Glossary of Terms
Adhesions- adhesions are bands of tissue that form between the abdominal organs. Normally, the surface of abdominal organs is smooth and glistening. This enables the abdominal organs to slide or glide over each other with ease. Adhesions cause the abdominal organs to stick together. Most often, the adhesions are asymptomatic and cause no trouble to a person. The most common cause of abdominal adhesions is surgery. Factors that promote adhesion formation post surgery include physical handling of the abdominal organs, contact of the organs with foreign objects such as gauze and blood clots that were not be completely cleaned out. Adhesions secondary to surgery may cause disease many years later. Adhesions can also be due to inflammation in the abdominal cavity. Inflammation can be due to appendicitis or peritonitis. Radiation treatment has also been shown to contribute to adhesion formation. Adhesions if symptomatic often present with chronic abdominal pain. In the abdomen, they can result in intestinal obstruction; in the pelvis they cause infertility.
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Artificial sweeteners- sugar substitutes are food additives that duplicate the effect of sugar in food. They can be of natural or synthetic nature. Artificial sweeteners are sugar substitutes that are synthetic. Other types of sugar substitutes are sugar alcohols, novel sweeteners and natural sweeteners. Sugar substitutes have gained popularity in the recent past because they deliver the same sweetness but with less calorie consumption. Sugar substitutes are not without health benefits. Artificial sweeteners are tooth friendly and reduce risk of developing dental caries. In diabetic patients, they contribute to better sugar control. They are not carbohydrates and therefore do not raise the blood sugar level after consumption. Virtually, they deliver no calories to the body and are a healthier alternative to patients who want to lose weight or assist individuals from piling on weight. Several artificial sweeteners have been approved for use by the FDA and include stevia, saccharine and sucralose. However, the consumption of artificial sweetener has to be within the limits of acceptable daily intake (ADI) to ensure that the health of an individual is not compromised.
Baroreceptor – Think of the baroreceptors in your body as the pressure gage system. A baroreceptor is a sensory nerve ending that resides in the major arteries of the human body. These sense changes in blood pressure and thus these nerve endings play an important role in assisting the circulatory system.
Baroreceptors may be found in larger arteries of the body and may be located in the aorta and the carotid artery for example. Thus these receptors send alerts to the brain about blood pressure changes so that the brain may then create a response to the changes. It works like this. As blood pressure rises the vessel walls expand. As the walls expand this triggers more rapid firing off of these receptors. If blood pressure lowers then the receptors lower the firing rate or signaling rate to a less than normal firings. The brain knows what “normal” should be and thus can respond based upon the signals given by the receptors.
Baroreceptors don’t simply note change. They note the amount of change and the timing of that change. By studying the reactions of a body’s receptors a medical professional can evaluate and diagnose some serious problems and thereby understand what kinds of treatment may be needed.
Bile duct- bile or gall is a fluid that is synthesized in the liver. It is a complex fluid that is composed of bile acids, cholesterol, phospholipids and bilirubin. Bilirubin is an end product of hemoglobin degradation. Bile is green in color and is essential in the digestion of fats in the small intestines. Bile is transported through a complex network of tubes known as the billiary tree from the liver to the gall bladder for storage. Many bile ducts make up the billiary tree. These are tubular structures with thin walls that act as transport passages for delivery of bile to the gall bladder through the hepatic duct. Sometimes bile ducts can become obstructed by bile stones. This results in severe right upper abdominal pain and abdominal discomfort which worsens with intake of fatty meals. The billiary ducts can be visualized through specialized medical imaging which employs use or radio isotopes to light up the billiary tree.
Biologic mesh- a mesh is a sheet made of interconnected strands of a given material. In medicine, meshes are a crucial component of hernia repair. They are either synthetic or biologic in nature. Biologic meshes are derived from the human or porcine dermis. Once inserted, a biologic mesh induces the proliferation of fibroblasts and endothelial cells into the mesh substance. This is achieved through action of residual growth hormone in the substance of the mesh. This process results in degradation and rebuilding of the collagen scaffold of the mesh with the end result being complete incorporation of the mesh in the body. Recently, there has been a shift from the use of synthetic to biologic meshes due to better outcome associated with the later. Synthetic meshes have been associated with higher incidence of complications such as infections, skin erosion and formation of fistulas. Biologic meshes have shown promising outcome especially in repair of hernias that have contaminated wounds.
