TOPICS OF THE DAY. - Basic Microscopic Anatomy. - Basic Growth & development

TOPICS OF THE DAY

- Basic Microscopic Anatomy

- Basic Growth & development

Berdasarkan ukuran dari bagian yang

dipelajari, anatomi dibagi menjadi :

• Anatomi makroskopik



•

Anatomi mikroskopik

( Histologi)



Levels of Structural Organization

(Organisasi struktural)

• Atom

• Sel

• Jaringan

• Organ

• System Organ

• Organisme

UMUM

• Sel  unit struktural dan fungsional dr kehidupan

• KOMPONEN (Eukaryotik) : 1. Membran sel

2. Sitoplasma 3. Nucleus

• FUNGSI UTAMA : - pemeliharaan

- pertumbuhan dan perkembangan - reproduksi

1. Diferensiasi Sel

2. Komunikasi intercelluler : - langsung

- tidak langsung 3. Adhesi sel

• !!! Each cell is unique

• !!! Each tissue is unique

• !!! Each organ is unique

4 Jaringan dasar :

- Epithel



menutupi

- Jaringan ikat



“mengikat”,

menghubungan, mengisi

- Otot



menggerakkan

- Otot polos

- Otot skeletal

- Otot jantung

- Saraf



meneruskan impuls

(“pesan”)

Gambaran &

fungsi

Body organs and structures contain

two types

of tissues:

•

The parenchymal tissues

contain the

functioning cells of an organ or body part

(e.g., hepatocytes, renal tubular cells).

•

The

stromal

tissues

consist

of

the

supporting connective tissues, blood vessels,

and nerve fibers

- Epithel



saling melekat erat

- Jaringan ikat



sel dan serabut/matriks

- Otot



dapat berkontraksi, mengandung

filamen penggerak

- Otot polos

- Otot skeletal

- Otot jantung

- Saraf



meneruskan impuls (“pesan”)

Gambaran & fungsi khusus



Epithel



Jaringan ikat



Otot



Syaraf

CIRI UMUM EPITHEL :

• dipisahkan dg jaringan di bawahnya oleh

Lamina

basalis /basement membrane

•

Avaskular

• melapisi pemukaan luar dan atau dalam

• selnya saling melekat satu sama lain



dg

perangkat khusus

(Intercellular Junction)

• ruang interseluler sedikit

• terdapat polarisasi

• Dapat terjadi differendiasi pada permukaan sel

Topografi



polarity

• Permukaan lateral (samping)

• Permukaan basal (“bawah”)

• Permukaan apikal (“atas”)

FUNGSI :

Umum : Membatasi permukaan/dalam cavitas

- TRANSPORT transeluler



difusi, karier,

vesikel

- Permeabilitas selektif



tight junction (*)

- Absorbsi



endocytosis.

ex : intestin

- Sekresi



exocytosis.

ex : kelenjar saliva

•

Selapis:

•

Berlapis:

Human Anatomy, Larry M. Frolich, Ph.D.

Epithel Berlapis

• Squamous

– E.g. epidermis

• Transitional

epithelium

– E.g. urinary structures--bladder

– Stretches from 6 cells to 3 cells thick as

bladder fills and expands

Kelenjar – Modifikasi dr epithel

Cavity Ep 1 2 3

A portion of an epithelium grows into the underlying supporting connective tissue. The downgrowth develops into a secretory portion and a duct. This is an exocrine gland. If the duct disappears, an extensive capillary

network collects the secretions in an ‘endocrine’ Gland (4).

4

Klj. exocrine

Klj. endokrin



Epithel



Jaringan ikat



Otot



Syaraf



Mengikat



Membentuk kompartemen



Penunjang



Pelindung



Penyimpanan



Repair



Transpor

FUNGSI :

• Tidak terpapar lingkungan luar secara

langsung

• Komponen dasar:

(1) specialized

cells

[SELULAR]

(2) extracellular protein

fibers

, and

(



klasifikasi)

* KOMPONEN

SELULER



Sel :



fibroblast



Fibrocyte



Makrofag



Mast cell



Plasma cell



Adipocyte



Sel2 derivat darah

KOMPONEN

•

Fibroblast

: berfungsi produksi, sekresi, dan

mempertahankan komponen matrix

extrasel. Bila inaktif



Fibrocyte

•

Mast cell

: berperan dlm respon inflamasi

•

Sel Lemak

: untuk penyimpanan lemak

•

Makrofag

: Fagositosis

•

Sel Plasma

: pembentukan Antibodi

•

Sel lain derivat darah



p.u Lekosit.

