2. Medical Terminology
Uses foundational anatomic and medical
terms and abbreviations in written and oral
communication with colleagues and other
health care professionals.
National EMS Education
Standard Competencies
3. • Paramedics must develop a strong working
knowledge of medical terminology.
– Used to describe patient care, including:
• Medical history
• Assessment results
• Treatment
• Outcomes
Introduction
4. Introduction
• You should understand
– Origin of medical terms (words)
– Components (parts)
– Guidelines for forming words
• Incorrect use can cause harm to a patient or
loss of a patient’s trust.
5. Introduction
• For effective communication and
documentation, you must comprehend:
– Key terms
– Acronyms
– Symbols
– Abbreviations
6. Introduction
• Understanding medical terminology means:
– Breaking down each word into separate
components and having a working knowledge of
the parts
– Learning accepted terms in your local area
– Determining if your emergency medical services
(EMS) systems have lists of pre-approved terms
• Have a working knowledge of common
slang terms.
8. Origins
• Understanding the origins of medical terms
helps you decipher the meanings.
– Most medical terms have Greek or Latin origins.
• Words referring to diseases are derived from
Greek words.
• Words referring to anatomic structures are derived
from Latin words.
10. Origins
• Eponyms
– Names of diseases, devices, procedures, or
drugs based on the person who invented,
discovered, or first described them
• “Diesel engine” named for inventor Rudolf Diesel
13. Origins
• Homonyms
– Pairs of words that are pronounced almost the
same way
• Ileum versus ilium
• Dysphagia versus dysphasia
– Incorrect pronunciation can lead to serious
medical errors.
14. Origins
• Antonyms
– Pairs of word roots, prefixes, or suffixes that
have the opposite meaning of another word.
15. Origins
• Synonyms
– Pairs of word roots, prefixes, or suffixes that
have the same or almost the same meaning.
16. Components of a Medical Term
• Medical terms are made of distinct parts
that perform specific functions.
• How the parts of a term are combined
determines its meaning.
17. Components of a Medical Term
• Components that comprise medical terms:
– Prefixes
– Suffixes
– Word roots
– Combining vowels
18. Components of a Medical Term
• Changing or deleting any portion of a term
can alter its content.
• Accurate spelling is essential.
– Hyperglycemia versus hypoglycemia
19. Components of a Medical Term
• Prefixes
– Appear at the beginning of a word
– Usually describe location or intensity
– Change the meaning of the medical term by
describing what, how, why, or when of the root
• Cutaneous versus subcutaneous
20. Components of a Medical Term
• Prefixes (cont’d)
– Learn to recognize a few commonly used
medical prefixes
• Prefix hypo- (low) plus word root volumen
(volume) plus suffix -emia (blood) = hypovolemia
• Prefix hypo- plus word root glyc/o (glucose) plus
suffix -emia = hypoglycemia
21. Components of a Medical Term
• Numerical prefixes
– Used to indicate
• Number of sides, limbs, or sensory organs
affected (eg, “monocular vision”)
• Time (eg, octogenarian)
22. Components of a Medical Term
• Suffixes
– Appear at the end of words
– Usually indicate:
• Procedures
• Conditions
• Diseases
• Parts of speech
– lip- (fat) plus -ase = lipase
23. Components of a Medical Term
• Word roots
– Main part or stem of a word
– Conveys the essential meaning
– Frequently indicates a body part
24. Components of a Medical Term
• Word roots (cont’d)
– Add or change a prefix or suffix to change the
meaning of the term.
– Consider the context of a word before assigning
its meaning.
• The same word root may have different meanings
in different fields of study.
25. Components of a Medical Term
• Colors
– Several word roots describe color.
26. Components of a Medical Term
• Combining vowels
– Connects word root to suffix or other word form
– Often an o
– Used when joining:
• A suffix that begins with a consonant
• Another word root
27. Components of a Medical Term
• Combining form: A word root, prefix, or
suffix with an added vowel (combining
vowel)
– Gastromegaly
– Word root is gastr-
– Gastr/o + megaly
– Stomach + irregular enlargement
28. Components of a Medical Term
• If the suffix begins with a vowel, a combining
vowel is not needed.
