KONTRAK PERKULIAHAN

Nama Mata Kuliah : Anatomi

Kode Mata Kuliah : FIT 1102

Pengajar : Dosen Anatomi

Semester : I

Hari pertemuan/Jam : Selasa/ 08.00-11.50

Tempat Pertemuan : R. Kuliah Fisiotherapy, R. Praktikum Anatomi

1. Manfaat Mata Kuliah

Mata kuliah ini diberikan pada mahasiswa untuk dapat memahami dasar-dasar

anatomi dan aplikasinya secara benar dan rasional.

2. Deskripsi Perkuliahan

Mata kuliah ini membahas tentang general anatomy, musculoskeletal system, upper

extremity, lower extremity, spine and thorax, head and neck, nervous system, digestive

system, urinary and reproductive system, endocrine system.

3. Tujuan Instruksional

Setelah menyelesaikan mata kuliah ini (pada akhir semester), mahasiswa akan dapat

menunjukkan, menerapkan dan melaksanakan anatomi agar dapat memberikan pelayanan

kesehatan pada umumnya dan memberikan pelayanan Fisioterapi pada khususnya secara

optimal.

4. Organisasi Materi

Organisasi materi dapat dilihat pada jadwal perkuliahan.

5. Strategi Perkuliahan

Strategi instruksional yang digunakan pada mata kuliah ini terdiri dari:

a. Urutan kegiatan instruksional berupa: pendahuluan (tujuan mata kuliah, cakupan materi

pokok bahasan, dan relevansi), penyajian (uraian, contoh, diskusi, evaluasi), dan penutup

(umpan balik, ringkasan materi, petunjuk tindak lanjut, pemberian tugas di rumah,

gambaran singkat tentang materi berikutnya)

b. Metode instruksional menggunakan: metode ceramah, demonstrasi, tanya-jawab, diskusi

kasus, dan penugasan.

Ceramah berupa penyampaian bahan ajar oleh dosen pengajar dan penekanan-

penekanan pada hal-hal yang penting dan bermanfaat untuk diterapkan nantinya

dalam praktek sebagai dokter umum.

Demonstrasi berupa menunjukkan contoh-contoh anatomi/modalitas Fisioterapi yang

berkaitan dengan pokok bahasan.

Tanya jawab dilakukan sepanjang tatap muka, dengan memberikan kesempatan

mahasiswa untuk memberi pendapat atau pertanyaan tentang hal-hal yang tidak

mereka mengerti atau bertentangan dengan apa yang mereka pahami sebelumnya.

Diskusi kasus dilakukan dengan memberikan contoh kasus/kondisi pada akhir pokok

bahasan, mengambil tema yang sedang aktual di masyarakat dan berkaitan dengan

pokok bahasan tersebut, kemudian mengajak mahasiswa untuk memberikan pendapat

atau menganalisis secara kritis kasus/kondisi tersebut sesuai dengan pengetahuan

yang baru mereka dapatkan.

Penugasan diberikan untuk membantu mahasiswa memahami bahan ajar, membuka

wawasan, dan memberikan pendalaman materi. Penugasan bisa dalam bentuk menulis

tulisan ilmiah, membuat review artikel ilmiah, ataupun membuat tulisan yang

membahas kasus/kondisi yang berkaitan dengan pokok bahasan. Pada penugasan ini,

terdapat komponen ketrampilan menulis ilmiah, berpikir kritis, penelusuran referensi

ilmiah, dan ketrampilan berkomunikasi.

c. Media instruksionalnya berupa: LCD projector, whiteboard, laptop, alat pratikum untuk

demonstrasi, artikel aktual di surat kabar/internet/majalah/jurnal ilmiah, buku diktat

bahan ajar, handout, dan kontrak perkuliahan.

d. Waktu: 5 menit pada tahap pendahuluan, 40 menit pada tahap penyajian, dan 5 menit

pada tahap penutup.

e. Evaluasi: evaluasi formatif dilakukan selama proses pembelajaran berlangsung.

6. Materi/Bacaan Perkuliahan

Buku/bacaan pokok dalam perkuliahan ini adalah:

1. Moore KL., Agur AMR., 2002. Essential Clinical Anatomy. 2nd

Ed. Philadelphia:

Lippincott Williams and Wilkins.

2. Sukardi E. 1985. Neuroanatomia Medica. 2nd

Ed. Jakarta: UI-Press.

