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Veterinary medical terminology guide and workbook [2nd edition.]
 9781119465720, 1119465729

Table of contents :
Title Page
Copyright Page
Contents
Preface
About the Companion Website
Chapter 1 Introduction
Anatomy of a Medical Term
The Root
The Combining Vowel
The Combining Form
The Prefix
The Suffix
Five Rules to Medical Terminology
Study Tips
Building the Terms
Combining Forms
Prefixes
Suffixes
Special Terms
Chapter Abbreviations
SOAP
Case Study: Define the medical terms and abbreviations in bold print
Exercises
Review Tables
Chapter 2 Anatomical Organization
Structural Organization
The Cell
Tissue
Organs
System
Cavities
Additional Terminology for Structural Organization
Pathology of Structures
Introduction to the Skeletal Anatomy
Directional Terms
Recumbency
Planes of the Body
The Spinal Column
From the Outside In
Building the Terms
Abbreviations
Case Study: Define the medical terms and abbreviations in bold print.
Exercises
Review Tables
Chapter 3 The Musculoskeletal System
Bones
Steps of Ossification
Anatomy of a Bone
Classifications of Bone
Related Terms and Processes
Divisions of the Skeleton
Additional Bone Pathology Terms
Joints
Anatomy of a Joint
Joint Pathology and Procedures
Muscles
Types of Muscles
Functions of Muscle
Additional Myopathy Terms
Building the Terms
Abbreviations
Case Study: Define the medical terms and abbreviations in bold print
Exercises
Review Tables
Chapter 4 The Gastrointestinal Tract
The Pathway of Food
The Oral Cavity
Pharynx
Esophagus
Stomach
Small Intestine
Large Intestine
Liver and Gallbladder
Pancreas
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study: Give the medical terms and abbreviations for definitions in bold print
Exercises
Review Tables
Chapter 5 The Reproductive System
The Male Reproductive System
Spermatozoon
Anatomy and Physiology
Terms for the Male Reproductive System
Male Reproductive System Pathology and Procedures
Anatomy and Physiology
Building the Terms
The Female Reproductive System
Ovaries
Uterine Tubes
Uterus
The Vagina and Vulva
Mammary Glands
Estrous Cycle
Pregnancy
Terms for the Female Reproductive System
Female Reproductive System Pathology and Procedures
Canine Age and Sex
Feline Age and Sex
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 6 The Cardiovascular System
Blood Vessels
Anatomy of the Heart
External Anatomy
Internal Anatomy: the Flow of Blood
The Heartbeat
Electrocardiogram
Blood Pressure
Circulation
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 7 The Respiratory Tract
Anatomy of the Respiratory Tract
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 8 Hematology
Anatomy and Physiology of Blood and Blood‐Forming Organs
Erythrocytes
Leukocytes
Thrombocytes
Serum or Plasma?
Acellular Dissolved Substances
Blood Banking
Anemia
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 9 Immunology
The Lymphatic System
The Blood System
The Immune System
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 10 The Endocrine System
Endocrine Glands
The Pituitary Gland
Thyroid Gland
Parathyroid Glands
Adrenal Glands
The Pancreas
The Thymus Gland
The Pineal Gland
The Gonads
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 11 The Integumentary System
Skin
Epidermis
Dermis
Subcutaneous Tissue
Hair
Glands
Sebaceous Glands
Sweat Glands
Nails
Related Terms
Pathology and Procedures
Coat Types and Color
Dogs
Cats
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 12 The Nervous System
Nerves
The Path of the Nervous Impulse
Nerves
Neuroglial Cells
Divisions of the Nervous System
The Central Nervous System
The Peripheral Nervous System
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study: Define the Terms and Abbreviations in Bold Print
Exercises
Review Tables
Chapter 13 The Eyes and Ears
The Eye
The Layers
The Path of Light
Ophthalmology Terms
Pathology and Procedures
Building the Terms
The Ear
The Outer Ear
The Middle Ear
The Inner Ear
Otology Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Exercises
Review Tables
Chapter 14 The Urinary System
Anatomy of the Urinary System
The Kidney
Related Terms
Pathology and Procedures
Building the Terms
Abbreviations
Case Study
Review Tables
Chapter 15 The Horse
Equine Anatomy
Equine Skeleton
Hoof Anatomy (Figure 15.2)
External Landmarks and Terminology (Figure 15.3)
Mobility
Types of Horses and their Markings
The Face
The Legs
Equine Coat Colors and Patterns
Equine Husbandry
Equipment
Care and Management
Age and Sex
Physiology and Pathology and Procedures
Commonly Used Equine Slang
Abbreviations
Exercises
Review Table
Chapter 16 Ruminants
Cattle
External Terminology
Bovine Husbandry
Age and Sex
Bovine Pathology
Sheep
External Terminology
Ovine Husbandry
Age and Sex
Goats
External Terminology
Caprine Husbandry
Age and Sex
Camelids
Camelid Husbandry
Age and Sex
Commonly Used Cattle Slang
Abbreviations
Exercises
Review Table
Chapter 17 Swine
Anatomy
Age and Sex
Husbandry
Pathology and Procedures
Abbreviations
Exercises
Review Table
Chapter 18 Exotics
Avian
External Anatomy
Feathers
Skeletal System (Figures 18.4 and 18.5)
Internal Anatomy
Egg Terminology (Figure 18.10)
Age, Sex, and Type
Pathology and Procedures
Reptiles
Amphibians
Amphibian and Reptile Terminology
Exercises
Chapter 19 Laboratory Animals
Rodents
Rats
Mice
Gerbils
Hamsters
Guinea Pigs
Chinchillas
Ferrets
Rabbits
Professional Organizations and Laws
Related Terms
Abbreviations
Exercises
Review Table
Chapter 20 Case Studies
Case Study 1: 93‐pound Labrador Mix
Case Study 2: Emma, four‐year‐old Golden Retriever
Case Study 3: Mare About to Foal
Case Study 4: Teddy, 11‐year‐old Pembroke Welsh Corgi
Case Study 5: Greta, 1½‐year‐old Golden Retriever
Case Study 6: Jewel, 13‐year‐old DSH
Case Study 7: Chuck, 10‐year‐old Maine Coon
Case Study 8: Fledge, one‐year‐old Retriever Mix
Case Study 9: Quesi, 13‐year‐old DLH
Case Study 10: Sparkle, 12‐year‐old Shetland Sheepdog
Case Study 11: Dante, four‐year‐old Rough Collie
Case Study 12: Luke, two‐year‐old Black Labrador Retriever
Case Study 13: Tiger, six‐year‐old DSH
Case Study 14: Punkin, 12‐week‐old DMH
Case Study 15: Belle, eight‐year‐old Great Pyrenees
Case Study 16: Macadamia, four‐year‐old Poodle Mix
Appendix A Pronunciation and Spelling of Terms Found in this Book
Similar Looks and Sounds of Terms
Pronunciation of Certain Vowels
Pronunciation of Certain Consonants
Rules for Plurals
Pronunciation List of Medical Terms Found in this Book
Appendix B Commonly Used Veterinary Medical Abbreviations
Recommended Reading
Glossary
Answers
Index
EULA

Citation preview

Veterinary Medical Terminology Guide and Workbook

Veterinary Medical Terminology Guide and Workbook Second Edition

Angela Taibo Bel-Rea Institute of Animal Technology, Denver, Colorado, USA

This edition first published 2019 © 2019 by John Wiley & Sons, Inc. Edition History 1e, 2014 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions. The right of Angela Taibo to be identified as the author of the editorial material in this work has been asserted in accordance with law. Registered Office John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA Editorial Office 111 River Street, Hoboken, NJ 07030, USA For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com. Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content that appears in standard print versions of this book may not be available in other formats. Limit of Liability/Disclaimer of Warranty While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. Library of Congress Cataloging‐in‐Publication Data Names: Taibo, Angela, author. Title: Veterinary medical terminology guide and workbook/ Angela Taibo. Description: 2nd edition. | Hoboken, NJ :Wiley-Blackwell, [2019] | Includes bibliographicalreferences and index. | Identifiers: LCCN 2018054702 (print) | LCCN 2018056396(ebook) | ISBN 9781119465720 (Adobe PDF) | ISBN 9781119465768 (ePub) | ISBN 9781119465706 (paperback) Subjects: LCSH: Veterinary medicine–Terminology. | Veterinary medicine–Problems, exercises, etc. | MESH: Veterinary Medicine | Terminology | Problems and Exercises Classification: LCC SF610 (ebook) | LCC SF610 .T35 2019(print) | NLM SF 610 | DDC636.089001/4–dc23 LC record available at https://lccn.loc.gov/2018054702 Cover Design: Wiley Cover Images: Background: © ivanastar/iStock.com, Horse Anatomy: © decade3d - anatomy online/Shutterstock, Rest of the images: © Angela Taibo Set in 10/12 pt Sabon by SPi Global, Pondicherry, India

10 9 8 7 6 5 4 3 2 1

Dedication For John John.

Contents

Preface About the Companion Website

xi xiii

Chapter 1 Introduction1 Anatomy of a Medical Term 1 Five Rules to Medical Terminology3 Study Tips 5 Building the Terms 5 Special Terms 12 Chapter Abbreviations 15 SOAP17 Case Study 19 Exercises20 Review Tables 23

Chapter 2 Anatomical Organization

27

Structural Organization 27 Introduction to the Skeletal Anatomy34 Building the Terms 40 Abbreviations45 Case Study 46 Exercises48 Review Tables 50

Chapter 3 The Musculoskeletal System

55

Bones55 Joints66 Muscles74 Building the Terms 78 Abbreviations86 Case Study 87 Exercises87 Review Tables 90

Chapter 4 The Gastrointestinal Tract

95

The Pathway of Food 95 Related Terms 111 Pathology and Procedures 115 Building the Terms 131 Abbreviations141 Case Study 145 Exercises145 Review Tables 149

Chapter 5 The Reproductive System

155

The Male Reproductive System Building the Terms

155 162

viii Contents

The Female Reproductive System 167 Building the Terms 186 Abbreviations192 Case Study 193 Exercises194 Review Tables 197

Chapter 6 The Cardiovascular System

203

Blood Vessels 203 Anatomy of the Heart 205 Circulation213 Related Terms 214 Pathology and Procedures 217 Building the Terms 227 Abbreviations230 Case Study 232 Exercises233 Review Tables 236

Chapter 7 The Respiratory Tract

239

Anatomy of the Respiratory Tract 239 Related Terms 242 Pathology and Procedures 243 Building the Terms 250 Abbreviations255 Case Study 257 Exercises257 Review Tables 260

Chapter 8 Hematology263 Anatomy and Physiology of Blood and Blood‐Forming Organs 263 Related Terms 275 Pathology and Procedures 276 Building the Terms 280 Abbreviations285 Case Study 287 Exercises287 Review Tables 289

Chapter 9 Immunology293 The Lymphatic System 293 The Blood System 295 The Immune System 297 Related Terms 299 Pathology and Procedures 300 Building the Terms 305 Abbreviations309 Case Study 310 Exercises310 Review Tables 312

Chapter 10 The Endocrine System

315

Endocrine Glands 316 Related Terms 323 Pathology and Procedures 325 Building the Terms 329 Abbreviations332 Case Study 333 Exercises334 Review Tables 335

Chapter 11 The Integumentary System

339

Skin339 Hair342 Glands342 Nails343 Related Terms 343 Pathology and Procedures 344 Coat Types and Color 360 Building the Terms 365 Abbreviations367 Case Study 368 Exercises368 Review Tables 372

Chapter 12 The Nervous System

375

Nerves375 Divisions of the Nervous System 378

ix

Contents

Related Terms 386 Pathology and Procedures 389 Building the Terms 394 Abbreviations401 Case Study 401 Exercises402 Review Tables 404

Chapter 13 The Eyes and Ears

409

The Eye 409 Building the Terms 425 The Ear 429 Building the Terms 434 Abbreviations437 Case Study 437 Exercises438 Review Tables 440

Chapter 14 The Urinary System

445

Anatomy of the Urinary System 445 Related Terms 449 Pathology and Procedures 451 Building the Terms 455 Abbreviations461 Case Study 462 Exercises462 Review Tables 464

Chapter 15 The Horse

467

Equine Anatomy 467 Mobility471 Types of Horses and their Markings472 Equine Coat Colors and  Patterns476 Equine Husbandry 477 Physiology and Pathology and Procedures488 Commonly Used Equine Slang 491 Abbreviations492

Exercises493 Review Tables 495

Chapter 16 Ruminants497 Cattle497 Sheep507 Goats510 Camelids513 Commonly Used Cattle Slang514 Abbreviations515 Exercises515 Review Table 519

Chapter 17 Swine521 Anatomy521 Age and Sex 522 Husbandry523 Pathology and Procedures 526 Abbreviations528 Exercises528 Review Table 529

Chapter 18 Exotics531 Avian531 Reptiles544 Amphibians545 Amphibian and Reptile Terminology546 Exercises549

Chapter 19 Laboratory Animals

551

Rodents551 Ferrets557 Rabbits561 Professional Organizations and Laws564

x Contents

Related Terms 565 Abbreviations566 Exercises567 Review Table 568

Chapter 20 Case Studies

569

Case Study 1: 93‐pound Labrador Mix 569 Case Study 2: Emma, four‐year‐ old Golden Retriever 571 Case Study 3: Mare About to Foal573 Case Study 4: Teddy, 11‐year‐old Pembroke Welsh Corgi 573 Case Study 5: Greta, 1½‐year‐ old Golden Retriever 574 Case Study 6: Jewel, 13‐year‐ old DSH 576 Case Study 7: Chuck, 10‐year‐old Maine Coon 577 Case Study 8: Fledge, one‐year‐ old Retriever Mix 578 Case Study 9: Quesi, 13‐year‐ old DLH 580

Case Study 10: Sparkle, 12‐year‐old Shetland Sheepdog 581 Case Study 11: Dante, four‐ year‐old Rough Collie 582 Case Study 12: Luke, two‐ year‐old Black Labrador Retriever584 Case Study 13: Tiger, six‐year‐ old DSH 586 Case Study 14: Punkin, 12‐week‐ old DMH 587 Case Study 15: Belle, eight‐year‐ old Great Pyrenees 588 Case Study 16: Macadamia, four‐year‐old Poodle Mix 589 Appendix A: Pronunciation and Spelling of Terms Found in this Book Appendix B: Commonly Used Veterinary Medical Abbreviations Recommended Reading Glossary Answers Index

591 615 623 625 675 707

Preface

I am honored to be writing a second edition to Veterinary Medical Terminology Guide and Workbook. When I wrote the first edition, my hope was to provide a medical terminology workbook that explained the terms in a simplistic way so that readers from all backgrounds and levels of education might find it useful. To be asked to write a new edition tells me that the students enjoy it. Having received feedback from many students and instructors, I decided to add a new chapter to this edition. A favorite among readers has been the small case studies at the end of each chapter that allow the reader to apply the terms. Because of this, I asked veterinarians and technicians if they would like to contribute a case from their practice that may be used to help others learn. Chapter 20 has taken some of these cases, changed the human names involved, and put them into a story for the reader to apply their knowledge. Also new to this edition are word searches available on the website and an expanded audio library containing the pronunciation of the majority of the terms in the book. Just click on the term and you can listen to how it is pronounced. This is a very useful tool when trying to remember how to spell the terms. Proper pronunciation of medical terms is essential for communication with others in the veterinary field. I’d like to thank Wiley‐Blackwell for allowing me to make this extensive library for the readers. Areas of challenge for new students include the large animals. To aid the reader, I’ve expanded the large animal chapters to include commonly used slang in practice and a section on equine coat colors. When asked to write this new edition, the first thing I wanted to do was to add more images to the book. Images can help with memorization and the reader can see the terms as they are applied in practice. While my personal library of images was vast, I still found myself in desperate need of images. I took to social media asking for images and case study ideas and was amazed at the feedback that I received. I’m always telling my students that the veterinary field is a tight‐knit community. We are always helping and learning from one another. I received images from my graduates, their contacts, and additional people whom I had never met. I continue to meet amazing people while working on this project and I know I have made friends that will last a lifetime. The key to medical terminology is finding which memorization skills work best for you. Repetition is a key study skill when memorizing these terms and definitions. To assist with this, I’ve added blank tables at the end of each chapter for the reader to fill in and practice what they’ve learned. I encourage my students to download these tables and utilize them daily to see how much they’re able to fill in without referring to their

xiiPreface

notes. Because a part of learning medical terminology is also learning basic anatomy and physiology, I’ve included blank versions of the many diagrams found in this book so that the student may practice their anatomy. I would like to thank the newest contributors of my book including Lanie Maes, Kari Walker, Lauren Minner, Kim Sykes, Judy Daniels, Amy Johnson, Alisha Coombe, Linda Coombe, Dan Coombe, Danielle Ritter, Holly Jensen, Jennifer Gunter, Christine Gilbreath, Ethan Heritage, Sarah Goos, Lindsey Towery, Steven Shimer, Lindsey Steele, Donna Tunis, Stacy Fowler, Heather Hyatt, Judy Zane, Kimberly Perkovich, Diane Tonmanikout, Sam Patterson, Sam Grebe, Jennifer Tabor, Dr. Sharyn Esposito, Jeanette Nash, Nora Vanatta, Chynel Dobbs, Beth Romano, Dr. Alison Traylor, Kayden Najera, Megan Dyer, Giselle Trujillo, Brittany Lindstrom, Katy Echeagaray, Dr. Bobbi Hafer, Cristina Montemayor, Kyana Silvia, Brian Lowery, Elsa Morales, Katie VanWinkle, Kristina Gutt, Rela Goodwin, Candace Cotter, Andrea Provenzano, Anna Morse, Pamela Danielson, Stephanie Hunt, Stacy Dietrich, Annie McCabe, Erin Gregory, Wendy White, Amanda Counterman, Stephanie Berg, Amanda Baca, Kristina Vigil, Shannen Casados, Annette Temple, Kylee Jewel, Brittany Carnes, Elizabeth Wallace, Dr. Carole C. Miller, Sara Sharp, Rose‐Ann Gillespie, Sarah Liechty, Kailey Adams, Tom Shaw, Megan Dujardin, Jennifer Poehlman, and Heather McAndrews. I am grateful to my previous contributors including Dr. Greg Martinez, Irene Chou, Deanna Roberts, Dr. Patrick Hemming, Tammy Schneider, Dr. Debra Van Houten, Gina Stonier, Janet King, Michaela Witcher, Scott Newman, Cyndi Rideout, Amy Perez, Jan Lyons‐Barnett, and Jessie Loberg. Not all of these people contributed images. Instead they contributed to my knowledge. At the beginning of each school term, I encourage my students to work at an animal hospital or shelter. This helps the students to see these various terms applied and it encourages repetition by performing some of the tasks. I have now been in the veterinary field for over 30 years and while I learned much in school, I feel the knowledge I gained working in practice was invaluable. The veterinarians and technicians that I worked with walk on water in my mind. They opened up a wealth of knowledge for me and made learning much easier while in school. To my former coworkers from VCA Wingate Animal Hospital including Dr. Sam Mersfelder, Dr. Earl Wenngren, Dr. Debra Singleton, Dr. Donna Anglin, and Beverly Gollehon, you changed my life all those years ago. You will always be my family. You were patient and encouraging with me and y’all taught me how best to succeed in this field and in life. I will forever be grateful for all that you did for me. Finally, I would like to thank my students and readers. You have probably been told by your instructors or coworkers that because you’re in a medical field, you will forever be learning. You will read journal articles, attend continuing education conferences, and listen to speakers from companies that visit your clinic. I have discovered that I am also continuing to learn from you all. The feedback that I receive and the variety of people and personalities that I meet keep me on my feet. I’m always listening and discovering new and better ways to teach. My goal is that in the future, I can continue to expand and share this knowledge with the reader.

About the Companion Website

This book is accompanied by a companion website: www.wiley.com/go/taibo/veterinary The website includes: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from each chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzles

C h a p t e r

1

Introduction

Understanding the language of medicine is basic to comprehension and com­petency in the world of veterinary ­ medicine. Medical terms are often heard on various television shows and movies and are seen in novels. What you may not realize is that these medical terms  are  variations of Greek and Latin terminology. When we see medical terms, we should look at them differently from other words in the English language. Your task in learning medical terminology is to break these big words into smaller components, understand the meaning of those compo­ nents, and then create an overall defini­ tion for the medical term. Basic knowledge of anatomy and physi­ ology is essential for the understanding of  these medical terms. Therefore, this textbook will use various diagrams and ­ photographs to help you to learn this new language. This book will not go into further detail other than the basics. You must learn medical terminology before focusing on more complicated curriculum. Ultimately the use of proper medical terminology is key to a professional work  environment. Proper spelling and pronunciation of medical terms is essential for communication with the professional staff as well as clients.

Anatomy of a Medical Term There are five components to medical terms. Typically, a medical term will use two or three of these components. There is no rule that states how many parts a medical term must use. Your goal is to break down a medical term into its component parts, then define each part separately. These compo­ nents were derived from Greek or Latin, so when defining these parts, we are in essence translating them to the English language. This book does not nearly cover all the medical terms that have ever existed. Instead, it will prepare you for any terms that you may encounter by teaching you how to translate their component parts.

The Root The root is the foundation of the term. It is the basic essential part of the word that other words are derived from. Think of it as the root of a tree. Like the roots of a tree holding it in place, the root of a medical term holds the main meaning of the word. You are probably already familiar with some roots of medical terms that you’ve heard from friends, family, and television shows. The following are examples of roots:

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

1

2

Root Cardi Hemat Dermat Gastr Enter

Veterinary Medical Terminology Guide and Workbook

Meaning = Heart = Blood = Skin = Stomach = Small intestine

Example of Use Cardiology Hematology Dermatology Gastrology Enterology

Study of the heart Study of blood Study of skin Study of the stomach Study of the small intestine

The Combining Vowel The combining vowel is a vowel that is used to link the root to its suffix. In most cases it is the letter “o.” The combining vowel has no meaning and therefore will not alter the meaning of the term. The ­following is an example of how the combining vowel is used: HEMAT/O/LOGY Root

Suffix Combining vowel

Notice that in order to attach the root “Hemat” to the suffix “‐logy,” we must use a combining vowel. In this case it is the letter “o.”

The Combining Form The combining form is the root plus its combining vowel. The meaning of the root is not altered by adding the combining vowel. Let’s use roots from previous examples: Combining Form Cardi/o Hemat/o Dermat/o Gastr/o Enter/o

Meaning = Heart = Blood = Skin = Stomach = Small intestine

The Prefix The prefix precedes the root (comes before the root) and modifies its meaning. Not all terms will have a prefix. Prefix Sub‐ Epi‐ Trans‐

Meaning Below Above Across

Example of Use Subgastric Epigastric Transgastric

Pertaining to below the stomach Pertaining to above the stomach Pertaining to across the stomach

Chapter 1 Introduction

3

The Suffix The suffix follows the root and modifies its meaning. Suffix ‐ic ‐logy ‐itis

Meaning Pertaining to Study of Inflammation

Example of Use Gastric Hematology Enteritis

Now we need to combine these parts. Because the suffix “‐ic” begins with a vowel, then we must drop the combining vowel in the combining form gastr/o. Therefore, we drop the letter “o.”

TECH TIP 1.1  If you need a quick reference for word parts and definitions, check out the glossary in the back of this book.

GASTR/ O



Five Rules to Medical Terminology

­IC

GASTRIC

In the second example we look at the definition “study of the stomach.”

There are five basic rules to medical termi­ nology. If you can remember these rules then understanding the terms and their meanings will be much easier. 1. If a suffix begins with a vowel, drop the combining vowel. The following are two different examples to illus­ trate this rule. In the first example, we’ll come up with the medical term that means “pertaining to the stomach.” If you refer to the previous examples under their word parts you’ll see that the suffix for “pertain­ ing to” is “‐ic,” and the combining form for stomach is “gastr/o.”



Pertaining to the stomach Study of blood Inflammation of the small intestine

Gastr/o Stomach ­logy Study of



Because the suffix does not begin with a vowel, we can keep the combining vowel. GASTR/O ­LOGY

GASTROLOGY

2. Read the parts to define the term from back, then to the beginning, and follow through. You have probably noticed by now that when we define a medical term, we begin at the suffix, then look at the beginning of the term, and follow through. The following is an example of this rule:

Gastr/o Stomach ­ic Pertaining to

SUBGASTRIC Prefix (Below)

=

SUB/GASTR/IC Suffix (Pertaining to)

Combining form (Stomach)

4

Veterinary Medical Terminology Guide and Workbook

Define the suffix, followed by the prefix, and then follow through. SUBGASTRIC

PERTAINING TO BELOW THE STOMACH

Not all medical terms will use this rule; however, the rule will apply 90% of the time. 3. Keep the combining vowel between roots. Some medical terms have more than one root. When attaching roots together we leave the combining vowel between them.

GASTR/O/ENTER/O/LOGY In this example we have combined the combining forms “gastr/o” for

the term enterogastrology because the intestines are not before the stomach. If you’re asking how I know this, don’t worry, this textbook will teach you basic anatomy so you will also know how to place certain roots in anatomical order. 5. Not all terms break down exactly. This rule – knowing when to define a medical term literally or use a “spe­ cial” definition – can be the most frus­ trating for students. Unfortunately, this knowledge only comes with prac­ tice and memorization. You will notice that common sense will become useful with some of these terms. To illustrate this rule, we will look at the term “orthopedic.” ORTH/O/PED/IC



GASTR/O/ENTER/O/LOGY Study of

Stomach Small intestines stomach and “enter/o” for small intestine. Because we have two roots in the term, “gastr” and “enter,” we must leave the combining vowel between them. In this case it’s the letter “o.” Using our previous rule of how to break down a medical term we get the following: Definition: Study of the stomach and small intestines. 4. List the roots in anatomical order. By now you’ve already used this rule without even realizing it. If we look at the previous term, gastroenterology, the roots are listed in ­ anatomical order. The stomach comes before the small intestines in the order of the organs of the gastrointestinal (GI) tract. It wouldn’t make sense to have

You or a friend may have been seen  by an orthopedic surgeon or orthopedic specialist. Usually people associate this term with bones and joints. However, if you break the term down literally, that doesn’t make sense. Word Part Orth/o Ped/o ‐ic

Meaning Straight Child Pertaining to

If using the basic rules of medical terminology to define this term, then the definition would be “pertaining to a straight child.” It is for this reason that we must create special definitions for certain terms.

Chapter 1 Introduction

5

Study Tips Understanding medical terminology comes down to memorization. You must find the study technique that works best for you. Memorizing the component parts and their definitions is essential to under­ standing and defining medical terms. Techniques that may help with memoriza­ tion include: • Writing the combining forms, suffixes, and prefixes on one side of a page and then their definitions on the other side. Repetition is the key. Also try to write out definitions first and then come up with the combining forms, prefixes, and suffixes. Learn the terms both ways. • Make up flashcards with the com­ ponent parts on one side and their meaning on the other side. By the end of this textbook, your pile of note cards will probably be more than 6 feet tall. • Write and speak the terms over and over again. • Learn the pronunciation of the terms. You can use the textbook website, which offers a list of the terms in this book and enables you to listen to how they are pronounced, or refer to the pronunciation sections in Appendix A. Sound out the terms. • Conduct group studies, which work well for subjects like medical terminol­ ogy. Bring a dry‐erase board to the study group and write the terms or definitions on the board, one at a time. The members of the group can say their answers and how they remembered them. Hearing classmates use these terms helps you to remember them. Memorization is both a visual and audio technique. • Relate the terms to a specific body part or body function. Whether you use this tech­ nique while thinking of your pet’s body or even your own, it can be quite useful. • Ask for help. Students don’t do this enough. I realize that this subject can be overwhelming and some of you may be afraid to ask for help. The sooner

• • •

• •

you ask someone for help, the easier your learning experience will be. If you fail to ask then you will feel as if you’re drowning halfway through the book. Use the review exercises at the end of each chapter. Make up your own terms using the component parts you’ve already learned. Create your own review exercises and mock quizzes. This can be a very use­ ful tool when working in study groups. It’s also a useful tool to prevent test anxiety. Make multiple copies of the work­ book pages and then each day, try to fill them in. If you aren’t already working in a practice or shelter, try volunteering or working part‐time at one. Hearing and  seeing these terms used on a con­sistent basis can help with m ­ emorization.

Building the Terms Combining Forms For combining forms with multiple mean­ ings, the context in which the term is used determines which definition to choose (Table 1.1).

Prefixes Prefixes alter the meaning of the term. For prefixes with multiple meanings, the combining form the prefix is attached to determines which meaning to use (Table 1.2).

Suffixes Suffixes also alter the meaning of the term. For suffixes with multiple meanings, the combining form the suffix is attached to determine which meaning to use (Table 1.3).

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Veterinary Medical Terminology Guide and Workbook

Table 1.1  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Arthr/o

Joint

Hemat/o

Blood

Bi/o

Life

Hepat/o

Liver

Carcin/o

Cancer

Hist/o

Tissue

Cardi/o

Heart

Iatr/o

Treatment

Cephal/o

Head

Leuk/o

White

Cis/o

To cut

Nephr/o

Kidney

Col/o; Colon/o

Large intestine (colon)

Neur/o

Nerve

Cyst/o

Urinary bladder; cyst

Ophthalm/o

Eye

Cyt/o

Cell

Opt/o

Eye; vision

Derm/o

Skin

Oste/o

Bone

Dermat/o

Skin

Path/o

Disease

Electr/o

Electricity

Radi/o

X‐rays

Encephal/o

Brain

Ren/o

Kidney

Enter/o

Small intestine

Rhin/o

Nose

Erythr/o

Red

Sarc/o

Connective tissue

Gastr/o

Stomach

Sect/o

To cut

Glyc/o

Sugar

Thromb/o

Clot; clotting

Gnos/o

Knowledge

Ur/o

Urine; urinary tract

Hem/o

Blood

TECH TIP 1.2  Do you know when to use Ren/o vs. Nephr/o? Ren/o may only be used with the suffix ‐al. Nephr/o can be used with a variety of suffixes to describe a condition (usually abnormal) of the kidney.

Chapter 1 Introduction

7

Table 1.2  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

in‐

in; into; not

brachy‐

short

intra‐

within; into

dia‐

through; complete

meso‐

middle

dolicho‐

long

pro‐

before; forward

endo‐

in; within

re‐

back; again; backward

epi‐

above; upon; on

retro‐

behind; back; backward

ex‐, exo‐

out; away from

sub‐

under; below

extra‐

outside

trans‐

across; through

hyper‐

above; excessive

hypo‐

deficient; below; under; less than normal

Suffix

Definition

‐ac, ‐al, ‐ic, ‐ical pertaining to

‐ion

process

‐algia

pain

‐ist

specialist

‐centesis

surgical puncture to remove fluid or gas

‐itis

inflammation

‐logy

study of

‐cyte

cell

‐oma

‐cytosis

increase in cell number

tumor; mass; fluid collection

‐drome

to run

‐opsy

view of

‐ectomy

removal; excision; resection

‐osis

abnormal condition

‐pathy

‐emia

blood condition

disease condition; emotion

‐emic

pertaining to a blood condition

‐scope

instrument for visual examination

‐genic

produced by or in

‐scopy

visual examination

‐gram

record

‐sis

state of; condition

‐graph

instrument for recording

‐tomy

‐graphy

process of recording

incision; process of cutting into

Table 1.3  Suffixes.

Suffix

Definition

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Veterinary Medical Terminology Guide and Workbook

TECH TIP 1.3  Be Careful with “‐genic”! Normally this suffix is defined as “produced by” or “produced in.” However, when attached to the combining forms Carcin/o and Path/o, rule 5 comes into play. We define ‐genic as “produces” or “producing.”

Parts Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o

+ ‐ectomy + ‐itis + ‐centesis + ‐logy + ‐pathy + ‐scope + ‐scopy + ‐osis + ‐tomy

Bi/o Bi/o Bi/o Carcin/o Cardi/o Cardi/o Cardi/o intra‐ retro‐ Cephal/o ex‐ in‐ Col/o Colon/o Col/o Colon/o Colon/o Colon/o Colon/o Cyst/o Cyst/o Cyst/o Cyst/o

+ ‐logy + ‐logy + ‐logy + ‐genic + ‐ac + ‐logy + ‐pathy + Cardi/o + Cardi/o + ‐ic + Cis/o + Cis/o + ‐ectomy + ‐ectomy + ‐itis + ‐itis + ‐ic + ‐pathy + ‐scopy + ‐algia + ‐ectomy + ‐itis + ‐centesis

Now it’s time to put these word parts together. If you memorize the meaning of the combining forms, prefixes, and suf­ fixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms.

Medical Term = Arthrectomy = Arthritis = Arthrocentesis = Arthrology = Arthropathy = Arthroscope = Arthroscopy = Arthrosis = Arthrotomy

+ ‐ical + ‐ist

+ ‐ac + ‐ac + ‐ion + ‐ion

= Biological = Biologist = Biology = Carcinogenic = Cardiac = Cardiology = Cardiopathy = Intracardiac = Retrocardiac = Cephalic = Excision = Incision = Colectomy = Colonectomy = Colitis = Colonitis = Colonic = Colonopathy = Colonoscopy = Cystalgia = Cystectomy = Cystitis = Cystocentesis (Figure 1.1)

Definition

:_______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ Notice that the combining vowel was dropped with the suffix “‐osis,” but kept with the suffix “‐tomy.” : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________

Chapter 1 Introduction

9

Figure 1.1  Cystocentesis on a cat. Source: Courtesy of Greg Martinez DVM; http://www.youtube.com/ drgregdvm.

Cyst/o Cyst/o Cyt/o Cyt/o Dermat/o Dermat/o Derm/o hypo‐ intra‐ Electr/o Electr/o Electr/o Encephal/o Encephal/o Encephal/o Encephal/o Endo‐ Endo‐

+ ‐gram + ‐tomy + ‐logy + ‐logy + ‐itis + ‐logy + ‐al + Derm/o + Derm/o + Cardi/o + Cardi/o + Encephal/o + ‐ic + ‐itis + ‐gram + ‐graphy + ‐scope + ‐scopy

Enter/o Enter/o Enter/o Enter/o Erythr/o Erythr/o

+ ‐ic + ‐itis + ‐logy + ‐pathy + ‐cyte + ‐cytosis

Gastr/o Gastr/o Gastr/o Gastr/o

+ ‐ectomy + ‐ic + ‐itis + ‐tomy

+ ‐ical

+ ‐ic + ‐al + ‐gram + ‐graphy + ‐gram

= Cystogram : _______________ = Cystotomy : _______________ = Cytology : _______________ = Cytological : _______________ = Dermatitis : _______________ = Dermatology : _______________ = Dermal : _______________ = Hypodermic : _______________ = Intradermal : _______________ = Electrocardiogram : _______________ = Electrocardiography : _______________ = Electroencephalogram : _______________ = Encephalic : _______________ = Encephalitis : _______________ = Encephalogram : _______________ = Encephalography : _______________ = Endoscope : _______________ = Endoscopy : _______________ (Figure 1.2) = Enteric : _______________ = Enteritis : _______________ = Enterology : _______________ = Enteropathy : _______________ = Erythrocyte : _______________ = Erythrocytosis : _______________ This condition is also known as polycythemia. = Gastrectomy : _______________ = Gastric : _______________ = Gastritis : _______________ = Gastrotomy : _______________

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Veterinary Medical Terminology Guide and Workbook

(A)

(B)

(C)

Figure 1.2  Endoscopy. (A) Veterinarian and technician with endoscope. (B) Image from the endoscope on the screen. (C) Foreign body located with endoscope. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Gastr/o epi‐ hypo‐ Glyc/o hyper hypo‐ Hemat/o Hemat/o Hepat/o Hepat/o Hepat/o sub‐

+ Enter/o + Gastr/o + Gastr/o + ‐emic + Glyc/o + Glyc/o + ‐logy + ‐oma + ‐ic + ‐itis + ‐oma + Hepat/o

+ ‐itis + ‐ic + ‐ic + ‐emia + ‐emia

+ ‐ic

= Gastroenteritis = Epigastric = Hypogastric = Glycemic = Hyperglycemia = Hypoglycemia = Hematology = Hematoma = Hepatic = Hepatitis = Hepatoma = Subhepatic

: _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________

Chapter 1 Introduction

trans‐ Hist/o Hist/o Hist/o

+ Hepat/o + ‐logy + ‐logy + Path/o

Iatr/o Leuk/o Leuk/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Neur/o Neur/o Neur/o Neur/o Neur/o Ophthalm/o Ophthalm/o Ophthalm/o Ophthalm/o

+ ‐genic + ‐cyte + ‐cytosis + ‐algia + ‐ectomy + ‐itis + ‐osis + ‐gram + ‐oma + ‐logy + ‐al + ‐algia + ‐ectomy + ‐itis + ‐logy + ‐ic + ‐logy + ‐logy + ‐scope

Opt/o Opt/o Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o Path/o Path/o Path/o Radi/o

+ + + + + Arthr/o + + + + + + ‐logy + ‐graph

Radi/o Radi/o Ren/o re‐ Rhin/o Thromb/o

+ ‐graphy + ‐logy + ‐al + Sect/o + ‐itis + ‐cyte

Thromb/o Ur/o

+ ‐cytosis + ‐logy

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+ ‐ic + ‐ist + ‐logy + ‐ist

+ ‐ist

‐ic ‐ical ‐ectomy ‐itis + ‐itis ‐genic ‐logy ‐tomy ‐genic ‐logy + ‐ist

+ ‐ion

= Transhepatic = Histology = Histologist = Histopathologist

: _______________ : _______________ : _______________ : _______________

= Iatrogenic : _______________ = Leukocyte : _______________ = Leukocytosis : _______________ = Nephralgia : _______________ = Nephrectomy : _______________ = Nephritis : _______________ = Nephrosis : _______________ = Nephrogram : _______________ = Nephroma : _______________ = Nephrology : _______________ = Neural : _______________ = Neuralgia : _______________ = Neurectomy : _______________ = Neuritis : _______________ = Neurology : _______________ = Ophthalmic : _______________ = Ophthalmologist : _______________ = Ophthalmology : _______________ = Ophthalmoscope : _______________ (Figure 1.3) = Optic : _______________ = Optical : _______________ = Ostectomy : _______________ = Osteitis : _______________ = Osteoarthritis : _______________ = Osteogenic : _______________ = Osteology : _______________ = Osteotomy : _______________ = Pathogenic : _______________ = Pathology : _______________ = Pathologist : _______________ = Radiograph : _______________ (Figure 1.4) = Radiography : _______________ = Radiology : _______________ = Renal : _______________ = Resection : _______________ = Rhinitis : _______________ = Thrombocyte : _______________ Also known as a platelet. = Thrombocytosis : _______________ = Urology : _______________

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Veterinary Medical Terminology Guide and Workbook

Figure 1.3  Ophthalmoscope.

Figure 1.4  Radiograph of a cat.

Special Terms The following medical terms do not break down correctly. Therefore, we must create new and more specific definitions. Anemia Biopsy Brachycephalic Dolichocephalic Mesocephalic Carcinoma Sarcoma Prodrome Syndrome Signalment Leukemia

Decrease in red blood cells and/or hemoglobin. Removal of tissue for microscopic examination. Pertaining to a short, wide head (i.e., Persians, Pugs, Boston Terriers). Pertaining to a narrow, long head (i.e., Greyhounds, Collies). Pertaining to an average width head (i.e., Golden Retrievers). Malignant tumor arising from epithelial tissue. Malignant tumor arising from connective tissue Symptoms run together before the onset of a more specific disease. Symptoms that run together and point to a specific disease. Description of the patient such as age, breed, weight, and sex. Increase in the number of cancerous white blood cells.

TECH TIP 1.4  Various breeds have a variety of skull shapes. Brachycephalics are of greatest concern because they are predisposed to various medical conditions. These animals are an anesthetic risk so additional precautions must be taken with surgery. See Figure 1.5.

TECH TIP 1.5  Leukocytosis vs. Leukemia At first glance the definitions for these terms are very similar. However, there is one word that makes a huge difference: cancerous. Leukocytosis is simply an increase in the number of white blood cells, whereas leukemia is an increase in the number of cancerous white blood cells.

Chapter 1 Introduction

(A)

13

(B)

(C)

(D)

Figure 1.5  (A) A Pug is an example of a brachycephalic breed. Source: Courtesy of Lanie Maes. (B) Persians are brachycephalics. Source: Courtesy of Lauren Minner, AAS, LVT. (C) Greyhounds are dolichocephalics. Source: Courtesy of shutterstock/Jagodka. (D) Golden Retrievers are mesocephalics. Source: Courtesy of Judy Daniels.

Diagnosis Prognosis Canine Feline Equine Bovine Ovine Caprine Porcine

Estimation of the cause of disease. Estimation of disease outcome. Dog. Cat Horse. Cattle. Sheep. Goat. Pig.

Aggressive Eager to fight (Figure 1.6A, B). Alert Energetic, quick, and responsive (Figure 1.6C). Docile Relaxed, easy to handle (Figure 1.6D). Feral Wild (Figure 1.6E). Submissive Willing to submit (Figure 1.6F). Anxious Feeling of uneasiness or apprehension (Figure 1.6G).

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Veterinary Medical Terminology Guide and Workbook

(A)

(B)

(C)

(D)

(F)

(E)

(G)

Figure 1.6  Types of behavior. (A) Aggressive cat. Source: Courtesy of shutterstock/Kuzmin Andrey. (B) Aggressive dog. Source: Courtesy of shutterstock/Antonova Victoria. (C) Alert cat. Source: Courtesy of shutterstock/Adisa. (D) Docile cat. Source: Courtesy of shutterstock/Jennifer Nickert. (E) Feral cat. Source: Courtesy of shutterstock/Andre Blais. (F) Submissive dog. Source: Courtesy of shutterstock/cynoclub. (G) Anxious dog. Source: Courtesy of Amy Johnson BS, LVT, RLATG.

Chapter 1 Introduction

Chapter Abbreviations At the end of each chapter there is a set of abbreviations that are commonly used in

15

veterinary medicine. These abbreviations can be used to communicate with other pro­ fessionals on cage cards, files, appointment books, and prescription labels (see Table 1.4).

Table 1.4  Abbreviations.

Abbreviation

Definition

BAR

Bright, alert, responsive

BARH

Bright, alert, responsive, hydrated

BD/LD

Big dog/little dog

QAR

Quiet, alert, responsive

CCU

Critical care unit

ICU

Intensive care unit

CWPM

Continue with previous medication

DLH

Domestic long hair (a mixed‐breed cat with long hair) (see Figure 1.7)

DMH

Domestic medium hair (a mixed‐breed cat with medium hair) (see Figure 1.7)

DSH

Domestic short hair (a mixed‐breed cat with short hair) (see Figure 1.7)

DOA

Dead on arrival

DOB

Date of birth

ER

Emergency room

OR

Operating room

GROS

Gross review of systems

K‐9

Canine

ISO

Isolation unit

NAF

No abnormalities found

NSF

No significant findings

P/E

Physical examination

PPH

Past pertinent history

R/O

Rule out (Continued )

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Veterinary Medical Terminology Guide and Workbook

Table 1.4  (Continued) Abbreviation

Definition

SOAP

Subjective, objective, assessment, plan (see explanation in following section)

TPR(W)

Temperature, pulse, respiration, (weight)

WNL

Within normal limits

°C

Degree Celsius

°F

Degree Fahrenheit

(A)

(B)

(C)

Figure 1.7  (A) Domestic long hair (DLH). Source: Courtesy of Alisha Coombe. (B) Domestic medium hair (DMH). Source: Courtesy of Danielle Ritter, CVT. (C) Domestic short hair (DSH). Source: Courtesy of Holly Jensen, CVT.

Chapter 1 Introduction

SOAP When the veterinary technician goes into the exam room to perform the TPR(W) (Figure 1.8) and to speak with the owner, the tech begins to fill out a patient record

17

(Figure  1.9). As you can see, the tech recorded the patient’s TPR(W) and began a SOAP. There are parts of the SOAP that can be filled out by the technician and other parts to be filled out by the veterinarian. The type of information is as follows:

Figure 1.8  Technician performing P/E and TPR. Source: Courtesy of J.M. Gunter, CVT.

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Veterinary Medical Terminology Guide and Workbook

Figure 1.9  Example of using SOAP in a patient file.

Chapter 1 Introduction

S (Subjective): O (Objective): A (Assessment): P (Plan):

19

How the animal appears; opinions. For example, is he/she depressed, BAR, not eating well. Facts. Things that can be reproduced or measured. For example, an increased temperature or white blood cell count. Initial diagnosis. This aspect is for the doctor only. Technicians do not diagnose so they will leave this section to the veterinarian. This is the technician’s focus. Lab tests, treatments, and radiographs are ordered. Surgery is recommended. It is the technician’s job to carry out these tests.

Case Study: Define the medical terms and abbreviations in bold print Maverick, a 12‐year‐old K‐9, comes in to your clinic for a yearly exam. His owners have just moved from Texas to your state. As the veterinary technician, you are the first into the exam room to perform the TPR(W) and to speak with the owner about their visit today. Maverick appears BAR and his TPR is normal. His DOB is May 5, 2000. The owner, Mrs. Nethery, mentions that Maverick was seen by a different veterinarian a few months ago because he was limping. After obtaining a PPH, the owner gives you the copies of Maverick’s records and radiographs from the previous clinic. According to Maverick’s records, he was previously diagnosed with cardiopathy, arthritis, and hepatitis. The veterinarian, Dr. Rojas, enters the exam room to perform the P/E. He immediately notices that Maverick has dermatitis on his abdomen. Dr. Rojas decides to perform a cytology on the affected area of skin. The skin scrape shows NSF. While speaking to Mrs. Nethery, the doctor feels a mass in the hypogastric region. After discussing the options, Mrs. Nethery agrees to let Dr. Rojas obtain a gastric biopsy the following day. The following day, Maverick checks in for surgery and has a pre‐surgical hematology panel done. His erythrocytes, leukocytes, and thrombocytes are WNL. Hepatic enzymes are slightly elevated, but Dr. Rojas isn’t too concerned about it. An electrocardiogram is also done because Maverick was previously diagnosed with a cardiopathy. The results were unremarkable. He’s taken to the OR where an incision is made into the abdomen and the mass is excised. Dr. Rojas asks you to send the mass to a reference lab for a biopsy. Maverick is sent to the ICU for recovery after surgery because of his age. The recovery goes well and Maverick is sent home. You tell Mrs. Nethery that the biopsy results will be back in three to five working days. After a week has passed, Mrs. Nethery has returned with Maverick for a post‐surgical exam. Maverick’s incision is healing nicely. Dr. Rojas explains that the mass was a carcinoma. His prognosis is guarded.

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Veterinary Medical Terminology Guide and Workbook

Exercises 1‐A:  Match the combining forms with their meaning. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

____________ Heart ____________ Small intestine ____________ Brain ____________ Liver ____________ Electricity ____________ Urinary bladder ____________ Stomach ____________ Sugar ____________ Joint ____________ Blood ____________ Skin ____________ Large intestine

A. Arthr/o B. Cardi/o C. Col/o D. Cyst/o E. Dermat/o F. Electr/o G. Encephal/o H. Enter/o I. Gastr/o J. Glyc/o K. Hemat/o L. Hepat/o

1‐B:  Write the correct medical term in the blank. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

___________________: Study of tissue ___________________: Mass or collection of blood ___________________: Inflammation of the brain ___________________: Disease condition of the heart ___________________: Tumor on the liver ___________________: Inflammation of the liver ___________________: Incision into bone ___________________: Increase in platelets ___________________: Specialist in the study of disease ___________________: Abnormal condition of the kidney ___________________: Instrument to visually examine the eye ___________________: Record of electricity in the heart ___________________: Pertaining to nerves ___________________: Red blood cell ___________________: Pertaining to below the skin ___________________: Pertaining to below the liver ___________________: Blood condition of excessive sugar ___________________: Estimation of the cause of disease ___________________: Inflammation of skin ___________________: Pertaining to outside the liver

1‐C:  Complete the definition for the following terms. 1.  2.  3.  4.  5. 

Arthralgia: Pain in the _________________. Neuritis: _________________ of nerves. Arthrocentesis: _________________ from a joint. Rhinitis: Inflammation of the _________________. Cephalic: Pertaining to the _________________.

Chapter 1 Introduction

21

6.  Anemic: Pertaining to a decrease in _________________ and/or _________________. 7.  Ophthalmology: Study of the _________________. 8.  Colectomy: Removal of the _________________. 9.  Incision: Process of _________________. 10.  Nephrectomy: Removal of the _________________. 1‐D:  Define the following suffixes. 1.  2.  3.  4.  5.  6. 

___________________: ‐itis ___________________: ‐ectomy ___________________: ‐tomy ___________________: ‐gram ___________________: ‐scopy ___________________: ‐osis

7.  8.  9.  10.  11.  12. 

___________________: ‐ist ___________________: ‐graph ___________________: ‐pathy ___________________: ‐algia ___________________: ‐centesis ___________________: ‐emia

1‐E:  Circle the correct answer. 1. A dog named Brutus presents to your clinic with an abnormal heart rhythm. After further testing it was recommended that Brutus be referred to a: a. Pathologist b. Histopathologist c. Ophthalmologist d. Cardiologist 2. Mrs. Potter calls your clinic worried about her cat, Harry. She says that Harry has had blood in his urine. She makes an appointment for Harry to come in for an exam and to have his urine checked. When Harry comes for his appointment, the doctor asks you to obtain urine from Harry. What procedure would you perform? a. Arthrocentesis b. Cystocentesis c. Osteocentesis d. Gastrocentesis 3. A horse named Desperado was rushed to your clinic unable to put weight on one of his legs. Apparently fell during a race. The veterinarian suspects a fracture (broken bone). What would confirm this? a. Encephalograph b. Radiograph c. Nephrogram d. Cardiogram 4. Mr. Manning has just rushed into your clinic with his dog, Peyton. Peyton hasn’t felt like playing with his ball like he usually does. Upon examination, you notice that he has pale gums. A blood test reveals that his erythrocyte count is decreased. Peyton has: a. Leukemia b. Thrombocytosis c. Leukocytosis d. Anemia

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Veterinary Medical Terminology Guide and Workbook

5. A boxer named Rosie presents to your clinic with a mass on her shoulder. The owner is worried that it might be cancerous. What procedure would be per­ formed to see if the cells in the mass are cancerous? a. Electrocardiogram b. Biopsy c. Cystocentesis d. Osteocentesis 1‐F:  Define the following abbreviations. 1.  2.  3.  4.  5.  6. 

_______________: BAR _______________: OR _______________: DSH _______________: ICU _______________: TPR(W) _______________: DOB

7.  8.  9.  10.  11.  12. 

_______________: P/E _______________: R/O _______________: ISO _______________: NSF _______________: PPH _______________: WNL

7. 8. 9. 10. 11. 12.

___________________: pro‐ ___________________: re‐ ___________________: endo‐ ___________________: retro‐ ___________________: a‐, an‐ ___________________: ex‐

8. 9. 10. 11. 12. 13. 14.

____________: Biology ____________: Brachycephalic ____________: Iatrogenic ____________: Optic ____________: Osteitis ____________: Rhinitis ____________: Urology

1‐G:  Define the following prefixes. 1. 2. 3. 4. 5. 6.

___________________: intra‐ ___________________: extra‐ ___________________: trans‐ ___________________: epi‐ ___________________: sub‐ ___________________: hyper‐

1‐H:  Define the following medical terms. 1. 2. 3. 4. 5. 6. 7.

___________: Hyperglycemia ___________: Prognosis ___________: Incision ___________: Cytology ___________: Carcinoma ___________: Thrombocytosis ___________: Gastroenterology

1‐I:  Circle the correct terms in parentheses. 1. A sterile urine sample must be obtained from a dog so a (cystocentesis, cys­ totomy, cystectomy) will be performed. 2. A (erythrocyte, leukocyte, thrombocyte) count is decreased in a cat confirming anemia. 3. A dog has an infection due to an old bite wound. An increase in white blood cells was noted on labwork. This dog has (erythrocytosis, leukocytosis, thrombocytosis). 4. A bovine stool sample is brought to the clinic because the owner has noticed diarrhea. A possible cause would be (nephritis, enteritis, neuritis).

Chapter 1 Introduction

23

5. To confirm a broken leg after being hit by car, the cat must have (nephrograph, radiograph, electrocardiograph) performed. 6. While performing a blood draw on a horse, a hematoma forms just under the skin. This is considered (carcinogenic, pathogenic, iatrogenic). 7. An owner has recently adopted a new cat. The owner has noticed a skin rash on the cat so the cat is referred to a specialist in (hematology, nephrology, ­cardiology, dermatology). 8. Charlie, an old Schnauzer, has cataracts in his eyes and the owner would like to pursue treatment options. The owner is referred to a/an (cardiologist, ­pathologist, ophthalmologist). 9. A biopsy is performed to determine if a mass is cancerous. The sample is sent for (histology, neurology, urology). 10. A horse presents with a laceration on its left hind leg. The horse is QAR on P/E, but has an elevated pulse. What part of the SOAP would the elevated pulse be noted? (Subjective, Objective, Assessment, Plan). What portion of the SOAP would QAR be noted? (Subjective, Objective, Assessment, Plan). Answers can be found starting on page 675.

Review Tables Fill in the tables and refer to Tables 1.1–1.4 for answers. Table 1.5

Combining Forms

Definition

Combining Forms

Arthr/o

Hem/o

Bi/o

Hemat/o

Brachy/o

Hepat/o

Carcin/o

Hist/o

Cardi/o

Iatr/o

Cephal/o

Leuk/o

Cis/o

Nephr/o

Col/o; colon/o

Neur/o

Cyst/o

Ophthalm/o

Cyt/o

Optic/o

Derm/o

Oste/o

Definition

(Continued )

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Veterinary Medical Terminology Guide and Workbook

Table 1.5  (Continued )

Combining Forms

Definition

Combining Forms

Dermat/o

Path/o

Electr/o

Radi/o

Encephal/o

Ren/o

Enter/o

Rhin/o

Erythr/o

Sarc/o

Gastr/o

Sect/o

Glyc/o

Thromb/o

Gnos/o

Ur/o

Definition

Table 1.6

Prefix

Definition

Prefix

a‐, an‐

in‐

brachy‐

intra‐

dolicho‐

meso‐

endo‐

pro‐

epi‐

re‐

ex‐, exo‐

retro‐

extra‐

sub‐

hyper‐

trans‐

hypo‐

Definition

Chapter 1 Introduction

25

Table 1.7

Suffix

Definition

Suffix

‐ac, ‐al

‐ion

‐algia

‐ist

‐centesis

‐itis

‐cytosis

‐logy

‐ectomy

‐oma

‐emia

‐opsy

‐emic

‐osis

‐genic

‐pathy

‐gram

‐scope

‐graph

‐scopy

‐graphy

‐sis

‐ic, ‐ical

‐tomy

Definition

Table 1.8

Abbreviation

Definition

BAR BD/LD CCU ICU CWPM DLH DMH DSH DOA DOB ER OR GROS (Continued )

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Veterinary Medical Terminology Guide and Workbook

Table 1.8  (Continued )

Abbreviation

Definition

K‐9 ISO NAF NSF P/E PPH R/O SOAP TPR(W) WNL °C °F

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word Search Puzzle

C h a p t e r

2

Anatomical Organization

This chapter will focus on the anatomical divisions and structural organization of the body. Because you’ll be learning how to use directional and positional terms, basic skeletal anatomy will be introduced. The book will go into more detail on anatomy in later chapters.

Anabolism Catabolism Metabolism

Structural Organization We can divide the body into four basic groups: cells, tissues, organs, and systems. Within each general group are more specialized structures with specific functions.

The Cell The cell is the basic structure of all things. Cells can be found everywhere in the body, where they exist in specific organs and tissues. While the functions of cells differ based on their anatomical location, their basic anatomy is the same. Label the cell diagram in Figure 2.1 using the structures listed in Table 2.1. Chemical Processes of the Cell There are three basic processes that occur within a cell. They are as follows:

Process of building up complex proteins from simpler substances. Process of breaking down complex foods into simpler substances. The total of the chemical processes in a cell: anabolism + catabolism.

Cell Types There are many different types of cells in the body. Each has a specific function. Although the types share similar internal structures, their morphologies (shapes) differ (Figure 2.2). TECH TIP 2.1  Did you know that the number of chromosomes is different from species to species? Some examples are as follows: Humans: Dogs: Cats: Horses: Donkeys: Cattle: Sheep: Goats: Pigs: Chickens: Birds:

46 78 38 64 62 60 54 60 38 20 69

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

27

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Veterinary Medical Terminology Guide and Workbook

(A) Structure of a typical animal cell 7

1

8

2

9

3

10

4

11

5

12 13

6 14

(B) Plasma membrane structure Extracellular fluid

Carbohydrates

Transmembrane glycoprotein

Pore

Glycolipid

Cholesterol

Peripheral protein

Transmembrane protein

Channel protein

Cytoplasm

Figure 2.1  (A) Anatomy of a cell. Source: Courtesy of shutterstock/Alila Sao Mai, Blamb, and SSCREATIONS. (B) Semipermeable cell membrane. Source: Courtesy of shutterstock/Alila Sao Mai.

Table 2.1  Cellular anatomy. Cell membrane (4)

Semipermeable structure that surrounds and protects the cell

Centrioles (6)

Tubular structures that maintain the cell’s shape and move chromosomes during mitosis

Chromosomes (2)

Rod‐like structures containing regions of DNA called genes

Cytoplasm (9)

Material inside the cell membrane that surrounds the nucleus

DNA (3)

The basic structure of genes that directs cell activity and transmits genetic information; deoxyribonucleic acid

Endoplasmic reticulum

Protein factory where proteins are made from simple materials. (11) Smooth endoplasmic reticulum synthesizes lipids (7) Rough endoplasmic reticulum synthesizes proteins

Golgi apparatus (8)

Processing factory where proteins are stored, modified, and transported

Lysosome (14)

Site of intracellular digestion containing enzymes to disintegrate microorganisms and damaged tissue

Mitochondria (12)

Energy factory of the cell in which foods are burned for energy

Nucleoplasm

Material within the nucleus

Nucleus (1)

The control center of the cell that contains chromosomes

Nucleolus (5)

Site of RNA synthesis. Plural form is nucleoli

Protoplasm

Cell membrane, cytoplasm, and nucleus

Ribosomes (13)

Structures found in endoplasmic reticulum containing RNA, and the site of protein synthesis. Note the ribosomes also found on the rough endoplasmic reticulum (7)

Vacuole (10)

Fluid‐filled cavity containing food, water, or waste products

Blood cells

Surface skin cells

Bone cell

Cardiac muscle cell Columnar epithelial and Goblet cells

Skeletal muscle cells Fat cell

Neuron

Smooth muscle cells

Figure 2.2  Cell and tissue types. Source: Courtesy of shutterstock/Alila Sao Mai.

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Veterinary Medical Terminology Guide and Workbook

Tissue Tissues are groups of similar cells working together for a specific function. The following are examples of tissue types. Adipose Collection of fat cells. tissue Connective Binds and supports various tissue structures. Examples include fat, bone, blood, cartilage. Epithelial Consists of epithelium, tissue which lines external and internal body surfaces. Consists of endothelium, which lines organs and blood vessels. Consists of mesothelium, which lines cavities such as the peritoneum. Muscle Skeletal muscle, which is tissue striated, voluntary muscle controlling movement. Cardiac muscle, which is striated, involuntary muscle controlling the heart. Visceral muscle, which is smooth, involuntary muscle controlling the internal organs (viscera). Nerve Cells that conduct electrical tissue impulses all over the body.

(Figure 2.3). For example, the respiratory system consists of the nose, throat, voice box, windpipe, and lungs working together to help an animal breathe. Table 2.2 is a list of the different systems of the body. The following chapters will focus on each system individually.

Cavities The body can be divided into different areas that contain organs working together. Each area is referred to as a cavity. This book will discuss each body cavity in detail in the later chapters. This chapter introduces the body cavities (Figure 2.3). Abdominal Cavity containing organs such as the stomach, intestines, spleen, and pancreas. Cranial Cavity containing the brain. Spinal Cavity containing the spinal cord. Thoracic Cavity containing organs such as the heart, lungs, esophagus, and trachea.

Additional Terminology for Structural Organization Anatomy

Organs Organs are different tissues working together for a specific function. For example, the organs of the abdomen and chest use nervous tissue, muscle tissue, and epithelial tissue to function. The medical term for internal organs is viscera. Examples of viscera include the heart, lungs, stomach, liver, and spleen.

Benign Cartilage Diaphragm Endocrine glands

System

Exocrine glands

A system is a group of different organs working together for a complex function

Larynx

The form and structure of the body. Not malignant, non‐invasive; not spreading. Flexible connective tissue attached to bones at a joint. Thin, muscular partition separating the thoracic and abdominal cavities. Glands that secrete hormones directly into the bloodstream (Figure 2.4). Glands that secrete chemicals through tubes everywhere in the body (Figure 2.4). Voice box (Figure 2.5).

Chapter 2  Anatomical Organization

31

(A) Cranial cavity

Spinal cavity

Abdominal cavity

Respiratory system Gastrointestinal system

Thoracic cavity

Urogenital system

Diaphragm

Cardiovascular system Nervous system

(B) Cranial cavity

Spinal cavity

Thoracic cavity

Abdominal cavity

Diaphragm

Figure 2.3  (A) Body systems of the dog. (B) Body systems of the cat. (C) Body systems of the horse. Source: Courtesy of shutterstock/decade3d.

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Veterinary Medical Terminology Guide and Workbook

(C) Cranial cavity

Spinal cavity

Abdominal cavity

Thoracic cavity Diaphragm

Figure 2.3  (Continued) Table 2.2  Systems.

System

Definition

Cardiovascular

Consists of organs such as the heart, veins, arteries, capillaries, and spleen

Digestive

Consists of organs such as the mouth, throat, esophagus, stomach, intestines, pancreas, liver, and gallbladder

Endocrine

Consists of organs such as the pancreas, pituitary gland, thyroid gland, ovaries, testes, and adrenal glands

Integumentary

Consists of organs such as the skin, hair (fur), nails and glands

Musculoskeletal

Consists of organs such as the bones, muscle, and joints

Nervous

Consists of organs such as the brain and spinal cord

Reproductive

Consists of organs such as the ovaries, vagina, uterus, testes, and penis

Respiratory

Consists of organs such as the windpipe, lungs, and heart

Urogenital

Consists of organs such as the kidneys, ureters, urinary bladder, and urethra

Chapter 2  Anatomical Organization

33

Chemical secretions Skin surface Blood in capillaries

Hormones are secreted into blood

Exocrine gland

Endocrine gland

Figure 2.4  Endocrine and exocrine glands. Source: Courtesy of shutterstock/GRei.

Peritoneum Larynx

Pharynx Physiology Trachea Left lung

Right lung

Trachea Umbilicus Ureter Urethra

Viscera

Membrane surrounding the organs of the abdomen. Throat Study of the body’s function. Windpipe (Figure 2.5). The navel (Figure 2.6). Tube that carries urine from the kidneys to the urinary bladder. Tube that carries urine from the urinary bladder to the outside of the body. Internal organs.

Pathology of Structures Heart

Evisceration Figure 2.5  Respiratory sytem. Source: Courtesy of shutterstock/BlueRingMedia.

Hernia Lavage Malignant Membrane

Irrigation or washing out of an organ or cavity. Tending to become progressively worse. Thin layer of tissue that covers a surface, lines a cavity, or divides a space or an organ.

Prolapse

Displacement of internal organs outside the cavity that should contain them (Figure 2.7C). Abnormal protrusion of an organ or tissue through the structure that should contain it (Figure 2.7A). Abnormal protrusion of an organ or tissue through a natural opening (Figure 2.7B).

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Veterinary Medical Terminology Guide and Workbook

Umbilicus

Figure 2.6  Umbilicus on a calf. Source: Courtesy of shutterstock/Damian Palus.

Introduction to the Skeletal Anatomy Figure  2.8 shows a diagram of the dog skeleton. Knowing the location of these bones is essential in understanding how to use directional terminology. This chapter merely introduces the location of these bones. Chapter 3 will go into more detail on skeletal anatomy.

Directional Terms We use directional terms when describing the location of various structures in the body and when comparing the relationship of one structure to another in the body (Table  2.3). These terms, for the most part, are widely used in veterinary medicine. To better understand their application, try picturing yourself on all fours. You’d be surprised how much this helps.

TECH TIP 2.2  Anterior and Posterior in Veterinary Medicine These two terms can get confusing when trying to use them to describe structures on quadrupeds (animals on four legs). In human medicine, anterior describes the front of our body or the side with our face and belly. Posterior describes the back of our body or the side with the back of our head and our behind. Since most animals are on four limbs, anterior and posterior no longer apply. The front of their body can be described as cranial or the head‐side, the back of their body can be described as caudal or the tail‐side. Depending on how you view it, the front of their body may be their belly side in which case ventral would be used, the back of their body would dorsal. Anterior and posterior can still be used on these animals though. For example, on the horse, when describing structures on the front and back side of the hoof.

Chapter 2  Anatomical Organization

(A)

35

(C)

(B)

Figure 2.7  (A) Umbilical hernia in a Cocker Spaniel puppy. Source: Courtesy of shutterstock/WilleeCole. (B) Vaginal prolapse in an American Pit Bull Terrier. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (C) Evisceration on dog about to go to surgery for repair. Source: Courtesy of Christine Gilbreath, CVT.

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Veterinary Medical Terminology Guide and Workbook

Skull Ilium Atlas, C1 Thoracic Axis, C2 vertebrae

Maxilla

Mandible

Lumbar vertebrae

Cervical vertebrae

Pubis

Scapula Humerus

Radius Ulna

Carpals Dewclaw P1

Sacral vertebrae sacrum

Ischium

Femur

Caudal vertebrae or coccygeal vertebrae

Patella Ribs Tibia Sternum Fibula Olecranon

Accessory carpal bone Metacarpals

Tarsals Phalanges digits

Calcaneus Metatarsals

Phalanges digits

Figure 2.8  Dog skeleton. Source: Courtesy of shutterstock/AlexOnline.

Table 2.3  Directional terms.

Directional Term

Definition

Example

Dorsal

Pertaining to the back; closer to the back; away from the ground

The spine is dorsal to the sternum The spine is dorsal to the heart

Ventral

Pertaining to the belly; closer to the belly; towards the ground

The heart is ventral to the spine The sternum is ventral to the heart

Cranial

Pertaining to the head; closer to the head

The neck is cranial to the tail The heart is cranial to the stomach

Caudal

Pertaining to the tail; closer to the tail

The hindlimb is caudal to the forelimb The lumbar vertebrae are caudal to the cervical vertebrae

Medial

Pertaining to the middle; closer to the median plane; closer to the midline

The dewclaw is medial to the other digits The heart is medial to the ribs

Lateral

Pertaining to the side; further from the median plane; further from the midline

The ribs are lateral to the heart Your pinky toe is lateral to your big toe

Proximal

Pertaining to the beginning; nearer the point of The femur is proximal to the tibia attachment The ulna is proximal to the carpals

Distal

Pertaining to far from the beginning; farther from The patella is distal to the femur the point of attachment The phalanges are distal to the humerus (Continued)

Chapter 2  Anatomical Organization

37

Table 2.3  (Continued)

Directional Term

Definition

Example

Superficial

Nearer the surface of the body.

A papercut is superficial The biceps are superficial to the humerus

Deep

Farther from the surface of the body.

A stab wound is deep The humerus is deep to the biceps muscle

Plantar

Pertaining to the caudal surface of the rear paw (pes) and tarsus.

A dog has a laceration on the plantar aspect of its left paw

Palmar

Pertaining to the caudal surface of the front paw (manus) and carpus.

A dog has a laceration on the palmar surface of its left paw

Rostral

Pertaining to the nose; closer to the nose.

The hard palate is rostral to the soft palate

Anterior

Pertaining to the front side of the body.

The toe of the hoof is anterior to the heel

Posterior

Pertaining to the back side of the body.

The heel of the hoof is posterior to the toe

Recumbency

Planes of the Body

Recumbent is defined as lying down. Certain procedures require an animal to  be positioned in a particular recumbency. The following are examples of recumbency:

Planes are imaginary flat surfaces that divide the body into different sections (Table 2.4 and Figure 2.10).

Dorsal recumbency

As you’ve probably noticed in the dog skeleton diagram, there are different kinds of bones in the back called vertebrae. In between these backbones are cartilage pads called intervertebral disks (Figure 2.11).

Ventral recumbency

Lateral recumbency

Animal is lying on its back. This is also known as supine recumbency (Figure 2.9A). Animal is lying on its belly. This is also known as sternal recumbency or prone recumbency. Animal is lying on its side. An animal lying on its right side is said to be in right lateral recumbency (Figure 2.9B).

The Spinal Column

Intervertebral disk

Cartilage pad between vertebrae used for cushion and support. Spinal cord Nervous tissue within the spinal cavity. Spinal column Bones surrounding the spinal cavity. Vertebra Backbone. Vertebrae Backbones.

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Veterinary Medical Terminology Guide and Workbook

(A)

(B)

Figure 2.9  (A) Animal prepped for surgery in dorsal recumbency. Source: Courtesy of shutterstock/Julie Keen. (B) Cat restrained in lateral recumbency for a femoral venipuncture. Source: Courtesy of Ethan Heritage, CVT.

Table 2.4  Planes of the body.

Plane

Definition

Dorsal plane

Divides the body into a belly side (ventral) and a back side (dorsal)

Median plane

Divides the body into equal right and left halves. This is also known as a midsagittal plane

Sagittal plane

Divides the body into unequal right and left halves

Transverse plane

Divides the body into cranial and caudal halves

Caudal

Median plane

Rostral Cranial

Caudal

Dorsal

al

ni

ra

al

C

Ventral

Proximal

ud

Ca

Dorsal plane

tar an

ar

lm

Pa

l

rsa

Do

Pl

Distal l rsa Do

Transverse plane

Figure 2.10  Medical planes and directional terms on a Pit Bull. Source: Courtesy of shutterstock/serg741.

Body of vertebra

Intervertebral disk

Figure 2.11  Intervertebral disk. Source: Courtesy of shutterstock/Alila Sao Mai.

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Veterinary Medical Terminology Guide and Workbook

Cheek

Table 2.5  Vertebrae.

Vertebrae

Location

Cervical (C)

Neck area

Thoracic (T)

Chest area

Lumbar (L)

Lower back area (waist)

Sacral (S)

Sacrum

Caudal; coccygeal (Ca, Cy)

Tail area

Table 2.5 is a list of the different vertebrae and where they fall along the spinal column.

TECH TIP 2.3  The different kinds of vertebrae differ in numbers in each species. Instead of merely writing out the numbers of each type in a table, we write them into vertebral formulas, as follows: Dog and Cat: Horse:

Cattle: Pigs: Sheep and Goats: Chickens:

C7T13L7S3fusedCa (Cy)3–24 C7T18L6S5fusedCa (Cy)15–21. Some Arabians have five lumbar C7T13L6S5Ca(Cy)18–20 C7T14–15L6–7S4Ca (Cy)20–23 C7T13L6–7S4Ca (Cy)16–18 C14T7LS14fusedCa(Cy)6

From the Outside In Anatomical terms change when describing structures and landmarks on the outside of the body (Figure 2.12).

Fleshy portion on either side of the face, forming the sides of the mouth and continuing rostrally to the lips. Chest Part of the body between the neck and abdomen; also called the thorax. Chin Anterior prominence of the mandible. Elbow Joint where the humerus, radius, and ulna meet; medically known as the humeroradioulnar joint. Flank Lateral aspect of the body between the ilium and ribs. Forehead Region between the eyes and ears. Hock Common name for the tarsus joint. Muzzle Skin, muscles, and fascia of the upper and lower lip and including the nasal bones. Pinna Flap of the ear; also known as the auricle. Rump Region around the pelvis, hindquarters, and buttocks; also known as the croup or gluteal region. Shoulder Joint where the scapula and humerus meet; medically known as the scapulohumeral joint. Stifle Joint where the femur and tibia meet; medically known as the femorotibial joint. Tail Caudal appendage of the vertebral column made up of caudal vertebrae.

Building the Terms Now it’s time to assemble the word parts listed in Tables 2.6, 2.7 and 2.8. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapter.

Chapter 2  Anatomical Organization

41

Forehead Back

Rump

Tail

Pinna Cheek Muzzle Chin

Chest

Flank

Shoulder

Hock

Elbow

Stifle

Figure 2.12  External landmarks on a kitten. Source: Courtesy of shutterstock/Ewa Studi. Table 2.6  Combining forms.

Combining Form

Definition

Combining Form

Definition

Abdomin/o

Abdomen

Medi/o

Middle

Aden/o

Gland

My/o

Muscle

Adip/o

Fat

Neur/o

Nerve

Anis/o

Unequal (in size)

Nucle/o

Nucleus

Anter/o

Front

Path/o

Disease

Bol/o

To cast (throw)

Pelv/o

Pelvis (hip)

Caud/o

Tail

Peritone/o

Peritoneum

Cervic/o

Neck

Pharyng/o

Pharynx; throat

Chondr/o

Cartilage

Poster/o

Back; behind

Chrom/o

Color

Prot/o

First

Coccyg/o

Tailbone

Proxim/o

Nearest

Crani/o

Skull

Rhin/o

Nose

Crin/o

To secrete

Sacr/o

Sacrum

Cyt/o

Cell

Sarc/o

Connective tissue (Continued)

Table 2.6  (Continued)

Combining Form

Definition

Combining Form

Definition

Dist/o

Far; distant

Spin/o

Spine; backbone

Dors/o

Back of body

Stern/o

Sternum

Duct/o

To lead or carry

Thel/o

Nipple

Hist/o

Tissue

Thorac/o

Chest

Inguin/o

Groin

Trache/o

Trachea; windpipe

Kary/o

Nucleus

Umbilic/o

Umbilicus; navel

Laryng/o

Larynx; voice box

Vertebr/o

Vertebrae; backbones

Later/o

Side

Viscer/o

Viscera; internal organs

Lumb/o

Lower back

Table 2.7  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

hypo‐

deficient; below; under; less than normal

ana‐

up

inter‐

between

cata‐

down

meta‐

change

endo‐

in; within

neo‐

new

epi‐

above; upon; on

uni‐

one

Table 2.8  Suffixes.

Suffix

Definition

Suffix

Definition

‐ac, ‐al, ‐ar, ‐eal, ‐iac, ‐ic, ‐ical, ‐ior, ‐ose

pertaining to

‐oma

tumor; mass; fluid collection

‐algia

pain

‐osis

abnormal condition

‐centesis

surgical puncture to remove fluid or gas

‐plasia

development; formation; growth

‐ectomy

removal; excision; resection

‐plasm

formation

‐ism

process; condition

‐plasty

surgical repair

‐ist

specialist

‐somes

bodies

‐itis

inflammation

‐tomy

incision; process of cutting into

‐logy

study of

Chapter 2  Anatomical Organization

Parts Abdomin/o Abdomin/o ana‐ cata‐ meta‐ Adip/o Caud/o Cervic/o Chondr/o Chondr/o Chondr/o Chondr/o Chondr/o

+ ‐al + ‐centesis + Bol/o + Bol/o + Bol/o + ‐ose + ‐al + ‐al + ‐al + ‐algia + ‐ectomy + ‐oma + Sarc/o

43

Medical Term

+ ‐ic + ‐ic + ‐ic

+ ‐oma

= Abdominal = Abdominocentesis = Anabolic = Catabolic = Metabolic = Adipose = Caudal = Cervical = Chondral = Chondralgia = Chondrectomy = Chondroma = Chondrosarcoma

Definition : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________

TECH TIP 2.4  Don’t Forget Rule 5!

TECH TIP 2.5  Rules for Using Sarcoma

The terms anabolic, metabolic, and catabolic do not break down exactly. Because of this, we use rule 5 of medical terminology. To simplify, we can define them as follows:

When a combining form is attached to the term “sarcoma,” then it is inserted into the definition for sarcoma. As an example, the term osteosarcoma has the combining form “oste/o” attached to the term “sarcoma.” Therefore, the definition is a malignant tumor of bone arising from connective tissue. Remember your definition for sarcoma from Chapter 1 and use the following guide. A malignant tumor of _____________ arising from connective tissue.

Anabolic – Pertaining to anabolism Catabolic – Pertaining to catabolism Metabolic – Pertaining to metabolism I placed these terms in the blanks so you can see where the terms were derived from. Ana‐ for building up and cata‐ for breaking down.

hypo‐ Coccyg/o Crani/o Crani/o Crani/o

+ Chondr/o + ‐eal + ‐al + ‐tomy + Sacr/o

+ ‐iac

+ ‐al

= Hypochondriac = Coccygeal = Cranial = Craniotomy = Craniosacral

: ____________ : ____________ : ____________ : ____________ : ____________

TECH TIP 2.6  Did You Know? We have all heard of or used the term hypochondriac when describing a person who thinks they are sick frequently. The origin of the term’s usage stems from ancient Greece. In ancient times, the most common complaints of sickness would be related to the viscera in the hypochondriac region: the stomach, liver, and spleen. In most cases, these people were truly sick. They usually had eaten something they shouldn’t have and were treated with medications to induce vomiting. However, with the limited knowledge of medicine in those times, many complaints went untreated and were believed to be lies created by the patients. Because these common complaints of the hypochondriac region were believed to be imaginary, these people became known as hypochondriacs: people suffering from hypochondriasis.

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Veterinary Medical Terminology Guide and Workbook

Crani/o Cyt/o Cyt/o Cyt/o Hist/o Hist/o Hist/o Hist/o Hist/o Inguin/o Anis/o Laryng/o Laryng/o Lumb/o Lumb/o neo‐ neo‐ Nucle/o Nucle/o Path/o Path/o Pelv/o Peritone/o Peritone/o Pharyng/o Pharyng/o Rhin/o Sacr/o Sacr/o Sacr/o Sacr/o Sacr/o Spin/o Trache/o Trache/o endo‐ Thorac/o

+ ‐plasty + ‐logy + ‐logy + ‐logy + ‐logy + ‐logy + ‐logy + Path/o + Path/o + ‐al + Kary/o + ‐eal + ‐itis + ‐ar + Sacr/o + ‐plasia + ‐plasm + ‐ar + ‐ic + ‐logy + ‐logy + ‐ic + ‐al + ‐itis + ‐eal + ‐itis + ‐itis + ‐al + ‐algia + Caud/o + Coccyg/o + Pelv/o + ‐al + ‐al + ‐tomy + Trache/o + ‐centesis

Thorac/o Thorac/o Vertebr/o inter Viscer/o Viscer/o uni‐

+ ‐ic + ‐tomy + ‐al + Vertebr/o + ‐al + ‐algia + Later/o

+ ‐ist + ‐ical + ‐ist + ‐ical + ‐logy + ‐logy + ‐ist + ‐osis

+ ‐al

+ ‐ist

+ ‐al + ‐eal + ‐ic

+ ‐al

+ ‐al + ‐al

= Cranioplasty : ____________ = Cytology : ____________ = Cytologist : ____________ = Cytological : ____________ = Histology : ____________ = Histologist : ____________ = Histological : ____________ = Histopathology : ____________ = Histopathologist : ____________ = Inguinal : ____________ = Anisokaryosis : ____________ = Laryngeal : ____________ = Laryngitis : ____________ = Lumbar : ____________ = Lumbosacral : ____________ = Neoplasia : ____________ = Neoplasm : ____________ = Nuclear : ____________ = Nucleic : ____________ = Pathology : ____________ = Pathologist : ____________ = Pelvic : ____________ = Peritoneal : ____________ = Peritonitis : ____________ = Pharyngeal : ____________ = Pharyngitis : ____________ = Rhinitis : ____________ = Sacral : ____________ = Sacralgia : ____________ = Sacrocaudal : ____________ = Sacrococcygeal : ____________ = Sacropelvic : ____________ = Spinal : ____________ = Tracheal : ____________ = Tracheotomy : ____________ = Endotracheal : ____________ = Thoracocentesis : ____________ Also known as thoracentesis. = Thoracic : ____________ = Thoracotomy : ____________ = Vertebral : ____________ = Intervertebral : ____________ = Visceral : ____________ = Visceralgia : ____________ = Unilateral : ____________

Chapter 2  Anatomical Organization

Abbreviations Table 2.9  Abbreviations.

Abbreviation

Definition

c

With

s

Without

ADR

Ain’t doin right

CBA

Cat bite abscess (Figure 2.13A)

DHLPP‐C

Distemper, hepatitis, leptospirosis, parvovirus, parainfluenza, coronavirus – canine vaccine set

ET tube

Endotracheal tube (Figure 2.14)

FeLV

Feline leukemia virus

FIP

Feline infectious peritonitis

FIV

Feline immunodeficiency virus

FVRCP

Feline viral rhinotracheitis, calicivirus, panleukopenia – feline vaccine set

HBC

Hit by car (Figure 2.13B)

IVD

Intervertebral disk (disc)

MM

Mucous membranes

neg or ⊝

Negative

pos or ⊕

Positive

pt.

Patient

PT

Physical therapy

RV

Rabies vaccine

stat

Immediately

V/D

Vomiting/diarrhea

TECH TIP 2.7  Mucus vs. Mucous These terms are pronounced the same, but have slightly different meanings. “Mucus” refers to the actual slimy substance produced in areas such as your nose and eyes. “Mucous” is defined as pertaining to mucus. Its use is to describe the source of the mucus.

45

46

Veterinary Medical Terminology Guide and Workbook

(A)

(B)

Figure 2.13  (A) Draining a cat bite abscess on a cat’s cheek. (B) Dog that has been hit by a car. Note the road rash and grease on the hair. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm.

Case Study: Define the medical terms and abbreviations in bold print. You’ll notice some terms from the previous chapter You hear a page over the intercom stating that you are needed in the emergency room, stat. The pt. is Bungee, a four‐year‐old male DLH with an abdominal evisceration. Apparently, Bungee had been fighting with the neighbor’s cat and fell from the top of the fence onto the gardening tools below. A quick check of his file shows that he is current on his FVRCP, FeLV, and RV. Upon P/E, a mass is found on the lateral aspect of his right stifle. The mass was warm to the touch. The veterinarian confirms that Bungee also has a CBA. His MM are pale and he’s breathing rapidly. Pre‐surgical bloodwork is run, which shows anemia. Bungee is taken into surgery to repair the evisceration. An endotracheal tube is placed and Bungee is positioned in dorsal recumbency for the procedure. After replacing the abdominal viscera, the veterinarian performs an abdominal lavage to try to prevent peritonitis. Bungee was moved to the recovery room after surgery. After waking up from the surgery, Bungee begins coughing. The owner should be told that Bungee will have short‐term laryngitis because of the ET tube.

Chapter 2  Anatomical Organization

47

(A)

(B)

(C)

Figure 2.14  (A) Endotracheal tube and laryngoscope. Source: Courtesy of shutterstock/Chris Pole. (B) Placing an ET tube in a cat using a laryngoscope. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm. (C) Cat waking up after surgery with an endotracheal tube still in place. Source: Courtesy of shutterstock/Julie Keen.

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Veterinary Medical Terminology Guide and Workbook

Exercises 2-A:  Match the combining forms with their meaning. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

____________ Throat ____________ Disease ____________ Nose ____________ Abdomen ____________ Groin ____________ Voice box ____________ Cartilage ____________ Fat ____________ Skull ____________ Tissue ____________ Cell ____________ Hip

A. Abdomin/o B. Adip/o C. Chondr/o D. Crani/o E. Cyt/o F. Hist/o G. Inguin/o H. Laryng/o I. Path/o J. Pelv/o K. Pharyng/o L. Rhin/o

2-B:  Write the correct medical term in the blank. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

____________________: Study of disease ____________________: New formation ____________________: Incision into the skull ____________________: Pertaining to the internal organs ____________________: Tumor of cartilage ____________________: Pertaining to the groin ____________________: Specialist in the study of cells ____________________: Pertaining to the throat ____________________: Inflammation of the voice box ____________________: Pertaining to between the backbones ____________________: Incision into the windpipe ____________________: Incision into the chest ____________________: Surgical repair of the skull ____________________: Pertaining to the hip ____________________: Pertaining to the sacrum and tail ____________________: Pertaining to the lower back ____________________: Pain in cartilage ____________________: Irrigation of organ or cavity ____________________: Not malignant; non‐invasive ____________________: Study of the body’s function

2-C:  Circle the correct spelling for each word. 1.  2.  3.  4.  5.  6. 

Diaphragm Larynx Diarrea Abcess Cartalige Maligent

Diaphram Layrnx Diahrrea Absess Cartilage Malignent

Diafram Larnyx Diarrhea Abscess Cartlaje Malignant

Chapter 2  Anatomical Organization

7.  8.  9.  10. 

Thorasic Vertibrea Cerival Vommitting

49

Thoracic Vertibra Cervical Vomiting

Thoraxic Vertebrae Cervicle Vomitting

2-D:  Define the following suffixes. 1.  2.  3.  4.  5.  6. 

___________________: ‐plasty ___________________: ‐ose ___________________: ‐logy ___________________: ‐algia ___________________: ‐centesis ___________________: ‐ist

7.  8.  9.  10.  11.  12. 

___________________: ‐plasia ___________________: ‐ism ___________________: ‐osis ___________________: ‐ar ___________________: ‐oma ___________________: ‐itis

2-E:  Match the following directional terms to complete the sentences. Some terms are used more than once. A. Cranial B. Caudal C. Deep D. Distal E. Dorsal 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

F. Lateral G. Medial H. Proximal I. Superficial J. Ventral

The sternum is _____________ to the thoracic vertebrae. The tarsals are _____________ to the carpals. A cat scratch is _____________; a stab wound is _____________. The humerus is _____________ to the metacarpals. The atlas is _____________ to the ilium. The ribs are _____________ to the heart. The dewclaw is _____________ to the other digits. A dog lying on its side is in _____________ recumbency. The intestines are _____________ to the heart. The phalanges are _____________ to the stifle. The tibia is _____________ to the fibula. The thoracic vertebrae are _____________ to the sacral vertebrae. The lumbar vertebrae are _____________ to the umbilicus. The accessory carpal bone is on the _____________ aspect of the carpus. The humerus is _____________ to the muscles. The mandible is ____________ to the thoracic vertebrae. A cat lying on its belly is in _____________ recumbency. The calcaneus is ___________ to the accessory carpal bone. The femur is ___________ to the tarsals. The bone is ___________to the skin.

2-F:  Define the following abbreviations. 1.  _______________: CBA 2.  _______________: FIP

50

3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13. 

Veterinary Medical Terminology Guide and Workbook

_______________: V/D _______________: stat _______________: P.T. _______________: ⊝ _______________: FIV _______________: DHLPP‐C _______________: s̄ _______________: pos _______________: c̄ _______________: MM _______________: ADR

2-G:  Define the following prefixes. 1.  2.  3.  4. 

_________________: hypo‐ _________________: inter‐ _________________: meta‐ _________________: cata‐

5.  6.  7.  8. 

_________________: ana‐ _________________: endo‐ _________________: neo‐ _________________: a‐, an‐

2-H:  Define the following medical terms. 1.  2.  3.  4.  5.  6.  7.  8. 

____________: Nucleus ____________: Prolapse ____________: Evisceration ____________: Anabolism ____________: Histopathology ____________: Chondrosarcoma ____________: Abdominal cavity ____________: Exocrine glands

9.  10.  11.  12.  13.  14.  15. 

____________: Endocrine glands ____________: Urethra ____________: Diaphragm ____________: Pharynx ____________: Cell membrane ____________: Catabolism ____________: IVD

Answers can be found starting on page 675.

Review Tables Fill in the tables and refer to Tables 2.6–2.9 for answers. Table 2.10

Combining Forms

Definition

Combining Forms

Abdomin/o

Medi/o

Aden/o

My/o

Adip/o

Neur/o

Anis/o

Nucle/o

Definition

Chapter 2  Anatomical Organization

51

Table 2.10  (Continued )

Combining Forms

Definition

Combining Forms

Anter/o

Path/o

Bol/o

Pelv/o

Caud/o

Peritone/o

Cervic/o

Pharyng/o

Chondr/o

Poster/o

Chrom/o

Prot/o

Coccyg/o

Proxim/o

Crani/o

Rhin/o

Crin/o

Sacr/o

Cyt/o

Sarc/o

Dist/o

Spin/o

Dors/o

Stern/o

Duct/o

Thel/o

Hist/o

Thorac/o

Inguin/o

Trache/o

Kary/o

Umbilic/o

Laryng/o

Vertebr/o

Later/o

Viscer/o

Definition

Lumb/o

Table 2.11

Prefix

Definition

Prefix

a‐, an‐

hypo‐

ana‐

inter‐

cata‐

meta‐

endo‐

neo‐

epi‐

uni‐

Definition

Table 2.12

Suffix

Definition

Suffix

‐ac, ‐al, ‐ar, ‐eal, ‐iac, ‐ic, ‐ical, ‐ior, ‐ose

‐oma

‐algia

‐osis

‐centesis

‐plasia

‐ectomy

‐plasm

‐ism

‐plasty

‐ist

‐somes

‐itis

‐tomy

‐logy

Table 2.13

Abbreviation c s ADR CBA DHLPP‐C ET Tube FeLV FIP FIV FVRCP HBC IVD MM neg or ⊝ pos or ⊕ pt. PT RV stat V/D

Definition

Definition

Chapter 2  Anatomical Organization

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

53

C h a p t e r

3

The Musculoskeletal System

The musculoskeletal system consists of bones, joints, cartilage, ligaments, tendons, and muscles. These different organs work together to achieve a variety of functions which include movement, protection, support, and storage.

Table 3.1  Formation of bone. Osseous tissue

Another name for bone tissue.

Ossification

Process of bone formation.

Osteoblast

Bone cell that forms bone tissue. Also known as an immature bone cell.

Osteoclast

Bone cell that absorbs and removes bone tissue. Also known as a phagocyte of bone.

Osteocyte

Bone cell (Figure 3.1).

Bones Bone is a hard form of connective tissue that makes up most of the skeleton. It is primarily composed of collagen and minerals such as calcium and phosphorus. In the earliest stages of development, the skeleton is made up of cartilaginous tissue which is softer and more flexible. After birth, that fibrous tissue is converted into osseous (bone) tissue (Table 3.1). TECH TIP 3.1  Puppies commonly have their dewclaws removed soon after birth because they are still made of primarily cartilaginous tissue. If the owners wait too long, then the dewclaw becomes osseous tissue and the surgical procedure is far more involved. Dewclaws should be removed to avoid injuries later in the dog’s life. Dogs often get their dewclaws caught on fabric and end up tearing the digit.

Steps of Ossification Bone formation is a constant process in that new bone tissue is continuously being formed while older bone tissue is contin­ uously being removed. The older tissue must be removed to prevent the bone from becoming too thick or too heavy. Within the osseous tissue are cells called osteoblasts and osteoclasts. The osteoblasts are the immature bone cells that help to build bone tissue by supplying the minerals needed for bone formation. Once the osteoblasts mature, they become oste­ ocytes, which act as part of the structural

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Veterinary Medical Terminology Guide and Workbook

Osteon

Osteocyte

Periosteum

Haversian canal

Compact bone

Spongy bone

Figure 3.1  Cross‐section of bone. Source: Courtesy of shutterstock/mmutlu.

matrix of bone. Osteoclasts are responsible for removing bone tissue that is no longer needed by resorbing and digesting it. If the bone is injured, then the osteoblasts patch the break while the osteoclasts smooth it out and remove the leftover materials. Even if the body is not injured, the osteo­ blasts are continuously making new bone tissue and the osteoclasts are removing the older bone tissue. This constant pro­ cess is what enables the bone to handle everyday stresses as well as repair itself once injured.

Anatomy of a Bone Bones are grouped into different cate­ gories based on their shapes and functions. Regardless of the category they fall in, their basic anatomy is the same. Label the bone in Figure 3.2 using the terms listed in Table 3.2.

TECH TIP 3.2  Rules for “endo‐,” “myo‐,” and “peri‐” When the prefixes endo‐, myo‐, and peri‐ are attached to a term that ends with the suffixes ‐ium or ‐eum, their meanings change. Endo‐ becomes the inner lining of the root that it’s attached to, myo‐ becomes the muscle lining of the root that it’s attached to, and peri‐ becomes the membrane surrounding the root that it’s attached to. For example: Endocardium is the inner lining of the heart. Myocardium is the muscle lining of the heart. Pericardium is the membrane surrounding the heart.

Classifications of Bone Bones are divided into different classi­ fications based on their shape and function.

Chapter 3  The Musculoskeletal System

57

1.

7.

6. 9. 2.

3. 4.

8. 11. Nutrient foramen

10. 5.

Nutrient vessel

Figure 3.2  Anatomy of a long bone. Source: Courtesy of shutterstock/Alila Sao Mai. Table 3.2  Bone anatomy. Articular cartilage (1)

Thin layer of cartilage covering the surface of bones at a joint.

Calcium

The most abundant mineral in the body. When combined with phosphorus it forms calcium phosphate, which is the principal calcium salt and hard material found in bones and teeth.

Cancellous bone (2)

Spongy or porous bone found at the ends of long bones and in the inner portions of long bones.

Collagen

Structural protein making up the white fibrous strands found in bone.

Compact bone (3)

Hard, dense bone tissue that forms the outer layer of bone. Also known as cortical bone.

Diaphysis (4)

The shaft of a long bone. The plural form is diaphyses.

Endosteum (5)

The inner lining of bone. This forms the lining of the medullary cavity.

Epiphyseal plate (6)

Cartilaginous region of long bones where lengthwise growth takes place. This is also known as the physis or growth plate.

Epiphysis (7)

Each end of a long bone. It is composed of cancellous bone and covered with articular cartilage. The plural form is epiphyses.

Medullary cavity (8)

Central, hollowed‐out portion in the shaft of a long bone that contains yellow bone marrow.

Metaphysis (9)

The flared portion of a long bone between the epiphyseal plate and diaphysis.

Periosteum (10)

Membrane surrounding bone. This fibrous tissue contains blood vessels and nerves.

Red bone marrow (11) Found in cancellous bone and is the site of hematopoiesis (blood formation). Yellow bone marrow

Found in the diaphysis of bone and consists of fatty tissue.

58

Long bones: Short bones: Flat bones: Sesamoid bones: Irregular bones:

Veterinary Medical Terminology Guide and Workbook

These bones are longer than they are wide. They are found in the front and rear limbs. Examples of long bones include the femur, tibia, radius, and metacarpals. These bones are cuboidal (cube shaped). Examples of short bones include the carpals and tarsals. These bones are actually two sheets of compact bone that allow for protection. Flat bones are flat and thin. Examples include the scapula, ribs, and bones of the pelvis and skull. Sesamoid bones are small bones that are embedded in tendons. They get their name because of their sesame seed shape. The patella is an example of a sesamoid bone. Horses have other sesamoid bones that will be discussed in later chapters. These bones don’t fit into the previous categories because they share traits of several categories. The best example of this classification is the vertebrae.

Related Terms and Processes The bones of the skeleton have various protrusions and depressions that allow for structural support (Table 3.3 and Figure 3.3). Table 3.3  Bone processes. Acetabulum

Cup‐like depression in the pelvis that creates the hip joint.

Bone head

Rounded articular process separated from the shaft of the bone by a neck. The bone head is usually covered in articular cartilage. Examples include the femoral head and humeral head.

Condyle

Knuckle‐like projections at the distal end of some long bones. They are usually covered by articular cartilage and articulate with other bones. Examples include the femoral and humeral condyles.

Crest

High projection or border projection of a bone. An example is the crest of the ilium (also known as the wing of the ilium).

Foramen

A hole in bone that allows for the passage of nerves and vessels. Examples include the obturator foramen and the foramen magnum.

Fossa

Shallow cavity or depression in bone. An example would be the trochanteric fossa which lies between the greater and lesser trochanter.

Groove

A narrow linear depression. Also known as a sulcus. An example is the bicipital groove on the humerus.

Olecranon

Bony process at the proximal end of the ulna.

Sinus

A hollow space or cavity in bone. An example is the nasal sinuses.

Trochanter

Large, blunt, roughened process on the femur for the attachment of muscles and tendons.

Tubercle

Rounded process on many bones for the attachment of muscles and tendons. The best example is the humeral tubercle.

Tuberosity

Small roughened process on many bones for the attachment of muscles and tendons. Examples include the tibial tuberosity and ischiatic tuberosity.

Chapter 3  The Musculoskeletal System

59

Femur Fossa

Lesser trochanter

Greater trochanter

Bone head

Bone head

Foramen

Cranial

Caudal view

view

Groove

Condyles

Figure 3.3  Processes on the femur of a cow.

Divisions of the Skeleton If we look at the skeleton as a whole, we can divide it into three portions: the axial skeleton, which consists of bones along the axis (center) of the body; the appendicular skeleton, which consists of the bones of the appendages (extremities); and the visceral (splanchnic) skeleton, which consists of bones that are embedded in tissue. We will focus on small animal skeletal structure in this chapter. Large animals and exotics will be covered in later chapters.

The Axial Skeleton Bones of the axial skeleton include the skull, vertebrae (backbones), ribs, and sternum. Notice that only bones along the axis (midline) of the body are a part of the axial skeleton. A common miscon­ ception is that the pelvis and scapula are a part of the axial skeleton. However, they don’t originate from the midline and instead play a role in the function of the limbs. Therefore, they’re a part of the appendicular skeleton.

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Veterinary Medical Terminology Guide and Workbook

The Skull The skull is composed of several bones that surround and protect the brain (Figure 3.4). Ethmoid bone

Bone that forms the roof of the nasal cavity and the floor of the rostral cranial cavity (orbits of the eyes). Paired bones making up the upper part of the face; the cranial aspect of the skull. The caudal aspect of the skull. Paired bones forming the sides and roof of the cranium. Wedge‐shaped bone at the base of the skull. Paired bones forming the lower sides of the skull. Facial bones make up the front of the skull. Within these facial bones are spaces of air called sinuses. Horseshoe‐shaped bone at the base of the tongue and below the thyroid cartilage. Bone bearing the incisors. Also known as the premaxilla. Bone forming the medial aspect of the orbit (eye socket). Horseshoe‐shaped bones forming the lower jaw.

Frontal bone Occipital bone Parietal bone Sphenoid bone Temporal bone Facial bones Hyoid bone Incisive bone Lacrimal bone Mandibular bones Maxillary bones Nasal bones Palantine bone Vomer Zygomatic bones

Two identical bones that form the upper jaw. Two bones forming the bridge of the nose. Bone that forms the hard palate. Bone forming the base of the nasal septum. A septum is a partition. Bones forming the hard part of the cheek and the lower portion of the orbit (eye socket).

Ethmoid

Frontal

Parietal Temporal

Lacrimal Nasal Occipital Incisive

Zygomatic arch Maxilla Mandible

Orbit

Sphenoid

Figure 3.4  Bones of the dog’s skull.

The Backbones The vertebral column, or spinal column, is composed of a series of backbones called vertebrae. They are arranged based on size and function. The vertebrae differ based

on function, but the general anatomy is the same (Figures 3.5 and 3.6). Figure 3.5 depicts the parts of a vertebra. Note the spinal cord, which passes through the opening in the middle, called a foramen.

Chapter 3  The Musculoskeletal System

61

Spinous process Meninges Foramen

Gray matter White matter Dorsal root

Inferior articular process

Ventral root Superior articular process Spinal nerve Posterior tubercle of transverse process

Anterior tubercle of transverse process

Nucleus pulposus

Foramen transversium

Vertebral body

Disc annulus

Figure 3.5  Anatomy of a vertebra. Source: Courtesy of shutterstock/udaix. Caudal (coccygeal) vertebrae

Sacral vertebrae

Lumbar vertebrae

Thoracic vertebrae

Cervical vertebrae

Figure 3.6  Vertebral column of the cat. Source: Courtesy of shutterstock/Linda Bucklin.

Bones of the Thorax The chest cavity is made up of the ribs and sternum. The number of ribs varies based on species. Each pair of ribs attaches to the thoracic vertebrae; therefore, the number of thoracic vertebrae corre­ sponds with the number of pairs of ribs.

For example, there are 13 thoracic verte­ brae in the dog; thus, there are 13 pairs of ribs in the dog or 26 in total. The sternum, or breastbone, lies along the midline of the chest and comprises the ventral portion of the rib cage. The sternum is made up of three portions

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Veterinary Medical Terminology Guide and Workbook

Body of the sternum Manubrium Xiphoid process

Figure 3.7  Parts of the sternum.

called sternebrae (Figure 3.7). The upper portion of the sternum is called the manubrium, the mid‐portion is called the body, and the lower portion is called the xiphoid process. The xiphoid process is an important structure for veterinary technicians. We use the xiphoid process as a landmark when taking abdominal radiographs, and we use it to determine where to stop shaving when we are shaving an animal for abdominal surgery. Veterinarians use the xiphoid as a guide for where to incise the patient for surgery.

1.

2. 3.

4. 5.

The Appendicular Skeleton Bones of the appendicular skeleton include the bones of the front and rear limbs and bones of the limb girdles (pelvis and scapula). Label the thoracic limb in Figure 3.8 using the terms listed in Table 3.4. Label the pelvic limb in Figure 3.9 using the terms listed in Table 3.5.

6. 7. 8. Figure 3.8  Thoracic limb of the dog. Source: Courtesy of shutterstock/Maluson.

Table 3.4  The thoracic limb.

Bones

Location

Scapula (1)

A flat, triangular bone at the top of the shoulder commonly known as the shoulder blade.

Clavicle

Also known as the collarbone; some animals have a reduced (imperfect) clavicle, while other species completely lack one. Only species capable of grasping with their front limbs possess one. Examples include cats and primates.

Humerus (2)

Bone of the upper front limb between the shoulder and the elbow.

Radius (5)

One of two bones in the lower front limb between the elbow and the wrist (carpus).

Ulna (4)

One of the two bones in the lower front limb between the elbow and wrist (carpus).

Olecranon (3)

Bony process on the proximal aspect of the ulna.

Carpals (6)

Six to eight bones (depending on species) grouped together in two rows to make up the carpus.

Metacarpals (7)

A group of long bones between the carpals and phalanges.

Phalanges (8)

Commonly known as the digits. Each phalanx has three phalanges.

Table 3.5  The pelvic limb.

1.

3.

2.

4. 5. 6.

Bones

Location

Pelvis

The pelvis is made up of three pairs of bones: the ilium (1), ischium (2), and pubis (3).

Femur (4)

Commonly called the thigh bone. The femur is between the hip and stifle.

Patella (5)

Large sesamoid bone found in the stifle. Commonly called the kneecap.

Fabella

Sesamoid bone found in the back of the femoral condyles. Most species have two.

Tibia (7)

The larger medial bone of the lower hindlimb.

Fibula (6)

The smaller lateral bone of the lower hindlimb.

Tarsals (9)

Seven bones that make up the tarsus (hock).

Calcaneus (8)

One of the seven tarsal bones that sits in the back of the tarsus. Commonly called the heel bone.

7.

8. 9. 10. Phalanges Figure 3.9  Pelvic limb of the dog. Source: Courtesy of shutterstock/Maluson.

Metatarsals Group of bones between the tarsus (10) and the phalanges.

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Veterinary Medical Terminology Guide and Workbook

The Visceral Skeleton The visceral skeleton contains bones that are embedded in tissues. This part of the skeleton helps to form an organ. Examples of bones of the visceral skeleton include the following: Os penis Os rostri Os cordis

Bone found in the penis of some carnivores (Figure 3.10). Bone found in the nose of pigs. Bone found in the heart of ruminants.

Additional Bone Pathology Terms The following terms don’t break down correctly using our rules of medical terminology.

Achondroplasia

Amputation Calcification Callus Chemonucleolysis Crepitation Decalcification Dislocation Fracture Herniation of IVD

Figure 3.10  Radiograph showing the os penis of the dog. Source: Courtesy of Beth Romano, AAS, CVT.

Hereditary condition in which the bones and cartilage of the limbs fail to grow to normal size. Commonly known as dwarfism, achondroplastic breeds include the dachshund and basset hound (Figure 3.11). Removal of a limb or other appendage (Figure 3.12). Deposit of calcium salts in tissue. Bone deposit formed at the ends of a bone fracture; it is absorbed as the fracture is repaired and then replaced by true bone. Procedure to dissolve a portion of the center of an intervertebral disk (IVD) to treat a herniated IVD. Crackling sounds produced by the grating of broken bones. Also known as crepitus. Loss of calcium salts in bone and teeth (Figure 3.13). Displacement of a bone from its joint. Sudden breaking of bone (Figure 3.14). Abnormal protrusion of an IVD into the neural cavity or spinal nerves (Figure 3.15).

TECH TIP 3.3  Achondroplasia is considered normal conformation for breeds such as basset hounds and dachshunds. In other breeds it’s considered a type of chondrodystrophy or ­chondrodysplasia. Examples includes Alaskan Malamutes and Norwegian Elkhounds.

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Figure 3.11  Long‐haired dachshund. Source: Courtesy of WikiCommons/Svenska Mässan.

(A)

(B)

(C)

(D)

(E)

Figure 3.12  Tail amputation surgery progression. (A) Note the skeletal appearance of the tail due to lack of blood supply. (B) An initial incision is made at the proximal aspect of the tail. (C) Scissors are used to cut soft tissue around the vertebrae. (D) Bone cutters are used to cut between the vertebrae. (E) Sutures are placed once the tail has been removed. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm.

