Musculoskeletal

System
14
Chapter Outline
Anatomy and Physiology, 542 Medical Terms, 558
Functions, 542 Adjectives and Other Related
Structures, 542 Terms, 558
Terms Related to Bone Structure, 542 Symptoms and Medical
Terms Related to the Skeleton and Conditions, 560
Bones, 542 Tests and Procedures, 568
Joints and Joint Movements, 546 Surgical Interventions and
Terms Related to Joints and Joint Therapeutic Procedures, 572
Movements, 546 Medications and Drug
Muscles, 548 Therapies, 578
Terms Related to Muscles, 549 Specialties and Specialists, 579
Abbreviations, 580
Word Parts, 553
Combining Forms, 553 Chapter Review, 582
Prefixes, 555
Suffixes, 555

Objectives
After completion of this chapter you will be able to:
1. Describe the location of key bones and muscles in the body.
2. Define terms related to bone structure, joints, joint movements, and muscles.
3. Define combining forms, prefixes, and suffixes related to the
musculoskeletal system.
4. Define common medical terminology related to the musculoskeletal
system, including adjectives and related terms, symptoms and conditions,
tests and procedures, surgical interventions and therapeutic procedures,
medications and drug therapies, and specialties.
5. Explain abbreviations for terms related to the musculoskeletal system.
6. Successfully complete all chapter exercises.
7. Explain terms used in medical records and case studies involving the
musculoskeletal system.
8. Successfully complete all pronunciation and spelling exercises, and complete all
interactive exercises included with the companion Student Resources.

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 ANATOMY AND PHYSIOLOGY

Functions
 To give shape and structure to the body and provide support
 To allow movement
 To protect internal organs
 To store calcium and other minerals (bones)
 To produce certain blood cells (bone marrow)
 To produce heat (muscles)

Structures
 The body has 206 bones, divided into the axial skeleton and appendicular skeleton.
 The body has more than 600 muscles.
 Bones articulate (meet) at joints where muscles allow for different types of
joint movements.

Terms Related to Bone Structure (Fig. 14-1)

Term Pronunciation Meaning
bone marrow bōn ma’rō soft tissue within bone, with multiple functions including
production of blood cells
cancellous bone, syn. kan’sĕ-lŭs bōn; spŏn’jē meshlike bone tissue (Fig. 14-2)
spongy bone bōn
compact bone kŏm-pakt’ bōn harder, denser bone (Fig. 14-2)
diaphysis dī-af’i-sis the shaft of a long bone
endosteum en-dos’tē-ŭm membrane within medullary cavity
epiphysis e-pif’i-sis the wider ends of a long bone
epiphysial plate ep’i-fiz’ē-ăl plāt the growth area of a long bone
medullary cavity med’ŭ-lar’ē kav’i-tē space within long bone shaft filled with bone marrow
metaphysis mĕ-taf’i-sis the flared section of a long bone between the diaphysis and
epiphysis
os, pl. ossa os, os’ă bone
osteoblast os’tē-ō-blast bone-forming cell
osteoclast os’tē-ō-klast a cell that helps remove osseous (bony) tissue
osteocyte os’tē-ō-sīt bone cell
periosteum per’ē-os’tē-ŭm membrane surrounding a bone

Terms Related to the Skeleton and Bones (Fig. 14-3)

Term Pronunciation Meaning
The Skeleton
axial skeleton ak’sē-ăl skel’ĕ-tŏn bones of the skull, spine, and chest
appendicular skeleton ap’ĕn-dik’yŭ-lăr skel’ĕ-tŏn bones of the upper and lower limbs, shoulder, and pelvis
thorax thō’raks the chest
(continued)

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Cancellous bone

Proximal
epiphysis Epiphyseal plate

Periosteum

Compact bone

Medullary cavity
Diaphysis

Distal
epiphysis
Figure 14-2 Types of bone tissue.
Cancellous bone makes up most of the
epiphysis of this long bone (arrows). A
Figure 14-1 The external and internal thin layer of compact bone is seen at
composition of a long bone. the surface.

Terms Related to the Skeleton and Bones (continued)

Term Pronunciation Meaning
Bones
acetabulum as-ĕ-tab’yū-lŭm the socket of the pelvic bone where the femur articulates
acromion ă-krō’mē-on lateral upper section of the scapula
calcaneus kal-kā’nē-ŭs bone of the heel
carpal bones kahr’păl bōnz the eight bones of the wrist
clavicle klav’i-kĕl collarbone
cranium krā’nē-ŭm the skull; composed of eight bones
femur fē’mŭr bone of the upper leg
fibula fib’yū-lă smaller, outer bone of the lower leg
humerus hyū’mĕr-ŭs bone of the upper arm
hyoid hī’oyd bone beneath the mandible
lamina lam’i-nă posterior section of a vertebra
mandible man’di-bĕl lower bone of the jaw
(continued)

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Cranium
Mandible
Vertebrae: Clavicle
Acromion
Cervical
Scapula
Ribs
Thoracic Sternum
Humerus
Costal
Lumbar cartilages
Sacrum

Pelvic bone Radius

Ulna
Carpal bones
Metacarpal Acetabulum
bones
Phalanges Coccyx

Femur

Patella

Tibia

Fibula

Tarsal bones

Metatarsal bones
Phalanges

Calcaneus

Figure 14-3 An anterior view of the skeleton with major bones identified.

Terms Related to the Skeleton and Bones (continued)

Term Pronunciation Meaning
maxilla mak-sil’ă upper bone of the jaw
metacarpal bones met’ă-kahr’păl bōnz the five bones of the palm of the hand
metatarsal bones met’ă-tahr’săl bōnz the five bones of the foot
patella pă-tel’ă kneecap
pelvic bone pel’vik bōn the hip bone, composed of three fused bones on each side
ischium is’kē-ŭm posterior lower section of the pelvic bone
ilium il’ē-ŭm upper section of the pelvic bone
pubis pyū’bis anterior lower section of pelvic bone; pubic bone
phalanges fă-lan’-jēz the bones of the fingers and toes; 14 in each hand or foot
(continued)

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Terms Related to the Skeleton and Bones (continued)

Term Pronunciation Meaning
radius rā’dē-ŭs the outer of two bones of the lower arm
ribs ribz long curved bones that form the bony wall of the chest
scapula skap’yū-lă shoulder blade
sternum stĕr’nŭm anterior bone of thorax; breast bone
tarsal bones tahr’săl bōnz the seven bones of the ankle
tibia tib’ē-ă larger inner bone of the lower leg
ulna ŭl’nă the more inner of two bones of the lower arm
vertebra vĕr’tĕ-bră a bone of the spine (Fig. 14-4)
cervical vertebrae (C1–C7) sĕr’vi-kăl vĕr’tĕ-brā bones of neck
thoracic vertebrae (T1–T12) thōr-as’ik vĕr’tĕ-brā bones of midspine
lumbar vertebrae (L1–L5) lŭm’bahr vĕr’tĕ-brā bones of lower back
sacrum sā’krŭm five fused vertebrae below the lumbar spine
coccyx kok’siks four fused vertebrae at the lower end of the spine, below
the sacrum; the tailbone
xiphoid process zī’foyd pros’es lower section of the sternum

Cervical vertebrae

Thoracic vertebrae

Lumbar vertebrae

Sacrum

Figure 14-4 The vertebral column

Coccyx showing the types of vertebrae.

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View the Vertebral Disk video on the electronic Student Resources to learn
more about the structure of the bones of the spine.

Joints and Joint Movements

 Joints occur wherever bones come together.
 Joints are categorized by the movements they perform.
 Terms for joint movements are based on the type and direction of movement.

Terms Related to Joints and Joint Movements

Term Pronunciation Meaning
Joints
articulation ahr-tik’yū-lā’shŭn the site where bones come together
bursa bŭr’să a fluid-filled fibrous sac within some joints
cartilage kahr’ti-lăj dense connective tissue attached to bone in many joints
synovial joint, syn. si-nō’vē-ăl joynt, a joint that moves freely; the joint cavity contains synovial fluid
diarthrosis dī’ahr-thrō’sis (Fig. 14-5)
intervertebral disk in’tĕr-vĕr’tĕ-brăl disk platelike structure of connective tissue between vertebrae
(or disc)
ligament lig’ă-mĕnt band of strong connective tissue joining bones
(continued)

Femur

Synovial membrane

Synovial fluid

Patella
Articular cartilage

Bursae
Meniscus

Tibia

Figure 14-5 The knee is a synovial joint.

