Exam

Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

Figure 8.1

Using Figure 8.1, match the following:

1) Periosteum. 1)

2) Articular cartilage. 2)

3) Joint (articular) cavity. 3)

4) Synovial membrane. 4)

5) Fibrous layer. 5)

1
MATCHING. Choose the item in column 2 that best matches each item in column 1.

Figure 8.2

Using Figure 8.2, what type of axial movement does each joint have?

6) Joint 1. A) Multiaxial
6)

7) Joint 2. B) Uniaxial
7)

8) Joint 3. C) Nonaxial
8)

9) Joint 4. D) Biaxial
9)

10) Joint 5.
10)

11) Joint 6.
11)

2
Figure 8.3

Using Figure 8.3, identify each type of synovial joint by name.

12) Joint 1. A) Hinge

12)

13) Joint 2. B) Plane

13)

14) Joint 3. C) Ball and socket

14)

15) Joint 4. D) Pivot

15)

16) Joint 5. E) Condyloid

16)

17) Joint 6. F) Saddle

17)

3
Match the following:

18) Moving a limb so it describes a cone in A) Abduction

18)
a space.
B) Circumduction
19) Movement of a limb away from the
19)
midline of the body. C) Adduction

20) Movement of a limb toward the D) Flexion 20)

midline of the body.

21) A bending movement that decreases

21)
the angle of the joint.

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.

22) The amount of movement permitted by a particular joint is the basis for the functional 22)
classification of that joint.

23) All joints permit some degree of movement, even if very slight. 23)

24) Hinge joints permit movement in only one plane. 24)

25) Synovial fluid is a viscous material that is derived by filtration from blood. 25)

26) The articular surfaces of synovial joints play a minimal role in joint stability. 26)

27) The major role of ligaments at synovial joints is to unite bones and prevent undesirable movement. 27)

28) Gliding movements occur when one flat, or nearly flat, bone surface glides or slips over another. 28)

29) Movement at the hip joint does not have as wide a range of motion as at the shoulder joint. 29)

30) A person who has been diagnosed with a sprained ankle has an injury to the ligaments that attach 30)
to that joint.

31) Supination is the movement of the forearm in which the palm of the hand is turned anteriorly or 31)
superiorly.

32) The wrist joint can exhibit adduction and eversion movements. 32)

33) Moving a limb so that it describes a cone in space is called circumduction. 33)

34) Movement of the ankle so that the superior aspect of the foot approaches the shin is called 34)
dorsiflexion.

35) The gripping of the trochlea by the trochlear notch constitutes the "hinge" for the elbow joint. 35)

4
 36) Pronation is a much stronger movement than supination. 36)

37) The structural classification of joints is based on the composition of the binding material and the 37)
presence or absence of a joint cavity.

38) Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or other 38)
debris.

39) A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the 39)
synovial fluids.

40) A ball-and-socket joint is a multiaxial joint. 40)

41) Bending of the tip of the finger exhibits flexion. 41)

42) Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles ending 42)
up in the infratemporal fossa.

43) Symphyses are synarthrotic joints designed for strength with flexibility. 43)

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

44) A situation where the bones are connected exclusively by ligaments, cords, or bands of fibrous 44)
tissue is a ________.
A) synchondrosis B) suture C) syndesmosis D) gomphosis

45) The cruciate ligaments of the knee ________. 45)

A) tend to run parallel to one another B) attach to each other in their midportions
C) prevent hyperextension of the knee D) are also called collateral ligaments

46) Articular cartilage found at the ends of the long bones serves to ________. 46)
A) produce red blood cells (hemopoiesis)
B) attach tendons
C) provide a smooth surface at the ends of synovial joints
D) form the synovial membrane

47) Synchondroses and symphyses are examples of ________ joints. 47)

A) synovial B) periodontal C) fibrous D) cartilaginous

48) On the basis of structural classification, which is a fibrous joint? 48)

A) pivot B) symphysis C) synchondrosis D) syndesmosis

49) Connective tissue sacs lined with synovial membrane that act as cushions in places where friction 49)
develops are called ________.
A) menisci B) tendons C) bursae D) ligaments

50) Articulations permitting only slight degrees of movement are ________. 50)
A) amphiarthroses B) synarthroses C) synovial joints D) diarthroses

5
51) Which of the following are cartilaginous joints? 51)
A) syndesmoses B) sutures C) gomphoses D) synchondroses

52) Bowing to your opponent before a jiu jitsu match would be considered a ________ movement. 52)
A) flexion B) extension C) hyperextension D) circumduction

53) The ligaments that protect the alignment of the femoral and tibial condyles and limit the 53)
movement of the femur anteriorly and posteriorly are called ________.
A) anterior ligaments B) patellar ligaments
C) tibial collateral ligaments D) cruciate ligaments

54) Bending your head back until it hurts is an example of ________. 54)
A) circumduction B) extension C) flexion D) hyperextension

55) In the classification of joints, which of the following is true? 55)

A) All synovial joints are freely movable.
B) Synarthrotic joints are slightly movable.
C) In cartilaginous joints, a joint cavity is present.
D) Immovable joints are called amphiarthroses.

