osteo arthro myologi dms

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 1/169

* *

OSTEOLOGI UMUM

 ARTHROLOGI UMUM

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 2/169

* *

II. Berdasarkan Letak

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 3/169

* *

 Arthrologi umum

• Defenisi : ilmu yang mempelajari persambungantulang (sendi) pada umumnya.

• Klasifikasi berdasar ada/ tdk persambungan:• SYN  ARTHROSIS, terdapat persambungan

antara kedua tulang oleh suatu jaringan.

• DI  ARTHROSIS, tidak terdapat persambungankrn ada ruang antar kedua tulang (cavumarticulare)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 4/169

* *

Synarthrosis

KLASIFIKASI, berdasarkan jenis jaringan

a. Sindesmosis (jar. Ikat)

i.

Suturaii. Schindylesis

iii. Gomphosis

iv. Syndesmosis elastica

v. Syndesmosis fibrosa

b. Synchondrosis (tulang rawan)

c. Synostosis (tulang)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 5/169

Indarti * *

a. sutura

d. Gomphosis e. Schindylesis

b. Syndesmosis elastica

c. Syndesmosis fibrosa

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 6/169

* *

DiarthrosisBagian -bagian sendi diarthrosis

• Capsula articulare

• Fossa articulare/ cavitas glenoidalis

• Cavum articulare

• Capsula articulare•  Alat –alat khusus:

• Labium articulare

• Discus articulare

• Meniscus

• Bursae mucosae

• Ligamentum , ekstra & intra-capsularis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 7/169

Indarti * *

Bursa mucosae

Caput articulare

ligamentum

Cavum articulare

Ligamentum

meniscus

Capsula articulare

Fossa articulare

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 8/169

* *

Klasifikasi diarthrosis

Berdasarkan kemungkinan geraknya:

1.  Amphiarthrosis, gerak sedikit

• Misal : art. Sacroiliaca2.  Articulationes, gerak luas

 A. Sendi satu sumbu

• sendi engsel (ginglymus); art. Humero-ulnaris• Sendi kisar (art. Trochoidea) ; art radio-ulnaris

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 9/169

* *

B. Sendi dua sumbu

• Sendi telur ( art ellipsoidea), kepala sendicembung. Misal : art. Radiocarpae

• Sendi pelana (art. Sellaris) , kepala sendi seperti

pelana, misal : art. Carpometacarpae I

C. Sendi tiga sumbu

• Sendi peluru (art. Globoidea), lekuk sendi

mencakup ½kepala sendi.Mis art Humeri.

• Sendi buah pala (art. Spheroidea), lekuk sendi

mencakup > ½ kepala sendi . Misal ; art. coxae

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 10/169

Indarti * *

a. Multi axial

c. Sendi kisar

d. Sendi ellipsoidea

b. Sendi engsel

f.sendi pelurue. Sendi pelana

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 11/169

 Terms of movement

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 12/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 13/169

Vertebral Column

ComponentsVertebrae

Intervertebral discs

Normal CurvaturesCervicalThoracicLumbar

SacralAbnormal CurvaturesScoliosisLordosisKyphosis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 14/169

Vertebral Colum

General Characteristics ofa Vertebra◼ The Cervical

Vertebræ◼ The Thoracic

Vertebræ◼ The Lumbar

Vertebræ◼ The Sacral and

Coccygeal Vertebræ

The Vertebral Column as a Whole

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 15/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 16/169

Vertebrae

Parts of a typicalvertebra• Body

• Vertebral arch• Pedicles (paired)

• Laminae (paired)

• Transverse

processes (paired)• Spinous process

(single)

• Vertebral

foramen

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 17/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 18/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 19/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 20/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 21/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 22/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 23/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 24/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 25/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 26/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 27/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 28/169

Joints of the vertebral column

• Joint of the vertebral bodies

• Joint of the vertebral arches(zygapophysial joints)

•Atlanto-axial joints• Atlanto-occipital joints

• Costo-vertebral joints

• Sacro-iliac joint

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 29/169

•  Atlantooccpital :•  Ante and retroflexie (30 ) degree it`s to retard by anterior

membr,atlantooccipital , and ant.,atlanto-epistropheus• Lateroflexie (20 ) degree

• Rotatio atlantoaxial joints

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 30/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 31/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 32/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 33/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 34/169

