Medical Terminology: A Living Language

Seventh Edition

Chapter 4
Musculoskeletal System

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Skeletal System at a Glance
• The skeletal system consists of 206 bones, collectively called the skeleton.

• The skeleton is the internal framework of the body.

• It supports the body, protects organs, and is the point of muscle attachment.

• It also produces blood cells (hematopoiesis) and stores minerals.

• Bones and joints are skeletal organs.

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Skeletal System Illustrated

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Anatomy and Physiology of the Skeletal
System
• Each bone is a body organ with a blood supply, nerves, and lymphatic vessels.

• Bones are connected to each other to form the skeleton.

• The skeleton protects organs and stores minerals.

• Bone marrow in the bones produces blood cells.

• Joints give the skeleton flexibility.

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Bones
• Bones are also called osseous tissue.
– Compact bone tissue = osteons
– Spongy bone tissue (cancellous) = trabeculae

• They are one of hardest materials in the body.

• Bones are formed by the gradual process of ossification. (Intramembranous and

endochondral)

• The fetal skeleton is made of cartilage. Fontanelles = soft spots

• The cartilage is replaced by osteoblasts that mature into osteocytes. Osteoclasts

remodel bone tissue.

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Bones: Bone Structure (1 of 3)
Long Short Irregular
Flat bones
bones bones bones
Longer than Roughly as Plate- Shape very
wide long as shaped irregular
wide
Example: Example: Example:
 femur Example:  sternum  vertebrae

 humerus  carpals  scapula

 tarsals  pelvis

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Figure 4.1
Classification of bones by shape.

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Bones: Bone Structure (2 of 3)
• The majority of bones are long bones.

• Long bones have two parts:

– The diaphysis is the central shaft and contains the medullary cavity.
– The epiphysis is the wide portion at either end of the bone.
 Articular cartilage covers the epiphysis.
 Periosteum covers the rest of the bone.

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Bones: Bone Structure (3 of 3)
• The hard exterior of the bone is called compact or cortical bone.
– It is found in the epiphysis and diaphysis.

• Cancellous or spongy bone is found inside the bone.

– It has spaces containing red bone marrow.
– It is found in some parts of all bones.

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Figure 4.2
Components of a long bone. The entire long bone is on the left side accompanied by
a blow-up of the proximal epiphysis and a section of the diaphysis.

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Bones: Projections and Depressions (1 of 3)
• Bones have many projections and depressions called processes.

• Round, smooth processes allow for joint articulation.

• Rough processes provide muscle attachment points.

• Specific terms describe the shapes and locations of these processes.

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Bones: Projections and Depressions (2 of 3)
Term Definition
Large smooth ball-shaped end of a long
head
bone
condyle Smooth rounded portion at end of bone
epicondyle Projection above or on a condyle
trochanter Large rough process
tubercle Small rough process
tuberosity Large rough process

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Figure 4.3
Bony processes found on the femur.

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Bones: Projections and Depressions (3 of 3)
Term Definition

sinus Hollow cavity within bone

Smooth opening for nerves and blood

Foramen
vessels
Shallow cavity or depression within a
fossa
bone

fissure A slit-like opening

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Skeleton
• Skeleton has two divisions:
– The axial skeleton contains the bones of the head, neck, spine, chest, and trunk.
– The appendicular skeleton contains the pectoral girdle, upper extremities, pelvic
girdle, and lower extremities.

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Figure 4.4
Bones of the axial skeleton.

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Skeleton: Axial Skeleton (1 of 9)
• The head, or skull, is divided into two parts:
– Cranium
– Facial bones

• The skull protects the brain, eyes, ears, nasal cavity, and oral cavity.

• The cranium provides attachment for chewing and head muscles.

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Skeleton: Axial Skeleton (2 of 9)
• The cranium can be subdivided:
– The frontal bone forms the forehead.
– The two parietal bones form the upper sides and roof of the skull.
– The two temporal bones form the sides and base of the skull.

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Skeleton: Axial Skeleton (3 of 9)
• The cranium can be subdivided:
– The ethmoid forms the eye orbit, nose, and part of the floor of the skull.
– The sphenoid forms part of the floor of the skull.
– The occipital bone forms the back of the skull and part of the base of the skull.

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Skeleton: Axial Skeleton (4 of 9)
• The facial bones have several parts:
– The mandible is the moveable lower jaw.
– The maxilla is the fixed upper jaw.
– The two zygomatic bones are the cheeks.
– The vomer is part of the nasal septum.