56) Synarthrotic joints ________. 56)

A) have large joint cavities B) are found only in adults
C) are immovable joints D) characterize all cartilaginous joints

57) Fibrous joints are classified as ________. 57)

A) symphysis, sacroiliac, and articular B) pivot, hinge, and ball and socket
C) hinge, saddle, and ellipsoidal D) sutures, syndesmoses, and gomphoses

58) In symphysis joints the articular surfaces of the bones are covered with ________. 58)
A) tendon sheaths B) synovial membranes
C) hyaline cartilage D) fibrocartilage

59) Synovial fluid is present in joint cavities of freely movable joints. Which of the following 59)
statements is true about this fluid?
A) It contains enzymes only. B) It contains hydrochloric acid.
C) It contains hyaluronic acid. D) It contains lactic acid.

60) Which of the following statements defines synchondroses? 60)

A) amphiarthrotic joints designed for strength and flexibility
B) interphalangeal joints
C) cartilaginous joints where hyaline cartilage unites the ends of bones
D) joints that permit angular movements

61) What are menisci (articular discs)? 61)

A) small sacs containing synovial fluid
B) tendon sheaths
C) cavities lined with cartilage
D) wedges of fibrocartilage that partially or completely divide the synovial cavity

6
62) Which of the following is a true statement regarding gliding movements? 62)
A) Gliding movements are multiaxial.
B) Gliding movements allow flexibility of the upper limbs.
C) Gliding movements occur at the intercarpal and intertarsal joints.
D) An example of a gliding movement is nodding one's head.

63) What is moving a limb away from the midline of the body along the frontal plane called? 63)
A) flexion B) abduction C) extension D) adduction

64) The terms inversion and eversion pertain only to the ________. 64)
A) feet B) hands and the feet
C) arms D) hands

65) The hip joint is a good example of a(n) ________ synovial joint. 65)
A) biaxial B) uniaxial C) nonaxial D) multiaxial

66) Which of the following movements does NOT increase or decrease the angle between bones? 66)
A) extension B) abduction C) circumduction D) rotation

67) Compared to the shoulder, displacements of the hip joints are ________. 67)
A) common in all people who are overweight
B) rare because the rotator cuff stabilizes the hip joint
C) rare because of the ligament reinforcement
D) common due to the weight bearing the hip endures

68) Which ligament of the knee initiates the knee-jerk reflex when tapped? 68)
A) the lateral patellar retinacula B) the patellar ligament
C) the extracapsular ligament D) the medial patellar retinacula

69) Football players often sustain lateral blows to the extended knee. Which of the following is (are) 69)
damaged as a result?
A) oblique popliteal and extracapsular ligaments
B) suprapatellar ligament
C) tibial collateral ligament, medial meniscus, and anterior cruciate ligament
D) arcuate popliteal and the posterior cruciate ligaments

70) Pointing the toes is an example of ________. 70)

A) pronation B) plantar flexion C) protraction D) circumduction

71) Which of the following is a true statement? 71)

A) The greater tubercle of the humerus articulates at the coracoid process of the scapula.
B) The annular ligament surrounds the head of the radius.
C) The head of the humerus articulates with the acromion process.
D) The rotator cuff is responsible for the flexible extensions at the elbow joint.

72) Presence of a synovial cavity, articular cartilage, synovial membrane, and ligaments are 72)
characteristics of what type of joint?
A) symphysis B) hinge joint C) synchondrosis D) suture

7
73) Extracapsular ligaments stabilizing the knee include ________. 73)
A) fibular and tibial collateral ligaments, which prevent lateral or medial rotation
B) the patellar ligament extending from femur to patella
C) cruciate ligaments, which help secure the articulating bones together
D) the oblique popliteal crossing the knee anteriorly

74) Baseball pitchers often require "Tommy John" surgery to repair damage to their elbow. Which 74)
ligament would this surgery target?
A) lateral ligament B) acetabular labrum
C) ulnar collateral ligament D) anular ligament

75) An example of an interosseous fibrous joint is ________. 75)

A) the radius and ulna along its length
B) between the vertebrae
C) between the humerus and the glenoid cavity
D) the clavicle and the scapula at the distal ends

76) Which of the following statements best describes angular movements? 76)
A) They turn a bone along its own long axis.
B) They change (increase or decrease) the angle between two bones.
C) They occur only between bones with flat articular processes.
D) They allow movement only in one plane.

