LECTURE 1.

BASIC HUMAN ANATOMY

dr. I Nyoman Gede Wardana, S.Ked.,M.Biomed

Aim:
- To develop an understanding anatomy is key to the practice of health and medicine.

Learning outcome
The student should know:
- Medical terminology related to body plane, orientation and directional term, anatomical
planes, basic body movement, organization of the body, and body regions
The student should be able to:
- Demonstrate, cooperate, and work with their friends related to body plane, orientation
and directional term, anatomical planes, basic body movement, organization of the body,
and body regions
The student must possess:
- Anatomical terminology, as well as eponyms required on a subject "Human Anatomy"

Curriculum contens:
- Medical terminology, level organization of body, orientation and directional term, body
planes, anatomical planes, basic body movement, organization of the body, and body
regions

Abstract
Anatomy is the identification and description of the structures of living things. It is a
branch of biology and medicine. The study of anatomy goes back over 2,000 years, to the
Ancient Greeks. It can be divided into three broad areas: Human anatomy, zootomy, or
animal anatomy, and phytotomy, which is plant anatomy. Human anatomy is the study of the
structures of the human body. An understanding of anatomy is key to the practice of health
and medicine. The word "anatomy" comes from the Greek words "ana," meaning "up," and
"tome," meaning "a cutting." Studies of anatomy have traditionally depended on cutting up,
or dissection, but now, with imaging technology, it is increasingly possible to see how a body
is made up without dissection.

Learning task
1. Define anatomy.
2. Identify kinds of anatomical studies.
3. Trace the organization of the human body into cells, tissues, organs, organ systems,
and the total organism
4. List the parts of an upper member and the parts of a lower member
5. Identify a reason for studying terminology.
6. Describe the anatomical position.
7. Given drawings illustrating planes and directions, name the planes and directions.
8. State the anatomic terms for the parts of the body.
9. Describe and practice with your friend basic principle of body movement
10. Use proper terminology to describe the location of body parts with respect to one
another.
11. Name the body cavities, their membranes, and some organs within each cavity.
 12. Describe the possible sections through the body or an organ.
13. Explain how and why the abdomen is divided into smaller areas. Be able to name
organs in these areas.

LECTURE 4 CENTRAL NERVOUS SYSTEM

Prof. Dr. dr. I Nyoman Mangku Karmaya, M.Repro, PA(K)

Abstract
The gross anatomy of the human brain can vary, but since the development of the
brain is strictly coded by genes, many of the notable structures have an uniformed
appearance and are the same in the brain of every human being. These structures are in the
form of the gyri and sulci, and the way they are positioned to each other defines the names
they carry. Also worthy of note regarding the lateral view of the brain is that the structures
seen from are specifically referred to as “cortex”, except for the brainstem part. Thus we
can see the cerebellar and cerebral cortices. The cortex is the most superficial layer of
these brain parts, and make up the largest portion of the brain’s grey matter.
The Cerebrum is the largest part of the brain and consists of the cerebral cortex
which is responsible for motor, sensory and cognitive functions. The large structures of the
brain are each divided into subparts or regions for simplified localization of structures, for
example the brainstem is composed of the midbrain, pons and medulla oblongata, while
the cerebrum is divisible into lobes. These parts of the brain are also marked with visible
gross features, like the gyri and sulci of the cerebrum. Sulci are small grooves; but there
are also large grooves called fissures. Fissures divide the cerebral cortex into lobes and
also divide the cerebrum into the right and left cerebral hemispheres along the sagittal plane.
The fissure involved in this division is called the medial longitudinal fissure.
The cerebellum (or small brain) weighs about 10% of the cerebral hemispheres and it
is about 150 g in the adult. It has a superficial layer of grey matter, the cerebellar cortex, and
like other parts of the brain, it is marked by numerous fissures. The cerebellum lies behind
the brainstem, and it is separated from the cerebrum by a fold of dura mater called the
tentorium cerebelli. The cerebellum consists of a part lying near the midline called the
vermis, and of two lateral hemispheres. It has two surfaces, superior and inferior. The
surface of the cerebellum is marked by a series of fissures that run more or less parallel to
one another. The fissures sub-divide the surface of the cerebellum into narrow leaf-like
bands or folia. The long axis of the majority of folia is more or less transverse. These
features divide the cerebellum into three lobes; a part anterior to the primary fissure, the
anterior lobe, a part between the two fissures, the posterior lobe (sometimes called the
middle lobe). The remaining part is flocculonodular lobe. The anterior and posterior lobes
together form the corpus cerebelli.

Aims:
 To develop an understanding of the general nervous system relevant to its clinical
setting.
 To increase students’ comprehension in their neuroanatomical knowledge and their
critical implementation to the structural and functional anatomy of the brain

Learning outcomes
The students should know:
 - The nerve cell and mention the role of its parts,
- The nature / basic properties of nerve cells,
- All types of cells that make up the nervous system and its functions,
- The subdivision of the nervous system based on its organization and based on its
properties,
- All the structures that make up synapses and their roles,
- The role of the nervous system in general
- The evolutionary development of the central nervous system
- The main parts of the central nervous system in the mediosagital section
- The association fibers, commisura fibers and projection fibers in the cerebrum
- The concept of the brain stem
- The relationship between motoric centers and subcortical structures in producing
integrated movements
- The anatomy and functional meaning of intracranial meninges and sinus durae matris

The students should be able to:

- Identify main sulcus and gyrus of cerebral cortex
- Identify corona radiate, internal capsule and its boundaries
- Identify the location of important subcortical structures in the forebrain, midbrain and
hindbrain and their respective functions
- Explain some important symptoms of extrapyramidal damage
- Explain the formation of cerebrospinal fluid, its function as well as the flow route
- Mention the main sources of arteria that serve the brain and which is assisted by
schematic figure as well

The students must possess:

- The location and function of functional centers in each lobe of the brain and their
relation to the Brodman area
- The arrangement and meaning of hemodynamic of the circulus arteriosus cerebri
(Willis)
- The distribution areas of a. Cerebrii anterior, a. Cerebrii media and a cerebrii
posterior primary which is assisted by schematic figure

SCENARIO 1
Mr. YZ, 48 years old, his main complaint was the presence of unilateral throbbing
vascular headaches and sometimes sudden pain. Pain is also felt in the back of one eye
until sometimes tears. Pain will increase episodically every few minutes and visual aura
symptoms occur. Pain occurs 2 - 5 times a week with a "pain free remission period". The
patient's social condition is active smoking and stress. The patient 5 years ago had suffered
a stroke but was stated to have improved. The vital sign revealed 170/100 mmHg, HR 88
bpm, and RR 18 rpm. As from the hetero anamnesis, his wife stated that his left arm felt
weak progressively since two days ago. Then, he had an uncomfortable mind and
sometimes he became angrier by himself.

