Human Anatomy and Physiology 9th

Edition Marieb Test Bank

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Exam
Name___________________________________

SHORT ANSWER. Write the word or phrase that best completes each statement or answers
the question.

Figure 8.1

Using Figure 8.1, match the following:

1) Periosteum. 1) _____________

2) Articular cartilage. 2) _____________

3) Joint (synovial) cavity. 3) _____________

4) Synovial membrane. 4) _____________

5) Fibrous capsule. 5) _____________

Figure 8.2

Using Figure 8.2, what type of axis does each joint have?

6) Joint 1. 6) _____________

7) Joint 2. 7) _____________

8) Joint 3. 8) _____________

9) Joint 4. 9) _____________

10) Joint 5. 10) _____________

11) Joint 6. 11) _____________

Figure 8.2

Using Figure 8.2, identify each type of synovial joint by name.

12) Joint 1. 12) _____________

13) Joint 2. 13) _____________

14) Joint 3. 14) _____________

15) Joint 4. 15) _____________

16) Joint 5. 16) _____________

17) Joint 6. 17) _____________

MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:

18) Joint found only in the skull A) Suture 18) ______

19) Tooth in socket A) Symphysis 19) ______

20) Bones united by hyaline cartilage B) Syndesmosis 20) ______

21) Bones united by fibrocartilage C) Gomphosis 21) ______

TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false.
22) The amount of movement permitted by a particular joint is the basis for 22) ______
the functional classification of joints.

23) All joints permit some degree of movement, even if very slight. 23) ______

24) Hinge joints permit movement in only two planes. 24) ______

25) Synovial fluid is a viscous material that is derived by filtration from 25) ______
blood.

26) The articular surfaces of synovial joints play a minimal role in joint 26) ______
stability.

27) The major role of ligaments at synovial joints is to help direct movement 27) ______
and restrict undesirable movement.

28) The only movement allowed between the first two cervical vertebrae is 28) ______
flexion.

29) Movement at the hip joint does not have as wide a range of motion as at 29) ______
the shoulder joint.

30) A person who has been diagnosed with a sprained ankle has an injury 30) ______
to the ligaments that attach to that joint.

31) Supination is the movement of the forearm in which the palm of the 31) ______
hand is turned from posterior to anterior..

32) The wrist joint can exhibit adduction and eversion movements. 32) ______

33) Moving a limb so that it describes a cone in space is called 33) ______
circumduction.

34) Flexion of the ankle so that the superior aspect of the foot approaches 34) ______
the shin is called dorsiflexion.

35) The gripping of the trochlea by the trochlear notch constitutes the 35) ______
"hinge" for the elbow joint.
 36) Pronation is a much stronger movement than supination. 36) ______

37) The structural classification of joints is based on the composition of the 37) ______
binding material and the presence or absence of a joint cavity.

38) Synovial fluid contains phagocytic cells that protect the cavity from 38) ______
invasion by microbes or other debris.

39) A person who has been diagnosed with rheumatoid arthritis would be 39) ______
suffering loss of the synovial fluids.

40) A ball-and-socket joint is a multiaxial joint. 40) ______

41) Bending of the tip of the finger exhibits flexion. 41) ______

42) Dislocations in the TMJ almost always dislocate posteriorly with the 42) ______
mandibular condyles ending up in the infratemporal fossa.

43) Symphyses are synarthrotic joints designed for strength with flexibility. 43) ______

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or
answers the question.
44) A fibrous joint that is a peg-in-socket is called a ________ joint. 44) ______
A) suture B) syndesmosis
C) gomphosis D) synchondrosis

45) The cruciate ligaments of the knee ________. 45) ______

A) are also called collateral ligaments
B) prevent hyperextension of the knee
C) attach to each other in their midportions
D) tend to run parallel to one another

46) Articular cartilage found at the ends of the long bones serves to 46) ______
________.
A) form the synovial membrane
B) provide a smooth surface at the ends of synovial joints
C) produce red blood cells (hemopoiesis)
D) attach tendons

47) A joint united by dense fibrocartilaginous tissue that usually permits a 47) ______
slight degree of movement is a ________.
A) gomphosis B) suture
C) symphysis D) syndesmosis

48) On the basis of structural classification, which joint is fibrous connective 48) ______
tissue?
A) pivot B) syndesmosis
C) symphysis D) synchondrosis

49) Connective tissue sacs lined with synovial membranes that act as 49) ______
cushions in places where friction develops are called ________.
A) menisci B) bursae
 C) tendons D) ligaments

50) Articulations permitting only slight degrees of movement are ________. 50) ______
A) synovial joints B) diarthroses
C) synarthroses D) amphiarthroses

51) Which of the following are cartilaginous joints? 51) ______

A) Gomphoses B) Syndesmoses
C) Sutures D) Synchondroses

52) The gliding motion of the wrist uses ________ joints. 52) ______
A) pivot B) hinge
C) condyloid D) plane

53) The ligaments that protect the alignment of the femoral and tibial 53) ______
condyles and limit the movement of the femur anteriorly and
posteriorly are called ________.
A) tibial collateral ligaments B) anterior ligaments
C) patellar ligaments D) cruciate ligaments

54) Bending your head back until it hurts is an example of ________. 54) ______
A) circumduction B) flexion
C) extension D) hyperextension

55) In the classification of joints, which of the following is true? 55) ______
A) Synarthrotic joints are slightly movable.
B) All synovial joints are freely movable.
C) Immovable joints are called amphiarthroses.
D) In cartilaginous joints, a joint cavity is present.

56) Synarthrotic joints ________. 56) ______

A) are found only in adults
B) have large joint cavities
C) are cartilaginous joints
D) permit essentially no movement

57) Fibrous joints are classified as ________. 57) ______

A) sutures, syndesmoses, and gomphoses
B) symphysis, sacroiliac, and articular
C) hinge, saddle, and ellipsoidal
D) pivot, hinge, and ball and socket

58) In symphysis joints the articular surfaces of the bones are covered with 58) ______
________.
A) hyaline cartilage B) fibrocartilage
C) synovial membranes D) tendon sheaths

59) Synovial fluid is present in joint cavities of freely movable joints. Which 59) ______
of the following statements is true about this fluid?
A) It contains hydrochloric acid.
B) It contains lactic acid.
C) It contains hyaluronic acid.
 D) It contains enzymes only.

