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Flashcards in 1a1-chapter 9 - Joints Deck (128):
1

joint

(articulation) –any point where two bones meet, whether or not the bones are movable at that interface

2

arthrology

science of joint structure, function, and dysfunction

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kinesiology

the study of musculoskeletal movement
–a branch of biomechanics–deals with a broad variety of movements and mechanical processes in the body, including the physics of blood circulation, respiration, and hearing

4

joint name

typically derived from the names of the bones involved
–atlanto-occipital joint, glenohumeral joint, radioulnar joint

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joints classified

according to the manner in which the adjacent bones are bound to each other, with differences in how freely the bones can move

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four major joint categories

–bony joints
–fibrous joints
–catilaginous joints
–synovial joints

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synostosis

bony joints
an immovable joint formed when the gap between two bones ossify, and they become in effect, a single bone
–frontal and mandibular bones in infants
–cranial sutures in elderly
–attachment of first rib and sternum with old age
can occur in either fibrous or cartilaginous joint

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Synarthrosis

fibrous joint, synarthrosis, or synarthrodial joint –a point at which adjacent bones are bound by collagen fibers that emerge from one bone, cross the space between them, and penetrate into the other

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three kinds of fibrous joints

–sutures
–gomphoses
–syndesmoses

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sutures

immovable or slightly movable fibrous joints that closely bind the bones of the skull to each other

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sutures

3 types

serrate
lap
plane

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serrate

serrate–interlocking wavy lines
•coronal, sagittal and lambdoid sutures

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lap

lap(squamous)-overlapping beveled edges
•temporal and parietal bones

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plane

plane(butt)-straight, nonoverlapping edges
•palatine processes of the maxillae

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Gomphoses

Fibrous Joint
attachment of a tooth to its socket
held in place by fibrous periodontal ligament

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periodontal ligament

–collagen fibers attach tooth to jawbone
–allows the tooth to move a little under the stress of chewing

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Syndesmosis

Fibrous Joint
a fibrous joint at which two bones are bound by longer collagenous fibers than in a suture or gomphosis giving the bones more mobility
interosseus membrane

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most movable syndesmosis

interosseus membranes unite radius to ulna allowing supination and pronation

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less movable syndesmosis

tibia to fibula

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Cartilaginous Joints

cartilaginous joint, amphiarthrosis or amphiarthrodial joint–two bones are linked by cartilage

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two types of cartilaginous joints

–synchondroses
–symphyses

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synchondrosis

bones are bound by hyaline cartilage
–temporary joint in the epiphyseal plate in children
first rib attachment to sternum
•other costal cartilages are joined to sternum by synovial joints

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symphysis

two bones joined by fibrocartilage
–pubic symphysis in which right and left pubic bones joined by interpubic disc
–bodies of vertebrae and intervertebral discs

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synovial joint,

synovial joint, diarthrosis or diarthrodial joint –joint in which two bones are separated by a space called a joint cavity

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synovial joint,
characteristics

•most familiar type of joint
•most are freely movable
•most structurally complex type of joint
•most likely to develop painful dysfunction
•most important joints for physical and occupational therapists, athletic coaches, nurses, and fitness trainers
•their mobility make them important to quality of life

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articular cartilage

layer of hyaline cartilage that covers the facing surfaces of two bones
–usually 2 or 3 mm thick

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joint (articular) cavity

separates articular surfaces

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synovial fluid

slippery lubricant in joint cavity
–rich in albumin and hyaluronic acid

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joint (articular) capsule

–connective tissue that encloses the cavity and retains the fluid

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joint (articular) capsule

outer fibrous capsule

continuous with periosteum of adjoining bones

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joint (articular) capsule

inner, cellular, synovial membrane

–composed mainly of fibroblast-like cells that secrete synovial fluid and macrophages that remove debris from the joint cavity

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articular disc

forms a pad between articulating bones that crosses the entire joint capsule
•temporomandibular joint, distal radioulnar joints, sternoclavicular and acromioclavicular joints

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meniscus

in the knee, two cartilages extend inward from the left and right but do not entirely cross the joint
•these cartilages absorb shock and pressure
•guide bones across each other
•improve the fit between bones
•stabilize the joints, reducing the chance of dislocation

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accessory structures associated with synovial joints

tendon
ligament
bursa
tendon sheaths

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tendon

a strip or sheet of tough collagenous connective tissue that attaches muscle to bone
•the most important structures in stabilizing a joint

