Chapter Nine CIRCULATORY SYSTEM Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc.
Circulatory System Cardiovascular system Lymphatic system Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 2
Circulatory Composition and Functions Cardiovascular (CV) structures Heart and great vessels Arteries and veins Lymphatic structures Functions Organs (spleen, thymus), lymph nodes, and lymph vessels Transportation of substances To cells Oxygen, nutrients, other substances Away from cells Waste products Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 3
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 4
Word Parts cardi/o, coron/o, cordi/o, = heart angi/o, vascul/o = vessel Cardiovascular Structures Heart Vessels Arteries Veins arteri/o = artery ven/o, phleb/o = vein Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 5
PCS Guideline Alert! B 2. 1 b Body systems designated as upper or lower contain body parts located above or below the diaphragm, respectively. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 6
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 7
Word Parts Circulation of the Blood Pulmonary circulation pulmon/o = lung ox/i, ox/o = oxygen capn/o = carbon dioxide Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 8
Word Parts aort/o = aorta arteriol/o = arteriole cyt/o, cellul/o = cell ren/o = kidney hepat/o = liver 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 Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 9
Word Parts vascul/o, angi/o, vas/o = vessel tunica = coat Vessels Tunica externa (adventitia) Tunica media Tunica interna (intima) externa = outside media = middle interna = inside Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 10
Word Parts apic/o = apex pre- = in front of cordi/o = heart -um = structure atri/o = atrium ventricul/o = ventricle sept/o = septum 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 Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 11
Heart and Great Vessels Chambers of the heart Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 12
Word Parts Heart and Great Vessels Pulmonary arteries and veins Pulmonary trunk pulmon/o = lung aort/o = aorta Aorta Superior and inferior venae cavae In PCS, the inferior vena cava is classified as a “lower vein”! Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 13
Word Parts endocardi/o = endocardium myocardi/o = myocardium pericardi/o = pericardium viscer/o = viscera, organs Layers of the Heart Wall Endocardium Myocardium Pericardium Visceral pericardium (epicardium) Parietal pericardium Terms related to heart wall disorders Transmural pariet/o = wall trans- = through mur/o = wall Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 14
Word Parts Heart Surface Left heart anter/o = anterior (front) infer/o = inferior (below) later/o = lateral (side) Left coronary sulcus Obtuse margin Right heart Right coronary sulcus Walls Anterior Inferior Lateral Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 15
Word Parts atri/o = atrium Structures of the Atria Left atrium Left auricular appendage Sinus venosus Coronary sinus auricul/o = ear Right atrium Right auricular appendage Sinus venosus Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 16
Word Parts ventricul/o = ventricle chord/o = cord con/o = cone Structures of the Ventricles Chordae tendineae Trabeculae carnae Papillary muscle Conus arteriorus Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 17
Word Parts and Abbreviations Blood Flow Through the Heart 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 Valves Annulus Chordae tendinae Papillary muscles Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 18
Word Parts Blood Flow Through the Heart Coronary arteries coron/o = heart Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 19
Review Question The upper chambers of the heart are the: A. arterioles B. atria C. venules D. ventricles Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 20
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 21
Blood Flow Through the Heart Ejection fraction Normal: approximately 65% Heart rate Beats per minute (BPM) Normal: 60 -100 BPM Pulse points Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 22
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 Electrical conduction pathways of the heart Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 23
EKG Recording of the Cardiac Cycle Conductive mechanism of the heart through the use of an electrocardiogram Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. ST segment 24
Arteries: Upper and Lower Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 25
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) Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 26
PCS Guideline Alert! Medial and Surgical B 4. 12 Nerves and Vessels Section (Section 0) B 2. 2 Body systems designated as upper or lower contain body parts located above or below the diaphragm, respectively. 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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 27
Upper Arteries Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 28
Word Parts Upper Arteries Head and neck • cerebr/o = cerebrum • tempor/o = temple • lingu/o = tongue • faci/o = face • occipit/o = occiput Right common carotid Internal and external carotid Cerebral (from external) Temporal • Lingual, facial, occipital Right subclavian Right vertebral • Basilar • Circle of Willis Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 29
