Acute Nursing Care

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A
α1 receptor Receptor within the sympathetic nervous system located on the post-synaptic surface, responds to epinephrine creating a physiological effect, e.g. vasocostriction.
α2 receptor Receptor within the sympathetic nervous system located on the pre-synaptic surface, detects unused or surplus epinephrine and inhibits further epinephrine secretion.
Abducens VIth cranial nerve, motor control of eye movements.
Abscess A collection of pus accumulation in a cavity.
Acetylcholine A neurotransmitter of the parasympathetic nervous system released by many neurones within the peripheral nervous system and by a few neurones in the central nervous system.
Acetylcholinesterase inhibitors Drugs that block the production of the enzyme acetylcholinesterase, e.g. pyridostigmine.
Acetylcholinesterase The enzyme that destroys the neurotransmitter acetylcholine.
Action potential An electrical signal that travels along the surface of a neurone, the signal is propagated by the movement of ions across the cell membrane of the neurone.
Action potential An event in which the electrical membrane potential of a cell rapidly changes due to ionic movement in and out of the cell. In the cardiac cell, this starts the wave of depolarisation giving rise to the PQRS complex.
Active transport Any movement of substances across a membrane that requires the input of energy.
Active transport Using energy in the form of adenosine triphosphate (ATP) to move fluid and solutes between cellular compartments.
Acute coronary syndrome (ACS) An umbrella term encompassing unstable angina, NSTEMI and STEMI.
Acute kidney injury An abrupt reduction in kidney function characterised by a rising serum creatinine level and a reduction in the urine output.
Adenosine triphosphate Usually abbreviated to ATP, this is a molecule that stores and provides energy for the metabolic activity of cells.
Adrenaline Naturally occurring hormone, also known as epinephrine, given during cardiac arrest to increase coronary and cerebral perfusion.
Adrenaline Now called epinephrine, neurotransmitter of the sympathetic nervous system.
Adrenergic receptors Receptors of the sympathetic nervous system, subdivided into alpha beta 1 and beta 2.
Aetiology The causes or origin of a disease.
Afferent neurone An alternative name for a sensory neurone, carries information towards the brain.
Afterload The load the (normally left) ventricle has to work against to open the aortic valve and eject its stroke volume. It can also be seen as ventricular wall stress in systole.
Aggregated weighted track and trigger system (AWTTS) AWTTS allocate points in a weighted manner (e.g. the more the parameter has deviated from normal, the higher the score generated) and these points are added to generate the early warning score. AWTTS allow the generation of low-, medium- and high-risk categories as recommended by NICE (2007).
Agonal breathing Deep sighing, irregular gasping breathing, also known as Cheyne–Stokes breathing, which occurs at the end of life.
Aldosterone A hormone produced by the adrenal cortex. Aldosterone increases sodium and water reabsorption from the distal convoluted tubule in the kidney and increases potassium excretion.
Algorithm Step-by-step procedure for problem-solving, often expressed as diagram or flow chart.
Alpha receptor Receptor of the sympathetic nervous system mainly located in the peripheral vasculature.
Amino acid The building blocks of proteins.
Anaemia A lower than normal number of red blood cells which depletes the ability to transport oxygen.
Anaphylaxis An acute multi-system severe type I hypersensitivity allergic reaction.
Angioedema Swelling of the deeper layers of the skin, this is often severe and is caused by a build-up of fluid.
Angiotensin-converting enzyme inhibitors (ACEI) A hormone necessary for the conversion of angiotensin 1 to angiotensin 2.
Anion A negatively charged electrolyte.
Anterior horns Section of the spinal cord, comprised of grey matter and containing motor axons.
Anticonvulsants Drugs used to control seizures.
Antidiuretic hormone (ADH) Also known as vasopressin, ADH is a hormone secreted from the posterior pituitary which promotes reabsorption of water back into the circulation via the collecting ducts of the kidney. It also causes widespread constriction of arterioles, which leads to increased arterial pressure.
Anuria Less than 100ml of urine in 24 hours.
Apathy Lack of interest or concern.
Aphasia Absence of speech.
Apneustic centre Located within the pons, controls breathing in conjunction with the pneumotaxic centre and the medulla.
Apnoea Temporary cessation of breathing, usually self-terminating, more prevalent following brainstem injury.
Aqueous Pertaining to water or water-based environments.
Arachnoid mater Middle layer of the meninges.
Arrhythmia Any electrical activity in the heart that differs from the normal.
Ascites Excess fluid that has accumulated in the peritoneal cavity. Comes from the Greekaskites, 'bag-like'. It can also be called hydroperitoneum.
Asepsis The absence of pathogenic organisms.
Asterixis This is the term for hepatic flap (of the hands). The word comes from 'without fixed position'. When the patient with hepatic encephalopathy stretches out their hands, they have jerky irregular flexion/extension of the wrist. It is thought to be due to the interference with the inflow of joint position sense to the brainstem. Although characteristic of liver failure, it can also occur in cardiac, respiratory and renal failure.
Astrocyte A type of glial cell within the central nervous system, star-like in appearance, with multiple processes extending from the cell body, some of which end in foot processes that interface with cerebral blood vessels forming part of the blood–brain barrier.
Asystole Complete absence of electrical and mechanical activity in the heart.
Atherosclerosis Disease of large and medium-sized muscular arteries where the lumen of the vessel is narrowed by build-up of lipid, cholesterol and calcium. This build-up results in plaque formation, abnormalities of blood flow and eventually diminished oxygen delivery.
Atrial fibrillation Common cardiac arrhythmia in which multiple ectopic foci in the atria cause them to fibrillate, rather than contracting in a coordinated manner. AF is characterised by an irregular pulse and lack of p waves on the ECG.
Atrial flutter Cardiac arrhythmia in which a single ectopic focus in the atria fires rapidly causing abnormal atrial conduction. Atrial flutter is normally regular (or regularly irregular) and is characterised by 'saw tooth' waves replacing the P wave on the ECG.
Atrioventricular node The conduit of the electrical impulse from the atria to the ventricles.
Automaticity The capacity of a cell to initiate an impulse without an external stimulus, i.e. to spontaneously generate an impulse.
