MUSCULOSKELETAL, NERVOUS

AND ENDOCRINE SYSTEM

MULIANI
Depression & Openings: Processes:
• Fissure • Condyle
• Foramen • Facet
• Fossa • Head
• Sulcus • Crest
• Meatus • Epicondyle
• Line
• Spinous process
• Trochanter
• Tubercle
• Tuberocity
 Axial skeleton

Appendicular skeleton

Tampak depan Tampak belakang

 AXIAL
SKELETON
The Axial Skeleton

Figure 7.1b
Cranial and Facial Subdivisions of the Skull

Figure 7.2
The Adult Skull- Anterior View

Figure 7.3d
 The Adult Skull – lateral view

Tympanic region
of temporal bone

Figure 7.3c
Figure 7.12 The Mandible and Hyoid
Bones

Figure 7.12a
The Adult Skull – Posterior and Superior View

Figure 7.3a, b
The Adult Skull-Inferior View

Figure 7.3e
ADULT HUMAN BRAIN

BAGIAN ANATOMI FK UNUD 2010 15

 Brain components

Table 5.3 (1) Cerebral cortex

Cerebral cortex

Page 144 Basal nuclei

(lateral to thalamus)
Basal nuclei

Thalamus
(medial) Thalamus

Diencephalon
Hypothalamus
Hypothalamus
Cerebellum
Cerebellum

Midbrain
(Mesencephalon) Brain stem
Brain stem Pons (midbrain, pons,
and medulla)
Medulla
oblongata
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Spinal cord 16
 Brain stem

• Midbrain
• Pons
• Medulla oblongata
 Internal structures

Gray matter
• Cranial nerve nuclei
• Relay nuclei
 Cranial Nerve names
Identify as many as you can when looking at model and sheep brain
(they will be more fully discussed in Chapter 14)
neuroscience and neurological disorder fk
21
2014
 General somatic motor nuclei

Nucleus Site Cranial n. Function

Nucleus of Midbrain Ⅲ Superior, inferior,and

medial recti, inf. obliquus,
Oculomotor n. levator palpebrae superioris

Nucleus of Midbrain Ⅳ Superior obliquus

trochlear n.
Nucleus of Pons Ⅵ Lateral rectus
abducent n.
Nucleus of Medulla Ⅻ Muscles of tongue
hypoglossal n.
 Special visceral motor nuclei
Nucleus Site Cranial n. Function

Motor nucleus of Pons Ⅴ Masticatory muscles

trigeminal n.
Nucleus of facial n. Pons Ⅶ Facial m., platysma,
posterior belly of digastric,
stylohyoid, stapedius

Nucleus ambiguus Medulla Ⅸ,Ⅹ.Ⅺ Skeletal m. of pharynx,

larynx and upper part of
esophagus
Accessory nucleus Medulla- Ⅺ Sternocleidomastoid,
cervical cord trapezius
 General visceral motor nuclei
Nucleus Site Cranial n. Function

Accessory Midbrain Ⅲ Sphincter pupillae and

oculomotor nucleus ciliary m.

Superior salivatory Pons Ⅶ Submandibular,

nucleus sublingual and lacrimal
glands
Inferior salivatory Medulla Ⅸ Parotid gland
nucleus

Dorsal nucleus of medulla Ⅹ Many cervical,

vagus n. thoracic and abdominal
viscera
Visceral sensory nuclei ( general and special )

Nucleus Site Cranial n. Function

Nucleus of Medulla Ⅶ,Ⅸ,Ⅹ Taste and visceral

solitary tract sensation
 General somatic sensory nuclei
Nucleus Site Cranial n. Function
Mesencephalic Midbrain Ⅴ Proprioception
nucleus of of head
trigeminal n.
Pontine nucleus Pons Ⅴ Tactile sensation
of trigeminal n. of head

Spinal nucleus of Medulla Ⅴ Pain and

trigeminal n. temperature
sense of head
 Special somatic sensory nuclei

Nucleus Site Cranial n. Function

Cochlear Pons and Ⅷ Sense of hearing

nuclei medulla

Vestibular Pons and Ⅷ Sense of

nuclei medulla equilibrium
 THEIR ROUTE
• 1. Olfactory-n cribriform plate of the ethmoidal bone.
• 2. Optic-n optic foramen/canal.
• 3. Ocular motor, trochlear and abducens
 superior orbital fissure. (And ophthalmic-n.)
• 4. Trigeminal-n
Ophthalmic-nsuperior orbital fissure; Maxillary-n
rotundum foramen;
Madibular-n oval foramen.
• 5. Vestibular-cochlear-n internal acustic meatus
a. n.VIII-vestsuperior, inferior vestibular
area and singular foramen.

