SKELETAL SYSTEM 1...== cylindrical, large space or canal at the cylindrical, large space or canal at...
Transcript of SKELETAL SYSTEM 1...== cylindrical, large space or canal at the cylindrical, large space or canal at...
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SISTEM SISTEM SKELETAL SKELETAL TULANGTULANG & & SENDISENDI
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Functions of the Bones
1. Support (penyokong)
2. Protection (pelindung)
3. Movement (gerakan)
4. Storage (deposit)
5. Hematopoiesis
2 Jenis Tulang
Tulang keras (Compacta)
Tulang berongga (Spongy )
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KLASIFIKASI TULANG
•• Menurut strukturnya:Menurut strukturnya:
1. compact = masa solid; padat & keras
= membentuk lapisan luar struktur tulang
= unit fungsionil --- Sistem Havers
2. cancellous or spongy = berongga
pada tulang bersumsum
= incomplete Sistem Havers
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CLASSIFICATION of BONES
•• Menurut BentukMenurut Bentuk
1.1. Tulang panjang Tulang panjang = = ukuran panjang lebih besar ukuran panjang lebih besar dibanding lebarnyadibanding lebarnya
= = Terdiri Terdiri ((diaphysisdiaphysis) & (epiphysis)) & (epiphysis)
diaphysisdiaphysis = = terisi sumsum kuningterisi sumsum kuning
= = cylindrical, large space or canal at the cylindrical, large space or canal at the centercenter
= = periosteumperiosteum
epiphysis epiphysis = = dibangun oleh jaringan dibangun oleh jaringan cancellouscancellous
e.g.: femur, e.g.: femur, humerushumerus, tibia, fibula, radius, ulna, phalanges, tibia, fibula, radius, ulna, phalanges
MembranesMembranes: : 1. 1. periosteumperiosteum
2. 2. endosteumendosteum
cont’n.
•• Menurut BentuknyaMenurut Bentuknya
2. 2. Tulang pendek Tulang pendek = = bentuk kuboidbentuk kuboid
= = tulang tulang spongy spongy dengan sedikit lapisan tulang dengan sedikit lapisan tulang
keraskeras
= = tulang tulang sesamoidsesamoid ---- tulangnya pendek melekat di tulangnya pendek melekat di
tendotendo e.g.: patellae.g.: patella
e.g.: carpals (wrist), tarsal (ankle) bonese.g.: carpals (wrist), tarsal (ankle) bones
3. 3. Tulang pipih Tulang pipih = = lebarlebar or or pipih panjangpipih panjang
= = proteksi proteksi & & perlekatan ototperlekatan otot
Komposisi Komposisi : 2 : 2 lapisan tipis tulang keras membungkus lapisan tipis tulang keras membungkus
tulang tulang spongyspongy
e.g.: bones of the skull, sternum, ribs, scapulae.g.: bones of the skull, sternum, ribs, scapula
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cont’n.
•• Menurut bentukMenurut bentuk
4. 4. TulangTulangIrregular Irregular = = Yang tidak termasuk 3 Yang tidak termasuk 3
klasifikasi tulang sebelumnyaklasifikasi tulang sebelumnya
e.g.: e.g.: vertebraevertebrae
pelvic bones pelvic bones
bones of the base of the skullbones of the base of the skull
KLASIFIKASI TULANG cont’n.
•• Menurut perkembangannya:Menurut perkembangannya:
1. MembraMembraosaosa = = seperti membran seperti membran fibrofibrosasa,,
calcium gradually deposited until structure calcium gradually deposited until structure
becomes ossified becomes ossified �� intramembranousintramembranous ossificationossification
e.g.: bones of the skull, mandiblee.g.: bones of the skull, mandible
2. 2. CartilagenoCartilagenosasa = starts as cartilage, gradually ossified= starts as cartilage, gradually ossified
enchondralenchondral or or intracartilagenousintracartilagenous ossification.ossification.
e.g.: long bonese.g.: long bones
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CLASSIFICATION of BONES cont’n.
•• Menurut Lokasinya: Menurut Lokasinya:
A X I A LA X I A Lskullskull 2222
hyoidhyoid 11
ossiclesossicles 66
vertebraevertebrae 2626
ribs & sternum ribs & sternum 25_25_
8080
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cont’n.
