Chapter 6 - Medical Terminology (Rice)

Learning Outcomes List the primary functions of bones. Explain various types of body movement that occur at the diarthrotic joints. Contrast the male pelvis to that of the female pelvis. Define fracture and state the various types. Learning Outcomes Analyze, build, spell, and pronounce medical words. Comprehend the drugs highlighted in this chapter. Describe diagnostic and laboratory tests related to the skeletal system. Identify and define selected abbreviations. Figure 6.1 Anterior of the human skeleton. Insert table 6-1 Anatomy and Physiology Overview The skeletal system is composed of 206 bones that, with cartilage, tendons, and ligaments, make up the framework or skeleton of the body. Axial skeleton 80 bones, the principal bones being the skull, spine, ribs, and sternum. Anatomy and Physiology Overview Appendicular skeleton 126 bones, the primary bones being the shoulder girdle, arms, hands, pelvic girdle, legs, and feet. Bones The primary organs of the skeletal system. Bones are 50% water and 50% osseous tissue. Life Span Considerations Bones begin to develop during the second month of fetal life as cartilage cells enlarge, break down, disappear, and are replaced by bone-forming cells called osteoblasts. This process is known as endochondral ossification. Life Span Considerations Bone cells deposit organic substances in the spaces vacated by cartilage to form bone matrix. As this process proceeds, blood vessels form within the bone and deposit salts that serve to harden the developing bone. After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year. Figure 6.2 Classification of bones by shape. Insert table 6-2 Bones Structure of a Long Bone Epiphysis Diaphysis Periosteum Compact bone Bones Structure of a Long Bone Medullary canal Endosteum Cancellous or spongy bone Figure 6.3 Features found in a long bone. Life Span Considerations In children, the epiphyseal plate is the center of longitudinal bone growth. Can determine biological age of a child from the development of epiphyseal ossification centers. About three years after onset of puberty, ends of long bones knit securely to their shafts. Bones Bone Markings Certain commonly used terms describe the markings of bones. Have roles in: joining bones together providing areas for muscle attachments serving as a passageway for blood vessels, ligaments, and nerves. Insert table 6-3 Joints and Movement A joint is an articulation, a place where two or more bones connect. The manner in which bones connect determines the type of movement possible at the joint. Figure 6.5 Knee joint. Life Span Considerations Age-related joint changes are due to: diminished viscosity of synovial fluid degeneration of collagen and elastin cells outgrowth of cartilaginous clusters in response to continuous wear and tear formation of scar tissues and calcification in the joint capsules. Life Span Considerations Osteoarthritis often results from years of accumulated wear and tear on joints and tends to occur more frequently in the hips, knees, and finger joints. Joints and Movement Classification of Joints Synarthrosis (Fibrous) Amphiarthrosis (Cartilaginous) Diarthrosis (Synovial) Joints and Movement Types of body movement that occur at the diarthrotic joints: Abduction Adduction Circumduction Dorsiflexion Joints and Movement Types of body movement that occur at the diarthrotic joints: Rotation Supination Figure 6.6 A Flexion and Extension Flexion–Bending a limb. Extension–Straightening a flexed limb. Figure 6.6 B Circumduction Circumduction–Moving a body part in a circular motion. Figure 6.6 C Abduction and Adduction Abduction–Moving a body part away from the middle. Adduction–Moving a body part toward the middle. Figure 6.6 D Protraction and Retraction Protraction–Moving a body part forward. Retraction–Moving a body part backward. Figure 6.6 E Rotation Rotation–Moving a body part around a central axis. Figure 6.6 F Dorsiflexion Dorsiflexion–Bending a body part backward. Figure 6.6 G Pronation and Supination Pronation–Lying prone (face downward); also turning the palm downward. Supination–Lying supine (face upward); also turning the palm or foot upward. Figure 6.6 H Eversion and Inversion Eversion–Turning outward. Inversion–Turning