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Anatomi dan Fisiologi

Sistem Persyarafan
Ns. Nury Sukraeny, S.Kep., MNS.
Overview
• Brain: forebrain, midbrain, hindbrain
Central
Nervous • Spinal cord: approximately 45 cm long in adults
System (CNS)

Peripheral • Comprises cranial nerve & spinal nerve


Nervous
System (PNS)

• Part of the peripheral nervous system and consists of the


sympathetic and parasympathetic systems.
Autonomic
Nervous • Regulates the function of the internal organs in response to
System (ANS) the changing internal and external environment
NERVOUS SYSTEM CELLS

- Neurons, which
transmit or conduct
nerve impulses, and

- Neuroglial cells,
which support the
neurons.
Neurons
• Each neuron consists of dendrites, a cell body,
and an axon.
• The function of the neuron is to transmit
impulses.
• Dendrites are short projections from the cell body
that conduct impulses toward the cell body via
afferent processes.
• Dendrites have varying numbers of branches, and
each branch synapses with another cell body, axon,
or dendrite.
• The cell body contains the nucleus and cytoplasm. It
is the metabolic focal point of the neuron.
• Most of the cell bodies are found within the CNS.
• They are clustered together in ganglia or nuclei.
Brain
• The cerebrum is the largest part of the brain.
• The surface of the cerebrum is covered by
multiple folds or wrinkles, called gyri, which
greatly increases the surface area.
• It is divided into two hemispheres, right and
left, by a deep groove.
• Each hemisphere has an outer layer of
neurons called the white matter and an inner
layer called the gray matter.
• These two hemispheres of the cerebrum are
connected by a thick band of white fibers
called the corpus callosum.
• The corpus callosum allows the two
hemispheres to communicate.
• Each hemisphere receives sensory and motor
impulses from the opposite side of the body.
• The majority of people are left brain
dominant.
• The left side controls language, while the right
side controls perception
VENTRICLES
• There are four ventricles (or chambers) within
the brain.
• These include two lateral ventricles located
within each hemisphere, the third ventricle,
and the fourth ventricle.
• The chambers are filled with CSF and are
linked by ducts (also called foramen), which
permit circulation.
• CSF is a clear, colorless fluid produced by the
choroid plexus, located in the ventricles.
• It circulates through a closed system, which
includes the four ventricles and area around
the spinal cord.
• Reabsorption occurs via the arachnoid villi.
LOBES
• The lobes of the cerebral hemispheres are
frontal, parietal, temporal, and occipital.
• Major functions of the frontal lobe include
high-level cognitive activities, information
storage or memory, voluntary eye movement,
basal motor control of breathing,
gastrointestinal (GI) function, blood pressure,
and motor control of speech in the dominant
hemisphere.
• The parietal lobe is the primary sensory
interpretation area.
• The temporal lobe is the primary auditory
reception and interpretation area.
• The limbic area is part of the temporal lobe
and is involved in emotional behavior and self-
preservation.
• The major function of the occipital lobe is
visual perception, some visual reflexes, and
involuntary smooth eye movements
Brainstem
• Midbrain: center for auditory & visual refleks
• Pons: respiration
• Medulla: heart rate, blood pressure,
respiration & swallowing
Skull
Cover by the thin layers of
muscle and connective
tissue

Variable
thickness;
The thinner bone in temporal and
orbital portions of the cranium
provides the ‘bone windows’

The only joints: between the auditory


ossicles and the temporomandibular
joints linking the skull to the jaw
Neurocranium
• Encloses the brain, labyrinth, and middle ear.
• The outer & inner tables of the skull are connected by
cancellous bone & marrow spaces.
• The bones of the roof of the cranium of adolescents and
adults are rigidly connected by sutures and cartilage
(synchondroses).
• The coronal suture extends across the frontal third of the
cranial roof. The sagittal suture lies in the midline,
extending backward from the coronal suture and
bifurcating over the occiput to form the lambdoid suture.
• The area of junction of the frontal, parietal, temporal, &
sphenoid bones is called the pterion; below the pterion lies
the bifurcation of the middle meningeal artery
The anterior fossa lodges the
olfactory tracts and the basal
surface of the frontal lobes;

The middle fossa, the


basal surface of the
temporal lobes,
hypothalamus, and
pituitary gland;

The posterior fossa, the


cerebellum,pons, and
medulla.
Scalp
The layers: skin (epidermis, dermis, &
hair), subcuticular connective tissue,
fascial galea aponeurotica,
subaponeurotic loose connective tissue,
and cranial periosteum (pericranium).

Hair of the scalp


grows
approximately 1
cm per month.

