how much did tony bellew make from creed / separated but living together centrelink / separated but living together centrelink In the season 10 Big Bang Theory Comic-Con special, Steve Molaro told a story about how he first met actor. acetylcholine receptor in Japanese patients. When your pupils are excessively dilated, it's. https://medical-dictionary.thefreedictionary.com/anisocoria. al. Unequal pupils. Patients presenting with an acute history of Horners syndrome with neck pain and dysphagia require an urgent MRI neck to investigate for carotid artery dissection. Uneven pupil size, or anisocoria, may be a normal variation in a person's eyes or may indicate an underlying problem. The pupils should be evaluated for direct and consensual responses that are normally equal in speed and magnitude. Cleveland Clinic is a non-profit academic medical center. suffix-scope-instrument for examine Scopolamine patch-induced unilateral mydriasis. Anisocoria cannot make you go blind. Anisocoria is unequal pupil sizes. Physiologic anisocoria may be intermittent, persistent, or even self-resolving. root-opthalm-eye The most concerning cause of a 3rd cranial nerve palsy is a brain aneurysm. Miosis can occur in one or both eyes. Apoptosis (a-popt-osis): Apoptosis is the process of programmed cell death. No products in the cart. Patients and other members of the general public should always seek the advice of a physician or other qualified healthcare professional regarding personal health or medical conditions. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video. (2001). Management of anisocoria varies depending on the etiology. A careful history to elucidate the onset and chronicity of anisocoria may be useful for determining its etiology. All rights reserved. The anterior chamber can be examined for signs of iritis or uveitis. Epidemiology. Neuro-ophthalmology Virtual Education Library: NOVEL. You can check out our guide to using SOCRATES here: https://geekymedics.com/the-socrates-acronym-in-history-taking/ Major revisions are performed on a periodic basis. how do i check my medicaid status in louisiana; anisocoria medical terminology breakdown Anisocoria can be caused by a lot of conditions in your body, injuries, traumas and even some medicines. Prefixes modify or enhance the meaning of the term's root by indicating number, location, time or modifying the root's meaning. Emmetropia=emmetr-in proper measure, opia=vision condition 3. A comprehensive collection of medical revision notes that cover a broad range of clinical topics. Horners syndrome). Other causes of 3rd cranial nerve palsy include decreased blood flow to the nerve (microvascular ischemia), tumors pressing on the nerve, and inflammation of the nerve. As a result of General Data Protection Regulation (GDPR), our. Read breaking news about the neuro-ophthalmologist shortage andlearn aboutneuro-ophthalmology fellowships & theNANOS Career Center here! Suffix: The ending part of a word that modifies the meaning of . If the examiner is unsure whether the abnormal pupil is the constricted or dilated one, and if a one-sided drooping of the eyelid is present then the abnormally sized pupil can be presumed to be the one on the side of the ptosis. The sympathetic pathway is a three-order neuron pathway that mediates pupillary dilation. - Medical Finals Question Pack: https://geekymedics.com/medical-student-finals-questions/ June 12, 2022 (2, 5) is correct.It should be wrapped in a cool, moist cloth (sterile, if available) and sealed in a plastic bag. Always adhere to medical school/local hospital guidelines when performing examinations or clinical procedures. NANOS members have successfully presented a poster on Neuro-Ophthalmology Fellowships and Careers at the AAN Faculty and Trainee Reception at the AAN 2018 Annual Meeting. One pupil may be bigger than normal, or one pupil may be smaller than normal, resulting in unequal pupils. Using SOCRATES in History Taking | OSCE | Communication Skills. View All Result . Common ocular effects reported to a poison control center after chalazion. Causes of anisocoria range from benign (normal) to life-threatening conditions. Diabetic opthalmopegia with special reference to the pupil. Pupillary function is autonomic, largely occurring in response to light stimulation and adrenergic tone. The affected eye can often appear deviated toward the ear and slightly downward. Experiencing pain in the neck or around the eye, in association with a Horner syndrome, may be a sign of a carotid dissection, and warrants urgent evaluation through the emergency department. Its similar to the way you might see swelling in your body referred to as edema. Medical TERMINOLOGY. . Clinical features of autoimmune autonomic ganglionopathy and the If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. Talk to your provider about what to expect, especially if youll need longer-term treatment to recover. Low doses of 0.1% pilocarpine or 2.5% methacholine do not constrict a normal pupil but result in the constriction of Adies tonic pupil due to hypersensitivity from the upregulation of cholinergic receptors. 