Chapter 4

The Skeletal
System
LEARNING OUTCOMES

LE
After studying this chapter, you will be able to
• identify and define medical terms associated with the major
structures and functions of the skeletal system;
• recognize, define, spell, and pronounce terms related to
the pathology, diagnosis, and treatment of skeletal system
diseases and conditions; and
• identify medical careers associated with the diagnosis and
treatment of skeletal system diseases and conditions.
P
M
• The purpose of the event
HOSA Event Prep
Do you know how physical • What is involved in the event
therapy helps people recover • What knowledge is demonstrated in the event
A

from diseases and conditions? What skills can aid

The information and activities in this chapter can help
in recovery and help people function better? As
prepare you for this and other competitive events. In
you study this chapter, you will learn the answers
the chapter, Event Prep icons label these activities. As
to these questions and more. You can demonstrate
you prepare for HOSA competitive events, be sure to
your knowledge by participating in a HOSA—Future
check the website and talk with your HOSA advisor for
Health Professionals event. HOSA events provide
the most up-to-date guidelines and procedures. Once
S

opportunities to build the technical, leadership, and

you have learned about the Physical Therapy event,
teamwork skills you need to pursue a career in the
answer the following questions:
healthcare field.
1. How might participating in this event benefit you
One example of a HOSA competitive event is the
personally and your future career? Explain.
HOSA Physical Therapy competitive event. Go to the
HOSA website to learn more about the HOSA Physical 2. Are you interested in participating in this event?
Therapy event. Find out: Why or why not?

first vector trend/Shutterstock.com

70 Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 70 9/27/2021 3:58:59 PM

 Medical Term Scavenger Hunt
In this chapter, you will learn medical word parts For each highlighted medical term or abbreviation,
and terms related to the skeletal system. Before you search through this chapter to find the meaning.
begin this chapter, read the scenario that follows. Some of these terms and abbreviations were
Bella Sotelo, an active, 35 y/o female with a healthy introduced in previous chapters. Use Appendix B:
lifestyle, came into the office with c/o of arthralgia Medical Abbreviations or the Glossary/Index if you
and edema in her Rt elbow. Recently, Bella noticed cannot find the meaning of a term or abbreviation.
increased aggravation of pain with movement. She has The terms and abbreviations in the scenario are
tried OTC pain medication, including NSAID Advil ® and listed below. Define and look up the pronunciation
other analgesics such as Tylenol ®, but with no relief. of each term to help you understand Bella’s story.
After enduring the pain for two weeks, Bella made an Then rewrite the scenario in common language.
appointment with her family physician, Dr. Turnbull. 1. y/o 8. analgesics
After examining Bella and getting an in-depth personal 2. c/o 9. Hx
and family Hx, Dr. Turnbull ordered a CT scan and RA

LE
3. arthralgia 10. CT scan
blood test. Testing revealed that Bella had bursitis.
4. edema 11. RA
Dr. Turnbull then performed an arthrocentesis and
an injection of corticosteroid to alleviate edema and 5. Rt 12. bursitis
pain. 6. OTC 13. arthrocentesis
7. NSAID 14. corticosteroid

Medical Word Parts P Combining Form

(Root Word plus
The many parts of the skeletal system can be Combining Vowel) Meaning
distinguished by their unique names. Mastery of chir/o hand
the combining forms, prefixes, and suffixes listed
chondr/o cartilage
in the tables that follow will help you understand
M
medical terms pertaining to the skeletal system. clavicul/o clavicle; collarbones
cost/o rib
Combining Forms crani/o skull
The combining forms that follow are common cubit/o elbow
in medical terms used to describe conditions and dactyl/o digits (fingers or toes)
procedures of the skeletal system. dextr/o to the right
A

Combining Form femor/o thigh bone

(Root Word plus fibul/o fibula; lower leg bone
Combining Vowel) Meaning humer/o humerus; upper arm bone
acr/o extremities hy/o hyoid bone
S

ankyl/o crooked; bent; stiff; fused ili/o ilium; top of the hip bone
together
kyph/o humpback
arthr/o joint
ligament/o ligament
brachi/o arm
lord/o curve; swayback
burs/o bursa (sac of fluid near a
joint) lumb/o lumbar region; loin
calcane/o calcaneus; heel bone lux/o slide
carp/o wrist mandibul/o mandible; lower jaw bone
cervic/o neck; cervix (neck of menisc/o meniscus; cartilage in the
uterus) knee joint
(Continued) myel/o bone marrow; spinal cord
(Continued)

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    71

Ch04.indd 71 9/27/2021 3:59:00 PM

 Combining Form Prefixes
(Root Word plus The prefixes listed are not specific to skeletal
Combining Vowel) Meaning system terminology. These universal prefixes are
narc/o numbness; sleep; stupor used in many other medical terms, which you will
nas/o nose learn as you progress through this book.
orth/o straight Prefix Meaning
oste/o bone a-, an- not; without
patell/o patella; kneecap ambi- both sides
ped/o foot; child anti- against
phalang/o phalanges; fingers or toes inter- between
physi/o nature; function intra- within; into
por/o opening; passageway; meta- change; beyond

LE
porous
non- not
pod/o foot
peri- around; surrounding
pub/o pubis; pubic region
poly- many; much
pyret/o fever
sub- below; under
rachi/o spine; vertebra
supra- above
rheumat/o watery flow
syn- together; with
rhin/o nose
sacr/o sacrum
sarc/o
scoli/o
sinistr/o
spondyl/o
to the left
P
flesh; connective tissue
crooked; bent

vertebra; backbone
Student Challenge
Eight in Three
EVENT
PREP

Read the eight definitions that follow and build the

M
ster/o solid structure; steroid correct medical terms. See how many terms you
stern/o sternum; breastbone can build in three minutes.
styl/o column; pillar; tube 1. condition of someone who has many fingers
synovi/o lubricating fluid of joints or toes
2. pertaining to the area below the clavicle
tars/o ankle
3. surgical repair of the nose
A

ten/o, tendin/o, tendon

tendon/o 4. to break down bones
5. condition of curvature of the spine
tibi/o tibia; lower leg bone
6. inflammation of a joint
uln/o ulna; lower arm bone
7. pertaining to both sides
vertebr/o vertebrae; spinal column
S

8. resembling a solid structure

bones

72   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 72 9/27/2021 3:59:00 PM

 Suffixes Anatomy and
The suffixes that follow are common in medical
terms used to describe conditions and procedures Physiology
of the skeletal system. You will encounter these The bones and related structures of the skeletal
suffixes in many other terms throughout this book. system aid body movement. The skeletal system
Suffix Meaning is divided into two major parts: the axial skeleton
and the appendicular skeleton (Figure 4.1).
-al, -an, -ic, -ous pertaining to
The axial skeleton includes the bones along the
-algia pain axis, or central line, of the human body. The axial
-ation process; condition skeleton consists of the skull, facial bones, sternum
-centesis surgical puncture to remove (breastbone), ribs, and vertebral column.
fluid The appendicular skeleton contains the bones
-clast to break down; destroy in the appendages of the body, as well as the struc-
tures that connect the appendages to the axial

LE
-desis to bind; tie together
skeleton. Specifically, the appendicular skeleton
-ectomy surgical removal; excision
includes the shoulder girdle; the arm, wrist, and
-graph instrument for recording hand bones; the pelvic girdle; and the leg, ankle,
-ism process; condition and foot bones.
-itis inflammation
-malacia softening
-oid like; resembling
Functions of Bone
-oma tumor; mass The skeletal system serves five important func-
-osis
-penia
-physis
-plasty
P
abnormal condition
deficiency
growth; growth plate
surgical repair
tions in the human body.
• Support—The skeletal system provides
structure and shape for the body.
• Protection—The skeletal system surrounds
and protects the internal organs.
M
-porosis abnormal condition of small • Mineral storage—The bones store calcium and
holes phosphorus, two minerals that the body needs
-scope instrument used to view for important regulatory functions.
-scopy visual examination using a scope • Blood cell formation—Red blood cells are
-tomy process of cutting; incision manufactured in the bone marrow.
• Anchoring and movement of muscles—The
A

Student Challenge bones of the skeletal system act as levers for

muscular action. Muscular movement would
Right and Left Hand
not be possible without tendons (fibrous cords
If a surgeon is able to perform surgical tasks
of tissue that attach muscle to bone) and
equally well with the right or left hand, what is the
ligaments (fibrous cords of tissue that attach
S

medical term for this unique ability?

bone to bone).

