Chapter 6: Musculoskeletal System Chapter Objectives

advertisement
Chapter 6: Musculoskeletal System
Chapter Objectives
Upon completion of this chapter the participant will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
List the functions of bones.
Define terms related to bone structure.
Distinguish between the axial and appendicular skeleton.
Describe the three types of joints.
List the 4 types of muscle found in the human body.
Differentiate between the types of muscles.
Describe the functions of muscles.
Analyze, define, spell and pronounce the common terms of the skeletal system.
Analyze, define, spell and pronounce terms related to the body’s muscular
system.
Successfully complete the review exercises at the end of the chapter.
Anatomy and Physiology of Bone & Muscles of the Musculoskeletal System
Bone
Many people think that bones are simply solid masses of non-living tissue. In reality
each of the 206 bones of the body is a complex, living organ. The shape, height and
weight of our body is determined by the length and thickness of our bones. Besides
giving us structure the bone has a number of other functions:
”
”
”
”
As a lever. The bones of the upper and lower limbs pull and push, with the
help of muscles.
Provide protection and support for inner organs (e.g. skull protects the
brain).
Blood cells essential for life are produced in the bone marrow
Play an important role in regulating the amount of essential nutrients. As
a calcium store. 97% of the body's calcium is stored in bone.
Bone Structure
Bone, a form of connective tissue, is one of the hardest tissues in the human body. The
only part of the body that is harder is the enamel of the teeth. Throughout our life bone
goes through a process of building up and tearing down. Bone is also capable of
healing and repairing itself. Oste/o, oss/e, osse/o and oss/i are the roots for bone.
When bone cells are mature they are referred to as osteocytes. Because of
osteoclasts (cells that break down and reabsorb bone) the life span of an osteocyte is
limited. The cells that create the new bone cells to replace those that are destroyed are
referred to as osteoblasts (immature bone). This process of making new bone is
referred to as ossification or osteogenesis. This continuous turnover of bone ensures
that the bones of the body remain strong.
Revised September 2001
-53-
Tissues of Bone
Bone is made up of four different tissues:
”
”
”
”
Periosteum:
Tough fibrous tissue that covers the outside of
the bone.
Compact Bone:
Hard dense strong bone that forms the outer most
layer of the bones
Spongy Bone:
Lighter, less dense tissue that is found in the inner
portion of the long bones. Red bone marrow is
located in the spongy layer.
Medullary Cavity: Located in the shaft of long bones and contains the
yellow bone marrow.
Internal and External Bone Parts
Red marrow
Proximal Epiphysis
Spongy Bone
Medullary cavity
Compact Bone
Diaphysis
Yellow marrow
Periosteum
Distal Epiphysis
Anatomic Landmarks of Bone
”
”
Epiphysis:
Diaphysis:
Revised September 2001
The end points of the bone
Shaft of the bone
-54-
Fractures
The most common problem that arises with bone is a break or fracture. There are a
number of different types of fractures the most common of which are simple (closed)
and compound (open). A simple fracture is one where the bone is broken but there is
not an open wound through the skin. The compound fracture is one in which the bone
is broken and there is an open wound through the skin.
Axial and Appendicular Skeleton
The skeleton is made up of 206 different bones. To make discussion of the skeleton
simpler it is divided into the axial and the appendicular skeletons. The axial skeleton
relates to the bones of the head and trunk (skull, spinal column, ribs and sternum). The
axial skeleton is made up of 80 bones. The appendicular skeleton consists of the
other 126 bones or those of the upper extremities and shoulder plus the lower
extremities and pelvis.
Joints
Joints are the connections that exist between bones. The root for joint is arthr/o,
articul/o.
”
”
”
Suture:
Jagged line where bones join and form a joint that does not
move. E.g. skull
Two bones are joined by cartilage and they function together as one bone.
This is called a cartilaginous joint.
Synovial:
Joints that are movable; e.g. knee, elbow, hips
Other structures which impact on the functioning of the skeletal system are:
”
Ligament:
”
Bursa:
Band of tissue that connects one bone to another.
(Ligament/o)
Fibrous sac that acts as a cushion for easy movement.
(Burs/o)
Muscles
You have more than 600 muscles in your body. If you were to grip your upper arm with
your left hand and move the right hand up and down and rotate it you will feel a series
of contractions in the tissue. This is the muscles’ of the arm responding to the
command you have given for it to move. While you did this you probably didn’t notice
that your heart continued to beat. This beating also involved a muscle contracting but
you didn’t have to tell it to beat as you did with your arm. This indicates that they are
different types of muscles. In fact you have three types of muscles in your body.
