1. health and fitness
2. disease

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MOSBY’S
DICTIONARY
OF MEDICINE, NURSING &
HEALTH PROFESSIONS
3RD AUSTRALIAN AND
NEW ZEALAND EDITION
EDITORS-IN-CHIEF
Peter Harris
MBBS, FRACGP; Senior Lecturer in Medical Education,
University of New South Wales, New South Wales
Sue Nagy
RN, BA(Hons), PhD, FCN; Adjunct Professor,
Faculty of Health,
University of Technology, Sydney, New South Wales
Nicholas Vardaxis
BSc(Hons), PhD; Executive General Manager,
Courses and Quality, Open Universities Australia
Sydney Edinburgh London New York Philadelphia St Louis Toronto
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Contents
Preface vi
Specialist Consultants vii
Appendix Consultants ix
Reviewers x
Editorial Board Members x
Consultants xi
Guide to the Dictionary xii
Pronunciation Key xv
Colour Atlas of Human Anatomy A-1
Skeletal system A-2
Muscular system A-8
Circulatory system A-12
Endocrine system A-19
Lymphatic system A-21
Nervous system A-24
Respiratory system A-29
Digestive system A-33
Reproductive system A-36
Urinary system A-40
Special senses A-43
Dictionary entries A–Z 1–1853
Appendices
1 Units of measurement 1857
2 Symbols and abbreviations 1869
3 Medical terminology 1880
4 Normal reference values 1900
5 Nutrition 1916
6 Medication: clinical calculations, interactions, issues of safety, and usage rates 1944
7 Infection control 1980
8 Health of Aboriginal, Torres Strait Islander and Māori people 1992
9 Tabular atlas of human anatomy and physiology 1998
Picture credits 2035
The following appendices are available at http://evolve.elsevier.com/AU/ANZMD/
10 Assessment guides 2035
11 Health promotion and immunisation 2044
12 Complementary and alternative medicine 2054
13 Herbs and natural supplements 2065
14 Health organisations and resources 2081
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v
Skeletal system
SKELETAL SYSTEM
POSTERIOR VIEW OF SKELETON
ANTERIOR VIEW OF SKELETON
Frontal bone
Parietal bone
Nasal bone
Orbit
Maxilla
Mandible
Clavicle
Zygomatic bone
Manubrium
Scapula
Sternum
Costal cartilage
Ribs
Xiphoid process
Humerus
Vertebral
column
Radius
Ulna
Coxal (hip)
bone
Ilium
Sacrum
Coccyx
Occipital bone
Cervical vertebrae (7)
Clavicle
Acromion
Scapula
Thoracic
vertebrae (12)
Ribs
Humerus
Lumbar
vertebrae (5)
Coxal (hip)
bone
Ulna
Radius
Carpal bones
Metacarpal
bones
Phalanges
Carpal bones
Metacarpal
bones
Phalanges
Pubis
Ischium
Greater trochanter
of femur
Coccyx
Ischium
Sacrum
Femur
Femur
S
R
L
Patella
I
Axial skeleton
Appendicular
skeleton
Tibia
Tibia
Fibula
Fibula
Tarsal bones
Metatarsal bones
Phalanges
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Tarsal bones
Phalanges
Metatarsal bones
Calcaneus
Skeletal system
ANTERIOR VIEW OF SKULL
Frontal bone
Squama of frontal bone
Frontal eminence
Coronal suture
Parietal bone
Superciliary ridge
Supraorbital foramen
Orbital plate of frontal bone
Sphenoid (greater wing)
Superior orbital fissure
Optic foramen
Lacrimal bone
Inferior orbital fissure
Infraorbital foramen
Glabella
Supraorbital margin
Zygomatic process
of frontal bone
Temporal bone
Nasal bone
Zygomatic bone
Nasal cavity
Maxilla
Middle and inferior
nasal conchae
Ramus of mandible
Body of mandible
Mental foramen
Anterior fontanel
Parietal bone
Frontal bone
Parietal
eminence
FETAL SKULL
Frontal suture
Frontal
eminence
Sphenoid
fontanel
Nasal bone
Lacrimal bone
Sphenoid
Maxilla
Posterior
fontanel
Occipital bone
Mastoid fontanel
Zygomatic bone
Temporal bone
(petrous portion)
Mandible
Tympanic ring
Temporal bone
(squamous portion) External auditory meatus
Coronal suture
Frontal bone
Superior temporal line
Inferior temporal line
Superciliary ridge
Splenoid (greater wing)
Supraorbital foramen
Nasal bone
Lacrimal bone
Infraorbital foramen
Sagittal suture
Parietal bone
Squamosal suture
Temporal bone
Occipital bone
Lambdoidal suture
External occipital
protuberance
Zygomatic bone
Maxilla
Mastoid process
External auditory meatus
Styloid process
Zygomatic process
of temporal bone
Mandible
RIGHT LATERAL VIEW OF SKULL
Mental foramen
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Skeletal system
THORAX AND RIBS
Costosternal articulation
Clavicle
C7
T1
1
2
3
True ribs
Manubrium
4
Body
Sternum
Xiphoid
process
5
6
7
False ribs
8
11
9
12
Costal
cartilage
L1
10
Floating ribs
PELVIS
MALE
FEMALE
Pelvic inlet
Pelvic outlet
Subpubic angle
Pelvic inlet
Sacral
promontory
Iliopectineal
line
Pubic crest
Symphysis
pubis
Pelvic inlet
Pelvic outlet
Ischial spine
Coccyx
Symphysis
pubis
Pelvic outlet
Subpubic angle
RIB
Tubercle
INDIVIDUAL VERTEBRA
Angle
Head
Neck
Internal surface
Costal
groove
Costal cartilage
Transverse
process
Spinous
process
Superior view
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External surface
Skeletal system
Atlas
Axis
VERTEBRAL COLUMN
Cer vical
cur vature
Cervical
vertebrae
cic curvature
(7)
Thora
Thoracic
vertebrae
ar cur vature
Lumb
Lumbar
vertebrae
(5)
Sa c
ral curva
tur
e
Intervertebral
foramina
(12)
Sacrum
Coccyx
Right lateral view
Anterior view
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Skeletal system
SECOND CERVICAL VERTEBRA (AXIS)
FIRST CERVICAL VERTEBRA (ATLAS)
Superior
articular
facet
Anterior tubercle
Anterior arch
Facet for dens
Lateral mass
Dens
Transverse
process
Impressions
for alar
ligaments
Transverse
foramen
Facet for
occipital condyle
Posterior arch
Vertebral
foramen
Posterior tubercle
Spinous process
THORACIC VERTEBRA
FIFTH CERVICAL VERTEBRA
Transverse foramen
Vertebral body
Vertebral body
Superior demifacet
Transverse
process
Vertebral
foramen
Pedicle
Vertebral canal
Spinous process
Spinous process
Facet for articulation
with tubercle of rib
Lamina
Transverse process
SACRUM AND COCCYX
Ala
LUMBAR VERTEBRA
Promontory
Vertebral
body
Pedicle
Anterior sacral
foramina
Transverse process
Vertebral
arch
Lamina
Cornua
Coccyx
Transverse process
Spinous process
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Skeletal system
MICROSCOPIC STRUCTURE OF BONE
Osteon
Concentric Circumferential Central
(Haversian system) lamellae
lamellae
(Haversian)
canal
Interstitial
lamellae
Lacunae
containing
osteocytes
Blood vessels
within central
(Haversian) canal
Periosteum
Blood vessel
within transverse
(Volkmann) canal
Osteons
(Haversian
systems)
Endosteum
Periosteum
Inner
layer
Outer
layer
Trabeculae
Compact bone
Cancellous
(spongy) bone
Central (Haversian) canals
Transverse (Volkmann) canals
Medullary
(marrow) cavity
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Muscular system
MUSCULAR SYSTEM
ANTERIOR VIEW
Facial muscles
Sternocleidomastoid
Trapezius
Deltoid
Pectoralis major
Serratus anterior
Biceps brachii
Rectus abdominis
Linea alba
Flexors of wrist
and fingers
Extensors of wrist
and fingers
External abdominal oblique
Adductors
of thigh
Tensor fasciae latae
Retinaculum
Vastus lateralis
Sartorius
Rectus femoris
Vastus medialis
Patella
Patellar tendon
Gastrocnemius
Tibialis anterior
Extensor digitorum
longus
Peroneus (Fibularis) longus
Soleus
Peroneus (Fibularis) brevis
Superior extensor
retinaculum
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Muscular system
POSTERIOR VIEW
Sternocleidomastoid
Seventh cervical vertebra
Splenius capitis
Trapezius
Deltoid
Infraspinatus
Teres minor
Teres major
Triceps brachii
Latissimus dorsi
External abdominal
oblique
Extensors
of the wrist
and fingers
Gluteus maximus
Semitendinosus
Hamstring
group
Adductor magnus
Biceps femoris
Semimembranosus
Gracilis
Iliotibial tract
Gastrocnemius
Calcaneal tendon
(Achilles tendon)
Peroneus (Fibularis) longus
Soleus
Peroneus (Fibularis) brevis
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Muscular system
LATERAL AND ANTERIOR VIEWS OF
MUSCLES OF THE FACE AND ANTERIOR CRANIUM
AND SEVERAL MUSCLES OF MASTICATION
Frontalis
Galea aponeurotica
Orbicularis oculi
Temporalis
Corrugator
Temporalis fascia
Procerus
Auricularis superior
Levator labii superioris
alaeque nasi
Levator labii superioris
Auricularis anterior
Occipitalis
Zygomaticus minor
Auricularis posterior
Levator anguli oris
Zygomaticus major
Masseter
Orbicularis oris
Risorius (cut)
Mentalis
Sternocleidomastoideus
Depressor labii inferioris
Depressor anguli oris
Trapezius
Buccinator
Omohyoideus
Sternohyoideus
Galea aponeurotica
(frontal portion)
Medial palpebral ligament
Epicranius
(frontal belly)
Orbicularis oculi
(orbital portion)
Orbicularis oculi
(palpebral portion)
Levator labii superioris
Zygomaticus minor
Parotid gland
Zygomaticus (major)
Risorius
Levator anguli oris
Procerus
Temporalis
Corrugator
Levator labii superioris alaeque nasi
Zygomaticus minor and major (cut)
Nasalis
Levator anguli oris (cut)
Masseter
Buccinator
Orbicularis oris
Depressor anguli oris
Mentalis
Depressor labii inferioris
Platysma (part)
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Muscular system
Splenius capitis
Dotted line indicates
outline of trapezius
Levator scapulae
Rhomboid minor
Rhomboid major
Supraspinatus
Infraspinatus
Teres minor
Dotted line indicates
attachment of latissimus
dorsi to humerus
Serratus posterior
superior
Rhomboids (cut edge)
Dotted line indicates
outline of trapezius
Longissimus thoracis
Teres major
Thoracolumbar
fascia
Latissimus dorsi
12th thoracic
vertebra
Iliocostalis thoracis
Spinalis thoracis
Serratus posterior
inferior
Internal oblique
External oblique
Erector spinae
SOME SUPERFICIAL
MUSCLES OF THE BACK
Sternocleidomastoid
tendon (cut)
Semispinalis capitis
CLINICAL NOTE: Chest wall muscles
The many insertions of dorsal muscles into the ribs
and vertebrae allow for precision in control and
flexibility in twisting and turning movements of the
trunk. The fibres of the intercostal muscles run
obliquely, but some are at right angles to others;
they play an important part in increasing thoracic
volume during respiration.
Splenius capitis
Sternocleidomastoid
Levator scapulae (cut)
Trapezius
Splenius cervicis
7th cervical vertebra
Rhomboid minor
Rhomboid major
Deltoid (cut)
Coracobrachialis
Deltoid
Pectoralis major
SUPERFICIAL MUSCLES OF THE
POSTERIOR NECK AND UPPER BACK
Serratus anterior
Biceps
brachii
SUPERFICIAL MUSCLES OF THE
UPPER CHEST AND SHOULDERS
Long head of
the triceps
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Circulatory system
CIRCULATORY SYSTEM
PRINCIPAL ARTERIES
Occipital
Facial
Internal carotid
External carotid
Right common carotid
Right subclavian
Left common carotid
Left subclavian
Arch of aorta
Pulmonary
Brachiocephalic
Right coronary
Left coronary
Axillary
Aorta
Splenic
Brachial
Renal
Superior mesenteric
Coeliac
Abdominal aorta
Inferior mesenteric
Common iliac
Radial
Internal iliac (hypogastric)
Ulnar
External iliac
Deep medial circumflex
femoral
Deep palmar arch
Superficial palmar arch
Digital
Descending branch of
lateral circumflex femoral
Deep artery of thigh
Perforating arteries
Femoral
Popliteal
Anterior tibial
Peroneal
Posterior
tibial
Arcuate
Dorsal pedis
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Circulatory system
PRINCIPAL VEINS
Occipital
Angular
Facial
External jugular
Internal jugular
Left brachiocephalic
Left subclavian
Right brachiocephalic
Right subclavian
Superior vena cava
Axillary
Right pulmonary
Cephalic
Great cardiac
Small cardiac
Inferior vena cava
Basilic
Hepatic
Long thoracic
Splenic
Hepatic portal
Superior mesenteric
Inferior mesenteric
Median cubital (basilic)
Common iliac
Common iliac
Internal iliac
External iliac
Digital
Femoral
Femoral
Great saphenous
Small saphenous
Popliteal
Fibular
Anterior tibial
Posterior tibial
Venous dorsal arch
Digital
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Circulatory system
MAJOR ARTERIES OF THE HEAD AND NECK
Superficial
temporal artery
Posterior
auricular artery
Occipital
artery
Maxillary
artery
Lingual artery
Internal carotid
artery
Ascending
pharyngeal
artery
Facial artery
External carotid
artery
Superior thyroid artery
Vertebral artery
Subclavian artery
Common carotid
artery
Brachiocephalic
artery
Superior sagittal sinus
Inferior sagittal sinus
Straight sinus
Transverse sinus
Occipital sinus
Cavernous sinus
Superior petrosal sinus
Sigmoid sinus
Ophthalmic veins
Facial vein
Inferior petrosal sinus
S
P
A
Internal jugular vein
I
(oblique)
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Circulatory system
VEINS FORMING THE SUPERIOR VENA CAVA
Retromandibular vein
Internal jugular vein
External jugular vein
Internal jugular vein
Facial vein
Lingual vein
Superior thyroid vein
Subclavian vein
Right brachiocephalic vein
Superior vena cava
Azygos vein
S
Intercostal veins
R
L
I
(oblique)
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Circulatory system
ANTERIOR VIEW OF THE HEART
Left common carotid artery
Left subclavian artery
Brachiocephalic trunk
Arch of aorta
Superior vena cava
Ligamentum arteriosum
Auricle of left atrium
Ascending aorta
Pulmonary trunk
Conus arteriosus
Left pulmonary veins
Right pulmonary veins
Great cardiac vein
Circumflex artery
Auricle of right atrium
Anterior interventricular branches of
left coronary artery and cardiac vein
Right coronary artery
and cardiac vein
Left ventricle
Right ventricle
Apex
POSTERIOR VIEW OF THE HEART
Left common carotid artery
Left subclavian artery
Left pulmonary artery
Left pulmonary veins
Auricle of left atrium
Left atrium
Great cardiac vein
Brachiocephalic trunk
Aortic arch
Superior vena cava
Right pulmonary artery
Right pulmonary veins
Right atrium
Inferior vena cava
Coronary sinus
Posterior artery
and vein of left ventricle
Left ventricle
Posterior interventricular branch
of right coronary artery
Middle cardiac vein
Posterior interventricular sulcus
Right ventricle
Apex
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Circulatory system
MAJOR ARTERIES OF THE UPPER EXTREMITY
Thyrocervical trunk
Subclavian artery
Common carotid artery
Brachiocephalic artery
Internal thoracic artery
Lateral thoracic artery
Axillary artery
Vertebral artery
Thoracoacromial artery
Humeral circumflex arteries
Subscapular artery
Deep brachial artery
Brachial
artery
Radial artery
Ulnar artery
Deep palmar arch
Superficial palmar arch
Digital arteries
MAJOR ARTERIES OF THE LOWER EXTREMITY
Inferior vena cava
Common iliac artery
External iliac artery
Superior gluteal
artery
Ascending branch
of lateral circumflex
femoral artery
Lateral circumflex
femoral artery
Perforating arteries
Descending branch
of lateral circumflex
artery
Popliteal artery
Abdominal aorta
Median sacral artery
Internal iliac artery
Lateral sacral artery
Inferior gluteal artery
Internal pudendal artery
Obturator artery
Deep artery of thigh
Medial circumflex
femoral artery
Femoral artery
Deep artery of thigh
Genicular arteries
Fibular artery
Anterior tibial artery
Lateral plantar arch
Plantar arch
Digital arteries
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Posterior tibial artery
Dorsalis pedis artery
Medial plantar artery
Circulatory system
MAJOR VEINS OF THE UPPER EXTREMITY
Internal jugular
vein
Brachiocephalic
vein
Subclavian vein
Axillary vein
Cephalic vein
Brachial
veins
Basilic vein
Median cubital
(basilic) vein
Ulnar vein
Radial vein
Digital veins
MAJOR VEINS OF THE LOWER EXTREMITY
Inferior vena cava
Common iliac vein
External iliac vein
Internal iliac vein
Femoral vein
Great saphenous vein
Popliteal vein
Fibular (peroneal) vein
Small
saphenous vein
Posterior tibial vein
Great saphenous vein
Anterior tibial vein
Dorsal veins of the foot
Dorsal venous arch
Digital vein
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Endocrine system
ENDOCRINE SYSTEM
GLANDS OF THE ENDOCRINE SYSTEM
Hypothalamus
Pineal
Pituitary
Parathyroids
Thyroid
Thymus
Adrenals
Pancreas
(islets)
Ovaries
(female)
Testes
(male)
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Endocrine system system
LOCATION OF THE PITUITARY AND PINEAL GLANDS
Cerebral
cortex
Cerebrum
Intermediate mass of thalamus
Corpus
callosum
Right lateral mass of
thalamus
Fornix
Pineal body
Third ventricle
Midbrain
Diencephalon
Hypothalamus
Optic chiasm
Pituitary gland
Infundibulum
GROSS ANATOMY OF THE THYROID GLAND
Epiglottis
Hyoid bone
Larynx
(thyroid cartilage)
Superior
parathyroid glands
Pyramidal lobe
Lateral lobe
Thyroid
gland
Inferior
parathyroid glands
Thyroid gland
Isthmus of
thyroid gland
Trachea
Tail of pancreas
PANCREAS
Bile duct
Accessory pancreatic duct
Main pancreatic duct
Minor duodenal papilla
Major duodenal papilla
Hepatopancreatic ampulla
Head of pancreas
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Lymphatic system
LYMPHATIC SYSTEM
ORGANS OF THE LYMPHATIC SYSTEM
Tonsils
Cervical lymph node
Entrance of thoracic duct
into subclavian vein
Thymus gland
Axillary lymph node
Right lymphatic duct
Thoracic duct
Superficial cubital
(supratrochlear) lymph nodes
Spleen
Cisterna chyli
Aggregated lymphoid nodules
(Peyer patches) in intestinal wall
Red bone marrow
Inguinal lymph node
S
R
L
I
Right lymphatic duct
Right subclavian vein
Thoracic duct
Left subclavian vein
Drained by thoracic duct
Drained by right lymphatic duct
STRUCTURE OF THE LYMPHATIC CAPILLARY
Overlapping endothelial cells
Interstitial fluid (IF) entering
lymphatic capillary
Valve closed
Valve open
Direction
of flow
Anchoring fibres
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Lymphatic system
STRUCTURE OF THE SPLEEN
Anterior margin
Trabecula
Capsule
Gastric surface
Renal surface
Splenic artery
Hilum
Splenic vein
Artery
Vein
Pancreatic surface
Red pulp
White pulp
Venous sinuses
GROSS ANATOMY OF THE THYMUS
Right internal thoracic artery
Left internal thoracic artery
TIV/V vertebral level
Thymus
Pericardial sac
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Lymphatic system
LYMPHATIC DRAINAGE SYSTEM
OF THE HEAD AND NECK
Posterior auricular
(mastoid) nodes
Preauricular
nodes
Parotid nodes
Occipital nodes
Sternomastoid nodes
Facial nodes
External jugular node
Submandibular nodes
Retropharyngeal (tonsillar) node
Posterior cervical
spinal nerve chain
Submental nodes
Sublingual node
Posterior superficial
cervical chain
Suprahyoid node
Thyrolinguofacial node
Anterior deep and
superficial cervical nodes
Internal jugular chain
Supraclavicular
nodes
SCHEMATIC SECTION OF A LYMPH NODE
Lymph
Capsule
Afferent
lymph
vessels
Sinuses
Germinal center
Cortical nodules
Trabeculae
Medullary cords
Hilum
Medullary sinus
Efferent lymph vessel
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Nervous system
NERVOUS SYSTEM
SIMPLIFIED VIEW OF THE NERVOUS SYSTEM
Cerebrum
Cerebellum
Brachial plexus
Musculocutaneous
nerve
Intercostal nerves
Spinal cord
Cauda equina
Femoral nerve
Ischial nerve
Femoral cutaneous nerve
Saphenous nerve
Tibial nerve
Peroneal nerve
Digital nerves
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Nervous system
GROSS ANATOMY OF THE SPINAL CORD
C1
C2
C3
C4
C5
Cervical
nerves
C6
Cervical
plexus
Cervical
vertebrae
C1
C2
C3
C4
C5
C6
C7
Brachial
plexus
C7
C8
Lumbar
vertebrae
T1
T2
T3
T3
T4
T4
T5
T5
T6
T6
T7
T7
T8
T9
T8
T9
T10
T10
T11
T11
T12
T12
L1
L1
L2
L2
L3
L3
L4
L4
L5
L5
Thoracic
nerves
Dura mater
Cauda equina
Lumbar
nerves
Lumbar
plexus
Thoracic
vertebrae
T1
T2
Sacrum
S1
Sacral
nerves
S3
S4
S5
Coccyx
Coccygeal
nerve
Filum terminale
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Sacral
plexus
S2
Nervous system
CEREBRAL NUCLEI
Lentiform nucleus
Basal nuclei
Caudate nucleus
Thalamus
Amygdaloid nucleus
Substantia nigra
(in midbrain)
Body of
caudate nucleus
Corpus
striatum
Internal capsule
Lentiform Putamen
nucleus
Pallidum
Putamen
Thalamus
Mamillary body
Head of caudate nucleus
RETICULAR ACTIVATING SYSTEM
Radiations to cortex
FUNCTIONAL AREAS OF THE CEREBRAL CORTEX
Precentral gyrus
(primary somatic
motor area)
Premotor area
Prefrontal area
Motor speech
(Broca) area
Auditory
Transverse association area
gyrus
Primary
auditory area
Central sulcus
Postcentral gyrus (primary
somatic sensory area)
Primary taste area
Somatic
sensory
association
area
Visual
association
area
Visual
impulses
Reticular formation
Visual cortex
Sensory
speech
(Wernicke’s) area
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Auditory
impulses
Projection to
Ascending spinal cord
sensory tracts
Nervous system
BASE OF THE BRAIN
CRANIAL
NERVES
ARTERIES
(Circle of Willis)
Olfactory n. (I)
Anterior cerebral a.
