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PANCA INDRA PSIK 2X

VIEWS: 511 PAGES: 147

									PANCA INDRA

BAGIAN ANATOMI FK UNUD
PANCA INDRA TERDIRI DARI :

1.MATA (PENGLIHATAN)                     n.
 opticus (reseptor sel rod dan cone di retina)
2.TELINGA (PENDENGARAN)                   n.
 cochlearis (organon Corti/cochlea)
3.HIDUNG (PENGHIDU)                       n.
 olfactorius (mucosa nasi superior)
4.LIDAH (PENGECAP)
  n. facialis & n. glossopharyngeus (taste
 bud di mucosa corpus dan radix linguae)
5. KULIT (PERABA)
•   nyeri  free nerve ending
•   panas  Ruffini
•   Dingin  Krause
•   raba halus  Meissner
•   Tekan  Paccini
•   proprioceptive / posisi sendi  muscle’s
    spindle
                       MATA
•   bulbus oculi  di dalam orbita
•   dilindungi oleh palpebra  sup. & inf.
•   gld. lacrimalis
•   bulbus oculi tdd. 3 lapisan :
      1.tunica fibrosa (cornea & sclera)
      2. lamina vasculosa
      3. tunica sensoria / retina
•   bulbus oculi berisi : refractive media (tdd. cornea,
    aqueous humor, lensa, corpus vitreous)
             Indra penglihatan
• Eye: terdiri dari visual receptors
  – Dibantu oleh accessory organ dlm menjalankan
    fungsinya
• Visual accessory organs
  – Eyelids, lacrimal apparatus (protects eye),
    extrinsic muscles (move eye)
              OTOT ORBITA
• M. Levator Palpebrae Sup.

• Mm. Recti (Sup., Inf., Med., Lat.)

• Mm. Obliqui (Sup., Inf.)
             Extrinsic eye muscles
Muscle             Movement              Nerve
Superior oblique Depresses eye,          IV (Trochlear)
                 turns laterally
Lateral rectus   Turns laterally         VI (Abducens)
Medial rectus      Turns medially        III (Oculomotor)
Superior rectus    Elevates              III (Oculomotor)
Inferior rectus    Depresses eye         III (Oculomotor)
Inferior oblique   Elevates eye, turns    III (Oculomotor)
                   laterally
M&M, fig. 16.4
      Support/Maintenance of Eye
• Eyebrows: shade, shield for perspiration
• Eyelids (palpebrae): skin-covered folds with “tarsal
  plates” connective tissue inside
   – Levator palpebrae superioris muscle opens eye (superior portion
     is smooth muscle—why?)
• Canthus (plural canthi): corner of eye
   – Lacrimal caruncle makes eye “sand” at medial corner
   – Epicanthal folds in many Asian people cover caruncle
   – Tarsal glands make oil to slow drying
• Eyelash—ciliary gland at hair follicle—infection is sty
• Eyelashes—touch sensitive, thus blink
        Support of Eye--conjunctiva
• Mucous membrane that coats inner
  surface of eyelid (palpebral part) and
  then folds back onto surface of eye
  (ocular part)
• Thin layer of connective tissue covered
  with stratified columnar epithelium
• Very thin and transparent, showing
  blood vessels underneath (blood-shot
  eyes)
• Goblet cells in epithelium secrete
  mucous to keep eyes moist
• Vitamin A necessary for all epithelial
  secretions—lack leads to conjunctiva
  drying up—”scaly eye”
       Support of eye--tears
                                  M&M, fig. 16.5



• Lacrimal glands—
  superficial/lateral in orbit,
  produce tears
• Lacrimal duct
  (nasolacrimal duct) —
  medial corner of eye
  carries tears to nasal
  cavity (frequently closed in
  newborns—opens by 1 yr
  usually)
• Tears contain mucous,
  antibodies, lysozyme
  (anti-bacterial)
         Eye as lens/optical device
                                           M&M, fig. 16.7