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    73

Ch04.indd 73 9/27/2021 3:59:00 PM

 Cranium
Skull
Facial Mandible
bones
Clavicle
Sternum Cervical

Scapula

Ribs
Thoracic Thoracic
cage

Humerus
Lumbar

LE
Vertebral
Sacrum column
Ulna Coxal (hip) bone (spine)

Radius

Carpals

Metacarpals
P Phalanges

Femur
Coccyx
M
Patella

Tibia

Fibula
A

Tarsals
Calcaneus
Metatarsals
S

Phalanges
© Body Scientific International

Figure 4.1 In this diagram, the axial skeleton is shown in a light magenta color to distinguish it from
the appendicular skeleton.

Bone Structure The extremities contain long bones. Short

bones are located in the hands and feet. They
Bone is a dense connective tissue made of col- are cube-shaped and composed of spongy bone,
lagen (KAH-luh-jen) fibers and minerals. Collagen which allows for flexible movement. Flat bones
fibers are resistant but flexible. They are also found protect vital organs and provide a broad surface
in skin and cartilage. There are 206 bones of vari- area for muscle attachment. Examples of flat bones
ous sizes and shapes in the adult body (Figure 4.2). include the cranium (bones of the head), facial
These bones can be classified in several ways.

74   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 74 9/27/2021 3:59:01 PM

 Long bone
Flat bone

LE
P Irregular bone

Short bones
M
A

Sesamoid bone
© Body Scientific International

Figure 4.2 The adult body contains bones of various shapes and sizes.

bones, scapulae (shoulder blades), and sternum The shaft of a long bone is called the diaphysis
S

(breastbone). (digh-AF-uh-sis) (Figure 4.3). Each end of a long

Sesamoid bones, so named because they resem- bone is called an epiphysis (uh-PIF-uh-sis).
ble large sesame seeds, are embedded within ten- The epiphyseal (uh-PIF-uh-SEE-uhl) plate, also
dons. Sesamoid bones enable joint movement and known as the epiphyseal line or growth plate, repre-
are found in the patella (kneecap), hands, wrists, sents an area of cartilage tissue that is consistently
and feet. being replaced by new, bony tissue as the bone
Irregular bones have an unusual or complex grows. Cartilage cells at the edge of the growth
shape and, therefore, cannot be categorized as long, plate form new bone. This process is responsible
short, or flat. They provide support and protection for the lengthening of bones during childhood and
yet allow flexible movement. Examples include adolescence. The growth plate calcifies (hardens
the vertebrae (bones or bone segments of the spi- through calcium deposition) and disappears when
nal column), jawbones, and coccyx (tailbone). the bone achieves its full growth.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    75

Ch04.indd 75 9/27/2021 3:59:02 PM

 Articular cartilage medullary (MED-yoo-lair-ee) cavity, which con-
tains yellow bone marrow composed chiefly of fat
Cancellous bone
cells.
Epiphysis Epiphyseal Cancellous bone, or trabecular (truh-BEK-yoo-
plate (line) ler) bone, is much more porous and much less
Red marrow dense than compact bone. For these reasons, can-
cavities cellous bone is commonly called spongy bone.
Cortical bone Cancellous bone is found mainly in the epiph-
yses (uh-PIF-uh-seez), or ends, of long bones.
Spaces in the cancellous bone contain red bone
marrow, where red blood cells, white blood cells,
Endosteum and platelets are manufactured. The produc-
tion of blood cells in the bone marrow is called
hematopoiesis (HEE-muh-toh-poy-EE-sis).
Medullary cavity

LE
Fascinating Fact
Yellow bone marrow If bone and steel were the same weight, the bones
Diaphysis (in medullary cavity) of the human body would be six times stronger
than steel.

Periosteum

Inquiring Minds
P Understanding Calcium
Directions: What does the mineral
Blood vessel calcium do for bones? Try this experiment
at home or in class:
1. Overnight, soak two uncooked chicken legs
in a jar of vinegar. Also soak two chicken
M
legs in a jar of water.
2. Compare and contrast the vinegar-soaked
Epiphysis and water-soaked chicken legs. What do
Articular you notice about the chicken legs that were
cartilage soaked in vinegar compared to those soaked
© Body Scientific International in water?
A

Figure 4.3 The anatomical structure of a long 3. Record your findings and share them with
bone. the class.

Fascinating Fact Joints

The bones in your hands and feet add up to more
than one-half of the bones in your whole body. A joint is any place in the body at which two
S

Each hand has 27 bones. Each foot has 26. or more bones connect, or articulate. Connective
bands of tissue called ligaments connect bone to
bone.
Bone Composition There are three main types of joints:
There are two basic types of bone tissue: cortical • Diarthroses (DIGH-ar-THROH-seez)—freely
bone and cancellous bone (Figure 4.3). movable joints. Examples include ball-
Cortical bone, also called compact bone, is very and-socket, hinge, gliding, pivot, condylar,
dense, hard, and strong. This type of bone tissue and saddle joints. Figure 4.4 shows the six
lies under the periosteum (peer-ee-AHS-tee-um), categories of diarthrotic (freely movable) joints.
or the outer membrane of a bone, and mainly • Amphiarthroses (AM-fee-ar-THROH-seez)—
around the diaphysis (shaft) of long bones. In long slightly movable joints. Examples include the
bones, cortical bone has a hollow center called the ribs and pelvis.

76   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 76 9/27/2021 3:59:02 PM

 Gliding joint (intercarpal) Hinge joint (humeroulnar)

Humerus

Ulna

Carpal bones

Pivot joint (radioulnar) Condylar joint (metacarpophalangeal)

Phalanx

LE
Ulna Metacarpal
Radius bone

Saddle joint (trapeziometacarpal) Ball-and-socket joint (humeroscapular)

Head of humerus Scapula

Metacarpal
bone

Carpal bone
P
Figure 4.4 Examples of the six different types of diarthroses, or freely movable joints.
© Body Scientific International
M
• Synarthroses (SIN-ar-THROH-seez)— Team Challenge
immovable joints. An example is the cranium.
Long Bones
Both ball-and-socket joints and hinge joints are
For this activity, you will need six 8½″ × 11″ sheets
also known as synovial (sih-NOH-vee-uhl) joints of paper; tape; one paper plate; several coins (any
because they contain a membrane that secretes denomination), small rocks, wooden blocks, and
synovial fluid. This fluid acts as a lubricant by paperweights or a stapler.
A

reducing friction between bones during move- Directions:

ment. The bursa sac contains the synovial fluid 1. Roll up three sheets of paper (8½″ × 11″)
(Figure 4.5). about 1 inch wide into a cylinder. Tape the cyl-
inder closed so it does not unroll. The sheets
of paper represent hollow bones.
Fascinating Fact
S

You have more than 230 movable and semi- 2. Test the strength of the paper bones by stand-
movable joints in your body. ing the “bones” on their ends and placing a
paper plate on top of the bones.
3. Add weight to the paper plate using rocks,
wooden blocks, coins, or household items
Bone Processes and Depressions such as a stapler or paperweights.
4. Observe how much weight the hollow paper
Processes and depressions in bones help make
bones can handle before they collapse.
up joints. Bone processes are areas on bones that
5. Now, roll up three more sheets of paper, as
extend outward and serve as attachment zones
tightly as you can, so there is no hollow section.
for muscles and tendons (Figure 4.6). Important
6. Repeat steps 2–4.
processes include tubercules, trochanters, tuber-
7. Record your observations. Then share them
osities, and condyles. A tubercule (TOO-ber-kuhl)
with the class.
is a small round process found on many bones. A

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    77

Ch04.indd 77 9/27/2021 3:59:03 PM

 trochanter is one of two large processes found on
the femur, or thigh bone. A tuberosity (TOO-buh-
Suprapatellar RAHS-ih-tee) is a large, rough process found on
bursa
many bones. A condyle (KAHN-DIGH-uhl) is a
Femur Synovial rounded-knuckle process at a joint.
membrane
and fluid A bone depression is an opening or hollow
region in the surface of a bone, where one bone
Kneecap articulates with another to form a joint (Figure 4.6).
Prepatellar Bone depressions also serve as passageways
Joint
bursa for blood vessels and nerves. A commonly seen
capsule
depression is a fossa (FAHS-uh), a shallow pit or
cavity in or on a bone. A foramen (foh-RAY-men)
Cartilage Infrapatellar is a passageway for blood vessels and nerves. A
bursae fissure (FIZH-yer) is a deep, narrow, slit-like open-
ing. A sulcus (suhl-kus) is a groove or furrow, and

LE
a sinus is a hollow cavity within a bone.