Upper Limb

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 35/169

Skeleton of Upper Limb

Shoulder (shoulder girdle)Clavicle, Scapula

Upper armHumerus

Lower armUlnaRadius

HandCarpus

MetacarpusPhalanges of the Hand

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 36/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 37/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 38/169

Carpal tunnel

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 39/169

Joints of the upper limb

• Sterno-clavicular joint

• Acromio-clavicular joint

• Shoulder joint

• Elbow joint• Radio-ulnar joint

• Wrist joint

• Intercarpal joints

• Carpo-metacarpal joints• MP joints

• IP joints

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 40/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 41/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 42/169

Elbow Joint

• Structure :• Distal part of humerus

• Proximal part of radiusand ulna

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 43/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 44/169

Wrist joint

Radio-carpal joint

Proximal parts :

◼ Distal end ofradius◼ Articular disc

Distal parts◼ Proximal row of

carpal bones

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 45/169

Skeleton of Lower Limb

PelvisHip Bone

Femur

PatellaLeg

TibiaFibula

The Foot

TarsusMetatarsusPhalanges of the Foot

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 46/169

Skeleton of theLower limb

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 47/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 48/169

Joints of the lower limb

• Hip joint• Knee joint• Tibio-fibular joints• Ankle joint• Foot joints :

• Involve tarsal,metatarsaland phalanges

• Subtalar joint• Talo-calcaneonavicular• Calcaneo-cuboid• Cuneonavicular•

Intercuneiform-cuneocuboid• Tarsometatarsal,and

intermetatarsal• Metacarpophalangeal and

iterphalangeal

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 49/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 50/169

HIP JOINT

• Type : enarthrosis (ball andsocket )

• Bones : head of femur and

acetabulum of hip bone

• Movement : flexion,extension, abduction,

adduction, lateral, medial

rotation

• Ligaments of hip joint :•  Acetabular labrum (glenoid

labrum)

• Transverse acetabular

• Iliofemoral

• Ischiofemoral

• Pubofemoral

• Capitis / teres femoris

• Synovial membrane

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 51/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 52/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 53/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 54/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 55/169

• Perasat Thomas

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 56/169

MUSCLE ACTING ON HIP JOINTS• Flexion : iliopsoas, sartorius, pectineus, rectus fem., add. long., add. Brevis,

add. magnus (anterior part), tensor fascia lata

• Medial rotate : Glut. max, semitend., semimemb., biceps fem., add. mag.

(posterior part)

• Lateral rotate : Piriformis, obturator int., gemelli., obturator ext., quadrat., fem.,glut. max., adductores (all)

• Extension : Gluteus max., semitend., semimemb., biceps fem., add., mag.,post., part.

•  Abduction : Glut. med., glut. min., tensor f.l., piriformis, sartorius

•  Adduction : add. mag., add. long., add. brev., gracilis, pectineus, obturator ext.,quadratus fem.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 57/169

CLINICAL CONSIDERATIONS A. Dislocation

1. Congenital

2. Traumatic• anterior dislocation much rarer  than

posterior dislocation

B. Osteoarthritis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 58/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 59/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 60/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 61/169

• Knee joints

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 62/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 63/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 64/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 65/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 66/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 67/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 68/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 69/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 70/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 71/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 72/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 73/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 74/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 75/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 76/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 77/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 78/169

Myologi Umum

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 79/169

Bag. Anatomi

FK. UNJANI

Myologi Umum

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 80/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 81/169

Tata Letak Otot

(Anterior)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 82/169

Tata Letak Otot

(Posterior)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 83/169

M l f th h ld

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 84/169

Muscle group of the shoulder

• Anterior Thoraco-Appendicular /pectoral Musclesh Pectoralis major / minor mh Subclavius mh Serratus anterior m

• Posterior Thoraco-Appendicular

Musclesa. Superficial : trapezius m,

latissimus dorsi mb. Deep : levator scapulae m,

rhomboids m• Scapulo-Humeral / Intrinsic shoulder

musclesh Deltoid mh Teres major mh 4 rotator cuff muscles (SITS)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 85/169

