Anatomy & Physiology ch 8
Anatomy & Physiology ch 8 Biol 2301
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Human Anatomy & Physiology, 8e (Marieb/Hoehn) Chapter 8 Joints Matching Questions Figure 8.1 Using Figure 8.1, match the following: 1) Periosteum. Answer: A Diff: 2 Page Ref: 251; Fig. 8.3 2) Articular cartilage. Answer: C Diff: 2 Page Ref: 251; Fig. 8.3 3) Joint (synovial) cavity. Answer: B Diff: 2 Page Ref: 251; Fig. 8.3 4) Synovial membrane. Answer: E Diff: 2 Page Ref: 251; Fig. 8.3 1 Copyright © 2010 Pearson Education, Inc. 5) Fibrous capsule. Answer: D Diff: 2 Page Ref: 251; Fig. 8.3 Figure 8.2 Using Figure 8.2, what type of axis does each joint have? A. Nonaxial B. Uniaxial C. Biaxial D. Multiaxial 6) Joint 1. Answer: D Diff: 2 Page Ref: 259; Fig. 8.7 7) Joint 2. Answer: B Diff: 2 Page Ref: 259; Fig. 8.7 2 Copyright © 2010 Pearson Education, Inc. 8) Joint 3. Answer: B Diff: 2 Page Ref: 259; Fig. 8.7 9) Joint 4. Answer: A Diff: 2 Page Ref: 259; Fig. 8.7 10) Joint 5. Answer: C Diff: 2 Page Ref: 259; Fig. 8.7 11) Joint 6. Answer: C Diff: 2 Page Ref: 259; Fig. 8.7 Figure 8.3 Using Figure 8.3, identify each type of synovial joint by name. 12) Joint 1. Answer: ball and socket Diff: 1 Page Ref: 259; Fig. 8.7 3 Copyright © 2010 Pearson Education, Inc. 13) Joint 2. Answer: pivot joint Diff: 1 Page Ref: 259; Fig. 8.7 14) Joint 3. Answer: hinge joint Diff: 1 Page Ref: 259; Fig. 8.7 15) Joint 4. Answer: plane joint Diff: 1 Page Ref: 259; Fig. 8.7 16) Joint 5. Answer: saddle joint Diff: 1 Page Ref: 259; Fig. 8.7 17) Joint 6. Answer: condyloid joint Diff: 1 Page Ref: 259; Fig. 8.7 True/False Questions 1) The amount of movement permitted by a particular joint is the basis for the functional classification of joints. Answer: TRUE Diff: 1 Page Ref: 249 2) All joints permit some degree of movement, even if very slight. Answer: FALSE Diff: 1 Page Ref: 249 3) Hinge joints permit movement in only two planes. Answer: FALSE Diff: 2 Page Ref: 259 4) Synovial fluid is a viscous material that is derived by filtration from blood. Answer: TRUE Diff: 1 Page Ref: 252 5) The articular surfaces of synovial joints play a minimal role in joint stability. Answer: TRUE Diff: 2 Page Ref: 252 4 Copyright © 2010 Pearson Education, Inc. 6) The major role of ligaments at synovial joints is to help direct movement and restrict undesirable movement. Answer: TRUE Diff: 2 Page Ref: 253 7) The only movement allowed between the first two cervical vertebrae is flexion. Answer: FALSE Diff: 2 Page Ref: 256 8) Movement at the hip joint does not have as wide a range of motion as at the shoulder joint. Answer: TRUE Diff: 1 Page Ref: 266 9) A person who has been diagnosed with a sprained ankle has an injury to the ligaments that attach to that joint. Answer: TRUE Diff: 1 Page Ref: 270 10) A movement of the forearm in which the palm of the hand is turned from posterior to anterior is supination. Answer: TRUE Diff: 1 Page Ref: 256 11) The wrist joint can exhibit adduction and eversion movements. Answer: FALSE Diff: 2 Page Ref: 256, 259 12) Cruciate ligaments are important ligaments that stabilize all ballandsocket joints. Answer: FALSE Diff: 2 Page Ref: 263 13) Flexion of the ankle so that the superior aspect of the foot approaches the shin is called dorsiflexion. Answer: TRUE Diff: 1 Page Ref: 259 14) The gripping of the trochlea by the trochlear notch constitutes the "hinge" for the elbow joint. Answer: TRUE Diff: 1 Page Ref: 266 15) The ligamentum teres represents a very important stabilizing ligament for the hip joint. Answer: FALSE Diff: 2 Page Ref: 267 16) The structural classification of joints is based on the composition of the binding material and 5 Copyright © 2010 Pearson Education, Inc. the presence or absence of a joint cavity. Answer: TRUE Diff: 2 Page Ref: 249 17) Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or other debris. Answer: TRUE Diff: 2 Page Ref: 252 6 Copyright © 2010 Pearson Education, Inc. 18) A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the synovial