Tibia
Inquiring Minds
© Body Scientific International
Foramens
The opening in the mandible for passage
Figure 4.5 The small, fluid-filled bursa sacs of
of the chin artery/nerve is known as the
the knee act like cushions by reducing friction
P mental foramen. How many foramens are in the
between bones, muscles, and tendons near the human body?
joints.
M
Tubercule
Trochanter
Sulcus
Sinus Foramen Fossa
A

Fissure Tuberosity

Process
S

Skull
Fossa

Pelvis
Tubercule
Condyle
Humerus

Femur Condyle
© Body Scientific International

Figure 4.6 Examples of bone processes and depressions in the femur, skull, humerus, and pelvis.

78   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 78 9/27/2021 3:59:04 PM

 Axial Skeleton other at joints called sutures. In newborns, the
cranial bones are not completely joined. Rather,
The axial skeleton consists of the bones along there are soft spots called fontanels (FAHN-tuh-
the axis, or central part, of the human skeleton. It nelz) between the cranial bones. These soft spots
includes the skull, thoracic cage, and vertebral col- develop into bone in early infancy.
umn (spine).
The cranium consists of the following bones:
Bones of the Skull • The frontal bone forms the forehead.
The skull contains the cranial and facial bones.
• Parietal (puh-RIGH-uh-tuhl) bones form the
The cranium is made up of bones that protect the
roof and upper sides of the cranium.
brain (Figure 4.7). The cranial bones attach to each

Frontal bone

LE
Parietal bone Nasal bone

Sphenoid bone Temporal bone

Palatine bone
Lacrimal bone
Zygomatic bone

Mastoid process
P
Maxillary bone

Mandible
Vomer
M
Anterior view

Coronal suture

Frontal bone
Parietal bone
A

Temporal bone
Sphenoid bone

Nasal bone Squamous suture

S

Lacrimal bone

Ethmoid bone Lambdoidal suture

Zygomatic bone

Maxillary bone Occipital bone

Mandible

Lateral view
© Body Scientific International

Figure 4.7 The bones of the skull.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    79

Ch04.indd 79 9/27/2021 3:59:04 PM

 • Occipital (ahk-SIP-ih-tuhl) bones form the Fascinating Fact
posterior floor and walls of the cranium. The stirrup bone of the middle ear is the smallest
• Temporal (TEM-puh-ruhl) bones form the bone in the body. It is equivalent to the size of a
sides and base of the cranium. grain of rice.
• The sphenoid (SFEE-noyd) bone forms part of
the base of the skull, and the floor and sides of Bones of the Thoracic Cage
the eye sockets.
The thorax, or rib cage, is made up of the ster-
• The ethmoid (ETH-moyd) bone forms part of num, ribs, and thoracic (thoh-RAS-ik) vertebrae.
the nose, eye socket, and floor of the cranium. The rib cage, formally called the thoracic cage, pro-
Sutures join all facial bones except one, making tects many vital organs (Figure 4.8). Plenty of car-
them immovable. The mandible, or lower jaw- tilage on the anterior of the thoracic cage allows
bone, is the only facial bone capable of movement. for movement of the thorax during the act of
It enables you to speak and chew. breathing.
The bones that make up the face are as follows: The bones of the thoracic cavity include the

LE
• Nasal bones form the bridge of the nose. following:
• The vomer (VOH-mer) bone is the septum, • The sternum forms the breastbone, which
or dividing line, between the left and right serves as the anterior attachment for the ribs.
cavities of the nose. The sternum is made up of three smaller
• The zygomatic (ZIGH-guh-MAT-ik) bones are sections: the manubrium (muh-NOO-
the cheekbones. bree-um), the body, and the xiphoid (ZIGH-
foyd) process.
• The maxillary (MAK-sih-lair-ee) bones form
the upper jawbone. • There are 12 pairs of ribs called costals, which
P attach posteriorly to the thoracic vertebrae. The
• The mandible is the lower jawbone. rib cage contains 24 bones arranged in pairs
• The palatine (PAL-uh-tighn) bone forms the of 12. The first seven pairs of costals are called
posterior part of the hard palate in the mouth. true ribs, or fixed ribs, because they attach
• Lacrimal (LAK-rih-muhl) bones make up part anteriorly to the costal cartilage. The remaining
M
of the eye socket. Each lacrimal bone contains a three pairs of ribs (8–10) are called false ribs
channel through which tears flow. because they indirectly attach to the sternum

Clavicle Costal cartilage

1
A

2 Manubrium
3

4
True ribs Body Sternum
S

7 Xiphoid
process
8

9
False ribs
10

11 12

Floating ribs
© Body Scientific International

Figure 4.8 The bones of the thoracic cage.

80   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 80 9/27/2021 3:59:05 PM

 by connecting with the cartilage of the ribs C1
above them. The last two pairs of costals C2
C3
(11 and 12) are called floating ribs because Cervical region C4 Cervical curve
they attach neither to the sternum nor to C5
cartilage, but to the vertebrae. C6
C7
• The thoracic vertebrae, made up of
T1
12 vertebrae, serve as the posterior attachment
for the ribs. T2
T3
Bones of the Vertebral Column T4
Twenty-six bone segments make up the T5
vertebral column, or spine (Figure 4.9). These seg- T6
ments are arranged in five sections that surround Thoracic region
T7
and protect the delicate spinal cord. Between most Thoracic curve
T8

LE
vertebrae lie intervertebral (IN-ter-VER-tuh-
T9
bruhl) disks, which are composed of cartilage and
act as shock absorbers, allowing for movement of T10
the spinal column. Bones that comprise the spinal T11
column include the following: T12
• Seven cervical vertebrae, also known as the
L1
C-spine (C1–C7), make up the neck region of
the spine. L2
• Twelve small bones form the thoracic
P
vertebrae, also known as the T-spine (T1–T12).
The thoracic vertebrae connect to the ribs.
• Continuing down the spinal column, the next
five vertebrae make up the lumbar vertebrae,
known as the L-spine (L1–L5). The lumbar
Lumbar region L3

L4

L5
Lumbar curve
M
vertebrae, which curve in the lower back, are Sacral curve
the strongest and largest vertebrae. Sacrum
• The sacrum (SAY-krum), or S-spine, is a
slightly curved, triangular bone composed of Coccyx
five segments that gradually fuse together to © Body Scientific International
become one. This fusion process takes place Figure 4.9 The vertebral (spinal) column, lateral
A

during childhood. view.

• The coccyx (KAHK-siks) is made up of four
small bones that fuse to become the tailbone. The appendicular skeleton comprises the shoulder
This fusion of coccygeal (kahk-SIJ-ee-uhl) girdles, arms, wrists, and hands in the upper part
vertebrae typically occurs in early adulthood. of the body and the pelvic girdle, legs, ankles, and
S

Fascinating Fact feet in the lower part of the body.

