KEMAMPUAN AKHIR YANG DIHARAPKAN

(1)

NEUROANATOMI dan FISIOLOGI OTAK PERTEMUAN KE - 2

ABDUL CHALIK MEIDIAN & JERRY MARATIS

(2)

KEMAMPUAN AKHIR YANG DIHARAPKAN

• Mahasiswa mampu memahami konsep dasar keilmuan bidang Neurosains dalam

A.Penerapannya  teori bidang fisioterapi

B. Implementasinya  praktik kasus penyakit bid. Fisioterapi

(3)

Gangguan Gerak dan fungsi

•

Gangguan gerak dan fungsi pada

kasus neurologi ini dapat

digolongkan sebagai sesuatu yang

unik, karena alat gerak tubuh itu

sendiri, dimana gerakan itu terjadi,

seperti otot, tendon dan tulang

tempat perlekatannya serta sendi,

berada dalam keadaan yang normal.

(4)

Proses Gerak Secara umum

Suatu gerakan terjadi dengan proses sbb: (1)Ide

(2)Perencanaan motorik

(3)Pengambilan keputusan (4)Programming proses

(5)

Susunan Saraf pada Tubuh Manusia

• SUSUNAN

SARAF

•

Susunan saraf pusat (SSP)

– _Otak

– _{Medulla Spinalis}

•

Susunan saraf tepi (SST)

– _{Saraf kranial : 12 ps}

(6)

(7)

Perjalanan Impuls Sensorik & Motorik

• Sensorik

Sensorik Tepi: Receptor  serabut saraf sensorik perifer ganglion pre spinale PHC

Sensorik Pusat: PHC  tr spinothalamicus 

thalamus 

tr. thalamo corticalis  cortex sensorik

• Motorik

• Upper Motor Neuron (UMN)/Motorik Pusat

: Cortex motorik  tr piramidal & extra piramidal (cortico spinalis)  AHC.

(8)

Brain (Otak)

• Berat otak 1200 – 1400 gram (2 % Berat Badan)

• Terbagi atas

– Otak besar (cerebrum)

– Otak kecil (cerebellum)

– Batang otak (brain stem, truncus cerebri)

Hemisfer Otak terdiri 4 Lobus :

1. Lobus Frontalis : fungsi kognitif, persepsi, bahasa & bicara 2. Lobus Parietalis : fungsi memproses informasi sensorik 3. Lobus Temporalis : fungsi memproses pendengaran

(auditory)

(9)

Lapisan Otak

•

Selaput otak-spinal terdiri dari 3

lapis, yaitu:

– _Duramater – Arachnoid

– Piamater

•

Dengan adanya selaput ini, maka

terbentuk ruangan-ruangan

– Subdural

(10)

Cerebrum (Otak Besar)

• _{Cerebrum (otak besar) merupakan bagian}

otak manusia yang terbesar, paling

berkembang dan memiliki fungsi luhur yang paling utama.

• _{Otak besar terdiri dari substansia abu-abu}

(grey mater) setebal + 2 cm (cortex cerebri) yang berfungsi sebagai pusat

(11)

• Sedangkan bagian dalam otak merupakan substansia

putih (white matter) berisi “network”

(12)

(13)

(14)

(15)

Peran Cerebellum dan Brain stem

• _{Cerebellum (otak kecil) merupakan bagian}

otak terbesar kedua, yang bertanggung jawab dalam mengatur keseimbangan, koordinasi dan berbagai kontrol motorik

• Brain stem (batang otak) merupakan jalur terakhir dari otak yang

(16)

Medulla Spinalis

•

Medulla spinalis berawal dari dasar

otak berjalan kebawah melalui

segmen cervical dan thorakal dan

berakhir setinggi antara L1-L2 (conus

medularis) ke bawah melanjutkan

(17)

(18)

Gross anatomy of the brain

•

Neuroscience is a composite of

several disciplines including :

– _{neuroanatomy,} – _{neurophysiology,} – _neurology,

– _{neuropathology,}

– _{neuropharmacology,}

– _{behavioral sciences, and} – _{cell biology.}

– _Etc.

(19)

Gross anatomy of the brain

•

An overview of the structural

organization of the nervous

system is helpful when beginning

to study the neurosciences.