W ll f h ll

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 86/169

Wall of the Axilla

anterior wall

lateral wall

posterior wall

medial wall

Contents of theAxilla

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 87/169

Articulation on the Pectoral Girdle

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 88/169

Articulation on the Pectoral Girdle

Movement, support/stability1. Sterno-clavicular joint2. Acromio-clavicular joint

h Acromiclavicular lig., coracoclavicular lig. ( trapezoid, conoid )3.   ”Scapulo-thoracic joint”

h Pseudo-joint,h Support : M.trapezius,rhomboidei,serratus anterior,levator

scapulae4. Shoulder joint ( art humeri )

h Unstableh Support:

h Lig.glenohumeral superior/media/inferior,coracohumeral,coracoacromialh Dynamic stability : SITS + Tendo m.biceps brachii caput

longumh Coracoacromial arc = roof of the shoulder

B hi l / U A R i

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 89/169

Brachial / Upper Arm Region

❑ Skeleton : humerus❑ Superficial structures

➢ Superficial brachial fascia

➢ Cephalica vein, basilic vein

➢ Cutaneus nerve

➢ Lymphatic system

❑ Fascial Compartment ( Deepfascia )

➢ Anterior

➢ Posterior

➢ Intermuscular septum

Cross section of the Arm

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 90/169

A t i F s i l C t t f th A

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 91/169

Anterior Fascial Compartment of the Arm

❑ Muscles:❑ Biceps brachii m. ;❑ Coracobrachialis m. ;❑ Brachialis m.

❑ Innervation :

musculocutaneus n.

❑ Function : Flexor on thecubital joint

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 92/169

Posterior Fascial Compartment of the

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 93/169

pArm

❑ Muscle:

❑ Triceps brachii m.❑ Nerve supply : radial

nerve

❑ Function : extension

Cubittal fossa

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 94/169

Cubittal fossa

❖ Boundariesh Superiorly / base : an

imaginary line connectingthe medial and lateralepicondyles

h Medially : pronator teresh Laterally : brachioradialis

h Floor : pronator teres,brachialis

h Roof : deep fascia (cubital fascia )

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 95/169

◼ Muscles acting the elbow jointsanterior /flexor compartmentsuperficial layers :biceps brachii m.,

deep layers :brachialis and coracobrachialisposterior /extensor compartment :superficial layers :long heads and lateral head oftriceps brachii m .,deep layers : medial head of the triceps m.,anconeus m.

Fascial compartment of the forearm

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 96/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 97/169

Anterior Fascial Compartment of the

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 98/169

pForeArm

❑ Superficial Muscles:• Pronator teres m. ;• Flexor carpi radialis m. ;• Palmaris longus m.• Flexor carpi ulnaris m• Flexor digitorum superficialis m

❑ Deep muscles• Flexor digitorum profundus m• Flexor pollicis longus m•

Pronator quadratus m

❑ Function : Flexor on the cubital joint

Posterior Fascial Compartment of the

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 99/169

pForeArm

• Extensor– supinatormuscles :

• Superficial :• extensor carpi radialis

longus & brevis, extensordigitorum, extensor

digiti minimi, extensorcarpi ulnaris, anconeus

• Common tendon of originis attached to lateralepicondyle of humerus

• Deep group• Supinator, abductor

pollicis longus, extensorpollicis longus & brevis,extensor indicis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 100/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 101/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 102/169

◼ Thenar muscles : abductor pollicis brevis,

flexor pollicis brevis,and opponens pollicis,

adductor pollicis.Hypothenar muscles: abductor digiti V,

flexor digiti V brevis, opponens digiti V.short

muscle of the hand :lumbricales(4 ) and

interossei (dorsal and palmar )

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 103/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 104/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 105/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 106/169

• The lower limb is specialized forlocomotion,

bearing weight equilibrium

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 107/169

Lower limb consists of :• Gluteal region

• Thigh and knee joint

•  Anterior leg and dorsal foot

• Posterior leg and plantar foot

Gluteal Region 1

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 108/169

G ut a g n

▪

Gluteal fascia▪ Gluteal Ligaments :

▪ Sacrotuberous, Sacrospinous ligament

▪ Greater sciatic foramen is the passageway for structures

entering or leaving the pelvis▪ Lesser sciatic foramen is the passageway for structures

entering or leaving the perineum

▪ Gluteal Muscles : ▪

Large glutei and a deep of smaller muscles ( piriformis,obturator internus, gemelli, quadratus femoris )

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 109/169

GLUTEAL REGION

◼ Lies posterior to the pelvis

◼ Between crista iliaca / iliaccrest

◼  And inferior border ofgluteus maximus is

indicated by gluteal sulcus when the tight is extended,it is inferior to the glutealfold

◼ Intergluteal cleft (clunial /

natal cleft) separated thebuttock from each order

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 110/169

• Gluteal ligaments :

• Sacrotuberous and sacrospinous lig.

