ANATOMI SARAF

OLEH :
DR. THONTOWI DJAUHARI NS, MKES

FAKULTAS ILMU KESEHATAN

PROGRAM STUDI ILMU KEPERAWATAN
UNIVERSITAS MUHAMMADIYAH MALANG
 Components of
the Nervous
System

Central Nervous System

brain, spinal cord

Peripheral NS
Sensory - input
afferent (approach)

Motor - output
efferent (exit)

Figure 11.1
 Plexus cervicalis
R. ventralis
Truncus

Divisi

Fasciculus
 Plexus cervicalis
R. ventralis

Truncus

Divisi

Fasciculus

Nervus
PLEXUS CERVICALIS in situ
INERVASI

 N. Medianus :
 Cabang : Nn.Digitalis volaris communis  Nn. Digitalis
propriae  3 ½ jari radial vola manus

 N. Ulnaris :
 Cabang : - Nn. Digitalis volaris communis  Nn. Digitalis
propria  1 ½ jari ulnar vola manus
- Nn. Digitalis dorsalis communis  Nn.
Digitalis propria  2 ½ jari ulnar dorsomanus

 N. Radialis :
 Cabang : Nn. Digitalis dorsalis communis  Nn. Digitalis
propria  2 ½ jari radial dorsomanus
 N. Ulnari
N.Medianus
N. MEDIANUS
. SETELAH MELEWATI ANT EPIC
MED PADA FOSSA CUBITI, IA BER-
JALAN ANT M. BRACH DAN MED A.
BRACH. KEMUDIAN MENEMBUS DI-
ANTARA CAPUT M. PRONATOR TE-
RES DAN DIANTARA CAPUT M.
FLEX DIG SUPERF. PADA PERGEL
TANGAN IA BERJALAN DIANTARA
TENDON M. PALMARIS LONGUS
DAN FLEX CARPI RAD UNTUK MA-
SUK CANALIS CARPI KE MANUS.
. MOTORIS:
- R. MUSCULARISOTOT SUPERF
- R. INTER ANTOTOT PROF
. SENSORIS UNTUK PERMUKAAN
LAT PALMAR MANUS
WRIST DROP
Canalis Carpi

1. N. medianus
2. tendon M.flexor
digitorum superficialis
3. tendons M. flexor
digitorum profundus
4. tendon M. flexor
pollicis longus
Carpal Tunnel Syndrome

"APE hand“ Median (C6-C8, T1)

Motor: Lateral Finger flexion, Wrist flexion,
and opposition of thumb
N. ULNARIS

. SETELAH MELEWATI SULCUS

N.
ULNARIS, IA MASUK ANTEBRA-
CHII VOL DIANTARA CAPUT M.
FLEXOR CARPI ULNARIS, TU-
RUN KE DISTAL . KEMUDIAN
BERJALAN LAT OS PISIFORMIS
DIBAWAH LAG. CARPI VOLARE
SUPERF LIG CARPI TRANSVER-
SUM. PADA REGIO MANUS IA
BERCABANG MENJADI RAMUS
SUPERF DAN PROFUNDUS
. CABANG MOTORIS UNTUK M.
FLEXOR CARPI ULNARIS DAN
 M.
FLEXDIGIT PROF, SENSORIS
UTK
PERMK MED PALMAR MANUS
CLAW HAND

Ulnar Claw, Ulnar C8, T1

Proximal: Motor: Medial Finger
flexion and wrist flexion
Asal dari Fasciculus lat
Menembus m.coracobrac
Inervasi: m.coracobrachi
m.bicep brachii,brachialis
Cb.achir.n.cut.antebrc.lat
 N
N
rad
uln

Injuries of
Pl brachialis’
terminal branches

N N
N med uln
med

wirono
Muscles of the Body – Anterior View
 The Lumbar Plexus
Lumbar plexus
Arises from L1– L4

Smaller branches
innervate the posterior
abdominal wall and
psoas muscle

Main branches
innervate the anterior
thigh
Femoral nerve –
innervates
anterior thigh
muscles

Obturator nerve –
innervates
adductor muscles Figure 14.12a, b
The Sacral Plexus

Figure 14.13
injury to the peroneal nerve
Dermatomes – Anterior - posterior View
Lumbar plexus
Arises from L1– L4

Sacral Plexus
Arise from L4 – S1

Figure 14.14a
The Gluteal Region
Lower Limb and Gluteal Region
 The Femoral Triangle
Superior border – inguinal ligament
Inferior borders
Sartorius
Adductor longus

Vastus lateralis – injection site

PUSING ??
SELAMAT BELAJAR
THE HUMAN BRAIN
 Skull Anatomy

The skull is a rounded layer of bone designed

to protect the brain from penetrating injuries.
Interior Skull Surface
Brain Development from Week
5 to Birth

Figure 13.8a–d
Neuron :
adalah unit fungsional system
saraf

Dendrit : menerima pesan

dari luar

Axon : meneruskan pesan

keluar.

