Medical Terminology

Knowledge of medical terminology is extremely important as a healthcare professional. For this reason,
you will continually be exposed to medical terms throughout all of the health science classes. First, you
will learn the word elements. Later, you will learn how to properly use and understand these elements
as they become medical terms.

Word elements are parts that are used to form medical terms. This includes the word root, prefix, suffix,
combining vowel, and combining form (word root and combining vowel together).

Word Root

The word root is the body or main element of a word. Some examples are:

Word Root Meaning

cardi heart
pulmon lung
path disease
nephr kidney

The word root is the foundation of the medical term and the meaning. In some cases, a medical term
may contain two or more-word roots.

Prefix

A prefix is the part of a word that comes before the word root. Some examples are:

Prefix Meaning
a- without; absent
dia- through
endo- within
micro- small

A prefix changes the word root’s meaning. It cannot be used alone as a medical term and always
requires that it be attached to a root word. When presented by itself as a word element, a hyphen is
used at the end of the prefix (example: sub-) to indicate that it cannot stand alone. Not all medical terms
contain a prefix.

Suffix

A suffix is the part of a word that is added after the word root. Some examples are:

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 Suffix Meaning
plasty- operative revision
-stomy new opening
-y process condition
-phobia fear

A suffix alters the meaning of the word root. When presented by itself as a word element, a hyphen is
used at the beginning of the suffix (example: -gram) to indicate that it cannot stand alone. Almost all
medical terms have a suffix, but there are a few exceptions (example: erythrocyte- red blood cell).

Combining Vowel

A combining vowel is a letter used to combine two-word roots or a word root and a suffix; it is usually an
“o”. It is important to note that there are some exceptions in which an “I” or “e” may be used as the
combining vowel instead. The combining vowel’s purpose is to make the word easier to pronounce and
does not impact the meaning of the word.

Combining Form

A combining form is a term that describes a word root and a combining vowel together; it is used to
form medical terms.

Word Root Word Root in Combining Form

cardi cardi/o
pulmon pulmon/o
path path/o
nephr nephr/o

Combining Word Elements

prefix + root word/combining vowel + suffix = medical term

(combining form)
mega- (large) + cephal/o (head) + -ic (pertaining to) = megacephalic
epi- (above + derm/o (skin) + -al (pertaining to) = epidermal
peri- + cardi/o (heart) + -itis (inflammation) = pericarditis
(surrounding)

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 electro- + cardi/o(heart) + -gram (record) = electrocardiogram
(electrical)
colon/o (colon or large + -scopy (visual = colonoscopy
intestine) examination)
neur/o (nerve) + -logy (study of) = neurology
hyster/o (uterus) + -ectomy (removal of) = hysterectomy

As shown above, not all medical terms contain all word elements. Some may just contain a word root,
combining vowel and suffix as in colonoscopy. Also, as seen in pericarditis, some medical terms may not
have a combining vowel. It is important to remember that all medical terms do contain a root word and
almost always contains a suffix.

Medical Terms
megacephalic-pertaining to large head
epidermal-pertaining to above the skin
pericarditis-inflammation surrounding the heart
electrocardiogram-record of the electrical activity of the heart
colonoscopy-visual examination of the colon
neurology-study of the nerves (nervous system)
hysterectomy- removal of the uterus

Additional word elements to know:

Prefixes (example word/example definition)

1. A- (asepsis) = without (without living organisms/pathogens)

2. Contra- (contraindicated) = against (not recommended)
3. Auto- (autoimmune) = self (response of immune system against itself)
4. Dys- (dysfunctional) = difficult, painful, abnormal (abnormal function)
5. Epi- (epicondyle) = over (projection above a condyle)
6. Hyper- (hyperactive) = excessive, above (excessively active)
7. Hypo- (hypoglycemia) =deficient, below (low blood sugar)
8. Mega- (megalocephalic) = enlargement (head enlargement)
9. Peri- (pericarditis) = around, surrounding (inflammation surrounding the heart)
10. Sub- (subcutaneous) = below (below the skin)
11. Brachy- (brachydactylia) = short ( abnormally short fingers and toes)
12. Brady- (Bradypnea) = slow (slow breathing)
13. Tach/y- (tachycardia) = fast (fast/rapid heartbeat)
14. Cyan/o- (cyanosis) = blue (condition of bluish discoloration)
15. Leuk/o- (leukocytes) = white (white blood cells)

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 16. Xanth/o- (xanthoderma) = yellow (yellowing of the skin)
17. Melan/o- (melanoderma) = black/dark (abnormal skin darkening)
18. Quadr/a/i- (quadriplegia) = four (paralysis of all 4 limbs)
19. Cirrh/o- (Cirrhosis) = orange-yellow (liver condition causing orange-yellow skin changes)
20. Poli/o- (poliomyelitis) = gray ( disease caused by a virus that attacks the brain)

Word Roots (example word/example definition)

1. Abdomin/o- (abdominoplasty) = abdomen (surgical repair of the abdomen)

2. Aden/o- (adenitis) = gland (inflammation of a gland)
3. Arthr/o- (arthralgia) = joint (severe joint pain)
4. Cardi/o- (cardiomegaly) = heart (enlargement of the heart)
5. Cephal/o- (cephalopathy) = head (head disease)
6. Cervic/o- (cervicitis) = neck ( neck inflammation)
7. Chondr/o- (chondromalacia) = cartilage (softening of the cartilage)
8. Crani/o- (craniotomy) = skull (opening into the skull)
9. Derm/a- (dermatitis) = skin (inflammation of the skin)
10. Cyt/o- (cytology) = cell (study of cells)
11. Gastr/o- (gastrointestinal) = stomach (pertaining to stomach and intestines)
12. Hem/a- (hematoma) = blood (mass of clotted blood)
13. Hepat/o- (hepatology) = liver (study of the liver)
14. Hist/o- (histolysis) = tissue (breakdown of tissue)
15. Nephr/o- (nephritis) = kidney (inflammation of the kidney)
16. Neur/o- (neuropathy) = nerve (nerve disease)
17. Oste/o- (osteoarthritis) = bone (inflammation of bone and joint)
18. Ot/o- (otoscope) = ear (instrument used to examine the ear)
19. Psych/o- (psychology) = mind (study of the mind)
20. Rhin/o- (rhinorrhea) = nose (excessive discharge of the nose)

Suffixes (example word/example definition)

1. -iac (sacroiliac) = pertaining to (pertaining to the sacrum and ilium)

2. -algia (neuralgia) = pain (nerve pain)
3. -ectomy (appendectomy) = surgical removal (removal of the appendix)
4. -gram (encephalogram) = record (record of electrical activity of the brain)
5. -ia (dysphasia) = condition of (condition of difficult speech)
6. -ian (technician) = specialist (specialist in technical procedures)
7. -ism (botulism) = condition, method or process (condition caused by exposure to Clostridium
botulinum)
8. -logy (dermatology) = study (study of skin disorders)
9. -oma (myoma) = tumor or new growth (tumor of muscle tissue)
10. -pathy (osteopathy) = disease (bone disease)
11. -malacia (osteomalacia) = softening (gradual softening of bone)
12. -megaly (cardiomegaly) = enlargement (abnormal enlargement of the heart)

Abbreviations

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Abbreviations or acronyms (words formed from the first letters or parts of other words) are often used
in healthcare. Abbreviations allow healthcare workers to communicate more quickly. Most hospitals
have a list of approved abbreviations that can be used in their facility. Below are examples of common
abbreviations or acronyms and their meanings.

1. T- temperature
2. P- pulse
3. R- respiration or right
4. L- left
5. BP- blood pressure
6. VS- vital sign
7. Ht- height
8. Wt- weight
9. BS- bowel sounds, breath sounds or blood sugar
10. Abd- abdomen/ abdominal
11. RUQ- right upper quadrant
12. LUQ- left upper quadrant
13. RLQ- right lower quadrant
14. LLQ- left lower quadrant
15. Ax- Axillary
16. R/O- Rule out
17. CXR- Chest X-ray
18. FUO- Fever of Unknown Origin
19. PT- physical therapy/ist
20. ROM- range of motion
21. Ad lib- as tolerated/ desired
22. ADL- activities of daily living
23. CBR- complete bedrest
24. BRP- bathroom privileges
25. BR- bedrest or bathroom
26. Amb- ambulate
27. HOB- head of bed
28. NPO- nothing by mouth
29. PRN- as needed
30. PO- oral
31. IM- intramuscular
32. IV- intravenous
33. NG- nasogastric
34. OG- orogastric
35. MD- doctor of medicineHF- congestive heart failure
36. CVA- cerebrovascular accident (stroke)
37. MI- myocardial infarction (heart attack)
38. UTI- urinary tract infection
39. URI- upper respiratory infection

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References

Marshall, J. R., & Roe, S. C. (2018). Health Science Concepts and Applications. The Goodheart-Willcox
Company, Inc.

