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Medical Terminology -2
29
Third Lecture
3. Digestive System: Medical, Surgical, and Diagnostic Procedures
3.1. Pathology34
Although some digestive disorders do not manifest symptoms (asymptomatic),
many are associated with nausea, vomiting, bleeding, pain, and weight loss.
Clinical signs, such as jaundice and oedema35, may indicate a hepatic disorder.
Severe infection, drug toxicity, hepatic disease, and changes in fluid and
electrolyte balance can cause behavioural abnormalities. Disorders of the GI
tract or any of the accessory organs (liver, gallbladder, and pancreas) may result
in far-reaching metabolic or systemic problems that can eventually threaten life
itself. Assessment of a suspected digestive disorder includes a thorough history
and physical examination. A range of diagnostic tests assist in identifying
abnormalities of the GI tract, liver, gallbladder, and pancreas.
For diagnosis, treatment, and management of digestive disorders, the medical
services of a specialist may be warranted. Gastroenterology is the branch of
medicine concerned with digestive diseases. The physician who specializes in
the diagnoses and treatment of digestive disorders is known as a
gastroenterologist. Gastroenterologists do not perform surgeries; however,
under the broad classification of surgery, they do perform such procedures as
liver biopsy and endoscopic examination.
3.2. Medical, Surgical, and Diagnostic Procedures36
This section introduces medical, surgical, and diagnostic procedures used to
treat and diagnose digestive system disorders. Descriptions are provided as well
as pronunciations and word analyses for selected terms.
34 Medical Terminology Systems - A Body Systems Approach: Digestive System – Pathology p. 135 35 Oedema: /ɪˈdiːmə/ (AmE edema) a condition in which liquid collects in the spaces inside the body and makes
it swell 36 Medical Terminology Systems - A Body Systems Approach: Digestive System – Medical, Surgical, and
Diagnostic Procedures p. 144
Medical Terminology -2
30
Procedure Pronunciation37 Arabic38 Meaning
Medical
nasogastric
intubation
nas/o: nose
gastr: stomach
-ic: pertaining
to
ˌneɪzəʊˈɡæstrɪk
ˈɪntjubeɪʃn
أنفي تنبيب
معدي
Insertion of a nasogastric tube through the
nose into the stomach to relieve gastric
distention39 by removing gas, food, or
gastric secretions; instil40
medication, food, or fluids; or obtain a
specimen for laboratory analysis
Surgical
anastomosis
ileorectal
ile/o: ileum
rect: rectum
-al: pertaining
to
intestinal
əˌnæstəˈməʊsɪs
ˌɪliəʊˈrektəl
ɪnˈtestɪnl
،تفاغر
مفاغرة
مفاغرة
لفائفية
مستقيمية
مفاغرة
معوية
Surgical joining of two ducts, vessels, or
bowel segments to allow flow from one to
another
Surgical connection of the ileum41 and
rectum42 after total colectomy43, as is
sometimes performed in the treatment of
ulcerative colitis
Surgical connection of two portions of the
intestines; also called
Enteroenterostomy44
bariatric
surgery
vertical
banded
gastroplasty
ˌbærɪˈætrɪk
ˈsɜːdʒəri
ˈvɜːtɪkl bændɪd
ˈɡæstrəʊˌplæsti
جراحة
منة الس
رأب
المعدة
العلوي
بط الر
Group of procedures that treat morbid
obesity, a condition that arises from severe
accumulation of excess weight as fatty
tissue, and the resultant health problems
Commonly employed bariatric surgeries
include vertical banded gastroplasty and
Roux-en-Y gastric bypass. (See Figure 3-
1).