Learning task
1. Identify which area of the cerebral cortex involved within this case?
2. Explain the normal nerve pathway so that the external environment could be
interpreted by the brain internally!
3. Based on number 1 above, especially for motoric terms, please mention all parts of
cerebrum ordered from the meninges till basis of cranium!
4. What is/are the role of the cerebellum based on this case?
5. What kind of structures which was passed through the motor neuron so that
weakness appeared? Please order them briefly!
6. Explain why does the muscle weakness presented in the left arm anatomically?
7. Identify the vascularization that had a role in this context!
8. Please mention what are the structure of the brain involved in the emotional status?
9. How is the regulation of vascularization and liquor cerebrospinalis (CSF) in the
normal neuroanatomy?
LECTURE 5 CENTRAL NERVOUS SYSTEM
Prof. Dr. dr. I Nyoman Mangku Karmaya, M.Repro, PA(K)

Abstract
The spinal cord is part of the central nervous system (CNS). It is situated inside the
vertebral canal of the vertebral column. During development, there’s a disproportion between
spinal cord growth and vertebral column growth. The spinal cord finishes growing at the age
of 4, while the vertebral column finishes growing at age 14-18. This is the reason why, in
adults, the spinal cord occupies only the upper two thirds of the vertebral canal. The spinal
cord is a continuation of the brainstem. It extends from the foramen magnum at the base of
the skull to the L1/L2 vertebra where it terminates as the conus medullaris (medullary
cone). A thin thread called filum terminale extends from the tip of the conus medullaris all
the way to the 1st coccygeal vertebra (Co1) and anchors the spinal cord in place.
Like the vertebral column, the spinal cord is divided into segments: cervical,
thoracic, lumbar, sacral, and coccygeal. Each segment of the spinal cord provides several
pairs of spinal nerves, which exit from vertebral canal through the intervertebral foramina.
There are 8 pairs of cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal pair of spinal
nerves (a total of 31 pairs). The spinal cord is supplied by branches of the vertebral and
segmental arteries. Ascending tracts convey information from the periphery to the brain.
On the other hand, the descending tracts carry information from the brain to the periphery.
The spinal cord is more than just a conduit, as it also modifies and integrates the information
that pass through it.
The spinal cord is made of gray and white matter just like other parts of the CNS. It
shows four surfaces: anterior, posterior, and two lateral. They feature fissures (anterior) and
sulci (anterolateral, posterolateral, and posterior). The spinal cord and spinal nerve roots are
wrapped within three layers called meninges. The outermost is the dura mater, underneath
it is the arachnoid mater, and the deepest is the pia mater. Dura mater has two layers
(periosteal and meningeal), between which is the epidural space. Between the arachnoid
and pia mater is the subarachnoid space, it is filled with cerebrospinal fluid.

Aims:
 To enhance students’ comprehension to the structural and functional anatomy of the
spinal cord (medulla spinalis) relevant to its clinical settings.

Learning outcomes
The students should know:
- The function of the spinal cord
- The layers and the space that surrounds the spinal cord and radices nervi spinalis
through schematic picture
- The anatomical route of impulse delivery from cerebral cortex, cerebelli cortex and
corpus striatum to skeletal muscles
- The spinal cord vascularization

The students should be able to:

- Compare the length of the spinal cord with the length of the vertebral canal from
children to adulthood and its clinical significance
 - Draw a cross-sectional scheme of the spinal cord, mentioning the parts and
comparing the images from various height of the fragments
- Explain the course of pain, temperature, specific touch and prooprioseptif impulses
ranging from receptors to cerebral cortex briefly
- Distinguish the ventral spinothalamicus tracts from the lateral, fasciculus grancilis
from cuneatus, spinocerebellaris ventrals from tractus dorsalis.
- Distinguish lateral corticospinal tract from ventral corticospinal tract

The students must possess:

- The upper motor neurons and lower motor neurons and distinguish the symptoms of
damage to the two structures
- Draw a map of the location of the tractus ascendentes and descendentes on the
cross section of the spinal cord of various niveau

SCENARIO 2
Mr. YZ, 48 years old, had been referred to the emergency unit due to vehicle
accident since 1 hour ago. He was unconscious that time. There were no families
accompanying him. The vital sign revealed 90/50 mmHg, HR 98 bpm, and RR 20 rpm on
manual bagging. As from the hetero anamnesis, the untrained helper stated that they just
lifted his head automatically without considered the situation of his neck. Furthermore, the
radiological examination had shown that his cervical was shifted due to unknown cause, but
the lifting moments trigger the cervical shifting as well as more worsening the patient
stabilization clinically.

Learning task
1. What is/are the structure of central nervous system that had poor condition in this
case? Please explain which pars of the spinal cord that was disrupted?
2. Please mention the division (pars) of spinal cord!
3. Based on number 2, which division that had similar horizontal appearance with the
cervical division?
4. How do you compare the level of spinal cord and vertebra?
5. If the accident damaged the dorsal horn within the pars cervicalis, please explain
what kind of disturbances/ illness/diseases that could be found afterward?
6. How do you relate the cauda equina and the lumbar punction?

CENTRAL NERVOUS SYSTEM (CENTRAL NERVOUS SYSTEM) PRACTICAL GUIDE

Tools
Brain mannequins/ real brain specimen

Identify the following structure

1. Hemispheres (right and left), lobes, cerebellum, gyrus, sulcus / fissure
2. Locate functional centers and adjust to the Brodman area
3. Corpus callosum and its parts
4. Forebrain, midbrain and hindbrain boundaries
5. Thalamus, hypothalamus, hipophyse, tegmentum, tectum, pons and medulla,
pedunculated cerebellaris, cerebellum hemisphere and vermis.
6. Meninges: piamater, arachnoid and duramater, falx cerebri, falx cerebelli, tentorium
cerebelli.
 7. Ventriculus lateral, ventriculus tertius, ventriculus quartus, capsula interna

Tools
Spinal cord mannequins

Identify the following structure

1. Substantia alba and gricea, anterior, posterior and lateral horn.
2. Fissures mediana ventralis et dorsalis, comissura alba et gricea, funiculus ventralis et
dorsalis.
3. Ventral radix, dorsal radix, spinal nerve
4. Cauda equine and fillum terminale.

LECTURE 6 ANATOMY PERIPHERAL NERVOUS SYSTEM

Prof.Dr.dr. I Nyoman Mangku Karmaya, M.Repro., PA (K)

Abstract
Spinal nerves are grouped as cervical (C1-C8), thoracic (T1-T12), lumbar (L1-L5),
sacral (S1-S5), and coccygeal (Co1), depending from which segment of the spinal cord they
extend. Segmentation of the spinal cord corresponds to the intrauterine period in which the
spinal cord occupies the entire vertebral canal. For this reason in adulthood, where the
vertebral column is longer than the cord, each spinal cord segment is located higher than its
corresponding vertebra. These differences become more obvious distally towards the lumbar
and sacral segments of the spinal cord–for example spinal cord segment L5 is at the level of
the L1 vertebra.
Spinal nerves, however, exit the vertebral column at their correspondly numbered
vertebrae. Cervical spinal nerves exit through the intervertebral foramina directly above their
corresponding vertebrae, whilst thoracic, lumbar and sacral spinal nerves exit directly below.
In order for the more distal spinal nerves to exit they must first descend through the vertebral
canal. Since the lumbar and sacral spinal nerves are the farthest from their intervertebral
foramina, they are the longest. While descending towards their corresponding intervertebral
foramina, lumbosacral spinal nerves form a bundle called the cauda equina (meaning
horse’s tail).
Each spinal nerve has an anterior and posterior root. Anterior roots transmit motor
information, and they originate from the anterior horns of the gray matter and exit the spinal
cord through the anterolateral sulcus. The posterior roots transmit sensory information and
have sensory ganglion attached to them. They originate from the posterior horns of gray
matter and exit through the posterolateral sulcus of the spinal cord. The anterior and
posterior roots merge just before the intervertebral foramen, and form the trunk of the spinal
nerve. The trunk is very short, and soon after exiting the vertebral column, it divides into four
branches: anterior ramus, posterior ramus, communicating ramus, and meningeal ramus.
A huge part of spinal cord function is under the influence of the brain, as it functions
to relay information to and from the periphery. But there are many reflexes that are
generated in the spinal cord independently from the brain. Spinal reflexes are either
monosynaptic or polysynaptic.

