The Skeletal System 1.

Match the names of the following bones 1-25 with their definition a-y:

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25.

backbone cartilage clavicle coccyx collagen elbow foot fovea head humerus hyoid incus limbs mandible orbit patella phalanges radius ribs shaft skeleton skull sternum tibia vertebra

2.

For gaps 26-40 use ONE word only:

a. b. c. d. e. f. g. h. i. j. k. l. m. n. o. p. q. r. s. t. u. v. w. x. y.

a bone in the arm which sounds as funny a little bone in the throat a small pit in the cartilage of the femur lower jaw arms and legs breast bone it is tough, flexible and lighter than bone it protects the brain it provides support, movement and protection the place of the metatarsals one of the bones in the lower arm spinal column the final limb bones the last bone in the back the long central section of the femur abundant cellular fibre in the body funny bone collar bone the shin bone the socket for the eye the spherical top end of the femur these protect vital body organs bone in the ear kneecap one bone of the spinal column

Bone forms by the gradual addition 26. ...... calcium and phosphorus salts 27. ...... cartilage. The process of ossification begins before birth and continues 28. ...... adulthood. The bone is living tissue which is constantly being replaced and remodelled 29. ...... life. There are three types of bone cells: osteoblasts, the cells 30. ...... produce bone; osteocytes, mature bone cells, and osteoclasts, involved 31. ...... the breakdown of bone tissue to release needed minerals or to allow for reshaping and repair. The process of bone destruction 32. ...... the components to be taken into the circulation is called resorption. The human skeleton is composed of 206 bones which 33. ...... arranged in two groups: the axial skeleton, which consists of bones that form the axis of the body

and support and protect the organs (skull, hyoid, ribs, sternum, vertebral column) and the appendicular skeleton, which is composed of bones that anchor the appendages 34. ...... the axial skeleton. Bones can be grouped according to their shapes, thus they can be long, short, flat or irregular or according to their location. Every bone has 35. ...... compact and cancellous osseous tissue. The compact tissue provides support and strength while the cancellous bone provides a site 36. ...... blood cell formation. Cancellous bone contains red marrow. Long bones contain 37. ...... central cavity, called the medullary cavity. It serves 38. ...... a storage location for adipose tissue. The distal and proximal ends of bones are called epiphyses. They are covered 39. ...... articular cartilage. The shaft of the bone is called diaphysis. Between the diaphysis and the epiphyses growth zones dating 40. ...... childhood can be seen in the form of epiphyseal lines. 3.

For gaps 41-45 choose the correct alternative:

The portion of the human skull which 41. …… the brain is called cranium. There are eight cranial bones: frontal, two parietal bones, occipital, two temporal, ethmoid and sphenoid. These are 42. …… bones tightly fitted together at immovable joints. At birth, many of these joints are not completely 43. …… together. The frontal bone is 44. …… to the two parietals at the coronal suture. The occipital is joined to both of the parietals. The rest of the skull is composed of the fourteen facial bones: two nasal bone, two lacrimal, two maxillae, two zygomatic bones, the vomer, the two inferior nasal conchae, the two palatine bones, and the mandible, which is the only 45. …… bone of the skull and the only skull bone which is not joined by a suture. The vertebral column is composed of 33 individual vertebrae stacked on top of each other and resting on the hip bones. They are separated by cartilage disks which allow a certain flexibility to the spinal column. The sternum is connected to all the ribs except the lower pair. During breathing the rib cage is flexible due to cartilage. 41. 42. 43. 44. 45.

A. A. A. A. A.

encloses solo stitched fastened moveable

B. B. B. B. B.

encircles sole sutured appended flexible

C. C. C. C. C.

includes individual stuck attached portable

1

The Skeletal System 4.

Use the words in the box to complete gaps 46-55: greenstick ligaments

hipbones metacarpals socket

humerus pelvis tarsals

joint scapula

The arms and legs are part of the appendicular skeleton. The upper bones of the four limbs are single: 46. …… and femur. Below a joint both limbs have a pair of bones that connect to another 47. …… . The carpals compose the wrist joint and the 48. …… are found in the ankle joint. Each hand or foot ends in 5 digits composed of 49. …… or metatarsals. The shoulder girdles are each composed of two bones: the 50. …… and the clavicle. The scapula is triangular with a lateral socket for the humerus while the clavicle is an S-shaped bone. The humerus is joined to the pectoral girdle and is held in place by muscles and 51. …… . A dislocated shoulder occurs when the end of the humerus slips out of the 52. …… of the scapula, stretching ligaments and muscles. The pelvic girdle consists of two 53. …… that form a hollow cavity, called the 54. …… . The vertebral column attaches to the top of the pelvis while the femur of each leg attaches to the bottom. However strong they are, bones can break. A break in a bone is called fracture. Fractures can be of different types depending on their nature. A compound or open fracture means that the skin is broken. If the skin is intact, the fracture is termed simple or closed. If the bone breaks on only one side, the fracture is called 55. .......

