Chapter Nine CIRCULATORY SYSTEM

Chapter Nine CIRCULATORY SYSTEM
Medical Terminology and Anatomy for ICD10 Coding

Circulatory System Cardiovascular system Lymphatic system
The Circulatory Chapter codes include those from the cardiovascular and lymphatic systems. Note the use of color to signify the vessels of the circulatory system: red for arteries, blue for veins, and green for lymphatic vessels. Cardiovascular system Lymphatic system Medical Terminology and Anatomy for ICD10 Coding

Circulatory Composition and Functions
Cardiovascular (CV) structures Heart and great vessels Arteries and veins Lymphatic structures Organs (spleen, thymus), lymph nodes, and lymph vessels Functions Transportation of substances To cells Oxygen, nutrients, other substances Away from cells Waste products The circulatory system is named for its continual movement of blood and lymph through the body. It is composed of the cardiovascular structures: the heart, arteries and veins, as well as the lymphatic structures: lymph organs, lymph nodes, and lymph vessels. The function of the cardiovascular system is to provide a means of transportation for a variety of substances to and from the cells of the body. The lymphatic system performs a cleansing function and is intimately connected with the cardiovascular system to carry out its functions. The substances that need to be delivered are oxygen, nutrients, water, body salts, and hormones. The primary waste product that needs to be removed from the body is carbon dioxide. Medical Terminology and Anatomy for ICD10 Coding

Circulatory Study Hints
Arteries, veins, and lymphatic structures are often named for the anatomical body parts that they serve (e.g., Brachial arteries are in the arm: brachi/o = arm). Directional terminology (superior vena cava returns blood from the upper body: super/o = upward) Oxygenated vessels (usually arteries) are colored red. Deoxygenated vessels (usually veins) are colored blue. Lymphatic vessels and nodes are colored green. To help your understanding of the various structures, processes, and diagrams in this chapter, you might want to consider the following points: 1. previously learned combining forms for body parts can be “recycled” when naming arteries, veins, and lymph nodes. 2. many of the structures in this system are additionally described with directional terms that were covered in Chapter 2. 3. the issue of oxygen-rich versus oxygen-poor is shown in most illustrations through the use of red and blue. 4. the lymphatic system is illustrated using the color green for its vessels. Medical Terminology and Anatomy for ICD10 Coding

Cardiovascular Structures Heart Vessels
Arteries Veins Word Parts cardi/o, coron/o, cordi/o, = heart angi/o, vas/o, vascul/o = vessel arteri/o = artery ven/o, phleb/o = vein As we move through the circulatory anatomy, we will be collecting (and using) several word parts. These will be displayed in the column to the left. Use this diagram and the combining forms provided to explain the differences among arteries, veins, and capillaries. Arteries are thick and muscular, necessary properties to withstand the force of the heartbeat, while veins are thinner and have one-way valves that prevent the backflow of blood. Capillaries are tiny and thin enough to allow only one blood cell at a time to pass through them. Tiny arteries (arterioles) connect the arteries to the capillaries, and tiny veins (venules) connect the capillaries to the veins. Medical Terminology and Anatomy for ICD10 Coding

PCS Guideline Alert! B2.1b Body systems designated as upper or lower contain body parts located above or below the diaphragm, respectively. This guideline refers to the cardiovascular system’s arteries and veins, not the lymphatic vessels. Medical Terminology and Anatomy for ICD10 Coding

Special Note Any vessel that an individual is born with is termed a “native vessel,” as opposed to those that may be acquired from another individual, an animal, or made from synthetic fibers. Note that the word native is derived from nat/o = birth and -ive meaning pertaining to those vessels that come with one’s birth. An understanding of what a native vessel is is an important concept as an option in the repair of cardiovascular vessels. Medical Terminology and Anatomy for ICD10 Coding

Circulation of the Blood Pulmonary circulation
Word Parts pulmon/o = lung ox/i, ox/o = oxygen capn/o = carbon dioxide Notice that circulation can be divided into three main areas: pulmonary (pulmon/o = lung + -ary = pertaining to) circulation, systemic (system/o = system + ic = pertaining to) circulation, and coronary circulation (through the heart itself) Pulmonary circulation begins with the right side of the heart (notice that the blood is deoxygenated) where the blood is pushed out to the lungs to offload the carbon dioxide and pick up oxygen. Now oxygenated, the blood travels back to the left side of the heart where it is pumped out to begin its route through the systemic circulation. Note that pulmonary circulation is about the exchange of oxygen and carbon dioxide with the cells of the lungs. Medical Terminology and Anatomy for ICD10 Coding

Circulation of the Blood Systemic circulation
Overall Heart -> aorta -> arteries -> arterioles -> capillaries -> cells -> capillaries -> venules -> veins -> upper (or lower) vena cava -> heart Renal circulation Hepatic portal circulation Word Parts aort/o = aorta arteriol/o = arteriole cyt/o, cellul/o = cell ren/o = kidney hepat/o = liver Systemic circulation describes the exchange of gases and substances between the blood and the cells of the body. The blood is pumped out of the left side of the heart through the aorta (the largest artery of the body) to a system of arteries that divide into smaller arterioles that end in tiny capillaries. The capillaries of the body tissues are the sites of exchange between the cells’ fluids and the plasma of the circulatory system. The journey then begins back to the heart through tiny veins called venules, then larger veins, and finally the two largest veins of the body, the inferior and superior venae cavae. Using the diagram, discuss the circulation of the blood, noting the differences between pulmonary and systemic circulation. Note the use of color to show oxygenated versus deoxygenated blood. Renal circulation is the part of systemic circulation where the blood passes through the kidneys. Hepatic portal circulation is the part of systemic circulation where the blood flows through the small intestines, collects in the portal vein, then the liver. The purpose is to have the liver filter sugars from the blood and store them as needed. Medical Terminology and Anatomy for ICD10 Coding

Tunica externa (adventitia) Tunica media Tunica interna (intima)
Vessels Tunica externa (adventitia) Tunica media Tunica interna (intima) Word Parts vascul/o, angi/o, vas/o = vessel tunica = coat externa = outside media = middle interna = inside Discuss the structure of the vessels of the cardiovascular system, noting the layers (tunics) and how their descriptors (externa, media, interna) help you know which layer is located where on a vessel. Adventitious breath sounds are those that have an external cause. Discuss the differences between the structures. Medical Terminology and Anatomy for ICD10 Coding

Heart and Great Vessels Size/location/description Chambers
Atria Right atrium (RA) Left atrium (LA) Ventricles Right ventricle (RV) Left ventricle (LV) Septa Atrial septum Ventricular septum Atrioventricular septum Word Parts apic/o = apex pre- = in front of cordi/o = heart -um = structure atri/o = atrium ventricul/o = ventricle sept/o = septum Discuss the size and location of the heart, including its apex (the tip) and the term precordium (area in front of the heart). You will be able to use the diagram on the next slide to note each of these structures. Medical Terminology and Anatomy for ICD10 Coding