Computer network- a computer network refers to a group of computers that are connected to each other electronically. Information can be shared between the linked computers through data connections. This is achieved through use of cables or wireless technology. Information technology has a key role in expansion and delivery of quality healthcare. In hospitals, two types of networks re found. The first is the local area network (LAN) which connects members of a given office or department. This facilitates formation of a departmental database that enables ease in communication and efficiency in execution of its mandates. The second type is the wide area network (WAN) which connects all the hospital departments to a central computer programme that is concerned with patient management. This ensures easy accessibility to patient records from various departments such as laboratory results, radiology examinations and consultation notes. The benefits of computer networking in a hospital are immense. It allows for easy access to a patients history and medical records for the multidisciplinary team that is involved in the treatment of the patient. One of its major downfalls is the safety of patient’s records in that an unauthorized person can hack past security measures and access a patient’s personal information.
Coping strategies- coping is a deliberate effort made by an individual to solve personal and interpersonal problems. Coping is a reaction to what is affecting an individual in the environment. It is a survival technique in which a person aims to master or tolerate stressors in the environment. The ability to cope varies with individuals. A number of factors contribute to the ability of a person to cope. The type of stressor, the person and the environment are key determinants. Coping can be successful or it can fail. When coping fails, the outcome is maladaptive behavior. There are numerous coping mechanisms. Broadly they can be divided into three. Appraisal focused coping mechanism is when an individual challenges himself or herself by facing ones assumptions. In problem focused approach, coping is aimed at reducing or eliminating the stressor. In the emotion focused approach, an individual aims at changing their own emotional response to various stressors.
Diaphragm – The main muscle in the respiration process is the diaphragm, located between the thoracic cavity and the abdomen. Damage to this muscle can cause severe breathing difficulties. Usually the contracting and then again relaxing of this muscle is involuntary, however, a person can control it at times.
A muscle that separates the pelvic cavity from the perineal cavity is also referred to as a diaphragm. It supports the pelvic and restrains abdominal pressure so that said pressure does not cause pelvic issues. A man made version of this can be surgically installed in order to prevent pregnancy and some sexually transmitted diseases.
To aid in diagnostics a physician can use a disc type object known as a diaphragm with the standard microscope. This objet acts to filter light rays in order to help create a more easily visible image. This disc can also be added to a camera lense for the capturing of a more useful image. One popular such type is the Iris Diaphragm.
Database- database refers to a collection of information or data that is arranged in such a way such that a computer software programme can effectively select required piece(s) of data to fulfill a given requirement. The organization of the data ensures easy retrieval. Database management systems are softwares that act as the go between the user and the database itself to help capture and analyze any data. Databases are a form of electronic filing system and organization of data is achieved through use of tables. In medical field, various kinds of databases exist. Medical research databases offer easy access to information including recent clinical trials, drug information updates and emerging evidence in various medical fields. Symptoms databases will enable a layman to have an idea of what disease(s) they could be ailing from. This however does not validate self treatment and there is still need to see a healthcare provider. Databases are also essential in analysis of medical research data because it is easier to retrieve all records that match a certain criteria, update records in bulk and cross reference data from various tables.
Dyspnea – In medical language shortness of breath is known as dyspnea. At onset it is important to know a few details. Was this onset gradual or rapid? Was onset at a time of rest or exercise? Does the patient have a medical condition already that could explain this new symptom? Dyspnea is a symptom and it is important to find the root cause so that proper treatment can be given.
Some activity related causes of dyspnea may include asthma, congestive obstructive pulmonary disease, heart related diseases or even anxiety. Inhalers hay be useful for the pulmonology related disorders. Medications may often be given for the other heart related or anxiety related conditions.
