Chapter 14
Musculoskeletal System
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1
Lesson 14.1
1. State the function of the musculoskeletal system,
2.
3.
4.
5.
and analyze associated terms.
Write the meanings of the word parts and use them
to build and analyze terms.
Label the major bones of the body and match them
with their common names.
Name the four types of bone tissue and their
functions.
List the three types of muscle tissue, and describe
their functions.
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2
Marrow: Red and Yellow


red marrow functions:
 formation of red blood cells, white blood
cells, and platelets
 stores and releases minerals, especially
calcium
 participates in body’s mineral balance
yellow marrow stores fat
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3
Long Bone Anatomy
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4
Bone Histology
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5
Word Parts: Bone
blast(o), -blast
myel(o)
oste(o)
embryonic form
bone marrow or spinal cord
bone
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6
From Frank ED, Long BW, Smith BJ: Merrill’s atlas of radiographic positioning and radiologic procedures, vol 1, ed 11, St Louis, 2007, Mosby.
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7
Terminology



calcification
osteogenesis
ossification
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Axial and Appendicular Skeletons

axial skeleton




skull
backbone
ribs
breastbone

appendicular skeleton





shoulder blades
collarbone
arms and hands
pelvic bones
legs and feet
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Combining
Form
Bone
Common
Name
cost(o)
costae
ribs
crani(o)
cranium
skull
rach(i),
vertebral or
spine
rachi(o), spin(o) spinal column (backbone)
spondyl(o),
vertebr(o)
vertebrae
bones of the
spine
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Combining
Form
Meaning
Common
Name
cervic(o)
cervical
neck bones
thorac(o)
thoracic
back bones
lumb(o)
lumbar
low back bones
sacr(o)
sacral
base of spine
coccyg(o)
coccygeal
tailbone
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Terminology





sternal, intrasternal, suprasternal, substernal
infrasternal, retrosternal
costal, subcostal, supracostal, infracostal
intercostal, sternocostal, vertebrocostal,
costovertebral
vertebrosternal, sternovertebral
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Appendicular Skeleton



shoulder girdle: clavicle (collarbone) and
scapula (shoulder blade)
pelvic girdle: 3 pelvic bones
extremities: arms and hands, legs and feet
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18
Word Parts: Shoulder and Arm
clavicul(o) clavicle
collarbone
scapul(o)
scapula
shoulder blade
humer(o)
radi(o)
uln(o)
humerus
radius
ulna
upper arm bone
a bone of the forearm
a bone of the forearm
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Terminology





clavicular, sternoclavicular, costoclavicular,
infraclavicular
scapular, interscapular, scapuloclavicular,
infrascapular
humeral, humeroscapular
ulnar, radial, ulnoradial
humeroradial, humeroulnar
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Word Parts: Wrist & Hand
phalang(o)
phalanx (pl.
phalanges)
carpus
finger
metacarp(o) metacarpals
hand
carp(o)
wrist
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21
From Frank ED, Long BW, Smith BJ: Merrill’s atlas of radiographic positioning and radiologic procedures, vol 1, ed 11, St Louis, 2007, Mosby.
Copyright © 2012, 2009, 2005, 2001, 1997, 1993, 1988, 1983 by Saunders, an imprint of Elsevier Inc.
22
Quick Quiz!

Which term means pertaining to the
collarbone and the shoulder blade?
A.
B.
C.
D.
interscapular
ulnoradial
humeroulnar
scapuloclavicular
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Terminology: Wrist & Hand




carpal, metacarpal
phalanges (phalanx)
carpophalangeal, interphalangeal
metacarpophalangeal
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Bones of the Pelvic Girdle
ili(o)
ischi(o)
pub(o)
ilium
iliac
ischium
ischial
pubis pubic
(These bones fuse to form the pelvic bone.)
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From Frank ED, Long BW, Smith BJ: Merrill’s atlas of radiographic positioning and radiologic procedures, vol 1, ed 11, St Louis, 2007, Mosby.
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26
Terminology: Pelvic Girdle



