key-Reading Passages for medical terminology

Reading ComprehensionReading Passage 1Case Study 19-1: Arthroplasty of the Right TMJS.A., a 38-year-old teacher, was admitted for surgery for degenerative joint disease (DJD) of her right temporomandibular joint (TMJ). She has experienced chronic pain in her right jaw, neck, and ear since her automobile accident the previous year. S.A.’s diagnosis was confirmed by CT scan and was followed up with conservative therapy, which included a bite plate, NSAIDs, and steroid injections. She had also tried hypnosis in an attempt to manage her pain but was not able to gain relief. Her doctor referred her to an oral surgeon who specializes in TMJ disorders. S.A. was scheduled for an arthroplasty of the right TMJ to remove diseased bone on the articular surface of the right mandibular condyle.On the following day, she was transported to the OR for surgery. She was given general endotracheal anesthesia, and a vertical incision was made from the superior aspect of the right ear down to the base of the attachment of the right earlobe. After appropriate dissection and retraction, the posterior-superior as-pect of the right zygomatic arch was bluntly dissected anteroposteriorly. With a nerve stimulator, the zy-gomatic branch of the facial nerve was identified and retracted from the surgical field with a vessel loop.The periosteum was then incised along the superior aspect of the arch. An inferior dissection was then made along the capsular ligament and retracted posteriorly. With a Freer elevator, the meniscus was freed, and a horizontal incision was made to the condyle. With a Hall drill and saline coolant, a high condylec-tomy of approximately 3 mm of bone was removed while conserving function of the external pterygoid muscle. The stump of the condyle was filed smooth and irrigated copiously with NSS. The lateral capsule, periosteum, subcutaneous tissue, and skin were then closed with sutures. The facial nerve was tested be-fore closing and confirmed to be intact. A pressure pack and Barton bandage were applied. The sponge, needle, and instrument counts were correct. Estimated blood loss (EBL) was approximately 50 mL.S.A. was discharged on the second postoperative day with instructions for soft diet; daily mouth open-ing exercises; an antibiotic (Keflex 500 mg po q6h); Tylenol no. 3 po q4h prn for pain; and four weekly postoperative appointments.Case Study 19-2: Osteogenesis ImperfectaM.H., a 3-year-old boy with osteogenesis imperfecta (OI) type III, was admitted to the pediatric ortho-pedic hospital for treatment of yet another fracture. Since he was born he has had 15 fractures of his arms and legs. His congenital disease is manifested by a defect in the creation of bone matrix, which gives normal bone its strength. His bones are very brittle and break with little pressure or trauma. This latest fracture occurred when he twisted at the hip while standing in his wheeled walker. He has been in a research study and receives a bisphosphonates infusion every 2 months. He is short in stature with short limbs for his age, and has bowing of both legs. He also has a pectus cavernosus of his chest, an inversion or concavity of the sternum.M.H. was transferred to the OR and carefully lifted to the OR table by the staff. After he was anes-thetized, he was positioned with gentle manipulation, and his left hip was elevated on a smallgel pil-low. After skin preparation and sterile draping, a stainless steel rod was inserted into the medullary canal of his left femur to reduce and stabilize the femoral fracture. The muscle, fascia, subcutaneous tissue, and skin were sutured closed. Three nurses gently held M.H. in position on a pediatric spica box while the surgeon applied a hip spica (body cast) to stabilize the fixation, protect the leg, and maintain abduction. M.H. was transferred to the PACU for recovery. The surgeon dictated the procedure as an open reduction internal fixation (ORIF) of the left femur with intramedullary rodding (IM) and appli-cation of spica cast.Case Study 19-3: Idiopathic Adolescent ScoliosisFour years ago, L.R., who is now 15, had a posterior spinal fusion (PSF) for correction of idiopathic adolescent scoliosis in a pediatric orthopedic hospital in another state. Her spinal curvature had been surgically corrected with the insertion of bilateral laminar and pedicle hooks and two 3⁄16-inch rods. A bone autograft was taken from her right posterior superior ilium and applied along the lateral processes of T4 to L2 to complete the fusion.During a follow-up visit, she presented with a significant prominence of the right scapula and back pain in the mid and lower