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REFLEKS & ARCUS REFLEKS

By
Dr. May Valzon MSc
• A reflex is a fast, automatic, unplanned sequence
of actions that occurs in response to a particular
stimulus  f(X) homeostatis MS
• Klasifikasi:
– inborn (bawaan lahir) dan aquiared/learned (dapatan;
dipelajari);
– refleks cerebral/cranial vs refleks spinal;
– refleks somatik vs refleks visceral (autonom)
• The pathway followed by nerve impulses that
produce a reflex is a reflex arc (reflex circuit)
Komponen Arcus Refleks

monosynaptic reflex arc

polysynaptic reflex arc


Empat Refleks Somatik Spinal
• The Stretch Reflex (refleks renggangan)
– A stretch reflex causes contraction of a skeletal
muscle (the effector) in response to stretching of
the muscle
• The Tendon Reflex (refleks tendon)
• Refleks Fleksor (Withdrawal Refleks)
• Crossed Extensor Reflexes
The Stretch Reflex (Refleks Renggang)
• muscle
Refleks
• tone, monosynaptic selalu
ipsilateral

• Muscle tone
• helps avert injury
by preventing
overstretching of
muscles
Kolateral akson

Neuron inhibitor  otot antagonis

reciprocal innervation
patellar reflex (knee jerk),
Muscle Spindles & Golgi Tendon
Organs
detecting tensional differences in tendons

detect changes in the length (distention) of


extrafusal muscle

maintain posture and to regulate the activity of


opposing muscle groups
The Tendon Reflex (refleks tendon)
Refleks Fleksor/withdrawal

intersegmental reflex arc


Crossed Extensor
Reflexes
Klinis
• Reflexes are often used for diagnosing
disorders of the nervous system and locating
injured tissue
• Patellar reflex (knee jerk)  hilang jika? Pd
penderita DM dan neurosyphilis
• Achilles reflex (ankle jerk)
• Babinski sign
• Abdominal reflex
Berjalan (walking) = The Gait Cycle
• Pergerakan ekstrimitas inferior selama berjalan terdiri
dari 2 fase:
– Stance phases
– Swing phases
• Gait cycle  one cycle of swing and stance by one limb
• Stance phase begins with heel strike and ends with
push off from the forefoot  60%
• The swing phase begins after push off and ends when
the heel strikes the ground  40%
• Berlari  stance phase berkurang
Siklus Berjalan
Articulatio Ekstrimitas Inferior
• Coxa
• Genus
• Tallo-cruralis

A. Normal; B. Genu varum; C. Genu valgum


Knee Joint = Artic. Genus = Lutut
• Tipe gynglimus + kemampuan rotasi (trochoid) 
melibatkan dua condylus  artic. Bicondylaris
• Facies articularis condylus lateral et medial os femur dan
tibia
• Facies patellaris os. Femur dan facies articularis patella
• Plg sering cedera pada olahragawan  distabilkan dengan
pemanasan  m. quadriceps femoris
• Ligamentum: 5 extracapsularis (intrinsik)
– Lig. patellae
– LCF
– LCT
– Lig. popliteum obliquum
– Lig. popliteum arcuatum
• Intra-articular ligaments:
• Lig.cruciatum anterius (LCA)
• Lig. cruciatum posterius (LCP)
• Meniscus
Gerakan Struktur yang membatasi gerakan
Flexion (femoropatellar and Soft tissue apposition posteriorly
femorotibial) Tension of vastus lateralis, medialis,
and intermedius
Tension of rectus femoris (especially
with hip joint extended)

Extension (femoropatellar and Ligaments: anterior cruciate and


femorotibial) posterior cruciate, fibular and tibial
collateral, posterior joint capsule, and
oblique popliteal ligament
Internal rotation (femorotibial with Ligaments: anterior cruciate and
knee flexed) posterior cruciate
External rotation (femorotibial with Ligaments: fibular and tibial collateral
knee flexed)
• Bursae disekitar lutut: ada setidaknya 12 bursae:
b. Prepatellaris , b. Infrapatellris profunda, b.
Supra patellaris, bursa subpoplitea, b. anserina
• Arteri : ada 10 cabang anastomosis (rate
articularis genus)
– A. femoralis  a. descendens genus
– A. poplitea  a. superior medial genus dan a.inferior
medialis genus, a.superior lateralis genus, a.inferior
lateralis genus
– R. reccurens a.tibialis ant
– A. circumflexa fibularis
• Nervus : branches from the femoral, tibial, and
common fibular nerves and the obturator and
saphenous nerves
• Genu Valgum (kaki X) dan Genu Varum (kaki
O)

arthrosis
Knee Joint Injuries
 ligament sprain

• Knee Replacement 
osteoarthritis
• Bursitis in the Knee
Region
Ankle Joint (Artic. Talocruralis) =
Gelang Kaki
• Tipe gynglimus; uni-axial;
• Gerakan: platar fleksi (fleksi) dan dorsifleksi (ekstensi)
• Malleolar mortise vs trochlea tali
• Ligamentum
– lateral: lig. talofibulare anterius; lig. talofibulare posterius;
lig. calcaneofibularis
– medial: Lig. collaterale mediale (deltoideum)  stabilisasi
sendi sewaktu eversi (mencegah subluksasi)
• Arteri: ramus maleolaris a.tibialis ant, post, dan
fibularis
• Nervus: cabang n.tibialis dan n. fibularis profundus
Ankle Joint (Artic. Talocruralis) =
Gelang Kaki
• Cedera artic. Talocruralis
• Sendi yg paling sering cedera
• Plg seirng: Ankle sprains  inversion
injury
• Robek lig. talofibulare anterius
• Pott fracture (dislocation of the ankle) 
eversi
• tarsal tunnel syndrome  Entrapment
and compression of the tibial nerve