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7/28/2019 ANFISANTMY

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ANATOMI DAN FISIOLOGI CNS

TRI

DAMAI

ELOKMIRZA


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PEMBAGIAN SUSUNAN SARAF MANUSIA

A. Anatomi

1. Susunan Saraf Pusat (SSP) : Otak (ensefalon) dan

medula spinalis

2. Susunan Saraf Tepi (SST) : Saraf saraf kranial dan

spinal

B. Fisiologi

1. Susunan Saraf Somatik : Mensarafi struktur dindingtubuh

(otot,kult,membran mukosa)2. Susunan Saraf Otonom : Mengontrol aktivitas otot otot dan

kelenjarkelenjar bagian dalam tubuh vsera) serta

pembuluh darah


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SSP

Otak (ensefalon)Serebrum

Telensefalon

Korteks

Subkorteks

Ganglia Basalis

Diensefalon

Talamus

Hipotalamus

Subtalamus

EpitalamusBatang Otak

Mesensefalon

Pons

Medula oblongata

Otak Kecil (serebelum)

Paleoserebelum

Neoserebelum

Arkiserebelum

Sumsum tulang belakang (medula spinalis)

Servikal

Torakal

Lumbal

Sakral

Koksigeal


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4 Parts

Cerebrum

Diencephalon

Brain Stem

Pons

Medulla

Midbrain

Cerebellum

Gray matter surrounded by White matter

The Brain


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Lobus Defisit Neurologik Fenomena Positif Psikopatologi/ Neuropsikologi

FRONTALIS Hemiparesis spastik (kontralateral)

Gaze paresis (kontralateral)

Bangkitan motorik fokal

Adversive fits

(gerakan tonik mata, kepala,

anggota gerak kontralateral)

Tak punya inisiatif

Afek datar

Moria (witzelsucht)

Afasia motorikBroca (dominan)

PARIETALIS Sindroma hemisensorik

(kontralateral)

Homonim kwadrananopsia bawah

(kontralateral)

Hemispasial neglect

Hilangnya nistagmus optokinetik

Bangkitan sensorik fokal

(Jacksonian)

Disorientasi ruang

Agnosia taktil

Apraksia konstruksional

Afasia amnesik (dominan)

Aleksia (dominan)

TEMPORALIS Homonim kwadrananopsia atas

(kontralateral)

Bangkitan psikomotor

Uncinate fits

Mudah marah

Disinhibisi

Defisit memori

Afasia sensorik/ Wernicke

(dominan)

OKSIPITALIS Homonim hemianopsia

(kontralateral)

Gangguan nistagmus optokinetik

Sensasi dan halusinasi visual Agnosia warna

Disorientasi visuospasial

Agnosia visual

Aleksia


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The Limbic System

A. Cingulate gyrus

B. Fornix

C. Anterior thalamic

nuclei

D. Hypothalamus

E. Amygdaloid nucleus

F. Hippocampus

The limbic system is the area of the brain that regulates

emotion and memory. It directly connects the lower and

higher brain functions.

The limbic lobe is located deep in the

brain, and makes up the limbicsystem.


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Cerebellum

The cerebellum is connected to thebrainstem, and is the center for body

movement and balance.

Click image to play or pause video

Cerebellum


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Thalamus

Thalamus means inner room in Greek, as

it sits deep in the brain at the top of thebrainstem.

The thalamus is called the gateway to the

cerebral cortex, as nearly all sensory inputs

pass through it to the higher levels of the

brain.

Thalamus


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LESI

LESI CEREBELLUM


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ASTENIA (otot otot anggota gerak

Terasa lembek dan cepat lelah)

1. DISEKUILIBRIUM

PENDULAR (turunnya refleks tendon)

2. DISKOORDINASI MUSKULAR

ASINERGIA (Kesimpangsiuran gerakan)

DEKOMPOSISI GERAKAN (Gerakan urutan kontraksi otot secara volunter tdk bisa)

DISDIADOKINESIA (gerakan cepat yang arahnya berlawanan)DISMETRIA ( Hipometria jangjauan gerakan volunter yang terlampau pendek)

HIPERMETRIA

LESI CEREBELLUM


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LOBUS FLOKULONODULARIS

GAIT ATAKSIA (kedua tungkai

Melangkah secara simpang siur dan ke2Kaki ditelapakkan secara acak - acakkan

NISTAGMUS

TRUNKAL ATAKSIA ( badan yg tdk

Bersandar tidak dapat memlihara sikapYang mantap shg bergoyang Goyang)

TREMOR DISARTHRIA

VERMIS

ROSTRAL CAUDAL

HEMISFER CEREBELLUM

LIMB ATAKSIA (ataksia yg timbul terutama pd kedua lengan)


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LESI THALAMUS


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Hypothalamus

The hypothalamus sits under the thalamus at thetop of the brainstem. Although the hypothalamus

is small, it controls many critical bodily functions:

Controls autonomic nervous system

Center for emotional response and behavior

Regulates body temperature

Regulates food intake

Regulates water balance and thirst

Controls sleep-wake cycles

Controls endocrine system

The hypothalamus is shaded

blue. The pituitary gland

extends from the

hypothalamus.


