CHAPTER 4

Musculoskeletal system

Contents Objectives
OBJECTIVES 45 After completing this chapter you should be
able to:
INTRODUCTION 46
1. state the meanings of the word elements
BONES 46 related to the musculoskeletal system
New word elements relating 2. build words using the word elements
to bones 46 associated with the musculoskeletal system
Vocabulary relating to bones 50 3. recognise, pronounce and effectively use
Abbreviations relating to bones 50 medical terms associated with the
Functions and structure of bones 50 musculoskeletal system
Pathology and diseases relating 4. expand abbreviations related to the
to bones 51 musculoskeletal system
5. describe the structure and functions of the
JOINTS 53
musculoskeletal system including the bones,
New word elements relating joints, tendons and muscles
to joints 53 6. describe common pathological conditions
Vocabulary relating to joints 54 associated with the musculoskeletal system
Abbreviations relating to joints 54 7. describe common laboratory tests, diagnostic
Functions and structure of joints 54 and surgical procedures associated with the
Pathology and diseases relating musculoskeletal system
to joints 55 8. apply what you have learned by interpreting
medical terminology in practice.
MUSCLES 58
New word elements relating
to muscles 58 It is recommended that you demonstrate your
knowledge of the musculoskeletal system by
Vocabulary relating to muscles 59
completing the exercises at the end of this
Abbreviations relating to muscles 59 chapter.
Functions and structure of muscles 59
Pathology and diseases relating to
muscles 62
TESTS AND PROCEDURES 64
EXERCISES 67

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
46 Module 2 The body as a framework

INTRODUCTION system have been divided into three sections: those

pertaining to bones, those pertaining to joints and
Musculoskeletal is a general term which is defined those pertaining to muscles.
as relating to muscles and the bones of the skeleton.
The musculoskeletal system comprises bones, joints,
cartilage, bursae, tendons, muscles and ligaments. It is BONES
the system that moves the body and maintains its form.
Study of this system consists of osteology (the study of New word elements relating to bones
bones), arthrology (the study of joints), and myology To reinforce your learning, write the meanings of the
(the study of muscles). medical terms in the spaces provided. Use the Glossary
The musculoskeletal system does not work in of Medical Terms on page 523 to help you work out
isolation. It is closely linked with many other systems the meanings. You may also need to check the meaning
in the body, including the nervous system, genitourinary in a medical dictionary but make an attempt yourself
system, circulatory system, immune system, respiratory first.
system, digestive system and endocrine system.
Other than the Tests and Procedures section, all
topics in this chapter related to the musculoskeletal

Combining forms relating to bones

Combining form Meaning Medical term Meaning of medical term
calc/i calcium hypercalcaemia
calc/o calcinosis
condyl/o condyle condyloid
kyph/o humpback kyphoscoliosis
lamin/o lamina laminotomy
lord/o curve, swayback lordosis
lumb/o loins, lower back lumbosacral
myel/o bone marrow, spinal cord myelopoiesis
orth/o straight, upright orthopaedic
osse/o bone osseous
oste/o osteomyelitis
scoli/o crooked, bent scoliosis
spondyl/o vertebra spondylitis
(used for disorders)
vertebr/o vertebra, spinal column vertebrocostal
(used for structures)

The following combining forms refer to specific identify the location of each of the bones on a picture
bones in the body. As well as knowing the meanings of the skeleton, as in Figure 4.1.
of each of the combining forms, make sure you can

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 47

Combining form Meaning Medical term Meaning of medical term

acetabul/o acetabulum acetabular
brachi/o arm brachial
calcane/o calcaneus calcaneodynia
carp/o carpal carpectomy
cervic/o neck, cervix uteri cervicothoracic
clavic/o clavicle clavicectomy
clavicul/o supraclavicular
cleid/o cleidocostal
cost/o rib intercostal
crani/o cranium, skull craniotomy
dactyl/o finger, toe syndactyly
disc/o intervertebral disc discectomy
femor/o femur femoral
fibul/o fibula fibulotibial
humer/o humerus humeroradial
ili/o ilium, hip iliac
ischi/o ischium ischial
malleol/o malleolus, little hammer malleolar
mandibul/o mandible, lower jaw submandibular
maxill/o maxilla, upper jaw maxillofacial
metacarp/o metacarpal metacarpophalangeal
metatars/o metatarsal metatarsalgia
olecran/o olecranon olecranal
patell/o patella patellectomy
pelv/i pelvis pelvimetry
phalang/o phalanx phalangeal
pub/o pubis pubiotomy
radi/o radius radial
scapul/o scapula scapular
stern/o sternum sternocleidomastoid
tars/o tarsal tarsalgia
thorac/o thorax, chest thoracic
tibi/o tibia tibial
uln/o ulna ulnar

Suffixes relating to bones

Suffix Meaning Medical term Meaning of medical term
-blast embryonic or developing osteoblast
cell
-clast to break osteoclast
-listhesis slip or slide retrolisthesis
-lysis separation, destruction, osteolysis
breakdown, dissolution
-malacia condition of softening osteomalacia
-physis growth diaphysis
-tome instrument to cut osteotome

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
48 Module 2 The body as a framework

Figure 4.1 Bones of the body

(Mosby’s Dictionary, 2014)
ANTERIOR VIEW OF SKELETON

Frontal bone

Nasal bone
Orbit
Zygomatic bone Maxilla
Mandible
Clavicle

Manubrium
Scapula
Sternum
Costal cartilage
Ribs
Xiphoid process
Vertebral Humerus
column

Coxal (hip) Radius

bone Ulna
Ilium
Sacrum
Coccyx
Carpal bones

Metacarpal
Pubis bones

Ischium Phalanges

Greater trochanter
of femur
Femur

S
Patella
R L

I
Tibia

Fibula
Axial skeleton
Appendicular
skeleton
Tarsal bones
Metatarsal bones
Phalanges

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 49

Figure 4.1, cont’d

POSTERIOR VIEW OF SKELETON

Parietal bone

Occipital bone

Cervical vertebrae (7)

Clavicle

Acromion

Scapula
Thoracic
Ribs vertebrae (12)

Humerus

Lumbar
Ulna
vertebrae (5)

Radius Coxal (hip)

bone

Carpal bones

Metacarpal
Coccyx bones

Ischium Phalanges

Sacrum
Femur

Tibia

Fibula

Tarsal bones

Phalanges
Metatarsal bones
Calcaneus

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
50 Module 2 The body as a framework

