The Cardiovascular System Medical Terminology

Chapter 8 The Cardiovascular System Learning Objectives After completing this chapter, you will be able to: 8.1 Define and spell the word parts used to create terms for the cardiovascular system. 8.3 Build medical terms from the word parts associated with the cardiovascular system. 8.2 Break down and define common medical terms used for symptoms, diseases, disorders, procedures, treatments, and devices associated with the cardiovascular system. 8.4 Pronounce and spell common medical terms associated with the cardiovascular system. The Cardiovascular System 193 Anatomy and Physiology Terms The following table provides the combining forms that commonly apply to the anatomy and physiology of the cardiovascular system. Note that the combining forms are colored red to help you identify them when you see them again later in the chapter. Combining Form Definition Combining Form Definition angi/o aort/o arter/o, arteri/o atri/o cardi/o coron/o my/o, myos/o blood vessel aorta artery atrium heart crown or circle, heart muscle pect/o, pector/o valvul/o vas/o vascul/o ven/o ventricul/o chest little valve vessel little vessel vein little belly, ventricle 8.1 Every one of the 50 trillion or so cells in your body requires a cardiovascular kar dee oh VAS kyoo lar blood continuous supply of oxygen and nutrients and an unending removal of waste materials. To meet these demands, the blood carries these materials by way of the body’s circulation within a series of closed tubes, called blood vessels, pushed along mainly by the movements of the heart. Blood vessels include arteries that carry blood away from the heart, veins that carry blood toward the heart, and microscopic capillaries that bridge arteries and veins, whose thin walls permit the exchange of materials between blood and interstitial fluid. The movement and transport of blood is thereby achieved by the ____________________ system, which consists of the heart and blood vessels, as the word parts that form the term cardiovascular suggest. The constructed form is cardi/o/vascul/ar, in which cardi/o is a combining form that means “heart,” and vascul is a word root that means “little vessel.” The continuous flow of ____________________ to all tissues is vital to maintain normal body functions. If the supply of oxygen or nutrients or the removal of carbon dioxide is reduced or cut off, even for a few minutes, the affected cells will die. Thus, a disease of the cardiovascular system can pose life-threatening risks to health and survival. 8.2 The functions of the cardiovascular system may be summarized as: heart ■■ Propulsion of blood by the ____________________ ■■ Transport blood vessels of blood to all body tissues by the ____________________ ____________________ ■■ Exchange of materials between the blood and body tissues 194 Chapter 8 8.3 Review the anatomy of the cardiovascular system by studying ■■Figure 8.1 and ■■Figure 8.2. AIR (OXYGEN) Trachea Right lung Left lung Right pulmonary artery Left pulmonary artery Lung capillaries Lung capillaries Left pulmonary veins Right pulmonary veins Heart (blood) Vein Artery Arterioles Venules BODY CAPILLARIES = Blood low in oxygen and high in carbon dioxide (deoxygenated) = Blood high in oxygen and low in carbon dioxide (oxygenated) ■ Figure 8.1 The cardiovascular system. A schematic view of the closed circulation of blood. The heart is sectioned, and the capillaries are enlarged to enable you to see them. The black arrows indicate the direction of blood flow. The Cardiovascular System 195 Superior vena cava Aorta Pulmonary trunk Left atrium Aortic valve Right atrium Pulmonary valve Mitral (bicuspid) valve Left ventricle Tricuspid valve Right ventricle Endocardium Myocardium Epicardium Inferior vena cava ■ Figure 8.2 Internal anatomy of the heart. The heart is sectioned to reveal its internal features. Medical Terms of the Cardiovascular System 8.4 Many diseases of the cardiovascular system have a profound blood effect on the body’s overall health. The result of cardiovascular disease is often the reduction or stoppage of blood flow to one or more parts of the body, which results in the death of cells. If ____________________ flow reduction affects a large area or a critical organ like the brain, kidneys, or heart itself, the resulting cell death can produce a condition that quickly becomes life-threatening. 8.5 The division of medicine known as cardiology (kar dee AHL oh cardi/o/logy cardiologist kar dee AHL oh jist jee) provides clinical treatment for heart disease. Cardiology is a constructed term, _____/_____/_____, where the combining form cardi/o means “heart” and the suffix -logy means “study or science of.” A physician specializing in this field is called a cardiologist. Generally, a ____________________ also treats conditions associated with blood vessels because of the close functional relationship between blood vessels and the heart. 196 Chapter 8 8.6 In the following sections, we review the prefixes, combining cardiovascular forms, and suffixes that combine to build the medical terms of the ____________________ system. Signs and Symptoms of the Cardiovascular System Here are the word parts that commonly apply to the signs and symptoms of the cardiovascular system that are covered in the following section. Note that the word parts are color-coded to help you identify them: prefixes are yellow, combining forms are red, and suffixes are blue. Prefix Definition Combining Form Definition Suffix Definition a- without, absence of slow bad, abnormal, painful, difficult rapid, fast angi/o cardi/o cyan/o pect/o, pector/o rhythm/o, rrhythm/o sten/o blood vessel heart blue chest rhythm narrow -a -algia -dynia -genic singular condition of pain condition of pain pertaining to producing, forming condition of condition of paralysis state of sudden involuntary muscle contraction bradydystachy- KEY TERMS A–Z angina pectoris an JYE nah * PEK tor iss -ia -osis -plegia -sis -spasm 8.7 The primary symptom of an insufficient supply of oxygen to the heart is chest pain called ____________________ ____________________. This Latin term literally means “chest choke.” The level of chest pain varies with the patient, varying from a very slight pressure to an overbearing pain that radiates to the shoulders, upper left arm, and back. 8.8 The common combining form of “blood vessel” is angi/o. angiospasm AN jee oh spazm Blood vessel disorders include abnormal muscular contractions, or spasms, of the smooth muscles in the vessel walls. This sign is called ____________________. The constructed form of this term is angi/o/spasm. The Cardiovascular System 197 8.9 Narrowing of a blood vessel is a sign of cardiovascular disease, angiostenosis AN jee oh sten OH siss causing a reduction of blood flow to the part of the body at the receiving end of the narrowed vessel. This sign is called angiostenosis. The constructed form of this term is angi/o/sten/osis and includes one combining form: angi/o, which means “blood vessel,” and the word root sten, which means “narrow.” Thus, the literal meaning of ____________________ is “condition of a narrow blood vessel.” 8.10 The prefix a- means “without, absence of,” and the prefix dys- arrhythmia ah RITH mee ah means “bad, abnormal, painful, difficult.” In some cases, they may be used interchangeably. For example, a loss of the normal rhythm of the heart is called ____________________, which means “condition of without rhythm” and is written a/rrhythm/ia. An alternate term for an abnormal heart rhythm is dysrhythmia. The constructed form of this term is written dys/rhythm/ia. Arrhythmia and Dysrhythmia WORDS TO Watch Out For These two medical terms relating to the abnormal rhythm of the heart are very similar in their meanings, but they have important differences. As you have learned, the prefix a- means “without, absence of,” and the prefix dys- means “bad, abnormal, painful, difficult.” Now look closer at the word roots. They are not identical. The term arrhythmia (“condition of without rhythm”) has an extra r. To remember which term is spelled with two rs, it might help to think of the expression “without rhyme or reason.” A condition of arrhythmia is a heartbeat “without rhyme or reason,” whereas a condition of dysrhythmia is a heartbeat with an abnormal rhythm. Arrhythmia is used much more frequently than dysrhythmia. 8.11 The common word root for heart is cardi. You will find it bradycardia brad ee KAR dee ah used in many terms in this chapter. In the term bradycardia, the prefix that means “slow” is used to form the meaning “slow heart.” ____________________ is an abnormally slow heart rate, usually under 60 beats per minute at rest. The normal resting heart rate ranges from 60 to 90 beats per minute. 8.12 The most common term for chest pain is, simply, chest cardiodynia kar dee oh DIN ee ah pain, abbreviated CP. An alternate term may also be used for this symptom. This term, cardiodynia, uses the suffix -dynia, which means “condition of pain.” The constructed form of ____________________ is cardi/o/dynia. 