Musculoskeletal System

Lecture Notes
10
Musculoskeletal
A PowerPoint Presentation System
Classroom Activity to
Accompany Medical
Terminology Systems,
Seventh Edition
Barbara A. Gylys ∙ Mary Ellen Wedding
10 MUSCULOSKELETAL SYSTEM
Structure and Function

• Muscles
• Three types
• Skeletal
• Smooth
• Cardiac
• Contract for body movement
2
Structure and Function (continued)

•Muscles (continued)
• Provide body posture
• Help passage and
elimination of food
• Help propel blood through
arteries and other vessels
• Contract bladder to
eliminate urine
3

•Skeleton
• Two divisions (See illustration.)
• Axial (bones colored in illustration)
• Appendicular (blue colored in
illustration)
• Provides a skeletal framework to
support and protect the body
• Stores calcium and other
minerals
• Produces blood cells within bone
marrow
4

•Bones
• Provide a framework to support and
protect the body
• Point of attachment with muscles
• Held close together at the joint by
ligaments, which are flexible bands
of fibrous tissue
• Store calcium and other minerals
• Produce blood cells within bone
marrow
5

•Bones (continued)
• Four types
• Short
• Irregular
• Flat
• Long
• Diaphysis — shaft, or long portion, of the bone
• Distal and proximal epiphysis — two ends of the
bone
6
Structure and Function Exercise

1. Name three types of muscles.
2. Where are smooth muscles found in the body

and are they voluntary muscles?
7

1. Name three types of muscles. Cardiac,
smooth, and skeletal
2. Where are smooth muscles found in the body

and are they voluntary muscles? Smooth
muscles are found in the walls of arteries,
respiratory passages, urinary and
reproductive ducts, and visceral organs.
Their actions are controlled by the autonomic
(involuntary) nervous system.
8

4. What are the four principal types of bones?
5. What are the terms given to the ends of a

long bone?
6. What is the function of ligaments?
9

4. What are the four principal types of bones?
Short, flat, irregular, and long
5. What are the terms given to the ends of a

long bone? Distal epiphysis and proximal
epiphysis
6. What is the function of ligaments? Ligaments

are flexible bands of fibrous tissue that hold
bones close together at the joint.
10
Combining Forms Exercise

List the CF(s) for:
1. cranium:
2. femur:
3. patella:
4. tibia:
5. carpals:
11

1. cranium: crani/o
2. femur: femor/o
3. patella: patell/o
4. tibia: tibi/o
5. carpals: carp/o
12

6. pelvis:
7. maxilla:
8. scapula:
9. vertebra:
10.sternum:
13

6. pelvis: pelv/o, pelv/i
7. maxilla: maxill/o
8. scapula: scapul/o
9. vertebra: vertebr/o
10.sternum: stern/o
14

11. ribs:
12. radius:
13. fibula:
14. tarsals:
15. phalanges:
15

11. ribs: cost/o
12. radius: radi/o
13. fibula: fibul/o
14. tarsals: tars/o
15. phalanges: phalang/o
16
Complete the Medical Word Exercise

1. inflammation of ribs and cartilage:
/o/ /itis
2. act of measuring the pelvis: /i/
3. malignant tumor of connective tissue and

muscle: /o/sarcoma
4. cell that breaks down bone: /o/clast

17

1. inflammation of ribs and cartilage:
cost/o/chondr/itis
2. act of measuring the pelvis: pelv/i/metry
3. malignant tumor of connective tissue and

muscle: my/o/sarcoma
4. cell that breaks down bone: oste/o/clast

18

5. inflammation around bone: / /itis
6. pertaining to under or below the ribs:

sub/ /al
7. pertaining to the sternum (breastbone) and

ribs: /o/ /al
8. pain in the calcaneum (heel bone):