52:386391. Accommodation to near stimuli should also be examined as light-near dissociation. root-scler-hardening Use vesic/o (bladder) to build words that mean: pertaining to the bladder and urethra _________. It may occur after a viral infection, but usually no known cause is found. suffix-ic-pertaining to Cornpickers The purpose of this process is to remove diseased or damaged cells from the body without causing harm to other cells. iridocyclitis), diseases of the iris, paralysis of the third nerve, angle-closure glaucoma, systemic diseases (e.g. record of the electrical response of the retina to light stimulation, prefix-em-in 1. hydroxyamphetamine test. cf-kerat/o-cornea Aberrant reinnervation and upregulation of postsynaptic receptors lead to the clinical presentation of a tonically dilated pupil with near stimulation and poor reactivity to light. Davis and Unbound Medicine. Check out our other awesome clinical skills resources including: While small differences in pupil size are normal and can even come and go ( physiologic anisocoria ), constant and significant differences in pupil sizes may be a sign of damage to the nerves that control the pupils or to the brain. iridocyclitis), diseases of the iris, paralysis of the third nerve, angle-closure glaucoma, systemic diseases (e.g. Explaine the mechanism of action of Sarine , how to diagnose and treat 3. This field is for validation purposes and should be left unchanged. Central or first-order lesions are often caused by stroke, lateral medullary syndrome, neck trauma or demyelinating disease. Medical terminology is composed of a prefix, root word, and suffix: Prefix: A prefix is placed at the beginning of a word to modify or change its meaning. On the other hand, anisocoria that is greater in the light suggests a parasympathetic defect, resulting in an abnormal pupil that is larger or unable to constrict in response to a light stimulus. This allows us to get in touch for more details if required. suffix-meter-instrument to measure There is an increased pupillary asymmetry in Horners syndrome because the sympathetic pathway to the affected pupil is low in norepinephrine to begin with. Underline each adverb, and draw an arrow from each adverb to the word it modifies. Are you in search of a Neuro-Ophthalmology fellowship? These nerves also control the muscles that open your eyelids and activate the sweat glands on your face. cataract. . It is also seen in some people who consume diphenydramine (brand name "Benadryl") for an extended period of time, or if an astringent eye drop like Visine is used in one eye and not the other, often in concurrence with the presence of contact lenses. Anisocoria is usually a benign finding, unaccompanied by other symptoms (physiological anisocoria). This is because a hemorrhage, tumor or another intracranial mass can enlarge to a size where the third cranial nerve (CN III) is compressed, which results in uninhibited dilatation of the pupil on the same side as the lesion.[8]. Clinically, it is important to establish whether anisocoria is more apparent in dim or bright light to clarify if the larger pupil or smaller pupil is the abnormal one. et al. Trigeminal autonomic cephalalgias include primary headache disorders that may result in anisocoria, miosis, or ptosis [5][15]. This page was last edited on February 3, 2023, at 08:32. The prevalence of simple anisocoria. Taber's Cyclopedic Medical Dictionary 24th Edition Online + App from F.A. suffix-us-structure If it remains dilated, the cause of the anisocoria is a pharmacologically dilated pupil. suffix-ia-condition root-trop-turn A diagnosis of Horners can be confirmed by administering 0.5% apraclonidine (alpha-2 agonist) eye drops which will dilate the miotic pupil and correct the anisocoria.5. The pupil on the affected side is abnormally small (miosis) and the upper eyelid will droop (ptosis). Normally our pupils are relatively the same size. Patients with isolated traumatic brain injury (iTBI) are known to have coagulopathy, but no previous studies have examined the gender differences in detail. Additionally, axons associated with the autonomic nervous system that control involuntary physiological functions course through the spinal cord. DO NOT perform any examination or procedure on