•• Menurut lokasinya :Menurut lokasinya :
APPENDICULARAPPENDICULARUpper ExtremitiesUpper Extremities Lower ExtremitiesLower Extremities
clavicleclavicle 22 hip bonehip bone 22
scapulaescapulae 22 femurfemur 22
humerushumerus 22 patellapatella 22
radiusradius 22 tibiatibia 22
ulnaulna 22 fibulafibula 22
carpalscarpals 1616 tarsalstarsals 1414
metacarpals 10metacarpals 10 metatarsals metatarsals 1010
phalanges phalanges 28__28__ phalanges phalanges 28__28__
6464 6262
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Fig. 6.10
Table. 6.1
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Table. 6.2
KERANGKA AKSIAL
I.I. TENGKORAKTENGKORAK
= skeleton = skeleton ------ kepalakepala & & wajahwajah
= = pipihpipih & irregular& irregular
= = gabungan berbagai sendigabungan berbagai sendi by joints (sutures)by joints (sutures)
cranium cranium ---- tengkorak non mandibularetengkorak non mandibulare
calvariumcalvarium ---- tengkorak termasuk tulang wajahtengkorak termasuk tulang wajah
cavities:cavities: a. Cranial a. Cranial -- berisi otakberisi otak
b. Orbital b. Orbital -- berisi bola mataberisi bola mata
& organ& organ asesorisasesoris
c. nasalc. nasal
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Fig. 6.11
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Fig. 6.14
Fig. 6.15
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PEMBAGIAN TULANG TENGKORAK
a.a. Cerebral / cranial bones / brain case (8 bones)Cerebral / cranial bones / brain case (8 bones)
unpaired (4)unpaired (4) paired (4)paired (4)
1. occipital1. occipital 1. parietal1. parietal
2. frontal2. frontal 2. temporal2. temporal
3. sphenoid3. sphenoid
4. 4. ethmoidethmoid
b.b. Facial or visceral craniumFacial or visceral cranium
paired (12)paired (12) unpaired (2)unpaired (2)
a. Nasala. Nasal a. a. VomerVomer
b. b. LacrimalLacrimal b. Mandibleb. Mandible
c. Maxillac. Maxilla
d. d. ZygomaticZygomatic / / malarmalar / cheek bones/ cheek bones
e. Palatinee. Palatine
f. Inferior nasal f. Inferior nasal conchaconcha or turbinateor turbinate
The uppermost portion of the human respiratory system, the nose is a The uppermost portion of the human respiratory system, the nose is a The uppermost portion of the human respiratory system, the nose is a The uppermost portion of the human respiratory system, the nose is a hollow air passage that functions in breathing and in the sense of hollow air passage that functions in breathing and in the sense of hollow air passage that functions in breathing and in the sense of hollow air passage that functions in breathing and in the sense of smell. The nasal cavity moistens and warms incoming air, while small smell. The nasal cavity moistens and warms incoming air, while small smell. The nasal cavity moistens and warms incoming air, while small smell. The nasal cavity moistens and warms incoming air, while small hairs and mucus filter out harmful particles and microhairs and mucus filter out harmful particles and microhairs and mucus filter out harmful particles and microhairs and mucus filter out harmful particles and micro----organisms. This organisms. This organisms. This organisms. This illustration depicts the interior of the human nose.illustration depicts the interior of the human nose.illustration depicts the interior of the human nose.illustration depicts the interior of the human nose.