Autonomic dysreflexia Extreme autonomic response that can occur in patients with spinal cord injury above the level of T6.
Autonomic nervous system Branch of the peripheral nervous system containing two major subdivisions; the sympathetic and parasympathetic nervous systems.
Autonomic nervous system The nervous system is divided into the somatic (voluntary) and autonomic (involuntary). The autonomic regulates individual organ function and homeostasis.
Autonomy The right of patients to make decisions about their health care without the health care provider trying to influence the decision.
Axon The section of the neurone that extends away from the cell body.
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B
β1 receptors Part of the sympathetic nervous system, adrenergic receptors located within the heart muscle, stimulation causes increase in heart rate and contractility.
β2 receptors Part of the sympathetic nervous system, adrenergic receptors with widespread activity including vasodilation and bronchodilation.
β3 receptors Part of the sympathetic nervous system, adrenergic receptors located in brown adipose tissue, stimulation causes thermogenesis.
Bacterial translocation of the gut Passage of indigenous bacteria from the GI tract to the systemic circulation. This can be due to a breach of mucosal barrier, impaired immune defence mechanisms and/or bacterial overgrowth.
Bag valve mask A device used to provide artificial ventilation which consists of a manual compressible chamber with an oxygen reservoir at one end and a one-way valve and mask at the other.
Baroreceptors Sensory nerve endings in the carotid bodies and aortic arch that detect stretch and therefore blood pressure changes.
Basal metabolic rate The base rate at which the body consumes calories for basic metabolic functions such as maintaining internal temperature and repairing cells.
Basic life support See cardiopulmonary resuscitation.
Basophil A type of white blood cell that contains histamine and heparin.
Beta adrenergic receptor A receptor of the sympathetic nervous system subtypes; beta 1 (in myocardium) and beta 2 (in smooth muscle).
Bile Bile (or gall) is fluid produced by the liver (and stored in the gall bladder) that is used to digest fats in the duodenum.
Blood–brain barrier An important structure that prevents harmful substances from entering the brain tissue. The blood–brain barrier has two main components; a thick capillary basement membrane and tight junctions between the endothelial cells of the capillaries.
Brainstem An essential structure within the brain containing the midbrain, the pons and themedulla oblongata.
Broca's speech area Motor control of speech within the cerebral cortex, motor neurones connect Broca's speech area with the larynx, pharynx, mouth and respiratory muscles to enable coordination of talking, breathing and swallowing.
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C
Capillary The smallest of the body's blood vessels.
Cardiac output The amount of blood ejected by the ventricle in one minute:
CO = SV x HR
Cardiopulmonary arrest The sudden cessation of breathing and effective cardiac output.
Cardiopulmonary resuscitation (CPR) Emergency procedures to be undertaken in the event of cardiopulmonary arrest aimed at preventing irreversible brain damage caused by lack of oxygen. CPR consists of rescue breathing and cardiac compressions. CPR is also known as basic life support (BLS).
Cardiovascular centre An area in the medulla of the brain that regulates the cardiovascular system. It responds to sensory information from the autonomic nervous system, and acts to maintain cardiac output via the sympathetic and parasympathetic nerves.
Care escalation Care moved forward in order that a set of timely appropriate interventions prescribed by clinicians with competence in critical care, aimed at treating/preventing acute deterioration, are commenced. May involve advice from critical care outreach, ITU, and transfer to a higher level of care.
Cation A positively charged electrolyte.
Cauda equina A collection of lumbar, sacral and coccygeal nerve roots within the spinal canal below the height of L2.
Cell body The main part of the neurone containing cytoplasm and organelles.
Cell The basic structural unit of living organisms.
Central nervous system A subdivision of the nervous system comprising the brain and spinal cord often referred to as the CNS.
Centrifuge A device that separates the components of a liquid, by spinning the liquid at a high speed.
Centriole Rod-like structures in the centrosome that are responsible for the production of the mitotic spindle.
Centrosome An area near the nucleus that contains the centrioles and is involved in mitosis.
Cerebellum Part of the brain that lies beneath the cerebral hemispheres and posterior to the brainstem, regulates posture and balance, important for the coordinated contraction of skeletal muscle.
Cerebral cortex Outer rim of grey matter that forms part of the cerebral hemispheres.
Cerebral dominance The development of one cerebral hemisphere more than the other.
Cerebral hemispheres The two halves of the cerebrum.
Cerebral oedema Swelling of the brain.
Cerebral perfusion pressure Or CPP, calculated from the mean arterial blood pressure minus the ICP, the pressure of the blood perfusing the brain.
Cerebrospinal fluid Also called CSF, a colourless, clear liquid that circulates around the brain and spinal cord, produced by a network of capillaries in the cerebral ventricles called the choroid plexus.
Cerebrum The largest part of the brain, divided into two parts by the great longitudinal fissure, each half is called a cerebral hemisphere.
Cervical nerves A group of eight spinal nerves that arise from the cervical section of the spinal column and are annotated C1–C8.
Cholinergic receptors Receptors within the sympathetic nervous system, divided into two subtypes; nicotinic receptors and muscarinic receptors.
Choroid plexus A network of capillaries in the walls of all four ventricles of the brain.
Chyme From Greek khymos meaning 'juice'. This is semi-fluid, partly digested food expelled by the stomach into the duodenum.
Circle of Willis Anastomoses of the right and left internal carotid arteries and the basilar artery which form a special cerebral circulation at the base of the brain.
Cirrhosis From Greek kirrhos meaning 'yellowish or tawny' which is the colour of the diseased liver. Cirrhosis is the consequence of chronic liver disease whereby the liver tissue is replaced by fibrosis and scar tissue.
Clinical governance A framework through which organisations are accountable for continually improving the quality of services and safeguarding high standards of care.
Coagulopathy Abnormal blood clotting.
Coccygeal nerves A pair of spinal nerves that arise from the coccygeal section of the spinal column and are annotated Co1.
Coercion Applying either physical or moral force to another.
Colloid oncotic pressure The pressure exerted by plasma proteins that pulls water back into capillaries.
Colloid A solution with large insoluble molecules that can generate an osmotic pressure and expand the plasma compartment.
