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 This International Student Edition is for use outside of the U.S.

SEVENTH EDITION

MEDICAL ASSISTING
REVIEW
Passing the CMA , RMA , CCMA , and NCMA Exams

Graw
Hill
 MEDICAL ASSISTING

REVIEW
Passing the CMA, RMA, CCMA, and NCMA Exams
SeventhEdition

Jahangir Moini, M.D., M.P.H.

Former Professor and Director of Allied Health Sciences including the
Medical Assisting Program, Everest University, Melbourne, Florida; and
Retired Professor of Science and Health, Eastern Florida State College,
Palm Bay, Florida

ISTUDY
 Final PDF to printer

MEDICAL ASSISTING REVIEW

Published by McGraw Hill LLC, 1325 Avenue of the Americas, New York, NY 10121. Copyright © 2022
by McGraw Hill LLC. All rights reserved. Printed in the United States of America. No part of this
publication may be reproduced or distributed in any form or by any means, or stored in a database or
retrieval system, without the prior written consent of McGraw Hill LLC, including, but not limited to, in
any network or other electronic storage or transmission, or broadcast for distance learning.

Some ancillaries, including electronic and print components, may not be available to customers outside
the United States.

This book is printed on acid-free paper.

1 2 3 4 5 6 7 8 9 LOV 26 25 24 23 22 21

ISBN 978-1-260-59793-6
MHID 1-260-59793-8

Cover Image: ra2studio/Shutterstock

All credits appearing on page or at the end of the book are considered to be an extension of the
copyright page.

The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a
website does not indicate an endorsement by the authors or McGraw Hill LLC, and McGraw Hill LLC
does not guarantee the accuracy of the information presented at these sites.

mheducation.com/highered

ISTUDY moi97938_fm_ise.indd ii 10/16/20 11:49 AM

 ABOUT THE AUTHOR

Dr. Moini was assistant professor at Tehran University School of Medicine for nine years, teaching medical and allied health stu-
dents. The author was a professor and former director (for 24 years) of allied health programs at Everest University. Dr. Moini rees-
tablished the Medical Assisting Program in 1990 at Everest University’s Melbourne campus. He also established several other new
allied health programs for Everest University. He is now a retired professor of science and health at Eastern Florida State College.
Dr. Moini was a physician liaison for the Florida Society of Medical Assistants 2000–2008. He has been a marketing strategy
team member of the National AAMA and president of the Brevard County chapter of the AAMA. He is the author of 43 published
textbooks since 1999. His book entitled “Anatomy & Physiology for Health Professionals” has been translated into Japanese and
South Korean, and released in those countries.

Dedication
To the memory of my Mother,
and
To my wonderful wife, 
Hengameh, my two daughters, 
Mahkameh and Morvarid, 
and also to my precious granddaughters, 
Laila Jade and Anabelle Jasmine Mabry.

ISTUDY
 BRIEF TABLE OF CONTENTS

Preface ix
SECTION 1 General Medical Assisting Knowledge 1
Chapter 1 The Profession of Medical Assisting 2
Chapter 2 Medical Terminology 12
Chapter 3 Anatomy and Physiology 42
Chapter 4 Pathophysiology 75
Chapter 5 Microbiology 92
Chapter 6 General Psychology 104
Chapter 7 Nutrition and Health Promotion 114
Chapter 8 Medical Law and Ethics 126
SECTION 2 Administrative Medical Assisting Knowledge 160
Chapter 9 Reception, Correspondence, Mail, Telephone Techniques, and Supplies 161
Chapter 10 Appointments, Scheduling, Medical Records, Filing, Policies, and Procedures 180
Chapter 11 Communication in the Medical Office 192
Chapter 12 Keyboarding and Computer Applications 202
Chapter 13 Financial Management 212
Chapter 14 Medical Insurance 233
Chapter 15 Medical Coding 249
SECTION 3 Clinical Medical Assisting Knowledge 284
Chapter 16 Blood-Borne Pathogens and Principles of Asepsis 285
Chapter 17 Preparing the Patient 296
Chapter 18 Vital Signs and Measurement 316
Chapter 19 Pharmacology 326
Chapter 20 Administration of Medication 352
Chapter 21 Electrocardiography 370
Chapter 22 Diagnostic Imaging 381
Chapter 23 Promoting Healing After an Injury 391
Chapter 24 Medical Emergencies and First Aid 403
Chapter 25 Clinical Laboratory 421
PRACTICE EXAMS 471
Practice Exam 1 - CMA 472
Practice Exam 2 - RMA 485
Practice Exam 3 - CCMA 496
Practice Exam 4 - NCMA 504
ANSWER KEYS TO END OF CHAPTER QUESTIONS 514
ANSWER KEY TO TEST YOUR KNOWLEDGE 522
ANSWER KEY TO PRACTICE EXAM 524
INDEX 527

iv
ISTUDY
 TABLE OF CONTENTS

Preface ix 3.9 Sensory System 57

3.10 Cardiovascular System 59
3.11 Respiratory System 64
Section 1 General Medical Assisting
Knowledge 1 3.12 Digestive System 65

Chapter 1 – The Profession of Medical 3.13 Endocrine System 67

Assisting 2 3.14 Urinary System 68
1.1 The Profession of Medical Assisting 3 3.15 Reproductive System 70
1.2 Membership in a Medical Assisting Chapter 3 Review 73
Association 4 Chapter 4 – Pathophysiology 75
1.3 Medical Assisting Credentials 4 4.1 Mechanisms of Disease 76
1.4 CMA and RMA Exam Topics 5 4.2 Immunology 76
1.5 Certified Clinical Medical  4.3 Hereditary and Congenital Diseases 
Assistant (CCMA) Examination 6 and Conditions 77
1.6 National Certified Medical  4.4 Neoplasia 78
Assistant (NCMA) Examination 6
4.5 Common Infectious Diseases 80
1.7 Externships 6
4.6 Major Diseases and Disorders 80
1.8 Preparing for Employment 7
Chapter 4 Review 90
Chapter 1 Review 9
Chapter 5 – Microbiology 92
Chapter 2 – Medical Terminology 12
5.1 Microorganisms 93
2.1 Word Building 13
5.2 Microbial Growth 96
2.2 Spelling 17
5.3 Microbes and the Human Body 96
2.3 Common Medical Abbreviations 18
Chapter 5 Review 102
2.4 Medical Terminology in Practice 21
Chapter 6 – General Psychology 104
2.5 Unacceptable Abbreviations 38
6.1 Basic Principles 105
Chapter 2 Review 40
6.2 Motivation and Emotion 105
Chapter 3 – Anatomy and Physiology 42
6.3 Personality 105
3.1 Levels of Organization 43
6.4 Humanistic Theory of Personality 106
3.2 Cell Structure 44
6.5 Behavioral/Learning Theory of Personality 107
3.3 Chemistry 45
6.6 Psychological Disorders 108
3.4 Tissues of the Body 46
6.7 Aging and Dying 109
3.5 Division Planes and Body Cavities 47
6.8 Grief 110
3.6 Integumentary System 48
6.9 Promoting Health and Wellness 110
3.7 Musculoskeletal System 49
6.10 Substance Abuse 110
3.8 Nervous System 54
Chapter 6 Review 111

ISTUDY
 Chapter 7 – Nutrition and Health Promotion 114 11.2 The Communication Cycle 193
7.1 Nutrition 115 11.3 Types of Communication 194
7.2 Water 115 11.4 Improving Your Communication Skills 194
7.3 Carbohydrates 115 11.5 Communicating in Special Circumstances 196
7.4 Lipids 115 11.6 Communicating with 
7.5 Protein 116 Coworkers and Superiors 198
7.6 Vitamins 116 11.7 Managing Stress and Preventing Burnout 198
7.7 Minerals 118 11.8 The Policy and Procedures Manual 198
7.8 Nutrition and Diet Needs 119 Chapter 11 Review 200
7.9 Food-Related Diseases 122 Chapter 12 – Keyboarding and Computer
Chapter 7 Review 123 Applications 202
Chapter 8 – Medical Law and Ethics 126 12.1 The Computer Revolution 203

8.1 Law 127 12.2 Types of Computers 203

8.2 The Law and Medicine 129 12.3 Computer Systems 203

8.3 Ethics 135 12.4 Using Computer Software 206

8.4 Death and Dying 137 12.5 Security in the Computerized Office 208
Chapter 8 Review 138 12.6 Computer System Care and Maintenance 208
Section 1 CMA Review 141 12.7 Computers of the Future 209
Section 1 RMA Review 144 Chapter 12 Review 210
Section 1 CCMA Review 146 Chapter 13 – Financial Management 212
Section 1 NCMA Review 148 13.1 Purchasing 213
Section 1 Test Your Knowledge – General 151 13.2 Accounting 215
13.3 Banking for the Medical Office 219
Section 2 Administrative Medical 13.4 Billing and Collections 222
Assisting Knowledge 160
13.5 Accounts Payable 224
Chapter 9 – Reception, Correspondence, Chapter 13 Review 231
Mail, Telephone Techniques,
and Supplies 161 Chapter 14 – Medical Insurance 233
9.1 Reception 162 14.1 Medical Insurance Terminology 234