Vocabulary relating to bones which make up the bones. In newborn babies the body
The following list provides many of the medical terms has 270 bones but many of these fuse as the child grows.
used for the first time in this chapter. Pronunciations The smallest bones are the ossicles in the middle ear and
are provided with each term. As you read the rest of the largest bones are the right and left femurs, or thigh
the chapter, make sure you identify each of these terms bones. Around 30–40% of the body’s total weight is
and understand their meanings. made up of the bones. There are certain differences in
the bones of males and females, primarily in the pelvic
Term Pronunciation region because of the requirement of the female pelvis
appendicular skeleton a-pen-DIK-yoo-lah skel-e-ton to accommodate pregnancy and childbirth.
axial skeleton AKS-ial skel-e-ton The two main divisions of the bones of the body
cancellous bone KAN-sel-us bohn
are called the axial skeleton and the appendicular
skeleton as can be seen in Figure 4.1. The axial skeleton
collagen KOL-a-jen is made up of the skull, rib cage and vertebral column.
compact bone KOM-pakt bohn The remainder of the skeleton, including the extremities,
fracture FRAK-sha is known as the appendicular skeleton. It is called
herniated intervertebral HER-nee-ay-ted appendicular because these bones are appended or
disc in-ter-VER-teb-ral disk attached to the axial skeleton.
kyphosis ky-FOH-sis
Bones are classified into five types: long bones (such
as femur, tibia, humerus, radius), short bones (such as
lordosis lor-DOH-sis the bones in the ankles and wrists), flat bones (sternum,
osseous tissue OS-ee-us TISH-oo cranium, scapula, ribs), irregular bones (vertebrae,
ossification os-if-i-KAY-shun
osteomalacia os-tee-oh-ma-LAY-see-a
osteoporosis os-tee-oh-pe-ROH-sis
Figure 4.2 Bone structure
scoliosis sko-lee-OH-sis
(Thibodeau & Patton, 2010)
Abbreviations relating to bones
Articular cartilage
The following abbreviations are commonly used Epiphysis
Spongy bone
in the Australian healthcare environment. As some
Epiphyseal plate
abbreviations can have more than one meaning it is
Red marrow cavities
suggested that you carefully check the context in which
the abbreviation is used before assigning a meaning to it.
Abbreviation Definition
AKA above knee amputation Compact bone
BKA below knee amputation
Medullary cavity
C1–C7 cervical vertebrae 1–7
Ca calcium Endosteum
fx, # fracture
L1–L5 lumbar vertebrae 1–5
NOF neck of femur Diaphysis Yellow marrow
OA osteoarthritis
ORIF open reduction internal fixation
(of fracture) Periosteum
POP plaster of Paris
RIF/LIF right iliac fossa/left iliac fossa
S1–S5 sacral vertebrae 1–5
T1–T12 thoracic vertebrae 1–12

Functions and structure of bones

The adult human body has 206 bones. Prior to birth,
the skeleton is made up of flexible cartilage. As the body
Epiphysis
grows, ossification takes place as the cartilage is replaced
by hard deposits of calcium, phosphorus and collagen,

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 51

hips, bones of the face) and sesamoid bones (round There are two types of osseous tissue making up
bone masses embedded in tendons, such as the patella). bones: compact or hard bony tissue (also known as
The functions of bones are: cortical tissue) and cancellous or spongy tissue. The
• provide a framework to shape and support the
to difference lies in the denseness of the cells. Hard bone
body and a place for tendons and muscles to is made up of closely packed cells which have thin
attach canals running through them for blood vessels to pass
• enable movement, by acting as levers in
to through. This compact tissue is usually located on the
collaboration with muscles and joints outside of bones and gives bones their characteristic
• provide protection for the body’s most vital
to hard, smooth, white appearance. Cancellous bone has
and delicate organs — the brain, heart and lungs spaces in between the cells, giving it a lattice-like
amongst others appearance. This type of osseous tissue is generally
• create blood cells by a process called
to found on the inside of bones, is highly vascular and
haematopoiesis — this takes place in the bone generally houses the bone marrow where haematopoiesis
marrow takes place.
• store minerals such as calcium and iron
to
• to help regulate certain hormones including those Pathology and diseases relating to bones
that assist with maintenance of blood sugar levels The following section provides a list of some common
and deposition of fats. diseases and pathological conditions relevant to bone.

Curvature of the spine

Term Pronunciation Definition

kyphosis ky-FOH-sis Kyphosis is an abnormal convex or posterior curvature of the thoracic spine. It is also
called hunchback or humpback.
lordosis lor-DOH-sis Lordosis is an abnormal concave or anterior curvature of the lumbar spine. It is also
called a sway back.
scoliosis skol-ee-OH-sis Scoliosis is a lateral S-shaped curvature of the spine.

Fractures

Term Pronunciation Definition

fracture FRAK-sha A fracture is a break or crack in a bone. Fractures are caused by trauma such as a fall or
motor vehicle accident, through overuse or repetitive movements as may occur in
athletes, or as a result of a disease process such as osteoporosis that weakens the bones.
Fractures are classified by type and whether they are open or closed.
Open fracture: a fracture in which there is an open wound communicating with the
fracture exposing the underlying bone. There is an increased risk of infection with an
open fracture.
Closed fracture: the bone is broken but there is no open wound.
Different types of fractures:
Avulsion: a closed fracture that occurs when a strong muscle contraction pulls a tendon free,
resulting in a fragment of bone being broken off. Avulsion commonly occurs in athletes.
Complete: bone fragments at the fracture site are completely separated.
Complicated: involves injury to bones and other organs such as blood vessels, brain,
lungs, etc.
Compound: another name for an open fracture.
Compression: a closed fracture that occurs when bones are forced into each other
crushing them. It commonly occurs to the bones of the spine and may be caused by a
heavy landing onto the feet or falling into a sitting position, or as a result of advanced
osteoporosis.
Comminuted: bone is broken into multiple fragments.
Greenstick: an incomplete break, a bending of the bone. Most often occurs in children.
Impacted: A closed fracture which occurs when force is applied to both ends of a bone,
driving them into each other.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
52 Module 2 The body as a framework

Table continued
Term Pronunciation Definition
Incomplete: bone fragments at the fracture site are partially joined.
Pathological: a fracture that is caused because bones have been weakened by a disease
process such as osteoporosis, metastatic neoplasm, Paget’s disease. Usually, no significant
trauma or injury occurs to cause the fracture. A gentle bump or rolling over in bed may
be enough force to cause the diseased bone to fracture.
Simple: a closed nondisplaced fracture that does not require manipulation.
Spiral: part of the bone has been twisted. The fracture runs around the long axis of the
affected bone.
Stress: a closed fracture, often just a hairline crack that occurs as a result of repetitive
movements that cause strain on a body part. It is common in athletes such as runners
and ballet dancers.
Transverse: the fracture is in a straight line across the affected bone.
Fractures are diagnosed by clinical history, x-ray and sometimes by CT scan or MRI.
Treatment involves administration of analgesic medication, immobilisation by a plaster
cast or splint and sometimes surgery.

