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

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 bodys weight.
The foots 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 fathers sperm or the mothers egg rather than
being in one of the parents complete genetic makeup. Unusually short stature for a
childs 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 patients 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