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Chapter Three MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Word Parts hemat/o = blood -poiesis = formation Functions of the Musculoskeletal System Acts as a framework for the organ systems Protects many of the body’s organs Provides the organism with the ability to move Storage of minerals Hematopoiesis (formation of blood cells) Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 2 Word Parts oste/o, oss/i, osse/o = bone muscul/o, my/o, myos/o = muscle arthr/o, articul/o = joint ligament/o, syndesm/o = ligament Musculoskeletal System Bones-inflexible Cortical- 2 types compact bone and cancellous (spongy) bone Muscles- smooth and striated Joints/articulations- shock absorbers Ligaments/Tendons- connective tissue Fascia Cartilage- collagen fibers and cartilage cells. Elastic- stretchy and forms parts of the ears and nose. Fibrocartilage- bundled collagen found in discs between vertebrae. Hyaline cartilage-covers ends of long bones and acts as a cushion. tendin/o, tend/o, ten/o = tendon cartilag/o, chondr/o = cartilage Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 3 The Importance of the MS System Bones are used to name structures throughout the body Examples: femur (thigh) Femoral artery Femoral vein Femoral nerves Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 4 Skeletal Divisions Axial skeleton Skull Spine (Vertebrae) Rib cage Appendicular skeleton Shoulder girdle Upper extremities Pelvic girdle Lower extremities Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 5 ICD-10-PCS Divisions Head and facial bones Upper bones Lower bones Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 6 Shapes of Human Bones Long bones- named for length (humerus, femur) Short bones- length (carpal, and tarsal) Flat bones- shape (sternum, scapula) Irregular bones vertebra, stapes (ear) Sesamoid bones- patella Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 7 Bone Structure Word Parts oste/o = bone -cyte = cell -blast = embryonic -clast = breaking down myel/o = bone marrow, spinal cord Osteocytes- mature bone cells Matrix- substance between osteocytes formed by a fibrous protein substance a framework for mineral salts called hydroxyapatitte. This gives bone its lattice-like structure. Osteoblasts- immature cells responsible for building bone. Osteoclasts- breaks down bone to release calcium salts. Bone requires a blood source to remain healthy, therefore passageways are created to allow blood supply. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 8 Bone Structure Osteons -cylindrical units within the harder outer bone Lamellae- layers surrounding osteons Vascular pathways – provide a system for blood to travel in for nourishment Haversian Volkman’s Trabeculae – allows space for storage of fat cells and formation of blood. (Haversian system)- Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 9 Word Parts perioste/o = periosteum trabecul/o = trabecula Bone Structure Trabeculae Lamellae- there are different types Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 10 Word Parts Long Bones and Bone Structure Diaphysis-shaft Epiphysis-ends dia- = through -physis = growth, nature epi-= above peri- = surrounding oste/o = bone Epiphyseal plate-where growth occurs Metaphysis- area where both the ephipysis and epihiseal plate meet. Endosteum-inner lining Periosteum – tissue surrounding bone Bone marrow- stores fat cells and produces blood cells endo- = within myel/o = bone marrow Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 11 Word Parts fissur/o = fissure foramin/o = foramen foss/o = fossa sin/o = sinus antr/o = antrum sulc/o = sulcus Bone Depressions Fissure- deep cleft or groove Foramen (pl. foramina)- opening or hole Fossa (pl. fossae)- hollow or depression, usually at the end Sinus (pl. sinuses)- cavity or channel that has membrane lining Synonym: antrum Sulcus (pl. sulci)- refers to groove or depression in a structure that is more shallow than a fissure. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 12 Bone Processes Word Parts Ramus- extension resembling a branch (bone) Head- rounded proxmimal portion of capit/o = head spirn/o = spine trochanter/o = trocanter tubercul/o = tubercle some long bones Spine- thornlike projection Trochanter- 1 of 2 bony projections on the proximal ends of the femurs that serve as points of attachment for muscle Tubercle- nodule or small raised area Tuberosity- elevation or protuberance larger than a tubercle. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 13 Word Parts condyl/o = condyle epicondyl/o = epicondyle Bone Processes Condyle- rounded projection found at the end of a bone Crest- narrow elongated elevation Epicondyle- projection on surface above a condyle Facet- smooth flat articular surface Neck- narrow area away from a bone head. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 14 Bone Depressions Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 15 Review Question If you see the combining form chondr/o in a report, you know that the term has to do with the: A. B. C. D. cartilage fascia bone ligaments Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 16 PCS Guideline Alert! B4.6 If a procedure is performed on the skin, subcutaneous tissue, or fascia overlying a joint, the procedure is coded to the following body part: shoulder is coded to upper arm elbow is coded to lower arm wrist is coded to lower arm hip is coded to upper leg knee is coded to lower leg ankle is coded to foot Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 17 PCS Guideline Alert! B4.5 Procedures performed on tendons, ligaments, bursae, and fascia supporting a joint are coded to the body part in the respective body system that is the focus of the procedure. Procedures performed on joint structures themselves are coded to the body part in the joint body systems. Example: Repair of the anterior cruciate ligament of the knee is coded to the knee bursae and ligament body part in the Bursae and Ligaments body system. Knee arthroscopy with shaving of articular cartilage is coded to the knee joint body part in the Lower Joints body system. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 18 Bones of the Axial Skeleton Skull (cranium and facial bones) Rib cage Spine (vertebrae) Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 19 Word Parts crani/o = cranium Cranium and Facial Bones Cranium front/o = frontal pariet/o = parietal occipit/o = occipital Frontal bone- front part of skull and forehead Parietal bone- sides of the skull Occipital bone- back of the skull Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 20 Word Parts tempor/o = temporal petr/o, petros/o = stone tympan/o = eardrum styl/o = styloid Cranium and Facial Bones Cranium Temporal bone- lower sides of the skull Mastoid process-back part of the temporal bone behind the ear Petrous bone-hard bone in the temporal bone that houses auditory canal, and middle and inner ear. Tympanic portion- lower area that encircles eardrum. Zygomatic process-front porjection that forms inferior portion of the cheek. Styloid process- thin pointed projection at the base of temporal bone that allows for attachment for ligaments and muscles. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 21 Word Parts ethmoid/o = ethmoid crib/i = sieve -form = shape sphenoid/o = sphenoid opt/o = eye al/i = wing para-= near nas/o = nose hy/o = u-shaped, hyoid bone Cranium and Facial Bones Cranium Ethmoid bone- seiveline bone that forms roof and walls of nasal cavity. Cribiform plate- contains holes for the olfactory nerves (for smell) Sphenoid bone- forms internal base of the skull. Optic foramina- openings for optic nerves Alisphenoid- wings of the triangular projections of the temporal bone Orbitosphenoid- small prjections that form the back of the orbit and support part of the frontal lobe. Paranasal sinuses- air filled cavities named for bones where they are located. Hyoid bone- u shape bone at the back of neck that is attached to styloid process. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 22 Word Parts zygomat/o, zygom/o = zygoma lacrim/o = lacrimal bone Cranium and Facial Bones Facial Bones Zygomatic- cheekbones Lacrimal bones- forner of each eye that cradle tear ducts Maxilla- upper jaw bone maxill/o = maxilla = Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 23 Cranium and Facial Bones Word Parts mandibul/o = mandible ment/o = chin condyl/o = condyle coron/o = crown vomer/o = vomer palat/o = palatine bone Facial Bones Mandible- jaw Mental foramina- holes in the central part of the mandible Ramus-back part of the verticle projections Condyloid process/Coronoid process- front projections of the ramus that articulates with the jaw. Mandibular notch- space between condyloid/coronoid processes. Nasal bones Vomer- bone that forms front and back part of the septum Nasal septum- divider between nostrils Palatine bones-roof of the mouth Orbit –bony socket of eyeball. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 24 Word Parts cost/o = rib stern/o = sternum supra- = above corpor/o = body xiph/o = xiphoid Rib Cage True/false/floating ribs- 12 pairs of thin, flat bones 7 pairs of true attached at sternum Five pairs of false, attached by cartilage Two floating that are not attached at the front at all Sternum- breastbonee Manubrium, suprasternal notch, corporis, xiphoid process Costochondral cartilage- cartilage that attaches ribs Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 25 View of the breastone Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 26 Word Parts cervic/o = neck axi/o = axis odont/o = tooth Spine (vertebrae) Cervical C1-C7 Atlas (C-1) Axis (C-2) Odontoid process/dens thorac/o = chest Thoracic T1-T12 lumb/o = loin Lumbar L1-L5 sacr/o = sacrum Sacral S1-S5 coccyg/o = coccyx (tailbone) Coccygeal Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 27 Word Parts Spine (vertebrae) Vertebra spin/o = spine lamin/o = lamina Body Foramen Arch Pedicle Spinous process Lamina Transverse process Facet/articular process Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 28 Review Question What is the combining form for the neck? A. cephal/o B. thorac/o C. cervic/o D. coccyg/o Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 29 Bones of the Appendicular Skeleton Shoulder girdle and upper extremity Pelvic girdle and lower extremity Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 30 Word Parts scapul/o = scapula glen/o = glenoid clavicul/o, cleid/o = clavicle humer/o = humerus Shoulder Girdle and Upper Extremity Scapula shoulder Acromion process Glenoid cavity Coracoid process Clavicle Humerus Caput Anatomical neck Medial and lateral epicondyles Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 31 • The scapulae (s. scapula) are the shoulder blades, which are flat bones on the dorsal aspect of the body. • The acromion process is the lateral protrusion of the scapula that forms the highest point of the shoulder. • The glenoid cavity (its orgins meaning a cavity) is the socket in the scapula where the head (caput) of the humerus sits. • The coracoid process is the beaklike process (corac/o comes from the term meaning a crow) that serves as a point of attachment for muscles and ligaments in the shoulder. • The clavicles are the collarbones. These are long, curved horizontal bones that attach to the upper sternum at one end and to the acromion process of the scapula at the other. These bones help stabilize the shoulder in the front of the body. It’s interesting to note that the “wishbone” of a chicken is composed of its clavicles fused together. • The humerus is the upper arm bone. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 32 Word Parts radi/o = radius uln/o = ulna olecran/o = elbow, olecranon Shoulder Girdle and Upper Extremity Radius Ulnar notch Ulna Radial notch Olecranon • The radius is the lower lateral arm bone (remember to position the body in anatomical position to determine which bone is medial and which is lateral). • The ulna is the lower medial arm bone. The olecranon is a proximal projection of the ulna that forms the tip of the elbow. This “funny bone” is actually a process, not a separate bone. • Note that the notches (ulnar and radial) appear on the opposite bone, because they are the locations where those bones articulate. The radial notch is at the proximal end, while the ulnar notch is at the distal end. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 33 Word Parts carp/o = carpus, wristbone capit/o = head ham/o =hooked, hamate lun/o = moon, lunate Shoulder Girdle and Upper Extremity Carpals First row Second row Capitate, hamate, lunate, pisiform, scaphoid, trapezium, trapezoid, triquetral pis/i = pea, pisiform -form = shape scaph/o = boat, scaphoid trapezi/o =table, trapezium triquetr/o = three corner, triquestral Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 34 Named for their shape Wrist Bones (Carpus) Capitate (head) Hamate (hooked) Lunate (moon) Pisiform (pea) Scaphoid (boat) Trapezium (table) Trapezoid (table) Triquetrum (three corner) Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 35 Word Parts metacarp/o = hand bone metacarpus, phalang/o = phalanx, finger/toe bone inter- = between dist/o = far proxim/o = near digit/o = digit, finger/toe Shoulder Girdle and Upper Extremity Metacarpals- hand bones Phalanges-bones of fingers/toes Interphalangeal joints DIP PIP Digitus, finger Pollex thumb pollic/o = thumb Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 36 PCS Guideline Alert! B4.7 If a body system does not contain a separate body part value for fingers, procedures performed on the fingers are coded to the body part value of the hand. If a body system does not contain a separate body part value for toes, procedures performed on the toes are coded to the body part value for the foot. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 37 Word Parts pelv/i = pelvis cox/o = hip Pelvic Girdle and Lower Extremity Pelvic Girdle Ilium- upper hip Ischium- lower hip Pubis-lower front pelvis Acetabulum- hip socket ili/o = ilium ischi/o = ischium pub/o = pubis acetabul/o = acetabulum Bony pelvis Sacrum Coccyx Be Careful! Don’t confuse ilium with ileum (part of the digestive system). Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 38 Did You Know? Archeologists can often tell a male from a female skeleton by examining the pelvic outlets. The female pelvis is wider. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 39 Word Parts Pelvic Girdle and Lower Extremity Femur femor/o = femur patell/a = patella Femoral head- connects the head to the shaft where the two protuberances (greater and lesser trochanter) allow for attached muscles. Distal end of the shaft are medial and lateral condyles that articulate with tibial condyles. Avoe those are the medial and lateral epicondyles. Femoral head Femoral neck Trochanters Greater Lesser Condyles Medial Lateral Epicondyles Medial Lateral Patella Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 40 Word Parts tibi/o = tibia fibul/o, perone/o = fibula malleol/o = malleolus Pelvic Girdle and Lower Extremity Tibia- shinbone. Condyles (proximal end) Medial Lateral Medial malleolus Fibula (lower lateral leg bone) Shaft Lateral malleolus-process that extends outward at the distal end of the bone Be Careful! Don’t confuse perone/o for fibula with peritone/o, meaning the lining of the abdomen. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 41 Word Parts tars/o = tarsus Pelvic Girdle and Lower Extremity Tarsus, tarsal bones (ankle, foot) calcane/o = calcaneus cuboid/o = cuboid cun/e = cuneiform navicul/o = navicular tal/o = talus Calcaneus- (heel) Cuboid-(box shaped) Cuneiform(wedge-shaped) Navicular- (boat shaped) Talus (dice) Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 42 Word Parts metatars/o = metatarsal, metatarsus, foot bone phalang/o = phalanx, finger/toe bone Pelvic Girdle and Lower Extremity Metatarsus, metatarsal bone Phalanges Hallux- great (big) toe halluc/o = great toe Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 43 Review Question One of your patient’s records documents a fracture of her upper arm bone. The healthcare term for it is the: A. B. C. D. femur radius sternum humerus Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 44 Muscles (Anterior View) Anterior view Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 45 Muscles (Posterior View) Posterior view Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 46 Did You Know? Muscle The word muscle comes from the Latin musculus, the diminutive of mus, meaning a mouse; hence, literally, little mouse, usually explained by the allusion to rippling of muscles under the skin as the scurrying of little mice. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 47 Word Parts ex- = out Muscle Actions Extension-stretch Flexion-bend at joint tens/o = stretching -ion = process of flex/o = bending Extension/flexion Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 48 Word Parts ad- = toward Muscle Actions Adduction-toward midline Abduction-away from midline duct/o = carry -ion = process of ab- = away duct/o = carry Adduction Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Abduction 49 Muscle Actions Supination-palm up Pronation-palm down Supination/pronation Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 50 Word Parts dors/i = back flex/o = bend -ion = process of Muscle Actions Dorsiflexion- toe up Plantar flexion- toe down plant/o = sole Dorsiflexion Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Plantar flexion 51 Word Parts e- = out Muscle Actions Eversion- turned out Inversion- turned in vers/o = turning -ion = process of in- = in Eversion/Inversion Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 52 Word Parts rot/o = wheel -ation = process of circum- = around duct/o = carry Muscle Actions Rotation- turning on its axis Circumduction-curcular movement at distal end around its Point of attachment. -ion = process of Rotation Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 53 Synonyms Medial rotation is the same as internal rotation. Medial – towards the midline/inward Lateral rotation is the same as external rotation. Lateral – towards the side/outward Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 54 Word Parts pro- = forward Muscle Actions Protraction- forward movement Retraction- backward movement tract/o = pulling -ion = process of re- = backward tract/o = pulling Protraction Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Retraction 55 Review Question A patient who experiences pain when stretching out his leg has problems with: A. B. C. D. extension flexion abduction adduction Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 56 Word Parts anti- = against syn- = together, with erg/o = work Functions of Muscles Agonist Primary movers Antagonist Opposite action of the agonist Synergist Muscles that work together Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 57 Word Parts fasci/o = fascia Fascia Structure of connective tissue that surrounds muscles, blood vessels, and nerves Binds some structures while permitting others to slide smoothly over each other. Composed of dense, closely packed bundles of fiber. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 58 Muscle Naming Conventions Location Zygomaticus, femoris, brachialis, mentalis, anterior/posterior Number of insertions Biceps, triceps, quadriceps Size Maximus, vastus, magnus Minimus Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 59 Muscle Naming Conventions Shape Deltoid, piriformis, pterygoid Muscle action Flexor, extensor Abductor, adductor Depressor, levator Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 60 Origin/Insertion of Muscles origin (sternum and clavicle) and insertion (mastoid bone). Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 61 Head Muscles Word Parts Auricularis m. – moves ears Temporalis m.- raises lower jaw auricul/o = ear Temporoparietalis m.-paired scalp muscles over pteryg/o = wing temporal and parietal regions Splenius capitis m.-holds head up Masseter m.- closes jaw Pterygoid m.- wing Like muscle allows Side to side movement capit/o = head tempor/o = temporal bone pariet/o = parietal bone Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 62 Facial Muscles Word Parts bucc/o = cheek corrug/o = wrinkle Buccinator m.- group of muscles of face Corrugator supercilii m.- wrinkles forehead Depressor supercilii m.- lowers eyebrows Zygomaticus m.-raises angle of mouth up and to size super- = above cili/o = tiny hairs zygomat/o = zygoma, cheek bone Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 63 Facial Muscles Word Parts or/o = mouth Orbicularis oris m.- pukers lips Depressor anguli oris m.lowers corners of mouth Levator anguli oris m.- raises upper lip Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 64 Word Parts Facial Muscles Depressor labii inferioris m.- lowers lips Levator labii superioris m.-rasies upper lip labi/o = lip alaeque = wing levator labii superioris alaeque nasi m.- raises upper lip and nostrils nas/o = nose Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 65 Facial Muscles Word Parts Nasalis m.- raises corners of nostrils Depressor septi nasi m.- lowers wall in nose nas/o = nose Procerus m.- draws eyebrows together frown sept/o = wall muscle Risorius m.-smile muscle Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 66 Neck Muscles Word Parts Anterior vertebral m.-in front of backbones and vertebr/o = vertebra infra- = under scapul/o = scapula, shoulder blade help neck bend. Arytenoid m.- moves focal cords together Cricothyroid m.- lengthens and tenses vocal cords Infrahyoid m.- moves hyoid and larynx down while speaking Levator scapulae m.- raises shoulder blade Platysma m.- tenses lower face and neck Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 67 Word Parts Neck Muscles cervic/o = neck stern/o = sternum, breastbone Scalene m.- raises ribs and flexes neck Splenius cervicis m.- bandlike bends and extends neck Sternocleidomastoid m.- rotates and tilts head Suprahyoid m.- raise the tongue and widen esophagus Thyroarytenoid m. –thickens vocal cords cleid/o = clavicle supra- = above thyr/o = thyroid Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 68 Word Parts palat/o = palate gloss/o = tongue salping/o = eustachian tube Tongue, Palate, and Pharynx Muscles Levator & tensor veli palatini m.- controls tension of soft palate Palatoglossal m.- raises tongue Palatopharyngeal m.- aids in swallowing Salpingopharyngeal m- raises nasopharynx Pharyngeal constrictor m.- narrows throat for swallowing pharyng/o = pharynx, throat Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 69 Word Parts chondr/o = cartilage Tongue, Palate, and Pharynx Muscles Chondroglossus m.- lowers tongue Genioglossus m.- lowers and protrudes tongue geni/o = chin Hypoglossus m.- lowers and pulls tongue backward gloss/o = tongue Inferior longitudinal m.- extends length of tongue hypo- = below, under pharyng/o = pharynx, throat Styloglossus m.- raises and retracts tongue Stylopharyngeus m.- raises voicebox and nasopharynx Superior longitudinal m.- changes shape of tongue for change Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 70 Review Question The infrahyoid muscles are those that are: A. above the hyoid bone B. around the hyoid bone C. under the hyoid bone D. below the hyoid bone Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 71 Word Parts Shoulder Muscles Deltoid m.- flexes,, abducts and extends arm Teres major m.- extends arm and medially rotates delt/o = triangle infra- = below sub- = below supra- = above shoulder Infraspinatus m.- rotates arm laterally Subscapularis m.- adducts and medially rotates arm Supraspinatus m.- assists deltoid at the shoulder Teres minor m.- laterally rotates arm Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 72 Upper Arm Muscles Word Parts bi- = two -ceps = heads brachi/o = arm Biceps brachii m.- flexes and supinates forearm at elbow Brachialis m.- flexes forearm at elbow Coracobrachialis m.- flexes and medially rotates arm at shoulder Triceps brachii m.- extends forearm at elbow corac/o = coracoid process tri- = three Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 73 Lower Arm Muscles Word Parts brachi/o = arm radi/o = radius carp/o = carpus, wrist uln/o = ulna palm/o = palm Anatomical snuffbox- triangular depression on the radial side of the back of the hand Brachioradialis m.- flexes forearm at elbow Extensor carpi radialis m.- extends and adducts hand at wrist Extensor carpi ulnaris m.- extends and abducts hand at wrist Flexor carpi radialis m.- flexes and abducts hand at wrist Flexor carpi ulnaris m.- flexes and adducts hand at wrist Palmaris longus m.