Commensal Living on or within another organism and deriving benefit without harming or benefiting the host.
Compliance When referring to the heart: the ease with which the ventricle expands or stretches to accommodate ventricular filling.
Computerised tomography (CT) scan A specialised X-ray where pictures are taken from a multidimensional perspective.
Conduction system Specialised conducting tissue of the heart which transmits an electrical wave across the heart, causing myocardial contraction.
Consciousness A state of awareness of oneself and one's surroundings.
Contractility The ability of the myocardium to contract.
Corneocytes The outer cells of the epidermis that are flattened and contain no nucleus. These are the cells that are shed from the surface of the skin.
Coronary circulation Arterial supply for the heart, arising from behind the aortic cusps of the aortic valve.
Corpus callosum A band of white matter that connects the two cerebral hemispheres.
CPAP (continuous positive airways pressure) A respiratory support therapy in which continuous positive pressure is delivered via a face mask, nasal mask or mouth piece. Positive end-expired pressure (PEEP) is achieved through a PEEP valve. This increases the lung functional residual capacity and aids oxygenation.
CPR Cardiopulmonary resuscitation (CPR) is an emergency procedure used to manually support the circulation, thereby preserving blood flow to the brain.
Cranial nerves A set of 12 nerves arising from within the brain and forming part of the peripheral nervous system, each nerve is named in accordance with its function and is identified numerically by the use of Roman numerals.
Cranium The section of the skull that encloses the brain.
Creatinine A waste product of muscle metabolism secreted by the kidney.
Cricothyroidotomy Cannula insertion into the cricothyroid membrane to facilitate ventilation.
Critical care outreach A team, often multi-professional, that provides clinical and educational support in the recognition and treatment at the onset of deteriorating health of adult patients on general wards. It also provides for patients after a period of critical illness when they are discharged back to a lower level of care on the general wards.
Croup A respiratory condition that is usually triggered by an acute viral infection of the upper airway.
Crystalloid An aqueous solution that contains mineral salts and other water soluble molecules.
CSF Cerebrospinal fluid.
Cytoplasm The contents of a cell inside the plasma membrane excluding the nucleus.
Cytoskeleton An array of connective tissue within the cell which helps to give the cell shape and to act as an attachment for organelles and inclusions.
Cytosol The viscous liquid component of the cytoplasm of cells in which organelles and inclusions are suspended.
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D
Decerebrate One of two types of extensor motor response.
Decorticate One of two types of extensor motor response.
Defibrillation The reversal of fibrillation (inefficient and non-rhythmic contraction) by the delivery of a controlled electric shock.
Delirium Acute confusional state.
Demyelination The loss or destruction of myelin.
Dendrites Projections from the cell body of the neurone that increase the surface area of the cell membrane making it easier to connect with other neurones, bringing information to the cell body.
Dendritic spines Small hair-like projections on the dendrites that maximise the surface area of the dendrites.
Depolarisation A rapid movement of ions across the cell membrane causing a change in voltage, that leads to the action potential. In cardiac muscle this initiates myocardial contraction.
Depolarisation The first phase of an action potential where the membrane potential changes from negative to positive due to the influx of sodium ions.
Dermatome A map of the parts of the body that are innervated by spinal nerves.
Diastole The resting phase of the cardiac cycle in which ventricular filling occurs.
Diastolic pressure The pressure exerted (usually in the vessels) during the relaxation phase of the cardiac cycle.
Diencephalon Located below the cerebrum, made up of the thalamus, hypothalamus andepithalamus.
Diffusion The movement of solutes from a state of higher concentration to that of lower concentration.
Dignity Providing dignity in care focuses on three integral aspects: respect, compassion and sensitivity.
Discrimination This can be direct or indirect and is associated with treating a person or a group of people less favourably than others in the same situation.
Disempowerment Processes that lead to a reduction of the power which individuals have to make their own choices and shape their own lives as well making decisions about their own health care and health care needs.
Diuretic A drug that elevates the rate of urine production.
Diuretic A drug that increases urine output.
Dopamine A neurotransmitter within the central and peripheral nervous systems.
Dorsal horns Section of the spinal cord, comprised of grey matter and containing sensory axons, also called the posterior horns.
Dura mater Outer layer of the meninges.
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E
Early warning system (EWS) A scoring system that detects early deterioration in the patient's condition.
Efferent neurone An alternative name for a motor neurone, information is transmitted from the brain towards the periphery.
Effusion Excess accumulation of fluid in a space.
Ejection fraction The amount of blood ejected from the ventricle in systole, divided by the amount of blood that was in the ventricle at the end of diastole.
Electrolyte A solution containing solutes that can conduct an electrical charge.
Electrolytes Atoms or molecules in an aqueous solution that have an electrical charge produced by the gaining or losing of an electron and can therefore conduct electricity.
Embolism Circulating foreign object such as air, fat or a blood clot which can lodge in and block a vessel.
End diastolic volume The amount of blood in the ventricle at the end of diastole.
Endocarditis An infection, usually caused by bacteria, of the inner lining of the heart which can damage the cardiac valves.
Endocardium The innermost layer of the heart.
Endocrine From Greek endo inside and crine to secrete. The secretion of hormones via ductless glands directly into the bloodstream.
Endocytosis A process whereby molecules too large to pass across the cell membrane can enter the cell. This is achieved by pinching off of a small section of the plasma membrane and forming a vesicle that can then pass into the cell. Water can be transported this way (pinocytosis) as can cell debris and microorganisms (phagocytosis).
Endoplasmic reticulum The array of tubes and discs in the cell that is responsible for production and processing of a variety of molecules in the cell. It has two forms: rough, which has ribosomes attached, and smooth which does not.
Endorphins A neuropeptide neurotransmitter, also described as an opioid-peptide, functions as a natural analgesic by binding to opiate receptors within the central nervous system.
Endothelium A thin layer of cells that lines the blood vessels.
Enterotoxin A protein toxin released by a microorganism in the intestine.
Enzyme Proteins causing chemical reactions.
Enzyme Proteins that catalyse chemical reactions.
Eosinphils Type of white blood cell so called because they can be stained with a dye called eosin.