198 Chapter 8 8.13 The suffix -genic means “pertaining to producing, cardiogenic kar dee oh JENN ik forming.” When combined with the word part for heart, the term ____________________ is formed. The constructed form of the term is written cardi/o/genic. It refers to a symptom or sign that originates from a condition of the heart. For example, the pain sensation of angina pectoris (Frame 8.7) is a cardiogenic symptom because it is caused by insufficient blood flow to the heart. 8.14 A symptom in which a blue tinge is seen in the skin cyanosis sigh ah NOH siss and mucous membranes is called cyanosis, which literally means “condition of blue.” The constructed form is cyan/osis. ____________________ is caused by oxygen deficiency in tissues and is a common sign of respiratory failure often caused by cardiovascular disease. 8.15 A symptom of pounding, racing, or skipping of the heartbeat palpitation pal pih TAY shun is called ____________________. The term is derived from the Latin word palpitatus, which means “a throbbing.” 8.16 The opposite of the prefix brady- is the prefix tachy-, tachycardia tack ee KAR dee ah which means “rapid, fast.” A rapid heart rate is called ____________________. It may be a symptom of heart disease if the heart exceeds 100 beats per minute at rest. 8.17 A temporary loss of consciousness and posture is known as syncope SIN koh pee syncope. Commonly known as “fainting,” it is often the result of a temporary reduction of blood flow to the brain. Frequent episodes may be symptoms of a cardiovascular disease. For example, heart disease may cause fainting spells, referred to as cardiogenic _______________. The term syncope is derived from the Greek word synkope, which means “to cut short.” The Cardiovascular System PRACTICE: Signs and Symptoms of the Cardiovascular System Break the Chain Analyze these medical terms: a) Separate each term into its word parts; each word part is labeled for you. (p = prefix, r = root, cf = combining form, and s = suffix). b) For the Bonus Question, write the requested definition in the blank that follows. The first set has been completed for you as an example. 1. a) angiostenosis angi/o/sten/osis cf r s b) Bonus Question: What is the definition of the suffix? condition of 2. a) bradycardia ________/________/________ p r s b) Bonus Question: What is the definition of the word root? 3. a) cardiodynia ________/___/________ cf s b) Bonus Question: What is the definition of the suffix? 4. a) cardiogenic ________/___/________ cf s b) Bonus Question: What is the definition of the suffix? 5. a) cyanosis ________/________ r s b) Bonus Question: What is the definition of the word root? 6. a) angiospasm ________/___/________ cf s b) Bonus Question: What is the definition of the suffix? The Right Match Match the term on the left with the correct definition on the right. ______ 1. cyanosis a. sign or symptom that originates from a condition of the heart ______ 2. angina pectoris b. pounding, racing, or skipping of the heartbeat ______ 3. syncope c. opposite of bradycardia; fast heartbeat ______ 4. cardiogenic d. pain associated with the heart ______ 5. cardiodynia e. chest pain or pressure ______ 6. arrhythmia f. blue tinge in the skin and mucous membranes ______ 7. tachycardia g. fainting ______ 8. palpitation h. term that literally means “condition of without rhythm” 199 200 Chapter 8 Diseases and Disorders of the Cardiovascular System Here are the word parts that commonly apply to the diseases and disorders of the cardiovascular system that are covered in the following section. Note that the word parts are color-coded to help you identify them: prefixes are yellow, combining forms are red, and suffixes are blue. Prefix Definition Combining Form Definition Suffix Definition endo- within epiupon, over, above, on top hyper- excessive, abnormally high, above hypo- deficient, abnormally low, below peri- around poly- excessive, over, many angi/o aort/o arter/o, arteri/o ather/o cardi/o coron/o hem/o isch/o my/o phleb/o scler/o sept/o sten/o tampon/o tens/o thromb/o valvul/o varic/o -ac -ade -al -ar -emia -ic -ion -itis -megaly -oma -osis -pathy pertaining to process pertaining to pertaining to condition of blood pertaining to process inflammation abnormally large tumor condition of disease blood vessel aorta artery fatty plaque heart crown or circle, heart blood hold back muscle vein hard putrefying; wall, partition narrow plug pressure clot little valve dilated vein KEY TERMS A–Z 8.18 An abnormal bulging of an arterial wall is called an aneurysm AN yoo rism aneurysm and is shown in ■■Figure 8.3. The term is derived from the Greek word aneurysma, which means “a widening.” An ____________________ is usually caused by a congenital defect or an acquired weakness of the arterial wall, which worsens in time as blood is pushed against it. The bursting of a large aneurysm is usually life-threatening, resulting in massive hemorrhage. ■ Figure 8.3 Aneurysm. Photograph of the aorta, the large blood vessel arising from the heart, with a large bulge, or aneurysm, in its wall (just to the left of the tubing). An aneurysm is caused by a weakened blood vessel wall that is in danger of bursting, which often results in a lifethreatening hemorrhage. Source: Kalewa/Shutterstock. Aneurysm Aorta The Cardiovascular System 201 8.19 Inflammation of the heart and blood vessels is a disease angiocarditis AN jee oh kar DYE tiss called angiocarditis. It is usually caused by a widespread bacterial infection of the blood, or septicemia (Frame 8.55). The four word parts of ____________________ are shown when it is written angi/o/ card/itis. 8.20 A term describing a tumor arising from a blood vessel angioma an jee OH mah combines the word root for blood vessel, angi, with the suffix for tumor, -oma, to form ____________________. This constructed term is written angi/oma. Also known as hemangioma (heh MAN jee OH mah), it is a benign clump of endothelium forming a mass. In some cases the mass can obstruct the flow of blood through the vessel. The term hemangioma carries a second meaning of a red or purple birthmark on the skin that does not obstruct blood flow. 8.21 The aortic valve is the semilunar valve located at the base of aortic insufficiency ay OR tik * in suf FISH un see the aorta, which normally prevents blood from returning to the left ventricle. If it fails to close completely during ventricular diastole, blood may return to the left ventricle, causing the left ventricle to work harder. This condition is called aortic insufficiency. The long-term result of ____________________ ____________________, abbreviated AI, is a chronic condition of the heart known as congestive heart failure, which is described in Frame 8.36. An alternate term for AI is aortic regurgitation. 8.22 The word root sten means “narrow.” An aortic stenosis is a aortic stenosis ay OR tik * sten OH siss aortitis ay or TYE tiss narrowing of the aortic valve, located between the left ventricle and aorta. An ____________________ ____________________ causes the left ventricle to work harder than normal. It is usually a more serious condition than aortic insufficiency, although the long-term effect is similar, leading to congestive heart failure (Frame 8.36). It is a constructed term, written aort/ic sten/osis. 8.23 Inflammation of the aorta is called ____________________. The constructed form of this term is aort/itis. Often caused by a bacterial infection, it can lead to acute aortic insufficiency (Frame 8.21). 8.24 A general term for a disease of an artery is arteriopathy ahr tee ree AH path ee ____________________. This constructed term uses the suffix -pathy (meaning “disease”) and is written arteri/o/pathy. 202 Chapter 8 8.25 One common form of arteriopathy occurs when an artery wall arteriosclerosis ahr TEE ree oh skleh ROH siss becomes thickened and loses its elasticity, resulting in a reduced flow of blood to the tissues. The risk of developing this disease, known as arteriosclerosis, increases with advanced age. The constructed form of ____________________ is arteri/o/scler/osis, which literally means “condition of hard artery.” If coronary arteries supplying the heart are damaged by this disease, the condition is called arteriosclerotic heart disease (ASHD). 