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Dermato-Musculoskeletal System, Absorbsi dan Ekskresi Kalsium dan Fosfat,…
Dermato-Musculoskeletal System
Dermato
Anatomy
Epidermis
S. corneum
20-30 layer
Korneosit
S. lucidum
2-3 layer
Hanya ada di lapisan tebal
S. granulosum
3-5 layer
Granula keratohialin
S. spinosum
Melanocyte
Langerhan Cell
S. basale
aktivitas mitotik
Merkel cell
Dermis
Papilary
Retikular
.
Sebaceous gland
Hair folicle
Arrector pili m.
Sweat gland
Apocrine
Eccrine
Free nerve ending
Messiner's corpuscle
Pacinian corpuscle
Blood vessels
Ruffini corpuscle
Fisiologi
Permeability Barrier
Thermoregulation
Protection from pathogen
Sensation
UV protection, Vit. D3 synthesis
Wound repair/regeneration
Physical Appearance
Patologi
Reaction to dermatogic medication
Irritation
Urticaria
Dermatitis
Photoirritation
Efloresensi
Primer
Makula, Papula, Plaque, Nodul, Vesikel, Bula, Pustula, Urtika
Sekunder
Skuama, Likenifikasi, Krusta,Erosi,Fisura, Ulkus, Sklerosis
Veruka Vulgaris
HPV tipe 2, 4, 27, 57
Peningkatan proliferasi --> hiperplasia sel
kutil
Salep salisilat 50%
Lesi berbentuk kembang kol, ukuran ≤ 1cm
Varicella Zoster
Varicella-Zoster Virus
Unilateral, dermatomal pain and rash
gejala prodromal
Dorman --> Herpes Zoster
Impetigo
Streptococcus, Staphylococcus aureus
honey crust lesion
mupirocin
Tinea
Versikolor
Pityrosporum
Lampu wood:kuning keemasan
makula hipopigmentasi
Korporis
Tricophyton
manus, pedis, barbae, dll
central healing lesion
antifungal topikal atau sistemik
Lampu wood: hijau
Skabies
Lebih gatal saat malam hari
Sarcoptes scabiei
lesi kanalikuli sekitar 2cm
Luka Bakar
Derajat 1,2,3,4
Panas, Listrik, Bahan Kimia, Suhu Dingin,dll
Histologi
Epidermis
Sel Melanosit
Sel Langerhans
Sel Merkel
Sel Keratinosit
Dermis
Serat kolagen tipe 1 dan 3
Proteoglikan
Serat elastis
Other Structure
Teeth
Molar
Premolar
Canine
Incisor
Nail
Nail matrix
Nail groove
Nail root
Hyponychium
Eponychium
Hair
Cuticle
Cortex
Medulla
Musculoskeletal
Anatomy
Head
Bones
Neurokranium
frontal, occipital, temporal, parietal, sphenoid, ethmoid
Viserokranium
maxilla,madibule,conchae,ethmoid,nasal,vomer,lacrimal,zygomaticum,palatine
Muscle
occipitofrontalis, corrugator supercili, nasalis, orbicularis oculi, orbicularis oris, zygomaticus mayor and minor, mentalis, platysma, depressor anguli oris, depressor labii inferioris, levator labii superioris, risorius, buccinator
Facial expression
Innervation
CN V (Trigeminal Nerve)
CN VII (Facial Nerve)
Joint
Temporomandibular
Back
Bones
33 vertebra
7 cervical
12 thoracal
5 lumbal
5 sacral
4 coccygeal
Joint
Zygopophysial
IV disk
Atlanto-occipital
Atlanto-axial
Muscle
Extrinsic
trapezius, latissimus dorsi, levator scapulae, rhomboid, serratus posterior
Intrinsic
splenius, illicostalis, longisimus, spinalis, multifundus, semispinalis, rotatores, interspinalis, intertransversarii, levatores costarum
Innervation
Anterior and Posterior Ramus
Neck
Bones
Cervical vertebrae, hyoid bone, manubrium of sternum, clavicle
Muscle
platysma, SCM, trapezius, splenius capitis, levator scapulae, scalene, digastric, myohyoid, geniohyoid, stylohyoid, sternohyoid, omohyoid, sternothyroid, thyrohyoid
Innervation
root of cervical plexus (C1-C4), Vagus Nerve, Phrenic Nerve, Symphatetic Trunk
Upper Limb
Region
Pectoral, Scapular,Deltoid, Brachium, Antebrachium, Manus
Bones
Clavicle,Scapula, Humerus, Radius, Ulna, Bones of Hand
Muscle
Pectoral and Scapular Region
Pectoralis, subclavius, serratus anterior, dll
Arm
biceps brachii, brachialis, triceps brahii, and coracobrachialis
Forearm
fleksor-pronator (anterior)
ekstensor-supinator(posterior)
Hand
thenar eminence, hypothenar eminence, interosseus, lumbricalis
Innervation
Brachial Plexus
C3-T2
Lower Limb
Region
Gluteal, femoral, patela, leg, ankle, foot
Bones
ilium,ischium, pubis, femur, tibia,fibula,tarsus, metatarsus, phalanges
Muscle
Gluteal
