83
4
Learning Objectives
Upon completion of this chapter, you will be able to
• Identifyanddefinethecombiningforms,prefixes,andsuffixes
introducedinthischapter.
• Correctlyspellandpronouncemedicaltermsandmajor
anatomicalstructuresrelatingtothemusculoskeletalsystem.
• Locateanddescribethemajororgansofthemusculoskeletal
systemandtheirfunctions.
• Correctlyplacebonesineithertheaxialortheappendicular
skeleton.
• Listanddescribethecomponentsofalongbone.
• Identifybonyprojectionsanddepressions.
• Identifythepartsofasynovialjoint.
• Describethecharacteristicsofthethreetypesofmuscletissue.
• Usemovementterminologycorrectly.
• Identifyanddefinemusculoskeletalsystemanatomicalterms.
• Identifyanddefineselectedmusculoskeletalsystempathology
terms.
• Identifyanddefineselectedmusculoskeletalsystemdiagnostic
procedures.
• Identifyanddefineselectedmusculoskeletalsystemtherapeutic
procedures.
• Identifyanddefineselectedmedicationsrelatingtothe
musculoskeletalsystem.
• Defineselectedabbreviationsassociatedwiththe
musculoskeletalsystem.
Musculoskeletal System
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84
Function
The skeletal system consists of 206 bones that make up the internal framework of the body, called the
skeleton. The skeleton supports the body, protects internal organs, serves as a point of attachment for
skeletal muscles for body movement, produces blood cells, and stores minerals.
Organs
Here are the primary structures that comprise the skeletal system:
bones joints
Word Parts
Here are the most common word parts (with their meanings) used to build skeletal system terms. For
a more comprehensive list, refer to the Terminology section of this chapter.
Combining Forms
Section I: Skeletal System at a Glance
ankyl/o stiffjoint
arthr/o joint
articul/o joint
burs/o sac
carp/o wrist
cervic/o neck
chondr/o cartilage
clavicul/o clavicle
coccyg/o coccyx
cortic/o outerlayer
cost/o rib
crani/o skull
femor/o femur
fibul/o fibula
humer/o humerus
ili/o ilium
ischi/o ischium
kyph/o hump
lamin/o lamina(partofvertebra)
lord/o bentbackward
lumb/o loin(lowbackbetweenribsand
pelvis)
mandibul/o mandible
maxill/o maxilla
medull/o innerregion
metacarp/o metacarpals
metatars/o metatarsals
myel/o bonemarrow,spinalcord
orth/o straight
oste/o bone
pector/o chest
patell/o patella
ped/o child;foot
pelv/o pelvis
phalang/o phalanges
pod/o foot
prosthet/o addition
pub/o pubis
radi/o radius;ray(X-ray)
sacr/o sacrum
scapul/o scapula
scoli/o crooked
spin/o spine
spondyl/o vertebrae
stern/o sternum
synovi/o synovialmembrane
synov/o synovialmembrane
tars/o tarsus(ankle)
thorac/o chest
tibi/o tibia
uln/o ulna
vertebr/o vertebra
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85
Skeletal System Illustrated
Scapula
Humerus
Ulna
Radius
Sacrum
Coccyx
Carpals
Metacarpals
Phalanges
Ischium
Femur
Patella
Sternum
Ribs
Thoracic
vertebrae (T11)
Lumbar
vertebrae (L4)
Ilium
Pubis
Skull
Cervical vertebrae
Maxilla
Mandible
Tibia
Fibula
Tarsals
Metatarsals
Phalanges
85
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86Chapter 4
Anatomy and Physiology
of the Skeletal System
bone marrow
bones
joints
ligaments (LIG-ah-ments)
skeleton
Each bone in the human body is a unique organ that carries its own blood
supply, nerves, and lymphatic vessels. When these bones are connected to each
other it forms the framework of the body called a skeleton. The skeleton protects
vital organs and stores minerals. Bone marrow is the site of blood cell production.
A joint is the place where two bones meet and are held together by ligaments. This
gives flexibility to the skeleton. The skeleton, joints, and muscles work together
to produce movement.
Bones
Med Term Tip
The term skeleton, from the
Greek word skeltos meaning
“dried up,” was originally used in
reference to a dried-up mummi-
fied body, but over time came to
be used for bones.
cartilage (CAR-tih-lij)
osseous tissue (OSS-ee-us)
ossification (oss-sih-fih-KAY-shun)
osteoblasts (OSS-tee-oh-blasts)
osteocytes (OSS-tee-oh-sights)
Bones, also called osseous tissue, are one of the hardest materials in the body.
Bones are formed from a gradual process beginning before birth called ossifi-
cation. The first model of the skeleton, made of cartilage, is formed in the fetus.
Osteoblasts, immature bone cells, gradually replace the cartilage with bone. In
a fully adult bone, the osteoblasts have matured into osteocytes that work to
maintain the bone. The formation of strong bones is greatly dependent on an
adequate supply of minerals such as calcium (Ca) and phosphorus (P).
Bone Structure
What’s In A Name?
Look for these word parts:
oste/o = bone
-blast = immature
-cyte = cell
-ous = pertaining to
articular cartilage (ar-TIK-yoo-lar)
cancellous bone (CAN-sell-us)
compact bone
cortical bone (KOR-ti-kal)
diaphysis (dye-AFF-ih-sis)
epiphysis (eh-PIFF-ih-sis)
flat bones
irregular bones
long bones
medullary cavity (MED-you-lair-ee)
periosteum (pair-ee-AH-stee-um)
red bone marrow
short bones
spongy bone
yellow bone marrow
Suffixes
-listhesis slipping
-logic pertainingtostudyof
-porosis porous
Prefixes
dis- apart
non- not
-blast immature
-clasia tosurgicallybreak
-desis tofuse
M04_FREM0254_06_SE_C04.indd 86 18/12/14 10:12 pm
MusculoskeletalSystem 87
•
Figure 4.1 Classification
ofbonesbyshape.
Irregular bones
(vertebrae)
Flat bones
(ribs)
Long bone
(humerus)
Flat bones
(scapula)
Short bones
(tarsals)
Bones have many projections and depressions; some are rounded and
smooth in order to articulate with another bone in a joint. Others are rough
to provide muscles with attachment points. The general term for any bony
Med Term Tip
The elbow, commonly referred
to as the funny bone, is actually
a projection of the ulna called
the olecranon process.
condyle (KON-dile)
epicondyle (ep-ih-KON-dile)
fissure (FISH-er)
foramen (for-AY-men)
fossa (FOSS-ah)
head
neck
process
sinus (SIGH-nus)
trochanter (tro-KAN-ter)
tubercle (TOO-ber-kl)
tuberosity (too-ber-OSS-ih-tee)
Several different types of bones are found throughout the body and fall into four
categories based on their shape: long bones, short bones, flat bones, and irregular bones
(see Figure 4.1
■
). Long bones are longer than they are wide; examples are the
femur and humerus. Short bones are roughly as long as they are wide; examples
are the carpals and tarsals. Irregular bones received their name because the shapes
of the bones are very irregular; for example, the vertebrae are irregular bones. Flat
bones are usually plate-shaped bones such as the sternum, scapulae, and pelvis.
The majority of bones in the human body are long bones. These bones have
similar structure with a central shaft or diaphysis that widens at each end, which is
called an epiphysis. Each epiphysis is covered by a layer of cartilage called articular
cartilage to prevent bone from rubbing directly on bone. The remaining surface of
each bone is covered with a thin connective tissue membrane called the periosteum,
which contains numerous blood vessels, nerves, and lymphatic vessels. The dense
and hard exterior surface bone is called cortical or compact bone. Cancellous or spongy
bone is found inside the bone. As its name indicates, spongy bone has spaces in
it, giving it a spongelike appearance. These spaces contain red bone marrow, which
manufactures most of the blood cells and is found in some parts of all bones.
The center of the diaphysis contains an open canal called the medullary cavity.
Early in life this cavity also contains red bone marrow, but as we age the red
bone marrow of the medullary cavity gradually converts to yellow bone marrow,
which consists primarily of fat cells. Figure 4.2
■
contains an illustration of the
structure of long bones.
Bone Projections and Depressions
What’s In A Name?
Look for these word parts:
articul/o = joint
cortic/o = outer layer
medull/o = inner region
oste/o = bone
peri- = around
-al = pertaining to
-ar = pertaining to
-ary = pertaining to
Med Term Tip
Do not confuse a long bone with
a large bone. A long bone is not
necessarily a large bone. The
bones of your fingers are short
in length, but since they are lon-
ger than they are wide, they are
classified as long bones.
Med Term Tip
The term diaphysis comes from
the Greek term meaning “to
grow between.”
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88Chapter 4
■
Figure 4.2 Componentsofalongbone.Theentirelongboneisontheleftsideaccompaniedbya
blow-upoftheproximalepiphysisandasectionofthediaphysis.
Proximal
epiphysis
Diaphysis
Distal
epiphysis
Articular cartilage
Epiphyseal line
Spongy bone
Compact bone
Medullary cavity
Compact (cortical) bone
Articular cartilage
Cancellous (spongy) bone
Yellow marrow (fat)
Compact bone
Periosteum
Arteries
axial skeleton (AK-see-al)
Axial Skeleton
What’s In A Name?
Look for these word parts:
-al = pertaining to
-ar = pertaining to
Med Term Tip
Newborn infants have about 300
bones at birth that will fuse into
206 bones as an adult.
projection is a process. Then there are specific terms to describe the different
shapes and locations of various processes. These terms are commonly used on
operative reports and in physicians’ records for clear identification of areas on
the individual bones. Some of the common bony processes include the following:
1. The head is a large, smooth, ball-shaped end on a long bone. It may be sep-
arated from the body or shaft of the bone by a narrow area called the neck.
2. A condyle refers to a smooth, rounded portion at the end of a bone.
3. The epicondyle is a projection located above or on a condyle.
4. The trochanter refers to a large rough process for the attachment of a
muscle.
5. A tubercle is a small, rough process that provides the attachment for ten-
dons and muscles.
6. The tuberosity is a large, rough process that provides the attachment of ten-
dons and muscles.
See Figure 4.3
■
for an illustration of the processes found on the femur.
Additionally, bones have hollow regions or depressions, the most common
of which are the:
1. Sinus: a hollow cavity within a bone.
2. Foramen: a smooth, round opening for nerves and blood vessels.
3. Fossa: consists of a shallow cavity or depression on the surface of a bone.
4. Fissure: a slit-type opening.
Skeleton
What’s In A Name?
Look for these word parts:
epi- = above
appendicular skeleton (app-en-DIK-yoo-lar)
The human skeleton has two divisions: the axial skeleton and the appendicular
skeleton. Figures 4.4 and 4.8 illustrate these two skeletons.
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MusculoskeletalSystem 89
Axial Skeleton
What’s In A Name?
Look for these word parts:
-al = pertaining to
-ar = pertaining to
Med Term Tip
Newborn infants have about 300
bones at birth that will fuse into
206 bones as an adult.
cervical vertebrae
coccyx (COCK-six)
cranium (KRAY-nee-um)
ethmoid bone (ETH-moyd)
facial bones
frontal bone
hyoid bone (HIGH-oyd)
intervertebral disk (in-ter-VER-teh-bral)
lacrimal bone (LACK-rim-al)
lumbar vertebrae
mandible (MAN-dih-bl)
maxilla (mack-SIH-lah)
nasal bone
occipital bone (ock-SIP-eh-tal)
palatine bone (PAL-ah-tine)
parietal bone (pah-RYE-eh-tal)
rib cage
sacrum (SAY-crum)
sphenoid bone (SFEE-noyd)
sternum (STER-num)
temporal bone (TEM-por-al)
thoracic vertebrae
vertebral column (VER-teh-bral)
vomer bone (VOH-mer)
zygomatic bone (zeye-go-MAT-ik)
■
Figure 4.3 Bony
processesfoundonthe
femur.
