The Language Of
Medicine
th
8
edition
Davi-Ellen Chabner
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Chapter 15
The Musculoskeletal System
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Learning Objectives



Define terms relating to the structure and
function of bones, joints, and muscles.
Describe the process of bone formation and
growth.
Locate and name the major bones of the
body.
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Learning Objectives (cont’d.)


Analyze the combining forms, prefixes, and
suffixes used to describe bones, joints, and
muscles.
Explain various musculoskeletal disease
conditions and terms related to bone
fractures.
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Learning Objectives (cont’d.)


Describe important laboratory tests and
clinical procedures related to the
musculoskeletal system, and recognize
relevant abbreviations.
Apply your new knowledge to understanding
medical terms in their proper contexts, such
as medical reports and records.
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Chapter 15
Lesson 15.1
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Introduction
Musculoskeletal System: bones, muscles,
and joints of the body
Bones: structural support and protection of
internal organs
Muscles: internal and external movement
Joints: where bones come together/type
determined by need for flexibility
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Physicians Associated with
Musculoskeletal System




Orthopedist: MD, bones, bone disease
Rheumatologist: MD, joints
Osteopathic physician: DO, body able to
heal itself with proper nutrition and bone
alignment
Chiropractor: physical manipulation of the
spinal column to relieve pressures on nerves
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BONE FORMATION
Ossification: replacement of cartilage with
bone
 Cells:

osteoblast: produce immature bony tissue that
replaces cartilage
 osteocyte: nourishes and maintains bone
 osteoclast: reabsorb or digest bone (remodels
bone)
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BONE FORMATION




Osteoblasts and osteoclasts work to deposit
and tear down bone throughout life.
The skeleton is a source of calcium.
Proper formation of bone depends on
sources of calcium, phosphorous, and vitamin
D.
Calcium phosphate enzyme helps create
hard bone from these sources.
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BONE FORMATION



Reservoir for calcium storage
Calcium necessary for nerve transmittal to
muscle, including heart muscle and muscles
attached to bones
Calcium level maintained in blood by
parathyroid gland, which secretes a hormone
to release calcium from bone
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BONE STRUCTURE





Long, short, flat, sesamoid (in shape)
Diaphysis: shaft
Epiphysis: end
Metaphysis: cone-like flared portion between
end and shaft
Epiphyseal line or plate: growth plate where
cartilage replaced by bone for bone growth
(in length)
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Bone Structure (cont’d.)
(A) Divisions of a
long bone and
interior
structure
(B) composition
of compact
(cortical) bone
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Bone Structure (cont’d.)
(A) Divisions of a
long bone and
interior
structure
(B) composition
of compact
(cortical) bone
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Bone Structure (cont’d.)



Ends of bones covered by articular cartilage
in the joint: cushions joint and allows it to
move smoothly
Compact bone: contains haversian systems
for blood vessels, nerves, and yellow bone
marrow (mostly fat)
Cancellous (spongy/trabecular bone):
spaces contain red bone marrow with
elements for blood formation
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Bone Marrow



Yellow marrow: chiefly fat
Red marrow: rich with blood vessels and
immature and mature blood cells in various
stages of development; in later life replaced
with yellow marrow
Ribs, pelvic bone, sternum, vertebrae,
epiphyses of long bones
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Bone Processes and
Depressions

Processes: serve as attachments for
muscles and tendons

Depressions: openings or hollow regions
help join bones or serve as passageways for
nerves and/or vessels
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Bone Processes and
Depressions
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Bone Processes and
Depressions
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Cranial Bones
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Cranial Bones
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Cranial Bones and
Associated Structures



Frontal bone
Parietal bone
Temporal bone




Occipital bone


foramen magnum
Sphenoid bone


temporomandibular (TMJ) joint
mastoid process
styloid process
sella turcica
Ethmoid bone
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Facial Bones
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Facial Bones
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Facial Bones (cont’d.)



