BODY STRUCTURE AND DIRECTIONAL TERMINOLOGY

BODY STRUCTURE AND DIRECTIONAL TERMINOLOGY
Chapter Two BODY STRUCTURE AND DIRECTIONAL TERMINOLOGY Mastering Healthcare Terminology/Chapter 2

Organization of the Human Body Human organism
Body systems – representing certain functions or purposes Organs- body parts Tissues- Four categories: Epithelial- internal or external covering Connective- connects Muscular- has the ability to contract and relax Nervous- provides transmission of information Cells- smallest unit of the body Share certain characteristics, such as fighting disease. Word Parts system/o = system viscer/o, organ/o = organ hist/o = tissue cyt/o, cellul/o = cell The human body is composed of several distinct systems that interact with each other. Can anyone name some of the body systems? (cardiovascular, digestive, respiratory, etc.) Systems are composed of a number of organs. Notice that the combining forms for an organ can be organ/o or viscer/o. Viscera, meaning organs, is the plural of viscus, a single organ. Each organ is composed of a variety of tissues (combining form hist/o). The four types of tissues are muscular, epithelial, connective, and nervous. Finally, cells make up tissues. Notice the combining forms cyt/o and cellul/o. Mastering Healthcare Terminology/Chapter 2

Organization of the Human Body Homeostasis
Energy conversion Metabolism- Finished product of: Anabolism- Building up substances Catabolism- breaking down substances Metabolism = anabolism + catabolism Word Parts home/o = same -stasis = controlling meta- = change, beyond ana- = up, apart cata- = down bol/o = throwing -ism = state of Homeostasis: home/o means same and -stasis means controlling. Homeostasis is a normal process of maintaining balance within the body. Can you think of any examples of this balancing act that the body is constantly maintaining? (temperature, fluid balance) Part of the balancing act that the body is involved in is the process of energy conversion. Anabolism is the building up [or literally, a process of “throwing” up (as in building up)], while catabolism is the process of “throwing” down (as in breaking down). Metabolism is the total process of building up and breaking down the body’s energy stores. What are some of the factors that affect metabolism? (Certainly taking in food will cause you to build up your energy reserves, while exercising will break them down.) In order to live, cells need a constant supply of energy. The prefix meta- means change (although we will see this term with another meaning later). Bol/o means to throw or throwing. The suffix –ism means the state of. Metabolism is the process of continually building up and breaking down substances that provide energy. The ancient Greeks thought of it as substances being changed by the process of throwing. Mastering Healthcare Terminology/Chapter 2

Organization of the Human Body
Cell components Cell membrane- outer wall that encloses the cell Cytoplasm- holds the organelles of the cell Lysosome-serves as digestive function Ribosome-site of protein formation Mitochondrion- converts nutrients to entergy when oxygen is present Nucleus- control center. Holds the DNA which houses the genetic information of the cell. Word Parts cyt/o = cell -plasm = formation lys/o = dissolving -some = body rib/o = ribose mitochondri/o = mitochondria -on = structure nucle/o = nucleus -us = structure It’s important to remember that metabolism takes place at the cellular level. Let’s look at the composition of a cell, to see what role its organelles (little organs) play. Cell membrane: the thin, outer wall that encloses the contents of the cell Cytoplasm: the substance that holds the organelles of the cell. Cyt/o means cell, while -plasm means formation. It is a formation inside of the cell. Lysosome: an organelle that serves a digestive function. Lys/o means dissolving, while -some means body. It is a body (albeit a tiny one) that serves to dissolve substances for the use of cell nutrition. Ribosome: an organelle that is the site of protein formation. Rib/o means ribose, a substance critical in the formation of RNA (ribonucleic acid) and –some, again, means body. This organelle is the site of protein formation in the cell. Mitochondrion (pl mitochondria): organelle that converts nutrients to energy in the presence of oxygen Nucleus: control center of the cell; holds the DNA (deoxyribonucleic acid), which contains genetic information The cell Mastering Healthcare Terminology/Chapter 2