9.2 Managing Correspondence and Mail 162 14.2 Types of Health Insurance 235
9.3 Telephone Techniques 173 14.3 Types of Health Plans 236
9.4 Supplies and Equipment in the  14.4 Determination of Benefits 240
Medical Office 175 14.5 Claims Processing 240
9.5 Travel Arrangements 176 Chapter 14 Review 246
9.6 Patient Education 176 Chapter 15 – Medical Coding 249
Chapter 9 Review 177 15.1 Data and Billing Basics 250
Chapter 10 – Appointments, Scheduling, 15.2 Basic Coding 251
Medical Records, Filing, Policies,
15.3 Diagnosis Codes: The ICD-10-CM 251
and Procedures 180
15.4 Procedure Codes 255
10.1 Appointments and Schedules 181
15.5 Comparison of ICD-9-CM 
10.2 Medical Records and Filing 184
and ICD-10-CM 257
10.3 Policies and Procedures 188
15.6 HCPCS 257
Chapter 10 Review 189
15.7 Avoiding Fraud 257
Chapter 11 – Communication in the
Medical Office 192 Chapter 15 Review 260

11.1 Communicating with Patients  Section 2 CMA REVIEW 263

and Families 193 Section 2 RMA REVIEW 266

vi TA BL E OF C ON T E N T S
ISTUDY
 Section 2 CCMA REVIEW 269 20.2 Measuring Medication 
Section 2 NCMA REVIEW 272 and Dosage Calculations 354
Section 2 Test Your Knowledge –  20.3 Methods of Administering Medications 357
Administrative 275 20.4 Setting Up Medications 362
20.5 Vaccinations 362
Section 3 Clinical Medical Chapter 20 Review 367
Assisting Knowledge 284
Chapter 21 – Electrocardiography 370
Chapter 16 – Blood-Borne Pathogens and
Principles of Asepsis 285 21.1 The Electrical System of the Heart 371

16.1 Blood-Borne Pathogens 286 21.2 The Electrocardiograph 372

16.2 Medical and Surgical Asepsis 288 21.3 Other Tests 376

16.3 OSHA Requirements 290 21.4 Other Heart Conditions 

and Procedures 377
Chapter 16 Review 293
Chapter 21 Review 378
Chapter 17 – Preparing the Patient 296
Chapter 22 – Diagnostic Imaging 381
17.1 Patient Rights, Responsibilities, 
and Privacy 298 22.1 Terminology 382

17.2 Medical Interview 298 22.2 Types of Diagnostic Imaging 383

17.3 Physical Examination 299 22.3 Therapeutic Uses of Radiation 385

17.4 Minor Surgery 308 22.4 Medical Assistant’s Role 385
Chapter 17 Review 313 22.5 Safety and Storage 387
Chapter 18 – Vital Signs and Measurement 316 Chapter 22 Review 388
18.1 Vital Signs 317 Chapter 23 – Promoting Healing
After an Injury 391
18.2 Body Measurements 322
23.1 Terminology 392
Chapter 18 Review 324
23.2 Patient Assessment 393
Chapter 19 – Pharmacology 326
23.3 Treatment 393
19.1 General Pharmacology Terms and 
Concepts 327 23.4 Mobility-Assisting Devices 396
19.2 Drugs and Their Effects 330 Chapter 23 Review 400
19.3 Drug Administration 337 Chapter 24 – Medical Emergencies
19.4 Antibiotics 337 and First Aid 403
24.1 Emergencies 404
19.5 Pharmacology of the Integumentary
System 340 24.2 Handling Emergencies 404
19.6 Pharmacology of the Musculoskeletal  24.3 Injuries Caused by Extreme 
System 340 Temperatures 405
19.7 Pharmacology of the Nervous System 340 24.4 Burns 407
19.8 Pharmacology of the Cardiovascular  24.5 Wounds 408
System 345 24.6 Bites and Stings 410
19.9 Pharmacology of the Respiratory System 346 24.7 Orthopedic Injuries 411
19.10 Pharmacology of the Digestive System 346
24.8 Head and Related Injuries 411
19.11 Pharmacology of the Endocrine System 348
24.9 Diabetic Emergencies 411
19.12 Pharmacology of the Sensory System 348
24.10 Cardiovascular Emergencies 412
19.13 Pharmacology of the Urinary System 348
24.11 Respiratory Emergencies 416
19.14 Pharmacology of the Reproductive 
24.12 Digestive Emergencies 416
System 349
Chapter 19 Review 350 24.13 Reproductive System Emergencies 416

Chapter 20 – Administration of 24.14 Poisoning 417

Medication 352 24.15 Bioterrorism 417
20.1 Drug Classifications 354 Chapter 24 Review 418

ISTUDY
 Chapter 25 – Clinical Laboratory 421 Practice Exams 471
25.1 Collecting and Testing Blood 423 Practice Exam 1 - CMA 472
25.2 Collecting and Testing Urine 437 Practice Exam 2 - RMA 485
25.3 Medical Microbiology 443 Practice Exam 3 - CCMA 496
Chapter 25 Review 448 Practice Exam 4 - NCMA 504
Section 3 CMA Review 450 Answer Keys to End of Chapter Questions 514
Section 3 RMA Review 453
Answer Key to Test Your Knowledge 522
Section 3 CCMA Review 456
Section 3 NCMA Review 459 Answer Key To Practice Exam 524

Section 3 Test Your Knowledge – Clinical 462 Index 527

v i i i TA BL E OF C ON T E N T S
ISTUDY

PREFACE
Catching your success has never been easier, with the sixth edition of Medical Assisting Review: Passing the CMA, RMA, CCMA, and
NCMA Exams. Confidently master the competencies you need for certification with a user-friendly approach and various practice
exams.
Organization
Medical Assisting Review is divided into three sections,
similar to how the certification exams are divided: General
Medical Assisting Knowledge (Chapters 1–8); Ad​ministra-
tive Medical Assisting Knowledge (Chapters 9–15); and
Clinical Medical Assisting Knowledge (Chapters 16–25). Each
chapter opens with Learning Outcomes to set the stage for the
content to come. That list is followed by a table listing the
relevant CMA, RMA, CCMA, and NCMA Medical Assisting
Competencies for that chapter. Throughout the chapters, you
will find At A Glance tables that summarize key information for
quick review. At the beginning and end of most chapters, there
are also Strategies for Success boxes, which contain tips on study
skills and test-taking skills. Each chapter then closes with the
Chapter Review—10 multiple-choice questions written in the style
of CMA, RMA, CCMA, and NCMA exam questions.
New to the Seventh Edition
OVERVIEW
A number of enhancements have been made with the sixth edi-
tion to enrich the user’s experience with the product:
• The Chapter Reviews, at the end of each chapter, have
additional questions so that they now have 25 questions
each instead of 10.
• This edition has many new figures that did not appear
previously.
ISTUDY moi21793_fm_i-xvi.indd ix
Rev. Confirming Pages
• At the end of each section, there is a new Test Your
Knowledge feature that contains 100 multiple choice
questions. The Answer Key for each of these is at the
end of the book.
• There are four exams included at the back of the book.
The existing exams have all been updated to reflect new
material in the chapters, and all of the exams have gone
through an accuracy review.
CHAPTER HIGHLIGHTS
Definitions have been expanded and added in every chapter in
direct response to market feedback:
• Chapter 4: Information has been added about Zika virus
disease and Ebola virus disease.
• Chapter 11: The rules or guidelines that determine the
daily working of an office have been removed from the
section entitled “The Policy and Procedures Manual.”
• Chapter 12: A new section has been added that is called
“Cell Phones and the Internet.”
• Chapter 13: A “W-9” form has been added.
• Chapter 15: A new introduction to medical coding has
been added, and there has been a large amount of updat-
ing and revisions in this chapter.
• Chapter 19: Drug information has been completely
updated.
11/22/21 12:46 PM
 • Chapter 20: Immunization schedules have been
updated. Information on the Coronavirus (COVID-19)
has been added.
• Chapter 23: This chapter has been retitled as “Promoting
Healing After an Injury”; it was previously called
“Physical Therapy.”
For a detailed transition guide between the sixth and seventh
editions for all chapters of Medical Assisting Review, visit the
Instructor Resources in Connect.
Medical Assisting Review Preparation in the Digital World:
Supplementary Materials for the Instructor and Student
Instructor Resources
You can rely on the following materials to help you and your
students work through the material in this book. All of the
resources in the following table are available through the
Instructor Resources on the Library tab in Connect.