Nasal bones
Lacrimal bones
Maxillary bones



Mandibular bones
Zygomatic bones
Vomer
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SINUSES
Air cavities located
in facial and cranial
bones. They
lighten the skull
and warm and
moisten the air as
it passes into the
respiratory system.
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Vertebral Column and Vertebrae
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Vertebral Column and
Vertebrae (cont’d.)



Vertebrae: 26 bone segments from base of
skull to tailbone in five divisions and
separated by pads of cartilage called
intervertebral disks.
Cervical, thoracic, lumbar, sacral
Coccyx: tailbone
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BONES
Thorax, Pelvis and Extremities
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BONES
Thorax, Pelvis and Extremities
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Thorax, Pelvis and Extremities
(cont’d.)
Thorax
Arm and Hand
 clavicle
 humerus
Pelvis
 pelvic girdle
 scapula
 ulna
 ilium
 sternum
 radius
 ischium
 ribs
 carpals
 pubis
 metacarpals
 phalanges
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Bones of Leg and Foot
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Bones of Leg and Foot and
Associated Structures

Femur



acetabulum
Tarsals


Patella
Tibia




medial malleolus

calcaneus
talus
Metatarsals
Phalanges
Fibula


lateral malleolus
talus
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QUICK QUIZ:
1. The knuckle-like process at the
end of a bone near the joint…
A. fossa
B. condyle
C. tubercle
D. diaphysis
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QUICK QUIZ:
2. Process of bone
formation____________
A. olecranon
B. ossification
C. osteoblast
D. xiphoid process
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
COMBINING FORMS
Combining Form






Meaning
calc/o
calci/o
kyph/o
lamin/o
lord/o
lumb/o
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
COMBINING FORMS
Combining Form






calc/o
calci/o
kyph/o
lamin/o
lord/o
lumb/o
Meaning
calcium
calcium
posterior curvature in
thoracic region
lamina
curve
loins, lower back
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
COMBINING FORMS
Combining Form






Meaning
myel/o
orth/o
oste/o
scoli/o
spondyl/o
vertebr/o
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
COMBINING FORMS
Combining Form






myel/o
orth/o
oste/o
scoli/o
spondyl/o
vertebr/o
Meaning
bone marrow
straight
bone
crooked
vertebra
vertebra
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
SUFFIXES
Suffix







Meaning
-blast
-clast
-listhesis
-malacia
-physis
-porosis
-tome
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COMBINING FORMS
AND SUFFIXES
GENERAL TERMS
SUFFIXES
Suffix







Meaning
-blast
-clast
-listhesis
-malacia
-physis
-porosis
-tome
embryonic cell
to break
slipping
softening
to grow
pore, passage
instrument to cut
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form






Meaning
acetabul/o
calcane/o
carp/o
clavicul/o
cost/o
crani/o
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form






acetabul/o
calcane/o
carp/o
clavicul/o
cost/o
crani/o
Meaning
acetabulum (hip socket)
calcaneus (heal)
carpals (wrist bones)
clavicle (collar bone)
ribs
cranium (skull)
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form






Meaning
femor/o
fibul/o
humer/o
ili/o
ischi/o
malleol/o
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form






femor/o
fibul/o
humer/o
ili/o
ischi/o
malleol/o
Meaning
femur (thigh bones)
fibula (smaller lower leg bone)
humerus (upper arm bone)
ilium (upper part of pelvic bone)
ischium (part of pelvic bone)
malleolus
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form







Meaning
mandibul/o
maxill/o
metacarp/o
metatars/o
olecran/o
patell/o
pelv/i
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form







mandibul/o
maxill/o
metacarp/o
metatars/o
olecran/o
patell/o
pelv/i
Meaning
mandible (lower jaw bone)
maxilla (upper jaw bone)
metacarpals (hand bones)
metatarsals (foot bones)
olecranon (elbow)
patella (kneecap)
pelvis
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form





Meaning
perone/o
phalang/o
pub/o
radi/o
scapul/o
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form





perone/o
phalang/o
pub/o
radi/o
scapul/o
Meaning
fibula
phalanges (finger, toe bones)
pubis
radius
scapula (shoulder blade)
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form