Organization of the Human Body Tissues
Parenchymal vs. stromal Four types of tissues Epithelial Connective Muscular Nervous Be Careful! Don’t confuse my/o, the combining form for muscle, and myel/o, the combining form for spinal cord or bone marrow. Word Parts hist/o = tissue strom/o = stromal par- = near en- = in chym/o = juice my/o = muscle neur/o = nerve Explain the difference between parenchymal (does the work of an organ) and stromal (is supportive in nature) tissues, giving examples (kidneys are parenchymal, ureters are stromal). Tissue types: Epithelial tissue acts as an internal or external covering for organs and is most prone to cancer because of contact with the environment. Connective tissue has the property of an internal structural network. Muscular tissue has the unique ability to contract and relax. Nervous tissue serves to provide for the transmission of information within the body. Examples of the types of tissues include the outer layer of the skin or lining of the digestive tract for epithelial tissue. Connective tissue includes bone, blood, and fat. Muscular tissue includes heart, skeletal, and visceral muscle, and nervous tissue includes the nerves, spinal cord, and brain. Mastering Healthcare Terminology/Chapter 2

Autologous- your own tissue
Word Parts Tissue Replacement Autologous- your own tissue Nonautologous/allogeneic- donor tissue Zooplastic- comprised from an animal source Syngeneic/isoplastic/isogeneic/ isologous- from identical twins or identical tissue. auto- = self -logous = pertaining to study of allo- =different -geneic = pertaining to zo/o = animal syn- = same is/o = equal -plastic = pertaining to formation For tissue replacement, the key is in the prefixes. These tissue replacement types are necessary for coding in PCS accurately. Discuss the different types of tissue replacement from one’s self (autologous), another human (nonautologous/allogeneic), and from another species (zooplastic). Note the last set of terms, which indicate the tissue is taken from an identical twin (syngeneic and isoplastic/isogeneic/isologous). Mastering Healthcare Terminology/Chapter 2

Organization of the Human Body
Organs- various tissue that accomplishes a specific purpose Termed “viscera” (s. viscus) Arrangements of various types of tissues Heart Endocardium (epithelial) Myocardium (muscular) May be instrumental in more than one system Word Parts viscer/o, organ/o = organ endo- = with cardi/o = heart -um = structure my/o = muscle Notice that organs have an easy combining form along with one that is more difficult. The combining form viscer/o is derived from the plural form for organs – viscera. The singular form is viscus (rhymes with discus). Which do you think you’ll see more of: organ/o or viscer/o? (Viscer/o of course; it’s the harder one to remember.) Organs are arrangements of different tissues. For example, the heart is composed of epithelial tissue along with muscular tissue. The endocardium is the lining of the chambers of the heart (the epithelial tissue), while the myocardium is the muscle tissue of the heart. It’s good to note that organs can have functions in more than one system. For example, the pancreas secretes hormones in the endocrine system, while it also functions as a gastrointestinal organ. Mastering Healthcare Terminology/Chapter 2

Review Question If you are reading a lab report that uses the combining form hist/o , you know that it refers to a/n: A. cell B. tissue C. organ D. system B. Tissue! The combining forms for the cell are cyt/o, cellul/o; for organ organ/o and viscer/o; and for system it’s simply system/o. Mastering Healthcare Terminology/Chapter 2

Parts of Organs Apex (apic/o) Body (corpor/o, som/o, somat/o)
Pointed extremity Largest or most important part Throughout your career in healthcare you will not only need to know the names of organs, but you will need to recognize locations within organs. There is a standard terminology to describe locations, and that is what we need to cover next. The apex is the pointed extremity of an organ. In the heart this is at the bottom, whereas in the lungs, the apex is at the top. The plural of apex is apices. (Remember the rule? If a term ends in –ex, it can be made plural by dropping the –ex and adding –ices.) The body of an organ is the largest or most important part of an organ. A synonym is corpus. Note that the combining forms are corpor/o, som/o, and somat/o. The diagram here is of the stomach with the body noted. A fornix is the arched part of an organ or structure. The diagram here shows you the fornices (note that plural!) of the vagina. They are the vault-like arches that are at the deepest part of the vagina. The fundus is the base or deepest part of an organ. Here we have the uterine fundus illustrated. Fundal height is an important measurement when determining the age of the fetus. It is measured from the pubic bone to the top of the uterus. You can also give examples of the adjective endings for these: apical, somatic, fornicate, fundal. Fundus (fund/o) Fornix (fornic/o) Base or deepest part Any vault-like or arched part Mastering Healthcare Terminology/Chapter 2