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 Medical Math
In health science classes, students also need to understand medical math. Below are some conversions
you should become familiar with.

The 24-Hour Clock

Hospitals, along with many other healthcare facilities, use military time. If a patient was admitted at
5:00 AM, it would be documented as 0500. If a patient was admitted at 5:00 PM, it would be
documented as 1700.

Practice

If a patient’s procedure was started at 2:00 PM, what time would be documented? __________

If a patient had labs drawn at 6:00 AM, what time would be documented? __________

If a patient ambulated at 3:15 PM, what time would be documented? __________

If medication was given at 11:20 PM, what time would be documented? __________

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(Answers can be found at the end of this document.)

Measurements

Many healthcare facilities use the metric system and some facilities along with the general public use
the US customary measurement system, so it is important for healthcare workers to know how to
convert measurements from both.

Common Medical Math Conversions

Length Volume in Fluids Temperature

1 ft = 12 inches 1 Liter = 1.06 quarts Celsius to Fahrenheit

(C x 1.8) + 32 = F
1 inch = 2.54 centimeters (cm) 1 Liter = 1000 ml

1 meter (m) = 100 centimeters 1 milliliter = 1 cubic centimeter (cc) Fahrenheit to Celsius
(cm) (F – 32) divide by 1.8 = Celsius

1 teaspoon = 5 cc or 5 ml
1 ounce = 30 cc or 30 ml
1 Tablespoon = 15 cc or 15 ml

Weight Conversion Weight

1 Kilogram (kg) = 2.2 pounds (lb.) 1 gram = 1000 milligrams (mg)

1 pound (lb) = 16 ounces (oz)

Know your metrics conversions: It is important to memorize!

Kilo-, hecto-, deca-, ____, deci-, centi-, milli-, micro-

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Practice

If a newborn infant weighs 3.5 kg, how many pounds and ounces would the nurse tell the parents that
the baby weighs?

2.2lb = 1 kg 1 X = 7.7 X = 7.7 lb 1 lb = 16oz 1X = 11.2 oz. X= 11.2 oz.

X lb = 3.5 kg 1 1 .7 lb X oz 1 1

The nurse would tell the parents that the baby weighs 7 lbs and 11.2 oz.

If a patient is 5 ft 3 inches tall, how many total inches is this? __________

If a patient drank 4 ounces of fluid, how many milliliters (ml) is this? __________

If an adult weighs 210 lb, how many kg is this? __________

If a child’s temperature is 100.4 degrees Fahrenheit, what is this in Celsius? __________

If an infant, drank 3 ounces, how many milliliters (ml) is this? __________

Answers

If a patient’s procedure was started at 2:00 PM, what time would be documented? 1400

If a patient had labs drawn at 6:00 AM, what time would be documented? 0600

If a patient ambulated at 3:15 PM, what time would be documented? 1515

If medication was given at 11:20 PM, what time would be documented? 2320

If a patient is 5 ft 3 inches tall, how many total inches is this? 63 in

If a patient drank 8 ounces of tea, how many milliliters (ml) is this? 240 ml

If an adult weighs 210 lb, how many kg is this? 95.45 kg

If a child’s temperature is 100.4 degrees Fahrenheit, what is this in Celsius? 38 degrees Celsius

If an infant, drank 3.5 ounces, how many milliliters (ml) is this? 105 ml

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 MATH AND MEASUREMENT CONVERSIONS

Convert the following units:

1. 1g to mg: _____________
2. 5 mg to mcg: ___________
3. 68lbs to kg: _____________
4. 15cc to tsp: _____________
5. 1 tsp to cc: ______________
6. 20 kg to lb: ______________
7. 180 lb to kg______________
8. 1 pint to ml: _____________
9. 36.8 degrees to “F: _______
10. 98.6 “F to Celsius: ________
11. 11 oz. to ml/cc__________________

1. Mrs. Barlow receives a lunch tray with a one 8 oz glass of iced tea, one 8 oz glass of milk,
and one 4 oz glass of juice.
When she is finished with lunch, you observe the iced tea glass empty, the glass of milk is ¾
full, and the juice glass is ½ full.
Record the amount Mrs. Barlow drank in oz _____________ and convert to ml__________

2. Your patient is taking a weight-based medication. You weigh the patient at 209 lb while he
is sitting in his wheelchair that weights 22 lb. What weight in kg would you report to the
nurse?____________________

3. Mr. Robby weighed 108 kg on Friday morning. On Monday morning he weighs 112 kg. How
much weight did he gain in lb? ______________

4. 6/75 is written as a decimal is _____________

5. .45 is written as a percentage is ___________

6. Calculate the total output from Mrs. Rodden’s 12-hour period. I & O: Orange juice 120cc,
Water 240cc, Coffee 200cc, Emesis 300cc, Wound drainage 100cc, Urine 800 cc
What is her total intake? ___________ Output____________ Which is more her intake or
her output and what is the difference? Intake or Output The difference is ________.

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 MATH AND MEASUREMENT CONVERSIONS

ANSWER KEY

Convert the following units:

12. 1g to mg: _____1000mg___

13. 5 mg to mcg.: ___5 mcg____
14. 68 lbs to kg: __30.9 kg_____
15. 15cc to tsp: _____3 cc_____
16. 1 tsp to cc: ______5 cc____
17. 20 kg to lb: ___44 lb______
18. 180 lb to kg___81.82 kg___
19. 1 pint to ml: _16 fl oz_____
20. 36.8 degrees to “F: _98.2 F__
21. 98.6 “F to Celsius: _37 degrees C__
22. 11 oz. to ml/cc__330 ml/cc_______

7. Mrs. Barlow receives a lunch tray with a one 8 oz glass of iced tea, one 8 oz glass of milk,
and one 4 oz glass of juice.
When she is finished with lunch, you observe the iced tea glass empty, the glass of milk is ¾
full, and the juice glass is ½ full.
Record the amount Mrs. Barlow drank in oz __12 oz_______ and convert to ml___360 ml__

8. Your patient is taking a weight-based medication. You weigh the patient at 209 lbs and he
is setting in his wheelchair that weights 22 lb. What weight in kg would you report to the
nurse? ___85 kg__________

9. Mr. Robby weighed 108 kg on Friday morning. On Monday morning he weighs 112 kg. How
much weight did he gain in lb? ____8.8 lb_______

10. 3/4 is written as a decimal is ____0.75___

11. .45 is written as a percentage is ____45%_______

12. Calculate the total output from Mrs. Rodden’s 12-hour period. I & O: Orange juice 120cc,
Water 240cc, Coffee 200cc, Emesis 300cc, Wound drainage 100cc, Urine 800 cc
What is her total intake? __560cc____ Output_1200 cc_______ Which is more her intake or
her output and what is the difference? Intake or Output The difference is __640 cc____.

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 Anatomy & Physiology
In order to understand disease, it is important that health science students have a good
understanding of anatomy and physiology.