• The greater sciatic foramen

• The lesser sciatic foramen

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 111/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 112/169

Muscle of gluteal region:

gluteus maximus, gluteus

medius, gluteus minimus,

periformis, obturatorinternus, gemelli superior

and inferior, quadrattus

femoris

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 113/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 114/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 115/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 116/169

• Gluteal muscles :• Three large glutei →maximus, medius, and minimus

 – which are mainly extensors, abductors, and medial

rotators of the thigh

• Deeper group : piriformis, obtorator internus, gemelli,and quadratus femoris → lateral rotators of the thigh

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 117/169

• Emerge to the inferior piriformis muscle are :• Sciatic, posterior cutaneus, inferior glutealis (A,V.N),

pudendal nerve,internal pudendal art.

• Emerge to the superior piriformis muscle are :• Superior gluteal art / vena and nerve

Intragluteal injection

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 118/169

Gluteus mediusparalyses

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 119/169

p y

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 120/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 121/169

THIGH MUSCLEThree compartment :

•  Anterior → quadriceps femoris, pectineus, 

iliopsoas, tensor fascia lata, and sartorius

• Medial / adductor group → adductor (longus,brevis, magnus), gracilis and obturator externus

• Posterior → hamstrings muscle

(semitendinosus, semimembranosus, bicepsfemoris / long head)

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 122/169

Muscles of the Anterior Fascial Compartment

f th Thi h

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 123/169

of the Thigh 

▪ Muscles :▪ Sartorius,

▪ Ilio-psoas,

▪ pectineus,

▪ quadricepsfemoris

Muscles of the Posterior FascialC mp tm nt f th Thi h

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 124/169

Compartment of the Thigh 

▪ Muscles :

▪ Biceps femoris,

▪ semitendinosus, semimembranosus,

▪ small part of the adductor magnus

Muscle in Posterior

Compartment of the

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 125/169

Compartment of the

Thigh

Popliteal fossa

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 126/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 127/169

Transverse section of the leg

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 128/169

Contents of the Anterior FascialCompartment of the Leg

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 129/169

Compartment of the Leg

▪ Muscles :▪ Tibialis anterior,

▪ extensor

digitorum longus,▪ peroneus tertius,

▪ extensor hallucis

longus

Contents of the Lateral FascialCompartment of the Leg

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 130/169

Compartment of the Leg

▪ Muscles :▪ Peroneus longus,

▪ peroneus brevis

Contents of the Posterior FascialCompartment of the Leg

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 131/169

Compartment of the Leg

▪ Muscles : • Deep transverse fascia

• Superficial group :Gastrocnemius, popliteus,soleus

• Deep group : Popliteus,flexor digitorum longus,tibialis posterior, flexorhallucis longus

Contents of the Posterior FascialCompartment of the Leg

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 132/169

Compartment of the Leg

▪ Muscles : • Deep transverse fascia

• Superficial group :Gastrocnemius, popliteus,soleus

• Deep group : Popliteus,flexor digitorum longus,tibialis posterior, flexorhallucis longus

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 133/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 134/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 135/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 136/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 137/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 138/169

FOOT / PEDIS 

Skeleton of the foot : 7 tarsal bones, 5 metatarsals

and 14 phalanges.

◼Three parts :

◼ Hindfoot : talus and calcaneus

◼ Mid foot : naviculare, cuboid, and cuneiforme

◼ Fore foot : metatarsals and phalanges

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 139/169

MUSCLES OF FOOT

• 4 layers muscles of the plantar of foot.

• Three compartment of the sole foot :

• Medial compartment : abductor hallucis, flexor hallucis, medial plantar nerve

and vessels

• Lateral compartment :abductor and flexor digiti minimi brevis• Central compartment : flexor digitorum brevis, flexor digitorum longus,

quadratus plantae, lumbricals, proximal part of tendon flexor hallucis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 140/169

◼ Foot/Pedis RegionMuscle of sole of the foot (plantar pedis):

First layer : abductor hallucis, flexor digitorum brevis, abductor digitiminimi/VSecond layer: quadratus plantae, lumbricalsThird layer : flexorhallucis brevis, adductor hallucis, flexor digiti minimi brevis/V

