kuliah 9 mata-tht

7/18/2019 Kuliah 9 Mata-THT

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ORGANON

VISUS

Dr. Thontowi Djauhari NS, MKesFK Univ. Muhammadiyah Malang



ORGANON

VISUS

Oculi accessorius

Alis mata

Palpebra - conjungtia

Musculi e!trinsi"

Apparatus lacrimalis

#ulbus Occuli Nerus opticus

Oculi



$A%&M

O'#(TA

BENTUK

Pirami)a * sisi

APEX

+ #AS(S

anterior

inerior

Din)ing Me)ial

os gomaticusos gomaticus

os ma!illaos ma!illa

os palatinaos palatina

os rontal

os lacrimal

os ethmoi)ale

Os rontal

Ala magnaos sphenoi)ale

os gomaticus

Din)ing /ateral

ATAP ATAP

os rontalos rontalala para os sphenoi)alisala para os sphenoi)alis

0posterior1 canalis opticus

superior

os rontal

os gomaticus

os ma!illa

Os sphenoi)alis

os lacrimal

os ethmoi)alis

os palatina

canalis opticus



Isi avum O!"i#a

2 #ulbus oculi2 Sara N. opticus 0N. ((1 N. occulomotorius 0N. (((1 N. trochlearis 0N. (%1 N. ab)ucens 0N. %(1 N. opthalmica 0N. %31

beserta cabangna2 Pembuluh )arah %asa opthalmica

beserta cabangna2 Musculi oculi2 /ema"

2 Apparatus lacrimalis



4oramen opticum

N. opticus, a. opthalmica

4issura orbitalis superior

N. occulomotorius,

N. trochlearis,

N. ab)ucens, N.opthalmica

0N.lacrimalis, N.rontalis,

N.nasociliaris1

. opthalmica superior

4issura orbitalis inerior N. ma!illaris, asa inraorbitalis

4oramen ethmoi)alis anterior et posterior Neri )an asa ethmoi)alis

4issura

orbitalis superior

4issura

orbitalis inerior

4oramen

ethmoi)alis

4oramen opticum

4oramen 5 4issura

dalam $aum Orbita



$UBUNGAN %ENGAN SEKITARN&A '

ATAP 4ossa cranii anterior

Sinus rontalis

DASA' Sinus ma!illaris

M6D(A/ $ellulae ethmoi)alis

Sinus sphenoi)alis

/AT6'A/ 4ossa temporalis0anterior1

4ossa cranii me)ia

0posterior1

Sinus rontalis



O$&/( A$6SSO'(A

#ola mata ter)apat )alam caum orbita )an )itutupi olehpalpebrae. Di atas palpebrae superior tumbuh alis matasepanjang arcus superciliaris ang berungsi melin)ungimata )ari "eringat

Oculi accessoria meliputi 7

Alis mata

Palpebrae - $onjungtia Musculi e!trinsi" Apparatus lacrimalis



Mus(uli E)#!insi*O(uli di Pal+,"!a,

Nama -#-# Fungsi Inn,!vasi

M. Orbicularis occuli

2 Pars palpebralis2 Pars orbicularis

2 Pars lacrimalis

Menutup mataMenutup mata

Mengatur pengeluaran air mata

N. 4ascialis

M. /eator palpebrasuperioris

Membu"a mata N. occulomotorius

m. l,va#-! +al+,"!alis m. O!"i(ula!is -(uli

Oculi Accessorius



Ta!sus

Pal+,"!a, di+,!*ua# -l,h

a!ingan i*a# *-lag,n

- Ta!sus su+,!i-!

- Ta!sus in/,!i-!

Ta!sus su+,!i-!

Ta!sus in/,!i-!

%il,*a#*an *, #,+i -!"i#a -l,h

- 0ig. +al+,"!al, la#,!al,

- 0ig. +al+,"!al, m,dial,

0ig. +al+,"!al, la#,!al,

0ig. +al+,"!al, m,dial



-nun(#iva

Pal+,"!a (-nun(#iva

2 Melapisi )in)ing )alam

palpebrae orni!

conjungtia

2 sangat ascular 2 Muara gl). lacrimalis,

gl). su)oriera, gl).

cebacea

Bul"a! (-nun(#iva 2 Dari orni! conjungtia permu"aan anterior bola mata

limbus cornea

2 Transparan

Pal+,"!a

(-nun(#iva

Bul"a!