60) Which of the following statements defines synchondroses? 60) ______

A) interphalangeal joints
B) amphiarthrotic joints designed for strength and flexibility
C) cartilaginous joints where hyaline cartilage unites the ends of
bones
D) joints that permit angular movements

61) What are menisci? 61) ______

A) semilunar cartilage pads
B) cavities lined with cartilage
C) small sacs containing synovial fluid
D) tendon sheaths

62) Which of the following is a true statement regarding gliding 62) ______
movements?
A) Gliding movements occur at the intercarpal and intertarsal joints.
B) Gliding movements allow flexibility of the upper limbs.
C) An example of a gliding movement is nodding one's head.
D) Gliding movements are multiaxial.

63) What is moving a limb away from the median plane of the body along 63) ______
the frontal plane called?
A) adduction B) abduction
C) dorsiflexion D) inversion

64) The terms inversion and eversion pertain only to the ________. 64) ______
A) hands and the feet B) arms
C) feet D) hands

65) The hip joint is a good example of a(n) ________ synovial joint. 65) ______
A) multiaxial B) nonaxial
C) biaxial D) uniaxial

66) Which of the following movements does not increase or decrease the 66) ______
angle between bones?
A) circumduction B) abduction
C) extension D) rotation

67) Compared to the shoulder, displacements of the hip joints are ________. 67) ______
A) rare because of the ligament reinforcement
B) rare because the rotator cuff stabilizes the hip joint
C) common in all people who are overweight
D) common due to the weight bearing the hip endures

68) Which ligament of the knee initiates the knee-jerk reflex when tapped? 68) ______
A) the extracapsular ligament
B) the medial patellar retinacula
C) the lateral patellar retinacula
D) the patellar ligament
69) Football players often sustain lateral blows to the extended knee. Which 69) ______
of the ligaments is (are) damaged as a result?
A) medial collateral, medial meniscus, and anterior cruciate
B) oblique popliteal and extracapsular ligament
C) arcuate popliteal and the posterior cruciate
D) suprapatellar

70) Pointing the toes is an example of ________. 70) ______

A) plantar flexion B) protraction
C) pronation D) circumduction

71) Which of the following is a true statement? 71) ______

A) The greater tubercle of the humerus articulates at the coracoid
process of the scapula.
B) The rotator cuff is responsible for the flexible extensions at the
elbow joint.
C) The head of the humerus articulates with the acromion process.
D) The annular ligament surrounds the head of the radius.

72) Presence of a synovial cavity, articular cartilage, synovial membrane, 72) ______
and ligaments are characteristics of what type of joint?
A) hinge joint B) synchondrosis
C) symphysis D) suture

73) Extracapsular ligaments stabilizing the knee include ________. 73) ______
A) the patellar ligament extending from femur to patella
B) cruciate ligaments, which help secure the articulating bones
together
C) the oblique popliteal crossing the knee anteriorly
D) lateral and medial collateral ligaments preventing lateral or
medial angular movements

74) Which of the following is a correct statement about development of 74) ______
joints?
A) Joints develop independent of bone growth.
B) Joints develop in parallel with bones.
C) All fibrous joints are in the adult form by the time of birth.
D) By the end of the fourth week, fetal synovial joints resemble adult
joints.

75) An example of an interosseous fibrous joint is ________. 75) ______

A) the clavicle and the scapula at the distal ends
B) between the humerus and the glenoid cavity
C) the radius and ulna along its length
D) between the vertebrae

76) Which of the following statements best describes angular movements? 76) ______
A) They occur only between bones with flat articular processes.
B) They allow movement in several planes.
C) They change (increase or decrease) the angle between two bones.
D) They allow movement only in one plane.
 77) Saddle joints have concave and convex surfaces. Identify the saddle 77) ______
joint of the skeleton.
A) Carpometacarpal joint of the phalanges.
B) Meatcarpophalangeal joint of the finger.
C) Interphalangeal joint of the finger.
D) Carpometacarpal joint of the thumb.

78) Tendon sheaths ________. 78) ______

A) are lined with dense irregular connective tissue
B) act as friction-reducing structures
C) are extensions of periosteum
D) help anchor the tendon to the muscle

79) Which of the following is not a part of the synovial joint? 79) ______
A) articular cartilage B) joint cavity
C) articular capsule D) tendon sheath

80) Which of the following is not a factor that contributes to keeping the 80) ______
articular surfaces of diarthroses in contact?
A) arrangement and tension of the muscles
B) strength and tension of joint ligaments
C) number of bones in the joint
D) structure and shape of the articulating bone

SHORT ANSWER. Write the word or phrase that best completes each statement or answers
the question.
81) Turning the foot medially at the ankle would be called 81) _____________
________.

82) Moving your jaw forward, causing an underbite, is called 82) _____________
________.

83) Fluid-filled fibrous sacs lined with a synovial membrane and 83) _____________
occurring where ligaments, muscles, and tendons rub together
are called ________.

84) The joint between the frontal and parietal bones is classified by 84) _____________
material as a ________ joint.

85) Why are epiphyseal plates considered temporary joints? 85) _____________

86) Using the functional classification, a freely movable joint would 86) _____________
be called a ________ joint.

87) The hip joint, like the shoulder joint, is a ________ joint. 87) _____________

88) The type of joint between the carpal and the first metacarpal is a 88) _____________
________ joint.

89) Synovial joints have five major features. What are they? 89) _____________

90) Often people who exercise prudently seem to have fewer bouts wit h osteoarthritis.
Will 90) ___
exercise ___
prevent ___
arthritis? ___
If so, _
how?

91) For each of the following movements, indicate the specific kind 91) _____________
of joint involved (e.g., hinge, etc.) and the movement performed
(e.g., extension, etc.).
a. Bending the elbow: ________, ________.
b. Turning head side to side: ________, ________.
c. Lowering your arm to your side: ________, ________.
d. Turning the sole of foot medially: ________, ________.

