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.