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MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics 75
4
The Musculoskeletal
System—Orthopedics
Upon completion of this chapter,
you will be able to:
. Identify the roots/word parts associated
with the musculoskeletal system.
. Translate the Subjective terms
associated with the musculoskeletal
system.
. Translate the Objective terms associated
with the musculoskeletal system.
. Translate the Assessment terms
associated with the musculoskeletal
system.
. Translate the Plan terms associated
with the musculoskeletal system.
. Distinguish terms associated with
the musculoskeletal system in the
context of electronic health records.
Learning Outcomes
Introduction and
Overview of the
Musculoskeletal System
Think of a crane at a construction site. It’s an impres-
sive piece of machinery. All the parts work together
to move some very heavy objects.
Your body, specifically your musculoskeletal sys-
tem, is also an amazing machine. All the parts work
in just the right way to allow you to make big move-
ments, like lifting a heavy box, and fine movements,
like writing a note on the box.
Continuing the crane analogy, your bones are like
the metal fused together to make the framework of
the crane. Like the metal, your bones are strong and
sturdy. They make the framework of your body. This
framework supports your body and protects your
internal organs. Your bones are lighter than the steel
of a crane, but like steel, they are incredibly strong.
Unlike steel, however, your bones are living
organs. They can grow, maintain themselves, and even
self-repair.
If you look at a crane up close, you’ll notice that
the framework is not one solid piece. Instead, it is
made up of many smaller pieces that are welded,
bolted, or hinged together. Some connection points
are immobile, while others allow movement. Your
joints are the connection points in your body. They
keep the parts together and allow for movement so
the crane can actually move things.
The crane couldn’t move anything without any power,
though. Your muscles are the workhorses of your mus-
culoskeletal system. They act as powerful movers and
stabilizers. Some muscles, like those in your thighs, are
thick and strong, while others, like those in your hands,
are smaller and are made for delicate movements. In fact,
the muscles of your eyes are at work even now as you
read these words. Together, your bones, joints, and mus-
cles move you, protect you, and give your body support.
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76 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
4.1 Word Parts of the Musculoskeletal System
to the two bones of your forearm (radius and ulna),
then to your wrist (carpo), and finally to your fingers
(phalanges). Your legs begin with your thigh bone
(femur), work down to the two shin bones (tibia and
fibula), move on to your ankle (tarsal), and ultimately
reach your toes (phalanges again, just like the fingers).
bone
: oste/o
: osteopathy, periosteum
: At birth, you had over 300 bones but no
kneecaps. As a full-grown adult, you now have
206 bones—including two kneecaps—a net
loss of at least 96 bones. A human’s neck also
contains the same number of bones as a girae’s.
The Skeleton
Your bones make up the framework of your body—
your skeleton. Like any good design, your skeleton
has a specific layout. The bones in the middle of the
skeleton are called the axial part of your skeleton.
Your skull (cranio) is attached to your spine.
Your spine is made of many smaller bones (verte-
bra) that connect together. They protect your spinal
cord, a very fragile and important body structure.
Your spine has four sections: the neck section (cer-
vical), chest/upper back section (thoracic), and lower
back (lumbar and sacral). Your ribs (costo) attach to
the vertebra of the thoracic section.
Your arms and legs branch off both sides of this cen-
tral part of the skeleton. Your upper arm (brachio) leads
Cervical vertebrae
Ribs
Vertebral column
Sacrum
Femur
Humeru
s
Phalanges
Skull
Tibia
Carpus
Tarsus
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MEDICAL LANGUAGE ACCELERATED 4.1 Word Parts of the Musculoskeletal System 77
head, skull
: crani/o
: craniometer, craniomalacia
: The term migraine comes from the word
hemicrania, meaning half the head. The term
reflects the fact that most migraines are
localized in half the patient’s head.
neck
: cervic/o
: cervical spine, cervicitis
: Remember: When a c is followed by a, o, or u,
it is pronounced hard like a k. When followed by
e or i, it is pronounced soft like an s. Therefore,
the two example words above are pronounced
SIR-vih-kal and SIR-vih-SAI-tis.
vertebra
: spondyl/o
: spondylodynia, spondylitis
: Vertebra comes from Latin, for to turn. It is called
this because the spine was once thought of as
the hinge or center around which all other bones
turned.
loin, lower back
: lumb/o
: lumbar, lumbodynia
: The root lumbo comes from the Latin lumbo, for
loin. It refers to the region between the rib cage
and the pelvis, but frankly, it makes us think
about steak.
finger
: dactyl/o
: adactyly, dactylalgia
: The flying dinosaur called the pterodactlyl gets
its name from ptero (winged) + dactly
(fingers), which obviously literally means winged
fingers.
wrist
: carp/o
: carpectomy, metacarpal
: The carpal tunnel is the
area in the wrist where
the nerves enter the
hand. Repetitive motions
using the wrist can cause
the nerve to swell, press
against the walls of the
carpal tunnel, and result
in numbness in the hand; this condition is called
carpal tunnel syndrome.
rib
: cost/o
: costectomy, intercostal
: The English word coast
comes from this word.
Think of a country’s coasts
as its ribs or sides. Also,
the word accost, which
means to come alongside
someone, comes from this word.
femur (thighbone)
: femor/o
: femoral artery
: The femur is the strongest bone in the human
body (nonetheless, a hyena can bite right
through it—ouch). The femur makes up about a
fourth of a person’s overall height.
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78 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
tibia (shinbone)
: tibi/o
: tibiaglia
: The term tibia originally meant pipe or flute.
Evidently, the person who named this bone
thought the shinbone bore a resemblance to this
instrument.
