TUTOR GUIDE BASIC MEDICAL SCIENCE 1 (BMS1) KASUS 1 TIM BLOK BMS 1 Dr.drg.Sri Tjahajawati,MKes., Dr.drg.Marry S.Mariam,MS , Dr. Winny Yohana,drg.,SPKGA, Drg.Nani Murniati,MKes., drg.Moch.Rodian,MKes., drg.Tadeus Arufan Yasrin,MM., drg.Rosiliwati Wihardja MDSc., drg.Ervin Rizali.,MKes., drg.Kartika Indah Sari,MKes., Fakultas Kedokteran Gigi Universitas Padjadjaran Bandung- 2016
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TUTOR GUIDE
BASIC MEDICAL SCIENCE 1 (BMS1)
KASUS 1
TIM BLOK BMS 1
Dr.drg.Sri Tjahajawati,MKes., Dr.drg.Marry S.Mariam,MS , Dr. Winny
a. Chondroitin 4-sulfate b. Chondroitin 6-sulfate c. Keratan Sulfate
BONE CELLS
1. OSTEOBLASTS
• Synthesis of bone matrix
a. Type I Collagen
b. Proteoglycans
c. Glycoprotein
• Located at the surfaces of bone tissue, side by side, in away that resembles
simple epithelium
• When actively : Cuboidal to columnar shape
• When actively declines : Flatten
OSTEOCYTES
• Lie in the lacunae
• One osteocytes in each lacuna
• Canaliculi house cytoplasmic process
• Processes of adjucent cell make contact via gap junction
This figure is section of bone tissue showing an osteocyte with its cytoplasmic processes surrounded by matrix. Ultrastructure compatible with a low level of synthetic activity is apparent in both nucleus and cytoplasm.
3. OSTEOCLASTS
• Very large
• 5 to 50 contain nuclei
• Lie in howship’s lacunae
• Derived from the fusion of monocytes
• Secrete :
a. Acid
b. Collagenase
c. Other proteolytic enzymes
PERIOSTEUM AND ENDOSTEUM
External and intrnal surfaces of bone are covered by layers of bone forming cells and connective
tissue called periosteum and endosteum.
1. Periosteum
Outer Layer
- Collagen fibers
Bundle : Sharpey’s fibers
- Fibroblasts
Inner Layer
More celllular (oteoprocenitor cells) is composed of
flattened cells to divided into osteoblasts
2. cells (single layer) a. Small amount of connective tissue
Therefore, the endosteum is consider ably thinner than the 3. periosteumEndosteum
Lines all internal surfaces of cavities with in the bone Composed :
Osteoprogenitor
Functions of periosteum and endosteum :
1. Nutrition of osseus tissue
2. Supply of new osteoblasts for repair or growth of bone
Schematic drawing of the wall of a long bone diaphsis.
Type of bone
A. MICROSCOPIC EXAMINATION
1. Primary, immature or woven bone
2. Secondary, mature or lamellar bone
B. GROSS OBSERVATION (CROSS SECTION)
1. Dense area without cavities : Compact Bone
2. Areas with numerous interconecting cavities : Cancellous (spongy)
bone
In long Bones :
1. Bulbous ends : Epiphyses
Spongy bone covered by a thin layer of compact bone
1. Cylindrical Part : Diaphysis
Almost totally composed of compact bone, with a small component of spongy
bone on its inner surface around the bone marrow cavity.
In Short Bones :
Usually have a core of spongy bone completely surrounded by compact bone.
In Flat Bones (Calvaria)
Have two layers of compact bone called plated (tables), separated called the diploe.
PRIMARY BONE TISSUE
First bone tissue
Temporary, replace by secondary bone tissue, except :
- Near the sutures of the flat bones of the skull
- In tooth sockets
- In the insertion some tendons
Characteristics :
- Irregular array of collagen fibers
- Smaller mineral content
- Higher proportion of osteocytes than in secondary bone tissue
SECONDARY BONE TISSUE
- Collagen fibers : Lamellae
- Haversian canals
- Haversian system or osteon
- Lacunae
The lamellae exhibit a typical organization consisting of :
1. Haversian system
2. Outer circumferential lamellae
3. Inner circumferential lamellae
4. Intertitial lamellae
The haversian canal communicate with :
1. The narrow cavity
2. The periosteum
3. The volkman’s canals (do not have concentric
lamellae)
Schematic drawing of the wall of a long bone diaphsis.