Bariatric surgery that involves vertical
stapling of the upper stomach near the
oesophagus to reduce it to a small pouch45
and insertion of a band that restricts food
consumption and delays its passage from
the pouch, causing a feeling of fullness
37 Oxford Advanced Lerner’s Dictionary, 9th ed. or: http://dictionary.reference.com/ 38 http://www.emro.who.int/Unified-Medical-Dictionary.html 39 Distend: /dɪˈstend/ (distension or distention / dɪˈstenʃn/) to swell or make something swell because of pressure
from inside 40 Instil: /ɪnˈstɪl/ (AmE instill) to pour in drop by drop 41 Ileum: /ˈɪliəm/ (pl. ilea /ˈɪliə/; ileal /ˈɪliəl/ adj) the third part of the small intestine 42 Rectum: /ˈrektəm/ the opening through which solid waste leaves the body 43 Colectomy: /kəˈlektəmi/ surgical removal of part or all of the colon 44 Enteroenterostomy: /ˈentərəʊˈentərɒstəmi/ a surgical connection between two segments of intestine 45 Pouch: /paʊtʃ/ a small bag, usually made of leather, and often carried in a pocket or attached to a belt
Medical Terminology -2
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Figure 3-1: Bariatric surgery: (A) Vertical banded gastroplasty. (B) Roux-en-
Y gastric bypass
Roux-en-Y
gastric
bypass
(RGB)
ruːen-ˈwaɪ
ˈɡæstrɪk
ˈbaɪpɑːs
Bariatric surgery that involves stapling the stomach to
decrease its size and then shortening the jejunum46 and
connecting it to the small stomach pouch, causing the
base of the duodenum leading from the non-functioning
portion of the stomach to form a Y configuration, which
decreases the pathway of food through the intestine, thus
reducing absorption of calories and fats
RGB can be performed laparoscopically or as an open
procedure (laparotomy), depending on the health of the
patient. RGB is the most commonly performed weight-
loss surgery today.
colostomy
col/o:
colon
kəˈlɒstəmi
فغر
القولون
Creation of an opening of a portion of the colon through
the abdominal wall to its outside surface in order to
divert faecal flow to a colostomy bag (See Figure 3-2).
46 Jejunum: /dʒɪˈdʒuːnəm/ the second part of the small intestine
Medical Terminology -2
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Figure 3-2: Colostomy
lithotripsy
lith/o: stone,
calculus
-tripsy: crushing
extracorporeal
shock-wave
lithotripsy
ˈlɪθəʊˌtrɪpsi
ˌekstrəkɔːˈpɔːriəl
ʃɒkweɪv
تفتيت
الحصاة
تفتيت
الحصاة
بأمواج
صدم
خارج
الجسم
Procedure for crushing a stone and
eliminating its fragments surgically or
using ultrasonic shock waves
Use of shock waves as a non-invasive
method to break up stones in the
gallbladder or biliary ducts (See Figure
3-3.)
In extracorporeal shockwave lithotripsy
(ESWL), ultrasound is used to locate the
stone(s) and to monitor their destruction.
polypectomy
polyp: small
growth
-ectomy:
excision,
removal
ˈpɒliˈpektəmi استئصال
السليلة
Excision of a polyp47
When polyps are discovered during
sigmoidoscopy or colonoscopy, they are
excised for microscopic tissue
examination for abnormal or cancerous
cells. (See Figure 3-4)
47 Polyp: /ˈpɒlɪp/ a small lump that grows inside the body, especially in the nose, that is caused by disease but
is usually harmless
Medical Terminology -2
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Figure 3-3: Extracorporeal shock-wave lithotripsy
pyloromyotomy
pylor/o: pylorus
my/o: muscle
-tomy: incision
paɪˈlɔːrɒmaɪətəmi بضع عضل
اب البو
Incision of the longitudinal and
circular muscles of the
pylorus, which is used to treat
hypertrophic48 pyloric stenosis
Figure 3-4: Polypectomy
48 Hypertrophy: /haɪˈpɜːtrəfi/ an increase in the size of an organ or tissue because its cells grow in size
Medical Terminology -2
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Diagnostic
Endoscopic
gastrointestinal
endoscopy
endo-: in, within
-scopy: visual
examination
ˌɡæstrəʊɪnˈtestɪnl
enˈdɒskəpi
تنظير داخلي
معدي معوي
Visual examination of the
gastrointestinal tract using a flexible
fibre-optic instrument with a
magnifying lens and a light source
(endoscope) to identify
abnormalities, including bleeding,
ulcerations49, and tumours
In endoscopy of the oesophagus
(oesophagostomy), stomach
(gastroscopy), and duodenum
(duodenoscopy), the endoscope is
inserted through the nose or mouth.