7. Tugas

Dalam perkuliahan, diberikan beberapa tugas sebagai berikut:

a. Materi perkuliahan sebagaimana disebutkan dalam jadwal perkuliahan harus sudah dibaca

sebelum mengikuti tatap muka. Apabila ada, handout sudah akan diserahkan pada

mahasiswa sebelum hari kuliah.

b. Minitest diberikan pada tiap kali tatap muka untuk menilai pemahaman mahasiswa dan

absensi. Kehadiran pada tatap muka minimal 75%. Apabila tidak diadakan minitest, akan

diberikan penugasan.

c. Penugasan sesuai pokok bahasan, yang harus sudah diselesaikan sesuai tanggal yang

ditentukan.

8. Kriteria Penilaian

Penilaian akan dilakukan oleh pengajar dengan menggunakan kriteria sebagai berikut:

Nilai dalam huruf Rentang skor

A 80-100

B 70-79

C 60-69

D 50-59

E 00-49

Pembobotan nilai adalah sebagai berikut:

Nilai Kehadiran : 5%

Nilai Tugas/Praktikum : 25% (minitest, penugasan kuliah, laporan praktikum)

UTS : 30%

UAS : 40%

Bagian Fisioterapi tidak mentolerir adanya kecurangan dalam ujian. Ujian Kuis, UTS,

UAS, pretest, minitest adalah instrumen untuk menguji kemampuan mahasiswa dalam

memahami mata kuliah. Apabila mahasiswa menunjukkan gerak-gerik mencurigakan

selama tes-tes tersebut, atau ditemukan mencontek/memberikan contekan, akan

mendapatkan pengurangan nilai 25% dari nilai yang diperolehnya untuk tes tersebut, dan

pengurangan ini akan disampaikan secara terbuka pada waktu pengumuman nilai. Apabila

mahasiswa ditemukan membawa/membuat (walaupun tidak membuka) catatan selama

tes-tes tersebut, baik berupa kertas, coretan di kursi, dan sebagainya, maka mahasiswa

tersebut akan mendapat nilai 0 untuk tes tersebut.

Presentasi ketentuan mendapatkan penilaian kehadiran sebagai berikut:

- Setiap mahasiswa wajib hadir tepat waktu saat perkuliahan dimulai. Bagi yang

terlambat melebihi 15 menit maka diperkenankan masuk tetapi tidak diperkenankan

melakukan presensi.

- Bagi mahasiswa yang jumlah presensinya kurang dari 75% dari jumlah kehadiran

kuliah sebelum UTS (atau tidak hadir sebanyak 2 kali) maka orang bersangkutan tidak

boleh mengikuti UTS (atau tidak hadir sebanyak 4 kali) maka orang bersangkutan

tidak boleh mengikuti UAS. Larangan ini tidak berlaku apabila yang bersangkutan

mengganti ketidakhadiran dengan menulis paper/tugas/makalah.

9. Jadwal Perkuliahan

MAHASISWA PROGRAM STUDI FISIOTERAPI SMT I

ANGKATAN 2015/2016

NO HARI TANGGAL JAM TOPIK LECTURER

1 SELASA 1-Sep-15 08.00 - 11.50 STUDIUM GENERALE WD

2 SELASA 8-Sep-15 08.00 - 11.50 AXIAL & APPENDICULAR SKELETON,

JOINT MUL

3 SELASA 15-Sep-15 08.00 - 11.50 UPPER LIMB & PECTORAL GIRDLE YUL

4 SELASA 22-Sep-15 08.00 - 11.50 LOWER LIMB & PELVIC GIRDLE MK

5 SELASA 3-Oct-15 08.00 - 11.50 BACK MUL

6 SELASA 13-Oct-15 08.00 - 11.50 HEAD AND NECK MK

7 SELASA 22-Oct-15 08.00 -

SELESAI UTS TIM

8 SELASA 3-Nov-15 08.00 - 11.50 THORAX WR

9 SELASA 10-Nov-15 08.00 - 11.50 NERVOUS SYSTEM SY

10 SELASA 17-Nov-15 08.00 - 11.50 NERVOUS SYSTEM SY

11 SELASA 24-Nov-15 08.00 - 11.50 DIGESTIVE SYSTEM WR

12 SELASA 1-Dec-15

08.00 - 09.40 URINARY SYSTEM WD

09.40 - 11.50 ENDOCRINE SYSTEM YUL

13 SELASA 8-Dec-15 08.00 - 11.50 REPRODUCTIVE SYSTEM WD

14 SELASA 22-Dec-15 08.00 -

SELESAI UAS TIM

KET

MK

: Prof. Dr. dr. I N. Mangku Karmaya, M. Repro, PA(K). (0811387105)

SY

: dr. Wayan Suarya, PAK (082144842442)

WR

: dr. I Nyoman Gede Wardana, M.Biomed (081999243174)

WD

: dr. I Gusti Ayu Widianti, M.Biomed (08123921765)

MUL

: dr. Muliani, S.Ked, M. Biomed (03618043575)

YUL

: dr. Yuliana, S.Ked, M. Biomed (085792652363)

R. Kuliah: Gedung Fisiotherapy (sebelah Utara GDLN), Lantai 4, Ruang kuliah SMT I (bgn Barat)

Contact Person

KOORDINATOR KULIAH ANATOMI: dr. Muliani, S. Ked, M. Biomed (HP:03618043575)

Demikian kontrak perkuliahan ini dibuat, agar disetujui dan ditaati oleh semua pihak.

