Anda di halaman 1dari 91

SISTEM MUSKULOSKELETAL (OTOT-RANGKA)

Gerak pada manusia

Alat gerak pasif Rangka

Alat gerak aktif Otot

Otot (muscle) jaringan tubuh yg berfungsi mengubah energi kimia menjadi kerja mekanik sebagai respons tubuh terhadap perubahan lingkungan

Rangka (skeletal) bagian tubuh yg terdiri atas tulang, sendi & tulang rawan (kartilago) sbg tempat menempelnya otot dan memungkinkan tubuh untuk mempertahankan sikap dan posisi

SISTEM OTOT
Otot membentuk 43% berat badan; > 1/3-nya mrpkn protein tubuh & -nya tempat terjadinya aktivitas metabolik saat tubuh istirahat Proses vital di dlm tubuh terjadi krn adanya aktivitas otot spt : kontraksi jantung, kontriksi pembuluh darah, bernapas, peristaltik usus

Fungsi Sistem Otot


1. 2. 3. 4. Menghasilkan gerakan rangka Mempertahankan sikap & posisi tubuh Menyokong jaringan lunak Menunjukkan pintu masuk & keluar saluran dlm sistem tubuh 5. Mempertahankan suhu tubuh (kontraksi otot : energi panas)

Karakteristik Otot
Kontraktibilitas, yakni kemampuan otot u/ berkontraksi atau mengadakan perubahan menjadi lebih pendek dari ukuran semula Ekstensibilitas, yakni kemampuan otot u/ berelaksasi atau memanjang dari ukuran semula Elastisitas, yakni kemampuan u/ kembali ke ukuran semula setelah berkontraksi Otot yg kembali ke ukuran semula disebut dalam keadaan relaksasi

3 Tipe Jaringan Otot

Otot jantung memiliki 1 inti yg berada di tengah dipersarafi oleh saraf otonom (involunter) serat otot berserat hanya ada di jantung tahan thd kelelahan

Otot polos memiliki 1 inti yg berada di tengah dipersarafi oleh saraf otonom (involunter) serat otot polos (tidak berserat) terdapat di organ dalam tubuh (viseral) tahan thd kelelahan

Otot rangka memiliki banyak inti dipersarafi oleh saraf motorik somatik (volunter) melekat pada tulang cepat lelah

Struktur Otot Rangka


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

Skeletal Muscle Organ of the muscular system Skeletal muscle tissue Nervous tissue Blood Connective tissues Fascia Tendons Aponeuroses

Aponeuroses

Skeletal muscles

Tendons

11

There is extensive blood and nerve supply to the skeletal muscles

Fascia

- Otot rangka mrpkn kumpulan fasciculus (berkas sel otot berbentuk silindris yg diikat oleh jaringan ikat) - Seluruh serat otot dihimpun menjadi 1oleh jar ikat yg disebut epimysium (fascia) - Setiap fasciculus dipisahkan oleh jar ikat perimysium - Di dlm fascicle, endomysium mengelilingi 1 berkas sel otot - Di antara endomysium & berkas serat otot tersebar sel satelit yg berfungsi dlm perbaikan jaringan otot yang rusak

Sel otot serat otot (endomysium) fascicle fasciculus (perimysium) fascia (epimysium) otot rangka (organ)

Steak

Superficial and deep fascia of chest wall

Tendon
Hampir semua otot rangka menempel pada tulang Tendon: jaringan ikat fibrosa (tdk elastis) yang tebal dan berwarna putih yg menghubungkan otot rangka dengan tulang TENDON

Origin and Insertion


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

Origin (origo) immovable end Insertion (insersio) movable end

Coracoid process

Origins of biceps brachii Tendon of long head

Tendon of short head


Biceps brachii Radius

Insertion of biceps brachii

18

External oblique aponeurosis

Motor end plates


merupakan tempat inervasi ujung-ujung saraf pada otot

Motor end plates


merupakan tempat inervasi ujung-ujung saraf pada otot

Motor end plates

Tipe Kontraksi Otot


Isotonic muscle contracts and changes length Eccentric lengthening contraction
(a) Muscle contracts with force greater than resistance and shortens (concentric contraction)

Concentric shortening contraction Isometric muscle contracts but does not change length