In endoscopy of the colon
(colonoscopy) and sigmoid colon50
(sigmoidoscopy) the endoscope is
inserted through the rectum. (See
Figure 3-5).
Figure 3-5: Colonoscopy and sigmoidoscopy
49 Ulceration: /ˌʌlsəˈreɪʃn/ the fact of becoming covered with ulcers 50 Sigmoid colon: /ˈsɪɡmɔɪd ˈkəʊlən/ the S-shaped section of the colon between the pelvic brim (the upper edge
of a bowl-like structure) and the third sacral (sacrum: /ˈseɪkrəm/ a bone in the lower back, between the two hip
bones of the pelvis) segment, continuous with the rectum. Also called sigmoid flexure /ˈflekʃə/
Medical Terminology -2
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Imaging
computed
tomography
(CT)
tom/o: to cut
-graphy: process
of recording
kəmˈpjuːtɪd
təˈmɒɡrəfi
تصوير
مقطعي
محوسب
Imaging technique achieved by rotating
an x-ray emitter around the area to be
scanned and measuring the intensity of
transmitted rays from different angles
In CT scanning, a computer is used to
generate a detailed cross-sectional image
that appears as a slice. (See Figure 1-2
D.) In the digestive system, CT scans are
used to view the gallbladder, bowel, liver,
bile ducts, and pancreas. They are also
used to diagnose tumours, cysts51,
inflammation, abscesses52, perforation,
bleeding, and obstruction.
sialography
sial/o: saliva,
salivary glands
-graphy: process
of recording
ˌsaɪəlɒɡrəfi تصوير
القناة
اللعابية
Radiologic examination of the salivary
glands and ducts
Sialography may be performed with or
without a contrast medium.
ultrasonography
(US)
ultra-: excess,
beyond
son/o: sound
-graphy: process
of recording
abdominal
abdomin:
abdomen
-al: pertaining to
ˌʌltrəsəˈnɒɡrəfi
æbˈdɒmɪnl
تخطيط
دى الص
تخطيط
دى الص
البطني
High-frequency sound waves (ultrasound)
are directed at soft tissue and reflected as
“echoes” to produce an image on a
monitor of an internal body structure; also
called ultrasound, sonography, and echo
US is a non-invasive procedure that does
not require a contrast medium. It is used
to detect diseases and abnormalities in the
digestive organs, such as the gallbladder,
liver, and pancreas. It is also used to
locate abdominal masses outside the
digestive organs.
Ultrasound visualization of the abdominal
aorta, liver, gallbladder, bile ducts,
pancreas, kidneys, ureters, and bladder
An abdominal US is used to diagnose and
locate cysts, tumours, and
malformations53 as well as document the
progression of various diseases and guide
the insertion of instruments during
surgical procedures.
51 Cyst: /sɪst/ a growth containing liquid that forms in or on a person's or an animal's body and may need to be
removed 52 Abscess: /ˈæbses; -sɪs/ a collection of pus formed by tissue destruction in an inflamed area of a localized
infection 53 Malformation: /ˌmælfɔːˈmeɪʃn/ a part of the body that is not formed correctly
Medical Terminology -2
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endoscopic enˈdɒskəpik تخطيط
دى الص
التنظيري
Combines endoscopy and ultrasound to
examine and obtain images of the
digestive tract and the surrounding
tissue and organs
In endoscopic US, a long, flexible tube
(endoscope) inserted via the mouth or
rectum emits high-frequency sound
waves (ultrasound) that produce images
of the organs and structures.