Menyetujui

Mahasiswa Ketua Bagian Anatomi

(……………………………) (dr. I G. A. Widianti, M. Biomed)

MODULE

Tuesday, September 24rd ,2013

Lecture 1 Overview of Human Anatomy

Muliani

Enabling outcomes

1. To know the history of anatomy

2. To know approaches to studying anatomy, systems of body, anatomical

variations and medical terminology anatomical positions and planes terms of

relationship and comparison terms of laterality and movements and others

Anatomy:

Anatomy is a science of the structure of the body. Anatomy (English) in Greek

anatome, from an etymological point of view, the term “dissection” (dis-, meaning asunder,

and scare, meaning to cut) is the Latin equivalent of the Greek anatome.

Greek anatomy had its origins in Egypt, by Alemaeon of Croton (500 B.C.) provided the

earliest records of actual (animal) anatomical observations.

Anatomy is one of biosciences and as a foundation of the building of medical sciences.

There are three main approaches to studying of anatomy, systemic, regional and

clinical anatomy. In medical sciences and anatomy has terminology. Anatomy has an

international vocabulary that is the foundation of medical terminology. It is important that

physicians, dentists, and others health professionals. The eponyms trend no used now, for

example: tuba Eustachius tuba auditiva or tuba pharyngotympanica.

In anatomy we have three planes : sagital, frontal and horizontal planes. So that we

have some terms direction, for example: left/sinister; right/dexter, upper/superior,

lower/inferior, etc. Terms of movement: flexion/flexio/flexi means bending of a part or

decreasing the angle between body parts. Extention/extentio/extenti means straightening a

part or increasing the angle between body parts, etc.

Learning Task 1 :

1. What is the meaning of anatomy. Word analog/equivalent to anatomy is….

2. Greek anatomy (anatomy) had its origins in…..

3. What do you know about Vesalius ?

4. What do you know about the nomina anatomica ?

5. Who is the founders of the science of anatomy ?

6. Who is the founders of comparative anatomy ?

7. Who is the father of physiology ?

8. What do you know about anatomical position ?

9. Mentions three main approaches to studying anatomy ?

10. Mention 10 systems of body!

11. Mention 3 anatomical planes! And mentions term directions from each planes!

12. Please mentions the others term directions

13. Please mention some terms of movement

14. What do you know about cavity in body ?

15. Mention 4 the most commonly used diagnostic imaging techniques.

LECTURE 2-3: MUSCULOSKELETAL SYSTEM

Oleh: dr. Muliani, M.Biomed.

Tujuan Pembelajaran:

- Mampu memahami dan menjelaskan bone structure, blood suply, growth, ossification

and classification.

- Mampu memahami dan menjelaskan joint classification, structure, movement, range,

limiting factors, stability, blood suply, dislocation dan penerapannya.

- Mampu memahami dan menjelaskan muscle classification, structure and functional

aspect.

Konten Kurikulum:

- Bone structure, blood suply, growth, ossification dan classification.

- Joint structure, classification, movement, range, limiting factors, stability, blood

suply, penerapannya.

- Muscle structure, classification dan fungsional aspect.

Abstrak

Sistem musculoskeletal terdiri dari 3 sistem, yaitu: sistem skeletal, sistem articular

dan sistem muscular. Sistem skeletal mempelajari mengenai tulang-tulang rangka yang

terdapat dalam tubuh. Tulang-tulang yang membentuk skeletal sistem dibagi menjadi tulang

axial dan tulang appendicular. Tulang axial terdiri dari cranium, vertebra, sternum dan costae

sedangkan tulang appendicular terdiri dari extremitas superior dan extremitas inferior.

Sistem articular mempelajari mengenai jenis-jenis persendian yang terdapat pada

tubuh beserta pergerakan yang dihasilkan dari persendian tersebut. Persendian

diklasifikasikan menjadi persendian synarthrosis dan diarthrosis. Persendian diarthrosis

memiliki pergerakan yang lebih bebas karena adanya cavum articularis di antara kedua tulang

yang mengadakan persendian.

Sistem muscular mempelajari mengenai otot-otot skelet. Otot skelet merupakan otot

yang menempel pada tulang dan berfungsi untuk menggerakkan tulang rangka (skelet).