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Lordosis

Orthopedic Osteoporosis

Reduction

Sequestrum

Figure 3.13  Decalcification of the bones in the hindlimb of a cat. Note the fracture of the femur due to the loss of bone density. Healthy bones will appear solid white on a radiograph. Source: Courtesy of Sarah Goos, CVT.

Immobilization Act of preventing a bone from being moved. Examples include sutures, bandages, and casts (see Figure 3.14d). Kyphosis Abnormal, increased dorsal curvature of the spine; also known as hunchback. Laminectomy Removal of part of the vertebral arch to relieve pressure from a ruptured IVD.

Downward or ventral curvature of the lumbar spine; also known as swayback. Branch of surgery dealing with the skeletal system. Decreased bone density due to loss of bone tissue. Bones become porous and fragile such that they can break easily. In animals, it is most often caused by malnutrition (Figure 3.16). Correction of a fracture. There are open reduc­ tions (after incision) and closed reductions (without incision). Piece of dead bone tissue that has separated from healthy bone tissue during necrosis (cell death).

TECH TIP 3.4  Lordosis, or swayback, is often seen in cats in heat or in lambs born with a copper deficiency.

Joints A joint is defined as two or more bones that come together. The naming of joints is simple if you know your bone anatomy. The medical name of a joint consists of the bones that make up that joint. They are usually, not always, listed in anatom­ ical order and are usually connected by the combining vowel of the letter “o.” Table 3.6 lists the major joints with their common names and Figure  3.17 shows the joints in a dog.

(A)

Transverse

Linear

(B)

Oblique, nondisplaced

Oblique, displaced

Spiral

Greenstick

Comminuted

(C)

(D)

Figure 3.14  (A) Different types of fractures. Source: Courtesy of shutterstock/Alila Medical Images. (B) Radiograph of a transverse fracture of the metatarsals. (C) Radiograph after orthopedic surgery to repair the fractured metatarsals. (D) Cast placed for immobilization after orthopedic surgery of fractured metatarsals.

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Compressed spinal nerve

Normal disk

Herniated disk

Figure 3.15  Herniation of an intervertebral disk (IVD). In many cases, the disk stays within the spinal canal and instead compresses the spinal cord. Source: Courtesy of shutterstock/Alila Sao Mai.

Healthy

Osteoporosis

Compact bone

Spongy bone

Figure 3.16  Comparison of healthy bone to a bone with osteoporosis. Source: Courtesy of shutterstock/ Alila Sao Mai.

skull, which are joined together by a suture. A suture is a line of union of adjoining bones of the skull. They appear as jagged little lines (Figure 3.18A). Examples of amphiarthroses (singular: amphiarthrosis) include the joints between the vertebrae and the symphysis between the pubic bones. A symphysis is a line of union in which two bones are united by fibrocartilage (Figure  3.18B). These types of joints allow for limited mobility. Diarthroses, or freely movable joints, are also known as synovial joints. Examples of synovial joints include the hip, elbow, shoulder, and hock. These joints have varying degrees of mobility so they can be further divided based on their range of motion. Table  3.7 lists the different types of synovial joints.

Anatomy of a Joint Joints can be divided into three basic categories based on their function. Categories of joints include synar­ throses (immovable joints), amphiar­ throses (partial­ly movable joints), and diarthroses (freely movable joints). Examples of synarthroses (singular: synarthrosis) include the bones of the

The most common joint injuries involve synovial joints. Stifle injuries such as torn cranial cruciate ligaments (anterior cruciate ligaments) are very common in high‐energy dogs. Figure  3.19 shows the general anatomy of a synovial joint, while Figure  3.20 shows the structures of a specific joint, the stifle.

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Table 3.6  Joints. Atlanto‐axial joint

Joint between the atlas and axis. Commonly known as the “no joint”.

Atlanto‐occipital joint Joint between the atlas and occipital bone. Commonly known as the “yes joint.” It is the only joint in which the bones are not listed in anatomical order. Carpus

Joint consisting of the carpal bones. Commonly known as the wrist in small animals and the knee in horses.

Coxofemoral joint

Joint between the pelvis (os coxae) and the femur. Commonly known as the hip.

Femorotibial joint

Joint between the femur and the tibia. Commonly known as the stifle. Within the stifle is a cartilage pad, called the meniscus, to withstand compressive forces.

Humeroradioulnar joint

Joint where the humerus meets the radius and ulna. Commonly known as the elbow.

Sacroiliac joint

Joint between the sacrum and the ilium.

Scapulohumeral joint

Joint between the scapula and humerus. Commonly known as the shoulder.

Tarsus

Joint consisting of the tarsal bones. Commonly known as the hock. The malleolus is the rounded process on either side of the tarsus.

TECH TIP 3.5  You will commonly hear owners refer to the stifle as the knee in small animal medicine; however, it is not proper use of terminology. The only time we use the term knee in veterinary medicine is to describe the carpus in horses. Owners of dogs and cats generally don’t know what a stifle is so you may need to communicate in lay terms that it is equivalent to the knee.

Atlanto-occipital joint Atlanto-axial joint

Sacroiliac joint

Coxofemoral joint (hip)

Scapulohumeral joint

Os penis Humeroradioulnar joint

Fabella

Femorotibial joint (stifle)

Carpus

Tarsus (hock)

Figure 3.17  Diagram of the joints in a dog. Source: Courtesy of shutterstock/decade3d.

(A)

Suture

(B) IIiac crest IIium

Pubis

Acetabulum Obturator foramen Ischium Ischiatic tuberosity Pubic (pelvic) symphysis

Figure 3.18  (A) Suture joints in the cat skull. (B) Anatomy of the pelvis showing a symphysis. Table 3.7  Synovial joints. Ball and socket

Joint in which the rounded head of one bone fits into the socket of another. Examples include the hip and shoulder joints. Also known as enarthroses or spheroid joints.

Gliding

These joint surfaces are flat, allowing for a gliding motion. Examples include the carpus. Also known as arthrodial joints.

Hinge

This joint allows for movement in one plane (one direction), similar to a door hinge. Examples include the elbow and stifle. Also known as ginglymus joints.

Pivot

These are pulley‐shaped or pivot‐like joints. An example is the atlanto‐axial joint. Also known as a trochoid joint.

Saddle

This joint can only be found in humans and non‐human primates. The surfaces of both bones are concave in one plane and convex, or saddle‐shaped, in the other. It allows for all range of motion except an axial twist. The best example is the carpometacarpal joint of the thumb.

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TECH TIP 3.6  The term “suture” has two different meanings depending on the context in which it is used. Sutures are commonly called stitches. We use sutures to close deep wounds. A suture is also a line of union that joins two bones, such as the sutures on the skull that join the skull bones together.

Articulation Where two or more bones come together; also known as a joint. Bursa Sac of fluid near a joint that acts as lubrication to ease friction between tissues. Bursae (plural form) can be found anywhere two types of tissue slide against one another. They can be found between bones and ligaments, skin and bones, and bones and tendons. Ligament Connective tissue that binds bone to bone. Suture Line or site of union of adjoining bones of the skull. Symphysis Line or site of union in which two bones are united by fibrocartilage. Synovial Space between bones at a synovial joint which contains synovial fluid. cavity Synovial Viscous (sticky) fluid within the synovial cavity that acts as a lubri­ fluid cant between bones. Synovial A freely movable joint, also known as diarthrosis. joint Synovial Membrane lining the synovial cavity that produces synovial fluid. membrane Tendon Connective tissue that binds muscle to bone.

Joint Pathology and Procedures Anterior drawer sign Congenital articular rigidity (CAR)

Cranial movement of the proximal tibia in relation to the distal femur to check for cranial cruciate ligament damage in the stifle. Condition present at birth in which the joints of the limbs are fixed in position. Commonly seen in calves, limbs are fixed in strange flexed positions.

Bones

Fibrous capsule Synovial membrane

Cartilage

Joint cavity with synovial fluid

Figure 3.19  Anatomy of a healthy synovial joint. Source: Courtesy of shutterstock/Alila Sao Mai.

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(A)

Femur Articular cartilage

Anterior cruciate ligament

Lateral collateral ligament Lateral meniscus

Medial meniscus Medial collateral ligament

Tibia

Fibula

(B) Fibula

Caudal (posterior) cruciate ligament

Articular surface of tibia

Lateral collateral ligament

Medial collateral ligament

Lateral meniscus Medial meniscus Red zone White zone Cranial (anterior) cruciate ligament

Tibia

Figure 3.20  (A) Structures of the stifle. (B) Meniscus of the stifle. Source: Courtesy of shutterstock/Alila Sao Mai.

Extracapsular technique (extra cap) Gait Gout Lame; lameness Luxation Osteochondritis dissecans (OCD)

Technique using nonabsorbable suture to replace the cranial cruciate ligament. Manner of walking. Inflammation of a joint due to the increased presence of uric acid crystals in the joint. Most commonly seen in chickens. Incapable of normal locomotion. Displacement of a bone from its joint; also known as dislocation (Figure 3.21). Inflammatory condition in which the articular cartilage separates from the underlying bone.

Chapter 3  The Musculoskeletal System

Pannus Rheumatoid arthritis (RA) Subluxation Tibial plateau leveling osteotomy (TPLO) Tibial tuberosity advancement (TTA) Total hip replacement (THR) Triple pelvic osteotomy (TPO)

73

Inflammatory fluid overlying synovial cells, commonly seen with rheumatoid arthritis. Inflammation of joints due to an autoimmune disease. Most commonly seen in dogs. Partial displacement of a bone from its joint (Figure 3.22). Procedure which changes the slope of the tibial plateau to help stabilize the stifle after tearing the cranial cruciate ligament. This is a common procedure in large breed dogs (Figure 3.23). Procedure to advance the tibial tuberosity to stabilize the stifle after tearing the cranial cruciate ligament. Replacement of the femoral head and acetabulum to correct hip dysplasia (Figure 3.24). Procedure in which the pelvis is cut in three different locations to change the angle at which the acetabulum meets the femoral head. This is a common procedure for correcting hip dysplasia in younger dogs (Figure 3.24).

TECH TIP 3.7  A torn cranial cruciate ligament, also known as an anterior cruciate ligament (ACL), is probably the most common orthopedic injury in veterinary medicine. The ACL is a constant load‐bearing ligament in the stifle that, when torn, can cause extreme pain and inflammation, which will prevent the animal from putting weight on the hindlimb. Without the ACL, the femur slides behind the tibia when the limb is in use. TPLO is a surgery which relocates the tibial plateau, which is the part of the tibia in contact with the distal femur. By moving the tibial plateau, the ACL is no longer needed to carry the load of the hindlimb.

Figure 3.21  Radiograph of a dislocated hip in a dog. Source: Courtesy of Lindsey Towery, CVT.

TECH TIP 3.8  Autoimmune disease is a disease in which the immune system attacks one’s own good cells. There are many examples of autoimmune disease that will be covered in later chapters.

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Quadriceps tendon

Patella Medial collateral ligament Lateral collateral ligament Patellar ligament

Tibia

Normal position of patella

Patella displaced

Figure 3.22  Diagram of subluxation of the patella. Source: Courtesy of shutterstock/Designua.

Muscles A muscle is an organ composed of bundles of fibers that contract to produce movement. In general, muscles are respon­ sible for locomotion and structural support. Through movement, muscles can also assist in other functions including the functions of viscera (internal organs) and generating body heat.

Types of Muscles Muscles can be divided into three groups based on their location and function. Table  3.8 lists the different types of muscles and their functions. Some muscles work together to achieve a similar function. These muscles are termed synergistic. For example, the quadriceps muscle actually consists of four different muscles (heads) all working together to extend the stifle. Other mus­ cles work against each other to achieve opposite functions. These muscles are

termed antagonists. Examples of antago­ nists include the biceps brachii and triceps brachii. While the biceps work to flex the elbow, the triceps work to extend the elbow. All muscles have the ability to contract and relax to produce movement. If a muscle contracts, then it is tightening, or shrinking, and drawing things together. When the muscle relaxes, it loosens its tension and returns to its original form. Fascia is a fibrous connective tissue that envelopes, separates, and supports the muscles listed in Table  3.8. Within the fasciae lie the muscle’s blood supply, nerve supply, and lymph. Figure  3.26 shows the white fascia between the layers of skeletal muscle on the cat. Notice the spider web appearance.

Functions of Muscle While some muscles are named based on their anatomical location, other muscles are named based on their point of attachment.

(A)

(B)

(C)

(D)

(E)

(F)

(G)

Figure 3.23  Tibial plateau leveling osteotomy (TPLO) surgery. (A) An osteotome is used to make small nicks in the bone where the osteotomy was performed to rotate the tibial plateau. The veterinarian measures a specific distance to rotate the osteotomy to correspond to the amount of degrees of rotation to end up with the desired tibial plateau angle. (B) After the bone is rotated, the jig is in place to keep the bone stable and aligned when rotating the tibial plateau. The pins are placed to secure the bone after it is rotated in preparation for the placement of the plate. (C) With the jig still in place, the plate has been contoured to the bone, and a drill guide is in a hole in the plate, ready for the bone to have the first hole drilled to place a screw in the plate. (D) A screw is being placed through the plate hole into the bone using a power screwdriver. (E) A total of six screws were placed, three above and three below the osteotomy. (F) Post‐surgical lateral radiograph of the stifle. (G) Post‐surgical cranial radiograph of the stifle. Source: Courtesy Steven Shimer, CVT.

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(A)

Veterinary Medical Terminology Guide and Workbook

(B)

(C)

Figure 3.24  (A) Hip dysplasia. Note that the head of the femur is not seated firmly in the acetabulum of the pelvis. (B) Triple pelvic osteotomy correcting the hip dysplasia. Note that after the three incisions are made, the femoral head is now seated firmly in the acetabulum. (C) Total hip replacement. Note the artificial femoral head and acetabulum that have replaced the animal’s hip joint. Table 3.8  Muscle types (see also Figure 3.25) Cardiac muscle

Striated, involuntary muscle found in the heart.

Skeletal muscle

Striated, voluntary muscles attached to bones all over the body; responsible for movement.

Visceral muscle

Smooth, involuntary muscles responsible for the functioning of internal organs. Also known as smooth muscle.

Skeletal muscle Smooth muscle

Cardiac muscle

Figure 3.25  The three muscle types. Source: Courtesy of shutterstock/Designua.

There are two points of attachment for a muscle: a stationary bone and a movable bone. The stationary bone is considered the origin of the muscle. The origin is the

point of attachment that is closest to the midline of the body. The stationary bone is held in place by other muscles. The bone that moves is considered the insertion of

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Figure 3.26  Dissected cat displaying the fasciae between the abdominal muscles.

the muscle and is generally farthest from the midline of the body. If describing the skeletal muscles on the limbs, then the origin is generally the proximal point of attachment and the insertion is the distal point of attachment. When describing Abduction Adduction Dorsiflexion Extension Flexion Pronation Supination Rotation

how the muscle moves we measure its range of motion using the degrees of a circle. Range of motion measures the range in which a joint can be flexed or extended. The following is a list of muscle functions and their definitions.

Movement away from the midline of the body. Movement toward the midline of the body. Backward bending (flexion); an example is the neck. Increasing the angle between two bones at a joint. Decreasing the angle between two bones at a joint. The act of turning the palmar or plantar surface downward. The act of turning the palmar or plantar surface upward. Circular movement that turns a body part around a central point (axis).

Additional Myopathy Terms Adhesion Ambulatory Atrophy Fascia Hyperplasia Hypertrophy Hypoplasia Laxity Myasthenia Myasthenia gravis

Fibrous band that connects two surfaces that are normally separate. Often results from surgery in which scar tissue forms around incisions. Able to walk; also known as ambulant or ambulation. No development due to a decrease from the normal cell size. Fibrous connective tissue that envelopes, separates, and supports the muscles. Plural is fasciae (see Figure 3.26). Increased development due to an increase in cell numbers. Excessive development due to increase in cell size. Incomplete development due to decrease in cell numbers. Looseness. Muscle weakness. Syndrome of muscular weakness that is aggravated by activity and relieved by rest. May be inherited in dogs and cats.

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Veterinary Medical Terminology Guide and Workbook

Repetitive contractions of skeletal muscles that persist during sleep. Sometimes seen in dogs with distemper virus. Disorder in which there is delayed relaxation of a muscle after contraction. Inflammation of the tendon and tendon sheath. May be seen with chronic arthritis or injuries such as paw lacerations on lawn edging. Continuous muscle spasms or twitching. Muscle tone; balanced muscle tension.

Building the Terms Now it’s time to assemble the word parts listed in Tables  3.9, 3.10 and 3.11. This will get easier each time if you memorize the meaning of the combining forms,

prefixes, and suffixes. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 3.9  Combining forms.

Combining Form

Definition

Combining Form

Definition

Acetabul/o

Acetabulum

Mandibul/o

Mandible; lower jaw

Ankyl/o

Stiff

Maxill/o

Maxilla; upper jaw

Arthr/o

Joint

Metacarp/o

Metacarpals

Articul/o

Joint

Metatars/o

Metatarsals

Brachi/o

Arm

My/o

Muscle

Burs/o

Bursa

Myel/o

Bone marrow; spinal cord

Calc/o

Calcium

Myos/o

Muscle

Calcane/o

Calcaneus

Necr/o

Death

Carp/o

Carpus

Olecran/o

Olecranon

Chondr/o

Cartilage

Orth/o

Bone

Clavicul/o

Clavicle

Oss/e, oss/i

Bone

Costal/o

Rib

Oste/o

Bone

Cost/o

Rib

Pariet/o

Side

Crani/o

Skull

Patell/o

Patella

Dactyl/o

Toes; digits

Ped/o

Child; foot

Electr/o

Electricity

Pelv/i, pelv/o

Pelvis; pelvic bone; hip

Erg/o

Work

Perone/o

Fibula

Fasci/o, fasc/i

Fascia

Phalang/o

Phalanges; digits

Table 3.9  (Continued)

Combining Form

Definition

Combining Form

Definition

Femor/o

Femur

Pub/o

Pubis

Fibr/o

Fibrous connective tissue

Radi/o

Radius; X‐ray

Fibros/o

Fibrous connective tissue

Rhabdomy/o

Striated (skeletal) muscle

Fibul/o

Fibula

Rheumat/o

Watery flow

Hem/o

Blood

Sacr/o

Sacrum

Hemat/o

Blood

Sarc/o

Connective tissue (flesh)

Humer/o

Humerus

Scapula/o

Scapula

Hydr/o

Fluid; water

Sphen/o

Wedge

Ili/o

Ilium

Spondyl/o

Vertebra

Ischi/o

Ischium

Stern/o

Sternum

Kinesi/o

Movement

Synov/o

Synovial membrane; tendon sheath

Kyph/o

Humpback; bent; hump

Tars/o

Tarsus

Lacrim/o

Tear; tear duct

Ten/o

Tendon

Lamin/o

Lamina

Tendin/o

Tendon

Leiomy/o

Smooth (visceral) muscle

Tibi/o

Tibia

Ligament/o

Ligament

Ton/o

Tension

Lord/o

Curve; swayback; bent backward

Uln/o

Ulna

Malleol/o

Malleolus

Vertebr/o

Vertebra

Table 3.10  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

hypo‐

deficient; below; under; less than normal

ab‐

away from

inter‐

between

ad‐

toward

meta‐

change; beyond

amph‐

around; on both sides; doubly

pan‐

all

anti‐

against

peri‐

surrounding; around

de‐

lack of; down; less; removal of

poly‐

many; much

dia‐

through; complete

sub‐

under; below

dys‐

bad; painful; difficult; abnormal

supra‐

above; upper

endo‐

in; within

sym‐

together; with

epi‐

above; upon; on

syn‐

together; with

hyper‐

above; excessive

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Veterinary Medical Terminology Guide and Workbook

Table 3.11  Suffixes.

Suffix

Definition

Suffix

Definition

‐ac, ‐al, ‐ar, ‐ary, ‐eal, ‐ic, ‐ous

pertaining to

‐oma

tumor; mass; fluid collection

‐algia

pain

‐osis

abnormal condition

‐blast

immature; embryonic

‐pathy

disease condition

‐centesis

surgical puncture to remove fluid

‐pexy

surgical fixation; to put in place

‐clast

to break

‐physis

to grow

‐cyte

cell

‐plasia

development; formation; growth

‐desis

surgical fixation; to bind; tie together

‐plasty

surgical repair

‐dynia

pain

‐poiesis

formation

‐ectomy

removal; excision; resection

‐porosis

condition of pores (spaces)

‐emia

blood condition

‐rrhaphy

suture

‐fication

process of making

‐sclerosis

hardening

‐genesis

producing; forming

‐scopy

visual examination

‐graphy

process of recording

‐sthenia

strength

‐ion

process

‐tome

instrument to cut

‐itis

inflammation

‐tomy

process of cutting into; incision

‐kinesis

movement

‐therapy

treatment

‐malacia

softening

‐trophy

development; nourishment

‐metry

measurement

‐y

condition

Parts Acetabul/o Ankyl/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Arthr/o Brachi/o Hem/o

+ ‐ar + ‐osis + ‐centesis + ‐desis + ‐graphy + ‐plasty + ‐scope + ‐scopy + ‐tomy + ‐al + Arthr/o

Medical Term

+ ‐osis

= Acetabular = Ankylosis (Figure 3.27) = Arthrocentesis = Arthrodesis = Arthrography = Arthroplasty = Arthroscope = Arthroscopy = Arthrotomy = Brachial = Hemarthrosis

Definition : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________

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Healthy joint

1. Synovitis

Synovial membrane inflamed and thickened

Fibrous capsule

Bones

Synovial membrane

Cartilage

Bones and cartilage gradually eroded

Joint cavity with synovial fluid

2. Pannus

3. Fibrous ankylosis

4. Bony ankylosis

Pannus Bones fused Extensive cartilage loss; exposed and pitted bones

Joint invaded by fibrous connective tissue

Figure 3.27  Stages of rheumatoid arthritis. Source: Courtesy of shutterstock/Alila Sao Mai.

Hydr/o poly‐ Calcane/o hyper‐ hypo‐ Carp/o Chondr/o Chondr/o Chondr/o Chondr/o supra‐ Cost/o inter‐ sub‐ Crani/o Crani/o poly‐ syn‐ dys‐

+ Arthr/o + Arthr/o + ‐al + Calc/o + Calc/o + ‐al + Cost/o + ‐oma + ‐malacia + Sarc/o + Clavicul/o + ‐al + Cost/o + Cost/o + ‐tome + ‐tomy + Dactyl/o + Dactyl/o + ‐plasia

+ ‐osis + ‐itis + ‐emia + ‐emia + ‐al + ‐oma + ‐ar + ‐al + ‐al + ‐y + ‐y

= Hydrarthrosis (Figure 3.28) = Polyarthritis = Calcaneal = Hypercalcemia = Hypocalcemia = Carpal = Chondrocostal = Chondroma = Chondromalacia = Chondrosarcoma = Supraclavicular = Costal = Intercostal = Subcostal = Craniotome = Craniotomy = Polydactyly (Figure 3.29) = Syndactyly = Dysplasia

: ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________

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Figure 3.28  Hydrarthrosis. Source: Courtesy of Lindsey Steele, AAS.

Fasci/o Femor/o Fibr/o Fibul/o Humer/o Hydr/o Ili/o Ischi/o Kinesi/o Leiomy/o Leiomy/o Ligament/o Malleol/o Mandibul/o Maxill/o Metacarp/o Metatars/o Electr/o My/o My/o My/o My/o Myel/o Myel/o

+ ‐itis + ‐al + ‐oma + ‐ar + ‐al + ‐therapy + ‐ac + ‐al + ‐logy + ‐oma + Sarc/o + ‐ous + ‐ar + ‐ar + ‐ary + ‐ectomy + ‐algia + My/o + ‐ectomy + ‐pathy + ‐plasty + ‐tomy + ‐oma + ‐poiesis

= Fasciitis = Femoral = Fibroma = Fibular = Humeral = Hydrotherapy = Iliac = Ischial = Kinesiology = Leiomyoma + ‐oma = Leiomyosarcoma = Ligamentous = Malleolar = Mandibular = Maxillary = Metacarpectomy = Metatarsalgia + ‐graphy = Electromyography = Myectomy = Myopathy = Myoplasty = Myotomy = Myeloma = Myelopoiesis

: ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : _______________ : _______________

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(A)

(B)

Figure 3.29  (A) Polydactyly in a Lab mix puppy. Note the extra dewclaw. Source: Courtesy of Beth Romano, AAS, CVT. (B) Polydactyly in a cat. Source: Courtesy of Donna Tunis, CVT.

TECH TIP 3.9  Myelopoiesis is often used to describe the production of white blood cells, specifically the production of a group of white blood cells called granulocytes.

Myos/o Necr/o Olecran/o Oste/o Oste/o Oste/o Oste/o Oste/o

+ ‐itis + ‐osis + ‐al + ‐algia + ‐itis + Arthr/o + ‐centesis + Chondr/o

+ ‐itis + ‐osis

= Myositis = Necrosis = Olecranal = Ostealgia = Osteitis = Osteoarthritis (Figure 3.30) = Osteocentesis = Osteochondrosis

: _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________

84

Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o Oste/o pan‐ peri‐ Pelv/i Perone/o Phalang/o Pub/o Radi/o Radi/o Scapul/o supra‐ Spondyl/o Spondyl/o Stern/o Patell/o sub‐ Synov/o Tars/o Tendin/o

Veterinary Medical Terminology Guide and Workbook

+ dys‐ + ‐genesis + ‐malacia + Myel/o + Necr/o + ‐pexy + ‐plasty + Sarc/o + ‐sclerosis + ‐tome + Oste/o + Oste/o + ‐metry + ‐al + ‐eal + ‐ic + ‐al + ‐graphy + ‐ar + Scapul/o + ‐itis + ‐osis + ‐al + ‐ar + Patell/o + ‐itis + ‐ectomy + ‐ectomy

+ ‐trophy = Osteodystrophy = Osteogenesis = Osteomalacia + ‐itis = Osteomyelitis + ‐osis = Osteonecrosis = Osteopexy = Osteoplasty + ‐oma = Osteosarcoma (Figure 3.31) = Osteosclerosis = Osteotome + ‐itis = Panosteitis + ‐itis = Periosteitis = Pelvimetry = Peroneal = Phalangeal = Pubic = Radial = Radiography (Figure 3.32) = Scapular + ‐ar = Suprascapular = Spondylitis = Spondylosis = Sternal = Patellar + ‐ar = Subpatellar = Synovitis = Tarsectomy = Tendinectomy

: _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________ : _______________

TECH TIP 3.10  The Prefix “pan‐” Beware of pan‐ when attached to certain combining forms and suffixes. For example, the term “panosteitis” is not defined as an inflammation of all bones. That would be rare. Instead, it is defined as an inflammation of all parts of a bone. Ask yourself what makes the most sense when using the prefix pan‐ before literally defining a term.

TECH TIP 3.11  A tenectomy was once considered to be an alternative to a declaw. Today, however, the practice is considered by most to be inhumane. A cat scratching the furniture is a common complaint of owners. Shelters are filled with cats that have been relinquished because of their scratching. Scratching posts can be purchased to try to redirect the behavior, but all too often frustrated owners will come to the clinic for a “quick fix.” While controversial, many veterinarians will still perform declaws. Declawing has been outlawed in other countries and many states are now in the process of trying to ban the practice. Declawing involves surgically removing the distal phalanx of each digit. Soft paws are caps that can be placed on the nails of the cat. A tenectomy involves cutting the tendons responsible for the control of the cat’s nails. Once performed, the cat is unable to retract its nails.

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Figure 3.30  Osteoarthritis of a synovial joint. Source: Courtesy of shutterstock/Alila Sao Mai. Figure 3.31  Osteosarcoma on the distal radius. Source: Courtesy of Stacey Fowler, LVT.

(A)

(B)

Figure 3.32  (A) Radiography of a dog. Source: Courtesy of shutterstock/Kanwarjit Singh Boparai. (B) Radiograph of a dog showing bullets from a gunshot wound. Source: Courtesy of shutterstock/P. Fabian.

Tendin/o Ten/o Ten/o Ten/o Tibi/o Uln/o Vertebr/o

+ ‐itis + ‐ectomy + ‐rrhaphy + ‐tomy + ‐al + ‐ar + ‐al

= Tendinitis = Tenectomy = Tenorrhaphy = Tenotomy = Tibial = Ulnar = Vertebral

: ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________

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Abbreviations Table 3.12  Abbreviations.

Abbreviation

Definition

AAHA

American Animal Hospital Association

ACL

Anterior cruciate ligament

AVMA

American Veterinary Medical Association

Bilat.

Bilateral

CAR

Congenital articular rigidity

CCL; CrCL

Cranial cruciate ligament

CK

Creatine kinase (muscle enzyme)

CVT

Certified veterinary technician

DJD

Degenerative joint disease

DVM; VMD

Doctor of Veterinary Medicine

EMG

Electromyogram

FHO

Femoral head osteotomy

GSW

Gunshot wound



Left

LVT

Licensed veterinary technician

MPL

Medial patellar luxation

M/S

Musculoskeletal

NAVTA

National Association of Veterinary Technicians of America

NSAID

Nonsteroidal anti‐inflammatory drug

OCD

Osteochondritis dissecans

OSA

Osteosarcoma

Ortho

Orthopedic or orthopedic procedure

PDR

Physicians’ Desk Reference

PROM

Passive range of motion

®

Right

RA

Rheumatoid arthritis

ROM

Range of motion

RVT

Registered veterinary technician

THR

Total hip replacement

Chapter 3  The Musculoskeletal System

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Table 3.12  (Continued)

Abbreviation

Definition

TPLO

Tibial plateau leveling osteotomy

TPO

Triple pelvic osteotomy

TTA

Tibial tuberosity advancement

VPB

Veterinary pharmaceuticals and biologicals

Case Study: Define the medical terms and abbreviations in bold print You’ll notice some terms from the previous chapters Partner, a two‐year‐old German Shepherd, comes to your clinic with lameness. The clinic is accredited by AAHA. The owners had noticed an abnormal gait in the past couple of weeks after a trip to the dog park. Upon P/E Partner wasn’t ambulatory. The doctor notes bilat. weakness in the rear limbs. There is slight atrophy of the rear leg muscles. To rule out an ACL tear the DVM checks anterior drawer signs. If there’s an ACL rupture, then a TPLO would be necessary due to the dog’s size. Anterior drawer sign was normal so PROM is checked next. The vet notices that the ® coxofemoral joint has a decreased ROM so radiographs are ordered. Osteitis is ruled out and Partner is diagnosed with hip dysplasia. The femoral head isn’t aligned with the acetabulum so a TPO is performed to correct the problem. Three weeks later Partner returns for PT, and he seems far more energetic. The CVT takes him to the back to begin his hydrotherapy. All the techs in the clinic are members of NAVTA.

Exercises 3‐A:  Match the combining forms with their meaning. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

____________ Skull ____________ Lower jaw ____________ Death ____________ Connective tissue ____________ Tension ____________ Rib ____________ Movement ____________ Vertebrae ____________ Blood ____________ Water; fluid ____________ Smooth muscle ____________ Ulna

A. Cost/o B. Crani/o C. Hem/o D. Hydr/o E. Kinesi/o F. Leiomy/o G. Mandibul/o H. Necr/o I. Sarc/o J. Spondyl/o K. Ton/o L. Uln/o

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3‐B:  Write the correct medical term in the blank. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

____________: Pertaining to below the ribs ____________: Softening of cartilage ____________: Inflammation of vertebrae ____________: Inflammation of fascia ____________: Pertaining to the upper jaw ____________: Disease condition of muscle ____________: Abnormal condition of bones and cartilage ____________: Removal of the hock ____________: Hardening of bone ____________: Study of movement ____________: Movement away from the midline ____________: Manner of walking ____________: Looseness ____________: Decrease in the angle between two bones ____________: Continuous muscle spasms ____________: Knuckle‐like process at the ends of some long bones ____________: Membrane surrounding bone ____________: Shaft of a long bone ____________: Displacement of a bone from its joint ____________: Bony process on the proximal ulna

3‐C:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Hypocalcemia ________________________________________________ Myasthenia __________________________________________________ Rhabdomyoma _______________________________________________ Hypertrophy _________________________________________________ Fracture _____________________________________________________ Dysplasia ____________________________________________________ Achondroplasia _______________________________________________ Ankylosis ____________________________________________________ Hemarthrosis _________________________________________________ Tenorrhaphy _________________________________________________

3‐D:  Define the following suffixes. 1. 2. 3. 4. 5. 6.

___________: ‐blast ___________: ‐pexy ___________: ‐malacia ___________: ‐metry ___________: ‐cyte ___________: ‐desis

7. 8. 9. 10. 11. 12.

___________: ‐emia ___________: ‐al ___________: ‐poiesis ___________: ‐kinesis ___________: ‐tome ___________: ‐physis

3‐E:  Define the following prefixes. 1. 2. 3. 4.

___________: pan‐ ___________: hypo‐ ___________: ab‐ ___________: inter‐

5. 6. 7. 8.

___________: peri‐ ___________: dys‐ ___________: endo‐ ___________: supra‐

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3‐F:  Define the following abbreviations. 1. 2. 3. 4. 5. 6. 7.

___________: AVMA ___________: VPB ___________: RVT ___________: THR ___________: Ortho ___________: GSW ___________: EMG

8. 9. 10. 11. 12. 13. 14.

__________: TPO __________: TTA __________: CAR __________: CCL __________: PDR __________: OCD __________: TPLO

3‐G:  Circle the correct term in parentheses. 1.  2.  3.  4.  5.  6.  7.  8.  9. 

Sac of fluid near a joint that helps lubricate: (fascia, bursa) Partial displacement of a bone from its joint: (subluxation, fracture) Striated, voluntary muscle that controls movement: (skeletal, visceral) Inflammation of muscles: (arthritis, myositis) Connective tissue that binds bone to bone: (ligament, tendon) Hunchback: (kyphosis, lordosis) A freely movable joint: (suture, synovial) Removal of a limb or other appendage: (laminectomy, amputation) Crackling sounds heard due to two broken bones rubbing together: (calcification, crepitation) 10.  Hole in bone that allows for the passage of nerves and vessels: (foramen, callus) 3‐H:  Define the following medical terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

____________________________________________: Amputation ____________________________________________: Ossification ____________________________________________: Necrosis ____________________________________________: Fibular ____________________________________________: Laminectomy ____________________________________________: Reduction ____________________________________________: Articulation ____________________________________________: Osteoblast ____________________________________________: Patellar ____________________________________________: Phalangeal ____________________________________________: Pelvimetry ____________________________________________: Chondrosarcoma ____________________________________________: Subcostal ____________________________________________: Tenotomy ____________________________________________: Osteopexy

3‐I:  List the three types of muscle and circle the correct answers for each in parentheses. Types of muscle _____________ _____________ _____________

Voluntary or involuntary (Voluntary, involuntary) (Voluntary, involuntary) (Voluntary, involuntary)

Answers can be found starting on page 675.

Smooth or striated (Smooth, striated) (Smooth, striated) (Smooth, striated)

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Review Tables Fill in the tables and refer to Tables 3.9–3.12 for answers. Table 3.13

Combining Form

Definition

Combining Form

Acetabul/o

Mandibul/o

Ankyl/o

Maxill/o

Arthr/o

Metacarp/o

Articul/o

Metatars/o

Brachi/o

My/o

Burs/o

Myel/o

Calc/o

Myos/o

Calcane/o

Necr/o

Carp/o

Olecran/o

Chondr/o

Orth/o

Clavicul/o

Oss/e, oss/i

Cost/o

Pariet/o

Costal/o

Oste/o

Crani/o

Patell/o

Dactyl/o

Ped/o

Electr/o

Pelv/i, pelv/o

Erg/o

Perone/o

Fasci/o, fasc/i

Phalang/o

Femor/o

Pub/o

Fibr/o

Radi/o

Fibros/o

Rhabdomy/o

Fibul/o

Rheumat/o

Hem/o

Sacr/o

Hemat/o

Sarc/o

Humer/o

Scapula/o

Hydr/o

Sphen/o

Definition

Chapter 3  The Musculoskeletal System

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Table 3.13  (Continued)

Combining Form

Definition

Combining Form

Ili/o

Spondyl/o

Ischi/o

Stern/o

Kinesi/o

Synov/o

Kyph/o

Tars/o

Lacrim/o

Ten/o

Lamin/o

Tendin/o

Leiomy/o

Tibi/o

Ligament/o

Ton/o

Lord/o

Uln/o

Malleol/o

Vertebr/o

Definition

Table 3.14

Prefix

Definition

Prefix

a‐, an‐

hypo‐

ab‐

inter‐

ad‐

meta‐

amph‐

pan‐

anti‐

peri‐

de‐

poly‐

dia‐

sub‐

dys‐

supra‐

endo‐

sym‐

epi‐

syn‐

hyper‐

Definition

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Table 3.15

Suffix

Definition

Suffix

‐ac, ‐al, ‐ar, ‐ary, ‐eal, ‐ic, ‐ous

‐oma

‐algia

‐osis

‐blast

‐pathy

‐centesis

‐pexy

‐clast

‐physis

‐cyte

‐plasia

‐desis

‐plasty

‐dynia

‐poiesis

‐ectomy

‐porosis

‐emia

‐rrhaphy

‐fication

‐sclerosis

‐genesis

‐scopy

‐graphy

‐sthenia

‐ion

‐tome

‐itis

‐tomy

‐kinesis

‐therapy

‐malacia

‐trophy

‐metry

‐y

Table 3.16

Abbreviation AAHA ACL AVMA Bilat. CAR CCL; CrCL CK

Definition

Definition

Chapter 3  The Musculoskeletal System

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Table 3.16  (Continued)

Abbreviation CVT DJD DVM EMG FHO GSW Ⓛ LVT MPL M/S NAVTA NSAID OCD OSA Ortho PDR PROM ® RA ROM RVT THR TPLO TPO TTA VPB

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

4

The Gastrointestinal Tract

The alimentary system, also referred to as the gastrointestinal system, has three main functions. The first function begins at the mouth, where the animal swallows the food and the food travels to the stomach to begin the process of digestion. The ­second function is the absorption of nutrients, which takes place in the intestines. The third function of the gastrointestinal system is the elimination of waste from the anus. In this chapter we will trace the flow of food through the gastrointestinal (GI) tract, learn about the various structures involved, and learn their individual functions.

The Pathway of Food Figure 4.1 shows a summary of the path that food takes through the gastrointestinal tract. Keep in mind that the process of digestion is very complex. We have simplified the anatomy and physiology ­ for introductory learning purposes.

The Oral Cavity The pathway of food through the gastrointestinal system begins at the oral cavity, which consists of the lips, mouth, cheeks, teeth, tongue, and salivary glands.

Once food enters the mouth, the function of digestion begins. While the teeth are chewing the food, the salivary glands are releasing saliva to begin the digestive process. The roof of the mouth is termed the palate and is actually divided into two parts, the hard palate and the soft palate. The hard palate of animals resembles that of humans in that they have ridges on their hard palate called rugae which help increase the surface area for absorption and secretion. If you were to run your own tongue along the roof of your mouth, you’d feel the rugae. The soft palate is the smooth caudal portion of the palate. It controls the closing of the nasal passage while the animal swallows. The muscle at the bottom of the oral cavity is the tongue. The tongue is constantly moving the food around while the animal chews and then aids in swallowing. Along the surface of the tongue are small raised bumps called papillae in which the taste buds can be found. In cats the papillae feel like sandpaper when they lick you. The arrangement of the teeth in the mouth is referred to as dentition or an arcade. Just as with humans, animals have a temporary set of teeth and a permanent set of teeth. For example, in

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Oral cavity

Pharynx (throat) Digestion Esophagus

Liver

Stomach

Bile Gallbladder

Bile

Enzymes Duodenum

Pancreas

Absorption Jejunum

Ileum

Cecum

Ascending colon Elimination Transverse colon

Descending colon

Rectum

Anus

Feces

Figure 4.1  The pathway of food through the gastrointestinal tract.

dogs think of it as having puppy teeth and adult teeth. The temporary dentition is referred to as deciduous dentition. Deciduous dentition isn’t necessarily the same as the permanent dentition in some animals. When animals reach a certain age, it’s important to check for any retained temporary teeth that were not shed because then they’ll need to be pulled (Figure 4.2).

There are four different groups of teeth that are divided based on shape and function. The number of each group of teeth differs in each species, but the function is the same. Incisor

Abbreviated “I,” these teeth are used for shearing and grooming. They are named based on their function, which is to cut or incise.

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Figure 4.2  Retained deciduous canine tooth next to the permanent canine tooth.

Abbreviated “C,” these teeth have a tearing function. They are commonly called fangs in some animals. In humans we commonly call them cuspids, which means tapered teeth. Premolar Abbreviated “P” or “PM,” these teeth have a tearing and grinding function. In humans, these are called bicuspids since they have two projections. Molar Abbreviated “M,” these teeth have a grinding function.

counted three on top and three on the bottom we begin writing our formula.

Once we know how many teeth are within each group in a species, we can then write the numbers into a formula. The dental formula is a shorthand method to help us remember the arrangement of teeth. To write a dental formula we first look at one side of an animal’s face. Let’s use a dog as an example. Start at the midline of the body and count the teeth on one side of the face. The first group of teeth you will count are the incisors. There are three incisors on top and three on the bottom. Remember, we are just counting one side of the face. Now that we’ve

Now let’s move laterally to the next group of teeth, the premolars. Dogs have four on the top and four on the bottom. There are two different ways to write the premolars in a dental formula. Some people abbreviate the premolars as “P,” whereas others abbreviate them using “PM.” In this textbook I will use PM for the premolars. Refer to your individual instructor as to his or her preference, though both are considered correct.

Canine

I



3 3

Next we work our way lateral to the next group of teeth after the incisors, the canines. Dogs have one canine on top and one on the bottom. Let’s add that to our equation. I





I

3 1 C 3 1

3 1 4 C PM 3 1 4

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Finally we come to the last group of teeth, the molars. Dogs have two on the top and three on the bottom. Let’s add them to our equation. 3 1 4 I C PM 3 1 4



2 M 3

At this point you’ve only counted the teeth in half of the animal’s mouth. To account for the other half of the face, we add a “2” in front of the equation.

3 1 4 2 I C PM 3 1 4

2 M 3

If you add up the numbers inside the brackets and then multiply that number by 2, then you have the total number of teeth in the dog.

2 I

3 1 4 C PM 3 1 4

M

2 3

42

Table 4.1 shows the dental formulas for different species. The dental formulas are most useful for learning the various types of teeth in each species; however, there’s a different method used in dental surgeries for identifying the teeth in a patient’s chart. This method is known as the triadan system (Figure 4.3). In this system each tooth is assigned a three‐ digit number based on its location and type. The first number is based on the quadrant of the mouth that the tooth is in. The quadrants are numbered beginning with the right side of the maxilla and then are counted clockwise from there. The second and third numbers represent the location of the tooth when looking from rostral to caudal. This second number starts at 01 and goes up to 11, depending on the species. Tooth anatomy is the same for all species. Label Figure  4.4 using the terms listed in Table 4.2. Surrounding the oral cavity are pairs of exocrine glands called salivary glands. These glands secrete a digestive enzyme called saliva.

TECH TIP 4.1  What Are Mucous Membranes? Mucous membranes are membranes covered with epithelium that can be found lining many tubular organs of the body. These membranes produce a slimy substance called mucus.

Table 4.1  Formula. Dogs

2 I

3 3

C

1 4 PM 1 4

M

2 3

42

Cats

2 I

3 3

C

1 3 PM 1 2

M

1 1

30

Horses

2 I

3 3

1 3 4 3 C +PM +M =40 – 42 1 3 3

Cattle, sheep, goats

2 I

0 3

C

0 3 PM 1 3

M

Pigs

2 I

3 3

C

1 4 PM 1 4

Humans

2 I

2 2

C

1 2 PM 1 2

Llamas

2 I

1 1 2 3 C PM M =28 30 3 1 1 2 3

Ferrets

2 I

3 3

Rabbits

2 I

2 0 C 1 0

PM

Guinea pigs

2 I

1 0 C 1 0

PM

1 3 M 1 3

20

Chinchillas 2 I 1 C 0 1 0

PM

1 3 M 1 3

20

1 0 C 1 0

PM

0 0

M

3 3

16

Hamsters 2 I 1 C 0 1 0

PM

0 0

M

3 3

16

Mice, rats 2 I 1 C 0 1 0

PM

0 0

M

3 3

16

Gerbils

2 I

C

2 4 PM 2 3 3 2

3 3

32

M

3 3

44

M

3 3

32

M

1 2

40

M

3 3

28

Chapter 4  The Gastrointestinal Tract

99

101 102 103

Right upper

201 202 203

104 Incisors Canines Premolars Molars

Left upper

204

105 106

205 206 207

107 108

208

209

109

210

110

411 410 409

311 310 309

408 407 406 405

308 307 306 305

404 Right lower

304 403 303 402 302 401 301

Left lower

Figure 4.3  Canine dentition with the triadan system. Tooth anatomy Gingival crevice 3.

1.

4. Gingival sulcus

Gum Pulp cavity 5. 6.

2.

Root canal

Apical foramen Blood vessels and nerves

Alveolar bone

Figure 4.4  Anatomy of the tooth. Source: Courtesy of shutterstock/Alila Sao Mai.

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Table 4.2  Tooth anatomy. Alveolus

Tooth socket; alveolar bone.

Crown (1)

Portion of the tooth above the gum line; supragingival portion of the tooth.

Root (2)

Portion of the tooth below the gum line; subgingival portion of the tooth.

Enamel (3)

White, hard, outer covering of the tooth that protects the crown; the hardest substance in the body.

Dentin (dentine) (4)

Hard tissue of teeth between the enamel and pulp cavity.

Gingiva (gums)

Mucous membranes surrounding the teeth and lining the mouth.

Gingival sulcus

Area between the tooth and gums.

Pulp cavity

Sensitive cavity in the tooth containing blood supply and nerves.

Periodontal ligament (5)

Connective tissue that connects the tooth to the alveolar bone.

Cementum (6)

Bone‐like connective tissue that covers the root.

Root canal

Portion of the pulp cavity extending from the pulp chamber to the apical foramen (opening at the distal aspect of the tooth).

Dental Terminology Abscess Bruxism Deciduous teeth Dental calculus Dental caries Dentition Epulis Extraction Gingival hyperplasia Halitosis Hard palate Malocclusion Occlusion Oronasal fistula Palate

Localized collection of pus. Grinding of teeth; common in cattle. Temporary teeth Also known as dental tartar, mineralized plaque that forms on the teeth (Figure 4.5). Tooth decay (Figure 4.6). The arrangement of teeth. Also known as arcade. Benign tumor arising from periodontal mucous membranes (Figure 4.9A). The act of pulling teeth (Figure 4.7). Excessive development of gums due to increased cell numbers (Figure 4.9E). Bad breath. Rostral portion of the roof of the mouth containing rugae. Abnormal position of teeth that results in faulty meeting of the teeth or jaws. Relation of the teeth of both jaws during functional activity. Abnormal tube‐like passageway between the mouth and nose. A fistula is an abnormal tube‐like passageway that can occur anywhere on the body (Figure 4.9C). Roof of the mouth.

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(A)

(B)

(C)

(D)

Figure 4.5  (A) Dental calculus. (B) Post dental surgery. (C) Dental calculus. (D) Post dental surgery. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Palatoschisis Papillae Periodontal disease Plaque Rugae Saliva Salivary glands Salivary mucocele Soft palate

Cleft palate (Figure 4.9B). Small, raised bumps on the tongue containing taste buds (Figure 4.8). Inflammation and degeneration of the tissue surrounding and supporting the teeth (bone and gums); also known as periodontitis or pyorrhea. Collection of bacteria, salivary products, and white blood cells that adheres to the surface of the tooth. Ridges on the hard palate and lining the stomach to increase surface area for absorption and secretion (Figure 4.8B). Digestive juice produced by salivary glands. Glands around the mouth that secrete saliva. There are three major pairs of glands called the parotid, mandibular, and sublingual glands. Collection of saliva that has leaked out from damaged salivary glands causing masses in the mouth (Figure 4.9D). Smooth, caudal portion of the roof of the mouth.

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(A)

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Caries

Caries extension

Inflamed pulp

Abscess

(B)

Figure 4.6  (A) Stages of tooth decay. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Dental caries in a dog. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Pharynx The pharynx is commonly called the throat. This tube‐like passageway connects the oral cavity to the other GI tract locations. It is also responsible for joining the oral cavity to the trachea, which leads to the respiratory tract. As an animal chews its food, a leaf‐ like piece of cartilage called the epiglottis covers the trachea to prevent that food from “going down the wrong pipe.” When the animal swallows, the epiglottis directs the food where to go. It closes over the

t­rachea to allow the food to proceed to the next structure, the esophagus.

Esophagus The esophagus is the tube that runs from the pharynx to the stomach. The tube is actually a muscle that contracts to move the food down toward the stomach. This process of wave‐like contractions to move the food is called peristalsis (Figure 4.10). It’s similar to when people do the wave at a football game.

(A)

(B)

(C)

Figure 4.7  (A) Dental procedure. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B) Extractions. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (C) Sutures in the gingiva post extraction. Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

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have what is considered a simple stomach or true stomach. Humans also have a simple stomach. The following are the parts of the simple stomach. Body Cardiac sphincter Fundus Figure 4.8  Papillae on a feline tongue. There are four types of papillae. The group in the front face backward to aid in grooming and help remove flesh from prey. This is why a cat’s tongue feels like sandpaper when licking you. Source: Courtesy of shutterstock/Joanna Zaleska.

Stomach After the food passes through the esophagus, it enters the stomach through a valve called the cardiac sphincter. Once in the stomach, the food is broken down by digestive enzymes such as hydrochloric acid. Lining the stomach are ridges called rugae that help increase the surface area for absorption and secretion. The rugae lining the stomach are the same as the rugae on the hard palate. After the food is broken down it exits the stomach through another valve called the pyloric sphincter. In veterinary medicine there are two different types of stomachs. Most animals

Pyloric sphincter Pylorus (antrum) Rugae

The main portion of the stomach. Valve between the esophagus and stomach. Cranial, rounded portion of the stomach. Valve between the stomach and duodenum. Caudal portion of the stomach. Ridges on the hard palate and in the stomach to increase surface area for absorption and secretion.

Figure 4.11 shows the parts of a simple stomach. Other animals, ruminants, have a more specialized stomach that contains four compartments. Examples of ruminants include cattle, sheep, and goats. These animals regurgitate their food, chew it, and then swallow it again. By regurgitating and chewing their food, they’re breaking it down further for digestion. That regurgitated food is referred to as cud and the process of regurgitating, re‐chewing, and re‐swallowing is known as ruminating.

Each compartment of the ruminant stomach has a specific function (Figure 4.12). Rumen

Reticulum

Omasum

This is the largest compartment of the ruminant stomach, where fermentation takes place. Fermentation is the process of breaking down organic compounds into simpler substances. Larger ingesta is broken down in the rumen. This small, most cranial portion of the ruminant stomach is lined with mucous membranes in a hexagon pattern. It is commonly called the honeycomb because of its internal appearance. Smaller food particles are collected in the reticulum to be transferred to the omasum. The third and smallest of the compartments. Inside are folds of tightly packed papillae used for grinding food. It’s commonly called the bible because the folds resemble pages in a book. The folds help to increase surface area for absorption of water.

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Figure 4.9  Dental pathologies. (A) Epulis. Source: Courtesy of Amy Johnson BS, CVT, RLATG. (B) Cleft palate in stillborn neonate. Note the rugae on the roof of the mouth. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (C) Oronasal fistula. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (D) Salivary mucocele. Source: Courtesy of Amy Johnson, BS, CVT, RLATG. (E) Gingival hyperplasia. Source: Courtesy of Amy Johnson BS, CVT, RLATG.

Abomasum The fourth and final compartment, which is considered the true stomach. Its function and anatomy resemble that of the true stomach in other mammals. Like small animals and humans, this portion of the stomach contains digestive enzymes and hydrochloric acid to break down food.

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Esophagus Constriction Peristaltic wave

Esophagus

Bolus

Relaxation Shortening Stomach

Figure 4.10  Peristalsis. Source: Courtesy of shutterstock/blamb.

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(B) Fundus Esophagus

Cardiac sphincter Body of the stomach Antrum or pylorus

Lesser curvature Pyloric sphincter Duodenum

Greater curature

Rugae

Figure 4.11  Anatomy of the simple stomach. (A) External stomach anatomy. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Internal stomach anatomy and upper GI tract. Source: Courtesy of shutterstock/ Lightspring.

Small Intestine The small intestine is divided into three portions: the duodenum, the jejunum, and the ileum. Lining the inside of the small intestine are small finger‐like projections called villi (Figure 4.13). These projections are used to absorb nutrients into the bloodstream. Goblet cells in the villi secrete mucus which will act as a blanket for the lining of the intestines. TECH TIP 4.2  Watch your spelling on ileum. It looks very similar to the ilium of the pelvis.

The first part of the small intestine is the duodenum. Once food enters the duodenum, the pancreas releases digestive enzymes that further digest the food. Simultaneously, the liver and gallbladder send bile to the duodenum to aid in the breakdown of the food. Once the food has been digested further and the nutrients have been absorbed, the remaining material passes to the second part of the small intestine, the jejunum. Following the jejunum is the third part of the small intestine called the ileum. The small intestines are anchored to the abdominal wall by a membranous

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Rumen

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Figure 4.12  The ruminant stomach. (A) The four compartments of the ruminant stomach. Source: Courtesy of shutterstock/Designua. (B) The flow of food through the ruminant GI tract. Source: Courtesy of shutterstock/Nicolas Primola. (C) Lining of the rumen. (D) Lining of the reticulum.

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Villi

Epithelial cells

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Blood vessel

Goblet cell

Villi

Enterocyte

Paneth cell Villus

Intestinal wall

(C) Microvilli Secretory vesicles with mucin

Rough endoplasmic reticulum

Golgi apparatus

Nucleus

Mitochondrion Figure 4.13  (A) Small intestine villi. Source: Courtesy of shutterstock/blamb. (B) Anatomy of an intestinal villus. Source: Courtesy of shutterstock/Designua. (C) Anatomy of a goblet cell. Source: Courtesy of shutterstock/Designua.

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Figure 4.14  Mesentery. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

sheet called mesentery (Figure  4.14). The mesentery contains blood vessels, lymph nodes, and nerves that supply the  organs of the digestive tract. The ­mesentery ­prevents the intestines from entangling.

TECH TIP 4.3  Where’s the Appendix? The appendix is a blind pouch that hangs from the cecum. Most mammals lack an appendix with the exception of humans, apes, and rabbits.

Large Intestine The large intestine doesn’t get its name because of its length, but rather its width. Its diameter is nearly three times that of the small intestine. It consists of the cecum, ascending colon, transverse colon, descending colon, rectum, and anus. Although the large intestine is used for elimination in all species, it has additional functions in herbivores due to their plant‐based diets. The cecum is a small, blind sac where the small and large intestines meet. In horses

and rabbits, the cecum plays a major role in digestion. Fermentation takes place in the cecum of horses and rabbits because they have a simple stomach. Because of the significant role that the cecum plays in the horse and rabbit, its size is considerably larger than that of other mammals. The large intestine, or colon, consists of three portions. They are arranged in the animal’s body similar to a question mark. The ascending colon would be the portion of the question mark going toward the head, the transverse colon is the portion that goes across, and the descending colon is in the caudal direction. In horses, ruminants, and pigs, the colon is slightly different. Horses have a large colon and small colon in which fermentation takes place and water is reabsorbed. Because of the colon’s long length, there’s an increased chance that it will become twisted and cause colic. The colon also has a series of sharp twists and turns which divide it into further portions. Ruminants and pigs have an ascending, transverse, and descending colon; however, their ascending colon takes on a spiral arrangement, giving it the name spiral colon.

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After passing through the colon, the remaining waste then passes through the anus to the outside of the body. Prebiotics and probiotics are often used to ensure colon health in animals. In large animals, plant material can be difficult to digest; therefore, prebiotics and probiotics are given to aid in digestion. A prebiotic is a plant fiber that the stomach is unable to digest. Once ingested, this fiber goes to the intestines and nourishes the normal bacteria, or normal flora, in the intestines. A healthy environment of “good bacteria” ensures proper digestion. Probiotics are actually living bacteria administered to increase the population of normal flora. These two substances can be very helpful in large animal medicine, and they are becoming increasingly popular in small animal medicine. Many veterinarians recommend probiotics to animals with diarrhea depending on the cause. Animals taking antibiotics risk destroying their normal flora with the medication so probiotics might be recommended to prevent this.

Liver and Gallbladder The liver is the largest organ in the body and has many important functions.Anatomically, the liver is caudal to the diaphragm. Here is a list of the functions of the liver.

1. Synthesizes (produces) bile. 2. Maintains blood sugar by storing excess glucose in the form of glycogen. 3. Synthesizes proteins, including clotting proteins and albumin. 4. Conjugates bilirubin. 5. Detoxifies the blood. 6. Metabolizes drugs. 7. Synthesizes cholesterol. In this chapter, we will focus on the functions of the liver that pertain to the alimentary system. The remaining functions will be discussed in later chapters. Bile is composed of bilirubin, cholesterol, and bile acids (bile salts). While ­animals get cholesterol from their diets, their liver also produces cholesterol. The cholesterol is then stored to help produce bile. Once produced, the bile travels from the liver to the gallbladder to be stored. When food reaches the duodenum, the bile in the gallbladder travels to the duodenum via the common bile duct to assist in digestion (Figure 4.15). Bilirubin is a metabolite of hemoglobin breakdown. Bilirubin travels to liver to become conjugated (water soluble) and is then stored by the liver to be added to bile. Bile salts are used for emulsification (fat breakdown) and are then reabsorbed by the body to be recycled and used again

Stomach Duodenum

Bile Pancreatic enzymes

Liver

Gallbladder

Common bile duct Stomach

Pancreas Bile salts

Duodenum

Figure 4.15  The flow of bile and digestive enzymes between the liver, stomach, and pancreas. Source: Courtesy of shutterstock/blamb.

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Figure 4.16  Dachshund with jaundice on gingiva and ears. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

in the future. The bile salts travel back to the liver via the portal vein. The bilirubin and remaining bile are passed in the feces and are what give feces its color. If bilirubin doesn’t leave the body, then it builds up in the blood and tissues, causing a yellowish coloration of the skin and mucous membranes called jaundice. Jaundice is synonymous with the term “icterus,” which is the yellowish coloration of the plasma. Many practicing veterinarians and technicians use these two terms interchangeably (Figure 4.16).

Pancreas The pancreas is both an endocrine and an exocrine organ. Its outward appearance resembles chewed gum. We will discuss the endocrine functions of the pancreas in a later chapter. This chapter will focus on its exocrine functions. The pancreas produces the digestive enzymes amylase, lipase, and trypsin. Amylase is a digestive enzyme that breaks down starch, lipase is an enzyme produced to digest fat, and trypsin is an enzyme that digests protein.

Related Terms Absorption Abdominal cavity Alimentary tract Amino acids Anal sacs

Anus Bile

Passage of materials through the walls of the intestine into the bloodstream. Space below, or caudal to, the diaphragm containing organs such as the liver, stomach, and intestines; also known as the abdomen. All organs associated with the passage of food from the mouth to the anus; also known as the gastrointestinal tract. “Building blocks” of proteins that are produced with the ingestion of protein. Pair of sacs between the internal and external anal sphincters. The walls of these sacs are lined with glands that secrete a malodorous material. Normal animals express their anal sacs during defecation for the purposes of territorial marking. Fear may also cause an animal to express its anal sacs (Figure 4.17). Opening from the GI tract to the outside of the body. Digestive juice produced in the liver and stored in the gallbladder. Aids in the breakdown of fat (emulsification).

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Figure 4.17  (A) Location of anal glands on a Sheltie. The anal glands are located at 4 and 8 o’clock. (B) Anal gland secretion from a dog. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm.

Bilirubin

Metabolite of hemoglobin breakdown; pigment released by the liver in bile. Bolus Rounded mass of food. In the case of pharmaceuticals, it refers to the preparation ready to be swallowed. Bowel Intestine. Cardiac sphincter Ring of muscle fibers at the proximal aspect of the stomach where it joins the esophagus. Cecum Small, blind sac where the small and large intestines meet; site of fermentation in horses and rabbits. Colon Large intestine; cecum, ascending colon, transverse colon, descending colon, and rectum. Common bile Carries bile from the liver and gallbladder to the duodenum. duct Defecation Passage of feces from the anus to the outside of the body; elimination. Deglutition Swallowing. Diaphragm Thin, muscular partition separating the thoracic and abdominal cavities. Diverticulum Pouch occurring on the wall of tubular organs of the GI tract. Duodenum First part of the small intestine where absorption takes place. Emulsification Breakdown of large fat globules into smaller globules. Enzymes Chemicals that speed up a reaction. Epiglottis Leaf‐like piece of cartilage over the trachea (windpipe) to prevent aspiration of food (Figure 4.18).

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Figure 4.18  Hemostats pulling down the epiglottis. Note the vocal folds behind the epiglottis. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm.

Esophagus Feces Flatulence Gallbladder Glucose Gluconeogenesis Glycogen Glycogenolysis Hydrochloric acid Jejunum Labia Liver Lumen Mastication Mesentery Mucosa Nutrients Omentum

Pancreas Parenchyma

Tube connecting the throat to the stomach. Stool; solid wastes. Presence of gas in the stomach and intestines; flatus. Sac under the liver that stores bile. Simple sugar. Production of glucose in the liver using fats and proteins. Form of glucose stored in the liver; starch. Glycogen is converted back into glucose in the liver when the patient becomes hypoglycemic. Produced in the stomach to digest food. Second part of the small intestine (Figure 4.19). Lips; singular is labium. Largest organ in the abdomen; responsible for synthesizing protein and bile, maintaining blood sugar, and detoxifying blood. Cavity or channel within a tube. Chewing. Membranous sheet that holds the organs of the abdominal cavity in place. Contains blood vessels and lymph nodes (Figure 4.19). Mucous membrane (i.e., intestinal mucosa is defined as mucous membranes of the intestine). Substances that are necessary for normal body function. Fold of peritoneum extending from the greater curvature of the stomach to the other organs in the abdominal cavity. Absorbs excess fluid and adheres to wounds to act as the body’s natural band‐aid (Figure 4.20). Organ under the stomach that produces digestive enzymes, insulin, and glucagon. Tissue composed of the essential cells of any organ (i.e., liver parenchyma is liver tissue).

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Figure 4.19  Mesentery and jejunum in a dissected cat. Mesenteric vessels are a landmark for identifying jejunum.

Figure 4.20  Abdominal cavity of a dissected cat showing the omentum, liver, and gallbladder.

Peristalsis Peritoneum Pharynx Pyloric sphincter Rectum Rugae

Wave‐like contractions of the tubes of the GI tract. Membrane surrounding the organs of the abdomen. Throat. Ring of muscle fibers at the distal end of the stomach where it joins the duodenum. Last portion of the colon. Ridges on the hard palate and in the stomach to increase surface area for absorption and secretion.

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Ruminant stomach Sphincter Trachea Tongue Villi

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Specialized four‐compartment stomach consisting of the rumen, reticulum, omasum, and abomasum. Group of ring‐like muscles that can contract in diameter. Windpipe. Muscular organ on the floor of the mouth. Microscopic, finger‐like projections in the walls of the small intestine that absorb nutrients into the bloodstream.

Pathology and Procedures Achalasia

Inability to relax the smooth muscles of the GI tract; most often associated with the esophagus. Activated Substance administered orally after accidental ingestion of a toxic charcoal substance. After inducing vomiting, activated charcoal is administered to coat the lining of the GI tract to prevent further absorption of any remaining toxins (Figure 4.21). Anal sacculitis Inflammation of the anal sacs. These sacs are prone to abscesses, blockage, and infections (Figure 4.22). Anastomosis Surgical connection between two tubes. Anorexia Lack of appetite. (A)

(B)

Figure 4.21  Activated charcoal administration. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Figure 4.22  (A) Anal gland abscess in a dog. Source: Courtesy of WikiCommons/Joel Mills. (B) Anal gland abscess. Source: Courtesy of Greg Martinez, DVM; www.youtube.com/drgregdvm.

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A substance given to counteract diarrhea. Substance given to counteract vomiting. Abnormal accumulation of fluid in the abdomen (Figure 4.23). Closure of a normal body opening (i.e., esophageal atresia).

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Figure 4.23  (A) Radiograph of a dog with ascites. Source: Courtesy of Beth Romano, AAS, CVT. (B) Ascites in a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Barium study Biopsy Body condition score (BCS) Borborygmus Cachexia

Barium test; introduction of contrast material used to evaluate the GI tract. A series of radiographs is then taken to isolate GI tract disorders (Figure 4.24). Removal of tissue for microscopic examination. A method to assess an animal’s weight based on outward appearance. Animals are given a score of 1–9, where 5 is considered an ideal weight. A score below 5 is underweight and a score above 5 is considered overweight (Figure 4.25). Rumbling noises caused by the movement of gas or fluid through the GI tract. General ill health and malnutrition (Figure 4.28A).

TECH TIP 4.4  Emaciation vs. Cachexia In both emaciation and cachexia, the patient is wasting away; however, the causes are different. Emaciation is caused by malnutrition and starvation. In general, emaciation can be corrected with nutrition. Cachexia is caused by an underlying pathology such as cancer, which means nutrition cannot fix the loss of body mass. No matter how much the patient eats, he or she will continue to lose weight.

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Figure 4.24  Barium study to find an obstruction. Source: Courtesy of Beth Romano, CVT.

Carcinoma

Malignant tumor arising from epithelial tissue.

TECH TIP 4.5  The definition for carcinoma is very similar to sarcoma at first glance, so be careful. The rules for carcinoma are the same as the rules in Chapter 2 for sarcoma. You insert the organ of issue into the definition of carcinoma. For example, a gastric carcinoma is a malignant tumor of the stomach arising from epithelial tissue. Remember to use this format: malignant tumor of _____________ arising from epithelial tissue.

Cirrhosis Colic

Degenerative disease in which the liver cells are replaced with scar tissue (Figure 4.26). Acute abdominal pain.

TECH TIP 4.6  Acute vs. Chronic Acute = sudden onset. Chronic = existing over a long period of time.

Constipation Coprophagia Diarrhea Displaced abomasum Diverticulitis Drench Emaciation Emesis

Difficulty passing feces (Figure 4.27). Ingestion of feces. Rapid movement of feces through the GI tract; loose, watery stool. Condition in which the abomasum becomes trapped under the rumen. Displacement may be to the left or right side. Inflammation of the diverticulum. To give medication in liquid form by mouth and forcing the animal to drink. Marked wasting or excessive leanness (Figure 4.28B). Vomiting; forcible expulsion of stomach contents through the mouth. The material vomited is termed vomitus (Figure 4.29).

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Figure 4.25  Examples of body condition score (BCS). (A) BCS of 1 in a Doberman. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM). (B) BCS of 2 in a dog. Source: Courtesy of Heather Hyatt, CVT. (C) BCS of 9 in a Beagle. Source: Courtesy of shutterstock/Eric Isselee. (D) BCS of 1 in a neglected horse. Source: Courtesy of WikiCommons/eXtensionHorses. (E) BCS of 3 in a horse. Source: Courtesy of WikiCommons/Montanabw.

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Normal liver

Cirrhotic liver

Figure 4.26  Healthy liver versus cirrhosis. Source: Courtesy of shutterstock/Rob3000.

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Figure 4.27  Radiograph of a constipated dog. Source: Courtesy of Beth Romano, AAS, CVT.

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Figure 4.28  (A) Dog with cachexia. Source: Courtesy of Deanna Roberts, BA, AAS, CVT. (B) Emaciation. Source: Courtesy of shutterstock/GlobetrotterJ.

Emetic Enema Eructation Esophageal atresia Esophageal reflux Etiology Fecal exam Foreign body Gastric dilatation Gastric dilatation volvulus

Substance given to produce vomiting (Figure 4.29A). Introduction of fluid into the rectum to promote defecation. Gas expelled from the stomach out of the mouth; a belch. Closure of the opening of the esophagus. The suffix “‐tresia” means opening. When combined with the prefix a‐, which means no or not, its meaning is reversed to a closure. A backward or return flow of stomach contents into the esophagus; also known as GERD (gastroesophageal reflux disease). Study of the cause of disease. Group of tests used to detect parasites in feces. Material which finds its way into organs and tissues (Figure 4.30). Abnormal condition in which the stomach fills with air and expands. This is a common problem in large breed dogs, particularly the deep‐chested breeds. Abnormal condition in which the stomach fills with air, expands, and then twists on itself. This is a common problem in large breed dogs, particularly the deep‐chested breeds. Commonly called “bloat” (Figure 4.31).

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Figure 4.29  Inducing emesis in a Dachshund after it ingested warfarin (rat poison). (A) Technician is injecting an emetic to induce emesis. (B) Dog beginning to vomit. (C) Dog has vomited the toxin. (D) Activated charcoal is then administered to coat the GI tract and prevent further absorption of the toxin. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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Figure 4.30  GI foreign bodies. (A) Radiograph of a dog with a GI foreign body. (B) Surgery to remove the foreign body. Note the redness of the intestines. (C) Foreign body removed. Source: (A–C) Courtesy of Judy Zane, CVT. (D) Radiograph of a canine abdomen showing a surgical instrument (hemostat) left in the body after surgery. Source: Courtesy of Stacey Fowler, LVT.

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Figure 4.30  (Continued)

Figure 4.31  Radiograph of gastric dilatation volvulus in a dog. Source: Courtesy of Beth Romano, AAS, CVT.

Gavage Hematochezia Hemorrhagic gastroenteritis Hepatic lipidosis

Forced feeding or irrigation through a tube passed into the stomach. Bright, red, fresh blood from the rectum. Acute condition in dogs causing vomiting and bloody diarrhea leading to dehydration, heart failure, and eventually death. Accumulation of fat in the liver that leads to liver damage. Disease typically occurs in cats after a period of anorexia (Figure 4.32).

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Normal liver

Fatty liver Figure 4.32  Hepatic lipidosis (fatty liver). Source: Courtesy of shutterstock/Rob3000.

Hiatal hernia

Protrusion of a structure, usually the stomach, through the esophageal opening in the diaphragm (Figure 4.33). Esophagus Hiatus

Portion of stomach herniated through hiatus

Diaphragm

Lower Esophageal sphincter

Stomach Figure 4.33  Hiatal hernia. Source: Courtesy of shutterstock/blamb.

Idiopathic Ileus Inappetence Incontinence Intussusception Jaundice

When the cause of disease is neither known nor understood. Failure of peristalsis with obstruction of the intestines. Lack of appetite. Inability to control excretory functions (defecation or urination). Telescoping of the intestines (Figure 4.34). Yellowish‐orange coloration of the skin and mucous membranes due to excessive bilirubin in the blood; synonymous with icterus. Lethargy Condition of drowsiness or indifference. Malabsorption Impaired absorption of nutrients in the duodenum.

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Figure 4.34  Intestinal obstruction caused by intussusception. (A) Stages of intussusception. Source: Courtesy of shutterstock/Artemida‐psy. (B) Surgery to correct intussusception. Source: Courtesy of shutterstock/Pthawatc.

TECH TIP 4.7  Jaundice vs. Icterus These two terms are often used interchangeably. There is a difference between the two terms, though. Both terms are used to describe a yellowish coloration; the difference is in where the yellow color is. In jaundice, the yellow color is on the skin and mucous membranes. In icterus, the yellow color is in the plasma of the blood. Both are caused by excessive levels of bilirubin.

Maldigestion

Inability to digest food due to lack of digestive enzymes. Also known as exocrine pancreatic insufficiency. Malaise A vague feeling of bodily discomfort. Megaesophagus Enlargement of the esophagus (Figure 4.35). Megacolon Enlargement of the colon (Figure 4.35).

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Figure 4.35  (A) Radiograph of megaesophagus. Source: Courtesy of shutterstock/P.Fabian. (B) Radiograph of megacolon. Source: Courtesy of Beth Romano, AAS, CVT. (C) Great Dane pups with megaesophagus using the Bailey Chair to eat. This chair has the animal sit up for 20–30 minutes to allow gravity to work the food down the esophagus. Source: Courtesy of Kimberly Perkovich, CVT, RVT.

TECH TIP 4.8  Melena vs. Hematochezia Both melena and hematochezia involve blood in the feces. The appearance of the blood is what separates these two terms. If the blood is bright, red, and fresh, then it came from the lower GI tract. If the blood is black and tarry in appearance, then it has been digested in the stomach and duodenum. Using the appropriate term can therefore isolate where in the GI tract the problem may be.

Melena Nasogastric intubation Nausea Obese Obstipation Obstruction

Black tarry stool; blood in feces. Placement of a tube from the nose to the stomach (Figure 4.36). Upset stomach and a tendency to vomit. Excessive fat accumulation in the body (Figure 4.37). Inability to eliminate. Complete stoppage or impairment of passage.

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Figure 4.36  (A) Nasogastric tube in a Husky. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B) Nasogastric tube in a Golden Retriever. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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Figure 4.37  (A) Overweight Weimaraner. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B) 77‐pound Dachshund named Obie. (C) Obie being prepped for surgery to remove excess skin after losing 40 pounds. (D) Obie 40 pounds lighter after a proper diet and exercise. Source: (B–D) Courtesy of Nora Vanatta.

Orogastric intubation Palpation Parenteral Pica

Placement of a tube from the mouth to the stomach. Method of examining the internal body by touching and feeling. Route of administration other than oral. Eating or licking abnormal substances; a depraved appetite (Figure 4.38).

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Figure 4.38  Pica. (A) Radiograph of a canine abdomen showing rocks in the stomach. This Rottweiler would come to the clinic every three months with rocks in its stomach. (B) Radiograph of a dog that frequently ingests nails and screws. Source: Courtesy of Stacey Fowler, LVT. (C) Radiograph of a dog that ingested a rubber ducky. Source: Courtesy of Diane Tonmanikout, CVT.

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Pneumocolon Air in the colon; procedure that places air in the colon as a means of diagnosis (Figure 4.39A). Portosystemic Condition in which the blood vessels bypass the liver and the blood shunt is not detoxified. Regurgitate Passive event in which swallowed food is returned to the oral cavity. Rumen fistula Procedure in which a canula is placed on the side of a cow for access to digestive contents in the rumen. This method allows for ingesta and the cow’s digestive tract to be studied (Figure 4.39B). (A)

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Figure 4.39  (A) Radiograph of pneumocolon. Source: Courtesy of Beth Romano, AAS, CVT. (B) Rumen fistula. Source: Courtesy of Deanna Roberts, BA, AAS, CVT.

TECH TIP 4.9  Vomiting vs. Regurgitation Vomiting is a forcible event, whereas regurgitation is a passive event. My students will often think of newborn babies when trying to distinguish these two terms. Newborn babies regurgitate often. They don’t even realize that it’s happening. It just comes up!

Scours Shunt Spasm Stasis Steatorrhea Stenosis Stoma

Diarrhea in livestock (Figure 4.40). To bypass or divert. Sudden, involuntary contraction. Stopping or controlling. Fat in feces. Tightening, narrowing, or stricture. An incised opening that is kept open for drainage and other purposes.

TECH TIP 4.10  Suffixes Used as Terms Some suffixes can be used as separate terms. Examples include: • • • •

Emesis Spasm Stasis Stenosis

Their meanings are still the same as when they are used as suffixes.

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Figure 4.40  (A, B) Calf with scours. (C) Calf on IV fluids for treatment. Source: Courtesy of Patrick Hemming, DVM.

Tenesmus

Ineffectual and painful straining at defecation and urination. Torsion Axial twist; twisting around the long axis of the gut Trichobezoar Hairball (Figure 4.41). Ulcer Erosion of the skin and mucous membranes (Figure 4.42). Ultrasound Diagnostic technique using ultrasound waves to produce an image of an organ or tissue (Figure 4.43). Volvulus Twisting on itself (Figure 4.44).

Figure 4.41  Trichobezoar surgically removed from a cat. Source: Courtesy of Samantha Patterson, AAS.

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Healthy

Duodenal ulcer

Stomach ulcer Figure 4.42  Gastric ulcers. Source: Courtesy of shutterstock/Alila Sao Mai.

Figure 4.43  Ultrasound on a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Figure 4.44  Intestinal volvulus. Source: Courtesy of shutterstock/ellepigrafica.

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Building the Terms TECH TIP 4.11  Rules for Using the Suffix “‐stomy” Rule 1: If “‐stomy” is attached to just one combining form, then its definition is a new opening to the outside of the body. You insert the combining form into the definition of “‐stomy.” For example, a gastrostomy would be a new opening from the stomach to the outside of the body. Just remember to use this format: a new opening from the ____________ to the outside of the body. Rule 2: If “‐stomy” is attached to more than one combining form then its meaning changes to a surgical connection or an anastomosis. For example, a gastrojejunostomy would be a surgical connection between the stomach and jejunum. Or you could say an anastomosis between the stomach and jejunum. Remember your basic rules to medical terminology. Combining forms must be listed in anatomical order.

Now it’s time to assemble the word parts listed in Tables 4.3, 4.4 and 4.5. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this will get easier each time.

Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 4.3  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Abdomin/o

Abdomen

Hem/o

Blood

Acu/o

Sudden; sharp; severe

Hemat/o

Blood

Adip/o

Fat

Hepat/o

Liver

Aliment/o

To nourish

Herni/o

Hernia

Amyl/o

Starch

Hydr/o

Fluid; water

An/o

Anus

Ile/o

Ileum

Bi/o

Life

Inguin/o

Groin

Bil/i

Bile; gall

Jejun/o

Jejunum

Bilirubin/o

Bilirubin

Labi/o

Lips

Bucc/o

Cheek

Lapar/o

Abdomen

Carcin/o

Cancerous; cancer

Lingu/o

Tongue

Cec/o

Cecum

Lip/o

Fat (Continued)

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Table 4.3  (Continued )

Combining Forms

Definition

Combining Forms

Definition

Celi/o

Belly; abdomen

Lith/o

Stone

Cheil/o

Lip

Mandibul/o

Mandible; lower jaw

Chol/e

Bile; gall

Muc/o

Mucus

Cholangi/o

Bile vessel; bile duct

Nas/o

Nose

Cholecyst/o

Gallbladder

Necr/o

Death

Choledoch/o

Common bile duct

Odont/o

Tooth

Chron/o

Time

Or/o

Mouth

Cib/o

Meals

Palat/o

Palate; roof of the mouth

Col/o, Colon/o

Large intestine; colon

Pancreat/o

Pancreas

Copr/o

Feces

Peritone/o

Peritoneum

Cyst/o

Urinary bladder; cyst; sac of fluid

Phag/o

Eat; swallow

Decidu/o

Shedding

Pharyng/o

Throat; pharynx

Dent/o, dent/i

Tooth

Proct/o

Anus and rectum

Dips/o

Thirst

Prote/o

Protein

Duoden/o, duoden/i

Duodenum

Py/o

Pus

Enter/o

Small intestine

Pylor/o

Pyloric sphincter; pylorus

Esophag/o

Esophagus

Radi/o

X‐ray; radius; radioactivity

Faci/o

Face

Rect/o

Rectum

Gastr/o

Stomach

Rug/o

Wrinkle or fold

Gingiv/o

Gums

Sial/o

Saliva; salivary

Gloss/o

Tongue

Sialaden/o

Salivary gland

Gluc/o

Sugar

Steat/o

Fat; sebum

Glyc/o

Sugar

Stomat/o

Mouth

Glycogen/o

Glycogen

Trich/o

Hair

Gnath/o

Jaw

Vill/i

Tuft of hair; thread‐ like projection from membrane

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133

Table 4.4  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

mega‐

large

ante‐

before; forward

meta‐

change; beyond

anti‐

against

neo‐

new

brachy‐

short

para‐

near; beside; abnormal; apart from; along the side of

de‐

lack of; down; less; removal of

peri‐

surrounding; around

dys‐

bad; painful; difficult; abnormal

poly‐

many; much

endo‐

in; within

post‐

after; behind

hyper‐

above; excessive

pre‐

before; in front of

hypo‐

deficient; below; under; less than normal

pro‐

before; forward

mal‐

bad

sub‐

under; below

Table 4.5  Suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐ary, ‐ eal, ‐ic, ‐ous

Pertaining to

‐opsy

view of

‐ase

enzyme

‐orexia

appetite

‐ation

process; condition

‐ose

full of; pertaining to; sugar

‐cele

hernia

‐osis

abnormal condition

‐centesis

surgical puncture to remove fluid

‐otic

pertaining to the abnormal condition

‐chezia

defecation; elimination of waste

‐pepsia

digestion

‐cyte

cell

‐pexy

surgical fixation; to put in place

‐ectasis, ‐ectasia

stretching; dilation; dilatation

‐phagia

eating; swallowing

‐ectomy

removal; excision; resection

‐plasty

surgical repair

‐emesis

vomiting

‐prandial

meal

‐emia

blood condition

‐ptyalo

spit; saliva

‐emic

pertaining to a blood condition

‐ptysis

spitting

‐gen

producing; forming

‐rrhaphy

suture (Continued)

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Table 4.5  (Continued )

Suffix

Definition

Suffix

Definition

‐genesis

producing; forming

‐rrhea

flow; discharge

‐graph

instrument for recording

‐scope

instrument for visual examination

‐graphy

process of recording

‐scopy

visual examination

‐ia

condition

‐spasm

sudden involuntary contraction of muscles

‐iasis

abnormal condition

‐stalsis

contraction

‐ion

process

‐stasis

stopping; controlling

‐ism

process; condition

‐stenosis

tightening; narrowing; stricture

‐itis

inflammation

‐stomy

new opening to the outside of the body

‐lithiasis

abnormal condition of stones

‐tomy

incision; process of cutting into

‐logy

study of

‐tresia

opening

‐lysis

breakdown; separation; destruction; loosening

‐um

structure; tissue; thing; pertaining to

‐megaly

enlargement

‐oma

tumor; mass; fluid collection

Parts Abdomin/o Abdomin/o

+ ‐al + ‐centesis

Adip/o Amyl/o An/o peri‐ An/o An/o anti‐ Bi/o Bil/i hyper‐ Bucc/o Carcin/o Cec/o Celi/o Cheil/o

+ ‐ose + ‐ase + ‐al + An/o + ‐plasty + Rect/o + ‐emesis + ‐logy + ‐ary + Bilirubin/o + ‐al + ‐gen + ‐al + ‐ac + ‐osis

Medical Term

+ ‐al + ‐al + ‐ic + ‐emia

Definition

= Abdominal :______________ = Abdominocentesis :______________ (Figure 4.45) Also called a paracentesis. = Adipose :______________ = Amylase :______________ = Anal :______________ = Perianal :______________ = Anoplasty :______________ = Anorectal :______________ = Antiemetic :______________ = Biology :______________ = Biliary :______________ = Hyperbilirubinemia :______________ = Buccal :______________ = Carcinogen :______________ = Cecal :______________ = Celiac :______________ = Cheilosis :______________

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Figure 4.45  Ultrasound‐guided abdominocentesis in a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Cholangi/o Cholangi/o Cholangi/o Cholangi/o Cholangi/o Cholangi/o Chol/e Cholecyst/o Cholecyst/o Cholecyst/o Cholecyst/o Cholecyst/o Choledoch/o Choledoch/o Choledoch/o Choledoch/o ante‐ post‐ Colon/o Col/o

+ ‐ectasia + ‐stomy + Carcin/o + Hepat/o + Gastr/o + Enter/o + ‐stasis + ‐ic + ‐ectomy + ‐itis + ‐lithiasis + Jejun/o + ‐al + ‐lithiasis + Jejun/o + ‐tomy + Cib/o + Cib/o + ‐ic + ‐itis

Colon/o

+ ‐scopy

Col/o

+ ‐stomy

+ ‐oma + ‐itis + ‐stomy + ‐stomy

+ ‐stomy + ‐stomy + ‐um + ‐um

= Cholangiectasia :______________ = Cholangiostomy :______________ = Cholangiocarcinoma :______________ = Cholangiohepatitis :______________ = Cholangiogastrostomy :______________ = Cholangioenterostomy :______________ = Cholestasis :______________ = Cholecystic :______________ = Cholecystectomy :______________ = Cholecystitis :______________ = Cholecystolithiasis :______________ = Cholecystojejunostomy :______________ = Choledochal :______________ = Choledocholithiasis :______________ = Choledochojejunostomy :______________ = Choledochotomy :______________ = Antecibum :______________ = Postcibum :______________ = Colonic :______________ = Colitis :______________ Also called colonitis. = Colonoscopy :______________ (Figure 4.46) = Colostomy :______________ Also called colonostomy.

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Figure 4.46  Colonoscopy showing diverticulitis. Source: Courtesy shutterstock/Juan Gaertner.

Col/o Copr/o Copr/o Duoden/o dys‐ dys‐ dys‐ Enter/o Enter/o Enter/o Enter/o Enter/o Enter/o Enter/o Esophag/o Esophag/o Esophag/o Esophag/o Faci/o Gastr/o Gastr/o Gastr/o Gastr/o Gastr/o Gastr/o Gastr/o Gastr/o

+ ‐tomy + ‐phagia + Phag/o + ‐al + ‐chezia + ‐pepsia + ‐phagia + ‐itis + ‐tomy + ‐stomy + ‐ic + ‐ic + Carcin/o + Col/o + Col/o + ‐eal + ‐eal + ‐plasty + ‐itis + ‐al + ‐ic + ‐tomy + ‐ectomy + ‐stomy + Jejun/o + Enter/o + Duoden/o + ‐pexy

+ ‐ic

+ ‐oma

= Colotomy = Coprophagia = Coprophagic = Duodenal = Dyschezia = Dyspepsia = Dysphagia = Enteritis = Enterotomy = Enterostomy = Enteric = Enteric carcinoma

+ ‐stomy = Enterocolostomy + ‐itis = Enterocolitis = Esophageal + Spasm = Esophageal spasm = Esophagoplasty = Esophagitis = Facial = Gastric = Gastrotomy = Gastrectomy = Gastrostomy + ‐stomy = Gastrojejunostomy + ‐itis = Gastroenteritis + ‐stomy = Gastroduodenostomy = Gastropexy (Figure 4.47)

:______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :_____________ :______________ :______________ :______________

This is the procedure used to correct bloat.

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137

Figure 4.47  Gastropexy to correct a gastric dilatation volvulus. Source: Courtesy of Deanna Roberts BA, AAS, CVT.

Gingiv/o Gingiv/o Gingiv/o Gloss/o Gloss/o hypo‐ Glyc/o hyper‐ hypo‐ hyper‐ hypo‐ brachy‐ pro‐ Gnath/o

+ ‐al + ‐itis + ‐ectomy + ‐al + ‐itis + Gloss/o + ‐emic + Glyc/o + Glyc/o + Glyc/o + Glyc/o + Gnath/o + Gnath/o + ‐ism

Hemat/o Hemat/o Hem/o Hem/o

+ ‐emesis + ‐chezia + peritoneum + abdomen

Hem/o Hepat/o Hepat/o Hepat/o Hepat/o Hepat/o Herni/o de‐

+ ‐ptysis + ‐megaly + ‐itis + ‐oma + ‐tomy + ‐cyte + ‐rrhaphy + Hydr/o

+ ‐al + ‐emia + ‐emia + ‐emic + ‐emic + ‐ia + ‐ia

+ ‐ation

= Gingival = Gingivitis = Gingivectomy = Glossal = Glossitis = Hypoglossal = Glycemic = Hyperglycemia = Hypoglycemia = Hyperglycemic = Hypoglycemic = Brachygnathia = Prognathia = Gnathism (Figure 4.48)

:______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________

Condition can affect the mandible or the maxilla. = Hematemesis :______________ = Hematochezia :______________ = Hemoperitoneum :______________ = Hemoabdomen :______________ (Figure 4.49) = Hemoptysis :______________ = Hepatomegaly :______________ = Hepatitis :______________ = Hepatoma :______________ = Hepatotomy :______________ = Hepatocyte :______________ = Herniorrhaphy :______________ = Dehydration :______________

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(A)

(B)

(C)

(D)

Figure 4.48  Mandibular deformities. (A) Elongated mandible. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B, C) Elongated mandible. Source: Courtesy of Greg Martinez, DVM; www. youtube.com/drgregdvm. (D) Chihuahua with mandibular brachygnathism. Source: Courtesy of Deanna Roberts BA, AAS, CVT.

Figure 4.49  Hemoabdomen in a dog. Source: Courtesy of Sam Grebe, CVT.

Ile/o Ile/o Ile/o Inguin/o Jejun/o

+ ‐itis + ‐stomy + Cec/o + ‐al + ‐stomy

+ ‐al

= Ileitis = Ileostomy = Ileocecal = Inguinal = Jejunostomy

:______________ :______________ :______________ :______________ :______________

Chapter 4  The Gastrointestinal Tract

Labi/o Lapar/o

+ ‐al + ‐tomy

139

= Labial = Laparotomy (Figure 4.50)

:______________ :______________

Figure 4.50  Laparotomy incision. Source: Courtesy of shutterstock/Kanwarjit Singh Boparai.

Lingu/o sub‐ Lip/o Lip/o (A)

+ ‐al + Lingu/o + ‐ase + ‐oma

+ ‐al

= Lingual = Sublingual = Lipase = Lipoma (Figure 4.51)

:______________ :______________ :______________ :______________

(B)

Figure 4.51  (A) Lipoma in a Beagle. (B) Lipoma surgically removed from the Beagle. Source: Courtesy of Jennifer Tabor, AAS.

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Mandibul/o sub‐ Muc/o Necr/o Necr/o Nas/o Nas/o Or/o Or/o Or/o Palat/o

+ ‐ar + Mandibul/o + ‐ous + ‐opsy + ‐osis + ‐al + Gastr/o + ‐al + Gastr/o + Nas/o + ‐plasty

Pancreat/o

+ ‐itis

+ ‐ar

+ ‐ic + ‐ic + ‐al

= Mandibular = Submandibular = Mucous = Necropsy = Necrosis (Figure 4.52) = Nasal = Nasogastric = Oral = Orogastric = Oronasal = Palatoplasty (Figure 4.53) = Pancreatitis (Figure 4.54)

Figure 4.52  Intestinal necrosis. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

:______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________

Figure 4.53  Palatoplasty in a dog in which the hard palate separated from the bone plate. Source: Courtesy of Deanna Roberts, BA, AAS, CVT.

Figure 4.54  Dog with pancreatitis. Note the hunched appearance due to abdominal pain. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Chapter 4  The Gastrointestinal Tract

Pancreat/o Peritone/o Peritone/o Pharyng/o Pharyng/o poly‐ poly‐ pre‐ post‐ Proct/o Proct/o Prote/o Py/o Pylor/o Pylor/o Pylor/o Pylor/o Radi/o Radi/o Rect/o Rect/o Sialaden/o Sialaden/o Sial/o Steat/o

+ ‐ic + ‐itis + ‐al + ‐eal + ‐itis + Dips/o + ‐phagia + ‐prandial + ‐prandial + ‐logy + ‐plasty + ‐ase + ‐rrhea + ‐ic + ‐plasty + ‐ic + ‐spasm + ‐graph + ‐logy + ‐al + ‐cele + ‐itis + ‐osis + ‐cele + ‐oma

Steat/o

+ ‐lysis

Steat/o Stomat/o Stomat/o Stomat/o

+ ‐itis + ‐itis + Gastr/o + ‐logy

141

= Pancreatic = Peritonitis = Peritoneal = Pharyngeal = Pharyngitis + ‐ia = Polydipsia = Polyphagia = Preprandial = Postprandial = Proctology = Proctoplasty = Protease = Pyorrhea = Pyloric = Pyloroplasty + Stenosis= Pyloric stenosis = Pylorospasm = Radiograph = Radiology = Rectal = Rectocele = Sialadenitis = Sialadenosis = Sialocele = Steatoma

+ ‐ic

:______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ :______________ Also called lipoma. = Steatolysis :______________ Also called emulsification. = Steatitis :______________ = Stomatitis :______________ = Stomatogastric :______________ = Stomatology :______________

Abbreviations Table 4.6  Abbreviations.

Abbreviation

Definition

ac

Before meals (ante cibum)

Alk. phos.

Alkaline phosphatase (liver enzyme)

ALT

Alanine aminotransferase (liver enzyme)

AST

Aspartate aminotransferase

BCS

Body condition score (Continued)

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Table 4.6  (Continued )

Abbreviation

Definition

BS

Body score

BSA

Body surface area

c

Cup

cc

Cubic centimeter

cg

Centigram

dg

Decigram

dkg

Dekagram

fl oz

Fluid ounce

GDV

Gastric dilatation volvulus

GI

Gastrointestinal

g or gm

Gram

gal

Gallon

gr

Grain

gtt, gtts

Drop, drops

hg

Hecogram

HGE

Hemorrhagic gastroenteritis

IC

Intracardiac

ID

Intradermal

IM

Intramuscular

IO

Intraosseous

IP

Intraperitoneal

IV

Intravenous

IVC

Intravenous catheter

inj

Injection

L (l)

Liter

LDA/RDA

Left displaced abomasum/right displaced abomasum; condition in which the abomasum becomes trapped under the rumen

Chapter 4  The Gastrointestinal Tract

Table 4.6  (Continued )

Abbreviation

Definition

TGE

Transmissible gastroenteritis

mcg; μg

Microgram

meq

Milliequivalent

mg

Milligram

mL

Milliliter; 1 mL = 1 cc

mm

Millimeter

ng

Nanogram

NG tube

Nasogastric tube

NPO

Nothing by mouth (nil per os)

oz

Ounce

pc

After meals (post cibum)

PO

By mouth (per os)

pt

Pint

qt

Quart

SQ or SC

Subcutaneous (sub Q)

T, Tbs, Tbsp

Tablespoon; 1 Tbsp = 15 mls

t or tsp

Teaspoon; 1 tsp = 5 mls

# or lbs

Pounds

kg

Kilogram; 1# = 2.2 kg

RUQ; RU

Right upper quadrant

RLQ; RL

Right lower quadrant

LUQ; LU

Left upper quadrant

LLQ; LL

Left lower quadrant

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(A)

(B)

(C)

Figure 4.55  Placement of an intravenous catheter (IVC). (A) The technician places the IVC in the cephalic vein while another technician holds off the vein. (B) Once placed into the vein, the IVC is taped onto the limb. (C) The IVC is then flushed with saline. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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145

Case Study: Give the medical terms and abbreviations for definitions in bold print You’ll notice some terms from the previous chapters Maverick, a three‐year‐old Shetland Sheepdog, presents to your clinic with blood in the feces and vomiting blood. On exam you notice a condition of drowsiness. Abdominal palpation is difficult because Maverick has a hunched posture. He also appears to have a condition of lack of fluid. A group of tests is performed to check for parasites. After the tests come back negative a diagnostic procedure using ultrasound waves is performed. Inflammation of the pancreas is noted and a slight enlargement of the liver is seen. An IVC (Figure 4.55) is placed and Maverick is given IV fluids. He was NPO for 24 hours. A substance is given to counteract the vomiting. Blood work is performed and the lab results show that Maverick has a blood condition of excessive sugar. His ALT and Alk. Phos. are also elevated. Maverick’s owner asks that we give him eye drops that he usually gets each night. The directions are to give 2 gtts in each eye at night. Maverick is also given an inj. for the pain. After two days of hospitalization, Maverick improves and is allowed to go home.

Exercises 4‐A:  Give the definition for the following: 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

adip/o, lip/o, and steat/o: _____________________________________________ dent/i and odont/o: __________________________________________________ ‐osis and ‐iasis: _____________________________________________________ or/o and stomat/o: __________________________________________________ chol/e and bil/i _____________________________________________________ gloss/o and lingu/o: __________________________________________________ labi/o and cheil/o: ___________________________________________________ lapar/o, abdomin/o, and celi/o: ________________________________________ hem/o and hemat/o: _________________________________________________ gluc/o and glyc/o: ___________________________________________________

4‐B:  Give the structure for the following definitions. 1.  2.  3.  4.  5. 

_______________: Throat _______________: Proximal small intestine _______________: Small blind sac between small and large intestine _______________: Distal large intestine _______________: Fold of peritoneum extending from the greater curvature of the stomach to the other organs 6.  _______________: Opening from the GI to outside of the body 7.  _______________: Organ that synthesizes protein and bile 8.  _______________: Tube from the throat to the stomach

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9.  10.  11.  12.  13.  14.  15.  16. 

_______________: Sac that stores bile _______________: Large intestine _______________: Lips _______________: Exocrine and endocrine organ _______________: Produces digestive enzymes and insulin _______________: Membrane surrounding the organs of the abdomen _______________: Second part of small intestine _______________: Leaf‐like piece of cartilage over the trachea to prevent aspiration of food 17.  _______________: Carries bile from the liver and gallbladder to the small intestine 18.  _______________: Microscopic finger‐like projections in the walls of the intestine 19.  _______________: Windpipe 4‐C:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11. 

Anorexia ___________________________________________________________ Steatorrhea _________________________________________________________ Colostomy __________________________________________________________ Gastrectomy ________________________________________________________ Ascites _____________________________________________________________ Dysphagia __________________________________________________________ Hepatitis ___________________________________________________________ Fistula _____________________________________________________________ Peristalsis ___________________________________________________________ Pulp cavity__________________________________________________________ Scours _____________________________________________________________

4‐D:  Give the term for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

Surgical connection between two tubes Ring‐like muscles between the esophagus and stomach Stricture of the ring‐like muscles between the stomach and duodenum Inflammation of the membrane surrounding the organs of the abdomen Ridges on the roof of the mouth and in the stomach that increase surface area for absorption Thin, muscular partition between the thoracic and abdominal cavities Passage of feces through the anus to the outside of the body Vomiting Removal of tissue for microscopic exam Ingestion of feces Yellowish‐orange coloration of the skin and mucous membranes Enlargement of the esophagus To bypass or divert Condition of a shortened jaw Hairball

Chapter 4  The Gastrointestinal Tract

4‐E:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

Laparoscopy_____________________________________________ Enterocolostomy _________________________________________ Glossitis ________________________________________________ Hypoglycemia ___________________________________________ Submandibular ___________________________________________ Gingivitis ________________________________________________ Cholecystectomy __________________________________________ Palatoplasty ______________________________________________ Hyperbilirubinemia ________________________________________ Polyphagia _______________________________________________ Hemoabdomen____________________________________________ Colostomy________________________________________________ Dyspepsia________________________________________________ Pyorrhea _________________________________________________ Buccal ___________________________________________________

4‐F:  Define the following abbreviations. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

_____________________: cc _____________________: gr _____________________: HGE _____________________: GDV _____________________: mg _____________________: gm _____________________: gtt _____________________: ID _____________________: IM _____________________: IVC _____________________: ml _____________________: LDA _____________________: Alk. phos. _____________________: RUQ _____________________: BCS _____________________: AST _____________________: IP _____________________: pc _____________________: meq _____________________: PO

4‐G:  Circle the correct term in parentheses. 1.  Route of administration other than oral: (parenteral, peritoneum) 2.  Erosion of the skin and mucous membranes: (ulcer, mucocele) 3.  Passive event in which swallowed food is returned to oral cavity: (vomit, regurgitation) 4.  Intestines: (bowel, colon) 5.  Telescoping of intestines: (obstipation, intussusception)

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6.  Acute abdominal pain: (ascites, colic) 7.  Surgical fixation of the stomach: (gastropexy, gastrostomy) 8.  Anastomosis of the stomach and second part of the small intestine: (gastroduodenostomy, gastrojejunostomy) 9.  Swallowing: (mastication, deglutition) 10.  Excessive thirst: (polydipsia, polyphagia) 4‐H:  Answer the following. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

What is the dental formula for the dog? ___________________________ How many incisors does a horse have? ___________________________ Which organ stores glucose in the form of glycogen? ________________ List the four parts of the ruminant stomach in order of occurrence. _____ The medical name for “puppy teeth” is ___________________________ Where does food go after leaving the cecum? ______________________ True or False: The correct spelling for chewing is mastification. ____________ When the cause of disease is neither known nor understood, it is termed ________________ The synonymous term for jaundice is __________________________ True or False: Unpleasant sensation and tendency to vomit defines flatus. _________________ True or False: GERD results from a failure of the muscles of the esophagus to relax. ____________ If a patient is jaundiced, what organ is of concern? _________________

4‐I:  Match the following terms with their descriptions. 1.  ________Twist on itself 2.  ________Incision of the common bile duct 3.  ________Formation of new sugar from proteins and fats 4.  ________Finger‐like projections in the small intestines 5.  ________Hard, outermost layer of the crown of the tooth 6.  ________Tooth decay 7.  ________Chemical that speeds up a reaction 8.  ________Breakdown of fat 9.  ________Tissue composed of essential cells of any organ 10.  ________Small, raised bumps on the tongue Answers can be found starting on page 675.

A. Choledochotomy B. Dental caries C. Emulsification D. Enamel E. Enzyme F. Gluconeogenesis G. Papillae H. Parenchyma I. Villi J. Volvulus

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Review Tables Fill in the tables and refer to Tables 4.3–4.6 for answers. Table 4.7

Combining forms

Definition

Combining forms

Abdomin/o

Hem/o

Acu/o

Hemat/o

Adip/o

Hepat/o

Aliment/o

Herni/o

Amyl/o

Hydr/o

An/o

Ile/o

Bi/o

Inguin/o

Bil/i

Jejun/o

Bilirubin/o

Labi/o

Bucc/o

Lapar/o

Carcin/o

Lingu/o

Cec/o

Lip/o

Celi/o

Lith/o

Cheil/o

Mandibul/o

Chol/e

Muc/o

Cholangi/o

Nas/o

Cholecyst/o

Necr/o

Choledoch/o

Odont/o

Chron/o

Or/o

Cib/o

Palat/o

Col/o, Colon/o

Pancreat/o

Copr/o

Peritone/o

Cyst/o

Phag/o

Decidu/o

Pharyng/o

Dent/o, Dent/i

Proct/o

Dips/o

Prote/o

Definition

(Continued)

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Table 4.7  (Continued )

Combining forms

Definition

Combining forms

Duoden/o, Duoden/i

Py/o

Enter/o

Pylor/o

Esophag/o

Radi/o

Faci/o

Rect/o

Gastr/o

Rug/o

Gingiv/o

Sial/o

Gloss/o

Sialaden/o

Gluc/o

Steat/o

Glyc/o

Stomat/o

Glycogen/o

Trich/o

Gnath/o

Vill/i

Definition

Table 4.8

Prefix

Definition

Prefix

a‐, an‐

mega‐

ante‐

meta‐

anti‐

neo‐

brachy‐

para‐

de‐

peri‐

dys‐

poly‐

endo‐

post‐

hyper‐

pre‐

hypo‐

pro‐

mal‐

sub‐

Definition

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Table 4.9

Suffix

Definition

Suffix

‐al, ‐ar, ‐ary, ‐eal, ‐ic, ‐ous

‐opsy

‐ase

‐orexia

‐ation

‐ose

‐cele

‐osis

‐centesis

‐otic

‐chezia

‐pepsia

‐cyte

‐pexy

‐ectasis, ‐ectasia

‐phagia

‐ectomy

‐plasty

‐emesis

‐prandial

‐emia

‐ptyalo

‐emic

‐ptysis

‐gen

‐rrhaphy

‐genesis

‐rrhea

‐graph

‐scope

‐graphy

‐scopy

‐ia

‐spasm

‐iasis

‐stalsis

‐ion

‐stasis

‐ism

‐stenosis

‐itis

‐stomy

‐lithiasis

‐tomy

‐logy

‐tresia

‐lysis

‐um

‐megaly ‐oma

Definition

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Table 4.10

Abbreviation ac Alk. phos. ALT AST BCS BS BSA c cc cg dg dkg fl oz GDV GI g or gm gal gr gtt, gtts hg HGE IC ID IM IO IP IV IVC inj

Definition

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Table 4.10  (Continued )

Abbreviation L (l) LDA/RDA TGE mcg; μg meq mg ml mm ng NG tube NPO oz pc PO pt qt SQ, SC, sub Q T, Tbs, Tbsp t or tsp # or lbs kg RUQ; RU RLQ; RL LUQ; LU LLQ; LL

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning ­materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

5

The Reproductive System

Animal reproduction is a broad area of study. The foundation of reproduction is similar to that of humans – it takes two to tango. The union of sperm (male sex cell) and ovum (female sex cell) is required to produce offspring. We use the term theriogenology to describe the study of animal reproduction. This area includes obstetrics, gynecology, neonatology (study of newborns), artificial insemination, and embryo transfer.

The Male Reproductive System The goal of both the male and female reproductive systems is to create life. Because the male reproductive system is the less complex of the two, this chapter will discuss the male first. The male reproductive organs produce and transport sperm out of the body and they produce hormones such as testosterone. Please note that the male reproductive system differs between species because some animals don’t possess all of the organs discussed.