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

(b) Muscle contracts with force less than resistance and lengthens (eccentric contraction)

(c) Muscle contracts but does not change length (isometric contraction)

No movement

Movement

Movement

29

22

Kerja Otot
Otot Sinergis, yaitu 2 otot yang kerjanya bersamaan. mis: otot-otot antar tulang rusuk bekerjasama mengangkat dan menurunkan tulang rusuk dan tulang dada Otot Antagonis, yaitu 2 otot yang kerjanya berlawanan. mis: otot bisep & trisep ketika fleksi & ekstensi lengan bawah

SISTEM RANGKA
Rangka/skelet : rangkaian tulang Fungsi : - memberi bentuk tubuh - melindungi organ tubuh - tempat melekatnya otot - tempat pembuatan sel-sel darah Jenis tulang berdasarkan bentuknya : - tulang panjang/pipa : tulang ekstremitas - tulang pendek : tulang tangan & kaki - tulang pipih : tengkorak, vertebrae, gelang bahu, panggul - tulang sesamoid : tulang patela

Tulang
Membran periosteum berasal dari perikondrium tulang rawan yang merupakan pusat osifikasi. Pada tulang yang sedang tumbuh terdiri atas 1 batang (diafisis) dan 2 ujung (epifisis)

27

SUSUNAN RANGKA MANUSIA


Tulang tengkorak : kubah : - os frontal (1) - os oksipital (1) - os parietal (2) - os temporal (2) basis : - os ethmoidal (1) - os sphenoidal (1) lateral : - os petrosus (2) - os maleus, os inkus, os stapes (2) - os mastoid (2) Tulang wajah : - os zigomatikum (2) - os maksila (2) - os nasal (2) - os lakrimal (2) - os vomer (1)

- os palatina (2) - konka nasal inferior (2) - os mandibula (1) - os hyoid (pd leher) (1)

Tulang Tengkorak

Tulang belakang /kolumna vertebralis : - servikal (7) - torakal (12) - lumbal (5) Tulang dada : - sternum : manubrium sterni korpus sterni prosesus xiphoideus

- sakral (5) - koksigis (4)

- kosta : kosta vera (7 pasang) kosta spuria (3 pasang) kosta fluktuantes (2 pasang)

Tulang panggul/pelvis : - ilium - ischium - pubis

coxae

Tulang anggota gerak atas (ekstremitas superior) : - skapula - karpal : I. navikulare, lunatum, triquetrum, pisiforme - klavikula II. trapezium/multangulum mayus, trapezoideum/ - humerus multangulum minus, kapitatum, hamatum - radius - metakarpal - ulna - phalangs

7 Ruas Tulang Leher

12 Ruas Tulang Punggung

5 Ruas Tulang Pinggang


5 Ruas Tulang Kelangkang 4 Ruas Tulang Ekor / koksigis

Tulang Dada

Tulang Rusuk

7 ps tlg rusuk sejati (costa vera)

3 ps tlg rusuk palsu (costa spuria) 2 ps tlg rusuk melayang

Tulang anggota gerak bawah (ekstremitas inferior) : - femur - tarsal : talus, kalkaneus, navikulare, kuboideum, - patela kuneiforme - tibia - metatarsal - fibula - phalangs

ARTIKULASI (PERSENDIAN)
Adalah : tempat dimana 2/ lebih tulang saling berhubungan (dimana pd tempat tsb dapat terjadi atau tidak terjadi pergerakan) Klasifikasi berdasarkan jaringan yang terletak di antara tulang : - sendi fibrosa - sendi kartilaginosa - sendi sinovial Sendi Fibrosa - di antara tulang yg bersendi terdapat jaringan fibrosa - kemungkinan gerak sangat sedikit - contoh : sutura kubah tengkorak, artikulatio tibiofibula inferior

Sendi Kartilaginosa - primer : - salah 1 tulang dilapisi oleh lempeng rawan hialin - tidak ada pergerakan - contoh : tulang iga I dgn manubrium sterni - sekunder : - salah 1 tulang dilapisi oleh lempeng rawan fibrosa & permukaan sendi kedua tulang diliputi rawan hialin - kemungkinan gerak sedikit - contoh : art. Intervertebralis, simfisis pubis
Sendi Sinovial - permukaan kedua tulang diliputi oleh lapisan tipis rawan hialin & dipisahkan oleh rongga sendi - pergerakan bebas - Rongga sendi dibatasi oleh membran sinovial Membran sinovial dilapisi oleh membran fibrosa (kapsula sendi) Rongga sendi berisi cairan kental (cairan sinovial)