Heart and Great Vessels
Chambers of the heart Medical Terminology and Anatomy for ICD10 Coding

Heart and Great Vessels Pulmonary arteries and veins Aorta
Pulmonary trunk Aorta Superior and inferior venae cavae In PCS, the inferior vena cava is classified as a “lower vein”! Word Parts pulmon/o = lung aort/o = aorta Note the various great vessels. Show how the pulmonary trunk divides to split to the right and left pulmonary arteries. Note that a “trunk” is a main vessel with vessels that split off of it. Medical Terminology and Anatomy for ICD10 Coding

Layers of the Heart Wall Endocardium Myocardium Pericardium
Visceral pericardium (epicardium) Parietal pericardium Terms related to heart wall disorders Transmural Word Parts endocardi/o = endocardium myocardi/o = myocardium pericardi/o = pericardium viscer/o = viscera, organs pariet/o = wall trans- = through mur/o = wall Show how the combining forms are compound: endo + cardi/o = endocardi/o, my/o + cardi/o = myocardi/o, peri- + cardi/o = pericardi/o. Note the two sides of the pericardium and the two names for the visceral pericardium. Explain how visceral and parietal layers can be remembered using the word parts. Note that the word “mural” pertains to a painting on a wall. A transmural infarct is tissue death through the entire thickness of the heart wall. Medical Terminology and Anatomy for ICD10 Coding

Heart Surface Left heart Right heart Walls Word Parts
Left coronary sulcus Obtuse margin Right heart Right coronary sulcus Walls Anterior Inferior Lateral Word Parts anter/o = anterior (front) infer/o = inferior (below) later/o = lateral (side) Explain that the term “sulcus” is a general term that is applied here to a groove in the heart for a coronary artery. Use directional terminology to explain the anterior, inferior, and lateral walls. Note the combination of the terms anterolateral, for example, would mean the front side of the heart. Medical Terminology and Anatomy for ICD10 Coding

Structures of the Atria Atria
Left atrium Left auricular appendage Sinus venosus Coronary sinus Right atrium Right auricular appendage Word Parts atri/o = atrium auricul/o = ear This slide gives more detail for the arteries. Note the left and right auricular appendages, which are small “earlike” pouches on top of each atria. The right auricular appendage is an area that can give rise to tachycardia, while the left auricular appendage is a structure responsible for a large number of blood clots during atrial fibrillation. The sinus venosus is an embryonic structure that holds blood as it returns to the heart. Later it becomes part of the right atrium, while on the left it becomes the coronary sinus and oblique vein of the left side of the heart. Medical Terminology and Anatomy for ICD10 Coding

Structures of the Ventricles Ventricles
Chordae tendineae Trabeculae carnae Papillary muscle Conus arteriorus Word Parts ventricul/o = ventricle chord/o = cord con/o = cone The lower vessels, the ventricles, are composed of fleshy beam-shaped structures termed the trabeculae carnae. The chordae tendinae (literally heart strings) are cordlike tendons attached to the valves by the papillary muscles. The conus arteriosus is the conical projection of the right ventricle into the pulmonary trunk. In some references it is referred to as the infundibulum, which means “funnel-shaped.” Medical Terminology and Anatomy for ICD10 Coding

Word Parts and Abbreviations
Blood Flow Through the Heart Valves Annulus Chordae tendinae Papillary muscles Word Parts and Abbreviations pulmon/o = lung tricuspid valve ( TV) pulmonary arteries (PA) pulmonary veins (PV) right atrium (RA) mitral (bicuspid) valve (MV) left atrium (LA) right ventricle (RV) left ventricle (LV) annul/o = ring Explain the structures and their abbreviations as you go. Note the pattern of vessels (inferior and superior venae cavae) chamber (right atrium), valve (tricuspid valve), chamber (right ventricle), valve (pulmonary valve), vessel (pulmonary trunk), LUNGS, vessels (pulmonary veins), chamber (left atrium), valve (mitral valve), chamber (left ventricle), valve (aortic valve). The annulus is the ringlike structure that is the fibrous base of a valve. Medical Terminology and Anatomy for ICD10 Coding

Blood Flow Through the Heart Coronary arteries
Word Parts coron/o = heart Note the names of the coronary arteries with the “hints” from terminology. Medical Terminology and Anatomy for ICD10 Coding

Review Question The upper chambers of the heart are the: A. arterioles
B. atria C. venules D. ventricles B. Atria Medical Terminology and Anatomy for ICD10 Coding

Did You Know? A good way to remember how the blood flows through the heart valves is to memorize the phrase “Try (tri) before you buy (bi).” In the heart, blood flows through the tricuspid valve and then through the bicuspid (mitral) valve.

Blood Flow Through the Heart
Ejection fraction Normal: approximately 65% Heart rate Beats per minute (BPM) Normal: BPM Pulse points The amount of blood expelled from the left ventricle compared with the total volume of blood filling the ventricle is referred to as the stroke volume and is a measure of the ejection fraction of cardiac output. Think of this as a measure of the strength and efficiency of the heart muscle. The normal reading is around 65% for the ejection fraction; any percentage under that may indicate disease. The measure of the heart rate is calculated in beats per minute. Normal range is from 60 to 100 beats per minute. The areas of measurement around the body are the pulse points. Take a look at the diagram to recognize these locations. Use the diagram to locate pulse points. Have students locate their carotid pulse and measure their heart rate for 1 minute. Compare this with the normal range. Pulse points Medical Terminology and Anatomy for ICD10 Coding

Conductive Mechanism System
Blood pressure (BP) Sphygmomanometer Electrical pathway Sinoatrial node (SA) Atrioventricular node (AV) Bundle of His/ atrioventricular bundle Purkinje fibers Bundle of Kent The cardiovascular system is dependent on the coordinated contractions and relaxations of the heart muscle. When this force, the blood pressure, is measured by an instrument termed a sphygmomanometer (a blood pressure cuff), the reading is measured as systole (the contractive phase) over diastole (the relaxation phase). Normal blood pressure is a range from /80-84. The timing of the contractions and relaxations is accomplished through the electrical pathways in the heart. The heartbeat begins at the sinoatrial node, the natural pacemaker of the heart. This initial signal causes the atria to contract. The signal is then sent to the atrioventricular node, located at the base of the right atrium proximal to the interatrial (inter- = between) septum. From the atrioventricular node, the signal travels to the bundle of His (also called the atrioventricular bundle) in the interatrial septum. Its right and left bundle branches transmit the impulse of the Purkinje fibers in the right and left ventricles. Once the Purkinje fibers receive stimulation, they cause the ventricles to contract and force the blood out to the pulmonary arteries and the aorta. Normal electrical activity is referred to as normal sinus rhythm (NSR). An abnormality of the signals may result in an arrhythmia (an abnormal heartbeat). Electrical conduction pathways of the heart Medical Terminology and Anatomy for ICD10 Coding