/o/
19

5. inflammation around bone: peri/oste/itis
6. pertaining to under or below the ribs:

sub/cost/al
7. pertaining to the sternum (breastbone) and

ribs: stern/o/cost/al
8. pain in the calcaneum (heel bone):

calcane/o/dynia
20
Build Medical Words Exercise

1. porous bone:
2. tumor (composed) of muscle:
3. binding, fixation (of a bone or joint):
4. rupture of muscle:
21

1. porous bone: oste/o/porosis
2. tumor (composed) of muscle: my/oma
3. binding, fixation (of a bone or joint):

arthr/o/desis
4. rupture of muscle: my/o/rrhexis
22

5. abnormal condition of being stiff, bent, or
crooked:
6. weakness or debility of muscle:
7. softening of cartilage:
8. visual examination of a joint:
23

5. abnormal condition of being stiff, bent, or
crooked: ankyl/osis
6. weakness or debility of muscle: my/asthenia
7. softening of cartilage: chondr/o/malacia
8. visual examination of a joint: arthr/o/scopy
24
Diseases and Conditions

Fracture
•Break or crack in a bone
•8 common types (See
illustration.)
•Closed (simple) — break with no
external skin wound (1)
•Open (compound) — break with
external wound that leads to the
fracture site and a piece of bone
protruding through the skin (2)
25
Diseases and Conditions (continued)

Fracture (continued)
•8 common types (continued)
•Complicated — broken bone
injures an internal organ, such as
the lung (3)
•Comminuted — bone broken or
splintered into pieces (4)
26

•Impacted — end of broken bone
wedged into the interior of
another bone (5)
•Incomplete — fracture line does
not include the whole bone (6)
27

•Greenstick — break in which bone
is partially bent and split (7), which
occurs most commonly in children,
especially those who have rickets,
or adults with soft bones
28

•Colles— break in lower end of
radius (8), which commonly occurs
when the wrist is extended to
break a fall
29

•Signs and Symptoms
•Depends on whether the fracture is caused by
trauma from a fall, an accident (usually motor
vehicle), or a crushing injury
•Depends on whether the fracture is the result of
trauma from bone disease, such as osteoporosis,
bone cancer, or some other pathological condition
of the bones
30

•Treatment
•External immobilization of affected part using
traction, casting, or splinting
•Open or closed reduction, which may be required
to realign bone for proper healing
31

•Treatment (continued)
•Analgesics or muscle relaxants to ease pain
•Open reduction (surgical) and external fixation or
internal fixation using metal plates, screws, or rods
•Possibly no treatment or bandaging or taping for
support and pain control (as with rib fractures)
32
Clinically Related Exercise

1. Mr. O. is involved in an automobile accident
and arrives at the ED with a broken rib that
pierces his lung. The physician diagnoses
this fracture as (closed, comminuted,
complicated).
2. Mr. Q.'s x-ray shows a line of fracture on his

femur that does not include the entire bone.
The radiologist identifies this as a(n) (Colles,
comminuted, incomplete) fracture.
33

1. Mr. O. is involved in an automobile accident
and arrives at the ED with a broken rib that
pierces his lung. The physician diagnoses
this fracture as (closed, comminuted,
complicated).
2. Mr. Q.'s x-ray shows a line of fracture on his

femur that does not include the entire bone.
The radiologist identifies this as a(n) (Colles,
comminuted, incomplete) fracture.
34

3. The doctor explains to Mrs. P. that he will
immobilize and align the bones of her hip at
the site of the fracture by inserting pins and
screws. This type of procedure is known as
(internal fixation, osteoclasis, synovectomy).
35

3. The doctor explains to Mrs. P. that he will
immobilize and align the bones of her hip at
the site of the fracture by inserting pins and
screws. This type of procedure is known as
(internal fixation, osteoclasis, synovectomy).
36

Herniated disk
•Protrusion, or herniation,
of the nucleus pulposus
(gelatinous material at the
center of the
intervertebral disk)
between two vertebrae
•Also called prolapsed disk
37

