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KELENJAR PARATIROID

TIROID
PARATIROID

CHIEF CELL

OXYPHIL CELL

METABOLISME TULANG

TULANG :

- ORGANIK MATRIX : 30%


- GARAM-GARAM

: 70%

* ORGANIK MATRIX
95% : KOLAGEN
5% : GROUND SUBSTANCE
- MUKO PROTEIN

(CHONDROITIN SULFAT &


ASAM HIALURON)

* GARAM-GARAM TULANG

T.U. : CALCIUM
PHOSPHAT

HYDROXYAPATITIES :
Ca w-x (H O ) (PO ) (OH )
RATIO Ca/P : 1.3 / 2.0``

TULANG :

STATIS

DINAMIS
DEPOSISI
PEMBENTUKAN

TULANG

RESORPSI
LARUTNYA GARAMGARAM TULANG

SOLUBILITY PRODUCT
(HASIL KELARUTAN)

Ca DARAH X PANORGANIK

S.P. =

1DEPOSISI

RESORPSI

PENGATURAN CALCIUM DARAH


9.8 - 10.2 mg %
TURUN (HIPOCALCEMIA)

7MG %

: TETANI

4MG %

: KEMATIAN

9-7

: LATENT TETANI
CHOVSTEKS SIGN
CARPOPEDAL SPASM

MENINGGI (HIPECALCEMIA)
PROSES CALCIFIKASI : EXTERNA TULANG
17 mg % : KEMATIAN

* PENGATURAN

1. PARAT HORMON (HORMON PARATHYROID)


2. CALCITONIN C CELL (CLEAR CELL)

KELENJAR THYROID DIANTARA SEL-SEL


FOLIKEL
3. VIT. D : CALCIFEROL
4. DIHYDROTACHYSTEROL (A T10)

EXCHANGEABLE CALCIUM
CaHPO4
TULANG : 0.4 - 1 %
- SEMUA SEL JARINGAN
- LIVER + G.I TRACT
(PERMEABLE SEL)

METABOLISME CALCIUM & PHOSPHAT


CA :SUMBER

: SUSU

ABSORPSI : INTESTINAL
1.000mg Ca MASUK/HARI
100mg ABSORPSI

700mg AKTIF & PASIF


600mg SEKRESI KEMBALI
900mg EKSKRESI PADA
FECES
EKSKRESI : FECES
URINE

CHOLECALCIFEROL (VIT. D3)


IN HIBITION
25-HYDROXYCHOLECALCIFEROL
PARATHYROID
HORMON
1,25- HYDROXYCHOLECALCIFEROL

CALCIUM

CALCIUM

ALKALINE

BINDING

STIMUL

PHOSPHATASE

PROTEIN

ATPase

INHIBITION

INTESTINAL ABSORPTION OF CALCIUM

PLASMA CALCIUM ION CONCENTRATION

PHOSPHAT :
SUMBER : SUSU, DAGING

ABSORSI : INTESTINAL
DIHALANGI CALCIUM
EKSRESI : FECES
URINE

DEPOSISI
OSTEOBLAST ALKALI PHOSPHATASE

P. ORGANIK

P. ANORGANIK

CA

P.ANORGANIK

60
(KEADAAN JENUH)

DEPOSISI

PERLU VIT.C

YANG CUKUP

RESORPSI
OSTEOCLAST
1. PROTEOLYTIC ENZYM

(LYSOSOME)
MELARUTKAN ORGANIK MATRIX

2. ASAM-ASAM
SITRAT -LAKTAT
MELARUTKAN GARAM2
SP. 30

50

MATRIX
1. BAHAN
`GARAM TULANG

CA; P
DEPOSISI

2. PROSES
RESORPSI
VIT. C
3. FAKTOR LAIN

VIT. D
STRESS

CA : - TULANG
- E,C.F

FUNGSI : 1. METABOLISME TULANG


2. NEURO-MUSCULAR
EXCITABILITY
3. JANTUNG

- DARAH :
10 mg/%

1. NON DISSFUSABLE
TERIKAT PROTEIN 50%

5 mEg% 2. DIFFUSABLE - NON 10 NESED


CITRAT

5%

3. DISFUSABLE - 10 NESED : 45%


FISIOLOGIS ARTIK
DIPENGARUHI HORMON

P.

- TULANG
- INTRA SELULER : ORGANIK
FUNGSI : BAGIAN PLASMA

BAGIAN NUKLEUS
ENZYM
METABOLISME
KARBOHIDRAT
- DARAH :
3-4mg%

1. HPO4

; H2 PO4

ANORGANIK

SINTESA
ASAM AMINO

PRE-PRO PTH(115)

PRO PTH 90

DEGRADASI

PTH 80_+
CA++
PLASMA PTH

CA

EFEK FISIOLOGIS

- ABSORPSI USUS : CA
- RESORPSI CA TULANG

- PHOSPHATURIE
- ANTICALCIURIE

KULIT

TIROID
CALCITONIN

PARATIROID
PTH

VIT.D3
LIVER

25 (OH)D3
RESORBSI
TULANG

TULANG
USUS
GINJAL

GINJAL

[CA++]

[CA++]

1.25 {OH} 2D3