inward. Vertebral Column Composed of a series of separate bones (vertebrae) connected in such a way as to form four spinal curves. Vertebral Column These curves are the: Cervical The first 7 vertebrae. Thoracic The next 12 vertebrae. Lumbar The next 5 vertebrae. Sacral Consists of the sacrum and coccyx (tailbone). Figure 6.7 Vertebral (spinal) column. Life Span Considerations Young children who are beginning to walk often have a pot-bellied stance because of a lumbar lordosis (often disappears around age five). After age six, the spine has normal thoracic convex and lumbar concave curves. Figure 6.8 Normal Development of posture and spinal curves. (A) Toddler: Protruding abdomen; lumbar lordosis. (B) School-age child: Height of Shoulders and hips is level; balanced thoracic convex and lumbar concave curves. Anatomical Differences in the Pelvis of a Male and Female The pelvis is the lower portion of the trunk of the body. The bony pelvis is formed by the sacrum, the coccyx, and the bones that form the hip and pubic arch, the ilium, pubis, and ischium. Male Pelvis The male pelvis is shaped like a funnel, forming a narrower outlet than the female. The bones are generally thick and heavy and more suited for lifting and running. Figure 6.9(A) The male pelvis (android) is shaped like a funnel, forming a narrower outlet than the female. Female Pelvis The female pelvis is shaped like a basin; can be oval to round, and is wider than the male pelvis. Designed to accommodate the average fetus during pregnancy and to facilitate its downward passage through the birth canal during childbirth. Figure 6.9(B) The female pelvis (gynecoid) is shaped like a basin. Fractures A fracture is classified according to its external appearance, the site of the fracture, and the nature of the crack or break in the bone. Fractures Types of fractures: Closed or simple Open or compound Comminuted Transverse Greenstick Spiral Fractures Types of fractures: Colles' Pott's Compression Vertebral compression Epiphyseal Stress Hip Figure 6.10 (C) Transverse–Breaks the shaft of a bone across its longitudinal axis; the break is in the fibula, the smaller bone (note that images A and C are the same) Figure 6.10 (D) Comminuted–Shatters the affected part into a multitude of bony fragments (x-ray of the femur bone) Figure 6.10 (E) Greenstick–Only one side of the shaft is broken, and the other is bent (like a greenstick); usually occurs in children whose long bones have not fully ossified Figure 6.10 (F) Spiral–Produced by twisting stresses that are spread along the length of a bone (note the break in the humerus) Figure 6.10 (G) Colles'–A break in the distal portion of the radius; often the result of reaching out to cushion a fall Figure 6.10 (H) Pott's–Occurs at the ankle and affects both bones of the lower leg (fibula and tibia) Figure 6.10 (I) Compression–Occurs in vertebrae subjected to extreme stresses, as when one falls and lands on his or her bottom Figure 6.10 (J) Vertebral compression–Fractures of the spine (vertebra) can cause severe ”band-like” pain that radiates from the back to the sides of the body; often occur in patients with osteoporosis. Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height or curving of the spine due to collapse of the vertebrae.The collapse gives individuals a hunched-back appearance of the upper back, often called a “dowager's hump” because it commonly is seen in elderly women. Figure 6.10 (K) Epiphyseal–Usually occurs through the growth plate where the matrix is undergoing calcification and chondrocytes (cartilage cells) are dying; this type of fracture is seen in children Figure 6.10 (L) Hip–Typically occurs as a result of a fall; with osteoporosis, hip fractures can occur as a result of trivial accidents Audio Pronunciations Acetabulum Achondroplasia Acroarthritis Acromion a- chondr/o -plasia = cartilage = without = formation Audio Pronunciations Ankylosis Arthralgia Arthritis Arthrocentesis Arthroplasty Audio Pronunciations Arthroscope Bone marrow transplant Bursa Bursitis Audio Pronunciations Calcaneal Calcium Carpal Carpal tunnel syndrome Cartilage Figure 6.11 Cross-section of wrist showing tendons and nerves involved in carpal tunnel syndrome. Audio Pronunciations Cast Chondral Chondrocostal Clavicular Figure 6.12 