View Section PDF - coursewareobjects.com

B, symbol for the element boron. 

B. See oxalic acid. 

B, . See beta. 

B6 bronchus sign, an artifact in a lung radiograph in 

which an air bronchogram appears in the lower lobe as a result 

of consolidation of atelectasis. 

B19 virus, a strain of human parvovirus associated with a 

number of diseases, including hemolytic anemia, erythema 

infectiosum, fifth disease, and symptoms of arthritis and arthralgia. 

B19 infects only humans. Approximately 50% of 

adults have been infected some time during childhood or 

adolescence. Children infected with erythema infectiosum, 

the most common illness caused by B19, develop a mild 

rash, usually across the face, which usually resolves in 7 to 

10 days. Postinfection children develop lasting immunity. 

Infection in adults not previously infected with B19 is usually 

more severe, involving joint aches and swelling, most 

often resolving in 2 to 3 weeks. 

Ba, symbol for the element barium. 

BA, 1. abbreviation for Bachelor of Arts. 2. abbreviation 

for blood alcohol. 

babbling, a stage in speech development characterized by 

the production of strings of speech sounds in vocal play, 

such as “ba-ba-ba.” 

Babcock’s operation [William W. Babcock, American surgeon, 

1872–1963], the removal of a varicosed saphenous 

vein by insertion of an acorn-tipped sound, tying the vein to 

the sound, and drawing it out. 

babesiosis /bYbēsē·ōsis/ [Victor Babés, Romanian bacteriologist, 

1854–1926], a potentially severe and sometimes 

fatal disease caused by infection with protozoa of the genus 

Babesia. The parasite is introduced into the host through the 

bite of ticks of the species Ixodes dammini and infects red 

blood cells. In the United States, incidence of the disease is 

highest in the Northeast and North Central regions. Symptoms 

include headache, fever, chills, vomiting, hepatosplenomegaly, 

hemolytic anemia, fatigue, myalgia, and hemolysis. 

Treatment is clindamycin or quinone. Most patients with 

babesiosis are asymptomatic. Approximately 25% of patients 

with babesiosis are also infected with Lyme disease. 

Also called babesiasis /babYsīYsis/. 

Babinski’s reflex /bYbinskēz/ [Joseph F.F. Babinski, French 

neurologist, 1857–1932], dorsiflexion of the big toe with 

extension and fanning of the other toes elicited by firmly 

stroking the lateral aspect of the sole of the foot. The reflex is 

normal in newborns and abnormal in children and adults, in 

whom it may indicate a lesion in the pyramidal tract or other 

neurologic insult. 

Babinski’s sign [Joseph Babinski], a series of partial responses 

that are pathognomonic of different degrees of upper 

motor neuron disease, including (1) absence of an ankle jerk 

in sciatica; (2) an extensor plantar response, with an extension 

of the great toe and adduction of the other toes; (3) a 

more pronounced concentration of platysma on the unaffected 

side during blowing or whistling; (4) pronation that 

occurs when an arm affected by paralysis is placed in supination; 

and (5) when a patient in a supine position with arms 

B 

180 

Babesiosis (Carr and Rodak, 2009) 

Babinski’s reflex in an adult 

(Seidel et al, 2006) 

crossed over the chest attempts to assume a sitting position, 

the thigh on the affected side is flexed, and the heel is raised, 

while the leg on the unaffected side remains flat. 

baby [ME, babe], 1. an infant or young child, especially 

one who is not yet able to walk or talk. 2. to treat gently or 

with special care. 

baby bottle caries. See early childhood caries. 

baby bottle tooth decay, a dental condition that occurs in

Baby Jane Doe regulations 181 bacille Calmette-Guérin 

children between 12 months and 3 years of age as a result of 

being given a bottle at bedtime, resulting in prolonged exposure 

of the teeth to milk or juice. Caries are formed because 

pools of milk or juice in the mouth break down to lactic acid 

and other decay-causing substances. Preventive measures include 

elimination of the bedtime feeding or substitution of 

water for milk or juice in the nighttime bottle. Formerly 

called nursing bottle caries. 

Baby bottle tooth decay 

(Seidel et al, 2006/Courtesy Drs. Abelson and Cameron) 

Baby Jane Doe regulations, rules established in 1984 by 

the U.S. Health and Human Services Department requiring 

state governments to investigate complaints about parental 

decisions involving the treatment of handicapped infants. 

The rules also allowed the federal government to have access 

to children’s medical records and required hospitals to 

post notices urging physicians and nurses to report any suspected 

cases of denial of proper medical care to infants. The 

controversial regulations have been found illegal by a federal 

court. The popular name for the federal rules was taken 

from the name “Jane Doe” given to an infant born in New 

York with an open spinal column and other defects who became 

the object of a campaign to force lifesaving surgery for 

the child over parental objections. Also called Baby Doe 

rules. 

baby talk, 1. the speech patterns and sounds of young 

children learning to talk, characterized by mispronunciation, 

imperfect syntax, repetition, and phonetic modifications, 

such as lisping or stuttering. See also lallation. 2. the intentionally 

oversimplified manner of speech, imitative of young 

children learning to talk, used by adults in addressing children 

or pets. 3. the speech patterns characteristic of regressive 

stages of various mental disorders, especially schizophrenia. 

BAC, abbreviation for bronchoalveolar carcinoma. 

bacampicillin hydrochloride, a semisynthetic penicillin. 

INDICATIONS: It is prescribed in the treatment of respiratory 

tract, urinary tract, skin, and gonococcal infections. 

CONTRAINDICATIONS: Known sensitivity to this drug or 

other penicillins prohibits its use. 

ADVERSE EFFECTS: Among the most serious adverse reactions 

are hypersensitivity reactions, gastritis, enterocolitis, 

and transient blood disorders. 

Bachelor of Science in Nursing (BSN) /bachYlYr/, 

an academic degree awarded on satisfactory completion of a 

4-year course of study in a college or university. The recipient 

is eligible to take the national certifying examination to 

become a registered nurse. A BSN degree is a prerequisite to 

advancement in nursing education and advancement in many 

systems and institutions that employ nurses. Compare Associate 

Degree in Nursing, diploma program in nursing. 

Bach remedies, a set of 38 flower essences, developed as 

a milder alternative to homeopathic remedies, that produce 

mental or emotional but not physical symptoms upon proving. 

They are used to treat mental and emotional complaints 

and have no direct effect on physical symptoms. 

bacill-, combining form meaning “rod-shaped bacterium”: 

bacillemia, bacillosis. 

Bacillaceae /basYlāsi·ē/ [L, bacillum, small rod], a family 

of Bacilli of the order Bacillales, consisting of grampositive, 

rod-shaped cells that can produce cylindric, 

ellipsoid, or spheric endospores situated terminally, 

subterminally, or centrally. These cells are chemoheterotrophic 

and mostly saprophytic, commonly appearing in soil. 

Some are parasitic on insects and animals and are pathogenic. 

The family includes the genus Bacillus, which is aerobic, 

and the genus Clostridium, which is facultatively 

anaerobic. 

bacillary angiomatosis /basYlerē/, a condition of multiple 

angiomata caused by an infection of Bartonella. The 

infectious agent is associated with contact with young cats 

infected with fleas and is also the cause of cat-scratch fever. 

It is manifested in persons with cellular immunodeficiency 

such as human immunodeficiency virus (HIV)-infected patients 

as small hemangioma-like lesions of the skin but may 

also involve the lymph nodes and viscera. The skin lesions 

are often mistaken for Kaposi’s sarcoma. Infection is curable 

but can be fatal if untreated. Treatments include oral erythromycin, 

tetracycline, trimethoprim-sufamethoxazole, and 

rifampicin. 

Bacillary angiomatosis 

(Stone and Gorbach, 2000) 

bacillary dysentery. See shigellosis. 

bacillary white diarrhea, pullorum disease. 

bacille Calmette-Guérin (BCG) /kalmetgāran/ [Léon 

C.A. Calmette, French bacteriologist, 1863–1933; Camille 

Guérin, French bacteriologist, 1872–1961], The bacillus 

of Calmette and Guérin (BCG) is an attenuated strain of Mycobacterium 

bovis that is given as a live bacterial vaccine to 

prevent the development of TB. An attenuated strain of tubercle 

bacilli, used in many countries as a vaccine against tuberculosis, 

most often administered intradermally, with a 

multiple-puncture disk. When administered to infants in 

high-prevalence areas, there is some evidence that it prevents 

the more serious forms of tuberculosis. It may have 

some efficacy against leprosy. BCG is also instilled into the 

bladder as a treatment for bladder cancer to stimulate the immune 

response in people who have certain kinds of malignancy. 

It induces a positive tuberculin reaction and may 

mask early, active infection by removing the diagnostic sign 

of conversion from the negative to the positive skin reaction. 

See also tuberculin test, tuberculosis.

acille Calmette-Guérin vaccine 182 backup 

bacille Calmette-Guérin vaccine, an active immunizing 

agent prepared from an attenuated bacille Calmette-Guérin 

strain of Mycobacterium bovis. 

INDICATION: It is prescribed most commonly for immunization 

against tuberculosis. It is instilled intravesically to 

treat carcinoma in situ of the urinary bladder in certain 

situations. It is seldom administered in the United States as 

an immunizing agent, but is often given in many countries 

to infants, caregivers, etc., who are at high risk for intimate 

and prolonged exposure to people with active 

tuberculosis. 

CONTRAINDICATIONS: Hypogammaglobulinemia, immunosuppression, 

or concomitant use of corticosteroids or isoniazid 

prohibits its use. It is not given after a vaccination for 

smallpox, nor is it given to patients with a positive tuberculin 

reaction or a burn. 


are anaphylaxis and disseminated pulmonary tuberculosis. 

Pain, inflammation, and granuloma may develop at the 

site of injection. 

bacillemia /basYlēmē·Y/, a condition in which bacilli are 

circulating in the blood. See also bacteremia, sepsis, 

septicemia. 

bacilli /bYsilī/ sing. bacillum [L, bacillum, small rod], 

any rod-shaped bacteria. See Bacillus. 

bacilliform /bYsilifôrm/, rod-shaped, like a bacillus. 

bacillosis /basYlōsis/, a condition in which bacilli have 

invaded tissues, inducing symptoms of an infection. 

bacillum. See bacilli. 

bacilluria /basYloo ˘ rē·Y/ [L, bacillum Gk, ouron, urine], 

the presence of bacilli in the urine. 

Bacillus /bYsilYs/, 1. a genus of aerobic, gram-positive, or 

facultatively anaerobic, spore-forming, rod-shaped microorganism 

of the family Bacillaceae, order Eubacteriales. The 

genus includes 34 species, 3 of which are pathogenic and the 

rest saprophytic soil forms; 25 species are considered medically 

important. Some species are nonpathogenic, but others 

cause a wide variety of diseases, ranging from anthrax 

(caused by B. anthracis) to tuberculosis. Many microorganisms 

formerly classified as Bacillus are now classified in 

other genera. See also acid-fast bacillus, Bacillaceae. 

2. any rod-shaped bacteria. 

Bacillus anthracis, a species of gram-positive, facultative 

anaerobe that causes anthrax, a disease primarily of cattle 

and sheep. The spores of this organism, if inhaled, can cause 

a pulmonary form of anthrax. Spores can live for many years 

in animal products, such as hides and wool, and in soil. See 

also anthrax, woolsorter’s disease. 

Bacillus cereus, a species of bacilli found in the soil. It 

causes food poisoning (an emetic type and a diarrheal type) 

by the formation of an enterotoxin in contaminated foods. 

The symptoms are similar to those of Staphylococcus food 

poisoning. It can also cause infections, such as ocular infections. 

bacitracin /basitrāsin/ [L, bacillum Tracy, surname of 

patient in whom toxin-producing bacillus species was isolated], 

an antibacterial. 

INDICATION: A common component of topical antibiotic 

ointments used for treating skin infections. 

CONTRAINDICATION: Known hypersensitivity to this drug 

prohibits its use. 

ADVERSE EFFECTS: Skin rash. 

back [AS, baec], the posterior or dorsal portion of the 

trunk of the body between the neck and the pelvis. The back 

is divided by a middle furrow that lies over the tips of the 

spinous processes of the vertebrae. The skeletal portion of 

the back includes the thoracic and the lumbar vertebrae and 

both scapulae. The nerves that innervate the various muscles 

of the back arise from the segmental spinal nerves. 

backache /bakāk/ [AS, baec ME, aken], a pain in the 

lumbar, lumbosacral, or cervical region of the back, varying 

in sharpness and intensity. Causes may include muscle strain 

or other muscular disorders or pressure on the root of a 

nerve, such as the sciatic nerve, caused in turn by a variety of 

factors, including a herniated vertebral disk. Treatment may 

include heat, ultrasound, and devices to provide support for 

the affected area while the individual is in bed or standing or 

sitting, bed rest, surgical intervention, and medications to relieve 

pain and relax spasm of the muscle of the affected area. 

back-action condenser, an instrument for compacting 

dental amalgams that has a U-shaped shank, which develops 

the condensing force from a pulling motion rather than from 

the more common pushing motions. 

backboard, a long, flat, rigid piece of wood or other material 

that is placed under an accident victim with possible 

spinal injury. It is used to transport the patient to a hospital or 

as a firm surface for CPR. 

Patient on a backboard (Shade et al, 2007) 

backbone, the vertebral column. 

backcross [AS, baec cruc, cross], 1. a mating (cross) 

between a heterozygote and a homozygote. 2. an organism 

or strain produced by such a cross. See also testcross. 

background level, the usual intensity of a chemical or 

other stimulus in the environment. 

background radiation [AS, baec OE, grund, ground], 

naturally occurring radiation emitted by soil, groundwater, 

building materials, radioactive substances in the body (especially 

potassium 40), and cosmic rays from outer space. 

Each year the average person is exposed to 44 millirad 

(mrad) of external terrestrial radiation, 18 mrad of naturally 

occurring internal radioaction, and 44 mrad of cosmic radiation. 

Background radiation levels may vary in different locales. 

backing /baking/ [AS, baec], in dentistry, the piece of 

metal that supports a porcelain or resin facing on a fixed or 

removable partial denture. 

back knee. See genu recurvatum. 

back pressure [AS, baec L, premere, to press], pressure 

that builds in a vessel or a cavity as fluid accumulates. The 

pressure increases and extends backward if the normal 

mechanism for egress or passage of the fluid is not restored. 

backscatter radiation. See scattered radiation. 

backup, 1. a duplicate computer, data file, equipment, or 

procedure for use in the event of equipment failure.

aclofen 183 bacterial protein 

2. The act of creating another copy of a file, group of files, 

or an entire computer hard drive. 

baclofen, an antispastic agent. 

INDICATION: It is prescribed to reduce the spasticity associated 

with multiple sclerosis, cerebal palsy, and spinal cord 

injury; not effective against spasticity caused by stroke. 



ADVERSE EFFECTS: Among the more serious adverse reactions 

are confusion, hypotension, dyspnea, impotence, nausea, 

and transient drowsiness. 

-bactam, combining form designating a beta-lactamase inhibitor. 

bacter-. See bacterio-. 

bacteremia /baktirēmē·Y/ [Gk, bakterion, small staff, 

haima, blood], the presence of bacteria in the blood. Undocumented 

bacteremias occur frequently and usually abate 

spontaneously. Bacteremia is demonstrated by blood culture. 

Antibiotic treatment, if given, is specific for the organism 

found and appropriate to the locus of infection. If untreated, 

bacteremia can be fatal. Also spelled bacteriemia. Also 

spelled bacteraemia. Compare septicemia. See also septic 

shock. —bacteremic, adj. 

bacteremic shock, septic shock caused by the release of 

toxins by bacteria, usually gram-negative bacteria, in the 

blood. 

bacteria /baktirē·Y/ sing. bacterium [Gk, bakterion, small 

staff], a domain of life existing as small unicellular microorganisms. 

The genera vary morphologically, being spheric 

(cocci), rod-shaped (bacilli), spiral (spirochetes), or commashaped 

(vibrios). The nature, severity, and outcome of any 

infection caused by a bacterium are characteristic of that 

species. 

-bacteria, suffix meaning “genus of microscopic plants 

forming the class Schizomycetes”: lysobacteria, 

streptobacteria. 

bacterial adherence /baktirēYl/, the process whereby 

bacteria attach themselves to cells or other surfaces before 

proliferating. 

bacterial aneurysm, a localized dilation in the wall of a 

blood vessel caused by the growth of bacteria. It often follows 

septicemia or bacteremia and usually occurs in peripheral 

vessels. See also mycotic aneurysm. 

bacterial cholangitis, the most common type of cholangitis, 

caused by bacterial infection. If bacteria invade the liver 

they can enter the bloodstream and cause septicemia that can 

be fatal. 

bacterial count. See count. 

bacterial endocarditis, an acute or subacute bacterial infection 

of the endocardium or the heart valves or both. The 

condition is characterized by heart murmur, prolonged fever, 

bacteremia, splenomegaly, and embolic phenomena. The 

acute variety progresses rapidly and is usually caused by 

staphylococci. The subacute variety is usually caused by 

lodging of Streptococcus viridans in heart valves damaged 

by rheumatic fever. Prompt treatment of both types with antibiotics, 

such as penicillin, cephalosporin, or gentamicin 

given intravenously, is essential to prevent destruction of the 

valves and cardiac failure. See also endocarditis, subacute 

bacterial endocarditis. 

bacterial enteritis, inflammation of the intestine caused 

by bacterial infection; the most common types in humans are 

Campylobacter enteritis, Salmonella enteritis, Shigella enteritis, 

and Yersinia enteritis. 

bacterial enzyme, an enzyme produced by a bacterium. 

bacterial food poisoning, a toxic condition resulting 

Bacterial endocarditis (Kumar et al, 2007) 

from the ingestion of food contaminated by certain bacteria. 

Acute infectious gastroenteritis caused by various species of 

Salmonella is characterized by fever, chills, nausea, vomiting, 

diarrhea, and general discomfort beginning 8 to 48 

hours after ingestion and continuing for several days. Similar 

symptoms caused by Staphylococcus, usually S. aureus, appear 

much sooner and rarely last more than a few hours. 

Food poisoning caused by the neurotoxin of Clostridium 

botulinum is characterized by GI symptoms, disturbances of 

vision, weakness or paralysis of muscles, and, in severe 

cases, respiratory failure. See also botulism. 

bacterial inflammation [L, bacterium inflammare, to set 

afire], any inflammation that is part of a body’s response to 

a bacterial infection. 

bacterial kinase, 1. a kinase of bacterial origin. 

2. a bacterial enzyme that activates plasminogen, the precursor 

of plasmin. 

bacterial laryngitis, a form of laryngitis caused by a bacterial 

infection and usually associated with rhinosinusitis or 

laryngotracheal bronchitis. Signs of a bacterial infection are 

a cough and purulent rhinorrhea. The infection is treated 

with any of several antibiotics. See also laryngitis. 

bacterial meningitis. See meningitis. 

bacterial overgrowth syndrome. See stasis syndrome. 

bacterial plaque, a dense, nonmineralized complex composed 

primarily of colonies of bacteria embedded in a gelatinous 

matrix. It contains amino acids, carbohydrates, proteins, 

lipids, and salts from saliva and gingival fluid; soluble 

food substances; shed leukocytes and epithelial cells; and 

products of bacterial metabolism. Plaque is the major causative 

factor in most dental diseases, including dental caries 

and inflammatory periodontal diseases. Also called dental 

plaque. 

bacterial pneumonia, pneumonia caused by bacteria, 

such as Klebsiella pneumoniae, Mycoplasma pneumoniae, 

Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus 

pyogenes, and others. 

bacterial prostatitis, a bacterial infection of the prostate. 

Acute bacterial infections usually involve gram-negative bacilli, 

such as Escherichia coli. Most cases are treated with a 

prolonged course (greater than 1 month) of broad-spectrum 

antimicrobial drugs. Abscesses may be associated with 

anaerobic bacteria. Chronic bacterial prostatitis is usually 

caused by gram-negative bacilli. It is less common and characterized 

by low back pain, dysuria, and perineal discomfort. 

See also prostatitis. 

bacterial protein, a protein produced by a bacterium.

acterial resistance 184 bag 

bacterial resistance, the ability of certain strains of bacteria 

to develop a tolerance to specific antibiotics to which 

they once were susceptible. 

bacterial toxin [Gk, bakterion, small staff, toxikon, poison], 

any poisonous substance produced by a bacterium. Kinds of 

bacterial toxins include endotoxins and exotoxins. 

bacterial vaccine, a saline solution suspension of a strain 

of attenuated or killed bacteria prepared for injection into a 

patient to stimulate development of active immunity to that 

strain and against similar bacteria. 

bacterial vaginosis [Gk, bakterion, small staff; L, vagina, 

sheath; Gk, osis, condition], a chronic inflammation of the 

vagina caused by bacterial imbalance (e.g., an overgrowth of 

the normal bacterial flora of the vagina). Vaginal flora commonly 

includes lactobacilli, streptococci, Gardnerella vaginalis, 

strains of enterobacteriaceae, and anaerobes. Also 

called vulvovaginitis. 

Bacterial vaginosis (Zitelli and Davis, 2007) 

bacterial virus, a virus with the ability to infect and/or destroy 

bacteria. It is usually species-specific. See also 

bacteriophage. 

bactericidal antibiotic [Gk, bakterion caedere, to kill; 

Gk, anti, against, bios, life], an antibiotic drug that kills 

bacteria. 

bactericide /baktirYsīd/ [GK, bakterion L, caedere, to 

kill], any drug or other agent that kills bacteria. Also 

spelled bacteriocide. Compare bacteriostasis. —bactericidal, 

adj. 

bactericidin [Gk, bakterion L, caedere, to kill], an antibody 

that kills bacteria in the presence of complement. 

Also called bacteriocidin. 

bacteriemia. See bacteremia. 

bacterio-, bacter-, bacteri-, combining form meaning 

“bacterial microorganism”: bacteriogenic, bacteriod, bactericide. 

bacteriocidal. See bactericidal. 

bacteriocidal antibiotic. See bactericide. 

bacteriocidin. See bactericidin. 

bacteriocin /baktirē·Ysin/, protein produced by certain 

species of bacteria that, by inducing metabolic block, are 

toxic to related strains of those bacteria. Also called protein 

antibiotic. 

bacteriocinogenic /baktirē·YsinYjenik/, pertaining to an 

organism capable of producing bacteriocins. 

bacteriogenic /baktirē·Yjenik/, 1. capable of producing 

bacteria. 2. derived from or originating in bacteria.3. caused 

by bacteria. 

bacterioidal. See bacteroid. 

bacteriologic /baktirē·Ylojik/ [Gk, bakterion], pertaining 

to bacteriology. Also bacteriological. 

bacteriologic sputum examination, a laboratory procedure 

to determine the presence or absence of bacteria in a 

sputum specimen. Part of the specimen is stained and examined 

microscopically on a glass slide, and part is inoculated 

on a culture medium and allowed to incubate for more spe- 

cific examination later. Also called a sputum culture and 

sensitivity test and smear. 

bacteriologist /baktirē·olYjist/, a specialist in the scientific 

study of bacteria. 

bacteriology /-olYjē/ [Gk, bakterion logos, science], 

the scientific study of bacteria. 

bacteriolysin /baktirē·Ylīsin/ [Gk, bakterion lyein, to 

loosen], an antibody that causes the breakdown of a particular 

species of bacterial cell. Complement is usually also 

necessary for this reaction. See also bacteriolysis. 

bacteriolysis /baktirē·olYsis/, the intracellular or extracellular 

breakdown of bacteria, resulting in the release of the 

cell’s contents. See also bacteriolysin. —bacteriolytic, 

adj. 

bacteriophage /baktirē·Yfāj/ [Gk,bakterion phagein, to 

eat], any virus that infects host bacteria, including the 

blue-green algae. Bacteriophages resemble other viruses in 

that each is composed of either ribonucleic acid (RNA) or 

deoxyribonucleic acid (DNA). They vary in structure from 

simple fibrous bodies to complex forms with contractile 

“tails.” Bacteriophages associated with temperate bacteria 

may be genetically intimate with the host and are named for 

the bacterial strain for which they are specific, such as 

coliphage and corynebacteriophage. —bacteriophagic, adj., 

bacteriophagy /-ofYjē/, n. 

bacteriophage typing, the process of identifying a species 

of bacterium according to the type of virus that attacks 

it. 

bacteriophagic, bacteriphagy. See bacteriophage. 

bacteriospermia /baktirēYspurmē·Y/, the presence of 

bacteria in semen or ejaculate. 

bacteriostasis /baktirē·ostYsis/ [Gk, bakterion Gk, stasis, 

standing still], a state of suspended growth and/or reproduction 

of bacteria. Compare bactericide. —bacteriostatic, 

adj. 

bacterium. See bacteria. 

bacteriuria /baktirēyoo ˘ rē·Y/, the presence of bacteria in 

the urine. The presence of more than 100,000 pathogenic 

bacteria per milliliter of urine is usually considered significant 

and diagnostic of urinary tract infection. Bacteriuria 

may be asymptomatic. See also urinary tract infection. 

bacteroid /baktYroid/, 1. pertaining to or resembling bacteria. 

2. a structure that resembles a bacterium. Also bacterioid 

/baktirē·oid/, —bacteroidal, bacterioidal, adj. 

Bacteroides /baktYroidēz/ [Gk, bakterion, small staff, 

eidos, form], a genus of obligate anaerobic bacilli normally 

found in the colon, mouth, genital tract, and upper respiratory 

system. Severe infection may result from the invasion 

of the bacillus through a break in the mucous membrane 

into the venous circulation, where thrombosis and bacteremia 

may occur. Foul-smelling abscesses, gas, and putrefaction 

are characteristic of infection with this organism. Of the 

30 species, Bacteroides fragilis is the most common and 

most virulent. 

Bactrim, trademark for a fixed-combination drug containing 

two antibiotics (sulfamethoxazole and trimethoprim) 

commonly prescribed to treat urinary tract infection. 

BAER, abbreviation for brainstem auditory evoked response. 

baffling, the process of removing large water particles 

from suspension in a jet nebulizer so that the particles entering 

the patient’s airways are of a uniform therapeutic size. 

The function may be performed in part by a perforated plate 

against which liquid particles impinge and fracture and are 

reflected into the vapor chamber of the nebulizer. 

bag [AS, baelg], a flexible or dilatable sac or pouch designed 

to contain gas, fluid, or semisolid material such as

agasse 185 balanced traction 

crushed ice. An Ambu bag or breathing bag is used to control 

the flow of respiratory gases entering the lungs of a patient. 

Several types of bags are used in medical or surgical procedures 

to dilate the anus, vagina, or other body openings. 

bagasse /bYgas/ [Fr, cane trash], the crushed fibers or the 

residue of sugarcane, a source of the thermophilic actinomycetes 

antigen that is a cause of bagassosis hypersensitivity 

pneumonitis. 

bagassosis /bagYsōsis/, a self-limited lung disease caused 

by an allergic response to bagasse, the fungi-laden, dusty debris 

left after the syrup has been extracted from sugarcane. It 

is characterized by fever, dyspnea, and malaise. 

bagging informal. the artificial ventilation performed with 

a respirator bag, such as an Ambu bag or the reservoir bag on 

an anesthesia machine. The bag is squeezed to deliver air to 

the patient’s lungs through a mask, an endotracheal tube, or 

another breathing device. During general anesthesia the 

anesthetist may use this technique to assist or control the respiration 

of an unconscious patient. 

bag lady/man, a homeless indigent woman or man who 

carries all personal possessions in a portable container. 

bag of waters, the membranous sac of amniotic fluid surrounding 

the fetus in the uterus of a pregnant woman. See 

amnion. 

bag-valve-mask resuscitator, a device consisting of a 

manually compressible container with a plastic bag of oxygen 

at one end and at the other a one-way valve and mask 

that fit over the mouth and nose of the person to be resuscitated. 

See also Ambu bag. 

Bag-valve-mask resuscitators 

(Sanders et al, 2007) 

Bainbridge reflex [Francis A. Bainbridge, English physiologist, 

1874–1921], a cardiac reflex in which stimulation of 

stretch receptors in the wall of the left atrium causes an increased 

pulse rate. It may be triggered by the infusion of 

large amounts of IV fluids or by backflow of blood in congestive 

heart failure. 

Baker’s cyst [William M. Baker, British surgeon, 1839– 

1896], a synovial cyst that forms at the back of the knee. It 

is often associated with rheumatoid arthritis and may appear 

only when the leg is straightened. 

baker’s itch [AS, giccan, to bake], a rash that may develop 

on the hands and forearms of bakery workers, probably 

as an allergic reaction to flours or other ingredients in 

bakery products. 

BAL, 1. abbreviation for British antilewisite. See 

dimercaprol. 2. abbreviation for bronchoalveolar lavage. 

balance 1 [L, bilanx, having two scales], 1. an instrument 

Baker’s cyst (Moll, 1997) 

for weighing. 2. a normal state of physiologic equilibrium. 

3. a state of mental or emotional equilibrium. 4. to bring 

into equilibrium. 

balance 2 , a nursing outcome from the Nursing Outcomes 

Classification (NOC) defined as ability to maintain body 

equilibrium. See also Nursing Outcomes Classification. 

balanced anesthesia, a highly variable technique of general 

anesthesia using narcotic analgesics, muscle relaxation, 

and minimal inhalation agent and nitrous oxide to render the 

patient unconscious. 

balanced articulation, simultaneous contact between the 

upper and lower teeth as they glide over each other when the 

mandible is moved laterally. See also balanced occlusion. 

balanced diet, a diet containing adequate energy and all of 

the essential nutrients that cannot be synthesized in adequate 

quantities by the body, in amounts adequate for growth, energy 

needs, nitrogen equilibrium, repair, and maintenance of 

normal health. 

balanced forearm orthosis (BFO). See mobile arm 

support. 

balanced occlusion, simultaneous contact between the 

upper and lower teeth on both sides and in the anterior and 

posterior occlusal areas of the jaws. An appropriate dental 

prosthesis develops, such as an occlusion, to prevent the 

denture base from tipping or rotating in relation to the supporting 

structures. This term is primarily associated with intraoral 

assessment of occlusal harmony but may also be used 

in the process of pretesting the occlusion while the dentures 

are mounted on casts attached to an anatomic articulator. See 

also balanced articulation. 

balanced polymorphism, in a population, the occurrence 

of a certain proportion of homozygotes and heterozygotes 

for specific genetic traits, which is maintained from generation 

to generation by the forces of natural selection. Compare 

genetic polymorphism. 

balanced suspension, a system of splints, ropes, slings, 

pulleys, and weights for suspending the lower extremities of 

the body, used as an aid to realignment and healing from 

fractures or from surgical intervention. See also lower extremity 

suspension, upper extremity suspension. 

balanced traction, a system of balanced suspension that 

supplements traction in the treatment of fractures of the

alanced translocation 186 Balint’s syndrome 

Trapeze 

Thomas splint 

Sling 

Half-Ring Pearson 

attachment 

Balanced suspension 

(Elkin, Perry, and Potter, 2007) 

Foot 

plate 

Skeletal 

traction 

weight 

lower extremities or after various operations affecting the 

lower parts of the body that require traction. 

balanced translocation, the transfer of segments between 

nonhomologous chromosomes in such a way that the configuration 

and total number of chromosomes change but 

each cell contains the normal amount of diploid or haploid 

genetic material. Usually the long arm of an acrocentric 

chromosome is transferred to another chromosome, and the 

small fragment containing the centromere is lost, leaving 

only 45 chromosomes. A person with a balanced translocation 

is phenotypically normal but may produce children with 

trisomies. Compare reciprocal translocation, robertsonian 

translocation. 

balancing side, the side of the mouth opposite the 

working side (predominant chewing side) of dentition or a 

denture. 

balanic /bYlanik/ [Gk, balanos, acorn], pertaining to the 

glans penis or the glans clitoridis. 

balanic hypospadias. See glandular hypospadias. 

balanitis /balYnītis/ [Gk, balanos itis], inflammation 

of the glans penis. 

balanitis diabetica, an inflammation of the glans penis or 

glans clitoridis caused by the sugar content of the urine and 

commonly seen in persons with diabetes. 

balanitis xerotica obliterans /zirotikY oblitYrans/ [Gk, 

balanos itis xeros, dry, tokos, labor; L, obliterare, to efface], 

a chronic skin disease (lichen sclerosis et 

atrophicus) of the glans penis, characterized by a white indurated 

area surrounding the meatus, that may result in urethral 

stenosis. Local antibacterial and antiinflammatory agents are 

used to treat it. 

balano-, balan-, combining form meaning “the head of 

the penis in males; may also mean the glans clitoris in females”: 

balanoplasty, balanitis. 

balanoplasty /balYnōplastē/ [Gk, balanos plassein, to 

mold], an operation involving plastic surgery of the glans 

penis to correct a congenital defect or to serve an aesthetic 

purpose. 

balanoposthitis /balYnōposthītis/ [Gk, balanos posthe, 

penis, foreskin, itis], a generalized inflammation of the 

glans penis and prepuce in uncircumcised males, usually 

Balanitis (Callen et al, 2000) 

caused by poorly retractile foreskin and poor hygiene. It is 

characterized by soreness, irritation, and discharge, which 

occur as a complication of bacterial or fungal infection. 

Smear and culture can determine the causative agent—often 

a common venereal disease—so that specific antimicrobial 

therapy can then be instituted. Circumcision may be considered 

in severe cases. To relieve discomfort, the inflamed area 

can be irrigated with a warm saline solution several times 

a day. 

balanopreputial /balYnōpripyoo ¯¯¯¯shYl/ [Gk, balanos L, 

praeputium, foreskin], pertaining to the glans penis and 

the prepuce. 

balanorrhagia /balYnōrājē·Y/ [Gk, balanos rhegnynai, 

to burst forth], balanitis in which pus is discharged copiously 

from the penis. 

balantidiasis /balYntidīYsis/, an infection caused by ingestion 

of cysts of the protozoan Balantidium coli, the largest 

human protozoan. Pigs are the animal reservoir. In some 

cases the organism is a harmless inhabitant of the large intestine, 

but infection with B. coli usually causes diarrhea. Infrequently 

the infection progresses, and the protozoan invades 

the intestinal wall and produces ulcers or abscesses, which 

may cause dysentery and death. The majority of infections in 

immunocompromised patients are asymptomatic. Diagnosis 

is made by identification of trophozoites in the stool or in 

sampled colonic tissue. Tetracycline, iodoquinol, or metronidazole 

is usually prescribed to treat the infection. 

Balantidium coli /balYntidē·Ym/ [Gk, balantidion, little 

bag, kolon, colon], the largest and the only ciliated protozoan 

species that is pathogenic to humans, causing balantidiasis. 

The organism is seen in two life stages: the motile trophozoite 

and the encysted cercaria. It is a normal inhabitant 

of the domestic hog and is transmitted to humans by the ingestion 

of cysts excreted in hog feces), occurring either during 

direct contact with pigs, handling of fertilizer that contains 

pig excrement, or contact with a water supply 

contaminated with excrement. 

baldness [ME, balled], absence of hair, especially from the 

scalp. See also alopecia. 

BAL in Oil, trademark for a heavy metal antagonist 

(dimercaprol). 

Balint’s syndrome [Rudolph Balint, Hungarian neurologist, 

1874–1929], a group of visual symptoms characterized by 

simultaneous anagnosia and optic ataxia. The patient experiences 

nystagmus, or loss of control of eye movements, and

Balkan traction frame 187 ball-valve action 

the inability to perceive all parts of a scene simultaneously. 

The patient may begin to follow a moving object but lose 

it. The cause is bilateral disease of the parietotemporal areas 

of the brain. 

Balkan traction frame, an overhead, rectangular frame 

attached to the bed and used for attaching splints, suspending 

or changing the position of immobilized limbs, or providing 

continuous traction with weights and pulleys. 

Balkan tubulointerstitial nephritis /too ¯¯¯¯byYlō·intYrstish-Yl/, 

a chronic kidney disorder marked by renal insufficiency, 

proteinuria, tubulointerstitial nephritis, and anemia. 

The onset is gradual, but end-stage disease occurs within 5 

years after the first signs. About one third of the patients also 

suffer from urinary tract cancers. The disease is endemic in 

the Balkans but is not hereditary. 

ball [ME, bal], spherical object, such as one of the collagen 

balls embedded in hyaline cartilage. 

Ballance’s sign [Charles A. Ballance, English surgeon, 

1856–1936], a dull percussion resonance sound heard on 

the right flank of a patient lying in the left decubitus position, 

an indication of a ruptured spleen. The sound is caused by an 

accumulation of liquid blood on the right side and coagulated 

blood on the left. 

ball-and-socket joint, a synovial or multiaxial joint in 

which the globular (ball-shaped) head of an articulating bone 

is received into a cuplike cavity, allowing the distal bone to 

move around an indefinite number of axes with a common 

center, such as in hip and shoulder joints. Also called enarthrosis, 

spheroidea. Compare condyloid joint, pivot joint, 

saddle joint. See also joint. 

ball-bearing feeder. See mobile arm support. 

ball-catcher position, a position of the hands used in 

making a radiograph to diagnose rheumatoid arthritis. The 

hands are held with the palms upward and the fingers 

cupped, as if to catch a ball. 

Baller-Gerold syndrome /bälYr garōlt/ [Friedrich Baller, 

German physician, 20th century; M. Gerold, German physician, 

20th century], an autosomal recessive syndrome 

characterized by craniosynostosis and absence of the radius. 

ballism. See ballismus. 

ballismus /bôlizmYs/ [Gk, ballismo, dancing], an abnormal 

neuromuscular condition characterized by uncoordinated 

swinging of the limbs and jerky movements. Ballism is 

associated with extrapyramidal disorders such as Sydenham’s 

chorea. The condition may occur in a unilateral form 

as hemiballismus. Also called ballism. 

ballistic movement /bYlistik/, a high-velocity musculoskeletal 

movement, such as a tennis serve or boxing punch, 

requiring reciprocal coordination of agonistic and antagonistic 

muscles. 

ballistics /bYlistiks/ [Gk, ballein, to throw], the study of 

the motion, trajectory, and impact of projectiles, including 

bullets and rockets. 

ballistocardiograph [Gk, ballein, to throw, kardia, heart, 

graphein, to record], an apparatus for recording body 

movements caused by the thrust of the heart during systolic 

ejection of the blood into the aorta and the pulmonary arteries. 

It has been used in measuring cardiac output and the 

force of contraction of the heart. 

ballistocardiography /balistōkärdē·ogrYfē/, the recording 

of body movements in reaction to the beating of the heart 

and the circulation of the blood. 

ball of the foot, the part of the foot composed of the distal 

heads of the metatarsals and their surrounding fatty fibrous 

tissue pad. 

balloon angioplasty /bYloo ¯¯¯¯n/, a method of dilating or 

opening an obstructed blood vessel by threading a small, 

balloon-tipped catheter into the vessel. The balloon is inflated 

to compress arteriosclerotic lesions against the walls 

of the vessel, leaving a larger lumen, through which blood 

can pass. It is used in treating arteriosclerotic heart disease. 

Balloon angioplasty 

(Thibodeau and Patton, 2007) 

balloon compression, a percutaneous therapy for trigeminal 

neuralgia. A balloon is inflated to compress the gasserian 

ganglion and produce trigeminal injury. 

ballooning degeneration hydropic degeneration. See 

granular degeneration. 

balloon septostomy. See Rashkind procedure. 

balloon tamponade [Fr, tamponnade], a procedure in 

which a device consisting of a flexible tube and two balloons 

is inserted into a passageway and the balloons are expanded 

to restrict the flow of blood or to force open a stenosis. See 

also balloon angioplasty. 

balloon-tip catheter, a catheter bearing a nonporous inflatable 

sac around its far end. After insertion of the catheter 

the sac can be inflated with air or sterile water, introduced 

via injection into a special port at the near end of the catheter. 

The inflated sac secures the catheter in the correct position. 

See also Foley catheter, Swan-Ganz catheter. 

ballottable /bYlotYbYl/ [Fr, balloter, a shaking about], 

pertaining to a use of palpation to detect movement of objects 

suspended in fluid, such as a fetus in amniotic fluid, or 

the patella bumping against the femur. See also ballottement. 

ballottable head [Fr, ballotage, shaking up], a floating 

fetal head; a fetal head that has not descended and has not 

become fixed in the maternal bony pelvis. 

ballottement /bälôtmäN, bYlotment/ [Fr, tossing], 

a technique of palpating an organ or floating structure by 

bouncing it gently and feeling it rebound. Ballottement of a 

fetus within a uterus is a probable objective sign of pregnancy. 

In late pregnancy a fetal head that can be ballotted is 

said to be floating or unengaged, as differentiated from a 

fixed or an engaged head, which cannot be easily dislodged 

from the pelvis. 

ball thrombus, a relatively round, coagulated mass of 

blood, containing platelets, fibrin, and cellular fragments, 

that may obstruct a blood vessel or an orifice, usually the mitral 

valve of the heart. 

ball-valve action, the intermittent opening and closing of 

an orifice by a buoyant, ball-shaped mass, which acts as a 

valve. Some kinds of objects that may act in this manner are 

kidney stones, gallstones, and blood clots.

alm 188 Banti’s syndrome 

balm /bäm/ [Gk, balsamon, balsam], 1. a healing or a 

soothing substance, such as any of various medicinal ointments. 

2. an aromatic plant of the genus Melissa that relieves 

pain. Also called balsam. 

balneology /balnē·olYjē/ [L, balneum, bath; Gk, logos, science], 

a field of medicine that deals with the chemical 

compositions of various mineral waters and their healing 

characteristics, especially in baths. —balneologic, adj. 

balneotherapy /balnē·ōtherYpē/ [L, balneum Gk, 

therapeia, treatment], use of baths in the treatment of 

many diseases and conditions. 

balneum pneumaticum. See air bath. 

balsalazide /bal-salah-zīd/, a prodrug of the antiinflammatory 

mesalamine, to which it is converted in the colon; administered 

orally as the disodium salt in the treatment of ulcerative 

colitis. 

balsam /bôlsYm/ [Gk, balsamon], 1. any of a variety of 

resinous saps, generally from evergreens, usually containing 

benzoic or cinnamic acid. Balsam is sometimes used in rectal 

suppositories and dermatologic agents as a counterirritant. 

2. See balm. 

Baltimore Longitudinal Study of Aging (BLSA), 

a long-range examination of interrelations between multiple 

correlates of aging. Although men of varied backgrounds 

were selected for the original study (1955) in order to explore 

uncontrolled factors that might lead to new knowledge 

regarding aging, the BLSA now includes both men and 

women. 

-bamate, combining form designating a propanediol or 

pentanediol derivative. 

Bamberger’s sign [Heinrich Bamberger, Austrian physician, 

1822–1888], 1. a neural disorder characterized by 

the feeling of a tactile stimulation at a corresponding point 

on the opposite side of the body (known as allochiria). 

2. pericardial effusion signs at the level of the scapula that 

disappear when the patient leans forward. 

bamboo spine /bamboo ¯¯¯¯/ [Malay, bambu], (in radiology) 

the appearance of the thoracic or lumbar spine with rigid 

characteristics of advanced ankylosing spondylitis. Also 

called poker spine. See also ankylosing spondylitis. 

band [ME, bande, strip], 1. (in anatomy) a bundle of fibers, 

as seen in tendon or striated muscle, that encircles a 

structure or binds one part of the body to another. 2. (in dentistry) 

a strip of metal that fits around a tooth and serves as 

an attachment for orthodontic components. Also called stab 

form. 3. informal. the immature form of a segmented granulocyte 

characterized by a sausage-shaped nucleus. It is the 

only immature leukocyte normally found in the peripheral 

circulation. Bands represent 3% to 5% of the total white cell 

number. An increase in the relative number of bands indicates 

bacterial infection or acute stress to the bone marrow. 

band adapter, an instrument for aiding in the fitting of a 

circumferential orthodontic band to a tooth. 

bandage /bandij/ [ME, bande, strip], 1. a strip or roll of 

cloth or other material that may be wound around a part of 

the body in a variety of ways to secure a dressing, maintain 

pressure over a compress, or immobilize a limb or other 

part of the body. See also cravat bandage. 2. to apply a 

bandage. 

bandage shears, a sturdy pair of scissors used to cut 

through bandages. The blades of most bandage shears are 

angled to the shaft of the instrument, and the lower blade is 

rounded and blunt to facilitate insertion under the bandage 

without harming the patient’s skin. Also called bandage 

scissors. 

band cell, a developing granular (immature) leukocyte in 

circulating blood, characterized by a curved or indented 

Figure-eight bandage for the ankle 

(Young and Proctor, 2007) 

nucleus. Band cells are intermediate leukocytic forms between 

metamyelocytes and adult leukocytes with segmented 

nuclei. 

band heterotopia, an anomaly of the cerebral cortex in 

which a heterotopic band of gray matter is found between 

the lateral ventricles and the cortex; affected patients may 

have mental retardation or epilepsy. 

banding [ME, bande, strip], any of several techniques of 

staining chromosomes with fluorescent stains or chemical 

dyes that produce a series of transverse light and dark areas 

whose intensity and position are characteristic of each chromosome. 

Banding patterns are identified as C-banding, 

G-banding, Q-banding, or R-banding according to the staining 

technique used. Also called chromosome banding. 

Bandl’s ring. See pathologic retraction ring. 

bandpass, (in radiology) a measure of the number of times 

per second an electron beam can be modulated, expressed as 

Hertz (Hz). It is a factor that influences horizontal resolution 

on a cathode-ray tube. The higher the bandpass, the greater 

the horizontal resolution. Also called bandwidth. 

band pusher, an instrument used for seating metal circumferential 

orthodontic bands into correct position on a tooth. 

band remover, an instrument used to help take circumferential 

orthodontic bands off teeth. 

bandwidth, 1. the range of frequencies that can be satisfactorily 

transmitted or processed by a system. 2. See 

bandpass. 

bang. See bhang. 

Bangkok hemorrhagic fever. See dengue fever. 

bank blood [It, banca, bench; AS, blod], anticoagulated 

preserved blood collected from donors usually in units of 

500 mL and stored under refrigeration for future use. Dated 

and identified as to blood type, it is stored for a usual maximum 

period of 21 days. Bank blood may be used in transfusion 

after crossmatching against the recipient’s blood or for 

the extraction and preparation of any of its components. See 

also packed cells, pooled plasma, whole blood. 

Banting, Sir Frederick G. [Canadian physician, 1891– 

1941], co-winner, with John J. Macleod, of the 1923 

Nobel prize for medicine and physiology for their research, 

with the Canadian physiologist Charles H. Best, showing the 

link between the pancreas and insulin in the control of diabetes. 

See also Macleod, John J. 

Banti’s syndrome /bantēz/ [Guido Banti, Italian pathologist, 

1852–1925], a chronic, progressive disorder involving 

several organ systems, characterized by portal hypertension, 

splenomegaly, anemia, leukopenia, GI tract bleeding, 

and cirrhosis of the liver. Obstruction of the blood vessels

BAO 189 Barker, Phil 

that lie between the intestines and the liver leads to venous 

congestion, enlargement of the spleen, and abnormal destruction 

of red and white blood cells. Early symptoms are 

weakness, fatigue, and anemia. Surgical removal of the 

spleen and creation of a portacaval shunt to improve portal 

circulation are sometimes necessary. Since the syndrome is 

often a complication of alcoholic cirrhosis of the liver, medical 

treatment includes prescribing improved nutrition, vitamins, 

abstinence from alcohol, and rest. Also called Banti’s 

syndrome. See also congestive splenomegalia, cirrhosis, 

portacaval shunt, portal hypertension. 

BAO, abbreviation for basal acid output. 

bar, (in physical science) a measure of air pressure. It is 

equal to 1000 millibars, or 10 6 dyne/cm 2 , or approximately 1 

standard atmosphere (1 atm). Also called barye. 

bar-. See baro-. 

Baraclude, a trademark for entecavir. 

baralyme /berYlīm/ [Gk, barys, heavy; AS, lim, lime], 

a mixture of calcium and barium compounds used to absorb 

exhaled carbon dioxide in an anesthesia rebreathing system. 

Bárány’s test. See caloric test. 

-barb, combining form designating a barbituric acid derivative. 

Barbados cherry. See acerola. 

barber’s itch. See sycosis barbae. 

barbiturate /bärbichoo ˘ rāt, -Yrit/ [Saint Barbara, drug discovered 

on day of the saint, 1864], a derivative of barbituric 

acid that acts as a sedative or hypnotic. These derivatives 

act by depressing the respiratory rate, blood pressure, temperature, 

and central nervous system. They have great addiction 

potential. Some barbiturates are used in anesthesia and 

in treatment of seizures. 

barbiturate coma [Ger, Saint Barbara’s Day, Gk, koma, 

deep sleep], an effect of barbituric acid or its derivatives, 

which may be rapid-acting sedatives, hypnotics, and respiratory 

depressants. Barbiturate coma may be intentionally induced 

for the treatment of some neurologic conditions. 

Death may result from intentional or accidental overdosage. 

barbiturate poisoning. See barbiturism. 

-barbituric, combining form used to designate compounds 

derived from barbituric acid: dibromobarbituric, 

isobarbituric. 

barbiturism /bärbichYrizYm/, 1. acute or chronic poisoning 

by any of the derivatives of barbituric acid. Ingestion 

of such preparations in excess of therapeutic quantities may 

be fatal or may produce physiologic, pathologic, and psychologic 

changes, such as depressed respiration, cyanosis, 

disorientation, and coma. Also called barbiturate poisoning. 

2. addiction to a barbiturate. 

bar clasp arm, (in prosthetic dentistry) a clasp arm that 

originates from a denture base and serves as an extracoronal 

retainer. 

Bardeleben’s bone. See os trigonum. 

Bard-Pic syndrome /bärdpik/ [Louis Bard, French anatomist, 

1857–1930; Adrian Pic, French physician, b. 1863], 

a condition characterized by progressive jaundice, enlarged 

gallbladder, and cachexia, associated with advanced pancreatic 

cancer. 

Bard’s sign [Louis Bard], the increased oscillations of the 

eyeball in organic nystagmus when the patient tries to visually 

follow a target moved from side to side across the line of 

sight. Such oscillations usually cease during the same test if 

the patient has congenital nystagmus. 

bare lymphocyte syndrome, an immune deficiency condition 

caused by defective beta-2 microglobulin, one of the 

major histocompatibility antigens on cell surfaces. It is inherited 

as an autosomal recessive trait. The deficiency causes 

a severe combined immunodeficiency resulting from the 

lack of antigen presentation by type I and/or type II major 

histocompatibility complex. 

baresthesia /bäresthēzhY/, sensitivity to weight or 

pressure. 

bar graph [OF, barre], a graph in which frequencies are 

represented by bars extending from the ordinate or the abscissa, 

allowing the distribution of the entire sample to be 

seen at once. 

bariatrics /berē·atriks/ [Gk, baros, weight, iatros, physician], 

the field of medicine that focuses on the treatment 

and control of obesity and diseases associated with obesity. 

bariatric surgery, surgery on part of the GI tract as a 

treatment for morbid obesity. 

baritosis /berYtōsis/, a benign form of pneumoconiosis 

caused by an accumulation of barium dust in the lungs. 

Barium does not cause fibrosis and is not a common cause of 

functional impairment. The condition is most likely to affect 

persons involved in the mining and processing of barite, a 

barium-containing compound used in the manufacture of 

paints. 

barium (Ba) /berē·Ym/ [Gk, barys, heavy], a pale yellow, 

metallic element classified with the alkaline earths. Its 

atomic number is 56; its atomic mass is 137.36. The acidsoluble 

salts of barium are poisonous. Barium carbonate, 

formerly used in medicine, is now used to prepare the cardiac 

stimulant barium chloride; fine, milky barium sulfate is 

used as a contrast medium in radiographic imaging of the digestive 

tract. 

barium enema, a rectal infusion of barium sulfate, a radiopaque 

contrast medium, which is retained in the lower intestinal 

tract during roentgenographic studies for diagnosis 

of obstruction, tumors, or other abnormalities, such as ulcerative 

colitis. The procedure is used therapeutically in children 

to reduce nonstrangulated intussusception. Also called 

contrast enema. 

barium enema with air contrast. See double-contrast 

barium enema. 

barium meal, the ingestion of barium sulfate, a radiopaque 

contrast medium, for the radiographic examination 

of the esophagus, stomach, and intestinal tract in the diagnosis 

of such conditions as dysphagia, peptic ulcer, and fistulas. 

The movement of the barium through the GI tract is followed 

by fluoroscopy, x-ray studies, or both. Before the test, 

the patient receives nothing by mouth for at least 8 hours. 

See also barium swallow. 

barium poisoning, a condition characterized by a severe, 

rapid decrease in plasma potassium levels and a shift of potassium 

into cells caused by the ingestion of soluble barium 

salts. The patient may experience nausea, vomiting, abdominal 

cramps, bloody diarrhea, dizziness, arrhythmias, ringing 

in the ears, cardiac arrest, and respiratory failure. 

barium sulfate, a radiopaque medium used as a diagnostic 

aid in radiology. 

INDICATION: It is prescribed for x-ray examination of the 

GI tract. 



ADVERSE EFFECTS: Among the more serious complications 

is severe constipation. 

barium swallow [Gk, barys, heavy; AS, swelgan, to swallow], 

the oral administration of a radiopaque barium sulfate 

suspension given to radiographically demonstrate possible 

defects in the esophagus and abnormal borders of the 

posterior aspects of the heart. See also barium meal. 

Barker, Phil, a nursing theorist who developed the Tidal 

Model of Health Recovery for psychiatric and mental health

Barlow’s disease 190 barrel chest 

Barium enema 

(Kowalczyk and Mace, 2009/Courtesy Ohio State University Medical 

Center) 

nursing. Psychiatric patients often feel that they are drowning 

in the flux of constant change and need rescue. Their life 

stories, or experiences, must be carefully evaluated to determine 

what resources they have for recovery and what kind of 

support is needed from and for the nurses who are caring for 

the patients. 

Barlow’s disease. See infantile scurvy. 

Barlow’s syndrome [John B. Barlow, South African cardiologist, 

b. 1924], an abnormal cardiac condition characterized 

by an apical systolic murmur, a systolic click, and an 

electrocardiogram indicating inferior ischemia. These signs 

are associated with mitral regurgitation caused by prolapse 

of the mitral valve. Also called floppy-valve syndrome. See 

also mitral valve prolapse. 

Barnard, Kathryn E. [b. 1938], a nursing theorist who 

developed the Child Health Assessment Interaction Model. 

Her model and theory were the outcome of the Nursing 

Child Assessment Project (1976–1979). Barnard believes 

that the parent-infant system is influenced by individual 

characteristics of each member. Those characteristics are 

modified to meet the needs of the system by adaptive behavior. 

The interaction between parent (or caregiver) and child 

is shown in Barnard’s model to take place with five cues and 

activities: (1) the infant’s clarity in sending cues; (2) the infant’s 

responsiveness to the parent; (3) the parent’s sensitivity 

to the child’s cues; (4) the parent’s ability to recognize 

and alleviate the infant’s distress; and (5) the parent’s social, 

emotional, and cognitive growth-fostering activities. A 

major issue in Barnard’s theoretic assertions is that the nurse 

gives support to the mother’s sensitivity and response to her 

infant’s cues rather than trying to change her characteristics 

or mothering style. 

baro-, bar-, bari-, combining form meaning “pressure, 

heaviness, weight”: baresthesia, barognosis, bariatrics. 

barognosis /berYgnōsis/ pl. barognoses [Gk, baros, 

weight, gnosis, knowledge], the ability to perceive and 

evaluate weight, especially that held in the hand. 

barograph /berYgraf/ [Gk,baros graphein, to record], 

an instrument that continually monitors barometric pressure 

and records pressure changes on paper. 

barometer /bYromYtYr/ [Gk, baros metron, measure], 

an instrument for measuring atmospheric pressure, commonly 

consisting of a slender tube filled with mercury, 

sealed at one end, and inverted into a reservoir of mercury. 

At sea level the normal height of mercury in the tube is 760 

mm. At higher elevations the mercury column height (barometric 

pressure) is less. Fluctuations in barometric pressure 

may precede major changes in weather, making a barometer 

useful in meteorologic forecasting. —barometric, adj. 

barometric pressure. See atmospheric pressure. 

baroreceptor /berōriseptYr/ [Gk, baros L, recipere, to 

receive], one of the pressure-sensitive nerve endings in the 

walls of the atria of the heart, the aortic arch, and the carotid 

sinuses. Baroreceptors stimulate central reflex mechanisms 

that allow physiologic adjustment and adaptation to changes 

in blood pressure via changes in heart rate, vasodilation, or 

vasoconstriction. Baroreceptors are essential for homeostasis. 

Also called pressoreceptor. 

barosinusitis. See aerosinusitis. 

Barosperse, trademark for a radiopaque medium (barium 

sulfate). 

barotitis. See aerotitis. 

barotitis media. See aerotitis media. 

barotrauma /berōtrômY, -troumY/ [Gk, baros trauma, 

wound], physical injury sustained as a result of exposure 

to changing air pressure, or rupture of the tympanic membranes, 

as may occur among scuba divers or caisson workers 

or anyone near nuclear or atomic blasts. Barotrauma may be 

iatrogenic as in the case of excessive ventilator pressures 

leading to lung injury. Compare decompression sickness. 

Barr body. See sex chromatin. 

barrel chest, a large, rounded thorax, as in the inspiratory 

phase, considered normal in some stocky individuals and 

certain others who live in high-altitude areas and consequently 

have increased vital capacity. Barrel chest may also 

be a sign of pulmonary emphysema. Also called emphysematous 

chest. 

Barrel chest (Swartz, 2006)

arrel distortion 191 Bartholin’s cyst 

barrel distortion, outward bowing of gridded straight 

lines in an image, resulting from lens distortion such that the 

lateral magnification at the center of the image is greater 

than that at the edges. 

Barr-Epstein virus. See Epstein-Barr virus. 

Barré’s pyramidal sign /bärāz/ [Jean A. Barré, French 

neurologist, 1880–1971], a diagnostic sign indicating a 

disease of the pyramidal tracts. The patient lies face down 

and the legs are flexed at the knee. The patient is unable to 

maintain this position. 

Barrett’s esophagus [Norman R. Barrett, English surgeon, 

1903–1979], a disorder of the lower esophagus marked by 

a benign ulcerlike lesion in columnar epithelium, resulting 

most often from chronic irritation of the esophagus by gastric 

reflux of acidic digestive juices. Major symptoms include 

dysphagia, decreased lower esophageal (LES) pressure, 

and heartburn. Symptoms may be relieved by eating 

frequent small meals, avoiding foods that produce gas, taking 

antacid medication, and elevating the head of the bed to 

prevent passive reflux when lying down. Treatment consists 

of proton pump inhibitors and H 2 blockers. The lesion is 

considered premalignant, and surveillance endoscopy is performed 

to screen for esophageal cancer. Also called Barrett’s 

syndrome. 

Barrett’s syndrome [Norman R. Barrett, English surgeon, 

1903–1979]. See Barrett’s esophagus. 

Barrett’s syndrome (Goldman et al, 2008) 

barrier /berē·Yr/ [ME, barrere], 1. a wall or other obstacle 

that can restrain or block the passage of substances. 

Barrier methods of contraception, such as the condom or cervical 

diaphragm, prevent the passage of spermatozoa into the 

uterus. Membranes and cell walls of body tissues function as 

screenlike barriers to permit the movement of water or certain 

other molecules from one side to the other while preventing 

the passage of other substances. Skin is an important 

barrier that protects against the entry of microorganisms and 

the exit of body fluids. Barriers in kidney tissues adjust automatically 

to regulate the retention or excretion of water 

and other substances according to the needs of organ systems 

elsewhere in the body. 2. something nonphysical that 

obstructs or separates, such as barriers to communication or 

compliance. 3. (in radiography) any device that intercepts 

beams of x-rays. A primary barrier is one that blocks the passage 

of the useful x-ray beam, such as the walls and floor. A 

secondary barrier is one that intercepts only leakage and 

scattered x-ray emissions. An example is the ceiling. 

barrier creams, ointments, lotions, and similar preparations 

applied to exposed areas of the skin to protect skin cells 

from exposure to various allergens, irritants, and carcinogens, 

including sunlight. 

barrier-free design [AS, freo, barreres; L, designare, to 

mark out], the design of homes, workplaces, and public 

buildings that allows physically challenged individuals to 

make regular use of such structures. 

barrier methods, contraceptive methods, such as 

condoms and diaphragms, in which a plastic or rubber barrier 

blocks passage of spermatozoa through the vagina or 

cervix. See discussion under contraception. 

Barsony-Koppenstein method, a procedure for making 

radiographic images of the cervical intervertebral foramina. 

Barthel Index (BI) [D.W. Barthel, twentieth century American 

psychiatrist], a disability profile scale developed by 

D.W. Barthel in 1965 to evaluate a patient’s self-care abilities 

in 10 areas, including bowel and bladder control. The patient 

is scored from 0 to 15 points in various categories, depending 

on his or her need for help, such as in feeding, 

bathing, dressing, and walking. 

bartholinian abscess. See Bartholin’s abscess. 

bartholinitis /bärtYlinītis/ [Caspar T. Bartholin, Danish 

anatomist, 1655–1738; Gk, itis], an inflammatory condition 

of one or both Bartholin’s glands, caused by bacterial 

infection. Usually the causative microorganism is a species 

of Streptococcus, Staphylococcus, or Escherichia coli, or a 

strain of gonococcus. The condition is characterized by 

swelling of one or both glands, pain, and development of an 

abscess in the infected gland. A fistula may develop from the 

gland to the vagina, anus, or perineum. Treatment includes 

local application of heat, often by soaking in hot water; antibiotics; 

or, if necessary, incision of the gland and drainage 

of the purulent material or excision of the entire gland and 

its duct. 

Bartholin’s abscess /bärtYlinz/ [Caspar T. Bartholin; L, 

abscedere, to go away], an abscess of the greater vestibular 

gland of the vagina. Also called bartholinian abscess. 

Bartholin’s cyst [Caspar T. Bartholin], a cyst that arises 

from one of the vestibular glands or from its ducts and fills 

with clear fluid that replaces the suppurative exudate characteristic 

of chronic inflammation. 

Bartholin’s cyst (Greer et al, 2001)

Bartholin’s duct 192 basal cell carcinoma 

Bartholin’s duct [Caspar T. Bartholin], the major duct of 

the sublingual salivary gland. 

Bartholin’s gland [Caspar T. Bartholin], one of two small 

mucus-secreting glands located on the posterior and lateral 

aspect of the vestibule of the vagina. Also called greater 

vestibular gland. 

Bartholin’s gland carcinoma [Caspar T. Bartholin], 

a rare malignancy that occurs deep in the labia majora. The 

tumor has overlying skin and some normal glandular tissue. 

The treatment and prognosis are the same as for squamous 

cell cancer of the vulva. 

Barton, Clara, (1821–1912), an American philanthropist, 

humanitarian, and founder of the American National Red 

Cross. During the U.S. Civil War, she was a volunteer nurse, 

often on the battlefield, and at its end she organized a bureau 

of records to help in the search for missing men. When the 

Franco-Prussian War erupted, she assisted in the organization 

of military hospitals in Europe in association with the 

International Red Cross. This experience led to her advocacy 

of the establishment of an American Red Cross organization, 

of which she became the first president. 

