromboflebitis thrombophlebitis
89. diaphoresis diaporesis diephoresis
90. defibrillation defibillation defibrilation
91. antarhythmic antiarrhythmic antiarhythmic
Write the term that means the opposite of the term given:
92. vasoconstriction ____________________________
93. coagulant ____________________________
94. hypotension ____________________________
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 261
95. bradycardia ____________________________
96. diastole ____________________________
Circle the combining form that corresponds to the meaning given:
97. chest phleb/o sphygm/o pector/o
98. vein aort/o phleb/o varic/o
99. vessel angi/o arteri/o coron/o
100. heart ven/o coron/o cardi/o
101. fatty paste aort/o ather/o atri/o
102. circle cardi/o coron/o sphygm/o
103. pulse sphygm/o steth/o thromb/o
104. clot atri/o angi/o thromb/o
105. artery arteri/o angi/o aort/o
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262 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
MEDICAL RECORD ANALYSIS
Medical Record 5-1
PROGRESS NOTE
S: This 54 y.o. � was admitted to CCU with onset of acute anterior chest pain radiating to theleft shoulder and SOB; pt underwent a CABG � 4 six months ago.
O: BP 190/110, P 100, R 72, T 38˚COn PE, pt was in moderate to severe distress. An ECG showed sinus tachycardia, and aCXR revealed left ventricular hypertrophy.
A: R/O MIP: Order blood enzyme measurement STAT
EchocardiogramCT scan of chest
QUESTIONS ABOUT MEDICAL RECORD 5-1
1. What is the patient’s CC?a. severe anginab. angina developing slowly over timec. enlargement of the heartd. fast heart ratee. slow heart rate
2. Describe the procedure that the patientunderwent 6 months ago:a. surgery to dilate and open narrowed por-
tions of coronary arteriesb. diversion of blood flow around occluded
coronary arteriesc. replacement of a diseased heart valved. coring of the lining of an artery to
remove a clote. heart transplant
3. Where was the patient treated?a. outpatient medical officeb. outpatient emergency roomc. inpatient intensive cared. inpatient coronary caree. outpatient cardiology department
4. What type of physician is most appropriateto provide initial care and assessment ofthis patient?a. ER physicianb. internistc. gerontologistd. cardiovascular surgeone. cardiologist
5. What did the electrical picture of the heartreveal?a. extremely rapid but regular contractions
of the heartb. slow heart ratec. chaotic, irregular contractions of the heartd. fast heart ratee. interference with normal electrical con-
duction of the heart known as a block
6. What was the assessment?a. patient may have had a heart attackb. patient may be suffering from right heart
failurec. patient has congestive heart failured. patient may have high blood pressuree. patient may have an enlarged heart
7. What were the objective findings of thechest radiograph?a. unknownb. increase in size of left ventriclec. vessel diseased. dead heart musclee. fast heart rate
8. Identify the x-ray imaging procedureordered in the plan:a. sonogram of heartb. chest radiographyc. blood pressured. computed tomographye. biochemistry panel
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 263
Medical Record 5-2
FOR ADDITIONAL STUDY
Richard Stratten has had serious heart problems for more than 10 years and has undergone twooperations. During the past six months, he has developed increasing pain in the chest and is hav-ing more trouble breathing. His cardiologist, Dr. Charles Feingold, has now admitted him toCentral Medical Center for further tests. Medical Record 5-2 is the history and physical examina-tion report dictated by Dr. Feingold after his examination of Mr. Stratten.
Read Medical Record 5-2 (pages 266–269), then write your answers to the following questionsin the spaces provided.
QUESTIONS ABOUT MEDICAL RECORD 5-2
1. Below are medical terms used in this record that you have not yet encountered in this text.Underline each where it appears in the record, and define the term below:
obtuse ____________________________________________________________________________
dyspnea (dyspneic) __________________________________________________________________
hiatal hernia _______________________________________________________________________
basilar rales ________________________________________________________________________
visceromegaly ______________________________________________________________________
clubbing ___________________________________________________________________________
2. In your own words (not using medical terminology), briefly describe why Mr. Stratten hasbeen admitted to the hospital and what test he will be undergoing:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
3. Name the diagnosis that underlies the nature of Mr. Stratten’s heart conditions:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Briefly describe this diagnosis using nonmedical language:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
4. Identify the surgical procedure noted in the history that was performed initially to treat Mr.Stratten’s heart disease:
a. dilation of narrow occluded coronary arteries
b. replacement of occluded arteries with transplanted portion of vein
c. replacement of a diseased heart valve
d. coring of the lining of an artery to remove a thrombus
e. heart transplant
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264 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
5. What were the patient’s symptoms 8 years later on May 15, 20xx?
___________________________________________________________________________________
Using nonmedical language, briefly describe the diagnosis made at that time:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
6. Describe the test that showed changes consistent with the diagnosis:
___________________________________________________________________________________
___________________________________________________________________________________
7. Spell out TPA, and identify the reason why the drug was given to Mr. Stratten:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
8. Which of the following were findings of the radiographic tests performed after the May 15thhospitalization? (Mark all that are appropriate.)