Fovea capitis
Head
Greater trochanter
Neck
Trochanteric line
Medial epicondyle
Medial condyle
Patellar surface
Lateral condyle
The axial skeleton includes the bones of the head, neck, spine, chest, and trunk
of the body (see Figure 4.4
■
). These bones form the central axis for the whole
body and protect many of the internal organs such as the brain, lungs, and
heart.
The head or skull is divided into two parts consisting of the cranium and facial
bones. These bones surround and protect the brain, eyes, ears, nasal cavity,
and oral cavity from injury. The muscles for chewing and moving the head
are attached to the cranial bones. The cranium encases the brain and consists
of the frontal, parietal, temporal, ethmoid, sphenoid, and occipital bones. The facial
bones surround the mouth, nose, and eyes, and include the mandible, maxilla,
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90Chapter 4
■
Figure 4.4 Bonesofthe
axialskeleton.
Sternum (1)
Ribs (24)
V
ertebrae (24)
Sacrum (1)
Coccyx (1)
Skull (22)
Cranium (8)
Face (14)
M04_FREM0254_06_SE_C04.indd 90 18/12/14 10:12 pm
MusculoskeletalSystem 91
■
Figure 4.5 Bonesofthe
skull.
Temporal bone
Occipital bone
Frontal bone
Suture
Sphenoid bone
Nasal bone
Lacrimal bone
Orbit
Maxilla
Zygomatic bone
Mandible (Jaw)
Parietal bone
Vomer
zygomatic, vomer, palatine, nasal, and lacrimal bones. The cranial and facial bones
are illustrated in Figure 4.5
■
and described in Table 4.1
■
.
The hyoid bone is a single U-shaped bone suspended in the neck between the
mandible and larynx. It is a point of attachment for swallowing and speech muscles.
The trunk of the body consists of the vertebral column, sternum, and rib cage. The
vertebral or spinal column is divided into five sections: cervical vertebrae, thoracic
vertebrae, lumbar vertebrae, sacrum, and coccyx (see Figure 4.6
■
and Table 4.2
■
).
Located between each pair of vertebrae, from the cervical through the lumbar
regions, is an intervertebral disk. Each disk is composed of fibrocartilage to provide
a cushion between the vertebrae. The rib cage has 12 pairs of ribs attached at the
back to the vertebral column. Ten of the pairs are also attached to the sternum
in the front (see Figure 4.7
■
). The lowest two pairs are called floating ribs and
What’s In A Name?
Look for these word parts:
-al = pertaining to
-ar = pertaining to
-oid = resembling
-tic = pertaining to
Med Term Tip
The term coccyx comes from
the Greek word for the cuckoo
because the shape of these
small bones extending off the
sacrum resembles this bird’s bill.
Name Number Description
Cranial Bones
Frontal bone 1 Forehead
Parietal bone 2 Upper sides of cranium and roof of skull
Occipital bone 1 Back and base of skull
Temporal bone 2 Sides and base of cranium
Sphenoid bone 1 Bat-shaped bone that forms part of the base of the skull, floor, and sides of eye orbit
Ethmoid bone 1 Forms part of eye orbit, nose, and floor of cranium
Facial Bones
Lacrimal bone 2 Inner corner of each eye
Nasal bone 2 Form part of nasal septum and support bridge of nose
Maxilla 1 Upper jaw
Mandible 1 Lower jawbone; only movable bone of the skull
Zygomatic bone 2 Cheekbones
Vomer bone 1 Base of nasal septum
Palatine bone 1 Hard palate (PAH lat) roof of oral cavity and floor of nasal cavity
Table 4.1 Bones of the Skull
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92Chapter 4
■
Figure 4.6 Divisionsofthevertebralcolumn.
Atlas
Axis
Sacrum
Coccyx
Cervical 1-7
Thoracic 1-12
Lumbar 1-5
Table 4.2 Bones of the Vertebral/Spinal Column
Name Number Description
Cervical vertebra 7 Vertebrae in the neck region
Thoracic vertebra 12 Vertebrae in the chest region with ribs attached
Lumbar vertebra 5 Vertebrae in the small of the back, about waist level
Sacrum 1 Five vertebrae that become fused into one triangular-shaped
flat bone at the base of the vertebral column
Coccyx 1 Three to five very small vertebrae attached to the sacrum,
often become fused
True ribs
(7 pairs)
False ribs
(3 pairs)
Ribs
(12 pairs)
Manubrium
Body
Xiphoid
process
Costal cartilage
Sternum
Floating ribs
(2 pairs)
■
Figure 4.7 Thestructureoftheribcage.
are attached only to the vertebral column. The rib cage serves to provide support
for organs, such as the heart and lungs.
Appendicular Skeleton
carpals (CAR-pals)
clavicle (CLAV-ih-kl)
femur (FEE-mer)
fibula (FIB-yoo-lah)
humerus (HYOO-mer-us)
ilium (ILL-ee-um)
innominate bone (ih-NOM-ih-nayt)
ischium (ISS-kee-um)
lower extremities
metacarpals (met-ah-CAR-pals)
metatarsals (met-ah-TAHR-sals)
os coxae (OSS / KOK-sigh)
patella (pah-TELL-ah)
pectoral girdle (PEK-toh-ral)
pelvic girdle (PEL-vik)
phalanges (fah-LAN-jeez)
pubis (PYOO-bis)
radius (RAY-dee-us)
scapula (SKAP-yoo-lah)
tarsals (TAHR-sals)
tibia (TIB-ee-ah)
ulna (UHL-nah)
upper extremities
.The appendicular skeleton consists of the pectoral girdle, upper extremities, pelvic
girdle, and lower extremities (see Figure 4.8
■
). These are the bones for our append-
ages or limbs and along with the muscles attached to them, they are responsible
for body movement.
What’s In A Name?
Look for these word parts:
pector/o = chest
pelv/o = pelvis
-al = pertaining to
-ic = pertaining to
Med Term Tip
The term girdle, meaning some-
thing that encircles or confines,
refers to the entire bony struc-
ture of the shoulder and the pel-
vis. If just one bone from these
areas is being discussed, like the
ilium of the pelvis, it would be
named as such. If, however, the
entire pelvis is being discussed,
it would be called the pelvic
girdle.
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MusculoskeletalSystem 93
Clavicle (2)
Scapula (2)
Humerus (2)
Radius (2)
Ulna (2)
Carpals (16)
Metacarpals (10)
Phalanges (28)
Hipbone
(coxe) (2)
Femur (2)
Patella (2)
Tibia (2)
Fibula (2)
Tarsals (14)
Metatarsals (10)
Phalanges (28)
Pectoral girdles (4
)
Upper
extremities (60)
Pelvic girdles (2)
Lower
extremities (60)
■
Figure 4.8 Bonesofthe
appendicularskeleton.
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94Chapter 4
The pectoral girdle consists of the clavicle and scapula bones. It functions to
attach the upper extremity, or arm, to the axial skeleton by articulating with
the sternum anteriorly and the vertebral column posteriorly. The bones of the
upper extremity include the humerus, ulna, radius, carpals, metacarpals, and pha-
langes. These bones are illustrated in Figure 4.9
■
and described in Table 4.3
■
.
■
Figure 4.9 Anatomical
andcommonnamesforthe
pectoralgirdleandupper
extremity.
Clavicle
(collarbone)
Humerus
(upper arm bone)
Radius
(forearm bone)
Ulna
(forearm bone)
Scapula
(shoulder blade)
Humerus
(upper arm bone)
Radius
(forearm bone)
Ulna
(forearm bone)
ANTERIOR
(front)
POSTERIOR
(back)
Name Number Description
Pectoral Girdle
Clavicle 2 Collar bone
Scapula 2 Shoulder blade
Upper Extremity
Humerus 2 Upper arm bone
Radius 2 Forearm bone on thumb side of lower arm
Ulna 2 Forearm bone on little finger side of lower arm
Carpals 16 Bones of wrist
Metacarpals 10 Bones in palm of hand
Phalanges 28 Finger bones; three in each finger and two in each thumb
Table 4.3 Bones of the Pectoral Girdle and Upper Extremity
The pelvic girdle is called the os coxae or the innominate bone or hipbone. It
contains the ilium, ischium, and pubis. It articulates with the sacrum posteriorly
to attach the lower extremity, or leg, to the axial skeleton. The lower extremity
bones include the femur, patella, tibia, fibula, tarsals, metatarsals, and phalanges.
These bones are illustrated in Figure 4.10
■
and described in Table 4.4
■
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MusculoskeletalSystem 95
■
Figure 4.10 Anatomical
andcommonnamesfor
thepelvicgirdleandlower
extremity.
Pubis
Femur
(thigh bone)
Patella
(knee cap)
Fibula
(lower leg bone)
Tibia
Tarsal
(ankle bone)
Metatarsal
(foot bone)
Phalange
(toe bone)
Ilium
Ischium
Femur
(thigh bone)
Fibula
(lower leg bone)
Tibia
Tarsal
(ankle bone)
Metatarsal
(foot bone)
ANTERIOR
(front)
POSTERIOR
(back)
Joints
articulation (ar-tik-yoo-LAY-shun)
bursa (BER-sah)
cartilaginous joints (car-tih-LAJ-ih-nus)
fibrous joints (FYE-bruss)
joint capsule
synovial fluid
synovial joint (sin-OH-vee-al)
synovial membrane
Name Number Description
Pelvic Girdle/Os Coxae
Ilium 2 Part of the hipbone
Ischium 2 Part of the hipbone
Pubis 2 Part of the hipbone
Lower Extremity
Femur 2 Upper leg bone; thigh bone
Patella 2 Knee cap
Tibia 2 Shin bone; thicker lower leg bone
Fibula 2 Thinner, long bone in lateral side of lower leg
Tarsals 14 Ankle and heel bones
Metatarsals 10 Forefoot bones
Phalanges 28 Toe bones; three in each toe and two in each great toe
Table 4.4 Bones of the Pelvic Girdle and Lower Extremity
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96Chapter 4
Joints are formed when two or more bones meet. This is also referred to as an
articulation. There are three types of joints based on the amount of movement
allowed between the bones: synovial joints, cartilaginous joints, and fibrous joints (see
Figure 4.11
■
).
Most joints are freely moving synovial joints (see Figure 4.12
■
), which are
enclosed by an elastic joint capsule. The joint capsule is lined with synovial mem-
brane, which secretes synovial fluid to lubricate the joint. As noted earlier, the ends
of bones in a synovial joint are covered by a layer of articular cartilage. Cartilage
is very tough, but still flexible. It withstands high levels of stress to act as a shock
absorber for the joint and prevents bone from rubbing against bone. Cartilage is
found in several other areas of the body, such as the nasal septum, external ear,
eustachian tube, larynx, trachea, bronchi, and intervertebral disks. One example
of a synovial joint is the ball-and-socket joint found at the shoulder and hip. The
ball rotating in the socket allows for a wide range of motion. Bands of strong
connective tissue called ligaments bind bones together at the joint.
Some synovial joints contain a bursa, which is a saclike structure composed
of connective tissue and lined with synovial membrane. Most commonly found
between bones and ligaments or tendons, bursas function to reduce friction.
