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This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Chapter 3 CASE STUDY Khalil Larkins, an 18-year-old senior at Wolfridge High School, was running the 100-meter dash for his qualifying time. As he left his starting block, he heard a “pop” and instantly felt a sharp pain in the upper back part of his left leg. He struggled as he limped off the track. His teammates helped him to the treatment area, where his trainer could assess him. After a quick evaluation, the trainer placed ice on Khalil’s left hamstring, the muscle in the posterior upper leg. Khalil was instructed to stay off his left leg and was given a pair of crutches to use until he could be examined by a physician. The next morning, Khalil’s pain had not subsided, and now there was swelling, bruising, and tenderness at the injury site. Khalil continued to use his crutches to move around, and when it was convenient, he iced the back part of his upper left leg. The following day, Khalil saw Dr. Schumacher for his initial assessment. Dr. Schumacher was an orthopedist (OR-thohPEE-dist), or a medical specialist who treats conditions and injuries of the musculoskeletal (MUS-kyoo-loh-SKEL-uh-tuhl) system, which is made up of the muscular and skeletal structures and tissues of the body. Dr. Schumacher determined that Khalil had a strained, or pulled, hamstring in his left leg. Chapter Objectives Upon completion of this chapter, you should be able to 1. identify and define medical terms associated with the major structures and functions of the muscular system; 2. recognize, define, spell, and pronounce terms related to the pathology, diagnosis, and treatment of muscular system diseases and conditions; and 3. identify medical careers associated with the diagnosis and treatment of muscular system diseases and conditions. What kinds of treatments do you think Dr. Schumacher recommended for Khalil’s hamstring strain? What facts in the case study led you to this answer? As you read through this chapter, you will learn medical terms that will help you understand the basic structures and functions of the muscular system, as well as common diseases and conditions, diagnostic tests and procedures, and surgical and therapeutic treatments. You will refer back to this case study when you interpret Khalil’s medical record in the Chapter Review. Medical Word Parts conditions, diagnostic and surgical procedures, and therapeutic treatment methods. YOUR TURN While studying, look for the activity icon • • • • to • Practice identifying medical word parts and abbreviations with e-flash cards. Review anatomical concepts with interactive art labeling. Assess your understanding of medical vocabulary with e-flash cards and vocabulary games. Listen to pronunciations of medical terms and spell them in audio activities. Expand your knowledge and skills with animated videos. Copyright Goodheart-Willcox Co., Inc. E-flash Cards The muscular system is made up of many unique structures and parts, all of which have specific names in the healthcare and medical fields. Mastery of the combining forms, prefixes, and suffixes listed in the tables that follow will help you understand medical terms pertaining to the muscular system. Combining Forms The combining forms that follow are common in medical terms used to describe muscular system 59 60 Introduction to Medical Terminology Combining Form (Root Word plus Combining Vowel) articul/o card/o, cardi/o duct/o electr/o fasci/o Meaning joint heart to lead; to carry electricity fibrous band; fascia (Continued) Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Combining Form fibr/o flex/o kines/o, kinesi/o lei/o muscul/o my/o, myos/o myocardi/o neur/o orth/o ped/o plant/o radi/o rhabd/o sarc/o son/o tax/o ten/o, tendin/o, tendon/o tens/o ton/o vers/o Meaning fiber to bend movement smooth muscle muscle heart muscle nerve straight; normal child; foot sole of the foot X-rays rod-shaped flesh; connective tissue sound coordination; order tendon stretched; strained tone; tension turn; turning Prefixes The prefixes that follow are not specific to muscular system terminology. These universal prefixes are used in many other medical terms, as you will see in your study of medical terminology and other body systems. Prefix a-, anabadbibradycircumdorsidyse-, exhemihyperhypo- Meaning not; without away; away from toward two; both slow around back painful; difficult out; away from half above; above normal; excessive below; below normal; deficient (Continued) Copyright Goodheart-Willcox Co., Inc. . Prefix inpar-, para- Meaning in; into; not near; beside; alongside; beyond; abnormal four fast three quadritachytri- Suffix -tomy -tonia -trophy Ponder This Suffixes The suffixes that follow are common in medical terms used to describe health conditions, diagnostic tests and procedures, and therapeutic treatments related to the muscular system. You will encounter many of the same suffixes in your study of other body systems. Suffix -ac, -al, -ar, -ic -algia -asthenia -cele -ceps -dynia -ectomy -esthesia -gram -graphy -ia -ion -itis -logy -lysis -malacia -oma -paresis -penia -plasty -plegia -plegic -rrhexis -scope -scopy Meaning process of cutting; incision tone; tension condition of growth or development Meaning pertaining to pain weakness hernia; swelling; protrusion heads (attachments) pain surgical removal; excision sensation record; image process of recording condition process; state; condition inflammation study of breakdown; separation; loosening softening tumor; mass weakness deficiency surgical repair paralysis pertaining to paralysis rupture instrument used to view visual examination using a scope Trapezius, deltoid, gluteus maximus, sartorius... it’s all Greek and Latin. Why do you think so many structures in the body get their names from long, sometimes difficult-to-pronounce words that originated in ancient cultures? Why would modernera science and medicine benefit from the continued use of terms that come from Greek and Latin? Anatomy and Physiology What is your favorite sport or activity? Do you enjoy volleyball, football, swimming, cycling, or dancing? Without muscles, none of these activities—or other forms of movement—would be possible. The muscular system is composed of different kinds of tissue that work together to perform several essential functions. These essential functions include • holding body parts in position and making movement possible; • providing a protective covering for the internal organs; • producing, through movement, nearly 85 percent of the heat that keeps the body warm; • moving food through the digestive system; • aiding blood flow through the veins as blood returns to the heart; and • assisting with the movement of fluids through the ducts and vessels of other body systems. Figure 3.1 illustrates some of the major