This girl has a long leg cast, which was applied after surgery to correct her clubfoot. Audio Pronunciations Coccygeal Coccygodynia Collagen Connective Costal Audio Pronunciations Costosternal Craniectomy Craniotomy Dactylic Audio Pronunciations Dactylogram Dislocation Femoral Fibular Fixation Audio Pronunciations Flatfoot Genu valgum Genu varum Gout Figure 6.13 (A) Genu valgum, or knock-knee. Note that the ankles are far apart when the knees are together. (B) Genu varum, or bowleg. The legs are bowed so that the knees are far apart as the child stands. Figure 6.14 Gout of the finger joint. (Source: Reprinted from the Clinical Slide Collection on the Rheumatic Diseases, © 1991, 1995. Used by permission of the American College of Rheumatology.) Audio Pronunciations Hallux Hammertoe Humeral Hydrarthrosis Iliac hydr- arthr -osis = water = joint = condition Figure 6.15 Hammertoe. Audio Pronunciations Iliosacral Intercostal Ischial Ischialgia Figure 6.16 Abnormal curvatures of the spine: (A) kyphosis, (B) lordosis, (C) scoliosis. Figure 6.17 X-ray showing typical joint changes associated with osteoarthritis. (Source: Getty Images/Stone Allstock.) Figure 6.18 Abscess of the brain due to osteomyelitis. Figure 6.19 (A) Normal Spongy Bone. (B) Spongy Bone with osteoporosis which is characterized by loss of bone material. Figure 6.20 Spinal changes caused by osteoporosis. Life Span Considerations With normal aging, individuals can lose 1.0 to 1.5 inches in height. Loss of more than 1.5 inches in height can be related to vertebral compression fractures and other issues due to osteoporosis. Osteoporosis Video Click on the screenshot to view a video on the topic of osteoporosis. Back to Directory Audio Pronunciations Patellar Pedal Periosteoedema Phalangeal Audio Pronunciations Phosphorus Polyarthritis Rachigraph Radial Radiograph Audio Pronunciations Reduction Rheumatoid arthritis Rickets Scapular Figure 6.21 Typical hand deformities associated with rheumatoid arthritis. (Reprinted with permission of Photo Researchers, Inc.) Figure 6.22 Multisystem effects of rheumatoid arthritis. Audio Pronunciations Scoliosis Spinal Splint Spondylitis Sprain Spur Sternal Audio Pronunciations Sternotomy Subclavicular Subcostal Submaxilla Symphysis Audio Pronunciations Tendonitis Tennis elbow Tibial Traction Figure 6.24 Traction is the application of a pulling force to maintain bone alignment during fracture healing. Different fractures require different types of traction. (A) Balanced suspension traction is commonly used for fractures of the femur. (B) Skeletal traction, in which the pulling force is applied directly to the bone, may be used to treat fractures of the humerus. Audio Pronunciations Ulnar Ulnocarpal Vertebral Vertebrosternal Xiphoid xiph -oid = sword = resemble Drug Highlights Anti-inflammatory agents can be classified as steroidal (corticosteroids) and nonsteroidal. Relieves the swelling, tenderness, redness, and pain of inflammation. Drug Highlights Disease-Modifying Antirheumatic Drugs (DMARDs) COX-2 Inhibitors Antitumor Necrosis Factor (Anti-TNF) Drugs Agents Used to Treat Gout Drug Highlights Agents Used to Treat or Prevent Postmenopausal Osteoporosis Antiresorptive agents decrease the removal of calcium from bones and increase the amount of bone in most patients. Estrogen hormone therapy has been shown to prevent bone loss, increase bone density, and prevent bone fractures. Drug Highlights Analgesics are agents that relieve pain. They are classified as narcotic or non-narcotic. Diagnostic and Lab Tests Arthrography Diagnostic examination of a joint (usually the knee) in which air and then a radiopaque contrast medium are injected into the joint space and x-rays are taken. Arthroscopy Process of examining internal structures of a joint via an arthroscope. Figure 6.25 Arthroscopic surgery involves the surgery of a joint with the use of a flexible arthroscope and other surgical tools. In this example, the surgeon inserts the arthroscope to evaluate the damage to the knee joint and then uses instruments to perform the necessary procedure. Diagnostic and Lab Tests Goniometry Measurement of joint movements, especially range of motion (ROM) and angles via a goniometer. Dual-energy X-ray absorptiometry scan (DXA, formerly