Meaning
stern/o
tars/o
tibi/o
uln/o
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COMBINING FORMS
AND SUFFIXES
TERMS RELATED TO SPECIFIC BONES
COMBINING FORMS
Combining Form




stern/o
tars/o
tibi/o
uln/o
Meaning
sternum (breastbone)
tarsals
tibia (shin bone)
ulna (lower arm bone)
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PATHOLOGIC CONDITIONS

Ewing sarcoma: malignant bone tumor
This x-ray shows a malignant bone tumor
(Ewing's sarcoma) of the upper arm bone
(humerus). This type of tumor usually occurs
during childhood and adolescence.
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Osteogenic Sarcoma:
malignant tumor arising from
bone
This x-ray shows a malignant bone tumor (osteogenic
sarcoma) of the knee. This type of tumor is usually
seen in adolescents (around 15 years old). This tumor
extends from the bone into the surrounding tissue
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osteomyelitis: inflammation
secondary to infection
osteomalacia: softening of bone
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Exostosis: bony growth on
surface of bone
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Talipes: congenital abnormality of hind foot
involving the talus (clubfoot)
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Pathologic Conditions
Fractures of Bones
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Pathologic Conditions
Normal Bone
Bone with osteoporosis
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
Intraosseous Infusion – insertion of a
needle into the bone marrow to gain
intravenous access
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Chapter 15
Lesson 15.2
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Joints

Joint (articulation): coming together of two
or more bones


Suture joints: immovable (skull)
Synovial joints: freely movable (ball and socket
types, e.g. hip or shoulder), (hinge type, e.g.,
elbow, knee, ankle)
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Synovial Joints




Joint capsule surrounds bone
Ligaments band bones together
Bones covered by articular cartilage
Synovial membrane lies under capsule and
lines synovial cavity; filled with synovial fluid
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Bursae


Closed sacks of synovial fluid with a synovial
membrane located near, but not within a joint.
Needed where sliding must take place
Common sites:



between tendons (connective tissue connecting muscle to
bone) and bones
between ligaments (binding bone to bone) and bone
between skin and bones (with prominent bony anatomy)
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Joints
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QUICK QUIZ:
3. Connective tissue that binds
muscles to bones____________
A. ligament
B. articulation
C. synovial membrane
D. tendon
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COMBINING FORMS
AND SUFFIXES
COMBINING FORMS
Combining Form

ankyl/o

arthr/o

articul/o

burs/o

chondr/o
Meaning
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COMBINING FORMS
AND SUFFIXES
COMBINING FORMS
Combining Form
Meaning

ankyl/o
stiff

arthr/o
joint

articul/o
joint

burs/o
bursa

chondr/o
cartilage
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COMBINING FORMS
AND SUFFIXES
COMBINING FORMS
Combining Form

ligament/o

rheumat/o

synov/o

ten/o

tendin/o
Meaning
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COMBINING FORMS
AND SUFFIXES
COMBINING FORMS
Combining Form
Meaning

ligament/o
ligament

rheumat/o
watery flow

synov/o
synovial membrane

ten/o
tendon

tendin/o
tendon
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COMBINING FORMS
AND SUFFIXES
SUFFIXES
Suffix


Meaning
-desis
-stenosis
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COMBINING FORMS
AND SUFFIXES
SUFFIXES
Suffix


Meaning
-desis
-stenosis
to bind, tie together
narrowing
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Pathologic Conditions

Arthritis: inflammation of joints

Ankylosing spondylitis: chronic progressive
stiffening of joints, mostly spine
 Gouty arthritis: inflammation due to excessive
uric acid in body
 Osteoarthritis (OA): loss of articular cartilage and
formation of bone spurs at articular surfaces
 Rheumatoid arthritis (RA): autoimmune reaction
against joint tissues (synovial membrane)
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Osteoarthritis and
Rheumatoid Arthritis
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Osteoarthritis is a chronic disease of the joint cartilage and bone, often
thought to result from "wear and tear" on a joint, although there are other
causes such as congenital defects, trauma and metabolic disorders. Joints
appear larger, are stiff and painful and usually feel worse the more they are
used throughout the day.
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Pathologic Conditions


