Definition of a Root Word III

N
nas/o nose
nat/o birth
necr/o death
nephr/o kidney
neur/o nerve
noct/i night
O
ocul/o eye
olig/o few
omphal/o navel
onc/o tumor
onych/o nail
oophor/o ovary
ophthalm/o eye
opt/o vision
orchid/o testicle
orch/o testicle
organ/o organ
or/o mouth
orth/o straight
oste/o bone
ot/o ear
ox/i oxygen
P
pachy/o thick
palat/o palate
pancreat/o pancreas
par/o labor
patell/o patella
path/o disease
pelv/i pelvis
perine/o peritoneum
petr/o stone
phalang/o pharynx
phas/o speech
phleb/o vein
phot/o light
phren/o mind
plasm/o plasma
pleur/o pleura
pneumon/o lung
poli/o gray matter
polyp/o small growth
poster/o posterior
prim/i first
proct/o rectum
proxim/o proximal
pseud/o fake
psych/o mind
pub/o pubis
puerper/o childbirth
pulmon/o lung
pupill/o pupil
pyel/o renal pelvis
pylor/o pylorus
py/o pus
Q
quadr/i four
R
rachi/o spinal
radic/o nerve
radi/o radius
rect/o rectum
ren/o kidney
retin/o retina
rhabd/o striated
rhytid/o wrinkles
rhiz/o nerve
S
sacr/o sacrum
scapul/o scapula
scler/o sclera
scoli/o curved
seb/o sebum
sept/o septum
sial/o saliva
sinus/o sinus
somat/o body
son/o sound
spermat/o sperm
spir/o breathe
splen/o spleen
spondyl/o vertebra
staped/o stapes
staphyl/o clusters
stern/o sternum
steth/o chest
stomat/o mouth
strept/o chain-like
super/o superior
synovi/o synovia
T
tars/o tarsal
ten/o tendon
test/o testicle
therm/o heat
thorac/o thorax
thromb/o clot
thym/o thymus
thyroid/o thyroid gland
tibi/o tibia
tom/o pressure
tonsill/o tonsils
toxic/o poison
trachel/o trachea
trich/o hair
tympan/o eardrum
U
uln/o ulna
ungu/o nail
ureter/o ureter
urethr/o urethra
ur/o urine
uter/o uterus
uvul/o uvula
V
vagin/o vagina
valv/o valve
vas/o vessel
ven/o vein
ventricul/o ventricle
ventro/o frontal
vertebr/o vertebra
vesic/o bladder
vesicul/o seminal vesicle

Definition of a Root Word II

F
femor/o femur
fet/i fetus
fet/o fetus
fibr/o fibrous tissue
fibul/o fibula
G
ganglion/o ganglion
gastr/o stomach
gingiv/o gum
glomerul/o glomerulus
gloss/o tongue
glyc/o sugar
gnos/o knowledge
gravid/o pregnancy
gynec/o woman
H
hem/o blood
hepat/o liver
herni/o hernia
heter/o other
hidr/o sweat
hist/o tissue
humer/o humerus
hydr/o water
hymen/o hymen
hyster/o uterus
I
ile/o ileum
ili/o ilium
irid/o iris
iri/o iris
ischi/o ischium
ischo/o blockage
J
jejun/o jejunum
K
kal/i potassium
kary/o nucleus
kerat/o hard
kinesi/o motion
kyph/o hump
L
lacrim/o tear duct
lact/o milk
lamin/o lamina
lapar/o abdomen
later/o lateral
lei/o smooth
leuk/o white
lingu/o tongue
lip/o fat
lith/o stone
lob/o lob/o
lord/o flexed forward
lumb/o lumbar
lymph/o lymph
M
mamm/o breast
mandibul/o mandible
mast/o breast
mastoid/o mastoid
maxill/o maxilla
meat/o opening
melan/o black
mening/o meninges
menisc/o meniscus
men/o menstruation
ment/o mind
metr/i uterus
metr/o uterus
mon/o one
muc/o mucus
myc/o fungus
myel/o spinal cord
my/o muscle