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Terms Related to Joints and Joint Movements (continued)

Term Pronunciation Meaning
meniscus mĕ-nis’kŭs cartilage structure in the knee
suture sū’chŭr an immovable joint, such as that which joins the bones of the skull

SUTURE When we think of joints, we think of those joints that move. Your
skull also has joints, but the joints of the skull do not move. These joints,
called sutures, hold the bones of the skull together, just as surgical sutures
(or “stitches”) hold two surfaces together.

symphysis sim’fi-sis a joint that moves only slightly

synovial fluid si-nō’vē-ăl flū’id lubricating fluid in a freely moving joint
tendon ten’dŏn band of fibrous connective tissue attaching a muscle to a bone
Joint Movements (Fig. 14-6)
abduction ab-dŭk’shŭn moving away from the midline
adduction ă-dŭk’shŭn moving toward the midline
circumduction sĭr’kŭm-dŭk’shŭn moving in a circular manner
inversion in-vĕr’zhŭn turning inward
eversion ē-vĕr’zhŭn turning outward
dorsiflexion dōr-si-flek’shŭn bending foot upward
plantar flexion plan’tahr flek’shŭn bending foot downward
extension eks-ten’shŭn motion that increases the joint angle
flexion flek’shŭn motion that decreases the joint angle
pronation prō-nā’shŭn turning downward (palm of hand or sole of foot)
supination sū’pi-nā’shŭn turning upward (palm of hand or sole of foot)
rotation rō-tā’shŭn moving in circular direction around an axis

Adduction, abduction: When distinguishing abduction from adduction, remember

the common word abduct, meaning to take away. Adduction has the word “add,”
meaning to bring to.

View the animation entitled Muscle Extension and Flexion for a

demonstration of muscles at work.

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Extension Flexion

Abduction Medial
rotation

Lateral
rotation
Adduction

Medial
rotation
Extension Flexion

Lateral
rotation

Abduction
Adduction

Eversion Inversion Plantar

flexion

Dorsiflexion

Supination Pronation

Cirumduction

Figure 14-6 Most joints are capable of several types of movement.

Muscles
 The three types of muscle tissue in the body are skeletal muscle, smooth
muscle, and cardiac muscle.
 Muscles are composed of bundles of muscle fibers along with other tissues.
 Tendons attach muscles to bones in or near joints.

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Frontalis
Temporalis
Orbicularis oculi Occipitalis

Zygomaticus Sternocleido-
Sternocleido-
Masseter mastoid
mastoid
Orbicularis oris Trapezius
Trapezius Infraspinatus
Deltoid
Deltoid
Rhom-
Pectoralis Teres major boideus
Serratus major
Teres minor Latissimus
anterior Biceps dorsi
Triceps
Rectus brachii
brachii Brachialis
abdominis Brachialis Brachio- External
External radialis
Brachio- oblique
oblique
radialis

Gluteus
Tensor medius
fasciae
latae Sartorius Gluteus
maximus
Adductor
Biceps femoris
Rectus femoris longus
Adductor
Gracilis Semitendinosus magnus
Vastus lateralis

Vastus medialis Semimembranosus

Sartorius
Peroneus
longus
Gastrocnemius
Extensor Gastrocnemius
digitorum
longus Soleus Soleus
Tibialis
Calcaneal tendon
anterior Peroneus
longus

A. B.
Figure 14-7 Skeletal muscles of the body. A. Anterior view. B. Posterior view.

Terms Related to Muscles (Fig. 14-7)

Term Pronunciation Meaning
agonist ag’ŏn-ist skeletal muscle that creates a movement by contracting; prime mover
antagonist an-tag’ŏ-nist skeletal muscle that opposes an agonist muscle and relaxes when the
agonist contracts
cardiac muscle kahr’dē-ak mŭs’ĕl heart muscle (Fig. 14-8)
fascia fash’ē-ă sheet of connective tissue covering a muscle
fascicle fas’i-kĕl bundle of muscle fibers (Fig. 14-10)
(continued)

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Skeletal muscle Smooth muscle

Tendons Origins

Biceps brachii

Insertion
Cardiac muscle

Scapula

Radius

Ulna Humerus
Tendon
Figure 14-8 Muscles have varying
internal characteristics depending on Figure 14-9 Muscles are attached to bones by
their function. tendons.

Muscle fiber

Muscle fascicle

Body of muscle
Blood vessels

Tendon

Bone
Figure 14-10 The structure of a skeletal
muscle.

Terms Related to Muscles (continued)

Term Pronunciation Meaning
insertion of muscle in-sĕr’shŭn mŭs’ĕl end of muscle attached to bone that moves during contraction (Fig. 14-9)
origin of muscle ōr’i-jin mŭs’ĕl end of muscle attached to bone that does not move during contraction
smooth muscle, syn. smūth mŭs’ĕl, type of muscle not under voluntary control; present in internal organs
unstriated muscle ŭn-strī’āt-ĕd mŭs’ĕl (Fig. 14-8)
skeletal muscle, syn. skel’ĕ-tăl mŭs’ĕl, type of muscle under voluntary control (“striated” refers to light and dark
striated muscle strī’āt-ĕd mŭs’ĕl bands in muscle fibers) (Fig. 14-10, also Fig. 14-8)
tonus tō’nŭs muscle tone

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 Exercises: Anatomy and Physiology

Exercise 1
Write the correct anatomic structure for the definition given.

1. bone of upper arm

2. bones of the palm

3. shoulder blade

4. breast bone

5. shaft of long bone

6. attaches muscle to bone

7. bundle of muscle fibers

8. bone of the heel

9. bones of the skull, spine, chest

10. a bone of the spine

Exercise 2
Write the meaning of the term given.

1. abduction

2. ligament

3. articulation

4. dorsiflexion

5. acetabulum

6. cranium

7. mandible

8. synovial joint

9. maxilla

10. cartilage

11. epiphysial plate

12. ossa

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Exercise 3
Circle the term that is most appropriate for the meaning of the sentence.

1. A severe injury to the kneecap may involve a fractured (cerebellum, patella, scapula).

2. The cartilage structure in the knee is called the (synovium, meniscus, bursa).

3. Muscle tissue present in internal organs is (unstriated, agonist, fascial).

4. (Synovial fluid, Endosteum, Fascia) is a sheet of connective tissue covering a muscle.

5. The smaller bone in the lower leg is the ( femur, ulna, fibula).

6. The (epiphysis, ilium, patella), or upper section of the pelvic bone, connects with the ischium
and pubis.

7. The (tibia, sacrum, lamina) is a part of each vertebra.

8. The (clavicle, metaphysis, radius) articulates with the acromion at one end and the top of the
sternum at the other end.

9. Between the diaphysis and the epiphysis of a long bone is the (metaphysis, meniscus, diarthrosis).

10. The large inner bone of the lower leg is the (tibia, ulna, radius).

11. A (tendon, fascia, bursa) is a fluid-filled fibrous sac within some joints.

12. The (ischium, ilium, pubis) is the posterior lower section of the pelvic bone, whereas the
(ischium, ilium, pubis) is the anterior lower section of the pelvic bone.

13. The plural of vertebra is (vertebrum, vertebras, vertebrae).

14. The metatarsal bones are just distal to the (tarsal, carpal, phalangeal) bones.

15. Movement that decreases the joint angle is termed (extension, flexion, inversion).

Exercise 4
Match each medical term with its meaning.

cancellous bone ulna carpal bones endosteum sacrum

intervertebral disk radius compact bone ossa osteocyte

Meaning Term

1. membrane within medullary cavity

2. strong solid bone tissue

3. outer bone in lower arm

4. eight bones of wrist

5. spongy bone

6. composed of fused vertebrae

7. connective tissue between vertebrae

8. inner bone in lower arm

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9. bones

10. bone cell

Exercise 5
Complete each sentence by writing in the correct medical term.

1. A patient with a broken collarbone has a fracture of the .

2. A fracture of the upper arm bone, the , is generally painful.

3. Bone tissue that is spongy and meshlike is called bone.

4. A(n) is a band of strong connective tissue that joins bones together

at a joint.

5. The end of a muscle attached to bone that moves with contraction is called the
of the muscle.

6. A(n) is a skeletal muscle that opposes a prime mover.

7. Skeletal muscle is , whereas smooth muscle is .

8. A freely moving joint is lubricated by fluid.

9. The movement of turning the foot outward is called .

10. The type of immovable joint connecting skull bones is a(n) .

11. Bones in many types of joint are joined by , a dense connective tissue.

12. Just above the coccyx is the spinal structure called the .

 WORD PARTS
Note that some word parts that have been introduced earlier in the book may not
be repeated here.

