KULIAH PERDANA ORTHOPAEDIOleh:Dr. Broto Suwadji, Sp.OT

Disampaikan pada kuliah Clerkship Dokter Muda UWK di RSUD BangilUntuk Kalangan Sendiri

ANATOMICAL POSITION

ORTHOPAEDICS Orthopaedics is concerned with

Bones Joints Muscles Tendons nerves the skeletal system and all that makes it move

ORTHOPAEDICS Congenital and developmental abnormalities Infection and inflammation Arthritis and rheumatic disorders Metabolic and endocrine disorders Tumours Neurological disorders Trauma or injury

BONES A bone is a rigid organ that constitutes part

of the vertebral skeleton Two different points of bones

Bones as anatomical structureProvides the strength of the body

Bones as physiological organHematopoetic tissueReservoir for calcium, phospor etc

JOINTS is the connection made between bones in the

body Synarthrosis

Less or none of movement Diarthrosis

Movement (+)

DIARTHROSIS

MUSCLE is a soft tissue contain protein filaments of

actin and myosin that slide past one another, producing a contraction that changes both the length and the shape of the cell

Muscles function to produce force and motion.

TENDON AND LIGAMENT A tendon is a tough band of fibrous

connective tissue that usually connects muscle to bone and is capable of withstanding tension. Origo Insertio

Tendons are similar to ligaments; both are made of collagen. Ligaments join one bone to another bone, while tendons connect muscle to bone.

NERVE SYSTEM

NERVE SYSTEM

DERMATOM

DERMATOM

PLEXUS BRACHIALIS

PLEXUS LUMBOSACRAL

DIAGNOSIS IN ORTHOPAEDIC Clinical

Anamnesa Physical diagnosis

Additional

ANAMNESA/HISTORY Auto anamnesa or heteroanamnesa Present History Past History Family History Social Background

PRESENT HISTORY Chief complaint Onset Duration Aggravated factor Relief factor Mechanism

ANAMNESA/HISTORY SYMPTOMS

Pain Stiffness Swelling Deformity Weakness

PHYSICAL DIAGNOSIS

LookFeelMove

LOOK Shape and posture Skin General survey

FEEL The skin The soft tissues The bones and joints Tenderness

MOVE Active movement Passive movement Range of movement

ADDITIONAL EXAMINATION MEDICAL IMAGING TECHNIQUES BLOOD TESTS SYNOVIAL FLUID ANALYSIS

MEDICAL IMAGING TECHNIQUES

Conventional radiography (X-ray images). Computerized tomography (CT). Ultrasonography (US). Magnetic resonance imaging (MRI). Nuclear medicine imaging Bone Mineral Densitometry (BMD)

X RAY

COMPUTED TOMOGRAPHY (CT)

MAGNETIC RESONANCE IMAGING

BONE SCAN

Photon emission by radionuclides taken up in specific tissues can be recorded by a gamma camera to produce an image which reflects physiological activity in that tissue or organ

USG ULTRA SONOGRAPHY

BONE MINERAL DENSITY (BMD)

now widely used in identifying patients with osteoporosis and an increased risk of osteoporotic fractures