 An
Introduction
As the science of traumatic injury care advances, the terminology of
that science becomes ever changing and complex. The language used to
define and describe personal injury from a medical, rehabilitative,
insurance and legal perspective can be difficult to understand. Yet
this information is essential for those who have experienced a
personal injury, who are undergoing evaluation and treatment, or who
are part of the physical therapy, rehabilitative, insurance or legal
fields where personal injury resources and solutions are found.
We hope this easy-to-use and practical online reference guide will
assist you in better understanding the common terminology used in
this critical area of public health. To contribute to this guide, or
ask questions, please contact the editors.
Aa
Abduction: Lateral movement of the limbs away
from the midline of the body. Opposite
of Adduction.
Aberrant Intersegmental Motion: Abnormal movement between
two adjacent vertebral
segments.
ABSTRACT CONCEPT: A concept or idea not related to any
specific instance or object and which potentially can be applied to many
different situations or objects. People with cognitive deficits often have
difficulty understanding abstract concepts.
ABSTRACT THINKING: Being able to apply abstract concepts
to new situations and surroundings.
ACALCULIA: The inability to perform simple or complex problems
of arithmetic.
Acceleration-Deceleration
Injury: Injury syndromes commonly
associated with
hyperextension-hyperflexion of the neck. Most often caused by a rear-end
auto accident.
ACQUIRED BRAIN INJURY (ABI): Harm to the brain that occurs
after birth. Usually it means harm caused by pressure on the brain from inside
the body. Examples are harm to the brain as a result of heart attacks, strokes,
illness, and near drowning.
Acquired Spinal Stenosis: Spinal stenosis usually
due to degenerative changes.
Acromion: The triangular projection of the scapula that
forms the point of the shoulder and articulates with the clavicle.
Active Range of Motion: Range of motion in the cervical,
thoracic, lumber spine, or any other joint of the body which patient does
under his or her own power.
Activities of Daily Living: The normal daily activities
and functions a person must perform or fulfill to maintain cleanliness, self-grooming,
home maintenance, eating, working and recreation.
ACUITY: Sharpness or quality of a sensation.
Acupressure: The application of manual pressure to specific
points along acupuncture meridian pathways for the purpose of decreasing
pain. Pain relief is believed to be accomplished by stimulating or sedating
the selected acupuncture points.
Acupuncture: An oriental medicine treatment modality where
needles are inserted in particular points on the “meridians” of
Qi (channels of energy in the body). This is believed to have neurophysiologic
effects which decrease pain and promote healing by balancing Qi.
Acute: A recent onset of an injury or problem. The precise
time line of an acute condition can range from hours after onset to 16 weeks
depending upon thestandard
of the particular physician or treatment provider.
Acute Exacerbation: A sudden aggravation of symptoms or
increase in severity of an already existing condition without re-injury or
trauma.
ADAPTIVE/ASSISTIVE EQUIPMENT: A special device which assists
in the performance of self care, work or play/leisure activities or physical
exercise.
Adaptive Changes: Changes in a spinal segment which occur
secondarily to another biomechanical problem in the spine. This usually
involves loss of range of motion in a specific direction to
compensate for the trauma at another area.
Adaptive Scoliosis: A lateral curvature of the
spine, which is secondary to soft tissue biomechanical imbalance and not
to bony changes (structural).
Adduction: Movement of a limb toward the middle of the
body. Opposite of Abduction.
Adhesions: Fibrosis tissue and scar tissue that bind together
tissues which are usually not attached.
Adjustment: A chiropractic term which describes
the skilled application of force to
a joint or motion segment to improve intersegmental motion, decrease
localized muscle tension, and restore normal motion and position.
ADJUSTMENT DISORDER: This diagnosis involves the development
of emotional or behavioral symptoms in response to an identifiable stress.
It is not as severe a reaction as is found in post-traumatic stress disorder
or acute stress disorder.
ADL: Activities of daily living. Routine activities carried
out for personal hygiene and health (including bathing, dressing, eating)
and for operating a household.
ADMINISTRATIVE LAW JUDGE (ALJ): A judge who makes decisions
about federal programs, such as Social Security, Medicaid, Medicare, housing,
education, and tax laws. When you appear before an ALJ, it is called a hearing.