Synapse: hubungan axon

dengan dendrit

Tempat synapse disebut

ganglion.
 The Brain/Enchepalon

• 4 Parts
– Cerebrum
– Diencephalon
– Brain Stem
• Pons
• Medulla
• Midbrain
– Cerebellum
• Substansia alba and subsansia grisea
 The Cerebrum
Terdiri dari 2 hemisphere yang dipisahkan falx cerebri.
Mengisi hampir seluruh cavum cranii diatas tenrorium cerebelli.
Pada permukaannnya terdapat sulcus dan gyrus.
Otak kiri dan kanan dihubungkan oleh corpus callosum
Cerebrum dibagi lima lobus
 Lobes of the Cerebrum Limbic Lobe

Frontal Lobe

Parietal Lobe

Occipital Lobe
Temporal Lobe
 Frontal Lobe

The frontal lobe

bertanggung jawab
terhadap fungsi cognitif
antara lain :
• Problem solving
• Spontanitas
• Memory
• bahasa
• Motivation
• Judgment
• Social and sexual
• Kebiasaan
 Temporal Lobe Auditory Area

Lobus temporal mengatur emosi,

bertanggung jawab pada
penciuman, rasa , persepsi, memori,
agresivitas dan kebiasaan sexual.
Lobus temporalberhubungan
dengan area bahasa didalam otak.

Temporal: smell, hearing, memory and abstract thought

 Parietal Lobe •Cutaneous Sensory Area

Lobus parietal mengatur sensasi

rasa, raba dan pembauan. Selain
itu juga mengatur koordinasi dan
gerakan.
Lobus ini ada daerah yang disebut
dengan area Wernicks yang
bertanggung jawab pada masalah
tulis menulis dan bahasa.

Parietal: reception and evaluation of sensory info

Occipital Lobe Visual Area

Retina
Tractus Opticus
Corpus Genic.Lateral
Radiatio Optica

19
Kortek Primer Area 17
Tahu / Know
17 18
Kortek Sekunder Area 18
Kenal / Synthesis Visual

Kortek Tertier Area 19

Faham / Analysis
Area 17 18 19
Visual
• Adalah kumpulan sejumlah nucleus dan
The Limbic System
tractus diantara cerebrum dan
diencephalonl
• System ini lebih merupakan kumpulan
fungsional daripada kumpulan anatomis.
• Fungsi:
• Mengendalikan dorongan emosi dan
perilaku.
• Menghubungkan fungsi kesadaran dan
intelektual cortex dengan bagian bawah
sadar dan pusat otonom
• Mengatur penyimpanan memory.

A. Cingulate gyrus
B. Fornix
C. Anterior thalamic
nuclei
D. Hypothalamus
E. Amygdaloid nucleus
terdiri dari serebrum dan
F. Hippocampus diensefalon yang terlibat
dalam aktivitas emosional,
terutama aktivitas perilaku
tidak sadar
 Berhubungan dengan batang otak
Cerebellum dan merupakan tempat mengatur
keseimbangan dan gerakan.

Fungsi. Serebelum bertanggung

jawab untuk mengkoordinasi dan
mengendalikan ketepatan gerakan
otot dengan baik.
Bagian ini memastikan bahwa
gerakan yang dicetuskan di suatu
tempat di SSP berlangsung dengan
halus bukannya mendadak dan Click image to play or pause video
tidak terkoordinasi.
a. Serebelum juga berfungsi untuk
mempertahankan postur.
b. Bagian ini membantu
mempertahankan ekuilibrium
tubuh. Informasi sensorik dan
telinga dalam dibawa ke lobus
serebelum.
11-41
Motor Skill Balance
 Hypothalamus
Hipotalamus berperan penting dalam
pengendalian aktifitas SSO yang melakukan
fungsi vegetatif penting untuk kehidupan
seperti :
pengaturan frekuensi jantung, tekanan
darah, suhu tubuh, keseimbangan air, selera
makan, saluran pencernaan, dan aktifitas
seksual.