(Eosinofil, Limfosit). P.u berperan dalam

sistem imun

* KOMPONEN

INTERSELULER (= matrix)

:



Ground substace

Fungsi :

Penunjang, pengikat, penyimpanan,

media, dan mencegah invasi substansi asing,

dan menahan tekanan.

Terdiri dari :

Glikoprotein, glikosaminoglikan,

dan proteoglikan.

Secara kasat mata substansi dasar ini tidak

berwarna, transparan, dan nampak seperti gel. Di

dalamnya terdispersi serabut dan sel jaringan ikat.

KOMPONEN

* KOMPONEN

INTERSELULER (= matrix)

:



Serabut

:

•

Kolagen : dominan, meliputi puluhan tipe.

memberikan kekuatan/ketahanan terhadap

tarikan, membantu kekuatan & fleksibilitas.

•

Elastik : tersusun atas elastin dan fibrilin.

kemampuan untuk melenting & meregang

•

Reticular : lebih tipis dan membentuk jala-jala

halus, kaya akan karbohidrat

membentuk arsitektur beberapa organ &

kelenjar.

KLASIFIKASI

•

Embryonal

J.I longgar

J.I padat teratur

J.I padat TIDK teratur

Jaringan ikat sejati

Adipose tissue

Cartilago

osteon Supporting

Cartilago

-

Hyalin

-

Elastic

-

Fibrocartilage

Fungsi : kekuatan, elastisitas, dan ketahanan terhadap tekanan.

Komponen seluler cartilago terdiri dari: Chondroblast, Chondrocyte, chondroclast

Komponen ekstraseluler berupa serabut kolagen

(terutama Type II ) dan substansi dasar (ground substance).

Tdd : hylaluronic acid, proteoglycan, chondronectin dan Chondroitin sulfat.

!!! avascular dan tidak memiliki innervasi saraf.

*** diliputi oleh jaringan ikat padat dengan vaskular  perichondrium.

1. Cartilago Hyalin

 paling banyak ditemui dalam tubuh manusia

 Ex : permukaan sendi pada sendi gerak, dinding saluran nafas (trachea dan bronchus), ujung depan iga yang menempel sternum, dsb

2. Cartilago Elastis

• memiliki sebaran lokasi yang lebih terbatas, yaitu di auricula telinga, dinding liang telinga luar, sebagian dinding Tuba Eustachii, dan Epiglottis

• lebih banyak serabut elastis yang membentuk anyaman sehingga secara fungsional lebih mampu untuk

3. Fibro Cartilago

gambaran antara Jaringan ikat colagen padat dan Kartilago Hyalin.

Lokasinya sangat terbatas, yaitu di intervertebral disc (annulus fibrosus) dan simfisis pubis.

osteon

Fungsi : membentuk kerangka  menegakkan tubuh, melindungi jaringan lunak, serta tempat perlekatan otot / tendon

Matrix Tulang

• bahan inorganik : 65% dari berat kering tulang, yang terdiri dari calcium, phosphate, bicarbonate, citrate, magnesium, potassium, and sodium. Kebanyakan tersusun berupa kristal hydroxyapatite (Ca10(PO4).6(OH)2).

• bahan organic kurang lebih 35% dari berat bkering, yang terutama tersusun atas kolagen tipe I (95%). Termasuk di dalamnya ground substance yang mengandung chondroitin sulfate dan keratan sulfate.

