neurofisiologi nyeri

7/26/2019 Neurofisiologi Nyeri

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NEUROFISIOLOGINYERI

I Wayan Tunjung, dr. Sp.S

BAGIAN NEUROLOGIRSUD KOTA MATARAM


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Defnisi:

Nyeri : pengalaman sensorik dan

emosional yang tidak menyenangkanyang berhubungan dengankerusakan jaringan baik yang

aktual/potensial, atau yangdigambarkan dalam bentukkerusakan semacam itu (Merskey,1!"#

Nosisepsi : deteksi $ transmisi stimulinoksius

%erabut nosisepti& : serabut sara& yang

terlibat dalam nosisepsi


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NYERI

Nyer n!""ep#$% nyer "!&a#'Nyer neur!pa#' % nyer

neur!gen'

Nyer ruju'an % re$erred pan


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Neur!ana#!& Ln#a"an Nyer

Nyer dde#e'" !(e) re"ep#!rn!""ep#$ d per$er *#ran"du'"+

"era-u# n!""ep#$ A / 'e '!rnud!r"a(" &edu((a "pna(" *#ran"&"per$er+

Ke #a(a&u" 'e '!r#e'" *#ran"&""en#ra(+


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D #ap ##' dar ja(anan nyer, &pu("nyer -"a d&!du(a" !(e) neur!n

n#rn"'0npu#1npu# de"2enden darpu"a#1pu"a# yang (e-) #ngg

Yang -era"a( dar '!r#e'"

"!&a#!"en"!r' (&-' dpr!ye'"'an 'e area gr"eapera3uedu'#a( 'e '!rnu d!r"a("

&edu((a "pna(" *M!du(a"+ Keru"a'an pada #ap ##', -a'

per$er0"en#ra( nyer neur!pa#'


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Wa(aupun "era-u#1"era-u# #er#en#uada(a) n!""ep#!r na&un "era-u#

yang (an da'#4a" !(e) "#&u(u"1"#&u(u" n!n n!'"u" "era-u# na'an &enng'a# a'#4#a"nya -(a

n#en"#a" "#&u(u"nya &enng'a#


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Ada gap an#ara penge#a)uan'(n" dengan (&u da"ar

5678 % #)e ga#e 2!n#r!( #)e!ry !$pan !(e) Me(9a2' Wa((

Seja' #u (&u da"ar neur!-!(!g!$ pan -er'e&-ang pe"a#

Gap &enjad "e&a'n (e-ar


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Me'an"&e n!""ep"

5.Tran"du'".Tran"&" per$er

:.Tran"&" "en#ra(

;.M!du(a"

8.


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FISIOLOGI NYERI.5.


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Tran"du'" N!""ep#!r

N!""ep" &e'an" % a')ran "ara$#eranya& d an#ara jarngan '!(agen %

(ga&en, #end!n, 'ap"u(, "end, $a"2a

peregangan N!""ep" '&a? % -a)an '&a

a(g!gen'% !n )dr!gen, !n p!#a""u&,

"er!#!nn, )"#a&n, -ad'nn, AD


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Tran"&"


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Tran"&" Sen#ra(

>p!#e"" ga#e 2!n#r!(C Me(9a2' Wa((%

nyer % -a(an" npu# "era-u# -er&ye(ndengan "era-u# #a' -er&e(n

Ba)an neur!#ra&"#er n!""ep#$%

"u-"#an"


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Tran"&" "en#ra(

In#erneur!n % "e( S#a('ed "e( I"(e#Tran"&" n!""ep#$ %-a(an"

pengaru) e'"#a#!r' n)-#!r'

pada neur!n #ran"&"Aeren# -erda&e#er -e"ar%

n)-" )u-ungan ?de dyna&2range neur!n dengan aeren#n!""ep#$


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Tran"&" "en#ra( Fun'u(u" an#er!(a#era(

Ta(a&u"

Nu'(eu" 4en#ra( p!"#er!r (a#era(

nu'(eu" "en#ra( (a#era(

(!-u" pare#a( % (!'a("a"""#e& (&-' % d&en" a4er"$ e&!"!na(


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Tran"&" "en#ra( F!r&a#! re#'u(ar"

nu'(eu" re#'u(ar" ggan#!"e(u(ar" #ra'#u" "pn!re#'u(ar"#a(a&'u"*&u(#"nap#'+

K!n"ep $ung"!na(

' S"#e& pa(e!"pn!#a(a&'u"

"era-u# /, (!'a("a" -uru'

*&u(#"nap#'+

' S"#e& ne!"pn!#a(a&'u"

"era-u# A de(#a, (!'a("a" -a'


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MODULASI

"u"-#an"a gr"ea per4en#r'u(er

"u-"#an"a gr"ea per a3uedu'#a(

nu'(eu" re#'u(ar" ggan#!"e(u(ar"

(!'u" 2!eru(eu"

Nu'(e re#'u(ar (a#era(

Nu'(eu" rap)e &agnu" % "er!#!nn

Fun'u(u" d!r"!(a#era("