Herniated disk (continued)
•Signs and symptoms
•Depend on the particular site of herniation
•Severe back pain that worsens with motion
•Paresthesia and restricted mobility of the neck (with
cervical disk herniation)
•Intensifying pain with coughing, sneezing, or bending
•Dull ache progressing to severe pain with lumbar
sciatic involvement
38

Herniated disk (continued)
•Treatment
•Bed rest and alternating application of heat and cold
to affected portion of the spine
•Muscle relaxants, salicylates, and analgesics
•Traction of lower extremities and a back brace
•Laminectomy possibly required if conservative
treatment is unsuccessful
•Spinal fusion possibly necessary to stabilize the spine
39

1. Mr. J. has a sensation of numbness and a
burning feeling in his right foot. His
physician diagnoses this condition as
(paraplegia, paresis, paresthesia).
2. Mr. F. complains of pain radiating from his

lower back and down his left leg. The
physician suspects an inflammation of the
major leg nerve, causing a condition called
.
40

1. Mr. J. has a sensation of numbness and a
burning feeling in his right foot. His
(paraplegia, paresis, paresthesia).
2. Mr. F. complains of pain radiating from his

lower back and down his left leg. The
physician suspects an inflammation of the
major leg nerve, causing a condition called
sciatica.
41

3. Mr. S. undergoes surgery to correct a
herniated disk. The surgeon excises the
vertebral posterior arch in a procedure called
(dislodgement, herniorrhaphy, laminectomy).
4. Treatment for herniated disk involves relief

of pain and pressure, treating muscle
spasms, and the use of weights and pulleys
to immobilize the site and facilitate healing,
which is called (traction, tractotomy, tractus).
42

3. Mr. S. undergoes surgery to correct a
herniated disk. The surgeon excises the
vertebral posterior arch in a procedure called
(dislodgement, herniorrhaphy, laminectomy).
4. Treatment for herniated disk involves relief

of pain and pressure, treating muscle
spasms, and the use of weights and pulleys
to immobilize the site and facilitate healing,
which is called (traction, tractotomy, tractus).
43

Rheumatoid arthritis
•Chronic, progressive,
systemic inflammatory
disease
•Affects the synovial
membranes of joints
•Possibly cartilage
destruction, bone erosion,
and joint deformity (See
illustration.)
44

Rheumatoid arthritis (continued)
•Congestion and edema of the synovial
membrane and joint
•Fibrous immobility of joints, or ankylosis,
resulting in visible deformities and total
immobility as the disease progresses
45

•Joint pain and stiffness
•Crippling deformities result
•Most common in women between ages 23 and 35,
but may affect people in any age group
•Atrophy of muscles, bones, and skin adjacent to the
affected joint
46

•Treatment
•Primary objective to reduce inflammation and pain,
preserve joint function, and prevent joint deformity
•Nonsteroidal anti-inflammatory drugs (NSAIDs),
physical therapy, and orthopedic measures for less
severe cases
•Surgery to reduce pain and improve mobility
47

1. Mrs. Y. has a history of rheumatoid arthritis
and is concerned about its effects on joint
cartilage. How should the doctor explain the
disease to her?
48

1. Mrs. Y. has a history of rheumatoid arthritis
and is concerned about its effects on joint
cartilage. How should the doctor explain the
disease to her? Joint cartilage is slowly
destroyed by changes associated with the
inflammatory process.
49

2. Ms. R. suffers from a chronic, progressive
systemic inflammatory disease that is
deforming the joints in her hands. The
arthritis.
50

2. Ms. R. suffers from a chronic, progressive
systemic inflammatory disease that is
deforming the joints in her hands. The
rheumatoid arthritis.
51

3. The physician assistant (PA) is speaking to a
support group of patients with rheumatoid
arthritis (RA). How should she explain the
prognosis of RA and why it is such a
crippling disease?
52

3. The physician assistant (PA) is speaking to a
support group of patients with rheumatoid
arthritis (RA). How should she explain the
prognosis of RA and why it is such a
crippling disease? Because there is no cure
for RA, the disease progresses until cartilage
and connective tissues of joints are
destroyed.
53