Penamaan otot skelet umumnya berdasarkan bentuk, lokasi, arah serat, origo-insertio, fungsi

dan komponen otot tersebut. Origo merupakan bagian otot yang tidak bergerak sementara

insertion adalah bagian otot yang bergerak.

LEARNING TASK 2

1. Sebutkan tulang-tulang yang termasuk dalam long, short, flat, sesamoid, irregular dan

pneumatic.

2. Jelaskan dan sebutkan tulang yang terdapat di bagian anterior dan posterior tubuh.

3. Jelaskan dan sebutkan tulang-tulang yang terdapat pada extremitas superior dan

inferior tubuh.

4. Jelaskan dan sebutkan tulang yang terdapat pada cranium.

LEARNING TASK 3

1. Deskripsikan (peragakan) pergerakan-pergerakan sendi.

2. Gambarkan bagian-bagian dari suatu persendian diarthrosis.

3. Jelaskan dan sebutkan jenis-jenis persendian diarthrosis beserta tulang-tulang yang

menyusun persendian tersebut.

4. Jelaskan otot-otot yang berkontraksi ketika terjadi flexi elbow.

5. Jelaskan dan sebutkan sendi-sendi (tipe, pergerakan dan tulang yang mengadakan

persendian) dan otot-otot yang terdapat di bagian anterior dan posterior tubuh.

6. Jelaskan dan sebutkan sendi-sendi (tipe, pergerakan dan tulang yang mengadakan

persendian), otot-otot yang terdapat pada extremitas superior dan inferior tubuh.

7. Jelaskan dan sebutkan sendi-sendi (tipe, pergerakan dan tulang yang mengadakan

persendian) dan otot yang terdapat pada cranium.

8. Jelaskan dan sebutkan otot-otot pada dinding ventrolateral abdomen.

SELF ASSESSMENT 2

1. Sebutkan fungsi tulang!

2. Sebutkan jenis-jenis tulang dan berikan contohnya!

3. Apa yang dimaksud dengan axial dan appendicular skeleton, jelaskan dan sebutkan

tulang-tulang penyusunnya!

4. Tulang cranium dibagi menjadi 2, sebut dan jelaskan. Sebutkan pula tulang-tulang

pembentuknya!

5. Sebut dan jelaskan susunan collumna vertebralis dan bagian-bagian umum vertebrae!

6. Sebut dan jelaskan tulang-tulang yang menyusun kerangka thorax!

SELF ASSESSMENT 3

1. Sebut dan jelaskan jenis-jenis sendi dan pergerakan yang dimungkinkan!

2. Sebut jenis dan pergerakan masing-masing persendian berikut:

a. Humeral joint.

b. Acromioclavicular joint.

c. Elbow joint.

d. Wrist joint.

e. Interphalangeal joint.

f. Femoral joint.

g. Knee joint.

h. Ankle joint.

3. Jelaskan perbedaan shoulder dan pelvic girdle!

4. Sebut dan jelaskan faktor-faktor yang menghambat persendian.

5. Apa yang dimaksud dengan ligament, tendon, bursa, aponeurosis,

6. Sebut dan jelaskan penamaan otot beserta contoh otot-ototnya.

7. Jelaskan apa yang dimaksud dengan origo dan insertion.

Reference

Moore KL., Agur AMR., 2002. Essential Clinical Anatomy. 2nd

Ed. Philadelphia:

Lippincott Williams and Wilkins.

LECTURE 4 - 5: UPPER LIMB AND LOWER LIMB ANATOMY Oleh: Prof. Dr. dr. Mangku Karmaya, M.Repro AIMS: Establish the appendicular skeleton for human movement LEARNING OUTCOMES: Comprehend the macroscopic aspect of appedicular skeleton CURRICULUM CONTENTS: 1. Upper

2. Lower limb ABSTRACTS Both appendicular skeletons that build upper and lower limb have the similar patern. They attach at axial skeleton through girdle. Humeral joint is analog to hip joint, humery analog to femur, elbow joint to knee, radius ulna to tibia fibula, wrist to ankle and hand to foot. Due to work load of both appendicular skeletons, joint and lower limb muscles are stronger than upper limb. The type of joint promotes for upper limb for more free movement, pronation supination and occur inversion eversion on lower limb. The phalanges of hand can do apposition movement compare to foot is not possible. All of the appedicular skeleton were covered by group muscles, and their type are similar. UPPER LIMB SELF DIRECTING LEARNING Basic knowledge that must be known: 1. The upper and lower limb. Explain the part of those bone

2. Important parts of upper and lower limb bones

3. The muscles in the regions of shoulder/buttock, fore arm/femur, lower arm/leg, hand/pedis LOWER LIMB Self assessment 1. Compare the upper and lower limb