Spermatozoon A spermatozoon (sperm cell) is the male gamete or sex cell (Figure 5.1). Its anatomy is simplistic, consisting of a head, m ­ idpiece,

and tail. The head of the sperm contains the DNA material (chromosomes), as well as an acrosome, which allows the sperm cell to penetrate the ovum during fertilization. The midpiece contains the mitochondria of the cell, which provides energy. The tail consists of a single flagellum that is used for motility (movement). Approximately 300 million to 2 billion sperm are released from the dog during ejaculation (ejection of sperm and fluid from the urethra). Sperm concentrations vary depending on species. Only one sperm can fertilize an ovum. If there are multiple ova released during ovulation, then multiple ova will be fertilized.

Anatomy and Physiology The male gonads (sex organs) are the testicles, or testes (singular: testis). The testes develop in the abdomen of the male fetus and then descend into the scrotum before birth. If the testes fail to descend, it is termed cryptorchism. The scrotum is a sac that encloses and supports the testes on the outside of the body. It provides an environment with a lower temperature than that of the normal body temperature. The lower temperature is necessary for the formation of sperm (spermatogenesis).

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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(A) Acrosome Head

Nucleus Basal body Midpiece Mitochondria

Tail Principal piece Axoneme

Endpiece

Spermatozoon (B)

Figure 5.1  (A) Anatomy of a sperm cell. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Stained slide of spermatozoa from a bull. Source: Courtesy of shutterstock/vetpathologist.

The area between the anus and genital organs is termed the perineum. Because we’re describing the perineum in males, its meaning changes to the area between the anus and scrotum.

Throughout the testes are sections of coiled tubes called seminiferous tubules, which are the site of spermatogenesis. The seminiferous tubules are surrounded by two groups of interstitial cells (cells

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between spaces). The Sertoli cells line the inside of the tubules and provide nourishment to the developing sperm cells. Leydig cells are those outside of the tubules and they produce the hormone testosterone. Once sperm cells are produced, they move to the next structure of the male reproductive system, the epididymis. The epididymis is a large tube where sperm

cells mature, become motile, and are stored before ejaculation. The epididymis runs the length of the testicle, eventually turning upward where it becomes a more narrow tube called the vas deferens, or ductus deferens (Figure 5.2). The vas deferens carries sperm from the epididymis to the urethra (tube from the urinary bladder to the outside of the body).

(A) Spermatic cord Testicular vein Testicular artery Epididymis Vas deferens

Seminiferous tubules

Testis

(B)

Spermatic cord

Epididymis

Testicle

Figure 5.2  (A) Structures of the testicle. Source: Courtesy of shutterstock/Alex Luengo. (B) Testicle from a canine neuter. Source: Courtesy of Dr. Sharyn Esposito, DVM.

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Figure 5.3  The prepuce and the glans penis of a dog. Source: Courtesy of Deanna Roberts BA, AAS, CVT.

It is encased in a structure called the spermatic cord, which also contains nerves and blood vessels. The vas deferens merges with the seminal vesicles to form the ejaculatory duct. Seminal vesicles are two glands at the base of the urinary bladder. These two glands produce a thick, yellowish substance that nourishes the sperm and adds volume to the ejaculated fluid (semen). Semen is the combination of sperm and fluid. The prostate gland is a single gland that encircles the urethra and secretes a thick fluid that aids in the motility of the sperm. Below, or caudal to, the prostate gland is a pair of glands called the bulbourethral glands which also secrete fluid into the urethra. The urethra is a tube that extends from the urinary bladder, through the penis, to the outside of the body. This tube acts as both a reproductive organ (transports semen) and a urinary organ (transports urine). The penis consists of the glans penis (sensitive tip), the prepuce (cutaneous sheath or foreskin), and erectile tissue (Figure  5.3). When an animal is sexually stimulated, the erectile tissue fills with

Seminiferous tubules

Testes

Epididymis

Vas deferens

Seminal vesicles

Ejaculatory duct

Urethra

Prostate gland Bulbourethral glands

Penis

Figure 5.4  The passage of sperm through the male reproductive system.

blood, causing an erection. Some carnivores, such as dogs, also have a bone in their penis called the os penis. Figure 5.4 shows the passage of sperm through the male reproductive system.

Chapter 5  The Reproductive System

Terms for the Male Reproductive System Bulbourethral Pair of glands below the glands prostate that secrete fluid into the urethra. Ejaculation Ejection of sperm and fluid from the male urethra. Ejaculatory Tube through which duct semen enters the urethra. Epididymis One of a pair of tightly coiled tubes lying on top of each testicle. They carry sperm from the seminiferous tubules to the vas deferens. Flagellum Hair‐like projection on a sperm cell that makes it motile. Gametes Sex cell; sperm in males and ova in females. Genitalia Reproductive organs such as the ovaries, uterus, and vagina in females; the testes, penis, and vas deferens in males. Also called genitals. Glans penis Sensitive tip of the penis.

159

Gonads

Sex organs that produce gametes (sex cells). Testes in males and ovaries in females. Intact Male that has not been neutered; male that still has its reproductive capability. Os penis Bone found in the penis of some carnivores (Figure 5.5). Perineum In males, the area between the anus and scrotum. Prepuce Cutaneous sheath covering the penis. Prostate gland Gland in males that surrounds the urethra. Depending on the species, it may be well defined or diffuse. It secretes a thick fluid that aids the motility of sperm. Scrotum External sac that contains the testes. Semen Spermatozoa and fluid. Seminal Pair of glands that secrete vesicles a fluid into the vas deferens.

Figure 5.5  Radiograph showing the os penis of the dog. Source: Courtesy of Beth Romano, AAS, CVT.

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Seminiferous tubules

Narrow, coiled tubules that produce sperm in the testes. Spermatozoon Sperm cell. (plural: spermatozoa) Sterility Inability to reproduce. Male gonads that Testes produce spermatozoa (singular: and the hormone testis) testosterone. Testosterone Hormone produced by the testes and responsible for male sex characteristics.

Urethra

Vas deferens

In males, tube that carries urine and semen to the outside of the body. The tube extends from the urinary bladder, through the penis, to the outside of the body. Narrow tube that carries sperm from the epididymis toward the urethra. Also called the ductus deferens.

Male Reproductive System Pathology and Procedures Azoospermia Castration

Lack of spermatozoa in the semen. Removal of gonads (sex organs) (Figure 5.6).

TECH TIP 5.1 Castration Since the definition of castration is the removal of gonads, can females be c­ astrated? The answer is yes. Castration is a generalized term; however, in veterinary medicine, it is most commonly used to describe the removal of male gonads.

Cryptorchism

Condition in which one or both testicles is undescended. Also called cryptorchidism. If only one testicle is undescended, then it is termed monorchid. If both are undescended, then the condition is termed bilateral cryptorchism (Figure 5.7). Electroejaculation Method used for the collection of semen for artificial insemination or for examination. Electrical stimulation is provided by electrodes to the nerves to promote ejaculation. The rectal probe used is called an electroejaculator (Figure 5.8). Neuter Removal of male gonads; orchiectomy (Figure 5.6). Paraphimosis Inability to retract the penis due to its swollen state or due to the constriction of the preputial orifice (Figure 5.9). Persistent frenulum Incomplete separation of the penis and prepuce which causes an inability to breed. Phimosis Constriction of the orifice of the prepuce preventing it from drawing back over the glans penis. Priapism Persistent erection of the penis due to injury or disease. Causes include injuries to the spinal cord or penis. Scrotal hydrocele Swelling of the scrotum due to a collection of fluid in the testes or along the spermatic cord (Figure 5.10).

(A)

(B)

(C)

Figure 5.6  (A) Castration of a dog. Source: Courtesy of Jeanette Nash, LVT. (B) Equine castration. Source: Courtesy of shutterstock/kiep. (C) Castration in a calf using Burdizzo forceps. This instrument crushes the blood vessels leading to the testicle, so eventually they shink and necrose. Source: Courtesy of shutterstock/Claudia Otte.

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(A)

(B)

(C)

Figure 5.7  Cryptorchism. (A) Monorchid: note the absence of one testicle. (B) Monorchid: testicle has been found in the abdominal cavity. Source: (A, B) Courtesy of Greg Martinez, DVM; http://www.youtube.com/ drgregdvm. (C) Monorchid: undescended testicle is protruding in the right inguinal region. Source: Courtesy of WikiCommons/Joel Mills.

Semen analysis

Testing done to evaluate a male as a potential breeder. Examinations include evaluation of motility, morphology, and concentration of sperm cells.

Building the Terms Now it’s time to assemble the word parts listed in Tables 5.1–5.3. If you memorize the meaning of the combining forms, prefixes,

and suffixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

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(A)

(B)

(C)

(D)

(E)

Figure 5.8  Electroejaculation. (A) Lane electroejaculator probe. (B) Electroejaculator probe insertion. (C) Adjusting the power on the electroejaculator. (D) Erection caused by the probe. (E) Collection of semen. Source: Courtesy of Patrick Hemming, DVM.

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Figure 5.9  Paraphimosis in a dog. Source: Courtesy of Ethan Heritage, CVT.

Figure 5.10  Scrotal hydrocele. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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Table 5.1  Male combining forms.

Combining forms

Definition

Combining forms

Definition

Balan/o

Glans penis

Priap/o

Penis

Crypt/o

Hidden

Prostat/o

Prostate gland

Epididym/o

Epididymis

Semin/i

Semen; seed

Gen/o

Producing

Sperm/o

Spermatozoa; semen

Hydr/o

Fluid; water

Spermat/o

Spermatozoa; semen

Later/o

Side

Test/o

Testis; testicles

Orch/o

Testis; testicles

Theri/o

Beast

Orchi/o

Testis; testicles

Urethr/o

Urethra

Orchid/o

Testis; testicles

Vas/o

Vessel; vas deferens

Pen/i

Penis

Zo/o

Animal life

Table 5.2  Male prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

mono‐

one; single

bi‐

two; both

oligo‐

scanty

Table 5.3  Male suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ar

pertaining to

‐logy

study of

‐cele

hernia

‐lytic

to reduce; to destroy; separate; breakdown

‐ectomy

removal; excision; resection

‐megaly

enlargement

‐genesis

producing; forming

‐one

hormone

‐ia

condition

‐pexy

surgical fixation; to put in place

‐ism

process; condition

‐stomy

new opening; anastomosis

‐itis

inflammation

‐tomy

incision; process of cutting into

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Parts Balan/o Epididym/o an‐ Orch/o Orch/o Orchi/o Orchi/o Orchid/o Prostat/o Prostat/o Prostat/o a‐

Medical Term

+ ‐itis + ‐itis +  Orch/o + ‐ism + ‐ectomy + ‐itis + ‐pexy + ‐ectomy

Definition

= Balanitis = Epididymitis = Anorchism = Orchectomy = Orchitis = Orchiopexy = Orchiectomy

: ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ This is the medical term for a neuter. + ‐ectomy = Orchidectomy : ________________ + ‐ectomy = Prostatectomy : ________________ + ‐itis = Prostatitis (Figures 5.11 and : ________________ 5.12) + ‐megaly = Prostatomegaly : ________________ +  Sperm/o + ‐ia = Aspermia : ________________ Prostatitis Normal

Inflamed prostate

Bladder

Urethra

Prostate gland Urine

Figure 5.11  Comparison of a normal prostate gland with prostatitis. Source: Courtesy of shutterstock/Alila Medical Images.

Figure 5.12  Inflamed prostate. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Chapter 5  The Reproductive System

oligo‐ Sperm/o Spermat/o Testicul/o Vas/o Vas/o + Vas/o

+  Sperm/o + ‐ia + ‐lytic + ‐genesis + ‐ar + ‐ectomy + ‐stomy

167

= Oligospermia = Spermolytic = Spermatogenesis = Testicular =  Vasectomy (Figure 5.13) = Vasovasostomy

: ________________ : ________________ : ________________ : ________________ : ________________ : ________________ This is the reversal of a vasectomy. “‐stomy” means anastomosis in this term because it is attached to two structures. In this case it is the anastomosis of the ends of the severed vas deferens.

Blood supply Small incision Vas deferens Cut ends of vas deferens are sealed

Epididymis Testis

Figure 5.13  Diagram of a vasectomy procedure. Source: Courtesy of shutterstock/blamb.

The Female Reproductive System While the goal of both reproductive ­systems is to create life, the female reproductive system must also support life.

ovary are small sacs called follicles that contain the ova and their encasing cells. There are different kinds of follicles within the ovary that are named based on the age of the ovum they contain (Figure 5.14).

Ovaries

Uterine Tubes

The ovaries are a pair of female gonads (sex organs) on each side of the pelvis. They produce ova (eggs) and the hormones estrogen and progesterone. Within the

Once the ovum has matured in the ovary, it passes into the uterine tubes. These tubes are equivalent to the fallopian tubes in humans. They are sometimes referred

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(A)

Corona radiata Zona pellucida

First polar body

Ovum

Egg cytoplasm

(B)

Figure 5.14  (A) Anatomy of an ovum. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Equine ovary. This was removed during a necropsy. Note the multiple follicles at various stages of development.

to as fallopian tubes or oviducts. On the ends of the uterine tubes are finger‐like projections called fimbriae, which “catch” the ovum once it is released from the ovary. The ovum then travels through the uterine tubes to the uterine horns. The uterine tubes are also used for the passage of sperm and are the  site of fertilization (union of sperm and ovum).

Uterus The uterus is a hollow, muscular organ in females which includes two uterine horns (cornus), a uterine body (corpus), and the cervix (neck). Uterine horns are a pair of tubes extending from the uterine tubes to the body of the uterus. It is the uterine horns that make animals adapted for

Chapter 5  The Reproductive System

litter bearing. The uterine horns are larger in species that bear multiple offspring. These animals are referred to as bicornuate. The body of the uterus is the mid‐portion of the uterus (Figure 5.15).

169

The caudal aspect of the uterus is called the cervix. It extends from the uterine body to the vagina. The cervix remains closed unless the animal is in heat (estrus). Estrus is the time of sexual receptivity. When the animal goes into heat, the cervix

(A)

(B)

Figure 5.15  (A) Routine spay surgery showing the uterine horns and ovaries about to be removed. Source: Courtesy of Sharyn Esposito, DVM. (B) Pyometra in a dog. Note the swollen uterine horns filled with pus. Source: Courtesy of Deanna Roberts, BA, AAS, CVT.

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relaxes its sphincters to allow for the passage of sperm. When the heat cycle ends, the sphincters close. If the animal becomes pregnant, the cervix is closed with a mucous plug. The mucous plug breaks off when an animal is about to give birth to allow for the passage of the offspring. All three portions of the uterus have three layers of tissue. The endometrium is the inner lining of the uterus and is lined with mucous membranes. The myometrium is the muscular lining of the uterus, and the perimetrium is the membrane surrounding the uterus (Figure 5.16).

TECH TIP 5.2  Remember Your Rules for the Prefixes “endo‐,” “myo‐,” and “peri‐” When the prefixes endo‐, myo‐, and peri‐ are attached to a term that ends with the suffixes ‐ium or ‐eum, their meanings change. Endo‐ becomes the inner lining of the root that it’s attached it, myo‐ becomes the muscle lining of the root that it’s attached to, and peri‐ becomes the membrane surrounding the root that it’s attached to.

The Vagina and Vulva The vagina is the tube that extends from the cervix to the outside of the body. Cattle, sheep, and cats have a pair of glands on either side of their vaginal orifice (opening) called Bartholin glands which produce a mucous secretion that helps lubricate the vaginal orifice during copulation (sexual intercourse) and birth. There is a membranous fold that partially or completely closes the vaginal orifice in some species, called the hymen; however, it is different than what is thought of in  humans. In general, most domestic ­animals lack a true hymen. The external genitalia of the female is called the vulva. Primates have two pairs of skin folds that protect the vaginal ­orifice, whereas carnivores have one pair. These skin folds are called labia (lips). On  the ventral aspect of the vulva is a small, elongated, erectile portion of tissue called a clitoris. The clitoris in females is homologous to the glans penis in males. The area between the anus and genital organs is called the perineum. Because we’re describing the perineum in a female, its meaning changes to the area between the anus and vagina. This area is sometimes torn during parturition (giving birth) so veterinarians may elect to cut the perineum before the female gives birth and then suture the area after delivery. This procedure is called an episiotomy.

Mammary Glands Endometrium Perimetrium

Myometrium

Figure 5.16  The linings of the uterus. Source: Courtesy of shutterstock/Alila Sao Mai.

The milk‐producing glands of females are called mammary glands. The term “breast” isn’t used in veterinary medicine. In large animals, the mammary glands are referred to as udders. Males of each species have rudimentary (imperfect) mammary glands. The number of mammary glands varies with each species. Horses, goats, sheep, and guinea pigs have two mammary glands. Cattle have four mammary glands.

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Litter‐bearing species have four or more pairs of mammary glands. The location of the mammary glands also varies with each species. Some species have mammary glands in their inguinal region, whereas others have them along their ventral abdomen and thorax. The fleshy projection on each mammary gland is called the nipple. After milk has been produced by the mammary gland, it exits through the nipple. In ruminants, they are called teats (Figure 5.17). Mammary glands are made up of ­alveolar tissue (glandular tissue), adipose tissue, (A)

(C)

fibrous connective tissue, lactiferous ducts, and sinuses. Alveolar tissue consists of milk‐secreting glands called alveoli. When an animal becomes pregnant, hormones from the ovaries and placenta stimulate the alveolar tissue of the mammary glands to further development. After parturition, hormonal changes cause the mammary glands to produce milk (lactation). Once produced, the milk travels toward the nipple (teat) through lactiferous ducts and lactiferous sinuses (cavities). Another name for the lactiferous sinus is the gland cistern. Milk travels

(B)

(D)

Figure 5.17  (A) Anatomy of a cow’s mammary gland. Internal structures have been superimposed on the actual image. Source: Courtesy of shutterstock/smereka. (B) Piglets nursing. Source: Courtesy of shutterstock/ InavanHateren. (C) Milking facility. Source: Courtesy of shutterstock/basketman23. (D) Cow milking tubes. Source: Courtesy of shutterstock/2bears.

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from the lactiferous sinus, which is at the base of the teat, to the teat sinus (teat cistern). When an animal becomes pregnant, hormones from the ovaries and placenta stimulate the alveolar tissue ­ of the mammary glands.

Estrous Cycle The estrous cycle comprises four phases: proestrus, estrus, diestrus, and anestrus. The common name of the estrous cycle is  a heat cycle. During this cycle, males are  attracted to females and females are receptive to the males. In most cases ­ovulation has just occurred or is about to  occur. Besides behavior, some species display changes to their external genitalia. While the behavior and external changes vary from species to species, the basic physiology of the cycle is the same.

TECH TIP 5.3  Types of Estrous Cycles Different species have different ­fre­quencies of estrous cycles. Below is a list of different types of estrous cycles. Induced ovulators

Monestrous Polyestrous Seasonal

Proestrus The anterior pituitary gland releases a hormone called follicle‐stimulating hormone (FSH) which has two effects on the ovaries. FSH stimulates the maturation of ova in the Graafian follicles. It also causes the ovaries to release estrogen in anticipation of a possible pregnancy. The estrogen causes the cells in the vagina to become cornified. Behaviorally the males are attracted to the females, but the females do not accept them. Animals may have a serosanguineous (thin, light red) to bloody discharge.

Spontaneous ovulators

Animal that releases ovum after copulation. Examples include cats (Figure 5.18), camelids (alpacas and llamas), rabbits, and ferrets. Animal has one estrous cycle per year. Animal has multiple estrous cycles per year. Animal has an estrous cycle at a specific time of year. For example, cats are polyestrous from February to October. Horses are polyestrous as well, but their cycle centers around the length of daylight. Their breeding season runs from April to September. Animal in which estrus occurs cyclically.

Estrus Estrus is the time of sexual receptivity. During estrus, luteinizing hormone (LH) is released by the anterior pituitary, causing the Graafian follicle to rupture and release the ovum from the ovary. This process is known as ovulation (Figure 5.19).

Figure 5.18  A feline penis. Note the cornified spines which stimulate the female to ovulate after copulation. This is what makes the cat an induced ovulator. Source: Courtesy of WikiCommons/Uwe Gille.

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Graafian follicle

Ovum Matures

Ovum

Corpus albicans

Ovum Regression Corpus luteum forms

Ovulation

Figure 5.19  Stages of ovulation. Source: Courtesy of shutterstock/GRei.

TECH TIP 5.4  Estrous or Estrus? Be careful with the spelling of these two terms as the meaning changes by the addition of the letter “o.” Estrous with the “o” is the term for the entire cycle. Estrus without the “o” is a stage within the cycle. Therefore, estrus is one of several stages of estrous.

Ovaries

Uterine tubes

Uterine horns

Uterine body

Once ovulation occurs, the ovum moves into the uterine tubes (Figure  5.20). If sperm is present at that point then the ovum will be fertilized. LH also plays a role in the formation of the corpus luteum. When the follicle ruptures, it fills with a yellow substance and begins secreting progesterone. This yellow secreting mass of the ovary is the corpus luteum. The progesterone that’s secreted prepares the lining of the uterus for implantation. If an animal fails to conceive, then the corpus luteum will regress and reduce its secretion of progesterone. As the corpus luteum shrinks, it is replaced with white ­

Cervix

Vagina

Vulva Figure 5.20  The path of ovum during ovulation.

fibrous tissue and becomes a corpus ­albicans. If the animal does conceive, the corpus ­luteum will continue to secrete progesterone to prevent future estrous cycles.

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Behaviorally males are attracted to the female and she’s accepting of them. Diestrus Diestrus is the resting period that follows estrus. Estrogen levels decrease and the females begin rejecting the males. The ­cornified cells quickly disappear. This is why vaginal cytologies can be so useful in determining stages of heat. Progesterone levels may still be increased in anticipation of possible fetal implantation and development. Ultimately the levels should eventually decrease if fertilization does not occur. In some cases, hormone levels fail to decrease and the body develops all of the signs of pregnancy, even though the animal isn’t pregnant. This condition is known as pseudocyesis or false pregnancy. Pseudocyesis can be seen in any species, but is most commonly seen in dogs. There are different theories as to the exact cause of pseudocyesis. In fact, there is also disagreement on whether it is breed specific. Some journals believe Pointers, Dalmatians, and Basset Hounds are more susceptible. Anestrus Anestrus is the time of the estrous cycle in  which the female is not sexually receptive.

Pregnancy Fertilization is the union of sperm and ovum (Figure  5.21). If fertilization succeeds, then the fertilized egg will implant in the endometrium. The condition of having a developing fetus in the uterus is termed gestation (pregnancy). The endometrium and chorion (outermost membrane surrounding the embryo) form a vascular organ called the placenta (Figure  5.22). The placenta is the site of  communication between the maternal and fetal bloodstreams. The bloodstreams never mix; instead, various soluble substances are transferred from the maternal blood to the fetal blood in the placenta (Figure 5.23). Once the fetal blood receives vital nutrients from the maternal blood, it travels from the placenta back to the fetus via the umbilical cord. The umbilical cord extends from the placenta to the umbilicus (navel) of the developing embryo. The developing embryo is surrounded by a series of membranes called fetal membranes. The innermost membrane is called the amnion, or amniotic sac (Figure 5.22). The amnion contains fluid in which the embryo is suspended, called amniotic fluid. If the fetus is capable of living outside the mother, then it is termed viable. The time at which a fetus becomes viable depends on the species because the length of gestation varies in different species.

TECH TIP 5.5  The Ruminant Placenta In ruminants, the anatomy is slightly d ­ ifferent. A pregnant cow develops fleshy masses on the wall of her uterus called caruncles. The ruminant placenta develops elevations called cotyledons which will adhere to the maternal caruncles. When the caruncle and ­cotyledon unite, they form a placentome.

TECH TIP 5.6  Different Types of Placentation Placentation refers to the structure and formation of the placenta. Placentation can vary among different species. There are three types of placentation: endotheliochorial placentation, epitheliochorial placentation, and hemochorial placentation. The different types of

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placentation are based on the number of tissue layers separating the maternal and fetal blood supplies. Endotheliochorial placentation is seen in dogs and cats. In this instance, the uterine endothelium is in contact with the chorion of the embryo. With epitheliochorial placentation, which is most seen in horses and cattle, there are three tissue layers in contact with the chorion: maternal connective tissue, uterine endothelium, and endometrial epithelium. Hemochorial placentation is seen in most lab animals and humans. In this type of ­placentation, the maternal blood is in direct contact with the chorion of the embryo.

(A)

(B) FERTILIZATION Sperm nucleus

Zona pellucida

Cytoplasm of ovum

Follicle cell

Acrosome

First polar body Egg nucleus

Ovum Figure 5.21  (A) Sperm fertilizing an ovum. Source: Courtesy of WikiCommons/Unknown. (B) Illustration of fertilization. Source: Courtesy of shutterstock/Svetlana Verbinskaya.

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Figure 5.22  Canine fetus with placenta. Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

Umbilical vein Umbilical arteries Umbilical cord

Main villus Septum Maternal blood in intervillous space Decidua Maternal vein Maternal spiral artery Uterine muscle Figure 5.23  Blood supply between mom and fetus. Source: Courtesy of shutterstock/blamb.

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Terms for the Female Reproductive System Amnion Amniotic fluid Cervix Chorion Clitoris Coitus

Innermost membrane around the developing embryo; amniotic sac. Fluid contained within the amnion. Lower neck‐like portion of the uterus. Outermost membrane surrounding the embryo. Small, elongated, erectile portion of tissue on the ventral aspect of the vulva. Sexual intercourse; also called copulation (Figure 5.24).

Figure 5.24  Donkey mounting. Source: Courtesy of shutterstock/Four Oaks.

Colostrum

First milk‐like substance produced by the female after parturition (birth); high in protein and antibodies (Figure 5.25).

Figure 5.25  Puppies ingesting colostrum. Source: Courtesy of shutterstock/jkelly.

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Conception Embryo Endometrium Estrogen Estrus Fertilization Fetus Fimbriae Follicle‐stimulating hormone (FSH)

The onset of pregnancy. Early stage of development from fertilization to when major structures begin to develop. Inner lining of the uterus. Hormone produced by the ovaries and responsible for the female secondary sex characteristics. Time of sexual receptivity; also known as heat. The union of sperm and ovum; conception. Later stages of development after major structures have developed. Finger‐like projections at the ends of the uterine tubes (fallopian tubes). Hormone produced by the pituitary to stimulate the maturation of ovum (Figure 5.26).

Hypothalamus

Anterior pituitary Gonad

FSH LH

Estrogen

Oxytocin Prolactin Milk Secretion

Progesterone

Uterine contractions Milk Production

Figure 5.26  The effects of the pituitary on the female reproductive system. Source: Courtesy of ­shutterstock/Alila Sao Mai.

Gestation Genital lock

Length of pregnancy. Male and female canine become locked together during coitus due to erectile tissue. Commonly called a tie.

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TECH TIP 5.7  Length of Gestation Please note that these are averages. Dogs and cats Cattle Ferret Gerbils Guinea pigs Horses Hamsters Llamas and alpacas Mice Pigs Rabbits Sheep and goats

Hymen Implantation Involution of the uterus Lactation Litter Luteinizing hormone (LH) Meconium Mount Myometrium Neonate Ovaries

62–65 days 283 days 42 days 24 days 63–68 days 330 days 15–18 days 344 days 20 days 114 days 30 days 150 days

Membranous fold that partially or completely closes the vaginal orifice. Attachment of the fertilized egg (zygote) to the uterus. The uterus returns to its normal non‐pregnant size. The normal secretion of milk. Group of offspring born during the same labor. Hormone produced by the pituitary to promote ovulation (Figure 5.26). First feces of the newborn. Preparatory step to mating of animals. Muscle lining of the uterus. Newborn. Pair of female organs on either side of the pelvis that produce estrogen and progesterone.

TECH TIP 5.8  Can an Animal Have Both Sex Organs? Animals may be born with both ovaries and testes. These animals are referred to as hermaphrodites. In most cases, the sex organs are nonfunctional. Hermaphrodites may have tissue from both sets of sex organs or the full organs themselves.

Ovulation Ovum (plural: ova) Oxytocin Parturition Perineum

Release of ovum from the ovary. Female gamete (sex cell). Hormone produced by the pituitary that stimulates the uterus to contract as well as milk secretion (Figure 5.26). The act of giving birth (Figure 5.27). In females, the area between the anus and vagina.

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Figure 5.27  Shih tzu giving birth. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/ drgregdvm.

Pituitary gland Placenta Pregnancy

Endocrine gland at the base of the brain that produces FSH and LH; also called the master gland or hypophysis (Figure 5.26). Vascular organ that develops in the uterine wall during pregnancy. Used for communication between maternal and fetal blood. Condition of having a developing embryo or fetus in the body (Figure 5.28).

TECH TIP 5.9  Types of Pregnancies Multipara (multiparous) Multigravida Nullipara (nulliparous) Nulligravida Primipara (primiparous) Primigravida

Presentation Progesterone Umbilicus Urethra Uterine horns Uterine tubes Uterus

Female having two or more pregnancies resulting in viable offspring. Female has been pregnant at least twice. Female has never had a pregnancy resulting in viable offspring. Female has never been pregnant. Female has had one pregnancy resulting in viable offspring. Female is pregnant for the first time.

Orientation of the fetus before delivery. Hormone produced by the ovaries during pregnancy to protect the embryo and stimulate lactation. Navel. Tube that carries urine from the urinary bladder to the outside of the body. Pair of tubes extending from the uterine tubes to the body of the uterus. Makes animals adapted for litter bearing. Pair of ducts through which the ovum travels to the uterine horns. Also called the fallopian tubes. The womb. Consists of three sections: the uterine horns, uterine body, and cervix.

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181

(B)

(C)

Figure 5.28  (A) Pregnant bulldog, 59 days along. Source: Courtesy of shutterstock/WilleeCole. (B) Fetal ultrasound. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (C) Radiograph to determine how many puppies the bitch will have.

Vagina Vaginal orifice Viable Vulva Wean

Tube extending from the uterus to the outside of the body. Opening of the vagina. Capable of living outside the uterus. External genitalia of the female (Figure 5.29). Remove the young from the mother so that they no longer nurse.

Figure 5.29  Inverted vulva. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

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Female Reproductive System Pathology and Procedures Abortion Artificial insemination Assisted delivery

(A)

Spontaneous or induced termination of pregnancy before the fetus is viable. Implanting of live sperm into the female genital tract. Aiding delivery of a fetus through use of equipment or hands (Figure 5.30). (B)

Figure 5.30  Examples of assisted delivery. (A) Assisting in delivery of a lamb. Source: Courtesy of shutterstock/Margo Harrison. (B) Assisted delivery of a calf using chains and handles. Source: Courtesy of Patrick Hemming, DVM.

Cesarean section

Removal of the fetus by abdominal incision; also spelled caesarean section (Figure 5.31). Congenital Malformation present at or existing from birth (Figure 5.32). anomaly Congenital means present at or existing from birth. An anomaly is a defect or malformation. Eclampsia Decreased calcium during lactation causing convulsions and coma; commonly called milk fever in most species. Cattle have a similar disorder called periparturient hypocalcemia. Ectopic pregnancy Fertilized ovum becomes implanted outside the uterus. Embryo transfer Transfer of fertilized ova from one female to another. Typically done with cattle. Episiotomy Incision through the skin of the perineum to enlarge the vaginal opening for delivery. Fetotomy Surgical excision of a fetus; also known as embryotomy or abortion. Galactorrhea Abnormal, persistent discharge of milk. Hydrocephalus Abnormal accumulation of fluid in the spaces of the brain. Commonly called water on the brain. Leukorrhea Sticky, white discharge from the vagina indicative of a disease elsewhere in the reproductive system. Malpresentation Faulty fetal presentation. Pneumovagina Involuntary aspiration of air into the vagina due to a conformational defect. Seen in cattle and horses. Animals are commonly referred to as windsuckers. Pyometra Pus in the uterus (Figure 5.33).

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(A)

(B)

(C)

(D)

(E)

(F)

Figure 5.31  Cesarean section. (A) Uterine horns containing puppies. Source: Courtesy of Nora Vanatta. (B) Removal of a puppy by C‐section. Source: Courtesy of Lindsey Steele, AAS. (C) Removal of a kitten by C‐section. Source: Courtesy of shutterstock/PardoY. (D) Newborn kitten after C‐section. Source: Courtesy of shutterstock/PardoY. (E) Bovine C‐section in the field. Source: Courtesy of shutterstock/Khaiwahan Pao. (F) Newborn calf after C‐section in the field. Source: Courtesy of shutterstock/Khaiwahan Pao.

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(A)

(B)

Figure 5.32  Examples of congenital anomalies. (A) Deformed mouth on a crocodile. Source: Courtesy of shutterstock/Shunsho. (B) Deformed beak on a goose. Source: Courtesy of shutterstock/chris2766.

Figure 5.33  Pyometra in a dog. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

TECH TIP 5.10  What Is Pus? Pus is a protein‐rich inflammatory product which consists of white blood cells, thin fluid, and cellular debris.

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Retained placenta Failure to pass the placenta after delivery of the fetus. Causes metritis and eventually infertility. Ultrasound Diagnostic technique using ultrasound waves to produce an image of an organ or tissue. Uterine prolapse Displacement of the uterus through the vaginal orifice (Figure 5.34). (A)

(B)

Figure 5.34  (A) Uterine prolapse in a cow. Note the caruncles from the endometrium. (B) Uterine prolapse in a dog. Source: (B) Courtesy of Chynel Dobbs, CVT.

Vaginal cytology Vaginal prolapse

Study of cells from the vagina to determine stage of heat. Displacement of the vagina through the vaginal orifice.

Canine Age and Sex

Feline Age and Sex

Stud

Tom Queen

Bitch Whelp Whelping Pack Litter

Intact male dog (Figure 5.35A). Intact female dog. Young dog or pup. Giving birth to whelps. Group of dogs. Multiple offspring from the same labor.

Intact male cat. Intact female cat (Figure 5.35B). Kitten Young cat. Queening Giving birth to kittens. Clowder Group of cats. Also known as a glaring. Litter Multiple offspring from the same labor. Also called a kindle.

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(A)

(B)

Figure 5.35  (A) Havanese stud and bitch with their litter. Source: Courtesy of shutterstock/Cartman0052007. (B) A Sphynx queen with her newborn kitten. Source: Courtesy of Beth Romano, AAS, CVT.

Building the Terms Now it’s time to assemble the word parts listed in Tables 5.4–5.6. If you memorize the meaning of the combining forms, prefixes,

and suffixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 5.4  Female combining forms.

Combining forms

Definition

Combining forms

Definition

Amni/o

Amnion (amniotic sac)

O/o

Egg

Cervic/o

Cervix; neck

Obstetr/o

Midwife; one who receives

Colp/o

Vagina

Oophor/o

Ovary

Cyt/o

Cell

Ov/i

Egg

Episi/o

Vulva

Ov/o

Egg

Galact/o

Milk

Ovari/o

Ovary

Genit/o

Related to birth; reproductive organs

Ovul/o

Egg

Gest/o

Pregnancy

Part/o

Birth; labor

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Table 5.4  (Continued )

Combining forms

Definition

Combining forms

Definition

Gestat/o

Pregnancy

Pelv/i, Pelv/o

Pelvis, hip

Gester/o

Pregnancy

Parturit/o

Birth; labor

Gynec/o

Woman

Perine/o

Perineum

Hyster/o

Uterus; womb

Py/o

Pus

Lact/o

Milk

Radi/o

X‐rays; radius; radioactivity

Later/o

Side

Salping/o

Fallopian tubes; uterine tubes; auditory (Eustachian) tubes

Mamm/o

Mammary glands

Umbilic/o

Umbilicus; navel

Mast/o

Mammary glands

Uter/o

Uterus; womb

Metr/o

Uterus; womb; measure

Vagin/o

Vagina

Metri/o

Uterus; womb

Viv/o

Life

My/o

Muscle

Vulv/o

Vulva

Nat/i

Birth

Table 5.5  Female prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

nulli‐

none

ante‐

before; forward

oxy‐

sharp; swift; rapid; acid; oxygen; quick

bi‐

two; both

peri‐

surrounding

di‐

twice

post‐

after; behind

dys‐

bad; painful; difficult; abnormal

primi‐

first

in‐

in; into; not

pro‐

before; forward

intra

within; into

pseudo‐

false

multi‐

many

vivi‐

live; life

neo‐

new

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Table 5.6  Female suffixes.

Suffixes

Definition

Suffixes

Definition

‐al, ‐an, ‐ary

pertaining to

‐metry

measurement

‐ation

process; condition

‐osis

abnormal condition

‐centesis

surgical puncture to remove fluid

‐para

to bear; bring forth (live births)

‐cyesis

pregnancy

‐parous

to bear; bring forth

‐cyte

cell

‐partum

birth; labor

‐ectomy

removal; excision; resection

‐plasty

surgical repair

‐genesis

producing; forming

‐rrhaphy

suture

‐graphy

process or recording

‐rrhea

flow; discharge

‐gravida

pregnancy

‐scopy

visual examination

‐itis

inflammation

‐tocia

labor; birth

‐ium

structure; tissue

‐tomy

incision; process of cutting into

‐logy

study of

‐version

to turn

Parts

Medical Term

Amni/o Cervic/o Cervic/o endo‐

+ ‐centesis + ‐itis + ‐al +  Cervic/o + ‐itis

= Amniocentesis = Cervicitis = Cervical = Endocervicitis

Colp/o Colp/o Cyt/o a‐ Hyster/o Hyster/o Lact/o Mamm/o Mamm/o

+ ‐scopy + ‐rrhaphy + ‐logy +  Galact/o + ‐ia + ‐ectomy + ‐scopy + ‐genesis + ‐ary +  ‐ary + Carcin/o + ‐oma

Mamm/o Mast/o Mast/o Metr/o endo‐

+ ‐plasty + ‐itis + ‐ectomy + ‐itis +  Metr/o + ‐itis

= Colposcopy = Colporrhaphy = Cytology = Agalactia = Hysterectomy = Hysteroscopy = Lactogenesis = Mammary = Mammary carcinoma (Figure 5.36) = Mammoplasty = Mastitis =  Mastectomy (Figure 5.37) = Metritis = Endometritis

Definition : ____________ : ____________ : ____________ : ____________ Remember your rules for the prefix “endo‐” : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________

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(A)

(B)

Figure 5.36  (A) Mammary carcinoma in a dog. Chances of cancer increase by 10% each time a female goes into heat. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (B) Ovarian carcinoma in a dog. Source: Courtesy of shutterstock/P.Fabian.

endo‐ Py/o neo‐ neo‐ O/o O/o Oophor/o

+  Metri/o + ‐osis +  Metr/o + ‐itis +  Nat/i + ‐al +  Nat/i + ‐logy + ‐genesis + ‐cyte + ‐ectomy

= Endometriosis = Pyometritis = Neonatal = Neonatology = Oogenesis = Oocyte = Oophorectomy

: ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________

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Figure 5.37  Full‐chain mastectomy. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

bi‐

+ Later/o + ‐al + Oophor/o + ‐ectomy Ovari/o + ‐an Ovari/o +  Hyster/o + ‐ectomy an‐ +  Ovul/o + ‐ation ante‐ + ‐partum post‐ + ‐mortem post‐ + ‐partum Pelv/i + ‐metry Perine/o + ‐rrhaphy pseudo‐ + ‐cyesis Py/o + ‐rrhea Radi/o + ‐graphy oxy‐ + ‐tocia dys‐ + ‐tocia Umbilic/o + ‐al Vagin/o + ‐itis Vulv/o + ‐plasty Vulv/o +  Vagin/o + ‐itis

=  Bilateral oophorectomy

: ____________

= Ovarian = Ovariohysterectomy = Anovulation = Antepartum = Postmortem = Postpartum =  Pelvimetry (Figure 5.38) = Perineorrhaphy =  Pseudocyesis (Figure 5.39) = Pyorrhea = Radiography = Oxytocia = Dystocia = Umbilical = Vaginitis =  Vulvoplasty (Figure 5.40) = Vulvovaginitis

: ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________ : ____________

Figure 5.38  Pelvimetry on a pregnant Yorkshire Terrier bitch that was bred with a Shepherd‐mix stud. Pelvimetry can be used to check if the offspring can fit through the birth canal. Source: Courtesy of Beth Romano, AAS, CVT.

Figure 5.39  Pseudocyesis in a dog showing lactation. The dog was spayed shortly after. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

(A)

(B)

Figure 5.40  Vulvoplasty on a Rottweiler showing before (A) and after (B). Source: Courtesy of Tom Shaw, CVT.

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Abbreviations Table 5.7  Abbreviations.

Abbreviation

Definition

AB

Abortion

AI

Artificial insemination

C‐sect

Cesarean section (C‐section)

DES

Diethylstilbestrol

GU

Genitourinary

Gyn

Gynecology

OB

Obstetrics

PG

Pregnant

SC

Scrotal circumference

TVT

Transmissible venereal tumor (Figure 5.41)

OHE, OVH

Spay

SF (F/S)

Spayed female

NM (M/N)

Neutered male

CM

Castrated male

FSH

Follicle‐stimulating hormone

LH

Luteinizing hormone

ad. lib.

As desired

prn

As needed

qn

Every night

qh

Every hour

qd

Every day

SID

Once daily; q24h

BID

Twice daily; q12h

TID

Three times daily; q8h

QID

Four times daily; q6h

EOD

Every other day

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Figure 5.41  TVT in a dog. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Case Study You’ll notice some terms from the previous chapters Sassy, an intact nine‐year‐old female Newfoundland, comes to your clinic after the owner notices a vaginal discharge. On P/E, Sassy is panting excessively and has leukorrhea. There is an odiferous smell coming from Sassy and she keeps licking her vulva. Her abdomen is distended and she has an elevated temperature. After restraining Sassy for the veterinarian, the doctor notes vulvitis. After a thorough examination, radiographs, and blood work, the veterinarian diagnoses Sassy with pyometra. An immediate OHE is recommended and Sassy is placed on antibiotics PO BID. The owner wonders if Sassy’s previous history of dystocia and multiple pregnancies may have contributed to her current condition. The OHE goes well and Sassy has a routine recovery.

Case Study Questions 1. Which of the following describes Sassy’s clinical signs? a. Bloody discharge from the vagina b. Vomiting a white thick substance c. White thick discharge from the vagina 2. Which of the following structures was inflamed? a. Tube from the uterus to the outside of the body b. Womb c. External genitalia 3. Why is surgery necessary? a. Inflammation of the uterus b. Pus in the uterus c. Inflammation of the inner lining of the uterus 4. What kind of surgery was recommended? a. Neuter b. Mastectomy c. Spay

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5. How were the antibiotics given? a. By mouth, once daily b. By mouth, twice daily c. By mouth, three times daily 6. The owner had two concerns about Sassy’s history. What were they? a. Difficult labor and abortions b. Rapid labor and nulliparous c. Difficult labor and multigravida

Exercises 5-A:  Give the definition for the following: 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

hyster/o, metri/o, and uter/o:__________________________________________ ovari/o and oophor/o:________________________________________________ lact/o and galact/o:__________________________________________________ colp/o and vagin/o:___________________________________________________ ov/o and o/o:________________________________________________________ episi/o and vulv/o:___________________________________________________ ‐cyesis and ‐gravida:_________________________________________________ ‐partum and ‐tocia:__________________________________________________ test/o and orch/o:____________________________________________________ pen/i and priap/o:____________________________________________________

5-B:  Give the structure for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14. 

————————————: External female genitalia ————————————: Male gamete ————————————: Tube from ovary to uterine horns ————————————: Site of spermatogenesis ————————————: Sac containing the testes ————————————: Sperm and fluid ————————————: Sensitive tip of the penis ————————————: Inner lining of the uterus ————————————: Lower, neck‐like portion of uterus ————————————: Tube from the urinary bladder to the outside of the body ————————————: Bone found in the penis of some carnivores ————————————: Tube carrying sperm from seminiferous tubules to the vas deferens ————————————: The womb ————————————: Inner membrane surrounding the embryo

5-C:  Define the following terms. 1.  Monorchid ————————————————————————————— 2.  Coitus ———————————————————————————————

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Vasectomy ————————————————————————————— Orchiectomy ———————————————————————————— Ovarian —————————————————————————————— Fetotomy —————————————————————————————— Fetus ——————————————————————————————— Castration ————————————————————————————— Meconium ————————————————————————————— Colostrum —————————————————————————————

5-D:  Define the following: 1.  2.  3.  4.  5.  6. 

—————————: Cervic/o —————————: Semin/i —————————: ‐megaly —————————: primi‐ —————————: Balan/o —————————: nulli‐

7.  8.  9.  10.  11.  12. 

—————————: oligo—————————: ‐cele —————————: ‐pexy —————————: ‐parous —————————: ‐oxy —————————: Py/o

5-E:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Balanitis —————————————————————————————— Spermatogenesis —————————————————————————— Cytology —————————————————————————————— Mastectomy ———————————————————————————— Postpartum ————————————————————————————— Orchiopexy ———————————————————————————— Prostatectomy ——————————————————————————— Endometriosis ——————————————————————————— Pseudocyesis ———————————————————————————— Amniocentesis ———————————————————————————

5-F:  Define the following abbreviations. 1. 2. 3. 4. 5. 6. 7. 8.

—————————: qn —————————: OHE —————————: C‐sect —————————: FS —————————: CM —————————: q24h —————————: PRN —————————: AB

9. 10. 11. 12. 13. 14. 15.

—————————: AI —————————: q6h —————————: MN —————————: qd —————————: q8h —————————: eod —————————: PG

5-G:  Circle the correct term in parentheses. 1.  Animal that gives birth to live young: (oviparous, viviparous) 2.  Area between the anus and scrotum: (peritoneum, perineum)

196

3.  4.  5.  6.  7.  8.  9.  10. 

Veterinary Medical Terminology Guide and Workbook

Termination of pregnancy: (OHE, AB) Fertilized ovum outside the uterus: (ectopic, hermaphroditic) Study of cells to determine stage of heat: (semen analysis, vaginal cytology) The act of giving birth: (gestation, parturition) Sex cell: (gamete, genitalia) Time of sexual receptivity: (proestrus, estrus) Normal secretion of milk: (lactorrhea, lactation) Newborn: (neonate, meconium)

5-H:  Match the following terms with their descriptions. 1.  2.  3.  4.  5.  6.  7.  8. 

_______ Discharge of pus _______ Inflammation of the vagina _______ False pregnancy _______ Visual exam of the vagina _______ Condition of no testes _______ Condition of no milk _______ Removal of both ovaries _______ S uture of the area between the anus and vagina 9.  _______ Uterus returns to normal, non‐pregnant size 10.  _______ Finger‐like projections on uterine tubes

A. B. C. D. E. F. G. H.

Agalactia Anorchism Bilateral oophorectomy Colposcopy Fimbriae Perineorrhaphy Pseudocyesis Pyorrhea

I.

Uterine involution

J. Vaginitis

5-I:  Write the structures in order for the passage of sperm. 1.  2.  3.  4.  5.  6. 

_________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________

5-J:  Write the structures in order for the passage of ovum. 1.  2.  3.  4.  5.  6.  7. 

_________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________

Answers can be found starting on page 675.

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Review Tables Fill in the tables and refer to Tables 5.1–5.7 for answers. Table 5.8

Combining Forms

Definition

Combining Forms

Balan/o

Priap/o

Crypt/o

Prostat/o

Epididym/o

Semin/i

Gen/o

Sperm/o

Hydr/o

Spermat/o

Later/o

Test/o

Orch/o

Theri/o

Orchi/o

Urethr/o

Orchid/o

Vas/o

Pen/i

Zo/o

Definition

Table 5.9

Prefix

Definition

Prefix

a‐, an‐

mono‐

bi‐

oligo‐

Definition

Table 5.10

Suffix

Definition

Suffix

‐al, ‐ar

‐logy

‐cele

‐lytic

‐ectomy

‐megaly

‐genesis

‐one

‐ia

‐pexy

‐ism

‐stomy

‐itis

‐tomy

Definition

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Table 5.11

Combining Forms

Definition

Combining Forms

Amni/o

O/o

Cervic/o

Obstetr/o

Colp/o

Oophor/o

Cyt/o

Ov/i

Episi/o

Ov/o

Galact/o

Ovari/o

Genit/o

Ovul/o

Gest/o

Part/o

Gestat/o

Pelv/i, Pelv/o

Gester/o

Parturit/o

Gynec/o

Perine/o

Hyster/o

Py/o

Lact/o

Radi/o

Later/o

Salping/o

Mamm/o

Umbilic/o

Mast/o

Uter/o

Metr/o

Vagin/o

Metri/o

Viv/o

My/o

Vulv/o

Nat/i

Definition

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Table 5.12

Prefix

Definition

Prefix

a‐, an‐

nulli‐

ante‐

oxy‐

bi‐

peri‐

di‐

post‐

dys‐

primi‐

in‐

pro‐

intra

pseudo‐

multi‐

vivi‐

Definition

neo‐

Table 5.13

Suffixes

Definition

Suffixes

‐al, ‐an, ‐ary

‐metry

‐ation

‐osis

‐centesis

‐para

‐cyesis

‐parous

‐cyte

‐partum

‐ectomy

‐plasty

‐genesis

‐rrhaphy

‐graphy

‐rrhea

‐gravida

‐scopy

‐itis

‐tocia

‐ium

‐tomy

‐logy

‐version

Definition

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Table 5.14

Abbreviation AB AI C‐sect DES GU Gyn OB PG SC TVT OHE, OVH SF (F/S) NM (M/N) CM FSH LH ad. lib. prn qn qh qd SID BID TID QID EOD

Definition

Chapter 5  The Reproductive System

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning ­materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

6

The Cardiovascular System

The cardiovascular system consists of the heart and blood vessels. The goal of these structures is to circulate blood – which is made up of cells, water, nutrients, gases, and much more  –  to tissues throughout the body. This chapter focuses on the heart and blood vessels.

Blood Vessels Before discussing the anatomy of the heart, we must first introduce blood vessels. There are three major types of blood vessels in the body: arteries, veins, and capillaries (Figure 6.1). Arteries are the largest of the blood vessels and always carry blood away from the heart. They have an inner lining called endothelium, which is a layer of epithelial cells that can be found lining the heart cavities and blood vessels. The endothelial cells in the arteries are able to increase and decrease the size of the artery itself, which then affects the blood flow. The layer surrounding the endothelial cells is smooth muscle. Arteries pump a large volume of blood from the heart so they need the strength to carry that blood to the rest of the body without rupturing. Arteries eventually branch out to various

organs and the extremities of the body. These smaller branches of arteries are called arterioles, and they carry blood to the capillaries. Capillaries are the smallest of all the blood vessels. They are lined with a single layer of endothelial cells. The capillaries are where systemic gas exchange occurs. The oxygenated blood that was brought to the capillaries crosses the lining of the capillaries into the tissues. Simultaneously, as the tissue is receiving oxygen, it’s releasing carbon dioxide and other waste products into the capillaries. The newly deoxygenated blood then begins traveling back to the heart by entering smaller veins called venules. These venules then branch out and enlarge into veins. Veins always carry blood toward the heart. As with arteries, a common mistake is to think that all veins are blue and carry deoxygenated (oxygen‐poor) blood. That is not always the case. Veins are smaller than arteries because the volume of blood they carry is considerably smaller. Unlike arteries and capillaries, veins contain interior valves that prevent the blood from flowing in the opposite direction. These valves are required due to the veins’ lack of muscle strength. If a patient has hypertension (high blood pressure), then

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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(A) Superficial temporal a.

Infraorbital a.

Internal carotid a. Common carotid a. Vertebral a.

Facial a.

Intercostal aa. Renal a.

Abdominal aorta

Left external iliac a.

Lingual a.

Cranial gluteal a. Right and left common carotid aa. Costocervical trunk Left subclavian a. Brachiocephalic trunk Aorta Heart Brachial a.

Caudial gluteal a.

Deep femoral a. Medial circumflex a. Pudendoepigastric trunk Femoral a.

Collateral ulnar a. Superficial brachial a. Common interosseous a.

Distal caudal femoral a. Internal thoracic a.

Median a.

External pudendal a. Cranial tribal a.

Ulnar a.

Saphenous a.

Caudal branch of saphenous a.

Radial a. Median a.

Cranial branch of saphenous a.

Dorsal pedal a.

(B)

Capillaries Venule

Arteriole

Vein

Artery

Endothelial cells

Smooth muscle cells

Smooth muscle cells

Figure 6.1  (A) Cardiovascular system of the dog. Notice that when the vessels bifurcate, or split into another branch, their name changes. Source: Courtesy of shutterstock/Alexander_P. (B) Anatomy of blood vessels. Source: Courtesy of shutterstock/blamb.

Chapter 6  The Cardiovascular System

the valves are unable to work due to the increased volume of blood, which causes the veins to swell. A common misconception is that all arteries carry oxygenated (oxygen‐rich) blood and are red in color. The pulmonary arteries carry deoxygenated blood from the heart to the lungs. TECH TIP 6.1  Venous Valves! When performing venipuncture on animals, sometimes the blood stops flowing into your syringe. The animal didn’t ­necessarily move. When this happens, it’s usually due to the valves within the veins that have closed in response to your needle. Rotating the needle slightly within the vessel should get the blood flowing into your syringe again.

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Pericardium

Membrane surrounding the heart. This ­membrane is actually a two‐layer sac made up of the visceral pericardium and parietal pericardium. The visceral layer adheres to the heart, whereas the parietal layer lines the fibrous outer portion of the pericardium. The space between the heart and the pericardium is termed the pericardial space. Within this pericardial space is a fluid that acts as a lubricant for the membranes as the heart beats. This fluid is called pericardial fluid.

Anatomy of the Heart External Anatomy The heart lies in the thoracic cavity, underneath the body of the sternum between the lungs. The space between the lungs is  called the mediastinum. If one were to  look at the cardiovascular system as a  symphony, then the heart would be its  conductor and the blood vessels, its players. There are three layers of the heart. Endocardium Inner lining of the heart. This layer of endothelial cells lines the chambers and valves within the heart. Myocardium Muscle layer of the heart. This is literally the heart muscle and gives the heart the power to push the blood throughout the body.

TECH TIP 6.2  Remember Your Rules! When “peri‐,” “endo‐,” or “myo‐” are attached to organs that end with the suffix “‐ium,” then their meanings change. “Peri‐” becomes a membrane surrounding that organ. “Endo‐” becomes the inner lining of that organ. “Myo‐” becomes the muscle layer of that organ.

From the outside, the heart has a “top” and a “bottom” where it comes to a point. In fact, the heart is a bit of an oxymoron in how these two parts are named. The top of the heart, where major vessels enter, is called the base. The bottom of the heart, where it comes to a point, is called the apex. On the surface of the heart are small blood vessels which solely supply the heart. The red vessels are coronary arteries and they supply blood and oxygen to the myocardium. The blue vessels on the surface of the heart are the coronary veins.

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The coronary veins remove the heart’s waste products. If the blood supply within these vessels is interrupted, then the heart can no longer function.

Internal Anatomy: the Flow of Blood Use Figure 6.2 to follow the flow of blood in Figure 6.3. Deoxygenated blood enters the heart through the venae cavae. These two veins

are the largest veins in the body. The cranial, or anterior, vena cava carries deoxygenated blood from the upper body to the heart. The caudal, or posterior, vena cava carries blood from the lower body to the heart. The first chamber the blood enters is the right atrium, which is the chamber on the upper right side of the heart. From the right atrium, the blood then passes through the first of several heart valves, the tricuspid valve. The tricuspid valve is also known as the right atrioventricular (AV)

(1) Venae cavae (2) Right atrium

Tricuspid valve

(3) Right ventricle

Pulmonary valve

(4) Pulmonary arteries Inhale O2

(5) Lungs

(6) Pulmonary veins (7) Left atrium Bicuspid valve (8) Left ventricle Aortic valve (9) Aorta

(10) Body Figure 6.2  The flow of blood through the heart.

Exhale CO2

Chapter 6  The Cardiovascular System

207

Aorta (to body)

Left pulmonary artery (to left lung)

10 Aortic valve

Cranial vena cava (from upper body)

Right pulmonary artery (to right lung)

Left pulmonary veins (from left lung)

1

6 9

4

5

Left atrium 7

6

2

Caudal vena cava (from lower body)

Left AV valve (Bicuspid)

8

Right pulmonary veins (from right lung) Right atrium Right Av valve (Tricuspid)

5

Left ventricle

3

1

Pulmonary valve Right ventricle

Figure 6.3  The path of blood through the heart. Source: Courtesy of shutterstock/Alila Sao Mai.

valve. The valve is named based on the number of cusps, or flaps, that are on the valve. After passing through the tricuspid valve, the blood enters the right ventricle, which is on the bottom right side of the heart. The blood moves from the right ventricle through the pulmonary valve and into the pulmonary arteries. Remember that arteries always carry blood away from the heart. The pulmonary arteries carry blood from the heart to the lungs. The blood is still deoxygenated at this point so these arteries are blue in color. The pulmonary arteries branch into smaller vessels, arterioles, which branch further into capillaries. These capillaries are where gas exchange occurs. The blood loses its carbon dioxide and gains fresh oxygen. As the animal inhales oxygen, it crosses from the lungs into the blood. When the animal exhales, the carbon

dioxide in the blood crosses into the lungs. The newly oxygenated blood moves from the capillaries to venules and then to the pulmonary veins. Veins always carry blood toward the heart, so these veins carry blood from the lungs to the heart. Pulmonary veins are red in color because they’re carrying oxygenated blood. Blood enters the heart again through the left atrium in the upper left side of the heart. From the left atrium, the blood passes through the bicuspid valve to the left ventricle. The bicuspid valve is also known as the left AV valve or the mitral valve. The left ventricle is the largest and thickest of all the heart chambers. The heart muscle of the left ventricle is almost three times as thick as that of the right ventricle because of where it has to pump the blood to. While the right ventricle has  to pump blood to the lungs, the left ventricle has to pump blood to the

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rest of the body. From the left ventricle, the blood passes through the aortic valve and into the aorta, the largest artery in the body. The aorta branches out to carry blood to the rest of the body. TECH TIP 6.3  Heart Valves: Helpful Reminders When memorizing the flow of blood through the heart, remember that the blood must go through a valve before it leaves the heart. The valves are named based on the structures that follow them. If you are having difficulty remembering the order of the AV valves, use this sentence to help: You TRY something before you BUY it. In other words, the tricuspid is before the bicuspid.

The deoxygenated blood never mixes with the oxygenated blood in a healthy heart because of partitions within the heart called septa (singular: septum). The upper

two chambers of the heart are ­separated by the interatrial septum. The lower two chambers of the heart are separated by the interventricular septum. If an animal has a septal defect, then a hole in one or both of the partitions is allowing the two kinds of blood to mix. In this case the deoxygenated blood would be pumped to the rest of the body. Please note that fetal circulation differs from the blood flow described here. This chapter focuses on normal circulation after birth.

The Heartbeat The heartbeat is created through a series of electrical impulses that travel through  the myocardium (Figure  6.4). The electrical impulses are created through a collection of specialized muscle fibers called the sinoatrial node (SA node). The rhythm of the heart’s contraction is established through the SA node, which is why it is commonly called the pacemaker of the heart. The impulse

Vena cava Left atrium Right atrium Bundle branches

Sinoatrial node (pacemaker)

Atrioventricular node

Atrioventricular bundle

Purkinje fibers Figure 6.4  The conduction system of the heart. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 6  The Cardiovascular System

produced by the SA node causes the atria to contract and thereby causes the blood to move to the ventricles. The electrical impulse then travels from the SA node to the next collection of muscle fibers called the atrioventricular node (AV node), which resides in the interatrial septum. The function of the AV node is to carry the electrical impulse from the SA node to the walls of the ventricles. The impulse moves from the AV nodes through a bundle of specialized muscle fibers called the atrioventricular bundle or bundle of His. The bundle runs through the interventricular septum to the walls of the ventricles and branches further into small muscle fibers called

209

Purkinje fibers. The bundle of His and Purkinje fibers cause the ventricles to contract. The contraction phase of the heartbeat is termed systole. When systole occurs, both the pulmonary and aortic valves are open and blood is pumped to the lungs and body. The tricuspid and bicuspid valves are closed. The relaxation phase of the heartbeat is termed diastole. Diastole occurs when both the tricuspid and bicuspid valves are open and blood is pumped to both ventricles. The pulmonary and aortic valves are closed. To summarize, the heart is pumping during systole and then filling during diastole (Figure 6.5).

Operation of the heart valves

Diastole

Systole

Figure 6.5  The flow of blood during systole and diastole. Note the valves that are open and closed during each cycle. In systole, the ventricles pump blood and the AV valves remain closed. In diastole, the ventricles fill with blood and the AV valves remain open, and both atria and ventricles are at rest. Source: Courtesy of shutterstock/Alila Sao Mai.

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When listening to the heart with a stethoscope, the sounds heard are described as a “lub‐dub” sound. The sounds are created when the heart valves close. The first sound, the lub, can be heard when both the tricuspid and bicuspid valves close. This is the beginning of systole. The second sound, the dub, can be heard when the aortic and pulmonary valves close at the end of systole. If an extra heart sound is heard, then it is referred to as a murmur. Heart murmurs can be caused by abnormal thickness of vessels, abnormal diameter of vessels, and abnormal blood flow. There are many causes of abnormal blood flow. Murmurs are typically assigned

a grade depending on their severity. For example, a grade I heart murmur is softest. Grade VI murmurs are so loud they can be heard without a stethoscope. Listening to where the murmur is heard during the lub‐ dub can isolate where the cause may lie.

Electrocardiogram The electrocardiogram (ECG or EKG) is the record of electricity in the heart, or more specifically, the heart muscle (Figure  6.6). The procedure of an EKG involves using colored wires (conductors) called leads that are connected from the R

P

1 1

T Q S 2 3 4

5

6 3

2

Atrial depolarization begins

4

Ventricular depolarization begins Atria repolarize

Atrial depolarization complete

6

5

Ventricular depolarization complete

Ventricular repolarization begins

= Depolarization

Ventricular repolarization complete

= Repolarization

Figure 6.6  Comparison of the electrical activity of the myocardium with an EKG tracing. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 6  The Cardiovascular System

211

Figure 6.7  EKG leads on an older Corgi during dental surgery. Note the sphygmomanometer attached to her right rear leg.

patient to the EKG machine. Each lead is connected to a specific area of the body (Figure 6.7). The animal is usually placed in right lateral recumbency. The placement of the leads is as follows: White lead Green lead Black lead Red lead

Right front Right rear Left front Left rear

There is sometimes a fifth lead (brown lead) that acts as a ground. A mnemonic to help remember the placement of the leads is “snow [white] over grass [green], smoke [black] over fire [red].” “White” rhymes with “right” to help get things started. The EKG machine measures the electrical changes in the heart muscle by tracing the changes in polarity. The machine then prints this activity as a series of waves (deflections) called tracings (Figure 6.8). P wave

Represents atrial function, specifically depolarization or excitation of the atria. PR segment Represents conduction through the AV node.

QRS wave

Represents ventricular function, specifically the excitation of the ventricles. ST segment Represents the end of ventricular depolarization and the onset of ventricular repolarization. T wave Represents the relaxation phase from the contraction. This is the recovery (repolarization) of the ventricles. If an animal has a normal heart rhythm, then it is called sinus rhythm (Figure 6.9).

Blood Pressure Blood pressure is the pressure of the blood against the walls of the blood vessels. The force of the blood flow is determined by the pumping of the heart, blood volume, resistance of blood flow through arterioles, elasticity of the arteries, and viscosity (thickness) of the blood. Blood pressure generally measures arterial pressure because of the vessel size and volume of blood. In fact, when taking an animal’s pulse, it is the

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R

T

P

Q S

Normal heart complex Figure 6.8  Waves of a typical EKG. The P wave represents atrial function, the QRS wave represents ventricular function, and the T wave represents the relaxation phase of the contraction. Source: Courtesy of shutterstock/ sfam_photo.

Sinus rhythm

Nodal rhythm P

P

P

P

Heart block

Atrial flutter

Atrial fibrillation

Ventricular fibrillation Figure 6.9  Examples of some normal and abnormal EKG tracings. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 6  The Cardiovascular System

213

arteries that are palpated (felt). Blood pressure is measured using a sphygmomanometer (Figure 6.7).

Circulation There are two types of circulation in the body: pulmonary circulation and systemic circulation (Figure 6.10).

External respiration

Pulmonary artery

Pulmonary circulation is the flow of blood from the right side of the heart, to the lungs, and back to the left side of the heart. This is where the oxygenation of blood occurs. Systemic circulation is the flow of blood from the heart, to the tissues, and then back to the heart. It is during systemic circulation that the blood becomes deoxygenated due to gas exchange at the tissue level.

Lung alveoli

CO2

O2

Pulmonary vein

Red blood cells Pulmonary circuit

Systemic veins

Systemic arteries Systemic circuit Red blood cells

CO2

O2

Internal respiration Tissue cells Figure 6.10  Systemic and pulmonary circulation. Source: Courtesy of shutterstock/blamb.

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Related Terms Aorta Aortic valve Apex Artery

Largest artery in the body. Valve between the left ventricle and aorta. Pointed end of the heart (Figure 6.11). A large vessel that carries blood away from the heart (Figure 6.14).

Base

Left coronary artery

Right coronary artery Circumflex artery

Anterior interventricular artery Posterior interventricular artery

Marginal artery Apex Figure 6.11  External anatomy of the heart. Source: Courtesy of shutterstock/Alila Sao Mai.

Atrioventricular bundle Atrioventricular node (AV node) Atrioventricular valves (AV valves) Atrium (plural: atria) Base Bicuspid valve Bifurcate

Specialized muscle fibers in the interventricular septum that carry electrical impulses to the ventricles. Also called the bundle of His. Specialized tissue in the interatrial septum; carries impulses from the SA node to the walls of the ventricles. Valves between the atria and ventricles. Two upper heart chambers. Cranial portion of the heart (Figure 6.11). Valve between the left atrium and left ventricle. Also called the mitral valve or left AV valve. Splitting into two branches.

Chapter 6  The Cardiovascular System

Capillaries Carbon dioxide (CO2) Coronary arteries Deoxygenated blood Diastole Endocardium Endothelium Myocardium Oxygen (O2) Oxygenated blood Pericardium

215

Smallest blood vessels. Gas released by tissue cells and transported to the heart and lungs for exhalation. Supply blood and oxygen to the myocardium (Figure 6.11). Oxygen‐poor blood. The relaxation phase of the heartbeat. Inner lining of the heart. Epithelial cells lining the heart cavities and vessels. Muscle layer of the heart. Gas that enters the blood through the lungs and travels to the heart to be pumped to the rest of the body. Oxygen‐rich blood. Membrane surrounding the heart (Figure 6.12).

Figure 6.12  Pericardium on a dissected sheep heart.

Pulmonary artery Pulmonary circulation Pulmonary valve Pulmonary veins Pulse

Artery that carries deoxygenated blood from the heart to the lungs. Flow of blood from the heart, to the lung, and back to the heart. Valve between the right ventricle and pulmonary artery. Veins that carry oxygenated blood from the lungs to the heart. Heartbeat felt through the walls of the arteries. A bounding pulse is a strong and powerful pulse. A thready pulse is a pulse that’s difficult to feel.

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Semilunar valves

Valves between the entrances of the aorta and pulmonary artery. Referred to as semilunar because they are shaped like a half‐moon. Partition Pacemaker of the heart. Normal heart rhythm. Flow of blood from the body cells to the heart and back out to the body cells. Contraction phase of the heart. Structures in veins and in the heart that temporarily close an opening so that blood can flow in one direction (Figure 6.13).

Septum Sinoatrial node Sinus rhythm Systemic circulation Systole Valves

(A) Normal functioning valves

Malfunctioning valves

(B)

Deep vein High pressure causes distention of vein and valve failure

Superficial vein Valve open

Valve closed

(C) Pulmonary valve

Tricuspid valve

Aortic valve

Mitral valve

Mechanical valves

Biological valves

Figure 6.13  (A) External view of valves in the veins. Source: Courtesy of shutterstock/blamb. (B) Internal view of valves in the veins. Source: Courtesy of shutterstock/blamb. (C) Types of heart valve. Source: Courtesy of shutterstock/Designua.

Chapter 6  The Cardiovascular System

217

Vein Smooth muscle

Inner layer

Vein

Valve

Valve Outer layer

Smooth muscle

Elastic layer

Inner layer Outer layer

Artery

Artery

Figure 6.14  Comparison of a vein and artery. Source: Courtesy of shutterstock/Designua.

Vein Vena cavae (singular: vena cava) Ventricles

Thin‐walled vessel that carries blood toward the heart (Figure 6.14). Largest vein in the body. Two lower chambers of the heart.

Pathology and Procedures Aneurysm Arrhythmia Asystole Atherosclerosis Atrial septal defect (ASD) Auscultation

Cardiac hypertrophy (HCM)

Sac (dilation) formed by weakening of a blood vessel. Can lead to hemorrhage and stroke (Figure 6.15). Abnormal heart rhythm. Also called dysrhythmia. Without contraction; lack of heart activity. Hardening of arteries due to plaque buildup (Figure 6.16). Small hole(s) in the interatrial septum. Listening with a stethoscope to sounds within the body. Thoracic auscultation is used to listen to heart and breath sounds. Abdominal auscultation is often used to listen to gut sounds (Figure 6.17). Enlargement of the heart due to increased cell size (Figure 6.18).

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Descending thoracic aneurysm

Endovascular surgery

Figure 6.15  Thoracic aneurysm. Source: Courtesy of shutterstock/Alila Sao Mai.

Normal artery

Blood flow

Artery narrowed by plaque

Atherosclerotic plaque

Figure 6.16  Atherosclerosis. Source: Courtesy of shutterstock/Rob3000.

Chapter 6  The Cardiovascular System

219

Figure 6.17  Abdominal auscultation of a horse. Source: Courtesy of shutterstock/OPIS.

Left ventricular hypertrophy

Normal heart Right ventricle

Left ventricle

Thickening of the myocardium of the left ventricle

Figure 6.18  Cardiomyopathy comparison. Source: Courtesy of shutterstock/Alila Sao Mai.

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Cardiac tamponade Congenital heart disease (CHD) Congestive heart failure (CHF) Capillary refill time (CRT) Defibrillation

Veterinary Medical Terminology Guide and Workbook

Compression of the heart due to fluid or blood in the pericardial sac. Abnormalities of the heart at birth. Heart is unable to pump its required amount of blood. The time it takes for the mucous membranes to return to a normal pink color after applying finger pressure. Use of electrical shock to restore normal heart rhythm (Figure 6.19).

Figure 6.19  A defibrillator. Source: Courtesy of shutterstock/Renewer.

Echocardiogram (ECHO) Embolism Embolus (plural: emboli) Fibrillation Flutter Heartworm disease Hyperemia

High‐frequency sound waves and echoes that produce an image of the heart (Figure 6.20). Blockage of a vessel by a clot or foreign material. A detached, moving clot. Rapid, random, and irregular contractions of the heart (Figure 6.21). Rapid but regular contractions of the atria and ventricles. Can be further isolated as an atrial flutter or ventricular flutter depending on the chambers involved. Infestation of the parasite Dirofilaria immitis in the right ventricle and pulmonary arteries. Transmitted after a blood meal from a mosquito (Figure 6.22). Excessive blood in a body part. This usually occurs due to vasodilation.

Chapter 6  The Cardiovascular System

221

Figure 6.20  Echocardiogram and color Doppler flow. Source: Courtesy of shutterstock/Renewer.

Sinus node

Atrial fibrillation impulses

Normal electrical pathways

Chaotic signals Rapid ventricular impulses

Atrioventricular node Normal heart

Atrial fibrillation

Figure 6.21  Atrial fibrillation. Source: Courtesy of shutterstock/Designua.

Figure 6.22  Blood film showing the microfilariae (larvae) of heartworm.

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Hypertension Hypotension Hypoxia Infarction Ischemia Ligate Mitral valve prolapse (MVP) Murmur Occlusion Patent

Veterinary Medical Terminology Guide and Workbook

Increased blood pressure. Decreased blood pressure. Decreased oxygen to tissues. Area of dead tissue. Lack of blood flow to tissues. To tie off a vessel to prevent bleeding or to constrict tissue using ligature. Ligature is material such as a thread or wire. Displacement of the bicuspid valve leading to incomplete closure of the valve during ventricular contraction (Figure 6.23). An extra heart sound. Blockage; obstruction or closure of body passage. Open; unobstructed. Term can be used to describe vessels and catheters.

TECH TIP 6.4  Ischemia vs. Hypoxia Be careful with the differences between these two conditions.

Mitral valve

Ischemia is a lack of blood flow to tissues. This can lead to tissue necrosis, and this tissue turns a black color. Hypoxia is a lack of oxygen to tissues. This can lead to cyanosis, or an abnormal blue color. Ultimately a lack of blood flow to tissues leads to a lack of oxygen in tissues because red blood cells carry oxygen.

Figure 6.23  Illustration of mitral valve prolapse. Note the regurgitation of blood due to improper closing of the valve. Source: Courtesy of WikiCommons/BruceBlaus.

Patent ductus arteriosus (PDA)

Perfusion (tissue perfusion)

Condition in which the small duct between the aorta and pulmonary artery, which normally closes after birth, remains open. The duct itself is called the ductus arteriosus. PDA causes continuous murmur, fatigue, and exercise intolerance. It is the most common heart malformation in dogs and is most often seen in Collies, Shelties, Old English Sheepdogs, and Pomeranians (Figure 6.24). Passage of fluid through the blood vessels of a specific organ; blood flow through the tissue.

Chapter 6  The Cardiovascular System

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Patent ductus arteriosus Aorta

Left pulmonary artery

Figure 6.24  Cross‐section of a heart with a patent ductus arteriosus. This duct should close soon after birth. If it remains open, oxygenated and deoxygenated blood will mix. Source: Courtesy of WikiCommons/ BruceBlaus.

Pericardial effusion

Escape of fluid into the pericardial sac leading to cardiac tamponade. An effusion is an escape of fluid and can occur anywhere in the body (Figure 6.25).

Figure 6.25  Radiograph of a pericardial effusion. Source: Courtesy of shutterstock/P.Fabian.

Premature ventricular contraction (PVC, VPC) Shock Sphygmomanometer

Ventricles are triggered to contract by the Purkinje fibers rather than the SA node. Inadequate tissue perfusion. Blood pools in the capillaries to increase the blood volume of the patient, which then decreases its flow to vital organs (Figure 6.26). Instrument that measures arterial blood pressure.

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Plaque Artery tent

ed s

Clos

Catheter nded

Expa

t

sten

Balloon

Stent Compressed plaque

Figure 6.27  Stent placement to prevent vessel collapse. Source: Courtesy of shutterstock/Alila Medical Images.

Figure 6.26  Dog in shock. Note the pale mucous membranes due to inadequate tissue perfusion. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Stent

Small expander inserted into tubular structures such as vessels to provide support and prevent collapse (Figure 6.27). Stethoscope Instrument used to listen to sounds within the body (Figure 6.28). Tetralogy of Fallot Congenital malformation of the heart that combines four structural defects: pulmonary artery stenosis, ventricular septal defect, aortic right shift, and right ventricular hypertrophy (Figure 6.29). Thrill Vibration felt on palpation of the chest. Usually caused by turbulence in the heart. Thrombus Stationary clot attached to the wall of a vessel (plural: thrombi) (Figure 6.30). Ventricular septal defect Small hole(s) in the interventricular septum. Causes (VSD) shunting of the blood and therefore deoxygenated blood is pumped to the rest of the body (Figure 6.31). Vasoconstriction Narrowing of a vessel (Figure 6.32). Vasodilation Expansion of a vessel (Figure 6.32).

Chapter 6  The Cardiovascular System

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Eartip Tubing

Headset Stem Bell (Light skin contact for low frequency sound)

Diaphragm (Firm skin contact for high frequency sound)

Chestpiece

Figure 6.28  Parts of the stethoscope. Source: Courtesy of shutterstock/blamb.

Displacement of aorta: connected to both ventricles

Narrowing of the pulmonary tract

Ventricular septal defect: hole between right and left ventricles

Thickening of wall of right ventricle Figure 6.29  Congenital heart disease: tetralogy of Fallot. Source: Courtesy of shutterstock/Alila Sao Mai.

Thrombus

Occlusive thrombus

Embolus

Figure 6.30  Thrombus vs. embolus. Source: Courtesy of shutterstock/Alila Medical Images.

Figure 6.31  Ventricular septal defect. Source: Courtesy of shutterstock/Alila Sao Mai. Sympathetic nerve fiber Artery

High rate of firing

Vasoconstriction

Sympathetic nerve fiber

Low rate of firing

Vasodilation Figure 6.32  Vasoconstriction and vasodilation. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 6  The Cardiovascular System

Building the Terms Now it’s time to assemble the word parts listed in Tables 6.1–6.3. If you memorize the meaning of the combining forms, prefixes,

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and suffixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 6.1  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Angi/o

Vessel

Necr/o

Death

Aort/o

Aorta

Ox/o

Oxygen (O2)

Arter/o

Artery

Pericardi/o

Pericardium

Arteri/o

Artery

Phleb/o

Vein

Ather/o

Plaque (fatty substance)

Sphygm/o

Pulse

Atri/o

Atrium

Steth/o

Chest

Capn/o

Carbon dioxide (CO2)

Thorac/o

Chest

Cardi/o

Heart

Thromb/o

Clot

Cholesterol/o

Cholesterol

Valv/o

Valve

Coron/o

Heart

Valvul/o

Valve

Cyan/o

Blue

Vascul/o

Vessel

Electr/o

Electricity

Vas/o

Vessel; vas deferes; duct

Hem/o

Blood

Ven/i

Vein

Isch/o

To hold back; back

Ven/o

Vein

Man/o

Pressure

Ventricul/o

Ventricle

My/o

Muscle

Table 6.2  Prefixes.

Prefix

Definition

Prefix

Definition

brady‐

slow

inter‐

between

endo‐

in; within

peri‐

surrounding; around

hyper‐

above; excessive; increased

tachy‐

fast

hypo‐

deficient; below; under; less than normal; decreased

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Table 6.3  Suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐ic, ‐ous

pertaining to

‐oma

tumor; mass; collection of fluid

‐centesis

surgical puncture to remove fluid

‐osis

abnormal condition

‐ectomy

removal; excision; resection

‐otic

pertaining to an abnormal condition

‐emia

blood condition

‐oxia

oxygen

‐gram

record

‐pathy

disease condition

‐graph

instrument for recording

‐plasty

surgical repair

‐graphy

process of recording

‐rrhaphy

suture

‐ia

condition

‐sclerosis

hardening

‐itis

inflammation

‐stenosis

tightening; narrow; stricture

‐lysis

breakdown; destruction; separation; loosening

‐tension

pressure

‐megaly

enlargement

‐tomy

incision; process of cutting

‐meter

measure

‐ule

small; little

‐ole

small; little

Angi/o Angi/o Angi/o Angi/o Hem/o Aort/o

Parts

Medical Term

+ ‐gram + ‐pathy + ‐plasty + ‐rrhaphy + Angi/o + ‐ic

= Angiogram : __________ = Angiopathy : __________ = Angioplasty : __________ = Angiorrhaphy : __________ = Hemangioma : __________ = Aortic stenosis : __________ Remember that stenosis can be a term by itself, not just a suffix. The definition is the same.

+ ‐oma + Stenosis

Definition

Chapter 6  The Cardiovascular System

endo‐ Arteri/o Arteri/o Arteri/o Arteri/o Arteri/o Arteri/o Atri/o Atri/o Capn/o hyper‐ hypo‐ brady‐ Cardi/o Cardi/o Cardi/o endo‐

+ Arter/o + ‐al + ‐ectomy + ‐graphy + ‐sclerosis + ‐tomy + ‐ole + ‐al + Ventricul/o + ‐graph + Capn/o + Capn/o + Cardi/o + ‐megaly + My/o + ‐itis + Cardi/o

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+ ‐ectomy = Endarterectomy : __________ + Anastomosis = Arterial anastomosis : __________ = Arteriectomy : __________ = Arteriography : __________ = Arteriosclerosis : __________ = Arteriotomy : __________ = Arteriole : __________ = Atrial : __________ + ‐ar = Atrioventricular : __________ = Capnograph : __________ + ‐ia = Hypercapnia : __________ + ‐ia = Hypocapnia : __________ + ‐ia = Bradycardia : __________ = Cardiomegaly : __________ + ‐pathy = Cardiomyopathy : __________ = Carditis : __________ + ‐itis = Endocarditis : __________ Remember your rules for “endo‐” when attached to an organ. tachy‐ + Cardi/o + ‐ia = Tachycardia : __________ hyper‐ + Cholesterol/o + ‐emia = Hypercholesterolemia : __________ Cyan/o + ‐osis = Cyanosis : __________ Cyan/o + ‐otic = Cyanotic : __________ Electr/o + Cardi/o + ‐gram = Electrocardiogram : __________ Electr/o + Cardi/o + ‐graph = Electrocardiograph : __________ hypo‐ + ‐oxia = Hypoxia : __________ hypo‐ + ‐oxia + ‐ic = Hypoxic : __________ mitral + Valvul/o + ‐itis = Mitral valvulitis : __________ Necr/o + ‐osis = Necrosis : __________ Pericardi/o + ‐centesis = Pericardiocentesis : __________ Phleb/o + ‐itis = Phlebitis : __________ Thorac/o + ‐ic = Thoracic : __________ Thorac/o + ‐tomy = Thoracotomy : __________ Thromb/o + ‐lysis = Thrombolysis : __________ Thromb/o + ‐osis = Thrombosis : __________ (Figure 6.33) Valv/o + ‐tomy = Valvotomy : __________ Valvul/o + ‐plasty = Valvuloplasty : __________ Vascul/o + ‐ar = Vascular : __________ Vascul/o + ‐itis = Vasculitis : __________ Ven/o + ‐ous = Venous : __________ Ven/o + ‐ule = Venule : __________

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Thrombus formation

Figure 6.33  Thrombosis. Source: Courtesy of shutterstock/Rob3000.

Abbreviations Table 6.4  Abbreviations.

Abbreviation

Definition

AF

Atrial fibrillation

AS

Aortic stenosis

ASD

Atrial septal defect (Figure 6.34)

BP

Blood pressure

bpm

Beats per minute/breaths per minute

CHF

Congestive heart failure (Figure 6.35)

CO2

Carbon dioxide

CPA

Cardiopulmonary arrest

CRT

Capillary refill time

CVS

Cardiovascular system

CVP

Central venous pressure

DCM

Dilated cardiomyopathy

DVT

Deep vein thrombosis

ECHO

Echocardiogram

Chapter 6  The Cardiovascular System

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Table 6.4  (Continued )

Abbreviation

Definition

EKG, ECG

Electrocardiogram

H2O

Water

HCM

Hypertrophic cardiomyopathy

HR

Heart rate

MI

Myocardial infarction

MR

Mitral regurgitation

MVP

Mitral valve prolapse

O2

Oxygen

PAC

Premature atrial contraction

PEA

Pulseless electrical activity

PDA

Patent ductus arteriosus

PVC

Premature ventricular contraction

ROSC

Return of spontaneous circulation

SOB

Short of breath

V fib

Ventricular fibrillation

VPC

Ventricular premature contraction; ventricular premature complexes

VSD

Ventricular septal defect

VT, V tach

Ventricular tachycardia

Atrial septal defect Right atrium

Left atrium

Left ventricle

Right ventricle Figure 6.34  Atrial septal defect. Source: Courtesy of WikiCommons/BruceBlaus.

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Right ventricle

Left ventricle Enlarged ventricle

Septum Normal heart

Heart failure

Figure 6.35  Congestive heart failure. Source: Courtesy of shutterstock/Designua.

Case Study You’ll notice some terms from the previous chapters A six‐month‐old Dalmatian named Bailey is brought to the clinic with lethargy. The owner states that Bailey has been resistant to going for walks and begins panting after walking around the yard. Bailey has tachycardia and a delayed CRT. MM are cyanotic and a Grade IV murmur can be heard on thoracic auscultation. The doctor orders radiographs and blood work. The blood work is unremarkable; however, the thoracic radiographs show a slight cardiomegaly. EKG and ECHO are done and PDA is diagnosed. Surgery is performed to tie off the PDA and Bailey has a routine recovery. On the two‐week post op exam, the owner is delighted with Bailey’s recovery. She states that Bailey’s energy has gone up and she’s much friskier at home and at the dog park.

Case Study Questions 1. Why was Bailey lethargic and resistant to walking around? a. Blood on the right side of the heart (deoxygenated) was mixing with blood on the left side of the heart (oxygenated) and then getting pumped to the rest of the body. b. Fluid was collecting between the heart and membrane surrounding the heart, which impeded the heart from beating. c. The bicuspid valve was protruding into the right atrium, disrupting the normal blood flow. 2. What color were Bailey’s MM? a. Pink b. Blue c. Black 3.  Which of the following describes Bailey’s symptoms? a. Slow heart rate b. Fast heart rate c. Increased blood pressure

Chapter 6  The Cardiovascular System

4.  On radiographs, what abnormality was seen? a. Enlarged heart b. Fluid in the lungs c. None of the above 5.  True or false: A Grade II murmur implies a loud heart sound.

Exercises 6-A:  Fill in the following blanks regarding the flow of blood through the heart. 1.  2.  3.  4.  5.  6.  7.  8. 

Venae cavae to the _____________ Left AV valve to the _____________ Pulmonary valve to the _____________ Pulmonary artery to the _____________ Lungs to the _____________ Tricuspid valve to the ______________ Left ventricle to the _______________ Right atrium to the ______________

6-B:  Give the term for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

____________________: Upper chambers of the heart ____________________: Surgical repair of a vessel ____________________: Breakdown of a clot ____________________: Lack of blood flow to tissues ____________________: Supply blood and O2 to myocardium ____________________: Largest vein in the body ____________________: An extra heart sound ____________________: Membrane surrounding the heart ____________________: Listening to sounds within the body ____________________: Narrowing of a vessel ____________________: Valve between the left atrium and ventricle ____________________: Inadequate tissue perfusion ____________________: A detached, moving clot ____________________: Contraction phase of the heartbeat ____________________: Blood flow through tissues

6-C:  Define the following terms. 1.  2.  3.  4.  5. 

Arrhythmia_____________________________________ Stethoscope_____________________________________ Thrill__________________________________________ Hypertension____________________________________ Fibrillation______________________________________

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234

6.  7.  8.  9.  10.  11.  12. 

Veterinary Medical Terminology Guide and Workbook

Sinoatrial node___________________________________ Myocardium_____________________________________ Cardiomegaly____________________________________ Hypoxia_________________________________________ Hypercapnia_____________________________________ Effusion ________________________________________ Bifurcation ______________________________________

6-D:  Define the following: 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15. 

_________________: ‐oxia _________________: ‐tension _________________: Capn/o _________________: Phleb/o _________________: Coron/o _________________: brady‐ _________________: ‐stenosis _________________: ‐lysis _________________: Thromb/o _________________: Ather/o _________________: Vascul/o _________________: ‐ole _________________: ‐otic _________________: Cyan/o _________________: Sphygm/o

6-E:  Define the following abbreviations. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

__________________: VSD __________________: CHF __________________: V fib. __________________: PDA __________________: ECHO __________________: ECG __________________: PVC __________________: V tach. __________________: AS __________________: BP __________________: BPM __________________: CO2 __________________: AF __________________: MI __________________: PAC __________________: CVP __________________: ASD __________________: MR __________________: CPA __________________: PEA

Chapter 6  The Cardiovascular System

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6-F:  Circle the correct term in parentheses. 1.  What procedure would be used for cardiac tamponade? (pericardiocentesis, thoracocentesis) 2.  Technique that can evaluate tissue perfusion: (auscultation, CRT) 3.  EKG wave used to evaluate ventricular function: (P, QRS) 4.  Causes cyanosis: (hypercapnia, hypoxia) 5.  Causes tissue necrosis: (ischemia, hypoxia) 6.  Given for an embolism: (thrombolytic, vasodilator) 7.  Instrument used to listen to murmur: (electrocardiograph, stethoscope) 8.  Felt on thoracic palpation: (thrill, Grade I murmur) 9.  Heartworm infestation leads to: (venous congestion, arterial congestion) 10.  Greyhounds and racehorses may have: (cardiac hypertrophy, pericardial effusion) 6-G:  Match the following terms with their descriptions. 1.  2.  3.  4.  5. 

__________ Inflammation of veins __________ Inflammation of the heart __________ Inflammation of the inner lining of the heart __________ Inflammation of vessels __________ I nflammation of the membrane surrounding the heart 6.  __________ Inflammation of the valve between the left atrium and left ventricle

A.  B.  C.  D.  E. 

Carditis Endocarditis Mitral valvulitis Pericarditis Phlebitis

F.  Vasculitis

6-H:  Match the following conditions with their descriptions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

__________ Displacement of the bicuspid valve. __________ Abnormalities of the heart at birth. __________ Small hole in the interventricular septum. __________ Congenital malformation of the heart with four defects __________ Compression of the heart due to fluid in the pericardium __________ Heart is unable to pump its required amount of blood __________ Sac formed by weakening of a blood vessel. __________ Enlargement of the heart due to cell size. __________ Ventricles contract due to Purkinje fibers. __________ S mall duct between the aorta and pulmonary artery stays open after birth.

Answers can be found starting on page 675.

A.  B.  C.  D. 

Aneurysm Cardiac tamponade CHD CHF

E.  CHM F.  MVP G.  H.  I.  J. 

PDA PVC Tetralogy of Fallot VSD

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Review Tables Fill in the tables and refer to Tables 6.1–6.4 for answers. Table 6.5

Combining Forms

Definition

Combining Forms

Angi/o

Necr/o

Aort/o

Ox/o

Arter/o

Pericardi/o

Arteri/o

Phleb/o

Ather/o

Sphygm/o

Atri/o

Steth/o

Capn/o

Thorac/o

Cardi/o

Thromb/o

Cholesterol/o

Valv/o

Coron/o

Valvul/o

Cyan/o

Vascul/o

Electr/o

Vaso

Hem/o

Ven/i

Isch/o

Ven/o

Man/o

Ventricul/o

Definition

My/o

Table 6.6

Prefix

Definition

Prefix

brady‐

inter‐

endo‐

peri‐

hyper‐

tachy‐

hypo‐

Definition

Chapter 6  The Cardiovascular System

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Table 6.7

Suffix

Definition

Suffix

‐al, ‐ar, ‐ic, ‐ous

‐oma

‐centesis

‐osis

‐ectomy

‐otic

‐emia

‐oxia

‐gram

‐pathy

‐graph

‐plasty

‐graphy

‐rrhaphy

‐ia

‐sclerosis

‐itis

‐stenosis

‐lysis

‐tension

‐megaly

‐tomy

‐meter

‐ule

Definition

‐ole

Table 6.8

Abbreviation

Definition

AF AS ASD BP bpm CHF CO2 CPA CRT CVS CVP DCM DVT (Continued )

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Table 6.8  (Continued )

Abbreviation

Definition

ECHO EKG, ECG H2O HCM HR MI MR MVP O2 PAC PEA PDA PVC ROSC SOB V fib VPC VSD VT, V tach

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

7

The Respiratory Tract

Respiration is the exchange of oxygen and carbon dioxide between the body and the atmosphere. It includes the acts of inspiration (inhalation) and expiration (exhalation) (Figure 7.1). When the animal inhales the room air, oxygen diffuses from the lungs into the blood, and carbon dioxide from the blood to the lungs. Simultaneously at the tissue level, oxygen diffuses from the blood into the tissue cells as carbon dioxide leaves the tissue cells and goes into the blood. The gas exchange that occurs within the lungs is referred to as external respiration and the gas exchange that occurs at the tissue level is referred to as internal respiration. The organs necessary for respiration to occur include the nasal sinuses, pharynx, larynx, and bronchi of the upper respiratory tract, and the bronchioles and alveoli of the lower respiratory tract. Muscles necessary for respiration to occur include the diaphragm, shoulder girdle, thoracic muscles, and intercostals.

Anatomy of the Respiratory Tract When an animal inhales, the oxygen enters the nose through two openings called the nostrils (nares). Once through the nostrils, the air is divided as it moves into the nasal cavity

due to a partition in the nose called a nasal septum. As the air passes through the nasal cavity, it is filtered through cilia which collect any foreign material that was inhaled. Cilia are thin hairs attached to the mucous membrane epithelium lining the respiratory tract. As introduced in Chapter  3, within the facial bones are air spaces called sinuses which are also lined with mucous membrane epithelium. These sinuses produce mucus which helps to lubricate the respiratory tract and warm the room air that is inhaled. The mucus aids the cilia in trapping foreign debris that has been inhaled. The best example of this function is if you have been working in your yard and mowing the lawn. After completing the task, try blowing your nose. You’ll see the debris that the nasal passage has caught as you worked in the yard. After passing through the nasal cavity, air then enters the pharynx (throat). The pharynx is divided into three sections based on their location: the nasopharynx, oropharynx, and laryngopharynx. The nasopharynx is above, or cranial to, the soft palate of the mouth, or behind the nasal cavity. The oropharynx is directly behind the mouth between the soft palate, the tongue, and epiglottis. Finally, the laryngopharynx is the caudal portion of the

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Diaphragm Inspiration

Expiration

Figure 7.1  Stages of respiration. Source: Courtesy of shutterstock/Alila Medical Images.

pharynx that enters the larynx (voice box). If you have difficulty remembering the locations, just try memorizing the combining forms: Nas/o for nose, Or/o for mouth, and Laryng/o for voice box. The three sections of the pharynx work together to direct food and air in the appropriate direction. When swallowing food, the nasopharynx closes to prevent the food from going into the nasal cavity. Simultaneously, the laryngopharynx prepares to direct the food toward the esophagus. In Chapter 4 the epiglottis was introduced as a leaf‐like piece of cartilage covering the trachea to prevent aspiration of food. The epiglottis directs the food swallowed or air inhaled into the appropriate tracts. The laryngopharynx is the common passageway where the epiglottis lies and directs food toward the gastrointestinal tract and air toward the respiratory tract. From the epiglottis, air enters the larynx (voice box). Within the larynx are two lip‐ like structures called vocal folds (vocal cords). The structure containing these folds is called the glottis. It is these two folds that create sound as air passes through. If “debarking” a dog, these two folds are cut to prevent the animal from making sounds, though this procedure isn’t widely done in veterinary medicine in today’s society. If placing an endotracheal tube in a patient before surgery, the epiglottis and vocal folds are our guide to proper tube placement. Once the epiglottis is pulled down, the vocal folds become

visible. If the tube is placed between the vocal folds, then it is assured that it is in the respiratory tract and, more specifically, in the trachea. After air passes the larynx, it enters the trachea (windpipe). The trachea is easily recognized by its cartilaginous rings. Unlike the esophagus, which is a collapsible tube that merely expands with the presence of food, the trachea is a rigid, stiff tube that’s always open in diameter. Label Figure 7.2 using the terms listed in Table  7.1 regarding the flow of air through the respiratory tract. Structures are listed in order of occurrence. Each lung is surrounded by a double‐ folded membrane called the pleura. The outer fold of the membrane is called the parietal pleura, which lines the thoracic cavity. The inner fold of the membrane is called the visceral pleura, which lines the lungs. The small space between the pleural membranes and surrounding each lung is termed the pleural space. Within this space is a thin, watery fluid which helps to lubricate the pleural membranes and moisten the pleura during respiration. This pleural fluid also acts as an adhesive for the lungs to move with the thoracic cavity during respirations. The final structure in the respiratory tract is a thin, muscular partition separating the thoracic and abdominal cavities, the diaphragm. As the diaphragm contracts, it causes the thoracic cavity to expand and the lungs to spread. As the lungs spread, they fill with air (inhalation).

(A)

The respiratory system 1.

Left lung Right lung

2.

2. 3. Terminal bronchioles 4.

7.

Pleura Pleural space

Inhalation

3.

Exhalation O2 CO2

5. 6.

4.

(B)

Trachea

Bronchus

Right lung

Left lung

Bronchioles

Figure 7.2  (A) Anatomy of the respiratory tract. Source: Courtesy of shutterstock/blamb and shutterstock/ Andrea Danti. (B) Ventral view of the lungs of the dog. Source: Courtesy of shutterstock/Alexander_P.

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Table 7.1  Structure of the respiratory tract. Trachea (1)

Windpipe.

Bronchus (2) The bifurcation of the (plural: bronchi) trachea that is a passageway into the air spaces of the lungs. The space in which the bronchi lie is called the mediastinum (7). Bronchioles (3)

Smallest branches of the bronchi.

Alveolus (4) (plural: alveoli)

Air sacs in the lungs located at the ends of the bronchioles.

Capillary (5)

Smallest blood vessel. O2 and CO2 diffuse across the walls of this vessel to and from the alveoli.

Erythrocytes (6)

Red blood cells (RBC). Transport oxygen from the lungs to the rest of the body.

When the diaphragm relaxes, the thoracic cavity returns to its normal size which causes the lungs to expel their air (exhalation).

Related Terms Alveoli Bifurcation Bronchus (plural: bronchi) Bronchioles Capillary Cilia

Air sacs in the lungs. Splitting into two branches. Bifurcation of the trachea; passageway into the air spaces of the lungs. Also called bronchial tubes. Smallest branches of the bronchi; lead to the alveoli. Smallest blood vessel. Thin hairs attached to the mucous membrane epithelium lining the respiratory tract.

Gas released by tissue Carbon dioxide (CO2) cells and transported to the heart and lungs for exhalation. Diaphragm Thin, muscular partition separating the thoracic and abdominal cavities. Epiglottis Leaf‐like piece of cartilage over the trachea (windpipe) to prevent aspiration of food. Expiration Breathing out; exhalation. External Gas exchange occurring respiration in the lungs. Glottis Opening to the larynx (voice box). Inspiration Breathing in; inhalation. Internal Gas exchange occurring respiration at the tissue level. Larynx Voice box. Mediastinum Space between the lungs. Mucous Specialized form of membranes epithelial tissue that secretes mucus. Mucus Slimy substance produced by mucous membranes; contains epithelial cells, salts, white blood cells, and glandular secretions. Nasal cavity Proximal aspect of the respiratory tract within the nose. Olfactory Condition of smelling. Oxygen (O2) Gas that enters the blood through the lungs and travels to the heart to be pumped to the rest of the body. Pharynx Throat. Pleura Membrane surrounding each lung. Pleural cavity Space between the pleural membranes and surrounding each lung. Also called pleural space.

Chapter 7  The Respiratory Tract

Respiration

Respiratory system

Trachea Ventilation Vocal cords (vocal folds)

Exchange of oxygen and carbon dioxide between the body and the atmosphere. Group of organs working together to transfer oxygen from the air to the blood and to transfer carbon dioxide from the blood to the air. Windpipe. Exchange of gas (air) in an enclosed space. Folds of mucous membranes in the larynx that vibrate to create sound.

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Pathology and Procedures Agonal Respirations near death. Antitussives Substances used to control and prevent coughing. Asphyxia Blockage of breathing leading to hypoxia; suffocation. Aspiration Inhalation of a foreign substance into the respiratory tract. Asthma Chronic inflammatory disorder marked by dyspnea (difficulty breathing) and wheezing (Figure 7.3).

Normal bronchiole

Asthmatic bronchiole

Figure 7.3  Asthma. Source: Courtesy of shutterstock/Rob3000.

Atelectasis Auscultation

Blood gas analysis

Incomplete dilation of a lung (alveoli). Listening with a stethoscope to sounds within the body. Laboratory test measuring oxygen and carbon dioxide in venous and arterial blood.

Bronchodilators

Drugs that cause dilation or expansion of the bronchus. Cardiopulmonary The reestablishment resuscitation of heart and lung (CPR) activity. Chest tube Hollow tube placed into the thoracic cavity to remove air or fluid.

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Chronic bronchitis Inflammation and excess mucus

Healthy

Emphysema Healthy

Alveolar membranes break down

Figure 7.4  Chronic obstructive pulmonary disease (COPD). Source: Courtesy of shutterstock/Alila Sao Mai.

Figure 7.5  Radiograph of a diaphragmatic hernia. Note the abdominal viscera in the thoracic cavity. Source: Courtesy of Beth Romano, AAS, CVT.

Chronic obstructive pulmonary disease (COPD)

Disease in horses consisting of chronic bronchitis, bronchiolitis, and emphysema. Commonly called heaves or broken wind (Figure 7.4).

Cough Diaphragmatic hernia

Forced expulsion of air from the lungs. Displacement of abdominal organs through the opening in the diaphragm (Figure 7.5).

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(A)

245

(B)

(C)

Figure 7.6  Endotracheal intubation. (A) In a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM). (B) In a snake. Courtesy of Kayden Najera, CVT. (C) In a turtle. Courtesy of Megan Dyer, CVT.

Emphysema

Lung disease caused by enlargement of the alveoli. This occurs due to changes, or loss of elasticity, in the alveolar wall.

Endotracheal intubation

Placement of a tube through the mouth and into the windpipe to establish an airway (Figure 7.6).

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Epistaxis Hyperpnea Hyperventilation Hypopnea Intubation

Metastasis

Mucolytics Palliative Paroxysmal

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Nosebleed. Increased depth of breathing. Abnormal, rapid, deep breathing. Slow or shallow breathing. Placement of a tube. This can refer to endotracheal, orogastric, and nasogastric. To spread beyond control; spreading of a tumor to a secondary location (Figure 7.7). Substances used to break down or dissolve mucus. Relieving symptoms, but not curing. Sudden occurrence such as a spasm or seizure. An example is a cough.

TECH TIP 7.1  Can Animals Get Lung Cancer? A curious belief that students often have is that animals can’t get lung cancer. Lung cancer as a primary disease isn’t often seen in veterinary medicine. It is possible, however, for animals to get lung cancer from second‐hand smoke. Owners who smoke in their houses put their ­animals at risk. In veterinary medicine, we typically take thoracic radiographs to check for metastasis of a cancer that originated elsewhere in the body. If the cancer has metastasized to the lungs, then the prognosis is poor.

Percussion

Phlegm Pleural effusion Pneumonia

Pulse oximeter

Purulent Rales and crackles

Rhonchi

Sputum

Stridor

Tidal volume

Tapping a surface to determine the density of the underlying structure. For example, if tapping the surface of a chest or abdomen filled with air, the sound produced is a hollow ping. If filled with fluid, the sound is more of a thunk or thud. Thick mucus excreted in large quantities. Escape of fluid into the pleural cavity. Acute inflammation and infection of the alveoli (Figures 7.8 and 7.9). Instrument for measuring oxygen concentration in arterial blood (Figure 7.10). Containing pus (Figure 7.11). Crackling noises heard on inspiration due to fluid in the alveoli. Also called crepitant. Wheezing. High‐ pitched whistling sounds heard during inspiration. Mucous secretion from the lungs, bronchi, and trachea. Strained shrill heard during inspiration due to an airway obstruction. Amount of gas passing in and out of the lungs during a respiratory cycle.

Chapter 7  The Respiratory Tract

(A)

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Tumor cells

Tumor cells enter the bloodstream

Giving rise to new tumor cells

Once in the bloodstream, the cells move through the circulatory system Until they reach a site suitable for deposition and reintegration in tissues

(B)

Figure 7.7  (A) Stages of metastasis. Source: Courtesy of shutterstock/Rob3000. (B) Metastasis in the lungs. Normal lungs are clear black on a radiograph. Source: Courtesy of Beth Romano, AAS, CVT. (C) Metastasis in the bronchioles. Source: Courtesy of shutterstock/Sebastian Kaulitzki.

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(C)

Figure 7.7  (Continued) Pneumonia

Healthy

Emphysema

Fluid and blood cells in alveoli

Alveolar walls thickened by edema

Alveolar membranes break down

Figure 7.8  Comparison of alveolar changes in lung diseases. Source: Courtesy of shutterstock/Alila Sao Mai.

Transtracheal wash

Introduction of sterile saline into the trachea through a catheter and then withdrawal of that fluid for cytology.

Vesicular sounds

Soft sounds heard on auscultation due to small bronchioles and alveoli. Also called a vesicular murmur.

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Figure 7.9  Radiograph of a dog with pneumonia. Source: Courtesy of Beth Romano, AAS, CVT.