Aims:
  To develop an understanding of the structural and functional anatomy of the nervi
spinales.
 To enhance the critical understanding of the reflex arc and its implementation.

Learning outcomes
The students should know:
- the division of peripheral nerves based on their anatomy and nature
- the formation of spinal nerves through chart drawings
- the relationship of the spinal nerve with the spinal cord and vertebral column

The students should be able to:

- explain the main symptoms of damage to the dorsal radix, ventral radix, spinal
nerves, posterior ramus and anterior ramus
- explain the components involved in monosynaptic and polysynaptic reflexes
- explain the mechanism of patellar reflex

The students must possess:

- the segmental, intersegmentary and suprasegmental reflex

SCENARIO 3
Mr. YZ, 48 years old, had been referred to the emergency unit due to hyperpyrexia
about 410C. He was unconscious that time. There were no families accompanying him. The
vital sign revealed 90/50 mmHg, HR 106 bpm, and RR 24 rpm. As from the hetero
anamnesis, he had seizure 3 hours ago prior to emergency room. Further past histories
revealed that he had stroke for 2 years. His family said that he could not receive any
sensation like thermal and soft or rough touching in the membrum inferius. His walking was
also disorganized.

Learning task
1. Based on your anatomical scope, why the patients had total loss of sensation in the
membrum inferius, but not in the membrum superius one?
2. You should observed the pathological reflex, but you also should knew the
physiological one. In the case, you found the damage of LMN. What is the
characteristic of LMN syndrome?
3. What do you think about the intersegmental reflex and suprasegmental reflex that
occurred in this case?
4. If the additional case occurred similarly in the membrum superius and inferius, which
the segmental area of spinal cord had damaged? Please explain how does it can be!
5. How to relate the dermatome and nervi spinales?

LECTURE 7 ANATOMY PERIPHERAL NERVOUS SYSTEM

Prof.Dr.dr. I Nyoman Mangku Karmaya, M.Repro., PA (K)

Abstract
 Cranial nerves anatomy is essential for almost any medical specialty since they
control so many body functions, such as rolling your eyes when you’re annoyed by
something. So let’s break the stigma of them being hard to understand, and learn them once
and for all.
Cranial nerves are the 12 nerves of the peripheral nervous system that emerge from
the foramina and fissures of the cranium. Their numerical order (1-12) is determined by their
skull exit location (rostral to caudal). All cranial nerves originate from nuclei in the brain. Two
originate from the forebrain (Olfactory and Optic), one has a nucleus in the spinal cord
(Accessory) while the remainder originate from the brainstem. Cranial nerves supply sensory
and motor to the head and neck, controlling the activity of this region. Only the vagus nerve
extends beyond the neck, to innervate thoracic and abdominal viscera.
The information is classified as special if it travels from our special senses (vision,
smell, taste, hearing and balance), while general describes information to/from everywhere
else. The information carried by a nerve is called somatic if it goes to/from the skin and
skeletal muscles, or visceral if it travels to/from our internal organs.
The visceral nervous system is commonly known as the autonomic nervous
system (ANS). It is involved in regulating the involuntary functions of organs and other
visceral components, by mediating the activity of smooth muscle fibers, cardiac muscle
fibers and glands. In order for the ANS to effectively regulate heart rate, blood pressure,
digestion, etc., it needs to first detect changes within these visceral components. The
sensing part is performed by the visceral sensory component, which consists of visceral
sensory neurons and general visceral afferent fibres. Information from the continuous
monitoring activities of the visceral sensory component are sent to the ANS, so that the
visceral motor component can make the needed adjustments for the correct functioning of
organs. The visceral motor component contains visceral motor neurons and general visceral
efferent fibres. The sensory (afferent) and motor (efferent) fibers of the visceral system
accompany each other in their trajectories.

Aims:
 To increase the critical thinking to the structural and functional anatomy of the nervi
craniales relevant to its clinical settings.
 To develop an understanding of the structural and functional anatomy of the
autonomic nervous system relevant to its clinical settings.

Learning outcomes
The students should know:
- The anatomical and functional organization of the autonomic nervous system
- the 12 pairs of nervi craniales with their properties

The students should be able to:

- Explain the function of the autonomic nervous system
- Explain the effect of the mechanism of the sympathetic and the parasympathetic
nervous system in various organs in the body
- Explain the connection of crania foramina base with the 12 pairs of nervi craniales

SCENARIO 4
 Mr. YZ, 48 years old, had been referred to the emergency unit due to active bleeding
run out from the ears and nose. Both his ocular was seems like raccoon-eye. He was
unconscious that time. There were no families accompanying him. The vital sign revealed
90/50 mmHg, HR 106 bpm, and RR 24 rpm on manual bagging. Furthermore, the
radiological examination had shown that his basis cranii was cracked due to heavy
momentum.

Learning task
1. Please mention all the hole that located on the basis cranii?
2. Please mention which cranial nerves that had couple functions as parasympathetic
nerve?
3. Based on number 2, which the hole passed through by them?
4. What kind of the reflex shown by n. craniles III, V, IX?
5. Please mention which n. craniales that have the biggest and which of them that have
the longest one?
6. Please explain what are the n. craniales delivered from the brain stem specifically!
7. Why does HR of the patients run faster than normal anatomically?
8. What other appearances that can be shown by the autonomic nervous system in this
case concomitantly?

PERIPHERAL NERVOUS SYSTEM PRACTICAL GUIDE

Tools
Plastination speciment

Identify the following structure

1. Plexus brachialis and its constituents
2. Radial nerve, axillary nerve, musculocutaneous nerve, radial nerve and ulnar nerve
3. Plexus lumbosacralis
4. Femoral nerve, ischiadica nerve, tibial nerve and fibularis nerve

Schematic diagrams/figures for Cranial Nerves and Basis Cranii

1. Identify the following structure
2. Nervus cranialis I through XII, state their characteristics and foramen passed
3. The hole / foramina on the base of the cranii and the structure that passes through

LECTURE 8 ANATOMY OF URINARY SYSTEM

Dr. dr. I Gusti Ayu Widianti, M.Biomed

Aim:
- Describe the general and topography and surface anatomy of the urinary system

Learning outcomes:
- Describe the general and topography and surface anatomy of kidney
- Desribe the surface anatomy of urinary tract
Curriculum contens:
- Topography anatomy of the kidney
- Topography anatomy of the ureter, urinary bladder and urethrae