Some common bursa locations are the elbow, knee, and shoulder joints.
Not all joints are freely moving. Fibrous joints allow almost no movement since
the ends of the bones are joined by thick fibrous tissue, which may even fuse into
solid bone. The sutures of the skull are an example of a fibrous joint. Cartilaginous
joints allow for slight movement but hold bones firmly in place by a solid piece
of cartilage. An example of this type of joint is the pubic symphysis, the point at
which the left and right pubic bones meet in the front of the lower abdomen.
What’s In A Name?
Look for these word parts:
articul/o = joint
fibr/o = fibers
synovi/o = synovial membrane
-al = pertaining to
-ous = pertaining to
Med Term Tip
Bursitis is an inflammation of the
bursa located between bony
prominences such as at the
shoulder. Housemaid’s knee, a
term thought to have originated
from the damage to the knees
that occurred when maids knelt
to scrub floors, is a form of
bursitis and carries the medical
name prepatellar bursitis.
■
Figure 4.11 Examplesofthreetypes
ofjointsfoundinthebody.
Skull
Pelvis
Hand
Fibrous joint
(skull suture)
Cartilaginous joint
Synovial joint
■
Figure 4.12 Structureofageneralizedsynovial
joint.
Medullary cavity
Periosteum
Spongy bone
Compact bone
Synovial membrane
Articular cartilage
Joint cavity
(contains
synovial fluid)
Joint capsule
M04_FREM0254_06_SE_C04.indd 96 18/12/14 10:12 pm
MusculoskeletalSystem 97
Practice As You Go
A. Complete the Statement
1. The two divisions of the human skeleton are the _____________________ and _____________________.
2. The five functions of the skeletal system are to _____________________, _____________________,
_____________________, _____________________, and _____________________.
3. _____________________ bones are roughly as long as they are wide.
4. The membrane covering bones is called the _____________________.
5. Another name for spongy bone is _____________________ bone.
6. _____________________ joints are the most common joints in the body.
7. A _____________________ is a smooth, round opening in bones.
8. The _____________________ is the shaft of a long bone.
Word Parts Used to Build Skeletal System Terms
The following lists contain the combining forms, suffixes, and prefixes used to build terms in the remaining sections of this
chapter.
Terminology
Combining Forms
ankyl/o stiffjoint
arthr/o joint
burs/o bursa
carp/o carpus
cervic/o neck
chondr/o cartilage
clavicul/o clavicle
coccyg/o coccyx
cortic/o outerlayer
cost/o rib
crani/o skull
cutane/o skin
erythr/o red
femor/o femur
fibul/o fibula
humer/o humerus
ili/o ilium
ischi/o ischium
kyph/o hump
lamin/o lamina
lord/o bentbackward
lumb/o loin
mandibul/o mandible
maxill/o maxilla
medull/o innerportion
metacarp/o metacarpus
metatars/o metatarsus
myel/o bonemarrow,
spinalcord
orth/o straight
oste/o bone
patell/o patella
path/o disease
ped/o child;foot
phalang/o phalanges
pod/o foot
prosthet/o addition
pub/o pubis
radi/o radius,ray(X-ray)
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98Chapter 4
Term Word Parts Definition
carpal
(CAR-pal)
carp/o=carpus
-al=pertainingto
pertainingtothecarpus
cervical
(CER-vih-kal)
cervic/o=neck
-al=pertainingto
pertainingtotheneck
clavicular
(cla-VIK-yoo-lar)
clavicul/o=clavicle
-ar=pertainingto
pertainingtotheclavicle
coccygeal
(cock-eh-JEE-all)
coccyg/o=coccyx
-eal=pertainingto
pertainingtothecoccyx
costal
(COAST-all)
cost/o=rib
-al=pertainingto
pertainingtotherib
sacr/o sacrum
sarc/o flesh
scapul/o scapula
scoli/o crooked
spin/o spine
spondyl/o vertebra
stern/o sternum
synov/o synovial
membrane
system/o system
tars/o tarsus
thorac/o thorax
tibi/o tibia
uln/o ulna
vertebr/o vertebra
Suffixes
-ac pertainingto
-al pertainingto
-algia pain
-ar pertainingto
-ary pertainingto
-centesis punctureto
withdrawfluid
-clasia surgicallybreak
-desis tofuse
-eal pertainingto
-ectomy surgicalremoval
-genic producing
-gram record
-graphy processof
recording
-iatry medicaltreatment
-ic pertainingto
-itis inflammation
-listhesis slipping
-logy study
-malacia abnormalsoftening
-metry processof
measuring
-oma tumor
-ory pertainingto
-osis abnormalcondition
-otomy cuttinginto
-ous pertainingto
-pathy disease
-plasty surgicalrepair
-porosis porous
-scope instrumentfor
viewing
-scopy processofvisually
examining
-stenosis narrowing
-tic pertainingto
-tome instrumenttocut
Prefixes
anti- against
bi- two
dis- apart
ex- outward
inter- between
intra- within
non- not
per- through
sub- under
Adjective Forms of Anatomical Terms
Terminology (continued)
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MusculoskeletalSystem 99
Term Word Parts Definition
cranial
(KRAY-nee-all)
crani/o=skull
-al=pertainingto
pertainingtotheskull
femoral
(FEM-or-all)
femor/o=femur
-al=pertainingto
pertainingtothefemur
fibular
(FIB-yoo-lar)
fibul/o=fibula
-ar=pertainingto
pertainingtothefibula
humeral
(HYOO-mer-all)
humer/o=humerus
-al=pertainingto
pertainingtothehumerus
iliac
(ILL-ee-ack)
ili/o=ilium
-ac=pertainingto
pertainingtotheilium
intervertebral
(in-ter-VER-teh-bral)
inter-=between
vertebr/o=vertebra
-al=pertainingto
pertainingtobetweenvertebrae
intracranial
(in-trah-KRAY-nee-al)
intra-=within
crani/o=skull
-al=pertainingto
pertainingtowithintheskull
ischial
(ISH-ee-all)
ischi/o=ischium
-al=pertainingto
pertainingtotheischium
lumbar
(LUM-bar)
lumb/o=lowback
-ar=pertainingto
pertainingtothelowback
mandibular
(man-DIB-yoo-lar)
mandibul/o=mandible
-ar=pertainingto
pertainingtothemandible
maxillary
(mack-sih-LAIR-ree)
maxill/o=maxilla
-ary=pertainingto
pertainingtothemaxilla
metacarpal
(met-ah-CAR-pal)
metacarp/o=metacarpus
-al=pertainingto
pertainingtothemetacarpus
metatarsal
(met-ah-TAHR-sal)
metatars/o=metatarsus
-al=pertainingto
pertainingtothemetatarsus
patellar
(pa-TELL-ar)
patell/o=patella
-ar=pertainingto
pertainingtothepatella
phalangeal
(fay-lan-JEE-all)
phalang/o=phalanges
-eal=pertainingto
pertainingtothephalanges
pubic
(PYOO-bik)
pub/o=pubis
-ic=pertainingto
pertainingtothepubis
radial
(RAY-dee-all)
radi/o=radius
-al=pertainingto
pertainingtotheradius
sacral
(SAY-kral)
sacr/o=sacrum
-al=pertainingto
pertainingtothesacrum
scapular
(SKAP-yoo-lar)
scapul/o=scapula
-ar=pertainingto
pertainingtothescapula
sternal
(STER-nal)
stern/o=sternum
-al=pertainingto
pertainingtothesternum
tarsal
(TAHR-sal)
tars/o=tarsus
-al=pertainingto
pertainingtothetarsus
Adjective Forms of Anatomical Terms (continued)
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100Chapter 4
Term Word Parts Definition
thoracic
(tho-RASS-ik)
thorac/o=thorax
-ic=pertainingto
pertainingtothethorax
tibial
(TIB-ee-all)
tibi/o=tibia
-al=pertainingto
pertainingtothetibia
ulnar
(UHL-nar)
uln/o=ulna
-ar=pertainingto
pertainingtotheulna
vertebral
(VER-the-bral)
vertebr/o=vertebra
-al=pertainingto
pertainingtoavertebra
Practice As You Go
B. Adjective Form Practice
Give the adjective form for the following bones.
1. femur __________________________________________________________________________________
2. sternum ________________________________________________________________________________
3. clavicle _________________________________________________________________________________
4. coccyx __________________________________________________________________________________
5. maxilla _________________________________________________________________________________
6. tibia ____________________________________________________________________________________
7. patella __________________________________________________________________________________
8. phalanges ______________________________________________________________________________
9. humerus _______________________________________________________________________________
10. pubis ___________________________________________________________________________________
Adjective Forms of Anatomical Terms (continued)
Term Word Parts Definition
Medical Specialties
chiropractic
(ki-roh-PRAK-tik)
-tic=pertainingto Healthcareprofessionconcerned
withdiagnosisandtreatmentof
malalignmentconditionsofthe
spineandmusculoskeletalsystem
withtheintentionofaffectingthe
nervoussystemandimproving
health.Healthcareprofessionalisa
chiropractor.
Pathology
M04_FREM0254_06_SE_C04.indd 100 18/12/14 10:12 pm
MusculoskeletalSystem 101
Term Word Parts Definition
orthopedics(Orth,ortho)
(or-thoh-PEE-diks)
orth/o=straight
ped/o=child,foot
-ic=pertainingto
Branchofmedicinespecializing
inthediagnosisandtreatmentof
conditionsofthemusculoskeletal
system;alsocalledorthopedic
surgery.Physicianisanorthopedist
ororthopedic surgeon.Name
derivedfromstraightening(orth/o)
deformitiesinchildren(ped/o).
orthotics
(or-THOT-iks)
orth/o=straight
-tic=pertainingto
Healthcareprofessionspecializing
inmakingorthopedicappliances
suchasbracesandsplints.Person
skilledinmakingandadjustingthese
appliancesisanorthotist.
podiatry
(po-DYE-ah-tree)
pod/o=foot
-iatry=medicaltreatment
Healthcareprofessionspecializingin
diagnosisandtreatmentofdisorders
ofthefeetandlowerlegs.Healthcare
professionalisapodiatrist.
prosthetics
(pross-THET-iks)
prosthet/o=addition
-ic=pertainingto
Healthcareprofessionspecializingin
makingartificialbodyparts.Person
skilledinmakingandadjusting
prosthesesisaprosthetist.
Signs and Symptoms
arthralgia
(ar-THRAL-jee-ah)
arthr/o=joint
-algia=pain
jointpain
bursitis
(ber-SIGH-tis)
burs/o=bursa
-itis=inflammation
inflammationofabursa
callus
(KAL-us)
Themassofbonetissuethatforms
atafracturesiteduringitshealing.
chondromalacia
(kon-droh-mah-LAY-she-ah)
chondr/o=cartilage
-malacia=abnormalsoftening
softeningofthecartilage
crepitation
(krep-ih-TAY-shun)
Thenoiseproducedbybones
orcartilagerubbingtogetherin
conditionssuchasarthritis.Also
calledcrepitus.
ostealgia
(oss-tee-AL-jee-ah)
oste/o=bone
-algia=pain
bonepain
osteomyelitis
(oss-tee-oh-mi-ell-EYE-tis)
oste/o=bone
myel/o=bonemarrow
-itis=inflammation
inflammationofboneandbone
marrow
synovitis
(sih-no-VI-tis)
synov/o=synovialmembrane
-itis=inflammation
inflammationofsynovialmembrane
Pathology (continued)
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102Chapter 4
Term Word Parts Definition
Fractures
closed fracture Fractureinwhichthereisnoopen
skinwound.Alsocalledasimple
fracture.