Ependymal cells A single layer of cells that line the ventricles of the brain and the central canal of the spinal cord, they form the blood–CSF barrier to control substances entering the CSF.
Epinephrine A neurotransmitter of the sympathetic nervous system, also a catecholamine and a hormone, used to be called adrenaline.
Epithalamus Region of the diencephalon comprising the pineal gland and the habenular nuclei.
Erythrocyte A red blood cell.
Erythropoietin A hormone produced in the kidney that promotes erythrogenesis in the bone marrow.
Ethics A system of moral principles, rules of conduct.
EWS (early warning score/system) System: a process by which objective criteria are used to generate a score, which is used as an indicator for 'calling for help'. Score: each of six physiological variables generates a number as it deviates from acceptable ranges. The EWS is the sum of those numbers.
Exocrine Exo = outside. Secretion of chemicals via glands with ducts.
Exocrine Exocrine glands secrete their products into ducts, e.g. stomach, pancreas or liver.
Exocytosis This is the reverse of endocytosis and involves a vesicle formed in the interior of the cell joining the cell membrane and expelling its contents into the interstitial space.
Expressive aphasia Patients are capable of thought but incapable of speech.
Extracellular matrix The fluid and connective tissue that fills the space between cells in the body.
Extracellular Relating to the internal areas of the body that are not cellular. The extracellular space is usually divided into interstitial and vascular space.
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F
Facial nerve VIIth cranial nerve, sensory and motor control for closing eyes, crying, smiling, grimacing, taste and salivation.
Fibrin A fibrous protein involved in the clotting of blood.
Fibrinogen A substance in the plasma activated by thrombin to produce fibrin, necessary for clot formation.
Fibrinolysis The breakdown of a clot also know as thrombolysis.
Filtration (renal) The forcing of blood and the substances in it through the glomerular-capsular membrane under arterial pressure.
Filtration The movement of dissolved substances across a membrane. The term implies that some molecules, protein and other insoluble substances will not be filtered.
First heart sound Heard as 'lub', this is the sound of the atrioventricular valves closing in the onset of systole.
Fissures Deep grooves between the gyri of the cerebral hemispheres.
Fistulae An abnormal connection or passageway between two epithelium-lined organs or vessels that do not usually connect.
Flexion A motor response where the limbs move towards the body in response to a pain stimulus.
Foam cells Foam cells are found in atheromatous plaques and are made up from both macrophages and smooth muscle.
Fraud A crime associated with deception deliberately practised in order to secure unfair or unlawful gain.
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G
Ganglion A cluster of neurone cell bodies within the peripheral nervous system.
Glasgow Coma Scale An assessment tool for assessing consciousness.
Glial cells Also known as neuroglia, the dominant cell structure within the central nervous system, cells that support neurones.
Glomerular filtration rate (GFR) The rate at which substances pass through the filtration membrane and enter the proximal convuluted tubule.
Glomerulonephritis Inflammation of the glomerulus.
Glomerulus The part of the nephron where the blood is filtered as the first step of urine production.
Glossopharyngeal nerve IXth cranial nerve, sensory and motor control of tongue and pharynx.
Gluconeogenesis Metabolic pathway resulting in the generation of glucose from non-carbohydrate sources such as lactate, glycerol and glucogenic amino acids.
Glycogenolysis Conversion of stored glycogen to glucose by the liver.
Glycoproteins Molecules that are composed of elements of carbohydrates and proteins.
Glycosuria Presence of glucose in the urine.
Golgi apparatus A series of flattened discs that are involved in finishing molecular production in the cell.
Gravitational forces Forces generated by gravity.
Grey matter Outer layer of the cerebral hemispheres, mainly made of neurone cell bodies, dendrites, unmyelinated axons and neuroglia. Also found within the spinal cord where it is arranged in an H shape and divided into regions called horns.
Guillain–Barré syndrome An acute demyelinating disease of the peripheral nervous system, also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).
Gyri The pleural of gyrus.
Gyrus Fold on the surface of the cerebral hemispheres which increase the surface area of the brain.
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H
Habenular nuclei Located within the epithalamus, have an integrative role linking smell and emotion, for example a particular smell may evoke a specific memory.
Haematemesis Vomiting of blood ('haem' is blood and 'emesis' vomiting).
Haematuria The presence of blood in the urine.
Haemoglobin A red pigment present in red blood cells made of haem, a molecule containing iron and globin, a protein with oxygen-carrying properties.
Haemolysis The breaking down of erythrocytes.
Haemolytic Destruction of red blood cells.
Haemopoesis Production of red blood cells and platelets from the bone marrow.
Haemostasis The stoppage of bleeding following the formation of a clot.
Harassment Any unwanted or uninvited behaviour which is offensive, embarrassing, intimidating or humiliating.
Health Service Ombudsman Exists to provide a service to the public by undertaking independent investigations into complaints about health services that have not acted properly or fairly or have provided a poor service.
Heimlich valve A type of portable chest drain.
Heparin An injectable anticoagulant.
Histamine A chemical that is released in the body as part of an allergic reaction.
Histocompatability This is the term used to describe the body's identification system and is usually based on molecules attached to the surface of cells identifying that the cell belongs to the particular person.
Homeostasis The maintenance of a stable internal environment irrespective of external conditions.
Hydrocephaly Increase in CSF caused by obstruction of CSF drainage.
Hydrophillic Any substance that interacts with water.
Hydrophobic Any substance that does not interact with water.
Hyperkaleamia High level of potassium in the blood.
Hypernatraemia High-serum sodium.
Hypertension High blood pressure.
Hypocalcaemia Low-serum calcium.
Hypoglossal nerve XIIth cranial nerve, motor function for speech and swallowing.
Hypokalaemia Low level of potassium in the blood.
Hypomagnesaemia Low-serum magnesium.
Hyponatraemia Low-serum sodium.
Hypothalamus Part of the diencephalon, situated under the thalamus, controls temperature, water metabolism, autonomic function, physical symptoms of emotion and pituitary secretions such as growth hormone. Also contains a feeding centre, a satiety centre and a thirst centre.
Hypothermia Abnormally low temperature.
Hypovolaemia Low circulating blood volume.