EKG Recording of the Cardiac Cycle
Explain the connection between the EKG and the conductive mechanism of the heart. Note that ST elevation myocardial infarctions (STEMIs) are coded differently than non-ST elevation myocardial infarctions (NSTEMIs). Conductive mechanism of the heart through the use of an electrocardiogram ST segment Medical Terminology and Anatomy for ICD10 Coding

Arteries: Upper and Lower
This slide shows the difference between how I10 divides the arteries into upper (those above the diaphragm) and lower (those below the diaphragm). Medical Terminology and Anatomy for ICD10 Coding

Arteries: Naming and Division
Upper/lower divisions based on relation to the diaphragm Many named by the anatomical structure that they supply Subdivisions may include information about the direction or position (ascending/descending, anterior/posterior, superior/inferior) Note those terms from Chapter 2 that become very important in this chapter. Medical Terminology and Anatomy for ICD10 Coding

PCS Guideline Alert! Medial and Surgical Section (Section 0)
B2.2 Body systems designated as upper or lower contain body parts located above or below the diaphragm, respectively. B4.12 Nerves and Vessels Nerves and vessels that are not identified by a separate body part value are coded to the closest proximal branch identified by a body part value. The concept of branches becomes important for the circulatory as well as the nervous system chapters. First, second and third order braches are described best by thinking of a tree and its branches. A first order branch is the one that first leaves the heart (the innominate or brachiocephalic artery). A second order branch is one that leaves the first order one (the right subclavian artery). And, as you might suspect, the third order branch would be one that divides off of the right subclavian (the axillary artery). This continues until the arteries reach their farthest point, and the blood begins its return through the venous vessels. Medical Terminology and Anatomy for ICD10 Coding

Upper Arteries First, we will take a look at the upper arteries. We will not be able to show every single artery, but we will cover the ones that I10 lists in the categories that they are coded to. Medical Terminology and Anatomy for ICD10 Coding

Upper Arteries Head and neck Word Parts Right common carotid
Internal and external carotid Cerebral (from external) Temporal Lingual, facial, occipital Right subclavian Right vertebral Basilar Circle of Willis Word Parts cerebr/o = cerebrum tempor/o = temple lingu/o = tongue faci/o = face occipit/o = occiput Note that the facila artery is also called the external maxillary artery. Use the word parts to help explain the structures/areas supplied. Medical Terminology and Anatomy for ICD10 Coding

Upper Arteries Thoracic aorta Word Parts
Right and left internal mammary arteries (also called internal thoracic arteries) Right and left subclavian arteries Superior and inferior thyroid artery Intercostal Bronchial Pericardial Esophageal Mediastinal Superior phrenic Word Parts clav/i = clavicle cost/o = rib bronchi/o = bronchi pericardi/o = pericardium esophag/o = esophagus mediastin/o = mediastinum phren/o = diaphragm The chest area is supplied with blood from the thoracic aorta, which divides to the right and left internal mammary arteries, then the right and left subclavian arteries. Use the word parts to identify the areas supplied. Note the last structure – the upper part of the diaphragm (superior phrenic) because of its use as a dividing line between upper and lower arteries. The inferior phrenic is a lower artery. Medical Terminology and Anatomy for ICD10 Coding

Upper Arteries Arteries to the arms Word Parts Brachial arteries
Ulnar arteries Radial arteries Hand arteries Word Parts brachi/o = arm uln/o = ulna radi/o = radius Again, word parts help! Note that the brachial arteries branch from the axillary arteries. Medical Terminology and Anatomy for ICD10 Coding

Lower Arteries Medical Terminology and Anatomy for ICD10 Coding

Abdomen, pelvis, and legs
Lower Arteries Abdomen, pelvis, and legs Begin at abdominal aorta Celiac artery Gastric Hepatic Splenic Superior mesenteric Colic arteries Renal Inferior mesenteric Suprarenal Common iliac Right and left internal and external iliac arteries Word Parts celi/o = abdomen gastr/o = stomach hepat/o = liver splen/o = spleen mesenter/o = midgut col/o = colon, large intestine ren/o = kidney supra- = above These terms have word parts that refer to the abdomen and pelvis, except for the common iliac, which divides into the right and left legs. Medical Terminology and Anatomy for ICD10 Coding

Lower Arteries Right and left femoral Word Parts
Branches from the external iliac Popliteal Anterior and posterior tibial Peroneal Dorsalis pedis Arcuate Word Parts femor/o = thighbone perone/o = tibia ped/o = foot Continued from the last slide. The right and left femoral arteries branch from the external iliacs. This then branches to the popliteal arteries, next anterior and posterior tibial, then peroneal. The dorsalis pedis branches from the popliteal, then branches into the arteries of the foot. Medical Terminology and Anatomy for ICD10 Coding

Veins: Upper and Lower A quick note: deep veins are those that are far from the surface, while superficial veins are close to the surface. Note again, that the dividing line for upper and lower is the diaphragm. Medical Terminology and Anatomy for ICD10 Coding

Upper Veins Facial veins Intracranial Vertebral External jugular
Internal jugular Subclavian Brachiocephalic Superior vena cava The upper veins begin their drainage from the face and skull, then through the neck (vertebral and internal and external jugulars). The vertebral and external jugulars drain into the subclavian veins, while the internal jugular joins the subclavian to form the brachiocephalic vein. From there, the veins drain into the superior vena cava. I10 refers to the brachiocephalic vein as the innominate vein. Medical Terminology and Anatomy for ICD10 Coding

Upper Veins Chest drainage Word Parts Azygos Hemiazygos
Accessory hemiazygos Intercostal Bronchial Pericardial Word Parts azyg/o = without a yoke inter- = between cost/o = rib bronchi/o = bronchus pericardi/o = pericardium The azygos vein drains blood from the organs and tissues of the thoracic cavity on the right. The hemiazygos and accessory hemiazygos drain blood from the organs and tissue of the thoracic cavity on the left. The intercostal veins drain blood from the area of the ribs; the bronchials from the bronchi, and the pericardial veins from the sac surrounding the heart. All drain back into the superior vena cava or through the brachiocephalic vein to the superor vena cava. Medical Terminology and Anatomy for ICD10 Coding

Veins of the arms and hands
Upper Veins Veins of the arms and hands Hands and fingers Palmar/volar digital and metacarpal veins Lower arms Deep drainage Radial and ulnar Anastomose at brachial vein Superficial drainage Median antebrachial vein Median cubital vein Connect to basilic and cephalic veins Upper arms Brachial and cephalic Drain into axillary vein Word Parts ante- = before brachi/o = arm cubit/o = elbow cephal/o = head Note the synonyms for the median cubital vein -- median basilic and antecubital. Medical Terminology and Anatomy for ICD10 Coding