Figure 7.10  Dog attached to pulse oximeter going into surgery. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Figure 7.11  Purulent fluid from a thoracentesis. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

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Building the Terms Now it’s time to assemble the word parts listed in Tables 7.2–7.4. If you memorize the meaning of the combining forms, prefixes,

and suffixes, then this will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 7.2  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Alveol/o

Alveoli; air sacs

Ox/o

Oxygen (O2)

Bronch/o

Bronchial tube

Pector/o

Chest

Bronchi/o

Bronchial tube

Pharyng/o

Pharynx; throat

Bronchiol/o

Bronchioles

Phragm/o

Wall

Capn/o

Carbon dioxide (CO2)

Phren/o

Diaphragm

Cyan/o

Blue

Pleur/o

Pleura

Diaphragmat/o

Diaphragm

Pneum/o

Lung; air; gas

Epiglott/o

Epiglottis

Pneumon/o

Lung; air; gas

Furc/o

Forking; branching

Pulmon/o

Lung

Gastr/o

Stomach

Py/o

Pus

Glott/o

Glottis

Rhin/o

Nose

Hem/o

Blood

Sinus/o

Sinus

Laryng/o

Larynx; voice box

Spir/o

To breathe; breathing

Lob/o

Lobe

Tel/o

Complete

Mediastin/o

Mediastinum

Thorac/o

Chest

Nas/o

Nose

Trache/o

Trachea; windpipe

Olfact/o

Smelling

Tuss/i

Cough

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Table 7.3  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

em‐

in

anti‐

against

hypo‐

deficient; below; under; less than normal; decreased

bi‐

two; both

meta‐

change; beyond

brady‐

slow

para‐

near; beside; abnormal; apart from; along the side of

dia‐

through; complete

tachy‐

fast

dys‐

bad; painful; difficult; abnormal

trans‐

across; through

hyper‐

above; excessive; increased

Table 7.4  Suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐ary, pertaining to ‐eal, ‐ic

‐osis

abnormal condition

‐ation

process; condition

‐plasty

surgical repair

‐centesis

surgical puncture to remove fluid ‐pnea

‐dynia

pain

‐ptysis

spitting

‐ectasia

stretching; dilation; expansion

‐rrhea

flow; discharge

‐ectasis

stretching; dilation; expansion

‐scopy

visual examination

‐ectomy

removal; excision; resection

‐spasm

sudden involuntary contraction of muscles

‐ema

condition

‐sphyxia pulse

‐graph

instrument to record

‐stasis

‐ia

condition

‐stenosis tightening; narrowing; stricture

‐itis

inflammation

‐stomy

new opening

‐lytic

to reduce; destroy; separate; breakdown

‐thorax

chest; pleural cavity

‐meter

measure

‐tomy

incision; process of cutting into

breathing

stopping; controlling

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Parts

Medical Term

Alveol/o Bronchi/o

+ ‐ar + ‐ectasis

= Alveolar = Bronchiectasis

Bronch/o Bronch/o Bronch/o

+ ‐itis + ‐spasm + ‐scopy

Definition

: ______________________ : ______________________ Sometimes called bronchiectasia. = Bronchitis (Figure 7.12) : ______________________ = Bronchospasm : ______________________ = Bronchoscopy : ______________________

Irritated airway

Excess mucus

Damaged cilia Figure 7.12  Chronic bronchitis. Source: Courtesy of shutterstock/Rob3000.

Bronchiol/o Capn/o hyper‐ hypo‐ Cyan/o Diaphragmat/o Epiglott/o Hem/o Hem/o Laryng/o Laryng/o Laryng/o Laryng/o Lob/o Mediastin/o Nas/o

+ ‐itis + ‐graph + Capn/o + ‐ia + Capn/o + ‐ia + ‐osis + ‐ic + ‐itis + ‐ptysis + ‐thorax + ‐eal + ‐itis + ‐scopy + ‐spasm + ‐ectomy + ‐al + Gastr/o + ‐ic

= Bronchiolitis = Capnograph = Hypercapnia = Hypocapnia = Cyanosis = Diaphragmatic = Epiglottitis = Hemoptysis = Hemothorax = Laryngeal = Laryngitis = Laryngoscopy = Laryngospasm = Lobectomy = Mediastinal = Nasogastric

: ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________

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para‐ an‐ hypo‐ Onc/o Pector/o Pharyng/o Pharyng/o Pharyng/o Pharyng/o Phren/o Pleur/o Pleur/o a‐ brady‐ dys‐ tachy‐ Pneum/o

+ Nas/o + ‐al + ‐oxia + ‐oxia + ‐logy + ‐al + ‐eal + ‐plasty + ‐tomy + ‐stomy + ‐ic + ‐al + ‐dynia + ‐pnea + ‐pnea + ‐pnea + ‐pnea + ‐thorax

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= Paranasal = Anoxia = Hypoxia = Oncology = Pectoral = Pharyngeal = Pharyngoplasty = Pharyngotomy = Pharyngostomy = Phrenic = Pleural = Pleurodynia = Apnea = Bradypnea = Dyspnea = Tachypnea = Pneumothorax (Figure 7.13)

(A)

: ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________

(B) Collapsed lung

Normal lung

Chest wound

Normal pleural sac

Air-filled pleural sac

Figure 7.13  (A) Diagram of a pneumothorax. Source: Courtesy of shutterstock/Rob3000. (B) Radiograph of a dog treated for pneumothorax. (Top) Radiograph of the dog following a thoracentesis. (Bottom) Note the air surrounding the heart from the pneumothorax. Courtesy of Greg Martinez, DVM; http://www.youtube. com/drgregdvm.

Pneumon/o Pulmon/o Py/o

+ ‐ectomy + ‐ary + ‐thorax

Rhin/o Rhin/o Rhin/o Sinus/o Sinus/o Spir/o dia‐ Thorac/o

+ itis + ‐plasty + ‐rrhea + ‐itis + ‐tomy + ‐meter + ‐meter + ‐centesis

= Pneumonectomy : ______________________ = Pulmonary : ______________________ = Pyothorax (Figure 7.14) : ______________________ Also called empyema. = Rhinitis : ______________________ = Rhinoplasty : ______________________ = Rhinorrhea : ______________________ = Sinusitis : ______________________ = Sinusotomy : ______________________ = Spirometer : ______________________ = Diameter : ______________________ = Thoracocentesis : ______________________ (Figure 7.15) Also called a thoracentesis.

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(A)

(B)

Pleural space normal

Empyema with accumulation of pus in the pleural space

Figure 7.14  (A) Empyema (pyothorax). Source: Courtesy of shutterstock/Rob3000. (B) Radiograph of a dog with pyothorax.

Figure 7.15  Thoracentesis in a dog with pneumothorax from HBC. Ideally it would be best to shave and surgically prep the site. This dog was hit by a car and emergency services acted quickly. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Thorac/o Thorac/o Thorac/o

+ ‐ic + ‐tomy + ‐scopy

= Thoracic = Thoracotomy = Thoracoscopy

Trache/o

+ ‐al + stenosis + ‐plasty + ‐stomy

= Tracheal stenosis

Trache/o Trache/o Trache/o trans‐

+ ‐tomy + Trache/o + ‐al

= Tracheoplasty = Tracheostomy (Figure 7.16) = Tracheotomy = Transtracheal

: ______________________ : ______________________ : ______________________ Also called thorascopy. : ______________________ : ______________________ : ______________________ : ______________________ : ______________________

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The upper airway is still intact Epiglottis Thyroid cartilage

Cricothyroid membrane Cricoid cartilage Tracheostomy tube

Larynx (voicebox) Vocal cords

Trachea

Esophagus

Figure 7.16  Tracheostomy. Source: Courtesy of shutterstock/blamb.

Abbreviations Table 7.5  Abbreviations.

Abbreviation

Definition

ABG

Arterial blood gas: measurement of O2 and CO2 in arterial blood.

BAL

Bronchoalveolar lavage.

BE

Base excess.

BG

Blood gas: measurement of O2 and CO2 in arterial and venous blood.

BRSV

Bovine respiratory syncytial virus: disease in calves caused by a pneumovirus. Causes dyspnea and eventually death.

cmH2O

Centimeters of water.

CO2

Carbon dioxide.

COPD

Chronic obstructive pulmonary disease.

CPA

Cardiopulmonary arrest.

CPCR

Cardiopulmonary cerebral resuscitation; new name for CPR.

CPR

Cardiopulmonary resuscitation (Figure 7.17).

ETCO2

End tidal carbon dioxide.

ET tube

Endotracheal tube. (Continued )

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Table 7.5  (Continued)

Abbreviation

Definition

IBR

Infectious bovine rhinotracheitis: infectious disease in cattle caused by a herpesvirus. Causes rhinorrhea, rhinitis, tracheitis, and fever.

mmHg

Millimeters of mercury.

OPP

Ovine progressive pneumonia: disease in sheep caused by lentivirus. Causes chronic pneumonia and eventually transfers to the brain, causing death.

O2

Oxygen.

O2Sat, SpO2

Oxygen saturation.

pCO2, PCO2

Partial pressure of carbon dioxide; measures dissolved carbon dioxide in the blood.

PaCO2

Partial pressure of arterial carbon dioxide.

PvCO2

Partial pressure of venous carbon dioxide.

pO2, PO2

Partial pressure of oxygen; measures dissolved oxygen in the blood (plasma).

PE

Pulmonary embolism.

PPV

Positive pressure ventilation.

psi

Pounds per square inch.

Pulse Ox

Pulse oximeter; pulse oximetry.

RR

Respiratory rate.

URI

Upper respiratory infection.

Figure 7.17  CPR being performed on an English Bulldog. Source: Courtesy of Giselle Trujillo, RVT.

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Case Study In this case study, you’ll notice some terms from the previous chapters. Nelson, a four‐year‐old Yorkie, has been rushed into the clinic after being attacked by an Akita. The owner claims that the Akita came out of nowhere and grabbed Nelson. Nelson is dyspneic and has obvious puncture wounds on his face, neck, and chest. He’s spitting blood and has swelling below his lower jaw. 1. Where is Nelson’s swelling? a. Submandibular b. Paranasal c. Maxillary 2.  What other clinical signs is Nelson displaying? a. Rapid breathing and hemoptysis b. Difficulty breathing and hemoptysis c. Slow breathing and hemorrhea Radiographs show that Nelson has a pneumothorax. 3.  Why is Nelson dyspneic? a. Pus in the chest cavity b. Blood in the chest cavity c. Air in the chest cavity 4.  What procedure can relieve the condition in question 3? a. Abdominocentesis b. Thoracentesis c. Cystocentesis After the procedure was performed, Nelson’s respiration improved. Some puncture wounds were deep and had to be repaired surgically. An ET tube was placed and Nelson went to surgery. 5.  Where was the tube placed? a. Into the lungs b. Within the windpipe c. Through the chest cavity Nelson was placed on antibiotics and pain medication and eventually sent home.

Exercises 7-A:  Give the term for the following definitions. 1.  2.  3.  4.  5. 

___________________________: Membrane surrounding the lungs ___________________________: Space between the lungs ___________________________: Throat ___________________________: Nares ___________________________: Bifurcation of the trachea that acts as a passageway into the lungs.

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6.  7.  8.  9.  10.  11.  12. 

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___________________________: Air sacs in the lungs ___________________________: Voice box ___________________________: Thin hairs lining the respiratory tract ___________________________: Smallest branches of the bronchi ___________________________: Leaf‐like piece of cartilage over trachea ___________________________: Space between pleural membranes ___________________________: Windpipe

7-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Epistaxis _____________________________ Agonal ______________________________ Atelectasis ___________________________ Inspiration ___________________________ Olfactory ____________________________ Mucolytics ___________________________ Percussion ___________________________ Palliative ____________________________ Bronchodilator ________________________ Diaphragm __________________________

7-C:  Complete the term. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

Not breathing: ____________pnea Lack of O2 to tissue: ____________oxia Blood in the chest cavity: hemo ____________ Inflammation of sinuses: ____________itis Visual exam of the voice box: ____________scopy New opening to the windpipe: ____________stomy Pertaining to the throat: ____________eal Abnormal condition of blue color: ____________osis Removal of a lung: ____________ectomy Surgical repair of the nose: rhino ____________ Pus in the chest cavity: ____________thorax Excessive carbon dioxide: Hypercap ____________

7-D:  Define the following abbreviations. 1. 2. 3. 4. 5. 6. 7.

________________: ABG ________________: ET tube ________________: CPCR ________________: OPP ________________: BRSV ________________: SpO2 ________________: BAL

8. 9. 10. 11. 12. 13. 14.

_________________: URI _________________: PE ________________: RR ________________: pCO2 ________________: Pulse ox ________________: CPR ________________: mmHg

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7-E:  Circle the correct answer. 1.  True or False: Aspiration is the same as inspiration. 2.  True or False: Slimy substance produced in the respiratory tract is spelled mucous. 3.  True or False: The definition of agonal is respirations near death. 4.  True or False: A pneumothorax is air in the lungs. 5.  True or False: Acute is a sudden onset. 6.  True or False: Antitussives are used to dilate the airways. 7.  True or False: Alveoli lose their elasticity in emphysema. 8.  True or False: Pneumonia is defined as acute inflammation and infection of the alveoli. 9.  True or False: Dyspnea and apnea are the same thing. 10.  True or False: A purulent wound contains pus. 7-F:  Match the following terms with their descriptions. 1.  2.  3.  4.  5. 

________ Strained shrill due to obstruction ________ Soft sounds due to small alveoli ________ Caused by fluid in the alveoli ________ Abnormal, rapid, deep breathing ________ Wheeze

A.  B.  C.  D.  E. 

Hyperventilation Rales and crackles Ronchi Stridor Vesicular sounds

7-G:  Complete the term for the following symptoms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

Slow or shallow breathing: ____________pnea Abnormal, rapid, deep breathing: hyper___________________. Nosebleed: epi ____________ Increased depth of breathing: ____________pnea Difficulty breathing: ____________pnea Wheezing: ____________chi Decreased CO2: hypo ____________ Inflammation of the voicebox: ____________itis Pus in the chest: ____________ema Spitting blood: hemo ____________ Dishcharge from the nose: rhino ____________ Strained shrill on inspiration: Stri ____________

Answers can be found starting on page 675.

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Review Tables Fill in the tables and refer to Tables 7.2–7.5 for answers. Table 7.6

Combining Forms

Definition

Combining Forms

Alveol/o

Ox/o

Bronch/o

Pector/o

Bronchi/o

Pharyng/o

Bronchiol/o

Phragm/o

Capn/o

Phren/o

Cyan/o

Pleur/o

Diaphragmat/o

Pneum/o

Epiglott/o

Pneumon/o

Furc/o

Pulmon/o

Gastr/o

Py/o

Glott/o

Rhin/o

Hem/o

Sinus/o

Laryng/o

Spir/o

Lob/o

Tel/o

Mediastin/o

Thorac/o

Nas/o

Trache/o

Olfact/o

Tuss/i

Definition

Table 7.7

Prefix

Definition

Prefix

a‐, an‐

em‐

anti‐

hypo‐

bi‐

meta‐

brady‐

para‐

dia‐

tachy‐

dys‐

trans‐

hyper‐

Definition

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Table 7.8

Suffix

Definition

Suffix

‐al, ‐ar, ‐ary, ‐eal, ‐ic

‐plasty

‐ation

‐pnea

‐centesis

‐ptysis

‐dynia

‐rrhea

‐ectasia

‐scopy

‐ectasis

‐spasm

‐ectomy

‐sphyxia

‐ema

‐stasis

‐ia

‐stenosis

‐itis

‐stomy

‐lytic

‐thorax

‐meter

‐tomy

Definition

‐osis

Table 7.9

Abbreviation

Definition

ABG BAL BE BG BRSV cmH2O CO2 COPD CPA CPCR CPR (Continued )

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Table 7.9  (Continued)

Abbreviation

Definition

ETCO2 ET tube IBR mmHg OPP O2 O2Sat, SpO2 pCO2, PCO2 PaCO2 PvCO2 pO2, PO2 PE PPV psi Pulse Ox RR URI

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

8

Hematology

Hematology is the study of the blood. Blood has three main components: cells, fluid, and acellular dissolved substances. Cellular components include erythrocytes (red blood cells), leukocytes (white blood cells), and thrombocytes (platelets). The fluid component of blood is water and acellular dissolved substances is a broad category that includes vitamins, minerals, proteins, gases, wastes, and much more. Each component of blood has a specialized function. About 45% of blood is made up of blood cells. The remaining 55% is fluid and acellular dissolved substances (Figure 8.1).

Anatomy and Physiology of Blood and Blood‐Forming Organs Within the bone marrow are hematopoietic cells called stem cells. These cells are capable of differentiating into precursors of red blood cells, white blood cells, and platelets (Figure 8.2).

Erythrocytes Erythrocytes are the most abundant of the blood cells. Their function is to transport oxygen from the lungs to the tissues.

Within the erythrocytes is an oxygen‐ carrying protein called hemoglobin, which allows the red blood cells to transport oxygen. If a red blood cell is lacking hemoglobin, then it is unable to transport oxygen to tissues and the animal will become hypoxic and cyanotic. Red blood cells, or RBCs, are produced in the bone marrow. The stimulus for red  blood cell production is hypoxia (Figure  8.3). When an animal becomes hypoxic, the kidneys begin secreting a hormone called erythropoietin (EPO). EPO then stimulates the stem cells in the bone marrow to differentiate into RBCs. The stem cells in the bone marrow can become anything that the blood needs except for lymphocytes. While in the bone marrow, the earliest stages of the RBC are large in size, contain a nucleus, and their cytoplasm is basophilic (blue) in color. The nucleus contains ribosomes which actively produce hemoglobin. After reaching maturity, the nucleus is no longer needed because the cell has been filled with the proper amount of hemoglobin. As the RBCs mature, three changes occur in the cell. The cell size decreases, the cell color changes from basophilic (blue) to eosinophilic (red), and the cell loses its nucleus. Once an RBC is

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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(A)

Fluid and acellular dissolved substances

Cellular

Plasma Buffy coat (white blood cells and platelets) Red blood cells

(B)

The elements of blood Plasma (about 55%)

White blood cells (about 4%): Lymphocyte

Platelets (0,01)

Basophil

Red blood cells (about 41%)

Eosinophil Monocyte

Neutrophil

Figure 8.1  (A) Anatomy of blood. Source: Courtesy of shutterstock/Nixx Photography. (B) Elements of blood. Source: Courtesy of shutterstock/Designua.

fully mature, the bone marrow releases it into the peripheral blood (circulation) to transport oxygen. Morphologically, the RBC is biconcave in shape (Figure  8.4). That slight “pinch” in the center of the cell is referred to as central pallor.

An RBC can stay in circulation for up to three months. When the cell has fulfilled it role, the body destroys the RBC using a group of cells called macrophages in the liver, spleen, and bone marrow. The breakdown of RBCs is termed hemolysis

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Blood stem cell

Lymphoid stem cell

Myeloid stem cell

Lymphoblast

Myeloblast

Monoblast

Lymphocyte Eosinophil

Neutrophil

Monocyte

Basophil

Platelets Red blood cells (erythrocytes)

Agranulocyte

Granulocytes

White blood cells (leukocytes) Figure 8.2  Hematopoiesis. Source: Courtesy of shutterstock/Athanasia Nomikou. EPO Hypoxia

Kidney

Bone marrow (stem cell)

Erythroblast

Erythrocyte

Figure 8.3  The stimulus for red blood cell production. Note that there are several growth stages that occur between the erythroblast stage and the mature RBC. They’ve been left out for introductory purposes.

TECH TIP 8.1  The Importance of RBC Morphology

Figure 8.4  The red blood cell. Source: Courtesy of shutterstock/Designua.

Changes seen in red blood cell ­morphology can aid in the diagnosis of various conditions. This chapter introduces some of the terminology used to describe these morphologic changes rather than their clinical significance (see Table 8.1).

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Table 8.1  RBC morphology terms.

Morphology

Definition

Agglutination

Clumping of RBCs; technically this is the joining of antibodies and antigens (Figure 8.5C).

Rouleaux

Stacking of RBCs; this is due to a “sticky” surface on the cells from high levels of antibodies (Figure 8.5B).

Anisocytosis

Unequal sizes of RBCs.

Poikilocytosis

Irregular shapes of RBCs (Figure 8.5D).

Normocytic

RBCs are normal in size.

Macrocytic

RBCs are larger in size.

Microcytic

RBCs are smaller in size.

Normochromic

RBCs are normal in color.

Hyperchromic

RBCs are more red than normal.This is an artifactual finding due to hemolysis.

Hypochromic

RBCs have less red color than normal. This is due to a lack of hemoglobin.

Spherocytosis

Presence of spherocytes; RBCs are rounded, lacking central pallor. Seen with hemolytic anemias (Figure 8.5A)

(A)

(C)

(B)

(D)

Figure 8.5  (A) Blood film of a dog with hemolytic anemia. Note the spherocytes which are smaller and a more solid pink. There is also anisocytosis. (B) Equine blood film showing rouleaux. (C) Blood film from a dog with hemolytic anemia showing agglutination. (D) Feline blood film with poikilocytosis.

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Hemoglobin

Heme

Bilirubin

Globin

Amino acids

Iron

Moved to the liver Iron stored as hemosiderin

Figure 8.6  The breakdown and recycling of hemoglobin.

RBCs

Hemoglobin

Unconjugated bilirubin

Conjugated bilirubin with blood

Urine

Kidney

Liver

Conjugated bilirubin with bile

Intestines

Feces

Figure 8.7  The path of bilirubin in the body.

After hemolysis occurs, the body ­recycles the hemoglobin. Hemoglobin is  made up of a heme molecule and a globin ­molecule (Figure 8.6). Globin is a protein which the body breaks down further into amino acids that can be recycled. The heme molecule is made up of iron and a yellow pigment called b ­ilirubin. Iron is stored within cells for  future use when the body  needs to  make more hemoglobin. That iron  storage within cells is called ­hemosiderin. The  bilirubin is excreted in stool and urine after being conjugated (­processed) in the liver (Figure 8.7).

Leukocytes There are five different kinds of white blood cells (WBCs) (Figures  8.8 and 8.9 and Table 8.2). Each has a specific function and a specific stimulus for its production. WBCs

are divided into two categories based on their cytoplasmic contents. Leukocytes with granules in their cytoplasm are termed granulocytes and those without granules in their cytoplasm are termed agranulocytes. Granulocytes include neutrophils, eosinophils, and basophils. The granules within each cell are packages that contain various substances including enzymes which are released during an immune response. When the substances within the granules are released, it is termed degranulation. Each granulocyte responds to a specific stimulus or chemical mediator. All three granulocytes have a segmented (pinched) nucleus in mammals. Neutrophils are the most numerous of the granulocytes and contain neutral‐ staining granules in their cytoplasm. Neutrophils are bacterial phagocytes (eating cells) so the stimulus for their production is a bacterial infection.

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Monocyte

Basophil

Eosinophil

Neutrophil Lymphocyte

Figure 8.8  The five different types of white blood cells. Source: Courtesy of shutterstock/MiAdS.

(A)

(B)

(C)

(D)

Figure 8.9  Equine white blood cells. (A) Basophil. (B) Neutrophil and eosinophil. (C) Neutrophil and lymphocyte. (D) Monocyte. Table 8.2  Leukocytes.

Leukocytes

Stimulus

Function

Neutrophil

Inflammation, infection, bacterial products

Primary bacterial phagocyte

Eosinophils

Allergies, parasites

Anti‐allergy (antihistamine) Anti‐parasite (acid)

Basophils

Exaggerated hypersensitivity

Anaphylaxis

Lymphocytes

Antigens

Produce antibodies

Monocytes

Inflammation, infection, bacterial products

Macrophage

Eosinophils have pink‐ or red‐staining granules. Eosin/o means red, rosy, or pink. The granules within the eosinophil ­contain substances that respond to allergies or parasites.

Therefore, the stimulus for eosinophil production is the presence of allergies or parasites. Basophils are the rarest of all the WBCs and they contain blue‐staining granules.

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Basophils increase in severe or exaggerated hypersensitivities. Their function therefore is anaphylaxis. TECH TIP 8.2  Allergies vs. Anaphylaxis Allergies are abnormal hypersensitivities which are not life‐threatening, for example an animal that’s allergic to chicken and breaks out in a skin rash. Anaphylaxis is an exaggerated ­hypersensitivity which is ­generally life‐threatening, for example an animal that’s allergic to chicken and their throat swells shut when they eat it (see Figure 8.10).

Agranulocytes include lymphocytes and monocytes. These cells are mononuclear, which means there’s no pinching in their nucleus. Lymphocytes are the most numerous of agranulocytes and their function is to produce antibodies, which are proteins that are produced in response to antigens (foreign proteins). They neutralize the antigens by hooking onto them. Examples of antigens include viruses and parasites. The diagnostic feature of lymphocytes is their high nucleus to cytoplasm (N:C) ratio. Monocytes are literally the garbage can of the blood vessels because these cells are macrophages (large eating cells). They eat everything from bacteria to (A)

older cells that are no longer needed. The diagnostic feature of monocytes is their ameboid‐looking nucleus. The stimulus for monocyte production is the same as that for the neutrophil because its main priority is to eat what neutrophils leave behind. With the exception of lymphocytes, the four remaining WBCs are produced in the bone marrow and originate from stem cells. The lymphocytes are produced in lymphoid tissue such as the spleen, lymph nodes, and thymus gland. Imagine when you get sick with the flu  –  your lymph nodes swell because they’re producing lymphocytes to battle the virus.

Thrombocytes Platelets are produced by stem cells in the bone marrow and their function is to aid in the clotting process (Figure 8.11). When platelets are needed, the stem cells in the bone marrow differentiate into a cell called a megakaryocyte. Platelets are cytoplasmic fragments of the megakaryocyte.

Serum or Plasma? After removing the cellular components of blood, fluid and acellular substances are left.

(B)

Figure 8.10  Allergies vs. anaphylaxis. (A) Allergic reaction in a puppy. Note the facial swelling. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM). (B) Anaphylactic reaction in a cat during anesthesia. The tongue and throat began to swell during surgery due to a reaction to the anesthetic drugs that were used. A tracheostomy had to be performed. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

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The fluid portion of blood is simply water. Dissolved in the water are the a­ cellular substances. The water may be used as a solvent to dissolve the acellular substances, it can be used to transport the acellular dissolved substances through the vessels and into the tissues where they may be needed, or it can be used to regulate temperature. This mixture of fluid and acellular matter is normally clear or straw in color in most animals. Serum is the fluid portion of coagulated (clotted) blood. Plasma is the fluid portion of anticoagulated or circulating blood. The difference between them is in the blood tubes in which the fluids were collected (Figure 8.12). Some blood tubes contain an anticoagulant so when blood is mixed with that anticoagulant and then spun down in a centrifuge, the fluid that results is called

plasma. If blood is placed in a blood tube that’s lacking an anticoagulant, then the blood will clot. After centrifuging the clotted blood, the fluid that results is termed serum. The difference is that plasma still contains all the clotting proteins in the blood, whereas serum has used up all of its clotting proteins with the exception of fibrinogen. Certain blood tests require plasma while others will require serum (Table 8.3).

Acellular Dissolved Substances Acellular dissolved substances in the blood include proteins, electrolytes, hormones, enzymes, vitamins, minerals, glucose, gases and waste products. Many of these substances play a role in maintaining ­

Figure 8.11  Clumps of platelets on a canine blood film.

Figure 8.12  Various types of vacutainer tubes used in blood collection.

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Table 8.3  Blood tubes.

Tube

Contents

Use

Fluid Portion

Red top tube (RTT)

Nothing

Blood chemistry (biochemistry)

Serum

Marble top tube (MTT) or serum separator tube (SST)

Nothing

Blood chemistry (biochemistry)

Serum

Green top tube (GTT)

Heparin

Blood gas analysis

Plasma

Blue top tube (BTT)

Sodium citrate

Coagulation studies

Plasma

Gray top tube (GTT)

Oxylate

Blood glucose test

Plasma

Lavender top tube (LTT)

EDTA

Complete blood count

Plasma

Table 8.4  Summary of the components of blood.

Components

Examples

Functions

Cellular

Red blood cell White blood cell Platelet

Oxygen transport Defense/immunity Coagulation

Acellular dissolved substances

Albumin Globulins Electrolytes Hormones Enzymes Clotting factors Vitamins Minerals Waste products Gases (O2 and CO2) Glucose

Maintain oncotic pressure Defense Water regulation/homeostasis Homeostasis Catalysts Coagulation Homeostasis Homeostasis Byproducts of metabolism Homeostasis Energy

Fluid

Water

Transport Tissue perfusion Thermoregulation Chemical reactions Solvent

homeostasis, which is the state of equilibrium of the body’s internal environment. Others may be used for defense or in the clotting process. Table  8.4 summarizes the components of blood and their main functions. Two proteins that dominate a protein measurement are albumin and globulins. Albumin maintains oncotic pressure, or

water concentration, in the blood. If albumin is decreased, then water no longer stays in the blood and the animal begins to feel dehydrated. Globulins are proteins that aid in immunity. There are three kinds of globulins: alpha, beta, and gamma. The gamma globulins, or immunoglobulins, are actually antibodies produced in response to antigens.

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(A) Injured blood vessel

Coagulation

Platelets

Red blood cells

Fibrin

Collagen Striated muscle

(B) Blood coagulation Platelet

Platelets move rapidly to the site of the lesion

Cascade reaction of coagulation factors

Endothelium

Lesion

Smooth muscle

Fibrin Fibrin

Red thrombus formation that permanently stops bleeding

Formation of fibrin going to settle on platelet thrombus stabilizing the consistency Action of plasmin that models the thrombus and dissolves the excessive proliferation Fibroblasts synthesize new tissue endothelium, restoring the integrity of the vessel wall

Plasmin

Fibroblast

Figure 8.13  (A) Clotting after damage to a vessel. Source: Courtesy of shutterstock/Rob3000. (B) Steps of coagulation. Note the multiple, intricate steps involved as well as the number of clotting proteins involved. Source: Courtesy of shutterstock/Rob3000.

Coagulation, or blood clotting, involves a series of clotting proteins and is far too complicated to thoroughly discuss in this book. The following is a very condensed version of the clotting process (Figure 8.13).

Hemostasis is defined as the stopping or controlling of blood. The goal of hemostasis is to maintain the blood within the vessels, keep it flowing and only clotting when necessary.

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Vessel injury

Red blood cells

Vascular spasm

Platelets

Fibrin Formation of the platelet plug (Primary hemostasis)

The coagulation

Fibrin filaments, red blood cells and white blood cells form the blood clot

(Secondary hemostasis)

Figure 8.14  Hemostasis. Source: Courtesy of shutterstock/Designua.

When an animal is injured, the first on the scene are the platelets, which are the body’s first line of defense to stop the bleeding (Figure  8.14). This is known as primary hemostasis. As the platelets clump together and plug the bleed, the blood ­vessels constrict to slow the bleed and c­ lotting proteins in the plasma are activated to form a clot, the reinforcement. Multiple clotting proteins are required to form a  stable fibrin clot, which is known as  secondary ­hemostasis. Some of these clotting proteins include prothrombin, thrombin, and fibrinogen. After these proteins are activated, they work together in a series of steps to ­produce the stable fibrin clot. Fibrin is the protein strands

that make up the clot. When the clot is no longer needed, fibrinolysis occurs to remove the clot. Animals with a bleeding disorder are ­typically lacking one or more of these clotting proteins. To detect a bleeding disorder in animals, we draw blood to measure the levels of the various clotting proteins.

TECH TIP 8.3  What Are “Blood Thinners”? Blood thinners are substances that inhibit the function of platelets or clotting proteins thereby hindering the clotting of blood.

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Blood Banking A common question is whether animals have blood types. Each species has its own typing system. Cats use the feline AB blood group system; the blood types for cats include A, B, and AB. Dogs use the DEA blood type system, or dog erythrocyte antigen system. Dogs are typed based on the antigens on the surface of their red blood cells. Examples of DEAs include 1.1, 1.2, and 7. There are a variety of tests available to determine blood types in cats; ­however, canine testing is still difficult. Most of the canine blood type tests available are only able to detect the

(A)

presence of DEA 1.1. The best test for compatibility between a donor and recipient is considered to be the crossmatch. This test involves combining blood components from the recipient and donor in a test tube. If the animals are not compatible, the RBCs from each animal will attack each other and it is possible to visualize agglutination of the RBCs (Figure 8.15). Other than blood typing, blood banking isn’t much different from human medicine. Blood components are often used rather than whole blood for transfusions. Examples of blood components used include plasma and packed red blood cells.

(B)

(i)

(ii)

Figure 8.15  (A) Jugular venipuncture to obtain blood from a canine donor. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (B) Microscopic view of a crossmatch to determine compatibility. Note in (i) the red blood cells are spread out, indicating compatibility. In (ii), the red blood cells are clumped, indicating that the two animals are not compatible. The red blood cells are attacking each other.

Anemia Anemia is a decrease in RBCs and/or hemoglobin. There are three general causes of anemia: decreased production, destruction, and loss. The following list is a summary of the types of anemia and their causes. Aplastic anemia Hemolytic anemia Hemorrhagic anemia

Decrease in RBCs and/or hemoglobin due to no production. Examples of no production include bone marrow problems and renal failure (no EPO). Decrease in RBCs and/or hemoglobin due to destruction. The body is destroying its own RBCs. Decrease in RBCs and/or hemoglobin due to loss. The animal is bleeding out and losing RBCs.

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Related Terms Agranulocytes Albumin Anemia Antibody (Ab) Antigens (Ag) Basophils Bilirubin Coagulation Eosinophil Erythrocyte Erythropoietin (EPO) Fibrin Fibrinogen Globulins Granulocytes Heme Hemoglobin (Hb) Homeostasis Leukocyte Lymphocyte Macrophages Megakaryocyte Neutrophil Plasma Prothrombin Reticulocyte Serum Stem cell Thrombin Thrombocyte

WBCs lacking granules in their cytoplasm; lymphocytes and monocytes. Plasma protein that maintains blood volume. Decrease in RBCs and/or hemoglobin. Proteins produced by WBCs in response to antigens. Foreign substance (protein) that stimulates the production of antibodies. Granulocytic WBC seen in anaphylaxis. Metabolite of hemoglobin breakdown; conjugated in the liver. Blood clotting. Granulocytic WBC seen with allergies and parasites. Red blood cell (RBC). Hormone secreted by the kidneys to stimulate RBC production. Protein threads that form the basis of a clot. Plasma protein that is converted to fibrin in the clotting process. Plasma proteins such as alpha, beta, and gamma globulins. WBCs containing granules in their cytoplasm; neutrophils, eosinophils, and basophils. Iron‐containing portion of hemoglobin. Oxygen‐carrying pigment (protein) of RBCs. State of equilibrium of the body’s internal environment. White blood cell (WBC). Agranulocyte that produces antibodies. Monocytes that migrate from the blood to the tissue; large tissue phagocytes. Precursor to a platelet formed in the bone marrow. Platelets are cytoplasmic fragments of the megakaryocyte. Granulocytic WBC that is the body’s primary bacterial phagocyte. Fluid portion of anticoagulated or circulating blood. Plasma protein that is converted to thrombin in the clotting process. Immature stage of a RBC seen when blood is stained in new methylene blue stain. Ribosomes appear dark blue inside the cell. Fluid portion of coagulated blood. Cell that has the potential to become any cell type. An enzyme that results from the activation of prothrombin. It converts fibrinogen to fibrin in the clotting process. Platelet; clotting cell.

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Pathology and Procedures Anticoagulant Autoimmune hemolytic anemia (AIHA) Biochemistries Bleeding time Bone marrow biopsy Complete blood count Disseminated intravascular coagulation (DIC) Dyscrasia Exsanguination Hematocrit

Agent that prevents coagulation of blood. Idiopathic disease in which the body destroys its own good RBCs. Test to measure enzymes and electrolytes in the body. Also called blood chemistries. Coagulation test used to measure the time required for a small wound to stop bleeding. In animals, the incision is generally made in the buccal mucosa. Procedure to obtain a bone marrow sample for cytology (Figure 8.16). Blood panel that includes WBC count, RBC count, and platelet count. Formation of clots throughout microcirculation which leads to hemorrhage due to consumption of clotting factors. Any abnormal or pathological condition of blood. Extensive blood loss due to internal and external hemorrhage. The percentage of red blood cells in a volume of blood (Figure 8.17). Also called packed cell volume (PCV).

Figure 8.16  Needles used for bone marrow sampling include the Rosenthal on the left and the Illinois sternal iliac, which are used to obtain a bone marrow cytology sample, and the Jamshidi needle on the right, which is used to obtain a core biopsy sample.

(A)

Whole blood

Plasma Buffy coat

Red blood cells

Clay

Clay

(B)

(C)

Figure 8.17  (A) Anatomy of a hematocrit tube used for a packed cell volume. On the left is a hematocrit tube with whole blood. On the right is the same tube after being spun in a centrifuge. (B) Actual spun hematocrit that will be used to measure PCV. (C) Measurement of a PCV. The reading is taken from the bottom of the packed RBCs to the top of the packed RBCs. This dog’s PCV is 35%.

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Hemophilia

Hemorrhage Icterus

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Bleeding disorder in which the animal is lacking one or more clotting proteins (Figure 8.18). The disorder can be further classified based on which proteins are missing. Examples include hemophilia A, hemophilia B, and hemophilia C. Escape of blood through ruptured blood vessels. Yellowish coloration of the plasma (Figure 8.19). Caused by increased bilirubin. Hemophilia

Damaged blood vessel

Coagulation disorder

Bleeding

Normal

Blood-clotting protein Figure 8.18  Hemophilia is a condition in which the animal lacks one or more clotting proteins. Source: Courtesy of shutterstock/Designua.

Figure 8.19  Plasma colors. Please note that the samples in each tube are strictly plasma, not whole blood. The colors are as follows: (A) clear, (B) hemolytic, (C) icteric, (D) lipemic, (E) straw.

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Leukemia Lipemia Phlebotomy Transfusion Von Willebrand’s disease

Warfarin toxicity White blood cell differential

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Increase in the number of cancerous WBCs. Fat in the blood. This term is most often used to describe a white plasma color (Figure 8.19). Venipuncture; the act of drawing blood (Figure 8.20). Transfer of blood and blood components from one animal to another. Congenital bleeding disorder in which the animal is lacking Von Willebrand’s clotting factor. Breeds commonly seen include Doberman Pinscher, Collie, Shetland Sheepdog, Scottish Terrier, and Irish Wolfhound. It is the most common inherited bleeding disorder in dogs. Coumarin compound found in rodenticides. Once ingested, it binds to vitamin K in the animal’s body, which is needed for proper function of certain clotting factors. Test to count the different types of WBCs on a slide.

Figure 8.20  Phlebotomy. Jugular venipuncture being performed on a bulldog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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Building the Terms Table 8.5  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Albumin/o

Albumin

Leuko/o

White

Bas/o

Base; blue

Lip/o

Fat

Bilirubin/o

Bilirubin

Lymph/o

Lymph

Chrom/o

Color

Mon/o

One; Single

Coagul/o

Clotting; Coagulation

Morph/o

Shape; Form

Cyt/o

Cell

Myel/o

Bone Marrow; Spinal Cord

Eosin/o

Red; Rosy; Dawn; Acid

Neutr/o

Neutrophil; Neutral; Neither

Erythr/o

Red

Nucle/o

Nucleus

Granul/o

Granules

Phag/o

Eat; Swallow

Hem/o

Blood

Phleb/o

Vein

Hemat/o

Blood

Poikil/o

Irregular; Varied

Hemoglobin/o

Hemoglobin

Protein/o

Protein

Home/o

Sameness; Unchanging; Constant

Sider/o

Iron

Is/o

Same; Equal

Spher/o

Round; Globe-shaped

Kary/o

Nucleus

Thromb/o

Clot

Table 8.6  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no; not; without

mega‐

large

anti‐

against

micro‐

small

dys‐

bad; abnormal; difficult; abnormal

mono‐

single; one

hyper‐

excessive; increased; above

pan‐

all

hypo‐

deficient; below; under; less than normal; decreased

poly‐

many; much

macro‐

large

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Table 8.7  Suffixes.

Suffix

Definition

Suffix

Definition

‐ar, ‐ic

pertaining to

‐oid

resembling

‐blast

immature; embryonic

‐osis

abnormal condition

‐cyte

cell

‐pathy

disease condition

‐cytosis

increase in the number of cells

‐penia

deficiency

‐emia

blood condition

‐phage

eat; swallow

‐emic

pertaining to a blood condition

‐phil

attraction for

‐genous

producing

‐philia

increase in the number of cells; attraction for

‐globin

protein

‐plasia

development; formation; growth

‐globulin

protein

‐poiesis

formation

‐logy

study of

‐rrhage

bursting forth

‐lysis

breakdown; destruction; separation; loosening

‐stasis

stopping; controlling; place

‐lytic

to reduce; destroy; separate; breakdown

‐tomy

incision; process of cutting into

TECH TIP 8.4  Increases and Decreases: “‐cytosis” vs. ‐“philia” Both suffixes are defined as an increase in cell numbers. The rule that works best for WBCs is if the cell that’s increased is a granulocyte, then the suffix “‐philia” is used. If the cell increased is an agranulocyte, then the suffix “‐cytosis” is used. Neutrophilia Eosinophilia Basophilia Lymphocytosis Monocytosis

Increase in neutrophils Increase in eosinophils Increase in basophils Increase in lymphocytes Increase in monocytes

When the WBCs are decreased, the suffix stays the same regardless of cell type. Neutropenia Eosinopenia Monocytopenia Lymphocytopenia

Decrease in neutrophils Decrease in eosinophils Decrease in monocytes; also called monopenia Decrease in lymphocytes; also called lymphopenia

Because basophils are rare in the healthy patient, there is no such thing as a basopenia.

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Now it’s time to assemble the word parts listed in Tables 8.5–8.7. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this will get easier each time. Remember your five basic rules Parts hypo‐ hyper‐ Coagul/o Cyt/o pan‐ Erythr/o Erythr/o

+ Albumin/o + Bilirubin/o + ‐pathy + ‐logy + Cyt/o + ‐blast + ‐cytosis

to medical terminology when building and  defining these terms. You’ll notice some word parts are repeated from the previous chapter.

Medical Term + ‐emia + ‐emia + ‐penia

Definition

= Hypoalbuminemia : _________ = Hyperbilirubinemia : _________ = Coagulopathy : _________ = Cytology : _________ = Pancytopenia : _________ = Erythroblast : _________ = Erythrocytosis : _________ Pay attention to when “‐osis” is attached to cyt/o to produce the new suffix “‐cytosis.” Erythrocytosis is also referred to as polycythemia (Figure 8.21).

Plasma

White blood cells & platelets Red blood cells

Normal

Anemia

Polycythemia

Figure 8.21  Comparison of three spun blood tubes. Source: Courtesy of Greg Martinez, DVM; http://www. youtube.com/drgregdvm.

Erythr/o Erythr/o Granul/o Hemat/o

+ Cyt/o + ‐poiesis + Cyt/o + ‐logy

+ ‐penia + ‐penia

= Erythrocytopenia = Erythropoiesis = Granulocytopenia = Hematology

: _________ : _________ : _________ : _________

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Hemat/o Hem/o Hem/o

+ ‐poiesis + ‐lytic + ‐lysis

Hem/o Hemoglobin/o Leuk/o

+ ‐stasis + ‐pathy + Cyt/o

Leuk/o Lymph/o Mon/o Mon/o Morph/o poly‐ Myel/o Myel/o Myel/o Myel/o Myel/o

+ ‐cytosis + ‐blast + Nucle/o + ‐blast + ‐logy + Morph/o + ‐blast + ‐genous + ‐oid + ‐poiesis + dys‐

Phag/o hyper‐ hypo‐ Thromb/o Thromb/o Thromb/o

+ ‐cyte + Protein/o + Protein/o + ‐cytosis + ‐osis + Cyt/o

283

= Hematopoiesis = Hemolytic = Hemolysis

+ ‐penia

+ ‐ar + Nucle/o + ‐ar

+ ‐plasia

+ ‐emia + ‐emia + ‐penia

: _________ : _________ : _________ This term is usually used to describe red blood cells. = Hemostasis : _________ = Hemoglobinopathy : _________ = Leukocytopenia : _________ Also called leukopenia. = Leukocytosis : _________ = Lymphoblast : _________ = Mononuclear : _________ = Monoblast : _________ = Morphology : _________ = Polymorphonuclear : _________ = Myeloblast : _________ = Myelogenous : _________ = Myeloid : _________ = Myelopoiesis : _________ = Myelodysplasia : _________ This term is most often used to describe white blood cells instead of bone marrow. It is an ineffective maturation of white blood cells in the bone marrow.

= Phagocyte (Figure 8.22) : _________ = Hyperproteinemia : _________ = Hypoproteinemia : _________ = Thrombocytosis : _________ = Thrombosis : _________ = Thrombocytopenia : _________ This is the most common acquired bleeding disorder in dogs.

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(A) 1

Phagocytosis of enemy cell (antigen)

2

Fusion of lysosome and phagosome

3

Enzymes start to degrade enemy cell

4

Enemy cell broken into small fragments

5

Fragments of antigen presented on APC surface

6

Leftover fragments released by exocytosis

1

2

3 4

5

6

(B)

4

3

1

Mast cell

Neutrophil

Inflammatory chemicals

Bacteria

2

1. Margination 2. Diapedesis 3. Chemotaxis 4. Phagocytosis

Figure 8.22  (A) Role of an antigen‐presenting cell (APC): stages of phagocytosis by a monocyte. A ­monocyte is also a phagocyte. (B) Inflammatory response of neutrophils. Source: (A, B) Courtesy of shutterstock/Alila Sao Mai.

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Abbreviations Table 8.8  Abbreviations.

Abbreviation

Definition

AIHA

Autoimmune hemolytic anemia

IMHA

Immune‐mediated hemolytic anemia

CBC

Complete blood count

Diff

White blood cell differential

HCT

Hematocrit

PCV

Packed cell volume

EPO

Erythropoietin

BMBT

Buccal mucosal bleeding time (Figure 8.23)

nRBC

Nucleated red blood cell

RBC

Red blood cell

WBC

White blood cell

Plt

Platelet

TP

Total protein; test to measure dissolved substances in the plasma (Figure 8.24)

Hb, Hgb

Hemoglobin

hpf

High power field; used when counting cells in a microscope

lpf

Low power field; used when counting cells in a microscope

qns

Quantity not sufficient

VWD

Von Willebrand’s disease

Baso

Basophils

Eos

Eosinophils

Lymph

Lymphocytes

Mono

Monocytes

Seg

Neutrophils

EDTA

Ethylenediaminetetraacetic acid

ESR

Erythrocyte sedimentation rate; rate at which red blood cells settle in a blood tube. In dogs, the rate increases in cases of inflammation. Also called sed rate.

MCH

Mean corpuscular hemoglobin; test to measure the average hemoglobin per cell.

MCHC

Mean corpuscular hemoglobin concentration; test to measure hemoglobin concentration. (Continued )

Table 8.8  (Continued )

Abbreviation

Definition

MCV

Mean corpuscular volume; test to measure the average size of RBCs.

PT

Prothrombin time; coagulation test that measures the activity of certain clotting proteins.

PTT

Partial thromboplastin time; coagulation test that measures the activity of certain clotting proteins.

DIC

Disseminated intravascular coagulation

g/dL

Grams/deciliter; unit of measurement used on total protein.

μL; mcL

Microliters; unit of measurement for blood cell counts

nL

Nanoliter

cL

Centiliter

mL

Milliliter

dL

Deciliter

L

Liter

dkL

Dekaliter

fL

Femtoliter

hL

Hectoliter

kL

Kiloliter

pg

Picogram

Figure 8.23  A Surgicut® device used to perform a BMBT. A small blade inside the device is used to make a small cut inside the cheek of the animal.

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287

(B)

Figure 8.24  (A) A refractometer can be used to measure total protein in blood. (B) Scales in the ­refractometer measure total protein (left) and specific gravity (right).

Case Study You’ll notice some terms from the previous chapters. A four‐month‐old Irish Wolfhound named Gandolf is brought to the clinic after the owner notices prolonged bleeding at the site of recent tooth loss. On P/E Gandolf has blood on his gingiva where his deciduous teeth recently fell out. Doctor orders a CBC. The results are as follows (normal ranges are in parentheses): RBC count WBC countt Platelet count

6.77 × 106 RBC/μL (5.00–10.00 × 106 RBC/μL) 8422 WBC/μL (6000–17 000 WBC/μL) 101 000 plt/μL (200 000–500 000 plt/μL)

1. What does Gandolf have? a. Anemia b. Leukemia c. Thrombocytopenia 2. True or False: Gandolf’s condition is the most common inherited bleeding disorder of dogs.

Exercises 8-A:  Give the term for the following definitions. 1.  _____________________: Red blood cell 2.  _____________________: Granulocyte seen with allergies 3.  _____________________: Agranulocyte that produces antibodies 4.  _____________________: Oxygen‐carrying pigment of RBCs 5.  _____________________: Hormone secreted by kidneys to stimulate erythropoiesis 6.  _____________________: Stopping or controlling of blood

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_____________________: Immature monocyte _____________________: Blood clotting _____________________: Venipuncture _____________________: Increase in cancerous WBCs _____________________: Fat in the plasma _____________________: Escape of blood from ruptured blood vessels

8-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Hemostasis ______________________ Neutropenia _____________________ Eosinophilia _____________________ Morphology _____________________ Thrombosis ______________________ Bilirubin ________________________ Antigen ___________________________ Megakaryocyte _____________________ Packed cell volume __________________ Dyscrasia _________________________

8-C:  Answer the following questions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

What is the stimulus for lymphopoiesis?____________ What clotting factor is missing in Von Willebrand’s disease? ____________ What causes aplastic anemia?____________ What is the function of a neutrophil?____________ Which organ conjugates bilirubin?____________ List three locations of macrophages. ____________ If blood is placed in a green TT, then the fluid that results is called ____________. What is the difference between leukemia and leukocytosis?____________ Another name for erythrocytosis is ____________. The synonymous abbreviation for HCT is ____________. True or False: Thrombosis is the same as thrombocytosis. What color is the plasma with hyperbilirubinemia?____________

8-D:  Define the following abbreviations. 1. 2. 3. 4. 5.

___________________: CBC ___________________: DIC ___________________: hpf ___________________: qns ___________________: Diff

A.  B.  C.  D.  E. 

___________________: Hgb ___________________: AIHA ___________________: TP ___________________: IMHA ___________________: lpf

8-E:  Give the term for the following definitions. 1.  2.  3.  4.  5. 

Resembling bone marrow: myel____________ Pertaining to one nucleus: mono____________ Destruction of RBCs: ____________lysis Deficiency in all cells: ____________penia Disease condition of clotting: coagulo____________

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6.  7.  8.  9.  10. 

289

Increase in WBCs: leuko____________ Blood condition of decreased albumin: hypo____________ RBCs are unequal in size: ____________osis State of equilibrium of the body’s internal environment: ____________stasis Decrease in RBCs and/or Hb due to loss: ____________anemia

8-F:  Match the following terms with their descriptions. 1. 2. 3. 4. 5.

____________ Protein threads forming the basis of a clot ____________ Segs, eos, basos ____________ Enzyme that converts fibrinogen to fibrin ____________ Lymphs, monos ____________ Maintains blood volume

A.  B.  C.  D.  E. 

Agranulocytes Albumin Fibrin Granulocytes Thrombin

8-G:  Match the WBCs with their function and stimulus. Blanks may have more than one answer. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

____________ Allergies ____________ Antigens ____________ Bacterial infection ____________ Produces antibodies ____________ Anaphylaxis ____________ Bacteriophage ____________ Exaggerated hypersensitivity ____________ Parasites ____________ Natural antihistamine ____________ Macrophage

A.  B.  C.  D.  E. 

Neutrophil Eosinophil Basophil Lymphocyte Monocyte

Answers can be found starting on page 675.

Review Tables Fill in the tables and refer to Tables 8.5–8.8 for answers. Table 8.9

Combining Forms

Definition

Combining Forms

Albumin/o

Leuko/o

Bas/o

Lip/o

Bilirubin/o

Lymph/o

Chrom/o

Mon/o

Coagul/o

Morph/o

Cyt/o

Myel/o

Eosin/o

Neutr/o

Erythr/o

Nucle/o

Definition

(Continued )

Table 8.9  (Continued )

Combining Forms

Definition

Combining Forms

Granul/o

Phag/o

Hem/o

Phleb/o

Hemat/o

Poikil/o

Hemoglobin/o

Protein/o

Home/o

Sider/o

Is/o

Spher/o

Kary/o

Thromb/o

Definition

Table 8.10

Prefix

Definition

Prefix

a‐, an‐

mega‐

anti‐

micro‐

dys‐

mono‐

hyper‐

pan‐

hypo‐

poly‐

Definition

macro‐

Table 8.11

Suffix

Definition

Suffix

‐ar, ‐ic

‐oid

‐blast

‐osis

‐cyte

‐pathy

‐cytosis

‐penia

‐emia

‐phage

‐emic

‐phil

‐genous

‐philia

‐globin

‐plasia

‐globulin

‐poiesis

‐logy

‐rrhage

‐lysis

‐stasis

‐lytic

‐tomy

Definition

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Table 8.12

Abbreviation

Definition

AIHA IMHA CBC Diff HCT PCV EPO BMBT nRBC RBC WBC Plt TP Hb hpf lpf qns VWD Baso Eos Lymph Mono Seg EDTA ESR MCH MCHC MCV (Continued )

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Table 8.12  (Continued )

Abbreviation

Definition

PT PTT DIC g/dL μL; mcL nL cL mL dL L dkL fL hL kL pg

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word search puzzle

C h a p t e r

9

Immunology

Immunology is the study of the body’s immune system. Three different systems work together to defend the body against foreign organisms such as bacteria, viruses, parasites, and fungi. The systems include the blood system, the lymphatic system, and the immune system itself.

The Lymphatic System The lymphatic system is made up of lymph vessels, lymph nodes, lymph fluid, and lymphoid organs. The lymphatic system has several functions besides immunity. It acts as a drainage system to collect any materials such as proteins that have leaked out of the circulatory system and transport them back to the blood. A second function is to transport substances. Examples include transporting fat that was absorbed by the intestinal villi to the bloodstream or transporting metabolic waste products from tissue to the bloodstream. Finally, it stores lymphocytes which produce antibodies in response to antigens. Lymphoid organs include the spleen and thymus gland. The spleen has three functions: it destroys old erythrocytes, filters the blood of foreign materials and organisms, and stores erythrocytes and

platelets. In veterinary medicine, splenomegaly (enlargement of the spleen) is frequently seen (Figure  9.1). The organ becomes enlarged due to neoplasias, inflammation, or excessive hemolysis. When enlarged, the risk of splenic rupture increases so a splenectomy is performed. Once removed, the macrophages in the liver and bone marrow take over the functions of the spleen. The thymus gland is located in the cranial mediastinum (Figure  9.2). The sole function of the thymus is to aid in immunity through the modification and storage of lymphocytes. The thymus gland  is most active in younger animals and tends to decrease in function as the animal gets older. Lymph fluid, or lymph, is a combination of water, lymphocytes, wastes, and a small amount of plasma proteins. As blood circulates, a small amount of fluid filters out of the capillaries and into the tissue spaces between cells (Figure  9.3). This fluid within the tissues is called interstitial fluid. As the fluid shifts through the interstitial space, it passes through tiny vessels called lymph capillaries. Once in the lymph capillaries, the fluid is referred to as lymph. The function of lymph is to transport waste products of metabolism from the

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Figure 9.1  Splenomegaly in a dog. Source: Courtesy of Deanna Roberts, BA, AAS, CVT.

Larynx Thyroid gland Trachea

Thymus

Lung

Pericardium

Heart

Figure 9.2  Diagram showing the location of the thymus gland. Source: Courtesy of shutterstock/GRei.

tissues to blood and to transport nutrients from the blood into the tissues. Lymph moves through the capillaries and into larger lymph vessels which are similar to veins in that the vessels only allow movement in one direction. The flow of lymph is always toward the thoracic cavity.

TECH TIP 9.1  Do Animals Have Tonsils? Tonsils are small masses of lymphoid tissue. Tonsils can be found in several areas of an animal’s body, but are most commonly associated with the throat.

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Vein Lymphatic trunk Lymph node Artery

Tissue cells Blood capillary bed Tissue fluid

Lymphatic capillaries

Figure 9.3  Lymphatic circulation. Source: Courtesy of shutterstock/Alex Luengo.

Along the lymphatic vessels are areas of stationary lymph tissue, called lymph nodes, which filter the lymph as it circulates around the body (Figure  9.4). Lymphocytes are stored within the lymph nodes (Figure 9.5). If an animal becomes sick, its lymph nodes will swell due to the proliferation (multiplication) of lymphocytes and the excessive amount of cells being destroyed during the filtration of lymph fluid. Lymph nodes can also become swollen due to neoplasias such as lymphoma. If the lymph vessels become obstructed, then the lymphatic fluid can’t drain. The fluid begins to accumulate in the tissue spaces, causing a condition called lymphedema (Figure 9.6). All lymph vessels merge into two large ducts in the chest, called lymphatic ducts. The right lymphatic duct empties into the venous system and drains lymph from the cranial right side of the body. The left

l­ymphatic duct, also called the thoracic duct, enters the circulatory system and drains the left cranial side of the body.

The Blood System As introduced in Chapter  8, neutrophils are granulocytes that act as bacterial phagocytes. Monocytes are agranulocytes that are phagocytic cells used to back up the neutrophils. Their responsibility is to remove any remnants that neutrophils leave behind. This is one aspect of the body’s natural defense mechanisms and is termed natural immunity. Every animal is born with this defense mechanism. When bacteria are introduced to the body through a wound, neutrophils are  the first to respond. They are the inflammatory mediators. The neutrophils

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Popliteal lymph nodes

Submandibular lymph nodes Cervical lymph nodes Axillary lymph nodes Inguinal lymph nodes

Figure 9.4  Lateral view of a dog showing the location of main lymph nodes. Source: Courtesy of shutterstock/tiggra.

Afferent lymphatic vessels

Sinus

Lymphatic nodule Germinal center

Capsule

Efferent lymphatic vessel

Figure 9.5  Anatomy of a lymph node. Source: Courtesy of shutterstock/Alila Sao Mai.

that are circulating in the blood begin to move across the vessel walls and into the tissues to engulf the bacteria. The process by which the neutrophils migrate from the  vasculature to the tissue is termed

­ iapedesis. Once at the site of infection, d the neutrophils engulf the bacteria. Monocytes soon follow to remove any remaining bacteria and cells. Once monocytes leave the vessels, they become tissue

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Capillary bed drainage by lymphatic capillary Lymphatic capillary

Tissue fluid (mostly colloidal substances) enters lymphatic capillary

Tissue fluid Capillary

Tissue cells Red cell

Arteriole

Venule

High pressure Plasma exuded

Low pressure Tissue fluid enters capillary

Capillary bed following loss/disruption of local lymphatics Capillary

Build-up of tissue fluid causing swelling (lymphedema)

Arteriole

Venule

Tissue cells

Figure 9.6  Illustration of lymphedema. Source: Courtesy of shutterstock/blamb.

macrophages capable of engulfing any foreign organisms including bacteria. If the animal has an infestation of worms and the worms have recently been killed, then the tissue macrophages will remove the dead worms.

The Immune System The immune system is the third type of immunity. Based on the name, the animal acquires immunity from an outside source. There are two types of immunity: active

immunity and passive immunity Passive immunity is the transfer of antibodies from a donor to a recipient. ­ Mammals obtain passive immunity with the ingestion of colostrum soon after birth. Colostrum has a high concentration of antibodies from the mother. Animals may also receive maternal antibodies while in utero through the placenta. In birds, maternal antibodies are transferred to the yolk of the egg where the developing chick can absorb them. Examples of passive immunity aren’t just isolated to maternal antibodies. Other examples include the

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administration of antitoxins after snake bites, injections of immunoglobulins (antibodies) in patients with poorly developed immune systems, or plasma transfusions. Active immunity is immunity that the animal acquires after being exposed to an antigen. The most obvious example is the administration of a vaccine. A vaccine is a suspension containing a killed or modified live virus that is given via injection. After receiving the vaccination, the animal undergoes an immune response which creates a memory to prevent future infections. Another example, which isn’t as common in animals as in humans, is simply getting sick and creating antibodies toward the virus. Those newly created antibodies remain in the body to prevent future sickness from the same virus. Once an animal undergoes an immune response, two specialized cell types are activated: B‐lymphocytes and T‐lymphocytes.

1. Antigen recognition

APC

Antigen

B‐lymphocytes develop from stem cells in the bone marrow and are activated by binding to the antigens. Once activated, the B‐lymphocytes differentiate (transform) into plasma cells, which produce immunoglobulins (antibodies) that neutralize the antigens by attaching to them. There are five different immunoglobulins with specialized functions: IgA, IgD, IgE, IgG, and IgM. This immune response is termed humoral immunity. T‐lymphocytes are produced in the bone marrow and then stored in the thymus gland (Figure 9.7). T‐lymphocytes don’t produce antibodies; instead, they attack the antigens directly. T‐lymphocytes proliferate in the presence of antigens, and then the resultant cells, T‐ cells, destroy the antigens. There are four subsets of T‐cells with more specialized functions. This immune response is known as cell‐mediated immunity.

MHC-II CD4+

Helper T cell

2. Clonal selection Effector cells

3. Interleukin secretion Memory T cell

Neutrophils, Macrophages Killer T cell Cellular Immunity Nonspecific Defense

B cell Humoral Immunity

Figure 9.7  Illustration of helper T‐cells and their role in immunity. Source: Courtesy of shutterstock/Alila Medical Images.

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TECH TIP 9.2  What Does Each Immunoglobulin Do? IgA IgD IgE IgG IgM

Exists in secretions of the body including saliva, bile, synovial fluid, intestinal secretions, and respiratory secretions including mucus. IgA acts as the body’s first line of defense in the mucous membranes. Exists on the surface of B‐lymphocytes and in serum. Its function is unknown. Exists in skin, lungs, and mucous membranes. IgE is increased in animals with allergies and therefore plays a role in allergic reactions. Also increased in animals with parasites. The most abundant of the immunoglobulins. Produced in response to antigens. It is the only immunoglobulin that can cross the placenta and plays a major role in passive transfer of maternal antibodies. First immunoglobulin produced in an immune response. Produced in response to antigens.

Helper T‐cells Cytotoxic T‐cells Suppressor T‐cells Memory T‐cells

Stimulate antibody production from B‐lymphocytes and stimulate cytotoxic T‐cells. Directly attack and destroy the antigen. Deactivate, or suppress, the B‐lymphocytes and T‐lymphocytes when they’re no longer needed. Initiate a quicker immune response in the future due to a previous encounter with the same antigen. These cell populations are dedicated to one specific antigen.

Related Terms Acquired immunity Antibody (Ab) Antigen (Ag) Antitoxin Bacterin Cellular immunity Histiocyte Humoral immunity Immunity Immunoglobulins Interstitial fluid Lymph Lymph capillaries Lymph node

Formation of antibodies after exposure to an antigen. Proteins produced by white blood cells in response to antigens. Foreign substance (protein) that stimulates the production of antibodies. Injection of preformed antibodies to a toxin. Immunization consisting of bacterial antigens. Immune response in which T‐lymphocytes directly attack antigens. Also called cell‐mediated immunity. A macrophage. Histiocytes are named based on their tissue locations. Immune response in which B‐lymphocytes produce immunoglobulins in response to antigens. The body’s ability to resist organisms and toxins; also called immune response. Antibodies (gamma globulins) produced by plasma cells (Figure 9.8). Fluid in the spaces between cells; extracellular fluid in tissues. Watery fluid found in lymphatic vessels. Tiniest lymphatic vessels. Stationary, bean‐shaped structure along lymphatic vessels.

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Immunoglobulin

Antigen

Immunoglobulin binds to antigen

Figure 9.8  Immunoglobulins attacking antigens. Source: Courtesy of shutterstock/blamb.

Lymph vessels Macrophages

Vessels that carry lymph throughout the body. Monocytes that migrate from the blood to the tissue; large phagocytes. Exist in liver, spleen, and bone marrow. Transfer of antibodies from a donor to a recipient resulting in a temporary, immediate immunity. An example would be colostrum which contains antibodies from the mother for the offspring. Organ in the cranial abdomen that stores, produces, and destroys blood cells. Organ in the cranial mediastinum that produces and stores lymphocytes. Immunization containing toxin antigens to elicit an immune response. These toxins have been modified using heat or chemicals to prevent a toxic reaction to the patient, yet still induce an immune response.

Passive immunity

Spleen Thymus gland Toxoid

Pathology and Procedures Allergen Allergy

Substance that causes a specific hypersensitivity. Abnormal hypersensitivity to an antigen (Figure 9.9). Antigen

B-cell

IgE

Mast cell

Memory T-cell

Histamine

Macrophage Figure 9.9  Mechanism of an allergy. Source: Courtesy of shutterstock/Designua.

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Allergy testing Test to determine if a patient has a hypersensitivity to an antigen. This can be done through blood testing for the presence of antigen‐ inducing antibodies or through intradermal testing (Figure 9.10). Anaphylaxis Exaggerated hypersensitivity to a foreign substance. Autoimmune Disease in which the body makes antibodies against its own good disease cells and tissues.

(A)

(B)

Figure 9.10  Intradermal allergy testing. (A) Mild reaction to intradermal testing on a beagle. (B) Severe reactions to intradermal testing in a mixed breed dog. Source: Courtesy of Brittany Lindstrom, BS, AAS, LVT.

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Carrier Culture Edema ELISA

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An animal that harbors a disease without displaying signs of infection. The animal can still transmit the disease to others. Cultivation of microorganisms in special media. Excess fluid (interstitial fluid) in tissues (Figure 9.11). Enzyme‐linked immunosorbent assay. Test to detect the presence of antibodies or antigens in a patient sample. Commonly used in‐house ELISA tests include heartworm, parvo, feline leukemia, and feline immunodeficiency virus. Also called a Snap® test (Figure 9.12).

Figure 9.11  Submandibular edema in a cow. This condition is commonly called bottle jaw. Source: Courtesy of WikiCommons/Lucyin.

(A)

(B)

Figure 9.12  Examples of ELISA tests used in‐house. (A) FeLV/FIV combo test. (B) K‐9 heartworm test.

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Febrile Feline infectious peritonitis (FIP)

Having a fever. Disease caused by a coronavirus in cats (Figure 9.13)

(A)

(B)

(C)

Figure 9.13  Feline infectious peritonitis. (A) Lateral radiograph of fluid in the abdomen. (B) Ventral radiograph showing the inflammation in the abdomen. (C) Small masses on the abdominal viscera. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Feline immunodeficiency virus (FIV) Feline leukemia virus (FeLV) Hypersplenism

Retrovirus causing immunosuppression. Also known as feline AIDS. Retrovirus that causes leukocytosis, immunosuppression, and lymphoma. The virus is passed through saliva and excretions. Condition marked by splenomegaly and excessive cell destruction causing anemia, leukopenia, and thrombocytopenia. Bone marrow biopsy shows increased cell numbers in response to the pancytopenia.

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Immunofluorescent antibody test (IFA) Immunosuppression Lymphoma

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Test used to detect antigens or antibodies using fluorescent dye. Widely used in veterinary medicine in reference laboratories. Impaired immune response; also known as immunocompromised or immunodeficient. Malignant tumor of lymphoid tissue; also called lymphosarcoma. This is the most common neoplasm of lymph nodes (Figure 9.14).

Figure 9.14  Blood film from a dog with lymphoma. Note the elevated number of lymphocytes (lymphocytosis). Many of these lymphocytes are abnormal in morphology. Source: Courtesy of shutterstock/ Kantarose Boonyuen.

Opportunistic Remission Relapse Resistant Retrovirus Sepsis Susceptible Toxin Vaccine Vaccination Zoonotic

Organism which is normally nonpathogenic that becomes pathogenic in certain conditions. Symptoms lessen and the patient feels better. Symptoms return after an apparent recovery. Does not easily affect; not susceptible. This term is often used to describe the relationship between a microorganism and antibiotics. RNA virus that multiplies by using the host’s DNA. An example would be FIV (Figure 9.15). Infection in the blood or other tissues (Figure 9.16). Easily affected; lacking resistance. This term is often used to describe the relationship between a microorganism and antibiotics. A poison. Suspension containing a killed or weakened microorganism given via injection to induce immunity; immunization containing viral antigens. Administration of a suspension containing a killed or weakened microorganism to induce immunity. Also called immunization. Disease capable of being transmitted from animals to humans.

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FIV entry to T-cell Docking CD4 receptor and corecepter Fusion

Double-stranded DNA

Viral RNA Reverse transcription cDNA

Integration

Chromosomal DNA

Provirus

Figure 9.15  Mode of entry and replication of a retrovirus, in this case FIV, in a T‐cell. Source: Courtesy of shutterstock/Alila Sao Mai.

2. Bacteria enter blood

1. Sources of infection

3. Leaking blood vessels

DEATH

4. Organ dysfunction

Figure 9.16  Sepsis. Source: Courtesy of shutterstock/Designua.

Building the Terms Now it’s time to assemble the word parts listed in Tables  9.1–9.3. If you memorize the meaning of the combining forms, ­prefixes, and suffixes, then this

will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

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Table 9.1  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Aden/o

Gland

Pyr/o, Pyret/o, pyrex/o

Fire; fever

Axill/o

Armpit

Seps/o, Sept/o

Infection

Chem/o

Drug; Chemical

Splen/o

Spleen

Cyt/o

Cell

Staphyl/o

Clusters; Uvula

Immun/o

Immune; Protection; Safe

Strept/o

Twisted Chains

Inguin/o

Groin

Thym/o

Thymus Gland

Lymph/o

Lymph

Tonsill/o

Tonsils

Lymphaden/o

Lymph Node (Gland)

Tox/o

Poison

Lymphangi/o

Lymph Vessel

Table 9.2  Prefixes.

Prefix

Definition

a‐, an‐

no, not, without

ana‐

up; apart; backward; again; anew

anti‐

against

auto‐

self; own

inter‐

between

Table 9.3  Suffixes.

Suffix

Definition

Suffix

Definition

‐al

pertaining to

‐itis

inflammation

‐ary

pertaining to

‐logy

study of

‐coccus; ‐cocci

berry‐shaped bacterium

‐oid

resembling

‐cyte

cell

‐oma

tumor; mass; collection of fluid

‐cytosis

increase in the number of cells

‐pathy

disease condition

‐ectomy

removal; excision; resection

‐penia

deficiency

‐globulin

protein

‐poiesis

formation

‐ic

pertaining to

‐sis

condition, state of

‐ism

process; condition

‐therapy

treatment

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Parts

Medical Term

anti‐ + Pyret/o a + Sept/o anti‐ + Sept/o Axill/o Chem/o Inguin/o Lymph/o Lymph/o

+ ‐ic + ‐ic + ‐ic + ‐ary + ‐therapy + ‐al + ‐oid + ‐poiesis

Lymph/o Lymph/o

+ ‐cytosis + Cyt/o + ‐penia

Definition

= Antipyretic = Aseptic = Antiseptic = Axillary = Chemotherapy = Inguinal = Lymphoid = Lymphopoiesis

: ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ Term can be used to describe lymphocytes or lymph fluid. = Lymphocytosis : ______________ = Lymphocytopenia : ______________ Also called lymphopenia.

Streptococcus pyogenes

Staphylococcus aureus

Streptococcus pneumoniae

Bacillus

Klebsiella pneumoniae Giardia E. coli; Salmonella

Bordetella pertussis

Corynebacterium diphtheriae

Helicobacter pylori

Fungus Clostridium botulinum

Clostridium tetani

Figure 9.17  Various pathogens seen in veterinary medicine including bacteria, protozoans, and fungus. Source: Courtesy of shutterstock/Sebastian Kaulitzki, shutterstock/Alila Sao Mai, and shutterstock/blamb.

308

Lymphaden/o Lymphaden/o Lymphangi/o Pyrex/o Splen/o Splen/o Staphyl/o Strept/o Thymo Thym/o Tonsill/o Tonsill/o Tox/o

Veterinary Medical Terminology Guide and Workbook

+ ‐itis + ‐pathy + ‐oma + ‐ic + ‐ectomy + ‐megaly + ‐cocci + ‐coccus + ‐ectomy + ‐oma + ‐ectomy + ‐itis + ‐ic

= Lymphadenitis = Lymphadenopathy = Lymphangioma = Pyrexic = Splenectomy = Splenomegaly = Staphylococci (Figure 9.17) = Streptococcus (Figure 9.18) = Thymectomy = Thymoma = Tonsillectomy = Tonsillitis (Figure 9.19) = Toxic

: ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________ : ______________

Figure 9.18  Streptococcus on a blood agar plate showing beta hemolysis. Source: Courtesy of shutterstock/attem.

Figure 9.19  Dog with tonsillitis. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/ drgregdvm.

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Abbreviations Table 9.4  Abbreviations.

Abbreviation

Definition

CA

Cancer

ELISA

Enzyme‐linked immunosorbent assay

FeLV

Feline leukemia virus

FIV

Feline immunodeficiency virus

IFA

Immunofluorescent antibody test

IgA, IgD, IgE, IgG, IgM

Immunoglobulins

LN

Lymph node

mets

Metastasis

sol.; soln

Solution

tab

Tablet

bx

Biopsy

dx

Diagnosis

DDx

Differential diagnosis

fx

Fracture

hx

History

Rx

Prescription/medication

sx

Surgery

Tx

Treatment

TR

Treatment

LRS

Lactated Ringer’s solution

PSS

Physiological saline solution (0.9% NaCl), normal saline

LSA

Lymphosarcoma

MCT

Mast cell tumor

sp.; spp.

Species

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Case Study You’ll notice some terms from the previous chapters. Ms. Petersen has just brought in her new kitten, Tofino. She found Tofino in the parking garage at her office. Based on Tofino’s pearly white teeth, it’s estimated that he’s around eight months old. Tofino is frisky during the exam, chasing the stethoscope and playing with the veterinarian’s pen. Before giving his vaccinations, venipuncture is performed so an FeLV/FIV Snap test can be done. Tofino turns up positive for FeLV Ag and negative FIV Ab. Because Tofino shows no signs of the disease, additional blood is drawn and sent to a reference lab for an IFA. The IFA can detect intracellular Ags, whereas the Snap test can only detect the Ags circulating freely in the blood. The IFA comes out negative for FeLV Ag. When seen 8–12 weeks later, another Snap test is done and still comes out positive for FeLV Ag. Tofino is still acting fine. 1. What is Tofino? a. A carrier b. Susceptible c. Autoimmune 2. What is another name for the Snap test? a. Retrovirus b. ELISA c. Allergen 3. Where can the IFA detect the antigens? a. In tissues b. Inside cells c. Outside cells

Exercises 9-A:  Give the term for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

__________: Disease capable of being transmitted from animals to humans __________: Another name for a macrophage __________: Stationary lymph tissue along lymph vessels __________: Substance that causes a hypersensitivity __________: Excess fluid in tissue __________: Lymphs that differentiate to plasma cells __________: Lymphoid organ that produces, filters, and stores blood. __________: Disease in which the body makes antibodies against its own cells and tissues __________: Removal of the spleen __________: A poison __________: Transfer of antibodies from a donor to a recipient resulting in a temporary, immediate immunity. __________: Vaccine consisting of killed bacteria

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9-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

Lymphangioma _____________________________________________________ Lymphadenitis ______________________________________________________ Toxic ______________________________________________________________ Resistant ___________________________________________________________ Tonsillitis ___________________________________________________________ Lymphocytosis ______________________________________________________ Thymoma __________________________________________________________ Lymphoid __________________________________________________________ Immunosuppression __________________________________________________ Interstitial fluid ______________________________________________________ Carrier _____________________________________________________________ Culture _____________________________________________________________

9-C:  Answer the following questions. 1.  2.  3.  4. 

Give an example of a retrovirus: _______________________________________ Where are inguinal lymph nodes found? _________________________________ Which T‐cells inhibit the B‐lymphs? ____________________________________ Define an immune response in which a recipient receives antibodies from a donor. _____________________________________________________________ 5.  Where are axillary lymph nodes found? _________________________________

9-D:  Define the following abbreviations. 1.  2.  3.  4.  5.  6.  7. 

——————————: ELISA ——————————: IFA ——————————: LN ——————————: FeLV ——————————: FIV ——————————: Sx ——————————: LSA

8.  9.  10.  11.  12.  13.  14. 

——————————: Rx ——————————: mets ——————————: bx ——————————: Tx ——————————: LRS ——————————: MCT ——————————: PSS

9-E:  Match the following terms with their descriptions. 1.  —————— Fluid found in lymphatic vessels 2.  —————— F  ormation of Abs after exposure to an Ag 3.  —————— Malignant tumor of lymphoid tissue 4.  —————— N  ormally nonpathogenic disease that becomes pathogenic 5.  —————— Antibodies Answers can be found starting on page 675.

A.  Acquired immunity B.  Immunoglobulins C.  Lymph D.  Lymphoma E.  Opportunistic

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Review Tables Fill in the tables and refer to Tables 9.1–9.4 for answers. Table 9.5

Combining Forms

Definition

Combining Forms

Aden/o

Pyr/o, Pyret/o, pyrex/o

Axill/o

Seps/o, Sept/o

Chem/o

Splen/o

Cyt/o

Staphyl/o

Immun/o

Strept/o

Inguin/o

Thym/o

Lymph/o

Tonsill/o

Lymphaden/o

Tox/o

Lymphangi/o

Table 9.6

Prefix a‐, an‐ ana‐ anti‐ auto‐ inter‐

Definition

Definition

Chapter 9 Immunology

313

Table 9.7

Suffix

Definition

Suffix

‐al

‐itis

‐ary

‐logy

‐coccus; ‐cocci

‐oid

‐cyte

‐oma

‐cytosis

‐pathy

‐ectomy

‐penia

‐globulin

‐poiesis

‐ic

‐sis

‐ism

‐therapy

Definition

Table 9.8

Abbreviation

Definition

CA ELISA FeLV FIV IFA IgA, IgD, IgE, IgG, IgM LN mets sol.; soln tab bx dx DDx fx hx Rx sx (Continued )

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Table 9.8  (Continued )

Abbreviation

Definition

Tx TR LRS PSS LSA MCT sp.; spp.

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word search puzzle

C h a p t e r

10

The Endocrine System

The endocrine system can be the most overwhelming system to learn (Table 10.1 and Figure 10.1). By comparison, systems such as the cardiovascular system and gas­ trointestinal systems aren’t as intimidating because we have a basic understanding of the purpose of the heart and stomach.

The endocrine system is made up of glands that secrete hormones into the blood­ stream. Hormones are chemical messengers that have a lock‐and‐key effect in which they bind to sites on other organs and tissues to trigger an action. These hormones only bind to specific sites called target tissues.

Table 10.1  Endocrine glands. Adrenal glands

Pair of suprarenal endocrine glands. These glands are made up of a cortex (outer section) and a medulla (inner section).

Ovaries

Pair of female organs on either side of the pelvis that produce estrogen and progesterone.

Pancreas

Organ under the stomach that produces insulin, glucagon, and digestive enzymes.

Parathyroid glands

Four small endocrine glands on the posterior aspect of the thyroid gland that regulate calcium.

Pineal gland

Endocrine gland in the brain which synthesizes melatonin. It is believed that the pineal gland influences sexual development and sleep–wake cycles.

Pituitary gland

Endocrine gland at the base of the brain composed of an anterior and posterior portion. Commonly known as the “master gland.”

Testicles

Male gonads that produce spermatozoa and the hormone testosterone.

Thymus gland

Gland in the cranial mediastinum that produces and stores lymphocytes.

Thyroid gland

Endocrine gland in the neck that produces thyroid hormones which help regulate metabolism. It is the largest of the endocrine glands and is responsible for the storage of iodine.

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Adrenal gland

Endocrine glands

Capsule

Cortex

Medulla

Kidney Ovary

Thyroid gland

Parathyroid glands

Uterus

Pancreas Testicle

Figure 10.1  Endocrine glands of the body. Source: Courtesy of shutterstock/serg741.

The goal of the endocrine system is to maintain homeostasis, which is the state of equilibrium of the body’s internal environ­ ment. For example, the pancreas produces the hormone insulin, which decreases blood sugar, as well as the hormone glucagon, which increases blood sugar.

Endocrine Glands The Pituitary Gland The pituitary gland, or hypophysis, is commonly known as the “master gland” of the body because it secretes hormones that control all other endocrine glands. The pituitary is divided into two lobes, the adenohypophysis (anterior portion) and the neurohypophysis (posterior portion). The adenohypophysis produces hor­ mones which stimulate other organs to  produce more specialized hormones.

The neurohypophysis produces hormones that directly stimulate a target organ. Figure  10.2 shows the pituitary and its functions. Note the differences between the anterior and posterior lobes. The pituitary gland is attached by a stalk, the infundibulum, to the hypothal­ amus of the brain. The hypothalamus is the portion of the brain that secretes releasing and inhibiting factors that affect the pituitary gland. Together, the hypothalamus and pituitary work on the principle of nega­ tive feedback. When the concentration of a certain hormone reaches a normal range, the hypothalamus and pituitary are inhib­ ited. If the hormone levels drop below normal levels, the hypothalamus begins secreting its releasing factors to stimulate the pituitary to secrete more hormones. Figure  10.3 and Table  10.2 list the hormones that are released from the pituitary.

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(A) Hypothalamus

Anterior pituitary Thyroid Gonad

Adrenal cortex

(B) Hypothalamus: Paraventricular nucleus Supraoptic nucleus

Posterior pituitary

Uterus ADH

Kidney

OT

Mammary glands

Figure 10.2  (A) Secretions from the anterior pituitary. (B) Secretions from the posterior pituitary. Source: Courtesy of shutterstock/Alila Sao Mai.

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Thyroid Gland The thyroid gland is a butterfly‐shaped gland found in the neck on either side of the larynx (Figure 10.4). This gland regu­ lates metabolism, stores iodine, and regu­ lates calcium levels. The thyroid produces Thyroid Hypothalamus

Pituitary (Anterior) (Posterior)

ADH Oxytocin

ACTH FSH GH LH MSH PRL TSH

Trachea

Figure 10.3  Summary of pituitary secretions.

Parathyroid glands

Figure 10.4  Anatomical location of the thyroid and parathyroid glands. Source: Courtesy of shutterstock/Zuzanae.

Table 10.2  Pituitary hormones. ADH

Antidiuretic hormone. Secreted from the posterior pituitary and controls the reabsorption of water by the kidneys. Also called vasopressin.

Oxytocin

Secreted by the posterior pituitary and causes the uterus to contract and stimulates milk secretion.

ACTH

Adrenocoricotropic hormone. Released by the anterior pituitary and stimulates the adrenal cortex to secrete steroids.

FSH

Follicle‐stimulating hormone. Released by the anterior pituitary and stimulates the maturation of the ovum.

GH

Growth hormone. Released by the anterior pituitary and stimulates the growth of bones and tissues. Also known as somatotropin.

LH

Luteinizing hormone. Released by the anterior pituitary to promote ovulation.

MSH

Melanocyte‐stimulating hormone. Released by the anterior pituitary and stimulates the production of melanin which gives the skin its pigment.

PRL

Prolactin. Released by the anterior pituitary and stimulates milks secretion.

TSH

Thyroid‐stimulating hormone. Released by the anterior pituitary and stimulates the thyroid to produce thyroid hormones.

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Thyroid hormones TRH - Thyroid Releasing Hormone TSH - Thyroid Stimulating Hormone T3 - Triiodothyronine hormone T4 - Thyroxine hormone

Hypothalamus

Neg

TRH

ati v ef

ee

db

Pituitary gland

ac

ki

n hib

Thyroid gland it i o n

TSH

T3

Calcitonin T4

Figure 10.5  The thyroid gland and its hormones. Source: Courtesy of shutterstock/Designua.

and secretes the hormones thyroxine (T4), triiodothyronine (T3), and calcitonin (Figure 10.5). T3 is made up of three iodine atoms, which is where its chemical name comes from. T4 is made up of four iodine atoms which is where its lesser known chemical name, tetraiodothyronine, comes from. Together, these two hormones regulate the body’s metabolism. Calcitonin controls the absorption of calcium from the blood into the bones. When a patient becomes hypercalcemic, calcitonin is secreted to stimulate the calcium to move from the blood to the bones to be stored.

Parathyroid Glands The parathyroid glands are four endocrine glands on the posterior aspect of the thy­ roid gland. They secrete a hormone called parathormone (PTH) which regulates calcium and phosphorus levels in the

blood. When secreted from the parathyroid  glands, PTH acts on the ­kidneys, controlling calcium reabsorption and phosphorus excretion. Calcium gets reabsorbed back into the bloodstream and phosphorus is excreted in the urine. PTH also causes the release of calcium from the bones back into the bloodstream when the patient becomes hypocalcemic.

Adrenal Glands The adrenal glands are located on the cranial aspect of each kidney. Each adrenal gland is divided into two parts, the adrenal cortex and the adrenal medulla (Figure 10.6). The adrenal cortex is the outer section of the adrenal gland and secretes steroid hormones called corticosteroids. Steroids, or corticosteroids, are derived from fats and are used in the production of hormones. Three types of corticosteroid are produced in the adrenal cortex: mineralocorticoids, glucocorticoids, and androgens.

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Capsule

Adrenal cortex: Zona glomerulosa Zona fasciculata Zona reticularis

Medulla

Figure 10.6  Anatomy of the adrenal gland. Source: Courtesy of shutterstock/Alila Sao Mai.

Mineralocorticoids are corticosteroids that regulate electrolyte and water balance. The principal mineralocorticoid is aldoste­ rone. Aldosterone acts on the kidneys to control the reabsorption of sodium back into the bloodstream and the excretion of potassium in the urine. If an animal has hyponatremia (decreased sodium), aldo­ sterone is released by the adrenal gland to stimulate the kidneys to reabsorb sodium back into the bloodstream. Where sodium goes, water follows. When sodium is reab­ sorbed, water is also reabsorbed. Glucocorticoids are corticosteroids that regulate the metabolism of carbohydrates, fats, and proteins, and they have an anti‐ inflammatory effect. The principal gluco­ corticoid is cortisol, which regulates the metabolism of carbohydrates, fats, and proteins. When carbohydrate levels are low, cortisol is released to promote the body’s cells to produce glucose using fats and proteins. This process is known as gluconeogenesis and occurs in the liver. Cortisone is a glucocorticoid that is released in cases of stress and has anti‐ inflammatory effects. Cortisone inhibits the immune system, which can decrease inflammation.

Androgens are corticosteroids respon­ sible for male sex characteristics. The adrenal medulla is the inner section of the adrenal gland. It secretes catechol­ amines, which are hormones derived from amino acids. There are two types of catecholamines, epinephrine and norepi­ nephrine. Epinephrine, also known as adrenaline, is a catecholamine that acts on the sympathetic nervous system to increase heart rate, blood pressure, and glucose levels. Norepinephrine, also known as noradrenaline, is a catecholamine that promotes vasoconstriction (vessel con­ traction), increases blood pressure, and increases heart rate.

The Pancreas The pancreas is both an endocrine and exocrine organ. The exocrine functions were discussed in Chapter  4. To review, the exocrine functions of the pancreas include the production of the digestive enzymes amylase, lipase, and trypsin. The endocrine functions of the pancreas include the production of insulin and glu­ cagon to maintain normal blood glucose

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(A) Pancreatic islets

Blood vessel

Beta cell

Pancreatic ducts Delta cell

Alpha cell

Normal islet (B) Hyperglycemia

Hypoglycemia

Pancreas

Pancreas

Beta cells produce insulin.

Alpha cells produce glucagon.

Tissue Glucose moves into tissue cells.

Normal blood glucose

Liver Liver releases stored glucose into the blood.

Normal blood glucose

Figure 10.7  (A) Islet cells of the pancreas. Source: Courtesy of shutterstock/Alila Medical Images. (B) Functions of the islet cells when blood glucose is out of range.

levels. While the majority of pancreatic cells have exocrine function, a small sec­ tion of specialized cells in the pancreas produce hormones to regulate blood glucose. These cells are known as the islets of Langerhans.

Insulin is a hormone produced by the beta cells of the islets of Langerhans to decrease blood glucose (Figure  10.7). Insulin promotes the glucose in blood to move into tissue cells when an animal is  hyperglycemic or when cells require

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energy to function. If glucose is not needed in the body’s cells, it is stored in the liver in the form of glycogen. Glucagon is a hormone produced by the alpha cells of the islets of Langerhans to increase blood glucose. When an animal is hypoglycemic, glucagon breaks down the glycogen back into glucose.

The Thymus Gland As introduced in Chapter  9, the thymus gland produces and stores lymphocytes. The endocrine function of the thymus is to secrete the hormone thymosin, which pro­ motes the maturation of T‐lymphocytes. This gland is more prominent in the young as their immune systems are developing.

The Pineal Gland The pineal gland is an endocrine gland found in the brain and whose functions are uncertain (Figure 10.8). It is believed that it secretes the hormone melatonin during hours of darkness. Melatonin plays a role in the body’s “biological clock,” meaning it regulates the release of gonadotropins.

Gonadotropins are hormones that stim­ ulate the gonads. Examples include growth hormone and follicle‐stimulating hormone.

The Gonads Gonads are sex organs such as the ovaries and testes. Gonads produce gametes, or sex cells, such as sperm and ova. The ovaries are a pair of female organs on either side of the pelvis that produce estrogen and progesterone. Estrogen is responsible for the female sex characteris­ tics and it regulates ovulation. Female sex characteristics include mammary gland development and sexual receptivity. Progesterone is produced during preg­ nancy to protect the embryo and stimulate lactation. The testes are the male gonads that produce spermatozoa and testosterone. ­ Testosterone is responsible for the male sex characteristics, including the development of horns and tusks in certain species. Testosterone is an androgen that is secreted from both the testes and the adrenal cortex. In females, it is secreted in very small amounts from the adrenal cortex.

Pineal gland Thalamus

Pineal gland

Hypothalamus Pituitary gland

Figure 10.8  The pineal gland. Source: Courtesy of shutterstock/Alila Medical Images.

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323

Related Terms Adrenal glands Adrenal cortex Adrenal medulla Adrenocorticotropic hormone (ACTH) Aldosterone

Pair of suprarenal glands that are made up of a cortex and medulla. Outer section of the adrenal gland that secretes corticosteroids (Figure 10.9). Inner section of the adrenal gland that secretes catecholamines (Figure 10.9). Hormone produced by the anterior pituitary; stimulates the adrenal cortex. Produced by the adrenal cortex; controls sodium reabsorption and potassium excretion. Hormone produced by the posterior pituitary that controls reabsorption of water by the kidneys. Also known as vasopressin. Hormone produced by the thyroid gland to regulate calcium levels. Hormones derived from amino acids secreted from the adrenal medulla. Examples include epinephrine and norepinephrine. Hormones derived from fats and secreted by the adrenal cortex. Examples include glucocorticoids and mineralocorticoids. Also called steroids. Glucocorticoid produced by the adrenal cortex to regulate metabolism of carbohydrates, fats, and lipids. Also increases blood glucose. Chemical substances necessary for proper functioning of cells. Examples include sodium, potassium, chloride, phosphorus, magnesium, and calcium. Specialist in the study of the endocrine system. Study of the endocrine system. Catecholamine produced by the adrenal medulla to increase blood pressure, heart rate, and blood glucose. Also known as adrenaline. Hormone produced by the ovaries; responsible for the female secondary sex characteristics. Hormone produced by the pituitary to stimulate the maturation of ova.

Antidiuretic hormone (ADH) Calcitonin Catecholamines Corticosteroids Cortisol Electrolytes Endocrinologist Endocrinology Epinephrine Estrogen Follicle‐stimulating hormone (FSH) Glucagon Glucocorticoids

Hormone produced by the pancreas to increase blood sugar (Figure 10.10). Corticosteroids that regulate the metabolism of carbohydrates, fats, and proteins; they have an anti‐inflammatory effect. Cortisol is an example. Stored starch form of glucose in the liver (Figure 10.10). Hormones that stimulate the gonads. Examples include FSH and GH. Produced by the anterior pituitary to stimulate growth of bones and tissues. Also known as somatotropin. State of equilibrium of the body’s internal environment. Chemical messengers that have a lock‐and‐key effect in which they bind to sites on other organs and tissues to trigger an action.

Glu

ids

Epinephrine and norepinephrine

ptides Pe

locortic ra

Somatostatin and substance P

s oid

Mine

holam tec

es in

Estrogens and testosterone

cortico co Cortisol and cortisone

og ndr en

s

A

Homeostasis Hormone

Ca

Glycogen Gonadotropins Growth hormone (GH)

Aldosterone and corticosterone

Medulla

Cortex Zona glomerulosa

Zona fasciculata

Zona reticularis

Figure 10.9  Adrenal gland hormones. Source: Courtesy of shutterstock/Designua.

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Veterinary Medical Terminology Guide and Workbook

PANCREAS

LIVER

Glucagon

GLYCOGEN

GLUCOSE

BLOOD VESSEL

Glucose

Figure 10.10  Function of glucagon. Source: Courtesy of shutterstock/Designua.

Insulin

Insulin receptor

Glucose

Insulin is the key that unlocks the glucose channel Glucose channel (closed)

Glucose channel open, glucose to enter the cell

Figure 10.11  Function of insulin. Source: Courtesy of shutterstock/Designua.

Hypothalamus

Portion of the interbrain that secretes releasing and inhibiting factors to influence the pituitary gland. Insulin Hormone produced by the pancreas to decrease blood sugar (Figure 10.11). Ketones Acid by‐products of fat metabolism. Luteinizing hormone (LH) Produced by the anterior pituitary to promote ovulation Mineralocorticoid Corticosteroids produced by the adrenal cortex to regulate electrolyte and water balance.

Chapter 10  The Endocrine System

Norepinephrine

Ovaries Oxytocin Pancreas Parathormone (PTH) Parathyroid glands Pituitary gland Progesterone Prolactin (PRL) Testes (singular: testis) Testosterone Thyroid gland

Thyroid‐stimulating hormone (TSH) Thyroxine (T)4 Triiodothyronine (T3)

325

Catecholamine produced by the adrenal medulla to promote vasoconstriction (vessel contraction), increase blood pressure, and increase heart rate. It is a major neurotransmitter of the autonomic nervous system. Pair of female organs on either side of the pelvis that produce estrogen and progesterone. Hormone produced by the posterior pituitary to stimulate the uterus to contract and the secretion of milk. Endocrine gland that secretes insulin and glucagon to regulate blood glucose. Hormone produced by the parathyroid glands to regulate calcium and phosphorus. Four small endocrine glands on the posterior aspect of the thyroid gland that regulate calcium. Endocrine gland at the base of the brain made of an anterior and posterior portion. Commonly known as the “master gland.” Hormone produced by the ovaries during pregnancy to protect the embryo and stimulate lactation. Produced by the anterior pituitary; stimulates milk secretion. Male gonads that produce spermatozoa and the hormone testosterone. Hormone produced by the testes; responsible for male sex characteristics. Endocrine gland in the neck that produces thyroid hormones which help regulate metabolism. It is the largest of the endocrine glands and is responsible for the storage of iodine. Produced by the anterior pituitary; stimulates the thyroid to produce thyroid hormones. Produced by the thyroid gland to regulate metabolism. Also known as tetraiodothyronine. Produced by the thyroid gland to regulate metabolism.

Pathology and Procedures Dexamethasone suppression test Diabetes insipidus (DI) Diabetes mellitus (DM)

Test that measures the body’s response to a dexamethasone injection to diagnose Cushing’s disease and its cause. Metabolic disorder causing a lack of antidiuretic hormone (ADH) secretion. Disorder characterized by a lack of insulin secretion or a resistance to insulin (Figure 10.12). Diabetic ketoacidosis (DKA) Low blood pH due to a build‐up of ketones in diabetics. Glucose curve Test used to diagnose DM. Blood is drawn every couple of hours to monitor glucose changes in a 24‐hour period.

TECH TIP 10.1  Dexamethasone is a potent glucocorticoid that mimics the presence of cortisol in the blood. When used in a low‐dose dexamethasone suppression test (LDDS), cortisol levels are measured after its administration to diagnose Cushing’s disease. When used in a high‐dose dexamethasone suppression test (HDDS), cortisol levels are measured after its administration to determine the cause of Cushing’s disease. Cushing’s is most often caused by either a tumor on the adrenal glands or on the pituitary gland. This test isolates the location of the tumor.

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Glucose

Glucose stored and/or used in organs

Insulin

Normal level of glucose in he blood

Healthy

Glucose

Glucose

Less glucose being stored and/or used in organs

Less insulin

Organs unresponsive to insulin; less glucose being stored and/or used

Insulin Increased level of glucose in the blood

Lack of insulin

Increased level of glucose in the blood

Insulin resistance

Figure 10.12  Comparison of the two types of diabetes mellitus. Source: Courtesy of shutterstock/Alila Medical Images.

TECH TIP 10.2  Do Animals Have Type 1 and Type 2 Diabetes Like Humans? In humans, those born lacking insulin production are said to have type 1 diabetes mellitus. Humans who develop resistance to insulin later in life, usually due to poor dietary habits, are said to have type 2 diabetes mellitus. Recent studies have found that dogs are more prone to the “type 1” form of diabetes while cats tend to develop the “type 2” form. This research took different groups of cats with resistance to insulin and experimented with various diets to try to reverse the DM. They found that the Atkins diet had the most success in reversing the disease.

Hyperadrenocorticism

Hypoadrenocorticism

Disease in which excessive cortisol is produced by the adrenal cortex; commonly called Cushing’s disease. Symptoms include excessive thirst, excessive urination, weight gain, poor hair coat, skin changes, muscle weakness, increased appetite, and abdominal distention (Figure 10.13). Most commonly affects dogs. Disease causing a lack of cortisol secretion by the adrenal cortex. Commonly called Addison’s disease. Symptoms are vague, including vomiting and lethargy. Most commonly affects dogs.

TECH TIP 10.3  A Helpful Hint! When the prefix hyper‐ is attached to a gland, it generally means that the gland is overactive. If the prefix hypo‐ is attached to a gland, it generally means that the gland is underactive.

Chapter 10  The Endocrine System

(A)

327

(B)

(C)

Figure 10.13  (A) Dachshund displaying abdominal distention and muscle atrophy due to endogenous Cushing’s disease. Source: Courtesy of WikiCommons/Self. (B) Thin hair coat and cutaneous atrophy in a dog with iatrogenic Cushing’s disease. Source: Courtesy of WikiCommons/Self. (C) Cushing’s disease in a sheltie. Note the hair loss and poor skin condition. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

TECH TIP 10.4  Common Names of Diseases Some of the medical terms that we are familiar with are actually eponyms. An eponym is a medical term or phrase formed from or including a person’s name. Addision’s disease and Cushing’s disease are examples of eponyms.

Hypercrinism Hypocrinism Hypergonadism Hypogonadism Hyperinsulinism Hypoinsulinism Hyperparathyroidism Hypoparathyroidism Hyperpituitarism Hypopituitarism Hyperthyroidism

Condition of excessive secretion from a gland. Condition of deficient secretion from a gland. Excessive hormone secretion from the gonads. Deficient hormone secretion from the gonads. Excessive insulin secretion from the pancreas. Deficient insulin secretion from the pancreas. Excessive secretion of parathormone from the parathyroid glands. Deficient secretion of parathormone from the parathyroid glands. Excessive secretion from the pituitary gland. Deficient secretion from the pituitary gland. Excessive hormone secretion from the thyroid gland. Symptoms include hyperactivity, weight loss, and increased appetite (Figure 10.14A). Most commonly seen in cats.

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Hypothyroidism

Deficient hormone secretion from the thyroid gland. Symptoms include lethargy, weight gain, and hair coat changes (Figure 10.14B). Most commonly seen in dogs (Figure 10.15). Tumor on the pancreas causing excessive secretion of insulin. Most commonly seen in ferrets. Hypopituitarism due to an absence of the pituitary gland. Notice that “pan‐” means all. In this term, all of the pituitary gland is absent.

Insulinoma Panhypopituitarism

(A) Weight loss Polyphagia

Hyperactivity

Cardiac disease

Polyuria polydipsia

Palpable thyroid gland

Tachycardia

Changes in vocalization

(B) Weight gain Lethargy

Poor hair coat

Alopecia (rat tail)

Dry skin

Hypercholesterolemia

Bradycardia

Muscle weakness Figure 10.14  (A) Symptoms of hyperthyroidism. (B) Symptoms of hypothyroidism. Source: Courtesy of shutterstock/Timonina.

Chapter 10  The Endocrine System

329

Figure 10.15  Golden Retriever with hypothyroidism. Hypothyroid dogs are typically overweight and have a poor hair coat due to the lack of thyroid hormones. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

TECH TIP 10.5 Tumors! Tumors are a lot like teenagers … they don’t listen. In the case of tumors, they cause excessive secretion of one certain substance regardless of whether the body needs it. In the case of an insulinoma, the animal has a tumor that constantly releases insulin. Though the body’s cells may send signals to the pancreas to stop releasing insulin, the tumor doesn’t listen. If an animal had a thyroid tumor, then the tumor would secrete excessive amounts of T3 and T4. Even if the body sends the proper signals to turn off the thyroid gland, the tumor won’t list and will continually secrete the hormones.

Pheochromocytoma Pituitarism T3 suppression test Thyrotoxicosis

Tumor in the adrenal medulla causing excessive secretion of catecholamines. Most commonly seen in dogs and cattle. Any disorder of the pituitary gland. Administration of T3 to diagnose borderline hyperthyroidism. Excessive, life‐threatening amounts of thyroid hormones.

Building the Terms Now it’s time to assemble the word parts listed in Tables  10.3–10.5. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this

will get easier each time. Remember your five basic rules to medical termi­ nology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

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Table 10.3  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Acr/o

Extremities

Keton/o

Ketone bodies (ketones)

Aden/o

Gland

Lact/o

Milk

Adren/o

Adrenal gland

Natr/o

Sodium

Adrenal/o

Adrenal gland

Pancreat/o

Pancreas

Andr/o

Male

Parathyroid/o

Parathyroid glands

Calc/o

Calcium

Phys/o

Growth; growing

Cortic/o

Cortex (outer region)

Pineal/o

Pineal gland

Crin/o

To secrete

Pituitar/o

Pituitary

Dips/o

Thirst

Somat/o

Body

Estr/o

Female

Ster/o

Solid structure

Gluc/o; Glucos/o

Sugar

Thym/o

Thymus gland

Glyc/o; Glycos/o

Sugar

Thyr/o

Thyroid gland

Gonad/o

Sex glands

Thyroid/o

Thyroid gland

Home/o

Sameness

Toc/o

Childbirth

Hormon/o

Hormones

Toxic/o

Poison

Insulin/o

Insulin

Ur/o

Urine; urinary tract

Kal/i

Potassium

Table 10.4  Prefixes.

Prefix

Definition

Prefix

Definition

endo‐

in; within

pan‐

all

eu‐

good; normal; true

poly‐

many; much

hyper‐

above; excessive; increased

tetra‐

four

hypo‐

below; deficient; decreased

tri‐

three

oxy‐

rapid; sharp; acid

Chapter 10  The Endocrine System

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Table 10.5  Suffixes.

Suffix

Definition

Suffix

Definition

‐agon

to assemble; gather

‐megaly

enlargement

‐al

pertaining to

‐oid

resembling

‐ectomy

removal; excision; resection

‐oma

tumor; mass; collection of fluid

‐emia

blood condition

‐one

hormone

‐emic

pertaining to a blood condition

‐osis

abnormal condition

‐gen

producing; forming

‐pathy

disease condition

‐in, ‐ine

a substance

‐stasis

stopping; controlling

‐ism

process; condition

‐tomy

incision; process of cutting into

‐ist

specialist

‐tropic

turning

‐itis

inflammation

‐tropin

stimulate; act on

‐logy

study of

‐uria

urination; condition of urine

Parts

Medical Term

Acr/o

+ ‐megaly

= Acromegaly

Adrenal/o Adren/o Adren/o Adren/o hyper‐ hypo‐ Glucos/o Glyc/o Glucos/o hyper‐ hypo‐ Hormon/o hyper‐ hypo‐ hyper‐ hypo‐ Pancreat/o Pancreat/o Pancreat/o

+ ‐ectomy + ‐ectomy + ‐pathy + ‐al + Calc/o + ‐emia + Calc/o + ‐emia + ‐uria + ‐emic + ‐uria + Glyc/o + ‐emia + Glyc/o + ‐emia + ‐al + Kal/i + ‐emia + Kal/i + ‐emia + Natr/o + ‐emia + Natr/o + ‐emia + ‐ectomy + ‐ic + ‐itis

= Adrenalectomy = Adrenectomy = Adrenopathy = Adrenal = Hypercalcemia = Hypocalcemia = Glucosuria = Glycemic = Glycosuria = Hyperglycemia = Hypoglycemia = Hormonal = Hyperkalemia = Hypokalemia = Hypernatremia = Hyponatremia = Pancreatectomy = Pancreatic = Pancreatitis

Definition : ________________ This is caused by excessive secretion of growth hormone by the pituitary gland. : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________

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TECH TIP 10.6  Rules for Using the Prefix “poly‐“ When “poly‐” is attached to an action, the meaning of the prefix changes to excessive. For example, the term polyphagia would be defined as excessive eating or excessive appetite.

Pancreat/o Parathyroid/o Pineal/o poly‐ poly‐ Thym/o Thym/o Eu‐ Thyroid/o Thyr/o

+ ‐tomy + ‐ectomy + ‐pathy + ‐dipsia + ‐uria + ‐ectomy + ‐oma + thyroid + ‐itis + ‐megaly

= Pancreatotomy = Parathyroidectomy = Pinealopathy = polydipsia = polyuria = Thymectomy = Thymoma = Euthyroid = Thyroiditis = Thyromegaly

: ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________ : ________________

Abbreviations Table 10.6  Abbreviations.

