The Language of Medicine

13th edition
Davi-Ellen Chabner

1
 Chapter 15
Musculoskeletal System

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 Chapter Goals (Slide 1 of 3)
• 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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 Chapter Goals (Slide 2 of 3)
• 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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 Chapter Goals (Slide 3 of 3)
• 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
Tendons: bind muscles to bones
Ligaments: bind bones to other bones
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Physicians Associated with Musculoskeletal
System

• Orthopedist: MD

• Rheumatologist: MD

• Physiatrist: MD

• Osteopathic physician: DO

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 Bone Formation (Slide 1 of 3)
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 (Slide 2 of 3)
• 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 (Slide 3 of 3)
• 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 (Slide 1 of 4)
• Long, short, flat, sesamoid (in shape)
• Diaphysis: shaft
• Epiphysis: end
• Metaphysis: conelike 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 (Slide 2 of 4)
Interior bone structure includes:
• Articular cartilage
• Epiphyseal line or plate
• Cancellous bone
• Compact (cortical) bone
• Medullary cavity
• Periosteum

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Bone Structure (Slide 3 of 4)

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 Bone Structure (Slide 4 of 4)
• 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

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 Bone Processes and Depressions
(Slide 1 of 2)
• Processes: serve as attachments for muscles,
tendons, and ligaments

• Depressions: openings or hollow regions help

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Bone Processes and Depressions (Slide 2 of
2)

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Cranial Bones (Slide 1 of 2)

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Cranial Bones (Slide 2 of 2)

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 Cranial Bones and
Associated Structures
• Frontal bone
• Parietal bone
• Temporal bone
 temporomandibular (TMJ) joint
 mastoid process
 styloid process
• Occipital bone
 foramen magnum
• Sphenoid bone
 sella turcica
• Ethmoid bone
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Facial Bones (Slide 1 of 2)

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 Facial Bones (Slide 2 of 2)
• Nasal bones • Mandibular bones
• Lacrimal bones • Zygomatic bones
• Maxillary bones • Vomer

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 Sinuses
Air cavities located in facial and cranial
bone lighten the skull and warm and
moisten the air as it passes into the
respiratory system.

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Vertebral Column and Vertebrae
(Slide 1 of 2)

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 Vertebral Column and
Vertebrae (Slide 2 of 2)
• Vertebrae: 26 bone segments from base of
skull to tailbone in five divisions and separated
by pads of cartilage called intervertebral discs
• Cervical, thoracic, lumbar, sacral
• Coccyx: tailbone

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 Bones: Thorax, Pelvis and
Extremities
Thorax Arm and Hand
 clavicle  humerus
 scapula  ulna
 sternum
 radius
 ribs
 carpals
Pelvis
 pelvic girdle  metacarpals
 ilium  phalanges
 ischium
 pubis
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Bones of Leg and Foot

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 Bones of Leg and Foot and Associated
Structures
• Femur • Tarsals
acetabulum calcaneus
• Patella talus
• Tibia • Metatarsals
medial malleolus • Phalanges
• Fibula
lateral malleolus
talus

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Vocabulary – Bones
(Slide 1 of 32)
Term
acetabulum
acromion

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 Vocabulary – Bones
(Slide 2 of 32)
Term Meaning/Definition
acetabulum Rounded depression in pelvis that joins the
femur, forming the hip joint
acromion Outward extension of shoulder blade
forming the point of the shoulder

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Vocabulary – Bones
(Slide 3 of 32)
Term
bone
bone depression
bone process

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 Vocabulary – Bones
(Slide 4 of 32)
Term Meaning/Definition
bone Dense, hard connective tissue composing
the skeleton
bone depression Opening or hollow region serving as a
connection for bones, or passageway for
blood vessels and nerves
bone process Enlarged area that extends from bones as an
attachment for muscles, tendons, and
ligaments

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Vocabulary – Bones
(Slide 5 of 32)
Term
calcium
cancellous bone
cartilage

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 Vocabulary – Bones
(Slide 6 of 32)
Term Meaning/Definition
calcium A mineral constituent of bone
cancellous bone Spongy, porous bone tissue in inner part of
bone
cartilage Flexible, connective tissue

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Vocabulary – Bones
(Slide 7 of 32)
Term
collagen
compact bone
cranial bones

