Chapter 8 Exam Answers

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. Answer: A 2) Articular cartilage. Answer: C 3) Joint (articular) cavity. Answer: B 4) Synovial membrane. Answer: E 1 5) Fibrous layer. Answer: D 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) Uniaxial Answer: B B) Multiaxial 7) Joint 2. Answer: A 8) Joint 3. Answer: A 2 9) Joint 4. A) Biaxial Answer: B B) Nonaxial 10) Joint 5. Answer: A 11) Joint 6. Answer: A Figure 8.3 Using Figure 8.3, identify each type of synovial joint by name. 12) Joint 1. A) Pivot Answer: B B) Ball and socket 13) Joint 2. Answer: A 3 14) Joint 3. A) Saddle Answer: B B) Hinge 15) Joint 4. Answer: C C) Plane 16) Joint 5. D) Condyloid Answer: A 17) Joint 6. Answer: D Match the following: 18) Moving a limb so it describes a cone in a space. Answer: D A) Flexion B) Adduction 19) Movement of a limb away from the midline of the body. Answer: C C) Abduction D) Circumduction 20) Movement of a limb toward the midline of the body. Answer: B 21) A bending movement that decreases the angle of the joint. Answer: A 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 classification of that joint. Answer: True False 23) All joints permit some degree of movement, even if very slight. Answer: True False 24) Hinge joints permit movement in only one plane. Answer: True False 25) Synovial fluid is a viscous material that is derived by filtration from blood. Answer: True False 26) The articular surfaces of synovial joints play a minimal role in joint stability. Answer: True False 27) The major role of ligaments at synovial joints is to unite bones and prevent undesirable movement. Answer: True False 4 28) Gliding movements occur when one flat, or nearly flat, bone surface glides or slips over another. Answer: True False 29) Movement at the hip joint does not have as wide a range of motion as at the shoulder joint. Answer: True False 30) A person who has been diagnosed with a sprained ankle has an injury to the ligaments that attach to that joint. Answer: True False 31) Supination is the movement of the forearm in which the palm of the hand is turned anteriorly or superiorly. Answer: True False 32) The wrist joint can exhibit adduction and eversion movements. Answer: True False 33) Moving a limb so that it describes a cone in space is called circumduction. Answer: True False 34) Movement of the ankle so that the superior aspect of the foot approaches the shin is called dorsiflexion. Answer: True False 35) The gripping of the trochlea by the trochlear notch constitutes the "hinge" for the elbow joint. Answer: True False 36) Pronation is a much stronger movement than supination. Answer: True False 37) The structural classification of joints is based on the composition of the binding material and the presence or absence of a joint cavity. Answer: True False 38) Synovial fluid contains phagocytic cells that protect the cavity from invasion by microbes or other debris. Answer: True False 39) A person who has been diagnosed with rheumatoid arthritis would be suffering loss of the synovial fluids. Answer: True False 40) A ball- and- socket joint is a multiaxial joint. Answer: True False 41) Bending of the tip of the finger exhibits flexion. Answer: True False 42) Dislocations in the TMJ almost always dislocate posteriorly with the mandibular condyles ending up in the infratemporal fossa. Answer: True False 43) Symphyses are synarthrotic joints designed for strength with flexibility. Answer: True False 5 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 tissue is a ________. A) gomphosis B) synchondrosis C) syndesmosis D) suture Answer: C 45) The cruciate ligaments of the knee ________. A) are also called collateral ligaments C) prevent hyperextension of the knee B) attach to each other in their midportions D) tend to run parallel to one another Answer: C 46) Articular cartilage found at the ends of the long bones serves to ________. A) produce red blood cells (hemopoiesis) B) form the synovial membrane C) attach tendons D) provide a smooth surface at the ends of synovial joints Answer: D 47) Synchondroses and symphyses are examples of ________ joints. A) periodontal B) synovial C) cartilaginous D) fibrous Answer: C 48) On the basis of structural classification, which is a fibrous joint? A) synchondrosis B) pivot C) symphysis D) syndesmosis Answer: D 49) Connective tissue sacs lined with synovial membrane that act as cushions in places where friction develops are called ________. A) ligaments B) tendons C) bursae D) menisci Answer: C 50) Articulations permitting only slight degrees of movement are ________. A) diarthroses B) synovial joints C) amphiarthroses D) synarthroses Answer: C 51) Which of the following are cartilaginous joints? A) syndesmoses B) synchondroses C) gomphoses D) sutures Answer: B 52) Bowing to your opponent before a jiu jitsu match would be considered a ________ movement. A) hyperextension B) flexion C) circumduction D) extension Answer: B 53) 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) patellar ligaments B) anterior ligaments C) tibial collateral ligaments D) cruciate ligaments Answer: D 6 54) Bending your head back until it hurts is an example of ________. A) flexion B) circumduction C) extension D) hyperextension Answer: D 55) In the classification of joints, which of the following is true? A) Synarthrotic joints are