Abbreviation

Definition

ACTH

Adrenocorticotropic hormone

ADH

Antidiuretic hormone

BG

Blood glucose

Ca

Calcium

Cl

Chloride

DI

Diabetes insipidus

DKA

Diabetic ketoacidosis

DM

Diabetes mellitus

FBS

Fasting blood sugar

FSH

Follicle‐stimulating hormone

GH

Growth hormone

GTT

Glucose tolerance test; used to diagnose borderline DM

HDDS

High dose dexamethasone suppression test

K

Potassium

LDDS

Low dose dexamethasone suppression test

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Table 10.6  (Continued)

Abbreviation

Definition

LH

Luteinizing hormone

Mg

Magnesium

Na

Sodium

OT

Oxytocin

PRL

Prolactin

PTH

Parathormone

PU/PD

Polyuria/polydipsia

RAI

Radioactive iodine; treatment for hyperthyroidism

T3

Triiodothyronine

T4

Thyroxine; tetraiodothyronine

TSH

Thyroid‐stimulating hormone

U

Unit

Case Study You’ll notice some terms from the previous chapters. A Sheltie named Tubby has come to the clinic for a routine exam with vaccines. Tubby is 10 years old and the owners have noticed that he isn’t energetic anymore. On P/E, Tubby is overweight by about 15 pounds and has a rough, coarse hair coat. There’s hair loss at the base of his tail, creating a “rat tail” appearance. The owners have noticed that Tubby has been eating more than usual. Dr. SkinnyMinny decides to order lab work to measure T4 levels. When the lab results return the following day, the T4 levels are decreased in the blood. 1. What does Tubby have? a. Addison’s disease b. Cushing’s disease c. Hyperthyroidism d. Hypothyroidism 2. Which of the following symptoms describes Tubby? a. Polydipsia b. Polyphagia c. Polyuria 3. Which hormone level was measured? a. Thyroxine b. Triiodothyronine c. Cortisol

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Exercises 10-A:  Give the other term for the following. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

______________________________: Addison’s disease ______________________________: Vasopressin ______________________________: Cushing’s disease ______________________________: Adrenaline ______________________________: Somatotropin ______________________________: Master gland ______________________________: Steroids ______________________________: Norepinephrine ______________________________: Thyroxine ______________________________: Hypophysis

10-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Adrenopathy ________________________________________________________ Pancreatitis _________________________________________________________ Thymoma __________________________________________________________ Hyperglycemia _______________________________________________________ Glucosuria __________________________________________________________ Acromegaly _________________________________________________________ Hyponatremia ______________________________________________________ Hyperkalemia _______________________________________________________ Hormonal __________________________________________________________ Thyromegaly _______________________________________________________

10-C:  Fill in the following chart regarding the source and action of hormones. Hormone 1. GH 2. Insulin 3. PTH 4. ACTH 5. ADH 6. T4 7. LH 8. Oxytocin 9. FSH 10. Aldosterone

Source ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

Action ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________

10-D:  Define the following abbreviations. 1. ________________________________________________________: PU/PD 2. ________________________________________________________: TSH 3. ________________________________________________________: PTH

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4.  5.  6.  7.  8.  9.  10. 

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________________________________________________________: DM ________________________________________________________: DI ________________________________________________________: DKA ________________________________________________________: ACTH ________________________________________________________: BG ________________________________________________________: PRL ________________________________________________________: LDDS

10-E:  What condition does an animal have with the following hormonal changes? 1. 2. 3. 4. 5. 6.

Elevated PTH. Elevated T4. Decreased cortisol. Decreased T4. Elevated cortisol. Decreased ADH.

10-F:  Match the following terms with their descriptions. 1. 2. 3. 4. 5.

________________ Cortisol ________________ Aldosterone ________________ Epinephrine ________________ FSH ________________ Testosterone

A. Androgen B. Catecholamine C. Glucocorticoid D. Gonadotropin E. Mineralocorticoid

Answers can be found starting on page 675.

Review Tables Fill in the tables and refer to Tables 10.3–10.6 for answers. Table 10.7

Combining Forms

Definition

Combining Forms

Acr/o

Keton/o

Aden/o

Lact/o

Adren/o

Natr/o

Adrenal/o

Pancreat/o

Andr/o

Parathyroid/o

Calc/o

Phys/o

Cortic/o

Pineal/o

Crin/o

Pituitar/o

Dips/o

Somat/o

Definition

(Continued)

Table 10.7  (Continued) Combining Forms

Definition

Combining Forms

Estr/o

Ster/o

Gluc/o

Thym/o

Glyc/o

Thyr/o

Gonad/o

Thyroid/o

Home/o

Toc/o

Hormon/o

Toxic/o

Insulin/o

Ur/o

Definition

Kal/i

Table 10.8

Prefix

Definition

Prefix

endo‐

pan‐

eu‐

poly‐

hyper‐

tetra‐

hypo‐

tri‐

Definition

oxy‐

Table 10.9

Suffix

Definition

Suffix

‐agon

‐megaly

‐al

‐oid

‐ectomy

‐oma

‐emia

‐one

‐emic

‐osis

‐gen

‐pathy

‐in, ‐ine

‐stasis

‐ism

‐tomy

‐ist

‐tropic

‐itis

‐tropin

‐logy

‐uria

Definition

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Table 10.10

Abbreviation ACTH ADH BG Ca Cl DI DKA DM FBS FSH GH GTT HDDS K LDDS LH Mg Na OT PRL PTH PU/PD RAI T3 T4 TSH U

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning mate­ rials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word search puzzle

C h a p t e r

11

The Integumentary System

The integumentary system consists of skin, hair, nails, and glands. Because we’re dealing with animals, the categories are expanded to include feathers, fur, scales, hooves, horns, and beaks. The functions of the integumentary system are to protect the body, maintain body temperature, lubricate, and provide nerve sensation. The skin is the largest organ of the body. It protects the body by acting as a barrier against infection from outside organisms and protects the tissues underneath it. The skin produces a pigment to shield the body from ultraviolet exposure and synthesizes vitamin D. Nerve receptors within the different layers of skin allow the animal to feel sensations such as heat, pain, and pressure. There are two types of glands in the skin layers: sebaceous glands and sweat glands. Sebaceous glands secrete an oily substance called sebum which lubricates the skin. Sweat glands secrete sweat, which helps to regulate the body’s temperature. Sweat is made up of water, lactic acid, and other waste products. The degree of sweating differs in each species. For example, horses sweat excessive amounts, whereas dogs lose a very insignificant amount of sweat. The hair, feathers, or fur on animals help to regulate body temperature.

Skin There are three layers of the skin. Label the three layers in Figure  11.1 using the terms listed in Table 11.1.

Epidermis The epidermis, which is composed of ­several layers of squamous epithelium, is completely cellular  –  there are no blood vessels in this layer. Epithelium was defined in previous chapters as layers of cells that cover the internal and external surfaces of the body, and there are different types of epithelium depending on the location and the function that is required. The surface of the skin requires protection and therefore it consists of several layers of squamous (scale‐like) cells. Because of the layers of squamous epithelial cells, the epidermis is sometimes referred to as stratified squamous epithelium because of the cells’ layered arrangement. Because the epidermis lacks blood vessels, it relies on the layer below, the dermis, to nourish it. The epidermis is made up of five layers, and literally develops from the inside out (Figure 11.2). The deepest layer of the epidermis is called the basal layer and it is

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Sweat pore

Hair shaft Meissner’s corpuscle Sweat gland Stratum corneum (homy cell layer)

1. Papillary layer Sebaceous (oil) gland

2.

Arrector pili muscle Reticular layer Nerve

3.

Pacinian Hair follicle Vein Artery corpuscle

Adipose (fat) tissue

Figure 11.1  The layers of skin. Source: Courtesy of shutterstock/stockshoppe.

Table 11.1  Skin layers. Epidermis (1)

Outermost layer of skin.

Dermis (2)

True layer of skin.

Subcutaneous tissue (3)

Innermost layer of skin.

here that new cells are formed. Once a cell is formed, it begins to migrate superficially until it reaches the outer layer, the stratum corneum. Eventually the cells on the surface of the skin slough (flake) off. As skin cells die and slough off, new cells are constantly being formed in the basal layer. During a cell’s migration from the basal layer to the surface, it becomes filled with a tough protein called keratin. Keratin is referred to as horny tissue because it is commonly found in the horns of animals. It is the keratin that gives the skin the property of being waterproof. The basal layer of the epidermis also contains a group of cells called melano-

cytes which produce melanin, the pigment that gives skin its color. Melanin protects the skin from the sun’s ultraviolet rays. All animals have melanocytes. Melanocytes that are incapable of producing melanin result in a condition called albinism. These animals have white skin and white hair. Their eyes are a bright red because of the lack of pigment in their retinas, which makes the blood vessels within their eyes visible. Animals that develop melanoma have melanocytes that produce excessive amounts of melanin.

Dermis The dermis, also called the corium, is considered the true layer of skin because it contains blood vessels, lymph vessels, sweat glands, hair follicles, and nerves. This layer contains connective tissue called collagen which gives the layer the properties of elasticity and longevity. Collagen can be found in bone, tendons, ligaments, and cartilage as well.

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(A) Stratum corneum

Old

Stratum lucidum Stratum granulosum

Stratum spinosum

Young Stratum basale Dermis

(B)

Simple squamous

Simple cuboidal

Simple columnar with microvilli

Stratified squamous

Transitional

Pseudostratified columnar with cilia and microvilli

Figure 11.2  (A) The layers of the epidermis. Source: Courtesy of shutterstock/Alila Medical Images. (B) The various types of epithelium. Simple squamous epithelium can be found in the capillaries, alveoli, glomeruli, and other tissues where diffusion takes place. Simple cuboidal epithelium can be found on the ovaries and nephrons of the kidney. Simple columnar epithelium can found in the intestines. Stratified squamous epithelium is found in the epidermis of the skin. Transitional epithelium is found in parts of the urinary tract. Pseudostratified columnar epithelium can be found in the respiratory tract. Source: Courtesy of shutterstock/blamb.

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Subcutaneous Tissue The subcutaneous layer is the innermost, fatty layer of the skin. The primary function of this layer is to produce fat to insulate the body. The predominant cell type is the lipocyte, or fat cell.

When the temperature in the environment changes or the physiology of the animal changes, the hair begins to fall off. This is referred to as shedding. Shedding can be caused by hormonal changes and dietary changes. If animals aren’t groomed on a regular basis, the hair begins to clump (mat) and can cause more serious skin problems.

Hair Hair is a long structure that contains keratin and grows from a sac called a hair follicle in the dermis. The hair follicle is held in place by a tiny muscle fiber called the arrector pili. When an animal becomes stressed, the arrector pili pulls the hair follicle, causing the hair on the animal to stand up. In humans, this can be caused from cold temperatures. Animals have different types of hair with different functions. Table  11.2 lists the different types of hair. Table 11.2  Types of hair. Cilia

Thin, tiny hairs. Most often associated with the lining of the respiratory tract. The eyelashes can also be classified as cilia.

Fur

Short, very fine, soft hair that functions to protect animals in cold‐temperature climates.

Primary hairs

Long straight hairs that form the outer coat of an animal. Also known as the top coat, overcoat, or guard hairs.

Secondary hairs Finer, softer hairs that form the inner coat of an animal. Also known as the undercoat. Not all animals have an undercoat. For those that do, it serves as insulation. Tactile hairs

Long, brittle hairs on the face that are very sensitive. An example would be whiskers.

TECH TIP 11.1  Raising Their Hackles? When dogs become upset, the hair on the dorsal aspect of their neck and along their spine begin to stand up. This is referred to as raising their hackles. The medical term for the hair standing straight up is piloerection.

Glands Sebaceous Glands Sebaceous glands can be found in the dermis along the hair follicles. They produce an oily substance called sebum, which lubricates the skin. Once produced, the sebum moves from the sebaceous gland to the hair follicle and then travels to the surface of the skin. Sebaceous glands are types of exocrine glands.

Sweat Glands Sweat glands are also found in the dermis and produce a slightly acidic, watery fluid called sweat. The function of sweat is to cool the body and protect it from microorganisms such as bacteria. The acid effect of the sweat helps to destroy the bacteria on the skin’s surface. There are two types of sweat glands: eccrine glands and apocrine glands. Eccrine glands secrete sweat directly to the surface of the body, which immediately evaporates to help cool the body. Apocrine glands secrete sweat into the hair follicle, and the sweat then travels

Chapter 11  The Integumentary System

to the surface of the skin. Both types of sweat glands are tightly coiled in the dermis.

TECH TIP 11.2  Other Types of Glands Anal sacs are a combination of sebaceous glands and apocrine glands. Mammary glands are a type of apocrine gland.

Nails Depending on the species, the nails category can include claws, hooves, antlers, and horns. In this chapter, we’ll try to keep things basic with regard to the anatomy of these structures. Anatomy will be emphasized in later chapters. Carnivores have claws which they use for holding and tearing their prey. Most animals are able to retract their claws when they’re no longer needed. Claws, like nails, are made up of two keratin plates. The difference between the two is in their shape. The ventral aspect of the claw is called the sole and the dorsal aspect is called the wall. The claw has a white portion on the distal aspect called the cuticle. The proximal

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aspect of the claw is very vascular dermis called the quick. To the naked eye this is the pink portion of the claw or nail. When performing a nail trim, the cuticle is cut and caution is taken to try to avoid the sensitive quick. Quicking an animal means you trimmed the nail too short, resulting in pain and bleeding. Claws in birds are referred to as talons. Depending on the species of bird, talons can be used to hunt for prey or for protection against predators. Talon anatomy resembles that of nails. If nails are long and strong enough to bear weight, they are called hooves. Hooved animals are termed ungulates.

TECH TIP 11.3  Where Are the Pads? Pads are found on the plantar and palmar surfaces of the feet. The pads have an extra thick of layer of keratin in the epidermis, a vascular dermis, and a subcutaneous layer. Most animals have sweat glands in their pads. Digitigrade animals walk on their phalanges; examples include the dog and cat. Plantigrade animals walk on their metacarpals and metatarsals. Primates, like humans, are plantigrade.

Related Terms Basal layer Collagen Dermis Epidermis Epithelium Hair follicle Integumentary system Keratin Melanin Melanocytes

Deepest layer of the epidermis, where new cells are produced. Structural protein found in the dermis of the skin. True layer of skin containing blood supply and nerves. Outermost layer of skin. Layer of cells that covers the outer and inner body surfaces. Also called epithelial tissue. Sac in the dermis in which hair grows. The skin, hair, nails, and glands, collectively. Hard protein found in the hair, claws, horns, antlers, and epidermis. Pigment that gives skin its color. Cells in the epidermis that produce melanin.

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Pore Sebaceous glands Sebum

Veterinary Medical Terminology Guide and Workbook

Small opening on the surface of the skin. Oil‐secreting gland of the dermis that’s associated with the hair follicles. Oily substance secreted by sebaceous glands.

TECH TIP 11.4  Did you know that lanolin, the substance found in lotions and creams, is actually sebum from sheep? It is a processed and purified form of sheep’s sebum.

Squamous epithelium Subcutaneous tissue Ungulates

Flat, scale‐like cells of the epidermis. Deep, fatty layer of the skin. Hooved animals.

Pathology and Procedures Abrasion Abscess Acne Albino/albinism Alopecia Atopy Biopsy Bulla (plural: bullae) Burn Carcinoma

Wound caused by scraping of the skin or mucous membranes. Localized collection of pus. Collection of comedones, or blackheads, caused by plugged sebaceous glands (Figure 11.3). Canine and feline acne commonly affects the chin and lips. Congenital absence of pigmentation in the skin, hair, and eyes (Figure 11.4). Absence of hair in areas where it normally grows (Figure 11.5). Hypersensitivity reaction characterized by pruritus (itching) and dermatitis (Figure 11.6). Commonly called allergic dermatitis. Removal of tissue for microscopic examination. Fluid‐filled skin elevation; commonly called a blister or vesicle (Figure 11.7). Injury to tissue caused by contact with heat, electricity, chemicals, or radiation (Figure 11.8). Malignant tumor arising from epithelial tissue.

TECH TIP 11.5  Remember the rule for carcinoma. When another combining form or structure is attached to the term, then you define it as: A malignant tumor of __________________ arising from epithelial tissue. For example, carcinoma of the skin would be defined as a malignant tumor of the skin arising from epithelial tissue.

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(A)

1. Healthy follicle

2. Duct clogged by dead cells, sebum starts to accumulate

Sebaceous duct gland

4. Follicle ruptures, pustule with fluid formed – acne

(B)

3. Bacterial infection, inflammation triggered – pimple

(C)

Figure 11.3  (A) Steps of acne formation. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Feline acne. Source: Courtesy of WikiCommons/Self. (C) Collection of comedones. Source: Courtesy of Katy Echeagaray, AAS, CVT.

Figure 11.4  Rabbit with albinism. Source: Courtesy of shutterstock/iava777.

(A)

(B)

Figure 11.5  (A) Alopecia in a beagle. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B) Alopecia in a ferret. Source: Courtesy of Bobbi Hafer, DVM.

Figure 11.6  Atopy in a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

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Figure 11.7  Blister of a dog’s paw. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/ drgregdvm.

(A)

Epidermis

Dermis

Hypodermis/ subcutaneous fat First degree burn

Second degree burn

Third degree burn

(B)

Figure 11.8  (A) Different degrees of burns. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Chemical burns on a dog. Source: Courtesy of Donna Tunis, CVT.

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Cauterization

Veterinary Medical Terminology Guide and Workbook

Destruction of tissue using heat, chemicals, or electrical current (Figure 11.9).

Figure 11.9  Cautery can be used to stop small bleeders and to remove small masses. In this image, cautery is being used to remove small papillomas. Source: Courtesy of Greg Martinez, DVM; http://www.youtube. com/drgregdvm.

Comedo (plural: comedones) Contusion Crust Cryosurgery

Blackheads; plug of keratin and sebum within the opening of a hair follicle (Figure 11.3c). A bruise; injury to tissue without breaking the skin. Characterized by pain, swelling, and tenderness due to broken blood vessels. Collection of dried exudate, usually sebum, on the surface of the skin. Use of cold temperatures to destroy tissue (Figure 11.10).

Figure 11.10  Cryosurgery performed to remove a mass on the skin. Source: Courtesy of Beth Romano AAS, CVT.

Chapter 11  The Integumentary System

Culture Cyst Debridement Decubitus ulcers Degloving

(A)

349

Procedure used to grow microbes in certain types of media. Thick‐walled sac containing fluid or semisolid material. Removal of contaminated tissue or foreign material to expose healthy tissue. This in turn aids in healing. Bedsores; pressure sores caused by lying in one position over an extended period of time. Injury in which the skin is separated from its underlying structures (Figure 11.11). Typically seen with traumas such as HBC (hit by car). (B)

Figure 11.11  (A, B) Degloving injuries in dogs due to HBC. Source: Courtesy of Deanna Roberts BA, AAS, CVT.

Dehiscence Ecchymosis (plural: ecchymoses)

Separation of all layers of a surgical wound; splitting open. Bluish‐black mark on the skin (Figure 11.12).

Figure 11.12  Ferret with ecchymosis. Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

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TECH TIP 11.6  Contusion vs. Ecchymosis A contusion, or bruise, is typically caused by trauma and involves swelling or a raised area of the skin. Within that raised area is blood from ruptured vessels and bacteria from the trauma. The swelling is also caused by the body’s response to the bacterial presence. Contusions cause pain when touched. Ecchymosis, also called a bruise, is a superficial bluish‐black mark on the skin most often caused by internal bleeding. Trauma to the skin is not involved so there is no skin elevation or swelling. The bleeding is typically spontaneous and associated with a bleeding disorder. Generally there is no pain when touched.

Erythema

Widespread redness on the skin. Caused by congestion of the capillary bed due to skin injury or infection (Figure 11.13).

Figure 11.13  Erythema around a cystotomy incision.

Eczema Ehlers‐Danlos syndrome Epidermolysis Fine needle aspirate (FNA) Fissure

Generalized term for any superficial inflammation ­characterized by erythema (redness), pruritus (itching), and oozing blisters which form scabs (Figure 11.14). Congenital connective tissue disorder characterized by hyperextensibility of joints and hyperelasticity of skin. Also called cutaneous asthenia (Figure 11.15). Loosening of the epidermis leading to the formation of large blisters. Collection of fluid or cells for laboratory exam. Most often used on masses for diagnosis (Figure 11.16). Deep crack in the skin.

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(A) Allergens

Inflammation of the skin

(B)

Figure 11.14  (A) Formation of eczema. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Eczema on a dog. Source: Courtesy of shutterstock/richsouthwales.

Figure 11.15  Ehlers–Danlos syndrome in a dog. Note the hyperelasticity of the skin due to a structural defect in collagen production. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

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Figure 11.16  A fine needle aspirate on a Corgi with a mass below the ear. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Fistula

(A)

Abnormal tube‐like passageway that can occur anywhere on the body. Most often caused by parasites or foreign bodies such as grass awns (Figure 11.17). (B)

Figure 11.17  (A) Canine abdomen with a fistula created by an infestation of the bot fly maggot, Cuterebra. Source: Courtesy of Beth Romano, AAS, CVT. (B) Removal of the Cuterebra from the fistula. Courtesy of Beth Romano, AAS, CVT. (C) Fistulas created by maggots. Source: Courtesy of Cristina Montemayor, CVT.

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(C)

Figure 11.17  (Continued )

Flea allergy ­dermatitis (FAD)

Inflammation of the skin due to hypersensitivity to flea saliva (Figure 11.18).

Figure 11.18  Flea allergy dermatitis in a dog. Source: Courtesy of WikiCommons/Self.

Fly strike

Frostbite Gangrene

In dogs, small bites on the ear tips from adult flies. Commonly seen in older, non‐ambulatory dogs. In ruminants, an infestation of maggots on an area of skin covered in urine or feces. Tissue damage due to exposure to extreme cold. Death of body tissue (necrosis) associated with loss of blood supply.

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Granuloma Hidrosis

Veterinary Medical Terminology Guide and Workbook

Mass of granulation tissue due to a chronic inflammatory process. Typically seen with either an infectious disease or foreign body (Figure 11.19). Sweating.

Figure 11.19  Lick granuloma on the leg of a dog. Source: Courtesy of Greg Martinez, DVM; http://www. youtube.com/drgregdvm.

TECH TIP 11.7  Be Careful! “Hidr/o” and “Hydr/o” look very similar on paper. “Hidr/o” means sweat; “hydr/o” means fluid or water.

Hyperkeratosis Infestation

Excessive growth of the horny layer (stratum corneum) of the dermis. Establishment of a parasite in or on a host.

TECH TIP 11.8  Infestation vs. Infection Infection is typically used when an animal has a virus or bacteria. Infestation is used when animals have parasites on or within their bodies.

Laceration Lance Lesion Lupus erythematosus (LE)

Wound caused by tearing. Examples include a stab wound or a surgical incision (Figure 11.20). To cut or incise with a sharp instrument. Abnormal change in tissue. The changes can be pathological or due to trauma. Examples include sores, wounds, and tumors. Generalized term for a disease in which the body makes antibodies against its own good cells and tissues. The disease causes redness on the surface of the skin. A type of autoimmune disease. In dogs there are two types of LE: discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE).

Chapter 11  The Integumentary System

(A)

355

(C)

(B)

(D) Wound

Blood

Blood clot

Blood vessel

Fat tissue

Scab Exudate

Scab Regenerated Epidermal tissue

Granulation tissue

Figure 11.20  Wounds. (A) Laceration on a horse. Source: Courtesy of Beth Romano, AAS, CVT. (B) Surgically repaired laceration on the horse. Source: Courtesy of Beth Romano, AAS, CVT. (C) Pitbull attacked by a porcupine. Source: Courtesy of Beth Romano, AAS, CVT. (D) Illustration of wound healing. Source: Courtesy of shutterstock/GRei.

Macule

DLE: Commonly called “Collie nose,” this disease causes redness (erythema), scaling, erosion, crusting, and depigmentation on the nose (Figure 11.21). Symptoms are often exaggerated with exposure to sunlight. Breeds such as Collies, Shelties, and German Shepherds are most susceptible. SLE: Autoimmune disease involving multiple body systems. Flat, discolored lesion on the skin; also called macula. Freckles are an example.

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Figure 11.21  Discoid lupus erythematosus. Commonly called “Collie nose.” Source: Courtesy of Kyana Silvia, CVT.

Mange

An infestation of mites. Commonly seen mites include Demodex and Sarcoptes, which causes scabies (Figure 11.22). (A)

(B)

(C)

Figure 11.22  Infestation of the mite Demodex. (A) Demodectic mange on an Australian Shepherd. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (B) Illustration of the site of infestation of Demodex in the skin. Source: Courtesy of shutterstock/spline09. (C) Skin scrape being performed to retrieve mites. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (D) Microscopic view of the Demodex mites. (E) Microscopic view of the Sarcoptes mite that causes scabies.

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(D)

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(E)

Figure 11.22  (Continued )

Melanoma

Malignant tumor of the skin; malignant tumor of melanocytes (Figure 11.23). Melanoma Melanocyte Epidermis

Dermis

Figure 11.23  Illustration of melanoma. Source: Courtesy of shutterstock/Rob3000.

Metastasis Nodule Onycholysis Pallor

To spread beyond control; spread of a tumor to a secondary location. A small, rounded mass. Separation of the nail or claw from the nail bed. Paleness of skin or mucous membranes.

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Papilloma Papule

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Benign epithelial growth found on the skin or mucous membranes. Commonly called a skin tag (Figure 11.24). Small, solid, elevated skin lesion less than a centimeter in diameter.

Figure 11.24  Papilloma on the lateral aspect of a poodle. Source: Courtesy of Greg Martinez, DVM; http:// www.youtube.com/drgregdvm.

Paronychia Petechia (plural: petechiae)

Inflammation of the tissue surrounding the nails or claws. Small, pinpoint hemorrhages (Figure 11.25).

Figure 11.25  Petechiae on a dog’s abdomen. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

TECH TIP 11.9  Petechiae vs. Ecchymosis Both of these conditions are due to bleeding under the skin. The difference between the two is in their size. Petechiae are pinpoint‐sized marks on the skin. The bluish marks of ecchymosis are much larger, or roughly greater than a couple of centimeters.

Chapter 11  The Integumentary System

Piloerection Polyp Pruritus Purpura Purulent Pus Pustule Ringworm

Condition in which the hair stands straight up. Mushroom‐like growth protruding from the mucous membranes. When attached to the mucous membranes by a stalk, it is termed a pedunculated polyp. Itching. Condition of hemorrhaging into the skin creating a bruise. Examples include petechiae and ecchymoses. Containing pus (Figure 11.26). Collection of white blood cells, usually neutrophils, and debris with fluid. Pus‐filled lesion on the skin. Fungal infection of the superficial layers of the skin (Figure 11.27).

Figure 11.26  Purulent wound on the ear of a poodle after children wrapped a rubber band around it for days. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Scar Sebaceous cyst Seborrhea Shedding

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Figure 11.27  Ringworm in a cat. The infection will fluoresce under a black lamp. Source: Courtesy of Donna Tunis, CVT.

Mark left on the skin after healing. Benign cyst containing sebum. Also called a steatoma. Excessive production of sebum. Condition of hair coat falling out.

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Skin scrape Trichobezoar Ulcer Urticaria Verruca (plural: verrucae) Wheal

Veterinary Medical Terminology Guide and Workbook

Scraping of the skin for laboratory exam. Most often used in the diagnosis of parasites or fungal infections (Figure 11.22). Hairball. Erosion of the skin or mucous membranes. Red, raised patches on the skin commonly called hives. Most often associated with an allergic reaction. Wart; skin growth caused by a virus. Localized area of swelling that itches.

Coat Types and Color Dogs Various terms are used to describe the color and type of coats on dogs. Many of the colors and coat patterns are seen in select breeds (Figure 11.28). Belton Bi‐color Blenheim Blue Brindle Dappled Harlequin Hound Long haired Mantle Merle Party Phantom Roan Sable and white Salt and pepper Tri‐color Wire‐haired

White coat with colored spots. Coat with two colors. Red and white. Typically used with spaniels. Solid silver color. Brown coat with black stripes. Splotchy colors with multiple markings. White coat and large areas of black and blue. The typically black, tan, and white patterns seen on Hound breeds such as a Beagle. Used to describe dogs with longer, fine hair (Figure 11.29A). Black body with white markings on the head, neck, legs, and tail. Marbled appearance. May be seen in reds or blues. Multicolored. Black and tan coloring patterns. Usually a black body with tan markings on the face, legs, and paws. Blended mixture of colors with white. Tan and white dogs. Often used to describe herding breeds. Mixture of black and white, giving the appearance of pepper sprinkles. Three colors in a distinct pattern of black, tan, and white. Often used with herding breeds. Long, wiry, rough coat (Figure 11.29B).

(A)

(C)

(B)

(D)

(E)

(F)

(G)

(H)

(I)

(J)

(K)

Figure 11.28  Canine coat colors. (A) Red belton coat on an English Setter. Source: Courtesy of shutterstock/ Alex White. (B) Blue belton coat on an English Setter. Source: Courtesy of shutterstock/Dorottya Mathe. (C) Blenheim coats on Cavalier King Charles Spaniel. Source: Courtesy of shutterstock/Liliya Kulianionak. (D) Bi‐ colored Dachshund. Source: Courtesy of shutterstock/Annmarie Young. (E) Blue coat on a Great Dane puppy. Source: Courtesy of shutterstock/Guy J. Sagi. (F) Brindle Mastiff. Source: Courtesy of shutterstock/Will Hughes. (G) Dappled Dachshund. Source: Courtesy of shutterstock/Erik Lam. (H) Harlequin Great Dane. Source: Courtesy of shutterstock/Eric Isselee. (I) Blue harlequin Great Dane puppy. Source: Courtesy of shutterstock/Erik Lam. (J) Hound coat on a Beagle. Source: Courtesy of shutterstock/gbarinov. (K) Hound coat on a Basset Hound. Source: Courtesy of shutterstock/Africa Studio. (L) Mantle colored Bull Terrier. Source: Courtesy of shutterstock/Mike Neale. (M) Red merle Australian Shepherd. Source: Courtesy of shutterstock/Maria Ulzutueva. (N) Blue merle Shetland Sheepdog. Source: Courtesy of shutterstock/Svetlana Valoueva. (O) Party‐colored Yorkshire Terrier. Source: Courtesy of shutterstock/Utekhina Anna. (P) Phantom colored dogs. Source: Courtesy of shutterstock/ Alexia Khruscheva. (Q) Black roan German Shorthaired Pointer. Source: Courtesy of shutterstock/Capture Light. (R) Sable and white Collie. Source: Courtesy of shutterstock/Eric Lam. (S) Salt and pepper coat on Miniature Schnauzer puppies. Source: Courtesy of shutterstock/Jagodka. (T) Tri‐colored Shetland Sheepdog.

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(L)

(M)

(N)

(O)

(P)

(Q)

(R)

Figure 11.28  (Continued )

(S)

(T)

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(B)

Figure 11.29  Types of canine coats. (A) Long‐haired and short‐haired Dachshunds. Source: Courtesy of shutterstock/Liliya Kulianionak. (B) Wire‐haired Dachshund. Source: Courtesy of shutterstock/Erik Lam.

Cats Feline coat patterns are a bit different than those of dogs; however, some terms used with canines cross over (Figure 11.30). (A)

(B)

(C)

(D)

Figure 11.30  Feline coat colors. (A) Calico Munchkin. Source: Courtesy of shutterstock/Linn Currie. (B) Seal‐point Ragdoll. Source: Courtesy of shutterstock/cath5. (C) Ruddy Abyssinian. Source: Courtesy of shutterstock/dien. (D) Brown tabby DSH. Source: Courtesy of shutterstock/disapier. (E) Orange tabby DSH. Source: Courtesy of shutterstock/Okssi. (F) Tortoiseshell DSH. Source: Courtesy of shutterstock/Jagodka. (G) Dilute tortoiseshell DSH. Source: Courtesy of shutterstock/Joy Baldassarre. (H) Tuxedo DSH.

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(F)

(H) (G)

Figure 11.30  (Continued )

Calico Colorpoint Ruddy Tabby Tortoiseshell

Tuxedo

Sometimes called tri‐color, these cats have a white base coat with black and tan patterns. In most cases, calicos are females. White or cream base coat with colored patterns on the face, paws, and tail. Red based coat with ticked patterns. Bi‐colored coat with striped or spotted patterns. Tri‐color coat with the colors blended together. The difference between the torties and calicos is in the white base. Torties have very little white in their coat patterns. Like the calicos, most torties are female. Black and white patterns resembling a tuxedo.

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Building the Terms Table 11.3  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Adip/o

Fat

Myc/o

Fungus

Albin/o

White

Onych/o

Nail

Bi/o

Life

Pil/o

Hair

Carcin/o

Cancer; cancerous

Py/o

Pus

Cutane/o

Skin

Seb/o

Sebum

Derm/o

Skin

Sebace/o

Sebum

Dermat/o

Skin

Squam/o

Scale

Erythem/o

Redness; flushed

Steat/o

Fat; sebum

Erythemat/o

Redness; flushed

Therm/o

Heat

Hidr/o

Sweat

Trich/o

Hair

Ichthy/o

Dry; scaly

Ungul/o

Hoof

Kerat/o

Horny; hard; cornea

Ungu/o

Nail

Lip/o

Fat

Xer/o

Dry

Melan/o

Black

Table 11.4  Prefixes.

Prefix

Definition

Prefix

Definition

epi‐

above; upon; on

meta‐

change; beyond

intra‐

within; into

par‐

other than; abnormal

hyper‐

increased; excessive; above

sub‐

under; below

hypo‐

deficient; below; under; less than normal

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Table 11.5  Suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ous

pertaining to

‐lysis

destruction; breakdown; separation

‐cyte

cell

‐oma

tumor; mass; collection of fluid

‐derma

skin

‐opsy

to view; view of

‐ectomy

removal; excision; resection

‐ose

pertaining to; full of; sugar

‐ema

condition

‐osis

abnormal condition

‐ia

condition

‐plasty

surgical repair

‐ism

process; condition

‐rrhea

flow; discharge

‐ist

specialist

‐itis

inflammation

‐logy

study of

Now it’s time to assemble the word parts listed in Tables  11.3–11.5. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this will get easier each

Parts Adip/o Dermat/o Dermat/o Dermat/o Dermat/o Lip/o

+ ‐ose + ‐itis + ‐logy + Myc/o + ‐plasty + ‐oma

Onych/o Onych/o Pil/o Py/o sub‐ Trich/o sub‐ Xer/o

+ ‐ectomy + Myc/o + Sebace/o + ‐derma + Cutane/o + Myc/o + Ungu/o + ‐derma

time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Medical Term

+ ‐ist + ‐osis

+ ‐osis + ‐ous + ‐ous + ‐osis + ‐al

= Adipose = Dermatitis = Dermatologist = Dermatomycosis = Dermatoplasty = Lipoma (Figure 11.31) = Onychectomy = Onychomycosis = Pilosebaceous = Pyoderma = Subcutaneous = Trichomycosis = Subungual = Xeroderma

Definition : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ : ______________________ Also called ichthyosis

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Figure 11.31  Surgery to remove a lipoma from a dog. Source: Courtesy of Greg Martinez, DVM; http:// www.youtube.com/drgregdvm.

Abbreviations Table 11.6  Abbreviations.

Abbreviation

Definition

CA

Cancer

Derm

Skin

DLE

Discoid lupus erythematosus

FAD

Flea allergy dermatitis

FNA

Fine needle aspirate

ID

Intradermal

LE

Lupus erythematosus

SC, SQ, Sub Q

Subcutaneous

SCC

Squamous cell carcinoma

SLE

Systemic lupus erythematosus

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Case Study You’ll notice some terms from the previous chapters Bum, a six‐year‐old West Highland White Terrier, has just been adopted by Mr. and Mrs. Phillips. They bring him to your clinic to have his skin checked. They noticed areas of bald spots under his eyes and around his legs. On P/E, the areas are isolated to suborbital (below the eye) and on the carpi. The doctor asks you to perform a scotch tape prep, but it turns up nothing so he orders a skin scrape. Figure 11.32 displays the results.

Figure 11.32  Can you identify the parasite?

1. What parasite does Bum have? a. Demodex b. Sarcoptes c. Streptococcus d. Staphylococcus 2. Which of the following clinical signs describes Bum? a. Pruritus b. Alopecia c. Acne 3. True or False: Since the parasite was seen on skin scrape and not a scotch tape prep, it was a superficial parasite.

Exercises 11-A:  Give the term for the following definitions of the integumentary system. 1.  2.  3.  4.  5. 

_____________: Layer of the epidermis containing melanocytes. _____________: True layer of skin. _____________: Found along the hair follicle and produces sebum. _____________: Structural protein found in the dermis of the skin. _____________: Pigment that gives skin its color.

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_____________: Oily substance secreted by sebaceous glands. _____________: Small opening on the surface of the skin. _____________: Deep, fatty layer of skin. _____________: Sac in the dermis in which hair grows. _____________: Outermost layer of skin.

11-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Percutaneous ________________________________________ Adipose ____________________________________________ Pyoderma __________________________________________ Trichomyosis _______________________________________ Subungual __________________________________________ Lipoma ____________________________________________ Dermatoplasty _______________________________________ Onychectomy ________________________________________ Xeroderma __________________________________________ Pilosebaceous ________________________________________

11-C:  Give the medical term for the following: 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12.  13.  14.  15.  16.  17.  18.  19.  20. 

_________________: Hairball. _________________: Erosion of the skin and mucous membranes. _________________: Containing pus. _________________: Small, pinpoint hemorrhages. _________________: Bluish‐black mark on the skin. _________________: Sweating _________________: Malignant tumor of the skin. _________________: Benign cyst containing sebum. _________________: Bedsores. _________________: Commonly called a skin tag. _________________: Spread of a tumor to a secondary location. _________________: A bruise. _________________: Itching _________________: Absence of hair in areas where it normally grows. _________________: Commonly called allergic dermatitis. _________________: Removal of tissue for microscopic exam. _________________: Localized collection of pus. _________________: Congenital absence of pigmentation. _________________: Plug of keratin and sebum at the hair follicle; blackhead. _________________: Abnormal tube‐like passageway that can occur anywhere on the body.

11-D:  Define the following abbreviations. 1.  2.  3.  4.  5. 

_________________: CA _________________: LE _________________: FNA _________________: SQ _________________: Derm

6.  7.  8.  9.  10. 

_________________: ID _________________: FAD _________________: DLE _________________: SC _________________: SLE

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11-E:  Match the following terms with their descriptions. 1.  2.  3.  4.  5. 

___________ Tough protein found in horny tissue ___________ Hooved animals ___________ Wound caused by scraping ___________ Wound caused by tearing ___________ Skin paleness

A.  B.  C.  D.  E. 

Abrasion Keratin Laceration Pallor Ungulates

11-F: Give the appropriate coat colors for the images shown in Figure 11.33 1–10. 1

3

5

2

4

6

Figure 11.33  Coats quiz. (1) Courtesy of Brian Lowery. (2) Courtesy of Donna Tunis, CVT. (3) Courtesy of Amy Johnson, BS, CVT, RLATG. (4) Courtesy of Ethan Heritage, CVT. (5) Courtesy of Elsa Morales. (6) Courtesy of Katherine Van Winkle, LVT. (7) Courtesy of Kristina Gutt, AAS. (8) Courtesy of Rela Goodwin, LVMT. (9) Courtesy of Candace C.

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7

8

9

10

Figure 11.33  (Continued ) Answers can be found starting on page 675.

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Review Tables Fill in the tables and refer to Tables 11.3–11.6 for answers. Table 11.7

Combining Forms

Definition

Combining Forms

Adip/o

Myc/o

Albin/o

Onych/o

Bi/o

Pil/o

Carcin/o

Py/o

Cutane/o

Seb/o

Derm/o

Sebace/o

Dermat/o

Squam/o

Erythem/o

Steat/o

Erythemat/o

Therm/o

Hidr/o

Trich/o

Ichthy/o

Ungul/o

Kerat/o

Ungu/o

Lip/o

Xer/o

Definition

Melan/o

Table 11.8

Prefix

Definition

Prefix

epi‐

meta‐

intra‐

par‐

hyper‐

sub‐

hypo‐

Definition

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Table 11.9

Suffix

Definition

Suffix

‐al, ‐ous

‐lysis

‐cyte

‐oma

‐derma

‐opsy

‐ectomy

‐ose

‐ema

‐osis

‐ia

‐plasty

‐ism

‐rrhea

‐ist ‐itis ‐logy

Table 11.10

Abbreviation CA Derm DLE FAD FNA ID LE SC, SQ, Sub Q SCC SLE

Defintion

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word search puzzle

C h a p t e r

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The Nervous System

The nervous system is the most complex of the body systems, controlling all the body’s activities. Some animals have millions of nerve cells in their bodies, while others have up to one billion nerve cells which are constantly detecting stimuli, sending messages to the brain to coordinate a response, and then sending messages from the brain to different parts of the body to carry out that response.

recognize the impulse, chemical substances called neurotransmitters are released to excite or inhibit the target cell (Figure 12.2). Different types of neurotransmitters create different responses and include acetylcholine, epinephrine, dopamine, endorphins, and serotonin. Table 12.2 lists the neurotransmitters and their effects on the body.

Nerves

When dendrites and axons are bundled together, they become visible to the naked eye, forming a structure called a nerve. There are two different kinds of nerves: sensory nerves and motor nerves. Sensory nerves, also called afferent nerves, carry impulses toward the brain. Motor nerves, also called efferent nerves, carry impulses away from the brain. For example, if you were to touch a hot stove, the sensory nerves would carry an impulse to your brain telling you that it’s hot. The motor nerves would then send an impulse from your brain to your hand to tell it to move.

The neuron, or nerve cell, is the basic structure of the nervous system. This microscopic structure transmits impulses after receiving a stimulus. Label the neuron in Figure 12.1 using Table 12.1.

The Path of the Nervous Impulse Once there’s a change in environment (a stimulus), an impulse is received by the dendrites of the nerve cell. The nervous impulse then passes through the cell body and along the axon. After leaving the axon, the nervous impulse passes through the terminal end fibers and into the synapse to be picked up by the dendrites of another nerve cell. In order to help other neurons

Nerves

Neuroglial Cells Neuroglial cells, or glial cells, play a supportive role in the nervous system ­ (Figure 12.3). The cells resemble n ­ eurons

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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1. 3.

2.

4. 5. Node of Ranvier 6. Neurotransmitters 7.

Figure 12.1  Anatomy of a neuron. Source: Courtesy of shutterstock/Alila Sao Mai.

Table 12.1  The nerve cell. Axon (4)

Fiber that carries a nervous impulse along a nerve cell away from the cell body.

Cell body (2)

Part of the nerve cell containing the nucleus (3). A collection of nerve cell bodies is called a ganglion.

Dendrites (1)

Branching structures that receive the nervous impulse.

Myelin sheath (5)

Fatty tissue around the axon of a nerve cell. Helps to protect and insulate the axon. The sheath is lobed, creating gaps between layers of myelin along the axon. These gaps are called nodes of Ranvier.

Synapse (7)

Space between neurons in which the nervous impulse passes.

Terminal end fibers (6)

Distal portion of the neuron where the impulse leaves the cell.

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Neurotransmitter

Postsynaptic cell

Presynaptic cell Synapse

Receptor

Figure 12.2  The synapse and the effect of neurotransmitters. Source: Courtesy of shutterstock/Meletios. Table 12.2  Neurotransmitters. Acetylcholine

Neurotransmitter that causes muscles to contract and aids in “dream” sleep.

Dopamine

Neurotransmitter that inhibits the firing of nerve cells which in turn relaxes the animal.

Endorphins

Neurotransmitters responsible for reducing pain and for pleasure. Endorphins are the body’s natural morphine.

Epinephrine

Hormone that acts as a neurotransmitter to increase heart rate and blood pressure. Also called adrenaline.

Norepinephrine

Neurotransmitter that causes vasoconstriction, increased heart rate, and increased blood pressure. Also called noradrenaline.

Serotonin

Neurotransmitter responsible for relaxation. When levels are decreased, it leads to stress and behavioral disorders.

morphologically, but their function is to protect the nerves by attacking foreign material and protect them from infection. Glial cells are far more numerous

Astroglial cells

than neurons and can reproduce and phagocytize foreign microorganisms. There are five different types of glial cells:

Commonly called astrocytes, these cells transport electrolytes and water between the capillaries and neurons of the brain, helping to form the blood–brain barrier (BBB). They prevent the passage of harmful substances from the blood into the nerve cells of the brain. These cells are shaped like a star, which is where their name comes from.

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Capillary

Neuron

Astrocyte

Microglia

Oligodendrocyte

Figure 12.3  Neuroglial cells. Source: Courtesy of shutterstock/Alila Sao Mai.

Microglial cells

Phagocytic cells which protect the nervous system from infection. Oligodendroglial Cells that form the cells myelin around the axon of the nerve cell. Ependymal cells Cells that line the ventricles of the brain and surround the spinal cord. They produce cerebrospinal fluid that circulates around the brain and spinal cord. Schwann cells Dual‐action cells that form myelin around the axon and act as phagocytes against foreign organisms.

TECH TIP 12.1 Essentials and Accessories Tissue that is essential to a system is termed parenchymal tissue. Tissue that is supportive to the essential tissue is called stromal tissue. In the case of the nervous system, a neuron would be an example of parenchymal tissue and glial cells would be classified as stromal tissue.

Divisions of the Nervous System The nervous system is divided into two portions, the central nervous system and the peripheral nervous system (Figure 12.4). The central nervous system consists of the brain and spinal cord. The peripheral

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Central nervous system

Brain

Spinal cord

Peripheral nervous system

Spinal nerve

Autonomic nerves

Parasympathetic nerves

Cranial nerves

Sympathetic nerves

Figure 12.4  Divisions of the nervous system.

­ervous system is made up of cranial n nerves, spinal nerves, and the autonomic nervous system.

The Central Nervous System Both the brain and spinal cord are a collection of nervous tissue. If cross‐sectioned, both have a gray layer and a white layer. The gray layer, or gray matter, is made up of nerve cell bodies and the white layer, or white matter, is made up of the axons and myelin sheaths. Therefore, the white matter is the conducting portion of both organs. The brain and spinal cord are also surrounded by three layers of membranes called meninges. The protective layers, in order from superficial to deep, are listed in Table 12.3.

The spaces between the meninges are named based on their location (Figure 12.5). Epidural space Space above the dura mater. Subdural space Space below the dura mater. Subarachnoid Space below the space arachnoid membrane, where cerebrospinal fluid can be found. Cerebrospinal fluid (CSF) is a transparent fluid that circulates throughout the brain and spinal cord. It is produced by the choroid plexus to help nourish the brain and spinal cord. The choroid plexus is a group of blood vessels in the pia mater of the brain. The Brain

Table 12.3  Meninges. Dura mater Tough, outermost layer of the meninges. Blood can enter brain tissue through this layer. Arachnoid membrane

Middle layer of the meninges. Also known as the arachnoid mater.

Pia mater

Innermost, delicate layer of the meninges which adheres to the brain and spinal cord.

The brain lies in the skull and is the c­ ontrol center of the body. There are three main sections of the brain: the cerebrum, the cerebellum, and the brainstem (Figure 12.6). The cerebrum is the largest part of the brain and is responsible for memory, speech, movement, hearing, vision, and smell. Sensory impulses from the afferent nerves are received by the cerebrum and motor impulses are sent to the efferent nerves. The outer section of the cerebrum, the cerebral cortex, is made up of gray

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Skull Superior sagittal sinus Arachnoid villus

Periosteal layer

Dura Meningeal layer mater Subdural space Arachnoid mater Subarachnoid space Pia mater Gray matter

Blood vessel

Brain

White matter Falx cerebri

Figure 12.5  The meninges. Source: Courtesy of shutterstock/Alila Sao Mai.

Central sulcus Parietal lobe

Frontal lobe

Parietooccipital sulcus

Corpus callosum

Lateral ventricle

Occipital lobe

Thalamus Hypothalamus Pituitary

Midbrain Pons

Temporal lobe

Medulla oblongata

Cerebellum Spinal cord

Figure 12.6  Anatomy of the brain (median section). Source: Courtesy of shutterstock/Alila Sao Mai.

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matter that is arranged in folds called gyri. The grooves between the gyri are called sulci (Figure  12.7). White matter and ventricles, the spaces within the brain, ­ can  be found in the inner section of the brain. The cerebrum is divided into a right side and a left side, called the cerebral

Left hemisphere

Right hemisphere

Gyrus Sulcus

Cerebellum Fissure

Figure 12.7  Dorsal view of a dog’s brain. Source: Courtesy of shutterstock/vetpathologist.

­ emispheres. Within each hemisphere are h four lobes which are named based on the skull bones that protect them (Figure 12.8). The cerebellum is the second largest portion of the brain and is commonly referred to as the “body’s gyroscope.” It is the cerebellum that helps the body maintain balance and coordinate voluntary movements. The brainstem is the stem‐like portion of the brain that connects the cerebrum to the spinal cord. It is made up of the midbrain, interbrain, pons, and medulla oblongata. The interbrain includes the thalamus and hypothalamus. The thalamus is a relay point of the brain where sensory and motor impulses are received and then redirected to the appropriate part of the cerebrum. The hypothalamus lies just beneath the thalamus and controls the pituitary gland, body temperature, emotions, sleep, thirst, and hunger. The midbrain is rostral to the pons and contains nerve fibers that allow communication between the cerebral hemispheres (Figure 12.9). This portion of the brain is responsible for reflexes of the eyes, ears, and head. The pons, or bridge, contains nerve fibers that allow the cerebrum and cerebellum to communicate with each other.

Frontal lobe Parietal lobe

Prefrontal lobe

Occipital lobe

Sylvian fissure Cerebellum Temporal lobe Pons Medulla Figure 12.8  Lobes of the brain. Source: Courtesy of shutterstock/MikiR.

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Figure 12.9  Lateral view of a dog’s brain. Source: Courtesy of shutterstock/vetpathologist.

The medulla oblongata is a stem‐like structure connecting the brain to the spinal cord. Essential life functions such as breathing, heart function, and blood pressure are controlled by the medulla oblongata. This portion is also responsible for the communication between one side of the body and the opposite side of the brain. When damaged in animals, symptoms include head tilt and circling. The Spinal Cord The spinal cord is the highway from the brain to the rest of the body. It carries impulses to and from the brain and carries all the nerves to the limbs (Figure 12.10). The spinal cord runs from the medulla oblongata to the lumbar or sacral vertebrae, depending on the species. When the spinal cord ends, the nerve endings of the cord branch out, thus forming the cauda equina (horse’s tail). The name comes from the appearance of the nerves due to their fanned‐out appearance.

The Peripheral Nervous System Cranial Nerves Cranial nerves are attached to the brain and pass through the skull to structures in the head and neck (Figure  12.11). There

are 12 pairs of cranial nerves, all named using Roman numerals. The tenth cranial nerve, the vagus nerve, is the exception to the rule in that it also controls functions in the chest and abdomen. Table 12.4 lists the cranial nerves and their functions. There are many mnemonics to help memorize the cranial nerves; some of them are clean, and some of them dirty. One example of a clean mnemonic is Oh, Oh, Oh, To Touch And Feel Vintage Green Velvet, Absolute Heaven. Spinal Nerves Spinal nerves carry nervous impulses between the spinal cord and the rest of the body (Figure 12.12). These paired nerves pass between the vertebrae where they eventually branch out to supply the trunk and limbs of the body. The Autonomic Nervous System Unlike the spinal nerves and cranial nerves, which primarily deal with the voluntary functions of skeletal muscle (Figure 12.13), the autonomic nervous system is responsible for involuntary functions of smooth muscle, cardiac muscle, and gland secretion. The two divisions of the autonomic nervous system are the sympathetic nervous system and the parasympathetic nervous system (Figure 12.14).

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Dorsal root

Dorsal root ganglion

Afferent signal

Efferent signal White matter

Ventral root

Spinal nerve

Gray matter

Dorsal ramus

Vertebra

Ventral ramus Communicating rami Sympathetic ganglion

Figure 12.10  Cross‐section of the spinal cord. Source: Courtesy of shutterstock/Alila Sao Mai.

Olfactory nerve fibers (I) Optic nerve (II) Oculomotor nerve (III) Trochlear nerve (IV) Trigeminal nerve (V) Abducens nerve (VI) Pons

Facial nerve (VII) Vestibulocochlear nerve (VIII)

Medulla

Glossopharyngeal nerve (IX) Vagus nerve (X) Accessory nerve (XI) Hypoglossal nerve (XII)

Figure 12.11  The cranial nerves. Source: Courtesy of shutterstock/Alila Sao Mai.

Table 12.4  Cranial nerves.

Cranial Nerve

Function

I. Olfactory

Smell

II. Optic

Vision

III. Oculomotor

Movement of eyes

IV. Trochlear

Movement of eyes

V. Trigeminal

Based on its name, this nerve has three branches: Ophthalmic: corneal senses Maxillary: upper jaw movement Mandibular: upper jaw movement

VI. Abducens

Movement of eyes

VII. Facial

Movement of face Taste

VIII.Vestibulocochlear

Hearing and balance

IX. Glossopharyngeal

Tongue taste Throat movement

X. Vagus

Throat Voice box Chest movement Abdominal sensations

XI. Accessory

Neck and shoulder movement

XII. Hypoglossal

Tongue movement

Ventral root of spinal nerve

Dorsal root of spinal nerve

Spinal nerve

Gray matter of spinal cord White matter of spinal cord Dorsal root ganglion

Sympathetic rami

Sympathetic ganglion

Spinal cord

Figure 12.12  Anatomy of the spinal nerves. Source: Courtesy of shutterstock/Alex Luengo.

Brain

Sensory receptor

Dorsal root ganglion

Sensory neuron Spinal cord

Motor neuron

Peripheral nerve

Motor nerve ending

Figure 12.13  Pathways of afferent and efferent nerves through the central and peripheral nervous systems. Source: Courtesy of shutterstock/Annie Potter.

Parasympathetic

Sympathetic Cranial

Cerebrum (brain)

Constricts pupils Increases saliva production

Constricts bronchi

Stimulates the activity of the pancreas Stimulates the gallbladder

Dilates bronchi

Inhibits the activity of the digestive organs Inhibits the activity of the pancreas Inhibits the gallbadder

Synapse Iumbar

Stimulates the adrenal medulla to release epinephrine (adrenaline) and norepinephrine (noradrenaline)

Constricts urinary bladder Sacral

Promotes erection

Inhibits saliva production

Increases heart rate

Thoracic

Stimulates the activity of the digestive organs

Spinaal cord

Cervical

Reduces the heart rate

Sympathetic chain

Dilates pupils

Relaxes urinary bladder Promotes ejaculation

Figure 12.14  The two divisions of the autonomic nervous system. Source: Courtesy of WikiCommons/ Geo‐Science_International.

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Extreme stress or threat

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Pituitary gland releases ACTH

Adrenals release cortisol and epinephrine (adrenaline)

• • • • • • • • • • • •

Heart rate increases Pupils dilate Bladder relaxes Tunnel vision Respiratory rate increases Digestion decreased Loss of hearing Blood pressure increases Dry mouth Flushed skin Blood glucose increases Shaking

Figure 12.15  The fight or flight response.

The parasympathetic nervous system is responsible for normal body function. Parasympathetic nerves reduce heart rate,  decrease blood pressure, constrict the pupils, decrease respiratory rate, and relax the structures of GI tract. The parasympathetic nervous system is also called the cholinergic pathway because it  uses the cholinergic neurotransmitter acetylcholine. The sympathetic nervous system is responsible for the “fight or flight” response in cases of extreme stress (Figure 12.15). Sympathetic nerves increase heart rate, respiratory rate, and blood pressure. Pupils

are dilated and GI function is decreased during this stress response. The sympathetic nervous system is also responsible for stimulating the release of epinephrine from the adrenal glands. The sympathetic nervous system is also called the adrenergic  pathway because it uses the adrenergic neurotransmitter epinephrine (or adrenaline). Ultimately, these two systems oppose each other. Just remember that the parasympathetic nervous system is used to “rest and digest.” The sympathetic nervous system is for “fight or flight” and that adrenergic equals adrenaline.

Related Terms Autonomic nervous system (ANS) Arachnoid membrane Axon Blood–brain barrier (BBB) Brainstem Cauda equina Cell body Central nervous system (CNS)

Nerves that control involuntary functions of muscles, glands, and viscera. Middle layer of the meninges. Also known as the arachnoid mater. Fiber that carries the nervous impulse along the nerve cell. Capillaries that allow certain substances to enter the brain while keeping other substances out. Consists of the pons, medulla oblongata, interbrain, and midbrain. This portion of the brain connects the brain to the spinal cord. Nerve roots leaving the caudal end of the spinal cord. Portion of the nerve cell that contains the nucleus. The brain and spinal cord.

Chapter 12  The Nervous System

Cerebral cortex Cerebrum

387

Outer section of the cerebrum. Largest part of the brain responsible for voluntary muscle movements, speech, vision, hearing, thought, memory, and taste. Second largest part of the brain, responsible for balance and coordination. Awake, alert, aware, responsive. Fluid circulating throughout the brain and spinal cord.

Cerebellum Conscious Cerebrospinal fluid (CSF) Dendrites Dura mater Gait Ganglion (plural: ganglia) Hippocampus

First part of the nerve cell to receive the stimulus. Tough, outermost layer of the meninges. Manner of walking. Collection of nerve cell bodies in the peripheral nervous system. Portion of the brain responsible for orientation and emotional responses. When an animal is suspected of dying from rabies, this portion of the brain is checked for round, reddish inclusions called Negri bodies (Figure 12.16). Portion of the interbrain that controls the pituitary gland, body temperature, emotions, sleep, thirst, and hunger (Figure 12.16).

Hypothalamus

Hypothalamus Pineal gland

Cerebral cortex

s

rpu

Co

um os m ptu Se

ll ca

Thalamus

Olfactory bulb

s

pu

am

c po

Hip Pons

Cerebellum

Fomix Pituitary gland

Midbrain Medulla oblongata

Spinal cord

Figure 12.16  Isolated structures of the midbrain. Source: Courtesy of shutterstock/Annie Potter.

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Innervation

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Supply of nerves to a part of the body. Medulla Stem‐like structure of oblongata the brainstem connecting the brain to the spinal cord. Responsible for essential life functions such as breathing, heart function, and blood pressure. Meninges Three protective layers surrounding the brain and spinal cord. Motor nerves Nerves that carry impulses away from the brain and spinal cord. Also known as efferent nerves. Myelin sheath Protective, fatty tissue around the axon of a nerve cell. Nerve Macroscopic cord‐ like structure made up of nerve cells. Neuron A nerve cell. Neurotransmitter Chemical messenger released from a neuron to stimulate or inhibit another nerve or target cell. Parasympathetic Portion of the nervous system autonomic nervous system responsible for normal body functions including regulating heart rate and respiratory rate. Peripheral Portion of the nervous system nervous system consisting of cranial nerves, spinal nerves, and the autonomic nervous system. Pia mater Innermost, delicate layer of the meninges which adheres to the brain and spinal cord.

Plexus

Pons

Proprioception Sensory nerves

Large, interlacing network of nerves. Named based on where they carry impulses to and from. For example, the brachial plexus supplies most of the front limbs. Contains nerve fibers that allow the cerebrum and cerebellum to communicate with each other. Commonly called the bridge. Knowing where your limbs are in space (Figure 12.17). Nerves that carry impulses toward the brain and spinal cord. Also known as afferent nerves.

Figure 12.17  Dog with decreased proprioception. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Chapter 12  The Nervous System

Sympathetic nervous system

Thalamus

Ventricles of the brain

Portion of the autonomic nervous system responsible for the “fight or flight” response in cases of extreme stress. Functions include increasing heart rate and respiratory rate. Relay point of the brain where sensory and motor impulses are received and then redirected to the appropriate part of the cerebrum (Figure 12.18). Spaces in the interbrain that contain CSF.

389

Caprine arthritis Multisystem viral encephalitis disease causing ataxia, (CAE) paralysis, arthritis, and pneumonia. Cataplexy Idiopathic condition causing sudden loss of skeletal muscle function due to extreme excitement, sexual activity, or vigorous exercise. Cerebellar Degeneration or loss of hypoplasia cells in the cerebellum causing ataxia. Cerebrovascular Disruption in the accident normal blood supply to the brain; stroke (Figure 12.19). TECH TIP 12.2  What Is the Purpose of a Behaviorist?

Thalamus

Hypothalamus

Figure 12.18  Relation of the thalamus to the hypothalamus. Source: Courtesy of shutterstock/ Alila Sao Mai.

Pathology and Procedures Aneurysm Ataxia Behaviorist Bovine spongiform encephalopathy (BSE)

Localized widening of a blood vessel. Lack of coordination. Specialist in behavior. Spongy degeneration of the brain and spinal cord causing ataxia, anorexia, aggression, and eventually death. Commonly called mad cow disease.

Owners will often bring in their animals for various behavioral issues such as inappropriate urination or destructive separation anxiety. When an animal presents to the clinic for a behavioral issue, it’s best to rule out any physical reasons for the behavior. Once the animal has been deemed physically healthy, then they may be referred to an animal behaviorist. These specialists can either recommend a change of lifestyle to counteract the behavior or possibly recommend anti‐anxiety medication.

Coma Concussion Contusion

Deep state of unconsciousness. Also called comatose. Violent shaking of the brain. A bruise; injury to tissue without breaking the skin. Characterized by pain, swelling, and tenderness due to broken blood vessels.

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Ruptured aneurysm

Aneurysm Figure 12.19  Mechanism of a stroke. Source: Courtesy of shutterstock/Alila Sao Mai.

CSF analysis

Laboratory examination of CSF to diagnose tumors and infections.

CSF tap

Figure 12.20  CSF tap. Source: Courtesy of shutterstock/Li Wa.

Surgical puncture to remove CSF. Sometimes called a lumbar or spinal puncture (Figure 12.20).

Chapter 12  The Nervous System

(A)

391

(B)

Figure 12.21  CT scan of a dog. (A) Machine performing CT scan. (B) Close‐up of dog sedated for CT scan. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Computed tomography (CT or CAT) of the brain Contraindication Epilepsy Equine viral encephalomyelitis

Horner’s syndrome

Hydrocephalus Lethargy

Radiographic imaging technique showing computerized cross‐sections of the brain and spinal cord (Figure 12.21). Any condition that renders a particular treatment undesirable. Idiopathic brain disorder characterized by recurrent seizures. Encephalomyelitis caused by viruses of the genus Alphavirus and transmitted by mosquitos. Symptoms include excitement, tremors, circling, paralysis, and recumbency. Three strains include Eastern (EEE), Venezuelan (VEE), and Western (WEE). Neurological disorder caused by paralysis of the cervical sympathetic nerve supply. Disease is characterized by sunken eyes, drooping of the upper eyelid, slight elevation of the lower eyelid, constriction of the pupils, and a prolapsed third eyelid (Figure 12.22). Abnormal accumulation of CSF in the ventricles of the brain. Also called water on the brain (Figure 12.23). Condition of drowsiness or indifference.

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TECH TIP 12.3  Cataplexy vs. Narcolepsy These conditions are often associated with each other. While it’s possible to have cataplexy without narcolepsy, it’s very rare. Animals with cataplexy without narcolepsy may remain conscious during episodes. Cataplexy is a common symptom of narcolepsy. Patients with both conditions typically lose consciousness. Both conditions may be seen in dogs, cats and horses. Shetland ponies are particularly susceptible.

(A)

(B)

Figure 12.22  Horner’s syndrome. Sources: (A) Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems. (B) Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Figure 12.23  Radiograph of a dog with hydrocephalus. Source: Courtesy of Anonymous.

Chapter 12  The Nervous System

Magnetic resonance image (MRI) of the brain Myasthenia gravis Narcolepsy Palliative Paralysis

393

Radiographic imaging technique showing a three‐ dimensional image of the brain. Neuromuscular disorder characterized by weakness of the skeletal muscles. Condition causing sudden, uncontrollable sleep episodes. Can be seen in dogs and Shetland ponies. Relieving symptoms, but not curing. For example, patients with epilepsy can be given drugs to decrease the frequency of seizures, but the drugs can’t cure the disease itself. Loss of motor function. Patients may have partial or complete paralysis. Also called palsy (Figure 12.24).

Figure 12.24  Paralyzed Wire Fox Terrier with a wheelchair. Source: Courtesy of shutterstock/pixshots.

Positron emission tomography (PET) scan Sedation Seizure Spasticity Spina bifida Stupor Syncope Thromboembolic meningoencephalitis (TEME) Tremor Vestibular disease

Radiographic imaging technique in which images are produced after injection of a radioactive substance. To diminish irritability or excitement; to administer a sedative. Sudden, involuntary contractions of voluntary muscles; also called convulsions, grand mal, or tonic clonic. Increased muscle tone. Congenital anomaly in which the spinal canal fails to close around the spinal cord. Partial unconsciousness and decreased response to stimuli. Fainting or temporary loss of consciousness. Systemic disease in cattle causing blindness, weakness, ataxia, recumbency, and eventually death. Repetitive twitching of skeletal muscle. Idiopathic neurological disorder characterized by head tilt, circling, and rapid back‐and‐forth movement of the eyes. Generally seen in older dogs (Figure 12.25).

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TECH TIP 12.4  Strokes vs. Vestibular Disease Strokes are very rare in veterinary medicine. Cases of stroke have been documented though. The more commonly seen disorder of older dogs is vestibular disease. It presents similar to a stroke, but the symptoms begin to subside after a few days and medication can help take the edge off the more severe symptoms.

Figure 12.25  Black Labrador with vestibular syndrome. Note the slight head tilt and imbalance on the table. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Building the Terms Now it’s time to assemble the word parts listed in Tables  12.5–12.7. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this

will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 12.5  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Alges/o

Sensitivity to pain

Hemat/o

Blood

Arachn/o

Arachnoid membrane

Hydr/o

Fluid; water

Astr/o

Star

Kines/o

Movement

Ax/o

Axis; main stem

Mening/o

Meninges

Caus/o

Burning

Meningi/o

Meninges

Caust/o

Burning

My/o

Muscle

Cephal/o

Head

Myel/o

Spinal cord; bone marrow

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Table 12.5  (Continued)

Combining Forms

Definition

Combining Forms

Definition

Cerebell/o

Cerebellum

Narc/o

Sleep; stupor; numbness

Cerebr/o

Cerebrum

Neur/o

Nerve

Comat/o

Deep sleep; coma

Plex/o

Plexus; network of nerves

Concuss/o

Shaken together violently

Pont/o

Pons

Contus/o

Bruise

Radicul/o

Nerve root

Crani/o

Skull; cranium

Spin/o

Spine

Dendr/o

Dendrite

Sulc/o

Groove

Dur/o

Dura mater

Synaps/o

Synapse

Electr/o

Electricity

Synapt/o

Synapse

Encephal/o

Brain

Syncop/o

To cut off; cut short; fainting

Esthesi/o

Nervous sensation

Tax/o

Coordination; order

Gangli/o

Ganglion; collection of nerve cell bodies

Thalam/o

Thalamus

Ganglion/o

Ganglion; collection of nerve cell bodies

Thec/o

Sheath

Gli/o

Neuroglial tissue; glue

Vag/o

Vagus nerve

Gyr/o

Folding

Vertebr/o

Vertebrae

Table 12.6  Prefixes.

Prefix

Definition

Prefix

Definition

a‐, an‐

no, not, without

micro‐

small

brady‐

slow

mono‐

one

cata‐

down

oligo‐

scanty

epi‐

above; upon; on

par‐

other than; abnormal

eu‐

normal; true; good

para‐

near; beside; abnormal; apart from; along the side of

hemi‐

half

polio‐

gray matter

hyper‐

increased; excessive; above

poly‐

many; much

hypo‐

deficient; below; under; less than normal

quadri‐

four

inter‐

between

sub‐

under; below

intra‐

within; into

tetra‐

four

macro-

large

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Table 12.7  Suffixes.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐ic

pertaining to

‐lepsy

seizure

‐algesia

sensitivity to pain

‐malacia

softening

‐algia

pain

‐oma

tumor; mass; collection of fluid

‐cele

hernia

‐ose

pertaining to; full of; sugar

‐cyte

cell

‐paresis

slight paralysis

‐ectomy

removal; excision; resection

‐pathy

disease condition

‐esthesia

nervous sensation

‐plasia

development; formation; growth

‐graphy

process of recording

‐plegia

paralysis; palsy

‐ia

condition

‐rrhaphy

suture

‐itis

inflammation

‐sthenia

strength

‐kinesia

movement

‐tomy

incision; process of cutting into

‐kinesis

movement

‐y

condition; process

‐kinetic

movement

Parts

Medical Term

Definition

= Analgesia =  Anesthesia (Figure 12.26) = Hyperesthesia = paresthesia = Macrocephaly = Microcephaly = Cerebellar

: _________ : _________ : _________ : _________ : _________ : _________ : _________

an‐ an‐ hyper‐ par‐ macro‐ micro‐ Cerebell/o

+ ‐algesia + ‐esthesia + ‐esthesia + ‐esthesia +  Cephal/o + ‐y +  Cephal/o + ‐y + ‐ar

Cerebr/o Comat/o intra‐ polio‐ polio‐

+ ‐al + ‐ose + Crani/o + ‐al + Encephal/o + ‐malacia + Encephal/o + Myel/o + ‐itis

= Cerebral = Comatose = Intracranial = Polioencephalomalacia = Polioencephalomyelitis

: ________ : ________ : ________ : ________ : ________

TECH TIP 12.5  Analgesia vs. Anesthesia These terms sound awfully similar and appear similar on paper. Be careful! Analgesia is reducing pain. Anesthesia means without pain sensation; technically it is a loss of all sensations including pain, heat, cold, etc.

Chapter 12  The Nervous System

(A)

(B)

Figure 12.26  (A) German Shepherd under anesthesia. Source: Courtesy of Anna Morse, CVT. (B) Horse under anesthesia. Source: Courtesy of Lindsey Steele, AAS.

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Electr/o Encephal/o Encephal/o Encephal/o Encephal/o

+ Encephal/o + ‐gram + ‐itis + ‐cele + ‐pathy + Myel/o + ‐itis

Hemat/o eu‐ a‐ brady‐ hyper‐ Mening/o Meningi/o Mening/o

+ ‐oma + ‐phoria + ‐kinetic + ‐kinesia + ‐kinesis + ‐eal + ‐oma + ‐itis

= Electroencephalogram : ________ = Encephalitis : ________ = Encephalocele : ________ = Encephalopathy : ________ = Encephalomyelitis : ________ Because myel/o is attached to the combining form for brain, the definition for myel/o is generally spinal cord. = Hematoma : ________ = Euphoria : ________ = Akinetic : ________ = Bradykinesia : ________ = Hyperkinesis : ________ = Meningeal : ________ = Meningioma : ________ = Meningitis : ________ (Figure 12.27)

Skull Blood vessel Arachnoid mater Arachnoid mater Subarachnoid space Pia mater

Subarachnoid space

Pia mater

Gray matter White matter

Clear colorless cerebrospinal fluid

Brain

Milky cerebrospinal fluid containing neutrophils and bacteria Normal Meningitis

Figure 12.27  Meningitis and a comparison between normal and abnormal CSF. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 12  The Nervous System

Mening/o

+ Myel/o

Myel/o Myel/o

+ ‐gram + ‐oma

+ ‐cele

399

= Meningomyelocele : ________ Because myel/o is attached to the combining form for meninges, the definition for myel/o is generally the spinal cord instead of bone marrow. = Myelogram : ________ = Myeloma : ________ (Figure 12.28)

Figure 12.28  Radiograph of a myeloma in a dog. Note the urine retention in the urinary bladder. Source: Courtesy of Beth Romano, AAS, CVT.

polio‐ My/o My/o Neur/o Neur/o Neur/o Neur/o Neur/o

+ Myel/o + Neur/o + ‐paresis + ‐algia + ‐asthenia + ‐ectomy + ‐itis + ‐pathy

Neur/o Neur/o Neur/o

+ ‐plasty + ‐rrhaphy + ‐tomy

+ ‐itis + ‐al

= Poliomyelitis = Myoneural = Myoparesis = Neuralgia = Neurasthenia = Neurectomy = Neuritis = Neuropathy (Figure 12.29) = Neuroplasty = Neurorrhaphy = Neurotomy

: ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________

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Dendrites

Nucleus Cell body Myelin sheath D ir e

c ti o

Damaged myelin sheath Pathways do not work Loss of feeling

no

fn erve

Axon

imp uls e

Axon terminals

Synapse

Healthy nerve cell

Unhealthy nerve cell

Figure 12.29  Neuropathy. Source: Courtesy of shutterstock/Tefi.

poly‐ hemi‐ mono‐ para‐ quadri‐ tetra‐

+ Neur/o + ‐paresis + ‐paresis + ‐paresis + ‐paresis + ‐paresis

+ ‐itis

= Polyneuritis = Hemiparesis = Monoparesis = Paraparesis = Quadriparesis = Tetraparesis

: ________ : ________ : ________ : ________ : ________ : ________

TECH TIP 12.6  Para vs. Hemi When using “para‐” and “hemi‐” on terms related to weakness or paralysis of the body, “para” refers to the hindlimb (rear legs) of the body while “hemi” refers to one side of the body, specifically right or left side.

hemi‐ mono‐ para‐ quadri‐ tetra‐ Radicul/o Radicul/o Syncop/o Thalam/o Vag/o

+ ‐plegia + ‐plegia + ‐plegia + ‐plegia + ‐plegia + ‐pathy + ‐itis + ‐al + ‐ic + ‐al

= Hemiplegia = Monoplegia = Paraplegia = Quadriplegia = Tetraplegia = Radiculopathy = Radiculitis = Syncopal = Thalamic = Vagal

: ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________ : ________

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Abbreviations Table 12.8  Abbreviations.

Abbreviation

Definition

ANS

Autonomic Nervous System

BBB

Blood Brain Barrier

BSE

Bovine Spongiform Encephalopathy (Mad Cow Disease)

CAE

Caprine Arthritis Encephalitis Virus

CNS

Central Nervous System

CSF

Cerebrospinal Fluid

CT, CAT scan

Computed Tomography

CVA

Cerebrovascular Accident (Stroke)

EEE

Eastern Equine Encephalitis

EEG

Electroencephalogram

kVp

Kilovolt peak

GSD

German shepherd dog

ICP

Intracranial Pressure

LP

Lumbar Puncture

ma

Milliamperage

mAs

Milliamperage seconds

MG

Myasthenia Gravis

MRI

Magnetic Resonance Imaging

PEM

Polioencephalomalacia

PET

Positron Emission Tomography

PNS

Peripheral Nervous System

Sz

Seizure

TEME, TME

Thromboembolic Meningoencephalitis

VEE

Venezuelan Equine Encephalitis

WEE

Western Equine Encephalitis

Case Study: Define the Terms and Abbreviations in Bold Print A 12‐year‐old M/N Irish Setter named Laddie is rushed into the clinic with bouts of syncope, convulsions, and tremors. The owners are inconsolable after staying up with their dog all night. Phlebotomy is performed to run lab work. Muscle enzymes are elevated, but

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­ therwise the labs are unremarkable. The vet orders an EEG and MRI. No extracranial or o intracranial abnormalities are found. Laddie is diagnosed with epilepsy and placed on the drug phenobarbital to help decrease the frequency of the seizures. When seen for a follow‐up visit the following week, Laddie is BAR and the owners are pleased with Laddie’s steady improvement. 1. Laddie’s treatment with the drug phenobarbital is considered: a. A cure b. Purulent c. Idiopathic d. Palliative

Exercises 12-A:  Give the term for the following definitions of the nervous system. 1.  _____________: Manner of walking. 2.  _____________: Condition of drowsiness. 3.  _____________: Nerve roots leaving the caudal end of the spinal cord that look like a horse’s tail. 4.  _____________: Network of nerves. 5.  _____________: A nerve cell. 6.  _____________: Three protective layers of the brain and spinal cord. 7.  _____________: Largest part of the brain. 8.  _____________: The body’s gyroscope. 9.  _____________: Tough, outermost layer of meninges. 10.  _____________: Localized widening of a blood vessel. 11.  _____________: Paralysis of one limb. 12.  _____________: Disease condition of a nerve root. 13.  _____________: Abnormal nervous sensation. 14.  _____________: Deep state of unconsciousness. 15.  _____________: Supply of nerves to a part of the body. 12-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

Encephalomalacia ___________________________________________________ Analgesia ___________________________________________________________ Bradykinesia ________________________________________________________ Hematoma _________________________________________________________ Neuropathy _________________________________________________________ Hemiplegia __________________________________________________________ Paraparesis __________________________________________________________ Meningitis __________________________________________________________ Comatose __________________________________________________________ Arachnoid membrane ________________________________________________ Microglial cells ______________________________________________________ Poliomyelitis ________________________________________________________

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12-C:  Circle the correct term in parentheses: 1.  Knowing where your limbs are in space. (palliative, proprioception, stupor) 2.  Protective, fatty tissue around the axon of a nerve cell. (axon, dendrite, myelin sheath) 3.  Nerves that carry impulses toward the brain and spinal cord. (afferent, efferent, motor) 4.  Capillaries that allow certain substances to enter the brain. (BBB, PET, CSF) 5.  The brain and spinal cord. (ANS, CNS, PNS) 6.  Mad cow disease. (BSE, CAE, TME) 7.  Increased muscle tone. (tremor, seizure, spasticity) 8.  Sudden compulsion to sleep. (cataplexy, epilepsy, narcolepsy) 9.  Imaging technique showing cross‐section of the brain. (CT, MRI, PET) 10.  Shaking of the brain. (contusion, concussion, coma) 11.  System responsible for “fight or flight.” (central, parasympathetic, sympathetic) 12.  Chemical messenger released by a neuron. (dendrite, neurotransmitter, terminal end fibers) 13.  Supply of nerves to a part of the body. (innervation, plexus, gyri) 14.  Hernia of the brain. (cephalocele, encephalocele, myelocele) 15.  Contains the pons, medulla oblongata and midbrain. (cerebrum, cerebellum, brainstem) 12-D:  Define the following abbreviations. 1. 2. 3. 4. 5. 6. 7. 8.

_____________________: BSE _____________________: LP _____________________: ICP _____________________: BBB _____________________: CAE _____________________: TEME _____________________: MG _____________________: CNS

9. 10. 11. 12. 13. 14. 15.

_____________________: CSF _____________________: PET _____________________: MRI _____________________: mAs _____________________: kVp _____________________: EEG _____________________: Sz

12-E:  Match the following disorders with their descriptions. 1. ______ Degeneration or loss of cells in the cerebellum causing ataxia. 2. ______ Neuromuscular disorder characterized by weakness of the skeletal muscles. 3. ______ Neurological disorder caused by paralysis of the cervical sympathetic nerve supply. 4. ______ Abnormal accumulation of CSF in the ventricles of the brain. 5. ______ Idiopathic neurological disorder characterized by head tilt, circling, and rapid back‐and‐forth movement of the eyes. Generally seen in older dogs. Answers can be found starting on page 675.

A. Cerebellar hypoplasia B. Horner’s syndrome C. Hydrocephalus D. Myasthenia gravis E. Vestibular disease

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Review Tables Fill in the tables and refer to Tables 12.5–12.8 for answers. Table 12.9

Combining Forms

Definition

Combining Forms

Alges/o

Hemat/o

Arachn/o

Hydr/o

Astr/o

Kines/o

Ax/o

Mening/o

Caus/o

Meningi/o

Caust/o

My/o

Cephal/o

Myel/o

Cerebell/o

Narc/o

Cerebr/o

Neur/o

Comat/o

Plex/o

Concuss/o

Pont/o

Contus/o

Radicul/o

Crani/o

Spin/o

Dendr/o

Sulc/o

Dur/o

Synaps/o

Electr/o

Synapt/o

Encephal/o

Syncop/o

Esthesi/o

Tax/o

Gangli/o

Thalam/o

Ganglion/o

Thec/o

Gli/o

Vag/o

Gyr/o

Vertebr/o

Definition

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Table 12.10

Prefix

Definition

Prefix

a‐, an‐

micro‐

brady‐

mono‐

cata‐

oligo‐

epi‐

par‐

eu-

para-

hemi‐

polio‐

hyper‐

poly‐

hypo‐

quadri‐

inter‐

sub‐

intra‐

tetra‐

Definition

macro‐

Table 12.11

Suffix

Definition

Suffix

‐al, ‐ar, ‐ic

‐lepsy

‐algesia

‐malacia

‐algia

‐oma

‐cele

‐ose

‐cyte

‐paresis

‐ectomy

‐pathy

‐esthesia

‐plasia

‐graphy

‐plegia

‐ia

‐rrhaphy

‐itis

‐sthenia

‐kinesia

‐tomy

‐kinesis

‐y

‐kinetic

Definition

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Table 12.12

Abbreviation ANS BBB BSE CAE CNS CSF CT, CAT scan CVA EEE EEG kVp GSD ICP LP ma mAs MG MRI PEM PET PNS Sz TEME, TME VEE WEE

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

13

The Eyes and Ears

The eye is a sensory organ used for vision. The ear is also a sensory organ; it is used for hearing and equilibrium. These two sensory organs take light and sound and convert those stimuli to nervous impulses to send to the brain to interpret.

The Eye Using Table 13.1, label parts of the eye on Figure 13.1.

The Layers The eyeball is protected by several structures. The dorsal aspect of the eyeball is protected by the orbital bones of the skull and the anterior portion of the eye is protected by conjunctiva. Conjunctiva is a thin membrane that covers the anterior eye and lines the eyelids. A group of structures around the eye produce tears to keep the eye lubricated and remove any foreign debris. This grouping is called the lacrimal apparatus. On the edge of the eyelids are tiny cilia called eyelashes which protect the anterior eye from foreign material. The eyeball is made up of three layers. The tough, white, outer layer of the eye is called the sclera (Figure 13.2).

The middle, vascular layer is called the choroid; it contains the blood vessels that supply the eye. Within a portion of the choroid is an iridescent layer of epithelium called the tapetum lucidum that gives the eye the property of shining in the dark. This layer aids in night vision. The retina is the light‐sensitive nervous tissue that makes up the inner layer of the eye. Lining the retina are specialized photoreceptor cells called rods and cones (Figure 13.3), which share the function of transforming light into a nervous impulse. Rods function best in dim light and aid in night vision and peripheral vision. Cones function best in bright light and are responsible for color vision and central vision. Rods are more numerous along the retina, whereas cones are most concentrated in the fovea centralis.

The Path of Light Light rays pass through the cornea where they are refracted, or bent, so that they focus toward the receptor cells along the retina. After passing through the cornea, the light rays pass through the pupil. The muscular structure around the pupil, called the iris, dilates and constricts to

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Table 13.1  Anatomy of the eye. Pupil (1)

Dark opening of the eye where light passes through.

Iris (2)

Muscle around the pupil that controls the amount of light that enters the pupil. When light is bright, the iris constricts in order to limit light entry. In dim light, the iris dilates to allow for more light entry.

Cornea (3)

Transparent layer of tissue that covers the anterior eyeball.

Lens (4)

Transparent, biconvex structure behind the pupil.

Anterior chamber (A)

Portion of the eyeball between the cornea and iris. This chamber contains a fluid called aqueous humor.

Ciliary body (5)

Muscle on each side of the lens that adjusts the shape of the lens.

Vitreous chamber (V)

Area behind the lens containing a jelly‐like fluid called vitreous humor which maintains the shape of the eyeball

Sclera (6)

The white, outer coat of the eyeball.

Choroid (7)

Middle, vascular coat of the eyeball.

Retina (8)

Light‐sensitive innermost layer of the eyeball.

Macula (9)

Small, yellowish area above the optic disk containing the fovea centralis.

Fovea centralis (10)

Central depression of the retina containing a high concentration of cones.

Optic disk (11)

Commonly called the blind spot, this is the portion of the eye where the retina meets the optic nerve.

Optic nerve (12)

Cranial nerve that carries impulses from the eye to the brain.

6. 7. 8.

5. 2.

10. 9. 1. A

V

11. Blood vessels

3. 4. Suspensory ligament

12.

Figure 13.1  Anatomy of the eye. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 13  The Eyes and Ears

Figure 13.2  External structures of the eye. Source: Courtesy of shutterstock/Igor Normann.

control how much light can pass through the pupil. From the pupil, the light rays hit the lens of the eye where they are refracted once again (Figure 13.4).

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As light passes through the lens, a group of muscles reshapes the lens based on the distance between the animal and the object on which it is focusing. The adjustment in lens shape is referred to as accommodation. The muscles are controlled by the ciliary body of the eye. The anterior chamber is the section of the eye between the cornea and the iris. The posterior chamber is caudal to the iris and cranial to the lens. Within these two chambers is a thin, watery fluid called aqueous humor which is produced by the ciliary body. The aqueous humor helps to maintain the shape of the anterior eye and helps to nourish the structures of the anterior eye. From the anterior chamber, light rays hit the receptor cells along the retina. At this point, the light is now in the vitreous chamber of the eye. Within the vitreous chamber is a jelly‐like fluid called vitreous humor which helps to maintain the shape of the eyeball. After light rays activate the photoreceptor cells of the retina, they convert this stimulus into a nervous impulse which is carried to the brain via the optic nerve. The area in which the optic nerve attaches to the retina is called the optic disk. The optic disk does not have rods or cones so it’s commonly called the “blind spot” of the eye.

Ophthalmology Terms Accommodation Adjustment of the eye from various distances. Acuity Sharpness or clearness of vision. Anterior chamber Portion of the eye between the cornea and iris; contains aqueous humor. Aqueous humor Thin, watery fluid produced by the ciliary body and located within the anterior chamber of the eye. Used the nourish the lens and maintain ocular pressure. Canthus The corner of the eye Choroid Middle, vascular layer of the eye located between the sclera and retina. Ciliary body Portion of the eye that connects the choroid to the iris. Contains ciliary muscles which control the shape of the lens. Cones Photoreceptor cells of the retina responsible for color and central vision.

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(A)

Cone cell

Rod cell

Retina

Fovea

Blind spot

(B)

Human color vision Dog color vision

Figure 13.3  (A) Photoreceptor cells of the retina. Source: Courtesy of shutterstock/Zhabska Tetyana. (B) Color spectrum comparison between humans and dogs. Dogs have fewer cones and more rods than humans.

Cornea - sphere shape

Normal vision

One focal point

Figure 13.4  Pathway of light through the eye. Source: Courtesy of shutterstock/Alila Medical Images.

Chapter 13  The Eyes and Ears

Conjunctiva Cornea Fovea centralis Fundus of the eye Intraocular pressure Iris

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Thin, delicate mucous membrane lining the eyelids and anterior eyeball. Transparent layer of tissue covering the anterior eyeball. Depression in the macula that is concentrated with cones. This is the area of clearest vision. Posterior portion of the inner eyeball that can be visualized with an ophthalmoscope. Pressure exerted against the outer coats of the eyeball.

Muscle that dilates and constricts to control light entry to the pupil. The colored portion of the eye. Lens Transparent, biconvex structure behind the pupil. Macula Small, yellowish area above the optic disk containing the fovea centralis. Nasolacrimal duct Duct that runs from the lacrimal (tear) sac to the nose. Nictitating Third eyelid; piece of conjunctiva reinforced by cartilage that membrane protects the eye (Figure 13.5).

Figure 13.5  Pronounced nictitating membranes in a cat with feline infectious peritonitis (FIP). Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

Optic disk Optic nerve Orbit Palpebra Pupil Refraction Retina

Portion in the posterior eyeball where the retina and optic nerve meet. Commonly called the blind spot. Cranial nerve that carries nervous impulses from the eye to the brain. Bony cavity of the skull containing the eyeball. Eyelid. Dark opening of the eye through which light passes. The bending of light rays. Light‐sensitive innermost layer of the eyeball that contains rods and cones.

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Rods Sclera Tapetum lucidum Uvea Vitreous chamber Vitreous humor

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Photoreceptor cells of the retina responsible for night and peripheral vision. The tough, white, outer coat of the eyeball. Iridescent layer of epithelium that gives the eye the property of shining in the dark; helps to improve night vision (see Figure 13.7). Vascular layer of the eye, made up of the iris, choroid, and ciliary body. Posterior chamber of the eyeball containing vitreous humor. Clear, jelly‐like fluid in the vitreous chamber that gives the eyeball its shape.

Pathology and Procedures Anophthalmos Congenital anomaly in which the animal lacks one or both eyes. Most commonly seen in pigs and sheep. Blindness Inability to see. Cataract Clouding of the lens leading to decreased vision. Commonly seen in older dogs (Figure 13.6). (A)

Clear lens

(B)

Normal

Cataract

Cloudy lens

Figure 13.6  (A) Illustration of a cataract. Source: Courtesy of shutterstock/Alila Sao Mai. (B) Bilateral cataracts in a Beagle mix. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Chalazion Chemosis Corneal ulcer Distichiasis

Granuloma of the eyelid due to obstructed sebaceous gland. Edema of the conjunctiva. Erosion of the corneal epithelium. Double row of eyelashes causing irritation to the conjunctiva.

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(A)

(B)

Figure 13.7  (A) Ectropion in an English Mastiff. Source: Courtesy of Megan Dyer, CVT. (B) Black Lab puppy with entropion. Note the green glow of the left eye from the tapetum lucidum. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Ectropion Entropion Enucleation Epiphora Esotropia

Turning outward of the eyelid (Figure 13.7A). Turning inward of the eyelid (Figure 13.7B). Removal of the eyeball (Figure 13.8). Overflow of tears due to an obstructed lacrimal (tear) duct (Figure 13.9). Cross‐eyed. Commonly seen in Siamese cats (Figure 13.10).

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Figure 13.8  Enucleation in a Boston Terrier. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

Figure 13.9  Epiphora in a dog. Source: Courtesy of Pamela Danielson, CVT.

Exophthalmos Exotropia Floaters Fluorescein stain Follicular ophthalmitis

Forward protrusion of the eyeballs. Brachycephalic breeds normally have exophthalmos, but it can also be a symptom of various conditions. Deviation of one eye outward. Particles in the vitreous fluid that cast shadows on the retina. Also called vitreous floaters (Figure 13.11). Can lead to a behavior called “fly biting.” Dye used to stain the cornea to help visualize injury. Hypertrophy and prolapse of the nictitating membrane. Commonly called “cherry eye” (Figure 13.12).

Figure 13.10  Esotropia in a Siamese kitten. Source: Courtesy of Amy Johnson, BS, CVT, RLATG. Retina Floaters casting shadows on the retina

Detached vitreous

Vitreous body Figure 13.11  Illustration of floaters. Source: Courtesy of shutterstock/Alila Sao Mai.

Figure 13.12  Cherry eye in a bloodhound. Source: Courtesy of Greg Martinez, DVM; http://www.youtube. com/drgregdvm.

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Glaucoma

Increased intraocular pressure resulting in damage to the eye (Figures 13.13 and 13.14). Incision into the anterior chamber to treat glaucoma. Difference in color of the iris in each eye or the same eye (Figure 13.15). Inflammation of the sebaceous glands in the eyelid. Condition in which one eye deviates upward.

Goniotomy Heterochromia iridis Hordeolum Hypertropia

Healthy eye

Flow of aqueous humor

Vitreous body

Drainage canal

Glaucoma

1. Drainage canal blocked; build-up of fluid

2. Increased pressure damages blood vessels and optic nerve

Figure 13.13  Illustration of glaucoma compared to a normal eye. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 13  The Eyes and Ears

(A)

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(B)

Figure 13.14  Australian Shepherd with glaucoma. Note the scleral injection (red eyes) and aqueous flare. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

(A)

(B)

Figure 13.15  Heterochromia. (A) Heterochromia of both eyes of a cat. Source: Courtesy of WikiCommons/ Alston Jenkins. (B) Heterochromia in the same eye of a Great Dane puppy. Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

Hyphema Hypopyon Hypotropia Macrophthalmia Macular degeneration Microphthalmia Miosis

Hemorrhaging into the anterior chamber of the eye (Figure 13.16). Pus in the anterior chamber of the eye. Condition in which one eye deviates downward. Abnormal enlargement of the eye. Degeneration of the macula causing loss of central vision (Figure 13.17). Abnormally small eyes. Abnormal contraction of the pupils.

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Figure 13.16  Hyphema in a Bernese Mountain Dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Mydriasis Nuclear sclerosis Nyctalopia Nystagmus Ocular dermoid Palpebral reflex Papilledema Photophobia Proptosis

Abnormal dilation of the pupils (Figure 13.18). Drying out of the lens with age. Night blindness. Rhythmic, rapid, back‐and‐forth movement of the eyes. Mass in the eye containing elements found in skin tissue such as epithelial cells and hair. Typically found in the corner of the eye around the conjunctiva, eyelid, or cornea (Figure 13.19). Blink reflex when the eyelids are touched. Swelling of the optic disk due to intracranial pressure. Sensitivity or visual intolerance to light. Forward displacement of the eye from its orbit (Figure 13.20).

TECH TIP 13.1  Proptosis vs. Exophthalmos The definitions are very similar, but the difference is in the placement. In exophthalmos, the eyes are still intact in the skull. In proptosis, the eyes have “popped out” of the head. Proptosis is often seen in brachycephalic breeds who normally have exophthalmos. Causes include trauma or excessive restraint.

Sclera Chorold Retina

Iris

Macula Pupil

Optic disk (blind spot) Blood vessels

Comea Lens Optic nerve

Normal

“Wet” macular degeneration

“Dry” macular degeneration

Figure 13.17  Illustration of macular degeneration. Source: Courtesy of shutterstock/ Alila Sao Mai.

Figure 13.18  Cat with mydriasis. Source: Courtesy of Donna Tunis, CVT.

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Figure 13.19  Ocular (conjunctival) dermoid in a Shih Tzu. Source: Courtesy of A.K. Traylor, DVM; Microscopy Learning Systems.

(A)

(B)

Figure 13.20  Proptosis. (A) Chihuahua. (B) Shih‐tzu. Source: Courtesy of Beth Romano, AAS, CVT.

Pupillary light reflex (PLR) Retinal detachment

Constriction of the pupils in response to light and dilation of the pupils when the light is removed. Separation of the inner layer of the retina from the other layers of the eyeball (Figure 13.21).

Chapter 13  The Eyes and Ears

Ciliary body

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Sclera Choroid

Iris

Retina Fovea centralis Pupil Optic disk (blind spot) Blood vessels Cornea Lens Suspensory ligament

Optic nerve

Figure 13.21  Illustration of retinal detachment. Source: Courtesy of shutterstock/Alila Sao Mai.

Schirmer tear test Test to measure secretions from the lacrimal (tear) duct. A strip of filter paper is placed just inside the conjunctiva of the lower eyelid for a short period of time (Figure 13.22).

Figure 13.22  Schirmer tear test being performed on a mixed breed dog. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Strabismus Tonometer Tonometry

Deviation of one or both eyes. Examples include esotropia and exotropia (Figure 13.23). Instrument to measure intraocular pressure (Figure 13.24). Measurement of intraocular pressure (Figure 13.24).

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Normal

Esotropia

Exotropia

Hypertropia

Hypotropia

Figure 13.23  Types of strabismus. Source: Courtesy of shutterstock/Radu Bercan.

Figure 13.24  Tonometry on a Chihuahua to measure intraocular pressure. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Chapter 13  The Eyes and Ears

Building the Terms Now it’s time to assemble the word parts  listed in Tables  13.2–13.4. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this

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will get easier each time. Remember your  five basic rules to medical terminology when building and defining these  terms. You’ll notice some word parts are repeated from the previous chapters.

Table 13.2  Combining forms for the eye.

Combining Forms

Definition

Combining Forms

Definition

Ambly/o

Dim; dull

Kerat/o

Cornea; horny; hard

Anis/o

Unequal

Lacrim/o

Tear; tear duct; lacrimal duct

Aque/o

Water

Lens/o

Lens

Blephar/o

Eyelid

Mi/o

Smaller; less

Canth/o

Corner of the eye or eyelid

Mydr/o

Wide

Choroid/o

Choroid layer of the eye

Nas/o

Nose

Conjunctiv/o

Conjunctiva

Nyct/o

Night

Cor/o

Pupil

Ocul/o

Eye

Core/o

Pupil

Ophthalm/o

Eye

Corne/o

Cornea

Opt/i

Eye; vision

Cycl/o

Ciliary body of the eye; cycle; circle

Opt/o

Eye; vision

Dacry/o

Tear

Optic/o

Eye; vision

Dacryoaden/o

Tear gland; tear duct

Palpebr/o

Eyelid

Dacryocyst/o

Tear sac; lacrimal sac

Phac/o

Lens of the eye

Dipl/o

Double

Phot/o

Light

Electr/o

Electricity

Pupill/o

Pupil

Glauc/o

Gray

Retin/o

Retina

Goni/o

Seed; angle

Scler/o

Sclera

Ir/i

Iris

Tars/o

Edge of eyelid; tarsus

Ir/o

Iris

Uve/o

Uvea

Irid/o

Iris

Vitre/o

Glassy

Irit/o

Iris

Vitr/o

Vitreous body

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Table 13.3  Prefixes for the eye.

Prefix

Definition

Prefix

Definition

an‐

no, not, without

extra‐

outside

bi‐

two

hyper‐

increased; excessive; above

bini‐

double

hypo‐

deficient; below; under; less than normal

ec‐

out; outside

intra‐

within; into

en‐

in; within

micro‐

small

epi‐

above; upon; on

mono‐

one

eso‐

inward

pan‐

all

exo‐

out; away from

peri‐

surrounding; around

Table 13.4  Suffixes for the eye.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐ic

pertaining to

‐pathy

disease condition

‐ation

process; condition

‐phobia

fear

‐centesis

surgical puncture to remove fluid

‐plegia

paralysis; palsy

‐graphy

process of recording

‐ptosis

drooping; sagging; prolapse

‐ia

condition

‐rrhaphy

suture

‐iasis

abnormal condition

‐scope

instrument for visual examination

‐ist

specialist

‐scopy

visual examination

‐itis

inflammation

‐spasm

sudden, involuntary contraction of muscles

‐logy

study of

‐tomy

incision; process of cutting into

‐metry

measurement

‐tropia

to turn

‐opia

vision

Parts Ambly/o Blephar/o Blephar/o Blephar/o Blephar/o

+ ‐opia + ‐ectomy + ‐itis + ‐plasty + ‐ptosis

Medical Term

Definition

= Amblyopia = Blepharectomy = Blepharitis = Blepharoplasty = Blepharoptosis

: ___________ : ___________ : ___________ : ___________ : ___________

Chapter 13  The Eyes and Ears

Blephar/o Blephar/o Blephar/o Canth/o Canth/o Conjunctiv/o Conjunctiv/o Conjunctiv/o aniso‐

+ ‐rrhaphy + ‐spasm + ‐tomy + ‐ectomy + ‐tomy + ‐al + ‐itis + ‐plasty + Core/o

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+ ‐ia

(A)

= Blepharorrhaphy = Blepharospasm = Blepharotomy = Canthectomy = Canthotomy = Conjunctival = Conjunctivitis = Conjunctivoplasty = Anisocoria (Figure 13.25)

: ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________

(B)

Figure 13.25  (A) Anisocoria in a DSH cat. Source: Courtesy of Samantha Patterson, AAS. (B) Anisocoria in a Great Dane puppy. Source: Courtesy of Katy Echeagaray, AAS, CVT.

Corne/o Corne/o Dacryoaden/o Dacryocyst/o Dacryocyst/o Dacryocyst/o Irid/o Irid/o Ir/o Kerat/o Kerat/o Kerat/o

+ ‐al + Scler/o + ‐itis + ‐ectomy + ‐itis + ‐tomy + ‐ectomy + ‐ic + ‐itis + ‐ectomy + ‐itis + ‐centesis

+ ‐al

= Corneal = Corneoscleral = Dacryoadenitis = Dacryocystectomy = Dacryocystitis = Dacryocystotomy = Iridectomy = Iridic = Iritis = Keratectomy = Keratitis = Keratocentesis

: ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________

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Figure 13.26  Keratoconjunctivitis in a Pug about to have an enucleation. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

Kerat/o

+ Conjunctiv/o

Kerat/o Kerat/o Lacrim/o Lacrim/o Nas/o Lens/o Ocul/o bini‐ extra‐ intra‐ peri‐ Ophthalm/o Ophthalm/o Ophthalm/o Ophthalm/o Ophthalm/o pan‐ Opt/o Palpebr/o Pupill/o Electr/o Retin/o Retin/o Scler/o Tars/o Tars/o Uve/o

+ ‐plasty + ‐tomy + ‐al + ‐ation + Lacrim/o + ‐ectomy + ‐ar + Ocul/o + Ocul/o + Ocul/o + Ocul/o + ‐ic + ‐logy + ‐plegia + ‐scope + ‐scopy + Ophthalm/o + ‐ic + ‐al + ‐ary + Retin/o + ‐itis + ‐pathy + -itis + ‐ectomy + rrhaphy + itis

+ ‐itis

+ ‐al + ‐ar + ‐ar + ‐ar + ‐ar + ‐ist

+ ‐itis

+ ‐graphy

= Keratoconjunctivitis (Figure 13.26) = Keratoplasty = Keratotomy = Lacrimal = Lacrimation = Nasolacrimal = Lensectomy = Ocular = Binocular = Extraocular = Intraocular = Periocular = Ophthalmic = Ophthalmologist = Ophthalmoplegia = Ophthalmoscope = Ophthalmoscopy = Panophthalmitis = Optic = Palpebral = Pupillary = Electroretinography = Retinitis = Retinopathy = Scleritis (Figure 13.27) = Tarsectomy = Tarsorrhaphy = Uveitis (Figure 13.28)

: ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________ : ___________

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Figure 13.27  Scleritis in a Chihuahua. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/ drgregdvm.

(A)

(B)

Figure 13.28  (A) Uremic uveitis in a cat. Source: Courtesy of Amy Johnson, BS, CVT, RLATG. (B) Blind Siberian Husky puppy with glaucoma and uveitis. Source: Courtesy of Rela Goodwin, LVMT.

The Ear

The Outer Ear

Using Table 13.5, label the parts of the ear on Figure 13.29. The ear is most often associated with hearing, but it also is used to help maintain balance. There are three sections of the ear: the outer ear, middle ear, and inner ear. When sound is produced, the sound waves travel through all three sections and then are converted to nervous impulses that travel to the brain.

The ear flap, or auricle, is the first structure to pick up a sound wave. That sound wave then travels from the auricle through the auditory canal where it hits the tympanic membrane, or eardrum. Along the external auditory canal are sebaceous glands that produce a waxy substance called cerumen, or ear wax, which helps protect and lubricate the canal. Cerumen acts as an insect repellent and can protect the ear from water.

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Table 13.5  Anatomy of the ear. Auricle (1)

Flap of the ear; Also known as the pinna.

Auditory canal (2)

Tube from the auricle to the eardrum. Also called the external auditory canal or external auditory meatus. A meatus is a passage. Glands along this tube secrete cerumen, or ear wax.

Tympanic membrane (3)

Eardrum; membrane between the outer and middle ear.

Malleus (4)

First ossicle of the middle. Malleus means hammer.

Incus (5)

Second ossicle of the middle ear. Incus means anvil.

Stapes (6)

Third ossicle of the middle ear. Stapes means stirrup.

Oval window (7)

Membrane between the middle and inner ear.

Eustachian tube (8)

Channel that connects the middle ear to the pharynx.

Cochlea (9)

Spiral, snail‐shaped tube filled with fluid that is essential for hearing.

Vestibule (10)

Oval cavity connecting the cochlea to the semicircular canals.

Semicircular canals (11)

Passages containing fluid and sensitive hairs. Their function is to maintain balance during movement.

Dog ear

Inner ear

11. 1.

9. 10.

Temporalis muscle

2.

Auricular cartilage 4.

5.

Middle ear

3.

Auditory ossicles

6.

Stabilizing ligaments External acoustic meatus

7. Auditory tube

Round 3. window 8. Tympanic cavity (middle ear)

Middle ear cavity

Tympanic bulla

Figure 13.29  Anatomy of the ear. Source: Courtesy of shutterstock/Dream Master (dog ear) and WikiCommons/Blausen Medical (middle ear).

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Cochlear nerve Stapes in oval window

Round window

Vestibular membrane Cochlear duct with endolymph

Organ of corti

Basilar membrane

Scala vestibuli with perilymph Spiral ganglion

Cochlear nerve fibers Scala tympani with perilymph

Figure 13.30  The bony labyrinth. Source: Courtesy of shutterstock/Alila Sao Mai.

The Middle Ear When a sound wave hits the tympanic membrane, the membrane vibrates and transmits the sound to the ossicles just behind it. Ossicles are small bones in the middle ear that vibrate to transmit the sound waves to the inner ear. The ossicles, in order of occurrence, are the malleus, incus, and stapes. They are named based on their shape. Sound waves from the ossicles travel to the oval window which is a membrane separating the middle and inner ear. Between the ossicles and oval window is an  auditory tube called the Eustachian tube which maintains equilibrium. This tube opens upon deglutition to help equalize the air pressure in the middle ear to match the air pressure in the outside environment.

The Inner Ear The inner ear is the most intricate portion of the ear. In fact, the inner ear is commonly called the labyrinth due to its maze‐like anatomy. The bony labyrinth is

made up of the cochlea, semicircular canals, and vestibule (Figure 13.30). From the oval window, sound waves enter a structure called the cochlea which gets its name because of its snail shape (cochlea means snail in Latin). Within the cochlea are two types of fluid called perilymph and endolymph, which transmit sound vibrations. From the two fluids, sound waves pass through the spiral‐shaped portion of the cochlea called the organ of Corti, which contains sensitive hairs that transmit the sound waves to the auditory nerves. The auditory nerves convert the sound waves into nervous impulses that travel to the brain to be interpreted. Next to the oval window is a cavity called the vestibule which connects the cochlea to the semicircular canals. Within the vestibule are specialized receptors which aid in balance. The semicircular canals are actually three tubes containing endolymph and sensory hair‐like structures that aid in balance while the animal is moving. The three canals, called the anterior, lateral, and posterior canals, are located at right angles to each other. When

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the animal moves its head, the fluid in the canals begins to shift. This shift causes the fluid to press against the sensitive hair‐ like receptors. The receptors convert this response to a nervous impulse that is sent to the brain. The fluid shifting in the semicircular canals after movement is what causes dizziness and vertigo. Animals riding in a car or on an airplane can experience motion sickness due to the fluid shifts after they move their head.