Parts of Organs Hilum (hil/o) Lumen (lumin/o) Sinus (sinus/o)
Recess or exit Space within an artery vein intestine or tube Cavity or channel in a bone, dilated channel for blood or cavity that permits escape of fluid or pus filled material The hilum is any recess, exit, or entrance in which a vessel or nerve enters an organ. You may see this in its adjective form as hilar. The illustration shows the hilum of the kidney where the ureters enter/exit along with the arteries and veins. The lumen of an organ or vessel is the space within it. Here we’re looking at the lumen of a vessel. If the lumen is blocked (or occluded), you know that there is very little space for the vessel to carry or transport blood, for example. Note that the combining form is lumin/o with an i instead of an e as in the noun form. The plural is lumina, one of the few –en/ina endings. A sinus is a cavity or a channel within bone, or a dilated channel for blood. Our figure illustrates a sinus in bone. The plural of sinus does NOT follow the rule of terms ending in –us. This plural is sinuses. Antrum is a synonym for sinus. Its plural form is antra. A vestibule is a small space or cavity at the beginning of a canal. For example, the vestibule of the ear is illustrated here. Vestibule (vestibul/o) Cavity at beginning of canal Mastering Healthcare Terminology/Chapter 2

Body Systems Body systems Cardiovascular- heart
Musculoskeletal- muscle and bone Integumentary- skin Gastrointestinal- stomach, intestines Urinary- kidneys, bladder Reproductive- genital organ Blood/lymphatic/ immune Cardiovascular- heart Respiratory- lungs Nervous/behavioral- brain Special senses- eyes/ears Endocrine- metabolism Organs are parts of body systems. Ask students to name organs in each system. Write the system on the board with their responses and give combining forms for at least one organ in each system mentioned. State the functions of each system and discuss how a disease/disorder can disrupt that function. We will go into more detail as to the functions of each of the systems, but for now, let’s just briefly look at their functions. The musculoskeletal system serves to support the body, protect internal organs (think of the rib cage!), and move the body. The integumentary system is that of the skin. Its function is to cover and protect the body from disease. The gastrointestinal system is responsible for nourishing the body. The urinary system is key in the elimination of nitrogenous waste. The reproductive systems are responsible for keeping our genetic material available through the function of reproduction. The blood, lymphatic, and immune systems are responsible for the transportation of nutrients and wastes and protecting the body against disease. The cardiovascular system serves to transport blood throughout the body. The respiratory system delivers oxygen to cells and removes carbon dioxide. The nervous system (along with behavioral health) is responsible for the reception and processing of information that is perceived by the organism. The special senses (eye and ear) are responsible for gathering visual and auditory information. Finally, the endocrine system is responsible for effecting change in the body through the use of chemical messengers termed hormones. Mastering Healthcare Terminology/Chapter 2

Specialists and Specialties Cytology Histology Anatomy Physiology
Cytologist Histology Histologist Anatomy Anatomist Physiology Physiologist Word Parts cyt/o = cell -logy = study of -logist = one who specializes in the study of hist/o = tissue ana- = up, apart, away -tomy = incision, cutting physi/o = growth Cytology is the study of cells, while a cytologist is one who specializes in the study of cells. Histology is the study of tissues, while a histologist is one who specializes in the study of tissues. The term anatomy has a literal meaning of to cut up or apart. We know that this really means the study of the structure of the body. An anatomist (no, not an anatomologist!) is one who specializes in the structure of the body. Physiology comes from the root physi/o having to do with growth. However, physiology is the study of the functions of the body, with a physiologist being one who is a specialist in the study of the function of the body. Mastering Healthcare Terminology/Chapter 2

Specialists and Specialties Pathology Biopsy Necropsy Autopsy
Pathologist Biopsy Necropsy Autopsy Word Parts path/o = disease bi/o = life, living necr/o = death, dead -opsy = viewing auto- = self Pathology is the study of disease. Path/o is a combining form for disease. The specialist is a pathologist. If you are an individual who loves healthcare, can tolerate blood and guts, but are not terribly good with patients, you might want to consider pathology. You’ll be looking at cells, tissues, organs, or dead bodies. The term biopsy comes from bi/o meaning life or living and –opsy meaning a viewing. Hence, a biopsy is a viewing of living tissue. Biopsies are important as tissue samples to diagnose diseases. The term necropsy is the opposite of biopsy. Here necr/o means dead or death. A necropsy is the viewing of dead tissue. Another name for this is an autopsy, a much more common term, but one that is etymologically a little more obscure. Auto- means self. The meaning comes from the pathologist him or herself (not the dead person!) viewing the tissue. Mastering Healthcare Terminology/Chapter 2