Bartonella /bärtYnelY/ [Alberto Barton, Peruvian bacteriologist, 

1871–1950], a genus of small gram-negative flagellated 

pleomorphic coccobacilli, some of which are opportunistic 

pathogens. Members of the genus infect red blood 

cells and the epithelial cells of the lymph nodes, liver, and 

spleen. They are transmitted at night by the bite of a sandfly 

of the genus Phlebotomus. Three species are considered important 

in human disease. B. bacilliformis, causes bartonellosis. 

Because of its distinctive appearance, it is easily identified 

on microscopic examination of a smear of blood 

stained with Wright’s stain. B. henselae is the causative 

agent of cat-scratch fever and bacillary angiomatosis. B. 

quintana causes trench fever and may cause peliosis of the 

liver. 

Bartonella henselae, the etiologic agent of cat-scratch 

fever. Feline infection results in chronic asymptomatic bacteremia, 

which may last up to 17 months. Approximately 

40% of cats are infected with the organism. Most human infections 

occur between September and February and follow 

a cat bite or scratch. 

bartonellosis /bärtYnYlōsis/, an acute infection caused by 

Bartonella bacilliformis, transmitted by the bite of a sandfly. 

It is characterized by fever, severe anemia, bone pain, and, 

several weeks after the first symptoms are observed, multiple 

nodular or verrucous skin lesions. The disease is endemic in 

the valleys of the Andes in Peru, Colombia, and Ecuador. 

The treatment usually includes chloramphenicol, penicillin, 

streptomycin, or tetracycline. Untreated, the infection is 

often fatal. Also called Carrión’s disease, Oroya fever, 

verruga peruana. 

Barton forceps. See obstetric forceps. 

Barton’s fracture [John R. Barton, American surgeon, 

1794–1871], a break in the distal articular surface of the 

radius, which may be accompanied by the dorsal dislocation 

of the carpus on the radius. 

Bartter’s syndrome /bärtYrz/ [Frederick C. Bartter, American 

physiologist, 1914–1983], a rare hereditary disorder, 

characterized by hyperplasia of the juxtaglomerular area and 

secondary hyperaldosteronism. Renin and angiotensin levels 

may be elevated, but blood pressure usually remains normal. 

Early signs in childhood are abnormal physical growth 

(dwarfism) and mental retardation, often accompanied by 

chronic hypokalemia and alkalosis. 

bary-, combining form meaning “heavy or difficult”: 

baryphonia. 

barye. See bar. 

basal /bāsYl/ [Gk, basis, foundation], pertaining to the 

fundamental or the basic, as basal anesthesia, which produces 

the first stage of unconsciousness, and the basal metabolic 

rate, which indicates the lowest metabolic rate; basal 

membrane. 

basal acid output (BAO), the minimum amount of gastric 

hydrochloric acid produced by an individual in a given 

period. Normal adult volume is 2 to 5 mEq/hr. It is used infrequently 

in the diagnosis of various diseases of the stomach 

and intestines, such as gastric ulcers and Zollinger- 

Ellison syndrome. 

basal anesthesia [Gk, basis, foundation, anaisthesia, lack of 

feeling], 1. a state of unconsciousness just short of complete 

surgical anesthesia in depth, in which the patient does 

not respond to words but reacts to pinprick or other noxious 

stimuli. 2. narcosis produced by injection or infusion of potent 

sedatives alone, without added narcotics or anesthetic 

agents. 3. also called narcoanesthesia. Any form of anesthesia 

in which the patient is completely unconscious, in contrast 

to awake anesthesia. 

basal body temperature, the temperature of the body 

under conditions of absolute rest, taken orally or rectally, 

after sleep and before the patient does anything, including 

getting out of bed, smoking a cigarette, moving around, talking, 

eating, or drinking. 

basal body temperature method of family planning, 

a natural method of family planning that relies on identification 

of the fertile period of the menstrual cycle by noting the 

rise in basal body temperature that occurs with ovulation. 

The progesterone-mediated rise is 0.5° to 1° F; rate and pattern 

vary greatly from woman to woman, and to some extent 

from cycle to cycle in any one woman. The woman keeps 

careful records over several cycles, taking her temperature at 

the same time every morning, before getting out of bed or 

doing anything else. She may take her temperature orally or 

rectally in the same way every day. Talking, getting up, 

smoking a cigarette, eating, or even moving about in bed 

may change the temperature. Many other factors may also 

affect the reading, including infection, stress, a bad night’s 

sleep, medication, or environmental temperature. If any of 

these factors is present, the woman notes them on her record. 

Abstinence is required to avoid pregnancy from 6 days before 

the earliest day that ovulation was noted to occur during 

the preceding 6 months until the third day after the rise in 

temperature in the current cycle. The days after that period 

are considered “safe” infertile days. Another way of calculating 

the possible beginning of the fertile days is to subtract 19 

days from the shortest complete menstrual cycle of the preceding 

6 months. The basal body temperature method is 

more effective when used with the ovulation method than is 

either method used alone. The combination of these methods 

is called the symptothermal method of family planning. 

Compare calendar method of family planning, ovulation 

method of family planning. 

basal bone, 1. (in prosthodontics) the osseous tissue of the 

mandible and the maxilla, except for the rami and the processes, 

which provides support for artificial dentures. 

2. (in orthodontics) the fixed osseous structure that limits the 

movement of teeth in the creation of a stable occlusion. 

basal cell, any one of the cells in the deepest layer of stratified 

epithelium; the base. 

basal cell acanthoma. See basal cell papilloma. 

basal cell carcinoma [Gk, basis L, cella, storeroom; Gk, 

karkinos, crab, oma, tumor], a malignant epithelial cell 

tumor that begins as a papule and enlarges peripherally, developing 

a central crater that erodes, crusts, and bleeds. Metastasis 

is rare, but local invasion destroys underlying and

asal cell papilloma 193 base-forming food 

adjacent tissue. It occurs most frequently in sun-exposed 

areas of the body, such as the face, ears, neck, scalp, shoulders, 

and back. The primary known cause of the cancer is excessive 

exposure to the sun or to radiation. Treatment is 

eradication of the lesion, often by electrodesiccation, laser, 

or cryotherapy. Lesions may also be treated with topical or 

injection chemotherapy or radiation. Also called basal cell 

epithelioma, basaloma, basiloma, carcinoma basocellulare, 

hair matrix carcinoma. See also rodent ulcer. 

Basal cell carcinoma (Swartz, 2006) 

basal cell papilloma. See seborrheic keratosis. 

basal energy expenditure (BEE). See basal metabolic 

rate. 

basal ganglia [Gk, basis ganglion, knot], the islands of 

gray matter, largely composed of cell bodies, within each cerebral 

hemisphere. The most important are the caudate 

nucleus, the putamen, the substantia nigra, the subthalamic 

nucleus, and the pallidum. The basal ganglia are surrounded 

by the rings of the limbic system and lie between the thalamus 

of the diencephalon and the white matter of the hemisphere. 

Basaljel, trademark for an antacid (aluminum carbonate 

gel). 

basal lamina [Gk, basis L, lamina, plate], a thin, noncellular 

layer of ground substance lying just under epithelial 

surfaces. Constituting the amorphous portion of the basement 

membrane, it can be examined with an electron microscope. 

Also called basement lamina. 

basal layer. See stratum basale. 

basal layer of endometrium, the deepest layer of the endometrium, 

which contains the blind ends of the uterine 

glands; the cells of this layer undergo minimal change during 

the sexual cycle. 

basal layer of epidermis. See stratum basale. 

basal membrane, a sheet of tissue that forms the outer 

layer of the choroid and lies just under the pigmented layer 

of the retina. It is composed of elastic fibers in an otherwise 

thin homogenous layer. 

basal metabolic rate (BMR), the amount of energy used 

in a unit of time by a fasting, resting subject to maintain vital 

functions. The rate, determined by the amount of oxygen 

used, is expressed in Calories consumed per hour per square 

meter of body surface area or per kilogram of body weight. 

Also called basal energy expenditure (BEE). See also 

Calorie. 

basal metabolism [Gk, basis metabole, change], 

the amount of energy needed to maintain essential body 

functions, such as respiration, circulation, temperature, peristalsis, 

and muscle tone. Basal metabolism is measured 

when the subject is awake and at complete rest, has not eaten 

for 14 to 18 hours, and is in a comfortable, warm environment. 

It is expressed as a basal metabolic rate, according to 

Calories per hour per square meter of body surface. See also 

Calorie. 

basal narcosis [Gk, basis, foundation, narkosis, a benumbing], 

a narcosis induced with sedatives in a surgical patient 

before general anesthetic is administered. It is less profound 

than that of general anesthesia. The patient is unresponsive 

to verbal stimuli but may respond to noxious stimuli. Also 

called basis narcosis. 

basaloid carcinoma /bāsYloid/ [Gk, basis eidos, form, 

karkinos, crab, oma, tumor], a rare transitional malignant 

neoplasm of the anal canal containing areas that resemble 

basal cell carcinoma of the skin. Basaloid carcinoma is rapidly 

invasive. Tumor may spread to the skin of the perineum. 

basaloma. See basal cell carcinoma. 

basal seat, (in dentistry) the oral structures that support a 

denture. See also basal seat outline. 

basal seat area. See stress-bearing area. 

basal seat outline, a profile on the oral mucous membrane 

or on a cast of the entire oral area to be covered by a denture. 

See also basal seat. 

basal temperature. See basal body temperature. 

basal temperature chart [Gk, basis, foundation; L, 

temperatura charta, paper], a daily temperature chart, 

usually including the temperature on awakening. A basal 

temperature chart is sometimes used by women to establish a 

date of ovulation, when the temperature may show a sudden 

increase. 

basal tidal volume, the amount of air inhaled and exhaled 

by a healthy person at complete rest, with all bodily functions 

at a minimal level of activity, adjusted for age, weight, 

and sex. See also tidal volume (TV). 

base [Gk, basis, foundation], 1. a chemical compound that 

increases the concentration of hydroxide ions in aqueous solution. 

See also acid, alkali. 2. a molecule or radical that 

takes up or accepts hydrogen ions. 3. an electron pair donor. 

4. the major ingredient of a compounded material, particularly 

one that is used as a medication. Petroleum jelly is frequently 

used as a base for ointments. 5. (in radiology) the 

rigid but flexible foundation of a sheet of x-ray film. The 

base is essentially transparent but is given a bluish tint during 

manufacture to reduce eyestrain of the radiologist viewing 

x-ray films. 

base analog [Gk, basis analogos, proportionate], 

a chemical analog of one of the purine or the pyrimidine 

bases normally found in RNA or DNA. 

Basedow’s goiter /bäsYdōz/ [Karl A. von Basedow, German 

physician, 1799–1854], a name for colloid goiter, which is 

an enlargement of the thyroid gland, characterized by the hypersecretion 

of thyroid hormone after iodine therapy. The 

condition causes increased basal metabolic rate, insomnia, 

and fine motor tremor. 

base excess, a measure of metabolic alkalosis or metabolic 

acidosis (negative value of base excess) expressed as the 

amount of acid or alkali needed to titrate 1 L of fully oxygenated 

blood to a pH of 7.40, the temperature being held at a 

constant 37° C and the PCO 2 at 40 mm Hg. 

base-forming food, a food that increases the pH of the 

urine. Base-forming foods mainly are fruits, vegetables, and

aseline 194 base ratio 

Temperature (°F) Day of Cycle 

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 

99.0 

.9 

.8 

.7 

.6 

.5 

.4 

.3 

.2 

.1 

98.0 

.9 

.8 

.7 

.6 

.5 

.4 

.3 

.2 

.1 

97.0 

dairy products, which are sources of sodium and potassium. 

Some foods that are acidic in their natural state may be converted 

to alkaline metabolites. 

baseline /bāslīn/ [Gk, basis L, linea], 1. a known value 

or quantity with which an unknown is compared when measured 

or assessed (e.g., baseline vital signs). 2. the patient‘s 

initial information at diagnosis or assessment against which 

later tests will be compared. 3. (in radiology) any of several 

basic anatomic planes or locations used for positioning purposes. 

They include the orbitomeatal, infraorbitomeatal, 

acanthomeatal, and glabellomeatal lines. 

baseline behavior, a specified frequency and form of a 

particular behavior during preexperimental or pretherapeutic 

conditions. 

baseline condition, an environmental condition during 

which a particular behavior reflects a stable rate of response 

before the introduction of experimental or therapeutic conditions. 

baseline fetal heart rate, the fetal heart rate pattern between 

uterine contractions. An electronic fetal monitor is 

used to detect abnormally rapid or slow rates (less than 110 

or more than 160 beats/min) at term. 

baseline pain, the average intensity of pain experienced 

for 12 or more hours in a 24-hour period. 

Basel Nomina Anatomica (BNA), an international system 

of anatomic terminology adopted at Basel, Switzerland. 

basement lamina. See basal lamina. 

basement membrane [Fr, soubassement, under base], 

the fragile noncellular layer that secures the overlying epithelium 

to the underlying tissue. It is the deepest layer, may 

contain reticular fibers, and can be selectively stained with 

silver stains. Also called basal lamina, basement lamina. 

base of gastric gland, the main part of a gastric gland interior 

to the neck. 

Biphasic pattern = Menstruation Restless sleep or other possible 

Monophasic pattern = Intercourse interference with temperature 

Basal temperature rise during ovulation 

(McKinney et al, 2005) 

base of renal pyramid, the part of a renal pyramid that is 

directed away from the renal sinus. 

base of the heart, the portion of the heart opposite the 

apex. It is superior and medially located. It forms the upper 

border of the heart, lies just below the second rib, and primarily 

involves the left atrium, part of the right atrium, and 

the proximal portions of the great vessels. 

base of the skull, the floor of the skull, containing the anterior, 

middle, and posterior cranial fossae and numerous foramina, 

such as the optic foramen, foramen ovale, foramen 

lacerum, and foramen magnum. 

base pair, a pair of nucleotides in the complementary 

strands of a DNA molecule that interact through hydrogen 

bonding across the axis of the helix. One of the nucleotides 

in each pair is a purine (either adenine or guanine), and the 

other is a pyrimidine (either thymine or cytosine). Because 

of their spatial configuration, adenine always pairs with 

thymine, and guanine always pairs with cytosine. 

base pairing, the formation of base pairs in DNA. 

baseplate [Gk, basis ME, plate], a temporary form that 

represents the base of a denture, used for making records of 

maxillomandibular relationships, for evaluating lip line and 

lip fullness, for arranging artificial teeth, or for ensuring a 

precise fit of a denture by trial placement in the mouth. Also 

called record base, temporary base. 

baseplate wax, a dental wax containing about 75% paraffin 

or ceresin with additions of beeswax and other waxes 

and resins; used chiefly to establish the initial arch form in 

making trial plates for the construction of complete dentures. 

base plus fog, the optical density of a processed film in the 

absence of any radiation exposure. 

base ratio, the ratio of the molar quantities of purine and 

pyrimidine bases in DNA and RNA.

as-fond 195 basiliximab 

Zygomatic process 

of maxilla 

ZYGOMATIC 

BONE 

SPHENOID BONE 

Foramen ovale 

Foramen lacerum 

Carotid canal 

Jugular foramen 

Mastoid process 

bas-fond /bäfôN/ [Fr, bottom], the bottom or fundus of 

any structure, especially the fundus of the urinary bladder. 

basi-, basio-, bas-, baso-, prefix meaning “a foundation 

or a base”: basicranial, basiotribe, basal, basophil. 

-basia /bāzhY/, suffix meaning “ability to walk”: 

brachybasia, dysbasia. 

-basic, suffix meaning “relating to or containing alkaline 

compounds”: ammonobasic, polybasic. 

BASIC /bāsik/, abbreviation for beginner’s all-purpose 

symbolic instruction code, a computer programming language. 

basic aluminum carbonate gel, an aluminum hydroxide 

aluminum carbonate gel, used as an antacid, for treatment of 

hyperphosphatemia in renal insufficiency and to prevent 

phosphate urinary calculi. 

basic amino acid, an amino acid that has a positive electric 

charge in solution at a pH of 7. The basic amino acids are 

arginine, histidine, and lysine. 

basic group identity, (in psychiatry) the shared social 

characteristics, such as world view, language, values, and 

ideologic system, that evolve from membership in an ethnic 

group. 

basic health services, the minimum degree of health care 

considered to be necessary to maintain adequate health and 

protection from disease. 

basic human needs, the elements required for survival 

and normal mental and physical health, such as food, water, 

shelter, protection from environmental threats, and love. 

basic life support (BLS) [Gk, basis, foundation; AS, lif 

L, supportare, to bring up to], emergency treatment of a 

victim of cardiac or respiratory arrest through cardiopulmonary 

resuscitation and emergency cardiac care. 

basic salt, a salt that contains an unreplaced hydroxide ion 

from the base generating it, such as Ca(OH)Cl. 

Basidiobolus /bYsidē·obYlYs/ [Gk., basis, foundation 

bolos, a throw], a mainly saprobic genus of fungi of the 

family Basidiobolaceae. The species B. ranarum causes 

entomophthoromycosis in humans and horses. 

basifacial /bāsifāshYl/ [Gk, basis L, facies, face], 

pertaining to the lower portion of the face. 

basilar /basilYr/ [Gk, basis, foundation], pertaining to a 

base or a basal area. 

basilar artery, the single posterior arterial trunk formed 

by the junction of the two vertebral arteries at the base of the 

skull. It extends from the inferior to the superior border of 

Base of the skull (Applegate, 2006) 

MAXILLA 

(palatine process) 

Alveolar process 

PALATINE BONE 

(horizontal plate) 

VOMER BONE 

Mandibular fossa 

Styloid process 

Stylomastoid 

foramen 

Occipital condyle 

Foramen magnum 

TEMPORAL BONE 

OCCIPITAL BONE 

the pons before dividing into the left and right posterior cerebral 

arteries. It supplies the internal ear and parts of the 

brain. Its branches are the pontine, labyrinthine, anterior inferior 

cerebellar, superior cerebellar, and posterior cerebral. 

basilar artery insufficiency syndrome, the composite of 

clinical indicators associated with insufficient blood flow 

through the basilar artery, a condition that may be caused by 

arterial occlusion. Common signs of this syndrome include 

dizziness, blindness, numbness, depression, dysarthria, dysphagia, 

and weakness on one side of the body. 

basilar artery occlusion, an obstruction of the basilar artery, 

resulting in dysfunction involving cranial nerves III 

through XII, cerebellar dysfunction, hemiplegia or tetraplegia, 

and loss of proprioception. 

basilar membrane, the cellular structure that forms the 

floor of the cochlear duct and is supported by bony and fibrous 

projections from the cochlear wall. It provides a fibrous 

base for the spiral organ of Corti. 

basilar plexus [Gk, basis L, braided], the venous network 

interlaced between the layers of the dura mater over 

the basilar portion of the occipital bone. It connects the two 

petrosal sinuses and communicates with the anterior vertebral 

venous plexus. 

basilar sulcus [Gk, basis L, furrow], the sulcus that 

cradles the basilar artery in the midline of the pons. 

basilar vertebra, the lowest or last of the lumbar vertebrae. 

basilic vein /bYsilik/, one of the four superficial veins of 

the arm, beginning in the ulnar part of the dorsal venous network 

and running proximally on the posterior surface of the 

ulnar side of the forearm. It is often chosen for blood testing. 

Compare dorsal digital vein, median antebrachial vein. 

basiliximab, a monoclonal antibody used for immunosuppression. 

INDICATIONS: This drug is used in combination with cyclosporine 

and corticosteroids to treat acute allograft rejection 

in renal transplant patients. 

CONTRAINDICATIONS: Known hypersensitivity to this drug 

contraindicates its use. 

ADVERSE EFFECTS: Life-threatening effects of this drug include 

pulmonary edema and cardiac failure. Other adverse 

effects include hypotension, headache, constipation, abdominal 

pain, infection, and moniliasis. Common side effects include 

pyrexia, chills, tremors, dyspnea, wheezing, chest 

pain, vomiting, nausea, and diarrhea.

asiloma 196 bathing 

basiloma. See basal cell carcinoma. 

basiloma terebrans /terYbrYnz/ [Gk, basis oma L, 

terebare, to bore], an invasive basal cell epithelioma. 

basin, 1. a receptacle for collecting or holding fluids. A 

kidney-shaped basin is commonly used as an emesis receptacle. 

2. term used to describe the shape of the pelvis. 

basio-. See basi-. 

basioccipital /bāsi·oksipYtYl/ [Gk, basis L, occiput, back 

of the head], pertaining to the basilar process of the occipital 

bone. 

basion /bāsē·on/ [Gk, basis, foundation], the midpoint on 

the anterior margin of the foramen magnum of the occipital 

bone. 

basis, the lower part, designating the base of an organ or 

other structure, such as the base of the cerebrum. 

basis narcosis. See basal narcosis. 

basis pedunculi cerebri. See crus cerebri. 

basket /bas·ket/, a container made of material woven together, 

or something resembling such a container. 

basket cell [L, bascauda, dishpan], 1. deep stellate cells 

(neurons) of the cerebral cortex with a horizontal axon that 

sends out branches. Each axon branch or collateral breaks up 

into a basketlike mesh that surrounds a Purkinje cell. 

2. myoepithelial cells of mammary glands stimulated by 

oxytocin. 

basolateral membrane, the layer of plasma membrane of 

epithelial cells that is adjacent to the basement membrane 

and separated from the apical membrane by the zonula 

occludens. 

basophil /bāsYfil/ [Gk, basis philein, to love], a granulocytic 

white blood cell characterized by cytoplasmic granules 

that stain blue when exposed to a basic dye. Basophils 

represent 1% or less of the total white blood cell count. The 

relative number of basophils increases in myeloproliferative 

diseases and decreases in severe allergic reactions. An increase 

in number is seen during the healing phase of inflammation. 

Basophils produce histamine during inflammatory 

reactions. Also called basophilic erythrocyte. Compare 

eosinophil, neutrophil. See also agranulocyte, differential 

white blood cell count, granulocyte, leukocyte, 

polymorphonuclear leukocyte. —basophilic, adj. 

Basophil (Carr and Rodak, 2009) 

basophilic adenoma [Gk, basis philein, to love, aden, 

gland, oma], a tumor of the pituitary gland composed of 

cells that can be stained with basic dyes. Compare acidophilic 

adenoma, chromophobic adenoma. 

basophilic erythrocyte. See basophil. 

basophilic leukemia [Gk, basis philein, to love, leukos, 

white, haima, blood], an acute or chronic malignant neoplasm 

of blood-forming tissues, characterized by large numbers 

of immature basophilic granulocytes in peripheral circulation 

and in tissues. See also acute myelocytic leukemia. 

basophilic stippling [Gk, basis philein, to love; D, 

stippen, to prick], the presence of punctate blue nucleic 

acid remnants in red blood cells, observed under the microscope 

on a Wright-Giemsa-Gram-stained blood smear. Stippling 

is characteristic of lead poisoning. See also basophil, 

lead poisoning. 

basosquamous cell carcinoma /bāsōskwāmYs/ [Gk, basis 

L, squamosus, scaly], a malignant epidermal tumor 

composed of basal and squamous cells. 

Bassen-Kornzweig syndrome. See abetalipoproteinemia. 

batch processing [ME, baten, to bake], a processing mode 

used with computers in which accumulated similar programs 

and input data are processed simultaneously. 

bath [AS, baeth], (in the hospital) a cleansing procedure 

performed by or for patients, as needed for hygienic or therapeutic 

purposes, to help prevent infection, preserve the unbroken 

condition of the skin, stimulate circulation, promote 

oxygen intake, maintain muscle tone and joint mobility, and 

provide comfort. 

METHOD: The bath may be a bed or tub bath, a shower, or 

a partial bath, depending on the patient’s condition and preference 

and the room temperature. The bath period may be 

used to instruct the patient on hygienic measures, range of 

motion exercises, and general measures to promote skin 

health. Observations are made of the general cleanliness and 

odor of the patient’s body; the color, dryness, turgor, and 

elasticity and integrity of the skin; and the condition of the 

hair, hands, joints, feet, fingernails, and toenails. Any discoloration, 

abrasion, rash, discharge, perineal or rectal irritation, 

clubbing of the digits, hair loss, or evidence of lice infestation 

is carefully noted. Mild soap and warm water are 

used for the bath, and a lanolin-based lotion may be used for 

an after-bath massage. The patient’s hair is combed daily 

and shampooed as needed; fingernails and toenails are 

cleaned and trimmed whenever required. The diabetic client 

may require specialized care of the nails. 

INTERVENTIONS: The nurse gives the bed bath in a setting 

that provides privacy for the patient. Firm, gentle strokes are 

used to wash, dry, and massage the person; vigorous rubbing 

is avoided. The partial bath is given with the patient seated in 

or on the side of the bed or in a chair. Self-help is encouraged, 

and the procedure is completed as quickly as possible 

to prevent chilling. In preparation for a tub bath, the nurse 

checks the safety strips in the bottom of the tub and the water 

temperature and assists the patient into the tub. Precautions 

are taken to prevent chilling, and on completion of the bath 

the nurse may help the patient out of the tub. In preparation 

for a shower, the nurse explains the operation of the dials 

regulating water temperature and provides a bath mat. 

OUTCOME CRITERIA: A bath provides an opportunity to assess 

external signs of disease, effects of therapy, and signs of 

pressure ulcer development and supports the patient’s sense 

of well-being and self-esteem. 

bath blanket, a thin, lightweight cloth used to cover a patient 

during a bath. It absorbs moisture while keeping the patient 

warm. See also blanket bath. 

bathesthesia /bathYsthēzhY/ [Gk,bathys, deep, aisthesia, 

feeling], sensitivity to deep structures in the body. Also 

called bathyesthesia. /bathē·Ys-/. 

bathing, a nursing intervention from the Nursing Interventions 

Classification (NIC) defined as cleaning of the body for

athmic evolution 197 Bayes’ theorem 

the purposes of relaxation, cleanliness, and healing. See also 

Nursing Interventions Classification. 

bathmic evolution. See orthogenic evolution. 

bathy-, batho-, prefix meaning “depth, deep”: 

bathycentesis, bathomorphic. 

bathyanesthesia /bathēanesthēzhY/ [Gk, bathys, deep, 

anaisthesia, loss of feeling], a loss of deep feeling, such as 

that associated with organs or structures beneath the body 

surface, or muscles and joints; a loss of sensitivity to deep 

structures in the body. 

bathycardia /bathēkärdē·Y/ [Gk, bathys, deep, kardia, 

heart], a condition in which the heart is located at an abnormally 

low site in the thorax. 

bathyesthesia. See bathesthesia. 

Batten disease /baten/, 1. Vogt-Spielmeyer disease. 

2. more generally, any or all of the group of disorders constituting 

neuronal ceroid lipofuscinosis. 

Batten’s disease [Frederick E. Batten, English ophthalmologist 

neurologist, 1865–1918], a progressive childhood encephalopathy 

characterized by disturbed metabolism of 

polyunsaturated fatty acids. It occurs in children between 5 

and 10 years of age. The child experiences sudden blindness 

and progressive mental deterioration. Also called neuronal 

ceroid lipofuscinosis. 

battered baby syndrome. See child abuse. 

battered woman syndrome (BWS), repeated episodes 

of physical assault on a woman by the person with whom she 

lives or with whom she has a relationship, often resulting in 

serious physical and psychologic damage to the woman. 

Such violence tends to follow a predictable pattern. The violent 

episodes usually follow verbal argument and accusation 

and are accompanied by verbal abuse. Almost any subject— 

housekeeping, money, childrearing—may begin the episode. 

Over time, the violent episodes escalate in frequency and severity. 

Most battered women report that they thought that the 

assaults would stop; unfortunately, studies show that the 

longer the women stay in the relationship the more likely 

they are to be seriously injured. Less and less provocation 

seems to be enough to trigger an attack once the syndrome 

has begun. The use of alcohol may increase the severity of 

the assault. The man is more likely to be abusive as the alcohol 

wears off. Battering occurs in cycles of violence. In 

the first phase the man acts increasingly irritable, edgy, and 

tense. Verbal abuse, insults, and criticism increase, and 

shoves or slaps begin. The second phase is the time of the 

acute, violent activity. As the tension mounts, the woman becomes 

unable to placate the man, and she may argue or defend 

herself. The man uses this as the justification for his 

anger and assaults her, often saying that he is “teaching her a 

lesson.” The third stage is characterized by apology and remorse 

on the part of the man, with promises of change. The 

calm continues until tension builds again. Battered woman 

syndrome occurs at all socioeconomic levels, and one half to 

three quarters of female assault victims are the victims of an 

attack by a partner. It is estimated that in the United States 

between 1 and 2 million women a year are beaten by their 

husbands. Men who grew up in homes in which the father 

abused the mother are more likely to beat their wives than 

are men who lived in nonviolent homes. Personal and cultural 

attitudes also affect the incidence of battering. Aggressive 

behavior is a normal part of male socialization in most 

cultures; physical aggression may be condoned as a means 

of resolving a conflict. A personality profile obtained by psychologic 

testing reveals the typical battered woman to be reserved, 

withdrawn, depressed, and anxious, with low selfesteem, 

a poorly integrated self-image, and a general 

inability to cope with life’s demands. The parents of such 

women encouraged compliance, were not physically affectionate, 

and socially restricted their daughters’ independence, 

preventing the widening of social contact that normally 

occurs in adolescence. Victims of the battered woman 

syndrome are often afraid to leave the man and the situation; 

change, loneliness, and the unknown are perceived as more 

painful than the beatings. Nurses are in an excellent position 

to offer assistance to battered women in several ways, because 

encouraging a woman to talk about the battering and 

the injuries may help her to admit what she may have been 

too embarrassed to reveal even to her parents. A realistic appraisal 

of the situation is then possible; the woman wants to 

hear that the nurse thinks the battering will not recur, but the 

nurse can tell her only that the usual pattern is for the abuse 

to continue and to become more severe. The woman may be 

referred to the social service department or given directions 

for contacting community agencies such as a battered women’s 

shelter or a hotline to a counseling service. Caring for 

and counseling a battered woman often require great patience 

because she is usually ambivalent about her situation 

and may be confused to the point of believing that she deserves 

the assaults she has suffered. Written, photographic, 

and videotaped records are maintained to document the extent 

of the problem, including the form of abuse reported, the 

injuries sustained, and a summary of similar incidents and 

previous admissions. 

battery [Fr, batterie], 1. a device of two or more electrolytic 

cells connected to form a single source providing direct 

current or voltage. 2. a series or a combination of tests to determine 

the cause of a particular illness or the degree of proficiency 

in a particular skill or discipline. 3. the unlawful use 

of force on a person. See assault. 

Battey bacillus /batē/ [Battey Hospital, in Rome, Georgia, 

where bacteria strain was first isolated], A bacillus, later 

renamed Mycobacterium intracellulare, that causes a 

chronic pulmonary disease resembling tuberculosis. It is 

considered an opportunistic pathogen and does not commonly 

infect healthy individuals. The organism is resistant 

to most of the common bacteriostatic and antibiotic medications 

but may be treated with multiple drug regimens. Surgical 

resection of involved lung tissue may be necessary and 

may improve the outcome in serious cases. Rest, good nutrition, 

and general supportive care are usually recommended. 

Compare tuberculosis. 

battledore placenta /batYldôr/ [ME,batyldoure, a beating 

instrument; L, placenta, flat cake], a condition in which 

the umbilical cord is attached at the margin of the placenta. It 

rarely occurs and does not affect placental functioning. Also 

called placenta battledore. 

Battle’s sign [William H. Battle, English surgeon, 1855– 

1936], a palpable bogginess of the area behind the ear that 

may indicate a fracture of a bone of the lower skull. 

batyl alcohol /batYl/, an alcohol found in fish liver oil that 

is used to treat bracken poisoning in cattle. 

baud /bôd/ [J.M.E. Baudot, French inventor, b. 1845], 

a measure of data flow or the speed with which a computer 

device transmits information. 

Baudelocque’s diameter. See external conjugate. 

bay, an anatomic depression or recess, usually containing 

fluid, such as the lacrimal bay of the eye. 

Bayes’ theorem /bāz/ [Thomas Bayes, British mathematician, 

1702–1761], a mathematic statement of the relationships 

of test sensitivity, specificity, and the predictive value 

of a positive test result. The predictive value of the test is the 

number that is useful to the clinician. A positive result demonstrates 

the conditional probability of the presence of a 

disease.

Bayetta 198 beam hardening 

Bayetta, a trademark for exenatide. 

Bayley Scales of Infant Development [Nancy Bayley, 

twentieth century American psychologist], a three-part 

scale for assessing the development of children between the 

ages of 2 months and 2 1 ⁄2 years. Infants are tested for perception, 

memory, and vocalization on the mental scale; sitting, 

stair climbing, and manual manipulation on the motor 

scale; and attention span, social behavior, and persistence on 

the behavioral scale. 

Baylisascaris /bālis·askä·ris/, a genus of ascarid nematodes 

found in the intestines of mammals, particularly raccoons. 

B. columnaris infests the central nervous system of 

dogs. B. procyonis is usually found in raccoons and rodents, 

but fecal contamination from those animals can cause spread 

to domestic animals and humans, resulting in larva migrans 

or eosinophilic encephalitis, which is often fatal. 

bayonet angle former. See angle former. 

bayonet condenser [Fr, baionette], an instrument used in 

dentistry for compacting restorative material. It has an offset 

nib and a shank with right-angle bends, used primarily 

for varying the line of force in the compaction of gold. There 

are many variations in angle, length, and diameter of the nib. 

BBB, 1. abbreviation for bundle branch block. 

2. abbreviation for blood-brain barrier. 

BBT, abbreviation for basal body temperature. 

BCAA, abbreviation for branched-chain amino acids. 

B cell, a type of lymphocyte that originates in the bone 

marrow and produces antibodies. A precursor of the plasma 

cell, it is one of the two lymphocytes that play a major role in 

the body’s immune response. Also called B lymphocyte. 

Compare T cell. See also plasma cell. 

B cell–growth/differentiation factor, one of several substances, 

such as interleukins IL-4, IL-5, and IL-6, that are 

derived from T-cell cultures and are necessary for the differentiation, 

growth, and maturation of plasma cells and B 

memory cells. 

B-cell lymphoma, any in a large group of non-Hodgkin’s 

lymphomas characterized by malignant transformation of 

the B cells. See also non-Hodgkin’s lymphoma. 

B-cell lymphoma 

(White and Cox, 2006/Courtesy Dr. L. Barco) 

B cell–mediated immunity, the ability to produce an immune 

response induced by B lymphocytes. Contact with a 

foreign antigen stimulates B cells to differentiate into plasma 

cells, which release antibodies. Plasma cells also generate 

memory cells, which provide a rapid response if the same 

antigen is encountered again. 

B cell stimulating factor-1. See interleukin-4. 

BCG, abbreviation for bacille Calmette-Guérin. 

BCG solution, an aqueous suspension of bacille Calmette- 

Guérin for instillation into the bladder to activate the immune 

system in treatment of superficial bladder cancers. It 

reduces the risk of a subsequent bladder cancer developing, 

although the exact mechanism of action is unknown. 

BCG vaccine. See bacille Calmette-Guérin vaccine. 

BCHC diet, abbreviation for Bristol Cancer Help Center 

diet. 

BCLS, abbreviation for basic cardiac life support. 

BCNU. See carmustine. 

B complex vitamins, a large group of water-soluble nutrients 

that includes thiamine (vitamin B 1), cyanocobalamin 

(vitamin B 12), niacin (vitamin B 3), pyridoxine (vitamin B 6), 

riboflavin (vitamin B 2), biotin, folic acid, and pantothenic 

acid. The B complex vitamins are essential, for example, for 

the conversion of simple carbohydrates like glucose and the 

carbon skeletons of amino acids into energy, and for the metabolism 

of fats and proteins. Good sources include brewer’s 

yeast, liver, whole grain cereals, nuts, eggs, meats, fish, and 

vegetables. Because some B complex vitamins are produced 

by intestinal bacteria, taking antibiotics may destroy these 

bacteria. Symptoms of vitamin B deficiency include nervousness, 

depression, insomnia, neuritis, anemia, alopecia, 

acne or other skin disorders, and hypercholesterolemia. See 

also specific vitamins. 

b.d. See b.i.d. 

BDI, abbreviation for Beck’s depression inventory. 

B-DNA, a long, thin form of deoxyribonucleic acid in 

which the helix is right-handed. 

Be, symbol for the element beryllium. 

beaded /bēdid/ [ME, bede], 1. having a resemblance to a 

row of beads. 2. pertaining to bacterial colonies that develop 

along the inoculation line in various stab cultures. 3. pertaining 

to stained bacteria that develop more deeply stained 

beadlike granules. 

beak, 1. any pointed anatomic structure, such as the beak 

of the sphenoid bone. 2. a pair of dental pincers used in 

shaping prostheses. 3. a radiographic image of a bony protuberance 

adjacent to a degenerative intervertebral disk. 

beaker cell. See goblet cell. 

beak sign, the appearance of abnormal structures on radiographic 

images of the GI tract: of the distal esophagus in 

achalasia and of the proximal pyloric canal in pyloric stenosis. 

Beals’ syndrome /bēlz/ [Rodney Kenneth Beals, American 

orthopedic surgeon, b. 1931], a congenital type of bone 

dysplasia with contractures and arachnodactyly. An autosomal 

dominant syndrome characterized by long thin extremities 

with arachnodactyly, multiple joint contractures, kyphoscoliosis, 

and malformed auricles of the ears; it is a form 

of hereditary bone dysplasia. 

beam [ME, beem, tree], 1. a bedframe fitting for pulleys 

and weights, used in the treatment of patients requiring 

weight traction. See Balkan traction frame. 2. (in radiology) 

the primary beam of radiation emitted from the 

x-ray tube. 

BEAM /bēm, bēēāem/, abbreviation for brain electric 

activity map. 

beam alignment, in radiography, the process of positioning 

the radiographic tube head so that it is aligned properly 

with the x-ray film. 

beam collimation, the restriction of x-radiation to the area 

being examined or treated by confining the beam with metal 

diaphragms or shutters with high radiation-absorption 

power. In addition to protecting the patient and others from 

scatter radiation, beam collimation reduces radiographic 

density. 

beam hardening, the process of increasing the average

BE amputation 199 bed cradle 

energy level of an x-ray beam by filtering out the low-energy 

photons. 

BE amputation, abbreviation for below-elbow amputation. 

beam quality, the energy of an x-ray beam. 

beam restrictor, a device that reduces the size of the beam 

of radiation from x-ray equipment. Three basic types of 

restrictors are variable-aperture collimators, cones or cylinders, 

and aperture diaphragms. 

beam splitter, a device that reflects light from the output 

phosphor of an image intensifier to a photographic recording. 

Also called image distributor. 

beam-splitting mirror, a device that allows a radiologist 

to view a fluoroscopic examination of a patient while the 

same view is being recorded on film. The mirror can be adjusted 

to reflect from 10% to 90% of the x-ray beam to the 

fluorescent screen while the rest is directed to the film. 

beam therapy. See chromotherapy, external beam 

radiotherapy. 

bean [ME, bene], the pod-enclosed flattened seed of numerous 

leguminous plants. Beans used in pharmacologic 

preparations are alphabetized by specific name. 

bearing down /bering/ [OE, beran, to bear, adune, down], 

a voluntary effort by a woman in the second stage of labor to 

aid in the expulsion of a fetus. By applying the Valsalva maneuver, 

the mother increases intraabdominal pressure. 

bearing down pains [OE, beran, to bear, adune, down; L, 

poena, penalty], the pains experienced by a woman during 

the second stage of labor while performing the Valsalva maneuver 

to help expel the fetus. 

beat, the mechanical contraction or electrical activity of the 

heart muscle, which may be detected and recorded as the 

pulse or on the electrocardiogram, respectively. 

Beau’s lines /bōz/ [Joseph H.S. Beau, French physician, 

1806–1865], transverse depressions that appear as white 

lines across the fingernails as a sign of an acute severe illness 

such as malnutrition, systemic disease, thyroid dysfunction, 

trauma, or coronary occlusion. 

Beau’s lines (Graham-Brown and Bourke, 2007) 

becaplermin /bĕ-kapler-min/, a recombinant plateletderived 

growth factor used in treatment of chronic severe 

dermal ulcers of the lower limbs in diabetes mellitus. 

Beck, Cheryl Tatano, a nursing theorist whose Postpartum 

Depression Theory asserts that postpartum depression 

results from a combination of physiologic, psychologic, and 

environmental stressors and that symptoms are varied and 

likely to be multiple. 

Becker’s muscular dystrophy [Peter E. Becker, German 

geneticist, b. 1908], a chronic degenerative disease of the 

muscles, characterized by progressive weakness. It occurs in 

childhood between 8 and 20 years of age. It occurs less frequently, 

progresses more slowly, and has a better prognosis 

than the more common pseudohypertrophic form of muscular 

dystrophy. The pathophysiologic characteristics of the 

disease are not understood; it is transmitted genetically as an 

autosomal recessive trait. Also called benign pseudohypertrophic 

muscular dystrophy. Compare Duchenne’s muscular 

dystrophy. 

Beck’s depression inventory (BDI) [Aaron T. Beck, 

American psychiatrist, b. 1921], a system of classifying a 

total of 18 criteria of depressive illness. It was developed by 

Aaron T. Beck in the 1960s as a diagnostic and therapeutic 

tool for the treatment of childhood affective disorders. The 

BDI is similar to the 21-criteria DSM-IV diagnostic system 

of the 1980s except that the DSM-IV scale includes loss of 

interest, restlessness, and sulkiness, which are missing from 

the BDI; the Beck inventory lists somatic complaints and 

loneliness, which are criteria not included in the DSM-III inventory. 

See also DSM. 

Beck’s triad [Claude Schaeffer Beck, American surgeon, 

1894–1971], a combination of three symptoms that characterize 

cardiac tamponade: high central venous pressure as 

evidenced, for example, by jugular venous distention; low 

arterial pressure; and a small, quiet heart. 

Beckwith’s syndrome [John B. Beckwith, American pathologist, 

b. 1933], a hereditary disorder of unknown 

cause associated with neonatal hypoglycemia and hyperinsulinism. 

Clinical manifestations include gigantism, macroglossia, 

omphalocele or umbilical hernia, visceromegaly, hyperplasia 

of the kidney and pancreas, and extreme 

enlargement of the cells of the adrenal cortex. Treatment 

consists of adequate glucose, diazoxide, and glucocorticoid 

therapy. Subtotal pancreatectomy is often necessary in cases 

of beta cell hyperplasia, nesidioblastosis, or beta cell tumor 

of the pancreas. 

Beckwith-Wiedemann syndrome. See EMG syndrome. 

beclomethasone dipropionate, a glucocorticoid. 

INDICATIONS: It is prescribed in a metered-dose inhaler in 

the maintenance treatment of bronchial asthma as prophylactic 

therapy and as an aerosol for inhalation to treat chronic 

rhinitis. 

CONTRAINDICATIONS: Status asthmaticus, acute asthma, or 

known hypersensitivity to this drug prohibits its use. 


of systemic administration are the symptoms of adrenal 

insufficiency. Hoarseness, sore throat, and fungal infections 

of the oropharynx and larynx may occur. Good oral and dental 

hygiene after each use is requisite. 

becquerel (Bq) /bekrel, bekYrel/ [Antoine H. Becquerel, 

French physicist, 1852–1908], the SI unit of radioactivity, 

equal to one radioactive decay per second. See also curie. 

bed [AS, bedd], (in anatomy) a supporting matrix of tissue, 

such as the nailbeds of modified epidermis over which the 

fingernails and the toenails move as they grow. 

bed board, a board that is placed under a mattress to give 

added support to a patient with back problems. 

bedbug [AS, bedd ME, bugge, hobgoblin], a bloodsucking 

wingless arthropod of the species Cimex lectularius 

or the species C. hemipterus that feeds on humans and other 

animals. The bedbug can be removed after covering it with 

petrolatum. The bite, which causes itching, pain, and redness, 

can be treated with a lotion or cream containing a corticosteroid 

or other topical antiinflammatory or analgesic 

preparation. 

bed cradle, a frame placed over a bed to prevent sheets or 

blankets from touching the patient. See also footboard.

Bedford finger stall 200 behavioral science 

Bedbug bites (White and Cox, 2006) 

Bedford finger stall, a removable finger splint that holds 

the injured and an adjacent finger in a brace or cast. It can be 

worn for prolonged periods. 

Bednar’s aphthae /bednärz/ [Alois Bednar, Austrian pediatrician, 

1816–1888], the small, yellowish, slightly elevated 

ulcerated patches that occur on the posterior portion of the 

hard palate of infants who place infected objects in their 

mouths. It is also associated with marasmus. Compare 

Epstein’s pearls, thrush. 

bed pan, a vessel, made of metal or plastic, used to collect 

feces and urine of bedridden patients. 

Bed pans (Potter and Perry, 2007) 

bed rest, the restriction of a patient to bed for therapeutic 

reasons for a prescribed period. 

bed rest care, a nursing intervention from the Nursing Interventions 

Classification (NIC) defined as promotion of 

comfort and safety and prevention of complications for a patient 

unable to get out of bed. See also Nursing Interventions 

Classification. 

bedridden, describing a person who is unable or unwilling 

to leave the bed because of illness or injury. 

bedside laboratory testing, a nursing intervention from 

the Nursing Interventions Classification (NIC) defined as 

performance of laboratory tests at the bedside or point of 

care. See also Nursing Interventions Classification. 

bedside manner, the behavior of a nurse or doctor as perceived 

by a patient or peers. 

bedside thermometer. See clinical thermometer. 

bedsore. See pressure ulcer. 

bedwetting. See enuresis. 

BEE, abbreviation for basal energy expenditure. 

bee cell pessary. See pessary. 

beef tapeworm. See Taenia saginata. 

beef tapeworm infection [OF, buef, cow; AS, taeppe, 

wyrm], an infection caused by the tapeworm Taenia 

saginata, transmitted to humans when they eat contaminated 

beef. The adult worm can live for years in the intestine of humans 

without causing any symptoms. The infection is rarely 

found in North America and Western Europe, where beef is 

carefully inspected before being made available and is often 

thoroughly cooked before eating, but it is common in other 

parts of the world. See tapeworm infection. 

bee sting [AS, beo stingan], an injury caused by the 

venom of bees, usually accompanied by pain and swelling. 

The stinger of the honeybee usually remains implanted and 

should be removed. Pain may be alleviated by application of 

an ice pack or a paste of sodium bicarbonate and water. Serious 

reactions may result from multiple stings, stings on 

some areas of the head, or the injection of venom directly 

into the circulatory system. In a hypersensitive person, a 

single bee sting may result in death through anaphylactic 

shock and airway obstruction. Hypersensitive individuals 

are encouraged to carry emergency treatment supplies, including 

epinephrine, with them when the possibility of bee 

sting exists. Compare wasp, yellow jacket venom. 

Bee sting (Zitelli and Davis, 2007) 

beet sugar, sucrose from sugar beets. 

behavior /bihāvyYr/ [ME, behaven], 1. the manner in 

which a person acts or performs. 2. any or all of the activities 

of a person, including physical actions, which are observed 

directly, and mental activity, which is inferred and interpreted. 

Kinds of behavior include abnormal behavior, 

automatic behavior, invariable behavior, and variable 

behavior. 

behavioral isolation /behāvyYrYl/, social isolation that 

results from a person’s socially unacceptable behavior. 

behavioral marital therapy, a form of marital therapy 

using principles and techniques from behavior therapy; it attempts 

to alleviate marital distress by increasing positive, 

pleasant interactions between the couple. 

behavioral medicine, a segment of psychosomatic medicine 

focused on psychologic means of influencing physical 

symptoms, such as biofeedback or relaxation. 

behavioral objective, a goal in therapy or research that 

concerns an act or a specific behavior or pattern of behavior. 

behavioral science, any of the various interrelated disciplines, 

such as psychiatry, psychology, sociology, and anthropology, 

that observe and study human activity, including 

psychologic and emotional development, interpersonal relationships, 

values, and mores.

ehavioral systems model 201 bejel 

behavioral systems model, a conceptual framework describing 

factors that may affect the stability of a person’s behavior. 

The model examines systems of behavior, not the behavior 

of an individual at any particular time. In one model, 

behavior is defined as an integrated response to stimuli. Several 

subsystems of behavior form the eight human 

microsystems, which are ingestion, elimination, dependency, 

sex, achievement, affiliation, aggression, and restoration. 

Each subsystem comprises several structural components 

called imperatives, which are goal, set, choice, action, and 

support. The goal of nursing care is to attain, maintain, or restore 

balance of the subsystems of behavior for the stability 

of the patient. 

behavior disorder, any of a group of antisocial behavior 

patterns occurring primarily in children and adolescents, 

such as overaggressiveness, overactivity, destructiveness, 

cruelty, truancy, lying, disobedience, perverse sexual activity, 

criminality, alcoholism, and drug addiction. Treatment 

may include psychotherapy, milieu therapy, medication, and 

family counseling. See also antisocial personality disorder. 

behavior, health, risk-prone, a nursing diagnosis accepted 

by the Seventh National Conference on the Classification 

of Nursing Diagnoses (revised 2007). Impaired adjustment 

is the inability to modify lifestyle or behaviors in a 

manner consistent with a change in health status. See also 

nursing diagnosis. 

DEFINING CHARACTERISTICS: The defining characteristics include 

a minimization of health status change, a failure to 

achieve optimal sense of control, a failure to take actions that 

would prevent further health problems, and a demonstration 

of nonacceptance of health status change. 

RELATED FACTORS: Related factors include inadequate 

comprehension or social support, low self-efficacy, low socioeconomic 

status, multiple stressors, and a negative attitude 

toward health care. 

behaviorism, a school of psychology founded by John B. 

Watson that studies and interprets behavior by observing 

measurable responses to stimuli without reference to consciousness, 

mental states, or subjective phenomena, such as 

ideas and emotions. See also neobehaviorism. 

behaviorist, an advocate of the school of behaviorism. 

behavioristic psychology. See behaviorism. 

behavior management, a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as helping 

a patient to manage negative behavior. See also Nursing 

Interventions Classification. 

behavior management: overactivity/inattention, a nursing 

intervention from the Nursing Interventions Classification 

(NIC) defined as provision of a therapeutic milieu that 

safely accommodates the patient’s attention deficit and/or 

overactivity while promoting optimal function. See also 


behavior management: self-harm, a nursing intervention 

from the Nursing Interventions Classification (NIC) defined 

as assisting the patient to decrease or eliminate selfmutilating 

or self-abusive behaviors. See also Nursing 


behavior management: sexual, a nursing intervention 


as delineation and prevention of socially unacceptable 

sexual behaviors. See also Nursing Interventions Classification. 

behavior modification 1 . See behavior therapy. 

behavior modification 2 , a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as promotion 

of a behavior change. See also Nursing Interventions 


behavior modification: social skills, a nursing intervention 


as assisting the patient to develop or improve interpersonal 

social skills. See also Nursing Interventions 


behavior reflex. See conditioned response. 

behavior therapy, a kind of psychotherapy that attempts 

to modify observable maladjusted patterns of behavior by 

substituting a new response or set of responses to a given 

stimulus. The treatment techniques involve the methods, 

concepts, and procedures derived from experimental psychology; 

they include assertiveness training, aversion therapy, 

contingency management, flooding, modeling, operant 

conditioning, and systemic desensitization. Also called behavior 

modification. See also biofeedback. 

behaviour. See behavior. 

Behçet’s disease /bāsets/ [Hulusi Behçet, Turkish dermatologist, 

1889–1948], a severe chronic, multisystem inflammatory 

illness of unknown cause, mostly affecting 

young males and characterized by severe uveitis and retinal 

vasculitis. Some other signs are optic atrophy and aphthous 

lesions of the mouth and the genitals, indicating diffuse vasculitis. 

It may involve all organs and affect the central nervous 

system. Immunosuppressive therapy may be considered. 

The disease is common in Japan, Turkey, and Israel, 

but rare in the United States. Also called Behçet’s syndrome. 

Behçet’s disease conjunctivitis 

(Regezi, Sciubba, and Jordan, 2008) 

Behla’s bodies. See Plimmer’s bodies. 

BEI, abbreviation for butanol-extractable iodine. 

bejel /bejYl/ [Ar, bajal], a nonvenereal form of endemic 

syphilis prevalent among children in the Middle East and 

North Africa, caused by the spirochete Treponema pallidum 

subsp. endemicum. It is transmitted by person-to-person contact 

and by the sharing of drinking and eating utensils. The 

primary lesion is usually on or near the mouth, appearing as 

a mucus patch, followed by the development of pimplelike 

sores on the trunk, arms, and legs. Chronic ulceration of the 

nose and soft palate occurs in the advanced stages of the infection. 

Destructive changes in the tissues of the heart, central 

nervous system, and mouth, often associated with the venereal 

form of syphilis, rarely develop. Intramuscular 

injection of penicillin is effective in curing the infection, but 

if extensive tissue destruction has occurred, scar tissue forms 

and may be permanently disfiguring. Also called dichuchwa, 

endemic syphilis, frenga, siti.

Békésy audiometry 202 Bence Jones protein test 

Békésy audiometry /bekYsē/ [George von Békésy, 

Hungarian-American physicist and Nobel laureate, 1899– 

1972], a type of hearing test in which the subject controls 

the intensity of the stimulus by pressing a button while listening 

to a pure tone whose frequency slowly moves through 

the entire audible range. The intensity diminishes as long as 

the button is pressed. When the intensity is too low for the 

subject to hear the tone, the button is released and the intensity 

begins to increase. When the subject again hears the 

tone, the button is again pressed, yielding a zigzag tracing. 

Continuous and interrupted tones are used, and the tracings 

of the two are compared. The test may be used to differentiate 

between hearing losses of cochlear and neural origins. 

Bekhterev-Mendel reflex. See Mendel’s reflex. 

bel [Alexander G. Bell, Canadian inventor, 1847–1922], 

a unit that expresses intensity of sound. It is the logarithm (to 

the base 10) of the ratio of the power of any specific sound to 

the power of a reference sound. The most common reference 

sound has a power of 10 16 watts per square centimeter, or 

the approximate minimum intensity of sound at 1000 cycles 

per second that is perceptible to the human ear. An increase 

of 1 bel approximately doubles the intensity or loudness of 

most sounds. See also decibel. 

belching. See eructation. 

belladonna /belYdonY, belädônä/ [It, fair lady], the dried 

leaves, roots, and flowering or fruiting tops of Atropa belladonna, 

a common perennial called deadly nightshade, containing 

the alkaloids hyoscine and hyoscyamine. Hyoscyamine 

has anticholinergic and antispasmodic properties. 

belladonna alkaloids, a group of anticholinergic alkaloids 

occurring in belladonna (Atropa belladonna). 

belladonna and atropine poisons [It, belladonna, fair 

lady; Gk, Atropos, one of three Fates; L, potio, drink], 

two powerful poisons obtained from solanaceous plants. Atropine, 

derived from Atropa belladonna, blocks the effects 

of acetylcholine in effector organs supplied by postganglionic 

cholinergic nerves. Belladonna is obtained from the 

dried leaves of Atropa belladonna, also known as deadly 

nightshade, or of Atropa acuminata, a source of alkaloids 

that are converted to atropine. Atropine sulfate is commonly 

used in ophthalmologic applications and as an antispasmodic. 

Bell-Magendie law. See Bell’s law. 

bellows murmur /beloo ¯¯¯¯z/ [AS, belg, bag; L, humming], 

a blowing sound, such as that of air moving in and out of a 

bellows. 

bellows ventilator, a respiratory care device in which oxygen 

and other gases are mixed in a mechanism that contracts 

and expands. The system pressure is increased or decreased 

in the chamber surrounding the bellows. The gases are 

moved into the patient circuit when the system pressure increases. 

As the patient exhales, the bellows contracts and 

fills again with gases from air and oxygen intakes. 

bell-shaped curve, the curve of the probability density 

function of the normal distribution, resembling the outline of 

a bell. Also called normal curve. 

Bell’s law [Charles Bell, Scottish surgeon, 1774–1842], 

an axiom stating that the anterior spinal nerve roots (and spinal 

cord and medulla) contain only motor and the posterior 

spinal nerve roots (and spinal cord and medulla) are sensory. 

Also called Bell-Magendie law, Magendie’s law. 

Bell’s palsy [Charles Bell, Scottish Surgeon, 1774-1842], 

a unilateral paralysis of the facial nerve, thought to result 

from trauma to the nerve, compression of the nerve, or infection, 

of which herpes simplex virus is thought to be the most 

common. Any or all branches of the nerve may be affected. 

The person may not be able to close an eye or control sali- 

vation on the affected side. It usually resolves over weeks 

but can leave some permanent damage, including decreased 

taste and hypersensitivity to noise on the affected side. Also 

called Bell’s paralysis. 

Bell’s palsy (Chabner, 2007) 

Bell’s phenomenon [Charles Bell], a sign of peripheral 

facial paralysis, manifested by the upward and outward rolling 

of the eyeball when the affected individual tries to close 

the eyelid. It occurs on the affected side in peripheral facial 

paralysis. 

Bell’s spasm [Charles Bell], a convulsive facial tic. 

belly [AS, beig, bag], 1. the fleshy central bulging portion 

of a muscle. 2. Informal term for abdomen. 

belly button. See umbilicus. 

belonephobia /belYnYfōbē·Y/ [Gk,belone, needle, phobos, 

fear], a morbid fear of sharp-pointed objects, especially 

needles and pins. 

below-elbow (BE) amputation, an amputation of the 

arm below the elbow. 

below-knee (BK) amputation, See long below-knee 

amputation and short below-knee amputation. 

belt restraint, a device used around the waist to secure a 

patient on a stretcher or in a chair. 

Benadryl, trademark for a first-generation antihistamine 

(diphenhydramine hydrochloride). 

Benassi method /bYnasē/, a positioning procedure for 

producing x-ray images of the liver. With the patient in a 

prone position so that the liver is closer to the x-ray film, two 

radiographs are made from the angles of 25 degrees caudad 

and 10 degrees cephalad. 

Bence Jones protein /bens/ [Henry Bence Jones, English 

physician, 1814–1873], a protein found almost exclusively 

in the urine of patients with multiple myeloma. The protein 

constitutes the light chain component of myeloma globulin; 

it coagulates at temperatures of 45° to 55° C and redissolves 

completely or partially on boiling. See also multiple myeloma, 

protein. 

Bence Jones protein test, a urine test whose positive result 

most commonly indicates multiple myeloma. The test is 

used to detect and monitor the treatment and clinical course 

of multiple myeloma and similar diseases.

ench research 203 benign mesenchymoma 

bench research informal, any research done in a controlled 

laboratory setting using nonhuman subjects. The 

focus is on understanding cellular and molecular mechanisms 

that underlie a disease or disease process. 

-bendazole, combining form designating a tibendazoletype 

anthelmintic. 

Bender’s Visual Motor Gestalt test [Lauretta Bender, 

American psychiatrist, 1897–1987; L, visus, vision, movere, 

to move; Ger, Gestalt, form; L, testum, crucible], a standard 

psychologic test in which the subject copies a series of 

patterns. 

bending fracture, a fracture indirectly caused by the 

bending of an extremity, such as the foot or the big toe. 

bendrofluazide. See bendroflumethiazide. 

bendroflumethiazide /bendrōfloo ¯¯¯¯mYthīYzīd/, a diuretic 

and antihypertensive. 

INDICATIONS: It is prescribed in the treatment of hypertension 

and edema. 

CONTRAINDICATIONS: Anuria or known hypersensitivity to 

this drug, to other thiazide medication, or to sulfonamide derivatives 


ADVERSE EFFECTS: Among the more serious are hypokalemia, 

hyperglycemia, hyperuricemia, and hypersensitivity 

reactions. 

bends. See decompression sickness. 

Benedict’s qualitative test [Stanley R. Benedict, American 

biochemist, 1884–1936], a test for sugar in the urine based 

on the reduction by glucose of cupric ions. Formation of an 

orange or red precipitate indicates more than 2% sugar 

(called 4), yellow indicates 1% to 2% sugar (called 3), 

olive green indicates 0.5% to 1% sugar (called 2), and 

green indicates less than 0.5% sugar (called 1). It is not in 

common use. Also called Benedict’s method. 

Benedict’s solution [Stanley R. Benedict], a term referring 

to two reagents (a qualitative and a quantitative) used in 

the examination of urine specimens. Both solutions contain 

cupric sulfate dissolved in a solution of sodium sulfate and 

sodium citrate in two different concentrations. When the solution 

is heated, the color of the resulting mixture depends 

on the concentration of glucose in the urine. See also Benedict’s 

qualitative test. 

beneficiary /benYfishYrē/, a person or group designated 

to receive certain profits, benefits, or advantages, as the recipient 

of a will or insurance policy. 

beneficiary member. See enrollee. 

benefit. See covered benefit. 

Benemid, trademark for a uricosuric (probenecid). 

benign /binīn/ [L, benignus, kind], (of a tumor) noncancerous 

and therefore not a direct threat to life, even though 

treatment eventually may be required for health or cosmetic 

reasons. See also benign neoplasm. Compare malignant. 

benign congenital hypotonia, a condition marked by 

signs of weakness and floppiness in babies, resulting from 

nonprogressive weakness of skeletal muscles from birth. 

benign cystic nephroma, multilocular cyst of kidney. 

benign essential tremor. See essential tremor. 

benign familial chronic pemphigus [L, benedicere, to 

bless, familia, household; Gk, pemphix, bubble], a hereditary 

condition of the skin characterized in the early stages by 

blisters that break, leaving red, eroded areas followed by 

crusts. It most commonly occurs on the neck, groin, and axillary 

regions. It presents in late adolescence or early adulthood. 

Also called Hailey-Hailey disease. 

benign familial hematuria, a rare, usually benign disorder 

characterized by abnormally thin basement membranes 

of the glomerular capillaries and persistent hematuria. Autosomal 

dominant inheritance is suspected. 

Benign familial chronic pemphigus 

(Callen et al, 2000) 

benign forgetfulness, a temporary memory block in 

which some fact from the recent or remote past is forgotten 

but later recalled. 

benign giant lymph node hyperplasia. See Castleman’s 

disease. 

benign hypertension, a misnomer implying a harmless 

elevation of blood pressure. Because any sustained elevation 

of blood pressure may adversely affect health, it is incorrect 

to refer to the condition as “benign.” See also essential 

hypertension. 

benign intracranial hypertension. See pseudotumor 

cerebri. 

benign juvenile melanoma, a noncancerous pink or 

fuchsia raised papule with a scaly surface, usually on a 

cheek. Occurring most commonly in children between 9 and 

13 years of age, it may be mistaken for a malignant melanoma. 

Also called compound melanocytoma, spindle cell 

nevus, Spitz nevus. 

