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© 2011 Pearson Education, Inc.
Section 1: Joint Design and Movement
• Articulations (joints)
• Where two bones interconnect
• Bones are relatively inflexible so joints are necessary to allow movement
• Reflect compromise between need for strength versus need for mobility
• Anatomical structure of each joint determines type and amount of movement possible
© 2011 Pearson Education, Inc.
Section 1: Joint Design and Movement
• Three functional categories
1. Synarthrosis (no movement)
2. Amphiarthrosis (little movement)
3. Diarthrosis (free movement)
© 2011 Pearson Education, Inc.Figure 8.1 1
The structure of synovial joints
Components of Synovial Joints
Articular cartilage
Joint capsule
Synovial fluid
Medullary cavity
Periosteum
Synovial membrane
Spongy bone of epiphysis
Compact bone
Synovial Joints
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Components of synovial joints
• Articular cartilages
• Slick and smooth, so reduce friction
• Are separated by thin film of synovial fluid
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Components of synovial joints (continued)
• Synovial fluid
• Similar in composition to ground substance in loose connective tissues
• Produced at the synovial membrane
Functions of synovial fluidLubricationNutrient distributionShock absorption
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Components of synovial joints (continued)
• Joint capsule
• Dense and fibrous
• Continuous with periosteum of each bone
© 2011 Pearson Education, Inc.Figure 8.1 1
The structure of synovial joints
Components of Synovial Joints
Articular cartilage
Joint capsule
Synovial fluid
Medullary cavity
Periosteum
Synovial membrane
Spongy bone of epiphysis
Compact bone
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Accessory structures
• Provide support and additional stability
• Not all are included in every joint!
• Most are seen in the knee
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Accessory structures in knee
• Tendons
• Pass across joint
• Limit movement
• Provide mechanical support
• Bursa (a pouch)
• Small pocket filled with synovial fluid
• Often form in areas where tendon or ligament rubs against other tissues
• Reduce friction and act as shock absorbers
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Accessory structures in knee (continued)
• Fat pads
• Adipose tissue(aka:fat) covered by synovial membrane
• Protect articular cartilages
• Act as packing material for joint
• Meniscus (a crescent)
• Pad of fibrous cartilage between bones of synovial joint
• May subdivide joint cavity and affect fluid flow or allow variations in shapes of articular surfaces
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Accessory structures in knee (continued)
• Accessory ligaments
• Support, strengthen, and reinforce joint
• Intrinsic ligaments• Localized thickening of joint capsule
• Example: cruciate liagments of knee (ACL,MCL,PCL)
• Extrinsic ligaments• Separate from joint capsule
• May pass inside (intracapsular) or outside (extracapsular) the joint capsule
• Extracapsular example: patellar ligament
© 2011 Pearson Education, Inc.Figure 8.1 3
Articularcartilage
Joint cavity
Joint capsule
Synovialmembrane
Patella
Tibia
Femur
Accessory Structures
Bursa
Fat pad
Meniscus
Extracapsular ligament
Intracapsular ligament
Tendon of the quadriceps muscles
Accessory structures of complex synovial joints,as seen in a diagrammatic view of asagittal section of the knee
© 2011 Pearson Education, Inc.
Module 8.1: Synovial joints
• Mobility vs. strength in joints
• Greater range of motion = weaker joint
• Examples:• Synarthrosis (strongest type of joint, no movement)
• Diarthrosis (far weaker but broad range of motion)
• Dislocation (luxation)
• Movement beyond normal range of motion
• Articulating surfaces forced out of position
• Can damage joint structures
• No pain from inside joint but from nerves or surrounding structures
© 2011 Pearson Education, Inc.
Module 8.1 Review
a. Define a joint dislocation (luxation).
b. Describe the components of a synovial joint, and identify the functions of each.
c. Why would improper circulation of synovial fluid lead to the degeneration of articular cartilages in the affected joint?
© 2011 Pearson Education, Inc.
Module 8.2: Types of motion and structural types of synovial joints
• Types of motion permitted at synovial joints• Gliding
• Movement along two axes in one plane
• Angular motion• Movement along two axes in one plane with
additional change in angle
© 2011 Pearson Education, Inc.