77) Saddle joints have concave and convex surfaces. Identify a saddle joint of the skeleton. 77)
A) interphalangeal joint of the finger B) carpometacarpal joint of the thumb
C) carpometacarpal joint of the phalanges D) metacarpophalangeal joint of the finger

78) Tendon sheaths ________. 78)

A) act as friction-reducing structures
B) are extensions of periosteum
C) help anchor the tendon to the muscle
D) are lined with dense irregular connective tissue

79) Which of the following is NOT strictly a part of a synovial joint? 79)
A) tendon sheath B) articular cartilage
C) joint (articular) cavity D) articular (joint) capsule

80) All of the following are factors that influence synovial joint stability EXCEPT ________. 80)
A) arrangement and tension of the muscles
B) structure and shape of the articulating bone
C) strength and tension of joint ligaments
D) number of bones in the joint

81) Performing "jumping jacks" requires ________. 81)

A) flexion and extension B) inversion and eversion
C) abduction and adduction D) pronation and supination

82) Moving your jaw forward, causing an underbite, is called ________. 82)
A) protraction B) adduction C) pronation D) retraction

8
 83) Which of the following conditions is joint inflammation or degeneration accompanied by stiffness, 83)
pain, and swelling?
A) rheumatoid arthritis B) osteoarthritis
C) Lyme disease D) arthritis

84) Lifting up a glass to take a drink involves the elbow joint. Which of the following correctly 84)
characterizes that joint?
A) diarthrotic B) biaxial C) pivot D) cartilaginous

85) An individual with a "double-jointed" thumb can pull it back towards the wrist much farther than 85)
normal. What does it mean to be "double-jointed?"
A) Greater than normal production of serous fluid lubricates the joint and extends it.
B) The joint capsules and ligaments are more stretchy and loose than normal.
C) The additional joint present doubles the range of motion.
D) Articular cartilage at bone ends is replaced with hyaline cartilage.

86) The type of joint between the carpal (trapezium) and the first metacarpal is a ________ joint. 86)
A) hinge B) plane C) saddle D) condylar

87) Which joint does NOT belong with the others? 87)
A) wrist B) interphalangeal (toes)
C) ankle D) elbow

88) Which joints are correctly matched? 88)

A) wrist; saddle B) interphalangeal; plane
C) elbow; pivot D) ankle; hinge

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.

89) Why are epiphyseal plates considered temporary joints? 89)

90) A friend finally completes a basement floor tiling project that required extensive time on 90)
his knees. Afterwards, knee pain took him to a doctor who diagnosed bursitis. Help
explain to your friend what bursitis is and what can be done to relieve it.

91) After months of very little exercise, you decide to go for a long run. After a mile, you start 91)
to feel pain in your kneecap area. What could explain this?

92) Synovial joints have six distinguishing features. What are they? 92)

93) How can gout be treated? 93)

94) For each of the following movements, indicate the specific kind of joint involved (e.g., 94)
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 in the frontal plane: ________, ________.
d. Turning the sole of foot medially: ________, ________.

9
 95) While the fingers can exhibit flexion and extension and other angular motions, the thumb 95)
has much greater freedom. Why?

96) Briefly describe the structure of a typical synovial joint. 96)

97) Although uric acid is a normal waste product of nucleic acid metabolism, excessive levels 97)
lead to gouty arthritis. How does this waste product build up and cause so much pain
when things go wrong and why is it more common in men?

98) After reading a medical report, you learn that a 45-year-old female has the following 98)
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?

99) Greg is somewhat of a "weekend athlete" who has overextended himself by pitching 99)
multiple baseball games for a local team during the week and by 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?

100) Many inflammations of joint areas can be treated by injections of cortisone into the area. 100)
Why don't we continually get injections rather than operations?

101) Why is muscle tone the most important stabilizing factor for most joints? 101)

ESSAY. Write your answer in the space provided or on a separate sheet of paper.

102) Steven, a football player, complained of severe pain and the inability to use his right arm and shoulder after
having been tackled during a game. What would you guess might be his problem?

103) 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?

104) 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?

105) Alexis grinds her teeth at night when she sleeps, especially when she is stressed. One morning she woke up
with extreme pain in her jaw muscles, a popping sound when she chewed, and joint stiffness. How do you
explain her condition and how is it treated?

106) A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For patients needing to be slid
toward the head of the bed, the nurse tells the PCAs to use a draw sheet under the patient's torso. She tells
them to avoid pulling on their hands or arms. Based on your knowledge of the shoulder joint, explain why
pulling on the extremities should be avoided.