Light path: Cornea  Anterior segment  Pupil  Lens 
  Posterior segment  Neural layer of retina  Pigmented
  retina
   Eye as optical device--structures
• Sclera (fibrous tunic): is tough connective tissue “ball” that forms
  outside of eyeball
   – like box/case of camera
   – Corresponds to dura mater of brain
• Cornea: anterior transparent part of sclera (scratched cornea is
  typical sports injury); begins focusing light
• Choroid Internal to sclera/cornea
   – Highly vascularized
   – Darkly pigmented (for light absorption inside box)
• Ciliary body: thick ring of tissue that encircles and holds lens
• Iris: colored part of eye between lens and cornea, attached at
  base to ciliary body
• Pupil: opening in middle of iris
• Retina: sensory layer that responds to light and transmits visual
  signal to brain
M&M, fig. 16.4
                        Detail: Aperture and focus
                                                              APERTURE
                                                              • Pupil changes shape
                                                                due to intrinsic
                                                                autonomic muscles
                                                                      – Sympathetic: Dilator
                                                                        pupillae (radial fibers)
                                                                      – Parasympathetic:
                                                                        sphinchter pupillae

M&M, fig. 16.8
                               (animation of lens
                               http://artsci.shu.edu/biology/Student%20Pages/Kyle%20Keenan/eye/lensmovementnrve.html   )
FOCUS
• Ciliary muscles in ciliary body pull on lens to focus far away
• Elasticity of lens brings back to close focus
• Thus, with age, less elasticity, no close focusfar-sighted
           Detail: eye color
• Posterior part of iris always brown in color
• People with brown/black eyes with pigment
  throughout iris
• People with blue eyes—rest of iris clear,
  brown pigment at back appears blue after
  passing through iris/cornea
  Details: Retina and photoreceptors
• Retina is outgrowth of brain
• Neurons have specialized receptors at end with “photo pigment” proteins
  (rhodopsins)
    – Rod cells function in dim light, not color-tuned
    – Cone cells have three types: blue, red, green
    – In color blindness, gene for one type of rhodopsin is deficient, usually red or
      green
• Photoreceptors sit on pigmented layer of choroid. Pigment from
  melanocytes--melanoma possible in retina!!
• Axons of photoreceptors pass on top or superficial to photoreceptor region
• Axons congregate and leave retina at optic disc (blind spot)
• Fovea centralis is in direct line with lens, where light is focused most
  directly, and has intense cone cell population (low light night vision best
  from side of eye)
• Blood vessels superficial to photoreceptors (retina is good sight to check for
  small vessel disease in diabetes)
                    Retina and
                  photoreceptors




M&M, fig. 16.10
Extrinsic muscles of the right eye (lateral view)
• PERJALANAN CAHAYA DARI LUAR SAMPAI
  KE RETINA :
• CORNEA  AQUEOUS HUMOR  PUPIL 
  LENSA  RETINA  N. OPTICUS 
  CHIASMA OPTICUS  TRACTUS OPTICUS
   CORPUS GENICULATUM LATERALE 
  RADIATIO OPTICA  CORTEX
  PENGLIHATAN.
  Accessory Structures of the Eye
• Lacrimal apparatus –
  keeps the surface of
  the eye moist
  – Lacrimal gland –
    produces lacrimal
    fluid
  – Lacrimal sac – fluid
    empties into nasal
    cavity

                               Figure 16.5b
Figure 16.8
The visual pathway includes the optic nerve, optic chiasma, optic tract, and optic radiations.
         sclera (white of the eye)




cornea
Sense of Hearing
              TELINGA (EAR)
• merupakan organ vestibulocochlearis
  (keseimbangan/equilibrium dan
  pendengaran/hearing)

• Telinga dibagi menjadi:
      1. telinga luar (external ear): utk hearing
      2. telinga tengah (middle ear): utk hearing
      3. telinga dalam (internal/inner ear): utk
             hearing & equilibrium
  TELINGA L U A R (external ear)
• 1. auricle (pinna)
       helix, concha tragus,lobule
• 2. meatus acusticus externa
       hair, kel sebacea, ceruminous glands
       disebut jg canalis auditorius external
The Outer (External) Ear




                           Figure 16.17a
                                                 Ear/Hearing




                                                                 M&M, fig. 16.17

• Outer Ear: auricle is elastic cartilage attached to dermis, gathers sound
• Middle ear: ear ossicles transmit and modulate sound
• Inner ear: cochlea, ampullae and semicircular canals sense sound and equilibrium
Major parts of the ear
Ceruminous glands secrete cerumen – ear wax
TELINGA TENGAH
(middle ear)
1. cavum tympani
      berisi : auditory bone (malleus, incus,stapes)
      berada di pars petrosa os temporalis
2. membran timpani
      batas antara telinga luar dan tengah)
      membran semitransparan

