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Medical Terminology: Get Connected! Second Edition Suzanne S. Frucht Chapter 6 Orthopedics Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Learning Objectives 6.1 DESCRIBE the medical specialty of orthopedics. 6.2 UNDERSTAND the function of the musculoskeletal system. 6.3 DEFINE orthopedic-related combining forms, prefixes, and suffixes. 6.4 IDENTIFY the organs treated in orthopedics. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Learning Objectives 6.5 BUILD orthopedic medical terms from word parts. 6.6 EXPLAIN orthopedic medical terms. 6.7 USE orthopedic abbreviations. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Introduction to Orthopedics • Musculoskeletal system consists of: – Bones – Muscles – Joints • Bones joined together by ligaments – Forms skeleton – Framework of body Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Introduction to Orthopedics • Joints – Point where two bones meet – Provides flexibility for movement • Muscles – Attached to bones by tendons – Contract to move bones at each joint Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics • Also called orthopedic surgery • Branch of medicine concerned with bones, muscles, and joints • Orthopedists or orthopedic surgeons – Use medical, surgical, and physical means – Correct defects and improve function of bones, joints, and muscles Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics • Examples of conditions include: – – – – – – Birth defects such as spina bifida Trauma such as fractures Infections such as osteomyelitis Tumors such as osteogenic sarcoma Inflammatory conditions such as arthritis Muscular problems such as muscular dystrophy Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Combining Forms • • • • • • • • • arthr/o burs/o chondr/o muscul/o my/o myel/o oste/o ten/o tendin/o joint bursa cartilage muscle muscle bone marrow bone tendon tendon Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Bone Combining Forms • • • • • carp/o clavicul/o coccyg/o cost/o crani/o carpus (wrist) clavicle (collar bone) coccyx (tailbone) rib skull Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Bone Combining Forms • • • • • • • femor/o fibul/o humer/o ili/o ischi/o kyph/o lord/o femur (thigh bone) fibula (thinner lower leg bone) humerus (upper arm bone) ilium (part of pelvis) ischium (part of pelvis) hump bent backwards Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Bone Combining Forms • • • • • mandibul/o maxill/o metacarp/o metatars/o patell/o mandible (lower jaw) maxilla (upper jaw) metacarpus (hand bones) metatarsus (foot bones) patella (kneecap) Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Bone Combining Forms • • • • • • phalang/o pub/o radi/o sacr/o scapul/o scoli/o phalanges (fingers and toes) pubis (part of pelvis) radius (part of forearm) sacrum (part of pelvis) scapula (shoulder blade) crooked, bent Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Bone Combining Forms • • • • • • spondyl/o stern/o tars/o tibi/o uln/o vertebr/o vertebra sternum (breast bone) tarsals (ankle) tibia (shin, larger lower leg bone) ulna (part of forearm) vertebra (back bone) Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Additional Combining Forms • • • • • cutane/o electr/o fibr/o orth/o path/o skin electricity fibrous straight disease Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Suffix Review • • • • • • • -ac -al -algia -ar -ary -asthenia -centesis • -clasia • -cyte pertaining to pertaining to pain pertaining to pertaining to weakness puncture to withdraw fluid surgical breaking cell • -desis • -dynia • -eal • -ectomy • -genic • -gram • -graphy • -ic Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. surgical fusion pain pertaining to surgical removal producing record process of recording pertaining to Suffix Review • -itis • -kinesia • -malacia • -metry • -oma • -osis • -otomy • -ous • -pathy inflammation movement abnormal softening process of measuring tumor abnormal condition cutting into pertaining to disease • • • • • -plasty -porosis -rrhaphy -rrhexis -scope • -scopy • -tome • -trophy Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. surgical repair porous suture rupture instrument for viewing process of visually examining instrument to cut development Prefix Review • a- without • brady- slow • dys- difficult, painful, abnormal • inter• intra- between within • • • • hyperpersubsupra- Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. excessive through under above Figure 6.1 Examples of three types of joints found in the body Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.2 The skeleton. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.3 Types of muscles in the body. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Building Orthopedic Terms For each orthopedic term introduced on the next few slides, write the completed term in your textbook (pg 77). Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. -ac • Suffix meaning pertaining to • Build a term meaning: – pertaining to under the ilium subiliac Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. -al • Suffix meaning pertaining to • Build a term meaning: – pertaining to the wrist carpal – pertaining to between the ribs intercostal – pertaining to between the vertebra intervertebral Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. -ar • Suffix meaning pertaining to • Build a term meaning: – pertaining to the fibula Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. fibular Arthr/o • Combining form meaning joint • Also called an articulation • Formed when two bones meet • Most joints are freely moving synovial joints Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.4 Typical synovial joints. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Arthr/o • Build a term meaning: – process of visually examining a joint arthroscopy – surgical fixation of a joint arthrodesis – record of a joint arthrogram arthr/o + -gram Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. -ary • Suffix meaning pertaining to • Build a term meaning: – pertaining to above the maxilla supramaxillary Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Burs/o • Combining form meaning bursa • Fluid-filled sac – Found between tendon and bone – Serves to reduce friction Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Burs/o • Build a term meaning: – bursa inflammation – surgical removal of a bursa bursitis bursectomy burs/o + -ectomy Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Chondr/o • Combining form meaning cartilage • Tough, flexible connective tissue • Covers ends of bones in joint • Serves as shock absorber Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Chondr/o • Build a term meaning: – cartilage softening – cartilage tumor chondromalacia chondroma Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Crani/o • Combining form meaning skull • Build a term meaning: – pertaining to the skull – pertaining to within the skull – surgical repair of the skull Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. cranial intracranial cranioplasty Figure 6.5 Skull. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. -eal • Suffix meaning pertaining to • Build a term meaning: – pertaining to the phalanges Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. phalangeal -ic • Suffix meaning pertaining to • Build a term meaning: – pertaining to above the pubis Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. suprapubic -kinesia • Suffix meaning movement • Build a term meaning: – slow movement – difficult movement – excessive movement bradykinesia dyskinesia hyperkinesia hyper- + -kinesia Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Muscul/o • Combining form meaning muscle • Contracts to produce movement • Three types – Skeletal muscle moves skeleton – Smooth muscle produces movement in internal organs like stomach and bladder – Cardiac muscle produces heartbeat Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.5 Muscles. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Muscul/o • Build a term meaning: – pertaining to within muscle intramuscular intra- + muscul/o + -ar Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Myel/o • Combining form meaning red bone marrow • Found inside bones • Produces blood cells Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Myel/o • Build a term meaning: – red bone marrow tumor – producing red bone marrow Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. myeloma myelogenic My/o • Another combining form meaning muscle • Build a term meaning: – muscle pain – muscle weakness – record of muscle's electricity Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. myalgia myasthenia electromyogram Oste/o • Combining form meaning bone • Hard, calcified connective tissue • Functions – – – – Supports and moves body Protects internal organs like heart and lungs Houses red bone marrow Serves as mineral storehouse Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.6 Bone. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Oste/o • Build a term meaning: – bone cell osteocyte – producing bone – bone and cartilage tumor Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. osteogenic osteochondroma Spondyl/o • Combining form meaning vertebra • Build a term meaning: – abnormal condition of a vertebra spondylosis Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Ten/o • Combining form meaning tendon • Strong bands of connective tissue • Anchors muscles to bone Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Ten/o • Build a term meaning: – suture of a tendon tenorrhaphy Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Tendin/o • Another combining form meaning tendon • Build a term meaning: – abnormal condition of a tendon Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. tendinosis Orthopedics Vocabulary Term Explanation bone graft Surgical procedure that uses a piece of bone to replace lost bone or to fuse two bones together bone scan Nuclear medicine scan using radioactive dye to visualize bones; especially useful for finding stress fractures and bone cancer carpal tunnel syndrome (CTS) Repetitive motion disorder caused by pressure on tendons and nerves as they pass through carpal tunnel of wrist closed fracture Broken bone with no open skin wound; also called simple fracture Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.8 Nerves and blood vessels enclosed by carpal tunnel formed by wrist bones and tendons. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.9 A) Closed (or simple) fracture and B) Open (or compound) fracture. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation comminuted fracture Bone break where bone shatters into many small fragments compound fracture Broken bone with open skin wound; also called open fracture (see Figure 6.9) compression fracture Bone break causing loss of height of vertebral body; may result from trauma, but in older persons, especially women, may occur in a bone weakened by osteoporosis contracture Abnormal shortening of muscle fibers, tendons, or connective tissue making it difficult to stretch muscle Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation creatine kinase (CK) Muscle enzyme found in skeletal and cardiac muscle; elevated blood levels associated with heart attack, muscular dystrophy, and other skeletal muscle pathologies deep tendon reflexes (DTR) Involuntary muscle contraction in response to striking muscle tendon with reflex hammer; test used to determine whether muscles respond properly Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.10 Testing patellar reflex with a reflex hammer. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation dislocation Occurs when bones in joint are displaced from normal alignment and ends of bones are no longer in contact with each other dual-energy absorptiometry (DXA) Test using low-dose x-ray beams to measure bone density; used to diagnose osteoporosis fibromyalgia Chronic condition with widespread aching and pain in muscles and fibrous soft tissue Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.11 The large bump on the top of the shoulder is caused by the upward dislocation of the humerus. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation fixation Procedure to stabilize fractured bone while it heals; external fixation includes casts, splints, and pins inserted through skin; internal fixation includes pins, plates, rods, screws, and wires that are put into place during a surgical procedure called open reduction fracture (FX, Fx) Broken bone greenstick fracture Fracture with incomplete break; one side of the bone breaks and other side only bends; commonly seen in children because their bones are still pliable Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation herniated nucleus pulposus (HNP) Protrusion of intervertebral disk between two vertebrae, which puts pressure on spinal nerves; also called herniated disk or ruptured disk; may require surgery impacted fracture Fracture in which one bone fragment is pushed into another kyphosis Abnormal increase in normal outward curvature of thoracic spine; also called hunchback or humpback Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.12 Protruding intervertebral disc putting pressure on a spinal nerve. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.13 Abnormal spinal curvatures: kyphosis, lordosis, and scoliosis. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation lordosis Abnormal increase in normal forward curvature of lumbar spine; also called swayback (see Figure 6.13) magnetic resonance imaging (MRI) Diagnostic imaging technique that uses electromagnetic energy to produce an image; especially useful for viewing soft tissues, such as spinal cord and intervertebral disks muscle atrophy Loss of muscle bulk due to muscle disease, nervous system disease, or lack of use; also called muscle wasting muscular dystrophy (MD) One of a group of inherited diseases involving progressive muscle degeneration, weakness, and atrophy nonsteroidal antiinflammatory drugs (NSAIDs) Large group of drugs that provide mild pain relief and antiinflammatory benefits for conditions such as arthritis Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.14 MRI showing a sagittal view of the vertebral column and intervertebral disks Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation oblique fracture Bone break where fracture line runs along an angle to shaft of the bone orthosis Externally applied brace or splint to prevent or correct deformities; orthotist is person skilled in making and adjusting orthoses osteoarthritis (OA) Arthritis caused by loss of cartilage cushion covering bones in joint; most common in bearing weight joints; results in bone rubbing against bone osteoporosis Condition that develops due to a decrease in bone mass; results in a thinning and weakening of the bone; may lead to pathologic fractures; most commonly seen in older women Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.15 A stroke patient with an orthotic brace on her right arm. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation osteogenic sarcoma Most common type of bone cancer; usually begins in osteocytes found at ends of bones; most frequently occurs in persons 10–25 years old pathologic fracture Broken bone caused by diseased or weakened bone, not trauma percutaneous diskectomy Thin catheter tube is inserted into intervertebral disk through skin to suck out pieces of herniated or ruptured disk; or laser is used to vaporize disk Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation prosthesis Any artificial device used as substitute for body part that is either missing from birth or lost as the result of an accident or disease; example: artificial leg; prosthetist is person trained in making prostheses radiography Diagnostic imaging procedure using X-rays to see internal structure of body; especially useful for visualizing bones and joints reduction Correcting fracture or dislocation by realigning bone; closed reduction moves bones externally; open reduction manipulates bones through a surgical incision; open reduction usually performed before internal fixation of bone fragments Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.16 X-ray of lower leg showing fractures in the tibia and fibula. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation repetitive Group of chronic disorders with tendon, motion disorder muscle, joint, and nerve damage caused by prolonged periods of pressure, vibration, or repetitive movements rheumatoid arthritis (RA) Arthritis with swelling, stiffness, pain, and degeneration of cartilage in joints caused by chronic soft tissue inflammation; may result in crippling deformities; an autoimmune disease scoliosis Abnormal lateral curvature of spine (see Figure 6.13) Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.17 Typical hand and wrist deformities of rheumatoid arthritis. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation spasm Sudden, involuntary, strong muscle contraction spina bifida Birth defect when vertebra fails to fully form around spinal cord; ranges from mild to severe; if spinal cord is damaged, paralysis results spiral fracture Bone break in which fracture line spirals around shaft of the bone; caused by twisting injury; often slower to heal than other types of fractures sprain Ligament injury from overstretching, but without joint dislocation or bone fracture Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation strain Damage to the muscle or tendons from overuse or overstretching stress fracture A slight bone break caused by repetitive lowimpact forces, like running, rather than single forceful impact total hip arthroplasty (THA) Surgical reconstruction of hip with artificial hip joint; also called total hip replacement (THR). Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Figure 6.18 A fractured femur (A); repaired with a total hip arthroplasty (B). Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Vocabulary Term Explanation total knee arthroplasty (TKA) Surgical reconstruction of knee joint with artificial knee joint; also called total knee replacement (TKR) transverse fracture Bone break with fracture line straight across shaft of bone Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Abbreviations AE above elbow CTS carpal tunnel syndrome AK above knee DTR deep tendon reflex BDT bone density test EMG electromyogram BE below elbow IM intramuscular BK below knee MD muscular dystrophy BMD bone mineral density C1, C2, etc first cervical vertebra, second cervical vertebra, etc. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Abbreviations Ca calcium JRA DJD degenerative joint disease L1, L2, etc DXA dual-energy absorptiometry fracture LE juvenile rheumatoid arthritis first lumbar vertebra, second lumbar vertebra, etc. lower extremity LLE left lower extremity herniated LUE nucleus pulposus left upper extremity FX, Fx HNP Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Abbreviations NSAID nonsteroidal antiinflammatory drug RA rheumatoid arthritis OA osteoarthritis RLE right lower extremity ORIF open reduction- RUE internal fixation right upper extremity Orth, ortho orthopedics T1, T2, first thoracic vertebra, etc second thoracic vertebra, etc. Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Orthopedics Abbreviations THA total hip arthroplasty THR total hip replacement total knee arthroplasty total knee replacement upper extremity TKA TKR UE Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved. Combining Forms Match Up 1. carp/o a. rib 2. chondr/o b. muscle 3. cost/o c. wrist 4. crani/o d. cartilage 5. my/o e. skull Copyright © 2017, 2014, 2012 Pearson Education, Inc. All Rights Reserved.