Dyspnea related to being at rest may also occur. Like the active type, this too has many different causes. Some examples of causes might include allergy, anxiety, amyotrophic lateral sclerosis, angina, chronic fatigue syndrome and many more. While some of these may be difficult to diagnose, it is best to find the cause of dyspnea and treat the cause rather than to just treat a symptom and not deal with the overall problem.
Eating awareness- awareness is the state or ability to perceive, feel, or to be conscious of events, objects or sensory patterns. Eating awareness is more or less refers to mindful eating. This is the accepting and dedicating special attention to an individual’s thoughts, feelings and behaviors as pertains to eating. Mindful eating tends to gear away from a dietary approach in terms of losing weight. In dieting, restrictions are put on amount and type of foods that are allowed. Most people however are not able to adhere to the strict diet guidelines. This results in indulgence of the prohibited foods. This places a person on an oscillating motion from dieting to indulgence interspersed with feelings of guilt and shame. Mindful eating is not a diet. It is giving food and eating one full’s attention which allows one to attain optimal enjoyment and without eating in excess. It makes it possible for one to experience the difference between physical satisfaction and fullness.
Electronic medical record- this is chart containing all of a patient’s information and medical history stored in digital form. It is patient’s information on past medical treatment from an individual practice office. It offers numerous advantages over paper records. It allows for storage of more information, it makes a patient’s information accessible to more than one person and enhances ease of understanding information by bypassing the hurdle of illegible handwriting. A clinician is also able to effectively tract a patient’s progress over time. It is also easier to follow up patients on some procedures such as vaccinations and screenings. It also enables patients to participate in their own care because this information can be made available to them. Overall, electronic medical records improve the quality of patient care in a practice. This should not be confused with an electronic health record. In the later, the patient’s information is more comprehensive and can be shared with clinicians in other practices.
Exercise – The act of using a part of the human in order to improve upon it may be referred to as exercise. Exercise may be either physical or mental. Exercise has the purpose of maintaining or building up whatever is being actively used.
- Mental exercise can be done in order to strengthen or improve mental abilities. A few examples of mental exercises would include puzzles, games, quizzes, discussion groups and active conversation on a given topic. The more a person exercises the mind the stronger that person’s mental abilities may become.
- Physical exercise maintains or builds up the physical body. Regular exercise can improve endurance, strength, balance and flexibility. Aerobic exercise can build endurance over time quite well. Weight lifting is an example of a strength building exercise. Balance related exercises can help prevent accidental falling, especially for older adults. Yoga is one example of flexibility exercise. Also one can use relaxation exercises to help relax the body before sleep or to help in the relief of stress.
- Regular exercise, either mental or physical, has many benefits. If a person wants to remain healthy and strong then a regular and challenging exercise program is in order. Physical exercise can also help with weightloss, improve heart health, release tension and much more. Exercise improves the life of a person and that is a good thing.
Fat- in chemistry, the term fat is used to describe a group of compounds that dissolve in organic solvents. Fats can exist in solid or liquid at room temperature. All fats are derived from fatty acids and glycerol. Fat in the body is referred t o as adipose tissue. The human body gets fat from the diet or from synthesis within the body. Dietary fat can be sourced from plant or animal fats. Animal products that contain fat include meats and milk products. Plant fats can be found in nuts, sunflower, and soya beans among others. In the body, excess calories are converted to fat. Broadly, fats can be categorized into unsaturated, saturated and Trans fats. Structurally, saturated fats do not have a double bond between any of its constituent’s carbon atoms. Most saturated fats are of animal origin and are unhealthy. Unsaturated fats have a double bond between the carbon atoms and are considered healthier. Trans fat which are unhealthy arise from the partial hydrogenation of fats during food processing and are found in processed foods. In the body, fats are useful for insulation, for production of steroid hormones and absorption of fat soluble vitamins among other functions.
Gland –A group of cells whose purpose is to secrete substances in order to make the body run more efficiently is known as a gland. Human anatomy has two types of these, the exocrine and the endocrine glands. These help to remove materials from the body and also to provide needed materials for certain processes requiring substances that otherwise would not be present in these areas.