Optic n. (II)
Middle cerebral a.
PITUITARY GLAND
Internal carotid a.
Oculomotor n. (III)
Posterior communicating a.
Trochlear n. (IV)
Posterior cerebral a.
Superior cerebellar a.
Trigeminal n. (V)
TEMPORAL LOBE
Basilar a.
Abducens n. (VI)
Facial n. (VII)
Internal auditory a.
Anterior inferior
cerebellar a.
Vertebral a.
Posterior inferior
cerebellar a.
Anterior spinal a.
Posterior cerebral a.
Vestibulocochlear
n. (VIII)
Glossopharyngeal
n. (IX)
Vagus n. (X)
Hypoglossal n. (XII)
Accessory n. (XI)
Right lobe of
cerebellum removed
CEREBELLUM
MEDULLA
BRAINSTEM AND DIENCEPHALON
Intermediate mass
Thalamus
Optic
chiasma
Hypothalamus
Cerebral
peduncle
Thalamus
Pineal body
Diencephalon
Superior colliculi
Midbrain
Inferior colliculi
Pons
Olive
Medulla
oblongata
Diencephalon
Midbrain
Cerebral peduncle
Pons
Superior cerebellar
peduncles
Middle
cerebellar
peduncle
of pons
Diencephalon
Fourth ventricle
Inferior cerebellar
peduncles of pons
Pyramid
Olive
Medulla oblongata
Brainstem
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Nervous system
BASIC STRUCTURE OF THE NEURON
Dendrite
Golgi
apparatus
Endoplasmic reticulum
Mitochondrion
Cell body (soma)
Nucleus
Axon hillock
Axon
Schwann cell
Myelin sheath
Axon collateral
Node of Ranvier
Synaptic knobs
Telodendria
MYELINATED AXON
Nucleus of Schwann cell
Node of Ranvier
Myelin sheath
Plasma membrane of axon
Neurilemma
(sheath of Schwann cell)
Neurofibrils, microfilaments, and
microtubules
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Respiratory system
RESPIRATORY SYSTEM
ORGANS OF THE RESPIRATORY SYSTEM
Nasal cavity
Nasopharynx
Oropharynx
Laryngopharynx
Upper
respiratory tract
Pharynx
Larynx
Trachea
Left and right
primary bronchi
Lower
respiratory tract
Alveolar
duct
Alveoli
Bronchioles
Bronchioles
Capillary
Alveolar
sac
NASAL PASSAGES AND THROAT
Cranial cavity
Cribriform plate
of ethmoid bone
Frontal sinus
Nasal bone
Superior nasal concha of ethmoid
Middle nasal concha of ethmoid
Vestibule
Inferior concha
Anterior naris
Hard palate
Lingual tonsil
Hyoid bone
Thyroid cartilage
(part of larynx)
Larynx
Vocal cords
(part of larynx)
Trachea
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Sphenoid sinus
Sella turcica
Pharyngeal tonsil
(adenoids)
Posterior naris
Opening of auditory
(eustachian) tube
Nasopharynx
Soft palate
Uvula
Palatine tonsil
Oropharynx
Epiglottis
(part of larynx)
Laryngopharynx
Oesophagus
Respiratory system
NASAL SEPTUM
Frontal sinus
Cribriform plate
of ethmoid bone
Nasal bone
Perpendicular
plate of ethmoid
Sphenoid
sinus
Septal
cartilage
Pharyngeal
tonsil
Vomer
Vomeronasal
cartilage
Incisive foramen
Maxilla Palatine
bone
NASAL CAVITY
Cribriform plate of ethmoid bone Sphenoid sinus
Sella turcica
Frontal sinus
Posterior
naris
Superior
turbinate
Pharyngeal
tonsil
Middle
turbinate
Inferior
turbinate
Vestibule
Anterior
naris
Hard palate
Soft palate
Uvula
Opening of auditory (eustachian) tube
BONES OF THE NASAL CAVITY
Crista galli of
ethmoid bone
Olfactory foramina
Frontal bone
Cribriform plate of
Sella turcica
ethmoid bone
of sphenoid
bone
Frontal sinus
Nasal bone
Sphenoid
bone
Perpendicular plate
of ethmoid bone
Sphenoid sinus
Vomer
Septal
cartilage
Greater alar cartilage
Horizontal plate of palatine bone
Anterior nasal spine
Palatine process of maxilla
Incisive canal
Central incisor
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Respiratory system
LUNGS
Trachea
First rib
Sternum
(manubrium)
Right superior lobe
Left superior lobe
Right primary bronchus
Left primary bronchus
Horizontal fissure
Body of sternum
Right middle lobe
Oblique fissure
Oblique fissure
Seventh rib
Right inferior lobe
Left inferior lobe
Sternum
(xiphoid process)
Right lung
Left lung
Apical segment
Superior
lobe
Anterior segment
II
Inferior
lobe
Superior
segment
Posterior
basal X
segment
Lateral basal
segment
Apicoposterior segment
I
I
Posterior segment
Anterior
segment
Superior
lingular
Superior
segment
lobe
III
II
III
IV
Superior
segment
VI
VI
IV
VII
IX
VIII
Anterior
basal segment
V
Middle
lobe
Inferior
lingular
segment
Medial segment
Lateral segment
Medial basal
(cardiac) segment
V
Medial basal
(cardiac)
segment
Anterior basal
segment
Inferior
lobe
VII
VIII
IX
X
Posterior
basal
segment
Lateral basal
segment
LARYNX AND UPPER TRACHEA
Hyoid bone
Superior thyroid notch
Epiglottis
Thyrohyoid ligament
Thyroid cartilage
Corniculate cartilage
Arytenoid cartilage
Cricothyroid ligament
Cricoid cartilage
Thyroid gland
Parathyroid gland
Trachea
Membranous part
of trachea
Tracheal cartilage
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Respiratory system
GAS-EXCHANGE STRUCTURES OF THE LUNG
Surfactant-producing
(type II) cell
Basement
membranes
Fluid containing
surfactant layer
Red
blood cell
Macrophage
Alveolus
Capillary
endothelium
Fluid
containing
surfactant
RBC
Alveolar
epithelium
O2
O2
O2
Capillary
CO2
Alveolar
epithelium
CO2
CO2
Interstitial space
Basement
membrane
Basement
membrane
Capillary
Alveolus
Respiratory membrane
LARYNX
Epiglottis
Tongue
Epiglottis
Vestibule
Hyoid bone
Vestibular fold
(false vocal fold)
Ventricle
Vocal fold
Vestibule
Cuneiform cartilage
Thyroid cartilage
(Adam’s apple)
Corniculate cartilage
Vestibular fold
(false vocal fold)
Arytenoid muscle
Vocal ligament
Thyroarytenoid
muscle
Thyroid cartilage
(Adam’s apple)
Cricoid cartilage
Cricothyroid muscle
Lumen of trachea
Cartilages
of trachea
Thyroid gland
Rima glottidis
Ventricle
Vocal fold
Vocalis muscle
Infraglottic cavity
Cricoid cartilage
S
S
A
P
Tracheal cartilage
I
Sample proofs A-32
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L
R
I
Digestive system
DIGESTIVE SYSTEM
ORGANS OF THE DIGESTIVE SYSTEM AND SOME ASSOCIATED STRUCTURES
Parotid gland
Submandibular
gland
Tongue
Sublingual gland
Pharynx
Cystic
duct
Larynx
Hepatic
duct
Trachea
Spleen
Liver
Oesophagus
Stomach
Liver
Diaphragm
Stomach
Transverse
colon
Gallbladder
Spleen
Hepatic
flexure
Duodenum
Pancreas
Splenic
flexure
Ascending
colon
Ileum
Descending colon
Caecum
Sigmoid colon
Vermiform
appendix
Anal canal
Rectum
Mesentery
Blood
vessels
Nerve
Myenteric plexus
Intramural plexus
Submucosal plexus
Submucosa
Gland in submucosa
Duct from gland
WALL OF THE
GASTROINTESTINAL TRACT
Mucosa
Mucous epithelium
Lamina propria
Serosa
Muscularis mucosae
Connective tissue layer
Muscularis
Peritoneum
Circular muscle layer
Longitudinal muscle
layer
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Lymph nodule
Digestive system
LOCATION OF THE SALIVARY GLANDS
Parotid gland
Parotid duct
Sternocleidomastoid
muscle
Buccinator
muscle
Masseter
muscle
Tongue
Frenulum
of tongue
Mandible
(cut)
Submandibular duct
(Wharton's duct)
Minor sublingual ducts
Major sublingual ducts
Sublingual gland
Submandibular gland
Mandible
(cut)
Mylohyoid
muscle
Left portion of mandible has been removed
Digastric
muscle
SOURCES OF INTESTINAL SECRETIONS
Bile from the bladder, pancreatic juice from the
exocrine pancreas, and mucus secretion from
Brunner's glands in the duodenal wall.
Stomach
Cystic duct
Common
hepatic
duct
Gallbladder neck
Gallbladder
Pancreas
(tail)
Common bile duct
Pancreas
(head)
Villi
Brunner's
glands
Ampulla
Pancreatic duct
Duodenum
Sample proofs A-34
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Spleen
Digestive system
LARGE INTESTINE
Enlarged detail of the large intestine, rectum, and
anus shows the junction between the large and
small intestines and the valve-like entry of the
ileum into the caecum.
