This page is a working list for terms/topics categorized by body system as well as various topics (drug, lab, measurements, surgery, etc.)
These could be new terms or topics, or about which I have been asked for information. Remember: This is not intended to a comprehensive list of all things relating to that body system. These are either new things I have had to add to my reference books, or from questions from students.
Index of major topic headings
(Alphabetic and in number order so you can find them easily further down)
~ ARVD: (arrhythmogenic right ventricular dysplasia): A form of cardiomyopathy.
~ coronary artery anatomy/coronary artery tree and the abbreviation "PLM":
The"PLM" abbreviation doesn't seem to show up anywhere in the reference books. The PLM (posterolateral marginal) is a branch off the circumflexcoronary artery. The circumflex (CX) coronary artery is a branch of the left main coronary artery (LM) after the latter runs it’s course in between the aorta and the main pulmonary artery.
The CX travels in the left atrioventricular groove that separates the left atrium from the left ventricle. The CX moves away from the LAD and wraps around to the back of the heart. The major branches that it gives off in the proximal or initial portion are known as obtuse marginal (OM or OMB) coronary arteries. As it makes its way to the posterior portion of the heart, it gives off one or more left posterolateral (PL) branches which are called "posterolateral marginal branches."
~ drug-eluting cardiac stents:
These stents have been coated with a drug that dramatically reduces any reblockage of the stent. By inhibiting scar tissue formation within the stent, the medicated stent reduces by 75% the chance a patient will need to return for a reblockage of the implanted stent. A couple of stent names of this type are: Cypher (fromCordis) and TAXUS (from the Taxus IV trial)
~ ejection fraction:
Even though it may sound like the dictator is saying injection fraction, if it is in relationship to the heart (especially with a percent to go with it), it is ejection fraction. See the definition in Dorland's Medical Dictionary under "fraction" but in brief: It is a proportion of the volume of blood in the ventricles at the end of diastole (resting phase of pump cycle, end-diastole) to that ejected during systole (contraction phase of pump cycle) or the stroke volume.
The formula is: STROKE VOLUME / END-DIASTOLIC VOLUME = EJECTION FRACTION. In other words, each time the ventricle pumps and expels its volume of blood, how much blood is left behind in the ventricle: Normal ejected amount is approximately 65% (leaving about 35% behind in diastole). A number less than about 50% indicates ventricular dysfunction. Numbers way above 65% indicate hypercontractility. You will hear numbers as low as 6% (meaning 94% of the blood is left behind in the ventricle after each contraction) - these are the people who have cardiomyopathy and need a heart transplant.
~ first-degree AV block:
The AV in thist erm stands for "atrioventricular." The term atrioventricular is a combined term discussing the atria (upper chambers of the heart) and the ventricles (lower chambers). Block in this case is not coronary artery blockage but blockage of the electrical system of the heart in the area between the upper and lower chambers.
~ heart catheterization:
The term "LV gram" would probably fall into the slang category. Left ventricle is the most correct of the 14 meanings for that term; however, it really doesn't make the term readable if we said left ventricle gram. We would need to use a combined form of the word.
The correct way to expand that term would be "left ventriculogram" which is the more upscale medical lingo for a heart cath(eterization). When they do a heart cath they usually just do the "shortened" version which is just to take pictures of the left ventricle after inserting the dye, which then allows them to take some measurements of sizes and pressures of the left ventricle. Most of the time you will see the term "left heart cath" or "left ventriculogram and coronary arteriography".
If they do a "complete" heart cath they use the dye to take pictures of the left and right ventricles and take measurements and pressures in both left and right ventricles. Sometimes you will hear the term "bilateral heart cath"or "right and left heart cath"
They also sometimes do just a "right heart cath." To take pressures in the right ventricle they usually use a Swan-Ganz catheter. This right heart cath is also referred to as "pulmonary artery catheterization." They often do the right heart cath by itself and get pressure readings when the person is in congestive heart failure and they need to know what the pulmonary artery pressure is and tissue oxygenation, etc.
The right heart cath can either be done as a one-time procedure or they can leave the Swan-Ganz catheter in place and use it to continuously record the pulmonary artery pressure. You might hear this referred to as a "PA line" or a "Swan line." Knowing the pressures in the right ventricle actually also tells them what the pressures are like in the left ventricle too, so it's a very useful tool. A lot of times they will leave a PA line in after doing open heart surgery. It just gives them a much better idea how the heart is doing.
~ May-Thurner syndrome:
Compression of the left iliac vein by the artery crossing over it. This is normal anatomy, but in some people the artery presses on the vein enough to thicken the vein wall over time. This condition may occur in adults or children. In young people in whom swelling and/or discomfort with exercise are signals, the syndrome may not be complicated by thrombosis, and stenting alone may give excellent long-term results. These results are generally better compared with results in patients who have deep venous thrombosis before the compression is recognized.
~ respirophasic chest pain: Same as pleuritic chest pain.
~ TriVex: System for power transilluminated phlebectomy (made by Smith & Nephew)
1. AMSA: anterior, middle superior alveolar (injection anesthetizes multiple maxillary teeth with one injection).
2. ASA: anterior superior alveolar.
3. IO: infraorbital (a block modification, substitute for the ASA & MSA, therefore one less injection).
4. MSA: middlesuperior alveolar.
5. PSA: posterior superior alveolar.
~ dental field blocks for lingual anesthesia:
1. GP: greater palatine.
2. NP: nasopalatine.
~ Gow-Gates: A dental block technique.
~ OKC: odontogenic keratocyst
3. DERMATOLOGY
~ antiwrinkle therapy: See Articol, Radiance, Restolin below
~ Articol (antiwrinkle therapy):
This is a combination of collagen and synthetic material injected under the skin. It's designed to be permanent. It costs about $800 per syringe. Most patients only require one or two applications. There are some side effects to be concerned about: lumpiness where the wrinkles are or redness, moderate pain. Not yet FDA approved.
~ Deaver inflammatory changes in alopecia
~ Fitzpatrick skin type classification: This classification denotes 6 different skin types, skin color, and reaction to sun exposure.