10
107) 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
doctor if she is going to be "crippled." How might the doctor explain the pathophysiology of rheumatoid
arthritis?

108) Susan was bitten by a deer tick and now complains of joint pain, flu-like symptoms, and difficulty thinking.
What might be her diagnosis and the treatment required to alleviate her symptoms?

11
Answer Key
Testname: UNTITLED8

1) A
2) C
3) B
4) E
5) D
6) A
7) B
8) B
9) C
10) D
11) D
12) C
13) D
14) A
15) B
16) F
17) E
18) B
19) A
20) C
21) D
22) TRUE
23) FALSE
24) TRUE
25) TRUE
26) TRUE
27) TRUE
28) TRUE
29) TRUE
30) TRUE
31) TRUE
32) FALSE
33) TRUE
34) TRUE
35) TRUE
36) FALSE
37) TRUE
38) TRUE
39) FALSE
40) TRUE
41) TRUE
42) FALSE
43) FALSE
44) C
45) C
46) C
47) D
48) D
49) C
50) A
12
Answer Key
Testname: UNTITLED8

51) D
52) A
53) D
54) D
55) A
56) C
57) D
58) C
59) C
60) C
61) D
62) C
63) B
64) A
65) D
66) D
67) C
68) B
69) C
70) B
71) B
72) B
73) A
74) C
75) A
76) B
77) B
78) A
79) A
80) D
81) C
82) A
83) D
84) A
85) B
86) C
87) A
88) D
89) Once long bone growth in length is complete, the cartilage of the epiphyseal plates completely ossifies to become a
permanent connection between the bones.
90) Bursitis is inflammation of the bursa. Repeated pressure and friction on the knee while completing the project caused
damage to the prepatellar bursa. This can be treated by avoiding pressure to the area and injection of
anti-inflammatory drugs into the bursa. If significant fluid accumulates, aspiration may be required to relieve
pressure.
91) Muscle tone is very important for stabilizing the knee joint. The long time off allowed the muscles whose tendons
span the knee joint to weaken and lose that stabilizing force. Running should stop until the muscles can be
reconditioned. Then the distance should be short at first and increased incrementally.
92) Articular cartilage, a joint (articular) cavity, an articular (joint) capsule, synovial fluid, reinforcing ligaments, nerves,
and blood vessels.

13
Answer Key
Testname: UNTITLED8

93) Several drugs (colchicine, nonsteroidal anti-inflammatory drugs, glucocorticoids, and others) that terminate or
prevent gout attacks are available. Patients are advised to drink plenty of water and to avoid excessive alcohol
consumption (which promotes uric acid overproduction) and foods high in purine -containing nucleic acids, such as
liver, kidneys, and sardines.
94) a. hinge; flexion
b. pivot; rotation
c. ball and socket; adduction
d. plane; inversion
95) The thumb's carpometacarpal joint is a biaxial saddle joint whereas the other carpometacarpal joints are plane joints
with no angular freedom.
96) 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.
97) Blood levels of uric acid increase due to excessive production or slow excretion. Males have higher blood levels of uric
acid than females because estrogens are thought to increase the rate of uric acid excretion. When blood levels of uric
acid rise excessively, it is deposited as needle-shaped urate crystals in the soft tissues of joints. This causes an
inflammatory response and pain, typically at one joint at the base of the great big toe.
98) Rheumatoid arthritis
99) 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 multiple baseball
games per week and playing golf on weekends.
100) 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.
101) 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.
102) He might have suffered a shoulder dislocation since the shoulder joint has sacrificed
stability for flexibility.
103) 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. However,
over the long term, the lack of weight distribution by the missing meniscus increases the likelihood of osteoarthritis in
her knee. Mary might consider taking up swimming instead.
104) Farhad is suffering from tendonitis. If he continues to use the keyboard incorrectly, the tendonitis could develop into
the more serious condition called carpal tunnel syndrome.
105) Alexis is suffering from dislocation of her temporomandibular joint (TMJ), which was probably exacerbated by her
grinding her teeth. Treatment includes relaxation of the jaw muscles using massage, muscle -relaxant drugs, heat or
cold, or stress reduction techniques. Use of a mouth guard at night may also help.
106) In the shoulder joint, stability has been sacrificed to provide the most freely moving joint of the body. The shoulder
joint is a ball-and-socket joint. Shoulder dislocations are fairly common; therefore, forces that are not under the
patient's control should be avoided.
107) 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 doctor should explain that RA is a chronic crippling
disease with joint stiffening (ankylosis) resulting in restriction of joint movement and extreme pain.
108) Susan should consider Lyme disease and test for it. Treatment is taking antibiotics for 3 to 6 months.

14