Joints
“The toe bone’s connected to the heel bone. The heel
bone’s connected to the foot bone ...” and so it goes.
While it doesn’t exactly reflect the way anatomy is
taught in medical school, the old children’s song has
the right idea. Every bone in the body, except the
hyoid bone, is connected to another, and these con-
nection points are known as joints.
Not all joints allow movement. For example, the
bones in your skull are bound tightly together. Usu-
ally when we think of joints, we picture the moving
ones, because after all, these are the ones that we
hurt when participating in sports or that cause prob-
lems in older age.
Moving joints allow motions like bending and
rotating. When a joint bends, it’s called flexion.
When it straightens, it’s called extension. Abduc-
tion is the widening of a joint to move parts away
from the body. The term adduction means just the
opposite—during adduction, the joint narrows to
bring parts back toward the body.
Moving joints often have surrounding support
tissues to absorb shock, keep the bones aligned, and
keep the bones moving smoothly. Tendons hold mus-
cle to bone. Ligaments hold bone to bone. Cartilage
surrounds bones at the joints and allows smooth
movement among them. Under many tendons lie
sacs of fluid, known as bursae, that help keep mus-
cles and bones moving smoothly as well.
cartilage
: chondr/o
: chondritis, chondrodynia
: People who always think
they are sick are called
hypochondriacs. This
term comes from hypo-
(beneath) + chondro
(cartilage—here specifically referring to the
ribs) and reflected an ancient belief that such
thoughts came from deep within the rib cage.
joint
: arthr/o
: arthritis, arthroscopic surgery
: Insects, spiders, scorpions, and shellfish belong
to the animal family known as arthropods. This
term comes from arthro (joint) + pod (feet) and
refers to their segmented limbs. If you have ever
eaten crab legs, you know exactly what I mean.
bursa
: burs/o
: bursitis, bursectomy
: A bursa is a small fluid-filled sac found near
the body’s joint. Bursae reduce friction and act
as cushions. The word comes from the Greek
word meaning purse or bag. In some places, the
treasurer of an organization is called a bursar
because he or she handles the purse. Also, to be
reimbursed means to have money put back in
your purse.
Muscles
Think of a thick rope. Unlike a piece of string, it is not
one strand but numerous strands bundled together.
This design makes the rope much stronger. Your
skeletal muscles are similar, as they are a collection
of thousands of muscle fibers bundled together. The
bundles are grouped together to form a muscle.
The muscle is encased in a thick membrane called
fascia. The fascia helps keep the muscle together.
Muscles attach to bones. If they didn’t, they wouldn’t
be very useful. Their job is to move the bones, after
all. Muscles attach to bones via tendons, which are
thick bands of connective tissue.
tendon (connective tissue
attaching muscle to bone)
: ten/o, tend/o, tendin/o
: tenodynia, tendolysis, tendinitis
: From Latin, for to stretch. This root is also found
in the English word attend, which means to
stretch toward.
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MEDICAL LANGUAGE ACCELERATED 4.1 Word Parts of the Musculoskeletal System 79
muscle
: muscul/o, my/o, myos/o
: musculoskeletal, myopathy, myositis
: The term muscle comes from Latin, for little
mouse. It was once thought that the movement
of certain muscles looked like mice running
underneath the skin. Personally, we don’t see
the connection, but linking muscle and mouse
must have been commonplace, as Greek,
German, and Arabic all have similar words for
muscle and mouse.
Superficial Deep
Biceps
brachii
Pectoralis
major
Deltoid
Trapezius
Pectoralis
minor
Deltoid (cut)
Triceps
brachii (cut)
Gluteus
minimus
Gastrocnemius
(cut)
External
abdominal
oblique
Internal
abdominal
oblique
Trapezius
Latissimus
dorsi
Gluteus
maximus
Gluteus
medius
External
abdominal
oblique
Triceps
brachii
Gastrocnemius
SuperficialDeep
Motion
Usually when you think about your muscles, you
think of movement (kinesio). While this is a very
important part of what they do, they’re also hard at
work when they’re not moving. Your muscles not
only move you, but they also support you.
This constant holding together—the built-in
strength of your muscles—is your muscles’ tone
(tono). Without any muscle tone, your body would
be completely limp. Your muscles require input from
your nervous system to move and coordinate (taxo).
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80 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
If you have problems transferring this input from the
nervous system, you may suffer from partial paraly-
sis (paresis) or complete paralysis (plegia).
tone, tension
: ton/o
: dystonia, tonograph
: Tonic is a word for a medicinal drink. This term
was used because medicinal drinks were once
thought to restore a person’s good muscle tone.
Today, tonic water still has medicinal value.
Although some people think tonic water is simply
another name for carbonated soda water, tonic
is actually a form of carbonated soda water in
which quinine, a drug used to treat malaria, has
been dissolved. Tonic water was developed to
treat people who lived in tropical areas, where
malaria is often prevalent.
movement, motion
: kinesi/o (also
sometimes kinet/o)
: kinesiology, hyperkinesia,
kinetic energy
: Akinetopsia (pronounced ah-KEE-no-TOP-
see-ah) comes from the roots a (no) + kinet
(movement) + opsia (vision) and refers to a
condition where a patient can see an object if it
is still but is unable to see it if it is moving.
arrangement, order, coordination
: tax/o
: ataxia, hypotaxia
: Syntax is an English grammar term made up of
the roots syn (together) + tax (arrangement)
and refers to the study of the way words are
arranged in a sentence.
Taxidermy, which comes from taxo (arrange) +
dermy (skin), refers to the practice of removing
and displaying the head and skin of an animal
killed during a hunt.
The arrangement of military forces before a
battle is called tactics.