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Skeleton: Axial Skeleton (5 of 9)
• The facial bones have several parts:
– The palatine is the roof of the mouth and floor of the nasal cavity.
– The two nasal bones form the nasal septum and bridge of the nose.
– The two lacrimal bones are the inner corners of the eye.

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Figure 4.5
Bones of the skull. Note: the palatine and vomer bones are not visible in sagittal
view.

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Skeleton: Axial Skeleton (6 of 9)
• The hyoid is a single U-shaped bone.
– It is found in the neck between the mandible and the larynx.
– It provides a point of attachment point for swallowing and speech muscles.
• The trunk is inferior to the hyoid and consists of the vertebral column, sternum, and rib
cage.

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Skeleton: Axial Skeleton (7 of 9)
• The vertebral column is divided into five sections.
– Cervical vertebrae: In the neck region; numbered C1 through C7.
– Thoracic vertebrae: In the chest region; numbered T1 through T12.
– Lumbar vertebrae: In the small of the back; numbered L1 through L5.

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Skeleton: Axial Skeleton (8 of 9)
• The vertebral column is divided into five sections.
– Sacrum: At the base of the vertebral column.
– Coccyx: Three to five vertebrae attached to the sacrum.

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Figure 4.6
Divisions of the vertebral column.

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Skeleton: Axial Skeleton (9 of 9)
• There are 12 pairs of ribs that attach to the vertebral column in the back.
– The first 10 pairs of ribs attach to the sternum in the front and are known as the
true ribs.
– The inferior 2 pairs of ribs do not attach to the sternum and are called floating ribs.

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Figure 4.7
The structure of the rib cage.

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Figure 4.8
Bones of the appendicular skeleton.

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Skeleton: Appendicular Skeleton (1 of 3)
• The pectoral girdle attaches the upper extremities to the axial skeleton.
– It articulates with the sternum and the vertebral column.
– It consists of the clavicle and the scapula.
• The upper extremity is the arm.
– It consists of the humerus, ulna, radius, carpals, metacarpals, and phalanges.

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Figure 4.9
Anatomical and common names for the pectoral girdle and upper extremity.

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Skeleton: Appendicular Skeleton (2 of 3)
• The pelvic girdle is called the os coxae, the innominate bone, or the hipbone.
– It attaches the lower extremity to the axial skeleton.
– It articulates with the sacrum posteriorly.
– It consists of the ilium, the ischium, and the pubis.

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Skeleton: Appendicular Skeleton (3 of 3)
• The lower extremity is the leg.

• It consists of:
– Femur, or thigh bone
– Patella, or knee cap
– Tibia, or shin bone
– Fibula, or lower leg bone
– Tarsals, or ankle bones
– Metatarsals, or foot bones
– Phalanges, or toe bones

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Figure 4.10
Anatomical and common names for the pelvic girdle and lower extremity.

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Joints (1 of 4)
• Joints are formed where two bones meet; they are also called an articulation.

• The three types of joints are classified either on the material that binds the bones
together(structural) or the movement allowed (functional):
– Synovial joints (structural) = Diarthrotic (functional) Shoulders, hips
– Cartilaginous joints (structural) = Amphiarthrotic (functional) Pubic symphysis,
intervertebral joints
– Fibrous joints (structural) = Synarthrotic (functional) Sutures of the skull, gomphois
(tooth socket)

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Joints (2 of 4)
• Synovial joints are freely moving joints.
– They are the most common type of joint.
– An example is a ball-and-socket joint.
– They contain a capsule lined with lubricant-secreting synovial membrane.

• Bones are held together by ligaments, or strong bands of connective tissue.

• Some synovial joints contain a bursa, a sac-like structure.

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Figure 4.12
Structure of a generalized synovial joint.

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Joints (3 of 4)
• Cartilaginous joints allow for slight movement.

• They hold bones firmly in place with a solid piece of cartilage.

• An example is the pubic symphysis, which allows the pelvis to widen during childbirth.

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Joints (4 of 4)
• Fibrous joints allow almost no movement.

• They are joined by thick fibrous tissue that can fuse into bone.

• An example is the sutures of the skull.

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Figure 4.11
Examples of three types of joints found in the body.