92) While the fingers can exhibit flexion and extension and other 92) _____________
angular motions, the thumb has much greater freedom. Why?

93) Briefly describe a typical synovial joint. 93) _____________

94) Although uric acid is a normal waste product of nucleic acid 94) _____________
metabolism, why are so many men suffering from a condition
known as gouty arthritis? How does this product that should be
eliminated in the urine cause so much pain when things go
wrong?

95) After reading a medical report, you learn that a 45-year-old 95) _____________
female has the following symptoms: inflammation of synovial
membranes, accumulation of synovial fluid, pain and
tenderness about the joints, pannus formation, and some
immobility at certain joints. On the basis of these symptoms,
what would the patient probably have?

96) Greg is somewhat of a "weekend athlete" who has overextended 96) _____________
himself by pitching baseball for a local team during the week
and playing golf on the weekends for several hours. He
presented himself to the emergency room last week with severe
shoulder pain (at the glenohumeral joint). The physician told
him that the X ray was not conclusive, but he may have damage
to his rotator cuff. What is the rotator cuff, and how might he
have caused this damage? What remedies will the physician
recommend?

97) Many inflammations of joint areas can be treated by injections 97) _____________
of cortisone into the area. Why don't we continually get
injections rather than operations?

98) Why is muscle tone the most important stabilizing factor for 98) _____________
most joints?

ESSAY. Write your answer in the space provided or on a separate sheet of paper.
99) Steven, a football player, complained of severe pain and the inability to use his right
arm and after having been tackled during a game. What would you guess might be his
shoulder problem?

100) Mary has been suffering from a "bad knee" for several months. She is a tennis player
who often slides in to attack a ball; she is an aerobic devotee and a jogger. She
visited an orthopedic surgeon last week who told her that he would "like to have a
look at her knee joint." He also told her that her symptoms indicated damage to the
meniscus, and it might have to be removed. What will the doctor do to see the joint,
and if the meniscus is removed will Mary be able to play tennis again?

101) Farhad begins typing his term paper on his new computer early one morning. After
8 hours of typing, he notices that his wrists are stiff and very sore. The next
morning, Farhad begins to finish his paper, but soon finds his wrists hurt worse
than last night. What is wrong?

102) Probenecid inhibits the active resorption of uric acid in the kidney, which leads to
increased urinary excretion of uric acid. Explain why this drug would be useful in
treating gout.

103) A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For
patients needing to be slid toward the head of the bed, the nurse tells the PCAs use a
draw sheet under the patient's torso. She tells them to avoid pulling on their hands
or arms. Based on your knowledge of the shoulder joint, explain why pulling on the
extremities should be avoided.

104) Maggie is a 28-year-old Caucasian woman who has newly diagnosed rheumatoid
arthritis. She complains of painful, stiff hands and feet, feeling tired all the time, and
reports an intermittent low-grade fever. She asks the nurse if she is going to be
"crippled." How might the nurse explain the pathophysiology of rheumatoid
arthritis?

105) Susan was bitten by a deer tick and now complains of joint pain, flu-like symptoms,
and difficulty thinking. What might be her diagnosis and the treatment required to
alleviate her symptoms?
 1) A
2) C
3) B
4) E
5) D
6) Multiaxial
7) Uniaxial
8) Uniaxial
9) Nonaxial
10) Biaxial
11) Biaxial
12) ball and socket
13) pivot joint
14) hinge joint
15) plane joint
16) saddle joint
17) condyloid joint