fluids. Answer: FALSE Diff: 2 Page Ref: 270271 19) A ballandsocket joint is a multiaxial joint. Answer: TRUE Diff: 2 Page Ref: 259 20) Bending of the tip of the finger exhibits flexion. Answer: TRUE Diff: 2 Page Ref: 255 21) Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles ending up in the infratemporal fossa. Answer: FALSE Diff: 2 Page Ref: 268269 22) Symphyses are synarthrotic joints designed for strength with flexibility. Answer: FALSE Diff: 2 Page Ref: 251 MultipleChoice Questions 1) A fibrous joint that is a peginsocket is called a ________ joint. A) syndesmosis B) suture C) synchondrosis D) gomphosis Answer: D Diff: 2 Page Ref: 250 2) The cruciate ligaments of the knee ________. A) tend to run parallel to one another B) are also called collateral ligaments C) prevent hyperextension of the knee D) assist in defining the range of motion of the leg Answer: C Diff: 2 Page Ref: 263264 3) Articular cartilage found at the ends of the long bones serves to ________. A) attach tendons B) produce red blood cells (hemopoiesis) C) provide a smooth surface at the ends of synovial joints D) form the synovial membrane 7 Copyright © 2010 Pearson Education, Inc. Answer: C Diff: 1 Page Ref: 251 4) A joint united by dense fibrocartilaginous tissue that usually permits a slight degree of movement is a ________. A) suture B) syndesmosis C) symphysis D) gomphosis Answer: C Diff: 1 Page Ref: 251 5) On the basis of structural classification, which joint is fibrous connective tissue? A) symphysis B) synchondrosis C) pivot D) syndesmosis Answer: D Diff: 1 Page Ref: 249250 6) Connective tissue sacs lined with synovial membranes that act as cushions in places where friction develops are called ________. A) menisci B) bursae C) ligaments D) tendons Answer: B Diff: 1 Page Ref: 252 7) Articulations permitting only slight degrees of movement are ________. A) amphiarthroses B) synarthroses C) diarthroses D) synovial joints Answer: A Diff: 1 Page Ref: 249 8) ________ are cartilaginous joints. A) Syndesmoses B) Sutures C) Synchondroses D) Gomphoses Answer: C Diff: 1 Page Ref: 250251 8 Copyright © 2010 Pearson Education, Inc. 9) The gliding motion of the wrist is accomplished because of the ________ joint. A) hinge B) plane C) pivot D) condyloid Answer: B Diff: 2 Page Ref: 259 10) The ligaments that protect the alignment of the femoral and tibial condyles and limit the movement of the femur anteriorly and posteriorly are called ________. A) cruciate ligaments B) patellar ligaments C) anterior ligaments D) tibial collateral ligaments Answer: A Diff: 1 Page Ref: 263264 11) Bending your head back until it hurts is an example of ________. A) flexion B) extension C) hyperextension D) circumduction Answer: C Diff: 1 Page Ref: 255 12) In the classification of joints, which of the following is true? A) Immovable joints are called amphiarthroses. B) All synovial joints are freely movable. C) Synarthrotic joints are slightly movable. D) In cartilaginous joints, a joint cavity is present. Answer: B Diff: 1 Page Ref: 249, 251 13) Synarthrotic joints ________. A) are found at the junction of the epiphysis and diaphysis of growing bone B) are cartilaginous joints C) permit essentially no movement D) have large joint cavities Answer: C Diff: 2 Page Ref: 249 9 Copyright © 2010 Pearson Education, Inc. 14) Fibrous joints are classified as ________. A) pivot, hinge, and ball and socket B) symphysis, sacroiliac, and articular C) hinge, saddle, and ellipsoidal D) sutures, syndesmoses, and gomphoses Answer: D Diff: 1 Page Ref: 249250 15) In symphysis joints the articular surfaces of the bones are covered with ________. A) hyaline cartilage B) synovial membranes C) fibrocartilage D) tendon sheaths Answer: A Diff: 1 Page Ref: 251 16) Synovial fluid is present in joint cavities of freely movable joints. Which of the following statements is true about this fluid? A) It contains enzymes only. B) It contains lactic acid. C) It contains hyaluronic acid. D) It contains hydrochloric acid. Answer: C Diff: 1 Page