back. She denied numbness or tingling of the lower extremities, bowel or bladder problems, chest pain, and shortness of breath. A CT scan of the upper thoracic spine showed a prominent rotatory scoliosis deformity of the right posterior thorax with acute angulation of the ribs.Her deformity is a common consequence of overcorrection of prior spinal fusion surgery, called crank shaft phenomenon.L.R. was referred to the chief spinal surgeon of a local pediatric orthopedic hospital for removal of the spinal instrumentation, posterior spinal osteotomies from T4 to L2, insertion of replacement hooks and rods, bilateral rib resections, autograft bone from the resected ribs, partial scapulectomy, and pos-sible allograft bone and bilateral chest tube placement. The surgical plan was explained to her and her mother and consent was obtained and signed. The surgical procedure as well as the potential benefits versus risks were discussed. L.R. and her mother stated that they fully understood and provided con-sent to proceed with the plan for surgery.CASE STUDY QUESTIONSMultiple choice: Select the best answer and write the letter of your choice to the left of each number._____ 1. A condylectomy is:a. removal of a joint capsuleb. plastic repair of a vertebrac. removal of a rounded bone protuberanced. enlargement of a cavitye. removal of a tumor_____ 2. The articulating surface of a bone is located:a. under the epiphysisb. in a jointc. around the bone marrowd. at a muscle attachmente. at a tendon attachment_____ 3. The dissection of the zygomatic arch was directed anteroposteriorly, which describes:a. posterior-superiorb. circumferentialc. front to backd. top to bottome. perpendicular to the mandible_____ 4. Another term for bow-legged is:a. internal rotationb. knock-kneedc. adductiond. varuse. valgus_____ 5. An IM rod is placed:a. inferior to the femoral condyleb. into the acetabulumc. within the medullary canald. on top of the periosteume. lateral to the epiphyseal growth plates_____ 6. The anatomic area described as thoracic or the thorax is the:a. chestb. lower pelvisc. between sternum and umbilicusd. shoulderse. posterior abdomen_____ 7. L.R.’s spinal fusion will immobilize the spina l levels of T4 to L2. These segments describe the _______________ and ________________ vertebrae.a. cervical and lumbarb. sacral and cranialc. lamina and disksd. thoracic and lumbare. lumbar and thoracic_____ 8. The grafted bone for L.R.’s fusion cam e from her own right ilium. The proper name for this is a(n):a. allograftb. autograftc. heterograftd. iliografte. homograftWrite a term from the case studies with each of the following meanings:9. pertaining to the cheekbone __________________________________10. the membrane around the bone __________________________________11. a crescent-shaped cartilage in a joint __________________________________12. on both sides __________________________________13. breastbone __________________________________14. plastic repair of a joint __________________________________15. term for a disease of unknown origin __________________________________16. removal of the shoulder blade __________________________________17. a break in the integrity of a bone __________________________________18. surgical openings into bones __________________________________ Abbreviations. Define the following abbreviations:19. DJD __________________________________20. MRI __________________________________21. NSAIDs __________________________________22. CT __________________________________23. NSS __________________________________24. TMJ __________________________________25. OI __________________________________26. ORIF __________________________________27. PSF __________________________________28. EBL __________________________________Answers to Case Study Questions1. c2. b3. c4. e5. c6. a7. d8. b9. zygomatic10. periosteum11. meniscus12. bilateral13. sternum14. arthroplasty15. idiopathic16. scapulectomy17. fracture18. osteotomies19. degenerative joint disease20. magnetic resonance imaging21. nonsteroidal anti-inflammatory drugs22. computed tomography23. normal saline solution24. temporomandibular joint25. osteogenesis imperfecta26. open reduction internal fixation27. posterior spinal fusion28. estimated blood lossReading Passage 2Case Study 21-1: Basal Cell Carcinoma (BSC)K.B., a 32-year-old fitness instructor, had noticed a “tiny hard lump” at the base of her left nostril while cleansing her face. The lesion had been present for about 2 months when she consulted a dermatolo-gist. She had recently moved north from Florida, where she had worked as a lifeguard. She thought the lump might have been triggered by the regular