Supplement Features
Instructor’s Manual Each chapter has:
• Learning Outcomes and Lecture Outline
• Overview of PowerPoint Presentations
• Teaching Strategies
• Answer Keys for End-of-Chapter Questions and two Practice Exams from the back of the book
• List of Additional Resources
PowerPoint Presentations • Key Concepts
Electronic Test Bank • TestGen (computerized)
(Two Practice Exams) • Word version
• These two exams are also available in the Library tab of Connect. Both of them, along with 12
additional exams, are available within Connect.
• Questions are tagged with learning outcomes, level of difficulty, level of Bloom’s taxonomy,
feedback, and ABHES and CAAHEP competencies.
Tools to Plan Course • Transition Guide, by chapter, from Moini, 6e, to Moini, 7e
• Correlations of the chapters to the major accrediting bodies (previously included in the book),
as well as correlations by learning outcomes to ABHES and CAAHEP
• Sample Syllabi
• Asset Map—a recap of the key instructor resources, as well as information on the content avail-
able through Connect

A few things to note:
• All student content is now available to be assigned
through Connect.
• Instructors can share the answer keys and test bank
exams available through the Instructor Resources at
their discretion.
Need help? Contact McGraw-Hill’s Customer Experience
Group (CXG). Visit the CXG website at www.mhhe.com/
support. Browse our FAQs (frequently asked questions) and
product documentation and/or contact a CXG representative.
CXG is available Sunday–Friday.
Practice Medical Office
Practice Medical Office is a 3-D immersive game that features 12
engaging and challenging modules representing the functional
areas of a medical practice: Administrative Check In, Clinical,
and Administrative Check Out. As the players progress through
each module, they will face realistic situations and learning
events, which will test their mastery of critical job-readiness
skills and competencies such as professionalism, soft skills,
office procedures, application of medical knowledge, and appli-
cation of privacy and liability regulation. An ideal way to engage,
excite, and prepare students to be successful on the job, Practice
Medical Office is available for use on tablets and computers.
It is perfect for the capstone Medical Assisting Examination
Preparation course, and Externship course, or may be used
throughout the Medical Assisting program. PMO is accessible
through a widget in Connect. For a demo of Practice Medical
Office, please go to http://www.mhpractice.com/products/
Practice_Medical_Office and click on “Play the Demo.”
Best-in-Class Digital Support
Based on feedback from our users, McGraw-Hill Education has
developed Digital Success Programs that will provide you and
your students the help you need, at the moment you need it.
• One-to-One Training: Get ready to drive classroom
results with our Digital Success Team—ready to provide
in-person, remote, or on-demand training as needed.
• Peer Support and Training: No one understands your
needs like your peers. Get easy access to knowledgeable

x PR E FAC E
ISTUDY
 digital users by joining our Connect Community, or Get started today. Learn more about McGraw-Hill Education’s
speak directly with one of our digital faculty consultants. Digital Success Programs by contacting your local sales
• Online Training Tools: Get immediate anytime, any- representative.
where access to modular tutorials on key features
through our Connect Success Academy at www.mhhe
.com/support.

Remote Proctoring & Browser-Locking Capabilities

New remote proctoring and browser-locking capabilities, hosted by Proctorio within Connect, provide control of the assessment envi-
ronment by enabling security options and verifying the identity of the student.
Seamlessly integrated within Connect, these services allow instructors to control students’ assessment experience by restricting
browser activity, recording students’ activity, and verifying students are doing their own work.
Instant and detailed reporting gives instructors an at-a-glance view of potential academic integrity concerns, thereby avoiding per-
sonal bias and supporting evidence-based claims.

ISTUDY
 Instructors: Student Success Starts with You
Tools to enhance your unique voice
Want to build your own course? No problem. Prefer to use our
turnkey, prebuilt course? Easy. Want to make changes throughout the
65%
Less Time
semester? Sure. And you’ll save time with Connect’s auto-grading too.
Grading

Study made personal

Incorporate adaptive study resources like
SmartBook® 2.0 into your course and help your
students be better prepared in less time. Learn
more about the powerful personalized learning
experience available in SmartBook 2.0 at
www.mheducation.com/highered/connect/smartbook

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Affordable solutions, Solutions for

added value your challenges
Make technology work for you with A product isn’t a solution. Real
LMS integration for single sign-on access, solutions are affordable, reliable,
mobile access to the digital textbook, and come with training and
and reports to quickly show you how ongoing support when you need
each of your students is doing. And with it and how you want it. Visit www.
our Inclusive Access program you can supportateverystep.com for videos
provide all these tools at a discount to and resources both you and your
your students. Ask your McGraw Hill students can use throughout the
representative for more information. semester.

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ISTUDY
 Students: Get Learning that Fits You
Effective tools for efficient studying
Connect is designed to make you more productive with simple, flexible, intuitive tools that maximize your
study time and meet your individual learning needs. Get learning that works for you with Connect.

Study anytime, anywhere “I really liked this

Download the free ReadAnywhere app and access your app—it made it easy
online eBook or SmartBook 2.0 assignments when it’s to study when you
convenient, even if you’re offline. And since the app don't have your text-
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assignments in Connect, all of your work is available book in front of you.”
every time you open it. Find out more at
www.mheducation.com/readanywhere - Jordan Cunningham,
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ISTUDY
 ACKNOWLEDGMENTS

Suggestions have been received from faculty and students throughout the country. This is vital feedback that is relied on for product
development. Each person who has offered comments and suggestions has our thanks. The efforts of many people are needed to
develop and improve a product. Among these people are the reviewers and consultants who point out areas of concern, cite areas of
strength, and make recommendations for change. In this regard, the following instructors provided feedback that was enormously
helpful in preparing the manuscript.

PREVIOUS EDITION REVIEWERS Cheryl Kolar, AS in HS, RMA, LPN

Cecil College
Many instructors have attended focus groups or reviewed the
Sarah Kuzera, BS, AAS, CMA (AAMA)
manuscript while it was in development, providing valuable feed- Bryan Career College
back that has directly impacted the last six editions.
Angela LeuVoy, AAMA, CCMA, CMA, CMRS
Elizabeth Cason, CPC, CDC, CMA Fortis College
Centura College
Lynnae Lockett, RMA, CMRS, RN
Cheryl Kolar, AS in HS, RMA, LPN Bryant and Stratton College
Cecil College
Marta Lopez, MD, LM, CPM, RMA, BMO
Sarah Kuzera, BS, AAS, CMA (AAMA) Miami Dade College
Bryan University Carrie A. Mack, AS, CMA (AAMA)
Melissa Rub, CMA (AAMA) Branford Hall Career Institute
Rasmussen College Lori Mikell, RMA, AHI
Jodi Wyrick, MBA, BBA, CMA (AAMA) Ridley-Lowell Business and Technical Institute
Bryant and Stratton University Nanci Milbrath, AAS, CMA (AAMA)
Ramona Atiles Pine Technical College
New Life Business Institute Shauna Phillips, CCMA, CPT, CET, CMT
William Butler, RMA, MHA Fortis College
ECPI University Dale Schwartz, RMA
Elizabeth Cason, CPC, CDC, CMA Sanford-Brown Institute
Centura College Lisa Smith, CMA (AAMA), LXMO
Amanda Davis-Smith, NCMA, AHI, CPC Minnesota School of Business
Jefferson Community College Kasey Waychoff, CMA, CPT
Jessica DeLuca Centura College
College of Westchester Jodi Wyrick, MBA, BBA, CMA (AAMA)
Kathy Gaeng, AOS in Bus Mgmt, MA, RMA, Red Cross Bryant and Stratton College
Instructor, Proctor-NCCT, Burdick Cert. Deborah Zenzal, RN, BSN, MS, CPC, CCS-P, RMA
Vatterott College Penn Foster College
Henry Gomez
ASA College SURVEY RESPONDENTS
Gabriel Holder Multiple instructors participated in surveys to help guide the
Berkeley College early development of the product.
Karlene Jaggan, NRAHA, PN, BIT Doris Allen, LPN
Centura College Wichita Technical Institute

xiv
ISTUDY
 Rev. Confirming Pages

Annette S. Baer, CMA (AAMA) TECHNICAL EDITING/ACCURACY PANEL

Johnicka Byrd, CMA (AAMA), AS
Virginia College A panel of instructors completed a technical edit and review of
Monica Cox, CMA, BA in HRM, MHA the content in the book page proofs to verify its accuracy.
Virginia College Annette S. Baer, CMA (AAMA)
Todd Farney, BS, DC Shauna Phillips, CCMA, CPT, CET, CMT
Wichita Technical Institute Fortis College