– Example: Gastric
– Gastr + -ic
29. Components of a Medical Term
• Guidelines for adding combining vowels to
word roots
– Use before a suffix that begins with a consonant
(eg, cyt/o + logy)
– Use to join other word roots (gastr/o/enteritis)
– Do not use before a suffix that begins with a
vowel (eg, gastritis, not gastroitis)
30. Components of a Medical Term
• Common combining forms and vowels:
– Cardi/o + logy = cardiology (study of the heart)
– Neur/o + logy = neurology (study of the nervous
system)
31. Compound Words
• Words that contain more than one word root
– Example: Osteoarthritis
– Osteo (bone) + arthr (joint or joints) + -itis
(inflammation)
– Osteoarthritis = inflammation of the bone joints
32. Plural Endings
• Apply these rules
– Sometimes you add an s (lung to lungs)
– Words ending in:
• -a change to -ae (vertebra to vertebrae)
• -is change to -es (diagnosis to diagnoses)
• -ex or -ix change to -ices (apex to apices)
• -on or -um change to -a (ganglion to ganglia,
ovum to ova)
• -us change to -i (bronchus to bronchi)
33. Topographic Anatomy
• Superficial landmarks of the body that serve
as guides to the structures beneath
– Landmarks make up the body’s topography.
– Familiarize yourself with landmarks to provide a
thorough assessment.
34. Topographic Anatomy
• Imagine the body in the anatomic position.
– Person is standing facing you.
– Arms at his/her sides
– Palms facing forward
– Thumbs point away from the body
• This position is a shared reference point.
35. Anatomic Planes and Axes of
the Body
• Anatomic plane
– Imaginary flat surface dividing the body
horizontally and vertically into sections
• Axis
– An imaginary line that divides the body equally
and creates a point of rotation
37. Anatomic Planes and Axes of
the Body
• 3 axes along which the body can be divided:
– Anteroposterior axis: Runs perpendicular to the
coronal plane
– Longitudinal axis: Runs perpendicular to the
transverse plane
– Horizontal axis: Runs perpendicular to the
sagittal plane
38. Anatomic Planes and Axes of
the Body
• Planes and axes help to:
– Identify the location of internal structures.
– Understand the relationships between and
among organs.
• Cross section
• Longitudinal section
39. Specific Areas of the Body
• Many body areas have specific names.
• Familiarize yourself with body regions to:
– Communicate effectively with other professionals
– Help you break down other terms
40. Specific Areas of the Body
• Example: Sternocleidomastoid
• Combination of sterno-, cleido-, and -mastoid
• If you understand the roots, you can locate the
origin and insertion of this neck muscle.
47. Directional Terms
• Directional terms
– Describe relative positions of body parts and
imaginary anatomic divisions
– Use to describe the location of pain or injury.
49. Directional Terms
• Directional terms occur in pairs
– Superior and inferior
– Lateral and medial
– Proximal and distal
– Superficial and deep
– Anterior and posterior
– Palmar and plantar
– Apex
50. Directional Terms
• Superior and inferior
– Superior: Nearer to the head
– Inferior: Nearer to the feet
– Also describe the relationship of one structure
to another
• Example: The knee is superior to the foot and
inferior to the pelvis.
51. Directional Terms
• Lateral and medial
– Lateral (outer)
• Body parts that lie farther from the midline
– Medial (inner)
• Body parts that lie closer to the midline
52. Directional Terms
• Proximal and distal
– Describe the relationship of any two structures
to each other
• Proximal: Closer to the body
• Distal: Farther from the trunk/nearer to the free
end of the extremity
• Example: The elbow is distal to the shoulder and
proximal to the wrist and hand.
53. Directional Terms
• Superficial and deep
– Superficial: Closer to or on the skin
– Deep: Farther inside the body and away from
skin
54. Directional Terms
• Anterior and posterior
– Anterior (or ventral)
• Refers to the belly side of the body
– Posterior (or dorsal)
• Refers to the spinal side of the body
55. Directional Terms
• Palmar and plantar
– Palmar (or volar) surface
• Front region of the hand (the palm)
– Plantar (or volar) surface
• Bottom of the foot
56. Directional Terms
• Apex (plural apices)
– Tip(s) of a structure
– Example: Apex of the heart is the bottom
(inferior portion) of the ventricles.
