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Equilibrium & Taste
Nurfitri Bustamam, SSi, MKes, MPdKed.
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Learning Objectives
Explain how the receptors in the semicircular
canals detect rotational acceleration & how
saccule & utricule detect linear acceleration
List the major sensory inputs that provide theinformation that is synthesized in the brain
into the sense of position space
Name the five major taste receptors & signal
transduction mechanisms in these receptors Outline the pathways by which impulses
generated in taste receptors reach theinsular cortex
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Equilibrium
Mendeteksi percepatan linier:
- utrikulus horizontal
- sakulus vertikal
Mendeteksi percepatan anguler:- canalis semisirkularis
horizontal (lateral)
sagital (anterior) vertikalfrontal (posterior)
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Utriculus & Saculus
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Canalis Semisirkularis
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Canalis Semisirkularis
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Nystagmus:refleks utk menjaga fiksasi penglihatan, tdd komponen
lambat & cepat
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Nystagmus
a) Komponen lambat (vestibulo-ocular-reflex)/VORReseptor: vestibuler
Aferen: N.VIII
Pusat: oculomotor nuclei
Eferen: N.III, N.IV, N.VI
Efektor: otot penggerak bola mata (berlawanan arah rotasi)
b) Komponen cepat (stretch reflex)
Otot bola mata teregang muscle spindle kontraksi
(searah rotasi)
Nystagmus umumnya horizontal, tetapi dpt pula vertikal
(kepala miring) atau berputar (kepala tertunduk)
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Vertigo: sensasi berputar tanpa ada putaran ygsesungguhnya
Caloric stimulation:
Perbedaan suhu konveksi gerakan cupula
nystagmus & nausea
Spatial Orientation
Motion Sickness
Menieres disease: fluid imbalance in inner ear
(vestibular apparatus & cochlea), simptom: vertigo,loss of hearing, ringing in the ears
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Caloric Stimulation
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Caloric Stimulation
Water 40oC (warm) & 30oC (cold) in external
auditory meatus
Temperature difference convection
currents in endolymph motion of cupula Healthy subjects COWS (Cold water
nystagmus is Opposite side, Warm water
nystagmus is Same side)
Unilateral lession in vestibular pathway
nystagmus or absent on the side of lesion
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BARANY ROTATION TEST
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BARANY ROTATION TEST
Barany introduced a routine clinical test that involves observationof the post-rotatory responses after a patient is spun around
several times in specially designed swivel chair.
post-rotatory nystagmus, abnormanalities in standing & walking,falling, and a past-pointing error can be obeserved
Nystagmus
The eyes remain fixed on their original point of focus, so thatthey must diverge slowly towards the left to compensate forrotation of the body to the right. When the limit to which the eyescan be rotated laterally is exceeded, they snap quickly back to theright and select a new point of fixation. These alternate slow andquick movements of the eyes are called nystagmus.
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FallingThe subject would be expected to fall towards the side of
flexion, which in the case of post-rotatory reflexes would be inthe same direction as the rotation. However, sinceproprioceptors in the trunk & limbs are still functioning, he mayover-correct this tendency and stagger over towards theextended side.
Past Ponting ErrorOccurs when the subject with eyes closed is instructed to
repeatedly extend his arm to touch an object directly in front ofhim, successive movement will deviate in the direction oppositeto his sensation of vertigo.
(Wiggers 1955: 171-174
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TASTE
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Taste bud tdd:
- basal cells
- Sel tipe 1&2 (sustentacular cells)
- Sel tipe 3 (gustatory receptor cells)
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Sel tipe 1, 2 & 3 memp. microvili yg menjulur kepori pengecap (taste pore)
Tiap taste bud diinervasi 50 serat saraf Tiap serat saraf menerima input dari 5 taste bud
Sel basal berdiferensiasi mjd reseptor yg baru,reseptor diganti secara continue, dg half life 10
hari Jika n. sensorik dipotong, taste bud yg
diinervasinya akan berdegenerasi. Namun, jikasaraf tsb beregenerasi sel-sel di sekitarnya akan
mjd taste bud Taste bud (fungiform & vallate papillae) tdpt pd
mucosa epiglottis, palate, pharynx & lidah
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Physiology of Taste
Pd manusia ada 4 basic taste: sweet, sour, bitter, salt
Taste bud tsb tdk berbeda dlm histologi
Asam:
- H+menstimulasi reseptor
- as.organik lbh terasa asam dari as. mineral (diduga
karena asam organik lbh cepat masuk ke sel)
Asin:
- Na+ sel
- beberapa senyawa organik juga terasa asin
Manis
- sukrosa, maltosa, glukosa, glyseral, as. aspartat
- sacharin & aspartane (pemanis buatan)
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Pahit:
quinine sulfate, nicotine, morphine, caffeine, strychnine,
magnesium, amonium & calcium
Intensity discrimination: perbedaan konsentrasi hinggalbh dari 30% baru disadari
Variation & after-effect
PTC (Phenylthiocarbamide) pd populasi Caucasian:70% merasakan asam + 30% tasteless
Miraculin (taste modifier protein) makes acid tastesweet
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Tes waktu sirkulasi: op disuntik suatu zat timbulrespons merasa pahit di lidah, mekanisme: zat disirkulasi sel kelenjar ludah sekresi rasapahit
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Taste pathways
Serat saraf sensorik dari taste bud di:
- 2/3 anterior lidah lewat n. VII- 1/3 posterior lidah lewat n. IX
- di luar lidah lewat n. X
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Abnormalities in Taste Detection
Ageusia & Hypogeusia Dysgeusia/parageusia
Altered in serotonin & Norepinephrin level (anxiety/depresionaltered taste threshold
Zinc or vit B3 deficiency
Damage glossopharyngeal nerve Neurological disorders: multiple sclerosis, bell palsy
Poor oral hygiene, smoking
Aging, drug: captoptril, cisplatin
Theraphy: improved oral hygiene & zinc supplementation
Supertaster: increased number of fungiform papillae on theirtounge
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