18) A
19) C
20) B
21) A
22) TRUE
23) FALSE
24) FALSE
25) TRUE
26) TRUE
27) TRUE
28) FALSE
29) TRUE
30) TRUE
31) TRUE
32) FALSE
33) TRUE
34) TRUE
35) TRUE
36) FALSE
37) TRUE
38) TRUE
39) FALSE
40) TRUE
41) TRUE
42) FALSE
43) FALSE
44) C
45) B
46) B
47) C
48) B
49) B
50) D
51) D
52) D
53) D
54) D
55) B
56) D
57) A
58) A
59) C
60) C
61) A
62) A
63) B
64) C
65) A
66) D
67) A
68) D
69) A
70) A
71) D
72) A
73) D
74) B
75) C
76) C
77) D
78) B
79) D
80) C
81) inversion
82) protraction
83) bursae
 84) suture
85) Once long bone growth in length is complete, the cartilage of the epiphyseal plates can
ossify to become a permanent connection between the bones.
86) diarthrosis
87) ball-and-socket
88) saddle
89) articular cartilage, a joint cavity, an articular capsule, synovial fluid, and reinforcing
ligaments
90) Exercise does not prevent arthritis, but lessens it by strengthening muscles that in turn
support and stabilize joints.
91) a. hinge, flexion
b. pivot, rotation
c. ball and socket, adduction
d. plane, inversion
92) The thumb's carpometacarpal joint is a biaxial saddle joint whereas the other
carpometacarpal joints are plane joints with no angular freedom.
93) The ends of each bone are covered with hyaline cartilage that is continuous with the
synovial membrane enclosing the joint. Synovial fluid fills the space between the articular
cartilage. Outside the synovial membrane there is a very tough, fibrous capsule that
prevents the synovial membrane from bulging out as pressure is applied to the ends of the
bones.
94) Males have higher blood levels of uric acid than females. When blood levels of uric acid
rise excessively, it is deposited as urate crystals in the soft tissues of joints. Sometimes gout
sufferers have an excessive rate of uric acid production; or it is possible that some are
unable to flush uric acid in the urine fast enough.
95) Rheumatoid arthritis
96) Greg has either stretched or torn his rotator cuff. He will be told to rest for a few months,
and if the pain does not subside, surgery will be necessary. The rotator cuff is made up of
four tendons that belong to the subscapularis, supraspinatus, infraspinatus, and teres
minor muscles and encircle the shoulder joint. They are vulnerable to damage when the
arm is circumducted vigorously. Greg is obviously overdoing his activities by pitching four
baseball games per week and playing golf on weekends.
97) A joint inflammation is always a symptom of an underlying problem such as cartilage or
ligament damage, arthritis, etc. Continued injection might cause the patient to reinjure the
area, or it might mask a more severe injury that may appear later.
98) The shapes of the articular surfaces may hinder rather than help joint stability. Ligaments
can stretch and reduce stability. Muscle tendons are kept taut at all times by the tone of
their muscle.
99) He might have suffered a shoulder dislocation since the shoulder joint has sacrificed
stability for flexibility.
100) The doctor will perform arthroscopic surgery on Mary in order to view the interior of the
joint. If she has severely damaged the meniscus, it can be removed with little impairment
to the knee except some loss in stability. However, over the long term, the lack of weight
distribution by the missing meniscus increases the likelihood of osteoarthritis in her knee.
Mary might consider taking up swimming instead.
101) Farhad is suffering from tendonitis. If he continues to use the keyboard incorrectly, the
tendonitis could develop into the more serious condition called carpal tunnel syndrome.
102) Uric acid, a normal waste product of nucleic acid metabolism, is ordinarily excreted in
urine without any problem. However, when blood levels of uric acid rise excessively, it
may be deposited as needle-shaped urate crystals in the soft tissue of joints. An
inflammatory response follows, which leads to gout. By lowering the uric acid level, no
crystals form, and inflammation subsides.
103) In the shoulder joint, stability has been sacrificed to provide the most freely moving joint of
the body. The shoulder joint is a ball-and-socket joint. Shoulder dislocations are fairly
common, therefore forces that are not under the patient's control should be avoided.
104) Rheumatoid arthritis (RA) is a chronic, systemic, and inflammatory disorder. RA is an
autoimmune disease in which the body's immune system attacks its own tissue. RA begins
with inflammation of the synovial membrane of the affected joints. Fluid accumulates,
causing joint swelling. The nurse should explain that RA is a chronic crippling disease with
joint stiffening (ankylosis) resulting in restriction of joint movement and extreme pain.
105) She probably has contracted Lyme disease, which is treated with antibiotics.
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walls has proved a direct cause of laceration. The seat of these
ruptures may be at any point, but it is most frequent in front of the
pelvic flexure, or in the floating colon, or directly in the seat of
impaction.
Symptoms. The attack comes on suddenly, perhaps in connection
with some special accident or injury, and is manifested by violent
colicy pains which show no complete intermission. In many respects
the symptoms resemble those of complete obstruction of the bowel,
there is a suspension of peristalsis, rumbling, and defecation, a
tendency to roll on the back and sit on the haunches, an oblivion of
his surroundings and pain on pressing the abdomen. Usually the
shock is marked in the dilated pupil, the weak or imperceptible
pulse, the short, rapid breathing, cold ears, nose and limbs and the
free perspirations. Tympany is usually present as the result of
fermentation. Signs of infective peritonitis and auto-intoxication are
shown in the extreme prostration, unsteady gait, dullness and
stupor, and general symptoms of collapse. The temperature, at first
normal, may rise to 105° or 106° as inflammation sets in, and may
drop again prior to death.
Termination is fatal either by shock or by the resulting peritonitis
and auto-intoxication. Exceptions may exist in case of adhesion of
the diseased intestine to the walls of the abdomen and the formation
of a fistula without implication of the peritoneum.
 RUPTURE OF THE INTESTINES IN
RUMINANTS.
From blows of horns, tusks, etc., from rectal abscess. Symptoms: colic, resulting
in septic peritonitis and sinking. Treatment.
Lesions of this kind usually come from blows with the horns of
others. They may lead to artificial anus as in a case reported by Rey,
or the formation of a connecting sac as in that of Walley. In a case
seen by the author a large abscess formed above the rectum, from
injuries sustained in parturition. This ruptured into the gut leaving
an immense empty cavity in which the hand could be moved about
freely, but which gradually contracted so that the cow made a good
recovery.
André furnishes an extraordinary record of rupture of the colon,
blocked by a potato. It seems incredible that a potato could have
traversed the stomachs and intestine without digestion.
The symptoms are those of violent colic suddenly appearing in
connection with some manifest cause of injury, and going on to
septic peritonitis and gradual sinking.
Treatment is manifestly useless excepting in the case of some such
fortunate condition as in the case of abscess of the rectum in which
the free use of injections and the antisepsis of the abscess cavity
proved successful.
 LACERATION OF THE INTESTINE IN
SWINE.
This is rare and appears to have been observed only in connection
with scrotal and ventral hernias, with adhesion. It may lead to an
artificial anus which in its turn may cicatrise and close, or to the
discharge of fæces into the peritoneal cavity with fatal effect. If seen
early enough, laparotomy with suture of the bowel and careful
antisepsis will be indicated.
 LACERATION OF THE INTESTINE IN
CARNIVORA.

Obstruction and overdistension, necrosis, ulceration, feculent impaction, kicks,

parasites, caustics, abscess, tubercle, cancer. Symptoms: peritonitis following
accident, vomiting, no defecation. Treatment: laparotomy.