(-nun(#iva



(nnerasi

(nnerasi sensoris- $abang N.opthalmicus

N. supraorbita,

N. supratrochlear

N. inratrochlear,

N. lacrimalis- $abang N.ma!illaris

N. inraorbitalis

(nnerasi motoris N. acialis 0pars palpebralis m. orbicularis oculi1

N. occulomotorius 0m. leator palpebrae superior1 Serabut simpatis 0m. tarsalis superior1



Glandula la(!imalis

%u(#us ,)(!,#-!ius la(!imalis

F-!ni) (-nung#iva

P,!mu*aan an#,!i-! "ul"us -(uli

0a(us la(!imalis

Pun(#a#a la(!imalis

anali(uli la(!imalis

Sa((us la(!imalis

%u(#us nas-la(!imalis

Apparatus lacrimalis



BU0BUS OU0I



ISI BU0BUS OU0I

2 8&MO' A9&6&S

2 /6NSA

$':STA/(NA

2 $O'P&S

%(T'6&M



$O'N6A

S$/6'A

$8O'O(D$O'P&S $(/(A'(S

('(S

'6T(NA

TUNIA FIBROSA TUNIA VASU0OSA TUNIA NERVOSA

PEMBUNGKUS BU0BUS OU0I



TUNIA FIBROSA OU0I

2 3;< bagian anterior transparan

$O'N6A

2 =;< bagian post. non transparan

S$/6'A



ORNEA

2 4ungsi M6D(A '64'AKS(

2 Aascular T'ANSPA'AN

2 4ree nere en)ing S>T S6NS(T(%6

2 (nnerasi 7 '. $(/(A'(S N. OPT8A/M($&S

2 Tonjolan en)othel ? /(>.P6$T(NAT&M

AN>&/( ('(DO$O'N6A/(S membentu"SPAT(&M 4ONTANA

berhubungan )g$ANA/(S S$8/6MM ; S(N&S %6NOS&S S$/6'A6



S0ERA

2 Ter)iri )ari S6'A#&T

$O//A>6N )an 6/AST(S

2 4ungsi 7 Menesuai"an )iri th)te"anan )ari )alam bulbus oculi

2 #agian sclera g )itembus olehn. opticus

/AM(NA $'(#'OSA S$/6'A

4ungsi74ungsi7

Mempertahan"an bentu" bola mataMempertahan"an bentu" bola mata

Melin)ungi traumaMelin)ungi trauma



TUNIA VASU0OSA OU0I1 h-!-id 2 -!+us (ilia!is 2 I!is 3

$OROI%2 #ana" mengan)ung

pembuluh )arah

0 A. ciliaris post.

breis1 , pigmen, )an

ena 0menuju .

%orticosa 12 4ungsi 7 nutrisi retina,

corpus ciliaris, iris

2 Terleta" )iantara sclera

)engan retina



ORPUS I0IARE

Menghubung"an

choroi) )engan iris,

ter)iri )ari 7

- P'O$$. $(/(A'(S

mempro)u"si humora@ueus

- M. $(/(A'(S

proses a"omo)asi



P!-((,sus (ilia!is

am,!a -(uli+-s#,!i-!

Pu+il

am,!a -(ulian#,!i-!

S+a#ia F-n#ana

analis S(hl,mm

V,na v-!#i(-sa



IRIS '

2 4ungsi 7 sebagai )iaphragma2 #erpigmen

2 Membagi ruang antara cornea lensa 7

$amera oculi anterior 5 $amera oculiposterior

2 $elah antara B iris ? P&P(/

2 M. sphincter pupillae 0PS1 miosis2 M. )ilatator pupillae 0S1 mi)riasis



Pupils & depth of field

The diameter of the pupils is controlled by theautonomic nervous system



Accommodation



Accommodation

When the cilary musclesare relaxed, the zonaluspulls tight and keeps thelens flattened for distantvision

When the cilary musclescontract, it releases thetension on the zonalusand the elastic lens returnsto a more rounded shapesuitable for near vision

MEKANISME

AKOMO%ASI

M.$iliaris"ontra"si

$orpus ciliare "eentral

Conula ciliaris"en)ur

#agian )epanlensa

cembung



TUNIA INTERNA4NERVOSA

RETINA

Ter)iri )ari 72 PA'S OPT($A2 PA'S $(/(A'(S2 PA'S ('(D(S



Retinal layers

Ganglion cell axons form the optic nerve



A peek with an ophthalmoscope

%ISUS OPTIUS 4 B0IN% SPOT

FOVEA ENTRA0IS

4 FOVEO0A

MAU0A 0UTEA



MAU0A 0UTEA '

- Daerah berpigmen retina p) sisi temporal

)iscus opticus

- Ter)apat ce"ungan aitu 4oea $entralis

FOVEA ENTRA0IS 4 FOVEO0A '