Kathy Gaeng, AOS in Bus Mgmt, MA, RMA, Red Cross Melissa M. Rub, BA, CMA (AAMA)
Instructor, Proctor-NCCT, Burdick Cert. Rasmussen College
Vatterott College Deborah Wuethrick, MBA/HR, AMT, CPT, CMAA, NHA,
Cindy Gordon, MBA, CMA (AAMA) BLS, AHA
Baker College Computer Systems Institute
Gary L. Hayes, MD
ECPI University
Pamela Hurst, CMA/AC (AAMA), AS
Ridley-Lowell Business and Technical Institute
SYMPOSIA
Christina Ivey, NRCMA, BSHS/M
Centura College An enthusiastic group of trusted faculty members active in this
course area attended symposia to provide crucial feedback.
Karlene Jaggan, NRAHA, PN, BIT
Centura College Sandra Brightwell, RHIA
Hunter Jones, PhD RN Central Arizona College
Virginia College Linda Buchanan-Anderson, RN, BSN, RMA (AMT)
Angela LeuVoy, AAMA, CCMA, CMA, CMRS Central Arizona College
Fortis College William Travis Butler, RMA, MHA
G. Martinez, BS (HSO), MS (HA), Cert. Medical Billing ECPI University
Wichita Technical Institute Mohammed Y. Chowdhury, MBBS, MPH, CCA (AHIMA),
M. McGuire, RN CBCS (NHA), CAHI (AMT)
Wichita Technical Institute Lincoln Technical Institute
Lori Mikell, RMA, AHI Kristy Comeaux, CMA, CPT, EKG
Ridley-Lowell Business and Technical Institute Delta College
Mariela Nale, CMA, RPT Amanda Davis-Smith, NCMA, AHI, CPC
Centura College Jefferson Community and Technical College
Sherry Nemconsky, CMA
Marylou de Roma-Ragaza, BSN, MSN, RN
Ridley-Lowell Business and Technical Institute
Lincoln Educational Services
Shauna Phillips, CCMA, CPT, CET, CMT
Kathy Gaeng, RMA, CAHI
Fortis College
Vatterott College
Sharmalan Sathiyaseelan, MD, RMA
Karlene Jaggan, PN, NRCAHA, BIT
Sanford-Brown Institute
Centura College
Lucy Schultz, BBA, NCICS
Dorsey Schools Jennifer B. Kubetin, CEHR
Branford Hall Career Institute
Dale Schwartz, RMA
Sanford-Brown Institute Cheryl A. Kuck, BS, CMA (AAMA)
Rhodes State College
LaShawn Smalls, DC
Virginia College Lynnae Lockett, RN, RMA, MSN
Bryant & Stratton College
Amy Voytek
Westmoreland College Marta Lopez, MD, LM, CPM, RMA, BMO
Miami Dade College – Medical Campus
Kasey Waychoff, CMA, CPT
Centura College Carrie A. Mack, CMA (AAMA)
Branford Hall Career Institute
Andrea Weymouth, CMA, NCCT, RMA
Ridley-Lowell Business and Technical Institute Nanci Milbrath, AAS, CMA (AAMA)
Pine Technical College
Deborah Wuethrick, MBA/HR, AMT, CPT, CMAA, NHA,
BLS, AHA Corina Miranda, CMPC-I, CPC
Computer Systems Institute Kaplan College
Deborah Zenzal, RN, BSN, MS, CPC, CCS-P, RMA Angela M. B. Oliva, BS, CMRS
Penn Foster College Heald College and Boston Reed College

ISTUDY moi21793_fm_i-xvi.indd xv 06/30/21 01:56 PM

 Debra J. Paul, BA, CMA-AAMA
Ivy Tech Community College
Denise Pruitt, EdD
Middlesex Community College
Wendy Schmerse, CMRS
Charter College
LaShawn D. Sullivan, BSHIM, CPC
Medtech
Gina F. Umstetter
Bachelor in Computer Management, MSIT (ABT)
Instructor, Delta College of Arts & Technology
Lisa Wright, CMA (AAMA), MT, SH
Bristol Community College
Deborah Ann Zenzal, RN BSN MS CCS-P CPC RMA
Penn Foster
SPECIAL THANKS TO THE
INSTRUCTORS WHO HELPED WITH
THE DEVELOPMENT OF CONNECT AND
LEARNSMART. THESE INCLUDE:
Belinda Beeman, M.Ed, CMA (AAMA), PBT (ASCP)
Eastern New Mexico University-Roswell
Kendra Barker, AA, BS
Pinnacle Career Institute
William Travis Butler, RMA, MHA
ECPI University
Susan Cousins, RN, CPC, M.Ed., MBA
Daymar College-Online
Carol Dew, MA-T, CMA-AC (AAMA)
Baker College
Amy Ensign, CMA (AAMA), RMA (AMT)
Baker College
Patti Finney, CMA
Ridley Lowell Business and Technical Institute
Cheryl Kolar, AS in HS, RMA, LPN
Cecil College
Cheryl A. Kuck, BS, CMA (AAMA)
Rhodes State College
Sarah Kuzera, BS, AAS, CMA (AAMA)
Bryan Career College
Marta Lopez, MD, LM, CPM, RMA, BMO
Miami Dade College–Medical Campus
Carrie A. Mack, CMA (AAMA)
Branford Hall Career Institute
x v i AC K NOW L E D G M E N T S
ISTUDY
Stephanie McGahee, CMA (AAMA)
Augusta Technical College
Nanci Milbrath, AAS, CMA (AAMA)
Pine Technical College
Lori Mikell, RMA, AHI
Ridley-Lowell Business and Technical Institute
Sherry Nemconsky, CMA
Ridley-Lowell Business and Technical Institute
Debra J. Paul, BA, CMA-AAMA
Ivy Tech Community College
Denise Pruitt, Ed.D.
Middlesex Community College; Fisher College
Kristy Royea, MBA, CMA (AAMA)
Mildred Elley College
Dale Schwartz, RMA
Sanford-Brown Institute
Lisa Smith, CMA (AAMA), LXMO
Minnesota School of Business
Sharon L. Vaughan, RN, BSN, RMA (AMT)
Georgia Northwestern Technical College
Kasey Waychoff, CMA, CPT
Centura College
Sten Wiedmeier RMA, BS
Bryan University
ACKNOWLEDGMENTS FROM
THE AUTHOR
Sincere thanks go to the following McGraw Hill staff for their
considerable efforts, invaluable assistance, and vital guidance
during the development of this book:
Chad Grall, Managing Director for Health Professions;
William Lawrensen, Executive Brand Manager; Harper
Christopher, Executive Marketing Manager; Christine “Chipper”
Scheid, Senior Product Developer; Katie Ward, Digital Product
Analyst.
I would also like to thank Danielle Mbadu for her work on
revising the Instructor’s Manual and PowerPoint presentation,
and Tammy Vannatter for her work on revising and updating the
Connect materials.
Additionally, I would like to express my appreciation to
McGraw Hill for providing the artwork that helped illustrate this
book. Lastly, I would like to thank Greg Vadimsky, Assistant to
the Author, for his help. I would also like to acknowledge the
reviewers listed for their time and efforts in aiding me and con-
tributing to this book.
 GENERAL MEDICAL SECTION 1
ASSISTING
KNOWLEDGE

SECTION OUTLINE

Chapter 1 – The Profession of Medical Assisting

Chapter 2 – Medical Terminology
Chapter 3 – Anatomy and Physiology
Chapter 4 – Pathophysiology
Chapter 5 – Microbiology
Chapter 6 – General Psychology
Chapter 7 – Nutrition and Health Promotion
Chapter 8 – Medical Law and Ethics

ISTUDY
 CHAPTER 1

THE PROFESSION OF
MEDICAL ASSISTING
LEARNING OUTCOMES

1.1 Describe the administrative, clinical, and 1.5 Explain the requirements for obtaining
­specialized duties of a medical assistant. and maintaining the CCMA credential.
1.2 List the benefits of a medical assisting program. 1.6 Describe the subject areas covered by the NCMA
1.3 Identify the different types of credentials exam.
available to medical assistants through 1.7 Describe the purpose and benefits of the extern
examination. experience.
1.4 List the three areas of knowledge included 1.8 Describe the personal attributes of a ­professional
in the CMA and RMA exams. medical assistant.

MEDICAL ASSISTING COMPETENCIES

COMPETENCY CMA RMA CCMA NCMA

General/Legal/Professional
Respond to and initiate written communications
by using correct grammar, spelling, and formatting
techniques X X X X
Recognize and respond to verbal and nonverbal
­c ommunications by being attentive and adapting com-
munication to the recipient’s level of understanding X X X X
Be aware of and perform within legal and ethical
boundaries X X X X
Demonstrate knowledge of and monitor current federal
and state health-care legislation and regulations; main-
tain licenses and accreditation X X X X
Exercise efficient time management X X X X
Project a positive attitude X X X

ISTUDY
 MEDICAL ASSISTING COMPETENCIES (cont.)

General/Legal/Professional
Be a “team player” X X X
Exhibit initiative X X X
Adapt to change X X X
Project a responsible attitude X X X
Be courteous and diplomatic X X X
Conduct work within scope of education, training, 
and ability X X X X
Be impartial and show empathy when dealing with
patients X X X
Understand allied health professions and credentialing X X X

1.1 The Profession of Medical
Assisting
Medical assisting is one of the most versatile health-care profes-
sions. Men and women can be equally successful as medical
assistants. They are able to work in a variety of administrative
and clinical positions within health care. According to the U.S.
Department of Labor’s Occupational Outlook Handbook, medi-
cal assisting is one of the 10 fastest growing occupations.
The Duties of a Medical Assistant
Medical assistants are skilled health-care professionals who
work primarily in ambulatory settings such as medical offices
and clinics. The duties a medical assistant may perform include
administrative and clinical duties.
Administrative duties: Administrative medical assisting duties
include the following:
• Greeting patients
• Handling correspondence
• Scheduling appointments
• Answering telephones
• Communicating with patients, families, and coworkers
• Creating and maintaining patient medical records
• Handling billing, bookkeeping, and insurance claim
form processing
• Performing medical transcription
• Arranging for hospital admissions and testing
procedures
• Organizing and managing office supplies
• Explaining treatment procedures to patients
• Educating patients
• Coding for specific procedures and tests when filling out
lab requests
• Collecting payments and speaking with patients about
collection policies
Clinical duties: Medical assistants’ clinical duties vary accord-
ing to state law. They may include the following:
• Maintaining asepsis and controlling infection
• Preparing the examination and treatment areas
• Interviewing patients and documenting patients’ vital
signs and medical histories
• Preparing patients for examinations and explaining treat-
ment procedures
• Assisting the physician during examinations
• Disposing of contaminated supplies
• Performing diagnostic tests, such as electrocardiograms
(ECGs)
• Giving injections (where allowed by law)
• Performing first aid and cardiopulmonary resuscitation
(CPR)
• Preparing and administering medications as directed
by the physician, and following state laws for invasive
procedures
• Removing sutures or changing wound dressings
• Sterilizing medical instruments
• Assisting patients from diverse cultural backgrounds, as
well as patients with hearing or vision impairments or
physical or mental disabilities
• Educating patients
Medical assistants’ clinical duties may also include process-
ing various laboratory tests. Medical assistants may prepare the

CHAPTER 1 /
ISTUDY
Another random document with
no related content on Scribd:
Aufschrift gewählt; im Uebrigen theile ich die von E. Smith in einer
jüngeren Schrift[52] ausgesprochene Ansicht, dass nämlich die von
B o u r g u i g n a t[51, 48, 56] unterschiedenen 8 Neothauma-Arten nur
Varietäten einer einzigen guten Art sind.