Humans and giraffes have the same number of
bones in their necks, but the vertebrae in a giraffe’s Shoulder Girdle
neck are much, much larger. The shoulder girdle is composed of bones that
support attachment of the upper extremities to the
axial skeleton. The bones that make up the shoul-
der girdle include the clavicle, commonly known
Appendicular Skeleton as the collarbone; the sternum (breastbone); and the
The appendicular skeleton contains 126 bones scapula, or shoulder blade. (See Figure 4.1.) The
that attach to the axial skeleton as appendages. clavicle connects the sternum to the scapula.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    81

Ch04.indd 81 9/27/2021 3:59:05 PM

 Student Challenge Pelvic Girdle
Build the Term The bones of the pelvic girdle support attach-
The bony process of the shoulder blade, which ment of the lower extremities to the axial skeleton
extends over the lateral anterior area of the (Figure 4.10). The bones that comprise the pelvic
shoulder joint, is known as the acromion. Using girdle are as follows:
one of the suffixes listed in this chapter, build the • The ischium (IS-kee-um) is the posterior part
term that means “pertaining to the bony process of of the pelvic bone.
the shoulder blade.”
• The ilium is the broad, blade-shaped bone that
forms the upper part of each side of the pelvis.
Upper Extremities • The pubis (PYOO-bis) is the anterior part of
The bones of the upper extremities, shown in the pelvic bone.
Figure 4.1, are as follows:
• The humerus is the upper arm bone. Lower Extremities
The bones that make up the lower extremities,

LE
• The radius is the smaller bone found on the
thumb side of the forearm. shown in Figure 4.1, are as follows:
• The ulna is the larger forearm bone. The • The femur, or thighbone, is the upper leg bone.
proximal end of the ulna forms the elbow. It is the longest bone in the human body.
• Eight carpal bones make up the wrist. • The patella, or kneecap, is the bone that forms
the anterior part of the knee.
• Five metacarpals (MET-uh-KAR-puhlz) form
the bones of the hand. • The tibia, or shinbone, is the larger, more
medially located lower leg bone.
• Fourteen phalanges (fuh-LAN-jeez) make
up the finger bones. Each finger (except the • The fibula, located laterally to the tibia, is the
P
thumb) has three phalanges: proximal, medial,
and distal. The thumb has only two phalanges:
the proximal and distal phalanges.
smaller of the two lower leg bones.
• Seven tarsal bones make up the ankle. The
largest of these bones, called the calcaneus
M
Coxal bone Sacroiliac
joints
Iliac crest
A

Ilium
Sacrum
S

Coccyx Acetabulum
Ischial spine
Obturator
foramen Ischium

Pubis
symphysis Ischial tuberosity Pubis

Pelvis Coxal bone, right lateral view

© Body Scientific International

Figure 4.10 The bones of the pelvic girdle.

82   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 82 9/27/2021 3:59:05 PM

 (kal-KAY-nee-us), is known as the heelbone. Fascinating Fact
The next largest is the talus (anklebone). The longest bone in your body is your femur
• Five metatarsals (MET-uh-TAR-suhlz) (thighbone). The femur is about one-quarter of your
comprise the bones of the foot. total height. The smallest bone in your body is the
stirrup bone, or stapes (STAY-peez). Located inside
• Each foot contains 14 phalanges. There are the ear, the stapes can measure one-tenth of an
two phalanges (proximal and distal) in the big inch. This tiny bone carries sound vibrations to the
toe. There are three phalanges in each of the cochlea, a spiral-shaped structure in the inner ear
other four toes: proximal, medial, and distal that generates nerve impulses in response to the
phalanges. vibrations.

Diseases and Conditions

In this section, you will learn about pathological conditions that affect

LE
bones, joints, or both. Rheumatoid arthritis, for example, is a chronic dis-
ease that affects both the joints and the bones. A patient with rheumatoid
arthritis experiences painful inflammation in the lining of the joints. This
inflammation causes deformity of the joints and erosion of bone.
Diseases and conditions common to the skeletal system are described
in the following list.

Disease/Condition Definition
ankylosing spondylitis
ANG-kuh-LOH-sing
SPAHN-duh-LIGH-tis
CF: ankyl/o = crooked;
bent; stiff; fused together
P
A form of rheumatoid arthritis
characterized by inflammation of
vertebral joints, which can become fused
and stiff; rheumatoid arthritis of the spine.
Fascinating Fact
Pectus excavatum (PEK-
tus ek-skuh-VAY-tum),
commonly known as “funnel
M
CF: spondyl/o = vertebra;
chest,” is a condition in which
backbone
the sternum (breastbone)
S: -itis = inflammation
is abnormally depressed
ankylosis A stiff joint caused by adhesion, or (displaced inward). The
ang-kuh-LOH-sis abnormal fusion of two bones into one. condition is thought to
be congenital. The term
CF: ankyl/o = crooked;
pectus excavatum comes
A

bent; stiff; fused together

S: -osis = process; directly from the Latin words
abnormal condition pectus (breast), ex- (a prefix
meaning “out” or “away
arthralgia Pain in a joint or joints. from”), and cavus (“hollow”).
ar-THRAL-jee-uh The suffix -um is a noun form
that means “structure.”
S

CF: arthr/o = joint

S: -algia = pain

arthritis Inflammation of joints; usually

ar-THRIGH-tis accompanied by pain and, frequently,
CF: arthr/o = joint structural changes in bone and cartilage.
S: -itis = inflammation

osteoarthritis Joint disease that mostly affects cartilage Timotheus Wolf/Shutterstock.com

AHS-tee-oh-ar- between the bone and joint; also known as
THRIGH-tis degenerative joint disease (DJD).
CF: oste/o = bone
CF: arthr/o = joint
S: -itis =
inflammation

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    83

Ch04.indd 83 9/27/2021 3:59:05 PM

 Disease/Condition Definition
arthritis (continued)
rheumatoid arthritis A chronic, systemic disease characterized
(RA) by inflammation, pain, and stiffness in
ROO-muh-toyd the joints; results in crippling deformities
ar-THRIGH-tis (Figure 4.11).
CF: rheumat/o =
WILLSIE/iStock/Getty Images Plus via Getty Images
watery flow
S: -oid = like; Figure 4.11 Rheumatoid
resembling arthritis (RA) in the hands.
gout Form of arthritis in which uric acid builds
gowt up in the blood and causes joint swelling
and pain; gouty arthritis.

LE
bunion Joint swelling at the base of the great toe,
BUN-yun caused by inflammation of the bursa. Ponder This
Broken Bones
bursitis Inflammation of the bursa, usually What do you think is the
bur-SIGH-tis between bony protrusions and muscle most commonly broken
or tendon. Examples include rotator cuff bone in the human body?
CF: burs/o = bursa (sac of
Share your response with
fluid near a joint) injury in the shoulder, tennis elbow, and
S: -itis = inflammation your classmates, along
knee injury.
P with an explanation for
chondromalacia Softening of the cartilage. your reasoning.
KAHN-droh-muh-LAY-shee-
uh
CF: chondr/o = cartilage
S: -malacia = softening
M
dislocation Total displacement of a bone from its joint; © Body Scientific International

luxation. Figure 4.12 Comminuted

fracture.
fracture A break in a bone.
Colles (KAH-leez) A fracture of the distal radius (bone on
A

fracture the thumb side of the forearm) that results

from a fall onto an outstretched hand.
comminuted (KAH- A bone that has splintered or has been © Body Scientific International

mih-NEW-ted) crushed (Figure 4.12). Figure 4.13 Compound

fracture fracture.
S

compound fracture A broken bone with an open wound

leading to the site of the fracture, or bone
that protrudes through the skin; also © Body Scientific International
called open fracture (Figure 4.13).
Figure 4.14 Greenstick
greenstick fracture An incomplete fracture; the bone is bent fracture.
and partially broken. This type of fracture
occurs primarily in children (Figure 4.14).
longitudinal A fracture that runs parallel to the long
fracture axis of the bone (Figure 4.15). © Body Scientific International

Figure 4.15 Longitudinal

fracture.

