Chapter 6:Musculoskeletal System
Chapter Objectives
Upon completion of this chapter the participant will be able to:
- List the functions of bones.
- Define terms related to bone structure.
- Distinguish between the axial and appendicular skeleton.
- Describe the three types of joints.
- List the 4 types of muscle found in the human body.
- Differentiate between the types of muscles.
- Describe the functions of muscles.
- Analyze, define, spell and pronounce the common terms of the skeletal system.
- Analyze, define, spell and pronounce terms related to the body’s muscular system.
- Successfully complete the review exercises at the end of the chapter.
Anatomy and Physiology of Bone & Muscles of the Musculoskeletal System
Bone
Many people think that bones are simply solid masses of non-living tissue. In reality each of the 206 bones of the body is a complex, living organ. The shape, height and weight of our body is determined by the length and thickness of our bones. Besides giving us structure the bone has a number of other functions:
As a lever. The bones of the upper and lower limbs pull and push, with the help of muscles.
Provide protection and support for inner organs (e.g. skull protects the brain).
Blood cells essential for life are produced in the bone marrow
Play an important role in regulating the amount of essential nutrients. As a calcium store. 97% of the body's calcium is stored in bone.
Bone Structure
Bone, a form of connective tissue, is one of the hardest tissues in the human body. The only part of the body that is harder is the enamel of the teeth. Throughout our life bone goes through a process of building up and tearing down. Bone is also capable of healing and repairing itself. Oste/o, oss/e, osse/o andoss/i are the roots for bone. When bone cells are mature they are referred to as osteocytes. Because of osteoclasts(cells that break down and reabsorb bone) the life span of an osteocyte is limited. The cells that create the new bone cells to replace those that are destroyed are referred to as osteoblasts (immature bone). This process of making new bone is referred to as ossification or osteogenesis. This continuous turnover of bone ensures that the bones of the body remain strong.
Tissues of Bone
Bone is made up of four different tissues:
Periosteum:Tough fibrous tissue that covers the outside of the bone.
Compact Bone:Hard dense strong bone that forms the outer most layer of the bones.
Spongy Bone:Lighter, less dense tissue that is found in the inner portion of the long bones. Red bone marrow is located in the spongy layer.
Medullary Cavity:Located in the shaft of long bones and contains the yellow bone marrow.
Internal and External Bone Parts
Anatomic Landmarks of Bone
Epiphysis:The end points of the bone
Diaphysis:Shaft of the bone
Fractures
The most common problem that arises with bone is a break or fracture. There are a number of different types of fractures the most common of which are simple (closed)and compound (open).A simple fracture is one where the bone is broken but there is not an open wound through the skin. The compound fracture is one in which the bone is broken and there is an open wound through the skin.
Axial and Appendicular Skeleton
The skeleton is made up of 206 different bones. To make discussion of the skeleton simpler it is divided into the axial and the appendicular skeletons. The axial skeletonrelates to the bones of the head and trunk (skull, spinal column, ribs and sternum). The axial skeleton is made up of 80 bones. The appendicular skeletonconsists of the other 126 bones or those of the upper extremities and shoulder plus the lower extremities and pelvis.
Joints
Joints are the connections that exist between bones. The root for joint is arthr/o, articul/o.
Suture:Jagged line where bones join and form a joint that does not move. E.g. skull. Two bones are joined by cartilage and they function together as one bone. This is called a cartilaginous joint.
Synovial:Joints that are movable; e.g. knee, elbow, hips
Other structures which impact on the functioning of the skeletal system are:
Ligament:Band of tissue that connects one bone to another. (Ligament/o)
Bursa:Fibrous sac that acts as a cushion for easy movement. (Burs/o)
Muscles
You have more than 600 muscles in your body. If you were to grip your upper arm with your left hand and move the right hand up and down and rotate it you will feel a series of contractions in the tissue. This is the muscles’ of the arm responding to the command you have given for it to move. While you did this you probably didn’t notice that your heart continued to beat. This beating also involved a muscle contracting but you didn’t have to tell it to beat as you did with your arm. This indicates that they are different types of muscles. In fact you have three types of muscles in your body.
Types of Muscle Tissue
Smooth Muscle:Smooth muscle fibers move the internal organs, such as the blood vessels, ducts from the glands. These muscles have a relatively slow rate of contracting. They are also involuntary in that they are under the control of your brain and you cannot control them.