- Aascular

- Ter)apat receptor cones- #erungsi untu" penglihatan )etail



%ISUS OPTIUS 4 B0IN% SPOT

- Ti)a" ter)apat receptor - 8ana ter)apat N. opticus

- Ti)a" sensitie terha)ap cahaa

VASU0ARISASI RETINA '

3. A. centralis retina berjalan bersama

n. opticus melalui blin) spotB. A. ciliaris posterior breis



MUSU0I OU0I

EKSTRINSIK '

3. M. O'#($&/A'(S O$&/(

B. M. /6%ATO' PA/P6#'A6S&P6'(O'

. M. '6$T&' S&P6'(O'

*. M. '6$T&S (N46'(O'=. M. '6$T&S /AT6'A/(S

<. M. '6$T&S M6D(A/(S

E. M. O#/(9&&S S&P6'(O'

F. M. O#/(9&SS (N46'(O'

INTRINSIK '3. M. $(/(A'(S

B. M. ('(D(S 7 - M. Sphincter pupillae

- M. Dilatator pupillae



Nama -#-# Fungsi Inn,!vasi

M. 'ectus superior A))u"si, eleasi, rotasime)ial

N. occulomotorius

(((

M. 'ectus me)ial A))u"si

M. 'ectus inerior A))u"si, )epresi, rotasilateral

M. Obli@uus

inerior

Ab)u"si, eleasi, rotasi

lateral

M. 'ectus lateralis Ab)u"si N. Ab)ucens %(

M. Obli@uussuperior

Ab)u"si, )epresi, rotasime)ial

N. Trochlearis (%

MUSU0I OU0I



(((

(((

(((

(((

%(

(%



VASU0ARISASI MATA '

Arteri 7 0 cabang A. opthalmica 1

A. centralis retina A. ciliaris posterior longus et breis

A. ciliaris anterior

%ena 7melalui ena opthalmica menuju "e Sinus

caernosus



A. centralis retina

A. ciliaris posterior longus et breis

A. ciliaris anterior

A. opthalmica

A. $arotis interna



M,dia R,/!a*si

2 $ornea

2 8umor a@uoues

2 /ensa cristallina2 8umor itreus

'era"si a)alah pembiasan cahaa )ari u)ara

untu" )ihantar"an menuju retina



kmr/ppds/05 40



Visual Pa#h5ay

12-64



Anatomy of vision

2x binocular vision

plus accessorystructures

Neural pathway

for vision

Optic disk blood supplyoptic nerve

Retina

Retinal cells

ANATOM( K/(N(S



ANATOM( K/(N(S



Lurus kedepan

Melirik Kekanan

Parese N VI ODParese N ?? D /S



Ptosis , Midriasis ,Diplopia

Strabismus Divergen

Lurus kedepan

Parese N III

OD

?

?

?



Parese N IV ODOtot

mObli!Sup

Kelu"an #- Diplopia $ Strabismus

saat melirik

keba%a" / saat miring ke sakit

- &akut turun tangga

?



Lurus kedepan

Melirik Ke KI'I

Melirik Ke K(N(N

Miring Keara" sakit

Strabism. >>>

Miring Keara" se"at

Strabism (-) Parese N IV OD

?



)ambar# *piskleritis



Non ne+rotiing s+leritis

Nodulars+leritis

Di-uses+leritis



Tumor sa"us la"rimal



Tumor retrobulbar



Katara" senilis hipermatur

2 Katara" hipermatur

)engan tan)a glau"oma

se"un)er

(nje"si siliar 6)ema "ornea

Pupil lebar

/ensa "eruh total



Katara" senilis

2 /ensa "eruh )i bela"ang pupil

2 Mata tenang



. )ambar # 'etinitis Pigmentosa



Ne+rotiing s+leritis %it" inamation

i



*sotropia



Orbital blowout fractures

There is often an implosion of

the orbital contents by thetrauma and the regions of least

structural integrity will give out

and that tends to be the orbital

floor and the medial orbital wallas these soft tissues try to find a

place to go when the trauma is

impacted. This is the typical

appearance of a blowout

fracture into the maxillary sinus

with a trapdoor sort of

appearance.

http//www.vh.org/adult/provider/radiology/!"O#$/%acialTrauma/#aptions/image&5'.html



E L I N G A

Dr. Thontowi Djauhari NS, MKes4a"ultas Ke)o"teran

&niersitas Muhamma)iah Malang

ORGAN AU%ITORIUS



ORGAN AU%ITORIUS

N.Au)itorius T,linga $orte! cerebri

0lobus temporalis1

AURIS EXTERNA AURIS ME%IA AURIS INTERNA

Auricula $aum tmpani $ochlea

Meatus acusticus %estibulum

e!ternus &)ara $analis semicirc.

