ABDOMINOPELVICUS

ABDOMINOPELVICUSCAVUM ORIS & OESOPHAGUS DINDING ABDOMINOPELVICUSTRACTUS ALIMENTARIUSHEPATOPANCREATICOBILLIER & LIENGb. kerangka

ABDOMINOPELVICUSSITUS ABDOMENBATAS- BATASORGAN- ORGAN SITUS UROGENITALE ( PELVIS )BATAS- BATASORGAN- ORGAN

CAVUM ORIS & OESOPHAGUSBatas cavum oris : a. cranial ( palatum ) b. caudal ( diaph. Oris ) c. anterior d. posterior ( fauces ) e. lateral ( buccal )Oesophagus : a. pars cervicalis b. pars thoracalis c. pars abdominalis

CAVUM ORISFungsi cavum oris : a. Pencernaan b. PernafasanBangunan intraoral : ( perlengkapan ) a. Gigi geligi b. Lingua c. Gld. salivariusLINGUA

LINGUA ( lymphatica )

DIAPHRAGMA ORIS & LINGUA

OESOPHAGUSPanjang : 25 cm.Fungsi : penghubung laryngopharynx ke gasterPenyempitan : a. laryngopharynx oesophagus b. persilangan dng.bifurcatio trachea c. masuknya kegaster OESOPHAGUS

ANATOMI SUPERFICIALMerupakan anatomi permukaan pada bagian anterior/ ventralBatas cranial ; proyeksi diaphragmaBatas caudal ; proyeksi diaphragma pelvisAnatomi superficial

LAPISAN DINDING ABDOMEN ANTEROLATERALCutisSubcutis ( tela subcutanea abdominalis/superficial fascia ) : fascia Camper, Scarpa.Deep fascia ( fascia innominata/Gallaudet/investiens superficialis abdominis )Musculi abdomen anterolateral :Fascia transversa

LAPISAN DINDING ABDOMEN ANTEROLATERAL 1. m. obliquus externus abdominis = fascia in- tiens intermedia abdominis 2. m. obliquus internus abdominis = fascia in- tiens profundus abdominis 3.m. transversus abdominis, m. rectus abd.+ m. pyramidalis.LAPISAN DINDING ABDOMEN ANTEROLATERALFascia endoabdominalis : fascia transversalis, fascia diaphragmatica,fascia iliaca,fascia thoracolumbalisdiaphragma

BATAS ABDOMINOPELVICUSCRANIAL : diaphragmaCAUDAL : diaphragma pelvisPOSTERIOR : vertebra,costae, sacro-coccygeal, os pelvis,ototLATEROANTERIOR : costae,ototDINDING ( cutis,subcutis,fascia,musculus, tulang )ISI CAVUM ABDOMINOPELVICUMPERITONEUM : parietale,cavum,visceraleTRACTUS GASTROINTESTINALTRACTUS UROGENITALIA : uropoitica,reproduksi ( laki/perempuan )VASA : arteriil,vena,lymphaticaDiaphragma pelvis & diaphragma urogenitale

DIAPHRAGMA PELVIS

Dinding posterior

DINDING POSTERIORTULANG : 1. cranial : costa( 7-12 ),vert.th.7- os ilium 2. caudal : sacro-coccygeal,os pubisOTOT : 1. cranial : m.quadratus lumb. m.psoas 2. caudal : m.iliacus,m.psoasDINDING LATEROANTERIORM. obliquus abd.externusM. obliquus abd.internusM. transversus abdominisM. rectus abdominisM. pyramidalisVAGINA MUSCULI RECTI

Lateroanterior ( m. OAE )

Lateroanterior ( m. OAI )

Lateroinferior ( m. TA )

Vagina musculi recti

Anterior ( m. rectus abd. & m. pyramidalis )

Canalis inguinalis

LIGAMENTUM INGUINAL

INGUINAL

Pot.transversal abd.

INNERVASI DINDINGDIAPHRAGMA : n.phrenicus,nn.intercostalDIAPHRAGMA PELVIS : cab.plexus sacrales3-4DINDING POSTEROLATERAL DAN ANTERIOR : -nn.intercostal 7- 12, nn. L 1- 5. -nn. Sacrales 2- 4.