tanning salon sessions she had used to retain her tan be-cause it did not resemble the acne pustules, blackheads, or resulting scars of her adolescent years.Although dermabrasion had removed the obvious acne scars and left several areas of dense skin, this lump was brown-pigmented and different. K.B. was afraid it might be a malignant melanoma. On ex-amination, the dermatologist noted a small pearly-white nodule at the lower portion of the left ala (outer flared portion of the nostril). There were no other lesions on her face or neck.A plastic surgeon excised the lesion and was able to re-approximate the wound edges without a full-thickness skin graft. The pathology report identified the lesion as a basal cell carcinoma with clean mar-gins of normal skin and subcutaneous tissue and stated that the entire lesion had been excised. K.B. was advised to wear SPF 30 sun protection on her face at all times and to avoid excessive sun exposure and tanning salons.Case Study 21-2: Cutaneous LymphomaL.C., a 52-year-old female research chemist, has had a history of T-cell lymphoma for 8 years. She was initially treated with systemic chemotherapy with methotrexate until she contracted stomatitis. Con-tinued therapy with topical chemotherapeutic agents brought some measurable improvement. She also had a history of hidradenitis.A recent physical examination showed diffuse erythroderma with scaling and hyperkeratosis, plus alopecia. She had painful leukoplakia and ulcerations of the mouth and tongue. L.C. was hospitalized and given two courses of topical chemotherapy. She was referred to Dental Medicine for treatment of the oral lesions and discharged in stable condition with an appointment for follow-up in 4 weeks. Her discharge medications included hydrocortisone ointment 2% to affected lesions q hs, Keralyt gel bid for the hyperkeratosis, and Dyclone and Benadryl for her mouth ulcers prn.Case Study 21-3: Pressure UlcerL.N., an elderly woman in failing health, had recently moved in with her daughter after herhospitalization for a stroke. The daughter reported to the home care nurse that her mother had minimal ap-petite, was confused and disoriented, and had developed a blister on her lower back since she had been confined to bed. The nurse noted that L.N. had lost weight since her last visit and that her skin was dry with poor skin turgor. She was wearing an “adult diaper,” which was wet. After examining L.N.’s sacrum, the nurse noted a nickel-sized open area, 2 cm in diameter and 1 cm in depth (stage II pres-sure ulcer), with a 0.5-cm reddened surrounding area with no drainage. L.N. moaned when the nurse palpated the lesion. The nurse also noted reddened areas on L.N.’s elbows and heels.The nurse provided L.N.’s daughter with instructions for proper skin care, incontinence manage-ment, enhanced nutrition, and frequent repositioning to prevent pressure ischemia to the prominent body areas. However, 6 months later L.N.’s pressure ulcer had deteriorated to a class III. She was hos-pitalized under the care of a plastic surgeon and wound-ostomy care nurse. Surgery was scheduled to débride the sacral wound and close it with a full-thickness skin graft taken from her thigh. L.N. was discharged 8 days later to a long-term care facility with orders for an alternating pressure mattress, position change every 2 hours, supplemental nutrition, and meticulous wound care.Multiple choice: Select the best answer and write the letter of your choice to the left of each number._____ 1. K.B.’s basal cell carcinoma may have been caused by chronic expo sure to the sun and ultraviolet tanning bed use. The scientific explanation for this is the:a. autoimmune responseb. actinic effectc. allergic reactiond. sun block tanning lotion theorye. dermatophytosis_____ 2. The characteristic pimples of adolescent acne are whiteheads and blackheads. The medical terms for these lesions are:a. vesicles and lymphotomesb. pustules and blistersc. pustules and comedonesd. vitiligo and maculese. furuncle and sebaceous cyst_____ 3. Which skin cancer is an overgrowth of pigment-producing epidermal cells:a. basal cell carcinomab. Kaposi sarcomac. cutaneous lymphomad. melanomae. erythema nodosum_____ 4. Basal cell carcinoma involves:a. subcutaneous tissueb. hair folliclesc. connective tissued. adipose tissuee. epithelial cells_____ 5. Hydradenitis is inflammation of a:a. sweat glandb. salivary glandc. sebaceous glandd. ceruminous glande. meibomian gland_____ 6. Leukoplakia is:a. baldnessb. ulcerationc. formation of white patches in the mouthd. formation of yellow patches on the skine. formation of scales on the skin_____ 7. Hydrocortisone is