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 Vocabulary – Bones
(Slide 8 of 32)
Term Meaning/Definition
collagen Dense, connective tissue protein strands
found in bone and other tissues
compact bone Hard, dense bone tissue, usually found
around outer portion of bones
cranial bones Skull bones: ethmoid, frontal, occipital,
parietal, sphenoid, and temporal

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Vocabulary – Bones
(Slide 9 of 32)
Term
diaphysis
disc
epiphyseal plate

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 Vocabulary – Bones
(Slide 10 of 32)
Term Meaning/Definition
diaphysis Shaft, or mid-portion, of a long bone
disc Flat, round, plate-like structure
epiphyseal plate Cartilaginous area at the ends of long bones
where lengthwise growth takes in the
immature skeleton

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Vocabulary – Bones
(Slide 11 of 32)
Term
epiphysis
facial bones
fontanelle

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 Vocabulary – Bones
(Slide 12 of 32)
Term Meaning/Definition
epiphysis Each end of a long bone; area beyond the
epiphyseal plate
facial bones Bones of the face: lacrimal, mandibular,
maxillary, nasal, vomer, and zygomatic
fontanelle Soft spot (incomplete bone formation)
between the skull bones of an infant

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Vocabulary – Bones
(Slide 13 of 32)

Term
foramen magnum
haversian canals
ligament

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 Vocabulary – Bones
(Slide 14 of 32)
Term Meaning/Definition
foramen magnum Opening of the occipital bone through which
the spinal cord passes
haversian canals Minute spaces filled with blood vessels;
found in compact bone
ligament Fibrous connective tissue that binds bones
to other

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Vocabulary – Bones
(Slide 15 of 32)

Term
malleolus
manubrium
mastoid process

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 Vocabulary – Bones
(Slide 16 of 32)
Term Meaning/Definition
malleolus Round process on both sides of the ankle
joint
manubrium Upper portion of the sternum
mastoid process Round projection on the temporal bone
behind the ear

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Vocabulary – Bones
(Slide 17 of 32)
Term
medullary cavity
metaphysis
olecranon

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 Vocabulary – Bones
(Slide 18 of 32)
Term Meaning/Definition
medullary cavity Central, hollowed-out area in the shaft of a
long bone
metaphysis Flared portion of a long bone, between the
diaphysis and the epiphyseal plate
olecranon Large process on the proximal end of the
ulna

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Vocabulary – Bones
(Slide 19 of 32)
Term
orthopedist
osseous tissue
ossification

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 Vocabulary – Bones
(Slide 20 of 32)
Term Meaning/Definition
orthopedist Medical doctor who specializes in bone,
joint, and muscle conditions
osseous tissue Bone tissue
ossification Process of bone formation

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Vocabulary – Bones
(Slide 21 of 32)
Term
ossification
osteoblast
osteoclast

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 Vocabulary – Bones
(Slide 22 of 32)
Term Meaning/Definition
ossification Process of bone formation
osteoblast Bone cell that helps form bony tissue
osteoclast Bone cell that absorbs and removes
unwanted bony tissue

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Vocabulary – Bones
(Slide 23 of 32)

Term
periosteum
phosphorus
physiatrist

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 Vocabulary – Bones
(Slide 24 of 32)
Term Meaning/Definition
periosteum Membrane surrounding bones; rich in blood
vessels and nerve tissue
phosphorus Mineral substance found in bones in
combination with calcium
physiatrist Medical doctor who specializes in
rehabilitation

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Vocabulary – Bones
(Slide 25 of 32)

Term
pubic symphysis
red bone marrow
ribs

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 Vocabulary – Bones
(Slide 26 of 32)
Term Meaning/Definition
pubic symphysis Area of confluence of the two pubic bones
in the pelvis
red bone marrow Found in cancellous bone; site of
hematopoiesis
ribs Twelve pairs of curved bones that form the
chest wall; true ribs are the first 7 pairs;
false ribs are pairs 8-10; floating ribs are
pairs 11 and 12

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Vocabulary – Bones
(Slide 27 of 32)
Term
sella turcica
sinus
styloid process

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 Vocabulary – Bones
(Slide 28 of 32)
Term Meaning/Definition
sella turcica Depression in the sphenoid bone where the
pituitary gland is located
sinus Hollow air cavity within a bone
styloid process Pole-like process extending downward from
the temporal bone on each side of the skull

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Vocabulary – Bones
(Slide 29 of 32)
Term
suture
temporomandibular joint
tendon