iliofemoral, ischiofemoral, pubofemoral
iliopubic, ischiopubic, ischiococcygeal
subpubic, suprapubic, interpubic
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Word Parts: Leg & Knee
femor(o)
patell(o)
tibi(o)
fibul(o)
femur
patella
tibia
fibula
thigh bone
kneecap
shin bone
(side leg bone)
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Word Parts: Ankle & Foot
tars(o)
calcane(o)
metatars(o)
phalang(o)
tarsus
calcaneus
metatarsals
phalanx
(pl. phalanges)
ankle
heel bone
foot bones
toes
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Lower Extremity
Photo From Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s Guide To Physical Examination, ed 6, St. Louis, 2006, Mosby.
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Terminology: Lower Limb





patellofemoral, infrapatellar, suprapatellar
tibial, tibiofibular, fibular
tarsal, tarsometatarsal
calcaneoplantar, calcaneotibial,
calcaneofibular
carpopedal
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Joints, Tendons, and Ligaments



Joints are where 2 or more bones meet.
Tendons connect muscle to bone.
Ligaments connect bone to bone.
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Synovial Joint
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Word Parts: Joints and Tendons
arthr(o), articul(o)
burs(o)
chondr(o)
synov(o), synovi(o)
ten(o), tend(o), tendin(o)
joint; articulation
bursa
cartilage
synovial membrane
tendon
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From Thibodeau GA, Patton KT: Anatomy & physiology, ed 3, St Louis, 1996.
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Terminology: Joints and Tendons




temporomandibular
joint
chondral,
chondroid
vertebrochondral,
chondrocostal
perichondrium,
perichondrial
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Quick Quiz!

Which of these means pertaining to the ribs
and their associated cartilage?
A.
B.
C.
D.
vertebrochondral
Perichondral
chondrocostal
tibiofibular
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Biceps and Triceps Reflexes
B and C From Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s Guide To Physical Examination, ed 6, St. Louis, 2006, Mosby.
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Joint Movements
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Types of Joints



immovable
 (example: sutures of the skull)
slightly movable
 (ex: symphysis pubis, joints connecting ribs
to sternum)
freely movable (synovial)
 (ex: shoulder, wrist, knee)
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Neonatal Fontanelles
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Shoulder Joint
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Lesson 14.2
6. Write the names of the diagnostic tests and
procedures for assessment of the musculoskeletal
system when given their descriptions, or match the
procedures with their descriptions.
7. Write the names of musculoskeletal pathologies
when given their descriptions, or match them with
their descriptions.
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45
Range of Motion
A From Barkauskas VH, Bauman LC, Darling-Fisher CS: Health & physical assessment, ed 3, St Louis, 2002, Mosby, Inc.
B From Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s guide to physical examination, ed 6, St Louis, 2006, Mosby.
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Electromyography
A From Mourad LA: Orthopedic disorders, St Louis, 1991, Mosby. B From Black JM, Hawks JH: Medical-surgical nursing, ed 7, St Louis, 2005, Saunders.
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Diagnostic Tests and Procedures
(cont.)


X-rays, bone densitometry
CT, MRI, bone scan
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Bone Marrow Aspiration
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Diagnostic Tests and Procedures




arthroscope, arthroscopy
arthrography, arthrogram
intraarticular
arthrocentesis
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Diagnostic Tests and Procedures
(cont.)

Laboratory Tests

antinuclear antibody (ANA)
• serum test, usually + in systemic lupus erythematosus,
sometimes in RA and scleroderma

erythrocyte sedimentation rate (ESR)
• blood test, elevated with any inflammatory process, such
as RA and osteomyelitis

rheumatoid factor (RF)
• blood test + in most patients with RA, sometimes lower
levels in other connective tissue disorders
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Diagnostic Tests and Procedures
(cont.)