VASADIAPHRAGMA : vasa phrenica inferiorDIAPHRAGMA PELVIS : vasa pudenda internaDINDING POSTEROLATERAL : vasa intercostales 7-12, lumbales 1-5,sacralesDINDING ANTERIOR : 1. cranial : epigastrica superior 2. caudal : epigastrica inferior & superficialis, circumflexa ilium prof & superficialis

VASA DIAPHRAGMA PELVIS

VENA

aa. Lumbales, v. Azygos & hemiazygos

VASA

VASA ANTERIOR

Vasa ( lymphatica )DIAPHRAGMA : mengikuti aliran venaDIAPHRAGMA PELVIS : nnll.sacralesDINDING POSTERIOR : nnll.paraaorticiDINDING LATEROANTERIOR : nnll.axillares, nnll.inguinalesBATAS CAVUM ABDOMEN DAN CAVUM PELVIS

CAVUM ABDOMEN PROPIUSCRANIAL : diaphragmaCAUDAL : inlet/P.A.P/aditus pelvisPOSTERIOR : vert.,costae,ilium,ototLATEROANTERIOR : costae,ototISI CAVUM ABDOMENPERITONEUM : parietale,viscerale,cavumTRACT. GASTROINTESTINAL : oesophagus- colon descen.TRACT. UROPOITICA : ren,ureter pars abd.VASAPERITONEUM

TRACTUS GASTROINTESTINALEMBRIOLOGI : 1. Preenteron/fore gut ( a.coeliacus ) 2. Mesenteron/mid gut ( a. mesenterica sup. ) 3. Metenteron/ hind gut ( a. mesenterica inf. ) EMBRIOLOGI TRACT. GASTROINTESTINAL

EMBRIOLOGI TRACT. GASTROINTESTINAL

PREENTERONOesophagus pars abdominalisGasterDuodenum pars superior- descendens ( cranial papilla duodeni major )PREENTERON

PREENTERON

PREENTERON

MESENTERONDuodenum pars descendens ( caudal Duodenum pars horizontalisDuodenum pars ascendensJejunumIleumCaecum & appendix vermiformisColon ascendens2/3 oral colon transversumMESENTERON

DIVERTICULUM MECKEL

METENTERON1/3 anal colon transversumColon descendensColon sigmoidrectumMETENTERON

TRACTUS GASTROINTESTINALCANALIS ALIMENTARIUS : oesophagus pars abdominalis - rectumHEPATO-PANCREATICO-BILIER & LIEN : 1. Hepar 2. Vesica fellea/ biliaris 3. Pancreas 4. Lien Innervasi, vascularisasi tract. gastrointestinalINNERVASI : 1. sympathis (T. 4- 12, L. 1-2) 2. parasympathis : a. N. Vagus ( X ) b. S. 2- 4 VASCULARISASI : ( lihat vasa embriologi )OESOPHAGUS PARS ABDOMINALIS & GASTER

GASTER

LAPISAN DINDING GASTER

OMENTUM MINUS

OMENTUM MAJUS

INNERVASI GASTER

VASCULARISASI GASTER

VENA GASTER

DUODENUM

INTESTINUM TENUE ( usus halus )DUODENUM : - pars superior ( I ) - pars descendens ( II ) - pars horizontalis ( III ) - pars ascendens ( IV ) JEJUNUM & ILEUM : pada in vivo dewasa 6 m. absorbsi sebagian nutrici

INTERIOR DUODENUM

LAPISAN DINDING DUODENUM

VASCULARISASI DUODENUM

JEJUNUM & ILEUMJEJUNUM : 3/5 bagian dari jejunum & ileum dinding >tebal & merah villi chorialis > panjang arcade vasanya > sedikitILEUM :2/5 bagian jejunum & ileumJejunum & ileum