Lower Veins Lower veins are those below the diaphragm.
The veins are covered as they are categorized in PCS. Medical Terminology and Anatomy for ICD10 Coding

Lower Veins Legs Word Parts Digital and metatarsal
Greater and lesser saphenous Peroneal Posterior tibial Popliteal vein Femoral External iliac Word Parts metatars/o = metatarsal poplite/o = behind the knee perone/o = fibula femor/o = thigh If you know your word parts, you will recognize that these veins are all in the leg. Medical Terminology and Anatomy for ICD10 Coding

Abdominopelvic cavity
Lower Veins Abdominopelvic cavity Hepatic portal system Hepatic Gastric Splenic Pancreatic Inferior and superior mesenteric Esophageal Adrenal and renal Inferior phrenic Internal iliac Word Parts hepat/o = liver gastr/o = stomach splen/o = spleen pancreat/o = pancreas mesenter/o = midgut esophag/o = esophagus adren/o = adrenal gland ren/o = kidney phren/o = diaphragm All of these drain back to the inferior vena cava. Medical Terminology and Anatomy for ICD10 Coding

Upper Veins: Be Careful!
The cephalic veins are in the arms, not in the head! Don’t confuse the basilic vein in the arms with the basilar artery in the head. Medical Terminology and Anatomy for ICD10 Coding

ICD-10-PCS Medical Surgical Divisions for the Circulatory System
Heart and great vessels Upper arteries Lower arteries Upper veins Lower veins When coding using PCS, coders need to recognize the anatomical terms we have just completed and be able to categorize them into the following: heart and great vessels, upper or lower arteries and upper or lower veins. Medical Terminology and Anatomy for ICD10 Coding

Note In ICD-10-PCS: The superior vena cava is classified as a great vessel of the heart, even though it is usually described as one of the two largest veins of the body. The inferior vena cava is classified as a lower vein. Medical Terminology and Anatomy for ICD10 Coding

Fetal Circulation Before birth After birth
Compare the two diagrams, before and after birth. Note the closure of the foramen ovale (foramen means “opening”) and the ductus venosus as part of a normal transition to the neonate’s own lungs. Before birth After birth Medical Terminology and Anatomy for ICD10 Coding

Lymphatic System Note that the lymph nodes (also termed lymph glands) are the small “knots” along the lymphatic vessels (nod/o literally translates to mean knot). Mention the role of the bone marrow, the thymus gland, and the spleen in lymphatic function. Medical Terminology and Anatomy for ICD10 Coding

Lymphatic System Discuss how the circulatory and lymphatic systems are interrelated. Trace the journey of the lymph from the cells of the body back to the heart. Medical Terminology and Anatomy for ICD10 Coding

Lymphatic System Lymph nodes in the head Word Parts Buccinators
Infraauricular Infraparotid Preauricular Submandibular Submaxillary Submental Subparotid Suprahyoid Word Parts bucc/o = cheek infra- = under, beneath pre- = in front of, before sub- = under auricul/o = ear par- = near ot/o = ear mandibul/o = mandible maxill/o = maxilla ment/o = chin Use the combining forms along with their associated prefixes to locate the lymph nodes of the head. Medical Terminology and Anatomy for ICD10 Coding

Lymphatic System Lymph nodes in the neck Word Parts Cervical Jugular
Postauricular Occipital Retropharyngeal Supraclavicular Right jugular trunk Right lymphatic duct Right subclavian trunk Word Parts cervic/o = neck post- = after, behind auricul/o = ear occipt/o = occiput retro- = behind pharyng/o = pharynx supra- = above clavicul/o = clavicle clav/o = clavicle Discuss the locations of the cervical lymph nodes including the differences between the right and left sides. Explain the meaning of a “trunk.” Medical Terminology and Anatomy for ICD10 Coding

A, normal B, bradycardia C, tachycardia
Circulatory Signs and Symptoms (R00-R99) Bradycardia Tachycardia Word Parts brady- = slow -cardia = heart condition Bradycardia (brady- = slow + -cardia = heart condition) is a slow heartbeat, with ventricular contractions less than 60 beats per minute. Tachycardia (tachy- = rapid + -cardia = heart condition) is a rapid heartbeat of more than 100 beats per minute. ECGs A, normal B, bradycardia C, tachycardia Medical Terminology and Anatomy for ICD10 Coding

Circulatory Signs and Symptoms (R00-R99)
Cardiac murmur Cardiac bruit Palpitations Be Careful! Do not confuse palpation, which means examination by touch, palpebration, which means blinking, and palpitation, which means a pounding or racing of the heart. Discuss the differences between bruits and murmurs, as both being an abnormal sound, but the bruit being higher pitched. Define palpitations (pounding or racing of the heart) and caution against confusing palpitation with the term palpation (examine by touching). Medical Terminology and Anatomy for ICD10 Coding

Circulatory Signs and Symptoms (R00-R99) Nausea Emesis Pallor Dyspnea
Dyspnea on exertion (DOE) Orthopnea Shortness of breath (SOB) Pulmonary congestion Syncope Word Parts emesis = to vomit dys- = difficult -pnea = breathing orth/o = straight pulmon/o = lung -ary = pertaining to Discuss the relationship of nausea and emesis. Explain that emesis can also be used as a suffix. Define pallor. Differentiate between the three breathing difficulties, including the use of dys- and orth/o to define two of the terms. Orthopnea (orth/o = straight, upright + -pnea = breathing) is a condition in which a person must sit or stand to breathe comfortably. Define pulmonary congestion (excessive amount of blood in the pulmonary vessels) and mention its relationship to heart failure. Note the unexpected pronunciation (SIN koh pee) and the definition (fainting) of syncope. Medical Terminology and Anatomy for ICD10 Coding

Circulatory Signs and Symptoms (R00-R99) Cyanosis Diaphoresis
Cardialgia Atypical Ischemic Precordial Word Parts cyan/o = blue -osis = abnormal condition cardi/o = heart -algia = pain Cyanosis (cyan/o = blue + -osis = abnormal condition) is a lack of oxygen in the blood, seen as a bluish or grayish discoloration of the skin, nail beds, and/or lips. Diaphoresis is the profuse secretion of sweat. Heart pain may be described as atypical or ischemic. Heart pain (cardialgia) may be described as atypical or ischemic. Atypical (a -= not) is a stabbing or burning pain that is variable in location and intensity and unrelated to exertion. Ischemic pain is a pressing, squeezing, or weight-like cardiac pain caused by decreased blood supply that usually lasts only minutes. Precordial (pre- = before, in front of + cordi/o = heart + -al = pertaining to) pain is pain in the area over the heart. Cardialgia and cardiodynia are synonyms. Medical Terminology and Anatomy for ICD10 Coding