Colles’ fracture
(COL-eez)
Acommontypeofwristfracture.
comminuted fracture
(kom-ih-NYOOT-ed)
Fractureinwhichtheboneis
shattered,splintered,orcrushedinto
manysmallpiecesorfragments.
compound fracture Fractureinwhichtheskinhasbeen
brokenthroughtothefracture.Also
calledanopen fracture(seeFigure
4.13B
■
).
B
A
■
Figure 4.13 A)Closed(orsimple)
fractureandB)open(orcompound)
fracture.
■
Figure 4.14 Colles’
fracture.
(Charles Stewart MD FACEP,
FAAEM)
Pathology (continued)
M04_FREM0254_06_SE_C04.indd 102 18/12/14 10:12 pm
MusculoskeletalSystem 103
Term Word Parts Definition
compression fracture Fractureinvolvinglossofheight
ofavertebralbody.Itmaybethe
resultoftrauma,butinolderpeople,
especiallywomen,itmaybecaused
byconditionslikeosteoporosis.
fracture
(FX,Fx)
Abrokenbone.
greenstick fracture Fractureinwhichthereisan
incompletebreak;onesideofbone
isbrokenandtheothersideisbent.
Thistypeoffractureiscommonly
foundinchildrenduetotheirsofter
andmorepliablebonestructure.
impacted fracture Fractureinwhichbonefragmentsare
pushedintoeachother.
oblique fracture
(oh-BLEEK)
Fractureatanangletothebone.
pathologic fracture
(path-a-LOJ-ik)
path/o=disease
-logic=pertainingtostudyof
Fracturecausedbydiseasedor
weakenedbone.
spiral fracture -al=pertainingto Fractureinwhichthefractureline
spiralsaroundtheshaftofthebone.
Canbecausedbyatwistinginjury
andisoftenslowertohealthanother
typesoffractures.
stress fracture Aslightfracturecausedbyrepetitive
low-impactforces,likerunning,
ratherthanasingleforcefulimpact.
■
Figure 4.15 X-ray
showingobliquefractureof
thehumerus.
(Charles Stewart MD
FACEP, FAAEM)
Pathology (continued)
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104Chapter 4
Term Word Parts Definition
transverse fracture Completefracturethatisstraight
acrosstheboneatrightanglestothe
longaxisofthebone.
Bones
chondroma
(kon-DROH-mah)
chondr/o=cartilage
-oma=tumor
Atumor,usuallybenign,thatformsin
cartilage.
Ewing’s sarcoma
(YOO-wings/sar-KOH-mah)
sarc/o=flesh
-oma=tumor
Malignantgrowthfoundintheshaft
oflongbonesthatspreadsthrough
theperiosteum.Removalisthe
treatmentofchoicebecausethis
tumorwillmetastasizeorspreadto
otherorgans.
exostosis
(eck-sos-TOH-sis)
ex-=outward
oste/o=bone
-osis=abnormalcondition
Abony,outwardprojectionfromthe
surfaceofabone;alsocalledabone
spur.
myeloma
(my-ah-LOH-mah)
myel/o=bonemarrow
-oma=tumor
Atumorthatformsinbonemarrow
tissue.
osteochondroma
(oss-tee-oh-kon-DROH-mah)
oste/o=bone
chondr/o=cartilage
-oma=tumor
Atumor,usuallybenign,thatconsists
ofbothboneandcartilagetissue.
osteogenic sarcoma
(oss-tee-oh-GIN-ik/sark-OH-mah)
oste/o=bone
-genic=producing
sarc/o=flesh
-oma=tumor
Themostcommontypeofbone
cancer.Usuallybeginsinosteocytes
foundattheendsoflongbones.
osteomalacia
(oss-tee-oh-mah-LAY-she-ah)
oste/o=bone
-malacia=abnormalsoftening
Softeningofthebonescausedbya
deficiencyofcalcium.Itisthought
tobecausedbyinsufficientsunlight
andvitaminDinchildren.
osteopathy
(oss-tee-OPP-ah-thee)
oste/o=bone
-pathy=disease
Ageneraltermforbonedisease.
■
Figure 4.16 X-rayshowing
transversefractureofradius.
(James
Stevenson/Science Photo Library/Photo
Researchers, Inc.)
Pathology (continued)
M04_FREM0254_06_SE_C04.indd 104 18/12/14 10:12 pm
MusculoskeletalSystem 105
Term Word Parts Definition
osteoporosis
(oss-tee-oh-por-ROH-sis)
oste/o=bone
-porosis=porous
Decreaseinbonemassproducinga
thinningandweakeningofthebone
withresultingfractures.Thebone
becomesmoreporous,especiallyin
thespineandpelvis.
Paget’s disease
(PAH-jets)
Afairlycommonmetabolicdisease
ofthebonefromunknowncauses.
Itusuallyattacksmiddle-agedand
olderadultsandischaracterized
bybonedestructionanddeformity.
NamedforSirJamesPaget,aBritish
surgeon.
rickets
(RIK-ets)
DeficiencyincalciumandvitaminD
foundinearlychildhoodthatresults
inbonedeformities,especially
bowedlegs.
Spinal Column
ankylosing spondylitis
(ang-kih-LOH-sing/spon-dih-LYE-tis)
ankyl/o=stiffjoint
spondyl/o=vertebra
-itis=inflammation
Inflammatoryspinalcondition
resemblingrheumatoidarthritis
andresultsingradualstiffening
andfusionofthevertebrae.More
commoninmenthaninwomen.
herniated nucleus pulposus (HNP)
(HER-nee-ated/NOO-klee-us/
pull-POH-sus)
Herniationorprotrusionofan
intervertebraldisk;alsocalled
herniated diskorruptured disk.May
requiresurgery.
kyphosis
(ki-FOH-sis)
kyph/o=hump
-osis=abnormalcondition
Abnormalincreaseintheoutward
curvatureofthethoracicspine.Also
knownashunchbackorhumpback.
SeeFigure4.18
■
foranillustrationof
abnormalspinecurvatures.
■
Figure 4.17 Magneticresonance
imaging(MRI)imagedemonstrating
abackherniateddisc.
(Michelle Milano/
Shutterstock)
Pathology (continued)
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106Chapter 4
Term Word Parts Definition
lordosis
(lor-DOH-sis)
lord/o=bentbackward
-osis=abnormalcondition
Abnormalincreaseintheforward
curvatureofthelumbarspine.Also
knownasswayback.Seeagain
Figure4.18foranillustrationof
abnormalspinecurvatures.
scoliosis
(skoh-lee-OH-sis)
scoli/o=crooked
-osis=abnormalcondition
Abnormallateralcurvatureofthe
spine.SeeagainFigure4.18for
anillustrationofabnormalspine
curvatures.
spina bifida
(SPY-nah/BIF-ih-dah)
spin/o=spine
bi-=two
Congenitalanomalyoccurringwhen
avertebrafailstofullyformaround
thespinalcord.
spinal stenosis
(ste-NOH-sis)
spin/o=spine
-al=pertainingto
Narrowingofthespinalcanalcausing
pressureonthecordandnerves.
spondylolisthesis
(spon-dih-loh-liss-THEE-sis)
spondyl/o=vertebra
-listhesis=slipping
Theforwardslidingofalumbar
vertebraoverthevertebrabelowit.
spondylosis
(spon-doh-LOH-sis)
spondyl/o=vertebra
-osis=abnormalcondition
Specificallyreferstoankylosing
ofthespine,butcommonlyused
inreferencetoanydegenerative
conditionofthevertebralcolumn.
■
Figure 4.18
Abnormalspinal
curvatures:kyphosis,
lordosis,andscoliosis.
Kyphosis
(excessive posterior thoracic
curvature - hunchback)
Lordosis
(excessive anterior lumbar
curvature - swayback)
Scoliosis
(lateral curvature)
Pathology (continued)
Word Watch
Watch how the term stenosis is used in this condition. It most often appears as the suffix
-stenosis. However, in this case, it is used as a freestanding word.
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MusculoskeletalSystem 107
Term Word Parts Definition
whiplash Cervicalmuscleandligamentsprain
orstrainasaresultofasudden
movementforwardandbackwardof
theheadandneck.Canoccurasa
resultofarear-endautocollision.
Joints
bunion
(BUN-yun)
Inflammationofthebursaofthefirst
metatarsophalangealjoint(baseof
thebigtoe).
dislocation dis-=apart Occurswhenthebonesinajoint
aredisplacedfromtheirnormal
alignmentandtheendsofthebones
arenolongerincontact.
osteoarthritis
(OA)(oss-tee-oh-ar-THRY-tis)
oste/o=bone
arthr/o=joint
-itis=inflammation
Arthritisresultingindegeneration
ofthebonesandjoints,especially
thosebearingweight.Resultsin
bonerubbingagainstbone.Also
calleddegenerativejointdisease
(DJD).
rheumatoid arthritis
(RA)(ROO-mah-toyd/ar-THRY-tis)
arthr/o=joint
-itis=inflammation
Chronicformofarthritiswith
inflammationofthejoints,swelling,
stiffness,pain,andchangesinthe
cartilagethatcanresultincrippling
deformities;consideredtobean
autoimmunedisease.
■
Figure 4.19 Patientwith
typicalrheumatoidarthritis
contractures.
Pathology (continued)
M04_FREM0254_06_SE_C04.indd 107 18/12/14 10:12 pm
108Chapter 4
Term Word Parts Definition
sprain Damagetotheligamentssurrounding
ajointduetooverstretching,butno
dislocationofthejointorfractureof
thebone.
subluxation
(sub-LUCKS-a-shun)
sub-=under Anincompletedislocation,thejoint
alignmentisdisrupted,buttheends
ofthebonesremainincontact.
systemic lupus erythematosus
(SLE)(sis-TEM-ik/LOOP-us/
air-ih-them-ah-TOH-sis)
system/o=system
-ic=pertainingto
erythr/o=red
Chronicinflammatoryautoimmune
diseaseofconnectivetissueaffecting
manysystemsthatmayincludejoint
painandarthritis.Maybemistaken
forrheumatoidarthritis.
talipes
(TAL-ih-peez)
Congenitaldeformitycausing
misalignmentoftheanklejointand
foot.Alsoreferredtoasaclubfoot.
Practice As You Go
C. Fracture Type Matching
Match each fracture type to its definition.
1. ________ comminuted
2. ________ greenstick
3. ________ compound
4. ________ simple
5. ________ impacted
6. ________ transverse
7. ________ oblique
8. ________ spiral
a. fracture line is at an angle
b. fracture line curves around the bone
c. bone is splintered or crushed
d. bone is pressed into itself
e. fracture line is straight across bone
f. skin has been broken
g. no open wound
h. bone only partially broken
Pathology (continued)
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MusculoskeletalSystem 109
Term Word Part Definition
Diagnostic Imaging
arthrogram
(AR-throh-gram)
arthr/o=joint
-gram=record
X-rayrecordofajoint,usuallytakenafter
thejointhasbeeninjectedbyacontrast
medium.
arthrography
(ar-THROG-rah-fee)
arthr/o=joint
-graphy=processof
recording
ProcessofX-rayingajoint,usuallyafter
injectionofacontrastmediumintothejoint
space.
bone scan Nuclearmedicineprocedureinwhichthe
patientisgivenaradioactivedyeandthen
scanningequipmentisusedtovisualize
bones.Itisespeciallyusefulinidentifying
stressfractures,observingprogressof
treatmentforosteomyelitis,andlocating
cancermetastasestothebone.
dual-energy absorptiometry(DXA)
(ab-sorp-she-AHM-eh-tree)
-metry=processof
measuring
Measurementofbonedensityusinglow-
doseX-rayforthepurposeofdetecting
osteoporosis.
myelography
(my-eh-LOG-rah-fee)
myel/o=spinalcord
-graphy=processof
recording
Studyofthespinalcolumnafterinjecting
opaquecontrastmaterial;particularlyuseful
inidentifyingherniatednucleuspulposus
pinchingaspinalnerve.
radiography radi/o=ray
-graphy=processof
recording
DiagnosticimagingprocedureusingX-rays
tostudytheinternalstructureofthebody;
especiallyusefulforvisualizingbonesand
joints.