Abstract:
The urinary system produces urine and conducts it to outside the body. The kidneys
are the primary organs of excretion. Excretion is the removal of metabolic wastes from the
body. As the kidneys produce urine, they carry out four functions: excretion of metabolic
wastes, maintenance of water-salt balance, and maintenance of acid-base balance and
secretion of hormones.
The kidneys are in the retroperineal spatium and paired kidneys are on either side of
vertebral column below diaphragm. The right kidney is located lower than the left kidney
because the right kidney is located below the liver. kidney shape such as cashews where the
medial portion is concave and the lateral convex. the kidney consists of five segments and
each segment has its own vascularization. the kidney consists of cortex and medulla. Cortex
contains many capillaries & outer parts of nephrons and medulla consists of renal pyramids
separated by renal columns. Pyramid contains minor calyces which unite to form a major
calyx
and is join to form renal pelvis which collects urine.
The ureter is about 25-30 cm long and is in the retroperineal spatium which has three
constriction. Urinary bladder has four surfaces namely superior, left and right inferolateral
and posterior surfaces. In males the urethra is 18-20 cm long and there are 4 parts:
preprostatic part, prostatic part, membranous part, and spongious part. Whereas in women
the length is 4 cm

Learning task
1. Identify the kidneys and to know their position in the abdomen
2. Identify the anatomical structures which can be seen in sagittal section of the kidney
3. Identify the ureters and trace their course to the pelvis
4. Identify the urinary bladder in specimens and models
5. Describe the course of the male and female urethrae
6. To describe the blood supply and lymph drainage of kidneys, ureters, urinary bladder
and urethrae

LECURE 9 ANATOMY OF REPRODUCTIVE SYSTEM

Dr. dr. I Gusti Ayu Widianti, M.Biomed

Aims:
- Describe the general and topography anatomy of the reproductive system and breast
Learning outcome:
- Describe topography anatomy of the female reproductive system
- Desribe the surface anatomy of the breast
- Describe topography anatomy of the male reproductive system

Curriculum contens:
- Topography anatomy of the female internal genital organs
- Topography anatomy of the female external genital organs
- Topography anatomy of the breast
- Topography anatomy of the male internal genital organs
- Topography anatomy of the male external genital organs

Abstract
The Female Internal Genital Organs
The female internal genital organs include the vagina, uterus, uterine tubes and
ovaries. The vagina, a musculomembranous tube, extends from yhe cervix of the uterus to
the vestibule, the cleft between the labia minora into which the vagina and urethra open. The
superior end of the vagina surrounds the cervix of the uterus. The vagina is usually
collapsed so its anterior and posterior walls are in contact, except at its superior end, where
the cervix holds them apart. The vagina: serves as a canal for menstrual fluid, form the
inferior part of the pelvic (birth) canal, receives the penis and ejaculate during sexual
intercourse.
The uterus is a thick-walled, pear-shaped, hollow muscular organ. The uterus usually
lies in the lesser pelvis, with its body lying on the urinary bladder and its cervix between the
urinary bladder and the rectum. The adult uterus is usually anteverted and anteflexed so that
its mass lies over the bladder. The uterus is divisible into two main part: the body and the
cervix. The wall of the body of the uterus consist of the three layers: perimetrium,
myometrium and endometrium.
The uterine tubes extend laterally from the uterine horns and open inyo the peritoneal
cavity near the ovaries. The uterine tubes lie in the mesosalphinx in the free edges of the
broad ligament. Each uterine tube is divisible into four parts: the infundibulum, ampulla,
isthmus and the uterine part.
Ovaries: the almond-shaped ovaries are typically near the attachment of the broad
ligament to the lateral pelvic walls, suspended from both by peritoneal folds, the mesovarium
from the posterosuperior aspect of the broad ligament and the suspensory ligament of the
ovary from the pelvic wall.
The Female External Genitalia Organs
The female external genitalia include the mons pubis and labia majora (enclosing the
pudendal cleft), labia minora (enclosing the vestibule), clitoris, bulbs of the vestibule and
greater and lesser vestibular glands. The synonymous terms pudendum and vulva include
all these parts. The vulva serves as sensory and erectile tissue for sexual arousal and
intercourse, direct the flow of urine and prevent entry of foreign material into the urogenital
tract.
Breasts
Both males and females have breasts (mammae), normaly the mammary glands are
well developed only in women. Mammary glands in women are accessory to reproduction,
but in men they are functionless, consisting of only a few small ducts or cords. The
mammary glands are modified sweat glands and therefore have no special capsule or
sheath. The contour and volume of the breasts are produced by subcutaneous fat, except
during pregnancy when the mammary glands enlarge and new glandular tissue forms.
Breast size and shape result from genetic, racial, and dietary factors. The roughly circular
base of the female breast extends transversely from the lateral border of the sternum to the
midaxillary line and vertically from the 2nd – 6th ribs.
The Male Internal Genital Organs
 The male internal genital organs include the testes, epididymides (plural of
epididymis), ductus deferentes (plural of ductus deferens), seminal glands, ejaculatory ducts,
prostate, and bulbourethralis glands.
The ovoid testes are suspended in the scrotum by the spermatic cords. The testes
produce sperms (spermatozoa) and hormones, principally testosterone. The sperms are
formed in the seminiferous tubules that are joined by straight tubules to the rete testis.
The epidymis is an elongated structure on the posterior surface of the testis formed by
minute convolutions of the the duct of the epididymis, so tightly compacted that they appear
solid. The efferent ductules transport newly formed sperms from the rete testis to the
epididymis, where they are stored until mature. The rete testis is a network of canals at the
termination of the seminiferous tubules. The epididymis consists of a head, body and tail.
The ductus deferens (deferent duct or vas deferens) is the continuation of the duct of
the epididymis. The ductus deferens:
 Begin in the tail of the epididymis at the inferior pole of the testis,
 Ascends in the spermatic cord and
 Passes through the inguinal canal.
 Crosses over the external iliac vessels and enters the pelvis
 Passes along the lateral wall of the pelvis where it lies external to the parietal
peritoneum
 Ends by joining the duct of the seminal glands to form the ejaculatory duct.
The seminal glands are obliquely placed sturtures superior to the prostate and do not
store sperms. Each seminal gland is an elongated structure that lies between the fundus of
the bladder and the rectum.
The ejaculatory ducts arise near neck of the bladder and run close together as they
pass anteroinferiorly through the posterior part of the prostate. Each ejaculatory ducts is a
slender tube that arises by the union of the duct of a seminal gland with the ductus deferens.
Prostate gland: the walnut-size prostate surrounds the prostatic urethra. The glandular
part makes up approximately two thirds of the prostate and the other third is fibromuscular.
The prostate has a base, an apex, a muscular anterior surface, a posterior surface and the
inferior surfaces.
Bulbourethral glands: the two pea-size bulbourethralis glands (Cowper glands) lie
posterolateral to the intermediate part of the urethra, largely embedded within the external
urethral sphincter. The duct of bulbourethralis glands pass through the perineal membrane
with the intermediate urethra and open through minute apertures into the proximal part of the
spogy urethra in the bulb of the penis.
The Male External Genital Organs
The male external genital organs include the scrotum and penis.
The scrotum is a cutaneous sac consisting of two layers: heavily pigmented skin and
closely related dartos fascia, a fat-free fascial layer including smooth muscle fibers (dartos
muscle) responsible for the rugose (wrinkled) appearance of the scrotum. The scrotum to
wrinkle when cold and reducing thus reducing heat loss.
The penis is the male organ of copulation and the outlet for urine and semen. The
penis consists of a root, body and glans penis. It is composed of three cylindrical bodies of
erectile cavernous tissue: the paired corpora cavernosa and the single corpus spongiosum
ventrally.
Learning Task
1. To identify the ovaries, uterine tubes, uterus and broad ligaments and vagina
2. Describe the normal position and support of the uterus
 3. To state the peritoneal relationships of the ovary and the uterine tube
4. To describe the support of the uterus
5. To identify the female external organs genital
6. To describe the blood supply and lymph drainage of the female genital system
7. To identify the testes, their size, shape and location
8. To identify the parts of the epididymis and the ductus deferens.
9. To state blood, nerve supply and lymph drainage of the testis
10. To identify the seminal glands, prostate, and its lobes and duct, and the bulbourethral
glands
11. To identify the penis and its attachments and component structures.