57. Movement and Positional
Terms
• Movement terms
– Useful in explaining mechanism of injury
– Range of motion: Full distance a joint can be
moved
60. Movement and Positional
Terms
• Prefix hyper- is added to the terms flexion or
extension to indicate mechanism of injury.
– Hyperflexion: Maximum flexion or flexion beyond
normal range of motion
– Hyperextension: Maximum extension or
extension beyond the normal range of motion
61. Movement and Positional
Terms
• Wrist injuries can be described using these
terms
– Supination: Turning the palms toward the sky
– Pronation: Turning the palms toward the ground
62. Movement and Positional
Terms
• Rotational deformities
– Internal rotation: Turning the anterior portion of
an extremity toward the midline
– External rotation: Turning an extremity away
from the midline
63. Other Directional Terms
• Bilateral: Appears on both sides of midline
– Eyes, ears, hands, feet
– Structures inside the body also appear on both
sides of midline (lungs and kidneys).
• Unilateral: Only one side of the body
– Spleen is only on left side of body.
• Ipsilateral: Same side of body
• Contralateral: Opposite side of body
65. Other Directional Terms
• Abdomen can also
be divided into 9
regions.
DatafromShier,D.N.,Butler,J.L.,andLewis,R.Hole’sEssentialsofHumanAnatomyand
Physiology,TenthEdition,McGraw-HillHigherEducation,2009.
66. Prefixes Indicating Position,
Direction, and Location
• Specialized prefixes can describe:
– Movement of the body or something within it
– Location of an organ, foreign body, or mass
– Surgical procedures and medical instruments
used to perform them
– Directions of radiation or ultrasound waves
67. Position of the Patient
• Use specific terms to describe position.
– Prone: Lying face down
– Supine: Lying face up
– Fowler position: Patient is sitting straight up, with
knees bent or straight.
– Semi-Fowler position: Patients sits at a 45°
angle.
68. Position of the Patient
• Recovery position
– Helps maintain a clear airway in an unresponsive
patient and prevents aspiration of vomitus
– Left lateral recumbent position
70. Abbreviations, Acronyms, and
Symbols
• Shorthand used for communication
– Developed for speed
• Do not trade speed for accuracy.
– Use only commonly understood acronyms and
abbreviations to minimize errors.
71. Abbreviations, Acronyms, and
Symbols
• Acronyms
– Form shortened words from the initials of several
words to produce a new word or phrase
– Example: “Urban Search and Rescue” becomes
USAR.
72. Abbreviations, Acronyms, and
Symbols
• An abbreviation is considered an acronym if
it’s pronounced as a word.
– HIPAA (“Health Insurance Portability and
Accountability Act”) is pronounced as “hippa.”
– DEA is not an acronym because it’s spelled out
like “D-E-A.”
73. Abbreviations, Acronyms, and
Symbols
• Abbreviations
– Take the place of words to shorten
documentation
– Ensure that abbreviations you use are
consistent with those approved in your EMS
area.
74. Abbreviations, Acronyms, and
Symbols
• Error-prone abbreviations
– Serious errors occur when an abbreviation is not
interpreted as intended.
– Some agencies publish “do not use” lists.
– Some agencies limit or ban use of abbreviations.
76. Abbreviations, Acronyms, and
Symbols
• Symbols
– Sometimes used as a shortcut
– Use only accepted symbols to avoid confusion
or errors.
– Learn which abbreviations are acceptable in
your service area.
78. Medical Terminology Related
to Pharmacology
• Become familiar with terminology related to
medications and medication administration.
– Prefixes commonly used in medication
administration
– Metric conversions used in drug calculation
– Selected medical abbreviations associated with
pharmacology
Chapter 7: Medical Terminology
Comprehensive Lecture
National EMS Education Standard Competencies
Medical Terminology
Uses foundational anatomic and medical terms and abbreviations in written and oral communication with colleagues and other health care professionals.
Lecture Outline
I. Introduction
A. As a paramedic, you must develop a strong working knowledge of medical terminology.
1. International language of medicine and health care
2. Used to describe and record every aspect of patient care, including:
a. Medical history
b. Assessment results
c. Treatment
d. Outcomes
Lecture Outline
3. You should understand the origin of medical terms (words), the components (parts), and the guidelines for forming words.