- Jenis sendi sinovial menurut susunan & permukaan sendi serta jenis pergerakannya : 1. Sendi plana - sendinya datar/hampir datar, memungkinkan tulang saling bergeser - contoh : art. Sternoclavicularis, art. Acromioclavicularis 2. Sendi engsel - mirip engsel pintu, memungkinkan gerak fleksi & ekstensi - contoh : sendi siku, sendi lutut, sendi mata kaki 3. Sendi condiloidea - permukaan konveks bersendi dgn konkaf, memungkinkan gerak fleksi, ekstensi, adduksi, abduksi & sedikit rotasi - contoh : art. Metacarpophalangea, art. Interphalangea 4. Sendi elepsoidea - permukaan konveks elips bersendi dgn konkaf elips, memungkinkan gerak fleksi, ekstensi, adduksi & abduksi - contoh : sendi pergelangan tangan

40

5. Sendi pasak - terdapat pasak tulang yg dikelilingi cincin bertulang, memungkinkan gerakan rotasi - contoh : art. Atlantoaxialis 6. Sendi pelana - permukaan sendi berbentuk konkavokonveks yg saling berlawanan & mirip pelana kuda, memungkinkan gerak fleksi, ekstensi, adduksi, abduksi & rotasi - contoh : art. Carpometacarpea ibu jari 7. Sendi peluru (ball & socket) - kepala sendi berbentuk bola & lekuk sendi berbentuk socket, memungkinkan gerak fleksi, ekstensi, adduksi, abduksi, rotasi medial, rotasi lateral & sirkumduksi - contoh : sendi bahu, sendi panggul

Symphysis Pubis

Sacral Promon tory

Vaginal examination to determine the diagonal conjugate

Muscles of the Pelvic Floor: Levator ani (Pubococcygeus , Iliococcygeus, Puborectalis) Ischiococcygeus Pirifomis Obturatorius Other structures: Gluteus Maximus Gluteus Medius Iliopsoas Transverse Abdominus Rectus Abdominus

Naming Skeletal Muscles


Location of the muscle Shape of the muscle Relative Size of the muscle Direction/Orientation of the muscle fibers/cells Number of Origins Location of the Attachments Action of the muscle

Muscles Named by Location


Epicranius (around cranium) Tibialis anterior (front of tibia) tibialis anterior

Naming Skeletal Muscles


Shape:
deltoid (triangle) trapezius (trapezoid, 2 parallel sides)

Trapezius

Deltoid

serratus (saw-toothed)
rhomboideus (rhomboid, 4 parallel sides) orbicularis and sphincters (circular)

Rhomboideus major Serratus anterior

Muscles Named by Size


maximus (largest) minimis (smallest) longus (longest) brevis (short) major (large) minor (small)
Psoas minor Psoas major

Muscles Named by Direction of Fibers


Rectus (straight) parallel to long axis Transverse Oblique External oblique Rectus abdominis

Muscles Named for Number of Origins


Biceps brachii

Biceps (2)
Triceps (3) Quadriceps (4)

Muscles Named for Origin and Insertion


Sternocleidomastoid originates from sternum and clavicle and inserts on mastoid process of temporal bone

insertion

origins

Muscles Named for Action


Flexor carpi radialis (extensor carpi radialis)
flexes wrist

Abductor pollicis brevis (adductor pollicis)


flexes thumb

Abductor magnus
abducts thigh

Adductor magnus

Extensor digitorum
extends fingers

Arrangement of Fascicles
Parallel
strap-like ex: sartorius

Fusiform
spindle shaped ex: biceps femoris

Arrangement of Fascicles
Pennate
"feather shaped

Unipennate
ex: extensor digitorum longus

Bipennate
ex: rectus femoris

Multipennate
ex: deltoid

Arrangement of Fascicles
Convergent
ex: pectoralis major

Circular
sphincters ex: orbicularis oris

There are about 60 muscles in the face.

