Patofisiologi

1. FISIOLOGI OTAK DAN
SARAF KRANIAL
SEKOLAH TINGGI ILMU KESEHATAN KOTA SUKABUMI
Program Study S1 Keperawatan
https://stikeskotasukabumi.wordpress.com

2. Thalamus
Hypothalamus
Midbrain
Pons
Medulla
Oblongata
Cerebrum
Corpus
callosum
Cerebellum
Area otak bagian kanan

3. Divisions and function of the brain
Brainstem Connect the spinal cord to the cerebrum, several important
functions, location of cranial nerve nuclei
Medulla
Oblongata
Pathway for ascending and descending nerve tracts; center for
several important reflexes (e.g., heart rate, breathing,
swallowing, vomiting)
Pons Contains ascending and descending nerve tracts; relay between
cerebrum and cerebellum; reflex centers
Midbrain Contain ascending and descending nerve tracts; visual reflex
centers; part of auditory pathway
Reticular
formation
Scattered throughout the brainstem; controls cyclic activities
such as the sleep-wake cycle
Cerebellum Control of muscles movement and tone; regulates extent of
intentional movement; involved in learning motor skills
Division ……………………

4. Diencephalon
Thalamus Major sensory relay center; influences mood and movement
Subthalamus Contain nerve tracts and nuclei
Epithalamus Contains nuclei responding to olfactory stimulation and contains
pineal body
Hypothalamus Major control center for maintaining homeostasis and regulating
endocrine function
Cerebrum Conscious perception; thought, and conscious motor activity;
can override most other systems
Basal Nuclei Control of muscle activity and postures; largerly inhibit
unintentional movement when at rest
Limbic System Autonomic response to smell, emotion, mood, and other such
functions
Brainstem ………………

5. Batang Otak
1. Batang otak menyambungkan medula spinalis dengan bagian
otak lainya
2. Bertanggung jawab terhadap beberapa fungsi  kerusakan
pada area walaupun kecil dapat menyebabkan kematian
3. Batang otak terdiri dari medula oblongata, pons dan midbrain

6. Gambaran depan batang otak dan diencephalon
Medulla oblongata ……..

7. Medulla Oblongata
1. medulla oblongata bersambungan dengan medula spinalis dan terdiri dari
jalur saraf asending dan desending
2. pyramids adalah jalur saraf yang berisi saraf pergerakan otot
3. olives adalah nukleus yang berfungsi dalam keseimbangan, koordinasi,
dan modulasi suara dari telinga bagian dalam
4. Medullary nuclei mengatur denyut jantung, pembuluh darah, respirasi,
menelan, batuk, bersin, dan sendawa . Nukleus saraf kranial V and IX –
XII ada di medula
Pons …………..

8. Pons
1. pons ada di atas medula
2. Jalur saraf asending dan desending melewati pons
3. Mengatur tidur dan respirasi. Nukleus saraf kranial V – IX are ada di
Pons
Midbrain ………

9. OTAK TENGAH
1. Otak tengah ada di atas PONS
2. Otak tengah terdiri dari nukleus nervus kranialis III, IV, and V
3. The substantia nigra connect to other basal nuclei and is involved with
muscle tone and movement
Reticular formation ……………

10. FORMASI RETIKULARIS
Formasi retikularis terdiri dari nukleus pd batang otak. RAS meluas ke
talamus dan cerebrum dan berfungsi mempertahankan kesadaran.

11. Cerebellum
1. Cerebellum berkomunikasi dengan otak tengah , pons,
dan medula oblongata
2. Cerebellum 3 bagian , flocculonodular lobe, vermis, and
lateral hemisphere.
3. Flocculonodular lobe merupakan bagian yang paling
sederhana membantu mengontrol keseimbthe simplest
part helps control balangan dan pergerakan mata
4. The vermis and medial portion of the lateral hemisphere
are involved in the control of posture, pergerakan, dan
koordinasi gerakan motorik halus  menghasilkan
gerakan yang halus
5. The major portion of the lateral hemispheres is
involved, with the cerebral cortex of the frontal lobe, in
planning, practicing, and learning complex movements
Diencephalon …………

12. Diencephalon
Diencephalon merupakan bagian dr otak dan berada diantara
batang otak dan cerebrum. Komponen utamanya adalah talamus,
sub talamus, epi talamus dan hipotalamuss

13. Thalamus
1. Merupakan bagian terbesar dari diencephalon.
2. Ian Ruangan sekitar bagian intermediate mass disebut ventrikel ke 3 otak
3. Hampir seluruh input sensoris masuk ke thalamus
4. Thalamus mempengaruhi mood dan emosi
5. ……………..

