Lecture Notes Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding 10 Musculoskeletal System 10 MUSCULOSKELETAL SYSTEM Structure • Muscles • Three types of muscles • Skeletal • Smooth • Cardiac 2 10 MUSCULOSKELETAL SYSTEM Function • Muscles • Provide contraction that allows body movement. • Provide body posture. • Help passage and elimination of food. • Help propel blood through arteries and other vessels. • Provide contraction of bladder to eliminate urine. 3 10 MUSCULOSKELETAL SYSTEM Structure • Human skeleton • Divided into axial skeleton (bone colored) and appendicular skeleton (blue colored). 4 10 MUSCULOSKELETAL SYSTEM Function • Bones • Provide a skeletal framework to support and protect the body. • Store calcium and other minerals. • Produce blood cells within bone marrow. 5 10 MUSCULOSKELETAL SYSTEM Structure and Function Exercise Q: What are four principal types of bones? A: Short bones, flat bones, irregular bones, and long bones. Q: Provide a few examples of long bones. A: Long bones are found in the extremities of the body, such as the legs, arms, fingers, and toes. Q: What are the terms given to the ends of a long bone? A: Distal epiphysis and the proximal epiphysis. Q: Where is smooth muscle found in the body and what are its functions? A: They are found in walls of arteries, respiratory passages, urinary and reproductive ducts, and visceral organs. Smooth muscles are those whose actions are involuntary. Q: What is the function of ligaments? A: They are flexible bands of fibrous tissue that hold bones close together at the joint. 6 10 MUSCULOSKELETAL SYSTEM Fractures Signs and Symptoms • Acute pain at affected site, deformity, swelling, and discoloration. • Loss of limb function, muscle spasm, hemorrhage, and shock. • Bone protrudes through the skin. 7 10 MUSCULOSKELETAL SYSTEM Fractures Treatment • External immobilization of affected parts using traction, casting, or splinting. • Open or closed reduction may be needed to realign bone for proper healing. • Analgesics or muscle relaxants to ease the pain. 8 10 MUSCULOSKELETAL SYSTEM Fractures Treatment (continued) • Open reduction by surgery, followed by external fixation or by internal fixation with use of metal plates, screws, or rods. • Closed reduction consists of manipulation and casting without surgical incision. • Rib fractures may require no treatment, or the chest may be bandaged or taped for support and pain control. 9 10 MUSCULOSKELETAL SYSTEM Clinically Related Exercise Q: John is in an auto accident and presents to the ED with a broken rib piercing his lung. This condition is documented in the medical record as a (closed, comminuted, complicated) fracture. A: complicated Q: The x-ray shows the fracture as a fine crack in the bone, but both bone segments are still connected. The radiologist transcribes it as a (Colles, comminuted, hairline) fracture. A: hairline Q: The doctor explains that he will immobilize and align the bones at the site of the hip fracture by inserting pins and screws. This type of procedure is known as (internal fixation, osteoclasis, synovectomy). A: internal fixation Q: During preoperative consultation of a fracture repair, the physician describes the complications that may result from a fracture. A: She explains that complications include embolism, infection, delayed union or nonunion of the fracture, and complications resulting from immobilization. 10 10 MUSCULOSKELETAL SYSTEM Herniated Disk Signs and Symptoms • Herniation of the nucleus pulposus (center of gelatinous material within an intervetebral disk) between two vertebrae; also called prolapsed disk. 11 10 MUSCULOSKELETAL SYSTEM Herniated Disk Signs and Symptoms (continued) • Depend on the particular site of herniation. • Severe back pain that worsens with motion. • For cervical disk herniation, paresthesia and restricted mobility of the neck. • Coughing, sneezing, or bending will intensify the pain and discomfort. • Lumbar sciatic involvement begins as a dull ache and progresses to severe pain. 12 10 MUSCULOSKELETAL SYSTEM Herniated Disk Treatment • Bed rest and alternating heat and cold applied to the affected portion of the spine. • Muscle relaxants, salicylate, and/or analgesics. • Traction of lower extremities and a back brace. • Laminectomy may be required if conservative treatment is unsuccessful. • Spinal fusion may be necessary to stabilize the spine. 13 10 MUSCULOSKELETAL SYSTEM Clinically Related Exercise Q: Joe presents with a sensation of numbness and a burning feeling in his right foot. The MA charts his condition as (paraplegia, paresis, paresthesia). A: paresthesia Q: Fred complains of pain emanating from his lower back that goes down to the left leg. The doctor suspects it is a flare up of pain along the sciatic nerve known as _______________. A: sciatica Q: An excision of the vertebral posterior arch to correct a herniated disk will be performed with a surgical procedure called (dislodgement, herniorrhaphy, laminectomy). A: laminectomy Q: Treatment for a herniated disk is to relieve pain, treat muscle spasms, and relieve pressure. It includes use of weights and pulleys to immobilize the site and facilitate healing and is known as (traction, tractotomy, tractus). A: traction 14 10 MUSCULOSKELETAL SYSTEM Rheumatoid Arthritis Signs and Symptoms • Autoimmune disease in which immune system attacks its own cartilage and connective tissues. 15 10 MUSCULOSKELETAL SYSTEM Rheumatoid Arthritis Signs and Symptoms (continued) • Results in crippling deformities. • Most commonly found in women between ages 23 and 35, but can affect people of any age group. • Muscles, bones, and skin adjacent to the affected joint atrophy. 