The exocrine glands secrete substances outside of the body. Examples would be the salivary glands or sweat glands. Salivary glands secrete fluid inside the mouth. Sweat glands secrete their substance through the skin in places such as the underarms, neck, forehead and other skin areas. While the salivary glands help with digestion, the sweat glands act as the body’s cooling system. Both are quite important.
Endocrine glands secrete their substances inside of the body. These too are quite important. The glands in this group include the pineal, hypothalamus, pituitary, thyroid, parathyroids, thymus, adrenals, pancreas and gonads. Each of these serves a special purpose and a deficiency in any of these areas will greatly impact quality of life. The physician who treats such problems is known as an endocrinologist.
Incarcerated hernia- a hernia is defined as a protrusion of abdominal contents through an area of weakening in the abdominal wall. A hernia can be reducible or irreducible. A reducible hernia is that which the contents of the herniation can be manually pushed back through the abdominal wall into the abdomen. An irreducible hernia is one in which it is not possible to reduce the contents of the hernia manually. In this case, the hernia contents become trapped in the hernia sac. An incarcerated hernia is irreducible. Femoral hernias, indirect inguinal hernias and abdominal wall hernias are likely to become incarcerated. Though the hernia is irreducible, the blood supply to the trapped abdominal contents is not compromised. However, there is a high risk of this occurring. Symptoms include a painful swelling that may have recently enlarged nausea and vomiting, fever and abdominal distention. Surgery is the only treatment option for incarcerated hernias. A potential complication of this hernia is strangulation which will result in death of trapped hernia contents due to lack of blood supply.
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Internal hernia- a hernia refers to the protrusion of an abdominal organ through an area of weakness in the abdominal wall. An internal hernia refers to protrusion of a visceral organ through the peritoneum, foramen or mesentry with the organ remaining within the abdominal cavity. In internal hernias, a swelling on the abdominal wall associated with external hernias is absent. Examples of internal hernias include diaphragmatic hernia, hiatal hernia, sigmoid mesocolon hernia, Winslow hernia, tranmesentric hernia among others. Internal hernias are common after gastric bypass surgery. Due to lack of physical signs associated with an external hernia, the diagnosis of an internal hernia is often difficult to make. The symptoms are due to the local effect that a hernia causes. For instance a hiatal hernia will present with gastroesopageal reflex disease. A spinal hernia may present with limb weakness, paresthesia urinary and stool incontinence. Treatment of internal hernias is surgical.
Machine learning – Machine learning is a type of artificial intelligence that is geared towards technological advancement of humans through use of computers. Machine learning equips computers with the ability to learn without them being programmed. Computer programmes are designed in such a way that they teach themselves to grow and react differently when exposed to new data. This advancement in computing is achieved through continuous exposure to new scenarios, tests and information. The computer is then able pick a pattern or detects a trend from the given data. Through this, the computers then learn how to perform tasks by generalizing from previous examples. In other words the computer is able to solve a problem using prior experience or examples from past data. In modern medicine, medical imaging is an indispensible tool. Machine learning is essential in the medical imaging field through applications that assist in medical image analysis, image fusion, image guided therapy and computer aided diagnosis. Machine learning can also be used to predict response of different patients to treatment through analysis of data.
Metabolic equivalent – It is also known as the metabolic equivalent of task (MET). This is a unit of measurement that is used to determine the energy requirement of a given task. 1 metabolic equivalent is defined as the amount of oxygen that is consumed while sitting and at rest. This translates to about 3.5 mls of oxygen per kilogram of body weight. The MET values of any given physical activity can be determined by dividing the oxygen cost of the activity by 3.5. The intensity of the activity is directly proportional to the MET value. MET values for various activities provide a simple and practical way that helps determine the energy expenditure of various activities. In medicine, MET values are useful in that they can be used to determine how much exercise or physical activity an individual can tolerate safely. The patient is then able to establish a repertoire of activities that they can partake in safely.