muscles in the body. As you view the figure, consider what muscles of the body perform what functions. Fascinating Fact On average, muscles make up 40 to 45 percent of your body weight. Your body has more than 630 muscles that help you perform different kinds of movement. Muscle Tissue Types Muscle is a type of body tissue made up of bundles of fibers (long, slender cells) that are held together by connective tissue. When nerves stimulate muscle fibers, the fibers contract (become shorter and thicker), causing body movement. Muscles that are stimulated to move through conscious control are called voluntary muscles. The phrase “conscious control” does not mean that your brain has to think about, or plan, every muscular action before it is performed. Rather, voluntary muscular activity is action that you can control through the force of your will (for example, swallowing). Much voluntary muscular activity happens when you are giving little, if any, thought to the actions that are performed by your body. By contrast, muscles that are not stimulated to move through conscious control are called involuntary muscles. You cannot force yourself to move these muscles through willpower (for example, the heart beating). Voluntary and involuntary muscles in the body come in three types: skeletal muscle, smooth muscle, and cardiac muscle. Skeletal muscle, also called striated (strigh-AYted) muscle, is voluntary muscle that is attached to bone and can be contracted or relaxed through conscious control. Striated muscle has a distinctively striped appearance and is composed of muscle fibers. Skeletal muscle fibers are long, slender cells grouped and held together with connective tissue and covered with fascia (FASH-ee-uh), a band or sheet of fibrous tissue that encloses a muscle or group of muscles. Skeletal muscle is found in the scalp, face, mouth, pharynx (throat), larynx (voice box), neck, chest, vertebral column, arms and hands, abdomen, back, and legs and feet. Smooth muscle, also called visceral (VIS-uh-ruhl) muscle, is a type of involuntary muscle, meaning it is not controlled by conscious thought processes. Smooth muscle surrounds internal organs and is found throughout your respiratory tract, stomach, intestines, and urinary tract. Smooth muscle contracts and relaxes to move contents through body system passageways. This involuntary movement, known as peristalsis (PEER-ih-STAHL-sis), enables blood to travel through arteries and veins, food to move through the stomach and intestines, and a fetus to be expelled through the birth canal. (Continued) Chapter 3 The Muscular System 61 62 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. • elasticity (EE-las-TIS-ih-tee)—the ability of skeletal muscle fibers to resume their resting length when a stretching force is removed; for example, when a spring is stretched and then released, it returns to its original position. • excitability (also called irritability)—the ability of a skeletal muscle to receive and respond to a nerve impulse by contracting. For example, nerves send a message to the heart muscle, and the heart pumps blood through the vessels throughout the body. • extensibility (eks-TENS-ih-BIL-ih-tee)—the ability of the skeletal muscles to be stretched. Extensibility is evident in the hamstrings and calf muscles during a toe touch, for example. Frontalis Trapezius Deltoid Pectoralis major Triceps brachii Biceps brachii Latissimus dorsi Origin point Coracoid process Origin point Supraglenoid tuberosity Biceps muscle Insertion point Tubercle of radius Abdominal muscles The ratio of muscle to total body weight is often expressed as a percentage. Percentages can also be expressed as fractions. (For example, ¼ is 25 percent.) To calculate a percentage, first set up a fraction. Then divide the numerator (top number) by the denominator (bottom number). Directions: To practice calculating percentages, do the word problems that follow. Round your answers to the nearest whole number. 1. Blake weighs 140 pounds, 60 pounds of which are muscle. What percentage of Blake’s body weight is muscle? 2. What is the percentage of muscle weight for an 80-pound female with 35 pounds of muscle? Gluteus medius Gluteus maximus Sartorius Biceps femoris Rectus femoris Gastrocnemius Achilles tendon A. Anterior view B. Posterior view Label art Figure 3.1 Anterior and posterior views of the major muscles in the body. Cardiac muscle, also called myocardial (MIGHoh-KAR-dee-uhl) muscle, is found only in the heart. Like smooth muscle, cardiac muscle is unconsciously controlled. As cardiac muscle involuntarily contracts, it pumps blood from the heart into blood vessels. Fascinating Fact You probably have heard the saying, “It takes more muscles to frown than it does to smile.” Did you know that you have more than 30 facial muscles that produce a range of subtly different expressions including happiness, sadness, surprise, anger, fear, disgust, and astonishment? Copyright Goodheart-Willcox Co., Inc. . Muscle Tissue Properties Muscle tissue has many unique properties. It is the only tissue in the body that has the following physiological characteristics: • automaticity (AW-toh-muh-TIH-sih-tee)—the ability of a muscle to contract without the involvement of a nerve supply. Automaticity is a property of visceral, smooth, and cardiac muscles. • contractility (KAHN-trak-TIL-ih-tee)—the ability of a skeletal muscle to contract (shorten); for example, the biceps muscle contracts when the arm is flexed. Chapter 3 The Muscular System 63 Muscle Origin and Insertion Skeletal muscle plays a vital role in directional movements of the skeleton. The connecting parts of each muscle are specific to that muscle and the bone to which the muscle is connected. Skeletal muscle is attached to bone at both ends of the muscle. Typically, during contraction, one end of a muscle remains fixed in its position, and the other end of the muscle moves. The origin of a muscle is the attachment site that does not move when the muscle contracts; the insertion is the attachment site that moves during muscular contraction. Figure 3.2 illustrates examples of origin and insertion points in the shoulder and forearm. Most skeletal muscle is attached to bone by tendons. A tendon is a band of fibrous tissue that 64 Introduction to Medical Terminology Biceps muscle Figure 3.2 The insertion is the attachment site that moves during muscular contraction. The origin is the muscular attachment site that does not move. connects muscle to bone (Figure 3.3). The Achilles tendon, for example, attaches the gastrocnemius (GAS-trok-NEE-mee-us) muscle on the calf of the leg to the calcaneus (kal-KAY-nee-us), or heel bone. Tendons are different from ligaments. As you learned in Chapter 2: The Skeletal System, a ligament is a fibrous cord of tissue that attaches bone to bone. Ligaments usually