1.

Explain and draw on the body region and body position

1. Position (posture)
Posis can be divided into 4 kinds of postures:
a. usual manner (fundamental standing posture) inclination pelvis (pelvic tilt) of 60o and
body are in labile equilibrium because of the weight point is above the transverse axis
(axis latitude), which through the two articulatio coxae which represents backers point
gain and transverse axis lies in frontal plane axis transverse joints along with the head
(articulatio atlanto occipitalis), the shoulder joint (humeral articulatio), knee joint
(articulatio genus), and joint top of the jump (articulatio talocruralis). In this attitude there
are no muscles that work because the body had been in a state of balance. on this attitude
b. attitude break
in this attitude pelvis (pelvic) rotated to the back of approximately 150, so that
iliofemorale stretched ligament. Weight point located behind the latitude axis (transverse
axis) groin. Weight line runs behind the articulatio coxae, front articulatio genus, and cut
off the feet at the highest place on the talus. In articulatio genus, the second thigh bone to
the front of the facies articularis condyli femoris met with condyli tibiae, so that the joints
have hyperextension. In this attitude there is no muscle is working, because the weight is
hung on iliofemorale ligament that will hold weight.
c. military attitudes
in this posture the pelvis rotated to the front and the angle lumbosacralis shrinking.
Weight point in front of coxae articulation axis tranversal, articulation and articulation
talocruralis genus. The balance is achieved because of the contraction m. erector trunci,
m. gluteus maximus, m. ischioa cruralis and dull muscles (flexor) lower leg like m.
gastrocnemius, m. soleus, m. plantar, and m. tibialis posterior.
d. anatomical position
for descriptive purposes of the human body is always seen in the anatomical position, the
man standing upright (as in the fundamental attitude) with eyes looking forward, arms
hanging at his sides with your palms facing forward. Body straight, both feet side by side
with the fingers pointing forward.
2. Field orientation
Human body three-dimensional form so that the introduction of the median area, the
frontal plane and transverse field. Median field is a field that divides the body into two
equal parts of left and right. Sagittal field is a field that is parallel with the median area.
Field paramedian sagittal fields are parallel to the left and right field of the median.
frontal plane is a field that is perpendicular to the field and the median and parallel to the
long axis of the body. Transverse field is a field that is perpendicular to the frontal plane
and perpendicular to the area median.
The terms relating toto the location is :
• Anterior: location closer to the front body
• posterior: lies more with the rear body
• Superior: location closer to the head
• Inferior: more lies near the foot
• medial: location closer to the median field
• Lateral: medial area lies further
• Cranial: towards the head
• caudal: toward the tail
• dorsal: toward the back
• Distal: towards the end
• proximal: heading to the base
2. Describe the muscles below the picture at the macro and microscopic