Endoscopic Procedures
arthroscope
(AR-throw-skop)
arthr/o=joint
-scope=instrumentfor
viewing
Instrumentusedtoviewinsideajoint.
arthroscopy
(ar-THROS-koh-pee)
arthr/o=joint
-scopy=processofvisually
examining
Examinationoftheinteriorofajointby
enteringthejointwithanarthroscope.The
arthroscopecontainsasmalltelevision
camerathatallowsthephysiciantoview
theinteriorofthejointonamonitorduring
theprocedure.Somejointconditionscan
berepairedduringarthroscopy.
Diagnostic Procedures
Med Term Tip
The combining form myel/o means “marrow” and is used for both the spinal cord and
bone marrow. To the ancient Greek philosophers and physicians, the spinal cord appeared
to be much like the marrow found in the medullary cavity of a long bone.
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110Chapter 4
Term Word Part Definition
Medical Treatments
arthrocentesis
(ar-thro-sen-TEE-sis)
arthr/o=joint
-centesis=punctureto
withdrawfluid
Involvestheinsertionofaneedleintothejoint
cavityinordertoremoveoraspiratefluid.May
bedonetoremoveexcessfluidfromajointorto
obtainfluidforexamination.
orthotic
(or-THOT-ik)
orth/o=straight
-tic=pertainingto
Orthopedicappliance,suchasabraceorsplint,
usedtopreventorcorrectdeformities.
prosthesis
(pross-THEE-sis)
prosthet/o=addition Artificialdeviceusedasasubstituteforabody
partthatiseithercongenitallymissingorabsentas
aresultofaccidentordisease.Anexamplewould
beanartificialleg.
Surgical Procedures
amputation
(am-pew-TAY-shun)
Partialorcompleteremovalofalimbforavariety
ofreasons,includingtumors,gangrene,intractable
pain,crushinginjury,oruncontrollableinfection.
arthroclasia
(ar-throh-KLAY-see-ah)
arthr/o=joint
-clasia=surgicallybreak
Toforciblybreaklooseafusedjointwhilethe
patientisunderanesthetic.Fusionisusually
causedbythebuildupofscartissueoradhesions.
arthrodesis
(ar-throh-DEE-sis)
arthr/o=joint
-desis=tofuse
Proceduretostabilizeajointbyfusingthebones
together.
arthroscopic surgery
(ar-throh-SKOP-ic)
arthr/o=joint
-scopy=processofvisually
examining
-ic=pertainingto
Performingasurgicalprocedurewhileusingan
arthroscopetoviewtheinternalstructure,suchasa
joint.
arthrotomy
(ar-THROT-oh-mee)
arthr/o=joint
-otomy=cuttinginto
Surgicalprocedurethatcutsintoajointcapsule.
bone graft Pieceofbonetakenfromthepatientusedtotake
theplaceofaremovedboneorabonydefectat
anothersite.
bunionectomy
(bun-yun-ECK-toh-mee)
-ectomy=surgicalremoval Removalofthebursaatthejointofthegreattoe.
bursectomy
(ber-SEK-toh-mee)
burs/o=bursa
-ectomy=surgicalremoval
Surgicalremovalofabursa.
chondrectomy
(kon-DREK-toh-mee)
chondr/o=cartilage
-ectomy=surgicalremoval
Surgicalremovalofcartilage.
chondroplasty
(KON-droh-plas-tee)
chondr/o=cartilage
-plasty=surgicalrepair
Surgicalrepairofcartilage.
craniotomy
(kray-nee-OTT-oh-mee)
crani/o=skull
-otomy=cuttinginto
Surgicalprocedurethatcutsintotheskull.
laminectomy
(lam-ih-NEK-toh-mee)
lamin/o=lamina
-ectomy=surgicalremoval
Removalofthevertebralposteriorarchtocorrect
severebackproblemsandpaincausedby
compressionofaspinalnerve.
osteoclasia
(oss-tee-oh-KLAY-see-ah)
oste/o=bone
-clasia=surgicallybreak
Surgicalprocedureinvolvingtheintentional
breakingofabonetocorrectadeformity.
osteotome
(OSS-tee-oh-tohm)
oste/o=bone
-tome=instrumenttocut
Instrumentusedtocutbone.
Therapeutic Procedures
M04_FREM0254_06_SE_C04.indd 110 18/12/14 10:12 pm
MusculoskeletalSystem 111
Term Word Part Definition
osteotomy
(oss-tee-OTT-ah-me)
oste/o=bone
-otomy=cuttinginto
Surgicalprocedurethatcutsintoabone.
percutaneous diskectomy
(per-kyou-TAY-nee-us/
disk-EK-toh-mee)
per-=through
cutane/o=skin
-ous=pertainingto
-ectomy=surgicalremoval
Athincathetertubeisinsertedintothe
intervertebraldiskthroughtheskinandthe
herniatedorruptureddiskmaterialissuckedoutor
alaserisusedtovaporizeit.
spinal fusion spin/o=spine
-al=pertainingto
Surgicalimmobilizationofadjacentvertebrae.
Thismaybedoneforseveralreasons,including
correctionforaherniateddisk.
synovectomy
(sih-no-VEK-toh-mee)
synov/o=synovial
membrane
-ectomy=surgicalremoval
Surgicalremovalofthesynovialmembrane.
total hip arthroplasty(THA)
(ar-thro-PLAS-tee)
arthr/o=joint
-plasty=surgicalrepair
Surgicalreconstructionofahipbyimplantinga
prostheticorartificialhipjoint.Alsocalledtotal hip
replacement (THR).
total knee arthroplasty(TKA)
(ar-thro-PLAS-tee)
arthr/o=joint
-plasty=surgicalrepair
Surgicalreconstructionofakneejointby
implantingaprosthetickneejoint.Alsocalledtotal
knee replacement (TKR).
Fracture Care
cast Applicationofasolidmaterialtoimmobilizean
extremityorportionofthebodyasaresultofa
fracture,dislocation,orsevereinjury.Itmaybe
madeofplasterofParisorfiberglass.
fixation Proceduretostabilizeafracturedbonewhileit
heals.External fixationincludescasts,splints,and
pinsinsertedthroughtheskin.Internal fixation
includespins,plates,rods,screws,andwiresthat
areappliedduringanopen reduction.
Therapeutic Procedures (continued)
■
Figure 4.20
Prosthetichipjoint.
(Lawrence
Livermore National Library/Science
Photo Library/Photo Researchers,
Inc.)
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112Chapter 4
Pharmacology
Classification Word Parts Action Examples
bone reabsorption
inhibitors
Conditionsthatresultinweak
andfragilebones,suchas
osteoporosisandPaget’s
disease,areimprovedby
medicationsthatreducethe
reabsorptionofbones.
alendronate,Fosamax;
ibandronate,Boniva
calcium supplements
and vitamin D therapy
Maintaininghighbloodlevels
ofcalciuminassociation
withvitaminDhelpsmaintain
bonedensity;usedtotreat
osteomalacia,osteoporosis,and
rickets.
calciumcarbonate,Oystercal,
Tums;calciumcitrate,Cal-
Citrate,Citracal
corticosteroids
cortic/o
=outer
layer
Ahormoneproducedbythe
adrenalcortexthathasvery
stronganti-inflammatory
properties.Itisparticularly
usefulintreatingrheumatoid
arthritis.
prednisone;
methylprednisolone,Medrol;
dexamethasone,Decadron
nonsteroidal anti-
inflammatory drugs
(NSAIDs)
non-=not
-al=pertainingto
anti-=against
-ory=pertainingto
Alargegroupofdrugs(other
thancorticosteroids)that
providemildpainreliefand
anti-inflammatorybenefitsfor
conditionssuchasarthritis.
ibuprofen,Advil,Motrin;
naproxen,Aleve,Naprosyn;
salicylates,Aspirin
Term Word Part Definition
reduction Correctingafracturebyrealigningthebone
fragments.Closed reductionisdoingthis
manipulationwithoutenteringthebody.Open
reductionistheprocessofmakingasurgical
incisionatthesiteofthefracturetodothe
reduction.Thisisnecessarywhenbonyfragments
needtoberemovedorinternal fixationsuchas
platesorpinsarerequired.
traction Applyingapullingforceonafracturedor
dislocatedlimborthevertebralcolumninorderto
restorenormalalignment.
Therapeutic Procedures (continued)
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MusculoskeletalSystem 113
AE aboveelbow
AK aboveknee
BDT bonedensitytesting
BE belowelbow
BK belowknee
C1, C2, etc. firstcervicalvertebra,secondcervical
vertebra,etc.
Ca calcium
DJD degenerativejointdisease
DXA dual-energyabsorptiometry
FX, Fx fracture
HNP herniatednucleuspulposus
JRA juvenilerheumatoidarthritis
L1, L2, etc. firstlumbarvertebra,secondlumbar
vertebra,etc.
LE lowerextremity
LLE leftlowerextremity
LUE leftupperextremity
Practice As You Go
D. What’s the Abbreviation?
1. total knee replacement _________________________________
2. herniated nucleus pulposus _________________________________
3. upper extremity _________________________________
4. fifth lumbar vertebra _________________________________
5. above the knee _________________________________
6. fracture _________________________________
7. nonsteroidal anti-inflammatory drug _________________________________
Abbreviations
NSAID nonsteroidalanti-inflammatorydrug
OA osteoarthritis
ORIF openreduction–internalfixation
Orth, ortho orthopedics
P phosphorus
RA rheumatoidarthritis
RLE rightlowerextremity
RUE rightupperextremity
SLE systemiclupuserythematosus
T1, T2, etc. firstthoracicvertebra,secondthoracic
vertebra,etc.
THA totalhiparthroplasty
THR totalhipreplacement
TKA totalkneearthroplasty
TKR totalkneereplacement
UE upperextremity
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114Chapter 4
Function
Muscles are bundles, sheets, or rings of tissue that produce movement by contracting and pulling on
the structures to which they are attached.
Organs
Here is the primary structure that comprises the muscular system:
muscles
Word Parts
Here are the most common word parts (with their meanings) used to build muscular system terms. For
a more comprehensive list, refer to the Terminology section of this chapter.