Metabolic surgery – This is a term that has recently gained popularity in the field of bariatric surgery. Obesity is associated with adverse effect on many of the body’s metabolic processes. Of concern is glucose metabolism. Obesity increases the risk for type 2 diabetes and most obese people have concurrent type 2 diabetes. Metabolic surgery is a term that refers to a set of gastrointestinal operations used with intent to treat diabetes and metabolic dysfunction including obesity. Simply put, these are surgical procedures that primarily aim at correcting dysfunction in glucose metabolism. An example of such a procedure is the RY gastric bypass. It is not clear how bariatric surgical procedures produce remission in type 2 diabetes. Theories existing include that introduction of food directly to the lower intestine via bypass stimulates release of GLP-1 whish results in secretion of insulin. It is also hypothesized that rearranging the gut results in decrease of hunger stimulating hormones such as peptide YY which result in decreased intake of sugar hence better glucose control.
Operation – An operation is a medical procedure involving incision, with instruments. It is performed for repair of damaged tissue for instance after trauma. It is also done to arrest the progress of any pathology. The term surgery and operation can be used synonymously. A surgeon is a trained medical specialist who performs the surgery. An operation can be elective or an emergency. An elective operation is scheduled and performed for conditions that do not pose an immediate threat to the patient. An emergence operation is performed immediately because of presence of a life threatening condition in a patient. Based on the degree of invasion, an operation can be minimally, moderately or extensively invasive. An operation is a sterile procedure that is performed in a sterile environment. It entails use of a multidisciplinary team. There is the surgeon, the anesthetist, the scrub nurse among others. During the procedure, the patient is given medication that makes them sleep. Most operations will involve a hospital stay of at least a few days and a recovery period of at least two weeks.
Revisional surgery – Increase in the incidence of obesity in the world birthed bariatric surgery. This is a division of surgery that provides procedures geared towards helping patients lose weight. Revisional surgery refers to an operation that is done in patients who have already undergone a previous form of bariatric surgery. It is usually performed in the setting of complications or if the post surgery weight loss in not tallying with the expected. Complications that can prompt revisional surgery include development of fistulas, ulcers, continuous vomiting and protein energy malnutrition. Reversal of a procedure can also be done if a patient loses too much weight. Options for revision are dependent on the primary procedure that was done, some limit revision options. Recent surgical techniques offer more revision options compared to older techniques. Revisional surgeries are associated with greater risk for adverse outcome in the patient. Risk is highest in people who have lost too much weight and lowest in those who had minimal weight loss after the primary procedure.
Scar – Nature marks an area that has not properly healed with what is called a scar, a mark or reminder of what happened. Such a mark may be on the skin, inside the body or it can be mental or emotional. Such a marking indicates a healing issue.
Scars on the skin come in different types. A normal scar may start out red and fade in time as the injury burns. A keloid scar results when there is extra collagen, resulting in a scar that continues to grow. This growth continues even after the wound has healed. The hypertrophic scar raises above the skin and is red. This type may last for up to five years. An atrophic scar, also known as a pitted scar or an ice pick scar, results from skin conditions such as acne. Finally with a burn the result may be a scar contracture where the skin shrinks up around the area of injury.
The above mentioned are physical manifestations due to injury. Serious life events may also leave emotional or mental scars that show up as behavior or mood issues due to the lack of healing. These too can fade over time.
Sheath – An envelope or casing that covers is known as a sheath. The human body has many of these. Also medicine has created some in order to make procedures easier. One example of such a tool would be a catheter sheath that is used to help make putting in a catheter easier.
In the human body there are other examples of a sheath. The male penis retracts into a sheath. A nerve may be protected by a myelin sheath. A tendon is protected by a tissue sheath.
The purpose of a sheath is to protect and to help in holding together whatever is inside the sheath or case. It is composed of tissue that surrounds the object being protected. Medical tools that protect and are called sheaths may be made of many different substances. One obvious example of a sheath is a rubber that a man wears to protect his partner from receiving the sperm at ejaculation. Such a sheath protects a woman from getting pregnant.