Otology Terms Auditory canal Auricle Cerumen

Cochlea

Tube from the auricle to the tympanic membrane (eardrum). Flap of the ear; also known as the pinna. Waxy substance secreted by the sebaceous glands in the auditory canal. Commonly called ear wax. Spiral, snail‐shaped tube in the inner ear containing fluid that is essential for hearing.

Endolymph Eustachian tube Incus

Fluid within the inner ear. Channel that connects the middle ear to the pharynx. Second ossicle of the inner ear. Incus means anvil in Latin. Labyrinth Maze‐like structure of the inner ear consisting of the vestibule, cochlea, and semicircular canals. Also known as the bony labyrinth. Organ of Sensitive receptor area in Corti the cochlea. Ossicles Small bones of the middle ear: the malleus, incus, and stapes (Figure 13.31). Oval Membrane between the window middle and inner ear. Perilymph Fluid within the inner ear. Semicircular Three tubes of the inner canals ear used to maintain equilibrium. Stapes Third ossicle of the inner ear. Stapes means stirrup in Latin.

Incudomalleolar joint

Malleus

Handle of malleus

Incus

Incudostapedial joint Lenticular process Stapes

Auditory ossicles

Base of stapes

Figure 13.31  The ossicles. Source: Courtesy of WikiCommons/Marc Giacone.

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Tympanic membrane Vestibule

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Eardrum; membrane between the outer and middle ear (Figure 13.32). Cavity connecting the cochlea to the semicircular canals. The vestibule is associated with balance.

Pathology and Procedures Ablation

Aural hematoma

Separation, detachment, or removal by cutting. Most often associated with removal of the external ear canal in cases of neoplasia or chronic otitis. Mass or collection of blood in the ear flap. Also known as an auricular hematoma (Figures 13.33 and 13.34).

Outer ear:

Tympanic membrane

Pinna auditory canal

Deafness Ear docking

Loss of hearing. Cosmetic procedure in which a portion of the auricle is removed and the remainder is set in a brace to stand erect. In the United States, this is a common practice in breeds such as Dobermans, Great Danes, Schnauzers, and Boxers. In Great Britain, the procedure is considered inhumane (Figure 13.35). Otitis Inflammation of the externa external ear. Otitis media Inflammation of the middle ear (Figure 13.36). Otitis Inflammation of the inner interna ear. Vertigo Sense of dizziness.

Middle ear: Incus malleus stapes

Oval window

Inner Ear: Cochlea Semicircular canals

Figure 13.32  The pathway of sound waves.

Figure 13.33  Aural hematoma in a Great Dane. Source: Courtesy of Amy Johnson, BS, CVT, RLATG.

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(A)

(B)

(D)

(C)

Figure 13.34  Stages of treatment for aural hematoma. (A) Aural hematoma in a Black Lab. (B) The normal other ear of the Black Lab for comparison. (C) Draining the hematoma. (D) Surgical repair of the aural hematoma. Source: Courtesy of Greg Martinez, DVM; http://youtube.com/drgregdvm.

Building the Terms Now it’s time to assemble the word parts listed in Tables  13.6–13.8. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this

will get easier each time. Remember your five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 13.6  Combining forms for the ear.

Combining Forms

Definition

Combining Forms

Definition

Acoust/o

Hearing

Laryng/o

Voice box; larynx

Aud/i

Ear; hearing

Myc/o

Fungus

Audi/o

Ear; hearing

Myring/o

Tympanic membrane; eardrum

Audit/o

Hearing

Ot/o

Ear

Aur/i

Ear

Pinn/i

External ear

Aur/o

Ear

Py/o

Pus

Hemat/o

Blood

Tympan/o

Tympanic membrane; eardrum

Labyrinth/o

Maze

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Table 13.7  Prefixes for the ear.

Prefix

Definition

Prefix

Definition

macro‐

large

pan‐

all

micro‐

small

post‐

after; behind

Table 13.8  Suffixes for the ear.

Suffix

Definition

Suffix

Definition

‐al, ‐ar, ‐eal, ‐ic, ‐ory

pertaining to

‐osis

abnormal condition

‐algia

pain

‐otia

ear condition

‐ectomy

removal; excision; resection

‐pathy

disease condition

‐itis

inflammation

‐plasty

surgical repair

‐logy

study of

‐rrhea

flow; discharge

‐metry

measurement

‐scope

instrument for visual examination

‐oma

tumor; mass; collection

‐scopy

visual examination

Parts

Medical Term

Definition

+ ‐metry + ‐ory + ‐al + ‐ar + Auricul/o + ‐ar + ‐ectomy + ‐itis + ‐otia + ‐otia + ‐algia + ‐ic + ‐itis + Laryng/o + ‐logy + Myc/o + ‐osis + ‐pathy + Py/o + ‐rrhea

= Audiometry = Auditory = Aural = Auricular = Postauricular = Myringectomy = Myringitis = Macrotia = Microtia = Otalgia = Otic = Otitis = Otolaryngology = Otomycosis = Otopathy = Otopyorrhea

: ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________ : ____________________

Audi/o Audit/o Aur/o Auricul/o post‐ Myring/o Myring/o macro‐ micro‐ Ot/o Ot/o Ot/o Ot/o Ot/o Ot/o Ot/o

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Ot/o Ot/o Ot/o pan‐ Tympan/o

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+ ‐rrhea + ‐scope + ‐scopy + Ot/o + ‐itis + ‐plasty

(A)

= Otorrhea = Otoscope = Otoscopy = Panotitis = Tympanoplasty

: ____________________ : ____________________ : ____________________ : ____________________ : ____________________

(B)

(C)

Figure 13.35  (A) Ear docking on a Doberman. Source: Courtesy of shutterstock/mmaxer. (B) Ear docking on a Great Dane. Source: Courtesy of Kimberly Perkovich, CVT, RVT. (C) Great Dane with ears that have not been docked. Source: Courtesy of Katy Echeagaray, AAS, CVT.

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Normal middle ear

Otitis media

Fluid build-up Eardrum

Ossicles

Infected fluid in middle ear

Eustachian tube

Figure 13.36  Otitis media. Source: Courtesy of shutterstock/Svetlana Verbinskaya.

Abbreviations Table 13.9  Abbreviations.

Abbreviation

Definition

AD

Right ear

AS

Left ear

AU

Both ears

IOP

Intraocular pressure

OD

Right eye

OS

Left eye

OU

Both eyes

PLR

Pupillary light reflex

TECA

Total ear canal ablation

VA

Visual acuity

Case Study A Cocker Spaniel named Lady has come to the clinic with swelling on the flap of her ear. The owner found blood splatter on her walls when she got home from work. Lady has a PPH of chronic otitis externa and otomycosis. Using an otoscope, the veterinarian noted myringitis. Lady was diagnosed with an aural hematoma and surgery was ordered. The

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hematoma was drained and Lady was sent home with ear cleaner and medications. Because Lady has frequent issues with her ears, the veterinarian has recommended an ear resection to prevent future ear infections. Ear infections cause chronic head shaking in dogs, which can lead to hematoma from the ruptured blood vessels in the ear flaps. 1. In which part of the ear had the hematoma formed? a. Pinna b. Eardrum c. Ear canal d. Cochlea 2. What is the veterinarian’s recommendation for prevention? a. Remove the ear b. Cut the opening of the ear back c. Remove the ear flap d. Remove the ear canal 3. Which of the following describes Lady’s PPH? a. External ear infection b. Internal ear infection c. Middle ear infection d. None of the above

Exercises 13-A:  Give the term for the following definitions of structures. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10.  11.  12. 

______________________________: Colored portion of the eye ______________________________: Eardrum ______________________________: Ear wax ______________________________: White of the eye ______________________________: Blind spot of the eye ______________________________: Dark opening of the eye ______________________________: Vascular layer of the eye containing the iris ______________________________: The corner of the eye ______________________________: Ear flap; pinna ______________________________: Small bones of the middle ear ______________________________: Third eyelid. ______________________________: Innermost layer of the eyeball

13-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Tympanoplasty _________________________________ Blepharoptosis _________________________________ Conjunctivitis __________________________________ Postauricular __________________________________ Keratitis ______________________________________ Myringectomy _________________________________ Aural ________________________________________ Otic _________________________________________ Panotitis _____________________________________ Audiometry __________________________________

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11.  12.  13.  14.  15. 

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Lacrimation ___________________________________ Otorrhea ______________________________________ Ophthalmology _________________________________ Otoscope ______________________________________ Macrotia ______________________________________

13-C:  Circle the correct term in parentheses: 1.  Clouding of the lens. (cataract, glaucoma, chalazion) 2.  Forward displacement of the eye. (anophthalmos, exophthalmos, proptosis) 3.  Rapid, back and forth movements of the eyes. (ectropion, hypertropia, nystagmus) 4.  Snail‐shaped structure of the inner ear. (cochlea, incus, stapes) 5.  Removal of the eyeball. (anophthalmos, enucleation, proptosis) 6.  Jelly‐like substance in the posterior eye chamber. (aqueous humor, floaters, vitreous humor) 7.  Abnormal dilation of the pupils. (miosis, mydriasis, nyctalopia) 8.  Iridescent layer of the retina. (conjunctiva, nictitating membrane, tapetum lucidum) 9.  Cross‐eyed. (ectropion, entropion, esotropia) 10.  Sensitivity to light. (photophobia, strabismus, tonometry) 13-D:  Define the following abbreviations. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

__________________________: OD __________________________: AU __________________________: IOP __________________________: OU __________________________: AD __________________________: PLR __________________________: OS __________________________: TECA __________________________: VA __________________________: AS

13-E:  Match the following with their descriptions. 1. ___________ Drying out of the lens with age. 2. ___________ Inflammation of the sebaceous glands in the eyelid. 3. ___________ Deviation of one or both eyes. 4. ___________ Channel that connects the middle ear to the pharynx. 5. ___________ Separation, detachment, or removal by cutting. 6. ___________ Sense of dizziness. 7. ___________ Swelling of the optic disk due to intracranial pressure. 8. ___________ Inflammation of the inner ear. Answers can be found starting on page 675.

A. Ablation B. Eustachian tube C. Hordeolum D. Nuclear sclerosis E. Otitis interna F. Papilledema G. Strabismus H. Vertigo

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Review Tables Fill in the tables and refer to Tables 13.2–13.4 and 13.6–13.9 for answers. Table 13.10

Combining Forms

Definition

Combining Forms

Ambly/o

Kerat/o

Anis/o

Lacrim/o

Aque/o

Lens/o

Blephar/o

Mi/o

Canth/o

Mydr/o

Choroid/o

Nas/o

Conjunctiv/o

Nyct/o

Cor/o

Ocul/o

Core/o

Ophthalm/o

Corne/o

Opt/i

Cycl/o

Opt/o

Dacry/o

Optic/o

Dacryoaden/o

Palpebr/o

Dacryocyst/o

Phac/o

Dipl/o

Phot/o

Electr/o

Pupill/o

Glauc/o

Retin/o

Goni/o

Scler/o

Ir/i

Tars/o

Ir/o

Uve/o

Irid/o

Vitre/o

Irit/o

Vitr/o

Definition

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Table 13.11

Prefix

Definition

Prefix

an‐

extra‐

bi‐

hyper‐

bini‐

hypo‐

ec‐

intra‐

en‐

micro‐

epi‐

mono‐

eso‐

pan‐

exo‐

peri‐

Definition

Table 13.12

Suffix

Definition

Suffix

‐al, ‐ar, ‐ic

‐pathy

‐ation

‐phobia

‐centesis

‐plegia

‐graphy

‐ptosis

‐ia

‐rrhaphy

‐iasis

‐scope

‐ist

‐scopy

‐itis

‐spasm

‐logy

‐tomy

‐metry

‐tropia

‐opia

Definition

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Table 13.13

Combining Forms

Definition

Combining Forms

Acoust/o

Laryng/o

Aud/i

Myc/o

Audi/o

Myring/o

Audit/o

Ot/o

Aur/i

Pinn/i

Aur/o

Py/o

Hemat/o

Tympan/o

Definition

Labyrinth/o

Table 13.14

Prefix

Definition

Prefix

macro‐

pan‐

micro‐

post‐

Definition

Table 13.15

Suffix

Definition

Suffix

‐al, ‐ar, ‐eal, ‐ic, ‐ory

‐osis

‐algia

‐otia

‐ectomy

‐pathy

‐itis

‐plasty

‐logy

‐rrhea

‐metry

‐scope

‐oma

‐scopy

Definition

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Table 13.16

Abbreviation

Definition

AD AS AU IOP OD OS OU PLR TECA VA

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

14

The Urinary System

The urinary system is made up of the ­kidneys, ureters, urinary bladder, and urethra (Figure  14.1). All four organs work together to eliminate waste products from the body; however, the kidney has additional and more specialized functions.

Aorta

Inferior vena cava

Right kidney

Left kidney

Ureter

Bladder

Urethra

Figure 14.1  Anatomy of the urinary system. Source: Courtesy of shutterstock/Vecton.

Anatomy of the Urinary System The urinary system begins with the kidneys which are located retroperitoneally on either side of the lumbar spine. Generally, the right kidney lies slightly more cranial than the left kidney. It may help to remember

that “right is tight.” The kidney is divided into three sections: the renal cortex (outer section), renal medulla (inner section), and renal pelvis (central section). Once urine has been produced by the kidneys, it travels to the urinary bladder via the ureters, a pair of tubes that carry urine from the kidneys to the urinary bladder by peristalsis. The point at which the ureters enter the urinary bladder is called the trigone, which translates to triangle in Greek. The function of the urinary bladder is to temporarily store urine. From the urinary bladder, urine travels through the urethra to the outside of the body. The function of the urethra varies depending on the sex of the animal. In females, the urethra carries urine from the urinary bladder to the outside of the body. In males, the urethra carries both urine and semen to the outside of the body. The external opening of the urethra in both sexes is called the urinary meatus. When the animal excretes urine to the outside of the body, it is termed urination or micturition.

The Kidney The kidney is made up of three basic sections: the cortex, the medulla, ­ and  the renal pelvis (Figure  14.2).

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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(A)

Cortex

Hilus Renal pelvis Calyces Medulla

Ureter

(B) Feline kidney

Renal pelvis Renal medulla Renal cortex

(C)

Figure 14.2  (A) Anatomy of the kidney. Source: Courtesy of shutterstock/Maxi_m. (B) Feline kidney from a dissected cat. The kidney was injected with a blue latex dye to designate venous flow. Did you know that the vessels on the surface of the kidney are sometimes referred to as “arbor vitae”? Arbor vitae translates to “tree of life” in Latin. The branching of the vessels look similar to the branches of a tree. (C) Bovine kidney. Source: Courtesy of shutterstock/llepet.

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The  indentation in the center of the kidney is referred to as the hilus. There are three steps of urine formation: ­filtration, reabsorption, and excretion. These steps take place in the functional unit  of  the kidney called the nephron. The  number of nephrons varies in each  kidney depending on the species (Figure 14.3).

TECH TIP 14.1  How Many Nephrons Are in the Kidney? The number of nephrons in the kidney varies depending on the species. Cats have roughly 200 000 nephrons in each kidney. Dogs have approximately 400 000 nephrons in each kidney.

Kidney tubule (nephron)

Cortex Renal artery

Medulla

Renal vein

Kidney

Interlobar artery

Arcuate artery

Interlobar vein Arcuate vein

Nephron Glomerulus

Distal tubule

Bowman’s capsule

Peritubular capillaries

Afferent arteriole Efferent arteriole Arcuate artery

Direction of blood flow Proximal tubule

Arcuate vein

Collecting duct Figure 14.3  The kidney and nephron in relation. Source: Courtesy of shutterstock/blamb.

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Filtration Renal circulation begins at the aorta, where the blood then travels to the renal arteries (Figure  14.3). From there the blood continues to the renal arterioles, which enter the renal cortex. The renal arterioles become a collection of capillaries called a glomerulus (Figure  14.4). The number of glomeruli varies depending on the species. Cats have approximately 200  000 glomeruli, whereas dogs have roughly 400 000 glomeruli. Filtration of substances occurs from the glomerulus to Bowman’s capsule, a cup‐shaped capsule that encloses each glomerulus. Substances that are filtered into the nephron are termed freely filtered substances. These substances follow the laws of diffusion in

that they move from a high concentration to a low concentration. Examples of freely filtered substances include water, electrolytes, nitrogenous wastes, and glucose. Filtration depends on blood pressure, the size of the molecules, and the actual amount of blood that reaches the ­glomerulus. If an animal has hypotension (decreased blood pressure), then the  degree of filtration is decreased. When this occurs, the kidneys secrete an enzyme called renin to increase the blood pressure. If an animal goes into shock, then the blood pools in the capillaries to increase their blood volume. As a result, decreased amounts of blood reach the glomerulus and the degree of filtration is decreased.

Blood flow Afferent arteriole

Efferent arteriole

1 Filtration

Renal corpuscle 2

Nephron

Reabsorption (solutes, water) Peritubular capillaries

3

Renal tubule

Secretion (additional wastes)

4 Excretion Figure 14.4  Steps of urine formation. Source: Courtesy of shutterstock/Alila Sao Mai.

Chapter 14  The Urinary System

Reabsorption Substances in Bowman’s capsule then move to the renal tubules where they are either reabsorbed back into the bloodstream or carried further in the nephron to become urine. Reabsorption is controlled by hormones in the body such as antidiuretic hormone (ADH) and aldosterone. ADH is responsible for the reabsorption of water from the renal tubules to the bloodstream. Aldosterone controls the reabsorption of sodium and excretion of potassium. Reabsorption is affected if these hormone levels change. For example, an animal with diabetes insipidus (DI) lacks the hormone ADH which means its kidneys can’t reabsorb water. The water in the kidneys is all excreted in the urine; thus, the animal feels dehydrated. Feeling dehydrated causes the animal to drink more water, which in turn causes it to urinate more frequently. Certain substances that were filtered into the nephron are reabsorbed back into the bloodstream because the concentration of those substances is lower in the blood than in the kidney. Again, this follows the laws of diffusion. For example, all glucose that was filtered into the nephron should be reabsorbed by the renal tubules back into the bloodstream because the blood glucose of the animal is less than the

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concentration of glucose in the kidneys. If  an animal has hyperglycemia, such as a  dog with diabetes mellitus, then the glucose in the renal tubules will not be reabsorbed back into the blood. Instead, it  will be excreted in the urine, causing glucosuria. After reabsorption occurs, waste products in the blood such as drugs are secreted into the renal tubules where they will join with the remaining glomerular filtrate to form urine. The renal tubules lead to two collecting tubules that carry urine to the renal pelvis. The renal pelvis is the central collecting region in the kidney. Within the renal pelvis are cup‐like spaces called calyces which temporarily collect and store the urine before it moves to the ureters. Storage and Excretion Urine travels to the urinary bladder via the ureters. Once in the urinary bladder, the urine is temporarily stored until the sphincters relax to allow for the passage of urine into the urethra. Sphincters are groups of ring‐like muscles that can contract in diameter. When an animal urinates, it voluntarily relaxes its sphincters to allow for the excretion of urine. The urine then travels through the urethra to the outside of the body.

Related Terms Antidiuretic hormone Aldosterone Bowman’s capsule Capillaries Creatinine Electrolytes Erythropoietin (EPO) Filtration Glomerulus Kidney

Hormone produced in the pituitary gland to control the reabsorption of water by the renal tubules. Hormone produced by the adrenals to control sodium reabsorption and potassium excretion. Cup‐like capsule enclosing each glomerulus. Smallest blood vessels. Non‐protein nitrogenous waste produced by muscle cell metabolism. Chemical substance that carries an electrical charge. Hormone produced by the kidney to stimulate the production of red blood cells in the bone marrow. Passage of substances from the glomerulus to Bowman’s capsule. Collection of capillaries in the renal cortex where filtration takes place. Pair of retroperitoneal bean‐shaped organs where urine is formed.

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Nephron Nitrogen Nitrogenous wastes Potassium Reabsorption Renal cortex Renal medulla Renal pelvis Renal tubules Renin Sodium Urea (BUN)

Ureter Urethra Uric acid

Veterinary Medical Terminology Guide and Workbook

The functional unit of the kidney. Electrolyte component of protein and amino acids. Waste product of protein metabolism; excreted in urine. Electrolyte secreted from the bloodstream to the renal tubules and then excreted in the urine. Substances return to the bloodstream from the renal tubules. Outer section of the kidney. Inner section of the kidney. Central collecting region of the kidney. Small tubes in the kidney where reabsorption takes place. Proteolytic enzyme produced by the kidney to regulate blood pressure. Electrolyte in the blood and urine; regulated by the kidneys. Non‐protein nitrogenous waste that results from protein breakdown. When the body breaks down protein, it is converted to ammonia. Ammonia is then sent to the liver to be converted to urea which is then excreted in the urine. Tube that carries urine from the kidneys to the urinary bladder. Tube that carries urine from the urinary bladder to the outside of the body. Metabolic by‐product produced by the liver; excreted in the urine.

TECH TIP 14.2  Dalmatians and Uric Acid Uric acid is a by‐product produced by the liver, filtered into the kidneys, and then ­reabsorbed into the bloodstream. In Dalmatians, this is not the case. Dalmatians have an increased excretion of uric acid in their urine and therefore uric acid crystals are a common and normal finding in Dalmatians. In most other breeds, it’s an indication of liver disease or portosystemic shunt.

Urinary bladder Urinary catheterization

Sac that temporarily stores urine. Catheter placed in the urethra to the urinary bladder to obtain a urine sample or relieve a urinary obstruction (Figure 14.5).

Figure 14.5  Urinary catheter in a male cat to relieve a urinary obstruction. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm

Chapter 14  The Urinary System

Urine

451

Water and waste products produced by the kidneys and stored in the urinary bladder. Emptying of urine from the urinary bladder. Also called ­micturition or urination.

Voiding

Pathology and Procedures Azotemia Calculus (plural: calculi)

Increase in non‐protein nitrogenous wastes in the blood. Also called uremia. Another name for a stone. Calculus is most often used to describe the small sedimentary particles in urine (Figure 14.6).

TECH TIP 14.3  What Is a Stone? Urinary stones are formed from high concentrations of minerals and crystals in the urinary tract. Stone formation can be caused by the following: Adequate pH: Some stones require acidic or alkaline urine in order to form. Urinary pH can be altered by changing the animal’s diet. Increased urine concentration: Urine concentration can be altered by giving the animal more access to water and by changing the animal’s diet. Foods advertised as low ash have low mineral content. Canned food has a higher water concentration than dry food. Adequate time in the urinary tract: Animals have an increased likelihood of stone formation if they have to hold their bladders for an extended period of time. A nidus: A nidus is something upon which a stone can form. Examples include crystals, suture material, polyps, and bacteria.

(A)

Figure 14.6  (A) Radiograph from a dog with urinary stones. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm. (B) Stones that have been removed from the same dog.

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(B)

Figure 14.6  (Continued )

Dialysis

Separation of waste products from the bloodstream.

TECH TIP 14.4  Do Animals Receive Dialysis or Kidney Transplants? Renal failure creates a build‐up of waste products in the blood due to a lack of glomerular filtration. Humans in renal failure receive dialysis from a machine called a hemodialyzer. The machine removes the patient’s blood, separates and removes the waste products, and then gives the “clean” blood back to the patient. In animals, hemodialyzers are far too expensive for most owners and clinics. Instead, the most common practice is to administer subcutaneous fluids to the animal to increase the filtration of waste products across the glomerulus. Animals may be required to receive subcutaneous fluids weekly or biweekly depending on the severity of the renal failure. In intensive care units, a common treatment for acute renal failure patients is to administer continuous abdominal peritoneal dialysis (CAPD). Kidney transplantation has been performed at various teaching hospitals in the United States.

Diuresis Enuresis Feline idiopathic cystitis (FIC) Feline lower urinary tract disease (FLUTD)

Increased excretion of urine. Inability to control excretion; also called incontinence. Inflammation of the bladder due to an unknown cause. Disease with a collection of symptoms including cystitis, urethritis, hematuria, dysuria, and crystalluria. Also known as feline urological syndrome (FUS).

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TECH TIP 14.5  FLUTD vs. FUS FLUTD is considered the new name for FUS; however, many veterinarians still draw a difference between these two names. In fact, after speaking with five different veterinarians regarding these conditions, I received five different answers. Some veterinarians see FLUTD as a disease most commonly caused by stress. Male cats begin displaying behavioral issues such as inappropriate urination. When a urinalysis is performed, blood cells are increased, but bacteria are not necessarily present. In essence the cat has a sterile cystitis, also called feline idiopathic cystitis (FIC). These cats are at risk for urinary stone formation if left untreated. The cause of the stress should be identified and the cats are placed on anti‐inflammatories. In some cases, the cats may even be placed on anti‐anxiety medications such as Prozac. Two‐thirds of cats with FLUTD also have FIC. These same veterinarians associate FUS with stone formation in cats. The stone formation in this disease is often associated with increased urine concentration or urinary pH changes. These cases are treated similar to other species in that diet is used to change pH or to change mineral content.

Free catch Perineal urethrostomy

Also known as a voided sample, this is the collection of urine into an open container. New opening in the area between the anus and scrotum to correct FUS (Figure 14.7).

Figure 14.7  Urethrostomy in a dog. Note the stones that have been flushed out once the opening has been made. Source: Courtesy of Greg Martinez, DVM; http://www.youtube.com/drgregdvm.

TECH TIP 14.6  Polyuria vs. Pollakiuria Pollakiuria is an increase in the frequency of urination. The animal wants to go outside or to the litterbox often. Common causes include stress and pregnancy. Polyuria is an increase in the volume or quantity of urine being excreted. This term is often used with physical conditions such as diabetes mellitus or renal failure.

Pollakiuria Polycystic kidney

Frequent urination. Fluid‐filled sacs within or upon the kidney; the most common congenital renal defect (Figure 14.8).

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Figure 14.8  Illustration of polycystic kidney disease. Source: Courtesy of shutterstock/Alila Medical Images.

Renal colic Renal ischemia Stranguria Urinalysis (U/A) Urethral stricture Urinary retention Urine specific gravity (A)

Pain caused by stones in the kidney. Lack of blood flow to the kidneys. Straining to urinate; slow or painful urination. Separation of urine into its components. Tightening or narrowing of the urethra. Inability to completely empty the bladder (Figure 14.9). Measurement of the density of urine. This measures the weight of dissolved substances in the urine and the hydration status of the patient based on the urine concentration. (B)

Figure 14.9  (A) Radiograph of a kitten with distended bladder due to urinary retention. Source: Courtesy of Stephanie Hunt, AAS, CVT. (B) Kitten from Figure 14.9a. After the urine was removed, the kitten weighed one pound less. Source: Courtesy of Stephanie Hunt, AAS, CVT.

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Building the Terms Now it’s time to assemble the word parts listed in Tables 14.1–14.3. If you memorize the meaning of the combining forms, prefixes, and suffixes, then this will get easier each time. Remember your

five basic rules to medical terminology when building and defining these terms. You’ll notice some word parts are repeated from the previous chapters.

Table 14.1  Combining forms.

Combining Forms

Definition

Combining Forms

Definition

Albumin/o

Albumin

Ile/o

Ileum

Azot/o

Nitrogen

Ket/o

Ketones; ketone bodies

Bacteri/o

Bacteria

Keton/o

Ketones; ketone bodies

Bilirubin/o

Bilirubin

Lith/o

Stone

Crystall/o

Crystals

Myoglobin/o

Myoglobin

Cyst/o

Urinary bladder; cyst

Nephr/o

Kidney

Dips/o

Thirst

Olig/o

Scanty

Erythr/o

Red

Protein/o

Protein

Glomerul/o

Glomerulus

Py/o

Pus

Gluc/o

Glucose; sugar

Pyel/o

Renal pelvis

Glyc/o

Glucose; sugar

Ren/o

Kidney

Glucos/o

Glucose; sugar

Ur/o

Urine; urinary tract

Glycos/o

Glucose; sugar

Ureter/o

Ureter

Hemat/o

Blood

Urethr/o

Urethra

Hemoglobin/o

Hemoglobin

Urin/o

Urine

Hydr/o

Fluid; water

Table 14.2  Prefixes.

Prefix

Definition

Prefix

Definition

an‐

no, not, without

dys‐

bad; painful; difficult; abnormal

anti‐

against

para‐

near; beside; abnormal; apart from; along the side of

di‐

twice

poly‐

many; much

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Table 14.3  Suffixes.

Suffix

Definition

Suffix

Definition

‐ar, ‐ic

pertaining to

‐pathy

disease condition

‐centesis

surgical puncture to remove fluid

‐pexy

surgical fixation; to put in place

‐ectomy

removal; excision; resection

‐plasty

surgical repair

‐emia

blood condition

‐poiesis

formation

‐etic

pertaining to; pertaining to the condition

‐poietin

substance that forms

‐gram

record

‐ptosis

drooping; sagging; prolapse

‐ia

condition

‐sclerosis

hardening

‐iasis

abnormal condition

‐scopy

visual examination

‐itis

inflammation

‐stomy

new opening

‐lith

stone

‐tomy

incision; process of cutting into

‐lithiasis

abnormal condition of stones

‐tripsy

to crush

‐malacia

softening

‐uria

urination; condition of urine

‐osis

abnormal condition

Parts Albumin/o an Bacteri/o Bilirubin/o Crystall/o

+ ‐uria + ‐uria + ‐uria + ‐uria + ‐uria

Cyst/o Cyst/o Cyst/o

+ ‐ectomy + ‐itis + ‐centesis

Medical Term = Albuminuria = Anuria = Bacteriuria = Bilirubinuria = Crystalluria (Figure 14.10) = Cystectomy = Cystitis = Cystocentesis (Figure 14.11)

Definition : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________

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(B)

Figure 14.10  Crystalluria in canine urine. (A) Ammonium biurate crystals, struvite crystals, and sperm. (B) Calcium oxalate dihydrate crystals.

Figure 14.11  Ultrasound‐guided cystocentesis on a dog. Source: Courtesy of Kari Walker, BS, CVT, VTS (SAIM).

Cyst/o Cyst/o Cyst/o Cyst/o

+ ‐gram + ‐pexy + ‐scopy + ‐stomy

= Cystogram = Cystopexy = Cystoscopy = Cystostomy

: _________________ : _________________ : _________________ : _________________

Cyst/o dys‐ Erythr/o

+ ‐tomy + ‐uria + ‐poiesis

= Cystotomy (Figure 14.12) : _________________ = Dysuria : _________________ = Erythropoiesis : _________________

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Glomerul/o Glomerul/o Glucos/o Hemat/o Hemoglobin/o Hydr/o

+ ‐ar + Nephr/o + ‐itis + ‐uria + ‐uria + ‐uria + Nephr/o + ‐osis

Keton/o Ket/o Lith/o

+ ‐uria + ‐osis + ‐tripsy

= Glomerular = Glomerulonephritis = Glucosuria = Hematuria = Hemoglobinuria = Hydronephrosis (Figure 14.13) = Ketonuria = Ketosis = Lithotripsy (Figure 14.14)

: _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ Also called litholapaxy.

Figure 14.12  Cystotomy to remove stones. Source: Courtesy of Greg Martinez, DVM; http://www.youtube. com/drgregdvm

Distended renal pelvis

Renal pelvis

Kidney stone Normal flow of urine

Weak flow of urine

Ureter

Blocked ureter NORMAL KIDNEY

HYDRONEPHROSIS

Figure 14.13  Illustration of hydronephrosis. Source: Courtesy of shutterstock/NoPainNoGain.

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Figure 14.14  Illustration of lithotripsy. Source: Courtesy of shutterstock/Alila Sao Mai.

Myoglobin/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o Nephr/o para‐ oligo‐ poly‐

+ ‐uria + ‐itis + ‐lith + ‐lithiasis + Lith/o + ‐tomy + ‐malacia + ‐pathy + ‐ptosis + ‐sclerosis + ‐osis + ‐stomy + Nephr/o + ‐ic + ‐uria + ‐dipsia

= Myoglobinuria = Nephritis = Nephrolith = Nephrolithiasis = Nephrolithotomy = Nephromalacia = Nephropathy = Nephroptosis = Nephrosclerosis = Nephrosis = Nephrostomy = Paranephric = Oliguria = Polydipsia

: _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________ : _________________

TECH TIP 14.7  What Is Myoglobin? Myoglobin is the oxygen‐carrying pigment of muscle cells. If the animal has a condition causing excessive muscle cell lysis, then the excessive myoglobin is excreted in the urine. The sample becomes red to reddish‐brown in color.

TECH TIP 14.8  Rules for Using the Prefix “poly‐” When “poly‐” is attached to a word component that involves an action, then the meaning of “poly‐” changes to excessive or frequent. For example, polyphagia would be defined as excessive eating instead of many eating or much eating.

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poly‐ Protein/o Pyel/o Pyel/o Pyel/o Pyel/o

Veterinary Medical Terminology Guide and Workbook

+ ‐uria + ‐uria + ‐itis + ‐gram + Lith/o + ‐tomy + Nephr/o + ‐itis

Normal

= Polyuria = Proteinuria = Pyelitis = Pyelogram = Pyelolithotomy = Pyelonephritis (Figure 14.15)

: _________________ : _________________ : _________________ : _________________ : _________________ : ________________

Chronic pyelonephritis Blunted calyx

Scar Figure 14.15  Illustration of pyelonephritis. Source: Courtesy of shutterstock/Alila Sao Mai.

Py/o Ureter/o

+ ‐uria + Ile/o + ‐stomy

Ureter/o Ureter/o Urethr/o Urethr/o Ur/o Ur/o Ur/o

+ Lith/o + ‐tomy + ‐plasty + ‐itis + ‐plasty + ‐lith + ‐lithiasis + ‐poiesis

= Pyuria = Ureteroileostomy

: ________________ : _________________ Remember the rule for “‐stomy” when it is attached to more than one combining form. = Ureterolithotomy : ________________ = Ureteroplasty : _________________ = Urethritis : _________________ = Urethroplasty : ________________ = Urolith (Figure 14.16) : _________________ = Urolithiasis : _________________ = Uropoiesis : _________________

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Figure 14.16  A urolith that was surgically removed from a dog. Source: Courtesy of Kimberly Perkovich, CVT, RVT.

Abbreviations Table 14.4  Abbreviations.

Abbreviation

Definition

Abbreviation

Definition

ADH

Antidiuretic hormone

FUS

ADR

Ain’t doin right

Feline urological syndrome

Bili

Bilirubin

IVP

Intravenous pyelogram

BUN

Blood urea nitrogen

K+

Potassium

Cl–

Chloride

CKD

Chronic kidney disease

Creat

Creatinine

CRF

Chronic renal failure

Cysto

Na

Sodium

PU

Perineal urethrostomy

sp. gr

Specific gravity

TCC

Transitional cell carcinoma

Cystocentesis

U/A

Urinalysis

FIC

Feline idiopathic cystitis

USG

Urine specific gravity

FLUTD

Feline lower urinary tract disease

UTI

Urinary tract infection

+

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Case Study Hershey, a 12‐year‐old Dalmatian, presents to your clinic with hematuria and dysuria. On macroscopic examination, the urine is dark red and cloudy. Microscopic evaluation reveals crystalluria and bacteriuria. After taking radiographs, two stones are discovered in the urinary bladder. Hershey will require surgery to remove the stones. 1. Which term is used in the diagnosis? a. Cholelithiasis b. Urolithiasis c. Choledocholithiasis 2. Which type of surgery will be performed? a. Cystectomy b. Cystotomy c. Cystostomy 3. The symptoms that Hershey presented with include: a. Bloody urine, frequent urination b. Bilirubin in urine, difficulty urinating c. Bloody urine, difficulty urinating

Exercises 14‐A:  Give the term for the following definitions of structures. 1.  2.  3.  4.  5.  6.  7. 

________________: Functional unit of the kidney. ________________: Nitrogenous waste of muscle cell metabolism. ________________: Tube from the kidney to the urinary bladder. ________________: Outer region of the kidney. ________________: Collection of capillaries where filtration takes place. ________________: Tube from the urinary bladder to the outside of the body. ________________: Hormone responsible for the reabsorption of water in the renal tubules. 8.  ________________: Cup‐like capsule enclosing the glomerulus. 9.  ________________: Tubes in the kidney where reabsorption takes place. 10.  ________________: Synonymous term for urination and voiding. 14‐B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Lithotripsy_____________________________ Nephrosclerosis_____________________________ Pyelonephritis_____________________________ Cystocentesis_____________________________ Erythropoiesis_____________________________ Anuria____________________________________ Polyuria____________________________________ Urethritis____________________________________ Ketosis____________________________________ Glomerular________________________________

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14‐C:  Circle the correct term in parentheses: 1.  Enzyme produced by the kidney to regulate blood pressure. (EPO, renin, sodium) 2.  Scanty urine. (anuria, oliguria, pyuria) 3.  Plasma protein that maintains oncotic pressure found in the urine. (albuminuria, ketonuria, proteinuria) 4.  Incision into the kidney to remove a stone. (pyelolithotomy, nephrolithotomy, cystotomy) 5.  Increased excretion of urine. (azotemia, diuresis, enuresis) 6.  Lack of blood flow to the kidney. (renal hypoxia, renal colic, renal ischemia) 7.  Passage of substances from the glomerulus to Bowman’s capsule. (filtration, reabsorption, excretion) 8.  Electrolyte reabsorbed by the renal tubules due to aldosterone. (chloride, potassium, sodium) 9.  Nitrogenous waste that results from protein breakdown. (BUN, creatinine, ketones) 10.  Increase in non‐protein nitrogenous wastes in the blood. (azotemia, diuresis, enuresis) 14‐D:  Define the following abbreviations. 1. 2. 3. 4. 5. 6.

__________________: ADH __________________: PU __________________: Na+ __________________: Cysto __________________: UTI __________________: FIC

7. 8. 9. 10 11 12

__________________: USG __________________: FLUTD __________________: FUS _________________: BUN _________________: U/A _________________: CKD

14‐E:  Match the following with their descriptions. 1. 2. 3. 4. 5.

______ Excessive thirst. ______ Abnormal accumulation of fluid in the kidney. ______ Pertaining to near the kidney. ______ Frequent urination. ______ Incontinence.

14‐F:  Identify the substances in the following urine samples. 1.  2.  3.  4.  5.  6.  7. 

Pyuria: _________in the urine. Bacteriuria: _________in the urine. Hematuria: _________in the urine. Bilirubinuria: _________in the urine. Crystalluria:_________in the urine. Albuminuria:_________in the urine. Hemoglobinuria: _________in the urine.

Answers can be found starting on page 675.

A. B. C. D. E.

Enuresis Hydronephrosis Paranephric Pollakiuria Polydipsia

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Review Tables Fill in the tables and refer to Tables 14.1–14.4 for answers. Table 14.5

Combining Forms

Definition

Combining Forms

Albumin/o

Ile/o

Azot/o

Ket/o

Bacteri/o

Keton/o

Bilirubin/o

Lith/o

Crystall/o

Myoglobin/o

Cyst/o

Nephr/o

Dips/o

Olig/o

Erythr/o

Protein/o

Glomerul/o

Py/o

Gluc/o

Pyel/o

Glyc/o

Ren/o

Glucos/o

Ur/o

Glycos/o

Ureter/o

Hemat/o

Urethr/o

Hemoglobin/o

Urin/o

Definition

Hydr/o

Table 14.6

Prefix

Definition

Prefix

an‐

dys‐

anti‐

para‐

di‐

poly‐

Definition

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Table 14.7

Suffix

Definition

Suffix

‐ar, ‐ic

‐pathy

‐centesis

‐pexy

‐ectomy

‐plasty

‐emia

‐poiesis

‐etic

‐poietin

‐gram

‐ptosis

‐ia

‐sclerosis

‐iasis

‐scopy

‐itis

‐stomy

‐lith

‐tomy

‐lithiasis

‐tripsy

‐malacia

‐uria

Definition

‐osis

Table 14.8

Abbreviation

Definition

ADH ADR Bili BUN Cl– CKD Creat CRF Cysto FIC FLUTD (Continued )

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Table 14.8  (Continued )

Abbreviation

Definition

FUS IVP K+ Na+ PU sp. gr TCC U/A USG UTI

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

15

The Horse

Now that you have a good foundation for medical terminology and the basics with regard to anatomy, we can introduce more species of animals. This chapter intro­ duces terms common to equine medicine.

Equine Anatomy The horse’s internal and external anatomy are different from those of dogs and cats. While the majority of bones are similar to small animals, the external terminology is considerably different.

Equine Skeleton The equine skeleton is similar to that of small animals, but there are some differ­ ences in the distal limbs. The differences begin with the front limb (Figure 15.1). TECH TIP 15.1  How to Remember the Joint Names Joints are named based on the bones that comprise them. The common name of the proximal interphalangeal joint, the pastern, is made up of the long pastern and short pastern. The common name of the distal interphalangeal joint is the coffin, which is made up of P2 and the coffin bone.

The Front Limb The scapula, commonly called the shoulder blade, connects to the humerus, the long bone of the upper arm. The elbow joint of the horse is still medically called the humeroradioulnar joint. From the elbow, the anatomical changes begin. The radius and ulna of the horse are fused. The radius sits cranial to the ulna and the ulna still has a process on the proximal aspect called the olecranon. The carpal bones make up the joint known as the carpus. In horses, this joint is commonly called the knee. Distal to the carpus are the metacarpals. Horses lack metacarpals I and V. Because the metacar­ pals are counted from medial to lateral, the first metacarpal in the horse is metacarpal II, commonly called the medial splint bone. Metacarpal III is the largest of the metacar­ pals and is commonly called the cannon bone. Lastly, metacarpal IV is commonly called the lateral splint bone. Metacarpals II and IV do not articulate with the ­phalanges as they do in other species. The point at which the metacarpals meet the phalanges is called the fetlock. The medical name for the fetlock is the metacarpophalangeal joint. Horses only have one “finger,” the mid­ dle finger. This phalanx, or digit, is made

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Thoracic vertebrae

Lumbar vertebrae

Caudal (Coccygeal) Sacral vertebrae vertebrae

Atlas Axis

Skull

Mandible Cervical vertebrae Pubis

Ischium

Scapula

Femur

Humerus Sternum Olecranon

Fibula

Patella

Ribs

Ulna

Radius

Tibia

Carpal bones Metacarpal III P1 P2 P3

Calcaneus

Tarsal Accessory carpal bones bone Metacarpal II or IV

Metatarsal II or IV

Metatarsal III Proximal sesamoid bone Distal sesamoid bone

Figure 15.1  Skeletal anatomy of the horse. Source: Courtesy of shutterstock/Alexonline.

P1 P2 P3

Proximal sesamoid bone Distal sesamoid bone

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up of three bones that are named proxi­ mally to distally. The proximal phalanx, or P1, is commonly known as the long pastern. The second bone of the phalanx is the middle phalanx, or P2, commonly called the short pastern. The last phalanx, called the distal phalanx, or P3, is com­ monly called the coffin bone. An interphalangeal joint is located bet­ ween each phalanx. The joint between P1 and P2 is known as the proximal inter­ phalangeal joint, or pastern. The joint ­between P2 and P3 is the distal interpha­ langeal joint, or coffin joint. Horses have proximal sesamoid bones, which are caudal to their fetlock joint. The distal sesamoid bone, or navicular, is caudal to the coffin joint. The Rear Limb The rear limb begins the same as in the small animals. The pelvis meets the femur to create the coxofemoral joint, or hip. The femur, the long bone of the upper rear limb, leads to the femorotibial joint, or stifle. The sesamoid bone just cranial to

the stifle joint is the patella. The tibia is the largest bone of the lower rear limb and is used for weight bearing. In horses, the fibula is a reduced bone. The shaft of the horse’s fibula is vestigial, or not pre­ sent, and the ends are fused with the tibia. The tarsal bones make up the tarsus joint, commonly called the hock. The remaining bones are almost identical to the front limb. Horses lack metatarsals I and V and the remaining metatarsals are still counted from medial to lateral. Metatarsal II is commonly known as the medial splint bone, metatarsal III is commonly known as the cannon bone, and metatarsal IV is com­ monly known as the lateral splint bone. The joint between the metatarsals and phalanges is the metatarsophalangeal joint, commonly called the fetlock. The medical names and common names of the phalanges in the rear limb are iden­ tical to those of the front limb, as are those of the interphalangeal joints. Horses also have proximal sesamoid bones caudal to the fetlock in their rear limbs and a navicular caudal to the coffin joint in their rear limbs.

Heel Bulb Frog Bars White line

Quarter

Sole

Toe Figure 15.2  Anatomy of the hoof.

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Hoof Anatomy (Figure 15.2) Bars Frog Heel bulb Hoof Hoof wall Lamina Quarter Sole Toe White line

V‐shaped depression on the distal surface of the hoof. V‐shaped pad of soft horn between the bars on the sole of the hoof. Swollen part of the hoof wall and adjacent soft tissue at the back of the hoof. Hard, horny covering of the digit of ungulates (hooved animals). Hard, horny covering of the hoof. Sensitive tissue that attaches the hoof wall to the underlying foot structures. Medial and lateral aspects of the hoof. Palmar and plantar surfaces of the hoof. Cranial aspect of the hoof. The fusion between the wall and the sole of the hoof.

External Landmarks and Terminology (Figure 15.3) Poll

Crest

Forelock

Mane Withers

Tailhead Croup

Loin

Paralumber fossa

Muzzle

Throat latch

Heart girth Barrel

Cheek

Shoulder Chest

Tail Hock

Flank Stifle Gaskin Chestnut

Knee

Cannon bone

Coronary band

Fetlcok Pastern

Ergot Hoof

Figure 15.3  External anatomy of the horse. Source: Courtesy of shutterstock/IronFlame.

Barrel Cheek Chest

The trunk of the horse; determined largely by the chest’s capacity. Fleshy portion on either side of the face, forming the sides of the mouth and continuing rostrally to the lips. Part of the body between the neck and abdomen; also called the thorax.

Chapter 15  The Horse

Chestnuts Corners Coronary band Crest Croup Cutters Dock Ergot

471

Flattened, oval masses of horny tissue on the medial surface near the knee and hock. Common name for the third incisors. Junction between the skin and the horny tissue of the hoof.

Root of the mane. Muscular area around and above the base of the tail. Common name for the second incisors. Solid portion of the tail. Small mass of horny tissue in a small bunch of hair on the palmar and plantar aspects of the fetlock. Forelock Cranial aspect of the mane hanging down between the ears and onto the forehead. Gaskin Muscular portion of the hind leg between the hock and stifle. Heart girth Greatest circumference of the chest behind the withers, shoulders, and elbows. Loin Lumbar region of the back between the thorax and pelvis. Mane Region of long, course hair at the dorsal border of the neck and terminating at the poll. Muzzle Skin, muscles, and fascia of the upper and lower lip and including the nasal bones. Nippers Common name for the central incisors. Paralumbar Hollow of the flank between the transverse process of the lumber fossa vertebrae, the last rib, and the thigh muscles. Poll Top of the head; also known as the occiput. Tail head Base of the tail that connects to the trunk of the body. Teat Nipple of the mammary gland. Udder Mammary gland. Withers Region of the backline where the neck meets the thorax and where the dorsal margins of the scapula lie just below the skin. Wolf teeth First upper premolars that are usually shed when the horse matures.

Mobility Horses are used for working, recreation, competition, and transportation. There­ fore, there are a variety of terms used to Beat Canter Gallop Jog

describe their gait, or manner of walking. This chapter merely introduces basic terms used to describe the gait and will not go into more specific terminology that relates to their jobs.

Time when the foot touches the ground. Galloping at an easy pace. This stride involves a three‐beat rhythm in which two diagonal legs are paired. This is also known as a lope in Western riding (Figure 15.4A). Fastest gait of the horse in which all four limbs are off the ground at one point. This stride involves a four‐beat rhythm; also known as a run (Figure 15.4B). Slow trot.

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Unable to walk; deviation from the normal gait. Fast, two‐beat rhythm similar to a trot except that the front and rear limbs on each side move in unison instead (Figure 15.4C). A single, coordinated movement of all four legs until they return to their normal position. Two‐beat rhythm gait in which diagonal limbs take off at the same time (Figure 15.4D). Slow, four‐beat rhythm in which all four limbs take off at separate times.

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Figure 15.4  (A) Canter; also called a lope. Source: Courtesy of Stacy Deitrich, BOE, LVT, RVT. (B) Gallop. Source: Courtesy of WikiCommons/Jeff Kubina. (C) Pace. Source: Courtesy of shutterstock/Anastasija Popova. (D) Trot. Source: Courtesy of shutterstock/Anastasija Popova.

Types of Horses and their Markings Horses are divided into categories based on their common characteristics (Table 15.1). There are hundreds of horse breeds,

so this chapter focuses on the groups into  which the various breeds are categorized. Regardless of the breed of horse, the terminology for markings is always the same.

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Table 15.1  Types of horses. Draft horse

Breeds with large muscular and bone structure. These breeds are commonly used as work horses because of their powerful bodies. Draft horses are generally 18 hands or greater. Examples of draft horses include the Clydesdale, the Belgian, and the Friesian (Figure 15.5A).

Gaited horse

Breeds with a smooth, easy gait commonly used for transportation and show. These breeds are typically 14–16 hands. Examples include the Tennessee Walker and American Saddlebred (Figure 15.5B).

Horses of color

Breeds with uniquely spotted patterns. These breed are typically 14–16 hands. Some horses of color are also classified as light horses. Examples include the Pinto and Appaloosa (Figure 15.5C).

Light horses

Breeds that are 14–16 hands. Like the gaited horse, these breeds are typically used for transportation and show. Examples include the Arabian (Figure 15.5D) and the Thoroughbred.

Pony

Breeds that are less than 14 hands. These breeds are often used for recreation and show. Examples include the Shetland Pony (Figure 15.5E) and the Welsh Pony.

Warmblood

Classification given to horses with a nervous and energetic temperament. Examples include Thoroughbred and Arabians.

Coldblood

Classification given to horses developed for draft work. Examples include the Clydesdale, Shire, and Belgian.

TECH TIP 15.2  What’s a Hand? A hand is a unit of measurement for the height of a horse: 1 hand = 4 inches = 10.16 cm.

The Face Bald Blaze Chin spot Snip Spot Star Stripe

White face; face with a blaze and a snip that extends beyond the eyes and nostrils (Figure 15.6A). White stripe on the face. White spot on the chin. White marking on the muzzle (Figure 15.6B). White mark on the face. White mark between the eyes, usually in the shape of a diamond (Figure 15.6C,D). Long, narrow, white mark down the nose; also called a strip or race (Figure 15.6c,d).

TECH TIP 15.3  Half Markings Markings that only span half of their area will have the word “half” in front of their term. For example, a half stocking has a white marking from the coronet to the middle of the cannon. A half pastern would have a white marking from the coronet to the middle of the pastern.

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Figure 15.5  (A) Friesian, which is a type of draft horse. Source: Courtesy of shutterstock/Makarova Viktoria (Vikarus). (B) American Saddlebred. Source: Courtesy of shutterstock/Jeff Banke. (C) Appaloosa. Source: Courtesy of shutterstock/Zuzule. (D) Arabian. Courtesy of shutterstock/Olga_i. (E) Shetland Pony. Source: Courtesy of shutterstock/Vera Zinkova.

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Figure 15.6  Facial markings. (A) Bald. (B) Snip. (C) Star and stripe. (D) Star, stripe, and snip.

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The Legs Ankle Coronet Heel Pastern Stocking

White marking from the fetlock down to the coronet; also called a sock. White marking covering the coronary band (Figure 15.7A). White marking on the heel. White marking from the pastern to the coronet (Figure 15.7B). White mark from the coronet to the knee (Figure 15.7C,D).

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Figure 15.7  Leg markings. (A) Coronet. (B) Pastern markings on the front legs, socks on the rear legs. (C) Stocking. (D) Stocking and half stocking. Source: Courtesy of Anna Morse, CVT.

Equine Coat Colors and Patterns Various terms can be used to describe the color and pattern of a horse’s coat. Some of these terms are used for select

horse breeds. This book describes the  most commonly encountered (Figure 15.8).

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Bay Black Buckskin Chestnut

Dappled Flea bitten Gray Grullo Palomino Paint

Pinto Roan Sorrel

White

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Reddish‐brown or tan color with a black mane, black tail, and lower legs. Solid black color. While unusual in many breeds, it can be a common color in others such as Friesians. Tan or golden color with a black mane, black tail, and lower legs. Reddish‐brown color. This color is often used synonymously with the color sorrel. However, sorrel is more often used to describe the color on Quarter Horses while chestnut is used on all other horse breeds. A spotted or mottled coat pattern that can occur with various coat colors. Term used to describe a flecked pattern on the coat. Dark coat color mixed with white giving the overall appearance of a gray color. Smoky coat color with a black mane, black tail, and lower legs. Light tan to golden color with a white or lighter shade mane and tail. Technically, Paint is a breed and not a color. However, paint is used to describe a coat pattern on Quarter Horses and horses registered with the American Paint Horse Association (APHA). These horses have large patches of white mixed with other colors. Multicolored horse with large, broken patches of white mixed with other colors. Often confused with paint. Blended mixture of colors with white. A reddish‐copper color. This color is often used synonymously with the color chestnut. However, sorrel is more often used to describe the color on Quarter Horses while chestnut is used on all other horse breeds. Solid white coat color.

Equine Husbandry The care and management of horses involves various equipment and housing tools not used in small animal medicine.

Equipment Bit Bridle Chain shank Cradle Halter Hobble

Metal portion of the bridle placed in the horse’s mouth to control it during riding (Figure 15.9). Headgear made up of a bit, reins, and straps to control the horse (Figure 15.9). Steel chain attached from the lead rope through the halter (Figure 15.10B). Barred restraining device on the horse that prevents it from biting an injured area. Head restraint for a horse used to guide and tie a horse (Figure 15.10A). Leather straps fastened around the front and hind feet of the horse to restrain it from moving (Figure 15.11).

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Figure 15.8  Colors and patterns. (A) Bay. Source: Courtesy of Stacy Dietrich, BOE, LVT, RVT. (B) Black. Source: Courtesy of Sarah Goos, CVT. (C) Buckskin. Source: Courtesy of WikiCommons/Sara Landvogt. (D) Chestnut. Source: Courtesy of shutterstock/Julia Remezova. (E) Dappled gray. Source: Courtesy of Shannen Casados, LVT. (F) Flea bitten pattern. Source: Courtesy of Stacy Dietrich, BOE, LVT, RVT. (G) Gray. Source: Courtesy of WikiCommons/Athineos. (H) Grullo. Source: Courtesy of Anna Morse, CVT. (I) Palomino. Source: Courtesy of Erin Gregory. (J) Sorrel Paint. Source: Courtesy of Annie McCabe, LVT. (K) Pinto. Source: Courtesy of Beth Romano, AAS, CVT. (L) Strawberry roan Appaloosa. Source: Courtesy of Sarah Goos, CVT. (M) Blue roan mare. Source: Courtesy of shutterstock/HTurner. (N) Sorrel Quarter Horse with “birdcatcher spots.” These random white spots sometimes develop in horses later in life. Source: Courtesy of Wendy White, RVT. (O) White. Source: Courtesy of Beth Romano, AAS, CVT.

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Figure 15.8  (Continued)

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Figure 15.8  (Continued)

Figure 15.9  Horse with bridle. Note the bit, which is part of the bridle. Source: Courtesy of Amanda Counterman, AAS.

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Figure 15.10  (A) Horse with halter. Source: Courtesy of Amanda Counterman, AAS. (B) Horse with chain shank on its halter. Source: Courtesy of WikiCommons/justchaos.

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Figure 15.11  (A) Hobbled horse. Source: Courtesy of shutterstock/withGod. (B) Hobbled horse in the pasture. Source: Courtesy of shutterstock/ihelgi.

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Hoof pick Hoof tester Rasp

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Instrument to remove debris from the crevices of the hoof (Figure 15.12A). Instrument shaped like a pair of pincers used to test the sensitivity of the hoof (Figure 15.12B). Instrument used for fine trimming of the hoof (Figure 15.12C).

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Figure 15.12  Hoof tools. (A) Hoof pick. (B) Hoof tester. (C) Rasp. Source: Courtesy of shutterstock/Terrance Emerson. (D) Shoe. Source: Courtesy of shutterstock/Anastasija Popova

Shoe Tack

Steel or aluminum plate nailed to the plantar and palmar aspects of the hoof for protection (Figure 15.12D). Equipment used for riding and care of the horse; also known as tackle.

Care and Management Bolt Bowline Box stall Breeding soundness exam (BSE) Cast Casting

Startle. A non‐slip knot used in restraint (Figure 15.13). Enclosed area where the horse can stay and move around (Figure 15.14). A reproductive evaluation of a female or male as potential breeders. A horse that lies down and is unable to rise into sternal recumbency. Method of restraint in horses to pull them down for surgical procedures.

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Cribbing

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Habit in which the horse grasps an object with its incisors and applies pressure as it swallows air (Figure 15.15). Commonly called wind‐sucking, this habit can be acquired or a neurosis. It can cause the teeth to erode and can cause severe weight loss with abdominal distention. (B)

Figure 15.13  (A) Illustration of how to tie a bowline knot. Source: Courtesy of shutterstock/dromp. (B) A bowline knot on a lead rope. Source: Courtesy of shutterstock/S Rock.

Figure 15.14  Horse getting used to his new box stall. Source: Courtesy of WikiCommons/Belinda Hankins Miller.

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Figure 15.15  Cribbing. Source: Courtesy of shutterstock/Thomas Barrat.

Cross tie Farrier Firing

Flighty Floating

Restraint method in which the horse is tied to two pillars on each side. This method is commonly used for simple procedures such as grooming. Person skilled in the making, fitting, and remodeling of horseshoes (Figure 15.16). Method used on lower limbs to encourage healing of tendons or ligaments in lame horses. A red‐hot iron is placed on an anesthetized area of skin to promote healing and rest. The iron may be placed deep or superficial depending on the desired effect. Nervous Filing of teeth using a dental float (Figure 15.17). Sometimes called rasping.

TECH TIP 15.4  Why Is Floating Necessary? Equine dentistry is a critical part of horse maintenance because occlusions are critical to proper mastication. Horse can develop high and low points on their teeth which interfere with two surfaces rubbing together.

Grade Lather Lunging

Animal that results from the mating of purebred and crossbred animals. The common name for sweat that develops on a horse’s body. Exercising a horse by having it circle at the end of a long lead (Figure 15.18). Near side Left side of the horse. Off side Right side of the horse. Paddock Small, fenced‐in field or enclosure; also called a corral. Pasture Land area for animals to graze where grasses grow. Pasture breeding Males are placed in a pasture with many females for natural mating. Pasture rotation Movement of animals from pasture to pasture to decrease the incidence of parasites. Quick release knot Knot that unties easily. Saddle Tack placed on the back of the horse for riding (Figure 15.19). There are two types: the Western saddle and English saddle.

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Figure 15.16  Farrier. (A) Farrier testing the hoof. Source: Courtesy of shutterstock/Sus Pons. (B) Farrier measuring a horseshoe. Source: Courtesy of shutterstock/Jaroslaw Kurek. (C) Farrier reshaping a horseshoe. Source: Courtesy of shutterstock/KaeCsImages. (D) Farrier working on a horseshoe. Source: Courtesy of shutterstock/Oscar C. Williams.

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Figure 15.17  (A) Dental float. (B) Floating the teeth. Source: (B) Courtesy of shutterstock/Chelle129.

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Figure 15.18  Lunging a horse. Source: Courtesy of shutterstock/Osetrik.

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Figure 15.19  Saddles. (A) English saddle. Source: Courtesy of shutterstock/marekuliasz. (B) English saddle on the horse. Source: Courtesy of Anna Morse, CVT. (C) Western saddle. Source: Courtesy of shutterstock/ Azuzi. (D) Western saddle on the horse. Source: Courtesy of Anna Morse, CVT.

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Tease Teaser Twitch Waxing

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Parading a male in front of a female to determine if she is in heat. Stud or mare used to sexually tease the opposite sex. Restraint method in which a device is used to twist the upper lip of the horse (Figure 15.20). Waxy covering derived from colostrum that accumulates on the teats and signals foaling.

Figure 15.20  Rope twitch used on a horse. Source: Courtesy of Anna Morse, CVT.

Age and Sex Colt Filly Foal Foaling Gelding Herd Mare

Intact male horse four years old or younger. Intact female horse four years old or younger. Young horse less than a year old. Giving birth. Castrated male horse. Group of horses Intact female horse four years or older.

TECH TIP 15.5  Different Types of Mares Mares are further classified based on their status. Agalactic mare Barren mare Brood mare Maiden mare Wet mare

Intact female horse that’s not producing milk. Intact female horse that did not conceive in the previous breeding season; also known as an open mare. Breeding female horse (Figure 15.21). Intact female horse that has never been bred. Intact female horse that has been bred and has foaled in the current breeding season.

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Figure 15.21  Mare and her foal. Source: Courtesy of Steph Berg, CVT.

Ridgeling Stallion Weanling Yearling Jack Jenny

Cryptorchid male horse. Intact male horse four years or older. A foal that has been weaned and is less than a year old. Young horse between the ages of one and two years. Intact male donkey; also known as a jack ass. Intact female donkey.

Physiology and Pathology and Procedures Soundness is the ability of the horse to perform the function required of it, including the ability to compete or work. An animal that is classified as unsound has been found to be unsatisfactory. Bishoping Bog spavin Bone spavin Bowed tendons Capped hock Check ligament

Clostridium tetani

Altering of the teeth to make the horse appear younger. Chronic synovitis of the tibiotarsal joint causing distention of the joint capsule. “Spavin” means inflammation. Periosteitis of the bones of the hock. Chronic tendinitis of the superficial flexor tendons causing enlargement of the tendons and lameness. Accumulation of fluid in a bursa near the hock. One of two ligaments to the digital flexors that help maintain the limbs in an extended position when standing. Also known as suspensory ligaments, they help suspend the sesamoid bones behind the fetlock. Bacterium that causes tetanus, characterized by hyperesthesia, convulsions, and eventually death; commonly called lockjaw.

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Cracks

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Commonly known as sandcracks, these defects form in the hoof at the coronet due to injury or extension of the sole. Curb Thickening of the plantar tarsal ligament in the hock. Dental star Mark on the occlusal surface of the incisors that develops as the tooth wears. These marks begin as narrow yellow lines and develop into dark circles. Exertional rhabdo- Muscle cramping leading to pain which is typically caused by myolysis (ER) exercise. Commonly called Monday morning sickness. Equine ehrlichiosis Infectious disease caused by organisms of the genus Ehrlichia; causes fever, ataxia, anorexia, and edema of extremities. Commonly called Potomac horse fever. Equine infectious Anemia caused by a retrovirus leading to jaundice, petechiae, anemia (EIA) weakness, and emaciation. Equine influenza Upper respiratory infection caused by an influenza A virus. (EI) Symptoms include a mild fever and persistent cough. Equine protozoal Condition caused by the parasite Sarcocystis neurona mani­ myeloencephalitis fested by ataxia, weakness, recumbency, and eventually death. (EPM) Equine viral Virus caused by organisms of the genus Pestivirus. Symptoms arteritis (EVA) include upper respiratory infection and lesions on the arteries. Equine viral Encephalomyelitis caused by the genus Alphavirus and trans­ encephalomyelitis mitted by mosquitos. Symptoms include excitement, tremors, circling, paralysis, and recumbency. Three strains include Easter (EEE), Venezuelan (VEE), and Western (WEE). Equine viral Virus caused by herpesvirus 4 leading to abortions, coughing, rhinopneumonitis fever, and nasal discharge. (EVR) Fistulous withers Inflammation of the withers causing a discharge at the withers. Flehmen’s response Reaction in males after sniffing the urine or perineum of females. The nostrils dilate and upper lip curls (Figure 15.22). Flexor tendon Tendon that causes the fetlock to flex. Foal heat The first heat cycle of the foal. Full‐mouthed Horse with all permanent teeth present. Galvayne’s groove Vertical groove on the labial surface of a horse’s tooth used to determine its age. Greasy heel Dermatitis of the back of the pastern commonly seen in horses in wet standing areas; commonly called scratches. Guttural pouch Large air‐filled sac that develops in the Eustachian tube of horses. TECH TIP 15.6  How to Determine Age The Galvayne’s groove appears on the gingival margin at 10 years of age. At 15 years of age, the groove extends halfway to the end of the tooth. Around 20 years of age, the groove reaches the end of the tooth. The groove disappears at the top of the tooth around 25 years of age and completely disappears around 30 years of age.

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Figure 15.22  Flehmen’s response. Source: Courtesy of WikiCommons/Das Nili.

Hindgut Laminitis Monkey mouth Osselets Parrot mouth

Quidding

The small intestine, cecum, and large intestine, collectively. Inflammation of the lamina causing lameness; commonly called founder. Condition in which the mandible is longer than the maxilla. Periosteitis of the cranial aspect of the fetlock joint. Condition in which the maxilla in longer than the mandible (Figure 15.23).

Figure 15.23  Skull of a horse with parrot mouth. Source: Courtesy of shutterstock/Margo Harrison.

Condition in which the horse drops food from its mouth during mastication. Commonly seen in cases of stomatitis and bad teeth. Horses with this condition are called quiddors. Quittor Chronic inflammation of the lateral cartilage of P3 causing a purulent discharge at the coronet and lameness. Ringbone Osteoarthritis or periosteitis of P1 and P2, creating a bony promi­ nence at the pastern or coffin joint. Smooth Condition in which the molars are worn so that the dentin and mouth enamel are even. Splints Inflammation of the interosseous ligament between the splint bones and cannon bone. Stay Anatomical mechanism in the limbs that enables the horse to stand apparatus with little or no muscular effort. Involves the participation of many tendons, muscles, and ligaments. Streptococcus Bacterial infection causing high fever, purulent nasal discharge, equi anorexia, pharyngitis, laryngitis, and swollen lymph nodes. Disease is commonly called strangles. Sweeney Paralysis of the scapular muscles.

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Thoroughpin Tenosynovitis of the sheath of the deep flexor tendon of the hindleg. Though it causes swelling, there is no lameness. Vesicular Inflammation of the mouth characterized by ulcers that rupture and stomatitis become necrotic. West Nile Mosquito‐transmitted virus causing ataxia, head tilt, seizures, paral­ virus ysis, and eventually death. Winking Quick, uncontrolled opening of the vulva when a mare is in heat.

Commonly Used Equine Slang In my experience, I have found that the majority of students don’t have large animal exposure. When they begin their clinicals, they hear slang used instead of scientific terms which can be confusing to them and often frustrating. The purpose of this new section is to help the beginner become familiar with the more commonly used slang. Back at the knee Balk Bolter Cinchy Cow hocked Easy keeper Grade horse Green Green broke Hard keeper Head shy Heaves Hot Lead mare Long in the tooth Moon blindness Over at the knee Paddling Papered Proud cut

Conformation defect in which the carpus is positioned backward. Horse that refuses to move forward. Horse that runs away at high speed, usually after being startled. Also known as girthy, these horses act cranky when the girth is tightened. Conformation defect in which the calcaneus is turned medially. Horse that easily maintains proper weight. Horse that is unable to be registered. Inexperienced horse. Horse that now accepts a rider on its back. Also known as under saddle. Horse that struggles to maintain proper weight. Horse that is resistant to being touched on the head. Respiratory disease in horses caused by allergies or inhalation of foreign particles; also known as recurrent airway obstruction (RAO). High‐energy horse. Dominant mare that controls the herd instead of the males. Also known as an alpha mare. Refers to an old horse. The name is derived from the length of their teeth which grow with the horse’s age. Recurrent blindness due to equine recurrent uveitis. These horses are photophobic. Historically, people believed the blind attacks were related to the phases of the moon. Conformation defect in which the carpus is positioned forward. Term used to describe an abnormal gait in which the lower limb turns outward instead of moving forward to back in a straight line. Registered horse with a breed association. A gelding cut late in life that still retains some of his stallion behaviors. This was once thought to be related to a retained epididymis.

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Exuberant granulation tissue. Medically known as laryngeal hemiplegia, these horses have damage to their laryngeal nerve. When they breath, it sounds like a roar. Horse that easily startles. Conformation defect in which the slope of the pastern is almost straight. Slang term for exertional rhabdomyolysis.

Abbreviations Table 15.2  Abbreviations.

Abbreviation

Definition

BSE

Breeding soundness exam

EEE

Eastern equine encephalitis

EI

Equine influenza

EIA

Equine infectious anemia

EPM

Equine protozoal myeloencephalitis

ER

Exertional rhabdomyolysis

EVA

Equine viral arteritis

EVR

Equine viral rhinopneumonitis

KBH

Kicked by horse

LA

Large animal

RAO

Recurrent airway obstruction

TGE

Transmissible gastroenteritis

VEE

Venezuelan equine encephalitis

VS

Vesicular stomatitis

WEE

Western equine encephalitis

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Exercises 15-A:  Give the term for the following definitions of structures. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

_______________: Common name of P3. _______________: Medical name of the long pastern. _______________: Common name of the carpus in horses. _______________: Common name of the distal sesamoid bone. _______________: Common name of the metacarpophalangeal joint. _______________: Medical name of the coffin joint. _______________: Common name of metatarsal III. _______________: Top of the head. _______________: Mammary gland. _______________: First upper premolars shed at maturity.

15-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Ergot ____________________________________________________________ Chestnuts ________________________________________________________ Lame ____________________________________________________________ Canter ___________________________________________________________ Mare ____________________________________________________________ Gelding __________________________________________________________ Hindgut _________________________________________________________ Parrot mouth _____________________________________________________ Laminitis ________________________________________________________ Cribbing _________________________________________________________

15-C: Circle the correct term in parenthesis: 1.  V‐shaped pad of soft horn between the bars on the sole of the hoof. (bar, frog, bulb) 2.  Head restraint used to guide and tie a horse. (bridle, halter, harness) 3.  Solid portion of the tail. (mane, tail head, dock) 4.  Breeds with large muscular and bone structure, over 18 hands. (draft, gaited, pony) 5.  Muscular area around and above the base of the tail. (croup, occiput, withers) 6.  White stripe on the face. (blaze, snip, stripe) 7.  Instrument used for fine trimming of the hoof. (dental float, hobble, rasp) 8.  Exercising a horse by having it circle at the end of a long lead. (firing, blis­ tering, lunging) 9.  White marking covering the coronary band. (coronet, pastern, heel) 10.  Region of the backline where the neck meets the thorax and where the dorsal margins of the scapula lie just below the skin. (croup, occiput, withers) 15-D: Define the following abbreviations. 1.  ____________________________________: EEE 2.  ____________________________________: EIA

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____________________________________: TGE ____________________________________: VS ____________________________________: KBH ____________________________________: VEE ____________________________________: WEE ____________________________________: EPM ____________________________________: LA ____________________________________: EI

15-E:  Match the following diseases with their causes. 1.  2.  3.  4.  5. 

_____________________ Equine ehrlichiosis _____________________ Clostridium equi _____________________ Laminitis _____________________ Clostridium tetani _____________________ Sarcocystis neurona

A.  B.  C.  D.  E. 

Tetanus Strangles Potomac horse fever Founder EPM

15-F:  Identify the coat colors in the images shown in Figure 15.24 1–8. 1

2

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Figure 15.24  (1) Courtesy of WikiCommons/[email protected] (2) Courtesy of WikiCommons/ AnemoneProjectors. (3) Courtesy of Jennifer Poehlman, LVT. (4) Courtesy of WikiCommons/ W.J. Pilsak. (5) Courtesy of WikiCommons/OTRS. (6) Courtesy of WikiCommons/Hanka Certik. (7) Courtesy of WikiCommons/Ruslan V. Albitsky. (8) Courtesy of WikiCommons/Vet‐Hekim‐Caner.

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Figure 15.24  (Continued) Answers can be found starting on page 675.

Review Table Fill in the table and refer to Table 15.2 for answers Table 15.3

Abbreviation

Definition

BSE EEE EI EIA (Continued )

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Table 15.3  (Continued)

Abbreviation

Definition

EPM ER EVA EVR KBH LA RAO TGE VEE VS WEE

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Blank diagrams for anatomy practice Word Search Puzzle

C h a p t e r

16

Ruminants

As introduced in Chapter 4, ruminants are a group of animals with a more specialized stomach that contains four compartments. The parts of the ruminant stomach include the rumen, reticulum, omasum, and abomasum. Ruminants regurgitate their food (cud), chew it, and then swallow it again. Cattle, sheep, goats, llamas, and alpacas are all ruminants.

Cattle Cattle play a large role in the food industry. They can be divided into two basic types: dairy cattle and beef cattle (Figure 16.1). Brisket Crest Dewclaw Dewlap Flank Heart girth Heel Hide Hooks Loin Muzzle

The hides of some cattle are also valuable. Terminology for the care and use of cattle will be discussed in this chapter; basic anatomy has been discussed previously.

External Terminology The terminology used to describe the external anatomy of cattle is similar to that of other animals (Figure  16.2). Therefore, the only terms listed here are those that may be new compared to those of other species. Terms such as elbow and hock are still labeled on the diagrams, but will not be discussed.

Mass of connective tissue and fat covering the cranial aspect of the chest. Dorsocranial margin of the neck. Accessory claw in ruminants. Loose skin under the throat and neck which may be pendulous in some breeds. Side of the body between the ribs and the ilium. Circumference of the chest just caudal to the shoulders. Area at the rear of the hoof or claw where horn and skin meet and where the hoof wall becomes the sole. Skin of cattle. Bony protrusion of the wing of the ilium dorsolaterally. Lumber region of the back, between the thorax and pelvis. Skin, muscles, and fascia of the upper and lower lip, including the nasal bones.

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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(C) Parts suitable for broiling and roasting Parts requiring longer cooking methods Top sirloin Rump r loin Tende Top sirloin Short lion Bottom Round sirloin Short Rib

Rib

Chuck

Brisket

Fore shank

Short plate

Flank Hind shank

Hanging tender

Figure 16.1  (A) Dairy cattle. Source: Courtesy of shutterstock/tarczas. (B) Angus beef cattle. Source: Courtesy of shutterstock/operative401. (C) Meat diagram of a cow. Source: Courtesy of shutterstock/life_is_fantastic.

Hook

Shoulder

Paralumbar fossa

Crest Poll

Forehead

Tailhead Muzzle

Pin Heart girth

Dewlap

Switch Hock

Elbow Knee

Dewclaw

Brisket

Hoof

Heel Figure 16.2  External anatomy of the bull. Source: Courtesy of shutterstock/Rey Kamensky.

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Hollow of the flank between the transverse process of the lumbar vertebrae, the last rib, and the thigh muscles. Bony protrusion of the ischium lateral to the tail base.

TECH TIP 16.1  Hooks and Pins Hooks and pins are used for body condition scoring (BCS).

Poll Rump Sole Switch Teat Toe Udder

Top of the head; also called the nuchal crest. The gluteal region; region around the pelvis, hindquarters, and buttocks. Palmar and plantar surfaces of the hoof. Hairy portion at the end of the tail. Nipple of the mammary gland. Cranial aspect of the hoof. Mammary gland.

Bovine Husbandry The care and management of cattle involves various equipment, housing tools, and techniques not used in small animal medicine. Balling gun

Instrument to administer bolus to livestock (Figure 16.3).

Figure 16.3  Balling gun.

Bolus Brand (A)

Mass of food or medication to be swallowed. Mark put on the skin as a means of identification (Figure 16.4). (B)

Figure 16.4  (A) Cow branding. Source: Courtesy of shutterstock/sursad. (B) Cow with brand and ear tag. Source: Courtesy of shutterstock/B.G. Smith. (C) Ear tagging in a goat. Source: Courtesy of shutterstock/ACEICheung.

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Figure 16.4  (Continued )

Calving interval Carcass Casting Chute

Average time between successive calves. Body of the animal after slaughter. Method of restraint to pull the cattle down to lateral recumbency. Mechanical device used for the animal to be examined and treated (Figure 16.5).

Figure 16.5  Chute to restrain cattle for procedures. Source: Courtesy of Patrick Hemming, DVM.

Commercial herd Cull Dehorning

Livestock raised for slaughter.

Removal of an animal from a herd. Culling can be due to disease, age, or a failure to reproduce. Removal of horns when the animal is young for the safety of the other animals in the herd. Methods of dehorning include electrocautery or use of a caustic paste (Figure 16.6).

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(B)

Figure 16.6  (A) Dehorned bull. Source: Courtesy of shutterstock/Margo Harrison. (B) Barnes dehorner.

Dual purpose Ear tagging

Cattle that can be used for both dairy and beef production. Placement of tags in the ear for identification of the animals (Figure 16.4). Emasculotome Instrument used for a bloodless castration. The procedure is commonly referred to as a pinch. Other commonly used instruments for castration include the emasculator and the elastrator (Figure 16.7). (A)

(B)

Figure 16.7  Instruments used for castration. (A) Emasculator is used to sever the spermatic cord with minimal bleeding. (B) Emasculator applying hemostasis. Source: Courtesy of WikiCommons/L Mahin. (C) Elastrator is used to place a rubber band around the neck of the scrotum.

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Figure 16.7  (Continued )

Embryo transfer Feedlot Flushing Free stall Halter Hutch Hybrid Hybrid vigor Inbred Marbling Offal Polled Rendering Rumination Scurs Seed stock Springing Stall Stanchion Standing heat

Collection and transfer of fertilized ova from one female to another. The ova are collected before implantation occurs. Confined area where animals are fed and “fattened up” before going to slaughter. Increase in nutrition to promote ovulation and conception in females and improve semen ­characteristics in males. Stall in which the cow is not tied and is free to move around or lie down. Head restraint for a cow used to guide and tie a cow. Housing area for calves. Offspring that results from the mating of two different breeds. Increased productivity and performance in the first generation of crossbred animals produced by the mating of dissimilar breeds. Offspring produced by inbreeding; the result of the mating of closely related animals. Intermixing of fat and muscle fibers in beef. Non‐edible products from slaughter. An animal that normally has horns but has either had its horns removed or has been born without horns. Use of an animal for by‐products; the melting of fatty tissue. The act of regurgitation, remastication, and reswallowing; chewing cud. Vestigial (underdeveloped) horns not attached to the skull. Pedigree livestock used for breeding purposes. Early signs such as vulvar swelling and relaxation of the ­sacrosciatic which indicate parturition is close. Small compartment to house an animal. Device used to restrain the neck of ruminants for procedures such as milking or administration of medicine (Figure 16.8). Stage of estrus in which the female stands to be mounted by a bull.

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Figure 16.8  Stanchion. Source: Courtesy of shutterstock/polat.

Tailing Tankage

Tattooing Tie‐stall Triple purpose Veal

Restraint method in which the tail is grabbed and raised vertically; also known as tail jacking. Heat‐digested animal residues left over after fat has been rendered in slaughter. Commonly called meat meal, these residues can be used as fertilizer or feed due to their high protein content. Permanent identification method in which ink is introduced via skin punctures. These identification numbers are typically placed inside the pinna on cattle. Stall just large enough for one animal, which is generally tied in by a neck chain. Cattle that can be used for dairy, beef production, and draft. Calves fed only milk to produce tender meat.

Age and Sex Bull Calf Calving Cow Freemartin Heifer Herd Teaser bull

Intact male bovine of breeding age; generally older than one year of age. Bovine less than a year old (Figure 16.9). Giving birth in a bovine (Figure 16.9). Female bovine that has given birth (Figure 16.9). Sterile female that was born as a twin with a male. Female bovine that has never given birth. Group of cattle. Bull used to detect females in heat; also known as a gomer bull.

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(B)

Figure 16.9  (A) Cow with her calf. Source: Courtesy of Amanda Bliss Baca, AAS. (B) Calving. Source: Courtesy of WikiCommons/Basile Morin.

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Bovine Pathology Bovine leukemia virus (BLV, BoLV) Bovine mastitis

Retrovirus in cattle that causes leukocytosis and lymphadenopathy. Inflammation of the mammary glands due to Staphylococcus aureus or other bacteria (Figure 16.10).

(A)

(B)

Figure 16.10  (A) Obtaining samples for bovine mastitis testing. Source: Courtesy of WikiCommons/ Halibutt. (B) Serous exudate from a cow with Escherichia coli mastitis (left) and normal milk for comparison (right). Source: Courtesy of WikiCommons/L Mahin. (C) Gangrenous mastitis. Source: Courtesy of WikiCommons/Mohammad Golkar.

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Figure 16.10  (Continued )

Bovine respiratory disease (BRD) Bovine respiratory syncytial virus (BRSV) Bovine viral diarrhea (BVD) Brucellosis Clostridium Clostridium tetani Coronavirus Hemophilosis Infectious bovine rhinotracheaitis (IBR) Leptospirosis Parainfluenzavirus (PI3) Pasteurellosis Rotavirus Tritrichomoniasis Vibriosis

Disease complex in cattle caused by viral, bacterial, fungal and parasitic infections (Figure 16.11). Commonly called shipping fever. Disease caused by the genus Pneumovirus. Symptoms include dyspnea and pneumonia with a high mortality rate. Disease caused by the genus Pestivirus and manifested in young cattle. Symptoms include scours, stomatitis, and rhinitis. Infection caused by Brucella abortus characterized by ­abortions in late pregnancy. Genus of bacteria which causes various conditions ­depending on the species involved. Bacterium that causes tetanus, characterized by hyperesthesia, convulsions, and eventually death; commonly called lockjaw. Ribonucleic acid (RNA) virus that causes enteritis in calves. Endometritis and purulent cervicitis caused by infection with the bacterium Haemophilus somnus. Herpesvirus infection causing fever, rhinitis, tracheitis, and pneumonia. Infectious disease causing fever, hemolytic anemia, ­jaundice, nephritis, and abortion. Virus causing fever and cough; part of complex etiology of shipping fever. Bacterial infection with Pasteurella multocida which causes hemorrhagic septicemia; Pasteurella haemolytica causes septicemia and respiratory disease. Virus causing scours in young cattle. Infestation of the protozoan Tritrichomonas foetus leading to embryonic death and infertility. Venereal disease of cattle caused by Campylobacter fetus leading to embryonic death and infertility.

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Figure 16.11  Cow with bovine respiratory disease (BRD). Source: Courtesy of WikiCommons/Feed‐Lot Magazine Inc.

Sheep

External Terminology

Sheep are important for their wool and their meat. The skeletal system of sheep is not much different from that of cattle and horses, so we will focus here on external landmarks.

The external landmarks in sheep are very similar to those of cattle. Joints that  have been covered previously are still  labeled, but will not be discussed (Figure 16.12).

(A)

Figure 16.12  (A) External anatomy of sheep. Source: Courtesy of shutterstock/ShaunWilkinson. (B) The absence of upper teeth in sheep. Source: Courtesy of shutterstock/Margo Harrison.

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Rump Sole Switch Teat Toe Udder

The gluteal region; region around the pelvis, hindquarters, and buttocks. Palmar and plantar surfaces of the hoof. Hairy portion at the end of the tail. Nipple of the mammary gland. Cranial aspect of the hoof. Mammary gland.

Ovine Husbandry

Figure 16.12  (Continued )

Brisket

Mass of connective tissue and fat covering the cranial aspect of the chest. Crest Dorsocranial margin of the neck. Dewclaw Accessory claw in ruminants. Flank Side of the body between the ribs and the ilium. Heart girth Circumference of the chest just caudal to the shoulders. Heel Area at the rear of the hoof or claw where horn and skin meet and where the hoof wall becomes the sole. Loin Lumbar region of the back, between the thorax and pelvis. Muzzle Skin, muscles, and fascia of the upper and lower lip and including the nasal bones. Paralumbar Hollow of the flank fossa between the transverse process of the lumbar vertebrae, the last rib, and the thigh muscles. Poll Top of the head; also called the nuchal crest.

The care and management of sheep involves various equipment, housing tools, and techniques not used in small animal medicine. Clip Combing

Crimp Crutching Docking Felting Fleece Lanolin

Mutton Rumping

Removing the wool of sheep; total wool produced by a flock at one shearing. Long‐fibered wool processed in a combing machine that separates longer and shorter fibers and then arranges them. Regular wave formation in wool. Shearing of wool from the perianal region to prevent fly strike (Figure 16.13A). Tail amputation (Figure 16.13B). Property of wool fibers interlocking and forming a compact mass. Wool. Commonly called wool fat or wool grease, this is the fatty substance produced by the sebaceous glands of sheep. Meat obtained from adult sheep. Restraint method in which sheep are placed in a seated position and their front legs are elevated; also known as tipping.

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(A)

(B)

Figure 16.13  Ovine husbandry. (A) Crutching to prevent fly strike. Source: Courtesy of WikiCommons/ Cgoodwin. (B) Rubber band tail docking in lambs. Source: Courtesy of WikiCommons/Julie Anne Workman.

Age and Sex Band Ewe Lamb Lambing Flock Ram Wether Yearling

Large group of range sheep, usually 1000 or more. Intact female sheep (Figure 16.14). Young sheep less than four months of age (Figure 16.14). Giving birth in the ewe. Group of sheep. Intact male sheep. Castrated male sheep. Sheep between one and two years of age.

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Figure 16.14  Ewe with her lambs. Source: Courtesy of shutterstock/Henk Bentlage.

TECH TIP 16.2 Twins? Sheep typically give birth to twins. When they give birth to one lamb, then that lamb is referred to as a singleton.

Goats Goats are raised for their milk, meat, and wool. Most of the terminology that has been discussed under cattle and sheep is also commonly used with goats.

External Terminology The external landmarks in goats are very similar to those of sheep and cattle. Joints that have been previously discussed are still labeled but are not discussed (Figure 16.15).

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Poll Forehead

Shoulder

Back

Rump

Loin

Muzzle Dock

Brisket

Elbow

Stifle

Hock

Knee

Hoof

Dewclaw

Figure 16.15  External goat anatomy. Source: Courtesy of shutterstock/Vasyl Helevachuk.

Brisket Chine Crest Dewclaw Flank Heart girth Heel

Hook Loin Muzzle

Mass of connective tissue and fat covering the cranial aspect of the chest. Thoracic region of the back. Dorsocranial margin of the neck. Accessory claw in ruminants. Side of the body between the ribs and the ilium. Circumference of the chest just caudal to the shoulders. Area at the rear of the hoof or claw where horn and skin meet and where the hoof wall becomes the sole. Bony protrusion of the wing of the ilium dorsolaterally. Lumbar region of the back, between the thorax and pelvis. Skin, muscles, and fascia of the upper and lower lip, including the nasal bones.

Paralumbar fossa

Pins Poll Rump

Sole Switch Teat Toe Udder Wattle

Hollow of the flank between the transverse process of the lumbar vertebrae, the last rib, and the thigh muscles. Bony protrusions of the ischium lateral to the tail base. Top of the head; also called the nuchal crest. The gluteal region; region around the pelvis, hindquarters, and buttocks. Palmar and plantar surfaces of the hoof. Hairy portion at the end of the tail. Nipple of the mammary gland. Cranial aspect of the hoof. Mammary gland. Appendage suspended by the mandibular area (Figure 16.16); also called tassel.

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Figure 16.16  Goat wattle. Source: Courtesy of shutterstock/everst.

Withers

Region of the backline where the neck meets the thorax and where the dorsal margins of the scapula lie just below the skin.

Caprine Husbandry Because most of the ruminant terminology has already been discussed, only new ­terminology is introduced in this section. Cabrito Cashmere Chevon Clip Disbudding

Meat from a young goat. Fine wool from the Kashmiri goat. Meat from an adult goat. Total wool produced from one animal at one shearing. Removal of the immature horns in young ruminants.

Age and Sex Buck Doe Herd Kid Kidding Wether

Intact male goat. Intact female goat. Group of goats (Figure 16.17). Young goat. Giving birth in the doe. Castrated male goat.

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Figure 16.17  Herd of goats including the buck, doe, and kits. Source: Courtesy of shutterstock/Maria Gaellman.

Camelids Camelids are mammals that are members of the camel family. These mammals have two toes and a three‐compartment stomach. Therefore, they are not considered true ruminants; instead, they are

termed pseudoruminants. Their stomach consists of a reticulum, omasum, and abomasum. The alpaca (Figure  16.18) and llama (Figure  16.19) are popular domesticated camelids which are commonly used for their very soft, lanolin‐ free wool.

Figure 16.18  Alpacas. Source: Courtesy of shutterstock/David Kay.

Figure 16.19  Llama. Source: Courtesy of shutterstock/Don Fink.

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Camelid Husbandry

Age and Sex

Because most of ruminant terminology has already been discussed, only new terminology is introduced in this section.

Bull

Banana ears

Cria Gelding Herd Yearling

Berserk male syndrome Fighting teeth Fleece Harem breeding Kush

Spitting

Terminology used to describe the orientation of the ears turning inwards. Aggressive behavior of males that have improperly imprinted on humans. Set of six modified canine and incisor teeth (Figure 16.20). Another name for the wool from a llama. Male is left with the females most of the year. The act of lying in sternal recumbency. Most often used to describe the female lying down in the mating ritual. The spitting of saliva to establish dominance or as a defense mechanism.

Cow

Intact male llama; also called a stallion or herdsire. Intact female llama; also called a dam. Young llama (Figure 16.21). Castrated male llama. Group of llamas. Llama between one and two years of age.

Figure 16.21  Herd of llamas with their cria. Source: Courtesy of Lindsey Steele, AAS.

Commonly Used Cattle Slang

Figure 16.20  Llama teeth. Source: Courtesy of shutterstock/Joy Brown.

In my experience, I have found that the majority of students don’t have large animal exposure. When they begin their clinicals, they hear slang used instead of

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scientific terms which can be confusing to them and often frustrating. The purpose of this new section is to help the beginner become familiar with the more commonly used slang. Brainer Buller

Chronics

Cattle showing symptoms of a neurological problem. Feedlot cattle that others in the pen think are in estrus. These cattle end up being mounted over and over, hence the slang term. Cattle that continue to show symptoms of a disease.

Downer Gummers Heiferettes

Lunger Realizer

Cattle that are recumbent for unknown reasons. Cattle with mastication problems. A female that is less than two years of age that has only had one calf. Typically sent to slaughter and isn’t used as a replacement cow. Cattle showing symptoms of a respiratory problem. Animal that needs to be culled.

Abbreviations Table 16.1  Abbreviations.

Abbreviation

Definition

AI

Artificial insemination

BRD

Bovine respiratory disease

BLV; BoLV

Bovine leukemia virus

BRSV

Bovine respiratory syncytial virus

BVD

Bovine viral diarrhea

ET

Embryo transfer

IBR

Infectious bovine rhinotracheitis

PI3

Parainfluenzavirus 3

Exercises 16-A:  Give the term for the following definitions of structures. 1.  2.  3.  4.  5.  6.  7. 

_____________: Hairy portion at the end of the tail. _____________: Bovine giving birth. _____________: Intact female goat. _____________: Castrated male sheep. _____________: Intermixing of fat and muscle fibers in beef. _____________: Circumference of the chest just caudal to the shoulders. _____________: Group of sheep.

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8.  _____________: Body of the animal after slaughter. 9.  _____________: Another name for the nuchal crest. 10.  _____________: Head restraint for a cow used to guide and tie a cow 16-B:  Define the following terms. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Offal _________________________________________________________ Feedlot _________________________________________________________ Bolus _________________________________________________________ Heifer _________________________________________________________ Lanolin _________________________________________________________ Mutton _________________________________________________________ Wattle _________________________________________________________ Hooks _________________________________________________________ Pins _________________________________________________________ Kid _________________________________________________________

16-C:  Circle the correct term in parentheses: 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

Lumbar region of the back, between the thorax and pelvis. (rump, loin, crest) Accessory claw in ruminants. (dewclaw, dewlap, coffin) Teaser bull. (gomer, herdsire, wether) The melting of fatty tissue. (spitting, rendering, springing) Tail amputation. (crimp, clipping, docking) Instrument to administer bolus to livestock. (boluser, emasculotome, balling gun) Goat meat from an adult goat. (cabrito, chevon, clip) Side of the body between the ribs and the ilium. (flank, brisket, loin) Thoracic region of the back of the goat. (crest, chine, withers) Removal of an animal from a herd. (casting, cull, crimp)

16-D:  Define the following abbreviations. 1.  _________________________: BRSV 2.  _________________________: IBR 3.  _________________________: BVD 4.  _________________________: PI3 5.  _________________________: BLV 6.  _________________________: BRD 7.  _________________________: ET 8.  _________________________: AI 16-E:  Match the following diseases with their causes. 1. ______ Complex in shipping fever A. Brucella abortus 2. ______ Brucellosis B. Coronavirus 3. ______ Hemorrhagic septicemia C. Parainfluenzavirus 4. ______ RNA virus causing enteritis D. Staphylococcus aureus 5. ______ Bovine mastitis E. Pasteurella multocida 16-F:  Give the appropriate term for age and sex for each of the animals shown in Figure 16.22 1–5.

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Figure 16.22  (1) Courtesy of Kristina Vigil, LVT (JnR Farms). (2) Courtesy of Kristina Vigil, LVT (JnR Farms). (3) Courtesy of Cristina Montemayor, CVT. (4) Courtesy of Kristina Vigil, LVT (JnR Farms). (5) Courtesy of WikiCommons/USDA.

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Figure 16.22  (Continued )

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5

Figure 16.22  (Continued ) Answers can be found starting on page 675.

Review Table Fill in the table and refer to Table 16.1 for answers. Table 16.2

Abbreviation AI BRD BLV; BoLV BRSV BVD ET IBR PI3

Definition

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Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

17 Swine

The swine category includes domesticated pigs used for meat and research, pot‐­bellied pigs used as pets, and wild pigs such as the wild boar. Basic anatomy has already been discussed in previous chapters, so this chapter focuses on anatomy, physiology, and husbandry related strictly to swine.

Anatomy The external anatomy of swine is very similar to that of other large animals with just a few changes (Figure 17.1). Dewclaw Flank Ham Loin Poll Rump Snout Teat Toe

Accessory claw in ruminants. Side of the body between the ribs and the ilium. Divided into the fore flank and rear flank. Muscular portion of the upper thigh. Lumbar region of the back between the thorax and pelvis. Top of the head. The gluteal region; region around the pelvis, hindquarters, and buttocks. Upper lip and apex of the nose; also called the rostrum. The bone on the rostral end of the nasal septum of pigs is called the os rostrale or os rostri. Nipple of the mammary gland. Cranial aspect of the hoof.

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Shoulder

Rump Loin

Tail Ham Stifle Hock Declaw

Snout

Elbow Hoof

Jowl

Figure 17.1  External anatomy of the pig. Source: Courtesy of shutterstock/Vasyl Helevachuk.

TECH TIP 17.1  Why Do Pigs Have Curly Tails? There are several theories as to why pigs have curly tails. The most common theory is that tails became curled for protection. Tail biting is a common problem among pigs. So if the tails are curled, they are more difficult to grab. The other theory is that early Chinese farmers specifically bred for curly tails in some pigs. Not all pigs have curly tails. Wild boars and pot‐bellied pigs have straight tails.

Age and Sex

Gilt

Barrow Boar Farrowing

Herd

Castrated, young male pig. Intact male pig. Giving birth in pigs.

Piglet

Female pig that has not yet had a litter of piglets. Group of pigs; also called a drove. Young pig (Figure 17.2).

Figure 17.2  Boar, sow, and piglets. Source: Courtesy of WikiCommons/Alan Fryer.

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Intact female pig (Figure 17.2). Castrated, mature male pig.

Husbandry The care and management of pigs involves various equipment and housing tools not used in small animal medicine. Abbatoir Backfat

Building used for slaughter; also called a slaughterhouse. Thickness of fat along the back of a pig (Figure 17.3).

Cuts of pork

Backat Loin Tenderlo

in

Neck

Boston shoulder Spare ribs

Neck

Picnic shoulder

Belly bacon

Side bacon

Ham

Belly bacon

Jowl

Hocks

Figure 17.3  Meat chart of the pig. Source: Courtesy of shutterstock/Stanil777.

Backfat probe Bacon Boar taint Brimming Casting Creep

Sharp instrument used to measure the thickness of backfat without incising the carcass. Electronic versions of the probe can be used on live animals. Meat from the back and side of a pig (Figure 17.3). Unpleasant odor or flavor from the meat of an adult boar. The word “taint” describes the unpleasant odor or flavor of meat or milk products that go into human consumption. Time of sexual receptivity when the female accepts the male. Method of restraint to pull the pig down to lateral recumbency. Area that only young piglets can access.

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Creep feeding Dung Dunging pattern Ear marking

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Food is placed in an area that only piglets can access. Feces; sometimes called manure or droppings. Animal’s tendency to defecate in certain areas. Also called ear notching; patterned pieces of cartilage punched out as a means of identification (Figure 17.4).

(B)

Figure 17.4  Ear marking. (A) Ear tagging. Source: Courtesy of shutterstock/Dmitry Kalinovsky. (B) Ear notching. Source: Courtesy of shutterstock/gudak.

Farrowing crate

Pipework holding pen large enough to hold the sow, but too narrow to allow movement. Farrowing crates prevent crushing losses of the piglets because they allow the piglets to escape (Figure 17.5). Also called a farrowing pen.

Figure 17.5  Farrowing pen. Source: Courtesy of shutterstock/Edler von Rabenstein.

Chapter 17 Swine

Finish Hog snare Hog tied In‐pig

Degree of fatness short of obesity. Wire loop passed over the hog’s snout and pulled by a person on the other end as a means of restraint. All four feet are tied together so that the pig is unable to stand. Terminology for a pregnant sow.

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Lard Needle teeth

Ringing

Pig fat. Once rendered it can be used for cooking. Common name for the ­deciduous incisors and canines of piglets. These teeth are often trimmed at birth to prevent injury to the sow during nursing. Ring placed in the nose of pigs to deter rooting (Figure 17.6A).

(A)

(B)

Figure 17.6  (A) Ringing. Source: Courtesy of WikiCommons/Richard New Forest. (B) Pigs rooting. Source: Courtesy of WikiCommons/Jim Champion.

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Turning up of the ground using the snout to look for food (Figure 17.6B). Tattoo placed on a pig as a means of identification.

Tusk Wallow

Well‐developed canine tooth in a boar. Area for pigs to rest and cool down; usually contains water or mud (Figure 17.7).

Figure 17.7  Pigs wallowing. Source: Courtesy of WikiCommons/Andrew Smith.

Pathology and Procedures Aujeszky’s disease

Bordetella Clostridium Escherichia coli (E. coli)

Erysipelas Glässer’s disease Haemophilus influenzae Leptospirosis

Herpesvirus causing respiratory, reproductive, and neurological signs. Symptoms in piglets include convulsions and recumbency leading to death. Commonly called pseudorabies or “mad itch.” Bacterium found in the respiratory tract of pigs that can cause atrophic rhinitis in pigs. Bacterium that causes enterotoxemia in pigs. Bacterium causing coliform ­gastroenteritis in piglets characterized by severe diarrhea and death. In adult pigs, this bacterium can cause colibacillosis, which is characterized by metritis and mastitis in sows and diarrhea, edema, ataxia, and death in all pigs. Common infection in pigs causing ­septicemia, skin lesions, ­endocarditis, and arthritis. Disease caused by a species of Haemophilus characterized by ­polyarthritis, pericarditis, and peritonitis. Commonly called swine flu, this disease causes fever, stiffness, recumbency, and dehydration with a high mortality rate. Infectious disease causing abortions, stillbirths, and septicemia in piglets.

Chapter 17 Swine

Mycoplasma hyopneumoniae Parvovirus Pasteurella multocida Proliferative hemorrhagic enteropathy Proliferative ileitis Porcine respiratory and reproductive syndrome (PRRS) Porcine SMEDI virus

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Bacterial infection causing a lethal pneumonia in pigs. Viral infection causing abortions, stillbirths, and infertility. Bacterium causing hemorrhagic septicemia. Acute disease of young pigs causing anemia, dysentery, and hemorrhagic lesions in the distal ileum and proximal colon with a high mortality rate. Ulceration and thickening of the ileum which may lead to perforation and acute peritonitis. Viral infection causing stillbirths, abortions, mummified fetuses, and cyanosis of the ear; commonly called blue‐ear pig disease. In piglets, it causes respiratory disease (Figure 17.8). Enterovirus causing stillborn, mummification, embryonic death, and infertility (SMEDI).

Figure 17.8  Pig with PRRS. Note the blue ears. Source: Courtesy of WikiCommons/Dingar.

Porcine stress syndrome (PSS) Rotavirus Streptococcus suis Transmissible gastroenteritis (TGE)

Acute death due to increased stress caused by shipping, fighting, exercise, and increased environmental temperature. Symptoms prior to death include dyspnea, tremors, stiffness, and hyperthermia. Virus in piglets causing damage to the small intestinal villi, leading to malabsorption and diarrhea. Bacterial infection causing meningitis in pigs. Coronavirus of piglets characterized by vomiting, diarrhea, dehydration, and eventually death.

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Abbreviations Table 17.1  Abbreviations.

Abbreviation

Definition

PRRS

Porcine respiratory and reproductive syndrome

PSS

Porcine stress syndrome

SMEDI

Stillborn, mummification, embryonic death, infertility

TGE

Transmissible gastroenteritis

Exercises 17-A:  Give the term for the following definitions of structures. 1. 2. 3. 4. 5. 6. 7. 8.

________________: Intact female pig. ________________: Muscular portion of the upper thigh. ________________: Female pig that has not yet had a litter of piglets. ________________: Well‐developed canine tooth in a boar. ________________: Intact male pig. ________________: Upper lip and apex of the nose in pigs. ________________: Giving birth in pigs. ________________: Common name for the deciduous incisors and canines of piglets. 9. ________________: Pig fat. 10. ________________: Unpleasant odor or flavor from the meat of an adult boar 17-B:  Define the following terms. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Rooting _____________________________________________________ Abbatoir __________________________________________________ Creep ______________________________________________________ Finish ______________________________________________________ Wallow ____________________________________________________ Farrowing crate ______________________________________________ Brimming ___________________________________________________ Backfat ___________________________________________________ __ Ear marking _________________________________________________ Barrow ___________________________________________________ _

17-C:  Define the following abbreviations. 1. 2. 3. 4.

__________________________: SMEDI __________________________: PRRS __________________________: TGE __________________________: PSS

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17-D:  Match the following diseases with their causes. 1. 2. 3. 4.

__________ Blue‐ear disease __________ Meningitis __________ Pseudorabies __________ Causes polyarthritis, pericarditis, and peritonitis 5. __________ Colibacillosis

A. Aujeszky’s disease B. E. coli C. Glässer’s disease D. PRRS E. Streptococcus suis

Answers can be found starting on page 675.

Review Table Fill in the table and refer to Table 17.1 for answers

Table 17.2

Abbreviation

Definition

PRRS PSS SMEDI TGE

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

18 Exotics

In veterinary medicine, animals such as birds, reptiles, and amphibians are classified as exotics. These animals are more specialized because of their anatomy and physiology. Veterinarians that are able to examine these animals are commonly called “exotic vets.”

Cheek Comb

Crown Forehead

Avian Avian medicine is a broad category which includes birds used as pets such as canaries and parakeets as well as poultry, ratites, and birds of prey. Basic anatomy has been covered in previous chapters so this section will focus on concepts specific to birds (Figure 18.1).

Foreneck

External Anatomy

Lore

Beak Breast Cere

Hard keratin layer that covers the maxilla and mandible. Anterior pectoral region of the bird. Fleshy part above the beak.

TECH TIP 18.1  Sexing Budgerigars The color of the cere is an easy means of sexing budgerigars. Male budgies have a blue cere and female budgies have a light brown or tan cere.

Frontal process

Nape Occiput Orbital ring Rump Throat Wattle

Area of the face below the eyes. Vascular, red cutaneous structure attached in a sagittal plane to the dorsum of the skull of domestic fowl. The top of the head. Portion of the head that is rostral to the eyes. Cranial aspect of the breast where the clavicle is located. Cone‐shaped mass of red vascular tissue that lies across the base of the turkey’s beak; commonly called the snood or nasal comb (Figure 18.14B). Lateral aspect of the face between the eye and rostral aspect of the beak. Back of the neck. Back of the head. Fleshy, unfeathered ring around the eye. Space between the pelvis and tail. Space between the head and chest. Double fold of skin suspended from the mandible in chickens and turkeys.

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Orbital Crown ring

Occiput Nape Ear coverts

Forehead Cere Beak

Shoulder

Bend of wing Mantle

Throat Foreneck

Breast

Figure 18.1  External anatomy of the bird. Source: Courtesy of shutterstock/Khmel Alena.

Feathers A feather is a skin appendage of birds (Figure 18.2). Equivalent to hairs in vertebrates, feathers share similar functions. Feathers are used for: Protection Insulation Flight Mating Nesting

Feathers have waterproof traits and can be used as camouflage in the wild. Feathers can insulate the body when temperatures are low. Certain groups of feathers are used to control flight. Feathers can be used as a display in mating rituals. Females pluck their own feathers to create a nest for their young.