8.26 A term describing a specific form of arteriosclerosis (Frame 8.25), atherosclerosis ATH er oh skleh ROH siss in which one or more fatty plaques form along the inner walls of arteries, uses the combining form that means “fatty plaque,” ather/o, to form the term ____________________. The plaques thicken with time, which reduces the flow of blood through the affected vessel (■Figure 8.4). The constructed form of this term is ather/o/scler/osis, which literally means “condition of hard fatty plaque.” A major cause of coronary artery disease (Frame 8.38), atherosclerosis poses an immediate threat to life if a plaque disrupts blood flow and releases blood clots, which may trigger an acute myocardial infarction (Frame 8.49). Coronary artery Plaque Adventitia Media Interna (a) ■ Figure 8.4 Atherosclerosis. (a) A sectioned coronary artery that exhibits an accumulation of fatty plaque, which reduces the internal diameter of the vessel. (b) In this close-up, you can see that the plaque consists of cholesterol, triglycerides, phospholipids, collagen, and smooth muscle cells. (c) Two types and degrees of atherosclerotic narrowing, or stenosis. Endothelium Collagen muscle cell Plaque Smooth Cholesterol crystal Lipid Internal elastic lamina (damaged) Fibrosis (b) (c) Moderate atherosclerotic narrowing of the lumen Almost complete atherosclerotic occlusion of the lumen The Cardiovascular System atrial septal defect AY tree al * SEP tal * DEE fekt atriomegaly AY tree oh MEG ah lee atri/o/megaly atrioventricular block AY tree oh ven TRIK yoo lar cardiac arrest KAR dee ak * ah REST 203 8.27 A general condition present at birth that centers on a malfunction of the heart is called a congenital heart disease. One form of this disease occurs when an infant’s heart allows blood to move between the two atria because of a small opening in the wall separating them. Known as an atrial septal defect, it results in a reduction of blood flow to the lungs. As a result, the tissues of an infant with ____________________ ____________________ ____________________ become starved of oxygen. Atrial and septal are constructed terms, as you can see when they are written as atri/al and sept/al. 8.28 The suffix -megaly means “abnormally large.” In the condition atriomegaly, the atria have become abnormally enlarged or dilated, reducing their ability to push blood into the ventricles. The constructed form of ____________________ reveals three word parts: _____/_____/_____. It is a form of cardiomegaly (Frame 8.32). 8.29 An injury to the atrioventricular node (AV node), which normally receives impulses from the sinoatrial node (SA node) and transmits them to the ventricles to stimulate ventricular contraction, is called an ____________________ ____________________, or AV block. The injury is usually caused by a myocardial infarction (Frame 8.49), during which the cells of the AV node die due to a loss of blood flow. The term atrioventricular is a constructed term: atri/o/ventricul/ar. 8.30 The cessation of heart activity is called ____________________ ____________________. As you should know, cardiac is a constructed term written cardi/ac. Arrest means “stop.” In sudden cardiac arrest, abbreviated SCA, the patient may have little or no warning signs; often the arrest causes death. According to the American Heart Association, more than 320,000 people die from an SCA each year in the United States. Most deaths occur within minutes, primarily due to a sudden loss of blood flow to the brain. The most common cause of SCA is an electrical disturbance to the heart that causes arrhythmia (Frame 8.10), although it may also follow a myocardial infarction, or heart attack (Frame 8.49). 204 Chapter 8 cardiac tamponade KAR dee ak * tamp oh NAHD cardiomegaly KAR dee oh MEG ah lee cardiomyopathy KAR dee oh my OPP ah thee cardiovalvulitis KAR dee oh val vyoo LYE tiss 8.31 Acute compression of the heart due to the accumulation of fluid within the pericardial cavity is known as cardiac tamponade. The term is constructed from word parts and is shown as cardi/ac tampon/ade. It literally means “pertaining to heart plug process.” ____________________ ____________________ is a complication of an inflammatory disease of the pericardium known as pericarditis (Frame 8.52). 8.32 Recall that the suffix -megaly means “abnormally large.” The abnormal enlargement of the heart is called ____________________, which occurs when the heart must work harder than normal to meet the oxygen demands of body cells. The constructed form of this term is cardi/o/megaly. 8.33 A general term for a disease of the myocardium of the heart is cardiomyopathy. The constructed form of ____________________ reveals five word parts: cardi/o/my/o/pathy. The most common causes of cardiomyopathy include coronary artery disease (Frame 8.38), viral or bacterial infection, and stress during pregnancy. 8.34 An inflammation of the valves of the heart is called cardiovalvulitis (■Figure 8.5). The constructed form of this term is cardi/o/valvul/itis. As you know, cardi/o means “heart,” and the suffix -itis means “inflammation.” The word root valvul means “little valve.” The most common causes of this disease are bacterial infection, which leads to the deposition of calcium deposits on heart valves (known as vegetations), and congenital defects, which result in abnormally shaped valves. ____________________ is usually diagnosed from the presence of a heart murmur (Frame 8.44), which is a gurgling sound detected during auscultation (Frame 8.68). ■ Figure 8.5 Cardiovalvulitis. The human heart has been sectioned to reveal the left ventricle and origin of the aorta, with the aortic valve between them. The yellow growths, called vegetations, on the aortic valve have been caused by a Streptococcus infection, rendering the valve disfigured and thereby unable to direct the flow of blood properly. Source: Courtesy of the Public Health Image Library, Centers for Disease Control and Prevention. Aortic valve vegetations The Cardiovascular System coarctation koh ark TAY shun congestive heart failure cor pulmonale kor * pull moh NAY lee coronary artery disease 205 8.35 A congenital (present at birth) heart disease affecting the infant’s aorta is coarctation of the aorta. The term coarctation is derived from the Latin word coarcto, which means “to press together.” ____________________ of the aorta causes reduced systemic circulation of blood and accumulation of fluid in the lungs and requires surgical repair. 8.36 A chronic form of heart disease characterized by the failure of the left ventricle to pump enough blood to supply systemic tissues is called congestive heart failure (CHF). Also known as left-ventricular failure, the reduced function of the left ventricle characteristic of ____________________ ____________________ ____________________ makes the heart work harder, resulting in cardiomegaly (Frame 8.32), pulmonary congestion (fluid in the lungs), and reduced left-ventricle function that eventually leads to cardiac arrest (Frame 8.30). The primary symptoms of CHF include shortness of breath and fatigue. 8.37 If a disease of one or both lungs affects blood flow within the lungs, blood may back up in the right ventricle of the heart (the right ventricle normally pumps blood to the lungs). As a result, the right ventricle will be forced to work harder but with less efficiency, which enlarges the heart on the right side. A chronic enlargement and reduced efficiency of the right ventricle resulting from backup of the pulmonary circulation is called cor pulmonale. A French word that literally means “heart lung,” ____________________ ____________________ is also known as right-ventricular failure. 8.38 A general term for a disease that afflicts the coronary arteries supplying the heart is ____________________ ____________________ ____________________ (CAD). The most common form of CAD is atherosclerosis (Frame 8.26). Because the coronary arteries supply the heart with blood, an alternate term to coronary artery disease is coronary heart disease (CHD). 206 Chapter 8 coronary occlusion 8.39 Occlusion is a general term that means “blockage.” A coronary occlusion is a blockage within a coronary artery, resulting in a reduced blood flow to an area of the heart muscle. The most common single cause of a ____________________ ____________________ is atherosclerosis (Frame 8.26). Atherosclerosis or other diseases may also lead to emboli (drifting blood clots), and a congenital stenosis may also contribute to coronary occlusion. embolism 8.40 A blockage or occlusion that forms when a blood clot or other foreign particle (including air or fat) moves through the circulation is called an embolism. The term is derived from the Greek word embolisma, which means “piece or patch.” An ____________________ can produce a severe circulatory restriction when the blood clot or particle, called an embolus (plural form is emboli), lodges in an artery. EM boh lizm endocarditis EHN doh kar DYE tiss 8.41 Inflammation of the endocardium, the thin membrane lining the inside walls of the heart chambers, is an acute disease called ____________________. The constructed form of this term is endo/ card/itis. Because the endocardium also covers the heart valves, endocarditis often results in cardiovalvulitis (Frame 8.34). It is usually caused by a bacterial infection. 8.42 A condition of uncoordinated, rapid contractions of the muscle fibrillation fih bril AY shun forming the ventricles or atria is called ____________________. It is a severe form of arrhythmia (Frame 8.10). Atrial fibrillation (A-fib) leads to a reduction of blood expelled from the atria and is usually not fatal, although it poses an increased risk of stroke due to blood clots forming in the left atrium that may lodge in the brain. However, ventricular fibrillation results in circulatory collapse due to the failure of the ventricles to expel blood. It is often fatal within 5 minutes if medical intervention through CPR (Frame 8.71) or defibrillation (Frame 8.74) is not immediately available. 