Benign juvenile melanoma 

(Callen et al, 2000) 

benign lymphocytic meningitis. See sterile meningitis. 

benign lymphoreticulosis. See cat-scratch fever. 

benign mesenchymoma [L, benignare Gk, meso, middle, 

egchyma, infusion, oma, tumor], a benign neoplasm that

enign migratory glossitis 204 benzene 

has two or more definitely recognizable mesenchymal elements 

in addition to fibrous tissue. 

benign migratory glossitis. See geographic tongue. 

benign mucosal pemphigoid. See cicatricial pemphigoid. 

benign myalgic encephalomyelitis. See postviral fatigue 

syndrome. 

benign neoplasm [L, benignare Gk, neos, new, plasma, 

formation], a localized tumor that has a fibrous capsule, 

limited potential for growth, a regular shape, and cells that 

are well differentiated. A benign neoplasm does not invade 

surrounding tissue or metastasize to distant sites. Some kinds 

of benign neoplasms are adenoma, fibroma, hemangioma, 

and lipoma. Also called benign tumor. Compare malignant 

neoplasm. 

benign nephrosclerosis, a renal disorder marked by 

arteriolosclerotic (arteriosclerosis affecting mainly the arterioles) 

lesions in the kidney. It is associated with hypertension. 

benign paroxysmal peritonitis. See familial Mediterranean 

fever. 

benign paroxysmal positional vertigo, recurrent vertigo 

and nystagmus occurring when the head is placed in certain 

positions. It can be debilitating and can cause difficulty in 

walking straight. It is usually not associated with central nervous 

system lesions. 

OBSERVATIONS: Patients may experience the sensation of 

disorientation in space combined with a sensation of motion 

accompanied by nystagmus, nausea and/or vomiting, perspiration, 

pallor, increased salivation, and general malaise. Diagnosis 

is made by history and clinical exam in conjunction 

with ENG and positional testing. Audiology, ABR, CT, or 

MRI may be used to rule out other causes of vertigo. 

INTERVENTIONS: Treatment is focused on a series of vestibular 

exercises, including gait training, sets of visual vestibular 

head and eye movements, Epley maneuvers, and Brandt- 

Daroff maneuvers. If exercises provoke nausea, premedication 

with antiemetics may be necessary. Surgical 

plugging of the posterior semicircular canal may be done in 

individuals with an intractable recurrent pattern of vertigo 

attacks that are unresponsive to exercise therapy. 

NURSING CONSIDERATIONS: Nursing care focuses on 

demonstration and return demonstration of prescribed 

exercises. 

benign prostatic hyperplasia (BPH), a histologic diagnosis 

associated with nonmalignant, noninflammatory enlargement 

of the prostate, most common among men over 50 

years of age. BPH diagnosis can only be made after biopsy 

or resection; otherwise the diagnosis is benign prostatic enlargement. 

BPH is usually progressive and may lead to urethral 

obstruction and to interference with urine flow, urinary 

frequency, nocturia, dysuria, and urinary tract infections. 

Treatment may include medication, localized application of 

heat, balloon dilation, laser vaporization, and microwave hyperthermia. 

Surgical resection of the enlarged prostate is 

sometimes necessary. Compare prostatitis. See also 

prostatectomy. 

benign prostatic hypertrophy. See benign prostatic 

hyperplasia. 

benign pseudohypertrophic muscular dystrophy. See 

Becker’s muscular dystrophy. 

benign stupor, a state of apathy or lethargy, such as occurs 

in severe depression. 

benign thrombocytosis. See thrombocytosis. 

benign tumor. See benign neoplasm. 

benne oil. See sesame oil. 

Benner, Patricia, a nursing theorist who confirmed the 

levels of skill acquisition in nursing practice in From Novice 

to Expert: Excellence and Power in Clinical Nursing 

Practice (1984). Benner used systematic descriptions of five 

stages: novice, advanced beginner, competent, proficient, 

and expert. Thirty-one competencies emerged from an 

analysis of actual patient care episodes. From this work 

seven areas of nursing practice having a number of competencies 

with similar intents, functions, and meanings developed. 

They are identified as (1) the helping role, (2) the 

teaching-coaching function, (3) the diagnostic and patientmonitoring 

function, (4) effective management of rapidly 

changing situations, (5) administering and monitoring therapeutic 

interventions and regimens, (6) monitoring and ensuring 

the quality of health care practices, and (7) organizational 

work-role competencies. Benner’s work describes 

nursing practice in the context of what nursing actually is 

and does rather than from context-free theoretic descriptions. 

Bennet’s small corpuscle. See Drysdale’s corpuscle. 

Bennett angle [Norman G. Bennett, English dentist, 1870– 

1947], the angle formed by the sagittal plane and the path 

of the advancing condyle during lateral mandibular movement, 

as viewed in the horizontal plane. 

Bennett hand tool test, a test used in occupational therapy 

and prevocational testing to measure hand function, coordination, 

and speed in performance. 

Bennett’s fracture [Edward H. Bennett, Irish surgeon, 

1837–1907], a fracture that runs obliquely through the 

base of the first metacarpal bone and into the carpometacarpal 

joint, detaching the greater part of the articular facet. 

Bennett’s fracture may be associated with dorsal subluxation 

or with dislocation of the first metacarpal. 

Benoquin, trademark for a depigmenting agent (monobenzone). 

benserazide /ben-serah-zīd/, an inhibitor of the decarboxylation 

of peripheral levodopa to dopamine, having actions 

similar to those of carbidopa. When given with levodopa, 

benserazide produces higher brain concentrations of 

dopamine with lower doses of levodopa, thus lessening the 

side effects seen with higher doses. It is used orally in conjunction 

with levodopa as an antiparkinsonian agent. 

bent fracture. See greenstick fracture. 

bentiromide test, (for pancreatic function) bentiromide is 

administered orally, and its cleavage into benzoyl-tyrosyl 

and p-aminobenzoic acid is monitored as a measure of pancreatic 

production of chymotrypsin. 

bentonite [Fort Benton, Montana], colloidal, hydrated aluminum 

silicate that, when added to water, swells to approximately 

12 times its dry size. It is used as a bulk laxative and 

as a base for skin care preparations. Also called mineral 

soap. 

bentonite test, a flocculation test for the presence of rheumatoid 

factor in patient blood samples. After sensitized bentonite 

particles are added to the serum, the test result is considered 

positive for rheumatoid arthritis if adsorption has 

occurred with 50% of the particles. 

bentoquatam /bento-kwahtam/, a topical skin protectant 

used to prevent or reduce allergic contact dermatitis 

from contact with poison ivy, oak, and sumac. 

Bentyl, trademark for an anticholinergic antispasmodic 

(dicyclomine hydrochloride). 

benz, abbreviation for a benzoate carboxylate anion. 

benzalkonium chloride, a disinfectant and fungicide prepared 

in an aqueous solution in various strengths. 

benzathine penicillin G. See penicillin G benzathine. 

benzene /benzēn/, a colorless, highly flammable liquid 

hydrocarbon (C 6H 6) originally derived by fractional distillation 

of coal tar. It is now derived by catalytic reforming during 

petroleum refining. The prototypical aromatic compound, 

it is used in the production of various organic 

compounds, including pharmaceuticals.

enzene poisoning 205 Bergonié-Tribondeau law 

benzene poisoning, a toxic condition caused by ingestion 

of benzene, inhalation of benzene fumes, or exposure to 

benzene-related products such as toluene or xylene, characterized 

by blurred vision, nausea, headache, dizziness, and 

incoordination. In acute cases, respiratory failure, convulsions, 

or ventricular fibrillation may cause death. Chronic 

exposure may result in aplastic anemia (a form of leukemia). 

See also nitrobenzene poisoning. 

benzethonium chloride /benzYthōnē·Ym/, a topical 

antiinfective used for disinfecting the skin and for treating 

some infections of the eye, nose, and throat. It is also used as 

a preservative in some pharmaceutical preparations. 

benzhexol hydrochloride. See trihexyphenidyl hydrochloride. 

benzo[a]pyrene dihydrodiol epoxide (BPDE-I), a carcinogenic 

derivative of benzo[a]pyrene associated with tobacco 

smoke. 

benzocaine /benzYkān/, an ester-type, local anesthetic 

agent derived from aminobenzoic acid that is most useful 

when applied topically. It is used in many over-the-counter 

compounds for pruritus and pain. Benzocaine has a low incidence 

of toxicity, but sensitization to it may result from 

prolonged or frequent use. Topical application of benzocaine 

may cause methemoglobinemia in infants and small children. 

A minimum of 5% benzocaine is required in a compound 

to be effective. 

benzodiazepine derivative /benzōdī·azYpin/, one of a 

group of psychotropic agents, including the tranquilizers 

chlordiazepoxide, diazepam, oxazepam, lorazepam, and 

chlorazepate, prescribed to alleviate anxiety, and the hypnotics 

flurazepam and triazolam, prescribed in the treatment of 

insomnia. Tolerance and physical dependence occur with 

prolonged high dosage. Withdrawal symptoms, including 

seizures, may follow abrupt discontinuation. Adverse reactions 

to the benzodiazepines include drowsiness, ataxia, and 

a paradoxic increase in aggression and hostility. These reactions 

are not common with the usual recommended dosage. 

benzoic acid /benzōik/, a keratolytic agent, usually used 

with salicylic acid as an ointment in the treatment of athlete’s 

foot and ringworm of the scalp. It has little antifungal 

action but makes deep infections accessible to more potent 

preparation. Mild irritation may occur at the site of application. 

benzonatate /benzōnYtāt/, a nonopiate antitussive. 

INDICATION: It is prescribed to suppress the cough reflex. 



ADVERSE EFFECTS: Hypersensitivity reactions, such as 

bronchospasm, laryngospasm, and cardiovascular collapse, 

may occur and may be serious. Vertigo, sedation, headache, 

and constipation may sometimes occur. 

benzoyl peroxide /benzōil/, an antibacterial, keratolytic 

drying agent. 

INDICATION: It is prescribed in the treatment of acne. 


prohibits its use. It is not used in the eye, on inflamed skin, or 

on mucous membranes. 


are excessive drying and allergic contact sensitization. 

benzquinamide /benzkwinYmīd/, an antiemetic. 

INDICATIONS: It is prescribed in the treatment of postoperative 

nausea and vomiting. 


prohibits its use. It is not usually administered to children or 

to pregnant women. 


are sudden increase in blood pressure and cardiac ar- 

rhythmia. Drowsiness, chills, and shivering are commonly 

noted. 

benzthiazide /benzthīYzid/, a diuretic and antihypertensive. 

INDICATIONS: It is prescribed in the treatment of hypertension 

and edema. 

CONTRAINDICATIONS: Anuria or known hypersensitivity to 

this drug, to other thiazide medication, or to sulfonamide derivatives 


ADVERSE EFFECTS: Among the more serious adverse effects 

are hypokalemia, hyperglycemia, hyperuricemia, and hypersensitivity 

reactions. 

benztropine mesylate /benztrōpēn/, an anticholinergic 

and antihistaminic agent. 

INDICATIONS: It may be prescribed as adjunctive therapy in 

the treatment of drug-induced extrapyramidal symptoms and 

all forms of parkinsonism. 

CONTRAINDICATIONS: Known sensitivity to this drug prohibits 

its use, and it is not administered to children less than 3 

years of age. 


are blurred vision, xerostomia, nausea and vomiting, 

constipation, depression, and skin rash. 

benzyl alcohol /benzil/, a clear, colorless, oily liquid, derived 

from certain balsams, used as a topical anesthetic and 

as a bacteriostatic agent in solutions for injection. Also 

called phenyl carbinol, phenyl methanol. 

benzyl benzoate /benzōāt/, a clear, oily liquid with a 

pleasant, pervasive aroma. It is used as an agent to destroy 

lice and scabies, as a solvent, and as a flavor for gum. 

benzyl carbinol. See phenylethyl alcohol. 

bepridil /bepr-dil/, a calcium channel blocking agent used 

orally as the hydrochloride salt in treatment of chronic angina 

pectoris. 

beractant /ber-aktant/, a substance obtained from bovine 

lungs, containing mostly phospholipids. It mimics the action 

of human pulmonary surfactant and is used in prevention 

and treatment of respiratory distress syndrome of the newborn. 

Administered by endotracheal intubation. 

Berdon’s syndrome, megacystis-microcolon-intestinal 

hypoperistalsis. 

bereavement /bYrēvmYnt/ [ME, bereven, to rob], a form 

of grief with anxiety symptoms that is a common reaction to 

the loss of a loved one. It may be accompanied by insomnia, 

hyperactivity, and other effects. Although bereavement does 

not necessarily lead to depressive illness, it may be a triggering 

factor in a person who is otherwise vulnerable to depression. 

See also grief, mourning. 

Berger’s disease [Jean Berger, twentieth century French 

nephrologist], a kidney disorder characterized by recurrent 

episodes of macroscopic hematuria, proteinuria, and a granular 

deposition of immunoglobulin A (IgA) from the glomerular 

mesangium. The condition may or may not progress to 

renal failure over a period of many years. A spontaneous remission 

occurs in some cases. The onset of disease is usually 

in childhood or early adulthood, and males are affected twice 

as often as females. Treatment is similar to that of other renal 

diseases. Also called mesangial IgA nephropathy 

/mesanjē·Yl/. 

Berger’s paresthesia [Oskar Berger, nineteenth century 

German neurologist; Gk, para, near, aisthesia, sensation], 

a condition of tingling, prickliness, or weakness and a loss of 

feeling in the legs without evidence of organic disease. The 

condition affects young people. 

Berger wave. See alpha wave. 

Bergonié-Tribondeau law /bergônētribôdō/ [Jean A. 

Bergonié, French radiologist, 1857–1925; Louis F.A.

eriberi 206 berry aneurysm 

Tribondeau, French physician, 1872–1918], a rule stating 

that the radiosensitivity of a tissue depends on the number of 

undifferentiated cells in the tissue, their mitotic activity, and 

the length of time they are actively proliferating. 

beriberi /berēberē/ [Sinhalese, beri, weakness], a disease 

of the peripheral nerves caused by a deficiency of or an inability 

to assimilate thiamine. It frequently results from a 

diet limited to polished white rice, and it occurs in endemic 

form in eastern and southern Asia. Rare cases in the United 

States are associated with stressful conditions, such as hypothyroidism, 

infections, pregnancy, lactation, and chronic 

alcoholism. Symptoms are fatigue, diarrhea, appetite and 

weight loss, disturbed nerve function causing paralysis and 

wasting of limbs, edema, and heart failure. Kinds of beriberi 

include alcoholic beriberi, atrophic beriberi, cardiac beriberi, 

and cerebral beriberi. Administration of thiamine prevents 

Berlock dermatitis (Callen et al, 2000) 

and cures most cases of the disease. Also called agulation disorder characterized by an absence of or a defi- 

athiaminosis. See also thiamine. 

ciency in the ability of the platelets to aggregate because of 

the relative lack of an essential glycoprotein in their membranes. 

On microscopic examination the platelets appear 

large and dispersed. The use of aspirin may provoke hemorrhage. 

After trauma or surgery, loss of blood may be greater 

than normal and a transfusion may be required. 

Bernoulli’s principle /bYrnoo ¯¯¯¯lēz/ [Daniel Bernoulli, Swiss 

scientist, 1700–1782], (in physics) the principle stating 

that the sum of the velocity and the kinetic energy of a fluid 

flowing through a tube is constant. The greater the velocity, 

the less the lateral pressure on the wall of the tube. Thus, if 

an artery is narrowed by atherosclerotic plaque, the flow of 

blood through the constriction increases in velocity and decreases 

in lateral pressure. Also called Bernoulli’s law. 

Bernoulli theorem /bYr·noo ¯¯¯¯lē/, in an experiment involv- 

Cardiac beriberi (McLaren, 1992) 

ing probability, the larger the number of trials, the closer the 

observed probability of an event approaches its theoretical 

probability. 

berry aneurysm [ME, berye Gk, aneurysma, widening], 

a small, saccular dilation of the wall of a cerebral artery. It 

occurs most frequently at the junctures of vessels in the 

circle of Willis. A berry aneurysm may be the result of a congenital 

developmental defect and may rupture without warn- 

berkelium (Bk) /burklē·Ym/ [Berkeley, California], ing, causing intracranial hemorrhage. Smoking and hyper- 

an artificial radioactive transuranic element. Its atomic number 

is 97; the atomic mass of its longest-lived isotope is 247. 

tension increase the likelihood of rupture. 

berlock dermatitis [Fr, breloque, bracelet charm], a temporary 

skin condition, characterized by hyperpigmentation 

and skin lesions. It is caused by a unique reaction to 

psoralen-type photosynthesizers, commonly used in perfumes, 

colognes, and pomades, such as oil of bergamot. Also 

Anterior cerebral 

artery 

Anterior communicating 

artery 

spelled berloque dermatitis. 

OBSERVATIONS: Berlock dermatitis commonly produces an 

acute erythematous reaction, similar to that associated with 

sunburn. The area affected becomes hyperpigmented and 

40% 

Middle cerebral 

artery 

surrounded by darker pigmentation. Areas of the neck where Internal carotid 

20% 

perfume containing oil of bergamot is applied often become 

artery 

affected by pendantlike lesions. Diagnosis is based on the 

34% 

appearance of such signs and on patient history, which may 

include recent exposure to psoralens. 

4% 

INTERVENTIONS: Treatment seeks to identify and eliminate 

the cause of the condition. Topical steroids may be administered 

to relieve discomfort. 

Posterior cerebral 

artery 

Posterior communicating 

artery 

NURSING CONSIDERATIONS: Patients benefit from advice 

about the complications of prolonged exposure to sunlight 

and ultraviolet light. They also appreciate the reassurance 

that the lesions will vanish within a few months. 

Basilar artery 

Bernard-Soulier syndrome /bernärsoo ˘ lyā/ [Jean A. Bernard, 

French hematologist, b. 1907; Jean-Pierre Soulier, 

Common sites of berry aneurysms 

French hematologist, b. 1915], an autosomal-recessive co- 

(Kumar et al, 2007)

Bertel method 207 beta 2-microglobulin test 

Bertel method /burtYl/, a positioning procedure for producing 

x-ray images of the inferior orbital fissures. The central 

x-ray beam is directed through the nasion at an angle of 

20 to 25 degrees cephalad. 

Bertin’s column hypertrophy, congenital enlargement 

of renal columns (columns of Bertin), a benign condition 

sometimes mistaken for a renal tumor. Also called renal column 

h. 

berylliosis /bYrilē·ōsis/, poisoning that results from the 

inhalation of dusts or vapors containing beryllium or beryllium 

compounds. The substance also may enter the body 

through or under the skin. It is characterized by granulomas 

throughout the body and by diffuse pulmonary fibrosis, resulting 

in a dry cough, shortness of breath, and chest pain. 

Symptoms may not appear for several years after exposure. 

See also inorganic dust. 

beryllium (Be), a steel-gray, lightweight metallic element. 

Its atomic number is 4; its atomic mass is 9.012. Beryllium 

occurs naturally as beryl and is used in metallic alloys and in 

fluorescent powders. Inhalation of beryllium fumes or particles 

may cause the formation of granulomas in the lungs, 

skin, and subcutaneous tissues. See also berylliosis. 

bestiality /beschē·alitē/ [L, bestia, beast], 1. a brutal or 

animal-like character or nature. 2. conduct or behavior characterized 

by beastlike appetites or instincts. 3. also called 

zooerastia. Sexual relations between a human being and an 

animal. 4. sodomy. See also zoophilia. 

besylate, a contraction for benzenesulfonate. 

beta /bētY, bātY/, B, , the second letter of the Greek alphabet, 

used in scientific notation to denote position of a carbon 

atom in a molecule, a type of protein configuration, or 

identification of a type of activity, as beta blocker, beta particle, 

or beta rhythm. It is used in statistics to define an error 

in the interpretation of study results. 

beta-adrenergic antagonist, beta-adrenergic blocking 

agent. 

beta-adrenergic blocking agent. See antiadrenergic. 

beta-adrenergic receptor. See beta receptor. 

beta-adrenergic stimulating agent. See adrenergic. 

beta-alaninemia /-alYninēmē·Y/, an inherited metabolic 

disorder marked by a deficiency of an enzyme, beta-alaninealpha-ketoglutarate 

aminotransferase. The clinical signs include 

seizures, drowsiness, and, if uncorrected, death. The 

condition is sometimes treated with vitamin B 6 (pyridoxine). 

beta blocker, a popular term for a beta-adrenergic blocking 

(or beta receptor antagonist) agent. See antiadrenergic. 

beta-carotene [Gk, beta; L, carota, carrot], a vitamin A 

precursor and ultraviolet screening agent. 

INDICATION: It is prescribed to ameliorate photosensitivity 

in patients with erythropoietic protoporphyria. 

CONTRAINDICATIONS: It is used with caution in patients with 

impaired renal or hepatic function. Known hypersensitivity 

to this drug prohibits its use. 

ADVERSE EFFECTS: No serious adverse reactions have been 

observed. Diarrhea may occur. 

beta cells, 1. insulin-producing cells situated in the islets 

of Langerhans. Their insulin-producing function tends to accelerate 

the movement of glucose, amino acids, and fatty 

acids out of the blood and into the cellular cytoplasm, countering 

glucagon function of alpha cells. 2. the basophilic 

cells of the anterior lobe of the pituitary gland. 

beta decay, a type of radioactivity that results in the emission 

of beta particles, either electrons or positrons. See beta 

particle. 

Betadine, trademark for a topical antiinfective (povidoneiodine). 

beta error. See type II error. 

beta-fetoprotein, a protein found in fetal liver and in 

some adults with liver disease. It is now known to be identical 

with normal liver ferritin. See also alpha-fetoprotein, 

ferritin, fetoprotein. 

beta-galactosidase. See lactase. 

Betagan, trademark for a topical glaucoma drug 

(levobunolol hydrochloride); same brand name is also used 

for povidone-iodine germicidal solutions. 

beta hemolysis, the development of a clear zone around a 

bacterial colony growing on blood agar, characteristic of certain 

pathogenic bacteria. Compare alpha hemolysis. 

beta-hemolytic streptococci, the pyogenic streptococci 

of groups A, B, C, E, F, G, H, K, L, M, and O that cause hemolysis 

of red blood cells in blood agar in the laboratory. 

These organisms cause most of the acute streptococcal infections 

seen in humans, including scarlet fever, many cases of 

pneumonia and sepsis syndrome, and streptococcal sore 

throat. Penicillin is usually prescribed to treat these infections 

when they are suspected, even before the results of the 

bacteriologic culture are available, because it is known that 

these organisms as a group are usually sensitive to the effects 

of penicillin and because the sequelae of untreated streptococcal 

infection may include glomerulonephritis and rheumatic 

fever. 

betahistine /batah-histēn/, a histamine analogue used as 

the hydrochloride salt and as a vasodilator to reduce the frequency 

of attacks of vertigo in Meniere’s disease, especially 

in patients having a high frequency of such attacks; administered 

orally. 

17-hydroxycorticosterone, cortisol. 

beta-hydroxyisovaleric aciduria, an inherited metabolic 

disease caused by a deficiency of an enzyme needed to metabolize 

the amino acid leucine. The condition results in an 

accumulation of leucine in the tissues, causing maple sugar 

odor in the urine, ketoacidosis, retardation, and muscle atrophy. 

See also maple syrup urine disease. 

beta 2-interferon. See interleukin-6. 

beta-ketobutyric acid. See acetoacetic acid. 

beta-lactam antibiotic, any of a group of antibiotics, including 

the cephalosporins and the penicillins, whose chemical 

structure contains a beta-lactam ring. 

beta-lactamase /-laktYmāz/ [lactam, a cyclic amide, ase, 

enzyme], a bacterial enzyme that catalyzes the hydrolysis 

of the beta-lactam ring of some penicillins and cephalosporins, 

producing penicilloic acid and rendering the antibiotic 

ineffective. Also called cephalosporinase, penicillinase. 

beta-lactamase resistance. See beta-lactamase-resistant 

antibiotics. 

beta-lactamase-resistant antibiotics, antibiotics that are 

resistant to the enzymatic effects of beta-lactamase. 

beta-lactamase-resistant penicillin. See beta-lactamase-resistant 

antibiotics. 

betamethasone, a glucocorticoid. 

INDICATION: It is prescribed for topical corticosteroidresponsive 

dermatoses and injected directly into lesions 

(bursitis, rheumatoid arthritis, etc.) to help control pain and 

inflammation. 

CONTRAINDICATIONS: Systemic fungal infections, dermatologic 

viral and fungal infections, impaired circulation, or 



associated with prolonged use of the drug are GI, endocrine, 

neurologic, and fluid and electrolyte disturbances. 

beta 2-microglobulin (B 2M) test, a test that analyzes 

blood, urine, or fluid for increased levels of B 2M, a protein 

found on the surface of all cells. Increased levels in the urine 

indicate renal tubule disease; drug-induced renal toxicity;

eta-naphthylamine 208 Bg blood group 

heavy metal–induced renal disease; lymphomas, leukemia, 

or myeloma; or AIDS. Increased serum levels indicate lymphomas, 

leukemia, or myeloma; glomerular renal disease; 

renal transplant rejection; viral infections, especially HIV 

and cytomegalovirus; or chronic inflammatory processes. 

beta-naphthylamine /-nafthilYmēn/, an aromatic amine 

used in aniline dyes and linked to the development of bladder 

cancer in humans. 

beta-oxidation, a catabolic process in which fatty acids 

are used by the body as a source of energy. The fatty acid 

molecules are converted through a series of intermediates 

into acetylcoenzyme A molecules, which then enter the tricarboxylic 

acid (TCA) cycle along with metabolites of carbohydrates 

and proteins. 

Betapar, trademark for a glucocorticoid (meprednisone). 

beta particle, an electron emitted from the nucleus of an 

atom during radioactive decay of the atom. Beta particles 

have a range of 10 m in air and 1 mm in soft tissue. Also 

called beta ray. 

Betapen-VK, trademark for an antibiotic (penicillin V potassium). 

beta phase, the period immediately following the alpha, or 

redistribution, phase of drug administration. During the beta 

phase the blood level of the drug falls more slowly as it is 

metabolized and excreted from the body. 

beta rays, a stream of beta particles, as emitted from atoms 

of disintegrating radioactive elements. Normally, the element 

is a nuclide with a high ratio of neutrons to protons. 

beta receptor, any one of the postulated adrenergic (sympathetic 

fibers of autonomic nervous system) components of 

receptor tissues that respond to epinephrine and such blocking 

agents as propranolol. Activation of beta receptors 

causes various physiologic reactions such as relaxation of 

the bronchial muscles and an increase in the rate and force of 

cardiac contraction. Also called beta-adrenergic receptor. 

Compare alpha receptor. 

beta rhythm. See beta wave. 

beta-thalassemia, an anemia that is caused by diminished 

synthesis of beta chains of hemoglobin. The homozygous 

form is known as thalassemia major and the heterozygous 

form is known as thalassemia minor. See thalassemia. 

betatron /bātYtron/, a cyclic accelerator that produces 

high-energy electrons for radiotherapy. The magnetic field of 

the betatron deflects electrons into a circular orbit, and an increasing 

magnetic orbital flux produces an induced circumferential 

electric field that accelerates them. 

beta wave, one of several types of brain waves, characterized 

by relatively low voltage and a frequency of more than 

13 Hz. Beta waves are the “busy waves” of the brain, recorded 

by electroencephalograph from the frontal and the 

central areas of the cerebrum when the patient is awake and 

alert with eyes open. Also called beta rhythm. Compare 

alpha wave, delta wave, theta wave. 

betaxolol hydrochloride /betaksYlol/, a topical drug for 

open-angle glaucoma (Betoptic). An oral preparation 

(Kerlone) is indicated for the management of hypertension. 

INDICATIONS: It is prescribed for the relief of ocular hypertension 

and chronic open-angle glaucoma (ophthalmic) and 

for the management of hypertension (oral). 

CONTRAINDICATIONS: Betaxolol hydrochloride is contraindicated 

in patients with sinus bradycardia, greater than firstdegree 

atrioventricular (AV) block, cardiogenic shock, and 

overt heart failure. The ophthalmic preparation is used with 

caution by patients who are also receiving oral betaadrenergic 

blocking drugs. 

ADVERSE EFFECTS: Adverse reactions include stinging and 

tearing of the eyes. Systemic effects are rare. Adverse effects 

of the oral preparation are bradycardia, fatigue, dyspnea, and 

lethargy. 

bethanechol chloride /bethanYkol/, a cholinergic. 

INDICATIONS: It is prescribed in the treatment of fecal and 

urinary retention and neurogenic atony of the bladder. 

CONTRAINDICATIONS: Uncertain strength of the bladder, obstruction 

of the GI or urinary tract, hyperthyroidism, peptic 

ulcer, bronchial asthma, cardiovascular disease, epilepsy, 

Parkinson’s disease, hypotension, or known hypersensitivity 

to this drug prohibits its use. It is not given during pregnancy. 

It is never given intramuscularly or intravenously. 


are flushing, headache, GI distress, diarrhea, excessive 

salivation, sweating, and hypotension. 

Betopic, trademark for a topical glaucoma medication (betaxolol 

hydrochloride). 

Betz cells [Vladimir A. Betz, Russian anatomist, 1834–1894; 

L, cella, storeroom], 1. large pyramidal neurons of the 

motor cortex with axons that form part of the pyramidal 

tract associated with voluntary movements. 2. upper motor 

neurons. 

bevacizumab, a DNA-derived monoclonal antibody that 

selectively binds to and inhibits activity of human vascular 

endothelial growth factor to reduce microvascular growth 

and inhibition of metastatic disease progression. 

INDICATIONS: This drug is used to treat metastatic carcinoma 

of the colon or rectum in combination with 5-FU IV. It 

is also being investigated for use as an adjunctive in breast 

and renal cancer. 



ADVERSE EFFECTS: Adverse effects of this drug include hypertension, 

hypotension, nausea, vomiting, anorexia, diarrhea, 

constipation, abdominal pain, anorexia, colitis, stomatitis, 

proteinuria, urinary frequency and urgency, bilirubinemia, 

hypokalemia, dyspnea, and upper respiratory 

tract infection. Life-threatening side effects include deep 

vein thrombosis, hypertensive crisis, GI hemorrhage, nephritic 

syndrome, leukopenia, neutropenia, thrombocytopenia, 

exfoliative dermatitis, and hemorrhage. Common side 

effects include asthenia and dizziness. 

bevel /bevYl/ [OFr, baif, open mouth angle], 1. any angle, 

other than a right angle, between two planes or surfaces. 

2. (in dentistry) any angle other than 90 degrees between a 

tooth cut and a cavity wall in the preparation of a tooth cavity. 

Compare cavosurface bevel, contra bevel. 

bexarotene, a second-generation retinoid. 

INDICATIONS: This drug is prescribed for cutaneous T-cell 

lymphoma. Investigational uses include treatment of breast 

cancer. 

CONTRAINDICATIONS: Pregnancy and known hypersensitivity 

to retinoids prohibit bexarotene’s use. 

ADVERSE EFFECTS: Life-threatening adverse reactions include 

acute pancreatitis, leukopenia, and neutropenia. Other 

serious side effects include asthenia, infection, anemia, and 

hypothyroidism. Among the drug’s common side effects are 

headache, nausea, abdominal pain, and diarrhea. 

bezoar /bēzôr/ [Ar, bazahr, protection against poison], 

a hard ball of hair or vegetable fiber that may develop within 

the stomach of humans. More often it is found in the stomachs 

of ruminants. In some societies it was formerly considered 

a useful medicine and possessed of certain magical 

properties. It is apparently still used as a therapeutic and 

mystical device by some, especially in the Far East. 

Bg blood group, a blood group consisting of the erythrocytic 

HLA antigens Bg a ,Bg b ,Bg c , DBG, Ho, Ho-like, Ot, 

and Sto.

Bh 209 biceps brachii 

Bh, symbol for the element Bohrium. 

bhang /bang/ [Hindi, bag], an Asian Indian hallucinogenic, 

composed of dried leaves and the young stems of uncultivated 

Cannabis sativa. It is usually ingested as a boiled mixture 

with milk, sugar, or water. It produces euphoria. It also 

may be smoked or chewed. Also spelled bang. See also 

cannabis. 

BHC, benzene hexachloride. 

Bi, symbol for the element bismuth. 

bi-, prefix meaning “twice, two”: biarticular, bicaudal. 

BIA, abbreviation for bioelectric impedance analysis. 

-bia, suffix meaning “creature possessing a mode of life”: 

aerobia. 

biarticular. See diarticular. 

bias /bīYs/ [MFr, biais], 1. an oblique or a diagonal line. 

2. a prejudiced or subjective attitude. 3. (in statistics) the 

distortion of statistical findings from the true value. There 

can be many kinds of bias; some may be caused by the sampling 

process, but bias can be caused by other factors. 

4. (in electronics) a voltage applied to an electronic device, 

such as a vacuum tube or a transistor, to control operating 

limits. See also detection bias. 

biased sample /bīYst/ [OFr, biais, slant; L, exemplum, 

sample], (in research) a sample of a group in which all factors 

or participants are not equally balanced or objectively 

represented. 

biasing /bīYsing/, a method of treating neuromuscular 

dysfunction by contracting a muscle against resistance, causing 

the muscle spindles to readjust to the shorter length and 

the muscle tissue to be more responsive and sensitive to 

stretching. 

biauricular /bīaw·rikyoo ¯¯¯¯·lYr/ [L, bis, twice auriculus, 

little ear], pertaining to the two auricles of the ears. Also 

called binauricular. 

Biavax, trademark for a rubella and mumps vaccine. 

bibliotherapy 1 , a type of group therapy in which books, 

poems, and newspaper articles are read in the group to help 

stimulate thinking about events in the real world and to foster 

relations among group members. 

bibliotherapy 2 should be used with caution in patients with moderate to severe 

liver dysfunction. 

ADVERSE EFFECTS: The side effects most often reported include 

hot flashes, general body pain, asthenia, constipation, 

nausea, and diarrhea. 

bicameral /bī·kamYr·Yl/ [L, bis, twice camera, vaulted 

chamber], having two chambers. 

bicameral abscess /bīkamYrYl/, 

arate cavities or chambers. 

an abscess with two sep- 

Bezoar (Kumar, Abbas, and Fausto, 2005) 

bicapsular /bī·kapsyoo ¯¯¯¯·lYr/ [L, bis, twice capsula, little 

box], having two capsules, as an articular capsule. 

 

bicarbonate (HCO3 ) /bīkärbYnāt/ [L, bis, twice, carbo, 

coal], an anion of carbonic acid in which only one of the 

hydrogen atoms has been removed, as in sodium bicarbonate 

(NaHCO3). It is also called hydrogencarbonate. 

bicarbonate of soda. See sodium bicarbonate. 

bicarbonate precursor, an injection of sodium lactate 

used in the treatment of metabolic acidosis. It is metabolized 

in the body to sodium bicarbonate. 

bicarbonate therapy, a procedure to increase a patient’s 

stores of bicarbonate when there are signs of severe acidosis. 

It is usually performed only in certain cases and as a stopgap 

measure to neutralize acidosis partially when the patient’s 

blood pH has fallen to levels that may be hazardous to the 

survival of vital tissues. 

bicarbonate transport, the route by which most of the 

carbon dioxide is carried in the bloodstream. Once dissolved 

in the blood plasma, carbon dioxide combines with water to 

form carbonic acid, which immediately ionizes into hydrogen 

and bicarbonate ions. The bicarbonate ions serve as part 

of the alkaline reserve. 

bicellular /bī·selyoo ¯¯¯¯·lYr/ [L, bis, twice cella, storeroom], 

made up of two cells, or having two cells. 

biceps brachii /bīseps brākē·ī/ [L, bis, twice, caput, head, 

bracchii, arm], the long fusiform muscle of the upper arm 

on the anterior surface of the humerus, arising in two heads 

from the scapula. It flexes the arm and the forearm and supinates 

the hand. Also called biceps, biceps flexor cubiti. 

Compare brachialis, triceps brachii. 

Coracobrachialis 

Biceps brachii 

Teres major 

Triceps brachii 

, a nursing intervention from the Nursing 

Brachialis 

Interventions Classification (NIC) defined as the therapeutic 

use of literature to enhance expression of feelings, active 

problem solving, coping, or insight. See also Nursing Inter- 

Radius 

ventions Classification. 

bicalutamide, an anticancer chemotherapy agent. 

Pronator teres 

INDICATIONS: It is prescribed in the treatment of metastatic 

prostate cancer. The drug acts by binding to androgen receptors 

within target cells, preventing androgens from binding 

to them. 

Ulna 

CONTRAINDICATIONS: The drug should not be given to patients 

who have an allergic reaction to it. Bicalutamide 

Biceps brachii (Thibodeau and Patton, 2007)

iceps femoris 210 bidet 

biceps femoris [L, bis, twice, caput, head, femoris, thigh], 

one of the posterior femoral muscles. It has two heads at its 

origin. The biceps femoris flexes the leg and rotates it laterally 

and extends the thigh, rotating it laterally. It is one of the 

hamstring muscle group and lies on the posterior, lateral 

side of the thigh. 

Long head 

Biceps femoris 

Short head 

biceps flexor cubiti. See biceps brachii. 

biceps reflex, a contraction of a biceps muscle produced 

when the tendon is tapped with a percussor in testing deep 

tendon reflexes. See also deep tendon reflex. 

Biceps reflex testing (Seidel et al, 2006) 

Bichat’s membrane /bishäz/ [Marie F.X. Bichat, French 

anatomist, 1771–1802], an elastic lining beneath the endothelium 

of an arterial wall. 

Bicillin C-R /bi-silin/, trademark for combination preparations 

of the antibiotics penicillin G benzathine and penicillin 

G procaine. 

bicipital aponeurosis, a flat sheet of connective tissue 

that fans out from the medial side of the tendon to blend 

with deep fascia covering the anterior compartment of the 

forearm. 

bicipital groove /bīsipYtYl/ [L, bis, twice, caput, head; D, 

groeve], a groove between the greater and lesser tubercles 

of the humerus for passage of the tendon of the long head of 

the biceps muscle. 

Bickerdyke, Mary Ann /bikYrdīk/, (1817–1901), an 

American nurse who, after taking a short course in homeopathy, 

cared for the sick and wounded on battlefields during 

the U.S. Civil War. She insisted on cleanliness, good food, 

and the best of medical care for her patients. At night she 

searched the battlefield with a lantern for survivors. 

biclor /bīklôr/, abbreviation for two chloride anions in 

a salt. 

biconcave /bīkonkāv/ [L, bis, twice, concavare, to make 

hollow], concave on both sides, especially as applied to a 

lens. —biconcavity, n. 

biconvex /bīkonveks/ [L, bis convexus, vaulted], 

convex on both sides, especially as applied to a lens. 

—biconvexity, n. 

bicornate /bīkôrnāt/ [L, bis cornu, horn], having two 

horns or processes. 

bicornate uterus, an abnormal uterus that may be either a 

single or a double organ with two horns, or branches. The 

anomaly is believed to result from an embryonic development 

error and is associated with a high incidence of preterm 

birth, spontaneous abortion, and infertility. 

bicornuate. See bicornate. 

bicuspid /bīkuspid/ [L, bis cuspis, point], 1. having 

two cusps or points. 2. See premolar. 

bicuspid valve. See mitral valve. 

bicycle ergometer [L, bis, twice; Gk, kyklos, circle, ergon, 

work, metron, measure], a stationary bicycle dynamometer 

that measures the strength of an individual’s muscle contraction. 

b.i.d., (in prescriptions) abbreviation for bis in die /dēā/, a 

Latin phrase meaning ‘twice a day.’ 

bidactyly /bīdaktilē/ [L, bis Gk, daktylos, finger], 

an abnormal condition in which the second, third, and fourth 

digits on a hand are missing and only the first and fifth are 

present. Also called lobster claw deformity. —bidactylous, 

adj. 

Bidactyly 

(Zitelli and Davis, 2007/Courtesy Dr. Christine L. Williams, New York 

Medical College) 

bidermoma /bīdYrmōmY/ pl. bidermomas, bidermomata 

[L, bis Gk, derma, skin, oma, tumor], a teratoid neoplasm 

composed of cells and tissues originating in two germ 

layers. 

bidet /bidā/ [Fr, pony], a fixture resembling a toilet bowl,

iduotertian fever 211 bilberry 

with a rim to sit on and usually equipped with plumbing 

implements for cleaning the genital and rectal areas. 

biduotertian fever /bīdoo ¯¯¯¯·YturshYn/ [L, bis dies, day, 

tertius, three], a form of malaria characterized by overlapping 

paroxysms of chills, fever, and other symptoms. It is 

caused by infection with two strains of Plasmodium, each 

having its own cycle of symptoms, such as in quartan and 

tertian malaria. Compare double quartan fever. See also 

malaria. 

Bier block /bēr blok/ [August Karl Gustav Bier, German surgeon, 

1861–1949], regional anesthesia accomplished after 

IV injection of a dilute local anesthetic such as lidocaine. 

Used for surgical procedures on the arm below the elbow or 

the leg below the knee, it is performed by wrapping the affected 

extremity with an eschmarch bandage to exsanguinate 

the affected extremity before inflation of a pneumatic tourniquet 

to prevent the anesthetic from entering the systemic circulation. 

It is limited to procedures of short duration (less 

than 1 hour). See also anesthesia, regional anesthesia. 

bifid /bīfid/ [L, bis findere to cleave], cleft, or split into 

two parts, as in the spinous processes of the cervical vertebrae. 

bifid scrotum, separation of the two halves of the scrotum, 

as in penoscrotal transposition. 

bifid tongue [L, bis findere, to cleave; AS, tunge], 

a tongue divided by a longitudinal furrow. Also called cleft 

tongue. 

bifid ureter, one in which proximal segments come from 

two different collecting systems but join to form one ureter 

before reaching the bladder. 

bifid uvula, bifurcation of the uvula, an incomplete form 

of cleft palate, commonly seen in Native Americans. 

bifocal /bīfōkYl/ [L, bis focus, hearth], 1. pertaining to 

the characteristic of having two foci. 2. (of a lens) having 

two areas of different focal lengths. 

bifocal contact lens, a contact lens that contains corrections 

for both near and far vision. 

bifocal glasses [L, bis, twice, focus, hearth; AS, glaes], 

eyeglasses in which each lens is made up of two segments of 

different refractive powers or strength. Generally, the upper 

part of the lens is used for ordinary or distant vision, and the 

smaller, lower section for near vision for close work, such as 

reading or sewing. Bifocal eyeglasses may be prescribed for 

presbyopia, which often occurs with aging. 

biforate /bīfôrāt/ [L, bis forare, to pierce twice], 

having two perforations or foramina. 

bifrontal suture /bīfrontYl/ [L, bis frons, front, sutura], 

the interlocking lines of fusion between the frontal and parietal 

bones of the skull. 

bifurcate /bīfurkāt/ [L, bis, twice, furca, fork], pertaining 

to the division or branching of an object into two branches, 

such as the branching of blood vessels or bronchi. 

—bifurcated, adj. 

bifurcate ligament, a V-shaped ligament in the foot that 

connects the anterior process of the calcaneus to the cuboid 

and navicular bones. 

bifurcation /bīfYrkāshYn/ [L, bis furca, fork], a splitting 

into two branches, such as the trachea, which branches 

into the two bronchi. 

Bigelow’s lithotrite /bigYlōz/ [Henry J. Bigelow, American 

surgeon, 1818–1890; Gk, lithos, stone; L, terere, to rub], 

a long-jawed instrument, passed through the urethra, for 

crushing a calculus in the bladder. 

bigeminal /bījeminYl/ [L, bis, twice, geminus, twin], 

pertaining to pairs, twins, or dual events, as a bigeminal 

pulse, which is characterized by two beats in rapid succession. 

See also bigeminy. 

bigeminal pregnancy, a twin pregnancy. 

bigeminal pulse, an abnormal pulse in which two beats in 

close succession are followed by a pause during which no 

pulse is felt. See also trigeminal pulse, trigeminy. 

bigeminal rhythm [L, bis geminus, twin; Gk, rhythmos], 

an abnormal heartbeat in which ectopic ventricular or atrial 

beats alternate with and are precisely coupled to sinus beats, 

or in which ventricular ectopic beats occur in pairs, as in 

ventricular tachycardia with 3:2 exit block. Also called bigeminy, 

coupled rhythm. 

bigeminy /bījeminē/ [L, bis geminus, twin], 1. an association 

in pairs. 2. See bigeminal rhythm. —bigeminal, 

adj. 

bilabe /bīlāb/ [L, bis labium, lip], a narrow forceps used 

to remove small calculi from the bladder by way of the urethra. 

bilabial /bī·lābē·Yl/, a consonantal speech sound produced 

by using the two lips, such as b, p, or m. Also called labial. 

bilaminar /bīlamYnYr/ [L, bis lamina, plate], pertaining 

to or having two layers, such as the ectoderm and endoderm 

of the blastula, and the basal lamina interspersed with reticular 

fibers to form the basement membrane of the epithelium. 

bilaminar blastoderm, the stage of embryonic development 

before mesoderm formation in which only the ectoderm 

and endoderm primary germ layers have formed. Compare 

trilaminar blastoderm. 

bilateral /bilatYrYl/ [L, bis lateralis, side], 1. having 

two sides. 2. occurring or appearing on two sides. A patient 

with bilateral hearing loss may have partial or total hearing 

loss in both ears. 3. having two layers. 

bilateral carotid artery [L, bis, twice, latus, side; Gk, 

karos, heavy sleep], a main artery to the head and neck 

that divides into left and right branches and again into external 

and internal branches. 

bilateral lithotomy [L, bis, twice, latus, side; Gk, lithos, 

stone, temnein, to cut], a surgical procedure for removing 

urinary tract stones from the bladder by making an incision 

across the peritoneum. 

bilateral long-leg spica cast, an orthopedic device of 

plaster of paris, fiberglass, or other casting material that encases 

and immobilizes the trunk cranially as far as the nipple 

line and both legs caudally as far as the toes. A horizontal 

crossbar to improve immobilization connects the parts of the 

cast encasing both legs at ankle level. It is used to aid the 

healing of fractures of the hip, the femur, the acetabulum, 

and the pelvis and to correct hip deformities. Compare oneand-a-half 

spica cast, unilateral long-leg spica cast. 

bilateral strabismus [L, bis latus, side; Gk, strabismos], 

an eye disorder, characterized by bilateral squint, which is 

caused by a failure of ocular accommodation. 

bilateral symmetry [L, bis latus, side; Gk, syn, together, 

metron, measure], similar structure of the halves of an organism. 

Bilbao tube /bilbōY/, a long, thin, flexible tube that is used 

to inject barium into the small intestine. The tube is guided 

with a stiff wire from the mouth to the end of the duodenum 

under fluoroscopic control. 

bilberry, an herb found in the central, Northern, and 

Southeastern regions of Europe. 

USES: This herb is used for diabetic retinopathy, macular 

degeneration, glaucoma, cataract, capillary fragility, varicose 

veins, hemorrhoids, and mild diarrhea; possibly effective 

for some indications but controlled clinical trials do not 

support its use for improving vision. 

CONTRAINDICATIONS: Bilberry should not be used during 

pregnancy and lactation or in children until more research is 

available.

ile 212 biliary colic 

bile /bīl/ [L, bilis], a bitter, yellow-green, viscid alkaline 

fluid secreted by the liver. Stored in the gallbladder, bile receives 

its color from the presence of bile pigments such as 

bilirubin. Bile passes from the gallbladder through the common 

bile duct in response to the cholecystokinin (CCK) produced 

in the duodenum in the presence of a fatty meal. Bile 

emulsifies these fats (breaks them into smaller particles and 

lowers the surface tension), preparing them for further digestion 

and absorption in the small intestine. Any interference in 

the flow of bile will result in the presence of unabsorbed fat 

in the feces and in jaundice. Also called gall. See also biliary 

obstruction, jaundice. —biliary, adj. 

bile acid, a steroid acid of the bile, produced during the 

metabolism of cholesterol. On hydrolysis, bile acid yields 

glycine and choleic acid. 

bile acid breath test, a breath test for overgrowth of bacteria 

in the intestine: the patient is given a dose of a conjugated 

bile acid labeled with carbon 14, and the amount of radioactively 

labeled carbon dioxide in the breath is measured 

at hourly intervals. Excessive labeled carbon dioxide in the 

breath indicates excessive bacteria in the intestine breaking 

down the bile acids. 

bile acid therapy, administration of bile acids for treatment 

of hyperliposis. 

bile duct. See biliary duct. 

bile duct abscess, a cavity containing pus and surrounded 

by inflamed tissue in the bile duct. 

bile pigments, a group of substances that contribute to the 

colors of bile, which may range from a yellowish green to 

brown. A common bile pigment is bilirubin, which contains 

a reddish iron pigment derived from the breakdown of old 

red blood cells. 

bile salts [L, bilis, bile; AS, sealt], a mixture of sodium 

salts of the bile acids and cholic and chenodeoxycholic acids 

synthesized in the liver as a derivative of cholesterol. Their 

low surface tension contributes to the emulsification of fats 

in the intestine and their absorption from the GI tract. 

bile solubility test, a bacteriologic test used in the differential 

diagnosis of pneumococcal and streptococcal infection. 

A broth culture of each organism is placed into two 

tubes. Ox bile is added to one and salt to the other. Pneumococci 

dissolve in ox bile, producing a clear solution. Because 

streptococci do not dissolve, the resulting solution is cloudy. 

The tube with salt is used for comparative purposes. 

Bilharzia. See Schistosoma. 

bilharziasis. See schistosomiasis. 

bili-, prefix meaning “bile”: biliary, bilifuscin. 

biliary /bilē·erē/, pertaining to bile or to the gallbladder 

and bile ducts, which transport bile. These are often called 

the biliary tract or the biliary system. Also bilious. See 

also bile, biliary calculus. 

biliary abscess, an abscess of the gallbladder or liver. 

biliary atresia, congenital absence or underdevelopment 

of one or more of the biliary structures, causing jaundice and 

early liver damage. As the condition worsens, the child’s 

growth may be retarded, and portal hypertension may develop. 

Surgery can correct the defective ducts in only a small 

percentage of cases. Liver transplantation is an option. Most 

infants die in early childhood from biliary cirrhosis. It is essential 

to distinguish between this condition and neonatal 

hepatitis, which is treatable. See also biliary cirrhosis. 

biliary calculus [L, bilis, bile, calculus, pebble], a stone 

formed in the biliary tract, consisting of cholesterol or bile 

pigments and calcium salts. Biliary calculi may cause jaundice, 

right upper quadrant pain, obstruction, and inflammation 

of the gallbladder. If stones cannot pass spontaneously 

into the duodenum, cholangiography or similar processes 

will reveal their location, and they can be removed surgically. 

Also called choledocholithiasis, gallstones. See also 

cholangitis, cholecystitis, cholelithiasis. 

Gallbladder 

Cystic 

duct 

Hepatic duct 

Small bile 

duct 

Common bile duct 

Greater duodenal 

papilla 

Common sites of biliary calculi 

(Monahan et al, 2007) 

biliary cirrhosis [L, bilis kirrhos, yellow-orange, osis, 

condition], an inflammatory condition in which the flow of 

bile through the ductules of the liver is obstructed. Primary 

biliary cirrhosis most commonly affects women in their middle 

years and is often associated with antimitochondrial antibodies. 

Its cause is unknown. It is characterized by itching, 

jaundice, steatorrhea, and enlargement of the liver and 

spleen. The disease is slowly progressive. Treatment includes 

ursodeoxycholic acid. Care must be taken to rule out 

secondary biliary cirrhosis caused by obstruction of the biliary 

structures outside the liver, because the latter condition 

can be treated more successfully. Compare biliary calculus, 

biliary obstruction. 

Biliary cirrhosis (Kumar et al, 2007) 

biliary colic [L, bilis kolikos, colon pain], a type of 

smooth muscle or visceral pain specifically associated with 

the passing of stones through the bile ducts. Also called 

cholecystalgia. See also biliary calculus.

iliary duct 213 bilirubin diglucuronide 

biliary duct, one of the muscular ducts through which bile 

passes from the liver and gallbladder to the duodenum. See 

also common bile duct. 

biliary dyskinesia, pain or discomfort in the epigastric region 

resulting from spasm, especially of the sphincter of 

Oddi, following cholecystectomy. It interferes with bile 

drainage. 

biliary dyspepsia, a digestive upset caused by an inadequate 

flow of bile into the duodenum. 

biliary fistula, an abnormal passage from the gallbladder, 

a bile duct, or the liver to an internal organ or the surface of 

the body. Biliary fistulae into the duodenum may complicate 

cholelithiasis; a gallstone may become impacted, usually in 

the ileocecal valve, and cause intestinal obstruction. 

biliary glands. See glands of bile duct. 

biliary obstruction, blockage of the common or cystic 

bile duct, usually caused by one or more gallstones. It impedes 

bile drainage and produces an inflammatory reaction. 

Less common causes of biliary obstruction include choledochal 

cysts, pancreatic and duodenal tumors, Crohn’s disease, 

pancreatitis, echinococcosis, ascariasis, and sclerosing 

cholangitis. Stones, consisting chiefly of cholesterol, bile 

pigment, and calcium, may form in the gallbladder and in the 

hepatic duct in persons of either sex at any age but are more 

common in middle-aged women. Increased amounts of 

serum cholesterol in the blood, such as occurs in obesity, diabetes, 

hypothyroidism, biliary stasis, and inflammation of 

the biliary system, promote gallstone formation. Cholelithiasis 

may be asymptomatic until a stone lodges in a biliary 

duct, but the patient usually has a history of indigestion and 

discomfort after eating fatty foods. A calculus biliary obstruction 

should be considered cancerous until proven 

otherwise. 

OBSERVATIONS: Biliary obstruction is characterized by severe 

epigastric pain, often radiating to the back and shoulder, 

nausea, vomiting, and profuse diaphoresis. The dehydrated 

patient may have chills; fever; jaundice; clay-colored stools; 

dark, concentrated urine; an electrolyte imbalance; and a tendency 

to bleed because the absence of bile prevents the synthesis 

and absorption of fat-soluble vitamin K. 

INTERVENTIONS: The patient is placed in bed in a semi- 

Fowler’s position and is usually administered intermittent 

nasogastric suctioning, parenteral fluids with electrolytes 

and fat-soluble vitamins, and medication for pain. Antibiotics, 

anticholinergic and antispasmodic drugs, and a cholecystogram 

or ultrasound scan may be ordered. The blood 

pressure, temperature, pulse, and respirations are monitored, 

and the patient is helped to turn, cough, and deep breathe 

every 2 to 4 hours. Fluid intake and output are measured, and 

the color and character of urine and stools are noted. When 

the nasogastric tube is removed, the patient initially receives 

a low-fat liquid diet and progresses to a soft or normal diet, 

as tolerated; up to 2500 mL of fluids a day are encouraged or 

administered intravenously, unless contraindicated. Cholecystectomy 

is usually the definitive treatment, but in most 

cases surgery is delayed until the patient’s condition is stabilized 

and any prothrombin deficiency (caused by vitamin 

K malabsorption) is corrected. 

biliary pseudolithiasis, pain in the bile ducts with symptoms 

resembling those of cholelithiasis but in the absence of 

gallstones. 

biliary system. See biliary. 

biliary tract [L, bilis, bile, tractus], the pathway for bile 

flow from the canaliculi in the liver to the opening of the bile 

duct into the duodenum. 

biliary tract cancer, a rare adenocarcinoma in a bile duct 

often causing jaundice, pruritus, and weight loss. The lesion 

Stents in place to correct biliary obstruction 

(Feldman, Friedman, and Brandt, 2006) 

may be papillary or flat and ulcerated. The tumor is often unresectable 

at diagnosis. 

biligenesis /bilijenYsis/, the process by which bile is produced. 

bilingulate /bīlinggyYlit/ [L, bis, twice, lingula, little 

tongue], having two tongues or two tonguelike structures. 

biliopancreatic diversion, a surgical treatment for morbid 

obesity consisting of resection of the distal two thirds of 

the stomach and attachment of the ileum to the proximal 

stomach. The duodenum and jejunum are bypassed and 

empty their secretions into the distal ileum through a new 

anastomosis. Also called biliopancreatic bypass. 

bilious /bilyYs/ [L, bilis, bile], 1. pertaining to bile. 

2. characterized or affected by disordered liver function and 

especially excessive secretion of bile. 

bilious vomiting, the vomiting of bile. Also called cholemesis. 

bilirubin /biliroo ¯¯¯¯bin/ [L, bilis ruber, red], the orangeyellow 

pigment of bile, formed principally by the breakdown 

of hemoglobin in red blood cells after termination of their 

normal lifespan. Water-insoluble unconjugated bilirubin normally 

travels in the bloodstream to the liver, where it is converted 

to a water-soluble, conjugated form and excreted into 

the bile. In a healthy person, about 250 mg of bilirubin is 

produced daily. The majority of bilirubin is excreted in the 

stool. The characteristic yellow pallor of jaundice is caused 

by the accumulation of bilirubin in the blood and in the tissues 

of the skin. Testing for bilirubin in the blood provides 

information for diagnosis and evaluation of liver disease, biliary 

obstruction, and hemolytic anemia. Normal levels of 

total bilirubin are 0.1 to 1 mg/dl or 5.1 to 17 µmol/L. See 

also jaundice, van den Bergh’s test. 

bilirubin blood test, a blood test performed in cases of 

jaundice to help determine whether the jaundice is caused by 

hepatocellular dysfunction (as in hepatitis) or extrahepatic 

obstruction of the bile ducts (as with gallstones or tumor 

blocking the bile ducts). Total serum bilirubin is made up of 

conjugated (direct) and unconjungated (indirect) bilirubin, 

with varying ratios of each characterizing different diseases. 

bilirubin cast, a cast containing bilirubin, giving it a 

yellow-brown color, as seen with obstructive jaundice. 

bilirubin diglucuronide, a conjugated water-soluble 

form of bilirubin, formed in the liver by esterification of two

ilirubinemia 214 bimolecular reaction 

molecules of glucuronide to the bilirubin molecule; this is 

the usual form in which bilirubin is found in the bile. 

bilirubinemia /-ēmē·Y/ [L, bilis, bile, ruber, red; Gk, haima, 

blood], the presence of bilirubin in the blood. 

bilirubinuria /-oo ˘ rē·Y/, the presence of bilirubin in urine. 

biliuria /biliyoo ˘ rē·Y/ [L, bilis Gk, ouron, urine], 

the presence of bile pigments in the urine. 

biliverdin /bilivurdin/ [L, bilis virdis, green], a greenish 

bile pigment formed in the breakdown of hemoglobin 

and converted to bilirubin. See also bile, bilirubin. 

billing limit. See limiting charge. 

Billings method, a way of estimating ovulation time by 

changes in the cervical mucus that occur during the menstrual 

cycle. See also ovulation method of family planning. 

Billroth’s operation I [Christian A. Billroth, Austrian surgeon, 

1829–1894], the surgical removal of the pylorus in 

the treatment of gastric cancer or peptic ulcer disease. The 

proximal end of the duodenum is anastomosed to the 

stomach. 

Vagus nerve 

50%-75% 

of stomach 

removed 

Duodenum 

Duodenum 

Vagotomy 

Remaining 

stomach 

Billroth’s operation I (Lewis et al, 2007) 

Billroth’s operation II [Christian A. Billroth], the surgical 

removal of the pylorus and the first part of the duodenum. 

The cut end of the stomach is anastomosed to the jejunum, 

which is pulled through the transverse mesocolon from the 

lower abdomen. The remaining duodenum carrying biliary 

and pancreatic secretions drains into the ileum through a 

new anastamosis in the lower abdomen. Also called 

gastrojejunostomy. 

Vagus nerve 

50% 

of stomach 

removed 

Duodenum 

Vagotomy 

Stomach sutured 

to jejunum 

Billroth’s operation II (Lewis et al, 2007) 

Bill’s maneuver [Arthur H. Bill, American obstetrician, 

1877–1961], an obstetric procedure in which a forceps is 

used to rotate the fetal head at midpelvis before extraction of 

the head during birth. 

bilobate /bīlōbāt/ [L, bis, twice, lobus, lobe], having two 

lobes. 

bilobate placenta [L, bis, twice, lobus, lobe, placenta, flat 

cake], a placenta with two connected lobes. Also called bilobed 

placenta, placenta bipartitia. 

Bilobate placenta (Carlson, 2004) 

bilobulate /bīlobyYlāt/, having two lobules. Also bilobular. 

bilocular /bīlokyYlYr/ [L, bis loculus, compartment], 

1. divided into two cells. 2. containing two cells. Also 

biloculate. 

Biltricide, trademark for an anthelmintic (praziquantel). 

bimanual /bīmanyoo ¯¯¯¯·Yl/ [L, bis manus, hand], with 

both hands. 

bimanual examination [L, bis manos, hand], an examination, 

usually vaginal, that requires the use of both of the 

examiner’s hands. 

bimanual palpation, the examination of a woman’s pelvic 

organs in which the examiner places one hand on the abdomen 

and one or two fingers of the other hand in the vagina. 

The size, shape, and consistency of the cervix, uterus, 

and adnexa are then assessed and noted. 

bimanual percussion [L, bis, twice, manus, hand, 

percutere, to strike through], a diagnostic technique of 

producing sound vibrations in body cavities by the use of 

two hands, one serving as the plexor, or “hammer,” and the 

other as the pleximeter, or striking plate. See also 

percussion. 

bimastoid /bīmastoid/, pertaining to the two mastoid processes 

of the temporal bone. 

bimatoprost /b-mato-prost/, a synthetic prostaglandin 

analogue that acts as an ocular hypotensive; applied topically 

to the conjunctiva in the treatment of open-angle glaucoma 

and ocular hypertension. 

bimaxillary /bīmaksilerē/ [L, bis maxilla, jawbone], 

pertaining to both the upper and lower jaws. 

bimodal distribution /bīmodYl/ [L, bis modus, measure], 

the distribution of quantitative data into two clusters. 

It is suggestive of two separate normally distributed 

populations from which the data are drawn. 

bimolecular reaction (E 2 ,SN2) /bīmolekyYlYr/, a reac-

in- 215 bioactive 

Bimanual palpation (Swartz, 2006) 

tion in which more than one molecule is involved in the slow 

step. An enzyme-catalyzed reaction usually consists of a series 

of bimolecular reactions. It may follow second-order, or 

more complicated, chemical kinetics. 

bin-, prefix meaning “twice, two”: binocular, binovular. 

binangle /binang·gYl/ [L, bini, twofold, angulus, angle], 

a double-ended surgical or operative instrument that has a 

shank with two offsetting angles to keep the cutting edge of 

the instrument within 3 mm of the shaft axis. 

binary fission /bīnYrē/ [L, bini, twofold, fissionis, splitting], 

the division of a cell or nucleus into two equal parts. It is the 

common form of asexual reproduction among bacteria, protozoa, 

and other unicellular organisms. Also called simple 

fission. Compare multiple fission. 

binary number, a number in base 2 represented by 0s and 

1s. For example, the number 2 in the decimal form is written 

as 10 in the binary form, the decimal number 3 is written as 

11, the decimal number 4 is written as 100 in the binary 

form, and so on. 

binaural /bī·nawrYl/ [L, bis, twice auris, ear], pertaining 

to both ears. 

binaural stethoscope. See diaphragm stethoscope. 

binauricular. See biauricular. 

bind [AS, binden], 1. to bandage or wrap in a band. 

2. to join together with a band or with a ligature. 3. (in 

chemistry) to combine or unite molecules by using reactive 

groups within the molecules or by using a binding chemical. 