Learning Outcome 4.1 Exercises
Additional exercises available in
EXERCISE 1 Match the word part on the left with its definition
on the right.
1. crani/o a. bone
2. oste/o b. head, skull
3. lumb/o c. loin, lower back
4. femor/o d. neck
5. cervic/o e. rib
6. cost/o f. thighbone
7. carp/o g. vertebra
8. spondyl/o h. wrist
EXERCISE 2 Translate the following word parts.
1. femor/o
2. crani/o
3. oste/o
4. cervic/o
5. lumb/o
6. cost/o
7. carp/o
8. spondyl/o
TRANSLATION
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MEDICAL LANGUAGE ACCELERATED 4.1 Word Parts of the Musculoskeletal System 81
Learning Outcome 4.1 Exercises
EXERCISE 3 Match the word part on the left with its definition
on the right. Some definitions will be used more
than once.
1. burs/o a. arrangement,
order, coordination
2. muscul/o b. bursa
3. arthr/o c. cartilage
4. ten/o, tend/o, d. joint
tendin/o
5. ton/o e. movement, motion
6. my/o, myos/o f. muscle
7. kinesi/o g. tendon
8. chondr/o h. tone, tension
9. tax/o
EXERCISE 4 Translate the following word parts.
1. arthr/o
2. burs/o
3. chondr/o
4. kinesi/o
5. muscul/o
6. my/o, myos/o
7. tax/o
8. ten/o, tend/o, tendin/o
9. ton/o
GENERATION
EXERCISE 5 Identify the word parts for the following
definitions.
1. tibia
2. tone, tension
3. thighbone
4. cartilage
5. head, skull
6. loin, lower back
7. neck
8. finger
9. rib
EXERCISE 6 Identify the word parts for the following definitions.
1. tendon (3 roots)
2. bursa
3. tone, tension
4. joint
5. movement, motion
6. muscle (3 roots)
7. arrangement, order, coordination
8. cartilage
EXERCISE 7 Build a medical term from the information provided.
1. inflammation of the tendon
2. inflammation of the bursa
3. joint inflammation
4. decrease in muscle tone or tightness
5. decrease in muscle movement or activity
6. softening of a muscle
7. abnormal softening of the cartilage
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bones
TERM WORD ANALYSIS
costalgia
kaws-TAL-jah
cost / algia
rib / pain
DEFINITION rib pain
ostealgia
aw-stee-AL-jah
oste / algia
bone / pain
DEFINITION bone pain
osteodynia
aw-stee-oh-DAI-nee-ah
osteo / dynia
bone / pain
DEFINITION bone pain
spondylodynia
spawn-dih-loh-DAI-nee-ah
spondylo / dynia
vertebra / pain
DEFINITION vertebra pain
tibialgia
tih-bee-AL-ja
tibi / algia
tibia / pain
DEFINITION tibia (shin) pain
muscles
TERM WORD ANALYSIS
bradykinesia
bray-dih-kih-NEE-zhah
brady / kinesia
slow / movement
DEFINITION slow movement
dyskinesia
dis-kih-NEE-zhah
dys / kinesia
bad / movement
DEFINITION inability to control movement
dystaxia
dis-TAK-see-ah
dys / taxia
bad / coordination
DEFINITION poor coordination
dystonia
dis-TOH-nee-ah
dys / tonia
bad / muscle tone
DEFINITION poor muscle tone
hyperkinesia
hai-per-kih-NEE-zhah
hyper / kinesia
over / movement
DEFINITION increase in muscle movement or activity
hypotonia
hai-poh-TOH-nee-yah
hypo / tonia
under / muscle tone
DEFINITION decrease in muscle tone or tigtness
joints
TERM WORD ANALYSIS
arthralgia
ar-THRAL-jah
arthr / algia
joint / pain
DEFINITION joint pain
arthrodynia
ar-throh-DAI-nee-ah
DEFINITION joint pain
arthro / dynia
joint / pain
cervicodynia
sir-vih-koh-DAI-nee-ah
cervico / dynia
neck / pain
DEFINITION neck pain
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82 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
UBJECTIVE
4.2 Patient History, Problems, Complaints
Pain is the most common musculoskeletal medical
complaint. A patient could have pain in a bone (oste-
algia), joint (arthralgia/arthrodynia), tendon (tenal-
gia), or muscle (myalgia/myodynia). A patient may
also notice a change in a muscle’s appearance—a
muscle may be wasting away (atrophy) or abnor-
mally large (hypertrophy). Most of the other prob-
lems people experience relate to a change in how
their muscles or joints are working.
Pain is the most common musculoskeletal medical
complaint.
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muscles
TERM WORD ANALYSIS
myalgia
mai-AL-jah
my / algia
muscle / pain
DEFINITION muscle pain
myasthenia
mai-as-THEH-nee-ah
my / asthenia
muscle / weakness
DEFINITION muscle weakness
muscles
TERM WORD ANALYSIS
tenalgia
ten-AL-jah
ten / algia
tendon / pain
DEFINITION tendon pain
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MEDICAL LANGUAGE ACCELERATED 4.2 Patient History, Problems, Complaints 83
4.2 Patient History, Problems, Complaints
continued continued
EXERCISE 1 Underline and define the word parts from this
chapter in the following terms.
1. tenalgia
2. tibialgia
3. costalgia
4. spondylodynia
5. cervicodynia
6. dyskinesia
7. dystaxia
8. dystonia
EXERCISE 2 Translate the following terms as literally as
possible.
EXAMPLE: nasopharyngoscope an instrument
for looking at the nose and throat
1. dystonia
2. dyskinesia
3. hyperkinesia
4. myasthenia
TRANSLATION
EXERCISE 3 Build a medical term from the information provided.