28
• 5.b. Cochlear –ncanal in the foramen
of spiral tracts.

• 6. Glossopharyngeal nervejugular
foramen.
• 7. Vagal nerve jugular foramen.

• 8. Accessory nervejugular foramen.

• 9. Hypogllossal nervehypoglossal canal.

29
30
 White matter
Ascending tracts
• Medial lemniscus
• Spinal lemniscus
• Trigeminal lemniscus
• Lateral lemniscus
• Spinothalamic tract
• Spinocerebellar tracts.
 Descending tracts
• Corticospinal tract
• Rubrospinal tract
• Tectospinal tract
• Vestibulospinal
• Reticulospinal tract
 BRAINSTEM
• Very important due to:
1. Center of cardiovascular and respiratory
system, primary conciousness.
2. Ascending and descending tracts.
3. Places the most nuclei of cranial nerves.

34
 Reticular formation of brain stem
• Ascending reticular
activating system (ARAS)
• Motor central and vital
centres
– Reticulospinal tract
– Cardiovascular center
and respiratory center
• Serotonergic rapheal
nuclei
MULTISYNAPTIC RETICULAR ASCENDING
TRACTS

36
 Cerebellum
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Longitudinal
fissure

Corpus callosum
Thalamus

Superior peduncle

Cerebellum
Pons

Middle peduncle

Inferior peduncle

Medulla oblongata

37
CEREBELLUM

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 Cerebellum
Primary fissure

Anterior Lobe

Regulation of
muscle tone,
coordination of
skilled voluntary
movement Posterior
Lobe

Planning and
initiation of Flocculo-Nodular
voluntary activity
Lobe (FN lobe)

Maintenance of
Vestibulocerebellum
balance, control
of eye movements Spinocerebellum
Folia Cerebrocerebelum
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 ENCEPHALON/BRAIN
• Otak: hemispherium cerebri (2) sinister et dexter
dan 1 cerebellum.
• Hemispherium: belajar, berpikir, asosiasi,
mengingat bagian superficial—subst.
gricea=cortex; bagian profundus subst alba, ada
sebagian nuclei-thalamus dll.
• Cerebellum berfungsi  koordinasi gerakan-
gerakan tubuh kita, termasuk mengatur gerakan-
gerakan yang rumit.
 BERAT OTAK
• HS-HOMO SAPIENS: 1100-1550 GRAM.
• RELATIF PALING BESAR-PEMBANDING BERAT
BADAN.
• MACACA; 100 GR ……..BB: 10 KG.
• ELEPHANT: 6000 GR……..BB: 7000 KG.
• HS : 1300 GR……..BB: 60 KG.
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Projection fibers: connect
cortex with lower part of brain
and spinal cord and they
include both ascending and
descending fibers
Internal capsule
• Position: a thick lamina of
white matter lying between
caudate nucleus, thalamus
and lentiform nucleus

BAGIAN ANATOMI FK UNUD 2010 53

 CAPSULA INTERNA
• Merupakan subst. alba yang dibatasi oleh:
-Nucleus caudatus.
-Thalamus.
-Nucleus lentiformis.
• Dilewati oleh: serat-serat saraf yg menuju:
-MS (medulla spinalis)tr. Cortico-spinalis
-Batang otaktr. Cortico-bulbaris/ cortico-
nuclearis.
 INGATAN DAN BELAJAR
• Ingatan ada 2: baru dan lama.

• Ingatan jangka panjang: ada perubahan

biomolekuler pada neuron.