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Additional Combining Forms (1 of 7)
Combining Form Definition
ankyl/o
arthr/o
burs/o
carp/o
cervic/o
chondr/o
clavicul/o
coccyg/o

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Additional Combining Forms (2 of 7)
Combining Form Definition
cortic/o
cost/o
crani/o
cutane/o
erythr/o
femor/o
fibul/o
humer/o

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Additional Combining Forms (3 of 7)
Combining Form Definition
ili/o
ischi/o
kyph/o
lamin/o
lord/o
lumb/o
mandibul/o
maxill/o

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Additional Combining Forms (4 of 7)
Combining Form Definition
medull/o
metacarp/o
metatars/o
myel/o
orth/o
oste/o
patell/o
path/o

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Additional Combining Forms (5 of 7)
Combining Form Definition
ped/o
phalang/o
pod/o
prosthet/o
pub/o
radi/o
sacr/o
sarc/o

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Additional Combining Forms (6 of 7)
Combining Form Definition
scapul/o
scoli/o
spin/o
spondyl/o
stern/o
synov/o
system/o
tars/o

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Additional Combining Forms (7 of 7)
Combining Form Definition
thorac/o
tibi/o
uln/o
vertebr/o

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Additional Suffixes (1 of 5)
Suffix Definition
-ac
-al
-algia
-ar
-ary
-centesis
-clasia
-desis

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Additional Suffixes (2 of 5)
Suffix Definition
-eal
-ectomy
-genic
-gram
-graph
-graphy
-iatry
-ic
-itis inflammation

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Additional Suffixes (3 of 5)
Suffix Definition
-listhesis
-logic
-logy
-malacia
-metry
-oma
-ory
-osis
-otomy

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Additional Suffixes (4 of 5)
Suffix Definition
-ous
-pathy
-plasty
-porosis
-scope
-scopic
-scopy

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Additional Suffixes (5 of 5)
Suffix Definition
-stenosis
-tic
-tome

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Additional Prefixes (1 of 2)
Prefix Definition
anti-
bi-
dis-
ex-
inter-
Intra-
non-

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Additional Prefixes (2 of 2)
Prefix Definition
per-
pre-
sub-

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Adjective Forms of Anatomical Terms (1 of 4)
Term Definition
carpal pertaining to the carpus (wrist)
cervical pertaining to the neck
clavicular pertaining to the clavicle (collar bone)
coccygeal pertaining to the coccyx (tail bone)
cortical pertaining to the outer layer
costal pertaining to the ribs
cranial pertaining to the skull
femoral pertaining to the femur

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Adjective Forms of Anatomical Terms (2 of 4)
Term Definition
fibular pertaining to the fibula
humeral pertaining to the humerus
iliac pertaining to the ilium
intervertebral pertaining to between vertebrae
intracranial pertaining to inside the skull
ischial pertaining to the ischium
lumbar pertaining to the low back
mandibular pertaining to the mandible (lower jaw)
maxillary pertaining to the maxilla (upper jaw)

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Adjective Forms of Anatomical Terms (3 of 4)
Term Definition
metacarpal pertaining to the metacarpus (hand)
metatarsal pertaining to the metatarsus (foot)
patellar pertaining to the patella (knee cap)
phalangeal pertaining to phalanges (fingers/toes)
pubic pertaining to the pubis
radial pertaining to the radius
sacral pertaining to the sacrum

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Adjective Forms of Anatomical Terms (4 of 4)
Term Definition
scapular pertaining to the scapula (shoulder blade)
spinal pertaining to the spine
sternal pertaining to the sternum (breast bone)
tarsal pertaining to the tarsus (ankle)
thoracic pertaining to thorax (chest)
tibial pertaining to the tibia
ulnar pertaining to the ulna
vertebral pertaining to a vertebra

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Medical Specialties (1 of 4)
Term Definition

Healthcare profession concerned with

diagnosis and treatment of malalignment
conditions of the spine and
chiropractic musculoskeletal system with the intention
of affecting the nervous system and
improving health. Healthcare professional
is a chiropractor.

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Medical Specialties (2 of 4)
Term Definition
Branch of medicine specializing in the
diagnosis and treatment of conditions of
the musculoskeletal system; also called
orthopedics orthopedic surgery. Physician is an
orthopedist or orthopedic surgeon.
Name derived from straightening (orth/o)
deformities in children (ped/o).

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Medical Specialties (3 of 4)
Term Definition
Healthcare profession specializing in
making orthopedic appliances such as
orthotics braces and splints. Person skilled in
making and adjusting these appliances is
an orthotist.
Healthcare profession specializing in
diagnosis and treatment of disorders of
podiatry
the feet and lower legs. Healthcare
professional is a podiatrist.

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Medical Specialties (4 of 4)
Term Definition
Healthcare profession specializing in
making artificial body parts. Person
prosthetics
skilled in making and adjusting
prostheses is a prosthetist.
Branch of medicine specializing in
diagnosis and treatment of
musculoskeletal and autoimmune
rheumatology
conditions affecting the joints, muscles,
and bones. Physician is a
rheumatologist.