•

However, frst it would be useful to

(20)

Neuroanatomical Terms (1)

•

The spatial relationships of the

brain and spinal cord usually are

described by one or more of fve

paired terms:

–

medial–lateral

–

anterior–posterior

–

rostral–caudal

–

dorsal–ventral

(21)

Neuroanatomical Terms (2)

•

Other terms commonly used in

neuroanatomy are:

– _{Ipsilateral–contralateral}

– _{Commissure and decussation} – _Neuron

– _Nucleus – _Tract

(22)

(23)

Medial-Lateral

•

Medial

means toward

the median plane, and

lateral

means away

(24)

Anterior–posterior

•

Above the midbrain,

brain, and

posterior

means

toward the back of the brain.

•

At and below the midbrain,

anterior means toward the

ventral surface of the body, and

posterior means toward the

(25)

Rostral–caudal

•

Above the midbrain,

rostral

means

toward the front of the brain, and

caudal

means toward the back of

the brain.

•

At and below the midbrain, rostral

(26)

Dorsal–ventral

•

Rostral to the midbrain,

dorsal

refers to the top of

the brain, and

ventral

refers

to the bottom of the brain.

•

At the level of and caudal to

the midbrain, dorsal means

toward the posterior surface

of the body, and ventral

refers to the anterior surface

of the body.

(27)

Superior–inferior

•

Both at positions above and

below the midbrain,

superior

means toward the top of the

cerebral cortex, and

inferior

(28)

Ipsilateral–contralateral

•

Ipsilateral

means on the

same side with reference to a

specifc point;

contralateral

means on the opposite side.

(29)

Commissure and decussation

•

Commissure

is a group of

nerve fbers connecting one

side of the brain with the

other.

Decussation

is the

(30)

Neuron

•

A

neuron

is the anatomical

and functional unit of the

nervous system, which

consists of a

nerve cell

body

,

dendrites

(which

receive signals from other

neurons), and an

axon

(which transmits the signal to

(31)

Nucleus

•

Nucleus

refers to groups of

neurons located in a specifc

region of the brain or spinal

cord that generally have a

similar appearance, receive

information from similar

(32)

Tract

•

Many axons grouped

together, which typically

pass from a given nucleus

to a common target region

or to several regions, form

a

tract.

(33)

White and gray matter

• _{When examining the brain or spinal cord}

with the unaided eye, one can distinguish white and gray tissue.

• _{The region that appears white is called}

white matter, and the area that appears gray is called gray matter.

• _{The appearance of the white matter is due}

to the large number of myelinated axons

(34)

(35)

(36)

Glial cells

•

These nonneural cells form

the interstitial tissue of the

nervous system.

•

There are diferent types of

glial cells

, which include

astrocytes

,

oligodendrocytes

,

microglia

, and

ependymal cells

(37)

Central and peripheral nervous

systems

• _The_{central nervous system (CNS)}_includes

the brain and spinal cord and is surrounded and protected by three connective tissue coverings called meninges.

• _{Within the CNS are fuid-flled spaces called}

ventricles.

• _{The bone of the skull and vertebral column}

surround the brain and spinal cord, respectively.

• _The_{peripheral nervous system (PNS)}

(38)

Autonomic and somatic nervous

systems

• _{These are functional subdivisions of the}

nervous system (in contrast to the anatomical classifcations described

earlier). Both of these divisions are present in the CNS and PNS.

• _The_{autonomic nervous system}

innervates smooth muscle and glands, whereas the somatic nervous system

innervates mainly musculoskeletal

structures and the sense organs of skin.

(39)

(40)

(41)

(42)

(43)

(44)

(45)

(46)

(47)

(48)

Components of the Central Nervous

System

(49)

Components of the

(50)

Cerebral Topography

1. Lateral Surface of the Brain

2. Medial Surface of the Brain

3. Inferior (Ventral) Surface of the

Cerebral Cortex

4. Posterior Aspect of the Cerebral

Cortex: Temporal and Occipital

Lobes

(51)

Lateral Surface of the Brain

(gambar 1.2)

•

Four lobes of the cerebral

cortex—

–

the

frontal

,

–

parietal

, and

–

temporal lobes

and

(52)

(53)

(54)

(55)

•

The lobes of the cerebral cortex

integrate:

–

motor,

–

sensory,

–

autonomic, and

(56)

•

The cortex consists of both :

–_cells

–_{nerve fbers}

•

The cellular components constitute

the gray matter of cortex and lie

superfcial (i.e., toward the surface of

the cortex) to the nerve fbers.

