Chapter 7 Orthopedics Skeletal System: Anatomy and Physiology

Orthopedics

is the medical specialty that studies the anatomy

and physiology of the skeletal and muscular systems.

• Orthopedists use diagnostic tests, medical and surgical

procedures, and drugs to treat skeletal and muscular diseases

Fracture (FX, Fx)

Broken bone caused by an accident,

injury, or disease.

• Stress fractures are caused by force

or torsion during a sport or activity.

• Pathologic fractures are caused by a

disease process like osteoporosis.

• Some fractures are categorized by

how the bone breaks.

No matter the cause of fracture, if the

bone heals without treatment, it may

show malunion or malalignment

Colles fracture:

Distal radius is broken by falling

onto an outstretched hand

Compression fracture:

Vertebrae are compressed due to

a fall or they collapse on

themselves (osteoporosis)

Depressed fracture:

Cranium is fractured inward to

brain

Greenstick fracture:

Bone is broken only on one side

(children)

Hairline fracture:

Very thin fracture (bone still

together)

Oblique fracture:

Bone is broken on an oblique

angle

Spiral fracture:

Spiral break due to twisting force

Transverse fracture:

Break is perpendicular to long axis

Osteomalacia

Abnormal softening of the bone due to

vitamin D deficiency or lack of sun

exposure; causes rickets in childres

• oste/o- = bone

• malac/o- = softening

• -ia = condition

Osteoporosis

Abnormal thinning of the bone structure;

bone breakdown exceeds bone formation

and calcium and phosphorus are lost

Osteoma,

Osteosarcoma,

Ewing sarcoma

Bone cancers:

• osteoma = benign growth

• osteosarcoma = malignant growth

of osteoblasts

• sarc/o- = connective tissue

Ewing sarcoma = malignant growth

in young men

Chondroma

Benign tumor of the cartilage.

• chondr/o- = cartilage

• -oma = tumor

Chondromalacia

patellae

Abnormal softening of the patella due

to thinning and uneven wear; caused

by pulling of the femur on the patella.

• malac/o- = softening

• -ia = condition

Osteomyelitis

Infection of the bone and bone marrow

when bacteria enter the bone

following injury or surgery.

• myel/o- = bone marrow

Pectus excavatum

Congenital deformity in which the sternum is

bent inward creating a depression in the

chest.

• pectus = chest

• excavatum = caved in

Kyphosis

Abnormal posterior curvature of the thoracic spine; also

called humpback

Lordosis

Abnormal anterior curvature of the lumbar spine; also

called swayback

Scoliosis

Abnormal C- or S-shaped lateral curvature of the spine

• dextroscoliosis = right side

• levoscoliosis = left side

Ankylosing

spondylitis

Chronic inflammation of the vertebrae

that leads to fibrosis, fusion, and spinal

motion restriction.

• ankyl/o- = fused together

• -osing = abnormal condition of making

• spondyl/o- = vertebrae

• -itis = infection of; inflammation of

Spondylolisthesis

Degenerative condition of the spine in which

one vertebra moves anteriorly and slips out

of alignment (due to intervertebral disk

degeneration, sports injury, or compression

fracture)

• spondyl/o- = vertebra

• -listhesis = abnormal condition of slipping

Genu valgum

Congenital deformity in which the knees rotate

toward the midline and the legs bend away

from midline; knock-knee.

• genu = knee

• valgum = knock-kneed

Genu varum

Congenital deformity in which the knees are

abnormally far apart and the legs bend toward

the midline; bowleg.

• varum = straddling

Hallux valgus

Deformity in which the great toe (hallux)

angles toward the other toes and there

is swelling at the base; bunion.

• hallux (from Latin allus) = big toe

• valgus = knock-kneed

Often due to poorly fitting shoes

Talipes

equinovarus

Congenital deformity in which the foot is pulled

downward and toward the midline; clubfoot

• talipes = talus (ankle) and pes (foot)

• equino = heel is elevated like horse’s

• varus = turned inward

Arthralgia

Pain in the joint due to injury,

inflammation, or infection from various

causes.

• arthr/o- = joint

• alg/o- = pain

• -ia = condition

Arthropathy

General term for disease of the joint from

any cause.

• -pathy = disease

Osteoarthritis

(OA)

Chronic inflammation, pain, and stiffness in the joints

as cartilage wears away and bone rubs on bone.

• oste/o- = bone

• arthr/o- = joint

• -itis = inflammation

Rheumatoid

arthritis

(RA)

Acute and chronic inflammatory disease of the

connective tissue, particularly the joints.

• It is an autoimmune condition in which the body’s own

antibodies attack cartilage and tissue.

• Joints are red and swollen with progressive deformity.

• rheumat- = watery discharge (because the dz

seemed to flow through the body)

• -oid = resembling

Dislocation

Complete displacement of the end of a

bone from its normal position in a joint;

usually caused by trauma but can

occur in the hip of the newborn

Subluxation

Partial dislocation with slight

displacement of bone ends from the

joint.

• sub- = below

• luxat/o- = displacement

• -ion = condition

Gout

Metabolic disorder in which high uric acid

levels cause pain in the joint; most often

occurs in the great toe.

