AbscessA swollen area contaning puss.
AccretionAn increase in size of a body part, due to accumulation
of deposits, such as salts.
Angiotensin Converting Enzyme inhibitor: for treatment of hypertension and
congestive heart failure, decreasing blood vessel tension and blood volume.
Examples: Captopril, Cilazapril, Enalapril, Fosinopril, Imidapril,
Lisinopril, Moexipril, Perindopril, Quinapril, Ramipril and Trandolapril.
AcetoneColourless inflammable liquid, with a distinctive smell,
occurring in diabetics.
neurotransmitter, stored in synaptic vesicles within nerve terminals, released by
exocytosis (nerve impulses). Binds with nicotinic
receptors on cholinergic nerve neurons in the motor end plate of the neuromuscular
junction. Nicotinic effect is depolarization, causing muscle contraction. ACh also
produces muscarinic effects, which may be countered by
antimuscarinic drugs, such as Glycopyrolate or Atropine. Acetylcholine is degraded
Acid refluxStomach acid moving into the oesophagus through a
faulty muscle in the oesophagus.
Acquired aortic valve diseaseAbnormalities of the aortic valve which
develop with age.
AdenitisInflammation of a gland or lymph node.
AdenosineAn anti-arhythmic, which slows down electrical conduction.
AdrenalineA positive inotropic hormone secreted by the adrenal glands,
and which stimulates the sympathetic nervous system, and increases the force of cardiac
contractions. Pharmacological Adrenaline is used in many emergency situations, such as
cardiac arrest and acute
Agonal rhythmAsystole with occasional P wave or QRS complex.
AldosteroneThe main hormone involved in potassium regulation.
AlimentaryRelating to food or nutrition.
Allergic reactionsAllergy is an abnormal reaction to naturally
occurring protein allergens. When an allergic person is exposed to those
allergens, the white blood cells (B-lymphocytes) produce anti-bodies which stick
to the surface of allergy cells, so the body can respond when next exposed to
allergens - a process known as sensitisation. The most common allergens are:
pollen, mould, dust mites, medicines, animal fur.
|Nasal||Sodium Cromoglicate, Levocabastine, Decongestants,
Corticosteroids (severe cases).|
|Eye drops||Sodium Cromoglicate (eg, Opticam), Nedocromal Sodium
(eg, Rapitil), Levocabastine.|
|Injections||Allergy inducing agents to create tolerance
|Intramuscular||Long acting steroids.|
Minor allergies are treated with anti-histamines, such as Levocabastine.
Alveolar VentilationThe amount of air which reaches the alveoli, and
is available for gas exchange with the blood, per unit time.
AnaplasiaChanges to the character of cells, as in tumourous tissue.
AnastamosisA surgical connection between two structures, typically tubular,
such as blood vessels or intestinal sections.
Anatomical dead spaceThe conducting airways which do not take part
in gas exchange (mouth, nose, pharynx, larnyx, trachea), but convect gases between
the atmosphere/gas supply and alveoli.
AneurysmAn abnormality of a blood vessel,
where the vessel wall is weakened, and expands or balloons into a blood filled
AnginaTight sensation of strangling or pain. Angina Pectoris:
Cardiac pain caused by insufficient blood supply to the heart.
AngioedemaSwelling of the deeper layers of the skin,
caused by a build-up of fluid. Symptoms can affect any part of the body, but
swelling usually affects the: eyes, lips, genitals, hands, or feet. This
condition is often accompanied by urticaria (hives).
AngiogenesisThe formation of new blood vessels.
AngiospasmA spasm which constricts blood vessels.
AngiotensinA polypeptide, formed in the blood through the action
of renin on plasma globulus, which increases blood pressure.
AnoxiaLack of oxygen supply to the organs/tissues.
AntibodyA Y shaped protein, produced in the blood, and present on the surface
of B cells, in response to the presence of antigens. Antibodies attach to antigens on
infectious organisms, then either destroy them, or render them harmless.
Antidiuretic Hormone (ADH, Vasopressin)Peptide
hormone secreted by the posterior lobe of the pituitary gland. ADH causes
reabsorption of water in the renal tubules, with consequent reducion in urine
output. In larger doses, ADH causes constriction of plain muscle, which increases
peripheral vascular resistance, resulting in increased arterial blood pressure.
Used in the treatment of diabetes inspidus.
A substance which evokes the production of one or more antibodies.
Anti platelet agentsFor example: NSAIDs, aspirin, clopidogrel, might
contribute to increased surgical blood loss, and should be stopped before surgery,
to allow platelet function to return to normal.
AortaThe largest artery in the body, which carries oxygenated
blood from the heart, for systemic circulation.
ApnoeaCessation of breathing.
ApraxiaThe inability to make proper movements.
ArrhythmiaVariation from normal
rhythm, such as that which can occur in the heart.
|Ventricular tachycardia||Abnormally fast beating of the ventricles.|
|Ventricular fibrillation||Erratic fluttering of the ventricles.|
|Atrial fibrillation||A supraventricular arrhythmia: Palpitation
- fast beating of the atria.|
- Chest pain
- Shortness of breath
Arterial Blood GasAnalysis of arterial blood
components, such as acid-base balance and oxygenation:
|Base Excess ||A negative or positive excessive level of bicarbonate (normal: -2 to +2 mEq/l)|
|HCO3 ||Level of bicarbonate; lower than 22 mEq/l means acidosis; greater than 26 is alkalosis|
|pCO2 ||Partial pressure of CO2 dissolved in arterial blood|
|pH ||Measurement of hydrogen ions(H+) in the blood (7.35 to 7.45)|
|PO ||Partial pressure of dissolved O2 in arterial blood|
|SaO2 ||Saturation level of arterial free oxygen|
Arterial PressureMean arterial pressure is defined as diastolic +
1/3 (systolic - diastolic).
