The Musculoskeletal System Lecture 4 of the Course “Medical English” for Sophomore Medical Students of Taipei Medical University

School of Medicine Taipei Medical University

Winston W. Shen, M.D.

Professor and ChairmanDepartment of Psychiatry

Taipei Medical University College of Medicine and

Chief, Department of Psychiatry TMU-Wan Fang Medical Center

Taipei, TAIWAN

E-mail address: Shenwinw@gmail.com

The Schedule for the Course “Medical English” Version of 3/4/07 (Part 1 of 2) Week 1 (March 1) The Digestive System

Week 2 (March 8) The Respiratory System Week 3 (March 15) The Cardiovascular System Week 4 (March 22) The Musculoskeletal System

(Turning in a 400-word essay on “My Visit to the Clinic” or “My Visit to the Hospital” (in double-line space hard copy)

Week 5 (March 29) The Central Nervous System Week 6 (April 5) Off (Spring Break) Week 7 (April 12) Urinary and Reproductive Systems Week 8 (April 19) The First Examination Week 9 (April 26) Medical Records

(Turning in a 400-word essay on “My Favorite Book” (in double line space hard copy)

The Schedule for the Course “Medical English” Version of 3/4/07 (Part 2 of 2) Week 10 (May 3) Scientific Papers

Week 11 (May 10) Hematology Week 12 (May 17) Infectious Diseases Week 13 (May 24) The Second Examination Week 14 (May 31) Endocrinology

(Turning in a 400-word essay on “How to Be a Good Physician” (in double line space hard copy)

Week 15 (June 7) Immunology Week 16 (June 14) Oncology Week 17 (June 21) No Class Week 18 (June 28) Final (The Third) Examination

Muscle

Pl. muscles; L. musculus, “little mouse”

Gr. der Muskel; F. muscle

Heart Muscles (1) to pump the heart (2) to conduct impulse

Skeletal Muscles (to move the bones)

Smooth Muscles in the GI Tract(to do peristalsis*)

The wavelike muscular contractions of the intestine or other tubular structure that propel the contents onward by alternate contraction and relaxation. Also called vermicular movement.

per·i·stal·sis  pl. –ses(Gk, peri, to wrap around :stellein, to place, to compress)

The muscle is attached to the bone through a tendon.

(ML. tendōn- s. of tendō; Gk. Ténōn, sinew (sp. with -d- by association with L. tendere to stretch)

e.g. Achilles tendon or tendon of Achilles

Anatomy. a cord or band of dense, tough, inelastic,white, fibrous tissue, serving to connect a muscle with a bone or part; sinew

Three Types of Muscles

Smooth muscle

Smooth

voluntary

Controlling movement of internal organs

Appearance

Cardiac muscle

Striated

Involuntary

Controlling contractionsof the heart

Skeletal* muscle

Striated

Voluntary

Moving bones

Voluntary or Involuntary

Function

*Skeletal muscles work in pairs. When one contracts, the other relaxes. They are attached to bone by bands of tissue called tendons.

Symptoms of Muscle Diseases

˙ Myoclonus (a clonic spasm of a muscle or muscle group) 

˙ Weakness

˙ Spasticity (L. spasticus afflicted with spasms; Gk. spastikós of a spasm, equiv. to spas-, s. of spân to pull off, pluck, convulse + -tikos-tic)

˙ Myalgia (from Gk. mys "muscle" + algos "pain." muscle pain)

bestbodyever.com/b-n-b-s.jpg

Trapezius

Hamstings

Calf musclesConsisting two muscles:

GastrocnomiceusSoleus

Achilles tendon lnavits.myweb.uga.edu/achil1.jpg

the greatest Greek warrior intheTrojan War and hero of Homer's Iliad. He killed Hector and was killed when Paris wounded him in the heel, his one vulnerable spot, with an arrow.

from Gk. gastroknēmiā, calf of the leg : gastro-, belly [from its belly-like shape]; see gastro- + knēmē, leg.]

Skeletal Muscles (1/3)

Skeletal Muscles (2/3)

space.mit.edu/home/liberty/muscle.JPG

Biceps brachi

Deltoid

Sternoclaidomastoid L. for two heads.

Gk. deltoeid s delta-shaped, equiv. to Délt (a)

The muscle involving the sternum, the clavicle, and the mastoid process. Gr. sternum + lavicle (key) + mastoid (nipple-like)

Either of two muscles of the neck that serve to flex and rotate the head.

Quadriceps (made of 4 muscles: Rectus femoris, Vastus lateralis,Vastus medialis andVastus intermediu)

Hamstrings (made of 3 muscles:1. Biceps femoris2. Semitendinosus3.Semimembranosus) Gluteus maximus

Rectus abdominis

Gk. rump

Pectoralis minor

Skeletal Muscles (3/3)

(L. short for trapezius musculus, trapeziform muscle) ]

(New Latin, from Medieval Latin trapēzium, trapezium, from the shape of the muscles paired)

Shapes

square

triangle, adj. triangular

rectangle, adj. rectangular

trapezoid

Parallelogram, adj. parallelogramatic

isoceles triangle (two sides of equal lengths )

right triangle acute triangle obtuse triangle scalene triangle (three sides of different lengths)

Equilateral or equiangular triangle

* asterisk

circle, adj. circular

ellipse, adj. elliptical; Ellipsis, “. . .”