slightly movable. C) Immovable joints are called amphiarthroses. B) In cartilaginous joints, a joint cavity is present. D) All synovial joints are freely movable. Answer: D 56) Synarthrotic joints ________. A) have large joint cavities C) are found only in adults B) are immovable joints D) characterize all cartilaginous joints Answer: B 57) Fibrous joints are classified as ________. A) sutures, syndesmoses, and gomphoses C) pivot, hinge, and ball and socket B) hinge, saddle, and ellipsoidal D) symphysis, sacroiliac, and articular Answer: A 58) In symphysis joints the articular surfaces of the bones are covered with ________. A) fibrocartilage B) hyaline cartilage C) tendon sheaths D) synovial membranes Answer: B 59) Synovial fluid is present in joint cavities of freely movable joints. Which of the following statements is true about this fluid? A) It contains lactic acid. B) It contains hyaluronic acid. C) It contains enzymes only. D) It contains hydrochloric acid. Answer: B 60) Which of the following statements defines synchondroses? A) cartilaginous joints where hyaline cartilage unites the ends of bones B) interphalangeal joints C) joints that permit angular movements D) amphiarthrotic joints designed for strength and flexibility Answer: A 61) What are menisci (articular discs)? A) cavities lined with cartilage B) tendon sheaths C) small sacs containing synovial fluid D) wedges of fibrocartilage that partially or completely divide the synovial cavity Answer: D 62) Which of the following is a true statement regarding gliding movements? 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. Answer: C 7 63) What is moving a limb away from the midline of the body along the frontal plane called? A) adduction B) extension C) abduction D) flexion Answer: C 64) The terms inversion and eversion pertain only to the ________. A) arms B) feet C) hands D) hands and the feet Answer: B 65) The hip joint is a good example of a(n) ________ synovial joint. A) uniaxial B) biaxial C) multiaxial D) nonaxial Answer: C 66) Which of the following movements does NOT increase or decrease the angle between bones? A) rotation B) abduction C) extension D) circumduction Answer: A 67) Compared to the shoulder, displacements of the hip joints are ________. A) common due to the weight bearing the hip endures B) rare because the rotator cuff stabilizes the hip joint C) rare because of the ligament reinforcement D) common in all people who are overweight Answer: C 68) Which ligament of the knee initiates the knee- jerk reflex when tapped? A) the extracapsular ligament B) the lateral patellar retinacula C) the medial patellar retinacula D) the patellar ligament Answer: D 69) Football players often sustain lateral blows to the extended knee. Which of the following is (are) damaged as a result? A) arcuate popliteal and the posterior cruciate ligaments B) suprapatellar ligament C) tibial collateral ligament, medial meniscus, and anterior cruciate ligament D) oblique popliteal and extracapsular ligaments Answer: C 70) Pointing the toes is an example of ________. A) plantar flexion B) circumduction C) pronation Answer: A 71) Which of the following is a true statement? A) The rotator cuff is responsible for the flexible extensions at the elbow joint. B) The greater tubercle of the humerus articulates at the coracoid process of the scapula. C) The head of the humerus articulates with the acromion process. D) The annular ligament surrounds the head of the radius. Answer: D 8 D) protraction 72) Presence of a synovial cavity, articular cartilage, synovial membrane, and ligaments are characteristics of what type of joint? A) hinge joint B) symphysis C) suture D) synchondrosis Answer: A 73) Extracapsular ligaments stabilizing the knee include ________. A) the oblique popliteal crossing the knee anteriorly B) cruciate ligaments, which help secure the articulating bones together C) fibular and tibial collateral ligaments, which prevent lateral or medial rotation D) the patellar ligament extending from femur to patella Answer: C 74) Baseball pitchers often require "Tommy John" surgery to repair damage to their elbow. Which ligament would this surgery target? A) lateral ligament B) acetabular labrum C) ulnar collateral ligament D) anular ligament Answer: C 75) An example of an interosseous fibrous joint is ________. A) between the humerus and the glenoid cavity C) between the vertebrae B) the radius and ulna along its length D) the clavicle and the scapula at the distal ends Answer: B 76) Which of the following statements best describes angular movements? A) They allow movement only in one plane. B) They turn a bone along its own long axis. C) They change (increase or decrease) the angle between two bones. D) They occur only between bones with flat articular processes. Answer: C 77) Saddle joints have concave and convex surfaces. Identify a saddle joint of the skeleton. A) interphalangeal joint of the finger B) carpometacarpal joint of the phalanges C) carpometacarpal joint of the thumb D) metacarpophalangeal joint of the finger Answer: C 78) Tendon sheaths ________. A) are extensions of periosteum C) are lined with dense irregular connective tissue B) act as friction- reducing structures D) help anchor the tendon to the muscle Answer: B 79) Which of the following is NOT strictly a part of a synovial joint? A) articular (joint) capsule