Pharyngotympanic tube (auditory or eustachian tube)
         tuba auditiva
         Menghubungkan telinga tengah dan pharynx

* Auditory Ossicles (Malleus, Incus, Stapes)
    –    transmisi vibrasi (getaran suara)
Auditory Ossicles bridge the tympanic membrane and the inner ear.
                 Auditory Tube
• Disebut jg tuba eustachius
• Menghubungkan telinga tengah dgn pharynx
• Membantu mempertahankan supaya tekanan
  udara sama antara kedua sisi membran
  timpani yg sangat diperlukan utk pendengaran
  normal (fungsi ini bisa dirasakan ketika Anda
  mendengar suara pop ketika terjadi
  perubahan ketinggian secara cepat, misalnya
  take off & landing saat naik pesawat)
• Nasopharyngitis bisa menyebabkan OMA krn
  penyebaran melalui tuba ini.
Structures of the Middle Ear




                               Figure 16.17b
 The Middle Ear

• Ear ossicles – tulang yg
  terrkecil pd tubuh ini
  tsmallest bones in
  the body
  – Malleus – melekat pd
    membran timpani
  – Incus – antara malleus
    dan stapes
  – Stapes – menggetarkan
    oval window



                             Figure 16.19
                     Middle Ear
• Otot-otot yg
  menghambat vibrasi
  ketika suara terlalu
  keras:
  – M. Tensor tympani (pd
    malleus)
  – M. Stapedius (pd
    stapes)




                                  M&M, fig. 16.19
Middle Ear
          Auditory Ossicles
                      Base of stapes fills
                      the oval window

                 20X amplification




Malleus
Incus
Stapes


  Air movement
 TELINGA DALAM (INNER EAR)
Merupakan organ tulang berongga (hollow bony
  structures) yg diisi cairan (endolymph)
Tdd organ:
1. Equilibrium – semicircular canals
2. Hearing -- cochlea
        The Inner (Internal) Ear
• Disebut jg labyrinth
• Berada di dalam pars petrosa os temporalis
• Bony labyrinth – suatu cavitas yg tdd dr 3
  bagian:
  – Semicircular canals
  – Vestibule
  – Cochlea
        The Inner (Internal) Ear
• Membranous labyrinth
  – Tdd 3 bgn utama:
    • Semicircular ducts
    • Utricle and saccule
    • Cochlear duct
Perilymph separates the osseous labyrinth of the inner ear from the membranous labyrinth,
which contains endolymph.
The Cochlea




              Figure 16.23a–c
The Inner (Internal) Ear




                           Figure 16.17b
Cochlea. A.) Cross section of the cochlea. B.) Organ of Corti and the tectorial membrane.
Anatomy and Function of the
         Maculae




                              Figure 16.21b
Hair Cells
The Inner Ear
                   Tinnitus
• Ringing or buzzing noise in the ears.

                  Ringing, buzzing, whistling, or roaring
                  noises in the ear). These noises may come
                  and go or may always be present. The
                  noises may get louder just before a vertigo
                  attack.
                                Otitis media
 • Inflammation of the
   middle ear
Bacterial or viral infection occurs in the fluid
buildup after a respiratory illness
Sense of Taste
       LIDAH / PENGECAP
• MUSCULAR ORGAN DLM BASIS CV. ORIS
• OTOT EXTRINSIK DAN INTRINSIK
• TDD: ORAL AND PHARYNGEAL PART 
  SULCUS TERMINALIS
• INNERVASI.: N. V3, IX, VII
• TASTE BUD PADA PAPILA
Taste receptors. A.) Taste buds on the surface of the tongue are associated with nipple-like elevations called
papillae. B.) A taste bud contains taste cells and has an opening, the taste pore, at its free surface .
Taste Buds




             Figure 16.1a, b
Taste
             Gustatory Pathway
• Taste information reaches the cerebral cortex
  – Primarily through the facial (VII) and
    glossopharyngeal (IX) nerves
  – Some taste information through the vagus nerve
    (X)
  – Sensory neurons synapse in the medulla
     • Located in the solitary nucleus
      Five taste sensations