Review Question The term that means profuse sweating is: A. cyanosis
B. diaphoresis C. emesis D. syncope B. Diaphoresis Medical Terminology and Anatomy for ICD10 Coding

Congenital Disorders of the Heart (Q20-Q28)
Coarctation of the aorta Patent ductus arteriosus (PDA) Coarctation of the aorta is a congenital cardiac anomaly characterized by a localized narrowing of the aorta. Coarctation is another term for a narrowing. Patent ductus arteriosus (PDA) is an abnormal opening between the pulmonary artery and the aorta caused by failure of the fetal ductus arteriosus to close after birth, most often in premature infants. Patent means open. Occluded means closed (or blocked). Coarctation of the aorta Medical Terminology and Anatomy for ICD10 Coding

Congenital Disorders of the Heart (Q20-Q28) Septal defect
Atrial septal defect (ASD) Ventricular septal defect (VSD) Tetralogy of Fallot Dextrocardia/levocardia Word Parts sept/o = septum, wall -al = pertaining to tetra- = four -logy = study of dextr/o = right -cardia = heart condition levo- = left A septal defect (sept/o = septum, wall + -al = pertaining to) is any congenital abnormality of the walls between the heart chambers. An atrial septal defect (ASD) is a hole in the wall between the upper chambers of the heart. A ventricular septal defect (VSD) is a hole in the wall between the lower two chambers of the heart. Tetralogy of Fallot (tetra- = four + -logy = study of) is a congenital cardiac anomaly that consists of four defects: pulmonic stenosis; ventricular septal defect; malposition of the aorta, so that it arises from the septal defect or the right ventricle; and right ventricular hypertrophy. Compare the position of the heart in dextrocardia (on the right instead of the left) compared to levocardia (the heart is in its normal position, but the remaining organs are in the opposite position of normal). Medical Terminology and Anatomy for ICD10 Coding

Rheumatic Fever and Hypertensive Diseases (I00-I15)
Rheumatic heart disease Hypertension Essential (primary) Secondary Controlled Uncontrolled Guideline Alert! Coders need to examine the record for the causes of the hypertension. Word Parts rheumat/o = watery flow hyper- = excessive, above -tension = pressure Explain the damage to the heart in rheumatic heart disease usually affects the valves. Define hypertension and explain the differences between essential (also termed primary) and secondary (due to another disorder); controlled and uncontrolled. Medical Terminology and Anatomy for ICD10 Coding

Ischemic Heart Diseases (I20-I25) Angina pectoris
Unstable angina Accelerating/crescendo angina and intermediate coronary syndrome Word Parts pector/o = chest -is = structure Note pector/o = chest. Discuss the role of ischemia in this disorder. Explain unstable angina and its relationship to accelerating/crescendo angina. Medical Terminology and Anatomy for ICD10 Coding

Ischemic Heart Diseases (I20-I25) Acute myocardial infarction
Be Careful! Infarction refers to tissue death. An infraction refers to a breaking, as in an incomplete bone fracture. Word Parts myocardi/o = heart muscle -al = pertaining to Explain the process of an AMI and refer back to the EKG with ST elevation MIs (STEMI) and non-ST elevation MIs (NSTEMI). Medical Terminology and Anatomy for ICD10 Coding

Did You Know? Research results show that men and women often experience different heart attack symptoms. Although men are more likely to experience crushing pressure or pain, nausea, and shortness of breath, women may not. Many women report extreme fatigue, weakness, dizziness, and a cold sweat, along with shortness of breath. Unfortunately, because most women are unaware that these symptoms may signal a life-threatening condition, they often delay seeking medical assistance.

Ischemic Heart Diseases (I20-I25)
Aneurysm (of heart) Coronary atherosclerosis Atherosclerotic coronary artery disease (CAD) An aneurysm is a localized dilation of an artery caused by a congenital or acquired weakness in the wall of the vessel. The acquired causes may be arteriosclerosis, trauma, infection, and/or inflammation. Use the analogy of a balloon whose walls become weaker as it fills with air. Discuss the diagrams and how atherosclerosis blocks blood flow. Atherosclerosis (ather/o = fat, plaque + -sclerosis = abnormal condition of hardening) is a form of arteriosclerosis in which medium and large arteries have atheromas, which can reduce or obstruct blood flow. Patients with peripheral atherosclerosis complain of intermittent claudication. Coronary atherosclerosis Medical Terminology and Anatomy for ICD10 Coding

Pulmonary Heart/Circulation and Other Heart Diseases (I26-I52)
Pulmonary hypertension Acute cor pulmonale Pulmonary embolism (PE) infarction Cardiac tamponade Heart failure Word Parts pulmon/o = lung -ary = pertaining to hyper- = excessive -tension = pressure cor = heart cardi/o = heart -ac = pertaining to Discuss the differences between the three pulmonary disorders. Pulmonary hypertension is excessive pulmonary arterial blood pressure. Acute cor pulmonale is sudden right ventricular failure due to chronic pulmonary hypertension. A pulmonary embolism infarction is the blockage of one of the pulmonary vessels accompanied by death of lung tissue. Discuss how the excessive accumulation of fluid in the pericardium results in the pathology of cardiac tamponade. Discuss heart failure and its previous terminology. Medical Terminology and Anatomy for ICD10 Coding

Mitral stenosis (MS) Tricuspid stenosis (TS) Word Parts stenosis = narrowing Mitral stenosis is a narrowing of the valve between the left atrium and left ventricle caused by adhesions on the leaflets of the valve, usually the result of recurrent episodes of rheumatic endocarditis. Left atrial hypertrophy develops and may be followed by right-sided heart failure and pulmonary edema (cor pulmonale). The term mitral is derived from the appearance of the valve and its similarity to a bishop’s miter, or hat. Tricuspid stenosis is a relatively uncommon narrowing of the tricuspid valve associated with lesions of other valves caused by rheumatic fever. Symptoms include jugular vein distension and pulmonary congestion. Valvular heart disease Medical Terminology and Anatomy for ICD10 Coding

Mitral valve prolapse (MVP) Mitral regurgitation Word Parts pro- = forward -lapse = fall Mitral regurgitation is a backflow of blood from the left ventricle into the left atrium in systole across a diseased valve. It may be the result of congenital valve abnormalities, rheumatic fever, or mitral valve prolapse. Mitral valve prolapse (pro- = forward + -lapse = fall) is the protrusion of one or both cusps of the mitral valve back into the left atrium during ventricular systole. Discuss why mitral valve regurgitation and mitral valve prolapse cause fatigue. MVP Medical Terminology and Anatomy for ICD10 Coding