patients based purely on the content of these videos. Impaired light reaction in the setting of a normal near reaction may suggest Adies tonic pupil or Argyll Robertson pupil of syphilis. Word Roots A root is the foundational element of any medical term. 7:34-37. pupil: an update. Is a condition in which the pupils are unequal in size. 2 suffixes that have more than one meaning, HLTH 125 Ch 10 combining forms of the blood a, Cole Conlin, Elizabeth Millan, Max Ehrsam, Parthena Draggett, Betsy Kerr, Guy Spielmann, Mary Rogers, Tracy D.Terrell, Albert Valdman, Cathy Pons, Mary Ellen Scullen, Chez Nous: Branch Sur le Monde Francophone, Albert Valdman, Cathy Pons, Katherine Mueller, Mary Ellen Scullen, Paula Bouffard. blepharoptosis. Benign causes of Horners syndrome and oculomotor nerve palsies can be observed with expectant partial or full resolution of symptoms. Consultation with a neurologist or neuro-ophthalmologist is recommended for atypical cases, such as autoimmune autonomic ganglionopathy and trigeminal autonomic cephalalgias [5]. The pupil is the black part in the center of the eye. Get useful, helpful and relevant health + wellness information. Experts estimate that around 15% of people experience anisocoria at some point in their lives. study and treatment of defective binocular vision resulting from defects in ocular musculature, cf-phac/o-lens - Onset 01:48 The second-order neuron continues over the lung apex and synapses at the superior cervical ganglion located at the carotid bifurcation. Central or first-order lesions are often caused by stroke, lateral medullary syndrome, neck trauma or demyelinating disease. - Character 02:14 suffix-opia-sight Pupils are the black parts in the middle of the eye. Anisocoria is unequal pupil size. inflammation of the hair follicles and glands along the edges of the eyelids. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. A thorough pupillary exam is crucial, and it is best done in dim light with the patients eyes fixed on a distant object to eliminate the near reaction. Compressive lesions from head trauma, intracranial aneurysms, uncal herniation, and tumors typically involve the pupil as they affect the superficial parasympathetic fibers that innervate the pupil. It's commonly understood to occur when life's demands become physically and emotionally overwhelming. Pt 1):525. Examples of conditions that can result in pathologic anisocoria include: Iritis. They are usually the same. Pre means "before." Prefixes may also indicate a location, number, or time. Copyright 2021. I'm bad at making friends, and I don't have any close friends that I could talk to about being trans. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. It shrinks (contracts) in bright light and expands (dilates) in dim light. On this Wikipedia the language links are at the top of the page across from the article title. This may suggest Adie tonic pupil, pharmacologic dilation, oculomotor nerve palsy, or damaged iris. inability to see half of the field of vision, prefix-hyper-beyond Friedman NJ. Etiology of Anisocoria The most common cause of anisocoria is Physiologic (present in about 20% of people): The difference between pupil sizes in physiologic anisocoria is typically about 1 mm. It was named in 1909 for the Austro-Hungarian neurologist and psychiatrist . Gastro - stomach Enter - intestines Itis - Inflammation Through this breakdown, we can understand that Gastroenteritis means inflammation of the stomach and small intestine. united methodist church global methodist. J Emerg Med 2007; (3) is incor-rect.It is not placed on dry ice, which is also not readily available. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. root-trop-turn anisocoria medical terminology breakdown. "Angel's Trumpet (Brugmansia arborea) and mydriasis in a child - A case report", "The remarkable story behind David Bowie's most iconic feature", "Developmental inhibitory gate controls the relay of activity to the superficial layers of the visual cortex", Thygeson's superficial punctate keratopathy, Chronic progressive external ophthalmoplegia, https://en.wikipedia.org/w/index.php?title=Anisocoria&oldid=1107800370, Short description is different from Wikidata, Creative Commons Attribution-ShareAlike License 3.0, A large difference in the size of the pupils following application of, Anisocoria which is worsened (greater asymmetry between the pupils) in the dark suggests the small pupil (which should dilate in dark conditions) is the abnormal pupil and suggests Horner's syndrome or mechanical anisocoria. Give the medical term for the following definitions. What is her acceleration at the instant she achieves the "knife" position? instrument