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Signs and Symptoms (1 of 2)
Term Definition
arthralgia joint pain

bursitis inflammation of a bursa

mass of bone tissue that forms at
callus
fracture site during healing
chondromalacia softening of the cartilage

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Signs and Symptoms (2 of 2)
Term Definition
noise produced by bones or cartilage
crepitation
rubbing together
ostealgia bone pain
synovitis inflammation of synovial membrane

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Building Signs and Symptoms Terms
• Ostealgia
– oste/o + -algia
– Bone pain

• Synovitis
– synov/o + -itis
– Inflammation of a synovial membrane

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Fractures (1 of 3)
Term Definition
fracture with no open skin wound; also
closed fracture
called simple fracture
Colles' fracture common wrist fracture
comminuted fracture where bone is shattered,
fracture splintered, or crushed
compound fracture with an open skin wound; also
fracture called open fracture

compression fracture with loss of height in vertebral

fracture body; often from osteoporosis

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Figure 4.13
A) Closed (or simple) fracture and B) open (or compound) fracture.

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Figure 4.14
Colles' fracture.

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Fractures (2 of 3)
Term Definition
fracture (FX, Fx) broken bone
incomplete break; one side of bone
greenstick
is broken, the other is bent;
fracture
common in children
bone fragments are pushed into
impacted fracture
each other
oblique fracture fracture at an angle to bone

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Figure 4.16
X-ray showing oblique fracture.

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Fractures (3 of 3)
Term Definition
pathologic fracture caused by diseased or
fracture weakened bone
fracture line spirals around shaft of
spiral fracture
bone; often slower to heal
slight fracture caused by repetitive
stress fracture
low-impact forces like running
transverse
fracture straight across bone
fracture

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Figure 4.17
X-ray showing transverse fracture of radius and ulna.

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Bones (1 of 3)
Term Definition
chondroma tumor in cartilage; usually benign
cancerous tumor of shaft of long
bones; spreads through periosteum;
Ewing's sarcoma
amputation is necessary to prevent
metastasis
exostosis bone spur

myeloma tumor forming in bone marrow tissue

osteochondrom tumor consisting of bone and

a cartilage tissue; usually benign

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Bones (2 of 3)
Term Definition
osteogenic most common type of bone cancer;
sarcoma begins in osteocytes
osteoma tumor found in bone tissue
softening of bones caused by calcium
osteomalacia deficiency; caused in children by
insufficient sunlight and vitamin D
inflammation of the bone and bone
osteomyelitis
marrow
osteopathy general term for bone disease

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Bones (3 of 3)
Term Definition
decrease in bone mass; results in
osteoporosis thinning and weakening of bones;
porous bone easily fractures
metabolic disease of bone; unknown
Paget's
cause; results in bone destruction and
disease
deformity
caused by calcium and vitamin D
rickets deficiency; results in bone deformities
like bowed legs

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Spinal Column (1 of 2)
Term Definition
inflammatory condition resembles
ankylosing
rheumatoid arthritis; gradual stiffening
spondylitis
and fusion of vertebrae
herniated nucleus protrusion of an intervertebral disk;
pulposus (HNP) also called ruptured disk
abnormal increase in curve of thoracic
kyphosis
spine; humpback
abnormal increase in forward curvature
lordosis
of lumbar spine; swayback
scoliosis lateral curve of spine

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Figure 4.18
Magnetic resonance imaging (MRI) image demonstrating a back herniated disc.

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Figure 4.19
Abnormal spinal curvatures: kyphosis, lordosis, and scoliosis.

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Spinal Column (2 of 2)
Term Definition
congenital anomaly; vertebra fails to
spina bifida
fully form around spinal cord
narrowing of spinal canal; causes
spinal stenosis
pressure on spinal cord and nerves
spondylolisthes forward sliding of lumbar vertebra
is over vertebra below it
general term for degenerative
spondylosis
vertebral column condition
whiplash cervical muscle and ligament sprain

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Joints (1 of 3)
Term Definition
inflammation of bursa at base of great
bunion
toe
bones in joint are displaced from normal
dislocation
alignment
Type of arthritis presenting as pain and
gout swelling, usually in the first
metatarsophalangeal joint
osteoarthriti results in degeneration of bone and
s (OA) joints; bone rubs against bone

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Joints (2 of 3)
Term Definition
prepatellar swelling of bursa between patella and
bursitis skin; seen in persons who kneel often
autoimmune inflammation of joints with
rheumatoid
swelling, stiffness, pain; results in joint
arthritis (RA)
deformities
damage to ligaments around joint due to
sprain
overstretching; no dislocation or fracture
incomplete dislocation; joint alignment is
subluxation disrupted, but ends of bones remain in
contact

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Figure 4.20
Patient with typical rheumatoid arthritis contractures.