4. Incorrect use of medical terminology can cause:
a. Administration of ineffective or harmful treatment
b. Patient could lose trust in the paramedic’s ability
Lecture Outline
5. For effective communication and documentation, you must comprehend:
a. Key terms
b. Acronyms
c. Symbols
d. Abbreviations
Lecture Outline
6. Understanding medical terminology requires you to:
a. Break down each word into separate components and have a working knowledge of the parts.
b. Learn the accepted terms in your local area.
c. Determine if your emergency medical services (EMS) systems have lists of pre-approved medical abbreviations and terms.
7. You should also have a working knowledge of common slang terms:
a. “Boarding a patient” for transport; “bagging” or “tubing” for airway management
Lecture Outline
8. To expand your vocabulary to be able to deliver better care:
a. Download the medical terminology app.
b. Carry a field guide or documentation handbook.
Lecture Outline
II. Origins
A. Understanding the origins of medical terms helps you decipher the meanings of terms.
1. Most medical terms have Greek or Latin origins.
a. Words that refer to diseases are derived from Greek words.
b. Words that refer to anatomic structures are derived from Latin words.
This table shows selected terms with Greek and Latin origins.
Lecture Outline
B. Eponyms
1. Names of diseases, devices, procedures, or drugs that are based on the person who invented, discovered, or first described them
a. Example: “Diesel engine” named for its German inventor, Rudolf Diesel.
b. Example: “Denim” derived from the French serge de Nîmes, a serge fabric from the town of Nîmes.
Lecture Outline
2. Sometimes appear in the possessive form
a. Hodgkin’s disease or Hodgkin disease
Lecture Outline
3. Often include the name of the physician or surgeon first associated in some way with them:
a. McBurney point
b. Foley catheter
c. Babinski reflex
d. Crohn disease
e. Cesarean section
f. Levine sign
g. Apgar score
4. Medical terminology can use a single word to express a concept that would have taken many words.
a. Example: “Arthritis” versus “inflammation of the joint”
Lecture Outline
C. Homonyms
1. Pairs of words that are pronounced almost the same way
a. Example: Ileum (the last anatomic portion of the small intestine) versus ilium (the largest bone of the pelvis)
b. Example: Dysphagia (difficulty eating or swallowing) versus dysphasia (difficulty speaking)
2. Incorrect pronunciation of medical terms can lead to misdiagnosis or other serious medical errors.
Lecture Outline
D. Antonyms
1. Pairs of word roots, prefixes, or suffixes that have the opposite meaning of another word.
Lecture Outline
E. Synonyms
1. Pairs of word roots, prefixes, or suffixes that have the same or almost the same meaning.
a. Pneumonologist and pulmonologist both refer to the lung.
i. Pneumonologist simply has not gained acceptance.
Lecture Outline
III. Components of a Medical Term
A. When you encounter an unfamiliar word, break it up into its component parts.
1. If you know the meaning of each part, you can combine the definitions to determine the broader meaning of the word.
2. Medical terms are composed of distinct parts that perform specific functions:
Lecture Outline
a. Prefix: Portion that appears before the word root
b. Suffix: Portion that appears after the word root
c. Word root: Foundation of the term
d. Combining vowel: Vowel that links one or more word roots to another component of a term
3. The way in which the parts of a word are combined determines its meaning.
Lecture Outline
a. Changing or deleting any portion of a term can alter its content.
b. Accurate spelling is essential.
i. Hyperglycemia (too much blood glucose) versus hypoglycemia (too little blood glucose)
Lecture Outline
B. Prefixes
1. Common in general language (autopilot, submarine, tricycle) and medical and scientific terminology
2. Appear at the beginning of a word and generally describe the location or intensity of a word root that follows
3. Change the meaning of a medical term by describing the what, how, why, or when of the word root
a. Cutaneous means skin.
b. Add the prefix sub, and it means “below the skin.”