Ampullaria ovata O liv.

1804. Ampullaria ovata O livi e r[1] Voyage emp. ottom. III. p.

39, Atlas pl. 31, Fig. 1.
1851. " " Oliv. Ph ili p p i, Monogr. Ampullaria
(Conch. Cab. I. 20) S. 49, Taf. 14, Fig. 5.
1856. " " " R e e ve, Monogr. pl. 14, Fig. 64.
1863. " " " Bo u r g u ig n a t, Moll. nouv. litig.
ou peu connus, III. 1863, p. 79, pl. 10, Fig. 11.
1866. " " " Ma r te n s[10] Mal. Bl. XIII. p. 1.
1868. Ampullaria ovata Oliv. Mo r e le t[14] p. 39, 40, 46, 94,
pl. 9, Fig. 10.
1874. " " " Ji cke l i[19] S. 230.
1881. " " " C r o sse[29] J. de Conch. p. 110.
1881. " " " C r o sse[30] J. de Conch. p. 280.
1888. " " " Bo u r g u ig n a t[48] Iconogr. pl. 6,
Fig. 1.
1889. " " " Bo u r g u ig n a t[50] p. 168.
1890. " " " Bo u r g u ig n a t[56] Hist. mal. p.
74.
1851. Ampullaria Kordofana Parreyss, Ph ili p p i, Monogr.
Ampullaria (Conch. Cab. I. 20) S. 44, Taf. 13, Fig. 1.
1863. " " " Bo u r g u ig n a t, Moll.
nouv. litig. ou peu connus, III. p. 78, pl. 11, Fig. 12, 13.
1868. " " " Mo r e le t[14] p. 40.
1874. Ampullaria ovata Oliv. var. Kordofana Parr., v.
Ma r t e n s[20] p. 42.
1880. Ampullaria Kordofana Parr. = ovata Oliv., Smit h[27] P.
Z. S. p. 348.
1851. Ampullaria lucida Parr. Ph i li p p i, Monogr. (Conch.
Cab. I. 20) S. 45, Taf. 13, Fig. 2 u. Taf. 14, Fig. 4.
 1863. " " " Bo u r g u ig n a t, Moll. nouv. litig.
ou peu connus III. p. 80.
1863. Ampullaria Raymondi, Bo u r g u ig n a t, Moll. nouv. litig.
ou peu connus III. p. 76, pl. 9, Fig. 4.
Unter den Exemplaren vom Nordende des Sees befindet sich
sowohl die schlankere, dem Typus der ovata Oliv. entsprechende
Form als auch die mehr aufgeblasene, welche sich auf die vormals
als Art betrachtete Kordofana Parr. bezieht.
Die Messungen ergaben:
für die Höhe der Schale 63 55 51 50½
" " Breite " " 55 44 46 40½
" " Höhe der Mündung 48 40 41 32
" " Breite " " 33 28 28 27 mm u. s. w.

Paramelania nassa Wo o d w.

1859. Melania (Melanella) nassa. sp. n. Wo o d wa r d[5] P. Z.

S. p. 349, pl. 47, Fig. 4.
1860. Melania nassa Woodw., Re e ve, Monogr. Melania pl.
32, Fig. 216.
1874. " " " Br o t, Monogr. Melanidae (Conch.
Cab. I. 24) S. 52, Taf. 6, Fig. 7.
1880. Melania (Melanella) nassa Woodw., Smit h[27] P. Z.
S. p. 348.
1881. Melania nassa Woodw., Cr o sse[29] p. 113, pl. IV.,
Fig. 3, 3a.
1881. Melania (Melanella) nassa Woodw., Smit h[31] P. S.
Z. p. 292, pl. 34, Fig. 26-26b.
1881. Paramelania (subg. nov.) nassa Woodw., Smit h[32] P.
Z. S. p. 559-561.
1881. Melania (Paramelania) nassa Woodw., C r o sse[30] J.
d. Conch. p. 284.
1885. Paramelania nassa Bourg., Bo u r g u ig n a t[39] p. 76.
1888. " " " Bo u r g u ig n a t[48] Iconogr. pl.
16, Fig. 7-8.
 1890. " " " Bo u r g u ig n a t[56] Hist. mal. p.
227.
Dr. Baumann hat von dieser Art am Nordende des Sees bloss ein
Exemplar gefunden (Höhe 13, Breite 8½ mm).

Rumella nov. sp.?

Fig. 19, 24.

Den Namen Rumella hat Bo u r g u i g n a t einer im Tanganyika-See

vorkommenden Gattung gegeben, welche grosse Aehnlichkeit mit
der im Meere lebenden Gattung Ruma (Natica) hat. Die
verschiedenen Arten, 6 an der Zahl, hat Bo u r g u i g n a t in seiner
Iconographie[48] abgebildet und in der Histoire malacologique[56]
ausführlich beschrieben. Ein paar Dutzend leider zumeist schlecht
erhaltener Repräsentanten dieses interessanten Genus, welche Dr.
Baumann fand, weichen von den bekannten Arten unbedeutend,
aber doch so ab, dass ich sie mit ruhigem Gewissen zu keiner
derselben rechnen kann. Ich lasse vor Allem die Abbildungen
sprechen (Fig. 19, 24), welche man mit den Bo u r g u i g n a t'schen
vergleichen möge, und füge nur hinzu: Die Exemplare sind von
blassgelber, gelbbrauner oder braungrauer Farbe; die Epidermis ist
zumeist abgerieben, und nur wo dies nicht der Fall ist, werden 8-10,
selten noch mehr orangerothe Längsstreifen sichtbar, welche parallel
zu einander laufen. Diese sind dann entweder in gleichen
Zwischenräumen von einander entfernt, oder es treten mehrere
feinere zusammen, oder es wechseln dickere und dünnere, gröbere
und feinere, mit einander ab. Die Anzahl der Umdrehungen ist 4-4½,
die Naht schneidet tief ein.
Die Grösse ist sehr variabel, wie die folgende Tabelle zeigt.
Höhe des Gehäuses 6,3 6,1 6,6 6,6 6,3
Breite " " 5,0 5,0 5,1 5,1 5,0
Höhe der Mündung 5,1 5,1 5,5 5,1 5,0
 Breite " " (incl. Callus) 4,6 4,6 4,0 4,5 4,0 mm u. s. w.

Das Gehäuse ist durchwegs schlanker, d. h. schmäler und dabei

etwas höher, als bei Rumella globosa Bourg. (Iconogr.[48] pl. 17,
Fig. 20-22 und Hist. mal.[56] p. 250).
Von Rumella Giraudi Bourg.[39] p. 90 (Iconogr.[48] pl. 17, Fig.
35-37 und Hist. mal.[45] p. 253), mit der die mir vorliegenden
Exemplare viel Aehnlichkeit hätten, sind sie durch den feinen, nicht
abgestumpften Apex unterschieden.

Genus Grandidieria.

Diese Lamellibranchiaten-Gattung ist im J. 1885 von

B o u r g u i g n a t[37] aufgestellt worden und zugleich hat der Autor
sehr treffende Merkmale zur Unterscheidung von den Unioniden und
Sphaeriiden angegeben. Im Jahre 1889 gibt Bo u r g u ig n a t[51]
schon ein Verzeichniss von 23 Grandidieria-Arten, wovon freilich
mehrere auf früher irrthümlich als Unio-Arten beschriebene
Muscheln zurückzuführen sind.
Dr. O. Baumann nun hat mir vom Nordende des Sees eine bunte
Mischung einzelner Grandidieria-Schalen (sozusagen halbe
Exemplare) übergeben, welche in der Farbe[28], Grösse und Form
so verschieden sind, dass es mir eine saure Arbeit schien, eine
strikte Determination vorzunehmen, indem sich auch hier wieder der
Gedanke aufdrängte, dass viele der Bo u r g u i g n a t'schen Arten
durch Uebergänge mit einander verbunden sind.
In dieser Auflese Baumann's sind vertreten:

Grandidieria rotundata Bo u rg .

1885. Bourguignat[39] p. 98.

 Grandidieria insignis A n c e y.

1885. Bo u r g u i g n a t[41] p. 16.

Grandidieria Smithi B o u rg .

1881. Unio Burtoni (non Woodward), Smit h[31] P. Z. S. pl.

34. Fig. 33a.
1885. Grandidieria Smithi, Bo u r g u i g n a t[37] p. 7.

Grandidieria Tanganikana Bo u rg .

