Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders (autoimmune diseases, hypersensitivities, immune deficiency, transplant rejection); the physical, chemical and physiological characteristics of the components of the immune system in vitro, in situ, and in vivo. Immunology has applications in several disciplines of science, and as such is further divided.
What is anesthesia? — Anesthesia is a term that doctors use for different types of medicine they give people before surgery or another procedure. These medicines work by making sure that you do not:
• Feel pain
• Move during the surgery or procedure
• Remember the surgery or procedure
What are the different types of anesthesia? — There are 3 main types of anesthesia:
• Local – This type of anesthesia uses medicine to numb a small part of your body so you don’t feel pain. It can be given as a cream, gel, or spray on the skin. It can also be given by an injection (shot) into the skin. You might be awake when you get local anesthesia.
Doctors give local anesthesia before minor surgery, such as a skin or breast biopsy. A biopsy is when a doctor takes a tiny sample of tissue using a needle.
• Regional – This type of anesthesia blocks pain in a large area of your body, such as an arm, leg, or the lower half of your body. One type is called a “spinal block.” The doctor puts a small needle in your lower back. The needle goes into the fluid around your spinal cord, which is the bundle of nerves that runs down your back. He or she then injects medicines that block pain and relax your muscles so you do not move. It can be used for surgery done on your legs or inside your belly.
Another type is an “epidural.” The doctor uses a needle to put a small tube (called a “catheter”) into your lower back, near the nerves around the spinal cord. Some women get epidurals during childbirth. Other people get them for a surgical procedure or to control pain after surgery.
If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called “sedatives.” Sedatives are given through a small tube put into a vein, called
• General – This type of anesthesia makes you unconscious so you can’t feel, see, or hear anything during surgery. Some of the medicines are given through an IV. Others are gases that you breathe through a mask that is placed over your mouth and nose. You might also get a breathing tube, which is a tube that goes down the throat and into the lungs. The other end is attached to a machine that helps with breathing. A specialist doctor called an “anesthesiologist” gives general anesthesia.
Pain management (also called pain medicine; algiatry) is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, and nurse practitioners. Pain sometimes resolves promptly once the underlying trauma or pathology has healed, and is treated by one practitioner, with drugs such as analgesics and (occasionally) anxiolytics. Effective management of long term pain, however, frequently requires the coordinated efforts of the management team.
Medicine treats injury and pathology to support and speed healing; and treats distressing symptoms such as pain to relieve suffering during treatment and healing. When a painful injury or pathology is resistant to treatment and persists, when pain persists after the injury or pathology has healed, and when medical science cannot identify the cause of pain, the task of medicine is to relieve suffering. Treatment approaches to long term pain include pharmacologic measures, such as analgesics, tricyclic antidepressants and anticonvulsants, interventional procedures, physical therapy, physical exercise, application of ice and/or heat, and psychological measures, such as biofeedback and cognitive behavioral therapy.
Chiropractors are allied health practitioners who are independently licensed in most jurisdictions. The World Federation of Chiropractic defines the practice as “A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.” Chiropractors as experts are often required in matters where subjects have been under the care and treatment of chiropractors for long periods of time, calling into question the relatedness, necessity, and reasonableness of chiropractic care and expenses with regard to the injury(ies) being litigated.
Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but the latter term is now used infrequently within medicine, and is most often employed to identify practices relating to the anus and rectum in particular. (the word proctology is derived from the Greek words Proktos, meaning anus or hindparts, and Logos meaning science or study).
Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, in order to become colorectal surgeons, these surgical doctors have to complete a general surgery residency, as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the American Board of Colon and Rectal Surgery or the American Osteopathic Board of Proctology. In other countries, certification to practice proctology is given to surgeons at the end of a 2-3 year subspecialty residency by the country’s board of surgery.
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered necessary for complete overall health. Doctors who practice dentistry are known as dentists. The dentist’s supporting team – which includes dental assistants, dental hygienists, dental technicians, and dental therapists – aids in providing oral health services.
Dermatology is the specialty of medicine that diagnoses and treats disorders of the skin and integument. A dermatological expert is required in matters where skin disorders are being claimed to have been caused or contributed to by exposure or environmental hazards. In some cases, a dermatologist can opine in matters where there has been trauma causing superficial scarring.
