dr. May Valzon Organ sensoris I

Mata ORBITA KELOPAK MATA (PALPEBRA) OTOT MATA FASCIA MATA APARATUS LACRIMALIS BOLA MATA (BULBUS OCULI) Vaskularisasi dan inervasi

Orbita

Orbita Memiliki basis, apex dan 4 dinding: Atap : pars orbitalis os frontale (utama), ala minus os spenoidale. Fossa lacrimalis  anterolateral Dinding medial: os. Ethmoidale (utama). Struktur lain: sulcus lacrimalis, fossa saccus lacrimalis Dinding lateral: processus frontalis os.zygomaticus, ala mayus os sphenoidale Lantai : maxilla, zymaticus dan palatina Apex: terdapat canalis opticus dan fisurra orbitalis superior

Otot mata Otot ekstrinsik (ekstra-oculer) : Skelet membuka palpebra dan pergerakan bola mata Otot intrinsik : involunter kecembungan lensa dan ukuran pupil Gerakan bolamata: elevasi, depresi, abduksi, adduksi, intorsi, dan ekstorsi

fascia orbita Periorbita  septum orbitalis + annulus tendineus communis Vagina bulbi = fascia bulbi = capsula tenon) Lemak orbita Ligamentum palpebralis: medial et lateral

Pembuluh darah orbita

INERVASI NERVUS OPTICUS NERVUS OCULOMOTORIUS NERVUS TROCHLEARIS NERVUS ABDUCENS NERVUS OPTHALMICUS SISTEM SARAF AUTONOM : PARA SIMPATIS DAN SIMPATIS

Nervus Opticus (NC II) Bukan merupakan nervus cranialis sesunguhanya  jadi apa? Diselubungi oleh meninges  lengkap ↑↑ TIK  papiledema  opthalmosop

NC V1 Bercabang menjadi: N. lacrimalis  hanya membawa sensoris glandula lacrimal Di dekat ujung menerima cabang dari n. zygomaticotemporale (N V2)  membawa simpatis dan parasimpatis N. frontalis  sensoris luar orbita, bercabgna dua: N. supra-orbitalis N. supra-trochlearis N. nasociliaris N. ciliaris longus N. infra-trochlearis N. ethmoidalis ant & post

Ganglion cilliare Ganglion parasimpaticus NC III

PALPEBRA

Disusun oleh (luar – dalam): Kulit -- Septum orbitalis Subkutan -- Tarsus dan m. levator P Otot volunter (pars -- Konjunctiva palpebra palpebralis m. orbicularis oculi) Kelenjar: glandula Meibom, glandula Moll, dan glandula Zeis Konjunctiva Konjunctiva palpebra Fornix conjunctiva Konjunctiva bulbaris

Vaskularisasi dan inervasi the supratrochlear, supra-orbital, lacrimal, and dorsal nasal arteries from the ophthalmic artery; the angular artery from the facial artery; the transverse facial artery from the superficial temporal artery branches from the superficial temporal artery itself Vena  mengikuti arteri Limfe  lnn. parotid Inervasi: Sensoris : the supra-orbital, supratrochlear, infratrochlear, and lacrimal branches of the ophthalmic nerve [V1]; the infra-orbital branch of the maxillary nerve [V2] Motoris: the facial nerve [VII], which innervates the palpebral part of the orbicularis oculi; the oculomotor nerve [III], which innervates the levator palpebrae superioris; sympathetic fibers, which innervate the superior tarsal muscle.

Klinis Loss of innervation of the orbicularis oculi by the facial nerve [VII] causes an inability to close the eyelids tightly and the lower eyelid droops away, resulting in a spillage of tears. Loss of innervation of the levator palpebrae superioris by the oculomotor nerve causes an inability to open the superior eyelid voluntarily, producing a complete ptosis. Loss of innervation of the superior tarsal muscle by sympathetic fibers causes a constant partial ptosis.