Figure 4.3 Types of fracture

(Griffith, 1994)

Hip Fracture Through Hip Fracture Through

Trochanter of Femur Neck of Femur

Greenstick Spiral Comminuted Transverse

Compound Compression

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 53

Other conditions

Term Pronunciation Definition

herniated HER-nee-ay-ted Intervertebral discs are pillows of fibrocartilagenous tissue located
intervertebral disc in-ter-VER-teb-ral disk between the vertebrae of the spine. Sometimes as a result of an acute
injury to the spine or because of degenerative wear and tear to a disc,
it splits or ruptures. When this happens, the inner gel-like substance
(nucleus pulposus) leaks out into the spinal canal. This is called a
herniation of the nucleus pulposus — or a herniated disc.
A herniated disc is often referred to as a slipped disc but this terminology
is erroneous as a disc cannot actually slip. The most common site for a
herniated disc is in the lumbar spine especially at L4–L5. Symptoms will
vary depending on the site and degree of the herniation but can include
paraesthesia (pa-ress-THEEZ-ee-a), sciatica (sy-AT-ik-a) and back pain.
Some patients will not experience any pain at all. Many cases will resolve
spontaneously with bed rest, analgesics and physiotherapy, but if the
condition persists, more invasive treatment such as discectomy or
laminectomy may be required.
osteomalacia os-tee-oh-ma-LAY-see-a Osteomalacia is a softening of the bones due to a lack of vitamin D or a
problem with the body’s ability to metabolise and absorb this vitamin.
Adequate amounts of vitamin D are essential for the body to be able to
absorb calcium and phosphorous into the bloodstream. Vitamin D
deficiency may be caused by a lack in the diet, limited exposure to
sunlight which produces vitamin D in the body or malabsorption by the
intestines. Treatment involves vitamin D, calcium and phosphorous
supplements. In children, osteomalacia is called rickets.
osteoporosis os-tee-oh-pe-ROH-sis Osteoporosis occurs when there is a decrease in bone density due to
bones losing minerals, such as calcium, more quickly than the body can
replace them. Bones become porous and brittle resulting in an increased
likelihood of fractures. While any bone can be affected by osteoporosis,
the most common sites for osteoporotic fractures are the hip, spine, ribs,
pelvis, wrist and upper arm. While it is most frequently seen in
postmenopausal women due to decreased levels of oestrogen,
osteoporosis can occur in younger women and in men.

JOINTS
of Medical Terms on page 523 to help you work out
New word elements relating to joints the meanings. You may also need to check the meaning
To reinforce your learning, write the meanings of the in a medical dictionary but make an attempt yourself
medical terms in the spaces provided. Use the Glossary first.

Combining forms relating to joints

Combining form Meaning Medical term Meaning of medical term

ankyl/o crooked, bent, stiff ankylosis
arthr/o joint haemarthrosis
articul/o joint articular
burs/o bursa bursitis
chondr/o cartilage chondrodysplasia
ligament/o ligament ligamental
menisc/o meniscus, crescent meniscectomy
rheumat/o watery flow rheumatology
synov/o synovial membrane or fluid synovectomy
synovi/o synoviosarcoma

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
54 Module 2 The body as a framework

Suffixes relating to joints

Suffix Meaning Medical term Meaning of medical term

-clasis break arthroclasis
-desis to bind, surgical fixation, arthrodesis
fusion
-stenosis narrowing, stricture craniostenosis

Vocabulary relating to joints Abbreviation Definition

The following list provides many of the medical terms ACL anterior cruciate ligament
used for the first time in this chapter. Pronunciations
are provided with each term. As you read the rest of CTS carpal tunnel syndrome
the chapter, make sure you identify each of these terms DJD degenerative joint disease
and understand their meanings. DMARD disease-modifying antirheumatic drugs
OA osteoarthritis
Term Pronunciation
NSAID non-steroidal anti-inflammatory drug
arthritis arth-RY-tis
RA rheumatoid arthritis
articulation ah-tik-yoo-LAY-shun
ROM range of movement
ball and socket joint ball and SOK-et joynt
THR total hip replacement
bunion BUN-yun
TKR total knee replacement
bursitis bur-SY-tis
TMJ temporomandibular joint
cartilage KAH-til-aj
cartilaginous joint kah-til-AJ-en-us joynt
condyloid joint KON-di-loyd joynt
Functions and structure of joints
Joints are the location where two or more bones come
coronal suture kor-OH-nal SOO-cha together to create body movement or articulation. The
dislocation dis-loh-KAY-shun three types of joints are fibrous, cartilaginous and
fibrous joints FY-brus joynt synovial, classified according to the amount of
gouty arthritis (gout) GOW-tee arth-RY-tis movement they permit.
Fibrous joints are fixed and unable to move because
hinge joint hinj joynt
thick membranous collagen fibres hold the bones
lambdoid suture lam-DOYD SOO-cha together. Also known as sutures, this type of joint is
meniscus tear me-NISS-kus tear found in the skull where the coronal suture joins the
osteoarthritis os-tee-o-arth-RY-tis frontal and parietal bones; the sagittal suture joins the
pivot joint PIV-ot joynt two parietal bones from the front to the back and
the lambdoid suture joins the parietal bones with the
rheumatoid arthritis ROO-ma-toyd arth-RY-tis
occipital bone.
rotator cuff syndrome roh-TAY-ta kuf SIN-drohm As the name suggests, cartilaginous joints have
saddle joint sa-del joynt cartilage between them. Although they allow movement,
sagittal suture SAJ-i-tel SOO-cha this is far more restricted than the movement of
sprain sprayn
synovial joints. The joints of the vertebral column and
the pelvis are examples of this type of joint.
synovial fluid sy-NOH-vee-al FLOO-id
Synovial joints permit the greatest range of
synovial joint sy-NOH-vee-al joynt movement. In between the bones are spaces covered
synovial membrane sy-NOH-vee-al MEM-brayn with synovial membrane, which fill with synovial fluid.
This fluid lubricates and protects the bones as they
move. Synovial joints include ball and socket joints
Abbreviations relating to joints (such as the shoulders and hips), hinge joints (such as
The following abbreviations are commonly used in the the ulnar part of the elbows and the knees), gliding
Australian healthcare environment. As some abbreviations joints, which allow bones to glide across each other
can have more than one meaning it is suggested that you (such as in the ankles and wrists), condyloid joints,
carefully check the context in which the abbreviation is which allow movement but not rotation (such as in the
used before assigning a meaning to it. jaw or the fingers and toes), pivot joints, which allow