Lecture Outline
4. Learn to recognize a few commonly used medical prefixes.
a. Prefix hypo- (low) plus word root volumen (volume) plus suffix -emia (blood)
i. Hypovolemia = low blood volume
b. Prefix hypo- plus word root glyc/o (glucose) plus suffix -emia
i. Hypoglycemia = low blood glucose
Lecture Outline
C. Numerical prefixes
1. Used to indicate:
a. Number of sides, limbs, or sensory organs affected (eg, “monocular vision”)
b. Time (eg, octogenarian—a person between 80 and 89 years of age)
Lecture Outline
D. Suffixes
1. Components added to the ends of word roots that change or add to the word’s meaning or provide further definition
2. In medical terminology, a suffix usually specifies a procedure, condition, disease, or part of speech.
a. -ase indicates an enzyme
b. lip- (fat) plus -ase = lipase (an enzyme that digests fats)
3. Suffixes are able to change the medical term to a noun or adjective as needed.
Lecture Outline
E. Word roots
1. Main part of word (sometimes called the root word)
a. Establishes the essential meaning of the word
b. Frequently indicates a body part
Lecture Outline
2. Prefixes are added to the beginnings of a word roots.
3. Suffixes are added to the ends.
4. Changing the prefix or suffix will change the meaning of the term.
5. Consider the context of a word before assigning its meaning.
a. The same word root may have different meanings in different fields of study.
Lecture Outline
F. Colors
1. Several word roots describe color.
Lecture Outline
G. Combining forms and vowels
1. Some word roots, prefixes, and suffixes cannot combine with other word forms without help.
2. Sometimes it’s necessary to change the last letter or last few letters of a word root or a prefix to ease pronunciation when a suffix is added.
a. Combining vowels facilitates the formation of new, more complex terms.
b. Often consist of an o added to a word root
Lecture Outline
3. Combining form: Word root, prefix, or suffix with an added vowel (combining vowel)
a. Example: Osteopathic
i. Word root is osteon
ii. Oste/o + pathic
iii. Bone + disease
b. Example: Gastromegaly
i. Word root is gastr-
ii. Gastr/o + megaly
iii. Stomach + irregular enlargement
Lecture Outline
4. If the suffix begins with a vowel, a combining vowel is not needed.
a. Gastr- + -ic = gastric
Lecture Outline
5. Follow these guidelines when adding combining vowels to word roots:
a. Use a combining vowel before a suffix that begins with a consonant (eg, cyt/o + logy).
b. Use a combining vowel to join other word roots (eg, gastr/o/enteritis).
c. Do not use a combining vowel before a suffix that begins with a vowel (eg, gastritis, not gastroitis).
Lecture Outline
6. Common combining forms and vowels:
a. cardi/o + logy = cardiology (study of the heart)
b. neur/o + logy = neurology (study of the nervous system)
Lecture Outline
IV. Compound Words
A. Compound words contain more than one word root.
1. Each word root retains its basic meaning.
2. Simple examples containing two word roots:
a. Electrocardiogram
b. Thermometer
3. More complicated:
a. Osteoarthritis
b. Ost (bone) + arthr- (means joint or joints) + -itis (means inflammation)
c. Osteoarthritis means inflammation of the bone joints.
Lecture Outline
V. Plural Endings
A. To change a term from singular to plural form, certain rules apply.
1. Sometimes you can simply add an s (lung becomes lungs), but some rules are more complicated.
2. Singular words that end in -a change to -ae when plural.
a. Example: Vertebra becomes vertebrae.
3. Singular words that end in -is change to -es when plural.
a. Example: Diagnosis becomes diagnoses.
4. Singular words that end in -ex or -ix change to -ices.
a. Example: Apex becomes apices.
5. Singular words that end in -on or -um change to -a.
a. Examples: Ganglion becomes ganglia; ovum becomes ova.
6. Singular words that end in -us change to –i.
a. Example: Bronchus becomes bronchi.
Lecture Outline
VI. Topographic Anatomy
A. Superficial landmarks of the body that serve as guides to the structures that lie beneath them
1. Taken together, these features make up the body’s topography.
2. Familiarize yourself with these landmarks to perform a thorough assessment.
Lecture Outline
3. Imagine the body in the anatomic position to describe topography accurately.
a. Person is standing, facing you, arms at his/her sides, with palms facing forward, thumbs point away from the body.
b. The position is a shared reference point so the meaning of various directional terms stays constant, regardless of body position or movement.