...... firmly to the humerus. The radius, however, contributes more 70. ...... the movement of the wrist and hand 71. ...... the ulna. The top of each bone connects to the humerus of the arm and the bottom of each connects to the bones of the 72. ...... . The hand consists of three parts (the wrist, palm, and five fingers) and twenty-seven bones. The wrist, or carpus, consists of 8 small bones called the 73. ...... bones that are tightly bound 74. ...... ligaments. These bones are arranged in two rows of four bones 75. ...... . The top row (the row closest to the forearm) from the lateral (thumb) side to the medial side contains the scaphoid, lunate, triquetral, and pisiform bones. The second row from lateral to medial contains the trapezium, trapezoid, capitate, and hamate. The scaphoid and lunate connect to the bottom of the radius. The palm 76. ...... metacarpus consists of five metacarpal bones, one aligned 77. ...... each of the fingers. The metacarpal bones have no names, they are numbered I to V starting with the thumb. The bases of the metacarpal bones are connected to the wrist bones and the heads are connected to the bones of the fingers. The heads of the metacarpals form the knuckles of a clenched 78. ...... . The fingers are made up 79. ...... 14 bones called phalanges. They are arranged in three rows. The first row (the closest to the metacarpals) is called the proximal row, the second row is the middle row, and the farthest row is called the distal row. Each finger has a proximal phalanx, a middle phalanx, and a distal phalanx, 80. ...... the thumb (also called the pollex) which does not have a middle phalanx. The digits are also numbered I to V starting from the thumb. 6.

5.

For gaps 56-80 use ONE word per gap:

The arm, 56. ...... brachium, is the region between the shoulder 57. ...... the elbow. In fact, it consists 58. ...... a single long bone 59. ...... the humerus, which is the longest bone in the 60. ...... extremity. The top, or head, is large, smooth, and rounded and fits into the scapula 61. ...... the shoulder. On the bottom of the humerus 62. ...... are two depressions where the humerus connects to the ulna and radius of the forearm. The radius is connected on the side away from the body and the ulna is connected on the side towards the body 63. ...... standing in the anatomical position. Together, the humerus and the ulna make 64. ...... the elbow. The bottom of the humerus protects the ulnar nerve and is commonly known 65. ...... the “funny bone” because striking the elbow on a hard surface stimulates the ulnar nerve and produces a tingling sensation. The forearm is the region 66. ...... the elbow and the wrist. It is formed 67. ...... the radius on the lateral side and the ulna on the medial side when the forearm is viewed in the 68. ...... position. The ulna is longer than the radius and connected 69.

For gaps 81-90 make a new word from the one in brackets:

The thigh is the region between the hip and the knee and is composed of a single bone called the femur or 81. ...... (THIGH). The femur is the longest and 82. ...... (LARGE) bone in the body. Along with the temporal bone of the skull, it is one of the two strongest bones. It is 83. ...... (COMPARE) in hardness to concrete. The average adult male femur is about 50 centimetres in 84. ...... (LONG) and over 2 centimetres in diameter. It is so strong that it can support up to 30 times the 85. ...... (WEIGH) of an adult. It forms part of the hip joint (at the acetabulum) and part of the knee joint, which is located above. The shaft of femur has a 86. ...... (CYLINDER) shape with a rough line on the posterior surface. Although in common language, people call leg the entire part of the body extending from the hip to the ankle, the leg is 87. ...... (TECHNIQUE) only the region of the lower limb between the knee and the ankle. It is formed by the fibula on the side away from the body and the tibia, also called the shinbone, on the side nearest the body. The tibia connects to the femur to form the knee joint and with the talus to allow the ankle to flex and extend. The tibia is larger than the fibula because it bears most of the weight, while the fibula serves as an area for muscle 88. ...... (ATTACH). 2

The Skeletal System The tibia is in fact the strongest weight bearing bone in the body. It is 89. ...... (PRISM) in form, expanded above, where it enters into the knee-joint, contracted in the lower third, and again 90. ...... (LARGE) but to a lesser extent towards the ankle joint. 7.