Anatomy- deals with the structure of humans, animals, and other living organisms
Physiology- deals with the function and activities of living organisms

CELLS: smallest structural unit of the body

• Golgi apparatus- transports substances around the cell

• Lysosomes- destroy toxins and debris
• Cytoplasm- jellylike substance that houses or contains all the organelles
• Endoplasmic reticulum- contains ribosomes that produce proteins
• Nucleus- control center of a cell that contains DNA
• Mitochondria- produce energy for the cell
• Ribosomes- located on the endoplasmic reticulum that makes proteins

TISSUES: groups of cells of the same type that act together to perform a specific
function

• 4 TYPES:
o Nerve
o Epithelial
o Connective
o Muscle
▪ Cardiac- heart muscle
▪ Smooth- internal organs
▪ Striated- used for movement

ORGANS: made up of groups of tissues

SYSTEMS: group of organs working together to perform a certain function

SKELETAL
• Made up of bone and connective tissue
• BONES:
o AXIAL (80 bones)
▪ Skull, vertebrae, ribs, and sternum
o APPENDICULAR (126 bones)
▪ Arms, hands, legs, feet, and pelvis

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 o FUNCTIONS:
▪ give structure and support
▪ protect internal structures
▪ produce blood cells in red bone marrow
▪ allows flexibility
o TYPES:
▪ LONG BONES (longer than are wide)
• Humerus, radius, ulna, tibia, fibula
▪ SHORT BONES (length and width are equal)
• Wrist, hand, ankle, and feet
▪ FLAT BONES (2 layer)
• Skull, sternum, ribs, and shoulder blade
▪ IRREGULAR
• Face, spine, and hip
• JOINTS:
o Immovable- cranium
o Slightly moveable- vertebral discs, symphysis pubis, sacroiliac joints
o Free movable- shoulder, knee, ankle, elbow, wrist, and finger joints

• DIRECTIONS:
o Superior- above
o Inferior- below
o Ventral or anterior- front
o Dorsal or posterior- back
o Medial- near the center or midline
o Lateral- away from the middle
o Proximal- nearest the point of attachment
o Distal- farthest from the point of attachment

• PLANES
o Coronal plane (frontal)- divides into front and back
o Transverse plane- divides into superior and inferior
o Median or Midsagittal plane- divides into right and left
• CAVITIES:
o DORSAL
▪ Cranial- brain
▪ Spinal- spinal cord
o VENTRAL
▪ Thoracic- heart, lungs, and large blood vessels
▪ Abdominal- stomach, intestines, kidneys, liver, gallbladder, pancreas,
spleen
▪ Pelvic- bladder, part of intestines, rectum, parts of respiratory system

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MUSCULAR
• Muscles make movement possible
• FUNCTIONS:
o Produce heat
o Produce movement
o Maintain posture
• TYPES:
o Voluntary- contract when you move (you control these muscles)
▪ Skeletal- provide movement
o Involuntary- contract automatically (heart, stomach, intestines)
▪ Visceral- form the walls of internal organs
▪ Cardiac- forms the walls of the heart
• Tendons connect muscles to bones

• MOVEMENTS:
o Adduct-towards the midline
o Abduct- away from the midline
o Extend- increase the angle of a muscle
o Flex- decrease the angle of a muscle
o Rotate- turning a body part on its axis

CIRCULATORY
• TYPES OF BLOOD VESSELS
o Arteries- carry oxygenated blood to all parts of the body
o Arterioles- connect arteries to capillaries
o Capillaries- allow nutrients, oxygen and carbon dioxide to move in and out of the
blood
o Venules- connect capillaries to veins
o Veins- carry unoxygenated blood to the heart
• THE HEART:
o HEART WALL:
▪ Endocardium- lines inside of the heart
▪ Myocardium- thickest layer made up of muscle
▪ Pericardium- lines outside of heart
o 4 CHAMBERS:
▪ Right Atrium- receives unoxygenated blood from veins
▪ Right Ventricle- gets blood from the right atrium and pumps to the lungs
through the pulmonary artery
▪ Left Atrium- receives oxygenated blood from the lungs
▪ Left Ventricle- pumps blood into aorta to the rest of the body
o VALVES:
▪ Tricuspid Valve- between the right and atrium and left ventricle

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 ▪ Pulmonary Semilunar Valve- between the right ventricle and the
pulmonary artery
▪ Mitral (Bicuspid) Valve- between the left atrium and left ventricle
▪ Aortic Semilunar Valve- between the left ventricle and aorta

LYMPHATIC
• Filters out organisms that cause disease, produces white blood cells (WBC) and makes
antibodies
• Drains excess fluids and protein to keep tissues from swelling up

• VESSELS AND ORGANS:

o Lymph capillaries- allow tissue fluids to move into them (the fluid is called
lymph)
o Lymph Vessels- lymph empties into them and becomes part of blood plasma
• (plasma is a watery, colorless fluid that contains leukocytes, erythrocytes, and platelets)
o Lymph Nodes- filter out bacteria and other waste products from lymph and
produce lymphocytes
o Tonsils- filter tissue fluid and not lymph
o Spleen- filters microorganisms and waste products from the blood and produces
lymphocytes and monocytes
o Thymus- stores lymphocytes that work to defend the body

• Antigen- foreign matter that causes the body to produce antibodies

• Antibody- substance made by the body to produce immunity to an antigen
• Lymphocyte- a type of white blood cell
• Monocyte- a single nucleus white blood cell
• Phagocyte- cells that surround, ingest, and digest microorganisms and cellular waste
• Erythrocyte- red blood cell

• TYPES OF IMMUNITY:
o Active immunity- protection that occurs when a body produces its own
antibodies
o Passive immunity- protection that occurs when a body receives antibodies from
another source

RESPIRATORY:
• Respiration is breathing
• Inspiration (Inhalation)- process of breathing in air during respiration (oxygen taken in)
• Expiration (exhalation)- process of forcing air out of the body during respiration (carbon
dioxide released)

• STRUCTURES:
o Nasal Cavity- (nose) where air enters the body

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 o Paranasal sinuses- mucus lined cavities in the bones of the face, connected by
passages to the nose, which helps to warm and moisten inhaled air
o Oral Cavity (mouth)- where air enters the body when the nasal passage is
blocked
o Pharynx (throat)- passageway that air enters after leaving the nose and mouth
o Epiglottis- flap that closes when food or water is swallowed
o Larynx (voice box)- contains a cordlike framework that creates voice sounds
o Trachea (windpipe)- passageway between the pharynx and lungs
o Bronchi- air passages that connect to the trachea and lead to the right and left
lungs
o Cilia- hair like objects that help move mucus and catches dust and pathogens
o Bronchioles- smallest subdivision of the bronchi
o Alveoli (air sacs)- at the ends of bronchioles and covered in capillaries
o Diaphragm- muscular wall that divides the chest cavity from the abdominal
cavity (it moves down when you inhale and then moves upward when you
breathe out)

DIGESTIVE
• Digestion is the process of changing food into a usable substance.
• Absorption- passage of a substance through a body surface into body fluids and tissues

• ORGANS:
o Mouth (oral cavity)- where food enters the body
o Salivary Glands- produce a secretion that dissolves food and coats food with a
mucus that allows it to pass through the esophagus
▪ Amylase is from the salivary glands and breaks down carbohydrates by
chemical digestion

o Pharynx (throat)- passageway for food

o Epiglottis- flap that covers the trachea when food or water is swallowed
o Esophagus- receives food and water from the pharynx

• Peristalsis- progressive wavelike motion that occurs involuntarily in hollow tubes of the
body

o Cardiac Sphincter- ring of muscle fibers located where the esophagus and
stomach join
o Stomach- enlarged part of the alimentary canal that receives food and water
from the esophagus
o Pyloric Sphincter- ringlike muscle found at the end of the stomach
o Small Intestine- attached to the stomach at the pyloric sphincter (where most
absorption takes place and contains villi that absorbs nutrients)

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 o Large Intestines- attached to the small intestine and receives food substances
that are little value to the body (absorbs water, mineral salts, and vitamins. It
also secretes mucus to aid in the movement of feces through the intestines)
o Rectum- the last 6-8 inches of the alimentary canal
o Anus- the end of the alimentary canal

• ACCESSORY STRUCTURES:
o Liver- largest gland- produces bile, removes poisons, stores vitamins, produces
clotting factors and antibodies
o Gallbladder- stores bile that the liver produces
o Pancreas- produces insulin that regulates the sugar used by the tissues

URINARY

• FUNCTIONS:
o Excretes urine
o Maintenance of water balance
o Regulates the body’s acid-base balance
o Controls blood volume and maintains blood pressure

• STRUCTURE (KIDNEY:
o Capsule- sac around the kidney
o Cortex- outer part of the kidney
o Medullais- inner part of the kidney
o Nephron- chief filtering mechanism
▪ Convoluted tubule
▪ Bowman’s capsule
▪ Glomerulus
o Ureters- carry the urine from the kidneys to the bladder
o Urinary Bladder- sac that receives the urine from the kidneys
o Urethra- tube that extends from the urinary bladder to the outside of the body

ENDOCRINE

• Regulates growth, metabolism, muscle contraction, and other body processes.