Otorhinolaryngology (or, ENT for short) is the surgical specialty that diagnoses and treats disorders and trauma of the senses involving hearing, smell, taste, and the anatomical structures of the head and neck. These specialists are often retained in cases involving head and neck trauma, hearing loss, alteration of taste and smell (whether environmental or trauma), sleep apnea, and tumors of the head and neck.
Critical care: The specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units. Also known as intensive care.
Family medicine (FM) is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (Wonca), the aim of family medicine is to provide personal, comprehensive and continuing care for the individual in the context of the family and the community.
The American College of Surgeons defines general surgery broadly
“General Surgery” is a discipline of surgery having a central core of knowledge embracing anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care, and neoplasia, which are common to all surgical specialties.
A general surgeon has specialized knowledge and experience related to the diagnosis, preoperative, operative, and postoperative management, including the management of complications, in nine primary components of surgery, all of which are essential to the education of a broadly-based surgeon:
- Alimentary tract
- Abdomen and its contents
- Breast, skin, and soft tissue
- Head and neck, including trauma, vascular, endocrine, congenital and oncologic disorders – particularly tumors of the skin, salivary glands, thyroid, parathyroid, and the oral cavity
- Vascular system, excluding the intracranial vessels and heart
- Endocrine system, including thyroid, parathyroid, adrenal, and endocrine pancreas
- Surgical oncology, including coordinated multimodality management of the cancer patient by screening, surveillance, surgical adjunctive therapy, rehabilitation, and follow-up
- Comprehensive management of trauma, including musculoskeletal, hand, and head injuries. The responsibility for all phases of care of the injured patient is an essential component of general surgery.
- Complete care of critically ill patients with underlying surgical conditions, in the emergency room, intensive care unit, and trauma/burn units
Medical doctors holding an MD or DO degree followed by at least a five-year accredited residency in general surgery are eligible for board certification in this discipline.
General surgeons are retained as experts in cases involving multiple trauma, burns, hernias, blunt force and penetrating injuries to the internal organs, as examples. Diseases that general surgeons often evaluate as experts include cancer, critical illness, and gastrointestinal disorders.
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness (i.e., characteristic medical signs and/or symptoms of disease) resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism. In certain cases, infectious diseases may be asymtomatic for much or all of their course. Infectious pathogens include some viruses,bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are the cause of disease epidemics, in the sense that without the pathogen, no infectious epidemic occurs.
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes. Internists care for hospitalized and ambulatory patients and may play a major role in teaching and research. Although some internists are full-time hospitalists, many fulfill locum tenens (temporary) positions both stateside and internationally. Internal medicine is also a specialty within veterinary medicine.
Neurology is a medical specialty dealing with disorders of the nervous system. To be specific, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. The corresponding surgical specialty is neurosurgery. A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research.
Neurology is the medical application of neuroscience that is the scientific study of the nervous system.
Neuropsychology is the discipline of psychology that adds standardized objective testing techniques to psychological interviews in order to diagnose both disease and trauma based deficits in higher cerebral functions, such as awareness, memory, cognitive deficits, and executive functions. A neuropsychological evaluation is frequently needed in cases claiming memory or cognitive deficits whether from trauma or disease.
Neurosurgery or neurological surgery is the specialty of medicine that diagnoses and treats, usually surgically, diseases and injuries involving the central and peripheral nervous system and their surrounding anatomical structures. Thus, there is some overlap with orthopaedic surgery especially in the areas of spinal surgery and peripheral nerve surgeries. The choice of a neurosurgeon as an expert hinges upon the specialty of the treating or opposing specialist in litigation. There are several subspecialties in neurosurgery, including spinal disorders/trauma, cranial and skull base surgery, and others including deep brain stimulation.
Obstetrics is the medical specialty dealing with the care of all women’s reproductive tracts and their children during pregnancy (prenatal period), childbirth and the postnatal period.Veterinary obstetrics is the same concept for veterinary medicine although theriogenology is more commonly used term that includes obstetrics, gynecology, and andrology. Almost all modern obstetricians are also gynaecologists.
Gynecology is the specialty of medicine that diagnoses and treats, including surgical treatment, the female reproductive system and lower urogenital structures.
Occupational Medicine is the branch of clinical medicine most active in the field of Occupational Health. Its principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained. Occupational Physicians must have a wide knowledge of clinical medicine and be competent in a number of important areas.
Occupational Health aims for the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations; the prevention among workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; placing and maintenance of a worker in an occupational environment adapted to his physiological and psychological equipment and, to summarize, the adaption of work to people and of each person to their job.