14. 5. Bagian ventral terlibat dalam fungsi motor dan mengkomunikasikan
antara basal ganglia, cerebellum, dan motor cortex.
6. Bagaian anterior berhubungan dengan sistem limbik .
7. Bagian dorsal sisi berhubungan dengan korteks serebri dan berperan
mengatur emosi
8. Bagian sisi belakang berperan dalam integrasi sensoris

15. Subthalamus
1. Bagian kecil dibawah talamus
2. Sebagian kecil dari nukleus dan substantia nigra di otak tengah meluas
sampai ke sub talamus
3. Sel sub talamus berhubungan dengan sel basal dan berperan dalam
mengontrol fungsi motorik

16. Epithalamus
1. Berada pada bagian atas belakang talamus terdiri dari sel habenular dan
bana pineal
2. Sel Habenular dipengaruhi oleh penciuman dan terlibat dalam emosi dan
respon terhadap bau
3. Badan pineal berperan dalam mulai pubertas dan juga berperan dalam
siklus tudur dan terjaga
Hypothalamus …………..

17. Hypothalamus
1. Bagian paling bawah dari diencephalon terdiri dari beberapa sel dan jaras-
jaras
2. Badan mammilary merupakan pusat refleks untuk penciuman
3. Hypothalamus mengatur beberapa fungsi endokrin (metabolisme,
reproduksi, respon terhadap stress, dan produksi urin). Kelenjar pituitari
menempel pada hipotalamus
4. Hipotalamus mengatus suhu tubuh, rasa lapar, haus, menelan dan juga
emosi.

18. Hypothalamic functions
Function Description
Autonomic Helps control heart rate, urine release from the bladder,
movement of food through the digestive tract, and blood vessel
diameter
Endocrine Helps regulate pituitary gland secretion and influences
metabolism, ion balance, sexual development, and sexual
functions
Muscle tone Controls muscles involved in swallowing and stimulate
shivering in several muscles
Temperature
regulation
Promotes heat loss when the hypothalamic temperature
increases by increasing sweat production (anterior
hypothalamus) and promotes heat production when the
hypothalamic temperature decreases by promoting shivering
(posterior hypothalamus)
Hypothalamic functions ………………..

19. Regulation of
food and water
intake
Hunger center promotes eating and satiety center inhibits eating;
thirst center promotes water intake
Emotions Large range emotional influences over body functions; directly
involved in stress – related and psychosomatic illnesses and
with feelings of fear and rage
Regulation of
the sleep–wake
cycle
Coordinates responses to the sleep-wake cycle with the other
areas of brain (e.g., the reticular activating system)
Cerebrum …………

20. Cerebrum
1. Bagian koteks dari cerebrum berlipat lipat, bagian tonjolan disebut girus
dan lipatan disebut sulci, atau fisur
2. Belahan longitudinal membagi cerebrum menjadi hemisfer kiri dan kanan.
Setiap hemisfer memiliki lima lobus:
a. Lobus frontalis untuk penciuman, fungsi motorik volunter, motivasi,
agresi dan mood
b. Lobus parietalis untuk area sensori utama menerima sensasi umum,
rasa dan keseimbangan
c. Lobus oksipitalis merupakan pusat penglihatan
d. LObus temporalis menerima input dari olfactorius dan auditori dan
terlibat dalam memori, fikiran abstrak dan keputusan
e. Cerebelum fungsinya equilibrium
3. Jaras saraf yang menghubungkan corteks dalam hemisfer yang sama
disebut serabut asosiasi, antara hemisfer berbeda disebut serabut
commisural dan dengan bagian otak lain dan medula spinalis disebut
serabut projeksi

22. AREA FUNGSIONAL DARI KORTEKS
SEREBRI
AREA MOTORIK DAN SENSORIK

23. Area fungsional korteks yang utama :
1. Area sensoris menerima dan menginterpretasikan impuls
2. Area motorik mengontrol pergerakan otot
3. Area asosiasi mengurusi fungsi integratif yang lebih
kompleks seperti memori, emosi, keinginan, penilaian,
personaliti dan kecerdasan

24. Area sensosik
1. Input sensorik ke korteks serebri masuk terutama ke
setengah hemisfer bagian bawah menuju ke sulci
2. Di dalam korteks, reseptor sensori primer langsung
berhubungan dengan reseptor sensori perifer
3. Ares sensoris sekunder dan area asosiasi bersebelahan dengan
area primer. Menerima input dari area primer dan disebarkan
ke bagian lain otak. Berperan dalam pola pengenalan dan
kewaspadaan