• GLANDS:
o EXOCRINE: carry substances to organs, body parts, or the outside of the body
o ENDOCRINE: do not have ducts; secrete hormones directly into the blood
stream
▪ External Secretions (excretion)- carried to an organ close by or to the
outside of the body

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 ▪ Internal Secretions- hormones that are carried to all parts of the body
through the blood and lymph systems

NERVOUS

• Receives, sends, and coordinates internal and external messages

• CENTRAL (CNS)-
o Includes the brain and spinal cord
o 3 parts of the brain
▪ Cerebrum- processes thought with memory and learning; controls
voluntary movement and sense interpretation
▪ Cerebellum- coordinates muscle activity and balance for smooth muscle
function
▪ Medulla- part of the brain stem that controls breathing, heartbeat,
circulatory action, and digestive movements
• PERIPHERAL (PNS)-
o Includes the nerves and ganglia outside of the brain and spinal cord
o 12 pairs of cranial nerves
o 31 pair of spinal nerves
o Nerve branches in the body organs

• Neurons- nerve; includes the cell and the long fiber coming from the cell

• THE EYE:
o Produces vision
o Protection:
▪ Lids and eyelashes protect the eye
▪ Tears form in the lacrimal duct
o Parts of the eye:
▪ Sclera- (white of the eye) is the outer lining
▪ Choroid- second coating of the eye that keeps light rays from scattering
▪ Retina- innermost coating of the eye
▪ Optic nerve- receives pictures and sends it to the brain for interpretation

• THE EAR:
o Provides hearing and equilibrium
o Parts of the Ear:
▪ External
• Auricle- outside projection
• External Auditory Canal

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 • Tympanic Membrane (eardrum)- separates the external and
middle ear
▪ Middle- contains the bones (ossicles) that amplify air waves received
▪ Inner- contains the semicircular canal that transmit waves received from
the middle ear to the nerves that allow us to translate sound; also
responsible for equilibrium
• TASTE AND SMELL:
o Taste buds sense 4 main tastes: sweet, salty, sour, bitter
o The nasal cavity has the receptors that receive smells
• GENERAL SENSES:
o Pressure sense- in the subcutaneous tissue layer
o Temperature sense- respond to heat and cold
o Sense of touch- sensed by receptors called tactile corpuscles found in the dermis
layer
o Sense of pain- found in the skin, muscles, joints, and internal organs

REPRODUCTIVE:

• Both male and female have gonads, tubes, and exocrine glands
o Gonads- endocrine or sex glands
▪ Males- testes- produce sperm
▪ Females- ovaries- produce ova

• FEMALE:
o Ovaries- produce ova and estrogen
o Fallopian Tubes- carries the ovum to the uterus
o Uterus-
▪ Endometrium- inner lining
▪ Menstruation- the shedding of the endometrial lining every 28 days
o Vagina- (birth canal) houses the neck of the uterus
• MALE:
o Testes- found in the scrotum; produce spermatozoa and testosterone
o Penis- primary male sex organ
o Epididymis- coiled in the scrotal sac where sperm is stored
o Vas Deferens- spermatic cord; passageway for sperm
o Seminal Vesicles- produce thick yellow secretion that adds to the volume of
semen
o Prostate Gland- makes a secretion that maintains the mobility of sperm
o Ejaculatory Duct- carries the sperm to the urethra
o Urethra- passage for urine and sperm, and leads from the urinary bladder to the
outside of the body

19
INTEGUMENTARY

• First line of defense against infection.

• Includes hair, nails, and cutaneous glands

• FUNCTIONS:
o Protect underlying body parts from injury and invasion of pathogens
o Regulate body temperature
o Eliminates waste with perspiration
o Store energy in fat and vitamins
o Sense touch, heat, cold, pain, and pressure
o Produces vitamin D

• STRUCTURES:
o Epidermis- outermost layer
o Dermis- under the epidermis that has blood vessels
o Subcutaneous- connects the skin to muscle

• CUTANEOUS GLANDS:
o Sweat glands- excrete sweat
o Sebaceous glands- oil-producing glands
o Ceruminous glands- produce ear wax
o Mammary glands- milk-producing glands in the breasts

Reference: Badash, Cheseboro. Principles of Health science: Texas Edition. Pearson Education, Inc. New York, New York.2017

20
 Communication
In health science class, students will be working on effective communication. Students need
to recognize that the ability to effectively communicate is essential in both their personal and
professional life. There are three types of communication: verbal (speaking), nonverbal (body
language), and written.

Verbal communication is the most widely used form of communicating. The speaker must
be able to convey the message being sent in a manner that is easily interpreted by the listener.
The listener must practice active listening and be open to the message being received. Most
individuals are able to stay attentive for no more than 20 minutes, so your message has to be
clear, concise, consistent, credible, and courteous. Some barriers to active listening may
include time restraints, environment, boredom, and complexity of the subject. There are many
ways to facilitate active listening, such as the desire to be a good listener, be open, express
interest, resist judgement, don’t interrupt, exhibit empathy and respect, maintain eye contact,
and give feedback. Mastering active listening skills will improve the quality of relationships that
you have in your personal, and professional, life.

Telephone etiquette is a form of verbal communication and is invaluable in the workplace.

Promptly and politely answering a ringing phone sets the tone for the rest of the
communication during the phone call. Be certain that you identify the facility, your name and
title when answering the phone. If you have to place the caller on hold, make sure you ask
him/her politely if it’s okay, and then don’t leave him/her on hold for more than a minute or
two. If he/she needs to leave a message, make sure you take his/her name, title, company,
number, and a short description of the reason for the call. Verify the information by repeating it
back to the caller. If you have to make a call, plan what you are going to say before calling,
speak clearly, and identify yourself. When talking on the phone, make certain that you are
speaking in a pleasant, polite tone, while holding the receiver at least an inch from your mouth,
and always use “please” and “thank you”. It is important to remember that you are not
authorized to give out any medical information, without the patient’s permission, and doing so
is a violation of HIPAA.

21
 Nonverbal communication (body language), although more subtle, speaks louder than
words. Our posture, facial expressions, proximity, tone of voice, speed in which we speak, eye
contact, and gestures convey our “true” message.

Written communication is used often in the professional world and is considered a very
important job skill. Being able to send a proper email or fax is essential in communication. It is
important to remember that anything sent via the internet is never private, and you should
always assume a third party has access to it. When sending an email, make sure to include a
subject and to address the receiver in a formal matter, unless it is a personal email. You should
always make sure you identify yourself, be courteous, and stay on subject. It is never wise to
send an email when you are angry. It is most professional to use a basic font, and you should
always proofread your email before sending.

Barriers to communication may occur in many forms and prevent the message from being
conveyed appropriately. Examples of barriers include cultural differences, stereotypes, aphasia
(language disorder related to brain damage), hearing and vision impairment, mental health,
language, and age. Overcoming these barriers requires the use of a “sender-receiver”
communication model, which emphasizes the importance of each participant.

In the sender-receiver model, the sender sends his/her thoughts and ideas into a message that
is understood by the receiver. The message may be sent either verbally or in a written format.
As the message is being delivered, it can encounter “noise”. Noise refers to the barriers,
mentioned previously, such as cultural differences, stereotypes and aphasia. The noise may
affect how the receiver interprets the message. This can lead to miscommunication. Upon
receiving a message, the receiver must decode it and respond back to the sender, expressing
his or her thoughts. Just like before, this message will also likely encounter “noise” along the
way. In order for communication to be effective, both parties must be able to express idea and
share information with each other.

It is important to remember that we have many different styles of communication that we

can use depending upon our audience. We should be mindful of communication barriers and

22
understand that communication is the foundation of building meaningful relationships,
improving teamwork, problem solving and overall social and emotional health.

Reference:

Marshall, J., & Roe, S. C. (2018). Health science: concepts and applications. Tinley Park, IL: The
Goodheart-Wilcox Company, Inc.

23
 HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) was passed by the US Congress
in 1996. HIPAA is a federal law that covers three areas:

• Insurance portability- making sure that people who move from one health plan to
another will maintain coverage and will not be denied coverage under pre-existing
condition clauses,
• Fraud enforcement (accountability)- increases the federal government’s fraud
enforcement authority in many different areas,
• Administrative simplification (reduction in healthcare costs)- provide standards for
electronic exchange of health information and privacy and security of health
information.
Prior to HIPAA, no generally accepted set of security standards or general requirements for
protecting health information existed in the healthcare industry. At the same time, new
technologies were evolving, and the healthcare industry began to move away from paper
processes and rely more heavily on the use of computers to pay claims, answer eligibility
questions, provide health information and conduct a host of other administrative and clinically
based functions. For example, in order to provide more efficient access to critical health
information a physician can check patient records and test result from wherever he/she is.
While this means that the medical workforce can be more mobile and efficient, the rise in these
technologies create an increase in potential security risks. The HIPAA act resulted in a law that
is enforced by the US government’s Office of Civil Rights since 2003. This rule establishes the
national standard that protect individual medical records and other personal health
information. It also gives patient’s rights regarding their health information, including the right
to examine and obtain a copy of their health records and request corrections. Fully enforced in
2006, this law insures patients be made aware of this privacy policy and notified when their
information is shared.