Cardiomegaly Cardiomyopathy Word Parts cardi/o = heart -megaly = enlargement cardiomy/o = heart muscle -pathy = disease Cardiomegaly (cardi/o = heart + -megaly = enlargement) is an enlargement of the heart. Cardiomyopathy is disease of the heart muscle; also termed myocardiopathy. Cardiomegaly Medical Terminology and Anatomy for ICD10 Coding

Acute bacterial endocarditis
Pulmonary Heart/Circulation and Other Heart Diseases (I26-I52) Endocarditis Pericarditis Word Parts endocardi/o = endocardium -itis = inflammation pericardi/o = pericardium Endocarditis is inflammation of the inner lining of the heart, while pericarditis is inflammation of the sac surrounding the heart. Acute bacterial endocarditis Medical Terminology and Anatomy for ICD10 Coding

Cardiac Dysrhythmias (Arrhythmias) (I44-I49) Dysrhythmia/ arrhythmia
Flutter Fibrillation Atrial Ventricular Ectopic beats Atrial vs. ventricular Word Parts dys- = abnormal rhythm/o = rhythm -ia = condition a- = no, not, without atri/o = atrium -al = pertaining to ventricul/o = ventricle -ar = pertaining to Dysrhythmia (dys- = abnormal + rhythm/o = rhythm + -ia = condition) is an abnormal heartbeat. An arrhythmia (a- = without) is a synonym. Flutter is extremely rapid but regular heartbeats ( /min). Atrial flutter is an extremely rapid, but regular atrial rhythm. Fibrillation is an extremely rapid and irregular contraction ( /min) that occurs with or without an underlying cardiovascular disorder, such as coronary artery disease. Atrial fibrillation is the most common type of cardiac arrhythmia. It is associated with excessive alcohol consumption. Ventricular fibrillation is rapid, irregular contractions that may be fatal unless reversed. Ectopic beats (ec- = out of + top/o = place + -ic = pertaining to) are heartbeats that occur outside of a normal rhythm. Atrial ectopic beats are irregular contractions of the atria. These are also termed premature atrial contractions (PAC). Ventricular ectopic beats are irregular contractions of the ventricles. These are also called premature ventricular contractions (PVC). These are not always considered pathologic. Medical Terminology and Anatomy for ICD10 Coding

Cardiac Dysrhythmias (Arrhythmias) (I44-I49) Heart block
Atrioventricular block Bundle branch block (BBB) Sick sinus syndrome (SSS) Ventricular tachycardia Word Parts venticul/o = ventricle -ar = pertaining to tachy- = rapid -cardia = heart condition Heart block is the result of a lack of electrical communication between the atria and the ventricles. It is also called atrioventricular block. Bundle branch block is an incomplete electrical conduction in the bundle branches, either on the left or right. Sick sinus syndrome is any abnormality of the sinus node; it may necessitate the placement of an implantable pacemaker. Ventricular tachycardia (tachy- = rapid + -cardia = heart condition) is a condition of ventricular contractions that are greater than 100 beats per minute. Medical Terminology and Anatomy for ICD10 Coding

Cerebrovascular Diseases (I60-I69)
Cerebral infarction Intracerebral hemorrhage Subarachnoid hemorrhage (SAH) Monoplegia Discuss the use of the term infarction in myocardial infarction and here in cerebral infarction. Explain the differences between the causes of a cerebral infarction: thrombus, embolus, and hemorrhage. Explain how each of the first three is a type of cerebrovascular accident (CVA) or stroke. Discuss the location of a SAH. Explain that monoplegia is a paralysis of one limb on one side of the body. Cerebral infarction, also called cerebrovascular accident (CVA). A, Events causing stroke. B, MRI showing hemorrhagic stroke in right cerebrum. C, Areas of the body affected by CVA. Medical Terminology and Anatomy for ICD10 Coding

Aphasia Apraxia Ataxia Dysarthria Word Parts a- = no, not, without
phas/o = speech -ia = condition prax/o = purposeful movement tax/o = order, coordination Aphasia is a lack or impairment of the ability to form or understand speech. Dysarthria is a difficulty in the pronunciation (articulation) of speech. Apraxia is an inability to perform purposeful movement. Ataxia is a condition of a lack of coordination. Medical Terminology and Anatomy for ICD10 Coding

Diseases of Arteries, Arterioles, and Capillaries (I70-I79)
Aortic aneurysm Arteriosclerosis Intermittent claudication Peripheral arterial occlusion Peripheral vascular disease (PVD) Raynaud’s syndrome Raynaud’s phenomenon Vasculitis Angiitis Word Parts arteri/o = artery -sclerosis = abnormal condition of hardening occlus/o = blockage -ion = process of vascul/o = vessel syn- = together -drome = run -itis = inflammation angi/o = vessel Explain the differences between the terms. Explain that intermittent means that it occurs at irregular intervals. Arteriosclerosis (arteri/o = artery + -sclerosis = abnormal condition of hardening) is a disease in which the arterial walls become thickened and lose their elasticity, without the presence of atheromas (ather/o = fat, plaque + -oma = mass). Arteriosclerosis is the leading cause of morbidity and mortality in the United States today. Raynaud’s syndrome is an idiopathic condition of the peripheral vascular system with a bilateral presentation. Raynaud’s phenomenon is secondary to rheumatoid arthritis, scleroderma, or trauma. Its presentation is unilateral. Medical Terminology and Anatomy for ICD10 Coding

Diseases of Veins (I80-I89)
Esophageal varices Hemorrhoids Thrombophlebitis Varicose veins Explain the similarities between esophageal varices and hemorrhoids. Esophageal varices (varic/o = dilated vein) are varicose veins that appear at the lower end of the esophagus as a result of portal hypertension; they are superficial and may cause ulceration and bleeding. Point out that an aneurysm is a dilation of an artery and a varicosity is a dilation of a vein. Hemorrhoids are varicose conditions of the external or internal rectal veins that cause painful swelling at the anus. Discuss the similarities between esophageal varices and hemorrhoids. Explain the difference between DVT and SVT. Explain what an incompetent valve in a varicose vein is. A, Deep vein thrombophlebitis (DVT). B, Large embolus derived from a lower extremity DVT and now located in a pulmonary artery branch. Medical Terminology and Anatomy for ICD10 Coding

Other and Unspecified Disorders of the Circulatory System (I95-I99)
Gangrene Hypotension Orthostatic idiopathic Word Parts hypo- = below, deficient tens/o = stretching -ion = process of Gangrene is death of tissue due to lack of blood supply. Define hypotension and explain the differences between orthostatic hypotension and idiopathic hypotension. Medical Terminology and Anatomy for ICD10 Coding