8.43 A block or delay of the normal electrical conduction of the heart heart block is called ____________________ ____________________. It is often the result of a myocardial infarction (Frame 8.49) that damages the SA node or AV node, which normally manage the rhythmic contractions of the heart. The Cardiovascular System 207 8.44 An abnormal sound heard during auscultation (Frame 8.68) of heart murmur the heart is a heart murmur. An “innocent” ____________________ ____________________ is not associated with a heart condition and is very common, while murmurs that are not innocent suggest heart disease such as cardiovalvulitis (Frame 8.34). A common source of heart murmur is a leaky mitral valve (the atrioventricular valve on the left side), and is known as mitral valve prolapse (MVP). Most people with MVP have an innocent heart murmur, but in some, the prolapse causes regurgitation of blood through the damaged mitral valve into the left atrium and thereby requires medical intervention. 8.45 The presence of dilated, or varicose, veins in the anal region hemorrhoids HEM oh roydz is called ____________________. The condition produces symptoms of local pain and itching. It usually results from too much pressure on the veins in the anal wall, producing swollen veins within the anal columns (internal hemorrhoids) or near the anal opening (external hemorrhoids). 8.46 Persistently high blood pressure while at rest is an abnormal hypertension HIGH per TEN shun condition called ____________________. This constructed term is written hyper/tens/ion and means “process of abnormally high pressure.” It includes essential hypertension, in which the condition is not traceable to a single cause, and secondary hypertension, in which the high blood pressure is caused by the effects of another disease, such as atherosclerosis or diabetes. Although hypertension usually produces no symptoms, it is one of the most common causes of stroke and kidney failure. 8.47 A condition of abnormally low blood pressure is called hypotension HIGH poh TEN shun ____________________, which includes the prefix hypo- that means “deficient, abnormally low, below.” It is usually an acute reaction to hemorrhage, hypothermia (abnormally low body temperature), or septicemia (Frame 8.55). 8.48 An abnormally low flow of blood to the tissues is the ischemia iss KEE mee ah condition known as ischemia. The term is a constructed term, isch/emia, which literally means “condition of holding back blood.” Coronary ____________________ is caused by an occlusion, such as atherosclerotic plaque (Frame 8.26), emboli (Frame 8.40), or thrombosis (Frame 8.57), and, because it damages the heart, can lead to a life-threatening myocardial infarction (Frame 8.49). 208 Chapter 8 8.49 Death of a portion of the myocardium is called myocardial myocardial infarction my oh KAR dee al * in FARK shun (a) infarction, abbreviated MI. The term infarction is derived from the Latin word infarctus, which means “stuff into.” In medicine, the term is used to describe a death of cells resulting from a sudden loss of blood flow (■■Figure 8.6). The term myocardial is constructed from word parts, as shown when it is written as my/o/cardi/al, which means “pertaining to heart muscle.” If the ____________________ ____________________ affects a large or functionally critical part of the heart, arrhythmia (Frame 8.10), cardiac arrest (Frame 8.30), or both may follow. The common name for an MI is a heart attack. According to the American Heart Association, approximately 790,000 individuals experience heart attacks in the United States each year, roughly 25% of which are fatal. (b) ■ Figure 8.6 Myocardial infarction. (a) A heart with a myocardial infarction of the ventricle wall, in which cardiac cells have died and surrounding tissues have become damaged. The right image is a section through the heart. (b) Photograph of a human heart (postmortem) to reveal the the dead cardiac tissue (necrosis), which perished due to a sudden loss of blood flow. Photo Source: Mediscan/Alamy Stock Photo. 8.50 Inflammation of the myocardium of the heart is an acute myocarditis my oh kar DYE tiss condition called ____________________. The constructed form of this term is my/o/card/itis. Often caused by bacterial infection, it is a form of cardiomyopathy (Frame 8.33). The Cardiovascular System 209 8.51 A congenital condition characterized by an opening between patent ductus arteriosus PAY tent * DUCK tuss * ahr tee ree OH siss the pulmonary artery and the aorta at birth due to a failure of the fetal vessel, called the ductus arteriosus, to close is called patent ductus arteriosus. The term patent means “open.” The condition ____________________ ____________________ ____________________ permits the flow of blood from the pulmonary artery to the aorta, which bypasses the pulmonary circulation. 8.52 Inflammation of the membrane surrounding the heart, the pericarditis pair ih kar DYE tiss pericardium, is called ____________________. The constructed form of the term is written peri/card/itis. It is usually caused by bacterial infection and affects both layers of the pericardium (the outer pericardial sac and the inner epicardium). 8.53 A word root for vein is phleb, and it is used in the construction phlebitis fleh BYE tiss of the term that means “inflammation of a vein.” The term is ____________________, and its constructed form is phleb/itis. In the related condition thrombophlebitis (THROM boh fleh BYE tiss), the inflammation of the vein includes an obstruction by a blood clot. 8.54 Simultaneous inflammation of many arteries is a condition polyarteritis PALL ee ahr ter EYE tiss known as ____________________. The constructed form of this term reveals three word parts and is poly/arter/itis. 8.55 A bacterial infection of the bloodstream is called septicemia. septicemia SEP tih SEE mee ah Because the bacteria are carried throughout the body by way of the infected blood, it becomes widespread and life-threatening quickly. The constructed form of ____________________ is sept/ic/emia, which literally means “condition of putrefying blood.” Recall that sepsis is a Greek word that means “putrefying.” 8.56 A severe congenital disease in which four defects associated tetralogy of Fallot teh TRALL oh jee * of * fah LOH with the heart are present at birth is called tetralogy of Fallot. The four defects are pulmonary stenosis (narrowing of the pulmonary valve), ventricular septal defect (Frame 8.59), incorrect position of the aorta, and right-ventricular hypertrophy. As a result of ____________________ ____________________ ____________________, the pulmonary circulation is partially bypassed. 210 Chapter 8 8.57 The presence of stationary blood clots within one or more thrombosis throm BOH siss varicosis vair ih KOH siss blood vessels is called thrombosis. The term is the Greek word for clotting, thrombosis. A coronary ____________________ is often caused by atherosclerosis (Frame 8.26), and its rupture can result in sudden cardiac arrest (Frame 8.30) due to an acute myocardial infarction (Frame 8.49). 8.58 An abnormally dilated vein is called ____________________, or varicose vein. Varicosis is a constructed term, written varic/osis, which literally means “condition of dilated vein.” It results when valves within a superficial vein of the leg or elsewhere fail, allowing blood to pool in response to gravitational forces (■■Figure 8.7). Open Closed Varicose vein Normal vein – competent valves (a) ■ Figure 8.7 Varicosis. (a) Varicose veins develop due to the failure of valves in the superficial veins of the leg, which leads to blood accumulation in response to gravity and vein dilation. (b)Photograph of spider veins (small varicose veins) of the leg. Photo Source: Schankz/ Shutterstock. (b) Dilated vein – incompetent valves The Cardiovascular System 211 8.59 A congenital disease in which an opening in the septum ventricular septal defect vehn TRIK yoo lar * SEPP tal * DEE fekt (sept/o in this case means “wall, partition”) separating the right and left ventricles is present at birth is called ____________________ ____________________ ____________________, abbreviated VSD. The opening allows some blood to flow from the left ventricle to the right ventricle, reducing blood flow to body organs while dangerously increasing blood flow to the lungs. PRACTICE: Diseases and Disorders of the Cardiovascular System Linkup Link the word parts in the list to create the terms that match the definitions. You may use word parts more than once. Remember to add in combining vowels when needed—and that some terms do not use any combining vowel. The first one is completed as an example. Prefix Combining Form Suffix hyperperi- angi/o ather/o cardi/o embol/o my/o scler/o tens/o thromb/o varic/o -ion -ism -itis -oma -osis -pathy Definition Term 1. An occlusion of blood flow 2. A general term for a disease of the myocardium of the heart 3. A specific form of arteriosclerosis in which one or more fatty plaques form along the inner walls of arteries 4. A tumor arising from a blood vessel 5. Inflammation of the membrane surrounding the heart 6. Inflammation of the heart and blood