Type I (very white or freckled) - Always burn
Type II (white)- Usually burn
Type III (white to olive) - Sometimes burn
Type IV (brown)- Rarely burn
Type V (dark brown) - Very rarely burn
Type VI (black)- Never burn
~ Glogau photoaging classification: Glogau developed the traditional rhytide classification scheme that is used most often today. This scheme classifies skin changes as minimal, moderate, advanced, or severe. As follows:
Mild (age 28-35 years) - Little wrinkles, no keratosis, requires little or no makeup
Moderate (age 35-50 years) - Early wrinkling, sallow complexion with early actinic keratosis, requires little makeup
Advanced (age 50-60 years) - Persistent wrinkling, discoloration of the skin with telangiectasias and actinic keratosis, always wears makeup
Severe (age 65-70 years) - Severe wrinkling, photoaging, gravitational and dynamic forces affecting skin, actinic keratosis with or without cancer, wears makeup with poor coverage
~ OKC: odontogenickeratocyst
~ Radiance (antiwrinkle therapy):
This is made from the same components as bone and teeth. It's injected under the skin. It lasts about five years. Cost is up to $1,200. Possible side effects: redness and lumpiness. Not yet FDA approved.
~ Restolin (antiwrinkle therapy):
It's a derivative of joint fluid actually injected underneath the skin. It can last about six months, cost $275 to $400 per treatment. It hasn't been really used in the United States that much, but 200,000 people in 60 countries around the world do use it. Possible side effects: redness and mild swelling. Not yet FDA approved.
~ skin type classifications: See Fitzpatrick and Glogau above.
4. DRUGS, MISCELLANEOUS INFORMATION
~ DuoDerm patch: My references list this capitalized this way.
~ ferrous sulfate/iron: The usual dose listed for this is 325 mg.
~ insulin:
"Regular" insulin is actually not a generic name but a trade name for insulin. It would sound like the dictator is saying the patient just takes "regular" insulin as opposed to "not regular" insulin, but anytime you hear them say "Regular insulin x-number of units," the word Regular should be capitalized.
See in the PDR in the green pages under "Antidiabetic Agents" and the subcategory "Rapid Acting Insulins" & you will see "Humulin R Regular" and "Iletin II, Regular" and "Purified Pork Regular," so technically the doctor should qualify what kind of "Regular" it is, but they usually don't. :-)
5. ENDOCRINOLOGY/INTERNAL MEDICINE
~ diabetes mellitus types:
If any of your reference materials list diabetes type as I and II, change this to 1 and 2. The American Diabetic Association (ADA) changed a few of years ago from the Roman numerals to the Arabic, and they want everyone to use this form.
~ febris disease or syndrome: fever (term sounds like fe'breeze)
~ glucose meters and supplies:
Accu-Chek Advantage meter
Accu-Chek Comfort Curve strips
Accu-Chek Complete meter
Accu-Chek Voicemate System (meter)
Assure meter from Chronimed Company
FastTake meter
Freestyle meter
One-Touch Profile meter
One-Touch Ultrameter
Precision Q.I.D. meter
Sof-serter for use with infusion set
Sof-set infusion set
~ ketogenic diet:
The ketogenic diet is a special diet used to treat multiple types of seizures (seems to be most effective for myoclonic seizures and "minor motor" seizures) in children (best in ages 1-10). It does not seem to be as effective in adults. It was initially studied in the 1920s as a treatment option for those with intractable epilepsy. Since then, medications have replaced the diet, but there is now a resurgence of interest in the ketogenic diet. The diet is high in fat and low in carbohydrate and protein, which results in ketosis. In addition, fluids are limited, which helps contribute to the diet's success. This ketotic state exerts an anti-epileptic effect, though its precise mechanism of action is not completely understood. In most patients anti-seizure medications are able to be reduced.
Uncomplicated hospital admissions scheduled to initiate the ketogenic diet are typically 4-5days in duration. If the diet proves to be a worthwhile form of therapy for a patient, usually the diet is followed for 2 years and weaned in the 3rd year, similar to what might be tried with an antiepileptic drug.
6. FOREIGN FOODS
~ ginchangsigumchi kuk (Korean spinach soup)
~ ingera (Ethiopian bread)
~ kanji (Vietnamese)
~ kimchee orgimchi (Korean pickled cabbage) - often linked with high blood pressure if too much is eaten
~ kochu chang (Korean red bean paste)
~ pakuchi (Vietnamese)
7. GASTROENTEROLOGY
~ chemoembolization: See entry in ONCOLOGY/HEMATOLOGY
~ endoscopy, wireless capsule: see wireless capsule endoscopy below.
~ fibrosis scoring systems in liver biopsies: See hepatitis C below.
~ Given Diagnostic Imaging System (Given video capsule): see wireless capsule endoscopy below
~ hepatitis C: fibrosis scoring systems in liver biopsies Ishak and Knodell (most used in USA) and METAVIR (most used in Europe)
~ Fibrosis scoring: Knodell/ METAVIR/ Ishak
None 0/ 0/ 0
Portal fibrosis(some) 1/ 1/ 1
Portal fibrosis (most) 1/ 1/ 2
Bridging (few) 3/ 2/ 3
Bridging (many) 3/ 3/ 4
Incomplete cirrhosis 4/ 4/ 5
Established cirrhosis 4/ 4/ 6
~ Murphy('s) sign: See in Dorland's under "sign" - A sign of gallbladder disease consisting of interruption of patient's deep inspiration when the physician presses in the area of the gallbladder.
~ wireless capsule endoscopy:
In 2001 the FDA approved the Given Diagnostic Imaging System. This 11 x 26-mm capsule weighs only 4 gms (about 1/7th of an ounce) and contains a color video camera and wireless radiofrequency transmitter, 4 LED lights, and enough battery power to take 50,000 color images during an 8-hour journey through the digestive tract. About the size of a large vitamin, the capsule is made of specially sealed biocompatible material that is resistant to stomach acid and powerful digestive enzymes.
8. INFECTIOUS DISEASE
~ BIA: bioelectrical impedance analysis.
BIA is important in the clinical assessment and care of people living with HIV. In addition to estimating percentage of body fat, this test measures body cell mass (how much muscle and organ tissue you have) as well as extracellular mass (how much bone, collagen, and fluid you have). BIA provides clinicians with an invaluable tool for diagnosing and monitoring progress in HIV-related conditions such as wasting.
~ BK virus and JC virus:
The BK and JC viruses (BKV and JCV) are human polyomaviruses. They are named JC and BK after the initials of the patients in which they were first discovered. Polyomaviruses are members of the Papovaviridae family, which are small, nonenveloped viruses with a closed, circular double DNA-stranded genome. Polyomaviruses are distinguished from papillomaviruses by a smaller virion size and a different genome size and organization. The human polyomaviruses were first isolated in 1971.
The JC virus (JCV) was isolated from the brain tissue of a patient with progressive multifocalleukoencephalopathy (PML).
The BK virus (BKV) was isolated from the urine of a renal transplant patient who developed ureteral stenosis postoperatively.