For gaps 91-100 use ONE word:

The foot is made up of 91. ...... 26 bones of the ankle, instep, and the five toes. The ankle, or tarsus, is composed of the 7 tarsal bones which correspond 92. ...... the carpals in the wrist. The largest tarsal bone is called the calcaneus or heel bone. The talus rests on top of the calcaneus and is connected to the tibia. Directly 93. ...... front of the talus is the navicular bone. The remaining bones 94. ...... medial to lateral are the medial, intermediate, the lateral cuneiform bones, and the cuboid bone. The metatarsal and phalanges of the foot are similar in number and position 95. ...... the metacarpal and phalanges bones of the hand. The five metatarsal bones are numbered I to V starting on the medial side with the 96. ...... toe. The first metatarsal bone is larger than the others because it 97. ...... a major role in supporting the body’s weight. The foot’s two arches are formed by the structure and arrangement of the bones and are maintained by tendons and ligaments. They may fall due to a weakening of the ligaments and tendons in the foot. The patella or kneecap is a large, triangular sesamoid bone between the femur and the tibia. It is formed in response 98. ...... the strain in the tendon that forms the knee. The patella protects the knee joint and strengthens the tendon 99. ...... forms the knee. The bones of the lower extremities are the heaviest, largest, and strongest bones in the body because they must bear the entire weight of the body when a person is 100. ...... in the upright position. 8.

are more 108. ...... to be dislocated again. Wearing protective 109. ...... during sports may help prevent dislocations. A sprain is a stretched or torn ligament, the tissues that connects bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are fairly 110. ...... . Symptoms include pain, 111. ...... , bruising and being unable to 112. ...... the joint. When the injury happens, a pop or tear might be felt. A strain is a stretched or torn muscle or tendon. Tendons are the tissues that connect muscle to bone. A strain is caused by a twisting or pulling of these tissues. Strains can happen suddenly or 113. ...... over time. Some of the symptoms include pain, muscle 114. ...... , swelling and trouble moving the muscle. The first stage in treating sprains or strains usually involves resting the injured area, icing it, wearing a bandage to 115. ...... the area, and medicines. Later on, the treatment might include exercise and physical therapy. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. 111. 112. 113. 114. 115.

A. A. A. A. A. A. A. A. A. A. A. A. A. A. A.

oblige derivation immobile clearly hunted severity truthfully liable device standard puffiness move grow ripples compress

B. B. B. B. B. B. B. B. B. B. B. B. B. B. B.

force origin stationary visibly wanted harshness accurately likely gear regular bump shift expand shudders squeeze

C. C. C. C. C. C. C. C. C. C. C. C. C. C. C.

compel root motionless apparently sought strictness suitably expected objects common bulge stir develop contractions condense

D. D. D. D. D. D. D. D. D. D. D. D. D. D. D.

induce cause frozen plainly desired austerity properly apt kit universal swelling swing enlarge spasms squash

For gaps 101-115 choose the correct variant, A, B, C or D:

Dislocations are joint injuries that 101. ...... the ends of the bones out of position. The 102. ...... is often a fall or a blow, sometimes from playing sports. When a dislocation occurs, the joint becomes 103. ...... . Ankles, knees, shoulders, hips and elbows can be dislocated along with finger and toe joints. Dislocated joints are often swollen, very painful and 104. ...... out of place. In case of a dislocated joint, medical attention should be 105. ...... . Treatment depends on which joint is dislocated and the 106. ...... of the injury. It might include manipulations to reposition the bones, medicine, a splint or sling, and rehabilitation. When 107. ...... repositioned, a joint will usually function and move normally again in a few weeks. Once a shoulder or kneecap has been dislocated, they 3

The Skeletal System 9.

