EXCITABLE TISSUES

Excitable Tissues:
• Nerves
• Muscle
• Cardiac muscle
• Skeletal muscle
• Smooth muscle
• Neuron: Functional unit of nervous system, with
excitability and conductivity characteristics
• The number of neurons in the CNS = 1011 = 10 billion
• Glial cells (neuroglia): Non conductive cells which protect, maintain, and support the nervous
system
• The number of glial cells = 10 – 50 x of neurons
THE HISTOLOGY OF NEURON
• Dendrite
• Cell body/ soma
• Axon hillock
• Axon
• Myelin sheath
• Synaptic knobs/
terminal buttons/
axon telodendria
• Stimulus: Any change in the environment that is strong enough to initiate an action potential
• Action potential: An electrical signal that propagates along the surface of the membrane of a
neuron
• Graded potential: A small deviation from the resting membrane potential that occurs because
ligand-gated or mechanically gated channels open or close  hyperpolarizing or depolarizing
graded potential
• Receptor potential (sensory receptors)
• Post-synaptic potential (mainly in dendrites & soma):
• Excitatory post-synaptic potential (EPSP)
• Inhibitory post-synaptic potential (IPSP)
• Action potential  generator potential/ receptor potential
• “Receptor”  - sensory receptor
- proteins bind to hormones/ neurotransmitters
• Sensory receptors: Transducers which alter various energy in the environment into action
potentials in neurons
• Sensory organs = receptor + non neural cells
 • Mechanism:
Stimulus  receptor/ generator potential (EPSP like; does not spread, graded, local)  reach firing
level/ neuronal threshold  action potential

Ion Channels
1. Leakage channels  K+ leakage channels > Na+ leakage channels
2. Voltage-gated channels  open/ close in response to a change in membrane potential  Na+,
K+, Ca+
3. Ligand-gated channels  open/ close in response to a specific chemical stimulus
(neurotransmitter, hormones, ions) directly or indirectly (second messenger system)  Na+, Ca+
inward, K+ outward
4. Mechanically gated channel  open/ close in response to mechanical stimulation (vibration,
pressure, stretching)  auditory receptors, stretch receptors of internal organs, touch receptors
of skin
THE PHYSIOLOGY OF NEURON
• Recording with an electrode inside an axon  resting membrane potential/ polarization 
typically -70 mV
(the potential difference between the inside and outside of the axon, the inside being more negative
than the extra-cellular fluid)

REFLEX

REFLEX: A Fast, automatic, predictable involuntary response

to a particular stimulus
REFLEX: - Inborn (pulling hand away from a hot surface)
- Acquired (Driving expertise)
REFLEX: 1. Somatic (skeletal muscle)
2. Autonomic (glands, cardiac & smooth muscle)
REFLEX: 1. Spinal reflex
2. Cranial reflex
REFLEX ARC COMPONENTS:
Sensory receptor  Sensory/ afferent neuron  Integrating center  Motor/ Efferent neuron 
Effector
REFLEX: 1. Monosynaptic reflex (e.g. stretch reflex)
2. Polysynaptic reflex (e.g. withdrawal reflex)
SOMATIC SPINAL REFLEXES
1. Stretch reflex
2. Tendon reflex
3. Flexor (withdrawal reflex)
4. Crossed extensor reflex
5. STRETCH (MYOTATIC) REFLEX
 - Control muscle length  muscle contraction response
- Monosynaptic reflex
- Tapping tendons at the elbow (biceps & triceps reflexes),
wrist, knee (knee jerk/ patellar reflex), ankle (Achilles
reflex)
PATELLAR REFLEX: Tendon  Muscle spindle  Ia afferent
neuron  Spinal cord   motor neuron excited
- Monosynaptic, ipsilateral reflex
- Reciprocal innervation  polysynaptic  antagonistic muscle
inhibited
2. TENDON REFLEX

- Control muscle tension  muscle relaxation response

- Polysynaptic, ipsilateral
- Golgi tendon organs  Ib afferent neuron  Spinal cord 
a.Inhibitory interneuron  Motor neuron inhibited/ muscle relaxes
b.Excitatory interneuron Motor neuron excited/ antagonistic muscle contracts
3. FLEXOR REFLEX