Revised September 2001
-55-
Types of Muscle Tissue
”
Smooth Muscle: Smooth muscle fibers move the internal organs, such
as the blood vessels, ducts from the glands. These muscles have a
relatively slow rate of contracting. They are also involuntary in that they
are under the control of your brain and you cannot control them.
”
Cardiac Muscle: Similar to smooth muscle and makes up the wall of
the heart. It is involuntary in function.
”
Skeletal Muscle: Muscles that attach to bones of the skeleton and
make movement possible. We can control the function of these so they
are voluntary.
Characteristics of Muscle
The study of the activity of muscle is referred to as kinesiology (kih-nee-see-ol-oh-jee).
The root for movement is kinesi/o and the suffix is -kinesis. The muscles of the body
are arranged in pairs and one muscle of the pair causes movement in one direction and
the other produces movement in the opposite direction. When one muscle contracts the
other relaxes. When a muscle contracts it tightens up and becomes shorter and thicker.
When the muscle relaxes it returns to its original form or shape. It is because of this
relaxing and contracting that we are able to move about.
The term range of motion refers to the movements that are possible by a muscle. One
aspect of diagnosing problems of the muscule is to test the range of motion of the
system. A variety of muscle movements can be assessed including:
”
”
”
”
”
”
”
Abduction: Movement away from the midline of the body (ab-).
Adduction: Movement toward the midline of the body (ad-).
Flexion:
Decreasing the angle between two bones, or bending a joint
flex-). Eg. bending the arm at the elbow
Extension: Increasing the angle between two bones, or to straighten out
a limb (ex-). Eg. straightening the arm out at the elbow
Rotation:
To move in a circular motion.
Pronation: Rotating a body part so it is facing down.
Supination: Rotating a body part so it is facing up.
Many muscles have what seem to be very complex names. The naming of a muscle is
generally based on one of the following:
”
”
”
”
”
”
how they act (flexor carpi radialis muscle)
where they are located (rectus abdominus)
the direction their fibers run (external abdominal oblique)
the number of times they divide (quadriceps femoris)
their size (gluteus maximus)
their shape (deltoid muscle)
Revised September 2001
-56-
Pathology of Muscular Diseases and Common Diagnostic Procedures
Health problems that affect the way muscles work in our body include:
”
”
”
”
Degeneration of the muscle e.g. Multiple Sclerosis, Parkinson’s Disease
Paralysis of muscle e.g. paraplegic
Problems with muscle tone, e.g. weakness, loss of tone, increased tone
Problems with muscle activity, e.g. impaired movements like tics, spasms;
slow movements, rapid movements.
The most common procedures done to diagnose problems with the muscles involve
graphic records of how a specific muscle is reacting to some form of stimulus.
Word Parts for the Musculoskeletal System
Roots
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
ankyl/o
articul/o; arthr/o
burs/o
carp/o
cervic/o
chondr/o
clavicul/o
coccyg/o
cost/o
crani/o
duct/o
electr/o
fasci/o
femor/o
fibr/o, fibros/o
fibul/o
flex/o
humer/o
ili/o
ischi/o
kinesi/o
lumb/o
mandibul/o
maxill/o
medull/o
metacarp/o
metatars/o
muscul/o, my/o, myos/o
myel/o
occipit/o
osse/o; oste/o; oss/e; oss/i
Revised September 2001
fusion of parts
joint
bursa
wrist bone
neck
cartilage
clavicle; collarbone
coccyx; tailbone
rib
skull
draw away
electric, electricity
fascia
femur, thigh bone
fibers
fibula
flexion, bend
humerus; upper arm
hip
ischium (posterior part of hip)
movement
lower back
mandible, lower jaw
maxilla, upper jaw
marrow, inner portion of an organ
metacarpals (bones of the hand)
metatarsals (bones of the foot)
muscle
bone marrow, spinal cord
occiput (back part of the head)
bone
-57-
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
pariet/o
patell/a; patell/o
pelv/i; pelv/o
phalang/o
radi/o
radicul/o
sacr/o
scapul/o
spondyl/o; vertebr/o
stern/o
synov/i/o
tempor/o
tendin/o, ten/o, tend/o
tens/o
thorac/o
tibi/o
ton/o
uln/o
parietal bone of the head
patella; kneecap
pelvis
phalanges; bone of the finger or toes
radius; bone of the lower arm
nerve root
sacrum
scapula
vertebra
sternum; breastbone
synovium; synovial fluid that lubricates
temporal bone of the head
tendon
stretch out
chest
tibia; bone of the lower leg
tone
ulnar; bone of the lower arm
Suffixes
”
”
”
”
”
”
”
”
”
”
”
”
”
”
”
-asthenia
-centesis
-clasis
-clast
-clonus
-desis
-kinesis
-lysis
-malacia
-osis
-paresis
-plegia
-porosis
-thermy
-trophy
no strength, weakness
surgical puncture to remove fluid
surgical fracture or refracture
breakdown
turmoil
surgical fusion or binding
movement
set free
softening
abnormal condition
partial paralysis
paralysis
porous open spaces
heat
nourishment
Prefixes
”
”
”
”
”
”
”
”
”
abadbibradyexhemiorthoquadrtri-
Revised September 2001
away from
toward
two
slow
extension, away from
half
straight
four
three
-58-
Term Analysis and Definition
Word Part
Term
articul/o
arthr/o
articular
articul = joint
-ar = pertaining to
Pertaining to a joint
arthralgia
arthr = joint
-algia = pain
Painful joint
arthritis
-itis = inflammation
Inflammation of a joint
arthropathy
- pathy = disease
Disease of a joint
arthroplasty
-plasty = surgical
repair
Surgical repair of a joint
arthroscopy
-scopy =
examination using a
scope
Examination of a joint using a
scope.
