The PreOp-Guide
A Patient's Guide To Surgery
Chapter 11
ABI:  See arterial brachial index.

Abscess:  A collection of infected fluid.  In the most basic terms, a pimple is a mini-abscess.  The fluid within an abscess contains dead white blood cells and an infectious organism such as bacteria.  If left untreated, an abscess will usually continue to expand and may ultimately rupture, spilling infectious material. 

Anastomosis:  The surgical connection of two hollow structures, so as to place their lumens in continuity.  For example, sewing two blood vessels together so that blood may flow from one into the other.  This may be accomplished with either sutures, or in some cases, specially designed staple devices.

Anemia:  Sometimes referred to as a low blood count.  This term is used to describe a person who has an abnormally low amount of hemoglobin (the substance that carries oxygen in the blood).  There are many causes for anemia, but in the post-surgical state, the most common cause is blood loss due to injury or the operation.

Angiogram:  Literally, a picture of a blood vessel.  To accomplish this, a catheter is placed within the blood vessel and contrast material (which shows up on x-rays) is injected into the vessel.  X-rays are then obtained, which show the course and extent of a blood vessel.  Virtually any blood vessel large enough to see with the eye can be evaluated with this method.

Angioplasty:  The process of dilating a blood vessel that has been evaluated by an angiogram. Numerous techniques accomplish this, and this field is evolving very rapidly.  Many times angioplasty can be used to open blocked blood vessels that would have required surgical bypass only a few years ago.  This technique is useful but will not work on every blood vessel. 

Anticoagulation:  The process of inhibiting blood clot formation by pharmaceutical means. Many drugs function as anticoagulants, including aspirin, Coumadin, and heparin.  In some diseases, pathological anticoagulation may occur, resulting in excessive bleeding.

Arterial brachial index: The result of dividing the blood pressure in the lower extremity by the blood pressure in the arm.  A normal index is around 1.  This number in and of itself is not very useful, but it gives a good indication of how much blood flow is reaching the lower extremities, and can be easily followed with simple measurements in the office or after an operation.

Atalectasis: The collapse of lung tissue due to either an internal obstruction of the airway or a failure to fully expand the lung with a deep breath.  This is a very common complication of surgery, and can result in fevers and possibly lead to pneumonia.  Deep breathing exercises, coughing, and the use of an incentive spirometer can all help to diminish the incidence of this condition.

Barium enema: This is a radiological test in which contrast material that shows up on x-ray films is introduced through the anus into the large intestine.  By altering your position and administering the proper amount of barium contrast, a radiologist can provide a fairly detailed picture of the inside of your large intestine (colon).  In many cases, this test has been replaced by colonoscopy; however, there are times when a barium enema is preferable.

BE:  See barium enema.

Benign:  This is a description of a tumor, which implies that there is no cancer within the mass.  These lesions may continue to grow and may require surgical removal; however they do not have the capacity to metastasize and spread to the rest of the body.  If you discover a new mass or tumor, you want it to be benign.

Biopsy:  There are numerous types of biopsy, but in general a biopsy is the removal of a portion of a suspicious lesion so that it can be characterized by microscopic examination.  In some cases, a biopsy can remove the entire lesion; this is termed an excisional biopsy.  In many cases, only a piece of the lesion will be removed, and by looking at the removed tissue under a microscope, your physician will be able to determine if you have a cancerous growth developing.  Biopsy samples are studied by a pathologist, who is a physician trained in making diagnoses using microscopy and other biochemical techniques.

Bleeding time:  A laboratory test in which a small incision is made in the skin.  The time it takes for the bleeding from this incision to stop is known as the bleeding time.

Blood culture:  See Culture.

Bronchoscopy:  The process of using a thin, lighted telescope to look at the inside of the major airways of the lung.  This can be done diagnostically to look for lung cancer, or therapeutically to remove foreign or infectious material from the lungs.

Cancer: A generic term for a growth of tumor cells that have the capacity to metastasize.  There are many different types of cancer, and the type of cancer depends upon the normal tissue from which it develops.

Cardiac echo:  See Echocardiogram.

CAT scan:  See CT scan.

Cath:  Slang for Catheterization (see below).