1880. Unio Tanganyicensis, Smith[27] P. Z. S. p. 351. pl.

31. Fig. 9, 9a.
1881. " " Cr o sse[29] J. de Conch. p. 154.
1881. " " Smith, Smith[31] P. Z. S. p. 298. pl.
34. Fig. 35.
1881. " " " Cr o sse[30] J. de Conch. p.
293.
1883. " " " v. Ma r te n s[33] p. 72.
1885. Grandidieria Tanganikana Bourg., Bo u r g u ig n a t[37]
p. 7.
1885. " " " Bo u r g u i g n a t[29] p.
102.
Einige Schalen, auffallend durch besondere Gestalt oder Grösse,
lassen sich mit keiner beschriebenen Art vereinigen, z. B. eine
aussen blaugraue, innen perlmutterartig glänzende linke Schale, 28
mm lang, 18½ mm hoch und (in der Hälfte) 9 mm tief. Diese ist
auffallend stark gewölbt und zeichnet sich auch dadurch aus, dass
der Wirbel nach vorne gerückt ist. Ich habe sie in Fig. 31 und 35 als
Grandidieria nov. sp.? abgebildet.
Fig. 18 und 28 stellt das grösste Exemplar dar; diese (linke)
Schale ist 33 mm lang, 24 mm hoch und 8½ mm tief, sie dürfte
verwandt sein mit der schon oben angeführten Grandidieria insignis
Ancey.

Cameronia Spekei (Wo o d w.) B o u rg .

1859. Iridina (Pleiodon) Spekii n. sp., Wo o d w a r d[5] P. Z. S.

p. 448, pl. 47, Fig. 2.
1866. Pleiodon Spekii Woodw., R e e ve, Monogr. Pleiodon,
pl. 1, Fig. 2.
1876. Iridina Spekii Woodw., Kü ste r - Cl e ssin, Monogr.
Anodonta etc. (Conch. Cab. IX, 1). S. 232, Taf. 70, Fig. 1.
1880. Pleiodon Spekii Woodw., Smith, [27] P. Z. S. p. 350.
1879. Cameronia Spekii, Bo u r g u ig n a t[24] p. 43.
1881. Pleiodon (Cameronia) Spekei Woodw., C r o sse[29] p.
130.
1881. " " " " Cr o sse[30] p. 291.
1881. Pleiodon Spekei Woodw., Smith[31] P. Z. S. p. 296,
pl. 34, Fig. 31, 31a.
1883. " " " v. Ma r t e n s[33] p. 71.
1883. Cameronia Spekei, Bo u r g u i g n a t[34] p. 19.
1885. " " Bo u r g u i g n a t[39] p. 106.
1886. " " Bo u r g u i g n a t[42] p. 67.
Die alte Woodward'sche Iridina (Pleiodon) Spekii ist im Jahre
1879 von Bo u r g u i g n a t[24] als erster Vertreter einer neuen
Gattung, genannt Cameronia, aufgestellt worden. Zu dieser Art
gehören zweifellos ein vollständig erhaltenes und ein zertrümmertes
Exemplar aus der Kollection Dr. Baumann's. Ersteres ist 118 mm
lang, 54 mm hoch und 34½ mm dick.
Ein drittes Exemplar vom Nordende des Tanganyika-Sees stimmt
überein mit

Cameronia admirabilis Bo u rg .

1886. Cameronia admirabilis, Bo u r g u i g n a t [42] p. 69.

 1888. " " Bo u r g u ig n a t [48] Iconogr. pl.
34, Fig. 1.
Dies ist eine der 26 Arten, welche Bo u r g u i g n a t späterhin
unterschied [42].
Das mir vorliegende Exemplar misst 140 mm in der Länge, 62½
mm in der Höhe und 48 mm in der Breite (Dicke). Die Epidermis ist
stark abgerieben.

[←] II. Zur Fauna des Nilquellgebietes und

hauptsächlich des Victoria-Sees.

Im Folgenden sind die Mollusken aufgezählt, welche Dr. O.

Baumann im K a g e r a - Ni lq u e ll g e b i e te, im G r u me ti- B a ch und in
den Bächen von Ng o r o ï n e (d. s. östliche Zuflüsse des Victoria-
Sees), sowie im Victoria-See selbst aufgefunden hat.
Das Material, welches im Laufe der letzten 3 Decennien von
verdienstvollen Forschern wie Sp e ke, H a u tte cœu r, G u il le mé,
L e r o y, Dr. F i sc h e r, Dr. Emin Pa sch a, Dr. S tu h lma n n,
Ha n n i n g to n, G o r d o n u. A. im Victoria-See gesammelt worden ist,
wurde in einer Reihe von Abhandlungen nach und nach bekannt
gemacht. [8, 25, 34, 38, 41, 46, 54, 58, 62].
Zuletzt hat E . S mit h [65, 66] die Molluskenfauna dieses
grossen Wasserbeckens zusammengestellt und unter kritischer
Ausscheidung derjenigen Formen, deren Vorkommen im See wegen
unverlässlicher Fundortsangaben zweifelhaft erschien (Koll. Sp e k e
[8]), im Ganzen 37 Arten angeführt. Hierzu kommen aber noch zwei
von diesem Autor übersehene, von D r. vo n Ma r te n s [54]
beschriebene Arten, Paludina constricta und Spatha subaequilatera,
und nun — nach Durchsicht des Baumann'schen Materiales —
möchte ich dem Verzeichnisse noch drei Arten hinzufügen: 1) die
Corbicula pusilla Phil. (s. unten!), 2) eine vermuthlich neue Mutela-
Art (s. unten!) und 3) die alte O livi e r'sche Paludina unicolor, welche
sich in einer Varietät im Kagera-Nilquellgebiete findet und in jungen
Exemplaren (?) auch aus dem Victoria-See selbst von Dr. Baumann
gebracht wurde (Abbildung und Beschreibung der letzteren siehe
unten!). Do h r n [8] hat zwar Anno 1864 Paludina unicolor Oliv. vom
Victoria-See angeführt, S mit h aber lässt in seinem Verzeichnisse
diese Art absichtlich — aus dem oben genannten Grunde — aus.
Die Muscheln aus Ngoroïne und dem Grumetibache sind neue
Spatha-Arten.

Paludina victoriae Smit h.

Fig. 5.
1890. Paludina sp. n., S mith [58] Ann. Mag. p. 149.
1892. Viviparus victoriae, Smith [65] Ann. Mag. p. 124. pl.
12. fig. 8-10.
Das einzige mir vorliegende, vollständig gebleichte, in der
Mündung etwas mangelhafte Exemplar aus dem Victoria-See misst
24,2 mm in der Höhe, 15,5 mm in der Breite. Die Mündung ist 10
mm hoch, 9 mm breit. Die Grössenverhältnisse würden also zu der
von E . v. Ma r t e n s beschriebenen Paludina constricta ([54] S. 56,
Taf. 41, Fig. 7) auffallend stimmen, und auch Gestalt und Skulptur
sind annähernd so, wie sie Pr o f. v. Ma r te n s in seiner Diagnose
angiebt. Da aber der über der Naht stehende und bis zur Mündung
reichende Kiel auffallend stark entwickelt ist und vortritt, und ferner
über diesem, etwa in der Mitte des Umganges, ein zweiter, aber
zarter Kielstreifen läuft, sehe ich mich veranlasst, das Baumann'sche
Exemplar zu Smit h's Viviparus victoriae zu rechnen und zwar
speciell auf die in Smit h's Abhandlung [65] in Fig. 10 abgebildete
var. a zu beziehen, obwohl dieses Exemplar bedeutend niedriger ist.
Sollte sich einmal herausstellen, dass die Arten victoriae und
constricta zusammenfallen, so hätte der Ma r t e n s'sche Name das
Prioritätsrecht. Nahe verwandt damit scheinen mir auch die von E.
v. Ma r te n s beschriebenen, aber noch nicht abgebildeten Arten
phtinotropis und trochlearis zu sein (siehe Ma r te n s [62] S. 17-18).

Paludina (?) rubicunda v. Ma rt e n s

Fig. 2, 3, 4.
1879. Paludina rubicunda n. sp. Ma r te n s [25] S. 104.
1888. Paludina unicolor var. Smith [47] P. Z. S. p. 53.
1892. Viviparus rubicunda Martens, Smit h [65] P. Z. S. p.
123, pl. 12, Fig. 3.
Die 4 Exemplare, welche Dr. Baumann im Victoria-See
gesammelt hat, und wovon hier die 3 grössten abgebildet sind,
zeigen sehr verschiedene Proportionen, wie die folgende Uebersicht
ergibt.
Höhe des Gehäuses 28,0 26,0 22,0 19,7
Breite des Gehäuses 18,5 16,6 14,3 13,3
Höhe der Mündung 12,7 10,4 10,0 10,4
Breite der Mündung 10,0 9,0 8,2 8,2 mm

Durch das Fehlen jedweder Kante an den Umgängen des

Gehäuses ist die Zugehörigkeit der Exemplare zu P. rubicunda sehr
wahrscheinlich; aber auch der Paludina Abyssinica vo n Ma r te n s
(siehe [10] Mal. Bl. XIII. S. 97, Taf. 3, Fig. 7) stehen sie nahe.