For more information see Ref1, Pages: 135, 144-149
Student Notes:
Medical Terminology -2
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Fourth Lecture
4. Respiratory System: Medical, Surgical, and Diagnostic Procedures
4.1. Pathology54
Common signs and symptoms of many respiratory disorders include cough (dry
or productive55), chest pain, altered breathing patterns, shortness of breath
(SOB), cyanosis56, fever, and exercise intolerance. Many disorders of the
respiratory system, including bronchitis57 and emphysema58, begin as an acute
problem but become chronic over time. Chronic respiratory diseases are usually
difficult to treat. Their damaging effects are commonly irreversible.
For diagnosis, treatment, and management of respiratory disorders, the medical
services of a specialist may be warranted. Pulmonology is the medical specialty
concerned with disorders of the respiratory system. The physician who treats
these disorders is called a pulmonologist.
4.2. Medical, Surgical, and Diagnostic Procedures59
This section introduces medical, surgical and diagnostic procedures used to treat
and diagnose respiratory disorders. Descriptions are provided as well as
pronunciations and word analyses for selected terms.
54 Medical Terminology Systems - A Body Systems Approach: Respiratory System – Pathology p. 176 55 Productive cough: /prəˈdʌktɪv kɒf/ a cough that expels mucus or sputum /spjutəm/ from the respiratory tract 56 Cyanosis: /ˌsaɪəˈnəʊsɪs/ a bluish discoloration of the skin and mucous membranes resulting from inadequate
oxygenation of the blood 57 Bronchitis: /brɒŋˈkaɪtɪs/ an illness that affects the bronchial (bronchus: /ˈbrɒŋkəs/ any one of the system of
tubes which make up the main branches of the windpipe through which air passes in and out of the lungs) tubes
leading to the lungs 58 Emphysema: /ˌemfɪˈsiːmə/ a condition that affects the lungs, making it difficult to breathe 59 Medical Terminology Systems - A Body Systems Approach: Respiratory System – Medical, Surgical, and
Diagnostic Procedures p. 186
Medical Terminology -2
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Procedure Pronunciation60 Arabic61 Meaning
Medical
aerosol
therapy
ˈeərəsɒl ˈθerəpi المعالجة
بالرذاذ
Lung treatment using various techniques to
deliver medication in mist form directly to the
lungs or air passageways
Techniques include nebulizers, metered-dose
inhalers (MDIs), and dry powder inhalers
(DPIs). Nebulizers change liquid medications
into droplets to be inhaled through a
mouthpiece. (See Figure 4-1.) MDIs deliver a
specific amount when activated. Children and
the elderly can use a spacer to synchronize
inhalation with medication release. (See Figure
4-2). A DPI is activated by a quick inhalation
by the user.
Figure 4-1: Nebulizer
Figure 4-2: Metered-dose inhaler
60 Oxford Advanced Lerner’s Dictionary, 9th ed. or: http://dictionary.reference.com/ 61 http://www.emro.who.int/Unified-Medical-Dictionary.html
Medical Terminology -2
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antral62 lavage ˈæntrəl ˈlævɪdʒ رحض
أو غسل
غاري
Washing or irrigating of the paranasal
sinuses to remove mucopurulent63 material
in an immunosuppressed patient or one
with known sinusitis that has failed
medical management
oximetry
ox/i: oxygen
-metry: act of
measuring
ˌɒksɪˈmetri قياس
التأكسج
Non-invasive method of monitoring the
percentage of haemoglobin (Hb) saturated
with oxygen; also called pulse oximetry
In oximetry, a probe attached to the
patient’s finger or ear lobe links to a
computer that displays the percentage of
haemoglobin saturated with oxygen.
polysomnography
poly-: many,
much
somn/o: sleep
-graphy: process
of recording
ˌpɒliˈsəˈmnɒɡrəfi Test of sleep cycles and stages using
continuous recordings of brain waves
(EEGs), electrical activity of muscles, eye
movement, respiratory rate, blood pressure,
blood oxygen saturation64, heart rhythm
and, sometimes, direct observation of the
person during sleep using a video camera
(See Figure 4-3).
postural65
drainage
ˈpɒstʃərəl
ˈdreɪnɪdʒ
نزح
وضعي
Method of positioning a patient so that
gravity aids in the drainage of
secretions from the bronchi and lobes of
the lungs
pulmonary
function tests
(PFTs)
pulmon: lung
-ary: pertaining to
ˈpʌlmənəri
ˈfʌŋkʃn tests
اختبارات
وظيفة
الرئة
Variety of tests used to evaluate respiratory
function, the ability of the
lungs to take in and expel air as well as
perform gas exchange across the
alveolocapillary66 membrane
Measurement of different portions of lung
volume provides an indication of breathing
impairments67, as does measurement of the
volume of air expelled during a rapid,
vigorous exhalation.