2. Identify the important parts of upper and lower limb bones

3. Identify the muscles in the regions of shoulder/buttock, fore arm/femur, lower arm/leg, hand/pedis

LECTURE 6 - 7: SPINE AND THORAX, HEAD AND NECK ANATOMY Oleh: Prof. Dr. dr. Mangku Karmaya, PA(K), M.Repro AIMS: Describe the common functional of musculoskeletal system related to musculoskeletal disorders LEARNING OUTCOME: 1. Describe the role of musculoskeletal system

2. Describe the element of musculoskeletal system

3. Describe the function of musculoskeletal

4. Describe the development of MSDs CURRICULUM CONTENTS: 1. Role of musculoskeletal system

2. Element of musculoskeletal system

3. Function of musculoskeletal

4. Development of MSDs ABSTRACTS: Musculoskeletal system consists of muscles and bones. Muscles are connected with bones, cartilages, ligaments and skin either directly or through the intervention of fibrous structures called tendons or aponeurosis. Muscles are various in their form, arrangement and size. So there are terms considering the form as long, broad, short, etc., used in the description of a muscle. The terms quadrilateral, fusiform, triangular, oblique, penniform, bipeniform, sphincter are correlate with muscle arrangement. Gastrocnemeus, sartorius and stapedius are terms according to their size. Name of the muscles are derived from: (1) their situation, as the Tibialis, Radialis, Ulnaris, Peroneus; (2) their direction as the Rectus abdominis, Obliqui capitis, Transversalis; (3) their uses, as Flexors, Extensors, abductors etc. (4) their shape as Deltoid, Rhomboid, Trapezius; (5) the number of their division as the Biceps, the Triceps; (6) the points of attachment as the Sternocleidomastoideus, Sternothyroid, Sternothyroid. It is very important to know the exact origin and insertion because it is of great importance in the determination of their action. There is a number of actions: flexion, extention, abduction, adduction, rotation, circumduction, supination, pronation, protrusion (protraction), retrusion (retraction), elevation and depression. Also the relation of the muscles especially those in immediate apposition with the larger blood vessels and the surface marking they produce should be remembered as they form useful guides in the application of a ligature to those vessels. The fibrous tisssues are in close relation with the muscle. They are tendons and aponeurosis. They are connected, on the one hand, with the muscles and, on the other hand with the movable structures as bones, cartilages and fibrous membranes. The skeleton of the body is composed of bones and cartilages. Bones provide protection for vital structures, support for the body, the mechanical basis for movement, storage for salts (e.g., calcium) and a continuous supply of new blood cells. Cartilage forms parts of the skeleton where more flexibility is necessary as yhe costal cartilage and articular cartilage. There are two types of bones: compact and spongy; its architecture varies according to function. Compact bone provides strength for weightbearing. Bones are classified according to their shape: long, short, flat, irregular and sesamoid bone. The skeleton system has two main parts: the axial skeleton consist of the bones of the head, neck and trunk and appendicular skeleton consist of the bones of the limbs, including those forming the pectoral and pelvic girdles.Thoracic skeleton (bony thorax) dibentuk oleh 12

pasang costae (ribs) dan costal cartilages, 12 thoracic vetebrae dan intervertbral disc dan sternum. SELF DIRECTING LEARNING Basic knowledge that must be known:

1. Functions of bones and muscles

2. Name of skeletal muscles according to their location, attachment, form, direction of the fibers and its function

3. Parts of bones and muscles

4. Clinical aspects of musculoskeletal system and its implications

5. Describe the name of bones that construct the axial skeleton.

6. Identify SCALP, facial muscles and mastication muscles

7. Compare the new born-baby and adult cranium

LECTURE 8 - 9: NERVOUS SYSTEM

Oleh: dr. I Wayan Suarya, PA(K)

Silabus:

1. Memahami dasar-dasar: sifat-sifat, penyusun dari susunan saraf.

2. Memahami pembagian serta penyusun masing-masing bagian system saraf.

3. Memahami nervi craniales: nama, sifat dan innervasinya.

4. Memahami nervi spinals: susunan,sifat-sifatnya dan innervasinya.

5. Memahami susunan saraf otonom/sso: symphatis dan parasymphatis.

6. Memahami susunan medulla spinalis: bagian-bagiannya, nucleus, tractus.

7. Memahami susunan dasar batang otak, serta hubungan-hubungannya.

8. Memahami susunandasar dan fungsi utama dari cerebellum.

9. Memahami susunan dari cerebrum, bagian-bagiannya, lapisan2 dari cortex, maupun

fungsi utama dari cortex cerebri.

10. Memahami susunan dasar dari meningen, refleksinya, serta pembentukan sinus dan

falx.