Arterial ThrombosisA blood clot which develops in an artery. Arterial
thrombosis is usually associated with atherosclerosis, which is hardening and
narrowing of the arteries. A heart attack occurs when a blood clot blocks the
arteries leading to the heart, inhibiting the blood supply. A stroke occurs when
a blood clot blocks an artery in the brain.
AscitesAn accumulation of serous fluid in the peritoneal cavity.
Atrial FlutterRapid contractions of the Atria, 240-350
beats/minute, often accompanied by AV block.
AxonLong thin cylindrical projection of a neuron, which propogates
nerve impulses to another neuron, gland cell, or muscle fibre.
BacteraemiaBactreria in the bloodstream.
Backward heart failurePulmonary and peripheral oedema.
BarotraumaAn injury caused by an excess of relative pressure.
For example, if an oxygen flush is made during the ventilator inspiratory phase,
the excess gas in the circuit (including lungs) cannot be vented, because the
ventilator relief valve is closed. The result of which could be a "burst lung".
BifurcationThe junction where a vessel divides into two
BigeminyTwo pulse beats which occur at the same time.
BiofilmA thin layer of microorganisms adhering to the surface
of a structure.
BloodBlood is a suspension of cells in plasma.
Cells are 45% of total blood volume, with the remaining 55% being plasma.
Clotting tests ||
Transfusion - AAGBI ||
Main tests ||
BM monitoring ||
Blood bottle colours
Blood:Gas Partition coefficientDescribes the solubility of inhaled
anesthetics in blood. Details
Blood gasesInspired gases, such as air or nitrous oxide, are
distributed throughout the body via arterial circulation. The component gases
have partial pressures (P), relative to ambient pressure, which are determined
by their particular proportions. At mean sea level, 100% oxygen has a mean
partial pressure of 101 kilo Pascals (kPa).
Of relevance to the patient´s condition, is the arterial oxygen partial pressure
(PaO2). In a healthy patient, inspired oxygen partial pressure should be
10 kPa higher than arterial oxygen partial pressure.
If the inspired
difference is greater than 10 kPa, the patient
may be suffering from pulmonary disease. This is the "rule of ten".
For example, if the patient is breathing 40% oxygen, which has a partial pressure
of oxygen (PaO2) of approximately 40 kPa,
the arterial oxygen partial pressure (PaO2) should be 30 kPa.
Blood oxygen terms
||Partial pressure of oxygen in the Alveolar|
||Partial Pressure of oxygen in arterial Blood - normal range is 75-100 mm/Hg|
||Arterial haemoglobin oxygen saturation - by direct measurement (arterial blood gas sample)|
|SpO2||Indirect measurement of blood oxygen content (pulse oximetry)|
Blood sugarBlood sugar (glucose) levels refer
to the amount of glucose in the blood - the serum glucose level. The glucode level is expressed
as millimoles per litre (mmol/L), and is stable for non diabetics; around 4 - 8 mmol/L.
The blood sugar level is lowest after sleeping, and highest after a meal.
The system for testing blood sugar was developed by Boehringer Mannheim, now Roche, hence the name - BM.
See also Diabetes
Body Mass Index (BMI)Weight (kg) divided by the square of the
height (m). A BMI of 30 is considered obese.
BronchitisInflammation of the bronchi, the tubes (airways)
which carry oxygen from the air through the lungs. The inflammation increases mucus production
in the airways, producing phlegm, and a cough reflex.
The Trachea divides into left and right main (primary) bronchi, at the
The right main bronchus divides into 3 Lobar (secondary) bronchi, serving
the 3 right lung lobes.
The left main bronchus divides into 2 Lobar bronchi of the left lung.
A Lobar bronchus divides into tertiary Segmental
bronchi (10); each serving a bronchopulmonary segment.
The right lung is distinguished by the Eparterial Bronchus, also known as the right
superior lobar bronchus, which is a branch of the right main bronchus, and occurs at about
1 inch (2.5cm) from the bifurcation of the trachea, at the secondary carina.
The Eparterial Bronchus supplies the superior lobe of the right lung, and is the most superior
of all secondary bronchi. It arises above the level of the pulmonary artery and, for this reason,
is known as the eparterial bronchus. (Distributions inferior to the
pulmonary artery are termed hyparterial.)
Bronchi have cartilaginous support, which prevents them collapsing, should their smoothe
muscle contract (spasm) due to eg, an irritant.
(The Trachea and the 2 primary/main bronchi from the bronchial tree.)
A tertiary (Segmental) bronchus branches into 30,000 terminal bronchioles
in each lung. Bronchioles do not have cartilaginous support, only smoothe muscle.
Bronchioles connect to Alveolar ducts which,
themselves, connect to the Alveoli.
Brugada syndromeA serious heart condition which can cause
fainting and arrhythmias.
Bundle of HissCardiac muscle which conducts atrioventricular node
impulses to the septum, and then divides to connect with the ventricles.
BursaA sac containing fluid, such as in a joint.
CaecumThe wide section of the large intestine,
in the lower right abdomen, where the large and small intestines join.
CalculusInsoluble crystallised matter which forms forms, for
example, within the gallbladder, urinary bladder, and kidneys.
CapillaryThe blood vessel between an arteriole and a venule,
which carries nutrients to the tissues.
Carbon dioxideCO2 is a heavy, colourless,
odourless, incombustible, and corrosive gas; a compound of carbon and oxygen, formed
during respiration, combustion, and organic decomposition (also called carbonic acid gas).
Carbonic acidA weak acid which is created when carbon dioxide is
dissolved in water, resulting in the chemical formula H2CO3. When the
acid dissociates, or gives up a hydrogen ion, the resulting molecule is called a bicarbonate
In physiology, carbonic acid is described as volatile acid or respiratory acid, because it is
the only acid excreted as a gas by the lungs.