Word Parts Upper Arteries Thoracic aorta cost/o = rib Right and left internal mammary arteries (also called internal thoracic arteries) bronchi/o = bronchi Right clav/i = clavicle pericardi/o = pericardium esophag/o = esophagus mediastin/o = mediastinum phren/o = diaphragm and left subclavian arteries Superior and inferior thyroid artery Intercostal Bronchial Pericardial Esophageal Mediastinal Superior phrenic Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 30
Word Parts brachi/o = arm uln/o = ulna radi/o = radius Upper Arteries to the arms Brachial arteries Ulnar arteries Radial arteries Hand arteries Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 31
Lower Arteries Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 32
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 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 Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 33
Word Parts Lower Arteries Right and left femoral femor/o = thighbone perone/o = tibia ped/o = foot Branches from the external iliac Popliteal Anterior and posterior tibial Peroneal Dorsalis pedis Arcuate Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 34
Veins: Upper and Lower Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 35
Upper Veins Facial veins Intracranial Vertebral External jugular Internal jugular Subclavian Brachiocephalic Superior vena cava Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 36
Word Parts Upper Veins Chest drainage azyg/o = without a yoke inter- = between cost/o = rib bronchi/o = bronchus pericardi/o = pericardium Azygos Hemiazygos Accessory hemiazygos Intercostal Bronchial Pericardial Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 37
Word Parts ante- = before brachi/o = arm Upper Veins of the arms and hands Hands and fingers Palmar/volar cubit/o = elbow digital and metacarpal veins Lower arms Deep drainage Radial and ulnar cephal/o = head 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 Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 38
Lower Veins Lower veins are those below the diaphragm. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 39
Word Parts Lower Veins Legs metatars/o = metatarsal poplite/o = behind the knee perone/o = fibula femor/o = thigh Digital and metatarsal Greater and lesser saphenous Peroneal Posterior tibial Popliteal vein Femoral External iliac Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 40
Word Parts Lower Veins Abdominopelvic cavity Hepatic portal system hepat/o = liver Hepatic gastr/o = stomach Gastric splen/o = spleen Splenic pancreat/o = pancreas Pancreatic mesenter/o = midgut Inferior esophag/o = esophagus adren/o = adrenal gland superior mesenteric Esophageal Adrenal and renal Inferior phrenic Internal iliac ren/o = kidney phren/o = diaphragm Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 41
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 42
ICD-10 -PCS Medical Surgical Divisions for the Circulatory System Heart and great vessels Upper arteries Lower arteries Upper veins Lower veins Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 43
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 44
Fetal Circulation Before birth After birth Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 45
Lymphatic System Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 46
Lymphatic System Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 47
Word Parts bucc/o = cheek infra- = under, beneath pre- = in front of, before Lymphatic System Lymph nodes in the head sub- = under auricul/o = ear par- = near ot/o = ear mandibul/o = mandible Buccinators Infraauricular Infraparotid Preauricular Submandibular Submaxillary Submental Subparotid Suprahyoid maxill/o = maxilla ment/o = chin Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 48
Word Parts cervic/o = neck post- = after, behind auricul/o = ear occipt/o = occiput retro- = behind pharyng/o = pharynx supra- = above clavicul/o = clavicle Lymphatic System Lymph nodes in the neck Cervical Jugular Postauricular Occipital Retropharyngeal Supraclavicular Right jugular trunk Right lymphatic duct Right subclavian trunk clav/o = clavicle Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 49
Word Parts brady- = slow -cardia = heart condition Circulatory Signs and Symptoms (R 00 -R 99) Bradycardia Tachycardia ECGs A, normal B, bradycardia C, tachycardia Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 50
Circulatory Signs and Symptoms (R 00 -R 99) 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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 51
Word Parts emesis = to vomit dys- = difficult -pnea = breathing orth/o = straight pulmon/o = lung -ary = pertaining to Circulatory Signs and Symptoms (R 00 -R 99) Nausea Emesis Pallor Dyspnea on exertion (DOE) Orthopnea Shortness of breath (SOB) Pulmonary congestion Syncope Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 52
Word Parts cyan/o = blue -osis = abnormal condition cardi/o = heart -algia = pain Circulatory Signs and Symptoms (R 00 -R 99) Cyanosis Diaphoresis Cardialgia Atypical Ischemic Precordial Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 53
Review Question The term that means profuse sweating is: A. B. C. D. cyanosis diaphoresis emesis syncope Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 54
Congenital Disorders of the Heart (Q 20 -Q 28) Coarctation of the aorta Patent ductus arteriosus (PDA) Coarctation of the aorta Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 55