Hypovolaemia Reduced circulating volume.
Hypoxaemia A low level of oxygen in the blood, measured by arterial blood gas analysis or by SpO2 in pulse oximetry.
Hypoxaemia Low level of oxygen in the blood.
Hypoxia Low levels of cellular oxygen.
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I
Ileum The final section of the small intestine.
Immunoglobulin Also known as an antibody.
Inclusions These are found in cells and are large unspecified molecules, food particles or cell debris.
Inflammation One of the body's non-specific responses to trauma or infection involving dilatation of blood vessels and movement of blood components into the interstitial space.
Initial segment The proximal portion of the axon where the action potential is generated.
Innate Existing since birth.
Inodilators A drug which has both inotropic and vasodilator properties.
Inotropic therapy Drugs that work on the contractility of the myocardium and ultimately improve cardiac performance.
Inotropic (also inotrope) Has an effect on myocardial contractility. A positive inotrope increases contractility, a negative inotrope decreases contractility.
Insomnia Inability to obtain an adequate amount or quality of sleep.
Inter-hospital transfer Moving a patient from one hospital to another.
Interstitial fluid Fluid around and between tissue cells.
Interstitial This refers to the space around cells that contains fluid (interstitial fluid) or connective tissue.
Intracellular fluid Fluid inside the cell walls.
Intracellular The contents of, or any activity that takes place inside, the cell.
Intracranial pressure The pressure within the skull.
Intra-hospital transfer Moving a patient from one area to another within the same hospital.
Intraosseous The inside of a bone.
Intravenous pyelogram (IVP) Investigation of the kidney and ureters for obstructive lesions (using contrast media).
Intravenous The inside of a vein.
Ischaemia A restriction of blood supply.
Isovolumetric ventricular contraction Phase of the cardiac cycle after ventricular depolarisation. All four valves are closed as the pressure in the ventricle is increasing, but not yet sufficient to open the aortic and pulmonic valves.
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J
Jejunum The middle aspect of the small intestine.
Jugular venous pressure (JVP) The pressure in the jugular veins which can be seen as a pulsating column in the neck. It can be used to estimate whether cardiac filling pressures are high.
Juxta glomerular cells A group of cells situated in the afferent arteries of the nephrons in the kidney that store renin.
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K
Ketoacidosis A metabolic condition associated with an accumulation of ketone bodies. Ketone bodies are the breakdown product of free fatty acids and the result of deamination of amino acids.
Kussmaul breathing Rapid, deep, laboured breathing due to respiratory compensation for a severe metabolic acidosis. This can arise from either ketoacidosis or renal failure. Named after Adolf Kussmaul, a nineteenth-century German doctor.
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L
Leucocyte A white blood cell containing a nucleus but no haemoglobin.
Leukaemia A malignant disease of the blood in which large numbers of leucocytes are present.
Lumbar nerves A group of five paired spinal nerves that arise from the lumbar section of the spinal column and are annotated L1–L5.
Lymphatic system A collection of capillaries, nodes and ducts that removes excess fluid and cell debris from the interstitial spaces and returns it to the vascular system via the subclavian veins.
Lysis Destruction of a cell or the process of breaking up or destruction.
Lysosome Intracellular organelle that is involved in processing microorganisms and cell debris entering the cell through phagocytosis.
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M
Macroglia Large glial cells.
Malar flush A high colour over the cheekbones, often with a bluish tinge. May be indicative of mitral stenosis.
Malnutrition Any condition in which the body does not receive enough nutrients for effective function. Malnutrition may range from mild to severe and life threatening.
Mean arterial pressure (MAP) The average pressure in the circulation throughout the cardiac cycle.
Medical emergency teams (MET) A team of health care professionals who have advanced life support skills, who are able to respond to patients who have abnormal physiological signs indicative of clinical deterioration. MET were first used in Australia.
Medical emergency An acute life-threatening event, usually preceded by a period of physiological deterioration and changes in vital signs.
Medulla oblongata Part of the brainstem, contains the vasomotor centre, which regulates the heartbeat and controls the diameter of blood vessels, thereby controlling blood pressure. Responsible for the rhythmical pattern of breathing. Contains ascending sensory pathways and descending motor pathways that connect the spinal cord with other parts of the brain. Contains important protective reflexes; swallowing, coughing, vomiting, sneezing and hiccoughing, and sensory nuclei for sensations of touch, pressure and vibration, taste, balance and hearing. It is the origin of cranial nerves VIII–XII.
Melaena This is the black, tarry faeces associated with gastrointestinal haemorrhage. The black ('melan') colour is caused by the oxidation of iron in the haemoglobin during the passage through the ileum and colon.
Membrane potential This is the voltage across the cell membrane created by the distribution of electrolytes. Changes in voltage across the cell membrane are important for stimulating electrical potential in nerves and muscles and also for ion pumps.
Meninges A collective term describing the three membranes that enclose the brain and spinal cord.
Meningitis Inflammation of the meninges.
Metabolism The term that describes all the chemical reactions that take place in the body.
Microbes Tiny organisms that cannot be seen by the naked eye.
Microglia Small glial cells.
Microthrombi Small thrombus located in a capillary or other small blood vessel.
Midbrain Part of the brainstem, contains sensory and motor pathways, involved in movement of eyes, head and trunk in response to visual and auditory stimuli, also the origin of cranial nerves III–IV.
Mitochondrion An intracellular organelle in which oxidative phosphorylation takes place.
Mitosis Asexual cell division involving the production of two daughter cells that are copies of the parent cell. Also known as mitotic cell division.
Mitotic cell division See Mitosis.
Mitral valve Valve which separates the left atria from the left ventricle.
Morphology The study of the form and structure of organisms.
Motor end plate The post-synaptic surface of a synapse between a nerve and a muscle fibre.
Motor neurone An alternative name for an efferent neurone, information is carried from the brain towards the periphery.
Multinucleate Cells that contain more than one nucleus.
Multi-parameter early warning system Multi-parameter systems trigger on two or more physiological variables that fall outside a predetermined range.
Multiple sclerosis A chronic demyelinating disease of the central nervous system, also known as MS.