Sprain

Overstretching or tearing of

ligaments around a joint

Torn meniscus

A tear in the cartilage pad in the knee

joint because of an injury.

• meniscus = crescent (moon

Hemarthrosis

A condition of blood in the joint cavity, usually due to

blunt trauma or penetrating injury.

• hem/o- = blood

• arthr/o- = joint

• -osis = abnormal condition

Rheumatoid factor (RF)

Blood test that is usually

positive in patients with

rheumatoid arthritis

Uric acid

Blood test that shows an

elevated level in patients with

gout and gouty arthritis.

Bone density

tests

Measure bone mineral density to diagnose

osteoporosis

X-ray

Most common diagnostic procedure for the skeletal

system; the primary means for diagnosing fractures,

dislocations, and bone tumors

Cast

A layer of plaster or fiberglass applied

around a fractured bone to immobilize the

bone as it heals

Closed reduction

A procedure in which bone ends in a

displaced fracture are manually

manipulated back into place; often followed

with a cast.

Goniometry

A procedure that measures the angle of a joint

and its range of motion (see next slide)

• goni/o- = angle

• -metry = process of measuring

Orthosis

An orthopedic device like a brace or splint that

is used to keep a body part straight and

immobile.

Physical therapy

(PT)

Exercise that improves a patient’s range of

motion, joint mobility, strength, and balance.

• Active exercises are done by the patient.

• Passive exercises are done by the therapist

Traction

A procedure that uses weight to pull the bone

ends of a fracture into correct alignment.

• Skin traction uses wraps or straps.

• Skeletal traction uses surgically inserted pins

or wires.

Prosthesis

An orthopedic device like a leg or arm that is

created for a patient following an amputation.

Gk: for in addition, to place

Analgesics

Treat pain associated with bone injury or

surgery.

• an- = without

• alges/o- = pain

• -ic = pertaining to

Bone resorption

inhibitors

Prevent osteoclasts from breaking down bone

to treat osteoporosis.

Corticosteroids

Decrease severe inflammation

Nonsteroidal anti-

inflammatories

(NSAIDs)

Treat inflammation and pain from

osteoarthritis (OA) and orthopedic injury

Amputation

Removal of all or part of an extremity damaged by

trauma or disease.

• Below the knee (BKA) = performed at the

level of the tibia and fibula

• Above the knee (AKA) = performed at the

level of the femur

Arthrocentesis

Removal of accumulated fluid from an injured joint

using a needle inserted in the joint space.

• Kéntēsis = puncture

Arthrodesis

Fusion of bones in a deteriorated, unstable joint.

• -desis = procedure to fuse together

Arthroscopy

Visualization of the inside of a joint using an

arthroscope inserted into the joint.

• arthro = joint

• -scopy = process of using an instrument to

examine

Bone graft

Replacement of bone severely damaged

due to bone cancer.

• autograft = patient’s own bone

• allograft = cadaver bone (all/o- =

other)

Bunionectomy

Removal of a bunion that has formed on

the metatarsal bone at the base of the

great toe

Cartilage

transplantation

Replacement of damaged cartilage in active

middle-aged adults; alternative to knee

replacement

External fixation

Treatment for complicated fractures; an

external device is placed on the bone and

secured with metal pins that immobilize the

fracture

Joint replacement

surgery (arthroplasty)

Replacement of a joint destroyed by trauma

or osteoarthritis with a metal or plastic

prosthesis.

• In the hip, this is total hip replacement

The head of the patient’s femur is

removed and replaced.

• A cup replaces the patient’s acetabulum

Open reduction

and internal

fixation

Treatment for a complicated fracture.

• In open reduction, an incision is made at

the fracture site and the bone pieces are

realigned.

• In the internal fixation, screws and plates

are used to hold the bone in anatomical

alignment.

AKA

above-the-knee amputation

anti-CCP

anti-cyclic citrullinated peptide

BKA

below-the-knee amputation

BMD

bone mineral density

C1

first cervical vertebra or (atlas)

C2

second cervical vertebra or (axis)

C1-C7

cervical vertebrae

CT

computerized tomography

DEXA

dual-energy x-ray absorptiometry

DIP

distal interphalangeal (joint)

DJD

degenerative joint disease

D.C.

Doctor of Chiropracty

D.O.

Doctor of Osteopathy

D.P.M.

Doctor of Podiatric Medicine

ESWT

extracorporeal shock wave therapy

FX, Fx

fracture

L1-L5

lumbar vertebrae

LLE

left lower extremity

LUE

left upper extremity

MCP

metacarpophalangeal (joint)

MRI

magnetic resonance imaging

NSAID

nonsteroidal anti-inflammatory drug

OA

osteoarthritis

ORIF

open reduction and internal fixation

Ortho

orthopedics (short form)

PT

physical therapist or physical

therapy

QCT

quantitative computerized

tomography

RA

rheumatoid arthritis

RF

rheumatoid factor

RLE

right lower extremity

ROM

range of motion

RUE

right upper extremity

S1

first sacral vertebra

T1-T12

thoracic vertebrae

THR

total hip replacement

tib-tib

tibia-fibula (short form)