Osteologi
Safrina D.Ratnaningrum, Msi.,Med.
(safrinadewi.lecture.ub.ac.id)
Osteologi
1. Pendahuluan
• Fungsi
• Klasifikasi tulang
• Komposisi
• Osteogenesis
2. Osteologi khusus
Fungsi Tulang
1. Penunjang (Support)
Tulang2 ekstremitas inferior, cingulum pelvicum, columna vertebralis
Mandibula pada gigi
Tulang lainnya yang menunjang organ danjaringan
2. Perlindungan (Protection)
Cranium melindungi otak
Costae dan sternum melindungi paru-paru danjantung
Vertebrae melindungai corda spinalis
Fungsi Tulang (lanjutan)
3. Pergerakan (Movement)
4. Penyimpan mineral dan jaringan lemak (adiposa)
99% kalsium tubuh
85% fosfor
Adipose tissue terdapat pada cavum medullaretulang2 tertentu
5. Hematopoiesis
Pembentukan sel darah di bone marrow
Klasifikasi Tulang
Berdasarkan:
• Letak
• Struktur
• Bentuk
Berdasarkan letak:
Axial skeleton
Membentuk sumbu panjangtubuh.
Tdd: cranium, columnavertebralis, dan costae.
Fungsi: proteksi, support.
Appendicular skeleton
Tulang2 ekstremitas sup daninf beserta cingulumnya(cingulum pectorale danpelvicum).
Fungsi: lokomosi danperlindungan thd lingkungan.
Klasifikasi Tulang
Berdasarkan struktur:
Pars cartilaginosa
Perichondrium
Pars ossea
1. Periosteum, tdd: osteoprogenitor, osteoblast.
2. Endosteum, tdd: osteoblast, osteoclast.
3. Substantia compacta
4. Substantia spongiosa(trabecularis)
Klasifikasi Tulang
Berdasarkan bentuk: Os longum
Epiphysis:
>> substantia spongiosa
Red marrow tdd jar. Hematopoetic: SDM, SDP,
platelet
Leukemia: >>> SDP
Diaphysis
>> substantia compacta
Yellow marrow Cadangan lemak dan red marrow
foramen nutriens canalisnutriens
Metaphysis histologis/zona peralihan
Klasifikasi Tulang
Berdasarkan bentuk:
Os breve
Cuboid; os carpalia
Eksterior: subs compacta; interior: subs spongiosa
Klasifikasi Tulang
Berdasarkan bentuk: Os planum
Subs compacta << subs spongiosa
Os scapulae, sternum, costae, >> cranium
Os irregulare
Bentuk tdk beraturan
Os vertebrae, coxae, sphenoidale, ethmoidale
Klasifikasi Tulang
Komposisi
Air: 50%
Padatan: 50%
Organik 31% (1/3)
Tdd serabut kolagen dan materi organik lain yang disekresi oleh osteoblast
Fleksibilitas terhadap stretching dan twisting.
Inorganik 69% (2/3)
Terutama tdd: Calcium phosphate dan calcium hydroxide
Menghasilkan tulang yang keras dan tahanterhadap tekanan.
Komposisi
Organik Inorganik
Anak-anak 1 1
Dewasa 3 7
Usia lanjut 1 4
Quiz:
Tulang ini mengalami …………..
a. Demineralisasi
b. Komponen organiknya dihilangkan
Sebelum mgg-8: terbentukmembrana fibrosa dankartilago hyalin.
Sesudah mgg-8: terbentukjaringan tulang, secara:
Intramembranousossification/Desmalisdari membrana fibrosa
Endochondral ossification dari kartilago hyalin
Osteogenesis (Ossifikasi)
Pertumbuhan tulang panjang
Perpanjangan tulang
Epiphyseal plate Kartilago pada epiphyseal
plate membelah cepat Zona proliferasi
Usia 18-25, epiphyseal plates menutup Kartilago berhenti membelah
dan terjadi penulangan
Perpanjangan tulang berhenti pada usia +25 th.
