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EMBRYOLOGI SISTEM MUSKULOSKLETAL
dr. May Valzon
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Sistem Skeletal
• Berkembang dari mesoderm paraxial, mesoderm lateral plate (somatic layer), neural crest(ektoderm)
• Mesoderm paraxial somitomers (somite)• Somite sclerotome dan dermomyotome• Minggu IV sclerotome menjadi mesencyme
fibroblasts, chondroblasts, or osteoblasts (bone-forming cells)
• bone-forming capacity sclerotome dan mesoderm lateral plate (somatic layer)
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• Sclerotome sel-sel dinding anteromedial somite membentuk vertebra dan costa
• Dermomyotome sel-sel dinding posterolateral membentuk ekstrimitas dan otot dinding tubuh
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• Neural crest mesencyme cranium dan ossa faciei
• Occipital somites and somitomeres basis cranii dan os occipitale
• Ada 2 macam proses penulangan (ossifikasi)– Intramemebranosa mesencyme langsung
menjadi tulang
– Endochondral mesencyme terlebih dahulu menjadi kartilago hyalin
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Perkembangan Tengkorak
• Neurocranium (asal mesederm, kec. Os frontale)– Membranous neurocranium ossifikasi intramembranosa calvaria
– Cartilaginous neurocranium ossifikasi endochondral basis
• Viscerocranium (asal ectoderm)– Is formed mainly from the first two pharyngeal arches – Membranous viscerocranium dari Arcus pharyngealis I:
• Pars dorsalis(processus maxillaris) maxilla, the zygomatic bone, and part of the temporal bone
• Pars ventralis (process mandibularis) berisi kartilago Meckel mengalami ossifikasi intramembranosa menjadi mandibulae
– Cartilaginous neurocranium dari AP I dan II ossicula auditiva dan os hyoid
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Ossifikasi intramembranosa diawali dengan pembentukan spikula
Asal embriyologi tulang tengkorak: biru (neural crest), merah (somit dan somitomeres)
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Figure 9.4 Skull of a newborn, seen from above (A) and the right side (B). Note the anterior and posterior fontanelles and sutures. The posterior fontanelle closes about 3 months after birth; the anterior fontanelle closes about the middle of the second year. Many of the sutures disappear during adult life.
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Korelasi klinis
• Craniofacial Defects and Skeletal Dysplasias
• Anencephaly
• Cranioschisis
• Dwarfism:– Achondroplasia (ACH)
– Thanatophoric dysplasia
– Hypochondroplasia
Craniosynostosis: scaphocephaly (A), acrocephaly, dan brachycephaly (B)
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Achondroplasia (ACH)
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Perkembangan Skeleton Axiale
• Vertebrae dan costa berkembang dari Sclerotome
• Sternum berkembang dari mesoderm dinding anterior tubuh
• Korelasi klinis: Vertebral Defects:
– Scoliosis
– Klippel-Feil sequence
– spina bifida
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Perkembangan Skeleton Appedicular
• Pertengahan Minggu IV upper limb buds dan lower limb buds
• Mesencyme dari mesoderm dibungkus ektoderm • Minggu VI hand plates dan foot plates• Minggu VII segmentasi brachium – antebrachium
– manus ; femur – cruris – pedis• Minggu VIII segmentasi membentuk regio bahu, cubiti,
carpal• Ossifikasi endochondral dimulai pada akhir minggu VIII• Minggu XII muncul pusat ossifikasi primer• Pusat ossifikasi sekunder baru muncul setelah lahir
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Limb Growth and Development
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Korelasi klinis
• Bone Age USG usia kehamilan • Limb Defects 6 per 10 rb kelahiran
– Meromelia Phocomelia– Amelia – micromelia
• Penggunaan Thalidomide (1957 s.d 1962) Limb Defects • Periode sensitif Mg IV dan V• Kelaian jari: brachydactyly, syndactyly, polydactyly,
ectrodactyly• Cleft hand and foot (lobster claw deformity), Clubfoot • Amniotic bands• Congenital hip dislocation• deficiency of the radius