BKV and JCV share 75% homology at the level of nucleotide sequence and each is 70% homologous to SV40. The two are not cross-reactive serologically and serologic tests for antibodies are able to distinguish between BKV and JCV.
~ clade and non-clade B virus:
Viruses in association with HIV. Roche ultrasensitive RT-PCR test is one used to identify these viruses. Example of RT-PCR test terminology: RT-PCR translocationst (15;17), AML subtypes M0 to M7
~ CRV: =community-acquired respiratory virus
A term to describe any one of a group of different viruses. The most common CRVs are the influenza viruses (types A and B), respiratory syncytial virus (RSV), parainfluenza viruses (1, 2, and 3), adenoviruses, and possibly rhinoviruses. The clinical syndromes associated with these viruses include the common cold, upper respiratory tract disease, pharyngitis, laryngitis, tracheobronchitis, influenza-like syndrome, bronchiolitis, and pneumonia.
~ HIV/AIDS study names:
PLUS (Positive Living through Understanding and Support) - This is a randomized clinical trial of an eight-session therapy intervention (versus an eight-session educational control) designed to reduce alcohol use and improve HIV medication adherence among HIV+ men and women who have alcohol use disorders.
Club Drug Use and Risky Sex - This is a randomized clinical trial of a four-session therapy intervention (versus a four-session educational control) designed to reduce the use of "club drugs" (e.g., Ecstasy, GHB, ketamine, cocaine, methamphetamine) and increase condom use among gay/bisexual men.
Project SPIN -This is an assessment study of sexual compulsivity among gay/bisexual men.
BUMPS - This is a study of "club drug" use among gay/bisexual men (both HIV negative and HIV+) looking at the use of club drugs in conjunction with sexual behaviors.
Seropositive Urban Men's Intervention Trial - This is a clinical trial of a large-group behavioral intervention for HIV+ gay/bisexual men testing whether or not the intervention can reduce unprotected sexual behaviors.
Positive Choices - This is a clinical trial of a combination individual counseling/small group intervention for HIV+ gay/bisexual men who abuse alcohol testing whether or not the intervention can reduce unprotected sexual behaviors AND reduce the use of alcohol.
Informed Choices - This is a clinical trial of an individual therapy intervention for HIV negative gay/bisexual men who abuse alcohol.
Project PILLS -This is a study of HIV medication adherence among HIV+ gay/ bisexual men looking at the role that substance use/abuse has on men's ability to adhere to their medication regimens, as well as the relationship between sexual behavior, substance use, and medication adherence.
Classified Project - This is a formative study of gay/bisexual male escorts who advertise their sexual services on the internet looking at how their sexual behaviors differ among their paying and non-paying partners.
9. LABORATORY INFORMATION
~ anion gap(electrolytes):
The anion gap you will see in electrolyte studies. An anion is an atom or ion with a negative charge. If you look up "gap" in Dorland's you will find "anion" and it will tell you that the number represents sodium minus (chloride plus bicarbonate). A lot of times it sounds like they are saying "an ion gap," but it really is "anion gap."
~ antibodies (I have added these to my Dorland's):
aCL: anticardiolipinantibody
amphysin antibody
ANCA antibody –synonyms are MPO-ANCA, PR3-ANCA
ANNA-1, ANNA 2 antibody
anti-amphiphysin antibody
anti-beta-2antibody
anti-ds DNA test
anti-endomysial antibody
anti-GAD antibody
anti-GM1 antibody
anti-HHV-8 antibody (in HIV)
antihistamine antibody
antihistone antibody
anti-Hu antibody
anti-IgA antibody
anti-JO-1antibody
anti-LKM (liver-kidney-muscle) antibody
anti-MAG antibody
anti-PCNR antibody
anti-phosphatidylserine antibody
antiproteinase3 antibody (PR3 ANCA)
anti-ribozymal antibody
anti-RNP antibody
anti-Ro-SS antibody
anti-SCL-70 antibody
anti-Sm antibody
anti-Smith antibody (is same as anti-Sm)
anti-TPO antibody
aPG: antiphosphatidylglycerol antibody
aPI: antiphosphatidylinositol antibody
aPL: antiphospholipid antibody
aPS: antiphosphatidylserine antibody
dsDNA antibody
Duffy A autoantibody (see entry for Duffy blood group)
endomysial antibody (for celiac sprue)
GALOP antibody
hexosaminidase antibody
Hu antibody
islet cell antibody
lipoproteinanticardiolipin antibody
MPO-ANCA (antimycloperoxidase) antibody
phosphatidylserine antibody
PR3 ANCA(antiproteinase 3 antibody)
Prostascintmouse antibody (prostate)
Purkinje cellcytoplasm type 1 antibody
Ro antibody
SGPG antibody
TPO antibody
Yo antibody
~ AST and ALT:
You may need to write the AST and ALT as their own entries into any diagnostic test books you use and in the lab section of Sloane's and then cross reference them as below. The doctors use these two terms all the time, but they aren't in the books anymore because they are old terms that have been supplanted by newer terms.
1. AST isaspartate aminotransferase, which is now called SGOT.
2. ALT isalanine aminotransferase, which is now called SGPT.
BRCA 1, BRCA 2 gene - variant IVS23 plus 2T to C (breast cancer)
C282Y gene (for hemochromatosis)
cytokeratin 7gene
Drosophiliapreseniling gene (homologue)
DYI1 gene (for dystonia)
factor V Leiden gene (notice this is not Leyden as in Leyden disease, Leyden jar, Leyden-Mobius muscular dystrophy syndrome)
HFE gene (for hemochromatosis)
L-ferriten gene
MLH-1 gene
MP2 myelin gene (for CMT disease)
MSH-2 gene
nef gene (AIDS)
NKX2A gene (thyroid transcription factor 1)
OMP-3 gene (for IBS)
PMS-2 gene
presenilin 1and 2 gene (PS1, PS2)
P-TEN gene (Cowden disease)
R1443X BRCA1 gene
spastin gene
tat gene (HIV)
TMPT gene (thiopurine methyltransferase)
TSC1, TSC2 (for tuberous sclerosis)
TTF1 or TTTF1 or NKX2A (thyroid transcription factor 1)
~ gene-related words:
exons, exon structure
introns, intron structure
genotypic, phenotypic correlation testing
genotype,genotypic resistance test for HIV
~ grouping of lab tests in reports and punctuation of:
Sloane's Medical Word Book, fourth edition, starting on page 285 and going through page 301 gives a nice list of the major groups of lab tests:
1) Hematology
2) Blood, Serum and Plasma (which is all your chemistry tests)
3) Urine
4) Levels of therapeutic drugs
5) Levels of toxic substances
6) Cerebrospinal fluid
7) Semen
8) Gastrointestinal function
9) Immune function
That sounds like a lot, but you usually only have #1, #2, #3 on most reports. The results do not need to go in this order, however. They could do the serum chemistry tests, then urine results, then hematology. It's just the grouping within the group that is important. If they did say some hematology tests, some serum chemistry tests, urine tests, then some more serum chemistry tests, just do a sentence for chemistry, then another sentence for urine, then another sentence for hematology, and then start another sentence if they do some more serum chemistry tests. Usually it won't be this messy, though. The dictators are usually reading off reports that are also grouped this way, so it's usually fairly orderly.