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 55

Figure 4.4 Types of joints

A. Condylar (wrist); B. Gliding (radioulnar); C. Hinge or ginglymus (elbow); D. Ball and socket (hip);
E. Saddle (carpometacarpal of thumb); F. Pivot (atlanto-axial)
(Drake, 2009)

A B C
Humerus

Ulna Radius
Synovial
membrane
Wrist
Articular joint Radius
disc

Olecranon
Synovial cavity Ulna

D Cartilage E F
Odontoid
Trapezium process
of axis
Synovial membrane

Atlas
Metacarpal I
Synovial
Femur membrane

both rotation and twisting (such as in the radius part Pathology and diseases relating to joints
of the elbow and the neck) and saddle joints, which The following section provides a list of some common
permit side to side and forward and backward diseases and pathological conditions relevant to
movement but not rotation (such as in the thumb). joints.

Term Pronunciation Definition

arthritis arth-RY-tis Arthritis is inflammation of a joint resulting in pain, swelling and
alteration to structure and function. There are several types of arthritis
with different aetiologies.
– osteoarthritis os-tee-o-arth-RY-tis Osteoarthritis is a progressive, degenerative joint disease
(OA) characterised by loss of articular cartilage, the presence of
osteophytes and hypertrophy of bone. This leaves the ends of the
bones unprotected, and the joint loses its ability to move smoothly
and becomes painful and stiff. Osteoarthritis occurs mainly in the hips
and knees. It is diagnosed by clinical history and x-ray. Treatment
consists of analgesic medication such as aspirin, and physiotherapy.
As the disease progresses, joint replacement surgery may be
necessary.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
56 Module 2 The body as a framework

Table continued
Term Pronunciation Definition

Figure 4.5 Osteoarthritis of the knee

(Based on LaFleur Brooks, 2005)
Narrowed joint space —
Bone thickened bone and
thinning of articular cartilage

Joint
Cartilage capsule

Osteophytes
Synovial and fibrosis
membrane in capsule

Normal Advanced osteoarthritis

Exposed bone from eroded cartilage

Bone cyst

Bone spurs

Coronal view schematic of

osteoarthritis of the knee

– rheumatoid ROO-ma-toyd arth-RY-tis Rheumatoid arthritis is a chronic autoimmune disease in which the
arthritis (RA) body’s immune system attacks the synovium, the thin membrane that
lines each joint. As a result, fluid builds up in the joints causing pain
and inflammation. Joint deformity and stiffness often result. The
hands, feet and knees are most commonly affected. There is no cure
but RA can be managed with NSAID (non-steroidal anti-inflammatory
drug) medication to reduce pain, DMARDs (disease-modifying
antirheumatic drugs) to stop disease progression and physiotherapy.
Complementary therapies such as acupuncture and massage may
help some patients.
– gouty arthritis GOW-tee arth-RY-tis Gouty arthritis is caused by hyperuricaemia (a build-up of uric acid in
(gout) the blood) resulting in the formation of tiny crystals of urate in body
tissues. When the crystals form in joints, acute arthritis results. The
feet, ankles, wrists and fingers can be affected but the big toe is the
most common site. Repeated bouts of gouty arthritis can damage the
joint and lead to chronic arthritis. A diet high in fats and alcohol and a
family history are possible causes of gout. Men are more likely to
develop gouty arthritis than are women. While gout is a progressive
disease, there are effective treatments to lower uric acid levels and
prevent inflammation. Dietary restrictions to reduce intake of fats and
alcohol are required.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 57

Table continued
Term Pronunciation Definition
bunion BUN-yun A bunion (hallux valgus) is an abnormal swelling of the medial aspect
of the joint between the big toe and the first metatarsal bones. It is a
common disorder that is caused by degenerative joint disease,
pressure from poorly fitting shoes or can be hereditary. Treatment
involves wearing wide-toed shoes with cushioned lining. If the bunion
is severe, a bunionectomy may be performed.
bursitis bur-SY-tis Bursitis is inflammation of a bursa (a fibrous fluid-filled sac between a
tendon and bone). Normally, the bursa provides a slippery surface
that assists movement and reduces friction. When a bursa becomes
inflamed it results in joint pain, stiffness and swelling around the
affected joint. Bursitis is caused by chronic overuse, trauma and
infection. The most commonly affected joints are the shoulder, elbow,
knee and hip. Treatment consists of administering NSAIDs such as
ibuprofen, physiotherapy and rest as required. In some cases an
injection of a corticosteroid into the joint is required.
dislocation dis-loh-KAY-shun A dislocation (also called a luxation) is the displacement of two bones
from their normal position where they articulate in a joint. It usually
occurs as the result of trauma. Ligaments in the joint are usually
injured as well. A subluxation is a partial dislocation. An x-ray is
required to identify if a fracture has also occurred. Any dislocation
needs to be reduced urgently to prevent complications such as
ischaemia.
meniscus tear men-IS-kus tear A tear to the meniscus may be a traumatic injury, commonly seen in
athletes, when a knee joint is bent then twisted. It often occurs in
conjunction with an anterior cruciate and medial cruciate ligament
tear. It can also be part of the degenerative process in older patients
who have more brittle cartilage. The most common symptoms of a
meniscus tear are swelling and pain in the knee, tenderness on
palpation of the meniscus, popping or clicking within the knee and
limited range of motion of the knee joint. A tear is diagnosed by MRI
or by an arthroscopy. Treatment consists of ice packs and rest
(conservative treatment) or meniscus repair.
rotator cuff roh-TAY-ta kuf SIN-drohm Rotator cuff syndrome occurs when there is a tear or impingement of
syndrome the tendons or muscles in the shoulder. The supraspinatus tendon is
the most common one to tear. This is often as a result of an acute
trauma or age-related degeneration. In some patients there is no pain,
in others it feels like a dull ache in the shoulder and may make sleep
difficult while others experience severe debility. Impingement
syndrome may cause pain when raising the arm to the front or to the
side. Conservative treatments such as analgesic medication, rest, hot/
cold packs and physiotherapy are the initial treatment options. If the
condition persists, a surgical procedure called a rotator cuff repair may
be performed.
sprain sprayn A sprain occurs when a ligament is overstretched or torn due to
trauma to the joint. The most common site affected is the ankle. There
is no fracture or dislocation present. It can result in pain, swelling,
joint instability and loss of function. Rest, application of ice and a
compression bandage are effective treatments.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
58 Module 2 The body as a framework

MUSCLES
New word elements relating to muscles
To reinforce your learning, write the meanings of the the meanings. You may also need to check the meaning
medical terms in the spaces provided. Use the Glossary in a medical dictionary but make an attempt yourself
of Medical Terms on page 523 to help you work out first.