84   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 84 9/27/2021 3:59:06 PM

 Disease/Condition Definition
fracture (continued)
© Body Scientific International
oblique (ahb-LEEK) A break across the bone at an angle Figure 4.16 Oblique fracture.
fracture (Figure 4.16).
pathologic fracture A fracture resulting from pressure on
weakened bone; due to osteoporosis or
cancer, for instance (Figure 4.17).
© Body Scientific International

simple fracture A broken bone that does not penetrate Figure 4.17 Pathologic
the skin; also called closed fracture fracture.
(Figure 4.18).
spiral fracture A fracture in which the bone has been

LE
twisted apart; a common sports injury
(Figure 4.19). © Body Scientific International

Figure 4.18 Simple fracture.

stress fracture A small crack in bone resulting from
chronic, excessive impact; an overuse
injury.
transverse fracture A fracture that runs straight across the
© Body Scientific International
bone, at a right angle to the long axis. It is
often caused by a direct blow or prolonged Figure 4.19 Spiral fracture.
stress, such as from running (Figure 4.20).
P
herniated disk Intervertebral disk that has slipped or
ruptured (Figure 4.21).
© Body Scientific International
lumbago Pain in the lower back (lumbar) region. Figure 4.20 Transverse
M
lum-BAY-goh fracture.
myeloma Cancer of the plasma cells (a type of white
Herniated disk
MIGH-uh-LOH-muh blood cell) that originates in the bone compressing nerve
CF: myel/o = bone marrow.
marrow; spinal cord
S: -oma = tumor; mass
A

ostealgia Pain in the bone.

AHS-tee-AL-jee-uh
CF: oste/o = bone
S: -algia = pain
S

osteitis or ostitis Inflammation of the bone.

AHS-tee-IGH-tis or
ahs-TIGH-tis
CF: oste/o = bone
S: -itis = inflammation
Normal disk
osteochondroma Tumor or bony projection that covers © Body Scientific International
AHS-tee-oh-kahn-DROH- cartilage. Figure 4.21 Herniated disk.
muh
CF: oste/o = bone
CF: chondr/o = cartilage
S: -oma = tumor; mass

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    85

Ch04.indd 85 9/27/2021 3:59:08 PM

 Disease/Condition Definition
osteoma Tumor of the bone.
AHS-tee-OH-muh
CF: oste/o = bone
S: -oma = tumor; mass

osteomalacia Abnormal softening of the bone. In

AHS-tee-oh-muh-LAY-shee-uh children, this condition is known as rickets.
CF: oste/o = bone
S: -malacia = softening

osteomyelitis Inflammation of the bone and bone

AHS-tee-oh-MIGH-uh- marrow (Figure 4.22).
LIGH-tis © Body Scientific International
CF: oste/o = bone

LE
Figure 4.22 Osteomyelitis.
CF: myel/o = bone
marrow
S: -itis = inflammation

osteopenia Bone deficiency; in a young person, less-

AHS-tee-oh-PEE-nee-uh than-average bone density.
CF: oste/o = bone
S: -penia = deficiency

osteoporosis Condition of small holes in the

AHS-tee-oh-puh-ROH-sis
CF: oste/o = bone
S: -porosis = abnormal
condition of small holes
osteosarcoma
P
bones; noticeable loss of bone density
(Figure 4.23).

Malignant tumor that arises from

A
M
AHS-tee-oh-sar-KOH-muh connective tissue and affects the bone.
CF: oste/o = bone
CF: sarc/o = flesh;
connective tissue
S: -oma = tumor; mass

Paget’s disease Excessive breakdown of bone and

A

PAJ-ets abnormal, enlarged bone formation; osteitis

deformans (AHS-tee-IGH-tis duh-FOR-
menz).
B
Top to bottom:
periostitis Inflammation of the periosteum, the angkhan/iStock/Getty Images Plus via Getty Images,
PEER-ee-ahs-TIGH-tis covering that surrounds the bone. Puwadol Jaturawuttichai/Shutterstock.com
S

P: peri- = around; Figure 4.23 X-rays of a

surrounding normal pelvic girdle (A)
CF: oste/o = bone and a pelvic girdle with
S: -itis = inflammation
osteoporosis (B).
sequestrum Bone tissue death that occurs when the
suh-KWES-trum bone has become sequestered, or separated,
from the healthy tissue around it, due to
lack of blood supply.

86   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 86 9/27/2021 3:59:09 PM

 Disease/Condition Definition
spina bifida Split spine; congenital condition in which
SPIGH-nuh BIF-ih-duh part of the membrane covering the spinal
cord protrudes through a gap in the spine
(Figure 4.24).
spinal curvatures Abnormal curvatures of the spine.
kyphosis Abnormal, outward curvature of the
kigh-FOH-sis thoracic spine; humpback; called Dowager’s
CF: kyph/o = hump in older females (Figure 4.25).
humpback
S: -osis = process;
abnormal condition

LE
lordosis Abnormal, forward curvature of the
lor-DOH-sis lumbar spine; swayback (Figure 4.26).
CF: lord/o = curve;
swayback
S: -osis = process;
abnormal condition

scoliosis Abnormal, lateral curvature of the spine

© Body Scientific International
SKOH-lee-OH-sis (Figure 4.27).
CF: scoli/o = Figure 4.24 Spina bifida is
crooked; bent P a congenital defect in which
S: -osis = process; nerves protrude from the
abnormal condition spine.
spondylosis Stiffening of the spine; spinal osteoarthritis.
SPAHN-duh-LOH-sis
M
CF: spondyl/o = vertebra;
backbone
S: -osis = process;
abnormal condition
A

Lateral
Accentuated deviation
thoracic curve of spine
S

Exaggerated
lumbar curve

© Body Scientific International © Body Scientific International © Body Scientific International

Figure 4.25 Kyphosis. Figure 4.26 Lordosis. Figure 4.27 Scoliosis.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    87

Ch04.indd 87 9/27/2021 3:59:10 PM

 Team Challenge
Your Spine in Action
In a small group, practice sharing your knowledge of vertebral disorders
using a homemade model of a section of the spine. For this activity, you
will need rice cakes (bones), marshmallows (disks), straws (spine), string
or yarn (nerves), water, and needles (to thread the nerves)
1. Place drops of water in the middle of several rice cakes. The rice
cakes should become soft in the center.
2. Put a straw through rice cakes and marshmallows in alternating order
(rice cake, marshmallow, rice cake, marshmallow) until the desired
number.
3. Thread a needle with thread or yarn. Stitch through each marshmallow
near the upper rice cake with a single thread. You may need to wipe
the needle between use. This is your model of a healthy spine.

LE
4. Make a second model of the spine using the same steps. Choose one
vertebral disorder and make your model to reflect how this disorder
affects the spine. Use this text and other reliable resources to find
signs and symptoms, complications, and current treatments for the
disorder.

Disease/Condition Definition
sprain Trauma to the ligaments surrounding a
joint, causing pain and, in some cases,
P
disability.
subluxation Partial dislocation of a bone from its joint.
sub-luk-SAY-shun
P: sub- = below; under
M
CF: lux/o = slide
S: -ation = process;
condition

talipes Congenital deformity of the foot involving

TAL-ih-peez the talus (anklebone); clubfoot (Figure 4.28).
A

Bunsinth-Nan-Pua/Shutterstock.com
tendinitis, tendonitis Inflammation of a tendon.
Figure 4.28 Talipes.
ten-duh-NIGH-tis
CF: tendin/o, tendon/o =
tendon
S: -itis = inflammation
S

Diagnostic Tests and Procedures

A diagnostician uses different kinds of tools and methods to aid in
pinpointing the cause of patients’ health conditions. Following are some
of the most common tests and procedures used to diagnose (identify)
diseases and conditions of the skeletal system.

88   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 88 9/27/2021 3:59:10 PM

 Case Study
Mary O’Toole, an active, 46-year-old female
with a healthy lifestyle, has been experiencing
lower back pain, as well as pain radiating down
her right leg and calf. Recently, Mary noticed
increased aggravation of pain when sitting. She
has tried over-the-counter pain medication,
including Advil® and Tylenol®, but with no
relief. After two weeks of the pain, Mary made
an appointment with her internist, Dr. Feeney.
An internist, or internal medicine specialist, is
a physician who specializes in the diagnosis,
treatment, and prevention of disease in adults.