- flexes wrist Pronator quadratus m.- pronates forearm Pronator teres m.- pronates forearm and flexes elbow Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 74 Word Parts pollic/o = pollex, thumb digit/o = finger, toe inter- = between osse/o = bone Hand Muscles Thenar m. (eminence) Group of muscles controlling the thumb: the abductor, flexor, and opponens pollicis brevis Hypothenar m. (eminence) Group of muscles controlling the little finger: the abductor, adductor, and opponens digiti minimi Palmar interosseous m. Synonym: interossei volares Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 75 Review Question The genioglossus muscle is located in the: A. neck B. tongue, palate, and pharynx C. shoulder D. lower arm Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 76 Word Parts coccyg/o = coccyx, tailbone Muscles of the Trunk Coccygeus m.- pulls tailbone forward Erector spinae m.- extends and bends spine and inter- = between an/o = anus quadra- = four lumb/o = loin head to side Interspinalis m.- extends spine Intertransversarius m.- flex the trunk sideways Latissimus dorsi m.-adducts, extends and medially rotates humerus Levator ani m.- raise pelvic floor around anus Quadratus lumborum m.- extends and flexes vertebral column to the side Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 77 Word Parts spin/o = spine Muscles of the Trunk Rhomboid major m.- pulls shoulder blade back and rotates to lower glenoid cavity Rhomboid minor m.- smaller version of the major and does same thing Serratus posterior m.- raise the ribs Transversospinalis m.- rotators of the spine Trapezius m.- raises,, rotates and pulls shoulders backward Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 78 Word Parts inter- = between cost/o = rib levat/o = raise pector/o = chest sub- = under trans- = through Muscles of the Thorax Intercostal m.- assist in inhalation Levatores costarum m.- help to raise ribs in respiration Pectoralis major m.- flexes, adduts, and medially rotates arm at shoulder Pectoralis minor m.- raises and lowers shoulder blades Serratus anterior m.- rotates shoulder blades upward Subclavius m.- pulls collarbone downward Subcostal m.- pulls ribs down in respiration Transverse thoracis m.- pulls ribs and costal cartilage down. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 79 Word Parts Muscles of the Abdomen rect/o = straight abdomin/o = abdomen External oblique m.- flex and rotate torso Internal oblique m.- support and compress abdomen and rotate vertebral column Pyramidlais m.- tenses the linea, a tendon located in the midline of the abdominal muscles Rectus abdominis m.- compress internal abdominal muscles and flex the trunk Transverse abdominis m.- compress and support internal abdominal muscles Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 80 Word Parts ischi/o = ischium perine/o = perineum Muscles of the Perineum Bulbospongiosus m.- contrats vagina in females; empties urethra in males Cremaster m.- raises and lowers scrotum in males Deep transverse perineal m.- provides support for the perineum Ischiocavernosus m.- assists bulbospongiosus muscle Superficial transverse perineal m.- helps resist increased intrapelvic pressure. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 81 Word Parts Muscles of the Hip glute/o = buttock ili/o = ilium Gemellus m.- laterally rotate and extend the thigh from the hip, and allows abduction of the flexed thigh at the hip. Gluteus maximus m.- extends the thigh at the hip and rotates the thigh latearlly. Gluteus medius m.- abducts and medially rotates the thigh at the hip. Gluteus minimus m.- abducts and metially rotates the thigh at the hip. Iliacus m.- flexes the hips and stabilizes the hip joint. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 82 Word Parts quadra- = four femor/o = femur, thighbone psoa = loin Muscles of the Hip Obturators m.- rotate and abduct the thigh. Piriformis m.- rotates the thigh. Psoas m.- flexes the hip, trunk, and vertebral column Quadratus femoris m.- rotates the thigh laterally at the hip. Tensor fasciae latae m.- tighten, abduct, medially rotate and flex the thigh at the hip. Be Careful! The pisiform is in the wrist, while the piriformis is in the hip. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 83 Muscles of the Upper Leg Word Parts ad- = toward Adductor brevis m.- shorter muscle that carries the duct/o = carry brev/o = short magnus = large thigh toward midline Adductor longus m.- longer muscle that carries the thigh toward midline and rotates thigh medially at the hip. Adductor magnus m.- adducts the thigh at the hip Gracilis m.- slender muscle that adducts the thigh at the hip Pectineus m.- adducts and flexes the thigh at the hip Sartorius m.- responsible for extending leg when sitting in cross legged position. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 84 Muscles of the Upper Leg Word Parts femor/o = femur, thighbone quadri-= four Hamstrings Semimembranosus m.- extends high at the hip, flexes and rotates the leg medially. Semitendinosus m.- extends thigh at the hip, flexes and medially rotates leg at knee. Biceps femoris m.- flexes the leg at the knee, rotates it laterally, and extends thigh at the hip. Quadriceps m. Rectus femoris m.- straight muscle in the thigh. Vastus intermedius m.- extends lower leg at the knee Vastus lateralis m.- extends lower leg at the knee Vastus medialis m.- extends lower leg at the knee Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 85 Word Parts ex- = out tens/o = stretching Lower Leg Muscles Extensor hallucis longus m.- extends great toe and dorsiflexes the foot at the ankle Flexor hallucis longus m.-flexes the great toe and plantar flexes the foot at the ankle. Popliteus m.- flexes the leg at the knee. flex/o = bending halluc/o = great toe, hallux poplite/o = back of knee Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 86 Lower Leg Muscles Word Parts ex- = out tens/o = stretching flex/o = bending perone/o = fibula Gastrocnemius m. – plantar flexes the foot at the ankle, raises heel during walking and flexes leg at knee joint Extensor digitorum longus m.- extends lateral for digits and dorsiflexes the foot at the ankle Flexor digitorum longus m.