impart stability by holding structures together (Figure 3.3). Skeletal Muscle Organization The basic structure of muscles includes several connective tissue layers (Figure 3.4). The inner layer, or endomysium (EN-doh-MIZ-eeum), is a fine sheath of areolar connective tissue around each muscle fiber. Areolar tissue consists of loosely woven fibers and many blood vessels. The perimysium (PEER-ih-MIZ-ee-um) is a sheath of connective tissue that surrounds bundles of muscle fibers called fascicles (FAS-ih-kuhlz). The outer layer, or epimysium (EP-ih-MIZ-ee-um), is a dense, fibrous connective tissue that surrounds the entire muscle. All of these structures are surrounded by fascia (FASH-ee-uh), fibrous connective tissue that binds muscles into functional Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. groups and envelops other structures in the body, such as bones, nerves, and blood vessels. The muscular system has its own blood and nerve supply. Muscles have arteries, veins, and capillaries due to their remarkable energy needs and the metabolic waste they generate as a product of contraction. Ligament Bone Joint capsule Fascinating Fact The eye muscles are the most active muscles in the body. Scientists estimate that these muscles may move more than 100,000 times a day. Skeletal muscle Directional Motion Tendon Three factors make the muscular system capable of moving the body: muscle type, muscle excitability (stimulation of a muscle by a nerve impulse), and opposition between agonist (AGuh-nist) and antagonist (an-TAG-uh-nist) muscle pairs (Figure 3.5). Agonist and antagonist muscle pairs work in opposition to create body movement. In these pairs, the agonist is the muscle that causes the primary movement. The antagonist is the muscle that works against this movement. For example, when you flex your arm, your biceps muscle functions as the agonist. When you straighten your arm, the biceps muscle becomes the antagonist while the triceps muscle functions as the agonist to achieve primary muscular movement. For this reason, agonist muscles are referred to as “prime movers.” Figure 3.3 Tendons connect muscle to bone, and ligaments connect bone to bone. Muscle fiber Fascicle (wrapped by perimysium) Many types of muscular movement have a directional opposite; therefore, the directional motions produced by agonist and antagonist muscles are typically categorized in pairs, as described in the table that follows, with a couple of exceptions. These movements are described from the perspective of anatomical position. Directional Movements Movement of a body part away from the midline of the body. abduction ab-DUK-shun ab- = away from duct/o = to lead -ion = process; state; condition adduction Tension in biceps (agonist) Blood vessel Triceps relaxed (antagonist) Endomysium (covers fibers) Perimysium (covers fascicle) Bone Nerve impulses are vital to the directional motion of the body. When nerve impulses are impaired, a condition called paralysis (puhRAL-uh-sis) can occur. Paralysis prevents muscular movement. The term neuromuscular (NEW-roh-MUS-kyoo-ler) is used to describe or define the relationship between nerves and muscles in the body. Directions: On a separate sheet of paper, dissect the word neuromuscular into its individual word parts. Identify each word part (combining form, prefix, or suffix). Then define each word part and the term as a whole. Epimysium (wraps entire muscle) Movement of a body part toward the midline of the body. uh-DUK-shun ad- = toward duct/o = to lead -ion = process; state; condition inversion in-VER-zhun in- = in; into vers/o = turn; turning -ion = process; state; condition eversion Tendon Fascia Animation Label art Figure 3.5 Agonist and antagonist muscular pairs work in opposition. ee-VER-zhun e- = out; away from vers/o = turn; turning -ion = process; state; condition The turning inward of the sole of the foot. The turning outward of the sole of the foot. (Continued) Figure 3.4 The organization of skeletal muscle. Copyright Goodheart-Willcox Co., Inc. . Chapter 3 The Muscular System 65 66 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. elevation Directional Movements Raising of a body part. depression Lowering of a body part. flexion The movement of two body surfaces toward each other, as in the act of bending. FLEK-shun flex/o = to bend -ion = process; state; condition extension eks-TEN-shun ex- = out; away from tens/o = stretched; strained -ion = process; state; condition hyperextension HIGH-per-eks-TEN-shun hyper- = above normal tens/o = stretched; strained -ion = process; state; condition dorsiflexion DOR-sih-FLEK-shun dorsi- = back flex/o = to bend -ion = process; state; condition plantar flexion PLAN-ter FLEK-shun plant/o = sole of the foot -ar = pertaining to flex/o = to bend -ion = process; state; condition rotation Directional Movements Movement of a body part around its longitudinal axis— that is, lengthwise. (Imagine doing “the Twist” with your foot.) medial (internal) rotation The straightening of a limb after it has been flexed. lateral (external) rotation The act of bending a joint or limb beyond normal extension or range of motion. pronation proh-NAY-shun Movement of the sole of the foot upward (flexed toward the lower leg). supination SUP-ih-NAY-shun circumduction Motion of the plantar surface (sole of the foot) away from the midline of the body. SER-kum-DUK-shun circum- = around duct/o = to lead -ion = process; state; condition Movement medially, or toward the midline of the body. (Imagine rotating one foot inward, toward the other foot.) Major Muscles and Their Functions table, along with brief descriptions of their main functions. The human body is made up of many muscles, all with specific functions and names. People in the fields of healthcare and medicine need to be familiar with the major muscles of the body. The major muscles of the body are listed in the following Muscle frontalis Fascinating Fact The term hamstring derives its name from eighteenth-century English butchers, who used string to hang slaughtered pigs (ham) by the muscles in the back of the knees. Location Primary Functions forehead Raises eyebrows; wrinkles forehead. upper back and neck Extends neck; elevates, adducts, and rotates scapula. external shoulder Abducts, flexes, extends, and rotates arm. chest Flexes, adducts, and rotates arm. posterior upper arm Extends forearm. anterior upper arm Flexes arm and forearm; supinates (rotates) hand. midback and lower spine Extends, adducts, and rotates arm. abdominal muscles ribs to pubic bone Flex and rotate trunk. gluteus medius Adducts and rotates thigh. GLOO-tee-us MEE-dee-us medial muscle of buttocks; outer surface of pelvis gluteus maximus outer muscle of buttocks Extends and rotates thigh. anterior thigh (crosses thigh obliquely) Flexes and rotates thigh; flexes leg. sar-TOR-ee-us