Word Parts Disease of Lymphatic Vessels and Lymph Nodes (I88-I89)
Lymphadenitis Lymphangiectasia Lymphangitis Lymphedema Splenomegaly Word Parts lymphaden/o = lymph gland -itis = inflammation lymphangi/o = lymph vessel -ectasia = expansion, dilation -edema = swelling splen/o = spleen -megaly = enlargement Use the word parts to help define the terms given. Splenomegaly Lymphedema Medical Terminology and Anatomy for ICD10 Coding

Benign Neoplasms of the Circulatory System
Atrial myxoma Hemangioma Thymoma An atrial myxoma (myx/o = mucus + -oma = tumor, mass) is a benign growth usually occurring on the interatrial septum. A hemangioma (hemangi/o = blood vessel + -oma = tumor, mass) is a noncancerous tumor of the blood vessels. It may be congenital (“stork bite”) or may develop later in life. A thymoma is a benign tumor of epithelial origin. It is often associated with myasthenia gravis. Hemangioma Atrial myxoma Medical Terminology and Anatomy for ICD10 Coding

Terms Related to Malignant Neoplasms
Cardiac myxosarcoma Hemangiosarcoma Cardiac myxosarcoma Cardiac myxosarcoma (myx/o = mucus + -sarcoma = connective tissue cancer) is a rare cancer of the heart usually originating in the left atrium. A hemangiosarcoma (hemangi/o = blood vessel + -sarcoma = connective tissue cancer) is a rare cancer of the cells that line the blood vessels. Medical Terminology and Anatomy for ICD10 Coding

Terms Related to Malignant Neoplasms Hodgkin lymphoma
Reed-Sternberg cells Non-Hodgkin lymphoma Malignant thymoma (thymic carcinoma) Word Parts thym/o = thymus gland -oma = tumor Explain the differences between Hodgkin and non-Hodgkin lymphoma, noting the appearance of Reed-Sternberg cells in Hodgkin lymphoma. Note that non-Hodgkin lymphoma is a group of disorders that comprise the 6th most common cancer in the US. Medical Terminology and Anatomy for ICD10 Coding

Review Question Extremely rapid and irregular heartbeats:
A. ectopic beats B. fibrillation C. flutter D. angina pectoris B. Fibrillation Medical Terminology and Anatomy for ICD10 Coding

Review Question Inflammation of a vein with formation of a clot is:
A. varicose veins B. thrombophlebitis C. claudication D. Raynaud’s disease B. Thrombophlebitis Medical Terminology and Anatomy for ICD10 Coding

Did You Know? Since 1900, cardiovascular disease has been the number one killer in the United States every year except for Cardiovascular disease claims almost 10,500 more lives each year than the next six leading causes of death combined. 1918 was the year of the influenza pandemic.

Circulatory System Procedures
Procedures related to the cardiovascular system Procedures related to the lymphatic system Medical Terminology and Anatomy for ICD10 Coding

PCS Guideline Alert! The coronary arteries are classified as a single body part that is further specified by number of sites treated, not by name or number of arteries. Separate body part values are used to specify the number of sites treated when the same procedure is performed on multiple sites in the coronary arteries. Medical Terminology and Anatomy for ICD10 Coding

Terms Related to Laboratory Tests
Cardiac enzymes test C-reactive protein (CRP) test Homocysteine levels Lipid profile A cardiac enzymes test measures the amount of cardiac enzymes during a myocardial infarction. CRP is a blood test to determine the degree of inflammation in the body. Used to predict the risk of heart disease. Homocysteine levels are used to predict the risk of stroke and CAD. Lipid profiles measure the lipids (cholesterol and triglycerides) in the blood. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Great Vessels and Aorta
Angiocardiography Digital subtraction angiography (DSA) Angiocardiography (angi/o = vessel + cardi/o = heart + -graphy = process of recording) is the injection of a radiopaque substance during cardiac catheterization for the purpose of imaging the heart and related structures. Digital subtraction angiography (sub- = under + tract/o = pulling + -ion = process of) is the digital imaging process wherein contrast images are used to “subtract” the noncontrast image of surrounding structures, leaving only a clear image of the blood vessels. DSA Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Great Vessels and Aorta Angiotripsy
Angioplasty: Percutaneous transluminal coronary angioplasty (PTCA) Stent Word Parts angi/o = vessel -tripsy = crushing -plasty = surgically repair Angiotripsy is a crushing of a vessel done to control bleeding. Percutaneous transluminal coronary angioplasty is a surgical procedure in which a catheter is threaded into the coronary artery that is affected by atherosclerotic heart disease. The balloon at the tip of the catheter is inflated and deflated to compress the plaque against the wall of the artery and increase blood flow. Stents (wire mesh tubes) are placed in the arteries and used to prop them open after the angioplasty. Recent studies show cases of in-stent restenosis, a narrowing of the lumen of a stent. PTCA Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Great Vessels and Aorta Aortoplasty
Transmyocardial revascularization Word Parts aort/o = aorta -plasty = surgically forming trans- = through myocardi/o = myocardium -al = pertaining to re- = again vascul/o = vessel -ization = process Aortoplasty is a correction of the aorta, such as repairing an aortic aneurysm. Transmyocardial revascularization is a procedure used to relieve severe angina in a patient who cannot tolerate a CABG or PTCA. With a laser, a series of holes is made in the heart tissue in the hope of increasing blood flow by stimulating new blood vessels to grow, which is called angiogenesis (angi/o = vessel + -genesis = production). Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Heart
Cardiac catheterization Cardiac catheterization is the threading of a catheter (thin tube) into the heart to collect diagnostic information about structures in the heart, coronary arteries, and great vessels; it is also used to aid in the treatment of CAD, congenital abnormalities, and heart failure. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Heart Cardioplegia Cardioversion
Word Parts cardi/o = heart -plegia = paralysis -version = turning Cardiplegia is an immobilization of the heart in order to perform cardiac surgery. Also called asystole of the heart. Cardioversion is a changing of an abnormal heart rhythm to a normal one. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Heart
Coronary artery bypass graft (CABG) Coronary artery bypass graft (CABG) surgery is an open-heart procedure in which a piece of a blood vessel from another location is grafted onto one of the coronary arteries to reroute blood around a blockage. Use the figure to explain a CABG. Explain the reason for terms such as triple or quadruple bypass. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Heart Pericardiocentesis Pericardiolysis Septoplasty
Valvuloplasty Word Parts pericardi/o = sac surrounding the heart -centesis = surgical puncture -lysis = releasing, destroying, breaking down sept/o = wall, partition -plasty = surgically forming valvul/o = valve aort/o = aorta Pericardiocentesis (pericardi/o = pericardium + -centesis = surgical puncture) is an aspiration of fluid from the pericardium to treat cardiac tamponade. Periocardiolysis is a release of adhesions of the pericardium. A septoplasty is forming a closure of an abnormal opening in an interatrial or interventricular wall of the heart. A valvuloplasty is a repair of a damaged heart valve. Medical Terminology and Anatomy for ICD10 Coding

