Medical Terminology The Basic Structure and Analysis of

Medical Terminology The Basic Structure and Analysis of Medical Terms By E. Suryadi Madarina Julia

ONCOLOGY: Cervix Sarcoma of the cervix therapy Sarcomas of the cervix show a variable and generally poor response to radiotherapy. If possible therefore, surgical removal is indicated if the disease is localized to the pelvis. This may vary from simple hysterectomy to total pelvic exenteration. Chemotherapy has not proved effective in these tumor The signs and symptoms of recurrent malignant disease are: 1. Positive cytologic examination 2. Palpable tumor in pelvis or abdomen 3. Ulceration of cervix or vagina 4. Unilateral lower extremity edema 5. Supraclavicular lymphadenopathy

History a vocabulary from ancient Greek and Latin Ancient doctors, e. g. Hippocrates: epilepsy, dysentery, asthma, diarrhea New advances in medical science – new terms derived from everyday vocabulary, e. g. cyt – kytos (hollow container)-cell

Why do we need to learn medical terminology ? To speak and to write exactly Health professional around the world use medical vocabulary to speak and to write exactly International language, Efficiency and effective learning “Perkembangan IPTEKDOK seiring dengan perkembangan medical terminology, New sciences/technology = New terminology”

How do we learn medical terminology? like learning other languages: memorize the vocabulary!! logical language: ® most terms can be broken down into its basic component parts and understood ® “basic word structure”

Basic Word Structure PANCYTOPENIA PREFIX COMBINING WORD VOWEL ROOT SUFFIX COMBINING FORM

Medical Terminology Commonly Used: Roots, Prefix and Suffix

WORD ROOT FOUNDATION OF THE WORD GASTER =GASTROS ROOT (stomach)

PREFIX WORD BEGINNING EPIGASTRIC PREFIX (above)

SUFFIX WORD ENDING GASTRITIS SUFFIX (inflammation)

COMPOUND WORD TWO OR MORE WORD ROOTS ELECTROCARDIOGRAM GASTROENTERITIS WORD ROOTS

LEUKOCYTE LEUKOCYTOSIS LEUKOCYTOPENIA SUFFIX or COMPOUND SUFFIX FORM

Correlate an understanding of a word with basic anatomy, physiology, and disease process of the human body PANCYTOPENIA PAN : all CYT : cell PENIA : deficiency DEFICIENCY OF ALL CELLS (deficiency of all types of blood cells)

LEUKEMIA LEUK (root): white EM (root): blood IA (suffix): state (noun) EMIA (compound-suffix form): state of blood “white blood” malignancy of white blood cells

The origin of a medical term Greek noun or adjective Greek verb Latin noun or adjective Latin verb è Influence how it was used in modern medical term

Tissues may have different terms in normal and diseased states Ø NORMAL: LATIN WORD Ø DISEASED/ ABNORMAL: GREEK WORD

normal TESTIS UTERUS VAGINA OVARIUM TUBA NASUS ORIS HEPAR orch/o metr/o colp/o and abnormal orchitis endometritis colpitis vaginitis oophor/o Oophoritis salphynx salphyngitis rhin/o rhinitis stomat/onep Stomatitis hepat/o hepatitis

normal REN COR PULMO nephr/o cardi/o pneum/o CORNEA AURIS CEREBRUM kerat/o ot/o encephal/o and abnormal nephritis carditis pneumonia keratitis otitis encephalitis

Tissue latin and Greek ADIPOSE TISSUE - Fascia adiposa LIP/O : FAT – Lipolysis – Lipogenesis – Lipodystrophy – lipoma

Tissue latin and Greek OSSEUS/OS -Os femur, os radius, os pallatum, -medulla osseum OSTE/O : BONE – Osteogenesis imperfecta – Osteoblast – Osteomyelitis

Tissue latin and Greek NERVUS -Nernus ischiadicus, - n. axillaris NEUR/O : NERVE – neuralgia – neuropathy – neuritis

Tissue latin and Greek MUSCULUS -Musculus pectoralis major, - m. rectus abdominis MY/O MYS/O: MUSCLE – myopathy – myositis – Myoglobin – Myofibra – Myocardium – Myometrium

