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Physiology of bone,

muscle and joint


Budi Santoso, Mkes
Learning objective
Bone Function
Muscle contraction
Knee and shoulder joint
Identify bone
Identify joint
Identify muscle ini knee and shoulder
The Human Skeleton Quiz 1. Carpals

2. Cranium

1. Clavicle 3. Femur

2. Fibula 4. Innominate

3. Humerus 5. Mandible

4. Patella 6. Metacarpals

5. Radius 7. Metatarsals

6. Sternum 8. Phalanges

7. Tarsals 9. Rib

8. Tibia 10. Scapula

9. Ulna 11. Sacrum

12. Vertebra
The Human Skeleton 1. Carpals

2. Cranium
2

1. Clavicle
1 5 3. Femur

2. Fibula 10
6 4. Innominate

3. Humerus
9
3 5. Mandible

4. Patella 12
5 4 6. Metacarpals

5. Radius
11
9 7. Metatarsals
1
6. Sternum 6
8 8. Phalanges
3
7. Tarsals
4 9. Rib

8. Tibia
8 10. Scapula

9. Ulna 2
11. Sacrum
7 7
12. Vertebra
Bone
Structural support of the body

Connective tissue that has the potential to


repair and regenerate

Comprised of a rigid matrix of calcium salts


deposited around protein fibers
Minerals provide rigidity
Proteins provide elasticity and strength
Shape
Long, short, flat, and irregular

www.sirinet.net/ ~jgjohnso/skeleton.html
Osteon

Periosteum

Cancellou
s Bone

Cortical Bone
Bone Physiology. Courtesy Gray's Anatomy35th edit Longman Edinburgh 1973
Composition of Bone:
Cells
Osteocytes

Osteoblasts

Osteoclasts
Composition of Bone:
Matrix

Cortical/ Compact
Bone

Cancellous/
Trabecular/ Spongy
Bone
Cancellou
Cortical
s
Physical Rigid lattice designed for
Descriptio Dense protective shell strength; Interstices are
n filled with marrow
Around all bones,
In vertebrae, flat bones
beneath periosteum;
Location (e.g. pelvis) and the ends
Primarily in the shafts
of long bones
of long bones
% of
Skeletal 80% 20%
Mass
Cancello
Cortical
us
First Level
Osteons Trabeculae
Structure
Porosity 5-10% 50-90%
Haversian system allows
diffusion of nutrients and
Circulatio Slow circulation of waste between blood
n nutrients and waste vessels and cells; Cells
are close to the blood
supply in lacunae
Cancello
Cortical
us
Strength Withstand greater stress Withstand greater strain
Direction Compression; Youngs
Bending and torsion,
modulus is much greater
of e.g. in the middle of
in the longitudinal
Strength long bones
direction
Stiffness Higher Lower
Fracture
Strain>2% Strain>75%
Point
Bone Remodeling
Bone Remodeling
Bone structural integrity is
continually maintained by remodeling

Osteoclasts and osteoblasts


assemble into
Basic Multicellular Units (BMUs)

Bone is completely remodeled in


approximately 3 years

Amount of old bone removed equals


new bone formed
http://www.elixirindustry.com/resource/osteoporosis/jilka.htm
BMU Remodeling
Sequence
www.ifcc.org/ejifcc/ vol13no4/130401004n.htm

Osteocytes

Activation

Quiescence
Resorption

Formation & Reversal


Mineralization
Load Characteristics of
Bone
Load characteristics of a bone include:

Direction of the applied force


Tension
Compression
Bending
Torsion
Shear

Magnitude of the load

Rate of load application


Basic Multicellular

Units
The Basic Multicellular Unit (BMU) is a
wandering team of cells that dissolves a pit
in the bone surface and then fills it with
new bone. http://uwcme.org/site/courses/legacy/bonephys/physiology.php

BMUs are discrete temporary anatomic


structures organized as functional unit

Osteoclasts remove old bone, then


osteoblasts synthesize new bone

old bone is replaced by new bone in quantized


packets
Basic Multicellular Units
(contd)

A photomicrograph of bone showing osteoblasts and osteoclasts


together in one Bone Metabolic Unit

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
Activation
Occurs when bone experiences micro damage
or mechanical stress, or at random

A BMU originates and travels along the bone


surface

Differentiated cells are recruited from stem cell


populations

Pre-osteoclasts merge to form multi-nucleated


osteoclasts

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
Bone Resorption
Newly differentiated osteoclasts are
activated and begin to resorb bone