Muscarinic receptor A type of receptor within the parasympathetic nervous system that responds to the neurotransmitter acetylcholine.
Myasthenia gravis An autoimmune degenerative disease in which acetylcholine receptors are destroyed resulting in muscle weakness.
Myelin sheath Up to 100 layers of myelin wrapped around an axon.
Myelin A lipid-based substance that is secreted by Schwann cells within the peripheral nervous system and by oligodendrocytes within the central nervous system. Myelin insulates axons and increases the speed of conduction along the axon.
Myelinated neurone A neurone whose axon is wrapped in myelin.
Myocardial infarction Death of cardiac muscle usually caused by acute lack of blood supply following blockage of coronary arteries.
Myocardium The thick muscle layer of the heart which contracts in a wave-like motion.
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N
Neglect This is a type of abuse where a person has been remiss in their provision of care or treatment.
Nephron The functional unit of the kidney, where blood is filtered and urine is produced.
Nephrotic syndrome An inflammatory disease of the glomerulus characterised by proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia.
Nerve impulse The transmission of an electrical signal along a bundle of axons within the peripheral nervous system.
Nerve A bundle of many hundreds of axons, together with their blood vessels and connective tissue. They only occur within the peripheral nervous system.
Neuroglia Cells that support neurones, the dominant cell structure within the central nervous system.
Neuroglycopenia A deficiency of glucose in the brain as a result of hypoglycaemia. This adversely affects the functioning of neurones.
Neurolemma The outer layer of a myelin sheath containing the nucleus of the Schwann cell, only found in the peripheral nervous system.
Neuromuscular junction A synapse between a neurone and a muscle fibre.
Neurones Cells within the nervous system that are capable of generating an action potential.
Neuropathic pain Pain that is generated by damaged nerves or central nervous system structures rather than in response to inflammation through pain receptors.
Neuropathy Damage to nerves.
Neurotransmitters Chemicals within the nervous system that are released from terminal boutons and diffuse across the synapse to excite or inhibit post-synaptic structures.
Neutrophil A type of white blood cell that can attack and destroy bacteria.
NHS Early Warning Score (NEWS) A proposed national early warning system to be used by the NHS, currently under development.
Nicotinic receptor A type of receptor within the parasympathetic nervous system that responds to the neurotransmitter acetylcholine.
Nissl bodies Rough endoplasmic reticulum within the cell body of the neurone, also called Nissl granules.
Node Localised swelling.
Nodes of Ranvier Gaps between sections of myelin where action potentials can jump along the axon in a process known as saltatory conduction. Nodes of Ranvier are more prevalent within the peripheral nervous system.
Non-invasive ventilation (NIV) A process that enables different pressures to be delivered during inspiration and expiration and providing ventilatory support. NIV is delivered via face or nasal mask, does not require intubation and is most commonly used for patients with type 2 respiratory failure.
Nuclei Clusters of neurone cell bodies within the central nervous system.
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O
Oculomotor nerve IIIrd cranial nerve, motor control of eye movement, upper eyelid control and pupil constriction.
Oedema Excess fluid, above the normal, found in the interstitial spaces that is not rapidly removed.
Olfactory nerve Ist cranial nerve, sensory function for sense of smell.
Oligodendrocytes A type of glial cell which produces myelin within the CNS.
Oliguria 100–400ml of urine in 24 hours.
Optic nerve IInd cranial nerve, sensory interpretation of sight.
Organ A combination of two or more tissues adapted to carry out a specific function.
Organelles Structures within the cytosol that are the sites of specific cellular activity.
Orthopnoea Shortness of breath when lying flat.
Osmolality The concentration of solutes in a kilogram of water.
Osmoreceptors Sensory neurones in the hypothalamus that are stimulated by a change in the osmotic pressure of the blood and trigger the sensation of thirst.
Osmosis The distribution of water from a lesser area of solute concentration to an area of higher concentration.
Osmosis The movement of water from an area of high solute concentration to one of lower concentration.
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P
Pancreatitis Inflammation of the pancreas that may either be acute or chronic.
Pancreatitis Inflammation of the pancreas.
Paralytic ileus Disruption in the normal propulsive ability of the gastrointestinal tract.
Paranoia Unfounded or exaggerated distrust of others.
Paraplegia Partial or complete loss of motor and sensory function from the thoracic region downwards.
Parasympathetic nervous system A branch of the autonomic nervous system.
Parasympathetic nervous system A branch of the autonomic nervous system, involuntary and as a generalisation counteracts the action of the sympathetic nervous system, it restores the body to its resting state and is needed for relaxation and sleep.
Parkinson's disease A chronic disease caused by inadequate levels of dopamine with a consequent imbalance in the ratio of dopamine to acetylcholine.
Pathogens An infectious agent (a germ).
Pericardiocentesis A procedure in which fluid from the pericardial sac is removed by a needles.
Pericardium Rigid sac-like structure surrounding and protecting the heart.
Peripheral cyanosis A blue tinge in fingers or extremities, due to inadequate circulation.
Peripheral nervous system A subdivision of the nervous system comprising the cranial nerves, spinal nerves and their branches, often referred to as the PNS.
Peristalsis Contraction and relaxation of muscles which propagates in a wave down a muscular tube. From Greek peristallein (to wrap around) from peri (around) and stallein (to place).
Peritonitis Inflammation of the peritoneum – the membrane which lines part of the abdominal cavity and viscera.
Peroxisomes Membranous sacs that are involved in intracellular detoxification.
pH A logarithmic scale representing H+ concentration where '0' is the highest acidity and '14' is the lowest.
Phagocytosis See Endocytosis.
Phospholipid A triacylglycerol (triglyceride) fat that has one of the three fatty acid components replaced by a phosphate molecule.
Photophobia Intolerance of light.
Physiological needs Physiological needs are those required to sustain life, such as air, water, nourishment and sleep.
Physiological variable A clinical measurement such as heart rate, respiratory rate, that varies over time.
Pia mater Innermost layer of the meninges.
Pineal gland Part of the epithalamus, secretes the hormone melatonin, considered an endocrine gland.
Pinocytosis See Endocytosis.