Also, a solution of carbon dioxide in water.
Cardiac compressionPressure on the heart caused by fluid in
Cardiac outputThe amount of blood, which the heart pumps, per minute.
Specifically, the product of Stroke volume and heart rate.
Cardiovascular SystemPertaining to the heart and blood vessels.
CarinaThe point at which the Trachea divides into the right and left main bronchii.
Central Nervous SystemThe brain and spinal cord.
Cerebrospinal fluid (CSF)A clear and colourless fluid, produced in the
choroid plexus of the brain. The CSF lies in the subarachnoid space (between the arachnoid mater
and the pia mater) and in the ventricular system around and inside the brain and spinal cord. The
CSF cushions the spine and brain against shock. A CSF test can be used to measure spinal fluid
pressure. Normal CSF glucose level is 50 - 80 mg/100 mL, or > 2/3 of blood sugar level.
ChalasiaRelaxation of the eosophageal muscles, resulting in
CholinergicRefers to neurons which release the neurotransmitter
Acetylcholine, and those receptors to which Acetylcholine binds.
An enzyme which breaks down Acetylcholine neurotransmitter hormones into
choline and acetyl coenzyme A. Found in the synaptic cleft, the gap between nerve
cells, through which, information flows.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease refers to chronic bronchitis and emphysema,
diseases of the lungs in which the airways become narrowed. This narrowing
results in reduced flow of air to and from the lungs, causing shortness of breath,
and is a condition which gets progressively worse. COPD is caused by noxious
particles or gas - most commonly from smoking - which trigger an abnormal
inflammatory response in the lung.
The inflammatory response in the larger
airways is known as chronic bronchitis, which is clinically diagnosed when the
sufferer regularly coughs up sputum. In the alveoli, the inflammatory response
The natural course of COPD is characterised by occasional sudden worsening of
symptoms, called acute exacerbations, most of which are caused by infection or
air pollution. Image
Chvostek's signSpasm of the facial muscles.
ChymeSemi-liquid mix of food and gastric juice, formed in the
CoagulopathyAn abnormality in the blood clotting process.
CoeliacReferring to the abdomen.
Compartment SyndromeAn increased level of pressure within an enclosed
(confined) bundle of muscles – known as a muscle "compartment"; caused by bleeding
or swelling (typically) in fascial compartments. The resultant pressure restricts blood flow
to the affected area. Affected compartments can be in the hand, arm, buttocks, leg
(especially below the knee), foot, and abdomen. Emergency treatment is by
fasciotomy - where the fascia is cut to relieve pressure.
Symptoms include: tightness, cramping, tingling/burning, pain.
CondyleThe rounded end of a bone, which articulates with another.
ContusionBruising: a superficial injury produced by impact, and
where the skin is unbroken.
ConvulsionInvoluntary contraction of a muscle.
Coronary artery bypass grafting (CABG)A procedure to treat narrowing
(stenosis) of the coronary arteries, by creating bypasses around the obstructions,
with arteries or veins from elsewhere in the body, thereby improving blood flow to
Cricoid cartilageRing shaped cartilage, at the lower end of the
larynx, inferior to the thyroid cartilage and cricothyroid membrane. The Cricoid
is the only complete ring of cartilage in the respiratory system.
CroupAcute obstruction of the larynx, caused by allergy,
infection, or new growth.
CyanosisBluish tinge to skin and mucous membranes.
CryoprecipitateA precipitate, concentrated from Fresh Frozen Plasma, which
results from cooling. The cryoprecipitate is rich in Factor VIII, and is used to treat
haemophilia. Additionally, for patients who are bleeding, but without significant
haemorrhage, having fibrinogen level below 1.5g/litre.
CutaneousPertaining to the skin.
CyanosisBluish tinge to skin and mucous membranes.
Dead space Part of the airway where gas
is not available for exchange.
injured tissue and foreign matter from a wound.
Deep Vein Thrombosis (DVT)A blood clot in a
lower limb vein, indicated by local pain and swelling. The thrombus can be caused
by sustained immobility, such as after a long flight.
The thrombus may
travel up the leg to the more proximal veins in the thigh and pelvis, forming
Popliteal and Ileofemoral thrombosis. A proximal vein thrombosis givea a
higher risk (50%) of pulmonary embolus, which can be fatal.
extension, reccurence, and embolisation, Heparin is given for immediate effect,
and Warfarin for the medium to long term. Mechanical prophylaxis is by means of
compression stockings and intermittent pneumatic compression cuffs (Flowtrons).
Dendrite(Greek: Little trees) Nerve fibre process which
receives nerve impulses, and provides signal input to the neuron.
DermatomeAn area of skin which is supplied by a single
spinal nerve. Each nerve relays sensation from it's region of skin to the brain.
Pain in a dermatome, without the associated heat of infection, can indicate damage
to the spine.
DiabetesA condition where the level of
glucose in the blood is too high. More
DuodenumThe initial part of the small intestine, between the
stomach and jejenum.
DyspnoeaLaboured or difficult breathing.
DysuriaDifficulty in passing urine.
EclampsiaHypertensive disorder and toxaemia of pregnancy:
an acute and life-threatening complication, characterized by the appearance of
seizures, usually in a patient who has developed pre-eclampsia (hypertension and
fluid retention). Patients will, typically, show signs of pregnancy induced
hypertension, before the onset of eclampsia (eclamptic convulsion). Other cerebral
signs may precede the convulsion, for example: nausea, vomiting, headache, and
cortical blindness. Organ symptoms may also be present, including abdominal pain,
liver failure, pulmonary oedema, and oliguria.