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ligament

similar tissue that attaches one bone to another

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bursa

a fibrous sac filled with synovial fluid, located between adjacent muscles, where tendon passes over bone, or between bone and skin
•cushion muscles, helps tendons slide more easily over joints, modify direction of tendon pull

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tendon sheaths

elongated cylindrical bursae wrapped around a tendon
•in hand and foot

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levers

any elongated, rigid object that rotates around a fixed point called a fulcrum
long bones act as levers to enhance the speed or power of limb movements

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Mechanical Advantage

advantage conferred by a lever can be of two kinds:
–to exert more force against a resisting object than the force applied to the lever
•human moving a heavy object with help of crowbar
–to move the resisting object farther or faster than the effort arm is moved
•movement of rowing a boat

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mechanical advantage (MA) of a lever

the ratio of its output force to its input force

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mechanical advantage

is calculated from the length of the effort arm divided by the length of the resistance arm

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First-Class Lever

has fulcrum in the middle between effort and resistance (RFE)
•atlanto-occipital joint lies between the muscles on the back of the neck and the weight of the face
–loss of muscle tone occurs when you nod off in class

44

Second-Class Lever

resistance between fulcrum and effort (FRE)
•resistance from the muscle tone of the temporalis muscle lies between the jaw joint and the pull of the digastric muscle on the chin as it opens the mouth quickly

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Third-Class Lever

effort between the resistance and the fulcrum (REF)
–most joints of the body
•the effort applied by the biceps muscle is applied to the forearm between the elbow joint and the weight of the hand and the forearm

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range of motion

(ROM) –the degrees through which a joint can move
–an aspect of joint performance
–physical assessment of a patient’s joint flexibility

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range of motion determined by:

–structure of the articular surfaces
–strength and tautness of ligaments and joint capsules
–action of the muscles and tendons

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muscle tone

state of tension maintained in resting muscles

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Axes of Rotation

a moving bone has a relatively stationary axis of rotation that passes through the bone in a direction perpendicular to the plane of movement

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multiaxial joint

shoulder joint has three degrees of freedom or axes of rotation

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other joints

monoaxial or biaxial(

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Classes of Synovial Joints

6

Ball-and-Socket Joints
Condyloid (ellipsoid) Joints
Saddle Joints
Plane (gliding) Joints
Hinge Joints
Pivot Joints

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Ball-and-Socket Joints

smooth, hemispherical head fits within a cuplike socket
–shoulder joint -head of humerus into glenoid cavity of scapula
–hip joint -head of femur into acetabulum of hip bone
•the only multiaxial joints in the body

54

Condyloid (ellipsoid) Joints

oval convex surface on one bone fits into a complementary shaped depression on the other
–radiocarpal joint of the wrist
–metacarpophalangeal joints at the bases of the fingers
•biaxial joints –movement in two planes

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Saddle Joints

both bones have an articular surface that is shaped like a saddle, concave in one direction and concave in the other
–trapeziometacarpal joint at the base of the thumb
–sternoclavicular joint –clavicle articulates with sternum
•biaxial joint
–more movable than a condyloid or hinge joint forming the primate opposable thumb

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Plane (gliding) Joints

flat articular surfaces in which bones slide over each other with relatively limited movement
•usually biaxial joint
–carpal bones of wrist
–tarsal bones of ankle
–articular processes of vertebrae
•although any one joint moves only slightly, the combined action of the many joints in wrist, ankle, and vertebral column allows for considerable movement

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Hinge Joints

one bone with convex surface that fits into a concave depression on other bone
–elbow joint -ulna and humerus
–knee joint -femur and tibia
–finger and toe joints
•monoaxial joint –move freely in one plane

58

Pivot Joints

one bone has a projection that is held in place by a ring-like ligament
•bone spins on its longitudinal axis
–atlantoaxial joint (dens of axis and atlas)
•transverse ligament
–proximal radioulnar joint allows the radius to rotate during pronation and supination
•anular ligament
•monoaxialjoint

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zero position

the position of a joint when a person is in the standard anatomical position
–joint movement is described as deviating from the zero position or returning to it

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flexion

movement that decreases the a joint angle
–common in hinge joints

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extension

movement that straightens a joint and generally returns a body part to the zero position

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hyperextension

further extension of a joint beyond the zero position
–flexion and extension occur at nearly all diarthroses, hyperextension is limited to a few