Anatomic Position Anatomic position is the frame of reference that is used to name the surface anatomy. To be in anatomic position, an individual is standing erect, face forward, arms at sides, with palms facing forward and toes pointed forward. Have you ever heard of the story about the blind men who were trying to describe an elephant? One was touching his trunk, another his body, another his tail. They obviously gave three very different descriptions of what they perceived. It is important that we all have the same frame of reference when we describe where a wound, burn, or pain occurs on the body. Our next terms will go through the body with the words used to describe the anatomy on the surface of the body. Stretch break? Have everyone stand up, stretch, and then assume an anatomic position! Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Head and Neck Buccal Cephalic Cervical
Word Parts Ventral Surface Anatomy: Head and Neck Buccal Cephalic Cervical Be Careful! In the female reproductive system cervic/o refers to the neck of the cervix. Also, collum refers to the neck. bucc/o = cheek cephal/o = head cervic/o = neck Buccal means pertaining to the cheek. Bucc/o is a combining form for the cheek. Cephalic means pertaining to the head. Cephal/o means the head. Cervical means pertaining to the neck. Cervic/o means the neck. But Be Careful! In the female reproductive system, cervic/o refers to the neck of the cervix. Also, collum refers to the neck. Notice the relationship to the word collar. Pay attention to the context of what you are reading to understand which “neck” is being talked about. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Head and Neck Cranial Deltoid Facial
Word Parts Ventral Surface Anatomy: Head and Neck Cranial Deltoid Facial Be Careful! Don’t confuse faci/o, meaning face, with fasci/o, meaning the tough outer covering of the muscles. crani/o = skull delt/o = triangle faci/o = face Cranial means pertaining to the skull. Crani/o means the skull. Deltoid means pertaining to the deltoid muscle. Delt/o means triangle and –oid means resembling. Facial means pertaining to the face. Faci/o means the face. Another Be Careful! Don’t confuse faci/o with fasci/o, the tough outer covering of the muscles. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Head and Neck Frontal Mental Nasal
Word Parts Ventral Surface Anatomy: Head and Neck Frontal Mental Nasal Be Careful! Mental means pertaining to the chin as well as pertaining to the mind. ment/o = chin nas/o = nose Frontal literally means pertaining to the front. In the context of surface anatomy, it refers to the forehead. Mental means pertaining to the chin when you are talking about surface anatomy of the face. The mental foramina are small holes in the bone of the lower jaw that provide an entrance/exit for blood vessels and nerves. Nasal means pertaining to the nose. Nas/o is a combining form for the nose. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Head and Neck Ocular Oral Otic
Word Parts Ventral Surface Anatomy: Head and Neck Ocular Oral Otic ocul/o = eye or/o = mouth ot/o = ear Ocular means pertaining to the eye. Ocul/o is a combining form for the eye. Oral means pertaining the mouth. Or/o is a combining form for the mouth. Otic means pertaining to the ear. Ot/o is a combining form for the ear. Auricular is another term for pertaining to the ear. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Trunk Abdominal Axillary Coxal Inguinal
Mammary Pelvic Sternal Thoracic Umbilical Word Parts abdomin/o = abdomen axill/o = armpit cox/o = hip inguin/o = groin mamm/o = breast pelv/i = pelvis stern/o = breastbone thorac/o = chest umbilic/o = umbilicus Abdominal means pertaining to the abdomen. Abdomin/o is one of the combining forms for the abdomen. Don’t confuse the abdomen with the stomach. The abdomen is a region, not an organ. And please notice the change of the e to an i when using the combining form. Axillary means pertaining to the armpit. Axill/o is a combining form for the armpit. Coxal means pertaining to the hip. Cox/o is a combining form for the hip. Inguinal means pertaining to the groin. Inguin/o is a combining form for the groin. Mammary means pertaining to the breast. Mamm/o is a combining form for the breast. Pelvic means pertaining to the pelvis. The combining form for pelvis is pelv/i. Sternal means pertaining to the sternum (the breastbone). Stern/o is a combining form for the sternum. Thoracic means pertaining to the chest. Thorac/o is a combining form for the chest. Umbilical means pertaining to the navel (belly button). Umbilic/o is a combining form for the umbilicus. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Arms
Antecubital Brachial Carpal Manual Palmar Digital Be Careful! Man/u and man/i mean hand, but man/o means pressure or scanty. Word Parts ante- = forward, in front of before cubit/o = elbow brachi/o = arm carp/o = wrist man/u = hand palm/o = palm digit/o = finger/toe Antecubital means pertaining to the front (ante-) of the elbow (cubit/o). Brachial means pertaining to the arm. Brachi/o is a combining form for the arm. Carpal means pertaining to the wrist. Carp/o is a combining form for the wrist. Manual means pertaining to the hand. Man/u is a combining form for the hand. Be Careful! Man/u and man/i mean hand, but man/o means pressure or scanty. Palmar means pertaining to the palm of the hand. Palm/o is a combining form for the palm. Digital means pertaining to a whole finger or toe. Digit/o is a combining form for the finger or toe. Mastering Healthcare Terminology/Chapter 2

