Neuromuskuloskeletal part1edit
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Transcript of Neuromuskuloskeletal part1edit
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Neuromuskuloskeletal
System
Liliana Sugiharto
Bagian Anatomi FKUAJ
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SasaranBelajar
• Dapat menjelaskan sistem saraf tepi
dalam fungsi muskuloskeletekstremitas dan thoraks
• Dapat menganalisis kelainan yang
terjadi pada sistemneuromuskuloskelet ekstremitas danthoraks
LS-FKUAJ-2011 2
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Neuromusculoskelet
LS-FKUAJ-2011 3
neuro musculo skelet
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Struktur Interna Medulla
Spinalis
• Sulcus mediana posterior
• Fissura mediana anterior
• Canalis centralis
• Substantia alba dan subtantia grisea
• Columna anterior , posterior, dan lateral
• Cornu anterior, posterior, dan lateral
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Pleus
Plexus cervicalis C!"C#$
Plexus %rachialis C&"'!$Plexus (umbalis (!"(#$
Plexus Sacralis (#"& dan S!"S#$
Plexus adalah anyamandari rami !entrales
nervi spinales
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"he !entral primary rami #orthe $ra%hial and lum$arpleuses issue #romenlargements o# the spinal %ord
• &er!i%al pleus' &()*
• Bra%hial pleus'&+)"(
• Lum$ar pleus' "(,)L+
• Sa%ral pleus' L*)S *
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Pleus Bra%hialis
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Plexus Brachialis
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Bra%hial Pleus' &+)"(
Made up o#'
• + !entral primary rami
• - trunks
• , di!isions
• - %ords
• + terminal $ran%hes
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Sistem sara#
untuk otot skelet
LS-FKUAJ-2011 16
Plexus brachialisPlexus lumbosacralisNervi intercostales
Ner!i %raniales
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Pem$entukan Pleus
Bra%hialis .(/• 'runcus superior → C& " C)
• 'runcus medius → C*
• 'runcus inferior → C+ '!
Setiap truncus bercabang dua,devisi ventral dan devisi dorsal
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Pem$entukan Pleus
Bra%hialis .,/• Fasciculus lateralis dari %a$ang !entral
truncus superior dan medius
• Fasciculus medialis dari %a$ang !entral truncus inferior
• Fasciculus dorsalis dari %a$ang dorsal seluruh truncus
Sesuai dengan letaknya terhadap-.axillaris
k l h d C b b l hi l
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• /ntuk leher dangelang bahu
• /ntuk otot otot
extensor• /ntuk otot"otot
0exor• /ntuk saraf kulit
Cabang"cabang Plexus %rachial
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LS-FKUAJ-2011 20
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Saraf yang berasal dari #as%i%uluslateralis
(0 N0mus%ulo%utaneus
1. %agian lateral N.medianus
2. N.pectoralis lateralis 'erutama ke 3.pectoralis major
N M l t
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N0Mus%ulo%utaneus%erasal dari N.Spinalis C&"
C*3enembus
3.coracobrachialis
%erjalan di antara 3.biceps
brachii dan 3.brachialis3empersara4 ketiga otot
otot"otot 0exor lengan
atas$%erakhir sebagai
N.cutaneus antebrachii
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1. Berasal dari fasciculus lat + med
2. Tidak mempunyai cabang di lengan
atas
3. Di pertengahan lengan atas menyilang
A.brachialis di sebelah ventral
4. Di !ssa cubiti ber"alan di sebelah
medialA.brachialis
N0Medianus .(/
N Medianus
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#. $empersarafi seluruh !t!t lengan
ba%ah& kecuali $.fle'!r carpi
ulnaris dan caput ulna $.fle'!r
digit!rum pr!fundus
(. Terletak superficial di canaliscarpi
). Tertutup !leh tend! $.palmaris
l!ngus
*. $empersarafi !t!t!t!t thenardan $m.lumbricalis 1 dan 2
*. ,araf kulit tangan 31-2 "ari
lateral v!la manus dan kuku 31-2
"ari
N0Medianus.,/
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&arpal "unnel Syndrome.&"S/
LS-FKUAJ-2011 25
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"est &"S
• 'inel 'est
• Phalen5s 'est
LS-FKUAJ-2011 26
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arpal Tunnel ,yndr!me
LS-FKUAJ-2011 27
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Sara# yang $erasal dari
#as%i%ulus medialis
!. N.cutaneus brachii medialis6ulit lengan atas
1. N.cutaneus antebrachiimedialis
6ulit lengan ba7ah
2. %agian medial N.medianus
*0 N0ulnaris
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N0ulnaris.(/
!. Nervus spinalis C+ '!
1. 'idak mempunyaicabang di lengan atas
2. 3enembus septumintermusculare mediale
#. %erjalan di sul%usner!i ulnaris .dorsal
epi%ondylus medialishumeri/
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N./lnaris 1$
/. $engurus 2 !t!t di lengan
ba%ah
#. Ber"alan di canalis Guyon
(. $engurus !t!t!t!t
hyp!thenar& $m.lumbricalis
3&4 dan $.inter!sseus
v!laris dan d!rsalis). ,araf kulit v!la manus
dan d!rsum manus
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Ulnar Ner!e Palsy
• &la1 hand
• Mor$us 2annsen
• 2andle$ar palsy
LS-FKUAJ-2011 31
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3uyonSyndrome
Fra%tura epi%ondylusmedialis humeri
LS-FKUAJ-2011 32
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Median 4 Ulnar ner!es in thehand
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LS-FKUAJ-2011 34
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Cabang"cabang fasciculusdorsalis
(0 N0aillaris
,0 N0radialis
-0 N0thora%odorsalis88 3.latissimusdorsi
*0 N0su$s%apularis
superior 883.subscapularis
+0 N0su$s%apularisin#erior 88 3.teres
major
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N0aillaris
• Dari N.spinalis C&"C)
• %erjalan bersama dengan-.circum0exa humeri
posterior di lacunaaxillaris lateralis
• 3empersara43.deltoideus dan 3.teres
minor• %erakhir sebagai saraf
kulit
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N05adialis .(/
!. 3embelok ke dorsal di
distal dari tendo3.latissimus dorsi
,0 Berjalan $ersamaA0pro#unda $ra%hii di
sul%us spiralis6n0radialis
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N05adialis .,/
#. 3enembus septum intermuscularelaterale
&. %erjalan di antara 3.brachialis dan3.brachioradialis
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N05adialis .-/
). 3engurus seluruh
otot"otot extensorlengan dantangan
*. 3engurus kulit
dorsum manus1!91 jari lateral
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5adial Ner!e Palsy
• Drop hand9drop7rist
• 'ennis elbo7
LS-FKUAJ-2011 40
&a$ang)%a$ang pendek
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&a$ang)%a$ang pendek
Pleus $ra%hialis
N.Thoracalis longus
N.Dorsalis scapulae
Nerve ke M.subclavius
N.Suprascapularis
M.Serratus antM.Levator scapulae
M.Subclavius
M.Supraspinatus
'erminal
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'erminalbranches
0.th!rac!d!rsalis
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S%apula Alata
• N.thoracalislongus
• 3.serratus
anterior
LS-FKUAJ-2011 43
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Shoulder 7ysto%ia
LS-FKUAJ-2011 44
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LS-FKUAJ-2011 45
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8r$9s dan Klumpke9s Palsy
LS-FKUAJ-2011 46
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LS-FKUAJ-2011 47
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