Osteomyelitis
•Acute or chronic infection of
the bone-forming tissue
•Disease progression (see
illustration)
•Beginning infection (A)
•Blocked blood flow in the area
of infection (B)
• Death of bone at infection site
(C), with continued pus
formation
54

Osteomyelitis (continued)
•Acute
•Fever
•Local signs of inflammation (such as tenderness, redness,
heat, pain, and swelling)
•Chronic
•Ulceration
•Drainage
•Localized pain
55

Osteomyelitis (continued)
•Treatment
•Goal of eliminating infection
•Long-term antibiotic therapy
•Surgical drainage to remove pus and necrotic bone
tissue
•Tissue and bone grafts if necessary to restore blood
flow to the site
56

1. Mr. K. suffers from infected bone tissue that
has become necrotic and results in a bone
abscess. This infection of bone and bone
marrow is diagnosed as (osteoporosis,
osteitis, osteomyelitis).
57

1. Mr. K. suffers from infected bone tissue that
has become necrotic and results in a bone
abscess. This infection of bone and bone
marrow is diagnosed as (osteoporosis,
osteitis, osteomyelitis).
58

2. Mr. Z. is diagnosed with osteomyelitis. The
physician explains that, if the infection goes
untreated, over a period of time the bone
tissue dies. This condition is known as
(nectoriasis, necropsy, necrosis).
59

2. Mr. Z. is diagnosed with osteomyelitis. The
physician explains that, if the infection goes
untreated, over a period of time the bone
tissue dies. This condition is known as
(nectoriasis, necropsy, necrosis).
60

3. Mrs. P. had hip surgery a few weeks ago and
complains of pain around the incision site.
After a series of tests, the physician
determines that there is local infection of
bone and bone marrow, most likely due to
bacteria introduced during her surgery. The
physician diagnoses her condition as
(osteomalacia, osteomyelitis, osteophlebitis).
61

3. Mrs. P. had hip surgery a few weeks ago and
complains of pain around the incision site.
After a series of tests, the physician
determines that there is local infection of
bone and bone marrow, most likely due to
bacteria introduced during her surgery. The
physician diagnoses her condition as
(osteomalacia, osteomyelitis, osteophlebitis).
62

Gout
•Systemic connective tissue
disorder
•Chronic disorder of uric
acid metabolism
•More common in middle-
aged and older men
•Illustration: Gout of the
great toe
63

Gout (continued)
•One or more severely inflamed joints due to build-up
of uric acid crystals
•Swollen joint that is hot and usually painful to the
touch
•Typically occurring in small joints
•Commonly occurring in the joint of the great toe
64

Gout (continued)
•Treatment
•Drug therapy (first-line treatment)
•NSAIDs to reduce inflammatory response to urate crystals
•Medications taken until joint inflammation subsides
•Applications of heat or cold with analgesics
•Control of uric acid formation with low-purine diet
65

1. Mr. J.'s right great toe is swollen and painful.
He suffers from a metabolic disease caused
by accumulation of uric acid crystals in the
blood. His condition is diagnosed as
.
2. Mrs. R. has a history of "aches and pains" in

her knees, and she has red, swollen, painful
knees. The nurse charts her symptoms as
(arthralgia, arthrodesis, arthrolysis).
66

1. Mr. J.'s right great toe is swollen and painful.
He suffers from a metabolic disease caused
by accumulation of uric acid crystals in the
blood. His condition is diagnosed as
gout.
2. Mrs. R. has a history of "aches and pains" in

her knees, and she has red, swollen, painful
knees. The nurse charts her symptoms as
(arthralgia, arthrodesis, arthrolysis).
67
Vocabulary Challenge Exercise