biceps femoris (hamstring) posterior thigh Extends thigh; flexes and rotates leg. anterior thigh Flexes thigh; extends leg. prominent muscle in posterior calf Flexes foot and leg. GAS-trok-NEE-mee-us tibialis anterior anterior lower leg Dorsiflexes and inverts foot. frun-TAY-lis Movement laterally, or away from the midline. (Imagine rotating one foot outward, away from the other.) trapezius truh-PEE-zee-us deltoid DEL-toyd pectoralis major Rotational motion of the forearm in which the palm moves to face downward. Rotational motion of the forearm in which the palm moves to face upward. Rotation of an arm or leg (as if “drawing a circle” with the limb). This type of motion occurs in multiple planes. pek-tuh-RAY-lis MAY-jer triceps brachii TRIGH-seps BRAY-kee-igh biceps brachii BIGH-seps BRAY-kee-igh latissimus dorsi luh-TIS-ih-mus DOR-sigh GLOO-tee-us MAK-sih-mus sartorius (Continued) BIGH-seps FEM-uh-ris rectus femoris (quadricep) REK-tus FEM-uh-ris gastrocnemius TIH-bee-AL-is an-TEER-ee-er Copyright Goodheart-Willcox Co., Inc. . Chapter 3 The Muscular System 67 68 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Diseases and Conditions How is the flexibility in your upper and lower extremities? In the passive range-of-motion (ROM) exercises that follow, you and a classmate will take turns being the patient and the physical therapist. Record your answers to the following questions as you work through each exercise. 1. In which passive ROM exercises did you demonstrate more joint flexibility? 2. Which exercises do you think might help you to strengthen certain joints and muscles? Directions: a. “Snow Angel Arms”—In a sitting position, keep your left arm straight at your side; then move the arm straight out while your classmate supports your left elbow and wrist. Repeat these steps with your right arm as your partner supports your right elbow and wrist. b. “Brush Your Hair”—As your classmate supports your elbow and wrist, bend your left or right arm at the elbow and bring your arm over your head. c. “Let’s Go Bowling”—Begin with your arm straight at your side; then move the arm slightly behind your back while your partner supports your elbow and wrist. d. “Open the Door”—As your classmate supports your elbow, place one hand in the palm of his or her other hand and rotate your forearm upward. Then rotate it downward, as if turning a doorknob. e. “Come Here”—Begin with your elbow supported on a desk, a table, or the arm of a chair. As your classmate provides support above and below your wrist, flex your palm toward the ventral (interior) side of your forearm. Then extend the back of your hand toward the top of your forearm. f. “Wave Goodbye”—Begin with your elbow supported on a flat surface. As your classmate provides support above and below your wrist, turn your hand toward your thumb; then turn your hand toward your pinky finger. g. Finger Curls—With your elbow supported on a flat surface, place the palms of your hands in the palms of your classmate’s hands. Next, curl your fingers around your classmate’s fingers; then straighten your fingers. Perhaps you or someone you know has experienced carpal tunnel syndrome, uses a wheelchair due to paralysis, or has been diagnosed with a chronic disease such as muscular dystrophy. In this section, you will learn about common characteristics of diseases and conditions that affect the muscular system. h. Thumb and Finger Touches—As your partner supports your elbow on a flat surface, touch the tip of each of your fingers with the tip of your thumb. i. Finger Spreads—As your partner supports your elbow on a flat surface, spread each of your fingers away from the midline of your hand. Disease/Condition Definition adhesion Normally, the formation of a fibrous band of tissue that holds two parts or surfaces together, as in the healing of a wound. In a disease condition, the formation of a fibrous band of tissue that holds two surfaces together due to inflammation or trauma (Figure 3.6). ad-HEE-zhun j. “Snow Angel Legs”—Lie in a supine (flat on your back) position. As your classmate provides support beneath your left knee and ankle, move your left leg straight out to your side; then move it back to its “starting” position. Repeat the exercise with your right leg. ataxia uh-TAKS-see-uh a- = without tax/o = coordination -ia = condition l. “Bicycle”—Lie in a supine position. With one leg straight and your classmate providing support beneath the knee and ankle of your other leg, bend the supported leg at your knee. Then straighten your leg and lower it to its original position. atrophy AT-troh-fee a- = without -trophy = condition of growth or development l. “The Twist”—Lie in a supine position on a mat. With one leg straight and your partner providing support beneath the knee and ankle of your other leg, rotate your entire supported leg inward; then rotate it outward. Inability to coordinate voluntary muscle activity; characterized by shaky, unsteady movements. Wasting away or shrinkage of muscle size. m. Ankle Circles—With your leg on a mat, and your classmate providing support above and below your ankle, rotate your foot in a circle to the right; then rotate it in a circle to the left. NOTE: For the exercises that follow, you and your classmate should wear gloves. n. Toe Curls—Lie with your legs straight on a mat. With your classmate providing support at your ankle, she or he curls your toes inward and then straightens them. o. Toe Spreads—As you lie with your leg on a mat, your partner moves each of your toes away from your middle toe and then back toward your middle toe. Figure 3.6 Abdominal adhesion. Endoscopic view of a patient’s abdomen with adhesions between the omentum (bottom left) and the abdominal wall (top). The omentum is a membranous sac that hangs down from the stomach, covering the intestines. Adhesions are growths of fibrous (scar) connective tissue formed as a response to tissue trauma. They often result from abdominal surgery. If the adhesions cause severe pain or obstruct part of the bowel, they are removed surgically. Copyright Goodheart-Willcox Co., Inc. . Chapter 3 The Muscular System 69 70 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Normal heart Disease/Condition Definition carpal tunnel syndrome (CTS) Disorder marked by pain, burning, and itching or tingling due to an inflamed median nerve and tendons in the wrist; commonly associated with repetitive activity and/or overuse injury. contracture Permanent tightening of skin, muscles, tendons, ligaments, and fascia (a band or sheet of fibrous tissue that encloses muscle tissue); most commonly due to lack of use or immobilization. kun-TRAK-cher Duchenne muscular dystrophy (DMD) doo-SHEN MUS-kyoo-ler DIS-truh-fee dystaxia dis-TAK-see-uh dys- = painful; difficult tax/o = coordination -ia = condition fasciitis FAS-ee-IGH-tis or FASH-eeIGH-TIS