24
HIPAA protects PHI. PHI stands for Protected Health Information. This health information in
any form- that can identify an individual. Here is the list of eighteen identifiers:

1. Names;
2. All geographical subdivisions smaller than a State, including street address, city, county,
precinct, and zip code;
3. All element of dates, (except years) related to an individual, including birth date,
admission date, discharge date, date of death; and exact age if over 89;
4. Telephone numbers;
5. Fax numbers;
6. Electronic mail addresses;
7. Social Security numbers;
8. Medical record numbers;
9. Health plan beneficiary numbers;
10. Account numbers;
11. Certificate/ license numbers;
12. Vehicle identifiers and serial numbers, including license plate numbers;
13. Device identifiers and serial numbers
14. Web Universal Resource Locators (URLs);
15. Internet Protocol (IP) address numbers;
16. Biometric identifiers, including finger and voice prints;
17. Full face photographic images and any comparable images; and
18. Any other unique identifying number, characteristic, or code that could uniquely identify
the individual.
These identifiers include the patient, healthcare plan members, and their covered dependents.
HIPAA defines how PHI may be used and shared. To be considered “de-identified”, ALL of the
eighteen HIPAA identifiers must be removed from the data set or a statistician verifies that the
information cannot be used to identify an individual. This includes all dates, such as surgery
dates, all voice recordings, and all photographic images.

To properly dispose of PHI is to render it essentially unreadable, indecipherable and otherwise

unable to be reconstructed. Healthcare facilities must insure their workforce members receive
training on disposal policies and procedures. Entities are not permitted to simply abandon PHI
or dispose of it in dumpers or other containers accessible to the public or other unauthorized
persons. The three main types of PHI that should be destroyed:

• paper documents,

25
 • electronic PHI, and
• x-ray film.
Proper disposal methods are not limited to but may include shredding, burning, pulping and
pulverizing and use of a strong magnetic field to fully erase the data (degaussing). Included in
this deconstruction are file folders, labels on prescription bottles, removable storage devices
(CDs, DVDs, USB memory sticks and the like), smartphones, PDAs and x-ray jackets.

Breaches, however, do occur. Information breaches can result in the abuse of an individual’s
privacy. An information breach occurs when PHI is:

• Accessed by people who do not have permission

• Discussed without a valid business purpose
• Shared with those who do not have a need to know
An information breach may occur on purpose or it may happen by accident. Examples include
faxing PHI to the wrong person or office using someone else’s computer password to access
PHI, or reading the medical record of a patient without valid need to know. Something as
simple as looking up a co-worker’s medical record to learn his or her birthday; or reading a
neighbor’s medical history because you are curious are also examples of information breaches.
Gossiping about patients to friends or coworkers, theft through loss or stolen devices (laptops,
desktops, smartphones, and other devices), texting of patient information, and/or posting
patient photos on social media are also considered breaches and are common reasons for
HIPAA violation citations.

Under HIPAA, breaking federal or state privacy rules can mean either a civil or a criminal
sanction. Thee penalties can apply to healthcare facilities as well as individuals. HIPAA
violations can result in substantial fines to a practice ranging from $100 to $1.5 million, loss of
license, and jail time. Intent to sell confidential information or identities of patients also result
in fines and imprisonment.

As you can see, maintaining physical and virtual security spelled out by HIPAA is a serious
matter. As potential healthcare workers, you will be exposed to a wide range of confidential
information about many patients and acting in professional manner is mandatory.

26
Sources used:

Webber, Kevin; “Three Types of PHI That Should Be Destroyed”; TriHaz Solutions; June 8, 2018.

Zabel, Laurie; “10 common HIPAA violations and preventive measures to keep your practice I
compliance”; Becker Hospital Review; June 22, 2016.

Centers for Medicare and Medicaid Services- HIPAA Security standards “Security 101 for
Covered Entities” vol 2 Paper 1; pages 3-4; March 2007.

GW Health Science Concepts and Applications, 1st edition, 2018; Chapter 2; pages 83-85

Texas Health Resources Privacy Handbook online; 2

27
 Safety and Infection Control
As students in health science class, it is important that you understand the importance of safety
and infection control; these are two essential attributes of a healthcare provider. Infection
control is defined as all efforts made to prevent the spread of infection. Each healthcare facility
will have a list of their own policies and procedures; however, several federal agencies will
oversee the facilities to make sure proper regulations are followed. This is important to keep
our patients, their families, and staff safe.

General Safety Rules

Employees need to be aware of the rules found in the safety manuals of the healthcare facilities
where they work.

General safety rules that help ensure precautions are taken to keep everyone safe include:

• Walk on the right-hand side of hallways and stairwells when feasible.

• When using stairs, always use the handrails.
• Never run in the hallways.
• Report any lights that are not working to your facility.
• Slowly open swinging doors.
• Remove any obstructions from floors or hallways to prevent tripping hazards.
• Never prop open fire safety doors.
• Wear practical shoes.
• Ensure your uniform is neat and clean.
• Store items in a safe and accessible manner.
• Know and follow evacuation routes displayed through the facility.
• Be aware of your environment, including the people around you.
• Continuously practice safety and be aware of potential hazards.

Hospital Emergency Codes

Hospitals use emergency codes to alert the staff of certain emergencies. Some universal codes
are code red = fire, code blue = cardiac arrest, code pink = infant or child abduction, code black =
bomb threat, code silver = dangerous person with a weapon. However, many hospitals are

28
switching over to direct announcements instead of using the codes, as they can cause some
confusion at times.

Patient Safety

When providing patient care, it is very important to pay attention to details so you can keep the
patient from sustaining any injuries. If you see any spills, cords in the walkway, a loose rug, or
confused patient, it is important for you to act quickly to prevent an injury. Always identify the
patient to ensure you have the correct patient. You can check wristbands and ask the patient
their name.

Universal patient safety guidelines include:

• Before interacting with your patient, always identify that you have the correct patient
by checking their ID band and asking them to verify their name and DOB.
• Make sure you provide privacy to your patient during all procedures.
• When leaving a patient’s room, make sure you lower the bed and make sure the patient
can reach their call light.
• Be sure to return any bed rails or side rails to the up position.
• Before you perform any procedures, explain the entire procedure, ensure the patient
understands and make sure you have consent before proceeding.
• Never perform a procedure you are not trained to perform. Be sure to work within your
scope of practice. (Scope of practice refers to tasks that a healthcare provider can
provide due to training and certification.)
• Report any safety concerns to your supervisor as soon as possible.
• Always wash your hands upon entering and exiting a patient’s room.

29
Employee Safety

Healthcare facilities must maintain employee safety as well as patient safety in order to operate
successfully. OSHA Hazard Communication Standard refers to rules established by the
Occupational Safety and Health Administration (OSHA) that require employers to educate
employees about chemical hazards in the workplace. Employees that work in certain areas
(housekeeping, laboratory, nurses, etc.) are at risk of chemical injuries. The most common
chemical injury is a burn.
Steps to reduce the risk of chemical injury:

• When using chemicals, always wear gloves (goggles and protective safety clothing may
also be required).
• Chemicals in unlabeled containers are not to be used.
• Read chemical labels carefully and double-check before using.
• Never mix unknown chemicals.
• Before using chemicals, be sure you are in a well-ventilated area.
• Clean up all spills immediately using a special spill kit if you are trained to do so.
• Immediately flush the skin or eyes if they come in contact with a chemical. Continue to
flush the area for up to 10 minutes.

Each chemical used in your facility is required to have a material safety data sheet (MSDS). This
document will contain important information about the chemical’s makeup, dilution, and
mixture concentration, and its instructions for use. In addition, it specifies the possible hazards
of the chemical and proper first aid treatment in case of a spill or accident.