Sel-sel tulang



Sel Osteoprogenitor



Osteoblasts



Osteocyte



Epithel



Jaringan ikat



Otot



Syaraf

KARAKTERISTIK

Sel = berbentuk serabut

Dalam sarcoplasma terdapat

contractile filament

(myofibril)

Komponen extrasel relatif sedikit

(terminologi)

* sitoplasma



sarcoplasma

* membran plasma



sarcolemma

* endoplasmic reticulum



sarcoplasmic reticulum

* mitochondria



sarcosome

………Characteristics of Muscle

• Contractility - ability to contract (develop tension)

• Excitability (Irritability) - ability to respond to a stimulus • Extensibility - ability to be stretched

Tipe otot :

• Otot bergaris (skeletal muscle)

• Otot polos (smooth muscle)

STRUKTUR

SEL

• Ukuran sel : P : s/d 30 mm Ф : 10 – 100 µ • Serabut : Silindris, panjang, tidak bercabang • Unique SR

• Inti :

Lonjong,pipih, multinucleated

tepi (di bawah sarcolemma)

Actin Myosin

SEL :

• P : 85-100 µ,Ф : 15 µ • Serabut : Silindris,

panjang, bercabang • Inti : 1-2, ovoid, pucat,

central

• Sarcoplasma :

 >> mitokhondria & granul2 glikogen & pigmen lipofuscin

STRUKTUR:

Sel : - bentuk spindle, dibungkus basal lamina & serabut retikuler

- susunan : bag.sempit menempel di bagian terlebar sel sebelah

Inti : tengah, dpt multinuclear, bulat lonjong (ovoid)

- Sitoplasma :terdapat organella & bundel2 myofilamen Sarcoplasmic reticulum rudimenter

MYOFILAMEN

• Filamen TIPIS

- actin & tropomyosin

- stabil, berkaitan dg dense body di membran plasma oleh α-actinin

• Filamen TEBAL

- myosin,kurang stabil - responsif thd stimulus



Epithel



Jaringan ikat



Otot

KLASIFIKASI

Secara STRUKTURAL : - neuron - neuroglia

Secara ANATOMIS :- CNS (otak dan medula spinalis)

- PNS ( serabut saraf & ganglia) Secara FUNGSIONAL : - ANS : * Parasimpatis

* Simpatis - Somatis

FUNGSI

 penunjang struktur

 membantu nutrisi neuron

 insulasi elektrik

 memperceepat konduksi impuls sepanjang axon

 pembentukan dan transmisi impuls (pasif)

 mempertahankan kompartemen

 memonitor material yg melintas

Type : • Macroglia : * astrocyte * oligodendroglia • microglia • sel ependym # sel Schwann # sel Satelit Utk CNS Utk PNS

Contoh :

System GIT

terdiri dari organ2 :  Esophagus  Gaster  Duodenum  Jejunum  Ileum  Caecum System CVS

terdiri dari organ2 :  Jantung

 Arteri  Vena  Kapiler

Contoh :

Pembuluh darah (Arteri dan vena)

 Dilapisi jaringan epithel

selapis pipih di bagian dalam

 Di lapisan tengah dilapisi

jaringan otot polos

 Di sisi luar terdapat

jaringan ikat longgar

 Dipersarafi oleh jaringan saraf

dr.Indriati Dwi R, M.Kes Lab. Anatomi-Histologi FKUB

•

Fertilization

•

Development Before Birth

•

Development of Male and Female Sex

•

Birth

Fertilization

sperma vs ovum

VIABILITY OF GAMETES

•

the oocyte cannot be fertilized after 24 hours

and that it degenerates shortly thereafter .

•

Most human sperms probably do not survive

for more than 48 hours in the female genital

tract

(1) Sperm penetration of

corona radiata

(2) Sperm binding and penetration of the zona pellucida

(3) one sperm enters the egg 

Fuse



zygote

Acrosome reaction :

•

_{Occurs after binding}

zona pellucida(zp)

•

Release of enzymes

(acrosin & trypsin

like substance )

needed to

Clinical Correlates

•

Contraceptive methods :

–

Barrier technique, ex : condom, diaphragm, cervical cap,

contraceptive sponges.

–

Hormonal contraceptive

:pills, Depo-provera, cyclofem,

morning-after

–

The intra uterine device(IUD).

–

Vasectomy and tubal ligation

•

Infertility :

= problem for 15%-30% couples :

–

Males : insufficient number of sperm and/or poor motility

–

Females : occluded oviduct, hostile cervical mucus,immunity

spermatozoa, absence of ovulation.