Laboratory Tests (cont.)





serum calcium
• in some bone tumors; in osteomalacia
serum creatine phosphokinase (CPK)
• in skeletal muscle disorders and myocardial infarction
serum phosphorus
• in osteomalacia; in some bone tumors
serum uric acid
• in patients with gout
urine calcium (calciuria, hypercalciuria)
• sometimes detected in metastatic bone disease
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Pathologies







stress and trauma injuries
infections
tumors and malignancies
metabolic disturbances
congenital defects
arthritis and connective tissue diseases
muscular disorders
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Pathologies (cont.)

stress and trauma injuries




strain, sprain
myalgia, myodynia
muscle cramp, tetany
fractures
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From Canale ST: Operative orthopaedics, ed 9, St Louis, 1998, Mosby.
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Pathologies (cont.)

stress and trauma injuries (cont.)





carpal tunnel syndrome (cts)
rotator cuff injury
bursitis
tendinitis, tendonitis
tenodynia, tenalgia
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Pathologies (cont.)

stress and trauma injuries (cont.)




joint crepitus
radiodynia, rachialgia, spondylalgia
sacrodynia, ischodynia, sternalgia
tibialgia, calcaneodynia, calcaneitis
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Pathologies (cont.)

stress and trauma injuries (cont.)



chondritis, chondrodynia
osteochondritis, arthrochondritis
TMJ pain dysfunction syndrome
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Quick Quiz!

Which of the following means increased
calcium in the urine?
A.
B.
C.
D.
creatine phosphokinase
chondrodynia
arthrocentesis
hypercalciuria
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From Ballinger PW, Frank ED: Merrill’s atlas of radiographic positions and radiologic procedures, vol 1, ed 10, St Louis, 2003, Mosby.
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Pathologies

stress and trauma injuries (cont.)




tarsoptosis
Morton neuroma
tarsal tunnel syndrome
Dupuytren contracture
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Dupuytren Contracture
From Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s guide to physical examination, ed 6, St Louis, 2006, Mosby.
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Hallux Valgus and Hammertoe
From Kamal A, Brockelhurst JC: Coloratlas of geriatric medicine, ed 2, St Louis, 1991, Mosby.
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Pathologies

infections



osteitis, ostealgia,osteodynia
osteomyelitis, myelitis
cellulitis, myocellulitis
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Pathologies (cont.)

tumors and malignancies: benign


chondrogenic, chondroma, osteochondroma
osteogenic, fibrogenic
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Pathologies (cont.)

tumors and malignancies: malignant




multiple myeloma, osteosarcoma
chondrosarcoma, fibrosarcoma, Ewing sarcoma
leukemia
metastatic bone cancer
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Pathologies (cont.)

classification of leukemia

lymphocytic, lymphoblastic
 myelocytic, myelogenous
 acute myelocytic leukemia (AML)
 chronic myelogenous leukemia (CML)
 acute lymphocytic leukemia (ALL)
 chronic lymphocytic leukemia (CLL)
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Pathologies (cont.)

metabolic disturbances




osteosclerosis
osteolysis
calcipenia, decalcification
osteopenia
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Osteoporosis
From Walter JB: An introduction to the principles of disease, ed 2, Philadelphia, 1982, Saunders.
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Pathologies

metabolic disturbances (cont.)



osteomalacia
rickets
osteitis deformans/Paget’s disease
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Word Parts
ankyl(o)
troph(o)
-asthenia
-clasia
-desis
stiff
nutrition
weakness
break
binding; fusion
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Pathologies

congenital defects




spina bifida, craniocele, encephalocele
rachischisis, sternoschisis
scoliosis, lordosis, kyphosis
muscular dystrophy
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From Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis, ed 5, St Louis, 2007, Mosby.
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Lordosis vs. Kyphosis
B from Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis, St Louis, 1997, Mosby.
C From Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis, ed 5, St Louis, 2007, Mosby.
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Polydactyly vs. Syndactyly
From Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis, ed 5, St Louis, 2007, Mosby.
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Pathologies

arthritis and connective tissue diseases





arthritis, arthropathy, osteoarthropathy
arthralgia, arthrodynia, arthrosclerosis
spondylarthritis, dorsalgia
osteoarthritis (degenerative joint disease [DJD])
connective tissue diseases
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From Swartz MH: Textbook of physical diagnosis: history and examination, ed 2, Philadelphia, 1994, Saunders.
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Pathologies

arthritis and connective tissue diseases
(cont.)



lupus erythematosus:
• systemic lupus erythematosus (SLE), discoid LE (DLE)
systemic scleroderma/sclerosis, Sjögren
syndrome
gout
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Systemic Lupus Erythematosus
From Behrman R, Kliegman R, Jenson HB: Nelson’s textbook of pediatrics, ed 17, Philadelphia, 2004, Saunders.
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Pathologies

arthritis and connective tissue diseases
(cont.)




polyarthritis
spondylarthropathy
ankylosis, ankylosing spondylitis
Lyme disease
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Quick Quiz!