Electrical Safety

Electrical shock injuries can result in moderate burns, severe skin damage, unconsciousness or
even death. Therefore, always observe safety guidelines to help reduce the risk of injury. Never
overload any electrical plugs or outlets; this can be a fire hazard. It is necessary for all equipment
to have a three-prong plug which adds further safety. Equipment must not have frayed cords or
loose wires. When electrical equipment is in use, make sure your hands, the patient’s hands and
floor are dry.

30
Fire Safety

One of the most frightening disasters within a healthcare facility is a fire. A fire, or threat of fire,
can be especially terrifying to patients who are immobile and unable to leave the facility without
assistance.

The most common causes of fire include matches, heating and cooking equipment, electrical
equipment, flammable liquids, and smoking. Three elements must be present for a fire to occur;
these include: oxygen, fuel, and heat. They are known as the fire triangle.

Two acronyms will help you remember what to do in the event of a fire.

• RACE
o Rescue- immediately stop what you are doing and remove anyone in immediate
danger.
o Alarm- activate the nearest fire alarm pull station
o Contain- close all doors and windows that you can safely reach to contain the
fire. During evacuation, close the doors behind you.
o Extinguish- only attempt to extinguish the fire if it is safe to do so.
• PASS
o Pull- pull the pin to break the tamper seal
o Aim- aim low, pointing the extinguisher nozzle at the base of the fire.
o Squeeze- squeeze the handle to release the extinguishing agent.
o Sweep- sweep from side to side at the base of the fire until it appears to be out.
Watch the area; if the fire reignites, repeat steps 2-4.

Quality Improvement and Safety

Some important organizations have been created in order to keep healthcare facilities safe and
to improve the quality.

• The Food and Drug Administration (FDA) responsibilities include protecting and
promoting public health through the regulation and supervision of food safety,
prescription and over-the-counter pharmaceutical drugs, vaccines, blood
transfusions, and medical devices.
• The National Institutes of Health (NIH) is an agency of the United States
Department of Health and Human Services. It is the primary agency of the United
States government responsible for biomedical and health-related research.

31
• The Centers for Disease Control and Prevention (CDC) conducts and supports
health promotion, disease prevention, and preparedness activities in the United
States with the goal of improving overall public health. The CDC tracks disease
throughout the United States and sponsors a great deal of research on disease
control and prevention.
• The Joint Commission (TJC) is a healthcare accrediting agency. An accrediting
agency certifies competency and credibility. The TJC publishes national patient
safety goals for hospitals, home care, labs, long term care, and many others and
monitors to make sure healthcare workers and facilities are in compliance.

32
Infection Control

As much as we would not like to think, microorganisms are everywhere in our environment.
Microorganisms include bacteria, viruses, and fungi and are found in the air, on our skin, in food,
and on everything that we touch.

Terms to know:

Bacteria- small one celled microorganism that cannot be seen by the naked eye; can be
pathogenic (cause disease). They are classified by their morphology (form and structure) as
seen under a microscope. Bacterial infections are treated with antibiotics.

Viruses- pathogenic microorganisms, much smaller than bacteria, that depend on a living cell
to survive; cause many serious diseases and illnesses. Viruses are the cause of common colds,
smallpox, chicken pox, measles, flu, HPV, and AIDS. Antibiotics do not kill viruses.

Fungi- parasitic organisms that live in the soil or on plants; include disease-causing
microorganisms such as yeasts and molds.

Aerobe- an organism that requires oxygen to live

Anaerobe- an organism that requires little or no oxygen to live

Protozoa- microorganisms that depend on a host cell to survive and replicate; can cause serious
illness. They are found in water and soil and can cause amoebic dysentery.

Rickettsiae- parasites that normally choose fleas, lice, ticks, or mites as their host organisms;
can cause severe infections. Causes Rocky Mountain spotted fever and types of typhus, both
of which are severe infections.

Parasites- organisms that live in or on another organism.

Methicillin-resistant Staphylococcus aureus (MRSA)- an antibiotic resistant bacterium

responsible for a difficult to treat infection; sometimes prevalent in hospitals, schools, prisons,
and nursing homes.

33
The Chain of Infection

Infections are transmitted through various modes. One mode is direct contact which the
pathogen travels directly from one host to another, such as in person-to-person transmission.
Another is indirect contact, which the pathogen takes an indirect path-such as through food, air,
or clothing- to its next host. Vectors, such as insects, rodents, or other small animals, can spread
pathogens by biting a host.

The chain of infection is used to visualize the sequence of events that allows infection to invade
the human body. This sequence consists of an infectious agent, reservoir or host, portal of exit,
mode of transmission, portal of entry, and susceptible host.

Nosocomial infections are infections acquired in hospitals and other healthcare facilities; they
are also known as healthcare-acquired infections.

Standard Precautions

Handwashing is the single most important way to prevent the spread of infection.

Standard precautions are a set of basic practices intended to prevent the transmission of
infectious diseases from one person to another. Because we do not always know if a patient has
an infectious disease, standard precautions are applied to every person, every time to ensure
that transmission of disease does not occur.

Transmission-Based Precautions

Transmission based precautions are intended for patients with highly communicable infections.
They are divided into three categories based on how the infections are transmitted and are used
in addition to standard precautions.

Airborne Precautions- used to prevent the spread of diseases, such as tuberculosis, that are
transmitted by tiny, airborne droplet residue or dust particles containing microorganisms. A N95
respirator is required to ensure protection for those caring for patients with these forms of
disease.

34
Droplet Precautions- used to prevent infection spread through large droplet transmission. In
these cases, disease is transmitted through coughing, talking and sneezing. Influenza is a good
example of this. Masks must be worn to prevent the spread of this.

Contact Precautions- designed to reduce the risk of transmission of certain infectious

microorganisms through direct or indirect contact. Hepatitis A and impetigo are examples of
infectious diseases. A gown and gloves are worn for contact precautions.

Personal Protective Equipment (PPE) is equipment that healthcare workers wear to protect them
from serious illnesses. This includes gowns, goggles, gloves, and masks. There is a proper order
for donning and doffing PPE to best protect the healthcare worker.

Donning- the order that PPE is applied

• Gown
• Mask
• Goggles
• Gloves
Doffing- the order that PPE is removed

• Gloves
• Goggles
• Gown
• Mask

Reference:

Marshall, Jacquelyn and Roe, Sue. Health Science Concepts and Applications. Tinley Park, IL
Goodheart-Willcox Publisher 2018. Pages 90-126

35
 Vital Signs
Some of the key clinical skills that students will develop throughout the health science cluster
are the skills associated with obtaining vital signs. There are four significant measurements that
make up vital signs; these include temperature, pulse, respiration, and blood pressure. While
possessing vital sign skills are important, it is also necessary to understand the physical
processes behind each one. It is also critical to know when a vital sign is within normal limits
and when it is abnormal.

Temperature

Temperature is a measurement of body heat. It can be measure in Fahrenheit as well as Celsius.

A normal body temperature can fluctuate throughout the day and can be influenced by activity.
The hypothalamus is continually working to regulate body temperature. Whenever a body
temperature rises, it can indicate that the body is fighting an infection.

There are different types of thermometers that are used to measure body heat. Most
commonly used today are the digital thermometer, the tympanic thermometer and the
temporal thermometer. Below are examples of some of these types of thermometers.

digital digital temporal

Body temperature can also be measured in different locations. These include oral, axillary,
rectal, tympanic and temporal.

An oral temperature is commonly taken in adults and older children using a digital
thermometer. It is taken by placing the tip of the thermometer under the tongue. It is
important to make sure that the patient has not had anything to eat or drink 15 minutes prior
to taking the oral temperature as this will impact the reading.

36
An axillary temperature is commonly used in young children using a digital thermometer. It is
taken by placing the thermometer probe in the axilla or armpit of the patient.

A rectal temperature is considered the most accurate means of obtaining a person’s body
temperature. It is obtained by inserting the tip of the digital thermometer into the patient’s
rectum. It is most commonly used in newborns and in patients whose body temperature is in
critical need of monitoring.

A tympanic thermometer is used to take a temperature in a person’s ear. It measures the

temperature of the tympanic membrane (eardrum). These thermometers can be difficult to
obtain an accurate reading due to improper placement of the thermometer.

A temporal thermometer measures the temperature of the temporal artery using an infrared
scanner. It is taken by sweeping the thermometer across the forehead.

Normal oral temperature is considered to be 98.6 degrees Fahrenheit. Normal oral body temperature
range is considered one degree above and one degree below 98.6.

