Fundamentals of Anatomy and Physiology 10th Edition Martini Solutions Manual

Fundamentals of Anatomy and Physiology 10th

Edition Martini Solutions Manual

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 Joints
CHAPTER

Introduction to the Chapter

The body moves around its joints. Muscle is used to provide the strength to move bones, but
there must be a space between two bones in order to produce movement. For example, if the
arm didn’t have the elbow joint, how would it move? Some joints are very obvious, such as
the knee and hip. Others are not, such as the gomphoses of the teeth. The joints between the
vertebrae of the spinal column aren’t seen, but all those small joints are what enable you to
twist your torso back and forth. Students should begin this chapter with the understanding of
the basic function of a joint, which is movement of the bones and therefore the body. Have
students consider the knee and the shoulder. Ask them to move their knee. What kind of action
do you get from that joint? How is it related to its structure? Have them put their shoulders
through the range of motions they can do. What kind of action(s) do you get from that joint?
How is it related to its structure? Using that as a starting point, introduce students slowly to
the classification of joints based on structure and function. There are a lot of new words in this
chapter and some describe only one unique joint (e.g., gomphosis). Students should focus on
being able to understand and explain the major joints based on structure and function.

Chapter Learning Outcomes

9-1 Contrast the major categories of joints, and explain the relationship between structure
and function for each category.
9-2 Describe the basic structure of a synovial joint, and describe common synovial joint
accessory structures and their functions.
9-3 Describe how the anatomical and functional properties of synovial joints permit
movements of the skeleton.
9-4 Describe the joints between the vertebrae of the vertebral column.
9-5 Describe the structure and function of the shoulder joint and the elbow joint.
9-6 Describe the structure and function of the hip joint and the knee joint.
9-7 Describe the effects of aging on joints, and discuss the most common age-related
clinical problems for joints.
9-8 Explain the functional relationships between the skeletal system and other body systems.

Teaching Strategies
1. Encouraging Student Talk
a. Get students talking at the start of instruction by asking them to think about how many
joints in the skull they can identify. Tell them they do not necessarily need to list

58 Copyright © 2015 Pearson Education, Inc.

 specific joint names at this point; you simply want them to point to or describe the
places where they have joints in their heads. Have students talk about this briefly with
a partner, and call on a few random students to report on their discussions. Students
will likely point out the joint that allows movement of their jaws and perhaps the joints
between their skulls and the first couple of vertebrae. Some students might additionally
note the sutures between cranial bones, or they might feel stumped after naming only
the movable joints. Calling on random students, as opposed to volunteers, will help to
identify whether many students have the common misconception that joints are de-
fined exclusively as movable articulations between bones. Even the students that iden-
tify the sutures probably do not recognize the other articulations found in the skull and
discussed in Section 9-1. This makes the prompt useful as a launching point for dis-
cussing joint types. After instruction, you can repeat this pair discussion and see if stu-
dents can identify both the movable and immovable joints of the head by naming their
joint types. For the movable joints, they should also recognize the temporomandibular
joint as a combination of hinge and gliding joints and the atlas/axis as a pivot joint.
2. Lecture Ideas and Key Points to Emphasize
a. Many students, when prompted to think about joints, will likely picture the knee or
some other prominent synovial joint. Correct this limited view when you begin the top-
ic by clarifying that joint refers simply to any joining of two bones, and doesn’t
require that they move. You can (literally) point to bones of the skull as familiar
examples of immovable joints.
b. Students might be overwhelmed if encountering the difficult terms of Section 9-1 all
at once. Consider beginning with a simple three-category functional scheme: List the
English descriptions (e.g., “no movement”) and then add the technical descriptors
(e.g., synarthrosis). Develop a table in a conversational style on the board. Section 9-1
then becomes a summary of what you have already covered with marker by hand.
c. Spotlight Figure 9–2 offers a nice way to illustrate the many classes of synovial joints.
The gross anatomy, structural models, and actual examples merit review in class. Point
out as you do that even “freely movable” synovial joints differ greatly in their ease and
range of movement.
d. The principle that there is a trade-off between stability and mobility can be clearly
illustrated using Figure 9–7 of the shoulder joint. As you review the gross anatomy,
point out how much of the anchoring of the joint depends on relatively weak connec-
tive tissue (rotator cuff tendons, ligaments, glenoid labrum). Also, the glenoid cavity
is rather shallow. Compare the shoulder to the elbow (Figure 9–8), a very tight-fitting,
uniaxial humero-ulnar joint. This concept then leads naturally to a presentation of the
robustly trussed (but heavily loaded) hip (Figure 9–9) and knee (Figure 9–10) joints.
Figures 9–10b and d offer rare views of freshly dissected human bones and joints.
3. Making Learning Active
a. One nice feature of this chapter is that much of the material can be easily observed
using nothing more than students’ own bodies. Almost all of Section 9-3 could be
quickly covered using peer teaching as opposed to traditional lecturing. Have students
work in groups of 3 or 4 with their textbooks. Project a list of all the terms describing
the types of movements found in Figures 9–3, 9–4, and 9–5. Tell students their groups
must learn to properly perform every movement using the information in their books.
In addition, their groups should be able to describe the joints that perform each
movement, including the types of synovial joints involved. This requires students to
confront ambiguity and make connections between content areas. For example,
“depression” and “elevation” are shown in relation to the jaw in Figure 9–5, but