Lecture Outline
B. Anatomic planes and axes of the body
1. Anatomic plane of the body: Imaginary flat surfaces dividing the body horizontally and vertically into sections
2. Axis: An imaginary line that divides the body equally and creates a point of rotation
Lecture Outline
3. Body can be divided along three main axes to create the following planes:
a. Coronal plane
i. Slices the body vertically, from ear to ear, dividing it into front (ventral) and back (dorsal) portions
ii. Also called the frontal plane
iii. “Corona” means head
b. Transverse plane
i. Passes horizontally through the body at the waist, creating top and bottom portions
ii. Also called the axial plane
c. Sagittal (lateral) plane
i. Divides body vertically, slicing it from front to back
ii. Also called the lateral plane
iii. “Sagitta” is Latin for arrow
iv. Midsagittal plane (midline): Divides the body into equal left and right halves
(a) Your nose and navel are found along this imaginary line.
Lecture Outline
4. The three axes along which the body can be divided are:
a. Anteroposterior axis: Runs perpendicular to the coronal plane
b. Longitudinal axis: Runs perpendicular to the transverse plane
c. Horizontal axis: Also called the mediolateral axis, runs perpendicular to the sagittal plane
Lecture Outline
5. These planes and axes help to:
a. Identify the location of internal structures.
b. Understand the relationships between and among the organs.
6. Cross section: Slicing across an object, perpendicular to its long axis, as you would do if you wanted to count the rings in a tree trunk
7. Longitudinal section: A view of an object cut along its long axis
a. Accomplished with a camera or a beam of radiation
Lecture Outline
C. Specific areas of the body
1. Many body areas have specific names.
2. Familiarizing yourself with the body regions will help you to:
a. Help you communicate with other professionals
b. Break down other terms
Lecture Outline
i. Example: Sternocleidomastoid: A combination of sterno-, cleido-, and -mastoid, which refers to the sternum, clavicle, and mastoid process
ii. If you understand the roots, you will be able to locate the origin and insertion of this large neck muscle.
This table shows terminology associated with specific body regions.
This table shows terminology associated with specific body regions.
Lecture Outline
D. Body cavities
1. The human body’s cavities contain various organs and other structures.
2. These cavities can be grouped into two categories: dorsal (posterior) and ventral (anterior).
Lecture Outline
a. Dorsal cavities (posterior)
i. Cranial cavity: Contains the brain
ii. Spinal cavity: Surrounds the spinal cord
Lecture Outline
b. Ventral cavities (anterior)
i. Thoracic cavity: Encloses the heart, lungs, and great vessels
ii. Abdominal cavity: Holds several digestive and endocrine organs
iii. Pelvic cavity: Contains digestive organs and female reproductive organs
3. The abdominal and pelvic cavities can be referred to together as the abdominopelvic cavity.
4. The retroperitoneal cavity is separate from and lies posterior to the abdominal cavity and contains different organs, most notably the kidneys.
This figure shows the body cavities.
Lecture Outline
E. Directional terms
1. Describe relative positions of body parts and imaginary anatomic divisions
2. Use the correct directional terms to describe the location of pain or injury.
This figure shows common directional terms.
Lecture Outline
3. Directional terms in medicine tend to occur in pairs because every direction has an opposite:
- superior and inferior
- lateral and medical
- proximal and distal
- superficial and deep
- anterior and posterior
- palmar and plantar
- apex
Lecture Outline
4. Superior and inferior
a. Superior part of any body part is the portion closest to the head.
b. The part closest to the feet is the inferior portion.
c. Also used to describe the relationship of one structure to another
i. Example: The knee is superior to the foot and inferior to the pelvis.
Lecture Outline
5. Lateral and medial
a. Parts of the body that lie farther from the midline are described as lateral (outer).
b. The parts that lie closer to the midline are described as medial (inner).
i. Example: The knee has medial (inner) and lateral (outer) aspects (surfaces).