Faktor pertumbuhan tulang
Nutrisi
Kecukupan vitamin dan mineral Kalsium dan fosfor untuk pertumbuhan tulang
Vitamin C untuk pembentukan kolagen scurvy
Vitamins K dan B12 untuk sintesa protein
Faktor pertumbuhan tulang (lanjutan) Hormon
Pada anak-anak berfungsi sebagai stimulanpembelahan sel Pituitari ~ Human growth hormone (hGH): > mitosis
kondrosit & osteoblas; > sintesa protein (kolagen, kartilago, enzym)
Tiroid
Thyrosin: > sintesa protein, > energi
Calcitonin: < reabsorbsi Ca dari tulang
Pankreas (insulin): > energi dari glukosa
Paratiroid: > reabsorbsi Ca dari tulang
Ovarium/testis ~ estrogen/testosteron: penutupan epifisis& membantu mempertahankan Ca dalam tulang
Proses penuaan
Demineralisasi- kehilangan mineral (osteoporosis) Pada wanita 40-45 karena turunnya kadar estrogen; cepat
Pada pria, dimulai usia 60; bertahap
Turunnya sintesa protein Hormon pertumbuhan menurun
Produksi kolagen menurun; tulang lebih keras dan mudahfraktur
Specific osteology
Safrina D. Ratnaningrum
Anatomy Dept. ~ FMBU
Skeleton axiale
• Truncus (trunk)
Bones of human: 206
Skeleton axiale (80)
Cranium (22) hyoid (1), ossiculaauditoria (6) = (29)
Truncus:
Ossa costae, sternum (25)
Columna vertebralis (26)
Skeleton appendiculare (126)
Cingulum ekstrimitas cranialis (4)
Ekstrimitas cranialis (60)
Cingulum ekstrimitas caudalis (2)
Ekstrimitas caudalis (60)
Skeleton axiale (truncus)
Consists of: costae, sternum, columnavertebralis (vertebrae, sacrum, vertebrae, sacrum, coccyx)
Vertebrae: *) Children, vertebrae=33, arranged as follows:
Vertebrae cervicalis: 7
Vertebrae thoracalis: 12
Vertebrae lumbalis: 5
Vertebrae sacral: 5 ( sacrum)
Vertebrae coccygeal: 3~4 ( coccyx)
Vertebrae separated by discus intervertebralis
Each vertebrae is given a name according to its location
Figure 5.14
Columna vertebralis
Structure of a typical vertebrae
(corpus)
General features of vertebrae
Corpus vertebrae
Arcus vertebrae
Pediculus: Incisura vertebrae sup. dan inf. foramen intervertebralis
Lamina consists of:
processus (7):
process spinousus (1)
process transversus (2)
processus articularis sup. dan inf. (4)
foramen vertebralisVertebral canal
Regional variations of vertebrae
Vertebrae cervicalis Corpus vertebrae: small
foramen vertebralis: larger; triangular
processes spinosus:
C3-C5: short & bifida
C6: long
C7: longest; not bifida
processus transversus: short, bifida, foramen transversum
processus articular: horizontal
Atypical vertebrae
Atlas (C1)
Corpus danprocessus spinoususare absent
Terdapat: arcus anterior,
posterior
2 lateral masses
Groove/sulcus for arteri vertebralis
Axis (C2):
Have dens epistropheus
Facies articularis anterior articulates with fovea dentis, arcus anterior os atlas
Vertebra prominens (C7):
processus spinosus: long; blunt (no bifid)
Can be palpated when flexion of the neck Used as clinical landmark in
counting cervical and thoracic spinous processes.
Vertebrae thoracalis
Corpus vertebrae:
heart-shape, fovea costalis superior & inferior
Foramen vertebralis: smaller; rounder
Processus spinosus:
long, point oblique-inferior
Processus transversus:
fovea costal transversalis
Processus articularis: coronal
Vertebrae lumbalis Corpus vertebrae: larger,
kidney-shape
Foramen vertebralis:
larger; triangular
Processus spinosus: projects horizontally
Processus transversus: long
processus articularis: projects sagitally
(+) processusmammilaris&accesorium proc. artic. sup.
Sacrum Facies anterior:
promontorium, foraminasacralis anteriora (4 pairs)
Facies posterior:crista sacralis media, foramina sacral posterior (4 pairs), crista sacralisintermedia, crista sacralislateralis, hiatus sacralis, cornu sacralis
Pars lateralis: Facies auricularis: tuberositas
sacralis
Trans-sacral (epidural) anasthesia
Cornu
palpation
Hiatus sacralis
Clinical correlation: Scoliosis; kyphosis; lordosis
Laminectomy Surgical removal of the processus spinosus and their supporting
lamina vertebralis to relieve pressure on the corda spinalis or nerve root caused by blood clot, tumor, herniated/ruptured discus intervertebralis
Coccygeal trauma; fx-dislocation of the sacrococcygealjoint
Spina bifida
Note: In aging, decrease of height (0,5- 2cm) occur between the ages 50-55
because of compression and shrinkage of the discus intervertebraliswhich collectively account for 25% of the height of columnavertebralis.
Sternum Manubrium sterni :
incisura jugularis, incisuraclavicularis, incisura costalis
Corpus sterni Processus xiphoideus
*) Angulus sternalis: The angle of the junction of manubrium and corpus sterniwhich connects costal cartilage II laterally; lies opposite lower border of V.Th.IV posteriorly
Sternum = chest; manubrium = handle; xiphoid = sword; costae = rib
Costae (12 pairs)
General features:
Costae 1~7 = costae vera
Costae 8~10 = costae spuriae
Costae 11~12 = costae (spuriae) fluitantes
Intercostal spaces (ICS) is space between the ribs musculus intercostalis
Characteristic of typical os costae
Posterior end: capitulum costae: facies articularis superior et inferior
capituli costae, crista capituli costae
collum costae
tuberculum costae: facies articularis tuberculi costae
Corpus: angulus costae
sulcus costae (~ anterior end)
Atypical os costae
Costae I: tuberculum musculiscaleni anterior, sulcusarteri/vena subclavia
Costae XI dan XII lack of collum costae, tuberculum, and angulus costae.
Clinical correlation:
Fx of the ribs are most frequent between ribs 3 and 10. The 1st two pair of ribs are protected by the clavicles; the last two pairs move freely and will give with an impact. Little can be done to assist the healing of broken ribs other than binding them tightly to limit movement.