HISTOGENESIS
Bone can be formaed in two ways :
I. Direct mineralization of matrix secreted
by osteoblasts (intra membranous
ossification)
II. Deposition of bone matrix preexiting
cartilage matrix (endochondral
ossification)
I. Intramembranous Ossification formed by intramembranous
ossification :
• The frontal and parietal bones of the skull
• The occipital and temporal bones of the skull
• The mandible and maxilla
The Beginning of Intramembranous Ossification
II. Endochondral Ossification
Takes place within a piece of Hyalin Cartilage whose shape
resembles a small version or model of the bone to be formed.
Endochondral ossification consists of two phases :
1. The first phase
Hypertrophy and destruction of the chondrocytes of
the model of the bone, leaving expanded lacunae
separated by septa of calcified cartilage matrix.
2. The second phase
THE OSSIFICATION CENTRE
1. Primary ossification centre appears in the diaphysis
2. Secondary ossification centre arises at the centre of each
epiphysis
When the bone tissue that originated at the secondary centres
occupies the epiphysis, cartilage remains restricted to 2 places:
1. Articular cartilage
- Persist throughout adult life
- Does not contribute to bone formation
2. Epiphyseal cartilage or the epiphyseal plate
- Connect epiphysis to diaphysis
- As the cartilage grows, it is replace continously by
newly formed bone matrix mainly from the diaphyseal
centre
Schematic drawings showing the 3-dimensional shape of bone spicules
in the epiphyseal plate area. Hyaline cartilages is stipple, calcifed
cartilage is black, and bone tissue is shown in color. The upper
drawing shown the region represented 3-dimensionally in the lower
drawing.
Epiphyseal cartilage, divided into five zones :
1. Resting zone
• With out morphologic changes in the cells
2. Proliferative zone
• Chondrocytes devided rapidly
• Form columns of stacked cells parallel to the long
axis of the bone
3. Hypertrophic cartilage zone
• Large chondrocytes who cytoplasm has accumulated
glycogen
• The resorbed matrix is reduced to thin septa
4. Calcified cartilage zone
• Simultaneous with the death of chondrocytes
• The thin septa become calcified
5. Ossification zone
• Endochondral bone tissue appears
• Blood capillaries and osteoprogenitor cells formed by
mitosis of cells originating from the periosteum
invade the cavities
• The osteoprogenitor cells form osteoblasts
• Osteoblasts turn form a discontinuous layer over the
septa
• Over these septa, the osteoblasts deposit matrix
MECHANISMS OF CLASSIFICATION
Bone calcium is mobilized by two mechanisms :
1. Rapid Mechanism
The simple transference of ions from hydroxyapatite crystal
to interstitial fluid into the blood
2. Slow Mechanism
Depends on the action hormones
a. Parathyroid hormone
Activates and increases the number of cells (osteoclasts)
promoting resorption of the bone matrix with the
consequent liberation of calcium
b. Calcitonin
Inhibits matrix resorption (its effect, is the opposite of
parathyroid hormone)
FRACTURE REPAIR
When fractures :
• The damaged blood vessels product a blood clot
• Destruction of bone cells
• Death of Bone cells
During repair :
• The blood clot, cells and damaged bone matrix are
removed by macrophages
Repair of a fractured bone by formation of new bone tissue through periosteal
and endosteal cell proliferation
MUSCLE TISSUE
Muscle tissue is composed of differentiated cell containingcontractile proteins. The structural
biology of these proteinsgenerates the forces necessary for cellular contraction,
which drives movement within certain organs and the body
as a whole muscle kinds
- Smooth muscle
- Skeletal muscle
- Cardiac muscle
Smooth muscle ; consists of collection of fusiform cells that in the light microscope, do not
show striatims Their contraction process is slow and not show subyect to voluntary control.
The cytoplasm of muscle cells (exluding the Myofibri) is called sarcoplasm, and the smooth
endoplasmic reticulum is called sarcoplasmic reticulum. The sarcolemma is the cell
membrane or plasmalemma
Skeletal muscle : is composed of bundles of very long,Cylindrical, multinucleated cells that
show cross-striations. Their contraction is quick, forceful, and usually under voluntary,
control. It is caused by the interacrions of this actin filaments and thick myosin filaments
whose molecular configuration allow them to slide upon one another.
The forces necessary for sliding are generated by weak interactions in the bridges that bind
actin to myosin.