EffusionLiquid discharge from a cavity.
ElectrolytesElectrolytes, such as bicarbonate, chloride,
potassium, and sodium, become ions in solution, thus effecting the electrical
EmbolismObstruction of a blood vessel by a substance which has
moved through the circulatory system. Typical substances include gas, fat, and
EmbolusA substance, such as gas, blood, or fat which travels
around the blood stream, until it forms a blockage in a blood vessel.
EmetogenicSomething which causes nausea/vomiting.
EmphysemaWhere the alveoli (air sacs)
in the lungs lose their elasticity, causing them to narrow. Consequently, the
lungs lose their efficiency at getting oxygen into the body, so the sufferer has
to breathe harder (characteristic shortness of breath).
EmpyemaA mass of pus in the pleural or other cavity.
End Tidal CO2Exhaled carbon dioxide, typically
4%-6% (35-45 mm/Hg).
EndometriosisA condition in which cells from the Endometrium
(lining of the uterus) grow outside of the uterine cavity, usually on the
peritoneum lining the abdominal cavity. These cells respond to hormones in
the same way as those in the lining of the womb but, with no outlet available,
the affected tissue becomes inflamed, scarred, and attracts adhesions. The
result is severe pain.
EnzymeA protein which catalyses a biological reaction.
EpicardiumOuter layer of the heart wall.
EpiglottisLeaf shaped cartilage which sits on top of the
larynx, and is attached to the thyroid cartilage. Prevents food from entering
the trachea when swallowing.
EpitheliasationDevelopment of surface layer skin cells.
EpitheliumLayer of cells which line tissues, or the surface
of the skin.
ErythrocytesMature red blood cells which contain haemoglobin;
created in red bone marrow.
ErythromycinA macrolide antibiotic which slows or stops the growth
of bacteria, and is often used in patients with Penicillin allergy.
ExtracellularExternal to the cells.
ExtracorporealWhere blood is taken from a patient´s circulation,
and a process applied to it, before being returned to the circulation.
ExtravasationA discharge or escape of blood/serum/lymph, from a
vessel, into the tissues.
ExudationThe discharge of serous fluid through the walls of blood vessels.
FasciaThe connective fibrous
tissue which surrounds muscles, blood vessels, and nerves.
FasciculationsIsolated muscle twitching.
FibrillationQuivering and vibration
of muscle fibres.
Fibrin (Factor 1A)An insoluble fibrous protein (formed from
Fibrinogen by the action of Thrombin) which forms a mesh over Platelets, helping to
form a blood clot over a wound.
FibrinogenA soluble protein, produced
by the liver, and contained within blood plasma. During the blood clotting
process, Fibrinogen is converted into Fibrin by Thrombin.
FibrinolysinEnzymes which promote the dissolution of blood clots.
FibrinolysisA normal body process which keeps naturally
occurring blood clots from growing. Primary fibrinolysis refers to the normal
breakdown of clots. Secondary fibrinolysis is the breakdown of blood clots due to
a medical disorder, medicine, or other cause, and which may cause severe bleeding.
Blood clots form on fibrin (a protein). The breakdown of fibrin (fibrinolysis) can
increase under certain conditions, such as:
- Bacterial infections
- Intense exercise
- Low blood sugar
- Not enough oxygen to tissues
FistulaAn abnormal passage between 2 organs, usually
between cavities, or between a cavity and the body surface.
Forward heart failureLow blood pressure and poor organ
Fraction of inspired oxygen (FiO2)The percentage of
oxygen in each inspired breath. The FiO2 is expressed as a number from
0 to 1 (0-100%). The FiO2 of normal atmospheric air is 21%. Breathing
100% oxygen for extended periods can lead to oxygen toxicity in adults; the figure
is 60% or more for infants.
FractureA break in a bone.
|Simple (closed)||The break does not pierce the skin|
|Greenstick||A partial fracture, where one side of the bone is
broken, the other side is bent; occurs in children|
|Compound (open)||A broken end of a bone protrudes through the skin|
|Comminuted||The broken bone is crushed or splintered|
|Impacted||One end or the fractured bone is forced into the other
part of the break|
FremitusVibration inside the body, felt from the outside by
hand or stethoscope.
Fresh Frozen PlasmaAn unconcentrated form of blood plasma, the liquid portion
of human blood which has been frozen and preserved after a blood donation. FFP contains all
of the clotting factors, except platelets. FFP can be used to supplement red blood cells,
when whole blood is not available for exchange transfusion, or to correct a bleeding problem
of unknown cause. FFP is also used to correct disseminated intravascular coagulation.
Thawed FFP is best used immediately, but may be stored at 4°C, and infused within 24
hours - if kept at this temperature, or returned to the blood bank, for storage, within 30
minutes of removal from the fridge.
Dose: 12-15 ml/kg body weight (3-4 units for an adult).
Typical infusion rate is 10-20 ml/kg/hour.
Anaesthesia UK ||
Functional Residual CapacityThe volume of gas, present in the lungs, at the end of
passive expiration. The FRC is the lung O2 store. Preoxygenation allows the FRC to act
as the Os reservoir, during periods of apnoea (eg, intubation).
At FRC, the opposing elastic recoil forces of the lungs and chest wall are in
equilibrium, and there is no exertion by the diaphragm or other respiratory muscles. When upright,
the FRC (adult) is ≅ 3 litres; When supine, the FRC drops to ≅ 2.2 litres.
FundusThe base of an organ.
GanglionA mass of nerve cells and fibres, outside of the
central nervous system. Also, describes a cystic welling on a tendon.
Gas exchangeBetween the lungs and the blood:
Cal State ||
GlottisThe true vocal folds (chords) and the space between them.
GlucagonPolypeptide produced by the pancreas, which helps
to break down glycogen in the liver, raising the blood sugar level.