25. AREA MOTORIK
INPUT MOTORIK DARI KORTEKS SEREBRI MENJALAR
TERUTAMA DARI BAGIAN ANTERIOR DARI SETIAP
HEMISFER

26. REFLEKS REFLEKS DI BATANG OTAK MELIBATKAN
SARAF KRANIA
1. Banyak refleks yang melibatkan homeostatis berkaitan
dengan syaraf kranial dan muncul di batang otak
2. Banyak dari refleks di batang otak berhubungan dengan
fungsi nervus kranialis

27. INTEGRASI DAN SARAF PUSAT

28. SENSASI
1. SENSASI MELIPUTI SENSASI UMUM DAN SPESIAL
2. Sensasi somatik meliputi sentuhan, tekanan, suhu, proprioseptif dan
nyeri
3. Sensasi visceral terutama sakit dan tekanan
4. Sensasi spesial meliputi penciuman, perasaan, penglihatan,
pendengaran dan keseimbangan
5. Sensasi atau persepsi adalah kewaspadaan yang disadari terhadap
stimulus yang diterima oleh reseptor sensori
6. Sensasi memerlukan stimulus, sebuah reseptor , konduksi dari
potensial aksi ke ssp, translasi dari potensial aksi, dan pemrosesan
potensial aksi dalam SSP sehingga seseorang sadar akan adanya
sensasi

29. RESEPTOR
1. Reseptor meliputi mekano reseptor, kemoreseptor ,
fotoreseptor dan nociceptor
2. Ujung saraf bebas mendeteksi sentuhan ringan, nyeri,
gatal, geli, dan temperatur

30. Reseptor di dalam kulit
1. Lempengan Merkel’s berespon terhadap sentuhan ringan dan
tekanan superfisial
2. Reseptor Folikel Rambut terlibat juga dalam sensasi sentuhan
ringan apabila rambut tertekuk

31. Reseptor di kulit
3. Badan pacini ada di lapisan dermis mendeteksi tekanan dan juga
terlibat dalam fungsi proprioseptif
4. Badan Meissner’s ada di lap dermis bertanggung jawab
mendiskriminasi dua titik sentuhan yang berbeda

32. Reseptor di kulit
Organ Ruffini’s terlibat dalam sentuhan yang kontinyu atau tekanan
organ

33. Reseptor sensori dalam otot
Serabut otot yang ada di dalam otot skelet merupakan proprioseptor

34. Reseptor Sensori di tendon
Organ golgi tendon yang ada di dalam tendon berespon pada perubahan
tekanan

35. TWO-POINT DISCRIMINATION
Apabila dua titik sentuhan atau tekanan berdekatan makaorang akan
merasakan satu titik, tapi apabila berjauhan maka akan bs membedakan
dua titik

36. Respon dari reseptor sensori
1. Menciptakan potensial reseptor di dalam reseptor sensoris.
Umumnya reseptor memiliki akson yang kemudian akan
mentransmisikan potensial
2. Proses adaptasi dapat menurunkan sensitifitas terhadap stimulus
yang kontinyu

37. Jalur Saraf Sensori
Spinothalamic System
Traktus spinothalamic bagian sisi
menyalurkan potensial aksi dr nyeri dan
suhu

38. Traktus Saraf Sensori
Spinothalamic System
Bagian depan traktus spinothalamic
menyalurkan potensial aksi untuk
sntuhan ringan

39. Posterior Spinocerebellar Tract
Traktus ini menjalarkan informasi
proprioseptif dr toraks, tungkai atas dan
begian lumbar atas ke cerebelum

40. AREA SENSORI KORTEKS SEREBRI
FUNGSI SISI KIRI DR KORTEKS SEREBRI

41. Areas of Referred pain on
the Body Surface

42. Topography of
the Somatic
Sensory Cortex

43. Topography of the
Primary Motor
Cortex
MOTOR
CORTEX

44. Direct Pathways
Lateral and anterior corticospinal
tract, which are responsible for
movement below the head. Lines in
the inset indicate levels of section

45. Indirect Pathways
Examples of indirect pathways:
rubrospinal and reticulospinal tracts.
Lines in the inset indicate levels of
section

46. Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron
1. The motor cortex sends action potentials to lower motor neurons in the spinal
cord