Ref: 251 17) Which of the following statements defines synchondroses? A) amphiarthrotic joints designed for strength and flexibility B) interphalangeal joints C) joints that permit angular movements D) cartilaginous joints where hyaline cartilage unites the ends of bones Answer: D Diff: 1 Page Ref: 250251 18) What are menisci? A) cavities lined with cartilage B) small sacs containing synovial fluid C) semilunar cartilage pads D) tendon sheaths Answer: C Diff: 2 Page Ref: 252 19) Which of the following is a true statement regarding gliding movements? A) Gliding movements occur at the intercarpal and intertarsal joints. B) Gliding movements allow flexibility of the upper limbs. C) Gliding movements are multiaxial. 10 Copyright © 2010 Pearson Education, Inc. D) An example of a gliding movement is nodding one's head. Answer: A Diff: 1 Page Ref: 255 20) What is moving a limb away from the median plane of the body along the frontal plane called? A) abduction B) adduction C) inversion D) dorsiflexion Answer: A Diff: 1 Page Ref: 256 21) The terms inversion and eversion pertain only to the ________. A) hands B) feet C) arms D) hands and the feet Answer: B Diff: 1 Page Ref: 259 22) The hip joint is a good example of a(n) ________ synovial joint. A) nonaxial B) uniaxial C) biaxial D) multiaxial Answer: D Diff: 1 Page Ref: 259; Tbl. 8.2 23) Movement allowed in a pivot joint is known as ________. A) biaxial movement B) flexion C) uniaxial rotation D) extension Answer: C Diff: 1 Page Ref: 259 24) Compared to the shoulder, displacements of the hip joints are ________. A) common due to the weight bearing the hip endures B) rare because of the ligament reinforcement C) common in all people who are overweight D) rare because the rotator cuff stabilizes the hip joint Answer: B Diff: 2 Page Ref: 263266 11 Copyright © 2010 Pearson Education, Inc. 25) Which ligament holds the radius to the ulna at the proximal end? A) anular B) ulnar collateral C) radial collateral D) iliofemoral Answer: A Diff: 1 Page Ref: 266 26) Which ligament of the knee initiates the kneejerk reflex when tapped? A) the patellar ligament B) the medial patellar retinacula C) the lateral patellar retinacula D) the extracapsular ligament Answer: A Diff: 1 Page Ref: 263 27) Football players often sustain lateral blows to the extended knee. Which of the ligaments is (are) damaged as a result? A) oblique popliteal and extracapsular ligament B) suprapatellar C) arcuate popliteal and the posterior cruciate D) medial collateral, medial meniscus, and anterior cruciate Answer: D Diff: 1 Page Ref: 264 28) Which of the following conditions is generally considered a noninflammatory type of arthritis? A) bursitis B) tendonitis C) osteoarthritis D) rheumatoid arthritis Answer: C Diff: 1 Page Ref: 270 29) What can cause gouty arthritis? A) excessive blood levels of uric acid deposited as crystals in the soft tissue joints B) a disorder in the body's immune system resulting in destruction of joints C) a thickening of the synovial membrane and a decrease in fluid production D) a bacterial infection in the bursae Answer: A Diff: 1 Page Ref: 271 12 Copyright © 2010 Pearson Education, Inc. 30) Pointing the toes is an example of ________. A) circumduction B) plantar flexion C) pronation D) protraction Answer: B Diff: 1 Page Ref: 259 31) Which of the following is a true statement? A) The head of the humerus articulates with the acromion process. B) The greater tubercle of the humerus articulates at the coracoid process of the scapula. C) The rotator cuff is responsible for the flexible extensions at the elbow joint. D) The anular ligament surrounds the head of the radius. Answer: D Diff: 2 Page Ref: 266 32) Multiaxial joints of the body include ________. A) the knee and elbow B) the ankle and wrist C) the hip and shoulder D) intercarpal and intertarsal joints Answer: C Diff: 2 Page Ref: 253; Tbl. 8.2 33) Presence of a synovial cavity, articular cartilage, synovial membrane, and ligaments are characteristics of what type of