fasci/o = fibrous band; fascia -itis = inflammation flaccidity fluh-SIH-dih-tee hemiparesis HEM-ee-puh-REE-sis hemi- = half -paresis = weakness hemiplegia Progressive disease that weakens the muscles of the shoulder and pelvic girdle. DMD is a sex-linked recessive trait that affects mostly males. Enlargement of the heart muscle Partial ataxia; a mild form of ataxia (lack of muscular coordination that produces shaky, unsteady movements). Right ventricle high-PER-truh-fee hyper- = above normal; excessive -trophy = condition of growth or development Copyright Goodheart-Willcox Co., Inc. . Disease/Condition Definition hypotonia Loss of muscle tone. HIGH-poh-TOH-nee-uh hypo- = below normal; deficient -tonia = tone; tension Condition or state in which muscles are flabby, relaxed, or have defective or absent tone. Tone is the normal tension present in muscles in a resting state. impingement syndrome im-PINJ-ment Weakness or slight paralysis on one side of the body. Acromion Condition that occurs when tendons of the shoulder become impinged, or compressed, by the bones of the shoulder (Figure 3.8). Swollen bursa Inflamed tendon muscular dystrophy (MD) Genetic disease characterized by progressive muscular weakness and skeletal muscle deterioration (Figure 3.9). MUS-kyoo-ler DIS-truh-fee dys- = painful; difficult -trophy = condition of growth or development Total paralysis on one side of the body. myalgia or myodynia Excessive growth or abnormal enlargement of a muscle (Figure 3.7 on the next page). Muscle pain. migh-AL-jee-uh or MIGH-ohDIN-ee-uh my/o = muscle -algia / -dynia = pain myasthenia gravis MIGH-uhs-THEE-nee-uh GRAV-is my/o = muscle -asthenia = weakness Chapter 3 The Muscular System Left ventricle Figure 3.7 At left, a normal heart; at right, a heart affected by muscular hypertrophy. Inflammation of a fascia (a band or sheet of fibrous tissue that encloses a muscle or group of muscles). HEM-ee-PLEE-jee-uh hemi- = half -plegia = paralysis hypertrophy Hypertrophic cardiomyopathy 71 72 Chronic autoimmune disease characterized by voluntary muscle weakness that worsens after activity and improves after rest. Introduction to Medical Terminology Figure 3.8 When the bones of the shoulder compress the shoulder tendon, the result is impingement syndrome. Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Disease/Condition Definition myoma (continued) leiomyosarcoma Malignant tumor of smooth muscle. LIGH-oh-MIGH-oh-sarKOH-muh lei/o = smooth my/o = muscle sarc/o = flesh -oma = tumor; mass rhabdomyoma RAB-doh-migh-OH-muh rhabd/o = rod-shaped my/o = muscle -oma = tumor; mass rhabdomyosarcoma (RMS) Benign tumor consisting of striated muscle that occurs on or in the smooth muscle of the heart (Figure 3.10). Malignant tumor of skeletal muscle. RAB-doh-MIGH-oh-sarKOH-muh rhabd/o = rod-shaped my/o = muscle sarc/o = flesh -oma = tumor; mass myomalacia Figure 3.9 Muscular dystrophy is a genetic disease marked by deterioration of skeletal muscle and progressive muscular weakness. Disease/Condition Definition myocele Herniation or protrusion of muscle through a tear in the fascia. MIGH-oh-seel my/o = muscle -cele = hernia; swelling; protrusion myolysis migh-AH-lih-sis my/o = muscle -lysis = breakdown myoma myoparesis leiomyoma Copyright Goodheart-Willcox Co., Inc. . Weakness or mild muscular paralysis. Rhabdomyoma Figure 3.10 A rhabdomyoma is a benign tumor consisting of striated muscle in or on the heart. MIGH-oh-puh-REE-sis my/o = muscle -paresis = weakness myorrhexis Degeneration or deterioration of muscle tissue. MIGH-oh-REK-sis my/o = muscle -rrhexis = rupture Tumor of the muscle. MIGH-oh-SIGH-tis myos/o = muscle -itis = inflammation myositis migh-OH-muh my/o = muscle -oma = tumor; mass LIGH-oh-migh-OH-muh lei/o = smooth my/o = muscle -oma = tumor; mass Abnormal softening of muscle tissue. MIGH-oh-muh-LAY-shee-uh my/o = muscle -malacia = softening paraplegia PAIR-uh-PLEE-jee-uh para- = beside; alongside -plegia = paralysis Benign tumor of smooth muscle, such as that found in the heart, bladder, or uterus. paresthesia PAIR-es-THEE-zee-uh par- = abnormal -esthesia = sensation Chapter 3 The Muscular System 73 74 Rupture or tearing of a muscle. Inflammation of a muscle. Paralysis of both legs and, often, the lower trunk. Abnormal sensation that typically is not painful, such as tingling, numbness, itching, prickling, or burning. An example of a common form of temporary paresthesia is when your foot “falls asleep,” causing a “pins and needles” sensation after you have sat on it too long. Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Disease/Condition Definition Disease/Condition Definition plantar fasciitis Inflammation of the plantar fascia (the thick band of tissue in the sole of the foot between the heel bone and the toes), resulting in heel pain. tremor An involuntary, repetitive shaking or quivering of a part or parts of the body. Causes include illness (such as Parkinson’s disease), fever, or hypothermia (dangerously low body temperature). PLAN-ter FAS-ee-IGH-tis or FASH-ee-IGH-TIS plant/o = sole of the foot -ar = pertaining to fasci/o = fibrous band; fascia -itis = inflammation quadriplegia Paralysis of all four extremities. Inquiring Minds QUAH-drih-PLEE-jee-uh quadri- = four -plegia = paralysis rigor or rigidity RIG-er or rih-JIH-dih-tee sarcopenia SAR-koh-PEE-nee-uh sarc/o = flesh -penia = deficiency Muscular stiffness/stiff muscle, as in rigor mortis (Latin rigor = “stiffness”; mortis = “of death”). Stiffness that occurs in dead bodies due to chemical changes in the muscles. Loss of muscle mass, strength, and function as a result of aging. shin splint Painful condition caused by muscle tearing away from the tibia. spasm Involuntary sudden movement or convulsive muscular contraction. Such a movement is described as spastic. sprain The stretching or tearing of a ligament, which connects bone to bone. strain The stretching or tearing of a muscle or tendon, the latter of which connects muscle to bone; pulled muscle or pulled tendon. tenalgia or tenodynia A trained individual conducting a postmortem exam can estimate the time of a person’s death by studying a few revealing facts, such as body temperature and the presence (or absence) of body stiffness, called rigor mortis. (The term postmortem comes from the Latin words post, which means “after,” and mortem, meaning “death.”) Use of a rectal thermometer is the most accurate method of assessing the temperature of a corpse. The normal body temperature of a living person is 98.6 degrees Fahrenheit (F), and normal rectal temperature is 99.6 degrees F. In a temperature-controlled environment, the body temperature of a deceased person drops an average of 1.5 degrees F per hour. Rigor mortis sets in approximately 2 to 4 hours after death, peaks around 12 to 18 hours postmortem, and usually fades 24 to 36 hours after