Module 8.2: Types of motion and structural types of synovial joints
• Types of motion permitted at synovial joints (continued)
• Circumduction• Special complex angular movement• Proximal end of bone remains fixed while distal end can
move in a circle (“trace circumference”)
• Rotation• Bone ends remain fixed and shaft rotates
Animation: Synovial Joints: Movement
© 2011 Pearson Education, Inc.Figure 8.2 1 – 5
The general types of movement at synovial joints
Starting position
Gliding
Angular motion
Circumduction
Rotation
© 2011 Pearson Education, Inc.Figure 8.2 6
Gliding joint
Hinge joint
Pivot joint
Ellipsoid joint
Saddle joint
Ball-and-socket joint
The anatomical types of synovial joints, with joint models and examples
Types of Synovial Joints Models of Joint Motion Examples
Manubrium
Clavicle
Ulna
Humerus
Atlas
Axis
Scaphoid bone
UlnaRadius
Metacarpal boneof thumb
Trapezium
Scapula
Humerus
• Acromioclavicular and claviculosternal joints• Intercarpal and intertarsal joints• Vertebrocostal joints• Sacro-iliac joints
• Elbow joints• Knee joints• Ankle joints• Interphalangeal joints
• Atlas/axis• Proximal radio-ulnar joints
• Radiocarpal joints• Metacarpophalangeal joints 2–5• Metatarsophalangeal joints
• First carpometacarpal joints
• Shoulder joints
• Hip joints
© 2011 Pearson Education, Inc.
Module 8.2 Review
a. Identify the types of synovial joints based on the shapes of the articulating surfaces.
b. What type of synovial joint permits the widest range of motion?
c. Indicate the type of synovial joint for each of the following: shoulder, elbow, ankle, and thumb.
© 2011 Pearson Education, Inc.
Module 8.3: Specific angular movements
• Flexion and extension
• Usually applied to movements of long bones of limbs but also axial skeleton
• Flexion
• Anterior/posterior movement that reduces angle between articulating elements• Lateral flexion
• Vertebral column bending to the side
• Dorsiflexion
• Flexion at ankle joint and elevation of sole
• Plantar flexion (planta, sole)
• Extension at ankle joint and elevation of heel
© 2011 Pearson Education, Inc.
Module 8.3: Specific angular movements
• Flexion and extension (continued)
• Extension
• Anterior/posterior movement that increases angle between articulating elements
• Hyperextension
• Extension past anatomical position
© 2011 Pearson Education, Inc.Figure 8.3 1
Flexion and extension
Flexion
Extension
Hyperextension
Flexion
Extension
Flexion Hyperextension
Lateral flexion
Dorsiflexion(ankle flexion)
Plantar flexion(ankle extension)
© 2011 Pearson Education, Inc.
Module 8.3: Specific angular movements
• Abduction and Adduction
• Always refers to movements of appendicular skeleton, not axial
• Movements are usually toward or away from body midline
• For fingers or toes, movements are spreading digits apart or bringing them together
• Abduction (ab, from)
• Movement away from body longitudinal axis in frontal plane
• Adduction (ad, to)
• Movement toward body longitudinal axis in frontal plane
© 2011 Pearson Education, Inc.Figure 8.3 2
Abduction and adduction
Abduction
Abduction
Abduction
Adduction
Adduction
Adduction
Adduction
Adduction
Abduction
Abduction
© 2011 Pearson Education, Inc.
Module 8.3: Specific angular movements
• Circumduction
• Moving arm or thigh as if to draw a big circle at distal end of limb
© 2011 Pearson Education, Inc.
Module 8.3 Review
a. When doing jumping jacks, which lower limb movements are necessary?
b. Which movements are associated with hinge joints?
c. Compare dorsiflexion to plantar flexion.
© 2011 Pearson Education, Inc.
Module 8.4: Rotation and special movements
• Rotation
• When applied to the trunk, described as left and right rotation
• When applied to limbs
• Medial rotation (internal or inward rotation)
• Anterior surface of limb toward trunk long axis
• Lateral rotation (external or outward rotation)
• Anterior surface of limb away from trunk long axis
© 2011 Pearson Education, Inc.Figure 8.4 1
Rotational movements
Rightrotation
Leftrotation
Lateral(external)
rotationMedial(internal)rotation
© 2011 Pearson Education, Inc.