Catheterization:  A very broad term.  In general a catheterization is the placement of a tubular structure in a body cavity.  A catheter may be placed through the urethra into the urinary bladder to drain urine, or a fluid collection in some other area may have a drainage catheter placed into it to remove the fluid.  Frequently this term is used to refer to the process of injecting contrast material, which shows up on x-ray film, into blood vessels to determine their course.  Commonly the vessels of the heart will be studied in this fashion, and this is referred to as a cardiac cath.

Cauterize:  The process of using heat to denature tissue and prevent bleeding.  Typically produced by the application of an electric current to an area of tissue.

Cecum:  The portion of the large intestine beyond the ileocecal valve (where the small intestine empties into the large intestine) is known as the cecum.  The appendix originates at the base of the cecum.  This is a frequent site of colon cancer, and is found on the right hand side of your abdomen below you belly button. 

Cerebrovascular accident:  Commonly known as a stroke.  This occurs when there is insufficient blood flow to a region of the brain.  If the lack of blood flow is transient, the symptoms may come and go quickly (called a transient ischemic attack or TIA).  If the lack of blood flow persists long enough, the brain tissue, which is starved for blood, will die.  In many cases, the symptoms of a stroke will improve over time, as other areas of the brain assume some of the function of the dead tissue.  In some cases, however, the symptoms never resolve.

Coags:  A slang term for the laboratory tests that determine the rate of blood clotting.

Coagulation:  The process of forming blood clots is known as coagulation.

Colon:  Also known as the large intestine.  This is the area of your intestines where water is absorbed and solid stool is formed.  It forms a long, upside down U in your abdomen and is broken into distinct regions, the ascending (right), transverse, descending (left), and sigmoid colon.  The sigmoid colon empties into the rectum.

Colonoscopy:  This is a test in which a long, flexible, lighted telescope is inserted through the anus and directed through the large bowel.  Colonoscopy is performed to look for masses, infections, bleeding sites, or problems with the lining of the colon.  This allows the doctor to actually see every inch of your colon.  Typically you will need to complete a bowel cleansing before this test can be performed.  You will probably be given a heavy sedative prior to this test, as it is uncomfortable (and sometimes downright painful) when performed on fully awake patients.

Colostomy:  The creation of a communication between the colon and the surface of the skin for the purpose of diverting stool from the colon or rectum.  These can be temporary or permanent.

Complication:  Any event or occurrence that is not a part of the normal course of treatment and recovery is termed a complication.  You can have a complication before, during, or after surgery.  Most complications are small and easily corrected. 

Compression boots:  See Sequential compression device.

Conscious sedation:  A process whereby a patient is given a sufficient dose of a sedative drug to render the patient comfortable without the patient losing consciousness.  Typically, you will not remember a test performed under conscious sedation, but you will remain awake and breathing normally during the procedure.

CT scan:  Formerly called a CAT scan.  This is a radiological test that provides detailed images of your internal organs.  The abbreviation CT stands for computed tomography.
Culture:  The process of placing a specimen on or in a controlled substance that supports the growth of micro-organisms.  If you develop a fever, samples of blood, urine, and sputum may be collected and cultured to determine if you have a bacterial (or fungal) infection that needs to be treated.

CVA:  See Cerebrovascular accident.

Deep venous thrombosis:  This is a condition whereby a blood clot develops in the deep venous system of an extremity.  This condition is dangerous in that these blood clots may move centrally toward the largest vein in your body, your vena cava.  Blood clots in the deep venous system can also break off and travel to your lungs or your brain, causing a blockage of an important artery.  This is a serious complication of surgery and several disease states, and requires immediate treatment.

Dehiscence:  The early failure of a wound closure.  This results in the separation of a wound below skin level.  This can sometimes be managed nonoperatively, but frequently will require an additional operation to repair the opening in the wound.  

Disease free survival:  A measure used to examine the effectiveness of a treatment for cancer.  This measure will tell you the likelihood that you will survive for a given number of years without a recurrence of your disease.

Diverticulitis:  A pathological state in which a diverticula becomes obstructed and infected.  The infectious material becomes trapped behind the obstruction in a blind ending outpouching, and as fluid and white cells flood into the area to combat the infection, the outpouching (or diverticula) expands.  If the infection is not controlled, the diverticula will eventually rupture, spilling infected material.  This condition requires antibiotic treatment at a minimum, and may require surgery if the inflammation cannot be controlled with medication alone.