Adson’s Test: A physical exam test used in evaluation
of thoracic outlet syndrome at the junction of the brachial
plexus and the scalene muscles of the neck. The patient
is placed in the sitting position with one arm straight out to the side
and extended slightly backwards. The patient then takes a deep breath
and turns the head toward the side being tested. A positive test is loss
or diminishment of the wrist pulse on the side being tested.
ADVANCE DIRECTIVE: A document people create to explain
what type of health care they would accept and would not accept if they were
to get sick. The Directive is only used if the person gets so sick that they
cannot think clearly or tell people what health care they want. Advance Directives
often include things like: 1) medications the person is allergic to and don’t
want to be given; 2) treatments that the person doesn’t want; and 3)
treatments that have worked in the past.
AFFECT: The observable emotional condition of an individual
at any given time.
Afferent Nerve Fibers: Nerve fibers which carry sensory
impulses to the central nervoussystem.
AFFIDAVIT: A written statement made under oath.
AGNOSIA: Failure to recognize familiar objects although
the sensory mechanism is intact. May occur for any sensory modality.
ALERT: State of being watchful or ready.
Allograft: A graft taken from another person (living or
dead).
ALTERNATIVE DISPUTE RESOLUTION (ADR): Refers to the broad
array of alternatives to trial for resolution of legal disputes. Includes mediation,
arbitration, and settlement conferences.
AMBULATE: To walk.
AMNESIA: Lack of memory about events occurring during a
particular period of time.
ANEURYSM: A balloon-like deformity in the wall of a blood
vessel. The wall weakens as the balloon grows larger, and may eventually
burst, causing a hemorrhage.
Ankylosing Spondylitis: A chronic inflammatory disease
wherein the spinal motion segments and the sacroiliac joints progressively
fuse, resulting in painful restriction of spinal movement.
Ankylosis: A joint condition of decreased or full loss
of range of motion, often due to advanced degenerative changes.
A spinal segment which is fused can be said to be “ankylosed”.
Also, the fusion of a joint either by advanced degeneration or by
artificial means (surgery).
Annular Bulge: A bulging out of the annulus fibrosis,
the tough fibrosis outer ring that provides support to the disc, which is
diffuse and, usually due to degenerative changes or trauma, leading
to degenerative changes. This condition may include partial rents
or tears in the annulus fibrosis.
Annular Rent: Another way to describe a tear in the annulus,
usually seen during discography, less commonly on MRI,
or during surgery. These tears can be traumatic in origin. Also known as
an annular fissure.
Annulus: See Annulus Fibrosis.
Annulus Fibrosis: The outer covering of the softer, gel-like nucleus
pulposus of the intervertebral disc. The intervertebral
discs are located between each of the vertebrae of the spine.
ANOMIA: Inability to recall names of objects. Persons with
this problem can often speak fluently but have to use other words to describe
familiar objects.
ANOSMIA: Loss of the sense of smell.
ANOXIA: A lack of oxygen. Cells of the brain need oxygen
to stay alive. When blood flow to the brain is reduced or when oxygen in
the blood is too low, brain cells are damaged.
ANSWER: A formal pleading which states the defendant’s
response to plaintiff’s complaint. The defendant, in the State
of Washington, has twenty (20) days to answer, admit, or deny the allegations
in plaintiff’s complaint.
Anterior: Front side, the opposite of posterior.
Synonymous with ventral.
Anterior Disc Herniation: An extrusion of the nucleus
pulposus through the front side of the annulus of the disc.
Anterior Discectomy and Fusion: The surgical removal of
an abnormal intervertebraldisc and replacement with bone
graft and/or surgical hardware for fusion, using an anterior approach
to the spine.
Anterior Scalene Syndrome: Compression of the bundle of
nerves, veins and arteries as it passes between the anterior and
middle scalene muscles. This is a cause of thoracic outlet syndrome or cervicobrachial
syndrome, as this is one of the more common areas of entrapment.
ANTEROGRADE AMNESIA: Inability to consolidate information
about ongoing events. Difficulty with new learning.
Anterolisthesis: A vertebral segment which is
moved forward relative to the segment below.
ANTICONVULSANT: Medication used to decrease the possibility
of a seizure (e.g., Dilantin, Phenobarbital, Mysoline, Tegretol).
AO Joint: Atlanto-occipital joint is the vertebral joint
formed by the occiput (a portion of the skull) at the base of the skull resting
upon the atlas or first cervicalvertebra (C1).
AP: Anterior to Posterior or front to
back. This refers to the orientation of the patient to the x-ray beam. With
AP films the patient faces away from the x-ray film and faces the x-ray machine.