a(n):a. vitaminb. steroidc. analgesicd. lubricante. diuretic_____ 8. An example of a topical drug is a:a. systemic chemotherapeutic agentb. drug derived from rain forest plantsc. subdermal allergy test antigensd. skin ointmente. Benadryl capsule 25 mg_____ 9. Stomatitis, a common side effect of systemic chemotherapy, is an inflammatory conditionof the:a. mouthb. colostomyc. stomachd. teeth and haire. nails_____ 10. Skin turgor is an indicator of:a. elasticityb. hydrationc. agingd. nutritione. all of the above_____ 11. Another name for a pressure ulcer is a:a. shearing forceb. bedsorec. decubitus ulcerd. a and be. b and c_____ 12. A FTSG is usually harvested (taken) from another body area with a scalpel, whereas a STSG is harvested with an instrument called a(n) ________________________, which can cut a thinner graft.a. tissue slicerb. Keralytc. erythrodermd. dermatomee. débridemenWrite a term from the case studies with each of the following meanings:13. skin sanding procedure ______ dermabrasion14. a solid raised lesion larger than a papule _________________________ nodule15. physician who cares for patients with skin diseases _______ dermatologist16. connective tissue and fat layer beneath the dermis _______________ subcutaneous tissue17. diffuse redness of the skin ________________ erythema/erythroderma18. increased production of keratin in the skin ____________________ hyperkeratosis19. removal of dead or damaged skin _____________________ débridement20. reduced blood flow to the tissue ___________________ ischemiaAbbreviations. Define the following abbreviations:21. FTSG __________________________________ full-thickness skin graft22. STSG __________________________________ split-thickness skin graft23. SPF __________________________________ sun protection factor24. hs __________________________________ at bedtime25. bid __________________________________ twice per dayReading Passage 3Case Study 6-1: Esophageal SpasmB.R., a 53-year-old woman, consulted with her primary physician because of occasional episodes of dys-phagia with moderate to severe tight, gripping pain in her midthorax. She reported that the onset was sud-den after ingestion of certain foods or beverages, beginning retrosternally and radiating to the cervical and dorsal regions. The pain was not relieved by assuming a supine position or holding her breath. B.R. also stated that she felt like her heart was racing and that she might be having a heart attack. She denied any dyspepsia, vomiting, or dyspnea. Her doctor suspected acute esophageal spasm or possibly a paraesophageal hiatal hernia and referred B.R. to a gastroenterologist for a gastroscopy and esophageal manometry study (pressure measurement). She also underwent a barium swallow study under fluoroscopic imaging.Case Study 6-2: HIV Infection and TuberculosisT.H., a 48-year-old man, was an admitted intravenous (IV) drug user and occasionally abused alcohol. Over 4 weeks, he had experienced fever, night sweats, malaise, a cough, and a 10-lb. weight loss. He was also concerned about several discolored lesions that had erupted weeks before on his arms and legs.T.H. made an appointment with a physician assistant (PA) at the neighborhood clinic. On exami-nation, the PA noted bilateral anterior cervical and axillary lymphadenopathy and pyrexia.T.H.’s tem-perature was 39°C. The PA sent T.H. to the hospital for further studies.T.H.’s chest radio graph (x-ray image) showed paratracheal adenopathy and bilateral interstitial in-filtrates, suspicious of tuberculosis (TB). His blood study results were positive for human immunode-ficiency virus (HIV) and showed a low lymphocyte count. Sputum and bronchoscopic lavage (washing) fluid were positive for an acid-fast bacillus (AFB), and a PPD (purified protein derivative) skin test re-sult was also positive. Based on these findings, T.H. was diagnosed with HIV, TB, and Kaposi sarcoma related to past IV drug abuse.Case Study 6-3: EndocarditisD.A., a 37-year-old alcoholic man, sought treatment after experiencing several days of high fever and generalized weakness on return from his vacation. D.A.’s family doctor suspected cardiac involvement because of D.A.’s history of rheumatic fever. The doctor was concerned because D.A.’s brother had died of acute malignant hyperpyrexia during surgery at the age of 12.D.A. was referred to a cardiologist, who scheduled an electrocardiogram (ECG) and a transesophageal echocardiogram (TEE).D.A. was admitted to the hospital with subacute bacterial endocarditis (SBE) and placed on high-dose IV antibiotics and bed rest. He had also developed a heart murmur, which was diagnosed as idio-pathic hypertrophic subaortic stenosis (IHSS).。