Combining Forms
Combining Form Meaning
ankyl/o stiff
arthr/o, articul/o joint
burs/o bursa
carp/o carpal bones
chondr/o cartilage
clavic/o, clavicul/o clavicle
cervic/o neck
cost/o rib
crani/o cranium, skull
(continued)

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Combining Forms (continued)

Combining Form Meaning
disk/o disk or disc
fasci/o fascia, band
femor/o femur
fibul/o fibula
humer/o humerus
ili/o ilium
ischi/o ischium
kinesi/o, kinet/o movement
kyph/o humpback
lei/o smooth
lamin/o lamina
lord/o curved, bent
lumb/o lumbar region, lower back
mandibul/o mandible
maxill/o maxilla
menisc/o meniscus
my/o, myos/o, muscul/o muscle
myel/o bone marrow, spinal cord
oste/o bone
patell/o patella
pelv/i, pelv/o pelvis, pelvic cavity
phalang/o phalanges
pub/o pubis
rachi/o spine
radi/o radius
rhabd/o striated muscle
sacr/o sacrum
scapul/o scapula
scoli/o crooked, twisted
stern/o sternum
synovi/o synovial joint or fluid
tars/o tarsal bones
ten/o, tend/o, tendin/o tendon
thorac/o thorax, chest
ton/o tone, tension
uln/o ulna
vertebr/o, spondyl/o vertebra

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Prefixes
Prefix Meaning
inter- between
intra- within
supra- above
sub- below, beneath
sym-, syn- together, with

Suffixes
Suffix Meaning
-algia pain
-asthenia weakness
-centesis puncture to aspirate
-clasia, -clasis, -clast to break
-desis surgical fixation, binding
-ectomy excision, surgical removal
-itis inflammation
-osis abnormal condition
-physis growth
-plasty surgical repair, reconstruction
-porosis pore, passage
-rrhaphy suture
-schisis to split
-trophy development, nourishment

 Exercises: Word Parts

Exercise 6
Write the meaning of the combining form given.

1. crani/o

2. lumb/o

3. scoli/o

4. oste/o

5. stern/o

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6. maxill/o

7. chondr/o

8. carp/o

9. ten/o, tend/o

10. spondyl/o

11. fasci/o

12. my/o, myos/o

13. mandibul/o

14. sacr/o

15. femor/o

Exercise 7
Write the correct combining form(s) for the meaning given.

1. rib

2. tarsal bones

3. smooth

4. fibula

5. bursa

6. joint

7. pelvis

8. chest

9. ischium

10. collarbone

11. lamina

12. neck

13. meniscus

14. phalanges

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Exercise 8
Write the meaning of the prefix or suffix given.

1. -plasty

2. -asthenia

3. sub-

4. -desis

5. -ectomy

6. -physis

7. -rrhaphy

8. sym-

9. -schisis

10. -clasis

Exercise 9
Considering the meaning of the combining form from which the medical term
is made, write the meaning of the medical term. (You have not yet learned
many of these terms but can build their meaning from the word parts.)

Combining Form Meaning Medical Term Meaning of Term

oste/o bone osteitis 1.

lord/o bent (forward) lordosis 2.

my/o muscle myalgia 3.

burs/o bursa bursitis 4.

maxill/o maxilla maxillitis 5.

scapul/o scapula subscapular 6.

pelv/i pelvis pelvic 7.

tend/o tendon tendonitis 8.

vertebr/o vertebra intervertebral 9.

arthr/o joint arthroplasty 10.

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Exercise 10
Using the given combining form and a word part from the earlier tables, build
a medical term for the meaning given.

Combining Form Meaning of Medical Term Medical Term

myos/o inflammation of muscle 1.

crani/o surgical repair of skull 2.

patell/o excision of patella 3.

ten/o suture of tendon 4.

arthr/o pain in a joint 5.

crani/o pertaining to within the skull 6.

tars/o excision of tarsal bone 7.

menisci/o inflammation of a meniscus 8.

disk/o excision of intervertebral disk 9.

chondr/o surgical repair of cartilage 10.

 MEDICAL TERMS
Adjectives and Other Related Terms
Term Pronunciation Meaning
carpal kahr’păl pertaining to the carpal bones
costovertebral kos’tō-vĕr’tĕ-brăl pertaining to the ribs and thoracic vertebrae
cranial krā’nē-ăl pertaining to the skull
femoral fem’ŏr-ăl pertaining to the femur
humeral hyū’mĕr-ăl pertaining to the humerus
iliofemoral il’ē-ō-fem’ŏr-ăl pertaining to the ilium and femur
intercostal in’tĕr-kos’tăl pertaining to the area between the ribs
intervertebral in’tĕr-vĕr’tĕ-brăl pertaining to the area between vertebrae
intracranial in-tră-krā’nē-ăl pertaining to the area within the skull
ischiofemoral is’kē-ō-fem’ŏr-ăl pertaining to the ischium and femur
lumbar lŭm’bahr pertaining to the lower back
lumbocostal lŭm’bō-kos’tăl pertaining to the lumbar vertebrae and ribs
(continued)

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Adjectives and Other Related Terms (continued)

Term Pronunciation Meaning
lumbosacral lŭm’bō-sā’krăl pertaining to the lumbar vertebrae and sacrum
osseous os’ē-ŭs pertaining to bone
pelvic pel’vik pertaining to the pelvis or pelvic cavity
sacral sā’krăl pertaining to the sacrum
sacrovertebral sā’krō-vĕr’tĕ-brăl pertaining to the sacrum and the vertebrae above
sternoclavicular stĕr’nō-klă-vik’yū-lăr pertaining to the sternum and clavicle
sternoid stĕr’noyd resembling the sternum
subcostal sŭb-kos’tăl pertaining to the area below a rib or the ribs
submandibular sŭb’man-dib’yū-lăr pertaining to the area below the mandible
submaxillary sŭb-mak’si-lar-ē pertaining to the area below the maxilla
subscapular sŭb-skap’yū-lăr pertaining to the area below the scapula
substernal sŭb-stĕr’năl pertaining to the area below the sternum
suprapatellar sū’pră-pă-tel’ăr pertaining to the area above the patella
suprascapular sū’pră-skap’yū-lăr pertaining to the area above the scapula
synovial si-nō’vē-ăl pertaining to, containing, or consisting of synovial fluid

 Exercises: Adjectives and Other Related Terms

Exercise 11
Circle the term that is most appropriate for the meaning of the sentence.

1. An (iliofemoral, ischiopubic, intercostal) wound is located between the ribs.

2. A broken upper leg bone is called a (humeral, cranial, femoral) fracture.

3. A herniated (intervertebral, carpal, sternoclavicular) disk involves an injury to the disks

between the vertebrae.

4. The (ischiofemoral, lumbocostal, subscapular) area includes both the ischium and femur.

5. Diagnosing a knee condition may require a needle puncture to draw (submaxillary, sternoid,
synovial) fluid for testing.

6. A(n) (substernal, pelvic, osseous) examination includes all of the organs in the pelvis.

7. The area below the shoulder blade is called the (subcostal, pubofemoral, subscapular)
region.

8. A wrist injury may involve a (carpal, subcostal, sternoid) fracture.

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 560 MEDICAL TERMINOLOGY

Exercise 12
Match each medical term with its meaning.

substernal costovertebral intracranial intervertebral

lumbar submandibular suprapatellar sacral
humeral lumbosacral intercostal cranial

Meaning Term

1. pertaining to the humerus

2. pertaining to the area between ribs

3. pertaining to the area below the sternum

4. pertaining to the area above the patella

5. pertaining to the skull

6. pertaining to the sacrum

7. pertaining to the area between vertebrae

8. pertaining to the area within the skull

9. pertaining to the lower back

10. pertaining to the ribs and thoracic vertebrae

11. pertaining to the area below the mandible

12. pertaining to the lumbar vertebrae and sacrum

Symptoms and Medical Conditions

Term Pronunciation Meaning
ankylosing spondylitis ang’ki-lōs-ing spon’di-lī’tis arthritis of the spine
ankylosis ang’ki-lō’sis abnormal condition of stiffening or fixation of a joint
arthralgia ahr-thral’jē-ă condition of pain in a joint
arthritis ahr-thrī’tis inflammation of a joint (Fig. 14-11)
arthrochondritis ahr’thrō-kon-drī’tis inflammation of an articular cartilage
atrophy at’rŏ-fē a wasting of tissue or an organ
bradykinesia brad’ē-kin-ē’sē-ă condition of decreased movement
bunion bŭn’yŏn swelling at metatarsophalangeal joint caused by
inflammatory bursa
bursitis bŭr-sī’tis inflammation of a bursa
bursolith bŭr’sō-lith a calculus (stone) formed in a bursa
(continued)

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 Chapter 14 Musculoskeletal System 561

Normal Early Stage Late Stage

Joint Inflammation
Bone capsule stretches
joint capsule

Cartilage
Articular particles
cartilage Cartilage
Loss of
degenerates
cartilage

Figure 14-11 Progressive joint changes in arthritis of the knee.