each consisting of skeletal muscle fascicular (file fibra muscular) which is wrapped
connective tissue called epimysium. The files are separated by a network fibra
epimysium entering into dibut perimysium, and every file fibra.
  emdomysium diseliputi muscle. Each fibra superficial muscles have many nuclei, as
well as mitochondria and organelle. Cell membrane or sarcolemma of muscle around
sarcoplasma fibra. Sarcolemma have the nature of trans-membrane potential (electrical
current can be stimulated) is where the first phase of the ongoing contraction.
a muscle fiber cells that can "creep" to follow the entire length of the muscle, containing
the file (fibra) myofibril is composed of many parallel and immersed in the intracellular
fluid with high-energy compound ATP is required for glycolysis. By using electron
mikrskop myofibril can be seen as dark and light bands turns. This tape each band called
A (anisotropic) dark ribbons, and tape I (isotrop) bright ribbon. A central area band called
H band (Zone H, Helle) looks solid compared to other parts of the tape. Band I was
divided in two by Z lines is called sarcomer. Sarcomer is the functional unit of muscle.
Sarcomer repeated along the myofibril axis with the distance between registration for
1500 - 2300 nm depending on the state of contraction.
Because of the fibrous skeletal muscle contraction signal must go inside the cell. For
entry into the cells used in the course of transverse tubules called transverses tubules (T
tubules). T tubule is narrow and tubular journey begins from the sarcolemma toward
sarcoplasma, with a street perpendicular to the surface of the cell membrane.
Extraselluler T tubules containing fluid and a discharge path through fibra muscular.
a. myofibril
myofilamen myofibril is a file consisting of filament proteins formed mainly by the actin
and myosin. Myofibril can shorten actively. They are the organelle that is responsible for
muscle contraction fibra. At each end fibra skeletal muscle myofibril attached (tied) in
the sarcolemma. Consequently when the myofibril to contract the cell selurul will
shorten. Among the scattered myofibril contained mitochondria and glycogen granules,
which is bentk glucose reserves. Breakdown of glucose through glycolysis of the activity
of mitochondria generate ATP needed for muscle contraction.
Each myofibril is built from two types of filament longitudinal namely:
• thick filament is limited to the band A mainly contains protein myosin. In cross section
arranged in a hexagonal shape.
• Filament flat situated in the bands A and I are also stuck in the band but not to the zone
Z. This flat filament proteins contain actin, tropomyosin, and troponin. In the tape A, the
filament flat arranged around the thick filament (myosin) as secondary and shaped
hexagonal arrangement. Each filament flat situated symmetrically between three thick
filaments, and each thick filament is surrounded symmetrically by a flat filament element.
Filament thick and flat to each other through mutual interaction of cross bridges (cross
bridge) which appear at intervals of 14 nm along the thick filament. Both ends of the
thick filament have opposite polarity and separated by segments that do not have a bulge
(linea M). Filament and lamellar thickness and arranged in interdigital. Cross-bridge
model is the basis of the theory of filament shifts (sliding filament theory) that is used for
member clarification process of muscle contraction.

b. Sarkomer
sarkomer is the smallest functional unit of muscle fibra that stretches between 2 line Z.
disibi can be seen the interaction between thick and flat filament is responsible for muscle
contraction. Sarcomer contain elements
• thick filament
• flat filament
• proteins that function as stabilizers and thick filament lies flat
• protein that regulates thick filament interactions and flat.
Sarkomer sightings can be seen by differences in size, density, and distribution of thick
filament and filament flat. Appearance sarkomer showed dark areas and bright when
viewed with polarized radiation (with a light microscope or electron microscope). Dark
areas are composed of thick filament and a portion of flat filament tape called A (A
band).
Bright regions which consist of flat filament tape I just called (I band). (A band = band =
Discus anisotropicus anisotropy); (I band = band = Discus isotrop isotropicus). Thick
filament is located within band A in the central part sarcomer. The length of tape A is
equal to the length of filament thickness. A ribbon terdsiri from:

a. A band (A band)
• M-line (mesophragma)
The middle of each thick filament protein associated with the neighbor with M line.
These proteins help make the layout stable thick filaments.
• Zone H (H = Helle = bright = zone lucida = stria Hensen)
It is a rather bright area next to the M line. H zone consists of thick filament and no flat
filament, can be seen in fibra muscle is relaxation.
• Zone overlap (overlap zone)
In the zone tumapang flat filament overlap in the encounter between the thick filament.
This place is situated in daerahsegitiga slender filament which formed a thick filament,
and each thick filament surrounded by six flat filament.
b. I tape
I tape stretched between the tape A one sarcomer with ribbon A sarcomer next. Line Z
(zwischen scheibe) becomes the boundary between two adjacent sarcomer. Z line consists
of a protein called connectin. This protein combines with a flat filament sarkomerny.
From the Z line endings sarkomer place, flat filament toward the M line and form a zone
of overlap. Diadapati two transverse tubules that encircle each sarcomer and packed sis
triads on each line M in the region overlapping zone. Triad is a combination of a pair of
cisterna terminalis with tubules T. as a result, when the ions released by the reticulum
sarcoplasma then untainya actin side and into the thick filament region and the flat can be
joined (attached cross bridges). Because of the band A and band I, the skeletal muscle
revealed the existence of the dark and part
alternately so that visible light striped / patterned and latitude referred to as muscle fibers
(striated muscle)
c. flat filament
Flat filament proteins contain F actin, tropomyosin, and troponin. F actin (actin filament
is a twisted strands and is formed by molekula globular actin (G.actin). Every molecule
G. actin has an active side of the thick filament that can bind with the same path as the
substrate molecules bind to the enzyme active site. In the resting state relations myosin
prevented by troponin-tropomyosin complex.
Tropomyosin strands covering the active site and prevent actin-myosin interaction. A
tropomyosin molecule is a protein sequence that is always covered the seven active side.
He was joined by one long amid tropomyosin troponin molecule.
Troponin molecule consists of three globular sub-units, namely:
• Sub unit that binds tropomyosin
• Sub-units that bind G. actin,-tropomyosin complex holds troponi tetentu position.
• Sub-units that have a receptor that binds low intracellular calcium ions, and the
bergabunga is empty.
Contraction can not occur until there are changes in the position of troponin-tropomyosin
complex that opens the active side of F. actin. Changes in position can occur when
calcium ions bind to receptors that exist on the troponin molecule.
d. thick filament
Each filament consists of more than 500 vests myosin molecule. A myosin molecule
consists of a melinkari sepasangsub myosin units to each other. Globular part (caput)
protruding toward the nearest flat filament. Long part (cauda) myosin molecules bind the
 other contained in the thick filament to another. Caput myosin interact with F. actin
filament flat on its active side subs contraction. Imnteraksi produces buildings called
cross bridges.