1. muscular dystrophy:
2. necrosis:
68

1. muscular dystrophy: group of hereditary
diseases characterized by progressive
degeneration of muscles, leading to
increased weakness and debilitation,
including Duchenne dystrophy (most
common form)
2. necrosis: localized tissue death that occurs in

groups of cells in response to disease or
injury
69

3. spondylolisthesis:
4. osteoporosis:
70

3. spondylolisthesis: forward slipping of one
vertebra onto the one below it with
predisposing factors that include
spondylosis, degeneration, and birth defects
in the spine, such as spina bifida
4. osteoporosis: abnormal bone density loss
with increased porosity, causing brittle bones
and increased risk of fracture and occurring
most commonly in postmenopausal women
or sedentary or immobilized persons
71

5. talipes:
72

5. talipes: deformity of
the foot and ankle
(usually congenital),
in which the foot is
twisted and relatively
fixed in an abnormal
position (See
illustration: Talipes
equinovarus.)
73
Medical and Surgical Procedures

•Total hip arthroplasty
•Replacement of the femoral
head and acetabulum with
prostheses that are
fastened to the bone (See
illustration.)
•Amputation
•Partial or complete removal
of an extremity due to
trauma or circulatory
disease
74
Medical and Surgical Procedures

(continued)
•Arthrocentesis
•Puncture of a joint space using a needle to remove
accumulated fluid
•Laminectomy
•Excision of the posterior arch of a vertebra
75

1. Mr. K. injures his knee in a high-school
football game. X-rays reveal a torn ligament.
He undergoes a procedure in which the
surgeon inserts a small instrument into the
joint of the knee to repair the ligament. This
procedure is known as (arthroclasis,
arthrodesis, arthroscopy).
76

1. Mr. K. injures his knee in a high-school
football game. X-rays reveal a torn ligament.
He undergoes a procedure in which the
surgeon inserts a small instrument into the
joint of the knee to repair the ligament. This
procedure is known as (arthroclasis,
arthrodesis, arthroscopy).
77

2. The orthopedic surgeon informs Mr. W. that
he must undergo an operation to remove his
herniated disk. The surgery is charted as
(traction, herniorrhaphy, laminectomy).
3. Mr. A. injures his right upper thigh muscle

when stabbed in a fight. Because of the
injury's severity, he must undergo a surgical
repair of the muscle, known as (myoplasty,
myotomy, myorrhaphy).
78

2. The orthopedic surgeon informs Mr. W. that
he must undergo an operation to remove his
herniated disk. The surgery is charted as
(traction, herniorrhaphy, laminectomy).
3. Mr. A. injures his right upper thigh muscle

when stabbed in a fight. Because of the
injury's severity, he must undergo a surgical
repair of the muscle, known as (myoplasty,
myotomy, myorrhaphy).
79

4. Mr. E. has a history of arthritis that has
damaged his hip joint. The physician
recommends a surgical procedure to replace
the hip joint, known as total hip .
80

4. Mr. E. has a history of arthritis that has
damaged his hip joint. The physician
recommends a surgical procedure to replace
the hip joint, known as total hip arthroplasty.
81
Diagnostic Procedures
•Arthroscopy
•Visual examination of the
interior of a joint
•Insertion of an endoscope
through a small incision to
repair and remove joint
tissue (See illustration.)
82
Diagnostic Procedures (continued)

•Myelography
•Radiography of the spinal cord after injection of a
contrast medium
•Used to identify and study spinal distortions caused
by tumors, cysts, herniated intervertebral disks, or
other lesions
•Rheumatoid factor
•Blood test used to detect the presence of rheumatoid
factor, an antibody present in patients with
rheumatoid arthritis
83
Build a Medical Word Exercise

1. visual examination of a joint:
2. pertaining to the neck and face:
3. disease of bones and joints:
84

1. visual examination of a joint: arthr/o/scopy
2. pertaining to the neck and face:

cervic/o/facial
3. disease of bones and joints:

oste/o/arthr/o/pathy
85

4. act of measuring the pelvis:
5. suture of muscle:
6. tumor of bone marrow:
86

4. act of measuring the pelvis: pelv/i/metry
5. suture of muscle: my/o/rrhaphy
6. tumor of bone marrow: myel/oma
87
Pharmacology
•Bone reabsorption inhibitors
•Gold salts
•Nonsteroidal anti-inflammatory drugs (NSAIDs)
•Salicylates
•Skeletal muscle relaxants
88