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FUNIKULUS DORSOLATERALIS

In)-" neur!n &argna( Lang"ung

Ta' (ang"ung

' In)-" n#erneur!n e'"#a#!r'' E'"#a" n#erneur!n % en')epa(n, DYNOR


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Ber-aga jen" n!""ep#!r N!""ep#!r p!(&!da( #da' -er&e(n d

jarngan 'u#aneu" N!""ep#!r &e'an!#)er&a( A

Me'an!re"ep#!r Aa&-ang #ngg

N!""ep#!r A N!""ep#!r / d "era-u# yang &engner4a"

"end !#!#


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A"u&"1a"u&"

Tda' ada "#ru'#ur )"#!(!g" "pe"'yang -e'erja "e-aga re"ep#!rn!""ep#$


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Sen"#"a" S#&u(u" du(ang1u(ang% "en"#"a"

Sen"#"a"%

' A&-ang a'#4a" &enurun

' Re"p!n #er)adap "#&u(u" yang d-er'an

&enng'a#'T&-u(nya a'#4a" "p!n#an

D)a"('an !(e) 'erja ""#e& &e""enger 'eduayang da'#4a" !(e) pe(epa"an -e-erapa&eda#!r n@a&a#!r' % -rad'nn,pr!"#ag(andn, "er!#!nn, )"#a&n

Menye-a-'an )pera(ge"a


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S(eepng N!""ep#!r

N!""ep#!r yang da(a& 'eadaan

n!r&a( #da' dapa# da'#4a"

Menjad e2#a-(e )anya pada '!nd"pa#!(!g", &"a(nya n@a&a"

D"e-u# "(en# n!""ep#!r % "(eepngn!""ep#!r

T)n 566: d(ap!r'an S2)a-(e danGru-- pada arngan "end

Ke&udan #ernya#a juga ada djarngan 4"era( dan 'u#aneu"


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Re"ep#!r1re"ep#!r yang -er(!'a("a" pada"era-u# aeren# pr&er dan (gand"nya yang-era"a( neur!na( &aupun n!n neur!na(

5. Re"ep#!r1re"ep#!r yang -era"!"a" dengan n!""ep#!r AT


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Lgand M!(e'u( !rgan' yang &end!n!r'an

e(e'#r!n1e(e'#r!n yang d-u#u)'anun#u' &e&-en#u' 'a#an '!4a(en'!!rdna# dengan !n (!ga&, "eper#

!'"gen #er'a# dengan a#!& Fe "en#ra(dar )e&!g(!-n

I!n 0 &!(e'u( yang -erea'" un#u'

&e&-en#u' &!(e'u( '!&p(e'" dengan&!(e'u( (an, "erng &a'r!&!(e'u("eper# '!&p(e'" an#gen an#-!d


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Ligand Gated Ion Channel

Meng'a# neur!#ran"#er pada re"ep#!r

-agan e'"#ra"e((u(er Meng'a# pr!#en 'na"e *p)!"p)!pr!#en

p)!"p)a#a"e+ pada re"ep#!r

B(a re"ep#!r02)anne( d-u'a !(e)neur!#ran"#er yang #er'a# !n Na K dapa# (e?a# &ene&-u" 2)anne(

Menye-a-'an p!#en"a( end p(a#e dapa# "e-aga dep!(ar"a" a#au "e-aga)perp!(ar"a"


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Lgand Ga#ed I!n /)anne(

/!n#!) % re"ep#!r02)anne( GABA A

GABA #er'a# pada dan &e&-u'a2)anne(

GABA A % )perp!(ar"a" "e( dann)-" -ag'#an &pu(" (e-) (anju#

/)anne( GABA1A &e&(' pa(ng

"ed'# 8 -ndng "#e yang -er-eda


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!(#age Ga#e I!n /)anne(

Tap "u-#pe da'#$ dan na'#$

pada ren#ang 4!(#a"e yang-er-eda dan pada 'e2epa#an yang-er(anan

E#)!'"u"&de dan a"a& 4a(pr!a#&engn)-" a(ran !n &e(a(u/a(2u& T /)anne(


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Re"ep#!r G(u#a&a#e "u-#pe NMDA

K!&-na" 4!(#age ga#ed !n 2)anne(dan (gand ga#e !n 2)anne(


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Brad'nnDr(" dar 'nn!gen dar "r'u(a"

A'#$a" n!""ep#!r &e(a(u ja(anyang #ergan#ung pr!#en 'na"e /

dan /aSen"#"a" re"ep#!r1re"ep#!r &e(a(ua'#4a" neur!n1neur!n "&pa#e#'

p!"# gang(!n' &e&pr!du'"pr!"#ag(andn E


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Su"-"#an2e T+ pen#ng da(a& nyer

Seju&(a) #pe dan "u-#pe re"ep#!r 8 >T1=

&e&per"u(# ap('a" '(n" Ag!n"# adren!re"ep#!r a($a , &"a(nya

2(!ndne, &e&(' e$e' ana(ge"2

Na&un ag!n"# re"ep#!r a($a &e&(' e$e'"a&png yang pen#ng


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TERIMA KASI>P.

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