EXAMPLE: inflammation of the sinuses
sinusitis
1. tendon pain
2. tibia (shin) pain
3. rib pain
4. vertebra pain
5. neck pain
6. decrease in muscle tone
7. slow movement
8. poor coordination
GENERATION
Learning Outcome 4.2 Exercises
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84 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
Learning Outcome 4.2 Exercises
EXERCISE 4 Multiple-choice questions. Select the correct
answer(s).
1. Select the term that means bone pain.
a. arthralgia d. arthrodynia
b. myalgia e. osteodynia
c. ostealgia
2. Select the term that means joint pain.
a. arthralgia d. arthrodynia
b. myalgia e. osteodynia
c. ostealgia
3. Select the term that means muscle pain.
a. arthralgia d. arthrodynia
b. myalgia e. osteodynia
c. ostealgia
BJECTIVE
4.3 Observation and Discovery
typical signs of inflammation: redness, swelling,
heat, and pain. Any of these symptoms can indicate
that an infection or inflammation is present.
There are not many skills that are specific to
evaluating bones. Patients with fractured bones
may present with a limp or pain upon touching or
pressure.
Much evaluation of bone issues is performed
with imaging. The bread-and-butter imaging method
for bones is the simple x-ray. An x-ray can reveal
fractures, bone destruction (osteolysis), and even
extra bone growth (exostosis). More involved imag-
ing methods include computed tomography (CT),
computed axial tomography (CAT), or magnetic
resonance imaging (MRI).
Examining a patient’s joint is usually more
involved. While the health care provider also checks
for the same signs of inflammation, the joint’s abil-
ity to move also needs to be checked. This is called
the joint’s range of motion (ROM). The provider
also checks to make sure the joint is not moving in a
direction that it’s not supposed to move in. This extra
movement is called joint laxity. The provider also
checks for fluid around the joint (effusion). There are
several diagnostic procedures specific to the joints.
Evaluation of bone issues is commonly performed with
imaging, including MRI.
When a patient with musculoskeletal problems is
evaluated, the physical exam is very important. The
exam of the muscles and bones focuses mainly on
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MEDICAL LANGUAGE ACCELERATED 4.3 Observation and Discovery 85
4.3 Observation and Discovery
To get a better view, the health care provider can
inject dye into the joint and perform an MRI. Other
means of investigating a joint include injecting a
needle and collecting fluid to send to the lab (arthro-
centesis) or even using a camera-like device to look
inside the joint (arthroscope).
Examining muscles often means checking how
they work. The function of muscles can be evalu-
ated by checking their tone (myotonia) or strength.
A more involved way to check this is electromyogra-
phy. In this procedure, two needles are inserted into
a muscle to measure the muscle activity.
diagnostic procedures
TERM WORD ANALYSIS
arthrocentesis
ar-throh-sin-TEE-sis
DEFINITION puncture of
a joint
arthro / centesis
joint / puncture
arthrogram
AR-throh-gram
arthro / gram
joint / record
DEFINITION visual record of a joint
arthroscope
AR-throh-skohp
arthro / scope
joint / instrument for looking
DEFINITION instrument for looking into a joint
arthroscopy
ar-THRAW-skoh-pee
DEFINITION procedure of
looking into a joint
arthro / scopy
joint / looking procedure
computed axial
tomography (CAT)
kom-PYOO-ted AK-see-al
taw-MAW-grah-fee
axi / al
axis / pertaining to
tomo / graphy
cut / recording procedure
DEFINITION imaging procedure using a computer to produce
cross sections along an axis
spinal curvatures
TERM WORD ANALYSIS
kyphosis
kai-FOH-sis
DEFINITION humped
back; abnormal
forward curvature of
the upper spine
kyph / osis
bent / condition
lordosis
lor-DOH-sis
DEFINITION sway
back; abnormal
forward curvature of
the lower spine
lord / osis
bent backward / condition
scoliosis
SKOH-lee-OH-sis
DEFINITION crooked
back; abnormal
lateral curvature of
the spine
scoli / osis
crooked / condition
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bones
TERM WORD ANALYSIS
fracture
FRAK-shur
from Latin, for break
DEFINITION a bone break
Transverse
Oblique Spiral Angulated Displaced Angulated
&
displaced
osteodystrophy
aw-stee-oh-DIH-stroh-fee
osteo / dys / trophy
bone / bad / nourishment
DEFINITION poor bone development
spondylitis
spawn-dih-LAI-tis
spondyl / itis
vertebra / inflammation
DEFINITION vertebra inflammation
spondylomalacia
spawn-dih-loh-mah-LAY-shah
spondylo / malacia
vertebra / softening
DEFINITION softening of the vertebra
tarsoptosis
tar-sawp-TOH-sis
tarso / ptosis
ankle / drooping condition
DEFINITION flat feet
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86 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
4.3 Observation and Discovery
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muscles
TERM WORD ANALYSIS
atrophy
A-troh-fee
DEFINITION
underdevelopment,
decrease, or loss of
muscle tissue
a / trophy
no / nourishment
Normal
muscles
TERM WORD ANALYSIS
hypertrophy
hai-PER-troh-fee
hyper / trophy
over / nourishment
DEFINITION overdevelopment of muscle tissue
myolysis
mai-AW-lih-sis
myo / lysis
muscle / loss
DEFINITION loss of muscle tissue
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MEDICAL LANGUAGE ACCELERATED 4.3 Observation and Discovery 87
4.3 Observation and Discovery
Learning Outcome 4.3 Exercises
TRANSLATION
EXERCISE 1 Underline and define the word parts from this
chapter in the following terms.