11. Memahami system ventricle otak, serta pembentukan, aliran dari liquor

cerebrospinalis.

12. Memahami system vascularisasi susunan saraf pusat maupun perifer.

Abstraks:

Susunan/system saraf mempunyai 2 sifat spesifik: irritabilitas, konduktivitas; sehingga

dengan 2 sifat utama dari system saraf ini manusia dapat mengadakan integrasi terhadap

lingkungan, baik external maupun internal. Biasanya system saraf dibagi menjadi susunan

saraf pusat dan perifer. Susunan saraf pusat terdiri dari medulla spinalis dan otak/brain/

encephalon. Susunan saraf perifer terdiri dari: saraf cranialis, spinalis dan otonom. Secara

anatomi system saraf penyususn dasarnya adalah neuron: yang dibagi menurut ukurannya:

kecil, sedang dan besar dengan rentang ukurannya: 4-120 mikron. Namun yang lebih penting

adalah dibagi menurut tonjolan sitoplasmanya: unipolar, bipolar dan multipolar (type I dan

type II). Secara fungsional susunan saraf disusun oleh: lengkungan reflex, yaitu: reseptor,

serat afferent, efferent, effektor dan interneuron/neuron intercalatus.

Nervus cranialis ada 12 pasang (I s/d XII): I. N. Olfactorius, sifatnya sensoris, ubntuk

pembau; II N. Opticus, sensoris, penglihatan; III. N. Oculomotorius, motoris dan

parasymphatis, untuk otot bola mata dan otot polos (m. ciliaris dan constrictor papillae.; IV.

N. Trochlealis, motoris, otot bola mata; V. N. rigeminus, motoris dan sensoris (motorisnya

untuk otot pengunyah, sensorisnya untuk rasa-rasa dari kulit muka, mukosa mulut, rongga

hidung, paranasalis, lidah (rasa umum), gusi, gigi.; VI. N. Abducens, Motoris untuk otot bola

mata-m. rectus lateralis. VII. N. Facialis, motoris-otot mimic, sensorisnya untuk rasa

kecap/taste dari lidah 2/3 anterior-rasa manis asam asin, parasymphatis-untuk kelenjar

sublingualis dan submandibularis, kelenjar air mata. VIII. N. Octavus/vestibulocochlearis,

sensoris saja, canalis semicircularis dan cochlea ( keseimbangan leher kepala dan

pendengaran). IX. N. Glossopharyngeus, sensoris-rasa kecap/taste pahit pangkal lidah,

motoris-untuk otot larynx dan pharynx, parasymphatis untuk kelenjar parotis. X. N. Vagus:

sensoris-rasa visceral umum dari thorax dan abdomen, motoris dari pharynx bagian bawah

dan esophagus, parasymphatis untuk kelenjar dan otot polos organ viscera di cavum thoracis

dan abdominis. XI. N. Accerssorius, motoris, untuk otot:m sternocleidomastoideus dan

trapezius. XII. N. Hypoglossus, motoris, untuk otot lidah (extrinsic dan intrinsic).

LECTURE 10: ALIMENTARY SYSTEM

Oleh: dr. I Nyoman Gede Wardana, S. Ked., M. Biomed.

Abstrak

The alimentary or digestive system consists of the organs and glands associated with the

ingestion, mastication (chewing), deglutition (swallowing), digestion, and absorption of food

and the elimination of feces (solid wastes) after the nutrients have been absorbed.The

alimentary system includes organs of the alimentary canal (mouth, pharynx, esophagus,

stomach, small and large intestine and accessory organs (teeth, tongue, salivary glands,

liver, gallbladder, and pancreas). The mouth, pharynx, and esophagus: food enters the GI

(gastro intestinal) tract via the mouth, which is continuous with the oropharynx posteriorly.

The boundaries of the mouth are lips and cheeks, palate, and tongue. The tongue is

mucosa-covered skeletal muscle. Its intrinsic muscles allow it to change shape; its extrinsic

muscles allow it to change position. Saliva is produced by many small buccal glands and

three pairs of major salivary glands-parotid, submandibular, and lingual-that secrete their

product into the mouth via ducts. The 20 deciduous teeth begin to be shed at the age of 6

and are gradually replaced during childhood and adolescence by the 32 permanent teeth.

Teeth function to masticate food. The C-shape stomach lies in the upper left quadrant of the

abdomen. Its major regions are cardia, fundus, body, and pyloric region.