Definition of a Root Word I

A
abdomin/o abdomen
acou/o hearing
aden/o gland
adenoid/o adenoids
adren/o adrenal gland
alveol/o alveolus
amni/o amnion
andro/o male
angi/o vessel
ankly/o stiff
anter/o frontal
an/o anus
aponeur/o aponeurosis
appendic/o appendix
arche/o beginning
arteri/o artery
atri/o atrium
aur/i ear
aur/o ear
aut/o self
B
bacteri/o bacteria
balan/o glans penis
bi/o life
blephar/o eyelid
bronch/i bronchus
bronch/o bronchus
C
calc/i calcium
cancer/o cancer
carcin/o cancer
cardi/o heart
carp/o carpals
caud/o tail
cec/o cecum
celi/o abdomen
cephal/o head
cerebell/o cerebellum
cerebr/o cerebrum
cervic/o cervix
cheil/o lip
cholangi/o bile duct
chol/e gall
chondro/o cartilage
chori/o chorion
chrom/o color
clavic/o clavicle
col/o colon
colp/o vagina
core/o pupil
corne/o cornea
coron/o heart
cortic/o cortex
cor/o pupil
cost/o rib
crani/o cranium
cry/o cold
cutane/o skin
cyes/i pregnancy
cyst/o bladder
D
dacry/o tear
dermat/o skin
diaphragmat/o diaphragm
dipl/o double
dips/o thirst
dist/o distal
diverticul/o diverticulum
dors/o back
duoden/o duodenum
dur/o dura
E
ech/o sound
electr/o electricity
embry/o embryo
encephal/o brain
endocrin/o endocrine
enter/o intestine
epididym/o epididymis
epiglott/o epiglottis
episi/o vulva
epitheli/o epithelium
erythr/o red
esophag/o esophagus
esthesi/o sensation

Prefixes

an- without
ante- before
bi- two
brady- slow
dia- through
dys- difficult
endo- within
epi- over
eu- normal
exo- outward
hemi- half
hyper- excessive
hypo- deficient
inter- between
intra- within
meta- change
multi- numerous
nulli- none
pan- total
para- beyond
per- through
peri- surrounding
post- after
pre- before
pro- before
sub- below
supra- superior
sym- join
syn- join
tachy- rapid
tetra- four
trans- through

Suffixes

-al pertaining to
-algia pain
-apheresis removal
-ary pertaining to
-asthenia weakness
-capnia carbon dioxide
-cele hernia
-clasia break
-clasis break
-crit separate
-cyte cell
-desis fusion
-drome run
-eal pertaining to
-ectasis expansion
-ectomy removal
-esis condition
-genesis cause
-genic pertaining to
-gram record
-graph recording device
-ial pertaining to
-iasis condition
-iatrist physician
-iatry specialty
-ic pertaining to
-ician one that
-ictal attack
-ior pertaining to
-ism condition of
-itis inflammation
-lysis separating
-malacia softening
-meter measure
-odynia pain
-oid resembling
-ology study
-oma tumor
-opia vision
-opsy view of
-orrhaphy repairing
-orrhea flow
-osis condition
-otomy cut into
-oxia oxygen
-paresis partial paralysis
-pathy disease
-pepsia digestion
-pexy suspension
-phagia swallowing, eating
-phobia excessive fear of
-phonia sound, voice
-physis growth
-plasia development
-plasm a growth
-plegia paralysis
-pnea breathing
-poiesis formation
-ptosis sagging
-salpinx fallopian tube
-sacoma malignant tumor
-schisis crack
-sclerosis hardening
-stasis standing
-stenosis narrowing
-thorax chest
-tocia labor, birth
-tome cutting device
-trophy develop
-uria urine

Dermatology Review

Atopic Dermatitis: Scaling, Itching, Redness and Excoriation. Possible lichenification in chronic cases. Most common in young children around the elbow and knees. Adults are more common in neck and knees. May be associated with an allergic disorder, hay fever, or asthma.