Smiling is easier than frowning.


It takes 20 muscles to smile and over 40 to frown.

Smile and make someone happy.

Major Skeletal Muscles


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

Temporalis Occipitalis Sternocleidomastoid Trapezius Deltoid Teres minor Teres major Triceps brachii Infraspinatus Brachialis Rhomboid Latissimus dorsi External oblique Gluteus medius Gluteus maximus Adductor magnus Biceps femoris Semitendinosus Semimembranosus Vastus lateralis Sartorius Gracilis

Gastrocnemius Fibularis longus Calcaneal tendon Soleus

61

Muscles of Facial Expression

62

Muscles of Mastication

63

Muscles of Facial Expression and Mastication


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

Epicranial aponeurosis Frontalis Epicranius Occipitalis Temporalis Orbicularis oculi Zygomaticus major Zygomaticus minor Masseter Buccinator Sternocleidomastoid Orbicularis oris

Platysma

(a)

Temporalis

Lateral pterygoid

Medial pterygoid Buccinator

64
(b) (c)

Muscles That Move the Head and Vertebral Column

65

Muscles That Move the Head and Vertebral Column


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

Splenius capitis (cut) Longissimus capitis

Semispinalis capitis Spinalis capitis

Splenius capitis Spinalis cervicis Semispinalis capitis (cut) Longissimus cervicis Iliocostalis cervicis

Iliocostalis thoracis Longissimus thoracis

Spinalis thoracis

Iliocostalis lumborum Quadratus lumborum

66

Muscles That Move the Pectoral Girdle

67

Muscles That Move the Pectoral Girdle


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

Trapezius Deltoid

Levator scapulae Supraspinatus Infraspinatus Teres minor Teres major Rhomboid minor Rhomboid major

Latissimus dorsi

(a)

Trapezius Deltoid

Rhomboid minor Rhomboid major

Latissimus dorsi

68
(b) (c) (d)

Muscles That Move the Arm

69

Muscles That Move the Arm


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

Sternocleidomastoid

Trapezius

Pectoralis minor Internal intercostal

Deltoid

Pectoralis major External intercostal Serratus anterior

Rectus abdominis

Linea alba (band of connective tissue)

Internal oblique Transversus abdominis

External oblique

Aponeurosis of external oblique

70

Muscles That Move the Arm


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

Levator scapulae Supraspinatus Spine of scapula Deltoid Infraspinatus Teres minor Teres major Long head of triceps brachii Lateral head of triceps brachii (a)

Levator scapulae

Supraspinatus

Infraspinatus Teres minor Teres major Triceps brachii

(b)

(c)

(d)

71

Muscles That Move the Forearm

72

Muscles That Move the Forearm


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

Trapezius Clavicle Subscapularis Coracobrachialis Medial border of scapula Short head of biceps brachii Long head of biceps brachii Brachialis

Deltoid

(a)

Subscapularis Coracobrachialis

Biceps brachii (short and long heads)

Brachialis

(b)

(c)

(d)

73

Muscles That Move the Forearm


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

Biceps brachii Brachialis Supinator Pronator teres Brachioradialis Extensor carpi radialis longus Flexor carpi radialis Palmaris longus Flexor carpi ulnaris Flexor digitorum superficialis Pronator quadratus Flexor retinaculum Brachioradialis Flexor carpi ulnaris

(a)

(b)

Pronator teres Flexor digitorum superficialis

Flexor carpi radialis Pronator quadratus

74
(c) (d) (e)

Cross Section of the Forearm


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

Abductor pollicis longus m. Flexor pollicis longus m. Radius Extensor carpi radialis brevis m. Extensor carpi radialis longus m. Pronator teres m. Plane of section Brachioradialis m. Radial n. Radial a. Flexor carpi radialis m. Anterior

Extensor digitorum m. Extensor carpi ulnaris m. Extensor pollicis longus m. Ulna Flexor digitorum profundus m. Ulnar n. Ulnar a. Flexor carpi ulnaris m. Median n. Flexor digitorum superficialis m. Palmaris longus m.