vessels 7. An abnormally dilated vein 8. The presence of a stationary blood clot within a blood vessel 9. Persistently high blood pressure embolism____________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ 212 Chapter 8 The Right Match Match the term on the left with the correct definition on the right. ______ 1. aneurysm a. a disease of the coronary vessels ______ 2. cardiac tamponade b. a congenital heart defect ______ 3. cor pulmonale c. a block of the heart conduction system ______ 4. heart murmur d. a blockage in a coronary vessel ______ 5. cardiac arrest e. abnormal bulging of an arterial wall ______ 6. coronary artery disease f. an abnormal sound heard through auscultation ______ 7. coronary occlusion g. cessation of heartbeat ______ 8. atrial septal defect h. uncoordinated, rapid heartbeat ______ 9. congestive heart failure i. literally, “heart lung” ______ 10. heart block j. left-ventricular failure ______ 11. fibrillation k. caused by fluid within the pericardial cavity Treatments, Procedures, and Devices of the Cardiovascular System Here are the word parts that commonly apply to the treatments, procedures, and devices associated with the cardiovascular system and are covered in the following section. Note that the word parts are color-coded to help you identify them: prefixes are yellow, combining forms are red, and suffixes are blue. Prefix Definition Combining Form Definition Suffix endo- within ultra- beyond normal angi/o aort/o arter/o, arteri/o cardi/o coron/o -ac -ary -ectomy -gram -graphy -ist -lytic -meter -metry ech/o electr/o embol/o man/o phleb/o pulmon/o son/o sphygm/o thromb/o valvul/o blood vessel aorta artery heart crown or circle, heart sound electricity plug thin, scanty vein lung sound pulse clot little valve Definition pertaining to pertaining to surgical excision, removal a record or image recording process one who specializes pertaining to loosen, dissolve measure, measuring instrument measurement, process of measuring -plasty surgical repair -rrhaphy suturing -scopy process of viewing -stomy surgical creation of an opening -tomy incision, to cut The Cardiovascular System 213 KEY TERMS A–Z 8.60 A diagnostic procedure that includes x-ray photography, MRI, angiography an jee OG rah fee or CT scan images of a blood vessel after injection of a contrast medium is called angiography. This constructed term is written angi/o/graphy. The image resulting from ____________________ is called an angiogram (AN jee oh gram), which is written angi/o/gram. When the procedure is focused on the heart, it is called cardiac angiography or coronary angiography. 8.61 The surgical repair of a blood vessel is generally known as angioplasty AN jee oh plass tee ____________________. The constructed form of this term is angi/ o/plasty. It includes procedures to reopen blocked vessels, such as balloon angioplasty, in which a balloon is inserted into a blocked vessel and inflated (■■Figure 8.8), and laser angioplasty, which uses a laser beam to open a blocked artery. ■ Figure 8.8 Angioplasty. One popular form is called balloon angioplasty, shown here. A balloon catheter is threaded into the blocked artery and positioned into the obstructed area (left). The balloon is then inflated, which presses the plaque against the vessel wall (right). After the balloon catheter is withdrawn, the plaque remains flattened, improving the flow of blood through the vessel. Source: Pearson Education Inc. Artery Atheromatous plaque Uninflated balloon on catheter Balloon inflated 8.62 The use of a flexible fiber-optic instrument, or endoscope, angioscopy AN jee OS koh pee to observe a diseased blood vessel and to assess any lesions is a procedure called ____________________. This constructed term is written angi/o/scopy. The endoscope is often a modified instrument, called an angioscope, which includes a camera at one end and a video monitor at the opposite end. 8.63 The suffix -stomy means “surgical creation of an opening.” angiostomy an jee OS toh mee The surgical procedure that involves the creation of an opening into a blood vessel, usually for the insertion of a catheter, is called ____________________. The constructed form of this term is angi/o/stomy. 8.64 The surgical incision into a blood vessel is called angiotomy an jee OT oh mee ___________________, which uses the suffix -tomy that means “incision, to cut.” The constructed form of this term reveals three word parts, as shown in angi/o/tomy. 214 Chapter 8 8.65 A procedure that obtains an x-ray image, MRI, or CT scan aortography AY or TOG rah fee image of the aorta is called ____________________. The constructed form of this term is aort/o/graphy. The image is called an aortogram. 8.66 A procedure that obtains an image of an artery is known as arteriography ahr tee ree OG rah fee ____________________. The constructed form of this term is arteri/ o/graphy, which literally means “process of recording an artery.” The image is called an arteriogram. arteriotomy ahr tee ree OT oh mee 8.67 An incision into an artery is called an ____________________. This constructed term is written arteri/o/tomy. It is usually performed to repair an injured artery during a procedure known as an arterioplasty. The conclusion of the procedure is achieved by suturing the opening, called arteriorrhaphy. 8.68 An important part of a physical examination involves listening auscultation oss kull TAY shun to internal sounds using a stethoscope (STETH oh skope) and is called ____________________. Certain sounds suggest abnormalities of heart function, especially arrhythmias and valve disorders (■Figure8.9). ■ Figure 8.9 Auscultation. A pediatrician is performing auscultation on an infant to check for possible heart disorders. Source: Image Point Fr/ Shutterstock. Did You KNOW AUSCULTATION Auscultation is derived from the Latin word ausculto, which means “to listen.” During the ancient times of Aristotle, early physicians practiced this form of evaluation by pressing an ear against the patient’s chest. The stethoscope, which literally means “instrument to view the chest,” is a device that made this procedure much more efficient by amplifying the sounds. French physician Rene Laennec was the inventor of the first stethoscope in 1816. He rolled paper into a tube shape to listen to the chest sounds of a young female patient to avoid unwanted contact between his ear and her chest. He was excited to learn of the amplified effect of the tube and developed a wooden tube that became widely used within a few years. Today, stethoscopes include two rubber earpieces and an amplifying bell orcone. The Cardiovascular System 215 8.69 Insertion of a narrow flexible tube, called a catheter, through a cardiac catheterization KAR dee ak * kath eh ter ih ZAY shun blood vessel leading into the heart is called ____________________ ____________________ (■■Figure 8.10). The procedure is performed to withdraw blood samples from heart chambers, measure pressures, and inject contrast medium for imaging purposes. The term catheter is derived from the Greek word katheter, which means “to send down.” ■ Figure 8.10 Cardiac catheterization. Insertion of a tube, called a catheter, through a blood vessel. In this example, the catheter is inserted into the brachial artery of the arm and is pushed through vessels until reaching the interior of the heart. 8.70 A cardiac pacemaker is a battery-powered device that is cardiac pacemaker KAR dee ak * PAYS may ker implanted under the skin and wired to the inner wall of the heart to help control abnormal heart rhythms (■■Figure 8.11). It produces timed electric pulses that replace the function of the SA node as a treatment for a heart block and certain other arrhythmias. Recently, the ____________________ ____________________ has been improved to adjust to the patient’s physical activity and SA node function. This is called an on-demand pacemaker. Pacemaker ■ Figure 8.11 Cardiac pacemaker. The pacemaker device is implanted beneath the skin near the heart. 216 Chapter 8 8.71 An emergency procedure that is used to maintain some cardiopulmonary resuscitation KAR dee oh PULL mon air ee * ree SUSS ih TAY shun blood flow to vital organs until the heart can be restarted is commonly abbreviated CPR, which means ____________________ ____________________. It consists of rhythmic chest compression. If the restoration of breathing is also needed, artificial respiration may be included. The constructed form of this term is written cardi/o/ pulmon/ary resuscitation. The term resuscitation is derived from the Latin word resuscitatio, which means “to revive.” 