1. spondylitis
2. arthroscopy
3. tarsoptosis
4. osteodystophy
5. myotonia (2 roots)
continued
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88 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
Learning Outcome 4.3 Exercises
EXERCISE 2 Match the term on the left with its definition on the right.
1. fracture a. imaging procedure using a computer to produce cross
sections along an axis
2. atrophy b. humped back; abnormal forward curvature of the upper spine
3. scoliosis c. sway back; abnormal forward curvature of the lower spine
4. computed axial tomography d. crooked back; abnormal lateral curvature of the spine
5. hypertrophy e. from Latin, for break; a bone break
6. lordosis f. underdevelopment, decrease, or loss of muscle tissue
7. kyphosis g. overdevelopment of muscle tissue
EXERCISE 4 Build a medical term from the information
provided.
EXAMPLE: inflammation of the sinuses sinusitis
1. vertebra inflammation
2. softening of the vertebra
3. instrument for looking into a joint
4. procedure of looking into a joint
EXERCISE 5 Multiple-choice questions. Select the correct
answer(s).
1. Select the terms that pertain to bone.
a. fracture d. hypertrophy
b. arthrocentesis e. osteodystrophy
c. atrophy
2. Select the terms that pertain to joints.
a. fracture d. hypertrophy
b. arthrocentesis e. osteodystrophy
c. atrophy
3. Select the terms that pertain to muscle.
a. fracture d. hypertrophy
b. arthrocentesis e. osteodystrophy
c. atrophy
4. What does the abbreviation CAT stand for?
a. chondro-arthrodysplasia tenotomy
b. computed axial tomography
c. computed arthrography telectasia
d. chondro-axial tomography
5. Which of the following terms means fluid
build-up?
a. affusion c. effision
b. effusion d. exfusure
EXERCISE 6 Briefly describe the difference between each pair
of terms.
1. arthrogram, myogram
GENERATION
EXERCISE 3 Translate the following terms as literally as possible.
EXAMPLE: nasopharyngoscope an instrument
for looking at the nose and throat
1. tarsoptosis
2. kyphosis
3. lordosis
4. scoliosis
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MEDICAL LANGUAGE ACCELERATED 4.4 Diagnosis and Pathology 89
SSESSMENT
4.4 Diagnosis and Pathology
As mentioned earlier, fractures are a common reason
why patients see health care providers. Fractures are
more common in people with weaker bones. Bone
loss (osteopenia) can be related to age or to a diet
that is deficient in calcium. Osteopenia leads to
soft bones in children (osteomalacia) or weak, frail
bones in adults (osteoporosis). Some patients suffer
from infections of the bone (osteomyelitis), a serious
illness that often requires hospitalization.
The vertebral column of bones is susceptible to
injury. Gymnasts, football players, or weight lifters
who bend their backs too far can suffer small stress
fractures of their vertebra (spondylolysis). If the frac-
ture is severe, the vertebrae can slip onto one another
(spondylolisthesis). A very serious version of this
condition can advance to problems with a narrowing
of the space for the spinal cord (spinal stenosis).
You move your joints all the time. They act as
shock absorbers for your body, and they take a lot
of abuse. It should come as no surprise, then, that
joint problems are a very common medical concern.
A swollen, painful joint (arthritis) can have many
causes—the most common being excessive wear and
tear. This type is called osteoarthritis. As the carti-
lage between the bones in a joint breaks down, the
bones eventually rub together and the joint becomes
painful to move. This is a very common reason for a
joint replacement surgery.
Other causes of arthritis include infection (septic
arthritis) and a disease of joint inflammation (rheu-
matoid arthritis). Other parts of the joint area that
can cause problems are the bursa (bursitis) and ten-
don (tendonitis). These are not usually caused by an
injury; instead, they are a result of normal wear and
tear over time.
Unusual inflammatory conditions also affect the
muscles. Muscles can become inflamed (myositis).
Sometimes this can involve the skin as well (derma-
tomyositis). General problems with all the muscles
are called myopathies. Myasthenia gravis and mus-
cular dystrophy are two of the most common types
of myopathy.
Like any system in the body, the musculoskeletal
system can develop tumors. Tumors can develop in
the bones (osteosarcoma, osteocarcinoma, osteo-
chondroma), or they can spread to the bones from
other parts of the body. Your muscles can get tumors
(myoma) as well—one example is an osteosarcoma.