Contact Dermatitis: Itchy, weepy reaction with a foreign substance (Poison Ivy) or lotions. Skin becomes red.

Diaper Rash: Inflammatory reaction in the region covered by a diaper. This may include chemical allergies, sweat, yeast, or friction irritation.

Ermatitis stasis: Decreased blood flow the lower legs resulting in a skin irritation, possible ulcer formation.

Onychomycosis: Fungal infection related to the fingernails or toenails. Often caused by Trichophyton rubrum.

Lichen planus: Treated with topical corticosteroids. The presence of pink or purple spots on the legs and arms. Lesions are itchy, flat and polygonal. May cause hair loss.

Pityriasis rosea: A mild to moderate rash that starts as a single pink patch and then numerous patches begin to appear on the skin. This may lead to itching. Found primarily in ages 10-35 years old.

Psoriasis: An autoimmune disease mediated by T lymphocytes that can lead to arthritis. Generally, treated with UV light, tar soap and topical steroid cream. A reddish rash that can be found in numerous locations.

Stevens-Johnson syndrome: An allergic reaction that can include rashes, and involve the inside of the mouth. May be due to drug sensitivity. Can lead to uveitis and keratitis. Other factors related to SJS include: pneumonia, fever, myalgia and hepatitis. SJS can be extremely similar to varicella zoster and pemphigus vulgaris conditions. There may also be the presence of herpes virus or Mycoplasma pneumoniae.

Bullous pemphigoid: Eruptions of the skin caused by the accumulation of antibodies in the basement membrane of the skin. Treated with cortisone creams or internally. Skin biopsy offers definitive diagnosis.

Acne vulgaris: Oil glands become inflamed, plugged or red. May be treated in moderate to severe cases with anti-inflammatory medications or creams.

Rosacea: A redness that covers the middle part of the face. Blood vessels in the face dilate. Most common in adults 30-50 years old. Unable to be cured, only treated. May cause long term skin damage is left untreated. Antibiotics are often prescribed.

Seborrheic keratosis: The development of skin “tags” or the barnacles of old age. Usually found in people over 30 years old. Appear to be tabs growing in groups or individually on your skin. Can be treated with Scrapping, Freezing or Electrosurgery.

Actinic keratosis: A site that can become cancerous, usually small and rough on the skin that has been exposed to the sun a lot. Usually treated with cryosurgery and photodynamic therapy.

Scabies: Caused by the human itch mite: Sarcaptes scabies, and identified by presence of raised, red bumps that are itchy. Closer identification with a visual aid will show streaks in the skin created by the mite.

Molluscum contagiosum: Considered a STD. Small downgrowths called molluscum bodies that include the presence of soft tumors in the skin caused by a virus. Contagious.

Herpes zoster: Infection caused by the varicella-zoster virus. Can cause chickenpox and then shingles in later years. The virus infects the dosal root ganglia of nerves and can cause intense itching.

St. Anthony’s Fire: Claviceps purpurea (fungus) can cause intense pain in the extremities by causing blood vessels to constrict. Fungus produces ergotamines.

Impetigo: A skin infection caused by Staph or Streptococcus that causes itchy, red skin and pustules. Treated with topical antibiotics and primarily affects children.

Acanthosis nigricans: The presence of dark velvety patches of skin around the armpit, back, neck and groin. Can occur with multiple diseases. Has been linked to patients with insulin dysfunction.

Hidradenitis suppurativa: The presence of numerous abscess in the groin and armpit region.

Melasma: “Mask of Pregnancy” Changes in the pigmentation of women that are pregnant. Occurs in 50% of all pregnancies.