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Joints (3 of 3)
Term Definition
autoimmune disease of connective
systemic lupus
tissue affecting many systems and
erythematosus
may include joint pain; looks like
(SLE)
rheumatoid arthritis
congenital deformity of ankle
talipes
misalignment; clubfoot

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Building Pathology Terms
• Osteoarthritis
– oste/o + arthr/o + -itis
– Inflammation of bones and joints

• Kyphosis
– kyph/o + -osis
– Abnormal condition of having a hump

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Diagnostic Imaging (1 of 2)
Term Definition
arthrogram x-ray record of a joint
visualizing joint by x-ray after injecting
arthrography
contrast medium into joint
nuclear medicine procedure; radioactive
dye is used to visualize bones; useful
bone scan
for identifying stress fractures and
metastases
dual-energy
measures bone density using low dose
absorptiometry
x-ray; detects osteoporosis
(DXA)

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Diagnostic Imaging (2 of 2)
Term Definition
study of spinal column after injecting
myelograp
opaque contrast medium; useful for
hy
identifying herniated nucleus pulposus

radiograph an x-ray

uses x-rays to study internal structure of

radiograph
body; especially useful for visualizing
y
bones and joints

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Endoscopic Procedures
Term Definition
arthroscop
instrument used to view inside a joint
e
examining interior of joint with an
arthroscop arthroscope, a fiberoptic camera; view of
y joint interior appears on monitor during
procedure

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Building Diagnostic Terms
• Myelography
– myel/o + -graphy
– Process of making an x-ray of the spinal cord

• Arthroscopy
– arthr/o + -scope
– Instrument to view inside a joint

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Medical Treatments
Term Definition
arthrocentesi insertion of needle into joint cavity to
s remove fluid
brace or splint used to prevent or
orthotic
correct deformities
artificial device to substitute for a
prosthesis
missing or damaged body part

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Surgical Procedures (1 of 4)
Term Definition
removal of a limb for reasons like
amputation
tumors, gangrene, or crushing injury
arthroclasia forcibly breaking loose a fused joint
arthrodesis stabilizing joint by fusing bones together
arthroscopi performing surgery while using an
c surgery arthroscope to view inside joint
arthrotomy cutting into a joint
harvesting bone from one location to
bone graft
replace a bony defect in another location

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Surgical Procedures (2 of 4)
Term Definition
bunionectom removal of the bursa at base of great
y toe
bursectomy removal of a bursa
chondrectom
removal of cartilage
y
chondroplast
repair of cartilage
y
craniotomy cutting into the skull
removal of posterior arch of vertebra to
laminectomy
remove compression of a spinal nerve
osteoclasia intentional breaking of a bone
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Surgical Procedures (3 of 4)
Term Definition
osteotome instrument used to cut bone
osteotomy cutting into a bone
tube is inserted into intervertebral
percutaneous
disk to suck out ruptured disk; may
diskectomy
also be done with a laser
surgical immobilization of adjacent
spinal fusion
vertebrae
synovectomy removal of a synovial membrane

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Surgical Procedures (4 of 4)
Term Definition
total hip
implanting a prosthetic hip joint
arthroplasty (THA)
total knee
implanting a prosthetic knee joint
arthroplasty (TKA)

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Figure 4.22
Prosthetic hip joint.

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Fracture Care
Term Definition
solid material to immobilize a fracture; may
cast
be made of plaster of Paris or fiberglass
stabilizes fracture while it heals; external
fixation fixation includes casts and splints; internal
fixation includes pins, plates, and screws
realigning bone fragments of fracture; closed
reduction reduction is manipulation without surgery;
open reduction requires surgery
applying a pulling force on fracture or
traction
dislocation to restore alignment

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Building Therapeutic Terms
• Arthrocentesis
– arthr/o + -centesis
– To puncture a joint to remove fluid

• Bursectomy
– burs/o + -ectomy
– The surgical removal of a bursa

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Skeletal System Pharmacology (1 of 2)
Drug Type Use Examples
reduce the
bone
reabsorption of bone;
reabsorption Fosamax, Boniva
treats osteoporosis
inhibitors
and Paget's disease
supplements that
calcium maintain bone
supplements density; treats Oystercal,
and vitamin osteomalacia, Citracal
D therapy osteoporosis, and
rickets

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Skeletal System Pharmacology (2 of 2)
Drug Type Use Examples
have strong anti-
prednisone,
inflammatory
corticosteroids Medrol,
properties; treat
Decadron
rheumatoid arthritis

nonsteroidal
provide mild pain relief
anti- Advil, Motrin,
and anti-inflammatory
inflammatory Aleve, aspirin
benefits; treat arthritis
drugs (NSAIDs)

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Skeletal System Abbreviations (1 of 5)
Term Definition
AE above elbow
AK above knee
BDT bone density testing
BE below elbow
BK below knee
C1, C2, etc. first cervical vertebra, etc.