Paludina unicolor O liv. (ju v?)

Fig. 8, 9.

cf.
1804-1812. Cyclostoma unicolor, O livi e r [1] Voyage emp.
ott. II. p. 39, Ausg. 8° III p. 68, Atlas II. pl. 31, Fig. 9.
1852. Paludina unicolor, Olivier, Kü ste r, Monogr. Paludina
etc. (Conch. Cab. I. 21.) S. 21, Taf. 4, Fig. 12, 13.
1852. Paludina biangulata, Kü ste r, Monogr. Paludina etc.
(Conch. Cab. I. 21) S. 25, Taf. 5, Fig. 11, 12.
1865-1866. Paludina unicolor Oliv., Ma r te n s [10] Mal. Bl.
XII. S. 202 und XIII. S. 97.
1874. Vivipara unicolor, Oliv., Jicke l i [19] S. 235. Taf. 7. Fig.
30.
1883. Vivipara unicolor, Oliv., Bo u r g u i g n a t [35] p. 130
etc. etc.
TAFEL XXIV
 Unter diesem Namen führe ich fünf Exemplare aus dem Victoria-
See an, welche mir bei der Bestimmung besondere Schwierigkeiten
bereiteten. Ihre Dimensionen sind die folgenden:
Höhe des Gehäuses 18,1 12,6 14,5 14,2 12,6
Breite " " 13,2 10,0 11,1 11,1 10,1
Höhe der Mündung 9,3 7,0 8,3 7,7 7,3
Breite " " 7,3 5,7 6,3 6,0 5,7 mm.
(Fig. 9) (Fig. 8)

Anfangs glaubte ich vermuthen zu müssen, dass E. v. Ma r t e n s

solche Exemplare wie diese vorgelegen sein mögen, als er Paludina
capillata F r n f l d . aus dem Victoria-See anführte (siehe [25] S. 104
»nur junge Exemplare mit zwei deutlichen Kanten«), aber ich kam
bald von dieser Idee ab, indem ich fand, dass die F r a u e n fe ld'sche
Abbildung der Vivipara capillata aus dem Nyassa-See ([9], S. 533.
Taf. 22) gar zu wenig auf die mir vorliegenden Exemplare passt; und
zweitens sind nach S mit h's Auslegung ([65] P. Z. S. p. 124) die
Ma r te n s'schen jungen capillata-Exemplare zu victoriae Smith zu
ziehen — und also müsste es auch mit den hier zu besprechenden
Exemplaren geschehen, was mir aber wenig plausibel erscheint.
Viviparus jucundus S mith ([65] p. 124. pl. 12. Fig. 6) steht in der
Abbildung wie in der angegebenen Grösse unseren Exemplaren
sehr nahe, in der sonstigen Beschreibung jedoch wieder nicht. Mit
der Kü st e r'schen Art biangulata (Kü ste r, Monogr. Paludina im
Conch. Cab. I, 21. S. 25. Taf. 5. Fig. 11, 12) aber, welche von E . v.
Ma r t e n s ([10] Mal. Bl. XII. S. 203) für unicolor juv. erklärt worden
ist, haben die von Dr. Baumann gesammelten Stücke
u n v e r ke n n b a r e A e h n l ich ke i t.

Paludina unicolor O liv. , n o v. v a r?

Fig. 16, 27.

 Dr. Baumann sammelte im Ka g e r a - N ilq u e l lg e b ie t e 6 Stück
einer zweifellos mit unicolor Oliv. verwandten, daher von mir
vorläufig als eine Varietät von dieser bezeichneten Paludina-Form.
Die Gehäuse sind leider stark gebleicht, besitzen einen engen,
schwach gedeckten Nabel und setzen sich aus 6½, durch eine tiefe
Naht getrennten Windungen zusammen. An der Oberseite der
Umgänge läuft ein Kiel und unter diesem Spuren von 1-2
Längsrippen; nur an den Embryonalwindungen sowie an dem letzten
Umgange, also vor der Mündung, fehlen diese Merkmale. Am
deutlichsten sind die Rippen an der vierten Windung (vom Apex an
gerechnet), d. h. hier bemerkt man eine Anzahl parallel laufender
Längsstreifen.
Kleinstes und grösstes
Ex.
Höhe des Gehäuses 21,0 26,0
Breite " " 16,0 20,5
Höhe der Mündung 11,5 13,2
Breite " " 9,2 10,3 mm.

Ampullaria Gordoni Smith.

Fig. 33.
1892. Smi t h [66] Ann. Mag. p. 382.
In der hier citirten Abhandlung beschreibt E. Smi th zwei
Ampullarien-Arten aus dem Victoria-See; die eine (Amp. nyanzae) ist
eine Riesenform, indem sie 115 mm misst, und wurde von Re v. E .
C y r il G o r d o n am Südende des Victoria-Sees gefunden; die
andere, ebenfalls von G o r d o n gesammelt, jedoch nur in einem
Exemplar, ist bedeutend kleiner (54 mm hoch) und unterscheidet
sich von jener durch einen engeren Nabel und die weitere Mündung.
Zu dieser letzteren Art, der Ampullaria Gordoni, gehören vermuthlich
die 11 leider schlecht erhaltenen Stücke, welche Dr. Baumann vom
Victoria-See gebracht hat. Eines von diesen ist 56 mm hoch und 48
mm breit und seine Mündung 45 mm hoch und 29 mm breit, die
übrigen variiren in der Höhe zwischen 31 und 44 mm, in der Breite
zwischen 26 und 35 mm. Die Höhe der Mündung ist in der Regel
ungefähr gleich der Breite des Gehäuses. Der Nabel ist zur Hälfte
von der Spindel bedeckt, die Farbe des Gehäuses aussen
dunkelolivgrün, innen purpurroth bis braunroth; hauptsächlich am
letzten Umgange laufen aussen zahlreiche dunkle Spiralbänder,
welche entweder scharf getrennt von einander sind oder zu breiteren
Bändern zusammenfliessen; dieselben scheinen nach innen durch.

Melania tuberculata Mü lle r v a r.

1879. Melania tuberculata Müller var., Ma r te n s [25] S. 104.

1883. " " Mllr., Bo u r g u i g n a t [34] p. 4.
1892. " " Mllr. var., Smith [65] P. Z. S. p.
123.
Von dieser aus dem Victoria-See schon lange bekannten und
immer schlechtweg als var. bezeichneten Lokalform der
kosmopolitischen Melania tuberculata Mllr. brachte Dr. Baumann 10
Exemplare.

Corbicula pusilla Ph il.

Cyrena pusilla Parr. in collect.

1847. " " " , Philippi [2] Bd. II, S. 78. Taf. 1, Fig.
7.
1848. " Africana var. β. albida, Kr a u ss [3] S. 9.
1866. " pusilla, Ma r te n s [10] Mal. Bl. XIII, S. 15.
" " Phil., Re e ve, Monogr. Cyrena. pl. 12,
Fig. 57a, b.
1874. Corbicula pusilla, Ji cke li [19] S. 288. Taf. 11, Fig. 11,
12.
1879. " albida Krss., Cle ssi n, Monogr. Cycladeen
(Conch. Cab. IX, 3) S. 156. Taf. 27, Fig. 25-26.
 Diese Art ist bisher im Victoria-See nicht konstatirt worden. Die
Exemplare, welche von Dr. Baumann von dort gebracht wurden, sind
jedoch so ähnlich den in Jicke l i's grossem Werk abgebildeten und
beschriebenen Exemplaren, dass ich die obige Bestimmung ruhig
hier publicire. In der Grösse variiren sie, wie folgt:
Breite der Schale 6,3 7,6 8,1 8,0 9,7
Höhe " " 6,0 7,0 7,4 7,2 9,0
Dicke " " 4,1 4,8 5,0 4,9 6,2 mm.

Die Farbe der Schalen ist aussen hell- oder dunkelgelb, innen
weiss bis schwach violett. Die Rippen sind deutlich, die Wirbel stets
abgerieben.
Das Verfahren von Pr o f. Kr a u ss [3], diese Art mit der
folgenden unter dem Namen Africana zu vereinigen, hat zwar später
keinen Anklang gefunden, ist aber doch empfehlenswerth. Dr.
Baumann hat, wie es scheint, die beiden Formen an e in e r Stelle
des Victoria-Sees gesammelt.

Corbicula radiata Ph il.

Cyrena radiata Parreyss in collect.

1847. " " " , Ph i lip p i [2] Bd. 2, S. 78. Taf. 1,
Fig. 8.
1848. " Africana var α. olivacea, Kr a u ss [3] S. 8. Taf.
1, Fig. 8.
1866. " radiata Phil., Ma r te n s [10] Mal. Bl. XIII, S. 15.
" " juv., R e e ve, Monogr. Cyrena, pl. 13,
Fig. 47c.
1873. Corbicula radiata Phil., Jicke l i [17] Mal. Bl. XX, S.
111.
1874. " " " Ji cke l i [19] S. 287. Taf. 11, Fig.
10.
1879. " " Parr., C le ssin, Monogr. Cycladeen
(Conch. Cab. IX, 3) S. 162. Taf. 28, Fig. 16-18.
 1879. Corbicula radiata Phil., v. Ma r te n s [25] S. 105.
1890. " " Parr., Smit h [58] p. 149.
1892. " " " Smith [65] p. 126.
Es liegen mir aus dem Victoria-See bloss einzelne stark
gebleichte Schalen vor, welche ihre Zugehörigkeit zu Corb. radiata
Phil. (Parr.) durch den rosig angehauchten Wirbel und ihre
intensivere violette Färbung im Innern verrathen.
Grössenproportionen für
linke Schalen 10,9 12,1 mm breit
9,7 11,1 mm hoch
und für rechte Schalen 10,8 12,1 14,0 12,8 mm breit
9,7 10,4 12,3 11,7 mm hoch.