Binding is especially associated with chemical bonds that 

are fairly easily broken, such as in the bonds between toxins 

and antitoxins. 

binder, a bandage made of a large piece of material to fit 

and support a specific body part. 

binding energy, 1. the amount of energy required to separate 

a nucleus into its individual nucleons. 2. the energy released 

as the nucleus forms from nucleons. 

binding site [ME, binden L, situs], the location on the 

surface of a cell or a molecule where other cell fragments or 

molecules attach to initiate a chemical or physiologic action. 

Binet age /binā/ [Alfred Binet, French psychologist, 1857– 

1911], the mental age of an individual, especially a child, 

as determined by the Binet-Simon tests, which are evaluated 

on the basis of tested intelligence of the “normal” individual 

at any given age. The Binet age corresponding to “profoundly 

retarded” is 1 to 2 years; to “severely retarded,” 3 to 

7 years; and to “mildly retarded,” 8 to 12 years. 

binge eating. See bulimia. 

binocular /bīnokyYlYr, bin-/ [L, bini oculus, eye], 

Abdominal binder 

(Harkreader and Hogan, 2007) 

1. pertaining to both eyes, especially regarding vision. 

2. a microscope, telescope, or field glass that can accommodate 

viewing by both eyes. 

binocular fixation, the process of having both eyes directed 

at the same object at the same time, which is essential 

for good depth perception. 

binocular ophthalmoscope, an ophthalmoscope having 

two eyepieces used for stereoscopic examination of the eye. 

binocular parallax /perYlaks/ [L, bini oculus Gk, parallax, 

in turn], the difference in the angles formed by the 

sight lines to two objects situated at different distances from 

the eyes. Binocular parallax is a major factor in depth perception. 

Also called stereoscopic parallax. 

binocular perception, the visual ability to judge depth or 

distance by virtue of having two eyes. 

binocular vision, the simultaneous use of both eyes so 

that the images perceived by each eye are combined to appear 

as a single image. Compare diplopia. 

binomial /bīnōmē·Yl/, 1. containing two names or terms. 

2. the unique, two-part scientific name used to identify a 

plant. The first name is the genus; the second, the species. A 

designation of the variety may also follow to further differentiate 

the plant. Use of the binomial is the only reliable way to 

accurately specify a particular herb, since common names differ 

from region to region and a single common name may 

often denote several herbs that differ widely from one another. 

binomial nomenclature [L, bis, twice; Gk, nomos, law; L, 

nomenclatio, calling by name], a system of classification 

of animals, plants, and other life forms (developed by Carl 

Linné) that assigns a two-part Latinized name to each species, 

such as Homo sapiens for humans. 

binovular /bīnovyYlYr/ [L, bini ovum, egg], developing 

from two distinct ova, as in dizygotic twins. Also diovular. 

Compare uniovular. 

binovular twins. See dizygotic twins. 

Binswanger’s disease /binswäng·Yrz/ [Otto Binswanger, 

German neurologist, 1852–1929], a degenerative dementia 

of presenile onset caused by thinning of the subcortical 

white matter of the brain; some have attributed it to sclerotic 

changes of blood vessels. Associated with multiple subcortical 

strokes. 

binuclear /bīnoo ¯¯¯¯klē·Yr/ [L, bis, twice, nucleus, nut kernel], 

having two nuclei, as in the example of a heterokaryon or binucleate 

hybrid cell. Also binucleate /bīnoo ¯¯¯¯’klē·āt/. 

bio- /bīō-/, prefix meaning “life”: bioassay, biopsy. 

bioactive [Gk, bios, life; L, activus, with energy], having 

an effect on or causing a reaction in living tissue.

ioactivity 216 biologic activity 

bioactivity /-aktivitē/, any response from or reaction in 

living tissue. —bioactive, adj. 

bioassay /bīō·asā, -Ysā/ [Gk,bios Fr, assayer, to try], 

the laboratory determination of the concentration of a drug 

or other substance in a specimen by comparing its effect on 

an organism, an animal, or an isolated tissue with that of a 

standard preparation. Also called biologic assay. 

bioastronautics /-astrōnôtiks/, the science dealing with 

the biologic aspects of space travel. 

bioavailability /-Yvālibilitē/ [Gk, bios ME, availen, to 

serve], the degree of activity or amount of an administered 

drug or other substance that becomes available for activity in 

the target tissue. 

biocenosis /-sYnōsis/ [Fk, bios, life, koinos, common], 

an ecologic community. 

biochemical genetics. See molecular genetics. 

biochemical marker /-kemikYl/ [Gk, bios chemeia, alchemy], 

any hormone, enzyme, antibody, or other substance 

that is detected in the urine, blood, or other body fluids 

or tissues that may serve as a sign of a disease or other 

abnormality. An example is the Bence Jones protein that 

appears in the urine of multiple myeloma patients. 

biochemistry /-kemistrē/, the chemistry of organisms and 

life processes. Also called biologic chemistry, physiologic 

chemistry. —biochemical, adj. 

biochemorphics /-kemôrfiks/, the study of the relationship 

between chemical structure and biologic function. 

biochromatic analysis /-krōmatik/ [Gk, bios chroma, 

color], the spectrophotometric monitoring of a reaction at 

two wavelengths. It is used to correct for background color. 

bioclimatology /-klīmYtolYjē/, the study of the relationship 

and interactions between climate and organisms. 

biocybernetics /-sībYrnetiks/, the science of communication 

and control within and among organisms and of the interaction 

between organisms and mechanical or electronic 

systems. 

biodegradable /-digrādYbYl/ [Gk, bios, life; L, de, away, 

gradus, step], the natural ability of a chemical substance to 

be broken down into less complex compounds or compounds 

having fewer carbon atoms by bacteria or other microorganisms. 

biodynamics /-dīnamiks/, the study of the effects of dynamic 

processes, such as radiation, on organisms. 

bioelectric impedance analysis (BIA) /-ilektrik/, 

a method of measuring the fat composition of the body, compared 

to other tissues, by its resistance to electricity. Fat tissue 

does not conduct electricity. Muscle and bone are poor 

conductors. The method is reported to be 95% accurate, depending 

on body water content, which may fluctuate with 

exercise, diet, sweating, and use of alcohol or drugs. See also 

total body electric conductivity (TOBEC). 

bioelectricity /-ilektrisitē/ [Gk, bios elektron, amber], 

electrical current that is generated by living tissues, such as 

nerves and muscles. The electrical potentials of human tissues, 

recorded by electrocardiograph, electroencephalograph, 

and similar sensitive devices, are used in diagnosing 

the condition of various vital organs. 

bioenergetics /-enYrjetiks/ [Gk, bios energein, to be active], 

a system of exercises based on the concept that natural 

healing will be enhanced by bringing the patient’s body 

rhythms and the natural environment into harmony. 

bioequivalent /bīō·ikwivYlYnt/ [Gk, bios L, aequus, 

equal, valere, to be strong], 1. (in pharmacology) pertaining 

to a drug that has the same effect on the body as another 

drug, usually one nearly identical in its chemical formulation 

but possibly requiring a different amount to see the same ef- 

fect. 2. going in and out of the body at the same rate. 

—bioequivalence, n. 

bioethics /bīō·ethiks/ [Gk, bios, life ethos, the habits of 

humans or animals], obligations of a moral nature relating 

to biological research and its applications. 

biofeedback 1 /-fēdbak/ [Gk, bios AS, faedan, food, baec, 

back], a process providing a person with visual or auditory 

information about the autonomic physiologic functions of 

his or her body, such as blood pressure, muscle tension, and 

brain wave activity, usually through use of instruments. By 

trial and error, the person learns consciously to control these 

processes, which were previously regarded as involuntary. 

Biofeedback may be used clinically to treat many conditions, 

such as pain, anxiety, hypertension, insomnia, and migraine 

headache. 

biofeedback 2 , a nursing intervention from the Nursing Interventions 

Classification (NIC) defined as assisting the patient 

to gain voluntary control over physiologic responses 

using feedback from electronic equipment that monitor 

physiologic processes. See also Nursing Interventions 


biofilm /bio-film/, a thin layer of microorganisms adhering 

to the surface of a structure, which may be organic or inorganic, 

together with the polymers that they secrete. 

bioflavonoid /bīōflāvYnoid/ [Gk, bios L, flavus, yellow; 

Gk, eidos, form], a generic term for any of a group of colored 

flavones found in many fruits. Once believed to reduce 

capillary bleeding, bioflavonoids are now considered nonessential 

nutrients. Several are being investigated as possible 

low-calorie sweeteners. 

biogenesis /bīōjenYsis/ [Gk, bios genein, to produce], 

1. also called biogeny /bī·oj’Ynē/, the doctrine that living 

material can originate only from preexisting life and not 

from inanimate matter. 2. the origin of life; ontogeny and 

phylogeny. Compare abiogenesis. —biogenetic, adj. 

biogenetic law. See recapitulation concept. 

biogenic /bīōjenik/, 1. produced by the action of a living 

organism, such as fermentation. 2. essential to life and the 

maintenance of health, such as food, water, and proper rest. 

biogenic amine, one of a large group of naturally occurring 

biologically active compounds, most of which act as 

neurotransmitters. The most dominant, norepinephrine, is involved 

in such physiologic functions as emotional reactions, 

memory, sleep, and arousal from sleep. Other biochemicals 

of the group include three catecholamines: histamine, serotonin, 

and dopamine. These substances are active in regulating 

blood pressure, elimination, body temperature, and many 

other centrally mediated body functions. 

biogenous /bī·ojYnYs/, 1. biogenetic. 2. biogenic. 

biogeny. See biogenesis. 

biogravics /-graviks/, the study of the effects of gravity, 

including reduced and increased gravitational forces, on organisms. 

biohazard /-hazYrd/ [Gk, bios, life; OFr, hasard], anything 

that is a risk to organisms, such as ionizing radiation or 

harmful bacteria or viruses. 

bioimpedance analysis, a method for analyzing the water 

content of the body through variations in bioimpedance between 

different types of tissue. 

bioinstrument, a sensor or other device implanted into or 

attached to a living organism for the purpose of recording 

physiologic data, such as brain activity or heart function. 

biokinetics /-kinetiks/ [Gk, bios, life, kinetikos, moving], 

the study of the movements within developing organisms. 

biologic activity, the inherent capacity of a substance, 

such as a drug or toxin, to alter one or more chemical or

iologic armature 217 biopotentials 

Biohazard label (Bonewit-West, 2008) 

physiologic functions of a cell, tissue, organ, or organism. 

The biologic activity of a substance is determined not only 

by the substance’s physical and chemical nature but also by 

its concentration and the duration of cellular exposure to it. 

Biologic activity may reflect a “domino effect,” in which the 

alteration of one function disrupts the normal activity of one 

or more other functions. 

biologic armature, the connective tissue-rich aggregate 

of larger ducts, vessels, and autonomic nerves that in many 

mammalian exocrine glands serves as an internal framework 

whose function of support, and often anchorage, resembles 

that of the armature within a clay sculpture. 

biologic assay. See bioassay. 

biologic chemistry. See biochemistry. 

biologic death, death attributed to natural causes. In CPR 

terms, biologic death refers to permanent cellular damage, 

resulting from lack of oxygen, that is not reversible. 

biologic dressing, a dressing for burn injuries that is made 

from pigskin or synthetic materials with characteristics like 

those of human skin. The dressing is most effective in treating 

burns that are of uniform depth and of superficial partial 

thickness. It should be applied as soon as possible after the 

injury and should adhere to the wound during healing. Once 

adherence is established the wound can be left open and the 

patient can bathe and wear clothing over it. 

biologic half-life, the time required for the body to eliminate 

half of an administered dose of any substance by regular 

physiologic processes. The biologic half-life is approximately 

the same for stable and radioactive isotopes of a specific 

element. Also called metabolic half-life. See also effective 

half-life, half-life. 

biologic monitoring, 1. a process of measuring the levels 

of various physiologic substances, drugs, or metabolites 

within a patient during diagnosis or therapy. 2. the measurement 

of toxic substances in the environment and the identification 

of health risks to the population. Biologic monitoring 

often uses indirect methods of identifying and measuring 

substances, such as analyses of samples of blood, urine, 

feces, hair, nails, sweat, saliva, or exhaled air and extrapolation 

from metabolic effects. 

biologic plausibility, a method of reasoning used to establish 

a cause-and-effect relationship between a biologic factor 

and a particular disease. 

biologic psychiatry, a school of psychiatric thought that 

stresses the physical, chemical, and neurologic causes of and 

treatments for mental and emotional disorders. 

biologic rhythm [Gk, bios, life, logos, science, rhythmos], 

the periodic recurrence of a biologic phenomenon, such as 

the respiratory cycle, the sleep cycle, or the menstrual cycle. 

Also called biorhythm. 

biologic vector. See vector. 

biologist /bī·olYjist/ [Gk, bios, life, logos, science], a person 

who studies life sciences. 

biology /bī·olYje/, the scientific study of life. Some 

branches of biology are biometry, cytology, ecology, evolution, 

genetics, molecular biology, paleontology, and 

physiology. 

biolysis /bī·olisis/ [Gk, bios, life, lysis, loosening], the disintegration 

or dissolution of organic matter resulting from 

the activity of organisms, such as bacterial action on living 

tissue. 

biome /bīōm/ [Gk, bios oma, tumor, mass], the collection 

of biologic communities existing in and characteristic of 

a broad geographic region, such as desert, tropical forest, 

or savanna. A biome includes all organisms of a particular 

region. 

biomechanic. See biomechanics. 

biomechanic adaptation, a process in which a patient 

with a physical disability adjusts to the use of an orthotic device, 

such as an ankle-foot brace or a patellar-tendon-bearing 

prosthesis. Adaptation requires the central nervous system 

input received during therapeutic exercises with the orthotic 

appliance. 

biomechanics [Gk, bios mechane, machine], the study 

of mechanical laws and their application to living organisms, 

especially the human body and its locomotor system. 

—biomechanic, biomechanical, adj. 

biomedical, pertaining to the biologic aspects of medicine. 

biomedical engineering /-medikYl/ [Gk, bios L, medicare, 

to heal], a system of scientific techniques that is applied 

to biologic processes to solve practical medical problems 

or answer questions in biomedical research. 

biometry /bī·omYtrē/, the application of statistical methods 

in analyzing data obtained in biologic or anthropologic 

research. See also biology. 

biomicroscopy /-mīkroskYpē/, 1. microscopic examination 

of living tissue in the body. 2. ophthalmic examination 

of the eye by use of a slit lamp and a magnifying lens. See 

also slit lamp, slit-lamp microscope. 

bionics /bī·oniks/, the science of applying electronic principles 

and devices, such as computers and solid-state miniaturized 

circuitry, to medical problems. An example of the application 

of bionics is the development of artificial 

pacemakers to correct abnormal heart rhythms. —bionic, 

adj. 

biopharmaceutics /-färmYsoo ¯¯¯¯tiks/, the study of the 

chemical and physical properties of drugs, their components, 

and their activities in living organisms. 

biophore /bīYfôr/ [Gk, bios phora, bearer], according 

to the German biologist A.F.L. Weismann (1834-1914), the 

basic hereditary unit contained in the germ plasm from 

which all living cells develop and all inherited characteristics 

are transmitted. Compare gemma. 

biophysics, the application of physical laws to life processes 

of organisms. 

biopotentials /-pYtenshYls/, a voltage produced by a tissue 

of the body, particularly muscle tissue during a contraction. 

Electrocardiography depends on measurement of changing 

potentials in contracting heart muscle. Electromyography

iopsy 218 biotoxins 

and electroencephalography function similarly in the diagnosis 

of neuromuscular and brain disorders, respectively. 

biopsy /bīopsē/ [Gk, bios opsis, view], 1. the removal 

of a small piece of living tissue from an organ or other part 

of the body for microscopic examination to confirm or establish 

a diagnosis, estimate prognosis, or follow the course of a 

disease. 2. the tissue excised for examination. 3. informal. 

to excise tissue for examination. Kinds of biopsy include aspiration 

biopsy, needle biopsy, punch biopsy, and surface 

biopsy. —bioptic /bī·optik/, adj. 

biopsychic /bīōsīkik/ [Gk, bios psyche, mind], pertaining 

to mental factors as they relate to living organisms. 

biopsychology. See psychobiology. 

biopsychosocial /bīōsīkōsōshYl/ [Gk, bios psyche, 

mind; L, socius, companion], pertaining to the complex of 

biologic, psychologic, and social aspects of life. 

biopsychosocial diagnosis, a holistic approach to diagnosis 

that takes into consideration the medical, developmental, 

psychologic, spiritual, and social conditions and symptoms 

that are present, and how they interact to produce a particular 

patient’s condition. 

bioptic. See biopsy. 

bioptome tip catheter /bī·optōm/, a catheter with a special 

end designed for obtaining endomyocardial biopsy 

samples. It is threaded through a guiding catheter to the right 

ventricle, where it snips small tissue samples from the septal 

wall for pathologic examination. The bioptome tip device is 

used to monitor heart transplantation patients for early signs 

of tissue rejection. 

biorhythm. See biologic rhythm. 

biosafety, a system for the safe handling of toxic and dangerous 

biologic and chemical substances. Guidance in biosafety 

is offered by the U.S. Centers for Disease Control and 

Prevention, Occupational Safety and Health Administration, 

and National Institute for Occupational Safety and Health. 

-biosis, suffix meaning “a specific way of living”: 

macrobiosis, otobiosis. 

biostatistics /-stYtistiks/, numeric data on births, deaths, 

diseases, injuries, and other factors affecting the general 

health and condition of human populations. Also called vital 

statistics. 

biosynthesis /-sinthYsis/ [Gk, bios synthesis, putting together], 

any one of thousands of chemical processes continually 

occurring throughout the body in which less complex 

molecules form more complex biomolecules, especially 

the carbohydrates, lipids, proteins, nucleotides, and nucleic 

acids. Biosynthetic reactions constitute the anabolism of the 

body. —biosynthetic, adj. 

biosystem, any organism or complex system of organisms. 

biotaxis /bīōtaksis/ [Gk, bios taxis, arrangement], 

the ability of cells to develop into certain forms and arrangements. 

See also cytoclesis. —biotactic, adj. 

biotaxy /bīōtaksē/, 1. biotaxis. 2. the systematic classification 

of organisms according to their phenotypic characteristics; 

taxonomy. 

biotechnology /-teknolYjē/ [Gk, bios techne, art, logos, 

science], 1. the study of the relationships between humans 

or other living organisms and machinery, such as the health 

effects of computer equipment on office workers or the ability 

of airplane pilots to perform tasks when traveling at supersonic 

speeds. 2. the industrial application of the results of 

biologic research, particularly in fields such as recombinant 

deoxyribonucleic acids (DNA) or gene splicing, which permits 

the production of synthetic hormones or enzymes by 

combining genetic material from different species. See recombinant 

DNA. 

biotelemetry /-tYlemYtrē/, the transmission of physiologic 

data, such as electrocardiographic (ECG) and electroencephalographic 

(EEG) recordings, heart rate, and body temperature 

by radio or telephone systems. Transmission of such 

data uses sophisticated electronic devices developed for the 

study of the effects of space travel on animals and humans; it 

has progressed to the use of communication satellites for relaying 

such data from one part of the world to another. 

bioterrorism, the calculated use, or threatened use, of biologic 

agents against civilian populations in order to attain 

political or ideologic goals by intimidation or coercion. 

bioterrorism infectious agents testing, testing for infectious 

agents used in bioterrorism, including botulism, anthrax, 

Yersinia pestis, and Francisella tularensis. Testing 

may include blood tests, urine tests, stool tests, tissue cultures, 

sputum cultures, lymph node biopsies, and skin tests. 

bioterrorism preparedness, a nursing intervention from 


preparing for an effective response to bioterrorism events or 

disaster. See also Nursing Interventions Classification. 

biotherapy, a type of cancer therapy that uses agents to 

stimulate the body’s own immune system to kill cancer. Examples 

include interleukins, interferons, and hematopoietic 

growth factors. The term is sometimes used interchangeably 

with targeted therapy. See also immunotherapy. 

-biotic, suffix meaning “life”: anabiotic, microbiotic; also, 

meaning “possessing a (specified) mode of life”: endobiotic, 

photobiotic. 

biotic factor /bī·otik/, an environmental influence on 

living things, as distinguished from climatic or geologic 

factors. 

biotic potential, the possible growth rate of a population 

of organisms under ideal conditions, which include an absence 

of predators and an unlimited availability of nutrients 

and space for expansion. 

biotin /bīYtin/ [Gk, bios, life], a colorless, crystalline, 

water-soluble B complex vitamin that acts as a coenzyme in 

fatty acid production and in the oxidation of fatty acids and 

carbohydrates. It also aids in the use of protein, folic acid, 

pantothenic acid, and vitamin B 12. Rich sources are egg 

yolk, beef liver, kidney, unpolished rice, brewer’s yeast, peanuts, 

cauliflower, and mushrooms. Formerly called vitamin 

H. See also avidin. 

biotin deficiency syndrome, an abnormal condition 

caused by a deficiency of biotin, a B complex vitamin. It is 

characterized by dermatitis, hyperesthesia, muscle pain, anorexia, 

slight anemia, and changes in electrocardiographic 

activity of the heart. The average daily requirement of biotin 

for an adult is 100 to 200 µg; the average American diet provides 

100 to 300 µg of the vitamin. Because biotin is synthesized 

by intestinal bacteria, naturally occurring deficiency in 

adults is unknown, although it can be induced by large quantities 

of raw egg whites in the diet. Symptoms include scaly 

dermatitis, grayish pallor, extreme lassitude, anorexia, muscle 

pains, insomnia, some precordial distress, and slight anemia. 

Some authorities consider seborrheic dermatitis in infants 

a form of biotin deficiency. 

biotope /bīYtōp/ [Gk, bios topos, place], a specific biologic 

habitat or site. 

biotoxin /bīYtokin/, poison produced by and derived from 

plants and animals. Biotoxins include abrin, from the jequirity 

bean or rosary pea (Abrus precatorius); ricin, from castor 

beans; and strychnine, from Strychnos nux-vomica. Biotoxins 

can be absorbed by ingesting or inhaling the toxin. Inhalation 

of ricin or abrin causes severe respiratory distress, 

and ingestion of these agents causes nausea and vomiting.

iotransformation 219 birthing chair 

Multisystem organ failure and death may occur. Strychnine 

attacks communication between the nerves and muscles and 

may lead to death from respiratory failure as the respiratory 

muscles tire. Treatment consists of removal of the toxin from 

the body and supportive care. 

biotransformation /-transfôrmāshYn/ [Gk, bios L, 

trans, across, formare, to form], the chemical changes a 

substance undergoes in the body, such as by the action of enzymes. 

See also metabolic. 

Biot’s respiration /bē·ōz/ [Camille Biot, French physician, 

b. 1878], an abnormal respiratory pattern, characterized by 

short episodes of rapid, uniformly deep inspirations followed 

by 10 to 30 seconds of apnea. Biot’s respiration is symptomatic 

of meningitis or increased intracranial pressure. 

biovular twins. See dizygotic twins. 

bipalatinoid /bīpalatinoid, -pal-/, describing a twocompartment 

capsule with different medications in each 

side. It is designed so that the two substances become mixed 

and activated as the gelatin capsule dissolves. 

bipara /bipYrY/, a woman who has given birth twice in 

separate pregnancies. 

biparental inheritance. See amphigenous inheritance. 

biparietal /bīpYrīYtYl/ [L, bis, twice, paries, wall], pertaining 

to the two parietal bones of the head, such as the biparietal 

diameter. 

biparietal diameter (BPD), the transverse distance between 

the protuberances of the two parietal bones of the 

skull. 

biparietal suture [L, bis paries, wall, sutura], the interlocking 

lines of fusion between the two parietal bones of 

the skull. 

biparous /bipYrYs/ [L, bis, twice, parere, to produce], 

pertaining to the birth of two infants in separate pregnancies. 

bipartite /bīpärtīt/, having two parts. 

biped /bīped/, 1. having two feet. 2. any animal with only 

two feet. 

bipedal /bīpēdYl, -pedYl/ [L, bis, twice, pes, foot], capable 

of locomotion on two feet. 

bipenniform /bīpenifôrm/ [L, bis penna, feather, forma, 

form], (of body structure) having the bilateral symmetry of 

a feather, such as the pattern formed by the fasciculi that 

converge on both sides of a muscle tendon in the rectus 

femoris. Compare multipenniform, penniform, radiate. 

biperforate /bī·pYrfY·rāt/ [L, bis, twice perforatus, bored 

through], having two perforations. 

biperiden hydrochloride /bīperidYn/, a synthetic anticholinergic 

agent. 

INDICATIONS: It may be prescribed in the treatment of Parkinson’s 

disease and drug-induced extrapyramidal disorders. 

Biperiden hydrochloride is administered orally, and biperiden 

lactate is administered intramuscularly or intravenously. 

CONTRAINDICATIONS: Narrow-angle glaucoma, asthma, obstruction 

of the genitourinary or GI tract, or known hypersensitivity 



are blurred vision, central nervous system effects, urinary 

retention, postural hypotension, tachycardia, dry 

mouth, decreased sweating, and hypersensitivity reactions. 

biphasic /bīfāzik/ [L, bis Gk, phasis, appearance], 

having two phases, parts, aspects, or stages. 

bipolar /bīpōlYr/ [L, bis polus, pole], 1. having two 

poles, such as in certain electrotherapeutic treatments using 

two poles or in certain types of bacterial staining that affects 

only the two poles of the microorganism under study. 

2. (of a nerve cell) having an afferent and an efferent 

process. 

bipolar cell, a cell, such as a retinal neuron, with two main 

processes arising from the cell body. 

bipolar disorder, a major mental disorder characterized 

by episodes of mania, depression, or mixed mood. One or 

the other phase may be predominant at any given time, one 

phase may appear alternately with the other, or elements of 

both phases may be present simultaneously. Characteristics 

of the manic phase are excessive emotional displays, such as 

excitement, elation, euphoria, or in some cases irritability accompanied 

by hyperactivity, boisterousness, impaired ability 

to concentrate, decreased need for sleep, and seemingly unbounded 

energy. In extreme mania, a sense of omnipotence 

and delusions of grandeur may occur. In the depressive 

phase, marked apathy and underactivity are accompanied by 

feelings of profound sadness, loneliness, guilt, and lowered 

self-esteem. Causes of the disorder are multiple and complex, 

often involving biologic, psychologic, interpersonal, 

and social and cultural factors. The disorder is a biologic illness 

that can be precipitated or exacerbated by psychosocial 

stressors. See also major depressive disorder. 

bipolar electrocautery, an electrocautery in which both 

active and return electrodes are incorporated into a single 

handheld instrument, so that the current passes between the 

tips of the two electrodes and affects only a small amount of 

tissue. 

bipolar lead /lēd/, 1. an electrocardiographic conductor 

having two electrodes placed on different body regions, with 

each electrode contributing to the record. 2. informal. a tracing 

produced by such a lead on an electrocardiograph. 

bipolar version, a method for changing the position of a 

fetus in which one hand is placed on the abdomen of the 

mother and two fingers of the other hand are inserted into the 

uterus. 

bipotentiality /bīpYtenshē·alitē/ [L, bis potentia, 

power], the characteristic of acting or reacting according 

to either of two possible states. 

bird breeder’s lung. See pigeon breeder’s lung. 

bird face retrognathism. See retrognathism. 

birth [ME, burth], 1. the event of being born, the entry of 

a new person out of its mother into the world. Kinds of birth 

are breech birth, live birth, and stillbirth. See also effacement, 

labor. 2. the childbearing event, the bringing forth by 

a mother of a baby. 3. a medical event, the delivery of a 

fetus by an obstetric attendant. 

birth canal informal. the passage that extends from the 

inlet of the true pelvis to the vaginal orifice through which an 

infant passes during vaginal birth. See also clinical 

pelvimetry. 

birth center, a health facility with services limited to maternity 

care for women judged to be at minimum risk for obstetric 

complications that would require hospitalization. 

birth certificate, a legal document recording information 

about a birth, including, among other details, the date, time, 

and location of the event; identity of the mother and father; 

and identity of the attending physician or licensed midwife. 

birth control. See contraception. 

birth defect. See congenital anomaly. 

birthing, a nursing intervention from the Nursing Interventions 

Classification (NIC) defined as delivery of a baby. 

See also Nursing Interventions Classification. 

birthing chair, a special seat used in labor and delivery to 

promote the comfort of the mother and facilitate the birthing 

process. The chair may be specially designed, having many 

technical features, or it may be a simple three-legged stool 

with a high, slanted back and a circular seat with a large central 

hole in it. The newer birthing chairs allow women to sit

irth injury 220 bitemporal hemianopia 

straight up or to recline. The chair has a lower section that cases of aortic regurgitation and obstructive cardiomyopa- 

may be removed or folded out of the way. Lights, mirrors, thy. Compare dicrotic pulse. 

and basins may be attached. The upright position appears to 

shorten the time in labor, particularly the second or expul- 

bishydroxycoumarin. See dicumarol. 

bis in die (b.i.d.) /dēā/, a Latin phrase, used in prescripsive 

stage of labor, probably because of gravity and intions, meaning “twice a day.” It is more commonly used in 

creased participation of the mother. The chair is not suitable its abbreviated form. 

for use with anesthesia. 

birth injury, trauma suffered by a baby while being born. 

bismuth (Bi) /bizmYth, bis-/ [Ger, wismut, white mass], 

a reddish, crystalline, trivalent metallic element. Its atomic 

Some kinds of birth injury are Bell’s palsy, cerebral palsy, number is 83. Its atomic mass is 208.98. It is combined with 

and Erb’s palsy. 

birthmark. See nevus. 

birth mother, the biologic mother or woman who bears a 

child. The child may have been conceived in a surrogate 

various other elements, such as oxygen, to produce numerous 

salts used in the manufacture of many pharmaceutic substances. 

bismuth gingivitis, a dark bluish line along the gingival 

mother with sperm of the biologic father. 

birth palsy [ME, burth Gk, paralyein, to be palsied], 

a loss of motor or sensory nerve function in some body part 

margin caused by bismuth administered in the treatment of 

systemic disease. See also bismuth stomatitis, gingivitis. 

bismuth stomatitis, an abnormal oral condition caused by 

caused by a nerve injury during the birth process. Also called the systemic use of bismuth compounds over prolonged pe- 

birth paralysis. 

riods. It is characterized by a blue-black line on the inner as- 

birth paralysis. See birth palsy. 

pect of the gingival sulcus or dark pigmentation of the buc- 

birth parent, one of an individual’s two biologic parents. 

birth rate, the proportion of the number of live births in a 

cal mucosa, 

sensation in 

sore tongue, metallic 

the mouth. Compare 

taste, and burning 

arsenic stomatitis, 

specific area during a given period to the total population of Atabrine stomatitis. 

that area, usually expressed as the number of births per 1000 bismuth subsalicylate, a bismuth salt of salicylic acid, 

of population. Compare crude birth rate, refined birth administered orally in the treatment of diarrhea and gastric 

rate, true birth rate. 

birth trauma, 1. any physical injury suffered by an infant 

distress, including nausea, indigestion, and heartburn. 

bisoprolol /biso-prolol/, a synthetic beta-adrenergic 

during the process of delivery. 2. the supposed psychic blocking agent, used as the fumarate salt; administered 

shock, according to some psychiatric theories, that an infant 

suffers during delivery. 

birth weight, the measured heaviness of a baby when 

orally as an antihypertensive agent. 

bisphosphonate /bis-fosfo-nāt/, diphosphonate. 

bit /bit/, abbreviation for binary digit, the smallest unit of 

born, usually about 3500 g (7.5 pounds). In the United information in a computer. Bits are the building blocks for 

States, 97% of newborns weigh between 2500 g (5.5 all information processing in digital electronics and comput- 

pounds) and 4500 g (10 pounds). Babies weighing less than 

2500 g at term are considered small for gestational age. Babies 

weighing more than 4500 g are considered large for 

ers. Eight bits equals one byte. See also byte. 

bitart, abbreviation for a bitartrate carboxylate anion. 

bitartrate /bītärtrāt/, the monoanion of tartaric acid, 

gestational age and are often infants of mothers with diabetes. 

bis-, prefix meaning “twice, two”: bisacromial, bisferious. 

bisacodyl /bisakōdil/, a cathartic. 

 

C4H5O6 . 

bitartrate carboxylate anion, an ionotropic agent used 

in the treatment of cardiovascular patients. 

bite [AS, bitan], 1. the act of cutting, tearing, holding, 

INDICATIONS: It is prescribed in the treatment of acute or grinding, crushing, or gripping with the teeth. 2. the lingual 

chronic constipation or for emptying of the bowel before or portion of an artificial tooth between its shoulder and its 

after surgery or before diagnostic radiographic proce- incisal edge. 3. an occlusal record or relationship between 

dures. 

the upper and lower teeth or jaws. Compare closed bite, 

CONTRAINDICATIONS: Abdominal pain, nausea, vomiting, 

rectal fissures, ulcerated hemorrhoids, or known hypersensitivity 


open bite. 

bite block. See occlusion rim. 

bitegauge /bītgāj/ [AS, bitan OFr, gauge, measure], 

ADVERSE EFFECTS: Among the more serious adverse reac- a prosthetic dental device that helps attain proper occlusion 

tions are colic, abdominal pain, and diarrhea. 

bisacromial /bīsYkrōmē·Yl/, pertaining to both acromions, 

of the upper and lower teeth. 

biteguard [AS, bitan OFr, garder, to defend], a resin or 

the triangular, flat, bony plates at the end of the scapula. rubber appliance that covers the occlusal and incisal surfaces 

bisalbuminemia /bisalbyoo ˘ minēmē·Y/, a condition in of the teeth. It is used to stabilize the teeth, to provide a plat- 

which two types of albumin exist in an individual. The two form for the excursive glides of the mandible, and to elimi- 

types are expressed by heterozygous alleles of the albumin nate the effects of nocturnal grinding of the teeth. Also called 

gene and are detected by differences in the mobility of the biteplane, night guard. Compare mouth guard. 

types on electrophoretic gels. 

biteguard splint, a device, usually made of resin or rub- 

bisect /bīsekt/ [L, bis secare, to cut], to divide into two ber, for covering the occlusal and incisal surfaces of the teeth 

equal lengths or parts. 

bisexual /bīsekshoo ¯¯¯¯·Yl/ [L, bis sexus, male or female], 

and for protecting them from traumatic occlusal forces during 

immobilization and stabilization processes. See also 

1. hermaphroditic; having gonads of both sexes. 2. possessing 

physical or psychologic characteristics of both sexes. 

Gunning’s splint. 

bitelock /bītlok/, a dental device for retaining occlusion 

3. engaging in both heterosexual and homosexual activity. 

4. desiring sexual contact with persons of both sexes. 

bisexual libido, (in psychoanalysis) the tendency in a person 

to seek sexual gratification with people of either sex. 

bisferious pulse /bisferē·Ys/ [L, bis ferire, to beat], 

rims in the same relation outside and inside the mouth. 

bitemporal /bītempYrYl/ [L, bis, twice, tempora, temples], 

pertaining to both temples or both temporal bones. 

bitemporal hemianopia [L, bis, twice, tempora, temples; 

Gk, hemi, half, opsis, vision], a loss of the temporal half of 

an arterial pulse that has two palpable peaks, the second of the vision in each eye, usually resulting from a lesion in the 

which is slightly weaker than the first. It may be detected in chiasmal area such as a pituitary tumor.

iteplane 221 bivalent chromosome 

biteplane /bītplān/, 1. See occlusal plane. 2. a metal 

sheet laid across the biting surfaces of the upper or lower 

teeth to determine the relationship of the teeth to the occlusal 

plane. 3. an orthodontic appliance of acrylic resin worn over 

the maxillary occlusal surfaces and used to treat pain of the 

temporomandibular joint and adjacent muscles. Although removable, 

the device is kept in place by labial wires and 

wrought wire clasps. 4. See biteguard. 

biteplate /bītplāt/, a device used in dentistry as a diagnostic 

or therapeutic aid for prosthodontics or orthodontics. It is 

made of wire and plastic and worn in the palate. It may also 

be used in the correction of temporomandibular joint problems 

or as a splint in restoring the full mouth. 

bite reflex, a swift, involuntary biting action that may be 

triggered by stimulation of the oral cavity. The bite can be 

difficult to release in some cases, such as when a spoon or 

tongue depressor is placed in a patient’s mouth. 

bite wing film [AS, bitan ME, winge], a dental radiographic 

film on which a tab is placed so that the teeth can 

hold the film in position during exposure, used to view the 

interproximal area of posterior teeth. Also called interproximal 

film. See also bite wing radiograph. 

bite wing radiograph, a dental radiograph that reveals 

the coronal portions of maxillary and mandibular teeth and 

portions of the interdental septa on the same film. See also 

bite wing film. 

Bite wing radiograph 

(Bird and Robinson, 2005) 

Bithynia /bYthinē·Y/, a genus of snails, species of which 

act as intermediate hosts to Opisthorchis. 

biting in childhood, a natural behavior trait and reflex action 

in infants, acquired at about 5 to 6 months of age in response 

to the introduction of solid foods in the diet and the 

beginning of the teething process. The activity represents a 

significant modality in the psychosocial development of the 

child, because it is the first aggressive action the infant 

learns, and through it the infant learns to control the environment. 

The behavior also confronts the infant with one of the 

first inner conflicts, because biting can produce both pleasing 

and displeasing results. Biting during breastfeeding causes 

withdrawal of the nipple and anxiety in the mother, yet it 

also serves as a means of soothing teething discomfort. Infants 

continue to use biting as a mechanism for exploring 

their surroundings. Toddlers and older children often use biting 

for expressing aggression toward their parents and other 

children, especially during play or as a means of gaining 

attention. Most children normally outgrow the tendency 

unless they have severe maladaptive or emotional problems. 

See also psychosexual development, psychosocial 

development. 

bitolterol /bi-tolter-ol/, a beta-adrenergic receptor agonist 

used as a bronchodilator; administered by inhalation as the 

mesylate salt in the treatment of bronchospasm associated 

with asthma and the treatment and prophylaxis of bronchospasm 

associated with chronic obstructive airway disease, 

including bronchitis and pulmonary emphysema. 

bitolterol mesylate /bitoltYrol mesilāt/, an orally inhaled 

bronchodilator. 

INDICATIONS: It is used in the treatment of bronchial 

asthma and reversible bronchospasm. 

CONTRAINDICATION: This product is contraindicated in patients 

who are known to be hypersensitive to it. 

ADVERSE EFFECTS: Among adverse reactions reported are 

tremor, nervousness, headache, dizziness, palpitations, chest 

discomfort, tachycardia, coughing, and throat irritation. 

Bitot’s spots /bitōz/ [Pierre Bitot, French surgeon, 1822– 

1888], white or gray triangular deposits on the bulbar conjunctiva 

adjacent to the lateral margin of the cornea, a clinical 

sign of vitamin A deficiency. Also called Bitot’s patches. 

Bitot’s spots (Spalton et al, 2005) 

bitrochanteric lipodystrophy /bītrōkYnterik/ [L, bis 

Gk, trochanter, runner; lipos, fat, dys, bad, trophe, nourishment], 

an abnormal and excessive deposition of fat on the 

buttocks and the outer aspect of the upper thighs, occurring 

most commonly in women. See also lipodystrophy. 

biuret test /bīyoo ˘ ret/ [L, bis Gk, ouron, urine], a 

method for detecting proteins in serum. In alkaline solution, 

copper sulfate ions react with the peptide bonds of proteins 

to produce a pink to purple color, called the biuret reaction. 

The amount of serum protein in a sample solution is estimated 

by comparing its color with that of a standard solution 

whose protein concentration is known. 

bivalent /bīvālYnt/ [L, bis valere, to be powerful], 

1. See divalent. (in genetics) a pair of synapsed homologous 

chromosomes that are attached to each other by chiasmata 

during the early first meiotic prophase of gametogenesis. 

The structure serves as the basis for the tetrads from 

which gametes are produced during the two meiotic divisions. 

2. See valence, def. 1. —bivalence, n. 

bivalent antibody, an antibody that has two or more binding 

sites that can cross-link one antigen to another. 

bivalent chromosome, a pair of synapsed homologous

ivalirudin 222 black widow spider antivenin 

chromosomes during the early stages of gametogenesis. See 

also bivalent. 

bivalirudin /bi-valroo-din/, an inhibitor of the clotpromoting 

activity of thrombin, used in conjunction with aspirin 

as an anticoagulant in patients with unstable angina 

pectoris who are undergoing percutaneous transluminal coronary 

angioplasty; administered intravenously. 

bivalved cast [L, bis valva, valve], a cast that is cut in 

half to detect or relieve pressure underneath, especially when 

a patient has decreased or no sensation in the portion of the 

body surrounded by the cast. “Windows” are often cut out of 

the cast over the pressure areas to assess circulation or open 

wounds under the cast. 

bivalve speculum, one with two blades that are adjustable. 

biventricular pacing, that in which a lead is used to deliver 

current directly to the left ventricle, in addition to those 

used to deliver current to the right atrium and ventricle, so 

that the ventricles can be induced to pump in synchrony. 

bizarre leiomyoma. See epithelioid leiomyoma. 

Björnstad’s syndrome /byôrnstädz/ [R. Björnstad, Swedish 

dermatologist, 20th century], an autosomal recessive 

disorder characterized by congenital sensorineural deafness 

and kinky hair. 

Bk, symbol for the element berkelium. 

BK, abbreviation for below knee. 

BK amputation, abbreviation for below-knee amputation. 

See long below-knee amputation and short below-knee 

amputation. 

black beauties. See amphetamines. 

black cohosh, a perennial herb that grows throughout the 

United States and in parts of Canada. 

USES: This herb is used to treat the symptoms of menopause 

(hot flashes and nervous conditions associated with 

menopause) and dysmenorrhea (menstrual cramps, pain, inflammation); 

generally considered to be effective against 

mild symptoms but not a substitute for estrogen-containing 

prescriptions needed to control more severe vasomotor 

symptoms. 

CONTRAINDICATIONS: Black cohosh should not be used during 

pregnancy, since uterine stimulation can occur. It also 

should not be used during lactation or in children. 

Black Creek Canal virus, a virus of the genus 

Hantavirus that causes hantavirus pulmonary syndrome. 

black damp. See damp. 

black death. See bubonic plague. 

Blackett-Healy method, a positioning procedure for producing 

x-ray images of the subscapularis area. The patient is 

placed in a supine position with the affected shoulder joint 

centered on the midline of the film, the arm abducted, and 

the elbow flexed. The opposite shoulder is raised about 15 

degrees and supported with a sandbag. 

black eye, contusion around the eye with bruising, discoloration, 

and swelling. It is usually treated for the first 24 

hours with ice packs to reduce swelling, then with hot compresses 

to aid in resorption of blood from the hematoma. 

Also called periorbital ecchymosis. 

Blackfan-Diamond anemia. See Diamond-Blackfan 

syndrome. 

black fever. See kala-azar. 

black hairy tongue. See parasitic glossitis. 

black haw, an herb found in the Eastern United States. 

USES: This herb is used for dysmenorrhea, menstrual 

cramps and pain, menopausal metrorrhagia, hysteria, 

asthma, and heart palpitations. It is also used to lower blood 

pressure. It is possibly effective at relieving uterine spasms, 

but effectiveness in other instances has not been verified. 

CONTRAINDICATION: Black haw should be used with 

caution in people with kidney stones since it contains oxalic 

acid. 

blackhead. See comedo. 

black light. See Wood’s light. 

black lung disease. See anthracosis. 

black measles [AS, blac OHG, masala], an acute 

tickborne illness caused by the bacterium Rickettsia 

rickettsii. The disease is characterized by a sudden onset of 

headache, chills, and fever, which can persist for 2 to 3 

weeks. A characteristic rash appears on the extremities and 

trunk about the fourth day of illness. Also called hemorrhagic 

measles. 

blackout informal. a temporary loss of vision or consciousness. 

black plague. See bubonic plague. 

Black’s Classification of Caries. See classification of 

caries. 

black spots film fault, a defect in a radiograph, seen as 

dark spots throughout the image area. It is caused by dust 

particles or developer on the x-ray film before development 

or by outdated film. 

blackwater fever, a rare, serious complication of chronic 

falciparum malaria, characterized by jaundice, hemoglobinuria, 

acute renal failure, and passage of bloody dark red or 

black urine caused by massive intravascular hemolysis. 

Death occurs in 20% to 30% of all cases; the mortality rate is 

particularly high among Europeans. See also falciparum 

malaria, malaria, Plasmodium. 

Blackwell, Elizabeth, (1821–1910), a British-born American 

physician, the first woman to be awarded a medical 

degree. She established the New York Infirmary, a 40-bed 

hospital staffed entirely by women, in which she trained 

nurses in a 4-month course. Her influence helped others establish 

nursing schools to improve patient care. 

black widow spider [AS, blac widewe; ME, spithre], 

Latrodectus mactans, a species of spider found in the United 

States, whose bite causes pain and sometimes death. 

Black widow spider with fresh egg case 

(Auerbach, 2007/Courtesy Michael Cardwell & Associates) 

black widow spider antivenin, a passive immunizing 

agent. 

INDICATION: It is prescribed in the treatment of black 

widow spider bite. 


or to horse serum prohibits its use. 

ADVERSE EFFECTS: Among the more serious adverse effects 

are allergic reactions.

lack widow spider bite 223 bladder outlet obstruction 

black widow spider bite [AS, blac widewe; ME, spithre 

AS, bitan], the bite of the spider species Latrodectus 

mactans, a poisonous arachnid found in many parts of the 

world. Black widow venom contains some enzymatic proteins, 

including a peptide that affects neuromuscular transmission. 

The bite is perceived as a sharp pinprick pain, followed 

by a dull pain in the area of the bite; restlessness; 

anxiety; sweating; weakness; and drooping eyelids. Muscular 

rigidity starts at the location of the bite and moves in peripherally 

to the chest. Small children, elderly adults, or persons 

with heart disorders are most severely affected and may 

require hospitalization and the administration of an antivenin. 

Immediate treatment includes keeping the victim 

quiet and immobilizing the bite area at the level of the heart. 

bladder [AS, blaedre], 1. a membranous sac serving as a 

receptacle for secretions, such as the gallbladder. 2. the urinary 

bladder. 

Trigone 

Urethra 

Ureters 

Opening of ureters 

Internal urethral 

orifice 

Bladder (Drake, Vogl, and Mitchell, 2005) 

bladder augmentation, augmentation cystoplasty, often 

achieved with the addition of a flap of bowel or stomach to 

the bladder to increase bladder volume. 

bladder calculus. See vesical calculus. 

bladder cancer, the most common malignancy of the urinary 

tract, characterized by multiple growths that tend to 

recur in a more aggressive form. Bladder cancer occurs more 

often in men than in women and is more prevalent in urban 

than in rural areas. The risk of bladder cancer increases with 

cigarette smoking and exposure to aniline dyes, betanaphthylamine, 

mixtures of aromatic hydrocarbons, or benzidine 

and its salts, used in chemical, paint, plastics, rubber, 

textile, petroleum, and wood industries and in medical laboratories. 

Other predisposing factors are chronic urinary tract 

infections, calculous disease, and schistosomiasis. Symptoms 

of bladder cancer include painless hematuria, frequent 

urination, and dysuria. Irritation from the tumor may mimic 

cystitis. Urinalysis, excretory urography, cystoscopy, or 

transurethral biopsy is performed for diagnosis. The majority 

of bladder malignancies are transitional cell carcinomas; 

a small percentage are squamous cell carcinomas or adenocarcinomas. 

Superficial or multiple lesions may be treated by 

fulguration or open loop resection. A segmental resection is 

usually performed if the tumor is at the dome or in a lateral 

wall of the bladder. Total cystectomy may be performed for 

an invasive lesion of the trigone and necessitates the creation 

of a urinary diversion. Radiation therapy and/or chemotherapy 

may be valuable under certain circumstances, such as 

unresectable tumor growth. Internal irradiation, the introduction 

of radioisotopes via a balloon of a catheter, or the implantation 

of radon seeds may be used in treating small localized 

tumors on the bladder wall. Medications that are 

often used as palliatives are BCG, 5-fluorouracil, thiotepa, 

and adriamycin. Patients may have a recurrence up to 10 

years after successful treatment. See also cystectomy. 

Transitional cell carcinoma of bladder cancer 

(Fletcher, 2007) 

bladder cancer markers test, a urine test used to dianose 

recurrent bladder cancer. 

bladder flap informal. the vesicouterine fold of peritoneum 

incised during low cervical cesarean section so the 

bladder can be separated from the uterus to expose the lower 

uterine segment for incision. The flap is reapproximated with 

sutures during closure to cover the uterine incision. See also 

cesarean section. 

bladder hernia, a protrusion of the bladder through an 

opening in the abdominal wall. 

bladder irrigation 1 [AS, blaedre L, irrigare, to conduct 

water], the washing out of the bladder by a continuous or 

intermittent flow of saline or a medicated solution. The bladder 

also may be irrigated by an oral intake of fluid. 

bladder irrigation 2 , a nursing intervention from the Nursing 

Interventions Classification (NIC) defined as instillation 

of a solution into the bladder to provide cleansing or medication. 


bladder neck dyssynergia, incomplete opening of the 

bladder neck during urination resulting in partial obstruction 

of urinary flow. Also called smooth sphincter dyssynergia. 

bladder neck incision, surgical incision of the bladder 

neck, an operation similar to but less extensive than bladder 

neck resection. 

bladder neck resection, surgical removal of tissue from 

the bladder neck to treat obstruction. 

bladder neck suspension, any of various methods of surgical 

fixation of the urethrovesical junction area and the 

bladder neck to restore the neck to a high retropubic position 

for relief of stress incontinence. The group includes the 

Marshall-Marchetti-Krantz operation and the Burch, 

Pereyra, and Stamey procedures. Also called colposuspension. 

bladder outlet obstruction (BOO), obstruction of the 

outflow of urine from the bladder resulting from various etiologies; 

causes include benign prostatic hyperplasia, prostate

ladder retraining 224 blastocoele 

cancer, bladder neck contracture, stricture, and a variety of 

other conditions. 

bladder retraining [AS, blaedre L, trahere, to draw], 

a system of therapy for urinary incontinence in which a patient 

practices withholding urine while maintaining a normal 

intake of fluid. The interval between urination is increased 

from about 1 hour to 3 to 4 hours over a period of 10 days. 

The patient also learns to recognize and react to the urge to 

urinate. 

bladder sphincter [AS, blaedre Gk, sphingein, to bind], 

a circular muscle surrounding the opening of the urinary 

bladder into the urethra. 

bladder stone. See vesicle calculus. 

bladder wall, the surrounding structure of the urinary 

bladder, consisting of the serous coat, subserous layer, muscular 

coat, submucus layer, and mucus coat. 

Blakemore-Sengstaken tube. See Sengstaken- 

Blakemore tube. 

Blalock-Taussig procedure /blāloktôsig/ [Alfred Blalock, 

American surgeon, 1899–1964; Helen B. Taussig, American 

physician, 1898–1986], surgical construction of a shunt 

between the right subclavian artery and the right pulmonary 

artery as a temporary measure to overcome congenital heart 

malformations, such as tetralogy of Fallot, in which there is 

insufficient pulmonary blood flow. Echocardiography is used 

to assess the malformation. General anesthesia and a cardiac 

bypass machine are used for the operation. The subclavian 

artery is joined end to side with the pulmonary artery, directing 

blood from the systemic circulation to the lungs. Thrombosis 

of the shunt is the major postoperative complication. 

Permanent surgical correction is performed in early childhood. 

See also heart surgery. 

blame placing, the process of placing responsibility for 

one’s behavior on others. 

blanch /blanch, blänch/ [Fr, blanchir, to become white], 

1. to cause to become pale, as a nailbed may be blanched by 

using digital pressure. 2. to press blood away and wait for 

return, such as blanching of fingernails and return of blood. 

3. to become white or pale, as from vasoconstriction accompanying 

fear or anger. 

blanch test [Fr, blanchir, to become white; L, testum, crucible], 

a test of blood circulation in the fingers or toes. 

Pressure is applied to a fingernail or toenail until normal 

color is lost. The pressure is then removed, and, if the circulation 

is normal, color should return almost immediately, 

within about 2 seconds. The time may be prolonged by dehydration; 

a compromise of circulation, such as arterial occlusion; 

hypovolemic shock; or hypothermia. Also called 

blanching test, capillary refill. 

bland [L, blandus], mild or having a soothing effect. 

bland aerosols, aerosols that consist of water, saline solutions, 

or similar substances that do not have important pharmacologic 

action. They are primarily used for humidification 

and liquefaction of secretions. 

bland diet, a diet that is mechanically, chemically, physiologically, 

and sometimes thermally nonirritating to the GI 

tract. It is often prescribed in the treatment of peptic ulcer, 

ulcerative colitis, gallbladder disease, diverticulitis, gastritis, 

idiopathic spastic constipation, and mucous colitis and after 

abdominal surgery. Historically, it was first called the “white 

diet” (or Sippy diet, after Dr. Sippy, who developed it). This 

allowed the use of only white foods, such as milk, cream, 

mashed potatoes, and hot cereal (Cream of Wheat). It has 

progressed to what has been called the “liberal bland diet,” 

which allows all foods except caffeine, alcohol, black pepper, 

spices, or any other food that could be considered irritating. 

The clinical value of the traditional bland diet has never 

Blanch test (Chapleau, 2004) 

been proven, and thus its use as a treatment for GI problems 

is questionable. 

blank, a solution containing all of the reagents needed for 

analysis of a substance except the substance tested. 

blanket bath [OFr, blanchet, a white garment], the procedure 

of wrapping the patient in a wet pack and then in 

blankets. 

blast, 1. a primitive cell, such as an embryonic germ cell. 

2. a cell capable of building tissue, such as an osteoblast in 

growing bone. 

-blast, suffix meaning an “embryonic state of development”: 

megaloblast, osteoblast. 

blast cell [Gk, blastos, germ], any immature cell, such as 

an erythroblast, lymphoblast, or neuroblast. 

blastema /blastēmY/ pl. blastemas, blastemata [Gk, bud], 

1. any mass of cells capable of growth and differentiation, 

specifically the primordial, undifferentiated cellular material 

from which a particular organ or tissue develops. 2. in certain 

animals, a group of cells capable of regenerating a lost 

or damaged part or creating a complete organism in asexual 

reproduction. 3. the budding or sprouting area of a plant. 

See also primordium. —blastemal, blastematic, blastemic, 

adj. 

-blastema /-blastYmY/, suffix meaning a “beginning substance 

or foundation for new growth”: epiblastema, 

scytoblastema. 

blastemata, blastemal, blastematic, blastemic. See 

blastema. 

blastic transformation, a late stage in the progress of 

chronic granulocytic leukemia. The leukemic cells become 

more undifferentiated and morphologically and genetically 

more abnormal, with more aggressive growth patterns. Signs 

of anemia and blood platelet deficiency are present, and half 

of the blood cells in the bone marrow are immature forms. 

Blastic transformation indicates that resistance to therapy 

has developed in the patient who has entered a terminal stage 

of leukemia. 

blastid /blastid/ [Gk, blastos, germ], the site in the fertilized 

ovum where the pronuclei fuse and the nucleus forms. 

Also called blastide. 

blastin /blastin/ [Gk, blastanein, to grow], any substance 

that provides nourishment for or stimulates the growth or 

proliferation of cells, such as allantoin. 

blasto-, blast-, combining form meaning “an early embryonic 

or developing stage”: blastocoele, blastema. 

blastocoele /blastYsēl/ [Gk,blastos, germ, koilos, hollow], 

the fluid-filled cavity of the blastocyst in mammals and the

lastocyst 225 blastomycosis 

blastula or discoblastula of lower animals. The cavity increases 

the surface area of the developing embryo to allow 

better absorption of nutrients and oxygen. Also spelled blastocoel, 

blastocele. Also called cleavage cavity, segmentation 

cavity, subgerminal cavity. 

blastocyst /blastYsist/ [Gk, blastos kystis, bag], the embryonic 

form that follows the morula in human development. 

Implantation in the wall of the uterus usually occurs during 

this stage, approximately 8 to 13 days after fertilization. The 

blastocyst consists of an outer layer (trophoblast) which is 

attached to the inner cell mast. 

Embryoblast 

(inner cell mass) 

Degenerating 

zona pellucida 

Blastocystic 

cavity 

Trophoblast 

Early blastocyst (Moore and Persaud, 2008) 

blastocyst cavity, the fluid-filled cavity developing in the 

morula as it becomes a blastocyst. 

blastocyte /blastYsīt/ [Gk, blastos kytos, cell], an undifferentiated 

embryonic cell that precedes germ layer formation. 

—blastocytic, adj. 

blastocytoma. See blastoma. 

blastoderm /blastYdurm/ [Gk, blastos derma, skin], 

the layer of cells forming the wall of the blastocyst in mammals 

and the blastula in lower animals during the early 

stages of embryonic development. It is produced by the 

cleavage of the fertilized ovum and gives rise to the primary 

germ layers, the ectoderm, mesoderm, and endoderm, from 

which the embryo and all of its membranes are derived. 

Kinds of blastoderm are bilaminar blastoderm, embryonic 

blastoderm, extraembryonic blastoderm, and trilaminar 

blastoderm. Also called germinal membrane. —blastodermal, 

blastodermic, adj. 

blastodisk /blastYdisk/, the disklike, yolk-free area of cytoplasm 

surrounding the animal pole in a yolk-rich ovum, 

such as that of birds and reptiles. The blastodisk is the site 

where cleavage occurs after fertilization. As cleavage continues, 

the blastodisk develops into the embryo. Also spelled 

blastodisc. 

blastogenesis /blastōjenYsis/ [Gk, blastos genein, to produce], 

1. asexual reproduction by budding. 2. the transmission 

of hereditary characteristics by the germ plasm. 

Compare pangenesis. 3. the early development of an embryo 

during cleavage and formation of the germ layers. 

4. the process of transforming small lymphocytes in tissue 

culture into large, blastlike cells by exposure to phytohemagglutinin 

or other substances, often for the purpose of inducing 

mitosis. —blastogenetic, adj. 

blastogenic /-jenik/, 1. originating in the germ plasm. 

2. initiating tissue proliferation. 3. relating to or characterized 

by blastogenesis. 

blastogenic factor, lymphocyte-transforming factor. 

blastogeny /blastojYnē/, the early stages in ontogeny. The 

germ plasm history of an organism or species, which traces 

the history of inherited characteristics. 

blastokinin /blastYkīnin/ [Gk, blastos kinein, to move], 

a globulin, secreted by the uterus in many mammals, that 

may stimulate and regulate the implantation process of the 

blastocyst in the uterine wall. Also called uteroglobulin. 

blastolysis /blastolisis/ [Gk, blastos lysis, loosening], 

destruction of a germ cell or blastoderm. —blastolytic, adj. 

blastoma /blastōmY/ pl. blastomas, blastomata [Gk, 

blastos oma, tumor], a neoplasm of embryonic tissue 

that develops from the blastema of an organ or tissue. A blastoma 

derived from a number of scattered cells is pluricentric; 

one arising from a single cell or group of cells is unicentric. 

Also called blastocytoma. —blastomatous 

/blastomYtYs/, adj. 

blastomatosis /blasttōmYtōsis/ [Gk, blastos oma, tumor, 

osis, condition], the development of many tumors from 

embryonic tissue. 

blastomatous. See blastoma. 

blastomere /blastYmēr/ [Gk, blastos meros, part], 

any of the cells formed from the first mitotic division of a 

fertilized ovum (zygote). The blastomeres further divide and 

subdivide to form a multicellular morula in the first several 

days of pregnancy. Also called segmentation cell. See also 

blastula. —blastomeric, adj. 

blastomere biopsy, a technique for preimplantation genetic 

diagnosis, in which a blastomere is removed from a 6or 

8-cell embryo and tested for genetic abnormalities. 

blastomerotomy /-merotYmē/ [Gk, blastos meros, part, 

tome, cut], destruction of blastomere. Also called blastotomy 

/blastotYmē/. —blastomerotomic, adj. 

Blastomyces /blastōmīsēz/ [Gk, blastos mykes, fungus], 

a genus of yeastlike fungi, usually including the species 

Blastomyces dermatitidis, which causes North American 

blastomycosis, and Paracoccidioides brasiliensis, which 

causes South American blastomycosis. 

Blastomyces dermatitidis 

(Forbes, Sahm, and Weissfeld, 2007) 

blastomycosis /blastōmīkōsis/ [Gk, blastos mykes, fungus, 

osis, condition], an infectious disease caused by a 

yeastlike fungus, Blastomyces dermatitidis. It usually affects 

only the skin but may cause acute pneumonitis or disseminated 

disease and may invade the lungs, kidneys, central nervous 

system, and bones. The disease is most common in 

river valleys of North America, particularly the southeastern 

United States, but outbreaks have occurred in Africa and 

Latin America. Skin infections are almost always a result of 

hematogeneous seeding from a primary infection and often

lastopore 226 blended family 

begin as small papules on the hand, face, neck, or other exposed 

areas where there has been a cut, bruise, or other injury. 

The infection may spread gradually and irregularly into 

surrounding areas. Lung infection is caused by inhalation of 

airborne conidia. When the lungs are involved, mucous 

membrane lesions resemble squamous cell carcinoma. The 

person usually has a cough, dyspnea, chest pain, chills, and a 

fever with heavy sweating. Diagnosis is made by identification 

of the disease organism in a culture of specimens from 

lesions. Treatment usually involves the administration of 

amphotericin B in pulmonary disease or intraconazole or ketoconazole. 

Recovery usually begins within the first week of 

treatment. The mortality rate is approximately 5%. Also 

called Gilchrist’s disease. See also fungus, mycosis, North 

American blastomycosis. 

Blastomycosis (Callen et al, 2000) 

blastopore /blastYpôr/ [Gk, blastos poros, opening], 

(in embryology) the opening into the archenteron made by 

invagination of the blastula. 

blastoporic canal. See neurenteric canal. 

blastosphere. See blastula. 

blastotomy. See blastomerotomy. 

blastula /blastyYlY/ [Gk,blastos, germ], an early stage of 

the process through which a zygote develops into an embryo, 

characterized by a fluid-filled sphere formed by a single 

layer of cells. The spheric layer of cells is called a blastoderm; 

the fluid-filled cavity is the blastocoele. The blastula 

develops from the morula stage and is usually the form in 

which the embryo becomes implanted in the wall of the 

uterus. Also called blastosphere. 

-blastula, suffix meaning an “early embryonic stage in the 

development of a fertilized egg”: coeloblastula, stereoblastula. 

blastulation, the transformation of the morula into a blastocyst 

or blastula by the development of a central cavity, the 

blastocoele. 