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abduction

movement of a body part in the frontal plane away from the midline of the body

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hyperabduction

raise arm over back or front of head

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adduction

movement in the frontal plane back toward the midline

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elevation

a movement that raises a body part vertically in the frontal plane

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depression

lowers a body part in the same plane

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protraction

the anterior movement of a body part in the transverse (horizontal) plane

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retraction

posterior movement(

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circumduction

circumduction

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rotation

movement in which a bone spins on its longitudinal axis
–rotation of trunk, thigh, head or arm

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medial (internal) rotation

turns the bone inwards

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lateral (external) rotation

turns the bone outwards

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supination

forearm movement that turns the palm to face anteriorly or upward
–forearm supinated in anatomical position
–radius is parallel to the ulna

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pronation

forearm movement that turns the palm to face posteriorly or downward
–radius spins on the capitulum of the humerus
–disc spins in the radial notch of ulna
–radius crosses stationary ulna like an X

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Mandible

lateral excursion

right or left movement from the zero position

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Mandible

medial excursion

movement back to the median, zero position
–side-to-side grinding during chewing

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hands
opposition

move the thumb to touch the tips of any of the fingers

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hands


reposition

return the thumb to the zero position

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Foot

dorsiflexion

elevation of the toes as you do while swinging the foot forward to take a step (heel strike)

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Foot

plantar flexion

extension of the foot so that the toes point downward as in standing on tiptoe (toe-off)

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Foot

inversion

a movement in which the soles are turned medially

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Foot

eversion

a movement in which the soles are turned laterally

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Temporomandibular

(TMJ) –articulation of the condyle of the mandible with the mandibular fossa of the temporal bone
–combines elements of condylar, hinge, and plane joints

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Temporomandibular divided by

synovial cavity of the TMJ is divided into superior and inferior chambers by an articular disc

86

two ligaments support joint

•lateral ligament –prevents posterior displacement of mandible
•sphenomandibular ligament –on the medial side

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temporomandibular joint (TMJ) syndrome

–may affect as many as 75 million Americans

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temporomandibular joint (TMJ) syndrome

signs and symptoms

–can cause moderate intermittent facial pain
–clicking sounds in the jaw
–limitation of jaw movement
–often severe headaches, vertigo (dizziness), tinnitus (ringing in the ears)
–pain radiating from jaw down the neck, shoulders, and back

89

cause of syndrome

–caused by combination of psychological tension and malocclusion (misalignment of teeth)

90

treatment

–psychological management, physical therapy, analgesic and anti-inflammatory drugs, corrective dental appliances to align teeth properly

91

glenohumeral (humeroscapular) joint

the hemispherical head of the humerus articulates with the glenoid cavity of the scapula
–the most freely movable joint in the body
–shallow glenoid cavity and loose shoulder joint capsule sacrifice joint stability for freedom of movement

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glenoid labrum

fibrocartilage ring that deepens glenoid cavity

93

five principal ligaments support shoulder

–three are called the glenohumeral ligaments
–coracohumeral ligament
–transverse humeral ligament

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four bursa occur at the shoulder

subdeltoid, subacromial, subcoracoid, and subscapular bursae

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4 muscles

supraspinatus, infraspinatus, teres minor and subscapularis

96

elbow

elbowis a hinge joint composed of two articulations:
–humeroulnar joint
humeroradial joint

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humeroulnar joint

where the trochlea of the humerus joins the trochlear notch of the ulna
•hinge joint

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humeroradial joint

where the capitulum of the humerus meets the head of the radius
•pivot joint
•edge of the disc-like head of the radius fits into the radial notch of the ulna
anular ligament holds the head in place

99

olecranon bursa

on posterior side of the elbow
–eases the movement of the tendons over the joint

100

coxal (hip) joint

point at which the head of femur inserts into the acetabulum of the hip bone
•bears much more weight, have deeper sockets, more stable than shoulder

101

acetabular labrum

horseshoe-shaped ring of fibrocartilage that deepens socket

102

ligaments supporting hip joint

iliofemoraland pubofemoral–on anterior
–ischiofemoral ligament –on posterior
–when standing, the ligaments become twisted and pull head of femur tightly into the acetabulum
–transverse acetabular ligament –bridges gap on inferior margin of acetabular labrum

103

fovea capitis

pit on the head of femur
–round ligament, or ligamentum teres –arises from here and attaches to the lower margin of the acetabulum
–contains artery that supplies blood to the head of the femur