GoitreEnlargement of the thyroid gland.
HaematocritA measure of the percentage of red cells found in the
blood. The normal range is 43-49% in men, and 37-43% in women.
HaematomaA swelling which contains clotted blood.
Haemoglobin (Hb)The complex protein molecule
contained within red blood cells (erythrocytes), which give them their colour,
and by which oxygen is transported. The fraction of haemoglobin which carries
oxygen is the measurement for oxygen saturation.
The normal range of haemoglobin
is 13.5 to 17.5 g/dl for men, and 11.5 to 15.5 g/dl for women.
HaemathoraxAn accumulation of blood in the pleural cavity.
The HeartThe heart comprises two pumps, left
and right. The right side pump sends blood to the lungs, to be oxygenated and to
remove waste products, such as CO2.
The left side pump sends blood around the systemic circulation, to oxygenate the
Heart blockAn arrhythmia, caused when impulses from the
sinoatrial node are interrupted between the atria and ventricles, resulting in
the independent contraction of the atria and ventricles. Block of the Atria
Ventricular node (AV block) is the most common type of heart block.
|Type of block||Effect on impulses|
|First degree||Impulses are longer|
|Second degree||Impulses are missing|
|Complete||Impulses are absent|
Hepatic veinThe vein which takes blood from the liver to the
Inferior Vena Cava.
HerniaProtruding part of an internal organ through it's
enclosing structure. Commonly referred to as a rupture.
|Hiatus||Part of the stomach protruding through the oesophageal
opening in the diaphragm|
|Incisional||Hernia at an old wound|
|Inguinal||Protrusion of the intestine through the inguinal canal|
|Reducible||When the organ can be pushed back into place|
HiatusA space or opening.
HistologyThe study of tissues.
Hives (urticaria, nettle rash)The recurrent eruption of
irritating weals, redness, a raised itchy rash.
HormonesA hormone (Greek "impetus") is a chemical released by a
gland (Endocrine system) in one part of the body, and travels to a target
receptor on a cell in another part of the body, where it stimulates an affect. A
hormone acts as a catalyst for cellular level chemical changes, necessary for
homeostasis, growth, development, and energy. Endocrine hormone molecules are
released into the bloodstream. Exocrine hormones are secreted into ducts, and then
flow into the bloodstream, or travel (by diffusion) from cell to cell, in a
process known as paracrine signalling.
HyperaemiaExcess of blood in a body part.
HyperalgesiaExcessive sensibility to pain.
HypercalcaemiaExcess of calcium in the blood.
Hypercapnia (hypercarbia)Increased level of carbon dioxide in
arterial blood, causing over stimulation of the respiratory centre, and depression
of the central nervous system. The result is confusion, drowsiness, and lack of
cooperation from the patient.
Partial pressure of CO2 (PaCO2)
> 45 mm/Hg (5.9%), typically caused by hypoventilation.
HyperglycaemiaExcess of blood sugar. Signifies diabetes mellitus.
- Sweet smelling breath
- Rapid, weak pulse
HyperkalaemiaExcess of potassium in the blood (greater than
5.5 mmol/l), which can result in cardiac arrest.
HypernatraemiaExcess of sodium in the blood.
HyperpneoaIncreased rate and depth of breathing.
HyperpyrexiaExcessive body temperature - above 41° C.
HyperthermiaExcessive body temperature - above 38° C.
HyperventilationAbnormally deep or quick breathing, resulting
in faster than normal removal of CO2 from the lungs, and resultant respiratory
alkalosis. Symptoms include:
- Tingling in the extremities
- Shortness of breath
HypervolaemiaExcessive level of blood in the circulation.
Hypocapnia (hypocarbia)Low level of carbon dioxide (CO2)
in arterial blood. Partial pressure of arterial CO2 (PaCO2)
< 35 mm/Hg (4.6%), usually caused by hyperventilation.
A normal partial pressure,
at rest, is 40 mm/Hg (5.3%). hypocapnia causes cerebral vasoconstriction, leading
to cerebral hypoxia. The reduced CO2 level can suppress breathing.
HypoglycaemiaA low level of blood sugar. Diabetics may become
hypoglycaemic after taking too much insulin, or going too long without food.
- Pale, dry skin
- Shallow breathing
HypokalaemiaA potassium level of less than 3.5 mmol/l, typically
due to dehydration.
HypoventilationAka respiratory depression: Inadequate
alveolar ventilation, relative to metabolic CO2 production, resulting in
increased alveolar CO2 partial pressure, with consequent respiratory acidosis.
HypoxaemiaA lower than normal partial pressure of oxygen
(PaO2) in arterial blood eg, less than 90% saturation.
HypoxiaLow level of oxygen in the tissues
(cellular level). More
IleumThe lower part of the small intestine,
between the jejunum and caecum.
Iliac arteriesLeft and right branches from the Common Illiac artery, which
is distal to the Abdominal Aorta. The Internal Iliac artery supplies the Uterus/Prostate,
bladder and buttocks. The External Iliac supplies the lower limbs.
IliumThe top part of the hip bone.
InfarctThe wedge shaped area of necrosis in an organ, caused by
a blocked blood vessel, often as a result of an embolus.
InfarctionThe formation of an infarct.
InguinalRelating to the groin.
InotropesIncrease cardiac contractility, affecting the force of
cardiac muscular contracations.
British Journal of Medicine ||
Intercostal MusclesThe muscles found between the ribs. The
internal intercostal muscles (inside of the ribcage) extend from the front of
the ribs, and go around the back, past the bend in the ribs. The external
intercostal muscles (outside of the ribcage) wrap around from the back of the
rib, almost to the end of the bony part of the rib in the front. The nipple is
located in the 4th intercostal space.