a. hemorrhage of insertion site of obtuse marginal artery graft
b. thromboembolism in the left anterior descending artery
c. occluded circumflex artery
d. torn sutures of the circumflex artery graft
e. stenosis of the left anterior descending artery graft
f. total occlusion of the left internal mammary vein graft
g. dilated right coronary artery graft
9. List the arteries that were grafted in both bypass operations:
___________________________________________________________________________________
___________________________________________________________________________________
10. Using nonmedical language, list the three symptoms Mr. Stratten is now experiencing:
a. _________________________________________________________________________________
b. _________________________________________________________________________________
c. _________________________________________________________________________________
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 265
11. Mr. Stratten is taking eight different medications. Translate the medication instructions foreach one:
Drug Name Dose Frequency of Dose
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
_________________________ __________________________ _________________________
12. What family members have had a medical history of problems in the same body system?
___________________________________________________________________________________
___________________________________________________________________________________
13. In addition to Mr. Stratten’s heart problems, Dr. Feingold’s physical examination revealedabnormal findings in what other areas?
a. head
b. abdomen
c. extremities
d. all of the above
e. none of the above
14. What does “probable end-stage cardiomyopathy” mean? What treatment seemed possible toDr. Feingold, even though he had not yet performed the diagnostic tests for which he hospi-talized Mr. Stratten?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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266 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
Medical Record 5-2: For Additional Study
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 267
Medical Record 5-2: For Additional Study (Continued)
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268 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
Medical Record 5-2: For Additional Study (Continued)
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 269
Medical Record 5-2: For Additional Study (Continued)
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270 MEDICAL TERMINOLOGY: A PROGRAMMED LEARNING APPROACH TO THE LANGUAGE OF HEALTH CARE
ANSWERS TO PRACTICE EXERCISES
1. angio/graphy_____ ______CF S
vessel/process of recording
2. varic/osis____ ____R S
swollen, twisted vein/condition orincrease
3. pector/al_____ __R S
chest/pertaining to4. vaso/spasm____ ______
CF Svessel/involuntary
contraction5. ven/ous___ ____
R Svein/pertaining to
6. thrombo/phleb/itis________ _____ ___CF R S
clot/vein/inflammation7. vasculo/path/y______ ____ __
CF R Svessel/disease/condition
or process of8. athero/genesis_____ _______
CF Sfatty paste (lipids)/origin
or production9. stetho/scope_____ ______
CF Schest/instrument for
examination10. myo/card/ium____ ___ ____
CF R Smuscle/heart/structure
or tissue11. aorto/plasty____ ______
CF Saorta/surgical repair orreconstruction
12. veno/stomy____ ______CF S
vein/creation of an opening
13. phlebo/tomy______ _____CF S
vein/incision14. ventriculo/graphy_________ ______
CF Sventricle/process of
recording15. phleb/itis_____ ___
R Svein/inflammation
16. angio/plasty_____ _____CF S
vessel/surgical repair or reconstruction
17. endo/vascul/ar____ ______ __P R S
within/vessel/pertaining to
18. arterio/gram______ _____CF S
artery/record19. ather/ectomy____ _______
R Sfat (lipids)/excision
or removal20. intra/cardi/ac____ ____ ___
P R Swithin/heart/
pertaining to21. h22. o23. n24. i25. g26. j27. a28. c29. l30. e31. m32. d33. k34. f35. b36. congenital anomalies 37. arteriosclerosis
38. arrhythmia or dysrhythmia
39. cardiomyopathy 40. anastomosis41. gallop42. echocardiogram43. cor pulmonale or right
ventricular failure44. coronary angiogram45. stress electrocardiogram46. atrial septum47. right atrium48. tricuspid valve49. right ventricle50. left atrium51. aortic valve52. pulmonary semilunar
valve53. left ventricle54. ventricular septum55. premature ventricular
contraction56. patent ductus arteriosus 57. acute coronary
syndrome58. implantable cardioverter
defibrillator59. congestive heart failure60. coronary artery disease61. hypertension62. mitral valve prolapse63. percutaneous coronary
intervention64. ventricular septal defect65. k66. e67. h68. b69. a70. j71. l72. i73. d74. f75. g76. c77. ventricle78. aorta
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CHAPTER 5 • CARDIOVASCULAR SYSTEM 271
79. thrombus80. myocardial81. hypotension82. diastole83. ischemia84. occlusion85. infarct86. aneurysm87. atherosclerotic
88. thrombophlebitis89. diaphoresis90. defibrillation91. antiarrhythmic92. vasodilation93. anticoagulant94. hypertension95. tachycardia96. systole
97. pector/o98. phleb/o99. angi/o
100. cardi/o101. ather/o102. coron/o103. sphygm/o104. thromb/o105. arteri/o
ANSWERS TO MEDICAL RECORD ANALYSIS
Medical Record 5-1: Progress Note
1. a 2. b 3. d 4. e 5. d 6. a 7. b 8. d
Medical Record 5-2: For Additional Study
See CD-ROM for answers.
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