bones
TERM WORD ANALYSIS
osteitis
AW-stee-AI-tis
oste / itis
bone / inflammation
DEFINITION bone inflammation
osteochondritis
AW-stee-oh-kon-DRAI-tis
osteo / chondr / itis
bone / cartilage / inflammation
DEFINITION inflammation of bone and cartilage
osteochondroma
AW-stee-oh-kon-DROH-mah
osteo / chondr / oma
bone / cartilage / tumor
DEFINITION a tumor made up of bone and cartilage, also
known as an exostosis made up of cartilage
osteomalacia
AW-stee-oh-mah-LAY-shah
osteo / malacia
bone / softening
DEFINITION softening of the bone
osteomyelitis
AW-stee-oh-MAI-eh-LAI-tis
osteo / myel / itis
bone / marrow / inflammation
DEFINITION inflammation of the bone and bone marrow
osteopenia
AW-stee-oh-PEE-nee-yah
osteo / penia
bone / deficiency
DEFINITION reduction in bone volume
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90 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
4.4 Diagnosis and Pathology
bones
TERM WORD ANALYSIS
osteoporosis
AW-stee-oh-por-OH-sis
DEFINITION loss of bone
density
osteo / por / osis
bone / pore / condition
Normal
spondylolisthesis
SPAWN-dih-loh-lis-THEE-sis
DEFINITION the slipping or
dislocation of a vertebra
spondylo / listhesis
vertebra / slipping
spondylosis
SPAWN-dih-LOH-sis
spondyl / osis
vertebra / condition
DEFINITION vertebra condition
continued
joints
TERM WORD ANALYSIS
osteoarthritis
AW-stee-oh-ar-THRAI-tis
osteo / arthr / itis
bone / joint / inflammation
DEFINITION inflammation of the joints, specifically those
that bear weight
rheumatoid arthritis
ROO-mah-toyd ar-THRAI-tis
DEFINITION inflammation
of the joints; it is called
rheumatoid because its
symptoms resemble those
of rheumatic fever
rheumat / oid
rheumatic fever / resembling
arthr / itis
joint / inflammation
joints
TERM WORD ANALYSIS
arthritis
ar-THRAI-tis
arthr / itis
joint / inflammation
DEFINITION joint inflammation
arthropathy
ar-THRAW-pah-thee
arthro / pathy
joint / disease
DEFINITION joint disease
bursitis
bur-SAI-tis
DEFINITION inflammation of
the bursa
burs / itis
bursa / inflammation
muscles
TERM WORD ANALYSIS
chondroma
kawn-DROH-mah
chondr / oma
cartilage / tumor
DEFINITION a tumor-like growth of cartilage tissue
costochondritis
KAW-stoh-kawn-DRAI-tis
costo / chondr / itis
rib / cartilage / inflammation
DEFINITION inflammation of the cartilage of the rib
muscular
dystrophy
MUS-kyoo-lar DIS-troh-fee
DEFINITION disorder
characterized by poor
muscle development
muscul / ar
muscle / pertaining to
dys / trophy
bad / nourishment
myoma
mai-OH-mah
my / oma
muscle / tumor
DEFINITION a muscle tumor
myopathy
mai-AW-pah-thee
myo / pathy
muscle / disease
DEFINITION muscle disease
continued
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EXERCISE 1 Underline and define the word parts from this
chapter in the following terms.
1. osteitis
2. tendinitis
3. tendonitis
4. myositis
5. rheumatoid arthritis
6. myoma
7. muscular dystrophy
8. osteomalacia
9. osteopenia
10. osteochondroma (2 roots)
11. spondylolisthesis
12. costochondritis (2 roots)
TRANSLATION
EXERCISE 2 Match the term on the left with its definition on the right.
1. myosarcoma a. loss of bone density
2. osteoporosis b. vertebrate condition
3. spondylosis c. a cancerous muscle tumor
4. rheumatoid arthritis d. a tumor made up of bone and cartilage
5. myoma e. inflammation of the joints, the symptoms of which resem-
ble rheumatic fever
6. chondroma f. muscle tumor
7. osteochondroma g. a tumor-like growth of cartilage tissue
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MEDICAL LANGUAGE ACCELERATED 4.4 Diagnosis and Pathology 91
4.4 Diagnosis and Pathology
muscles
TERM WORD ANALYSIS
myosarcoma
MAI-oh-sar-KOH-mah
myo / sarc / oma
muscle / flesh / tumor
DEFINITION a cancerous muscle tumor
myositis
MAI-oh-SAI-tis
myos / itis
muscle / inflammation
DEFINITION muscle inflammation
continued
muscles
TERM WORD ANALYSIS
tendinitis
TEN-dih-NAI-tis
tendin / itis
tendon / inflammation
tendonitis
TEN-dah-NAI-tis
tendon / itis
tendon / inflammation
DEFINITION tendon inflammation
NOTE: These words are both accepted spellings for the same
condition.
continued
Learning Outcome 4.4 Exercises
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92 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
Learning Outcome 4.4 Exercises
EXERCISE 3 Translate the following terms as literally as possible.
EXAMPLE: nasopharyngoscope an instrument
for looking at the nose and throat
1. tendinitis
2. tendonitis
EXERCISE 4 Build a medical term from the information
provided.
EXAMPLE: inflammation of the sinuses
sinusitis
1. inflammation of the bursa
2. inflammation of the cartilage and rib
3. overdevelopment (trophic) vertebrae
inflammation
4. bone deficiency
EXERCISE 5 Multiple-choice questions. Select the correct
answer(s).
1. Select the terms that have the root meaning
muscle.
a. osteitis d. osteoarthritis
b. arthritis e. osteochondritis
c. myositis
2. Select the terms that have the root meaning
joint.
a. osteitis d. osteoarthritis
b. arthritis e. osteochondritis
c. myositis
3. Select the terms that have the root meaning
cartilage.
a. osteitis d. osteoarthritis
b. arthritis e. osteochondritis
c. myositis
4. Select the terms that have the root meaning
bone.
a. osteitis d. osteoarthritis
b. arthritis e. osteochondritis
c. myositis
5. A disorder characterized by poor muscle
development is known as
a. myositis c. myopathy
b. myosarcoma d. muscular dystrophy
GENERATION
3. arthropathy
4. osteomyelitis
5. osteoporosis
6. spondylolisthesis
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MEDICAL LANGUAGE ACCELERATED 4.5 Treatments and Therapies 93
The medicines used to treat musculoskeletal prob-
lems are designed to decrease pain (analgesic)
or inflammation (anti-inflammatory). The most
commonly used medicines for both are known as
nonsteroidal anti-inflammatory drugs (NSAIDs).
Ibuprofen is a common example of this type of med-
icine. Other nonsurgical treatments include physical
therapy, in which patients exercise and stretch in
order to heal injuries, or wearing a device used to
relieve tension on a joint (orthotics). Shoe inserts are
a very common type of orthotic.