Urticaria: Elevated itchy areas that are linked to allergic reactions. May be accompanied with edema and may blanch with touch. “Hives”

Vitiligo: Loss of melanocytes resulting in skin turning white. Hair in regions affected will also turn white. Primarily identified in ages 10-30. Several genetic factors involved. May be associated with other more severe autoimmune disorders.

Disorder of the Ears

Otitis media: Most common caused by the bacteria (H.flu) and Streptococcus pneumoniae in about 85% of cases. 15% of cases viral related. More common in bottlefeeding babies. Can be caused by upper respiratory infections. Ear drums can rupture in severe cases. A myringotomy may be performed in severe cases to relieve pus in the middle ear.

Barotitis: Atmospheric pressures causing middle ear dysfunction. Any change in altitude causes problems.

Mastoiditis: May be caused by an ear infection and is known as inflammation of the mastoid.

Meniere's disease: Inner ear disorder. Causes unknown. Episodic rotational vertigo, Tinnitus, Hearing loss, and Ringing in the ears are key symptoms. Dazide is the primary medication for Meniere’s disease. Low salt diet and surgery are also other treatment options. Diagnosis is a rule-out diagnosis.

Labyrinthitis: Vertigo associated with nausea and malaise. Related to bacterial and viral infections. Inflammation of the labyrinth in the inner ear.

Otitis externa: Usually caused by a bacterial infection. Swimmer’s ear. Infection of the skin with the outer ear canal that progress to the ear drum. Itching, Drainage and Pain are the key symptoms. Suctioning of the ear canal may be necessary. Most common ear drops (Volsol, Cipro, Cortisporin).

Disorder of the Eyes

Diabetic retinopathy: Blood vessels in the retina are affected. Can lead to blindness if untreated. Two primary stages (Proliferative and Nonproliferative. Retina may experience bleeding in nonproliferative stage. During the proliferative stage damage begins moving towards the center of the eye and there is an increase in bleeding. Any damage caused is non-reversible. Only further damage can be prevented.

Strabismus: Eyes are moving in different stages. The axes of the eyes are not parallel. Normally, treated with an eyepatch; however, eye drops are now used in many cases. Atropine drops are placed in the stronger eye for correction purposes. Surgery may be necessary in some cases. Suture surgery will reduce the pull of certain eye muscles.

Macular Degeneration: Impaired central vision caused by destruction of the macula, which is the center part of the retina. Limited vision straight ahead. More common in people over 60. Can be characterized as dry or wet types. Wet type more common. Vitamin C, Zinc, and Vitamin E may help slow progression.

Esotropia: Appearance of cross-eyed gaze or internal strabismus.

Exotropia: External strabismus or divergent gaze.

Conjunctivitis: Inflammation of the conjuctiva, that can be caused by viruses or bacteria. Also known as pink eye. If viral source can be highly contagious. Antibiotic eye drops and warm cloths to the eye helpful treatment. Conjunctivitis can also be caused by chemicals or allergic reactions. Re-occurring conjunctivitis can indicate a larger underlying disease process.

Glaucoma: An increase in fluid pressure in the eye leading to possible optic nerve damage. More common in African-Americans. Minimal onset symptoms, often picked to late. Certain drugs may decrease the amount of fluid entering the eye. Two major types of glaucoma are open-angle glaucoma and angle-closure glaucoma.

Disorders of the mouth

Acute pharyngitis: Often the cause of sore throats, inflammation of the pharynx.

Acute tonsillitis: Viral or Bacterial infection that causes inflammation of the tonsils.

Aphthous ulcer: Also known as a canker sore. A sensitive ulcer in the lining of the mouth. 1 in 5 people have these ulcers. Cause is unknown in many cases.

Acute Epiglottitis: Inflammation of the epiglotitis that may lead to blockage of the respiratory system and death if not treated. Often caused by numerous bacteria. Intubation may be required and speed is critical in treatment. IV antibiotics will help reverse this condition in most cases. Common symptoms are high fever and sore throat.