Portal vein
Inferior vena cava
Aorta
Transverse
colon
Splenic
vein
Superior mesenteric artery
Splenic (left colic)
flexure
Taeniae coli
Hepatic
(right colic)
flexure
Inferior mesenteric
artery and vein
Ascending colon
Descending
colon
Mesentery
Ileocaecal valve
Ileum
Sigmoid artery
and vein
Caecum
Vermiform
appendix
Haustra
Rectum
Superior rectal
artery and vein
External anal
sphincter
muscle
Anus
CAECUM AND TERMINAL ILEUM
Ascending
colon
Ileum
Ileocaecal
fold flaps
Caecum
Appendix
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Sigmoid colon
Reproductive system
REPRODUCTIVE SYSTEM
Suspensory ligament
(of uterine tube)
Ovarian ligament
Body of uterus
Fundus of uterus
Round ligament
Vesicouterine pouch
Parietal peritoneum
Sacral promontory
Uterine tube
Ureter
Uterosacral ligament
Rectouterine pouch
LATERAL VIEW OF FEMALE
(of Douglas)
REPRODUCTIVE ORGANS AND
Cervix
Fornix of vagina
ASSOCIATED STRUCTURES
Coccyx
Urinary bladder
Pubic symphysis
Urethra
Clitoris
Labium minus
Anus
Vagina
Labium majus
Location of
pubic symphysis
Foreskin
(prepuce)
EXTERNAL GENITALS
OF THE FEMALE
Labium minus
External urinary
meatus
Hymen
Orifice of vagina
Vestibule
Opening of greater
vestibular gland
Labium majus
(without pubic
hair)
Urogenital triangle
Perineal body
Anal triangle
Anus
ANTERIOR VIEW OF
PELVIC FEMALE ORGANS
Mons pubis
(without pubic hair)
Clitoris (glans)
Fundus of uterus
Location of
ischial tuberosity
Location of
coccyx
Isthmus of uterine tube
Ovarian ligament
Ampulla of uterine tube
Body of
uterus
Uterine
body
cavity
Endometrium
Myometrium
Cervix of uterus
Internal os of cervix
Cervical canal
Fornix of vagina
External os of vaginal cervix
Ovary
Infundibulum of uterine tube
Infundibulopelvic ligament
Fimbriae
Broad ligament
Uterine artery and vein
Vagina
Sample proofs A-36
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Reproductive system
FEMALE BREAST
Clavicle
Intercostal muscle
Fascia of pectoral muscles
Pectoralis major muscle
Alveolus
Ductule
Duct
Lactiferous duct
Pectoralis
major muscle
Alveoli
Areola
Lactiferous sinus
Nipple
Nipple pores
Adipose tissue
Suspensory ligaments
(of Cooper)
LYMPHATIC SYSTEM AND THE FEMALE BREAST
Supraclavicular nodes
Interpectoral
(Rotter) nodes
Midaxillary
nodes
Lateral
axillary
(brachial)
nodes
Subclavicular
nodes
Subscapular nodes
Internal mammary
nodes
Anterior axillary
(pectoral) nodes
Cross-mammary pathways
to opposite breast
Pathways to
subdiaphragmatic
nodes and liver
Sample proofs ©A-37
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Reproductive system
MALE REPRODUCTIVE ORGANS AND ASSOCIATED STRUCTURES
Ureter
Seminal vesicle
Urinary bladder
Ejaculatory duct
Pubic symphysis
Prostate gland
Ductus (vas)
deferens
Rectum
Urethra
Bulbourethral
(Cowper’s) gland
Penis
Anus
Epididymis
Testis
Foreskin
(prepuce)
Scrotum
EXTERNAL GENITALS OF THE MALE
Location of
pubic symphysis
Urogenital
triangle
Location of
ischial tuberosity
Anal
triangle
Anus
Location of
coccyx
Sample proofs A-38
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Reproductive system
Acrosome
TUBULES OF THE TESTIS AND EPIDIDYMIS
Nerves and blood vessels Epididymis
in the spermatic cord
Efferent
ductules
Seminiferous
tubules
Head
Midpiece
Testis
Rete
testis
Ductus
(vas)
deferens
Nucleus
Centrioles
Mitochondria
Tail
Tail
Tunica
Septum Lobule albuginea
ANTERIOR VIEW OF MALE REPRODUCTIVE STRUCTURES
Ureter
Ampulla
of vas (ductus)
deferens
Ductus (vas) deferens
Seminal vesicle
Urinary
bladder
Ejaculatory duct
Prostate
gland
Inguinal canal
Prostatic
portion of
urethra
Cremaster
muscle
Internal
spermatic fascia
Ductus (vas)
deferens
Bulbourethral
gland
Spongy
portion of
urethra
Testicular artery
Venous plexus
Genital nerve
Ductus (vas)
deferens
Penis
Cremaster
muscle
Head of
epididymis
Epididymis
Body of
epididymis
Tunica
vaginalis
Testis
Tail of
epididymis
Glans penis
External
urinary meatus
Scrotum
(skin)
Dartos
fascia
and
muscle
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Spermatic
cord
Urinary system
URINARY SYSTEM
URINARY SYSTEM AND SOME ASSOCIATED STRUCTURES
Adrenal
gland
Spleen
Renal artery
Liver
Renal vein
Twelfth rib
Left kidney
Right
kidney
Abdominal
aorta
Ureter
Inferior
vena cava
Urinary
bladder
Common
iliac artery
and vein
Urethra
Inferior
vena cava
Peritoneum
Peritoneal cavity
Renal fat pad
Renal vein
Renal artery
Abdominal
aorta
Left kidney
Muscle
Spinous
process
of vertebra
Sample proofs A-40
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Urinary system
BLADDER
Ureter
Cut edge of
peritoneum
Smooth muscle
(detrusor)
Trigone
Opening
of ureter
Opening
of ureter
Rugae
Prostate gland
Pelvic floor
External urethral
sphincter
Internal urethral
sphincter
Prostatic urethra
Bulbourethral
gland
INTERNAL STRUCTURE OF THE KIDNEY
Interlobular
arteries and veins
Interlobar arteries
and veins
Lobar arteries
and veins
Segmental
arteries and veins
Renal artery
Renal vein
Ureter
Lobar arteries
and veins
Renal pyramid
Sample proofs ©A-41
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Arcuate
arteries
and veins
Urinary system
NEPHRON
Bowman’s capsule
Glomerulus
Distal
convoluted
tubule
(DCT)
Renal
corpuscle
Proximal
convoluted
tubule (PCT)
Cortex
Medulla
Descending
limb of Henle (DLH)
Renal
tubule
Collecting
duct (CD)
Thick ascending
limb of Henle (TAL)
Henle (nephron) loop
Thin ascending
limb of Henle (tALH)
Papilla
of renal
pyramid
Sample proofs A-42
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Special senses
SPECIAL SENSES
GROSS ANATOMY OF THE EAR
External ear (not to scale)
Auricle
(pinna)
External acoustic
meatus
Middle ear
Temporal
bone
Inner ear
Tympanic
membrane
Semicircular canals
Oval window
Facial nerve
Vestibular nerve
Cochlear nerve
Vestibulocochlear
nerve (CN VIII)
Cochlea
Vestibule
Round window
Malleus Incus Stapes
Auditory (eustachian) tube
Auditory
ossicles
STRUCTURE OF THE SKIN
Openings of
sweat ducts
Hair shaft
Stratum corneum
Stratum granulosum
Epidermis
Stratum spinosum
Stratum
germinativum
Stratum basale
Dermal
papilla
Dermis
Meissner
corpuscle
Sebaceous
(oil gland)
Subcutaneous
layer
(hypodermis)
Hair
follicle
Papilla
of hair
Sweat gland
Cutaneous nerve
Pacinian
corpuscle
Arrector
pili muscle
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Special senses
CROSS-SECTIONAL VIEW OF THE EYE
Cornea
(transparent)
Visual (optic) axis
Lens
Anterior chamber
(contains aqueous humor)
Pupil
Iris
Lower (inferior) lid
Lacrimal caruncle
Fibrous layer
Ciliary body
Suspensory
ligament
Vascular layer
Retina
Choroid
Sclera
Inner layer
Posterior chamber
(contains vitreous humour)
Optic disc
Central artery
and vein
Optic nerve
Fovea Macula
centralis
Sclera
Choroid
Scleral venous sinus
(canal of Schlemm)
Iris
Posterior
chamber
Anterior
chamber
Cornea
Retina
Ciliary
muscle
Ciliary
ring
Ciliary
processes
Ciliary
body
Suspensory
ligaments
Lens
Sample proofs A-44
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Kk
k, abbreviation for kilo, 1000 or 103.
K, 1. symbol for ionisation constant. 2. symbol for Kelvin
scale. 3. symbol for the element potassium (kalium).
4. abbreviation for kilobyte. 5. symbol in electronics for
1024 (210). 6. abbreviation for katal.
kA, abbreviation for kiloampere.
-kacin, suffix for antibiotics derived from Streptomyces
kanamyceticus.
kainate kƯ‫މ‬nƗt, a non10'$ (NmethyldasSartate)
receStor aJonist. 7he natural mineral is used as a fertiliser.
kak-, combininJ form meaninJ µbad¶ kakidrosis, kakosmia.
kakosmia. See cacosmia.
kala-azar kl‫މ‬l‫ۑ‬āl]lr‫> މ‬+indi, kala, black $ssamese, azar,
fever@, a disease caused by the Sroto]oon Leishmania
donovani, transmitted to humans, Sarticularly to children,
by the bite of the sandfly. .alaa]ar occurs Srimarily in $sia,
Sarts of $frica, several South and &entral $merican coun
tries, and the 0editerranean reJion. 7he liver and sSleen
are the main sites of infection siJns and symStoms include
anaemia, heSatomeJaly, sSlenomeJaly, irreJular fever and
emaciation. 3atients Zith kalaa]ar are also susceStible to
secondary bacterial infections. Untreated, the disease has
an extremely hiJh mortality. 7reatment includes sodium
antimony Jluconate, blood transfusions (for anaemia), bed
rest and adeTuate nutrition. $lso called Assam fever, black
fever, dumdum fever, ponos, visceral leishmaniasis. See
also leishmaniasis.
Kala-azar (Cohen et al, 2010)
kalaemia k‫ۑ‬lƝ‫މ‬mƝā‫ۑ‬, the Sresence of Sotassium in the blood.
kali-, combininJ form meaninJ µSotassium¶ kaligenous,
kalinite, kalium.
kaliopenia. See hypokalaemia.
kalium (K) kƗ‫މ‬lƝā‫ۑ‬m >$r, al qaly, Sotash@, Sotassium.
kaliuresis kal‫މ‬iyo଱ orƝ‫މ‬sis, increased excretion of Sotassium
in the urine.
kallikrein-kinin system kalik‫މ‬rƝāin, a SroSosed hormonal
system that functions Zithin the kidney, Zith the en]yme
kallikrein in the renal cortex mediatinJ Sroduction of
bradykinin, Zhich acts as a vasodilator SeStide. .allikrein
is Sresent in blood Slasma, urine and tissues in an inactive
state. $lso sSelt kallikren-kinin system.
Kallmann’s syndrome >)ran] -. .allmann, $merican
Ssychiatrist, 1±1@, a condition characterised by the
absence of the sense of smell. ,t is caused by aJenesis of the
olfactory bulbs and secondary hySoJonadism related to a fall
in luteinisinJ hormonereleasinJ hormone levels.
kampo medicine kam‫މ‬Sǀ, traditional -aSanese medicine.
7he Sractice of kamSo medicine in -aSan is reJulated.
kanamycin, an aminoJlycoside antibacterial substance
derived from Streptomyces kanamyceticus.
kanamycin sulfate, an aminoJlycoside antibiotic.
Q INDICATIONS ,t is Srescribed in the treatment of certain
severe JramneJative infections and those resistant to other
antibiotics.
Q CONTRAINDICATIONS &oncomitant administration of
ototoxic druJs or knoZn hySersensitivity to this druJ or to
other aminoJlycoside antibiotics Srohibits its use. ,t is used
Zith caution in Satients havinJ imSaired renal function and
in the elderly.
Q ADVERSE EFFECTS $monJ the more serious are neShro
toxicity, vestibular and auditory ototoxicity, neuromuscular
blockade and hySersensitivity reactions.
kangaroo care, a bioloJically sound aSSroach to restore the
mother±infant bond folloZinJ the sudden seSaration durinJ
the birth exSerience for term and esSecially Sreterm babies.
,t has tZo essential comSonents skintoskin contact and
breastfeedinJ. $lso knoZn as kangaroo mother care (KMC).
Kanner’s syndrome >/eo .anner, $ustrianborn $merican
child Ssychiatrist, b. 14@. See autism disorder spectrum.
kaodzera. See Rhodesian trypanosomiasis.
kaolin kƗ‫ۑމ‬lin >&hin, kaoling, hiJh ridJe@, an adsorbent
used internally to treat diarrhoea, often in combination with
Sectin. .aolin in an ointment base is also used toSically as
an absorbent and a Srotective emollient.
kaolinosis kƗ‫ۑމ‬linǀ‫މ‬sis, a form of Sneumoconiosis acTuired
by inhalinJ clay dust (kaolin). .aolin is used in the manu
facture of SaSer, ceramics, heatresistant wood, soaSs,
toothSaste, and some medicines.
Kaposi’s sarcoma (KS, ks) >0orit] .. .aSosi@, a maliJnant,
multifocal neoSlasm of vascular oriJin and reticuloendo
thelial cells that beJins as soft, brownish or SurSle SaSules
Sample proofs ©
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950
Kaposi’s sarcoma-associated herpesvirus
karyomorphism
951
on the feet and slowly sSreads in the skin, metastasisinJ
to the lymSh nodes and viscera. ,t is caused by a herSesvirus
known as human herSesvirus (++9), occurs most often in
men and is associated with diabetes, maliJnant lymShoma,
acquired immunodeficiency syndrome or other disorders.
5adiotheraSy and chemotheraSy are usually recommended.
$lso called idiopathic multiple pigmented haemorrhagic
sarcoma, multiple idiopathic haemorrhagic sarcoma.
Kaposi’s sarcoma (Swartz, 2010)
Kaposi’s sarcoma-associated herpesvirus. See human
herpesvirus 8.
Kaposi’s varicelliform eruption. See eczema herpeticum.
kappa kaS‫ۑމ‬, Ȁ, ț, the tenth letter of the *reek alShabet,
used to denote (in chemistry) the tenth carbon atom in a
chain one of two liJht chains in an immunoJlobulin
molecule a tySe of killer Sarticle Sresent in certain strains
of Paramecium and a visual axis anJle. See also lambda
(Ȝ) light chain.
kaps-. See caps.
karakia, (1ew =ealand 0Ɨori) traditional ancient rite,
charm or sSell, variations of which would be used on every
imSortant occasion from JreetinJ the new day to farewellinJ
voyaJers or beJinninJ a new SroMect or undertakinJ. Used
in modern times to denote a Srayer, or worshiS. See mihi,
wairua.
karaya powder klr‫މ‬lyl >+indi, karayal, resin /, pulvis,
dust], a dried form of Sterculia urens or other sSecies of
Sterculia, used as a bulk cathartic. 7he use of such a bulk
forminJ cathartic may also increase the loss of sodium,
Sotassium and water. :ith some individuals the use of
karaya Sowder may cause allerJic reactions such as urti
caria, rhinitis, dermatitis and asthma. 0ethylcellulose has
larJely reSlaced this druJ in modern use. (xternally it is
used as a dryinJ aJent for staJe , and staJe ,, Sressure ulcers.
Kardex, trademark for a cardfilinJ system that allows quick
reference to the Sarticular needs of each Satient for certain
asSects of nursinJ care. ,ncluded on the card may be a
schedule of medications, level of activity allowed, ability
to Serform basic selfcare, diet, any sSecial Sroblems, a
schedule of treatments and Srocedures, and a care Slan. 7he
.ardex is uSdated as necessary and is usually keSt at the
nurses¶ station. ,t is now larJely reSlaced by comSuterised
systems.
karyenchyma. See karyolymph.
karyo-, caryo-, combininJ form meaninJ µnucleus¶ karyochrome, karyokinesis, karyolymph.
karyoclasis kar‫މ‬Ɲāok‫މ‬l‫ۑ‬sis >*k, karyon + klasis, breakinJ],
1. the disinteJration of a cell nucleus or nuclear membrane.
2. the interruStion of mitosis. $lso sSelt karyoklasis.
—karyoclastic, adj.
karyocyte a normoblast, or develoSinJ red blood cell with
a nucleus condensed into a homoJeneous staininJ body.
,t is normally found in the red bone marrow. $lso sSelt
caryocyte.
karyogamy kar‫މ‬ƝāoJ‫ۑމ‬mƝ >*k, karyon, nut + gamos,
marriaJe], the fusion of cell nuclei, as in conMuJation and
]yJosis. —karyogamic, adj.
karyogenesis kar‫މ‬ƝāǀMen‫ۑމ‬sis >*k, karyon + genein, to
Sroduce], the formation and develoSment of the nucleus of
a cell. —karyogenetic, adj.
karyokinesis kar‫މ‬ƝāǀkinƝ‫މ‬sis >*k, karyon + kinƝsis, motion],
the division of the nucleus and equal distribution of nuclear
material durinJ mitosis and meiosis. 7he Srocess involves
the four staJes of SroShase, metaShase, anaShase, and telo
Shase it Srecedes the division of the cytoSlasm. $lso called
karyomitosis. See also cytokinesis. —karyokinetic, adj.
karyoklasis, karyoklastic. See karyoclasis.
karyology kar‫މ‬Ɲāol‫ۑމ‬MƝ >*k, karyon + logos, science], the
branch of cytoloJy that concentrates on the study of the cell
nucleus, esSecially the structure and function of the chromo
somes. —karyological, adj., karyologist, n.
karyolymph kar‫މ‬Ɲā‫ۑ‬limf‫*> މ‬k, karyon + /, lympha, water],
the clear, usually nonstaininJ, fluid substance of a cell
nucleus. ,t consists Srimarily of Sroteinaceous colloidal
material in which the nucleolus, chromatin, linin and
various submicroscoSic Sarticles are disSersed. $lso called
karyenchyma, nuclear hyaloplasm, nuclear sap, nucleochyme. —karyolymphatic, adj.
karyolysis kar‫މ‬Ɲāol‫މ‬isis >*k, karyon + lysis, looseninJ], the
dissolution of a cell nucleus. ,t occurs durinJ the Jeneration
of new cells throuJh mitosis and meiosis, but also in Satho
loJical conditions, cell inMury, and necrosis.
Dissolution
of nuclear
structure
Rupture
of cell
membrane
Karyolysis (Huether and McCance, 2008)
karyolytic kar‫މ‬Ɲā‫ۑ‬lit‫މ‬ik, 1. SertaininJ to karyolysis. 2. some
thinJ that causes the destruction of a cell nucleus.
karyomegaly kar‫މ‬ƝāǀmeJ‫ۑމ‬lƝ >*k, karyon, nut + megas,
larJe], an increase in the nuclear si]e of tissue cells.
karyomere kar‫މ‬Ɲā‫ۑ‬mir‫*> މ‬k, karyon + meros, Sart], 1. a
saclike structure containinJ an unequal Sortion of the
nuclear material after atySical mitosis. 2. a seJment of a
chromosome. See also chromomere.
karyometry kar‫މ‬Ɲāom‫ۑމ‬trƝ, the measurement of the nucleus
of a cell. —karyometrical, adj.
karyomit kar‫މ‬Ɲā‫ۑ‬mit‫*> މ‬k, karyon + mitos, thread], 1. a
sinJle chromatin fibril of the network within the nucleus of
a cell. 2. a chromosome.
karyomitome kar‫މ‬Ɲāom‫މ‬itǀm >*k, karyon + mitos, thread],
the fibrillar chromatin network within the nucleus of a cell.
$lso called karyoreticulum.
karyomitosis. See karyokinesis.
karyomorphism m{r‫މ‬fi]‫ۑ‬m >*k, karyon + morphƝ form],
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karyon
katadidymus
952
karyotin. See chromatin.
karyotype kar‫މ‬Ɲā‫ۑ‬tƯS‫*> މ‬k, karyon + typos, mark], 1. the
number, form, si]e and arranJement within the nucleus of
the somatic chromosomes of an individual or sSecies, as
determined by a microShotoJraSh taken durinJ metaShase
of mitosis. 2. a diaJrammatic reSresentation of the chromo
some comSlement of an individual or sSecies, in which the
chromosomes are arranJed in Sairs in descendinJ order of
si]e and accordinJ to the Sosition of the centromere. See also
chromosome, Denver classification. —karyotypical, adj.
Kasabach Merritt syndrome. See haemangioma±
thrombocytopenia syndrome.
Kasabach method kas‫ۑމ‬bak, (in radioloJy) a technique for
SositioninJ a Satient for radioJraShic examination of the
odontoid Srocess. ,t involves an $3 oblique SroMection with
the central ray anJled 10±1 deJrees caudad at a central
Soint midway between the outer canthus of the eye and the
external auditory meatus.
Kasai operation. See portoenterostomy.
Kashin-Bek disease >1ikolai ,. .ashin, 5ussian orthoSae
dist, 12±12 (.9. %ek /, dis + )r, aise, ease], a form
of osteoarthrosis afflictinJ mainly children livinJ in &hina,
Korea, and eastern Siberia. It is believed to be caused by
eatinJ foods made with wheat contaminated by a funJus,
Fusarium sporotrichiella. $lso sSelt Kaschin-Beck disease.