Cardiac Muscle:Similar to smooth muscle and makes up the wall of the heart. It is involuntary in function.
Skeletal Muscle:Muscles that attach to bones of the skeleton and make movement possible. We can control the function of these so they are voluntary.
Characteristics of Muscle
The study of the activity of muscle is referred to as kinesiology (kih-nee-see-ol-oh-jee). The root for movement is kinesi/o and the suffix is -kinesis. The muscles of the body are arranged in pairs and one muscle of the pair causes movement in one direction and the other produces movement in the opposite direction. When one muscle contracts the other relaxes. When a muscle contracts it tightens up and becomes shorter and thicker. When the muscle relaxes it returns to its original form or shape. It is because of this relaxing and contracting that we are able to move about.
The term range of motion refers to the movements that are possible by a muscle. One aspect of diagnosing problems of the muscule is to test the range of motion of the system. A variety of muscle movements can be assessed including:
Abduction: Movement away from the midline of the body (ab-).
Adduction:Movement toward the midline of the body (ad-).
Flexion:Decreasing the angle between two bones, or bending a joint flex-). Eg. bending the arm at the elbow
Extension:Increasing the angle between two bones, or to straighten out a limb (ex-). Eg. straightening the arm out at the elbow
Rotation:To move in a circular motion.
Pronation:Rotating a body part so it is facing down.
Supination:Rotating a body part so it is facing up.
Many muscles have what seem to be very complex names. The naming of a muscle is generally based on one of the following:
how they act (flexor carpi radialis muscle)
where they are located (rectus abdominus)
the direction their fibers run (external abdominal oblique)
the number of times they divide (quadriceps femoris)
their size (gluteus maximus)
their shape (deltoid muscle)
Pathology of Muscular Diseases and Common Diagnostic Procedures
Health problems that affect the way muscles work in our body include:
Degeneration of the muscle e.g. Multiple Sclerosis, Parkinson’s Disease
Paralysis of muscle e.g. paraplegic
Problems with muscle tone, e.g. weakness, loss of tone, increased tone
Problems with muscle activity, e.g. impaired movements like tics, spasms; slow movements, rapid movements.
The most common procedures done to diagnose problems with the muscles involve graphic records of how a specific muscle is reacting to some form of stimulus.
Word Parts for the Musculoskeletal System
Roots
ankyl/ofusion of parts
articul/o; arthr/ojoint
burs/obursa
carp/owrist bone
cervic/oneck
chondr/ocartilage
clavicul/oclavicle; collarbone
coccyg/ococcyx; tailbone
cost/orib
crani/oskull
duct/odraw away
electr/oelectric, electricity
fasci/ofascia
femor/ofemur, thigh bone
fibr/o, fibros/ofibers
fibul/ofibula
flex/oflexion, bend
humer/ohumerus; upper arm
ili/ohip
ischi/oischium (posterior part of hip)
kinesi/omovement
lumb/olower back
mandibul/omandible, lower jaw
maxill/omaxilla, upper jaw
medull/omarrow, inner portion of an organ
metacarp/ometacarpals (bones of the hand)
metatars/ometatarsals (bones of the foot)
muscul/o, my/o, myos/omuscle
myel/obone marrow, spinal cord
occipit/oocciput (back part of the head)
osse/o; oste/o; oss/e; oss/ibone
pariet/oparietal bone of the head
patell/a; patell/opatella; kneecap
pelv/i; pelv/opelvis
phalang/ophalanges; bone of the finger or toes
radi/oradius; bone of the lower arm
radicul/onerve root
sacr/osacrum
scapul/oscapula
spondyl/o; vertebr/overtebra
stern/osternum; breastbone
synov/i/osynovium; synovial fluid that lubricates
tempor/otemporal bone of the head
tendin/o, ten/o, tend/otendon
tens/ostretch out
thorac/ochest
tibi/otibia; bone of the lower leg
ton/otone
uln/oulnar; bone of the lower arm
Suffixes
-astheniano strength, weakness
-centesissurgical puncture to remove fluid
-clasissurgical fracture or refracture
-clastbreakdown
-clonusturmoil
-desissurgical fusion or binding
-kinesismovement
-lysisset free
-malaciasoftening
-osisabnormal condition
-paresispartial paralysis
-plegiaparalysis
-porosisporous open spaces
-thermyheat
-trophynourishment
Prefixes
ab-away from
ad-toward
bi-two
brady-slow
ex-extension, away from
hemi-half
ortho-straight
quadr-four
tri-three
Term Analysis and Definition
Word Part / Term / Term Analysis / Definitionarticul/o arthr/o / articular
arthralgia
arthritis
arthropathy
arthroplasty
arthroscopy / articul = joint
-ar = pertaining to
arthr = joint
-algia = pain
-itis = inflammation
- pathy = disease
-plasty = surgical repair
-scopy = examination using a scope / Pertaining to a joint
Painful joint
Inflammation of a joint
Disease of a joint
Surgical repair of a joint
Examination of a joint using a scope.
