Circumcision Quick Reference: Removal of the foreskin of the penis.


Advanced Reference: Removal of a part of the foreskin (prepuce) is a better description. Carried out for both medical and religious/cultural reasons. Medical reasons involve phimosis and paraphimosis.

Cirrhosis Quick Reference: (sir-o-sis) Disorder of the liver.

Advanced reference: Leads to the development of fibrous tissue in the organ with consequent scarring, hardening and loss of function. There are a number of causes, e.g. chronic alcoholism, chronic hepatitis (types B and C).

Citanest Quick Reference: Proprietary local anaesthetic (LA).

Advanced Reference: It is a preparation of prilocaine hydrochloride. Used regularly as an LA in dental practice. Also available with octa-pressin as a vasoconstrictor.

CJD Quick Reference: Creutzfelds-Jakob disease. A new variant form of 'mad cow' disease also known as bovine spongiform encephalopathy (BSE).

Advanced Reference: CJD destroys brain cells, leading to confusion, disability and eventually death. It cannot be destroyed by normal sterilisation of surgical instruments. Any instruments used on known infected patients must be removed from use and dealt with according to national policy.

Clamps Quick Reference: Generally referring to vascular clamps.

Advanced Reference: Specialised instruments used in vascular surgery. They occlude the vessels without causing trauma to the arteries or veins. They are available in many shapes and sizes depending on where in the body they are required. The most popular being Bulldog, Cooley, Debakey, Glover, Leland-Jones and Satinsky, etc.

Claudication: Quick Reference: Limping. Name derived from Emperor Claudius who was a cripple.

Advanced Reference: Cramp-like pain in the legs during mild exercise due to inadequate blood supply to the muscles from diseased arteries.

Clausen Head Harness Quick Reference: A harness used to hold the anaesthetic mask on the patient.

Advanced Reference: A three tailed black antistatic harness that assisted the anaesthetist in securing the face mask in position. Although the har- n ness is still available, the laryngeal mask airway has become more popular. <

Clavicle Quick Reference: The collarbone. g

Advanced Reference: Bone joined at its inner end to the breastbone and ^ its outer end to the shoulder blade. I

Cleft palate Quick Reference: Defect in the roof of the mouth.

Advanced Reference: Cleft indicates a fissure or opening. A congenital condition due to failure of the medial plates of the palate to meet. Has an effect on speech. Often found in conjunction with harelip.

Clinical Quick Reference: Associated with a clinic, or indicates to the bedside.

Clinical trials

Advanced Reference: Referring to actual observation and treatment of patients, as distinguished from theoretical treatment.

Clinical trials Quick Reference: Trials carried out in the clinical setting and can involve drugs, equipment, procedures, etc.

Advanced Reference: Carried out to determine if a treatment is viable and to make comparisons with current practices.

Closed circuit Quick Reference: Alternative name used for the circle anaesthetic breathing system.

Advanced Reference: So called due to patient re-breathing their own gases as they are recycled via the 'closed' system. Consequently, there is a build-up of carbon dioxide, hence the use of soda lime within the circuit as an absorber. Has a number of advantages, i.e. use of low flows therefore reducing pollution and cost, maintains humidification and heat from patients' own expired gases.

Clostridium Quick Reference: A genus of bacteria.

Advanced Reference: Includes those bacteria responsible for tetanus and gas gangrene. Are anaerobic, i.e. thrive in the absence of oxygen. Most strains of Clostridium are found in soils and infection through this route is common.

Clubbing Quick Reference: Indicates clubbing of the fingers due to poor circulation.

Advanced Reference: Involves both toes and fingers, and due to chronic disease of the heart and respiratory system.

CNS Quick Reference: Central nervous system.

Advanced Reference: Incorporates the spinal cord and brain, and not the peripheral nervous system.

Coagulation Quick Reference: Refers to the clotting of blood.

Advanced Reference: Circulating fibrinogen is converted into insoluble fibrin which forms the framework for a clot. The change from fibrinogen to fibrin is brought about by an enzyme, thrombin, not normally present in normal blood but is produced from prothrombin by the action of ry thromboplastin which is produced when tissue cells are injured. Platelets < (thrombocytes) and calcium are also involved in the clotting process.

o Coarctation Quick Reference: Abnormal narrowing of a vessel.

£ Advanced Reference: The aorta is a common site for this. Often a con-

§ genital cause and involves constriction which reduces blood flow and

■I supply to those parts downstream of the stricture. Compensation for the g blockage involves the establishment of a collateral circulation. Surgical

° intervention is usually required to restore adequate circulation.

g Coaxial Quick Reference: Refers to patient breathing circuits used in 8 anaesthesia where there is more than one channel for inspiration and expiration of gases.


Advanced Reference: The most commonly used variations are the Lack and Bain circuits which have two channels. With the former, fresh gas passes via the outer channel carries the fresh gas, and expired gases exit through the inner tube whereas the Bain has the directly opposite arrangement. Corresponds to the Mapleson D arrangement.

Cocaine Quick Reference: CNS stimulant.