arthrotomy
-tomy = surgical
incision
Surgical incision into a joint.
periarthritis
peri = around
-itis =inflammation
Inflammation around a joint.
carpal
carp/o = wrist
-al = pertaining to
Pertaining to the wrist
carpectomy
-ectomy = surgical
removal
Surgical removal of a bone of
the wrist.
cervic/o
cervical
cervic = neck
-al = pertaining to
Pertaining to the neck
chondr/o
chondrocyte
chondr = cartilage
-cyte = cell
Cartilage cells
chondroma
-oma = tumor
Tumor of the cartilage
chondrosarcoma
-sarcoma =
malignant tumor
Malignant tumor of cartilage
clavicular
clavicul =
collarbone, clavicle
-ar = pertaining to
Pertaining to the collarbone
carp/o
clavicul/o
Revised September 2001
Term Analysis
-59-
Definition
Word Part
Term
Term Analysis
Definition
coccyg/o
coccygeal
coccyg = coccyx,
tail bone
-al = pertaining to
Pertaining to the tailbone
cost/o
costal
cost = rib
-al = pertaining to
Pertaining to the ribs
Pertaining to the ribs and
vertebrae
costovertebral
-vertebr = vertebrae
craniotomy
crani = skull
-tomy = surgical
incision
Surgical incision into the skull
cranioplasty
-plasty = surgical
repair
Surgical repair of the skull
craniofacial
-faci = face
-al = pertaining to
Pertaining to the skull and face
fascial
fasci = fascia (band
of tissue around
muscle)
-al = pertaining to
Pertaining to fascia
fasciectomy
-ectomy = surgical
excision
Excision of fascia
fascitis
-itis =inflammation
Inflammation of fascia
femor/o
femoral
femor = femur, thigh
bone
-al = pertaining to
Pertaining to the thigh bone
fibul/o
fibular
fibul = fibula
-ar = pertaining to
Pertaining to the fibula
fibr/o
fibros/o
fibrous
fibr/o = fiber
-ous = pertaining to
Pertaining to fibrous tissue.
humer/o
humeral
humer = humerous,
upper arm
-al = pertaining to
Pertaining to the upper arm
ili/o
iliac
ili = hip
-ac = pertaining to
Pertaining to the hip
iliosacral
sacr = sacrum
-al = pertaining to
Pertaining to the hip and
sacrum
crani/o
fasci/o
Revised September 2001
-60-
Word Part
Term
ischi/o
ischial
ischi = ischium
-al = pertaining to
Pertaining to the ischium
ischiorectal
rect = rectum
Pertaining to the ischium and
the rectum
kinesi/o
kinesiology
kinesi = movement
-logy = study of
Study of movment
lumb/o
lumbodynia
lumbo = lower back
-dynia = pain
Pain in the lower back
lumbosacral
-sacr = sacrum
-al = pertaining to
Pertaining to the lower back
and sacrum
mandibul/o
mandibular
mandibul =
mandible, lower jaw
-ar = pertaining to
Pertaining to the lower jaw
maxill/o
maxillary
maxill = maxilla,
upper jaw
-ary = pertaining to
Pertaining to the upper jaw
metacarp/o
metacarpal
metacarp = bones
of the hand
-al = pertaining to
Pertaining to the bones of the
hand
metatars/o
metatarsal
Pertaining to the bones of the
foot
my/o
muscul/o
myos/o
muscular
metatars = bones of
the foot
-al = pertaining to
muscul = muscle
-ar = pertaining to
myalgia
my = muscle
-algia = pain
Pain in a muscle
polymyositis
poly- = many
myos = muscle
-itis = imflammation
Inflammation of many muscles
myopathy
-pathy = disease
Muscle disease
myeloma
myel = bone
marrow, spinal cord
-oma = tumor
Tumor of the bone marrow or
spinal cord
osteomyelitis
oste/o = bone
-itis = inflammation
Inflammation of the bone and
bone marrow.
