Using Figure 8.2, what type of axis does each joint have?
The amount of movement permitted by a particular joint is the basis for the functional
classification of joints.
The major role of ligaments at synovial joints is to help direct movement and restrict
Movement at the hip joint does not have as wide a range of motion as at the shoulder joint.
A person who has been diagnosed with a sprained ankle has an injury to the ligaments that
attach to that joint.
A movement of the forearm in which the palm of the hand is turned from posterior to anterior
Cruciate ligaments are important ligaments that stabilize all ball-and-socket joints.
Flexion of the ankle so that the superior aspect of the foot approaches the shin is called
The gripping of the trochlea by the trochlear notch constitutes the ʺhingeʺ for the elbow joint.
The ligamentum teres represents a very important stabilizing ligament for the hip joint.
The structural classification of joints is based on the composition of the binding material and
the presence or absence of a joint cavity.
Chondromalacia patellae is hardening of the articular cartilage on the posterior patella surface.
Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or
A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the
Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles
ending up in the infratemporal fossa.
Fill-in-the-Blank/Short Answer Questions
1) Turning the foot medially at the ankle would be called ________.
6) Using the functional classification, a freely movable joint would be called a ________ joint.
9) The joint between the carpal and the first metacarpal is called a ________ joint.
10) Synovial joints have five major features. What are they?
11) Often people who exercise prudently seem to have fewer bouts with osteoarthritis. Will
exercise prevent arthritis? If so, how?
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: ________, ________.
13) While the fingers can exhibit flexion and extension and other angular motions, the thumb has
much greater freedom. Why?
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 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.
15) Since 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.
16) After reading a medical report, you learn that a 45-year-old 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?
17) Greg is somewhat of a ʺweekend athleteʺ 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.
18) Many inflammations of joint areas can be treated by injections of cortisone into the area. Why donʹt we continually get injections rather than surgeries?
1) Akira, a 2.5-ranked 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?
2) Mary has been suffering from a ʺbad kneeʺ 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 ʺlike to have a look at her knee joint.ʺ 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?
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?
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 needle-shaped urate crystals in the soft tissue of joints. An
inflammatory response follows, which leads to gout.
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 clientʹs axillae, and
place their hands on the clientʹs 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.
6) Maggie is a 28-year-old 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 low-grade fever. She asks the nurse if she is going to be ʺcrippled.ʺ How might
the nurse explain the pathophysiology of rheumatoid arthritis?
Answer: Rheumatoid arthritis (RA) is a chronic, systematic, and inflammatory disorder. RA is an
autoimmune disease in which the bodyʹs 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 ankylosis stage, but all cases do involve restriction of joint movement and