• Proses belajar terutama hal yang rumit dan

lebih tinggi: bukan hanya cortex tapi juga:
emosi dan batang otak.
 THALAMUS
• Kumpulan dari sel neuronterbagi nuclei.
• Merupakan integrasi sensorik utama ssp.
• Memegang peran yang dominan dlm mem
pertahankan dan pengaturan kesadaran
dan kewaspadaan.
• Menyangkut aspek emosi.
• Integrasi fungsi motorik: menerima eferen
dari: cerebellum dan corpus striatum.
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 Thalamic Function
• Afferent impulses from all senses converge
and synapse in the thalamus
• Impulses of similar function are sorted out,
edited, and relayed as a group
• All inputs ascending to the cerebral cortex
pass through the thalamus
• Plays a key role in mediating sensation, motor
activities, cortical arousal, learning, and
memory
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 Hypotyhalamus
• Merupakan bagian diencephalon-
berhubungan eret dengan hypophyse.
• Berat kira-kira 4 gram.
• Pengaturan dan pengendalian kegiatan pusat
saraf otonom di batang otak & MS.
• Salah satu pusat utama ekspresi emosi.
• Mengadakan korelasi impulse-2 visceral dan
olfactorik, integrasi pusat lapar dan haus.
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Endocrine System

67
 Endocrine System

• Major control system

– Works with the nervous system
– Function:
• to maintain homeostasis
• Both use
– specific communication
methods
– affect specific target organs
• Their methods and effects
differ.
 Endocrine Glands & Hormones

• Exocrine glands: ducted

– secretions released into
ducts
– open onto an epithelial
surface
• Endocrine glands: ductless
– secrete product directly into
the bloodstream
• All endocrine cells are
located within highly
vascularized areas
– ensure that their products
enter the bloodstream
immediately.
Major Endocrine Glands
Hypothalamic Control of the Endocrine
System

• Master control center of the endocrine

system
• Hypothalamus oversees most endocrine
activity:
– special cells in the hypothalamus secrete
hormones that influence the secretory activity of
the anterior pituitary gland
• called regulatory hormones
– releasing hormones (RH)
– inhibiting hormones (IH)
• Hypothalamus has indirect control over
these endocrine organs.
Hypothalamic Control of the Endocrine
System

• Hypothalamus produces two hormones that are

transported to and stored in the posterior pituitary.
– oxytocin
– antidiuretic hormone (ADH)
• Hypothalamus directly oversees the stimulation and
hormone secretion of the adrenal medulla.
– An endocrine structure that secretes its hormones in
response to stimulation by the sympathetic nervous system.
• Some endocrine cells are not under direct control of
hypothalamus.
Hypothalamic Hormones
 Pituitary Gland

 Size of a grape
 Hangs by a stalk from the hypothalamus
 Protected by the sphenoid bone
 Has two functional lobes
 Anterior pituitary – glandular tissue
 Posterior pituitary – nervous tissue
 Hormones of the Anterior Pituitary

 Six anterior pituitary hormones

 Two affect non-endocrine targets
 Four stimulate other endocrine glands
(tropic hormones)
Hormones of the Anterior Pituitary
 Control of Anterior Pituitary Gland
Secretions

• Anterior pituitary gland is controlled by

regulatory hormones secreted by the
hypothalamus.
• Hormones reach the anterior pituitary via
hypothalamo- hypophyseal portal system.
– takes venous blood carrying regulatory
hormones from the hypothalamus directly to
the anterior pituitary
LIMBIC SYSTEM

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part of the human brain involved in

•emotion
•motivation
•memory
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includes the cerebral cortex and sub-cortex

• AMYGDALA: motivation: rewards and fear

• HIPPOCAMPUS: longterm memories
• PARAHIPPOCAMPUS GYRUS: spatial memory
• CINGULATE GYRUS: autonomic functions
(heart rate, blood pressure), cognitive and
attentional processing
• HYPOTHALAMUS:hunger, thirst, sexual
arousal, and the sleep/wake cycle

BAGIAN ANATOMI FK UNUD 2010 83

includes the cerebral cortex and sub-cortex

• MAMMILARY BODY: Important for the formation of

memory
• NUCLEUS ACCUMBENS: Involved in reward, pleasure,
and addiction
• ORBITO FRONTAL CORTEX: Required for decision
making
• THALAMUS: The "relay station" to the cerebral cortex
• OLFACTORY BULB: Olfactory sensory input

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 Function
• operates by influencing the endocrine system and
the autonomic nervous system (modulated by
dopaminergic)
• highly interconnected with the nucleus accumbens,
the brain's pleasure center, which plays a role in
sexual arousal and the "high" derived from certain
recreational drugs.
• also tightly connected to the prefrontal cortex:
related to the pleasure obtained from solving
problems
• maintenance of a healthy conscious state of mind

BAGIAN ANATOMI FK UNUD 2010 89

• Corpus striatum
Basal nuclei
Globus pallidus －paleostriatum

– Lentiform nucleus putamen Neostriatum

– Caudate nucleus
Claustrum
– Amygdaloid body

90
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 SUSUNAN JALUR SARAF PENGLIHATAN:

• Susunan saraf penglihatan ada 2 jalur:

1.Jalur penglihatan sadar.
2.Jalur reflex berhubungan penglihatan.