•

Fertilization

•

Development Before Birth

•

Development of Male and Female Sex

•

Birth

Development Before Birth

•

developmental stages

- pre-embryonic : fertilisasi s.d menjelang implantasi

- embryonic : mulai implantasi

Approximately 6 days after fertilization, the cell mass is termed a blastocyst. Human chorionic gonadotropin now is produced in amounts that may be detected by commercial laboratories.

zygote

embryoblast pre-embryonic

Inner cell mass = embryo Outer cell mass = trophoblast

Pre-embyonic

developmental

stages

Cleavage

•

Fertilization



zygote



2 cell stage



mitotic division



number of cells

Blastomeres

Cleavage is a series of mitotic

division that result in increase in

cells, blastomere, which become

smaller with each division

Blastocyst Formation :

•

At the time morula enter the uterine cavity,

fluids penetrate through zona pellucida into

intercellular spaces of inner cell mass(icm).

Single cavity (blastocele)

•

Embryo =blastocyst

•

Inner cell mass = embryo

•

Outer cell mass = trophoblast

Blastocyst Formation :

•

Early pregnancy factor, an

immunosuppressant protein, is secreted by

the trophoblastic cells and appears in the

maternal serum within 24 to 48 hours after

fertilization

Heading to

Implantation

•

Zona pellucida is covering the embryo until its

reach uterus



preparation for implantation

•

Four to 5 days after fertilization, the zona

pellucida is shed and the trophoblast adjacent to

the embryoblast attaches to the endometrial

Approximately 6 days after fertilization, the cell mass is termed a blastocyst. Human chorionic gonadotropin now is produced in amounts that may be detected by commercial laboratories.

Implantation

•

= kontak fisik & fisiologis pertama; antara blastocyst

vs mucosa uterus (6

th

_-8

th

_day),

•

3 phase :

–

Preparation of the uterus for adhesion and

implantation

–

Trophoblast-uterus adhesion

–

Blastocyst movement into the uterus (mid portion

of the posterior/anterior)

zona pellucide disappear →

polar trophoblast touch the endometrium→

secrete proteolytase → dissolve the endometrium →

embedded into endometrium→ coagulation plug

HLA-G

Tcell Bcell NKcell APC

Th1Th2 Apoptosis Inhibisi cytitoxic Ab anti HLA-G Inhibisi toksisitas Sekresi : PgE2, IL-10, TGF Resistensi trophoblast Eliminasi - Supresi Supresi embryonic

embryonic

Clinical corellation 3

Abnormal implantation :

•Immunorejection

•Placenta praevia

•Ectopic pregnancy

Organogenesis

Embyonic

developmental

stages

4 to 8 week of development (organogenesis

)

•

Differentiation of ectoderm:



CNS

•

Differentiation of mesoderm:



dermis,

bone, cartilage, CT, muscles, pleura,

peritoneum and pericardium,

cardiovascular and lymph system

•

Differentiation of endoderm:



digestive,

respiratory and urinary system

Fetal Development

During fetal development, the fetus has a human appearance, but refinements are still taking place.

Fetal

developmental

stages

Extraembryonic Membranes

1. Chorion. The chorion develops into the fetal half of the placenta,

2. Yolk sac. The yolk sac has little yolk and is the first site of blood cell formation.

3. Allantois. The allantois blood vessels become the umbilical blood vessels.

4. Amnion. The amnion contains fluid to cushion and protect the embryo.

 embryonic period lasts from approximately 2 weeks after fertilization until 8 weeks after fertilization, THEN  FETUS

!!! Most body structures are formed during the embryonic period

PLACENTA :

- Mulai akhir mgg I

- 100 % : akhir embryo, awal fetal

The placental membrane

• separates maternal blood from fetal blood.

• Some substances that cross can be either beneficial or harmful. Some substances do not cross the placental membrane.

• The composition of the placental membrane changes during pregnancy.

A. In early pregnancy, the placental membrane has four layers: syncytiotrophoblast, cytotrophoblast (Langhans cells),

connective tissue, and endothelium of fetal capillaries.

Hofbauer cells (large, sometimes pigmented, elliptical cells found in the connective tissue), are most numerous in early pregnancy and have characteristics similar to those of

macrophages.

B. In late pregnancy, the placental membrane has two layers: the syncytiotrophoblast and the endothelium of fetal capillaries.

TRANSPLACENTAL DRUG TRANSFER

•

Most drugs move from the maternal circulation to

the fetal circulation

by diffusion

.

•

Drugs with molecular weights less than 500 Da

readily cross the placenta, whereas larger molecules

(600–1,000 Da) cross more slowly.