$lso called osteoarthritis deformans endemica.
kat, abbreviation for katal.
katadidymus kat‫ۑމ‬did‫ۑމ‬m‫ۑ‬s >*k, kata, down + didymos,
twin], conMoined twins united in the lower Sortion of the
body and seSarated at the toS.
the shaSe or form of a cell nucleus, esSecially that of a leuco
cyte. —karyomorphic, adj.
karyon kar‫މ‬Ɲāon >*k, nut], the nucleus of a cell. —karyontic, adj.
karyophage kar‫މ‬ƝāǀfƗM‫*> މ‬k, karyon + phagein, to eat], an
intracellular Sroto]oan Sarasite that destroys the nucleus
of the cell it infects. —karyophagic, karyophagous, adj.
karyoplasm. See nucleoplasm.
karyoplasmic ratio. See nucleocytoplasmic ratio.
karyopyknosis Siknǀ‫މ‬sis >*k, karyon + pyknos, thick], the
state of a cell in which the nucleus has shrunk and the chro
matin has condensed into solid masses, as in cornified cells
of stratified squamous eSithelium. —karyopyknotic, adj.
karyoreticulum. See karyomitome.
karyorrhexis rek‫މ‬sis >*k, karyon + rhƝ[is, ruSture], the
fraJmentation of chromatin and distribution of it throuJhout
the cytoSlasm as a result of nuclear disinteJration. —karyorrhectic, adj.
karyosome kar‫މ‬Ɲā‫ۑ‬sǀm‫*> މ‬k, karyon + sǀma body], a dense,
irreJular mass of chromatin filaments in a cell nucleus. ,t
is often seen durinJ interShase and may be confused with
the nucleolus because of similar staininJ SroSerties. $lso
called chromatin nucleolus, chromocentre, false nucleolus, prochromosome.
karyospherical sfer‫މ‬ik >*k, karyon + sphaira, ball], 1. a
sSheric nucleus. 2. SertaininJ to such a nucleus.
karyostasis kar‫މ‬Ɲāos‫މ‬t‫ۑ‬sis >*k, karyon + stasis, standinJ],
the restinJ staJe of the nucleus between cell division. See
also interphase. —karyostatic, adj.
karyotheca. See nuclear envelope.
2
1
3
6
7
8
13
14
15
19
20
4
9
10
16
5
11
12
17
18
21
22
Sex chromosomes
Normal male karyotype (Martin, Fanaroff and Walsh, 2011)
Sample proofs © Elsevier Australia
katal (K, kat)
953
katal (K, kat) kat‫މ‬al >*k, kata, down], an en]yme unit in
moles Ser second defined by the SI system 1 K . î 10 U.
It is used to exSress catalytic activity, which is a SroSerty
of the catalyst.
katipo spider, Latrodectus katipo, a sSecies of sSider native
to 1ew =ealand from the /atrodectus family of sSiders.
It is found amonJ the Jrasses and driftwood lininJ sandy
beaches, and is the most venomous creature in 1ew =ealand.
It is closely related to the $ustralian redback sSider. (nven
omation may result in latrodectism, and is treated with
redback sSider antivenom. See also latrodectism, redback
spider, redback spider antivenom.
kat-, kata-, cat-, cata-, Srefix meaninJ µto Jo down, to
Jo aJainst, or to reverse¶ katadidymus, katakinetomeric,
katolysis.
kaumātua, (1ew =ealand 0Ɨori) an elder, elderly, old man.
7he holder of wisdom, a suSSortive role and a symbolic one.
KaumƗtua will often accomSany the family into healthcare
settinJs and may sSeak for the family on imSortant matters.
0ay be referred to as µuncle¶. &omSare kuia.
Kaunihera o Nga Nēhi Māori o Aotearoa (National
Council of Māori Nurses), established in 13, the only
mandated body by Iwi (0Ɨori tribe or social JrouS) to
reSresent 0Ɨori on health issues. :orkforce develoSment
is one of the core issues for the &ouncil.
kava kava >3olynesian, bitter], a ceremonial, nonalcoholic
beveraJe SreSared from the root of Piper methysticum. It
is cultivated throuJhout the South 3acific and the name
refers to the Slant, the beveraJe SreSared from the Slant,
and the ceremony associated with drinkinJ the beveraJe.
7his Ssychoactive substance has been used socially, cere
monially and medicinally for thousands of years by many
Pacific island societies. It has more recently found favour as
a dietary suSSlement, due to its Srofound diuretic SroSerties.
InJestion has varyinJ effects, ranJinJ from a numbinJ of the
tonJue to mild euShoria. &hronic inJestion has been asso
ciated with anorexia, bloodshot eyes, letharJy, restlessness,
stomach Sains and scalinJ of the skin. It enhances the effects
of alcohol and other &1S deSressants. $lso called kava.
Kawasaki disease. See mucocutaneous lymph node
syndrome.
Kayser-Fleischer ring kƯ‫ ۑ]މ‬flƯ‫މ‬sh‫> ۑ‬%ernhard Kayser, *erman
oShthalmoloJist, 1±14 %runo )leischer, *erman
oShthalmoloJist, 14±104], a JreyJreen to redJold
SiJmented rinJ at the outer marJin of the cornea, SathoJno
monic of heSatolenticular deJeneration, a rare SroJressive
disease caused by a defect in coSSer metabolism and transmit
ted as an autosomalrecessive trait. 7he disease is characterised
by cerebral deJenerative chanJes, liver cirrhosis, sSlenomeJ
aly, involuntary movements, muscle riJidity, SsycholoJical
disturbances and dysShaJia. See also Wilson’s disease.
Kayser-Fleischer ring (Zitelli et al, 2012)
keloid acne
Kazanjian’s operation kasan‫މ‬MƝā‫ۑ‬n] >9ara]tad -. Ka]an
Mian, $rmenianborn maxillofacial surJeon in United States,
1±14], a surJical Srocedure for extendinJ the vestibu
lar sulcus to imSrove the Srosthetic foundation of toothless
dental ridJes.
kb, 1. abbreviation for kilobase. 2. abbreviation for kilobit.
kbe, abbreviation for keyboard entry.
kbp, abbreviation for kilobase pair.
kbs, abbreviation for kilobits per second. $lso kbps.
kcal, abbreviation for kilocalorie.
K cell. See null cell.
kCi, abbreviation for kilocurie.
KDOQI, abbreviation for kidney disease outcome quality
initiative.
KE, abbreviation for kinetic energy.
Kearns-Sayre syndrome kern]āsƗr >7homas P. Kearns,
$merican oShthalmoloJist, b. 122 *eorJe P. Sayre,
$merican SatholoJist, b. 111], SroJressive oShthalmo
SleJia, SiJmentary deJeneration of the retina, myoSathy,
ataxia, and cardiac conduction defect onset is before aJe 20.
$lmost all Satients have larJe mitochondrial '1$ deletions,
and raJJed red fibres are seen on muscle bioSsy. $lso called
ophthalmoplegia plus.
Kedani fever. See scrub typhus.
keel, (in Srosthetics) a device in a storedenerJy foot Sros
thesis that bends the foot uSwards when weiJht is aSSlied to
the toe. See also carina, Seattle Foot, stored-energy foot.
kefir kef‫> ۑމ‬5uss, fermented milk], a sliJhtly effervescent,
acidulous beveraJe SreSared from the milk of cows, sheeS or
Joats throuJh fermentation by kefir Jrains contains yeasts
and lactobacilli. It oriJinated in the &aucasus 0ountains
and is a source of menaquinones, Srobably derived from the
bacterial fermentation. %acterial fermentation in the *I tract
synthesises vitamin K2. $lso sSelt kephir. See vitamin K2.
Kegel exercises. See pubococcygeus exercises.
Keith-Wagener-Barker classification system >1orman
0. Keith, &anadian Shysician, b. 1 +enry P. :aJener,
$merican Shysician, b. 10 1.:. %arker, 20thcentury
$merican Shysician], a method of classifyinJ the deJree
of hySertension in a Satient on the basis of retinal chanJes.
7he staJes are JrouS 1, identified by constriction of the
retinal arterioles JrouS 2, constriction and sclerosis of
the retinal arterioles JrouS 3, characterised by haemor
rhaJes and exudates in addition to JrouS 2 conditions and
JrouS 4, SaSilloedema of the retinal arterioles.
kel-, combininJ form meaninJ µtumour or fibrous Jrowth¶
kelectome, keloid, keloplasty.
Kelly clamp >+oward $. Kelly, $merican JynaecoloJist,
1±143 $S, clam, to fasten], a curved haemostat
without teeth, used mainly in JynaecoloJical Srocedures
for JrasSinJ vascular tissue.
Kelly’s pad, a horseshoeshaSed inflatable rubber drainaJe
Sad used in a bed or on the oSeratinJ table.
keloid kƝ‫މ‬loid >*k, kƝlis, sSot + eidos, form], an overJrowth
of collaJenous scar tissue at the site of a skin inMury, Sarticu
larly a wound or a surJical incision. 7he new tissue sSreads
outside the confines of the oriJinal wound, may not diminish
in si]e without intervention and may recur. 7he tissue is
elevated, rounded, and firm. %lackskinned individuals
are Sarticularly susceStible to keloid formation. 7ySes of
theraSy include cryotheraSy, intralesional corticosteroid
inMections, radiation, silicone Jel, and surJery. 7reatment
may worsen the condition and should be Serformed only by
skilled Srofessionals. $lso sSelt cheloid. —keloidal, adj.
keloid acne >*k, kƝlis, sSot + eidos, form + akmƝ, Soint],
keloid scarrinJ arisinJ from inflammatory acne lesions.
&omSare folliculitis keloidalis nuchae.
Sample proofs © Elsevier Australia
K
keloidal
954
Keloids (Zitelli et al, 2012)
keloidal. See keloid.
keloidal scar. See keloid scar.
keloidosis kƝ‫މ‬loidǀ‫މ‬sis >*k, kƝlis + eidos, form + osis,
condition], habitual or multiSle formation of keloids. $lso
sSelt cheloidosis.
keloid scar >*k, kƝlis, sSot + eidos, form eschara, scab],
an overJrowth of tissue in a scar at the site of skin inMury,
Sarticularly a wound or a surJical incision. 7he amount
of tissue Jrowth is in excess of that necessary to reSair
the wound and is Sartially caused by an accumulation of
collaJen at the site. $lso called keloidal scar.
kelp, the marine brown alJae fronds of Laminaria digitata,
L. japonica, Macrocystis pyrifera.
Q INDICATIONS &laimed uses are for the treatment of obesity
and underactive thyroid states, hySertension, antitumour,
anticoaJulant, abortifacient and antirheumatic states. 1o
evidence exists for the use of kelS other than for thyroid
function.
Q CONTRAINDICATIONS Use cautiously in SreJnant women.
$s kelS contains siJnificant amounts of iodine, it should be
used with caution in SeoSle with thyroid disorders.
Q ADVERSE EFFECTS $bnormal erythroSoiesis, acneform
eruStions, autoimmune thrombocytoSenia and bleedinJ.
KelS may be contaminated with arsenic. In healthy volun
teers hiJh doses of kelS reduce 73 levels and elevate 7S+
levels and 75+ resSonse after 4 weeks.
Kelvin scale (K) >/ord Kelvin (:illiam 7homson), %ritish
Shysicist, 124±10], an absolute temSerature scale calcu
lated in &elsius units from the Soint at which molecular
activity aSSarently ceases, ±23.1ƒ&. 7o convert &elsius
deJrees to Kelvin, add 23.1.
Kennedy classification >(dward Kennedy, $merican
dentist, b. 13], a method of classifyinJ Sartial edentulous
conditions and Sartial dentures, based on the Sosition of the
sSaces once occuSied by the missinJ teeth in relation to
the remaininJ teeth.
Kenny treatment. See Sister Kenny’s treatment.
keno-, combininJ form meaninJ µemSty¶ kenophobia,
kenoto[in, kenotron.
kenogenesis. See caenogenesis.
kenophobia kƝ‫މ‬nǀfǀ‫މ‬bƝā‫*> ۑ‬k, kenos, emSty + phobos,
fear], the morbid fear of larJe and oSen sSaces aJoraShobia.
$lso sSelt cenophobia.
Kent bundle >$lbert ).S. Kent, (nJlish ShysioloJist,
13±1 $S, byndel, to bind], an accessory Sathway
between an atrium and a ventricle outside the conduction
keratoacanthoma
system. 7his conJenital anomaly causes :olffParkinson
:hite syndrome. 7he term µaccessory Sathway¶ is Sreferred
because the one Kent described had a Srecise location
(anterior and near the fibrous rinJ of the tricusSid valve).
Kenya fever. See Marseilles fever.
kephal-. See cephalo.
kephir. See kefir.
kera-, combininJ form meaninJ µhorn¶ keraphyllocele,
keratosis, keratin.
kerasin ker‫ۑމ‬sin >*k, kƝros, wax], a cerebroside, found
in brain tissue, that consists of a fatty acid, Jalactose and
sShinJosine.
keratectomy ker‫ۑމ‬tek‫މ‬t‫ۑ‬mƝ >*k, keras, horn + ektomƝ,
excision], surJical removal of a Sart of the cornea
Serformed to excise a small, suSerficial lesion that does
not warrant a corneal Jraft. /ocal anaesthesia is used.
7he scar is excised, and an antibiotic is inMected under the
conMunctiva. $ toSical steroid is Jiven and a liJht Sressure
dressinJ aSSlied. $fter surJery, the dressinJs are chanJed
daily. &orneal eSithelium Jrows raSidly, fillinJ a small
surJical area in about 0 hours.
keratic k‫ۑ‬rat‫މ‬ik >*k, keras, horn + /, icus, like], 1. Sertain
inJ to keratin. 2. SertaininJ to the cornea.
keratic precipitate, a JrouS of inflammatory cells deSos
ited on the endothelial surface of the cornea after trauma or
inflammation, sometimes obscurinJ vision.
keratin ker‫ۑމ‬tin >*k, keras, horn], a fibrous sulfurcontaininJ
Srotein that is the Srimary comSonent of the eSidermis, hair,
nails, enamel of the teeth, and horny tissue of animals. 7he
Srotein is insoluble in most solvents, includinJ Jastric Muice.
)or this reason, it is often used as a coatinJ for Sills that
must Sass throuJh the stomach unchanJed to be dissolved
in the intestines.
keratin cyst, an eSithelial cyst containinJ keratin.
keratinisation Ư]Ɨ‫މ‬sh‫ۑ‬n >*k, keras + izein, to cause], a
Srocess by which eSithelial cells lose their moisture and are
reSlaced by horny tissue.
keratinise ker‫ۑމ‬tinƯ], to make or become horny tissue.
keratinocyte kerat‫މ‬inǀsƯt‫*> މ‬k, keras + kytos, cell], an
eSidermal cell that synthesises keratin and other Sroteins
and sterols. 7hese cells constitute of the eSidermis,
beinJ formed from undifferentiated, or basal, cells at the
dermal±eSidermal Munction. In its various successive staJes,
keratin forms the squamouscell or Sricklecell layer and the
Jranularcell layer, in which the cells become flattened and
slowly die to form the horny layer, the stratum corneum,
which Jradually exfoliates.
keratinophilic kerat‫މ‬inǀfil‫މ‬ik, describinJ a tySe of funJus
that uses keratin as a substrate.
keratitis ker‫ۑމ‬tƯ‫މ‬tis, any inflammation of the cornea. Kinds
of keratitis include dendritic keratitis, interstitial keratitis, keratoconjunctivitis sicca and trachoma. &omSare
keratopathy. —keratic, adj.
kerat-, kerato-, 1. combininJ form meaninJ µhorny, corni
fied¶ keratolysis, keratoma, keratonosis. 2. combininJ form
meaninJ µcornea, corneal¶ keratoiritis, keratoleukoma,
keratome.
keratoacanthoma ker‫ۑމ‬tǀāak‫މ‬anthǀ‫މ‬m‫*> ۑ‬k, keras +
akantha, thorn + oma, tumour], a raSidly JrowinJ, flesh
coloured SaSule or nodule of the skin with a central SluJ
of keratin. 7he lesion is most common on the face or the
back of the hands and arms. It Jrows raSidly, then may
disaSSear sSontaneously in 4 to months, leavinJ a sliJhtly
deSressed scar. (xcision is necessary as it can be difficult
to differentiate from squamous carcinoma. )erJusonSmith
and *rw]ybowski syndromes are rare diseases characterised
by multiSle eruStive keratoacanthomas.
Sample proofs © Elsevier Australia
keratocele
keratolysis exfoliativa
955
Keratoacanthoma (Courtesy Department of Dermatology,
School of Medicine, University of Utah)
keratocele ker‫ۑމ‬tǀsƝl‫މ‬, a hernia of 'escemet¶s membrane
throuJh an ulcer in the outer layers of the cornea.
keratoconjunctivitis ker‫ۑމ‬tǀk‫ۑ‬nMunJk‫މ‬tivƯ‫މ‬tis >*k, keras
+ /, conjunctivus, connectinJ + *k, itis, inflammation],
inflammation of the cornea and the conMunctiva. Kinds of
keratoconMunctivitis include eczematous conjunctivitis,
epidemic keratoconjunctivitis and keratoconjunctivitis
sicca.
keratoconjunctivitis sicca, dryness of the cornea caused by
a deficiency of tear secretion in which the corneal surface
aSSears dull and rouJh and the eye feels Jritty and irritated.
7he condition may be associated with erythema multiforme,
SM|Jren¶s syndrome, trachoma, and vitamin $ deficiency.
$rtificial tears, Jel and ointment may Jive some relief. In
severe cases Sunctal occlusion, toSical corticosteroids and
cyclosSorin may be used.
keratoconus ker‫ۑމ‬tǀkǀ‫މ‬n‫ۑ‬s >*k, keras + kǀnos, cone],
a noninflammatory Srotrusion of the central Sart of the
cornea. It is more common in females and may cause marked
astiJmatism contact lenses usually restore visual acuity.