Tissue latin and Greek CARTILAGO - Cartilago thyreoidea, - cartilago septi nasi CHONDR/O : CARTILAGE – chondrodysplasia – Achondroplasia – Osteogenesis enchondralis – Chondrogenesis

Tissue latin and Greek CUTIS CUTANE/0 - Intracutane, - subcutane DERMIS DERMAT/O : SKIN – dermatitis – leukoderma – epidermis – dermatology

Tissue latin and Greek VASA VASCUL/O - vascularisation, - avascular ANGI/O : BLOOD VESSEL – angiopathy/ vasculopathy – angiography – Angiogram – angioma – Vasculitis

Tissue latin and Greek SANGUIS; SANGUINIS HEM/O =HAIMA EM HEMAT/O: BLOOD – hematology – hematopoiesis – anemia – cholesterolemia – hemoglobin

Greek nouns and adjectives (1) Root of a noun or an adjective is found by dropping the ending (os, on, e, s, ys) nephros – nephritis neuron – neuritis leukos – leukemia tachys – tachypnea glykys -- glycemia

Greek nouns and adjectives (2) … when a suffix begins with a consonant attached to a root ends with a consonant, a combining vowel is needed leukocyte neurogenic nephroblast

so…drop the combining vowel before a suffix beginning with a vowel GASTRIC, and not GASTROIC LEUKEMIA, and not LEUKOEMIA

but… retain the combining vowel between two roots in a word GASTROENTERITIS ELECTROENCEPHALOGRAM

Greek nouns and adjectives (3) Some words may come in two combining forms: derma, dermatos hypodermic, dermatology soma, somatos macrosomia, somatotroph haima, haimatos hemoglobin, hematology stoma, stomatos tracheostomy, stomatitis

Greek Verbs gignesthai gen(e) - gen pathogenesis hematogen lyein ly(s)- hemolysis tome tom- cholecystotomy graphein graph- cardiograph rhein rhe- diarrhea, leukorrhea

Latin Nouns Combining form of a noun is found by dropping the ending (a, um) fistula – fistulectomy vagina – vaginoplasty lympha – lymphogen ileum – ileostomy cerebrum – cerebrovascular palatum – palatorrhaphy

Latin and Greek Color LEUK/O : ALBUS : WHITE ALBINO, CORPUS ALBICAN LINEA ALBA LEUKOCYTE LEUKOCYTURIA LEUKOCYTOSIS LEUKEMIA LEUKODERMA LEUKODYSTROPHY LEUKOPLAKIA LEUKORRHEA FLUOR ALBUS

Latin and Greek Color MELAN/O : FUSCUS : BLACK MELANOCYTE MELANOBLAST MELANOMA MELANURIA MELANIN MELENA

Latin and Greek Color ERYTHR/O : RUBRO : RED CORPUS RUBRUM NUCLEUS RUBER ERYTHROBLAST ERYTHROCYTE ERYTHROCLAST ERYTHEMA ERYTHREMIA ERYTHRODERMA

Latin and Greek Color CYAN/O: BLUE CYANOTIC CYANOSIS CYANOPHIL CYANOPSIA CYANOLABE glaucos : bluish green Griseus : bluish grey

Latin and Greek Color CHLOR/O: CHLOASMA : GREEN CHLOROMA CHLOROPHYL CHLOROPSIA CHLOROLABE

Latin and Greek Color GRISEUS = POLIOS = PHAIOS =GREY Substantia grisea Poliomyelitis

Latin and Greek Color XANTH/O: FLAVUS: LUTEUS: YELLOW CORPUS LUTEUM XANTHOCHROMIC XANTHOCHROMIA XANTHOMA XANTHOPSIA

Body activities Audio = acouo = to hear Opsia /opia = blepo =to see Phagien = to eat Dipsa = to drink Phrasis = to speech Laleo = to talk Gradior = to walk Halo = pneu = to breathe Oureo = to urinate Ergo = to work Sedeo =sella = to sit Osme = bromo = to smell Mnena = to memory Palpo = to touch Kineo= moveo = to move Gustatus = geuma = to taste Hypnos /somnus/sopor= to sleep Glutio = to swallow Defaecatio/chezo = to defaecate