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 Vocabulary – Bones
(Slide 30 of 32)
Term Meaning/Definition
suture Immovable joint between bones
temporomandibular Connection on either side of the head
joint between the temporal bone of the skull
and the mandibular bone of the jaw
tendon Fibrous connective tissue that binds
muscles to bones

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Vocabulary – Bones
(Slide 31 of 32)
Term
trabeculae
vertebra
xiphoid process
yellow bone
marrow

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 Vocabulary – Bones
(Slide 32 of 32 )
Term Meaning/Definition
trabeculae Supporting bundles of bony fibers in
cancellous bone
vertebra Individual segment of the spine composed
of the vertebral body, vertebral arch,
spinous process, transverse process, and
lamina
xiphoid process Lower, narrow portion of sternum
yellow bone Fatty tissue found in the medullary cavity of
marrow most adult long bones

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 QUICK QUIZ (Slide 1 of 4)
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 (Slide 2 of 4)
2. The process of bone formation is
____________.

A. olecranon
B. ossification
C. osteoblast
D. xiphoid process

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 Terminology – Bones
Combining Forms (Slide 1 of 2)
Combining Form Meaning
calc/o calcium
calci/o calcium
kyph/o posterior curvature in thoracic region
lamin/o lamina
lord/o curve
lumb/o loins, lower back

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 Terminology – Bones
Combining Forms (Slide 2 of 2)
Combining Form Meaning
myel/o bone marrow
orth/o straight
oste/o bone
scoli/o crooked
spondyl/o vertebra
vertebr/o vertebra

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 Terminology – Bones
Suffixes
Suffix Meaning
-blast embryonic cell
-clast to break
-listhesis slipping
-malacia softening
-physis to grow
-porosis pore, passage
-tome instrument to cut

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Terminology Related to Specific Bones
Combining Forms (Slide 1 of 5)
Combining Form Meaning
acetabul/o acetabulum (hip socket)
calcane/o calcaneus (heal)
carp/o carpals (wrist bones)
clavicul/o clavicle (collar bone)
cost/o ribs
crani/o cranium (skull)

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Terminology Related to Specific Bones
Combining Forms (Slide 2 of 5)
Combining Form Meaning
femor/o femur (thigh bones)
fibul/o fibula (smaller lower leg bone)
humer/o humerus (upper arm bone)
ili/o ilium (upper part of pelvic bone)
ischi/o ischium (part of pelvic bone)
malleol/o malleolus

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Terminology Related to Specific Bones
Combining Forms (Slide 3 of 5)
Combining Form Meaning
mandibul/o mandible (lower jaw bone)
maxill/o maxilla (upper jaw bone)
metacarp/o metacarpals (hand bones)
metatars/o metatarsals (foot bones)
olecran/o olecranon (elbow)
patell/o patella (kneecap)
pelv/i pelvis

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Terminology Related to Specific Bones
Combining Forms (Slide 4 of 5)
Combining Form Meaning
perone/o fibula
phalang/o phalanges (finger, toe bones)
pub/o pubis
radi/o radius
scapul/o scapula (shoulder blade)

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Terminology Related to Specific Bones
Combining Forms (Slide 5 of 5)
Combining Form Meaning
stern/o sternum (breastbone)
tars/o tarsals
tibi/o tibia (shin bone)
uln/o ulna (lower arm bone)

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 Pathology — Bones
• Ewing sarcoma: malignant bone tumor
• exostosis: bony growth on surface of bone
• osteogenic sarcoma: malignant tumor arising
from bone
• osteomalacia: softening of bone
• osteomyelitis: inflammation secondary to
infection
• talipes: congenital abnormality of hindfoot
involving the talus (clubfoot)
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Pathologic Conditions
Fractures of Bones

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Chapter 15
Lesson 15.2

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 Joints (Slide 1 of 2)
• 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, for
example, elbow, knee, ankle)

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 Synovial Joints
• Joint capsule surrounds bone.
• Ligaments band bones together.
• Bones are covered by articular cartilage.
• Synovial membrane lies under capsule and
lines synovial cavity; filled with synovial fluid.
• A meniscus is a crescent-shaped
fibrocartilaginous structure that partly divides
a join cavity; acts as a protective cushion;
present in the knee.
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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
bones
between skin and bones (with prominent bony
anatomy)
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Joints (Slide 2 of 2)

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Vocabulary – Joints (Slide 1 of 6)