gluteus(3), piriformis, gemellus, illiopsoas, quadratus femoris
Thigh
Anterior
Lateral
Posterior
Foot
ekstensor hallucis longus, ekstensor digitorum, lumbricalis, interosseus,fleksor digitorum
Leg
Anterior
Lateral
Posterior
Histology
Bone
Bone Cells
Osteocyte
Osteoblast
Osteoclast
Bone Matrix
Organic
Inorganic
Type of Bone
Woven/Spongy
Lamellar/Compact/Cancellous
Periosteum & Endosteum
Osteogenesis
Endochondral
Intermembranous
Bone Repair
Hematoma forms
Fibrocartilaginous calus forms
Hard calus forms
Bone remodeled
Cartilage
Hyaline
Elastic
Fibrocartilage
Joint
Synovial Membrane
Joint cavity
Articular Ligament
Fibrous Layer
Muscle Tissue
Sarkoplasma
Sarcolemma
Retikulum Sarkoplasma
Myofibers
Sarkomer
Physiology
Bone
Muscle
Patology
Osteomielitis
Infeksi tulang (S. aureus mostly)
Diagnosis: CBC, Bone Biopsy, CT-Scan, MRI
Treatment: Antibiotics, surgery,amputation
weakness, fever, not swelling
Osteoporosis
Post-menopausal ( tipe I), senilis (tipe II), gangguan hormon atau penyerapan kalsium (sekunder)
Diagnosis: T Score < -2,5
Treatment: Bisphosphonates,Teripartide, Thiazine Diuretics, Vit. D
Prevention: excercise, vit. d and ca2+ food source
tulang keropos
Silent Epidemic
1 dari 3 wanita, 1 dari 5 pria mengalami osteoporosis
Kasus fraktur akibat osteoporosis
20% meninggal dunia dalam satu tahun
Produktivitas menurun
Menghambat Indonesia Emas 2045
OSTEOCAR
Pendekatan Keluarga
Tindakan Preventif
skrining rutin dan jalani pola hidup sehat
3 more items...
1/3 butuh bantuan orang lain
1/3 hanya bisa berbaring
1/3 bisa sembuh dan beraktivitas normal
Kerugian dana
alokasi dana untuk pembangunan berkurang
Prevalensi Osteopenia 41.7%
2 dari 5 penduduk Indonesia terancam osteoporosis di masa tua
Osteoarthritis
usia tua, stress, obesitas, trauma, RA, gout, dll
kerusakan sendi
swelling, krepitus, weakness, deformitas
Treatment: NSAID, Steroid, Acetaminiophen
Fraktur
Trauma, stress, patologis
Classification
Close
Open
IIIA
IIIB
II
IIIC
I
Treatment
Reduksi fraktur
Imobilitas
Rehabilitation
diskontinyu tulang
Farmakology
Anti-inflamasi
NSAID
Cox 1-2 Inhibitor
Aspirin/Asetosal
Cox 2 Inhibitor
Celecoxib
Cox 3 Inhibitor
Paracetamol
Non-selective COX Inhibitor
Ibuprofen
Naproxen
Semiselective
Meloxicam
Diclofenac
Steroid
Prednison
Dexametason
Metil Prednisolon
Anti-bacterial
Mupirocin
Inhibit RNA and protein synthesis
Obat impetigo
Polimiksin B
Disrupt outer cell membrane, neutralize lipopolysaccharide, and inhibit respiration
Infeksi bakteri (-)
Antiviral
Acyclovir
Herpes labialis
Menghambat enzim spesifik pada virus
Pensiklovir
Herpes genitalia
Menghambat DNA polimerasi virus
Antifungal
Azole Derivate, Allylamine
Ergosterol synthesis disruption
Candida albicans, Pityrosporm orbiculare
Nystatin
increase membrane permeability
Candida albicans
Acne Treatment
Retinoid Acid & Derivate
meningkatkan regenerasi
Benzoyl Peroxide
mengurangi lipid, asam lemak bebas, dan P. acnes
Drug in Gout
Kolkisin
Allopurinol
Prednison
Antirheumatics
Abatacept
Chloroquine
Adalimumab
Siklosporin
Affect Bone Homeostasis
Hormonal
Calcitonin
Glucocorticoids
Estrogen
Non-hormonal
Biphosphonates
Thiazide Diuretics
Denosumab
Vit. D
Absorbsi dan Ekskresi Kalsium dan Fosfat
Usus
Ginjal
PTH
Calcitonin
Vit. D
Resorpsi dan Formasi
OPG
Inhibisi osteoclast
PTH
Osteoblast (OPG Receptor)
RANKL dan MCS-F
Osteoclast
Contraction of Smooth Muscle
Actin
Tanpa troponin
Attach to dense bodies
Miosin
Control by autonomic nerve
Need Ca2+
Without sarcomer structure
Contraction of Skeletal Muscle
Mechanism
Actin
Tropomyosin
Troponin
Ca2+ present
Contraction
No Ca2+
Relaxation
Miosin
Bind with and pull actin
Act if ATP present
Characteristic
Isometric
Untuk menahan gaya
Isotonic
Untuk bergerak
Energy Source
Phosphocreatine
Products of Glycolysis
Oxidative Metabolism
Type
I (Slow Oxydative)
IIA (Fast Oxydative)
IIB (Fast Glycolytic)
Tia Idovanni Purba
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