death. At this stage, decomposition (decay) begins to occur. Imagine that you are a forensic pathologist, a medical professional who determines cause of death by examining corpses. You establish that the rectal temperature of a corpse at midnight was 95 degrees F. You also note that rigor mortis was present. Based on these factors, what do you estimate to be the time of death? What medical terms would you, as a forensic pathologist, need to know to communicate your observations? Summarize your observations and share with a partner using the appropriate medical vocabulary. Diagnostic Tests and Procedures A diagnostician uses different kinds of tools and methods to aid in pinpointing the causes of patients’ health problems. Following are some of the most common tests and procedures used to diagnose diseases and conditions of the muscular system. Pain in the tendon. tuh-NAL-jee-uh or TEN-ohDIN-ee-uh ten/o = tendon -algia / -dynia = pain tendinitis or tendonitis tetany Copyright Goodheart-Willcox Co., Inc. . Definition The removal of a small piece of living tissue for microscopic examination (Figure 3.11). computerized tomography (CT) also called computed tomography (CT) or computerized axial tomography (CAT) Process in which radiographic images of a specific section of the body are taken from multiple angles. The images are then analyzed using a computer to identify muscular injury or disease. CT scans provide more detailed imagery than standard X-rays. Inflammation of a tendon. TEN-dih-NIGH-tis or TENduh-NIGH-tis tendin/o, tendon/o = tendon -itis = inflammation TET-uh-nee Test/Procedure biopsy A state of sustained muscular contraction. Chapter 3 The Muscular System 75 76 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Puncture site Biopsy needle To triceps To biceps To dry-earth strap Figure 3.13 An electromyogram, or EMG, is a graphic recording of the contraction of a muscle produced by electrical stimulation. Figure 3.11 During a muscle biopsy, a small piece of muscle tissue is removed for microscopic examination. Definition Test/Procedure Definition deep tendon reflexes (DTR) Evaluation of involuntary muscular responses with a reflex hammer (Figure 3.12). Patients under heavy sedation or in a deep coma do not exhibit these reflexes. radiography Diagnostic imaging technique that uses electromagnetic waves to create images of the inside of the body. X-rays are used to check for structural abnormality or disease. electromyogram (EMG) A graphic recording of the contraction of a muscle as a result of electrical stimulation (Figure 3.13 on the next page). range-of-motion (ROM) testing Diagnostic procedure performed to evaluate the extent to which joints can be moved in a variety of directions. sonography Diagnostic imaging method involving the use of high-frequency sound waves to generate images of structures in the body, such as muscles, ligaments, and displaced or dislocated structures. Also called diagnostic sonography or, more commonly, ultrasound. Test/Procedure ee-LEK-troh-MIGH-oh-gram electr/o = electricity my/o = muscle -gram = record; image goniometry GOH-nee-AH-muh-tree magnetic resonance imaging (MRI) RAY-dee-AH-gruh-fee radi/o = X-rays -graphy = process of recording The measurement of range of motion in a joint. A noninvasive scanning test that involves use of an electromagnetic field and radio waves to visualize soft-tissue structures. suh-NAH-gruh-fee son/o = sound -graphy = process of recording Figure 3.12 A neurologist performs a deep tendon reflex (DTR) test on a patient. nuclear medicine imaging Diagnostic imaging technique in (NMI) which a radioactive substance and a special camera are used to visualize structures and functions in the body. The radioactive substance is injected into or swallowed by the patient. Copyright Goodheart-Willcox Co., Inc. . Chapter 3 The Muscular System Fascinating Fact The term goniometry comes from the Greek gonia (“angle”) and metron (“measure”). More precisely, goniometry is the measurement of the angles produced by joints during range-of-motion activity. 77 78 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Directions: In a group of three or four students, research one of the following topics. Then prepare and present a report to the class. As you work on this project, practice your ability to cooperate, contribute, and collaborate with members of your team. 1. Choose one of the individuals below. Using reliable resources for research if necessary, discuss the importance of the individual’s contributions to our understanding of the human muscular system. • Jacopo Berengario da Carpi • Leonardo da Vinci • William Harvey • Andreas Vesalius 2. Investigate the pros and cons of a high-protein diet as it relates to safe bodybuilding techniques. 3. Visit the National Institutes of Health website and type the phrase “anabolic steroid abuse” in the search box. What are anabolic steroids? What are their effects on health? Why do people abuse these drugs? What can be done to prevent steroid abuse? Surgical repair of a muscle through plastic surgery. MIGH-oh-PLAS-tee my/o = muscle -plasty = surgical repair physical therapy range-of-motion (ROM) therapy Copyright Goodheart-Willcox Co., Inc. . Most common first-aid treatment for muscular injuries; often referred to as “RICE.” tenotomy Incision to the tendon, usually to repair a deformity caused by a shortened muscle. Injuries and conditions of the muscular system often require treatment with medications. The following list includes common drugs and their pharmacodynamics (actions in the body). Once a muscular condition or disease has been diagnosed, a treatment plan can be developed and implemented. For example, when an EMG (electromyogram) reveals symptoms of muscle weakness, physical therapy may be the recommended treatment. Following is a list of common surgical and noninvasive treatments for diseases and conditions of the muscular system. myoplasty Rest Ice Compression Elevation (RICE) Therapeutic Drug Treatments Surgical Procedures and Therapeutics Definition Definition teh-NAH-tuh-mee ten/o = tendon -tomy = process of cutting; incision • John Moir • Juan Valverde de Amusco Treatment Treatment Drug Effect on the Body analgesic A drug that relieves pain; includes nonprescription pain relievers, such as aspirin, and prescription pain relievers, such as hydrocodone. AN-uhl-JEE-zik anti-inflammatory A drug that reduces inflammation. antispasmodic or anticholinergic A drug prescribed to suppress smoothmuscle contractions of the bladder, stomach, or intestine. AN-tee-spaz-MAH-dik or AN-tee-koh-lih-NER-jik Treatment to rehabilitate a patient disabled by illness or injury. Common methods include exercise; hydrotherapy (water therapy), shown in Figure 3.14; ultrasound; and diathermy (DIGH-uhTHER-mee), or deep heating of body tissues using a high-frequency electrical