3. Identify different types of human muscle

A. Muscle Lurik
• Another name: skeletal muscle, muscle fiber cross (striated musculus)
• Structure: fiber length, color / striated with lines of light and dark, has a core in large
quantities and is located alongside. Muscle ends are attached to the frame called tendons.
Tendons attached to bone that moves when the muscle contracts is called insersia.
Tendons are attached to the bones that remain in his position is called origin.
• Contraction: according to our will (under control of the central nervous system), fast
motion, strength, fatigue and irregular.
• Example: back muscles, thigh muscles, etc..
• The structure of skeletal muscle anatomy like the picture below!

B. Muscle Polos
• Another name: muscle the tools in / visceral / musculus nonstriated.
• Structure: the form of long fibers such as coil, with a pointed tip, with a core number
one located in middle.
• Contraction: not according to the will or beyond the control of the central nervous
system, slow movements, rhythmic and not easily tired.
• Example: the stomach muscles, intestinal muscle, muscle blood vessels, etc..
C. heart muscle
• Another name: myocardium or musculus cardiata
• structure: Form serabutnya elongated, cylindrical, branched. Visible presence of light
and dark lines. have a single nucleus located in the middle
 • Contraction: not according to the will, slow motion, rhythmic and not easily tired

4. Identification of a major muscle in the human body

1. Biceps

2. Sternoclei Domastoid

3. Pectoralis Major

4. Rectus Abdominus

5. Rectus Femoris

6. Tibialis Anterior

7. Trapezius

8. Rhomboid

9. Triceps

10. Deltoid
 11. Extensor Digitorum

12. Gloteus Maxsimus

13. Vastus Lateralis

14. Gasctrocnemius

5. Describe how the process until the release of neurotransmitter can stimulate the
occurrence of muscle contraction
Neurotransmitters are the chemicals that are released by the presinaps to the post-synaptic
to deliver impulses from one neuron (nerve cell) to another neuron. When the impulse
reaches the synapse, dining gate will open and calcium ions - calcium ions will enter into
presinapsis. This will stimulate the calcium ions inside the vesicles to release
neurotransmitter presinaps in eksositosis. Once out, the neurotransmitter will go to the
postsinaps and will stick to its receptor so that ion gate will open at the post-synapse.
With the opening of ion gates, the ions that exist outside the nerve fibers will enter and
become involved in further impulse to the nerve fibers. There are several
neurotransmitters that have been known and identified to date, including among other
things
1. Acetylcholine
Is a neurotransmitter that is released by nerve - parasympathetic nerves and nerve -
preganglionic nerve.
2. Norepinephrine
Is the only neurotransmitter released by nerves - the sympathetic nerves. In addition,
norepinephrine as well as a hormone produced in the adrenal gland.
3. Serotonin
Is a neurotransmitter in the brain that functions as an inhibitor of appetite and cause a
sense of calm.
4. Dopamine
 Also present in the brain, but its function as opposed to serotonin. Dopamine normally
secreted when we are in a state of stress, depression, worry, etc..
5. GABA (Gamma Amino Acid Butiric)
Is a neurotransmitter inhibitor, meaning that would impede delivery of impulses in nerve
fibers. GABA will open the gate negatively charged chlorine ions so that nerve fibers will
be charged highly negative. That way the impulse is difficult to be conducted through the
nerve fibers.