8.72 A surgical procedure that involves removing a blood vessel coronary artery bypass graft from another part of the body and inserting it into the coronary circulation is called ____________________ ____________________ ____________________ ____________________, or CABG. The grafted vessel restores blood flow to an oxygen-deprived area of the heart by carrying blood around an occluded (blocked) coronary artery (■■Figure 8.12). Saphenous vein grafts Aorta Occlusion Occlusion ■ Figure 8.12 Coronary artery bypass graft (CABG). The grafts are often obtained from the patient’s saphenous veins in the legs and are inserted to carry blood around the blockage (occlusion). The Cardiovascular System 217 8.73 An artificial, metallic scaffold that is used to support an injured coronary stent blood vessel, compress an atherosclerotic plaque, or anchor a surgical implant or graft is called a stent (■■Figure 8.13). In coronary circulation, a coronary stent may be implanted into a coronary artery that is occluded to restore blood flow to an oxygen-deprived part of the heart. A ____________________ ____________________ may also be used to prevent closure of a coronary artery after angioplasty (Frame 8.61). ■ Figure 8.13 Coronary stent. Insertion of a stent to open a coronary artery that is blocked by an atherosclerotic plaque is a popular surgery that improves blood flow to the heart. The top figure shows the stent, temporarily attached to a catheter, in place in the area of the occluding plaque. The middle figure shows the process of expanding the stent, which pushes the plaque to clear the occlusion. In the bottom figure, the catheter has been removed and the stent is fully expanded, and will remain in place after the surgery. Source: Pearson Education, Inc. Unexpanded stent on catheter Sheath removed from stent Expanded stent in place 218 Chapter 8 8.74 In cases in which an arrhythmia progresses to the state of defibrillation dee fib rih LAY shun ventricular fibrillation (Frame 8.42), an electric charge may be applied to the chest wall to stop the heart conduction system momentarily, then restart it to establish a more normal heart rhythm. This procedure is called ____________________. In most cases, the electric charge is applied to the skin of the chest with paddles using an automated external defibrillator. Abbreviated AED, a portable unit is illustrated in ■■Figure 8.14a. Alternatively, a smaller device may be surgically implanted under the skin with electrodes terminating directly on the heart. This device is called an implantable cardioverter defibrillator (ICD) and is illustrated in ■Figure 8.14b. Emergency medical technician helping with defibrillation Pads with electrodes stick to patient’s chest AED has written instructions and gives voice instructions ICD Automated external defibrillator (AED) (checks heart rhythm and can send electric shock to restore normal rhythm) (a) (b) ■ Figure 8.14 Defibrillator. Defibrillators are devices that supply a voltage charge to the heart in the hope of restarting the cardiac cycle (heartbeat). (a) A portable automated external defibrillator (AED). The unit includes two paddles that are pressed against the external chest wall, which deliver a brief voltage charge from a generator to the patient. AEDs are given credit for saving thousands of lives every year, mainly from sudden cardiac arrest (SCA). (b) An implantable cardioverter defibrillator (ICD), which is used during surgery and may be inserted for postsurgical maintenance. 8.75 An ultrasound procedure that evaluates blood flow through a Doppler sonography DOP ler * son OG rah fee blood vessel is called Doppler sonography. It is often performed on the heart or on the carotid artery of the neck to evaluate problems in blood flow in a noninvasive manner, and it may also be used to monitor pulse rate from peripheral arteries. In the term ____________________ ____________________, sonography is a constructed term, written son/o/graphy, which literally means “recording process of sound.” The Cardiovascular System 8.76 An ultrasound procedure that directs sound waves through echocardiography ek oh kar dee OG rah fee the heart to observe heart structures in an effort to evaluate heart function is called ____________________ (■■Figure 8.15). This is a constructed term with five word parts that is written ech/o/ cardi/o/graphy. The procedure may also be called cardiac ultrasonography (KAR dee ak * ul trah son OG rah fee). The record or image of the data is typically called an echocardiogram (ek oh KAR dee oh gram). If a heart condition is suspected, it is often performed during or immediately after exercise using a treadmill or stationary bicycle to reproduce the dysfunction for closer evaluation, in the procedure known as a stress ECHO. (a) ■ Figure 8.15 Echocardiography. (a) The procedure is performed by placing electrodes on the chest wall, which sends ultrasound pulses to the heart. A receiver, held by the physician or technician, picks up echoes from the pulses and sends them to a computer for analysis. (b)A monitor displays the flow of blood passing through the heart (red and yellow) and action of the heart valves, providing a record that may be digitally saved and printed. Source: (a) Anamaria Mejia/ Shutterstock (b)cylonphto/123RF.com. (b) 219 220 Chapter 8 8.77 In the procedure known as electrocardiography, electrodes electrocardiography ee LEK troh KAR dee AWG rah fee are pasted to the skin of the chest to detect and record the electrical events of the heart conduction system (■■Figure 8.16). The constructed form of ____________________ is written electr/o/ cardi/o/graphy. The record or image of the data is called an electrocardiogram and abbreviated ECG or EKG (the K is from the Greek word for heart, kardia) (see Figure 8.16b). Electrocardiography is used extensively to evaluate heart function and is the most common method for diagnosing a heart attack. It is particularly useful in diagnosing cardiac arrhythmias (Frame 8.10). When measured during physical activity using a treadmill or stationary bicycle, it is called a stress ECG. Sinoatrial node Atrioventricular node R T P Q PR interval ST segment S QT interval Time(s) 0 (b) (a) 0.2 0.4 0.6 0.8 P = Atrial depolarization QRS = Ventricular depolarization T = Repolarization ■ Figure 8.16 An electrocardiogram may be obtained while at rest (shown) or during exercise when it is called a stress ECG. (a)Electrodesare placed on the patient’s chest to record the electrical events within the heart, and the results are collected by computer and displayed on a monitor. (b) Each cardiac cycle of a normal electrocardiogram includes three peaks or waves, called the P wave, QRS wave, and T wave. Source (a): Lapina/Shutterstock. Echocardiography and Electrocardiography WORDS TO Watch Out For Echocardiography and electrocardiography are both methods of measuring heart function. The two medical terms are similar enough in construction and in meaning to be confusing. Let the word parts provide the clue. Remember that one hears an echo, and thus, echocardiography is the procedure that uses ultrasound technology to make measurements of heart function. Also remember a synonym for ultrasound is sonography, which means “recording process of sound.” The Cardiovascular System 221 8.78 The suffix -ectomy means “surgical excision, removal.” The embolectomy EM boh LEK toh mee surgical removal of a floating blood clot, or embolus (Frame 8.40), is called ____________________. The constructed form of this term is embol/ectomy. 8.79 The removal of the inner lining of an artery to remove a endarterectomy END ahr teh REK toh mee fatty plaque is a surgical procedure called endarterectomy. The constructed form of ____________________ is end/arter/ectomy, which literally means “surgical excision or removal of within artery.” The most common surgical site for this procedure is the carotid artery in the neck, which is subject to developing atherosclerotic plaques (Frame 8.26). Note that the o ending in the prefix endo- is deleted from this constructed term for ease of pronunciation. 8.80 A portable electrocardiograph may be worn by the patient to Holter monitor monitor electrical activity of the heart over 24-hour periods. The device is called a ____________________ ____________________ and is useful in detecting periodic or transient cardiac abnormalities (■Figure 8.17). ■ Figure 8.17 Holter monitor. Photograph of a portable Holter monitor on a male patient. Source: Papa1266/Shutterstock. 8.81 A drug that is commonly used as an emergency vasodilator nitroglycerin NIGH troh GLIH ser ihn to treat severe angina pectoris (Frame 8.7) or myocardial infarction (Frame 8.49) is the compound nitroglycerin. The vasodilation that results from ____________________ temporarily improves blood flow to the heart and other vital organs. 222 Chapter 8 8.82 Phlebectomy is constructed from the word root meaning phlebectomy fleh BEK toh mee “vein” (phleb) and the suffix meaning “surgical excision, removal” (-ectomy). From its word parts, we know that a ____________________ is a procedure involving the surgical removal of a vein. The constructed form of this term is phleb/ectomy. 8.83 A puncture into a vein to remove blood for sampling or phlebotomy fleh BOT oh mee donation is called phlebotomy (■■Figure 8.18). This constructed term combines the word root for vein, the combining vowel o, and the suffix meaning “incision or to cut” to create the term ____________________, which is written phleb/o/tomy. Although the word part for incision is included, a small puncture is made rather than an incision when withdrawing blood (called a venipuncture). A healthcare professional who performs this procedure is called a phlebotomist (fleh BOT oh mist). ■ Figure 8.18 Phlebotomy. In this common procedure, a syringe needle punctures a vein, usually in the arm, and withdraws blood for sampling or donation. Source: Courtesy of the Public Health Image Library, Centers for Disease Control and Prevention. 