•   Sweet—front middle
•   Sour—middle sides
•   Salty—front side/tip
•   Bitter —back
•   “umami”—posterior
    pharynx



                   M&M, Fig. 16.1
        2. Gustation (Taste)


Differential
distribution of
taste buds




                         Taste buds
        2. Gustation (Taste)




VII – ant. 2/3
IX – post. 1/3
Cutaneous
     KULIT / ALAT PERABA
• KULIT TIPIS DAN TEBAL
• TDD.: EPIDERMIS DAN DERMIS
• EPIDERMIS TDD. :4-5 LPS
• DALAM DERMIS DITEMUKAN : UJUNG
  SARAF,KORPUSKEL MEISSNER, PACCINI
• KELENJAR
    The Integumentary System
• Organ Terbesar
  – Luas ?? Berat ???
• Menutupi Seluruh Tubuh
• Salah Satu Indikator Kesehatan
• Didalamnya terdapat
  – Rambut, kuku, kelenjar and reseptor spesifik
 Functions of the Integumentary
            System
• Menutupi jaringan/organ dibawahnya
• Proteksi terhadap : trauma, bakteri,
  kekeringan
• Pengaturan suhu tubuh
• Reseptor terhadap rasa raba, suhu, nyeri
• Ekskresi (keringat)
• Absorpsi sinar ultra violet  sintesa vit. D
         Cutaneous sensation
†   Free nerve ending
†   Corpusculum Meissner
†   Corpusculum Pacinian
†   Corpusculum Krause
†   Corpusculum Ruffini
          Differentiation :
• Thick skin
• Thin skin

  • Cari perbedaannya ???
         Skin (Integument)

• Terdiri Atas Tiga Bagian
  • Epidermis – paling superficial
  • Dermis – bagian tengah
  • Hypodermis paling profundus
Skin (Integument)
                Epidermis

• Dibentuk oleh epitel berlapis pipih
  menanduk, terdiri atas 4 tipe sel dan
  tersusun menjadi 4 atau 5 lapisan.
• Sel : keratinosit, melanosit, Merkel sel, and
  Langerhans’ sel
• Merupakan lapisan terluar yang
  berhubungan dengan dunia luar dalam
  fungsi Proteksi.
              Epidermis

• Tiap hari dihasilkan sel baru dan ada sel
  yang mati
• Dari awal terbentuk di basal sampai
  akhirnya terkelupas ( 25 – 45 hari )
• Tidak ada pembuluh darah dan limfatik
        Layers of the Epidermis
  1. Stratum Germinativum / Basale
  2. Stratum Spinosum
  3. Stratum Granulosum
  4. “ Stratum Lusidum “
  5. Stratum Corneum

• Tiap hari terjadi penggantian sel !
Epidermis
Epidermis
      Cells of the Epidermis

• Keratinocytes – memproduksi fibrous
  protein “keratin”
• Melanocytes – memproduksi pigmen
  melanin
• Langerhans’ cells – epidermal
  macrophages yang membantu imun system
• Merkel cells – fungsinya sebagai reseptor
  yang berhubungan dengan sensory nerve
  endings
Epidermis
Epidermis
Epidermis
                Dermis

• Lapisan kedua dari kulit yang terdiri
  dari jaringan ikat kolagen dan elastis.
• Didalamnya terdapat sel fibroblas,
  macrophag, mast sel, sel darah putih,
  rambut, kel sebacea dan m. arrector
  pili
                    Dermis
• Terdiri atas dua lapisan :
  – lapisan papillary
  – lapisan reticular
                  Sidik jari
• Finger print
• Bentukan ditentikan oleh lapisan papilary dari
  dermis
• Dermatogliphic
• Tiap orang berbeda ( Kembar identik ??? )
Dermis
               Hypodermis
• Lapisan subcutaneous.
• Superficial fascia
• Terdiri atas “jaringan lemak” dan jaringan ikat
  longgar.
• Didalamnya terdapat kel. Sebacea, pemb.
  darah dan limfe
                Deep fascia
• Jaringan ikat yang sangat kuat.
  – Investing fascia
  – Intermuskular septa
  – Subserous fascia