Unio Edwarsianus Bo u rg .

1883. Bo u r g u i g n a t [34] p. 12, Fig. 7-9.

Dr. Baumann brachte ein einziges Exemplar dieser Art aus dem
Vic t o r i a - S e e. Dasselbe ist 22,6 mm lang, 14,4 mm hoch und 11
mm dick.

Unio Hauttecœuri B o u rg .

1883. Bo u r g u i g n a t [34] p. 3, Fig. 1-3.

Von dieser — ebenso wie die vorige — bloss im Vi cto r ia - Se e
vorkommenden, also für ihn charakteristischen Art liegen nur 3
Stücke vor, wovon das grösste 28,5 mm in der Länge, 21,2 mm in
der Breite und 15 mm in der Dicke misst.

Mutela nov. sp.?

Fig. 30, 34.

 Die hier zu besprechende linke Schale aus dem Vict o r ia - S e e
vermochte ich mit keiner der bisher bekannt gewordenen Arten aus
dem genus Mutela, in dessen Formenkreis sie jedenfalls zu gehören
scheint, zu identificiren. Vielleicht aber fällt sie mit M. diaphana
(B o u r g u i g n a t in sched. 1875) zusammen, einer Art, die leider
weder schon beschrieben, noch irgendwo abgebildet ist, nach
B o u r g u i g n a t aber im ganzen Lauf des Nil vorkommt (op. c. [34] p.
5).
Die Schale ist 62,6 mm lang, 26,5 mm hoch und 8,5 mm dick; in
der Wirbelgegend ist sie stark abgerieben, die Farbe von
dunkelbraungrün gegen den Hinterrand in ein helles kastanienbraun
übergehend; Jahresringe ziemlich deutlich; Innenseite dunkel
perlmutterglänzend; hinterer Muskeleindruck schärfer als der
vordere. Das Schloss ist eine lange, scharfe Kante. Ueber die
allgemeine Gestalt mögen die Figuren Aufklärung geben.

Spatha Baumanni n. sp.

Fig. 38.

Das Exemplar, welches ich mit diesem Namen belege, wurde von
Dr. Baumann am 4. März 1892 im G r u me ti - Ba ch, welcher von der
Ostseite des Victoria-Sees her in diesen einmündet, gesammelt. Es
ist 107 mm lang, 58 mm breit und 32 mm dick. Die Farbe ist rings
um den stark abgewetzten, weisslichen Wirbel gelbbraun und geht
nach dem Rande hin allmählich in ein kastanienbraun über; innen ist
die Muschel schön rosenroth (rosa) gefärbt. Indem der Vorderrand
abgerundet ist und der Dorsalrand in den Hinterrand ohne stark
merklichen Winkel und ohne zuerst aufwärts zu ziehen, übergeht,
ferner die Rundung auch nach unten schön geschlossen und der
Unterrand nicht eingebogen ist, weicht diese Form von der Spatha
Hartmanni v. Martens ab (vgl. Jickeli [19] S. 263, Taf. 8, Fig. 2;
Martens [10] Mal. Bl. XIII, S. 10; Conch. Cab. IX. 1, S. 190, Taf. 61,
Fig. 2, 3).
Nach einer brieflichen Mittheilung des Herrn Prof. E. v o n
Ma r t e n s ist die hier kurz beschriebene Spatha-Art und die folgende
von den bisher bekannten Formen so verschieden, dass es
gerechtfertigt erscheint, beide mit neuen Namen zu belehnen.

Spatha Martensi n. sp.

Fig. 39.

Aus einem der Bäche von Ng o r o ïn e, ebenfalls einem östlichen

Zuflusse des Victoria-Sees, stammt eine einzige rechte Schale,
welche, wie die Abbildung bekräftigen möge, zwischen Spatha
Caillaudii v. Martens[29] und Spatha Hartmanni v. Martens steht.
Sie misst 137 mm in der Länge, 77 mm in der Höhe und 21 mm
in der Tiefe und fällt durch den stark ausgezogenen und nach
abwärts gekrümmten Hinterrand auf. Der Wirbel ist stark
ausgefressen und auch im Uebrigen die Aussenseite durch
Eindrücke, die wahrscheinlich von den Eingeborenen herrühren,
verunziert. Die Farbe ist dunkelbraun.

Aetheria elliptica L a m.

1880. Aetheria elliptica, L a m. Annales du Mus. vol. X, p.

401, pl. 29 und pl. 31, Fig. 1.
1825. " " L a m., Bl a in vi lle, Man. Malacol. p.
543, pl. 70 bis Fig. 2.
" " L a m., So we r b y, Conch. Icon. Fig.
1a, 1b.
1880. " " L a m., Smit h[27] P. Z. S. p. 352.
1881. " " L a m., Cr o sse[29] J. de Conch. p.
136.
 1881. " " L a m., Cr o sse[30] J. de Conch. p.
295.
1882. " " L a m., Smit h[66] p. 381.
Smit h schreibt in seiner jüngsten Abhandlung[66] p. 381: »In
addition to the above species Mr. Gordon also obtained the Aetheria
elliptica from the Nile and the Ripon Falls. This species was found at
the southern part of Lake Victoria by the late Bishop Hannington«
und stellt damit das Vorkommen dieser interessanten
»Süsswasserauster« auch im Victoria-See fest. 3 Exemplare, welche
Dr. Baumann von dort gebracht hat, bestätigen diese Angabe. Sie
messen 8-9 cm in der Länge und 6-7 cm in der Höhe. Innen an der
Perlmutterschicht bemerkt man zahlreiche, oft geplatzte Blasen. Die
Muskeleindrücke und der Mantelrand sind ziemlich deutlich, die
ersteren aber nicht tief.

[←] III. Ueber die Fauna des Manyara-Sees.

Aus dem von Dr. Baumann entdeckten Ma n ya r a - Se e, der im

südlichen Theil des grossen ostafrikanischen Grabens, westlich vom
Kilimanjaro gelegen ist, liegen 5 Arten vor. Dieselben sind echte
Süsswasserformen und ihr Vorkommen in dem stark salzigen
Wasserbecken ist daher sehr auffallend. Einen Schluss auf die
Herkunft der Manyara-Fauna aber, welcher für die Graben-Theorie
interessant gewesen wäre, lässt das vorliegende Material n i ch t zu.
Die hier gefundene Ampullaria ovata Oliv. z. B. ist eine im Nil- und
Nilquellgebiet weitverbreitete Art, findet sich aber auch im
Tanganyika-See; das Gleiche gilt von der Planorbis sudanicus v.
Martens, welche im Manyara-See nur etwas grösser wird (var.
magna s. unten).
Lanistes affinis Smith, zu der ich die Manyara-Form als Varietät
stelle, ist ausserdem auch in den Landschaften südlich vom Victoria-
See, in Unyamwesi verbreitet und kommt auch im Nyassa-See vor.
 Von den 2 Paludina-Arten schliesslich, welche Dr. Baumann
gefunden hat, ist die kleinere eine vermuthlich neue, für den See
charakteristische Art. Die grössere lässt, wiewohl sie mit e in e r im
K a g e r a - Ni lq u e l l g e b i e t v o r ko mme n d e n a u ffa ll e n d ä h n lich
gestaltet ist, keinen sicheren Schluss auf die Provenienz zu, weil sie
als Varietät einer sehr weit verbreiteten Art, der Paludina unicolor
Oliv. oder wenigstens als sehr nahe mit dieser verwandt angesehen
werden muss.
Ueber die hier im Voraus genannten 5 Arten des Manyara-Sees
lasse ich nun die näheren Angaben folgen.

Planorbis Sudanicus v. Ma rt e n s var. magna mi h i.

Fig. 10, 14, 29.

(Literatur über Planorbis Sudanicus v. M a r t e n s, siehe im Kapitel I.)

Die mir vorliegende Reihe aus dem Manyara-See enthält

Exemplare von sehr wechselnder Grösse, wie die Beispiele hier
zeigen sollen:
Höhe des Gehäuses 7,0 6,3 5,8 5,0 5,0 4,0
Breite (Diam.) des Gehäuses 21,4 20,5 18,6 16,4 15,0 13,2 mm.

Anzahl der langsam und regelmässig anwachsenden,

gerundeten Umgänge 5, 5½ oder 6.
Die Oberseite ist bei den grösseren Stücken weniger concav als
bei den kleineren, die Unterseite aber meist stark ausgehöhlt. Farbe
des Gehäuses blassgelb.
Von dem Typus von Sudanicus v. Ma r t. sind die Exemplare des
Manyara-Sees also bloss durch die beträchtliche Grösse
unterschieden.

Ampullaria ovata O liv.