Module 8.4: Rotation and special movements
• Rotation (continued)
• Other special terms for rotation of forearm
• Pronation• Proximal end of radius rotates near ulna
• Distal end rolls across anterior ulnar surface
• Turns the wrist and hand from palm facing front to palm facing back
• Supination• Opposing movement
• Palm is turned anteriorly
© 2011 Pearson Education, Inc.Figure 8.4 1
Rotational movements
Supination
Pronation
© 2011 Pearson Education, Inc.
Module 8.4: Rotation and special movements
• Special movements
• Opposition
• Movement of thumb toward palm surface or other fingers
• Protraction
• Movement forward in anterior plane
• Retraction
• Reverse of protraction
• Inversion (in, into + vertere, to turn)
• Twisting foot motion to turn sole inward
• Eversion (e, out)
• Opposing movement to inversion
© 2011 Pearson Education, Inc.
Module 8.4: Rotation and special movements
• Special movements (continued)
• Depression
• Movement inferiorly
• Elevation
• Movement superiorly
© 2011 Pearson Education, Inc.Figure 8.4 2
Special movements
Opposition
Eversion Inversion
Retraction Protraction
Depression Elevation
© 2011 Pearson Education, Inc.
Module 8.4 Review
a. Snapping your fingers involves what movement with the thumb and third metacarpophalangeal joint?
b. What movements are made possible by the rotation of the radius head?
© 2011 Pearson Education, Inc.
Section 2: Articulations
• SPECIFIC ARTICULATIONS
© 2011 Pearson Education, Inc.
Section 2: Articulations
• Axial skeleton articulations
• Typically are strong but very little movement
• Appendicular skeleton articulations
• Typically have extensive range of motion
• Often weaker than axial articulations
© 2011 Pearson Education, Inc.Figure 8 Section 2 1
Joints of theAxial Skeleton
Sutures of the skull
Temporomandibular joint(temporal bone andmandible)
Atlanto-occipital joint(occipital bone and atlas)and the atlanto-axial joint(C1–C2)
Joints of the thoracic cage
Intervertebral joints
The lumbosacral joint,which attaches the lastlumbar vertebra to thesacrum
The sacrococcygeal andintercoccygeal joints,which structurallyresemble simplifiedintervertebral joints
© 2011 Pearson Education, Inc.Figure 8 Section 2 2
Joints of the foot and toes
Ankle joint
Knee joint
Hip joint
Joints of the handand fingers
Wrist joint
Pubic symphysis
Superior and inferiorradio-ulnar joints
Elbow joint
The sacro-iliac joint, whichfirmly attaches the sacrumof the axial skeleton to thepelvic girdle of theappendicular skeleton
Shoulder joint
The sternoclavicular joint,the only articulation betweenthe axial skeleton and thepectoral girdle and upperlimb
Joints of theAppendicular Skeleton
© 2011 Pearson Education, Inc.
Module 8.5: Vertebral articulations
• Vertebral articulations
• Between superior and inferior articular processes of adjacent vertebrae
• Gliding diarthrotic joints
• Permit flexion and rotation
• Adjacent vertebral bodies form symphyseal joints with intervertebral discs
• Numerous ligaments attach bodies and processes of vertebrae to stabilize column
© 2011 Pearson Education, Inc.
Module 8.5: Vertebral articulations
• Intervertebral discs
• Composition
• Anulus fibrosis• Tough outer layer of fibrous cartilage
• Collagen fibers attach to adjacent vertebrae
• Nucleus pulposus• Soft, elastic, gelatinous core
• Provides resiliency and shock absorption
• Account for ¼ length of vertebral column
• Water loss from discs causes shortening of vertebral column with age and increases risk of disc injury
© 2011 Pearson Education, Inc.Figure 8.5 1
An intervertebral disc
Superior view
Anulus fibrosus
Nucleus pulposus
© 2011 Pearson Education, Inc.