Diverticulosis:  A medical condition in which a hollow organ (most commonly, the colon) develops outpouchings of its inner surface.  These outpouchings penetrate through the wall of the organ and form small pouches where particulate matter can be trapped.  This is a common condition, and in and of itself is not a problem.  People with known diverticulosis are often asked not to eat corn or nuts, to prevent an obstruction of one of the outpouchings (known as diverticula).

Doppler:  A type of ultrasonic test that uses the Doppler effect (a principle of physics) to determine the rate and direction of blood flow.  This is useful in determining if a blood vessel contains a blockage or clot.

Drain:  A device that prevents the accumulation of fluid in a body space or cavity.  A drain may be made of cloth, rubber, or plastic.  It may also allow the drainage fluid to empty onto the skin or may have a reservoir, which serves to capture the escaping fluid.
Duplex imaging:  The use of both an ultrasound image and a Doppler study to better evaluate the conditions within a blood vessel.  The ultrasound image will provide a visual representation of the blood vessel while the Doppler study will quantify the rate and direction of blood flow.

DVT:  See Deep Venous Thrombosis.

ECG:  Formerly known as an EKG.  This test uses electrodes to determine the electrical activity of your heart.  By examining the conduction of electrical activity in the heart, your physician can determine if you have electrical disturbances or if you have ever had a heart attack in the past.

Echocardiogram:  A test that uses an ultrasound device to obtain images of your heart.  This test is good at determining the size and motion of the heart as well as giving a good look at the heart valves.  There are two ways to perform this test, transthoracic (looking through the rib cage) and transesophogeal (putting the probe down into your esophagus and looking through its wall at the heart).

EGD:  See Upper endoscopy.  This is an abbreviation for the term  esophagogastro-duodenoscopy

Electrocardiogram:  See ECG.

Endoscopy:  A generic term that refers to a procedure whereby a lighted telescope is passed through an orifice into a body cavity to visually examine that region.  There are both flexible and rigid endoscopes, and their use is increasing dramatically for both diagnosis and therapy.

Endotracheal tube:  A narrow plastic tube that is inserted between the vocal chords and into the trachea for the purpose of protecting the airway and allowing the administration of mechanical ventilation.

Enteroclysis:  See Small bowel series.

Epidural:  A method of analgesia (or anesthesia) in which pain medication is injected directly into the space surrounding the spinal cord.  Although this sounds dangerous, it is actually a safe and possibly the most effective method for controlling pain during and after an operation.  Epidural catheters are sometimes left in place for several days after an operation, and intermittent or continuous dosing of an anesthetic agent may be used.

ET tube:  See Endotracheal tube.

Feeding tube:  A tube placed either surgically or endoscopically into the stomach or small intestine for the purpose of providing nutrition to a patient who is either unwilling or unable to consume sufficient calories to sustain life.

Fever work up:  The process of determining the cause of a fever in a patient after an operation.  Usually your surgeon will perform a physical examination, obtain numerous samples for culture, obtain laboratory studies, and perhaps order an x-ray or CT scan.

Five-year survival:  A measure used when describing the effectiveness of a treatment for cancer.  This will give you an idea of the likelihood of remaining alive for a full five years after your therapy.  Ten-year survival is another common measure used.

Flat and upright:  A descriptive term for a series of abdominal x-rays that are taken with you lying flat, and then sitting or standing in an upright position.  This allows your surgeon to look at the contents of your bowels in a very gross sense.  This is a good initial test but does not provide very detailed information, and it rarely leads to a diagnosis in and of itself.

Gastrojejunostomy:  An anastamosis between the stomach and the jejunum.  There are numerous techniques to accomplish this.

Greenfield filter:  A metallic filter that is placed under x-ray guidance into the main vein of the body, the vena cava.  This filter is designed to capture blood clots that may break off from the lower extremities and pass into the lung.  By capturing these clots, the filter prevents the development of pulmonary embolism.

Hemorrhage:  A medical term that signifies heavy (severe) bleeding.

Hartman’s pouch:  When a portion of the colon is removed but there is remaining colon above and below the removed segment, it is sometimes not possible to connect the two ends of colon together.  The proximal (or higher) end is brought through the skin as a colostomy.  The distal (lower) end can also be brought through the skin (termed a mucus fistula), or it can be sutured or stapled shut and left in the abdomen.  This small pouch is also known as a Hartman’s pouch.

Hematocrit:  A measure of the volume of red blood cells in your total blood volume.  Normally about half of your blood volume is made up of red blood cells.  If this level falls, you are said to have anemia.