The most common cause of intestinal rupture is obstruction by

foreign bodies, with overdistension of the bowel immediately in
front, or necrosis and ulceration of the portion of the bowel pressed
upon. Feculent impaction acts in a similar way. Kicks and other
external injuries sustained on a full intestine will lead to rupture.
Perforation by parasites, by caustic agents swallowed, by abscesses,
and by tubercle or cancer is also to be met with.
The symptoms are those of sudden peritonitis, with marked
abdominal tenderness, tucking up of the abdomen, bringing the legs
together under the body, vomiting, suspension of defecation and
peristalsis. Rabiform symptoms have been noted.
Treatment. As in swine there is every hope of success by suture of
the intestinal wound if done early. The same general method may be
followed as in closing the wound after extraction of a foreign body.
 ABSCESS OF THE BOWEL IN SOLIPEDS.
In strangles, from puncture, kicks, blows, foreign bodies in food, larva, cysts,
large or small, creamy or cheesy, open into bowel or peritoneum, infective
peritonitis. Symptoms: rigor, ill health, unthrift, colics, tender abdomen, tympany,
painful movements, lying, rising, turning, going downhill, rectal exploration,
phlegmonous swelling, pus passed by anus. Treatment: open when it points on
abdominal wall, or when near rectum, antiseptics, support strength, careful
dieting, antipuruleut agents.
This is most common as an irregular form of strangles, the abscess
forming in connection with the mesenteric glands or on the walls of
the intestine. Small abscesses may also implicate the mucous glands
or Peyer’s patches as a result of catarrhal enteritis. Less frequently an
abscess forms in the seat of the puncture of the colon for tympany, or
in connection with blows, kicks, punctures with stable forks, nails
and other pointed objects. Foreign bodies entering with the food and
the cysts of the larvæ of the sclerostomata will also give rise to
suppuration.
These abscesses may attain a large size, especially in strangles, and
involve adhesions between the bowel and other viscera, or the walls
of the abdomen. Or they may be small like peas or beans scattered
along the coats of the intestine or between the folds of the mesentery.
They may be inspissated to the consistency of thick cream or rich
cheese, and they may rupture into the intestine, through the
abdominal walls or into the peritoneum. In the last case infective
peritonitis sets in usually with fatal results.
Symptoms. These are generally obscure. There may have been
noticed a rigor, and there are always marked indications of ill health,
dullness, lack of spirit or appetite, dryness and erection of the hair,
hide bound, insensibility of the loins to pinching, colics after meals,
tenderness of the abdomen, tympany, groaning when lying down or
rising, when turned around short, or when walked down hill.
Sometimes the abscess can be distinctly felt by the hand in the
rectum. When it implicates the abdominal walls there is usually a
diffuse phlegmonous swelling, at first soft and pasty, then firm and
solid, and finally softening and fluctuating in the center. Sometimes
there is the evacuation of pus by the anus or of the investing
membrane of the abscess, and this may be expected to herald
recovery. In case of infective peritonitis there are the usual
symptoms of stiff movement, the bringing of the feet together under
the belly, abdominal tenderness, trembling, hyperthermia, cold ears
and limbs, cold perspirations, great dullness and prostration, small,
weak or imperceptible pulse, hurried breathing and gradual sinking.
Treatment. This is most favorable when the abscess approaches
the surface so as to be punctured through the abdominal walls. In
other cases it is so situated that it can be punctured with trochar and
cannula through the rectum. In such a case it may be evacuated and
injected with a nontoxic antiseptic, the puncture and injection being
repeated as wanted. In the internal and deeply seated abscesses we
must seek to support the general health, give pure air, easily
digestible and nourishing food, and agents that may be hoped to
retard suppuration. Hyposulphite of soda in ½ oz. doses, or sulphide
of calcium in scruple doses, may be repeated two or three times a
day.
 ULCERATION OF THE INTESTINES.

Symptom or sequel of other disease, or from traumas, caustics, neoplasms,

peptic ulcers, verminous thrombosis, tubercle. Catarrhal erosion, peptic, deep,
round ulcer, calculi with irregular ulcers, cord ulcer at mesenteric attachment,
small, follicular, grouped ulcers, sloughing ulcers of infectious diseases, circular
projecting, button like ulcers of hog cholera, microbes. Symptoms: diarrhœa,
black, or red, sloughs, fever, blood stained vomit, manipulation. Treatment: for
foreign body, poison, or infectious disease, careful diet, antiseptics.

Ulceration of the intestines is commonly a symptom or sequel of

other intestinal disorder, such as intestinal catarrh, impaction,
calculus, foreign body, parasites, petechial fever, influenza, glanders,
rinderpest, Southern cattle fever, hog cholera, pneumoenteritis,
rabies, canine distemper. Then there are ulcers, caused by sharp
pointed bodies, by caustic agents ingested, and by obstructive
changes in neoplasms. Peptic ulcers may occur in the duodenum as
in the stomach. Finally local disturbances of the circulation and
especially such as attend on verminous thrombosis, are at once
predisposing and exciting causes of ulceration. Tuberculosis and
other neoplasms are additional causes.
The ulcers may vary in different cases. In catarrh there is usually
superficial desquamation of the epithelium, and erosions rather than
deep ulcers. The peptic ulcer forms on the dependent wall of the gut,
where the gastric secretions settle, and assumes a more or less
perfectly circular outline (round ulcer). Those due to calculus or
impaction, may be irregular patches mostly on the unattached side of
the intestine and resulting from necrosis of the parts most exposed to
pressure. The ulcers resulting from cords stretched along inside the
bowel, are in the form of longitudinal sores on the attached or
mesenteric side of the intestine, where the wall being shorter the
cord continually presses. Follicular ulcerations are usually small,
deep excavations, commonly arranged in groups. Ulcers connected
with neoplasms have an irregular form determined by that of the
morbid growth. In infectious diseases the ulcers are round or
irregular, resulting from circumscribed sloughs. In most of the
infectious diseases the tendency appears to be to attack the intervals
between the folds of the mucosa, probably because the bacteria of
ulceration find a safer lodgement in such places. In the hog cholera
ulcers the older ulcers tend to the circular form with thick mass of
necrotic tissue in the form of plates or scales imbedded in the bottom
and projecting above the adjacent surface of the mucosa. As a rule
the microbes which in the different cases preside over the
necrobiosis are found in the depth and walls of the ulcers.
The symptoms are largely those of the diseases of which the ulcers
are a concomitant or result. There is usually diarrhœa, which is
generally black from extravasated blood, and may be marked by
fresher red bloody striæ. Sloughs of variable size are not at all
uncommon in the fæces. Hyperthermia is usually more intense than
in ordinary chronic enteritis, indicating the action on the heat
producing centres of the necrosing microbes and their toxins. In pigs
and dogs there may be vomiting of dark blood stained material or of
feculent matter. In the small animals it may be possible to feel
through the walls of the abdomen the thickening of the intestine at
and around the seat of any extensive ulcer.
Treatment. So far as this is not the treatment of the foreign bodies,
poisons, or specific fevers which cause the ulcers, it consists mainly
in careful dieting and the use of antiseptics such as subcarbonate of
bismuth, salol, salicylic acid, sodium salicylate or naphthol.
 DILATION OF THE INTESTINE.