~ Punctuation of lab results:
1. Never use a comma to separate a lab value from the test it describes.
2. Separate related test values with commas when multiple lab results are given, for instance the individual parts of a CBC separated by commas.
3. Start a new sentence for unrelated tests. Example: CBC results. SMA-20 results. Urinalysis results.
4. When uncertain if tests are related or unrelated, start a new sentence.
5. Use semicolons if entries in the series have internal commas. Example: CMP shows electrolytes of test, test, test; lipid panel of test, test, test; iron studies of test, test, test.
~ HHV-8: humanherpesvirus 8 (seen in HIV/AIDS)
~ nitrite(s):
No matter how much it may sound like they are saying "nitrate(s)," if it is part of urinalysis results, it is "nitrite(s)."
~ PDC &PDC-E2:
= pyruvate dehydrogenase complex. Antibody lab test. Often checked in pregnancies with advanced maternal age.
~ PPD tuberculosis test:
PPD ="purified protein derivative" (at least 99.9% of the time it means this).
It is one of the terms that is usually not expanded because it is really used as the sort of abbreviated term for the lab test for the PPD and lab tests are not usually expanded. The PPD test is the tuberculin skin test with the four little prongs that they do on your arm and do a reading in 48 hours to see if there is a redness reaction. A positive test means you have tuberculosis or have had tuberculosis (therefore have the antibodies) and negative mean you don't have the antibodies. But the tests are sometimes inaccurate, and if you ever had a positive test sometime in the past, they will often repeat it.
~ PRA: panel reactive antibody.
It's a blood test routinely performed on patients waiting for kidney transplants. It's a way of measuring the anti-human antibodies in the blood. A person's PRA can be anywhere from 0% to 99%. Your PRA represents the percent ofthe U.S. population that the anti-human antibody in your blood reacts with. For example, if you had a PRA of 25%, then the antibodies in your blood would bind to the tissue types of 25% of the people in the population.
~ Roche ultrasensitive RT-PCR test:
One test to identify clade and non-clade B virus in HIV disease. Sample of test terminology: RT-PCR translocations t(15;17), AML subtypes M0 to M7
~ specific gravity:
If you hear a physician dictating a urinalysis result and say numbers like "Specific gravity ten fifteen, ten twelve" (etc) you need remember that the specific gravity of urine is a comparison value with water, water being 1. Urine will always be a little heavier than water, therefore some number just over 1, as in the examples above 1.015 or 1.012. "Spec grav" is a slang form of this.
~ WBC, WBCs versus wbc, wbc's and RBC, RBCs versus rbc, rbc's:
The way to differentiate between white/red blood cell count and white/red blood cells is the following:
WBC, WBCs, RBC, RBCs = white blood COUNT(s) or red blood COUNT(s)
wbc, wbc's,rbc, rbc's = white blood CELL(S) or red blood CELL(S)
EXAMPLE: Urinalysis revealed 12-15 white blood cells (wbc's) per high power field, 6-9 red blood cells (rbc's) per high power field. White blood count (WBC) was 9700.
It often helps to read out loud the expanded term in your sentence and see which is the correct abbreviation. Try reversing the terms with the example above and notice how you can see it's not right.
10. MEASUREMENTS, MISCELLANEOUS INFORMATION
~ kilocalories (abbreviated form: kg-cal):
The definition for this term will be found in Dorland's under "calorie," subcategory "large."
Often used in connection with ADA (American Diabetic Association) diets and the calorie restriction the patient has: 1200 calorie ADA diet, 1500 calorie ADA diet, 1800 calorie ADA diet, etc. Kilocalorie (or large calorie) is actually the more precise term for what we all think of as a calorie and is the amount of heat required to raise the temperature of 1 kilogram of water 1 degree Celsius (centigrade) and is used to express the fuel or energy value of food.
~ mev (millielectron volts):
This is a special measurement used with photons in radiation therapy. The dictators sound like they are saying "mv" but they are saying "mev," just very quickly.
~ microvolt, micrometer, microliter, etc.:
Some employer programs don't allow you to use the symbol for "micro," so anytime you have a "micro-something" term you would need to spell it out except for mcg (for microgram), which is an accepted abbreviation.
11. NEPHROLOGY/UROLOGY
~ cavernosography:
Radiographic examination which demonstrates the corpora cavernosa and draining veins after injection of contrast medium into the corpora to check for venous leakage. If present, venous drainage is usually seen within 10 to 20 seconds via the deep dorsal vein or via the crural veins. The incidence of venous leakage causing erectile impotence is estimated to be between 25 and 75%. (Source:http://www.medcyclopaedia.com, Amersham Health)
~ cavernosometry:
Pressure measurement in the corpora cavernosa during intracorporal infusion of fluid, performed to show failure of normal corporal trapping and/or the presence of abnormal venous leakage in erectile impotence. Typically a 20- to 21-gauge needle is placed into each corpus, just proximal to the glans penis. One needle is used for injection of fluid, and the other is connected to a pressure transducer. A muscle relaxant (e.g. 20 μg prostaglandin E1 or 40-60 mg of papaverine) is injected intracorporally, and pressure changes are monitored. Once the pressure has increased as an indication of muscle relaxation, injection of fluid (saline or dilute contrast medium) is started at a rate of 100-120 mL/min. Continuing pressure measurements are performed during infusion. At a rate of 100 mL/min, a maximum pressure of 100 mmHg should be achieved. Once this pressure is obtained, the infusion rate is reduced to the rate required to maintain the pressure. The infusion is then stopped, and the drop in pressure is monitored for 30 seconds. Criteria for venous leakage are:
1) poor tumescencein response to the muscle relaxant,
2) a maintenance flow rate of more than 20 mL/min, and
3) a pressure drop of more than 50 mmHg during the 30-second period.
Bladder diverticula can be congenital or acquired. Congenital diverticula occur most commonly immediately adjacent to the uretericorifice, the so-called Hutch diverticula. These diverticula most often resultin vesicoureteric reflux, but may also produce ureteric obstruction. On occasion, they may arise posterior and lateral to the ureteric orifice and can produce bladder outlet obstruction.