Feathers differ depending on the species of bird, but their basic anatomy and terminology is the same (Figure 18.3). Apterium Barb Barbule Calamus

Area of the bird’s skin carrying no feathers or down. Paired delicate filaments projecting from the main shaft of the feather. Hooked processes that fringe from the edges of the barbs. Proximal hollow shaft, or quill, that inserts into the skin.

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Calamus Barbs

Rachis

Figure 18.2  Anatomy of a feather. Source: Courtesy of shutterstock/MustafaNC.

(A) Alula

Marginal coverts Scapulars

Primary coverts

Primary fight feathers

Secondary Secondary flight coverts feathers

Figure 18.3  (A) The different wing feathers. Source: Courtesy of shutterstock/EcoPrint. (B) Illustration of the different types of feathers and their molting pattern. Source: Courtesy of WikiCommons/Muriel Gottrop. (C) Pin feathers on a lovebird. Source: Courtesy of WikiCommons/Simon Redwood.

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(B) Primary flight feathers Primary coverts

Alula

3 Scapulars

Secondary flight feathers Greater secondary coverts Median secondary coverts Lesser secondary coverts Tertiary feathers

7

2

6

5 1 4

8

Molting pattern of wing feathers

(C)

Figure 18.3  (Continued )

Coverts Down feathers Flight feathers Filoplume Molt Pin feathers Primary feathers Pteryla Rachis Rectrices Remiges

Small feathers that cover other feathers at the base. Soft, fine feathers found underneath the exterior feathers; also called plume. Long, stiff feathers found on the wings and tail to enable flight. Hair‐like feathers that grow along down feathers. The shedding and replacement of old feathers with new ones. Developing feathers with a blood supply through them; they are commonly called blood feathers. Mature feathers lack a blood supply and are in essence dead feathers. After becoming worn, they eventually fall off. Flight feathers connected to the metacarpus and phalanges of the wing. These feathers are responsible for thrust. Feather tracts on the skin of birds. The distal shaft of a feather. Flight feathers of the tail. Flight feathers of the wing.

Chapter 18 Exotics

Secondary feathers Shaft Tertiary feathers Uropygial gland

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Short, wide flight feathers connected to the ulna; used for lift. Central part of the feather. Short feathers connected to the humerus and used to protect the primaries and secondaries. Tertiary feathers are not considered true flight feathers. Bi‐lobed sebaceous gland at the base of the tail that secretes an oil to waterproof feathers; commonly called the preen gland.

Skeletal System (Figures 18.4 and 18.5)

Nostrils

Olfactory foramen

Maxilla

Cranium Parietal bone

Mandible Optic foramen

Atlas Axis

Cervical vertebrae

Thoracic vertebrae Ribs Scapula

Pelvic girdle

Humerus Clavicle

Caudal vertebrae

Radius Ulna Metacarpus Pygostyle Femur Keel bone

Tibiotarsal bone Fibula Tarsometatarsal bone

Phalanges

Figure 18.4  Skeletal system of the bird.

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Columella

Bony structure between the eardrum and perilymph of the inner ear. This structure is equivalent to the ossicles in mammals. Bone of the shoulder braced against the sternum. Commonly called the wishbone, this bone is the fusion of two clavicles. Commonly called the breastbone, this is the large surface of the bird’s sternum. Bony termination of the vertebral column in birds. Also known as the rump post, this is where the tail feathers attach. Fused lumbar and sacral vertebrae in birds. Fused metatarsal and tarsal bones. Fused tibia and tarsal bones.

Coracoid Furcula Keel

Pygostyle

Synsacrum Tarso­metatarsus Tibiotarsus

Figure 18.5  Cross‐section of a chicken skeleton. Source: Courtesy of shutterstock/liubomir.

Internal Anatomy The body systems of birds have much in common with other vertebrates (Figure 18.6). This section focuses on the structures specific to the bird’s organ systems.

Eye Beak

Spine Lungs

Kidney

Ovary

Trachea Esophagus Crop Heart Spleen

Oviduct

Liver

Cloaca

Gizzard Intestine Figure 18.6  Internal anatomy of the chicken. Source: Courtesy of shutterstock/BlueRingMedia.

Chapter 18 Exotics

Gastrointestinal System Cloaca

Common passage for fecal, urinary, and reproductive discharge in birds and lower vertebrates. Crop Esophageal pouch near the throat to store food temporarily. Droppings Term used for the combination of evacuated urine and feces. Proventriculus Elongated, spindle‐shaped, glandular stomach of birds. Vent External opening of the cloaca. Ventriculus Stomach of birds. Also called the gizzard. Respiratory Tract Air sacs

Choana

Parabronchi

Syrinx

Thin‐walled sacs found in the respiratory tract and bones of birds. Air sacs in the respiratory tract connect to small bronchi in the lungs. The air sacs in bones help make them hollow to allow for gliding in flight (Figure 18.7). Paired openings between the nasal cavity and nasopharynx (Figure 18.8). Tertiary bronchi; tiny passages where gas exchange occurs. Birds lack alveoli. Vocal organ in birds at the base of the trachea that produces sound.

Reproductive System (Figure 18.9) Infundibulum Funnel‐shaped structure at the top of the oviduct which captures the ova after ovulation.

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Isthmus

Short, narrower portion of the oviduct that is farthest from the ovary. The function of this passage is to add the shell membranes. Magnum Mid‐portion of the oviduct known as the albumen‐ secreting zone. Albumen is the white of the egg. Shell Caudal portion of the uterus gland where the egg is held while the shell is produced. Sperm “Packages” in the infundibnests ulum where sperm is kept until it can fertilize the egg when released from the ovary; also called sperm tubules or sperm glands. Urodeum Portion of the cloaca in which the urogenital system opens. Vagina Portion of the reproductive tract in which the egg passes into the cloaca.

Egg Terminology (Figure 18.10) Albumen The white of the egg surrounding the yolk and surrounded by the shell. Chalaza Strands of albumen that suspend the yolk from the poles of the egg. TECH TIP 18.2  Albumen or Albumin? Watch your spelling on these two terms. Just one letter can completely change the meaning of the term. As a reminder, albumin is the plasma protein that helps to maintain blood volume. Albumen with an “e” is the white portion of a bird’s egg.

TECH TIP 18.3  How is an Egg Laid? While in the shell gland, the egg is turned so that it is passed with the blunt end first.

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(A) Bones showing signs of connection to air sac tissue

Exhalation pathway Lung Posterior air sacs

Anterior air sacs

(B) Humeral diverticulum of the clavicular air sac Paranasal sinus

Lung Abdominal Air sac Paratympanic sinus Trachea Cervical air sac Clavicular air sac Anterior thoracic air sac

Posterior thoracic air sac

Figure 18.7  (A) Air sacs of the bird and their relation to other anatomy. Source: Courtesy of WikiCommons/National Science Foundation. (B) The respiratory system of birds. Source: Courtesy of WikiCommons/C. Abraczinskas.

Hatch Incubation Yolk

Term used for the emergence from an egg. Development of an embryo inside an egg. The yellow portion of the egg where nutrients and antibodies are stored for the developing embryo.

Choana

Figure 18.9  Reproductive system of a hen: (1) infundibulum, (2) magnum, (3) isthmus, (4) uterus, (5) vagina with egg inside. Source: Courtesy of WikiCommons/Uwe Gille.

Figure 18.8  Choana in an ostrich. Source: Courtesy of shutterstock/KarSol.

(A) Thick albumen

Germinal disk Thin albumen

Eggshell

Yolk

Cuticula Chalaza Air cell

(B) Allantoic fluid

Yolk

Albumen Amniotic liquid

Embryo Air cell

Eggshell

Figure 18.10  (A) Anatomy of an egg. Source: Courtesy of shutterstock/Designua. (B) Anatomy of an egg containing an embryo. Source: Courtesy of shutterstock/Designua.

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Age, Sex, and Type Anseriformes

Clutch Columbiformes

Order of birds that includes ducks, geese, and swans; commonly called Anserines (Figure 8.14A). Group of eggs. Order of birds with short beaks, short legs, small heads, and stout bodies. Examples include pigeons and doves (Figure 18.11).

Fledgling Hatchling Passeriformes

Poultry

A young bird whose wing feathers have just come in (Figure 18.12). Young bird that has recently emerged from the egg (Figure 18.12). Order of perching birds including canaries, finches, and sparrows (Figure 18.11). Farmed, domesticated birds such as fowl, turkey, ducks, and geese (Figures 18.13).

(A)

(B)

(C)

Figure 18.11  (A) Pigeons are an example of Columbiformes. Source: Courtesy of shutterstock/Denis Omelchenko. (B) Canaries are an example of Passeriformes. Source: Courtesy of shutterstock/Eric Isselée. (C) Budgies are an example of Psittacines. Source: Courtesy of shutterstock/Jagodka.

(A)

(B)

(C)

Figure 18.12  Stages of development. (A) Sulfur Crested Cockatoo hatchling, four days old. (B) Sulfur Crested Cockatoo fledgling, 35 days old. (C) Sulfur Crested Cockatoo, eight weeks old. Source: Courtesy of shutterstock/Eric Isselée.

(A)

(B)

(C)

Figure 18.13  Poultry. (A) Rooster. (B) Hen. (C) Chicks. Source: Courtesy of Kristina Vigil, LVT (JnR Farms).

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(A)

(B)

(C)

Figure 18.14  (A) A family of ducks. Source: Courtesy of shutterstock/Kirychun Viktar. (B) Turkey close‐up. Note the snood below the beak. Source: Courtesy of shutterstock/Double Brow Imagery. (C) Ostrich. Source: Courtesy of shutterstock/Joy Brown.

Chicken Broiler

Brood

Young male or female chicken about eight weeks of age and weighing 1.5 kg. Group of young birds produced from one hatching.

Chick Cockerel Capon Flock Hen Layer Poult

Young chicken. Young male chicken. Castrated male fowl. Group of chickens. Intact female chicken. Commercial fowl that is laying eggs. Young chicken.

Chapter 18 Exotics

Pullet Rooster Duck Drake Duck Duckling Flock Goose Gander Goose Gosling Gaggle Turkey Flock Hen Poult Tom Psittacine

Chick Cock Flock Hen Ratite

Chick Flock Hen Rooster

Young female chicken. Intact male chicken; also called cock. Intact male duck. Intact female duck. Young duck. Group of ducks. Intact male goose. Intact female goose. Young goose. Group of geese. Group of turkeys. Intact female turkey. Young turkey. Intact male turkey. Common name used for birds in the order Psittaciformes such as parrots, macaws, cockatoos, conures, lovebirds, parakeets, cockatiels, and budgies. Young psittacine. Intact male psittacine. Group of psittacines. Intact female psittacine. Group of running birds with a flat, raft‐like sternum and strong muscular legs. These are flightless birds due to their lack of a keel bone. Examples include the ostrich (Figure 18.14C), emu, rhea, and kiwi. Young ratite. Group of ratites. Intact female ratite. Intact male ratite.

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Pathology and Procedures Care and management depends on the type of birds involved. The following terms are commonly used in avian husbandry. Beak trim

In pet birds such as psitticines, this is a procedure using a dremel to trim the tip of the beak to ensure proper alignment. In poultry, special blades and cautery are used to trim beaks to prevent cannibalism. Egg Term used to describe the bound inability to pass an egg. Feather Symptom that occurs due to picking disease or stress in which the bird removes its own feathers; also known as feather plucking or depluming (Figure 18.15).

Figure 18.15  Feather picking in an African Gray. Source: Courtesy of shutterstock/Michelle D. Milliman.

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Figure 18.16  Budgie preening. Source: Courtesy of WikiCommons/Slipperymonkey44.

Flighted Term used for birds with the ability to fly; often used to describe birds that need their wings trimmed. Hand‐ Commonly used term for pet raised birds raised by humans from birth. Perch This term can be used as a noun or a verb. A perch is a stick that can be placed in a cage for the bird to stand or rest upon. Perching is the act of the bird resting on the stick. An inability to perch can be an indication of sickness. Preen Term commonly used to describe a bird grooming itself, which includes cleaning its feathers (Figure 18.16). Wing Procedure in which wing trim feathers are clipped to prevent flight.

Reptiles Reptiles are vertebrates that can be found living in water or on land. They have lungs with which to breathe air, a heart with three chambers – two atria and one

ventricle  –  and their bodies are covered with horny scales. Animals in the class Reptilia are ectotherms, which means their body temperature varies with that of their environment. Depending on the species of reptile, they may or may not have legs. Those with legs have short legs which are strictly used for crawling. There are three notable subgroups of reptiles: Squamata, Chelonia, and Crocodilia (Figure 18.17). Animals in the order Squamata have scaly bodies and are capable of expanding their mouths to ingest large prey. Examples of animals in this order include snakes and lizards. Because of the varieties of snakes and lizards, this is one of the largest subgroups of reptiles. Chelonia is an order of reptiles known for their tough, outer shell. Examples include turtles, sea turtles, tortoises, and terrapins. Members of the order Crocodilia include the crocodile, alligator, and caiman. Reproduction varies depending on the type of reptile. Some are oviparous (lay eggs), such as turtles, whereas others are ovoviviparous (form eggs that hatch and birth live young), such as some lizards.

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(B)

(A)

(C)

(D)

Figure 18.17  (A) Ball python. Source: Courtesy of shutterstock/Anita Patterson Peppers. (B) Bearded Dragon. Source: Courtesy of WikiCommons/Vicki Nunn. (C) Pond terrapin turtle. Source: Courtesy of shutterstock/Olga Popova. (D) Alligator. Source: Courtesy of shutterstock/AlexVirid.

Amphibians Like reptiles, amphibians are ectotherms. Unlike reptiles, amphibians lack scales and instead have a smooth, moist body with which to absorb water, aid in breathing, and escape predators. In the earliest developmental stages, amphibians live in water and breathe through their gills. When the young mature, they undergo a developmental change (A)

in which they acquire lungs with which to breathe air on land. Once mature, amphibians may live on land or in water. Like reptiles, there are three orders of note: Anura, Caudata, and Gymnophiona (Figure 18.18). Amphibians in the order Anura lack tails, have large eyes, and have long hindlimbs, for example frogs and toads. The order Caudata consists of newts and salamanders, which have elongated bodies and tails.

(B)

Figure 18.18  (A) Frog. Source: Courtesy of shutterstock/kornik. (B) Salamander. Source: Courtesy of shutterstock/Arun Roisri.

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Finally, the order Gymnophiona contains worm‐like amphibians called caecilians.

These amphibians take on a snake‐like appearance because they lack legs.

Amphibian and Reptile Terminology Bask Carapace

To lie in the sun or under a heat lamp to absorb the heat. Dorsal aspect of the turtle’s shell (Figure 18.19).

TECH TIP 18.4  Can Turtles Crawl Out of Their Shell? The shell of the turtle is actually an extension of its ribs and vertebrae and therefore it would be impossible for a turtle to crawl out of its shell.

Clutch Dysecdysis Ecdysis Ectotherm

Group of eggs (Figure 18.20). Difficult shedding of skin (Figure 18.20C). Shedding of the external layer of skin (Figure 18.20B). Animal that is unable to regulate its own body temperature. Commonly called cold‐blooded animals, ectotherms require the external environment to regulate their body temperature. Also called poikilothermic.

(A)

(B)

Bridge

Humeral Pectoral Abdominal Femoral Anal

Nuchal

Supracauda

(C)

Figure 18.19  (A) Carapace of the turtle. Source: Courtesy of shutterstock/kohy. (B) Plastron of the turtle. Source: Courtesy of shutterstock/ Eric Isselée. (C) Turtle skeleton. Source: Courtesy of shutterstock/liubomir.

(A)

(B)

(C)

Figure 18.20  (A) Corn snake clutch about to hatch. Source: Courtesy of WikiCommons/zakirrm. (B) Snake shedding its skin. Source: Courtesy of Kylee Jewell, LVT. (C) Dysecdysis. Source: Courtesy of shutterstock/J.L. Levy. (D) Shed snake skin. Source: Courtesy of Megan Dujardin. (E) Pits on a pit viper. Source: Courtesy of WikiCommons/Anurag nashirabadkar.

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(D)

(E)

Figure 18.20  (Continued)

Envenomation Impaction Metabolic bone disease Metamorphosis Mitotic parthenogenesis

The introduction of venom from a venomous animal. Inability to pass waste from the intestines due to a build‐up of foreign material, such as sand in herbivores. Loss of bone tissue leading to malformations. Commonly seen in reptiles due to malnutrition. Transition from one developmental stage to another such as a tadpole to a frog. The ability of a female to reproduce without a male for the survival of its species.

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Figure 18.21  Collection of snake venom for production of antivenom. Source: Courtesy of shutterstock/ LittleStocker.

Pits Plastron Scute Spectacle Substrate Venom Venom gland

Organs found on some snakes to sense warm‐blooded prey; also used for thermoregulation (Figure 18.20E). The ventral aspect of the turtle’s shell (Figure 18.19). Thick epidermal plate found on the heads of snakes or shells of turtles. Commonly called the eyecap, this is a transparent covering over the cornea of snakes. The spectacle is required for protection because snakes lack eyelids. The spectacle is shed during ecdysis. General term used to describe the material used on the bottom of a cage or tank. Poison secreted by an animal or insect (Figure 18.21). Salivary gland found in some snakes that produces venom.

Exercises 18-A:  Give the term for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

____________: Shedding and replacement of old feathers with new ones. ____________: External opening of the cloaca. ____________: Stomach of birds. ____________: Esophageal pouch near the throat of birds to temporarily store food. ____________: Intact male turkey. ____________: Order consisting of pigeons and doves. ____________: Developing feather with a blood supply. ____________: White portion of an egg. ____________: Fleshy part above the beak of birds. ___________: The breastbone of birds.

18-B:  Define the following terms. 1.  Clutch ________________________________________________________ 2.  Carapace ______________________________________________________

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3.  4.  5.  6.  7.  8.  9.  10. 

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Ectotherm _____________________________________________________ Urodeum_______________________________________________________ Syrinx _________________________________________________________ Primary feathers ________________________________________________ Cloaca ________________________________________________________ Yolk __________________________________________________________ Egg bound _____________________________________________________ Ecdysis ________________________________________________________

18-C:  Circle the correct term in parentheses: 1.  2.  3.  4.  5.  6.  7.  8. 

Small feathers that cover other feathers at the base. (barb, coverts, down) Flight feathers of the wing. (rachis, rectrices, remiges) Eyecap of a snake. (pit, scute, spectacle) Material used on the bottom of a cage or tank. (scute, substrate, syrinx) Bird cleaning its feathers. (bask, chalaza, preen) A young bird whose wing feathers have just come in. (chick, fledgling, hatchling) The wishbone of a bird. (coracoid, furcula, pygostyle) Mid‐portion of the oviduct known as the albumen‐secreting zone. (isthmus, magnum, urodeum) 9.  Group of birds including parrots and macaws. (aniserines, columbiformes, psittacines) 10.  Tertiary bronchi that are tiny passages where gas exchange occurs. (apterium, choana, parabronchi) 18-D:  List five functions of feathers. 1.  2.  3.  4.  5. 

______________________________ ______________________________ ______________________________ ______________________________ ______________________________

Answers can be found starting on page 675.

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning ­materials for this chapter: • • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Unlabeled diagrams for anatomy practice Word search puzzle

C h a p t e r

19

Laboratory Animals

Laboratory animals are groups of animals used in laboratories for research. The category of laboratory animals is a broad one and can include anything from mice to nonhuman primates. This chapter focuses on the most commonly used laboratory animals. These animals are becoming more popular as pets and can be grouped into a category called pocket pets. Because these animals are not the typical dog and cat pets, they may also be considered exotic animals in some veterinary practices.

Rodents Animals that are members of the order Rodentia include mice, rats, gerbils, hamsters, guinea pigs, and chinchillas. Rodents are a popular choice for research because they have short gestation periods and are therefore easy to observe for several generations. Anatomically, all rodents share a similar dentition in that they generally lack canines and premolars. Rodents have a pair of upper and lower incisors which are used for gnawing and for defense. The number of molars varies depending on species.

Rats Rats have pointed snouts and a long, almost hairless tail (Figure  19.1). They are nocturnal omnivores that originated in Asia. Throughout history these animals have been associated as disease‐carrying pests causing such outbreaks as bubonic plague. The plague is actually caused by a flea, but because rats carried the fleas the outbreaks were associated with the rat population. Wild rats are carriers of many zoonotic diseases; however, pet rats are safe and typically disease‐free. While commonly used in research facilities, rats are also becoming popular as pets. The most common species today is the black rat, Rattus rattus, and the brown rat, Rattus norvegicus. Figure 19.2 shows the method of sexing rats using their anogenital distance, the distance between their anus and genitals.

Mice Like rats, mice are thought to have originated in Asia and have often been considered disease‐carrying pests. However, like the rat, the mouse is a popular pet and is commonly used in research. Anatomically,

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(A)

(B)

Figure 19.1  (A) Black and white rat. (B) Hairless rat. Source: Courtesy of Shutterstock.com/Utekhina Anna.

(A)

(B)

Figure 19.2  Sexing rats. (A) Male rat. (B) Female rat.

the mouse and rat are similar with their pointed snouts and almost hairless tails. The internal anatomy is identical between the two species. The difference is that the mouse is much smaller. Mice have very

poor eyesight and instead use their hearing and sense of smell to find food and detect predators. Mice are nocturnal omnivores that do best living in colonies of one male and multiple females. The most commonly

Chapter 19  Laboratory Animals

seen species is Mus musculus, or the house mouse. Figure 19.5 shows the anogenital difference between the male and female mouse.

Dam Pup Pinkies Sire

Intact female rat or mouse (Figure 19.3). Baby rat or mouse (Figure 19.3). Newborn mice without fur (Figure 19.4). Intact male rat or mouse (Figure 19.5).

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Gerbils Gerbils are mouse‐like animals with long tufted tails which they use for balance while standing (Figure 19.6). Their movement and behavior are often described as kangaroo‐ like. Gerbils are diurnal omnivores thought to have originated in China. They are very social and easy to raise, which is why they are more popular than mice and rats as pets. A common problem with gerbils is tail sloughing, which results from improper restraint. Often new owners or children grab these animals by their tail and the tail breaks off when the gerbil tries to escape. The most common species of gerbil today is the Mongolian gerbil, which comes in a variety of colors. Sexing of gerbils is demonstrated in Figure 19.7. TECH TIP 19.1  Do You Know?

Figure 19.3  Laboratory mice. A dam with her pups. Source: Courtesy of shutterstock/anyaivanova.

Gerbils and ferrets are illegal in the state of California. Several states and countries have restrictions on the ownership of ferrets. These laws were put in place due to concerns about the animal escaping into the wild and altering the ecosystem.

Figure 19.4  Pinkie mice. Source: Courtesy of shutterstock.com/Jaroslav74.

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(A)

(B)

Figure 19.5  Sexing mice. (A) Male mouse. (B) Female mouse.

Figure 19.6  Gerbil. Source: Courtesy of shutterstock.com/Anna Kucherova.

Hamsters Hamsters are popular as pets because of their cute teddy bear‐like appearance (Figure  19.8). A variation of the hamster, the dwarf hamster, has risen in popularity because of its smaller size; ­ however, it isn’t as social as its larger

counterparts. In general, hamsters are nocturnal omnivores with pronounced cheek pouches to temporarily store food. Unlike the previous rodents discussed, hamsters have a short, stubby tail and prefer to live alone. Figure  19.9 shows the differences between the male and female when sexing.

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Figure 19.7  Sexing gerbils. (A) Male gerbil. (B) Female gerbil.

Figure 19.8  Hamsters. Source: Courtesy of shutterstock/ADA_photo and shutterstock/AlexandreNunes.

Guinea Pigs Guinea pigs are popular as pets because of their easy‐going nature (Figure  19.10). Commonly called cavies, guinea pigs have short, stout bodies and short, stubby legs.

These animals originated in South America, with the most common species being Cavia porcellus. Compared to the 20‐day gestation period of mice, guinea pigs have a much longer gestation period of 63 days. Because of their longer gestation period,

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Figure 19.9  Sexing hamsters. (A) Male hamster. (B) Female hamster.

the newborns are much larger at birth, which can create complications for the expectant female. Guinea pigs are well known for their inability to synthesize vitamin C like other mammals. Owners must supplement their diets with food rich in vitamin C to compensate for this. Boar Herd

Intact male guinea pig (Figure 19.11A). Group of guinea pigs.

Pup Sow

Young guinea pig (Figure 19.12). Intact female guinea pig (Figure 19.11B).

Chinchillas Chinchillas are squirrel‐like rodents well  known for their thick silver fur (Figure  19.13). Originating from South America, the most commonly seen species today is Chinchilla laniger. They are nocturnal omnivores with an unusual

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Figure 19.10  (A) Abyssinian, American/English and Skinny guinea pigs. Source: Courtesy of WikiCommons/Erin Koski. (B) Peruvian guinea pig. Source: Courtesy of Annette Temple, BS, CVT.

dentition compared to the previous rodents discussed. Chinchillas have premolars. Several species of Chinchilla have been extinct for years because they were hunted for their fur. Chinchillas are known for their requirement of a dust bath. These animals can’t get wet because their thick fur makes it impossible to get dry. If they get wet, the water can become trapped between their fur and skin, which can lead to fungal infections. To clean their fur, they are given a dust bath with dust from lava rocks or pumice. The dust absorbs the dirt and oils that accumulate on their fur and make it silky. It is also believed that the

“dusting” is relaxing to the animal and helps to alleviate stress (Figure 19.14). Boar Herd Kit Sow

Intact male chinchilla. Group of chinchillas. Young chinchilla. Intact female chinchilla.

Ferrets Ferrets are nocturnal carnivores with elongated, thin bodies that allow them to crawl into very small spaces (Figure 19.15). This is why ferrets were historically used for hunting small animals such as moles, rabbits, and rodents. Today, ferrets are used

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Figure 19.11  Sexing guinea pigs. (A) Male guinea pig. (B) Female guinea pig.

in research, as pets, and for hunting pests in certain countries. Like many rodents, ferrets have poor eyesight, especially in the daylight. Instead they use their keen senses of smell and hearing to find food and sense danger. Ferrets have all four types of teeth and scent glands similar to those of a skunk. When startled, ferrets can release their anal glands to detract enemies, so it is common for pet ferrets to be de‐scented when purchased. De‐scenting is the removal of the anal glands, which many believe to

be inhumane. Even if de‐scented, ferrets tend to have a musky smell. Common health issues in ferrets include insulinomas and canine distemper virus. Gib Hob Jill Kit Kindling Sprite

Neutered male ferret. Intact male ferret (Figure 19.17A). Intact female ferret (Figure 19.17B). Young ferret (Figure 19.16B). Giving birth to ferrets (Figure 19.16A). Spayed female ferret.

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Figure 19.12  (A) Sow with her pup. Source: Courtesy of Kylee Jewell, LVT. (B) Guinea pig pups six hours old. Source: Courtesy of Amy Johnson, BS, AAS, LVT, RLATG.

Figure 19.13  Chinchilla sow with her kit. Source: Courtesy of shutterstock.com/Marina Jay.

Figure 19.14  Chinchillas bathing in sand. Source: Courtesy of shutterstock/Irina oxilixo Danilova.

Figure 19.15  The scruff and hang technique used to restrain ferrets. This restraint technique can help relax the ferret for various procedures. Source: Courtesy of shutterstock/IrinaK.

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Figure 19.16  (A) Newborn ferrets from C‐section. Source: Courtesy of shutterstock/Radka Tesarova. (B) Kit. Source: Courtesy of shutterstock/Jagodka.

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Figure 19.17  Sexing ferrets. (A) Male ferret. (B) Female ferret.

Rabbits

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Rabbits are members of the order Lagomorpha, so they are commonly called lagomorphs. These animals are used in research, as pets, as food, and for their fur. While rabbits vary in size, their basic anatomy is the same (Figures  19.18 and 19.19). Their keen eyesight and hearing allow them to detect enemies and their powerful hindlegs allow them to run fast or kick their predators. Care must be taken when restraining these animals because if done improperly, both the rabbit and restrainer can be hurt. Rabbits are diurnal herbivores lacking canine teeth. Instead, they have two pairs of upper incisors. They are hindgut digesters with the bulk of digestion taking place in their large cecum. Therefore, nutrients may not be completely absorbed by the time the rabbit defecates. To compensate for this, rabbits are coprophagic so that they may re‐ingest nutrients that

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Figure 19.18  (A) A doe with her kits. Source: Courtesy of shutterstock/Anikakodydkova. (B) The digestive system of the rabbit. Note the large cecum. Source: Courtesy of shutterstock/blamb.

Esophagus Stomach

Cecal appendix Small intestine Ileocecal valve

Proximal colon

Anus

Cecum Fusus coli Distal colon

Rectum

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Figure 19.19  Breeds of rabbits. (A) Giant. Source: Courtesy of Brittany Carnes, CVT. (B) Lop‐eared. Source: Courtesy of Elizabeth Wallace, BS, AAS. (C) Mini. Source: Courtesy of Annette Temple, BS, CVT. (D) Dwarf. Source: Courtesy of WikiCommons/shogun1192.

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had not been absorbed the first time. There are two types of feces from rabbits: feces still rich in nutrients and feces with processed roughage. Rabbits are unable to vomit, which can lead to serious health issues if foreign material such as fur is ingested.

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Buck Doe Herd Lapin Kit Kindling

Intact male rabbit (Figure 19.21). Intact female rabbit (Figure 19.21). Group of rabbits. Neutered male rabbit. Young rabbit (Figure 19.20). Giving birth to rabbits.

Figure 19.20  Newborn rabbits. Source: Courtesy of shutterstock/Marina Jay.

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Figure 19.21  Sexing rabbits. (A) Male rabbit. (B) Female rabbit.

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TECH TIP 19.2  Rabbits vs. Hares Rabbits and hares are both lagomorphs, but they are different species. Hares are much larger and considered wild compared to species of rabbits that have been domesticated. Rabbits live in burrows and give birth to blind, hairless young (see Figure 19.20). Hares (Figure 19.22) live in nests above ground and give birth to young with hair and the ability to see. It is believed that because hares live above ground, it is necessary that their young can fend for themselves soon after birth.

Figure 19.22  Wild Hare. Source: Courtesy of shutterstock/Borislav Borisov.

Professional Organizations and Laws In 1966, the United States passed the Animal Welfare Act to ensure the humane treatment and care of animals used in research facilities.

The United States Department of Agriculture inspects these facilities each year to ensure that the facilities meet or exceed the standards of these laws. The following are associations and laws that are in place to protect animals used in research facilities.

AAALAC Association for Assessment and Accreditation of Laboratory Animal Care. This is a private, nonprofit organization which facilities may voluntarily join to show that they treat animals humanely and exceed the standards set by laws. AAALAC inspects and accredits these organizations. AALAS American Association for Laboratory Animal Science. This organization is a membership program for laboratory professionals to communicate and find educational materials. AALAS certifies personnel in the laboratory animal field and provides materials for laboratory professionals. ACLAM American College of Laboratory Animal Medicine. This is a college that certifies licensed veterinarians in the laboratory animal field after they meet training requirements and take an exam. The college ensures the humane treatment of laboratory animals through their certification process.

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APHIS AWA FDA IACUC NIH PHS USDA

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Animal and Plant Health Inspection Service. Agency of the United States Department of Agriculture which protects the health and well‐being of plants and animals used in research. Animal Welfare Act. Law passed by the United States to ensure the humane treatment and care of animals used in research facilities. APHIS and the USDA ensure that the laws are followed by research facilities. Food and Drug Administration. Agency of the United States Department of Agriculture which protects the public through the inspection of food. Institutional Animal Care and Use Committee. Committee created by the research facility to ensure state requirements are followed. National Institutes of Health. Agency of the United States Department of Agriculture to which the IACUC reports. NIH sets up the policies for the IACUC to follow. Public Health Service. Division of the United States Department of Health which was created to protect, promote, and advance the health and safety of the American people. United States Department of Agriculture. Government department that inspects research facilities each year to ensure that facilities meet or exceed the standards of the laws

Related Terms The field of laboratory animal science is so broad that not all terms can be discussed here. This section introduces basic laboratory animal terminology. Axenic Contact bedding Crepuscular Ecological typing Genetic typing Genotype Gnotobiotic

Hybrid Hystricomorpha Inbred Lagomorpha Murine Myomorpha Noncontact bedding Outbred

Animal that is totally free of infection with microorganisms. Bedding that an animal is in direct contact with or will touch. Animal that is most active at dusk and/or dawn. Classifies an animal based on microbiological status. Examples include axenic, gnotobiotic, or specific‐pathogen free. Classifies an animal based on genetics. Examples include inbred, outbred, or transgenic. The genetic composition an organism carries. Animals whose microflora and microfauna are known in complete detail. Microflora are microscopic organisms of the bacterial, viral, and fungal kingdoms. Microfauna are microscopic organisms of the Animalia and Protista kingdoms including, but not limited to, protozoans and nematodes (worms). Offspring from parents of different strains, varieties, or species. Suborder of rodents consisting of guinea pigs, chinchillas, and porcupines. Strains resulting from the mating of closely related animals. Taxonomic order of rabbits. Pertaining to mice and rats. Suborder of rodents consisting of gerbils, hamsters, mice, and rats. Bedding that the animal will not touch; bedding in trays under the cage to help absorb waste. Stock from unrelated parents; also known as random bred.

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Outward appearance of an animal including anatomical, physiological, and behavioral characteristics. Ancestor or parent. Descendants or offspring. To reproduce. Suborder of rodents consisting of squirrels. Disease caused by a deficiency of vitamin C. An animal with a normal bacterial flora. The bacterial agents may not be known, but the animal is free of specific bacterial agents. The animal is guaranteed to be free of specific pathogens. Outbred animal lines and genetics. Inbred animal lines and genetics. An animal that has been genetically manipulated to contain DNA from another animal.

Abbreviations Table 19.1  Abbreviations.

Abbreviation

Definition

AAALAC

Association for Assessment and Accreditation of Laboratory Animal Care.

AALAS

American Association for Laboratory Animal Science.

ACLAM

American College of Laboratory Animal Medicine.

APHIS

Animal and Plant Health Inspection Service.

AWA

Animal Welfare Act.

FDA

Food and Drug Administration.

IACUC

Institutional Animal Care and Use Committee.

NIH

National Institutes of Health.

PHS

Public Health Service.

USDA

United States Department of Agriculture.

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Exercises 19–A:  Give the term for the following definitions. 1.  2.  3.  4.  5.  6.  7.  8.  9.  10. 

_________________________: Intact male ferret. _________________________: Young rabbit. _________________________: Pertaining to mice and rats. _________________________: Young guinea pig. _________________________: Animal totally free of infection. _________________________: To reproduce. _________________________: Disease due to vitamin C deficiency. _________________________: Animal most active at dusk or dawn. _________________________: Offspring. _________________________: Stock from unrelated parents.

19-B:  Define the following terms. 1.  2.  3.  4.  5. 

Hybrid ______________________________________________ Stock ________________________________________________ Transgenic ____________________________________________ Gnotobiotic ___________________________________________ Lapin ________________________________________________

19–C:  Define the following abbreviations. 1. 2. 3. 4. 5.

__________________: IACUC __________________: USDA __________________: NIH __________________: AALAS __________________: APHIS

6. 7. 8. 9. 10.

__________________: AWA __________________: FDA __________________: PHS __________________: ACLAM __________________: AAALAC

19–D:  Match the following animals with their taxonomic groups. 1.  2.  3.  4. 

_____ Rabbits _____ Squirrels _____ Guinea pigs, chinchillas, porcupines _____ Gerbils, hamsters, mice, rats

Answers can be found starting on page 675.

A. Hystricomorpha B. Lagomorpha C. Myomorpha D. Sciuromorpha

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Review Table Fill in the table and refer to Table 19.1 for answers Table 19.2

Abbreviation

Definition

AAALAC AALAS ACLAM APHIS AWA FDA IACUC NIH PHS USDA

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning ­materials for this chapter: • • • • • • •

A crossword puzzle Flashcards Audio clips to show how to pronounce terms Case studies Review questions The figures from the chapter in PowerPoint Word search puzzle

C h a p t e r

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Case Studies

This chapter has a collection of case studies to be used as a review. Case studies allow readers to apply what they have learned in previous chapters.

Case Study 1: 93‐pound Labrador Mix Courtesy of Sara Sharp, CVT, VTS (Dentistry) A 93lb NM Labrador Mix was presented for swelling around the muzzle, salivation, inappetence, lethargy, and sensitivity when his head/mouth were manipulated. His owners reported that the duration of this behavior was about three days. On P/E, his HR and RR were elevated, CRT was prolonged, and temperature was increased. Since he was NPO, we could keep him for a full work‐up that day including a sedated oral exam if needed. The patient was admitted for observation and treatment. Blood was drawn for a full chemistry panel and a CBC. A UA was obtained for analysis. An IVC was placed in the right cephalic vein and maintenance fluids (LRS) were administered. The chemistry panel was WNL. The CBC showed an 8% increase in the PCV and TP. The WBC ct. was also increased and the neutrophil count was significantly increased. The UA showed a high USG. The patient was given a sedation of 0.02 mcg/kg of dexmedetomidine IM in the right epaxial muscle so that a thorough oral examination could be performed. Within 15 minutes, the patient was sedate enough to be examined. The oral examination revealed a FB present across the palate between 108 and 208 with ulcerations present on the palate. The FB was removed and the ulcerations were cleaned and debrided. The FB was identified as a small stick that had wedged between the carnassial teeth. The owners were given a disinfectant oral rinse to use BID and systemic antibiotics to be given BID for 14  days. Also dispensed was an NSAID to help with pain and inflammation. At the two‐week recheck, the owners reported that the patient was “back to normal.” No further Tx was necessary.

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Case Study 1 Questions 1. Which of the following is the correct signalment for this patient? a. 93‐pound, neutered male Labrador b. Increased appetite, high energy c. 93‐kg, spayed female Labrador d. Elevated TPR and CRT 2. What tubes should be drawn for the CBC and chemistry panels? a. LTT, RTT b. Green TT, SST c. BTT, RTT d. LTT, Gray TT 3. Which of the following best describes the lab results? a. Leukocytosis with neutrophilia, anemia, and hyperproteinemia b. Leukopenia with neutropenia, polycythemia, and hypoproteinemia c. Leukocytosis with neutrophilia, polycythemia, and hyperproteinemia d. Leukopenia with neutropenia, anemia, and hypoproteinemia 4. How often were the antibiotics and oral rinse to be used? a. Once daily b. Twice daily c. Three times daily d. Four times daily 5. Dexmedetomidine was given: a. 0.02 mg/kg intramuscular b. 0.02 mcg/kg intramuscular c. 0.02 mcg/kg intermuscular d. 0.02 mg/kg intermuscular 6. What part of the SOAP would the elevated TPR be noted? a. Subjective b. Objective c. Assessment d. Plan 7. What was the veterinarian’s initial diagnosis? a. Foreign body between the upper right and left fourth premolars b. Foreign body between the upper right and left first premolars c. Foreign body between the upper right and left fourth incisors d. Foreign body between the upper right and left first molars 8. Which statement is true regarding treatment after the foreign body was removed? a. Contaminated tissue was removed to expose healthy tissue b. Skin was separated from its underlying structures c. Nodules were surgically removed d. The teeth were pulled 9. Why was the hospital able to admit the patient, run labwork and sedate him the same day? a. Animal had just eaten b. Animal was recently exercised c. Animal had not eaten recently due to lack of appetite d. Animal was castrated

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10. What kind of fluids were administered? a. Lactation Ringers solute via intravenous catheter b. Physiological saline solution via intranasal catheter c. Psychological saline solution via intravenous catheter d. Lactated Ringer’s solution via intravenous catheter

Case Study 2: Emma, four‐year‐old Golden Retriever

Figure 20.1  Emma. Source: Courtesy of Kailey R. Adams, AAS.

Emma, a four‐year‐old Golden Retriever, was brought in the ER after a suspected HBC. On P/E, Emma is dyspneic and has pale MM. Dr. Mills notices sensitivity while palpating the dog’s elbow. Her stifle has deep abrasions and blood has been observed on the plantar aspect of the rear paws. An IVC is placed and fluids and pain medications are administered. Full body radiographs and bloodwork are performed. Radiographs show pneumothorax and an olecranal fx. On CBC, Emma has leukocytosis, anemia, and thrombocytopenia.

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Case Study 2 Questions 1. What are Emma’s presenting symptoms on P/E? 2. What bone is the fx on? 3. Give the medical name of the joint that has the deep abrasions. 4. What procedure should be performed to relieve the pneumothorax? a. Cystocentesis b. Abdominocentesis c. Pericardiocentesis d. Thoracentesis 5. Emma has: a. Increased WBCs, decreased RBCs, increased Plts b. Decreased WBCs, increased RBCs, decreased Plts c. Increased WBCs, decreased RBCs, decreased Plts d. Decreased WBCs, increased RBCs, increased Plts 6. The blood was observed on the top/bottom (circle one) of the rear paws. After treating the pneumothorax, Emma is scheduled for Sx the following day to reduce the fx. While staying in the hospital, Dr. Mills orders that pain medications be given SQ TID. Emma is NPO due to the scheduled Sx. Emma is to remain on PSS through the night. 7. Since pain meds were given at 8 p.m. that evening, what time would the next dose be administered? a. 1 a.m. b. 4 a.m. c. 6 a.m. d. 8 a.m. 8. What kind of doctor will perform the surgery? a. Rheumatologist b. Oncologist c. Orthopedist d. Ophthalmologist 9. What does PSS mean in this particular case? a. Physiological saline solution b. Porcine stress syndrome c. Portosystemic shunt d. Pathological serum solution The surgery was a success and Emma sent home on antibiotics and NSAIDs for 10 days. Due to the stress, Emma had some GI upset. Dr. Mills prescribed a bland diet for two days and then prn. Emma will need to return q3d for bandage changes and then return in 14 days for suture removal. 10. What were the instructions given for the bland diet after the two days? a. Feed bland food as needed b. Feed bland food every other day c. Stop the bland diet d. Feed bland food four times daily

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11. How often will the bandage need to be changed? a. Every day b. Every three hours c. Every three days d. Every other day 12. Emma is an example of a: a. Brachycephalic b. Mesocephalic c. Dolichocephalic

Case Study 3: Mare About to Foal Courtesy of Carole C. Miller, DVM, PhD, DACT A mare is anticipated to foal in 60 days. Prior to being bred, the mare was subjected to a BSE by a theriogenologist to estimate the likelihood of achieving pregnancy. On that day, rectal palpation, transrectal utero‐ovarian ultrasound and vaginoscopy were performed. All findings were WNL. The mare was bred to a high‐quality stallion. Given that the length of gestation in horses is 335 days, a tentative due date has been identified. In preparation for the delivery the owner has taken vacation allowing her to be present in the event the mare experiences dystocia. She also has prepared a foal‐care kit that includes an antiseptic solution to apply to the umbilicus as well as dry towels, a stethoscope, a rectal thermometer, palpation sleeves, examination gloves and sterile lubricant. In the past, this mare has experienced agalactia. Because foals are born immunodeficient, the consumption of colostrum by foals in the first 24 hours after birth is a high priority. The owner has arranged for access to frozen colostrum through her DVM if that becomes necessary. The owner also intends to have the foal’s IgG level tested the day after it is born. Phlebotomy will be necessary for this test to be conducted, so she has arranged for an RVT from the veterinary practice she uses to come to the farm and collect the necessary sample with approval of the practice owner. Everything that can be done to optimize the conditions for a successful outcome has been prepared.

Case Study 3 Question 1. Define the underlined terms.

Case Study 4: Teddy, 11‐year‐old Pembroke Welsh Corgi Courtesy of Rose‐Ann Gillespie Teddy has been brought to the clinic to have a mass checked that the owner noticed earlier in the week. PPH shows Teddy current on vaccines and heartworm testing. Teddy has been on Rimadyl 50 mg SID and Cosequin for DJD. The owner has mentioned an ongoing intermittent cough. On GROS, abnormalities were discovered with integumentary, musculoskeletal, and ophthalmic areas. The temperature was 101 °F, pulse 90 and Teddy was panting. Teddy’s weight was recorded at 23.7 kg. Upon P/E, a decreased ROM of the left hip and crepitus of the left stifle were observed. Bilateral cataracts were noted and a pedunculated

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mass on the L caudal thigh was palpated. The mass was roughly 1.5 cm in diameter and ulcerated. Lung auscultation was clear and a cough could not be induced during tracheal palpation. After scheduling surgery for a mass removal and biopsy in 10 days, cervical rads are ordered and Teddy is placed on antihistamines for the cough.

Case Study 4 Questions 1. SOAP this patient. 2. What did the veterinarian observe on the stifle? a. Decreased range of motion b. Crackling sounds c. Fracture d. Subluxation 3. How did the mass appear? a. On a stalk b. Under the skin c. Dead d. Fluid‐filled 4. Where are the radiographs being taken? a. Neck b. Chest c. Abdomen d. Lower back 5. How often is Rimadyl given? a. q24h b. q12h c. q8h d. q6h 6. Define, DJD, GROS, and PPH. 7. What are the four main components of the integumentary system?

Case Study 5: Greta, 1½‐year‐old Golden Retriever Courtesy of Linda Coombe Greta’s owner called the ER worried that her dog swallowed a magnet while working on a science project with her grandchildren. The magnet is roughly 2 inches in diameter and very strong. When asked how long ago the magnet was ingested, the owner responds that it was approximately 15 minutes. Unfortunately, the owner lives too far away to immediately get Greta into the office. Therefore, the LVT has told the owner to induce emesis by administering hydrogen peroxide orally using a turkey baster. The dosage is 1 ml/lb and Greta weighs 55 lbs. When the owner called 10 minutes later, she said that the magnet had been retrieved and Greta was acting fine.

Chapter 20  Case Studies

Figure 20.2  Greta with the magnet. Source: Courtesy of Linda Coombe.

Case Study 5 Questions 1. What does LVT stand for? 2. What was the owner asked to do? a. Give Greta an enema to cause diarrhea b. Pump fluid into her abdomen c. Make Greta vomit d. None of the above 3. The hydrogen peroxide is an example of an: a. Emetic b. Diuretic c. Enema d. Mucolytic 4. How much hydrogen peroxide was given to Greta? a. 55 mm b. 55 mg c. 55 μl d. 55 ml 5. Greta is an example of an animal with: a. Ascites b. Pica c. GDV d. GERD

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Case Study 6: Jewel, 13‐year‐old DSH Courtesy of Donna Tunis, CVT Jewel, a 13‐year‐old DSH, has a small mass (pea sized) on the dorsal aspect of her neck. The owners noticed that the mass had started out barely palpable under the skin but over the last three months the mass grew until it was protruding. Weight loss was observed over the same period of time. However, Jewel had been on a low‐calorie diet for obesity so the weight loss was not a concern to the owners. On P/E, TPR was normal, lung auscultation was clear, abdominal palpation was not painful, and the cat was BAR. Neurological exam was WNL. Thoracic rads were done to check for mets and an FNA was performed on the mass. Thoracic rads showed no obvious mets, but the FNA showed malignant changes so excision of the mass was recommended.

Case Study 6 Questions 1. Jewel is a: a. Short‐haired cat b. Short‐haired dog c. Horse d. Goat 2. Jewel’s mass is located on the ___________side of the neck. a. Belly b. Back c. Left d. Right 3. Where were the radiographs taken? a. Chest b. Abdomen c. Head d. Tail 4. What does FNA stand for? 5. Define the underlined terms. 6. An excision was recommended. What does this mean? a. Cutting out the mass b. Cutting back the mass c. Cutting into the mass d. Leaving the mass alone The mass was sent to a pathologist for bx and the results came back as a high‐ grade  adenocarcinoma with a high probability of metastasis. Palliative care is recommended. 7. What kind of tumor did Jewel have? a. Benign tumor of a vessel b. Malignant tumor of a vessel arising from connective tissue c. Benign tumor of a gland d. Malignant tumor of a gland arising from epithelial tissue

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8. To whom was the sample sent? a. Specialist in the study of disease b. Specialist in the study of bone c. Specialist in the study of tissue d. Specialist in the study of birth 9. True or False: There’s a high probability that the tumor will spread beyond control. 10. What does palliative care mean?

Case Study 7: Chuck, 10‐year‐old Maine Coon Courtesy of Amy Johnson, BS, LVT, RLATG Chuck presented to your clinic for wheezing, PU/PD, and lethargy. On P/E, TPR was normal and Chuck had a BCS of 5. MM were pink and CRT was WNL. Chuck was BARH. Thoracic auscultation confirmed wheezing and the urinary bladder was enlarged on palpation. The remainder of the exam was unremarkable.

Case Study 7 Questions 1. Which of the following best describes Chuck? a. Drowsy, dehydrated, rhonchi, increased appetite b. Drowsy, hydrated, rhonchi, increased thirst, increased urination c. Energetic, dehydrated, rales and crackles, increased thirst, increased appetite d. Energetic, hydrated, rhonchi, increased urination, increased thirst 2. Chuck is: a. At an ideal weight b. Overweight c. Underweight d. Emaciated The DVM ordered a CBC, blood chemistry panel, thyroid panel, and rads. The T4 levels were WNL. Glucose was present in the urine and elevated in the blood. NSF were found on CBC. 3. Chuck is: a. Hyperthyroid b. Hypothyroid c. Euthyroid d. Isothyroid 4. Chuck has: a. Proteinuria and hyperglycemia b. Glycosuria and hyperglycemia c. Ketonuria and hypoglycemia d. Glycosuria and hypoglycemia Based on bloodwork and rads, Chuck was diagnosed with DM and bronchitis. Distention of the duodenum was noted on radiographs with some fluid build‐up so a trichobezoar was also diagnosed. Chuck was given antibiotics, steroid, and a nebulizer for the bronchitis. He was also placed on a prescription diet for the DM and put on insulin BID.

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5. Chuck was diagnosed with: a. A resistance to insulin, inflammation of the bifurcation of the trachea, and hairball in the first part of the small intestine b. Overproduction of insulin, inflammation of the smallest branches of the bronchi, and hairball in the second part of the small intestine c. Resistance to insulin, inflammation of the windpipe, and hairball in the third part of the small intestine d. Overproduction of insulin, inflammation of the bifurcation of the trachea, hairball in the stomach 6. Chuck’s insulin was to be given: a. Once daily b. Twice daily c. Three times daily d. Four times daily Chuck’s owner monitored his BG weekly and the DVM adjusted his insulin as needed. When seen five weeks post dx, Chuck’s BG has normalized and insulin is no longer needed. 7. Chuck: a. Is having a relapse b. Is in remission c. Is resistant d. Is susceptible

Case Study 8: Fledge, one‐year‐old Retriever Mix Courtesy of Heather E. McAndrews, CVT Fledge has transferred to your clinic with a PPH of bleeding from the prepuce. The owner has noticed that the penis has turned red in the last couple of days. The previous DVM had placed Fledge on antibiotics, but the symptoms have persisted. On P/E, a large amount of dark, bloody discharge was flushed from the prepuce. A urinary catheter was passed and normal, clear urine was obtained. Another round of antibiotics were prescribed and NSAIDs were added to the Rx. U/S and U/A were recommended.

Case Study 8 Questions 1. Where was the bleeding seen? a. The sensitive tip of the penis b. The cutaneous sheath covering the penis c. The sac containing the testicles d. The area between the anus and scrotum 2. Which of the following test was ordered? a. Radiographic imaging technique showing a three‐dimensional image of the brain b. Radiographic imaging technique in which images are produced after injection of a radioactive substance c. Radiographic imaging technique showing computerized cross‐sections of the brain and spinal cord d. Diagnostic technique using ultrasound waves to produce an image of an organ or tissue

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3. What is an NSAID? When seen a week later, there was no improvement so radiographs were ordered to check for stones and urine for a U/A was obtained. No stones were seen on rads and a leptospirosis was run which came back negative. A new round of antibiotics and NSAIDs were ordered to be given BID.

4. What were the radiographs checking for? a. Uroliths b. Choleliths c. Cholecystoliths d. Sialadenoliths A week later, Fledge returned for an U/S after problems persisted. On U/S, a double lobulated area was seen on the midline of the prepuce. One nodule ruptured during the procedure and dark blood was released. Possible abscess, granuloma, or trauma from previous castration was suspected. The prostate was mildly enlarged. Kidney and urinary bladder appeared normal. A new antibiotic was prescribed; one capsule every 12 hours. Prednisone was also dispensed: half a tablet every 12 hours for five days, then half a tablet every 24 hours for five days, then half a tablet every other day for five days. 5. How will the Rx be written for the prednisone? a. Half a tablet SID for five days, then half a tablet BID for five days, then half a tablet prn b. Half a tablet BID for five days, then half a tablet TID for five days, then half a tablet EOD for five days c. Half a tablet TID for five days, then half a tablet BID for five days, then half a tablet prn d. Half a tablet BID for five days, then half a tablet SID for five days, then half a tablet EOD for five days 6. Other than trauma, what is suspected to be the problem? a. Localized collection of pus or small mass of granulation tissue b. Collection of comedones or blisters c. Death of body tissue or warts d. Hives or ulcers Two weeks later, an open wound has appeared on the prepuce and hematuria was seen. Sx and bx has been ordered by the DVM. CBC, chem panel and U/A were done. CBC and chem panel were WNL. The urine obtained by cystocentesis was normal. Following surgery, Fledge was sent home with another round on antibiotics and some pain medication until biopsy results were returned. 7. How was the urine obtained this time? a. Incision into the urinary bladder b. Excision of the urinary bladder c. Surgical puncture of the urinary bladder d. Resection of the urinary bladder A week later, biopsy results revealed a TVT. 8. What is a TVT? Outcome: Fledge was seen two months later after receiving chemotherapy. No tumors seen on U/S in the genitourinary areas. Oncologist confirms Fledge is cured and can go home. No medications needed. 9.  What kind of specialist treated Fledge? a. Specialist in the study of the eye b. Specialist in the study of tumors c. Specialist in the study of tissue d. Specialist in the study of disease

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Case Study 9: Quesi, 13‐year‐old DLH Quesi, a 13‐year‐old DLH, has presented for PU/PD, lethargy, and weight loss. On P/E, Quesi was QAR. He had a BCS of 6, but his weight had decreased 3 lbs from his previous visit when he weighed 19#. TPR was normal. On palpation, the kidneys were small and the urinary bladder was full. Auscultations were normal. Phlebotomy was performed and the blood was collected into an LTT and RTT. Urine was obtained by cystocentesis. The BUN and creatinine were markedly increased, the Hct was decreased, and USG was low.

Case Study 9 Questions 1. What tests were run using the LTT and RTT? a. CBC, BG b. BG, coagulation study c. Blood chemistries, BG d. CBC, blood chemistries 2. Quesi has: a. Anemia and azotemia b. Leukocytosis and anemia c. Azotemia and leukopenia d. Leukopenia and polycythemia 3. How was the blood obtained for labwork? a. Incision of a vein b. Venipuncture c. Resection of a vein d. Excision of a vein 4. What anticoagulant is in the LTT? a. Heparin b. EDTA c. Sodium citrate d. Oxylate Quesi was diagnosed with renal failure and admitted to the hospital for dialysis via IV fluids. 5. Given the dx, why does Quesi have a decreased Hct? 6. How were the fluids administered? Outcome: After the laboratory values normalized, Quesi was sent home and the owners were taught how to administer SQ fluids to Quesi on a weekly basis in order to remove waste products from the blood. 7. Quesi’s treatment is considered: a. Palliative b. Curing 8. How will the owners be administering the fluids?

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Case Study 10: Sparkle, 12‐year‐old Shetland Sheepdog

Figure 20.3  Sparkle. Source: Courtesy of WikiCommons/MBOE3.

The ER received a call from a frantic owner about her sheltie, Sparkle, who was having a seizure. Sparkle was rushed to the clinic after the seizure subsided and labwork was immediately run. On P/E, Sparkle was in a stupor and had decreased proprioception. The owner noted that Sparkle had fainted shortly after the seizure. The CVT noticed Sparkle’s eyes were rapidly twitching back and forth while blood was being drawn. When Sparkle was returned to the owner in the exam room after the blood draw, the DVM noticed that the dog was ataxic.

Case Study 10 Questions 1. What did the owner notice after Sparkle’s seizure? a. Cataplexy b. Narcolepsy c. Syncope d. Coma 2. What did the CVT witness during venipuncture? a. Cataplexy b. Ataxia c. Nystagmus d. Aneurysm 3. What is a CVT? 4. Which best describes Sparkle on P/E? a. Decreased response to stimuli, BAR b. Decreased response to stimuli, lack of coordination c. Lack of coordination, QAR d. BAR, QAR Once the labwork was completed, while not definitive, the results pointed to epilepsy. Sparkle was placed on phenobarbital to decrease the incidence of the seizures and the owners were told to bring Sparkle back in six months to have ALT, AST, and ALK Phos. levels monitored.

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5. What organ is the veterinarian wanting to check in six months? a. Liver b. Kidney c. Urinary bladder d. Brain 6. Epilepsy is: a. Cancerous b. Idiopathic c. Contagious d. Inflammatory 7. Sparkle’s color is: a. Tricolor b. Hound c. Merle d. Sable and white

Case Study 11: Dante, four‐year‐old Rough Collie

Figure 20.4  Dante. Source: Courtesy of WikiCommons/Martin L.

Dante was recently adopted from a rescue facility in Louisiana while the owners were vacationing there. Upon return to Colorado, the owners noticed that Dante was lethargic and exercise intolerant. While watching Dante urinating in the backyard, the owners noticed a reddish color of the urine. On auscultation, an extra heart sound was detected. Dante’s MM were blue and his respirations were increased. A voided sample of urine was obtained and a clear, bright red color was noted. Tests revealed the red color in the urine to be hemoglobin. On CBC, Dante had a leukocytosis with eosinophilia, anemia and the plasma was slightly white.

Case Study 11 Questions 1. What was detected on auscultation? a. Flutter b. Fibrillation c. Murmur d. Thrill

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2. Dante’s gums were: a. White b. Blue c. Pink d. Red 3. What is the best term to describe Dante’s urine? a. Hematuria b. Albuminuria c. Hemoglobinuria d. Proteinuria 4. Which best describes the color of the plasma and substance causing it? a. Lipemic, fat b. Icteric, bilirubin c. Hemolytic, hemoglobin d. Straw, albumin 5. Dante has: a. Increased WBCs, increased eosinophils, increased RBCs b. Decreased WBCs, decreased eosinophils, decreased RBCs c. Increased WBCs, increased eosinophils, decreased RBCs d. Decreased WBCs, decreased eosinophils, increased RBCs After further lab tests, Dante was diagnosed with Dirofilaria immitis. 6. Dante has: a. Lungworm b. Heartworm c. Mites d. Lice Due to the type of infestation Dante has, surgery is recommended to remove as many adult worms as possible. Then Dante will undergo a series of injections to treat  the remainder of the infestation. The injections will be given IM and Dante will  be hospitalized during treatment since the drugs used are nephrotoxic and hepatotoxic. 7. What organs should be monitored during the drug treatment? a. Liver and kidneys b. Kidneys and lungs c. Liver and lungs d. Kidneys and pancreas 8. How are the injections administered? 9. Given the diagnosis, why does Dante have an eosinophilia? 10. Dante’s color is: a. Tricolor b. Hound c. Merle d. Sable and white

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Case Study 12: Luke, two‐year‐old Black Labrador Retriever Mrs. Skywalker has brought in her dog Luke to your clinic. Luke has been vomiting bile, not eating, and has seemed painful in the abdomen. On P/E, Luke was lethargic and dry‐heaving. Luke’s abdomen was tense and he was febrile. His pulse was elevated and he was panting. Mrs. Skywalker had been out of town on business and is unsure how long Luke has had these symptoms. Mr. Skywalker claims he hadn’t noticed any symptoms while watching the dog. Dr. Vader orders a CBC, chemistry panel and radiographs. Bloodwork revealed a leukocytosis and thrombocytopenia. On radiographs, gas was seen in the intestine. A barium study revealed a FB in the duodenum so Sx was ordered asap. During the surgery, the duodenum was discovered to be necrosed so it would need to be excised and an anastomosis of the stomach and jejunum would need to be performed. Once the anastomosis was completed, a lavage was done to remove possible contamination and saline was injected into the anastomotic site to measure patency of the lumen and check for leaks at the suture site. After Luke was sent to recovery, Dr. Vader opened up the excised duodenum to see the FB. A pair of black, lacy thong underwear was retrieved and saved to show the owner. The next day, Mrs. Skywalker returned to pick up Luke and was given post‐op instructions which included antibiotics and NSAIDs for a week. It was recommended that if she saw Luke take a marked turn for the worse, to please bring him back in. We would run labwork to check for a neutrophilia which would indicate dehiscence of the anastomotic site. Otherwise suture removal would be in two weeks. When shown the removed underwear, Mrs. Skywalker stated she didn’t own a pair of black, lacy thong underwear! Outcome: Luke had a normal recovery. Mrs. Skywalker filed for divorce from Mr. Skywalker and a custody battle for the dog ensued. Mrs. Skywalker won.

Case Study 12 Questions 1. On P/E, Luke had a/an: a. Decreased RR b. Increased temperature c. Decreased temperature d. None of the above 2. On presentation, Luke has: a. Cachexia b. Anorexia c. Emaciation d. Diarrhea 3. Luke’s bloodwork showed: a. Increased WBCs, decreased Plts b. Decreased, increased Plts c. Increased WBCs, increased Plts d. Decreased WBCs, decreased Plts 4. What test was done with radiographs? a. Radiographic imaging technique showing a three‐dimensional image of the brain b. Radiographic imaging technique in which images are produced after injection of a radioactive substance

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c. Radiographic imaging technique showing computerized cross‐sections of the brain and spinal cord d. Introduction of contrast material used to evaluate the GI tract. A series of radiographs is then taken to isolate GI tract disorders 5. Where was the FB discovered? a. First part of the small intestine b. Second part of the small intestine c. Third part of the small intestine d. Small blind sac where the small and large intestine meet 6. The duodenum was: a. Sutured b. Cut into c. Cut out d. Cut back 7. Why was the duodenum excised? a. Tissue died b. Tissue was inflamed c. Tissue was cyanotic d. Tissue was yellow 8. After the duodenum was excised, what procedure was performed? a. Gastrostomy b. Gastrojejunostomy c. Gastrojejunotomy d. Jejunostomy 9. What is an anastomosis? 10. Which of the following was performed to decrease risk of contamination? a. Forced feeding b. Irrigation or washing out of a cavity c. Removal of tissue for microscopic exam d. None of the above 11. Why would Luke have a neutrophilia if there was dehiscence?

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Case Study 13: Tiger, six‐year‐old DSH Tiger, a six‐year‐old DSH, has been brought to the clinic for head shaking. On P/E, Tiger’s ears were set low and he was scratching them.

Figure 20.5  Tiger.

Case Study 13 Questions 1. What instrument should be used to examine the ears? a. Ophthalmoscope b. Endoscope c. Otoscope d. Laryngoscope 2. What color is Tiger? a. Colorpoint b. Ruddy c. Brown tabby d. Tuxedo Both ears had a dark brown crusty exudate. An ear swab was performed and cytology slides were made. The swab was negative for ear mites, but a fungal infection was seen on cytology. Tiger was sent home with ear cleaner and medication to be administered twice daily. 3. What does cytology mean? 4. What was Tiger diagnosed with? a. Otomycosis b. Trichomycosis c. Onychomycosis d. Ophthalmomycosis

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Because of Tiger’s excessive head shaking, he returned with a collection of blood on his pinna. Surgery was performed and Tiger was sent home with antibiotics. 5. Tiger has: a. Conjunctival hematoma b. Aural hematoma c. Palpebral hematoma d. Pineal hematoma

Case Study 14: Punkin, 12‐week‐old DMH

Figure 20.6  Punkin.

Punkin has been brought to the clinic for a routine exam after being adopted. The owner states a family in her neighborhood was giving away free kittens. Part of a routine first kitten exam includes an ELISA test for FeLV and FIV. The ELISA test came out positive for FeLV antigens in her blood, but the owner states that Punkin has been acting fine. Additional blood was drawn so that blood could be sent to the reference lab for an IFA test and the owner was asked to bring Punkin back in 8–12 weeks for a retest. The IFA test came out negative for FeLV and when Punkin returned 12 weeks later, the ELISA test was still positive for FeLV. Because the IFA was negative and the ELISA was positive, Punkin is diagnosed as being a carrier of FeLV.

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Case Study 14 Questions 1. What color is Punkin? a. Ruddy b. Orange tabby c. Calico d. Tortoiseshell 2. What does ELISA stand for? 3. What does IFA stand for? 4. What specifically is the ELISA testing for on FeLV? a. Foreign substance (protein) that stimulates the production of antibodies b. Proteins produced by white blood cells in response to antigens c. Antibodies (gamma globulins) produced by plasma cells d. Substance that causes a specific hypersensitivity 5. Punkin is: a. An animal that harbors a disease and displaying outward signs of harm b. An animal that harbors a disease without displaying signs of infection. The animal can still transmit the disease to others c. An animal that harbors a disease without displaying signs of infection. The animal can’t transmit the disease to others d. None of the above

Case Study 15: Belle, eight‐year‐old Great Pyrenees Belle has been brought into the clinic after the owner noticed she was (condition of drowsiness or indifference). On P/E, Belle was panting and (running fever). Her abdomen was distended and a strong odor was detected from her. A (containing pus) discharge was seen from her (external genitalia of the female). The DVM ordered (instrument to record X‐rays) and bloodwork. The rads showed enlarged (pair of tubes extending from the uterine tubes to the body of the uterus). Labwork showed a (increase in WBCs). Belle was also (condition of lack of fluid). Dr. Sebastian diagnosed Belle with (pus in the uterus). An emergency (removal of ovaries and uterus) was ordered and Belle was taken to Sx. An (pertaining to within the windpipe) tube was placed and Belle went under (without pain sensation). During Sx, Belle had (increased blood pressure) which regulated post op. The uterine vessels were (tie off a vessel) to prevent (escape of blood from ruptured blood vessels). Belle has a hx of (excessive activation of the clotting mechanism) so blood was monitored closely. After the OHE, Belle was placed on (pertaining into the vein) fluids and antibiotics. After an overnight stay, Belle was sent home with her medications and the owners were asked to bring her back in two weeks for a suture removal.

Case Study 15 Questions 1. Give the medical names for the definitions in parentheses. 2. What does Sx stand for? 3. What does OHE stand for? 4. What is an alternate abbreviation for OHE?

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Case Study 16: Macadamia, four‐year‐old Poodle Mix Courtesy of Sarah Liechty, LVT While volunteering at a local shelter, Sarah noticed a dog that could use some extra loving care. The dog had been chewing and licking himself and Sarah noticed hair loss in localized locations. There was a strange, white, odiferous substance on widespread areas of the skin. Due to health issues, Sarah wasn’t allowed to adopt the pup yet. One month later, Sarah was able to adopt the dog whom she named Macadamia, or Mac for short. Mac still smelled and had patchy white areas on his skin. When Sarah tried to bathe Mac, the dog was too painful to be touched. Sarah immediately took Mac to her regular veterinarian. Sarah took Mac’s records from the shelter to her veterinarian which showed that Mac had received multiple dips for unknown skin problems. On physical exam, the veterinarian noticed Mac had an ear infection in both ears. Labwork showed that Mac had an elevated eosinophil count. Skin scrapings confirmed an infestation of Demodex mites. Mac also had retained deciduous teeth. Mac was given a medicated bath and treated with antibiotics and pain medications. Sarah was sent home with ear medication to administer to Mac. Heartworm preventatives were sent home which also would treat fleas and mites. Benadryl was prescribed to relieve the itching. A grain‐free prescription diet was recommended to cover possible food allergies. Over the next few months, Mac returned several times with no improvement. Eventually, Mac needed to be muzzled when handled due to the discomfort. Upon referral to a dermatologist, new medications and shampoos were prescribed and improvement was beginning to be seen. Hair was beginning to grow back and the itching had decreased. Mac began putting on weight and eventually the ear infection cleared up. After a negative skin scraping, Mac was well again. Sarah scheduled a dental cleaning for Mac and his deciduous teeth were removed at that time. Today, Mac is loving life and is spoiled rotten in his new forever home.

Case Study 16 Questions 1. Which best describes Mac’s initial symptoms? a. Pyoderma, pruritus, ophthalmitis, dermatitis b. Pyoderma, pruritus, alopecia, dermatitis, otitis c. Otitis, pruritus, otitis, ophthalmitis d. Pruritus, alopecia, dermatitis, ophthalmitis, otitis 2. Mac was referred to a: a. Specialist in the study of skin b. Specialist in behavior c. Specialist in ears d. Specialist in the study of tumors 3. Mac had retained: a. Placenta b. Hernia c. Puppy teeth d. Testicle 4. Initial labwork showed an: a. Eosinocytopenia b. Eosinopenia c. Eosinophilia d. Eosinocytosis

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5. What are the possible causes for Mac’s elevated eosinophil count? a. Bacterial infection b. Antigen stimulation c. Anaphylaxis d. Allergies and parasites 6. What is the PPH for Mac that was taken to Sarah’s regular veterinarian?

Appendix A  Pronunciation and Spelling of Terms Found in this Book

Similar Looks and Sounds of Terms Spelling can be tricky with some of these medical terms. Just one letter can make a difference with certain words. For example, the terms “hematoma” and “hepatoma” look very similar on paper, but have very different meanings. Hematoma is a mass or collection of blood, whereas hepatoma is a tumor on the liver. Other terms may be  pronounced exactly the same and have  completely ­ different meanings. For example, the ilium is a part of the pelvis and the ileum is the third part of the small  intestine. Also, be aware of terms with similar meanings. For example, the difference between urethra and ureters. The urethra is a tube that transports urine from the urinary bladder to the outside of the body. The ureters are tubes that transport urine from the kidneys to the urinary bladder. Spelling plays an important role in good record keeping. When hospitals are reviewed for accreditation, patient records are checked for detail and accuracy. Spelling is a part of that accuracy. In

essence, you’re writing in a legal document when you are writing in a patient file. As a reminder, take advantage of the pronunciation section of the website that  accompanies this book (http:// www.wiley.com/go/taibo/terminology) which allows  you to listen to how each term is pronounced.

Pronunciation of Certain Vowels The symbols ˇ and ˉ above certain vowels help you sound out the vowels. For example, if the vowel has ˉ above it, the vowel sounds like the “capital form” or “long form” of itself. If the vowel has the ˇ above it, then it sounds like its “lowercase form” or “short form.” ā ă ē ĕ ı̄ ı̆ ō ŏ ū ŭ

āte ăx ēleven ĕver pı ē ı̆nternal oāk lŏck ūnite ŭntie

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Pronunciation of Certain Consonants Consonants can have different sounds depending on what other letters they are attached to in a term. When viewing the pronunciation of terms pay attention to how the sounds of the consonants change in each term.

Rules for Plurals There will always be exceptions to the following rules but, in general, these rules will apply. Rule 1: If a word ends with “a,” then add an “e” to make it plural. For example, the  plural form of vertebra is vertebrae. The plural form of larva is larvae. Rule 2: If a word ends with “um,” then the plural form ends with an “a” instead of “um.” For example, the plural form of bacterium is bacteria. Rule 3: If a word ends with “is,” then the plural form will end with “es.” For example, the plural form of diagnosis is diagnoses. The plural form of metastasis is metastases. Rule 4: If a word ends with “on,” then the plural form will end with “a.” For example, the plural form of ganglion is ganglia. Rule 5: If a word ends with “ix” or “ex,” then its plural form will end with “ices.” For example, the plural form of index is indices. Rule 6: If a word ends with “us,” then its plural form will end with “i.” For example, the plural form of nucleus is nuclei.

Pronunciation List of Medical Terms Found in this Book Listen to an audio clip of all terms at http://www. wiley.com/go/taibo/veterinary.

Appendix A  Pronunciation and Spelling of Terms

abdomen abdominal abdominocentesis abducens abduction ablation abomasum abortion abscess absorption accessory nerve accommodation acetabular acetabulum acetylcholine achalasia achondroplasia acne acoustic acromegaly acromion acrophobia acuity acute Addison’s disease adduction adenectomy adenitis adenohypophysis adenoidectomy adenoids adenoma adenopathy adhesion adipose adrenal adrenalectomy adrenaline adrenectomy adrenocoricotropic hormone adrenopathy agalactia agglutination agonal agranulocytes akinetic alanine aminotransferase

Ă b‐dō‐mĕn ăb‐DŎ M‐ı̆‐năl ăb‐dŏ m‐ı̆‐nō‐sĕn‐TĒ ‐sı̆s ăb‐doo‐sĕnz ăb‐DŬ K‐shŭn ă‐BLĀ‐shŭn ă‐bō‐MĀ‐sŭm ă‐BŎ R‐shŭn Ă B‐sĕs ăb‐SŎ RP‐shŭn ăk‐SĔ S‐ŏ ‐rē ă‐kŏ m‐ō‐DĀ‐shŭn ăs‐ĕ‐TĂ B‐ū‐lăr ăs‐ĕ‐TĂ B‐ū‐lŭm ăs‐ĕ‐tı̆l‐KŌ ‐lēn ăk‐ăh‐LĀ‐zē‐ă ā‐kŏ n‐drō‐PLĀ‐zē‐ă Ă K‐nē ă‐KOOS‐tı̆k ăk‐rō‐MĔ G‐ă‐lē ă‐KRŌ ‐mē‐ŏ n ăk‐rō‐FŌ ‐bē‐ă ă‐KŪ ‐ı̆‐tē ă‐KŪ T Ă D‐ı̆‐sŏ n dı̆‐ZĒ Z ă‐DŬ K‐shŭn ăd‐ĕ‐NĔ K‐tō‐mē ăd‐ĕ‐NŎ P‐ă‐thē ăd‐ĕ‐nō‐hı̄‐PŎ F‐ı̆‐sı̆s ăd‐ĕ‐noyd‐Ĕ K‐tō‐mē Ă d‐ĕ‐noydz ăd‐ĕ‐NŌ ‐mă ̄ s ăd‐ĕ‐NI‐tı̆ ̄ ăd‐HE‐shŭn Ă ‐dı̆‐pōs ă‐DRĒ ‐năl ă‐drē‐năl‐Ĕ K‐tō‐mē ă‐DRĔ N‐ă‐lı̆n ă‐drē‐Ĕ K‐tō‐mē ă‐drē‐nō‐kŏ r‐tı̆‐kō‐ TRŌ P‐I ̆k HŎ R‐mōn ă‐drē‐NŎ P‐ă‐thē ā‐gă‐LĂ K‐tē‐ă ă‐gloo‐tı̆‐NĀ‐shŭn Ă ‐gŭ‐nŭl ā‐GRĂ N‐ū‐lō‐sı̄t ā‐kı̆‐NĔ T‐ı̆k Ă L‐ă‐nēn or Ă L‐ă‐nı̆n ă‐mē‐nō‐trănz‐fĕr‐ās

Appendix A  Pronunciation and Spelling of Terms

albino albumin albuminuria aldosterone alimentary alkaline phosphatase allergen allergy alopecia alveolar alveoli; alveolus amblyopia ambulatory amino acids amniocentesis amnion amniotic fluid amniotic sac amphiarthroses amputation amylase anabolic anabolism anal anal sac anal sacculitis analgesia analysis anaphylaxis anastomosis androgen anemia anencephaly anesthesia anestrus aneurysm angiogenesis angiogram angiography angiopathy angioplasty angiorrhaphy anisocoria anisocytosis anisokaryosis ankylosis anomaly anophthalmos

̄ ăl‐BI‐nō ăl‐BŪ ‐mı̆n ăl‐bū‐mı̆‐NŪ ‐rē‐ă ăl‐DŎ S‐tĕ‐rōn ăl‐ı̆‐MĔ N‐tăr‐ē Ă L‐kă‐lı̄n FŎ S‐fă‐tās Ă l‐ĕr‐jĕn Ă l‐ĕr‐jē ăl‐ō‐PĒ ‐shē‐ă ăl‐VĒ ‐ō‐lăr ăl‐VĒ ‐ō‐lı̄; ăl‐VĒ ‐ō‐lŭs ăm‐blē‐Ō ‐pē‐ă Ă M‐bū‐lă‐tŏ ‐rē ă‐MĒ ‐nō Ă ‐sı̆dz ăm‐nē‐ō‐sĕn‐TĒ ‐sı̆s Ă M‐nē‐ŏ n ăm‐nē‐Ŏ T‐ı̆k FLOO‐ı̆d ăm‐nē‐Ŏ T‐ı̆k SĂ K ăm‐fē‐ăr‐THRŌ ‐sēs ăm‐pū‐TĀ‐shŭn Ă M‐ı̆‐lās ăn‐ă‐BŎ L‐ı̆c ă‐NĂ B‐ō‐lı̆zm Ā‐năl Ā‐năl săk ̄ s Ā‐năl săk‐ū‐LI‐tı̆ ̄ ăn‐ăl‐JE‐zē‐ă ă‐NĂ L‐ı̆‐sı̆s ăn‐ă‐fı̆‐LĂ K‐sı̆s ă‐năs‐tō‐MŌ ‐sı̆s Ă N‐drō‐jĕn ă‐NĒ ‐mē‐ă ăn‐ĕn‐SĔ F‐ă‐lē ăn‐ĕs‐THĒ ‐zē‐ă ăn‐Ĕ S‐trŭs Ă N‐ūr‐ı̆‐zı̆m ăn‐jē‐ō‐JĔ N‐ĕ‐sı̆s Ă N‐je‐̄ ō‐grăm ăn‐jē‐Ŏ G‐ră‐fē ăn‐jē‐Ŏ P‐ă‐thē ăn‐jē‐ō‐PLĂ S‐tē ăn‐jē‐Ŏ R‐ă‐fē ăn‐ē‐sō‐KŌ ‐rē‐ă ăn‐ē‐sō‐sı̄‐TŌ ‐sı̆s ăn‐ē‐sō‐KĂ R‐ē‐ō‐sı̆s ăng‐kı̆‐LŌ ‐sı̆s ă‐NŎ M‐ă‐lē ăn‐ŏ f‐THĂ L‐mŏ s

anoplasty anorchism anorectal anorexia anovulation anoxia antagonist antecibum antepartum anterior anterior chamber anterior cruciate ligament antibiotic antibody anticoagulant antidiarrheal antidiuretic hormone antiemetic antigen antipyretic antisepsis antitoxin antitussives antrum anuria anus aorta aortic stenosis aortic valve apex aplastic anemia apnea apocrine gland appendicular appendicular skeleton aqueous humor arachnoid membrane arcade arrector pili arrhythmia arterial arteriectomy arteriography arteriole

593

ā‐nō‐PLĂ S‐tē ăn‐Ŏ R‐kı̆zm ā‐nō‐RĔ K‐tăl ăn‐ō‐RĔ K‐sē‐ă ăn‐Ŏ V‐ū‐lā‐shŭn ă‐NŎ K‐sē‐ă ăn‐TĂ ‐gō‐nı̆st Ă N‐tē‐SĒ ‐bŭm Ă N‐tē‐PĂ R‐tŭm ăn‐TĒ ‐rē‐ŏ r ăn‐TĒ ‐rē‐ŏ r CHĀM‐bĕr ăn‐TĒ ‐rē‐ŏ r KROO‐shē‐ ı̆t LIĞ ‐ă‐mĕnt ăn‐tı̆‐tı̄‐Ŏ T‐ı̆k Ă N‐tı̆‐bŏ d‐ē ăn‐tı̄‐kō‐Ă G‐ū‐lănt ăn‐tı̄‐dı̄‐ū‐RĒ ‐ăl ăn‐tı̄‐dı̄‐ū‐RĔ ‐tI ̆k HŎ R‐mōn ăn‐tı̄‐ĕ‐MĔ ‐tı̆k Ă N‐tı̆‐jĕn ăn‐tı̄‐pı̄‐RĔ T‐ı̆k ăn‐tı̆‐SĔ P‐sı̆s ăn‐tı̆‐TŎ K‐sı̆n ăn‐tē‐TŬ ‐sı̆vz Ă N‐trŭm ăn‐Ū ‐rē‐ă Ā‐nŭs ā‐Ŏ R‐tă ā‐Ŏ R‐tı̆k stĕ‐NŌ ‐sı̆s ā‐Ŏ R‐tı̆k vălv

Ā‐pĕkz ā‐PLĂ S‐tı̆k ă‐NĒ ‐mē‐ă Ă P‐nē‐ă Ă P‐ō‐krı̆n glănd ăp‐ı̆n‐DI ̆K‐ū‐lăr ăp‐ĕn‐DI ̆K‐ū‐lăr SKĔ L‐ı̆‐tı̆n ̄ A‐kwē‐ŭs or Ă K‐wē‐ŭs HŪ ‐mĕr ă‐RĂ K‐noyd MĔ M‐brān ăr‐KĀD ă‐RĔ K‐tĕr PĒ ‐lē ā‐RI ̆TH‐mē‐ă ăr‐TĒ ‐rē‐ăl ăr‐tē‐rē‐Ĕ K‐tō‐mē ăr‐tē‐rē‐Ŏ G‐ră‐fē ăr‐TĒ R‐ē‐ōl

594

arteriosclerosis arteriotomy artery arthralgia arthrectomy arthritis arthrocentesis arthrodesis arthrodial joint arthrography arthrology arthropathy arthroplasty arthroscope arthroscopy arthrosis arthrotomy articular cartilage articulation artificial insemination ascending colon ascites aspermia asphyxia aspiration asthma astroglial asystole ataxia atelectasis atherosclerosis atlanto‐axial joint atlanto‐occipital joint atopy atresia atria; atrium atrial atrioventricular atrophy audiometry auditory auditory canal aural auricle auricular auscultation autoimmune

Appendix A  Pronunciation and Spelling of Terms

ăr‐tē‐rē‐ō‐sklĕ‐RŌ ‐sı̆s ăr‐tē‐rē‐Ŏ T‐ō‐mē Ă R‐tĕ‐rē ăr‐THRŎ L‐jă ăr‐THRĔ K‐tō‐mĕ ̄ s ăr‐THRI‐tı̆ ăr‐THRŌ ‐sĕn‐TĒ ‐sı̆s ăr‐thrō‐DĒ ‐sı̆s ăr‐THRŌ ‐dē‐ăl joynt ăr‐THRŎ G‐ră‐fē ăr‐THRŎ L‐ō‐jē ăr‐THRŎ P‐ă‐thē ăr‐thrō‐PLĂ S‐tē ăr‐THRŌ ‐skōp ăr‐THRŎ ‐skō‐pē ăr‐THRŌ ‐sı̆s ăr‐THRŎ ‐tō‐mĕ ăr‐TI ̆K‐ū‐lăr KĂ R‐tı̆‐lăj ăr‐tı̆k‐ū‐LĀ‐shŭn ăr‐tı̆‐FI ̆SH‐ăl ı̆n‐sĕm‐ı̆‐NĀ‐shŭn ă‐SĔ N‐dı̆ng KŌ ‐lĕn ̄ z ă‐SI‐tē ā‐SPĔ R‐mē‐ă ăs‐FI ̆K‐sē‐ă ăs‐pĕ‐RĀ‐shŭn Ă Z‐mă ăs‐trō‐GLĒ ‐ăl sĕl ā‐SI ̆S‐tō‐lē ā‐TĂ K‐sē‐ă ă‐tĕ‐LĔ K‐tă‐sı̆s ăth‐ĕr‐ō‐sklĕ‐RŌ ‐sı̆s ăt‐LĂ N‐tō‐Ă X‐ē‐ăl joynt ăt‐LĂ N‐tō‐ŏ k‐SI ̆P‐ı̆‐tăl joynt Ă T‐ō‐pē ā‐TRĒ ‐zē‐ă Ā‐trē‐ă; Ā‐trē‐ŭm Ā‐trē‐ăl ā‐trē‐ō‐vĕn‐TRI ̆K‐ū‐lăr Ă T‐rō‐fē ăw‐dē‐Ŏ M‐ĕ‐trē ăw‐dı̆‐TŌ ‐rē ăw‐dı̆‐TŌ ‐rē kă‐NĂ L Ă W‐răl Ă W‐rı̆‐kŭl ăw‐RI ̆K‐ū‐lăr ăw‐skŭl‐TĀ‐shŭn ăw‐tō‐ı̆‐MŪ N

autonomic nervous system axial axial skeleton axillary axon azoospermia azotemia bacteriuria balanitis barium study basal layer basophil benign bicornuate bicuspid valve bifurcation bilateral bile biliary bilirubin binocular biochemistries biological biologist biology biopsy blepharectomy blepharitis blepharoplasty blepharoptosis blepharorrhaphy blepharospasm blepharotomy blood bolus bone marrow borborygmus bovine bovine respiratory syncytial virus bovine spongiform encephalopathy bovine viral diarrhea bowel Bowman’s capsule brachial brachycephalic

ăw‐tō‐NŎ M‐ı̆k NĔ R‐vŭs SI ̆S‐tĕm ̆ AX‐ē‐ăl Ă X‐ē‐ăl SKĔ L‐ı̆‐tı̆n Ă K‐sı̆‐lăr‐ē Ă K‐sŏ n ā‐zō‐ō‐SPĔ R‐mē‐ă ā‐zō‐TĒ ‐mē‐ă băk‐tē‐rē‐Ū ‐rē‐ă ̄ s băl‐ă‐NI‐tı̆ ̆ BAR‐ē‐ŭm STŬ ‐dē BĀ‐săl LĀ‐ĕr BĀ‐sō‐fı̆l ̄ bē‐NIN ̆ bı̄‐KOR‐nāt bı̄‐KŬ S‐pı̆d vălv bı̄‐fŭr‐KĀ‐shŭn bı̄‐LĂ T‐ĕr‐ăl BI ̆L BI ̆L‐ē‐ăr‐ē bı̆l‐ē‐ROO‐bı̆n bı̄‐NŎ K‐ū‐lăr bı̄‐ō‐KĔ M‐ı̆s‐trēz bı̄‐ō‐LŎ G‐ı̆k‐ăl bı̄‐Ŏ L‐ō‐jı̆st bı̄‐Ŏ L‐ō‐jē ̄ p‐sē BI‐ŏ blĕf‐ă‐RĔ K‐tō‐mē ̄ s blĕf‐ă‐RI‐tı̆ blĕ‐fă‐rō‐PLĂ S‐tē blĕ‐fă‐rŏ p‐TŌ ‐sı̆s blĕ‐fă‐RŎ R‐ă‐fē BLĔ ‐fă‐rō‐spăzm blĕ‐fă‐RŎ T‐ō‐mē blŭd BŌ ‐lŭs bōn MĂ ‐rō bŏ r‐bō‐RIĞ ‐mŭs BŌ ‐vı̄n BŌ ‐vı̄n RĔ S‐pı̆r‐ă‐tō‐rē ̄ s sı̆n‐SI ̆SH‐ăl VI‐rŭ ̆ ̄ BO‐vı̄n SPUN‐jı̆‐fŏ rm ĕn‐sĕf‐ă‐LŎ P‐ă‐thē ̄ l dı̄‐ă‐RĒ ‐ă BŌ ‐vı̄n VI‐ră ̆ BOW‐ĕl BŌ ‐măn KĂ P‐sŭl BRĀ‐kē‐ăl BRĀ‐kē‐sĕ‐FĂ L‐I ̆k

Appendix A  Pronunciation and Spelling of Terms

brachygnathia bradycardia bradykinesia bradypnea brainstem bronchi; bronchus bronchial bronchiectasis bronchiole bronchiolitis bronchitis bronchodilators bronchoscopy bronchospasm bruxism buccal bulbourethral gland bulla; bullae bundle of His bursa; bursae bursitis cachexia calcaneal calcaneus calcification calcitonin calcium calculi calicivirus callus calyces; calyx cancellous bone canine canthectomy canthotomy canthus capillary caprine carbon dioxide carcinogen carcinogenesis carcinogenic carcinoma cardiac cardiac muscle cardiac tamponade cardiology cardiomegaly

bră‐kē‐gNĀ‐thē‐ā brăd‐ē‐KĂ R‐dē‐ă bră‐dē‐kı̆‐NĒ ‐zē‐ă bră‐DI ̆P‐nē‐ă BRĀN‐stĕm BRŎ NG‐kı̄; BRŎ NG‐kŭs BRŎ NG‐kē‐ăl brŏ ng‐kē‐Ĕ K‐tă‐sı̆s BRŎ NG‐kē‐ōl ̄ s brŏ ng‐kē‐ō‐LI‐tı̆ ̄ brŏ ng‐KI‐tı̆s ̄ ‐tĕr brŏ ng‐kō‐DI‐lā ̆ brŏ ng‐KOS‐kō‐pē BRŎ NG‐kō‐spăsm BRŬ K‐sı̆‐zŭm BŪ K‐ăl bŭl‐bō‐ū‐RĒ ‐thrăl glănd BŬ L‐ă; BŬ L‐ē BŬ N‐dl of HI ̆ss BĔ R‐să; BĔ R‐sē ̄ s bĕr‐SI‐tı̆ kă‐KĔ K‐sē‐ă kăl‐KĀ‐nē‐ăl kăl‐KĀ‐nē‐ŭs kăl‐sı̆‐fı̆‐KĀ‐shŭn kăl‐sı̆‐TŌ ‐nı̆n KĂ L‐sē‐ŭm KĂ L‐kū‐lı̄ ̄ s kă‐LĒ ‐sē VI‐rŭ ̆ KAL‐ŭs KĀ‐lı̆‐sēz; KĀ‐lı̆ks KĂ N‐sĕ‐lŭs bōn KĀ‐nı̄n kănth‐Ĕ K‐tō‐mē kănth‐Ŏ T‐ō‐mē KĂ N‐thŭs KĂ P‐ı̆‐lăr‐ē KĂ P‐rı̄n kăr‐bŏ n dı̄‐Ŏ K‐sı̄d kăr‐SI ̆N‐ō‐jĕn kăr‐sı̆‐nō‐JĔ N‐ĕ‐sı̆s kăr‐sı̆‐nō‐JĔ N‐ı̆k kăr‐sı̆‐NŌ ‐mă KĂ R‐dē‐ăk KĂ R‐dē‐ăk MŬ S‐ĕl

KĂ R‐dē‐ăk tăm‐pō‐NŎ D kăr‐dē‐Ŏ L‐ō‐jē kăr‐dē‐ō‐MĔ G‐ă‐lē

cardiomyopathy cardiopathy cardiopulmonary cerebral resuscitation cardiopulmonary resuscitation carditis carpals carpus cartilage castration catabolic catabolism cataplexy cataract catecholamines catheter catheterization cauda equina caudal cauterization cecal cecum celiac cell membrane cellulitis cementum centrioles cephalic cerebellar cerebellum cerebral cerebrospinal fluid cerebrovascular cerebrum cerumen cervical cervicitis cervix cesarean section chalazion cheilosis chemonucleolysis chemotherapy cholangiectasia cholangiocarcinoma cholangio‐enterostomy

595

kăr‐dē‐ō‐mı̄‐Ŏ P‐ă‐thē kăr‐dē‐Ŏ P‐ă‐thē kăr‐dē‐ō‐PŬ L‐mō‐nĕr‐ē sĕ‐RĒ ‐brăl rē‐sŭ‐sı̆‐TĀ‐shŭn kăr‐dē‐ō‐PŬ L‐mō‐nĕr‐ē rē‐sŭ‐sı̆‐TĀ‐shŭn ̄ s kăr‐DI‐tı̆ ̆ KAR‐pălz KĂ R‐pŭs KĂ R‐tı̆‐lı̆j kăs‐TRĀ‐shŭn căt‐ă‐BŎ L‐ı̆c kă‐TĂ B‐ō‐lı̆zm KĂ T‐ŭ‐plĕk‐sē KĂ T‐ă‐răkt kăt‐ĕ‐KŌ L‐ă‐mēnz KĂ ‐thĕ‐tĕr kăth‐ĕ‐tĕr‐ı̆‐ZĀ‐shŭn ̄ KĂ W‐dă ĕ‐KWI‐nă KAWD‐ăl kăw‐tĕr‐ı̆‐ZĀ‐shŭn SĒ ‐kăl SĒ ‐kŭm SĒ ‐lē‐ăk sĕl MĔ M‐brān ̄ s sĕl‐ū‐LI‐tı̆ ̆ sē‐MEN‐tŭm SĔ N‐trē‐ōl sĕ‐FĂ L‐ı̆k sĕr‐ĕ‐BĔ L‐ăr sĕr‐ĕ‐BĔ L‐ŭm sĕ‐RĒ ‐brăl ̄ l FLŪ ‐ı̆d sĕr‐ĕ‐brō‐SPI‐nă ̆ sĕ‐RE‐brō‐VĂ S‐kū‐lăr sĕ‐RĒ ‐brŭm sĕ‐ROO‐mĕn SĔ R‐vı̆‐kăl ̄ s sĕr‐vı̆‐SI‐tı̆ ̆ SER‐vı̆ks sĕ‐SĀ‐rē‐ăn SĔ K‐shŭn kă‐LĀ‐zē‐ŏ n kı̄‐LŌ ‐sı̆s kē‐mō‐nū‐klē‐Ŏ L‐ı̆‐sı̆s kē‐mō‐THĔ R‐ĕ‐pē kōl‐ăn‐jē‐ĕk‐TĀ‐zē‐ă kōl‐ăn‐jē‐ō‐kăr‐sı̆‐NŌ ‐mă kōl‐ăn‐jē‐ō‐ĕn‐tĕ‐RŎ S‐ tō‐mē

596

cholangio‐gastrostomy cholangiohepatitis cholangiostomy cholecystectomy cholecystic cholecystitis cholecystojejunostomy cholecystolithiasis choledochal choledochojejunostomy choledocholithiasis choledochotomy cholelithiasis cholestasis cholesterol chondral chondralgia chondrectomy chondrocostal chondroma chondromalacia chondrosarcoma chorion choroid choroid plexus chromosomes chronic cilia ciliary body circulation cirrhosis clavicle clitoris coagulation coagulopathy coccygeal cochlea cochlear coitus colectomy colic colitis collagen colon colonectomy colonic

Appendix A  Pronunciation and Spelling of Terms

kōl‐ăn‐jē‐ō‐găs‐TRŎ S‐ tō‐mē ̄ s kōl‐ăn‐jē‐ō‐hĕp‐ă‐TI‐tı̆ ̆ kōl‐ăn‐jē‐OS‐tō‐mē kō‐lē‐sı̆s‐TĔ K‐tō‐mē kō‐lē‐SI ̆S‐tı̆k ̄ s kō‐lē‐sı̆‐STI‐tı̆ kō‐lē‐sı̆s‐tō‐jĕ‐jū‐NŎ S‐ tō‐mē ̄ ‐sı̆s kō‐lē‐sı̆s‐tō‐lı̆‐THI‐ă ̆ kō‐lē‐DOK‐ăl kō‐lēd‐ō‐kō‐jı̆‐jū‐NŎ S‐ tō‐mē ̄ ‐sı̆s kō‐lēd‐ō‐kō‐lı̆‐THI‐ă ̆ kō‐lēd‐ō‐KOT‐ō‐mē ̄ ‐sı̆s kō‐lē‐lı̆‐THI‐ă ̄ kō‐lē‐STA‐sı̆s kŭ‐LĔ S‐tĕr‐ŏ l KŎ N‐drăl kŏ n‐DRĂ L‐jă kŏ n‐DRĔ K‐tō‐mē kŏ n‐drō‐KŎ S‐tăl kŏ n‐DRŌ ‐mă kŏ n‐DRŌ ‐mă‐LĀ‐shă kŏ n‐drō‐săr‐KŌ ‐mă KŌ ‐rē‐ŏ n KŎ R‐oyd KŎ R‐oyd PLĔ K‐sŭs KRŌ ‐mō‐sōm KRŎ N‐ı̆k SI ̆L‐ē‐ă SI ̆L‐ē‐ăr‐ē BŎ ‐dē sĕr‐kū‐LĀ‐shŭn sı̆r‐RŌ ‐sı̆s KLĂ V‐ı̆‐kŭl KLI ̆‐tō‐rı̆s kō‐ağ‐ū‐LĀ‐shŭn kō‐ağ‐ū‐LŎ P‐ă‐thē kŏ k‐sı̆‐JĒ ‐ăl KŎ K‐lē‐ă KŎ K‐lē‐ăr KŌ ‐ı̆‐tŭs kō‐LĔ K‐tō‐mĕ KŎ L‐ı̆k ̄ s kō‐LI‐tı̆ ̆ KOL‐ă‐jĕn KŌ ‐lĕn kō‐lĕn‐Ĕ K‐tō‐mē kō‐LŎ N‐ı̆k

colonitis colonopathy colonoscopy colostomy colostrom colotomy colporrhaphy colposcopy coma comatose comedo; comedones common bile duct compact bone conception concussion condyle congenital congestive heart failure conjunctiva conjunctival conjunctivitis conjunctivoplasty conscious constipation contract contraction contraindication contralateral contusion coprophagia coprophagic copulation cornea corneal corneoscleral corona coronary arteries cortex cortical corticosteroid cortisol cortisone costal cough coxofemoral cranial cranioplasty craniosacral

̄ s kō‐lŏ n‐I‐tı̆ kō‐lŏ n‐Ŏ ‐pă‐thē kō‐lŏ n‐Ŏ S‐kō‐pē kō‐LŎ S‐tō‐mē kō‐LŎ ‐strŭm kō‐LŎ ‐tō‐mē kŏ l‐PŎ R‐ă‐fē kŏ l‐PŎ S‐kō‐pē KŌ ‐mă KŌ ‐mă‐tōs KŎ M‐ĕ‐dō; kŏ m‐ĕ‐DŌ NZ KŎ ‐mŭn BIL̄ dŭkt KŎ M‐păkt bōn kŏ n‐SĔ P‐shŭn kŏ n‐KŬ S‐shŭn KŎ N‐dı̄l kŏ n‐JĔ N‐ı̆‐tăl kŏ n‐GĔ S‐tı̆v hărt FĀL‐ŭr ̄ kŏ n‐jŭnk‐TI‐vă ̄ l kŏ n‐jŭnk‐TI‐vă ̄ s kŏ n‐jŭnk‐tı̆‐VI‐tı̆ ̆ kŏ n‐JUNK‐tı̆‐vō‐plăs‐tē KŎ N‐shŭs cŏ n‐stı̆‐PĀ‐shŭn kŭn‐TRĂ KT kŭn‐TRĂ K‐shŭn kŏ n‐tră‐ı̆n‐dı̆‐KĀ‐shŭn kŏ n‐tră‐LĂ T‐ĕr‐ăl kŏ n‐TŪ ‐shŭn kŏ ‐prō‐FĀ‐jē‐ă kŏ ‐prō‐FĀ‐jı̆k kŏ p‐ū‐LĀ‐shŭn KŎ R‐nē‐ă KŎ R‐nē‐ăl kŏ r‐nē‐ō‐SKLĔ ‐răl kŭ‐RŌ ‐nă KŎ R‐ō‐năr‐ē Ă R‐tĕ‐rēz KŎ R‐tĕks KŎ R‐tı̆‐kăl kŏ r‐tı̆‐kō‐STĔ ‐royd KŎ R‐tı̆‐sŏ l KŎ R‐tı̆‐zōn KŎ S‐tăl KŎ F kŏ k‐sō‐FĔ M‐ŏ r‐ăl KRĀ‐nē‐ăl KRĀ‐nē‐ō‐plăs‐tē KRĀ‐nē‐ō‐SĀ‐krăl

Appendix A  Pronunciation and Spelling of Terms

craniotome craniotomy creatinine crepitation crepitus crest crown cryosurgery cryptorchid cryptorchism crystalluria culture Cushing’s syndrome cyanosis cyanotic cyst cystalgia cystectomy cystitis cystocele cystocentesis cystogram cystopexy cystoscopy cystostomy cystotomy cytological cytologist cytology cytoplasm dacryoadenitis dacryocystectomy dacryocystitis dacryocystotomy debridement decalcification deciduous teeth decubitus ulcers defecation degloving deglutition dehiscence dehydration dendrite dental calculus dental caries dentin

KRĀ‐nē‐ō‐tōm krā‐nē‐Ŏ T‐ō‐mē krē‐Ă T‐ı̆‐nēn krĕ‐pı̆‐TĀ‐shŭn KRĔ P‐ı̆‐tŭs krĕst krŏ wn krı̄‐ō‐SŬ R‐jĕr‐ē krı̆p‐TŎ R‐kı̆d krı̆p‐TŎ R‐kı̆zm krı̆‐stăl‐Ū ‐rē‐ă KŬ L‐chĕr KŬ SH‐ı̆ng SI ̆N‐drōm sı̄‐ă‐NŌ ‐sı̆s sı̄‐ă‐NŌ T‐ı̆k sı̆st sı̆s‐TĂ L‐jă sı̆s‐TĔ K‐tō‐mĕ ̄ s sı̆s‐TI‐tı̆ ̆ SI S‐tō‐sēl sı̆s‐TŌ ‐sĕn‐TĒ ‐sı̆s sı̆s‐TŌ ‐grăm sı̄‐tŏ ‐PĔ K‐sē sı̆s‐TŎ S‐kō‐pē sı̆s‐TŎ S‐tō‐mĕ sı̆s‐TŎ ‐tō‐mĕ sı̄‐tŏ ‐LŎ G‐ı̆c‐ăl sı̄‐TŎ L‐ō‐jı̆st sı̄‐TŎ L‐ō‐jē ̄ ‐plăzm SI‐tō ̄ s dăk‐rē‐ō‐ăd‐ĕ‐NI‐tı̆ ̆ dăk‐rē‐ō‐sı̆s‐TEK‐ tō‐mĕ ̄ s dăk‐rē‐ō‐sı̆s‐TI‐tı̆ dăk‐rē‐ō‐sı̆s‐TŎ ‐tō‐mĕ dı̆‐BRĒ D‐mı̆nt dē‐kăl‐sı̆‐fı̆‐KĀ‐shŭn dı̆‐SI ̆‐dū‐ŭs tēth dē‐KŪ ‐bı̆‐tŭs Ŭ l‐sĕrs dĕf‐ĕ‐KĀ‐shŭn dē‐GLŬ ‐vı̆ng dē‐glū‐TI ̆‐shŭn dē‐HI ̆S‐sı̆ns dē‐hı̄‐DRĀ‐shŭn DĔ N‐drı̄t DĔ N‐tăl KĂ L‐kū‐lŭs DĔ N‐tăl KĂ R‐ēz DĔ N‐tı̆n

597

dĕn‐TI ̆‐shŭn dē‐Ŏ K‐sı̆‐jĕ‐NĀ‐tĕd ̄ s dĕr‐mă‐TI‐tı̆ ̆ DE R‐măl dĕr‐mă‐TŎ L‐ŏ ‐jı̆st dĕr‐mă‐TŎ L‐ŏ ‐jē dĕr‐mă‐tō‐mı̄‐KŌ ‐sı̆s DĔ R‐mı̆s dē‐SĔ N‐dı̆ng KŌ ‐lĕn dĕk‐sŭ‐MĔ TH‐ŭ‐sōn dı̄‐ă‐BĒ ‐tēz ı̆n‐SI ̆P‐ı̆‐dŭs dı̄‐ă‐BĒ ‐tē MĔ L‐ı̆‐tŭs dı̄‐ă‐BĔ T‐ı̆k kē‐tō‐ă‐sı̆‐DŌ ‐sı̆s diagnosis dı̄‐ağ‐NŌ ‐sı̆s dialysis dı̄‐Ă L‐ı̆‐sı̆s diameter dı̄‐Ă M‐ı̆‐tĕr diapedesis dı̄‐ă‐pı̆‐DĒ ‐sı̆s ̄ ‐frăm diaphragm DI‐ă diaphragmatic hernia dı̄‐ă‐frağ‐MĂ ‐tı̆k HĔ R‐nē‐ă diaphyses dı̄‐Ă F‐ı̆‐sēs diaphysis dı̄‐Ă F‐ı̆‐sı̆s diarrhea dı̄‐ă‐RĒ ‐ă diarthroses dı̄‐ăr‐THRŌ ‐sēs diastole dı̄‐Ă S‐tō‐lē diestrus dı̄‐Ĕ S‐trŭs diethylstilbestrol dı̄‐ĕth‐ı̆l‐stı̆l‐BĔ ‐strŏ l diffusion dı̆‐FŪ ‐zhŭn digestion dı̄‐JĔ ST‐yŭn dilation dı̄‐LĀ‐shŭn disk (disc) dı̆sk dislocation dı̆s‐lō‐KĀ‐shŭn disseminated intravascular dı̆s‐SĔ M‐ı̆‐nā‐tĕd coagulation ı̆n‐tră‐VĂ S‐kū‐lăr kō‐ağ‐ū‐LĀ‐shŭn distal DI ̆S‐tăl dentition deoxygenated dermatitis dermal dermatologist dermatology dermatomycosis dermis descending colon dexamethasone diabetes insipidus diabetes mellitus diabetic ketoacidosis

distemper distichiasis diuresis diverticulitis diverticulum dolichocephalic dopamine dorsal dorsiflexion drench duodenal

dı̆s‐TĔ M‐pĕr ̄ ‐sı̆s dı̆s‐tı̆‐KI‐ă dı̄‐ŭr‐RĒ ‐sı̆s ̄ s dı̄‐vĕr‐tı̆k‐ū‐LI‐tı̆ ̆ dı̄‐vĕr‐TI K‐ū‐lŭm dō ‐LĒ ‐kō‐sĕ‐FĂ L‐ı̆k DŌ ‐pă‐mēn DŎ R‐săl dŏ r‐sē‐FLĔ K‐shŭn drĕnch dū‐Ŏ D‐dĕ‐năl or dū‐ō‐DĒ ‐năl