When nonsurgical treatment fails, surgery may be
necessary. Orthopedic surgery deals with joints and
bones. Many of the tools used in orthopedic surgery
look like they came from a home improvement store—
including drills, saws, and hammers. These tools are
used to cut into bone (osteotomy), joints (arthrotomy), or
muscle (myotomy). Sometimes they remove part or all of
these structures (osteectomy, arthrectomy, myectomy).
When defective areas or cancer are present in a
bone, the diseased area of bone must be removed before
new bone (graft) or artificial hardware (prosthesis)
can be installed. This reconstruction of bone proce-
dure is called osteoplasty.
4.5 Treatments and Therapies
LAN
Femur
Tibia
Fibula
Common procedures for the musculoskeletal
system include knee and hip replacements.
drugs
TERM WORD ANALYSIS
analgesic
A-nal-JEE-zik
DEFINITION a drug that
relieves pain
an / alge / sic
no / pain / agent
antiarthritic
AN-tee-ar-THRIH-tik
anti / arthri / tic
against / joint (pain) / agent
DEFINITION a drug that opposes joint inflammation
anti-inflammatory
AN-tee-in-FLA-mah-TOR-ee
anti / inflammatory
against / inflammation
DEFINITION a drug that opposes inflammation
Similar procedures exist for joints. Sometimes,
removal of a diseased joint (arthrectomy) is neces-
sary, followed by a reconstruction of the joint with a
prosthesis (arthroplasty). These are common treat-
ments for diseased knees and hips. A less aggressive
surgery for fixing diseased joints, chondroplasty,
involves fixing the bad cartilage of a joint. It is very
common in athletes and older patients with chronic
osteoarthritis.
Not all orthopedic surgery involves complete
reconstruction of a bone or joint. Sometimes some-
thing that has snapped must be repaired, as in a
tendon repair (tenorrhaphy) or a muscle repair
(myorrhaphy). Other times, new attachments must
be made. This can involve attaching leftover muscle
to bone (myodesis) after an amputation or fixing two
bones surrounding a joint (arthrodesis). While the
latter procedure results in immobility of the joint, it
may be necessary to relieve pain.
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94 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
4.5 Treatments and Therapies
bones
TERM WORD ANALYSIS
carpectomy
kar-PEK-toh-mee
carp / ectomy
wrist / removal
DEFINITION removal of all or part of the wrist
costectomy
kaws-TEK-toh-mee
cost / ectomy
rib / removal
DEFINITION removal of a rib
craniectomy
KRAY-nee-EK-toh-mee
crani / ectomy
skull / removal
DEFINITION removal of a portion of the skull
craniotomy
KRAY-nee-AW-toh-mee
cranio / tomy
skull / incision
DEFINITION removal of a portion of the skull
NOTE: The difference between a craniectomy and a craniotomy is
whether or not the piece of bone is replaced. After a craniotomy, the
piece of bone that was removed to allow surgical access to the brain
is replaced. In a craniectomy, the piece of bone is not replaced.
joints
TERM WORD ANALYSIS
arthroplasty
AR-throh-PLAS-tee
arthro / plasty
joint / reconstruction
DEFINITION reconstruction of a joint
arthrotomy
ar-THRAW-toh-mee
DEFINITION incision into a joint
arthro / tomy
joint / incision
chondrectomy
kawn-DREK-toh-mee
chondr / ectomy
cartilage / removal
DEFINITION removal of cartilage
muscles
TERM WORD ANALYSIS
myectomy
mai-EK-toh-mee
my / ectomy
muscle / removal
DEFINITION removal of muscle
myomectomy
MAI-oh-MEK-toh-mee
my / om / ectomy
muscle / tumor / removal
DEFINITION removal of a muscle tumor
NOTE: It is easy to miss the oma root in this word because the o
looks like it belongs with myo and the a gets swallowed up by
ectomy. The m is your clue. Don’t just read over it—it needs to be
explained.
myoplasty
MAI-oh-PLAS-tee
myo / plasty
muscle / reconstruction
DEFINITION muscle reconstruction
myorrhaphy
mai-OR-ah-fee
myo / rrhaphy
muscle / suture
DEFINITION muscle suture
myotomy
mai-AW-toh-mee
myo / tomy
muscle / incision
DEFINITION incision into muscle
tenorrhaphy
ten-OR-ah-fee
teno / rrhaphy
tendon / suture
DEFINITION suture of a tendon
EXERCISE 1 Underline and define the word parts from this
chapter in the following terms.
1. myodesis
2. arthroplasty
TRANSLATION
Learning Outcome 4.5 Exercises
3. costectomy
4. craniectomy
5. myomectomy
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MEDICAL LANGUAGE ACCELERATED 4.5 Treatments and Therapies 95
Learning Outcome 4.5 Exercises
EXERCISE 4 Build a medical term from the information
provided.
EXAMPLE: inflammation of the sinuses
sinusitis
1. reconstruction of a joint
2. reconstruction of a muscle
3. removal of a rib
4. removal of all or part of the wrist
5. removal of cartilage
6. muscle reconstruction
7. suture of a muscle
8. suture of a tendon
EXERCISE 5 Briefly describe the difference between each pair
of terms.
1. myectomy, myomectomy
2. craniectomy, craniotomy
GENERATION
EXERCISE 2 Match the term on the left with its definition on the
right.
1. arthrotomy a. incision into a
joint
2. carpectomy b. incision into a
muscle
3. chondrectomy c. incision into the
skull
4. craniotomy d. removal of all or
part of the wrist
5. myectomy e. removal of
cartilage
6. myotomy f. removal of
muscle
EXERCISE 3 Translate the following terms as literally as
possible.