ProJression can be slowed by use of riboflavin droSs with
ultraviolet liJht which induces crosslinkinJ of stromal
collaJen. Severe forms may require corneal JraftinJ. 7he
cause of the condition is unknown.
keratocyst ker‫ۑމ‬tǀsist‫މ‬, a thinwalled, toothforminJ cyst
lined by keratinisinJ eSithelium. It may be solitary or Sart
of a multiSle lesion, most frequently in the Sosterior body
or ramus of the mandible, and may or may not be associated
with teeth.
keratocyte. See corneal corpuscle.
keratoderma ker‫ۑމ‬ātǀādur‫މ‬m‫*> ۑ‬k, keras, horn + derma,
skin], 1. a horny skin or coverinJ. 2. hySertroShy of the horny
layer of the skin the term is most often aSSlied to thickened
skin of Salms and soles. See also callus, hyperkeratosis.
keratoderma blennorrhagica dur‫މ‬m‫ۑ‬, the develoSment
of hySerkeratotic skin lesions of the Salms, soles, and
nails. 7he condition occurs in some Satients with 5eiter¶s
syndrome.
keratoectasia ker‫ۑމ‬tǀāektƗ‫]މ‬ha, a forward bulJinJ or Srotru
sion of the cornea. $lso called kerectasis.
keratoepithelioplasty, a surJical Srocedure for the reSair of
corneal eSithelial defects. 7he defective cornea is removed
and reSlaced with small Sieces of donor cornea, which
Sroliferate and reSlace the oriJinal tissue.
keratogenesis Men‫ۑމ‬sis, the formation of horny tissue
caused by the Jrowth of keratinSroducinJ cells.
Keratoderma blennorrhagica (Callen, 2000)
keratogenic Men‫މ‬ik, SertaininJ to an aJent that induces a
Jrowth of horny tissue.
keratogenous ker‫ۑމ‬toM‫ۑމ‬n‫ۑ‬s, SertaininJ to develoSment of
the horny layer of the skin or its Jrowth.
keratoglobus Jlǀ‫މ‬b‫ۑ‬s, a conJenital anomaly characterised
by distension of the eyeball or the anterior seJment of the
eye. $lso called megalocornea.
keratohyalin hƯ‫ۑމ‬lin >*k, keras + hyalos, Jlass], a substance
in the Jranules found in keratinocytes of the eSidermis.
7he keratohyalin Jranule develoSs within and around the
fibrillar Srotein, contributinJ in an unknown manner to the
functional maturity of keratin.
keratoiritis ker‫ۑމ‬tǀāƯrƯ‫މ‬tis, an inflammation of the cornea in
association with iritis.
keratolysis ker‫ۑމ‬tol‫ۑމ‬sis >*k, keras + lysis, looseninJ], the
looseninJ and sheddinJ of the outer layer of the skin, which
may occur normally by exfoliation or as a rare conJenital
condition in which the skin is shed at Seriodic intervals.
—keratolytic, adj.
K
Keratolysis (Lawrence and Cox, 2002)
keratolysis exfoliativa, uninflamed condition affectinJ
Salms and soles characterised by localised SeelinJ. $lso
called exfoliative keratolysis, focal palmar peeling.
Sample proofs © Elsevier Australia
keratolytic
Kessler 10
956
keratolytic, an aJent or druJ that Sromotes the softeninJ and
SeelinJ or removinJ of the horny (keratin) layer of skin
used to treat skin disorders such as corns, callouses, warts,
dandruff, and chronic, scaly lesions, esSecially in Ssoriasis.
keratoma ker‫ۑމ‬tǀ‫މ‬m‫ۑ‬, a hard, thick eSidermal Jrowth
caused by hySertroShy of the horny layer of the skin. See
also callus.
keratomalacia m‫ۑ‬lƗ‫މ‬sh‫*> ۑ‬k, keras + malakia, softness],
a condition characterised by xerosis and ulceration of
the cornea, resultinJ from severe vitamin $ deficiency. It
commonly occurs as a secondary result of diseases that affect
vitamin $ absorStion or storaJe, such as ulcerative colitis,
coeliac syndrome, cystic fibrosis or sSrue. $lso at risk are
infants and children who are Jiven dilute formula, who
are malnourished, or who are allerJic to whole milk and fed
skimmed milk, which is a Soor source of vitamin $. (arly
symStoms include niJht blindness ShotoShobia swellinJ
and redness of the eyelids and dryinJ, rouJhness, Sain
and wrinklinJ of the conMunctiva. In advanced deficiency
%itot¶s sSots aSSear the cornea becomes dull, lacklustre
and ha]y, and without adequate theraSy it eventually softens
and Serforates, resultinJ in blindness. 7reatment consists of
vitamin $ suSSlements determined by the severity of the
condition, althouJh SrolonJed daily administration of larJe
doses, esSecially to infants, may result in hyServitaminosis.
$n adequate diet containinJ whole milk and foods hiJh
in vitamin $ or carotenes Srevents the condition. See also
vitamin A.
keratometer, an instrument for measurinJ the curves of
the cornea.
keratomycosis mƯkǀ‫މ‬sis, a funJal disease of the cornea.
keratopathy ker‫ۑމ‬toS‫ۑމ‬thƝ >*k, keras + pathos, disease],
any noninflammatory disease of the cornea. &omSare
keratitis.
keratophakia fƗ‫މ‬kƝā‫ۑ‬, the surJical imSlantation of donor
cornea to the anterior cornea to modify a refractive error.
keratoplasty. See corneal transplantation.
keratosis ker‫ۑމ‬tǀ‫މ‬sis >*k, keras + osis, condition], a scaly
skin lesion in which there is overJrowth of the cornified
eSithelium. Kinds of keratosis include actinic keratosis,
keratosis senilis, and seborrhoeic keratosis. —keratotic,
adj.
keratosis follicularis. See Darier’s disease.
Keratosis follicularis (Hordinsky, Sawaya and Scher, 2000)
keratosis pilaris, a common skin condition in which there
are multiSle tiny follicular scaly SaSules on the uSSer arms
and thiJhs, sometimes also on cheeks and elsewhere. :hen
there is Serifollicular erythema, it is called keratosis rubra
pilaris. 7reatment includes emollients and toSical retinoids.
See also ulerythema ophryogenes.
keratosis seborrhoeica. See seborrhoeic keratosis.
kerauno-, combininJ form meaninJ µliJhtninJ¶ keraunoneurosis, keraunophobia.
kerectasis. See keratoectasia.
kerion kir‫މ‬Ɲāon >*k, honeycomb], an inflamed, boJJy Jran
uloma that develoSs as an immune reaction to a suSerficial
funJus infection, Jenerally in association with Tinea capitis
of the scalS. 7he lesion heals within a short time without
treatment. Systemic treatment with Jriseofulvin, itracona
]ole or terbinafine may be required and Sermanent aloSecia
of the affected reJion may result. Prednisone can also be
used to lessen local inflammation.
Kerion (Cordoro and Ganz, 2005)
Kerley lines kur‫މ‬lƝ >Peter -. Kerley, Irish radioloJist,
100±1], lines resemblinJ interstitial infiltrate that
aSSear on chest xray imaJes and that are associated with
certain disease conditions, such as conJestive heart failure
and Sleural lymShatic enJorJement. 7hey are several centi
metres lonJ and may be oriented in many directions. $lso
called everywhere lines.
KERMA, abbreviation for kinetic energy released in the
medium, a quantity that describes the transfer of enerJy from
a Shoton to a medium as the ratio of enerJy transferred Ser
unit mass at each Soint of interaction. Used in radiation
oncoloJy.
kernicterus k‫ۑ‬rnik‫މ‬t‫ۑ‬r‫ۑ‬s >*er, kern, kernel *k, ikteros,
Maundice], an abnormal toxic accumulation of bilirubin in
central nervous system tissues caused by hySerbilirubinae
mia. See also hyperbilirubinaemia of the newborn.
Kernig’s sign ker‫މ‬niks >9ladimir 0. KerniJ, 5ussian Shysi
cian, 140±11], a diaJnostic siJn for meninJitis, marked
by a loss of the ability of a suSine Satient to comSletely
straiJhten the leJ when it is fully flexed at the knee and hiS.
Pain in the lower back and resistance to straiJhteninJ the
leJ constitute a Sositive KerniJ¶s siJn. Usually the Satient
can extend the leJ comSletely when the thiJh is not flexed
on the abdomen.
kerosene poisoning ker‫ۑމ‬sƝn >*k, kƝros, wax /, potio,
drink], a toxic condition caused by the inJestion or inhalation
of the aliShatic hydrocarbon mixture kerosene. SymStoms
after inJestion include drowsiness, fever, tachycardia,
tremors, and severe Sneumonitis if the fluid is asSirated.
9omitinJ is not to be induced. See hydrocarbon toxicity.
See also petroleum distillate poisoning.
Kessler 10 >5onald &. Kessler, $merican socioloJist, 14±],
a screeninJ tool desiJned to detect distress that can indicate
hiJh Srevalence mental disorders. 7he K10 has 10 items, can
Sample proofs © Elsevier Australia
ketamine
957
Assessing for Kernig’s sign (Marshall and Ruedy, 2011)
be comSleted by the individual client, and is widely used as
a routine mental health outcome measure.
ketamine kƝ‫މ‬t‫ۑ‬mƝn, a Sotent nonbarbiturate Jeneral
anaesthetic aJent that antaJonises 1methyl'asSartate
(10'$) receStors also interacts with muscarinic receStors,
descendinJ monoaminerJic Sain Sathways, voltaJesensitive
calcium channels and oSioid receStors in the brain and sSinal
cord. It does not cause muscle relaxation.
Q INDICATIONS Induction and maintenance of anaesthesia,
suSSlement to lowSotency aJents such as nitrous oxide. It
is also used as an analJesic in Sainful Srocedures.
Q CONTRAINDICATION $llerJy to ketamine.
Q ADVERSE EFFECTS &ommon effects include hySertension,
increased Sulse rate, increased muscle tone, lacrimation,
hySersalivation, raised intraocular and intracranial Sres
sures, emerJency reactions. +allucinations, confusion and
disorientation may occur on emerJence from anaesthesia.
See also dissociative anaesthesia.
keto- kƝ‫މ‬tǀ, combininJ form indicatinJ Sossession of the
carbonyl (&2) JrouS ketoheptose, ketolysis, ketonuria.
ketoacidosis as‫މ‬idǀ‫މ‬sis >*er, keton, form of acetone /,
acidus, sour, osis, condition], acidosis accomSanied by
an accumulation of ketones in the body, resultinJ from
extensive breakdown of fats because of faulty carbohy
drate metabolism. It occurs Srimarily as a comSlication of
diabetes mellitus and is characterised by a fruity odour of
acetone on the breath, mental confusion, dysSnoea, nausea,
vomitinJ, dehydration, weiJht loss and, if untreated,
ketone
coma. (merJency treatment includes the administration of
insulin and I9 fluids and the evaluation and correction of
electrolyte imbalance. 1asoJastric intubation and bladder
catheterisation may be required if the Satient is comatose.
%efore discharJe of the Satient from the hosSital, the nurse
carefully reviews the diet, activity, blood Jlucose and
urine ketone monitorinJ and insulin schedule Srescribed,
emShasisinJ to the Satient that ketoacidosis may be life
threateninJ and is larJely avoidable by strict adherence to
the Satient¶s diabetes schedule, monitorinJ, and aSSroSriate
action for illness or stress. See also diabetes mellitus,
ketosis. —ketoacidotic, adj.
ketoaciduria as‫މ‬ido଱ or‫މ‬Ɲā‫*> ۑ‬er, keton + /, acidus,
sour *k, ouron, urine], Sresence in the urine of exces
sive amounts of ketone bodies, occurrinJ as a result of
uncontrolled diabetes mellitus, starvation, or any other
metabolic condition in which fats are raSidly catabolised.
7he condition can be diaJnosed with a diSstick reaJent or
acetone test tablet. $lso called ketonuria. See also ketosis.
—ketoaciduric, adj.
17-ketoandrosterone andros‫މ‬t‫ۑ‬rǀn, a metabolite of a sex
hormone secreted by the testes and adrenal Jlands that may
be measured in the urine to assess hormonal and adrenal
functions. 1ormal amounts in the urine of men after 24hour
collection are 0.2±1 mJ in women, 0.2±0. mJ.
ketoconazole, an antifunJal aJent.
Q INDICATIONS It is Srescribed for the treatment of candidi
asis, coccidioidomycosis, histoSlasmosis and other funJal
diseases. It is also used toSically in a number of cream
SreSarations for a variety of dermatoShytes as well as in a
shamSoo for the treatment of dandruff.
Q CONTRAINDICATIONS Known hySersensitivity to this druJ
Srohibits its use. It should not be used for funJal meninJitis.
Q ADVERSE EFFECTS 7he most serious are liver disorders.
&ommon reactions include nausea, vomitinJ, abdominal
Sain, constiSation, rash, headache, di]]iness. It has a number
of druJ±druJ interactions as it is a Sotent inhibitor of the
&<P3$4 metabolisinJ isoen]yme Sathway.
ketogenesis Men‫ۑމ‬sis >*er, keton + *k, genein, to Sroduce],
the formation or Sroduction of ketone bodies.
ketogenic amino acid Men‫މ‬ik, an amino acid whose carbon
skeleton serves as a Srecursor for ketone bodies.
ketogenic diet, a diet hiJh in fats (often as mediumchain
triJlycerides) and Sroteins, and low in carbohydrates. It
was used in the treatment of eSileSsy until suSerseded by
anticonvulsant druJs in the 130s, and has recently been
revived. :hile clinical reviews of mainly SrosSective
and observational studies reSort efficacy as a treatment
for children with Soorly controlled sei]ures, a &ochrane
review concluded that there was no reliable evidence from
randomised controlled trials to suSSort the use of ketoJenic
diets for SeoSle with eSileSsy.
ketonaemia kƝ‫މ‬tǀnƝ‫މ‬mƝā‫*> ۑ‬er, keton + *k, haima, blood],
accumulation of ketones in the blood. 7he main ketones are
acetoacetate and betahydroxybutyrate (the anions of keto
acids with four carbon atoms), and acetone, a breakdown
Sroduct of acetoacetate. $cetone is volatile and Jives the
breath of ketonaemic SeoSle a fruity odour. Some keto
naemia is normal in the fastinJ state. In tySe 1 diabetes,
insulin deficiency can result in excessive ketone Sroduction
and an acidosis (ketoacidosis) that can be lifethreateninJ.
See also diabetes mellitus, ketoacidosis, ketone. —
ketonaemic, adj.
ketone kƝ‫މ‬tǀn >*er, keton, form of acetone], an orJanic
chemical comSound characterised by havinJ in its structure
a carbonyl, or keto, JrouS (!& 2) attached to two alkyl
JrouSs. It is Sroduced by oxidation of secondary alcohols.
Sample proofs © Elsevier Australia
K
ketone alcohol
958
ketone alcohol >*er, keton + $r, alkohl, essence], an alcohol
containinJ the ketone JrouS.
ketone bodies, two Sroducts of free fatty acid metabolism,
betahydroxybutyric acid and aminoacetic acid, from
which acetone may arise sSontaneously. Ketone bodies are
Sroduced via acetylcoen]yme $ in the liver and are oxidised
by the muscles. (xcessive Sroduction leads to elevation in
the blood and their excretion in urine, as in diabetes mellitus.
$lso called acetone bodies.
Measurement of ketone bodies
(Belchetz and Hammond, 2003)
ketone group, the chemical carbonyl JrouS with attached
hydrocarbons. See also ketone.
ketonuria. See ketoaciduria.
ketoprofen, a nonsteroidal antiinflammatory druJ (1S$I')
with analJesic and antiSyretic actions.
Q INDICATIONS It is Srescribed for the treatment of rheuma
toid and osteoarthritis and related conditions. It is used in
the form of oral tablets and toSically as a Jel formulation.
Q CONTRAINDICATIONS +ySersensitivity to ketoSrofen or to
asSirin or other 1S$I's Srohibits its use.
Q ADVERSE EFFECTS $monJ the more serious are *I distur
bances, includinJ SeStic ulcer and *I bleedinJ central
nervous system effects of headache, di]]iness and drowsi
ness and skin rash. &are in elderly Satients, Sarticularly if
takinJ an $&( inhibitor and a diuretic can lead to kidney
failure or the socalled triple whammy effect.
ketorolac, an antiinflammatory indoleacetic acid.
Q INDICATIONS 0ild to moderate SostoSerative Sain, Jiven
either orally or by I0 inMection.
Q CONTRAINDICATIONS 0oderate to severe renal imSairment,
conditions where risk of bleedinJ is increased, dehydration
or hyServolaemia, concurrent treatment with Srobenecid.
Q ADVERSE EFFECTS &ommon effects are Sain at inMection site,
itchinJ, sweatinJ, SurSura.
ketose kƝ‫މ‬tǀs >*er, keton + glykys, sweet], the chemical
form of a monosaccharide in which the carbonyl JrouS is
a ketone.
ketosis kitǀ‫މ‬sis >*er, keton + glykys, sweet, osis, condition],
the accumulation of ketones in the body as a result of exces
sive breakdown of fats caused by a deficiency or inadequate
use of carbohydrates. )atty acids of metabolised ketones are
Sroduced and accumulate. 7his condition is seen in star
vation, occasionally in SreJnancy if the intake of Srotein
and carbohydrates is inadequate, and most often in diabetes
mellitus. It is characterised by ketonuria, loss of Sotassium
in the urine, and a fruity odour of acetone on the breath.
In tySe 1 diabetes, ketosis may SroJress to ketoacidosis,
coma and death. See also diabetes mellitus, ketoacidosis,
starvation. —ketotic, adj.
ketosis-prone diabetes. See type 1 diabetes mellitus.
kidney cancer
ketosis-resistant diabetes. See type 2 diabetes mellitus.