Hemoglobin:  A measure of the amount of iron your blood is carrying in a given volume of blood.  This measurement allows your physician to determine how much oxygen is being carried by your circulation at any time.  If this level falls, you are said to have anemia.

Heparin:  A medication that inhibits blood clot formation.  It is a naturally occurring compound which our bodies produce.  The commercially available medication is derived from animal tissue.  It may be given by injection into the skin or directly into an intravenous line.  If your are given skin injections of heparin, it is common to develop bruising at the site of injection.

I & D:  See Incision and drainage.

Ileostomy:  The creation of an opening between the ileum and the surface of the skin for the purpose of diverting stool away from the colon.  These may be temporary or permanent. 

Ileum:  The final portion of the small bowel.  It is connected directly to the colon.  It is responsible for absorption of food and is the specific site of absorption of several vitamins and other important compounds.

Ileus:  Technically, an obstruction of the small bowel.  Typically used to describe the condition of adynamic ileus, in which a portion of the bowel does not contract, resulting in a dilation of the bowel proximal (before) to the non-contracting segment.  This commonly occurs after abdominal surgery, and usually resolves spontaneously within several days.

Incentive spirometer:  A small plastic device, which is used to encourage the performance of deep breathing after surgery.  It comes in many shapes and sizes and typically allows you to measure how deep a breath you are able to take.  The frequent use of an incentive spirometer will help to reduce the likelihood that you will develop a pulmonary (lung) complication after your operation.

Incision and drainage:  A surgical procedure that makes use of a small skin incision to drain a localized collection of infected fluid.  Similar to the old-time tradition of lancing a boil.  Depending upon location and type of fluid collection, this may be a definitive treatment (i.e., a cure) or a temporizing measure to prevent the progression of an infection prior to a definitive operation.

Intravenous catheter:  A small plastic or metal tube, which is inserted through the skin directly into a vein.  This allows for the administration of fluid and medications directly into the circulation.

IV:  See Intravenous catheter.

Jejunum:  The mid-portion of the small bowel, this is the region in which most of the nutrients contained in food are absorbed into the body.

J-pouch:  The creation of an artificial rectum by sewing a loop of ileum together in the form of a J.  This is done to expand the caliber of the lumen of the ileum so that it can accommodate a larger volume of liquid stool.  This is typically performed in situations where the rectum is removed but the anal sphincter remains in place.

Large intestine:  See Colon

Lesion:  This is a commonly used medical term to describe a mass, tumor, ulcer, or other abnormal area that has not yet been diagnosed.  Your doctor may tell you that you have a suspicious lesion, which requires further investigation.

Lumen: The space within an artery, vein, intestine, or tube.

Lymph node:  An immunologic organ whose main purpose is to allow infection-fighting white cells to come into contact with foreign material so that it may be removed from the body.  There are thousands of lymph nodes scattered throughout the body.  In situations where cancer has metastasized from its point of origin, cancer cells often show up in nearby lymph nodes before they are discovered elsewhere.  In some situations, lymph nodes will trap the escaping cancer cells, and if the nodes are removed before the cancer cells pass through them, a cure is possible by removing the nodes.

Magnetic resonance imaging:  A radiographic test that makes use of strong magnetic fields to alter the spin of electrons in the tissues of your body.  This technique produces extremely detailed pictures of internal organs.  It is superior to CT scans in many (but not all) situations.  People with claustrophobia may find this test difficult, in that you may be asked to lie in a confined space for a prolonged period of time.  Special MRI machines for people with claustrophobia exist.  This technology is rapidly advancing, and new MRI- based tests are being introduced constantly.

Mass: This is the term given to any firm, space-occupying lesion that develops over time.  This term is very general, and is typically used to describe something that has not yet been studied and characterized.

Mechanical ventilation:  See Ventilator.

Metastasis: The process whereby malignant cancer cells spread through the body and grow in different sites.  This is the result of tumor cells breaking free from the original site of cancer and implanting at a different site.

MI:  See Myocardial infarction

MODS:  Short for multi-organ dysfunction syndrome.  See Sepsis.

Morbidity:  Usually described as a percentage.  This gives you the expected rate of complications following a particular surgery.  This term  can also be used to describe a typical complication following an operation.

Mortality:  Typically described as a percentage or rate.  This tells you the likelihood of death associated with a particular operation or treatment.