Treatment of patients with Hutch diverticula is geared toward relieving symptoms related to obstruction or reflux. When significant reflux or obstruction is present, the diverticula can be surgically excised with reimplantation of the ureter. In mild cases, serial follow-up is all that is required.
Bladder diverticula are well demonstrated by intravenous urography or cystography, but may also be seen on ultrasound, CT or MRI. (Source: http://www.medcyclopaedia.com, AmershamHealth).
~ NKF-DOQI: National Kidney Foundation-Dialysis Outcomes Quality Initiative
~ NKF-K/DOQI: National Kidney Foundation-Kidney/Disease Outcomes Quality Initiative
~ Penile implants:
Four discrete categories of prostheses are currently available (semi-rigid, malleable, inflatable, and hinged). Below are some brand names.
1. Dura II penile implant (available in United Kingdom).
2. DuraPhase prosthesis (by Dacomed). Has internal cables that allow the device to bend to a flaccid state when not in use. The unit is activated by adjusting the cable to produce penile rigidity.
3. Finney prosthesis. Is hinged and converts from flaccid to rigid state merely by locking the hinge in place.
4. FlexiFlate. Has internal fluid system and is designated as self-contained penile prosthesis (SCPP). The SCPP transforms the penis from a flaccid to erect state by manipulation of a valve implanted in the tip of the penis.
5. Hydroflex. Same mechanism as FlexiFlate above.
6. Jonas prosthesis. A semi-malleable device that depends on a network of internal silver wires to allow for some degree of flexibility.
7. Mentor Corporation makes a prosthesis with an abdominal fluid reservoir.
8. Mentor makes a malleable device with a similar design to the OmniPhase and DuraPhase.
9. OmniPhase prosthesis (by Dacomed). Has internal cables that allow the device to bend to a flaccid state when not in use. The unit is activated by adjusting the cable to produce penile rigidity.
10. Scott-AMS 600. Malleable device with similar design to OmniPhase and DuraPhase.
11. Scott-AMS 700. A prothesis with abdominal fluid reservoir.
12. Small-Carrion. Prosthesis consists simply of two rigid rods.
~ PRA: = panel reactive antibody.
It's a blood test that is routinely performed on patients waiting for kidney transplants. It's a way of measuring the anti-human antibodies in the blood. A person's PRA can be anywhere from 0% to 99%. Your PRA represents the percent of the U.S. population that the anti-human antibody in your blood reacts with. For example, if you had a PRA of 25%, then the antibodies in your blood would bind to the tissue types of 25% of the people in the population.
~ UKM (couldsound like You-Com): = urea kinetic modeling (for following Kt/V with dialysis patients
12. NEUROLOGY
~ Botterell scale (grading of severity of subarachnoid hemorrhage):
1 Conscious with or without signs of blood in the subarachnoid space
2 Drowsy without significant neurological deficit
3 Drowsy with neurological deficit and probably intracerebral hematoma
4 Major neurological deficit and deterioration due to large intracerebral clot, or older age with less severe neurological deficit but pre-existing cerebrovascular disease
5 Moribund or near-moribund with failing vital centres and extensor rigidity
~ CIBP: chronic intractable benign pain
~ Fisher grading (grading of severity of subarachnoid hemorrhage):
1 No blood detected
2 A diffuse deposition or thin layer with all vertical layers of blood (interhemispheric fissure, insular cistern, ambient cistern) less than 1-mm thick.
3 Localized clots and/or vertical layers of blood 1 mm or greater in thickness
4 Diffuse or no subarachnoid blood, but with intracerebral or intraventricular clots
~ Hunt and Hess scale (severity of subarachnoid hemorrhage):
1 Asymptomatic or minimal headache and slight nuchal rigidity
2 Moderate to severe headache, nuchal rigidity, no neurological deficit other than cranial nerve palsy
3 Drowsiness, confusion, or mild focal deficit
4 Stupor, moderate to severe hemiparesis, possible early decerebrate rigidity and vegetative disturbances
5 Deep coma, decerebrate rigidity, moribund appearance
~ Nylen-Barany maneuver, test, sign: Same as Dix-Hallpike maneuver.
~ Roos test: Same as the hands-up test for thoracic outlet syndrome.
~ SEPS: = subdural evacuation port system. A minimally invasive system of draining subdural hematomas.
~ subarachnoid hemorrhage, severity grading of:
See Botterell, Fisher, Hunt and Hess, and WFNS (World Federation of Neurological Surgeons)
~ Synchromed 1,2, EL intrathecal pump:
Made by Medtronic. Intrathecal pump for infusion of long-term medications for indications like pain, spasticity.
~ tectal glioma:
Also known as plate glioma. A low-grade tumor arising from a type of cell of the central nervous system known as a glial cell. These tumors originate from a specific type of glial cell known as an astrocyte.
~ astrocytes
Make up a supportive structure of the brain and spinal column. They are named for their star-like appearance. Tectal gliomas are classified as grade I pilocyticastrocytomas or grade II fibrillary astrocytomas. They arise from the tectum or roof of the brain stem.
~ word salad:
A mixture of words and phrases that lack comprehensive meaning or logical coherence; commonly seen in schizophrenic states.
~ World Federation of Neurological Surgeons scale or WFNS scale (grading of severity of subarachnoid hemorrhage):
(I find the scale listed both these ways):
1 Glasgow coma scale 15, no motor deficit
2 GCS 13 to 14, no motor deficit
3 GCS 13 to 14, with motor deficit
4 GCS 7 to 12, with or without motor deficit
5 GCS 3 to 6, with or without motor deficit
Grade GCS Motor Deficit
I 15 Absent
II 13-14 Absent
III 13-14 Absent
IV 7-12 +/-
V 3-6 +/-
~ written meningeal sign:
A neurological test where the health provider writes or prints with a dull object on the patient's arms or legs in form of letters or numbers to see if the patient can tell what they are. This is indicative of neurotransmission from the skin through the meningies covering the spinal cord and transmitted to the brain for identification.
13. OBSTETRICS/GYNECOLOGY
~ fetal echocardiogram measurement names and abbreviations:
AC: abdominal circumference
BPD: biparietal diameter
CI: cephalic index
CRL: crown-rump length
FL: femur length
GS: gestational sac
HC: head circumference
HC/AC ratio: head circumference/abdominal circumference ratio
HL: humeral length
LV: length of vertebrae
~ fetal lung maturity tests:
Tested often in high-risk pregnancies. Some types are:
The FP method on the TDx (either with the Abbott TDx/FLM® test, which reports in milligram of surfactant per gram of albumin, or the home-brew version that involves fluorescently labeled phosphatidylcholine and has units of polarization).
phosphatidylglycerol (PG) with the slide method (AmnioStat-FLM® from Irvine Scientific).