Jejunum & ileum

JEJUNUM & ILEUM

Innervasi dan vascularisasi intestinum tenueDUODENUM : 1. sympathis ( T. 7- 8 ) 2. parasympathis ( N.X ) 1. a/v. gastroduodenalis 2. a/v. panreaticoduo denalis sup.& inf. 3. a/v. jejunales ( cab. )

JEJUNUM & ILEUM 1. sympathis ( T.9- 10 ) 2. parasympathis ( T.X )

1. a/v. jejunales 2. a/v. ileiArteiil jejunum & ileum

Vena jejunum & ileum

INTESTINUM CRASSUM ( usus besar )CAECUM & APPENDIX VERMIFORMISCOLON ASCENDENSCOLON TRANSVERSUMCOLON DESCENDENSCOLON SIGMOIDRECTUMCANALIS ANORECTALISINTESTINUM CRASSUM

Morphologi intestinum crassumKondensasi str.long.T.musc. ( TENIA )Kondensasi str.circ. T. musc. ( > HAUSTRA < )Appendices epiploicae ( KANTONG ISI LEMAK )APPENDIX VERMIFORMISRECTUMCaecum & appendix,colon ascendens

idem

idem

Colon asc.,trans.,desc., sigmoid

INNERVASI & VASA INT. CRASSUMINNERVASI : 1. sympathis ( T.10- 11, L. 1- 2 ) 2. parasympathis ( cae- cum & app.-2/3 oral trans. N. vagus, 1/3 anal trans.-rectum S.2- 4 )VASCULARISASI : 1. a/v. ileocaecalis a. a/v. caecalis b. a/v. appendicularis 2. a/v. colica dextra 3. a/v. colica media 4. a/v. colica dextra 5. a/v. sigmoidea 6. a/v. rectalis sup.Vascularisasi intestinum crassum

HEPATO-PANCREATICO-BILIER & LIENHEPAR : pembagian,fungsi,innervasi,vasaPANCREAS : VESICA BILIARIS/ FELLEA : LIEN : HEPARPEMBAGIAN : 1. Anatomis ( fiss.sag. sinistra ) 2. Fungsional ( fiss.sag. dextra ), area I- VIII. FUNGSI : ( bilier,metabolisme,hemopoetic dll )INNERVASI : 1. N. Vagus 2. T 7- 8.VASCULARISASI : 1. sistemik (a. hepatica prop.) 2. portal (v. porta) 3. v. hepatica ( portocaval )FACIES DIAPHRAGMATICA

FACIES VISCERALIS, area porta

ANATOMI KLINIK HEPARRuptur heparTumor heparCirrhosis hepatisProyeksi externa hepar

VESICA BILIARIS/ FELLEA

VESICA BILIARISANATOMIS : facies vesica biliarisFUNGSI : menyimpan cairan biliaris meningkatkan konsentrasiINNERVASI : 1. N. Vagus 2. T 7- 8VASCULARISASI : vasa cystica cab. a. hepatica dextra ANATOMI KLINIK V. BILLIARISCallot triangle ( ln. cystica )Hartmann pouch ( infundibulum ) --- batuProyeksi externa ( fundus )Innervasi v. Billiaris = sphincter Oddi

PANCREASANATOMIS : ( caput,collum,corpus,cauda )FUNGSI : 1. Exocrin ( pencernaan ) 2. Endocrin/ Langerhans ; ( glucagon ), ( insulin )INNERVASI : 1. N. vagus 2. T 8- 10VASCULARISASI : 1.a/v pancreaticoduodenalis superior dan inferior 2.a/v pancreatici ( lienalis ) 3.a/v jejunalis PANCREAS

PANCREAS ( ampulla Vateri )

ANATOMI KLINIK PANCREASAnnular pancreasCarcinoma caput pancreasPancreatitis Ruptur pancreas LIEN ( SPLEEN )FACIES DIAPHRAGMATICA : FACIES VISCERALIS : 1. gastrica 2. renalis 3. colica 4. hilus lienalis 5. omentum majus ( lig.gastrolienalis, lig. lienorenalisINNERVASI & VASCULARISASI LIENInnervasi : 1. N. Vagus 2. T 8- 10Vascularisasi : 1. A. lienalis 2. V. Lienalis 3. ln. splenici