Ventral Surface Anatomy: Legs
Word Parts Ventral Surface Anatomy: Legs Crural Femoral Patellar Pedal Plantar Tarsal Be Careful! Ped/0 means foot but can also mean child or children, such as pediatrics. crur/o = leg femor/o = femur patell/a = patella, knee ped/o = foot plant/o = sole tars/o = ankle Crural means pertaining to the leg. Crur/o is a combining form for the leg. Femoral means pertaining to the thigh. The femur is the thighbone. Femor/o means the thighbone. Patellar means pertaining to the knee. Patell/a is a combining form for the knee and kneecap. Pedal means pertaining to the foot. Ped/o is a combining form for the foot. But Be Careful! Don’t confuse ped/o meaning foot with ped/o meaning children. Context rules! Plantar means pertaining to the sole of the foot. Plant/o is a combining form for the sole. Tarsal means pertaining to the ankle. Tars/o is a combining form for the ankle and the tarsals (ankle bones). Mastering Healthcare Terminology/Chapter 2

Dorsal Surface Anatomy Acromial Dorsal Gluteal Lumbar Nuchal Perineal
Scapular Sacral Vertebral Olecranal Popliteal Sural Word Parts acromi/o = acromion dors/o = back glute/o = buttocks lumb/o = loin nuch/o = neck perine/o = perineum scapul/o = scapula sacr/o = sacrum vertebr/o = vertebra olecran/o = elbow poplite/o = back of knee sur/o = calf Acromial means pertaining to the shoulder. Acromi/o is a combining form for the shoulder or the acromion process. Did you know that this is actually a compound term built from acro- meaning an extremity and om/o meaning shoulder? It refers to the highest point of the shoulder. Dorsal means pertaining to the back. Dors/o is a combining form for the back. Gluteal means pertaining to the buttocks. Glute/o is a combining form for the buttocks. Lumbar means pertaining to the loins or the lower back. Lumb/o means lower back or loins. Nuchal means pertaining to the neck, especially the back of the neck. Perineal means pertaining to the perineum between the external genitalia and the anus. Scapular means pertaining to the scapula (shoulder blade). Sacral means pertaining to the sacrum. As you can see, the sacrum is below the lumbar region. Sacr/o means the sacrum. Be careful here. Sarc/o looks very similar but means flesh. Vertebral means pertaining to the vertebrae, the bones in the back. Vertebr/o means the vertebrae. Now we need to look at the back of the arms and the legs. Olecranal means pertaining to the elbow. Olecran/o is a combining form for the elbow. Popliteal means pertaining to the back of the knee. Poplite/o is a combining form for the back of the knee. Sural means pertaining to the calf. Sur/o is a combining form for the calf. That ‘s the end of the surface anatomy terms. I can assure you that you will be seeing each and every one of these in the following chapters, especially in the medical reports, and they will be used throughout your career in healthcare. Mastering Healthcare Terminology/Chapter 2

Review Question What surface anatomy term means “pertaining to the front of the elbow”? A. brachial B. crural C. olecranal D. antecubital D. Antecubital Remember that ante- means in front of and cubit/o means the elbow. This is often the site of blood draws. Mastering Healthcare Terminology/Chapter 2