16 10 MUSCULOSKELETAL SYSTEM Rheumatoid Arthritis Treatment • No specific cure, but medications can slow spread of the disease. • Less severe cases are treated with nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and orthopedic measures. • Surgery may reduce pain and improve mobility. 17 10 MUSCULOSKELETAL SYSTEM Clinically Related Exercise Q: Tish has a recent diagnosis of an autoimmune disease in which the immune system attacks its own cartilage and connective tissues. This results in crippling deformities and causes muscles, bones, and skin adjacent to the affected joint to atrophy. This chronic condition is known as ______________________. A: rheumatoid arthritis Q: The patient with a history of rheumatoid arthritis is concerned about its effects on joint cartilage and asks the nurse for an explanation. A: The nurse states that joint cartilage is slowly destroyed by changes associated with the inflammatory process. Q: Michelle’s case of rheumatoid arthritis is not severe and she presents with complaints of mild pain. The physician recommends she take an over-the-counter anti-inflammatory, such as ibuprofen, that is commonly used to relieve mild to moderate pain and reduce inflammation. This type of drug is known as a ________________________. A: nonsteroidal anti-inflammatory drug (NSAID) Q: The NP is speaking to a support group of patients with rheumatoid arthritis. She explains the prognosis of RA and why it is such a crippling disease. A: The NP explains since there is no cure for RA, the disease progresses until cartilage and connective tissues of joints are destroyed. 18 10 MUSCULOSKELETAL SYSTEM Medical Vocabulary • ankylosis • antirheumatic • arthodesis • articulate • carpoptosis • chiropractor • contraction • costochondritis • crepitation • diaphysis • dystrophy 19 10 MUSCULOSKELETAL SYSTEM Medical Vocabulary (continued) • • • • • • • • • • hemiplegia herniated intervertebral kyphosis laminectomy leiomyoma lumbosacral myasthenia myosarcoma nonsteroidal 20 10 MUSCULOSKELETAL SYSTEM Medical Vocabulary (continued) • • • • • • • • • • osteoporosis periosteum sacroiliac scoliosis sequestum spondylitis spondylolisthesis synovial talipes tendinitis 21 10 MUSCULOSKELETAL SYSTEM Medical Vocabulary (continued) • talipes equinovarus 22 10 MUSCULOSKELETAL SYSTEM Diagnostic Procedures • Arthroscopy • Visual examination of interior of a joint performed by inserting an endoscope through a small incision. • Performed to repair and remove joint tissue. 23 10 MUSCULOSKELETAL SYSTEM Diagnostic Procedures (continued) Myelography • Radiography of spinal cord after injection of a contrast medium to identify and study spinal distortions caused by tumors, cysts, herniated intervertebral disks, or other lesions. • Rheumatoid factor • Blood test to detect presence of rheumatoid factor, a substance present in patients with rheumatoid arthritis. 24 10 MUSCULOSKELETAL SYSTEM Word Building Exercise Q: Visual examination of a joint: A: arthroscopy Q: Pertaining to the neck and face: A: cervicofacial Q: Disease of bones and joints: A: osteoarthropathy Q: Act of measuring the pelvis: A: pelvimetry Q: Suture of muscle: A: myorrhaphy Q: Tumor of bone marrow: A: myeloma 25 10 MUSCULOSKELETAL SYSTEM Medical and Surgical Procedures • Total hip arthroplasty • Replacement of femoral head and acetabulum with prostheses that are fastened into the bone. 26 10 MUSCULOSKELETAL SYSTEM Medical and Surgical Procedures (continued) • Amputation • Partial or complete removal of an extremity due to trauma or circulatory disease • Arthrocentesis • Puncture of a joint space using a needle to remove accumulated fluid. • Laminectomy • Excision of the posterior arch of a vertebra. 27 10 MUSCULOSKELETAL SYSTEM Clinically Related Exercise Q: A 19-year-old male sustains a knee injury in a high school football game. X-rays reveal a torn ligament. The orthopedic surgeon recommends a procedure in which a small instrument is inserted into the joint to repair the ligament. This procedure is known as (arthroclasis, arthroplasty, arthoscopy). A: arthroscopy Q:The surgeon informs Wayne that he must undergo surgery to remove his herniated disk. The surgery is charted as a (traction, herniorrhaphy, laminectomy). ________________________. A: laminectomy Q: James sustained an injury to his upper thigh muscle when he was stabbed in a street fight. Because of the severity of the injury, he must undergo a surgical repair of the muscle known as _________________. A: myoplasty Q: Melvin has a history of arthritis that has damaged his hip joint. The doctor recommends a surgical procedure to replace the hip. This procedure is known as total hip _____________________________. A: arthroplasty 28 10 MUSCULOSKELETAL SYSTEM Pharmacology • Bone reabsorption inhibitors • Gold salts • Nonsteroidal anti-inflammatory drugs NSAIDs • Salicylates • Skeletal muscle relaxants 29 10 MUSCULOSKELETAL SYSTEM Clinically Related Exercise Q: Dr. C prescribes a nonsteroidal anti-inflammatory drug to relieve pain and inflammation due to tendinitis. The abbreviation for this drug is ________. A: NSAID Q: Mary is diagnosed with osteoporosis. To inhibit further breakdown of her bones, the physician prescribes a (bone reabsorption inhibitor, gold salt, salicylate). A: bone reabsorption inhibitor Q: Joanne complains of morning pain and stiffness in her joints caused by arthritis. The doctor prescribes a (bone reabsorption inhibitor, skeletal muscle relaxant, salicylate). A: salicylate Q: John suffers from muscle spasms in his back due to an old sports injury. To relieve this pain, the physician prescribes a (bone reabsorption inhibitor, gold salt, muscle relaxant). A: muscle relaxant 30