Word Parts sept/o = septum, wall -al = pertaining to tetra- = four -logy = study of dextr/o = right -cardia = heart condition Congenital Disorders of the Heart (Q 20 -Q 28) Septal defect Atrial septal defect (ASD) Ventricular septal defect (VSD) Tetralogy of Fallot Dextrocardia/levocardia levo- = left Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 56
Word Parts rheumat/o = watery flow hyper- = excessive, above -tension = pressure Rheumatic Fever and Hypertensive Diseases (I 00 -I 15) Rheumatic heart disease Hypertension Essential (primary) Secondary Controlled Uncontrolled Guideline Alert! Coders need to examine the record for the causes of the hypertension. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 57
Word Parts pector/o = chest -is = structure Ischemic Heart Diseases (I 20 -I 25) Angina pectoris Unstable angina Accelerating/crescendo angina and intermediate coronary syndrome Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 58
Word Parts myocardi/o = heart muscle Ischemic Heart Diseases (I 20 -I 25) Acute myocardial infarction -al = pertaining to Be Careful! Infarction refers to tissue death. An infraction refers to a breaking, as in an incomplete bone fracture. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 59
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 60
Ischemic Heart Diseases (I 20 -I 25) Aneurysm (of heart) Coronary atherosclerosis Atherosclerotic coronary artery disease (CAD) Coronary atherosclerosis Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 61
Word Parts pulmon/o = lung -ary = pertaining to hyper- = excessive -tension = pressure cor = heart cardi/o = heart -ac = pertaining to Pulmonary Heart/Circulation and Other Heart Diseases (I 26 -I 52) Pulmonary hypertension Acute cor pulmonale Pulmonary embolism (PE) infarction Cardiac tamponade Heart failure Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 62
Word Parts stenosis = narrowing Pulmonary Heart/Circulation and Other Heart Diseases (I 26 -I 52) Mitral stenosis (MS) Tricuspid stenosis (TS) Valvular heart disease Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 63
Word Parts pro- = forward -lapse = fall Pulmonary Heart/Circulation and Other Heart Diseases (I 26 -I 52) Mitral valve prolapse (MVP) Mitral regurgitation MVP Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 64
Word Parts cardi/o = heart -megaly = enlargement cardiomy/o = heart muscle Pulmonary Heart/Circulation and Other Heart Diseases (I 26 -I 52) Cardiomegaly Cardiomyopathy -pathy = disease Cardiomegaly Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 65
Word Parts endocardi/o = endocardium -itis = inflammation pericardi/o = pericardium Pulmonary Heart/Circulation and Other Heart Diseases (I 26 -I 52) Endocarditis Pericarditis Acute bacterial endocarditis Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 66
Word Parts dys- = abnormal rhythm/o = rhythm -ia = condition a- = no, not, without atri/o = atrium -al = pertaining to ventricul/o = ventricle Cardiac Dysrhythmias (Arrhythmias) (I 44 -I 49) Dysrhythmia/ arrhythmia Flutter Fibrillation Atrial Ventricular Ectopic beats Atrial vs. ventricular -ar = pertaining to Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 67
Word Parts venticul/o = ventricle Cardiac Dysrhythmias (Arrhythmias) (I 44 -I 49) Heart block -ar = pertaining to tachy- = rapid -cardia = heart condition Atrioventricular block Bundle branch block (BBB) Sick sinus syndrome (SSS) Ventricular tachycardia Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 68
Cerebrovascular Diseases (I 60 -I 69) Cerebral infarction Intracerebral hemorrhage Subarachnoid hemorrhage (SAH) Monoplegia 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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 69
Word Parts Aphasia Dysarthria Apraxia a- = no, not, without phas/o = speech Ataxia -ia = condition prax/o = purposeful movement tax/o = order, coordination Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 70
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 Diseases of Arteries, Arterioles, and Capillaries (I 70 -I 79) Aortic aneurysm Arteriosclerosis Intermittent claudication Peripheral arterial occlusion Peripheral vascular disease (PVD) Raynaud’s syndrome Raynaud’s phenomenon Vasculitis Angiitis Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 71
Diseases of Veins (I 80 -I 89) Esophageal varices Hemorrhoids Thrombophlebitis Varicose veins A, Deep vein thrombophlebitis (DVT). B, Large embolus derived from a lower extremity DVT and now located in a pulmonary artery branch. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 72
Word Parts hypo- = below, deficient tens/o = stretching -ion = process of Other and Unspecified Disorders of the Circulatory System (I 95 -I 99) Gangrene Hypotension Orthostatic idiopathic Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 73
Word Parts lymphaden/o = lymph gland -itis = inflammation lymphangi/o = lymph vessel -ectasia = expansion, dilation Disease of Lymphatic Vessels and Lymph Nodes (I 88 -I 89) Lymphadenitis Lymphangiectasia Lymphangitis Lymphedema Splenomegaly -edema = swelling splen/o = spleen -megaly = enlargement Lymphedema Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. Splenomegaly 74
Benign Neoplasms of the Circulatory System Atrial myxoma Hemangioma Thymoma Hemangioma Atrial myxoma Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 75