joint? A) suture B) synchondrosis C) symphysis D) hinge joint Answer: D Diff: 2 Page Ref: 251252, 259 34) Extracapsular ligaments stabilizing the knee include ________. A) the patellar ligament extending from femur to patella B) lateral and medial collateral ligaments preventing lateral or medial angular movements C) cruciate ligaments, which help secure the articulating bones together D) the oblique popliteal crossing the knee anteriorly Answer: B Diff: 2 Page Ref: 263264 13 Copyright © 2010 Pearson Education, Inc. 35) Which of the following is a correct statement about development of joints? A) Joints develop in parallel with bones. B) By the end of the fourth week, fetal synovial joints resemble adult joints. C) All fibrous joints are in the adult form by the time of birth. D) Joints develop independent of bone growth. Answer: A Diff: 2 Page Ref: 272 36) An example of an interosseus fibrous joint is ________. A) the clavicle and the scapula at the distal ends B) the radius and ulna along its length C) between the vertebrae D) between the humerus and the glenoid cavity Answer: B Diff: 2 Page Ref: 249250 37) Which of the following statements best describes angular movements? A) They allow movement only in one plane. B) They allow movement in several planes. C) They occur only between bones with flat articular processes. D) They change (increase or decrease) the angle between two bones. Answer: D Diff: 2 Page Ref: 255 38) Saddle joints have concave and convex surfaces. Name the two bones of the hand that articulate to form a saddle joint. A) The scaphoid of the index finger and the triquetrum of the middle finger. B) The trapezium of the ring finger and the capitate of the fourth finger. C) The scaphoid of the middle finger and lunate of the index finger. D) The trapezium of the carpal bone and the thumb's metacarpal. Answer: D Diff: 2 Page Ref: 259 39) Tendon sheaths ________. A) act as frictionreducing structures B) are lined with dense irregular connective tissue C) form channels for tendons D) help anchor the tendon to the muscle Answer: A Diff: 2 Page Ref: 252 14 Copyright © 2010 Pearson Education, Inc. 40) Which of the following is not a part of the synovial joint? A) joint cavity B) tendon sheath C) articular cartilage D) articular capsule Answer: B Diff: 1 Page Ref: 251252 41) Which of the following is not a factor that contributes to keeping the articular surfaces of diarthroses in contact? A) structure and shape of the articulating bone B) arrangement and tension of the muscles C) strength and tension of joint ligaments D) number of bones in the joint Answer: D Diff: 2 Page Ref: 252253 FillintheBlank/Short Answer Questions 1) Turning the foot medially at the ankle would be called ________. Answer: inversion Diff: 1 Page Ref: 259 2) Moving your jaw forward, causing an underbite, is called ________. Answer: protraction Diff: 1 Page Ref: 259 3) A ________ is a fluidfilled sac a tendon slides over. Answer: bursa Diff: 1 Page Ref: 252 4) The joint between the frontal and parietal bones is called a ________ joint. Answer: suture Diff: 1 Page Ref: 249 5) Why are epiphyseal plates considered temporary joints? Answer: Once long bone growth in length is complete, the cartilage of the epiphyseal plates ossifies to become a permanent synostosis. Diff: 2 Page Ref: 250251 6) Using the functional classification, a freely movable joint would be called a ________ joint. Answer: diarthrosis Diff: 1 Page Ref: 249 7) The hip joint, like the shoulder joint, is a ________ joint. 