104

tibiofemoral (knee) joint

largest and most complex diarthrosis of the body
primarily a hinge joint

105

primarily a hinge joint

–capable of slight rotation and lateral gliding when knee flexed
–patellofemoral joint –gliding joint

106

joint capsule

encloses only the lateral and posterior aspects of the knee, not the anterior
–anterior covered by patellar ligament and lateral and medial retinacula
•all are extensions of the tendon of quadriceps femoris muscle

107

knee stabilized:

–quadriceps tendon in front
–tendon of semimembranosus muscle on rear side of thigh

108

joint cavity contains two C-shaped cartilages

lateral meniscus and medial meniscus
–joined by transverse ligament
•absorbs shock on the knee
•prevents femur from rocking side-to-side on the tibia

109

popliteal region of knee

–supported by a complex array of:

extracapsular ligaments
two intracapsular ligaments deep within joint capsule

110

extracapsular ligaments

external to joint capsule
•prevent knee from rotating when joint is extended
•fibular (lateral) collateral ligament
•tibial (medial) collateral ligament

111

two intracapsular ligaments deep within joint capsule

deep within joint capsule
•synovial membrane folds around them, so they are excluded from the fluid filled synovial cavity
•ligaments cross each other to form an X
•anterior cruciate ligament (ACL)
–prevents hyperextension of knee when ACL is pulled tight
–one of the most common sites of knee injury
•posterior cruciate ligament (PCL)
–prevents femur from sliding off tibia
–prevents the tibia from being displaced backward

112

ability to “lock” the knees

important aspect of human bipedalism
–when knee is extended to the fullest degree allowed by ACL
•femur rotates medially on the tibia
•locks the knee, and all major knee ligaments are twisted and tau

113

–“unlock” knee

popliteus muscle rotates the femur laterally and untwists the ligaments

114

Knee Joint –Sagittal Section

knee joint has at least 13 bursae
•four anterior: superficial infrapatellar, suprapatellar, prepatellar, and deep infrapatellar
•popliteal region: popliteal bursa and semimembranosus bursa
•seven more bursae on lateral and medial sides of knee joint

115

medial and lateral meniscus

absorb shock and shape joint

116

Knee Injuries

most common injuries are to the meniscus and anterior cruciate ligament (ACL)
•heal slowly due to scanty blood flow

117

arthroscopy

procedure in which the interior of the joint is viewed with a pencil-thin arthroscope inserted through a small incision
–less tissue damage than conventional surgery
–recovery more quickly
–arthroscopic ACL repair –about nine months for healing to be complete

118

talocrural (ankle) joint

includes two articulations:

–medial joint –between tibia and talus
–lateral joint –between fibula and talus

119

talocrural (ankle) joint

includes two articulations:
–both enclosed by one joint capsule
–malleoli of tibia and fibula overhang the talus on either side and prevent side-to-side motion
–more restricted range of motion than the wrist

120

ankle ligaments

–anterior and posterior tibiofibular ligaments –bind the tibia to fibula
–multipart medial (deltoid) ligament –binds the tibia to the foot on the medial side
–multipart lateral (collateral) ligament –binds fibula to the foot on the lateral side
–calcaneal (Achilles) tendon –extends from the calf muscle to the calcaneus
•plantar flexes the foot and limits dorsiflexion

121

sprains

sprains(torn ligaments and tendons) are common at the ankle
•pain and immediate swelling

122

arthritis

a broad term for pain and inflammation of a joint
•most common crippling disease in the United States

123

rheumatologists

physicians who treat arthritis and other joint disorders

124

osteoarthritis

osteoarthritis(OA) –most common form of arthritis
–‘wear-and-tear arthritis’
–results from years of joint wear
–articular cartilage softens and degenerates
–accompanied by crackling sounds called crepitus
–bone spurs develop on exposed bone tissue causing pain

125

crepitus

accompanied by crackling sounds called

126

rheumatoid arthritis (RA)

-autoimmune attack against the joint tissues
–misguided antibodies (rheumatoid factor) attack synovial membrane, enzymes in synovial fluid degrade the articular cartilage, joint begins to ossify

127

ankylosis

solidly fused, immobilized joint
–remissions occur, steroids and aspirin control inflammation

128

arthroplasty

the replacement of diseased joint with artificial device called prosthesis