The foam stability test (either with the Beckman Lumadex®-FSI, or a home-brew version that involves ethanol and amniotic fluid mixtures at differing concentrations).
~ NovaSure™Impedance Controlled Endometrial Ablation System
~ premenstrual dysphoric disorder (PMDD):
A woman who has PMDD experiences severe depression, irritability and/or mood swings, which interfere with relationships, social functioning, and work or school. The symptoms of PMDD start 7 to 14 days before menstruation, and they resolve a few days after menstruation starts. The difference between this and PMS is that PMDD is more severe and interferes more with daily functioning. PMDD was recently added as a diagnosis in the DSM-IV.
~ rollerball endometrial ablation (using an operating hysteroscope)
14. ONCOLOGY/HEMATOLOGY
~ chemoembolization:
A way of delivering cancer treatment directly to a tumor in the liver. Under x-ray guidance, a small catheter is inserted into an artery in the groin. The catheter's tip is threaded into the artery in the liver that supplies blood flow to the tumor. Chemotherapy is injected through the catheter into the tumor, mixed with particles that embolize or block the flow of blood to the diseased tissue.
Chemoembolization works to attack the cancer in two ways. First, it delivers a very high concentration of chemotherapy directly into the tumor, without exposing the entire body to the effects of those drugs. Second, the procedure cuts off blood supply to the tumor, depriving it of oxygen and nutrients, and trapping the drugs at the tumor site to enable them to be more effective.
Chemoembolization is most beneficial to patients whose disease is limited to the liver, whether the tumor began in the liver or spread to it (metastasized) from another organ. Some success has been demonstrated with patients whose cancer has spread to other areas. Cancers that may be treated by chemoembolization include:
Hepatoma (primary liver cancer)
Metastasis (spread) to the liver from:
colon cancer
carcinoid
ocular melanoma
sarcomas
a primary tumor in another part of the body
~ hemoglobin SC disease: hemoglobin S and hemoglobin C both present.
~ Hb H-Pakse disease. An alpha thalassemia variant.
~ Hb H-CS or Hb CS disease (Hemoglobin H Constant Spring). An alpha thalassemia variant.
~ Hb Quong Sze or Hb QS disease. An alpha thalassemia variant.
Cancer treatment technique for widespread peritoneal cancer. All visible malignant tumor is first removed by standard surgical technique. Then heated Mitomycin-C solution is washed throughout the peritoneal cavity to hopefully kill any remaining malignancttumor cells.
~ alphathalassemia
This is a group of hereditary anemias which are commonly due to the deletion of one or more of the alpha globin genes on chromosome 16. Loss of three genes results in Hb H disease and complete deletion of all four alphaglobin genes results in severe anemia in utero (Hb Bart's hydrops fetalis).
~ RTOG (RadiationTherapy Oncology Group)
protocols with RPA (recursive partitioning analysis). RPA criteria includes Karnofsky performance status, primary tumor status, presence of extracranial system metastases and age. Validated RTOG recursive partitioning analysis classification for brain metastasis is class 1: Karnofsky Performance Score (KPS) >/=70%, age <65>
~ WHO grading of brain tumors =I through IV. (WHO = World Health Organization)
15. OPHTHALMOLOGY
~ ABMD: See map-dot-fingerprint dystrophy below
~ anterior basement membrane dystrophy: See map-dot-fingerprint dystrophy below
~ Cogan syndrome: See map-dot-fingerprint dystrophy below
~ disc versus disk:
As to spelling and use of disc versus disk, years ago we had to use both terms, and actually they are not interchangeable. Disc must be used for the eye (but never disk), whereas orthopedic terms can use disc or disk, so if you want to simplify your memorization, just use "disc" for everything medical.
~ map-dot-fingerprint dystrophy (of cornea):
Also referred to as: anterior basement membrane dystrophy, ABMD, Cogan's syndrome, MDF
Map-dot-fingerprint dystrophy (MDF) is a corneal disorder that is characterized by recurrent erosions of the epithelium (skin like covering) of the cornea. When this occurs, the patient usually experiences severe eye pain, light sensitivity, and reduced vision. Each episode resolves as soon as the epithelium heals. The ophthalmologist may see the telltale signs of this aptly named disorder by observing the epithelial cysts (dots), ridges (fingerprints), and geographic opacities of the epithelium (maps). The disorder is quite common and thought to be dominantly inherited.
~ MDF: Seemap-dot-fingerprint dystrophy above
16. ORTHOPEDICS
~ Coleman block test:
Cavovarus deformities in the rear foot can result from a forefoot cavus deformity or an isolated plantarflexed first metatarsal. In these situations the rearfoot compensates by rotating into varus. The Coleman block test is used to determine if the deformity is in the forefoot or hindfoot and to see if the deformity is reducible. The forefoot is off-weighted by placing a block under the heel so that the rearfoot no longer has to compensate for a forefoot cavus. If the rearfoot normalizes and becomes perpendicular to the ground, the deformity lies in the forefoot and should be addressed as part of the procedure. In rigid cavovarus foot, the deformity will not reduce.
~ CVA tenderness:
This stands for "costovertebral angle tenderness." Also abbreviated as CVAT. If you have terms in your built-in dictionary that will expand automatically, be sure to NOT let this expand to say "cerebrovascular accident tenderness." This is a common mistake transcriptionists make, and the spell checker will not find this error. In the physical exam, CVA tenderness could be put in the "Abdomen"section or sometimes dictators will put it in the the "Chest/Chest wall" area of the exam.
~ disk versus disc: See disc in OPHTHALMOLOGY section above.
~ Hotchkiss fracture classification:
Radial head fracture classification (modified Mason Johnston). I = nondisplaced or mildly displaced fractures of the radial head or neck; II = displaced (>2 mm) fractures of the head or neck (angulated); III= severely comminuted fracture of the radial head and neck
~ JAS splint: = Joint Active Systems (manufacturer).
Static progressive stretch splints to improve range of motion - used with many different joints, i.e., knees, shoulders, elbows
~ Lichtman test: midcarpal shift test of the wrist for TFCC instability
~ Mason fracture classification: I through IV radial head fracture classification (see also Mason-Johnston below)
~ Mason-Johnston fracture classification: Classification of radial head and neck fractures. I=Nondisplaced; II = Minimally displaced with depression, angulation and impaction; III = Comminuted and displaced; IV =Radial head fractures associated with dislocation of the elbow
~ modified Mason-Johnston: See Hotchkiss fracture classification above.