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Skeletal System Abbreviations (2 of 5)
Term Definition
Ca calcium
DJD degenerative joint disease
DXA, DEXA dual-energy absorptiometry
FX, Fx fracture
HNP herniated nucleus pulposus
JRA juvenile rheumatoid arthritis

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Skeletal System Abbreviations (3 of 5)
Term Definition
L1, L2, etc. first lumbar vertebra, etc.
LE lower extremity
LLE left lower extremity
LUE left upper extremity
NSAID nonsteroidal anti-inflammatory drug
OA osteoarthritis
ORIF open reduction – internal fixation

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Skeletal System Abbreviations (4 of 5)
Term Definition
Orth, ortho orthopedics
P phosphorus
RA rheumatoid arthritis
RLE right lower extremity
ROM range of motion
RUE right upper extremity
SLE systemic lupus erythematosus
T1, T2, etc. first thoracic vertebra, etc.

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Skeletal System Abbreviations (5 of 5)
Term Definition
THA total hip arthroplasty
THR total hip replacement
TKA total knee arthroplasty
TKR total knee replacement
UE upper extremity

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Muscular System at a Glance
• The muscular system works with the skeletal system to move the body.

• Individual cells of the muscular system contract—or shorten in length.

• The shortening produces movement.

• The muscles are the organs of the muscular system.

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Muscular System Illustrated

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Anatomy and Physiology of the Muscular
System
• Muscles are bundles of parallel muscle tissue fibers.

• The fibers contract to produce movement.

• Movement may bring bones together, push food through the digestive system, or pump
blood.

• Muscles may be voluntary or involuntary.

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Figure 4.23
The three types of muscles: skeletal, smooth, and cardiac.

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Types of Muscles: Skeletal Muscle
• Skeletal muscles are attached to bones.

• They produce voluntary skeletal movement.

• Muscle is wrapped in fascia that tapers to form a tendon.

• The tendon is anchored to bone by the periosteum.

• Skeletal muscle is stimulated by motor neurons at the myoneural junction.

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Types of Muscles: Smooth Muscle
• Smooth muscle is found in the internal organs.
– Hollow organs, like the stomach
– Tube-shaped organs, like the airways
– Blood vessels

• It is named for its lack of striations.

• Smooth muscle produces involuntary movement.

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Types of Muscles: Cardiac Muscle
• Cardiac muscle is also called myocardium.

• It makes up the walls of the heart.

• Involuntary contractions of the heart pump blood through the heart’s chambers and out
to the body.

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Figure 4.24
Characteristics of the three types of muscles.

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 Criteria for Naming Skeletal Muscles
• Size = maximus, minimus, major, minor

• Shape = deltoid, trapezius

• Direction of fibers = oblique, rectus

• Number of heads of origin = biceps, triceps

• Origin to Insertion = brachioradialis

• Action = flextor, extensor

• Location = abdominis, gluteal

• Position = superficialis, profundus, medial, lateral

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Naming Skeletal Muscles (1 of 2)
Location Origin and insertion Size
rectus
sternocleidomastoid gluteus maximus
abdominis

straight named for its origins

abdominal at the sternum and
large buttock
muscle clavicle and its
muscle
insertion at the
mastoid process

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Naming Skeletal Muscles (2 of 2)
Number of
Action Fiber direction
attachment points
flexor carpi external oblique bicep
muscle that abdominal
bends the muscle with
wrist muscle with two heads
fibers running at
an angle

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Skeletal Muscle Actions (1 of 4)
• Skeletal muscles attach to two different bones and overlap a joint.

• When muscles contract, both bones move, but not equally.

– The origin is the less moveable bone.
– The insertion is the more moveable bone.

• The movement produced is the action.

• Muscles are arranged in antagonistic pairs.

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Figure 4.25
Origin and insertion of a muscle

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Skeletal Muscle Actions (2 of 4)
Term Definition
abduction movement away from midline of body

adduction movement toward midline of body

Term Definition
flexion act of bending or being bent
extension brings limb into a straight condition

Term Definition
dorsiflexion backward bending of foot

plantar flexion bending sole of foot; pointing toes

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Figure 4.26
Abduction and adduction of the shoulder joint.

