Medical terms and the language of location

1. You findYou meet a long term you have never seen, such as cholecystitis.You doTake it apart one piece at a time. Chol/e means bile, cyst means a closed sac and -itis means inflammation: inflammation of the sac that holds bile, the gallbladder. A root carries the core meaning, a prefix at the front modifies it, and a suffix at the end completes it.
2. You findYou need to say where an injury is, and the patient is curled on their side on the floor.You doPicture the anatomic position: standing upright, facing forward, palms forward. Every directional term assumes that position no matter how the patient is actually lying, and left and right always mean the patient's left and right.
3. You findThe wound is on the forearm, close to the wrist.You doUse the paired opposites. Distal is farther from the torso and proximal is closer to it, so the wound is on the distal forearm. The other pairs work the same way: medial and lateral, anterior and posterior, superior and inferior.
4. You findThe patient points to pain in the belly, up under the ribs on their right side.You doName the quadrant. Lines through the navel divide the abdomen into four: right upper (RUQ), left upper (LUQ), right lower (RLQ) and left lower (LLQ). This is the right upper quadrant. On the chest, the midclavicular and midaxillary lines do the same job of pinning down a spot.
5. You findYou have to report how the patient is positioned.You doUse the positional terms: supine is on the back, prone is facedown, the recovery position is on the side, Fowler is sitting with the head of the stretcher raised 45 to 60 degrees, and semi-Fowler is leaning back, half sitting.
6. You findYou are writing the report, handing the patient over, or asking the patient a question.You doUse plain language wherever a term could be misread. Common abbreviations such as CPR and EMS are fine. With patients and families, drop the jargon: ask about a "heart attack", not an "MI".

• Word parts. A root (cardi, heart) usually cannot stand alone. Add a vowel, almost always an o, and you have a combining form (therm/o + meter = thermometer). A prefix goes in front (dys- + pnea = dyspnea, difficult breathing); a suffix goes on the end (arthr + -itis = arthritis, joint inflammation).
• Prefixes worth knowing cold: brady- (slow), tachy- (fast), hyper- (above normal), hypo- (below normal), dys- (difficult or painful), intra- (within), inter- (between), peri- (around), sub- (below), supra- and super- (above).
• Suffixes worth knowing cold: -itis (inflammation), -algia (pain), -emesis (vomiting), -pnea (breathing), -plegia (paralysis), -rrhea (discharge).
• Three planes. Sagittal (median) cuts the body into right and left halves, frontal (coronal) into front and back, transverse (horizontal) into top and bottom.
• Synonyms. Anterior is the same as ventral (front); posterior is the same as dorsal (back). Palmar is the palm of the hand; plantar is the sole of the foot. Bilateral means both sides; unilateral means one side.
• Reference lines. The midline runs down the center of the body and divides right from left. The midaxillary line runs down from the middle of the armpit and divides front from back. The midclavicular line runs through the center of each collarbone.
• The recovery position (lateral recumbent) is preferred for an unresponsive patient without trauma who is breathing adequately, because it lets fluid drain from the mouth and helps prevent aspiration.

The wrong idea: Directional terms describe the patient the way I find them, and left and right are as I look at the patient.

What is actually true: Every directional term is defined from the anatomic position (standing, facing forward, palms forward), however the patient is lying. Anterior is the front of the body even when the patient is facedown, and left and right are always the patient's own left and right.

Medical terms are roots joined to prefixes and suffixes, often through a combining vowel, and they come apart one piece at a time. Every directional term is measured from the anatomic position (standing, facing forward, palms forward), and left and right are the patient's. Directions come as paired opposites (medial and lateral, anterior and posterior, superior and inferior, proximal and distal), three planes slice the body, reference lines and the four abdominal quadrants pin down a spot, and positional terms such as supine, prone, recovery and Fowler say how the patient is lying. Abbreviations and jargon cause errors, so use plain language in reports, at handoff and above all with patients.

The body systems an EMT works with →