Combining Forms
Section II: Muscular System at a Glance
114
duct/o tobring
extens/o tostretchout
fasci/o fibrousband
fibr/o fibers
flex/o tobend
kinesi/o movement
muscul/o muscle
my/o muscle
myos/o muscle
plant/o soleoffoot
rotat/o torevolve
ten/o tendon
tend/o tendon
tendin/o tendon
vers/o toturn
Suffixes
-asthenia weakness
-ion action
-kinesia movement
-tonia tone
-trophic pertainingtodevelopment
Prefixes
ab- awayfrom
ad- toward
circum- around
e- outward
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MusculoskeletalSystem 115
115
Muscular System Illustrated
Rectus abdominis
External oblique
Sartorius
Vastus medialis
Tibialis anterior
Frontalis
Trapezius
Pectoralis
Deltoid
Orbicularis oris
Sternocleidomastoid
Biceps brachii
Brachioradialis
Gastrocnemius
Rectus femoris
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116Chapter 4
Anatomy and Physiology of the
Muscular System
muscle tissue fibers muscles
Muscles are bundles of parallel muscle tissue fibers. As these fibers contract (shorten
in length) they produce movement of or within the body. The movement may
take the form of bringing two bones closer together, pushing food through the
digestive system, or pumping blood through blood vessels. In addition to pro-
ducing movement, muscles also hold the body erect and generate heat.
Types of Muscles
Med Term Tip
The term muscle is the diminu-
tive form of the Latin word mus
or “little mouse.” This is thought
to describe how the skin ripples
when a muscle contracts, like a
little mouse running.
cardiac muscle
involuntary muscles
skeletal muscle
smooth muscle
voluntary muscles
The three types of muscle tissue are skeletal muscle, smooth muscle, and cardiac muscle
(see Figure 4.21
■
). Muscle tissue may be either voluntary or involuntary. Voluntary
muscles are those muscles for which a person consciously chooses to contract and
for how long and how hard to contract them. The skeletal muscles of the arm and
leg are examples of this type of muscle. Involuntary muscles are the muscles under
the control of the subconscious regions of the brain. The smooth muscles found
in internal organs and cardiac muscles are examples of involuntary muscle tissue.
■
Figure 4.21 Thethree
typesofmuscles:skeletal,
smooth,andcardiac.
Skeletal
muscle
Cardia
c
muscle
Smooth
muscle
Skeletal Muscle
What’s In A Name?
Look for these word parts:
cardi/o = heart
-ac = pertaining to
in- = not
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MusculoskeletalSystem 117
Skeletal Muscle
What’s In A Name?
Look for these word parts:
cardi/o = heart
-ac = pertaining to
in- = not
fascia (FASH-ee-ah)
motor neurons
myoneural junction (MY-oh-NOO-rall)
striated muscles (stry-a-ted)
tendon (TEN-dun)
A skeletal muscle is directly or indirectly attached to a bone and produces volun-
tary movement of the skeleton. It is also referred to as a striated muscle because
of its striped appearance under the microscope (see Figure 4.22
■
). Each muscle
is wrapped in layers of fibrous connective tissue called fascia. The fascia tapers
at each end of a skeletal muscle to form a very strong tendon. The tendon then
inserts into the periosteum covering a bone to anchor the muscle to the bone.
Skeletal muscles are stimulated by motor neurons of the nervous system. The
point at which the motor nerve contacts a muscle fiber is called the myoneural
junction.
Smooth Muscle
visceral muscle (vis-she-ral)
Smooth muscle tissue is found in association with internal organs. For this rea-
son, it is also referred to as visceral muscle. The name smooth muscle refers to the
muscle’s microscopic appearance; it lacks the striations of skeletal muscle (see
again Figure 4.22). Smooth muscle is found in the walls of the hollow organs,
such as the stomach, tube-shaped organs, such as the respiratory airways, and
blood vessels. It is responsible for the involuntary muscle action associated with
movement of the internal organs, such as churning food, constricting a blood
vessel, and uterine contractions.
Cardiac Muscle
myocardium (my-oh-CAR-dee-um)
Cardiac muscle, or myocardium, makes up the wall of the heart (see again
Figure 4.22). With each involuntary contraction the heart squeezes to pump
blood out of its chambers and through the blood vessels. This muscle is more
thoroughly described in Chapter 5, Cardiovascular System.
What’s In A Name?
Look for these word parts:
cardi/o = heart
my/o = muscle
neur/o = nerve
viscer/o = internal organ
-al = pertaining to
Med Term Tip
The human body has more than
400 skeletal muscles, which
account for almost 50% of the
body’s weight.
■
Figure 4.22
Characteristicsofthethree
typesofmuscles.
Contracts Slowly Rapidly Rapidly
Found Viscera, blood vessels Trunk, extremities, Heart
head and neck
Control Involuntary Voluntary Involuntary
No striations
Central nucleus
Striations
Peripheral
nuclei
Striations
Central
nuclei
Visceral
(smooth)
Skeletal
(striated)
Cardiac
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118Chapter 4
Practice As You Go
E. Complete the Statement
1. Another name for visceral muscle is _____________________ muscle.
2. Nerves contact skeletal muscle fibers at the _____________________ junction.
3. The three types of muscle are _____________________, _____________________, and _____________________.
Naming Skeletal Muscles
biceps (BYE-seps)
extensor carpi
external oblique
flexor carpi
gluteus maximus (GLOO-tee-us /
MACKS-ih-mus)
rectus abdominis (REK-tus / ab-DOM-ih-nis)
sternocleidomastoid (STER-noh-KLY-doh
MASS-toid)
The name of a muscle often reflects its location, origin and insertion, size, action, fiber
direction, or number of attachment points, as illustrated by the following examples:
• Location: the term rectus abdominis means straight (rectus) abdominal
muscle.
• Origin and insertion: the sternocleidomastoid is named for its two ori-
gins (stern/o for sternum and cleid/o for clavicle) and single insertion
(mastoid process).
• Size: when gluteus, meaning rump area, is combined with maximus,
meaning large, we have the term gluteus maximus.
• Action: the flexor carpi and extensor carpi muscles are named as such
because they produce flexion and extension at the wrist.
• Fiber direction: the external oblique muscle is an abdominal muscle
whose fibers run at an oblique angle.
• Number of attachment points: the prefix bi-, meaning two, can
form the medical term biceps, which refers to the muscle in the upper
arm that has two heads or connecting points.
What’s In A Name?
Look for these word parts:
cleid/o = clavicle
extens/o = to stretch out
flex/o = to bend
stern/o = sternum
-al = pertaining to
bi- = two
ex- = outward
Skeletal Muscle Actions
action
antagonistic pairs
insertion
origin
Skeletal muscles are attached to two different bones and overlap a joint. When
a muscle contracts, the two bones move, but not usually equally. The less
movable of the two bones is considered to be the starting point of the muscle
and is called the origin. The more movable bone is considered to be where the
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MusculoskeletalSystem 119
■
Figure 4.23 Originand
insertionofamuscle
Origins
Biceps
brachii
Insertion
Action-Flexion
muscle ends and is called the insertion (see Figure 4.23
■
). The type of movement
a muscle produces is called its action. Muscles are often arranged around joints
in antagonistic pairs, meaning that they produce opposite actions. For example,
one muscle will bend a joint while its antagonist is responsible for straighten-
ing the joint. Some common terminology for muscle actions are described in
Table 4.5
■
.
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120Chapter 4
AB
■
Figure 4.26 Dorsiflexion(A)andplantarflexion(B)oftheanklejoint.(Poulsons Photography/
Shutterstock)
Table 4.5 Muscle Actions Grouped by Antagonistic Pairs
Action Word Parts Description
abduction
(ab-DUCK-shun)
ab- = away from
duct/o = to bring
-ion = action
Movement away from midline of the body (see Figure 4.24
■
)
adduction
(ah-DUCK-shun)
ad- = toward
duct/o = to bring
-ion = action
Movement toward midline of the body (see again Figure 4.24)
flexion
(FLEK-shun)
flex/o = to bend
-ion = action
Act of bending or being bent (see Figure 4.25
■
)
extension
(eks-TEN-shun)
extens/o = to stretch out
-ion = action
Movement that brings limb into or toward a straight condition (see again Figure 4.25)
dorsiflexion
(dor-see-FLEK-shun)
dors/o = back of body
flex/o = to bend
-ion = action
Backward bending, as of hand or foot (see Figure 4.26A
■
)
plantar flexion
(PLAN-tar / FLEK-shun)
plant/o = sole of foot
-ar = pertaining to
flex/o = to bend
-ion = action
Bending sole of foot; pointing toes downward (see Figure 4.26B
■
)
■
Figure 4.24 Abductionandadduction
oftheshoulderjoint.
180°
0°
Abduction
to 180°
Abduction
to 50°
■
Figure 4.25 Flexionand
extensionoftheelbowjoint.
Flexion to
160°
Extension
0°
160°
180°
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MusculoskeletalSystem 121
Action Word Parts Description
eversion
(ee-VER-zhun)
e- = outward
vers/o = to turn
-ion = action
Turning outward (see Figure 4.27
■
)
inversion
(in-VER-zhun)
in- = inward
vers/o = to turn
-ion = action
Turning inward (see again Figure 4.27 )
pronation
(proh-NAY-shun)
To turn downward or backward as with the hand or foot (see Figure 4.28
■
)
supination
(soo-pin-NAY-shun)
Turning the palm or foot upward (see again Figure 4.28)
elevation To raise a body part, as in shrugging the shoulders
depression A downward movement, as in dropping the shoulders
The circular actions described below are an exception to the antagonistic pair arrangement.
circumduction
(sir-kum-DUCK-shun)
circum- = around
duct/o = to bring
-ion = action
Movement in a circular direction from a central point as if drawing a large, imaginary circle
in the air
opposition
Med Term Tip
Primates are the only animals with
opposable thumbs.
Moving thumb away from palm; the ability to move the thumb into contact with the other
fingers
rotation rotat/o = to revolve
-ion = action
Moving around a central axis
Table 4.5 Muscle Actions Grouped by Antagonistic Pairs (continued)
■
Figure 4.28 Pronationandsupinationofthe
forearm.
Pronation
to 90°
Supination
to 90°
0°
■
Figure 4.27 Eversionandinversionofthefoot.
Inversion
to 30°
Eversion
to 20°
30°
0°
20°
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122Chapter 4
Practice As You Go
F. Terminology Matching
Match each term to its definition.
1. ________ abduction
2. ________ rotation
3. ________ plantar flexion
4. ________ extension
5. ________ dorsiflexion
6. ________ flexion
7. ________ adduction
8. ________ opposition
a. backward bending of the foot
b. bending the foot to point toes toward the ground
c. straightening motion
d. motion around a central axis
e. motion away from the body
f. moving the thumb away from the palm
g. motion toward the body
h. bending motion
Word Parts Used to Build Muscular System Terms
The following lists contain the combining forms, suffixes, and prefixes used to build terms in the remaining sections of this
chapter.
Terminology
Combining Forms
bi/o=life
carp/o=wrist
electr/o=electricity
fasci/o=fibrousband
fibr/o=fibers
kinesi/o=movement
later/o=side
muscul/o=muscle
my/o=muscle
myos/o=muscle
ten/o=tendon
tend/o=tendon
tendin/o=tendon
Suffixes
-al=pertainingto
-algia=pain
-ar=pertainingto
-asthenia=weakness
-desis=tofuse
-dynia=pain
-gram=record
-graphy=processofrecording
-itis=inflammation
-kinesia=movement
-logy=studyof
-opsy=viewof
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MusculoskeletalSystem 123
Term Word Parts Definition
fascial
(FAS-ee-all)
fasci/o=fibrousband
-al=pertainingto
pertainingtofascia
muscular
(MUSS-kew-lar)
muscul/o=muscle
-ar=pertainingto
pertainingtomuscles
musculoskeletal
(MUSS-kew-loh-SKEL-eh-tal)
muscul/o=muscle
-al=pertainingto
pertainingtothemusclesandskeleton
tendinous
(TEN-din-us)
tendin/o=tendon
-ous=pertainingto
pertainingtotendons
Term Word Parts Definition
Medical Specialties
kinesiology
(kih-NEE-see-oh-loh-jee)
kinesi/o=movement
-logy=studyof
Thesciencethatstudiesmovement,howit
isproduced,andthemusclesinvolved.