LE
After examining Mary, Dr. Feeney referred
her to Dr. Peter Lanips, who ordered X-rays of Monkey Business Images/Shutterstock.com

Mary’s lumbosacral (LS) spine. The lumbosacral

(LUM-boh-SAY-kruhl) spine is the lower part Your Turn
of the vertebral column, made up of the lumbar Based on the facts mentioned in the case study, what
region and the sacrum (the bone segment that kind of procedure do you think Mary’s doctor will
connects the spine to the pelvis). The X-rays perform to alleviate her pain? Explain your answer.
revealed a 2-centimeter bulge between vertebral You will refer back to this case study when you interpret
disks L5 and S1 (lumbar vertebra 5 and sacral Mary’s medical record in the Chapter Review.
vertebra 1). P
Test/Procedure Definition
arthroscopy Visual examination of a joint using a scope
M
ar-THRAHS-koh-pee (Figure 4.29).
CF: arthr/o = joint
P: -scopy = visual
examination using a
scope
A

Cannula
Knee
S

Arthroscope
(camera and
light source)
Arthroscopic
(surgical)
instrument

© Body Scientific International

Figure 4.29 Arthroscopy.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    89

Ch04.indd 89 9/27/2021 3:59:11 PM

 Workplace Skills Lab EVENT PREP

Assisting a Client to Ambulate • Ask the client to hold the backs of your
Using a Transfer Belt elbows.
Estimated time: 7–10 minutes • Standing in front of the client, maintain a
Materials needed: one chair, gait belt, and call signal wide base with feet positioned outside the
client’s feet and knees stabilizing client’s
Preparation knees.
As one grows older, the probability of mobil- 3. On your signal (“one, two, three”), help the
ity issues increases. To decrease the risk of muscle client stand, using underhanded grasp on the
tone loss and falls, people should include physical transfer belt.
activity in their daily routines. Working in pairs,
4. Walk slightly behind and to one side (the weak
designate one person the client and the other the

LE
side) of the client for 15 feet while holding the
caregiver. The first caregiver will perform this skill
transfer belt using an underhanded grasp.
on the client, then the client will take a turn at being
the caregiver. The caregiver will assist the client to 5. Assist the client with ambulating back to the
ambulate (walk) 15 feet safely using a transfer belt, chair and remove the transfer belt.
without injuring self or the client. 6. Give the client the call signal (a button that
displays a light and sound to notify the care-
Steps
giver when a client needs assistance).
1. Explain the entire ambulation procedure to
the client before starting. Describe every step 7. Store the gait belt.

contact and speaking clearly.

2. Before ambulation:
P
of the process, while maintaining face-to-face

• Assist the client to move forward in the

8. Wash your hands or use alcohol-based hand
sanitizer for hand hygiene.

Discussion
• Did the ambulation go smoothly? Did the
chair until the feet are flat on the floor and
M
client is wearing shoes. client know what to expect during ambulation?
Communication is key to any skill or care.
• Place the transfer belt around the client’s
waist and secure until snug around the • What conditions, injuries, or diseases could
smallest portion of the abdominal area. make your attempt to ambulate a client more
• Coordinate the transfer with your client. difficult?
For example, say “On the count of three, • What safety factors should you consider before
A

stand with me, then pivot….” ambulating a client?

Test/Procedure Definition
S

bone density test X-ray test that determines loss of, or

changes in, bone density. It is used to
diagnose diseases such as osteomalacia,
osteoporosis, and osteopenia. Also called
bone densitometry (den-sih-TAH-muh-tree)
(Figure 4.30).
bone marrow aspiration Process involving the use of a syringe and
izusek/E+ via Getty Images
needle to withdraw bone marrow liquid;
used in medical procedures such as stem- Figure 4.30 Bone density
cell transplant. test.

90   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 90 9/27/2021 3:59:11 PM

 Test/Procedure Definition
bone scan A nuclear scanning test that identifies
bone fractures, tumors, or infections. Spinal needle is inserted
between 3rd and 4th
computerized Process in which a computer analyzes lumbar vertebrae.
tomography (tuh-MAH- radiographic images of a specific section of
gruh-fee) or computed the body from multiple angles to identify
tomography (CT) bone injury or disease. CT scans provide
more detailed imagery than standard
X-rays (Figure 4.31).
lumbar puncture Spinal tap; needle aspiration of
spinal canal fluid in the lumbar area
(Figure 4.32).

LE
magnetic resonance A noninvasive scanning test that involves
imaging (MRI) use of an electromagnetic field and radio
waves to visualize soft-tissue structures.
rheumatoid factor (RF) A blood test performed to diagnose
rheumatoid arthritis. Cerebrospinal fluid
© Body Scientific International
X-ray Radiographic image used to diagnose
Figure 4.32 Lumbar
skeletal changes in the body.
puncture.

Direction of rotation
P Rotating X-ray source
M
Fan-shaped X-ray beam

Computerized tomography
scans are made by rotating an
X-ray beam around the patient.
A

The CT scanner images the

body in a series of “slices” that
Motorized platform
a computer then stitches
together to create 3-D views.

Rotating X-ray detectors

S

Patient lies on
motorized platform
CT scan machine

© Body Scientific International

Figure 4.31 Anatomy of a CT scan.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    91

Ch04.indd 91 9/27/2021 3:59:12 PM

 Surgical Procedures and
Therapeutics
After the diagnosis of a pathological condition, a treatment can be
planned and implemented. For instance, when an X-ray shows a simple
fracture of the wrist, the treatment of choice may be a closed reduction
and internal fixation (CRIF). This procedure involves manual manipula-
tion of the fracture to set the bones in proper alignment without surgical
intervention.
Following is a list of common surgical and noninvasive treatments for
diseases and conditions of the skeletal system.
Treatment Definition
amputation Removal of a limb, usually surgical; for

LE
example, above-the-knee amputation.
arthrocentesis Surgical puncture of the joint space with
AR-throh-sen-TEE-sis a needle to remove accumulated fluid
CF: arthr/o = joint (Figure 4.33).
S: -centesis = surgical Femur
puncture to remove fluid
Cartilage
arthrodesis Surgical immobilization of a joint.
AR-throh-DEE-sis P
CF: arthr/o = joint
S: -desis = to bind; tie
together Synovial
membrane
arthroplasty Surgical repair of a joint.
Tibia
M
AR-throh-PLAS-tee
CF: arthr/o = joint Needle
S: -plasty = surgical repair © Body Scientific International

Figure 4.33 Arthrocentesis.

bone grafting Process of transplanting and implanting
tissue from one part of the body to
another; used to repair a defect or injury.
A

bursectomy Surgical removal of the bursa.

bur-SEK-tuh-mee
CF: burs/o = bursa
S: -ectomy = surgical
removal; excision
S

closed reduction and External manipulation to restore a

internal fixation (CRIF) fractured bone to normal position.
cast Solid mold of a body part; used to
immobilize fractures or dislocations.
splint An appliance made of bone, wood, metal,
or plaster of Paris; used for fixation of an
injured body part.
traction Application of a pulling force to align a
dislocated part of the body.

92   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 92 9/27/2021 3:59:12 PM

 Treatment Definition
diskectomy Surgical removal of a herniated (ruptured)
dis-KEK-toh-mee vertebral disk.
open reduction and Surgical procedure involving the use of
internal fixation (ORIF) steel rods, plates, or screws to realign a
severe bone fracture to normal position.
orthosis Straightening or correction of a bone
or-THOH-sis deformity.
CF: orth/o = straight
S: -osis = process;
abnormal condition

osteoplasty Surgical correction of the bone.

LE
AHS-tee-oh-PLAS-tee
CF: oste/o = bone
S: -plasty = surgical repair

osteotomy Incision through the bone.