Qualitative Measurement Major= magnus = mega = great Minor/parvus=small Breve = short Longus = long Durum = hard Lepto/pia = thin Mollis = soft Bradys = tardus=slow Tachys = celer =fast Poly = multi = many Oligos = few = rare Asthenia = weak Sthenia = strong

prefix – Location retr/o supra/super /ultra epi par/a peri end/o – ento - en eso intra infra/ sub extra ect/o exo ec

prefix – Location mes/o Circum/peri

Position Ante = before; Post = after Meta = behind Trans = beyond, to the other side Inter = between, among Dia = complete = through Per = through, over Ana = upon, upwards Cata = downward Ab = away from; ad = to ward

prefix – Location examples: ectopic pregnancy ectoderm, mesoderm, endoderm encephalitis endometrium vs. parametrium endotoxin vs. exotoxin Periosteum, pericardium Circumoral, circumductio retroperitoneal suprarenal, etc.

prefix - number A/AN NULLI WITHOUT LACKING DEFICIENT ANEMIA APLASTIC ANEMIA ANALGESIA NULLIPARA

½ prefix number hemi HALF semi PARTIAL HEMIPARESIS HEMIPLEGIA HEMIHYPERTROPHY SEMICOMATOSE

prefix number uni - mono MONOCLONAL ANTIBODY MONOPARESIS MONONUCLEAR CELLS UNICELLULAR UNILATERAL

st 1 primi prefix number PRIMIPARA, PRIMIPAROUS PRIMIGRAVIDA PRIMITIVE PRIMORDIAL GERM CELLS

prefix number BI - DI(PLO) BICUSPID VALVE BICEPS BIFURCATIO DIPLOCOCCUS DIPLOID

prefix number • MULTI – MANY : ® MULTIPARA, MULTINUCLEAR GIANT CELLS, MULTIGRAVIDA • 3 - TRI : ® TRICUSPIDALIS, TRI IN DIE • 4 - TETRA : ® TETRAPARESES, TETRAPLEGIA • 5 - PENTA : PENTAMER

negative sense ANTI (ANT): CONTRA = AGAINST, OPPOSED • ANTIBIOTIC • ANTIHISTAMINE • ANTITOXIN

MAL = BAD Malnutrition, malaria, Malformation A, AN = ABSENCE OF SOMETHING, DEFICIENT Anaerobe, anemia, anhidrosis

negative sense dys : difficult, painful, abnormal DYSMENORRHEA DYSPEPSIA DYSTROPHY (DUCHENNE MUSCULODYSTROPHY) DYSURIA

hyper and hypo hyper : beyond normal, excessive, over hypo: under, deficient, below normal HYPOGLYCEMIA HYPERGLYCEMIA HYPOTHYROIDISM HYPERTHYROIDISM HYPOTENSI HYPERTENSI HYPODERMIC

tachy and brady tachy: rapid, fast brady: slow tachycardia tachypnea bradycardia bradypnea

suffix – noun a, ia, y, sia, sis, asia, asis, ema, ism, us: dyspnea, rhinorrhea anemia, osteomalacia hypertrophy ectasia arteriosclerosis state, condition • • • nephrolithiasis erythema hyperchromasia diuresis synergism hydrocephalus

suffix – noun itis oma, ma oophoritis endometritis colitis ulcerosa hepatitis carditis inflammation tumor, disease fibroadenoma adenocarcinoma glioma edema lymphoma

Suffix NOUN - ADJECTIVE NOUN ADJECTIVE cyanosis anemia nervus sclerosis stenosis paralysis cyanotic anemic nervous sclerotic stenotic paralytic

SUFFIXES -ALGIA = PAIN -CELE = HERNIA -CENTESIS = SURGICAL PUNCTURE TO REMOTE A FLUID -PENIA = DECREASE -DYNIA = PAIN -LYSIS = DESTRUCTION = BREAKDOWN -MALACIA = SOFTENING -OPSY = TO VIEW -POIESIS = FORMATION -PLASIA = DEVELOPMENT