15 Copyright © 2010 Pearson Education, Inc. Answer: ballandsocket Diff: 1 Page Ref: 259 8) Partial dislocation of a joint is called a ________. Answer: subluxation Diff: 2 Page Ref: 270 9) The type of joint between the carpal and the first metacarpal is a ________ joint. Answer: saddle Diff: 2 Page Ref: 259 10) Synovial joints have five major features. What are they? Answer: articular cartilage, a joint cavity, an articular capsule, synovial fluid, and reinforcing ligaments Diff: 2 Page Ref: 251252 11) Often people who exercise prudently seem to have fewer bouts with osteoarthritis. Will exercise prevent arthritis? If so, how? Answer: Exercise does not prevent arthritis, but it strengthens muscles that in turn support and stabilize joints. Diff: 2 Page Ref: 272 12) For each of the following movements, indicate the specific kind of joint involved (e.g., hinge, etc.) and the movement performed (e.g., extension, etc.). a. Bending the elbow: ________, ________. b. Turning head side to side: ________, ________. c. Lowering your arm to your side: ________, ________. d. Turning the sole of foot medially: ________, ________. Answer: a. hinge, flexion b. pivot, rotation c. ball and socket, adduction d. plane, inversion Diff: 2 Page Ref: 255259 13) While the fingers can exhibit flexion and extension and other angular motions, the thumb has much greater freedom. Why? Answer: The thumb possesses a saddle joint where each articular surface has both a concave and a convex surface. Diff: 3 Page Ref: 259 14) Describe a typical synovial joint. Answer: The ends of each bone are covered with hyaline cartilage that is continuous with the synovial membrane enclosing the joint. Synovial fluid fills the space between the articular 16 Copyright © 2010 Pearson Education, Inc. cartilage. Outside the synovial membrane there is a very tough, fibrous capsule that prevents the synovial membrane from bulging out as pressure is applied to the ends of the bones. Diff: 2 Page Ref: 251252 17 Copyright © 2010 Pearson Education, Inc. 15) Although uric acid is a normal waste product of nucleic acid metabolism, why are so many men suffering from a condition known as gouty arthritis? How does this product that should be eliminated in the urine cause so much pain when things go wrong? Answer: Males have higher blood levels of uric acid than females. When blood levels of uric acid rise excessively, it is deposited as urate crystals in the soft tissues of joints. Sometimes gout sufferers have an excessive rate of uric acid production; or it is possible that some are unable to flush uric acid in the urine fast enough. Diff: 3 Page Ref: 271 16) After reading a medical report, you learn that a 45yearold female has the following symptoms: inflammation of synovial membranes, accumulation of synovial fluid, pain and tenderness about the joints, pannus formation, and some immobility at certain joints. On the basis of these symptoms, what would the patient probably have? Answer: Rheumatoid arthritis Diff: 3 Page Ref: 270271 17) Greg is somewhat of a "weekend athlete" who has overextended himself by pitching baseball for a local team during the week and playing golf on the weekends for several hours. He presented himself to the emergency room last week with severe shoulder pain (at the glenohumeral joint). The physician told him that the X ray was not conclusive, but he may have damage to his rotator cuff. What is the rotator cuff, and how might he have caused this damage? What remedies will the physician recommend? Answer: Greg has either stretched or torn his rotator cuff. He will be told to rest for a few months, and if the pain does not subside, surgery will be necessary. The rotator cuff is made up of four tendons that belong to the subscapularis, supraspinatus, infraspinatus, and teres minor muscles and encircle the shoulder joint. They are vulnerable to damage when the arm is circumducted vigorously. Greg is obviously overdoing his activities by pitching four baseball games per week and playing golf on weekends. Diff: 3 Page Ref: 264266 18) Many inflammations of joint areas can be treated by injections of cortisone into the area. Why don't we continually get injections rather than surgeries? Answer: A joint inflammation is always a symptom of an underlying problem such as cartilage or ligament damage, arthritis, etc. Continued injection might cause the patient to reinjure the area, or it might mask a more severe injury that may appear later. Diff: 3 Page Ref: 269270 19) Why is muscle tone the most