• RETINA: merupakan receptor cahaya:

a.pars pigmentosa-epithelium berpigmen.
b.pars nervosa: Rods and Cones;
Sel neuron bipolar.
Sel2 ganglion.
96
GAMBAR 84:

97
GAMBAR 86 atau 13-9 HNA:

98
Reflex Pupil
Reflex Accomodation
101
 SISTEM SARAF PEMBAU:
• Bulbus olfactoriusRhinencephalon.
• Rhinencephalon meliputi:
• *Bulbus olfactorius.
• *Tractus olfactorius.
• *Striae olfactoriae.
• *Substantia perforata anterior.
• *Bag2 dari corpus amygdaloideum.
• *Bag2 dari cortex prepiriformis.

102
 Mekanisme Penghantaran Impuls:
• Epithelium olfactorium (“sel2 olfactus”)
Axon sel olfactus inifila olfactoria la-
mina cribrosa ossis ethmoidalis cavitas
craniisel2 mitral dalam bulbus olfactorius
axon2 sel mitraltractus olfactorius.
• Dendrit sel mitral dengan axon sel2 olfactus
membentuk “glomerulus”.
• Axon sel mitralcab collat.yg bersynaps dgn sel
granularcircuit (sehingga bau busuk bisa
tercium sampai 3 hari). 103
Gambar 90 A dan B:

104
AUDITORY PATHWAYS
& HEARING

Anthony J Greene 105

 Cochlea

Auditory Nerve

Cochlear Nucleus Medial

Geniculate
Nucleus
Auditory
Superior Olive Inferior Cortex

Colliculus Inferior
Colliculus
Cochlear Nucleus Superior
Left Auditory Olive
Medial Geniculate Nerve
Right Auditory Nerve
Nucleus

Primary Auditory - A1 (41) Auditory

Pathways
Secondary Auditory - A2 (42) 106
108
Sensory
Input

109
The Hyoid Bone
 The only bone that
does not articulate
with another bone
 Serves as a moveable
base for the tongue
 Supports the larynx
 Attaches muscles of
the larynx, pharynx,
and tongue

Figure 5.12
Department of Anatomy, Medical Faculty
Udayana University Slide111
5.26
The Vertebral Column
 VERTEBRAE :

 Each typical vertebra consist of:

 Body
 Arch
 Spinous proc.
 Transverse proc.
 Articular proc. (Superior and inferior).
 Vertebral foramen
Vertebral Anatomy

Figure 7.18
 Parts of avertebra
Corpus (1)
Pedicle (4)
Lamina (6)
Arcus vertebralis
Foramen vertebralis (5)
Facies articularis (7)
Processus transversus (3)
Processus spinosus (2)

The lesser load the smaller in size

Department of Anatomy, Medical Faculty

116
Udayana University
 Sacrum

• Protects reproductive, digestive and

urinary organs
• Articulates with pelvic girdle and fused
elements of coccyx
Figure 7.22 The Sacrum and Coccyx