Advanced Reference: Used mainly as an anaesthetic for topical application in ear, nose and throat (ENT) surgery and in eye drops. Once used as a constituent in elixirs prescribed to treat pain in terminal care.

Coccus Quick Reference: Spherical-shaped bacteria.

Advanced Reference: Cocci are arranged in various groups, i.e. the Staphylococcus in bunches like grapes, the Streptococcus in chains and the Diplococcus in pairs.

Coccyx Quick Reference: The lower end of the backbone.

Advanced Reference: A small triangular bone projecting beyond the sacrum and consists of four tiny vertebrae fused together. Is all that remains of a human tail.

Cochlea Quick Reference: Part of the inner ear.

Advanced Reference: Shaped like a spiral shell, the cochlea contains the hearing apparatus. A cochlea implant is an electronic device inserted under GA whose function is to stimulate the auditory nerve in an attempt to restore partial hearing in profound sensory deafness.

Cockpit drill Quick Reference: Alternative term used to describe anaesthetic machine checking.

Advanced Reference: As the induction and reversal of GA is often likened to the take-off and landing of an aeroplane, the term for checking and preparing anaesthetic equipment was adopted due to the cockpit checks carried out by pilots.

Codeine Quick Reference: Alkaloid drug derived from opium.

Advanced Reference: Closely related to morphine but less powerful and less habit forming. Used for pain relief alone and in combination with other drugs, such as aspirin. n

Coeliac disease Quick Reference: (seal-e-ac) Disorder of the small intestine. g Advanced Reference: Involves malabsorption due to the lining of the intestine not tolerating a component of gluten which is a protein found £

Colic Quick Reference: Intermittent pain, often severe, arising from ^

internal organs. ®

Advanced Reference: Due to contraction of involuntary muscles which c?

in turn stretch sensory nerve endings. Can be due to inflammation, fj obstruction, etc. Examples are inflammation of the intestines, stone S. obstruction of a bile duct or within the kidney.


Colitis Quick Reference: Inflammation of the colon.

Advanced Reference: Usually the large bowel. Common causes are bacterial food poisoning and various types of dysentery.

Collagen Quick Reference: An insoluble protein.

Advanced Reference: A group of proteins of which the molecules form long fibres. The principal fibrous component of connective tissue. Many body components are regularly broken down and re-synthesised but when collagen is degraded there is little regeneration. This is why ageing is said to be a condition of connective tissue.

Collateral Quick Reference: Alternative route for blood flow.

Advanced Reference: Refers to blood supply which develops as an alternative route when the main arterial system is interrupted and involves the enlargement and activation of smaller networks.

Colles fracture Quick Reference: Fracture of the wrist.

Advanced Reference: Usually due to a fall on the palm of the hand forcing back the wrist. Consequently, the radius is broken off and displaced backwards. Due to the connection between the radius and ulna bones, there is commonly injury to the latter or adjoining ligaments.

Colloid Quick Reference: A suspension of particles rather than an actual solution.

Advanced Reference: The term is used to indicate a group of IV solutions containing large molecules which determine them to remain in the circulation as they cannot pass through the vessel walls (semipermeable membrane) and exert osmotic pressure that draws fluid into the vessels from the surrounding tissues. This is the function of plasma expanders such as dextran, haemaccel, etc.

Colon Quick Reference: The main part of the large intestine.

Advanced Reference: Begins in the right iliac fossa, where the small intestine joins the caecum at the illeo-caecal junction. This is followed by the ascending colon, transverse colon and descending colon which become the sigmoid colon and terminates at the rectum.

^ Colostomy Quick Reference: A surgical procedure to form a temporary or ■g permanent opening onto the surface of the abdomen.

Advanced Reference: A colostomy takes over the natural function of the c rectum. It is performed when there is an obstruction in the large intes-| tine. The intestinal contents are collected into a colostomy bag.

® Colporrhaphy Quick Reference: (col-pora-fi) Surgical repair of the vagina.

Advanced Reference: There are two procedures, namely anterior and is posterior. Anterior involves prolapse of the bladder into the vagina (cys-S. tocele), usually following childbirth and posterior, which involves prolapse of the rectum into the vagina (rectocele).


Colposcopy Quick Reference: Performed for patients with an abnormal pap smear suggestive of dysplasia.

Advanced Reference: A diagnostic examination to identify abnormal cells in the vulva, vagina or cervix such as dysplasia and carcinoma in situ.

Coma Quick Reference: A state of deep unconsciousness.

Advanced Reference: Deep unconsciousness in which the patient cannot be roused, all reflexes such as coughing and blinking are totally absent. Also the patient has no response to painful stimuli.

Commensal Quick Reference: An organism that lives in or on another species.

Advanced Reference: This organism can live in harmony within or on the body without causing any ill effects.

Common bile duct Quick Reference: A duct that conveys bile from the gall bladder to the duodenum.

Advanced Reference: Can become blocked with gallstones requiring cholecystectomy (open surgery, laparoscopic removal or shock-wave therapy).

Compliance Quick Reference: Indicates the degree of stiffness of the lungs.