◼ Fourth layer : Plantar interossei (three muscles), dorsal interossei (fourmuscles)

◼ Muscles of dorsum of the foot (dorsum pedis):extrinsic muscles: tibialis

anterior, extensor digitorum longus, extensor hallucis longusintrinsicmuscles: externsor digitorum brevis, extensor hallucis brevis◼ Joints :

hip jointknee/ genu jointtibiofibular joint proximal and distalankle jointfoot joints

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 141/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 142/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 143/169

Muscles of dorsum of thefoot (dorsum

pedis)  :extrinsic muscles :

tibialis anterior, extensor

digitorum longus, extensor

hallucis longusintrinsic

muscles:  externsor

digitorum brevis, extensorhallucis brevis

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 144/169

FOOT / PEDIS 

Skeleton of the foot : 7 tarsal bones, 5 metatarsals

and 14 phalanges.

◼Three parts :

◼ Hindfoot : talus and calcaneus

◼ Mid foot : naviculare, cuboid, and cuneiforme

◼ Fore foot : metatarsals and phalanges

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 145/169

 ARCHES OF FOOT

• Longitudinal arch is composed of :

✓ Medial → talus, navicular, 3 cuneiforms, 3 medial

metatarsals. Talus and navicular are most subject toinjury.

✓ Lateral → calcaneus, cuboid, 2 lateral metatarsals.

• Transversal arch is spreading the weight in all directions :

✓ Posterior transverse arch → navicular and cuboid

bone.✓  Anterior transverse arch → heads of the metatarsal

bones.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 146/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 147/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 148/169

•  Arcus is to endured : by interpillar lig.,intersegmental lig. and strapmedial

•  medial longitudinal arcus

• Intersegmental is form by lig.,: calcaneo-naviculare, cuneonaviculare, cuneometatarsalia.

• Interpillar : plantar aponeurosis, abductor

hallucis, flex., digit., brevis• Strap by posterior tibial m.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 149/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 150/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 151/169

• Lateral longitudina arcus is toendured by

lig.,:intersegmental : plantar longum.

Calcaneocuboidea,

• Inrpillar : aponeurosis plantaris, abductor digiti V,

flexor pollicis brevis

• Strap : longus peroneus m.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 152/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 153/169

•  Arcus plant., tranversus :

• Intersegmental :lig tarsi plantaris, lig., tarsi

interossea.• Interpillar : post., tibial m., and longus peroneus

m.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 154/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 155/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 156/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 157/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 158/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 159/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 160/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 161/169

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 162/169

 Appendix

Istilah

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 163/169

•  Apponeurosis: Tendo yang tipis seperti pita,

mengubungkan otot dengan bagian yang

digerakkannya

• Fascia: Lembaran jaringan ikat fibrosa yangmembentang di bawah kulit atau membungkus otot

dan oragan tubuh

• Ligamentum: Jaringan ikat yang menghubungkantulang atau organ dalam

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 164/169

Kesimpulan

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 165/169

• Otot merupakan jaringan yang penting dalam tubuh

manusia, dengan fungsi yang utama sebagai alat penggerak

• Terdapat 3 jenis otot: polos, jantung, rangka

• Gerakannya dipengaruhi oleh sistem syaraf ➔ unit motor

system; volunter dan involunter

• Terminologi otot menggambarkan arah gerak, posisi, bentuk

dan lokasinya dalam tubuh

Referensi

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 166/169

Gray’s. Atlas of Anatomy. Churchill Livingstone. 2008 

Martini, Frederic H. Fundamentals of Anatomy & Physiology.

Ed 7th. Pearson Education. 2006

Moore, Keith L. Essential Clinical Anatomy. Hipokrates. 1996.

Moore, Keith L. Clinically Oriented Anatomy. Ed th. Lippincott

Williams & Wilkins. 2006.

Rohen J, Yokochi. Atlas Anatomi Manusia. Ed 5th

. ECG. 2002Snell RS. Clinical Anatomy. Ed 7th. Lippincott Williams &

Wilkins. 2004.

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 167/169

INTERMEZZO

Pertanyaan

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 168/169

1. Gerakan apa yang dilakukan ?

2. Otot apakah berkontaksi untuk menimbulkangerakan tersebut?

8/10/2019 Osteo Arthro Myologi DMS

http://slidepdf.com/reader/full/osteo-arthro-myologi-dms 169/169