~ Orbay orthopedic plate: Named for Jorge L. Orbay. Volar fixed-angle implant plate with pegs in distal radius fractures
~ osteotomy, some types of:
Combined LeFort I and intraoral vertical oblique ramus osteotomy
intraoral vertical oblique osteotomy
Le Fort I wedge osteotomy
Le Fort III midface osteotomy
mandibular osteotomy variant types
mandibular setback osteotomy
Obwegeser osteotomy
sagittal split osteotomy
subcondylar ramus osteotomy
~ Polaris intermedullary nail
~ prosthetic foot/knee names and types:
Cadence HP foot
Carbon Copy 2 foot
Dermatos foot/arm
dynamic pylon foot
dynamic response carbon fiber split toe prosthetic foot
Flex-Foot foot
four-bar knee (4-bar)
Freedom Series foot, FS 1000, FS 2000, FS 3000
Genesis II foot
Jaipur foot
K2, K3 and K4 foot type
Kingsley "STEN" flexible keep foot
Lehneis Advantage DP and Advantage AP foot
LuXon Max DP dynamic pylon foot by Otto Bock company
LuXon MaxS-style pylon curve foot by Otto Bock company
Niagra foot
Pathfinder foot
PFO (could be either plantar fascia orthosis or prefabricated foot orthosis)
rolling-joint prosthetic foot
SACH foot (Solid Ankle, Cushion Heel)
Safe II foot
Seattle Lite adjustable heel foot
Springlite foot by Lehneis company
TruStep foot by College Park company
~ smooth and move procedure: Alternative procedure for rotator cuff tears.
~ splint, dynamic extension: One type of splint is a dynamic extension splint.
~ viscoelastic substances for osteoarthritis:
Orthovisc (hyaluronan): viscoelastic substance for treating knee osteoarthritis. It is a high-molecular weight, ultra-pure natural hyaluronan injectable that is directly administered into the knee joint.
hylan or hylan G-F 20: viscoelastic substance for treating knee osteoarthritis. The molecular weight of the hylan molecule (developed by cross-linking hyaluronan molecules) is ten times that of the hyaluronan molecule, it may therefore be superior to lower-molecular-weight products.
Other viscoelastic substance names: Synvisc, hyaluranon, and Neovisc which is a Canadian drug
17. OTOLARYNGOLOGY
~ cords, vocal:
Vocal cords is spelled without the "h." There are "chords" terms with the"h" in medical, but these are usually referred to as chorda- see"chorda" in Dorland's.
Tympanograms are plotted by amplitude (normal, stiff, flaccid), pressure (normal, absent-negative, or negative or positive daPA with numbers like -125 daPA, +90daPA [daPA is a measurement of tenths of a Pascal]) or shape (normal, abnormal as peaked, flat, notched, etc).
The shapes are categorized as A and subtypes of A, and B and C:
The purpose of this test is to determine if the saccule, one portion of the otoliths, as well the inferior vestibular nerve and central connections, are intact and working normally. The saccule, which is the lower of the two otolithic organs, has a slight sound sensitivity and this can be measured.
EMG electrodes are applied to the middle third of anterior neck muscles (sternocleidomastoids)and the supine patient holds their head up unsupported, using the anterior neck muscles. Another method of obtaining activation is to have patients sit upright with their chin turned over the contralateral shoulder to tense the SCM muscle. Subjects are instructed to tense the muscle during acoustic stimulation, and relax between runs. If the neck muscles are not activated, no VEMP is produced.
Loud clicks or tone bursts are repetitively presented to each ear in turn at 200 msec intervals. The optimum frequency lies between 500 and 1000 Hz. The response evoked in the neck EMG is averaged and presented as a VEMP.
Variant VEMP methods:
Bone conduction VEMP: Skull taps and bone conduction tones can also be used to elicit VEMP's.
Galvanic VEMP
Click-evoked VOR: A closely related test to the VEMP. Event triggered averaging is used to detect electro-oculographic responses to loud clicks.
18. PEDIATRICS
~ WIC program:
Stands for Women, Infant and Children program. If you have a client who wants periods in their terms, you may see this as W.I.C. It is a nationwide program administered through the states, usually through the local health department. They have nurses who will do home visits, nutritionists, social workers. Vouchers or coupons are given out to qualifying moms to be able to get milk, cheese, etc. through local grocery stores.
Used in physical therapy. This web site shows a picture of the BAPS board. http://www.rehaboutlet.com/BAPSboard_biomechanical_ankle_platform.htm
~ Belso exercises, for carpal tunnel
~ Berg functional balance test
~ chip bags:
Also known as muffs, Schneider packs or JoVi PAK®. Used to treat lymphedema postmastectomy. Bernd Schneider, lymphedema therapist for the Foeldi Clinic in Germany, discovered in the mid 1980's that chipped foam under short-stretch bandages increases the efficacy of CDP (Complete Decongestive Physiotherapy)for the treatment of lymphedema. The varying degrees of pressure created by the foam chips soften fibrotic tissue while still allowing channels for the lymphatic fluid to seek new pathways.
~ Cyriax physical therapy technique
~ drive-through sign: indication for joint laxity
~ Durham protocol and modified Durham protocol: passive motion of fingers postoperative
~ EAST: elevated arm stress test for thoracic outlet syndrome
~ effleurage: massage therapy technique
~ EquiTest system: balance and mobility management
~ ERSL: extended, rotated, sideflexed to the left
~ frottage: massage therapy technique
~ FRSL: flexed, rotated, sideflexed to the left
~ Fugl-Meyer assessment: test for motor performance after a stroke.
~ Gillet test: seated flexion test
~ HEP: home exercise program
~ high-volt galvanic stimulation
~ IMCT: intermediate mechanical cervical traction
~ in side lying (position)
~ is side laid (position)
~ joint glide, arthrokinematic
~ JoVi PAK: See "chip bags" entry above.
~ LBQC: large-base quad cane
~ Low-Dye taping: for plantar fasciitis (named after Arnold Dye, DPM).
~ McConnell taping
~ McKenzie test
~ MET: muscle energy technique
~ MFR: myofascial release
~ muffs: See "chip bags" entry above.