LECTURE 10 ANATOMY OF CARDIOVASCULAR SYSTEM (HEART)

Dr.dr. I Gusti Ayu Widianti, M.Biomed

Aims:
- To develop an understanding of the general structure, topography, and surface anatomy
of the cardiovascular system

Learning outcome:
- Describe the general anatomy of the cardiovascular system
- Describe topography of the cardiovascular system
- Describe surface anatomy of the cardiovascular system
- Desribe the surface anatomy of the cardiovascular system

Curriculum contens:
- Topography anatomy of the heart and great vessel
- Mediastinum
- Pulmonary/lesser and systemic/greater circulation

Abstract:
The heart is a hollow, fibromuscular organ of a conical or pyramidal form, with a base,
apex and a series of surfaces (sternocostal/anterior, diaphragmatic/inferior and pulmonaries)
and borders (acute and obtuse borders). Enclosed in the pericardium, occupies the middle
mediastinum between the lungs. It is placed obliquely behind the body of the sternum and
adjoining costal cartilage and ribs, one-third lies to the right of the midline. Because of
intimate relation between left atrium, the arch of aorta and esophagus, enlargement of them
resulting compression to each other.
The human heart is a pair of valved muscular pumps combined in a single organ.
Right and left heart pumps is physiologically separate, being interposed in series of different
point in the double circulation: pulmonary/lesser circulation for blood oxygenation and
systemic/greater circulation for tissue perfusion.
Of the four cardiac chambers, the two atria received venous blood for filling of the two
ventricles which then provide the powerful expulsive contraction, forcing blood into the main
arterial trunks: pulmonal trunk and aorta.
On the anterior surface of the chest, the outline of the heart and the sound produced
by the valves can be traced.
Learning Task Lecture 3.1
1. Describe the location and functions of the heart.
2. Identify the auscultatory point of mitral, aortic, pulmonal, and tricuspid valves.
3. Identify the mediastinum
4. Identify the major external features of the heart
5. Identify the features of the chambers of the heart
6. Compare the pulmonary and systemic circulation.
7. Describe the blood supply and lymphatic drainage of the heart
8. Describe the intrinsic and extrinsic innervation of the heart
9. Describe the before and after birth circulation

LECTURE 11 ANATOMY OF VASCULAR AND LYMPHATIC VESSELS

Dr.dr. I Gusti Ayu Widianti, M.Biomed

Learning task
1. Describe the arterial system of vessels
2. Describe the main blood supply to the head and neck, thorax and abdomen, upper
and lower limb
3. Describe the venous system of vessels including the portal circulation
4. Describe the right and left lymphatic system

LECTURE 12 THORAX
Dr. I Nyoman Gede Wardana, S.Ked., M.Biomed

Abstract
The chest, or thorax (thora- is Greek for “breastplate”; “chest”), is the region of the
body between the neck and the abdomen. It is flattened in front and behind but rounded at
the sides. Skin and muscles of the shoulder girdle cover the exterior of the thoracic wall,
whereas parietal pleura lines its inner surface. The skeletal framework of the thoracic walls is
referred to as the thoracic cage. This is formed by the thoracic part of the vertebral column
posteriorly, the ribs and intercostal spaces laterally on either side, and the sternum and
costal cartilages anteriorly. Superiorly, the thorax communicates with the neck, and inferiorly,
it is separated from the abdomen by the diaphragm. The thoracic cage protects the lungs
and heart and provides attachment for the muscles of the thorax, upper extremity, abdomen,
and back.

Learning task:
1. Identify the bones of the thoracic cage and their major features.
2. Describe the functional aspects of these structures.
3. Identify the bony components, major supporting ligaments, and movements permitted
at the joints of the thoracic cage.
4. Describe the structure of the thoracic wall, including its layers and the contents of a
typical intercostal space. Note the arrangement of the intercostal muscles and
neurovascular elements. Note collateral routes and major anastomoses of arteries.
5. Describe the development, structure, position, and actions of the diaphragm. Identify
its innervation, and indicate the segmental sources and pathways taken by these
nerves to reach the diaphragm.
 6. Describe the mechanics of respiration, including a comparison of the roles of the
diaphragm, thoracic cage, and thoracoabdominal muscles in normal respiration.
7. Trace the course of motor and sensory innervation of the thoracic wall. Predict the
functional consequences of lesions of individual peripheral nerves.
8. Trace the flow of blood to and through the thoracic wall by describing the courses
and branching patterns of the major arteries and veins.
9. Identify the territories supplied and drained by the major vessels. Note the main
collateral routes, and describe the composition of significant anastomoses.
10. Describe the pattern of lymphatic drainage of the thoracic wall, including the
relationship of this drainage to that of the axilla and breast.
11. Identify the major structures of the thoracic wall in standard medical imaging.
12. Locate the surface projections and palpation points of the major thoracic structures in
a basic surface examination

PRACTICAL GUIDELINE THORAX

IDENTIFY THESE STRUCTURES
Osteology
- Sternum
- Ribs
- Vertebrae
Joints
- Sternal Joints
- Joints of Heads of Ribs
- Joints of Tubercles of Ribs
- Joints of Ribs and Costal Cartilages
- Joints of Costal Cartilages with Sternum
- Rib and Costal Cartilage Movements
Thoracic Openings
- Thoracic Apertures
- Intercostal Spaces
Muscles
- Intercostal Muscles
- Diaphragm
- Levatores Costarum
- Serratus Posterior Muscles
Vasculature
- Internal Thoracic Artery
- Internal Thoracic Vein
- Intercostal Arteries and Vein
Surface Anatomy
- Anterior Chest Wall
- Ribs
- Diaphragm
- Nipple
- Apex Beat of Heart
LECTURE 13 ANATOMY OF RESPIRATORY SYSTEM
dr. I Nyoman Gede Wardana, S.Ked., M.Biomed

Aim:
- To develop an understanding basic structure of human respiratory system, its normal
functional relationship and the basis for common disease affected organs of respiratory
system, imaging, and general surface examination

Learning outcomes:
The student should know:
- The gross anatomy of organs respiratory system including structure, anatomic
relationship, vascular, and nerve supply
- Muscles that involve in respiration
- Structure of diaphragm
The student should be able to:
- Identify and locate position of organs respiratory system in the body
- Palpate (feel out) and determine the position of organs respiratory system (larynx,
trachea, bronchus, lungs, respiratory muscles, bony prominences on the thoracic wall,
diaphragm
The student must possess:
- Diagnoses skill to identify diseases or problem that occur in organs respiratory system

Curriculum contens:
- Structure of upper respiratory tract
- Structure of lower respiratory tract
- Muscles of respiration
- Structure of diaphragm

Abstract:
The respiratory system may be divided into the upper respiratory tract and the lower
respiratory tract. The upper respiratory tract consists of the parts outside the chest cavity:
the air passages of the nose, nasal cavities, pharynx, larynx, and upper trachea. The lower
respiratory tract consists of the parts found within the chest cavity: the lower trachea and
the lungs themselves, which include the bronchial tubes and alveoli. Also part of the
respiratory system are the pleural membranes and the respiratory muscles that form the
chest cavity: the diaphragm and intercostal muscles.

