Combined LJM TBL 1

Which of the following best describes the structure of the articular capsule in synovial joints?

An outer layer of dense irregular connective tissue continuous with periostea and an inner synovial membrane of loose connective tissue

The synovial fluid in joints primarily originates from which structure?

Capillary beds within the synovial membrane

What is the main function of the articular cartilage found on the ends of bones in synovial joints?

To transmit joint loading and protect bony surfaces by cushioning

"Weeping lubrication" in synovial joints refers to:

The squeezing of synovial fluid in and out of the articular cartilage during joint movement

Which of the following statements about synovial joint ligaments is TRUE?

They guide movement by maintaining tautness to prevent excessive joint mobility

What is the role of mechanoreceptors found within the synovial joint capsule?

To sense mechanical stretch and contribute to proprioception

Which of the following best explains the reason why synovial fluid viscosity decreases with joint activity?

Movement facilitates the cycling of synovial fluid in and out of cartilage, maintaining fluidity

The coracoacromial ligament of the shoulder:

Supports the joint by holding adjacent structures in place without crossing the joint

Which factor does NOT directly affect synovial joint mobility?

Amount of synovial fluid produced by the periosteum

Relaxin hormone affects synovial joints primarily by:

Increasing connective tissue laxity to allow greater mobility, especially in the female pelvis

Which connective tissue type composes the fibrous outer layer of the articular capsule?

Dense irregular connective tissue with fibers oriented variably

What is the primary source of nutrients and waste removal for cartilage cells in synovial joints?

Diffusion via synovial fluid moved by joint loading

Collateral ligaments in joints like the metacarpophalangeal joint are best described as:

Thickened regions of the articular capsule blending into it

The joint cavity in synovial joints is:

The space between articulating surfaces containing synovial fluid

Why is the fibrous outer layer of the articular capsule described as 'continuous with periostea'?

Because it blends seamlessly with the periosteum, the connective tissue covering bone

What is the fundamental cause of Systemic Lupus Erythematosus (SLE)?

Autoimmune reaction to host nuclear proteins

Which type of hypersensitivity reaction is most associated with SLE?

Type I (IgE mediated)

What is the significance of antinuclear antibodies (ANA) in SLE?

They form immune complexes that cause inflammation

The classic malar flush seen in SLE appears where?

On the cheeks

Rheumatoid arthritis primarily affects which tissue?

Joint soft tissues

What is ‘pannus’ in the context of rheumatoid arthritis?

Inflamed soft tissue mass over joints formed by inflammatory complexes

In rheumatoid arthritis, what is the typical deformity of the hands?

Ulnar deviation at MCP joints and radial deviation at the wrist

How do symptoms of rheumatoid arthritis typically change with activity?

Worsen with rest and improve with activity

Which autoimmune disease mainly causes inflammation of skeletal muscles?

Polymyositis

Which viral infections have been implicated as triggers in polymyositis?

HIV, Hepatitis C, Coxsackievirus

What cells primarily cause muscle damage in polymyositis?

Cytotoxic T lymphocytes and macrophages

What histological feature is characteristic of polymyositis?

Endomysial mononuclear infiltrates and muscle fiber necrosis

Which muscles are predominantly affected in polymyositis?

Proximal muscles such as shoulder girdle and hip muscles

Which autoimmune disease is characterized by collagen deposition and fibrosis rather than inflammation?

Scleroderma

Raynaud’s phenomena associated with scleroderma differs from primary Raynaud’s disease in that:

It occurs secondary to another disease such as scleroderma

What is the fundamental pathology in vasculitis?

Autoimmune inflammation of blood vessel walls

Which antibody is commonly tested for in vasculitis involving neutrophil cytoplasmic antigens?

ANCA

Sjögren’s syndrome primarily affects which glands?

Exocrine glands such as lacrimal and salivary glands

Which viruses have been linked to triggering Sjögren’s syndrome?

Epstein-Barr virus

The autoantibodies SSA/Ro and SSB/La are associated with which condition?

Sjögren’s syndrome

What type of antibodies are naturally present in healthy individuals as part of immune housekeeping?

Low affinity IgM autoantibodie

Pathological autoantibodies in autoimmune disease are primarily of which class?

IgG

Rheumatoid Factor is:

An autoantibody that may appear in multiple autoimmune diseases

What is the key challenge in diagnosing autoimmune conditions like SLE?

Correlation of multiple symptoms, signs, and complex blood tests

Which of the following best describes the relationship between genetics and autoimmune diseases discussed?

Genetic predisposition combined with environmental triggers

Which cell type is primarily responsible for maintaining cartilage?

Chondrocytes

What component of cartilage is most crucial for retaining water and thus providing compressive strength?

Proteoglycans

Why does cartilage have a poor capacity to heal after injury?

Absence of blood vessels and nerves

What type of cartilage forms as a repair response after damage to hyaline cartilage?