Figure 7.22
 MEDULLA SPINALIS / SPINAL CORD
• DIBAGI MENJADI SEGMEN: CERVICALIS,
THORACALIS, LUMBALIS, SACRALIS DAN
COCCYGEUS: 31 SEGMEN.
• Dibungkus/diliputi meningen: Duramater,
arachnoidea, dan piamater. Antara
arachnoidea dan piamater ada celah: spatium
subarachnoidalis-doaliri oleh liquor
cerebrospinalis.
• Piamater menempel pada permukaan MS.
• Ujung distalnya: berbentuk kerucut: conus
medullaris. Distal dari conus ini hanya ada
serat2 saraf: cauda equina.
• Lumbal punksi: penusukan dengan jarum
lumbal: L3-4mengambil contoh
liquorpemeriksaan lab. Dari LCS/CSF.
• Cervicalis: 8; Thoracal: 12; Lumbal 5; sacral 5;
Coccygeus: (rata-rata) 1.
• Superficial: substantia alba-serat-serat saraf-
tractus; profundus: substantia gricea-nuclei.
• Tractus: pada subst. alba: ascendens ,
descendens dan proprius/ intersegmentalis.
• Subst. gricea: cornu dorsalis, ventralis dan
intermedius (intermediolaterale-
symphaticus; intermedio-mediale-
parasymphaticus).
• Cornu dorsalis: sensoris; cornu ventralis
motoris; intermediusotonom.
 TRACTUS ASCENDENS
• Tr. Spinothalamicus lateralis:
berasal dr MSthalamus
• Membawa impulse rasa nyeri dan suhu dari
kulit; kontralateral; dari kulit sisi kanan dibawa
tractus sinister/kiri.
• Tr. Gracilis dan cuneatus: membawa impulse
rasa raba spesifik/halus dan proprioceptif
pada sisi yang sama/ homolateral medulla
oblongata.
 TRACTUS DESCENDENS
• Tr. Cortico-spinalis: berasal dari cortex
cerebri MS/ medulla spinalis.
• Menyilang garis tengah 70-90 % di medulla
oblongata; 10-30% terus ke inferior.
• Yang menyilang tr. C-s lateralis.
• Yang tidak menyilang tr.C-s ventralis.
• Stroke mengenai capsula interna kiri
kelumpuhan yang kanan.
 Tractus proprius.
• Jamaknya tractus proprii.
• Disebut juga tractur intersegmentalis.
• Antara segment-segment di MS.
• Memungkinkan untuk terjadinya reflex-reflex
intersegmental.
 Vascularisasi MS
• Darah bersumber dari sepasang arteri:
1. A. vertebralis sinister.
2. A. vertebralis dexter.membentuk arteri
spinalis ventralis dan dorsalis.
* Dibantu oleh: a. radicularis magna dan parva
merupakan cabang dari: rami dorsalis arteri
intercostalis posterior.
 LIQUOR CEREBROSPINALIS
• Cerebrospinal fluid.
• Sebagai pengganti lymphatic system.
• Diproduksi di: plexus choroideus yang
terdapat pada: dasar ventricle lateralis, atap
ventricle III, atap dari ventricle IV.
• Dari system ventricle otakfor. Lushcka (2)
dan Magendie (1) spatium
subarachnoidalisekresi ke sistem sinus
duramateris melalui villi (villus arachnoidalis)
• Jumlah rata-rata liquor: 135 ml, terbentuk
dalam 24 jam: 550 ml; praktis setiap 6 jam
liquor diperbarui.
• Warna: jernih tidak berwarna.
• Tekanan: kurang dari 18 cm liquor/air.
• Peredarannya: ventricle latfor.
InterventriculareVentricle IIIaquaductus
mesencephaliVentricle IVfor. Lushcka dan
Magendie spatium
subarachnoidalisVilli sistem sinus
duramateris.
 HYDROCEPHALUS
• Menumpuknya liquor: interna-ventricle; dan
externa-subaracnoidalis.
• Bisa congenital dan didapat/acquired.
• Bayi: Kepala/cranium membesar.
• Pada orang dewasa: kepala tak membesar,
tapi otaknya cepat atrophy.
 VASCULARISASI SSP
• BERASAL DARI 2 PASANG ARTERI:
1. A. carotis interna.
2. A. vertebralis.
 membentuk ciculus arteriosus di dasar
otak menjaga kontinyuitas pemberian
darah: oxygen dan nutrisi.
• Diberikan sejak dini pembentukan susunan
saraf.
• Asas Monro-Kellie: massa tetap yi: otak, darah
dan liquor cerebrospinalis.
 STROKE
• Ganggual awal adalah pada endothel dari
pembuluh darah.
• Faktor: multifaktorial.
• Ada 4 macam: Hemorrhagic, Thrombus,
Emboli dan TIA (Transient Ischemic attack).
• Bersama serangan jantung  pembunuh No:1
setelah kecelakaan lalin di Indonesia
 Thoracic cage

• Thoracic vertebrae
• Ribs
• Sternum

– Ribs and sternum forms the rib cage

Department of Anatomy, Medical
155
Faculty Udayana University
 The Thoracic Cage

Figure 7–24c The Ribs.

Copyright © 2009 Pearson
Education, Inc., publishing as
Pearson Benjamin Cummings
 The Thoracic Cage
• Ribs (costae)
– Are 12 pairs of long, curved, flat bones
– Extending from the thoracic vertebrae
– Ribs are divided into three types
• True ribs
• False ribs
• Floating ribs

Copyright © 2009 Pearson

Education, Inc., publishing as
Pearson Benjamin Cummings
 The Thoracic Cage

Figure 7–23 The Thoracic Cage.

