ANATOMY OF

JOINT/ARTICULATION
I Nyoman Mangku Karmaya
 Sendi s
yg pali
kita mi

Tujuan bergera

• Memahami jenis, struktur dan fungsi tulang

• Memahami persendian, jenis, contoh dan
macam gerakannya
• Menggambarkan skema synovial joint/diarthrosis
dan menunjukkan bagian-bagiannya
• Menjelaskan dan membedakan antara fascia,
tendon, aponeurosis, ligamen, bursae dan
tendon sheath
 The Human Skeletal System
22 bones in skull
6 in middle ears
1 hyoid bone
26 in vertebral column
25 in thoracic cage

4 in pectoral girdle
60 in upper limbs
60 in lower limbs
2 in pelvic girdle

206 bones in all Department of Anatomy, Medical 3

Faculty Udayana University
 Axial skeleton

Appendicular skeleton

Ventral view Dorsal view

Human skeleton

Axial skeleton – consist of 80 bones

cranium
spine
/columna vertebralis
ribs
sternum
Appendicular skeleton – consist of 126 bones
shoulder
arm
elbow
hand TOTAL: 206 BONES
pelvis
leg
knee
ankle
foot
 Fung
- P
206 tulang manusia dewasa mempunyai 5 fungsi - S
m
d
utama le
Cals
naik
turu
mem
• Menyangga tubuh Ca d
kem
men
• Deposit mineral dan lemak oste
ham
bany
Yang
• Produksi sel-sel darah lema
okul
itu m
tulan
• Melindungi organ (emb
men
jantu
- M
• Memungkinkan melakukan gerakan Dara
s

mengungkit dan gerakan umumnya liver

tulan
- M
Orga
tulan
 Jenis
a. Tu
cont

Jenis tulang
b. Tu
cont
c. Tu
cont
teng
d. Tu
bera
a. Tulang panjang, tulan

contoh: femur.
b. Tulang pendek,
contoh: tulang
carpal
c. Tulang pipih,
contoh: tulang atap
tengkorak
d. Tulang tidak
beraturan, contoh
tulang vertebra.
 Gari
sum
untu
Arteri : Perio
Periosteal a. tulan
Terd
Nutrient a. pem
Metaphysial and man
epiphysial aa teran
Dida
END
Vena:
Med
Mengikuti perjalanan ruan
a.nutricia

Lymphatics (vessels)
sangat banyak dalam
periosteum

Nerves:
Periosteal nerves (serat
syaraf nyeri)
Tulan
sel s
tidak
pem
mas
terda
mas
 Bone Marks
• crest : a sharp prominent bony ridge
• condyle : a rounded prominence that articulates with
another bone
• epicondyle : a small projection located on or above a
condyle
• facet : a smooth, nearly flat articular surface
• fissure : a narrow cleft-like passage
• foramen (foramina) : a hole
• fovea : a pit, generally used for attachment rather than
for joint
• head : larger end of long bone, often set off from shaft
from neck
 Bone Marks
• line : a slight bony ridge
• meatus : a canal or tube-like structure
• process : a prominence or projection
• spine : a slender pointed projection
• sulcus : a groove
• trochanter : a large, somewhat blunt process
• tubercle : a nodule or small rounded process
• tuberosity : a broad process, larger than a
tubercle
•
 Joints/Articulation Joint : hubungan
antar tulang
Hubungan antara
tulang ditentukan
oleh medianya

A joint, or articulation, is the place where two Media bones

diantara tulang
come together. :
- Fibrous ( fibrous
The type depend on the structure in between joint)
Sifatnya : susah /
• Fibrous- Immovable:connect bones, no movement. bahkan gak bisa
(skull and pelvis). bergerak
(immovable)
• Cartilaginous- slightly movable, Letak : daerah kepala
(cranium) & pelvis
bones are attached by cartilage, a little movement
- Cartilago /(sp tulang
ine or ribs). rawan ( kartilago
joint)
• Synovial- freely movable, much more movement Sifatnya : lebih bisa
than cartilaginous joints. Cavities between bergerak
bones are
(lembut tapi
tidak bebas)
filled with synovial fluid. This fluid helps lubricate
Letaknya and
: spine /
rusuk
protect the bones. - synovial (memiliki
ruang dan berisi
cairan synovial
serta dibungkus
oleh membrane
FIBROUS JOINT