MRI:  See Magnetic resonance imaging.

Myocardial infarction:  Commonly known as a heart attack.  This occurs when insufficient blood flow reaches the heart muscle, and the heart muscle becomes damaged for lack of oxygen and nutrients.  Heart muscle will rapidly die when starved of oxygen and nutrients.

Nasogastric tube:  A thin plastic tube, which is inserted through the nose and passes down the esophagus and into the stomach.  This tube can be used to drain fluid and air from the stomach or to introduce nutritional supplements directly into the gut.  It is an uncomfortable but effective way to keep the stomach from distending. 

NG tube:  See Nasogastric tube.

Obstruction:  A blockage of a hollow organ.  Any organ that has a lumen in which blood, liquid, or stool passes can be blocked.  Obstructions can result from a mass blocking the lumen, or a mass outside of the organ can compress it, resulting in a closing off of the normally open lumen.

Occlusion:  The blockage of a hollow tubular structure such as a blood vessel, duct, or loop of bowel.

Packed red blood cells:  When you are given a blood transfusion today, this is what you will receive in most instances.  The blood from a donor is centrifuged, and the red blood cells (oxygen carrying cells) are removed and stored.  When you require a transfusion to improve the oxygen carrying capacity of your blood, you are given packed red blood cells.  As with all therapies derived from living donors, transfusion with packed cells carries a small risk of infection.

Path:  A slang term for pathology.  If your physician tells you it will be a week before the path is back, this means the pathology report determining the character of the tissue removed by the biopsy or operation will take a week to be completed.

Patient controlled analgesia:  A concept whereby the delivery of pain medication is controlled directly by the patient at the bedside.  This technique has been shown to improve pain control and reduce the amount of pain medication requested by patients.

PCA:  See Patient controlled analgesia.

PE:  See pulmonary embolism.

PEG tube:  Also known as a feeding tube.  This is a tube that is placed through the skin and into the stomach with the assistance of an endoscope.  This is an effective means of providing nutrition to a patient who is unable or unwilling to consume sufficient calories to meet the body’s needs.

Plasma:  Also called fresh frozen plasma (FFP).  This is the component of the blood that includes all of the proteins found in circulation.  Typically plasma is given to patients who are having problems with bleeding or their coagulation factors.  This is obtained from donated blood, and as such, transfusions carry a small risk of infection.

Platelets:  The cellular elements in blood that are responsible for forming blood clots.  These are obtained from donor blood and are transfused when your own platelet count becomes too low to support the clotting of blood.  As with all therapies derived from living donors, transfusion with platelets carries a small risk of infection.

Polyp:  A descriptive term that describes a small, fleshy mass that protrudes from a mucosal surface.  Polyps are typically benign but may harbor cancerous or pre-cancerous cells.

Pressors:  A category of drugs that serve to increase blood pressure.  They function to either increase the amount of blood the heart is pumping, or constrict the veins and arteries of the vascular system so that the pressure increases.  These drugs are typically used in the treatment of shock (see below).

Pulmonary embolism:  This is a condition in which a blood clot travels through the venous system to the right side of the heart.  The blood clot travels through the right side of the heart and lodges in the first blood vessel that it is too big to pass through.  Typically this is one of the branches of the pulmonary artery, which brings deoxygenated (oxygen depleted) blood to the lungs in order to pick up more oxygen.  Small pulmonary embolisms will be broken down by the blood clot dissolving system of the blood, but large ones can cause chest pain, shortness of breath, inability to fill the blood with oxygen, and in some situations, death.  This is a dreaded complication and the reason that so much effort is directed toward preventing blood clots from forming in the venous system (see also, Deep venous thrombosis).

Purulence:  The development of an infectious liquid composed of white blood cells and infectious organisms.  This may be a thin, watery liquid or a thick, creamy substance.

Pus:  See Purulence.

Rectum:  The very end of your digestive system.  The rectum is the portion of the large bowel just above the anus.  It is nearly straight, and is about seven inches in length.  It serves as a reservoir for solid stool; when it becomes full, you get the urge to have a bowel movement.

Regional anesthesia:  The process of blocking transmission in specific nerves to achieve total anesthesia for a certain portion (or region) of the body.  For example, it is possible to inject a local anesthesia in several locations resulting in a total loss of sensation to a hand or foot.

SCDs:  See sequential compression device.