Copyright © 2009 Pearson
Education, Inc., publishing as
Pearson Benjamin Cummings
 The Thoracic Cage

Figure 7–24a The Ribs.

Copyright © 2009 Pearson
Education, Inc., publishing as
Pearson Benjamin Cummings
 The Thoracic Cage
• The sternum
– A flat bone
– In the midline of the thoracic wall
– Three parts of the sternum
• The manubrium
• The sternal body
• The xiphoid process

Copyright © 2009 Pearson

Education, Inc., publishing as
Pearson Benjamin Cummings
Department of Anatomy, Medical
163
Faculty Udayana University
 KEY CONCEPT
• The axial skeleton:
– protects the brain, spinal cord, and visceral organs
of the chest
• Vertebrae:
– conduct body weight to the lower limbs
• Lower vertebrae are larger and stronger:
– because they bear more weight
The Appendicular Skeleton
 THE SKELETAL SYSTEM
The Appendicular Skeleton
• 2 pairs of limbs and 2 girdles
• Pectoral (shoulder) girdle attaches
upper limbs
• Pelvic (hip) girdle secures lower
limbs
• 3-Segmented limbs
– Upper = arm
• Arm
• Forearm
• Hand
– Lower = leg
• Thigh
• Leg
• Foot
UPPER LIMB
 Upper extremity
• Arm or Brachium =
upper arm
– Between shoulder and
elbow (humerus)
• Forearm or
Antebrachium
– Radius & ulna
• Hand includes:
– Wrist (carpus)
– Palm (metacarpus)
– Fingers (phalanges)
Right humerus,
posterior view
Right forearm bones, anterior
view
Right forearm bones, posterior
view
 Hand
• Proximal is “wrist” – 8 carpal bones
• Palm of hand - 5 metacarpals
• Fingers (or digits) consist of miniature long bones called
phalanges: thumb (“pollex”) has 2; fingers have 3: proximal,
middle, distal
Right hand, 2 views:
 Lower limb

• Thigh: femur

• Leg (lower
leg)
– Tibia
– Fibula

• Foot
 Ischium

• Body
• Ramus
• Ischial spine ischium
• Ischial
tuberosity
• Part of socket

ischium
Hip bones with labels
 False (greater) and
true (lesser) pelvis
Ligaments
 Pelvis and childbearing

• Male/female differences
– Large & heavy vs light & delicate
– Heart shaped pelvic inlet vs oval
– Narrow deep true pelvis vs wide & shallow
– Narrow outlet vs wide
– Less than 90 degree pubic arch vs more than 90 degree
• Birth canal changes shape as baby descends: head turns ¼
– Higher: pelvic inlet (brim) - side to side largest
– Lower: pelvic outlet - largest in AP direction
 Thigh

• Femur is largest, longest

and strongest bone in the
body
• Head fits in socket
(acetabulum) of pelvis
• Neck is weakest
• Greater trochanter
• Distal: lateral & medial
condyles and epicondyles
• Patella: sesamoid bone
Coxa valga

Coxa vara
 Right lower
leg, anterior
view
Right foot, superior (dorsal) view and inferior (plantar) view
Right foot, lateral
and medial views
Arches
SENDI DIKLASIFIKASIKAN MENJADI:

1. SYNARTHROSIS:
o FIBROUS JOINTS:
♦ SUTURA.
♦ SYNDESMOSIS.
♦ GOMPHOSIS.

o CARTILAGINOUS JOINTS:
♦ SYNCHONDROSIS.
AMPIARTHROSIS.
2. DIARTHROSIS:
o MONOAXIAL:
♦ HINGE JOINT.
♦ PIVOT JOINT.
♦ PLANE JOINT.
o BIAXIAL:
♦ CONDYLOID JOINT.
♦ SADDLE JOINT.
o TRIAXIAL:
BALL & SOCKET JOINT
(SPHAEROIDEUS JOINT).
 FAKTOR / STRUKTUR YG
MEMBATASI PERGERAKAN
DIARTHROSIS :
1. KETEGANGAN OTOT.
2. KETEGANGAN LIGAMENTUM.
3. APOSITIO LEMAK.
4. LOCKING OF THE BONE.
 VASCULARISASI & INERVASI SENDI
o AA. ARTICULARIS DARI
PEMBULUH DARAH DI SEKITAR
SENDI.
o TERLETAK DALAM CAPSULA
ARTICULARIS.
o DILAYANI OLEH NN.
ARTICULARIS.
o HK. HILTON :
SARAF YG MELAYANI SENDI JG
MELAYANI OTOT-OTOT YANG
MENGGERAKAN SENDI ATAU
KULIT YANG MENUTUPINYA.
 Muscle Tissues
Characteristics
• Excitability – ability to receive and respond to
stimuli