Minerals are dissolved and the matrix is digested


by enzymes and hydrogen ions secreted by the
osteoclastic cells

Move longitudinally on bone surface

This process is more rapid than formation,


though it may last several days

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
http://www.britannica.com/ebc/article?tocId=41887
Reversal
Transition from osteoclastic to osteoblastic
activity
Takes several days

Results in a cylindral space (tunnel) between


the resorptive region and the refilling region
Forms the cement line
Bone Formation
Following Resorption, osteoclasts are replaced by osteoblasts
around the periphery of the tunnel
Attracted by cytokines and growth factors

Active osteoblasts secrete and produce layers of osteoid,


refilling the tunnel

Osteoblasts do not completely refill the tunnel


Leaves a Haversian canal
Contains capillaries to support the metabolism of the
BMU and bone matrix cells
Carries calcium and phosphorus to and from the bone

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
Mineralization
When the osteoid is about 6 microns thick, it begins
to mineralize
Formation of the initial mineral deposits at multiple
discrete sites (initiation)
Mineral is deposited within and between the collagen
fibers

This process, also, is regulated by the osteoclasts

Mineral maturation
Once the cavity is full the mineral crystals pack
together, increasing the density of the new bone

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
Quiescence
After the tunneling and refilling
Some osteoblasts become osteocytes
Remain in bone, sense mechanical stresses
on bone
Remaining osteoblasts become lining cells
Calcium release from bones

Period of relative inactivity


Secondary osteon and its associated cells carry
on their mechanical, metabolic and homeostatic
functions

http://uwcme.org/site/courses/legacy/bonephys/physiology.php
Mechanical Support
Provides strength and stiffness
Hollow cylinder: Strong and light
Have mechanisms for avoiding fatigue
fracture
Hematopoiesis
Development of blood cells
Occurs in the marrow of bone
These regions are mainly composed of
trabecular bone
(e.g. The iliac crest, vertebral body,
proximal and distal femur)
Protection of Vital
Structures
Flat bones in the head protect the
brain

Protects heart and lungs in chest

Vertebrae in the spine protect the


spinal cord and nerves
Mineral Homeostasis
Primary storehouse of calcium and
phosphorus
Trabecular bone are rapidly formed
or destroyed
In response to shifts in calcium stasis
without serious mechanical
consequences
Joint
Table of Joint Types
Functional across Synarthroses Amphiarthroses Diarthroses
(immovable joints) (some movement) (freely movable)
Structural down

Bony Fusion Synostosis


(frontal=metopic
suture; epiphyseal
lines)
Fibrous Suture (skull only) Syndesmoses Syndesmoses
-fibrous tissue is -ligaments only -ligament longer
continuous with between bones; here, (example: radioulnar
periosteum short so some but not interosseous
a lot of movement membrane)
(example: tib-fib
Gomphoses (teeth) ligament)
-ligament is
periodontal ligament

Cartilagenous Synchondroses Sympheses


(bone united by -hyaline cartilage -fibrocartilage
cartilage only) (examples: (examples: between
manubrium-C1, discs, pubic
epiphyseal plates) symphesis

Synovial Are all diarthrotic


Synovial joints

Include most of the bodys joints

All are diarthroses (freely


movable)

All contain fluid-filled joint


cavity
General Structure of Synovial
Joints
1. Articular cartilage
Hyaline
Spongy cushions
absorb compression
Protects ends of bones
from being crushed

2. Joint (synovial) cavity


Potential space
Small amount of
synovial fluid
General structure of synovial joints
(cont.)
3. Articular (or joint) capsule
Two layered
Outer*: fibrous capsule of
dense irregular connective
tissue continuous with *
periosteum *
Inner*: synovial
membrane of loose
connective tissue (makes
synovial fluid)
*
Lines all internal joint
surfaces not covered by
cartilage*
General structure of synovial joints
(cont.)
4. Synovial fluid
Filtrate of blood
Contains special
glycoproteins
Nourishes cartilage and
functions as slippery
lubricant
Weeping lubricatioin
5. Reinforcing ligaments
(some joints)
Capsular (most) thickened
parts of capsule
Extracapsular
Intracapsular
General structure of synovial joints
(cont.)
6. Nerves
Detect pain
Monitor stretch (one of
the ways of sensing
posture and body
movements)