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A. Amelia unilateral, B. Meromelia called phocomelia
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A: Brachydactyly, B: Syndactyly, C: Polydactyly, D: Cleft foot, lobster claw deformity
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OSSIFIKASI ENDOCHONDRAL PADA TULANG PANJANG
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Ossifikasi Endochondral
• Pusat ossifikasi primer diaphysis
• Pusat ossifikasi sekunder epiphysial plate
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Sistem Muscular
• Otot skelet Paraxial mesoderm
• Otot polos dan jantung splanchnic mesoderm
• Otot skelet dari dermomyuotome:
– ventrolateral edge or lip (VLL) (hypomeric, hypaxial) musculature
– dorsomedial edge or lip (DML) epimeric, epaxial musculature
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Korelasi klinis
Poland anomalyPrune belly syndrome
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MIOLOGI UMUM
• Ada 3 type Otot:
– Otot Skelet
– Otot Jantung
– Otot Halus
• Fungsi:
1.Alat gerak aktif
2.Penyokong statis
3.Memberi bentuk tubuh
4.Penyedia panas
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Komponen Otot skelet
• Caput (bellies) a fleshy contractile portion
• Tendon dan aponeurosis a white non-contractile portion composed mainly of collagen bundles
• Otot skelet melekat ke: tulang, kartilago, ligamentum, atau kombinasi struktur tersebut, organ (contohnya?), membran mukosa (contohnya?), dan kulit (contohnya?)
• Otot skelet melekat melalui tendon atau aponeurosis
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Penamaan Otot Skelet
• Berdasarkan fungsi contohnya? m. abductor digiti minimi
• Berdasarkan nama tulang tempat melekat m. sternocleidomastoid
• Berdasarkan bentuk dasar m. deltoideus
• Berdasrakn posisi (lat, med, ant, post), panjang (longus, brevis), ukuran (maximus, minimus), jumlah perlekatan (triceps, biceps)
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Otot skelet berdasar bentuk:
– Pennatus = bulu: uni, bi, multi pinnatus
– Fusiform
– Flat
– Quadratus
– Convergent muscles
– Circular muscle
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• Tipe otot skelet berdasarkan jenis serabutnya:
– Berdasarkan myoglobin: Otot merah vs Otot putih
– Berdasarkan frekwensi kontraksi: Fast twitch vs slow twitch
– Berdsarkan kedua hal tersebut :
1. slow oxidative fibers
2. fast oxidative-glycolytic fibers
3. fast glycolytic fibers
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Slow Oxidative Fibers
• Diameter kecil• large amounts of myoglobin and many blood
capillaries, dark red in color• These slow-twitch• generate ATP mainly by aerobic cellular
respiration• fatigue-resistant fibers • are adapted formaintaining posture and for
aerobic, endurance-type activities such as running a marathon
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Fast Oxidative–Glycolytic Fibers
• Diameter sedang
• contain large amounts of myoglobin and many blood capillaries, red
• contribute to activities such as walking and sprinting
• intracellular glycogen level is high
• Generated ATP from aerobic respiration and glycolysis
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Fast Glycolytic Fiber
• largest in diameter most powerful contractions
• low myoglobin content, relatively few blood capillaries, few mitochondria, and appear white in color
• contain large amounts of glycogen and generate ATP mainly by glycolysis
• adapted for intense anaerobic movements of short duration lifting or throwing a ball
• fatigue quickly
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Kontraksi otot
Tiga jenis kontraksi otot:
– Reflexive contraction
– Tonic contraction
– Phasic contraction:
Isometric contractions
Isotonic contractions
Concentric contraction
Eccentric contraction
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Muscles serve specific functions in moving and positioning the body
• A prime mover or agonist
• Fixators
• Synergist
• Antagonist