Oral candidiasis: This is a yeast infection of the throat and mouth by Candida albicans.

Oral leukoplakia: A patch or spot in the mouth that can become cancerous.

Parotitis: A feature of mumps and inflammation of the parotid glands.

Gastrointestinal Review

Zollinger-Ellison syndrome: Tumors of the pancreas that cause upper GI inflammation. The tumors secrete gastrin causing high levels of stomach acid.

Wilson’s disease: High levels of copper in various tissues throughout the body. (Genetically linked- Autosomal recessive). Kayser-Fleisher Rings in the eye (bluish rings aound the iris)

Pancreatitis: Inflammation of the pancreas

Pancreatic Cancer: cancer of the pancreas. Higher rates in men.

Hepatitis A: Viral infection that causes liver swelling.

Hepatitis B: Sexually transmitted disease, also transmitted with body fluids and some individual may be symptom free but still be carriers.

Hepatitis C: An inflammation of the liver caused by infection with the hepatitis C virus.

Gastritis: can be caused by various sources (bacteria, viruses, bile reflux or autoimmune diseases). Inflammation of the stomach lining.

Ulcers

Peptic Ulcers -ulcer in the duodenum or stomach

Gastric Ulcers - ulcer in the stomach (pain 30 to 60 minutes after a meal)

Duodenum Ulcer -ulcer in the duodenum (pain 30 to 60 minutes after a meal)

Bacteria: Helicobacter pylori- often associated with ulcer formation.

Diverticulitis – abnormal pouch formation that becomes inflamed in the intestinal wall.

Intestinal obstruction: Can a paralytic ileus/false obstruction (children) or a mechanical obstruction:

Carcinoid Syndrome: symptoms caused by carcinoid tumors. Linked to increased secretion of Serotonin.

Hiatal Hernia: Stomach sticks into the chest through the diaphragm. Can cause reflux symptoms.

(GERD) -Gastroesophageal reflux disease, a disorder in which there is recurrent return of stomach contents back up into the esophagus, frequently causing heartburn, a symptom of irritation of the esophagus by stomach acid.

Ulcerative colitis: chronic inflammation of the rectum and large intestine.

Leukemia Review

ALL- acute lymphocytic leukemia is a fast-growing cancer in which the body produces a large number of immature white blood cells (lymphocytes). These cells can be found in the blood, bone marrow, lymph nodes, spleen, and other organs. Most cases occur in children between ages 3 and 7.

AML- acute myelocytic leukemia is cancer that starts inside bone marrow, the soft tissue inside bones that helps form blood cells. The cancer grows from cells that would normally turn into white blood cells. It generally occurs around age 65.

CLL- chronic lymphocytic leukemia causes a slow increase in the number of B lymphocytes in the bone marrow. The cancerous cells spread from the blood marrow to the blood, and can also affect the lymph nodes and other organs. CLL causes the bone marrow to fail and weakens the immune system.

CML- chronic myeloid leukemia is a slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow.

Musculoskeletal Review

Legg-Calve-Perthes disease: poor blood supply to the superior aspect of the femur. Most common in boys ages 4-10. The femur ball flattens out and deteriorates. 4x higher incidence in boys + Bony cresent sign.

Developmental dysplasia of the hip: abnormal development of the hip joint found that is congenital.

Slipped capital femoral epiphysis: 2x greater incidence in males, most common hip disorder in adolescents. The ball of the femur separates from the femur along the epiphysis.

Polymyalgia Rheumatica- hip or shoulder pain disorder in people greater than 50 years old.

Systemic lupus erythemtosus: autoimmune disorder that affects joints, skin and various organ systems. Chronic and inflammatory. 9x more common in females. Butterfly rash

Scleroderma: connective tissue disease that is diffuse.

Rheumatoid Arthritis: inflammatory autoimmune disease that affects various tissues and joints.