Symptoms and Medical Conditions (continued)

Term Pronunciation Meaning
carpal tunnel syndrome kahr’păl tŭn’ĕl sin’drōm nerve entrapment syndrome in the wrist, causing pain
(CTS)
carpoptosis, syn. kar’pop-tō’sis, rist drop paralysis of wrist and finger muscles
wrist-drop
chondromalacia kon’drō-mă-lā’shē-ă softening of a cartilage
cranioschisis krā’nē-os’ki-sis congenital incomplete closure of the skull
curvature of the spine kŭr’vă-chŭr spīn abnormal curving of the spine in one or more directions
(Fig. 14-12)
kyphosis kī-fō’sis abnormal forward curvature; humpback
lordosis lōr-dō’sis abnormal backward curvature
scoliosis skō’lē-ō’sis abnormal lateral curvature
dyskinesia dis’ki-nē’sē-ă difficulty performing voluntary movements
(continued)

A. Normal B. Kyphosis C. Lordosis D. Scoliosis

Figure 14-12 Curvatures of the spine can cause pain and disfigurement.

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 562 MEDICAL TERMINOLOGY

Comminuted Spiral Transverse Greenstick Compound Simple

(open) (closed)

Figure 14-13 Common types of fractures.

Symptoms and Medical Conditions (continued)

Term Pronunciation Meaning
dystrophy dis’trŏ-fē abnormal development or growth of a tissue or organ often
resulting from nutritional deficiency
exostosis eks’os-tō’sis bony projection that develops from cartilage
fibromyalgia fī’brō-mī-al’jē-ă condition of chronic aching and stiffness of muscles and soft
tissues of unknown cause
fracture (fx) frak’shŭr a break in a bone or cartilage (Figs. 14-13 and 14-14)
gout gowt metabolic disorder involving painful deposits of crystals in
connective tissue and articular cartilage
(continued)

Figure 14-14 Depressed skull fracture.

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 Chapter 14 Musculoskeletal System 563

Normal
disk

Spinal nerves Herniated

Spinous process nucleus pulposus
impinging on Herniated
spinal nerve disk

Spinal nerve root

Herniated disk

Fibrocartilage

Sacrum
A. B.
Figure 14-15 Protrusion of a herniated disk through the fibrocartilage. A. Cross-section view. B. Lateral view.

Symptoms and Medical Conditions (continued)

Term Pronunciation Meaning
herniated disk (or disc) hĕr’nē-ā-tĕd disk protrusion of a degenerated or fragmented intervertebral disk
(Fig. 14-15)
hyperkinesia hī’pĕr-ki-nē’zē-ă condition of excessive muscular movements
hypertrophy hī-pĕr’trō-fē increased development of a part or organ not caused by a tumor
maxillitis mak’si-lī’tis inflammation of the maxilla
meniscitis men-i-sī’tis inflammation of a meniscus
muscular dystrophy mŭs’kyū-lăr dis’trŏ-fē hereditary condition causing progressive degeneration of
(MD) skeletal muscles

MUSCULAR DYSTROPHY While there are several variations of muscular dystrophy,

there are two prominent types. They are called Becker and Duchenne. Both of these are
X-linked, which means the mother can pass along this genetic mutation to the children.
However, muscular dystrophy affects more boys than girls.

myalgia mī-al’jē-ă condition of muscular pain

myasthenia gravis (MG) mī-as-thē’nē-ă gra’vis condition of neuromuscular disorder causing weakness and
fatigue of voluntary muscles
myositis mī-ō-sī’tis inflammation of a muscle
osteitis os-tē-ī’tis inflammation of bone
(continued)

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 564 MEDICAL TERMINOLOGY

Symptoms and Medical Conditions (continued)

Term Pronunciation Meaning
osteoarthritis (OA) os’tē-ō-ahr-thrī’tis arthritis involving erosion and inflammation of articular cartilage
osteochondritis os’tē-ō-kon-drī’tis inflammation of a bone and its articular cartilage
osteomalacia os’tē-ō-mă-lā’shē-ă condition of softening of bones
osteomyelitis os’tē-ō-mī-ĕ-lī’tis inflammation of bone marrow
osteonecrosis os’tē-ō-nĕ-krō’sis condition or process of bone tissue death
osteoporosis os’tē-ō-pŏr-ō’sis age-related disorder of decreased bone mass and weakening
(Fig. 14-16)
polymyositis pol’ē-mī’ō-sī’tis inflammation of multiple voluntary muscles
rachischisis ră-kis’ki-sis embryologic failure of vertebral arches to fuse
rheumatoid arthritis rū’mă-toyd ahr-thrī’tis disease causing progressive destructive changes and
(RA) inflammation in multiple joints, especially in the hands and
feet (Fig. 14-17)
rickets rik’ĕts disease caused by vitamin D deficiency, involving skeletal
deformities and muscular weakness
spondylarthritis spon’dil-ahr-thrī’tis inflammation of intervertebral articulations
sprain sprān injury of a ligament caused by abnormal or excessive forces
on a joint
strain strān injury of a muscle caused by overuse or improper use
tendonitis, tendinitis ten’dŏ-nī’tis, ten’di-nī’tis inflammation of a tendon
tenodynia ten-ō-din’ē-ă condition of pain in a tendon
tenosynovitis ten’ō-sin-ō-vī’tis inflammation of a tendon and its sheath

Figure 14-16 Bone becomes less dense in osteoporosis.

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 Chapter 14 Musculoskeletal System 565

A. B.
Figure 14-17 The changes of severe rheumatoid arthritis. A. X-ray of normal hand. B. Hand severely deformed from
rheumatoid arthritis.

 Exercises: Symptoms and Medical Conditions

Exercise 13
Write the correct medical term for the definition given.

1. abnormal lateral curvature of spine

2. inflamed tendon

3. break in a bone

4. softening of cartilage

5. inflamed bursa

6. decreased bone mass

7. disease caused by vitamin D deficiency

8. pain in a tendon

9. inflamed intervertebral articulations

10. arthritis of the spine

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 566 MEDICAL TERMINOLOGY

11. abnormal forward curvature of spine

12. pain in a joint

13. inflammation of a joint

14. softening of bone

Exercise 14
Circle the term that is most appropriate for the meaning of the sentence.

1. Mrs. Jones presented with weakness and fatigue in her voluntary muscles, and, after clinical
study, her physician diagnosed her condition as (myasthenia, myalgia, myositis) gravis.

2. Mr. Carelton was seen in follow-up for his condition of inflammation of multiple voluntary
muscles, also called (polymyositis, carpal tunnel syndrome, atrophy).

3. Dr. Gonzalez informed Mr. Lawson that when (gout, fibromyalgia, osteitis) occurs, crystals are
deposited in connective tissue and articular cartilage.

4. Young Bridget LaRoux suffered a(n) (sprain, strain, atrophy) to her calf muscle and a(n)
(sprain, strain, atrophy) to one of her ligaments.

5. Mrs. Anderson suffers from progressive destructive changes in multiple joints caused by
(muscular dystrophy, rheumatoid arthritis, myasthenia gravis).

6. After spending years in chronic pain without a known cause, the patient was diagnosed with
( fibromyalgia, gout, hypertrophy).

7. After his x-ray report showed a stone in his elbow area, the patient was told that he had a(n)
(bunion, bursolith, exostosis).

8. Mrs. Gabai had (atrophy, hypertrophy, dystrophy) of her lower limbs after spending many
years in a wheelchair.

9. The physician diagnosed Ms. Allen with (carpal, metacarpal, tarsal) tunnel syndrome after
she complained of pain in her wrist after many years of repetitive work.

10. Mr. Kowalski suffered from (osteitis, dyskinesia, exostosis) after his stroke.

11. After reporting pain in his left throwing arm, the baseball player was diagnosed with
inflammation of a tendon and its sheath, also called (tenosynovitis, tenodynia, osteochondritis).

Exercise 15
Build a medical term from an appropriate combining form and suffix, given
their meanings.

Use Combining Form for Use Suffix for Term

1. joint inflammation

2. joint pain

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 Chapter 14 Musculoskeletal System 567

3. spine split

4. maxilla inflammation

5. tendon pain

6. bursa inflammation

7. muscle pain

8. joint and cartilage inflammation

9. bone softening

Exercise 16
Break the given medical term into its word parts and define each part. Then
define the medical term. (Note: This exercise uses some suffixes learned
previously.)