• Contractility – ability to shorten and thicken

• Extensibility – ability to stretch

• Elasticity – ability to return to the original

shape 206
• Muscles are responsible for all movement
of the body
• PEMBAGIAN OTOT:
1. OTOT SOMATIK.
 OTOT SKELET.
 OTOT ORBITAL.
 OTOT HYPOBRANCHIAL.
 OTOT BRANCHIAL.
2. OTOT VISCERAL.
 Info About Muscles

• Only body tissue able

to contract
• create movement by
flexing and extending
joints
• Body energy
converters (many
muscle cells contain
many mitochondria)
Types of Muscles
 Three types of muscle

Skeletal Cardiac Smooth

 Muscle Tissues

Skeletal Muscle Smooth Muscle

Cardiac Muscle
 Characteristics of Muscle
• Skeletal and smooth muscle are elongated
• Muscle cell = muscle fiber
• Contraction of a muscle is due to
movement of microfilaments (protein
fibers)
• All muscles share some terminology
– Prefixes myo and mys refer to muscle
– Prefix sarco refers to flesh
The Skeletal Muscles

There are about 650 muscles in the

human body. They enable us to
move, maintain posture and
generate heat. In this section we will
only study a sample of the major
muscles.
 Skeletal Muscle
• Human body contains over 400 skeletal
muscles
– 40-50% of total body weight
• Functions of skeletal muscle
– Force production for locomotion and breathing
– Force production for postural support
– Heat production during cold stress
 Structure of Skeletal Muscle:
Connective Tissue Covering
• Epimysium
– Surrounds entire muscle
• Perimysium
– Surrounds bundles of muscle fibers
• Fascicles
• Endomysium
– Surrounds individual muscle fibers
• Aponeurosis –
the tendon that extends as a broad, flat layer.
• Fascia – sheet or broad band of fibrous
connective tissue
superficial – under the skin
deep – holds the muscles together thus forming
functional groups
 KOMPONEN OTOT SKELET

a) Muscle belly

d) myofibril c) muscle fibre b) muscle fibre bundle

 PERLEKATAN OTOT PADA TULANG:
o ORIGO: PUNCTUM FIXUM.
o INSERTIO: PUNCTUM MOBILE.
o Muscles are always attached to at
least 2 points.
Movement is attained due to a muscle
moving an attached bone
 Muscle Attachments