- flexes the lateral four digits and plantar flexes the foot at the ankle Fibularis (peroneus) brevis & longus m.everts foot Soleus m.-plantar Flexes foot at ankle Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 87 Muscles of the Foot Word Parts ab- = away from duct/o = carry halluc/o = great toe ex- = out tens/o = stretching flex/o = bending Abductor hallucis m.- abducts and flexes great toe Adductor hallucis m. adducts great toe Extensor digitorum brevis m.- extends lateral digits 2-4 Flexor digitorum brevis m.- flexes the lateral four digits and flexes foot at ankle Extensor hallucis brevis m- flexes proximal phalanx of great toe Flexor hallucis brevis m.- short great toe muscle for bending Quadratus plantae m.- muscles on the sole of the foot that assist in flexing lateral four digits. brev/o = short quadra- = four Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 88 Review Question The peroneus brevis is a muscle in the: A. hip B. upper leg C. lower leg D. foot Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 89 Joints/Articulations Range of motion (ROM) Synarthoses- joints that have no movement because they are joined Amphiarthroses- joints that have limited range of motion Diarthroses – synovial joints, and have free movement (synovial) Bursa (pl. bursae)- sacs of fluid that are located between bones and cushion them Meniscus (pl. menisci)- crescent shaped Cartilage in the knee that adds extra Cushion. The knee joint Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 90 Upper Joints Head joints Upper spine joints Upper extremity joints Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 91 Head Joints Word Parts Temporomandibular Joint- tempor/o = temporal bone mandibul/o = mandible, lower jaw Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 92 Word Parts occipit/o = occipital bone cervic/o = neck vertebr/o = vertebra atlant/o = atlas axi/o = axis thorac/o = thorax, chest Upper Spine Joints Occipital-cervical joint-between base of skull and first certical vertebrae Cervical vertebral joint- one of the articulations between the 7 cervical vertebrae Atlantoaxial joint- c1 and c2 Cervical facet joint between the adjoining facets of the neck vertebrae Cervical vertebral joint articulation between two or more vertebrae Cervical vertebral disc- discs between c7 and t1 Cervicothoracic vertebral joint- articulation between c7 and t1 Cervicothoracic facet joint- articulation between c7 and t1 Cervicothoracic vertebral disc disc between c7 and t1 Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 93 Word Parts cost/o = rib vertebr/o = vertebra thorac/o = chest lumb/o = loin, lumbar vertebrae Upper Spine Joints Thoracic vertebral joint (T2-T7) Costotransverse joint- articulation between posterior end of the 6 ribs and t2-t7 vertebrae Costovertebral joint- articulations between ribs and the thoracic vertebrae including floating and false ribs Thoracic facet joints- articulations between t8 and t12 Thoracic vertebral joints- articulations between t8 and t12 Thoracic vertebral disc- discs between any of the thoracic vertebral joints Thoracolumbar joint Thoracolumbar facet joints- articulations between t12 and l1 Thoracolumbar disc- intervertebral disc between t12 and l1 Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 94 Word Parts stern/o = sternum, breastbone clavicul/o = clavicle, collarbone acromi/o = acromion process humer/o = humerus, upper arm bone Upper Extremities Joints Sternoclavicular joint- articulation between the manubrium of the breastbone and the medial end of the collarbone. Acromioclavicular joint- articulation between the acromion process of the scapula and the lateral end of the collarbone. Humeroulnar joint- articulation between upper arm bone and lower medial arm bone. Humeroradial joint- articulation between upper arm bone and lower lateral arm bone. Proximal radioulnar joint- articulation between lower arm bones nearest the humerus. uln/o = ulna, lower medial armbone radi/o = radius, lower lateral armbone proxim/o = near Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 95 Upper Extremities Joints Word Parts carp/o = carpus, wrist inter- = between mid- = middle dist/o = far metacarp/o = hand bone, metacarpal bone phalang/o = phalanx, finger/toe bone Carpal joints Intercarpal joints- articulations between individual carpal bones Midcarpal joint- articulations between the distal row Wrist joints Radiocarpal joint- articulations between distal end of the lower lateral arm bone and carpal bones Distal radioulnar joint- articulations between distal ends of both lower arm bones Metacarpal joints Metacarpocarpal/carpometacarpal joints- joints between carpal bones and 5 meta carpal bones Metacarpophalangeal joints Finger phalangeal joints DIP and PIP Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 96 Upper Extremity Joints Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 97 Lower Joints Lower spine joints Lower extremities joints Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 98 Word Parts lumb/o = loin, lumbar bones sacr/o = sacrum coccyg/o = coccyx, tailbone Lower Spine Joints Lumbar vertebral joints Lumbosacral joints Sacrococcygeal joint Synonym: coccygeal joint Sacroiliac joint ili/o = ilium Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 99 Word Parts Congenital Conditions (Q00Q99) Achondroplasia- result of cartilage at the epiphyses of long bones causing dwarfism Polydactyly- more than 5 fingers or toes Spina bifida occulta- malformation of the bony spinal canal without spinal cord involvement. a- = without chondr/o = cartilage -plasia = development poly- = many dactyl/o = finger, toe spin/o = spine bi- = two -fida = to split occulta = hidden Polydactyly Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 100 Word Parts syn- = joined, together dactyl/o = fingers, toes -y = process of Congenital Conditions (Q00Q99) Syndactyly- webbed fingers or toes Talipes- club foot Torticollis- muscle contraction of neck called wryneck Syndactyly Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Talipes 101 Word Parts arthr/o = joint -osis = abnormal condition Arthropathies (M00-M25) and Dentofacial