Bma Illustrated Medical Dictionary

to the lungs, where carbon dioxide is

exchanged for oxygen. The reoxygenated

blood then returns through the pul-

monary veins to the heart and re-enters

the systemic circulation.

circumcisionSurgical removal of the
foreskin of the penis, usually performed
in newborn babies for religious reasons
or for reasons of hygiene. Circumcision
may be needed to treat phimosis, recur-
rent attacks of balanitis,or paraphimosis.
circumcision, femaleRemoval of all or
parts of the clitoris, labia majora, and
labia minora (see labia), sometimes com-
bined with narrowing of the entrance to

the vagina. Female circumcision is com-

mon in parts of Africa but has no valid

medical purpose. It can cause retention

of urine and injuries during sexual

intercourse and childbirth.

cirrhosisA condition of the liverarising

from long-term damage to its cells. In

cirrhosis, bands of fibrosis (internal

scarring) develop, leaving nodulesof

regenerating cells that are inadequately

supplied with blood. Liver function is

gradually impaired; the liver no longer

effectively removes toxic substances

from the blood (see liver failure). The

distortion and fibrosis also lead to por-

tal hypertension. The most common

cause of cirrhosis is heavy alcoholcon-

sumption. Other causes include forms

of hepatitis and, more rarely, disorders of

the bile ducts, haemochromatosis, Wilson’s

disease, cystic fibrosis, and heart failure.

Cirrhosis may go unrecognized until

symptoms such as mild jaundice, oede-

ma, and vomiting of blood develop.

There may be enlargement of the liver

and spleen and, in men, enlargement of

the breasts and loss of body hair due to

an imbalance in sex hormones caused

by liver failure. Complications of cirrho-

sis include ascites, oesophageal varices,

and hepatoma. Treatment is focused on

slowing the rate at which liver cells are

being damaged, if possible by treating

the cause. In some cases, however, the

condition progresses and a liver trans-

plantmay be considered.

cisplatinAn anticancer drugused to treat

some cancers of the testisand ovary.

citalopramAn antipressant drug.

CJDThe abbreviation for Creutzfeldt–

Jakob disease.

clapA slang term for gonorrhoea.

clarithromycinAn antibiotic drugused

to treat infections of the skin and respi-

ratory tract.

claudicationA cramp-like pain in a

muscle, most often in the legs, due to

inadequate blood supply. Claudication

in the legs is usually caused by blockage

or narrowing of arteries du to athero-

sclerosis(see peripheral vascular disease).

A rarer cause is spinalstenosis. In inter-

mittent claudication, pain is felt in the

calves after walking a certain distance

and is relieved by rest.

CIRCUMCISION CLAUDICATION

C

Radial
artery

Great

saphenous vein

Femoral

vein

Inferior
vena cava

Aorta

Brachial
vein

Superior vena cava

CIRCULATORY SYSTEM

Iliac
artery

Femoral
artery

Jugular

vein

Temporal

artery

Heart

Common carotid

artery

Popliteal

artery

Posterior

tibial artery

Brachial artery