Fibrocartilage

What role does the meniscus play in the knee joint?

Provides energy dissipation and shock absorption

Which nutrient source supports cartilage maintenance since it lacks blood supply?

Synovial fluid diffusion

Which movement term describes moving a limb away from the midline of the body?

Abduction

What is the best description of a chondral fracture?

A fracture involving cartilage without underlying bone damage

Why is osteoarthritis more common in professional athletes like footballers?

Due to repetitive joint trauma and excessive biomechanical stress

Which statement about osteochondritis dissecans is TRUE?

It involves repetitive damage to cartilage and subchondral bone

Osteonecrosis primarily results from

Blood supply interruption leading to bone and cartilage death

Which of the following conditions is NOT typically associated with causing osteonecrosis?

Excessive exercise

Which type of cartilage is present in the meniscus?

Fibrocartilage

What biomechanical advice is often given after a cartilage or bone fracture in the knee?

Movement or mobilization to stimulate repair

What happens when the meniscus is removed completely?

Reduced energy dissipation leading to increased cartilage failure risk

Which of these is NOT a component of cartilage extracellular matrix?

Myelin

Which statement about cartilage healing is correct?

Fibrocartilage repair tissue lacks the biomechanical properties of hyaline cartilage

Which of the following is the best example of a biomechanical factor contributing to cartilage failure?

Meniscal removal increasing joint stress

The most characteristic early symptom of osteoarthritis due to cartilage failure is:

Pain worsening after activity

Which of the following statements about synovial fluid is FALSE?

It contains immune cells to attack pathogens

Why is osteonecrosis more disabling in adults compared to children?

Adults’ bones have less capacity for spontaneous repair

Which of these best explains why complete meniscal removal is rarely done?

Meniscus removal increases risk of early joint degeneration

Which of the following is primarily responsible for forming the bone matrix

Osteoblasts

What gives bone its mechanical properties such as stiffness and toughness?

Extracellular matrix

Osteoclasts are derived from which cell lineage?

Specialized macrophages

Which of the following accurately describes osteogenic cells?

Precursors to osteocytes and osteoblasts

Which bone cell primarily regulates calcium levels through resorption activity?

Osteoclast

According to Wolff’s Law, bone density changes in response to:

Mechanical stress

Inverse Wolff’s Law refers to

Loss of bone mass due to lack of mechanical load

Disuse osteopenia occurs as a result of:

Lack of mechanical stress

Osteoporosis differs from rickets primarily in that it is:

A quantitative bone deficiency

Which region of bone is most affected in rickets?

Epiphyseal plate

Strain is defined as:

Deformation divided by original length

Which region of the stress-strain curve shows reversible deformation?

Elastic region

The slope of the elastic portion of the stress-strain curve represents:

Young’s Modulus

The area under the stress-strain curve represents:

Toughness

Hooke’s Law is valid within which region of the stress-strain graph?

Elastic

What marks the transition from elastic to plastic deformation on the stress-strain graph?

Yield point

Necking is characterized by:

Decrease in cross-sectional area before fracture

A plastic bag demonstrates which sequence when pulled until failure?

Elastic → Plastic → Necking

Toughness is best defined as the material’s ability to:

Absorb energy before fracturing

Why is titanium preferred over stainless steel in hip implants?

It has a closer Young’s Modulus to bone

Modulus mismatch can lead to:

Stress shielding and bone loss

Which material shows almost no plastic deformation before breaking?

Ceramic

In a stress-strain curve, ceramic materials are represented by:

High-gradient elastic lines with no plastic region

Compact bone primarily consists of:

Hydroxyapatite

Compared to cortical bone, spongy bone has:

Lower stiffness

Which bone type is more likely to fracture under low stress due to thin cortices?

Spongy bone

Bone fractures when:

The stress exceeds the elastic limit

Osteoporotic bone fractures more easily because:

. It has lower toughness and stiffness

Which statement about primary vs secondary bone healing is true?

The strain level influences the type of healing

Which synovial joint type allows movement primarily in one plane like flexion and extension?

Hinge joint

Which synovial joint permits rotational movement around a single longitudinal axis?

Pivot joint

Which synovial joint allows movement in two planes (flexion-extension and abduction-adduction) but no rotation?

Condyloid joint

Which synovial joint type allows movement in multiple planes including rotation, flexion, extension, abduction, and adduction?

Ball-and-socket joint

Which synovial joint has saddle-shaped articulating surfaces allowing movement in two planes plus opposition?

Saddle joint

Which synovial joint type is characterized by flat or slightly curved articular surfaces that allow only gliding movements?

Plane joint

Which of the following lists includes all six types of synovial joints?

Hinge, pivot, plane, ball-and-socket, saddle, condyloid

Which of the following is an example of a hinge joint?

Elbow joint

The joint that allows rotational movement around a single axis, such as the proximal radioulnar joint, is classified as a:

Pivot joint