Combining forms relating to muscles

Combining form Meaning Medical term Meaning of medical term

clon/o turmoil clonic
dors/o back (of body) dorsodynia
fasci/o fascia (a band) fasciectomy
fibr/o fibre fibromyalgia
fibros/o fibrous connective tissue fibrosis
kinesi/o movement, motion kinesiologist
lei/o smooth muscle leiodermia
leiomy/o leiomyoma
muscul/o muscle muscular
my/o muscle myofascial
myos/o myositis
plant/o sole of the foot plantar
rhabd/o rod shaped, striated rhabdomyosarcoma
(skeletal)
tax/o order, coordination ataxia
ten/o tendon tenorrhaphy
tend/o tendolysis
tendin/o tendinitis
ton/o tone, tension, pressure myotonia
tort/i twisted torticollis

Prefixes relating to muscles

Prefix Meaning Medical term Meaning of medical term

ab- away from abductor
ad- toward adductor
dorsi- back dorsiflect
poly- many, much polymyalgia

Suffixes relating to muscles

Suffix Meaning Medical term Meaning of medical term

-asthenia condition of weakness myasthenia
-trophy development, nourishment atrophy

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 59

Vocabulary relating to muscles As the muscle fibres contract and relax, they produce
The following list provides many of the medical terms movement in the body. Many body movements are a
used for the first time in this chapter. Pronunciations result of several muscles working collaboratively.
are provided with each term. As you read the rest of Muscles are often grouped in pairs, where a contraction
the chapter, make sure you identify each of these terms of one muscle moves a bone in a particular direction,
and understand their meanings. and a contraction of the other muscle moves the bone
in the opposite direction. The biceps and triceps
Term Pronunciation muscles of the upper arm are a good example of this
mechanism. When the central nervous system instructs
aponeurosis ap-on-yoo-ROH-sis
the biceps muscle to contract, a corresponding impulse
cardiac muscle KAH-dee-ak MUS-el relaxes the triceps muscle, and vice versa. Occurring at
fascia FASH-ee-a the same time, these impulses allow for movement in
fibromyalgia fy-broh-my-AL-jee-a both directions.
involuntary muscle in-VOL-un-terry MUS-el Muscles can be attached to bones, to skin or to
other muscles by tendons and aponeuroses. Tendons
muscular dystrophy MUS-kyoo-lah DIS-troh-fee
are thick fibrous bands of tissue, whereas aponeuroses
myasthenia gravis my-as-THEEN-ee-ah are more like flat ribbons, having fewer blood vessels
GRA-vis and nerves than tendons. The body regions with
polymyositis pol-ee-my-oh-SY-tis aponeuroses are in the ventral abdominal region, the
skeletal muscle ske-LEE-tal MUS-el dorsal lumbar region, and in the palm of the hand.
smooth muscle smooth MUS-el Humans have three different kinds of muscle:
Skeletal muscle attaches to bones by tendons
strain strayn
across a connecting joint, which allows the
striated stry-AY-ted muscles to pull on bones and create
tendon TEN-don movement. Skeletal muscle is striated in
voluntary muscle VOL-un-terry MUS-el appearance; that is, the cell fibres have
alternating light and dark bands (known as
striations). Skeletal muscles are under the
conscious control of the body — in other
Abbreviations relating to muscles words they are voluntary muscles. These
The following abbreviations are commonly used in muscles hold the skeleton together, give the
the Australian healthcare environment. As some body shape, and help it with everyday
abbreviations can have more than one meaning it is movements by contracting or tightening.
suggested that you carefully check the context in which Skeletal muscles vary considerably in size,
the abbreviation is used before assigning a meaning shape and arrangement of fibres. The smallest
to it. muscles in the body are found in the inner ear
and the largest and most bulky is the muscle
Abbreviation Definition in the buttock.
Smooth muscles are commonly involved in
DMD Duchenne’s muscular
dystrophy
involuntary movements — movements over
which we have no conscious control. Smooth
EMG electromyogram muscles are formed from thin layers or sheets
IM intramuscular made up of cells and are found in the walls of
the internal organs, such as the stomach,
intestine, bladder and blood vessels (excluding
the heart).
Functions and structure of muscles Cardiac muscles are unique in that they are
There are more than 650 muscles in the human body, striated in appearance but involuntary in
which together compose around half of the body action. As the name implies, cardiac muscles
weight of the average human. Muscle tissue is made up are found in the myocardium of the heart and
of cells that are called fibres. Depending on their largely make up the heart wall. This type of
purpose, the size and shape of the fibres differs. The muscle contracts to force blood out of the
fibres are surrounded by connective tissue and are heart into the blood vessels, and relaxes to
enclosed in fascia, a type of strong connective tissue. allow the heart to fill with blood.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
60 Module 2 The body as a framework

Figure 4.6 Muscles of the body

(Mosby’s Dictionary, 2014)
ANTERIOR VIEW

Facial muscles

Sternocleidomastoid

Trapezius

Deltoid
Pectoralis major

Serratus anterior
Biceps brachii
Rectus abdominis
Linea alba
Flexors of wrist
Extensors of wrist and fingers
and fingers
External abdominal oblique

Adductors
of thigh Tensor fasciae latae

Retinaculum

Vastus lateralis
Sartorius
Rectus femoris

Vastus medialis

Patella
Patellar tendon
Tibialis anterior

Extensor digitorum
Gastrocnemius longus
Peroneus longus

Soleus Peroneus brevis

Superior extensor
retinaculum

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 61

Figure 4.6, cont’d

POSTERIOR VIEW

Sternocleidomastoid Splenius capitis

Seventh cervical vertebra Trapezius

Deltoid
Infraspinatus
Teres minor
Teres major

Triceps brachii

Latissimus dorsi

External abdominal
oblique
Extensors
of the wrist
and fingers
Gluteus maximus

Semitendinosus
Adductor magnus
Hamstring Biceps femoris
group Gracilis

Semimembranosus
Iliotibial tract

Gastrocnemius

Calcaneal tendon
(Achilles tendon)
Peroneus longus Soleus

Peroneus brevis

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
62 Module 2 The body as a framework

Figure 4.7Types of
muscle tissue
(Thibodeau, 2003)

Skeletal muscle Smooth muscle

Cardiac muscle

Pathology and diseases relating to muscles

The following section provides a list of some common
diseases and pathological conditions relevant to the
muscles.