Bunion: swelling of medial aspect of joint
between big toe and first metatarsal bone
Dislocation: displacement of bone from a
joint
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Carpal tunnel syndrome:
compression of median nerve as it
passes between ligament and bones
and tendons of the wrist.
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Pathological Joint Conditions
(cont’d.)
Carpal tunnel syndrome
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Pathologic Conditions

Ganglion: a fluid-filled cyst arising from the
joint capsule or a tendon in the wrist.

Herniation of an intervertebral disk:
abnormal protrusion of the disk into the neural
canal or against spinal nerves.

Lyme disease: recurrent arthritis, myalgia,
malaise and neurologic and cardiac symptoms.
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Pathologic Conditions (cont’d.)

Sprain: trauma to joint with pain, swelling and
injury to ligaments
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Muscle strain – overstretching of a muscle
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Systemic lupus
erythematosus (SLE): chronic
inflammatory disease involving
joints, skin, kidneys, nervous
system, heart and lungs affecting
collagen in tendons, ligaments,
bones, and cartilage all over the
body
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Chapter 15
Lesson 15.3
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Muscles




Three types of muscles: striated, smooth, cardiac
Striated: under voluntary control—they move all the
bones as well as face and eyes
Smooth: control is involuntary—they move internal
organs (digestive tract, blood vessels, ducts of
glands)
Cardiac: not consciously controlled and found
exclusively in the heart
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Types of Muscle
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Types of Muscle
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Named Skeletal Muscles
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Named Skeletal Muscles
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Actions of Muscles




flexion
extension
abduction
adduction





rotation
dorsiflexion
plantar flexion
supination
pronation
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Actions of Muscles (cont’d.)
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QUICK QUIZ:
4. Movement AWAY from the midline
of the body____________
A. adduction
B. abduction
C. flexion
D. dorsiflexion
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COMBINING FORMS, SUFFIXES,
AND PREFIXES
COMBINING FORMS
Combining Form




Meaning
fasci/o
fibr/o
leiomy/o
my/o
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COMBINING FORMS, SUFFIXES,
AND PREFIXES
COMBINING FORMS
Combining Form




fasci/o
fibr/o
leiomy/o
my/o
Meaning
facia
fibrous
smooth muscle
muscle
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
COMBINING FORMS
Combining Form




Meaning
myocardi/o
myos/o
plant/o
rhabdomy/o
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
COMBINING FORMS
Combining Form




myocardi/o
myos/o
plant/o
rhabdomy/o
Meaning
heart muscle
muscle
sole of the foot
skeletal muscle
connected to bones
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
SUFFIXES
Suffix


Meaning
-asthenia
-trophy
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
SUFFIXES
Suffix


Meaning
-asthenia
-trophy
lack of strength
development,
nourishment
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
PREFIXES
Prefixe




Meaning
abaddorsipoly-
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS, SUFFIXES,
AND PREFIXES
PREFIXES
Prefixe




abaddorsipoly-
Meaning
away from
toward
back
many, much
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Pathologic Conditions

Muscular dystrophy: group of inherited
diseases with progressive muscle weakness
and degeneration without nervous system
involvement

Polymyositis: chronic inflammatory
myopathy; may be an autoimmune disorder
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Laboratory Tests Related to
Muscle






Antinuclear antibody test (ANA)
Erythrocyte sedimentation rate (ESR)
Rheumatoid factor test (RF)
Serum calcium (Ca)
Serum creatine kinase (CK)
Uric acid test
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Clinical Procedures Related to
Bones, Joints, and Muscle







Arthrocentesis
Arthrography
Arthroplasty
Arthroscopy
Bone density test
Bone scan
Computed tomography
(CT)




Diskography
Electromyography
(EMG)
Magnetic resonance
imaging (MRI)
Muscle biopsy
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.