International Normalised Ratio (INR)A relative measurement
of a patient's prothrombin time ratio - how long it takes blood to clot. A normal reading
would be 1.1 or less.
Interstitial fluidFluids (excluding plasma), such as extracellular,
lymph, cerebrospinal, eye, synovial, serous, and secretions of the
gastrointestinal tract. A 70 kg adult male has 12 litres of interstitial fluid.
IntracellularWithin a cell.
IschaemiaDeficient blood supply to an organ.
JejunumPart of the small intestine (6 feet)
between the Duodenum and the Ileum.
LactateA chemical which is formed when
sugars are broken down for energy, in the absence of adequate oxygen. Lactate causes the muscle
pain athletes experience after engaging in strenuous physical activity for long periods. In
people with mitochondrial disorders, too much lactate forms because the ability to burn foods
using aerobic respiration is impaired.
Arterial lactate: 0.5-1.6 mmol/L. Venous lactate: 0.5-2.2 mmol/L
LeukocytesWhite blood cells.
Liver Function TestA measurement of enzymes and
proteins, in order to determine how well the liver is functionig. A damaged liver will
release enzymes into the blood, and the level of proteins produced by the liver begins to drop.
MaxillaUpper jaw bone.
MedullaThe soft inner part of an organ. The outer part being
pneumonitis: acid aspiration into the lungs.
MesenteryA fold of the peritoneum, connecting the small intestine
and abdominal organs to the posterior abdominal wall.
Metabolic AcidosisA bicarbonate (HCO3)
level less than 22 mEq/L, with a pH less than 7.35; caused by a deficit of
base in the bloodstream, or an excess of acids (other than
bicarbonate level greater than 26 mEq/L, with a
pH greater than 7.45; caused by an excess of base, or a lack
of acid in the blood. More
MetabolitesSubstances produced by metabolic processes.
MetacarpusThe bones between the phalanges (fingers) and carpus
Mitral valve (bicuspid)The one-way heart valve which allows blood
to flow from the left atrium to the left ventricle.
MonocyteWhite blood cell which ingests bacterial cells.
receptors of the Parasympathetic Nervous System, activated by Acetylcholine.
The binding of Acetylcholine with Muscarinic receptors has several effects:
Binding of Acetylcholine with Muscarinic receptors...
Anticholinesterase drugs, such as Neostigmine, increase the above muscarinic
effects, so an antimuscarinic agent (Glycopyrrolate, Atropine) must be given to
- Relaxation of smooth muscle sphincters in
- Contraction of irises
- Increased sweating
- GI and uterine motility
- Salivary and gastric secretions
auto-immune disease, which attacks Acetylcholine receptors at the neuromuscular
junctions of skeletal muscles. The resultant failure of neuro transmission causes
muscle weakness, often affecting muscles which control chewing, speaking,
swallowing, and vision.
MyocarditisInflammation of the myocardium.
MyocardiumMuscle tissue of the heart.
NecrosisTissue which has died.
NeoplasiaProcess of abnormal growth of new tissue (benign or
NeoplasmCells (tumour) produced by neoplasia.
NervesA nerve is a bundle of hundreds to thousands of axons,
plus associated connective tissue and blood vessels. Each nerve serves a specific
region of the body. There are 12 pairs of cranial nerves, and 31 pairs (left and
right) of spinal nerves.
Neuromuscular junctionThe synapse between the presynaptic motor
neuron and the postsynaptic muscle membrane. The axon divides into terminal
buttons that invaginate into the muscle fibre.
NeuroneAn electrically excitable nerve cell, comprising a cell
body, dendrites, and an axon. A neuron responds to a stimulus, by creating an
action potential (impulse), which is propogated to it's neighbour.
NeurotransmitterA substance which is released from axon terminals
to bind with receptors at the neuromuscular junction. Examples include:
- Substance P
NicotinicCholinergic receptors on
skeletal muscle end-plate neurons. Activation by Acetylcholine causes
depolarisation of cells, with resultant contraction of skeletal muscle.
Nitrous OxideN2O has a low blood:gas partition coefficient
and, therefore, a rapid onset and offset of action. N2O is about 20
times more soluble than O2 and N2. During induction, the
volume of N2O, entering the pulmonary capillaries, is greater than the
N2 leaving the blood, and entering the alveolus. As a result, the volume
of the alveolus decreases, thereby increasing the fractional concentration of the
remaining gases. This process augments ventilation, as bronchial and tracheal gas
is drawn into the alveolus, to make good the diminished alveolar volume.
OedemaExcessive fluid in tissues.
Peripheral oedema results from soft-tissue swelling due to the accumulation
of interstitial fluid.
- Varicose veins
- Right heart failure
- Deep vein thrombosis
Oesophagus (gullet)The canal running between the pharynx and
stomach, approx 10 inches long.
OmentumDouble fold of peritoneum joining the stomach to the
OxytocinA hormone which is normally released by the pituitary
gland, towards the end of pregnancy, stimulating the smooth muscle of the uterus (womb).
The Oxytocin causes the muscle of the uterus to contract, during labour, so that the baby
can be pushed out. Synthetic Oxytocin (Syntocinon) can be used to induce labour.
After the baby has been born, Syntocinon may be given to stimulate contractions which
help push out the placenta, and prevent heavy bleeding.
Abnormal rate or rhythm of the heart, felt by the patient.
ParenteralApart from the alimentary canal: Introduction of
drugs or fluids into the body by a route other than the mouth or rectum, such as
IV or subcutaneously.
ParietalThe wall of the body, or of a body cavity,
or hollow structure.
Parotid(1) Near the ear. (2) Salivary gland in front of each ear.
PercutaneousThrough (per) the skin (cutis).