BLB mask, abbreviation for Boothby-Lovelace- 

Bulbulian mask. 

bleaching /blēching/ [ME, blechen], the act or process of 

removing stains or color by chemical means. 

bleaching agents, medications and over-the-counter 

preparations used to depigment the skin. The products may 

be used by persons whose skin has become hyperpigmented 

through exposure to sunlight and particularly for melasma 

associated with pregnancy, the use of oral contraceptives, or 

hormone replacement therapy. Most agents are sold as 

creams or lotions and contain hydroquinone. 

bleach poisoning, an adverse reaction to ingestion of hypochlorite 

salts commonly found in household and commercial 

bleaches. Symptoms include pain and inflammation of 

the mouth, throat, and esophagus; vomiting; shock; and circulatory 

collapse. 

bleb /bleb/ [ME, blob], an accumulation of fluid under 

the skin. 

bleed [AS, blod, blood], 1. to lose blood from the blood 

vessels of the body. The blood may flow externally through 

an orifice or a break in the skin or flow internally into a cavity, 

into an organ, or between tissues. 2. to cause blood to 

flow from a vein or an artery. 

bleeder informal. 1. a person who has hemophilia or any 

other vascular or hematologic condition associated with a 

tendency to hemorrhage. 2. a blood vessel that bleeds, especially 

one cut during a surgical procedure. 

bleeding, the release of blood from the vascular system as 

a result of damage to a blood vessel. See also blood clotting. 

bleeding diathesis, a predisposition to abnormal blood 

clotting. 

bleeding precautions, a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as reduction 

of stimuli that may induce bleeding or hemorrhage in 

at-risk patients. See also Nursing Interventions Classification. 

bleeding reduction, a nursing intervention from the Nursing 

Interventions Classification (NIC) defined as limitation 

of the loss of blood volume during an episode of bleeding. 


bleeding reduction: antepartum uterus, a nursing intervention 

from the Nursing Interventions Classification 

(NIC) defined as limitation of the amount of blood loss from 

the pregnant uterus during third trimester of pregnancy. See 

also Nursing Interventions Classification. 

bleeding reduction: gastrointestinal, a nursing intervention 

from the Nursing Interventions Classification (NIC) 

defined as limitation of the amount of blood loss from the 

upper and lower gastrointestinal tract and related complications. 


bleeding reduction: nasal, a nursing intervention from 


limitation of the amount of blood loss from the nasal cavity. 


bleeding reduction: postpartum uterus, a nursing intervention 

from the Nursing Interventions Classification 

(NIC) defined as limitation of the amount of blood loss from 

the postpartum uterus. See also Nursing Interventions 


bleeding reduction: wound, a nursing intervention from 


limitation of the blood loss from a wound that may be a result 

of trauma, incisions, or placement of a tube or catheter. 


bleeding time, the time required for blood to stop flowing 

from a tiny wound. A test of bleeding time is the Ivy 

method. See also hemostasis, simplate bleeding time. 

bleeding time test, a blood test used to evaluate the vascular 

and platelet factors associated with hemostasis. This 

test is occasionally performed preoperatively to ensure adequate 

hemostasis. 

blemish [OFr, bleme, to deface], a skin stain, alteration, 

defect, or flaw. 

blended family [ME, blenden, to mix], a family formed

lending inheritance 227 blepharospasm 

when parents bring together children from previous marriages. 

blending inheritance, the apparent fusion in offspring of 

distinct, dissimilar characteristics of the parents. Blended 

characteristics are usually of a quantitative nature, such as 

height, and fail to segregate in successive generations. The 

phenomenon is the result of multiple pairs of genes that have 

a cumulative effect. See also polygene. 

blenno-, blenn-, combining form meaning “mucus”: 

blennemesis, blennothorax. 

blennorrhea /blenYrēY/ [Gk,blennos, mucus, rhoia, flow], 

excessive discharge of mucus. See also pharyngoconjunctival 

fever. Also called blennorrhoea, blennorrhagia 

/blenôrājē·Y/. 

Blenoxane, trademark for an antineoplastic (bleomycin 

sulfate). 

bleomycin sulfate /blē·Ymīsin/, an antineoplastic antibiotic. 

INDICATIONS: It is prescribed in the treatment of a variety 

of neoplasms. 

CONTRAINDICATION: Hypersensitivity to this drug prohibits 

its use. 


are pneumonitis, pulmonary fibrosis, and a syndrome 

of hyperpyrexia and circulatory collapse. Rashes and skin reactions 

commonly occur. 

blephar-. See blepharo-. 

blepharal /blefYrYl/ [Gk, blepharon, eyelid], pertaining to 

the eyelids. 

blepharedema /blefYridēmY/, a fluid accumulation in the 

eyelid, causing a swollen appearance. 

-blepharia, suffix meaning “(condition of the) eyelid”: 

atretoblepharia, macroblepharia. 

blepharitis /blefYrītis/ [Gk, blepharon itis], an inflammatory 

condition of the lash follicles and meibomian glands 

of the eyelids, characterized by swelling, redness, and crusts 

of dried mucus on the lids. Ulcerative blepharitis is caused 

by bacterial infection. Nonulcerative blepharitis may be 

caused by psoriasis, seborrhea, or an allergic response. 

OBSERVATIONS: Individuals report a foreign-body sensation 

of the eye. There are red eyelid margins, flaking and scaling 

around lashes, an itching and burning sensation, and loss of 

lashes. Light sensitivity, conjunctivitis, and possible corneal 

inflammation may also occur. In ulcerative blepharitis there 

are crusts on the eyelids, which bleed when removed. Small 

pustules develop in lash follicles, and eyelids become 

“glued” together by dried drainage during sleep. Lid margins 

thicken over time with misdirected growth and/or loss of 

eyelashes. Corneal pannus, ulcerative keratitis, and lid ectropion 

can occur in severe cases. Diagnosis is made by clinical 

examination, and lab tests may be run to isolate the causative 

agent. Individuals with chronic diseases, such as diabetes, 

gout, anemia, and rosacea, or a history of sties, chalazia, 

or chronic infections of the mouth and/or throat are at 

greater risk. 

INTERVENTION: Blepharitis is stubborn to treat and is often 

resistant to various therapies. Topical antiinfective ointments 

and drops are used, but the mainstay of treatment is the use 

of eyelid scrubs. Resistant cases may require oral antibiotic 

treatment. 

NURSING CONSIDERATIONS: Nurses need to provide individuals 

with detailed instructions in scrubbing and washing techniques. 

Eyelid hygiene consists of scrubbing the lid margins 

and lashes on closed eyelids daily and massaging lid margins 

to stimulate flow of secretions then cleansing with a cotton 

swab dipped in a diluted solution of baby shampoo. Careful 

instructions are needed for the application of antibiotic oint- 

ments to lid margins and drops to ocular surfaces. Individuals 

should also be instructed to use seborrheic dermatitis 

medicated shampoos and to apply hot compresses for 5 to 10 

minutes to closed eyelids to loosen lid debris. 

Blepharitis (Zitelli and Davis, 2007) 

blepharo-, blephar-, combining form meaning “eyelid or 

eyelash”: blepharochalasis, blepharelosis. 

blepharoadenoma /-adinōmY/, pl. blepharoadenomas, 

blepharoadenomata, a glandular epithelial tumor of the 

eyelid. 

blepharoatheroma /-athYrōmY/, pl. blepharoatheromas, 

blepharoatheromata, a tumor of the eyelid. 

blepharochalasis /blefY·rō·kalY·sis/ [Gk, blepharon, eyelid 

chalasis, relaxation], relaxation of the skin of the eyelid 

because of atrophy of the intercellular tissue. 

blepharoclonus /blefYroklōnYs/, a condition characterized 

by muscle spasms of the eyelid, appearing as increased 

winking. 

blepharoncus /blefYronkYs/ [Gk, blepharon onkos, 

swelling], a tumor of the eyelid. 

blepharophimosis /blefY·rō·fi·mōsis/ [Gk, blepharon, eyelid 

phimōsis, a muzzling], abnormal narrowness of the 

palpebral fissure in the horizontal direction, caused by lateral 

displacement of the medial canthus. 

blepharoplasty /blefYroplastē/ [Gk, blepharon, eyelid, 

plassein, to mold], the use of plastic surgery to restore or 

repair the eyelid and eyebrow. Also called brow lift. 

Excision of fat during a blepharoplasty 

(Tyers and Collin, 2008) 

blepharoplegia /-plējē·Y/ [Gk, blepharon plege, stroke], 

paralysis of muscles of the eyelid. 

blepharospasm /blefYrōspazYm/ [Gk, blepharon, eyelid,

lessed thistle 228 blood 

spasmos, spasm], the involuntary contraction of eyelid 

muscles. The condition may be caused by a local lesion of 

the eye, a neurologic irritation, or psychologic stress. 

blessed thistle, an annual herb found in Europe and Asia. 

USES: This herb is used for loss of appetite, indigestion, 

and intestinal gas. Probably safe when used as recommended 

but evidence of effectiveness is lacking. 

CONTRAINDICATIONS: Blessed thistle should not be used 

during pregnancy, in children, or in those with known hypersensitivity 

to the herb. 

Bleuler, Eugen /bloilYr/ [Swiss psychiatrist, 1857–1939], 

a pioneer investigator in the fields of autism and schizophrenia. 

Bleuler introduced the term schizophrenia to replace dementia 

praecox and identified four primary symptoms of 

schizophrenia, known as Bleuler’s “4 As”: ambivalence, associative 

disturbance, autistic thinking, and affective incongruity. 

blighted ovum /blītid/, a fertilized ovum that fails to develop. 

On x-ray or ultrasonic visualization it appears to be a 

fluid-filled cyst attached to the wall of the uterus. It may be 

empty, or it may contain amorphous parts. Many first trimester 

spontaneous abortions represent the expulsion of a 

blighted ovum. Suction curettage may be necessary if the 

blighted ovum is retained. 

blind. See blindness. 

blind fistula [AS, blind L, pipe], an abnormal passage 

with only one open end; the opening may be on the body surface 

or on or within an internal organ or structure. Also 

called incomplete fistula. 

blindgut. See cecum. 

blind intubation. See intubation. 

blind loop [AS, blind ME, loupe], a redundant segment 

of intestine. Bacterial overgrowth occurs and may lead to 

malabsorption, obstruction, and necrosis. Blind loops may 

be created inadvertently by surgical procedures, such as a 

side-to-side ileotransverse colostomy. See also blind spot. 

blind loop syndrome. See stasis syndrome. 

blindness [AS, blind], the absence of sight. The term may 

indicate a total loss of vision or may be applied in a modified 

manner to describe certain visual limitations, as in yellow 

color blindness (tritanopia) or word blindness (dyslexia). 

Legal blindness is defined as best corrected visual acuity less 

than 20/200 in the better eye or marked constriction of the 

visual fields. 

blind spot, 1. a normal gap in the visual field occurring 

when an image is focused on the space in the retina occupied 

by the optic disc. 2. an abnormal gap in the visual field 

caused by a lesion on the retina or in the optic pathways or 

resulting from hemorrhage or choroiditis, often perceived as 

light spots or flashes. 

blink reflex [ME, blenken L, reflectere, to bend back], 

the automatic closure of the eyelid when an object is perceived 

to be rapidly approaching the eye. 

blister, a vesicle or bulla of the skin, containing watery 

matter or serum. 

blister agents/vesicants, chemicals that cause blistering 

of the skin or mucous membranes on contact. These agents 

include phosgene oxime, lewisite, distilled mustard, mustard 

gas, nitrogen mustard, sesqui mustard, and sulfur mustard. 

Exposure is mainly by inhalation or by contact with the skin 

or eyes. Inhalation causes shortness of breath, tachypnea, 

and hemoptysis, and death may result from the accumulation 

of fluid in the lungs; contact with the skin causes blistering 

and necrosis; and ocular contact causes swelling of the eyelids 

and corneal damage and can lead to blindness. Exposure 

to high doses affects the cardiovascular and nervous systems 

and may lead to cardiac arrest, convulsions, and coma. If 

these agents are ingested, nausea, vomiting, hematemesis, 

and diarrhea result. No antidote exists for most blister agents 

and treatment consists of removal of clothing, washing of the 

exposed areas, and supportive care. Lewisite can be neutralized 

by the application of British antilewisite if it is done 

soon after exposure. 

bloat [ME, blout], a swelling or filling with gas, such as 

distension of the abdomen that results from swallowed air or 

from intestinal gas. The stomach on percussion will have a 

tympanic sound. 

Blocadren, trademark for a beta-adrenergic receptor 

blocking agent (timolol maleate). 

Bloch-Sulzberger incontinentia pigmenti, Bloch- 

Sulzberger syndrome. See incontinentia pigmenti. 

block [OFr, bloc], 1. a disruption in the conduction of a 

nerve impulse. The term may apply to stoppage of nerve 

conduction as produced by local anesthetics, inhibition of 

beta receptors by beta-blocker drugs, or prevention of neuromuscular 

transmission by blockade of nicotinic receptors by 

muscle-relaxant drugs. 2. a device to maintain separation of 

the teeth, such as a bite block. 

blockade /blokād/, an agent that interferes with or prevents 

a specific action in an organ or tissue, such as a cholinergic 

blockade that inhibits transmission of acetylcholinestimulated 

nerve impulses along fibers of the autonomic 

nervous system. 

blockage. See obstruction. 

block anesthesia. See conduction anesthesia. 

blocked communication, a situation in which communication 

with a patient is made difficult because of incongruent 

verbal and nonverbal messages and messages that contain 

discrepancies and inconsistencies. To clarify blocked communication, 

therapists may record meetings with patients on 

videotapes that can be studied for eye contact and other clues 

to the patient’s thinking processes. See also blocking. 

blocked pleurisy, circumscribed pleurisy, encysted 

pleurisy. 

blocker. See blocking agent. 

blocking [ME, blok], 1. preventing the transmission of an 

impulse, such as by an antiadrenergic agent or by the injection 

of an anesthetic. 2. interrupting an intracellular biosynthetic 

process, such as by the injection of actinomycin D or 

the action of an antivitamin. 3. an interruption in the spontaneous 

flow of speech or thought. 4. repressing an idea or 

emotion to prevent it from obtruding into the consciousness. 

blocking agent, an agent that inhibits a biologic action, 

such as movement of an ion across the cell membrane, passage 

of a neural impulse, or interaction with a specific receptor. 

blocking antibody, an antibody that fails to cross-link and 

cause agglutination. When such antibodies are present in 

high concentration, they interfere with the action of other antibodies 

by occupying all the antigenic sites. See also 

antigen-antibody reaction, hapten. 

blockout /blokout/ [OFr, bloc AS, ūt], in dentistry, 

elimination in a cast of undesirable undercut areas by filling 

them in with a suitable material; this includes all areas that 

would offer interference to placement of the denture framework 

and those not crossed by a rigid part of the denture. A 

blockout creates a common path of insertion. 

blood [AS, blod], the liquid pumped by the heart through 

all the arteries, veins, and capillaries. The blood is composed 

of a clear yellow fluid, called plasma, and the formed elements, 

and a series of cell types with different functions. The 

major function of the blood is to transport oxygen and nutrients 

to the cells and to remove carbon dioxide and other 

waste products from the cells for detoxification and elimina

lood agar 229 blood buffers 

tion. Adults normally have a total blood volume of 7% to 8% 

of body weight, or 70 mL/kg of body weight for men and 

about 65 mL/kg for women. Blood is pumped through the 

body at a speed of about 30 cm/second, with a complete circulation 

time of 20 seconds. Compare lymph. See also 

blood cell, erythrocyte, leukocyte, plasma, platelet. 

Blood (Carr and Rodak, 2009) 

blood agar, a culture medium consisting of blood (usually 

sheep’s blood) and nutrient agar, used in bacteriology to cultivate 

certain microorganisms, including Staphylococcus 

epidermidis, Streptococcus pneumoniae, and Clostridium 

perfringens. 

blood agents, poisons that affect the body by being absorbed 

into the blood. Blood agents include arsine and cyanide. 

Exposure to both may occur by inhalation, and cyanide 

exposure may also occur by ingestion and absorption 

through the skin and eyes. Arsine causes hemolysis, resulting 

in generalized weakness, jaundice, delirium, and renal 

failure; high doses may result in death. There is no antidote 

and treatment is supportive. Cyanide prevents cells from 

using oxygen, leading to cell death, and poisoning especially 

affects the cardiovascular and nervous systems and can lead 

to heart and brain damage and death from respiratory failure. 

Treatment consists of the administration of an antidote and 

supportive care. 

blood albumin [AS, blod L, albus], the plasma protein 

circulating in blood serum. Also called serum albumin. 

blood and urine cortisol, a blood or urine test that assists 

in the evaluation of adrenal activity. Adrenal hyperfunction 

may indicate Cushing’s disease, adrenal adenoma or carcinoma, 

ectopic ACTH-producing tumors, or hyperthyroidism, 

while hypofunction may indicate congenital adrenal hyperplasia, 

Addison’s disease, hypopituitarism, hypothyroidism, 

or liver disease. 

blood and urine uric acid, a blood/urine test that detects 

levels of uric acid in order to determine the presence of hyperuricemia 

(elevated uric acid in the blood) and uricosuria 

(elevated uric acid in the urine). Causes of abnormal uric 

acid levels may include gout, kidney failure, alcoholism, leukemias, 

metastatic cancer, multiple myeloma, hyperlipoproteinemia, 

diabetes mellitus, stress, lead poisoning, and 

dehydration. 

blood bank, an organizational unit responsible for collecting, 

processing, and storing blood for transfusion and other 

purposes. The blood bank is usually a subdivision of a laboratory 

in a hospital and is often charged with the responsibility 

for serologic testing. See also bank blood, component 

therapy, transfusion. 

blood bank technology specialist, an allied health professional 

who performs both routine and specialized immu- 

nohematologic tests in technical areas of the modern blood 

bank and who performs transfusion services using methodology 

that conforms to the Standards for Blood Banks and 

Transfusion Services of the American Association of Blood 

Banks. The individual may be responsible for testing for 

blood group antigens, compatibility, and antibody identification; 

investigating abnormalities such as hemolytic diseases 

of the newborn, hemolytic anemias, and adverse responses 

to transfusions; supporting physicians and nurses in transfusion 

therapy, including that for homologous organ transplantation; 

collecting and processing blood, including selecting 

donors, drawing and typing blood, and performing 

pretransfusion tests to ensure patient safety. 

blood bilirubin test, a blood test performed in cases of 

jaundice to help determine whether the jaundice is caused by 

prehepatic causes (as with hemolytic anemia), hepatocellular 

dysfunction (as in hepatitis), or extrahepatic obstruction of 

the bile ducts (as with gallstones or tumor blocking the bile 

ducts). Total serum bilirubin is made up of conjugated (direct) 

and unconjungated (indirect) bilirubin, with varying ratios 

of each characterizing different diseases. 

blood blister, a blister containing blood. It may be caused 

by a pinch, a bruise, or persistent friction. 

blood-borne pathogens, pathogenic microorganisms that 

are transmitted via human blood and cause disease in humans. 

They include, but are not limited to, hepatitis B virus 

(HBV) and human immunodeficiency virus (HIV). Although 

a number of pathogens can be transmitted percutaneously, 

HIV-1 remains the most common. 

blood-brain barrier (BBB) [AS, blod bragen ME, 

barrere], an anatomic-physiologic feature of the brain 

thought to consist of walls of capillaries in the central nervous 

system and surrounding astrocytic glial membranes. 

The barrier separates the parenchyma of the central nervous 

system from blood. The blood-brain barrier prevents or 

slows the passage of some drugs and other chemical compounds, 

radioactive ions, and disease-causing organisms 

such as viruses from the blood into the central nervous 

system. 

Blood-brain barrier 

blood buffers [AS, blod ME, buffe, to cushion], a system 

of buffers, composed primarily of dissolved carbon di-

lood capillaries 230 blood gas determination 

oxide and bicarbonate ions, that functions in maintaining the 

proper pH of the blood. See also buffer, arterial pH. 

blood capillaries [AS, blod L, capillaris, hairlike], 

the tiny vessels that convey blood between the arterioles and 

the venules and allow for internal respiration and nourishment 

of tissues. The capillary wall generally has a thickness 

of one cell, permitting easy diffusion of gas molecules; occasional 

tiny openings permit diapedesis of leukocytes, distribution 

of nutrients to the tissues supplied by the capillary 

network, and collection of waste products released by the 

cells. 

blood cell, any of the formed elements of the blood, including 

red cells (erythrocytes) and white cells (leukocytes). 

Blood cells constitute about 50% of the total volume of the 

blood. See also erythrocyte, leukocyte, platelet. 

blood cell casts [AS, blod L, cella, storeroom; ONorse, 

kasta], a mass of blood debris released from a diseased 

body surface or excreted in the urine. 

blood chloride test, a blood test performed as part of 

multiphasic testing of electrolytes. It is performed along with 

other electrolyte tests to indicate the patient’s acid-base balance 

and hydrational status. 

blood circulation [AS, blod L, circulare, to go around], 

the circuit of blood through the body, from the heart through 

the arteries, arterioles, capillaries, venules, and veins and 

back to the heart. 

blood clot [AS, blod clott, lump], a semisolid, gelatinous 

mass, the final result of the clotting process in blood. 

Red cells, white cells, and platelets are enmeshed in an insoluble 

fibrin network of the blood clot. Compare embolus, 

thrombus. See also blood clotting, fibrinogen. 

blood clotting, the conversion of blood from a freeflowing 

liquid to a semisolid gel. Although clotting can 

occur within an intact blood vessel, the process usually starts 

with tissue damage. Within seconds of injury to the vessel 

wall, platelets clump at the site. If normal amounts of calcium, 

platelets, and tissue factors are present, prothrombin is 

converted to thrombin. Thrombin acts as a catalyst for the 

conversion of fibrinogen to a mesh of insoluble fibrin, in 

which all the formed elements are immobilized. Different 

pharmacologic agents may interact throughout this process. 

Also called blood coagulation. Compare hemostasis. See 

also anticoagulant, coagulation. 

blood coagulation, a nursing outcome from the Nursing 

Outcomes Classification (NOC) defined as the extent to 

which blood clots within a normal period of time. See also 

Nursing Outcomes Classification. 

blood component therapy, transfusion of one or more of 

the components of whole blood. 

blood corpuscle [AS, blod L, corpusculum, little body], 

an old term for a blood cell, an erythrocyte, a leukocyte, and 

sometimes a thrombocyte. 

blood count. See complete blood count. 

blood creatinine test, a blood test that measures the 

amount of creatinine in the blood, in order to diagnose impaired 

renal function. Elevated creatinine levels suggest a 

chronic disease process. This test’s results are interpreted in 

conjunction with those for blood urea nitrogen, as part of a 

renal function study. 

blood crossmatching, the direct matching of donor and 

recipient blood to prevent the transfusion of incompatible 

blood types. Crossmatching tests for agglutination of 

(1) donor red blood cells (RBCs) by recipient serum and 

(2) recipient RBCs by donor serum. 

blood culture and sensitivity test, a blood culture obtained 

to detect the presence of bacteria in the blood (bacter- 

STAGE I 

STAGE II Prothrombin 

STAGE III 

Injured vessel 

C 

Fibrinogen 

Fibrin fibers 

Trapped red blood 

cells (RBCs) 

C Coumadin H Heparin 

Prothrombin 

activator (PTA) 

Ca 2+ 

Blood clotting (Herlihy, 2007) 

H 

Thrombin 

Blood clot 

emia). Bacteria present are identified and tested for resistance 

to antibiotics. 

blood culture medium, a liquid enrichment medium for 

the growth of bacteria in the diagnosis of blood infections 

(bacteremia and septicemia). It contains a suspension of 

brain tissue in meat broth with dextrose, peptone, and citrate 

and has a pH of 7.4. 

blood donor, anyone who donates blood or blood components. 

See also blood bank, transfusion. 

blood doping, the administration of blood, red blood cells, 

or related blood products to an athlete to enhance performance, 

often preceded by the withdrawal of blood so that 

training continues in a blood-depleted state. 

blood dyscrasia [AS, blod Gk, dys, bad, krasis, mingling], 

a pathologic condition in which any of the constituents 

of the blood are abnormal in structure, function, or quality, 

as in leukemia or hemophilia. 

blood fluke, a parasitic flatworm of the class Trematoda, 

genus Schistosoma, including the species S. haematobium, S. 

japonicum, and S. mansoni. See also Schistosoma, 

schistosomiasis. 

blood gas, 1. gas dissolved in the liquid part of the blood. 

Blood gases include oxygen, carbon dioxide, and nitrogen. 

2. a laboratory test to determine the amount of oxygen, carbon 

dioxide, and nitrogen in blood. 

blood gas analysis, the determination of oxygen and carbon 

dioxide concentrations and pressures with the pH of the 

blood by laboratory tests; the following measurements may 

be made: PO 2, partial pressure of oxygen in arterial blood; 

PCO 2, partial pressure of carbon dioxide in arterial blood; 

SO 2, percent saturation of hemoglobin with oxygen in arterial 

blood; total CO 2 content of (venous) plasma; and pH. 

blood gas determination, an analysis of the pH of the 

blood and the concentration and pressure of oxygen and carbon 

dioxide in the blood. It can be performed as an emergency 

procedure to assess acid-base balance and ventilatory 

status. Blood gas determination is often important in the 

evaluation of cardiac failure, hemorrhage, kidney failure, 

drug overdose, shock, uncontrolled diabetes mellitus, or any

lood gas tension 231 blood pressure 

other condition of severe stress. The blood for examination 

is drawn from an artery, as ordered in a heparinized syringe, 

sealed from air, placed on ice, and immediately transported 

for analysis. Normal adult arterial blood gas values are pH 

 

7.35 to 7.45; PCO2 35 to 45 mm Hg; HCO3 21 to 28 mEq/L; 

PO2 80 to 100 mm Hg; O2 saturation 95% to 100%. See also 

acid-base balance, acidosis, alkalosis, oxygenation, 

PaCO2,pH,PO2. blood gas tension, the partial pressure of a gas in the 

blood. 

blood glucose [AS, blod OFr, livel Gk, glykys, sweet], 

the concentration of glucose in the blood, represented in milligrams 

of glucose per deciliter of blood. Home monitoring 

devices make blood glucose measurement both efficient and 

accurate. Normal adult blood glucose levels range from 70 to 

115 mg/dL (4 to 6 mmol/L), with generally higher levels 

after 50 years of age. A fasting serum glucose of 126 mg/dL 

on two or more occasions signifies diabetes mellitus. See 

also hyperglycemia, hypoglycemia. 

blood glucose level, a nursing outcome from the Nursing 

Outcomes Classification (NOC) defined as the extent to 

which glucose levels in plasma and urine are maintained in 

normal range. See also Nursing Outcomes Classification. 

blood glucose test, a blood test used to detect hyperglycemia 

or hypoglycemia. This test must be performed frequently 

in patients with newly diagnosed diabetes mellitus, 

in order to assist in monitoring and adjusting the insulin 

dose. See also fasting plasma glucose. 

Blood glucose meter (Sanders et al, 2007) 

blood group, the classification of blood based on the presence 

or absence of genetically determined antigens on the 

surface of the red cell. Several different grouping systems 

have been described. These include ABO, Duffy, highfrequency 

antigens, I, Kell, Kidd, Lewis, low-frequency antigens, 

Lutheran, MNS, P, Rh, and Xg. Their relative importance 

depends on their clinical significance in transfusion 

therapy, organ transplantation, maternal-fetal compatibility, 

and genetic studies. See also ABO blood group. 

blood island, one of the clusters of mesodermal cells that 

proliferate, on the outer surface of the embryonic yolk sac 

and gives it a lumpy appearance. 

blood lactate, lactic acid that appears in the blood as a result 

of anaerobic metabolism when oxygen delivery to the 

tissues is insufficient to support normal metabolic demands. 

blood lavage [AS, blod L, lavere, to wash], the removal 

of toxic elements from the blood by the injection of serum 

into the veins. 

bloodless, 1. any organ or body part that lacks blood or appears 

to lack blood. 2. a surgical field in which the normal 

local blood supply has been shunted to other areas. 

bloodless phlebotomy [AS, blod ME, les Gk, phleps, 

vein, tomos, cutting], a technique of trapping blood in a 

body region by the application of tourniquet pressure that is 

less than the pressure needed to interrupt arterial blood flow. 

bloodletting, the therapeutic opening of an artery or vein 

to withdraw blood from a particular area. It is sometimes 

performed to treat polycythemia and congestive heart failure. 

See also phlebotomy. 

blood level, the concentration of a drug or other substance 

in a measured amount of plasma, serum, or whole blood. 

blood loss severity, a nursing outcome from the Nursing 

Outcomes Classification (NOC) defined as the severity of internal 

or external bleeding/hemorrhage. See also Nursing 

Outcomes Classification. 

blood osmolality [AS, blod Gk, ōsmos, impulsion], 

the osmotic pressure of blood. It measures the amount of solute 

concentration per unit of total volume of a particular solution. 

The normal values in serum are 280 to 295 mOsm/L. 

See also osmolality. 

blood osmolality test, a blood test that measures the concentration 

of dissolved particles in the blood. It is useful in 

evaluating patients with fluid and electrolyte imbalance, seizures, 

coma, and ascites; and in monitoring and evaluating 

hydration status, acid-base balance, and suspected antidiuretic 

hormone (ADH) abnormalities. 

blood patch. See epidural blood patch. 

blood pH, the hydrogen ion concentration of the blood, a 

measure of blood acidity or alkalinity. The normal pH values 

for arterial whole blood are 7.35 to 7.454; for venous whole 

blood, 7.36 to 7.41; for venous serum or plasma, 7.35 

to 7.45. 

blood plasma [AS, blod Gk, plassein, to mold], the liquid 

portion of the blood, free of its formed elements and particles. 

Plasma represents approximately 50% of the total volume 

of blood and contains glucose, proteins, amino acids, 

and other nutritive materials; urea and other excretory products; 

and hormones, enzymes, vitamins, and minerals. Compare 

serum. See also blood, plasma protein, pooled 

plasma. 

blood platelet. See platelet, thrombocyte. 

blood poisoning. See septicemia. 

blood potassium (K ) test, a blood test that detects the 

serum concentration of potassium, the major cation within 

cells. Potassium levels are followed carefully in patients 

with uremia, Addison’s disease, or vomiting and diarrhea; in 

those on steroid therapy; in those taking potassium-depleting 

diuretics; and in those taking digitalis-like drugs. 

blood pressure (BP) [AS, blod L, premere, to press], 

the pressure exerted by the circulating volume of blood on 

the walls of the arteries and veins and on the chambers of the 

heart. Blood pressure is regulated by the homeostatic mechanisms 

of the body by the volume of the blood, the lumen of 

the arteries and arterioles, and the force of cardiac contraction. 

In the aorta and large arteries of a healthy young adult, 

blood pressure is approximately 120 mm Hg during systole

lood pressure monitor 232 blood protein test 

and 70 mm Hg during diastole. See also hypertension, 

hypotension. 

METHOD: The indirect blood pressure is most often measured 

by auscultation, using an aneroid or mercury sphygmomanometer, 

a stethoscope, and a blood pressure cuff. 

With the upper arm at the level of the heart, the cuff is placed 

around the upper arm and inflated to a pressure greater than 

the systolic pressure, occluding the brachial artery. The diaphragm 

of the stethoscope is placed over the artery in the antecubital 

space, and the pressure in the cuff is slowly released. 

No sound is heard until the cuff pressure falls below 

the systolic pressure in the artery; at that point a pulse is 

heard. As the cuff pressure continues to fall slowly, the pulse 

continues, first becoming louder, then dull and muffled. 

These sounds, called sounds of Korotkoff, are produced by 

turbulence of the blood flowing through a vessel that is partially 

occluded as the arterial pressure falls to the low pressure 

of diastole. When the cuff pressure is less than the diastolic 

pressure, no pulse is heard. Thus the cuff pressure at 

which the first sound is heard is the systolic blood pressure, 

indicative of the pressure in the large arteries during systole; 

the cuff pressure at which the sounds stop is the diastolic 

blood pressure, indicative of the pressure in the arteries during 

diastole. A variation of this method involves the use of 

palpation in place of auscultation in the antecubital space to 

determine the systolic pressure (the pressure at which a pulse 

is first palpated). Another variation uses a transducer in the 

cuff to translate changes in ultrasound frequency caused by 

blood movement within the artery to audible sounds. Blood 

pressure may be monitored directly by means of a strain 

gauge or mercury manometer after a cannula has been 

placed in an artery. The flush method is used when blood 

pressure is difficult to measure by other methods. The cuff is 

applied, and complete capillary emptying is performed, usually 

with an elastic bandage. The cuff is inflated, the elastic 

bandage is removed, and the earliest discernible flush is observed 

as the cuff is deflated. This method measures mean 

blood pressure. 

INTERVENTIONS: The intervals at which the patient’s blood 

pressure is to be taken are specified. The pressure in both 

arms is taken the first time the procedure is performed; persistent 

major differences between the two readings is indicative 

of a vascular occlusion. Alternatively, the blood pressure 

may be taken using the thigh and the popliteal space when 

the leg is at the level of the heart. The width of the cuff 

should be one third to one half the circumference of the limb 

Measurement of blood pressure 

(Bonewit-West, 2008) 

used. Thus, a larger cuff is required for a large patient or for 

any patient if the pressure is taken at the thigh. 

OUTCOME CRITERIA: Any factor that increases peripheral resistance 

or cardiac output increases the blood pressure. 

Therefore, it is important to obtain a blood pressure reading 

when the patient is at rest. Increased peripheral resistance 

usually increases the diastolic pressure, and increased cardiac 

output tends to increase the systolic pressure. Blood 

pressure increases with age, primarily as a result of the decreased 

distensibility of the veins. As a person grows older, 

an increase in systolic pressure precedes an increase in diastolic 

pressure. 

Classification of blood pressure for adults 

Blood pressure 

classification 

Systolic blood 

pressure 

Normal

lood pump 233 blood urea nitrogen 

cirrhosis, rheumatoid-collagen diseases, nephrotic syndrome, 

advanced cirrhosis, tuberculosis, endocarditis, and 

myeloma, among others. 

blood pump, 1. a device for regulating the flow of blood 

into a blood vessel during transfusion. 2. a component of a 

heart-lung machine that pumps the blood through the machine 

for oxygenation and then through the peripheral circulatory 

system of the body. Also called mechanical 

heart-lung. See also cardiopulmonary bypass, oxygenation. 

blood relative, a related person who shares some of the 

same genetic material through a common ancestry. 

blood serum. See serum. 

bloodshot, a redness of the conjunctiva or sclera of the eye 

caused by dilation of blood vessels in the tissues. 

blood smear, a blood test used to provide information concerning 

drugs and diseases that affect the morphology of red 

and white blood cells and to help diagnose certain congenital 

and acquired diseases. A properly performed and analyzed 

blood smear is the most informative of all hematologic tests, 

allowing examination of erythrocytes, platelets, and leukocytes. 

blood sodium test (Na + ), a blood test used to determine 

the presence of hypo- or hypernatremia by measuring levels 

of sodium, the major cation in the extracellular space. 

bloodstream, the blood that flows freely through the circulatory 

system. 

blood substitute, a substance used for a replacement or 

volume expansion for circulating blood. Plasma, human 

serum albumin, packed red cells, platelets, leukocytes, and 

concentrates of clotting factors are often administered in 

place of whole blood transfusions in the treatment of various 

disorders. Substances that are sometimes used to expand 

blood volume include dextran, hetastarch, albumin solutions, 

or plasma protein fraction. Perfluorocarbon emulsions, 

although potentially toxic, have been tested as blood substitutes; 

they are able to carry oxygen to tissues, have a long 

shelf life without refrigeration, and do not induce antigenantibody 

reactions. 

blood sugar, one of a group of closely related substances, 

such as glucose, fructose, and galactose, that are normal constituents 

of the blood and are essential for cellular metabolism. 

See also blood glucose. 

blood test, any test that yields information about the characteristics 

or properties of the blood. 

blood transfusion [AS, blod L transfundere, to pour 

through], the administration of whole blood or a component, 

such as packed red cells, to replace blood lost through 

trauma, surgery, or disease. 

METHOD: Needed equipment is gathered; physician order 

is reviewed; transfusion consent completed; and blood component 

obtained, verified, and inspected per institution protocol. 

It is extremely important that the blood component to 

be transfused is compatible with the individual receiving the 

transfusion and that the correct individual is receiving the 

transfusion. Once verification of product and individual is 

confirmed, the blood component is hung using the appropriate 

tubing and setup and infused. A piggybacked 0.9% normal 

saline solution is set up to follow the infusion or to flush 

the line in event of a transfusion reaction. Infusion must be 

completed in under 4 hours to prevent bacterial growth. Individuals 

must be carefully monitored for a transfusion reaction 

during infusion. Vital signs should be checked every 5 

minutes along with checks for signs and symptoms such as 

fever, facial flushing, rapid thready pulse, cold clammy skin, 

itching, swelling at infusion site, dizziness, dyspnea, and low 

back or chest pain. (Stop infusion immediately at any sign of 

transfusion reaction.) After infusion, IV tubing is cleared 

with saline solution and the blood bag discarded according 

to institution policy. 

OUTCOME CRITERIA: No signs of transfusion reaction. (See 

transfusion reaction for appropriate interventions if reaction 

occurs.) Laboratory values show positive response to 

administration of blood component. 

Blood bag 

Identification 

number 

Expiration date 

ABO group 

Rh type 

Roller clamps 

to client 

0123-456-789 

Filter 

1.31.2001 

Rh neg 

Drip chamber 

Roller clamp 

Saline 

Setup for blood administration 

(Harkreader and Hogan, 2007) 

blood transfusion reaction, a nursing outcome from the 

Nursing Outcomes Classification (NOC) is defined as the severity 

of complications with blood transfusion reaction. See 

also Nursing Outcomes Classification. 

blood typing, a blood test used to determine the character 

of the blood of prospective blood donors and of expectant 

mothers and newborns on the basis of agglutinogens in the 

erythrocytes. The test detects the presence of ABO antigens 

as well as the Rh factor. See also blood group. 

blood urea nitrogen (BUN) [AS, blod Gk, ouron, urine, 

nitron, soda, genein, to produce], a measure of the amount

lood vessel 234 blue phlebitis 

of urea in the blood. Urea forms in the liver as the end product 

of protein metabolism, circulates in the blood, and is excreted 

through the kidney in urine. The BUN, determined by 

a blood test, is directly related to the metabolic function of 

the liver and the excretory function of the kidney. Normal 

findings (in mg/dL) are 10 to 20 for adults, 5 to 18 for children 

and infants, 3 to 12 for newborns, and 21 to 40 for cord 

blood. In the elderly, the BUN may be slightly higher than 

the normal adult range. A critical value of 100 mg/dL indicates 

serious impairment of renal function. Also called urea 

nitrogen, serum urea nitrogen. See also azotemia. 

Compare creatinine. 

blood vessel, any one of the network of muscular tubes 

that carry blood. Kinds of blood vessels are arteries, arterioles, 

capillaries, veins, and venules. 

blood warming coil, a device constructed of coiled plastic 

tubing used for the warming of reserve blood before massive 

transfusions, such as those often required for patients who 

experience extensive bleeding. Administration of cold blood 

in such transfusions may cause the patient to go into a state 

of shock. The blood warming coil is a prepackaged sterile 

single-use device. Compare electric blood warmer. 

bloody show. See vaginal bleeding. 

bloody sputum [AS, blod L, sputum, spittle], bloodtinged 

material expelled from the respiratory passages. The 

amount and color of blood in sputum expelled by coughing 

or clearing the throat may indicate the cause and location of 

the bleeding. Swallowed blood regurgitated from the stomach 

most often loses its vital coloring, however, thus eliminating 

the opportunity to judge the origin. 

blooming, an increase in x-ray focal spot size due to electrostatic 

repulsion. 

Bloom’s syndrome [David Bloom, American physician, 

b. 1892], a rare genetic disease occurring mainly in 

Ashkenazi Jews. It is transmitted as an autosomal recessive 

trait and is characterized by growth retardation, dilated capillaries 

of the face and arms, sensitivity to sunlight, and an 

increased risk of malignancy. 

blot, 1. a technique transferring electrophoretically separated 

components from a gel onto a nitrocellulose membrane, 

chemically treated paper, or filter for analysis. It is 

frequently used to analyze genetic material. 2. the substrate 

containing the transferred material. See also Northern blot 

test, Southern blot test, Western blot test. 

blotch, a skin discoloration that may vary in severity from 

an area of pigmentation to large pustules or blisters. 

blow-out fracture, a break in the floor of the orbit caused 

by a blow that suddenly increases the intraocular pressure. 

blowpipe /blōpīp/ [AS, blāwan pīpe], a tube through 

which a current of air or other gas is forced on a flame to 

concentrate and intensify the heat. 

BLS, abbreviation for basic life support. 

blue asphyxia. See asphyxia livida. 

blue baby [OFr, blou ME, babe], an infant born with 

cyanosis caused by a congenital heart lesion that results in a 

right-to-left shunt, most commonly tetralogy of Fallot. Other 

causative lesions include transposition of the great vessels, 

and incomplete expansion of the lungs (congenital atelectasis). 

Congenital cyanotic heart lesions are diagnosed by cardiac 

catheterization, angiography, or echocardiography and 

are corrected surgically, preferably in early childhood. See 

also congenital cardiac anomaly, tetralogy of Fallot, 

transposition of the great vessels. 

blue cohosh, a perennial herb found in the midwest and 

eastern regions of the United States. 

USES: This herb is used to treat menopausal symptoms 

and uterine and ovarian pain, to improve the flow of men- 

strual blood, and as an antiinflammatory and antirheumatic. 

It is also a popular remedy in African American ethnic 

medicine. 

CONTRAINDICATIONS: Should not be used for any of these 

indications since it has caused serious toxicities. 

Blue Cross, an independent nonprofit U.S. corporation 

that functions as a health insurance agency, providing protection 

for an enrolled patient by covering all or part of the 

person’s hospital expenses. Blue Cross programs vary in different 

communities because of state laws regulating them. 

See also Blue Shield. 

blue diaper syndrome [OFr, blou; ME, diapre, patterned 

fabric], a defect of tryptophan absorption in which, because 

of intestinal bacterial action on the tryptophan, the 

urine contains abnormal indoles, giving it a blue color. It is 

similar to Hartnup’s disease. 

blue dome cyst, a spherical dilation of a mammary duct in 

which bleeding has occurred. 

Blue dome cyst 

(Kumar et al, 2007/Courtesy Dr. Kyle Molberg, Department of Pathology, 

University of Texas Southwestern Medical School) 

blue dot sign, a tender blue or black spot beneath the skin 

of the testis or epididymis, a sign of testicular torsion of the 

appendix testis or, less commonly, appendix epididymis. 

blue fever informal. Rocky Mountain spotted fever, so 

named for the dark cyanotic discoloration of the skin after 

the initial rickettsial infection. The disease is characterized 

by headache, chills, and fever, as well as a rash. See also 

rickettsiosis, Rocky Mountain spotted fever, typhus. 

blue-green algae, misnomer formerly applied to the group 

now called the cyanobacteria. 

blue-green algae poisoning. See cyanobacteria poisoning. 

blue line, a bluish discoloration sometimes observed on 

the gingival side of the mouth in cases of gingivitis. It is a 

sign of chronic lead or bismuth poisoning. 

blue nevus [OFr, blou L, naevus, mole], a sharply circumscribed, 

usually benign, steel blue skin nodule with a diameter 

between 2 and 7 mm. It is found on the face or upper 

extremities, grows very slowly, and persists throughout life. 

The dark color is caused by large, densely packed melanocytes 

deep in the dermis of the nevus. Nodular blue nevi 

found on the buttocks or in the sacrococcygeal region occasionally 

become malignant. Any sudden change in the size of 

such a lesion demands surgical attention and biopsy. Compare 

melanoma. 

blue phlebitis, a severe form of thrombosis of a deep vein, 

usually the femoral vein. The condition is acute and fulminating 

and is usually accompanied by vast edema and cyano-

lue rubber bleb nevus 235 Bodansky unit 

sis of the limb distal to the occluding thrombus. It can lead to 

venous gangrene. Also called phlegmasia cerulea dolens. 

blue rubber bleb nevus [OFR, blou, blue; ME, rubben, 

to scrape; ME, bleb, blob; L, naevus, mole], a type of 

congenital nevus, transmitted as an autosomal dominant 

trait, characterized by blue hemangiomas with soft elevated 

nipple-like centers, found on the skin surface, in the GI tract, 

and sometimes on mucous membranes; it may be accompanied 

by pain, regional hyperhidrosis, or GI bleeding. 

Blue rubber bleb nevus (Callen et al, 2000) 

blues informal. 1. a designation for Blue Cross (an insurance 

system that pays the costs of treatment by a hospital or 

clinic) and Blue Shield. 2. informal. mild depression. 

Blue Shield, an independent nonprofit U.S. corporation 

that offers patient protection for costs of surgery and other 

medical services. Although Blue Cross and Blue Shield are 

technically separate organizations, they generally coordinate 

their functions in providing benefits covering both hospital 

costs and physician fees. 

blue spot, 1. one of a number of small grayish blue spots 

that may appear near the armpits or around the groins of individuals 

infested with lice, such as in pediculosis corporis 

and pediculosis pubis. These spots are usually less than 1 cm 

in diameter and are caused by a substance in the saliva of 

lice that converts bilirubin to biliverdin. Also called macula 

cerulea /seroo ¯¯¯¯lē·Y/. 2. one of a number of dark blue round 

or oval spots that may appear as a congenital condition in the 

sacral regions of certain children less than 4 or 5 years of 

age. They usually disappear spontaneously as the affected individual 

matures. Also called mongolian spot. 

blunt dissection [ME, blunt L, dissecare, to cut apart], 

a dissection performed by separating tissues along natural 

lines of cleavage without cutting. 

blunt-ended DNA, a segment of DNA in which the ends 

of both strands are even with each other. 

blunthook /blunthoo ˘ k/ [ME, blunt AS, hoc], 1. a 

sturdy hook-shaped bar used in obstetrics for traction between 

the abdomen and the thigh in cases of difficult breech 

deliveries. 2. a hook-shaped device with a blunt end used in 

embryotomy. 

blunting, a decrease in the intensity of emotional expression 

from the level one would normally expect as a reaction 

to a specific situation. It is the opposite of overreaction and 

may be marked by apathy, minimal response, or indifference. 

blurred film fault /blurd/, a defect in a photograph or radiograph 

that appears as an indistinct or blurred image. It is 

caused by film movement during exposure, bending of film 

during exposure, double exposure, or film emulsion flow 

during processing in excessively warm solutions. 

blush [ME, blusshen, to redden], a brief, diffuse erythema 

of the face and neck, commonly the result of dilation of superficial 

small blood vessels in response to heat or sudden 

emotion. 

BLV-HTLV retroviruses, a genus similar in morphology 

and replication to the type C retroviruses. Organisms have a 

long latency and cause B and T cell leukemia and lymphoma 

and neurologic disease. Included in this genus are human 

T-lymphotropic viruses 1 and 2. 

B lymphocyte. See B cell. 

B/M, abbreviation for black male, often used in the initial 

identifying statement in a patient record. 

B 2M, abbreviation for beta 2-microglobulin. 

BMA, abbreviation for British Medical Association. 

BMD, abbreviation for Bureau of Medical Devices. See 

National Center for Devices and Radiological Health. 

BMI, abbreviation for body mass index. 

B-mode, brightness modulation in diagnostic ultrasonography. 

Bright dots on an oscilloscope screen represent echoes, 

and the intensity of the brightness indicates the strength of 

the echo. See also A-mode, M-mode. 

BMR, abbreviation for basal metabolic rate. 

BNA, abbreviation for Basel Nomina Anatomica. 

BOA, abbreviation for born out of asepsis. 

board. See custodial care. 

board and care, nonmedical, community-based residential 

care for individuals who can care for themselves; meals 

and supervision are provided. 

board certification, a process by which physicians are 

certified in a given medical specialty or subspecialty. Certification 

is awarded by the 23-member boards of the American 

Board of Medical Specialties on completion of accredited 

training and examinations and fulfillment of individual 

requirements of the board. 

board certified, denoting a physician who has completed 

the certification requirements established by a medical specialty 

board and has been certified as a specialist in a particular 

field of medicine. 

board eligible, denoting a physician who has completed 

all of the requirements for admission to a medical specialty 

board. 

boarder baby, 1. an infant abandoned to a hospital because 

the mother is unable to care for him or her. Many infants 

born with human immunodeficiency virus (HIV) or to a 

mother with HIV infection or infants delivered to mothers 

who are drug users are boarder babies. 2. in some hospitals, 

any infant still in the nursery after the mother’s discharge for 

any reason (even if only temporarily). 

board of health, an administrative body acting on a municipal, 

county, state, provincial, or national level. The functions, 

powers, and responsibilities of boards of health vary 

with the locales. Each board is generally concerned with the 

recognition of the health needs of the people and the coordination 

of projects and resources to meet and identify these 

needs. Among the tasks of most boards of health are disease 

prevention, health education, and implementation of laws 

pertaining to health. 

bobbing, the act of moving up and down, usually with a 

jerking motion. 

Bochdalek’s hernia, a hernia through the defect in the left 

posterior pleuroperitoneal canal of the diaphragm. 

Bodansky unit /bōdănskē/ [Aaron Bodansky, American 

biochemist, 1887–1961], the quantity of alkaline phosphatase 

that liberates 1 mg of phosphate ion from glycerol

ody 236 body mechanics 

2-phosphate in 1 hour at 37° C and under other standardized 

conditions. 

body [AS, bodig], 1. the whole structure of an individual 

with all the organs. 2. a cadaver (corpse). 3. the largest or 

the main part of any structure, such as the body of the stomach. 

Also called corpus, soma. 

body burden, 1. the state of activity of a radioactive 

chemical in the body at a specified time after administration. 

2. chemicals stored in the body that may be detected by 

analysis. 

body cast [AS, bodig, body; ONorse, kasta], a molded cast 

that may extend from the chest to the groin to immobilize the 

spine. 

body cavity, any of the spaces in the human body that contain 

organs. One major cavity, the thoracic cavity, is subdivided 

into a pericardial and two pleural cavities. 

R 

S 

I 

L 

Cranial 

cavity 

Spinal 

cavity 

Thoracic 

cavity 

Pleural 

cavity 

Mediastinum 

Diaphragm 

Abdominal 

cavity 

Abdominopelvic 

cavity 

Pelvic 

cavity 

Dorsal body cavity 

Ventral body cavity 

Major body cavities 


body composition, the relative proportions of protein, fat, 

water, and mineral components in the body. It varies among 

individuals as a result of differences in body density and degree 

of obesity. 

body fluid [AS, bodig L, fluere, to flow], fluid contained 

in the three fluid compartments of the body: the plasma of 

the circulating blood, the interstitial fluid between the cells, 

and the cell fluid within the cells. See also blood plasma, interstitial 

fluid, extracellular fluid (ECF), intracellular 

fluid. 

body image 1 [AS, bodig L, imago, likeness], a person’s 

concept of his or her physical appearance. The mental representation, 

which may be realistic or unrealistic, is constructed 

from self-observation, the reactions of others, and a 

complex interaction of attitudes, emotions, memories, fantasies, 

and experiences, both conscious and unconscious. A 

marked inability to conceptualize one’s personal body characteristics 

may be caused by organic brain damage, as in 

A 

S 

I 

P 

autotopagnosia; by a physical disability, such as the loss of a 

limb; or by psychologic and emotional disturbances, as in 

anorexia nervosa. 

body image 2 , a nursing outcome from the Nursing Outcomes 

Classification (NOC) defined as perception of own 

appearance and body functions. See also Nursing Outcomes 


body image agnosia. See autotopagnosia. 

body image, disturbed, a nursing diagnosis accepted by 

the Seventh National Conference on the Classification of 

Nursing Diagnoses. The condition is defined as a disruption 

in the way one perceives one’s body. See also nursing 

diagnosis. 

DEFINING CHARACTERISTICS: Objective characteristics of the 

deficit include verbal or nonverbal responses to a real or perceived 

change in structure or function, a missing body part, 

trauma to a nonfunctioning part, and a change in the ability 

to estimate spatial relationship of the body to the environment. 

Subjective characteristics include personalization of 

the missing part by giving it a name, refusal to look at a part 

of the body, negative feelings about the body, a change in 

general social involvement or life-style, and a fear of rejection 

by others. 

RELATED FACTORS: Related factors include biophysical, 

cognitive, perceptual, psychosocial, cultural, and spiritual 

factors. 

body image enhancement, a nursing intervention from 


improving a patient’s conscious and unconscious perceptions 

and attitudes toward his/her body. See also Nursing Interventions 


body jacket, an orthopedic cast that encases the trunk of 

the body but does not extend over the cervical area; it may 

be equipped with shoulder straps. The cast is used to help 

position and immobilize the trunk for the healing of spinal 

injuries and scoliosis and after spinal surgery. Compare 

Risser cast. See also thoracolumbosacral orthosis. 

body language [AS, bodig L, lingua, tongue], a set of 

nonverbal signals, including body movements, postures, 

gestures, spatial positions, facial expressions, and body 

adornment, that give expression to various physical, mental, 

and emotional states. See also kinesics. 

body louse. See lice, Pediculus humanus corporis. 

body mass index (BMI), a formula for determining obesity. 

It is calculated by dividing a person’s weight in kilograms 

by the square of the person’s height in meters. An 

adult with a BMI of 25 to 29.9 is considered overweight. A 

BMI of 30 or greater indicates obesity. 

Body mass index calculation 

Underweight =

ody mechanics performance 237 body temperature, imbalanced, risk for 

cially important in the prevention of injury during the performance 

of tasks that require the body to lift and move. 

body mechanics performance, a nursing outcome from 

the Nursing Outcomes Classification (NOC) defined as personal 

actions to maintain proper body alignment and to prevent 

muscular skeletal strain or injury. See also Nursing 

Outcomes Classification. 

body mechanics promotion, a nursing intervention from 

the Nursing Interventions Classification (NIC) defined as facilitating 

the use of posture and movement in daily activities 

to prevent fatigue and musculoskeletal strain or injury. See 


body movement, motion of all or part of the body, especially 

at a joint or joints. Body movements include abduction, 

adduction, extension, flexion, rotation, and circumduction. 

body odor, a fetid smell associated with stale perspiration. 

Freshly secreted perspiration is odorless, but after exposure 

to the atmosphere and bacterial activity at the surface of the 

skin, chemical changes occur to produce the odor. Common 

body odor usually can be eliminated by bathing with soap 

and water. Body odors can also be the result of discharges 

from a variety of skin conditions, including cancer, fungus, 

hemorrhoids, leukemia, and ulcers. See also bromhidrosis. 

body of Retzius /retsē·Ys/ [Magnus G. Retzius, Swedish 

anatomist, 1842–1919], any one of the masses of protoplasm 

containing pigment granules at the lower end of a hair 

cell of the organ of Corti in the internal ear. 

body plethysmograph [AS, bodig Gk, plethynein, to increase, 

graphein, to record], a device for studying alveolar 

pressures, lung volumes, and airway resistance. The patient 

sits or reclines in an airtight compartment and breathes normally. 

The pressure changes in the alveoli are reciprocated in 

the compartment and are recorded automatically. 

body position, attitude or posture of the body. See anatomic 

position, decubitus position, Fowler’s position, 

prone, supine, and Trendelenburg position. 

body positioning: self-initiated, a nursing outcome from 

the Nursing Outcomes Classification (NOC) defined as ability 

to change one’s own body position independently with or 

without assistive device(s). See also Nursing Outcomes 


body righting reflex. See righting reflex. 

body scheme, a piagetian term for a cognitive structure 

that develops in infants in the sensorimotor period during the 

first 2 years of life as they learn to differentiate between 

themselves and the world around them. 

body-scheme disorder. See autotopagnosia. 

body-section radiography, a radiographic technique in 

which the film and x-ray tube are moved in opposite directions 

to produce a more distinct image of a selected body 

plane. The process has the effect of blurring adjacent body 

structures during exposure. Also called tomography. 

body stalk, the elongated part of the embryo that is connected 

to the chorion. See also allantois. 

body surface area. See surface area. 

body systems model, (in nursing education) a conceptual 

framework in which illness is studied in relation to the functional 

systems of the body, such as the circulatory, nervous, 

GI, and reproductive. In this model, nursing care is directed 

to manipulating the patient’s environment in such a way that 

the signs and symptoms of the health problem are alleviated. 

As the body systems model traditionally focuses on the disease 

rather than the patient, current educational programs 

tend to integrate it with other concepts that allow the nurse to 

approach the patient in a more holistic framework. Also 

called medical model. 

body temperature, the level of heat produced and sustained 

by the body processes. Variations and changes in body 

temperature are major indicators of disease and other abnormalities. 

Heat is generated within the body through metabolism 

of nutrients and lost from the body surface through radiation, 

convection, and evaporation of perspiration. Heat 

production and loss are regulated and controlled in the hypothalamus 

and brainstem. Fever is usually a function of an 

increase in heat generation; however, some abnormal conditions, 

such as congestive heart failure, produce slight elevations 

of body temperature through impairment of the heat 

loss function. Contributing to the failure to dissipate heat 

are reduced activity of the heart, lower rate of blood flow to 

the skin, and the insulating effect of edema. Diseases of the 

hypothalamus or interference with the other regulatory centers 

may produce abnormally low body temperatures. Normal 

adult body temperature, as measured orally, is 98.6° F 

(37° C). Oral temperatures ranging from 96.5° F to 99° F are 

consistent with good health, depending on the person’s physical 

activity, the environmental temperature, and that person’s 

usual body temperature. Axillary temperature is usually 

from 0.5° F to 1° F lower than the oral temperature. 

Rectal temperatures may be 0.5° F to 1° F higher than oral 

readings. Body temperature appears to vary 1° F to 2° F 

throughout the day, with lows recorded early in the morning 

and peaks between 6 PM and 10 PM. This diurnal variation 

may increase in range during a fever. Whereas adult body 

temperature, normal and abnormal, tends to vary within a 

relatively narrow range, children’s temperatures respond 

more dramatically and rapidly to disease, changes in environmental 

temperature, and levels of physical activity. 

40 

Strenuous 

exercise, 

heat stress 

Motion, moderate 

exercise, hot 

environments 

Usual range in 

awake adults 

During sleep, 

cold exposure 

35 

104 

95 

°C °F 

50 122 

45 113 

40 104 

Irreversible cell 

damage 

Thermoregulation 

ceases 

Heatstroke 

Fever 

Range of 

normal values 

Temperature 

regulation impaired 

Temperature 

regulation ceases 

Cardiac 

dysrhythmias 

Respiratory 

movements stop 

Cardiac arrest 

Cells still viable 

Normal and abnormal body temperatures 


body temperature, imbalanced, risk for, a nursing diagnosis 

accepted by the Seventh National Conference on the 

Classification of Nursing Diagnoses. The condition is a state 

in which the individual is at risk for failure to maintain body 

temperature within a normal range. See also nursing 

diagnosis. 

35 

30 

25 

20 

95 

86 

77 

68

ody type 238 bonding 

RISK FACTORS: Risk factors are extremes of age; extremes 

of weight; exposure to cool-to-cold or warm-to-hot environments; 

dehydration; inactivity or vigorous activity; 

medications causing vasoconstriction or vasodilation; altered 

metabolic rate; sedation; clothing inappropriate for environmental 

temperature; and illness or trauma affecting 

temperature regulations. 

body type, the general physical appearance of an individual 

human body. Three commonly used terms for body types 

are ectomorph, describing a thin, fragile physique; endomorph, 

denoting a round, soft body; and mesomorph, indicating 

a muscular, athletic body of average size. See also asthenic 

habitus, athletic habitus, ectomorph, endomorph, 

mesomorph, pyknic. 

body-weight ratio, a relation expressed by dividing the 

body weight in grams by the height in centimeters. 

Boeck’s disease, Boeck’s sarcoid. See sarcoidosis. 

Boerhaave’s syndrome /bôrhävz/ [Hermann Boerhaave, 

Dutch physician, 1668–1738], a condition marked by 

spontaneous rupture of the esophagus, usually preceded by 

severe vomiting, leading to mediastinitis and pleural effusion. 

Clinical manifestations are violent retching or vomiting. 

Emergency care with surgery and drainage is needed to 

save the life of the patient. 

Bohr effect [Christian Bohr, Danish physiologist, 1855– 

1911], the effect of CO 2 and H on the affinity of hemoglobin 

for molecular O 2. Increasing PCO 2 and H decrease 

oxyhemoglobin saturation, whereas decreasing concentrations 

have the opposite effect. In humans a decrease of pH 

from 7.4 to 7.3 at 40 mm Hg PO 2 decreases oxyhemoglobin 

saturation by 6%. The Bohr effect is particularly significant 

in the capillaries of working muscles and the myocardium 

and in maternal and fetal exchange vessels of the placenta. 

bohrium (Bh). See element 107. 

boil [AS, byle, sore], a skin abscess. A tender, swollen area 

that forms around a hair follicle. See furuncle. 

boiling point [ME, boilen, to make bubbles; L, pungere, to 

prick], 1. the temperature at which a substance passes 

from the liquid to the gaseous state at a particular atmospheric 

pressure. 2. the temperature at which the vapor pressure 

of a liquid equals the external pressure. See also 

evaporation. 

-bol, combining form designating an anabolic steroid. 

bole /bōl/, any of a variety of soft, friable clays of various 

colors, although usually red from iron oxide. They consist of 

hydrous silicate of aluminum, are used as pigments, and 

were once commonly used as absorbents and astringents. 

Bolivian hemorrhagic fever /bYlivē·Yn/, a febrile illness 

caused by an arenavirus, generally transmitted by contact 

with or inhalation of aerosolized rodent urine. Person-toperson 

infection has been documented, but it is very rare. 

After an incubation period of 1 to 2 weeks, the patient experiences 

chills, fever, headache, muscle ache, anorexia, nausea, 

and vomiting. As the disease progresses, hypotension, 

dehydration, bradycardia, pulmonary edema, and internal 

hemorrhage may occur. The mortality rate may reach 30%; 

pulmonary edema is the most common cause of death. There 

is no specific therapy. Peritoneal dialysis is sometimes performed. 

Also called Machupo. See also Arenavirus, Argentine 

hemorrhagic fever, Lassa fever. 

bolus /bōlYs/ [Gk, bolos, lump], 1. also called alimentary 

bolus, a round mass, specifically a masticated lump of 

food ready to be swallowed. 2. a large round preparation of 

medicinal material for oral ingestion, usually soft and not 

prepackaged. 3. a dose of a medication or a contrast material, 

radioactive isotope, or other pharmaceutic preparation 

injected all at once intravenously. 4. (in radiotherapy) mate- 

rial used to fill in irregular body surfaces to improve dose 

distribution for hyperthermia or to increase the dose to the 

skin when high-energy photon beams are used. 5. a clumping 

in the stomach of ingested foreign material, often the result 

of habitual behavior. 

bolus dose, an amount of IV medication administered rapidly 

to decrease the response time or to be used as a loading 

dose prior to an infusion. See also bolus. 

bombard /bombärd/, to shower a drug or tissue sample 

with radioactive particles from a nuclear isotope source. 

Bombay phenotype /bombā/ [Bombay, India, where first 

reported], a rare genetic trait involving the phenotypic expression 

of the ABO blood groups. The gene for the H antigen, 

which in the usual dominant form of HH or Hh is responsible 

for the precursor necessary for the production of 

the A and B antigens, is homozygous recessive in individuals 

with this trait so that the expression of the A, B, and H antigens 

is suppressed. Cells of such individuals are phenotypically 

of blood type O, and the serum contains anti-A, anti-B, 

and anti-H antigens. In such cases the offspring from two 

phenotypic O blood type parents may be blood type AB. The 

phenomenon is an example of the intricate interaction of 

linked genes in which one gene on a chromosome controls 

the expression or suppression of another gene that is not its 

allele. See also ABO blood group. 

bombesin /bombY·sin/, a neurohormone and pressor substance 

found in small amounts in brain and intestinal tissue 

under normal conditions and in increased amounts in certain 

pulmonary and thyroid tumors. It is a potent mitogen and its 

effects on gastrin and other hormones are attributed to increased 

cell numbers. 

bond, a strong coulombic force between atoms in a substance 

due to attraction of ions of opposite charge for each 

other or of the nuclei for shared electrons. See also coulomb, 

Coulomb’s law. 

bonding [ME, band, to bind], 1. (in dentistry) a technique 

of joining orthodontic brackets or other attachments directly 

to the enamel surface of a tooth, using orthodontic adhesives. 