For gaps 116-120 choose the correct ending from A-H. There are three extra ones that do not need to be used:

Osteoporosis is a condition characterised by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone 116. ...... . This disorder of the skeleton weakens the bone and results in frequent fractures in the bones. If it is not prevented or is left untreated, osteoporosis can progress painlessly until a bone breaks. Fractures occur typically in the hip, spine, and wrist but they can occur in almost any skeletal bone. The strength of a normal bone is given by its composition of protein, collagen, and calcium. Bones that are affected by osteoporosis can fracture with relatively minor injury 117. ...... . The fracture can be either in the form of cracking or collapsing. Osteoporosis can be present without any symptoms for years because it does not cause symptoms until a bone breaks. Moreover, some osteoporotic fractures may escape detection since they do not cause symptoms. Thus, patients may not be aware of their disease until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain, the location of which depends on the location of the fracture. Fractures of the spine can cause severe pain 118. …… . Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height or curving of the spine due to collapse of the vertebrae. The collapse gives people a hunched-back appearance of the upper back. As a result of a fall hip fractures typically occur. With osteoporosis, hip fractures can occur as a result of accidents 119. …… . Hip fractures also may heal slowly or poorly after surgical repair because of poor healing of the bone. Elderly patients can develop pneumonia and blood clots in the leg veins 120. …… . A. B. C. D. E. F. G. H.

which can travel to the lungs due to prolonged bed rest after the hip fracture which is compressible, like a sponge which is constantly being replaced and remodelled which is not what the patient would expect which is the main cause that leads to osteoporosis which normally would not cause a bone to fracture which radiates from the back to the sides of the body which would be insignificant under different circumstances

10. The italicised words 121-130 have been swapped around. Use them in their correct position:

Bone cancer is caused by a 121. growth with the cells that make bone. It may originate in the bones or spread there from another 122. surgery of the body. Only about one percent of cancer 123. symptoms is bone cancer. Bone tumours occur most commonly in 124. cases and adolescents and are less common in older adults. It usually occurs in people under the age of twenty. Cancer involving the bone in older adults is most commonly the 125. ache of metastatic spread from another tumour. The 126. children of bone cancer are a localised swelling and a dull 127. part. Because it has such symptoms, bone cancer is often mistaken for a 128. problem and is overlooked. Since the symptoms are so easily misinterpreted, the disease is many times not diagnosed until after metastasis has occurred. Prompt 129. result, radiation, or chemotherapy treatment usually leads to complete recovery. The most common primary malignant bone cancer is osteosarcoma. It most commonly affects males between the ages of 10 and 25. It often occurs in the long bones of the arms and legs at areas of rapid 130. bruise around the knees and shoulders of children. This type of cancer is often very aggressive with risk of spread to the lungs. Unfortunately, its five-year survival rate is only about 65%. 11. For gaps 131-150 make a new word from the one in brackets: Rickets is a 131. ...... (SOFT) of the bones in children potentially leading to fractures and 132. ...... (DEFORM). Rickets is a 133. ...... (NUTRITION) disorder among the most frequent 134. ...... (CHILD) diseases in many developing countries. The predominant cause is a vitamin D 135. ...... (DEFICIENT), but lack of adequate calcium in the diet may also lead to rickets. Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or 136. ...... (STARVE) during the early stages of childhood. It is characterised by the improper 137. ...... (HARD) or development of bones. It often leaves children with bowed legs, swollen joints, muscle pain, a curved spine, or a swollen skull due to 138. ...... (SOFT) bones. Preventing rickets is easily accomplished through vitamin D supplements and moderate exercise. Treatment includes diet 139. ...... (MODIFY), exercise, and 140. ...... (AVOID) of excessive sleep. 141. ...... (DWARF) refers to a condition characterised by extremely small size. In older popular and medical usage, any type of marked human 142. ...... (SMALL) could also be termed dwarfism. The term is often used to refer 143. ...... (SPECIFIC) to those forms of extreme shortness characterised by disproportion of body parts, typically due to an 144. ...... (INHERIT) disorder in bone or cartilage development. Most dwarfism-related conditions are genetic disorders, but the causes of some disorders are unknown. Most 145. ...... (OCCUR) of dwarfism result from a 4