• Membentuk retinakulum dan bursa
                Skin Color
• Three pigments contribute to skin color :
  • Melanin  Kuning, Merah, Cokelat, s/d Hitam
     Warna kulit
  • Carotene  Kuning s/d Orange  Telapak
  • Hemoglobin  Merah.
Adneksa Kulit
             Sweat Glands

• Different types prevent overheating of the
  body; secrete cerumen and milk
  • Eccrine sweat glands – found in palms, soles
    of the feet, and forehead
  • Apocrine sweat glands – found in axillary and
    anogenital areas
  • Ceruminous glands – modified apocrine glands
    in external ear canal that secrete cerumen
  • Mammary glands – specialized sweat glands
    that secrete milk
          Sebaceous Glands
• Simple alveolar glands found all over the body
• Soften skin when stimulated by hormones
• Secrete an oily secretion called sebum
                  Hair Follicle

• Struktur berbentuk batang mengandung keratin
  (hard keratin), menonjol dari permukaan epidermis
• Ada 2 bagian : shaft dan root (akar)
• Jenis :
   – Vellus hairs (halus, pendek, dan pucat)
   – Terminal hairs (kasar, tebal, panjang, dan gelap)
   – Lanugo (sangat halus : pada fetus)
• Lapisan-lapisan : medulla, cortex, cuticula of the hair
Hair Follicle
Hair Follicle
                 Nail / Kuku
• Merupakan modifikasi dari stratum lucidum
  dan korneum
• Terdiri dari :
  – Bagian root, body, dan free edge
• Lunula : bagian keputih – putihan pada basis
  kuku berbentuk bulan sabit
Nail / Kuku
Nail / Kuku
    Pigmentation And Rashes

• Pigmentasi :        • Rashes :
  † Melanoid            † Bula
  † Hyperpigmentasi     † Papula
  † Hypopigmentasi      † Vesikula
  † Leukoplacia         † Edema
  † Albino
  † Ras
     Proses Penyembuhan Luka
•   Luka
•   Inflamasi
•   Proliferasi
•   Remodeling
             Skin Cancer
• The three major types of skin cancer are:
  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma
             Burns / Combustio

• First-degree – only the epidermis is damaged
  • Symptoms include localized redness, swelling, and pain
• Second-degree – epidermis and upper regions of
  dermis are damaged
  • Symptoms mimic first degree burns, but blisters also appear
• Third-degree – entire thickness of the skin is damaged
  • Burned area appears gray-white, cherry red, or black; there is
    no initial edema or pain (since nerve endings are destroyed)
                Skin (Integument)
•   Cover up our body
•   Broad : 1,75 meter square & (16 % dari BB)
•   Mucocutaneus junction
•   Inside : Hair, nail, glands and specific receptor
•   Differentiation :
     • Thick skin
     • Thin skin
          Skin (Integument)

• Consists of three major regions
  • Epidermis – outermost superficial region
  • Dermis – middle region
  • Hypodermis (superficial fascia) – deepest
    region
Skin (Integument)
               Epidermis

• Composed of keratinized stratified
  squamous epithelium, consisting of four
  distinct cell types and four or five layers
• Cell types include keratinocytes,
  melanocytes, Merkel cells, and Langerhans’
  cells
• Outer portion of the skin is exposed to the
  external environment and functions in
  protection
       Cells of the Epidermis
• Keratinocytes – produce the fibrous protein
  keratin
• Melanocytes – produce the brown pigment
  melanin
• Langerhans’ cells – epidermal
  macrophages that help activate the immune
  system
• Merkel cells – function as touch receptors in
  association with sensory nerve endings
Layers of the Epidermis: Stratum Basale
              (Basal Layer)

• Deepest epidermal layer firmly attached to
  the dermis
• Consists of a single row of the youngest
  keratinocytes
• Cells undergo rapid division, hence its
  alternate name, stratum germinativum
 Layers of the Epidermis: Stratum Spinosum
                (Prickly Layer)


• Cells contain a weblike system of
  intermediate filaments attached to
  desmosomes
• Melanin granules and Langerhans’ cells are
  abundant in this layer
 Layers of the Epidermis: Stratum Granulosum
                (Granular Layer)
• Thin; three to five cell layers in which drastic
  changes in keratinocyte appearance occurs
• Keratohyaline and lamellated granules
  accumulate in the cells of this layer
Layers of the Epidermis: Stratum Lucidum
               (Clear Layer)