Capacity adapted to ingesta, rich and nutritious food improves breeds, excessive
filling renders paretic, dilates; obstructions, impactions, strangulations, hernias,
invaginations, twisting, tumors, compressions, calculi, lowered innervation,
impaired circulation, verminous aneurism, peritonitis, persistent umbilical vesicle
in horse and ox, hernia of mucous through muscular coat, cæcal dilatation, colic,
rectal, with atresia ani, diseased end of cord, retained fæces. Symptoms: colics
after meals, abdominal and rectal exploration, softer than impaction. Treatment:
empty mechanically or by laxatives, demulcents, kneading, stimulants, nux
vomica, ergot, barium chloride, eserine, rich concentrated food, electricity,
enemata, laxatives.

It is a physiological law that the intestine developes in ratio with

the demands made upon it, provided these demands are not too
sudden and extreme. Thus the domestic pig and rabbit have
intestines at once longer and more capacious than those of the wild
varieties. The same is true of cattle and even of horses, heavy, rich
feeding, generation after generation, increases the capacity to take in
and utilize more, and to attain to a larger size and earlier maturity. In
such a case the walls of the intestinal canal retain their primary
thickness and strength and the whole change is in the direction of
physiological improvement for economical ends.
When, however, the retention or habitual accumulation of food in
the alimentary canal exceeds the self-adapting powers of its walls a
true pathological dilatation takes place, and attenuation or
thickening and paresis or actual paralysis of the walls ensues.
Whatever interferes with the normal active movement of the
ingesta predisposes to this. Thus partial obstructions of all kinds,
strictures, impactions, strangulations, hernias, invaginations,
twisting, tumors, compressions, calculi, contribute to the overfilling
of the bowel in front of them and to its more or less speedy
dilatation. Whatever weakens the muscular walls of the bowels or the
nerves presiding over these has a similar effect. Thus pressure on the
solar plexus or its branches from any cause, or degeneration of the
same, a tardy and imperfect circulation resulting from verminous
aneurism and thrombosis, and a circumscribed peritonitis extending
from the serous to the muscular coat of the bowel act in this way.
The persistence of the canal of the umbilical vesicle has been
repeatedly observed in solipeds, in the form of a pouch or dilatation
connected with the ileum three or four inches in front of the ileo-
cæcal valve. Rauscher records one of these of thirteen inches long
and having a capacity of seven quarts. These have been noticed in
cattle as well.
Another form of sacculation results from rupture of the muscular
coat through which the mucous forms a hernial sac in the peritoneal
cavity. On a small scale these sacs are not uncommon, the size of a
pea, a bean, or a marble, and very often containing larval or mature
worms. Degive records an enormous dilatation of the horse’s cæcum,
Peuch, one of the pelvic flexure of the colon having a capacity of forty
pounds, and Simonin one of the floating colon. Dilatations of the
rectum always take place in the new born affected with atresia ani.
Dilatation of the rectum into a cloaca is found in the horse and ox,
often connected with disease or injury of the terminal part of the
spinal cord, and is very common in dogs and cats in connection with
the compulsory retention of the fæces indoors. Pigs also present
instances of the kind.
The symptoms are in the main slight colics, with or without
tympany and recurring after each meal. In the small animals the
distended gut may often be recognized by palpation through the
abdominal walls, and in the larger animals by rectal exploration. The
distended viscus has not the firmness nor hardness of impaction or
calculus and is mainly recognizable by its bulk and form. When the
distension is in the rectum it may be easily reached and contents
dislodged with the effect of giving complete relief for the time being.
Treatment. Treatment is necessarily mainly palliative and consists
in the removal of abnormal accumulations. From the rectum this can
be done with the hand, or in the smaller animals with the finger. For
abnormal dilatations more anterior, purgatives and mucilaginous
injections are required, with kneading of the bowels through the
abdominal walls, or through the rectum in the larger animals, and
stimulation of the peristalsis by nux vomica, ergot, barium chloride
or eserine.
Having unloaded the dilated portion of any undue collection,
further accumulation should be guarded against by giving nutritious
food in small compass, and of a laxative nature, by stimulating
peristalsis by nux vomica or other nerve stimulant and by the daily
application of electricity. Enemata and laxatives should be employed
when necessary.
 STRICTURE OF THE INTESTINE.
From healing of ulcers, inflammation or infiltration, neoplasms, ring like or
sacculated, in small intestine in horse preceded by a dilatation, an effect of
verminous thrombosis; in cattle; in dog. Symptoms: Progressive, if in duodenum
can’t eat full meal, belches gas, has colics and tympany; in cattle tympany, unthrift;
in dog vomiting, tympany, colic, accumulations. Treatment: Gradual stretching by
bougies if within reach.
Strictures of the intestine are in the main the result of ulceration of
the intestinal walls which contract in healing, or inflammation, and
infiltration which leads to contraction in their organization into
tissue. Neoplasms of the walls (cancer, myxoma, lipoma, polypus,
melanosis, actinomycosis, tubercle) are additional causes of
constriction. If resulting from a lesion which completely encircled
the bowel there is an uniform constriction in the form of a circular
ring; if on the other hand it started from a longitudinal ulcer or
lesion the bowel is shortened on that side and puckered.
In solipeds strictures are most frequent in the small intestine, or
rectum. The pylorus is often affected. When on the small intestine
there is constantly a dilatation just in front of the obstruction. The
constricted portion is usually short, but as seen from outside of the
gut may be duplicated a number of times. Cadeac mentions
seventeen such strictures in the same animal, each preceded by a
dilatation. The individual stricture may be less than two inches in
length and so narrow as just to allow the passage of the index finger.
The walls of many times their natural thickness, are still further
thickened by an external layer of adipose tissue. It may be the seat of
a small abscess, or of a tumor. Internally the mucosa may show
ulcerations.
The stricture or strictures in solipeds often depend on the
disturbance of the circulation which results from verminous
thrombosis, the exudate into the intestinal walls, undergoing
organization, at once thickens and constricts the tube, and
determines as secondary result the dilatation in front of it.
Professor Mauri of Toulouse records the case of a horse with a
rectal stricture 4 inches from the anus, and a great dilatation in front.
The removal of the stricture, secured normal defecation, (whereas
before this the fæces had to be removed by hand) and the colics