Hipotalamus juga berperan sebagai pusat

otak untuk emosi seperti kesenangan, nyeri,
kegembiraan, dan kemarahan.

Hipotalamus memproduksi hormone yang

mengatur pelepasan atau inhibisi hormone
kelenjar hipofisis, sehingga mempengaruhi
keseluruhan system endokrin.
The hypothalamus is shaded blue. The
pituitary gland extends from the
hypothalamus.
 The Brainstem

Midbrain

Pons

The brainstem is the most primitive part

of the brain and controls the basic Medulla
functions of life: breathing, heart rate, Oblongata
swallowing, reflexes to sight or sound,
sweating, blood pressure, sleep, and
balance. Autonomic Functions
The brainstem controls the basic functions of
life. Damage to these areas of the brain are
usually fatal:
•The pons plays a critical role in respiration.
•The medulla oblongata is responsible for
respiration and cardiovascular functions.
Brainstem: Midbrain, Pons,
Medulla
 Passage of signals between spinal cord and cerebrum
 *Midbrain: contains cell bodies of CN III, IV
 *Pons: attachment of CN V, VI, VII
 *Medulla: attachment of CN VIII, IX, X, XI, XII

*
* pg 366
 The Cranial Nerves
I. Olfactory nerve
II. Optic nerve
III. Oculomotor nerve
IV. Trochlear nerve
V. Trigeminal nerve
VI. Abducens nerve
VII. Facial nerve
VIII. Vestibulocochlear nerve
IX. Glossopharyngeal nerve
X. Vagus nerve
XI. Accessory nerve
XII. Hypoglossal nerve
Medulla Spinalis/Nervus Spinalis.
 Substantia alba.
 Sustantia gricea.
Gray matter : berisi cell syaraf (neuron)
White matter berisi serat syaraf (tractus)
The Meninges Meninges
• protect CNS
• three layers : dura mater
arachnoid mater
pia mater

11-2
 Cerebrospinal Fluid

Cerebrospinal fluid is a colorless

liquid that bathes the brain and
spine.
It is formed within the ventricles
of the brain, and it circulates
throughout the central nervous
system.
Cerebrospinal fluid fills the
ventricles and meninges,
allowing the brain to “float”
within the skull.
 The Cranial Nerves
I. Olfactory nerve
II. Optic nerve
III. Oculomotor nerve
IV. Trochlear nerve
V. Trigeminal nerve
VI. Abducens nerve
VII. Facial nerve
VIII. Vestibulocochlear nerve
IX. Glossopharyngeal nerve
X. Vagus nerve
XI. Accessory nerve
XII. Hypoglossal nerve
NERVUS CRANIALIS
 The Olfactory Nerve (I)
 Carries sensory information
 Sense of smell
 Synapse within olfactory bulbs
 Anatomy of vision
Neural pathway
for vision

Retinal cells

2x binocular vision Retina

plus accessory Optic disk - blood supply
structures optic nerve
 The optic nerve (II)
 Carries visual information
•The oculomotor nerve (III) •The abducens nerve (VI)
–Primary source of innervation for –Innervates lateral rectus muscle of
extra-ocular muscles eye

•Move the eyeball

•The trochlear nerve (IV) • The optic nerve (II)

–Smallest cranial nerve – Carries visual information
–Innervates superior oblique eye
muscle
 The Trigeminal Nerve (V)
 Largest cranial nerve
 Mixed nerve
 sensory – touch, pain & thermal
 Ophthalmic branch
 sensory – upper eyelid, eyeball
lacrimal glands, side of nose, forehead
and scalp
 Maxillary branch
 sensory – nose, palate, part
of pharynx, upper teeth, upper
lip and lower eyelid
 Mandibular branch
 sensory – tongue, cheek,
lower teeth, skin over mandible
and side of head anterior to ear
-motor – muscles of chewing

-inferior alveolar nerve (branch of mandibular)

-often anesthetized in dental procedures – lower jaw
-numbs to mental nerve (branch of the IAN)
-superior alveolar nerve (branch of the maxillary)
-numbs the upper jaw
The Facial Nerve (VII)
 Mixed
nerve
 Controls
muscles of
scalp and
face
 Pressure
sensations
from face
 Taste
sensations
from
tongue
The Vestibulocochlear Nerve
(VIII)
 Vestibular nerve
 Monitors sense of balance, position and movement
 Cochlear nerve
 Monitors hearing
 The Glossopharyngeal Nerve (IX)
 Mixed nerve
 Innervates the
tongue
 Controls
swallowing
The Vagus Nerve (NX)
 Mixed nerve
 Vital to
autonomic
control of
visceral function
 The accessory nerve (XI)
 Internal branch
 Innervates swallowing muscles
 External branch
 Controls muscles associated with pectoral girdle