Lecture Outline
6. Proximal and distal
a. Proximal describes structures that are closer to the body (eg, a fracture of the proximal humerus would involve the end of the bone that is closest to the shoulder).
b. Distal indicates structures that are farther from the trunk or nearer to the free end of the extremity (eg, a fracture of the distal humerus is one that involves the end of the bone farther from the body [adjacent to the elbow]).
i. Use these terms to describe the relationship of one structure to another (eg, the elbow is distal to the shoulder and proximal to the wrist and hand).
Lecture Outline
7. Superficial and deep
a. Superficial means closer to or on the surface of the skin.
b. Deep means farther inside the body and away from the skin.
Lecture Outline
8. Anterior and posterior
a. Anterior (or ventral) refers to the belly side of the body.
b. Posterior (or dorsal) refers to the spinal side of the body, including the back of the hand.
c. In human medicine, use “anterior” and “posterior”; ventral and dorsal are used in other sciences.
Lecture Outline
9. Palmar and plantar
a. The front region of the hand is referred to as the palm or palmar (or volar) surface.
b. The bottom of the foot is referred to as the plantar (or volar) surface.
Lecture Outline
10. Apex
a. The apex (plural apices) is the tip(s) of a structure.
i. Example: The apex of the heart is the bottom (inferior portion) of the ventricles in the left side of the chest.
Lecture Outline
F. Movement and positional terms
1. All movement can be broken down into simple components and described with specific terms.
2. An accepted set of terms describes body movement.
a. Particularly useful in explaining mechanism of injury
3. Range of motion: The full distance that a joint can be moved
Lecture Outline
a. Flexion: Moving the distal point of an extremity toward the trunk while in the anatomic position
i. Examples: Flexion of the elbow brings the hand closer to the shoulder, flexion of the knee brings the foot up to the buttocks.
b. Dorsiflexion: Movement of the foot toward the dorsal aspect
c. Plantar flexion: Movement of the foot toward the sole
d. Extension: The return of a body part from a flexed position to the anatomic position
e. Abduction is movement away from the midline.
f. Adduction is movement toward the midline.
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4. A patient’s neck can be in one of several positions when the patient is lying supine.
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5. The prefix hyper- is added to the terms flexion or extension to indicate mechanism of injury.
a. Hyper: Indicates normal range of motion for the particular joint was maximized or exceeded
b. Hyperflexion: Maximum flexion or flexion beyond the normal range of motion
i. Example of injury: A hyperflexion injury of the back can occur while bending.
c. Hyperextension: Maximum extension or extension beyond the normal range of motion
i. Example: Injury that occurs when a person falls on an outstretched hand, resulting in a distal radius fracture
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6. Wrist injuries can also be described using the terms supination and pronation.
a. Supination: Turning the palms upward (toward the sky)
b. Pronation: Turning the palms downward (toward the ground)
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7. Rotational deformities
a. Internal rotation: Turning the anterior portion of an extremity toward the midline
b. External rotation: Turning an extremity away from the midline
i. Rotational deformities are noted when comparing an injured extremity to an uninjured extremity.
ii. Hips can be dislocated anteriorly or posteriorly.
iii. The term rotation can also be applied to the spine.
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G. Other directional terms
1. Bilateral: A body part or condition that appears on both sides of the midline
a. Eyes, ears, hands, feet
b. Structures inside the body also appear on both sides of the midline (lungs and kidneys).
2. Unilateral: Something that appears on only one side of the body
a. Example: The spleen is only on the left side of the body.
3. Unilateral and bilateral can also describe the location of pain, numbness, itching, or other phenomena.
4. Ipsilateral: Refers to the same side of the body
5. Contralateral: Refers to the opposite side of the body
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6. You must be able to describe the exact location of areas of the abdomen.
a. The abdominal cavity is divided into four equal quadrants.
i. Right upper quadrant (RUQ)
ii. Left upper quadrant (LUQ)
iii. Right lower quadrant (RLQ)
iv. Left lower quadrant (LLQ)
b. The quadrants are formed from two lines intersecting at the umbilicus.
c. Again, right and left refer to the patient’s right and left, not yours.
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d. To describe location even more specifically, the abdomen can also be divided into nine regions.