Sepsis:  Strictly speaking, this is a term for overwhelming infection, usually by a type of bacteria.  More commonly this term is used to signify a condition termed “sepsis syndrome.”  In sepsis syndrome (now also referred to as multi-organ dysfunction syndrome or MODS)  patients behave as though they have an overwhelming infection, even if there is no infection present.  This is a highly studied but, as yet, poorly understood condition, which frequently leads to death.

Septic:  The state of Sepsis (see above)

Sequential compression device:  A pneumatic pump that tightens around your legs (rarely used on the arms), designed to “squeeze” venous blood out of your legs to prevent blood clot formation.  They are designed to mimic the effect of muscle contraction, which also serves to prevent pooling of blood in the deep veins of your legs.  If you are given a pair of these after your operation, it is important that you use them while you are resting in bed.  They are an uncomfortable but important way to prevent blood clots.

Shock:  From a surgical perspective, shock represents a lack of adequate tissue blood flow.  Shock can result from many causes, including blood loss, infection, heart failure, or spinal chord injury.  This is a condition that requires immediate treatment or it can quickly become life threatening.

Small bowel:  The portion of your gut that is responsible primarily for absorption of digested food.  There are three regions of the small bowel.  The first region is directly attached to your stomach and is known as the duodenum.  The duodenum becomes the jejunum, which in turn becomes the ileum.  The ileum empties into the large bowel (colon) through the ileocecal valve.

Small bowel series:  Also known as a small bowel series or enteroclysis.  A radiographic test that allows your physician to examine your small bowel.  You will be asked to drink a contrast material, which shows up on x-rays.  You will then have multiple x-rays taken over the span of several hours.  The results will allow your physician to determine if there are any masses, surface irregularities, or points of dilatation or obstruction.

Sputum:  The product produced by the secretion of mucus in  your lungs.  Typically a thick, mucus-like product, which may range in color from clear to tan, yellow, or green.  This is indicative of pneumonia or bronchitis but may result simply from smoking tobacco.

Staples:  Surgical staples are used to close large skin lacerations or incisions.  They are typically removed 7 to 14 days after an operation with a specially designed remover.  The removal of surgical staples is a surprisingly simple and pain-free experience.

Stent:  An artificial tube that is used to hold open a hollow organ that is closing off for some reason.  Stents can be used to open blocked blood vessels or prevent tumors from blocking the lumen of a hollow organ such as the esophagus or bronchus.

Stoma:  The artificial opening of a loop of bowel through the skin. 

Stress gastritis: A problem that used to surface frequently after surgery; this complication has decreased in incidence with the development of drugs that inhibit stomach acid secretion.  Under states of biological stress (such as after an illness, injury, or operation), the lining of the stomach becomes weakened and does not do a good job of protecting the stomach lining from the acid the stomach secretes.  In response to acid contact with the stomach wall, the lining of the stomach becomes inflamed, causing pain and occasionally bleeding.  This is now treated with oral or intravenous medications, and rarely will progress to the development of stress ulcers.

Stress test:  This is a test that looks at the function of your heart when it is placed under stress.  There are many variations on the stress test, some which involve you exercising while hooked up to monitors, and others where medications are administered that alter the function and blood flow in your heart.  This test will be performed if you have an abnormal ECG or have had a heart attack in the past.

Stress ulcer:  A problem that used to surface frequently after surgery, this complication has decreased in incidence with the development of drugs that inhibit stomach acid secretion.  Under states of biological stress (such as after an illness, injury, or operation), the lining of the stomach becomes weakened and does not do a good job of protecting the stomach lining from the acid the stomach secretes.  In response to acid contact with the stomach wall, ulcers form in the stomach lining, which may cause pain or bleeding.  Typically this can be treated with antacids or other drugs that prevent acid formation.  In some cases, the ulcers may be so bad that upper endoscopy is required to evaluate the lining of the stomach.  Very rarely will a stomach need to be surgically removed because of this problem (something that occurred fairly regularly just 20 years ago).

Stricture:  A point of narrowing.  There are many causes for strictures, but when a tubular structure, such as a duct, develops a narrowing, pressure builds up above the narrowing.  If a stricture progresses, it can result in an obstruction.

Stroke:  See Cerebrovascular accident.

TEDS:  These are stockings designed to prevent the development of blood clots in the deep veins of your legs.  They are intentionally tight and promote the circulation of venous blood out of the legs.