598

duodenum dura mater dyschezia dyscrasia dyspepsia dysphagia dysplasia dyspnea dystocia dysuria ecchymoses; ecchymosis eccrine gland echocardiogram eclampsia ectopic ectropion eczema edema effusion ejaculation ejaculatory duct electrocardiogram electrocardiograph electrocardiography electroejaculation electroencephalogram electroencephalograph electroencephalography electrolyte electromyogram electromyography electroretinography elimination emaciation emboli; embolus embolism embryo emesis emetic emphysema empyema emulsification

Appendix A  Pronunciation and Spelling of Terms

dū‐Ŏ D‐dĕ‐nŭm or dū‐ō‐DĒ ‐nŭm DŬ R‐ă MĂ T‐tĕr dı̆s‐KĒ ‐zē‐ă dı̆s‐KRĀ‐zē‐ă dı̆s‐PĔ P‐sē‐ă dı̆s‐FĀ‐jē‐ă dı̆s‐PLĀ‐zē‐ă DI ̆SP‐nē‐ă dı̆s‐TŌ ‐sē‐ă dı̆s‐Ū ‐rē‐ă ĕk‐ı̆‐MŌ ‐sēz; ĕk‐ı̆‐MŌ ‐sı̆s ĕk‐rı̆n glănd ĕk‐ō‐KĂ R‐dē‐ō‐grăm ĕ‐KLĂ MP‐sē‐ă ĕk‐TŎ P‐ı̆k ĕk‐TRŎ ‐pē‐ŏ n Ĕ K‐zē‐mă ĕ‐DĒ ‐mă ĕ‐FŪ ‐zhŭn ē‐jăk‐ū‐LĀ‐shŭn ē‐JĂ K‐ū‐lă‐tŏ r‐ē dŭkt ē‐lĕk‐trō‐KĂ R‐dē‐ō‐grăm ē‐lĕk‐trō‐KĂ R‐dē‐ō‐grăf ē‐lĕk‐trō‐kăr‐dē‐Ŏ G‐ră‐fē ē‐lĕk‐trō‐ē‐jă‐kū‐LĀ‐shŭn ē‐ lĕk‐trō‐ĕn‐SĔ F‐ă‐lō‐ grăm ē‐ lĕk‐trō‐ĕn‐SĔ F‐ă‐ lō‐grăf ē‐ lĕk‐trō‐ĕn‐sĕf‐ă‐LŎ G‐ ră‐fē ē‐LĔ K‐trō‐lı̄t ̄ ‐grăm ē‐ lĕk‐trō‐MI‐ō ē‐ lĕk‐trō‐mı̄‐Ŏ G‐ră‐fē ē‐lĕk‐trō‐rĕ‐tı̆n‐Ŏ G‐ră‐fē ē‐lı̆m‐ı̆‐NĀ‐shŭn ē‐mā‐sē‐Ā‐shŭn Ĕ M‐bō‐lı̄; Ĕ M‐bō‐lŭs Ĕ M‐bō‐lı̆zm Ĕ M‐brē‐ō Ĕ ‐mı̆‐sı̆s ĕ‐MĔ ‐tı̆k ĕm‐fı̆‐ZĒ ‐mă ĕm‐pı̄‐Ē ‐mă ē‐mŭl‐sı̆‐fı̆‐KĀ‐shŭn

enamel enarthroses encephalic encephalitis encephalocele encephalogram encephalography encephalomyelitis encephalopathy endarterectomy endocarditis endocardium endocervicitis endocrine gland endocrinologist endocrinology endolymph endometriosis endometritis endometrium endoplasmic reticulum endorphins endoscope endoscopy endosteum endothelial cells endothelium endotracheal endotracheal intubation enema enteric enteritis enterocolitis enterocolostomy enterology enteropathy enterostomy enterotomy entropion enucleation enuresis enzyme eosinophil eosinophilia ependymal

ē‐NĂ M‐ĕl ĕn‐ăr‐THRŌ ‐sēs ĕn‐sĕ‐FĂ L‐ı̆k ̄ s ĕn‐sĕf‐ă‐LI‐tı̆ ̆ ĕn‐SEF‐ă‐lō‐sēl ē‐lĕk_trō‐ĕn‐SĔ F‐ă‐lō‐grăm ē‐lĕk_trō‐ĕn‐SĔ F‐ă‐LŎ G‐ ră‐fē ̄ s ĕn‐sĕf‐ă‐lō‐mı̄‐ĕ‐LI‐tı̆ ̆ ĕn‐sĕf‐ă‐LOP‐ă‐thē ĕnd‐ăr‐tĕr‐Ĕ K‐tō‐mē ̄ s ĕn‐dō‐kăr‐DI‐tı̆ ̆ ĕn‐dō‐KAR‐dē‐ŭm ̄ s ĕn‐dō‐sĕr‐vı̆s‐SI‐tı̆ ̆ EN‐dō‐krı̆n glăndz ĕn‐dō‐krı̆‐NŎ L‐ō‐jı̆st ĕn‐dō‐krı̆‐NŎ L‐ō‐jē Ĕ N‐dō‐lı̆mf ĕn‐dō‐mē‐trē‐Ō ‐sı̆s ̄ s ĕn‐dō‐mē‐TRI‐tı̆ ̄ ĕn‐dō‐ME‐trē‐ŭm ĕn‐dō‐PLĂ Z‐mı̆k rĕ‐TI ̆K‐ū‐lŭm ĕn‐DŎ R‐fı̆nz Ĕ N‐dō‐skōp ĕn‐DŎ S‐kō‐pē ĕn‐DŎ S‐tē‐ŭm ĕn‐dō‐THĒ ‐lē‐ăl sĕlz ĕn‐dō‐THĒ ‐lē‐ŭm ĕn‐dō‐TRĀ‐kē‐ăl ĕn‐dō‐TRĀ‐kē‐ăl ı̆n‐tū‐BĀ‐shŭn ̆ E‐nĕ‐mă ĕn‐TĔ R‐ı̆c ̄ s ĕn‐tĕ‐RI‐tı̆ ̄ s ĕn‐tĕr‐ō‐kō‐LI‐tı̆ ĕn‐tĕr‐ō‐kō‐LŎ S‐tō‐mē ĕn‐tĕ‐RŎ L‐ō‐jē ĕn‐tĕ‐RŎ P‐ă‐thē ĕn‐tĕ‐RŎ S‐tō‐mē ĕn‐tĕr‐Ŏ T‐ō‐mē ĕn‐TRŌ ‐pē‐ŏ n ē‐nū‐klē‐Ā‐shŭn ĕn‐ū‐RĒ ‐sı̆s Ĕ N‐zı̄m ē‐ō‐SI ̆N‐ō‐fı̆l ē‐ō‐sı̆n‐ō‐FI ̆L‐ē‐ā ĕp‐Ĕ N‐dı̆‐măl

Appendix A  Pronunciation and Spelling of Terms

epidermis epidermolysis epididymis epididymitis epidural epigastric epiglottis epiglottitis epilepsy epinephrine epiphora epiphyseal plate epiphysis episiotomy epistaxis epithelial epithelium epulis eructation erythema erythroblast erythrocyte erythrocytopenia erythrocytosis erythropenia erythropoiesis erythropoietin esophageal esophageal atresia esophageal reflux esophageal spasm esophagitis esophagoplasty esophagus esotropia estrogen estrus ethmoid bone etiology euphoria Eustachian tube euthyroid evisceration excision excretion exhalation exocrine gland exophthalmos

ĕp‐ı̆‐DĔ R‐mı̆s ĕp‐ı̆‐dĕr‐MŎ L‐ı̆‐sı̆s ĕp‐ı̆‐DI ̆D‐ı̆‐mı̆s ̄ s ĕp‐ı̆‐dı̆d‐ı̆‐MI‐tı̆ ̄ ĕp‐ĕ‐DU‐răl ĕp‐ı̆‐GĂ S‐trı̆k ĕp‐ı̆‐GLŎ T‐ı̆s ̄ s ĕp‐ı̆‐glŏ ‐TI‐tı̆ ̆ EP‐ı̆‐lĕp‐sē ĕp‐ı̆‐NĔ F‐rı̆n ē‐PI ̆F‐ŏ ‐ră ĕ‐pı̆‐FI ̆Z‐ē‐ăl ē‐PI ̆F‐ı̆‐sı̆s ĕ‐pı̆s‐ē‐Ŏ T‐ō‐mē ĕp‐ı̆‐STĂ K‐sı̆s ĕp‐ı̆‐THĒ ‐lē‐ăl ĕp‐ı̆‐THĒ ‐lē‐ŭm ĕp‐ŭl‐ŭs ē‐rŭk‐TĀ‐shŭn ĕr‐ı̆‐THĒ ‐mă ĕ‐RI ̆TH‐rō‐blăst ĕ‐RI ̆TH‐rō‐sı̄t ĕ‐rı̆th‐rō‐sı̄‐tō‐PĒ ‐nē‐ă ĕ‐RI ̆TH‐rō‐sı̄‐TŌ ‐sı̆s ĕ‐rı̆th‐rō‐PĒ ‐nē‐ă ĕ‐rı̆th‐rō‐pō‐Ē ‐sı̆s ĕ‐rı̆th‐rō‐PŌ ‐ı̆‐tı̆n ĕ‐sŏ f‐ă‐JĒ ‐ăl ĕ‐sŏ f‐ă‐JĒ ‐ăl ā‐TRĒ ‐zē‐ă ĕ‐sŏ f‐ă‐JĒ ‐ăl RĒ ‐flŭks ĕ‐sŏ f‐ă‐JĒ ‐ăl spăsm ̄ s ĕ‐sŏ f‐ă‐JI‐tı̆ ̆ ĕ‐SOF‐ă‐gō‐plăs‐tē ĕ‐SŎ F‐ă‐gŭs ĕ‐sō‐TRŌ P‐ē‐ă Ĕ S‐trō‐jĕn ĕs‐TRŬ S Ĕ TH‐moyd bōn ē‐tē‐Ŏ L‐ō‐jē ū‐FŎ R‐ē‐ā ū‐STĀ‐shŭn ̄ ū‐THI‐royd ̆ ̄ E‐VI S‐ĕr‐ā‐shŭn ĕk‐SI ̆ZH‐ŭn ĕks‐KRĒ ‐shŭn ĕks‐să‐LĀ‐shŭn Ĕ K‐sō‐krı̆n glăndz ĕk‐sŏ f‐THĂ L‐mŏ s

599

exotropia expiration exsanguination extension external extraction extraocular exudate

ĕk‐sō‐TRŌ ‐pē‐ă ĕks‐pı̆r‐RĀ‐shŭn ĕk‐SĂ NG‐wı̆‐nā‐shŭn ĕk‐STĔ N‐shŭn ĕks‐TĔ R‐năl ĕk‐STRĂ K‐shŭn ĕks‐tră‐Ŏ K‐ū‐lăr Ĕ K‐sū‐dāt

facial fascia fasciectomy fasciitis fecal feces feline feline immunodeficiency virus femoral femorotibial femur fertilization fetotomy fetus fibrillation fibrin fibrinogen fibroma fibrosarcoma fibrosis fibula

FĀ‐shŭl FĂ SH‐ē‐ă făsh‐ē‐Ĕ K‐tō‐mē ̄ s făsh‐ē‐I‐tı̆ ̄ FE‐kŭl FĒ ‐sēz FĒ ‐lı̄n FĒ ‐lı̄n ı̆m‐ū‐nō‐dē‐FI ̆SH‐ ̄ s ĕn‐sē VI‐rŭ ̆ FEM‐ŏ r‐ăl fĕ‐mŏ ‐rō‐TI ̆‐bē‐ăl FĒ ‐mŭr fĕr‐tăl‐ı̆‐ZĀ‐shŭn fē‐TŎ T‐ō‐mē FĒ ‐tŭs fı̆b‐rı̆‐LĀ‐shŭn ̄ n FI‐brı̆ fı̄‐BRI ̆N‐ō‐jĕn fı̄‐BRŌ ‐mă fı̄‐brō‐săr‐KŌ ‐mă fı̄‐BRŌ ‐sı̆s FI ̆B‐ū‐lă FI ̆B‐ū‐lăr

fibular filtration fimbriae fissure fistula flagella flagellum flatulence flexion fluorescein flutter follicle‐stimulating hormone fontanelle foramen fossa fovea centralis

fı̆l‐TRĀ‐shŭn FI ̆M‐brē‐ē FI ̆SH‐ŭr FI ̆S‐tū‐lă flă‐JĔ L‐ă flă‐JĔ L‐ŭm FLĂ ‐tū‐lĕns FLĔ K‐shŭn floo‐ō‐RĔ S‐ē‐ı̆n FLŬ ‐tĕr FŎ L‐lı̆‐kŭl STI ̆M‐ū‐lā‐ tı̆ng HŎ R‐mōn fŏ n‐tă‐NĔ L fōr‐Ā‐mĕn FŎ S‐ă FŌ ‐vē‐ă sĕn‐TRĂ ‐lı̆s

600

fracture frontal bone fundus gait galactorrhea gallbladder gamete ganglion gangrene gastrectomy gastric gastric dilatation gastric dilatation volvulus gastritis gastroduodenostomy gastroenteritis gastroenterology gastrointestinal gastrojejunostomy gastropexy gastrostomy gastrotomy gavage genes genital lock genitalia genitourinary gestation gingiva gingival gingival sulcus gingivectomy gingivitis glans penis glaucoma glial cell gliding globin globulin glomerular glomerulonephritis glomerulus glossal glossitis glossopharyngeal glottis

Appendix A  Pronunciation and Spelling of Terms

FRĂ K‐shŭr FRŎ N‐tăl bōn FŬ N‐dŭs GĀT gă‐lăk‐tō‐RĒ ‐ă găwl‐BLĂ ‐dĕr GĂ M‐ēt GĂ NG‐lē‐ŏ n găng‐GRĒ N găs‐TRĔ K‐tō‐mĕ GĂ S‐trı̆k GĂ S‐trı̆k dı̆‐lă‐TĀ‐shŭn GĂ S‐trı̆k dı̆‐lă‐TĀ‐shŭn VŎ L‐vū‐lŭs ̄ s găs‐TRI‐tı̆ găs‐trō‐dū‐ŏ d‐dĕ‐NŎ S‐ tō‐mē ̄ s găs‐TRŎ ‐ĕn‐tĕ‐RI‐tı̆ ̆ găs‐trō‐ĕn‐tĕr‐OL‐ō‐jē găs‐trō‐ı̆n‐TĔ S‐tı̆n‐ăl găs‐trō‐jı̆‐jū‐NŎ S‐tō‐mē găs‐trō‐PĔ K‐sē găs‐TRŎ S‐tō‐mē găs‐TRŎ T‐ō‐mē gă‐VĂ J jēnz JĔ N‐ı̆‐tă lŏ k jĕn‐ı̆‐TĀ‐lē‐ă jĕn‐ı̆‐tō‐Ū R‐ı̆‐năr‐ē jĕs‐TĀ‐shŭn JI ̆N‐jı̆‐vă JI ̆N‐jı̆‐văl JI ̆N‐jı̆‐văl SŬ L‐kŭs jı̆n‐jı̆‐VĔ K‐tō‐mē ̄ s jı̆n‐jı̆‐VI‐tı̆ glănz PĒ ‐nı̆s glăw‐KŌ ‐mă GLĒ ‐ăl sĕl ̄ ng GLI‐dı̆ GLŌ ‐bı̆n GLŎ B‐ū‐lı̆n glō‐MĔ R‐ū‐lăr ̄ s glō‐mĕr‐ū‐lō‐nĕ‐FRI‐tı̆ ̆ glō‐MER‐ū‐lŭs GLŎ ‐săl ̄ s glŏ ‐SI‐tı̆ glŏ s‐ō‐fă‐rı̆n‐JĒ ‐ăl GLŎ ‐tı̆s

glucagon glucocorticoids gluconeogenesis glucose glucosuria glycemia glycemic glycogen glycogenolysis glycolysis glycosuria Golgi apparatus gonad gonadotropin goniotomy gout grain granuloctye granulocytopenia granulocytosis granuloma gynecology gyri; gyrus

GLOO‐kă‐gŏ n gloo‐kō‐KŎ R‐tı̆‐koyds gloo‐kō‐nē‐ō‐JĔ N‐ĕ‐sı̆s GLOO‐kōs gloo‐kōs‐Ū ‐rē‐ă glı̄‐SĒ ‐mē‐ă gli‐SĒ ‐mı̆k ̄ ‐jĕn GLI‐kō glı̄‐kō‐jĕ‐NŎ L‐ı̆‐sı̆s glı̄‐KŎ L‐ı̆‐sı̆s glı̄‐kōs‐Ū ‐rē‐ă GŌ L‐jē ăp‐ŭ‐RĂ ‐tŭs GŌ ‐năd gō‐năd‐ō‐TRŌ ‐pı̆n gō‐nē‐Ŏ T‐ō‐ē GŎ WT GRĀN GRĂ N‐ū‐lō‐sı̄t GRĂ N‐ū‐lō‐sı̄‐tō‐PĒ ‐nē‐ă grăn‐ū‐lō‐sı̄‐TŌ ‐sı̆s gră‐nū‐LŌ ‐mă gı̄‐nĕ‐KŎ L‐ō‐jē ̄ ; JI‐rŭ ̄ s JI‐rē

hair follicle hard palate Haversian canals hemangioma hemarthrosis hematemesis hematochezia hematocrit hematology hematoma hematopoiesis hematopoietic hematuria

hār FŎ L‐ı̆‐kŭl hărd PĂ L‐ăt hă‐VĔ R‐shăn kă‐NĂ LZ hē‐MĂ N‐jē‐ō‐mă hēm‐ăr‐THRŌ ‐sı̆s hĕ‐mă‐TĔ M‐ı̆‐sı̆s hĕ‐mă‐tō‐KĒ ‐zē‐ă hē‐MĂ T‐ō‐krı̆t hē‐mă‐TŎ L‐ō‐jē hē‐mă‐TŌ ‐mă hĕ‐mă‐tō‐pō‐Ē ‐sı̆s hĕ‐mă‐tō‐pō‐Ĕ ‐tı̆k hēm‐ă‐TŪ ‐rē‐ă

heme hemiglossectomy hemiparesis hemiplegia hemisphere hemodialysis hemoglobin hemoglobinopathy hemolysis hemolytic hemoperitoneum hemophilia

hēm hĕm‐ē‐glŏ s‐SĔ K‐tō‐mē hĕm‐ē‐pă‐RĒ ‐sı̆s hĕm‐ē‐PLĒ ‐jă hĕm‐ē‐sfēr hē‐mō‐dı̄‐Ă L‐ı̆‐sı̆s HĒ ‐mō‐glō‐bı̆n HĒ ‐mō‐glō‐bı̆n‐Ŏ P‐ă‐thē hē‐MŎ L‐ı̆‐sı̆s hē‐mō‐LI ̆‐tı̆k hē‐mō‐pĕ‐rı̆‐tō‐NĒ ‐ŭm hē‐mō‐FI ̆L‐ē‐ă

Appendix A  Pronunciation and Spelling of Terms

hemopytsis hemorrhage hemorrhagic anemia hemorrhagic gastroenteritis hemosiderin hemostasis hemothorax hemolytic anemia heparin hepatic hepatic lipidosis hepatitis hepatocyte hepatoma hepatomegaly hepatotomy hernia herniation herniorrhaphy hiatal hernia hidrosis hinge hippocampus histocyte histological histologist histology histopathologist histopathology homeostasis hordeolum hormonal hormone humeral humeroradioulnar humerus humoral immunity hydrarthrosis hydrocephalus hydrochloric acid hydronephrosis hydrotherapy hydrothorax hymen hyperadrenocorticism hyperbilirubinemia hypercalcemia

hē‐MŎ P‐tı̆‐sı̆s HĔ M‐ŏ r‐ı̆j hĕ‐mō‐RĂ ‐jı̆k ă‐NĒ ‐mē‐ă hĕ‐mō‐RĂ ‐jı̆k ̄ s găs‐TRŎ ‐ĕn‐tĕ‐RI‐tı̆ ̆ hē‐mō‐SI ‐dĕr‐ı̆n hē‐mō‐STĀ‐sı̆s hē‐mō‐THŌ ‐răks hē‐mō‐LI ̆‐tı̆k ă‐NĒ ‐mē‐ă HĔ P‐ă‐rı̆n hĕ‐PĂ T‐ı̆k hĕ‐PĂ T‐ı̆k lı̆‐pı̆‐DŌ ‐sı̆s ̄ s hĕp‐ă‐TI‐tı̆ ̆ hĕ‐PA‐tō‐sı̄t hĕp‐ă‐TŌ ‐mă hĕp‐ă‐tō‐MĔ G‐ă‐lē hĕp‐ă‐TŎ ‐tō‐mē HĔ R‐nē‐ă hĕr‐nē‐Ā‐shŭn hĕr‐nē‐Ŏ R‐ă‐fē hı̄‐Ā‐tăl HĔ R‐nē‐ă hı̄‐DRŌ ‐sı̆s or hı̆‐DRŌ ‐sı̆s hı̆nj hı̆‐pō‐KĂ M‐pŭs HI ̆S‐tō‐sı̄t hı̆s‐tō‐LŎ G‐ı̆k‐ăl hı̆s‐TŎ L‐ō‐jı̆st hı̆s‐TŎ L‐ō‐jē hı̆s‐tō‐pă‐THŎ L‐ō‐jı̆st hı̆s‐tō‐pă‐THŎ L‐ō‐jē hō‐mē‐ō‐STĀ‐sı̆s hŏ r‐DĒ ‐ō‐lŭm hŏ r‐MŌ N‐ăl HŎ R‐mōn HŪ ‐mĕr‐ăl hū‐mĕr‐ō‐rā‐dē‐ō‐Ŭ L‐năr HŪ ‐mĕr‐ŭs HŪ ‐mŏ r‐ăl ı̆‐MŪ ‐nı̆‐tē hı̄‐drăr‐THRŌ ‐sı̆s hı̄‐drō‐SĔ F‐ă‐lŭs hı̄‐drō‐KLŎ R‐ı̆k Ă ‐sı̆d

hı̄‐drō‐nĕ‐FRŌ ‐sı̆s hı̄‐drō‐THĔ R‐ă‐pē hı̄‐drō‐THŌ ‐răks ̄ n HI‐mĕ hı̄‐pĕr‐ă‐drē‐nō‐KŎ R ‐tı̆‐sı̆‐zm hı̄‐pĕr‐bı̆l‐ē‐roo‐bı̆‐NĒ ‐mē‐ă hı̄‐pĕr‐kăl‐SĒ ‐mē‐ă

601

hypertropia hyperventilation hypoadrenocorticism

hı̄‐pĕr‐KĂ P‐nē‐ă hı̄‐pĕr‐kō‐lĕs‐tĕr‐ŏl‐Ē ‐mē‐ă hı̄‐pĕr‐KRŌ ‐mı̆k hı̄‐pĕr‐KRI ̆N‐ı̆zm hı̄‐pĕr‐ĕs‐THĒ ‐zē‐ă hı̄‐pĕr‐glı̄‐SĒ ‐mē‐ă hı̄‐pĕr‐GŌ ‐năd‐ı̆zm hı̄‐pĕr‐ı̆N‐sŭ‐lı̆n‐ı̆zm hı̄‐pĕr‐kā‐LĒ ‐mē‐ă hı̄‐pĕr‐kĕr‐ă‐TŌ ‐sı̆s hı̄‐pĕr‐kı̆‐NĒ ‐sı̆s hı̄‐pĕr‐nā‐TRĒ ‐mē‐ă ̄ hı̄‐pĕr‐pă‐ră‐THI‐royd‐ı̆ zm ̄ hı̄‐pĕr‐pı̆‐TU‐ı̆‐tăr‐ı̆zm hı̄‐pĕr‐PLĀ‐zē‐ă hı̄‐PĔ RP‐nē‐ă hı̄‐pĕr‐sĕn‐sı̆‐TI ̆V‐ı̆‐tē hı̄‐pĕr‐SPLĔ N‐ı̆zm hı̄‐pĕr‐TĔ N‐shŭn ̄ hı̄‐pĕr‐THI‐royd‐ı̆ zm ̆ hı̄‐PER‐trō‐fe ̄ hı̄‐pĕr‐TRŌ ‐pē‐ă hı̄‐pĕr‐vĕn‐tı̆‐LĀ‐shŭn hı̄‐pō‐ă‐drē‐nō‐KŎ R‐tı̆‐

hypoalbuminemia hypocalcemia hypocapnia hypochondriac hypochromic hypocrinism hypodermic hypogastric hypoglossal hypoglycemia hypogonadism hypoinsulinism hypokalemia hyoid bone hyponatremia hypoparathyroidism hypophysis hypopituitarism hypoplasia hypopnea hypopyon hypotension hypothalamus hypothyroidism

sı̆‐zm ̄ ‐ăl‐bū‐mI ̆‐NĒ ‐mē‐ă hI‐pō hı̄‐pō‐kăl‐SĒ ‐mē‐ă hı̄‐pō‐KĂ P‐nē‐ă hı̄‐pō‐KŎ N‐drē‐ăk hı̄‐pō‐KRŌ ‐mı̆k hı̄‐pō‐KRI ̆N‐ı̆zm hı̄‐pō‐DĔ R‐mı̆k hı̄‐pō‐GĂ S‐trı̆k hı̄‐pō‐GLŎ ‐săl hı̄‐pō‐glı̄‐SĒ ‐mē‐ă hı̄‐pō‐GŌ ‐năd‐ı̆zm hı̄‐pō‐I ̆N‐sŭ‐lı̆n‐ı̆zm hı̄‐pō‐kā‐LĒ ‐mē‐ă ̄ HI‐oyd hı̄‐pō‐nā‐TRĒ ‐mē‐ă ̄ hı̄‐pō‐pă‐ră‐THI‐royd‐ı̆ zm ̆ hı̄‐POF‐ı̆‐sı̆s hı̄‐pō‐pı̆‐TŪ ‐ı̆‐tăr‐ı̆zm hı̄‐pō‐PLĀ‐zē‐ă hı̄‐PŎ P‐nē‐ă hı̄‐PŎ P‐ē‐ŏ n hı̄‐pō‐TĔ N‐shŭn hı̄‐pō‐THĂ L‐ă‐mŭs ̄ hı̄‐pō‐THI‐royd‐ı̆ zm

hypercapnia hypercholesterolemia hyperchromic hypercrinism hyperesthesia hyperglycemia hypergonadism hyperinsulinism hyperkalemia hyperkeratosis hyperkinesis hypernatremia hyperparathyroidism hyperpituitarism hyperplasia hyperpnea hypersensitivity hypersplenism hypertension hyperthyroidism hypertrophy

602

hypotropia hypoxia hypoxic hysterectomy hysteroscopy iatrogenic icterus idiopathic ileitis ileocecal ileostomy ileum ileus iliac ilium immobilization immune response immunity immunodeficiency immunofluorescent antibody test immunoglobulin immunosorbent immunosuppression implantation impulses inappetance incision incisive bone incisor incontinence incus infarction infection infectious infestation inflammatory infracostal infundibulum inguinal inhalation injection innervation inspiration insulin insulinoma intact

Appendix A  Pronunciation and Spelling of Terms

hı̄‐pō‐TRŌ ‐pē‐ă hı̄‐PŎ K‐sē‐ă hı̄‐PŎ K‐sı̆k hı̆s‐tĕr‐Ĕ K‐tō‐mē hı̆s‐tĕr‐Ŏ S‐kō‐pē ı̄‐ăt‐rō‐JĔ N‐ı̆k I ̆K‐tĕr‐ŭs ı̆d‐ē‐ō‐PĂ TH‐ı̆k ̄ s ı̆l‐ē‐I‐tı̆ ı̆l‐ē‐ō‐SĒ ‐kăl ı̆l‐ē‐Ŏ S‐tō‐mē

I ̆L‐ē‐ŭm I ̆L‐ē‐ŭs I ̆L‐ē‐ăk I ̆L‐ē‐ŭm ı̆‐mō‐bŭl‐ı̆‐ZĀ‐shŭn ı̆‐MŪ N rē‐SPŎ NS ı̆‐MŪ ‐nı̆‐tē ı̆m‐ū‐nō‐dē‐FI ̆SH‐ĕn‐sē ı̆m‐ū‐nō‐flŏ ‐RĔ S‐sĕnt Ă N‐tı̆‐bŏ d‐ē tĕst ı̆m‐ū‐nō‐GLŎ B‐ū‐lı̆n ı̆m‐ū‐nō‐SŎ R‐bĕnt ı̆m‐ū‐nō‐sŭ‐PRĔ ‐shŭn ı̆m‐plăn‐TĀ‐shŭn ı̆m‐PŬ L‐sĕs ı̆n‐Ă P‐pı̆‐tĕns ı̆n‐SI ̆ZH‐ŭn ̄ v ı̆n‐SI‐sı̆ ̄ r ı̆n‐SI‐zŏ ı̆n‐KŎ N‐tı̆‐nĕns I ̆NG‐kŭs ı̆n‐FĂ RK‐shŭn ı̆n‐FĔ K‐shŭn ı̆n‐FĔ K‐shŭs ı̆n‐fĕ‐STĀ‐shŭn ı̆n‐FLĂ ‐mă‐tō‐rē ı̆n‐fră‐KŎ S‐tăl ı̆n‐fŭn‐DI ̆‐bū‐lŭm I ̆NG‐gwı̆‐năl ı̆n‐hă‐LĀ‐shŭn ı̆n‐JĔ K‐shŭn ı̆n‐ĕr‐VĀ‐shŭn ı̆n‐spı̆‐RĀ‐shŭn I ̆N‐sŭ‐lı̆n ı̆n‐sŭ‐lı̆‐NŌ ‐mă ı̆n‐TĂ KT

intussusception involution iridectomy iridic iris iritis ischemia ischemic ischial ischiatic ischium

ı̆n‐teğ‐ū‐MĔ N‐tăr‐ē ı̆n‐tĕr‐Ā‐trē‐ăl ı̆n‐tĕr‐BRĀN ı̆n‐tĕr‐KŎ S‐tăl ı̆n‐TĔ R‐năl ı̆n‐tĕr‐STI ̆‐shŭl ı̆n‐tĕr‐vĕn‐TRI ̆K‐ū‐lăr ı̆n‐tĕr‐VĔ R‐tē‐brăl ̄ IN‐tră ‐KĂ R‐dē‐ăk ı̆n‐tră‐KRĀ‐nē‐ăl ̄ IN‐tră ‐DĔ R‐mŏ l ı̆N‐tră‐hĕ‐PĂ T‐ı̆k ı̆n‐tră‐MŬ S‐kū‐lăr ı̆n‐tră‐Ŏ K‐ū‐lăr ı̆n‐tră‐VĒ ‐nŭs ı̆n‐tră‐VĒ ‐nŭs KĂ ‐ thĕ‐tĕr ı̆n‐tŭs‐sŭs‐SĔ P‐shŭn ı̆n‐vō‐LŪ ‐shŭn ı̆r‐ı̆‐DĔ K‐tō‐mē ı̆‐RI ̆D‐ı̆k ̄ s I‐rı̆ ̄ s ı̄‐RI‐tı̆ ı̆s‐KĒ ‐mē‐ă ı̆s‐KĒ ‐mı̆k ı̆SH‐ē‐ăl ı̆SH‐ē‐ă‐tı̆k ı̆SH‐ē‐ŭm

jaundice jejunostomy jejunum

JĂ WN‐dı̆s jĕ‐joo‐NŎ S‐tō‐mē jĕ‐JOO‐nŭm

keloid keratectomy keratin keratitis

KĒ ‐loyd kĕr‐ă‐TĔ K‐tō‐mē KĔ R‐ă‐tı̆n ̄ s kĕr‐ă‐TI‐tı̆ kĕr‐ă‐tō‐sĕn‐TĒ ‐sı̆s

integumentary interatrial interbrain intercostal internal interstitial interventricular intervertebral intracardiac intracranial intradermal intrahepatic intramuscular intraocular intravenous intravenous catheter

keratocentesis keratoconjunctivitis keratoplasty keratotomy ketones ketonuria ketosis kidney kinesiology kyphosis

kĕr‐ă‐tō‐kŏ n‐jŭnk‐tı̆‐VI‐̄ tı̆s kĕr‐ă‐tō‐PLĂ S‐tē kĕr‐ă‐TŎ T‐ō‐mē KĒ ‐tōnz kē‐tōn‐Ū ‐rē‐ă kē‐TŌ ‐sı̆s KI ̆D‐nē kı̆‐nē‐sē‐Ŏ L‐ō‐jē kı̄‐FŌ ‐sı̆s

Appendix A  Pronunciation and Spelling of Terms

labia labial labium labyrinth laceration lacrimal lacrimal bone lacrimation lactation lactogenesis lame lameness lamina laminectomy lance laparoscope laparoscopy laparotomy laryngeal laryngectomy laryngitis laryngopharynx laryngoscopy laryngospasm larynx lateral lavage laxity leiomyoma leiomyosarcoma lens lensectomy leptospirosis lesion lethargic lethargy leukemia leukocyte leukocytopenia leukocytosis leukorrhea ligament ligamentous lingual lipase lipemia lipid lipocyte

LĀ‐bē‐ă LĀ‐bē‐ăl LĀ‐bē‐ŭm LĂ B‐ı̆‐rı̆nth lă‐sĕ‐RĀ‐shŭn LĂ ‐krı̆‐măl LĂ ‐krı̆‐măl bōn lă‐krı̆‐MĀ‐shŭn lăk‐TĀ‐shŭn lăk‐tō‐JĔ N‐ĕ‐sı̆s lām LĀM‐nĕs LĂ M‐ı̆‐nă lăm‐ı̆‐NĔ K‐tō‐mē lăns LĂ P‐ă‐rō‐skōp lă‐pă‐RŎ S‐kō‐pē lăp‐ă‐RŎ T‐ō‐mē lă‐RI ̆N‐jē‐ăl lăr‐ı̆n‐JĔ K‐tō‐mē ̄ s lă‐rı̆n‐JI‐tı̆ ̆ lă‐RI N‐jō‐făr‐ı̆nks lă‐rı̆n‐GŎ S‐kō‐pē lă‐RI ̆NG‐jō‐spăzm LĂ R‐ı̆nks LĂ T‐ĕr‐ăl lă‐VĂ J LĂ K‐sı̆‐tē lı̄‐ō‐mı̄‐Ō ‐mă lı̄‐ō‐mı̄‐ō‐săr‐KŌ ‐mă lĕnz lĕn‐ZĔ K‐tō‐mē ̄ ‐sı̆s lĕp‐tō‐SPI‐rō ̄ LE‐zhŭn lĕ‐THŎ R‐jı̆k LĔ ‐thĕr‐jē lū‐KĒ ‐mē‐ă LŪ ‐kō‐sı̄t lū‐kō‐sı̄‐tō‐PĒ ‐nē‐ă lū‐kō‐sı̄‐TŌ ‐sı̆s loo‐kō‐RĒ ‐ă LIĞ ‐ă‐mĕnt lığ‐ă‐MĔ N‐tŭs LI ̆NG‐wăl ̄ s LI‐pā lı̄‐PĒ ‐mē‐ă LI ̆‐pı̆d LI ̆P‐ō‐sı̄t

lipoma lithotripsy litter liver lobectomy lordosis lumbar lumbosacral lumen lupus erythematosus luteinizing hormone luxation Lyme disease lymph lymphadenitis lymphadenopathy lymphangioma lymphatic lymphedema lymphoblast lymphocyte lymphocytopenia lymphocytosis lymphoid lymphoma lymphopoiesis lysosome macrocephaly macrocytic macrocytosis macrophage macrophthalmia macrotia macula macular degeneration macule malabsorption malaise maldigestion malignant malleolar malleolus malleus malocclusion mammary mammoplasty

603

lı̄‐PŌ ‐mă LI ̆TH‐ō‐trı̆p‐sē LI ̆‐tĕr LI ̆‐vĕr lō‐BĔ K‐tō‐mē lŏ r‐DŌ ‐sı̆s LŬ M‐băr lŭm‐bō‐SĀ‐krăl LŪ ‐mĕn LŪ ‐pŭs ĕ‐rı̆‐thē‐mă‐TŌ ‐sŭs LŪ ‐tĕ‐nı̄‐zı̆ng HŎ R‐mōn lŭk‐SĀ‐shŭn lı̄m dı̆‐ZĒ Z lı̆mf ̄ s lı̆mf‐ă‐dĕ‐NI‐tı̆ lı̆mf‐ă‐dĕ‐NŎ P‐ă‐thē lı̆mf‐ăn‐jē‐Ō ‐mă lı̆m‐FĂ ‐tı̆k lı̆mf‐ĕ‐DĒ ‐mă LI ̆M‐fō‐blăst LI ̆M‐fō‐sı̄t lı̆m‐fō‐sı̄‐tō‐PĒ ‐nē‐ă lı̆m‐fō‐sı̄‐TŌ ‐sı̆s LI ̆M‐foyd lı̆m‐FŌ ‐mă lı̆m‐fō‐pō‐Ē ‐sı̆s ̄ ‐sōm LI‐sō măk‐rō‐SĔ F‐ă‐lē măk‐rō‐SI ̆‐tı̆k măk‐rō‐sı̄‐TŌ ‐sı̆s MĂ K‐rō‐fāj măk‐rōf‐THĂ L‐mē‐ă măk‐RŌ ‐shē‐ă MĂ K‐ū‐lă MĂ K‐ū‐lăr dē‐jĕn‐ĕ‐RĀ‐shŭn MĂ K‐ūl măl‐ăb‐SŎ RP‐shŭn măl‐ĀZ măl‐dı̄‐JĔ ST‐yŭn Mă‐LIĞ ‐nănt mă‐LĒ ‐ō‐lŭs mă‐LĒ ‐ō‐lăr MĂ L‐ē‐ŭs măl‐ŏ ‐KLOO‐zhŭn MĂ M‐ŏ r‐ē MĂ M‐ō‐plăs‐tē

604

mandible mandibular mange manubrium mastectomy mastication mastitis maxillary bone mean corpuscular hemoglobin mean corpuscular volume meatus meconium medial median mediastinal mediastinum medulla medulla oblongata medullary megacolon megaesophagus megakaryocyte melanin melanocyte melanoma melatonin melena membrane meningeal meninges meningioma meningitis meningomyelocele mesentery mesocephalic metabolic metabolism metacarpal metacarpectomy metamorphosis metaphysis metastasis metatarsalgia metatarsals

Appendix A  Pronunciation and Spelling of Terms

MĂ N‐dı̆‐bŭl măn‐DI ̆B‐ū‐lăr mānj mă‐NŪ ‐brē‐ŭm măs‐TĔ K‐tō‐mē măs‐tı̆‐KĀ‐shŭn ̄ s măs‐TI‐tı̆ ̆ MAK‐sı̆‐lă‐rē bōn mēn kŏ r‐PŬ S‐kū‐lăr HĒ ‐mō‐glō‐bı̆n mēn kŏ r‐PŬ S‐kū‐lăr

VŎ L‐ūm mē‐Ā‐tŭs mĕ‐KŌ ‐nē‐ŭm MĒ ‐dē‐ăl MĒ ‐dē‐ăn ̄ l mē‐dē‐ă‐STI‐nă ̄ m mē‐dē‐ă‐STI‐nŭ ̄ mĕ‐DUL‐ă or mĕ‐DŬ L‐ă mĕ‐DŪ L‐ă or mĕ‐DŬ L‐ă ŏ b‐lŏ n‐GĂ ‐tă MĔ D‐ū‐lăr‐ē mĕ‐gă‐KŌ ‐lĕn mĕ‐gă‐ĕ‐SŎ F‐ă‐gŭs mĕ‐gă‐KĂ R‐ē‐ō‐sı̄t MĔ L‐ă‐nı̆n mĕ‐LĂ N‐ō‐sı̄t mĕl‐ă‐NŌ ‐mă mĕl‐ă‐TŌ ‐nı̆n MĔ L‐ĕ‐nă or mĕ‐LĒ ‐nă MĔ M‐brān mĕ‐NI ̆N‐jē‐ăl or mĕ‐nı̆n‐JĒ ‐ăl mĕ‐NI ̆N‐jēz mĕ‐nı̆n‐jē‐Ō ‐mă ̄ s mĕn‐ı̆n‐JI‐tı̆ ̄ ‐lō‐sēl mĕ‐nı̆n‐jō‐MI‐ĕ ̆ MES‐ĕn‐tĕr‐ē MĒ ‐sō‐sĕ‐FĂ L‐ı̆k mĕ‐tă‐BŎ L‐ı̆k mĕ‐TĂ B‐ō‐lı̆zm mĕ‐tă‐KĂ R‐păl mĕ‐tă‐kăr‐PĔ K‐tō‐mē mĕt‐ă‐MŎ R‐fŏ ‐sı̆s mĕ‐TĂ ‐fı̆‐sı̆s mĕ‐TĂ S‐tă‐sı̆s mĕ‐tă‐tăr‐SĂ L‐jă mĕ‐tă‐TĂ R‐sălz

metritis microcephaly microcytosis microcytic microglial microphthalmia microscope microtia micturition midbrain mineralocorticoid miosis mitochondria mitral valvulitis molar monoblast monocyte mononuclear monoparesis monoplegia monorchid morphology mount mucolytics mucosa mucous mucous membranes mucus multigravida multipara murmur muscular myalgia myasthenia myasthenia gravis mydriasis myectomy myelin sheath myelitis myeloblast myelodysplasia myelogenous myelogram myeloid myeloma myelopoiesis myocardial myocardium

̄ s mē‐TRI‐tı̆ mı̆‐krō‐SĔ F‐ă‐lē mı̄‐krō‐sı̄‐TŌ ‐sı̆s mı̆‐krō‐SI ̆‐tı̆k mı̆‐krō‐GLĒ ‐ăl sĕl mı̆‐krōf‐THĂ L‐mē‐ă ̄ MI‐krō ‐skōp mı̄‐KRŌ ‐shē‐ă mı̆k‐tū‐RI ̆SH‐ŭn mı̆d‐BRĀN ̆ r‐ăl‐ō‐KŎ R‐tI ‐koyd ̆ mI n‐ĕ ̄ mı̄‐O‐sı̆s mı̄‐tō‐KŎ N‐drē‐ă ̄ l văl‐vū‐LI‐tı̆ ̄ s MI‐tră ̄ MO‐lăr mŏ n‐ō‐blăst MŎ N‐ō‐sı̄t mŏ n‐ō‐NŪ ‐klē‐ăr mŏ n‐ō‐pă‐RĒ ‐sı̆s mŏ n‐ō‐PLĒ ‐jă mŏ n‐Ŏ R‐kı̆d mŏ r‐FŎ L‐ō‐jē mŏ wnt mū‐kō‐LI ̆‐tı̆ks mū‐KŌ ‐să MŪ ‐kŭs MŪ ‐kŭs MĔ M‐brāns MŪ ‐kŭs mŭl‐tē‐GRĂ V‐ı̆‐dă mŭl‐TI ̆P‐ă‐ră MŬ R‐mĕr MŬ S‐kū‐lăr mı̄‐Ă L‐jă mı̄‐ăs‐THĒ ‐ne‐̄ ă mı̄‐ăs‐THĒ ‐nē‐ă GRĂ ‐vı̆s ̄ ‐sı̆s mı̆‐DRI‐ă ̆ mı̄‐EK‐tō‐mē ̄ ‐lı̆n shēth MI‐ĕ ̄ s mı̄‐ĕ‐LI‐tı̆ ̄ MI‐ĕ‐lō‐blăst mı̄‐ĕ‐lō‐dı̆s‐PLĀ‐zē‐ă mı̄‐ĕ‐LŌ J‐ĕn‐ŭs ̄ ‐lō‐grăm MI‐ĕ ̄ ‐loyd MI‐ĕ mı̄‐ĕ‐LŌ ‐mă mı̄‐ĕ‐lō‐pō‐Ē ‐sı̆s mı̄‐ō‐KĂ R‐dē‐ăl mı̄‐ō‐KĂ R‐dē‐ŭm

Appendix A  Pronunciation and Spelling of Terms

myoclonus myoma myometrium myoneural myoparesis myopathy myoplasty myosarcoma myositis myotomy myotonia myringectomy myringitis myxoma narcolepsy nares nasal nasal bone nasogastric nasogastric intubation nasolacrimal nasopharynx nausea necropsy necrosis necrotic neonatal neonate neonatology neoplasia neoplasm nephralgia nephrectomy nephritis nephrogram nephrolithiasis nephrolithotomy nephrologist nephrology nephroma nephromalacia nephron nephropathy nephroptosis nephrosclerosis nephrosis

mı̄‐Ŏ K‐lŏ ‐nŭs mı̄‐Ō ‐mă mı̄‐ō‐MĒ ‐trē‐ŭm mı̄‐ō‐NŪ ‐răl mı̄‐ō‐pă‐RĒ ‐sı̆s mı̄‐Ŏ P‐ă‐thē mı̄‐ō‐PLĂ S‐tē mı̄‐ō‐săr‐KŌ ‐mă ̄ s mı̄‐ō‐SI‐tı̆ ̆ mı̄‐OT‐ō‐mē mı̄‐ō‐TŌ ‐nē‐ă mēr‐ı̆n‐JĔ K‐tō‐mē ̄ s mı̆r‐ı̆n‐JI‐tı̆ ̄ mı̆k‐SO‐mă NĂ R‐kō‐lĕp‐sē NĂ ‐rēz NĀ‐zăl NĀ‐zăl bōn nā‐zō‐GĂ S‐trı̆k nā‐zō‐GĂ S‐trı̆k ı̆n‐tū‐BĀ‐shŭn nā‐zō‐LĂ ‐krı̆‐măl nā‐zō‐FĂ R‐ı̆nks NĂ W‐zē‐ă NĒ ‐krŏ p‐sē nĕ‐KRŌ ‐sı̆s nĕ‐KRŌ T‐ı̆k nē‐ō‐NĀ‐tăl NĒ ‐ō‐nāt nē‐ō‐nā‐TŎ L‐ō‐jē nē‐ō‐PLĀ‐zē‐ă NĒ ‐ō‐plăzm nĕ‐FRĂ L‐jă nĕ‐FRĔ K‐tō‐mē ̄ s nĕ‐FRI‐tı̆ nĕ‐FRŎ ‐grăm ̄ ‐sı̆s nĕ‐frō‐lı̆‐THI‐ă nĕ‐frō‐lı̆‐THŎ T‐ō‐mē nĕ‐FRŎ L‐ō‐jı̆st nĕ‐FRŎ L‐ō‐jē nĕ‐FRŎ ‐mă nĕ‐frō‐mă‐LĀ‐shă NĔ F‐rŏ n nĕ‐FRŎ ‐pă‐thē nĕ‐FRŎ P‐Tō‐sı̆s nĕ‐frō‐sklĕ‐RŌ ‐sı̆s nĕ‐FRŎ ‐sı̆s

nephrostomy nephrotic nerve neural neuralgia neurasthenia neurectomy neuritis neurohypophysis neurological neurology neuron neuropathy neuroplasty neurorrhaphy neurotomy neurotransmitter neuter neutropenia neutrophil nictitating membrane nitrogen nitrogenous nodule norepinephrine normochromic normocytic nostrils nuclear nuclear sclerosis nucleic nucleoplasm nucleus nullipara nutrients nyctalopia obese obstetrics obstipation obstruction occipital bone occlusion ocular ocular dermoid oculomotor olecranal

605

nĕ‐FRŎ S‐tō‐mē nĕ‐FRŎ T‐ı̆k nĕrv NŪ ‐răl nū‐RĂ L‐jă nŭr‐ăs‐THĒ ‐nē‐ă nū‐RĔ K‐tō‐mē ̄ s nū‐RI‐tı̆ nū‐rō‐hı̄‐PŎ F‐ı̆‐sı̆s nū‐rō‐LŎ J‐ı̆k‐ăl nū‐RŎ L‐ō‐jē NŪ ‐rŏ n nū‐RŎ P‐ă‐thē nū‐rō‐PLĂ S‐tē nū‐RŎ R‐ă‐fē nū‐RŎ T‐ō‐mē nū‐rō‐trănz‐MI ̆T‐ĕr NŪ ‐tĕr nŭ‐trō‐PĒ ‐nē‐ă nŭ‐trō‐FI ̆L‐ē‐ā NI ̆K‐tı̆‐tā‐tı̆ng MĔ M‐brān ̄ ‐jĕn NI‐trō nı̄‐TRŎ J‐ĕ‐nŭs NŎ D‐ūl nŏ r‐ĕp‐ı̆‐NĔ F‐rı̆n nŏ r‐mō‐KRŌ ‐mı̆k nŏ r‐mō‐SI ̆‐tı̆k NŎ S‐trŭlz NŪ ‐klē‐ăr NŪ ‐klē‐ăr sklĕ‐RŌ ‐sı̆s nū‐KLĔ ‐ı̆k NŪ ‐klē‐ō‐plăzm NŪ ‐klē‐ŭs nŭl‐LI ̆P‐ă‐ră NŪ ‐trē‐ĕnts nı̆k‐tă‐LŌ ‐pē‐ă ō‐BĒ S ŏ b‐STĔ T‐rı̆ks ŏ b‐stı̆‐PĀ‐shŭn ŏ b‐STRŬ K‐shŭn

ŏ k‐SI ̆P‐ı̆‐tăl bōn ō‐KLū‐jŭn Ŏ K‐ū‐lăr Ŏ K‐ū‐lăr DĔ R‐moyd Ŏ K‐ū‐lō‐mō‐tĕr ō‐LĔ K‐ră‐năl

606

olecranon olfactory oligodendroglial oligospermia oliguria omasum omentum oncologist oncology onychectomy onycholysis onychomycosis oocyte oogenesis oophorectomy ophthalmic ophthalmologist ophthalmology ophthalmoplegia ophthalmoscope ophthalmoscopy opportunistic optic optic disk optic nerve optical oral orbit orchiectomy orchiopexy orchitis orifice orogastric orogastric intubation oronasal oronasal fistula oropharynx orthopedic os cordis os penis os rostri osseous ossicle ossification ostealgia ostectomy

Appendix A  Pronunciation and Spelling of Terms

ō‐LĔ K‐ră‐nŏ n ōl‐FĂ K‐tĕ‐reē ōl‐ē‐gō‐dĕn‐drō‐GLĒ ‐ăl ōl‐ē‐gō‐SPĔ R‐mē‐ă ōl‐ē‐GŪ ‐rē‐ă ō‐MĀ‐sŭm ō‐MĔ N‐tŭm ŏ n‐KŎ L‐ō‐jı̆st ŏ n‐KŎ L‐ō‐jē ŏ ‐nı̆‐KĔ K‐tō‐mē ŏ n‐ı̆‐KŎ L‐ı̆‐sı̆s ŏ n‐ı̆‐kō‐mı̄‐KŌ ‐sı̆s ō‐ŭh‐sı̄t ō‐ō‐JĔ N‐ĕ‐sı̆s oo‐fō‐RĔ K‐tō‐mē or ō‐ŏ f‐ō‐RĔ K‐tō‐mē ŏ f‐THĂ L‐mı̆k ŏ f‐thăl‐MŎ L‐ō‐jı̆st ŏ f‐thăl‐MŎ L‐ō‐jē ŏ f‐thăl‐mō‐PLĒ ‐jă ŏ f‐THĂ L‐mō‐skōp ŏ f‐thăl‐MŎ S‐kō‐pē ŏ p‐ĕr‐too‐NI ̆S‐tı̆k Ŏ P‐tı̆k Ŏ P‐tı̆k dı̆sk Ŏ P‐tı̆k nĕrv Ŏ P‐tı̆k‐ăl Ŏ R‐ăl Ŏ R‐bı̆t ŏ r‐kē‐Ĕ K‐tō‐mē ŏ r‐kē‐ō‐PĔ K‐sē ̄ s ŏ r‐KI‐tı̆ ̆ OR‐ı̆‐fı̆s ŏ r‐ō‐GĂ S‐trı̆k ŏ r‐ō‐GĂ S‐trı̆k ı̆n‐tū‐BĀ‐shŭn ŏ r‐ō‐NĀ‐zăl ŏ r‐ō‐NĀ‐zăl FI ̆S‐tū‐lă ŏ r‐ō‐FĂ R‐ı̆nks ŏ r‐thō‐PĒ ‐dı̆k ŏ s KŌ R‐dı̆s ŏ s PĒ ‐nı̆s ŏ s RŎ S‐trı̄ Ŏ S‐ē‐ŭs Ŏ S‐ı̆‐kŭl

ŏ s‐ı̆‐fı̆‐KĀ‐shŭn ŏ s‐tē‐Ă L‐jă ŏ s‐tē‐Ĕ K‐tō‐mē

osteitis osteoarthritis osteoblast osteocentesis osteochondrosis osteoclast osteocyte osteodystrophy osteogenesis osteogenic osteology osteomalacia osteomyelitis osteonecrosis osteopexy osteoplasty osteoporosis osteosarcoma osteosclerosis osteotome osteotomy otalgia otic otitis otitis externa otitis interna otitis media otolaryngology otomycosis otopathy otopyorrhea otorrhea otoscope otoscopy ova ovarian ovariohysterectomy

̄ s ŏ s‐tē‐I‐tı̆ ̄ s ŏ s‐tē‐ō‐ăr‐THRI‐tı̆ ̆ OS‐tē‐ō‐blăst ŏ s‐tē‐ō‐sĕn‐TĒ ‐sı̆s ŏ s‐tē‐ō‐kŏ n‐DRŌ ‐sı̆s Ŏ S‐tē‐ō‐klăst Ŏ S‐tē‐ō‐sı̄t ŏ s‐tē‐ō‐DI ̆S‐trō‐fē ŏ s‐tē‐ō‐JĔ N‐ĕ‐sı̆s ŏ s‐tē‐ō‐JĔ N‐ı̆k ŏ s‐tē‐Ŏ L‐ŏ ‐jē ŏ s‐tē‐ō‐mă‐LĀ‐shă ̄ s ŏ s‐tē‐ō‐mı̄‐ĕ‐LI‐tı̆ ŏ s‐tē‐ō‐nĕ‐KRŌ ‐sı̆s Ŏ S‐tē‐ō‐pĕk‐sē ŏ s‐tē‐ō‐PLĂ S‐tē ŏ s‐tē‐ō‐pŏ r‐Ō ‐sı̆s ŏ s‐tē‐ō‐săr‐KŌ ‐mă ŏ s‐tē‐ō‐sklĕ‐RŌ ‐sı̆s Ŏ S‐tē‐ō‐tōm ŏ s‐tē‐Ŏ T‐ō‐mē ō‐TĂ L‐jă Ō ‐tı̆k ̄ s ō‐TI‐tı̆ ̄ s ĕx‐TĔ R‐nă ō‐TI‐tı̆ ̄ s ı̆n‐TĔ R‐nă ō‐TI‐tı̆ ̄ s MĒ ‐dē‐ă ō‐TI‐tı̆ ō‐tō‐lă‐rı̆n‐GŎ ‐lō‐jē ō‐tō‐mı̄‐KŌ ‐sı̆s ō‐TŎ ‐păth‐ē

ovary ovine ovulation ovum oxygen oxytocia oxytocin

ō‐tō‐pı̄‐ō‐RĒ ‐ă ō‐tō‐RĒ ‐ă Ō ‐tō‐skōp ō‐TŎ S‐kō‐pē Ō ‐vă ō‐VĂ ‐rē‐ăn ō‐VĂ R‐ē‐ō‐hı̆s‐tĕr‐Ĕ K‐ tō‐mē Ō ‐vă‐rē Ō ‐vı̄n ŏ v‐ū‐LĀ‐shŭn Ō ‐vŭm Ŏ K‐sı̆‐jĕn ŏ ks‐ē‐TŌ ‐sē‐ă ŏ ks‐ē‐TŌ ‐sı̆n

palate palatine bone

PĂ L‐ăt PĂ L‐ŭn‐tı̄n bōn

Appendix A  Pronunciation and Spelling of Terms

palatoplasty palatoschisis palliative pallor palmar palpation palpebra palpebral palpitations palsy pancreas pancreatectomy pancreatic pancreatitis pancreatotomy pancytopenia panhypopituitarism panleukopenia panophthalmitis panosteitis panotitis papillae papilledema papilloma papule paracentesis parainfluenza paralysis paranasal paranephric paraparesis paraphimosis paraplegia parasympathetic parathormone parathyroid gland parathyroidectomy parenchyma parenteral paresthesia parietal parietal bone paronychia parotid gland paroxysmal parturition parvo

PĂ L‐ă‐tō‐plăs‐tē păl‐ă‐TŎ S‐kı̆‐sı̆s PĂ ‐lē‐ă‐tı̆v PĂ L‐ĕr PĂ L‐măr păl‐PĀ‐shŭn PĂ L‐pē‐bră PĂ L‐pē‐brăl păl‐pı̆‐TĀ‐shŭnz PĂ L‐zē PĂ N‐krē‐ăs păn‐krē‐ă‐TĔ K‐tō‐mē păn‐krē‐Ă H‐tı̆k ̄ s PĂ N‐krē‐ă‐TI‐tı̆ ̆ păn‐krē‐ă‐TO‐tō‐mē păn‐sı̄‐tō‐PĒ ‐nē‐ă păn‐hı̄‐pō‐pı̆‐TŪ ‐ı̆‐ tăr‐ı̆zm păn‐LŪ ‐kō‐PĒ ‐nē‐ă ̄ s păn‐ŏ f‐thăl‐MI‐tı̆ ̄ păn‐ŏ s‐tē‐I‐tı̆s ̄ s păn‐ō‐TI‐tı̆ ̆ pă‐PI L‐ē păp‐ĕ‐lĕ‐DĒ ‐mă pă‐pı̆l‐Ō ‐mă PĂ P‐ūl pă‐ră‐sĕn‐TĒ ‐sı̆s pĕ‐ră‐I ̆N‐flū‐ĕn‐ză pă‐RĂ L‐ı̆‐sı̆s pă‐ră‐NĀ‐zăl pă‐ră‐NĔ F‐rı̆k pă‐ră‐pă‐RĒ ‐sı̆s pă‐ră‐fı̄‐MŌ ‐sı̆s păr‐ă‐PLĒ ‐jă păr‐ă‐sı̆m‐pă‐THĔ T‐ı̆k pă‐ră‐THŎ R‐mōn ̄ păr‐ă‐THI‐royd glănd păr‐ă‐thı̄‐roy‐DĔ K‐tō‐mē păr‐Ĕ N‐kı̄‐mă pă‐RĔ N‐tĕr‐ăl păr‐ĕs‐THĒ ‐zē‐ă ̄ ‐tăl pă‐RI‐ĕ ̄ ‐tăl bōn pă‐RI‐ĕ păr‐ŏ ‐NI ̆K‐ē‐ă pă‐RŎ T‐ı̆d glănd păr‐ŏ k‐SI ̆Z‐măl păr‐tū‐RI ̆SH‐ŭn PĂ R‐vō

patella patellar patent patent ductus arteriosus pathogenesis pathogenic pathological pathologist pathology pectoral pedunculated pelvic pelvimetry pelvis percussion percutaneous perfusion perianal pericardial pericardiocentesis pericarditis pericardium perilymph perineal urethrostomy perineorrhaphy perineum periocular periodontal disease periodontal ligament periosteitis periosteum peripheral nervous system peristalsis peritoneal peritoneum peritonitis peroneal persistent frenulum petechia; petechiae phagocyte phalangeal phalanges pharyngeal

607

pă‐TĔ L‐ă pă‐TĔ L‐ăr PĀ‐tĕnt PĀ‐tĕnt DŬ K‐tŭs ăr‐tĕr‐ē‐Ō ‐sı̆s păth‐ō‐JĔ N‐ĕ‐sı̆s păth‐ō‐JĔ N‐ı̆k păth‐ō‐LŎ J‐ı̆k‐ăl pă‐THŎ L‐ŏ ‐jı̆st pă‐THŎ L‐ŏ ‐jē pĕk‐TŎ R‐ăl pĕ‐DŬ NG‐kū‐lāt‐ĕd PĔ L‐vı̆k pĕl‐VI ̆M‐ı̆‐trē PĔ L‐vı̆s pĕr‐KŬ SH‐ŭn pĕr‐kū‐TĀ‐nē‐ŭs pĕr‐FŪ ‐shŭn pĕ‐rē‐Ā‐năl pĕ‐rē‐KĂ R‐dē‐ăl pĕr‐ı̆‐KĂ R‐dē‐ō‐sĕn‐TĒ ‐ sı̆s ̄ s pĕr‐ı̆‐kăr‐DI‐tı̆ ̆ pĕr‐ı̆‐KAR‐dē‐ŭm PĔ R‐ı̆‐lı̆mf pĕ‐rı̆‐NĒ ‐ăl ū‐rē‐THRŎ S‐tō‐mē pĕ‐rı̆‐nē‐Ŏ R‐ră‐fē pĕ‐rı̆‐NĒ ‐ŭm pĕ‐rı̆‐Ŏ K‐ū‐lăr pĕr‐ē‐ō‐DŎ N‐tăl dı̆‐ZĒ Z pĕr‐ē‐ō‐DŎ N‐tăl LIĞ ‐ă‐mĕnt

̄ s pĕr‐ē‐ŏ s‐tē‐I‐tı̆ ̆ pĕr‐ē‐OS‐tē‐ŭm pĕ‐RI ̆F‐ĕr‐ăl NĔ R‐vŭs SI ̆S‐tĕm pĕr‐ı̆‐STĂ L‐sı̆s pĕr‐ı̆‐tō‐NĒ ‐ăl pĕ‐rı̆‐tō‐NĒ ‐ŭm ̄ s pĕ‐rı̆‐tō‐NI‐tı̆ ̄ pĕr‐ō‐NE‐ăl pĕr‐SI ̆S‐tĕnt FRĔ N‐ū‐lŭm pĕ‐TĒ ‐kē‐ă; pĕ‐TĒ ‐kē‐ı̄ FĂ G‐ō‐sı̄t fă‐lăn‐JĒ ‐ăl fă‐LĂ N‐jēz fă‐RI ̆N‐jē‐ăl

608

pharyngitis pharyngoplasty pharyngostomy pharyngotomy pharynx pheochromocytoma phimosis phlebotomy phlegm phosphorus photophobia phrenic physiology pia mater pica piloerection pilosebaceous pineal gland pinealopathy pinna pituitarism pituitary gland pivot placenta plane plantar plaque plasma platelet pleomorphic pleura pleural pleurodynia plexus pneumocolon pneumonectomy pneumonia pneumothorax pneumovagina poikilocytosis polioencephalomalacia polioencephalomyelitis pollakiuria polyarthritis polycystic polycythemia

Appendix A  Pronunciation and Spelling of Terms

̄ s fă‐rı̆n‐JI‐tı̆ ̆ fă‐RI N‐gō‐plăs‐tē fă‐rı̆n‐GŎ S‐tō‐mē fă‐rı̆n‐GŎ T‐ō‐mē FĂ R‐ı̆nks fē‐ō‐krō‐mō‐sı̄‐TŌ ‐mă fē‐MŌ ‐sı̆s flĕ‐BŎ T‐ō‐mē FLĔ M FŎ S‐fō‐rŭs fō‐tō‐FŌ ‐bē‐ă FRĔ N‐ı̆k fı̆‐sē‐Ŏ L‐ō‐jē PĒ ‐ă MĂ ‐tĕr ̄ PI‐kă ̄ ‐ē‐rĕk‐shŭn PI‐lō pı̄‐lō‐sĕ‐BĀ‐shŭs pı̄‐NĒ ‐ăl glănd pı̆n‐ē‐ăl‐Ŏ P‐ă‐thē PI ̆N‐ă pı̆‐TŪ ‐ı̆‐tăr‐ı̆zm pı̆‐TŪ ‐ı̆‐tăr‐ē glănd PI ̆‐vı̆t plă‐SĔ N‐tă plān plăn‐tĕr PLĂ K PLĂ Z‐mă PLĀT‐lĕt plē‐ō‐MŎ R‐fı̆k PLOO‐ră PLOOR‐ăl Plŭr‐ō‐DI ̆N‐ē‐ă PLĔ K‐sŭs nū‐mō‐KŌ ‐lĕn nū‐mō‐NĔ K‐tō‐mē nū‐MŌ N‐ē‐ă nū‐mō‐THŌ ‐răks ̄ nū‐mō‐vă‐JI‐nă poy‐kē‐lō‐sı̄‐TŌ ‐sı̆s pō‐lē‐ō‐ĕn‐sĕf‐ă‐lō‐mă‐ LĀ‐shă pō‐lē‐ō‐ĕn‐sĕf‐ă‐lō‐mı̄‐ĕ‐ ̄ s LI‐tı̆ ̆ POL‐lă‐kē‐Ū ‐rē‐ă

̄ s pŏ l‐ē‐ăr‐THRI‐tı̆ ̆ pŏ l‐ē‐SI S‐tı̆k pŏ l‐ē‐sı̄‐THĒ ‐mē‐ă

polydipsia polymorphonuclear polymyalgia polymyelitis polymyositis polyneuritis polyp polyphagia polyuria pons portal vein portosystemic shunt postauricular postcibum posterior postmortem postpartum postprandial potassium precancerous pregnancy premolar prenatal preprandial prepuce presentation priapism primigravida primipara primiparous proctology prodrome proestrus progesterone prognathia prognosis prolactin prolapse pronation prone proprioception proptosis prostate gland prostatectomy prostatitis prostatomegaly protease

pŏ l‐ē‐DI ̆P‐sē‐ă pŏ l‐ē‐mŏ r‐fō‐NŪ ‐klē‐ăr pŏ l‐ē‐mı̄‐Ă L‐jă ̄ s pō‐lē‐ō‐mı̄‐ĕ‐LI‐tı̆ ̄ pŏ l‐ē‐mı̄‐ō‐SI‐tı̆s ̄ s pŏ l‐ē‐nū‐RI‐tı̆ ̆ POL‐ı̆p pŏ l‐ē‐FĀ‐jē‐ă pŏ l‐ē‐Ū ‐rē‐ă pŏ nz PŎ R‐tăl Vān pŏ r‐tō‐sı̆s‐TĔ M‐ı̆k SHŬ NT pōst‐ăw‐RI ̆K‐ū‐lăr pōst‐SĒ ‐bŭm pōs‐TĒ R‐ē‐ŏ r pōst‐MŎ R‐tĕm pōst‐PĂ R‐tŭm pōst‐PRĂ N‐dē‐ăl pō‐TĂ ‐sē‐ŭm prē‐KĂ N‐sĕr‐ŭs PRĔ G‐nŭn‐sē prē‐MŌ ‐lăr prē‐NĀ‐tăl prē‐PRĂ N‐dē‐ăl PRĒ ‐pūs prĕ‐sĕn‐TĀ‐shŭn ̄ ‐pı̆‐zŭm PRI‐ŭ prı̆‐mı̆‐GRĂ V‐ı̆‐dă prı̆‐MI ̆‐pă‐ră prı̆‐MI ̆P‐ă‐rŭs prŏ k‐TŎ L‐ō‐jē PRŌ ‐drōm prō‐Ĕ S‐trŭs prō‐JĔ S‐tĕ‐rōn prō‐gNĀ‐thē‐ā prŏ g‐NŌ ‐sı̆s prō‐LĂ K‐tı̆n PRŌ ‐lăps prō‐NĀ‐shŭn prōn PRŌ ‐prē‐ō‐sĕp‐shŭn prŏ p‐TŌ ‐sı̆s PRŎ S‐tāt glănd prŏ s‐tă‐TĔ K‐tō‐mē ̄ s prŏ s‐tă‐TI‐tı̆ prŏ s‐tă‐tō‐MĔ G‐ă‐lē PRŌ ‐tē‐āse

Appendix A  Pronunciation and Spelling of Terms

proteinuria prothrombin protoplasm proximal pruritus pseudocyesis pubic pubis pulmonary pulp pulse pulse oximeter pupil pupillary Purkinje fibers purpura purulent pus pustule pyelitis pyelogram pyelolithotomy pyelonephritis pyloric pyloric stenosis pyloroplasty pylorospasm pyoderma pyometra pyometritis pyorrhea pyothorax pyuria

prō‐tēn‐Ū ‐rē‐ă prō‐THRŎ M‐bı̆n PRŌ ‐tō‐plăzm PRŎ K‐sı̆‐măl ̄ s prū‐RI‐tı̆ sū‐dō‐sı̄‐Ē ‐sı̆s PŪ ‐bı̆k PŪ ‐bı̆s PŬ L‐mō‐nĕr‐ē pŭlp pŭls pŭls ŏ k‐SI ̆‐mĕ‐tĕr PŪ ‐pı̆l PŪ ‐pı̆‐lăr‐ē ̄ rz pĕr‐KI ̆N‐jē FI‐bĕ ̆ PUR‐pū‐ră PŪ R‐ū‐lĕnt PŬ S PŬ S‐tūl ̄ s pı̄‐ĕ‐LI‐tı̆ ̄ PI‐ĕ‐lō‐grăm pı̄‐ĕ‐lō‐lı̆‐THŎ T‐ō‐mē ̄ s pı̄‐ĕ‐lō‐nĕf‐RI‐tı̆ ̆ pı̄‐LOR‐ı̆k pı̄‐LŎ R‐ı̆k stĕ‐NŌ ‐sı̆s pı̄‐LŎ R‐ō‐plăs‐tē pı̄‐LŎ R‐ō‐spăsm pı̄‐ō‐DĔ R‐mă pı̄‐ō‐MĒ ‐tră ̄ s pı̄‐ō‐mē‐TRI‐tı̆ ̄ pı̄‐ō‐RE‐ă pı̄‐ō‐THŌ ‐răks pı̄‐Ū ‐rē‐ă

quadriparesis quadriplegia

kwŏ d‐rı̆‐pă‐RĒ ‐sı̆s kwŏ d‐rı̆‐PLĒ ‐jă

rabies radial radiculitis radiculopathy radiograph radiographer radiography radiology radiotherapy radius rales and crackles

RĀ‐bēs RĀ‐dē‐ăl ̄ s ră‐dı̆k‐ū‐LI‐tı̆ ră‐dı̆k‐ū‐LŎ P‐ă‐thē rā‐dē‐Ō ‐grăf rā‐dē‐Ŏ G‐ră‐fĕr rā‐dē‐Ŏ G‐ră‐fē rā‐de‐̄ Ŏ L‐ō‐jē rā‐dē‐ō‐THĔ ‐ră‐pē RĀ‐dē‐ŭs rāhlz and kră‐kŭlz

reabsorption rectal rectocele rectum recumbency recumbent reduction refraction regurgitate relapse remission renal renal pelvis renal tubule renin resection respiration respiratory reticulocyte reticulum retina retinal retinitis retinopathy retrocardiac retroperitoneal retrovirus rhabdomyoma rhabdomyosarcoma rheumatoid arthritis rhinitis rhinoplasty rhinorrhea rhinotracheitis rhonchi ribosome ribs rod rostral rotation rouleaux rugae rumen

609

rē‐ăb‐SŎ RP‐shŭn RĔ K‐tăl RĔ K‐tō‐sēl RĔ K‐tŭm rē‐KŬ M‐bĕn‐sē rē‐KŬ M‐bĕnt rĕ‐DŬ K‐shŭn rē‐FRĂ K‐shŭn rē‐GĔ R‐jı̆‐tāt RĒ ‐lăps rē‐MI ̆‐shŭn RĒ ‐năl RĒ ‐năl PĔ L‐vı̆s RĒ ‐năl TŪ ‐būl RĒ ‐nı̆n Rē‐SĔ K‐shŭn rĕs‐pĕ‐RĀ‐shŭn RĔ S‐pı̆r‐ă‐tō‐rē rĕ‐TI ̆K‐ū‐lō‐sı̄t rĕ‐TI ̆K‐ū‐lŭM RĔ T‐ı̆‐nă RĔ T‐ı̆‐năl ̄ s rĕt‐ı̆‐NI‐tı̆ rĕ‐tı̆‐NŎ P‐ă‐thē rĕ‐trō‐KĂ R‐dē‐ăk rĕ‐trō‐pĕr‐ı̆‐tō‐NĒ ‐ăl rĕ‐trō‐VI ̆‐rŭs răb‐dō‐mı̄‐Ō ‐mă răb‐dō‐mı̄‐ō‐săr‐KŌ ‐mă ROO‐mă‐toyd ̄ s ăr‐THRI‐tı̆ ̄ rı̄‐NI‐tı̆s ̄ ‐PLĂ S‐tē RI‐nō rı̄‐nō‐RĒ ‐ăh ̄ ‐TRĀ‐kē‐ı̄‐tı̆s RI‐nō RŎ NG‐kı̄ ̄ ‐sōm RI‐bō rı̆bz rŏ d RŎ S‐trăl rō‐TĀ‐shŭn ROO‐lō ROO‐gē

ruminant

ROO‐mĕn ROO‐mĕ‐nănt

sacral sacralgia

SĀ‐krăl sā‐KRĂ L‐jă

610

sacrocaudal sacrococcygeal sacroiliac sacropelvic sacrum saddle sagittal saliva salivary gland salivary mucocele sarcoma scabies scapula scapular scapulohumeral scar Schwann sclera scleral scleritis scours scrotal circumference scrotal hydrocele scrotum sebaceous gland seborrhea sebum seizure semen semicircular canal seminal vesicles seminiferous tubules septa; septum sequestrum serotonin serum sesamoid bone shock shunt sialadenitis sialadenosis sialocele sinoatrial node sinus sinus rhythm sinusitis

Appendix A  Pronunciation and Spelling of Terms

SĀ‐krō‐KAWD‐ăl SĀ‐krō‐kŏ k‐sı̆‐JĒ ‐ăl SĀ‐krō‐ı̆L‐ē‐ăk SĀ‐krō‐PĔ L‐vı̆k SĀ‐krŭm SĂ ‐dŭl SĂ J‐ı̆‐tăl ̄ să‐LI‐vă ̆ SAL‐ı̆‐vĕr‐ē glănd SĂ L‐ı̆‐vĕr‐ē MŪ ‐kō‐sēl săr‐KŌ ‐mă SKĀ‐bēz SKĂ P‐ū‐lă SKĂ P‐ū‐lăr SKĂ P‐ū‐lō‐HŪ ‐mĕr‐ăl skŏ r shwŏ n SKLĔ ‐ră SKLĔ ‐răl ̄ s sklĕ‐RI‐tı̆ SKOW‐ĕrz SKRŌ ‐tăl sĕr‐KŬ M‐fĕr‐ĕns ̄ SKRŌ ‐tăl HI‐drō ‐sēl ̄ SKRO‐tŭm sĕ‐BĀ‐shŭs glănd sĕb‐ō‐RĒ ‐ă SĒ ‐bŭm SĒ ‐zhŭr SĒ ‐mĕn sĕ‐mē‐SĔ R‐kū‐lăr kă‐NĂ L SĔ M‐ı̆n‐ăl VĔ S‐ı̆‐kŭlz sĕ‐mı̆‐NI ̆F‐ĕr‐ŭs TŪ B‐ūlz SĔ P‐tă; SĔ P‐tŭm sı̆‐KWĔ S‐trŭm sĕr‐ŭh‐TŌ ‐nı̆n SĔ ‐rŭm SĔ S‐ă‐moyd SHŎ K SHŬ NT ̄ s sı̄‐ăl‐ă‐dĕ‐NI‐tı̆ sı̄‐ăl‐ă‐dĕ‐NŌ ‐sı̆s ̄ l‐ō‐sēl SI‐ă sı̄‐nō‐Ā‐trē‐ăl nōd ̄ s SI‐nŭ ̄ s RI ̆TH‐ŭm SI‐nŭ ̄ s sı̄‐nū‐SI‐tı̆

sinusotomy skeletal muscle skull sodium soft palate somatotropin spasm spasticity spermatic cord spermatogenesis spermatozoa spermatozoon spermolytic sphenoid bone spherocytosis spheroid joint sphincter sphygmomanometer spina bifida spinal spinal cavity spinal column spinal cord spirometer splanchnic skeleton spleen splenectomy splenic rupture splenomegaly spondylitis spondylosis sputum squamous stapes staphylococcus stasis steatitis steatolysis steatoma steatorrhea stem cell stenosis stent sterility sterilization sternal sternum

sı̄‐nū‐SŎ ‐tō‐mē SKĔ L‐ĕ‐tăl MŬ S‐ĕl skŭl SŌ ‐dē‐ŭm sŏ ft PĂ L‐ăt sō‐mă‐tō‐TRŌ ‐pı̆n SPĂ ‐zı̆m spă‐STI ̆‐sı̆‐tē spĕr‐MĂ T‐ı̆k kŏ rd spĕr‐mă‐tō‐JĔ N‐ĕ‐sı̆s spĕr‐mă‐tō‐ZŌ ‐ă spĕr‐mă‐tō‐ZŌ ‐ōn spĕr‐mō‐LI ̆T‐ı̆k SFĔ ‐noyd bōn sfēr‐ō‐sı̄‐TŌ ‐sı̆s SFĒ ‐royd joynt SFI ̆NGK‐tĕr sfı̆g‐mō‐mă‐NŎ M‐ĕ‐tĕr ̄ SPI‐nă BI ̆F‐ı̆‐dă ̄ SPI‐năl ̄ l KĂ ‐vı̆‐tē SPI‐nă ̄ l KŎ L‐ŭm SPI‐nă ̄ l kŏ rd SPI‐nă spı̄‐RŎ M‐ĕ‐tĕr SPLĀNGK‐nı̆k SKĔ L‐ı̆‐tı̆n splēn splĕ‐NĔ K‐tō‐mē SPLĔ ‐nı̆k RŬ P‐shŭr splē‐nō‐MĔ G‐ă‐lē ̄ s spŏ n‐dı̆‐LI‐tı̆ spŏ n‐dı̆‐LŌ ‐sı̆s SPŪ ‐tŭm SKWĀ‐mŭs STĀ‐pēz stăf‐ı̆‐lō‐KŎ K‐ŭs STĀ‐sı̆s ̄ s stē‐ă‐TI‐tı̆ stē‐ă‐TŎ L‐ı̆‐sı̆s stē‐ă‐TŌ ‐mă stē‐ă‐tō‐RĒ ‐ă stĕm sĕl stĕ‐NŌ ‐sı̆s stı̆nt stĕ‐RI ̆L‐ı̆‐tē stĕr‐ı̆‐lı̆‐ZĀ‐shŭn STĔ R‐năl STĔ R‐nŭm

Appendix A  Pronunciation and Spelling of Terms

steroid stethoscope stifle stimulus stoma stomach stomatitis stomatogastric stomatology strabismus stranguria stratum corneum streptococci striated stricture stridor stroma stupor subarachnoid subcostal subcutaneous subdural subhepatic sublingual subluxation submandibular subpatellar subungual sulci; sulcus superficial supination supine suppurative supraclavicular suprascapular susceptible suture symmetry sympathetic symphysis synapse synarthroses syncopal syncope syndactyly syndrome synergistic synovial cavity

STĔ R‐oyd STĔ TH‐ō‐skōp ̄ l STI‐fŭ ̆ STI M‐ū‐lŭs STŌ ‐mă STŬ ‐măk ̄ s stō‐mă‐TI‐tı̆ stō‐mă‐tō‐GĂ S‐trı̆k stō‐mă‐TŎ L‐ō‐jē stră‐BI ̆Z‐mŭs străng‐Ū ‐rē‐ă STRĂ ‐tŭm KŎ R‐nē‐ŭm strĕp‐tō‐KŎ K‐sı̄ ̄ ‐tĕd STRI‐ā ̆ STRI K‐shŭr ̄ r STRI‐dŏ STRŌ ‐mă STOO‐pŏ r sŭb‐ă‐RĂ K‐noyd sŭb‐KŎ S‐tăl sŭb‐kū‐TĀ‐nē‐ŭs sŭb‐DŪ ‐răl sŭb‐hĕ‐PĂ T‐ı̆k sŭb‐LI ̆NG‐wăl sŭb‐lŭk‐SĀ‐shŭn sŭb‐măn‐DI ̆B‐ū‐lăr sŭb‐pă‐TĔ L‐lăr sŭb‐Ŭ NG‐wăl SŬ L‐sı̄; SŬ L‐kŭs sū‐pĕr‐FI ̆SH‐ăl sū‐pı̆‐NĀ‐shŭn SŪ ‐pı̄n SŬ ‐pĕr‐ă‐tı̆v sū‐pră‐klă‐VI ̆K‐ū‐lăr sū‐pră‐SKĂ P‐ū‐lăr sŭs‐SĔ P‐tı̆‐bŭl SŪ ‐tŭr SI ̆M‐mĕ‐trē sı̆m‐pă‐THĔ T‐ı̆k SI ̆M‐fı̆‐sı̆s SI ̆N‐ăps sı̆n‐ăr‐THRŌ ‐sēs SI ̆N‐kō‐păl SI ̆N‐kō‐pē sı̆n‐DĂ K‐tı̆‐lē SI ̆N‐drōm sı̆n‐ĕr‐JI ̆S‐tı̆k sı̆‐NŌ ‐vē‐ăl KĂ ‐vı̆‐tē

synovial fluid synovial joint synovial membrane synovitis synthesis systemic systole tachycardia tachypnea tactile tapetum lucidum tarsals tarsectomy tarsorrhaphy tarsus temporal bone tendinectomy tendinitis tendon tenectomy tenesmus tenorrhaphy tenosynovitis tenotomy testes testicles testicular testis testosterone tetany tetraiodothyronine tetralogy of Fallot tetraparesis tetraplegia thalamus theriogenology thoracentesis thoracic thoracocentesis thoracoscopy thoracotomy thorascopy thorax thrill thrombin thrombocyte thrombocytopenia

611

sı̆‐NŌ ‐vē‐ăl FLOO‐ı̆d sı̆‐NŌ ‐vē‐ăl joynt sı̆‐NŌ ‐vē‐ăl MĔ M‐brān ̄ s sı̆n‐ō‐VI‐tı̆ ̆ SI N‐thĕ‐sı̆s sı̆s‐TĔ M‐ı̆k SI ̆S‐tō‐lē tăk‐ē‐KĂ R‐dē‐ă tă‐KI ̆P‐nē‐ă tăk‐TIL̄ tă‐PĒ ‐tŭm LOO‐sı̆‐dŭm TĂ R‐sălz tăr‐SĔ K‐tō‐mē tăr‐SŎ R‐ă‐fē TĂ R‐sŭs TĔ M‐pĕr‐ăl bōn tĕn‐dı̆‐NĔ K‐tō‐mē ̄ s tĕn‐dı̆‐NI‐tı̆ ̆ TEN‐dŭn tĕn‐Ĕ K‐tō‐mē tĕ‐NĔ Z‐mŭs tĕn‐Ŏ R‐ă‐fē ̄ s tĕn‐ō‐sı̆‐nō‐VI‐tı̆ ̆ tĕn‐O‐tō‐mē TĔ S‐tēs TĔ S‐tı̆‐kŭlz tĕs‐TI ̆K‐ū‐lăr TĔ S‐tı̆s tĕs‐TŎ S‐tĕ‐rōn TĔ T‐ă‐nē ̄ ‐nēn tĕ‐tră‐ı̄‐ō‐dō‐THI‐rō ̆ tĕ‐TRAL‐ō‐jē of fă‐LŌ tĕ‐tră‐pă‐RĒ ‐sı̆s tĕ‐tră‐PLĒ ‐jă THĂ L‐ă‐mŭs thēr‐ē‐ō‐jĕ‐NŎ L‐ō‐jē thō‐ră‐sĕn‐TĒ ‐sı̆s thō‐RĂ S‐ı̆k thōr‐ră‐kō‐sĕn‐TĒ ‐sı̆s thōr‐ră‐KŎ S‐kō‐pē thō‐ră‐KŎ T‐ō‐mē thō‐RŎ S‐kō‐pē thō‐RĂ KS thrı̆l THRŎ M‐bı̆n THRŎ M‐bō‐sı̄t thrŏ m‐bō‐sı̄‐tō‐PĒ ‐nē‐ă

612

thrombocytosis thromboembolic meningoencephalitis thrombolysis thrombolytic thromboplastin thrombosis thrombus thymectomy thymoma thymosin thymus gland thyroid gland thyroiditis thyromegaly thyrotoxicosis thyrotropin thyroxine tibia tibial tidal volume tissue tomography tongue tonometer tonometry tonsil tonsillectomy tonsillitis tonus torsion toxic toxin trachea tracheal tracheal stenosis tracheoplasty tracheostomy tracheotomy transfusion transhepatic transtracheal transurethral transverse transverse colon tremor triadan trichobezoar trichomycosis

Appendix A  Pronunciation and Spelling of Terms

THRŎ M‐bō‐sı̄‐TŌ ‐sı̆s thrŏ m‐bō‐ĕm‐BŎ L‐ı̆k mĕ‐NI ̆N‐gō‐ĕn‐sĕf‐ă‐ ̄ ̆s LI‐tI thrŏ m‐BŎ L‐ı̆‐sı̆s thrŏ m‐bō‐LI ̆‐tı̆k thrŏ m‐bō‐PLĂ S‐tı̆n thrŏ m‐BŌ ‐sı̆s THRŎ M‐bŭs thı̄‐MĔ K‐tō‐mē thı̄‐MŌ ‐mă ̄ THI‐mŭ ‐sı̆n ̄ THI‐mŭs glănd ̄ THI‐royd glănd ̄ s thı̄‐royd‐I‐tı̆ thı̄‐ro‐MĔ G‐ă‐lē thı̄‐ro‐tŏ k‐sı̆‐KŌ ‐sı̆s thı̄‐rō‐TRŌ ‐pı̆n thı̄‐RŎ K‐sı̆n TI ̆B‐ē‐ă TI ̆B‐ē‐ăl ̄ l VŎ L‐ūm TI‐dă ̆ TI SH‐ū tō‐MŎ G‐ră‐fē TŬ NG tō‐NŎ ‐mĕ‐tĕr tō‐NŎ M‐ĕ‐trē TŎ N‐sı̆l tŏ n‐sı̆‐LĔ K‐tō‐mē ̄ s tŏ n‐sı̆‐LI‐tı̆ ̄ TO‐nŭs TŎ R‐shŭn TŎ K‐sı̆k TŎ K‐sı̆n TRĀ‐kē‐ă TRĀ‐kē‐ăl TRĀ‐kē‐ăl stĕ‐NŌ ‐sı̆s trā‐kē‐ō‐PLĂ S‐tē trā‐kē‐Ŏ S‐tō‐mē trā‐kē‐Ŏ T‐ō‐mē trăns‐FŪ ‐zhŭn trănz‐hĕ‐PĂ T‐ı̆k trănz‐TRĀ‐kē‐ăl trăns‐ū‐RĒ ‐thrăl trănz‐VĔ RS trănz‐VĔ RS KŌ ‐lĕn TRĔ ‐mŏ r

̄ ‐dăn TRI‐ă trı̆‐kō‐BĒ ‐zŏ r trı̆k‐ō‐mı̄‐KŌ ‐sı̆s

tricuspid valve trigeminal trigone triiodothyronine trochanter trochlear trypsin tubercle tuberosity tympanic membrane tympanoplasty ulcer ulna ulnar ultrasound umbilical umbilical cord umbilicus ungulates unilateral urea uremia ureter ureteroileostomy ureterolithotomy ureteroplasty urethra urethral stricture urethritis urethroplasty uric acid urinalysis urinary bladder urinary retention urination urine

trı̄‐KŬ S‐pı̆d vălv trı̄‐JĔ M‐ı̆‐năl ̄ n TRI‐gō ̄ ‐nēn trı̄‐ı̄‐ō‐dō‐THI‐rō ̆ trō‐KAN‐tĕr TRŌ ‐klē‐ăr TRI ̆P‐sı̆n TŪ ‐bĕr‐kŭl tū‐bĕ‐RŎ S‐ı̆‐tē tı̆m‐PĂ N‐ı̆k MĔ M‐brān tı̆m‐pă‐nō‐PLĂ S‐tē Ŭ L‐sĕr Ŭ L‐nă Ŭ L‐năr Ŭ L‐tră‐sound ŭm‐BI ̆L‐ı̆‐kăl ŭm‐BI ̆L‐ı̆‐kăl kŏ rd ŭm‐BI ̆L‐ı̆‐kŭs Ŭ N‐gū‐lŭt or Ŭ N‐gū‐lāts ū‐nē‐LĂ T‐ĕr‐ăl ū‐RĒ ‐ă ū‐RĒ ‐mē‐ă Ū ‐rĕ‐tĕr ū‐rē‐tĕr‐ō‐ı̆l‐ē‐Ŏ S‐tō‐mē ū‐rē‐tĕr‐ō‐lı̆‐THŎ T‐ō‐mē ū‐rē‐tĕr‐ō‐PLĂ S‐tē ū‐RĒ ‐thră ū‐RĒ ‐thrăl STRI ̆K‐shŭr ̄ s ū‐rē‐THRI‐tı̆ ū‐rē‐thrō‐PLĂ S‐tē Ū ‐rı̆k Ă S‐ı̆d ū‐rı̆n‐Ă L‐ı̆‐sı̆s Ū R‐ı̆‐năr‐ē BLĂ ‐dĕr Ū R‐ı̆‐năr‐ē rē‐TĔ N‐shŭn ūr‐ı̆‐NĀ‐shŭn

urolithiasis urological urology uropoiesis urticaria uterine uterus uvea uveitis

ū‐rı̆n ̄ ‐sı̆s ūr‐ō‐lı̆‐THI‐ă ̆ ūr‐ō‐LOG‐ı̆k‐ăl ū‐RŎ L‐ō‐jē ū‐rō‐pō‐Ē ‐sı̆s ŭr‐tı̆‐KĀ‐rē‐ă Ū ‐tĕr‐ı̆n Ū ‐tĕ‐rŭs Ū ‐vē‐ă ̄ s ū‐vē‐I‐tı̆

vaccination vaccine vacuole

văk‐sı̆‐NĀ‐shŭn văk‐SĒ N VĂ C‐ū‐ōl

Appendix A  Pronunciation and Spelling of Terms

vagal vagina vaginal vaginitis vagus valvotomy valvuloplasty vas deferens vascular vasculitis vasectomy vasoconstriction vasodilation vasopressin vasovasostomy vein vena cava; venae cavae venipuncture venous ventilation ventral ventricle ventricular ventricular septal defect venule verruca; verrucae vertebra vertebrae vertebral vertigo

VĀ‐găl ̄ vă‐JI‐nă ̆ VA‐jı̆‐năl ̄ s vă‐jı̆‐NI‐tı̆ ̄ VA‐gŭs văl‐VŎ T‐ō‐mē văl‐vū‐lō‐PLĂ S‐tē văs DĔ F‐ĕr‐ĕnz VĂ S‐kū‐lăr ̄ s văs‐kū‐LI‐tı̆ ̆ vă‐SEK‐tō‐mē vă‐zō‐kŏ n‐STRI ̆K‐shŭn vă‐zō‐dı̄‐LĀ‐shŭn vāz‐ō‐PRĔ S‐ı̆n vă‐zō‐vă‐ZŎ S‐tō‐mē VĀN VĒ ‐nă KĀ‐vă; VĒ ‐nē KĀ‐vē vĕ‐nı̆‐PŬ NK‐chŭr VĒ ‐nŭs vĕn‐tı̆‐LĀ‐shŭn VĔ N‐trăl VĔ N‐trı̆‐kŭl vĕn‐TRI ̆K‐ū‐lăr vĕn‐TRI ̆K‐ū‐lăr SĔ P‐tăl DĒ ‐fĕkt VĔ N‐ūl vĕ‐ROO‐kă; vĕ‐ROO‐kē VĔ R‐tĕ‐bră VĔ R‐tĕ‐brā VĔ R‐tĕ‐brăl VĔ R‐tı̆‐gō

vesicular vessel vestibular disease vestibule vestibulocochlear viable villi viral viscera visceral visceral muscle visceral skeleton visceralgia vitreous chamber vitreous humor vocal cords vocal folds voiding vomer von Willebrand disease volvulus vulva vulvovaginitis

613

vĕ‐SI ̆K‐ū‐lăr VĔ S‐ĕl vĕs‐TI ̆‐bū‐lăr dı̆‐ZĒ Z VĔ S‐tı̆‐būl vĕs‐tı̆b‐ū‐lō‐KŎ K‐lē‐ăr ̄ ‐bŭl VI‐ă ̆ VI L‐ı̄ ̄ l VI‐ră ̆ VI S‐ĕr‐ă VI ̆S‐ĕr‐ăl VI ̆S‐ĕr‐ăl MŬ S‐ĕl VI ̆S‐ĕr‐ăl SKĔ L‐ı̆‐tı̆n VI ̆S‐ĕr‐ăl‐jă VI ̆T‐rē‐ŭs CHĀM‐bĕr VI ̆T‐rē‐ŭs HŪ ‐mĕr VŌ ‐kăl kŏ rds VŌ ‐kăl fōlds VOY‐dı̆ng VŌ ‐mĕr fŏ n VI ̆‐lĕ‐brănts dı̆‐ZĒ Z VŎ L‐vū‐lŭs VŬ L‐vă ̄ s vŭl‐vō‐vă‐jı̆‐NI‐tı̆

warfarin wean wheal

WĂ R‐fă‐rı̆n WĒ N wēl

xeroderma xiphoid process

zĕ‐rō‐DĔ R‐mă ̄ ZIF‐oyd PRŎ S‐ĕs

zygomatic bone

zı̄‐gō‐MĂ ‐tı̆k bōnz

Go to http://www.wiley.com/go/taibo/veterinary to find additional learning materials: • Audio clips to show how to pronounce terms

Appendix B  Commonly Used Veterinary Medical Abbreviations

% # °C °F A A/P AAALAC

AAEVT AAFCO AAHA AALAS AB Ab ABC ABCDE ABG ABVP ABVT ac Ach AChE ACL ACLAM ACPV ACT ACTH

percent pound degree Celsius degree Fahrenheit accommodation; ampere; anode; axial; anterior anterior/posterior Association for Assessment and Accreditation of Laboratory Animal Care Academy of Equine Veterinary Nursing Technicians American Association of Feed Control Officials American Animal Hospital Association American Association for Laboratory Animals abortion antibody aspiration biopsy cytology airway, breathing, circulation, disability/dehydration, exposure arterial blood gas American Board of Veterinary Practitioners American Board of Veterinary Toxicology before meals (ante cibum) acetylcholine acetylcholinesterase anterior cruciate ligament American College of Laboratory Animal Medicine American College of Poultry Veterinarians American College of Theriogenologists adrenocorticotropic hormone

ACVA ACVB ACVCP ACVD ACVECC ACVIM ACVM ACVN ACVO ACVP ACVPM ACVR ACVS ACZM AD ad. lib. ADH ADR AEMP AF Ag AHT

American College of Veterinary Anesthesiologists American College of Veterinary Behaviorists American College of Veterinary Clinical Pharmacology American College of Veterinary Dermatology American College of Veterinary Emergency and Critical Care American College of Veterinary Internal Medicine American College of Veterinary Microbiologists American College of Veterinary Nutrition American College of Veterinary Ophthalmologists American College of Veterinary Pathologists American College of Veterinary Preventative Medicine American College of Veterinary Radiology American College of Veterinary Surgeons American College of Zoological Medicine right ear as desired antidiuretic hormone ain’t doin right Animal Emergency Management Program atrial fibrillation antigen animal health technician

Veterinary Medical Terminology Guide and Workbook, Second Edition. Angela Taibo. © 2019 John Wiley & Sons, Inc. Published 2019 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/taibo/veterinary

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Appendix B  Commonly Used Veterinary Medical Abbreviations

AI AIHA AIMVT

artificial insemination autoimmune hemolytic anemia Academy of Internal Medicine for Veterinary Technicians AKC American Kennel Club ALAT assistant laboratory animal technician Alb albumin Alk. phos. alkaline phosphatase (liver enzyme) ALT alanine aminotransferase (liver enzyme) amp ampule; ampere amyl amylase ANS autonomic nervous system APHIS–VS Animal and Plant Health Inspection Services–Veterinary Services AS aortic stenosis AS left ear ASAP as soon as possible ASD atrial septal defect ASM Animal Shelter Management Certification ASPCA American Society for the Prevention of Cruelty to animals AST aspartate aminotransferase ASVDT American Society of Veterinary Dental Technicians AU both ears AVCPT Academy of Veterinary Clinical Pathology Technicians AVDC American Veterinary Dental College AVDT Academy of Veterinary Dental Technicians AVECCT Academy of Veterinary Emergency and Critical Care Technicians AVMA American Veterinary Medical Association AVNT Academy of Veterinary Nutrition Technicians AVST Academy of Veterinary Surgical Technicians AVTA Academy of Veterinary Technician Anesthetists AVTCP Academy of Veterinary Technicians in Clinical Practice AVTE Association of Veterinary Technician Educators, Inc. AVZMT Association of Veterinary Zoological Medical Technicians AWA Animal Welfare Act AZVT Association of Zoo Veterinary Technicians BAL BAR BARH Baso BBB BCS BD/LD

bronchoalveolar lavage bright, alert, responsive bright, alert, responsive, hydrated basophils blood–brain barrier body condition score big dog/little dog

BG BG BID Bilat. Bili BLV BM BMBT BoLV BP BPM BRD BRSV BS BSA BSE BSE BUN BVD bx c̅ c C Ca CA CAE cal cap CAPD CAT scan cath CAR CBA CBC cc CC CCL CCU CDC CFT cg CH ChE CHD CHF CHOL CK CKD cL Cl CM cm cmH2O CMAR CMT

blood gas blood glucose twice daily; q12h bilateral bilirubin bovine leukemia virus bowel movement buccal mucosal bleeding time bovine leukemia virus blood pressure beats per minute/breaths per minute bovine respiratory disease bovine respiratory syncytial virus body score body surface area breeding soundness exam bovine spongiform encephalopathy (mad cow disease) blood urea nitrogen bovine viral diarrhea biopsy with cup castrated calcium cancer caprine arthritis encephalitis virus calorie capsule continuous abdominal peritoneal dialysis computed tomography catheter congenital articular rigidity cat bite abscess complete blood count cubic centimeter chief complaint cranial cruciate ligament critical care unit Centers for Disease Control complement fixation test centigram certified herbalist cholinesterase congenital heart disease congestive heart failure cholesterol creatine kinase chronic kidney disease centiliter chloride castrated male centimeter centimeters of water Certified Manager Animal Resources Program California mastitis test

Appendix B  Commonly Used Veterinary Medical Abbreviations

CNS CO CO2 conc COPD CP CPA CPCR CPR CREA Creat CRF CRT C‐Sect CSF CSM CT CVA CVA CVP CVPM CVS CVT CVTEA CVTS CWPM Cysto D.Bili DA DC DCM DD DDN ddx DEA Derm DES dg DHIA DHLPP‐C DI DIC Diff DJD DKA dkg dkL dL DLE DLH DM DMH DNA

central nervous system carbon monoxide carbon dioxide concentration chronic obstructive pulmonary disease conscious proprioception cardiopulmonary arrest cardiopulmonary cerebral resuscitation cardiopulmonary resuscitation creatinine creatinine chronic renal failure capillary refill time Cesarean section (c‐section) cerebrospinal fluid cerebrospinal meningitis computed tomography cerebrovascular accident (stroke) certified veterinary acupuncturist central venous pressure certified veterinary practice manager cardiovascular system certified veterinary technician Committee on Veterinary Technician Education and Activities Committee of Veterinary Technician Specialties continue with previous medication cystocentesis direct bilirubin displaced abomasum Doctor of Chiropractic dilated cardiomyopathy differential diagnosis dull, depressed, nonresponsive differential diagnosis Drug Enforcement Administration skin diethylstilbestrol decigram Dairy Herd Improvement Association distemper, hepatitis, leptospirosis, parvovirus, parainfluenza, coronavirus diabetes insipidus disseminated intravascular coagulation white blood cell differential degenerative joint disease diabetic ketoacidosis dekagram dekaliter deciliter discoid lupus erythematosus domestic long hair (a mixed breed cat with long hair) diabetes mellitus domestic medium hair (a mixed breed cat with medium hair) deoxyribonucleic acid

617

DOA DOB dr DSH DVM DVT dx, ddx

dead on arrival date of birth dram domestic short hair Doctor of Veterinary Medicine deep vein thrombosis diagnosis; differential diagnosis

ECHO ED EDTA EEE EEG EI EIA EKG ELISA EMG EOD Eos EPM EPO ER ER ESR

echocardiogram effective dose ethylenediaminetetraacetic acid eastern equine encephalitis elecroencephalogram equine influenza equine infectious anemia electrocardiogram (or ECG) enzyme‐linked immunosorbent assay electromyogram every other day eosinophils equine protozoal myeloencephalitis erythropoietin emergency room exertional rhabdomyolysis erythrocyte sedimentation rate (sed rate) embryo transfer endotracheal tube equine viral arteritis equine viral rhinopneumonitis

ET ET tube EVA EVR F FA FAD FBS FDA Fe FeLV FHO FIC

fx

Fahrenheit; female Fatty acid flea allergy dermatitis fasting blood sugar Food and Drug Administration iron feline leukemia virus femoral head osteotomy feline idiopathic cystitis or feline interstitial cystitis feline infectious peritonitis feline immunodeficiency virus femtoliter fluid ounce feline lower urinary tract disease fine needle aspirate follicle‐stimulating hormone Food Safety and Inspection Services fever of unknown origin feline urological syndrome feline viral rhinotracheitis, calicivirus, panleukopenia, and chlamydia fracture

g g/dL gal GDV

gram grams per deciliter gallon gastric dilatation volvulus

FIP FIV fL fl oz FLUTD FNA FSH FSIS FUO FUS FVRCP‐C

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Appendix B  Commonly Used Veterinary Medical Abbreviations

GFR GGT GH GI GLU g; gm gr GROS GSD GSW gtt gtts GTT Gyn

glomerular filtration rate gamma‐glutamyltranspeptidase growth hormone gastrointestinal glucose gram grain gross review of systems German Shepherd dog gunshot wound drop drops glucose tolerance test gynecology

H H&E HGE H2 O H2O2 Hb; Hgb HBC HCG HCl HCM HCO3 HCT HDDS

hydrogen hematoxylin and eosin stain hemorrhagic gastroenteritis water hydrogen peroxide hemoglobin hit by car human chorionic gonadotropin hydrochloric acid hypertrophic cardiomyopathy bicarbonate hematocrit high dose dexamethasone suppression test high‐density lipoprotein hectogram hectoliter high power field heart rate hour heartworm history

HDL Hg hL hpf HR hr HW hx I I.Bili IA IACUC IBR IC ICP ICSH ICU ID IFA IgA, IgD, IgE, IgG, IgM IM IMHA Inj IO IOP IP ISO

iodine indirect bilirubin intra‐arterial Institutional Animal Care and Use Committee infectious bovine rhinotracheitis intracardiac intracranial pressure interstitial cell‐stimulating hormone intensive care unit intradermal immunofluorescent antibody test immunoglobulins

intramuscular immune‐mediated hemolytic anemia injection intraosseous intraocular pressure intraperitoneal isolation unit

IT IU IV IVAPM IVC IVD IVDD IVP

intrathecal international units intravenous International Veterinary Academy of Pain Management intravenous catheter intervertebral disk (disc) intervertebral disk disease intravenous pyelogram

K K+ K‐9 KBH KCl kg kL km kVp

potassium potassium ion canine or dog kicked by horse potassium chloride kilogram kiloliter kilometer kilovolt peak

Ⓛ L (l) LA LAT LATG lb or # LD LDA/RDA

left liter large animal laboratory animal technician laboratory animal technologist pound lethal dose left displaced abomasum/right displaced abomasum low dose dexamethasone suppression test lactic acid dehydrogenase low‐density lipoprotein lupus erythematosus large luteinizing hormone left lower quadrant lymph node level of consciousness lumbar puncture low power field lactated Ringer’s solution lymphosarcoma left upper quadrant left ventricle licensed veterinary technician lymphocytes

LDDS LDH LDL LE lg LH LLQ/LL LN LOC LP lpf LRS LSA LUQ/LU LV LVT Lymph m M Ma mAs mcg, μg MCH MCHC mcL MCT MCV MDB

meter male milliamperage milliamperage seconds microgram mean corpuscular hemoglobin mean corpuscular hemoglobin concentration microliter mast cell tumor mean corpuscular volume minimum database

Appendix B  Commonly Used Veterinary Medical Abbreviations

ME MED meq mets mg Mg MG MI MIC MID mL MLD MLV MM mm mmHg Mono MPL MR MRI M/S MS MSDS MSH MVP N Na Na+ NA (n/a) NADC NAF NAPCC NAVTA neg or θ ng NG tube NH3 NIH nL NM (M/N) NPN NPO nRBC NS NSAID NSF NVSL

O2 OB OCD OD OFA

myeloid–erythroid ratio minimal effective dose milliequivalent metastasis milligram magnesium myasthenia gravis myocardial infarct