47. 2. Action potentials from the motor neuron inform the cerebellum of the
intended movement
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

48. 3. Lower motor neurons in the spinal cord send action potentials to the
skeletal muscle, causing them to contract
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

49. 4. Proprioceptive signals from the skeletal muscles and joints to the
cerebellum conveys information concerning the status of the muscle and
the structure being moved during contraction
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

50. 5. The cerebellum compares the information from the motor cortex to the
proprioceptive information from the skeletal muscles and joints
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

51. 6. Action potentials from the cerebellum to the spinal cord modify the
stimulation from the motor cortex to the lower motor neuron
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

52. 7. Action potentials from the cerebellum are sent to the motor cortex, which
modify its motor activity
Cerebellar Comparator Function
Motor Cortex
Skeletal
muscle
1
2
3
4
5
6
7
Red nucleus
Proprioception
Thalamus
Cerebellum
Spinal cord
Lower motor
neuron

53. BRAIN WAVES AND SLEEP
EEG showing brain waves
(a) EEG tracing when a person is awake and during four stage of sleep.
(b) Atypical night’s sleep pattern in a young adult. The time spent in REM sleep
is labeled and shown by dark bars

54. MEMORY
1. Sensory memory
 Very short-term retention of sensory input received by the brain
while something is scanned, evaluated, and acted on.
 Lasts less than a second
2. Short term memory
 If a given piece of data held in sensory memory is considered
valuable enough, information is retained for a few second to a few
minute
 This memory is limited by the number of bits of information (usually
about seven, telephone number) that can be stored at one time,
although the amount varies from person to person. More bit can be
stored when the number are grouped into specific segments separated
by the spaces, such as when adding an area code. This memory will
be eliminated when a new information is given
3. Long-term memory………..

55. Limbic System
1
2
3
4
5
6
7
8
9
10
11
12
13
1. Fornix
2. Anterior
thalamic
nucleus
3. Anterior
commissure
4. Septal nucleus
5. Olfactory bulb
6. Olfactory
Cortex
7. Mammillary
body
8. Cingulate
gyrus
9. Corpus callosum
10. Habenular nucleus
11. Dentate nucleus + 12 Fimbria = Hippocampus
13. Amygdaloid nucleus

56. Limbic System
1. The limbic system includes parts of the cerebral cortex, basal
nuclei, thalamus, hypothalamus, and the olfactory cortex
2. The limbic system controls visceral function through the
autonomic neurons system and the endocrine system and is
also involved in emotion and memory

57. Cranial Nerves
1. Cranial nerves perform sensory, somatic motor,
prorprioceptive, and parasympathetic function
2. N. I (olfactory) and II (optic) are involved in sense of smell
and vision
3. N. III (oculomotor) innervates four of six extrinsic eye
muscles and the upper eyelid. The N. III also provides
parasympathetic supply to the iris and lens of the eye
4. N. IV (trochlear) controls an extrinsic eye muscle
5. …..

58. Cranial Nerves
5. N. V (trigeminal) supplies the mastication muscles, as well as
middle ear muscle, a palatine muscle, and two throat muscle.
Has the greatest sensory distribution of the cranial nerve. Has
three branches, two of them innervate teeth
6. N. VI (abducens) control an extrinsic eye muscle
7. N. VII (facial) supplies the muscles of the facial expression,
an inner ear muscle, and two throat muscles. It is involved in
the sense of taste. It’s parasympathetic to two set of salivary
glands and to the lacrimal glands
8. N. VIII (vestibulocochlear) is involved in the sense of hearing
and balance
9. ………..

59. 9. N. IX (glossopharyngeal) in involved in taste and supplies
tactile sensory innervation from the posterior tongue, middle
ear, and pharynx. It’s also sensory for receptors that monitor
blood pressures and gas level in the blood. N. IX is
parasympathetic to the parotid salivary glands
10. N. X (vagus) innervates the muscles of the pharynx, palate,
and larynx. It’s also involved in the sense of taste. N. X is
sensory for pharynx and larynx and for receptors that monitor
blood pressure and gas level in the blood. N. X. is sensory
for thoracic and abdominal organs. N. X provides
parasympathetic innervation to the thoracic and abdominal
organs
11. …….

60. 11. N. XI (accessory) has a cranial and a spinal component.
The cranial component joins the vagus nerve. The spinal
component supplies the sternocleidomastoid and trapezius
muscles.
12. N. XII (hypoglossal) supplies the intrinsic tongue muscles,
three of four extrinsic tongue muscles, and two throat
muscles.