myel/o
Revised September 2001
Term Analysis
-61-
Definition
Pertaining to muscle
Word Part
Term
oste/o
oss/e
oss/i
osseous
osse = bone
-ous = pertaining to
Pertaining to bone.
osteoblast
-blast = immature
Immature bone cell
osteochondritis
-itis = inflammation
chondr/o = cartilage
Inflammation of bone &
cartilage
osteocyte
-cyte = cell
Mature bone cell
osteogenesis
-genesis = formation
Bone formation (ossification)
osteoma
-oma = tumor
Tumor of the bone
osteosarcoma
-sarcoma =
malignant tumor
Malignant tumor of bone
patellar
patell = kneecap
-ar = pertaining to
Pertaining to the kneecap
patellopexy
-pexy = surgical
fixation
Surgical fixation of the knee
infrapatellar
infra = below
Pertaining to below the
kneecap
suprapatellar
supra = above
Pertaining to above the
kneecap
pelvic
pelv = pelvis
-ic = pertaining to
Pertaining to the pelvis
pelvimeter
-meter = instrument
used to measure
Instrument used to measure
the size of the pelvis
phalang/o
interphalangeal
inter- = between
phalang = one of
the bones of the
fingers or toes
-eal = pertaining to
Pertaining to a bone of the
fingers or toes
radi/o
radiocarpal
joint
radi- = bones of the
lower arm
carp = wrist
-al = pertaining to
Pertaining to the joint between
the lower arm and wrist
sacr/o
sacral
sacr = sacrum
-al = pertaining to
Pertaining to the sacrum
patell/a,
patell/o
pelv/i,
pelv/o
Revised September 2001
Term Analysis
-62-
Definition
Word Part
Term
scapul/o
subscapular
sub- = below
scapul = scapula
-ar = pertaining to
Pertaining to below the scapula
spondyl/o
spondylitis
spondyl = vertebra
-itis = inflammation
Inflammation of the vertebra
spondylopathy
-pathy = disease
Disease of the vertebra
sternal
stern = breastbone,
stenum
-al = pertaining to
Pertaining to the breastbone
costosternal
cost = rib
Pertaining to ribs and
breastbone
synovial
synov = synovial
membrane/fluid
-al = pertaining to
Pertaining to the synovial
membrane or the fluid that
lubricates the joint
synovitis
-itis = inflammation
Inflammation of the synovial
membrane
tendinitis
tendin = tendon
-itis =inflammation
Inflammation of a tendon
tendinous
-ous = pertaining to
Pertaining to a tendon
tenodesis
-desis = surgical
fixation
Surgical fixation of a tendon
tenotomy
-tomy = surgical
incision
Surgical incision into a tendon
thorac/o
thoracic
thorac = chest
-ic = pertaining to
Pertaining to the chest
tibi/o
tibiofibular
Pertaining to the tibia and fibula
ton/o
atonic
tibi = tibia
fibul = fibula
ar = pertaining to
a = without, no
ton = tone
-ic = pertaining to
hyper = excessive
Pertaining to excessive tone
stern/o
synov/i
synov/o
tendin/o,
ten/o
tend/o
hypertonic
Term Analysis
uln = ulnar, bone of
Revised September 2001
-63-
Definition
Pertaining to no tone
Word Part
Term
Term Analysis
uln/o
ulnar
the lower arm
-ar = pertaining to
Pertaining to the bone of the
lower arm
vertebr/o
vertebrofemoral
vertebr = vertebra
femor = femur
-al = pertaining to
Pertaining to the vertebrae and
femur
-centesis
arthrocentesis
arthro = joint
-centesis = surgical
puncture
Surgical puncture into a joint to
remove fluid
-clasis
osteoclasis
oste = bone
-clasis = surgical
fracture
Surgical fracture of a bone
-clast
osteoclast
oste = bone
-clast = breakdown
Cell which breaks down bone
-desis
arthrodesis
arthr = joint
-desis = surgical
fusion
Surgical fusion of a joint
-malacia
osteomalacia
oste = bone
-malacia = softening
Softening of the bone
chondromalacia
chondr = cartilage
Softening of cartilage
kyphosis
kyph = humpback
-osis = abnormal
condition
Abnormal curvature of the
spine.
osteoporosis
oste = bone
-porosis = porous
-osis
ortho-
orthopedics
Revised September 2001
ortho = straight
ped = child
-ic = pertaining to
-64-
Definition
Abnormal condition where
bone becomes to porous
Surgical speciality dealing with
correction of deformities of the
skeletal system
Summary Exercises Chapter 6
Exercise 6.1
Select the option that best answers the question.