2. the reciprocal attachment process that occurs between 

an infant and the parents, especially the mother. Bonding 

is significant in the formation of affectionate ties that 

later influence both the physical and psychologic development 

of the child. It is usually initiated immediately after 

birth by placing the nude infant on the mother’s abdomen so 

that both the parents and the child can see and touch one another 

and begin to interact. The newborn is in an alert, reactive 

state for about 30 minutes to 1 hour after birth and displays 

such behaviors as crying, sucking, clinging, grasping, 

and following with the eyes, which in turn stimulate the expression 

of parenting instincts. By about the second to third 

week of the infant’s life, a definite, reciprocal pattern of interacting 

behavior that involves an attention-nonattention 

cycle occurs during each encounter of parents and child. At 

the peak of the attention phase, the infant reaches out toward 

the parent and is very attentive. This peak is followed in a 

short time by deceleration of excitement in the infant and a 

turning away from the parent. This nonattentive phase prevents 

the infant from being overwhelmed by excessive 

stimuli, and no visual or verbal attempt will regain the infant’s 

attention. Recognizing that the nonattention phase 

does not represent rejection helps the mother and father develop 

competence in parenting. Assessment of the attachment 

process is an important nursing function and requires 

skillful observation and interviewing. The nurse observes the 

mother’s reactions, especially while feeding, bathing, and 

comforting her infant, for potential signs of inadequate or 

delayed mothering. Among the most important actions for

ond specificity 239 bone densitometry 

bonding are eye contact in the en face position and embracing 

of the infant close to the body. Many variables determine 

the development of bonding and parenting, including the 

parents’ fantasies about the child, the conditions surrounding 

the pregnancy, the arrangements that have been made concerning 

changes in life-style with the addition of a dependent 

family member, and the type of parenting the mother and father 

received as children. Bonding is also seen in adoptive 

situations and is not limited to the newborn period. Although 

bonding is considered primarily an emotional response, it is 

hypothesized that some biochemical and hormonal interaction 

in the mother may stimulate the response; results of 

studies testing this hypothesis are inconclusive. Also called 

maternal-child attachment. See also maternal deprivation 

syndrome, maternal-infant bonding. 

bond specificity, the nature of enzyme action that causes 

the disruption of only certain bonds between atoms. 

bone [AS, ban], 1. the dense, hard, and somewhat flexible 

connective tissue constituting the framework of the human 

skeleton. It is composed of compact osseous tissue surrounding 

spongy cancellous tissue permeated by many blood vessels 

and nerves and enclosed in membranous periosteum. 

2. any single element of the skeleton, such as a rib, the sternum, 

or the femur. Also called (Latin) os. See also connective 

tissue. 

Articular cartilage 

Spongy bone 

Space containing 

red marrow 

Endosteum 

Medullary cavity 

Compact bone 

Yellow marrow 

Periosteum 

Epiphyseal disks 

Femur 

Proximal 

epiphysis 

Diaphysis 

Distal 

epiphysis 

Structure of a long bone (Muscolino, 2006) 

bone age [AS, ban L, aetas], the stage of development 

or decline of the skeleton or its segments, as seen in radiographic 

examination, when compared with x-ray views of 

the bone structures of other individuals of the same 

chronologic age. 

bone-anchored hearing aid, a hearing aid that allows direct 

bone conduction of sound to the cochlea by means of a 

Flat bone 

Short bones 

Irregular bone 

Types of bones (Herlihy, 2007) 

Long bone 

sound processing device attached to an osseointegrated titanium 

fixture implanted posterior to the ear. 

bone cancer [AS, ban Gk, karkinos, crab], a skeletal 

malignancy occurring as a sarcoma or in an area of rapid 

growth or as metastasis from cancer elsewhere in the body. 

Primary bone tumors are rare. The incidence peaks during 

adolescence, decreases, and then rises slowly after 35 years 

of age. In adults, bone cancer is linked to exposure to ionizing 

radiation. Paget’s disease, hyperparathyroidism, chronic 

osteomyelitis, old bone infarcts, and fracture callosities increase 

the risk of many bone tumors. Most osseous malignancies 

are metastatic lesions found most often in the spine 

or pelvis and less often in sites away from the trunk. These 

are referred to as cancers of the primary site and not bone 

cancer. Bone cancers progress rapidly but are often difficult 

to detect. Alkaline phosphatase levels are elevated in osteoblastic 

tumors, and serum calcium and urinary calcium levels 

are increased in highly destructive lesions. X-ray films, 

radioisotopic scanning, arteriography, and biopsy are diagnostic. 

Surgical treatment consists of local resection of slowgrowing 

tumors or amputation, including the joint above the 

tumor, if the lesion is aggressive. Radiotherapy may be given 

preoperatively or as the primary form of treatment. See also 

chondrosarcoma, Ewing’s sarcoma, fibrosarcoma, multiple 

myeloma, osteosarcoma. 

bone cell [AS, ban L, cella, storeroom], an osteocyte, 

osteoblast, or osteoclast, a cell with myriad spidery processes 

embedded in the matrix of bone. See also osteoblast. 

bone cutting forceps, a type of forceps that has long 

handles, single or double joints, and heavy blades for cutting 

bone. 

bone cyst [AS, ban Gk, kytis, cyst], 1. a dilation in the 

wall of a blood vessel in a bone, usually eccentrically placed. 

2. a sac in bone tissue in the parathyroid disorder osteitis fibrosa. 

bone densitometry, any of several methods of determining 

bone mass by measuring radiation absorption by the

one graft 240 bone turnover biochemical markers test 

skeleton. Common techniques include single-photon absorptiometry 

(SPA) of the forearm and heel, dual-photon absorptiometry 

(DPA) and dual-energy x-ray absorptiometry 

(DXA) of the spine and hip, quantitative computed tomography 

(QCT) of the spine and forearm, radiographic 

absorptiometry (RA) of the hand, and quantitative ultrasound 

(QU). 

bone graft, the transplantation of a piece of bone from one 

part of the body to another to repair a skeletal defect. 

bone healing, a nursing outcome from the Nursing Outcomes 

Classification (NOC) defined as the extent of regeneration 

of cells and tissue following bone injury. See also 

Nursing Outcomes Classification. 

bone lamella [AS, ban, bone, lamella, plate], a thin plate 

of bone matrix, a basic structural unit of mature bone. 

bone loss. See bone recession. 

bone marrow [AS, ban ME, marowe], the soft, organic, 

spongelike material in the cavities of bones; also called medulla 

ossium. It is a network of blood vessels and special 

connective tissue fibers that hold together a composite of fat 

and blood-producing cells. Its chief function is to manufacture 

erythrocytes, leukocytes, and platelets. These blood 

cells normally do not enter the bloodstream until they are 

fully developed, so that the marrow contains cells in all 

stages of growth. If the body’s demand for leukocytes is increased 

because of infection, the marrow responds immediately 

by stepping up production. The same is true if more 

erythrocytes are necessary, as in hemorrhage or anemia. Red 

marrow is found in many bones of infants and children and 

in the spongy (cancellous) bone of the proximal epiphyses of 

the humerus and femur and the sternum, ribs, and vertebral 

bodies of adults. Fatty yellow marrow is found in the medullary 

cavity of most adult long bones. 

Nuclei 

bone marrow biopsy, a microscopic tissue examination 

used to help evaluate patients with hematologic diseases. 

The biopsy may be done to confirm a diagnosis of megaloblastic 

anemia, to diagnose leukemia or myeloma, to determine 

the cause of reduced red blood cells in the peripheral 

bloodstream, to document deficient iron stores, to document 

bone marrow infiltrative diseases such as neoplasm or fibrosis, 

to identify tumors, and to diagnose a variety of other 

conditions. 

bone marrow failure, failure of the hematopoietic function 

of the bone marrow. See also hematopoietic system. 

bone marrow infusion, a method of injecting a fluid substance 

through an aspiration needle directly into the marrow 

Fat 

Bone marrow 

(© Ed Reschke; Used with permission) 

cavity of a long bone. The substance is absorbed into the 

general circulation almost immediately. 

bone marrow reserve, a storage pool of mature neutrophils 

in the bone marrow, which can be released as necessary. 

bone marrow suppression, suppression of bone marrow 

activity, resulting in reduction in the number of platelets, red 

cells, and white cells, such as in aplastic anemia. Also called 

myelosuppression. 

bone marrow transplantation, the transplantation of 

bone marrow from a healthy donor to stimulate production 

of normal blood cells. The marrow may be autologous (from 

a previously harvested and stored self-donation) or allogeneic 

(from a living related donor or a living unrelated donor). 

The bone marrow is removed from the donor by aspiration 

and infused intravenously into the recipient. Used to treat 

malignancies, such as leukemia, lymphoma, myeloma, and 

selected solid tumors; and nonmalignant conditions, such as 

aplastic anemia, immunologic deficiencies, and inborn errors 

of metabolism. Transplantation is usually preceded by chemotherapy 

and total body radiation of the recipient. 

bone plate [AS, ban, bone; OFr, plate], a metal plate used 

to reconstruct a bone that has been fractured. The plate is designed 

to hold bone fragments in apposition. 

bone recession [AS, ban L, recedere, to recede], 

apical progression of the level of the alveolar crest, resulting 

in decreased bone support for the teeth. The condition, 

which may be horizontal or vertical, is associated with inflammatory 

or dystrophic periodontal disease. Also called 

bone resorption, bone loss. 

bone resorption. See bone recession. 

bone scan, the injection of a radioactive substance to enable 

visualization of a bone via the image produced by emission 

of radioactive particles. 

bone tissue [AS, ban OFr, tissu], a hard form of connective 

tissue composed of osteocytes and a calcified collagenous 

intercellular substance arranged in thin plates. See 

connective tissue. Also called bony tissue. 

Osteons 

(Haversian systems) 

Periosteum 

Inner 

layer 

Outer 

layer 

Compact bone 

Cancellous 

(spongy bone) 

Medullary 

marrow cavity 

Bone tissue (Thibodeau and Patton, 2007) 

Endosteum 

Trabeculae 

Haversian 

canals 

Volkmann 

canals 

bone turnover biochemical markers test, a blood or 

urine test to identify small changes in bone metabolism. This 

test is used primarily to determine the effectiveness of treat-

one x-ray 241 born out of asepsis 

ment for osteoporosis, Paget’s disease, hyperparathyroidism, 

and bone tumors. 

bone x-ray, radiographic studies to detect abnormalities of 

the bones or joints. 

Bonine, trademark for an antiemetic (meclizine hydrochloride). 

Bonnevie-Ullrich syndrome. See Turner’s syndrome. 

Bonnie Pruden myotherapy, a method of applying 

manual pressure on muscles with the fingers, knuckles, and 

elbows to defuse trigger points and relax muscle spasm, improve 

circulation, and alleviate pain. 

Bonwill’s triangle [William G.A. Bonwill, American dentist, 

1833–1899], an equilateral triangle formed by lines 

from the contact points of the lower central incisors (or the 

median line of the residual ridge of the mandible) to the 

mandibular condyle on each side and from one condyle to 

the other. 

bony labyrinth, a series of bony cavities in the inner ear. 

See also membranous labyrinth. 

bony landmark [AS, ban AS, land, mearc], a groove or 

prominence on a bone that serves as a guide to the location 

of other body structures. An example is the posterior, superior 

iliac crest. 

bony palate. See hard palate. 

bony thorax [AS, ban Gk, thorax, chest], the skeletal 

part of the chest, including the thoracic vertebrae, ribs, and 

sternum. 

bony tissue. See bone tissue. 

BOO, abbreviation for bladder outlet obstruction. 

book retinoscopy, a measure of accommodation in which 

retinoscopy is performed while the patient focuses on reading 

a book. It is commonly used with children. 

booster injection, the administration of an additional dose 

of antigen within a defined period of time, such as a vaccine 

or toxoid, usually in a smaller amount than the original immunization. 

It is given to maintain the immune response at 

an appropriate level. 

booster phenomenon /bōōster/, on a tuberculin test, an 

initial false-negative result caused by a diminished amnestic 

response that becomes positive on subsequent testing. 

booster response. See secondary antibody response. 

boot, 1. a shoelike prosthetic device for holding a leg or 

arm during treatment. 2. a basketweave bandage that covers 

the foot and lower leg. 3. an airtight device in which the arm 

or leg can be inserted and the air pumped out, creating a partial 

vacuum to divert blood flow from the surrounding area. 

Boothby-Lovelace-Bulbulian (BLB) mask, an apparatus 

for the administration of oxygen consisting of a mask fitted 

with an inspiratory-expiratory valve and a rebreathing 

bag. 

boracic acid. See boric acid. 

borage, an annual herb found in North America and 

Europe. 

USES: This herb is used as an antiinflammatory for premenstrual 

syndrome, rheumatoid arthritis, Raynaud’s disease, 

and other inflammatory conditions. It is also used to 

treat atopic dermatitis, infant cradle cap, cystic fibrosis, high 

blood pressure, and diabetes; effectiveness is not proven. 

CONTRAINDICATIONS: Should not be used since it is likely 

unsafe when used in amounts ingested for medicinal 

purpose. 

borage oil, the oil extracted from the seeds of borage 

(Borago offıcinalis). It is used for the treatment of neurodermatitis 

and as a food supplement. 

borate /bôrāt/, any salt of boric acid. Borate salts and 

boric acid, although formerly used as mild antiseptic irrigant 

solutions, especially for ophthalmic conditions, are highly 

poisonous when taken internally or absorbed through a cut, 

abrasion, or other wound in the skin. Because of the potential 

for fatal poisoning, such solutions are rarely used now. 

See also boric acid. 

borax bath [Ar, bauraq AS, baeth], a medicated bath in 

which borax and glycerin are added to the water. 

borborygmos /bôrbYrigmYs/ pl., borborygmi [Gk, 

borborygmos, bowel rumbling], an audible abdominal 

sound produced by hyperactive intestinal peristalsis. Borborygmi 

are audible abdominal sounds produced by hyperactive 

intestinal peristalsis. Borborygmi are very loud rumbling, 

gurgling, and tinkling noises heard in auscultation, 

often without a stethoscope. The increased intestinal activity 

noted at times in cases of gastroenteritis and diarrhea result 

in borborygmi that do not have the intensity or the episodic 

character of “normal borborygmi.” Borborygmi that are 

high-pitched and accompanied by vomiting, distension, and 

intestinal cramps suggest a mechanical obstruction of the 

small intestine and often precede complete bowel obstruction. 

border [OFr, bordure], an edge or boundary of a body 

structure. 

borderline [OFr, bordure L, linea], pertaining to a state 

of health in which the patient has some of the signs and 

symptoms of a disease but not enough to justify a definite diagnosis. 

borderline personality [OFr, bordure L, linea personalis], 

a disorder in which there is a pervasive pattern of instability 

of self-image, interpersonal relationships, and 

mood. There is almost always a marked, persistent disturbance 

of identity, which is frequently manifested by uncertainty 

about more than one important personal issue. The 

hallmark of borderline personality is the defense mechanism 

of “splitting” in which the person views people or situations 

as being either all good or all bad and acts accordingly. Five 

or more traits are required to meet the criteria for borderline 

personality. 

Bordetella /bôrditelY/ [Jules J.B.V. Bordet, Belgian bacteriologist, 

1870–1961], a genus of gram-negative coccobacilli, 

some species of which are pathogens of the respiratory 

tract of humans, including Bordetella bronchiseptica, 

B. parapertussis, which causes mild pharyngitis, and B. pertussis, 

the causative agent of pertussis. See also parapertussis, 

pertussis. 

boric acid /bôrik/, a white, odorless powder or crystalline 

substance used as a buffer (H 3BO 3) and formerly used as a 

topical antiseptic and eyewash. Also called boracic acid, 

orthoboric acid. 

boric acid poisoning, an adverse reaction to the ingestion 

or absorption through the skin of boric acid, a mild but potentially 

lethal antiseptic. Symptoms include nausea, vomiting, 

diarrhea, rash, convulsions, and shock. Absorption of 

boric acid from diapers is a threat to infants. 

Bornholm disease. See epidemic pleurodynia. 

born out of asepsis (BOA), (in a hospital) denoting a 

newborn who was not delivered in the usual place in an obstetric 

unit. Depending on the policy of the institution, a 

BOA-designated infant may have been born on the way to 

the hospital or in the hospital, on the way to the delivery 

suite, or in a labor room. 

OBSERVATIONS: Initial assessment in the admitting unit includes 

evaluation of respiration, quality of cry, skin color, 

apical pulse rate, muscle tone, reflexes, temperature, condition 

of umbilical cord or cord stump, ability to suck, presence 

of meconium, congenital defect, skin eruption, or signs

oron 242 botulism 

of sepsis, including jaundice, anorexia, vomiting, diarrhea, 

irritability or lethargy, high-pitched cry, and hypothermia or 

hyperthermia. 

INTERVENTIONS: The usual steps in caring for a newborn 

are performed. Head and chest circumferences are measured, 

weight is taken, and the baby is placed in a warmer until the 

axillary temperature is 36.5° C. Vitamin K and silver nitrate 

are usually given, and a bath is given when the body temperature 

is over 36.5° C and stable. In many hospitals, BOA infants 

are placed in a special nursery and isolated from other 

infants to prevent contagion if they are infected. 

NURSING CONSIDERATIONS: Daily care for the BOA infant is 

the same as that given to other newborns, but, in addition, 

the BOA baby is closely observed for signs of sepsis. The 

parents are involved in the care of the infant as soon as possible, 

and the usual instructions are given at discharge for 

home care of the baby. 

boron (B) /bôron/, a nonmetallic element, whose atomic 

number is 5; its atomic mass is 10.81. Elemental boron occurs 

in the form of dark crystals and as a greenish yellow 

amorphous mass. Certain concentrations of this element are 

toxic to plant and animal life, but plants need traces of boron 

for normal growth. It is the characteristic element of boric 

acid, which is used chiefly as a dusting powder and ointment 

for minor skin disorders. Boric acid in solution was formerly 

extensively used as an antiinfective and eyewash, but the 

high incidence of toxic reactions and fatalities associated 

with these preparations has greatly reduced their use. 

Borrelia /bYrelē·Y/ [Amédée Borrel, French bacteriologist, 

1867–1936], a genus of coarse, unevenly coiled helical 

spirochetes, several species of which cause tickborne and 

louseborne relapsing fever. The organism is spread to offspring 

from generation to generation. This does not occur in 

lice. Many animals serve as reservoirs and hosts for Borrelia. 

The spirochete may be identified by microscopic examination 

of a smear of blood stained with Wright’s stain; it is 

also easily inoculated onto culture media for bacterial culture 

and identification. 

Borrelia burgdorferi /burgdôrferī/, the causative agent 

in Lyme disease. The organism is transmitted to humans by 

tick vectors, primarily Ixodes dammini. In the United States 

the disease is found primarily in the Northeast, North- 

Central, and Northwest. 

bortezomib, a miscellaneous antineoplastic. 

INDICATIONS: This drug is used to treat multiple myeloma 

when at least two other treatments have failed. 

CONTRAINDICATIONS: Pregnancy and known hypersensitivity 

to this drug, boron, or Mannitol prohibit its use. 

ADVERSE EFFECTS: Adverse effects of this drug include hypotension, 

edema, anemia, fatigue, malaise, weakness, arthralgia, 

bone pain, muscle cramps, myalgia, back pain, abdominal 

pain, constipation, diarrhea, dyspepsia, nausea, 

vomiting, anorexia, anxiety, insomnia, dizziness, headache, 

peripheral neuropathy, rigors, paresthesia, cough, pneumonia, 

dyspnea, upper respiratory infection, dehydration, 

weight loss, herpes zoster, rash, pruritus, and blurred vision. 

Life-threatening side effects include neutropenia and 

thrombocytopenia. 

bosentan, a vasodilator used to treat pulmonary arterial 

hypertension. 

boss [ME, boce], a swelling, eminence, or protuberance on 

an organ, such as a tumor or overgrowth on a bone surface or 

a tooth. For example, on the forehead it is often a sign of 

rickets. 

Boston exanthema [Boston; Gk, ex, out, anthema, blossoming], 

an epidemic disease characterized by scattered, pale 

red maculopapules on the face, chest, and back, occasionally 

accompanied by small ulcerations on the tonsils and soft palate. 

There is little or no adenopathy, and the rash disappears 

spontaneously in 2 or 3 weeks. It is caused by echovirus 16 

and requires no treatment. Compare herpangina. 

Botox, trademark for a preparation of botulinum toxin, 

type A. See botulinum toxin. 

bottle feeding 1 [OFr, bouteille AS, faeden], feeding an 

infant or young child from a bottle with a rubber nipple on 

the end as a substitute for or supplement to breastfeeding. 

METHOD: The infant is held on one arm close to the body 

of the mother or nurse during feeding. The bottle is held at 

an angle to ensure that the nipple is always filled with liquid 

so that the infant does not ingest air while feeding. For a 

newborn, rest periods may be given every several minutes. 

At least once in the course of the feeding and again at the 

end, the infant is encouraged to burp by being held upright 

on the mother’s or nurse’s shoulder or on its stomach on the 

feeder’s lap. Gentle rubbing or patting on the back and pressure 

on the stomach often help induce burping. 

INTERVENTIONS: The formula contains protein, fats, carbohydrates, 

vitamins, and minerals in amounts similar to those 

in breast milk. The formula may be warmed before feeding 

by immersing the bottle in warm water for several minutes 

(although this is not necessary if the formula is kept at room 

temperature), and the size of the nipple hole is adjusted to 

the needs of the infant. Smaller infants need larger nipple 

holes, which require less sucking. Premature or weak infants 

may be fed by using a long, soft nipple through which it is 

very easy for the infant to feed. 

OUTCOME CRITERIA: Bottle feeding is used as a substitute 

for breastfeeding when the mother is unable or unwilling to 

breastfeed. Bottle feeding can also be substituted for breastfeeding 

occasionally, once lactation has been established. 

Bottle feeding is recommended if the mother has active tuberculosis 

or other active, acute contagious disease; if she 

has a serious chronic disease, such as cancer or cardiac disease; 

or if she has recently undergone extensive surgery. Severe 

mastitis, narcotic addiction, or concurrent use of medication 

that is secreted in the breast milk usually requires the 

mother to bottle feed. 

bottle feeding 2 , a nursing intervention from the Nursing 

Interventions Classification (NIC) defined as preparation and 

administration of fluids to an infant via a bottle. See also 


bottle mouth caries, early childhood caries. 

botulinum toxin /bochYlīnYm/ [L, botulus, sausage; Gk, 

toxikon, poison], any of a group of potent bacterial toxins 

produced by different strains of Clostridium botulinum. It 

may be used therapeutically for blepharospasm or cosmetically 

to relax facial wrinkles. The strains are sometimes 

identified by letters of the alphabet, such as A, B, or C. Also 

called Botox, botulinus toxin. 

botulism /bochYlizYm/ [L, botulus, sausage], an often 

fatal form of food poisoning caused by an endotoxin produced 

by the bacillus Clostridium botulinum. In the United 

States, approximately 25% of cases are food-borne botulism, 

72% are infant botulism, and the rest are wound botulism. In 

food-borne botulism, the toxin is ingested in food contaminated 

by C. botulinum, although it is not necessary for the 

live bacillus to be present if the toxin has been produced. In 

infant botulism, which is associated with eating unpasteurized 

honey, infants may consume pores that produce the 

toxin. In wound botulism, the toxin may be introduced into 

the human body through a wound contaminated by the organism. 

Botulism differs from most other types of food poisoning 

in that it develops without gastric distress and occurs 

18 hours up to 1 week after the contaminated food has

ouba 243 bound carbon dioxide 

been ingested. Botulism is characterized by lassitude, fatigue, 

and visual disturbances, such as double vision, difficulty 

in focusing the eyes, and loss of ability of the pupil to 

accommodate to light. Muscles may become weak, and dysphagia 

often develops. Nausea and vomiting occur in fewer 

than half the cases. Affected infants are lethargic, feed 

poorly, are constipated, and have a weak cry and poor muscle 

tone. Hospitalization is required, and antitoxins are administered. 

Sedatives are given, mainly to relieve anxiety. 

Approximately 8% of the cases of botulism are fatal, usually 

as a result of delayed diagnosis and respiratory complications. 

Most botulism occurs after eating improperly canned 

or cooked foods. Reporting botulism to public health authorities 

is mandatory. See also Clostridium. 

OBSERVATIONS: Symptoms usually appear 18 to 36 hours 

after ingestion of a contaminated food substance. Severity of 

symptoms is related to the quantity of the botulinum toxin 

that was ingested and include dry mouth, diplopia, loss of 

pupillary light reflex; nausea, vomiting, cramps, and diarrhea, 

which precede dysphagia, dysarthria, and progressive 

descending muscular paralysis. Botulism is fatal in about 8% 

of cases, usually because of respiratory paralysis or circula- 

Bouchard nodes 

tory failure. Serum may be positive for botulinal toxins, and 

cultures may be taken of stomach contents, feces, or suspected 

food to confirm the causative organism. 

Bouchard’s node (Huether and McCance, 2008) 

INTERVENTIONS: The trivalent botulinal antitoxin is administered 

as soon as possible after onset and clinical diagnosis. 

The GI tract is purged using laxatives, gastric lavage, and 

high colonic enemas to dilute and decrease absorption of the 

toxin. Tracheostomy and mechanical ventilation may be instituted 

if necessary. Care is supportive with a long recovery 

period and the need for rehabilitation to regain muscle tone, 

strength, and function. 

NURSING CONSIDERATIONS: Nurses should be alert to signs 

and symptoms of serum sickness that frequently occur after 

the administration of the antitoxin, including fever, arthralgia, 

lymphadenopathy, skin eruption, pain, pruritus, and erythematous 

swelling at the injection site. Individuals may 

also report joint and muscle aches, chest pain, and difficulty 

breathing. Nursing care for acute illness is largely supportive 

and involves airway management, prevention of aspiration, 

fluid and electrolyte management, pain management, nutrition 

management, prevention of skin breakdown and 

contractures during paralysis, minimization of stimuli, pre- 

Balloon in 

cardiac sphincter 

of esophagus 

cise communication because of altered vision and loss of 

speech, and allaying anxiety about paralysis and treatment. 

Primary prevention targets education of consumers in the 

safe handling, storage, and preparation of food. Nurses 

should also be prepared for an effective response should 

botulinum toxin be used in a bioterrorism event. This in- 

Diaphragm 

cludes familiarization with institution policies, procedures, 

and protocols and maintenance of current knowledge regarding 

bioterrorism threats. 

Passage of a bougie (Black and Hawks, 2005) 

bouba. See yaws. 

Bouchard’s node /boo ¯¯¯¯shärz/ [Charles J. Bouchard, French boundary /boundYrē/, (in psychology) an aspect of family 

physician, 1837–1915], an abnormal cartilaginous or bony health in which the generations are clearly defined and issues 

enlargement of a proximal interphalangeal joint of a finger, are dealt with by the appropriate generation. There are also 

usually occurring in diseases of the joints, such as rheuma- limits between the family “turf” and the larger society. This 

toid arthritis. Compare Heberden’s node. 

Bouchut’s tubes /boo ¯¯¯¯shoo ¯¯¯¯z/ [Jean E.W. Bouchut, French 

physician, 1818–1891], a set of short cylindric devices 

term can also apply to the roles of patient and therapist in 

psychotherapy. 

boundary lubrication, a coating of a thin layer of mol- 

used for intubation of the larynx. 

bougie /boo ¯¯¯¯zhē, boo ¯¯¯¯zhē/ [Fr, candle], a thin cylindric instrument 

made of rubber, waxed silk, or other flexible mateecules 

on each weight-bearing surface of a joint to facilitate 

a sliding action by the opposing bone surfaces. 

boundary maintenance mechanisms, (in psychology) 

rial for insertion into canals of the body in order to dilate, ex- behavior and practices that exclude members of some groups 

amine, or measure them. 

-boulia. See -bulia. 

from the customs and values of another group. 

bound carbon dioxide, carbon dioxide that is transported

ounding pulse 244 bowel training 1 

in the bloodstream as part of a sodium bicarbonate molecule, 

as distinguished from dissolved carbon dioxide or bicarbonate 

ion. 

bounding pulse [OFr, bondir, to leap; L, pulsare, to beat], 

a pulse that feels full and springlike on palpation as a result 

of an increased thrust of cardiac contraction or an increased 

volume of circulating blood within the elastic structures of 

the vascular system. 

bound water, water in the tissue of the body bound to 

macromolecules or organelles. 

bouquet fever. See dengue fever. 

Bourdon regulator, a commonly used adjustable device 

with an attached pressure gauge for controlling the flow of 

oxygen or other gases from cylinders in medical applications. 

Bourneville’s disease. See tuberous sclerosis. 

bouton /boo ¯¯¯¯tôN, boo ¯¯¯¯ton/ [Fr, button], 1. a button, pustule, 

or knoblike swelling, such as the expanded end of an 

axon at a synapse (terminaux) which comes into contact with 

cell bodies of other neurons. 2. a lesion associated with cutaneous 

leishmaniasis. 3. a small abscess of the intestinal 

mucosa in amebic dysentery. 

boutonneuse fever /boo ¯¯¯¯tYnoo ¯¯¯¯z/ [Fr, bouton, button; L, 

febris], a febrile disease of the Mediterranean area, the 

Crimea, Africa, and India caused by infection with Rickettsia 

conorii, transmitted to humans through the bite of a tick. The 

onset of the disease is characterized by a lesion called a 

tache noire /täshno·är/, or black spot, at the site of the infection; 

fever lasting from a few days to 2 weeks; and a papular 

erythematous rash that spreads over the body to include the 

skin of the palms and soles. The disease is usually a mild 

form of rickettsial disease, but severe complications occur in 

approximately 10% of patients. Usually, mild forms only are 

observed in children. Treatment usually involves administration 

of antibiotics. There is no prophylactic medication 

available, and prevention depends primarily on avoiding 

ticks. See also rickettsiosis, Rocky Mountain spotted 

fever. 

boutonnière deformity /boo ¯¯¯¯tônyer/ [Fr, buttonhole], 

an abnormality of a finger marked by fixed flexion of the 

proximal interphalangeal joint and hyperextension of the 

distal interphalangeal joint. The condition occurs in rheumatoid 

arthritis. 

Boutonnière deformity (Zitelli and Davis, 2007) 

bovine spongiform encephalopathy (BSE), an infection 

of cattle characterized by degenerative, clumsy, apprehensive 

behavior, and death. The BSE brain tissue is perforated 

and spongy in appearance. The disease was first 

observed in cattle by veterinarians in 1883. It has been associated 

with other spongiform encephalopathies such as 

scrapie in sheep and goats and Creutzfeldt-Jakob disease 

(CJD) in humans. In European “mad cow” disease, it is believed 

the disease was transmitted to cattle through livestock 

feed that contained remains of scrapie-infected sheep. The 

disease was then transmitted to humans who ate BSEinfected 

beef. 

bovine tuberculosis /bōvīn/ [L, bos, ox, tuber, swelling; 

Gk, osis, condition], a form of tuberculosis caused by Mycobacterium 

tuberculosis that primarily affects cattle but is 

occasionally found in deer. Mastitis and pulmonary symptoms 

can occur. 

Bowditch’s law. See all-or-none law. 

bowel. See intestine. 

bowel bypass syndrome, a series of adverse effects that 

may follow bowel bypass surgery, which include chills, 

fever, joint pain, and skin inflammation on the arms, legs, 

and thorax. 

bowel continence, a nursing outcome from the Nursing 

Outcomes Classification (NOC) defined as control of passage 

of stool from the bowel. See also Nursing Outcomes 


bowel elimination, a nursing outcome from the Nursing 

Outcomes Classification (NOC) defined as the formation 

and evacuation of stool. See also Nursing Outcomes 


bowel incontinence. See incontinence, bowel. 

bowel incontinence care, a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as promotion 

of bowel continence and maintenance of perianal 

skin integrity. See also Nursing Interventions Classification. 

bowel incontinence care: encopresis, a nursing intervention 

from the Nursing Interventions Classification (NIC) 

defined as promotion of bowel continence in children. See 


bowel irrigation, a nursing intervention from the Nursing 

Interventions Classification (NIC) defined as instillation of a 

substance into the lower GI tract. See also Nursing Interventions 


bowel management, a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as establishment 

and maintenance of a regular pattern of bowel 

elimination. See also Nursing Interventions Classification. 

bowel resection, an excision of a diseased or injured section 

of the small or large intestine through a laparoscope or 

an abdominal incision to treat obstruction, inflammatory 

bowel disease, cancer, ruptured diverticulum, ischemia, or 

traumatic injury. After excision, the bowel is reanastomosed. 

bowel training 1 [OFr, boel], a method of establishing 

regular evacuation by reflex conditioning used in the treatment 

of fecal incontinence, impaction, chronic diarrhea, and 

autonomic hyperreflexia. In patients with autonomic hyperreflexia, 

distension of the rectum and bladder causes paroxysmal 

hypertension, restlessness, chills, diaphoresis, headache, 

elevated temperature, and bradycardia. 

METHOD: The patient’s previous bowel habits are assessed, 

and the necessity of developing a program to induce 

an evacuation at the same time each day or every other day is 

explained. Exercises to strengthen abdominal muscles, such 

as pushing up, bearing down, and contracting the musculature, 

are demonstrated. The patient is instructed to recognize 

and respond promptly to signals indicating a full bowel, such 

as goose pimples, perspiration, and piloerection on arms or 

legs, and to develop cues to stimulate the urge to defecate, 

such as drinking coffee or massaging the abdomen. Fluids to 

3000 mL daily are encouraged; exercise is increased as able, 

and the importance of eating well-balanced meals that include 

bulk and roughage and of avoiding constipating or 

gas-producing foods, such as bananas, beans, and cabbage, 

is discussed. Depending on the patient and the problem, the

owel training 2 

training program may involve drinking warm fluid, ensuring 

privacy, and inserting a lubricated glycerin suppository before 

the set time. The patient is told that no formed stools for 

3 days, semiliquid feces, restlessness, and discomfort are 

signs of impending impaction and that the condition may be 

treated with a laxative suppository or with a tap water or oil 

retention enema. The importance of reporting symptoms of 

autonomic hyperreflexia to the physician is stressed. The 

possibility that emotional stress or illness may cause accidental 

incontinence after the program has been established is 

discussed. Many clients require weeks or months of training 

to achieve success. 

INTERVENTIONS: The nurse provides instruction, encourages 

the patient to establish a program of regular evacuation, 

and offers positive reinforcement frequently. 

OUTCOME CRITERIA: Reflex conditioning is often an effective 

method of developing regular bowel habits for incontinent 

patients, especially those who are highly motivated and 

are given good instruction and understanding support. Young 

persons with spinal cord lesions are able to develop automatic 

defecation when adequately trained, but some elderly 

incontinent people may not be able to learn the program. 

bowel training 2 , a nursing intervention from the Nursing 

Interventions Classification (NIC) defined as assisting the 

patient to train the bowel to evacuate at specific intervals. 


bowel urgency, the sudden, almost uncontrollable, need to 

defecate. 

bowenoid papulosis. See Bowen’s disease. 

Bowen’s disease [John T. Bowen, American dermatologist, 

1857–1941], a form of intraepidermal carcinoma (squamous 

cell). It is characterized by red-brown scaly or crusted 

lesions that resemble a patch of psoriasis or dermatitis. 

Treatment includes curettage and electrodesiccation. A corresponding 

lesion found on the glans penis is called erythroplasia 

of Queyrat. Also called Bowen’s precancerous 

dermatosis. 

Bowen’s disease (White and Cox, 2006) 

Bowen technique, a system of gentle but powerful soft 

tissue mobilizations using the thumbs and fingers over 

muscles, tendons, nerves, and fascia to restore the selfhealing 

mechanism of the body. This technique has been 

used for conditions affecting the musculoskeletal system, including 

back, neck, hip, and shoulder pain. 

bowleg. See genu varum. 

Bowman’s capsule /bōmanz/ [William Bowman, English 

anatomist, 1816–1892], the cup-shaped end of a renal tu- 

245 BPD 

bule or nephron enclosing a glomerulus. With the glomerulus, 

it is the site of filtration in the kidney. Also called glomerular 

capsule. 

Blood 

Afferent renal 

arteriole 

Sugar 

Water 

Urea & 

wastes 

Efferent renal 

arteriole 

Salts 

Bowman’s capsule (Chabner, 2007) 

Blood 

Glomerulus 

(capillaries) 

Bowman 

capsule 

Renal tubule 

Bowman’s glands [William Bowman; L, glans, acorn], 

branched tubuloalveolar glands in mucous membranes of the 

mouth. They keep the mouth surfaces moist. 

Bowman’s lamina [William Bowman; L, lamina, plate], 

a tough membrane beneath the corneal epithelium. Also 

called anterior elastic lamina, Bowman’s layer, Bowman’s 

membrane. 

bowtie filter /bōtī/, a filter shaped like a bowtie that may 

be used in computed tomography to compensate for the 

shape of the patient’s head or body. It is used with fanshaped 

x-ray beams to equalize the amount of radiation 

reaching the film. 

boxer’s ear. See pachyotia. 

boxer’s fracture [Dan, bask, a blow; L, fractura, break], 

a break in one or more metacarpal bones, usually the fourth 

or the fifth, caused by punching a hard object. Such a fracture 

is often distal, angulated, and impacted. 

boxing, the forming of vertical walls, most commonly 

made of wax, to produce the desired shape and size of the 

base of a dental cast. 

boxing wax [L, buxis, box; AS, weax], (in dentistry) a thin 

sheet of flexible wax used for boxing. 

Boyd’s amputation, amputation at the ankle with removal 

of the talus and fusion of the tibia and calcaneus. 

Boykin, Anne, a nursing theorist who, with Savina O. 

Schoenhofer, wrote Nursing as Caring: A Model for Transforming 

Practice, which postulates that caring is the end, not 

the means, of nursing. 

Boyle’s law /boilz/ [Robert Boyle, English scientist, 1627– 

1691], (in physics) the law stating that the product of the 

volume and pressure of a gas contained at a constant temperature 

remains constant. 

BP, abbreviation for blood pressure. 

BPD, 1. abbreviation for biparietal diameter, 2. abbreviation 

for bronchopulmonary dysplasia.

BPDE-I 246 brachial region 

BPDE-I, abbreviation for benzopyrene dihydrodiol 

epoxide. 

BPH, abbreviation for benign prostatic hyperplasia. 

bpm, abbreviation for beats per minute. 

Br, symbol for the element bromine. 

brace [OFr, bracier, to embrace], an orthotic device, sometimes 

jointed, used to support and hold any part of the body 

in the correct position to allow function and healing, such as 

a leg brace that permits walking and standing. Compare 

splint. 

brachi- /brākē-/, prefix meaning “arm”: brachiation, 

brachiocyllosis. 

-brachia /-brākē·Y/, suffix meaning an “anatomic condition 

involving an arm”: acephalobrachia, monobrachia. 

brachial /brākē·Yl/ [Gk, brachion, arm], pertaining to 

the arm. 

brachial artery, the principal artery of the upper arm that 

is the continuation of the axillary artery. It has three branches 

and terminates at the bifurcation of its main trunk into the radial 

artery and the ulnar artery. 

brachialgia /-aljē·Y/ [L, brachium, arm; Gk, algos, pain], 

a severe pain in the arm, often related to a disorder involving 

the brachial plexus. 

brachialis /brākē·alis/ [Gk, brachion, arm], a muscle of 

the upper arm, covering the distal half of the humerus and 

the anterior part of the elbow joint. It functions to flex the 

forearm. Compare biceps brachii, triceps brachii. 

Brachialis 

Brachialis 

brachial paralysis [L, brachium, arm; Gk, paralyein, to be 

palsied], paralysis of an arm or a hand as a result of a lesion 

of the brachial plexus. See also Erb’s palsy. 

brachial plexus [Gk, brachion L, braided], the plexus 

that innervates the upper limb, formed by the anterior rami 

of cervical spinal nerves C5 to C8 and T1. It is initially 

formed in the neck and continues through the axillary inlet 

into the axilla. See also plexus. 

Brachial plexus 

Cords 

Dorsoscapular nerve 

Suprascapular nerve 

Subclavian nerve 

Axillary nerve 

Radial nerve 

Musculocutaneous 

nerve 

Medial and lateral 

pectoral nerves 

Median nerve 

Ulnar nerve 

Medial brachial 

cutaneous nerve 

Ventral rami Anterior divisions 

brachial plexus anesthesia, an anesthetic block of the 

upper extremity, performed by injecting local anesthetic near 

the plexus formed by the last four cervical and first two thoracic 

spinal nerves. The plexus extends from the transverse 

processes of the spine to the apex of the axilla, where the terminal 

nerves are formed. Because of the anatomy of this 

area, many approaches are possible. Approaches include the 

axillary (in the armpit), supraclavicular and infraclavicular 

(above and below the collarbone), and interscalene (between 

the muscles of the neck). Various approaches may result in 

Horner’s syndrome, phrenic nerve block, pneumothorax, recurrent 

laryngeal paralysis, persistent sensory deficits, venous 

or arterial puncture, subarachnoid injection, paresthesias, 

or hematoma. Also called brachial plexus block. 

See also regional anesthesia. 

brachial plexus block. See brachial plexus anesthesia. 

brachial plexus paralysis. See Erb palsy. 

brachial pulse [Gk, brachion L, pulsare, to beat], 

the pulse of the brachial artery, palpated in the antecubital 

space. See also pulse. 

brachial region, an anatomic term used to refer to the 

arm (shoulder to elbow), divided into anterior and posterior 

brachial regions. 

C5 

T1 

Trunks Posterior divisions 

Brachial plexus (Thibodeau and Patton, 2007) 

C4 

C5 

C6 

C7 

Long thoracic 

nerve 

C8 

T1

achial vein 247 Bradford frame 

Assessment of brachial pulse 

(Wilson and Giddens, 2005) 

brachial vein, a vein in the arm that accompanies the brachial 

artery and drains into the axillary vein. 

brachiocephalic, relating to the arm and head. 

brachiocephalic arteritis. See Takayasu’s arteritis. 

brachiocephalic artery, first branch of the aortic arch. 

See also innominate artery. 

brachiocephalic trunk. See innominate artery. 

brachiocephalic vein, the vein feeding the superior vena 

cava, collecting blood from the subclavian and jugular veins. 

See also innominate vein. 

brachiocubital /-kyoo ¯¯¯¯bitYl/ [Gk, brachion L, cubitus, 

elbow], pertaining to the arm and forearm. 

brachioplasty, a surgical procedure to lift and tighten skin 

of the upper arm. 

brachioradialis /-rādē·alis/, the most superficial muscle 

on the radial side of the forearm. It functions to flex the 

forearm. 

brachioradialis 

Brachioradialis (Thibodeau and Patton, 2007) 

brachioradialis reflex [Gk, brachion L, radial, 

reflectare, to bend backward], a deep tendon reflex elicited 

by striking the lateral surface of the forearm proximal to the 

distal head of the radius, characterized by normal slight 

elbow flexion and forearm supination. It is accentuated by 

disease of the pyramidal tract above the level of the fifth cervical 

vertebra. See also deep tendon reflex. 

Brachioradialis reflex testing 


-brachium /-brākē·Ym/, 1. suffix meaning “the upper arm 

from shoulder to elbow.” 2. suffix meaning “an arm or 

armlike growth”: prebrachium, pontibrachium. 

brachy- /brakē-/, prefix meaning “short”: brachycheilia, 

brachyskelous. 

brachybasia /-bāzhY/, abnormally slow walking, with a 

short, shuffling gait. The condition is associated with cerebral 

hemorrhage or pyramidal tract disease, or Parkinson’s 

disease. 

brachycardia. See bradycardia. 

brachycephaly /-sefYlē/ [Gk, brachys, short, kephale, 

head], a congenital malformation of the skull in which premature 

closure of the coronal suture results in excessive lateral 

growth of the head, giving it a short, broad appearance. 

Also called brachycephalia /-sYfālē·Y/, brachycephalism 

/-sefYlizYm/. See also craniostenosis. —brachycephalic 

/-sYfalik/, brachycephalous /-sefYlYs/, adj. 

brachydactyly /-daktYlē/, a condition in which fingers or 

toes are abnormally short. 

brachygnathia. See micrognathia. 

brachytherapy [Gk, brachys, short, therapeia, treatment], 

the placement of radioactive sources, such as seeds, needles, 

or catheters, in contact with or implanted into the tumor tissues 

to be treated for a specific period. Sources can be temporary 

or permanent. The rationale for this treatment is to 

provide a high absorbed dose of radiation in the tumor tissues 

and a very limited absorbed low dose in the surrounding 

normal tissues. Traditional brachytherapy implants deliver 

low doses of radiation; the newest variations deliver high 

doses. Compare teletherapy. 

bracket /brakYt/ [Fr, braguette, codpiece], a support projecting 

from the main structure. An orthodontic bracket is a 

small metal attachment soldered or welded to an orthodontic 

band or cemented directly to the teeth, serving to fasten the 

arch wire to the band or tooth. Also called orthodontic 

attachment. See also orthodontic appliance, orthodontic 

band. 

Bradford frame [Edward H. Bradford, American surgeon, 

1848–1926], a rectangular orthopedic frame made of pipes 

to which heavy movable straps of canvas are attached. The

Bradford solid frame 248 brain abscess 

straps run from side to side to support a patient in a prone or 

supine position. They can be removed to permit the patient 

to urinate or defecate while remaining immobile. 

Bradford solid frame, a rectangular metal orthopedic device 

that provides support for the entire body and is especially 

appropriate for patients who are less than 5 years of 

age, hyperactive, or mentally retarded. The main purpose of 

the device is to assist in maintaining proper immobilization, 

positioning, and alignment by controlling movement. To facilitate 

nursing care, the Bradford solid frame is not placed 

directly on a bed but is elevated at both ends by plywood 

blocks or other suitable devices. It is most often used with 

Bryant traction but never with balanced suspension traction, 

cervical traction, cervical tongs, or certain other kinds of 

traction. 

Bradford split frame, a rectangular metal orthopedic device 

covered with two separate pieces of canvas fastened at 

both ends of the frame. Used especially in pediatrics to aid in 

the immobilization of children in traction, it is divided in the 

middle by a large opening designed to accommodate the excretory 

functions of an incontinent patient in a hip spica cast. 

The division also allows the upper and lower extremities of 

the patient to be elevated separately and the cast to be kept 

clean and dry. 

Bradley method [Robert Bradley, twentieth century American 

physician], a method of psychophysical preparation 

for childbirth, comprising education about the physiologic 

characteristics of childbirth, exercise, and nutrition during 

pregnancy, and techniques of breathing and relaxation for 

control and comfort during labor and delivery. The father is 

extensively involved in the classes and acts as the mother’s 

“coach” during labor. Among the advantages of the method 

are its simplicity, the father’s involvement, and the realistic 

approach to the efforts and discomfort of labor. Also called 

husband-coached childbirth. Compare Lamaze method, 

Read method. 

brady- /bradē-/, prefix meaning “slow, dull”: bradycardia, 

bradydiastalsis, bradyphagia. 

bradyarrhythmia /-Yrithmē·Y/ [Gk, bradys, slow, a 

rhythmos, without rhythm], any disturbance of cardiac 

rhythm in which the heart rate is less than 60 beats/min. 

bradycardia /-kärdē·Y/ [Gk,bradys, slow, kardia, heart], 

a condition in which the heart rate is less than 60/min. 

Bradycardia takes the form of sinus bradycardia, sinus arrhythmia, 

and second- or third-degree atrioventricular block. 

Sinus bradycardia may be caused by excessive vagal tone, 

decreased sympathetic tone, or anatomic changes. It is common 

in athletes and is relatively benign. It may even be beneficial 

in acute myocardial infarction (especially inferior). 

Pathologic bradycardia may be symptomatic of a brain 

tumor, digitalis toxicity, heart block, or vagotonus. Cardiac 

output is decreased, causing faintness, dizziness, chest pain, 

and eventually syncope and circulatory collapse. Treatment 

may include administration of atropine, implantation of a 

pacemaker, or change in medical treatment. Also called 

brachycardia. 

bradycardia-tachycardia syndrome [Gk, bradys 

kardia, tachys, fast, kardia syn, together, dromos, 

course], a disorder characterized by a heart rate that alternates 

between being abnormally low (less than 60 beats/min) 

and abnormally high (greater than 100 beats/min). Also 

called bradytachycardia, tachycardia-bradycardia syndrome. 

See also sick sinus syndrome, sinus nodal 

dysfunction. 

bradyesthesia /-esthēzhY/[Gk,bradys, slow, aisthesis, feeling], 

a slowness in perception. 

bradykinesia /-kinēzhY, -kīnēzhY/ [Gk,bradys kinesis, 

motion], an abnormal condition characterized by slowness 

of all voluntary movement and speech, such as caused by 

parkinsonism, other extrapyramidal disorders, and certain 

tranquilizers. 

bradykinin /-kīnin/ [Gk, bradys kinein, to move], 

a peptide containing nine amino acid residues produced from 

2-globulin by the enzyme kallikrein. Bradykinin is a potent 

vasodilator. 

bradylalia. See bradyphasia. 

bradyphagia /-fājY/, a habit of eating very slowly. 

bradyphasia /-fāzhY/, an abnormally slow manner of 

speech, often associated with mental illness. Also called 

bradylalia. 

bradypnea /-pnēY/ [Gk, bradys pnein, to breath], 

an abnormally low rate of breathing (lower than 12 breaths/ 

min). Compare hypopnea. See also respiration rate. 

bradyspermatism /-spurmYtizYm/, ejaculation that lacks 

normal force so that semen trickles slowly from the penis. 

bradytachycardia. See bradycardia-tachycardia syndrome. 

bradyuria /bradēyoo ˘ rē·Y/, slow micturation. 

Bragg curve [William H. Bragg, English physicist, 1862– 

1942], the path followed by ionizing particles used in a radiation 

treatment. Because certain particles reach a peak of 

potential near the end of their path, the Bragg curve can be 

used to direct the radiation to deep-seated tumors while significantly 

sparing normal overlying tissues. 

Braille /brāl, bräyY/ [Louis Braille, French teacher of the 

blind, 1809–1852], a system of printing for the blind consisting 

of raised dots or points that can be read by touch. 

brain [AS, bragen], the portion of the central nervous system 

contained within the cranium. It consists principally of 

the cerebrum, thalamus, hypothalamus, cerebellum, midbrain, 

pons, and medulla. Specialized cells in its mass of 

convoluted, soft gray or white tissue coordinate and regulate 

the functions of the central nervous system, integrating the 

functions of the body as a whole. 

Diencephalon 

Cerebrum 

Pineal body 

(part of 

epithalamus) 

Hypothalamus 

Thalamus 

Cerebellum 

Corpus callosum 

Midbrain 

Pons 

Medulla 

oblongata 

Pyramid 

Spinal cord 

Major structures of the brain 

(Monahan et al, 2007) 

Brainstem 

brain abscess [AS, bragen L, abscedere, to go away], 

a pocket of infection in a part of the brain. It is usually a result 

of the spread of an infection from another source, such 

as the skull, sinuses, or other structures in the head. The in-

ain airway 249 brain tumor 

fection also may be secondary to a disease in the bones, the 

nervous system outside the brain, or the heart. Also called 

cerebral abscess, intracranial abscess. 

Brain abscess (Damjanov and Linder, 2000) 

brain airway. See laryngeal mask airway. 

brain attack, term signifying that a stroke is in progress 

and an emergency situation exists. So-called to draw attention 

to the situation as in heart attack by the American Stroke 

Association. See cerebrovascular insult. 

brain compression. See cerebral compression. 

brain concussion [AS, bragen L, concussus, a shaking], 

a bruising to cerebral tissues caused by a violent jarring or 

shaking or other blunt, nonpenetrating injury to the brain resulting 

in a sudden change in momentum of the head. Characteristically, 

after a mild concussion there may be a transient 

loss of consciousness followed, on awakening, by a 

headache. Severe concussion may cause prolonged unconsciousness 

and disruption of certain vital functions of the 

brainstem, such as respiration and vasomotor stability. The 

treatment for a person recovering from a concussion consists 

principally of observation for signs of intracranial bleeding 

and increased intracranial pressure. Also called concussion. 

brain death [AS, bragen death], an irreversible form of 

unconsciousness characterized by a complete loss of brain 

function while the heart continues to beat. The legal definition 

of this condition varies from state to state. The usual 

clinical criteria for brain death include the absence of reflex 

activity, movements, and spontaneous respiration requiring 

mechanical ventilation or life support to continue any cardiac 

function. The pupils are dilated and fixed. Because hypothermia, 

anesthesia, poisoning, or drug intoxication may 

cause deep physiologic depression that resembles brain 

death these parameters must be within normal limits prior to 

testing. Diagnosis of brain death may require evaluating and 

demonstrating that electrical activity of the brain is absent on 

two electroencephalograms performed 12 to 24 hours apart. 

Brain death can be confirmed with electroencephalograms 

showing a complete lack of electrical activity (a flat line) or 

vascular perfusion studies showing a lack of blood flow to 

the brain. Also called irreversible coma. Compare coma, 

sleep, stupor. 

brain edema. See cerebral edema. 

brain electric activity map (BEAM), a topographic map 

of the brain created by a computer that is able to respond to 

the electric potentials evoked in the brain by a flash of light. 

Potentials recorded at 4-msec intervals are converted into a 

many-colored map of the brain, showing them to be positive 

or negative. The waves may be observed traveling through 

the brain. If the wave is disordered, blocked, too small, or 

too large, a tumor or other lesion may be causing the abnormal 

pattern. 

brain fever, informal. any inflammation of the brain or 

meninges. See also encephalitis. 

brain natriuretic peptide (BNP), a hormone, originally 

isolated from porcine brain tissue, having biologic effects 

similar to those of atrial natriuretic peptide and stored 

mainly in the myocardium of the cardiac ventricles. Blood 

levels of BNP are elevated in hypervolemic states, such as 

congestive heart failure and hypertension. 

brain scan [AS, bragen L, scandere, to climb], a diagnostic 

procedure used to image the brain. Common modalities 

include CT, MRI, and PET. Imaging can be done with a 

radioisotope used to localize and identify intracranial 

masses, lesions, tumors, or infarcts. Intravenously injected 

radioisotopes accumulate in abnormal brain tissue and are 

traced and photographed by a scintillator or scanner. The nature 

and rate of accumulation of radioisotopes in pathologic 

tissue are diagnostic of some lesions. Compare computed 

tomography. See also isotope, radioisotope. 

Brain’s reflex [Walter R. Brain, English physician, 1895– 

1966; L, reflectere, to bend back], the reflexive extension 

of the flexed paralyzed arm of a hemiplegia patient when assuming 

a quadrupedal posture. Also called quadrupedal extensor 

reflex. 

brainstem [AS, bragen stemm], the portion of the brain 

comprising the medulla oblongata, the pons, and the mesencephalon. 

It performs motor, sensory, and reflex functions 

and contains the corticospinal and reticulospinal tracts. The 

12 pairs of cranial nerves from the brain arise mostly from 

the brainstem. Compare medulla oblongata, mesencephalon, 

pons. 

brainstem auditory evoked response (BAER), the 

electric activity that may be recorded from the brainstem in 

the first 10 msec after presentation of an auditory stimulus. 

In a subject with normal brainstem functioning, seven peaks 

are observed. A delayed, normally shaped waveform may indicate 

a hearing loss caused by a middle or inner ear disorder; 

one or more missing peaks may indicate a neural disorder. 

brain swelling. See cerebral edema. 

brain syndrome, a group of symptoms resulting from impaired 

function of the brain. It may be acute and reversible, 

or chronic and irreversible. An organic mental disorder is a 

specific organic mental syndrome in which the cause is 

known or presumed. An organic mental syndrome is a temporary 

or permanent brain dysfunction of any cause. 

brain tumor, an invasive neoplasm of the intracranial portion 

of the central nervous system. Brain tumors cause significant 

rates of morbidity and mortality but are occasionally 

treated successfully. In adults 20% to 40% of malignancies 

in the brain are metastatic lesions from cancers in the breast, 

lung, GI tract, or kidney or a malignant melanoma. These are 

referred to as secondary tumors. The origin of primary brain 

tumors is not known, but the risk is increased in individuals 

exposed to vinyl chloride, in the siblings of cancer patients, 

and in recipients of renal transplantation being treated with

ainwashing 250 Braxton Hicks version 

immunosuppressant medication. Causes under investigation 

are genetic changes, heredity, ionizing radiation, environmental 

hazards, viruses, and injury. Symptoms of a brain 

tumor are often those of increased intracranial pressure, such 

as headache, nausea, vomiting, papilledema, lethargy, and 

disorientation, but vary depending on the site of a tumor. Localizing 

signs, such as loss of vision on the side of an occipital 

neoplasm, may occur. Diagnostic measures include visual 

field and funduscopic examinations, skull x-ray examinations, 

electroencephalography, brain scanning, magnetic 

resonance imaging, computed tomography, and spinal fluid 

studies. Cerebral angiography is used for information about 

vascular supply. Gliomas, chiefly astrocytomas, are the most 

common malignancies. Medulloblastomas occur often in 

children. Surgery is the initial treatment for most primary tumors 

of the brain. Radiotherapy is indicated for inoperable 

lesions, medulloblastomas, and tumors with multiple foci 

and is used in postoperative treatment of residual tumor tissue. 

The blood-brain barrier impedes the effect of some antineoplastic 

agents, but the administration of disk-shaped 

drug wafers is an emerging practice. Postoperative nursing 

care includes assessment of the patient to detect elevation in 

intracranial pressure. Compare spinal cord tumor. 

Brain tumor 

(Kowalczyk and Mace, 2009/Courtesy Riverside Methodist Hospitals) 

brainwashing, intensive indoctrination, usually of a political 

or religious nature, applied to individuals to develop in 

their minds a specific belief and motivation. 

brain wave [AS, bragen wafian], any of a number of 

patterns of rhythmic electric impulses produced in different 

parts of the brain. Most patterns, identified by the Greek letters 

alpha, beta, delta, gamma, kappa, and theta, are similar 

for all normal persons and are relatively stable for each individual. 

Brain waves help in the diagnosis of certain neurologic 

disorders, such as epilepsy or brain tumors. See also 

alpha wave, beta wave, delta wave, theta wave. 

bran, a coarse outer covering or coat (seed husk) of cereal 

grain, such as wheat or rye. Bran provides a source of dietary 

fiber, B vitamins, iron, magnesium, and zinc. When separated 

from the meal or flour portion of a grain, it is less nutritious. 

bran bath [OFr, bren AS, baeth], a bath in which bran 

has been boiled in the water. It is used for the relief of skin 

irritation. 

branch, (in anatomy) an offshoot arising from the main 

trunk of a nerve or blood vessel. 

branched-chain amino acids, leucine, isoleucine, and 

valine; they are incorporated into proteins or catabolized for 

energy. 

branched chain ketoaciduria. See maple syrup urine 

disease. 

branched tubular gland [OFr, branche], one of the many 

multicellular glands with one excretory duct from two or 

more tube-shaped secretory branches, such as some of the 

gastric glands. 

brancher glycogen storage disease. See Andersen’s 

disease. 

branchial /brangkē·Yl/ [Gk, branchia, gills], pertaining to 

body structures of the face, neck, and throat area, particularly 

the muscles. 

branchial arches [Gk, branchia, gills; L, arcus, bow], 

arched structures in the embryonic pharynx. 

branchial cleft [Gk, branchia, gills; ME, clift], a linear 

depression in the pharynx of the early embryo opposite a 

branchial or pharyngeal pouch. 

branchial cyst [Gk, branchia, gills, kystis, bag], a cyst derived 

from a branchial remnant in the neck. 

branchial fistula, a congenital abnormal passage from the 

pharynx to the external surface of the neck, resulting from 

the failure of a branchial cleft to close during fetal development. 

Also called cervical fistula. 

branching canal. See collateral pulp canal. 

branchiogenic /brangkē·ōjenik/ [Gk, branchia, gills, 

genein, to produce], pertaining to any tissues originating 

in the branchial cleft or arch. —branchiogenous 

/-kē·ojYnes/, adj. 

branchio-oto-renal syndrome /brangkē·ō·ōtō·rēnYl/ 

[Gk, branchia, gills ous, ear L, ren, kidney], branchial 

arch anomalies (preauricular pits, branchial fistulas or 

pits) associated with congenital deafness resulting from dysgenesis 

of the organ of Corti, and with renal dysplasia; inherited 

as an autosomal dominant trait with high penetrance and 

variable expression. 

brand name. See trademark. 

Brandt-Andrews maneuver [Thure Brandt, Swedish obstetrician, 

1819–1895; Henry R. Andrews, English obstetrician, 

1871–1942], a method of expressing the placenta 

from the uterus in the third stage of labor. One hand grasps 

the umbilical cord while the other is placed on the mother’s 

abdomen with the fingers over the anterior surface of the 

uterus. While the hand on the abdomen is pressed backward 

and slightly upward, the other applies gentle traction on 

the cord. 

Braschi valve, a one-way valve put into the inspiratory 

limb of a ventilator circuit to measure the intrinsic positive 

end-expiratory pressure. 

brass founder’s ague. See metal fume fever. 

brassy cough [AS, brase, brassy, cohhetan, to cough], 

a high-pitched cough caused by irritation of the recurrent 

pharyngeal nerve or by pressure on the trachea. 

brassy eye. See chalkitis. 

Braun’s canal. See neurenteric canal. 

brawny arm, a swollen arm caused by lymphedema, usually 

after a mastectomy. 

Braxton Hicks contractions. See preterm contractions. 

Braxton Hicks version /brakstYn hiks/ [John Braxton 

Hicks, English physician, 1823–1897], one of several

Brazelton assessment 251 breast cancer 

Clavicle 

Intercostal 

muscle 

Pectoralis 

major muscle 

Alveolus 

Ductule 

Duct 

Lactiferous 

duct 

Lactiferous 

sinus 

Nipple 

pore 

Suspensory 

ligaments 

of Cooper 

types of maneuvers sometimes used to turn the fetus from an 

undesirable position to one that is more likely to facilitate 

delivery. See also version. 

Brazelton assessment. See Neonatal Behavioral Assessment 

Scale. 

Brazilian trypanosomiasis. See Chagas’ disease. 

BRCA1, symbol for a breast cancer gene. A healthy 

BRCA1 gene produces a protein that protects against unwanted 

cell growth. The protein is packaged by the cell’s 

Golgi apparatus into secretory vesicles, which release their 

contents on the cell’s surface. The protein circulates in the 

intracellular space, attaching itself to neighboring cell receptors. 

The receptors signal the cell nuclei to stop growing. 