Term Pronunciation Definition

fibromyalgia fy-bro-my-AL-jee-a Fibromyalgia is a term used to describe a common syndrome in which
people experience long-term, widespread pain and tender points in
joints, muscles, tendons and other soft tissues. It also results in
disturbed sleep and exhaustion. The cause is unknown but possible
triggers include viral infection, physical and emotional stress. It tends
to be more common in people with pre-existing lupus, rheumatoid
arthritis, or ankylosing spondylitis. There is no cure but symptomatic
treatment can help some patients.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 63

Table continued
Term Pronunciation Definition
muscular dystrophy MUS-kyoo-lah DIS-troh- Muscular dystrophy (MD) refers to a group of hereditary diseases that
fee weaken different muscle groups in various ways. A person affected
with MD has a genetic mutation that prevents the repair of muscle
tissue. This muscle weakening occurs gradually over time. Symptoms
may start at any time from infancy through to adulthood.
The most common form of muscular dystrophy is Duchenne’s
muscular dystrophy (DMD). It is caused by a genetic defect, which
results in the body’s failure to produce a specific protein called
dystrophin. It predominantly affects boys between the ages of
2 and 6 years. By age 10 to 12 years these children will often be
in a wheelchair. This disease also affects other body systems so
patients need regular respiratory and cardiac assessment. It is
likely that these patients will eventually need a ventilator to breathe.
People with DMD usually do not survive beyond their late teens or
early adulthood.
myasthenia gravis my-as-THEEN-ee-a Myasthenia gravis is an autoimmune, neuromuscular disorder that
GRA-vis causes weakness of the voluntary (skeletal) muscles. The flow of
impulses between nerves and muscles is compromised. It can occur
at any age but predominantly affects young women and older men.
Muscle weakness becomes worse with activity but improves with rest.
Patients with myasthenia gravis will experience dyspnoea, dysphasia,
dysphagia, facial paralysis, diplopia, blepharoptosis and general
fatigue. There is currently no cure but treatment can help alleviate
some of the symptoms. Medications, plasmapheresis, intravenous
immunoglobulins and lifestyle adjustments to allow for more rest can
all improve quality of life.
polymyositis pol-ee-my-oh-SY-tis Polymyositis is an inflammatory muscle disease that results in
muscle weakness. The cause is unknown; however, it is thought to be
triggered by environmental agents such as viruses. Other research
indicates an autoimmune or genetic aetiology. Polymyositis is often
associated with autoimmune diseases such as rheumatoid arthritis
and lupus erythematosus. It is more common in females than males
and tends to develop between the ages of 50 and 70 years.
Most patients experience an improvement of their symptoms with
treatment such as corticosteroids, although there may be some
long-term muscle weakness. It is rarely fatal, but it has been linked
with respiratory and cardiac conditions, as well as an increased risk of
certain cancers, such as bladder cancer and non-Hodgkin’s lymphoma.
strain strayn A strain occurs when a muscle and/or tendon is overstretched or torn.
There is no fracture or dislocation present. Pain, weakness and muscle
spasms are common symptoms experienced after a strain occurs.
Rest, application of ice and a compression bandage are effective
treatments.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
64 Module 2 The body as a framework

TESTS AND PROCEDURES

The following section provides you with a list of surgical interventions that are performed on the
common diagnostic tests, procedures and clinical and musculoskeletal system.

Test/Procedure Pronunciation Definition

amputation amp-yoo-TAY-shun An amputation is the surgical or traumatic removal/excision of an
extremity (arm, hand, finger, leg, foot, toe). In addition to traumatic
amputations, some of the common reasons leading to the need for
amputation include diabetes, peripheral vascular disease and cancer.
antinuclear an-tee-NYOO-klee-a An ANA is a diagnostic test used in patients with systemic lupus
antibody test AN-tee-bod-ee test erythromatosus (SLE or lupus) to detect antibodies present in the
(ANA) patient’s serum.
arthrocentesis arth-roh-sen-TEE-sis An arthrocentesis is also known as joint aspiration. A needle is
inserted into the joint to withdraw synovial fluid for the purpose of
relieving joint pain and swelling or for analysis to identify conditions
such as infection, rheumatoid arthritis and gout.
arthrography arth-ROG-raf-ee An arthrography involves the injection of contrast material
containing iodine into a joint to allow for an x-ray called a
fluoroscopy to be performed. It is used to identify abnormalities with
the function and structure of a joint and to determine the need for
further treatment and surgery.
arthroplasty ARTH-roh-plas-tee An arthroplasty is a surgical procedure that leads to the
reconstruction or replacement of joint structures with artificial
devices. The procedure is performed to relieve the symptoms of pain
from conditions such as osteoarthritis. Arthroplasty of the knee or
hip are the most common. Total or partial replacement may be
performed, e.g. a hemiarthroplasty is commonly performed for a
fractured neck of femur.
arthroscopy arth-ROS-kop-ee An arthroscopy is a procedure to view a joint using an arthroscope.
The procedure is used both as a diagnostic process and as a method
of entry to allow for more complex procedures such as a
meniscectomy.
Figure 4.8 Arthroscopy
(Leonard, 2005)
Quadriceps femoris
Head of femur
Synovial space

bone density test bohn DEN-sit-ee test A bone density test is a diagnostic procedure used to identify
decreased bone density. The test identifies conditions such as
osteoporosis and osteopenia. Generally x-rays of the spinal column,
pelvis and wrist are taken to measure the density of the bones.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 65

Table continued
Test/Procedure Pronunciation Definition
bone scan bohn skan A bone scan is a diagnostic test used to identify abnormalities in
bones resulting from conditions such as primary bone cancers, bony
metastases and bone inflammation. The patient receives an injection
of a small amount of radioactive material and then is scanned using
a gamma camera. Bones with an abnormality will have a greater
uptake of the radioactive material.
Figure 4.9 technetium-99m bone scan
showing an area of increased radioactive
uptake on the left tibia that indicates a bone
tumour.
(Orkin et al, 2009)

computed kom-PYOO-ted to-MOG- A CT is a diagnostic test performed to identify disorders of the soft
tomography (CT) raf-ee tissues, bone and muscle. Cross-sectional images are taken using a
computer in conjunction with x-ray beams.
electromyography ee-LEK-troh-my-OG-raf-ee An EMG is a diagnostic test used to identify neuropathic and
(EMG) myopathic disorders. Electrodes are placed on the muscle and are
used to record motor unit activity at rest and also during muscle
contraction.
erythrocyte e-REETH-roh-syt SED-ee- ESR is a measure to determine the rate at which erythrocytes settle
sedimentation rate men-TAY-shun rayt out of plasma in a test tube. In diseases such as infections, joint
(ESR) inflammation and tumours that increase the immunoglobulin
content of blood, the sedimentation rate is altered.
joint injection joynt in-JEK-shun A joint injection is a method of treatment using a hypodermic
needle to inject anti-inflammatory agents into a joint to treat such
conditions as arthritis, gout and tendonitis.
laminectomy lam-in-EK-tom-ee A laminectomy is a surgical procedure that involves incising a
vertebra to allow access to the spinal cord to remove herniated
intervertebral discs and tumours. It is also used to relieve pressure
on a spinal nerve.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
66 Module 2 The body as a framework