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Hemibalismus lateral

Gerakan involunter kasar yang nyata dan cepat melemparbagian proksimal lengan dan tungkai

LESI SUBTHALAMUS

GANGGUAN :


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The Brainstem

The brainstem is the mostprimitive part of the brain and

controls the basic functions of

life: breathing, heart rate,

swallowing, reflexes to sight or

sound, sweating, blood pressure,

sleep, and balance.The brainstem can be divided into

three major sections.

Click image to play or pause video


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Hemiplegi alternans (Hemiplegi kontralat UMN, ggn N III

Ipsilat LMN, parese

n. XII kontralat UMN, parese n.IX,X

kontralateral UMN

SINDROMA WEBER :

Hemiplegi alternans N. III kiri

UMN : Otot tubuh sisi kanan ( N. XII, N. IX dan X)

LMN : N. III kiri (midriasis, strabismus divergen,

diplopia, ptosis)

SINDROMA BENEDICT :

Hemiplegi alternans ringan

Parese N.III ringan

Gerakan involunter lengan & tungkai yg paretik

(ringan)

LESI MESENSEFALON


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The Pons

The pons is the rounded brainstemregion between the midbrain and

the medulla oblongata. In fact, pons

means bridge in Latin.

The main function of the pons is to

connect the cerebellum to the rest of

the brain and to modify the

respiratory output of the medulla.

The pons is the origin of several

cranial nerves.

LESI PONS


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Hemiplegi alternans (Hemiplegi kontralat

UMN, ggn N.VI & N.VII Ipsilateral LMN

SINDROMA MILLIARD GUBLER :

Kelumpuhan LMN yg melanda otot otot yg disarafi N.VI, VII, ipsilat

Strabismus convergen

SINDROMA FOVILLE :

Lesi yg mengenai serabut kortiko

bulbar N.VI (deviasi conjugate)


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The Medulla Oblongata

The medulla oblongata merges seamlesslywith the spinal cord and creates the base

of the brainstem.

The medula is primarily a control center

for vital involuntary reflexes such as

swallowing, vomiting, sneezing, coughing,

and regulation of cardiovascular and

respiratory activity.

The medulla is also the origin of many

cranial nerves. N.IX / X

LESI MEDULA OBLONGATA (lateral)


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1. SINDROMA MEDULAR LATERAL (SINDROM WALLENBERG)Hemihipestesi alternans, Hipestesi tubuh kontralateral, Hipestesi wajah ipsilateral

Ataksia ipsilateral

Vertigo

Sindroma Horner ipsilateral, nistagmus, gangguan bicara, gangguan menelan

LESI MEDULA OBLONGATA (medial)


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2. SINDROMA MEDULAR MEDIAL HEMIPLEGI

ALTERNANS = MEDIAL (BASAL) MEDULLARY

SYNDROME (DEJERINE SYNDROME)

Lumpuh UMN tubuh kontralateral di bawah

leher

Lumpuh LMN lidah ipsilateralDisebabkan OBSTRUKSI Cab paramedian

Dari Arteri basilaris atau Vertebralis

CSF: sodium chloride ions proteins


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CSF: sodium, chloride ions, proteins,glucose, O2

Liquid cushion for brain and

spinal cord

Nourishes brain

Removes waste

Conducts chemical signals

between parts of CNS

Produced in Choroid Plexuses:

group of capillaries surrounded

by ependymal cells

Forms as a filtrate of blood


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CAROTIDSYSTEM

VERTEBRO-

BASILARSYSTEM

( circulus arteriosus Willisii).

LESI ARTERI VERTEBRO-BASILER


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Lesi intrakranial berdasar kelainan motorik


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Lesi intrakranial berdasar kelainan motorik

Hemiparese / hemiplegia

Tipika hemisfereAlternans brainstem

Posisi ekstremitas : posisi dekortikasiposisi deserebrasi

Test fungsi batang otak : pernafasanref. batang otak

Involuntari movement : ggn pd susunan

ekstrapiramidal.

Ggn. Koordinasi :ggn pd serebellum.

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