The connection between galea


and pericranium is mobile
except at the upper rim of the
orbits, the zygomatic arches,
and the external occipital
protuberance..
Viscerocranium
• Comprises the bones of the orbit, nose, and paranasal sinuses.
• The superior margin of the orbit is formed by the frontal bone, its
inferior margin by the maxilla and zygomatic bone.
• The frontal sinus lies superior to the roof of the orbit, the maxillary
sinus inferior to its floor.
• The nasal cavity extends from the anterior openings of the nose
(nostrils) to its posterior openings (choanae) and communicates
with the paranasal sinuses—maxillary, frontal, sphenoid, and
ethmoid.
• The infraorbital canal, which transmits the infraorbital vessels and
nerve, is located in the superior (orbital) wall of the maxillary sinus.
• The portion of the sphenoid bone covering the sphenoid sinus
forms, on its outer surface, the bony margins of the optic canals,
prechiasmatic sulci, and pituitary fossa.
Meninges

The meninges lie immediately deep to the inner


surface of the skull and constitute the
membranous covering of the brain

The pericranium and the dura


mater are collectively termed
the pachymeninges

The pia mater and arachnoid


membrane are the leptomeninges
Pachymeninges
• Contains meningeal arteries, which supply
both dura mater & bone marrow of cranial
vault
Cerebrospinal Fluid
• A clear and colorless ultra filtrate of blood plasma, is
mainly produced in the choroid plexus of the
cerebral ventricles and in the capillaries of the brain.
It normally contains no red blood cells and at most 4
white blood cells/μl. Its functions are both physical
(compensation for volume changes, buffering and
equal distribution of intracranial pressure despite
variation in venous and arterial blood pressure) and
metabolic (transport of nutrients and hormones into
the brain, and of waste products out of it).
The Spinal Cord
• The spinal cord is a continuation of the
brainstem.
• It exits the skull through the foramen
magnum, an opening in the base of the skull.
• The spinal cord is approximately 45
centimeters, or 18 inches, in length and is the
thickness of one finger.
• The cord is divided into right and left halves
and has a shallow groove, called the posterior
median sulcus, on the dorsal side and a deep
groove, called the anterior median fissure, on
the ventral side.
• The cord tapers to a thin tip, called the conus
medullaris, at the first lumbar vertebrae, and
terminates as a thin cord of connective tissue,
called the filum terminale, which continues as
far as the second sacral vertebra
• There are 31 pairs of spinal nerves originating
from the spinal cord.
• Each pair contains a dorsal, or posterior, nerve
root and a ventral, or anterior, nerve root.
• The dorsal nerve roots carry sensory impulses
from the body to the brain; the ventral nerve
roots carry motor impulses from the spinal
cord to the body.
• The spinal cord has an H-shaped appearance
of gray matter within the white matter.
Cranial Nerves
• The 12 pairs of cranial nerves have sensory,
motor, or mixed functions.
• The cranial nerves originate from the brain or
brainstem, with most originating from the
brainstem.
• Although always identified by Roman
numerals, the cranial nerves also have names.
Spinal Nerves
• Thirty-one pairs of spinal nerves exit from the
spinal cord through the vertebral column:
cervical, 8 pairs; thoracic, 12 pairs; lumbar, 5
pairs; sacral, 5 pairs; and coccyx, 1 pair.
• The dorsal, or posterior, nerve roots carry
sensory impulses to the brain.
• The ventral, or anterior, nerve roots carry
motor impulses from the spinal cord and brain
to the muscles. Motor and sensory impulses
are transmitted from the body and internal
organs.
• Reflex activity is a stereotypical response to a
stimulus that is initiated by the nervous system
(Hickey, 2008).
• The three classifications of reflexes are muscle
stretch, or deep tendon; superficial, or cutaneous;
and pathological (see later section on assessment of
reflexes).
• Reflex activity requires the function of five areas in
the nervous system: the sensory fibers, the neuron
relaying the impulse, the association center in the
brain, the neuron relaying the motor impulse from
the brain to the body, and the specific organ
involved.
CEREBRAL CIRCULATION
• The source of blood to the brain occurs via the
internal carotid arteries (anterior circulation)
and the vertebral and basilar arteries
(posterior circulation).
• These arteries join at the base of the brain to
form the circle of Willis (cerebral arterial
circle).
• The two anterior cerebral arteries (ACA)
supply the medial portion on the frontal lobes.
• Two middle cerebral arteries (MCA) supply the
outer portions of the frontal, parietal, and
superior temporal lobes.
• The two posterior inferior cerebral arteries
(PICA) supply the medial portions of the
occipital and inferior temporal lobes.
• Venous blood drains from the brain via the
dural sinuses that empty into the two jugular
veins.