•

Drugs with molecular weights

greater than 1,000 Da

,

such as insulin and heparin,

do not cross

the

TRANSPLACENTAL DRUG TRANSFER

•

Lipophilic

drugs

, such as opiates and antibiotics,

cross the placenta

more easily

than do water-soluble

drugs.

•

Maternal plasma albumin progressively decreases

while fetal albumin increases during the course of

pregnancy,



higher concentrations of certain

protein-bound drugs

in the

fetus.

•

Fetal pH is slightly more acidic than maternal pH,



permitting

weak bases

to more easily cross the

•

Fertilization

•

Development Before Birth

•

Development of Male and Female Sex

•

Birth

• During weeks 1–6, the embryo remains in a sexually indifferent or undifferentiated stage.

 genetically female embryos and male embryos are phenotypically indistinguishable.

• During week 7, the indifferent embryo begins phenotypic

sexual differentiation.

• By week 12, female or male characteristics of the external genitalia can be recognized.

Development

of Sex organs

Phenotypic sexual differentiation is determined by the SRY gene (di

kromosom Y) The SRY gene encodes testes-determining factor [TDF] In the presence of TDF, testosterone, and MIF 

•

Fertilization

•

Development Before Birth

•

Development of Male and Female Sex

•

Birth

Time of birth

•

The length of pregnancy is considered to be

280

days or 40 weeks

after the

onset of last normal

menstrual period

or more accurately

266 days or

38 weeks after fertilization

•

The age of embryo determined by combining data

of the onset last menstrual period with fetal

length, weight, and morphological characteristic

•

Fertilization

•

Development Before Birth

•

Development of Male and Female Sex

•

Birth

Development After Birth

life stages in humans

•

Neonatus : s.d 30 hari

(*)

•

Bayi 1

•

Batita

•

Balita

•

Anak

•

Pubertas

•

Adolescence : puberty to reproduction

• Abortion:

Interruption of pregnancy before pregnancy 28 weeks with the death of her fetus

• Perinatal period:

The period since pregnancy 28 -7 mgg days after birth. • Neonatal period:

The period from birth until the age of 4 weeks (28 days) after birth. • Preterm:

Babies born with a gestation <37 weeks (<259 days) • Term:

Babies are born with a gestational age between 37-42 weeks (259-293 days)

• Post-term:

Babies born with gestational age> 42 weeks (294 days) • Low birth weight:

Babies born weighing <2500 grams. Small for gestational age (SGA)

•

BBLR dapat disebabkan obat2an, a.l :

Antikonvulsan, warfarin, antagonis asam folat,

anti neoplasma

A teratogen

is any infectious agent, drug, chemical, or

irradiation that alters fetal morphology or fetal function if the fetus is exposed during a critical stage of development.

1. The resistant period (week 1 of development)  the “all

-or-none” phenomenon (i.e., the conceptus will either die as a result of the teratogen or survive unaffected).

2. The maximum susceptibility period (weeks 3–8; 18 to 60 days postconception = embryonic period). All organ morphogenesis

occurs at this time. Teratogenic exposures may result in

structural anomalies.

3. The lowered susceptibility period (weeks 9–38; fetal period) All organs systems have already formed;

Teratogen exposure at this period generally results in a

functional derangement of an organ system. may result in structural anomalies.

X-drugs

: absolut c.i

•

Thalidomide

•

Antagonis as.folat : ex:aminopterin, MTX

•

Alkylating agent : ex : busulfan

•

Fenitoin

•

Warfarin

•

Clomiphene

•

Nicotine

•

Alcohol

•

etc

D-drugs

: risky (by evidence)



Diazepam



Hct



Tetra



Fenobarbital



As.valproat



etc

MATERNAL PHARMACOKINETIC CHANGES

•

_{maternal plasma volume, cardiac output, and glomerular}

filtration increase by 30% to 50%,

potentially lowering the

concentration of renally cleared drugs

•

body fat increases during pregnancy, the volume of

distribution of fat-soluble drugs may increase

•

_{Plasma albumin concentration decreases, which}

_increases

the volume of

distribution of drugs that are highly protein

bound

. However, these unbound drugs are more rapidly

cleared by the liver and kidney during pregnancy, resulting in

little change in concentration

Gratias...