Extraocular Muscles (EOMs)

Superior rectus m.Inferior rectus m.Medical rectus m.Lateral rectus m.Superior oblique m. Inferior oblique m.

www.msmedia.com.au/.../IMAGES/Senses_IM.jpg

Rectus (Gr. gerade,glatt; Fr. droit, raide; NL réctus [musculus], straight [muscle])

Rectus abdominisRectus capitis posterior majorRectus capitis posterior minorRectus femorisRectus m. of thighRectus inferiorRectus lateralisRectus medialisRectus superior

Oblique (Gr. schräg;Fr. oblique; Middle English, from Old French, oblique, from Latin oblīquus, slanting)

www.medrounds.org/ocular-

pathology-study-guid

static.howstuffworks.com/gif/vision3.gif www.childrenshospital.org

www.tipztime.com/minicharts/skeleton.gif

The Skeleton

Patella (pl. patellae or patellas; L, dim. of patina, patena pan, lit., something wide open)

Skull (Middle English skulle, probably of Scandinavian origin)

Femur (Pl. femurs or femora; L. femur “thigh“)

Humerus (L. (h)umerus shoulder; c. Gk. ômos, Goth ams, Skt ámsas ]

Pelvis (pl. pelves, L. basin; akin to Gk. pellís bowl)

Tibia (L. tībia lit., reed pipe)

Fibula( Pl. fibulae or fibulas;L. Fībula, bolt, pin, clasp, prob. *fīvibula, equiv. to fīv(ere), early form of fīgere, to fasten)

Radius (L. staff, rod, spoke, beam, orig., ray)Ulna

(L. elbow; akin to Gk. ōléné, OE eln)

Rib

Scapula(L. shoulder, from L. scapulae,the shoulder blades.]

Vertebra (L. [spinal] joint, equiv. to verte (re) to turn)

Mandible (L. mandibula jaw, equiv. to mandi- (comb. form of L mandere to chew)

Sacrum

Wrist

Maxilla(from L. maxilla, upper jaw, dim. of mala jaw, cheekbone)

Carpal

MetatarsalsTarsals

Phalanges

Phalanges

Metacarpal

(wrist, from P.Gmc. *wristiz, cf. O.N. rist, instep, O.Fris. wrist, M.Du. wrist, Gr. Rist, back of the hand, instep,from P.Gmc. *wrig-, *wreik-, to turn. The notion is "the turning joint." )

pl. sa·cra (sā'krə, sāk'rə) A triangular bone made up of five fused vertebrae and forming the posterior section of the pelvis.

(From NL. from Late L. (os) sacrum (translation of Greek hieron (osteon), sacred(bone)), neuter of Latin sacer, sacred)

The Skeleton of the Foot Consisting of the Tarsals, Metatarsals, and Phalanges)    

Metatarsals (The middle part of the human foot that forms the instep and includes the five bones between the toes and the ankle).

Tarsals,

Phalanges

Plantar viewDorsal view

(Gk. tarsós flat of the foot)

(Old F., body of infantrymen, from L. from Gk. phalanx, phalang-, log, battle array, bone between the finger and toe joints)

(From the undersurface of the foot) (From the back of the foot)

Fractures of the BoneA bone fracture is a medical condition in which a bone becomes cracked, splintered, or bisected as a result of physical trauma. A bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis, certain types of cancer or osteogenesis imperfecta.

Osteoporosis (Gk. osteo- + pór (os) passage, pore)

osteomyelitis (pl. os·teo·my·elit·i·des; Gk. osteo + myelits)

osteopathy (Gk. Gk. osteon "bone" + -pathy)

e.g. sympathetic pathology

osteoporosis (Gk. osteo- + pór (os) passage, pore)

pororsity

Word Family with “Osteo-”

osteoarthritis (pl. os.teo.arthr.i.des; Gk. osteo + arthritis)

e.g. porous

Closed fractures are those in which the skin is intact.

Open (compound) fractures involve wounds that communicate with the fracture and may expose bone to contamination. Open injuries carry an elevated risk of infection; they require antibiotic treatment and usually urgent surgical treatment (débridement).

Compression fracture is when the front portion of a vertebra in the spine collapses due to osteoporosis, a medical condition which causes bones to become brittle and susceptible to fracture (with or without trauma).