Learning task:
1. Describe the anatomy of upper respiratory passages: nasal cavities, pharynx, and
larynx.
2. Describe the structure and role of the parietal and visceral pleurae and the pleural
cavity
3. Describe the anatomy of lower respiratory passages: trachea, bronchi and
bronchioles
4. Describe the structure of the lungs and the chest wall
5. Identify muscles that involve in inspiration and expiration process
6. Describe the structure of diaphragm
PRACTICAL GUIDELINE RESPIRATORY SYSTEM

IDENTIFY
Nose
Nasal Cavity
Paranasal Sinuses
Larynx
Thoracic Cavity
Mediastinum
Superior Mediastinum
Inferior Mediastinum
Pleurae
Layers and Cavity
Nerve Supply
Lower Respiratory Tract
Trachea
Bronchi
Lungs
Lobes and Fissures
Diaphragm
Respiratory muscles

LECTURE 14 ANATOMY OF ALIMENTARY SYSTEM

dr. I Nyoman Gede Wardana, S.Ked., M.Biomed

Aim:
- To develop an understanding basic structure of alimentary and hepatobiliary system, its
normal functional relationship and the basis for common disease that affected organs of
alimentary and hepatobiliary system, imaging, and general surface examination

Learning outcomes:
The student should know:
- The gross anatomy of organs alimentary and hepatobiliary system including structure,
anatomic relationship, vascular, and nerve supply
- Ventrolateral abdominal wall
- Structure of peritoneum
The student should be able to:
- Identify and locate position of organs alimentary and hepatobiliary system in the body
- Identify muscles of ventrolateral abdominal wall
- Define peritoneum
- Palpate (feel out) and determine the position of organs alimentary and hepatobiliary
system (esophagus, gaster, intestinum tenue, intestinum crassum, liver, pancreas,
spleen)
The student must possess:
- Diagnoses skill to identify diseases, problem, or symptom that occur in organs
alimentary and hepatobiliary system
Abstract:
The two divisions of the digestive system are the alimentary tube and the accessory
organs. The alimentary canal extends from the mouth to the anus. It consists of the oral
cavity, pharynx, esophagus, stomach, small intestine, and large intestine. Digestion takes
place within the oral cavity, stomach, and small intestine; most absorption of nutrients takes
place in the small intestine. Undigestible material, primarily cellulose, is eliminated by the
large intestine (also called the colon). The accessory organs of digestion are the teeth,
tongue, salivary glands, liver, gallbladder, and pancreas. Digestion does not take place
within these organs, but each contributes something to the digestive process.

Learning task:
1. Describe the oral cavity, pharynx, esophagus
2. Identify the salivary glands
3. Describe of the peritoneum and the mesenteries
4. Describe the anatomy of the stomach,
5. Describe small and large intestine, distinguish these two structure
6. Distinguish between ileum and jejunum
7. Identify the pancreas and spleen

PRACTICAL GUIDELINE

IDENTIFY

Part of these structure:

- Esophagus
- Gaster
- Small intestine (duodenum ,jejunum, ileum)
- Large intestine (cecum, appendix vermiformis, ascending colon, transverse colon,
descending colon, sigmoid colon)
- Rectum and anal canal
- Pancreas, lien, liver, gallbladder
LECTURE 15 ANATOMY OF ENDOCRINE SYSTEM AND SPECIAL SENSES
dr. Yuliana, S.Ked.,M.Biomed

Endocrine System
Abstract
The endocrine system uses hormones to convey information between different
tissues. Hormones derive from the major classes of biologic molecules, this can be proteins
(including glycoproteins), peptides or peptide derivatives, amino acid analogs, or lipids.
Endocrine hormones are part of a large complement of small intercellular signaling
molecules. Examples of endocrine glands are pituitary gland, hypothalamus, thyroid,
parathyroid, testes, ovary, pancreas, thymus, and adrenal.
The pituitary gland lies on the base of the skull in a portion of the sphenoid bone
called the sella tursica. The hypothalamus and pituitary gland form a unit which exerts
control over the function of several endocrine glands: thyroid, adrenal, and gonads, as well
as a wide range physiologic activities. This unit constitutes a paradigm of
neuroendocrinology: brain-endocrine interactions.
The pancreas is made up of two functionally different organs: exocrine and
endocrine. The major product of exocrine pancreas is the digestive enzims. The endocrine
pancreas consists of 0.7-1 million small endocrine glands – the islets of Langerhans –
scattered within the glandular substance of the exocrine pancreas.
Thyroid gland is the largest organ specialized for endocrine function in the human
body. The major function of thyroid gland is to secrete a sufficient amount of thyroid
hormones, which promote normal growth and development, regulate a number of
homeostatic function including energy and heat production.

Aim:
- To develop an understanding about anatomy of endocrine system is key to the practice
of health and medicine.

Learning outcome
The student should know:
- The structure of pituitary gland, hypothalamus, thyroid, parathyroid, testes, ovary,
pancreas, thymus, and adrenal, including their position in the human body and the
surface anatomy of the other organs in the body; the relationship between the structure
and function of organs

The student should be able to:

- Show on the body about anatomical structures of endocrine system (pituitary gland,
hypothalamus, thyroid, parathyroid, testes, ovary, pancreas, thymus, and adrenal.

Learning Task
1. Describe and give examples why pituitary gland is called as master gland. Give 3
examples.
2. Draw and describe anatomical structure, innervation and vascularisation of thyroid
gland.
3. Draw and describe anatomical structure, innervation and vascularisation of
parathyroid gland.
 4. Draw and describe anatomical structure, innervation and vascularisation of pancreas
gland.
5. Draw and describe anatomical structure, innervation and vascularisation of
hypothalamus.
6. Draw and describe anatomical structure, innervation and vascularisation of
hypophysis
7. Draw and describe anatomical structure, innervation and vascularisation of testes
8. Draw and describe anatomical structure, innervation and vascularisation of ovary
9. Draw and describe anatomical structure, innervation and vascularisation of thymus
10. Draw and describe anatomical structure, innervation and vascularisation of adrenal
gland

Abstract
The five senses are very important in the body and consist of eyes, ears, nose,
tongue, and skin. Eyes have receptors in the form of rod and cone cells which are located in
the retina. Ears as hearing organs, innervated by the cochlear nerve and its receptors are in
the cochlea (organ of Corti). Nose as the organ of smell. It is innervated by olfactory nerve
and its receptor were in the superior nasal mucose. The tongue has taste bud as receptor. It
is innervated by the facial nerve and the glossopharyngeal nerve. The skin as a sense of
touch has several receptors. Pain receptors in the form of free nerve ending, heat receptors
are Ruffini, receptors for cold are Krause, smooth touch receptors areMeissner corpuscle,
pressure receptors are Pacinian corpuscle, and for proprioceptive position is known from the
muscle’s spindle.