62 Antrum: /ˈæntrəm/ (antral adj) a natural cavity, hollow, or sinus, especially in a bone 63 Mucopurulent: /ˌmjuːkəʊˈpjʊərələnt/ containing mucus and pus 64 Saturation: /ˌsætʃəˈreɪʃn/ the degree to which something is absorbed in something else, expressed as a
percentage of the greatest possible 65 Postural: /ˈpɒstʃərəl/ connected with the way you hold your body when sitting or standing 66 alveolocapillary /ælˈviːələʊkəˈpɪləri/ 67 Impairment: /ɪmˈpeəmənt/ the state of having a physical or mental condition which means that part of your
body or brain does not work correctly; a particular condition of this sort
Medical Terminology -2
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Figure 4-3: Polysomnography
spirometry
spir/o: breathe
-metry: act of
measuring
spaɪˈrɒmetri قياس
التنفس
PFT that measures the breathing capacity of the
lungs, including the time necessary for exhaling
the total volume of inhaled air (See Figure 4-4).
A spirometer68 produces a graphic record of
spirometry results for placement in the patient’s
chart.
Figure 4-4: Spirometry
68 Spirometer: /spaɪˈrɒmɪtə/ an instrument for measuring the volume of air entering and leaving the lungs
Medical Terminology -2
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Surgical
endotracheal
intubation
endo-: in, within
trache: trachea
-al: pertaining to
endəˈtrəkiːəl
ˈɪntjubeɪʃn
تنبيب
داخل
غامى الر
Procedure in which a plastic tube is inserted
into the trachea to maintain
an open airway
Endotracheal intubation is commonly
performed before surgery when the
patient is first placed under sedation69 or in
emergency situations to facilitate
ventilation if necessary. (See Figure 4-5).
pleurectomy
pleur: pleura
-ectomy:
excision, removal
ˈplʊərektəmi استئصال
الجنبة
Excision of part of the pleura70, usually the
parietal71 pleura
Pleurectomy is performed to reduce pain
caused by a tumour mass or to prevent the
recurrence of pleural effusion72 but is
generally ineffective in the treatment of
malignancy73 of the pleura.
pneumectomy
pneum: air; lung
-ectomy:
excision, removal
njuːˈmektəmi استئصال
ئة الر
Excision of a lung or a portion of the lung,
commonly for treatment of
cancer (See Figure 4-6).
Figure 4-5: Endotracheal intubation
69 Sedation: /sɪˈdeɪʃn/ the act of giving somebody drugs in order to make them calm or to make them sleep; the
state that results from this 70 Pleura: /ˈplʊərə/ one of the two membranes that surround the lungs 71 Parietal: /pəˈraɪɪtəl/ relating to or forming the wall of any cavity 72 Effusion: /ɪˈfjuːʒn/ something, especially a liquid, that flows out of sb/sth; the act of flowing out 73 Malignancy: /məˈlɪɡnənsi/ a malignant mass of tissue in the body; tumour
Medical Terminology -2
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Figure 4-6: Types of pneumonectomies
septoplasty
sept/o: septum
-plasty: surgical
repair
septəʊˈplæsti رأب
الوتيرة
Surgical repair of a deviated nasal septum
usually performed when the septum is
encroaching74 on the breathing passages or
nasal structures
Common complications of a deviated
septum include interference with breathing
and a predisposition75 to sinus infections.