For example:
arthritis word parts: arthr/o / -itis
meanings: joint / inflammation
term meaning: inflammation of a joint

1. hypertrophy word parts: /

meanings: /

term meaning:

2. scoliosis word parts: /

meanings: /

term meaning:

3. cranioschisis word parts: /

meanings: /

term meaning:

4. carpoptosis word parts: /

meanings: /

term meaning:

5. ankylosis word parts: /

meanings: /

term meaning:

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 568 MEDICAL TERMINOLOGY

6. bursolith word parts: /

meanings: /

term meaning:

7. atrophy word parts: /

meanings: /

term meaning:

8. osteitis word parts: /

meanings: /

term meaning:

9. bradykinesia word parts: / /

meanings: / /

term meaning:

10. polymyositis word parts: / /

meanings: / /

term meaning:

Tests and Procedures

Term Pronunciation Meaning
Laboratory Tests
creatine kinase (CK) krē’ă-tin kī’nās test for the presence of the enzyme creatine kinase in the blood that
may indicate conditions that can cause muscle weakness or pain
erythrocyte sedimentation ĕ-rith’rŏ-sīt sed’i- time measurement of red blood cells settling in a test tube over
rate (ESR) mĕn-tā’shŭn rāt 1 hour; used to assess for inflammatory or necrotic conditions
rheumatoid factor (RF) rū’mă-toyd fak’tŏr blood test used to help diagnose rheumatoid arthritis
synovial fluid analysis si-nō’vē-ăl flū’id test for the presence of crystals caused by some conditions,
ă-nal’i-sis such as arthritis, and also signs of joint infection
uric acid yūr’ik as’id test for elevated presence of uric acid in the blood, indicating gout
Diagnostic Procedures
arthrography ahr-throg’ră-fē x-ray imaging of a joint using a contrast agent
arthroscopy ahr-thros’kŏ-pē endoscopic examination of the interior of a joint (Fig. 14-18)
bone densitometry dens’i-tom’ĕ-trē x-ray technique for determining density of bone
bone scan bōn skan nuclear medicine imaging of bone to diagnose bone disorders
(Fig. 14-19)
(continued)

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Endoscope

Patella

Tibia

Femur

A. B.
Figure 14-18 A. Arthroscopic examination of the knee. B. Endoscopic view of joint interior.

Figure 14-19 Whole body nuclear medicine bone scan.

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 570 MEDICAL TERMINOLOGY

Figure 14-20 Computed tomography (CT) scans with three-dimensional reconstruction demonstrating different types
of fractures.

Tests and Procedures (continued)

Term Pronunciation Meaning
computed tomography kŏm-pyū’tĕd x-ray technique producing computer-generated cross-sectional
(CT) tŏ-mog’ră-fē images; used to evaluate disorders of and injuries to the
musculoskeletal system (Fig. 14-20)
electromyogram (EMG) ĕ-lek’trō-mī’ō-gram diagnostic test producing graphic record of electric currents
associated with muscular action (Fig. 14-21)
magnetic resonance mag-net’ik rez’ŏ-năns imaging technique that uses magnetic fields and radiofrequency
imaging (MRI) im’ăj-ing waves to visualize anatomic structures; often used for
diagnosing joint disorders (Fig. 14-22)
radiography rā’dē-og’ră-fē examination of any part of the body by x-ray
range of motion (ROM) rānj mō’shŭn measurement of the amount of movement allowed in a joint
testing

Range of motion testing is done to assess a patient’s joint motion, and range of
motion exercises are used to preserve or increase the amount of movement
allowed in a joint. An instrument called a goniometer measures the range of
motion of a joint.

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 Chapter 14 Musculoskeletal System 571

L2 vertebral body

Normal L2-L3
intervertebral disk

Figure 14-21 Electromyography. Figure 14-22 Magnetic resonance imaging (MRI)

of a herniated intervertebral disk (arrows).

 Exercises: Tests and Procedures

Exercise 17
Circle the term that is most appropriate for the meaning of the sentence.

1. Wanting a cross-sectional view of the lateral meniscus, the orthopedist ordered a procedure
using (computed tomography, arthroscopy, range of motion testing).

2. A record of the electrical currents associated with muscular action is called a(n) (arthrogram,
radiograph, electromyogram).

3. (Magnetic resonance imaging, Arthroscopy, Arthrography) is a radiographic technique for

imaging a joint, usually after administering a contrast agent.

4. A bone scan is produced with (nuclear medicine imaging, endoscopy, arthrography).

5. The examination of any part of the body by x-ray is called (radiography, electromyography,
computed tomography).

6. The laboratory test for (creatine kinase, rheumatoid factor, uric acid) may help diagnose
conditions that cause muscle weakness and pain.

7. (Rheumatoid factor, Uric acid, Creatine kinase) is the laboratory test that indicates gout.

8. The laboratory test that will help determine the presence of rheumatoid arthritis is called
(erythrocyte sedimentation rate, uric acid, rheumatoid factor).

Exercise 18
Complete each sentence by writing in the correct medical term.

1. The radiographic technique used to determine bone density is called .

2. The amount of movement a joint allows can be determined by .

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 572 MEDICAL TERMINOLOGY

3. The use of nuclear medicine imaging of bone to diagnose bone disorders is called
a(n) .

4. An interior joint space can be viewed through an endoscope in .

5. The diagnostic modality based on the effects of a magnetic field on body tissues is
called .

6. The laboratory test that can indicate inflammation in the body is called .

7. The laboratory test that may detect crystals caused by certain conditions and also signs of joint
infection is called .

Surgical Interventions and Therapeutic Procedures

Term Pronunciation Meaning
arthrocentesis ahr’thrō-sen-tē’sis needle puncture to remove fluid from a joint (Fig. 14-23)
arthroclasia ahr’thrō-klā’zē-ă surgical breaking of adhesions in ankylosis
arthrodesis ahr-throd’ĕ-sis surgical artificial stiffening of a joint
arthroplasty ahr’thrō-plas-tē surgical restoration of joint function or creation of an artificial joint (such as
a total hip or knee replacement)
bursectomy bŭr-sek’tŏ-mē excision of a bursa
carpectomy kahr-pek’tŏ-mē excision of part or all of the carpal bones
chondrectomy kon-drek’tŏ-mē excision of cartilage
chondroplasty kon’drō-plas-tē surgical repair of cartilage
costectomy kos-tek’tŏ-mē excision of a rib
cranioplasty krā’nē-ō-plas-tē surgical repair of the skull
craniotomy krā’nē-ot’ŏ-mē surgical creation of an opening (incision) into the skull
diskectomy disk-ek’tŏ-mē excision of part or all of an intervertebral disk (Fig. 14-24)
laminectomy lam’i-nek’tŏ-mē excision of a vertebral lamina
laminotomy, syn. lam-i-not’ŏ-mē, enlargement of the intervertebral foramen by excision of a portion of
rachiotomy rā’kē-ot’ŏ-mē the lamina
maxillotomy mak’si-lot’ŏ-mē surgical resection of the maxilla

(continued)

Palmaris longus tendon

Carpal tunnel

Figure 14-23 In arthrocentesis, synovial fluid is

Median nerve
aspirated from the wrist joint to reduce inflammation.

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 Chapter 14 Musculoskeletal System 573

Vertebral disk

Spinal endoscope Vertebral disk nucleus

Disk herniation pushing

on spinal nerve root

Spinal nerve root

Spinal cord

Vertebra

Figure 14-24 Surgical excision of a tissue from a herniated Figure 14-25 Surgical fixation is done to produce
disk (diskectomy). spinal fusion (spondylosyndesis) and limit patient
movement.

Surgical Interventions and Therapeutic Procedures (continued)

Term Pronunciation Meaning
meniscectomy men’i-sek’tŏ-mē excision of a meniscus, usually from the knee joint
myoplasty mī’ō-plas-tē surgical repair of muscular tissue
myorrhaphy mī-ōr’ă-fē suture of a muscle
open reduction, ō’pĕn rĕ-duk’shŭn, surgical repair of a fracture by making an incision into the skin and muscle
internal fixation in-tĕr’năl fik-sā’shŭn at the site of the fracture, manually moving the bones into alignment, and
(ORIF) fixing the bones in place with surgical wires, screws, pins, rods, or plates
ostectomy os-tek’tŏ-mē excision of bone tissue
osteoclasis os-tē-ok’lă-sis intentional fracture of a bone to correct deformity
osteoclast os’tē-ō-klast surgical instrument used to fracture a bone to correct a deformity
patellectomy pat-ĕ-lek’tŏ-mē excision of the patella
phalangectomy fal-an-jek’tŏ-mē excision of one or more phalanges of the hand or foot
(continued)

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 574 MEDICAL TERMINOLOGY

Figure 14-26 Suturing a torn tendon (tenorrhaphy).

Surgical Interventions and Therapeutic Procedures (continued)

Term Pronunciation Meaning
reduction rĕ-dŭk’shŭn manipulative or surgical procedure to restore a part to its normal position,
such as by reducing a fracture (putting bone ends back in place)
spondylosyndesis spon’di-lō-sin-dē’sis surgical procedure to create ankylosis between two or more vertebrae
(Fig. 14-25); also called spinal fusion
synovectomy sin’ō-vek’tŏ-mē excision of part or all of a joint’s synovial membrane
tarsectomy tahr-sek’tŏ-mē excision of part or all of the tarsal bones
tenorrhaphy te-nōr’ă-fē suture of the divided ends of a tendon (Fig. 14-26)
traction trak’shŭn a pulling force exerted on a limb or other part of the body to maintain a
desired position for healing (Fig. 14-27)
(continued)

Figure 14-27 Cervical traction.