- Withdrawal reflex
- Polysynaptic, ipsilateral, intersegmental
- Pain receptor  Sensory neuron  Integrating center 
Interneuron  Motor neuron  Ipsilateral flexor muscles
- Reciprocal innervation  extensor muscles
4. CROSSED EXTENSOR REFLEX
- Polysynaptic, contralateral,
intersegmental
- Contralateral reflex arc
- Pain receptor  Sensory neuron
 Integrating center 
Interneuron  Motor neuron 
Contralateral extensor muscles
- Reciprocal innervation  Flexor
muscles
DIAGNOSTICS
1. Muscle tone
- Poliomyelitis  hypotonia/ atonia
- Stroke  hypertonia
 - Muscle spasm (broken bone, peritonitis), cramps
2. Reflex
- Afferent fibers/ lower motor neuron lesions (e.g. poliomyelitis,
diabetes, syphilis)  hyporeflexia
- Descending motor pathways from the brain (e.g. stroke)
 hyperreflexia
- Mass reflex
3. Patellar reflex
Diabetes mellitus, neurosyphilis  decrease/ absent
Motor tracts descending from the brain disorders 
increase/ hyperreflexia
4. Achilles reflex
Diabetes mellitus, neurosyphilis, alcoholism,
subarachnoid hemorrhages  decrease/ absent
Cervical cord compression, motor tracts lesion 
increase
5. Abdominal reflex
6. Pupillary light reflex (autonomic reflex)  brain injury indicator
7. Babinski sign

SISTEM SARAF OTONOM

• Sistem Saraf Pusat
• Sistem Saraf Perifer
– Sistem Saraf Somatik
– Sistem Saraf Otonom
– Sistem Saraf Enterik
Saraf otonom

REFLEKS-REFLEKS OTONOM
• Tekanan darah, denyut jantung, kontraksi ventrikel, diameter pembuluh darah, digesti
(motilitas tractus gastrointestinal), defekasi, urinasi
• Arkus refleks otonom
Reseptor  Neuron sensoris  Pusat integrasi (hypothalamus, batang otak, medulla spinalis) 
Neuron motoris  Efektor
KONTROL OTONOM
Hypothalamus
• Asupan sensoris (viscera, penghidu, pencecap, temperatur, osmolaritas, emosi (sistem limbik)
• Keluaran motoris (batang otak: kardiovaskular, salivasi, menelan, vomitus; medulla spinalis:
defekasi & urinasi)
• Simpatis (hypothalamus bagian posterior & lateral)
• Parasimpatis (hypothalamus bagian anterior & medial)

Mekanisme musculetal

• Muscle = neuron  excited chemically, electrically, mechanically to produce action potentials

• Muscle  neuron  contractile mechanism activated by action potentials

Skeletal muscle:
• cross-striations
• does not contract without innervation
• lacks anatomic & functional connections between fibers
• voluntary control

Cardiac muscle:
• cross-striations
• functionally syncytial
• contracts rhythmically in the absence of external innervation
• contains pacemaker

Smooth muscle:
• Lacks cross-striations
• functionally syncytial
• contains pacemaker

Skeletal muscle  muscle fibers  myofibrils

• Muscle fiber: multinucleated, long, cylindrical, single cell surrounded by sarcolemma (cell membrane)
 • Filaments = contractile proteins:
• Myosin II (thick filament)
• Actin
• Tropomyosin
• Troponin: - Troponin I
- Troponin T thin filament
- Troponin C
Thick filaments  A bands
Thin filaments  I bands
• Myosin  2 globular heads & long tail
• Head of myosin contains actin-binding site & catalytic site that hydrolize ATP
• Thin filaments  two chains of actin
• Tropomyosin in the groove of actin .

Thermoregulation
Normal Body Temperature
• Skin temperature  rise and falls  surroundings
• Core temperature  constant (36C – 37.5C)
Body Temperature = Heat Production >< Heat Loss
Heat Production
• Metabolic rate of the body:
• Basal rate of metabolism of cells
• Muscle activity
• Thyroxine
• Epinephrine, norepinephrine, sympathetic stimulation
• Chemical activity in cells
• Extra metabolism for digestion, absorption, storage of food
Heat Loss
• Heat is mostly produced in the liver, brain, heart, exercised skeletal muscle
• The rate of heat lost:
• Conduction from the body core to the skin
• The degree of vasoconstriction (sympathetic nerves)
• Transfer from the skin to the surroundings
• Insulator system (skin, subcutaneous tissue, fat)
• Fat  transfer 1/3 heat
• Women = better insulation
• Clothing; wet clothing
Sweating
• Stimulation of the anterior hypothalamus-preoptic area  sympathetic nerves  cholinergic 
sweat glands
• Sweat secretion
• coiled/ glandular portion  primary secretion ≈ plasma (except protein); Na = 142
mEq/L, Cl = 104 mEq/L
 • duct portion
• slight stimulation  low level salt
• strong stimulation  high level salt (50 – 60 mEq/L)
• Aldosterone  15– 30 g/day salt excreted (unacclimatized)
 3 – 5 g/day salt
Temperature – Increasing Mechanisms:
1. Skin vasoconstriction
• Stimulation of sympathetic centers (posterior hypothalamus)
2. Piloerection
• Entrapping “insulator air”
3. Increase in thermogenesis
• Shivering
• Sympathetic excitation
• Thyroxine
Shivering
• Heat center (anterior hypothalamic-preoptic area)
inhibition
• Primary motor center for shivering (dorsomedial portion of posterior hypothalamus)
stimulation
• Cold signals (skin & spinal cord)
brain stem
FISIOLOGI PENDENGARAN