Juvenile Rheumatoid Arthritis: inflammatory disease that occurs in children.

Paget’s disease: abnormal bone development that follows bone destruction. The disease is characterized by excessive breakdown of bone tissue, followed by abnormal bone formation. The new bone is structurally enlarged, but weakened and filled with new blood vessels.

Osteoarthritis: chronic condition affecting the joint cartilage that may result in bone spurs being formed in the joints. Morning stiffness

Gout: uric acid development in the joints causing arthritis.

Fibromyalgia: joint, muscle and soft tissue pain in numerous locations. Presence of tender points and soft tissue pain.

Duchenne muscular dystrophy: Genetically X-linked recessive type of muscular dystrophy that starts in the lower extremities. Dystrophin-protein dysfunction.

Ankylosing spondylitis: Vertebrae of the spine fuse. A type of arthritis that causes chronic inflammation of the spine and the sacroiliac joints. Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process called ankylosis. Ankylosis causes total loss of mobility of the spine.

Compartment syndrome: impaired blood flow and nerve dysfunction caused by nerve and blood vessel compression.

Osteosarcoma: bone tumor that is malignant and found in adolescents.

CNS Pharmacology

Sympathomimetics:

Dopamine

Dobutamine

Epinephrine

Norephinephrine

Isoproterenol

Cholinomimetics:

Carbachol

Neostigmine

Pyridostigmine

Echothiophate

Bethanechol

Cholinoreceptor blockers:

Hexamethonium-Nicotinic blocker

Atropine-Muscarinic blocker

Beta blockers:

Atenolol

Nadolol

Propranolol

Metoprolol

Pindolol

Labetalol

Tricyclic Antidepressants:

Doxepine

Imipramine

Amitriptyline

Nortriptyline

Amitriptyline

Parkinson’s Treatment:

L-dopa

Amantadine

Bromocriptine

Benzodiazepindes:

Iorazepam

Triazolam

Oxazepam

Diazepam

Opiod Analgesics:

Heroin

Methadone

Morphine

Codeine

Dextromethorphan

Meperidine

MAO Inhibitors:

Tranylcypromine

Phenelzine

Seroton specific Re-uptake inhibitors:

Paroxetine

Sertraline

Fluoxetine

Citalopram

Epilepsy Treatment:

Valproic acid

Phenobarbital

Benzodiazepines

Gabapentin

Ethosuximide

Carbamazepine

Barbiturates:

Pentobarbital

Thiopental

Phenobarbital

Secobarbital

IV Anethestics:

Midazolam

Ketamine

Morphine

Fentanyl

Propofol

Thiopental

Local Anesthetics:

Tetracaine

Procaine

Lidocaine

Neuroleptics (Antipsychotic drugs)

Chlorpromazine

Thioridazine

Clozapine

Fluphenazine

Haloperidol

Alpha 1 Selective blockers:

Terazosin

Prazosin

Doxazosin

Alpha 2 Selective blockers:

Yohimbine

Endocrine Condition

Hypothyroidism: Poor production of thyroid hormone: Hashimoto’s thyroiditis

Primary- Thyroid cannot meet the demands of the pituitary gland.

Secondary- No stimulation of the thyroid by the pituitary gland.

Hyperthyroidism: excessive production of thyroid hormone. Graves’ disease

Congenital adrenal hyperplasia: Excessive production of androgen and low levels of aldosterone and cortisol. (Geneticially inherited disorder). Different forms of this disorder that affect males and females differently.

Causes: Adrenal gland enzyme deficit causes cortisol and aldosterone to not be produced. Causing male sex characteristics to be expressed prematurely in boys and found in girls.

Primary/Secondary Hyperaldosteronism

Primary Hyperaldosteronism: problem within the adrenal gland causing excessive production of aldosterone.

Secondary Hyperaldosteronism: problem found elsewhere causing excessive production of aldosterone.

