Description #
VCH Perioperative Program – clinical program. Review of anatomical locations and regions, body/joint movements and medical terminology.
Learning Objectives #
At the end of the session the nurse will be:
1. Prepared with information that will relate to the surgical specialty lecture topics to follow
Medical Terminology #
In order to decipher the words you will see describing the surgical procedures scheduled for the day (on the operative slate) or a patient’s diagnosis – it is useful to review some basic medical terminology. This section will not be a comprehensive terminology course, but rather a refresher tool to help understand the types of surgical procedures that you may be involved in. In the future, it will enable you to look at the surgical procedure and have a clue to what to expect. For example:
- What anatomical organ is involved
- How extensive the surgical procedure may be (i.e. is it a biopsy or a full resection)
- What position the patient may be placed in to be able access the region being worked on
- What type of equipment, supplies or instruments may be required
- If a specimen will be obtained
Most medical terms are derived from Latin or Greek origins. Medical terms are made up of a combination of the following:
- Prefix – placed at the beginning of a word. Changing the prefix can change the meaning of the word root.
- Word root – the word root is the main part of the word, the reference
- Combining form – is a vowel attached to the word root (usually an “O”). The combining form makes a word easier to pronounce and usually appears to be part of the word root
- Suffix – attached to the end of a word. Changing the suffix can change the meaning of the word root.
Examples:
- Prefix: Hyper (means excessive) + word root: therm (means heat) + suffix: ia (means condition) = hyperthermia (condition of heat excess). Changing the prefix to hypo (meaning deficient) can change the word to mean condition of deficient heat = hypothermia
- Gastroscopy = word root: gastr (meaning stomach + suffix: scopy (meaning inspection) = inspection of the stomach. Gastrscopy would be a difficult word to pronounce, so a combining form (an “o”) is added (gastr/o/scopy) to smooth out pronunciation.
The following is not a comprehensive listing of prefixes, word roots and suffixes, but rather the most common examples that you may encounter. Each future body systems lecture will include the most common surgical procedures – the tables below will assist you in identifying what the surgery will involve.
Prefixes #
Some common prefixes are:
Word Roots #
The following are some common word roots you will encounter in the perioperative area.
Suffixes #
Common descriptive suffixes include:
–al = pertaining to
–genesis = formation of
–gram = written record, graph
–ia = derived from, relating to, belonging to, disease
–ic = pertaining to
–ium = plural
–on = plural
–ous = pertaining to
–tion = result of
Most of the following are common diagnostic or procedural suffixes:
Anatomical Locations and Regions #
Anatomical Position #
It is useful learn some basic terms of direction in order to identify the structures of the body. The terms are applied to the body when it is in the anatomical position; which means that the body is standing erect, eyes looking forward, arms at the sides of the body, and the palms and toes are directed forward.
Anatomical Locations and Regions #
Anatomical Position #
It is useful learn some basic terms of direction in order to identify the structures of the body. The terms are applied to the body when it is in the anatomical position; which means that the body is standing erect, eyes looking forward, arms at the sides of the body, and the palms and toes are directed forward.
Superior/ Inferior – The top of the human body is the head is its superior point. The soles of the feet are the most inferior point of the body. In terms of direction one would say that the heart is superior to the stomach because it is closer to the head. The neck is inferior to the head and the stomach is inferior to the heart. The terms cephalic and cranial are sometimes used instead of the word superior. In human anatomy, the term caudal (towards the tail) is sometimes used instead of the word inferior.
Anterior/ Posterior – The (abdominal) surface of the body is anterior or ventral. The stomach is anterior to the vertebral column. The back surface of the body is posterior or dorsal. The vertebral column is posterior to the stomach.
Medial/ Lateral – The body axis is an imaginary line extending from the center or the top of the head to the groin – this is called the midline. A structure is said to be medial if it is closer to the midline of the body than to another structure. The umbilicus is medial to the hip bone. A structure is lateral if it is toward one side of the body away from the midline. The hip bone is lateral to the umbilicus.
Proximal/ Distal – When a structure is closer to the body’s midline or point of attachment to the torso, it is described as proximal. This term is used especially in locating structures in the extremities. The wrist is proximal to the fingers. Distal means farther from the midline or point of attachment to the torso. The fingers are distal to the wrist.
Superficial/ Deep – Structures located toward the surface of the body are superficial. Blood vessels in the skin are superficial to those lying beneath in the muscle. Structures located farther inward (away from the body surface) are deep. Blood vessels in the muscle are deep to those in the skin.
Body Regions #
The body may be subdivided into an axial portion consisting of the head, neck and trunk/ torso (consisting of the thorax, abdomen and vertebral bodies), and the appendicular portion consists of the pelvis and limbs/ extremities.
Some regions of the body are further divided, for example, we are all familiar with the basic regions of the abdomen – the right and left upper quadrants, and the right and left lower quadrants.
Having an understanding of anatomical direction and the regions of the body will assist you when you are reading about the different body systems and the surgeries that are involved. If one can understand the location of various organs in relation to one another, it provides a sense of their location and what type of instruments might be required (i.e. Is the organ deep? Do I need longer instruments?). The surgeon may also ask you or the assistant to assist in a manner that involves direction (i.e to hold an instrument, such as a retractor, more distally than where they are cutting).
Body Movements #
Each joint of the body has a range of motion (ROM). Full ROM is the greatest degree of motion to which each joint is normally capable. Normal range of motion for a patient is that movement in which the joint can move without pain within the limits of full or partial ROM. ROM is often measured in degrees from a neutral position.
Terms used to describe the body’s range of motion include:
Axial Skeleton #
The following are pictures of the joints of the axial skeleton and their normal ROM:
Movements of the Head/Neck #
Movements of the Spine (vertebral bodies) #
Appendicular Skeleton #
The following are pictures of the joints of the appendicular skeleton and their normal ROM:
Movements of the Shoulder #
Movements of the Elbow #
Movements of the Fingers (metacarpophalangeal joints) #
Movements of the Hip #
Movements of the Knee #
Why is it important to know the ROM of different joints? #
To know how to:
- position the patient comfortably and in proper body alignment (see PN 004)
- assist the surgeon – you may be asked to turn an extremity in a certain way (i.e. during total joint replacement of the hip – “turn the leg in external rotation” or postoperatively the hip should be placed in abduction)
- hold a limb for skin prep (see PN 005)
- position the patient postoperatively in order to prevent surgical complications (i.e. after total hip replacement, place legs – hips – in abduction; to prevent dislocation of hip joint)