Plasma membrane A membrane composed of phospholipids, proteins and cholesterol that surrounds cells and intracellular organelles.
Plasma protein A protein found in plasma, e.g. albumin, gamma globulin, fibrinogen.
Plasma Yellow watery liquid that makes up the fluid component of blood.
Platelet A small blood cell which multiplies rapidly following injury and encourages clotting of blood.
Pneumotaxic area Located within the pons, influences breathing.
Pneumothorax A collection of air in the pleural space (between the lung and the chest wall) resulting in collapse of the lung on the affected side.
Polyuria The passage of large amounts of urine.
Pons Part of the brainstem, contains sensory and motor pathways, a relay station between the cerebral cortex and the cerebellum, contains the apneustic and pneumotaxic areas which influence breathing. The pons is the origin of cranial nerves V–VIII.
Posterior horns Section of the spinal cord, comprised of grey matter and containing sensory axons.
Preload Left ventricular end diastolic pressure/volume. It can be thought of as the amount of blood returning to the heart from the circulation into the ventricle.
Primary motor area A highly specialised area of the cerebral cortex located immediately anterior to the primary somatosensory area, in the posterior section of the frontal lobe, immediately anterior to the central sulcus, important motor control of complex, skilled or delicate movements.
Primary somatosensory area A highly specialised area of the cerebral cortex located in the anterior portion of each parietal lobe immediately posterior to the central sulci, important for perception of sensations including touch, tickle, itch, pain, temperature and joint posture.
Proteinuria The presence of protein in the urine.
Pulmonary embolism The blockage of a pulmonary artery by a blood clot, fat or air.
Pulse pressure The difference in pressure between systole and diastole.
Pulseless electrical activity (PEA) Organised electrical cardiac activity in the absence of a pulse.
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Q
Quadriplegia Partial or complete loss of sensation and motor function from the neck down.
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R
Racism Discrimination or prejudice based on race.
Receptive aphasia Inability to put words together coherently.
Renal calculi Stones made up of calcium and minerals that can obstruct the ureters.
Renal replacement therapy An extra-corporeal circuit used to filter excess fluid and waste products from the blood.
Renin A protein produced by the juxta glomerular apparatus that leads to the formation of angiotensin 2.
Repolarisation A phase within the action potential where the membrane potential changes from positive to negative by the efflux of potassium ions and returns to its resting state.
Repolarisation Movement of ions back across the cell membrane causing the resting potential to be re-established.
Respect To show regard or consideration for another person, respect a person's rights.
Ribosome An intracellular organelle composed of protein and ribonucleic acid which is responsible for protein production in the cell.
RSVP Reason–Story–Vital Signs–Plan System used in acute life- threatening events recognition and treatment (ALERT) course. An easy to remember tool including essential information to be used in an emergency, to enable medical staff to respond appropriately.
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S
Sacral nerves A group of five paired spinal nerves which arise from the sacral section of the spinal column and are annotated S1–S5.
Saltatory conduction The term used to describe an action potential that jumps from one node of Ranvier to another. This only occurs in myelinated axons.
Sarcomere The basic functional unit of striated muscle made up of muscle fibres.
SBAR Situation, Background, Assessment, Recommendation. An easy to use mechanism used to structure communication, to communicate accurately what requires a clinician's immediate attention.
Schwann cells A type of glial cell responsible for myelin production within the peripheral nervous system.
Second heart sound Heard as 'dub', this is the sound of the aortic and pulmonic valves closing at the beginning of diastole.
Selectively permeable A membrane that is able to control molecules that can cross it. It is usually referred to in connection with the movement of water from an area of high solute concentration to one of lower concentration. This is also known as osmosis.
Self-esteem Central to a person's survival, the basis of our well-being, the degree of worth and competence one attributes to oneself.
Sengstaken–Blakemore tube This is used in upper GI tract bleeding. It consists of a tube with two balloons, one of which is inflated against the walls of the oesophagus, and the other in the stomach, the purpose of which is to apply pressure to bleeding points.
Sensory depravation Deprivation of adequate and appropriate interpersonal or environmental experience and deprivation of usual external stimuli and the opportunity for development.
Sensory receptors Nerve endings that detect information internally and externally.
Sepsis A life-threatening illness caused by the body overreacting to an infection.
Sexism Discrimination or prejudice based on sex.
Single-parameter early warning system Single-parameter systems trigger on one extreme physiological observation value.
Sino-atrial node The heart's primary pacemaker which spontaneously depolarises 100 times per minute.
Somatic nervous system A subdivision of the peripheral nervous system.
Specific gravity A measurement of urine osmolality.
Spinal accessory nerve XIth cranial nerve, motor control of shoulder and head movement.
Spinal cord injury Damage to the spinal cord that results in loss of mobility or sensation, also known as SCI.
Spinal cord An extension of the brainstem that runs from the medulla oblongata to the top of the second lumbar vertebra.
Spinal nerves Part of the peripheral nervous system, a group of 31 pairs of spinal nerves that exit the spinal column between each vertebra.
Splinter haemorrhages Tiny line haemorrhages that can be seen under the nails, indicative of bacterial endocarditis.
Statute A law enacted by a legislator.
Stress response Activation of the sympathetic nervous system by an environmental or physiological stressor.
Stridor A high-pitched sound heard on inspiration indicating airway obstruction.
Stridor A high-pitched wheezing sound resulting from turbulent air flow in the upper airway.
Stroke volume The amount of blood ejected by the ventricle during systole, normally about 70mL.
Subarachnoid haemorrhage Haemorrhage into the subarachnoid space.
Subarachnoid space The space between the arachnoid mater and the pia mater.
Substance P A neuropeptide neurotransmitter released by neurones in the peripheral nervous system that are responsible for the transmission of pain information to the central nervous system.
Sulci The pleural of sulcus.
Sulcus Shallow groove between the gyri of the cerebral hemispheres.
Sympathetic nervous system A branch of the autonomic nervous system.
Sympathetic nervous system A division of the autonomic nervous system that is involuntary, controls the 'fight and flight' response and maintains the body in a state of alertness.
Sympathomimetic A substance that mimics the sympathetic nervous system (used to categorise inotropic pharmacology).