Module 8.5: Vertebral articulations
• Primary vertebral ligaments• Ligamentum flavum
• Connects adjacent vertebral laminae• Posterior longitudinal ligament
• Connects posterior surfaces of adjacent vertebral bodies• Interspinous ligament
• Connects spinous processes of adjacent vertebrae• Supraspinous ligament
• Connects spinous processes from sacrum to C7 • Ligamentum nuchae from C7 to base of skull
• Anterior longitudinal ligament• Connects anterior surfaces of adjacent vertebral bodies
© 2011 Pearson Education, Inc.Figure 8.5 2
The ligaments attached to the bodies and processes of all vertebrae
Primary Vertebral Ligaments
Ligamentum flavum
Posterior longitudinal ligament
Interspinous ligament
Supraspinous ligament
Anterior longitudinal ligament
Lateral view Sectional view
Posteriorlongitudinalligament
Spinal nerve
Spinal cord
Anulus fibrosus
Nucleus pulposus
Intervertebral disc
© 2011 Pearson Education, Inc.
Module 8.5: Vertebral articulations
• Disorders of vertebral column
• Slipped disc
• Posterior longitudinal ligaments weaken causing more pressure on discs
• Nucleus pulposus compresses, distorts anulus fibrosus
• Disc bulges into vertebral canal (doesn’t actually slip!!!)
• Herniated disc
• Nucleus pulposus breaks through anulus fibrosus
• Spinal nerves are often affected
© 2011 Pearson Education, Inc.Figure 8.5 3
A slipped disc, as seen in a lateral view
Normalintervertabraldisc
Slippeddisc
T12
L1
L2
© 2011 Pearson Education, Inc.Figure 8.5 4
Anulusfibrosis
Spinal cord
Spinal nerve
Nucleus pulposusof herniated disc
Compressed areaof spinal nerve
A herniated disc, as seen in a superior view
© 2011 Pearson Education, Inc.
Module 8.5: Vertebral articulations
• Disorders of vertebral column (continued)
• Osteopenia (penia, lacking)
• Inadequate ossification leading to loss of bone mass
• Often occurs with age beginning between ages 30 and 40
• More severe in women than men
• Osteoporosis (porosus, porous)
• Bone loss sufficient to affect normal function
© 2011 Pearson Education, Inc.Figure 8.5 5
The effects of osteoporosis on spongy bone
Clinical scan of a compressionfracture in a lumbar vertebra
© 2011 Pearson Education, Inc.Figure 8.5 5
The effects of osteoporosis on spongy bone
Normal spongy bone SEM x 25 SEM x 21Spongy bone withosteoporosis
© 2011 Pearson Education, Inc.
Module 8.5 Review
.
a. Describe the nucleus pulposus and anulus fibrosus of an intervertebral disc.
b. Compare a slipped disc with a herniated disc.
© 2011 Pearson Education, Inc.
Module 8.6: Shoulder and hip joints
• Shoulder joint (glenohumeral joint)
• Greatest range of motion of any joint• Most frequently dislocated joint
• Demonstrates stability sacrificed for mobility
• Most stability provided by surrounding skeletal muscles, associated tendons, and various ligaments
• Ball-and-socket diarthrosis
• Formed by head of humerus and glenoid cavity of scapula
• Socket of glenoid cavity increased by fibrous-cartilaginous glenoid labrum (labrum, lip or edge)
© 2011 Pearson Education, Inc.
Module 8.6: Shoulder and hip joints
• Shoulder joint (continued)
• Ligaments stabilizing the shoulder
• Coracoclavicular ligaments
• Acromioclavicular ligament
• Coraco-acromial ligament
• Coracohumeral ligament
• Glenohumeral ligaments
© 2011 Pearson Education, Inc.Figure 8.6 1
The shoulder joint (glenohumeral joint)
Coracoid process Clavicle
Acromion
Bursae
Articularcapsule Scapula
Humerus
Tendon of the bicepsbrachii muscle
Ligaments Stabilizingthe Shoulder
Coracoclavicular ligaments
Acromioclavicular ligament
Coraco-acromial ligament
Coracohumeral ligament
Glenohumeral ligaments
© 2011 Pearson Education, Inc.Figure 8.6 2 – 3
The structures within and surrounding the shoulder joint
A frontal section of the shoulder joint A lateral view of the shoulder joint
Subdeltoidbursa
Articularcapsule
Coraco-acromialligament
Coracoclavicularligaments
Clavicle
HumerusScapula
Articularcartilages
Glenoidlabrum
Synovialmembrane
Frontal section
Glenoidlabrum
Articularcapsule
Acromioclavicularligament Clavicle Tendon of
supraspinatus muscle
Tendon ofinfraspinatus muscle
Tendon of bicepsbrachii muscle
Coracohumeralligament (cut)
Glenohumeralligaments
Subscapularis muscle
Teres minor muscle
Scapula
Lateral view
Glenoidcavity
Acromion
© 2011 Pearson Education, Inc.