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments that develop, recover, or maintain clients’ activities of daily living. The therapist helps clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. The goal of occupational therapy is to help clients have independent, productive, and satisfying lives.
Branch of medicine and surgery (both methods are used) that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a specialist in Ophthalmology. Their credentials include a doctorate degree in medicine, followed by an additional four years of Ophthalmology residency training. They may or may not receive residency training in internal medicine, pediatrics, or general surgery before the ophthalmology residency. Additional training may be sought through a fellowship in a particular specialty of eye pathology. Ophthalmologists are allowed to use medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists may participate in academic research on the diagnosis and treatment for eye disorders.
Oral and maxillofacial surgeons are dental specialists who treat conditions, defects, injuries and esthetic aspects of the mouth, teeth, jaws and face. Their training involves a four year graduate degree in dentistry and the completion of a minimum four year hospital surgical residency program.
Oral and maxillofacial surgeons care for patients who experience such conditions as problem wisdom teeth, facial pain and misaligned jaws. They treat accident victims suffering from facial injuries, offer reconstructive and dental implant surgery, and care for patients with tumors or cysts of the jaws and functional and esthetic conditions of the maxillofacial areas.
- Upper Extremities
- Neck and Spine
- Lower Extremities
- Foot and Ankle
- Joint Disorders
Orthopaedic Surgery is the specialty of medicine that diagnoses and treats disorders of the musculoskeletal system and mechanical disorders of the peripheral nervous system. Thus, there is some overlap with the specialties of neurosurgery, plastic surgery, and general surgery. The choice of an orthopaedic surgeon as an expert also hinges upon the specialty of the treating or opposing specialist in litigation, and whether the services of a subspecialist are required. There are at least seven subspecialties in orthopaedics, including spine surgery, pediatric orthopaedics, sports medicine, joint replacement, foot and ankle surgery, hand and upper extremity surgery, and orthopaedic oncology.
Pediatrics is the specialty of medical science concerned with the physical, mental, and social health of children from birth to young adulthood. Pediatric care encompasses a broad spectrum of health services ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases.
Physical medicine and rehabilitation, also referred to as physiatry or rehabilitation medicine, is a branch of medicine concerned with evaluation and treatment of, and coordination of care for, persons with musculoskeletal injuries, pain syndromes, and/or other physical or cognitive impairments or disabilities.
Physical therapy (or physiotherapy), often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention and rehabilitation. This encompasses physical, psychological, emotional, and social well being.
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.
Podiatry is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle, and lower leg. A specialist who is qualified by their education and training to diagnose and treat conditions affecting the foot, ankle, and related structures of the leg. Within the field of podiatry, practitioners can focus on many different specialty areas, including surgery, sports medicine, biomechanics, geriatrics, pediatrics, orthopedics, or primary care.
Psychiatry is the specialty of medicine devoted to diagnosis and treatment of major emotional disturbance, thought, and abnormal behaviors that usually require medication and/or hospitalization. Choosing a psychiatric expert instead of a psychologist is usually predicated upon whether the subject is being medicated or has been hospitalized for a relevant disorder that is factored into an evaluation.
Psychology is the scientific study of the mind and behavior. Psychology is a multifaceted discipline and includes many sub-fields of study such areas as human development, sports, health, clinical, social behavior and cognitive processes.
In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the respiratory tract and respiratory disease. It is called chest medicine and respiratory medicine in some countries and areas. Pulmonologyis generally considered a branch of internal medicine, although it is closely related to intensive care medicine (aka critical care medicine) when dealing with patients requiring mechanical ventilation.
Radiology is the specialty of medicine that aids in the diagnosis and treatment of disorders and trauma through imaging and imaging related (interventional) procedures. Radiologists can be subspecialized in many different fields, including neuroradiology, chest, cardiac, gastrointestinal, and skeletal imaging. Interventional radiologists perform minimally invasive procedures using radiological imaging as a tool. Experts in radiology commonly re-read “over-read” existing medical imaging in the context of the litigation environment, providing important granular and contextual detail to imaging study “reads” that do not have the benefit of complete medical histories.
Rheumatology is a sub-specialty in internal medicine and pediatrics, devoted to diagnosis and therapy of rheumatic diseases. Clinicians who specialize in rheumatology are called rheumatologists. Rheumatologists deal mainly with clinical problems involving joints, soft tissues, autoimmune diseases, vasculitis, and heritable connective tissue disorders.