entirely disappeared.
In cattle strictures have been found mainly at or near the pylorus,
less frequently in the rectum, and on one occasion (Revel) in
connection with a cancerous tumor, in the colon.
In the dog the pylorus is also the favorite seat of thickening and
stricture, yet it may occur in the small intestine, the rectum, or the
colon.
Symptoms. These are gradually advancing, as the stricture
approaches more and more nearly to a complete stenosis. If the
stricture is in the pylorus or duodenum, the patient can not eat a full
feed of grain without discomfort. He stops, hangs back on the halter,
plants the fore feet in front, arches the neck, drawing in the nose and
eructating gas. If he cannot eructate he is liable to show colics,
tympany, and the general symptoms of gaseous indigestion of the
stomach.
In cattle there is tympany, partial loss of appetite, tardy
rumination, and loss of condition.
Dogs show vomiting as a prominent symptom. When the stricture
is in the rectum there is a gradual lessening of the amount of fæces
passed at a time and an accumulation of feculent masses in advance
of the obstruction, recognizable by rectal exploration. When in the
terminal part of the small intestine or in the colon, a gradual
lessening of defecation, with tympanies and colics, culminating in
complete obstruction, may afford a suggestion of the trouble but no
means of certain diagnosis. In the smaller animals some additional
indications may be had from abdominal palpation.
Treatment is usually hopeless unless the stricture is in the
terminal portion of the rectum. In the latter case gradual dilatation
by the passage of the hand, the finger, or of bougies which are used
larger and larger, as they can be forced through with moderate
pressure may secure a sufficient dilatation. Forced dilatation, or even
careful incision at several different points of the circumference of the
stricture may give good results in certain cases.
 INTESTINAL INVAGINATION.
INTUSSUSCEPTION IN SOLIPEDS.
Definition. Seat: ileum into cæcum, rectum through sphincter, duodenum into
stomach, floating small intestine into itself, cæcum into colon. Lesions: blocking,
or tearing of mesentery, dark congestion, peritoneal adhesions, incarcerate gut,
necroses, sloughing of invagination. Symptoms: colics of obstruction, enteritis, and
septic infection, eructation, emesis, tenesmus, signs of sepsis and collapse, death in
seven hours or more, or recovery by disinvagination or sloughing. Diagnosis: by
rectal exploration or passing of slough. Treatment: oily laxatives, demulcents,
enemata, mechanical restoration of everted rectum, laparotomy.
Definition. The sliding of one portion of an intestine into a more
dilated one, as if a few inches of the leg of a stocking were drawn
within an adjoining portion which is continuous with it.
Seat. It is most commonly seen in the inversion of the small
intestine into itself or into the cæcum, or next to this the passage of
the rectum through the sphincter ani, to constitute eversion of the
rectum. It would appear to be possible at any part of the intestinal
canal in the horse, in which the bowels are more free to move than
they are in ruminants. Peuch records a case of invagination of the
duodenum into the stomach and Cadeac gives a woodcut of such a
case, which one would suppose the fixed position of the duodenum
would render impossible. It is conceivable that the jejunum could be
invaginated into the duodenum, and that this should have continued
until it extended into the stomach, but it is difficult to see how the
duodenum itself could have passed into the stomach without tearing
itself loose from its connections with the pancreas, liver and
transverse colon.
Schrœder, Serres and Lafosse describe cases in which the small
intestine was everted into the cæcum and thence through the colon
and rectum until it protruded from the anus.
The invagination of the floating small intestine into itself is
common at any point, and extensive and even repeated. Marcout
records a case in which 24 feet were invaginated, and Rey a case of
quadruple invagination at the same point.
 The invagination of the cæcum into the colon is frequent, the blind
end of the cæcum falling into the body of the same organ, and this
continuing to increase until it passes on into the colon, and even
carries a portion of the small intestine with it. This lesion is more
rare in solipeds because the cæcum has its blind end lowest and
gravitation opposes its invagination.
Resulting Lesions. In any case of invagination it must be noted
that it is not the intestine alone which slips into its fellow, but it
carries with it its attaching mesentery, which, dragging on one side of
the invaginated gut, shortens and puckers that and turns its opening
against the wall of the enclosing gut so as to block it, while the
opposite or free side passes on and tends to form convolutions. If the
outer and enveloping intestine is too small to allow of this, the
detaining mesentery of the invaginated mass must be torn or
stretched unduly and its circulation and innervation correspondingly
impaired. When the invagination occurs of one portion of the small
intestine into another of nearly equal size, the resulting mass is firm
like a stuffed sausage, and this enlargement and consolidation ends
abruptly at the point of visible entrance of the smaller contracted
portion, into the larger dilated one.
If recent, the invaginated mass is still easily disengaged from the
enveloping portion, though considerably congested and dark in color
in proportion to the duration of the lesion. When it has been longer
confined the incarcerated portion is the seat of extreme congestion,
and extravasation, and has a dark red or black color. The exudation
into its substance, which is especially abundant in the mucosa and
submucosa, produces a thickening which may virtually close the
lumen, and on the opposing peritoneal surfaces leads to adhesions
which prevent the extraction of the imprisoned mass. The
interruption of the circulation and the compression of the
invaginated mass, leads soon to necrosis and thus a specially
offensive odor is produced, and if the animal survives the whole may
be sloughed off and passed with the fæces, the ends of the
intussuscepted portion and of that receiving it meanwhile uniting
and becoming continuous with each other.
Symptoms. These are the violent colic of obstruction of the bowels,
soon complicated by those of enteritis and finally of septic infection.
 The animal looks at his flank, paws, kicks with his hind feet, lies
down, rolls, sits on his haunches, waves the head from side to side,
and sometimes eructates or even vomits. Straining may be violent,
with the passage of a few mucus-covered balls only, and rumbling
may continue for a time if the small intestines only are involved.
The partial subsidence of the acute pains, the presence of tremors,
dullness and stupor, the coldness of the ears and limbs, the small,
weak or imperceptible pulsations, the cold sweats, dilated pupils, and
loss of intelligence in the expression of the eye and countenance may
indicate gangrene, and bespeak an early death which may take place
in seven hours.
The subsidence of the acute symptoms with improvement in the