Signs and Symptoms
adhesion Scartissueforminginthefascia
surroundingamuscle,makingitdifficultto
stretchthemuscle.
atonia a-=without
-tonia=tone
Thelackofmuscletone.
atrophy
(AT-rah-fee)
a-=without
-trophy=development
Poormuscledevelopmentasaresultof
muscledisease,nervoussystemdisease,
orlackofuse;commonlyreferredtoas
muscle wasting.
bradykinesia
(brad-ee-kih-NEE-see-ah)
brady-=slow
-kinesia=movement
Havingslowmovements.
Suffixes
-otomy=cuttinginto
-ous=pertainingto
-pathy=disease
-plasty=surgicalrepair
-rrhaphy=suture
-rrhexis=rupture
-tonia=tone
-trophic=pertainingto
development
-trophy=development
Prefixes
a-=without
brady-=slow
dys-=abnormal;difficult
epi-=above
hyper-=excessive
hypo-=insufficient
poly-=many
pseudo-=false
Adjective Forms of Anatomical Terms
Pathology
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124Chapter 4
Term Word Parts Definition
contracture
(kon-TRACK-chur)
Abnormalshorteningofmusclefibers,
tendons,orfascia,makingitdifficultto
stretchthemuscle.
dyskinesia
(dis-kih-NEE-see-ah)
dys-=difficult,abnormal
-kinesia=movement
Havingdifficultorabnormalmovement.
dystonia dys-=abnormal
-tonia=tone
Havingabnormalmuscletone.
hyperkinesia
(high-per-kih-NEE-see-ah)
hyper-=excessive
-kinesia=movement
Havinganexcessiveamountofmovement.
hypertonia hyper-=excessive
-tonia=tone
Havingexcessivemuscletone.
hypertrophy
(high-PER-troh-fee)
hyper-=excessive
-trophy=development
Increaseinmusclebulkasaresultofuse,
aswithliftingweights.
hypokinesia
(HI-poh-kih-NEE-see-ah)
hypo-=insufficient
-kinesia=movement
Havinganinsufficientamountof
movement.
hypotonia hypo-=insufficient
-tonia=tone
Havinginsufficientmuscletone.
intermittent claudication
(klaw-dih-KAY-shun)
Attacksofseverepainandlameness
causedbyischemiaofthemuscles,
typicallythecalfmuscles;broughtonby
walkingevenveryshortdistances.
myalgia
(my-AL-jee-ah)
my/o=muscle
-algia=pain
Musclepain.
myasthenia
(my-ass-THEE-nee-ah)
my/o=muscle
-asthenia=weakness
Muscleweakness.
myotonia my/o=muscle
-tonia=tone
Muscletone.
spasm Sudden,involuntary,strongmuscle
contraction.
tenodynia
(ten-oh-DIN-ee-ah)
ten/o=tendon
-dynia=pain
Tendonpain.
Muscles
fasciitis
(fas-ee-EYE-tis)
fasci/o=fibrousband
-itis=inflammation
Inflammationoffascia.
fibromyalgia
(figh-broh-my-AL-jee-ah)
fibr/o=fibers
my/o=muscle
-algia=pain
Conditionwithwidespreadachingand
paininthemusclesandsofttissue.
lateral epicondylitis
(ep-ih-kon-dih-LYE-tis)
later/o=side
-al=pertainingto
epi-=above
-itis=inflammation
Inflammationofthemuscleattachmentto
thelateralepicondyleoftheelbow.Often
causedbystronglygripping.Commonly
calledtennis elbow.
muscular dystrophy
(MD)(MUSS-kew-ler/DIS-troh-fee)
muscul/o=muscle
-ar=pertainingto
dys-=abnormal
-trophy=development
Inheriteddiseasecausingaprogressive
muscledegeneration,weakness,and
atrophy.
myopathy
(my-OPP-ah-thee)
my/o=muscle
-pathy=disease
Ageneraltermformuscledisease.
Pathology (continued)
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MusculoskeletalSystem 125
Term Word Parts Definition
Clinical Laboratory Test
creatine phosphokinase(CPK)
(KREE-ah-teen/foss-foe-KYE-nase)
Muscleenzymefoundinskeletalmuscle
andcardiacmuscle.Bloodlevelsbecome
elevatedindisorderssuchasheartattack,
musculardystrophy,andotherskeletal
musclepathologies.
Term Word Parts Definition
myorrhexis
(my-oh-REK-sis)
my/o=muscle
-rrhexis=rupture
Tearingamuscle.
polymyositis
(pol-ee-my-oh-SIGH-tis)
poly-=many
myos/o=muscle
-itis=inflammation
Thesimultaneousinflammationoftwoor
moremuscles.
pseudohypertrophic muscular
dystrophy
(soo-doh-HIGH-per-troh-fic)
pseudo-=false
hyper-=excessive
-trophic=pertainingto
development
muscul/o=muscle
-ar=pertainingto
dys-=abnormal
-trophy=development
Atypeofinheritedmusculardystrophy
inwhichthemuscletissueisgradually
replacedbyfattytissue,making
themusclelookstrong.Alsocalled
Duchenne’s muscular dystrophy.
torticollis
(tore-tih-KOLL-iss)
Severeneckspasmspullingtheheadto
oneside.Commonlycalledwryneckora
crick in the neck.
Tendons, Muscles, and/or Ligaments
carpal tunnel syndrome(CTS) carp/o=wrist
-al=pertainingto
Repetitivemotiondisorderwithpain
causedbycompressionofthefingerflexor
tendonsandmediannerveastheypass
throughthecarpaltunnelofthewrist.
ganglion cyst
(GANG-lee-on)
Cystthatformsontendonsheath,usually
onhand,wrist,orankle.
repetitive motion disorder Groupofchronicdisordersinvolvingthe
tendon,muscle,joint,andnervedamage,
resultingfromthetissuebeingsubjected
topressure,vibration,orrepetitive
movementsforprolongedperiods.
rotator cuff injury Therotatorcuffconsistsofthejoint
capsuleoftheshoulderjointreinforced
bythetendonsfromseveralshoulder
muscles.Thehighdegreeofflexibilityat
theshoulderjointputstherotatorcuffat
riskforstrainandtearing.
strain Damagetothemuscle,tendons,
orligamentsduetooveruseor
overstretching.
tendinitis
(ten-dih-NIGH-tis)
tendin/o=tendon
-itis=inflammation
Inflammationofatendon.
Diagnostic Procedures
Pathology (continued)
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126Chapter 4
Term Word Parts Definition
Surgical Procedures
carpal tunnel release carp/o=wrist
-al=pertainingto
Surgicalcuttingoftheligamentinthewrist
torelievenervepressurecausedbycarpal
tunnelsyndrome,whichcanresultfrom
repetitivemotionsuchastyping.
fasciotomy
(fas-ee-OT-oh-mee)
fasci/o=fibrousband
-otomy=cuttinginto
Asurgicalprocedurethatcutsintofascia.
myoplasty
(MY-oh-plas-tee)
my/o=muscle
-plasty=surgicalrepair
Asurgicalproceduretorepairamuscle.
myorrhaphy
(MY-or-ah-fee)
my/o=muscle
-rrhaphy=suture
Tosutureamuscle.
tendoplasty
(TEN-doh-plas-tee)
tend/o=tendon
-plasty=surgicalrepair
Asurgicalproceduretorepairatendon.
tendotomy
(tend-OT-oh-mee)
tend/o=tendon
-otomy=cuttinginto
Asurgicalprocedurethatcutsintoa
tendon.
tenodesis
(ten-oh-DEE-sis)
ten/o=tendon
-desis=fuse
Surgicalproceduretostabilizeajoint
byanchoringdownthetendonsofthe
musclesthatmovethejoint.
tenoplasty
(TEN-oh-plas-tee)
ten/o=tendon
-plasty=surgicalrepair
Asurgicalproceduretorepairatendon.
tenorrhaphy
(tah-NOR-ah-fee)
ten/o=tendon
-rrhaphy=suture
Tosutureatendon.
Term Word Parts Definition
Additional Diagnostic Procedures
deep tendon reflexes(DTR) Musclecontractioninresponsetoastretch
causedbystrikingthemuscletendonwith
areflexhammer.Testusedtodetermineif
musclesarerespondingproperly.
electromyogram(EMG)
(ee-lek-troh-MY-oh-gram)
electr/o=electricity
my/o=muscle
-gram=record
Thehardcopyrecordproducedby
electromyography.
electromyography(EMG)
(ee-lek-troh-my-OG-rah-fee)
electr/o=electricity
my/o=muscle
-graphy=processof
recording
Studyandrecordofthestrengthand
qualityofmusclecontractionsasaresultof
electricalstimulation.
muscle biopsy
(BYE-op-see)
bi/o=life
-opsy=viewof
Removalofmuscletissueforpathological
examination.
Diagnostic Procedures (continued)
Therapeutic Procedures
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MusculoskeletalSystem 127
Pharmacology
Classification Word Parts Action Examples
skeletal muscle
relaxants
-al=pertainingto Medicationtorelaxskeletal
musclesinordertoreduce
musclespasms.Alsocalled
antispasmodics.
cyclobenzaprine,Flexeril;
carisoprodol,Soma
Abbreviations
CTS carpaltunnelsyndrome EMG electromyogram
CPK creatinephosphokinase IM intramuscular
DTR deeptendonreflex MD musculardystrophy
Practice As You Go
G. What’s the Abbreviation?
1. intramuscular _________________________________
2. deep tendon reflex _________________________________
3. muscular dystrophy _________________________________
4. electromyogram _________________________________
5. carpal tunnel syndrome _________________________________
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128
Real-World Applications
Medical Record Analysis
This Discharge Summary contains 10 medical terms. Underline each term and write it in the list below the
report. Then define each term. You will find Chapter 14 of your textbook helpful with the rehabilitation
terms.
Chapter Review
DischargeSummary
Admitting Diagnosis: Osteoarthritis bilateral knees.
Final Diagnosis: Osteoarthritis bilateral knees with right TKA
History of Present
Illness:
Patient is a 68-year-old male. He reports he has experienced occasional knee pain and swelling
since he injured his knees playing football in high school. These symptoms became worse while
he was in his 50s and working on a concrete surface. The right knee has always been more
painful than the left. He saw his orthopedic surgeon six months ago because of constant knee
pain and swelling severe enough to interfere with sleep and all activities. He required a cane to
walk. CT scan indicated severe bilateral osteoarthritis. He is admitted to the hospital at this time
for TKR right knee.
Summary of Hospital
Course:
Patient tolerated the surgical procedure well. He began intensive physical therapy for lower
extremity ROM and strengthening exercises and gait training with a walker. He received occu-
pational therapy instruction in ADLs, especially dressing and personal care. He was able to
transfer himself out of bed by the third post-op day and was able to ambulate 150 ft with a
walker and dress himself on the fifth post-op day.
Discharge Plans: Patient was discharged home with his wife one week post-op. He will continue rehabilitation as
an outpatient. Return to office for post-op checkup in one week.