The Skeletal System random genetic mutation in either the father’s sperm or the mother’s egg rather than being in one of the parent’s complete genetic makeup. Unusually short stature for a child’s age is usually what brings the child to medical attention. Skeletal dysplasia (dwarfism) is usually suspected because of obvious physical features (e.g., unusual configuration of face or shape of skull), because of an obviously affected parent, or because the body indicates 146. ...... (PROPORTION). Bone x-rays are often the key to diagnosis of a specific skeletal dysplasia. Most dwarfism treatments will not increase stature but may alleviate problems caused by complications. There are several 147. ...... (SURGERY) procedures that may correct problems with bones in people with 148. ...... (PROPORTION) dwarfism. A surgeon may insert metal staples into the ends of long bones where growth occurs in order to correct the direction in which bones are growing. Another procedure is the 149. ...... (DIVIDE) of a limb bone, 150. ...... (STRAIGHT) it and inserting metal plates to hold it in place. Apart from these, rods or staples may be inserted to help correct the shape of the spine or the size of the opening in bones of the spine may be increased to alleviate pressure on the spinal cord. 12. For gaps 151-165 use the words from the box. There are five words that will not be needed: appearance cushion inflammation organs susceptibility

base degeneration invaders period syndrome

blood ear movement prevalence trauma

cartilage factors muscles surfaces wearing

Osteoarthritis, also known as degenerative arthritis, degenerative joint disease, is a clinical 151. ...... in which low-grade inflammation results in pain in the joints, caused by abnormal 152. ...... of the cartilage that covers and acts as a 153. ...... inside joints and destruction or decrease of the synovial fluid that lubricates those joints. As the bone 154. ...... become less well protected by cartilage, the patient experiences pain upon weight bearing, including walking and standing. Due to decreased 155. ...... because of the pain, regional 156. ...... may atrophy, and ligaments may become more lax. Although it commonly arises from 157. ...... , osteoarthritis often affects multiple members of the same family, suggesting that there is hereditary 158. ...... to this condition. A number of studies have shown that there is a greater 159. ...... of the disease between siblings and especially identical twins, indicating a hereditary basis. Over half of osteoarthritis cases are thought to result from genetic 160. ...... . There is some evidence that allergies, whether fungal, infectious or systemically induced, may be a significant contributing factor to the 161. ...... of osteoarthritis in a synovial sac.

In osteoarthritis, the joint 162. ...... breaks down. Cartilage exists within the incudomalleolar and incudostapedial joints. In addition, the cartilage-covered 163. ...... of the stapes footplate is bound to the cartilage-covered rim of the oval window by the annular ligament. Thus, higher prevalence of middle 164. ...... abnormalities and hearing loss can be expected in osteoarthritis due to 165. ...... of the cartilage and the subsequent abnormal repair response. Osteoarthritis and hearing loss are considered among the top chronic health concerns in older individuals. 13. From the word given in capitals make a new one for gaps 176-190: Bursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body. The bursae rest at the points where internal 176. ...... (FUNCTION), such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost 177. ...... (FRICTION) functional gliding surface making normal movement 178. ...... (PAIN). When bursitis occurs, however, movement relying upon the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, 179. ...... (PERPETUATE) the problem. Bursitis is commonly caused by 180. ...... (REPEAT) movement and excessive pressure. Elbows and knees are the most commonly affected. Inflammation of the bursae might also cause other inflammatory conditions such as 181. ...... (RHEUMATISM) arthritis. Although 182. ...... (FREQUENT), scoliosis might cause bursitis of the shoulders, however, shoulder bursitis is more commonly caused by overuse of the shoulder joint and related muscles. 183. ...... (TRAUMA) injury is another cause of bursitis. The inflammation irritates because the bursa no longer fits in the original small area between the bone and the functionary muscle or tendon. Bursitis results when the bone increases pressure upon the bursa. Bursitis symptoms vary from local joint pain and 184. ...... (STIFF), to burning pain that surrounds the joint around the inflamed bursa. In this condition, the pain usually is worse during and after activity, and then the bursa and the surrounding joint become stiff. The treatment of any form of bursitis depends on whether or not it involves infection. Bursitis that is not infected (from injury or underlying rheumatic disease) can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires 185. ...... (ASPIRE) of the bursa fluid. This procedure involves 186. ...... (REMOVE) of the fluid with a needle and syringe under sterile conditions. Non-infectious bursitis can also be treated with a cortisone 187. ...... (INJECT) into the swollen bursa. This is sometimes done at the same time as the aspiration procedure and typically rapidly reduces the inflammation of the swollen bursa. Infectious bursitis requires even further 188. ...... (EVALUATE) and aggressive treatment. The bursal fluid can be examined in the laboratory to identify the microbes causing the infection. Septic bursitis requires antibiotic therapy, sometimes 189. ...... 5

