Neumann: Kinesiology of the Musculoskeletal System, 2nd Edition

Chapter 02: Basic Structure and Function of Human Joints

Study Questions and Answers

1. Describe the morphologic differences between ovoid and saddle joints. Provide an
anatomic example of each type of joint.
An ovoid joint has one articular surface that is convex and another that is concave. Most
diarthrodial joints in the body are classified as ovoid. Examples include the glenohumeral,
tibiofemoral, and hip joints. A saddle joint has an articular surface that is convex in one
dimension and concave in the other; the opposing joint surface has a reciprocal shape. The
classic saddle joint in the body is the carpometacarpal joint of the thumb.

2. Cite the major distinguishing structural and functional differences between a

synarthrodial and a diarthrodial (synovial) joint.
A synarthrodial joint (or synarthrosis) allows slight to essentially no movement.
Synarthrodial joints are classified as fibrous (such as the distal tibiofibular joint), or
cartilaginous (such as the symphysis pubis). A diarthrodial joint (or diathrosis) allows
moderate to extensive movement. Diarthrodial joints, also called synovial joints, comprise
most of the joints throughout the musculoskeletal system. Examples include the radiocarpal
(wrist), glenohumeral, and talocrural (ankle) joints.

3. Intra-articular discs (or menisci) are sometimes found in diarthrodial joints. Name
three joints in the body that contain intra-articular discs. Describe the most likely
function(s) of these structures at these joints.
Examples of diarthrodial joints that contain intra-articular discs (or menisci) are the knee,
sternoclavicular, temporomandibular, and distal radio-ulnar. The discs within these joints
have several functions, including increasing contact area, absorbing loading, improving
articular stability, and guiding complex arthrokinematics.

4. List the four primary types of tissues that exist throughout the body.
The four primary types of biologic tissues in the human body are connective tissue, muscle,
nerve, and epithelium. The musculoskeletal system, including the surrounding soft tissues
and vascular structures, includes all four types of tissues.

5. Which of the joints illustrated in Figures 2-3 through 2-9 have (a) the greatest and (b)
the least degrees of freedom?
A joint can have up to three degrees of (rotary) freedom. The hip has three (Figure 2-6), and
the humero-ulnar joint has only one (Figure 2-3).

6. Cite the major functional differences between type I collagen and elastin. Cite tissues
that contain a high proportion of each protein.
Type I collagen forms relatively thick fibers that display relatively high stiffness and tensile
strength. Tissues such as ligaments, tendons, and fascia contain a high proportion of type I
collagen. These structures can withstand a high tensile load with minimal elongation. As its

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Study Questions and Answers 2-2

name implies, elastin exhibits a high degrees of elasticity. The ligamentum flavum, located
between the laminae of adjacent vertebrae, contains a high proportion of elastin and can be
stretched 35% beyond its neutral length before sustaining injury (Chapter 9). Other tissues
with a high proportion of elastin are ear and nose cartilage and the inner walls of arteries.

7. What is the difference between an evolute and an instantaneous axis of rotation? Cite
one biomechanical or practical consequence of a joint that possesses a significantly
large, although normal, evolute.
Evolute describes the path of an axis of rotation about a joint, throughout a full range of
motion. The term evolute is most often used to describe the medial-lateral (ML) axis of
rotation at the knee. The term instantaneous axis of rotation describes the specific location of
an axis of rotation at a distinct point (instant) in a joint’s range of motion.
The ML axis of rotation at the knee demonstrates a relatively large evolute; the ML axis of
rotation experiences significant migration throughout flexion and extension. The migrating
axis alters the length of the internal moment arm of the knee flexor and extensor muscles,
partly accounting for the differences in strength (peak torque) across different knee joint
angles.
Several hinged external devices applied clinically to the knee have a fixed axis of rotation,
such as most goniometers, braces, or isokinetic testing devices. Care must be taken to align
the axis of these devices as close as possible with the average axis of rotation of the knee, a
point near the lateral epicondyle of the femur.

8. Define (a) perichondrium and (b) periosteum. What is the primary function of these
tissues?
The perichondrium is a connective tissue that surrounds many types of cartilage. The
perichondrium contains some blood vessels, as well as a source of chondroblasts and
fibroblasts. Adult articular cartilage lacks a perichondium, partly explaining why the tissue
typically does not heal well after injury.
The periosteum is a connective tissue that surrounds the external surfaces of bone. The
periosteum contains blood vessels and sensory nerve endings, as well as a source of
osteoblasts and fibroblasts. The presence of a periosteum membrane explains in part why
bone usually heals well after a fracture.