Positional and Directional Terms
Anterior (anter/o) Ant Ventral (ventr/o) Posterior (poster/o) Pos Dorsal (dors/o) Be Careful! Don’t confuse anter/o, meaning front, and antr/o, meaning a cavity. Anterior means pertaining to the front. It’s abbreviated ant and has a synonym, ventral. Ventr/o, the combining form used in ventral, means the “belly side”, which you can understand to mean the same as the front. The back is posterior with an abbreviation of pos. The synonym for posterior is dorsal. Remember that from surface anatomy? Ventral and dorsal are also used to describe the back and the belly side of animals. Why is the definition of ventral (the belly side) more useful than the definition of anterior (front) for animals? (it’s kind of hard to determine if the area under a dog or cat’s face is part of its back or front. If you think of having the animal stand on its back feet, you can easily see that it’s part of the belly side, or the ventral surface.) Anterior Posterior Mastering Healthcare Terminology/Chapter 2

Terms we use to describe positions and directions in the human body. Anteroposterior and posteroanterior: Anteroposterior means from front to back. It is abbreviated AP. Posteroanterior means from back to front. It is abbreviated PA. Can you see how it is describing the direction of the x-ray beam? Ask why a combining vowel is used between anter/ and poster/ as well as poster/ and anter/. (Because the rule is that combining vowels are used between combining forms, regardless of whether they start with a consonant or a vowel.) Anteroposterior (AP) Posteroanterior (PA) From Frank: Merrill’s Atlas, ed 11, Mosby Mastering Healthcare Terminology/Chapter 2

Superior (super/o) Sup Cephalad (cephal/o) Inferior (infer/o) Inf Caudad (caud/o) Superior means pertaining to upward. Super/o is a combining form meaning upward. The abbreviation for superior is sup. Cepahlad means toward the head. Cephal/o is a combining form meaning the head. Point out that the suffix -ad means towards. Inferior means pertaining to downward. Infer/o is a combining form meaning downward. Caudad means toward the tail. Caud/o is the combining form for the tail. Again, why is the definition of caudad (towards the tail) a more useful definition in animals than in humans? (Up and down are even harder to discern on an animal. So it’s either: towards the head or towards the tail.) Superior Inferior Mastering Healthcare Terminology/Chapter 2

Medial (medi/o) Lateral (later/o) Lat Medial means pertaining to the middle (doesn’t it look like that?), with medi/o being a combining form for middle. Lateral means pertaining to the side. Later/o is a combining form for the side. The abbreviation is lat. Use the example of “the big toes are medial to the little toes” and “the little toes are lateral to the big toes”—or any that you like! Medial Lateral Mastering Healthcare Terminology/Chapter 2

Ipsilateral (ipsi-) Contralateral (contra-) Ipsilateral means pertaining to the same side. The prefix ipsi- means the same. Contralateral means pertaining to the opposite side. Contra- is a prefix meaning the opposite. The example of most strokes affecting the contralateral side of the body is a good one for this term. Ipsilateral Contralateral Mastering Healthcare Terminology/Chapter 2

Unilateral (uni-) Bilateral (bi-) Be Careful! Don’t confuse bi-, meaning two, and bi/o, meaning life. Unilateral means pertaining to one side. Uni- is a prefix for one. Bilateral means pertaining to two sides. Bi- is a prefix meaning two. Don’t confuse the prefix bi- with the combining form bi/o meaning life, living. Unilateral and bilateral may be easier to remember if students think of how many wheels a unicycle has as opposed to a bicycle. Unilateral Bilateral Mastering Healthcare Terminology/Chapter 2

Guideline Alert! REPORTING THE SAME DIAGNOSIS CODE MORE THAN ONCE
Each unique ICD-10-CM diagnosis code may be reported only once for an encounter. This applies to bilateral conditions when there are no distinct codes identifying laterality or two different conditions classified to the same ICD-10-CM diagnosis code. LATERALITY For bilateral sites, the final character of the codes in the ICD-10-CM indicates laterality. An unspecified side code is also provided should the side not be identified in the medical record. If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. Many structures of the body come in pairs – pay attention if the disorder is noted to be on one side (unilateral) or two sides (bilateral). Mastering Healthcare Terminology/Chapter 2