17-ketosteroid kƝ‫މ‬tǀstir‫މ‬oid, kƝtǀ‫މ‬st‫ۑ‬roid, any of the
adrenal cortical hormones, or ketosteroids, that has a
ketone JrouS attached to its 1th carbon atom. 7hey are
commonly measured in the blood and urine to aid the
diaJnoses of $ddison¶s disease &ushinJ¶s syndrome
stress and endocrine Sroblems associated with Srecocious
Suberty, feminisation in men, and excessive hair Jrowth. It
is usually measured on a 24 hour urine collection. /evels of
1ketosteroids increase by 0±100 after an inMection
of $&7+.
17-ketosteroids (17-KS) test, a 24hour urine test that is
useful in diaJnosinJ adrenocortical dysfunction. It is used
to detect levels of 1KS, which are metabolites of the
testosterone and nontestosterone androJenic sex hormones
secreted from the adrenal cortex and the testes.
ketotic kƝtot‫މ‬ik >*er, keton, form of acetone], 1. Sertain
inJ to the Sresence of ketone in the body. 2. denotinJ the
Sresence of a carbonyl JrouS in a chemical comSound.
ketotifen, an +1 antihistamine and a mast cell stabiliser.
Q INDICATIONS Seasonal allerJic conMunctivitis administered
as eyedroSs.
Q CONTRAINDICATIONS $llerJy to ketotifen.
Q ADVERSE EFFECTS StinJinJ on instillation, mild eye irrita
tion, headache.
keV, an abbreviation for kiloelectron volts, an enerJy unit
equivalent to 1000 electron volts. $lso abbreviated kev.
Kew Gardens spotted fever. See rickettsial pox.
key pinch. See lateral pinch.
key points of control, areas of the body that can be handled
by a theraSist in a sSecific manner to chanJe an abnormal
Sattern, to reduce sSasticity throuJhout the body, and to
Juide the Satient¶s active movements. 7he key Soints are
the shoulder and Selvic Jirdles.
key ridge, the lowest Soint of the ]yJomaticomaxillary ridJe.
$lso called zygomaxillare.
kg, abbreviation for kilogram.
kG, abbreviation for kilogauss.
kg cal, abbreviation for kilogram calorie. See calorie.
KHA, abbreviation for Kidney Health Australia; formerly
Australian Kidney Foundation.
khat, a herbal Sroduct taken from the leaves of a tree, Catha
edulis, found in $frica and the $rabian Seninsula.
Q USES It has claimed uses for obesity and Jastric ulcers,
and as a stimulant.
Q CONTRAINDICATIONS It should not be used durinJ SreJ
nancy and lactation, in children, or in those with known
hySersensitivity. PeoSle with renal, cardiac or heSatic
disease should also avoid its use.
kHz, abbreviation for kilohertz.
kidney, one of a Sair of beanshaSed, SurSlishbrown urinary
orJans located dorsally between 712 and /3. Internally it
is divided into a cortex, medulla and Selvis. 7he cortex
contains the Jlomerular caSsule, Sroximal and distal
convoluted tubules and Sart of the collectinJ ducts, while the
medulla contains the looSs of +enle and other Sarts of the
collectinJ ducts. 7hese ducts collect filtrate from a number
of neShrons and drain into the renal Selvis. 7he kidneys
have a number of imSortant functions, includinJ filterinJ
the blood and removinJ wastes and toxins. 7hey also Slay
an imSortant role in reJulatinJ fluid and electrolyte balance.
kidney cancer, a maliJnant neoSlasm of the renal Sarenchyma
or renal Selvis. 7here are about 2000 cases of kidney cancer
in $ustralia every year and 0 deaths. )actors associated
with an increased incidence of disease are exSosure to
aromatic hydrocarbons or tobacco smoke and the use of
druJs containinJ Shenacetin. $ lonJ asymStomatic Seriod
Sample proofs © Elsevier Australia
kidney dialysis
kidney disease
959
Renal column
Pyramid in renal medulla
Renal cortex
Major calyx
Renal papilla
Renal artery
Renal sinus
Hilum of kidney
Renal vein
Minor calyx
Renal pelvis
Ureter
Kidney: coronal section (Drake et al, 2010)
Kidney cancer (Kumar et al, 2013)
may Srecede the onset of the characteristic symStoms, which
include haematuria, flank Sain, fever and a SalSable mass.
'iaJnostic measures include urinalysis, excretory uroJraShy,
neShrotomoJraShy, ultrasonoJraShy, renal arterioJraShy, and
microscoSic and cytoloJical studies of cells from the renal
Selvis. $denocarcinoma of the renal Sarenchyma accounts
for 0 of kidney tumours, occurrinJ twice as often in men
as in women; transitional cell or squamous cell carcinomas
in the renal Selvis account for aSSroximately 1, and are
equally frequent in men and women. 5adical neShrectomy
with lymSh node dissection is usually recommended for
tumours of the Sarenchyma; neShroureterectomy is usually
recommended for oSerable tumours of the renal Selvis. 5adio
theraSy may be used before or after surJery and as Salliation
for inoSerable tumours. Palliative care is used for onJoinJ
manaJement of symStoms associated with metastatic disease.
&hemotheraSeutic aJents may induce temSorary remission.
See also Wilms’ tumour.
kidney dialysis. See haemodialysis.
kidney disease, any one of a larJe JrouS of conditions,
includinJ infectious, inflammatory, obstructive, vascular and
neoSlastic disorders, of the kidney. &haracteristics of kidney
disease are haematuria, Sersistent Sroteinuria, Syuria, oedema,
dysuria and Sain in the flank. SSecific symStoms vary with
the tySe of disorder. )or examSle, haematuria with severe,
colicky Sain suJJests obstruction by a kidney stone; haema
turia without Sain may indicate renal carcinoma; Sroteinuria
is Jenerally a siJn of disease in the Jlomerulus, or filtration
unit, of the kidney; Syuria indicates infectious disease; and
oedema is characteristic of the neShrotic syndrome. 'iaJnosis
of kidney disease is made after laboratory tests and other
Srocedures have been Serformed. $monJ the sSecial tests for
kidney disorders are excretory uroJraShy, I9 SyeloJraShy,
tests of the Jlomerular filtration rate, bioSsy, and ultrasound
examination. 7reatment deSends on the tySe of disease diaJ
nosed. Some forms of advanced kidney disease may lead to
renal failure, coma and death unless haemodialysis is started.
Sample proofs © Elsevier Australia
K
kidney dish
960
See also glomerulonephritis, nephrotic syndrome, renal
failure, urinary calculus.
kidney dish, a kidneyshaSed basin commonly used to hold
instruments, dressinJs and inMection devices.
kidney failure. See renal failure.
kidney machine. See artificial kidney, dialyser, def. 1.
kidney punch, test for renal tenderness as found in renal
infection; Jently strike renal anJle with closed fist.
kidney stone. See renal calculus.
Kielland forceps. See obstetric forceps.
Kielland’s rotation kƝ‫މ‬land] >&hristian Kielland, 1orwe
Jian obstetrician, 11±141], an obstetric Srocedure in
which Kielland¶s forceSs are used in turninJ the head of
the fetus from an occiSut Sosterior or occiSut transverse
Sosition to an occiSut anterior Sosition. It is Serformed most
commonly to correct an arrest in the active staJe of labour.
7he rotation is done at the midSlane of the Selvis. $s it is
associated with increased harm to the mother and to the
baby, caesarean section is often Sreferred instead. See also
forceps delivery, obstetric forceps.
Kiesselbach’s plexus kƝ‫މ‬s‫ۑ‬lblkhs‫މ‬, blks‫> މ‬:ilhelm Kies
selbach, *erman larynJoloJist, 13±102], a converJence
of small, fraJile arteries and veins located suSerficially
on the anterosuSerior Sart of the nasal seStum. It is the
commonest site of seStal bleedinJ.
Kikuchi’s lymphadenitis kƝākoଲ o‫މ‬chƝ] >0. Kikuchi,
-aSanese SatholoJist, 20th century], a beniJn, selflimited
syndrome of lymShadenoSathy, usually in the neck, with
a female Sredominance. &haracteristics include Satchy
necrotisinJ lesions of the Saracortex and Sroliferation
of distinctive histiocytes, Slasmacytoid monocytes and
lymShoblasts surrounded by karyorrhectic debris. Some
consider it a selflimited form of systemic luSus erythema
tosus. $lso called histiocytic necrotising lymphadenitis,
Kikuchi’s disease, subacute necrotising lymphadenitis.
See also systemic lupus erythematosus.
killed vaccine, a vaccine SreSared from dead micro
orJanisms. Killed vaccines are Jenerally used to Srovide
immunisation from orJanisms that are too virulent to be
used in the livinJ attenuated state. 7he immune system
reacts to the Sresence of the SathoJen in the same manner,
whether the orJanism is live or dead. +owever, when
Sossible, immunity Sroduced by a live, attenuated vaccine
is usually more effective.
killer cell, a small lymShocyte without the characteristic % or
7cell markers. It is the effector cell of antibodydeSendent
cellmediated cytotoxicity, recoJnises antibodies on
tarJet cells, and lyses those cells throuJh a cell±cell inter
action that does not require comSlement. &omSare killer
T-cells, natural killer (NK) cell. See also null cell.
killer T-cells. See cytotoxic T-cell, natural killer (NK) cell.
killer yeast, a strain of yeast cells containinJ a toxic Srotein
that destroys other yeast strains.
kilo- kil‫ۑމ‬, Srefix meaninJ µone thousand¶ kilocalorie,
kilogram, kilometre.
kilobase (kb), a lenJth of nucleic acid equal to 1000 bases
or nucleotides.
kilobase pair (kbp), a lenJth of '1$ or doublestranded
51$ equal to 1000 base Sairs.
kilobyte (kB) bƯt, one thousand (or, more Srecisely, 1024)
bytes.
kilocalorie (kcal), 1. the amount of heat (enerJy) needed to
raise the temSerature of 1 kJ of water by 1ƒ& at a Sressure
of 1 atmosShere. 2. a unit, equal to 1000 calories, used to
denote the heat exSenditure of an orJanism and the fuel or
enerJy value of food. 1ow reSlaced by the kiloMoule 1 kilo
calorie 4.1 kiloMoules. )or aSSroximate calculations,
kinematic face-bow
the conversion factor 4.2 k- 1 kcal may be used. &omSare
calorie. See kilojoule.
kilogram (kg) Jram >*k, chilioi, thousand; )r, gramme],
a unit for the measurement of mass in the metric system.
2ne kiloJram is equal to 1000 Jrams or to 2.204 Sounds
avoirduSois.
kilohertz (kHz) hurts >*k, chilioi, thousand; hertz, +einrich
5. +ert], *erman Shysicist, 1±14], unit of frequency
equal to 1000 (103) hert]. See also hertz.
kilojoule (kJ) kil‫މۑ‬Moଲ ol/, equal to 103 Moules. +as reSlaced
the kilocalorie 1 kilocalorie 4.1 kiloMoules. )or aSSrox
imate calculations, the conversion factor 4.2 k- 1 kcal may
be used. &omSare joule.
kilolitre (kL) /lƝ‫މ‬t‫ۑ‬/ >*k, chilioi, thousand; )r, litre], unit of
volume equivalent to 220 Jallons, 1000 litres.
kilometre (km) /mƝ‫މ‬t‫ۑ‬/ >*k, chilioi, thousand, metron],
measure equivalent to 1000 metres (about 0.2 miles).
kilovolt (kV) /volt/ >*k, chilioi, thousand; volt, &ount
$lessandro 9olta, Italian scientist, 14±12], measure of
electrical Sotential, 1000 volts.
kilovolt peak (kVp), a measure of the maximum electrical
Sotential in kilovolts across an xray tube. 0ost diaJnos
tic xray units have a k9S ranJe of 40±10. 'ental and
mammoJraShic units may use k9S values lower than those
used for Jeneral radioJraShy and &7.
Kimmelstiel-Wilson syndrome >Paul Kimmelstiel, *erman
SatholoJist in the US$, 100±10; &lifford :ilson, (nJlish
Shysician, b. 10]. See intercapillary glomerulosclerosis.
kinaesthesia /kin‫މ‬esthƝ‫]މ‬h‫ۑ‬/ >*k, kinƝsis, motion, aisthƝsis
feelinJ], the SerceStion of one¶s own body Sarts, weiJht and
movement. $lso sSelt kinesthesia.
kinaesthetic memory /kin‫މ‬esthet‫މ‬ik/, the recollection of
movement, weiJht, resistance and Sosition of the body or
Sarts of the body.
kinaesthetic sense >*k, kinƝsis, motion; /, sentire, to feel],
an ability to be aware of muscular movement and Sosition.
%y SrovidinJ information throuJh receStors about muscles,
tendons, Moints, and other body Sarts, the kinaesthetic sense
helSs control and coordinate activities such as walkinJ and
talkinJ.
kinanaesthesia /kin‫މ‬anesthƝ‫]މ‬h‫ۑ‬/, 1. an inability to Serceive
the movement or Sosition of one¶s body Sarts. 7he condition
is observed as a siJn of ataxia. 2. loss of movement sense.
$lso sSelt kinanesthesia.
kinase /kƯ‫މ‬nƗs/ >*k, kinƝsis, motion; ase, en]yme], 1. an
en]yme that catalyses the transfer of a ShosShate JrouS
or another hiJhenerJy molecular JrouS to an acceStor
molecule. (ach of these kinases is named for its substrate,
such as acetate kinase, fructokinase or hexokinase. 2. an
en]yme that activates a Sreen]yme (]ymoJen). (ach of
these kinases is named for its source, such as bacterial
kinase, enterokinase, fibrinokinase, staShylokinase, streSto
kinase, streStokinasestreStodornase or urokinase.
kinase-linked receptors, hiJhaffinity cell surface receStors
for many SolySeStide Jrowth factors, cytokines and hormones.
7hey are key reJulators of normal cellular Srocesses, but also
have a role in the develoSment of cancer. $n examSle of a
kinaselinked receStor is the insulin receStor.
kind firmness, (in SsycholoJy) a direct, clear and confident
aSSroach to a Satient in which rules and reJulations are
calmly cited in resSonse to infractions and requests.
kindred /kin‫މ‬drid/, a JrouS of Jenetically related individuals.
kine-. See kinesio.
kinematic face-bow /kin‫ۑމ‬mat‫މ‬ik/, an adMustable caliSerlike
device used for Srecisely locatinJ the axis of rotation of a
mandible throuJh the saJittal Slane. $lso called adjustable
axis face-bow and hinge-bow.
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kinematics
961
kinematics /kin‫ۑމ‬mat‫މ‬iks/ >*k, kinƝma, movement], the
descriStion, measurement and recordinJ of body motion
without reJard to the forces actinJ to Sroduce the motion.
5ecordinJs of body motions are defined in oneSlane rela
tionshiSs, althouJh natural motions of the body often occur
in more than one Slane. Kinematics considers the motions
of all body Sarts relative to the seJments of the Sart involved
in the motion and not necessarily in relation to the standard
anatomical Sosition; for examSle, the movements of the
finJers are considered in relation to the midline of the hand,
not the midline of the body. 7he commonest tySes of motion
studied in kinematics are flexion, extension, adduction,
abduction, internal rotation and external rotation. Kinemat
ics is esSecially imSortant in orthoSaedics, rehabilitation
medicine and Shysical theraSy. $lso called cinematics.
&omSare kinetics.
kinesia /kƯnƝ‫]މ‬h‫ۑ‬/ >*k, kinƝsis, motion], a condition caused
by erratic or rhythmic motions in any combination of
directions, such as in a boat or a car. Severe cases are
characterised by nausea, vomitinJ, vertiJo and headache;
mild cases by headache and Jeneral discomfort. 9arious
antihistamines are used SroShylactically. 0otion sickness
includes air sickness, car sickness, and sea sickness (mal de
mer). $lso sSelt cinesia. $lso called kinetosis, (informal)
motion sickness.
-kinesia, suffix meaninJ µmovement¶ hyperkinesia.
kinesic behaviour /kƯnƝ‫މ‬sik/, nonverbal cues of commu
nication that function to achieve and maintain bonds of
attachment between SeoSle.
kinesics /kƯnƝ‫މ‬siks/ >*k, kinƝsis, motion], the study of body
Sosition, Sosture, movement and facial exSression in relation
to communication. 7he observance of nonverbal interac
tional behaviour is an inteJral Sart of health assessment
and is used esSecially in mental health assessment as an
obMective and measurable tool for diaJnosinJ disturbances
of communication and behavioural disorders. See also body
language, communication.
kinesio-, kine-, combininJ form meaninJ µmovement¶
kinesiology, kinesioneurosis, kinesiotherapy.
kinesiological electromyography, the study of muscle
activity involved in body movements.
kinesiology /ol‫ۑމ‬MƝ/ >*k, kinƝsis + logos, science], the scien
tific study of muscular activity and the anatomy, ShysioloJy
and mechanics of the movement of body Sarts.
kinesiotherapist, 1orth $merican Srofessional Sosition.
$ health Srofessional who, under the direction of a doctor,
treats the effects of disease, inMury and conJenital disorders
throuJh rehabilitative exercise and education alone. See also
kinesiotherapy.
kinesiotherapy, a sSecialised area of medicine in which
exercise and movement are used as the main form of reha
bilitation. It is tySically used in the treatment of amSutees.
See also kinesiotherapist.
kinesis /kƯnƝ‫މ‬sis, kinƝ‫މ‬sis/, Shysical movement or force,
Sarticularly when induced by a stimulus.
-kinesis, -kinesia, suffix meaninJ µactivation¶ angiokinesis,
lymphokinesis, thrombokinesis.
kinesthesia. See kinaesthesia.
kinetic analysis /kinet‫މ‬ik/, analysis in which the chanJe of the
monitored Sarameter with time is related to concentration,
such as chanJe of absorbance Ser minute, to determine the
rate of a reaction.
kinetic ataxia. See motor ataxia.