Copyright © 2015 Pearson Education, Inc. CHAPTER 9 Joints 59

 Spotlight Figure 9–2 does not tell students what type of joint the jaw is. Students
would have to infer that this joint has qualities of both hinge and gliding joints.
Students will also come to recognize that individual joints may fall into multiple
categories from Spotlight Figure 9–2. Once groups have had a little time to learn the
movements and identify joint types, call groups to the front of the room to demonstrate
a movement and describe the joints involved. Ask students in the audience if they have
any different interpretations for classifying the joints demonstrated. Students can then
discuss the reasons for ambiguity in classifying any unfamiliar or tricky joints, like the
temporomandibular joint.
4. Analogies
a. Describe flexion as encompassing those movements that result in a fetal position.
b. Bursae can be compared to car bumpers or air bags to help cushion joints.
c. The humero-ulnar (elbow), the femoral-tibial (knee), and tibial-talar (ankle) joints can
be analogized to door hinges, a familiar uniaxial “joint.”
d. A kitchen faucet that has only one handle that is used for hot and cold water is an
analogue of ball-and-socket joints such as the shoulder and hip. This type of faucet
even incorporates an equivalent to a labrum made of plastic!
e. A dovetail joint in an antique wooden box or drawer is a “synarthrosis” held together
with collagen-based (hide) glue.
f. The femoral condyles look like big knuckles on which the femur rests its weight.
5. Demonstrations
a. Unlike synarthroses and amphiarthroses, diarthroses have a cavity between the bones
surrounded by a capsule. This cavity is lined with a synovial membrane, and filled
with synovial fluid. The cavity and capsule give this joint its freedom of movement.
A simplified example of such a structure can be demonstrated using two dowel rods
held together with a piece of rubber tubing. The sticks are the bones, the tubing is the
capsule, and the space inside the tubing is the synovial cavity.
b. The use of fully articulated three-dimensional models of representative joints
(obtainable from many lab supply houses) can be a very effective way to bring out
the principles of diarthroses.
c. Artificial synovial fluid (e.g., Synvisc® made from rooster combs) is used to treat osteo-
arthritis. Using Synvisc is a way of putting off a hip replacement. Since osteoarthritis
means bone to bone contact, Synvisc might be effective in resolving hip pain or putting
off surgery for several years. Its viscosity is similar to liquid hand soap or egg whites.
d. Ask the class to point at the location of the only bone in their body that doesn’t articu-
late with another bone. They should be pointing at the space between the muscular
base of the tongue and the soft tissue above the thyroid cartilage (hyoid bone).
6. Applications
a. A whiplash injury to the neck is the result of hyperextension.
b. Full body flexion (“fetal position”) is recommended for lumbar puncture (“spinal
tap”).
c. In physical rehabilitation after joint injury or surgery, quantitative measurements of the
angular range of motion (ROM) are made as a guide to progress.
d. Man-made synovial fluid (Synvisc®) can be injected within the synovial joint capsule
in tiny amounts to treat the pain and disability of osteoarthritis.
e. To reinforce the concept that mobility is purchased at the price of instability, point to
the fact that the shoulder joint is the one most commonly dislocated.