Cushing’s syndrome: Abnormal production of ACTH (adrenocoticotropic hormone) which in turn causes elevated cortisol levels.

Diabetic ketoacidosis: increased levels of ketones due to a lack of glucose.

Causes: Insufficient insulin causing ketone production which end up in the urine. More common in type I vs. type 2 DM.

T3/T4 Review

Both are stimulated by TSH release from the Pituitary gland

T4 control basal metabolic rate

T4 becomes T3 within cells. (T3) Active form.

T3 radioimmunoassay- Check T3 levels

Hyperthyroidism- T3 increased, T4 normal- (in many cases)

Medications that increase levels of T4:

Methadone

Oral contraceptives

Estrogen

Cloffibrate

Medications that decrease levels of T4:

Lithium

Propranolol

Interferon alpha

Anabolic steroids

Methiamazole

Lymphocytic thyroiditis: Hyperthyroidism leading to hypothyroidism and then normal levels.

Causes: Lymphocytes permeate the thyroid gland causing hyperthyroidism initially.

Graves’ disease: most commonly linked to hyperthyroidism, and is an autoimmune disease. Exophthalmos may be noted (protruding eyeballs). Excessive production of thyroid hormones.

Type I diabetes (Juvenile onset diabetes)

Causes: Poor insulin production from the beta cells of the pancreas. Excessive levels of glucose in the blood stream that cannot be used due to the lack of insulin. Moreover, the patient continues to experience hunger, due to the cells not getting the fuel that they need. After 7-10 years the beta cells are completely destroyed in many cases.

Type II diabetes

The body does not respond appropriately to the insulin that is present. Insulin resistance is present in Type II diabetes. Results in hyperglycemia.

Cardiovascular Conditions

Cardiogenic Shock: heart is unable to meet the demands of the body. This can be caused by conduction system failure or heart muscle dysfunction.

Aortic insufficiency: Heart valve disease that prevents the aortic valve from closing completely. Backflow of blood into the left ventricle.

Aortic aneurysm: Expansion of the blood vessel wall often identified in the thoracic region.

Hypovolemic shock: Poor blood volume prevents the heart from pumping enough blood to the body.

Cardiogenic shock: Enough blood is available, however the heart is unable to move the blood in an effective manner.

Myocarditis: inflammation of the heart muscle.

Heart valve infection: endocarditis (inflammation), probable valvular heart disease. Can be caused by fungi or bacteria.

Pericarditis: Inflammation of the pericardium.

Arrhythmias: Irregular heart beats and rhythms disorder

Arteriosclerosis: hardening of the arteries.

Cardiomyopathy: poor heart pumping and weakness of the myocardium. As greater amounts of blood fill and remain in the heart's lower chambers (ventricles), the ventricles expand. In time, the heart muscle stretches out of shape (dilates) and becomes even weaker

Types:

Alcoholic cardiomyopathy - due to alcohol consumption

Dilated cardiomyopathy - left ventricle enlargement

Hypertrophic cardiomyopathy - abnormal growth left ventricle

Ischemic cardiomyopathy - weakness of the myocardium due to heart attacks.

Peripartum cardiomyopathy - found in late pregnancy

Restrictive cardiomyopathy - limited filling of the heart due to inability to relax heart tissue.

Congestive Heart Failure:

Class I describes a patient who is not limited with normal physical activity by symptoms.

Class II occurs when ordinary physical activity results in fatigue, dyspnea, or other symptoms.

Class III is characterized by a marked limitation in normal physical activity.

Class IV is defined by symptoms at rest or with any physical activity.