Terms Related to Malignant Neoplasms Cardiac myxosarcoma Hemangiosarcoma Cardiac myxosarcoma Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 76
Word Parts thym/o = thymus gland -oma = tumor Terms Related to Malignant Neoplasms Hodgkin lymphoma Reed-Sternberg cells Non-Hodgkin lymphoma Malignant thymoma (thymic carcinoma) Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 77
Review Question Extremely rapid and irregular heartbeats: A. B. C. D. ectopic beats fibrillation flutter angina pectoris Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 78
Review Question Inflammation of a vein with formation of a clot is: A. B. C. D. varicose veins thrombophlebitis claudication Raynaud’s disease Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 79
Did You Know? Since 1900, cardiovascular disease has been the number one killer in the United States every year except for 1918. Cardiovascular disease claims almost 10, 500 more lives each year than the next six leading causes of death combined. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 80
Circulatory System Procedures related to the cardiovascular system Procedures related to the lymphatic system Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 81
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 82
Terms Related to Laboratory Tests Cardiac enzymes test C-reactive protein (CRP) test Homocysteine levels Lipid profile Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 83
Procedures of the Great Vessels and Aorta Angiocardiography Digital subtraction angiography (DSA) DSA Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 84
Word Parts angi/o = vessel -tripsy = crushing -plasty = surgically repair Procedures of the Great Vessels and Aorta Angiotripsy Angioplasty: Percutaneous transluminal coronary angioplasty (PTCA) Stent PTCA Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 85
Word Parts aort/o = aorta -plasty = surgically forming trans- = through Procedures of the Great Vessels and Aorta Aortoplasty Transmyocardial revascularization myocardi/o = myocardium -al = pertaining to re- = again vascul/o = vessel -ization = process Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 86
Procedures of the Heart Cardiac catheterization Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 87
Word Parts cardi/o = heart Procedures of the Heart Cardioplegia Cardioversion -plegia = paralysis -version = turning Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 88
Procedures of the Heart Coronary artery bypass graft (CABG) Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 89
Word Parts pericardi/o = sac surrounding the heart -centesis = surgical puncture -lysis = releasing, destroying, breaking down Procedures of the Heart Pericardiocentesis Pericardiolysis Septoplasty Valvuloplasty sept/o = wall, partition -plasty = surgically forming valvul/o = valve aort/o = aorta Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 90
Cardiac Procedures Left ventricular assist device (LVAD) Minimally invasive direct coronary artery bypass (MIDCAB) Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 91
Word Parts electr/o = electricity cardi/o = heart -graphy = recording echo- = sound Procedures of the Heart and Great Vessels Electrocardiography (ECG/EKG) Echocardiography Transesophageal echocardiography trans- = through esophag/o = esophagus Echocardiography Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 92
PCS Guideline Alert! B 4. 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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 93
Word Parts arteri/o = artery -rrhaphy = suturing end- = within -ectomy = cutting out phleb/o = vein -graphy = recording -tomy = cutting ven/o = vein Procedures of the Arteries and Veins Arteriorrhaphy Endarterectomy Phlebography Phlebotomy Sclerotherapy Venotripsy -tripsy = crushing Endarterectomy Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 94
PCS Guideline Alert! B 3. 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. B 3. 6 c 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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 95
Word Parts lymphaden/o = lymph gland/node -ectomy = cutting out lymphangi/o = lymph vessel -graphy = recording splen/o = spleen Procedures of the Lymph Glands, Spleen, and Thymus Lymphadenectomy Lymphangiography Splenectomy Splenopexy Thymectomy -pexy = suspension thym/o = thymus gland Lymphangiography Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 96
Suffixes and Root Operations for the Circulatory System -centesis -ectomy -lysis -pexy -plasty -rrhaphy -tomy -tripsy drainage excision, resection release repair, reposition dilation, repair, replacement, supplement repair drainage occlusion Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 97
Pharmacology Angiotensin-converting enzyme inhibitors Angiotension II receptor blockers Antiarrhythmic drugs Anticoagulants Antihyperlipidenics Beta-blockers Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 98
Pharmacology Calcium channel blockers Diuretics Nitrates Thrombolytics Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 99
Sort these terms into their correct categories Terms 1. pericardiocentesis 2. angina pectoris 3. hemangioma 4. atria 5. splenopexy Categories __ A + P __ Pathology __ Procedures Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 100
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. Copyright © 2015 by Mosby, Inc. , an imprint of Elsevier Inc. 101
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