7. Blood vessels
Rich blood supply
Extensive capillary beds
in synovial membrane
(produce the blood
filtrate)
General structure of synovial
joints
Some joints
Articular disc or
meniscus
(literally crescent)
Only some joints
Those with bone
ends of different
shapes or fitting poorly
Some to allow two kinds of movement (e.g.
jaw)
Of fibrocartilage
Examples: knee
TMJ (temporomandibular joint)
sternoclavicular joint
Movements allowed by synovial
joints
Gliding
Angular movements: or the angle
between two bones DO TOGETHER
Flexion
Extension
Abduction
Adduction
Circumduction
Rotation
Special movements
Special movements

Pronation Protraction
Supination Retraction
Dorsiflexion Elevation
Plantar flexion Depression
Inversion Opposition
Eversion
Synovial joints
classified by shape
(of their articular
surfaces)

Plane (see right)


Hinge (see right)
Pivot
Condyloid
Saddle
Ball-and-socket
Knee joint
Largest and most complex joint
Primarily a hinge
Compound and bicondyloid: femur and
tibia both have 2 condyles
Femoropatellar joint shares joint cavity
At least a dozen bursae
Prepatellar
Suprapatellar
Lateral and medial
menisci
torn cartilage
Capsule absent
anteriorly
Capsular and
extracapsular
ligaments
Taut when knee
extended to prevent
hyperextension
Patellar ligament
Continuation of
quad tendon
Medial and lateral
retinacula
Fibular and tibial
collateral
ligaments
Called medial and
lateral
Extracapsular
Oblique popliteal
Arcuate popliteal
Cruciate
ligaments
Cross each other
(cruciate means cross)
Anterior cruciate (ACL)
Anterior intercondylar
area of tibia to medial
side of lateral condyl of
femur
Posterior cruciate
Posterior intercondylar
area of tibia to lateral
side of medial condyl
Restraining straps
Lock the knee
Cruciate ligaments
Knee injuries

Flat tibial surface


predisposes to
horizontal injuries
Lateral blow:
multiple tears
ACL injuries
Stop and twist
Commoner in
women athletes
Heal poorly
Require surgery
Bones and Landmarks
Femur
Head Lateral epicondyle
Neck Medial epicondyle
Greater trochanter Adductor tubercle
Lesser trochanter Linea aspera
Body Pectineal line
Medial condyle Patellar surface
Lateral condyle
Bones and Landmarks
Tibia
Intercondylar eminence
Medial condyle
Lateral condyle
Plateau
Tibial tuberosity
Bones and Landmarks
Fibula
Patella
Calcaneus
Ligaments and Other
Structures
Knee joint
Anterior and posterior cruciate
ligaments
Medial and lateral collateral ligaments
Medial and lateral meniscus
Bursae of the knee
Popliteal space
Pes anserine muscle group
Muscles of the Knee
Anterior muscles
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedialis
Muscles of the Knee
Posterior
muscles Gastrocnemius
Semimembranos Tensor fascia
us latae
Semitendinosus Gracilis
Biceps femoris Sartorius
Popliteus
Selected synovial joints
Shoulder
(glenohumeral)
joint
Stability sacrificed for
mobility
Ball and socket: head
of humerus with
glenoid cavity of
scapula Rotator cuff muscles add to stability
Glenoid labrum: rim of
fibrocartilage
Thin, loose capsule
Strongest ligament:
coracohumeral
Muscle tendons help
stability
Disorders
Biceps tendon is intra-articular
Elbow joint
Hinge: allows only
flexion and extension
Annular ligament of
radius attaches to
capsule
Capsule thickens into:
Radial collateral
ligament
Ulnar collateral
ligament
Muscles cross joint
Trauma
Stages in the Healing of a Bone
Fracture

Figure 5.5

Copyright2003PearsonEducation,Inc.publishingasBenjaminCummings Slide 5.19


Muscle
Muscle function:
produce movement
maintain posture
stabilize joints
generate heat

Functional Characteristics:
Excitability- respond to a
stimulus
Contractility- ability to
shorten forcibly when
adequately stimulated
Extensibility- the ability to be
stretched
Elasticity- the ability of a
muscle fiber to resume
its resting length after
being stretched
STRUKTUR DAN FUNGSI OTOT

MACAM
MACAMOTOT
OTOT
OTOT POLOS OTOT RANGKA OTOT JANTUNG

Ciri dan fungsi Ciri dan fungsi Ciri dan fungsi


a. Fusiform shape a. voluntary a. involuntary
b. Involuntary b. Has not branch b. Has branch
c.One nuclei in the c. Composed of c. Nuclei located in
centre miofibril the middle