6. What is the process of muscle contraction

1. Action potential of motor neurons to the neuro-muscular junction (end-plate) → end-
plate potential
2. Secretion of the neurotransmitter acetylcholine from the nerve endings
3. Acetylcholine-gated channels in muscle membrane open
4. Na ions into the muscle fiber action potential →
5. Action potential spreads along the muscle fiber membrane
6. Depolarization arise to sarkoplasmik → reticulum Ca ions in the release into miofibril
7. Ca ions to initiate the process of attraction of actin and myosin → sliding actin and
myosin contraction →
8. Ca pump back into the reticulum ionCa sarkoplasmik → contraction stop (relaxation)

7. Describe the molecular events in muscle contraction

There are 12 phases of the molecular events of muscle contraction

 a. At the beginning of contraction, ATP binds to myosin in the side of an enzyme
called ATP-ase hydrolyze
b. ATP-ase break ATP into ADP, inorganic phosphate, and energy. All components
remain attached to the myosin head.
c. Enzyme hydrolysis activates the myosin heads into the inclined position of each
bind actin.
d. Ca ions which have been disposed of sarcoplasmic reticulum binds to troponin
attached to tropomiosin and actin
e. Troponin complex and Ca composition changes that allow tropomiosin actin away
from the barrier position.
f. Myosin binding on actin side then opens to allow the attachment on the side of
actin binding in myosin head
g. At the time of binding, ADP and ATP is released from chief inorganic myosin
and myosin head moves, rotates in the opposite direction to pull the actin
filaments attached to the ribbon H (power stroke myosin heads)
h. Myosin head remains firmly attached to actin until a new ATP molecule attached
to it and weaken the bond between actin and myosin.
i. Regardless of the actin myosin heads, leaning back and ready to be attached to
actin in the new side, turn around and go back interesting to repeat the cycle.
j. The cycle occurs in thousands of myosin heads during nerve stimulation is still
there and the amount of Ca ions and ATP are sufficient.
k. Muscle relaxation occurs when the nerve stimulation stopped and Ca ions are no
longer removed. Ca ions are transferred back into the sarcoplasmic reticulum Ca
pump in the sarcoplasmic reticulum membrane.
l. Rigot mortis ATP is required separately to remove myosin from actin. Depletion
of ATP in the muscle and total inability to produce more ATP, as was the case
when dead. Resulting in permanent attachment of actin and myosin resulting in
muscle rigidity (stiffness).

8. Explain the source of energy in muscle contraction and how the process
 Sources of energy for muscle cells is adenosine triphosphate (ATP) generated by cellular
oxidative metabolism. Creatinine phosphate is also present in muscle cells play a role as
second reserve energii metabolism can be converted to ATP when necessary. At low
activity, skeletal muscle mensitesis ATP from oxidation of glucose to water and carbon
dioxide. During the period of high activity, if not terdsedia adequate oxygen, especially in
the metabolism of glucose into lactic acid. Although ATP can also be generated during
the production of lactic acid, this process is inefficient when compared with oxidative
path. So that more glucose is required and must be provided by muscle glycogen.
Glycogen is a starch made from glucose, is stored in the cells during periods of rest, and
used for a period of inactivity. Muscle fatigue may be caused by solving the energy
savings as well as glycogen and lactic acid buildup. As a result, the circular muscle
contraction and relaxation can not continue.
9. Draw the vascularization in the muscles
Vascular is a tract or blood vessels, so it is a muscle vascularization of blood vessels /
blood circulation in the muscle.
muscle
a.Vaskularisasi skeletal muscle

In skeletal muscle there are blood vessels / arteries that can penetrate layers of
endomysium which will then be circulated to kpiler small-capillary blood.
b. Cardiac muscle vascularity
 The heart is a muscular organ that pumps blood, the heart itself contained the blood
vessels that supply blood to the heart. Heart obtain blood supply through coronary
arteries. Coronary artery branches into two parts, namely the right and left. Right and left
coronary arteries who were the first to leave the aorta and then branch into arteries ang
smaller. These small arteries around the heart and deliver blood to all parts of the heart
organ. Blood returning from the heart mainly collected by the coronary sinus and straight
back into the right atrium.
10. Identification of the human skeletal system
Axial Skelet: Appendicular Skeleton:

1. Skull 1. Scapula & Collarbone

2. Sternum 2. Upper limb bones
3. Ribs 3. Hip
4. Vertebrae 4. Lower limb bones
5. Sacrumon

Axial Skeleton:
1. Skull
- Os Occipitale
- Os Parietale
- Os Temporale Cranium
- Os Frontale
- Os Sphenoid
- Os Ethmoid
- Os Maxilla
- Os Palatine
Face
- Os Nasal
- Vomer
- Concha nasal inferior
- Os Zygomatic
- Os Lacrimal
- Mandibula
- Ossicles auditori & Os Hyoid
2. Os Sternum
- Manubrium sterni
- Louis angle
- Corpus Sterni
- Processus Xyphoideus
3. Ribs/Costae
- Costae vera
- Costae spuriae affixae
- Costae spuriae fluctuantes
4. Vertebrae
- Cervical
- Torakal
- Lumbal
5. Sacrum

Appendicular Skeleton:
1. Scapula & Collarbone

2. Upper limb:

 Os Scapula
 Os Clavicula
 Os Humerus
 Os Radius
 Os Ulna
 Os Carpals
 Ossa Metacarpals
 Ossa Phalanges

3. Hip

4. Lower limb bones:

 Os coxae (Os Ilium, Os Ischium, Os Pubis)

 Os Femur
 Os Patella
 Os Tibia
 Os Fibula
 Os Tarsals
 Ossa Metatarsals
Ossa phalanges
 11. Explain the structure and function of bone at the macro and microscopic

In Macro, the bone can be distinguished by the form and matrix.

Based on the shape, the bone is divided into pipe bone, flat bone, short bone, and bone out of
shape.

a) .Bone pipe

Bone pipeline has the characteristics:

• oval shape like a pipe.

• At both ends gnarled.

• It contains yellow marrow and fat. Yellow marrow is a provision for the formation of red
marrow.

6. Examples: femur, upper arm bone, bone In Macro, the bone can be distinguished by the form
and matrix.

Based on the shape, the bone is divided into pipe bone, flat bone, short bone, and bone out of
shape.

Bone pipeline has the characteristics:

• oval shape like a pipe.

• At both ends gnarled.

• It contains yellow marrow and fat. Yellow marrow is a provision for the formation of red
marrow.

Examples: femur, upper arm bone, bone

dried calf bone, joints of fingers / toes vertebra, ulna, and bone lever

Bones pipe is divided into 3 parts, namely:

• The end of the so-called epiphyseal.

• The middle part is called diafisis.

• In between epiphyseal and epiphyseal diafisis there chakra (disc epiphysealis). This chakra is
rich in osteoblasts and to determine high growth. In its center there are cavity containing bone
marrow. Cavity formed by the activity of osteoclasts (bone decomposer).

b. Flat bone

• Form of flat or thin.

• It contains red marrow, where the manufacture of red blood cells and white blood cells.

• Example: the head bone (skull), ribs, sternum, and scapula.

c. Short bone

• Establish short and round.

• It contains red marrow, where the manufacture of red blood cells and white blood cells.

• Example: the joints of the spine, wrist, and ankle.

d. Bone shapeless

 Having a specific shape

 Bones have face and spine.

Based on the matrix, the bone divided by 2 is:

1. Compact bone

It is a bone with a dense matrix and meetings, such as bone tube.

2. Spongy bone

Is a hollow bone matrix, such as flat bones and short bones.

Microscopically, bone is distinguished by its network.

Based on the type of tissue, bone can be divided into two, namely cartilage (cartilage) and hard
bone (bone / osteon / true).

a. Cartilage

Cartilage is flexible, composed of cartilage cells (chondrocytes) that secrete matrix (kondrin) of
hyaline or collagen. In cartilage contains a lot of gluten in the form of collagen and contain little
substance lime. That's why cartilage is flexible. Cartilage cells or chondrocytes formed by
chondroblasts. In infancy or during the growth of most bones are still in the form of cartilage.
Along with the growth of infants and older, experienced bone-cartilage ossification (ossification)
so that the bones are not flexible anymore, but rather grow up to be hard. However, not all
experienced reinforcement and permanent form of cartilage. For example, in the joints, ears,
nostrils, and the joints of the spine.