1.
Which term means inflammation of the tissue around bone?
1.
Periostitis
2.
Infraostitis
3.
Osteomyelitis
2.
Which term means disease of the cartilage?
1.
Chondropathy
2.
Chondritis
3.
Chondroplasty
3.
Which term means a malignant tumor of the bone?
1.
Myeloma
2.
Osteoma
3.
Osteosarcoma
4.
Which term means a loss of bone density and an increase in its porous state?
1.
Osteomalacia
2.
Sarcoma
3.
Osteoporosis
5.
Which term means inflammation of bone?
1.
Osseous
2.
Osteitis
3.
Osteoitis
6.
What is the medical term for removal of the synovial membrane?
1.
Synovectomy
2.
Synovotomy
3.
Synovitis
7.
Which term best describes pain in fibrous tissue throughout the body?
1.
Fibromyalgia
2.
Carpal tunnel syndrome
3.
Myalgia
8.
Which term means pain in several muscles?
1.
Myositis
2.
Polymyalgia
3.
Myalgia
Revised September 2001
-65-
9.
Which term means suturing torn fascia?
1. Fascioplasty
2. Fasciotomy
3. Fasciorrhaphy
10.
Which term refers to a muscle that moves a part toward the midline?
1. Abductor
2. Adductor
3. Extension
11.
Which of the following terms means abnormal hardening of muscle tissue?
1. Myosclerosis
2. Myomalacia
3. Myonecrosis
12.
Which term means delayed relaxation of a muscle after a strong contraction?
1. Myotonia
2. Dystonia
3. Atrophy
13.
Which term means to suture a muscle wound?
1. Myorrhaphy
2. Myotomy
3. Myectomy
14.
Which of the following terms means to free a tendon from adhesions?
1. Tenotomy
2. Tenodesis
3. Tenolysis
15.
Which type of muscles are found in hollow structures and organs?
1. Striated
2. Visceral
3. Voluntary
16.
Which term means abnormally increased motor function or activity?
1. Hypokinesia
2. Hyperkinesia
3. Bradykinesia
Revised September 2001
-66-
Exercise 6.2
Complete the statement with the appropriate word or words.
1.
The medical term for a painful joint is _________________________________.
2.
Inflammation of the vertebrae is referred to as __________________________.
3.
A surgical puncture into a joint to remove fluid is referred to as ______________.
4.
An X-Ray examination of a joint after a dye has been injected is referred to as an
_______________________________________________________________.
5.
The bony structure which protects the brain is the ________________________.
6.
___________________________ is the shaft portion of the bone.
7.
Inflammation of a rib is referred to as __________________________________.
8.
Softening of bone is referred to as ____________________________________.
9.
Surgical removal of part of the skull is referred to as ______________________.
10.
An immature bone cell is referred to as a(n) ____________________________.
11.
____________________________________ means inflammation of the fascia.
12.
The medical term for suturing a tendon is _________________________.
13.
Surgical removal of a tendon is referred to as ___________________________.
14.
_________________ means pertaining to the fascia surrounding muscle tissue.
15.
Surgical removal of fascia is referred to as _____________________________.
16.
The study of muscle activity is termed _________________________________.
17.
______________________________ is a malignant tumor derived from muscle.
18.
Muscle pain or tenderness is referred to as _____________________________.
19.
The term for abnormal softening of the muscle is ________________________.
20.
Medical term for inflammation of several voluntary muscles is ______________.
Exercise 6.3
Create the medical term for the following definition.
1.
Record of the electrical currents in a muscle ____________________________
2.
Slow movement _________________________________________________
Revised July 2000
-67-
3.
Wasting away of muscle ___________________________________________
4.
Muscle pain ____________________________________________________
5.
Inflammation of a muscle __________________________________________
6.
Excessive movement ______________________________________________
7.
Any muscle disease _______________________________________________
8.
Impaired movement _______________________________________________
9.
Enlargement of an organ from the increase in cell size ____________________
10.
Inflammation of many muscles _______________________________________
Revised July 2000
-68-
Download