Shunt – A device surgically implanted in order to drain excess cerebrospinal fluid from the brain is known as a shunt. These may be either the fixed pressure type or the programmable variety. If the needs of the patient change then the fixed pressure type will require a new surgery. The programmable type can have the pressure setting changed while in the physician’s office.
A typical shunt has four parts. First fluid begins to be transferred out via a catheter or pouch in the brain. It is then collected in a reservoir that has been connected to the catheter. A valve then controls the pressure build up, allowing excess cerebrospinal fluid to then be taken away via the lower catheter, which then sends the fluid elsewhere in the body to be absorbed.
Shunts are identified based on where they have been placed and where they drain into. Thus a ventriculo-peritoneal shunt, for example, has been placed in the ventricular part of the brain and will be drained into the stomach. A patient should carry medical identification so that if an emergency does happen the authorities will know about the shunt.
Sinus – A cavity or space where something can flow through is known as a sinus. The human body contains several areas that this term can be applied to. Most people know about the nasal cavity, known as your sinuses, but the body also has other places where it has similar cavities.
This term sinus applies to cavities in the heart, neck, anis, cervix and more. These spaces can become homes for infections at times. Allergens can inflame a sinus cavity. Such inflammations may be treated with antihistamines to relieve symptoms.
Most frequently this term “sinus is used in referring to the sinuses in the skull. Four pairs of sinus passages exist in the human skull. Air fills these, however, they may be blocked by excess mucous. Such an infection may be referred to as sinusitis. Symptoms may include headache, congestion, watery eyes and even mild fever. Antibiotics and decongestants may be given to treat sinusitis.
Stapler – In medicine this is a surgical tool used to close wounds. The kind of stapler used depends upon the kind of staples required by the procedure. These instruments differ depending upon what is being done. They may be placed externally or internally. Medical staplers may even be purchased by anyone online at places like Amazon.
The use of the stapler makes closing the wound easier for the surgeon. Also such technology provides for a faster recovery time for the patient. A stapler may also come with a removing tool to be used when the patient returns for his or her check up. Disolvable staples are also available, thus making removal not necessary.
The stapler provides quality temporary wound closure, allowing for ease of care and ease of removal. Staplers come in many sizes and shapes, designed according to purpose and wound size. Staplers are an intrinsic part of any surgeon’s tools.
Strangulated hernia – A hernia refers to protrusion of abdominal contents through an area of weakness in the abdominal wall. Anatomically, a hernia is composed of the hernia sac, the hernia contents and the neck of the hernia. A hernia becomes strangulated when its blood supply is cut off and the trapped components become ischemic. A femoral hernia has the highest likelihood of becoming strangulated. This is because it has a narrow neck. After the blood supply is cut off, death of trapped tissue occurs as early as within 6 hours. Strangulated hernia has a high risk of perforation due to impaired integrity of the intestinal wall. A patient experiences severe abdominal pain of sudden onset. The pain is first located at the site of the hernia then it becomes generalized over the whole abdomen. This may be accompanied by abdominal distention, nausea and vomiting. A strangulated hernia is a medical emergency. Surgery is the mainstay of treatment. The dead portion of the intestine is cut off and the two healthy ends are then anastomosed. The hernia is also repaired to avoid recurrence.
Surgical obstruction – Intestinal obstruction exists when there is failure, reversal or impairment of the normal transit of the intestinal contents. It can be partial or complete. The obstruction can be within the hollow tubular structure of the gut. An example is in when swallows a foreign body, in the presence of massive number of intestinal worms or human hair. The defect can also be due to dysfunction in muscular activity of the intestinal wall and peristalsis is impaired. The defect can also be outside the gut wall which is usually due to a mass pressing on the gut such as a tumor or due to adhesions. Intestinal obstruction presents with severe abdominal pain, cramping, bloating and swelling of the abdomen, constipation and inability to pass flatus. Intestinal obstruction is a medical emergency and if untreated can be fatal. Surgical intervention is the only modality of treatment. Intraoperatively, the obstruction is relieved and any intestinal tissue
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