LIEN

ANATOMI KLINIK LIENSplenomegali ( proyeksi externa ) --- Suffner I VIII Fungsi optimal lien

VASCULARISASI PORTADEFINISI : sistim vena pd.tract.gastrointestinal yg. melalui hepar sbg. organ yg.melakukan metabolisme nutrici.AKAR V. PORTA : v.mesenterica sup.,v.lienalis, v.paraumbilicalis,v.oesophagei sistim ini beranastomosis dng vena sistemik Vena porta

ANASTOMOSIS AKAR v. PORTA DENGAN VENA SISTEMIKVv. Oesophagei -------- Vv. Phrenica inferiorV. Rectalis superior ------- V. Rectalis inferiorVv. Transperitoneal/ colicae dextra et sinistra ( Retzius ) -------- Vv. LumbalesV. Pancreaticoduodenalis, vena yg. Bermuara ke V. Lienalis -------- V. Renalis dextra et sinistraV. Parumbilicalis --------- vena subcutan sekitar umbilicusANATOMI KLINIK V. PORTAVarices oesophagei/ hematemesisSplenomegaliHemorrhoid internaAscites TRACTUS UROGENITALIATRACTUS UROPOITICA 1. Ren ( 2 ) 2. Ureter ( 2 ) a. pars abdominal b. pars pelvina 3. Vesica urinaria 4. UrethraTRACTUS GENITALIA 1. Genitalia feminina a. Interna b. Externa 2. Genitalia masculina a. Interna b. ExternaREN & URETER

EMBRIOLOGI REN & URETER

PERKEMBANGAN NEPHRON

RENANATOMI : retroperitonealFUNGSI : 1. regulasi H2O 2. regulasi pH 3. mineral 4. excresiGLANDULA SUPRARENALIS INNERVASI : 1. sympathis ( T. 10 ) 2. parasympathis (N.X ) VASCULARISASI : 1. a/v renalisREN

URETERANATOMIS : ( pars abdominalis & pelvina )FUNGSI : ( saluran urin dari ren ke vesica urinaria )INNERVASI : ( T. 10- 11 )VASCULARISASI : ( a/v. renalis,a/v. vesicalis sup.,a/v.uterina/defferentia lis.CAVUM PELVISPELVIS MAJOR : cavum abdomen cranial inlet/ P.A.PPELVIS MINOR : cranial : inlet caudal : outlet/ P.B.P ISI : ( genitalia interna feminina,sigmoid, rectum,anorectalis,dllPELVIS

PELVIS

GASTROINTESTINAL ( intrapelvis )COLON SIGMOID : ( gambar )RECTUM : penampung faecesANORECTALIS : Batas rectum dan anus : 1. anatomis : linea dentata 2. fungsional : white line HiltonSIGMOID,RECTUM, ANORECTALIS

COLON SIGMOIDANATOMI : bentuk sigma, intraperit.,INNERVASI : T.11-12, S.2-4.VASCULARISASI : a/v. sigmoidea cab./akar a/v. mesenterica inferior RECTUM & ANORECTALISRECTUM : mempunyai 2 lekukan Innervasi : L.1-2, S2-4 vascularisasi : a/v.recta- lis superior ( a/v. me- senterica inf.)

PLEXUS HEMORRHOIDALIS ( interna & externa )ANORECTALIS :RectumAnus : Innervasi : n. pudendus ( S 2-4 ) Vascularisasi : a/v. pudenda internaVESICA URINARIAANATOMIS : prisma sisi tiga ( kosong ); apex, basis,inferolateral,superiorFUNGSI : menampung urinINNERVASI : L.1-2, S2-4VASCULARISASI : vesicalis sup/inf, obturatorius,glutea inf.,vaginalis,defferentialis plexus venosus vesicoprostaticus nnll.vesicoprostaticus- nnll.iliaca interna VESICA URINARIA