Normal axillary temperature is considered to be 97.6 degrees Fahrenheit. Normal axillary body
temperature range is considered one degree above and one degree below 97.6.

Normal rectal temperature is considered to be 99.6 degrees Fahrenheit. Normal rectal body
temperature range is considered one degree above and one degree below 99.6.

Pulse

Pulse is the measurement of heart beats per minute. It helps determine how well a person’s
cardiovascular system is functioning. A person has several locations where the blood pushing
against the arterial walls can be felt as the heart beats; these are called pulse points. An
example of a pulse point is the radial pulse. The radial pulse can be felt on the thumb side of
the wrist by placing two fingers (not your thumb because it has its own pulse) over the radial
artery and counting the number of beats per minute. A pulse can also be auscultated by using a
stethoscope to listen to the apical pulse which is found at the bottom left side of the heart.

37
Pulse points:

https://i.pinimg.com/236x/55/a1/27/55a127d4c7d1ca10f31edea4d3a22c70.jpg?nii=t

Normal Range Pulse Rates bpm=beats per minute

Adults 60-100 bpm
Teenagers 60-100 bpm
Children 70-120 bpm
Infants 120-160 bpm

Respiration

Respiration is the measurement of breaths per minute. A respiration consists of one inhalation
(breath in) and one exhalation (breath out). Respirations are counted while watching for the
rise and fall of the chest (one inhalation and one exhalation). Respiratory rates provide
information on the exchange of oxygen and carbon dioxide from the air into our lungs and are
important in assessing many health conditions.

38
 Normal Range Respiratory Rates bpm=breaths per minute

Adults 12-20
Children 18-30
Infants 30-60

Blood Pressure

Blood pressure is a measurement of the force of blood pushing against artery walls. This
pressure is measured in two parts. The first is the systolic pressure and consists of the
measurement of force upon the arterial walls when the heart is contracting. The second
consists of the measurement of force upon the arterial walls when the heart is at rest between
contractions. Different factors affect blood pressure readings; these can include race, gender,
age, blood volume and the diameter of arteries.

Watch the following video to help you understand the physiology associated with blood
pressure.

https://www.youtube.com/watch?v=rc4vipEx__U

Blood pressure is measured either manually with a stethoscope and a mercury or aneroid
sphygmomanometer or with an electronic sphygmomanometer. Below are examples of
different types of equipment.

Stethoscope aneroid sphygmomanometer electronic sphygmomanometer

Watch the following video to help you learn the skills necessary to obtain a blood pressure
using a stethoscope and an aneroid sphygmomanometer.

https://www.youtube.com/watch?v=bHXvhOQ0hYc&t=3s

39
 Average Blood Pressure Measurements by Age

Age Systolic Pressure Diastolic Pressure

Adult 100-130 60-90
Teenager 94-134 64-84
Children 100-120 60-74
Infant 70-90 50-64

Important vital sign terms:

Febrile- fever
Afebrile-without fever
Pyrexia-fever
Hyperthermia- body temperature exceeds 104 degrees Fahrenheit (should be measured
rectally)
Hypothermia- body temperature below 95 degrees Fahrenheit (should be measured rectally)
Bradycardia-slow heart rate (below 60 bpm in adults)
Tachycardia-fast heart rate (above 100 bpm in adults)
Stethoscope- a medical device that allows you to listen to the heart, lungs and bowel sounds
Auscultate- listening for sounds with a stethoscope
Bradypnea- below normal respiratory rate
Tachypnea- above normal respiratory rate
Apnea- absence of breathing
Dyspnea-difficulty breathing
Hypotension-below normal blood pressure
Hypertension-above normal blood pressure

40
Reference:
Marshall, J., & Roe, S. C. (2018). Health science: concepts and applications. Tinley Park, IL: The
Goodheart-Wilcox Company, Inc.

41
Maslow’s Hierarchy of Human Needs & Growth and Development

When providing care to patients, healthcare workers need to understand the basics of human
needs, growth and development.

Maslow’s Hierarchy of Human Needs:

Self-Actualization Needs-This
is need for self-fulfillment of
one’s potential and talents. All
needs have been fulfilled to
some degree.

Esteem Needs-This is the need to be liked and be

respected.

Love and Acceptance Needs-This is the need to have

support, assurance, praise, and acceptance.

Security Needs-This is the need to want to feel safe in surroundings.

Physical Needs-This is the need for air, water, food, clothing, shelter, and medical care
and is the most basic of needs.

There are 4 types of Growth and Development.

1. Physical or body growth.

2. Mental or development of the mind.
3. Emotional or development of the mind.
4. Social-interacting and relating to others.

42
Each stage presents its own challenge.

Infancy: Birth to 1 year- Physical, Security, Love, and Acceptance. In this stage, the first month
of life is considered a neonate. After the first 30 days, the baby is called an infant. Babies
require Maslow’s Hierarchy of Physical Needs. This stage brings dramatic and rapid changes.
The baby begins to roll over, crawl, walk, and grasp objects in this stage. Mental development
brings responses to cold, hunger, and pain through crying. The baby begins to recognize
surroundings and people. Emotionally the baby can show anger, distrust, happiness, and
excitement.

Good nutrition is very important in this stage. Babies need a well-balanced diet. Newborns are
just learning to suck and swallow, so their nutrition must come in liquid form. Breast milk is
ideal for the first 6 months. If breast milk is not an option, then supplemental formula is
needed. Selection of formula is important to meet nutritional requirements. Between 6 and 12
months, babies can begin eating solids. Solid foods should be introduced one at a time and
always in small amounts. Parents may notice food intolerance at this time.

Sleep is also very important to an infant’s growth and development. Typically, babies sleep for
about 3 hours, wake for one, and then repeat the pattern. Eating and sleeping patterns are not
necessarily consistent. As babies grow, their stomach can hold more food, and they may adapt
to the rhythms of the household. Throughout infancy, babies may take two naps a day.

Early Childhood: One to Six Years-Physical, Security, Love, and Acceptance

Children in this stage, who are between one and three years of age are called toddlers. A
toddler needs constant attention. Most toddlers walk by 15 months and can run easily, throw a
ball, and scribble with a crayon by the age of two.

By their second birthday, most toddlers weigh about 27 pounds and are about 3 feet tall.
Currently, most toddlers also have all their primary teeth except the second molars. By their
third birthday, toddlers weigh around 32 pounds and are about 38 inches tall. Toddlers can fall
and get up several times an hour. Toddlers can open cabinets and get into bottles that may
contain harmful or poisonous liquids. As a result. Toddlers must be monitored constantly.

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Childproofing is important at this stage. By age three, most children have made significant
progress with toilet training. However, they still have accidents, and they need to be reminded
to use the toilet throughout the day. The progress of toilet training varies among children.

Children who are between three and five years old are often called preschoolers. During this
period, boys, and girls appear slimmer as the trunk of their bodies lengthen and body fat
lessens. Their bodies are more muscular, and most preschoolers are capable of learning many
coordinated activities. Fine-motor skills begin to improve, and by four years old, most children
can attempt activities such as coping alphabet letters, building a block tower, and dressing and
undressing.

Middle Childhood: Six to Ten Years-Physical, Security, Love, Acceptance, and Esteem

The period from six to ten years is the middle childhood stage. Physical development at this
state is slow and steady. Muscle coordination become well developed, and some children
master physical activity requiring complex motor-sensory coordination. Mentally, these
children are developing quickly, as much of their life revolves around school. Reading and
writing skills advance, and abstract concepts like loyalty, values, honesty, and morals become
understood. Typical growth in height averages between two and three inches a year. At this
age, many children show signs that their bodies are changing.

Obesity is on the rise in children from six to ten years old. Some children lead sedentary lives,
spending most of their time inside watching TV or playing computer games. They may eat junk
food as a snack instead of fruits and vegetables. Obesity during childhood is a serious concern
because it can lead to diseases throughout life such as high blood pressure, high cholesterol,
and type 2 diabetes.

Children in this age range may become involved with sports. Team sports can be beneficial
because they allow children to gain experience interacting with other and to improve their
motor skills. Sports also provide outdoor exercise.

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Late Childhood: Ten to Twelve Years- Physical, Security, Love, Acceptance, and Esteem

Preadolescence is often defined as the years from age 10-12. Children in this age group are
sometimes referred to as preteens. Many preteens begin to replace fear with the ability to
cope. Socially, preteen activities become more group-oriented and the opinions of others
become more important. Preteens need reassurance, parental approval, and acceptance from
their peers.