60 INSTRUCTOR'S MANUAL FOR FUNDAMENTALS OF ANATOMY & PHYSIOLOGY, 10E, GE Copyright © 2015 Pearson Education, Inc.
 7. Common Student Misconceptions and Problems
a. To many students, a “joint” is a movable, easily visible feature such as the knee. Most
students don’t recognize that a joint is any joining of two bones, and have difficulty
visualizing the interior structures of joints.
b. Students may have trouble sorting joints into three functional categories. Remind
them that they are now familiar with the concept of categorization (they have seen
organ systems, epithelia, and connective tissues sorted into categories). Tell them to
ask these three questions about each joint: How freely does it move? What holds it
together? Is there a synovial capsule? Ideally, as they examine the skeleton, they will
see that each joint belongs in one of three functional categories. Moreover, they will
learn to apply structural specifics to further subdivide the joints.
c. The informal use of the word “flex” may cause confusion when applied to joints and
movements. Because people colloquially use the word “flex” for any muscle contrac-
tion (e.g., “flex your muscles”), students tend to associate flexion with any type of
movement. For example, they might talk about flexing your jaw (actually elevation)
or flexing your triceps (which results in extension). Recognize the somewhat ambigu-
ous informal use of the word “flex,” and point out that the word “flexion” means
something very specific in terms of the A&P of joints and movement.
d. Certain types of joint movements may be difficult for students to comprehend. For
example, “flexion” and “extension” are easy to distinguish when applied to uniaxial
joints but become cryptic for a multiaxial joint. The simple model of articular motion
(Spotlight Figure 9–2) using a pencil on paper is a useful tool for visualizing move-
ments. Also, performing and naming the movements by groups will make the learning
task more concrete and therefore more manageable (see Encouraging Student Talk
section).

8. Terminology Aids
a. For a suture, compare the uniting of two skull bones with fibrous connective tissue
to the sewing together of two pieces of fabric with a zigzag stitch. The word suture
comes from sutura, Latin for seam.
b. Dissect the word syn–chondro–sis to illustrate that it literally means “[held] together
with cartilage.” Point out that a synchondrosis can become a synostosis if ossification
of the cartilage occurs.
c. The word cruciate means “crossed”; crux is Latin for cross. Crucify derives from
that root. The anterior and posterior cruciate ligaments are named from their points
of attachment on the tibia. They cross the joint within the knee capsule and attach
to posterior and anterior positions on the femur, respectively. Because they angle,
the cruciates provide stability in both lateral–medial and anterior–posterior directions.
d. When someone is “abducted,” they are taken away, just as abduction takes the limb
away from the body. During “adduction,” the limb is “added” to the body.
e. When someone is prone, they are lying face down. Imagine the palm as the “facial”
side of your hand. Pronation of the hand is to position the palm downward or posterior-
ly. When your hand is supinated, it is in the position of being ready to hold a bowl of
soup (“soupinated”).
f. The word synovial means “like egg white,” that is, a clear, slippery, viscoelastic fluid.
g. Point out that the interspinous and supraspinous ligaments get their names because
they are attached to the spinous processes of the vertebrae, not because they stabilize
what most people call the “spine.”

Copyright © 2015 Pearson Education, Inc. CHAPTER 9 Joints 61

Fundamentals of Anatomy and Physiology 10th Edition Martini Solutions Manual

9. Incorporating Diversity & the Human Side of A&P

a. Augustus White, an orthopedic surgeon, was the first African American to graduate
from medical school at Stanford University and the first African American resident in
orthopedics at Yale. He served in the Army Medical Corp in Vietnam and is now the
chief orthopedic surgeon at Harvard Medical School. Dr. White’s biography includes a
fascinating range of stories, from attending segregated schools as a child to playing
football in college to serving as a mentor to and advocate for numerous minority
aspiring doctors. Dr. White’s work has focused on the biomechanics of the vertebral
column. He has studied and written extensively on the ways the vertebrae move and
how those movements relate to chronic back pain. Dr. White’s background and profes-
sional life would serve as an excellent backdrop to studying Section 9-4 and other
areas of Chapter 9.

References/Additional Information:
http://news.harvard.edu/gazette/story/2010/04/augustus-a-white-iii-receives-tipton-award-for-
orthopedic-leadership/
http://minorityhealth.hhs.gov/templates/content.aspx?ID=4039
http://stanmed.stanford.edu/2006summer/alumni-profiles.html

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