1. Helix
2. Antihelix
3. Tympanic membrane (eardrum)
4. External auditory meatus
5. Lobule
6. Middle ear
7. Round window
8. Eustachian tube
9. Stapes footplate covering oval window
10. Cochlear and vestibular nerves
11. Cochlea
12. Lateral semicircular canal
13. Superior semicircular canal
14. Rear semicircular canal
15. Stapes
16. Incus
17. Malleus

Gelombang Suara
• Kecepatan di udara = 344 m/detik, 20°C
• Kecepatan seiring suhu & ketinggian
• Kecepatan di air tawar = 1450 m/s, 20°C
• Kecepatan di air garam
• Frekuensi getaran suara = pitch
• Frekuensi suara terdengar: 20 – 20.000 Hz (biasanya
500 – 5000 Hz)
• Frekuensi bicara = 100 – 3000 Hz

FISIOLOGI PENDENGARAN
1. Auricula mengarahkan gelombang suara ke meatus acusticus externus  canalis auditoris
externus  membrana tympani
2. Membrana tympani bergetar (resonator) tergantung frekuensi & intensitas
3. Vibrasi malleus  incus  stapes (kekuatan 1,3 x)
4. Getaran stapes  fenestra ovale (20x > kuat daripada membrana tympani)
5. Getaran fenestra ovale  perilymphe scala vestibuli
6. Scala vestibuli  scala tympani  fenestra rotunda
7. Deformasi dinding scalae  membrana vestibularis
8. Membrana vestibularis  endolymphe (ductus cochlearis)
9. Endolymphe  membrana basalis
10. 10. Membrana basalis  menggerakkan sel rambut terhadap membrana tectoria

• About the size of a fist, the hollow, cone-shaped heart

• Mass between 250 and 350 grams
• Snugly enclosed within the middle mediastinum with two-thirds of its mass lies to the left of the
midsternal line
• Its broad, flat base, or posterior surface, directed toward the right shoulder
• Its apex points inferiorly toward the left hip
• Enclosed in a double-walled sac called the pericardium
• Loosely fitting superficial part of this sac is the fibrous pericardium
(1) protects the heart
(2) anchors it to surrounding structures
(3) prevents overfilling of the heart with blood
• Serous pericardium, a thin, slippery, two-layer serous membrane
– Parietal layer
– Visceral layer = epicardium
• Between the parietal and visceral layers is the slitlike pericardial cavity
• Small, wrinkled, protruding appendages called auricles  pectinate muscles
• The posterior and anterior regions of the right atrium are separated by a C-shaped ridge called
the crista terminalis (“terminal crest”)
• The interatrial septum bears a shallow depression, the fossa ovalis  remnant of foramen
ovale, existed in the fetal heart
• Blood enters the right atrium via three veins:
(1) superior vena cava; (2) inferior vena cava; (3) coronary sinus
• Four pulmonary veins enter the left atrium
• Irregular ridges of muscle called trabeculae carneae
• The conelike papillary muscles
• The right ventricle pumps blood into the pulmonary trunk
• The left ventricle ejects blood into the aorta
Sense organ -cortex cerebri, thalamus, cerebeluum
Homunculus sensorik

kulit

• Reseptor di kulit terdistribusi ke seluruh permukaan badan.

• Dengan penyebaran kepadatan berlainan. Kulit sensitif – dengan reseptor banyak, dan jumlah
sedikit – kurang sensitif.yaitu: ujung lidah> ujung jari> sisi hidung> punggung tangan>
punggung badan.

• Struktur indera di kulit – reseptor simpel, dendrit dari neuron dengan atau tanpa capsula
berupa jaringan ikat atau epitelial

• Lintasan aferen - : somatic afferent neuron- medulla spinalis /nervi cranialis-thalamus – area
sensorik umum (corteks lobus parietal cerebrum-lobus postcentralis)