PerfusionThe passage of fluid through vessels/tissue, such as
blood through the lungs.
PericardiumThe fluid filled sac which surrounds the heart and the
proximal ends of the aorta, vena cava, and pulmonary artery. Functionally, this sac: fixes
the heart in place, prevents overfilling, acts as an infection barrier between the heart and
other organs, and reduces friction as the heart moves within the thoracic cavity.
Peripheral Nervous SystemAll of the neurons which are either
partly or entirely outside of the central nervous system, and comprising the
Sensory-Somatic and Autonomic systems.
Controls glands and the skeletal muscles (to
move the bones), by use of motor neurons. Comprises 12 pairs of cranial nerves,
and 31 pairs of spinal nerves.
Controls the visceral organs.
PeritoneumSerous membrane lining the abdominal cavity, and
forming a covering for the abdominal organs.
- Parietal peritoneum: membrane lining the abdominal cavity.
- Visceral peritoneum: the inner layer which covers the abdominal
organs and mesenteries.
Petechial rashA purpuric non-blanching rash, caused by bleeding
into the skin layers.
PhlebitisInflammation of a vein.
PlasmaClear, yellowish (or straw coloured)
extracellular fluid, which is the liquid part of blood.
Plasma Cholinesterase (pseudocholinesterase)
An enzyme, made by the liver, and present in the bloodstream, which breaks
down Suxamethonium. A deficiency results in Suxamethonium apnoea.
Platelets (thrombocytes)Platelets take part in the
clotting process, and are transfused when a patient:
There are 150,000 - 450,000 platelets per microlitre of blood. Each unit of platelets
raises the count by approximately 5,000 platelets per microliter of blood.
(Not to be put through a rapid infuser.)
- Has a low platelet count (thrombocytopenia)
- Has platelets which functionin abnormally
- Has bone marrow failure
- Following a transplant or chemotherapy treatments
- To treat leukaemia
PleuraSerous membrane lining the chest cavity, covering each lung.
PlexusA network of nerves, veins, or lymphatics.
PonsA bridge of tissue connecting parts of an organ.
PoplitealThe back of the knee.
PortalReferring to a vein which does not lead to the heart but,
instead, has capilliaries at each end, allowing blood to pass between organs.
Postictal stateThe abnormal condition occurring
between the end of an epileptic seizure and return to baseline condition.
PostpartumThe period shortly after giving birth.
Postural hypotensionDizziness caused by low blood pressure,
which occurs when standing up suddenly.
PotassiumThe major intracellular cation,
which is involved in maintenance of the resting membrane potential. Hyperkalaemia and hypokalaemia
can result in serious cardiac compromise.
Blood serum potassium normal range is 3.5 – 5.3 mmol/L.
Hyperkalaemia: Give 10ml of calcium gluconate 10% intravenously over 2 minutes.
PrecipitateDeposition of solid matter which was previously in solution.
PrecordiumThe part of the thorax over the heart.
Pregnancy complicationsDehydration, oedema, gastroesophageal
reflux disease, DVT, anaemia, abdominal separation.
Preload The venous return to the heart.
Aka Bed Sores: The break down of an area of skin and underlying tissue, caused when
the skin is placed under an accumulated pressure. The extra pressure leads to a disruption to
the flow of blood through the skin, resulting in reduced perfusion of oxygen and nutrients.
The ulcers/sores can range in severity from patches of discoloured skin, to open wounds which
expose the underlying bone or muscle.
ProlapseAn organ which has moved out of position - downwards.
ProteinsOrganic compounds (molecules) which are present in all living
cells. Some proteins provide structural support (bone,hair,teeth,cartilage); some proteins,
such as enzymes, hormones, antibodies, and globulins, regulate body chemistry; other
proteins, such as myoglobin, lipoproteins, and haemoglobin, provide the means of
transport of oxygen.
Prothrombin Complex ConcentrateTo counteract heavy bleeding, or to reverse
the effects of Warfarin.
ProthromboticSomething which leads to thrombosis.
PruritusIrritation of the skin.
Pulmonary circulationCirculation between the heart and lungs.
Pulmonary oedemaExcess fluid in the lungs.
Pulse pressureThe difference between diastolic and systolic pressures.
Pyloric sphincterThe muscle which helps regulate the emptying of
food from the stomach into the small bowel.
PylorusThe opening into the duodenum at the lower end of
the stomach, surrounded by the pyloric sphincter.
QRS complexECG waveforms which
occur at the start of ventricular contraction.
RadialA bone in the arm, or something which branches.
RalesAbnormal lung sounds characterized by discontinuous
clicking or rattling sounds. They can sound like salt dropped onto a hot pan or like
cellophane being crumpled.
ReceptorA special cell or nerve
(neuron) ending which detects external stimuli, such as heat or touch, and
passes the information to the central nervous system in the form of an impulse.
RefluxA backward flow; regurgitation.
Respiratory AcidosisA pH less than 7.35, with a
PaCO2 greater than 45 mm/Hg. The acid state occurs when an accumulation of
PaCO2 combines with water to produce carbonic acid, which lowers blood pH.
Hypoventilation can lead to Respiratory Acidosis, and an increase in ventilation may
correct the problem. More
Respiratory AlkalosisA pH greater than 7.45, with a
PaCO2 less than 35 mm/Hg, often caused by hyperventilation.
Respiratory functionThe urge to breathe, driven by two
factors: firstly, reduced oxygen levels in the tissues;
secondly, the level of carbon dioxide in the blood.
Respiratory SystemThe Lungs, Trachea, Bronchi, and Diaphragm.
Exchanges O2 (oxygen) with CO2 (Carbon dioxide).
Supplies the blood with oxygen, through inhalation, which is then delivered to all parts
of the body. Exhalations expel waste gases, such as carbon dioxide, which are delivered
to the lungs by the bloodstream.