By age 10-12, sexual maturation and changes in body functions can lead to emotional ups and
downs. These changes can cause restlessness, anxiety, and periods during which the preteen is
difficult to understand. By this age, many children can better understand abstract concepts
such as loyalty, honesty, and values. Preteens also may begin to develop an awareness of the
opposite sex. Dependency on parents begins to lessen during this time, and preteens may
spend less time at home.

Adolescence: Twelve to Twenty Years- Physical, Security, Love, Acceptance, and Esteem

Adolescence can be full of excitement and exploration. It is also a time for tremendous physical
and psychological changes that can cause anxiety and conflict. Physical development during
this stage is accelerated. Puberty leads to the development of secondary sexual characteristics.
Both boys and girls experience the growth of underarm and pubic hair. Girl’s breasts begin to
develop, and their hips widen, while boys experience muscle growth and facial hair
development. Girls also begin to menstruate, and boys produce sperm and semen. Hormones
surge, weight control may become an issue, and acne may influence teenager’s physical
appearance and social interactions.

Mental development during this stage may include reasoning, abstract thinking, and critical
thinking. Adolescents may not see the connection between behavior and consequences,
leading them to make potentially bad decisions. In this stage of life, teenagers must learn to
make good decisions and accept responsibility for negative actions.

Mental development during this stage may include reasoning, abstract thinking, and critical
thinking. Adolescents may not see the connection between behavior and consequences,

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leading them to make potentially bad decisions. In this stage of life teenagers must learn to
make good decisions and accept responsibility for negative actions.

A teenager’s emotions can be stormy and may cause conflict with those around them. The use
of alcohol and/or drugs can occur at any life stage, but it frequently begins during adolescence.
Reasons for drug abuse may include stress relief, peer pressure, escape from problems,
experimentation, the need for instant gratification, and possibly hereditary traits. During this
stage, teenagers may also develop concern for the welfare of others. This may lead to
involvement in community service projects.

Social development revolves around a teenager’s peers, who hold great influence. Adolescents
often feel enormous pressure to look good. Body image is often influenced by flawless,
unrealistic examples presented in the media. As a result, eating disorder can be a problem at
this age.

Toward the end of adolescence, teenagers hopefully feel more comfortable with who they are
and begin to focus on who they might become as an adult.

Early Adulthood: Twenty to Forty Years-Security, Love, Acceptance, and Esteem

When an individual reaches early adulthood, physical development has been completed.
Muscles are fully developed, and coordination is at its peak. Young adults often experience
many transitions in their lives as they choose careers and achieve independence, which can be
a challenge. Moving from familiar, comfortable environment to a new location can be stressful
and intimidating. Early adulthood can also be exciting for those who are happily establishing
their adult identities and feeling free to manage their own lives. Some young adults pursue
additional education so they may progress in their chosen careers.

Many individuals find a partner and start a family during this life stage. However, this stage in
life is very different now than it was in the past, when people got married in their late teens or
early twenties. Economic strains may result in young adults living at home until their late
twenties. This may cause young adults to delay the start of their own families, and they may

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not have children until their thirties or even early forties. Young adults do not experience many
health problems.

Socially, young adults may spend more time with friends who have similar ambitions, interests,
and life paths. Career decisions may dictate a young adult’s lifestyle choices. Women can
choose a career that wasn’t available to their mothers or grandmothers. Men may stay at
home with the children or choose position that were traditionally filled by females. Traditional
gender roles continue to be in flux for this age group. This is an exciting life stage for most
young adults.

Middle Adulthood: Forty to Sixty-Five Years- Security, Love, Acceptance, and Esteem

People in middle adulthood, often called middle age, are active and productive but may notice
signs of aging. Middle-aged adults may experience thinning or graying hair, wrinkles on their
skin, weakening muscles, hearing loss, changes in eyesight, and weight gain. Women
experience menopause, or the end of menstruation, which causes decreased hormone
production and physical and emotional changes. Men also experience a slowing of hormone
production.

Middle-aged adults continue to develop mentally, often becoming confident decision makers
and troubleshooters. At this stage in life, many people seek more education, sometimes
graduating from college with a new degree or starting a new career. By this time, individuals
have often gained an understanding of life and have learned to cope productively with stresses.

Emotionally, middle adulthood can bring satisfaction and contentment. However, the fear of
aging, the loss of youth and vitality, and stresses of older children and aging parents can cause
feelings of depression, anxiety, and even anger. Divorce rates are high in this age group, as
couples who have stayed together to raise children decide to separate.

The term midlife crisis was coined in the 1980’s to describe a period between the ages of forty
and fifty when some men and women realize their own mortality. The burden of unrealized
goals, an unfulfilling career, and the appearance of aging-related physical changes may cause
personal crises. Children leaving home can cause an individual to reevaluate his or her role in

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the family. This phenomenon does not appear throughout all cultures, meaning that the
“culture of youth” in Western societies might account for this “crisis.”

The health of many middle-aged people is still good, but signs of future problems can appear.
These signs may include high cholesterol, arthritis, diabetes, and other issues resulting from
obesity and lack of exercise.

Late Adulthood: Sixty-Five Years and Up Security, Love, Acceptance, Esteem, and Self-
Actualization

During these years, all body systems begin to show signs of aging. Advances in geriatrics, a
branch of medicine concerned with problems associated with old age, have successfully
extended this stage of life for many people. Travel, volunteerism, and social activities can
enhance late adulthood. Many individuals do not show physical signs of aging until their
seventies or eighties. Mental ability can vary among older adults. Some people in their nineties
remain alert and oriented, while some younger people may already show signs of decreased
mental ability.

In late adulthood, wrinkles and age spots begin to appear, and the skin begins to dry. Muscles
lose tone and strength, and the bone disease osteoporosis can lead to an increased incidence of
bone fracture, especially of the hip. Memory loss can occur during this stage, but many people
remain mentally active. A decline in the function of the nervous system can lead to hearing
loss, declining vision, and intolerance for temperatures that are either too cold or too hot.

Emotional development during this stage can vary great among individuals. Some people slip
into depression due to loss of identity after retirement or the death of a spouse and friends.
Older adults often feel depressed when facing the reality of their own eventual death as well.
Physical infirmities can lead to increased dependence on others, which is very difficult for most
people. These infirmities may mean a person must move to a retirement community or
assisted-living facility. Today, many retirement communities offer a broad range of life-
affirming activities.

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Emotional stability varies greatly among individuals in late adulthood. Some people can cope
with the stresses of getting old, while others become lonely, frustrated and depressed. In
general, how a person has dealt with stresses throughout his or her entire life will dictate the
way stress is handled in late adulthood.

For many aging people, grandchildren become very important in their daily lives. Interacting
with young people can bring back positive memories of childhood and raising children.
However, grandparents are increasingly raising their grandchildren on their own. Nationwide,
there are millions of children living in households headed by grandparents. Some common
reasons for this phenomenon include parental abandonment, divorce, teenage pregnancy,
mental or physical illness, substance abuse, abuse and neglect, and incarceration. These
situations can place great stress on older adults, especially if they have limited financial
resources, making it difficult to provide adequate housing, food, and clothing.

Lastly, people are living longer, and the number of older adults is increasing, along with the
diversity of older adults’ needs and interests. In addition, many states predict dramatic
workforce shortages in industries that provide services to the aging population. Therefore, the
demand for professionals with expertise in aging is growing rapidly, and career opportunities in
gerontology and geriatrics are numerous and varied.

Death and Dying-This is the final stage of growth, and life. There are 5 stages:

1. Denial. The person refuses to believe death is coming.

2. Anger. Feelings of negativity develop and may be directed at a person’s own illness or
body.
3. Bargaining. A person wants more time and proposes deals or exchanges to extend life.
4. Depression. Struggling with the loss of life can cause people to become dad, withdrawn,
and disinterested in activities.
5. Acceptance. The reality of death is understood and accepted. If a person reaches this
stage, death can be a peaceful experience.
Death is a part of life. By understanding the process of dying and learning about the needs of
the dying, the healthcare worker can provide special care to patients, and possibly to his or her
own family members when the time comes.

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 References

Marshall, J., & Roe, S. C. (2018). Health science: concepts and applications. Tinley Park, IL: The
Goodheart-Wilcox Company, Inc. pp. 272-287

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