Ada 3 macam:
1. Sutura
Serat minim yang
mengikat tulang erat.
Hanya ada di
cranium.
Memungkinkan ketika
dalam kandunga otak
berkembang secara
sempurna dan ketika
lahir bisa lebih kecil
sehingga mudah
untuk lahir.
Ketika lahir kepala
kita dibagi menjadi :
- Patella
- Anterior
- Posterior
Posisi kepala yg baik
ketika lahir :
hiperfleksi
Describe the name of all
sutures at cranium
 Perb
man
Fontanela anterior hew
dahi

Fontanela posterior
FIBROUS JOINT

Ada 3 macam:
2. Syndemoses
Ligamen yg mengubungkan tulang
Ex : ligament yg menghubungkan radius –
ulna & tibia – fibula.
FIBROUS JOINT

Ada 3 macam:
3. Gomphoses
Jaringan yg kemudian jadi tempat meleka
rahang.
Hanya pada gigi dan alveoli
CART
JOIN
1. S
Send
tulan
hyal
Ex :
stern
Man
bern

2. Sy
Send
tulan
fibro
Ex :
pubi
kem
inter
 Discus intervertebralis
memungkinkan tulang belakang
lentur & bisa bergerak

Intervertebral
disc
Medulla spinalis

Medulla
spinalis/spinal
cord goes
through
vertebral
canal which is
formed by
vertebral
foramen
 Discus
intervertebralis
tersusun dari jaringan
yg melingkar
(annulus fibrosis
dengan pusatnya :
nucleus pulposis)

INTERVERTEBRAL
DISC
LOAD Kalau ada beban
berat, hernia keluar
sampe menekan
medulla spinalis
namanya: hernia
nucleus pulposis
Mangkanya sakit
banget kalau angkat2
Hernia
gak kuat
Nucleus
Pulposus
(HNP) push
the spinal
cord
 Cair
• Most common joints in dibu

body Synovial Joints sino

dibu
cap
• Most mobile joints itu d
dilin
• Have liga
– Articular surfaces
on bone with hyaline
cartilage
– Completely enclosed
joint capsule formed
from ligamentous
connective tissue
– Synovial fluid within
capsule lubricates
joint
– Some have
meniscus or
articular disc(e.g.
knee, jaw joint)
Kala
bisa
cair
infe
Keti
bert
tula
aka
syn
bur
Bur
aga
tida
 Ben
join

Synovial Joint Shape Types

men
seb
berg

• Plane joints--intercarpal joints

• Hinge joints--elbow,ankle, inter-phalangeal
• Pivot joints--radio-ulnar joint, atlas-dens joint
• Condyloid joints (egg into oval)--metacarpo-
phalangeal
• Saddle joints--carpo-metacarpal joint of thumb
• Ball-and-socket--hip, shoulder

The type of joint, in part, determines the

range and direction of movement
Types of Synovial Joints Based on Shape

Figure 5.29a–c

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
Liga
liga
radi
PIVOT
JOINT
BETWEEN
C1 AND C2
Types of Synovial Joints Based on Shape

Figure 5.29d–f

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide
 Types of Joints
Hinge- A hinge joint allows extension and
retraction of an appendage. (Elbow, Knee)
Ball and Socket- A ball and socket joint
allows for radial movement in almost
any direction. They are found in the hips
and shoulders. (Hip, Shoulder)
Gliding- In a gliding or plane joint bones
slide past each other. Mid-carpal and mid-
tarsal joints are gliding joints. (Hands,
Feet)
Saddle- This type of joint occurs when
the touching surfaces of two bones have
both concave and convex regions with
the shapes of the two bones
complementing one other and allowing
a wide range of movement. (Thumb)
ypes of movement and examples (with muscles)
flexion- move lower leg toward upper
extension- straightening the leg

abduction- moving leg away from body

adduction- movong leg toward the body

rotation- around its axis

supination- rotation of arm to palm-up position
pronation- palm down

circumduction- swinging arms in circles

inversion- turning foot so sole is inward Pada telapa

eversion- sole is out Agar telapa
bisa menye
Rotator cuff :
Jaringan yg terdiri
dari otot
(m.supraspinatus,
m.infraspinatus,
m.teres major,
m.subcapularis) dan
tendon yng
melindungi humerus
dgn scapula yg
celahnya sempit.
Shoulder Joint
Fungsi bursa :
melindungi tendon
agar bekerja dengan
bagus
Shoulder Joint
Di dalam knee joint
trerdapat ligament
intraartikularis.