9. Describe the fundamental mechanism used by articular cartilage to repeatedly

disperse compression forces across joints.
Proteoglycans within the ground substance of articular cartilage strongly attract water. The
water causes the articular cartilage to swell, which is resisted by the tensile properties of the
embedded collagen fibers. The swollen and hydrated environment of the ground substance is
responsible for supporting and dissipating compression forces. As articular cartilage accepts
weight, a small amount of water is pushed outward from the ground substance. When
unloaded, however, the water is reabsorbed, preparing the cartilage for the next loading
cycle.

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Study Questions and Answers 2-3

10. Describe the primary reasons why bone possesses a far superior healing potential
than articular cartilage.
Bone heals much better than articular cartilage because bone has an excellent blood supply
and a well-developed periosteum and endosteum. These connective tissues contain primitive
osteoblasts and fibroblasts, which are essential to the manufacturing of new bone after a
fracture.

11. Describe the natural effects of advanced aging on periarticular connective tissues. In
extreme cases, how could these changes manifest themselves clinically?
In general, aged periarticular connective tissues have a slower rate of synthesis of fibrous
proteins and proteoglycans. The reduced concentration of proteoglycans reduces the ability
of periarticular connective tissues to absorb and retain water. These changes reduce the
strength and load absorption qualities of the tissue. Also, the tendon of muscles becomes
more complaint (less stiff) with advanced age. As a result, the tendon may be unable to
transmit stabilizing forces quickly and effectively from active muscle to the joints. When
extreme, the combination of these age-related changes can lead to joint instability and
abnormal alignment, as well as increased degeneration of the articular cartilage.

12. List three histologic features that are common to articular cartilage, tendon, and
bone.
Articular cartilage, tendon, and bone all contain fibrous proteins, ground substance, and cells.
The specific type, amount, and relative proportion of each vary based on the structure and
ultimate function of the tissue.

13. Briefly contrast osteoarthritis and rheumatoid arthritis.

Osteoarthritis, frequently referred to as degenerative arthritis, is characterized primarily by
degeneration of the articular cartilage, often with a relatively low inflammatory component.
Degeneration of the articular cartilage may lead to (or is associated with) degeneration of
other periarticular connective tissues, including the subchondral bone. Idiopathic
osteoarthritis tends to occur more frequently in larger weight-bearing joints, often occurring
unilaterally. Symptoms include pain, reduced range of motion, development of osteophytes,
and morphologic changes in the subchondral bone. Secondary symptoms may be related to
weakness of muscles and other periarticular connective tissues.
Although osteoarthritis occurs with greater frequency in aged persons, the ageing process
itself is not considered a direct cause. With advanced age, the reparative process of the
articular cartilage may not be able to keep pace with the cumulative loading that occurs over
the decades. Genetic, biochemical, and anatomic factors may also be involved with the
genesis of the disease.
Rheumatoid arthritis is a systemic, autoimmune disease with a high inflammatory
component. Chronic synovitis, a hallmark of the disease, causes degeneration of the articular
cartilage and other periarticular connective tissues. Secondary destruction of the joint may
occur as the thinned articular cartilage and weakened connective tissues fail to protect the
joint from forces produced by muscles and body weight. Rheumatoid arthritis may occur in
any joint, frequently with bilateral involvement.

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Study Questions and Answers 2-4

14 List three structures always found in synovial joints. Cite common pathologies that
may affect these structures, and comment on the nature of the resulting impairment.
Selected structures always found in synovial (diarthrodial) joints include:
Synovial membrane: Inflammation and enlarged synovial membrane (synovitis) may cause
pain, reduced motion, and, if chronic, destruction of the articular cartilage.
Articular cartilage: Degeneration (fragmentation and thinning, hallmarks of osteoarthritis)
reduces the ability of the cartilage to protect the subchondral bone from damaging forces.
Bursa: Inflammation and enlarged bursae (bursitis) often cause pain and reduced motion.
Capsule: Partial tears or over-distension can reduce joint stability.

15. What is the function of synovial fluid?

Synovial fluid is secreted by the synovial membrane that lines the internal surfaces of the
capsule of diarthrodial joints. Synovial fluid provides nutrients to the articular cartilage. The
fluid as acts as a lubricant that reduces the coefficient of friction between the joint surfaces.

Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.