75

Muscles That Move the Hand

Flexors (anterior) and extensors (posterior)


76

Muscles That Move the Hand


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

Triceps brachii Brachioradialis

Extensor carpi radialis longus Flexor carpi ulnaris Extensor carpi ulnaris Extensor carpi radialis brevis Extensor digitorum

Extensor carpi radialis longusand brevis

Extensor retinaculum

Extensor carpi ulnaris Extensor digitorum

(a)

(b)

(c)

77

Muscles of the Abdominal Wall

78

Muscles of the Abdominal Wall


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

Rectus abdominis

External oblique Internal oblique


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

Transversus abdominis Peritoneum Linea alba Transversus abdominis Internal oblique External oblique

(a)

Skin (e)

Rectus abdominis

External oblique Internal oblique Transversus abdominis

(b)

(c)

(d)

79

Muscles of the Pelvic Outlet

80

Muscles of Pelvic Outlet


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

Scrotum Penis Clitoris Ischiocavernosus Bulbospongiosus Superficial transversus perinei Levator ani Gluteus maximus External anal sphincter (a) (b) Urethral orifice Vaginal orifice

Anus

Anus

Coccyx Coccygeus Levator ani Rectum Vagina Urogenital diaphragm (c) Urethra Symphysis pubis

81

Muscles That Move the Thigh

82

Muscles That Move the Thigh


Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Psoas major Psoas minor Iliacus Tensor fasciae latae Sartorius Rectus femoris Vastus lateralis Quadriceps femoris tendon (patellar tendon) Patella Patellar ligament (a) (b)

Pectineus Adductor longus Adductor magnus Gracilis Vastus medialis Sartorius Vastus intermedius

Adductor brevis Gracilis Adductor longus Adductor magnus

(c) Psoas major Psoas minor

(d)

(e)

Iliacus

(f)

(g)

83

Muscles That Move the Thigh


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

Gluteus medius Tensor fasciae latae Gluteus maximus Sartorius Rectus femoris

Vastus lateralis Biceps femoris Iliotibial tract (band)

(a)

Gluteus medius Gluteus maximus

Gluteus minimus Piriformis

(b)

(c)

(d)

84

Muscles That Move the Leg

85

Muscles That Move the Leg


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

Gluteus medius

Gluteus maximus

Adductor magnus Gracilis Semitendinosus Vastus lateralis covered by fascia Biceps femoris

Semimembranosus

Sartorius

Gastrocnemius

Semitendinosus (a) Semimembranosus Biceps femoris (short head) Biceps femoris (long head)

(b)

(c)

86

Muscles That Move the Leg


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

Lateral

Medial

Long head of biceps femoris m.

Semitendinosus m. Semimembranosus m.

Short head of biceps femoris m.

Gracilis m. Adductor magnus m.

Sciatic n. Plane of section

Shaft of femur Vastus lateralis m. Vastus intermedius m. Adipose tissue Skin

Adductor longus m. Great saphenousv. Femoralv . and a. Sartorius m. Vastus medialis m.

Rectus femoris m.

Anterior

87

Muscles That Move the Leg


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

Plantaris

Iliotibial tract (band) Semitendinosus Semimembranosus Gracilis Sartorius Biceps femoris

Soleus

Gastrocnemius

Gastrocnemius: Medial head Lateral head Fibularis longus (b) (c)

Soleus Calcaneal tendon Flexor digitorum longus Flexor retinaculum Fibular retinacula (a) Fibularis brevis Tibialis posterior Flexor digitorum longus

Calcaneus

88
(d) (e)

Muscles That Move the Foot

89

Muscles That Move the Foot


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

Patella Patellar ligament

Tibialis anterior Fibularis longus Extensor digitorum longus Fibularis brevis

Gastrocnemius

Soleus Tibia

Extensor retinacula

(a)

Tibialis anterior Extensor digitorum longus Fibularis tertius Extensor hallucis longus

(b)

(c)

(d)

90

Muscles That Move the Foot


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

Biceps femoris

Vastus lateralis

Head of fibula Gastrocnemius Tibialis anterior Fibularis longus Soleus Extensor digitorum longus

Calcaneal tendon Fibularis brevis Fibularis tertius Fibular retinacula (a) Extensor retinacula

Fibularis longus

Fibularis brevis

91
(b) (c)