general appearance and partial recovery of appetite may indicate a
spontaneous reduction of the invagination, an issue which may
happily arrive in any case in the early stages, but especially in those
implicating the cæcum and colon.
An absolutely certain diagnosis is rarely possible, unless the lesion
is a protrusion of the rectum, or unless as the disease advances the
invaginated part is sloughed off and passed per anum.
Treatment. The failure to make a certain diagnosis usually stands
in the way of intelligent treatment. Oleaginous laxatives and
mucilaginous gruels are advised to keep the contents liquid, and
favor their passage through the narrowed lumen of the invaginated
bowel. In cases implicating the floating colon and rectum abundant
watery or mucilaginous injections may assist in restoring a bowel
which has not been too long displaced. In case of eversion of the
rectum, the hand should be inserted into the protruding gut and
carried on till it passes through the sphincter ani. Then, by pushing it
onward, the arm carries in a portion of the invaginated gut and
usually of the outer portion next to the anus as well, and this should
be assisted by the other free hand, and even if necessary by those of
an assistant, and whatever is passed through the sphincter should be
carefully retained, while the arm is withdrawn for a second
movement of the same kind, and this should be repeated until the
whole protruding mass has been replaced.
Invaginations situated more anteriorly and which can be correctly
diagnosed by rectal exploration or otherwise, will sometimes warrant
laparotomy, especially those of the cæcum into the colon, where
adhesion of the peritoneal surfaces is less common or longer delayed.
The patient should be given chloroform or ether, the abdominal walls
should be washed and treated with antiseptics, and the incision
made back of the sternum and to one side of the median line, and
large enough to admit the exploring hand. It has also been suggested
to introduce the hand through the inguinal ring, or behind the
posterior border of the internal oblique muscle.
 INTESTINAL INVAGINATION IN
RUMINANTS AND SWINE.
Double colon cannot be invaginated, floating small intestine, cæcum and floating
colon can. Causes. Lesions. Symptoms: Acute, violent, persistent colic, palpation of
right flank causes gurgling, rectal exploration, prostration, collapse. Duration 1 to 5
weeks. Treatment: Laxative, enemata, injections of sodium bicarbonate and
tartaric acid, laparotomy.
In these animals the double colon is rolled around itself between
the folds of the great mesentery the free border of which supports the
small intestine. The arrangement is as if a piece of rubber tubing
were first doubled upon itself, and the end of the loop were then
turned inward and the remainder wound round it as a centre. If this
were then sewed between two pieces of cloth, the stitches passing
between the different windings of the tube at all points, we would
have an arrangement fairly representing that of the double colon of
ruminants, and, for our present purpose, of swine as well. It must be
evident that no portion of a tube arranged in this way can slide into
another. It would also appear that the small intestine cannot become
invaginated to any extent into another portion or into the cæcum
without extreme stretching or laceration of the small portion of
mesentery left between it and the coils of the double colon above.
The anatomical arrangement is therefore opposed to the formation
of invaginations in a way that is not the case in the horse.
Yet invaginations are by no means unknown in these genera. The
small intestine can be invaginated into itself or into the cæcum. The
cæcum, which floats loose at the right side of the mesentery that
envelopes the double colon, can be invaginated into the colon, and
the floating colon can be invaginated into the double colon on the
one hand and into the rectum and through the anus on the other.
Invagination into the rectum, for eight inches, in a bull calf, of six
days old, is reported by Cartwright in the Veterinarian for 1829. In a
similar case of Youatt’s the intussuscepted portion sloughed off and
was discharged per anum.
 The causes are like those acting in solipeds, and which give rise to
excessive and irregular peristalsis. A drink of ice cold water,
indigestions and colics of various kinds, diarrhœa, chills, the
irritation caused by poisons or parasites, and the paresis and
dilatation of portions of the intestine into which the more active
portions can easily pass. Almost any irritation or congestion may
cause intussusception, and young animals in which peristalsis is
most energetic are the most liable.
Lesions. The intussusception is usually found in the ileum and to a
less extent in other parts of the small intestine, or involving the
cæcum and colon, or again the floating colon and rectum. The
successive conditions of congestion, exudation, adhesion,
obstruction, necrosis, sloughing, and repair by union of the
remaining ends are the same as in the horse.
Symptoms. There is acute, agonizing and dangerous colic in an
animal in which these troubles are usually comparatively slight and
transient. The animal looks at the right flank, paws or stamps with
fore feet as well as hind, lies down and rises often, strains to pass
manure but passes only mucus or a few small hard masses, if
anything. If pressure is made on the right side of the abdomen and
the hand suddenly withdrawn there is a significant gurgling and the
corresponding hind foot is lifted or moved forward or backward,
appetite and rumination are lost, the pulse becomes rapid and weak,
and the animal becomes prostrate, dull and stupid, often remaining
recumbent in spite of all efforts to raise him. Rectal exploration may
detect the firm tender mass in the seat of the invagination. The
disease may last from one week to five, according as the obstruction
is complete or partial. The usual termination is a fatal one, though a
certain number of spontaneous recoveries are met with.
Treatment. By a happy accident the peristalsis or anti-peristalsis
determined by a purgative will sometimes disengage the
intussuscepted bowel. Copious injections into the rectum may also
prove useful in case of intussusception of the floating colon or
rectum. Or the disengagement of carbon dioxide from the injection
of solutions of sodium bicarbonate and tartaric acid may be tried.
Laparotomy is however the most radical measure when a certain
diagnosis has been made and this is less dangerous in the cow than
in the horse in which peritonitis is so grave. Under antiseptic
precautions an incision is made in the right flank and the
invagination found and reduced. In case firm adhesions have already
taken place, and above all if the included gut is apparently
gangrenous, the latter may be exposed by breaking down the
connections at the side opposite to the attachment of the mesentery,
or where the adhesions are least firm, then cutting out and removing
the incarcerated gut and carefully closing the opening between the
ends by suture. The use of a sublimate or carbolic acid solution and
careful suturing and bandaging of the external wound with
carbolated cotton wool will often give a successful issue.