-kinetic, -cinetic, suffix meaninJ µmovement¶ akinetic,
parakinetic, synkinetic.
kinetic energy (KE) >*k, kinƝsis, motion, energeia], the
enerJy Sossessed by an obMect by virtue of its motion. It is
kinomere
exSressed by the formula E (½)mv2, where m reSresents
the mass of the obMect and v is its velocity.
kinetic hallucination >*k, kinƝsis, motion; /, halucinari,
wanderinJ mind], a false SerceStion of body movement.
kinetic proofreading, 1. a molecular activity in which an
en]yme distinJuishes correct substrates. 2. a mechanism
that Sermits a ribosome to make correct codon±anticodon
interactions.
kinetic reflex >*k, kinƝsis, motion; /, reflectere, to bend
back], a Sostural resSonse resultinJ from stimulation of the
vestibular aSSaratus. $lso called labyrinthine reflex.
kinetics /kinet‫މ‬iks/ >*k, kinƝsis + /, icus, like], the study
of the forces that Sroduce, arrest, or modify the motions
of the body. 1ewton¶s first and third laws of motion are
esSecially aSSlicable to kinetics. 1ewton¶s first law states
that bodies at rest stay at rest and bodies in motion keeS
movinJ unless they are acted on by an unbalanced force.
1ewton¶s third law states that every action force has a
reaction force that is equal in maJnitude but oSSosite in
direction. 7hese two laws aSSly to the forces Sroduced
by muscles that act on Moints. 7he reaction forces of the
muscles contribute to equilibrium and the motion of
the body. &omSare kinematics.
kineto-, combininJ form meaninJ µmovable¶ kinetochore,
kinetogenic, kinetoplasm.
kinetochore. See centromere.
kinetoplasm /kƯnet‫މ‬ǀSla]‫ۑމ‬m/, the most hiJhly contractile
Sart of a cell.
kinetosis. See kinesia.
king brown snake antivenom, a Solyvalent snake anti
venom used in the treatment of systemic kinJ brown snake
envenomation. See antivenom.
King, Imogene, a nursinJ theorist who introduced her theory
of Joal attainment in her book, Toward a Theory of Nursing
(11). KinJ¶s conceStual framework sSecifies three interact
inJ systems Sersonal system, interSersonal system, and social
system. KinJ defined nursinJ as a Srocess of human inter
actions between nurse and clients who communicate to set
Joals and then aJree to meet the Joals. She believes that the
Satient is a Sersonal system within a social system, coexistinJ
throuJh interSersonal Srocesses with other Sersonal systems.
7he nurse and Satient Serceive each other and the situation,
act and react, interact, and transact. )rom her maMor conceSts
(interaction, SerceStion, communication, transaction, role,
stress, Jrowth and develoSment, and time and sSace), she
derived her theory of Joal attainment. KinJ describes nursinJ
as a disciSline and an aSSlied science, with emShasis on the
derivation of nursinJ knowledJe from other disciSlines. She
suJJests that the Satient¶s and nurse¶s SerceStions, MudJments
and actions lead to reaction, interaction and transaction, which
she calls the Srocess of nursinJ.
kin group, family members who are related Jenetically or
by marriaJe.
kinin /kƯ‫މ‬nin/, any of a JrouS of SolySeStides with varyinJ
ShysioloJical activity, such as contraction of visceral smooth
muscle, vascular Sermeability and vasodilation. 7wo Srinci
Sal kinins, bradykinin and lysylbradykinin, are formed in the
blood from Srecursor kininoJens by the action of kallikreins
and kinases.
kinky hair disease, an inherited condition characterised by
short, sSarse, Soorly SiJmented hair with shafts that are
twisted and broken. 2ther mental and Shysical disorders
are usually associated with the disease. $lso called Menkes’
kinky hair syndrome.
kino-, kinesi-, kinesio-, combininJ form meaninJ
µmovement¶ kinematics, kinesiology, hyperkinesia.
kinomere. See centromere.
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K
Kinsbourne syndrome
Klippel-Feil syndrome
962
Kinsbourne syndrome /kin]‫މ‬born/, a neuroloJical disorder
of unknown cause with onset between aJes 1 and 3 years,
characterised by myoclonus of trunk and limbs and by non
rhythmic hori]ontal and vertical oscillations of the eyes,
with ataxia of Jait and intention tremor; some cases have
been associated with occult neuroblastoma. $lso called
myoclonic encephalopathy of childhood.
kinship model family group, a family unit comSrisinJ
the bioloJical Sarents and their offsSrinJ with various ties
to an extended family deSendinJ on the cultural back
Jround. &ultural diversity means that there is considerable
variation in notions of kinshiS. )or examSle, kinshiS in
$boriJinal terms of reference is a key conceSt of family
and social orJanisation that has comSlex relationshiSs to
birth, conceStion, marriaJe, land and social relations. In
this context kinshiS includes the Sosition of a Serson within
their social network and in relation to the land where they
were conceived and born.
Kirklin staging system, a system for determininJ the
SroJnosis of colon cancer, based on the extent to which
the tumour has Senetrated the bowel area. See also cancer
staging, Dukes’ classification, TNM.
Kirschner’s wire /kursh‫މ‬n‫ۑ‬r]/ >0artin Kirschner, *erman
surJeon, 1±142; $S, wir], a threaded or smooth metallic
wire. 7he wire is used in internal fixation of fractures or for
skeletal traction.
Kirschner’s wire (Elkin et al, 2012)
kiting /kƯ‫މ‬tinJ/, informal, the imSroSer and illeJal Sractice of
alterinJ a druJ SrescriStion to indicate that more of a druJ
was Srescribed than was actually ordered by the doctor, and/
or to add an additional druJ. KitinJ may be done by a Satient
seekinJ Jreater quantities of druJs, esSecially oSioids and
ben]odia]eSines, than the doctor Srescribed, or by the Shar
macist to increase reimbursement from a third Sarty, such as
Jovernment aJencies. $lso known as forgery.
KJ, abbreviation for knee jerk.
kL, abbreviation for kilolitre.
klang association. See clang association.
Klebsiella /kleb‫]މ‬Ɲāel‫ۑމ‬/ >7heodore $.(. Klebs, *erman
bacterioloJist, 134±113], a Jenus of nonmotile Jram
neJative bacteria with Solysaccharide caSsules. Klebsiella
sSecies are ubiquitous in nature. Klebsiella orJanisms can
cause a wide ranJe of infections includinJ Sneumonia and
urinary tract infections.
Klebsiella pneumoniae >7heodore $.(. Klebs; *k, pneumǀn
lunJ], a sSecies of bacteria found in soil, water, cereal Jrains,
and the intestinal tract of humans and other animals. It is
associated with many infections, includinJ Sneumonia. See
also Friedländer’s bacillus.
Klebs-Loeffler bacillus /kleb]‫މ‬lef‫މ‬l‫ۑ‬/ >7heodor $.(. Klebs,
*erman bacterioloJist, 134±113; )riederich $.-. /oeffler,
Klebsiella pneumonia (Belchetz and Hammond, 2003)
*erman bacterioloJist, 12±11; /, bacillum, small rod],
Corynebacterium diphtheriae. See also Corynebacterium.
Kleeblattschädel deformity syndrome. See cloverleaf
skull deformity.
Kleine-Levin syndrome /klƯn‫މ‬lev‫މ‬in/ >:illi Kleine, 20th
century *erman Ssychiatrist; 0ax /evin, 5ussianborn
$merican neuroloJist, b. 101], a disorder of unknown
cause, often associated with Ssychotic conditions, that is
characterised by eSisodic sleeS, abnormal hunJer and hySer
activity. 7he eSisodes of sleeS may last for several hours or
days and are followed by confusion on awakeninJ. 7here is
no sSecific treatment. &omSare narcolepsy.
Klein-Waardenburg syndrome. See Waardenburg’s
syndrome, def. 2.
klepto-, Srefix meaninJ µtheft or stealinJ¶ kleptolagnia,
kleptomania.
kleptolagnia >*k, kleptein, to steal, lagneia, lust], sexual
excitement or Jratification Sroduced by stealinJ.
kleptomania /mƗ‫މ‬nƝā‫ۑ‬/ >*k, kleptein, to steal, mania,
madness], an anxiety disorder characterised by an abnormal,
uncontrollable and recurrent urJe to steal. 7he obMects are
not taken for their monetary value or immediate need. 7hey
are usually Jiven away, returned surreStitiously, or keSt
and hidden. PeoSle who have the condition exSerience an
increased sense of tension before committinJ the theft and
intense Jratification durinJ the act. $fterwards they disSlay
siJns of deSression, Juilt and anxiety over the Sossibility of
beinJ aSSrehended and losinJ status in society. In less severe
cases the imSulse is exSressed by continuously borrowinJ
obMects and not returninJ them. 7reatment consists of Ssycho
theraSy to uncover the underlyinJ emotional Sroblems. See
also impulse control disorder. —kleptomaniac, n.
Klinefelter’s syndrome /klƯn‫މ‬felt‫ۑ‬r]/ >+arry ). Klinefelter,
$merican Shysician, b. 112], affects 1 in 00 males and is
associated with the Sresence of an extra ; chromosome in at
least one cell line. &haracteristics are small, firm testes, lonJ
limbs and Jynaecomastia. :hile the ranJe of intellectual
ability reSorted is from well above to well below averaJe,
the averaJe I4 is ±0. Infertility is extremely common.
7he severity of the abnormalities increases with the numbers
of ; chromosomes. 7he commonest abnormality is a 4
;;< karyotySe. 0en with the karyotySe ;;;;< have
marked conJenital malformations and intellectual disability.
Klippel-Feil syndrome /kliSel‫މ‬fel‫މ‬, kliS‫ۑމ‬lfƯl‫މ‬/ >0aurice
KliSSel, )rench neuroloJist, 1±142; $ndre )eil, )rench
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Klippel-Trénaunay syndrome
963
Klinefelter’s syndrome (Patton and Thibodeau, 2010)
Klippel-Feil syndrome (Zitelli et al, 2012)
neuroloJist, b. 14], a condition of short neck and limited
neck movements because of conJenital fusion of the cervical
vertebrae or reduction in the number of cervical vertebrae.
$lso called Klippel’s disease, Klippel-Feil disease, KlippelFeil malformation. See congenital short neck syndrome.
Klippel-Trénaunay syndrome /kliāSel‫މ‬trƗānǀānƗ‫މ‬/ >0aurice
KliSSel, )rench neuroloJist, 1±142; Paul 7rpnaunay,
)rench Shysician, 20th century], a rare condition usually
affectinJ one extremity, characterised by hySertroShy of the
bone and related soft tissues, larJe cutaneous haemanJio
mas, Sersistent naevus flammeus, and skin varices.
Kloehn headgear, an extraoral orthodontic aSSliance
consistinJ of a cervical straS and a lonJ outer bow. It is used
to retract maxillary teeth or to reinforce tooth anchoraJe
durinJ retraction.
Klumpke’s palsy /klo଱ omS‫މ‬kƝ]/ >$uJusta 'pMprineKlumSke,
)rench neuroloJist, 1±12], atroShic Saralysis of the
forearm. It is Sresent at birth and involves the seventh and
knee joint
eiJhth cervical nerves and the first thoracic nerve. 7he
condition may be accomSanied by +orner¶s syndrome,
Stosis and miosis because of the involvement of symSathetic
nerves. $lso called Déjérine-Klumpke’s paralysis.
Km, symbol for Michaelis-Menten constant. See MichaelisMenten kinetics.
km, abbreviation for kilometre.
kneading /nƝ‫މ‬dinJ/, a JrasSinJ, rollinJ and SressinJ move
ment which uses the whole hand while the finJers and thumb
squee]e the tissues beneath, as is used in massaJinJ the
muscles. See also massage.
knee /nƝ/, a Moint comSlex that connects the thiJh with the
lower leJ. It consists of three condyloid Moints, 12 liJaments,
13 bursae and the Satella. 7he motion of this Moint is not
a simSle JlidinJ motion, because the articular surfaces of
the bones involved are not mutually adaSted to each other.
9arious orthoSaedic conditions such as arthritis commonly
affect the knee, esSecially in elderly individuals. 7he knee is
relatively unSrotected by surroundinJ muscles and is often
inMured by blows, sudden stoSs and turns, esSecially those
associated with sSorts. /iJamental tears of the knee Moint are
extremely common in athletes and Sroduce a variety of siJns
and symStoms, such as effusion surroundinJ the knee Moint,
varyinJ deJrees of oedema, differences in the shaSe of the
knee Moint, tenderness on SalSation, creSitation, instability
of the knee Moint, and Sossible ecchymosis. 7orn menisci
are very common sSorts inMuries and can cause severe Sain,
limSinJ, oedema, and Jreatly reduced motion.
knee–ankle interaction, one of the five maMor kinetic deter
minants of Jait, which helSs to minimise the disSlacement
of the body¶s centre of Jravity durinJ the walkinJ cycle. 7he
knee and the foot work simultaneously to lower the body¶s
centre of Jravity. :hen the heel of the foot is in contact
with the Jround, the foot is dorsiflexed, and the knee is fully
extended so that the associated limb is at its maximum lenJth
with the centre of Jravity at its lower Soint. Plantar flexion
of the foot with the initiation of knee flexion maintains the
centre of Jravity in its forward SroJression at about the same
level, also helSinJ to minimise the vertical disSlacement of
the centre of Jravity. Knee±ankle interaction is often a factor
in the diaJnosis and treatment of various orthoSaedic diseases,
deformities and abnormal conditions and in the analysis and
correction of SatholoJical Jaits. &omSare knee±hip flexion,
lateral pelvic displacement, pelvic rotation, pelvic tilt.
kneecap. See patella.
knee–chest position. See genupectoral position.
knee–elbow position, a Sosition in which a Satient beinJ
examined rests on the knees and elbows with the head
suSSorted on the hands.
knee–hip flexion, one of the five maMor kinetic determinants
of Jait, which allows the SassaJe of body weiJht over the
suSSortinJ extremity durinJ the walkinJ cycle. Knee±hiS
flexion occurs durinJ the stance and swinJ Shases of the
cycle. 7he knee first locks into extension as the heel of
the weiJhtbearinJ limb strikes the Jround and is unlocked
by final flexion and initiation of the swinJ Shase in the
walkinJ cycle. +iS flexion is synchronised with these move
ments, which helS minimise the vertical disSlacement of
the body¶s centre of Jravity in the act of walkinJ. Knee±hiS
flexion is often a factor in the diaJnosis and treatment of
various orthoSaedic diseases, deformities and abnormal
conditions, and in the analysis and correction of SatholoJi
cal Jaits. &omSare knee±ankle interaction, lateral pelvic
displacement, pelvic rotation, pelvic tilt.
knee-jerk reflex. See patellar reflex.
knee joint, the comSlex, hinJed Moint at the knee, reJarded
as three articulations in one, comSrisinJ condyloid Moints
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K
knee replacement
964
Femur
Articular
cartilage
Capsule
Patella
Joint cavity
(filled with
synovial fluid)
Synovial
membrane
Lateral
meniscus
Tibia
Knee joint (Herlihy, 2011)
connectinJ the femur and the tibia and a Sartly arthrodial
Moint connectinJ the Satella and the femur. 7he knee Moint
and its liJaments Sermit flexion, extension and, in certain
Sositions, medial and lateral rotation. It is a common site
for sSrain and dislocation. $lso called articulatio genus.
knee replacement, the surJical insertion of a Srosthesis
Serformed to relieve Sain and restore motion to a knee
severely affected by osteoarthritis, rheumatoid arthritis or
trauma. :ith the Satient under Jeneral or sSinal anaesthesia,
the diseased surfaces are removed and a twoSiece Srosthetic
Moint is inserted into the medullary cavities of the femur and
tibia. $fter surJery SroJressive exercise and whirlSool baths
are Srescribed throuJh Shysical theraSy. Possible comSli
cations include infection, fat embolism, thromboShlebitis,
Seroneal nerve Salsy, looseninJ of the Srosthesis, and flexion
contractures. 7o Srevent contractures the Satient is cautioned
to keeS the leJ extended in bed; a blanket roll alonJ the
femur Srevents external rotation. 7he mobility and ranJe of
motion of the Moint imSrove slowly. See also arthroplasty,
hip replacement, osteoarthritis.
Knee replacement (Black and Hawks, 2009)
knee sling, a leJ suSSort in slinJ form used under the knee
for 5ussell¶s traction. See also Russell’s traction.
knife needle /nƯf/, a slender surJical knife with a needle
kon-
Soint, used in the discission of a cataract and other oShthal
mic Srocedures such as Joniotomy and JonioSuncture.
knock-knee. See genu valgum.
Knoop hardness test /noଲ oS/ >)rederick KnooS, 20th century
$merican metallurJist], a method of assessinJ surface
hardness by measurinJ resistance to the Senetration of an
indentinJ tool made of diamond. 7he test is commonly used
for testinJ the hardness of teeth.
knot /not/, (in surJery) the interlacinJ of the ends of a
liJature or suture so they remain in Slace without sliSSinJ
or becominJ detached. 7he ends of the suture are Sassed
twice around each other before beinJ Sulled taut to form a
simSle surJeon¶s knot. )or additional stability the ends may
be recrossed and a second simSle knot made over the first.
knuckle /nuk‫ۑމ‬l/, the dorsal asSect of any ShalanJeal Moint,
esSecially of the metacarSoShalanJeal Moints of the flexed
finJers. %y extension sometimes aSSlied to any anatomical
structure of similar aSSearance, such as an extruded looS of
intestine in hernia.
knuckle pads, skin thickeninJs over the knuckles, sometimes
induced by trauma. Some are familial.
Kocher’s forceps >(mil 7. Kocher, Swiss surJeon, 141±11],
a kind of surJical forceSs that has notched Maws, interlockinJ
teeth, and thick curved or straiJht Sowerful handles.
Koch’s bacillus /koks/ >5obert Koch, *erman bacterioloJist,
143±110; /, bacillum, small rod], the Mycobacterium
tuberculosis microorJanism.
Koch’s phenomenon >5obert Koch; *k, phainomenon,
anythinJ seen], a tuberculin reaction that occurs when a
culture of tubercle bacilli is inMected into the skin of a subMect
already infected with the disease. In humans a Sositive
tuberculin reaction indicates sensitisation resultinJ from
a tuberculosis infection. $lso called Koch’s reaction.