8.84 A noninvasive procedure that provides blood flow images positron emission tomography scan PAHZ ih tron * ee MISH uhn * toh MOG rah fee using positron emission tomography (PET) techniques combined with radioactive isotope labeling may be used to produce images of the heart to reveal functional defects. The procedure is called ____________________ ____________________ ____________________ ____________________, or PET scan. The Cardiovascular System 223 8.85 A common procedure that measures arterial blood sphygmomanometry SFIG moh mah NOM eh tree pressure is called ____________________. This constructed term is written sphygm/o/man/o/metry, which literally means “the process of measuring scanty gas.” It utilizes a device called a sphygmomanometer (sfig moh mah NOM eh ter), which consists of an arm cuff and air pressure pump with a pressure gauge (■Figure8.19). In recent years, the mercury pressure gauge has been replaced by aneroid dials and digital technology. ■ Figure 8.19 Sphygmomanometry. Photograph of a physician taking blood pressure readings with the use of a sphygmomanometer, which includes an arm cuff and pressure gauge. Source: Keith Brofsky/ Photodisc/Getty Images. 8.86 Treatments to dissolve unwanted blood clots are often thrombolytic therapy throm boh LITT ik * THAIR ah pee necessary after surgery to prevent the development of emboli (Frame 8.40). It is also performed soon after a myocardial infarction (Frame 8.49) to minimize damage to the heart and is credited with saving many lives. Known as ____________________ ____________________, it includes the use of drugs such as streptokinase and tissue plasminogen activator (TPA). The constructed term thrombolytic is made up of the combining form that means “clot” (thromb/o) and the suffix that means “pertaining to loosen or dissolve” (-lytic). 8.87 If a heart condition is suspected, a cardiologist will often treadmill stress test require the patient to undergo exercise during echocardiography or electrocardiography (or both) in an effort to examine heart function under stress. The most common term for this procedure is ____________________ ____________________ ____________________. 8.88 The surgical repair of a heart valve is called valvuloplasty VAL vyoo loh plass tee ____________________. The constructed form of this term is written valvul/o/plasty. If repair is not possible due to the extent of the damage or defect, valve replacement may be required using an artificial valve or a porcine (pig) valve. 224 Chapter 8 PRACTICE: Treatments, Procedures, and Devices of the Cardiovascular System The Right Match Match the term on the left with the correct definition on the right. ______ 1. cardiac pacemaker ______ 2. defibrillation a. an artificial metallic scaffold that is implanted to open a blocked coronary artery ______ 3. phlebotomy b. a drug that is commonly used as an emergency vasodilator ______ 4. Holter monitor ______ 5. coronary stent c. a patient undergoes exercise before or during echocardiography to examine heart function under stress ______ 6. PET scan ______ 7. stress ECHO ______ 8. nitroglycerin ______ 9. auscultation ______ 10. Doppler sonography d. a battery-powered device that is implanted under the skin and wired to the wall of the heart e. puncture into a vein, usually to remove blood for sampling or donation f. a portable electrocardiograph worn by the patient g. an electric charge applied to the chest wall to stop the heart conduction system momentarily, then restart it with a more normal heart rhythm h. a noninvasive procedure that provides blood flow images using positron emission tomography techniques combined with radioactive isotope labeling i. an ultrasound procedure that evaluates blood flow j. a physical examination that involves listening to internal sounds Break the Chain Analyze these medical terms: a) Separate each term into its word parts; each word part is labeled for you (p = prefix, r = root, cf = combining form, and s = suffix). b) For the Bonus Question, write the requested definition in the blank that follows. 1. a) arteriogram ________/___/________ cf s b) Bonus Question: What is the definition of the suffix? 2. a) echocardiography ________/___/________/___/________ cf cf s b) Bonus Question: What is the definition of the first combining form? 3. a) embolectomy ________/________ r s b) Bonus Question: What is the definition of the word root? The Cardiovascular System 4. a) sphygmomanometry 225 ________/___/________/___/________ cf cf s b) Bonus Question: What is the definition of the suffix? 5. a) phlebotomist ________/___/________/________ cf r s b) Bonus Question: What is the definition of the combining form? 6. a) electrocardiography ________/___/________/___/________ cf cf s b) Bonus Question: What is the definition of the suffix? 7. a) cardiopulmonary ________/___/________/________ cf r s b) Bonus Question: What is the definition of the word root in the first word? 8. a) endarterectomy ________/________/________ p r s b) Bonus Question: What is the definition of the prefix? 9. a) valvuloplasty ________/___/________ cf s b) Bonus Question: What is the definition of the suffix? Abbreviations of the Cardiovascular System The abbreviations that are associated with the cardiovascular system are summarized here. Study these abbreviations and review them in the exercise that follows. Abbreviation Definition Abbreviation Definition AED A-fib AI AS ASD ASHD AV CABG CAD CHD CHF CP CPR ECG, EKG ICD LA LV MI MVP PET RA RV SCA VSD automated external defibrillator atrial fibrillation aortic insufficiency aortic stenosis atrial septal defect arteriosclerotic heart disease atrioventricular coronary artery bypass graft coronary artery disease coronary heart disease congestive heart failure chest pain cardiopulmonary resuscitation electrocardiogram implantable cardioverter defibrillator left atrium left ventricle myocardial infarction mitral valve prolapse positron emission tomography right atrium right ventricle sudden cardiac arrest ventricular septal defect 226 Chapter 8 PRACTICE: Abbreviations Fill in the blanks with the abbreviation or the complete medical term. Abbreviation Medical Term 1. 2. 3. 4. 5. 6. 7. 8. ____________________ ASD ____________________ MI ____________________ CPR ____________________ AV congestive heart failure 9. 10. 11. 12. 13. 14. ____________________ CAD ____________________ RV ____________________ MVP electrocardiogram coronary artery bypass graft positron emission tomography arteriosclerotic heart disease automated external defibrillator ventricular septal defect CHAPTER REVIEW Word Building Construct medical terms from the following meanings. (Some are built from word parts, some are not.) The first question has been completed as an example. 1. generalized disease of the heart muscle cardiomyopathy 2. inflammation of the heart and blood vessels angio____________________ 3. narrowing of a blood vessel angio____________________ 4. tumor arising from a blood vessel angi____________________ 5. hardening of the arteries ____________________sclerosis 6. abnormally slow heart rate ____________________cardia 7. a sensation of pain in the heart cardio____________________ 8. incision into an artery to remove plaque end____________________ectomy 9. abnormal hypertrophy of the heart cardio____________________ 10. inflammation of the inner heart membrane endo____________________ 11. an abnormal heart rhythm a____________________ 12. high blood pressure that is persistent ____________________tension 13. death of a portion of the myocardium _______cardial in_______________ 14. inflammation of the myocardium myo____________________ 15. a process of recording heart electrical activity ____________________cardiography The Cardiovascular System 227 Define the Combining Form In the space provided, write the definition of the combining form, followed by one example of the combining form used to build a medical term in Chapter 8. 1. angi/o Definition Use in a Term _________________________________ _________________________________ 2. cardi/o _________________________________ _________________________________ 3. hem/o _________________________________ _________________________________ 4. phleb/o _________________________________ _________________________________ 5. sten/o _________________________________ _________________________________ 6. scler/o _________________________________ _________________________________ 7. thromb/o _________________________________ _________________________________ 8. ech/o _________________________________ _________________________________ 9. arter/o _________________________________ _________________________________ 10. coron/o _________________________________ _________________________________ 11. electr/o _________________________________ _________________________________ 12. valvul/o _________________________________ _________________________________ 13. isch/o _________________________________ _________________________________ 14. sphygm/o _________________________________ _________________________________ 228 Chapter 8 Complete the Labels Complete the blank labels in the illustrations by writing the labels in the spaces provided. 