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- The nerve which connects the femoral nerve with sensory nerves in the skin of the lower leg.
- The 2 veins which drain blood from the foot.
SagittalThe plane which divides an organ into left and right
SartoriousThe long muscle which flexes the thigh and lower leg, and
extends from the anterior iliac spine, across the thigh, and down to the tibia.
SepsisInfection, caused by bacteria, and resulting in pus.
SequelaA morbid condition resulting from a disease.
Secondary Gas EffectAt induction, the increase in alveolar partial pressure
of gases, resulting from the higher uptake, by the blood, of the Nitrous Oxide, in the
inhaled mixture. The higher uptake of Nitrous Oxide is due to its lower blood
solubility. At emergence from anaesthesia, the reverse happens: Nitrous Oxide
more rapidly clears from the blood, and into the alveoli. This can result in hypoxia.
SerumClear blood plasma, minus corpuscles and
fibrin. Serum includes all proteins not used in blood
clotting (coagulation) and all of the electrolytes, antibodies, antigens, hormones, and any
exogenous substances (e.g., drugs and microorganisms).
ShuntDescribes a V:Q ratio of less than 1, which means there is a lack of
ventilation of alveoli which are perfused with blood. The usual cause is alveolar collapse.
Sinoatrial NodeThe heart's pacemaker, composed of cardiac
muscle fibres, located in the right atrium, and inferior to the opening to the
Vena Cava. The SA Node produces an action potential (impulse) at a typical rate
of 100 per minute, which leads to the normal sinus rhythm.
Sinus arrhythmiaAn abnormal pulse rhythm caused by sinoatrial
node disturbance, causing tachycardia on inspiration, and bradycardia on
expiration. A slight arrhythmia is normal.
Slough(sluf): Dead tissue resulting from inflammation or
injury, which is washed away by serum exudate.
SomaticPertaining to body wall, rather than the viscera.
SpasmSudden involuntrary muscle contraction.
SpiculeA splinter of bone.
SpirometryThe measurement of lung volume and flow rate.
SplanchnicReferring to viscera.
Stenosis (stricture)An abnormal narrowing of an opening or
vessel, such as an artery.
StomaAn opening from outside the body to an internal cavity. Examples
are Colostomy, Ileostomy, Tracheostomy, and Urostomy.
StrokeA serious medical condition which occurs
when the blood supply to part of the brain is cut off.
Supraventricular ArrhythmiaAn Arrhythmia originating in the Atria.
SyncopeTemporary loss of consciousness.
SynostosisThe fusing of bones by formation of new bone.
TachypnoeaFast rate (> 20 breaths/minute) of breathing.
A normal body temperature range is 36 - 37.6° C (96.8 - 99.7° F). A high
temperature may rise to 40° C (104° F), and is considered a normal response to
ThoraxThe chest cavity; containing the heart, lungs, bronchi,
ThrombinAn enzyme which converts Fibrinogen into Fibrin, during
the later stages of blood clotting.
Thromboelastography (TEG)A test of the efficiency of blood coagulation,
platelet function, clot strength, and fibrinolysis. See Monitoring
ThromboplastinA plasma protein which aids blood
ThrombosisA blood clot within a blood vessel. There are two main types:
- Venous thromboembolism
- Arterial thrombosis
ThrombusA stationery blood clot in an unbroken blood vessel,
usually a vein.
Tidal volumeVT is the volume of air displaced between
normal inspiration and expiration, when extra effort is not applied. Typical
values are 500 ml or 7ml/kg bodyweight.
Tricuspid valveThe one-way heart valve which allows blood
to flow from the right atrium to the right ventricle.
Trousseau's signSpontaneous peripheral
TurgescenceSwelling caused by a build up of fluid.
UlnaThe inner of the 2 bones connecting the
elbow and wrist.
UrticariaHives, nettle rash: An
allergic reaction to an injection or food, causing a raised itchy rash on the skin.
UvulaThe soft tissue which hangs down the back of the soft palate.
Vagus Nerve (cranial nerve X)The tenth of
twelve paired cranial nerves, and provides parasympathetic nerve supply to the thorax
and abdomen. The nerve lies medial and posterior to the internal jugular vein and
carotid artery, and extends below the head, to the neck, chest and abdomen, where
it contributes to the innervation of the viscera. The vagus nerve also conveys
sensory information about the state of the organs to the central nervous system.
80-90% of the nerve fibers in the vagus nerve are afferent (sensory) nerves,
which communicate the state of the viscera to the brain.
VarixAn abnormally dilated vessel, typically a vein, with a
VascularisationDevelopment of new blood vessels within tissue.
Venous Thromboembolism A blood clot which develops in a vein, such as in a
vein of the leg (Deep Vein Thrombosis). If part of the clot detaches and travels
through the bloodstream to become lodged in another part of the body, it is known
as an embolism. If the embolism forms in a lung, it is known as a pulmonary embolism
(PE). Venous thromboembolism (VTE) refers to both deep vein thrombosis (DVT) and
VentilationThe process of exchanging breathing gas, such as air, between
the lungs and the atmosphere.
VesicalReferring to the bladder.
VesicantA substance which causes blistering/tissue necrosis.
VirusAn infectious agent which replicates outside of a cell.
VisceraPlural of viscus.
ViscusPertaining to organs within the body cavites, such
as the abdomen.
VomitingThe active reflux action of expelling stomach
contents via the oesophagus and mouth. Typical intraoesophageal pressure is
WoundsA break in tissue, produced by trauma or
Stages of wound healing...
- Cleansing - removal of debris
- Granulation - growth of new tissue
- Contraction - reduction of wound area
- Vascularisation - growth of new blood vessels
- Epitheliasation - growth of surface skin