Hi
mlwjackson! I'll try to further clarify this for you, as I'm not sure what Neil means by "USB stand-offs".
The PCI card will allow USB2.0 speeds on your computer. The "internal" ports can be connected to the ports on the external front of your case. You will need to move the correct cable from the motherboard to the new PCI card for this. Your computer's manual should identify which is the correct cable.
This should leave you with a total of 6x USB2.0 ports - four on the back of the card you install, and (hopefully - if you wire it right) two on the front of your machine. Or a local computer shop should be able to install it for a small fee.