VESICA URINARIA

TRACTUS GENITALIAFEMININA : 1. EXTERNA : vagina, labium majus/ minus, clitoris,mons pubis, gld vestibularis major 2. INTERNA : uterus,tu- ba uterina,ovarium, bangunan lainMASCULINA : 1. EXTERNA : urethra, scrotum,penis,gld.bul bourethralis 2. INTERNA : testis,epidi dymis,ductus deffe- rens,vesicula semina- lis,prostat. EMBRIOLOGI GENITALIA

FEMININA EXTERNA

FEMININA EXTERNA

Innervasi & vascularisasi

FEMININA INTERNA

FEMININA INTERNA

UTERUS & TUBA UTERINAUTERUS : 1. FUNDUS UTERI 2. CORPUS UTERI 3. CERVIX UTERITUBA UTERINA : 1. INTRAMURAL 2. ISTHMUS 3. AMPULLA 4. INFUNDIBULUM & FIMBRIAEInnervasi & vascularisasiINNERVASI : dicab.plex.hypogastricus ( T.10- L.1 dan S2- 4 ) rasa nyeri dibawa oleh saraf sympathis ( dysmenorrhoe, cervix,nyeri saat melahirkan ) VASCULARISASI : 1.a/v.uterina dan ovarica 2.nnll.iliaca int. 3.nnll.iliaca int.& ext. ( cervix )Vascularisasi uterus & tuba

OVARIUMFUNGSI : hormonal, ovumINNERVASI : vasoconstrictor ( T.10-11) parasympathis ( S.2-4 mela- lui plex.hypogastricus inf.VASCULARISASI: a/v. ovarica ( melalui lig. Ovarii proprium ) nnll.paraaortici nnll.inguinalis ta135GENITALIA MASCULINA EXTERNA

Lapisan PENIS : 1. cutis 2. fascia superfisialis v.supf dors penis 3. fascia profunda v.prof dors penis a.dors penis n.dors penis 4. tunica albuginea innervasi n.ilioinguinalis vasa cab.a/v. pudenda intSCROTUM : 1. cutis 2. tunica Dartos 3. fascia sperm.externa 4. m.cremaster 5. fascia sperm.interna innervasi n.ilioinguinalis serabut sympathis pd cre- mater. vasa : pudenda ext.Masculina externa

Innervasi & vascularisasi externa

URETHRA MASCULINAPARS PENILE : 1. pendulosa 2. bulbosaPARS MEMBRANACEA : tipis,mudah rupturPARS PROSTATICA : dikelilingi gld prostatMASCULINA INTERNA

Masculina interna

Sebagian organ genitalia interna terdapat didalam cavum scroti !INNERVASI DAN VASCULARISASI GENITALIA INTERNA TESTIS ( ES )EPIDIDYMISDUCTUS ( VAS )DEFERENSGLANDULA PROSTATAVESICULA SEMINALIS

Masculina internaTESTIS : 1. innervasi : sympathis T. 10 ggl. coeliacus 2. vascularisasi : a. testi- cularis/spermatica- interna nnll.paraaortici ( L. 2 )EPIDIDYMIS : 1. innervasi : sympathis ggl. coeliacus 2. vascularisasi : cabang a. testicularis/sperma tica internaGLANDULA PROSTATAANATOMIS : 4x3x2 cm,caudal v.u. central,periurethra,perifir ( Mc. Neal )FUNGSI : produksi spermaINNERVASI : acini ( n.splanch.pelvicus/ PS. ) stroma ( plex.hypogastricus/ S. )VASCULARISASI : a.vesicalis inferior plexus vesicoprostaticus nnll. Iliaca interna/ nnll.Iliaca ext.Masculina internaDUCTUS DEFERENS : saluran sperma & sper- ma ( spt.epididymis ) 1. innervasi : plx.hypo- gastricus inf. & L.1 2. vascularisasi : a/v. de- ferentialis > a.vesica- lis inferior VESICULA SEMINALIS : produksi cairan ( glico- protein ) 1. innervasi : plx.hypo gastricus inf.& L. 1 2. vascularisasi : cabang dari a. vesicalis inf.TERIMA KASIH