important stabilizing factor for most joints? Answer: The shapes of the articular surfaces may hinder rather than help joint stability. Ligaments can stretch and reduce stability. Muscle tendons are kept taut at all times by the tone of their muscle. Diff: 3 Page Ref: 253 18 Copyright © 2010 Pearson Education, Inc. Clinical Questions 1) Akira, a 2.5ranked tennis player (who thought he was a 4.5 player!), experienced severe pain in his elbow joint after playing for five straight hours, well beyond his limit. He told everyone it was due to a fall while diving to retrieve a difficult shot. What do you think? Answer: It was probably tennis elbow or inflammation of the bursa close to the olecranon process because he overextended his abilities. Diff: 3 Page Ref: 270 2) Mary has been suffering from a "bad knee" for several months. She is a tennis player who often slides in to attack a ball; she is an aerobic devotee and a jogger. She visited an orthopedic surgeon last week who told her that he would "like to have a look at her knee joint." He also told her that her symptoms indicated damage to the meniscus, and it might have to be removed. What will the doctor do to see the joint, and if the meniscus is removed will Mary be able to play tennis again? Answer: The doctor will perform arthroscopic surgery on Mary in order to view the interior of the joint. If she has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability. Diff: 3 Page Ref: 262264, 269 3) Farhad begins typing his term paper on his new computer early one morning. After 8 hours of typing, he notices that his wrists are stiff and very sore. The next morning, Farhad begins to finish his paper, but soon finds his wrists hurt worse than last night. What is wrong? Answer: Farhad is suffering from tendonitis. If he continues to use the keyboard incorrectly, the tendonitis could develop into a very serious condition called carpal tunnel syndrome. Diff: 3 Page Ref: 270 4) Probenecid inhibits the active resorption of uric acid in the kidney, which leads to urinary excretion of uric acid. Explain why this drug would be useful in treating gout. Answer: Uric acid, a normal waste product of nucleic acid metabolism, is ordinarily excreted in urine without any problem. However, when blood levels of uric acid rise excessively, it may be deposited as needleshaped urate crystals in the soft tissue of joints. An inflammatory response follows, which leads to gout. Diff: 3 Page Ref: 271 5) A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For patients requiring more assistance, the nurse tells the PCAs to reach through the patient's axillae, and place their hands on the patient's scapulae during the transfer. She tells them to avoid placing hands or pressure in the axillae area. Based on your knowledge of the shoulder joint, explain why this area should be avoided. Answer: In the shoulder joint, stability has been sacrificed to provide the most freely moving joint of the body. The shoulder joint is a ballandsocket joint. Shoulder dislocations are fairly common, therefore pressure in this area should be avoided. Diff: 3 Page Ref: 264267 19 Copyright © 2010 Pearson Education, Inc. 6) Maggie is a 28yearold Caucasian woman who has newly diagnosed rheumatoid arthritis. She complains of painful, stiff hands and feet, feeling tired all the time, and reports an intermittent lowgrade fever. She asks the nurse if she is going to be "crippled." How might the nurse explain the pathophysiology of rheumatoid arthritis? Answer: Rheumatoid arthritis (RA) is a chronic, systemic, and inflammatory disorder. RA is an autoimmune disease in which the body's immune system attacks its own tissue. RA begins with inflammation of the synovial membrane of the affected joints. Fluid accumulates, causing joint swelling. The nurse should explain that RA is a chronic crippling disease with joint stiffening (ankylosis) resulting in restriction of joint movement and extreme pain. Diff: 3 Page Ref: 270271 20 Copyright © 2010 Pearson Education, Inc.