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Figure 4.27
Flexion and extension of the elbow joint.

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Figure 4.28
Dorsiflexion (A) and plantar flexion (B) of the ankle joint.

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Skeletal Muscle Actions (3 of 4)
Term Definition
eversion turning outward

inversion turning inward

Term Definition
pronation turning palm downward
supination turning palm upward

Term Definition
elevation to raise

depression to drop down

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Figure 4.29
Eversion and inversion of the foot.

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Figure 4.30
Pronation and supination of the forearm.

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Skeletal Muscle Actions (4 of 4)
• Circular actions are an exception to the antagonist pair pattern.
– Circumduction is movement in a circular direction from a central point.
– Opposition is moving the thumb away from the palm to contact the other fingers.
– Rotation is movement around a central axis.

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Additional Combining Forms (1 of 3)
Combining Form Definition
bi/o life
carp/o wrist
cry/o cold
electr/o electricity
fasci/o fibrous band
fibr/o fibers
habilitat/o ability
hydr/o water

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Additional Combining Forms (2 of 3)
Combining Form Definition
kinesi/o movement
later/o side
muscul/o muscle
my/o muscle
myos/o muscle
necr/o death
phon/o sound
physic/o body

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Additional Combining Forms (3 of 3)
Combining Form Definition
ten/o tendon
tend/o tendon
tendin/o tendon
therm/o heat

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Additional Suffixes (1 of 3)
Suffix Definition
-al pertaining to
-algia pain
-ar pertaining to
-asthenia weakness
-desis to fuse
-dynia pain
-gram record
-graphy process of recording

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Additional Suffixes (2 of 3)
Suffix Definition
-itis inflammation
-kinesia movement
-logy study of
-opsy view of
-otomy cutting into
-ous pertaining to
-pathy disease
-phoresis carrying

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Additional Suffixes (3 of 3)
Suffix Definition
-plasty surgical repair
-rrhaphy suture
-rrhexis rupture
-therapy treatment
-tonia tone
-trophic pertaining to development
-trophy development

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Additional Prefixes (1 of 2)
Prefix Definition
a- without
brady- slow
dys- abnormal, difficult
epi- above
hyper- excessive
hypo- insufficient
poly- many
pseudo- false

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Additional Prefixes (2 of 2)
Prefix Definition
re- again
ultra- beyond

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Adjective Forms of Anatomical Terms
Term Definition
fascial pertaining to fascia
muscular pertaining to muscles
musculoskeletal pertaining to muscles and skeleton
tendinous pertaining to tendons

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Medical Specialty
Term Definition
The science that studies movement,
kinesiology how it is produced, and the muscles
involved.
Assists a person to regain, develop, and
occupational
improve skills important for independent
therapy
functioning.
physical Branch of medicine focused on restoring
medicine function; physician is a physiatrist.
Involves the evaluation and treatment
physical
of disorders as well as rehabilitation
therapy (PT)
using physical methods.

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Signs and Symptoms (1 of 3)
Term Definition
scar tissue in fascia; makes muscle
adhesion
movement difficult
atonia lack of muscle tone
poor muscle development; result of
atrophy muscle disease or lack of use; muscle
wasting
bradykinesi
having slow movements
a
abnormal shortening of muscle fibers,
contracture
tendons, or fascia
dyskinesia having difficult or abnormal movements
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Signs and Symptoms (2 of 3)
Term Definition
dystonia having abnormal muscle tone
having an excessive amount of
hyperkinesia
movement
hypertonia having excessive muscle tone
hypertrophy increase in muscle bulk from use
hypokinesia having insufficient amount of movement
hypotonia having insufficient muscle tone

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Signs and Symptoms (3 of 3)
Term Definition
attacks of severe pain and lameness
intermittent
caused by muscle ischemia; usually in
claudication
calf muscles
myalgia muscle pain
myasthenia muscle weakness
myotonia muscle tone
sudden, involuntary, strong muscle
spasm
contraction
tenodynia tendon pain

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Building Signs and Symptoms Terms
• Hyperkinesia
– hyper- + -kinesis
– Excessive movement

• Tenodynia
– ten/o + -dynia
– Tendon pain

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Muscles (1 of 2)
Term Definition
widespread aching and pain in
fibromyalgia
muscles and soft tissue
inflammation of elbow muscles;
lateral
caused by strong gripping; tennis
epicondylitis
elbow
muscular inherited disease with progressive
dystrophy (MD) muscle atrophy
myopathy general term for muscle disease