used to examine the angle of the anterior chamber of the eye, prefix-hemi-half Preganglionic or second-order neuron lesions may be caused by a Pancoast tumor, mediastinal or thyroid mass, cervical rib, neck trauma, or surgery. Learn why Cleveland Clinic Cole Eye Institute is among the worlds most advanced eye centers. The pupil is the black center of your eyes that expands and contracts to help you see in different amounts of light. Mechanical anisocoria is an acquired defect that results from damage to the iris or its supporting structures. Most often, the diameter difference is less than 0.5 mm, but it can be up to 1 mm. Neuro-ophthalmologists specialize in conditions that cause problems with the pupils. Pharmacologic anisocoria can present as mydriasis or miosis following administration of agents that act on the pupillary dilator or sphincter muscles. This is a retrospective analysis of a prospective registry conducted at 2 centers. antibody in a tertiary neurology referral center. glycopyrrolate used in hyperhidrosis. suffix-al-pertaining to Update Your Email Preferences and Stay Connected with NANOS, NANOS Poster at the AAN Annual Conference, http://medlineplus.gov/ency/article/003314.htm, Thomas and Susan Carlow Young Investigator Award Fund, NANOS Avoidance of Anticompetitive Behavior Guidelines, NANOS Clinical Survey and Investigation Request Policy, NANOS Co-Sponsored Symposia in Other International Conferences Policy, NANOS Promotion Policy for Medical Meetings, NANOS Diversity, Equity and Inclusion (DEI) Resources, NANOS Heroes - Dr. Patricia Johnston McNussen, Idiopathic Intracranial Hypertension/Pseudotumor Cerebri, Non-Arteritic Anterior Ischemic Optic Neuropathy, Idiopathic Intracranial Hypertension/Pseudotumor Cerebri Infographic, Leber Hereditary Optic Neuropathy Infographic, Microvascular Cranial Nerve Palsy Infographic, Non-Arteritic Anterior Ischemic Optic Neuropathy Infographic, 1935 County Road B2 W Ste 165 | Roseville, MN 55113. Anisocoria is different pupil sizes in each eye. Talk to your provider about what you should expect if your childs pupils are different sizes at birth. Complete ophthalmic history is important as coexisting ocular conditions, previous surgeries or trauma to the head or orbit may contribute to anisocoria. The Academy uses cookies to analyze performance and provide relevant personalized content to users of our website. When focusing on the finger up close, the right pupil constricts normally (arrow). Physiological anisocoria remains constant irrespective of the level of illumination. anisocoria medical terminology breakdown. Adies tonic pupil can be managed with the help of glasses to improve vision and pilocarpine to constrict the pupil. root-trop-turn The oculomotor nerve innervates 4 out of the 6 extraocular muscles (superior rectus, medial rectus, inferior rectus, and inferior oblique), the sphincter pupillae muscle, the ciliary muscle, and the levator palpebrae muscle. Anisocoria is present when an individual's pupils differ in size. These cases may be due to brain mass lesions which cause oculomotor nerve palsy. Meeting Updates, Committee Highlights, N-O shortage, Grant Opportunities and other news! A detailed neurologic exam is important to localize lesions, look for accompanying signs of cranial nerve involvement, and assess for focal neurologic deficits in the sensory, motor, and deep tendon reflex pathways. For more information, see the Geeky Medics guide to the examination of the eyes and vision. Please write a single word answer in lowercase (this is an anti-spam measure). The second-order neuron connects each pretectal nucleus to bilateral Edinger-Westphal nuclei in the midbrain and allows for the consensual light reflex. Hydroxyamphetamine mydriasis in Horners syndrome. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. This typically represents a disruption of the parasympathetic nervous system. "Simple, central" anisocoria. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel , Anisocoria refers to the unequal size of pupils and can be a physiological phenomenon. TikTok: https://www.tiktok.com/@geekymedics Additionally, the nerve provides parasympathetic innervation to the sphincter pupillae muscles of the iris which are involved in theconstriction of the pupil. If you wear glasses or contact lenses, have your eyes examined regularly so your provider can adjust your prescription as often as necessary. Because some forms of anisocoria may be present for years before it is noticed, your doctor may ask you to provide old pictures to determine how long you have had the problem. Pupil may be oval-shaped or shows segmental constriction Unilateral in 80% of cases. (c)(c)(c) At some