Term
articular cartilage
articulation
bursa (plural: bursae)
ligament

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 Vocabulary – Joints (Slide 2 of 6)
Term Meaning/Definition
articular cartilage Smooth, glistening white tissue that covers
the surface of a joint
articulation Any type of joint
bursa (plural: Sac of fluid near a joint
bursae)
ligament Fibrous connective bands binding bones to
other bones

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Vocabulary – Joints (Slide 3 of 6)

Term
meniscus
suture joint
synovial cavity

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 Vocabulary – Joints (Slide 4 of 6)
Term Meaning/Definition
meniscus Crescent-shaped fibrocartilaginous structure
found in the knee
suture joint Immovable joint
synovial cavity Space between bones at a synovial joint

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Vocabulary – Joints (Slide 5 of 6)

Term
synovial fluid
synovial joint
synovial
membrane
tendon

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 Vocabulary – Joints (Slide 6 of 6)
Term Meaning/Definition
synovial fluid Viscous fluid within the synovial cavity
synovial joint Freely movable joint
synovial Tissue lining the synovial cavity; produces
membrane synovial fluid
tendon Fibrous connective bands that connect
muscles to bones

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 QUICK QUIZ (Slide 3 of 4)
3. The fibrous connective band that
binds muscles to bones is
___________.

A. ligament
B. articulation
C. synovial membrane
D. tendon

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Combining Forms and Terminology
Joints (Slide 1 of 2)
Combining Form Meaning
ankyl/o stiff
arthr/o joint
articul/ joint
burs/o bursa
chondr/o cartilage

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Combining Forms and Terminology
Joints (Slide 2 of 2)
Combining Form Meaning
ligament/o ligament
rheumat/o watery flow
synov/o synovial membrane
ten/o tendon
tendin/o tendon

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 Suffixes and Terminology
Joints
Combining Form Meaning
-desis to bind, tie together
-stenosis narrowing

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 Pathology — Joints
• Arthritis: inflammation of any joint
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; can
occur in any joint, but mainly in spine, hips, and
knees of older people
Rheumatoid arthritis (RA): autoimmune reaction
against joint tissues (synovial membrane)
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 Osteoarthritis and
Rheumatoid Arthritis

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 Pathology — Joints (Slide 1-4)
• Bunion: swelling of medial aspect of joint
between big toe and first metatarsal bone
• Carpal tunnel syndrome: compression of
median nerve as it passes between transverse
ligament and bones and tendons of the wrist
• Dislocation: displacement of bone from a joint

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Pathology — Joints (Slide 2 of 4)
Carpal Tunnel Syndrome

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 Pathology — Joints (Slide 3 of 4)
• Ganglion: a fluid-filled cyst arising from the joint
capsule or a tendon in the wrist.
• Herniation of an intervertebral disc: abnormal
protrusion of the disc into the neural canal or against
spinal nerves; “slipped disc”.
• Lyme disease: recurrent arthritis, myalgia, malaise
and neurologic and cardiac symptoms; often marked by a
“bull’s eye” rash at the site of the tick bite.

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 Pathology — Joints (Slide 4 of 4)
• Sprain: trauma to joint with pain, swelling and injury to
ligaments without rupture
• 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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Actions of Skeletal Muscles
(slide 1 of 3)

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 Actions of Skeletal Muscles
(slide 2 of 3)
• flexion • rotation
• extension • dorsiflexion
• abduction • plantar flexion
• adduction • supination
• pronation

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Actions of Muscles (slide 3 of 3)

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Vocabulary – Muscles (Slide 1 of 8)

Term
abduction
adduction
dorsiflexion
extension

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Vocabulary – Muscles (Slide 2 of 8)
Term Meaning/Definition
abduction Movement away from midline of body
adduction Movement toward midline of body
dorsiflexion Upper movement of the foot
extension Straightening of a flexed limb

102
Vocabulary – Muscles (Slide 3 of 8)

Term
fascia
flexion
insertion of a muscle
origin of a muscle

103
Vocabulary – Muscles (Slide 4 of 8)
Term Meaning/Definition
fascia Fibrous membrane separating and
enveloping muscles
flexion Downward movement of the foot
insertion of a Connection of the muscle to a bone that
muscle moves
origin of a muscle Connection of the muscle to a stationary
bone