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Fig. 6.13
Fontanelle
= = membran yang mengandung ruangmembran yang mengandung ruang terang untuk terang untuk
newborn infantsnewborn infants
e.g.:e.g.: 1. 1. anterior anterior = largest= largest
2. 2. posterior posterior
3. 3. anterolateralanterolateral ((sphenoidalsphenoidal))
4. 4. posterolateralposterolateral (mastoid)(mastoid)
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Fig. 6.37
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KERANGKA AXIAL
I.I. HYOID BONE HYOID BONE
= = berbentuk Uberbentuk U; ; terletak di bagian depan leherterletak di bagian depan leher
= = perlekatan dasar lidahperlekatan dasar lidah
= = ada diantara ada diantara mandibmandibuullaa & & kartilago kartilago thyroid thyroid
II. II. OSSICLESOSSICLES
= = tulang pada telingantulang pada telingan
a. Stapes (stirrup)a. Stapes (stirrup) 22
b. b. IncusIncus (anvil)(anvil) 22
c. c. MalleusMalleus (hammer)(hammer) 22
Fig. 6.16
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AXIAL SKELETON
I.I. VERTEBRAL COLUMNVERTEBRAL COLUMN
= = panjangpanjang, , kurvekurve, , gerakan sedikitgerakan sedikit
= = persatuan oleh persatuan oleh cartilage & ligamentscartilage & ligaments
= = panjang panjang 71 71 –– 75 cm.75 cm.
= = dibentuk oleh tulangdibentuk oleh tulang----tulangtulang vertebraevertebrae
FUNCTION:FUNCTION:
1.1. penopang badanpenopang badan
2. 2. berisiberisi & & melindungi spinal kord melindungi spinal kord & &
serabut sarafserabut saraf
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VERTEBRAL COLUMNVERTEBRAL COLUMN
Ruas vertebraRuas vertebra youngyoung adultadult
cervicalcervical 77 77
ThoracicThoracic 1212 1212
lumbarlumbar 55 55
sacralsacral 55 1 1
coccygealcoccygeal 4 4 1 1
3333 2626
Diskusb Diskusb IntervertebralIntervertebral = = pipih terdiri pipih terdiri atas atas fibrocartilagefibrocartilage terletak terletak antara permukaan badan antara permukaan badan vertebrtavertebrta
Fungsi Fungsi :: 1. 1. menyambung antar menyambung antar vertebtavertebta
2. 2. bantalan (bantalan ( shock absorbershock absorber))
3. flexibility & g3. flexibility & gerakan erakan kolumna vertebrakolumna vertebra
VERTEBRAL COLUMNVERTEBRAL COLUMN
General parts of vertebraeGeneral parts of vertebrae
1. body1. body 5. transverse process5. transverse process
2. arch2. arch 6. 6. articulararticular processprocess
3. pedicle or root3. pedicle or root 7. 7. spinousspinous processprocess
4. lamina4. lamina 8. spinal or vertebral foramen8. spinal or vertebral foramen
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CiriCiri--ciri bagian tulag vertebraciri bagian tulag vertebra
a. vertebraea. vertebrae servikalservikal (7)(7) = = membentuk kerangka lehermembentuk kerangka leher, , semua meimiliki semua meimiliki fotramenfotramen
atypical vertebraeatypical vertebrae servikalservikal: :
1. atlas 1. atlas ---- 11st st
2. axis or 2. axis or epistropheusepistropheus = 2= 2nd nd
3. 73. 7thth vertebraevertebrae servikalservikal = = spinousspinous process process sempit sempit , , foramen foramen transversus keciltransversus kecil
b. Thoracic vertebrae (12)b. Thoracic vertebrae (12) = = selubung dadaselubung dada-- perlekatan igaperlekatan iga--igaiga
= circular vertebral canal= circular vertebral canal
Special characteristics of individual vertebrae Special characteristics of individual vertebrae cont’ncont’n
c. Lumbar vertebrae (5)c. Lumbar vertebrae (5) = presence of = presence of mamillarymamillary & accessory processes& accessory processes
= triangular vertebral foramen= triangular vertebral foramen
d. Sacrumd. Sacrum = = tulang tulang triangular triangular menghubungan tulang panggulmenghubungan tulang panggul
e. e. CoccygealCoccygeal vertebrae (1)vertebrae (1) = 4 = 4 tulang tulang vertebraevertebrae inkomplit inkomplit
bersatu membentuk ekor /bersatu membentuk ekor /coccyx; triangularcoccyx; triangular
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Fig. 6.17
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Fig. 6.18
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AXIAL SKELETON
I.I. STERNUM (STERNUM (tulang dadatulang dada))
= = tulang pipihtulang pipih, , dinding anterodinding antero--posterior posterior
dinding toraksdinding toraks
= = terdiri atas 2 tulang terdiri atas 2 tulang compact compact dengan lapisan dengan lapisan
tulang tulang spongy spongy mengandung sumsum merah mengandung sumsum merah
BagianBagian--bagiannyabagiannya::
a. a. ManubriumManubrium
b. Corpus or bodyb. Corpus or body