Cardiac muscle : also has cross-striations, and is composed of elongated, branched individual
cells that lie parallel to each other. At sites of end to end contract are the intercalated disks,
structures found only in cardiac muscle. Cardiac muscle contraction is involuntary vigorous,
and rhythmic
INNERVASI
1. MULTI - UNIT
2. TYPE – VISCERAL
SKELETAL MUSCLE Macroscopic - Muscle fibre of red - Muscle fibre of white - Muscle fibre of transition
- Shape :to lie diagonal Drawing of to lie diagonal line multynuclear nucleus in the side
Shape of to lie diagonal skeletal muscle sheaf
Diagram of a segment of mammalian skeletal muscle. The sarcolemma and muscle fibrils are partially cut,showing the following components: The invagination of the T system (show in color: T and 5) occur at the level of transition between the A and I bands twice in every sacomere. They associate with terminal cisternae of the sarcoplasmic reticulum (3), formingtriads. Abundant mitochondria (4) lie between the myofibrils. The cut surface of the myofibrils (1) shows the thin and thick filaments. Surrounding the sarcolemma are a basal lamina (7) and reticular fibers (8). (Reproduced, with permission, from Krstic RV:Ultrastructure of the Mammalian Cell Springer-Verlag, 1979)
Initiation of muscle contraction occurs by the binding of Ca2+ to the TnC unit of troponin, which exposes the myosin binding site on action (cross-hatched area). In a second step, the myosin head binds to action and the ATP breaks down ADP, yielding energy, which produces a movement of the myosin head. As a consequence of this change in myosin, the bound thin filaments slide over the thick filaments. This process, which repeats itself many times during a single contraction, leads to a complete overlapping of the action and myosin a resultant shortening of the whole myofiber
Diagram of a section of heart muscle, showing central nuclei and intercalated disks
HISTOGENESIS AND REGENERATION
OF MUSCLE TISSUE
Histogenesis
• Smooth muscle : mesenchym tissue --->myoblast
• Skeletal muscle : myoblast ---> sinsytium
• Cardiac muscle : splanchnopleura (myoblast)
Regeneration
• Smooth muscle : - muscle cell
- mesenchym cell
• Skeletal muscle : - nucleus + sarcoplasma
- in charge myoblast
• Cardiac muscle : - very difficult
3.Fisiologi Sistem Rangka dan Otot
3.1 Pendahuluan
Sistem rangka bersama-sama sistem otot membangun dan membentuk tubuh secara
keseluruhan. Sistem kerangka dibungkus oleh sistem otot yang bertanggung jawab dalam
fungsi gerakan tubuh melalui fungsi khusus, yaitu kontraksi otot.
3.2 Maksud dan Tujuan
Mahasiswa harus mengetahui dan mempunyai kompetensi dalam :
1. Organisasi sistem kerangka dan otot.
2. Menjelaskan mekanisme kerja dan fungsi sistem kerangka dan otot.
3. Karakteristik kontraksi otot polos, otot lurik dan otot jantung.
4. Menjelaskan kelainan fungsi sistem kerangka dan otot.
3.3 Kegiatan
3.3.1 Sistem Kerangka
Sistem kerangka dibangun oleh struktur tulang yang terdiri dari : tulang tengkorak, tulang
belakang, tulang dada, tulang rusuk, tulang bahu, tulang belikat, tulang ekstremitas atas dan
bawah, serta tulang panggul.
3.3.1.1 Fungsi Sistem kerangka
Sistem kerangka berfungsi :
1. Sebagai penyokong struktur tubuh dan memberikan bentuk pada tubuh
2. Melindungi organ organ dalam yang lunak dan penting
3. Sebagai pengungkit yang pasif dalam pergerakan tubuh
4. Sebagai gudang penyimpan mineral seperti kalsium dan fosfor.
3.3.1.2 Fungsi sendi
Sendi adalah jaringan penyambung yang berfungsi menghubungkan tulang dengan tulang,
sebagai tempat pertemuan tulang dengan tulang yang befungsi untuk pergerakan sistem
kerangka tubuh.
Jenis pergerakan sendi yaitu :
1. Fleksi: gerak membengkok ke depan
2. Ekstensi: gerak meluruskan dari gerak fleksi
3. Abduksi: gerak ekstremitas menjauhi garis tengah tubuh.
4. Aduksi: gerak mendekat garis tengah tubuh
5. Rotasi: gerak memutar pada sumbu sentral.
3.3.1.3 Kelainan Tulang
Kelainan yang terjadi pada tulang diakibatkan beberapa faktor, diantaranya :