Cartilage has three types, namely hyaline, fibrous, and elastic. Consider figure 3.1. All three have
the following characteristics:
1) hyaline cartilage

Hyaline cartilage is flexible, semi-transparent, white and blue. Cartilage is a compiler framework
of embryos that will develop into hard bone. In addition to the embryo, hyaline cartilage was also
present in the joint motion of the rib tip, nose, bronchi, and trachea.

2) fibrous cartilage (fibrokartilago) / Fibre

Matrix containing collagen fibers rough and irregular; located in attachment ligaments, joints of
the spine, and symphysis pubis. The other characteristic of this cartilage is lakuna - lakunanya
round or oval and contain cells - the cells (chondrocytes).

3) Elastic Cartilage

Polikandrium composition, matrix, cells and elastic cartilage Lacuna same as hyaline cartilage.
However, collagen fiber elastic cartilage not spread and real as in hyaline cartilage. Forms of
fiber - elastic fibers bumpy. elastic cartilage found in the epiglottis and the outer ear.

b. Hard bone (bone true)

Hard bone formation originated from cartilage (derived from mesenchyme). Hard bone is made
up of hard bone tissue, which consists of bone cells (osteosit) that form a circle. In the middle
there are bone cells Havers channels. In the Havers channels are capillaries that function to
transport nutrients and oxygen on bone cells.

In many bone hard calcareous (calcium) and low in gluten. Matrix will issue a lime and
phosphorus that causes bones to become hard. The hardening process is called ossification or
bone ossification. Consider Figure 3.2. Type of ossification is desmal and kondral. Kondral
include perikondral and enkondral. Desmal is the reinforcement of hard bone, while kondral is
the reinforcement of cartilage.

Transverse slices (transverse) in the dense layers of bone shows a beautiful painting circles. In
the center of each circle there are canals or channels Havers. Bone plates or lamella arranged
concentrically around the channel and between the plates there is little room called Lacuna.
These rooms contain bone cells, interconnected with each other and also connected with Havers
channels in the middle by small ducts called kanalikuli. Each painting is tebentuk dengna Havers
thus is a complete system comprising:

• Channel Havers at its center contains nerves, blood vessels and lymph flow.

• Lamela is composed of concentric.

• Lacuna containing bone cells, and

• Kanalikuli that shine between the Lacuna and menggandengkannya with Havers channels.
The area between the system-consistent Havers occurred over interstissil lamella, while
kanalikuli somewhat different. Lamella in the form of mesh network composed of less organized
and has no Havers channels, whereas the blood vessels ramify in interstisiil room that contains
the marrow to make blood supply to the blood vessels are more subtle.

Bone Function

Bone - bone in humans in addition to preparing the framework, it also has other functions,
namely:

a. Give your body shape, eg skull bones that gives form to the face

b. Protecting the vital organs, for example, brain, heart and lungs.

c. Hold and straightened, for example leg bone that support the entire body.

d. Muscle attachment

e. A place to store minerals, especially calcium and phosphorus.

f. Place the formation of blood cells especially red blood cells

g. Energy storage, ie in the form of fat in yellow marrow.

Is a passive motion device

 ACTIVITY and EXERCISES 1st
This paper was compiled to fulfill Activity and Exercises module

by:

SHOLIKHA DELA APRILIA G2B 009 007

NURSING SCIENCE PROGRAM

MEDICAL FACULTY

DIPONEGORO UNIVERSITY

2011

REFERENSI
Potter&Perry. 2005. Buku Ajar Fundamental keperawatan Ed.4 vol.2. Jakarta: EGC

Suzzane C. Smeltzer, Brenda G. Bare. 2001. Buku Ajar Keperawatan Medikal Bedah Vol. 3.
Jakarta: EGC

Guyton, hall. 19996. Buku Ajar Fisiologi Kedokteran. Jakarta: EGC

Pearce, evelyn.2006. Anatomi dan Fisiologi untuk Paramedis. Jakarta: PT.Gramedia