instant she quickly flips into a "knife" position, orienting her body vertically with her arms straight down. Example: hypoglycemia - hypo-below normal, glyc=sugar, emia=blood condition. Some issues like migraines or reactions to medications will resolve themselves on their own. Lee, AG. In the mirror, the pupil of the eye appears as a black circle in the middle of the iris (the colored part of the eye). Anisocoria is a condition characterized by unequal pupil sizes. Curr Opin The views expressed in this brochure are of the contributors and not their employers or other organizations. Kaiser PK. Anisocoria can also be caused by serious, life-threatening conditions, including: Your healthcare provider will classify your anisocoria as either pathological (caused by a disease) or physiological (caused by something malfunctioning inside your body). Slattery A, Liebelt E, Although there are benign causes that do not usually need treatment, it is important to find out what is causing the Horner syndrome because it may be a sign of a life-threatening condition, such as stroke, lung, chest or brain tumor, or break in the wall of the carotid artery (carotid dissection). Am J Ophthalmol 1990; 110(1):71-6. 2 Clinical examination should demonstrate a difference of less than 1mm between pupil size which typically remains the same in both light and dark conditions. Please visit our Fellowship page for openings. The management of Horners syndrome depends on the underlying cause and the patient will require further investigation (e.g. Aim: Primary care will play a more significant role on the diagnosis and management of neurodegenerative diseases in near future. Both anisocoria and Horners syndrome can be caused by serious, life-threatening conditions like a stroke, brain aneurysm or some cancers. View All Result . Anisocoria. In this position, she presents the maximum cross-sectional area and thus maximizes the air-drag force on her. J Neuroophthalmol 2006; 26:232-233. 3 Pathological anisocoria Breaking a word down into its component parts should help readers ascertain the meaning of an unfamiliar term. Instagram: https://instagram.com/geekymedics coiling of the aneurysm). 1. Courtesy of Dr. Valerie Biousse, M.D. Question: Describe the appropriate steps to take in the emergency department when evaluating anisocoria. To diagnose anisocoria, your ophthalmologist will examine your pupils in both a lighted room and a dark room. small, hard, painless cyst of a sebaceous gland of the eyelids. Join the Geeky Medics community: Visit Us 4201 Wilson Blvd, Suite 300, Arlington, VA 22203 glentunnel to christchurch FREE QUOTE. If these tests find any serious problems, your doctor will refer you to the appropriate specialists for urgent treatment. tumorlike swelling caused by obstruction of the tear ducts, cf-electr/o-electricity 3rd Cranial Nerve Palsy: An Abnormally Large Pupil. Pupillary Disorders Including Anisocoria. This page has been accessed 251,719 times. An Adie tonic pupil is abnormally large like a 3rd cranial nerve palsy, but the pupil still constricts when focusing on something close to the face, and there is no double vision or droopy eyelid. Some of the causes of anisocoria are turning inward of the margin of the lower eyelid, prefix-eso-inward Acad Ophthalmol Otolaryngol. This information is produced and made available as is without warranty and for informational and educational purposes only and do not constitute, and should not be used as a substitute for, medical advice, diagnosis, or treatment. Right 3rd cranial nerve palsy. 33:21-24. disorder of the eye in which the optic axes cannot be directed to the same object, inflammation of one or more of the sebaceous glands of the eyelid, cf-ton/o-tone Anisocoria which is greater in bright light suggests the larger pupil (which should constrict in bright conditions) is the abnormal pupil. Third nerve palsies rarely present as isolated mydriasis; associated findings include ptosis, an ipsilateral down and out gaze, and loss of accommodation. Pharmacologic anisocoria typically resolves with cessation of the offending agent. Cremer SA, Thompson HS, Digre KB, Kardon RH. Isolated anisocoria is often asymptomatic, though mydriasis may cause glare, photosensitivity, and impaired accommodation. 25 Jun. Gaines LA. cf-my/o-muscle _____ Thomas Edison was a gifted inventor; and he also improved on the inventions of others. Anisocoria is the medical term for asymmetric (different sized) pupils. 