Sense of sight consists of the eye and visual accessory organ. Eye ball is located in the
orbit. It is protected by the superior and inferior eyelid. It consists of three layer fibrous tunic
(cornea and sclera), lamina vasculosa (choroid, ciliary body, iris), and sensorial tunica
(retina). Bulbus oculi contains refractive media (aqueous humor, lens, cornea, and vitreous
body).The ear is a vestibulocochlear organ that functions for balance and hearing. The ear is
divided into outer, middle, and internal ear. External ear includes the auricle and external
auditory canal. Middle ear consists of hearing bones (maleus , incus, stapes). The inner ear
(internal ear) consists of cochlea, ampulla, and semicircular canal. The tongue is a sense
organ that is innervated by n. V, n. VII, n. IX, and n. X.

Taste bud on the papillae of the tongue is very important to taste the various flavors of food
and beverages. Tongue is divided into two parts, namely the root (radix) and the body
(corpus).The nose consists of an external nose and nasal cavity. The external nose consists
of radix, dorsum, apex, nares, and septum. Nasal cavity is divided into two areas, namely
the respiratory area and the olfactory area. One third of the superior mucosa acts as an
olfactory area, while two-thirds on inferior part are for respiration.The skin as a sense organ
consists of the epidermis and dermis. The epidermis consists of 4-5 layers. In the dermis,
there are nerves, Meissner corpuscle, and Pacinian corpuscle. The skin function is for
protection. It covers the tissue / organ underneath, regulates body temperature, touch
receptors, temperature, and pain, sweat excretion, and absorption of ultraviolet light.

Aim

- Understanding the anatomy of the five senses to practice physiotherapy well

Learning Outcome
Students are expected to know:
1. The anatomical structure of ear (internal, middle and external ear, nerves)
2. The anatomical structure of tongue (root, body, taste bud, nerves)
3. The anatomical structure of skin (glands and receptors)
4. The anatomical structure of eye (lens, pupil, cornea, muscles, nerves)
5. The anatomical structure of nose (olfactory and respiratory area, nerves)

Show on manikin on some structural anatomy as the following:

Ear
Outer ear
- Auricula / auricle / pinna
- Auditory canal
Middle ear
- Tympanic membrane
- Maleus
- Incus
- Stapes
- Pharyngotympanic tube
Internal Ear
- Cochlea
- Semicircular canal
- Vestibulocochlear nerve (N.VIII)
Skin
Epidermis
- Stratum corneum
- Stratum Lucidum
- Stratum granulosum
- Stratum spinosum
- Stratum basale / basalis / germinativum
Dermis
Hypodermis
Sweat gland
Sebaceous gland
Meissner corpuscle
Pacinian corpuscle
Eye
- Cornea
- Lens
- Optic nerve
- Superior rectus muscle
- Inferior rectus muscle
- Lateral rectus muscle
- Medial rectus muscle
- Superior oblique muscle
- Inferior oblique muscle
- Optic chiasm
- Pupil

Learning task
1. Mention and explain the receptors in the five senses
2. Describe skin adnexa
3. Explain the lacrimal apparatus
4. Explain the passage of light from the cornea to the occipital lobe
 5. Explain ear anatomy and innervations

PRACTICAL GUIDE FOR SPECIAL SENSE

dr. Yuliana, S.Ked , M.Biomed
In the special sense practice, the emphasis is
on understanding the anatomical structure of the skin, ears, and eyes.

Students are expected to be able to:

Show on manikin some anatomical structure of the following:

Ear
Outer ear
- Auricula / auricle / pinna
- Auditory canal
Middle ear
- Tympanic membrane
- Maleus
- Incus
- Stapes
- Pharyngotympanic tube
Internal Ear
- Cochlea
- Semicircular canal
- Vestibulocochlear nerve (N.VIII)
Skin
Epidermis
- Stratum corneum
- Stratum Lucidum
- Stratum granulosum
- Stratum spinosum
- Stratum basale / basalis / germinativum
Dermis
Hypodermis
Sweat gland
Sebaceous gland
Meissner corpuscle
Pacinian corpuscle
Eye
- Cornea
- Lens
- Optic nerve
- Superior rectus muscle
- Inferior rectus muscle
- Lateral rectus muscle
- Medial rectus muscle
- Superior oblique muscle
- Inferior oblique muscle
- Optic chiasm
- Pupil

LECTURE16-17 MEMBRUM SUPERIUS

Dr.Yuliana , S.Ked , M.Biomed
 Abstract
The upper extremity or arm is a functional unit of the upper body. It consists of three
sections, the upper arm, forearm, and hand. It extends from the shoulder joint to the fingers.
It also consists of many nerves, blood vessels (arteries and veins), and muscles. The nerves
of the arm are supplied by one of the two major nerve plexus of the human body, the
brachial plexus.
Bones form the upper limb are humerus, radius, ulna, scapula, carpal, metacarpal,
and phalanges. The anterior muscles include the subclavius, pectoralis minor, and serratus
anterior. The posterior muscles include the trapezius, rhomboid major, and rhomboid minor.
When the rhomboids are contracted, your scapula moves medially, which can pull the
shoulder and upper limb posteriorly.

Aim:
- To develop an understanding about the anatomy of the upper limb in order
to practise physiotherapy well.

Learning outcome
The student should know :
- The anatomy of the upper limb includes the bones, muscles, and nerves.

The student should be able to :

- Show on the body about anatomy of the upper limb include
the bones, muscles, and nerves.

Learning task
1. Why upper limb is important for the body? Mention 5 reasons
2. Describe all the bones that make up the upper limb
3. Explain all the muscles making up the upper limb
4. Describe the innervation of the upper limb

LECTURE 18-19: LOWER LIMB

dr. Muliani, S. Ked., M. Biomed.

Aims:
- Establish the lower limb skeleton, joint, muscles and nerves for human movement

Learning outcomes:
- Comprehend the macroscopic aspect of lower limb skeleton, joint, muscles and nerves

Curriculum contents:
- Lower limb

Abstracts
Similar to the upper limb, the lower limb skeleton also attach at axial skeleton through
girdle and divided into three regions, that is thigh, leg and foot. The thigh is analog to arm,
leg to forearm and foot to hand. Their bones and joints are also have similar pattern to the
upper limb, such as femur to humery, tibia fibula to radius ulna, shoulder to hip, elbow to
knee joint, wrist to ankle and hand to foot. The lower limb muscles are stronger than upper
limb due to working load of both appendicular skeletons and joints. The type of joint
promotes for lower limb for more stable movement and occur inversion eversion on lower
limb.
All of lower limb skeleton covered by group muscles. On thigh region, there are three
groups of muscles, that is anterior, posterior and medial. Muscles on the leg region also
divided into three groups, which is anterior, posterior and lateral. Each group of muscles has
different function. They innervated by nerves that branched from the lumbosacral plexus.