Term Definition
1. __________________________ _________________________________________________________
2. __________________________ _________________________________________________________
3. __________________________ _________________________________________________________
4. __________________________ _________________________________________________________
5. __________________________ _________________________________________________________
6. __________________________ _________________________________________________________
7. __________________________ _________________________________________________________
8. __________________________ _________________________________________________________
9. __________________________ _________________________________________________________
10. __________________________ _________________________________________________________
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MusculoskeletalSystem 129
Chart Note Transcription
The chart note below contains 11 phrases that can be reworded with a medical term that you learned in this
chapter. Each phrase is identified with an underline. Determine the medical term and write your answers in the
space provided.
Pearson General Hospital Emergency Room Record
Task Edit View Time Scale Options Help Download Archive Date: 17 May 2015
Current Complaint: An 82-year-old female was transported to the Emergency Room via ambulance with severe
left hip pain following a fall on the ice.
Past History:
Patient suffered a broken wrist bone 1 2 years earlier that required immobilization by
solid material. 2 Following this broken bone, 3 her physician who specializes in treat-
ment of bone conditions 4 diagnosed her with moderate porous bones 5 on the basis of a
computer-assisted X-ray. 6
Signs and Symptoms:
Patient reported severe left hip pain, rating it as 8 on a scale of 1 to 10. She held her hip in
a bent position 7 and could not tolerate movement toward a straight position. 8 X-rays of
the left hip and leg were taken.
Diagnosis:
Shattered broken bone 9 in the neck of the left thigh bone. 10
Treatment:
Implantation of an artificial hip joint 11 on the left.
1.
_________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
4. _________________________________________________________________________________
5. _________________________________________________________________________________
6. _________________________________________________________________________________
7. _________________________________________________________________________________
8. _________________________________________________________________________________
9. _________________________________________________________________________________
10. _________________________________________________________________________________
11. _________________________________________________________________________________
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130Chapter 4
Questions
1. What pathological condition does this patient have? Look this condition up in a reference source and
include a short description of it.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
2. What type of long-term damage may occur in a patient with rheumatoid arthritis?
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
3. Describe the other major type of arthritis mentioned in your textbook.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
4. What two diagnostic procedures did the physician order? Describe them in your own words. What were
the results? (One of these procedures is described in Chapter 6 of your text.)
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
5. What treatments were ordered? Explain what the physical therapy procedures involve (refer to Chapter 14).
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
6. This patient is experiencing an acute episode. Explain what this phrase means and contrast it with chronic.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Case Study
Below is a case study presentation of a patient with a condition covered by this chapter. Read the case study
and answer the questions below. Some questions will ask for information not included within this chapter. Use
your text, a medical dictionary, or any other reference material you choose to answer these questions.
Mary Pearl, age 60, has come into the physician’s office complaining of swelling,
stiffness, and arthralgia, especially in her elbows, wrists, and hands. A bone scan
revealed acute inflammation in multiple joints with damaged articular cartilage and
an erythrocyte sedimentation rate blood test indicated a significant level of acute
inflammation in the body. A diagnosis of acute episode of rheumatoid arthritis was
made. The physician ordered nonsteroidal anti-inflammatory medication and physi-
cal therapy. The therapist initiated a treatment program of hydrotherapy and AROM
exercises.
(Monkey Business Images/Shutterstock)
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MusculoskeletalSystem 131
Practice Exercises
A. Word Building Practice
The combining form oste/o refers to bone. Use it to write a term that means:
1. bone cell __________________________________________________________________________________________________
2. immature bone cell _________________________________________________________________________________________
3. porous bone _______________________________________________________________________________________________
4. disease of the bone __________________________________________________________________________________________
5. cutting into a bone __________________________________________________________________________________________
6. instrument to cut bone _______________________________________________________________________________________
7. inflammation of the bone and bone marrow ___________________________________________________________________
8. abnormal softening of bone __________________________________________________________________________________
9. bone and cartilage tumor ____________________________________________________________________________________
The combining form my/o refers to muscle. Use it to write a term that means:
10. muscle disease ______________________________________________________________________________________________
11. surgical repair of muscle _____________________________________________________________________________________
12. suture of muscle ____________________________________________________________________________________________
13. record of muscle electricity ___________________________________________________________________________________
14. muscle weakness ____________________________________________________________________________________________
The combining form ten/o refers to tendons. Use it to write a term that means:
15. tendon pain _________________________________________________________________________________________________
16. tendon suture _______________________________________________________________________________________________
The combining form arthr/o refers to the joints. Use it to write a term that means:
17. to fuse a joint _______________________________________________________________________________________________
18. surgical repair of a joint __________________________________________________________________________________________
19. cutting into a joint ___________________________________________________________________________________________
20. inflammation of a joint __________________________________________________________________________________________
21. puncture to withdraw fluid from a joint _________________________________________________________________________
22. pain in the joints ____________________________________________________________________________________________
The combining form chondr/o refers to cartilage. Use it to write a term that means:
23. surgical removal of cartilage __________________________________________________________________________________
24. cartilage tumor ______________________________________________________________________________________________
25. abnormal softening of cartilage ______________________________________________________________________________________
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132Chapter 4
B. Name That Suffix
Suffix Example from Chapter
1. to fuse ____________________________________________________ __________________________________
2. weakness ____________________________________________________ __________________________________
3. slipping ____________________________________________________ __________________________________
4. to surgically break ____________________________________________________ __________________________________
5. movement ____________________________________________________ __________________________________
6. porous ____________________________________________________ __________________________________
C. Spinal Column Practice
Name the five regions of the spinal column and indicate the number of bones in each area.
Name Number of Bones
1. ______________________________________________________ ________________________________________________
2. ______________________________________________________ ________________________________________________
3. ______________________________________________________ ________________________________________________
4. ______________________________________________________ ________________________________________________
5. ______________________________________________________ ________________________________________________
D. Prefix and Suffix Practice
Circle the prefix and/or suffix. Place a P for prefix or an S for suffix over these word parts, then define the term.
1. arthroscopy________________________________________________________________________________________________
2. intervertebral________________________________________________________________________________________________
3. chondromalacia____________________________________________________________________________________________
4. diskectomy________________________________________________________________________________________________
5. intracranial________________________________________________________________________________________________
6. spondylosis________________________________________________________________________________________________
E. Define the Combining Form
Definition Example from Chapter
1.lamin/o
______________________________________________________ ____________________________________
2.ankyl/o
______________________________________________________ ____________________________________
3.chondr/o
______________________________________________________ ____________________________________
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MusculoskeletalSystem 133
Definition Example from Chapter
4.spondyl/o
______________________________________________________ ____________________________________
5.my/o
______________________________________________________ ____________________________________
6.orth/o
______________________________________________________ ____________________________________
7.kyph/o
______________________________________________________ ____________________________________
8.tend/o
______________________________________________________ ____________________________________
9.myel/o
______________________________________________________ ____________________________________
10.articul/o
______________________________________________________ ____________________________________
F. Fill in the Blank
1. Mrs. Lewis, age 84, broke her hip. Her physician will be running tests for what potential ailment? ___________________
2. Jamie, age six months, is being given orange juice and vitamin supplements to avoid what condition? ________________
3. George has severe elbow pain after playing tennis four days in a row. He may have _______________________________.
4. Marshall’s doctor told him that he had a ruptured disk. The medical term for this is _______________________________.
5. Mr. Jefferson’s physician has discovered a tumor at the end of his femur. He has been admitted to the hospital for a
biopsy to rule out what type of bone cancer? __________________________________________________________________
6. The school nurse has asked Janelle to bend over so that she may examine her back to see if she is developing a lateral
curve. What is the nurse looking for? _________________________________________________________________________
7. Gerald has experienced a gradual loss of muscle strength over the past five years even though his muscles look large
and healthy. The doctors believe he has an inherited muscle disease. What is that disease? __________________________
8. Roberta has suddenly developed arthritis in her hands and knees. Rheumatoid arthritis had been ruled out, but what
other autoimmune disease might Roberta have? _______________________________________________________________
9. Mark’s X-ray demonstrated forward sliding of a lumbar vertebra; the radiologist diagnosed _________________________.
10. The orthopedist determined that Marcia’s repetitive wrist movements at work caused her to develop _________________
G. Name That Anatomical Name
1. knee cap __________________________________________________________________________________________________
2. ankle bones _______________________________________________________________________________________________
3. collar bone ________________________________________________________________________________________________
4. thigh bone ________________________________________________________________________________________________
carpal tunnel syndrome rickets lateral epicondylitis systemic lupus
scoliosis osteogenic sarcoma pseudohypertrophic erythematosus
herniated nucleus osteoporosis muscular dystrophy
pulposus spondylolisthesis
M04_FREM0254_06_SE_C04.indd 133 18/12/14 10:13 pm
134Chapter 4
5. toe bones _________________________________________________________________________________________________
6. wrist bones _______________________________________________________________________________________________
7. shin bone _________________________________________________________________________________________________
8. shoulder blade _____________________________________________________________________________________________
9. finger bones _______________________________________________________________________________________________
H. What Does it Stand For?
1. DJD______________________________________________________________________________________________________
2. EMG______________________________________________________________________________________________________
3. C1_______________________________________________________________________________________________________
4. T6_______________________________________________________________________________________________________
5. IM_______________________________________________________________________________________________________
6. DTR______________________________________________________________________________________________________
7. JRA_______________________________________________________________________________________________________
8. LLE_______________________________________________________________________________________________________
9. ortho_____________________________________________________________________________________________________
10. CTS_______________________________________________________________________________________________________
I. Define the Term
1. chondroplasty_______________________________________________________________________________________________
2. bradykinesia_______________________________________________________________________________________________
3. osteoporosis_______________________________________________________________________________________________
4. lordosis____________________________________________________________________________________________________
5. atrophy____________________________________________________________________________________________________
6. myeloma__________________________________________________________________________________________________
7. prosthesis__________________________________________________________________________________________________
8. craniotomy_______________________________________________________________________________________________
9. arthrocentesis_______________________________________________________________________________________________
10. bursitis____________________________________________________________________________________________________
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MusculoskeletalSystem 135
J. Pharmacology Challenge
Fill in the classification for each drug description, then match the brand name.
Drug Description Classification Brand Name
1. ________ Treats mild pain and is an anti-inflammatory ________________________ a. Flexeril
2. ________ Hormone with anti-inflammatory properties ________________________ b. Aleve
3. ________ Reduces muscle spasms ________________________ c. Fosamax
4. ________ Treats conditions of weakened bones ________________________ d. Oystercal
5. ________ Maintains blood calcium levels ________________________ e. Medrol
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M04_FREM0254_06_SE_C04.indd 135 18/12/14 10:13 pm
136Chapter 4
Labeling Exercise
Image A
Write the labels for this figure on the numbered lines provided.
1. ________________
17. _______________
18. _______________
19. ______________
_
20. ______________
_
21. ______________
_
22. _______________
23. ______________
_
24. ______________
_
25. ______________
_
26. _______________
27. _______________
9. ________________
10. _______________
1
1. _______________
2. ________________
3. ________________
4. ________________
5. ________________
6. ________________
7. ________________
8. ________________
12. _______________
13. _______________
16. _______________
15. _______________
14. _______________
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MusculoskeletalSystem 137
Image B
Write the labels for this figure on the numbered lines provided.
5. __________________
6. __________________
7. _________________
_
8. __________________
4. __________________
3. __________________
2. __________________
1. __________________
Image C
Write the labels for this figure on the numbered lines provided.
5. _________________
_
4. _________________
_
3. _________________
_
2. _________________
_
1. __________________
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