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 Chapter 14 Musculoskeletal System 575

A. B.
Figure 14-28 Orthopedic devices (orthoses). A. Knee brace. B. Back brace.

Surgical Interventions and Therapeutic Procedures (continued)

Term Pronunciation Meaning
Related Terms
orthosis ōr-thō’sis external orthopedic device, such as a brace or splint (Fig. 14-28)
prosthesis pros-thē’sis fabricated substitute for a damaged or missing part of the body

Osteoclast: “Osteoclast” has two meanings in medicine: (i) a body cell that helps
remove osseous tissue and (ii) a surgical instrument used to fracture a bone to
correct a deformity. The correct definition depends on the context in which it is used.
For example, the first definition might be used in a laboratory report, and the second
definition might be used in an operative report.

 Exercises: Surgical Interventions and Therapeutic Procedures

Exercise 19
Write the correct medical term for the definition given.

1. excision of some or all of a synovial membrane

2. putting bone ends back in their proper place

3. suture of a muscle

4. excision of cartilage

5. surgical breaking of adhesions in ankylosis

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 576 MEDICAL TERMINOLOGY

6. excision of an intervertebral disk

7. pulling force exerted on a limb

8. surgical repair of skull

9. spinal fusion

10. intentional fracture to correct bone deformity

11. excision of the patella

12. surgical instrument used to break a bone

13. surgical repair of cartilage

14. excision of a meniscus

15. surgical resection of the maxilla

16. surgical creation of an artificial joint

Exercise 20
Circle the term that is most appropriate for the meaning of the sentence.

1. Mrs. Yin required a(n) (cranioplasty, arthrodesis, ostectomy) to excise a cancerous bone growth.

2. Mr. Behringer had a very painful bursa but was, nonetheless, reluctant to undergo
(arthroplasty, bursectomy, laminectomy) to remove it.

3. The first step of surgery for Ms. Barbosa’s brain tumor was a (craniotomy, cranioplasty,
costectomy).

4. Following surgical removal of a sarcoma that had spread through his vastus medialis muscle,
Mr. McCarty required extensive (tenorrhaphy, myoplasty, arthrodesis) to repair the muscle.

5. To brace her leg and provide support while healing occurred, Mrs. Ahern needed to wear a
custom (osteoclasis, arthrodesis, orthosis) at all times.

6. After breaking her arm, Mrs. Latta had a(n) (meniscectomy; open reduction, internal fixation;
osteoclast) to repair the fracture.

7. Mr. Karposky’s surgery for a herniated intervertebral disk included (carpectomy, tarsectomy,
laminectomy).

8. During surgery for the skier’s injured knee, Dr. Tanaka discovered a tendon that had
completely divided and had to perform (phalangectomy, tenorrhaphy, arthroclasia).

9. With (arthrocentesis, arthrodesis, chondrectomy), the orthopedic surgeon aspirated synovial

fluid from Mrs. Updike’s severely swollen shoulder joint.

10. Within months of the emergency amputation of her gangrenous left leg, Ms. Pappas was
adapting well to walking using a (spondylosyndesis, prosthesis, traction).

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Exercise 21
Using the given suffix, build a medical term for the meaning given.

Suffix Meaning of Medical Term Medical Term

-plasty surgical repair of muscle 1.

-ectomy excision of cartilage 2.

-desis surgical fixation or binding of a joint 3.

-rrhaphy suture of divided ends of a tendon 4.

-tomy incision into the skull 5.

Exercise 22
Break the given medical term into its word parts and define each part. Then
define the medical term.

For example:
arthritis word parts: arthr/o / -itis
meanings: joint / inflammation
term meaning: inflammation of a joint

1. osteoclasis word parts: /

meanings: /

term meaning:

2. myorrhaphy word parts: /

meanings: /

term meaning:

3. arthroplasty word parts: /

meanings: /

term meaning:

4. phalangectomy word parts: /

meanings: /

term meaning:

5. rachiotomy word parts: /

meanings: /

term meaning:

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 578 MEDICAL TERMINOLOGY

6. diskectomy word parts: /

meanings: /

term meaning:

7. chondroplasty word parts: /

meanings: /

term meaning:

8. arthrocentesis word parts: /

meanings: /

term meaning:

9. synovectomy word parts: /

meanings: /

term meaning:

10. ostectomy word parts: /

meanings: /

term meaning:

Medications and Drug Therapies

Term Pronunciation Meaning
analgesic an’ăl-jē’zik a drug that relieves pain without producing anesthesia
corticosteroid kōr’ti-kō-ster’oyd a drug that reduces inflammation around joints
nonsteroidal non’ster-oy’dăl drug with anti-inflammatory action (and usually analgesic and
anti-inflammatory an’tī-in-flam’ă-tōr-ē antipyretic effects as well); used to treat joint and muscle conditions
drug (NSAID) drŭg
skeletal muscle skel’ĕ-tăl mŭs’ĕl a drug that relaxes skeletal muscle spasms and spasticity
relaxant rē-lak’sănt

 Exercise: Medications and Drug Therapies

Exercise 23
Write the correct medication or drug therapy term for the definition given.

1. relaxes skeletal muscles

2. relieves pain without anesthesia

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 Chapter 14 Musculoskeletal System 579

3. reduces inflammation around joints

4. reduces inflammation without the use of steroids

Specialties and Specialists

Term Pronunciation Meaning
chiropractic kī’rō-prak’tik health care discipline involving physical manipulation of musculoskeletal structures
chiropractor kī’rō-prak’tŏr one who specializes in chiropractic
orthopedics, ōr’thō-pē’diks medical specialty focusing on diagnosis and treatment of disorders of the
orthopaedics musculoskeletal system
orthopedist, ōr’thō-pē’dist physician who specializes in orthopedics
orthopaedist
orthotics ōr-thot’iks the science of making and fitting orthopedic devices
orthotist ōr-thŏt’ist one who makes and fits orthopedic appliances
osteopathy os’tē-op’ă-thē school of medicine emphasizing manipulative measures in addition to
techniques of conventional medicine
osteopath os’tē-ō-path physician who specializes in osteopathy
podiatry pō-dī’ă-trē medical specialty focusing on diagnosis and treatment of disorders of the foot
podiatrist pō-dī’ă-trist physician who specializes in podiatry
rheumatology rū’mă-tol’ŏ-jē medical specialty focusing on the study, diagnosis, and treatment of joint conditions
rheumatologist rū’mă-tol’ŏ-jist physician who specializes in rheumatology

 Exercise: Specialties and Specialists

Exercise 24
Match each medical specialist with the description of the specialty.

podiatrist chiropractor orthopedist

rheumatologist osteopath orthotist

Description Term

1. physical manipulation of
musculoskeletal structures

2. diagnosis and treatment of foot disorders

3. making and fitting orthopedic devices

4. school of medicine emphasizing

manipulative measures

5. diagnosis and treatment of joint conditions

6. diagnosis and treatment of disorders of the

musculoskeletal system

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 580 MEDICAL TERMINOLOGY

Abbreviations
Abbreviation Meaning
C1 to C7 cervical vertebrae 1 to 7
CK creatine kinase
CT computed tomography
CTS carpal tunnel syndrome
EMG electromyogram
ESR erythrocyte sedimentation rate
fx fracture
L1 to L5 lumbar vertebrae 1 to 5
MD muscular dystrophy
MG myasthenia gravis
MRI magnetic resonance imaging
NSAID nonsteroidal anti-inflammatory drug
OA osteoarthritis
ORIF open reduction, internal fixation
RA rheumatoid arthritis
RF rheumatoid factor
ROM range of motion
T1 to T12 thoracic vertebrae 1 to 12

 Exercises: Abbreviations

Exercise 25
Write the definition of each abbreviation used in these sentences.

1. Mr. de la Cruz had an MRI to assist with the diagnosis of a herniated intervertebral disk.

2. Because of her MG, Ms. Hart frequently felt fatigued after walking even a short distance.

3. After her car accident, Mrs. Stegner was found on radiography to have a fracture of C2.

4. MD is a hereditary degenerative disease.

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 Chapter 14 Musculoskeletal System 581

5. Because of pain resulting from severe osteoarthritis, Mr. Springer has limited ROM in his
shoulder.

6. An ORIF was performed to repair Mr. Harrell’s fracture of the femur.

7. An EMG was obtained to help diagnose the nerve damage in Mr. Dura’s arm.

8. Ms. Dhalaya told her orthopedist that she was sure her CTS resulted from all the typing she
did at work.

9. Mr. Murphy’s medical record indicated RA diagnosed at age 55.

10. Mrs. Helmsley’s physician wanted her to try a NSAID for her arthritis before prescribing a
different drug.

11. To test for musculoskeletal problems, Mr. Kapur was scheduled for the following lab tests:
ESR, RF, and CK.

Exercise 26
Match each abbreviation with the appropriate description.

