BRAIN FLUID AND CRANIAL

FLUID

Nura Eky
Department of Physiology
UNISSULA
2017
 Brain Organization,
Protection, and Blood Supply
 Otak dan MS berasal dari ectodermal neural
tube. Bagian depan dari neural tube meluas,
bersamaan dg jaringan neural creast yang
terkait.
 Kontriksi pada tube yang meluas ini 
menciptakan 3 regio yang disebut primary
brain vesicles (prosencephalon,
mesencephalon, and rhombencephalon)
 mesencephalon
Proencephalon/forebrain Rhobencephalon/hindbrain

midbrain and
aqueduct of the
Metencephalon myelencephalon
Telencephalon diencephalon midbrain
(cerebral
aqueduct).
Cerebrum
thalamus,
dan ventrikel pons, cerebellum, medulla
hypothalamus,
lateral and upper part oblongata and
epithalamus, and
of the fourth lower part of the
third ventricle
ventricle fourth ventricle.
 Dinding regio otak berkembang mjd jaringan
saraf, bagian lubang di dalamnya
bertransformasi menjadi ventrikel (spasium
yang berisi cairan).
 Neural creast yang berekspansi ini akan
menonjol di sisi depan.
 Hampir semua struktur pelindung otak –
tulang tengkorak, jaringan ikat, dan membran
meningeal- berasal dari neural creast yang
berekspansi ini
Major Parts of the Brain
 Otak dewasa tersusun atas 4 bagian utama :
batang otak, cerebellum, diencephalon, dan
cerebrum.
 Batang otak melanjut ke MS, dan terdiri dari
medulla oblongata, pons, dan midbrain.
 Posterior batang otak ada cerebellum.
 Superior batang otak ada diencephalon,
which consists of the thalamus,
hypothalamus, and epithalamus.
 Cerebrum, the largest part of the brain
 Otak manusia : konsistensi seperti tahu dan
beratnya 3 ponds
 Mampu untuk:
(1) meregulasi lingkungan internal dibawah
alam sadar
(2) merasakan emosi
(3) Secara sadar mengontrol pergerakan
(4) Mempersepsikan tubuh dengan sekitarnya
(5) Kognisi dan Memori. Kognisi berarti suatu
tindakan proses ―mengetahui‖, termasuk
kesadaran dan keputusan.
Protective Coverings of the Brain
 Tulang cranium dan cranial meninges mengelilingi dan
melindungi otak
 cranial meninges akan berlanjut menjadi spinal meninges,
strukturnya: dura mater, arachnoid mater, dan pia mater
 cranial duramater has two layers; the spinal dura mater has
only one.
 The two dural layers are called the periosteal layer (which is
external) and the meningeal layer (which is internal).
 Three extensions of the dura mater separate parts of the
brain: (1) The falx cerebri separates the two hemispheres of
the cerebrum. (2) The falx cerebelli separates the two
hemispheres of the cerebellum. (3) The tentorium cerebelli
separates the cerebrum from the cerebellum.
Brain Blood Flow and the Blood–
Brain Barrier
 Aliran darah menuju otak terutama via a.carotis interna dan
a.vertebralis.
 Sinus vena duramater mengalirkan ke v. jugularis interna
menuju jantung.
 Pada dewasa, aliran otak (2% dari total BB), tapi otak
mengkonsumsi sekitar 20% oxygen and glucose, bahkan ketika
saat istirahat.
 Sel Neurons mensintesis ATP hampir semua dari glukosa via
reaksi yang menggunakan oksigen.
 Sedikit saja perlambatan aliran  disorientasi dan penurunan
kesadaran, such as when you stand up too quickly after sitting
for a long period of time.
 Gangguan aliran otak 1-2 menit  gangguan fungsi saraf dan
penurunan oksigen sekitar 4 menit  cedera permanen
 The blood–brain barrier (BBB)
 Terutama tersusun oleh tight junctions yang melapisi sel
endotel kapiler darah otak dan thick basement membrane
yang mengelilingi kapiler.
 Sel astrosit, bagian prosesusnya menahan kapiler dan
mensekresi substansi kimia yang mempertahankan karakteristik
permeabilitas tight junction.
 Substansi water-soluble, such as glucose, cross the BBB by
active transport. Substansi lain, such as creatinine, urea, and ion,
cross the BBB very slowly.
 Proteins and most antibiotic drugs—do not pass at all from the
blood into brain tissue.
 Lipid-soluble substances, such as O2, CO2, alcohol, and most
anesthetic agents, are able to access brain tissue freely.
 Trauma, certain toxins, and inflammation can cause a
breakdown of the blood–brain barrier.
 Cerebrospinal fluid (CSF) : bening, tersusun dari cairan,
pelingdung dari bahan kimia dan cedera fisik
 Total volume CSF = 80 - 150 mL (dewasa).
 CSF mengandung sedikit oksigen, glucose, substansi yang
dibutuhkan saraf, sedikit proteins, lactic acid, urea, (Na, K, Ca2,
Mg2), (Cl– and HCO3 –); dan sedikit sel darah putih.
 Kavum berisi CSF di otak : ventricles.
 Ada 1 lateral ventricle pada tiap hemisphere cerebrum.
(ventrikel 1 dan 2), di Anterior-nya, lateral ventricles
dipisahkan oleh membran tipis/ septum pellucidum.
Ventricle 3 : kavum yang sempit sepanjang superior tengah
hypothalamus dan antara separuh thalamus ka-ki.Ventricle 4
berada antara batang otak dan serebelum.
 Functions of CSF
1. Mechanical protection. As shock absorbance
medium and let the brain and MS float in CSF
2. Homeostatic function. The pH of the CSF
affects pulmonary ventilation and cerebral blood
flow maintain homeostatic of brain.
a transport system for polypeptide hormones
secreted by hypothalamic neurons.
3. Circulation. As medium for minor exchange of
nutrients and waste products between the blood
and adjacent nervous tissue.
 Formation of CSF in the Ventricles

 Produksi CSF terutama dibuat dari choroid plexuses, networks

of blood capillaries in the walls of the ventricles.
 Sel Ependymal berhubungan dengan tight junctions melingkupi
kapiler plexus choroid.
 Selected substances (mostly water) dari plasma darah  difilter
dan disekresi oleh sel ependymal  CSF
 Oleh karena tight junctions between ependymal cells, material
yang masuk ke CSF dari kapiler choroid cannot leak between
these cells; Tapi mereka harus menembus sel ependimal dahulu.
The blood–cerebrospinal fluid barrier is formed by tight
junctions of ependymal cells  so it gives the barrier
 Circulation of CSF
 CSF dari plexus choroid ventrikel lateral 1 dan
2  foramen interventrikular ventrikel 3
(CSF ditambah lagi)  cerebral aqueduct
(midbrain)  ventrikel 4 (plexus choroid di
ventrikel 4 memproduksi CSF).
melalui

Spasium Canalis sentralis MS

Apertura media (1) subarachnoid dan Spasium
Apertura lateral (1 subarachnoid otak
pasang) dan MS
 CSF direabsorbsi secara gradual ke darah
melalui arachnoid villi, fingerlike extensions
of the arachnoid mater that project into the
dural venous sinuses, especially the superior
sagittal sinus. Normally, CSF is reabsorbed as
rapidly as it is formed by the choroid
plexuses, at a rate of about 20 mL/hr (480
mL/day). Because the rates of formation and
reabsorption are the same, the pressure of
CSF normally is constant. For the same
reason, the volume of CSF remains constant.
Aliran LCS
Referensi :