Proximal (proxim/o) Distal (dist/o) Proximal means pertaining to near the point of origin. Proxim/o is a combining form for near. Distal means pertaining to farther from the point of origin. Dist/o is a combining form for far. A frame of reference is important in this definition. That’s why the definition includes “the point of origin.” If the terms are used to describe a location that is nearer to or farther from the points of origin of the arms and legs, they are referring to the shoulders and hips, respectively. If proximal and distal are used to describe sites within the body, they are referring to the beginning and end of the organ. Take time to review the use of proximal and distal. For example: Hold out your arm and say, “the wrist is ________ to the elbow?” The wrist is distal to the elbow because it is farther from the shoulder (the point of attachment) than the elbow is. But! “The elbow is ______ to the wrist.” The elbow is proximal to the wrist because it is closer to the shoulder than the wrist. Proximal Distal Mastering Healthcare Terminology/Chapter 2

Superficial Deep Superficial means pertaining to the surface. A superficial wound is on the surface. External is used to mean the same as superficial. Deep means away from the surface of the body. This means the same as internal. Superficial Deep Mastering Healthcare Terminology/Chapter 2

Supine Prone Supine A patient who is in the supine position is lying on his/her back. See the word “up” in supine? Maybe it will help you to remember the meaning of the term if you remember that the person is face up. A patient who is in the prone position is lying on his/her belly. In the term prone, you can remember that the person is lying on his/her belly. Prone Mastering Healthcare Terminology/Chapter 2

Dextrad (dextr/o) Sinistrad (sinistr/o, levo-) Dextrad means towards the right, while sinistrad means towards the left. Note that there is one combining form for the right (dextr/o), while the left has a combining form (sinistr/o) and a prefix (levo-). Go over the meanings of right and left for dextr/o, sinistr/o, and levo-. Students may be interested in the origins of these terms in cultures that considered the body to have a good and an evil side. For instance, those who are “dexterous” are considered to be skilled, especially with the hands. Those who are “sinister” are considered to be almost evil. In medical terminology, however, these word parts only refer to right and left! Dextrad Sinistrad Mastering Healthcare Terminology/Chapter 2

Afferent (af-) Efferent (ef-) Afferent means pertaining to carrying (fer/o) toward (af-) a structure. Efferent means pertaining to carrying (fer/o) away from (ef-) a structure. Can you see how afferent vessels carry substances toward a structure, like this kidney, while efferent vessels carry substances away from the structure. Efferent Afferent Mastering Healthcare Terminology/Chapter 2

Review Question One of the patients has had a stroke. Because it was on the left side of his brain, it affected the right side of his body. Which of the following terms means “pertaining to the opposite side”? A. unilateral B. ipsilateral C. contralateral D. bilateral C. Contralateral Remember that the prefix contra- means opposite. Mastering Healthcare Terminology/Chapter 2

Body Cavities: Dorsal and Ventral Dorsal cavities
Cranial Spinal Ventral cavities Thoracic Abdominal Pelvic Be Careful! Abdomen refers to a region, whereas the stomach is an organ Word Parts dors/o = back crani/o = cranium, skull spin/o = spine ventr/o = belly, front thorac/o – thorax, chest abdomin/o = abdomen pelv/i = pelvis Body cavities Looking inside, we can see that the body is composed of cavities in the back of the body, the dorsal cavities, and in the front of the body, the ventral cavities. The dorsal cavities are the cranial cavity (remember that crani/o means skull) and the spinal cavity. Spin/o is a combining form for the spine. The ventral cavities are the thoracic cavity (thorac/o means chest), the abominal cavity (abdomin/o means abdomen), and the pelvic cavity (pelv/i is a combining form for the pelvis). Discuss the critical thinking question regarding the protective nature of most body cavities. (The majority of the cavities are protected by bones. The skull, the vertebrae, the ribs and the hip bones.) Mastering Healthcare Terminology/Chapter 2

Body Cavities: Dorsal and Ventral
Word Parts Body Cavities: Dorsal and Ventral Ventral cavities Thoracic Mediastinal cavities Pleural cavities Pericardial cavity Abdominal Diaphragm Pelvic Peritoneum visceral and parietal layers Omenta Mesentery mediastin/o = mediastinum pleur/o = pleura pericardi/o = pericardium diaphragm/o, phren/o = diaphragm peritone/o = peritoneum viscer/o = viscera pariet/o = wall mesenter/o = midgut The thoracic cavity is further divided into the mediastinum, the pleural, and the pericardial cavities. The abdominal and pelvic cavities are lined by a serous membrane termed the peritoneum. The two layers are the visceral (closest to the organs) and the parietal (closest to the body wall) layers. The omenta is an extension of the visceral peritoneum that supports the visceral organs. The mesentery is the fold of peritoneum that joins the two layers and attaches to the posterior wall of the abdominal cavity. Mastering Healthcare Terminology/Chapter 2