1. Mr. C. experiences pain and inflammation
due to tendinitis. His physician prescribes a
nonsteroidal anti-inflammatory drug,
abbreviated as .
2. Ms. M. is diagnosed with osteoporosis. To

inhibit further breakdown of her bones, the
physician prescribes a (bone reabsorption
inhibitor, gold salt, salicylate).
89

1. Mr. C. experiences pain and inflammation
due to tendinitis. His physician prescribes a
nonsteroidal anti-inflammatory drug,
abbreviated as NSAID.
2. Ms. M. is diagnosed with osteoporosis. To

inhibit further breakdown of her bones, the
inhibitor, gold salt, salicylate).
90

3. Mrs. N. complains of morning pain and
stiffness in her joints caused by arthritis. The
inhibitor, muscle relaxant, salicylate).
4. Mr. H. suffers from muscle spasms in his

back due to old sports injury. To relieve his
pain, the physician prescribes a (bone
reabsorption inhibitor, gold salt, muscle
relaxant).
91

3. Mrs. N. complains of morning pain and
stiffness in her joints caused by arthritis. The
inhibitor, muscle relaxant, salicylate).
4. Mr. H. suffers from muscle spasms in his

back due to old sports injury. To relieve his
pain, the physician prescribes a (bone
reabsorption inhibitor, gold salt, muscle
relaxant).
92
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Lecture Notes

Structure and Function

Structure and Function (continued)

Structure and Function (continued)

Structure and Function (continued)

Structure and Function (continued)

Structure and Function Exercise

2. Where are smooth muscles found in the body

Structure and Function Exercise

2. Where are smooth muscles found in the body

Structure and Function Exercise

5. What are the terms given to the ends of a

6. What is the function of ligaments?

Structure and Function Exercise

5. What are the terms given to the ends of a

6. What is the function of ligaments? Ligaments

Combining Forms Exercise

Combining Forms Exercise

Combining Forms Exercise

Combining Forms Exercise

Combining Forms Exercise

Combining Forms Exercise

12. radius: radi/o

13. fibula: fibul/o

14. tarsals: tars/o

15. phalanges: phalang/o

Complete the Medical Word Exercise

2. act of measuring the pelvis: /i/

3. malignant tumor of connective tissue and

4. cell that breaks down bone: /o/clast

Complete the Medical Word Exercise

2. act of measuring the pelvis: pelv/i/metry

3. malignant tumor of connective tissue and

4. cell that breaks down bone: oste/o/clast

Complete the Medical Word Exercise

6. pertaining to under or below the ribs:

7. pertaining to the sternum (breastbone) and

8. pain in the calcaneum (heel bone):

Complete the Medical Word Exercise

6. pertaining to under or below the ribs:

7. pertaining to the sternum (breastbone) and

8. pain in the calcaneum (heel bone):

Build Medical Words Exercise

2. tumor (composed) of muscle:

3. binding, fixation (of a bone or joint):

Build Medical Words Exercise

2. tumor (composed) of muscle: my/oma

3. binding, fixation (of a bone or joint):

4. rupture of muscle: my/o/rrhexis

Build Medical Words Exercise

6. weakness or debility of muscle:

8. visual examination of a joint:

Build Medical Words Exercise

6. weakness or debility of muscle: my/asthenia

7. softening of cartilage: chondr/o/malacia

8. visual examination of a joint: arthr/o/scopy

Diseases and Conditions

Diseases and Conditions (continued)

Diseases and Conditions (continued)

Diseases and Conditions (continued)

Diseases and Conditions (continued)

Diseases and Conditions (continued)

Diseases and Conditions (continued)

Diseases and Conditions (continued)