Thrombosis:  The clotting off of a blood vessel.  When this occurs, no blood may pass through the vessel, and the tissue normally supplied by this blood vessel is at risk for death due to lack of oxygen and nutrients.

TIA:  See Transient ischemic attack.

Trachea:  Sometimes known as the windpipe, the trachea is the major passageway for air entering the lungs.  The trachea begins below the vocal chords, and extends into the chest where it divides into the left and right mainstem bronchi.

Tracheostomy:  A surgical airway that provides access to the lungs for long term mechanical ventilation.  A tracheostomy will be performed for many patients who are undergoing head and neck surgery.  In cases of patients who can not be removed from a mechanical ventilator in a timely fashion (typically less than 10 to 14 days), a tracheostomy will be performed so that the endotracheal tube may be removed.

Transient ischemic attack:  An event whereby blood flow to a certain region of the brain is decreased, and the affected brain tissue is starved for oxygen and nutrients.  These symptoms are caused by a blockage of a blood vessel that is either incomplete or is quickly resolved.  Symptoms develop suddenly but then quickly resolve.  These are warning signs that a cerebral vascular accident (stroke) may occur.

Transfusion reaction:  An adverse reaction to a transfusion of blood or blood products.  To minimize these reactions, blood is typed and screened for reactive antigens and antibodies before it is administered.  Since there are many more reactive antigens and antibodies than we can test for; sometimes, adverse reactions occur despite our best efforts.  Most transfusion reactions are minor and resolve quickly when the transfusion is stopped, but some can be life threatening. 

Tumor: A new mass.  Technically speaking, all mass-forming lesions are tumors, so this includes abscesses, fluid collections, and large blood clots.  Commonly this term is used to describe a mass that has not yet been identified.  Most tumors are benign, which is to say they are not cancers.  However, all cancers are also technically tumors.

Type & cross:  A series of laboratory tests in which your blood type is determined and donated blood is checked to see if it will react with a sample of your blood.  This process is performed prior to giving a blood transfusion (except in emergency situations, where you may receive uncrossmatched blood).

Type & screen:  A series of blood tests in which your blood type is determined, and your blood is examined for certain common antigens.  This is done prior to crossmatching blood for transfusion.

UA:  See Urinalysis.

Ultrasound:  A type of radiological examination that uses sound waves instead of x-rays to produce an image.  This basically works in a similar fashion to the sonar used by ships.  By reflecting sound waves off of structures in the body, a visual image is created.  By studying this image, a radiologist can see the size of structures and determine if there are abnormal fluid collections or stones present in organs.  

Umbilicus:  The medical name for the belly button.

Upper endoscopy:  Similar to a colonoscopy, in this test a long, flexible, lighted telescope is inserted through the mouth and passed down the esophagus and into the stomach and beyond.  This allows your physician to directly inspect the upper portion of your digestive tract.  By passing instruments through this scope, you doctor may be able to take biopsies or control points of bleeding.  A new technique allows specially trained physicians to pass ultrasound probes into your digestive system to get a better look at some of your upper abdominal organs.

Urinalysis:  A series of lab tests that determine the properties of urine.  This simple and inexpensive set of tests can determine if you have a urinary tract infection, high blood glucose levels, and a number of other important parameters.

Vascular invasion:  This is a term that describes a cancer that has begun to spread into nearby blood vessels.  This is usually a bad sign and indicates a higher chance that the cancer will metastasize. 

Ventilator:  A mechanical device that administers oxygen into a patient’s lungs.  It can be programmed to breathe for a patient who is unable to breathe for him or herself.  This is also known as mechanical ventilation.

White count:  A measure of infection or inflammation.  This number represents the quantity of white blood cells in circulation at a given time.  An elevated white count is suggestive of the presence of infection; however, it is common for the white count to be elevated for a few days after surgery due to the stress of the operation.

Wound infection:  A relatively common complication following surgery.  Wound infections range from simple cellulitis (which can be treated with antibiotics) all the way to abscess formation (which typically requires some type of open drainage in addition to antibiotics).  Wound infections can occur due to bacteria that are normally present in the skin, or from bacteria released from internal organs during surgery.  The more contamination or infection present before the operation, the higher the likelihood of a wound infection afterwards. 

Chapter 2
Chapter 3
Chapter 1
Chapter 4
Chapter 5
Chapter 6
Chapter 8
Chapter 9
Chapter 10
Chapter 11