Table continued
Test/Procedure Pronunciation Definition
magnetic mag-NET-ik REZ-on-ans An MRI is a diagnostic test that creates images of soft tissue using
resonance imaging IM-a-jing radio waves and a magnetic field.
(MRI)
meniscectomy men-i-SEK-toh-mee A meniscectomy is a surgical procedure that involves removal of
damaged meniscal tissue in the knee. The route for entry is generally
via arthroscopy.
muscle biopsy MUS-el BY-op-see A muscle biopsy is a diagnostic procedure involving the excision of a
sample of muscle for laboratory examination.
reduction and re-DUK-shun and fik-SAY- This group of procedures generally refers to the manipulation of a
fixation shun bone or joint following a dislocation or fracture to correct its
position and the subsequent process of securing the structure with
screws, wires, pins or plates.
The reduction can be accomplished either as a closed (non-surgical
incision) procedure or open (a surgical incision is required to access
the fracture or dislocation) procedure.
For those fractures and dislocations that require fixation, the
procedure can involve internal or external fixation. Internal fixation
involves the use of fixators such as pins, bone screws, wires, rods and
plates that are used to support the structure whilst healing occurs.
External fixation involves the placement of pins and screws which
are then secured to a frame on the outside of the skin.
rheumatoid factor ROO-ma-toyd FAK-ta test An RF test is a diagnostic test used in patients with rheumatoid
test (RF) arthritis to detect antibodies present in the patient’s serum.
serum calcium (Ca) SEE-rum KAL-see-um A serum Ca test is a diagnostic test to identify the levels of calcium
in serum. It is used to identify the presence of hypercalcaemia or
hypocalcaemia.
serum creatine SEE-rum kree-AT-in KY-naze A serum CK test is a diagnostic test to identify increased levels of the
kinase (CK) enzyme creatine kinase in serum which is present in the conditions
polymyositis, muscular dystrophy and traumatic muscular injuries.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 67

EXERCISES
Exercise 4.1: Label the Diagrams
Using the information provided in this chapter, label the anatomical parts in the figures below.

1
1
2
2 14
3
3 15
4
16
5
17
6
18
7
19
4
8
20
9 5
21
10
22
11 6

12
23
13 7 24
14 8

15 9
10
16
25
17
26
12
18
13 27
19

20
11
21 28

22
S
23 29
R L
24
I
25 30
26
31
27 35

28 36

29

30 32
33
31 34

32

33 Figure 4.10A
(Mosby’s Dictionary, 2014)
34

35

36

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
68 Module 2 The body as a framework

1
11
2

3 12

4 13

1
5
2
6
3
7 14
4
8

9 5

10
15
11 6

12 7 16

13
17
14
18
15 9
10 19
16

17
8
20
18

19

20

21
21
22
22
23

24
23
25

26 24
25
26
Figure 4.10B

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 69

Exercise 4.2: Word Analysis and Meaning

Break up the medical terms below into their component parts (prefixes, suffixes, word roots, combining vowels).
Provide the meaning for each word element and each term as a whole.

Example:
osteomalacia
oste/o/malacia
oste/o = bone
malacia = pertaining to softening
Meaning = pertaining to softening of bone

1. costovertebral

2. arthroscopy

3. osteogenic

4. bursitis

5. meniscectomy

6. polymyositis

7. intervertebral

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
70 Module 2 The body as a framework

8. fibromyalgia

9. dyskinesia

10. lordosis

Exercise 4.3: Match Word Elements and Meanings

Match the prefix, suffix or word root in Column A with its meaning from Column B.

Column A Answer Column B

1. spondyl/o A. clavicle

2. -listhesis B. joint

3. scoli/o C. to bind, surgical fixation or fusion

4. lei/o D. vertebra

5. -desis E. slip or slide

6. articul/o F. rod shaped, striated

7. rhabd/o G. crooked or bent

8. cleid/o H. narrowing or stricture

9. tort/i I. smooth

10. lumb/o J. weakness

11. -stenosis K. loins, lower back

12. -asthenia L. twisted

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 71

Exercise 4.4: Match Medical Terms and Meanings

Match the medical term in Column A with its meaning in Column B.

Column A Answer Column B

1. metatarsals A. kneecap

2. radius B. bones of the toes

3. occipital bone C. thigh bone

4. fibula D. breastbone

5. patella E. lower jaw

6. ischium F. cheekbone

7. femur G. back of the skull

8. calcaneus H. outer, thinner bone of lower leg

9. zygoma I. part of the nasal cavity

10. sternum J. part of the pelvis

11. mandible K. outer bone of the forearm

12. ethmoid L. heel

Exercise 4.5: Expand the Abbreviations

Expand the abbreviations to form correct medical terms.

Abbreviation Expanded abbreviation

ACL

CT scan

CTS

MRI

NOF

NSAID

OA

ORIF

T1–T12

TKR

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
72 Module 2 The body as a framework

Exercise 4.6: Applying Medical Terminology

Fill in the blank or select the correct medical term or word element.

1. Which of the following is a term for involuntary 6. Softening of the bone is termed _______________.
contraction and relaxation of skeletal muscles? a) osteoporosis
a) rigor b) osteomyalgia
b) spasm c) osteomalacia
c) tetany d) osteosclerosis
d) tremor
7. The clavicle is part of the _________________ skeleton.
2. Osteomyelitis is a condition of the bone and bone a) appendicular
marrow causing ______________. b) axial
a) decreased bone density
b) vitamin D deficiency 8. A surgical repair of damaged cartilage is
c) atrophy of skeletal muscles _____________________.
d) inflammation a) arthroplasty
b) chondritis
3. Which of the following means stiff? c) chondroplasty
a) lord/o d) osteoplasty
b) scoli/o
c) ankyl/o 9. A fracture in which the ends of the bones are crushed
d) rhabd/o is a _________________ fracture.
a) compound
b) comminuted
4. _______________ provide(s) a protective covering for c) simple
internal organs and produces body heat. d) greenstick
a) skeleton
b) tendons 10. What term means slowness of movement?
c) cartilage a) hypotonia
d) muscles b) myotonia
c) dyskinesia
5. Which of the following is not an inflammation of the d) bradykinesia
musculoskeletal system?
a) bursitis
b) chondromalacia
c) myositis
d) epiphysitis

Exercise 4.7: Correct the Spelling and Identify the Incorrect Terms
Identify the medical terms spelled incorrectly or words used inappropriately. Provide the correct terms.