DEXA) Test used to measure bone mass or bone mineral density. Figure 6.26 Using a goniometer to measure joint ROM. Diagnostic and Lab Tests Photon Absorptiometry Bone scan that uses a low beam of radiation to measure bone mineral density and bone loss in the lumbar vertebrae. Diagnostic and Lab Tests Thermography Process of recording heat patterns of the body's surface. X-ray Examination of bones using an electromagnetic wave of high energy produced by the collision of a beam of electrons with a target in a vacuum tube. Diagnostic and Lab Tests Alkaline Phosphatase Blood Test Increased level in osteoblastic bone tumors, rickets, osteomalacia, and during fracture healing. Antinuclear Antibodies (ANA) Present in a variety of immunologic diseases. Bone Mineral Density Test (BMD) Used to measure bone mass or bone mineral density. Diagnostic and Lab Tests Calcium (Ca) Blood Test Calcium level in the blood can be increased in metastatic bone cancer, acute osteoporosis, prolonged immobilization, and during fracture healing. C-Reactive Protein Blood Test (CRP) Positive result can indicate rheumatoid arthritis, acute inflammatory change, and widespread metastasis. Diagnostic and Lab Tests Phosphorus (P) Blood Test Phosphorus level of the blood can be increased in osteoporosis and fracture healing. Serum Rheumatoid Factor (RF) Immunoglobulin present in the serum of 50% to 95% of adults with rheumatoid arthritis. Uric Acid Blood Test Uric acid is increased in gout, arthritis, multiple myeloma, and rheumatism. Life Span Considerations Bone mineral density, as measured by a DXA scan, indicates if the bone is stronger or weaker than normal. People with a high risk for bone fracture can be treated with the goal of preventing future fractures. A DXA scan is recommended every two years after osteoporosis is diagnosed to evaluate effectiveness of treatment. Insert abbreviations from book Combining Form Match Up Quiz carp/o a. finger or toe crani/o b. foot dactyl/o c. skull oste/o d. wrist ped/o e. bone Review Quiz The medical name for knock-knee is: genu valgum genu varum hammertoe myelitis The medical name for knock-knee is: genu valgum genu varum hammertoe myelitis The term that means softening of the bones is: osteochondritis osteogenesis osteomalacia osteomyelitis The term that means softening of the bones is: osteochondritis osteogenesis osteomalacia osteomyelitis The lowest portion of the sternum is the: clavicle diaphragm scapular xiphoid The lowest portion of the sternum is the: clavicle diaphragm scapular xiphoid Fractures are classified according to all of the following except: the time the injury occurred the external appearance the site of fracture the nature of the break in the bone Fractures are classified according to all of the following except: the time the injury occurred the external appearance the site of fracture the nature of the break in the bone Another term for fingerprint is: dactylic dactylogram phalangeal rachigraph Another term for fingerprint is: dactylic dactylogram phalangeal rachigraph The twisting of a joint that causes pain is called a strain. True False The twisting of a joint that causes pain is called a strain. True False Surgical excision of a portion of the skull is known as a craniotomy. True False Surgical excision of a portion of the skull is known as a craniotomy. True False Pain in the lower back is called lumbodynia. True False Pain in the lower back is called lumbodynia. True False Another name for humpback is kyphosis. True False Another name for humpback is kyphosis. True False Open fractures do not involve a break in the skin. True False Open fractures do not involve a break in the skin. True False The abbreviation for osteoarthritis is OSA. True False The abbreviation for osteoarthritis is OSA. True False Goniometry is a diagnostic examination of the knee. True False Goniometry is a diagnostic examination of the knee. True False The humerus is a long bone. True False The humerus is a long bone. True False The process of moving a body part away from the middle is called abduction. True False The process of moving a body part away from the middle is called abduction. True False The pinky toe is also called the hallux. True False The pinky toe is also called the hallux. True False