Koch’s postulates >5obert Koch; /, postulare, to demand],
the Srerequisites for exSerimentally establishinJ that a
sSecific microorJanism causes a Sarticular disease. 7he
conditions are the followinJ (1) the microorJanism must be
observed in all cases of the disease; (2) the microorJanism
must be isolated and Jrown in Sure culture; (3) micro
orJanisms from the Sure culture, when inoculated into a
susceStible animal, must reSroduce the disease; and (4) the
microorJanism must be observed in and recovered from the
exSerimentally diseased animal.
Koch’s reaction. See Koch’s phenomenon.
Koebner phenomenon /kǀb‫މ‬n‫ۑ‬/ >+einrich Koebner, Polish
dermatoloJist, 13±104; *k, phainomenon, somethinJ
observed], the develoSment of isomorShic lesions at the
site of an inMury occurrinJ in Ssoriasis, lichen nitidus, lichen
Slanus, and verruca Slana.
Koenen tumour, SeriunJal fibroma common in tuberous
sclerosis.
KOH, chemical formula for potassium hydroxide.
Kohnstamm’s phenomenon. See aftermovement.
koilo-, combininJ form meaninJ µhollow or concave¶ koilonychia, koilorrhachic, koilosternia.
koilonychia /koi‫މ‬lǀnik‫މ‬Ɲā‫ۑ‬/ >*k, koilos, hollow, ony[, nail],
sSoon nails; a condition in which nails are thin and concave
from side to side. It is usually familial but may occur with
trauma, iron deficiency anaemia, or as a result of oral
retinoid theraSy.
koinoni-, combininJ form meaninJ µcommunity¶ koinonia,
koinoniphobia.
kolpo-. See colpo.
koly-, combininJ form meaninJ µto hinder¶ kolypeptic,
kolyphrenia, kolyseptic.
kon-, combininJ form meaninJ µdust¶ konometer,
koniocorte[.
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Kopan’s needle
Krukenberg’s tumour
965
Koplik’s spots (Zitelli et al, 2012/Courtesy Robert Hickey MD,
Children’s Hospital of Pittsburgh)
Koebner phenomenon (Zitelli et al, 2012)
Koilonychia (Hordinsky, Sawaya and Scher, 2000)
Kopan’s needle /kǀ‫މ‬S‫ۑ‬n]/, a lonJ bioSsy needle used to locate
the Sosition of a breast tumour on xray film. 7he needle is
inserted into the aSSroximate location of the tumour and is
left in Slace durinJ radioJraShy so that it can be reSositioned
if necessary. In some cases the site is further identified for the
surJeon by inMectinJ a coloured dye such as methylene blue.
Koplik’s spots /koS‫މ‬liks/ >+enry KoSlik, $merican Saediatri
cian, 1±12], small, red sSots with bluishwhite centres
on the linJual and buccal mucosa, characteristic of measles.
7he rash of measles usually eruSts a day or two after the
aSSearance of KoSlik¶s sSots.
kopr-, kopra-. See copro.
Korányi’s sign /k{r‫ۑމ‬nyƝ]/ >)riedrich von Korinyi, +unJar
ian Shysician, 12±113; /, signum], a Saravertebral area
of dullness found Sosteriorly on the side oSSosite a Sleural
effusion. $lso called Grocco’s sign, Korányi-Grocco
triangle, triangular dullness.
Korean haemorrhagic fever. See epidemic haemorrhagic
fever.
Korotkoff sounds /k{rot‫މ‬k{f/ >1ickolai Korotkoff, 5ussian
Shysician, 14±120], sounds heard durinJ the takinJ of
a blood Sressure readinJ usinJ a sShyJmomanometer and
stethoscoSe. $s air is released from the cuff, Sressure on the
artery is reduced, and the blood is heard SulsinJ throuJh
the vessel. See also blood pressure, diastole, sphygmomanometer, systole.
Korsakoff’s psychosis /k{r‫މ‬s‫ۑ‬k{fs/ >SerJei S. Korsakoff,
5ussian Ssychiatrist, 14±100], a form of amnesia often
seen in chronic alcoholics that is characterised by a loss of
shortterm memory and an inability to learn new skills. 7he
Serson is usually disoriented, may Sresent with delirium and
hallucinations, and confabulates to conceal the condition.
7he cause of the condition can often be traced to deJener
ative chanJes in the thalamus as a result of a deficiency of
% comSlex vitamins, esSecially thiamine and %12. &omSare
Wernicke’s encephalopathy.
kosher >+eb, kasher, fit or SroSer], SertaininJ to the SreSara
tion and servinJ of foods accordinJ to -ewish dietary laws.
Inherently kosher foods include common fruits, veJetables,
and cereals, as well as tea and coffee. )oods that are not
kosher include Sork, birds of Srey, and seafood that lacks fins
and scales, such as lobster and eels. 0ost Soultry and meat
Sroducts, excludinJ Sork, are kosher if SroSerly Srocessed.
0eat and milk Sroducts should be SreSared seSarately.
K+ pump. See potassium pump.
Kr, symbol for the element krypton.
Krabbe’s disease. See galactosyl ceramide lipidosis.
Kraske position /kras‫މ‬k‫ۑ‬/ >Paul Kraske, Swiss surJeon,
11±130], an anatomical Sosition in which the Satient is
Srone, with hiSs flexed and elevated, head and feet down. 7he
Sosition is used for renal surJery, as it enlarJes the costoverte
bral anJle, allowinJ the surJeon oStimal access to the kidneys.
kraurosis vulvae, outdated terminoloJy. See lichen
sclerosus.
Krause’s corpuscles >:ilhelm -.). Krause, *erman anat
omist, 133±110; /, corpusculum, little body], any of a
number of sensory endorJans in the conMunctiva of the
eye; mucous membranes of the liSs and tonJue; eSineurium
of nerve trunks, the Senis and the clitoris; and synovial
membranes of certain Moints. Krause¶s corSuscles are tiny,
cylindrical, oval bodies with a caSsule formed by the
exSansion of the connective tissue sheath of a medullated
fibre. 7hey contain a soft, semifluid core in which the axon
terminates either in a bulbous extremity or in a coiled mass.
$lso called end bulbs of Krause. &omSare Golgi-Mazzoni
corpuscles, Pacini’s corpuscles.
Krebs cycle. See citric acid cycle.
Krebs-Henseleit cycle. See urea cycle.
Krukenberg’s tumour /kroଲ o‫މ‬k‫ۑ‬nb‫ۑ‬rJ]/ >)riedrich (. Kruken
berJ, *erman SatholoJist, 11±14], a neoSlasm of the
ovary that is a metastasis from a *I maliJnancy, usually
stomach cancer. &ytoloJical examination often reveals
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K
krypto-
966
Krukenberg’s tumour (Fletcher, 2007)
mucoid deJeneration and many larJe cells shaSed like siJnet
rinJs. $lso called carcinoma mucocellulare.
krypto-. See crypto.
krypton (Kr) /kriS‫މ‬ton/, a Jenerally inert rare Jaseous element
Sresent in air. Its atomic number is 3; its atomic mass is 3.0.
KS, ks, abbreviation for Kaposi’s sarcoma.
k-space, the mathematical sSace used in 05 to define the
relative Sositions of frequency and Shase Soints in a Jiven
sequence.
Kt/V, a formula to measure the adequacy of dialysis reflectinJ
clearances (K) of urea from the Satient¶s total body water
(9) over a Seriod of time (t). $ value over 1.0 results in
lower morbidity rates, althouJh many suJJest that Kt/9
•1.2. See also adequacy, urea reduction ratio.
KUB, abbreviation for kidney, ureter and bladder; a term used
in a radioJraShic examination to describe the location, si]e,
shaSe and malformation of the kidneys, ureters and bladder.
Stones and calcified areas may be detected.
Kuchendorf method /koଲ o‫މ‬k‫ۑ‬nd{rf/, (in radioloJy) a tech
nique for SositioninJ a Satient for radioJraShic examination
of the Satella. 7he Satella is Slaced aJainst the imaJe
receStor and is moved laterally to reduce suSerimSosition.
kudzu, a herb that Jrows in vine form, native to &hina and
-aSan.
Q USES It has claimed uses to reduce alcohol cravinJs and
menoSausal symStoms.
Q CONTRAINDICATIONS It should not be used durinJ SreJ
nancy and lactation, in children, or in those with known
hySersensitivity. It should be used with caution by SeoSle
who have heart disease.
Kufs’ disease /koଲ ofs/ >+. Kufs, *erman Ssychiatrist,
11±1; /, dis + )r, aise, ease], an adult form of hered
itary cerebral sShinJoliSidosis (amaurotic familial idiocy),
characterised by cerebromacular deJeneration, hySertonic
ity, and SroJressive sSastic Saralysis. $lso called adult
ceroidlipofuscinosis.
Kugelberg-Welander syndrome. See juvenile spinal
muscular atrophy.
kuia, (1ew =ealand 0Ɨori) an elder, elderly, old woman.
7he holder of wisdom, a suSSortive role and a symbolic
one. Kuia will often accomSany the family into healthcare
settinJs and may sSeak for the family on imSortant matters.
0ay be referred to as µaunty¶. &omSare NDXPƗWXD.
Kulchitsky cell carcinoma. See carcinoid.
Kulchitsky’s cell. See argentaffin cell.
Kümmell’s disease /kim‫ۑމ‬l]/ >+ermann Kmmell, *erman
surJeon, 12±13; /, dis + )r, aise, ease], a set of
symStoms that develoS after a comSression fracture of the
kVp test cassette
vertebrae with sSinal inMury. 7hey include sSinal Sain, inter
costal neuralJia, kyShosis, and weakness in the leJs. $lso
called Kümmell’s spondylitis, posttraumatic spondylitis,
traumatic spondylopathy.
kunitz inhibitor. See trypsin inhibitor.
Kunjin virus, a flavivirus, first isolated from Cule[ annulirostris mosquitoes collected in northern 4ueensland in 10
near the 0itchell 5iver. It is named after the $boriJinal
clan that lived nearby, and is closely related to the :est
1ile virus. Subclinical infection is common. 0ild disease
consists of lymShadenoSathy, fever, letharJy and rash.
(nceShalitis can occur but is rare. Infection is usually
confirmed by blood samSles showinJ a siJnificant rise in
antibody titre to the virus. In some reference laboratories
the KunMin virus can be cultured or viral 51$ detected in
clinical material. 7he virus is endemic in the troSical north
of $ustralia and Sarawak, where it has cycles of infection
between birds and mosquitoes in en]ootic foci. 7here is no
evidence of SersontoSerson transmission.
Küntscher nail /ko଱ on‫މ‬ch‫ۑ‬/ >*erhard Kntscher, *erman
surJeon, 102±12; $S, naegel], the first stainless steel
intramedullary nail used in orthoSaedic surJery for the fixation
of fractures of the lonJ bones, esSecially the femur and tibia.
Kupffer cells /ko଱ oS‫މ‬f‫ۑ‬r/ >Karl :. von KuSffer, *erman
anatomist, 12±102], larJe, ShaJocytitic cells of the
reticuloendothelial system lininJ the sinusoids of the liver.
kuru /koଲ o‫މ‬roଲ o/ >1ew *uinea, tremblinJ], a slow, SroJres
sive, fatal Srion infection of the central nervous system
that was endemic to natives of the 1ew *uinea hiJhlands.
7he incubation Seriod could be 30 or more years, but death
usually occurred within months of the onset of symStoms.
&haracteristic of kuru are ataxia and decreased coordination
SroJressinJ to Saralysis, dementia, slurrinJ of sSeech and
visual disturbances. 'isease was transmitted by ritual canni
balism of brain tissue durinJ funeral rites. 1o new cases
have been recorded since cessation of the cannibalism. See
Creutzfeldt-Jakob disease.
Kussmaul breathing /ko଱ os‫މ‬moul/ >$dolf Kussmaul,
*erman Shysician, 122±102; $S, braeth], abnormally
deeS, very raSid siJhinJ resSirations associated Sarticularly
with diabetic ketoacidosis and other causes of metabolic
acidosis. +yServentilation reduces carbon dioxide and
induces resSiratory comSensation for the acidosis. $lso
called Kussmaul respiration.
Kussmaul’s coma >$dolf Kussmaul; *k, kǀma deeS sleeS],
a diabetic coma characterised by acidosis and deeS breathinJ
or extreme hySerSnoea.
Kussmaul’s sign >$dolf Kussmaul; /, signum, mark], 1. a
Saradoxical rise in venous Sressure with distension of the
MuJular veins durinJ insSiration, as seen in constrictive Seri
carditis or mediastinal tumour. 2. conditions of convulsions
and coma associated with a *I disorder caused by absorStion
of a toxic substance.
kV, abbreviation for kilovolt.
Kveim reaction >0orten $. Kveim, 1orweJian Shysician,
12±1; /, re, aJain, agere, to act], a reaction used in
a diaJnostic test for sarcoidosis, based on an intradermal
inMection of antiJen derived from a lymSh node known to
be sarcoid. If a noncaseatinJ Jranuloma aSSears on the
skin at the test site in 4 to weeks, the reaction is said to be
Sositive evidence that the Satient has sarcoidosis. 7his test
is now rarely Serformed.
kVp, abbreviation for kilovolt peak.
kVp test cassette, (in radioloJy) a liJhtSroof box containinJ
a coSSer filter, a series of steSwedJes and an oStical atten
uator, used to test the accuracy of k9S settinJs for Seak
electrical Sotential across an xray tube.
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kwashiorkor
kyphosis
967
kwashiorkor /kwl‫މ‬shƝā{r‫މ‬k{r/ >$fr], a malnutrition disease,
Srimarily of children, caused by severe Srotein deficiency
that usually occurs when the child is weaned from the breast.
7he child does not lose weiJht as dramatically and is not as
wasted as a marasmic child, who lacks Srotein and calories.
7he main siJn of kwashiorkor is oedema. (ventually the
followinJ symStoms occur retarded Jrowth, chanJes in skin
and hair SiJmentation, diarrhoea, loss of aSSetite, nervous
irritability, letharJy, anaemia, and fatty deJeneration of the
liver, often accomSanied by infection and multivitamin defi
ciencies. Initial stabilisation is followed by rehabilitation.
'ietary treatment is usually based on milk (whole or skim),
Jiven as small frequent feeds. 'ietary fats and/or lactose
may be Soorly tolerated, in which case a lowlactose milk
substitute may be used. 9itamin and mineral suSSlements
are imSortant. 7hese initial feedinJs are followed by addi
tional foods until a full, wellbalanced diet is achieved. See
also marasmic kwashiorkor, marasmus, protein±energy
malnutrition.
kyphos /kƯ‫މ‬f‫ۑ‬s/ >*k, kyphos, hunchbacked], the exaJJera
tion or anJulation from the normal Sosition of the thoracic
vertebral column that is associated with kyShosis. See also
kyphosis.
kyphoscoliosis /kƯ‫މ‬fǀskǀ‫މ‬lƝāǀ‫މ‬sis/ >*k, kyphos, hunchbacked
+ skolios, curved + osis, condition], an abnormal condition
characterised by an anteroSosterior and a lateral curvature
of the sSine. It occurs in children and adults and is often
associated with cor Sulmonale. &omSare kyphosis, scoliosis. —kyphoscoliotic, adj.
Kyphoscoliosis (Swartz 2010)
The child on the left has severe muscle wasting with
oedema representing marasmic kwashiorkor. The other
child pictured does not have a nutritional deficiency
(Shetty, 2006)
Kyasanur Forest disease, a flavivirus infection transmitted
by the bite of a tick that is harboured by shrews and other
forest animals in western troSical India. &haracteristics of
the infection include fever, headache, muscle ache, couJh,
abdominal and eye Sain, and ShotoShobia. 7reatment is
symStomatic. $ vaccine is used in India.
Kylie, an $ustraliandeveloSed bed sheet, similar in si]e to a
draw sheet, which is used in incontinence. It is comSosed
of a Sorous toS layer that allows urine to Sass freely into
a hiJhly absorbent middle layer, Slus a moistureresistant
backinJ, thereby helSinJ to keeS the Satient and the bed
dry.
kymo-, combininJ form meaninJ µwaves¶ kymograph, kymoscope, kymotrichous.
kymography /kƝmoJ‫މ‬r‫ۑ‬fƝ/ >*k, kyma, wave + graphein, to
record], a technique for JraShically recordinJ motions of
body orJans, such as the heart and the blood vessels.
kyno-, combininJ form meaninJ µdoJs¶ kynocephalus,
kynophobia.
kypho-, combininJ form meaninJ µhumS¶ kyphoscoliosis,
kyphosis, kyphotone.
kyphosis /kƯfǀ‫މ‬sis/ >*k, kyphos, hunchbacked], an abnormal
condition of the vertebral column, characterised by increased
convexity in the curvature of the thoracic sSine as viewed
from the side. 7he sSinal saJittal contour ordinarily consists
K
Severe kyphosis of the thoracic spine
(Zitelli et al, 2012)
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Kyrle’s disease
968
of a lordosis in the lumbar and cervical sSinal seJments
that balances the roundinJ, or the kyShosis, in the thoracic
seJment. KyShosis describes this exSected roundinJ but
it is also used to describe the abnormal condition of the
vertebral column. It may be caused by rickets or tuberculosis
of the sSine. $dolescent kyShosis is usually selflimitinJ
and often undiaJnosed but, if the curvature SroJresses, there
may be moderate back Sain. &onservative treatment consists
of sSinestretchinJ exercises and sleeSinJ without a Sillow
kyto-
with a board under the mattress. $ modified 0ilwaukee
brace may be used for severe kyShosis and, rarely, sSinal
fusion may be required. $lso called humpback, roundback.
—kyphotic, adj.
Kyrle’s disease, chronic skin disease usually arisinJ in
diabetes and chronic renal failure, characterised by hySer
keratotic SaSules.
kysth-, kystho-. See colpo.
kyto-. See cyt.
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