Heart Sounds:

S1- tricuspid and mitral valve close

S2- pulmonary and aortic valve close

S3- ventricular filling complete

S4- elevated atrial pressure (atrial kick)

Wave Review

ST segment: ventricles depolarized

P wave: atrial depolarization

PR segment: AV node conduction

QRS complex: ventricular depolarization

U wave: hypokalemia creates a U wave

T wave: ventricular repolarization

Wave Review Indepth:

1. P WAVE - small upward wave; indicates atrial depolarization

2. QRS COMPLEX - initial downward deflection followed by large upright wave followed by small downward wave; represents ventricular depolarization; masks atrial repolarization; enlarged R portion - enlarged ventricles; enlarged Q portion - probable heart attack.

3. T WAVE - dome shaped wave; indicates ventricular repolarization; flat when insufficient oxygen; elevated with increased K levels

4. P - R INTERVAL - interval from beginning of P wave to R wave; represents conduction time from initial atrial excitation to initial ventricular excitation; good diagnostic tool; normally <>.

5. S-T SEGMENT - time from end of S to beginning to T wave; represents time between end of spreading impulse through ventricles and ventricular repolarization; elevated with heart attack; depressed when insufficient oxygen.

6. Q-T INTERVAL - time for singular depolarization and repolarization of the ventricles. Conduction problems, myocardial damage or congenital heart defects can prolong this.

Arrhythmias Review

Supraventricular Tachyarrhythmias

Atrial fibrillation – Abnormal QRS rhythm and poor P wave appearance. (>300bpm.)

Sinus Tachycardia - Elevated ventricular rhythum/rate.

Paroxysmal atrial tachycardia - Abnormal P wave, Normal QRS complex

Atrial flutter - Irregular P Wave development. (250-350 bpm.)

Paroxysmal supraventricular tachycardia- Elevated bpm (160-250)

Multifocal atrial tachycardia - bpm (>105). Various P wave appearances.

Ventricular Tachyarrhythmias

Ventricular Tachycardia - Presence of 3 or greater PVC’s (150-200bpm), possible abrupt onset. Possibly due to an ischemic ventricle. No P waves present.

(PVC)- Premature Ventricular Contraction - In many cases no P wave followed by a large QRS complex that is premature, followed by a compensatory pause.

Ventricular fibrillation - Completely abnormal ventricular rate and rhythm requiring emergency innervention. No effective cardiac output.

Bradyarrhythmias

AV block (primary, secondary (I,II) Tertiary

Primary - >.02 PR interval

Secondary (Mobitz I) – PR interval Increase

Secondary (Mobitz II) – PR interval (no change)

Tertiary - most severe, No signal between ventricles and atria noted on ECG. Probable use of Atrophine indicated. Pacemaker required.

Right Bundle Branch Block (RBBB)/Left Bundle Branch Block (LBBB)

Sinus Bradycardia - <60>

Cardiac Failure Review

Right Sided Heart Failure

A. Right Upper Quadrant Pain

B. Right Ventricular heave

C. Tricuspid Murmur

D. Weight gain

E. Nausea

F. Elevated Right Atrial pressure

G. Elevated Central Venous pressure

H. Peripheral edema

I. Ascites

J. Anorexia

K. Hepatomegaly

Left Sided Heart Failure

A. Left Ventricular Heave

B. Confusion

C. Paroxysmal noturnal dyspnea

D. DOE

E. Fatigue

F. S₃ gallop

G. Crackles

H. Tachycardia

I. Cough

J. Mitral Murmur

K. Diaphoresis

L. Orthopnea

ECG Changes with MI

T Wave inversion

ST Segment Elevation

Abnormal Q waves

ECG Changes with Digitalis

Inverts T wave

QT segment shorter

ECG Changes with MI

T Wave inversion

ST Segment Elevation

Abnormal Q waves

ECG Changes with Digitalis

Inverts T wave

QT segment shorter

ECG Changes with Potassium

Hyperkalemia- Lowers P wave, Increases width of QRS complex

Hypokalemia- Lowers T wave, causes a U wave

ECG Changes with Calcium

Hypercalcemia-Makes a longer QRS segment

Hypocalcemia- Increases time of QT interval