104
Vocabulary – Muscles (Slide 5 of 8)

Term
plantar flexion
pronation
rotation
skeletal muscle

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Vocabulary – Muscles (Slide 6 of 8)
Term Meaning/Definition
plantar flexion Bending the sole of the foot downward
toward the ground
pronation Turning the palm downward
rotation Circular movement around a central point
skeletal muscle Muscle connected to bones; voluntary or
striated muscle

106
Vocabulary – Muscles (Slide 7 of 8)

Term
smooth muscle
striated muscle
supination
visceral muscle

107
Vocabulary – Muscles (Slide 8 of 8)
Term Meaning/Definition
smooth muscle Visceral muscle
striated muscle Skeletal muscle
supination Turning the palm upward
visceral muscle Muscle connected to internal organs;
involuntary or smooth muscle

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 QUICK QUIZ (Slide 4 of 4)
4. Movement AWAY from the midline of
the body is ____________.

A. adduction
B. abduction
C. flexion
D. dorsiflexion

109
Combining Forms and Terminology
Muscles (Slide 1 of 2)
Combining Form Meaning
fasci/o fascia
fibr/o fibrous
leiomy/o smooth muscle
my/o muscle

110
Combining Forms and Terminology
Muscles (Slide 2 of 2)
Combining Form Meaning
myocardi/o heart muscle
myos/o muscle
plant/o sole of the foot
rhabdomy/o skeletal muscle connected to bones
sarco muscles and flesh

111
 Suffixes and Terminology
Muscles
Suffix Meaning
-asthenia lack of strength
-trophy development, nourishment

112
 Prefixes and Terminology
Muscles
Prefix Meaning
ab- away from
ad- toward
dorsi- back
poly- many, much

113
 Pathology — Muscles
• Muscular dystrophy: group of inherited
diseases with progressive muscle weakness
and degeneration without nervous system
involvement

• Polymyositis: chronic inflammatory myopathy;

114
 Laboratory Tests
• Antinuclear antibody test (ANA)
• Erythrocyte sedimentation rate (ESR)
• Rheumatoid factor test (RF)
• Serum calcium (Ca)
• Serum creatine kinase (CK)
• Uric acid test

115
 Clinical Procedures Related to
Bones, Joints, and Muscle
• Arthrocentesis • Discography
• Arthrography • Electromyography (EMG)
• Arthroplasty • Magnetic resonance
• Arthroscopy imaging (MRI)
• Bone density test • Muscle biopsy
• Bone scan
• Computed tomography
(CT)

116
Abbreviations (Slide 1 of 6)
Prefix
AC
ACL
ANA
BKA
BMD
C1 TO C7
Ca
CK
CMC
CTS
DEXA or DXA
DMARD

117
 Abbreviations (Slide 2 of 6)
Prefix Meaning
AC Acromioclavicular (joint)
ACL Anterior cruciate ligament of the knee
ANA Antinuclear antibody
BKA Below-knee amputation
BMD Bone mineral density
C1 TO C7 Cervical vertebrae
Ca Calcium
CK Creatine kinase
CMC Carpometacarpal (joint)
CTS Carpal tunnel syndrome
DEXA or DXA Dual-energy x-ray absorptiometry
DMARD Disease-modifying antirheumatic drug

118
Abbreviations (Slide 3 of 6)
Prefix
DO
DTRs
EMG
ESR (sed rate)
HNP
IM
L1 to L5
NSAID
OA
ORIF
ortho

119
 Abbreviations (Slide 4 of 6)
Prefix Meaning
DO Doctor of osteopathy
DTRs Deep tendon reflexes
EMG Electromyography
ESR (sed rate) Erythrocyte sedimentation rate
HNP Herniated nucleus pulposus
IM Intramuscular
L1 to L5 Lumbar vertebrae
NSAID Nonsteroidal anti-inflammatory drug
OA Osteoarthritis
ORIF Open reduction (of fracture)/ internal fixation
ortho Orthopedics (or orthopaedics)

120
Abbreviations (Slide 5 of 6)
Prefix
OT
P
PT
RA
RF
ROM
SLE
T1 to T12
TKR
THR
TMJ

121
 Abbreviations (Slide 6 of 6)
Prefix Meaning
OT Occupational therapy
P Phosphorus
PT Physical therapy
RA Rheumatoid arthritis
RF Rheumatoid factor
ROM Range of motion
SLE Systemic lupus erythematosus
T1 to T12 Thoracic vertebrae
TKR Total knee replacement/arthroplasty
THR Total hip replacement/arthroplasty
TMJ Temporomandibular joint

122