Aparatus lacrimalis Glandula lacrimalis Ductus lakrimalis Canliculi lacrimalis Saccus lacrimalis Ductus nasolacrimalis

Inervasi

Reflek lakrimasi r. Lakrimalis n. opthalmicus & n. infra orbitalis Iritasi conjunctiva atau cornea r. Lakrimalis n. opthalmicus & n. infra orbitalis Otak n. Facilais Parasimpatis ganti neuron Nucleus salivarius sup Glnadula lakrimalis Ganglion pterygoplatina n.Spinalis segmen thorak superior Lakrimasi

BOLA MATA (BULBUS OCULI)

Terdiri dari 3 lapisan: Tunica fibrosa 5/6 post = sclera 1/6 ant = cornea Tunica vascularis (tractus uvealis) = choroid, corpus cilliaris, iris Tunica interna (retina) Lamina pigmentosa Lamina neuralis

Tunica fibrosa Sclera: putih tak tembus cahaya “putih mata” F(x) : melindungi dan menjaga bentuk bola mata, tempat insertio musculi ekstrinsik Berlanjut sebagai duramater Cornea: transparan (1/6 anterior bola mata) 5 lapisan: epithelium, membrana bowmen, stroma, membrana descement, endothelium Corneo-scleral junction (limbus) Kaya vaskularisasi Canalis schlemm

Tunica vascularis (uvea) Choroid : kaya vascularisasi berwarna hitam (kaya melanosit), f(X)= nutrisi retina Lamina eksterna, Lamina choriocapilari, Membrana bruch Corpus cilliaris M. ciliaris  2 bundel otot polos Processus ciliaris  oxytalan fibers/zonula, menghasilakan humor aqueous

Trujnkus simpatikus sup Iris Pupil  mengatur cahaya, Ø 1 – 8 mm Otot iris: M. dilator pupil dan M. spincter pupil Vaskularisasi: a. siliaris anterior dan a.siliaris posterior longus Inervasi : para simpatis / simpatis N. nasociliaris m. Spincter pupil r. Ciliaris longus N. III Gln. ciliaris r. Ciliaris brevis m. Dilator pupil Trujnkus simpatikus sup

Ganglion siliaris

Retina

Lamina pigmentosa: Lamina neuralis Menyerap kelebihan cahaya Fagosit  sel potoreceptor rusak Penyimpan vit A untuk fotoreceptor Lamina neuralis Fotoreceptor : sel konus dan basilus Sel bipolar Sel ganglion

Discus opticus dan vaskularisasi retina

Media refraksi mata Cornea Aqueous humor: dihasilkan oleh epithelium non pigmentosum corpus ciliary Aliran: corpus cilliary  camera oculi post  pupil  camera oculi ant  angulus iridocornealis sinus venosus sclera (canalis schlemm)  limbal plexus  v. Verticose dan v. Ciliaris ant Glucoma: peningkatan tekanan intra oculi karena obstruksi pd angulus iridocornealis Lensa Viterous body

Lensa Corpus viterous Berisi viterous humor (gel), 4/5 bola mata Campsula lentis di gantung oleh lig. Suspensorium lentis (zonula fibers) dari processus ciliaris Akomodasi oleh m. ciliaris oleh saraf simpatis Rangsangan parasimpatis  kontaksi m. siliaris  longgarnya lig. Supensorium  lensa mencembung: untk melihat dekat Hilangnya rangsang para simpatis  melihat jauh (lensa memipih) Corpus viterous Berisi viterous humor (gel), 4/5 bola mata

Melihat (vision)

Visual defect

Control neuronal pandangan Saccades  merubah pandang dg gerakan cepat Smoot persuit system atau Vestibulo-ocular dan optokinetic system  fokus sewaktu bergerak Gerakan horizonatal: PPRF Gerakan vertikal

Figure 24. 3 Summary of eye movement control   Figure 24.3 Summary of eye movement control. The central drawing shows the supranuclear connections from the frontal eye field (FEF) and the posterior eye field (PEF) to the superior colliculus (SC), rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), and the paramedian pontine reticular formation (PPRF). The FEF and SC are involved in the production of saccades, while the PEF is thought to be important in the production of pursuit. The drawing on the left shows the brain stem pathways for horizontal gaze. Axons from the PPRF travel to the ipsilateral abducens nucleus innervating lateral rectus (LR). Abducens internuclear axons cross the midline and travel in the medial longitudinal fasciculus (MLF) to the portion of the oculomotor nucleus (III) innervating medial rectus (MR) of the contralateral eye. The drawing on the right shows the brain stem pathways for vertical gaze. Important structures include the riMLF, PPRF, the interstitial nucleus of Cajal (INC), and the posterior commissure (PC). Other abbreviations: DLPFC, dorsolateral prefrontal cortex; IV, trochlear nucleus; SEF, supplementary eye field; VN, vestibular nucleus.

Reflek pupil

TERIMAKSIH