SUFFIXES -OSIS = ABNORMAL CONDITION -PATHY = DISEASE -PEXY = FIXATION -STASIS = STOPPING. CONTROLING -SCOPE = INSTRUMENT FOR EXAMINATION -PTOSIS = DROPPING

Rules for commonly forming plurals ending change to is um us a ex/ix es a i ae ices

Examples of plurals is to es SINGULAR PLURAL anastomosis metastasis epiphysis prosthesis anastomoses metastases epiphyses prostheses

Examples of plurals um to a SINGULAR PLURAL bacterium diverticulum ovum bacteria diverticula ova

Examples of plurals us to i SINGULAR calculus bronchiolus nucleus PLURAL calculi bronchioli nuclei

Examples of plurals a to ae SINGULAR vertebra bursa bulla PLURAL vertebrae bursae bullae

Examples of plurals ix or ex to ices SINGULAR PLURAL apex varix apices varices

diminutive suffix (1) culus – venter – ventriculus, ventricle – vasa – vasculus – vesica – vesiculus, vesicle olus – arteria – arteriole – alveus -- alveolus

diminutive suffix (2) ulus – calcis – calculus – globulus, globule illa – fibril -fibrilla ellum – cerebrum - cerebellum

What are we going to discuss in this session? ABREVIATIONS IN MEDICAL TERMINOLOGY CLINICAL TERMS/ PHRASES etc.

Abbreviations 1. 2. 3. 4. 5. 6. Measurements Chemical Diagnoses Procedures Health Professions Charting

Abbreviations Measurements g or gm mcg tsp kcal m. Mol/L g/d. L mg% BMI gram microgram teaspoon calorie m. Mol per liter gram per deciliter miligram percent body mass index

Abbreviations Chemical O 2 (oxygen) CO 2 (carbon dioxide) Na. Cl (sodium chloride) RL (Ringer Lactate) K (potassium, kalium)

Abbreviations Diagnoses CP (cerebral palsy) AIDS (acquired immunodeficiency syndrome) ALL (acute lymphoblastic leukemia) CVA (cerebrovascular accident) CVD (cardiovascular disease) DHF (Dengue Haemorrhagic Fever)

Abbreviations Procedures (1) radiology IVP: intravenous pyelography ECG: electrocardiography USG: ultrasonography MRI: magnetic resonance imaging CT-SCAN (CAT-SCAN): computerized axial tomography scanning

Abbreviations Procedures (2) laboratory 2 hr pp (2 hour post prandial blood glucose) LDH (lactic dehydrogenase) CK (creatine kinase) LFT (liver function test) RFT (renal function test)

Abbreviations Health professions û MD (medical doctor) û ENT (ear, nose, throat) û OB (obstetry) û GYN (gynecology)

Medicine as an informationintensive domain One million articles are published every year in scientific journals Medical terminologies (UMLS = unified medical language system) consist of more than 250. 000 concepts and more than 540. 000 different terms

Abbreviations Charting û ex/ exam (examination) û Dx (diagnosis) û Tx (treatment) û Rx (prescribe) û BP (blood pressure) û iv (intravenous) û OS (oculus sinister, left eye) û tid (tri in die, thrice a day)

Clinical Terms/ Phrases anamnesis: history of symptoms examination: physical examination of signs diagnosis therapy/ treatment prognosis

diagnosis/diseases (1) related to organ system/ tissue inflammation: rhinopharyngitis, cystitis tumor/ cancer: hepatocellular carcinoma, osteosarcoma, melanoma maligna, neurofibromatosis condition: mitral stenosis, arteriosclerosis, nephrolithiasis, dysenteri, hemothorax syndrome: nephrotic syndrome, hepatorenal syndrome, AIDS

diagnosis/diseases (2) related to the causing factors organism: – Dengue Haemorrhagic Fever (DHF) – Dengue Shock Syndrome (DSS) – Chikungunya Fever – Diphteria (C. diphteriae) – Tuberculosis (M. tuberculosis) toxin: – tetanus (tetanin – C. tetani) – botulism (botulinum – C. botulinum)