Module 8.6: Shoulder and hip joints
• Hip joint
• Sturdy ball-and-socket joint
• Permits flexion, extension, adduction, abduction, circumduction, and rotation
• Formed by head of femur and acetabulum of hip bone
© 2011 Pearson Education, Inc.Figure 8.6 4
The hip joint in lateral view
Acetabulum
Transverse acetabular ligament
Iliofemoral ligament Fibrous cartilage pad
Acetabular labrum
Ligamentum teres(ligament of thefemoral head)
Fat pad
© 2011 Pearson Education, Inc.
Module 8.6: Shoulder and hip joints
• Hip joint (continued)
• Reinforcing ligaments
1. Transverse acetabular ligament
• Crosses acetabular notch, filling gap in inferior border
2. Ligamentum teres (teres, long and round)
• Originates along transverse acetabular ligament and attached to fovea capitis
3. Pubofemoral ligament
4. Iliofemoral ligament
5. Ischiofemoral ligament
© 2011 Pearson Education, Inc.Figure 8.6 5
Greatertrochanter
Inter-trochantericline
Lesser trochanter Anterior view
The ligaments of the hip joint in anterior view
The ligaments of the hip joint in posterior view
Posterior view
Ischialtuberosity
Pubofemoral ligament
Iliofemoral ligament
Ischiofemoral ligament
Reinforcing Ligaments
The ligaments of the hip joint
© 2011 Pearson Education, Inc.
Module 8.6 Review
a. Which tissues or structures provide most of the stability for the shoulder joint?
b. At what site are the iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament located?
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Elbow joint
• Complex hinge joint involving humerus, radius, and ulna
• Extremely strong and stable due to:
1. Bony surfaces of humerus and ulna interlock
2. Single, thick articular capsule surrounds both humero-ulnar and proximal radio-ulnar joints
3. Articular capsule reinforced by strong ligaments
• Muscles flexing elbow attach on anterior while those extending attach on the posterior
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Elbow joint (continued)
• Specific joints of the elbow
• Humeroradial joint
• Capitulum of humerus articulating with head of radius
• Humero-ulnar joint
• Largest and strongest articulation
• Trochlea of humerus articulates with trochlear notch of ulna
• Shape of ulnar notch determines plane of movement
• Shapes of olecranon fossa and olecranon limit degree of extension
• Proximal radio-ulnar joint is not part of elbow joint
© 2011 Pearson Education, Inc.Figure 8.7 1
The elbow joint
Anteriorview Humerus
Humeroradial joint
Humeroulnar joint
UlnaRadius
Proximal radio-ulnar joint(not part of the elbow joint)
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Elbow joint (continued)
• Reinforcing ligaments
• Radial collateral ligament
• Stabilizes lateral surface of joint
• Ulnar collateral ligament
• Stabilizes medial surface of joint
• Annular ligament
• Binds head of radius to ulna
© 2011 Pearson Education, Inc.Figure 8.7 1
The elbow joint
Humeroulnar joint
Posteriorview
Olecranonfossa
Olecranon
Ulna
Humerus
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Knee joint
• Contains three separate articulations
1. Medial condyle of tibia to medial condyle of femur
2. Lateral condyle of tibia to lateral condyle of femur
3. Patella and patellar surface of femur
• Permits flexion, extension, and very limited rotation
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Knee joint (continued)
• External support
• Quadriceps tendon to patella
• Continues as patellar ligament to anterior tibia
• Fibular collateral ligament
• Lateral support
• Tibial collateral ligament
• Medial support
• Popliteal ligaments
• Posterior support extending between femur and heads of tibia and fibula
• Tendons of several muscles that attach to femur and tibia
© 2011 Pearson Education, Inc.Figure 8.7 3 – 4
Superficialanterior view
Superficialposterior view
The knee joint
Quadricepstendon
Fibularcollateralligament
Fibula Tibia
Patellarligament
Patella
Joint capsule
Bursa
Tibial collateralligament
Popliteal ligaments
Femur
Tibia
Fibula
Fibularcollateralligament
Cut tendonof bicepsfemorismuscle
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Knee joint (continued)
• Internal support
• Cruciate ligaments limit anterior/posterior movement of femur and maintain alignment of condyles• Anterior cruciate ligament (ACL)
• At full extension, knee becomes “locked” (slight lateral rotation tightens ACL, and lateral meniscus forced between tibia and femur)
• Posterior cruciate ligament (PCL)
© 2011 Pearson Education, Inc.