~ NeuroCom Balance Master System: balance and mobility management
~ PPIVM: passive physiologic intervertebral movement testing
~ prolotherapy: strengthening treatment for chronic pain
~ proning: supportive continuous axial rotation therapy in prone position
~ PUS: pulsed ultrasound
~ Reiki acupuncture technique
~ Rolfing, Rolfer (person trained in Rolfing): physical therapy technique
~ Russian stimulation __ minutes at __ amps, __ seconds on, __ seconds off channel 1 on the Chattanooga Unit
~ Sahrmann level I lower abdominal strengthening exercises
~ Schneiderpacks: See "chip bags" entry above.
~ Scower test: range of motion hip test
~ Speeds test, modified
~ STM: soft tissue massage
~ therex
~ Thomas test: for hip flexors
~ Tinetti score (x/28): measurement of risk for falls
~ VOR1, VOR2: vestibular ocular reflex exercises
20. PODIATRY
~ IPK: intractable plantar keratosis
21. PSYCHIATRY
~ DSM-IV
Axis I: (clinical disorders and conditions that need clinical attention).
Axis II: (personality disorders and mental retardation).
Axis III: (general medical conditions).
Axis IV: (psychosocial and environmental problems).
Axis V: (GlobalAssessment of Functioning [GAF] Scale).
This is how you will often see this section:
DSM-IV: (or DSM-IV DIAGNOSES):
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V:
Notice there are five axes, but the DSM-IV is referring to four. They added an axis sincethe DSM was created. The next major revision of the DSM (i.e., DSM-V) will not appear until 2010 or later (i.e., at least 16 years after DSM-IV), so we still say DSM-IV.
If a section spills over to more than one line, some clients say to double space between axis sections and some say keep it compact. Also sometimes you may have two or more things under each axis and the dictator may ask you to number them, i.e.,
Axis I:
1.
2.
Axis II:
1.
2.
Here's what each section is referring to:
DSM-IV (Diagnostic and Statistical Manual of Mental Disorders)
Axis I: clinical disorders and conditions that need clinical attention (this would be psychiatric conditions that the doctor is treating currently, like major depressive disorder [MDD], psychosis, etc.)
Axis II: personality disorders This section often is "deferred"
Axis III: general medical conditions (this would be other diagnoses like hypertension, diabetes, etc., that the patient has. Often you will hear the dictator skip this section and say "deferred.")
Axis IV: psychosocial and environmental problems (this would be things like homelessness, unemployment, etc.)
Axis V: Global Assessment of Functioning Scale (GAF). The GAF is a 100-point tool rating overall psychological, social and occupational functioning of people over 18 years of age and older. Sometimes they just give the number, sometimes they say GAF 50, etc. It should just be one number or it could be a range, for instance 45-55.) The children's score is the CGAF.
~ Foa OCD workbook:
Edna Foa and Rothbaum developed this workbook for OCD patients and is given as homework when patients are in treatment for OCD.
~ SIMD: substance-induced mood disorder
~ SUDS: =Subjective Units of Distress Scale. Used with Obsessive Compulsive Disorder.
22. PULMONARY MEDICINE
~ Buteyko: breathing method for asthma
~ oxygen saturation:
You will hear this as a slang term often as "O2 sats" and a plural verb as in"His O2 sats were 98% on room air." This is slang for oxygen saturation and is actually a singular term, so should be "His oxygen saturation is 98% on room air." You could have the plural version occasionally in a sentence such as "His oxygen saturations ranged from 83% to 90% on 2 L of oxygen." Spell out the slang form.
~ pulse oximetry:
The dictators many times say the slang of "pulse ox" for pulse oximetry and this is reported as a percent if there is a number attached or they might just say"His pulse ox after exercise rose." Spell out the slang form.
~ RESPeRATE: FDA-approved biofeedback breathing machine for hypertension.
~ sleep apnea masks:
AirSep
DeVilbiss
Nellcor PuritanBennett
Nidek
ResMed (Sullivan)
Respironics
SleepNet
23. RADIOLOGY/IMAGING
~ cavernosography: See entry under NEPHROLOGY/UROLOGY.
~ cavernosometry: See entry under NEPHROLOGY/UROLOGY.
~ V/Q scan or ventilation-perfusion scan:
Occasionally seen as just VQ scan, could find references to it as a VP scan, but most commonly is V/Q or else the dictator will say the expanded term "ventilation-perfusion scan."
In the Sloane's Medical Word Book under "abbreviations" in the back you will find it correctly as "ventilation-perfusion scan." It is a nuclear medicine lung scan. The slash / is between V and Q because it is actually a ratio. I have never been able to find anywhere where they refer to what the Q stands for. Everywhere you look for V/Q scan you will see a definition that it is a ventilation-perfusion scan and then it will tell what it is for and how it is done but never ever mentions why they use Q instead of just the more obvious P for perfusion, but I think it stands for "quotient" as in "ventilation quotient".
Notice that the V/Q is with a slash to represent a ratio, whereas if you expand the term it is ventilation-perfusion not ventilation/perfusion.
24. SURGICAL TERMS
~ suture sizes:
Sizes range from 11-0 (smallest) to 7 (largest). Thus a size 7 suture is different from and larger than a size 7-0 suture.
Example: The dictator will say "three oh" Vicryl and this should be transcribed as 3-0 Vicryl (use zero, not letter "O"). Place # before the size only ifthe word "number" is dictated, i.e. #7 cotton.
So the sizes from smallest to largest are: 11-0, 10-0, 9-0, 8-0, 7-0, 6-0, 5-0, 4-0, 3-0, 2-0, 1-0, 0-0, 1, 2, 3, 4, 5, 6, 7.
An old sizing method, which is still acceptable, though not preferred and not used much, is to use groups of zeros for sutures up to 4-0, thus 1-0 = 0, 2-0 = 00, 3-0 =000, 4-0 = 0000. Don’t go any higher than four zeroes as this becomes unreadable.
25. WOUND CARE
~ Acticoat:
- A. burn dressing with nanocrystalline silver
- A. absorbent dressing with noncrystalline silver
- A. 7 with noncrystalinesilver
- A. moisture control
~ Kaltostat: A seaweed derivative used in wound care.
~ V.A.C. device
You may hear a dictator say something like "The patient was prescribed a vac for his wound." This is probably referring to the V.A.C. (Vacuum Assisted Closure) device.
Made by KineticConcepts, Inc., it assists in wound closure by applying localized subatmospheric pressure (negative pressure) to help promote wound healing. V.A.C. therapy is applied to a special dressing positioned in the wound cavity or over a flap or graft. This pressure distributing wound packing helps remove fluids from the wound and promote the normal healing process.
In other words, it cleans, irrigates and removes infectious materials from patients' wounds while administering topical solutions such as cleaners, antibiotics, antifungals and anesthetics to the wound.