c. c. XiphoidXiphoid processprocess
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AXIAL SKELETON
I.I. IGAIGA--IGAIGA (12 pairs)(12 pairs)
= = tulang pipih dengan lengkung dan 2 ujungtulang pipih dengan lengkung dan 2 ujung
1. vertebral 1. vertebral -- posterior; posterior; perlekatan perlekatan toratoraksks
2. 2. sternalsternal -- anterior; anterior; perlekatan perlekatan costal costal cartilagescartilages
Classification of ribs:Classification of ribs:
a. a. SternalSternal or true ribs (1or true ribs (1stst to 7to 7thth))
-- ribs whose costal cartilages are directly ribs whose costal cartilages are directly
attached to sternumattached to sternum
b. b. AsternalAsternal or false ribs (8or false ribs (8thth to 12to 12thth))
-- ribs whose costal cartilages are not attached ribs whose costal cartilages are not attached
directly to the sternum but to 7directly to the sternum but to 7thth
subdivisions:subdivisions: 1. false rib proper 1. false rib proper -- 88thth, 9, 9thth, 10, 10thth ribsribs
2. floating or hanging ribs 2. floating or hanging ribs –– 1111thth & 12& 12thth
Fig. 6.21
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APPENDICULAR SKELETON
BONES of the UPPER BONES of the UPPER
EXTREMITY (UEEXTREMITY (UE))
11.. Clavicle (collar bone)Clavicle (collar bone)
2.2. Scapula (shoulder Scapula (shoulder
blade) blade) –– articulates with articulates with
humerushumerus & clavicle& clavicle
3.3. HumerusHumerus (arm bone) (arm bone) --
longest & largest longest & largest
bone of UEbone of UE
articulates with articulates with
scapula (above)scapula (above)
radius & ulna radius & ulna
(below)(below)
4.4. Radius Radius -- lateral lateral
bone of the bone of the
forearm; cupforearm; cup--
shaped headshaped head
5.5. Ulna Ulna -- principal principal
bone of the bone of the
forearm; forearm;
longer & larger longer & larger
than radiusthan radius
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APPENDICULAR SKELETON
BONES of the UPPER EXTREMITY BONES of the UPPER EXTREMITY
(UE)(UE) cont’ncont’n
6. 6. Carpals (wrist bone) Carpals (wrist bone) -- 8 8
bones arranged into 2 rowsbones arranged into 2 rows
-- proximal & distal rows proximal & distal rows
7. 7. Metacarpals (bones of the Metacarpals (bones of the
hand) hand) -- 5 long bones 5 long bones
placed between carpals & placed between carpals &
phalangesphalanges
-- numbered from lateral numbered from lateral
to medialto medial
8. 8. Phalanges Phalanges (bones of the (bones of the
fingers) = 14 long bones of fingers) = 14 long bones of
the fingers the fingers ---- 3 bones except 3 bones except
thumb thumb -- 2 bones2 bones
Fig. 6.22
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APPENDICULAR
SKELETON
BONES of the LOWER BONES of the LOWER
EXTREMITY (LE)EXTREMITY (LE)
1. 1. Tulang PANGGULTulang PANGGUL ((innominateinnominate
bone)bone)
Tulang panggul kanan & kiri Tulang panggul kanan & kiri
+ sacrum = + sacrum = lingkar panggullingkar panggul
3 3 bones: bones: 11. . iliumilium**
22. . ischiumischium**
33. pubis*. pubis*
Fig. 6.30
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Male Pelvic Girdle Female Pelvic Girdle
Fig. 6.31
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Fig. 6.32
2. Femur (2. Femur (pahapaha) = ) = paling paling
panjangpanjang, , kuatkuat, , terbesarterbesar
3. Tibia (3. Tibia (tulang keringtulang kering) = ) =
tulang panjangtulang panjang; ;
anterior, medial, & anterior, medial, &
lebih besar dari fibulalebih besar dari fibula
4. Fibula (4. Fibula (peronealperoneal bone) = bone) =
panjang ramping sejajar panjang ramping sejajar
tibia tibia ttp agakttp agak laterallateral
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Fig. 6.34
KERANGKA APPENDICULARTULANG EKSATREMITAS TULANG EKSATREMITAS
BAWAH BAWAH cont’ncont’n
5. 5. TarsalsTarsals (ankle bone) = (ankle bone) =
tulang pendektulang pendek; ;
2 2 barisbaris: : internal internal
& & externalexternal
6. Metatarsals (bones of 6. Metatarsals (bones of
foot) = 5 foot) = 5 tulang tulang
panjang panjang
dihitung dari dihitung dari
medial medial to lateralto lateral
7. Phalanges (bones of 7. Phalanges (bones of
toes) = toes) = tulang jaritulang jari--jarijari
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Fig. 6.35
Common Fracturesgreenstickgreenstickgreenstickgreenstick fracturefracturefracturefracture= the bone does not break = the bone does not break = the bone does not break = the bone does not break all of the way through. all of the way through. all of the way through. all of the way through.