• Thin, transparent band superficial to the
  stratum granulosum
• Consists of a few rows of flat, dead
  keratinocytes
• Present only in thick skin
   Layers of the Epidermis: Stratum Corneum
                  (Horny Layer)

• Outermost layer of keratinized cells
• Accounts for three quarters of the epidermal
  thickness
• Functions include:
  • Waterproofing
  • Protection from abrasion and penetration
  • Rendering the body relatively insensitive to
    biological, chemical, and physical assaults
                 Dermis

• Second major skin region containing strong,
  flexible connective tissue
• Cell types include fibroblasts,
  macrophages, and occasionally mast cells
  and white blood cells
• Composed of two layers – papillary and
  reticular
 Layers of the Dermis: Papillary
              Layer
• Papillary layer
  • Areolar connective tissue with collagen and
    elastic fibers
  • Its superior surface contains peglike
    projections called dermal papillae
  • Dermal papillae contain capillary loops,
    Meissner’s corpuscles, and free nerve endings
 Layers of the Dermis: Reticular
              Layer
• Reticular layer
  • Accounts for approximately 80% of the
    thickness of the skin
  • Collagen fibers in this layer add strength and
    resiliency to the skin
  • Elastin fibers provide stretch-recoil properties
              Hypodermis
• Subcutaneous layer deep to the skin
• Composed of adipose and areolar connective
  tissue
                    Skin Color
• Three pigments contribute to skin color
  • Melanin – yellow to reddish-brown to black
    pigment, responsible for dark skin colors
     • Freckles and pigmented moles – result from local
       accumulations of melanin
  • Carotene – yellow to orange pigment, most
    obvious in the palms and soles of the feet
  • Hemoglobin – reddish pigment responsible for the
    pinkish hue of the skin
    Pigmentation And Rashes

• Pigmentasi :        • Rashes :
  † Melanoid            † Bula
  † Hyperpigmentasi     † Papula
  † Hypopigmentasi      † Vesikula
  † Leukoplacia         † Edema
  † Albino
  † Ras
             Sweat Glands

• Different types prevent overheating of the
  body; secrete cerumen and milk
  • Eccrine sweat glands – found in palms, soles
    of the feet, and forehead
  • Apocrine sweat glands – found in axillary and
    anogenital areas
  • Ceruminous glands – modified apocrine glands
    in external ear canal that secrete cerumen
  • Mammary glands – specialized sweat glands
    that secrete milk
Sense of Smell
              HIDUNG / PEMBAU
•   NOSE TDD.:
    –   EXTERNAL NOSE
        (ROOT,DORSUM,APEX,NARES,SEPTUM)
    –   CAVUM NASI / NASAL CAVITY :
        •   RESPIRATORY AREA
        •   OLFACTORY AREA

        PENGANTAR IMPULS
        • EPITHELIUM OLFACTORIUM PADA ATAP CAVITAS NASI
           (AREA OLFACTORIA)RESEPTOR  AXON  KUMPUL
           JADI FILA OLFACTORIA  CAVITAS CRANII MELALUI
           FORMINAE PD LAMINA CRIBROSA ETHMOIDALIS 
           BULBUS OLFACTORIUS  TRACTUS OLFACTORIUS 
           CORTEX CEREBRI AREA BRODMAN 28 DAN 33 /
           PENGENALAN BAU.
Olfactory
epithelium just
under cribiform
plate (of ethmoid
bone) in superior
nasal epithelium at
midline
                      M&M, Fig. 16.3
Olfactory receptors. A.) Columnar epithelial cells support olfactory receptor cells, which have cilia at their
distal ends. B.) The olfactory area is associated with the superior nasal concha.
        Olfactory Nerve Pathways
• Stimulated olfactory receptor cells send nerve impulses along
  their axons which form the first cranial nerves and synapse
  with neurons located in enlargements called olfactory bulbs.
• Impulses are analyzed in the olfactory bulbs and travel along
  olfactory tracts to the limbic system
• Major interpreting areas (olfactory cortex) for these impulses
  are located within the temporal lobes and at the bases of the
  frontal lobes
That’s all folks!

								
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