Synapse A collective term that describes the interface between a terminal bouton and another tissue structure, which may be another nerve but could also be a blood vessel, a muscle, an organ or a gland. Synapses can be electrical or chemical.
Synaptic cleft The space between the presynaptic surface and the post-synaptic surface.
Systemic vascular resistance The resistance offered to the circulation by the peripheral circulation.
Systole Phase of the cardiac cycle when contraction occurs.
Systolic pressure Pressure, usually systemic, exerted on the walls of the arteries during systole.
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T
Tamponade Compression of the heart by the accumulation of fluid in the pericardial space.
Tension pneumothorax Presence of air in the pleural space that occurs when air escapes into the pleural cavity from a bronchus but cannot regain entry into the bronchus. As a result, continuously increasing air pressure in the pleural cavity causes progressive collapse of the lung tissue.
Terminal boutons 'Button-like' terminals at the ends of the axon branches, containing synaptic vesicles where neurotransmitters are stored.
Tetany Muscle spasms caused by low-serum calcium.
Thalamus A pair of oval-shaped structures within the diencephalon, comprised of grey matter and usually joined by a bridge of grey matter. A relay station between the cerebral cortex and the spinal cord, also relays information between different areas of the cerebrum and between the cerebrum and the cerebellum. The thalamus is involved with consciousness.
Thalassaemmia A hereditary disorder that causes an abnormality in the protein component of haemoglobin.
Thoracic nerves A group of 12 paired spinal nerves that arise from the thoracic section of the spinal column and are annotated T1–T12.
Thrombin A substance which converts fibrinogen to fibrin to enable blood clotting.
Thrombocyte Another name for platelet.
Thrombus A blood clot.
Tissue Combination of similar cells and extracellular substances that perform a specific function.
Toxin A poisonous substance produced within living cells or organisms.
Track and trigger tool A set of predetermined objective criteria used as indicators for 'calling for help' in the management of a patient at risk of clinical deterioration.
Transfer bag A bag that contains all the necessary transfer equipment. This is checked on a daily basis by the nurse.
Transfer equipment checklist A checklist of transfer bag equipment.
Transfer for clinical reasons Moving a patient because she requires treatment.
Transfer for non-clinical reasons Moving a patient because there are capacity issues or they are transferring to a hospital nearer to home.
Transfer form A record of the transfer event documenting any problems that occurred.
Transient ischaemic attacks Brief episodes of altered consciousness caused by temporary obstruction of the arterial blood supply to the brain, also known as a TIA.
Transport molecules These are molecules attached to the surface of the cell or free-moving inside the cell that act as transport or carrier molecules for other molecules being brought into the cell or transferred from one organelle to another.
Triacylglycerol Known as triglycerides or neutral fats. These molecules are composed of a glycerol molecule joined to three fatty acid molecules.
Tricuspid valve Valve which separates the right atrium from the left ventricle.
Trigeminal nerve Vth cranial nerve, sensory and motor control of face, scalp, nose and mouth.
Trochlear nerve IVth cranial nerve, motor control of eye movement.
Tubular reabsorption Reabsorption of the filtrate back into the peritubular capillaries.
Tubular secretion Substances are filtered out of the blood into the tubular fluid for secretion.
Tumour A lump or growth of tissue made up from abnormal cells.
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U
Ultrasound The production of an image from ultrasound waves that are created by structures within the body.
Unconsciousness Lack of awareness of oneself and one's surroundings.
Unmyelinated neurone A neurone whose axon is not wrapped in myelin.
Urea A waste product of protein metabolism.
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V
Vagal tone The level of activity in the parasympathetic nervous system, for example the vagus nerve has an inhibitory affect on the heart rate.
Vagus nerve Xth cranial nerve, motor and sensory control of pharynx, larynx, heart, lungs, gut, viscera.
Varices Varices are distended veins. From the Latin varix meaning twisted veins.
Vasa recta A network of blood vessels found in the cortex and medullary regions of the kidney.
Vasomotor centre Located within the brainstem, regulates the heartbeat and controls the diameter of blood vessels, thereby controlling blood pressure, also called the cardiovascular centre.
Vasopressin Also known as the antidiuretic hormone, this polypeptide controls water reabsorption and secretion.
Vasopressor A substance (often a drug) which increases the degree of vasoconstriction of the blood vessels.
Vennule Small vessel connecting the capillary bed and vein.
Ventricular assist device (VAD) A mechanical device which can be used to assist the pumping action of the heart.
Ventricular fibrillation Disorganised electrical activity in the ventricular myocardium resulting in an absence of effective cardiac output.
Ventricular hypertophy A thickening of the muscle layer of the heart, the ventricular myocardium, usually in response to disease, high blood pressure, or problems that increase ventricular afterload.
Ventricular tachycardia Cardiac arrhythmia originating from within the ventricles characterised by rapid ventricular complexes at a rate greater than 100/min. It may or may not be associated with a pulse.
Ventriculitis Inflammation of the ventricles within the brain.
Venturi mask Type of disposable oxygen face mask which delivers a precise consistent mixture of air and oxygen regardless of the patient's inspiratory flow rate.
Venturi masks These oxygen masks are so named because they utilise a Venturi effect, which is to entrain air to mix with piped oxygen to achieve a specified oxygen percentage being delivered to the patient (fixed performance oxygen).
Venule A small blood vessel in the microcirculation.
Vesicle A small fluid-filled sac. In cellular terms it is surrounded by plasma membrane and may also contain particulate matter and a variety of metabolic intermediates and products.
Vestibulocochlear nerve VIIIth cranial nerve, sensory control of hearing and balance.
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W
Wernicke's area Located within the left temporal and parietal lobes, interprets speech by recognising spoken words and translating them into thoughts.
White matter Inner area of the cerebral hemisphere, mainly comprised of myelinated axons. Also found within the spinal cord where it is divided into regions called columns: anterior, posterior and lateral white columns.
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X
Xanthelesma Yellow/white fatty bumps under the skin around the eye lids, often the upper lid.
Xanthomata A bump in the skin caused by fats building up under the surface. They appear as small white, or larger yellow bumps, and may be associated with a high level of lipids in the blood.
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