Entries by cortana


Knee and Leg

Bones and Joints There are four bones joined at the knee, al- though no one bone touches all three of the others. The femur from above and the tibia from below articulate to form a joint that approximates a hinge. The patella, a sesamoid bone within the quadriceps tendon, articulates with the femur to create […]


Hip and Thigh

Bones and Joints The hip joint is the articulation of the femur within the acetabulum of the pelvis. The hip spans the pelvis and the proximal femur. The proximal femur contains the femoral head, which is covered with articular cartilage; the femoral neck, which connects the head to the shaft; and two bony prominences, the […]


Hand and Wrist

Bone and Joints The radius and ulna are the bones of the forearm; they connect the hand to the arm. Proximally, the main articulation is between the ulna and the distal humerus, forming the hinge of the elbow. The radius functions primarily to allow pronation and supination. At the wrist, the roles are reversed. Here, […]


Elbow and Forearm

Bones and Joints The elbow is the junction of the distal humerus and the two bones of the forearm, the radius and ulna (Fig. 9). Unlike the knee, at which the femur makes contact with only one of the two distal bones (the tibia but not the fibula), in the elbow joint, the humerus makes […]



  Shoulder and Arm The shoulder comprises three bones (the clavicle, scapula, and humerus) and three joints (the glenohumeral, the acromioclavicular [AC], and the scapu- lothoracic) (Fig. 1).


  Barnes PJ, Karin M: Nuclear factor-kappaB: A piv- otal transcription factor in chronic inflammatory diseases. N Engl J Med 1997;336:1066-1071. Benbow U, Brinckerhoff CE: The AP-1 site and MMP gene regulation: What is all the fuss about? Matrix Biol 1997;15:519-526. Crawford HC, Matrisian LM: Mechanisms control- ling the transcription of matrix metalloproteinase genes in […]

Key Terms

Arachidonic acid – The substance that is a pre- cursor of inflammatory mediators such as prostaglandins and leukotrienes Chemokines – An agent of the inflammatory process that attracts or recruits cells to the site Cyclooxygenase pathway – One arm of the arachidonic acid cascade that leads to pro- duction of prostaglandins and thromboxanes Cytokines – Proteins produced […]

Modification of the Mediators of Inflammation

Endogenous Inhibitors To regulate the inflammatory response, numerous endogenous agents have been em- ployed. IL-4 and IL-10 inhibit cytokine production. PGE2 can either stimulate or inhibit inflammation indirectly. Several other agents are competitive inhibitors of inflammation. 

Mediators of Inflammation

Inflammatory mediators often play important roles in the normal cell, regulating the synthesis and turnover of ECM, for ex- ample. Accordingly, blocking their production can have adverse effects on normal cell physiology. At best, inflammation can be controlled by modulating the production of these mediators.

Triggers of Inflammation

Inflammation may be initiated by either en- dogenous or exogenous factors. It can be an acute response to trauma (as in a ligament tear) or a chronic response (as in autoim- mune diseases such as RA). Infection and crystalline deposits also can provoke an in- flammatory response that will persist until the underlying cause is […]