Tulang

Membrana tmpani Otot



(uricula(uricula

)eatus)eatus acusticus externusacusticus externus

)embrana tympani)embrana tympani

#avum tympani#avum tympani#ochlea#ochlea

*estibulum*estibulum

#analis semicirc#analis semicirc

AURIS EXTERNA



AURIS EXTERNA

6. AURIU0A

2 T)). Tulang rawan

2 Menang"ap gelombang suara Meatus

acusticus e!ternus

2 Musculi intrinsi" 7 M. helicis major M. helicis minor

M. tragices

M. anti tragices M. obli@ues auriculae

M. transersus auriculae



M. helicis majorM. helicis major

M. helicis minorM. helicis minor

). tragices). tragices

). anti tragices). anti tragices

). obli+ues auriculae). obli+ues auriculae

). transversus auriculae). transversus auriculae

M li " t i i" M i l i t i



2 Musculi e"strinsi" 7 M. auricularis anterior

M. auricularis posterior

M. auricularis superior

2 (nnerasi Auricula7

sensori" 7 N. occipitalis minor

N. auricularis magnus

N. auricularis temporalis '. auricularis nn. agi

motori" 7 cabang n. agus

2 %ascularisasi Auricula7 A. auricularis posterior

A. temporalis superisialis



). auricularis anterior ). auricularis anterior

). auricularis superior ). auricularis superior

). auricularis anterior ). auricularis anterior

M. helicis majorM. helicis major

M. helicis minorM. helicis minor

). tragices). tragices

). anti tragices). anti tragices



7. MEATUS AUSTIUS EXTERNUS

2 T)p. "elenjar ceruminosa 5cebacea

2 #era"hir p) membrana tmpani

2 Sebelah luar ? cartilago2 Sebelah )alam ? tulang

2 Menempit pa)a 7 perbatasancartilago )engan tulang, isthmus

2 (nnerasi 7 N. auriculotemporalis'. auricularis n. agus

2 %ascularisasi 7

2 A. auricularis posterior

A. temporalis superisialis

MEMBRANA T&MPANI



MEMBRANA T&MPANI

2 Mele"at p) -s #,m+-!alis

2 Memisah"an auris e!terna)engan caum tmpani

2 Permu"aan lateral cembung

pusatna ? Um"-

2 Permu"aan me)ial mele"at

mall,us

2 Ter)iri )ari 7 +a!s #,nsa )an

+a!s /la((ida2 #ila terja)i ruptur membrana

tmpani tuli



AURIS ME%IA 1AVUM T&MPANI3

avum #ym+ani '

rongga u)ara )i )alam ostemporal berisi tulang

pen)engaran

Ba#as (avum #ym+ani '

cranial 7 pars tegmentalis

cau)al 7 pars jugularislateral 7 pars membranacea

me)ial 7 pars labrinthicus

posterior 7 pars mastoi)ea

anterior 7 pars coraticus

pars tegmentalis pars tegmentalis

pars ,ugularis pars ,ugularis

-ars-ars coraticuscoraticus



2 (si $aum Tmpani 7- &)ara

- Tulang pen)engaran 7

MA//6&S (N$&S

STAP6S

- Otot 7 M. tensor tmpani

M. stape)ius

2 4oramen )alam caumTmpani 7

- muara meatus acusticuse!ternus

- enestra oalis

- enestra rotun)um

- sinus mastoi)

- tuba au)itia

T&#A A&D(T(%A 7



2 Menghubung"an auris me)ia nasopharn!

2 Menjaga te"anan p) membrana tmpani

2 Sebagai jalan ine"si g menebar )ari

tenggoro"an auris me)ia sinus

mastoi)

2Tetap tertutup "ecuali wa"tumengunah;menelan

2 #ila terbu"a u)ara )r hi)ung atau mulut

te"anan p) permu"aan )alam membrana

tmpani ? te"anan p) permu"aan luar membranatmpani

ti)a" terja)i ruptur membrana tmpani



2 Vas(ula!isasi #,linga #,ngah

A. tmpanica anterior

A. auricularis posterior

2 Inn,!vasi #,linga #,ngah

N. auriculotemporalis

'. auricularis n. agus

N. tmpanicus

AURIS INTERNA 1 0AB&RINT$ 3



AURIS INTERNA 1 0AB&RINT$ 3

/abrinthus Osseus /abrinthus Membranaceus

- )ibt" oleh os petrossa - )lm labrinthus osseus- isi ? perilmphe - isi ? en)olmphe

