TONGUE
to c o p h e ro l
A constituent of
v ita m in
f.Together, four
tocopherols (alpha, beta, gamma, and
delta) and several tocopherol derivatives
make up the vitamin.
to d d le r’s d ia rrh o e a
A common condition affecting some
children for a period after the introduc-
tion of an adult diet. It occurs because
the child is unable to digest food prop-
erly,
perhaps
because
of inadequate
chewing. The diarrhoea is no cause for
concern, and no treatment is needed.
T o d d ’s p a ra ly s is
Weakness in part of the body following
some types of epileptic seizure
(see
e p ile p s y
) .
The weakness may last for
minutes, hours, or even days, but there
is no lasting effect. The cause is thought
to be temporary damage to the motor
cortex (the area of the
b ra in
that con-
trols movement).
to e
One of the digits of the foot. Each toe
has three
p h a la n g e s
(bones), except for
the
h a llu x
(big toe), w hich has two. The
phalanges join at hinge joints, w hich are
moved by tendons that flex (bend) or
extend (straighten) the toe. An artery,
vein, and nerve run down each side of
the toe, and the
whole structure is
enclosed in skin with a nail at the top.
The main function of the toes is to
maintain balance during walking.
DISORDERS
C o n g e n it a l
disorders include toes missing
at birth,
p o ly d a c ty ly
(extra toes),
s y n -
d a c ty ly
(fused toes), or
w e b b in g
(skin
flaps between the toes).
Injuries to the toes, including frac-
tures, are fairly common. Inflammation
of the joints, with pain, stiffness, and
swelling, may be caused by
o s t e o a r t h r i-
tis, r h e u m a t o id a rth ritis ,
or
g o u t
.
A common deformity of the big toe
is
h a llu x v a lg u s
,
in w hich the toe turns
inwards to the others. This often leads
to the development of a
b u n io n
(a fluid-
filled swelling) over the joint at the base
of the toe. Abnormality of a tendon in
one of the toes may also cause distor-
tion (see
h a m m e r t o e
) .
to e n a il, in g ro w in g
A painful condition of a toe (usually the
big toe) in which one or both edges of
the
n a il
press into the adjacent skin,
leading to infection and inflammation.
The cause is usually incorrect cutting of
the nail or wearing tight-fitting shoes.
Pain relief can be obtained by bathing
the foot once or twice daily in a strong,
warm, salt solution, then covering the
nail with a dry gauze dressing.
A n t ib io t ic s
may be prescribed. In some cases, the
edge of the nail is removed and the nail
bed obliterated to prevent recurrence.
to ile t-tra in in g
The process of teaching a young child to
acquire complete bowel and bladder con-
trol. A child is unlikely to be completely
toilet-trained before age three and may
normally take much longer to remain
dry at night (see
e n u r e s is
) .
WHEN TO START
Up to about
18
months, emptying of
the bladder or bowel is a totally auto-
matic reaction. The child is not yet able
to connect the actions of defaecation
and urination with their results, and
cannot control these actions at will.
At around
18
months, a child can
usually indicate
that he
or she has
passed urine or a bowel movement, but
is not yet aware when he or she is about
to do so. At this stage, the child is not
quite ready to use a potty, but can prac-
tise sitting on it. By the age of two, a
child is aware when he or she is about
to pass urine or a bowel movement and
says so. At this stage, the child is ready
to start using the potty.
METHODS
Toilet-training should be approached in
a relaxed, unhurried manner. A child
should never be forced to sit on a potty.
Boys initially urinate sitting down but
soon learn how to manage standing up.
Once a child uses the potty confidently,
he or she can gradually progress to
using the toilet.
When reasonable control has been
achieved, the child can be taken out of
nappies during the day. Nappies should
be worn at night until the child is usu-
ally dry on waking.
Toilet accidents, particularly wetting,
are common up to the age of five,
because a young child can delay urina-
tion for
only a few minutes. Some
children revert to soiling or wetting
when anxious or under stress. (See also
e n c o p r e s is ; e n u r e s is ; s o il in g
. )
to lb u ta m id e
An oral hypoglycaemic drug (see
h y p o -
g ly c a e m ic s , o ra l
)
used in the treatment of
type 2
d ia b e t e s m e llit u s
.
to le ra n c e
The need to take increasingly higher
doses of a
d ru g
to obtain the same phys-
ical or mental effect. Tolerance develops
after taking a drug over a period of
time, and usually results either from the
liver becoming more efficient at break-
ing the drug down or from tissues
becoming less sensitive to it.
to ln a fta te
An
a n tifu n g a l d ru g
applied to the skin to
treat, and sometimes prevent, recurrent
tin e a
infections, including
a th le t e ’s f o o t
.
In rare cases, tolnaftate may cause skin
irritation or a rash.
to m o g ra p h y
An
im a g in g t e c h n iq u e
that produces a
cross-sectional
image
(“slice”)
of an
organ or part. Most tomography today
is performed using
C T s c a n n in g
and
M R I
,
producing accurate and detailed images.
-to m y
A
suffix
denoting
the
operation
of
cutting or making an incision.
to n e , m u s c le
The natural tension in the
m u s c le
fibres.
At rest, all muscle fibres are kept in a
state of partial contraction by nerve
impulses from the spinal cord. Abnor-
mally high muscle tone causes increased
resistance to movement,
s p a s t ic it y ,
and
rigidity. Abnormally low muscle tone
causes floppiness (see
h y p o t o n ia
) .
to n g u e
A muscular, flexible organ in the floor
of the
m o u t h
.
T
749
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