CT OA T4
L3 fx MRI

1. fourth thoracic vertebra

2. injury of osseous tissue

3. radiographic cross-section

4. located well below the ribs

5. imaging of magnetic effects

6. involving articular cartilage

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 Chapter Review
Review of Terms for Anatomy
and Physiology
Exercise 27
Write the appropriate combining forms on the blanks for the bones indicated.

(5)____________

(6)____________
(1)____________
(7)____________
Cervical
(8)____________

(9)____________

Thoracic (10)____________
(11)____________
Costal
Lumbar cartilages
Sacrum
Radius
Pelvic bone
Ulna
(2)____________
Acetabulum
Metacarpal
bones
(3)____________ Coccyx

(12)____________

(13)____________

Tibia

Fibula

(4)____________

Metatarsal bones
Calcaneus
Phalanges

582

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 Chapter 14 Musculoskeletal System 583

Exercise 28
Fill in the blanks as appropriate for the structures illustrated.

(1)____________
(structure)
(2)____________ (3)____________
(structure name) of muslce

(4)____________
of muscle

Scapula

Radius

Ulna (5)____________ (combining form)

(6)____________ (combining form)

Understanding Term Structure

Exercise 29
Break the given medical term into its word parts and define each part. Then
define the medical term. (Note: you may need to use word parts from other
chapters.)

For example:
arthritis word parts: arthr/o / -itis
meanings: joint / inflammation
term meaning: inflammation of a joint

1. ankylosis word parts: /

meanings: /

term meaning:

2. carpoptosis word parts: /

meanings: /

term meaning:

3. electromyogram word parts: / /

meanings: / /

term meaning:

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 584 MEDICAL TERMINOLOGY

4. myositis word parts: /

meanings: /

term meaning:

5. kyphosis word parts: /

meanings: /

term meaning:

6. intracranial word parts: / /

meanings: / /

term meaning:

7. polymyositis word parts: / /

meanings: / /

term meaning:

8. suprapatellar word parts: / /

meanings: / /

term meaning:

9. tenodynia word parts: /

meanings: /

term meaning:

10. arthrocentesis word parts: /

meanings: /

term meaning:

11. chondrectomy word parts: /

meanings: /

term meaning:

12. costovertebral word parts: / /

meanings: / /

term meaning:

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 Chapter 14 Musculoskeletal System 585

13. submandibular word parts: / /

meanings: / /

term meaning:

14. osteoarthritis word parts: / /

meanings: / /

term meaning:

15. myorrhaphy word parts: /

meanings: /

term meaning:

16. osteomalacia word parts: /

meanings: /

term meaning:

17. arthroscopy word parts: /

meanings: /

term meaning:

18. myalgia word parts: /

meanings: /

term meaning:

19. spondylarthritis word parts: / /

meanings: / /

term meaning:

Comprehension Exercises
Exercise 30
Fill in the blank with the correct term.

1. Movement of an appendage toward the midline of the body is called .

2. is the science of making and fitting orthopedic devices.

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 586 MEDICAL TERMINOLOGY

3. The general term for the surgical restoration of joint function or creation of an artificial joint
is .

4. A(n) is one who specializes in the diagnosis and treatment of

disorders of the foot.

5. An artificial leg is an example of a(n) .

6. is caused by nerve entrapment in the wrist that produces pain.

7. The type of bone tissue that is solid and strong is called bone.

8. The abnormal development or growth of a tissue or organ, often resulting from nutritional
deficiency, is called .

9. is a condition of chronic aching and stiffness of muscles and soft

tissues of unknown cause.

10. is a direction of movement that increases the joint angle.

11. Nuclear medicine imaging can produce an image of the body’s bones, called
a(n) , to diagnose possible bone disorders.

12. Muscular is a hereditary condition causing progressive

degeneration of skeletal muscles.

13. Progressive destructive changes in multiple joints, especially in the hands and feet, may be
caused by .

14. The amount of movement allowed in a joint is termed its .

15. Excessive muscular activity is termed .

16. is a nonmedical specialty involving physical manipulation of

musculoskeletal structures.

17. is the joint movement that bends the foot upward.

18. The medical specialty focusing on diagnosis and treatment of disorders of the musculoskeletal
system is .

Exercise 31
Write a short answer for each question.

1. What kind of joint is a suture?

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 Chapter 14 Musculoskeletal System 587

2. A ligament attaches what structures together?

3. Where in the body are the metacarpal bones?

4. What does it mean to say a tissue is osseous?

5. How is the practice of an osteopath different from that of other physicians?

6. In what situation might a tenorrhaphy be performed?

7. Rickets may result from a deficiency of what?

8. Arthrodesis performed during spinal surgery does what to a spinal joint?

9. What is deposited in a joint’s tissues that causes pain in someone with gout?

10. What kind of diagnostic image is produced with arthrography?

11. Which end of a muscle is its insertion?

12. Where is the xiphoid process located?

13. In addition to skeletal and unstriated muscle tissue, what other type of muscle tissue is found

in the body?

14. What is another term for a laminotomy?

Exercise 32
Circle the letter of the best answer in the following questions.

1. The term that most specifically applies to 2. The clavicle articulates with the:
inflammation of an articular cartilage is:
A. femur
A. osteitis B. fibula
B. chondritis C. ilium
C. arthrochondritis D. sternum
D. arthritis

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 588 MEDICAL TERMINOLOGY

3. A diarthrosis: 9. A patient with ankylosing spondylitis is

most likely to feel pain when:
A. moves freely
B. causes pain A. typing at a computer keyboard
C. requires surgery B. bending down to tie their shoes
D. is herniated C. waving hello to someone at a
distance
4. An exostosis may develop from: D. chewing gum
A. bone marrow
10. A traumatic injury that fractures the
B. a sarcoma
patella might also injure which other
C. a herniated disk
structure?
D. cartilage
A. the humerus
5. Hypertrophy of an organ means it is: B. a suture
C. the pubis
A. abnormally large
D. a meniscus
B. malignant
C. gouty
11. Which of the following vertebrae is closest
D. necrotic
to the sacrum?
6. Dyskinesia generally refers to difficulty A. L5
in: B. T12
C. T1
A. hyperextending the wrist
D. C7
B. embryonic fusing of vertebra
C. obtaining a clear radiographic
12. Which kind of tissue is in closest proximity
image
to periosteal tissue?
D. performing voluntary movements
A. bone
7. Even if you had never heard of this B. muscle
condition, you might assume that C. ligament
chondromalacia refers to: D. bone marrow
A. hardening of cartilage
13. Tenodynia is most likely to occur with:
B. softening of cartilage
C. hardening of bone A. rickets
D. softening of bone B. tarsectomy
C. tenosynovitis
8. An example of circumduction is: D. bursitis
A. movement at the shoulder joint when
14. In scoliosis, the spine curves:
the arm is moved in circles
B. movement at cervical spinal joints when A. from side to side
the head is turned right and left B. from forward to backward in the lumbar
C. movement at the wrist when the hand is area
turned from palm down to palm up C. from forward to backward in the
D. movement at the wrist when the hand is cervical area
turned from palm up to palm down D. from backward to forward

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 Chapter 14 Musculoskeletal System 589

Application and Analysis

CASE REPORTS
Exercise 33
Read the case reports and circle the letter of your answer choice for the
questions that follow each case.

CASE 14-1

Because of severe osteoarthritis, Mr. Hughes is

undergoing total hip replacement. During this
surgery the proximal end of his femur will be
resected, and the stem of a metal prosthesis will
be inserted in the femur. Damaged bone in the
acetabulum will be excised, and a plastic cup-
Acetabular shaped prosthetic piece cemented into the bone.
prosthesis
The ball on top of the femoral prosthesis fits
within this cup. Together these components will
compose his new hip joint (Fig. 14-29).

Femoral stem of
prosthesis

Figure 14-29 Total hip replacement with

the prosthesis in place.

1. The acetabulum is part of what bone? 4. The stem of the femoral prosthesis will
extend down into:
A. the pelvic bone
B. the femur A. the pubis
C. the coccyx B. the patella
D. the ilium C. the femur’s medullary cavity
D. the epiphysis of the tibia
2. The new hip is called a prosthesis because
it is: 5. In Mr. Hughes’ new hip, the metallic
femoral ball will articulate with:
A. a surgical correction
B. inside the body A. the ischium
C. an orthopedic device B. the acetabular prosthesis
D. a fabricated replacement part C. the femoral periosteum
D. cancellous bone
3. Resection of the proximal end of the femur
means: 6. This total hip replacement is an example of
a(n):
A. it is filed down to a smooth surface
B. it is surgically removed A. chondroplasty
C. a new osseous section will be B. diskectomy
transplanted there C. arthroplasty
D. surgical reconstruction D. arthroclasia

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 590 MEDICAL TERMINOLOGY

CASE 14-2

Mr. Bhatnagar suffered a tear of his anterior cruciate

ligament (ACL) during a football game, causing significant
pain and instability of the joint. The diagnosis was made
with x-rays, MRI scans, and a stress test of the ligament.
Arthroscopic reconstructive surgery of the knee joint is
to be performed. The ACL will be reconstructed using a
harvested section of the central third of the patellar
tendon in a graft. The entire procedure will be performed
arthroscopically (Fig. 14-30).