The x-ray photons pass from anterior to posterior through
the patient. The image produced is a “front to back” view of
the patient.
APATHY: A lack of interest or concern.
APHASIA: Loss of the ability to express oneself and/or
to understand language. Caused by damage to brain cells.
APPEAL: A request by a party for a higher court
to review a lower court’s decisions regarding questions of law.
Applied
Kinesiology: A chiropractic diagnostic
technique based on the theory the neuromuscular system can be accessed
through specific neuromuscular pressure points. This is usually combined
with manual muscle testing to determine which muscles are weak and need
to be balanced. Some chiropractors use this technique as a way to plan
their adjustments and to recheck the patient following the chiropractic adjustment.
APRAXIA: Inability to carry out a complex or skilled movement,
not due to paralysis, sensory changes or deficiencies in understanding.
ARBITRATION: Alternative to trial where parties agree
to appoint an individual or panel to make a binding award or decision based
on the evidence and testimony presented.
AROM Exercise: An exercise designed to increase Active
Range of Motion.
AROUSAL: Being awake. Primitive state of alertness managed
by the reticular activating system (extending from medulla to the thalamus
in the core of the brainstem) activating the cortex. Cognition is not possible
without some degree of arousal.
ARTERIAL LINE: A very thin tube (catheter) inserted into
an artery to allow direct measurement of the blood pressure, the oxygen and
carbon dioxide concentrations in arterial blood.
Arthralgia: Joint pain.
Arthrochondritis:Inflammation of the cartilage portion
of a joint.
Arthrogram: The injection of radiographic dye into a joint
that is then x-rayed. The contrast dye allows for better visualization of
the joint and possible irregularities. Arthrograms are being progressively
replaced by MRI.
Arthrosis: A disorder of a joint.
Articulation: 1. The joint between
bones. The movement of bones as a result of the joint. 2. Movement of the
lips, tongue, teeth and palate into specific patterns for purposes of speech.
Also, a movable joint.
Articular Dysfunction: A chiropractic term, which refers
to an abnormality of spinal biomechanics involving a loss of normal movement
of vertebral motion segment.
Articular Fixation: A loss of one or more joint motions.
One of the components of the chiropractic diagnosis of subluxation.
See Subluxation. See Hypomobility.
Articular Spondylolisthesis: A forward or anterior “slipping” of
one vertebra in relation to another, due to trauma and/or degenerativechanges within
the facet joints and/or the discs.
Articular Surface: The surface of a joint, lined with cartilage and synovial
fluid to lubricate joint movement.
ASSISTIVE TECHNOLOGY DEVICE (AT): Equipment used by people
with disabilities to help them function better. Examples include crutches,
wheelchairs, hearing aids, flashing doorbells, computers, and memory aids,
such as, post-it notes, alarm clocks, or tape recorders.
Atlanto-Occipital: Referring to the articulation of
the joint between the occiput of the skull and the C1 vertebra (atlas).
See AO Joint.
Atlas: The first cervicalvertebra which
moves with the occipital bone of the skull, and the second cervical vertebra in
the neck. Also known as C1.
ATAXIA: A problem of muscle coordination not due to apraxia,
weakness, rigidity, spasticity, or sensory loss. Caused by lesion of the
cerebellum or basal ganglia. Can interfere with a person’s ability
to walk, talk, eat and perform other self-care tasks.
Atrophy: A wasting or decrease in size, often in reference
to muscle tissue.
ATTENTION/CONCENTRATION: The ability to focus on a given
task or set of stimuli for an appropriate period of time.
AUDIOLOGIST: One who evaluates hearing defects and who
aids in the rehabilitation of those who have such defects.
AUGMENTATIVE AND ALTERNATIVE COMMUNICATION: Use of forms
of communication other than speaking, such as: sign language, “yes,
no” signals, gestures, picture board and computerized speech systems
to compensate (either temporarily or permanently) for severe expressive communication
disorders.
Autonomic Nervous System: The part of the nervous system
controlling involuntary
bodily functions, including regulation of glands, organs, and smooth
muscle tissue. The autonomic nervous system acts upon these tissues to slow
or initiate their function.
Autograft: A graft taken from the patient.
Avulsion: The pulling away of one tissue from another,
either by trauma or surgery.
AWARENESS: Conscious of stimulation, arising from within
or from outside the person.
Axilla: The armpit.
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