current. Exercises performed to improve or maintain joint mobility and flexibility. Active ROM exercises are those that can be performed on your own. Assisted ROM exercises require minor assistance due to mild weakness, pain, or stiffness. Passive ROM exercises are performed by a physical therapist on a person who requires total assistance to do the exercises. Figure 3.14 Hydrotherapy is often recommended for patients with arthritis because the buoyancy of the water means less weight-bearing impact on the joints. Chapter 3 The Muscular System 79 narcotic A drug that, in moderate doses, depresses the central nervous system, relieves pain, and induces sleep. Taken in excess, narcotics produce unconsciousness, stupor, coma, and possibly death. nonsteroidal A group of drugs with analgesic, anti-inflammatory, and antipyretic (AN-tee-pigh-RET-ik) (fever-reducing) properties. Aspirin, ibuprofen, and naproxen are common over-the-counter (OTC) NSAIDs. This group of drugs is set apart from other drugs that have the same properties because they are nonsteroidal. (Steroidal drugs have narcotic effects and may result in addiction.) (NON-steer-ROY-duhl) anti-inflammatory drugs (NSAID) 80 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Common Medical Abbreviations E-flash Cards Careers to Consider The following medical abbreviations are commonly used in reference to the muscular system. These abbreviations provide a shorthand method of communication among healthcare professionals concerning pathological conditions, diagnostic tests, surgical procedures, and therapeutic treatments. These abbreviations can be found in this chapter and in the medical record activity that follows. Abbreviation Meaning amb ambulate (walk) computerized axial tomography CFT DTR EMG certified fitness trainer complains of; complaining of cardiopulmonary resuscitation computed tomography; computerized tomography carpal tunnel syndrome Duchenne muscular dystrophy deep tendon reflex electromyogram h hour(s) Q8H Hx, hx IM history intramuscular R RICE L MD left muscular dystrophy milligram(s) magnetic resonance imaging not applicable RMS ROM CPR CT CTS DMD mg MRI N/A Copyright Goodheart-Willcox Co., Inc. . Certified Fitness Trainer Abbreviation Meaning NMI nuclear medicine imaging NSAID nonsteroidal antiinflammatory drug OTC over-the-counter CAT c/o If you pursue any of the following careers, you will interact on a regular basis with patients who have conditions or diseases of the muscular system. For more detailed information on the career opportunities discussed in this section, visit the US Bureau of Labor Statistics website. PCN penicillin PCP primary care physician personal fitness trainer PFT PRN, p.r.n. Pt, pt. PT Q2–3H wt y/o A certified fitness trainer (CFT) serves as a leader and instructor in exercise programs and helps people achieve and maintain a healthful lifestyle. This career path demands a passion for being physically active, healthy, and fit. CFTs must have excellent communication skills and a talent for encouraging and motivating others. Certified fitness trainer programs take, on average, six months to complete. These programs teach a well-rounded curriculum that includes coursework in exercise programs, nutrition, anatomy and physiology, and psychology. Admission to a CFT program generally requires a high school diploma and current certification in first aid and cardiopulmonary resuscitation (CPR). as needed (from the Latin pro re nata) patient physical therapy every two or three hours every eight hours (from the Latin quaque octava hora) right rest, ice, compression, elevation rhabdomyosarcoma range of motion The work environment for CFTs varies widely. Certified fitness trainers are employed in fitness and health clubs, gyms, hospitals, resorts, country clubs, universities, and yoga and Pilates studios. A CFT may also choose to work as a personal fitness trainer (PFT), traveling to people’s homes and developing custom-tailored exercise programs to help clients become physically fit. weight years old; year-old (as in 18-year-old) Chapter 3 The Muscular System Exercise physiologists develop individualized exercise plans based on their clients’ needs, and they design exercise programs to help athletes achieve specific goals. To prepare for a career in this field, candidates must have at least a bachelor’s degree in exercise physiology. With further education and successful completion of the Exercise Physiologist Certified (EPC) exam, administered by the American Society of Exercise Physiologists (ASEP), a person can obtain board certification. Exercise physiologists are employed in a variety of environments, including healthcare facilities, fitness centers, colleges and universities, athletic or military training facilities, and rehabilitation centers. Sports Medicine Physician A sports medicine physician treats and prevents sports-related injuries of the bones, joints, and muscles. These healthcare professionals are qualified to diagnose and treat patients, prescribe medication and therapy, and perform surgery. They attend an accredited medical school to obtain a Medical Doctor (MD) degree or a Doctor of Osteopathic Medicine (DO) degree. Both types of physicians must complete residency programs and obtain a license to practice. Sports medicine physicians may work exclusively for an athletic team, for a university sports program or fitness center, in a private practice, or with a group of physicians. Exercise Physiologist An exercise physiologist is a healthcare professional who performs exercise stress tests and evaluates a person’s physical condition, focusing on cardiovascular health and metabolism. 81 82 Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Chapter 3 Review Chapter 3 Review Anatomy and Physiology Directions: Provide the correct term(s) for each question that follows. For each exercise that follows, write your answers on a separate sheet of paper. Identify the Anatomical Structure 1. What type of body tissue is made up of bundles of fibers held together by connective tissue? Directions: Identify the correct anatomical term that corresponds to each letter in the diagram. 