•The hypoglossal
nerve (XII)
–Voluntary motor
control over tongue
movements
 Cranial Nerves

I Olfactory--------Sensory--smell
II Optic-------------Sensory--vision
III Oculomotor----Motor----extrinsic eye muscles
IV Trochlear-------Motor----extrinsic eye muscles
V Trigeminal
V1 Opthalmic-----Sensory-cornea, nasal mucosa, face skin
V2 Maxillary------Sensory-skin of face, oral cavity, teeth
V3 Mandibular---Motor-muscles of mastication
---Sensory-face skin, teeth, tongue (general)
 Cranial Nerves (continued)
VI Abducens--------------Motor-----eye abduction muscles
VII Facial-------------------Sensory---part of tongue (taste)
-------------------Motor------muscles of facial expression
VIII Vestibulocochlear---Sensory----hearing, equilibrium
IX Glossopharyngeal----Motor------stylopharyngeus muscle
----Sensory----tongue (gen & taste), pharynx
X Vagus------------------Motor-------pharynx, larynx
-------------------Sensory----pharynx, larynx, abd. organs
XI Accessory-------------Motor------trapezius, sternocleidomastoid
XII Hypoglossal----------Motor-------tongue muscles
Aliran Darah Otak

 Otak butuh energy tinggi sehingga aliran

darah otak sangat intensif.
 Otak mendapat darah dari :
 A. carotis interna.
 A. vertebralis.
 CVA ( Stroke ) adalah keadaan dimana terjadi
gangguan fungsi otak akibat adanya
hambatan aliran darah.
Arteri : Circulus Willisi
Circulus Willisi

 Letak
 Basis cranii
 Melingkari infundibulum lek
hypophyse
 Komponen
 A. carotis interna (2)
 A. cerebri anterior (2)
 A. communicans anterior (1)
 A. communicans posterior (2)
 A. cerebri posterior (2)
 V.jugularis

 Vena superficial yang

mengalirkah darah dari
wajah dan kulit kepala.
 Terletak diatas m.
sternocleidomastoidea.
 Components of
the Nervous
System

Central Nervous System

brain, spinal cord

Peripheral NS
Sensory - input
afferent (approach)

Motor - output
efferent (exit)

Figure 11.1
 Autonomic Nervous System (ANS)
Parasympathetic
• Most active in non-stressful
situations
– “Resting and Digesting”
System
• Concerned with keeping body
energy low
• BP, HR, RR are low
• GI Tract is active
• Skin is warm
– No need for blood to go to
skeletal muscle
Simpathetic
 Most active in stressful
situations
 “Fight-or-Flight” System
 Concerned with providing extra
energy
 BP, HR, RR are high
 GI activity is halted
 Blood diverted to skeletal
muscles
ANS

Pembagian ANS.
 Divisi symphatic (Divisi
Thoracolumbal)

 Divisi parasymphatic.
(Devisi Craniosacral)
 Organ Sympathis Parasympathis
Pupil Dilatasi/Midriasis Konstriksi/Miosis

Cor Tachycardia Bradycardia

Bronchus Bronchodilatasi Bronchokonstriksi

Pemb. darah Vasokonstriksi Vasodilatasi

Kelenjar Hipersekresi Hiposekresi

M. Erector pili Kontr  bulu roma Relaksasi

Dinding usus • Relaks  peristaltik < • Konst  peristaltik >

• Kontr.sphincter  defekasi - • Rel.sphincter  defekasi +

Vesica urinaria Relaks.detrusor / kontraksi Kontr. Detrusor / relaksasi

sphincter  Mictie - sphincter  mictie +
Genital Vasokonst  c.cavernosus --  Vasodil  c.cavern ++ 
vena terbuka  Ereksi - vena tertutup  Ereksi +
 By development
Classification of
 Innate, acquired
 Where information is processed
Reflexes
 Spinal, cranial
 Motor response
 Somatic, visceral
 Complexity of neural circuit
 Monosynaptic
Design of the Nervous System
PUSING ??
SELAMAT BELAJAR