When the gene is defective, it produces a faulty protein that 

is unable to prevent proliferation of abnormal cells as they 

evolve into potentially deadly breast cancer. BRCA1 may 

also normally inhibit ovarian cancer. 

BRCA2, symbol for a breast cancer gene with activity 

similar to that of BRCA1. 

BRCA3, symbol for a breast cancer gene. 

breach of contract, the failure to perform as promised or 

agreed in a contract. The breach may be complete or partial 

and may entail repudiation, failure to recognize the contract, 

or prevention or hindrance of performance. 

breach of duty, 1. the failure to perform an act required 

by law. 2. the performance of an act in an unlawful way. 

breakbone fever. See dengue fever. 

break test, a test of a person’s muscle strength by application 

of resistance after the person has reached the end of a 

range of motion. Resistance is applied gradually in a direction 

opposite to the line of pull of the muscle or muscle 

group being tested. The resistance is released immediately if 

there is any sign of pain or discomfort. 

breakthrough, (in psychiatry) a sudden new insight into a 

problem and its solution after a period of little or no 

progress. 

breakthrough analgesia, analgesia administered for the 

relief of breakthrough pain. 

breakthrough bleeding, the escape of uterine blood between 

menstrual periods, a possible side effect of fibroids or 

oral contraceptive use. 

breakthrough dose, the dose of an analgesic required for 

the relief of breakthrough pain. Also called rescue dose. 

Breast (Seidel et al, 2006) 

breakthrough pain, a transient increase in pain intensity 

that occurs in patients with stable, baseline persistent pain. 

breast [AS, breast], 1. the anterior aspect of the surface of 

the chest. 2. a mammary gland. 

breast abscess, an abscess of a mammary gland, usually 

during lactation or weaning. 

Breast abscess (Zitelli and Davis, 2007) 

breast augmentation, popular name for augmentation 

mammoplasty. 

breast cancer, a malignant neoplastic disease of breast tissue, 

a common malignancy in women in the United States. 

The incidence increases with age from the third to the fifth 

decade and reaches a second peak at age 65. Risk factors include 

certain genetic abnormalities, a family history of 

breast cancer, nulliparity, exposure to ionizing radiation, 

early menarche, late menopause, obesity, diabetes, hypertension, 

chronic cystic disease of the breast, and, possibly, postmenopausal 

estrogen therapy. Women who are older than 30 

years of age when they bear their first child and individuals 

who have malignancies in other body sites also have an increased 

risk of development of breast cancer. Initial symptoms, 

detected in most cases by self-examination, include a 

small painless lump, thick or dimpled skin, or nipple retraction. 

As the lesion progresses, there may be nipple discharge, 

pain, ulceration, and enlarged axillary glands. The diagnosis 

may be established by a careful physical examination, mammography, 

and cytologic examination of tumor cells obtained 

by biopsy. Infiltrating ductal carcinomas are found in

east cancer genetic screening test 252 breast cancer genetic screening test 

about 75% of cases, and infiltrating lobular, infiltrating medullary, 

colloid, comedo, or papillary carcinomas in the others. 

Inflammatory carcinomas account for approximately 1% 

of cases. Tumors are more common in the left than in the 

right breast and in the upper and outer quadrant than in the 

other quadrants. Metastasis through the lymphatic system to 

axillary lymph nodes and to bone, lung, brain, and liver is 

common, but there is evidence that primary carcinomas of 

the breast may exist in multiple sites and that tumor cells 

may enter the bloodstream directly without passing through 

lymph nodes. Surgical treatment may consist of a mastectomy 

or a lumpectomy, with dissection of axillary nodes, or 

sentinel lymph node biopsy for women without palpable 

lymph nodes. Postoperative radiotherapy, chemotherapy, or 

both is often prescribed. Chemotherapeutic agents frequently 

administered in various combinations are cyclophosphamide, 

methotrexate, 5-fluorouracil, phenylalanine mustard 

(L-PAM), thiotepa, DOXOrubicin, vinCRIStine, paclitaxel, 

methotrexate, and predniSONE. The presence of estrogen 

receptors in breast tumors is considered an indication for 

hormonal manipulation such as the administration of antiestrogens. 

Implantation of a prosthesis after mastectomy is 

optional and does not appear to decrease survival probability. 

Reconstructive surgery is now common, with few complications. 

Males account for 17% of all breast cancer cases; 

those with Klinefelter’s syndrome are at much greater risk 

than other men. See also lumpectomy, mastectomy, scirrhous 

carcinoma. 

OBSERVATIONS: Increasing numbers of breast cancers are 

found on mammogram. The most common presenting sign is 

a lump in the breast. About 50% of all lumps are found in the 

upper outer quadrant. Nipple discharge may also be present. 

A mass detected by breast self-examination, physical examination, 

or mammogram requires follow-up. Ultrasonography 

helps distinguish cysts from a solid mass. Definitive diagnosis 

is made by incisional, excisional, fine needle, or 

stereotactic core biopsy of the mass. Pain, tenderness, 

changes in breast shape, dimpling, and nipple retraction 

rarely occur until the disease reaches an advanced stage. 

Prognosis dims markedly as the number of involved lymph 

nodes increases. Pleural effusion, ascites, pathologic fracture, 

and spinal compression can occur with advanced 

disease. 

INTERVENTIONS: The treatment of choice is resection of the 

lump with removal of varying amounts of surrounding 

healthy tissue, ranging from a margin of breast tissue to the 

entire breast, axillary lymph nodes, mammary lymphatic 

chain, and pectoral muscles. Adjunct systemic multidrug 

chemotherapy is used primarily for premenopausal nodepositive 

women. Adjunct hormone therapy (estrogens, androgens, 

and progestins) is used primarily for postmenopausal 

node-positive or receptor-positive women. Antiestrogen 

therapy (Tamoxifen and Femara) is used as first line 

therapy; biologic therapy with trastuzumab (Herceptin) is 

used in select patients for treatment of metastatic disease. 

Bone marrow/stem cell transplants are under investigation 

for advanced metastatic disease. Radiation may be used as 

an adjunct after surgery and for palliation in advanced 

disease. 

NURSING CONSIDERATIONS: Nurses have responsibilities for 

patient care at all levels of the care continuum, from primary 

care and screening to acute and long-term follow-through 

after diagnosis and medical treatment for breast cancer. 

Nurses play a large role in early detection and should educate 

and instruct women age 40 and older and women at increased 

risk (e.g., family history, genetic tendency, past 

breast cancer) to get an annual mammogram and clinical 

breast exam. Women under 40 and at high risk should be encouraged 

to get a clinical breast exam every 3 years. All 

women should perform regular breast self-exams. Nurses 

work with women who are diagnosed with breast cancer to 

better understand and cope with treatment options. Acute 

care management is dictated in part by the treatment intervention. 

Physical care after surgery includes prevention of 

infection, incision site care, pain management, and prevention 

of loss of function or feeling on affected side. Management 

of radiation side effects, such as erythema, ulceration, 

edema, and peeling, are necessary. Chemotherapy and radiation 

protocols and side effects need to be reviewed. Psychosocial 

support is paramount to recovery. Emotional needs, 

such as fear over a cancer diagnosis, grieving over loss of a 

breast, and altered body image must be addressed. Counseling 

may be needed. Referrals can be made for age-specific 

recovery support groups. Referral may also be made for fitting 

and construction of a breast prosthesis or surgical reconstruction 

of the breast. The need for long-term follow-up of 

physical and emotional sequelae is stressed. 

Breast cancer: invasive ductal carcinoma 

(Kumar et al, 2007) 

Breast cancer (Swartz, 2006) 

breast cancer genetic screening test (BRCA genetic 

testing), a blood test used to detect the presence of breast 

cancer genes, which indicates an increased susceptibility for 

development of breast cancer. One breast cancer gene also 

confers an increased susceptibility for ovarian cancer.

east cancer tumor analysis 253 breastfeeding, ineffective 

breast cancer tumor analysis, a microscopic examination 

of breast cancer tissue to predict the probability of cancer 

recurrence. 

breast ductal lavage, a fluid analysis of exfoliated cells 

from breast ducts to assess breast cancer risk. There is no 

statistical support for the accuracy of this test. 

breast examination 1 , a process in which the breasts and 

their accessory structures are observed and palpated in assessing 

the presence of changes or abnormalities that could 

indicate malignant disease. See also self-breast examination. 

METHOD: The breasts are observed with the patient sitting 

with her arms at her sides; sitting with her arms over her 

head, back straight, then leaning forward; and, finally, sitting 

upright as she contracts the pectoral muscles by placing 

hands on hips. The breasts are observed for symmetry of 

shape and size and for surface characteristics, including 

moles or nevi, hyperpigmentation, retraction or dimpling, 

edema, abnormal distribution of hair, focal vascularity, or lesions. 

With the patient still sitting, the axillary nodes and the 

supraclavicular and subclavicular areas are palpated. With 

the patient lying on her back, each breast is shifted medially, 

and the glandular area in each is palpated with the flat of the 

fingers of a hand in concentric circles or in a pattern like the 

spokes of a wheel, from the periphery inward. The areolar 

areas, the nipples, and the axillary tail of Spence in the upper 

outer quadrant extending toward the axilla are then palpated. 

The nipple is squeezed to check for discharge. 

INTERVENTIONS: The patient should be taught to perform a 

self-breast examination and encouraged to do it monthly. 

The American Cancer Society recommends starting at about 

age 18. Premenopausal women should examine breasts approximately 

1 week past the menstrual period, when breasts 

are less tender and less swollen. Postmenopausal women 

should choose a specific time each month, such as the first 

day of the month. Many women find it helpful to check their 

breasts every time they shower for the first few months after 

being taught the procedure to practice and to become very 

familiar with their own breasts. 

OUTCOME CRITERIA: Early diagnosis greatly improves the 

rate of cure in cancer of the breast. 

Compression of nipple 

Palpation of glandular area 

Palpation of areolar area 

Breast examination 

breast examination 2 , a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as in- 

spection and palpation of the breasts and related areas. See 


breastfeeding [AS, braest ME, feden], 1. suckling or 

nursing, giving a baby milk from the breast. Breastfeeding 

encourages postpartum uterine involution and slows the 

natural return of the menses. Also called nursing. 2. taking 

milk from the breast. See also breast milk, lactation. 

breastfeeding assistance, a nursing intervention from the 

Nursing Interventions Classification (NIC) defined as preparing 

a new mother to breastfeed her infant. See also Nursing 


breastfeeding, effective, a nursing diagnosis accepted by 

the Ninth National Conference on the Classification of Nursing 

Diagnoses. Effective breastfeeding is a state in which a 

mother-infant dyad/family exhibits adequate proficiency and 

satisfaction with the breastfeeding process. See also nursing 

diagnosis. 

DEFINING CHARACTERISTICS: The defining characteristics are 

the mother’s ability to position the infant at the breast to promote 

a successful latch-on response, regular and sustained 

suckling/swallowing at the breast, infant content after feeding, 

appropriate infant weight patterns for age, effective 

mother-infant communication patterns, signs and/or symptoms 

of oxytocin release, adequate infant elimination patterns 

for age, eagerness of the infant to nurse, and maternal 

verbalization of satisfaction with the breastfeeding process. 

RELATED FACTORS: Related factors include basic breastfeeding 

knowledge, normal breast structure, normal infant 

oral structure, infant gestational age greater than 34 weeks, 

support sources, and maternal confidence. 

breastfeeding establishment: infant, a nursing outcome 

from the Nursing Outcomes Classification (NOC) defined as 

proper attachment of an infant to and sucking from the mother’s 

breast for nourishment during the first 2 to 3 weeks. See 

also Nursing Outcomes Classification. 

breastfeeding establishment: maternal, a nursing outcome 

from the Nursing Outcomes Classification (NOC) defined 

as maternal establishment of proper attachment of an 

infant to and sucking from the breast for nourishment during 

the first 3 weeks of breastfeeding. See also Nursing Outcomes 


breastfeeding, ineffective, a nursing diagnosis accepted 

by the Eighth National Conference on the Classification of 

Nursing Diagnoses. Ineffective breastfeeding is a state in 

which a mother, infant, and/or family experiences dissatisfaction 

or difficulty with the breastfeeding process. See also 

nursing diagnosis. 

DEFINING CHARACTERISTICS: The major defining characteristic 

is the unsatisfactory breastfeeding process. Other characteristics 

include an actual or perceived inadequate milk supply, 

no observable signs of oxytocin release, persistence of 

sore nipples beyond the infant’s first week of life, and maternal 

reluctance to put the infant to breast as necessary. The infant 

may be unable to attach to the maternal nipple correctly 

or may resist latching on, with arching and crying at the 

breast. Within the first hour after breastfeeding the infant 

may exhibit fussiness or crying and be unresponsive to other 

comfort measures. There may also be observable signs of an 

inadequate infant intake, nonsustained suckling at the breast, 

suckling at only one breast per feeding, and nursing fewer 

than seven times in 24 hours. 

RELATED FACTORS: Related factors in the diagnosis of ineffective 

breastfeeding are prematurity, infant anomaly, maternal 

breast anomaly, previous breast surgery, previous history 

of breastfeeding failure, supplemental feeding of the infant 

with an artificial nipple, poor infant sucking reflex, non-

eastfeeding, interrupted 254 breathing pattern, ineffective 

supportive partner or family, knowledge deficit, and interruption 

in breastfeeding. 

breastfeeding, interrupted, a nursing diagnosis accepted 

by the Tenth National Conference on the Classification of 

Nursing Diagnoses. Interrupted breastfeeding is a break in 

the continuity of the breastfeeding process as a result of inability 

or inadvisability of putting the baby to the breast for 

feeding. See also nursing diagnosis. 

DEFINING CHARACTERISTICS: The major defining characteristic 

is insufficient nourishment by the infant at the breast for 

some or all feedings. Minor defining characteristics are a 

maternal desire to maintain lactation and provide her breast 

milk for her infant’s nutritional needs, separation of mother 

and infant, and lack of knowledge about expression and storage 

of breast milk. 

RELATED FACTORS: Related factors include maternal or infant 

illness, prematurity, maternal employment, contraindications 

to breastfeeding (e.g., drugs, true breast milk jaundice), 

or a need to wean the infant abruptly. 

breastfeeding maintenance, a nursing outcome from the 

Nursing Outcomes Classification (NOC) defined as the continuation 

of breastfeeding from establishment to weaning for 

nourishment of an infant/toddler. See also Nursing Outcomes 


breastfeeding: weaning, a nursing outcome from the 

Nursing Outcomes Classification (NOC) defined as the progressive 

discontinuation of breastfeeding of an infant/ 

toddler. See also Nursing Outcomes Classification. 

breast implant, the surgical placement of prosthetic material 

in a breast, either to increase the breast’s size or for reconstruction 

after a mastectomy. 

breast milk [AS, braest meoluc], human milk, nursing 

considerations: The nurse should counsel mothers that it is 

easily digested, clean, and warm and that it confers some immunities 

(bronchiolitis and gastroenteritis are rare in 

breastfed babies). Infants fed breast milk are less likely to 

become obese, become constipated, and to have dental malocclusion. 

See also breastfeeding. Compare colostrum. 

breast milk jaundice, jaundice and hyperbilirubinemia in 

breastfed infants that occur in the first weeks of life as a result 

of a metabolite in the mother’s milk that inhibits the infant’s 

ability to conjugate bilirubin to glucuronide for excretion. 

See also hyperbilirubinemia of the newborn. 

OBSERVATIONS: Breast milk jaundice usually peaks around 

the tenth day of life. Serum bilirubin levels usually exceed 

5 mg/100 mL but rarely reach dangerous levels of 20 mg/ 

100 mL, at which point kernicterus may develop. The infant 

seems normal and healthy, but the skin, the whites of the 

eyes, and the serum are jaundiced (yellow). 

INTERVENTIONS: If serum bilirubin exceeds acceptable levels, 

breastfeeding should continue frequently to enhance 

stooling and decrease the chance for enterohepatic circulation. 

Phototherapy may be used to accelerate excretion of 

bilirubin through the skin. The use of oral supplementation 

with glucose water or water alone is not recommended. 

NURSING CONSIDERATIONS: The primary concerns of the 

nurse are to observe for signs of increasing jaundice, to 

monitor serum bilirubin levels, and usually to reassure the 

mother that her child is well and that the jaundice resolves 

slowly but completely in time. 

breast pump, a mechanical or electronic device for withdrawing 

milk from the breast. 

breast scintigraphy, a nuclear scan used to identify breast 

cancer in patients whose dense breast tissue precludes accurate 

evaluation by conventional mammography. It is also 

used as a second-line imaging modality in patients with an indeterminate 

mammogram and in women with lumpy breasts. 

breast self-examination (BSE). See self-breast examination. 

breast shadows, artifacts caused by breast tissue that appear 

on chest radiographs of women. The shadows accentuate 

the underlying tissue and may cause the appearance of an 

interstitial disease process. Breast nipples may also appear 

on the radiograph as “coin lesions,” requiring that a second 

radiograph with special markers attached to the nipples be 

made so that the two films can be compared. 

breast sonogram, an ultrasound test that is used primarily 

to determine if a mammographic abnormality or a palpable 

lump is a cyst (fluid-filled) or a solid tumor (benign or malignant). 

It is also used to examine symptomatic women who 

should not be exposed to mammographic radiation, such as 

pregnant women and women under the age of 25. 

breast transillumination [AS, braest L trans, through, 

illuminare, to light up], a method of examining the inner 

structures of the breast by directing light through the outer 

wall. See also diaphanography. 

breath, the air inhaled and exhaled during ventilation of 

the lungs. 

Breathalyzer /brethYlīzYr/, trademark for a device that 

analyzes exhaled air. It is commonly used to test for blood 

alcohol levels; the test is based on the relationship between 

alcohol in the breath and alcohol in the blood circulating 

through the lungs. Also spelled Breathalyser. 

breath-holding /breth-/ [AS, braeth ME, holden], 

a form of voluntary apnea that is usually but not necessarily 

performed with a closed glottis. Although breath-holding 

may be prolonged for several minutes, it is invariably terminated 

either voluntarily or when the person or child loses 

consciousness. 

breathing. See respiration. 

breathing biofeedback, the monitoring of breathing rate, 

volume, rhythm, and location by sensors placed on the chest 

and abdomen, used in the treatment of asthma, hyperventilation, 

and anxiety. The feedback is displayed to the patient visually 

and is used by the patient to learn to breathe more 

slowly, deeply, and rhythmically using the abdominal 

muscles. 

breathing cycle /brēthing/, a ventilatory cycle consisting 

of an inspiration followed by the expiration of a volume of 

gas called the tidal volume. The duration or total cycle time 

of a breathing cycle is the breathing or ventilatory period. 

Also called respiratory cycle. 

breathing frequency (f). See respiration rate. 

breathing nomogram [AS, braeth Gk, nomos, law, 

gramma, a record], a chart that presents scales of data for 

body weight, breathing frequency, and predicted basal tidal 

volume arranged so that one can find an unknown value on 

one scale by drawing a line that connects known values on 

the other two scales. 

breathing pattern, ineffective, a nursing diagnosis accepted 

by the Fourth National Conference on the Classification 

of Nursing Diagnoses (revised 1998). An ineffective 

breathing pattern is a state in which inspiration and/or expiration 

do not provide adequate ventilation for the individual. 

See also nursing diagnosis. 

DEFINING CHARACTERISTICS: Defining characteristics are 

dyspnea, shortness of breath; respiratory rate (adults [14 

years of age or more], 11 or 24; infants, 25 or 60; ages 1 to 4, 

20 or 30; ages 5 to 14, 15 or 25); depth of breathing (adults, 

tidal volume 500 mL at rest; infants, 6 to 8); timing ratio; 

nasal flaring (infants); use of accessory muscles; altered 

chest excursion; assumption of three-point position, pursed 

lip breathing, prolonged expiratory phases, increased anteroposterior 

diameter; orthopnea; decreased vital capacity; de

eathing-related sleep disorder 255 bremsstrahlung radiation 

creased minute ventilation; and decreased inspiratory/ 

expiratory pressure. 

RELATED FACTORS: Related factors are neuromuscular dysfunction, 

pain, musculoskeletal impairment, perception/ 

cognitive impairment, anxiety, hyper/hypoventilation, bone 

deformity, pain, chest wall deformity, obesity, spinal cord injury, 

body position, neurologic immaturity, respiratory muscle 

fatigue, and decreased energy/fatigue. 

breathing-related sleep disorder, any of several disorders 

characterized by sleep disruption caused by some sleeprelated 

breathing problem, resulting in excessive sleepiness 

or insomnia. Included are central sleep apnea, obstructive 

sleep apnea, and primary alveolar hypoventilation (Ondine’s 

curse). 

breathing tube. See endotracheal tube, nasotracheal 

tube. 

breathing work, the energy required for breathing movements. 

It is the cumulative product of the instantaneous pressure 

developed by the respiratory muscles and the volume of 

air moved during a breathing cycle. 

breathlessness. See dyspnea. 

breath odor, an odor usually produced by substances or 

diseases in the lungs or mouth. Certain specific odors are associated 

with some diseases, such as diabetes, liver failure, 

uremia, or a lung abscess. 

breath sound [AS, braeth L, sonus], the sound of air 

passing in and out of the lungs, as heard with a stethoscope. 

Vesicular, bronchovesicular, and bronchial breath sounds are 

normal. Decreased breath sounds may indicate an obstruction 

of an airway, collapse of a portion or all of a lung, thickening 

of the pleurae of the lungs, emphysema, or other 

chronic obstructive pulmonary disease. Also occur with frail 

clients who are not physically able to breathe deeply. 

ILL WELL 

Rhonchi: coarse, 

low-pitched; may clear 

with cough 

Wheeze: 

whistling, 

high-pitched 

bronchus 

Bronchial: coarse, 

loud; heard with 

consolidation 

Rub: scratchy, 

high-pitched 

Crackles: fine crackling, high-pitched 

Bronchial: 

coarse, 

loud 

Bronchovesicular: 

combination 

bronchial 

and vesicular, 

normal in some 

areas 

Vesicular: 

high-pitched, 

breezy 

Breath sounds in the ill and well patient 


breath test, any of various tests in which a person’s breath 

is analyzed for presence of something abnormal. Subgroups 

called the 13 C breath tests and 14 C breath tests involve administration 

of organic compounds labeled with carbon 13 

(heavy carbon) or carbon 14 (radioactive carbon) and measuring 

the subsequent levels of labeled carbon dioxide in the 

patient’s breath; the labeled compound may be found to be 

metabolized normally, too fast, or too slow in the GI tract. 

breath tests, diagnostic tests for intestinal disorders such 

as bacterial overgrowth, ileal disease, lactase deficiency, and 

steatorrhea. Lactose malabsorption is treated by giving the 

patient 12.5 to 25.0 grams of lactose and measuring the 

amount of hydrogen excreted in the breath. If lactose absorption 

is impaired in the small intestine, colonic bacteria ferment 

the lactose, releasing hydrogen, which is excreted in 

the breath. Bacterial overgrowth is tested with 14 Ccholylglycine, 

which is normally absorbed by the ileum and 

recycled via the enterohepatic circulation. In cases of bacterial 

overgrowth the labeled glycine is removed by conjugation 

in the small intestine, absorbed, and metabolized, resulting 

in an increase of 14 CO 2 in the breath. Breath tests are 

also used to test for the presence of Helicobacter pylori. 

Breckinridge, Mary, (1881–1965), the American nurse 

who founded the Frontier Nursing Service in Kentucky to 

improve the obstetric care of women living in remote mountainous 

areas. The nurses in the service had training in midwifery 

and reached their patients on horseback and on foot, 

often encountering personal danger. The service began training 

midwives and stimulated the establishment of other midwifery 

schools. 

breech birth [ME, brech burth], parturition in which 

the infant emerges feet, knees, or buttocks first. Breech birth 

is often hazardous. The body may deliver easily, but the 

aftercoming head may become trapped by an incompletely 

dilated cervix because infants’ heads are usually larger than 

their bodies. See also assisted breech, breech presentation, 

complete breech, footling breech, frank breech, version 

and extraction. 

breech extraction [ME, brech L, ex, out, trahere, to pull], 

an obstetric operation in which an infant being born feet or 

buttocks first is grasped before any part of the trunk is born 

and delivered by traction. Compare assisted breech. 

breech presentation [ME, brech L, praesentare, to 

show], intrauterine position of the fetus in which the buttocks 

or feet present. It occurs in approximately 3% of labors. 

Kinds of breech presentation are complete breech, 

footling breech, and frank breech. Compare vertex 

presentation. See also breech birth. 

Frank breech Full breech Single footling 

breech 

Breech presentation (McKinney et al, 2000) 

bregma /bregmY/ [Gk, the front of the head], the junction 

of the coronal and sagittal sutures on the top of the skull. 

—bregmatic, adj. 

bregmacardiac reflex /bregmYkärdē·Yk/ [Gk, bregma, 

front of the head], a phenomenon in which pressure on the 

anterior fontanel of an infant’s skull causes the heart to slow. 

bremsstrahlung radiation /bremsshträloo ˘ ng/ [Ger, braking 

radiation], a type of radiation produced by the interac-

Brenner tumor 256 British Medical Association 

tion between projectile electrons and the nuclei of target 

atoms. 

Brenner tumor [Fritz Brenner, German pathologist, 

b. 1877], an uncommon benign ovarian neoplasm consisting 

of nests or cords of epithelial cells containing glycogen 

that are enclosed in fibrous connective tissue. The tumor 

may be solid or cystic and is sometimes difficult to distinguish 

from certain granulosa-theca cell neoplasms. 

Brenner tumor (Fletcher, 2007) 

Brethine, trademark for a beta2 receptor agonist agent (terbutaline 

sulfate). 

bretylium tosylate /britilē·Ym/, an antiarrhythmic agent. 

INDICATION: It is prescribed in the treatment of selected 

life-threatening ventricular arrhythmias when other measures 

have not been effective. 




are hypotension, nausea and vomiting, anginal pain, 

and nasal stuffiness. 

brevi- /brevē-/, prefix meaning “short”: brevicollis, 

breviradiate. 

Brevicon, trademark for a norethindrone-ethinyl estradiol 

oral contraceptive. 

Brevital Sodium, trademark for a barbiturate (methohexital 

sodium). 

brewer’s yeast /broo ¯¯¯¯Yrz/ [ME, brewen, to boil, yest, foam], 

a preparation containing the dried pulverized cells of a yeast, 

such as Saccharomyces cerevisiae, that is used as a leavening 

agent and as a dietary supplement. It is one of the best 

sources of the B complex vitamins and a rich source of many 

minerals and a high grade of protein. 

Bricanyl, trademark for a beta2 receptor agonist agent (terbutaline 

sulfate). 

brick dust urine, a reddish discoloration signaling precipitated 

urates in acidic urine. 

bridge. See bridgework. 

bridge of Varolius. See pons. 

bridgework, a fixed partial denture that is cemented permanently 

to abutment teeth. Also called bridge. See also 

abutment, pontic, retainer. 

bridging [AS, brycg], 1. a nursing technique of positioning 

a patient so that bony prominences are free of pressure 

on the mattress by using pads, bolsters of foam rubber, or 

pillows to distribute body weight over a larger surface. 

2. a nursing technique for supporting a part of the body, such 

as the testicles in treating orchitis, using a Bellevue bridge 

made of a towel or other material. 3. a physical rehabilitation 

technique that strengthens abdominal and leg muscles. 

Reclining with knees bent, the patient plants the feet on a 

firm surface and lifts the buttocks off the surface. 

Brief Psychiatric Rating Scale (BPRS), a rating scale 

for assessing psychopathology on the basis of a small number 

of items, usually 16 to 24, encompassing psychosis, depression, 

and anxiety symptoms. 

brief psychotherapy, (in psychiatry) treatment directed to 

the active resolution of personality or behavioral problems 

rather than to the speculative analysis of the unconscious. It 

usually concentrates on a specific problem or symptom 

and is limited to a specified number of sessions with the 

therapist. 

brief psychotic disorder, an episode of psychotic symptoms 

(incoherence, loosening of associations, delusions, hallucinations, 

disorganized or catatonic behavior) with sudden 

onset, lasting less than 1 month. If it occurs in response to 

a stressful life event, it may be called brief reactive psychosis. 

brief reactive psychosis, a short episode, usually less 

than 2 weeks, of psychotic behavior that occurs in response 

to a significant psychosocial stressor. 

brightness gain /brītnes/, the increase in illumination 

level of a radiograph produced by an image intensifier. It is 

calculated as the minification gain multiplied by the flux 

gain. The product is the ratio of the number of photons at the 

output phosphor to the number at the input phosphor. 

Brill-Symmers disease. See giant follicular lymphoma. 

Brill-Zinsser disease /brilzinsYr/ [Nathan E. Brill, American 

physician, 1860–1925; Hans Zinsser, American bacteriologist, 

1878–1940], a mild form of epidemic typhus that 

recurs in a person who appears to have completely recovered 

from a severe case of the disease years earlier. Some rickettsiae 

remain in the body after the symptoms of the disease 

abate, causing the recurrence of symptoms, especially when 

stress, illness, or malnutrition weakens the person. Treatment 

with antibiotics may eradicate the organism. See also epidemic 

typhus, murine typhus, rickettsiosis, typhus. 

brim, 1. edge or margin. 2. the edge of the upper border of 

the true pelvis, or the pelvic inlet. See also pelvis. 

brim of true pelvic cavity. See iliopectineal line. 

brimonidine /bri-mōni-dēn/, an alpha-adrenergic receptor 

agonist used as the tartrate salt in treatment of open-angle 

glaucoma and ocular hypertension. It is administered topically 

to the conjunctiva. 

Brinnell hardness test [Johann A. Brinnell, Swedish engineer, 

1849–1925], a means of determining the surface 

hardness of a material by measuring the resistance the material 

offers to the impact of a steel ball. The test result is recorded 

as the Brinnell hardness number (BHN); harder materials 

have higher BHNs. The Brinnell hardness test is 

commonly used to measure abrasion resistance in materials 

used in dental restorations, such as amalgams, cements, and 

porcelains. Compare Knoop hardness test. 

brinzolamide /brin-zolah-mīd/, a carbonic anhydrase inhibitor 

used in treatment of open-angle glaucoma and ocular 

hypertension. 

Briquet’s syndrome. See somatization disorder. 

Brissaud’s dwarf /brisōz/ [Edouard Brissaud, French physician, 

1852–1909], a person affected with infantile myxedema 

in which short stature is associated with hypothyroidism. 

Bristol Cancer Help Center (BCHC) diet, a stringent 

diet of raw and partly cooked vegetables with proteins from 

soy. It is claimed to enhance the quality of life and attitude 

toward illness in cancer patients. 

British antilewisite. See dimercaprol. 

British Medical Association (BMA), a voluntary professional 

organization of physicians and medical students in the 

United Kingdom.

British Pharmacopoeia 257 bromocriptine mesylate 

British Pharmacopoeia (BP), the official British reference 

work setting forth standards of strength and purity of 

medications and containing directions for their preparation 

to ensure that the same prescription written by different doctors 

and filled by different pharmacists will contain exactly 

the same ingredients in the same proportions. The first British 

Pharmacopoeia was published in 1864 by the General 

Medical Council; it superseded the London Pharmacopoeia, 

which had been published since 1618. See also British Medical 

Association, United States Pharmacopeia (USP). 

British thermal unit (BTU), a unit of heat energy. The 

amount of thermal energy that must be absorbed by 1 lb of 

water to raise its temperature by 1° at 39.2° F. It is also 

equivalent to 1055 joules or 252 Calories. 

brittle bones. See osteogenesis imperfecta. 

brittle diabetes, poorly controlled diabetes mellitus in 

which blood glucose levels are unstable. See also type 1 diabetes 

mellitus. 

broach, an elongated, tapering dental instrument that contains 

multiple projecting sharp barbs, used in removing pulpal 

material. 

broad beta disease, type III familial hyperlipoproteinemia 

in which a lipoprotein, high in cholesterol and triglycerides, 

accumulates in the blood. The condition, which 

affects males in their twenties and females in their thirties 

and forties, is characterized by yellowish nodules (xanthomas) 

on the elbows and knees, peripheral vascular disease, 

and elevated serum cholesterol levels. Persons with this disease 

are at risk of development of early coronary disease. 

Therapy includes dietary measures to reduce weight and levels 

of serum lipids. Also called dysbetalipoproteinemia, 

hyperlipidemia type III. See also hyperlipidemia, hyperlipoproteinemia. 

broad ligament [ME, brood L, ligare, to tie], a folded 

sheet of peritoneum draped over the uterine tubes, the uterus, 

and the ovaries. It extends from the sides of the uterus to the 

sidewalls of the pelvis, dividing the pelvis from side to side 

and creating the vesicouterine fossa and pouch in front of the 

uterus and the rectouterine fossa and pouch behind it. See 

also cardinal ligament. 

broad ligament of the liver [ME, brod L, ligare, to bind; 

AS, lifer], a crescent-shaped fold of peritoneum attached 

to the lower surface of the diaphragm, connecting with the 

liver and the anterior abdominal wall. Also called falciform 

ligament of the liver. 

broad-spectrum antibiotic, an antibiotic that is effective 

against a wide range of infectious microorganisms. 

Broca’s aphasia /brōkYz/ [Pierre P. Broca, French neurologist, 

1824–1880], a type of aphasia consisting of nonfluent 

speech, with a laconic and hesitant, telegraphic quality 

caused by a large dominant hemisphere frontal lesion extending 

to the central sulcus. The patient’s agrammatic 

speech is characterized by abundant nouns and verbs but few 

articles and prepositions, the resulting speech is economic 

but lacking in syntax. Compare Wernicke’s aphasia. 

Broca’s area [Pierre P. Broca], an area involved in speech 

production situated on the inferior frontal gyrus of the brain. 

See also aphasia, Broca’s aphasia, motor speech areas, 

speech centers. 

Broca’s fissure [Pierre P. Broca], a cleft or groove encircling 

Broca’s area in the left frontal area of the brain. 

Broca’s plane [Pierre P. Broca], a plane that includes the 

tip of the interalveolar septum between the upper central incisors 

and the lowest point of the left and right occipital 

condyles. 

Brödel’s bloodless line, a longitudinal light-colored zone 

on the anterior surface of the kidney near the convex border, 

considered to be less vascularized than other areas be- 

cause it is the border between two areas of arterial distribution. 

Brodie’s abscess [Benjamin Brodie, English surgeon, 1783– 

1862], 1. a subacute form of osteomyelitis consisting of 

an indolent staphylococcal infection of bone, usually in the 

metaphysis of a long bone of a child, characterized by a necrotic 

cavity surrounded by dense granulation tissue. See 

also osteomyelitis. Also called circumscribed abscess of 

bone. 2. a chronic abscess of bone surrounded by dense fibrous 

tissue and sclerotic bone. 

Brodmann’s areas /brodmanz, brōtmons/ [Korbinian 

Brodmann, German anatomist, 1868–1918], the 47 different 

areas of the cerebral cortex that are associated with specific 

neurologic functions and distinguished by different cellular 

components. They control movements of the lips and 

vocal cords as well as motor speech. Compare motor area. 

See also cerebral cortex. 

broken cell preparation. See homogenate. 

brom, abbreviation for a bromide anion. 

bromazepam /bro-mazĕ-pam/, a benzodiazepine used as 

an antianxiety agent and as a sedative and hypnotic. It is administered 

orally. 

brom-, bromo-, prefix meaning a compound containing 

bromine or meaning “odor, stench”: bromhidrosis, 

bromoacetophenon. 

bromelain /brōmYlān/, any of several enzymes that catalyze 

cleavage of proteins on the carboxyl side of alanine, 

glycine, lysine, and tyrosine bonds. Differing forms are derived 

from the fruit (fruit bromelain) and stem (stem bromelain) 

of the pineapple plant. The enzyme is administered 

orally as an antiinflammatory agent (especially to relieve 

swelling in the nasal and paranasal sinuses) and is also used 

in immunology to render red cells agglutinable by incomplete 

antibody. 

Bromfed, trademark for a fixed-combination decongestant 

containing brompheniramine maleate and pseudoephedrine 

maleate. 

bromhidrosis /brōmidrōsis/ [Gk, bromos, stench, hidros, 

sweat], an abnormal condition in which the apocrine sweat 

has an unpleasant odor. The odor is usually caused by bacterial 

decomposition of perspiration on the skin. Treatment 

includes frequent bathing, changing of socks and underclothes, 

and use of deodorants, antibacterial soaps, and dusting 

powders. Also called body odor. 

bromide /brōmīd/ [Gk, bromos, stench], an anion of bromine. 

Bromide salts, once widely prescribed as sedatives, 

are now seldom used for that purpose because they may 

cause serious mental disturbances as side effects. 

bromide poisoning, an adverse reaction to ingested bromide. 

Symptoms include nausea, vomiting, an acnelike rash, 

slurred speech, ataxia, psychotic behavior, and coma. 

bromine (Br) /brōmēn/, a corrosive, toxic red-brown liquid 

element of the halogen group. Its atomic number is 35; 

its atomic mass is 79.904. It exists naturally as a diatomic 

molecule, Br 2. Bromine is used in industry, in photography, 

in the manufacture of organic chemicals and fuels, and in 

medications. Bromine gives off a red vapor that is extremely 

irritating to the eyes and the respiratory tract. Liquid bromine 

causes serious skin burns. Compounds of bromine have 

been used as sedatives, hypnotics, and analgesics and are 

still used in some nonprescription, over-the-counter preparations. 

Prolonged use of these products may cause brominism, 

a toxic condition characterized by acneiform eruptions, 

headache, loss of libido, drowsiness, and fatigue. See 

also bromide. 

bromo-. See brom-. 

bromocriptine mesylate /brōmōkriptēn/, a dopamine 

receptor agonist.

omoderma 258 bronchiectasis 

INDICATIONS: It is prescribed for the treatment of amenorrhea 

and galactorrhea associated with hyperprolactinemia, 

female infertility, and Parkinson’s disease. 

CONTRAINDICATIONS: Sensitivity to any ergot alkaloid prohibits 

its use. The drug was disqualified for use in suppressing 

postpartum lactation by the FDA in 1994 because of a 

previously unrecognized increase in intracranial hemorrhages. 

ADVERSE EFFECTS: Among the more severe adverse reactions 

are palpitations, hypotension, bradycardia, hallucinations, 

syncope, nausea, ataxia, dyspnea, dysphagia, and 

confusion. 

bromoderma /brōmōdurmY/ [Gk,bromos, stench, derma 

skin], an acneiform, bullous, or nodular skin rash occurring 

as a hypersensitivity reaction to ingested bromides. 

brompheniramine maleate /bromfYnirYmin/, an antihistamine. 

INDICATIONS: It is prescribed in the treatment of allergic reactions, 

including rhinitis, skin reactions, and itching. 

CONTRAINDICATIONS: Asthma or known hypersensitivity to 

this drug prohibits its use. It is not given to newborns, lactating 

mothers, or other people for whom anticholinergic medications 

are contraindicated. 

ADVERSE EFFECTS: Drowsiness, skin rash, hypersensitivity 

reactions, dry mouth, and tachycardia commonly occur. 

Brompton’s cocktail, an analgesic solution containing alcohol, 

morphine or heroin, and, in some cases, a phenothiazine. 

Formulations vary, and recently cocaine has generally 

been eliminated from the mixture. The cocktail is administered 

in the control of pain in the terminally ill patient. Given 

frequently at the lowest effective dose, it may relieve pain 

for many months. It was developed at the Brompton Hospital 

in England. Also called Brompton’s mixture. 

bronch-, broncho-, combining form meaning “bronchus”: 

bronchiectasis, bronchodilation. 

bronchi(o)-, prefix meaning relationship to a bronchus. 

See also bronch(o)-. 

bronchial /brongkē·Yl/ [Gk, bronchos, windpipe], pertaining 

to the bronchi or bronchioles. 

bronchial artery, the nutritive vascular system of the pulmonary 

tissues, originating from the thoracic aorta or one of 

its branches. They interconnect within the lung with 

branches of the pulmonary arteries and veins. 

bronchial asthma. See asthma. 

bronchial atresia, occlusion or obstruction of a lobar or 

segmental bronchus, usually in the left upper lobe; the affected 

lung segment is often hyperinflated because of leakage 

of air through the alveolar pores. 

bronchial breath sound [Gk, bronchos, windpipe], 

a normal sound heard with a stethoscope over the main airways 

of the lungs, especially the trachea. Expiration and inspiration 

produce noise of equal loudness and duration, 

sounding like blowing through a hollow tube. The expiratory 

sound is heard during the greater part of expiration, whereas 

the inspiratory sound stops abruptly at the height of inspiration, 

with a pause before the sound of expiration is heard. 

Also called tracheal breath sound. 

bronchial cast, a cylindrical solid or semisolid plug that 

blocks a bronchus and is sometimes expectorated. 

bronchial challenge, bronchial challenge test, a challenge 

test in which a nonspecific agent such as histamine or 

methacholine is applied to the bronchi and they are assessed 

for a bronchoconstriction reaction. Also called bronchial 

provocation. See inhalational challenge. 

bronchial cough, a cough associated with bronchiectasis 

and heard in early stages as hacking and irritating, becoming 

looser in later stages. 

bronchial drainage. See postural drainage. 

bronchial fremitus, a vibration that can be palpated on 

the chest wall (usually the posterior thorax) over a bronchus. 

It results from congestion by secretions that rattle as air 

passes during respiration. See also fremitus. 

bronchial hyperreactivity [Gk, bronchos hyper, excess; 

L, re, again, agere, to act], an abnormal respiratory condition 

characterized by reflex bronchospasm in response to 

histamine or a cholinergic drug, such as methacholine. It is a 

universal feature of asthma and is used in the differential diagnosis 

of asthma and heart disease. 

bronchial murmur, a murmur heard as a blowing sound, 

caused by air flowing in and out of the bronchial tubes. 

bronchial pneumonia. See bronchopneumonia. 

bronchial provocation. See bronchial challenge. 

bronchial secretion, a substance produced in the bronchial 

tree that consists of mucus secreted by the goblet cells 

and mucous glands of the bronchi, protein salts released 

from disintegrating cells, plasma fluid, and proteins, including 

fibrinogen, that have escaped from pulmonary capillaries. 

bronchial spasm. See bronchospasm. 

bronchial toilet, special care that is given to patients with 

tracheostomies and respiratory disorders, including stimulation 

of coughing, deep breathing, and suctioning of the respiratory 

tract with a tracheobronchial aspiration pump. 

bronchial tree, an anatomic complex of the trachea and 

bronchi. The bronchi branch from the trachea. The right 

bronchus is wider and shorter than the left bronchus and 

branches into three secondary bronchi, one passing to each 

of the three lobes of the right lung. The left bronchus is 

smaller in diameter and about twice as long as the right bronchus. 

It is also more horizontal and more susceptible to obstruction. 

It branches into the secondary bronchi for the inferior 

and the superior lobes of the left lung. The bronchus is 

sometimes described as a bronchial tube. 

bronchial tube. See bronchus. 

bronchial washing [Gk, bronchos, windpipe; ME, wasshen, 

to wash], irrigation of the bronchi and bronchioles performed 

during bronchoscopy to cleanse the tubes and to collect 

specimens for laboratory examination. 

bronchiectasis /brongkē·ektYsis/ [Gk, bronchos ektasis, 

stretching], an abnormal condition of the bronchial tree 

characterized by irreversible dilation and destruction of the 

bronchial walls. The condition is sometimes congenital but 

is more often a result of bronchial infection or of obstruction 

by a tumor or an aspirated foreign body. Symptoms include a 

constant cough producing copious purulent sputum; hemoptysis; 

chronic sinusitis; clubbing of fingers; and persistent 

moist, coarse crackles. Some of the complications of bronchiectasis 

are pneumonia, lung abscess, empyema, brain abscess, 

and amyloidosis. Treatment includes frequent postural 

drainage, expectorants, antibiotics, and, rarely, surgical resection 

of the affected part of the lungs. 

OBSERVATIONS: The individual is often asymptomatic early 

in the disease. A chronic cough with sputum production is 

the most common presenting sign. Hemoptysis, recurrent 

pneumonia, dyspnea, wheezing, and fatigue are also frequently 

seen. Fever, night sweats, weight loss, fetid breath, 

and hemoptysis may also be present. Moist crackles in lung 

bases may be heard on auscultation. Sputum appears purulent 

and foamy with sediment and has a large number of 

WBCs. Sputum cultures and Gram’s stain are used to identify 

microorganisms. Chest x-rays reveal increased markings, 

honeycombing, and tram tracking. Pulmonary function 

studies show a decrease in vital capacity and expiratory flow. 

CT scans are used to detect cystic lesions and rule out neo

onchioalveolar adenocarcinoma 259 bronchiolitis 

plastic obstruction. Bronchography may be used when surgery 

is contemplated to visualize bronchiectatic areas. 

Clubbed fingers, pulmonary hypertension, right ventricular 

failure, and cor pulmonale are complications associated with 

long-standing disease. 

INTERVENTIONS: Acute treatment includes medications, 

such as mucolytics to clear secretions; antibiotics to treat 

bacterial infection; and bronchodilators to reduce dyspnea. 

Chest physiotherapy, with postural drainage, is used to clear 

secretions. Adequate hydration and a vaporizer help liquefy 

secretions. Supplemental oxygen is administered for hypoxemia. 

Bronchial resection is used to treat confined disease, 

which is unresponsive to conservative therapy. 

NURSING CONSIDERATIONS: The focus of nursing care during 

acute episodes is to promote airway clearance and effective 

breathing patterns through respiratory monitoring, cough enhancement, 

anxiety reduction, and rest. Preventive and 

chronic care focuses on avoidance of air pollution and contact 

with individuals with respiratory infections; prompt 

identification and treatment of respiratory infection; maintenance 

of adequate nutrition and hydration; smoking cessation 

as applicable; and use of influenza and pneumonia vaccines 

for prophylaxis. 

Bronchiectasis (Wilson and Giddens, 2005) 

bronchioalveolar adenocarcinoma, bronchioalveolar 

carcinoma. See bronchioloalveolar carcinoma. 

bronchiolar. See bronchiole. 

bronchiolar adenocarcinoma, carcinoma. See bronchioloalveolar 

carcinoma. 

bronchiolar collapse /brongkyYlYr/ [L, bronchiolus, little 

windpipe, conlabi, to fall], a condition in which bronchioles, 

which are pliable and lack cartilaginous support, become 

compressed by surrounding structures in the absence 

of inflowing air needed to keep them inflated. The condition 

occurs in disorders such as emphysema, cystic fibrosis, and 

bronchiectasis. 

bronchiole /brongkē·ōl/ [L, bronchiolus, little windpipe], 

a small airway of the respiratory system extending from 

the bronchi into the lobes of the lung. There are two divisions 

of bronchioles: The terminal bronchioles passively 

conduct inspired air from the bronchi to the respiratory bronchioles 

and expired air from the respiratory bronchioles to 

the bronchi. The respiratory bronchioles function similarly, 

allowing the exchange of air and waste gases between the alveolar 

ducts and the terminal bronchioles. —bronchiolar 

/brongkēYlYr/, adj. 

Venule 

(leading to pulmonary 

veins and heart) 

Alveoli 

Bronchioles 

Oxygenated 

Arteriole (coming from 

pulmonary artery) 

Capillaries (carbon dioxide leaves; oxygen enters) 

Bronchioles (Chabner, 2004) 

Deoxygenated 

bronchiolitis /brongkē·ōlītis/ [L, bronchiolus, little windpipe; 

Gk, itis, inflammation], an acute viral infection of the 

lower respiratory tract that occurs primarily in infants less 

than 12 months of age. It begins as a mild upper respiratory 

tract infection and over a period of 2 to 3 days develops into 

more severe respiratory distress. It is characterized by expiratory 

wheezing, inflammation, and obstruction at the level 

of the bronchioles. The most common causative agents are 

the respiratory syncytial viruses (RSVs) and the parainfluenza 

viruses. Mycoplasma pneumoniae, rhinoviruses, enteroviruses, 

and measles virus are less common causative 

agents. Transmission occurs by infection with airborne particles 

or by contact with infected secretions. The diagnosis 

consists of evidence of hyperinflation of the lungs through 

percussion or chest x-ray. 

OBSERVATIONS: The condition typically begins as an upper 

respiratory tract infection with serious nasal discharge and 

often with low-grade fever. Increasing respiratory distress 

follows, characterized by tachypnea, tachycardia, intercostal 

and subcostal retractions, a paroxysmal cough, an expiratory 

wheeze, and often an elevated temperature. The chest may 

appear barrel-shaped; x-ray films show hyperinflated lungs 

and a depressed diaphragm. Respiration becomes more shallow, 

causing increased alveolar oxygen tension and leading 

to respiratory acidosis. Complete obstruction and absorption 

of trapped air may lead to atelectasis and respiratory failure. 

Blood gas determinations indicate the degree of carbon dioxide 

retention. 

INTERVENTIONS: Routine treatment includes administering 

humidity and mist, generally combined with oxygen; ensuring 

an adequate fluid intake, usually given intravenously because 

of tachypnea, weakness, and fatigue; suctioning the 

airways to remove secretions; and promoting rest. Endotracheal 

intubation is indicated when carbon dioxide retention 

occurs, when bronchial secretions do not loosen and clear, or 

when oxygen therapy does not alleviate hypoxia. Such medications 

as antibiotics, bronchodilators, corticosteroids, 

cough suppressants, and expectorants are not routinely used. 

Ribavarin may be used when RSV is the causative agent but 

is generally used only in the high-risk population. Sedatives 

are contraindicated because of their suppressant effect on the 

respiratory tract. The infection typically runs its course in 7 

to 10 days, with good prognosis. A major complication is 

bacterial infection, most commonly after prolonged use of a 

mist tent. The disorder is often confused with asthma. A family 

history of allergy, the presence of other allergic manifes-

onchiolitis obliterans 260 bronchoalveolar lavage 

tations, and improvement with epinephrine injection are usually 

indicative of asthma, not bronchiolitis. Cystic fibrosis, 

pertussis, the bronchopneumonias, and foreign body obstruction 

of the trachea are other disorders that may be confused 

with bronchiolitis. 

NURSING CONSIDERATIONS: The focus of nursing care is to 

promote rest and to conserve the child’s energy by reducing 

anxiety and apprehension; to increase the ease of breathing 

with humidity and oxygen as needed; to aid in changing position 

for comfort; and to induce drainage of secretions or to 

suction when necessary. Fever is usually controlled by the 

cool atmosphere of the mist tent and by administration of 

antipyretics as needed. Frequent changing of clothing and 

bed linen is often necessary in a mist environment to reduce 

chilling. Vital signs and chest and breath sounds are continuously 

monitored to detect early signs of respiratory distress. 

bronchiolitis obliterans, a form of bronchiolitis in which 

the exudate is not expectorated but becomes organized and 

obliterates the bronchial tubes, causing collapse of the affected 

part of the lungs. 

bronchioloalveolar carcinoma /brongkē·ōlō·al·vēY·lYr/, 

the less common variant of the two types of adenocarcinoma 

of the lung, with columnar to cuboidal epithelial cells lining 

the alveolar septa and projecting into alveolar spaces in 

branching papillary formations. Also called alveolar 

adenocarcinoma, alveolar carcinoma, alveolar cell 

carcinoma, bronchioalveolar adenocarcinoma, bronchioalveolar 

carcinoma, bronchiolar adenocarcinoma, 

bronchiolar carcinoma, bronchoalveolar adenocarcinoma, 

bronchoalveolar carcinoma. See also adenocarcinoma 

of the lung. Compare bronchogenic adenocarcinoma. 

bronchiospasm. See bronchospasm. 

bronchitis /brongkītis/ [Gk, bronchos, windpipe, itis, inflammation], 

acute or chronic inflammation of the mucous 

membranes of the tracheobronchial tree. Caused by the 

spread of upper respiratory viral or sometimes bacterial infections 

to the bronchi, it is often observed with or after 

childhood infections, such as measles, whooping cough, 

diphtheria, and typhoid fever. See also chronic bronchitis, 

chronic obstructive pulmonary disease, respiratory syncytial 

virus. 

OBSERVATIONS: Acute bronchitis is frequently preceded 

by an upper respiratory infection. The most common presenting 

sign is a dry, hacking cough that increasingly produces 

viscous mucus. Other symptoms include low-grade 

fever, substernal pain, and fatigue. Rhonchi and occasional 

wheezing may be heard when auscultating lungs. Diagnosis 

is usually made from the type of cough and sputum. Chest 

x-rays are taken to rule out other disorders. Arterial blood 

gases are monitored when the underlying chronic disease is 

present, and sputum is cultured for evidence of superimposed 

infection. Pneumonia is the most common complication. 

Acute respiratory failure occurs in some individuals 

with underlying pulmonary disease. Chronic bronchitis 

may be asymptomatic for years. A productive cough with copious 

mucopurulent sputum, peripheral cyanosis, and variable 

dyspnea are typical presenting signs. The cough becomes 

increasingly progressive and the sputum production 

more copious. Wheezing, tachypnea, and tachycardia may 

also be present. Several attacks per year are common. Chest 

x-rays reveal cardiac enlargement, congested lung fields, and 

thickened bronchial markings. Pulmonary function studies 

show increased residual volume, and decreases in forced 

vital capacity and forced expiratory volume. PaO 2 is decreased 

and PaCO 2 increased on arterial blood gas results. 

Sputum cultures show presence of multiple microorganisms 

and neutrophils. Cor pulmonale, pulmonary hypertension, 

right ventricular hypertrophy, and respiratory failure are 

common complications seen in chronic bronchitis. 

INTERVENTIONS: Treatment for acute episodes include medications, 

such as inhaled bronchodilators for wheezing, expectorants 

for cough, and antipyretics for fever. Antiinfective 

drugs are used only with concomitant chronic obstructive 

pulmonary disease (COPD) or a superimposed infection. 

Adequate hydration and a vaporizer help liquefy 

secretions. Treatment for chronic bronchitis includes 

antiinfective drugs for infection, bronchodilators to reduce 

dyspnea, and corticosteroids to reduce inflammation. Chest 

physiotherapy is used to loosen secretions. A vaporizer and 

hydration help liquefy secretions. Oxygenation is used for 

hypoxia. Health promotion in individuals with chronic disease 

include a consistent exercise program to improve ventilatory 

and cardiac function; smoking cessation programs 

and use of flu and pneumonia vaccines for prophylaxis. 

NURSING CONSIDERATIONS: The focus of nursing care during 

acute episodes is supportive and includes rest, increased fluids, 

and steam vaporizer. Education plays a large role for 

those suffering from chronic bronchitis and includes information 

on the disease process; instruction on medication administration 

(schedule and use of spacer), home use of oxygen, 

chest physiotherapy program, effective coughing, 

exercise program, nutrition plan to decrease weight if indicated, 

smoking cessation if indicated, and proper use of respirators 

in work place if exposed to respiratory irritants. Importance 

of long-term and consistent follow-up should be 

stressed. 

Air tubes narrow as 

a result of swollen 

tissues and excessive 

mucus production. 

Chronic Bronchitis 

Chronic bronchitis 


Enlarged 

submucosal gland 

Inflammation 

of epithelium 

Mucus 

accumulation 

Hyperinflation 

of alveoli 

bronch(o)-, prefix meaning relationship to a bronchus. See 

also bronchi(o)-. 

bronchoalveolar /-alvēYlYr/ [Gk, bronchos, windpipe; L, 

alveolus, little hollow], pertaining to the terminal air sacs 

at the ends of the bronchioles. 

bronchoalveolar adenocarcinoma, bronchoalveolar 

carcinoma (BAC). See bronchioloalveolar carcinoma. 

bronchoalveolar lavage (BAL), a diagnostic procedure 

in which small amounts of physiologic solution are injected 

through a fiberoptic bronchoscope into a specific area of the 

lung, while the rest of the lung is sequestered by an inflated 

balloon. The fluid is then aspirated and inspected for pathogens, 

malignant cells, and mineral bodies.

onchoaortic constriction 261 bronchopulmonary hygiene 

bronchoaortic constriction, thoracic constriction of 

esophagus. 

bronchoconstriction [Gk, bronchos, windpipe; L, 

constringere, to draw tight], a narrowing of the lumen of 

the bronchi, restricting airflow to and from the lungs. 

bronchodilation /-dilāshYn/ [Gk, bronchos, windpipe; L, 

dilatare, to widen], a widening of the lumen of the bronchi, 

allowing increased airflow to and from the lungs. 

bronchodilator /-dilātYr/, a substance, especially a drug, 

that relaxes contractions of the smooth muscle of the bronchioles 

to improve ventilation to the lungs. Pharmacologic 

bronchodilators are prescribed to improve aeration in 

asthma, bronchiectasis, bronchitis, and emphysema. Commonly 

used bronchodilators include albuterol, terbutaline, 

and various derivatives and combinations of these drugs. 

The adverse effects vary, depending on the particular class of 

the bronchodilating drug. In general, bronchodilators are 

given with caution to people with impaired cardiac function. 

Nervousness, irritability, gastritis, or palpitations of the heart 

may occur. 

bronchofibroscopy, the visual examination of the tracheobronchial 

tree through a fiberoptic bronchoscope. It is 

also used for diagnosing/treating hemoptysis. See also 

fiberoptic bronchoscopy. 

bronchogenic /-jenik/ [Gk, bronchos genein, to produce], 

originating in the bronchi. 

bronchogenic adenocarcinoma, the more common type 

of adenocarcinoma of the lung. See also adenocarcinoma of 

the lung. Compare bronchioloalveolar carcinoma. 

bronchogenic carcinoma, one of the more than 90% of 

malignant lung tumors that originate in bronchi. Lesions, 

usually resulting from cigarette smoking, may cause coughing 

and wheezing, fatigue, chest tightness, and aching joints. 

In the late stages, bloody sputum, clubbing of the fingers, 

weight loss, and pleural effusion may be present. Diagnosis 

is made by bronchoscopy, sputum cytologic examination, 

lymph node biopsy, radioisotope scanning procedures, or exploratory 

surgery. Surgery is the most effective treatment, 

but well over 50% of cases are unresectable when first detected. 

Palliative treatment includes radiotherapy and chemotherapy. 

Bronchogenic carcinoma (Kumar et al, 2007) 

bronchogenic cyst, a cyst that develops in the lungs or 

mediastinum. It may be asymptomatic or cause cough, stridor, 

wheezing, or dyspnea. It may also become infected or 

malignant, requiring surgical removal. 

bronchogram /brongkō·gram/ [Gk, bronchos, windpipe 

gramma, something drawn or written], the radiogram obtained 

by bronchography. 

bronchography /brongkogrYfē/, an x-ray examination of 

the bronchi after they have been coated with a radiopaque 

substance. 

broncholithiasis /-lithīYsis/, inflammation of the bronchi 

caused by an accumulation of hard concretions or stones on 

their lining. 

bronchomediastinal trunk, one of the two lymphatic 

vessels, right and left, that drain the lung and bronchi, mediastinal 

structures, and thoracic wall. 

bronchomotor tone, the state of contraction or relaxation 

of the smooth muscle in the bronchial walls that regulates 

the caliber of the airways. 

bronchophony /brongkofYnē/ [Gk, bronchos phone, 

voice], an increase in the intensity and clarity of vocal 

resonance that may result from an increase in lung tissue 

density, such as in the consolidation of pneumonia. Assessed 

by having the patient repeat a phrase such as 99 during auscultation. 

bronchopleural fistula /-ploo ˘ rYl/, an abnormal passageway 

between a bronchus and the pleural cavity. 

bronchopneumonia [Gk, bronchos pneumon, lung], 

an acute inflammation of the lungs and bronchioles, characterized 

by chills, fever, high pulse and respiratory rates, 

bronchial breathing, cough with purulent bloody sputum, severe 

chest pain, and abdominal distension. The disease is 

usually a result of the spread of infection from the upper to 

the lower respiratory tract, most common caused by the bacterium 

Mycoplasma pneumoniae, Staphylococcus pyogenes, 

or Streptococcus pneumoniae. Atypical forms of bronchopneumonia 

may occur in viral and rickettsial infections. The 

most common cause in infancy is the respiratory syncytial 

virus. Bronchopneumonia may lead to pleural effusion, empyema, 

lung abscess, peripheral thrombophlebitis, respiratory 

failure, congestive heart failure, and jaundice. Treatment 

includes administration of an antibiotic, oxygen 

therapy, supportive measures to keep the bronchi clear of secretions, 

and relief of pleural pain. Also called bronchial 

pneumonia, catarrhal pneumonia. Compare aspiration 

pneumonia, eosinophilic pneumonia, interstitial pneumonia. 

See also lobar pneumonia, respiratory syncytial 

virus. 

bronchoprovocation inhalation test, a pulmonary function 

test performed on patients with a history of asthma who 

have normal pulmonary function at rest. In a specific test, the 

patient inhales a particular antigen while the forced expiratory 

volume (FEV) is measured. In a nonspecific test, the patient 

inhales a substance such as histamine periodically at increasing 

concentrations while the FEV is measured. 

bronchopulmonary /-pulmōnerē/ [Gk, bronchos L, 

pulmonis, lung], pertaining to the bronchi and the lungs. 

bronchopulmonary dysplasia (BPD) /-poo ˘ lmYnerē/, 

a chronic respiratory disorder characterized by scarring of 

lung tissue, thickened pulmonary arterial walls, and mismatch 

between lung ventilation and perfusion. It often occurs 

in infants who have been dependent on long-term artificial 

ventilation. 

bronchopulmonary hygiene, the care and cleanliness of 

the respiratory tract and of ventilatory/respiratory therapy. 

Hygienic care may include providing assistance with postural 

drainage and controlled coughing techniques, percussion, 

vibration, nasotracheal or endotracheal suctioning, and 

rib shaking. Respiratory care equipment is a potential source 

and reservoir of infectious organisms and must be cleaned 

and sterilized periodically.

onchopulmonary lavage 262 bronchotracheal 

Bronchopneumonia 

(Kumar, Abbas, and Fausto, 2005) 

bronchopulmonary lavage [Gk, bronchos, windpipe; L, 

pulmonis, lung; Fr, lavage, washing out], the irrigation or 

washing out of the bronchi and bronchioles to remove pulmonary 

secretions. 

bronchopulmonary segment, the area of lung supplied 

by a segmental bronchus and its accompanying pulmonary 

artery branch. Each segment is shaped like an irregular cone 

with the apex at the origin of the segmental bronchus and the 

base projected peripherally onto the surface of the lung. 

bronchoscope /brongkYskōp/, a curved, flexible tube for 

visual examination of the bronchi. It contains fibers that 

carry light down the tube and project an enlarged image up 

the tube to the viewer. The bronchoscope is used to examine 

the bronchi, to secure a specimen for biopsy or culture, or to 

aspirate secretions or a foreign body from the respiratory 

tract. See also fiberoptic bronchoscopy. —bronchoscopic, 

adj. 

Fiberoptic bronchoscope 

(Lewis et al, 2007/Courtesy Olympus America, Inc.) 

bronchoscopy /brongkoskYpē/, the visual examination of 

the tracheobronchial tree, using the standard rigid, tubular 

metal bronchoscope or the narrower, flexible fiberoptic bronchoscope. 

The procedure also may be used for suctioning, 

for obtaining a biopsy specimen and fluid or sputum for examination, 

for removing foreign bodies, and for diagnosing 

such conditions as localized atelectasis, bronchial obstruction, 

lung abscess, and tracheal extubation. See also bronchial 

washing, bronchoscope. 