Insertion

Origin
 VASCULARISASI & INERVASI :
o SERAT SARAF SENSORIK &
MOTORIK.
o HK. ALL OR NONE: KEKUATAN
KONTRAKSI OTOT TGT PD
BYKNYA SATUAN OTOT YG
BERKONTRAKSI / BEKERJA.
o PBLH DRH (-) PADA:
APONEUROSIS, TENDINES
KECIL-KECIL & CHORDA
TENDINEA.
 PERTUMBUHAN & REGENERASI
OTOT:
o JMLH SERAT OTOT TDK BERUBAH.
o PEMBESARAN OTOT TERUTAMA
PD SARCOPLASMANYA.
o JK RUSAK → DIGANTI JAR. IKAT
PARUT.
 BAGIAN-BAGIAN OTOT:
o OTOT.
o TENDON / APONEUROSIS.
  PEMBERIAN NAMA OTOT
BERDASARKAN:
1. LOKALISASINYA: M. BRACHIALIS.
2. ARAH SERAT: M. RECTUS ABDOMINIS.
3. FUNGSI: MM.FLEXORES, MM.EXTENSORES.
4. BENTUK: M. DELTOIDEUS, M. TRAPEZIUS.
5. KOMPONEN: M. BICEPS BRACHII.
6. ORIGO & INSERTIO:
M. STERNOCLEIDOMASTOIDEUS.
 FAKTOR-FAKTOR YANG
MEMPENGARUHI KONTRAKSI OTOT:
1. KEMAMPUAN MEMENDEK OTOT
(LIFTING HEIGHT).
2. KEKUATAN KONTRAKSI OTOT
(LIFTING FORCE).
3. GARIS TARIK OTOT.
4. STRUKTUR PEMBANTU OTOT.
5. KOORDINASI OTOT.
 Antagonistic Muscle Action
• Muscles are either contracted or relaxed
• When contracted the muscle exerts a
pulling force, causing it to shorten
• Since muscles can only pull (not push), they
work in pairs called antagonistic muscles
• The muscle that bends the joint is called
the flexor muscle
• The muscle that straightens the joint is
called the extensor muscle
 Elbow Joint
• The best known example of antagonistic
muscles are the bicep & triceps muscles
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Fe
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SCALP 1. Skin
2. Close sub cutaneous
tissue
• Superficial (fatty,
avascular)
• Deeper
(membranous,
vascular)
3. Aponeurosis (galea
aponeurotica)
4. Loose subaponeurotic
tissue (vv emissariae/
dangerous area)
5. Pericranium
Levator palpebrae
Muscles of Facial Expression
Orbicularis oris
Buccinator
Zygomaticus – major / minor
Levator anguli oris
Risorius
Levator labii superioris
Depressor anguli oris
Depressor labii inferioris
mentalis
1.Platysma
2.M. risorius
3.M. levator anguli oris
4.M. zytomaticus (major et minor)
5.M. levator labii superioris
6.M. angularis
7.M. buccimator
8.M. robicularis oris
9.M. mentalis
10.M. depressor labii inferioris
11.M. depressor anguli oris
Muscles of Mastication
Temporalis
Masseter
Pterygoids – lateral/medial
Sternocleidomastoideus
Flexes and Rotates Head
Masseter
Elevate Mandible
 Temporalis
Elevate & Retract Mandible
 Trapezius
Extend Head, Adduct, Elevate or
Depress Scapula
 Latissimus Dorsi
Extend, Adduct & Rotate Arm Medially
 Deltoid
Abduct, Flex & Extend Arm
 Pectoralis Major
Flexes, adducts & rotates arm medially
Biceps Brachii
Flexes Elbow Joint
Triceps Brachii
Extend Elbow Joint
Rectus Abdominus
Flexes Abdomen
External Oblique
Compress Abdomen
External Intercostals
Elevate ribs
Internal Intercostals
Depress ribs
Diaphragm
Inspiration
 Forearm Muscles
• Flexor carpi—Flexes wrist
• Extensor carpi—Extends wrist
• Flexor digitorum—Flexes fingers
• Extensor digitorum—Extends fingers
• Pronator—Pronates
• Supinator—Supinates
 Gluteus Maximus
Extends & Rotates
Thigh Laterally
 Rectus Femoris
Flexes Thigh,
Extends Lower Leg
 Gracilis
Adducts and Flexes Thigh
 Sartorius
Flexes Thigh, &
Rotates Thigh
Laterally
 Biceps Femoris
Extends Thigh &
Flexes Lower Leg
 Gastrocnemius
Plantar Flexes Foot &
Flex Lower Leg
Tibialis Anterior
Dorsiflexes and Inverts Foot
 REFLEKS/REFLEX
• Adalah reaksi yang berulang-ulang, tetap yang
diakibatkan oleh rangsangan/ stimulus tanpa
melibatkan fungsi saraf yang lebih tinggi.
• Sebagian besar kegiatan/aktivitas kita sehari-
hari berlangsung secara reflex: berjalan,
berbicara, menelan mengedipkan kelopak
mata, dll.
 PEMBAGIAN REFLEX
• 1. Reflex regang/stretch reflex: reflex lutut.
• 2. Reflex superficial: reflex kulit.
• 3. Reflex khusus: reflex mencucu.
• 4. Reflex patologik: Reflex Babinski- Reflex
yang muncul bila ada kelainan
patologik/kerusakan neurologik/saraf pusat.
 Plexus Brachialis:
• Dibentuk oleh rami ventrales C5678
Th 1 Nervi Segmentales.
Dari 5 rami 3 Trunk 6 Division 3
Fasciculi 5 Nervous perifer.
• Pelajari dengan seksama plexus ini pada p.
440/Table 7.4. Essential Clinical Anatomy,
Second Edition.
 Plexus Lumbosacralis:
• Plexus lumbalis/Lumbar plexus: nervous yang
paling besar plexus ini: N. femoralis (L234).
Terminal branch saphenous nerve.

• Cabang-cabang Lumbar Plexus: page 194 ,

342—349, ECA.