EXAMPLE: nasopharyngoscope an instrument
for looking at the nose and throat
1. myotomy
2. analgesic
3. antiarthritic
4. anti-inflammatory
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96 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
Subjective
History of Present Illness:
Mrs. Maureen Goldman presented to the orthopedic clinic with a chronic
history of arthralgia. She was previously diagnosed with osteoarthritis.
She was initially treated with NSAIDs and an orthotic that helped for a time;
however, Mrs. Goldman’s condition worsened and was eventually treated with
an intraarticular steroid injection. She reported improved pain and range of
motion. The knee pain returned last year, however, and she was treated in our
clinic with arthroscopic surgery. While it helped some, she reports it didn’t
completely get rid of her symptoms, and she returns today for evaluation.
PMHx: Septic arthritis requiring hospitalization and IV antibiotics 4 years ago.
Objective
Physical Exam:
RR: 16; HR: 70; Temp: 98.6; BP: 110/60
Gen: Alert, oriented.
CV: RRR, no murmurs.
Resp: CTA.
Musculoskeletal: Crepitation in right knee, decreased ROM. Mild effusion.
Mild muscular atrophy of right quadriceps muscle compared to left.
Labs: ESR normal, joint aspiration normal.
X-ray: Subchondral cysts, subchondral sclerosis, joint space narrowing.
Assessment
DDx: Includes osteoarthritis,
rheumatoid arthritis, and
bursitis. Given her history of
osteoarthritis on exam and
the results of the x-ray and
joint aspiration, I believe
Mrs. Goldman has OA
that has failed to respond
to previous treatments.
Plan
I have discussed treatment
options, and the patient prefers
surgery. I have explained
the risks and benefits of a
total knee replacement
arthroplasty and she
understands. I have scheduled
her for surgery next month.
—Electronically signed by
Ricchelle Mitchell, MD
01/26/2015 11:22 AM
Orthopedic Clinic Note
4.6 Electronic Health Records
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Additional exercises available in
Chapter Review exercises, along with additional
practice items, are available in Connect!
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MEDICAL LANGUAGE ACCELERATED 4.6 Electronic Health Records 97
Learning Outcome 4.6 Exercises
EXERCISE 1 Match the term on the left with its definition on the right.
1. ROM a. underdevelopment, decrease, or loss of muscle tissue
2. atrophy b. procedure of looking into a joint
3. osteoarthritis c. beneath the cartilage
4. arthroplasty d. reconstruction of a joint
5. arthroscopy e. range of motion
6. subchondral f. inflammation of the joints, specifically those that bear weight
EXERCISE 2 Fill in the blanks.
1. Mrs. Goldman was previously diagnosed with (abbreviation for inflamma-
tion of the joints, specifically those that bear weight).
2. Along with (nonsteroidal anti-inflammatory drugs), she was given an
orthotic (give definition:
).
EXERCISE 3 True or false questions. Indicate true answers with a T and false answers with an F.
1. Mrs. Goldman has a chronic history of bone pain.
2. Mrs. Goldman was initially treated with nonsteroidal anti-inflammatory drugs.
3. After the intraarticular steroid injection, Mrs. Goldman reported improved arthralgia and ROM.
4. Mrs. Goldman was previously hospitalized for joint inflammation caused by infection.
5. Mrs. Goldman’s right quadricep muscle had an unusual new growth.
6. Mrs. Goldman’s x-ray revealed hardening of the cartilage.
7. After understanding the risks involved, Mrs. Goldman has agreed to a TKR joint reconstruction.
EXERCISE 4 Multiple-choice questions. Select the correct answer.
1. Arthroscopic surgery is
a. closed reduction c. surgery on a bone
b. external fixation d. surgery on a joint
2. Septic arthritis requires which of the follow-
ing forms of treatment?
a. antibiotics c. osteectomy
b. prosthesis d. myomectomy
3. The term subchondral means
a. beneath the cartilage c. beneath the joint
b. beneath the knee d. beneath the muscle
4. The term arthrostenosis means
a. joint narrowing c. joint hardening
b. muscle narrowing d. muscle hardening
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Quick Reference
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98 MEDICAL LANGUAGE ACCELERATED Chapter 4 The Musculoskeletal System—Orthopedics
quick reference glossary of roots
ROOT
Definition
ROOT
Definition
arthr/o
joint
kinesi/o
movement, motion
burs/o
bursa
lumb/o
loin, lower back
carp/o
wrist
muscul/o
muscle
cervic/o
neck
my/o, myos/o
muscle
chondr/o
cartilage
oste/o
bone
cost/o
rib
spondyl/o
vertebra
crani/o
head, skull
tax/o
arrangement, order, coordination
dactyl/o
finger
ten/o, tend/o, tendin/o
tendon
femor/o
femur
tibi/o
tibia
ton/o
tone, tension
musculoskeletal system abbreviations
ABBREVIATION DEFINITION
Fx
fracture
ACL
anterior cruciate ligament
MCL
medial collateral ligament
LCL
lateral collateral ligament
PCL
posterior cruciate ligament
C1–C7
cervical (of the neck) vertebrae
T1–T12
thoracic (of the chest) vertebrae
L1–L5
lumbar (of the loin) vertebrae
S1–S5
sacral vertebrae
CAT
computed axial tomography
CT
computed tomography
CTS
carpal tunnel syndrome
EMG
electromyogram
FROM
full range of motion
MD
muscular dystrophy
NSAID
nonsteroidal anti-inflammatory drug
OA
osteoarthritis
PT
physical therapy
RA
rheumatoid arthritis
ROM
range of motion
TKR
total knee replacement
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