$ANA/(S S6M($('$&/A'(S D&$T&S S6M($('$&/A'(S

%6ST(#&/&M &T'($&/&S

$O$8/6A SA$$&/&S

D&$T&S $O$8/6A'(S



0AB&RINT$ OSSEUS

$ANA/(S S6M($('$&/A'(S%6ST(#&/&M

$O$8/6A

6. ANA0IS SEMIIRU0ARIS



A)a saluran 0anterior;superior,posterior,lateral1

&jung sara p) AMP&//A terangsang oleh getaran

cairan

three canals at right angles

ampulla

swelling of membranous

labyrinth that communicates

with the vestibule crista ampullaris

sensory organ of ampulla

hair cells and supporting

cells

rapid turns of head or body

stimulate hair cells12-!

7. VESTIBU0UM Ter)iri )ari 7



- &T'($&/&S - SA$&//&S

Serabut N. %estibularis bera"hir )i utriculus )anSacullus

"tricle

communicates with

saccule and membranousportion of semicircular

canals

#accule

communicates with

cochlear duct

Mucula

hair cells of utricle and

saccule12-$

E ili" i



E8uili"!ium

#tatic %&uilibrium

vestibule

sense position ofhead when body is

not moving

'ynamic %&uilibrium

semicircular canals

sense rotation andmovement of head and

body

12-6

Ma( la



Ma(ula

responds to

changes in headposition

bending of hairs

results in generation

of nerve impulse

12-(

i # A ll i



!is#a Am+ulla!is

12-4)



O / #i



O!gan -/ -!#i

group of hearing receptor cells

*hair cells+

on upper surface of basilar

membrane different fre&uencies of vibration

move different parts of basilar

membrane

particular sound fre&uencies cause

hairs of receptor cells to bend

nerve impulse generated

12-2

9. O$0EA



9. O$0EA

Saluran berbentu" spiral

Membrana #asillaris

S$A/A %6ST(#&/( S$A/A T:MPAN(

Membrana %estibularis

S$A/A %6ST(#&/(

S$A/A M6D(A ; D&$T&S $O$8/6A'(S

4isiologi $ochlea



4isiologi $ochlea

!ochlea !ilia



hl



-(hl,a

#cala vestibuli

upper compartment

leads from oval window to

apex of spiral part of bony labyrinth

#cala tympani

lower compartment

extends from apex of the

cochlea to round window

part of bony labyrinth

12-)

hl



-(hl,a

,ochlear duct

portion of membranous

labyrinth in cochleaestibular membrane

separates cochlear duct

from scala vestibuli

asilar membrane

separates cochlear duct

from scala tympani

12-1



0AB&RINT$ MEMBRANAEUS



0AB&RINT$ MEMBRANAEUS

D&$T&S S6M($('$&/A'(S

&T'($&/&S

SA$&/&S

D&$T&S $O$8/6A'(S



T"!#1T"!#1

1(#11(#1

2#T1 #O#$3("!12#T1 #O#$3("!1

2#T12#T1

13)!#!"#("!113)!#!"#("!1



2#T12#T1

13)!#!"#("!113)!#!"#("!1

T"!#1T"!#1

1(#11(#1

2#T1 #O#$3("!12#T1 #O#$3("!1



Alat Keseimbangan 7

3. Macula utriculiB. Macula sacculi

. $rista ampullaris

Alat Pen)engaran 7

O!gan-n -!#i 0)i )asar )ustus cochlearis1

(nnerasi oleh N. %((( 0N .estibulocochlearis1

%ascularisasi oleh A. Au)itia (nterna

(nner 6ar7 structures G unctions



(nner 6ar7 structures G unctions

Tulang )embranous %unction of )embranous

abyrinth abyrinth abyrinth

&. 1emicircular 1emicircular 3+uilibrium rotational

canals ducts acceleration of head

. *estibule tricle 6 1accule 3+uilibrium static e+uilib

6 linear e+uilib of head

7. #ochlea #ochlear duct $earing



Noise !onvection and



!onduction



Operation of the Cochlea



Audi#-!y N,!v, Pa#h5ays



Audi#-!y N,!v, Pa#h5ays

12-4

Summa!y -/ #h, G,n,!a#i-n -/



Summa!y -/ #h, G,n,!a#i-n -/

S,ns-!y Im+uls,s /!-m #h, Ea!

12-/

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