Abdominopelvic Regions
Nine regions Left and right hypochondriac Epigastric Left and right lumbar Umbilical Left and right iliac (inguinal) Hypogastric Be Careful! Don’t’ confuse hypo-, meaning under or deficient, and hyper-, meaning above or excessive. Also, ile/o means ileum (part of the intestine) and ili/0 means ilium (part of the hip). Word Parts hypo- = under chondr/o = cartilage epi- = upon, above gastr/o = stomach umbilical = umbilic/o, omphal/o ili/o = ilium inguin/o = groin The abdominopelvic regions describe the surface area over the abdominopelvic cavities. Ask students to draw these in their notes. Show them how to label their drawings with the correct application of left and right (you can use the shaking hands analogy). Note the other meaning of the term hypochondriac (in ancient times, it was thought that an area under the cartilage of the ribs was responsible for the mental condition of an individual who thinks they have many illnesses when in reality they don’t). Show how the prefixes epi- (meaning above or upon) and hypo- (meaning under or below) help locate the epigastric and hypogastric regions. Remind students that right and left is always interpreted from the patient’s perspective. Mastering Healthcare Terminology/Chapter 2

Review Question Which abdominopelvic region is inferior to the umbilical region? A. epigastric B. hypogastric C. hypochondriac D. lumbar B. Hypogastric The hypogastric region is the one that is inferior (below) the umbilical region. Mastering Healthcare Terminology/Chapter 2

Abdominopelvic Quadrants
Right upper quadrant (RUQ) Liver Left upper quadrant (LUQ) Stomach and spleen Right lower quadrant (RLQ) Appendix and McBurney’s point Left lower quadrant (LLQ) Munro’s point Abdominopelvic quadrants divide the area into four segments (quadri- means four). They are either upper or lower and left or right. The right upper quadrant is the location of the liver, while the left upper quadrant is the location of the stomach and spleen. The right lower quadrant is the location of the appendix, intestines, and ovaries in the female. The location directly above the appendix (approximately two thirds of the way between the hipbone and the navel) is called McBurney’s point. The left lower quadrant contains the same organs as the right, excepting the appendix. Munro’s point, a location about halfway between the hipbone and navel in this quadrant, is the standard site of entrance for abdominal laparoscopic surgery. Have students draw the abdominopelvic quadrants, again labeling their diagrams correctly with right and left, upper and lower quadrants. Note that some professionals also use the abbreviations RUQ, LUQ, RLQ, and LLQ. Discuss the differences between McBurney’s point and Munro’s point. Mastering Healthcare Terminology/Chapter 2

Planes of the Body Sagittal Midsagittal Sagittal Midsagittal
Planes are slices of the body that are used in imaging. Sagittal separates the sides – or you could say, the right from the left. Midsagittal separates them exactly in the middle. Sagittal Midsagittal Vertical-separates sides Separates in lt/rt halves Mastering Healthcare Terminology/Chapter 2

Planes of the Body Frontal/coronal Front/Back portions
Frontal/coronal separates the front from the back into anterior and posterior portions. Front/Back portions Mastering Healthcare Terminology/Chapter 2

Planes of the Body Transverse Upper/Lower View
The example here is of a transverse plane, the type that is used in CT scans. Transverse planes separate the body into superior and inferior portions. Oblique planes, not as commonly used, divide the body at a slanted angle. Upper/Lower View Mastering Healthcare Terminology/Chapter 2

Review Question One of the imaging reports of the brain uses a term that means a plane that separates the sides. This longitudinal plane would separate the ears. Which one is it? A. frontal B. transverse C. sagittal C. Sagittal Remember, sagittal “separates the sides.” Mastering Healthcare Terminology/Chapter 2

Sort These Terms into Their Correct Categories
1. antecubital 2. hypogastric 3. proximal 4. cranial 5. supine Categories __ Surface anatomy __ Cavities __ Abdominopelvic quadrants and regions __ Directional/positional Surface anatomy – antecubital Cavities – cranial Abdominopelvic quadrants and regions – hypogastric Directional/positional – proximal, supine

BODY STRUCTURE AND DIRECTIONAL TERMINOLOGY

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BODY STRUCTURE AND DIRECTIONAL TERMINOLOGY

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