1. There had clearly been atrofy of the upper extremity muscles since the patient’s last attendance at the authopedic
clinic.

2. Spinal x-ray revealed spondilosis and there was forward slipping of the fifth vertebrae of the lumber spine onto the
saccrum.

3. Mrs Jones had bylateral carple tunnel sindrome. Surgical division of the ligament in the left wrist was undertaken to
compress the middle nerve.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 73

4. Her arteritis of the knee was so debilitating that she had to have a prosthotic device implanted.

5. The spinal fracture was reduced at open surgery and an internal fixation device was inserted into the tibia to maintain
alignment.

Exercise 4.8: Pronunciation and Comprehension

Read the following paragraphs aloud to practise your pronunciation. Using your textbook and a medical
dictionary, find the meanings of the underlined medical terms.

Mrs Lennane was an elderly lady who was admitted to hospital after slipping on a wet path in the garden at her
home. On admission she was disoriented and in considerable pain. An indwelling catheter was inserted. She was
sent for x-rays which confirmed the presence of an intertrochanteric fracture of her left neck of femur. There was
also significant soft tissue injury around the fracture site. She was sent to theatre where an ORIF using pins and
plate was performed under a GA. Her ASA score was 3NE.
Postoperatively she progressed slowly. Unfortunately, on day 3 she fell out of bed and dislocated her right
shoulder and sustained a laceration to her right forearm. She was taken back to theatre where the shoulder
dislocation was reduced and her forearm was sutured under a light GA. There were no further complications but
re-mobilisation was slow.
She was transferred to the rehabilitation unit for intensive physiotherapy. After 2 weeks she was discharged
home into the care of her daughter. On discharge she was mobile with the assistance of a walking frame.

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
74 Module 2 The body as a framework

Exercise 4.9: Crossword Puzzle

Complete the puzzle by providing the medical term for each of the clues below.

ACROSS DOWN
2. tear or impingement of the tendons or muscles in the 1. cell fibres having alternating light and dark bands (8)
shoulder (7, 4, 8) 3. fibrous connective tissues that attach muscles to bone,
4. a break or crack in a bone (8) bind muscle together or to other tissue at their point
5. connective tissue that provides structure and support of origin or insertion (11)
to other tissue (9) 6. pertaining to inflammation of a joint (9)
8. the process of formation of bone (12) 7. s-shaped curvature of the spine (9)
9. an inflammatory muscle disease that results in muscle
weakness (12)
10. fixed immovable joint (7)

2 3

5 6

10

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 75

Exercise 4.10: Anagram

Work out each medical term from the jumbled letters below. Then, using the letters in brackets, determine the
medical term that matches the description given.

1. aemltngi _ _ _ _ _ _ _ (_) a band of connective tissue that connects joints

2. ylaagim _ _ _ _ _ (_) _ pain in a muscle

3. xtbalsniouu (_) _ _ _ _ _ _ _ _ _ _ an incomplete displacement of a joint

4. xnefoil _ _ _ _ (_) _ _ bending a limb

5. aieblnmd _ (_) _ _ _ _ _ _ the lower jaw

6. valeiccl _ _ _ _ _ (_) _ _ the combining form cleid/o refers to this bone

7. csfiaa _ _ _ (_) _ _ the fibrous connective membrane surrounding a

muscle

8. tionucabd (_) _ _ _ _ _ _ _ _ move away from the midline

Rearrange the letters in brackets to form a word that means ‘pain radiating from lower back down the leg’.
__ __ __ __ __ __ __ __

Exercise 4.11: Discharge Summary Analysis

Read the Discharge Summary below and answer the questions.

UNIVERSITY HOSPITAL DISCHARGE UR number: 123456

Name: Harrison Brown
SUMMARY Address: 55 Idol Court, Farrowville
Date of birth: 25/06/1982
Sex: M
Nominated primary healthcare provider:
Dr Elizabeth French
Episode details Discharge details
Consultant: Dr Gamble Status: Home
Registrar: Dr Winters Date of discharge: 28/3/2016
Unit: Orthopaedics
Admission source: Elective
Date of admission: 23/3/2016
Reason for admission/Presenting problems:
Autologous bone graft to non-union of # of right tibia
Principal diagnosis: Non-union # of right tibia
Comorbidities:
Nil reported

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
76 Module 2 The body as a framework

Previous medical history:

This 33-year-old man presented 3 months after a motor bike accident in which he sustained a fractured right femur,
fractured right tibia and fibula and left brachial plexus injury. At the time an ORIF was performed. A recent x-ray had
revealed that the fractured tibia had failed to unite.
Clinical synopsis:
• General examination was unremarkable. Right leg examination corroborated the Dx.
• The following morning, under GA, a bone graft was performed on the right tibial fracture site (donor site right
iliac crest).
• He was managed with bed rest and was mobilised on crutches.
• Five days post-surgery, the patient was discharged home.
Complications:
Postoperatively, the patient was given IV cloxacillin. He had a hypersensitivity reaction to this antibiotic which was
discontinued, with a warning to the patient about taking penicillin therapy in the future.
Clinical interventions:
Bone graft — right tibial fracture site (donor site right iliac crest)
Diagnostic interventions:
Nil reported
Medications at discharge:
Panadol, as required
Ceased medications:
Nil reported
Allergies:
Intravenous cloxacillin
Alerts:
Nil reported
Arranged services:
Recommendations:
He is to be reviewed in the Orthopaedic Outpatient Clinic in 2 weeks time.
Information to patient/relevant parties:
Patient is to rest at home.
Authorising clinician:
Dr Winters
Document recipients
Patient
LMO: Dr Elizabeth French
1. Expand the following abbreviations as found in the discharge summary above.
GA

ORIF

IV

Dx

2. What is non-union of a fracture?

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.
 Chapter 4 Musculoskeletal system 77

3. What is an autologous bone graft?

4. What is a brachial plexus injury?

5. What does a hypersensitivity reaction mean?

Downloaded for Shannon Montgomery ([email protected]) at Victoria University Polytechnic from ClinicalKey.com.au/nursing by Elsevier on June 29, 2020.
For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.