The small intestine is the longest portion of the alimentary tract, which 7 m in length. The

small intestine has three regions: duodenum, jejunum, and ileum. Although these regions

are similar histologically, their minor differences permit their identification. Throughout its

length, the wall of small intestine is made up of the same four layers previously described for

the stomach: (1) mucosa, (2) submucosa, (3) muscularis, (4) serosa. The luminal surface of

small interstine is modified to increase its surface area. Three types of modifications have

been noted: (1) plicae circulares (valves of Kerckring), (2) villi, (3) microvilli. The duodenum

is the shortest segment of the small intestine, only 25 cm in length. It receives bile from the

liver and digestive juices from the pancreas via the common bile duct and pancreatic duct,

respectively. The duodenum differs from the jejunum and ileum in that its villi are broader,

taller, and more numerous per unit area. It has fewer goblet cells, and there are Brunner’s

glands in its submucosa. The villi of the jejunum are narrower, shorter, and sparser than

those of the duodenum. The number of goblet cells per unit area is greater in the jejunum

than in the duodenum. The villi of the ileum are the sparsest, shortest, and narrowest of the

small intestine.

The large intestine constitutes the terminal part of the alimentary system. It is divided into

three main sections: cecum including the appendix, colon and rectum with the anal canal.

The primary function of the large intestine is the reabsorption of water, inorganic salts and

gases, through those processes the feces is formed and then excreted. The only secretion of

any importance is mucus, which acts as a lubricant during the transport of the intestinal

contents. The wall of large intestine is also divided into four layers as in the small intestine.

Cecum and colon are similar histologically, they have no villi but its Crypts of Lieberkhun

usually longer and straighter than small intestine. When its enter the rectum and anal, its

become shorter and finally disappear in the distal half of anal canal. The histological

appearance of appendix resembles the colon, except it is much smaller in diameter. Large

intestine has specific structure, three flattened strands of outer longitudinal muscular layer,

named taenia coli. In pectinate line region of anal the inner muscle layer is thickened to form

internal sphincter.

The liver is a lobed organ overlying the stomach. Its digestive role is to produce bile, which it

secretes into the common hepatic duct. The gallbladder, a muscular sac that lies beneath

the right liver lobe, stores and concentrates bile. The pancreas is retroperitoneal between

the spleen and small intestine. Its exocrine product, pancreatic juice, is carried to the

duodenum via the pancreatic duct. The subdivisions of the large intestine are the cecum

(and appendix), colon (ascending, descending, and sigmoid portion, rectum, and anal canal.

It opens to the body exterior at the anus.

Liver and panceas secretion play important role in digestion process. Liver is

synthesized and secreted bile and then store in the gall blader. Bile salt as one of the bile

content is play important role in fat digestion as catalyst of pancreatic lipase. Pancreas

secreted enzyme, amylase, lipase and proteolytic enzyme that digest carbohydrate, fat and

protein in the intestine into smaller molecule and continued by eznzyme secreted bay

enterocyter into monosaccharide and aminoacid.

At the end of the study, medical student is expected to understand thefunction of bile salt

and pancreatic enzyme and its regulatory

Learning Task 1

1. Distinguish the oral cavity and the oral vestibule. 2. Identify the alimentary layer of the neck: Pharynx. 3. Identify the esophagus in the neck, thorax and abdomen, including structures in

immediate relationship to it. 4. State the nerve and blood supply of esophagus. 5. Explain the clinical implication of constrictions of the esophagus.

Learning Task 2

1. What you know about: weight, location, surfaces, lobes and bare area of the liver? 2. How about visceral surface of the liver: covered with, related to? 3. What you know about: lesser omentum, greater omentum, porta hepatic,

hepatoduodenal ligament, portal triad and subphrenic abscess? 4. Please compare the anatomical lobes and segments of the liver.What is the application

in surgery. 5. Please make/write short scheme about vasculature, lymphatic drainage and innervation

/nerves of the liver. 6. Please give in short answer about: liver biopsy, rupture of the liver, and cirrhosis of the

liver (cirrhosis hepatis). 7. Please mention and look for in atlas the portal venous system communications. 8. Please give in short answer about portal hypertension.

Learning Task 3

9. What you know about: weight, location, surfaces, lobes and bare area of the liver? 10. How about visceral surface of the liver: covered with, related to? 11. What you know about: lesser omentum, greater omentum, porta hepatic,

hepatoduodenal ligament, portal triad and subphrenic abscess? 12. Please compare the anatomical lobes and segments of the liver.What is the application

in surgery. 13. Please make/write short scheme about vasculature, lymphatic drainage and innervation

/nerves of the liver.

14. Please give in short answer about: liver biopsy, rupture of the liver, and cirrhosis of the liver (cirrhosis hepatis).

15. Please mention and look for in atlas the portal venous system communications. 16. Please give in short answer about portal hypertension.