simple,simple,simple,simple, or or or or closedclosedclosedclosed= = = = when the bone breaks but when the bone breaks but when the bone breaks but when the bone breaks but the skin does not. the skin does not. the skin does not. the skin does not.
compound,compound,compound,compound, or or or or open open open open = when the broken bone = when the broken bone = when the broken bone = when the broken bone tears through the skin, tears through the skin, tears through the skin, tears through the skin, introducing the dangerous introducing the dangerous introducing the dangerous introducing the dangerous possibility of infection. possibility of infection. possibility of infection. possibility of infection.
The area around a break The area around a break The area around a break The area around a break swells and discolors, but swells and discolors, but swells and discolors, but swells and discolors, but some fractures can be some fractures can be some fractures can be some fractures can be detected only by Xdetected only by Xdetected only by Xdetected only by X----ray. ray. ray. ray.
The weakened bones of the The weakened bones of the The weakened bones of the The weakened bones of the elderly are especially elderly are especially elderly are especially elderly are especially susceptible to fractures.susceptible to fractures.susceptible to fractures.susceptible to fractures.
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Fig. 6B
Fig. 6C
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Bone Deformation
RicketsRicketsRicketsRickets can result from can result from can result from can result from
insufficient vitamin D in the diet insufficient vitamin D in the diet insufficient vitamin D in the diet insufficient vitamin D in the diet
or from insufficient amounts of or from insufficient amounts of or from insufficient amounts of or from insufficient amounts of
ultraviolet radiation from the ultraviolet radiation from the ultraviolet radiation from the ultraviolet radiation from the
sun. sun. sun. sun.
It can lead to skeletal It can lead to skeletal It can lead to skeletal It can lead to skeletal
deformation, such as vertebral deformation, such as vertebral deformation, such as vertebral deformation, such as vertebral
or leg curvature. or leg curvature. or leg curvature. or leg curvature.
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Sendi
• Persambungan/ artikulasio :pertemuan antara dua atau lebihdari tulang rangka.
• Artrologi: ilmu yang mempelajaripersendian.
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3 Jenis Sendi Berdasarkanstrukturnya
• Fibrosa: hubungan antar sendi oleh jaringan fibrosa
• Kartilago/tulang rawan: ruang antar sendinya berikatandengan tulang rawan.
• Sinovial/sinovial joint: ada ruang sendi dan ligament untukmempertahankan persendian.