Learning task
1. Identify the important parts of lower limb bones
2. Identify the muscles in the regions of buttock, femur, leg and pedis
3. Identify the nerves that supply the regions of buttock, femur, leg, pedis
LECTURE 20-21: HEAD AND NECK
dr. Muliani, S. Ked., M. Biomed.

Aims:
- Establish the head and neck skeleton, joint, muscles and nerves for human movement

Learning outcomes:
- Comprehend the macroscopic aspect of head and neck skeleton, joint, muscles and
nerves

Curriculum contents:
- Head and neck

Abstracts:
Skeletal system divided into two parts: axial dan appendicular skeleton. Axial
skeleton is consists of: head, neck and trunk meanwhile appendicular skeleton among
others, form the upper and lower limb, including bones that form pectoral dan pelvic girdle.
Head and neck are important due to occupied by brain, carotid artery, jugular vein
and brachial plexus which branch from C5-Th1 nerves.
Head has a SCALP, that is Skin, Connective Tissue, Aponeurosis, Loose Connective
Tissue and Pericranium. There are two important group muscles of the head, which are
facial muscle and masticator muscle. The two groups came from a different branchial arch
so they also innervated by different cranial nerves. Facial muscle can change expressions of
the face and masticator muscle has a role in mastication.
Neck area divided into anterior and posterior cervical triangles. These two triangles is
separated by sternocleidomastoid musle and transverse by various important structures. The
muscles of the neck are also covered by fascia.

Learning task
Basic knowledge that must be known:
1. Describe the name of bones that construct the head and neck.
2. Identify SCALP, facial and mastication muscles and their function.
3. Identify the nerves that innervate the facial and mastication muscles.
4. Compare the new born-baby and adult cranium
5. Identify the anterior and posterior triangle of the neck including their boundaries.
6. Identify the fascia and muscles of the neck.
 ANATOMY PRACTICAL GUIDANCE MUSCULOSKELETAL SYSTEM

A. BONE

UPPER LIMB IDENTIFY

Specific objectives
1. to describe the bones forming the
upper limb (pectoral girdle)
2. to know the bones of the upper
limb and to bne able to identify
their parts and markings

Pectoral girdle:
 Clavicle
 Scapula Sternal end and scapular end
The borders, sngles, spine, fossae and
processes
Humerus
Head, neck,, greater and lesser
tubercles, deltoid tuberosity, lateral and
medial epicondyles and condyles
(capitulum and trochlea), olecranon,
coronoid and radial fossae.
Radius
Head, neck, tuberosity and styloid
process
Ulna
Olecranon, trochlear notch, coronopid
process, tuberosity, head and styloid
process.
Carpus, metacarpus and digits
All bones and its name

LOWER LIMB IDENTIFY

Specific objectives
1. to describe the bones foming the
lower limb (pelvic girdle)
2. to describe the bones of the lower
limb

Hip bone
The ischium, ilium an pubis and its
borders
Femur
Head, neck, greater and lesser
trochanter, shaft, lateral and medial
 epicondyles and condyles, patellar and
Tibia popliteal surfaces.

Medial and lateral condyles, tibial

tuberosity, anterior, lateralk and posterior
Fibula surfaces on the shaft and medial
maleolus
Tarsal, metatarsal and digits
Head, neck, shaft and laterasl maleolus

All bones and its name

AXIAL SKELETON IDENTIFY

Specific objectives
1. to identify the bones of the skull
2. to identify the major foramina and
fossae
3. to identify the major features of
the vertebral column and the
vertebrae of each region
4. to identify the features of the rib
cage, of the sternum, and of the
individual ribs

The skull
(1) The bone of the brain case (frontal,
ethmoidal, sphenoid, occipital, temporal
and parietal; find the cribriform plate,
optic foramen, superior orbital fissure,
internal auditort meatus and foramen
magnum; (2) the bone of the special
sense capsules which house the visual,
auditory and olfactory organs and (3) the
bones of the masticatory apparatus
(maxilla, mandible, zygoma, temporal
and nasal bones) (4) Foramen magnum,
foramina for internal carotid artery and
internal jugular vein
Typical vertebra
Body, vertebral arch, pedicals, laminae
and processes: spinous, articular and
transverse
Cercical vertebrae 1,2 and 7
Their special features
 B. MUSCLES

MUSCLE OF THE AXIAL SKELETON IDENTIFY

Specific objectives
1. to be able to describe the
characteristic features of the
skeletal, smooth and cardiac
muscles
2. to be able to describe the
attachments of the skeletal
muscles and to deduce the action
of a particular muscle or a group
of muscle at a given point
3. to understand the principles
involved in the action (movement)
of muscles)
4. to be able to locate and name the
main groups of muscles of the
axial skeleton

4 Groups :
1. postvertebral muscles

2. prevertebral muscles of the Superficial layer: erector spinae; deep

posterior abdominal wall
3. anterolateral abdominal wall
4. head and neck muscles
layer: transversospinalis
Psoas major, quadratus lumborum
External and internal oblique, rectus
abdominis and transverses abdominis
Mimic muscles, sternocleidomastoid,
suprahyoid group (example: digastric),
infrahyoid group (example: sternohyoid)

UPPER LIMB AND PECTORAL GIRDLE IDENTIFY

Specific objectives
1. to be able to identify the muscles
of the shoulder joint
2. to be avle to identify and give the
action of the main groups of
muscles of the arm
3. to know the muscles acting on the
elbow joint
4. to know the division of the
forearm muscles into flexor and
extensor groups
Groups :
1. shoulder to vertebral column
2. shoulder to the thoracic wall
Trapezius, Latissimus dorsi
Pectoralis major and minor, Seratus
3. shoulder t scapula
anterior
 Deltoid, supraspinatus, infraspinatus,
Arm teres major and minor, subscapularis

Flexor (biceps brachi, brachialis) and

Elbow joint extensor (triceps)

Flexor (biceps brachi, brachioradialis,

Forearm brachialis); extensor (triceps)

Wrist and digit Supinator, pronator teres and quadratus

Flexor groups (flexor carpi radialis,

palmaris longus, flexor digitorum
superficialis and flexor carpi ulnaris) and
extensor group (extensor carpi radialis
longus and brevis, extensor digitorum,
Hand extensor carpi radialis)

Thenar and hypothenar muscles

LOWER LIMB AND PELVIC GIRDLE IDENTIFY

Specific objectives
1. to know the group of muscles
around the hip joint
2. to be able to identify the flexor,
extensor and adductor groups of
the thigh muscles
3. to be able to identify and to know
the main function of the anterior,
lateral and posterior groups of the
leg muscles
Hip:
 Back of the hip
 In front of the hip Gluteal muscles (gluteus maximus)
 Around the hip Iliopsoas
Short muscle of hip joiny (as a group
Thigh
only)
 Extensor of the thigh (in front of
the thigh)
Sartorius and quadratus femoris (rectus
femoris, Vastus medialis, lateralis and
 Adductor of the thigh (medial side
of the thigh) intermedius)
 Flexor of the thigh (back of the Gracilis, Adductor longus and magnus
thigh)
Leg: Hamstring (Biceps femoris,
 Anterior group Semitendinosus, Semimmbranosus)

 Lateral group Tibialis anterior, Extensor digitorum

 Posterior group longus and Extensor hallucus longus
Peroneus longus and brevis
Gastrocnemeus and Soleus (known as
Triceps surae) and Plantaris