74 Encroach: /ɪnˈkrəʊtʃ/ to advance beyond proper, established, or usual limits 75 Predisposition: /ˌpriːdɪspəˈzɪʃn/ a condition that makes sb/sth likely to behave in a particular way or to suffer
from a particular disease
Medical Terminology -2
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thoracentesis ˌθɔːrəsenˈtiːsɪ
s
بزل
در الص
Surgical puncture and drainage of the pleural
cavity; also called pleurocentesis or
thoracocentesis
Thoracentesis as a diagnostic procedure helps
determine the nature and cause of an effusion
and, as a therapeutic procedure, relieves the
discomfort caused by the effusion.
tracheostomy
trache/o: trachea
-stomy: forming
an opening
(mouth)
ˌtrækɪˈɒstəmi فغر
غامى الر
Surgical procedure in which an opening is
made in the neck and into the trachea into
which a breathing tube may be inserted (See
Figure 4-7).
Figure 4-7: Tracheostomy: (A) Lateral view with tracheostomy tube in place.
(B) Frontal view
Diagnostic
Endoscopy
bronchoscopy
bronch/o:
bronchus
-scopy: visual
examination
brɒŋˈkɒskəpi تنظير
القصبات
Visual examination of the bronchi using an
endoscope (flexible fibre-optic or rigid)
inserted through the mouth and trachea for
direct viewing of structures or for projection
on a monitor (See Figure 4-8).
Attachments on the bronchoscope can be
used to suction mucus, remove foreign
bodies, collect sputum76, or perform biopsy.
76 Sputum: /ˈspjuːtəm/ liquid from the throat or lungs, especially when it is coughed up because of disease
Medical Terminology -2
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laryngoscopy
laryng/o: larynx (voice
box)
-scopy: visual examination
ˌlærɪŋˈgɒskəpi تنظير
الحنجرة
Visual examination of the larynx
to detect tumours, foreign bodies,
nerve or structural injury, or other
abnormalities
Figure 4-8: Bronchoscopy of the left bronchus
mediastinoscopy
mediastin/o:
mediastinum
-scopy: visual
examination
ˈmiːdɪeɪstənɒskəpi تنظير
المنصف
Visual examination of the
mediastinal77 structures, including the
heart, trachea, oesophagus, bronchus,
thymus78, and lymph nodes
The mediastinoscope is inserted
through a small incision made above
the sternum. The attached camera
projects images on a monitor.
Additional incisions may be made if
nodes are removed or other diagnostic
or therapeutic procedures are
performed.
77 Mediastinum: /ˌmiːdɪəˈstaɪnəm/ (mediastinal: /ˌmiːdɪəˈstaɪnl) the part of the thoracic cavity that lies between
the lungs, containing the heart, trachea, etc. 78 Thymus: /ˈθaɪməs/ an organ in the neck that produces lymphocytes (= cells to fight infection)
Medical Terminology -2
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Imaging
computed tomography
pulmonary angiography
(CTPA)
tom/o: to cut
-graphy: process of recording
pulmon: lung
-ary: pertaining to
angi/o: vessel (usually blood
or lymph)
-graphy: process of recording
kəmˈpjuːtɪd
təˈmɒɡrəfi
ˈpʌlmənəri
ˌændʒiˈəʊɡrəfi
تصوير
األوعية
الرئوية
بالتصوير
يالمقطع
حوسبالم
Minimally invasive imaging
that combines computed
tomography scanning and
angiography to produce
images of the pulmonary
arteries
This test is highly sensitive
and specific for the presence
of pulmonary emboli79.
ventilation-perfusion (V-Q)
scan
ˌventɪˈleɪʃn
pəˈfjuːʒn skæn
تفريسة
التهوية
واإلرواء
Nuclear test scan that
evaluates both airflow
(ventilation) and blood flow
(perfusion) in the lungs for
evidence of a blood clot in
the lungs; also called V-Q
lung scan
For more information see Ref1, Pages: 176, 186-192
Student Notes:
79 Embolus: /ˈembələs/ (pl. emboli /ˈembəlaɪ/) a blood clot, air bubble, or small object that causes an embolism
(/ˈembəlɪzəm/ a condition in which a blood clot or air bubble blocks an artery in the body