Human Organization

INTEGUMEN
&
OSTEOLOGY
Dr. Thontowi Djauhari NS,Mkes
Program Studi Farmasi
Universitas MuhammadiyahMalang

Integumentary System
The skin and its accessory organs make
up the integumentary system.
Skin plays a significant role in
homeostasis by protecting underlying
tissues from trauma, infection, and water
loss, and by helping to regulate
temperature.
The skin synthesizes vitamin D and
houses sensory receptors.

Regions of the Skin

The skin has two regions:
Outer epidermis made up of stratified squamous
epithelium, with waterproof keratin, and pigmentproducing melanocytes
Inner dermis made up of fibrous connective
tissue with collagen and elastic fibers, blood
vessels, and sensory receptors.
A subcutaneous layer, composed of loose
connective and adipose tissues, connects the
dermis to underlying organs.

Accessory Organs of the Skin

Nails, glands, and hair are structures of
epidermal origin even though they are
located in the dermis.
Nails are a protective covering of the ends
of the fingers and toes; these increase
dexterity.
Nails grow from cells in the nail root; these
become keratinized as they grow over the
nail bed.

Nail anatomy

 Hair follicles are in the dermis and extend

through the epidermis; arrector pili muscles
allow the hair to become erect.
Each hair follicle has oil (sebaceous) glands
that secrete moisturizing sebum.
Sweat (sudoriferous) glands are present in
all regions of the skin and play a role in
temperature regulation.

INTERRUPTED SUTURES

CONTINOUS SUTURES

Introduction of the osteology

Bones in adult are 206 in number.
Classification of bone
Bones are classified according to their position
and shape
The position can be:
skull

bones of trunk
appendicular skeleton
Types of shape include:

long bone
short bone
flat bone
irregular bone

The Axial Skeleton & Appendicular Skeleton

Figure 5.6
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Arthrology Is
Studi tentang sendi dan gerakan
Diatur oleh bermacam elemen tulang yang menyertai

Klasifikasi Persendian
Berdasarkan Fungsi
- focus kepada derajat kebebasan
gerakan
Berdasarkan struktur
- focus kepada materi persendian
Berdasarkan Axis/sumbu gerak
- focus kepada jumlah sumbu
gerakan

Klasifikasi Persendian berdasar Fungsi

Type
Synarthrosis

gerakan

contoh

tidak/sedikit Sutures, Teeth,

Epiphyseal plates,
gerak
1st rib and costal cart.

Amphiarthrosis sedikit gerak Distal Tibia/fibula

Intervertebral discs
Pubic symphysis
Diarthrosis

gerak bebas Glenohumeral joint

Knee joint
TMJ

Klasifikasi Persendian berdasar

Struktur
Structural
Class
Fibrous

Cartilaginous

Characteristics
Bones united by
collagen fibers

Bone ends united by

cartilage

Types
1.
2.
3.

1.
2.

Synovial

Bone ends covered

with articular
cartilage and
enclosed within a
capsule lined with a
synovial membrane

1.
2.
3.
4.
5.
6.

Suture
Syndesmosis
gomphosis

Mobility
1.

3.

Immobile
(synarthrosis)
Slightly moveable
(amphiarthrosis)
Immobile

Synchondrosis
(hyaline)
Symphysis
(fibrocartliage)

1.
2.

Immobile
Slightly moveable

Plane
Hinge
Pivot
Condyloid
Saddle
Ball and
socket

Freely moveable
(diarthrosis) which
depends on joint design

2.

Joint Classification

Fibrous Joints

Three types.
gomphoses
Disatukan oleh jaringan fibrosa
sutures
syndesmoses

SYNOVIAL JOINTS
Dihubungkan oleh
tulang rawan
dengan membrana
synovial yang
melapisi cavitas
articularis
Sendi ini biasanya
diperkuat oleh
ligamen
Untuk bergerak
dibantu oleh
kontraksi musculus

Types of Synovial Joints

Bones of upper limbs

Composition:
Should girdle
clavicle
scapula
Bones of free upper limb
Humerus in arm
Radius and ulna in
forearm
Carpal, metacarpals and
phalanges in hand

Bones of the Shoulder Girdle

Figure 5.20a, b
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Clavicle

S shaped, medial 2/3

convex forward and lateral
1/3 convex backward
Sternal end medially and
acromial end laterally

Fraktura Clavicula

Scapula
Three borders
Superior: coracoid process ,
scapular notch

Lateral (axillary) border

Medial (vertebral) border

Three angles
Superior: opposite to the 2nd rib
Inferior: opposite to the 7th rib or 7th intercostals
space
Lateral: glenoid cavity,
supra- and infraglenoid tubercles