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Sendi berdasarkan jenispersambungannya
SinartrosisSendi yang terdapat kesinambungan krn di antara
kedua ujung tulang yang bersendi tdp suatujaringan
DiartrosisSendi terdapat ketidak-sinambungan karena di antara
tulang yg bersendi terdapat rongga (cavumarticulare)
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Sinartrosis
1. Syndesmosis: jaringan penghubungnya mrpjaringan ikata. Sutura: tepi-tepi tulang dihubungkan olehjaringan ikat yg tipis. Cth: di antara tulang-tulang tengkorak
b. Schindylesis: lempeng pd tulang yg satuterjepit di dlm celah pada tulang lain. Cthantara rostrum sphenoid & vomer
c. Ghomphosis: tulang yg 1 berbentuk kerucutmasuk ke dalam lekuk yg sesuai dgn bentukitu pd tlng lain.Cth: antara gigi dg rahang
d. Syndesmosis elastica: jar ikatpenghubungnyamrp jar ikat elastin. Cth: di antara arc. Vertebra oleh lig.flavum
e. Syndesmosis fibrosa: jar ikatpenghubungnyamrp serat kolagen. Cth: antara ulna & radius oleh membran interossa antebrachii
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Sinartrosis
2. Synchondrosis: jaringan penghubungnyajaringan tulang rawan. Cth:antara epifisis & diafisis sebelum penulangan selesai, antarakedua ossa pubica
3. Synostosis: jaringan penghubungnyajaringan tulang. Cth: antara epifisis & diafisissetelah penulangan selesai, antara os ilium, os pubis, dan os ischium
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Diartrosis
Pada diartrosis tdp bgn2 sbb:
1. Ujung-ujung tulang yg bersendi: kepala sendi (caput articulare) & lekuk sendi (cavitas glenoidalis)
2. Simpai sendi (capsula articularis): stratum fibrosum (bgn luar) & stratum synoviale(bgn dlm)
3. Rongga sendi (cavum articulare) berisicairan synovial
4. Alat-alat khusus:- tendon: membatasi gerak sendi & sbgpenyokongmekanik- kartilago & bantalan lemak (fat pads): discus & meniscus articulares sbg alat menerimatumbukan, penyangga, & untuk mengurangidiskongruen- kandung sega (bursae mucosae) untukmemudahkangerakan sendi- ligament (accessories, extracapsular, & intracapsularligaments)
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Diartrosis bdskn kemungkinan gerak
1. Sendi kejur (amphiartrosis): kemampuan gerak sangat sedikit-Symphysis; dihubungkan oleh fibrokartilago. Cth: intervertebraldisc, pubic symphysis
2. Articulationes: kemampuan gerak luasa. Sendi sumbu 1(1) sendi engsel/ hinge joint (ginglymus): sumbu gerak tegak lurus
pd arah panjang tulang. Cth: art.interphalangeae, humero-ulnaris
(2) sendi kisar/ pivot joint (art trochoidea): sumbu gerak kira-kirasesuai dgn arah panjang tulang. Cth:
art.radioulnaris,atlantodentalis
b. Sendi sumbu 2: kedua sumbu gerak berpotongan tegak lurus(1) Sendi telur/ ellipsoidal joint (art. Ellipsoidea): kepala sendi
cekungberbentuk ellipsoid dg sumbu panjang & sumbu pendek. Cth: art.radiocarpae
(2) Sendi pelana/saddle joint (art.sellaris): permukaan sendiberbentuk
pelana; arah sumbu yg 1 permukaannya cembung & arah sumbu yg lain cembung. Cth: art.carpo-metacarpea
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Diartrosis bdskn kemungkinan gerak
c. Sendi sumbu 3 (arthroida): kemampuan gerak paling luas; kepala sendi berbentuk bola(1) Sendi peluru/ ball & socket joint (art. Globoidea): lekuk sendi mencakup kurang dari setengah kepala sendi. Cth: art.humeri
(2) Sendi buahpala (enarthrosis spheroidea): lekuk sendi mencakup lebih dari setengah kepala sendi. Cth: art coxae
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Penstabil sendi1. Jaringan kolagen kapsula sendi & ligamen.
2. Bentuk permukaan sendi→menentukan gerakan spesifik sendi
3. Adanya tulang lain, otot rangka, & bantalan lemak pd sendi
4. Tegangan pd tendon yg menempel pd tulang yang bersendi
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Gerakan Sendi
1. Gerakan lurus (linear motion) - gliding
2. Gerakan sudut (angular motion) * fleksi-ekstensi-hiperekstensi* abduksi-adduksi* sirkumduksi
3. Gerakan putar (rotation)* rotasi kanan-kiri* rotasi medial-lateral* pronasi-supinasi
4. Gerakan khusus* inversi-eversi* dorsofleksi-plantar fleksi* opposisi* protraksi-retraksi* elevasi-depresi* fleksi lateral
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Fig. 6.41abcde
Fig. 6.41f
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Goodluck!