Cardiac Procedures Left ventricular assist device (LVAD)
Minimally invasive direct coronary artery bypass (MIDCAB) A left ventricular assist device is a mechanical pump device that assists a patient’s weakened heart by pulling blood from the left ventricle into the pump and then ejecting it out into the aorta. LVADs may be used on those patients awaiting a transplant. A minimally invasive direct coronary artery bypass is a surgical procedure in which the heart is still beating while a minimal incision is made over the blocked coronary artery and an artery from the chest wall is used as the bypass. Discuss the advantages of procedures such as MIDCAB. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Heart and Great Vessels
Electrocardiography (ECG/EKG) Echocardiography Transesophageal echocardiography Word Parts electr/o = electricity cardi/o = heart -graphy = recording echo- = sound trans- = through esophag/o = esophagus Electrocardiography (electr/o = electricity + cardi/o = heart + -graphy = process of recording) is a recording of electrical impulses of the heart as wave deflections of a needle on an instrument called an electrocardiograph (-graph = instrument to record). The record, or recording, is called an electrocardiogram. A Holter monitor is worn by the patient to measure cardiac activity during ADLs. Echocardiography (echo- = reverberation + cardi/o = heart + -graphy = process of recording) is the use of ultrasonic waves directed through the heart to study the structure and motion of the heart. Transesophageal echocardiography (trans- = through) images the heart through a transducer introduced into the esophagus. Echocardiography Medical Terminology and Anatomy for ICD10 Coding

PCS Guideline Alert! B4.4 The coronary arteries are classified as a single body part. They are further specified by number of sites treated, not by name or number of arteries. Separate body part values are provided to indicate the number of sites treated, when the same procedure is performed on multiple sites in the coronary arteries. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Arteries and Veins Arteriorrhaphy Endarterectomy
Phlebectomy Phlebography Phlebotomy Sclerotherapy Venotripsy Word Parts arteri/o = artery -rrhaphy = suturing end- = within -ectomy = cutting out phleb/o = vein -graphy = recording -tomy = cutting ven/o = vein -tripsy = crushing Define the terms using word parts. Note the differences in root procedures/categories depending on their suffixes. Ex: A phlebectomy (phleb/o = vein + -ectomy = removal) is the removal of a vein. Root procedure = excision. Phlebotomy is also called venipuncture. Sclerotherapy is the intravenous injection of a chemical substance to treat varicose veins. A venotripsy is the crushing of a vein to control bleeding. Endarterectomy Medical Terminology and Anatomy for ICD10 Coding

PCS Guideline Alert! B3.5 Bypass procedures are coded according to the direction of flow of the contents of a tubular body part; the body part value identifies the origin of the bypass and the qualifier identifies the destination of the bypass. Note: coronary arteries are coded differently. The body part value identifies the number of coronary artery sites bypassed. The qualifier identifies the origin of the bypass. B3.6c If multiple coronary artery sites are bypassed, a separate procedure is coded for each coronary artery site that uses a different device and/or qualifier. Tuck this away for later! I10 requires a tremendous amount of detail. Medical Terminology and Anatomy for ICD10 Coding

Procedures of the Lymph Glands, Spleen, and Thymus
Lymphadenectomy Lymphangiography Splenectomy Splenopexy Thymectomy Word Parts lymphaden/o = lymph gland/node -ectomy = cutting out lymphangi/o = lymph vessel -graphy = recording splen/o = spleen -pexy = suspension thym/o = thymus gland Define the terms noting the difference between the structures in lymphadenectomy and lymphangiography. Lymphangiography Medical Terminology and Anatomy for ICD10 Coding

Suffixes and Root Operations for the Circulatory System
-centesis drainage -ectomy excision, resection -lysis release -pexy repair, reposition -plasty dilation, repair, replacement, supplement -rrhaphy repair -tomy drainage -tripsy occlusion Note that -centesis and -tomy share a root operation (drainage) and -pexy and -plasty share the repair root operation. Mastering Healthcare Terminology/Chapter 3

Pharmacology Angiotensin-converting enzyme inhibitors
Angiotension II receptor blockers Antiarrhythmic drugs Anticoagulants Antihyperlipidenics Beta-blockers Angiotensin-converting enzyme (ACE) inhibitors: relax blood vessels by preventing the formation of the vasoconstrictor angiotensin II. This inhibition causes a decrease in water retention and blood pressure and an improvement in cardiac output. ACE inhibitors are commonly used to treat hypertension and heart failure. Angiotension II receptor blockers (ARBs): lower blood pressure by inhibiting the vasoconstrictor angiotension II from binding its action sites. Antiarrhythmic drugs: restore normal sinus rhythm via various mechanisms to treat cardiac arrhythmias. Anticoagulants: prevent the formation of blood clots. Examples are warfarin (Coumadin) and heparin. Antihyperlipidemics: lower “bad” and or raise “good” cholesterol levels to reduce the risk of heart attack or stroke. Beta-blockers: depress the heart rate and force of heart contractions by decreasing the effectiveness of the nerve impulses to the cardiovascular system. They typically are prescribed to treat angina pectoris, hypertension, and cardiac arrhythmias. Medical Terminology and Anatomy for ICD10 Coding

Pharmacology Calcium channel blockers Diuretics Nitrates Thrombolytics
Calcium channel blockers (CCBs): decrease myocardial oxygen demand by inhibiting the flow of calcium to smooth muscle cells of the heart, which causes arterial relaxation. CCBs are used to treat angina, hypertension, and heart failure. Diuretics: promote the excretion of sodium and water as urine; they are used in the treatment of hypertension and heart failure. Nitrates (antianginals): relax blood vessels and reduce myocardial oxygen consumption to lessen the pain of angina pectoris; also used to treat hypertension and heart failure. Thrombolytics: aid in the dissolution of blood clots. Medical Terminology and Anatomy for ICD10 Coding

Sort these terms into their correct categories
1. pericardiocentesis 2. angina pectoris 3. hemangioma 4. atria 5. splenopexy Categories __ A + P __ Pathology __ Procedures A+ P – atria Pathology – angina pectoris, hemangioma Procedures – pericardiocentesis, splenopexy

Take Aways It’s easier to remember the names and locations of the arteries/veins and lymph nodes if you have a solid knowledge of combining forms from the organization of the body and the musculoskeletal chapters. Medical terminology often includes multiple combining forms for the same structure: mur/o, sept/o, pariet/o and diaphragm/o all refer to partitions or walls. Study them together! Practice makes perfect – use all of your exercises in the text and on Evolve to help you remember these new terms. Medical Terminology and Anatomy for ICD10 Coding

Chapter Nine CIRCULATORY SYSTEM

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Chapter Nine CIRCULATORY SYSTEM

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