1. AIR (OXYGEN) 2. 3. Right pulmonary artery Right lung Trachea Left lung Left pulmonary artery 1._________________ 1._____________ 2._________________ Right pulmonary veins 4._______________ Veins 3. _______________ Arterioles Venules BODY CAPILLARIES = Blood low in oxygen and high in carbon dioxide (deoxygenated) ■ Figure 8.20 = Blood high in oxygen and low in carbon dioxide (oxygenated) The cardiovascular system. 4. 5. 6. 7. 8. Superior vena cava 5. ______________ Pulmonary trunk Left atrium Aortic valve Right atrium Pulmonary valve 7. ______________ valve 8. ______________ ventricle Tricuspid valve 6. ______________ ventricle Myocardium ■ Figure 8.21 Internal anatomy of the heart. The heart is sectioned to reveal its internal features. Endocardium Epicardium Inferior vena cava The Cardiovascular System MEDICAL REPORT EXERCISES Robert Gorman Read the following medical report, then answer the questions that follow. PEARSON GENERAL HOSPITAL 5500 University Avenue, Metropolis, New York Phone: (211) 594-4000 • Fax (211) 594-4001 Medical Consultation: Cardiology Patient: Robert Gorman Dob: 3/14/1954 Age: 62 Date: 10/22/2016 Patient ID: 123456 Sex: Male Allergies: NKDA Provider: Richard Freemann, MD Subjective: “I have been experiencing chest pain for the past couple of weeks, unlike any I’ve felt before. I am also tired most of the time and have lost my appetite.” 62 y/o male patient has a recent history of mild chest pain, shortness of breath, and malaise. No murmur has yet been reported. The patient says he underwent tooth extractions a month ago and had been given antibiotics by the dentist, but since he wasn’t feeling ill, he did not take them. Patient reports his father died at 79 y/o due to CHF. Objective: Vital Signs: T: 98.6°F; P: 80; R: 23; BP: 144/102 Ht: 5'8" Wt: 183 lb General Appearance: Some pallor and edema present in the face and neck. Mild diaphoresis. No noticeable discolorations of the skin. Heart: Rate at 80 bpm, with possible murmur at mitral valve. Lungs: Clear without signs of disease. AbD: Bowel sounds normal all four quadrants. MS: Joints and muscles symmetric. No swelling, masses, or deformity. CV: ECG normal. Stress ECHO shows minor vegetations of mitral valve. Assessment: Endocarditis with cardiovalvulitis on left side Plan: Long-term IV drip with nonpenicillin antibiotic. If there is no improvement in 4 weeks, consult for valvuloplasty. Photo Source: Aletia2011/Fotolia. 229 230 Chapter 8 Comprehension Questions 1. What complaints support the diagnosis? 2. Why is the patient history an important part of this diagnosis? ______________________________________________________________________________________________ 3. What is the meaning of the abbreviation CHF? Case Study Questions The following Case Study provides further discussion regarding the patient in the medical report. Fill in the blanks with the correct terms. Choose your answers from the following list of terms. (Note that some terms may be used more than once.) angina pectoris angiostenosis atherosclerosis block cardiologist cardiology cardiovalvulitis electrocardiography endocarditis myocardial infarction stress ECHO valvuloplasty A patient named Robert Gorman complained of pain in the heart area of the chest, or (a)____________________, and was subsequently referred to (b) ____________________ for immediate diagnosis and treatment. The specialist, a (c) ____________________, diagnosed the pain as having a cause from insufficient blood supply to the heart. The patient was given medication and educated about heart disease management. Several weeks later, the patient was readmitted due to continued complaints of chest pain. After evaluating heart electrical events with (d) ____________________, the physician performed a technique using sound waves to evaluate heart activity during physical exercise, known as a(n) (e)____________________ ____________________. The ECG showed a normal conduction system, thereby ruling out damage to the conduction system, or a heart (f) ____________________. The stress ECHO also showed mostly normal results, ruling out damage to the heart muscle, or a(n) (g) ____________________ ____________________, because the heart muscle was receiving sufficient levels of oxygen. Because blood flow was normal, the narrowing of a coronary artery, generally called a(n) (h) ____________________, was The Cardiovascular System 231 eliminated as a cause, which also eliminated the common plaque-forming disease that causes a stenosis, known as (i) ____________________. However, the stress ECHO did reveal abnormal valvular activity during ventricular contraction, or systole, indicating a valvular disorder called (j) ____________________. A course of treatment was ordered that included a long-term, nonpenicillin antibiotic therapy with an IV drip. If the patient did not improve, consideration for a surgical operation to repair a damaged valve, called (k) ____________________, would be made. 232 Chapter 8 For a greater challenge, read the following medical report and answer the critical thinking questions that follow from the information in the chapter. Medical Consultation: Cardiology Date: Patient: Danika Price Patient ID: Dob: 04/15/1974 Age: 42 Sex: Female Allergies: NKDA Provider: Donald H. Surley, MD Subjective: “I have been experiencing pain in my upper abdomen that comes and goes. It started about a week ago, and it interrupts my sleep.” 42 y/o female patient describes the pain as recent, within 1 week, occurring between the median and radiating to the left upper quadrant. According to her it is a sharp, intermittent pain, which increases in intensity when she stands from a sitting or lying position. Objective: Vital Signs: T: 98.6°F; P: 83; R: 21; BP: 135/90 Ht: 5'7" Wt: 135 lb General Appearance: No pallor, edema, or diaphoresis of the skin. No noticeable discolorations of the skin. No masses. Heart: Rate at 83 bpm. Heart sounds with auscultation appear normal. Lungs: Clear without signs of disease. AbD: Bowel sounds normal all four quadrants. Tenderness of the LUQ with palpation. MS: Joints and muscles symmetric. No swelling, masses, or deformity. CV: ECG normal. Aortogram reveals abnormal swelling of the aorta inferior to the celiac trunk. Assessment: Aortic aneurysm of upper abdominal aorta inferior to celiac trunk Plan: Angioplasty with stent insertion at aortic aneurysm. The Cardiovascular System 233 Comprehension Questions 1. What is the actual cause of the abdominal pain reported by the patient? ____ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 2. What procedure provided the evidence for the diagnosis? ______________________________________________________________________________________________ ______________________________________________________________________________________________ 3. What is an angioplasty and how might it correct an aortic aneurysm? ______________________________________________________________________________________________ ______________________________________________________________________________________________ Case Study Questions The following case study provides additional discussion of the patient’s condition in the medical report. Fill in the blanks with the correct terms from your readings in this chapter. Danika Price, a 42-year-old female patient with a history of persistently high blood pressure, or (l)__________________, complained of intermittent pain sensations in the upper abdomen. Upon evaluation during which an x-ray was taken of the aorta, called a(n) (m) ____________________, it became apparent that the source of the pain was from abdominal spasms of the aorta wall, called (n) ____________________, due to an abnormal dilation of the vessel wall known as a(n) (o) ____________________. To prevent a possible rupture of the wall of the aorta, a surgical repair called a(n) (p) ____________________ was scheduled. During the repair, an incision was made into the wall of the vessel in a procedure called a(n) (q) ____________________ and the vessel wall received a stent to strengthen it. The patient made a complete recovery, and received education on ways to control her essential hypertension. MyLab Medical Terminology™ MyLab Medical Terminology is a premium online homework management system that includes ahost of features to help you study. Registered users will find: • A multitude of quizzes and activities built within the MyLab platform • Powerful tools that track and analyze your results—allowing you to create a personalized learning experience • Videos and audio pronunciations to help enrich your progress • Streaming lesson presentations (Guided Lectures) and self-paced learning modules • A space where you and your instructors can view and manage your assignments