AHS-tee-AH-tuh-mee
CF: oste/o = bone
S: -tomy = process of
cutting; incision
Fascinating Fact
physical therapy Rehabilitation that focuses on restoring
P Ancient Egyptians developed
physical function and preventing the world’s first functional
disability. prosthetic bone. This bone
was the big toe.
prosthesis Artificial replacement for a missing body
prahs-THEE-sis part, such as an extremity (arm or leg).
M
spondylosyndesis Surgical fusion of joints (ankylosis)
SPAHN-dih-loh-sin-DEE-sis between vertebrae; spinal fusion
CF: spondyl/o = vertebra; (Figure 4.34).
backbone
P: syn- = together; with
S: -desis = to bind; tie
A

together
ChooChin/Shutterstock.com
tenotomy Incision to, or cutting of, a tendon.
Figure 4.34
teh-NAH-tuh-mee
Spondylosyndesis.
CF: ten/o = tendon
S: -tomy = process of
S

cutting; incision

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    93

Ch04.indd 93 9/27/2021 3:59:13 PM

 Therapeutic Drug Treatments
Injuries and illnesses of the skeletal system often require treatment
with medications. The following list includes common drugs and their
pharmacodynamics (actions in the body).
Drug Effect on Body Student Challenge
Skeletal Alphabet
analgesic Drug that relieves pain.
Directions: Working with a
AN-uhl-JEE-zik partner, see how fast you
anti-inflammatory Agent that counteracts inflammation. can recite the alphabet by
naming a skeletal system
antipyretic Agent that reduces fever. term that begins with each
AN-tee-pigh-RET-ik letter of the alphabet. The
first person names a term
narcotic Drug that relieves pain and induces sleep that starts with the letter A,

LE
by depressing (reducing the activity of) the second person names
the central nervous system. a term that begins with the
letter B, and so on. You
nonsteroidal anti- Agent that relieves pain, counteracts might also do this activity
inflammatory drug inflammation, and reduces fever; by writing separate lists.
(NSAID) commonly used to treat arthritis. After you have written as
many terms as you can
think of, exchange your
Common Medical Abbreviations P results with your partner.

The following medical abbreviations are commonly used in reference

to the skeletal system. These abbreviations provide a shorthand method
of communication among healthcare professionals concerning patho-
logical conditions, diagnostic tests, surgical procedures, and therapeutic
treatments. These abbreviations can be found in this chapter and in the
M
medical record activity that follows.

Abbreviation Meaning Abbreviation Meaning

ATT PHYS attending physician NSAID nonsteroidal anti-inflammatory drug
BP blood pressure OA osteoarthritis
CRIF closed reduction and internal fixation ORIF open reduction and internal fixation
A

CT computerized tomography; computed OTC over-the-counter

tomography
CV cardiovascular PO, p.o. by mouth (from the Latin per os)
DJD degenerative joint disease PRN, p.r.n. as needed (from the Latin pro re nata)
S

Fx function; fracture Pt, pt. patient

GI gastrointestinal Q4H every four hours (from the Latin
quaque quarta hora)
L, Lt left R, Rt right
L5–S1 lumbar vertebra 5 to sacral vertebra 1 RA rheumatoid arthritis
LBP lower back pain RF rheumatoid factor
LS lumbosacral Rx, Rhx prescription
mg milligram(s) y/o years old; year-old
MRI magnetic resonance imaging

94   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 94 9/27/2021 3:59:13 PM

 Careers to Consider
If you pursue any of the following careers, you will interact on a regular basis with patients who have
conditions or diseases of the skeletal system. For more detailed information on the career opportunities
discussed on this page, visit the US Bureau of Labor Statistics website.

Chiropractor a Doctor of Physical Therapy (DPT) degree and

a license in their state of practice. PTs typically
Chiropractors treat illness and injury of the neu- work in private offices, hospitals, clinics, nursing
romusculoskeletal system, which includes nerves, homes, and rehabilitative centers.
muscles, ligaments, and tendons. These specialists
treat patients primarily by manual manipulation
or adjustment of parts of the body, especially the
Orthopedic Surgeon

LE
spinal column. They may use X-rays to help locate Orthopedics (or-thoh-PEE-diks) is a branch of
the source of a patient’s health concern. medicine focused on treating or correcting mus-
Chiropractors may combine manipulative ther- culoskeletal conditions, including spine and joint
apy techniques with adjunctive therapies such as injuries or deformities. Orthopedic surgeons are
acupuncture and ultrasound. They also recom- physicians who specialize in the diagnosis and
mend dietary modifications, supportive devices, treatment of spinal disorders, sports injuries,
and exercises designed to improve physical arthritis, and fractures. Orthopedic surgeons must
health. They do not prescribe medications or sur- hold a Medical Doctor (MD) or a Doctor of Osteo-
gery, but refer patients to other healthcare profes- pathic Medicine (DO) degree.
sionals when necessary. P
Chiropractors must hold a Doctor of Chiroprac-
tic (DC) degree and a state license. A Doctor of
Chiropractic program generally takes four years
to complete. Most chiropractors work indepen-
Prosthetist
A prosthetist (PRAHS-thuh-tist) measures,
designs, fabricates, fits, and services a prosthesis
(prahs-THEE-sis), or artificial limb. A licensed
M
dently or in a group practice. physician can prescribe a prosthesis for the
replacement of an extremity due to amputation,
Physical Therapist congenital deformity, or absence. A prosthetist
must have at least a master’s degree and complete
Physical therapists (PTs) work with a patient’s
a one-year residency to obtain certification.
doctor to develop a plan for restoring and main-
taining the patient’s maximum movement and
A

functional ability. They use specific exercises, man- Radiologic Technologist

ual manipulation, and other physical therapy inter- Radiologic technologists perform diagnostic
ventions, and they educate patients about ways imaging (X-rays) of the body for diagnosis or treat-
to improve their mobility and manage their pain. ment of health conditions. They may find employ-
PTs also work with ment in hospitals,
S

individuals to pre- doctors’ offices, or

vent loss of mobility cancer treatment
by developing cus- centers. A radiologic
tomized fitness- and technologist typi-
wellness-oriented cally holds an asso-
programs. ciate’s degree. Some
Physical therapists states require licens-
are required to hold antoniodiaz/Shutterstock.com ing or certification. Marcus Chung/E+ via Getty Images

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    95

Ch04.indd 95 9/27/2021 3:59:13 PM

 Chapter 4 Review
For each exercise that follows, write your answers in a separate document or sheet of paper.

Identify the Anatomical Structure

Directions: Identify the correct anatomical term that
corresponds to each number in the diagram.

2
1

3
5
4

LE
6

7
26

25

24
P 9
10
11
M
13

14

15
A

12
16

17
S

18

19

23
20
22

21
© Body Scientific International

96   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 96 9/27/2021 3:59:14 PM

 Chapter 4 Review

Word Parts Spelling EVENT PREP

Directions: Write the meaning(s) of each word part. Directions: Identify the correctly spelled medical term
Identify each word part by type (prefix, combining form, in each numbered item. Then define each term. If you
or suffix). are not sure of the correct spelling, look up the term in
1. arthr/o 8. sub- a medical dictionary.
2. peri- 9. -scopy 1. arthritis artheritis
arthrytis arthuritis
3. oste/o 10. lumb/o
2. apendicular appendiculer
4. crani/o 11. -porosis
appendicular apendiculor
5. -itis 12. -ectomy
3. thorracic thorasic
6. -oma 13. orth/o thorassic thoracic
7. scoli/o 14. -malacia 4. craneal cranial
craenial crannial