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Muscles (2 of 2)
Term Definition
myorrhexis tearing a muscle
necrotizing fasciitis infection that results in death of the
(NF) soft tissue
polymyositis inflammation of two or more muscles
one type of inherited muscular
pseudohypertrophic
dystrophy; also called Duchenne's
muscular dystrophy
muscular dystrophy
severe neck spasms pulling head to
torticollis one side; wryneck or crick in the
neck

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Pathology of Tendons, Muscles, and/or
Ligaments (1 of 2)
Term Definition
repetitive motion disorder; compression
carpal tunnel
of finger tendons and median nerve as
syndrome
they pass through carpal tunnel of the
(CTS)
wrist
cyst on tendon sheath; usually on hand,
ganglion cyst
wrist, or ankle
chronic disorders involving tendon,
repetitive
muscles, joints, and nerve damage;
motion
tissue is subjected to pressure, vibration,
disorder
or repetitive movements

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Pathology of Tendons, Muscles, and/or
Ligaments (2 of 2)
Term Definition
joint capsule of shoulder joint is
rotator cuff reinforced by tendons; high degree of
injury flexibility puts rotator cuff at risk for
strain and tearing

damage to muscle, tendons, or ligaments

strain
due to overuse or overstretching

tendinitis inflammation of a tendon

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Building Pathology Terms
• Myorrhexis
– my/o + -rrhexis
– Rupture of muscle

• Polymyositis
– poly- + myos/o + -itis
– Inflammation of many muscles

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Clinical Laboratory Test
Term Definition
muscle enzyme found in skeletal and
creatine
cardiac muscle; elevated blood levels
phosphokinase
indicate muscle damage; seen in
(CPK)
muscular dystrophy and heart attack

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Additional Diagnostic Procedures
Term Definition
muscle contraction in response to
deep tendon
stretch; used to determine if
reflexes (DTR)
muscles are responding properly
electromyogram hardcopy record produced by EMG
study of strength and quality of
electromyograp
muscle contraction in response to
hy (EMG)
electrical stimulation
removal of muscle tissue for
muscle biopsy
examination

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Rehabilitation Procedures (1 of 2)
Term Definition
activities typically performed in a
activities of daily
normal day, like dressing and
living (ADLs)
washing
cryotherapy cold treatment
assisting a patient to learn to walk
gait training again or teaching them to use
assistive devices to walk
hydrotherapy application of warm water
Kneading or applying pressure by
massage
hand to promote muscle relaxation

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Rehabilitation Procedures (2 of 2)
Term Definition
exercise, massage, and physical
mobilization
manipulation to restore movement
passive range of putting a joint through the range of
motion (PROM) motion without assistance
use of ultrasound waves to introduce
phonophoresis
medication across skin
exercise planned and carried out to
therapeutic exercise
achieve physical benefit
thermotherapy application of heat
ultrasound therapy use of ultrasound waves to create heat
(US) in soft tissues under the skin

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Surgical Procedures (1 of 2)
Term Definition
cutting of ligament in wrist to relieve
carpal tunnel
pressure caused by carpal tunnel
release
syndrome
fasciotomy surgically cutting into fascia

myoplasty surgical repair of a muscle

myorrhaphy procedure to suture together a muscle

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Surgical Procedures (2 of 2)
Term Definition
tendoplasty surgical repair of a tendon
tendotomy procedure to cut into a tendon
surgical stabilization of a joint by
tenodesis anchoring down tendons of muscles that
move the joint

tenoplasty surgical repair of a tendon

tenorrhaphy procedure to suture together a tendon

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Building Surgical Terms
• Myoplasty
– my/o + -plasty
– To surgically repair a muscle

• Tenodesis
– ten/o + -desis
– To fuse a tendon

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Muscular System Pharmacology
Drug Type Use Examples
skeletal muscle relax skeletal muscle
Flexeril, Soma
relaxants to reduce spasms

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Muscular System Abbreviations (1 of 2)
Term Definition
ADLs activities of daily living
CK creatine kinase
CPK creatine phosphokinase
CTS carpal tunnel syndrome
DTR deep tendon reflexes
EMG electromyogram
IM intramuscular
MD muscular dystrophy

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Muscular System Abbreviations (2 of 2)
Term Definition
NF necrotizing fasciitis
OT occupational therapy
PROM passive range of motion
PT physical therapy
US ultrasound

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 Game Time!

Join your fellow students as we play Student Review

Game #2 for Chapter 4!

Audience, remember to turn in your game #2 Chapter

4 critique at the beginning of the next class session to
earn one graded point.

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Copyright

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