Module 8.7: Elbow and knee joints
• Knee joint (continued)
• Internal support (continued)
• Medial and lateral menisci
• Fibrous cartilage pads between tibial and femoral condyles
• Act as cushions and provide lateral stability to joint
© 2011 Pearson Education, Inc.Figure 8.7 3 – 4
Deep anteriorview, flexed
Fibularcollateralligament
Fibula
Tibia
Lateralcondyle
Medialcondyle
Patellarsurfaceof femur
PCL
ACL PCL
ACL
Tibial collateral ligament
Medial and lateral menisci
Medialcondyle
Lateralcondyle
Fibularcollateralligament
Tibia Fibula
Femur
Deep posteriorview, extended
The knee joint
© 2011 Pearson Education, Inc.Figure 8.8 5
© 2011 Pearson Education, Inc.
Module 6.7 Review
a. Define intramembranous ossification.
b. During intramembranous ossification, which type(s) of tissue is (are) replaced by bone?
c. Explain the primary difference between endochondral ossification and intramembranous ossification.
© 2011 Pearson Education, Inc.
• Endocrine and metabolic problems can affect the skeletal system
• Disorders causing shortened bones
• Pituitary growth failure
• Reduction in growth hormone leads to reduced epiphyseal cartilage activity and short bones
• Rare due to treatment with synthetic growth hormone
• Achondroplasia
• Epiphyseal cartilage grows unusually slowly
• Limbs are short
• Trunk is normal size
Module 6.8 CLINICAL MODULE: Abnormal bone growth and development
© 2011 Pearson Education, Inc.Figure 6.8 1
© 2011 Pearson Education, Inc.Figure 6.8 2
© 2011 Pearson Education, Inc.
• Disorders causing lengthened bones
• Marfan syndrome
• Excessive cartilage formation at epiphyseal cartilage
• Causes long, slender limbs
• Other connective tissue abnormalities cause cardiovascular issues
• Gigantism
• Overproduction of growth hormone before puberty
Module 6.8 CLINICAL MODULE: Abnormal bone growth and development
© 2011 Pearson Education, Inc.Figure 6.8 3
© 2011 Pearson Education, Inc.Figure 6.8 4
© 2011 Pearson Education, Inc.
• Other skeletal growth abnormalities
• Fibrodysplasia ossificans progressiva (FOP)
• Gene mutation that causes bone deposition around skeletal muscles• Bones developing in unusual places = heterotopic
(hetero, place) or ectopic (ektos, outside)
• Acromegaly
• Growth hormone levels rise after epiphyseal plates close
• Bones get thicker• Especially those in face, jaw, and hands
Module 6.8 CLINICAL MODULE: Abnormal bone growth and development
© 2011 Pearson Education, Inc.Figure 6.8 5
© 2011 Pearson Education, Inc.Figure 6.8 6
© 2011 Pearson Education, Inc.
Module 6.8 CLINICAL MODULE: Review
a. Describe Marfan syndrome.
b. Compare gigantism with acromegaly.
c. Why is pituitary dwarfism less common today in the United States?