Two surfaces
Anterior surface concave:
subscapular fossa
Posterior surface: supra- and infraspinous
fossae, spine of scapula, acromion

Humerus

Upper end: head of humerus,

anatomical neck, greater and
lesser tubercles, crests of
greater and lesser tubercle,
intertubercular groove,
surgical neck
Shaft: deltoid tuberosity on
lateral surface, and a groove
for radial nerve on posterior
surface
Lower end: lateral and medial
epicondyles, capitulum,
trochlea , coranoid fossa and
radial fossa (anteriorly) and
olecranon fossa (posteriorly),
and sulcus for ulnar nerve

Glenohumeral (shoulder) joint

Stabilizers of the
Shoulder Joint

Bones of the Upper Limb

The forearm
has two bones
Ulna
Radius

Figure 5.21c
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Elbow Joint ( Humeroulnar-humeroradial)

Flexi
Extensi
Pronasi
Supinasi

Elbow: Radial head dislocation

Elbow: medial epicondylitis

Elbow: Olecranon Bursitis

Carpal bones
Proximal row (lateral to medial)
scaphoid, lunate, triquetral and
pisiform
Distal row (lateral to medial)
trapezium, trapezoid, capitate and
hamate
Metacarpal bones
Numbered one to five from thumb to
little finger
Structure of eachbase (proximally),
shaft, and head (distally)
Phalanges of fingers
Consist of 14 two for first digit
(thumb) and three for each of other
four digits
Structure of each base (proximally),
shaft, and trochlea of phalanx
(distally), tuberosity of distal phalanx

T
C

Tr
Tz

Wrist: Colles Fracture

Wrist: Scaphoid Fracture

Wrist: Boxers Fx X-ray

Bones of trunk

Composition: vertebrae, sacrum,

coccyx, sternum and ribs
Vertebrae
There are 33 vertebrae in children,
arranged as follows:
Cervical vertebrae C.7
Thoracic vertebrae T.12
Lumbar vertebrae
L.5
Sacral vertebrae
S.5
sacrum
Coccygeal vertebrae
Co.3~4
coccyx

Structure of a Typical Vertebrae

Figure 5.16
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Slide 5.29

SCOLIOSIS
Lateral curvature of
the spine
Idiopathic
Associated with other
condition

Sacrum

Anterior surface:
promontory, anterior sacral
foramina (four pairs)

Posterior surface:
median sacral crest ,
posterior sacral foramina (four
pairs), sacral hiatus sacral &
cornu

Lateral part:
auricular surface, sacral
tuberosity

Cornua
Sacral hiatus
palpation

Transsacral (epidural) anasthesia

Sternum
Manubrium sterni :
jugular notch, clavicular
notch
Body of sternum
Xiphoid process
Sternal angle :
the junction of manubrium
and body, which connects
2nd costal cartilage
laterally

Sternal angle
Made-up of three
parts
Sternum
Ribs
Thoracic vertebrae

Ribs: 12 pair
General features
Ribs 1~7 called true
ribs
Ribs 8~10 called
false ribs
Ribs 11~12 called
floating ribs

Atypical rib

First rib:
tubercle for scalenus
anterior, sulcus for
subclavian artery and
vein
11th and 12th ribs
lack costal necks,
tubercles and angles

Bones of Lower Limb

Composition:
Pelvic girdle:
hip bone
Bones of free lower limb:
Femur in thigh ( patella)
Tibia and fibula in leg
Tarsals, metatarsals,
phalanges of toes in foot

Femur

Upper end: femoral head,

fovea of femoral head, neck of
femur, greater
trochanterlesser trochanter,
intertrochanteric line,
intertrochanteric crest
Shaft: linea aspera , gluteal
tuberosity , pectineal
linepopliteal surface
Lower end: medial and lateral
condyles
medial and lateral
epicondyles, adductor
tubercle
intercondylar fossa,
patellar surface

Hip Joint
Joint capsule
strengthened by
ligaments
pubofemoral
ischiofemoral
iliofemoral

Fracture of the femoral neck

Tibia

Upper end: medial

and lateral condyles,
intercondylar
eminence, fibular
articular surface,
tuberosity of tibia
Shaft: interosseous
border, soleal line
Lower end: fibular
notch, medial
malleolus

Fibula
Upper end: fibular head,
neck of fibula
Shaft:
interosseous border
Lower end: lateral malleolus

Patella
triangular sesamoid bone

Dislokasi Patella
Bergesernya posisi patella
dari kedudukan semula.
Hal ini yang menyebabkan
nyeri.