diagnosis/diseases (3) named after the person who found it signs: – Turner syndrome – Biot respiration – Spleen Schuffner 1 -8 disease: – Duchenne muscular dystrophy – Becker muscular dystrophy – Hashimoto disease – Grave’s disease – Neurofibromatosis von Recklinghausen

therapy/ treatment Causative/ Curative: address the cause of the disease – aimed at curing the disease Symptomatic/Palliative: address the symptoms of the disease – aimed at making the patients feel better Ex juvantivus: a try out

surgical procedures tomy (to cut): pyloromyotomi, osteotomi stomy (to make an opening): tracheostomy, nephrostomy, ileostomy ectomy (resection= to cut out): nephrectomy, splenectomy, gastrectomy rraphy (to sew): herniorrhaphy, palatorraphy incision vs. excision

prognosis dubia ad malam dubia ad bonam five years survival rate of 80% fatality rate remission rate cure rate

other terms acute vs. chronic degree of consciousness: compos mentis, lethargy, stupor, soporocomatous, coma shock headache/ cephalgia: tension headache, cluster headache, migraine, vertigo

Aware of spelling and pronunciation problem 4 pronounced alike – different spelling 4 may give wrong diagnosis CYSTITIS vs. CYTOSIS Endometritis vs. Endometriosis ILEUM vs. ILIUM HEPATOMA vs. HEMATOMA

Aware of spelling and pronunciation problem similar pronunciation URETER vs. URETHRA ureteritis urethritis

How do we analyze a medical terms? break it down into its component part find the meaning of every part Read the meaning from the suffix back to the first part of the word

PANCYTOPENIA PAN (prefix): all CYT (root): cell PENIA (suffix-form): deficiency DEFICIENCY OF ALL CELLS (deficiency of all types of blood cells)

ELECTROCARDIOGRAM ELECTR (root): electricity CARDI (root): heart GRAM (suffix): record The record of the electricity of the heart

GASTROENTERITIS GASTR (root): stomach ENTER (root): intestines ITIS (suffix): inflammation Inflammation of the stomach and intestines

Read the meaning of medical terms from the suffix back to the first part of the word PANCYTOPENIA ELECTROCARDIOGRAM GASTROENTERITIS

ASYNERGY A (prefix): without SYN (prefix): together ERG (root): working Y (suffix): noun-suffix without synergy without working together

OSTEOSARCOMA OSTEO (combining form): bone SARCOMA (suffix-form): tumor of the tissue – SARC (root): tissue – OMA (suffix): tumor of bone tissue lymphosarcoma, liposarcoma, chondrosarcoma, etc.

RETROPERITONEAL RETRO (prefix): behind PERITONEUM (root–peritonaion): to stretch over AL (suffix): adjectival suffix behind the peritoneum Peritoneum is a serous sac that lines the abdominal cavity

Further Readings Chabner DE. The Language of Medicine. W. B. Saunders Company, 1981 Dunmore CW, Fleischer RM. Medical Terminology. Exercises in Etymology, 2 nd ed. F. A Davis Company, 1985 Dennerll JT. Medical Terminology. A Programmed Text, 5 th ed. John Wiley & Sons, Inc. , 1988 Suryadi. E. Buku saku Terminologi Kedokteran. BPK

(Adopted from: Gordon Reeves & Ian Todel. 1996: Lecture Notes on Immunology. pp: 258) 1. Abnormal proliferation of the cells of the immune system takes many forms, e. g. leukaemia, lymphoma, myeloma, macroglobulinemia and heavy chain diseases. Cryoglobuminemia and amyloidosis are also associated with the abnormal production of proteins involved in the immune respons.

2. The monoclonal gammopathies are caused by the uncontrolled proliferation of a single clone of plasma cells (in myelomatosis) or B Lymphoblasts (in macroglobulinemia). In macroglobulinemia the excess production of pentameric Ig. M is associated with hyperviscosity and cryoglobulinemia. In myeloma the monoclonal immunoglobuline can be of class Ig. G, Ig. A, Ig. D, Ig. M, or monomeric Ig. M. Decalcification, hypercalcemia and bone pain is mediated by cytokine release initiated by the abnormal plasma cells and agents that inhibit IL-6 are under investigation for treatment of myelomatosis.