Figure 14-30 Arthroscopic knee

surgery.

7. The ACL joins: C. -clasia

D. -tomy
A. muscle to muscle
B. muscle to bone
10. The patellar tendon harvested for use in
C. bone to muscle
the graft normally joins:
D. bone to bone
A. muscle to muscle
8. An arthroscope is an instrument that: B. muscle to bone
C. bone to ligament
A. allows viewing inside a joint
D. bone to bone
B. forms an image based on tissue effects
of magnetism
11. If the grafted tendon section is sutured to a
C. is used to create radiographic images
section of the torn ligament, which suffix is
D. involves administration of radionuclides
most likely used in the term for that procedure?
9. Which suffix most likely is used in the term A. -rrhaphy
for the procedure for creating an opening B. -physis
into the knee joint? C. -ectomy
D. -centesis
A. -physis
B. -desis

MEDICAL RECORD ANALYSIS

MEDICAL RECORD 14-1
You are a physical therapy assistant
working in a physical therapy clinic. It is
your job to help assess patients and
develop individualized treatment
programs under the guidance of the
physical therapist. Ms. Jackson was
referred to your clinic by her primary
physician because of a history of chronic
back pain. You review this medical record
from her physician so you may assist in
her care.

Physical therapy assistant working with a patient.

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 Chapter 14 Musculoskeletal System 591

LOW BACK PAIN

SUBJECTIVE: The patient came to my office with chief complaints of chronic back pain radiating down
to the right more than left buttock and the thigh area. This pain increases with walking, standing, and
rotating the back. She is taking Ambien and etodolac at this time. She is a known hypertensive with
low back pain and left foot pain. She denies any new family or social history. She was on Vioxx and
stopped when changed to etodolac. On review of systems, she reports some weight loss. She denies
any heart pain, skin problems, eye problems, ear problems, hearing problems, swallowing problems,
abdominal problems, diarrhea, constipation, or bowel/bladder incontinence.

OBJECTIVE: On examination the patient is a moderately built, well-nourished female. She appears
to be comfortable. Her blood pressure is 136/69, heart rate 63, temperature 98.6. Her current weight
is 200 pounds. She is awake, alert, and oriented. Pupils are equal and reacting. Sclerae are
anicteric. Oropharynx is clear. The neck is supple. Carotid pulses are felt well. Trachea is midline.
Breath sounds are heard. The abdomen is soft. The breath sounds are easily heard. The heart has a
regular rate and rhythm. Upper extremity sensation reveals motor power within normal limits. The
back has an old surgical scar. There is severe myofascial tenderness noted, paraspinal region in the
lower lumbar and upper sacral area. Lower extremities are symmetrical. There is mild edema
noted, more so in the ankles. There is decreased range of motion in the hips secondary to pain.
Sensation is intact to light touch. Gait is slow and stable. She walks with a single-point cane.
Sensation is intact.

ASSESSMENT: This is a patient with chronic low back pain, bilateral total knee replacement, and a
prior low back surgery. She continues to have pain.

PLAN: The previous injection significantly helped the patient with her pain for about 3 months.
I will consider her for a repeat L5-S1 foraminal block under fluoroscopy in the next 2 to 3 weeks.
I have advised the patient to continue the current medications and have ordered a physical therapy
consultation.

Exercise 34
Write the appropriate medical terms used in this medical record on the blanks
after their definitions. Note that not all the terms appear in the chapter, but you
should be able to identify these terms based on word parts that are included in
this chapter.

1. pertaining to area beside or around the spine

2. pertaining to fused vertebrae below lumbar vertebrae

3. pertaining to muscle and fascia

4. amount of movement in a joint

Bonus Question

5. Where has this patient had arthroplasty in the past?

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 592 MEDICAL TERMINOLOGY

MEDICAL RECORD 14-2

Mrs. Formosa, a patient who suffers from rheumatoid arthritis, has returned to the
physician’s office where you work as a phlebotomist. You are responsible for drawing
blood samples from Mrs. Formosa to be used for the CBC and sedimentation rate
tests ordered by the physician.

RHEUMATOID ARTHRITIS FOLLOW-UP NOTE

HISTORY OF PRESENT ILLNESS: The patient is a 38-year-old woman who has an illness of about
3 to 4 years, characterized by myalgias, (1) , and arthritis located in the MCP
joints, PIP joints, wrists, and ankles. In addition, the patient has had intermittent Raynaud, mild hair
loss, and a transient rash located on the face and the neck. Other problems are sleep abnormalities
and problems with equilibrium that are under evaluation by neurology. In our initial evaluation, we
considered that the patient may have an undifferentiated connective tissue disease, and the
possibilities were rheumatoid arthritis, lupus, or scleroderma. A trial of prednisone 15 mg was
initiated. Two days after the patient started taking prednisone, she felt an impressive improvement
that she describes as a miracle. The chronic sensation of fatigue was almost eliminated, and the
(2) is very mild, as well as the arthritis. The patient has not had episodes of
(3) since. The patient has been unusually active at work with energy and is
able to do gardening. There is no significant change in morning stiffness, and this is still about
30 minutes in duration.

PERTINENT PHYSICAL FINDINGS: The general examination is benign. There is no hair loss. There
is very mild erythema on the neck with fine telangiectasis that was mentioned before. There are no
other skin lesions, and there are no mucosal lesions either. Musculoskeletal examination shows a
motor power of 5/5 in all four extremities, (4) is normal in all joints, and there
is no evidence of synovitis at any level.

X-rays of hands show only mild osteopenia around the MCP and PIP joints. There are no erosions.

ASSESSMENT/PLAN: The patient is a 38-year-old woman with an undifferentiated inflammatory

polyarthritis. Considering the family history of a father and a brother with rheumatoid arthritis, it is
possible that the patient is at the stage of an early (5) , which is seronegative.
Given the presence of Raynaud and fine telangiectasis, we have to keep in mind the possibility of
this illness evolving to scleroderma. We do not have serologic evidence of lupus, and there is no
biochemical evidence of myositis. Our plan at the moment will be to initiate high-dose chloroquine
at 400 mg once daily, evaluation by an ophthalmologist, and a slow reduction of prednisone to
10 mg in 1 month and then 1 mg per week. We are scheduling an appointment in 2 months and
requesting a CBC and sedimentation rate for the next visit.

Exercise 35
Fill in the blanks in the medical record above with the correct medical terms.
The definitions of the missing terms are listed below.

1. joint pain

2. muscle pain

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 Chapter 14 Musculoskeletal System 593

3. joint inflammation

4. amount of movement in a joint

5. disease causing progressive destructive changes in multiple joints

Bonus Question

6. Although this chapter does not define the term “polyarthritis” used in the Assessment/Plan
section of the record, you should be able to define it from its word parts:

Pronunciation and Spelling

Exercise 36
Review the Chapter 14 terms in the Dictionary/Audio Glossary in the Student
Resources and practice pronouncing each term, referring to the pronunciation
guide as needed.

Exercise 37
Circle the correct spelling of each term.

1. laminetomy laminotomy lamanotomy

2. ostoarthritis ostioarthritis osteoarthritis

3. rheumatology rhuematology rheumetology

4. tenodyne tenodyna tenodynia

5. osseis osseous oseous

6. clavicle clavicel clavecle

7. myorhaphy myorrhapphy myorrhaphy

8. vertebrea vertebrae vertabrae

9. fibromyalgia fibrilmyalgia fibromyolgia

10. dorseflexion dorsaflexion dorsiflexion

11. ankelosis ankylosis ankylesis

12. polimyositis polymyositis polymiositis

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 594 MEDICAL TERMINOLOGY

13. faisca fasckia fascia

14. osteoporosis ostioporosis osteoporesis

15. intervertebrel intervertabral intervertebral

Media Connection
Exercise 38
Complete each of the following activities available with the Student Resources.
Check off each activity as you complete it, and record your score for the
Chapter Quiz in the space provided.

Chapter Exercises

____ Flash Cards ____ True/False Body Building

____ Concentration ____ Quiz Show

____ Abbreviation Match-Up ____ Complete the Case

____ Roboterms ____ Medical Record Review

____ Word Builder ____ Look and Label

____ Fill the Gap ____ Image Matching

____ Break It Down ____ Spelling Bee

____ Chapter Quiz Score: _______%

Additional Resources

____ Video: Vertebral Disk

____ Animations: Muscle Flexion and Extension; Bone Growth

____ Dictionary/Audio Glossary

____ Health Professions Careers: Physical Therapy Assistant

____ Health Professions Careers: Phlebotomist

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