Tibiofemoral (Knee) joint

Ligamen cruciatum anterior

Ligamen cruciatum posterior

Knee Joint
Ligamen collateral fibulare

Capsula articularisnya
diperkuat oleh :
Ligamen popliteum arcuatum
- Ligamen patellae,
Ligamen collaterale
fibulare, Ligamen
collaterale tibiale,
Ligamen popliteum
obliquum dan Ligamen
popliteum arcuatum
- Masih terdapat juga
ligamen cruciatum
anterior dan posterior
yang menghubungkan
femur dan tibia
didalam sendi

Ligamen collateral tibiale

Ligamen popliteum obliqum

KNEE DISLOCATION

Bones of the Lower Limbs

The foot
Tarsus ankle
Metatarsals
sole
Phalanges
toes
Figure 5.25
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Slide 5.41

Tulang
penyusun :

1. Os tibia malleolus medialis

2. Os talus facies malleolaris
medialis
facies malleolaris lateralis
3. Os fibula malleolus lateralis

Ligamentum Lateralis :
1. Lig. Talofibulare anterior
2. Lig. Talofibulare posterior
3. Lig. Calcaneofibulare

Ligamentum Medialis (Deltoideum) :

Lig. Tibionaviculare
Lig. Calcaneotibiale
Lig. Talotibiale anterius
Lig. Talotibiale posterius

ASPEK KLINIS
1. Ankle sprains (keseleo)
- robekan dari serat-serat ligamen
tersering (lig.lateralis)

 2. Potts Fracture-dislocation of the Ankle

The Pelvic Girdle

Paired hip bones
Os coxae or coxal
bones
Ilium
Ischium
Pubis
Articulate w/each
other in anterior
midline
Pubic symphysis

The Pelvis

Figure 5.23a

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Articulations
Ilia
Articulate with
sacrum

Hip
Acetabulum with
head of femur

Pubic symphysis
R and L os coxae

Note: Bone features will be studied in lab

Gender Differences of the Pelvis

Figure 5.23c
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Slide 5.39

Bones of the Skull

Figure 5.11
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Slide 5.22

parietal bone

Frontal bone

Sphenoid bone

Temporal bone
Zygomatic bone
Nasal bone

Maxilla

Mandible

Occipital bone

The Skull

Figure 5.7
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 Body of mandible

Mandible

Superior border: alveolar arch

Inferior border: base of mandible
Outer surface: mental protuberance,
mental foramen

Inner surface: mental spine,

digastric fossa

Ramus: has two vertical processes

separated by mandibular notch

Coronoid process
Condylar process

head of mandible
neck of mandible

Mandibular foramen
mandibular lingula
Angle of mandible
Masseteric tuberocity

Ligamen yang
mengikat
Temporomandibularis
(Lateralis)

Sphenomandibulare
Stylomandibular
Jenis Gerakannya :
Elevasi
Protrusi
Depresi
Retrusi
Graiding and chewing

Temporomandibular Joint

TMJ syndrome caused by malocclusion & stress

Clicking sounds, headaches, vertigo, pain, or tinnitus

The
skull
as
a
whole
Skull viewed from above
(superior view)

Bones: frontal, parietal, occipital

Sutures:
coronal,
sagittal,
lambdoid

parietal tuber, parietal foramen

Internal surface of the

calvaria
sulcus for superior sagittal
sinus
granular foveola
arterial grooves

Human Skull, Superior View

Figure 5.8
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Slide 5.23

Human Skull, Inferior View

Figure 5.9
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Slide 5.24

Orbit
pyramid-shaped paired cavities
Base: supraorbital notch
infraorbital foramen Apex: optic
canal
Walls
Superior:
fossa for lacrimal gland
- Medial:
fossa for lacrimal sac
Inferior:
infraorbital fissure
infraorbital groove
infraorbital canal

Apparatus lacrimalis
Glandula lacrimalis
Ductus excretorius lacrimalis
Fornix conjungtiva
Permukaan anterior bulbus oculi
Lacus lacrimalis
Punctata lacrimalis
Canaliculi lacrimalis
Saccus lacrimalis
Ductus nasolacrimalis

Paranasal Sinuses
Functions of paranasal sinuses
Lighten the skull
Give resonance and amplification to voice

Figure 5.10
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 Maxillary sinus
Largest paired sinus, lie in the body of maxilla;
Opening into middle nasal meatus

Proc. Nasalis os frontalis

Os nasalis
Cartilago septalis
Proc. Frontalis os
maxilla
Cartilago lateralis
Cartilago alaris minor
Cartilago alaris
major

NASUS EXTERNUS

The Fetal Skull

The fetal skull is

large compared
to the infants
total body length

Figure 5.13
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The Fetal Skull

Fontanelles
fibrous membranes
connecting the
cranial bones
Allow the brain
to grow
Convert to bone
within 24 months
after birth
Figure 5.13
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