B) articular cartilage C) joint (articular) cavity D) tendon sheath Answer: D 80) All of the following are factors that influence synovial joint stability EXCEPT ________. A) strength and tension of joint ligaments B) number of bones in the joint C) arrangement and tension of the muscles D) structure and shape of the articulating bone Answer: B 9 81) Performing "jumping jacks" requires ________. A) pronation and supination C) flexion and extension B) abduction and adduction D) inversion and eversion Answer: B 82) Moving your jaw forward, causing an underbite, is called ________. A) adduction B) protraction C) retraction D) pronation Answer: B 83) Which of the following conditions is joint inflammation or degeneration accompanied by stiffness, pain, and swelling? A) osteoarthritis B) arthritis C) rheumatoid arthritis D) Lyme disease Answer: B 84) Lifting up a glass to take a drink involves the elbow joint. Which of the following correctly characterizes that joint? A) pivot B) diarthrotic C) cartilaginous D) biaxial Answer: B 85) An individual with a "double- jointed" thumb can pull it back towards the wrist much farther than normal. What does it mean to be "double- jointed?" A) The additional joint present doubles the range of motion. B) The joint capsules and ligaments are more stretchy and loose than normal. C) Articular cartilage at bone ends is replaced with hyaline cartilage. D) Greater than normal production of serous fluid lubricates the joint and extends it. Answer: B 86) The type of joint between the carpal (trapezium) and the first metacarpal is a ________ joint. A) plane B) condylar C) hinge D) saddle Answer: D 87) Which joint does NOT belong with the others? A) wrist C) interphalangeal (toes) B) elbow D) ankle Answer: A 88) Which joints are correctly matched? A) interphalangeal; plane C) ankle; hinge B) wrist; saddle D) elbow; pivot Answer: C SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 89) Why are epiphyseal plates considered temporary joints? Answer: Once long bone growth in length is complete, the cartilage of the epiphyseal plates completely ossifies to become a permanent connection between the bones. 10 90) A friend finally completes a basement floor tiling project that required extensive time on 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. Answer: 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) After months of very little exercise, you decide to go for a long run. After a mile, you start to feel pain in your kneecap area. What could explain this? Answer: 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) Synovial joints have six distinguishing features. What are they? Answer: Articular cartilage, a joint (articular) cavity, an articular (joint) capsule, synovial fluid, reinforcing ligaments, nerves, and blood vessels. 93) How can gout be treated? Answer: 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) 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 in the frontal plane: ________, ________. d. Turning the sole of foot medially: ________, ________. Answer: a. hinge; flexion b. pivot; rotation c. ball and socket; adduction d. plane; inversion 95) While the fingers can exhibit flexion and extension and other angular motions, the thumb has much greater freedom. Why? Answer: The thumb's carpometacarpal joint is a biaxial saddle joint whereas the other carpometacarpal joints are plane joints with no angular freedom. 96) Briefly describe the structure of 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. 11 97) Although uric acid is a normal waste product of nucleic acid metabolism, excessive levels 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? Answer: 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) 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? Answer: Rheumatoid arthritis 99) Greg is somewhat of a "weekend athlete" who has overextended himself by pitching 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? 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 multiple baseball games per week and playing golf on weekends. 100) Many inflammations of joint areas can be treated by injections of cortisone into the area. Why don't we continually get injections rather than operations? 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. 101) 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. 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? Answer: He might have suffered a shoulder dislocation since the shoulder joint has sacrificed stability for flexibility. 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? 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. 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. 12 104) 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? Answer: 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 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? Answer: 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) 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. Answer: 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) 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? 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 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 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? Answer: Susan should consider Lyme disease and test for it. Treatment is taking antibiotics for 3 to 6 months. 13