Advanced Reference: Also involves the elasticity and distensibility of the chest wall as well as a number of related factors, i.e. respiratory disease, anatomical anomalies, etc. A decrease in compliance results in the need for a greater effort during respiration. If the lungs inflate easily they are said to have a high compliance. Therefore, a low compliance indicates difficult inflation.

Concussion Quick Reference: Shaking of the brain, caused by a blow to the head causing temporary loss of consciousness.

Advanced Reference: Any damage to the head can cause the brain to violently shake within the skull. This then causes damage to the brain and the tissues become bruised. The result causes loss of consciousness and concussion.

Conduction anaesthesia Quick Reference: Alternative term indicating regional anaesthesia.

Advanced Reference: Indicates drugs that act locally to block nerve impulses before they reach the CNS.

Congenital Quick Reference: Means 'present at birth'.

Advanced Reference: Present from birth but not necessarily hereditary.

Conjunctiva Quick Reference: A transparent covering of the eyeball.

Advanced Reference: A delicate membrane covering the inside of the eyelids and the front of the eye.

Consent Quick Reference: To give permission. g

Advanced Reference: An important part of the pre-operative process involving the patient giving their permission for treatment to take place.

Continuous suture

Consent can be expressed in writing or verbally or given on behalf by a guardian or a legally appointed person.

Continuous suture Quick Reference: Suturing technique.

Advanced Reference: Consists of a series of stitches, of which only the first and last are tied as opposed to an interrupted suture when each throw through the skin is knotted. Continuous technique is not widely favoured because a break at any point may mean a disruption of the entire suture line.

Contraception Quick Reference: Birth control to prevent a pregnancy.

Advanced Reference: Artificial prevention of a pregnancy by using various methods of birth control.

Controlled drugs Quick Reference: Term used in relation to medications that are controlled under law.

Advanced Reference: A number of evolving laws (Dangerous Drugs Act, Controlled Drugs, Misuse of Drugs Act, etc.) have overseen the control, use and handling of certain classified drugs.

Contusion Quick Reference: A bruise.

Advanced Reference: Injury to deep tissue through intact skin.

Convulsion Quick Reference: A fit or seizure.

Advanced Reference: Involuntary, spasmodic muscular contractions. Can be seen in patients with epilepsy or head injuries.

Co-proxamol Quick Reference: A compound analgesic.

Advanced Reference: It is a combination of the narcotic dextro-propoxyphene with paracetamol.

Cornea Quick Reference: Transparent part of the eyeball.

Advanced Reference: The cornea lies over the pupil and iris through which we see. If it becomes scarred by injury or disease, vision is disturbed or lost.

Coronary arteries Quick Reference: Arteries which supply the heart muscle itself.

Advanced Reference: The right and left coronary arteries branch off the aorta as it leaves the heart. The left divides into an anterior interventric-ular branch which passes downwards between the ventricles to the apex of the heart and a left circumflex branch which runs round between the left atrium and ventricle. The right coronary artery runs round between the right atrium and ventricle, and supplies the right ventricle and the sino-atrial node.

Corpuscle Quick Reference: Small body or cell.

Advanced Reference: Generally used to describe the red blood cells.

Cricoid cartilage

Corrugated tubing Quick Reference: Refers to the design of tubing used in patients' anaesthetic and ventilator circuits.

Advanced Reference: Originally referred to black rubber corrugated tubing but now also includes plastic clear varieties. So designed to allow for stretching, collection of vapour in exhaled breath while allowing for increased tubing diameter.

Cortex Quick Reference: The outer layer.

Advanced Reference: The outer layer of an organ or other structures such as bone, brain, kidney and adrenal gland.

Corticosteroids Quick Reference: Steroid hormones.

Advanced Reference: Produced and secreted by the cortex of the adrenal glands or produced synthetically. Best known is hydrocortisone which is used primarily as an anti-inflammatory.

COSHH Quick Reference: Control of substances hazardous to health.

Advanced Reference: An act brought out under the Health and Safety (H&S) Act, which concentrates on the control and use of substances in the workplace which may be harmful to health if used without assessment and control. The COSHH Act has been constantly updated since first being introduced in the late 1980s. In relation to hospitals may involve cleaning and sterilising fluids, gases, vapours and even the reconstitution of medicines, etc.

CPAP Quick Reference: Continuous positive airway pressure

Advanced Reference: Indicates the application of positive airway pressure throughout all phases of spontaneous ventilation. Designed to reduce airway collapse and so increase arterial oxygenation.

CPR Quick Reference: Cardiopulmonary resuscitation.

Advanced Reference: Involves supplying artificial ventilation of the lungs and chest/heart compressions for a patient who has ceased breathing and has no cardiac output.

Cremophor Quick Reference: Solubilising (emulsifying) agent used in drug preparations.

Advanced Reference: The use of cremophor was highlighted when suspected of being responsible for some of the adverse effects of the now withdrawn induction agent, althesin.

Crepitus Quick Reference: Grating noise or sensation.

Advanced Reference: Crackling sound heard with a stethoscope over inflamed lungs or the sounds made by broken bones moving against each other.

Cricoid cartilage Quick Reference: The uppermost ring of cartilage around the trachea.

Sleep Apnea

Sleep Apnea

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