carp/o / carpal / carp/o = wrist
-al = pertaining to / Pertaining to the wrist
cervic/o / cervical / cervic = neck
-al = pertaining to / Pertaining to the neck
chondr/o / chondrocyte
chondroma
chondrosarcoma / chondr = cartilage
-cyte = cell
-oma = tumor
-sarcoma = malignant tumor / Cartilage cells
Tumor of the cartilage
Malignant tumor of cartilage
clavicul/o / clavicular / clavicul = collarbone, clavicle
-ar = pertaining to / Pertaining to the collarbone
cost/o / costal
costovertebral / cost = rib
-al = pertaining to
-vertebr = vertebrae / Pertaining to the ribs
Pertaining to the ribs and vertebrae
crani/o / craniotomy
craniofacial / crani = skull
-tomy = surgical incision
-faci = face
-al = pertaining to / Surgical incision into the skull
Pertaining to the skull and face
fasci/o / fascial
fascitis / fasci = fascia (band of tissue around muscle)
-al = pertaining to
-itis =inflammation / Pertaining to fascia
Inflammation of fascia
femor/o / femoral / femor = femur, thigh bone
-al = pertaining to / Pertaining to the thigh bone
fibul/o / fibular / fibul = fibula
-ar = pertaining to / Pertaining to the fibula
fibr/o
fibros/o / fibrous / fibr/o = fiber
-ous = pertaining to / Pertaining to fibrous tissue.
humer/o / humeral / humer = humerous, upper arm
-al = pertaining to / Pertaining to the upper arm
ili/o / iliac
iliosacral / ili = hip
-ac = pertaining to
sacr = sacrum
-al = pertaining to / Pertaining to the hip
Pertaining to the hip and sacrum
ischi/o / ischial
ischiorectal / ischi = ischium
-al = pertaining to
rect = rectum / Pertaining to the ischium
Pertaining to the ischium and the rectum
kinesi/o / kinesiology / kinesi = movement-logy = study of / Study of movement
lumb/o / lumbosacral / lumbo = lower back
-sacr = sacrum
-al = pertaining to / Pertaining to the lower back and sacrum
mandibul/o / mandibular / mandibul = mandible, lower jaw
-ar = pertaining to / Pertaining to the lower jaw
maxill/o / maxillary / maxill = maxilla, upper jaw
-ary = pertaining to / Pertaining to the upper jaw
metacarp/o / metacarpal / metacarp = bones of the hand
-al = pertaining to / Pertaining to the bones of the hand
metatars/o / metatarsal / metatars = bones of the foot
-al = pertaining to / Pertaining to the bones of the foot
my/o
muscul/o
myos/o / muscular
myalgia
myopathy / muscul = muscle
-ar = pertaining to
my = muscle
-algia = pain
-pathy = disease / Pertaining to muscle
Pain in a muscle
Muscle disease
myel/o / myeloma
osteomyelitis / myel = bone marrow, spinal cord
-oma = tumor
oste/o = bone
-itis = inflammation / Tumor of the bone marrow or spinal cord
Inflammation of the bone and bone marrow.