Which type of arthritis is also called
degenerative joint disease?
A.
B.
C.
D.
osteoarthritis
rheumatoid arthritis
ankylosing spondylitis
systemic lupus erythematosus
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Pathologies

muscular disorders





polymyositis, myopathy, myofascial
chronic fatigue syndrome
polymyalgia, polymyalgia rheumatica
fibromyalgia, fibromyalgia syndrome
nonarticular
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Pathologies (cont.)

muscular disorders




atrophy
myolysis
myasthenia, myasthenia gravis
myocele, myofibrosis
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Lesson 14.3
8.
9.
10.
11.
12.
13.
Match surgical and therapeutic interventions with
their descriptions, or write the names of the
interventions when given their descriptions.
Use word parts from this chapter to determine the
meanings of terms in a health care report.
Spell the terms accurately.
Pronounce the terms correctly.
Write the meanings of the abbreviations.
Categorize terms as anatomy, a diagnostic test or
procedure, pathology, surgery, or therapy.
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Terminology: Fracture Treatment





orthopedics, orthopedists
reduction, closed reduction,
open reduction
splint, cast, traction
external fixation
internal fixation
From Frank ED, Long BW, Smith BJ: Merrill’s atlas of radiographic positioning and radiologic procedures, vol 1, ed 11, St Louis, 2007, Mosby.
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Terminology: Surgical & Therapeutic
Interventions




anti-osteoporotics
ostectomy, osteoplasty, cranioplasty,
craniectomy
craniotomy, craniotome, sternotomy,
costectomy
vertebrectomy, carpectomy, coccygectomy,
phalangectomy
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Terminology: Surgical & Therapeutic
Interventions




tendoplasty, tenotomy, tenorrhaphy
bursectomy
myoplasty, tenomyoplasty
myorrhaphy
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Terminology: Surgical & Therapeutic
Interventions




spondylosyndesis
muscle relaxants
laminectomy, diskectomy
vertebroplasty
Copyright © 2012, 2009, 2005, 2001, 1997, 1993, 1988, 1983 by Saunders, an imprint of Elsevier Inc.
94
Terminology: Surgical & Therapeutic
Interventions


arthrotomy, arthrectomy
arthroplasty, joint replacement
B From Ignatavicius DD, Workman ML: Medical-Surgical Nursing: Patient-centered collaborative care, 6e, St. Louis, 2010, Saunders.
Copyright © 2012, 2009, 2005, 2001, 1997, 1993, 1988, 1983 by Saunders, an imprint of Elsevier Inc.
95
Terminology: Surgical & Therapeutic
Interventions





artial fasciectomy
bunionectomy
chondroplasty, chondrectomy
arthrocentesis
arthrodesis, arthroclasia
Copyright © 2012, 2009, 2005, 2001, 1997, 1993, 1988, 1983 by Saunders, an imprint of Elsevier Inc.
96
Terminology: Surgical & Therapeutic
Interventions



antiinflammatories, nonsteroidal
antiinflammatory drugs (NSAIDs)
Cox-2 inhibitors
antiarthritics, disease-modifying antirheumatic
drugs (DMARDs)
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Terminology: Surgical & Therapeutic
Interventions


myelosuppression, myelosuppressive
bone marrow transplants
 autologous transplants
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Abbreviations: Anatomy





Cl, C2, etc.
L-l, L-2, etc.
MTP
T-l, T-2, etc.
TMJ
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99
Abbreviations: Diagnosis






ANA
CPK
EMG
ESR
RF
ROM, AROM, PROM
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Abbreviations: Pathology







CTS
DJD
LE, DLE, SLE
fx
RA
ALL, AML
CLL, CML
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101
Abbreviations: Therapy





BMT
CPM
DMARD
NSAID
TJR
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102