2. What are the three types of muscle tissue in the body? Give an example of each. A 3. What term is used to describe muscles that are controlled consciously? B 4. What term is used to describe muscles that cannot be consciously controlled? C 5. Which property describes the ability of muscle to shorten (for example, the biceps muscle when flexed)? D 6. Which property describes the ability of skeletal muscle fibers to resume their resting length when a stretching force is removed? E F 7. Identify the term for the attachment site of a muscle that does not move when the muscle contracts. G 8. What is the name for the attachment site of a muscle that moves during muscular contraction? H 9. What is the term for the band of fibrous tissue that connects muscle to bone? 10. What is the term for the band of fibrous tissue that connects bone to bone? Word Construction I Directions: Using word parts and meanings presented in the chapter, build the medical term described in each definition that follows. J K 1. surgical repair of a muscle L 2. pertaining to muscle 3. process of leading toward M 4. pertaining to the sole of the foot 5. the study of movement N 6. paralysis of half (of the body) O 7. without growth or development 8. three heads (a muscle with three heads or attachments) A. Anterior view 9. pertaining to paralysis of four (extremities) B. Posterior view 10. process of leading away from 11. process of bending Word Parts Directions: Write the meaning(s) of each word part listed. Identify each word part by type (prefix, combining form, or suffix). 1. muscul/o 3. ab2. tendin/o 4. -malacia Copyright Goodheart-Willcox Co., Inc. . 5. -asthenia 11. -plegic 6. kinesi/o 12. quadri- 7. myocardi/o 13. -ar 8. ad- 14. -tonia 9. -paresis 15. fibr/o 12. inflammation of the tendon Word Surgery Directions: Dissect each medical term into its word parts. Identify the word-part types (prefix, combining form, or suffix), and write the meaning(s) of each word part. Then write a definition of the term. 10. my/o Chapter 3 The Muscular System 83 84 Introduction to Medical Terminology Example: muscular Dissection: muscul / ar muscul / o (combining form) = muscle -ar (suffix) = pertaining to Definition: pertaining to muscle 1. hypertrophy 2. dystaxia 3. hypotonia 4. myomalacia 5. leiomyosarcoma 6. paresthesia 7. hyperextension 8. adduction 9. myocele 10. eversion 11. circumduction 12. fibromyalgia Matching Directions: Match the combining form (root word and combining vowel) to the correct meaning. 1. fibr/o a. heart muscle 2. rhabd/o b. coordination; order 3. lei/o c. muscle 4. muscul/o d. tendon 5. plant/o e. rod-shaped 6. kinesi/o f. movement 7. orth/o g. stretched; strained 8. articul/o h. straight; normal 9. sarc/o i. tone; tension 10. tax/o j. smooth 11. flex/o k. flesh 12. ton/o l. joint 13. tendin/o m. to bend 14. myocardi/o n. fiber 15. tens/o o. sole of the foot Spelling Directions: Identify the correctly spelled medical term in each numbered item. 1. fasciitis fasceitis fashiitis fascitis 2. hypertonnia hipertonia hypertonia hypertoenia 3. myalgea myalgia mialgea mialgia 4. dorsaflexion dorsiflexion dorsaflection dorsiflection Copyright Goodheart-Willcox Co., Inc. This sample chapter is for review purposes only. Copyright © The Goodheart-Willcox Co., Inc. All rights reserved. Chapter 3 Review Chapter 3 Review 5. lieomyoma leomyoma laiomyoma leiomyoma Interpreting Abbreviations Medical Record Practice 6. dystraphy dystrophy distrophy distraphy 7. kinesiology kynesiology kenesiology kinesialogy Directions: Write the correct medical term or phrase for each abbreviation listed. 1. mg 9. ROM Following is a physical therapy report for Khalil, the 18-year-old high school senior who was introduced in the Case Study. Read Khalil’s medical record. Then, on a separate sheet of paper, write a definition for each highlighted term and abbreviation. 8. paraplegea peraplegia periplegia paraplegia 9. fibermyalgia fibromyalgea fibromyalgia fibremyalgia 10. myorrhexis myorrexis myorhexis myarhexis Pronunciation Directions: Pronounce each term below, then write the correct spelling. 1. FASH-ee-uh 2. MUS-kyoo-ler 3. QUAH-drih-PLEE-jik 4. high-PER-truh-fee 5. TRIGH-seps 6. DOR-sih-FLEK-shun 7. HEM-ih-PLEE-jee-uh 8. fas-ee-IGH-tis or fash-ee-IGH-TIS 9. MIGH-uhs-THEE-nee-uh 10. HEM-ee-puh-REE-sis 2. DTR 10. PRN 11. EMG 3. amb 4. IM 5. L 12. h 13. R 6. wt 14. RICE 7. PCN 8. NSAID 15. PT 16. CT HERMAN ORTHOPEDIC CLINIC 987 Medical Drive, Hospital City, US 12345 PHONE: (xxx) xxx-4321 PT NAME: Khalil Larkins ID NO: 86523497 DATE: 03/20/20xx Search the Source PCP: Dr. Evan Schumacher 1. There are more than 30 different forms of muscular dystrophy, but Duchenne muscular dystrophy tops the list. Working with a partner, visit the National Institutes of Health (NIH) website and research the facts about DMD. What is it? What are the common signs and symptoms? How does DMD develop? What is its prevalence? 2. A sprain and a strain are similar types of injuries but involve different body parts. Visit the NIH website and research the facts about both types of injuries. What are the similarities and differences? What body parts are affected during a strain and a sprain? What is the leading cause of each injury? How is each injury treated? Subjective Data: Identifying Abbreviations Directions: Write the correct abbreviation for each medical term or phrase listed. 1. electromyogram 2. muscular dystrophy 3. years old; year-old 4. physical therapy 5. computerized axial tomography 6. range of motion 7. primary care physician 8. nonsteroidal anti-inflammatory drug 9. computed tomography; computerized tomography 10. rest, ice, compression, elevation 11. nuclear medicine imaging 12. carpal tunnel syndrome 13. history 14. Duchenne muscular dystrophy No prior surgeries. Social Hx: No alcohol or drug use. Current Limitations: Unable to amb and bear wt on L leg. Medications: Ibuprofen 800 mg Q8H PRN for pain. Allergies: PCN Current Pain Level: 8 on a 1–10 pain scale. Pt Goal: Pain free, return of full ROM and strength. Objective Data: Injury Involved: L hamstring strain. Matching Terms of Directional Motion Directions: Match each directional movement to the correct definition. a. movement away from the midline of the body 1. abduction 2. 3. 4. 5. 6. 7. 8. 9. 10. adduction rotation circumduction flexion extension supination pronation elevation depression b. raising of a body part c. straightening of a limb d. rotational movement in which the palm moves to face downward e. rotation of a limb, as if drawing a circle Treatment Recommendations: f. movement of a body part around its longitudinal axis g. movement toward the midline of the body h. rotational movement in which the palm moves to face upward 15. complains of; complaining of i. lowering of a body part 16. intramuscular j. bending Copyright Goodheart-Willcox Co., Inc. . Pt. is an 18 y/o male c/o pain, swelling, and tenderness to L hamstring area. Past Medical Hx: Limitation before Injury: N/A 11. MIGH-oh-KAR-dee-um 12. migh-AH-lih-sis FAX: (xxx) xxx-2910 PHYSICAL THERAPY NOTE Chapter 3 The Muscular System 85 86 1. 2. 3. 4. 5. 6. 7. 8. Rest the injury. Ice to injured site Q2–3H. Compression bandage to minimize bleeding into the tissue. Elevation of the injury to decrease swelling. Continue RICE treatment for the next 48 h. Use crutches for next 48 h. After 48 h, alternate ice and heat. Return to PT department for initial stretching and strengthening exercises in 72 h. Introduction to Medical Terminology Copyright Goodheart-Willcox Co., Inc.