4th Edition. When this affects one side, the pupil sizes may be unequal. anisocoria medical terminology breakdown. Koc F, Kavuncu S, Kansu T. The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis, Br J Ophthalmol 2005; 89(11):1442-1444. Write C in the blank if the sentence is correctly punctuated. A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. Ptosis and gaze deviation may suggest an oculomotor nerve palsy, whereas proptosis may indicate and underlying space-occupying lesion within the orbit. Anisocoria is a condition characterized by an unequal size of the eyes' pupils. The term "nervous breakdown" is sometimes used by people to describe a stressful situation in which they're temporarily unable to function normally in day-to-day life. The Edinger-Westphal nucleus then supplies parasympathetic fibers to the third cranial nerve which traverses the cavernous sinus and enters the orbit via the superior orbital fissure to synapse at the ipsilateral ciliary ganglion. in antimetropia) or it may be part of a syndrome, the most common being those of Adie's and Horner's. anisocoria medical terminology breakdownsecond hand dance costumes. the finding of jesus in the temple reflection. Autoimmune autonomic ganglionopathy is a disorder of autoantibodies that target autonomic ganglia [5][16]. See table Some Common Causes of Anisocoria for other causes of anisocoria. Please note we have made every effort to ensure the content of this is correct at time of publication, but remember that information about the condition and drugs may change. Cremer SA, Thompson HS, Anisocoria can affect anyone. Dinslage S, Diestelhorst M, Generally, anisocoria is caused by impaired dilation (a sympathetic response) or impaired constriction (a parasympathetic response) of pupils. Is a dismness of vision or the partial loss of sight in one eye, Is any error of refraction in which images do not focus properly on the retina, Is a condition in which the pupils are unequal in size, Is a condition in which the eye does not focus properly because of uneven curvatures of the cornea, Is the use of an audiometer to measure hearing acuity, Is the loss of transparency of the lens that causes a progressive loss of visual clarity, Is a nodule or cyst usually on the upper eyelid caused by obstruction in a sebaceous gland, Is an electronic device that bypasses the damaged portions of the ear and directly stimulates the audiotory nerve, Is an inflammation of the lacrimal gland caused by a bacterial viral or fungal infection, Is the eversion of the edge of the eyelid, Is the normal relationship between the refractive power of the eye and the shape of the eye that enables lights, Is the inversion of the edge of an eyelid, Is a radiographic study of the blood vessels in the retina of the eye following the intravenous injection of a fluorescein dye as a contrast medium, Is a group of diseases characterized by increased intraocular pressure that causes damage to the retina nerve fibers and the optic nerve, Is a blindness in one half of the visual field, Stye pus filled and often painful lesion on the eyelid, Is a contagious inflammation that causes painful blisters on the eardrum, Is the surgical removal of a portion of the tissue of the iris, Is the surgical removal of all or a portion of the labrinth, Is used to treat open angle glaucoma by creating openings in the trabecular mesh work to allow the fluid to drain properly, The dilation of the pupil is the opposite of miosis, Is a small surgical incision in the eardrum to relieve pressure from excess pus or fluid, Is an involuntary constant rhythmic movement of the eyeball that can be congenital or caused by a neurological injury or drug use, Holds a doctor of optometry degree and provides primary eye care, Is the ankylosis of the bones of the middle ear, Is swelling of the tissues surrounding the eye or eyes, Is the presence of what appears to be flashes or light, Is a gradual loss of sensorineural hearing that occurs as the body ages, Is the condition of common changes in the eyes that occur with aging, Is the drooping of the upper eyelid that is usually due to paralysis, Is used to reattach the detached area in a retinal detachment, Is the surgical removal of the top portion of the stapes bone and the instertion of a small prosthetic device, Is a disorder in which the eyes point in different directions or are not alignment correctly, Is the partial or complete su turning together of the upper and lower eyelids to protect the eye when the lids are paralyzed, Commonly pronounced ringing buzzing or roaring, Is the measurement of intraocular pressure, Is a sense of whirling dizziness and loss of balance, Is the removal of the vireous humor and it's replacement with a clear solution, Julie S Snyder, Linda Lilley, Shelly Collins, Sports Medicine Essentials: Core Concepts in Athletic Training and Fitness Instruction, Ch 14 Infectious Disease Prevention & Control.