(57)

(58)

(59)

(60)

(61)

Medial Surface of the Brain

(Gambar 1.3)

•

The principal structures on the

medial aspect of the brain can

be seen clearly after the

hemispheres are divided in

(62)

(63)

(64)

(65)

(66)

Inferior (Ventral) Surface of the

Cerebral Cortex

(Gambar 1.4)

• _{The medial aspect of the anterior part of}

the prefrontal cortex contains a region called the gyrus rectus.

• _{Lateral to the gyrus rectus lies a structure}

called the olfactory bulb, a brain

structure that appears as a primitive form of cortex consisting of neuronal cell

bodies, axons, and synaptic connections.

• _{The olfactory bulb receives information}

from the f rst (olfactory) cranial nerve and gives rise to a pathway called the

(67)

(68)

Posterior Aspect of the Cerebral

Cortex: Temporal and Occipital Lobes

(Gambar 1.4, 1.5, 1.6)

• _The_{occipitotemporal gyrus}_lies

medial to the inferior temporal gyrus

and is bound medially by the collateral sulcus.

• _The_{parahippocampal gyrus}_lies

medial to the collateral sulcus.

• _{There is a medial extension of the}

anterior end of the parahippocampal gyrus called the uncus.

• _{The hippocampal formation and}

amygdala (described in the following discussion) are situated deep to the cortex of the parahippocampal gyrus and uncus.

(69)

Forebrain Structures Visible in

Horizontal and Frontal Sections of

the Brain

•

Ventricles

•

Basal Ganglia

•

Diencephalon

(70)

Ventricles

•

As shown in horizontal and

frontal sections of the brain

cavities present within each

hemisphere are called

ventricles and contain

cerebrospinal fuid

([CSF]

(71)

(72)

Basal Ganglia

•

The basal ganglia play an important

role in motor integration processes

associated with the cerebral cortex.

Damage to this region results in

motor dysfunctions referred to as

dyskinesias

(i.e., disorders of

movement at rest).

(73)

Diencephalon

•

As mentioned previously, the

diencephalon includes

principally the thalamus,

situated dorsally, and the

hypothalamus, situated

(74)

Limbic Structures

•

Limbic structures serve

important functions in the

regulation of emotional behavior,

short-term memory processes,

and control of autonomic, other

visceral, and hormonal functions

usually associated with the

hypothalamus.

(75)

(76)

(77)

(78)

(79)

Topography of the Cerebellum

and Brainstem

•

The cerebellum

plays a vital role

in the integration, regulation, and

coordination of motor processes.

Damage to this region can result in

loss of balance, loss of coordinated

movements,

hypotonia

, and errors

in movement when attempting to

(80)

(81)

(82)

General Function of The

brain

(83)

(84)

(85)

(86)

(87)

(88)

(89)

(90)

Proses Gerak SECARA UMUM

Suatu gerakan terjadi dengan proses sbb: (1)Ide

(2)Perencanaan motorik (3)Pengambilan keputusan (4)Programming proses

(5)Perintah untuk gerakan (6)Eksekusi gerakan.

(91)

Gangguan Gerak

• _{Ganguan gerak dan fungsi pada kasus}

neurologi ini dapat digolongkan sebagai sesuatu yang unik, karena alat gerak

tubuh itu sendiri dimana gerakan itu terjadi, seperti otot, tendon dan tulang

tempat perlekatannya serta sendi berada dalam keadaan yang normal.

• _{Kelainan pada sistem saraf yaitu}

(92)

Reference

1. Siegel, A. Sapru, H, N. 2015.

Essential Neuroscience. 3rd.

Philadelphia: Lippincott Williams &

Wilkins

2. Kandel, E, R. Et. Al. 2013. Principles

Of Neural Scoence. 5th. New York:

McGraw-Hill Companies