Ligament :
ngehubungin tulang –
tulang
Tendon :
ngehubungin tulang –
otot
Knee Joint
Ada bantalan antara
femur dgn tibia yg
tersusun dari
fibrouscartilage yg
berbentuk stengah
lingkaran, namanya :
meniscus

Kalau penuh : diskus

(@vertebra)

1. Intra and extra articular ligament; 2. meniscus, 3. sesamoid bone (patella)

 What is

• Fascia
• Tendon
• Ligament
• Bursae
SKIN
 OUR BODY IS COVERED BY
• Skin
• Fascia superficialis (subcutaneous tissue)
• Fascia profundus = fascia=fibrous
membrane between more specialized
tissue such as muscles
– More or less continues over the entire body
and commonly named according to region eg.
Fascia pectoralis, fascia lata etc.
 Epidermis

Dermis
 Function of the fascia
• Provide muscles origins and insertions
• Serving as an elastic sheath for muscles
• Forming specialized retaining band (retinacula)
and fibrous sheaths for tendons
• Provides pathways for the passage of vessels
and nerves (neurovascular sheath)
• Aided the venous return in lower limb by
muscular action
• May limit or control the spread of pus
• Strips of fascia are sometimes used for the
repair of the tendinous or aponeurotic defects
Tendons are
structures that connect
bone to muscle and are
made up of tendon
tissue

Can have various

shapes
Typical is cord-like
tendon of biceps

Sheeths are
common--”aponeurose
s” e.g.
acromiotrapezius
origin from thoracic
vertebral spines,

Aponeurosis
of abdominal wall
Serous Cavities of the Human Body
• serous = watery-
type fluid.
• Serous cavities =
sacs lined with
serous
membranes.
• serve as lubricating
devices, reduce the
friction during the
motion between
organs
• Exp: bursa,
pleural,
pericardial,
peritoneal
cavities
Bursae vs Synovial Tendon Sheath
•Tendon Sheaths: tubelike bursae that wrap
around tendons. Found at the wrist, ankle, fingers
and toes.
 Aging and Joints
• Decreased production of synovial fluid
• Articular cartilage becomes thinner with
age, ligaments shortens and lose
flexibility.
• Genetic factors
• Males commonly develop degenerative
changes in the vertebral column-hunched.
• Osteoarthritis-occurs over age 70.
Joint Diseases
Arthritis
 Gout
• Gout is a disease that results from an
overload of uric acid in the body. This
overload of uric acid leads to the
formation of tiny crystals of urate that
deposit in tissues of the body, especially
the joints. When crystals form in the
joints it causes recurring attacks of joint
inflammation (arthritis). Chronic gout
can also lead to deposits of hard lumps
of uric acid in and around the joints and
may cause joint destruction, decreased
kidney function, and kidney stones.
X-ray of hand affected by arthritis
 Bursitis
• Inflammation of the Bursa (fluid
filled sac surrounding the joint).
• A bursa can become inflamed from
injury, infection (rare in the
shoulder), or due to an underlying
rheumatic condition.
• Bursitis is typically identified by
localized pain or swelling,
tenderness, and pain with motion
of the tissues in the affected area.
 Tendonitis
• Sometimes the tendons become
inflamed for a variety of reasons, and
the action of pulling the muscle
becomes irritating. If the normal smooth
gliding motion of your tendon is
impaired, the tendon will become
inflamed and movement will become
painful. This is called tendonitis, and
literally means inflammation of the
tendon.
• The most common cause of tendonitis is
overuse.
Artificial Hip Joint
TRAUMA !!!
R. I. C. E. :
• REST

• ICE

• COMPRESS

• ELEVATE
TERIMAKASIH