oste/o
oss/e
oss/i / osteoblast
osteochondritis
osteocyte
osteoma
osteosarcoma / oste/o = bone
-blast = immature
-itis = inflammation
chondr/o = cartilage
-cyte = cell
-oma = tumor
-sarcoma = malignant tumor / Immature bone cell
Inflammation of bone & cartilage
Mature bone cell
Tumor of the bone
Malignant tumor of bone
patell/a, patell/o / patellar
infrapatellar
suprapatellar / patell = kneecap
-ar = pertaining to
infra = below
supra = above / Pertaining to the kneecap
Pertaining to below the kneecap
Pertaining to above the kneecap
pelv/i, pelv/o / pelvic
pelvimeter / pelv = pelvis
-ic = pertaining to
-meter = instrument used to measure / Pertaining to the pelvis
Instrument used to measure the size of the pelvis
phalang/o / interphalangeal / inter- = between
phalang = one of the bones of the fingers or toes
-eal = pertaining to / Pertaining to a bone of the fingers or toes
sacr/o / sacral / sacr = sacrum
-al = pertaining to / Pertaining to the sacrum
scapul/o / subscapular / sub- = below
scapul = scapula
-ar = pertaining to / Pertaining to below the scapula
spondyl/o / spondylitis
spondylopathy / spondyl = vertebra
-itis = inflammation
-pathy = disease / Inflammation of the vertebra
Disease of the vertebra
stern/o / sternal
costosternal / stern = breastbone, stenum
-al = pertaining to
cost = rib / Pertaining to the breastbone
Pertaining to ribs and breastbone
synov/i
synov/o / synovial / synov = synovial membrane/fluid
-al = pertaining to / Pertaining to the synovial membrane or the fluid that lubricates the joint
tendin/o, ten/o
tend/o / tendinitis
tenodesis / tendin = tendon
-itis =inflammation
-desis = surgical fusion / Inflammation of a tendon
Surgical fusion of a tendon
thorac/o / thoracic / thorac = chest
-ic = pertaining to / Pertaining to the chest
tibi/o / tibiofibular / tibi = tibia
fibul = fibula
ar = pertaining to / Pertaining to the tibia and fibula
ton/o / atonic
hypertonic / a = without, no
ton = tone
-ic = pertaining to
hyper = excessive / Pertaining to no tone
Pertaining to excessive tone
uln/o / ulnar / uln = ulnar, bone of the lower arm
-ar = pertaining to / Pertaining to the bone of the lower arm
vertebr/o / vertebrofemoral / vertebr = vertebra
femor = femur
-al = pertaining to / Pertaining to the vertebrae and femur
-centesis / arthrocentesis / arthro = joint
-centesis = surgical puncture / Surgical puncture into a joint to remove fluid
-clasis / osteoclasis / oste = bone
-clasis = surgical fracture / Surgical fracture of a bone
-clast / osteoclast / oste = bone
-clast = breakdown / Cell which breaks down bone
-desis / arthrodesis / arthr = joint
-desis = surgical fusion / Surgical fusion of a joint
-malacia / osteomalacia
chondromalacia / oste = bone
-malacia = softening
chondr = cartilage / Softening of the bone
Softening of cartilage
-osis / kyphosis
osteoporosis / kyph = humpback
-osis = abnormal condition
oste = bone
-porosis = porous / Abnormal curvature of the spine.
Abnormal condition where bone becomes too porous
ortho- / orthopedics / ortho = straight
ped = child
-ic = pertaining to / Surgical speciality dealing with correction of deformities of the skeletal system
VOCABULARY WORDS:
Arthroscope An instrument used to examine the interior joint.
Bone marrow transplantThe surgical procedure of transferring bone marrow from a donor to a patient.
BursaA small space between muscles, tendons, and bones that is lined with synovial membrane and contains a fluid, Synovia
Calcium A mineral that is essential for bone growth, teeth development, blood coagulation
Carpal tunnel syndromeA condition caused by compression of the median nerve by the carpal ligament; symptoms : soreness, tenderness, weakness, pain , tingling and numbness of wrist
DislocationThe displacement of a bone from a joint
Genu valgumknock-knee
Genu varumbowleg
HalluxThe big or great toe
MeniscusCrescent shaped interarticular fibrocartilage
Found in certain joints, especially the knee
Joint
Sequestrumdead bone
SprainTwisting of a joint that causes pain
Abbreviations:
AP - anteroposterior
Fx - fracture
JRA -juvenile rheumatoid arthritis
OA - osteoarthritis
Ortho - orthopedics, orthopaedics
RA -rheumatoid arthritis
Tx - traction