Anomalies (M26M27) hem/o = blood hydr/o = fluid py/o = pus con- = together Arthrosis Hemarthrosis Hydrarthrosis Pyarthrosis Bunion- painful enlargement of great toe Contracture- fixation of a joint in flexion Crepitus- crackling sound heard in a joint Gout- buildup of uric acid that causes crystals to form and inflames joints. tract/o = pullin crepit/o = crackling Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 102 Word Parts Arthropathies (M00-M25) and Dentofacial Anomalies (M26M27 oste/o = bone arthr/o = joint -itis = inflammation rheumat/o = watery flow Osteoarthritis (OA) Degenerative joint disease (DJD)- degeneration of joints making movement difficult Rheumatoid arthritis (OA)- autoimmune disease that causes joint inflammation. Diagnosed with a rheumatoid factor test. -oid = resembling, like Rheumatoid arthritis Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 103 Word Parts oste/o = bone Arthropathies (M00-M25) and Dentofacial Anomalies (M26M27 Osteophytosis- abnormal bone growth Temporomandibular joint disorder (TMJ) Gnathalgia-jaw pain phyt/o = growth, nature -osis = abnormal condition tempor/o = temporal bone mandibul/o = mandible, lower jawbone gnath/o = jaw -algia = pain Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 104 Word Parts ankyl/o = stiffening spondyl/o = vertebra -listhesis = slipping stenosis = narrowing Systemic Connective Tissue Disorders (M30-M-36) and Deforming Dorsopathies (M40-M54) Ankylosing spondylitis- chronic inflammatory disease that causes fusion of the spine Spondylosis- stiffening of the vertebral joints Spondylolisthesis- forward dislocation of one vertebra over the one beneath it Spinal stenosis- narrowing of the spinal canal causing pain, and many times seen with arthritis or spondylolithesis. Spinal stenosis Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 105 Word Parts inter- = between vertebr/o = vertebra Systemic Connective Tissue Disorders (M30-M-36) and Deforming Dorsopathies (M40-M54) Herniated intervertebral disc- protrusion of the central part of the disc that lies between vertebrae. Causes compression and pain. Sciatica- inflammation of the sciatic nerve, can cause pain in buttocks and down the leg. Sciatica Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 106 Word Parts poly- = many myos/o = muscle -itis = inflammation Systemic Connective Tissue Disorders (M30-M-36) and Deforming Dorsopathies (M40-M54) Polymyositis- inflammation of many voluntary muscles Systemic lupus erythematosus (SLE)- chronic systemic inflammation, and characterized by rash below. Systemic scleroderma- connective tissue disorder that causes hardening and thickening of the skin. system/o = system erythemat/o = red scler/o = hard Systemic lupus erythematosus Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 107 Word Parts kyph/o = round back lord/o = swayback scoli/o = curvature -osis = abnormal condition Systemic Connective Tissue Disorders (M30-M-36) and Deforming Dorsopathies (M40-M54) Kyphosis- hunchback Lordosis- inward curve Scoliosis- s shaped Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 108 Word Parts Soft Tissue Disorders (M60M79) Baker’s cyst- inflammation of synovial fluid in the knee area. Bursitis- inflammation of bursa burs/o = bursa -itis = inflammation Baker’s cyst Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 109 Word Parts Soft Tissue Disorders (M60M79) Fibromyalgia- disorder causing muscular pain, fatigue, muscle stiffness, spasms, and sleep disturbances. No definitive test Tendinitis- inflammation in a tendon fibr/o = fiber my/o = muscle -algia = pain tendin/o = tendon -itis = inflammation Fibromyalgia Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 110 Word Parts epicondyl/o = epicondyle plant/o = sole fasci/o = fascia rhabdomy/o = striated muscle -lysis = breakdown, destruction Soft Tissue Disorders (M60M79) Lateral epicondylitis- tennis elbow Plantar fasciitis- inflammation of the fascia of the foot Rhabdomyolysis- breakdown of striated/skeletal muscle. my/o = muscle -algia = pain Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 111 Word Parts Osteopathies and Chondropathies (M80-M94) Osteitis deformans- mishhaped bone resulting from inflammation Osteomalacia- softening of a bone Rickets- osteomalacia in childhood Osteomyelitis- inflammation of the bone and marrow Osteoporosis- loss of bone mass causing fragile bone Osteopenia- less severe bone mass loss oste/o = bone -itis = inflammation deformans = misshapen -malacia = softening myel/o = bone marrow -itis = inflammation por/o = passage Osteitis deformans Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Osteoporosis 112 Word Parts chondr/o = cartilage -malacia = softening cost/o = rib Cartilage Disorders Chondromalacia- softening of cartilate Costochondritis- inflammation of the rib cartilage chondr/o = cartilage -itis = inflammation Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 113 Review Question The patient’s problem list includes the term for an inflammation of bone and bone marrow. The term is: A. B. C. D. osteoporosis osteomyelitis chondromalacia osteomalacia Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 114 Review Question One of the physicians is doing a study on patients who have a softening of the cartilage. What is the term? A. B. C. D. crepitus chondromalacia costochondritis osteophytosis Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 115 Trauma Fractures Displaced/nondisplaced-the ends of the bone are separated) or nondisplaced (the ends of the bone are still together). Closed/open-Closed fractures (also called simple fractures) are those in which the bone is broken but the skin remains intact. Open fractures (also called compound fractures) are those in which the bone is broken and one or both ends pierce the skin. Pathologic-is one that results from an underlying disease, such as osteoporosis or cancer Comminutedthose in which the bone is crushed and/or shattered into multiple pieces Compression-one in which the bone collapses on itself. Colles’-occurs at the distal end of the radius at the epiphysis. It usually occurs as a result of bracing oneself for a fall Complicated-bone is broken and one or both ends then pierce an internal organ. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 116 Trauma Fractures Impacted -which the ends of the broken bones are driven into each other Hairline-a minor fracture appearing as a thin line on an x-ray Salter-Harris-occurs at the epiphyseal plate in children Greenstick-which the bone is partially bent and partially broken Avulsion-occurs when part of the bone is pulled away by a tendon or ligament Avulsion Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 117 Trauma Sprain Grade I Grade II- part tear Grade III- complete tear Strain-lesser than sprain Dislocation- completely out of place Subluxation- partially out of the joint Compartment syndrome- selling within the fascia that can lead to nerve and muscle damage. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Strain/sprain 118 Word Parts ex- = out oste/o = bone -osis = abnormal condition -oma= tumor Benign Neoplasms (D10-D36) Exostosis Osteoma Chondroma Leiomyoma Rhabdomyoma chondr/o = cartilage leiomy/o = smooth muscle rhabdomy/o = skeletal muscle WHAT DO THEY MEAN? Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 119 Malignant Neoplasms Osteosarcoma Ewing’s sarcoma Chondrosarcoma Leiomyosarcoma Rhabdomyosarcoma Synonyms: Rhabdosarcoma, Rhabdomyoblastoma Ewing’s sarcoma From Damjanov: Pathology for the health professions, ed 3, Mosby Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 120 Word Parts acetabul/o = acetabulum -plasty = surgically forming Bone Procedures Acetabuloplasty Alveoloplasty Amputation Bunionectomy alveol/o = small cavity bunion/o = bunion -ectomy = cutting out Bunionectomy Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 121 Word Parts carp/o = carpus, wrist bone chondr/o = cartilage clavicul/o = clavicle, collarbone Bone Procedures Carpectomy Chondrectomy Claviculectomy Condylectomy Costectomy condyl/o = condyle cost/o = rib Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 122 Word Parts Bone Procedures Densitometry densit/o = density -metry = measuring Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 123 Word Parts disc/o = disc -graphy = recording Bone Procedures Discography Genioplasty Mentoplasty geni/o = chin Kyphoplasty ment/o = chin, mind Mandibulectomy kyph/o = round back mandibul/o = mandible, lower jaw Kyphoplasty Be Careful! Geni/o means chin, while –gen means producing and gen/u means knee. Also, ment/o means both chin and mind. Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 124 Word Parts metatars/o = metatarsus, foot bone -ectomy = cutting out oste/o = bone -clasis = breaking Bone Procedures Metatarsectomy Osteoclasis Patellapexy Sacrectomy Scapulopexy patell/a = kneecap, patella -pexy = fixation sacr/o = sacrum scapul/o = shoulder blade, scapula Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 125 Word Parts sequestr/o = sequestrum -ectomy = cutting out spondyl/o = vertebra Bone Procedures Sequestrectomy Spondylosyndesis Sternotomy Tarsectomy syn-= joined, together -desis = binding stern/o = breastbone, sternum -tomy = cutting tars/o = tarsus, ankle bone Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 126 Word Parts mal- = bad non- = not Setting Fractures Malunion Nonunion Sequestrum Débridement Reduction/manipulation Fixation Internal External External fixation Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. Internal fixation 127 Word Parts achill/o = Achilles tendon -rrhaphy = suturing acromi/o = acromon Joint, Muscle, and Fascia Procedures Achillorrhaphy Acromioplasty Arthrocentesis -plasty = surgically forming arthr/o = joint -centesis = surgical puncture Arthrocentesis Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 128 Joint, Muscle, and Fascia Procedures Arthroplasty Total hip replacement Total knee replacement Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 129 Word Parts arthr/o = joint -desis = binding -graphy = recording Joint, Muscle, and Fascia Procedures Arthrodesis Arthrography Arthrotomy -tomy = cutting Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 130 Joint, Muscle, and Fascia Procedures Arthroscopy Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 131 Word Parts burs/o = bursa -ectomy = cutting out Joint, Muscle, and Fascia Procedures Bursectomy Bursocentesis -centesis = surgical puncture Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 132 Word Parts disc/o = disc -ectomy = cutting out electr/o = electricity Joint, Muscle, and Fascia Procedures Discectomy Electromyography (EMG) Fasciotomy my/o = muscle -graphy = recording fasci/o = fascia -tomy = cutting Electromyography Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 133 Word Parts lamin/o = lamina, thin plate -ectomy = cutting out Joint, Muscle, and Fascia Procedures Laminectomy Meniscectomy Myopexy menisc/o = meniscus my/o = muscle -pexy = fixation Laminectomy Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 134 Word Parts synov/o = synovial membrane -ectomy = cutting out tend/o = tendon Joint, Muscle and Fascia Procedures Synovectomy Tendolysis Tenomyoplasty -lysis = release, destruction ten/o = tendon my/o = muscle -plasty = surgically forming Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 135 Pharmacology Analgesics Anti-inflammatories Antirheumatics Bisphosphonates Disease-modifying antirheumatic drugs (DMARDS) Muscle relaxants Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 136 Review Question In the “Surgeries” section of an electronic health record, a procedure is done that means a binding or stabilization of a joint. This term is: A. B. C. D. arthrocentesis arthrodesis arthroplasty osteoclasis Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 137 Suffixes and Root Operations for the Musculoskeletal System -clasis -desis -ectomy -pexy -plasty -tomy division fusion excision, resection, extirpation repair, reposition repair, replacement, supplement, alteration release, division, drainage Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 138 Sort These Terms into Their Correct Categories Terms 1. osteoclasis 2. arthrodesis 3. polymyositis 4. scapula 5. electromyography Categories __ A + P __ Pathology __ Procedures Copyright © 2015 by Mosby, Inc., an imprint of Elsevier Inc. 139