Other Types of Fracture are:

˙ Complete Fracture (a fracture in which bone fragments separate completely)

˙ Incomplete Fracture (a fracture in which the bone fragments are still partially joined)

˙ Linear Fracture (a fracture that is parallel to the bone's long axis)

˙ Transverse Fracture (a fracture that is at a right angle to the bone's long axis)

˙ Oblique Fracture (a fracture that is diagonal to a bone's long axis.

˙ Spiral Fracture (a fracture where at least one part of the bone has been twisted)

˙ Comminuted Fracture (A fracture causing many fragments)

˙ Impacted Fracture (A fracture caused when bone fragments are driven into each other)

Types of Fractures

Original version

The patient prefers to take oral medications to receiving parenteral injections.

Original text

The patient prefers taking oral medications to receiving parenteral injections.

Ten Commandments to Write Better English 1. Thou shalt always use correct grammar

Ten Commandments to Write Better English 2. Thou shalt use simpler sentences

Original version

Art is the best demonstration of spirit and emotion, both of which can create a world of overwhelming love.

Revision

Art is the best demonstration of spirit and emotion, to create a world of overwhelming love.

Ten Commandments to Write Better English 3. Thou shalt vary your writing.

Original version

The characteristic of this area is that huge paintings can be exhibited here because the space on the walls is quite spacious.

Revision

The characteristic of this area is that huge paintings can be exhibited here because of spacious walls.

Ten Commandments to Write Better English 4. Thou shalt use more active voice.

Original version

Another highly antigenic fragment Sb-b (aa 150- 400) was also recognized by 70% of patients’ sera was not identified previously.

Revision

For the first time, we also identified another highly antigenic fragment, Sb-b (aa 150-400), which was also recognized by 70% of patients’ sera.

Ten Commandments to Write Better English 5. Thou shalt avoid redundancies

Original version

The research was carried out in two steps. The first step was to include patients who were registered in the trauma chapter of the Trauma Registry in Taiwan. The second step was to conduct the survey of variables related . . .

Revision

The research was carried out in two steps: (1) to include patients who were registered in the trauma chapter of the Trauma Registry in Taiwan, and (2) to conduct the survey of variables related . . .

Ten Commandments to Write Better English 6. Thou shalt avoid using Latinate words

Original version

We have previously employed [131I]FIAU and demonstrated the applicability of noninvasive imaging to monitor cancer gene therapy.

Revision

We have previously used [131I]FIAU and showed the applicability of noninvasive imaging to monitor cancer gene therapy.

Ten Commandments to Write Better English 7. Thou shalt use strong verbs

Original version

Many artists showed their willingness of participation.

Revision

Many artists were willing to participate.

Ten Commandments to Write Better English 8. Thou shalt use the parallel construction

Original version

The spatial resolution of most clinical PET scanners is around (6-8)3 mm3, and the higher resolution of clinical brain scanners have been developed approaching resolutions of around 33 mm3. Final version

The spatial resolution of most clinical PET scanners for the body is around (6-8)3 mm3, and that for the brain around 33 mm3.

Ten Commandments to Write Better English 9. Thou shalt avoid using empty phrases.

Original version

We have found out that it is necessary to think with the perspective of patients because this is the best way to know what kind of service patients need.

Revision

We have found out the need of thinking with patients’ perspective to know what kind of service they want.

Ten Commandments to Write Better English 10. Thou shalt be specific in using words.

Original version

Mr. Smith is a straight man.

Revision Mr. Smith is a straight speaker.1.without a bend, angle, or curve; not curved; direct: a straight path. 2.exactly vertical or horizontal; in a perfectly vertical or horizontal plane: a

straight table. 3.(of a line) generated by a point moving at a constant velocity with respect to another point. 4.evenly or uprightly formed or set: straight shoulders.

5.without circumlocution; frank; candid: straight speaking. 6.honest, honorable, or upright, as conduct, dealings, methods, or persons. 7 Informal. reliable, as a report or information. 8.right or correct, as reasoning, thinking, or a thinker. 9.in the proper order or condition: Things are straight now. 10.continuous or unbroken: in straight succession. 11.thoroughgoing or unreserved: a straight Republican. 12.supporting or cast for all candidates of one political party: to vote a straight ticket. 13.unmodified or unaltered: a straight comedy. 14.without change in the original melody or tempo: She does straight songs, with just the piano backing her.

15.Informal. a. heterosexual. b.traditional; conventional. c.free from using narcotics. d.not engaged in crime; law-abiding; reformed.

Random House Unabridged Dictionary, Random House, Inc. 2006

Exercises III

7. Malaysia is (A) a Christian, (A) a Buddhistic, (C) a Moslem, or (D) an Indian country.

8. The expression, “You can not teach an old dog new trick” means that the old dog is (A) having a short learning curve, (B) easy to be taught, (C) having very long learning curve, or (D) trainable.

9. Parenteral route does NOT include taking the medication (A) by mouth (per os, PO), (B) by intravenous (IV) injection, (C) by intramuscular (IM) injection, or (D) by inhaling.

Choosing the Most Appropriate Answers