Self Assessment 1

1. Describe the boundaries of the oral vestibule and the oral cavity proper. 2. Describe the structures and the functions of the teeth. 3. Describe the boundaries, structures and functions of the hard and soft palate 4. Describe the structures and functions of the tongue. 5. Describe the locations and the secretion drainage of three major salivary glands. 6. Describe the “saliva’s functions. 7. Describe the boundaries and functions of the three parts of pharynx. 8. Describes the muscles of pharynx and their functions. 9. Describe the parts, locations and sphincter of esophagus and its clinical implication.

Self Assessment 2

2. Describe the boundaries and regions of the abdominal cavity. 3. Describe the boundaries of the inguinal canal and the locations of the inguinal rings. 4. Describe the external and internal surfaces, layers and surface anatomy of the

abdominal wall. 5. Describe the weakness areas of the inguinal region in conjunction with the inguinal

hernias. 6. Differentiate the abdominal wall and the peritoneum 7. Differentiate the abdominal cavity and the peritoneal cavity. 8. Differentiate the male and female peritoneal cavity and its clinical implication. 9. Differentiate the greater sac and the lesser sac (omental bursa). 10. Describe the greater omentum and its clinical implication. 11. Describe the meaning of “the stomach have a dynamic shape” 12. Differentiate the four parts of stomach. 13. Describe the stomach bed 14. Describe the vascularization of the stomach 15. Differentiate the four parts of duodenum 16. Describe the ampulla or duodenal cap. 17. In which part of duodenum, the duodenal ulcers used to happen and which artery

usually suffered? 18. Differentiate the jejunum and ileum. 19. Describe the vascularization of the jejunum and ileum. 20. Describe the vasa recta and its clinical implications. 21. Describe the mesentery and its functions. 22. Describe the ileal diverticulum (Meckel diverticulum of ileum) and its clinical

implications. 23. Describe the parts of the large intestine. 24. Differentiate the large and the small intestine. 25. Describe the taenia coli, haustra and omental appendices. 26. Differentiate the cecum, colon and appendix. 27. Describe the pain locations of appendicitis (acute inflammation of the appendix). 28. Differentiate the four parts of colon and their vascularization. 29. Describe the rectum and anal canal. 30. Describe the anorectal flexure and its important functions. 31. Describe the vascularization of rectum and anal canal; the portacaval anastomosis;

the internal and external hemorrhoid

Reference:

Moore KL., Agur AMR., 2002. Essential Clinical Anatomy. 2nd

ed. Philadelphia:

Lippincott Williams and Wilkins

LECTURE 13: ENDOCRINE

Oleh: dr. Yuliana, M.Biomed.

Tujuan pembelajaran:

- Mampu memahami dan menjelaskan anatomi kelenjar pituitari

- Mampu memahami dan menjelaskan anatomi kelenjar tiroid

- Mampu memahami dan menjelaskan anatomi kelenjar paratiroid

Konten kurikulum:

- Kelenjar pituitari

- Kelenjar tiroid

- Kelenjar paratiroid

Abstrak

Sistem endokrin, dalam kaitannya dengan sistem saraf, mengontrol dan memadukan

fungsi tubuh. Kedua sistem ini bersama-sama bekerja untuk mempertahankan homeostasis

tubuh. Jika sistem endokrin bekerja melalui hormon, maka sistem saraf bekerja melalui

neurotransmitter yang dihasilkan oleh ujung-ujung saraf.

Kelenjar endokrin meliputi hipofisis (pituitary), tiroid, paratiroid, adrenal, testes,

ovarium, dan timus. Kelenjar pituitari disebut dengan master gland. Hormon yang dihasilkan

kelenjar pituitari akan mengatur kerja kelenjar endokrin yang lainnya. Sebagai contoh,

Thyroid Stimulating Hormone yang dihasilkan oleh pituitari akan mengatur kerja kelenjar

tiroid.

Learning task

1. Mengapa kelenjar pituitari disebut dengan master gland ? Coba berikan 2 contoh

2. Jelaskan vaskularisasi kelenjar tiroid dan paratiroid

3. Jelaskan inervasi kelenjar adrenal

4. Jelaskan vaskularisasi dan inervasi testes, ovarium, dan timus

Self assessment

1. Jelaskan posisi anatomi kelenjar pituitari

2. Jelaskan posisi anatomi kelenjar tiroid

3. Jelaskan posisi anatomi kelenjar paratiroid

4. Jelaskan posisi anatomi adrenal

5. Jelaskan posisi anatomi testes

6. Jelaskan posisi anatomi ovarium

7. Jelaskan posisi anatomi timus

Reference:

Moore KL., Agur AMR., 2002. Essential Clinical Anatomy. 2nd

ed. Philadelphia:

Lippincott Williams and Wilkins.