LE
Anatomy and Physiology 5. osteoporosis osteporosis
Directions: Provide the correct term(s) for each item osteoporeosis osteoperosis
that follows. 6. clavical clavacle
1. What are the two major parts of the human clavicle clavycle
skeleton? 7. epyphisis epiphysis
2. Name two examples of long bones. epiphasis epiphasys
3. Name two examples of flat bones. 8. amphearthrosis amphiarthrasis
amphiarthrosis amphiartherosis
4. What is the term for the bones in the fingers and
toes? P 9. epiphyseal epyphiseal
epiphiseal epiphysial
5. What is the end of a long bone called?
10. synoveal sinovial
6. What is the term for the shaft of a long bone?
sinoveal synovial
7. Name the term for the growth zone located
between the epiphysis and diaphysis.
Pronunciation EVENT PREP
M
8. Name the structure within bone that contains
yellow marrow composed mainly of fat cells. Directions: Pronounce each term that follows, then
write the correct spelling and define. If you are not sure
9. What is the term for the membrane that covers
of the correct spelling or definition, look up the term in
bone?
a medical dictionary.
10. Name the term for the point at which two or more
1. uh-PIF-uh-sis
bones articulate (join together).
A

2. MED-yoo-lair-ee
Matching: Combining Forms 3. DIGH-ar-THROH-seez
4. KAHK-siks
Directions: Match the combining form (root word and
combining vowel) to the correct meaning. 5. fuh-LAN-jeez
A. bone marrow; spinal cord 1. ankyl/o 6. met-uh-TAR-suhlz
S

B. rib 2. crani/o 7. MAK-sih-lair-ee

C. crooked; bent; stiff; fused 3. ped/o 8. sih-NOH-vee-uhl
together 4. myel/o 9. migh-uh-LOH-muh
D. foot; child 5. lumb/o 10. AHS-tee-oh-puh-ROH-sis
E. wrist 6. cost/o 11. AR-throh-PLAS-tee
F. ankle 7. orth/o 12. KAHN-droh-muh-LAY-shuh
G. extremities 8. carp/o
H. straight 9. tars/o
Word Surgery EVENT PREP

I. skull 10. acr/o Directions: Dissect each medical term into its word
J. lumbar region; loin parts. Identify the word-part types (prefix, combining
form, or suffix), and write the meaning(s) of each word
part. Then write a definition of the term.

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    97

Ch04.indd 97 9/27/2021 3:59:14 PM

 Chapter 4 Review
Example: osteomyelitis 14. blood pressure 16. lower back pain
Dissection: oste/o/myel/itis 15. right
oste/o (combining form) = bone
myel/o (combining form) = bone marrow Interpreting Abbreviations
-itis (suffix) = inflammation
Definition: inflammation of the bone and bone Directions: Write the correct medical term or phrase
marrow for each abbreviation listed.
1. arthritis 9. osteoarthritis 1. RA 9. ATT PHYS
2. ostealgia 10. arthroscopy 2. LS 10. L
3. osteomalacia 11. spondylosis 3. MRI 11. LBP
4. osteoporosis 12. synovial 4. R 12. mg
5. chondromalacia 13. arthroscope 5. y/o 13. CT
6. myeloma 14. chondrectomy 6. PRN 14. Q4H

LE
7. osteitis 15. patellar 7. DJD 15. pt.
8. bursitis 8. BP 16. PO

Word Construction EVENT PREP Doctor’s Orders

Directions: Using word parts and meanings presented Directions: Each item that follows contains a doctor’s
in the chapter, build the medical term described in lab order for a patient. Transcribe each order, with its
each definition that follows. abbreviations, symbols, and acronyms, into everyday
language.
1. surgical repair of a joint
1. Pt. c/o pain from DJD. Rx for NSAID p.o. q.i.d.
2. abnormal stiffening of a joint P 2. L femur fx to pre-op for ORIF.
3. softening of cartilage
3. Lab to ER room 3—RA, CBC, and UA.
4. incision to the skull
4. TPR and BP am and pm.
5. pertaining to (being located) beyond the ankle
5. 2 y/o wt 29 lbs 8oz, ht 30 in to X-ray for stat CT
6. inflammation of a tendon scan of skull.
M
7. inflammation of the bursa sac 6. New pt OV obtain VS, CXR, EKG.
8. pertaining to the wrist bone 7. MRI R knee.
9. pertaining to around the bone
10. pertaining to between the ribs Search the Source EVENT PREP

11. pertaining to inside the ribs Directions: Using reliable and credible online
12. pertaining to below the ribs resources, complete the following activities.
A

13. process of recording pictures of a joint 1. Juvenile arthritis (JA) is being increasingly diag-
14. pertaining to the calcaneus (heelbone) nosed in people younger than 16 years of age in
the United States. Visit the Centers for Disease
15. inflammation of the mastoid
Control and Prevention (CDC) website and search
16. surgical repair of the tendon for information about childhood arthritis. Then
S

answer the following questions: What is the most

Identifying Abbreviations common form of JA, and what main symptoms
Directions: Write the correct abbreviation for each does it involve? In general, does JA occur more
medical term or phrase listed. frequently in males or females? What does this
fact suggest? How does geographic location
1. lumbosacral 8. years old; year-old
impact JA?
2. every four hours 9. by mouth 2. Make a list of what you think are the five most
3. patient 10. left commonly broken bones in the human body. Then
4. milligram(s) 11. degenerative joint use reliable resources to research the answer.
5. computerized disease Prepare a report for the class, describing your
tomography 12. magnetic resonance findings in clear, concise, effective language. Ask
imaging classmates for feedback on the effectiveness of
6. as needed your language.
7. attending physician 13. rheumatoid arthritis

98   Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.

Ch04.indd 98 9/27/2021 3:59:14 PM

 Chapter 4 Review
Medical Record Practice
Directions: Following is a preoperative history report for Mary, the patient who was introduced in the Case Study.
A preoperative history report is submitted to a hospital before a patient is admitted for surgery. Read Mary’s medical
report. Then, on a separate sheet of paper, write a definition for each highlighted term and abbreviation. These terms
and abbreviations are also listed. You may encounter terms or abbreviations that were introduced in previous chapters.

Holland Medical Center

987 Medical Drive, Hospital City, US 12345-6789
PHONE: (XXX) XXX-4321 FAX: (XXX) XXX-2910
PREOPERATIVE HISTORY
PT NAME: Mary O’Toole
ID NO: 43370056

LE
ROOM NO: 304
DATE OF ADMISSION: 11/15/20XX
ATT PHYS: Peter Lanips, MD
History of Present Illness: The patient is a 46 y/o white female with a chief complaint of LBP
radiating to R leg and calf. Pain worsens when patient bends over or
attempts to touch toes. Sitting aggravates R leg and calf pain. Previous
X-ray shows 2 cm bulge of disk between L5 and S1. Patient is admitted
at this time for elective L5–S1 diskectomy. Surgery has been discussed
with patient. The patient’s internist is Fred Feeney, MD.
Medications:
Past Medical History:
Past Surgical History:
Family History:
None.
P
Tylenol 500 mg 2 PO Q4H PRN, pain; Advil 200 mg 2 PO Q4H PRN, pain.
Usual childhood diseases.

Mother and grandmother have history of arthritis.

M
Gynecological History: Regular menses (menstrual period).
Social History: Pt. is a nonsmoker. Alcohol use is limited to 2–3 glasses of wine a
week. Drug use denied.
Review of Systems: CV (cardiovascular): No high BP, heart murmurs, or shortness of breath.
Pulmonary: No chronic lung disease; no asthma.
GI (gastrointestinal): No hepatitis (infection of the liver).
A

Renal (pertaining to the kidney): Negative for infections.

Endocrine (relating to hormone-secreting glands in the body): No
diabetes or thyroid disease.
Musculoskeletal (pertaining to the muscles and bones): Positive for
early signs of arthritis.
S

Hematologic (pertaining to study of the blood): No history of anemia

(deficiency of red blood cells or hemoglobin, the main protein in
blood cells) or bleeding tendencies.
Peter Lanips, MD
PL:cjk
D: 11/13/20XX
T: 11/14/20XX

1. ATT PHYS 5. L5–S 9. Q4H 12. Pt.

2. y/o 6. diskectomy 10. PRN 13. BP
3. LBP 7. mg 11. arthritis 14. Musculoskeletal
4. R 8. PO

Copyright Goodheart-Willcox Co., Inc. Chapter 4 The Skeletal System    99

Ch04.indd 99 9/27/2021 3:59:15 PM