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H. Prefixes indicating position, direction, and location
1. Specialized prefixes are used to specify position, direction, or location.
a. These terms can describe:
i. Movement of the body or something within it (eg, a blood clot or tumor metastasis)
ii. Location of an organ, foreign body, or mass
iii. Surgical procedures and the medical instrument used to perform them
iv. Direction of radiation or ultrasound waves
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I. Position of the patient
1. Use specific terms to describe the patient’s position.
a. Prone: Lying face down
b. Supine: Lying face up
c. Fowler position: Patient is sitting straight up, with the knees either bent or straight
d. Semi-Fowler position: Patient sits at a 45° angle; generally a position of comfort for those who do not need spinal immobilization
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2. Recovery position: Helps maintain a clear airway in an unresponsive patient and prevents aspiration of vomitus
a. Patient is lying on his or her left side, with the head resting on the bottom arm. The top knee is bent, angling the front of the patient’s body slightly toward the floor or ground.
b. Also referred to as left lateral recumbent position
This figure shows the anatomic positions.
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VII. Abbreviations, Acronyms, and Symbols
A. Medical abbreviations, acronyms, and symbols are a type of shorthand used to communicate in the medical world.
1. Developed to allow us to communicate faster
a. Do not to trade speed for accuracy.
b. Use only commonly understood acronyms and abbreviations to minimize misinterpretations and errors.
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2. All acronyms are abbreviations, but not all abbreviations are acronyms.
3. When you use an abbreviation, pronounce each letter of the abbreviation separately and distinctly.
a. For the abbreviation EMT, say “E–M–T.”
4. Acronyms form shortened words from the initials of several words to produce a new word or phrase.
a. Example: “Urban Search and Rescue” becomes USAR (pronounced “U-sar”).
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5. An abbreviation is still considered an acronym if it’s pronounced as a word, even if the word formed isn’t part of the English language.
a. Example: HIPAA (“Health Insurance Portability and Accountability Act”) is an acronym because it’s pronounced as “hippa.”
b. Example: DEA is not an acronym because it’s spelled out like “D-E-A.”
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B. Medical abbreviations
1. Abbreviations take the place of words to shorten documentation.
2. Some acronyms have become a common part of the English language.
a. Example: ASAP for “as soon as possible”
3. Ensure that the medical abbreviations you use are consistent with those approved in your EMS system.
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C. Error-prone abbreviations
1. The Joint Commission and the Institute for Safe Medication Practices (ISMP) have each published “do not use” lists.
2. Serious errors can occur when an abbreviation is not interpreted as intended.
a. HS on a prescription can mean either “hours of sleep” or “half strength.”
3. To avoid errors, some agencies limit use of abbreviations or do not allow their use.
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4. Trailing zeros and naked decimals
a. Trailing zeros: Zeros after the decimal point
i. To avoid errors, always include a zero before the decimal, but leave it off after.
ii. Write “5 mg” not “5.0 mg” and “0.5 mg” not “.5 mg”
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D. Symbols
1. Like abbreviations, symbols are sometimes used as a shortcut in documentation and other communication.
2. As with abbreviations, it is important to only use symbols that are widely understood and accepted.
a. Symbols that are easily confused:
i. > or < may be mistaken for the number 7, the letter L, or each other.
ii. µ may be mistaken for mg.
b. Spell out symbols that may be misinterpreted.
3. To protect patients’ safety, The Joint Commission requires every hospital to issue a list of approved abbreviations.
a. Certain abbreviations are prohibited (eg, “µm” for micrograms).
b. Each EMS system should also keep a list of approved medical abbreviations available for reporting and documentation purposes.
c. Learn which abbreviations are acceptable in your service area.
d. When in doubt, write out the term in full.
This table shows common symbols.
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VIII. Medical Terminology Related to Pharmacology
A. A paramedic must be familiar with terminology related to medications and medication administration, such as:
1. Prefixes commonly used in medication administration
2. Metric conversions used in drug calculation
3. Selected medical abbreviations associated with pharmacology
IX. Master Tables
A. Tables 7-15 through 7-18 provide reference lists of selected prefixes, suffixes, word roots and combining forms, and common abbreviations.
These tables show prefixes commonly used in medication administration and metric conversions used in drug calculation.
This table shows selected medical abbreviations associated with pharmacology.