The Skeletal System (VEIN). Repeated aspiration of the infected fluid may be required. Surgical drainage and removal of the infected bursa sac, called 190. ...... (BURSA), may also be necessary. Generally, the adjacent joint functions normally after the surgical wound heals. 14. Choose the best ending A-J for gaps 166-175: Rheumatoid arthritis is an autoimmune disease 166. ...... . It can also cause inflammation of the tissue around the joints, as well as in other organs in the body. The immune system contains a complex organisation of cells and antibodies designed normally 167. ...... . Patients with autoimmune diseases have antibodies in their blood 168. ...... . Because it can affect multiple other organs of the body, rheumatoid arthritis is referred 169. ...... . While rheumatoid arthritis is a chronic illness, it can last for years, patients may experience long periods without symptoms. However, rheumatoid arthritis is typically a progressive illness that has the potential 170...... . Gout, also called metabolic arthritis is a disease created by a build-up of uric acid. In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due 171. ...... . This provokes an inflammatory reaction of these tissues. Gout is caused by too much uric acid in the blood. Hyperuricemia usually does no harm, and most people with high levels of uric acid in the blood never develop gout. The exact cause of hyperuricemia sometimes goes undiscovered 172. ...... . When uric acid levels in the blood are too high, uric acid may form crystals that accumulate in the joints. Gout is characterised by excruciating, sudden, unexpected, burning pain, as well as swelling, redness, warmth, and stiffness in the affected joint. Low-grade fever may also be present. The patient usually suffers from two sources of pain. The crystals inside the joint cause intense pain whenever the affected area is moved. The inflammation of the tissues around the joint also causes the skin 173. ...... . Gout usually attacks the big toe 174. ...... . In some cases, the condition may appear in the joints of small toes that have become immobile due 175. ...... . The first line of treatment should be pain relief. Once the diagnosis has been confirmed, the drugs of choice are indomethacin, other nonsteroidal anti-inflammatory drugs (NSAIDs), oral glucocorticoids, or intraarticular glucocorticoids administered via a joint injection. A. although inherited factors seem to play a role B. although it can also affect other joints such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine C. that causes chronic inflammation of the joints D. that target their own body tissues, where they can be associated with inflammation E. to as a systemic illness and is sometimes called rheumatoid disease

F. G. H. I. J.

to be swollen, tender and sore if it is even slightly touched to cause joint destruction and functional disability to destroy invaders of the body, particularly infections to elevated concentrations of uric acid in the bloodstream to impact injury earlier in life, causing poor blood circulation that leads to gout

15. Choose the best alternative for gaps 191-200: Osteomyelitis is an infection of bone or bone marrow, usually caused by pyogenic bacteria or mycobacteria. It can be usefully 191. ...... on the basis of the causative organism, the route, duration and anatomic location of the infection. Staphylococcus aureus is the 192. ...... most commonly isolated from all forms of osteomyelitis. Signs and symptoms of osteomyelitis depend on whether the 193. ...... is acute, lasting several months or less, or chronic, lasting several months to years. Signs and symptoms of acute osteomyelitis include: fever that may be 194. ...... , irritability or lethargy in young children, pain in the area of the infection, 195. ...... , warmth and redness over the area of the infection. Numerous abscesses in the bone show as radiolucency. The process of diagnosing a spinal infection usually starts with an x-ray. X-rays will usually be 196. ...... in the first 2 to 4 weeks after the infection starts. For changes to show up on an x-ray, 50% to 60% of the bone in the vertebral body needs to be 197. ...... . If the disc space is involved (discitis), the disc space may narrow and destruction of the endplates around the disc may be seen on the x-ray. Osteomyelitis often requires 198. ...... antibiotic therapy, with a course lasting a matter of weeks or months. Osteomyelitis also may require surgical debridement. Severe cases may lead to the loss of a 199. ...... . Initial first line antibiotic 200. ...... is determined by the patient’s history and regional differences in common infective organisms. 191. 192. 193. 194. 195. 196. 197. 198. 199. 200.

A. A. A. A. A. A. A. A. A. A.

sorted organism circumstance hasty lump normal destroyed lengthened branch variety

B. B. B. B. B. B. B. B. B. B.

subclassified being incident abrupt growth average damaged delayed limb choice

C. C. C. C. C. C. C. C. C. C.

graded creature condition rushed swelling ordinary ruined prolonged bough diversity 6