To remote viewer 

Flexible 

bronchoscopic 

tube 

Eyepiece 

Open channel 

Fiberoptic tube 

connected to 

cold light source 

Suction 

tubing 

Bronchoscopy (Elkin, Perry, and Potter, 2007) 

In-line 

sputum 

trap 

bronchospasm /-spazYm/, an excessive and prolonged 

contraction of the smooth muscle of the bronchi and bronchioles, 

resulting in an acute narrowing and obstruction of 

the respiratory airway. The contractions may be localized or 

general and may be caused by irritation or injury to the respiratory 

mucosa, infections, or allergies. A cough with generalized 

wheezing usually indicates the condition. Bronchospasm 

is a chief characteristic of asthma. Treatment includes 

the use of active bronchodilators, catecholamines, corticosteroids, 

or methylxanthines and preventive drugs such as 

cromolyn sodium. Also called bronchial spasm, bronchiospasm. 

See also asthma, bronchitis. 

bronchospirometry /-spīromYtrē/, a technique for the 

study of the ventilation and gas exchange of each lung separately 

by the introduction of a catheter into either the left or 

the right mainstem bronchus. A double-lumen tube permits 

simultaneous but separate sampling of the gas from both 

lungs. 

bronchotomogram /-tomYgram/, an image of the respiratory 

system from the trachea to the lower bronchi produced 

by tomography. The procedure is used to detect tumors or 

other causes of obstruction of the respiratory tract. 

bronchotracheal. See tracheobronchial.

onchovesicular 263 brucellosis 

bronchovesicular /-vesikyYlYr/, pertaining to the bronchi, 

bronchioles, and alveoli. 

bronchovesicular sounds [Gk, bronchos, windpipe; L, vesicula, 

small bladder, sonus, sound], one of three normal 

breath sounds that occur between the sounds of the bronchial 

tubes and those of the alveoli, or a combination of the two 

sounds. 

bronchus /brongkYs/ pl. bronchi /-kī/ [L; Gk, bronchos, 

windpipe], any one of several large air passages in the 

lungs through which pass inhaled air and exhaled air. Each 

bronchus has a wall consisting of three layers. The outermost 

is made of dense fibrous tissue, reinforced with cartilage. 

The middle layer is a network of smooth muscle. The innermost 

layer consists of ciliated mucous membrane. Kinds of 

bronchi are lobar bronchus (secondary bronchus), primary 

bronchus, and segmental bronchus (tertiary bronchus). 

Also called bronchial tube. See also bronchiole. 

—bronchial, adj. 

Bronkodyl, trademark for a smooth muscle relaxant (theophylline). 

Bronkosol, trademark for a bronchodilator (isoetharine 


Brønsted acid [Johannes N. Brønsted, Danish physical 

chemist, 1879–1947], a molecule or an ion that acts as a 

hydrogen ion donor. 

Brønsted base [Johannes N. Brønsted], a molecule or an 

ion that acts as a hydrogen ion acceptor. 

brontophobia. See tonitrophobia. 

bronze diabetes. See exogenous hemochromatosis. 

broth, 1. a fluid culture medium, such as a solution of lactose 

or thioglycollate, used to support the growth of bacteria 

for laboratory analysis. 2. a beverage or other clear fluid 

made with meat extract and water, such as chicken bouillon. 

Brovana, a trademark for arformoterol. 

brow, the forehead, particularly the eyebrow or ridge 

above the eye. 

brow lift, forehead lift. It is the removal or alteration of 

muscles and tissues of forehead to raise the eyebrows and 

minimize frown lines. Compare blepharoplasty. 

brown fat [ME, broun AS, faett, filled], a type of fat 

present in newborns and rarely found in adults. Brown fat is 

a unique source of heat energy for the infant because it has 

greater thermogenic activity than ordinary fat. Brown fat deposits 

occur around the kidneys, neck, and upper chest. 

brownian motion /brounyYn/ [Robert Brown, Scottish 

botanist, 1773–1858], a random movement of microscopic 

particles suspended in a liquid or gas, such as the continuing 

erratic behavior of dust particles in still water. The movement 

is produced by the natural kinetic activity of molecules 

of the fluid that strike the foreign particles. Also called 

brownian movement. 

brownian movement. See brownian motion. 

brown recluse spider, a small poisonous arachnid, 

Loxosceles reclusa, also known as the brown or violin spider, 

found in both North and South America. The bite produces 

a characteristic necrotic lesion. The venom from its 

bite usually creates a blister surrounded by concentric white 

and red circles. This so-called bull’s-eye appearance is helpful 

in distinguishing it from other spider bites. There is little 

or no initial pain, but localized pain develops in about an 

hour. The patient may experience systemic symptoms; nausea, 

fever, and chills are common, but the reaction is usually 

self-limited. Immediate treatment includes keeping the victim 

quiet and immobilizing the bite area at the level of the 

heart. A bleb forms, sometimes in a target or bull’s-eye pattern. 

The blood-filled bleb increases in size and eventually 

ruptures, leaving a black scar. Antivenin is not available in 

the United States. 

Brown recluse spider 

(Auerbach, 2007/Courtesy Indiana University Medical Center) 

Brown recluse spider bite after 48 hours 

(Auerbach, 2007) 

Brown-Séquard’s syndrome /brounsākärz/ [Charles E. 

Brown-Séquard, French physiologist, 1817–1894], a traumatic 

neurologic disorder resulting from compression or 

transection of one side of the spinal cord, above the tenth 

thoracic vertebrae, characterized by spastic paralysis and 

loss of postural sense (proprioception) on the body’s injured 

side, and loss of the senses of pain and heat on the other side 

of the body. 

Brown-Séquard’s treatment. See organotherapy. 

brown spider. See brown recluse spider. 

brow presentation, an obstetric situation in which the 

brow, or forehead, of the fetus is the first part of the body to 

enter the birth canal. Because the diameter of the fetal head 

at this angle may be greater than that of the mother’s pelvic 

outlet, a cesarean section may be recommended. However, 

the fetus usually converts to a vertex presentation. 

Brucella abortus. See abortus fever. 

brucellosis /broo ¯¯¯¯sYlōsis/ [David Bruce, English pathologist, 

1855–1931], a disease caused by any of several species 

of the gram-negative coccobacillus Brucella: Brucella 

melitensis, B. abortus, B. suis, and B. canis, the latter of 

which is very rare and causes only mild illness. Brucellosis 

is most prevalent in rural areas among farmers, veterinarians, 

meat packers, slaughterhouse workers, and livestock 

producers. Laboratory workers are also at risk. It is primarily 

a disease of animals (including cattle, pigs, sheep, camels, 

goats, and dogs); humans usually acquire it by ingestion of

Bruch’s disease 264 bubonic plague 

contaminated milk or milk products or raw meat or marrow, 

through a break in the skin, through contact with an infected 

animal, or through inhalation of dust from contaminated soil. 

It is characterized by fever, chills, sweating, malaise, and 

weakness. The fever often occurs in waves, rising in the 

evening and subsiding during the day, at intervals separated 

by periods of remission. Other signs and symptoms may include 

anorexia and weight loss, headache, muscle and joint 

pain, and an enlarged spleen, and orchiepididymitis in young 

men. In some victims the disease is acute; more often it is 

chronic, recurring over a period of months or years. Although 

brucellosis itself is rarely fatal, treatment is important 

because serious complications such as pneumonia, endocarditis, 

meningitis, and encephalitis can develop. Tetracycline 

plus streptomycin is the treatment of choice; bed rest is also 

important. A vaccine is available outside the United States. 

This organism is considered a potential agent of bioterrorism 

due to its low infectious dose (10-100 organisms) and 

method of infection by way of aerosol, allowing distribution 

over a large area. Also called Cyprus fever, dust fever, 

Gibraltar fever, Malta fever, Mediterranean fever, rock 

fever, undulant fever. See also abortus fever. 

Bruch’s disease. See Marseilles fever. 

Brudzinski’s sign /broo ¯¯¯¯dzinskēz/ [Josef Brudzinski, Polish 

physician, 1874–1917], an involuntary flexion of the hip 

and knee when the neck is passively flexed. It can occur in 

patients with meningitis. 

Brudzinski’s sign (Seidel et al, 2006) 

epithelial cells, particularly the absorptive surfaces of the intestine 

and the proximal convoluted tubules of the kidney. 

Brushfield’s spots [Thomas Brushfield, English physician, 

1858–1937; ME, spotte, stain], pinpoint white or light yellow 

spots on the iris of a child with Down syndrome. Occasionally, 

they are seen in normal infants. 

Bruton’s agammaglobulinemia [Ogden C. Bruton, American 

physician, b. 1908], a sex-linked, inherited condition 

characterized by the absence of gamma globulin in the 

blood. Those (usually children) affected by the syndrome are 

deficient in antibodies and susceptible to repeated infections. 

Compare agammaglobulinemia. 

bruxism /bruksizYm/ [Gk, brychein, to gnash the teeth], 

the compulsive, unconscious grinding or clenching of the 

teeth, especially during sleep or as a mechanism for releasing 

tension during periods of extreme stress in the waking 

hours. Also called bruxomania. See also attrition. 

bruxomania. See bruxism. 

bry-, prefix meaning “tree moss”: bryocyte, bryocytole. 

Bryant’s traction [Thomas Bryant, English physician, 

1828–1914; L, trahere, to pull], an orthopedic mechanism 

used to immobilize both lower extremities in the treatment 

of a fractured femur or in the correction of a congenital hip 

dislocation. The mechanism consists of a traction frame supporting 

weights, which are connected by ropes that run 

through pulleys to traction foot plates. The traction pull elevates 

the lower extremities to a vertical position with the 

patient supine, the trunk and the lower extremities forming a 

right angle. The weight applied to the traction mechanism is 

usually less than 35 pounds. Compare Buck’s traction. 

BSA, 1. abbreviation for body surface area. See surface 

area. 2. abbreviation for bovine serum albumin. 

BSE, abbreviation for breast self-examination. 

BSE, 1. abbreviation for breast self-examination. See 

self-breast examination. 2. Abbreviation for bovine 

spongiform encephalopathy. 

BSN, abbreviation for Bachelor of Science in Nursing. 

BSP, abbreviation for Bromsulphalein. 

BT, abbreviation for bleeding time. 

BTPD, abbreviation for body temperature, ambient 

pressure, dry. 

BTPS, abbreviation for body temperature, ambient pressure, 

saturated (with water vapor). See also volume BTPS. 

BTU, abbreviation for British thermal unit. 

buba. See yaws. 

bubble-diffusion humidifier, a device that provides humidified 

oxygen or other therapeutic gases by allowing the 

gas to bubble through a reservoir of water. 

bubble goniometer, a device used for measuring joint 

angles, consisting of a spirit level and a pendulum. 

bubble oxygenator, a heart-lung device that oxygenates 

the blood while it is diverted outside the patient’s body. 

Brueghel’s syndrome. See Meige’s syndrome (def. 1). 

Brugia /brujY/ [S.L. Brug, Dutch parasitologist in Indonesia, 

1879–1946], a genus of nematodes of the superfamily Filarioidea 

that parasitize humans and other mammals. See 

also filariasis. 

bruise. See contusion, ecchymosis. 

bruit /broo ¯¯¯¯ē/ [Fr, noise], an abnormal blowing or swishing 

sound or murmur heard while auscultating a carotid artery, bubo /byoo ¯¯¯¯bō/ pl. buboes [Gk, boubon, groin], a greatly 

the aorta, an organ, or a gland, such as the liver or thyroid, enlarged, tender, inflamed lymph node usually in the groin 

and resulting from blood flowing through a narrow or par- that is associated with diseases such as chancroid, lymtially 

occluded artery. The specific character of the bruit, its phogranuloma venereum, and syphilis. Treatment includes 

location, and the time of its occurrence in a cycle of other specific antibiotic therapy, application of moist heat, and 

sounds are all of diagnostic importance. Bruits are usually of 

low frequency and are heard best with the bell of a stetho- 

sometimes incision and drainage. 

bubonic plague /byoo ¯¯¯¯bonik/ [Gk, boubon, groin; L, plaga, 

scope. 

Brunnstrom hemiplegia classification, an evaluation 

stroke], the most common form of plague. It is characterized 

by painful buboes in the axilla, groin, or neck; fever 

procedure that assesses muscle tone and voluntary control of often rising to 106° F (41.11° C); prostration with a rapid, 

movement patterns in a stroke patient. Results indicate the thready pulse; hypotension; delirium; and bleeding into the 

patient’s progress through stages of recovery. 

brush biopsy, the use of a catheter with bristles that is in- 

skin from the superficial blood vessels. The symptoms are 

caused by an endotoxin released by a bacillus, Yersinia pesserted 

into the body to collect cells from tissues. 

brush border, microvilli on the free surfaces of certain 

tis, usually introduced into the body by the bite of a rat flea 

that has bitten an infected rat. Inoculation with plague vac-

ucardia 265 buccopharyngeal 

Bubble diffusion humidifiers 

(Harkreader and Hogan, 2007/Courtesy Allied Health Care) 

cine confers partial immunity; infection provides lifetime 

immunity. Treatment includes antibiotics, supportive nursing 

care, surgical drainage of buboes, isolation, and stringent 

precautions against spread of the disease. Conditions favor a 

plague epidemic when a large infected rodent population 

lives with a large nonimmune human population in a damp, 

warm climate. Improved sanitary conditions and eradication 

of rats and other rodent reservoirs of Y. pestis may prevent 

outbreaks of the disease. Killing the infected rodents, which 

may include ground squirrels and rabbits, and not the fleas 

allows a continued threat of human infection. It is a possible 

agent of bioterrorism if the bacilli are aerosolized and has 

the highest potential for negative public health. Also called 

(informal) black death, black plague. Compare pneumonic 

plague, septicemic plague. See also bubo, plague, Yersinia 

pestis. 

bucardia /boo ¯¯¯¯kärdē·Y/, extreme enlargement of the heart. 

bucca-. See bucco-. 

buccal /bukYl/ pl. bucca [L, bucca, cheek], pertaining to 

the inside of the cheek, the surface of a tooth, or the gum beside 

the cheek. 

buccal administration of medication, oral administration 

of a drug, usually in the form of a tablet, by placing it 

between the cheek and the teeth or gum until it dissolves. 

buccal artery, a branch of the maxillary artery that supplies 

the buccinator muscle, the skin, and mucous membrane 

of the cheek. See also buccinator. 

buccal bar, a portion of an orthodontic appliance consisting 

of a rigid metal wire that extends anteriorly from the 

buccal side of a molar band. See also arch bar, labial bar, 

lingual bar. 

buccal cavity, the vestibule of the mouth, specifically the 

area lying between the teeth and cheeks. 

buccal contour [L, bucca cum, together with, tornare, to 

turn], the shape of the buccal side of a posterior tooth. It is 

usually characterized by a slight occlusocervical convexity 

that has its largest prominence at the gingival third of the 

clinical buccal surface. 

buccal fat pad, a fat pad in the cheek under the subcutaneous 

layer of the skin, over the buccinator. It is particularly 

prominent in infants and is often called a sucking pad. 

buccal fentanyl, an opioid analgesic. 

INDICATIONS: This drug is used to treat breakthrough pain 

in cancer patients who are taking regularly scheduled doses 

of another opiate pain medication and who are tolerant to 

opiates. 

CONTRAINDICATIONS: Known intolerance or hypersensitivity 

to this drug or its components prohibits its use. This drug 

must not be used in the management of acute or postoperative 

pain. 

ADVERSE EFFECTS: Adverse effects of this drug include dizziness, 

delirium, euphoria, lightheadedness, sedation, dysphoria, 

agitation, anxiety, confusion, headache, depression, 

bradycardia, hypotension, hypertension, facial flushing, 

chills, chest pain, dysrhythmias, blurred vision, miosis, nausea, 

vomiting, diarrhea, cramps, anorexia, constipation, dyspepsia, 

urinary retention, urgency, dysuria, frequency, oliguria, 

sweating, pruritus, rash, erythema, papules, asthenia, 

depressed cough, hypoventilation, dyspnea, hiccups, and 

apnea. Life-threatening side effects include cardiac arrest, 

respiratory depression, laryngospasm, and bronchospasm. 

buccal flange [L, bucca OFr, flanche, flank], the portion 

of a denture base that occupies the cheek side of the mouth 

and extends distally from the buccal notch. Compare labial 

flange, lingual flange. See also flange. 

buccal frenum, a fold or band of mucous membrane connecting 

the alveolar ridge to the cheek and separating the labial 

vestibule from the buccal vestibule. 

buccal glands [L, bucca, cheek, glans, acorn], small salivary 

glands located between the buccinator muscle and the 

mucous membranes in the vestibule of the mouth. 

buccal mucosa, the mucous membranes lining the inside 

of the mouth. 

buccal nerve, a branch of the anterior trunk of the mandibular 

nerve that supplies general sensory nerves to the skin 

of the cheek, oral mucosa, and buccal gingivae of the lower 

molars. It may also carry the motor innervations to the lateral 

pterygoid muscle and to part of the temporalis muscle. 

buccal notch, a depression in a denture flange that accommodates 

the buccal frenum. See also labial notch. 

buccal smear, a sample of cells removed from the buccal 

mucosa for purposes of obtaining a karyotype to determine 

the genetic sex of an individual. 

buccal splint, material, usually plaster, that is placed on 

the buccal surfaces of fixed partial denture units to hold the 

units in position for assembly. 

buccal vestibule, that portion of the vestibule of the 

mouth that lies between the cheeks and the teeth and gingivae 

or residual alveolar ridges. 

bucci-. See bucco-. 

buccinator /buksinātYr/ [L, buccina, trumpet], the main 

muscle of the cheek, one of the 12 muscles of the mouth. It 

is pierced by the duct of the parotid gland opposite the second 

molar tooth. The buccinator, innervated by buccal 

branches of the facial nerve, compresses the cheek, acting as 

an important accessory muscle of mastication by holding 

food under the teeth. 

bucco-, bucc-, bucca-, bucci-, combining form meaning 

“cheek”: buccodistal, buccal, buccinator. 

buccoclusion /bukY·kloo ¯¯¯¯zhYn/ [L, bucca, cheek 

occludere, to close up], a malocclusion in which the dental 

arch or the quadrant of a dental arch or group of teeth is positioned 

closer to the cheek than normal. 

buccogingival /bukōjinjīvYl/, pertaining to the internal 

mouth structures, particularly the cheeks and gums. 

buccolinguomasticatory triad /bukōlingwōmastYkYtôre/ 

[L, bucca, cheek, lingua, tongue, masticare, to gnash 

the teeth], a complex of involuntary lip, tongue, jaw, and 

head movements seen in tardive dyskinesia. 

buccopharyngeal /bukōfYrinjē·Yl/, pertaining to the 

cheek and the pharynx or to the mouth and the pharynx.

uccopharyngeal fascia 266 buddy splint 

Parotid 

duct (cut) 

Buccinator muscle 

Pterygomandibular raphe 

Superior pharyngeal 

constrictor muscle 

Buccinator (Drake, Vogl, and Mitchell, 2005) 

buccopharyngeal fascia, a thin layer of fascia that coats 

the outside of the muscular part of the pharyngeal wall. 

buccopharyngeal membrane. See pharyngeal membrane. 

buccula /bukyYlY/ [L, bucca, cheek], a fold of fatty tissue, 

literally a “little cheek” beneath the chin. Also called double 

chin. 

bucket handle fracture [OFr, buket, tub; ME, handel, part 

grasped; L, fractura, break], a fracture that produces a tear 

in a semilunar cartilage along the medial side of the knee 

joint. 

bucking informal. 1. gagging, coughing. 2. involuntarily 

resisting positive pressure ventilation in a patient with an endotracheal 

tube in place. 

buck knife, a periodontal surgical knife with a spearshaped 

cutting point, used to make an interdental incision associated 

with a gingivectomy. 

Buck’s fascia [Gurdon Buck, American surgeon, 1807– 

1877], the deep fascia encasing the erectile tissue of the 

penis. 

Buck’s skin traction [Gurdon Buck], an orthopedic procedure 

that applies traction to the lower extremity with the 

hips and the knees extended. It is used in the treatment of hip 

and knee contractures, in postoperative positioning and immobilization, 

and in disease processes of the hip and the 

knee. It is also used to maintain alignment of the hip and leg 

in patients with hip fractures until reduction of the hip can be 

performed. This type of traction may be unilateral, involving 

one leg, or bilateral, involving both legs. 

Buck’s traction [Gurdon Buck; L, trahere, to pull], 

one of the most common orthopedic mechanisms by which 

pull is exerted on the lower extremity with a system of ropes, 

weights, and pulleys. Buck’s traction, which may be unilateral 

or bilateral, is used to immobilize, position, and align 

the lower extremity in the treatment of contractures and diseases 

of the hip and knee. The mechanism commonly consists 

of a metal bar extending from a frame at the foot of the 

patient’s bed, supporting traction weights connected by a 

rope passing through a pulley to a cast or a splint around the 

affected body structure. Compare Bryant’s traction. 

buckwheat allergy, an allergic reaction to buckwheat 

Fagopyrum esculentum, characterized primarily by photosensitivity. 

It is seen in susceptible humans who eat grain 

and in ruminants that eat excessive numbers of buckwheat 

plants. Also called fagopyrism. 

Bucky diaphragm [Gustav P. Bucky, American radiologist, 

1880–1963; Gk, diaphragma, partition], a moving grid 

that limits the amount of scattered radiation reaching a radiographic 

film, thereby increasing the film contrast. Also 

called Bucky grid. 

buclizine hydrochloride /boo ¯¯¯¯klYzēn/, an antiemetic/ 

antivertigo drug derived from piperazine that has anticholinergic 

and antihistaminic properties. It is used to treat nausea, 

vomiting, and dizziness of motion sickness. 

bud [ME, budde], any small outgrowth that is the beginning 

stage of a living structure, as a limb bud from which an 

upper or lower limb develops. 

Budd-Chiari syndrome /budkē·ärē/ [George Budd, English 

physician, 1808–1882; Hans Chiari, Czech-French pathologist, 

1851–1916], a disorder of hepatic circulation, 

marked by occlusion of the hepatic veins, that leads to liver 

enlargement, ascites, extensive development of collateral 

vessels, and severe portal hypertension. It may be congenital. 

Also called Chiari’s syndrome, Rokitansky’s disease. 

Budd-Chiari syndrome (Kumar et al, 2007) 

budding [ME, budde], a type of asexual reproduction in 

which an organism produces a budlike projection containing 

chromatin that eventually detaches and develops into an independent 

organism. It is common in simple organisms, such 

as sponges, yeasts, and molds. 

buddy splint, a splinting technique commonly used after a 

finger or toe injury requiring immobilization. The injured 

and an adjacent digit are typically taped together to limit the 

range of motion of the affected digit. Also called buddy 

tape.

uddy tape 267 bulbospongiosus 

Budding (Forbes, Sahm, and Weissfeld, 2007) 

buddy tape. See buddy splint. 

budesonide, a nasal corticosteroid antiinflammatory agent. 

It is available under the brand name Pulmicort as a 

turboinhaler (used in the mouth) and for use in nebulizers. 

INDICATIONS: It is prescribed in the management of symptoms 

of seasonal or perennial allergic rhinitis or perennial 

nonallergic rhinitis. Neublizer solutions are used for the 

treatment of asthma in children. 

CONTRAINDICATIONS: The drug should not be given to patients 

who have an allergic reaction to the drug or to any of 

its components or to patients with an untreated infection of 

the mucous membranes. 

ADVERSE EFFECTS: The side effects most often reported include 

nasal or throat irritation, stinging, burning, or dryness 

in the respiratory system, nosebleeds, sneezing, and congestion. 

Buerger’s disease. See thromboangiitis obliterans. 

Buerger’s postural exercises [Leo Buerger, American physician, 

1879–1943; L, ponere, to place, exercere, to continue 

working], exercises designed to maintain circulation in 

a limb. 

buffalo hump, an accumulation of fat on the back of the 

neck associated with the prolonged use of large doses of glucocorticoids 

or the hypersecretion of cortisol caused by 

Cushing’s syndrome. 

Buffalo hump (Zitelli and Davis, 2007) 

buffer [ME, buffe, to cushion], a substance or group of substances 

that tends to control the hydrogen ion concentration 

in a solution by reacting with hydrogen ions of an acid added 

to the system and releasing hydrogen ions to a base added to 

the system. Buffers minimize significant changes of pH in a 

chemical system. Among the functions carried out by buffer 

systems in the body is maintenance of the acid-base balance 

of the blood and of the proper pH in kidney tubules. See also 

blood buffers, pH. 

buffer anions, the negatively charged bicarbonate, protein, 

and phosphate ions that comprise the buffer systems of 

the body. 

buffer cations, the positively charged ions associated with 

the buffering anions of the body’s electrolytes, mainly protein 

cations. 

buffered insulin human, human insulin buffered with 

phosphate. It is used particularly in continuous infusion 

pumps but is also administered subcutaneously, intramuscularly, 

or intravenously. 

buffer solution [ME, buffet L, solutus, dissolved], 

a solution that will minimize changes in pH value despite dilution 

or addition of a small amount of base or acid. 

buffy coat [ME, buffet Fr, cote], a grayish white layer of 

white blood cells and platelets that accumulates on the surface 

of sedimented erythrocytes when blood is allowed to 

stand or is centrifuged. 

buffy coat transfusion, light stratum of a blood clot seen 

when the blood is centrifuged or allowed to stand in a test 

tube. See also granulocyte transfusion. 

bug, an error in a computer program (software bug) or a 

design flaw in computer hardware (hardware bug), usually 

resulting in an inability to process data correctly. 

bulb [L, bulbus, swollen root], any rounded structure, such 

as the eyeball, hair roots, and certain sensory nerve endings. 

bulbar /bulbYr/ [L, bulbus], 1. pertaining to a bulb. 

2. pertaining to the medulla oblongata of the brain and the 

cranial nerves. 

bulbar ataxia [L, bulbus, swollen root; Gk, ataxia, without 

order], a loss of motor coordination caused by a lesion in 

the medulla oblongata or pons. 

bulbar conjunctiva. See conjunctiva. 

bulbar myelitis [L, bulbus, swollen root; Gk, myelos, marrow, 

itis, inflammation], an inflammation of the central 

nervous system involving the medulla oblongata. 

bulbar palsy [L, bulbus, swollen root; Gk, paralyein, to be 

palsied], a form of paralysis resulting from a defect in the 

motor centers of the medulla oblongata. See also bulbar 

poliomyelitis. 

bulbar paralysis, a degenerative neurologic condition 

characterized by progressive paralysis of cranial nerves and 

involving the lips, tongue, mouth, pharynx, and larynx. The 

condition occurs most commonly in people over 50 years of 

age, in multiple sclerosis, and in amyotrophic lateral sclerosis. 

bulbar poliomyelitis [L, bulbus, swollen root; Gk, polios, 

gray, myelos, marrow, itis, inflammation], a form of poliomyelitis 

that involves the medulla oblongata and gradually 

progresses to bulbar paralysis, with respiratory and circulatory 

failure. 

bulbiform /bulbifôrm/, shaped like a bulb. 

bulbocavernosus /bulbōkavYrnōsYs/ [L, bulbus, swollen 

root, cavernosum, full of hollows]. See bulbospongiosus. 

bulbocavernosus reflex, bulbospongiosus reflex, 

the contraction of the bulbospongiosus muscle when the dorsum 

of the penis is tapped or the glans penis is compressed. 

Also called penile reflex. 

bulbospongiosus, a muscle that covers the bulb of the 

penis in the male and the bulbus vestibuli in the female. Also 

called accelerator urinae, ejaculator urinae. Formerly 

called bulbocavernosus.

ulbourethral gland 268 bundle branch 

bulbourethral gland /-yoo ¯¯¯¯rēthrYl/, one of two small 

glands located on each side of the prostate, draining to the 

wall of the urethra. Bulbourethral glands secrete a fluid component 

of the seminal fluid. Also called Cowper’s gland. 

bulbous [L, bulbus, swollen root], pertaining to a structure 

that resembles a bulb or that originates in a bulb. 

bulb syringe, a device with a flexible bulb that replaces 

the plunger for instillation or aspiration. Bulb syringes can 

be used to irrigate an external orifice, such as the auditory 

canal. See also syringe. 

bulbus oculi. See eye. 

-bulia, -boulia, suffix meaning “(condition of the) will”: 

abulia, hyperbulia. 

bulimia /boo ¯¯¯¯limē·Y/ [Gk,bous, ox, limos, hunger], a disorder 

characterized by an insatiable craving for food, often 

resulting in episodes of continuous eating and often followed 

by purging, depression, and self-deprivation. Also called 

binge eating. See also anorexia nervosa. 

bulimic /boo ¯¯¯¯limik/, pertaining to bulimia. 

bulk. See dietary fiber. 

bulk cathartic [ME, bulke, heap; Gk, kathartikos, evacuation 

of bowels], a cathartic (laxative) that acts by softening 

and increasing the mass of fecal material in the bowel. Bulk 

cathartics contain a hydrophilic agent such as methylcellulose 

or psyllium seed. 

bulla /boo ˘ lY, bulY/ pl. bullae [L, bubble], a thin-walled 

blister of the skin or mucous membranes greater than 1 cm in 

diameter containing clear, serous fluid. Compare vesical. 

—bullous, adj. 

Bulla (du Vivier, 1993) 

bulldog forceps, short spring forceps for clamping an artery 

or vein for hemostasis. The jaws may be padded to prevent 

injury to vascular tissue. 

bullet forceps, a kind of forceps that has thin, curved, serrated 

blades that are designed for extracting a foreign object, 

such as a bullet, from the base of a puncture wound. 

bullous. See bulla. 

bullous disease /boo ˘ lYs/, any disease marked by eruptions 

of blisters, or bullae, filled with fluid, on the skin or mucous 

membranes. An example is pemphigus. 

bullous emphysema, single or multiple large cystic alveolar 

dilations of lung tissue. Also called cystic 

emphysema. 

bullous impetigo, a form of impetigo in which the skin lesions 

are bullae instead of vesicles. The crusts are thin and 

greenish yellow. Infection is treated with oral antistaphylococcal 

antibiotics. 

bullous myringitis [L, bulla myringa, eardrum], 

an inflammatory condition of the eardrum, characterized by 

painful fluid-filled vesicles on the tympanic membrane and 

the sudden onset of severe pain in the ear. The condition 

often occurs with bacterial otitis media. Treatment includes 

administration of antibiotics and analgesics and surgical 

draining of the vesicles. See also otitis media. 

Bullous myringitis (Swartz, 2006) 

bullous pemphigoid [L, bulla, bubble; Gk, pemphix, 

bubble, eidos, form], a rare, relatively benign subepidermal 

autoimmune blistering disease of the elderly. It is of unknown 

origin. 

Bullous pemphigoid (Callen et al, 2000) 

bullseye rash. See erythema migrans. 

bumetanide /boo ¯¯¯¯metYnīd/, a loop (high ceiling) diuretic 

related to furosemide. 

INDICATIONS: It is prescribed for edema caused by cardiac, 

hepatic, or renal disease. 

CONTRAINDICATIONS: Anuria, electrolyte depletion, or 

known sensitivity to this drug prohibits its use. 


are hypokalemia, hyperuricemia, and azotemia. 

Bumex, trademark for a diuretic (bumetanide). 

Buminate, trademark for a blood volume expander 

(human albumin). 

BUN, abbreviation for blood urea nitrogen. 

-bund, suffix meaning “prone to” something specified: 

moribund. 

bundle, a group of nerve fibers or other threadlike structures 

running in the same direction. See also fasciculus. 

bundle branch [Dan, bondel Fr, branche], a segment of

undle branch block 269 Burkholderia 

the network of specialized conducting fibers that transmits buoyant density, the thickness or compactness of a sub- 

electrical impulses within the ventricles of the heart. Bundle 

branches are a continuation of the atrioventricular (AV) 

bundle, which extends from the upper part of the intravenstance 

that allows it to float in a standard fluid. 

buphthalmos. See congenital glaucoma. 

bupivacaine hydrochloride /byoo ˘ pivYkān/, a local anestricular 

septum. The AV bundle divides into a left and a right thetic. 

branch, each going to its respective ventricle by passing 

down the septum and beneath the endocardium. Within the 

INDICATIONS: It is prescribed for caudal, epidural, peripheral, 

or sympathetic anesthetic block. 

ventricles the bundle branches subdivide and terminate in 

the Purkinje fibers. 

bundle branch block (BBB), an inability of cardiac im- 


or to any of the amide class of local anesthetics prohibits 

its use. 

pulses to be conducted down the bundle branches, causing a 

broad and abnormally shaped QRS complex. BBB is com- 


are central nervous system disturbances, cardiovascular 

monly seen in high-risk, acute, anterior wall myocardial in- depression, respiratory arrest, cardiac arrest, and hypersensifarction. 

It may be caused by ischemia or necrosis of the tivity reactions. 

bundle branches, trauma (as in surgical manipulation), or Buprenex, trademark for a parenteral analgesic (buprenor- 

mechanical compression of the branches by a tumor. A pacemaker 

may be inserted if further deterioration of conduction 

phine hydrochloride). 

buprenorphine /buprĕ-norfēn/, a synthetic opioid 

is anticipated. See also left bundle branch block, right agonist-antagonist derived from thebaine, used in the form 

bundle branch block. 

bundle of His. See atrioventricular (AV) bundle. 

bunion /bunyYn/ [Gk, bounion, turnip], an abnormal, me- 

of the hydrochloride salt as an analgesic for moderate to severe 

pain and as an anesthesia adjunct. Administered sublingually 

or by intramuscular or IV injection. 

dial enlargement of the joint at the base of the great toe. It is 

caused by inflammation of the bursa, usually as a result of 

INDICATIONS: It is administered parenterally for the relief 

of moderate to severe pain and is used in tablet form to treat 

heredity, degenerative joint disease, or chronic irritation and opioid dependence. 

pressure from poorly fitted shoes. It is characterized by soreness, 

swelling, thickening of the skin, and lateral displace- 

CONTRAINDICATION: This Schedule V controlled substance 

is contraindicated for patients who may be opioid dependent. 

ment of the great toe. 

ADVERSE EFFECTS: Among the reported adverse effects are 

respiratory depression, sedation, nausea, dizziness, vertigo, 

headache, vomiting, miosis, diaphoresis, and hypotension. 

buPROPion /boo ˘ prōpē·on/, a heterocyclic moodelevating 

drug used to treat some types of depression (trademark: 

Wellbutrin) and also to promote smoking cessation 

(trademark: Zyban). 

bur. See burr. 

Burch procedure /berch/, a type of bladder neck suspension 

for stress incontinence, consisting of fixation of the lateral 

vaginal fornices to the iliopectineal ligaments. 

burden, 1. load. 2. a heavy, oppressive load, as a disabling 

clinical load. 

burdock root, a perennial herb found in the United States, 

Bunion (du Vivier, 1993) 

China, and Europe. 

USES: This herb is used for skin diseases, inflammation, 

rashes, colds and fever, cancer, gout, and arthritis; insufficient 

data to know if it is effective. 

bunionectomy /bunyYnektYmē/, excision of a bunion. 

bunionette /bunyYnet/, an abnormal enlargement and in- 

CONTRAINDICATIONS: Burdock is probably safe except in 

those who are hypersensitive to this plant. Burdock also 

flammation of the joint at the base of the small toe. Also should be used cautiously in people with diabetes or cardiac 

called tailor’s bunion. 

Bunnell block, trademark for a small wooden block used 

disorders. 

Bureau of Medical Devices (BMD). See National Cen- 

in exercise of the fingers after surgery. The exercises with the ter for Devices and Radiological Health. 

block allow each joint to be exercised individually with full buret, burette /byoo ˘ ret/ [Fr, small jug], a laboratory uten- 

tendon excursion while the other joints are held extended. 

Bunsen burner /boo ˘ nsYn, bunsYn/ [Robert E.W. Bunsen, 

German chemist, 1811–1899], a standard laboratory gas 

sil used to deliver a wide range of volumes accurately. 

buried penis, concealed penis. 

buried suture [L, sutura], a suture, often absorbable, that 

burner designed to produce nearly complete combustion in a is inserted to draw together soft tissues between the viscus 

smokeless flame. 

Bunyamwera virus infection /bunyYmwirY/ [Bun- 

and the skin. 

Burke, Mary Lermann, a nursing theorist who, with 

yamwera, town in Uganda where the type species was iso- Georgene Gaskill Eakes and Margaret A. Hainsworth, delated], 

one of a group of arthropod-borne viruses of the veloped the Theory of Chronic Sorrow to describe the on- 

genus Bunyavirus, composed of over 150 virus types in the going feelings of loss that arise from illness, debilitation, or 

family Bunyaviridae, that infect humans and are carried by 

mosquitoes from rodent hosts. Related viruses cause Califor- 

death. 

Burkholderia /bYrkholdērēY/, a genus of gram-negative, 

nia encephalitis, Rift Valley fever, and other diseases charac- aerobic, rod-shaped bacteria that includes several species 

terized by headache, weakness, low-grade fever, myalgia, formerly classified in the genus Pseudomonas, including the 

and a rash. Convalescence is prolonged. Outbreaks have oc- agents of glanders and melioidosis. The bacteria are both 

curred in North America, South America, Africa, and Europe. 

human and plant pathogens. Their role in the biodegradation

Burkholderia cepacia 270 burning mouth syndrome 

of polychlorinated biphenols also makes them important environmental 

bacteria. 

Burkholderia cepacia, formerly Pseudomonas cepacia. A 

group of bacteria found in the environment that is often resistant 

to common antibiotics. Immunocompromised persons 

or those with chronic lung disease, especially cystic fibrosis, 

are susceptible to infection. In patients without cystic 

fibrosis, B. cepacia infections are almost all nosocomial or 

related to IV drug abuse. Outbreaks have been related to 

intra-aortic balloon pumps, contaminated water sources, respiratory 

therapy equipment such as reusable electronic ventilator 

probes or contaminated disinfectants. A variety of approaches 

including strict segregation of cystic fibrosis 

patients based on the presence of this organism have been 

tried in order to reduce nosocomial transmission. Even a 

single significant nosocomial infection with B. cepacia may 

warrant investigation. 

Burkholderia mallei, a nonmotile species that causes 

glanders. It is primarily a disease of horses, mules, and donkeys 

but may also infect humans and other animals. It is a 

potential agent for bioterrorism. 

Burkholderia pickettii, formerly called Pseudomonas 

pickettii. B. pickettii has been responsible for epidemics of 

bloodstream infections associated with contaminated distilled 

or sterile water. 

Burkholderia pseudomallei, a species that inhabits water 

and soil and causes melioidosis. Infection is spread via contact 

with a contaminated source and is a predominant disease 

of tropical climates. The species is a potential agent for bioterrorism. 

See also melioidosis. 

Burkitt’s lymphoma /burkits/ [Denis P. Burkitt, English 

surgeon in Africa, b. 1911], a malignant neoplasm composed 

of undifferentiated lymphoreticular cells that form a 

large osteolytic lesion in the jaw or, in children, an abdominal 

mass. The tumor, which is seen chiefly in Central Africa, 

is characteristically a gray-white mass sometimes containing 

areas of hemorrhage and necrosis. Central nervous system 

involvement often occurs, and other organs may be affected. 

The Epstein-Barr virus (EBV), a herpesvirus, is associated 

with this lymphoma. Chemotherapy can often cure 

the disease. Also called African lymphoma, Burkitt’s 

tumor. 

burn [AS, baernan], any injury to tissues of the body 

caused by hot objects or flames, electricity, chemicals, radiation, 

or gases in which the extent of the injury is determined 

by the nature of the agent, length of time exposed, body part 

involved, and depth of burn. The treatment of burns includes 

pain relief, careful asepsis, prevention of infection, regulation 

of body temperature, maintenance of the balance in the 

body of fluids and electrolytes, and good nutrition. First priority 

with burns of the airway is airway control. Severe 

burns of any origin may cause shock, which is treated before 

the wound. Burns are sometimes classified as first, second, 

third, and fourth degree. First-degree burns involve only a 

superficial layer of epidermal cells. Second-degree burns 

may be divided into superficial partial-thickness and deep 

partial-thickness wounds. Damage in second-degree burns 

extends through the epidermis to the dermis but is usually 

not sufficient to prevent skin regeneration. In third-degree 

burns the entire thickness of the epidermis and dermis is destroyed. 

Fourth-degree burns are full-thickness injuries that 

penetrate the subcutaneous tissue, muscle, and periosteum or 

bone. See also chemical burn, electrocution, thermal 

burn. 

burn center, a health care facility that is designed to care 

for patients who have been severely burned. A number of 

burn centers has been established throughout the United 

States and Canada to provide sophisticated advanced techniques 

of care for burn victims. 

burner syndrome, a condition of burning pain, especially 

in the upper extremities, and sometimes accompanied by 

shoulder girdle weakness. It may be experienced during contact 

sports, such as football, as a result of a blow to the head 

or shoulder. It is attributed to an upper trunk neuropathy of 

the brachial plexus. 

Burnett’s syndrome. See milk-alkali syndrome. 

burn healing, a nursing outcome from the Nursing Outcomes 

Classification (NOC) defined as the extent of healing 

of a burn site. See also Nursing Outcomes Classification. 

burning drops sign, a sensation of hot liquid dripping 

into the abdominal cavity caused by a perforated stomach 

ulcer. 

burning feet syndrome, a neurologic disorder characterized 

by symptoms of a burning sensation in the sole of the 

foot. The burning tends to be more intense at night and may 

also involve the hands. Possible causes include causalgia 

from injury to the sciatic nerve, degeneration of the spinal 

cord, and polyneuropathy. The condition is also associated 

with diabetes mellitus, kidney disease, and a B vitamin deficiency. 

Also known as Gopalan’s syndrome. 

burning mouth syndrome, a burning sensation in the 

mouth that is often associated with menopause. 

First-degree burn (Sanders et al, 2007) First-degree burn: damaged epidermis and edema

urning pain 271 burning pain 

Superficial partial-thickness second-degree burn 

(Sanders et al, 2007/Courtesy St. John’s Mercy Medical Center) 

Deep partial-thickness second-degree burn 

(Sanders et al, 2007/Courtesy St. John’s Mercy Medical Center) 

Superficial partial-thickness second-degree burn 

Deep partial-thickness second-degree burn 

Third-degree burn 

(Sanders et al, 2007/Courtesy St. John’s Mercy Medical Center) Third-degree burn

urning pain 272 Burow’s solution 

burning pain [AS, baernan, to burn; L, poena, penalty], 

the pain experienced as a result of a thermal burn. The term 

is also used sometimes to describe heartburn or myocardial 

pain. 

burnisher /burnishYr/ [ME, burnischen, to make brown], 

a dental instrument shaped with rounded smooth edges of 

the nib, used to closely adapt, polish, or work-harden a metallic 

material to an underlying object, usually the margin of 

a gold restoration. 

burnishing /burnish·ing/ [ME, burnischen, to make brown], 

1. (in dentistry) the process of adapting, polishing, and/or 

work-hardening a metal restoration under the sliding pressure 

of a smooth hard instrument, as in finishing the surface 

of a gold filling. 2. (in dentistry) smoothing and adapting the 

margins of a thin, annealed sheet of platinum to form a band 

about a tooth as a matrix for a porcelain restoration. 

burnout, a popular term for a mental or physical energy 

depletion after a period of chronic, unrelieved job-related 

stress characterized sometimes by physical illness. The person 

suffering from burnout may lose concern or respect for 

other people and often has cynical, dehumanized perceptions 

of people, labeling them in a derogatory manner. Causes of 

burnout peculiar to the nursing profession often include 

stressful, even dangerous, work environments; lack of support; 

lack of respectful relationships within the health care 

team; low pay scales compared with physicians’ salaries; 

shift changes and long work hours; understaffing of hospitals; 

pressure from the responsibility of providing continuous 

high levels of care over long periods; and frustration and 

disillusionment resulting from the difference between job realities 

and job expectations. 

burn recovery, a nursing outcome from the Nursing Outcomes 

Classification (NOC) defined as the extent of overall 

physical and psychological healing following major burn injury. 

See also Nursing Outcomes Classification. 

burn therapy, the management of a patient burned by 

flames, hot liquids, explosives, chemicals, or electric current. 

Partial-thickness burns may be first degree, involving only 

the epidermis, or second degree, involving the epidermis and 

dermis, whereas full-thickness or third-degree burns involve 

all skin layers. Second-degree burns covering more than 

30% of the body and third-degree burns on the face and extremities, 

or more than 10% of the body surface, are critical. 

In the first 48 hours of a severe burn, vascular fluid, sodium 

chloride, and protein rapidly pass into the affected area, 

causing local edema, blister formation, hypovolemia, hypoproteinemia, 

hyponatremia, hyperkalemia, hypotension, and 

oliguria. The initial hypovolemic stage is followed by a shift 

of fluid in the opposite direction, resulting in diuresis, increased 

blood volume, and decreased serum electrolyte 

level. Potential complications in serious burns include circulatory 

collapse, renal damage, gastric atony, paralytic ileus, 

infections, septic shock, pneumonia, and stress ulcer (Curling’s 

ulcer), characterized by hematemesis and peritonitis. 

METHOD: The extent of the burn; its cause; its time of occurrence; 

and the patient’s age, weight, allergies, and any 

preexisting illness are recorded. If respiratory distress is 

present, endotracheal intubation or tracheostomy may be 

performed. Specimens are obtained for urinalysis; blood 

type; blood urea nitrogen level; hematocrit; prothrombin 

time; electrolyte levels; blood gases; and cultures of nasal, 

throat, wound, and stool organisms. Parenteral fluids and 

electrolytes, antibiotics, tetanus prophylaxis, and pain medication 

are administered as ordered; large doses of analgesics 

and sedatives are avoided when possible to prevent depression 

of respiration and masking of symptoms. An indwelling 

urinary catheter is inserted, and a nasogastric tube and cath- 

eter for monitoring central venous pressure may be indicated. 

Local treatment of the burn may use the closed 

method or the more frequently used open method, in which 

the injured area is cleaned and exposed to air and the patient 

is kept warm by a blanket or linen over a bed cradle or by a 

heater or lamp. In the closed method, a germicidal or bacteriostatic 

cream, ointment, or solution is applied to the burn, 

and the wound is covered with a dressing. A porcine heterograft 

may be used to cover the wound temporarily. This technique 

prevents fluid loss and reduces the risk of infection, 

but the graft dries in 1 or 2 days and may pull and cause pain. 

Newly developed artificial skin holds great promise for treating 

severe burns. During the acute stage of a burn, the patient’s 

blood pressure, pulse, respiration, and cerebrovascular 

pressure are checked every 30 to 60 minutes, and the 

rectal temperature every 2 to 4 hours. Oral hygiene and assistance 

in turning, coughing, and deep breathing are provided 

every 2 hours, and the patient’s sensorium is evaluated 

hourly. If oral fluids are ordered, juices and carbonated 

drinks are offered, but plain water and ice chips are avoided. 

Fluid intake and output are measured hourly; if a child excretes 

less than 1 mL/kg of urine or an adult less than 

0.5 mL/kg, a diuretic or an increase in IV infusion of fluid 

may be necessary. Blood transfusions, steroid therapy, and 

antipyretics may be ordered; aspirin is contraindicated. Excessive 

chilling and exposure to upper respiratory and 

wound infections are carefully prevented. Burned extremities 

are elevated, and contractures are prevented by using 

firm supports to keep affected areas properly aligned. The 

patient is weighed daily at the same time on the same scale, 

and, after the initial acute period, an adequate intake of a 

high-calorie, high-protein diet is encouraged. To stimulate 

appetite, the patient is offered frequent small meals of preferred 

foods and beverages that are high in potassium. Vitamins 

may be required. Tranquilizers may be given before 

wound care, but narcotics for pain usually are not needed 

after the acute phase. The patient is encouraged to stand for 

a few minutes every hour or every second hour and is generally 

able to walk in 7 to 10 days, but convalescence may be 

prolonged. Burn patients often are frightened, withdrawn, 

and disoriented initially, but after a few days they may become 

angry, depressed, or rebellious and need emotional 

support to help them cooperate with their treatment and rehabilitation. 

Extensive plastic surgery and repeated skin 

grafts may be required to restore function and the physical 

appearance of burn patients. 

INTERVENTIONS: The burn patient requires intensive, prolonged 

care to prevent complications and disfiguring 

contractures. The nurse administers parenteral fluids and 

medication, implements wound care, closely monitors the 

patient’s condition, limits physical discomfort, provides 

emotional support and diversion, and encourages the family 

to visit regularly and become involved in the patient’s care. 

OUTCOME CRITERIA: The outcome for the severely burned 

patient depends greatly on the detailed, near-constant care 

required during the acute phase of treatment. Scarring may 

cause residual dysfunction and discouragement. Encouragement 

to participate fully in physical therapy and to continue 

treatments may be helpful. Although protection from infection 

is essential, the nurse does not isolate the patient unless 

necessary. 

Burow’s solution /byoo ˘ rōz/ [Karl A. Burow, German physician, 

1809–1874], a liquid preparation containing aluminum 

sulfate, acetic acid, precipitated calcium carbonate, and 

water, used as a topical astringent, antiseptic, and antipyretic 

for a wide variety of skin disorders. Also called aluminum 

acetate solution.

urp 273 busulfan 

burp informal. 1. to belch, or eructate; to expel gas from 

the stomach through the mouth. 2. a belch, or eructation. 

burr, a rotary instrument fitted into a handpiece and used to 

cut teeth or bone. Also spelled bur. 

burr cell [ME, burre L, cella, storeroom], a form of mature 

erythrocyte in which the cells or cell fragments have 

spicules, or tiny projections, on the surface. 

burr holes, holes drilled in the skull during surgery to 

drain and irrigate an abscess. 

Bone 

cut 

Burr hole 

Bone removed 

Burr holes for craniotomy (Phillips, 2007) 

burrowing flea. See chigoe. 

bursa /bursY/ pl. bursae [Gk, byrsa, wineskin], 1. afibrous 

sac between certain tendons and the bones beneath 

them. Lined with a synovial membrane that secretes synovial 

fluid, the bursa acts as a small cushion that allows the tendon 

to move over the bone as it contracts and relaxes. See also 

adventitious bursa, bursa of Achilles, olecranon bursa, 

prepatellar bursa. 2. a sac or closed cavity. See also omental 

bursa, pharyngeal bursa. —bursal, adj. 

bursa-equivalent tissue, bursal equivalent tissue, 

a hypothesized lymphoid tissue in nonavian vertebrates, including 

human beings, equivalent to the bursa of Fabricius in 

Burst fracture of the third lumbar vertebra 

(Kowalczyk and Mace, 2009/Courtesy Ohio State University 

Medical Center) 

Burr hole 

Bone 

removed 

birds: the site of B lymphocyte maturation. It now appears 

that B lymphocyte maturation occurs primarily in the bone 

marrow. 

bursal abscess /bursYl/, a collection of pus in the cavity 

of a bursa. 

bursa of Achilles, bursa separating the tendon of Achilles 

and the calcaneus. 

bursectomy /bYrsektYmē/ [Gk, byrsa, wineskin, ektomē, 

cutting out], the excision of a bursa. 

bursitis /bYrsītis/, inflammation of the bursa, the connective 

tissue structure surrounding a joint. Bursitis may be precipitated 

by arthritis, infection, injury, or excessive or traumatic 

exercise or effort. The chief symptom is severe pain of 

the affected joint, particularly on movement. Treatment 

goals include the control of pain and the maintenance of 

joint motion. Acute pain is often treated with an intrabursal 

injection of an adrenocorticosteroid. Other common treatments 

are analgesics, antiinflammatory agents, cold, and immobilization 

of the inflamed site. After the inflammation has 

subsided, heat may be helpful. In chronic cases, surgery may 

be required to remove calcium deposits. Kinds of bursitis include 

housemaid’s knee, miner’s elbow, and weaver’s 

bottom. See also rheumatism. 

burst, to break suddenly while under tension or expansion. 

burst fracture [ME, bersten +L,fractura, break], any 

fracture that disperses multiple bone fragments, usually at or 

near the end of a bone. It frequently occurs in a vertebra. 

Burton’s line [Henry Burton, English physician, 1799– 

1849], a dark blue stippled line along the gingival margin, 

which is a sign of lead poisoning. See also blue line. 

Buruli ulcer /boo ¯¯¯¯rY·le/ [Buruli, district in Uganda], 

an ulcer of the skin with widespread necrosis of subcutaneous 

fat, caused by a species of Mycobacterium ulcerans, 

manifested by a small, firm, painless, movable subcutaneous 

nodule that enlarges and ulcerates. It occurs principally in 

Central Africa (the Nile river banks), but has also been seen 

in other tropical areas. 

bus, a set of parallel wires in a computer to which the central 

processing unit and all input-output units are connected. 

Each separate wire carries the electric current representing 

1 bit. Buses interconnect the parts of the computer that communicate 

with each other, such as a video card or modem. 

Buschke’s disease. See cryptococcosis. 

bushy chorion, the region of the chorion that bears villi. 

BuSpar, trademark for an oral antianxiety drug (buspirone 


busPIRone hydrochloride /boo ˘ spirōn/, an antianxiety 

agent not related chemically to others. Administered orally 

as the hydrochloride salt. Unlike benzodiazepines, does 

cause sedation, has low abuse potential, takes several days to 

weeks to exert its effect, and does not intensify the effects of 

other CNS depressants. 

INDICATIONS: It is prescribed for generalized anxiety 

disorders. 

CONTRAINDICATIONS: This drug is contraindicated in patients 

with severe hepatic or renal impairment. Patients taking 

a benzodiazepine drug should be gradually withdrawn 

from that medication before starting therapy with buspirone. 

ADVERSE EFFECTS: Among adverse reactions reported are 

dizziness, headache, lightheadedness, excitement, and 

nausea. 

busulfan /boo ¯¯¯¯sulfYn/, an alkylating agent. 

INDICATION: It is prescribed in the treatment of chronic 

myelocytic leukemia. 

CONTRAINDICATIONS: Radiation therapy, depressed neutrophil 

or platelet counts, concurrent administration of neoplas-

utabarbital sodium 274 button suture 

tic medication, or known hypersensitivity to this drug prohibits 

its use. 

ADVERSE REACTIONS: Among the more serious adverse reactions 

are alveolar hyperplasia (busulfan lung), depression 

of the bone marrow, and severe nausea and diarrhea. Amenorrhea 

commonly occurs. 

butabarbital sodium /byoo ¯¯¯¯tYbärbitôl/, a sedative; 

intermediate-acting barbiturate. 

INDICATIONS: It is prescribed for the relief of anxiety, nervous 

tension, and insomnia. 

CONTRAINDICATIONS: Porphyria, seizure disorders, or 



are jaundice, skin rash, and paradoxical excitement. 

butamben picrate /byoo ¯¯¯¯tambYn pikrāt/, a topical local 

anesthetic for the temporary relief of pain from minor burns. 

butanamide. See acebutolol. 

butane (C4H10), a colorless petroleum-based gas. It is the 

fourth member of the paraffin series of hydrocarbons. 

butanoic acid. See butyric acid. 

butanol. See butyl alcohol. 

Butazolidin, 

butazone). 

trademark for an antirheumatic (phenyl- 

butenafine /bu-tenah-fēn/, a topical antifungal agent used 

as the hydrochloride salt in the treatment of athlete’s foot, 

jock itch, and ringworm. 

Butisol Sodium, trademark for a sedative (butabarbital sodium). 

Butler-Albright syndrome, a type of distal renal tubular 

acidosis occurring later than infancy and having autosomal 

dominant inheritance. 

butoconazole nitrate /byoo ¯¯¯¯tYkōnYzōl/, 

antifungal cream. 

an intravaginal 

INDICATIONS: It is prescribed for the treatment of vulvovaginal 

fungal infections caused by Candida species. 

CONTRAINDICATIONS: Its use is contraindicated during the 

first trimester of a pregnancy. 

ADVERSE EFFECTS: Adverse reactions include vulvar and 

vaginal burning and itching. 

butorphanol tartrate /byoo ¯¯¯¯tôrfYnôl/, an agonist/ 

antagonist opioid of the phenanthrene family. 

INDICATIONS: It is administered parentally for surgical premedication, 

as an analgesic component of balanced anesthesia, 

for prompt relief of moderate to severe pain associated 

with surgical procedures, and as a nasal spray for the relief 

of migraine pain. 

CONTRAINDICATIONS: Butorphanol tartrate is not given to 

patients known to be sensitive to phenanthrenes or to persons 

dependent on opioids because it may provoke withdrawal 

symptoms. 

ADVERSE EFFECTS: Toxicity may result from the use of 

butorphanol with other opioids. 

butt, 1. to place two surfaces together to form a joint. 

2. (in dentistry) to place directly against the tissues covering 

the residual alveolar ridge. 

butter, a soft, solid substance, such as the oily mass produced 

by churning cream. 

butterfly bandage [AS, buttorfleoge], a narrow adhesive 

strip with broader winglike ends used to approximate the 

edges of a superficial wound and to hold the edges together 

as they heal. It is used in place of a suture in certain cases. 

Also called butterfly. 

butterfly fracture, a bone break in which the center fragment 

contained by two cracks forms a triangle. 

butterfly needle, a short needle attached to plastic stabilizers 

at 90 degrees. It is used for IV access of small veins of 

adults and children. Usual gauge is 25 to 22 length. 

Butterfly needle 

(Harkreader and Hogan, 2007/Courtesy Medline Industries) 

butterfly rash, an erythematous eruption of both cheeks 

joined by a narrow band of rash across the nose. It may be 

seen in lupus erythematosus, rosacea, and seborrheic dermatitis. 

Butterfly rash (Habif, 2004) 

buttermilk [Gk, boutyron, butter; AS, meoluc], 1. the 

slightly sour tasting liquid remaining after the solids in 

cream have been churned into butter. It is nearly fat free and 

is nutritionally comparable to whole milk. 2. cultured milk 

made by the addition of certain organisms to fat-free milk. 

butter stools, a fatty fecal discharge from the bowels, as 

may occur in steatorrhea. 

buttock, the fleshy hillocks at the lower posterior part of 

the torso comprising fat and the gluteal muscles. Also called 

nates. 

buttock augmentation, a reconstructive procedure in 

cosmetic surgery for reshaping the buttocks. 

button /butYn/ [OFr, boton], 1. a knoblike elevation or 

structure. 2. a small appliance shaped like a spool or disk, 

used in surgery for construction of an intestinal anastomosis. 

buttonhole [OFr, boton AS, hol], a small slitlike hole in 

the wall of a structure or a cavity of the body. 

buttonhole fracture, a fracture caused by a straight perforation 

of a bone, such as by a bullet. 

buttonhole stenosis, an extreme narrowing of a vessel. 

The term usually refers to the mitral valve, in which the 

valve cusps are contracted to form an opening shaped like a 

buttonhole. 

buttonhook, an adaptive device designed to help patients 

who have limited finger range of motion, dexterity, or weakness 

with fastening buttons on clothing. 

button suture, a technique in suturing in which the ends 

of the suture material are passed through buttons on the sur-

uttressing 275 Byzantine arch palate 

face of the skin and tied. It is used to prevent the suture from 

cutting through the skin. 

buttressing, a phenomenon of osteoarthritis in which 

osteophytes at the hip joint extend across the femoral neck 

inferior to the femoral head and combine, with a proliferation 

along the medial aspect of the femoral neck. 

buttress plate, a thin, flat metal plate used to provide support 

in the surgical repair of a fracture. 

butyl /byoo ¯¯¯¯til/ [Gk, boutyron, butter, hyle, matter], a hydrocarbon 

radical (C4H9), most compounds of which are obtained 

from petroleum. It exists as four isomers: n-butyl, 

isobutyl, secondary butyl, and tertiary butyl. Butyl compounds, 

some of which are toxic and irritating, are used in a 

variety of industrial and medical applications, including anesthesia. 

butyl alcohol (C4H9OH), a clear, toxic liquid used as an 

organic solvent. It exists as four isomers, n-butyl, isobutyl, 

secondary butyl, and tertiary butyl alcohol. Also called 

butanol. 

butyr-, combining form meaning “butter”: butyric, 

butyrinase. 

butyric acid (C4H7OOH) /byoo ¯¯¯¯tirik/, a clear, colorless 

liquid with an odor of rancid butter or vomit that is miscible 

with water, alcohol, glycerin, and ether. Butyric acid is obtained 

commercially from 1-butanol by oxidation and can 

be obtained from carbohydrates by butyric fermentation. It is 

used in the production of artificial flavors. Also called butanoic 

acid /byoo ¯¯¯¯tYnōik/, propylformic acid. 

butyric fermentation, the conversion of carbohydrates to 

butyric acid. 

butyrophenone /byoo ¯¯¯¯tYrōfēnōn/, one of a small group of 

major tranquilizers. They are used in treating psychosis, to 

decrease the choreic symptoms of Huntington’s disease and 

the tics and coprolalia of Gilles de la Tourette’s syndrome, 

and are used as an adjunct in neuroleptanesthesia. Principal 

butyrophenones are haloperidol and droperidol. Butyrophenones 

are pharmacologically and clinically similar to phenothiazines. 

Buzzard’s maneuver [Thomas Buzzard, English neurolo- 

gist, 1831–1919], a modified patellar reflex in which the 

patient’s toes are firmly pressed on the floor while the quadriceps 

muscle is tapped. 

BWS, abbreviation for battered woman syndrome. 

Byler’s disease, progressive familial intrahepatic cholestasis; 

an autosomal-recessive disorder caused by an error in 

conjugated bile salt metabolism, with early onset of loose, 

foul-smelling stools; jaundice; hepatosplenomegaly; and 

dwarfism. 

bypass [AS, bi, alongside; Fr, passer], 1. any one of various 

surgical procedures to divert or shunt the flow of blood 

or other natural fluids from normal anatomic courses. A bypass 

may be temporary or permanent. Bypass surgery is 

commonly performed in the treatment of cardiac and GI disorders. 

2. a term used by some hospitals to signal that its 

emergency department lacks the personnel and equipment to 

handle additional patients, thereby advising that ambulances 

transporting new patients be diverted to other hospitals. 

by-product material, 1. the radioactive waste of nuclear 

reactors. 2. something produced in the making of something 

else. 

byssinosis /bisinōsis/ [Gk, byssos, flax, osis, condition], 

an occupational respiratory disease characterized by shortness 

of breath, cough, and wheezing. The condition is an allergic 

reaction to dust or fungi in cotton, flax, and hemp fibers. 

The symptoms are typically more pronounced on 

Mondays when workers return after a weekend break. They 

are reversible in the early stages, but prolonged exposure results 

in chronic airway obstruction, bronchitis, and emphysema 

with fibrosis, leading to respiratory failure, pulmonary 

hypertension, and cor pulmonale. Treatment is symptomatic 

for the irreversible changes of emphysema and chronic bronchitis. 

Compare pneumoconiosis. See also organic dust. 

byte /bīt/, the amount of memory required to encode one 

character of information (letter, number, or symbol) in a 

computer system; it is normally 8 bits. See also bit. 

Byzantine arch palate /bizYntēn/, a congenital anomaly 

of the roof of the mouth marked by incomplete fusion of the 

palatal process and the nasal spine.

View Section PDF - coursewareobjects.com

Create successful ePaper yourself

Delete template?

Save as template?